bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Ketamine Soaked Pharyngeal Pack for Prevention of Sore Throat Following Oro-Nasal Surgeries in Paediatrics
Authors:   Professor, Department of Anesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560034, India., K Sandhya , Nijalingappa Bingi Shilpa ,   Post Graduate Student, Department of Anesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560034, India.
Published: January 2024

Background and Aim: Post operative sore throat has reported incidence of upto 62% following general anaesthesia. The incidence in paediatric anaesthesia is variable, and the etiology is unclear. Many methods have been used to mitigate postoperative sore throat in paeditrics. The aim of the current study was to evaluate the efficacy of Ketamine soaked pharyngeal pack in preventing post operative sore throat with probable advantage of prolonged contact with mucosa, thereby producing sustained drug release at the site of action. Methods: This is a prospective randomized control study in 70 ASA1 or ASA2 patients undergoing oro-nasal surgeries. Group K (n=35) received Ketamine soaked pharyngeal pack (1mg/Kg) and group N (n=35) received normal saline soaked pharyngeal pack intra operatively. We compared post-operative sore throat, dysphagia, observational pain scores and hemodynamic variables in both the groups Results: Post-operative sore throat, dysphagiaand observational pain score were comparatively less in group K compared to group N (p=<0.05). Hemodynamic profile were comparable in both groups with no side effects . Conclusion: Ketamine soaked pharyngeal pack at the dose of 1mg/kg, reduced the incidence of post-operative sore throat and dysphagia with minimal side-effects compared to normal saline soaked pharyngeal pack in paediatrics. It also reduced the requirement of post operative analgesia. Keywords: Ketamine; Pharyngeal pack; Postoperative sore throat; Dysphagia and Observational pain score.
Comparative Assessment of Bupivacaine and Ropivacaine in Upper Limb Surgeries
Authors:   Assistant Professor, Department of Anesthesia, Pacific Institute of Medical Sciences, Udaipur, Rajasthan 313015., Sharma Venus , Goda Mamta ,   Medical Officer, Department of Anesthesia, Government Medical College, Dungarpur, Rajasthan 314001, India., Goda Vineeta ,   Assistant Professor, Department of Anesthesia, Pacific Institute of Medical Sciences, Udaipur, Rajasthan 313015.
Published: January 2024

Overview: The advent of modern methodologies led to the development of better analgesic and operative techniques. The block technique has been effectively employed since a long time. The present study was formulated to ascertain if any specific drug among the selected ones have a better efficacy in upper limb surgeries. Methodology: The present study employed a pool of 60 subjects who were randomly divided in two groups. The subjects were evaluated for operative and post operative parameters after administration of Ropivacaine and Bupivacaine respectively. Results: The study showed a shorter time for induction and regression of both motor and sensory block in Ropivacaine subjects, while Bupivacaine had a longer duration of action. Conclusion: Ropivacaine proved more efficacious as compared to Bupivacaine. Keywords: Axillary block; Brachial plexus; Bupivacaine; Forearm; Ropivacaine.
Rebound Intracranial hypertension: A Complication of Epidural Blood Patch as Treatment for Intracranial Hypotension
Authors:   Consultant Anesthetist, Department of Anaesthesia, Fortis Hospital, Mumbai 400078, Maharastra,, Rane Shashank , Shende Vaishali ,   Consultant Anesthetist, Department of Anaesthesia, Fortis Hospital, Mumbai 400078, Maharastra,, Shetty Vijay ,   Head of the Department, Department of Anaesthesia, Fortis Hospital, Mumbai 400078, Maharastra,, Benny Rajesh ,   Consultant Neurologist, Department of Neurology, Fortis Hospital, Mumbai 400078, Maharastra, India.
Published: January 2024

Rebound intracranial hypertension is a known complication of epidural blood patch. An elderly male presented with nausea, vomiting and poor GCS. The MRI brain showed subdural haematoma with sagging of brain matter suggestive of intracranial hypotension secondary to CSF leak resulting from multiple recent sessions of intrathecal chemotherapy. The patient underwent a lumbar epidural blood patch followed by burr hole procedure under general anaesthesia. The patient had a brief period of complete improvement and subsequently reintubated as his GCS deteriorated. The MRI brain shows mild dilatation of ventricles. The diagnostic lumbar puncture showed a high opening pressure confirming the diagnosis of Intracranial Hypertension. The patient completely resolved symptomatically with oral acetazolamide. Conclusion: Anaesthesiologists must be aware about this condition and efforts at adequate monitoring to detect Intra Cranial Hypertension after an Epidural Blood Patch. Keywords: Epidural blood patch; Rebound intracranial hypertension; Intracranial hypotension.
A Comparative Study of Bolus Dose of Propofol with Equipotent Dose of Thiopentone Faciltating
Authors:   Post graduate, Department of Anesthesia, Vinayaka Mission’s Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University) Karaikal, Puducherry 609609, India., Thendral A Thamizh , Cheran K ,   HOD & Professor, Department of Anesthesia, Vinayaka Mission’s Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University) Karaikal, Puducherry 609609, India.
Published: January 2024

