bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraperitoneal drain tip migration into the liver parenchyma following pancreaticoduodenectomy
Authors: Olajide Thomas Olagboyega , Makanjuola Ayomide , Adeuja Durojaiye Abiodun , Atoyebi Oluwole Ayoola
Published: April 2021

Intraperitoneal drains are widely used in surgery for therapeutic or diagnostic purposes. The placement of drains following pancreaticoduodenectomy may decrease postoperative complications. Commonly reported complications of intraperitoneal drains include pressure necrosis with bleeding, viscus perforation, fistula formation, and mechanical bowel obstruction. We report a rare complication of drain tip migration and erosion into the liver parenchyma.
Histopathological analysis of male breast cancer in Southwestern Nigeria
Authors: Ajani Mustapha Akanji , Odetola Segun Samson , Awosusi Babatope L. , Fatunla Ebenezer O. , Salami Ayodeji A.
Published: April 2021

Background:

Breast cancer in men is still an uncommon and largely understudied disease. It accounts for 1% of all breast cancers. The aim of this study was to review all the male breast cancer cases diagnosed at the tertiary medical institution in South West Nigeria over a 10-year period and to compare the findings with other similar studies done in Nigeria and globally.

Methods:

We retrospectively reviewed all histologically diagnosed cases of male breast cancers in the Department of Pathology, Tertiary Medical Institution in South West Nigeria over a 10-year period from January 1, 2009, to December 31, 2018. Clinicopathological parameters including patients' age, laterality, and specific histological sub-types were extracted from surgical day book and Cancer Registry of the Department. The data were analyzed using the IBM SPSS Statistics (version 22; IBM Corporation, Armonk, New York, USA). The results were subsequently presented in tables, relative frequencies, group percentages, and photomicrographs.

Results:

Forty-two cases of male breast cancer were seen accounting for 1.7% of all breast cancer cases. The age range was between 22 and 91 years with a mean age of 60.3 years, and a peak occurrence was in the 8th decade. The right breast was more affected than the left accounting for 52% of the total number of cases seen. The most common histological sub-type found was invasive ductal carcinoma accounting for 88% of all the cases.

Conclusion:

Male breast cancer is relatively uncommon compared to female breast cancer. It is more common in the older age group, and invasive ductal carcinoma is still the most common histological subtype.
Evaluation of the use and effectiveness of telemedicine among the health professionals during the COVID 19 lockdown period
Authors: James Olutayo , Akinboboye Bolanle Oyeyemi , Okunade Kehinde Sharafadeen , Adekunle Adeola Adegbayi , Adeyemo Wasiu Lanre
Published: April 2021

Background:

Telemedicine has been documented as a viable option in attending to patient's need where distance is a critical factor. The Federal Government of Nigeria on March 27, 2020, imposed a total lockdown in Lagos state in order to curb the spread of the coronavirus disease 2019 (COVID-19) pandemic. The restriction in movement prevented many patients from attending their regular clinics and physical consultations. The aim of this study was to evaluate the use and effectiveness of telemedicine among the hospital health professionals during the lockdown period.

Methods:

This was an online cross-sectional study among doctors at a tertiary health facility in Lagos. Ethical approval was obtained from the institutional ethical committee. A list of the telephone and WhatsApp contacts of doctors were obtained from the hospital directory; the SurveyMonkey tool was used as an online web-based structured questionnaire for data collection. The information obtained was analyzed to find means and averages.

Results:

A total of 104 doctors completed the survey. The proportion of participants who used