Objective: The LMA (Laryngeal Mask Airway) is a method to offer endotracheal intubation while avoiding the dangerous side effects of visualization of cords and forcing them apart. The present study is designed to compare the conditions to facilitate the insertion of LMA with the two most used agents Thiopentone and Propofol after adequate pre-induction doses of midazolam and fentanyl. Materials and Methods: A study conducted on 60 patients of either sex belonging to 18 to 50 years of age and ASA grade 1 who were to undergo elective surgeries. Patients were randomly divided into two groups. Both groups received pre-induction doses of Glycopyrrolate (0.2mg), Midazolam (0.5mg/kg) and Fentanyl (1.5mg/kg), and were induced with either Propofol (3mg/kg) or Thiopentone (6mg/kg) to facilitate insertion of LMA. Result: Conditions facilitating LMA insertion and ease of insertion were significantly greater in Propofol group when compared to Thiopentone group. The difference was statistically significant (p<0.0001). Conclusion: In view of better ease of insertion, lesser time taken for insertion and better recovery profiles associated with Propofol seems to be superior to Thiopentone in LMA insertion.
Anaesthetic Management of an Infant with Laryngeomalacia and CHD Scheduled for Rigid Tracheobronchoscopy
Authors:   Post Graduate, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India., Raj Ishita , Madhusudhana Ravi ,   Professor and HOD, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Laryngomalacia is defined as collapse of supraglottic structures during inspiration. It is the most common laryngeal disease of infancy and cause of stridor in newborns. Case Report: A 17 days old child (2.75kgs) with congential laryngomalacia was scheduled for rigid tracheobronchoscopy. Child had a history of recurrent lower respiratory tract infection which resolved with intravenous antibiotics and steroids. On auscultation he had no adventitious sounds when quiet but added sounds were heard when he cried. Echocardiography showed CHD with situs solitus levocardia with 4mm ASD and 2mm PDA with dilated RA/RV. The child was administered atropine, midazolam, atracurium and ketamine. Maintainence with sevoflurane . During rigid bronchoscopy we provided adequate analgesia and sedation without clinically significant hemodynamic or respiratory adverse effects. Conclusion: In summary we noted that ketamine provided a reliable and effective method of sedating infants undergoing a rigid bronchoscopic examination in spontaneous ventilating conditions and noted no clinically significant haemodynamic or respiratory problems. When these patients do present, their care is likely to be complex and challenging. As such , a multidisciplinary approach should be adopted throughout their period of care.
Anaesthetic Management of a Patient with Endotracheal Tuberculosis Posted for Endoscopic CSF Leak Repair
Authors:   Post Graduate,  Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India., Easwari S Shri , Madhusudhana Ravi ,   2Professor and HOD, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India., GNS Sravanthi ,   Senior Resident, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Patient with tracheal tuberculosis with active lung infection requiring Intubation using Double lumen Endotracheal tube pose a challenge to anesthesiologist to prevent contamination of healthy lung. Case Report: 55 year female presented with complaints of nasal discharge for 2 weeks, cough with expectoration for one week. A diagnosis of CSF Rhinorrhoea was made. HRCT chest report showed tree in bud opacities suggestive of TB. General anaesthesia was planned. Preoperatively nebulized with Lignocaine with adrenaline; Patient was Pre medicated, Preoxygenation done with 100% oxygen. Induced with Inj Propofol. 35F Left Double lumen tube was inserted under fibreoptic guidance and was confirmed by chest rise and ETCO2 and Tube fixed in place. A portable ventilator was used with Tidal volume of 5ml per kg for the right lung and regular ventilator with same tidal volume to left lung. Intra operative vitals were stable throughout the procedure. The patient was extubated after adequate spontaneous efforts. After extubation the patient started desaturating, saturation went upto 70% on room air, immediately the patient was reintubated and shifted to ICU with ET tube insitu. The patient was extubated in ICU after 2 days and shifted to postoperative ward. Conclusion: In patients with active lung infection a plan for Double lumen ET tube may help in avoiding the infection spreading to healthy lung, intubation period is crucial to avoid most common problems such as malposition, airway trauma and tension pneumothorax caused by high ventilating pressure or large tidal volumes in patients.
A Case of Late Presenting Congenital Diaphragmatic Hernia-Anaesthetic Management
Authors:   Assistant Professor,  Department of Anaesthesiology, Travancore Medical College, Kollam 691020, Kerala, India., S Sreesabari , S Fathima ,   First year PG Resident, Department of Anaesthesiology, Travancore Medical College, Kollam 691020, Kerala, India.
Published: January 2024

Late presenting Congenital Diaphragmatic hernia beyond the neonatal period though rare, mostly misdiagnosed, mistreated and end up in life threatening complications. CDH can occur at any older age and usually present as mild respiratory symptoms to as severe as gastric obstruction or acute obstructive respiratory problems. Perhaps the error at reaching a definitive diagnosis is simply because of the fact, the possibility of CDH at an older age is totally neglected.
Panfacial Injury Submental Intubation A Valuable Option A Retrospective Study
Authors:   Assistant Professor, Department of Anesthesiology, Sanjay Gandhi institute of trauma and orthopedics, Bangalore, Karnataka 560011., Kumar Malathi Anil , HR Madhumala ,   Assistant Professor, Department of Anesthesiology, Bangalore Medical college and research institute, Bangalore, Karnataka 560034, India.
Published: January 2024

Maxillo-facial trauma involving maxillary and mandibular structures presents with difficulties in maintaining airway and sometimes challenges anaesthesiologist and surgeon more often at intra-operative period. Patient can have serious destruction of soft tissue, bony and cartilagenous components of the upper airway. Nasal intubation in these patients is controversial1, more particularly when performed without fibre optic bronchoscope. The necessity of intra-operative restoration of occlusion by maxillo-madibular fixation(I.M.F) makes oral intubation not feasible. For patients with pan facial trauma where nasal and oral intubation not possible and tracheostomy is the only option and only when short term post operative airway control is required, submental intubation can be a valuable option2. In our study submental intubation was done on 12 patients with a technical modification to prevent tearing of the oral mucosa which is known to be common in submental intubation. Keywords: Panfacial trauma; Submental intubation; Airway management.
Nalbuphine versus Dexmeditomedine Effect on Hemodynamic Stress Response During Intubation
Authors:   Assistance Professor, Department of Anesthesiology, PIMS, Thiruvalla 689101, Kerala., Mammen Mary , MR Sreekumar ,   Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala 689105, India.
Published: January 2024

Aims: Sympathetic system gets stimulated ondirect laryngoscopy and intubationand catecholamines are released. This response though of short duration, is hazardous to compromised subjects with brain and cardiac dysfunction. Vagus nerve also can be stimulated during laryngoscopy and intubation. Ourstudy is to find out the effects of Nalbuphine Hcl 5mgm and Dexmedetomidine 25mgm on hemodynamic variables SBP, DBP, MAP and HR at the time of laryngoscopy and intubation. Study was carried out in Pushpagiri Institute of Medical Sciences. Consecutive sampling technique was used to select study population. Methodology: We selected 100 subjects, ASA1 and 2, were randomly grouped into 2 groups of 50 each. All our subjects received 500ml crystalloid solution. Allsubjects were induced on Propofol and intubated on succinylcholine. The stress response was assessed by observing hemodynamic variables SBP, DBP, MAP and HR. Statistical Analysis: Data was digitized and analyzed using SPSS22.0. Independent sample test was used to assess the difference in parameters. Data was stratified on the basis of age and weight of 2 groups. P-value of less than 0.05 was considered statistically significant. Conclusions: Dexmedetomidine influences HR and the effect is more as age advances. In subjects heavier than 80kg, mean HR was higher. The effect of Dexmedetomidine on heart rate was statistically significant at a P value less than 0.05. Nalbuphine, according to studies, increases BP and HR. In our study, this rise in MAP was observed in subjects heavier than 70kg. But this finding was not statistically significant.
A Comparative Study of Dexmedetomidine and Tramadol for Prevention of Post-Spinal Anesthesia Shivering
Authors:   3rd year resident, Department of Anesthesiology, Government Medical College, Bhavnagar, Gujarat 364001, India., Kavad Jay , Shah Komal ,   Associate professor, Department of Anesthesiology, Government Medical College, Bhavnagar, Gujarat 364001, India., Parmar Sameer ,   Assistant Professor, Department of Anesthesiology, Government Medical College, Bhavnagar, Gujarat 364001, India.
Published: January 2024

Background: Shivering is an unpleasant and stressful symptom for the patient undergoing surgery. It occurs as a thermoregulatory response to hypothermia. Shivering obscures intraoperative monitoring. It can be detrimental to patients with low cardiorespiratory reserve as it increases oxygen demand, produces arterial hypoxemia and lactic acidosis. This study aimed to evaluate the relative efficacy of intravenously administered Inj. Dexmedetomidine 0.5µg/kg in 100 ml NS and Tramadol 0.5 mg/kg in 100 ml NS and 100 ml NS as a placebo group in controlling shivering posted for lower abdominal surgeries and lower limb general surgeries under spinal anaesthesia. Method: 120 participants, aged 18 to 65 years, of ASA Physical status I and II, scheduled for lower abdominal surgeries and lower limbgeneral surgeries under spinal anaesthesia. The patients were randomly allocated into 3 groups of 40 each and were named as group D (Dexmedetomidine 0.5µg/kg), group T (Tramadol 0.5mg/kg) and group N (100ml Normal Saline) as aplacebo. Vital parameters of the patients such as heart rate, blood pressure, spo2, temperature and shivering score, sedation score were monitored at regular intervals as per protocol. Statistical tests like Chi square test, Student’s t test (unpaired and paired) were applied to the data collected. Results: Both the dexmedetomidine and tramadol were effective in the prevention of postspinal shivering. Dexmedetomidine had better sedation profile (P value<0.00001) without any respiratory depression and had fewer incidences of nausea and vomiting when compared to Tramadol. Thus, it can be used as a better alternate for shivering prophylaxis for patients undergoing surgeries under regional anesthesia. Conclusion: Dexmedetomidine is more effective in the prevention of shivering when compared with tramadol and placebo (normal saline). Dexmedetomidine has an added advantage of adequate reliable sedation. Hence we conclude that Dexmedetomidine at 0.5µg/ kg is most effective in the prevention of shivering when compared with tramadol.
Comparative Evaluation of Supraclavicular and Infraclavicular Approaches to Brachial Plexus Block for Upper Limb Surgeries Using Ultrasonography
Authors:   Junior resident, Department of Anesthesiology, Bharati Vidyapeeth Medical College, (Deemed to be University) Pune, Maharashtra 411043, India., Rajendran Rohini , Ladi Sushma D ,   Professor, Department of Anesthesiology, Bharati Vidyapeeth Medical College, (Deemed to be University) Pune, Maharashtra 411043, India.
Published: January 2024

Background and Aim: Brachial plexus blocks when administered adroitly offer numerous benefits over general anaesthesia for upper limb surgeries. It is especially beneficial in patients with substantial comorbid conditions such as diseases involving the respiratory and cardiovascular system, life-threatening obesity, and those with an anticipated difficult airway. Out of its many approaches, we aim to compare and assess the Supraclavicular and Infraclavicular techniques utilising ultrasonography. Methods: Sixty consenting ASA I–II patients, aged 18–65 years, scheduled for elective upper limb surgery were randomly divided into two groups of 30 each: Supraclavicular (S) and Infraclavicular block Groups (I). Blocks were performed under ultrasound-guidance. The quality of the block intra-operatively, patient satisfaction post-operatively, duration of the sensory & motor block, and complications were observed. Results: Demographics, number of attempts, mean pain score felt during the administration of the block, mean duration of motor and sensory blockade and incidence of complications were all comparable between the two groups & statistically not significant. However, at 5 and 10 minutes after the execution of the block, the Infraclavicular group showed a higher level of blockade, indicating that the onset of action of the block was significantly quicker. Conclusion: Time taken to perform & rapidity of onset were more in the Infraclavicular block with no difference in adequacy of both blocks at 30 minutes.
Tele-OPD: Bridging distance between Clinician and Patient
Authors:   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India-605006., Sireesha Konda , R.K. Chittoria ,   Professor and head, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India-605006., Pandey Sandhya ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India-605006., M.T. Friji ,   Associate Professor, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India-605006., D.P. Mohapatra ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India-605006., S. Dineshkumar ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India-605006.
Published: January 2024

Background: The use of mobile devices has become increasingly universal in almost every aspect of life, including emerging use in healthcare, which encompasses diverse issues to solve clinical problems and promote public health initiatives in pioneering ways. Wide availability of Mobile phones with low call rates and smart phone applications like Skype, WhatsApp can be used as means of communication between the consultant and patient. Methods: The study is an observational retrospective study conducted in the Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry from April 2015 to May 2016. The tele -OPD consisted use of telephonic conversations, video conferencing, mail, whatsApp etc. At the end of the study period, the feedback was obtained from consultants, patients and analyzed. Results: In the 1 year study period, 2048 telephonic calls were made to patients, 1806 calls were received from patients, 126 WhatsApp messages, 118 emails received and 20 Skype calls were done. On taking feedback from patients & Consultant it was found to be patient friendly, inexpensive and time saving. An internal record of all the patients phone numbers, email ids were noted down in a register. Conclusion: Tele-OPD is found to be a promising method of communication, especially in nonemergency situations where the patient doesn’t have to physically come to OPD but might need some advice or information regarding treatment. It is Userfriendly, time saving and cost-effective means to obtain consultation in less time-critical contexts.
Sexual History Taking’– Difficulties Faced by Undergraduate Medical Students and their Preferred Teaching Learning Methods
Authors:   Professor, Department of Dermatology and Venerology, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur Puducherry 605102, India., R. Roshni Menon , David Brinda G. ,   Assistant Professor, Department of Dermatology and Venerology, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur Puducherry 605102, India.
Published: January 2024

Background: Sexual history taking (SHT) for instance is described as an important clinical skill that formal medical school curricula have historically neglected. However, such skill deficit might not be overcome even after graduation. The deficiency in learning SHT skills might eventually affect students’ career choices. Aim: To assess the difficulties faced by undergraduate medical students while eliciting sexual history and to identify the pitfalls and the students preferences in the teaching learning methods for taking sexual history perceived by the students. Methodology: A cross-sectional study was conducted in our medical college hospital between Jan 2016 and June 2016 involving the students of final year medical students and CRRI’S. Total numbers of participants were 220 students. Questions related to their comfort and confident level in eliciting sexual history along with general history, prerequisites in obtaining sexual history and the ideal age and gender according to the students perception was all obtained in the questionnaire. Questions for assessing the barriers in eliciting sexual history among the medical student’s and the current teaching methods which were followed for obtaining the sexual history was obtained. Likerts scale was used for assessing the student’s attitude towards asking the sexual history. Finally suggestions were also asked in improving the teaching methods for obtaining the sexual history. Results: The CRRI’s were found to be more confident in eliciting sexual history than the final year MBBS students, as they had one more additional year of exposure and females in both the groups were found to be slightly more confident than the males in eliciting the sexual history. Most of the students in both the groups felt that cultural and religious differences are the major barriers in eliciting the sexual history and they were also able to recognise their own limitations. Majority of the students agree to the point that they had not been adequately trained in eliciting sexual history. Students felt that they have to be taught by means of role play, video clips and simulated patients which would practically guide them in eliciting sexual history to the patient in a much more skilful and confident manner. Conclusions: Lack of confidence in approaching the subject of sexual health, inadequate preparation were some of the barriers identified. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take a sexual history from patients.
Dial-JIPMER Service (24x7): Our Experience
Authors:   Senior resident, Department of Plastic Surgery, Head of Telemedicine Registrar (Academic) ,  Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Pondicherry-605006, India., S. Elankumar , R.K. Chittoria ,   Professor, Department of Plastic Surgery, Head of Telemedicine Registrar (Academic), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Pondicherry-605006, India, Ishaq Z. Mohamed ,   Content Developer and Telemedicine Technician, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Pondicherry-605006, India.
Published: January 2024

Telemedicine enables health services to be connected across distance by the use of information and communication technology. Role of telemedicine on emergency services has a great impact on health services. JIPMER has developed 24x7 Help Line in Casualty for patients requiring Tele-Emergency Consultations. Teleconsultation is given to people who seek medical advice and guided for future treatment based on their complaints. Use of this service helps the patient in terms of cost and time and enables them to get specialist consultation if needed in real time. From our experience, use of telemedicine through dial JIPMER service has been satisfactory for both the patient and the Doctors and can be further extended to other institutions.
Application of SWCR Guidelines in a Case of Pressure Sore
Authors:   Senior resident, Department of Plastic Surgery, Head of Telemedicine Registrar (Academic), Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry-605006., S. Elankumar , Chittoria Ravi Kumar ,   Professor, Department of Plastic Surgery, Head of Telemedicine Registrar (Academic), Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry-605006.
Published: January 2024

Pressure sores are the common problems faced by the health care personnel and the family members of critically ill patients. They cause significant burden for the health care system. Even though pressure is the main reason, the etiology is multifactorial. And the patients affected usually will have other associated co-morbidities. Hence systematic approach for the management of pressure sores is necessary for obtaining the better result. SWCR guidelines for wound management are one of the guidelines for manage the chronic wounds. This study highlights the experience of managing pressure sore using SWCR guidelines.
Temporomandibular Joint: A Short Insight
Authors:   Associate Professor, Division of Removable Prosthodontics, Department of Clinical dental sciences, Batterjee Medical College of science & technology, Jeddah, KSA., Naeem Ahmad , Nadeem Ahmad ,   Professor & Head, Department of Community Medicine, Integral Institute of Medical Sciences, Lucknow, India., Basem Mohamed Mohsen Abuzenada ,   Assistant Professor, Faculty of Dentistry, King Abdulaziz University, Jeddah/Head of Program, Department of Conservative Dentistry, Department of Clinical dental sciences, Batterjee Medical College of science & technology, Jeddah, KSA., Thamer Alsharif Abdulmohsin Al-Ghalib ,   4 Medical Director, Division of Removable Prosthodontics, Department of Clinical dental sciences, Batterjee Medical College of Science & Technology, Jeddah, KSA., Mai Adel Helmy Ahmed Ali ,   Head of Division, Division of Removable Prosthodontics, Department of Clinical dental sciences, Batterjee Medical College of science & technology, Jeddah, KSA., Mahmoud Elhomossany ,   Assistant Professor, Division of Removable Prosthodontics, Department of Clinical dental sciences, Batterjee Medical College of science & technology, Jeddah, KSA.
Published: January 2024

Temporomandibular joint is a synovial articulation, formed by condyle of the mandible and glenoid (mandibular) fossa and articular eminence of temporal bone at the base of the skull. It differs from other joints of body because it shows the properties of both hinge and sliding joint so it also called as ginglymo-arthrodial joint. Temporomandibular joint abnormalities affect 5-12% of the population. The correct diagnosis of early abnormalities of this joint is of paramount importance because they can result in temporomandibular joint disorders. In the present article, a short insight is presented on Temporomandibular joint with emphasis on its anatomy, physiology & applied aspect.
To Study the “Knowledge” About Psoriasis in Undergraduate MBBS Students
Authors:   Assistant Professor, Dept of Medicine, BKL Walawalkar Rural Medical College, Chiplun, Maharashtra 415606, India., Bamane Eknath Maruti , Dhumale Shashikant B. ,   Professor & Head, Dept. of DVL, BKL Walawalkar Rural Medical College, Chiplun, Maharashtra 415606, India.
Published: January 2024

Background: Psoriasis is a chronic inflammatory skin disease with itchy, coloured scaly lesion/ patches on the skin. It can present with arthritis, nail involvement with cosmetically disfiguring affecting the quality of life (QOL). Knowledge of psoriasis is essential so as to avoid misbelieves & discrimination against psoriasis patients, which can be achieved through the future medicos if they are aware of scientific facts. Materials & method: An observational, crosssectional study of 100 MBBS students’ undergone clinical batches with 20 objective questions of answers Yes/No, comprising of six different headings as entered in a master chart. Percentage of desired/correct answers was calculated & “average” of 6 categories compared for ranking, so as to judge the level /percentage of awareness of each question/ headings. Results: Out of six-6 categories all students heard about psoriasis. Knowledge of “Myths - misbelieves” as well as advanced knowledge was 34.8%, Scientific knowledge- 29.3%, General knowledge- 27.4%, Awareness- 20%, Except the A, all categories lie below average (35%), showing poor knowledge about psoriasis. Conclusions: The undergraduate MBBS students having a poor knowledge about psoriasis who must be well trained with exposure to psoriasis patients since Doctors are the topmost in spreading the knowledge.
A case of fever of Unknown Origin (FUO): Problems, Pitfalls and Eventually Diagnosis
Authors:   Speicalist, Department of Medicine (Rustaq Campus), College of Medical and Health Sciences, National University of Science and Technology, Sultanate of Oman., Zishan Asma , Alabri Almur Abdullah ,   Seniore specialist, Department of Medicine (Rustaq Campus), College of Medical and Health Sciences, National University of Science and Technology, Sultanate of Oman., Kumar Bakshi Surrinder ,   Associate Professor, Department of Medicine (Rustaq Campus), College of Medical and Health Sciences, National University of Science and Technology, Sultanate of Oman., Kamal Mohammad ,   Seniore specialist, Department of Medicine (Rustaq Campus), College of Medical and Health Sciences, National University of Science and Technology, Sultanate of Oman., Shakilli Nasir ,   Speicalist, Department of Medicine (Rustaq Campus), College of Medical and Health Sciences, National University of Science and Technology, Sultanate of Oman.
Published: January 2024

Fever of unknown origin (FUO) or pyrexia of unknown origin (PUO) is a real medical issue at times. Modern investigations can help in diagnosing but in some rare cases, it remains a medical challenge. Patients and clinicians are worried about unexplained fevers. Causes of most of the fevers is identified and approach to diagnosis in such cases is usually related to history, physical examination and basic laboratory clues. The correct approach in such cases is to follow clues and start with the least invasive evaluation. This will help in avoiding unnecessary harm and cost to the patient. Miscellaneous conditions also cause FUO.
Therapeutic Value of Organic Foods: A Review
Authors:   Head, Department of Nutrition, SRM College of Nursing, SRM Institute of Science and Technology (SRM IST), SRM Nagar, Kattankulathur, Tamil Nadu 603203, India., Lakshmi E
Published: January 2024

The science of nutrition is currently transiting to organic age. Organic food consumption has become more popular and accepted in present-day scenario. The market for organic foods has boomed rapidly. The present review is related to health benefits that could be attributed to the consumption of foods produced under organic farming method. Relevant papers were identified from Science Direct, Google Scholar and pubmed by using all combinations of the search terms related to health and organic foods.
Developments in Analysis of Fire Debris Residues
Authors:   Research Fellow, Department of Forensic Science, Punjabi University, Patiala- 147002, India., Singh Bumbrah Gurvinder , Kumar Sarin Rajinder ,   Director, Forensic Science Laboratory, Govt. of NCT of Delhi, Sector-14, Rohini, Delhi-110085, India., Mohan Sharma Rakesh ,   Professor, Department of Forensic Science, Punjabi University, Patiala- 147002, India.
Published: January 2024

This review gives a brief overview of the recent developments in the field of analysis of petroleum products in fire debris residues by different spectroscopic and chromatographic techniques for forensic purpose. The review covers different aspects of analysis such as the types of accelerants, substrates involved, isolation procedures, column and mobile phase used, and subsequent detection in tabular form. This paper covers detection of petroleum products such as petrol, kerosene and diesel in various types of samples recovered in arson cases.
Suicidal Cut Injury of Wrist: Crime Scene and Autopsy Findings
Authors:   Assistant Professor, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, India-110029., Yadav Abhishek
Published: January 2024

Cut Injury of wrist (CIW) is also known as ‘Spaghetti wrists’ with a minimum of three completely transected structures, a nerve, artery and a tendon. The investigators have to answer the most challenging question i.e. manner of death. Some circumstances cannot be understood by the investigators and have to be explained by a Forensic Pathologist. We report a case of an individual who was found dead in a bathroom with blood splashes all over the walls and floor of the bathroom along clothes and body of the deceased. The amount of blood found in the bathroom was baffling. The case later examined in totality with autopsy findings was found to be suicidal in nature. The authors intend to recommend that wherever possible the autopsy surgeon should visit the crime scene in such cases before conducting autopsy to have a fair idea about the circumstances of death and to lead the investigation towards natural course of justice.
DIGITAL TRANSFORMATION AND THE BANKING MARKET: FRIEND OR FOE? A COUNTRY-LEVEL STUDY
Authors: Khan Noureen A. , Ahmed Khattak Mudeer
Published: January 2024

Countries’ digital transformation continues and yet the impact on the banking sector is unknown. This uncertainty might become even worse if banks start to compete among themselves to get ahead of digital lending and payment platforms. Competition among banks leads to lower lending rates and increased deposit rates. These smaller margins might lead to instability in the banking sector. We address the impact of digital transformation and bank competition on banking sector stability by looking at country-level data from 48 Asian economies. We integrate the moderating role of bank competition into the picture. The findings suggest that digital transformation leads to banking sector stability while bank competition results in banking sector fragility. During high competition within the banking sector, digital transformation lessens the overall banking sector stability and as competition declines, the relationship moves towards insignificance after falling below a moderate level of competition. These findings carry important policy implications. Countries should have control over banking sector competition and should at the same time move towards digital transformation to achieve larger goals like financial inclusion. Lower competition helps to avoid any negative impacts from digital transformation in a country.
IMPROVING DIGITAL BANKING THROUGH RISK ASSURANCE: TAM MODIFICATION ANALYSIS
Authors: Marlina Wijayanti Dwi , Al-Banna Hasan , Nurdany Achmad
Published: January 2024

The rapid growth of digital banks has been followed by changing customer behaviour patterns. On the other hand, customer perceptions of digital banks are that they still carry considerable risk. Therefore, the role of institutions in providing certainty and security guarantees for digital banking customers is very important. Based on this situation, this research explores what factors can encourage individuals to use digital banks, which are currently growing quite rapidly through the role of institutions. The Technological Acceptance Model (TAM) is used as a construct in exploring individual behaviour in reaction to technological innovation in digital banks. In addition, risk guarantees from government institutions are also explored as safeguarding customer security. The sample for this study were 977 digital bank users. Data was collected through a self-administered survey. The results show that perceived service quality (PSQ), service innovation (SI), perceived usefulness (PU), perceived ease of use (PEoU), attitude, and behavioural intentions are factors that encourage actual use of digital banking services. It is also known that perceived risk assurance moderates the relationship between attitude and behavioural intention. This research contributes to policy makers for the expansion of digital bank market share through appropriate marketing strategies for digital banks, as well as strategies to increase deposit insurance literacy.
THE COVID-19 CONTAINMENT IN INDONESIA AND SOFT LAW: A RISK-TO-OBJECTIVE ANALYSIS
Authors: Ibnu Adi
Published: January 2024

This article illustrates how Basel III, a soft law legal framework guiding how regulators supervise financial institutions in order to prevent and mitigate systemic financial crises, especially the requirement regarding the governance of sovereign debt, is being implemented in Indonesia. The analysis was done by scrutinising the relevant authority’s responses and monetary policy during COVID-19. Also, it examines whether the applicable regulations and other related policies align with the grand objectives of the financial sector. This article provides several important takeaways. First, benefiting from the soft traits of Basel III, the oversight authorities (OJK and BI) have tried to enshrine the government’s resilient and prudent financial state through flexibility. Second, instead of taking expansionary legal measures to stimulate the state’s income and limit the state’s expenses, BI and the government have worked together to contain the damage of the pandemic through a quasi-fiscal program (burden-sharing program, BSP). Third, the legislation of Law No. 3/2023 did not make the BI’s objective less risky. It also suggests that more could have been done to prevent the fiscal deficit, especially by the government, through fiscal consolidation (limiting or decreasing the state’s expenses).
THE RESPONSE OF BRICS TRADE INTEGRATION TO GEOPOLITICAL RISKS
Authors: Sohag Kazi , Islam Md Monirul , Mariev Oleg
Published: January 2024

Mounting geopolitical risks have led over time to a reorientation of trade integrations across different economic blocs. As one of the increasingly dominant global blocks, the organisation comprised of Brazil, Russia, India, China, and South Africa (BRICS) has intensified their trade integration. Therefore, we conducted a thorough analysis of how BRICS countries’ multilateral trade integration responded to geopolitical risk events from January 1996 to December 2021. To achieve this, we utilized a sophisticated econometric method, specifically the cross-quantilogram approach, to analyse high frequency data due to their non-normal and fat-tailed features. Our study confirms the proposition that geopolitical risks strengthened trade integration within the BRICS bloc. Specifically, our findings show that the volume of exports from one economy to another responded positively at lower to medium quantiles of exports and lower geopolitical risks, considering a 12–36-month horizon. Moreover, we found that the quantity of exports from Russia to China was higher in the presence of higher geopolitical risks. Our study demonstrates that geopolitical risks can create a sense of shared identity and mutual interest among the BRICS countries, fostering greater cooperation and trade integration.
Impact of poultry oil supplementation on liver health and fatty liver syndrome in caged layers
Authors: Liaqat Saima
Published: January 2024

Poultry oil is commonly used as a cost-effective energy source in poultry feed. However, when used at higher levels, raw poultry oil has been found to have adverse effects on the liver of birds. Unfortunately, many poultry farmers remain unaware of these harmful effects. The objective of this experiment was to investigate how poultry oil impacts liver health and contributes to fatty liver syndrome in layers. Using a completely randomized design, 120 Lohmann Single Comb (LSL-Lite) layers (25- week-old) were randomly assigned to 4 experimental groups, each of which had 30 birds. Increasing amounts of poultry oil (0, 1.5, 3.0 and 4.5%) were used in experimental diets. Hens were fed these experimental diets for 20 weeks. The results showed maximum liver fat percentage in 4.5% poultry oil in diet, severe liver congestion, degeneration and cell necrosis in caged layers. Plasma lipid profile (cholesterol, HDL, LDL, triglycerides) and liver enzymes (AST, ALT, ALP and LDH) were significantly (p<0.05) affected by poultry oil addition. Higher liver scores indicative of fatty liver syndrome was observed in layers receiving 4.5% poultry oil, while the control group showed the lowest incidence. This study indicated that poultry oil dietary addition at a higher level (4.5%) lead to an increased serum lipid profile and has a negative impact on liver health, ultimately causing fatty liver syndrome in caged layers
ASSESSING THE IMPACT OF CAMEL BREED AND THEIR GRAZING HABITS ON THE NUTRITIONAL PROFILE OF MILK
Authors: Hameed Aneela
Published: January 2024

Camel milk has numerous nutraceutical and therapeutical properties due to camel s desert habitat and grazing habits on wild vegetation. However limited literature was available about the milk composition of camel breeds of south Punjab in Pakistan. The current study aims to depict variations in nutritional aspects of milk among camel breeds of South Punjab Pakistan. The various parameters of milk i.e. physicochemical analysis fatty acids composition protein contents amino acid profiling and mineral concentrations were evaluated and characterized to provide fundamental knowledge to researchers interested in working in its medicinal role. Minerals i.e. Na K Zn and Pb in camel milk were found in considerable concentrations such as 405.94?0.02 204.16?0.10 2.45? 0.02 and 0.25?0.02 ppm accordingly. During physicochemical analysis pH and protein were present in higher amounts. Casein of camel breeds contains higher amounts of amino acids i.e. Leucine (0.25?0.039 %) Lysine (0.12?0.019 %) Aspartic acid (0.18?0.017 %) and Glutamic acid (0.56?0.087 %). Fatty acids were present in significant concentrations in all camel breeds i.e. Butyric acid (0.760?0.012 g/100g) Lauric acid (0.770?0.120 g/100g) Myristic acid (12.420?1.163 g/100g) and Linoleic acid (2.390?0.112 g/100g). Camel milk is less prone to allergies and can be used in dairy-based food products infant milk formulas and medicinal industries.
Chemical compositions, phytochemicals, and biological activity of dried edible wild fruits
Authors: Sangsopha Jintana
Published: January 2024

Edible wild fruits have recently attracted increased attention due to their nutritional compositions, phytochemicals, and biological properties that benefit to human health. In this study, eleven wild fruits were investigated after the drying process using tray drying. Carbohydrates are the major component of dried wild fruits ranging from 37.17% to 75.96%. The highest protein content was found in Polyalthia debilis (15.28%) whereas Ficus carica L. was high in fiber (33.26%). The highest total phenolic compounds were found in Irvingia malayana Oliv. (121.57 mg GAE/g), with highest TFC found in Terminalia chebula Retz. Phyllanthus emblica L., showed highest DPPH, ABTS and FRAP values. The most potent anticancer properties against MCF-7 and HepG2 cancer cells were shown by Terminalia chebula and Diospyros mollis, respectively. Highest - amylase and -glucosidase inhibitions were observed in the Canarium subulatum. Results suggested that dried edible wild fruits are a feasible source of nutrients, phytochemicals, with strong antioxidant and biological activities. These findings can be promoted and increased the utilization of wild fruits as a sustainable food source or food ingredient with applications in food formulations.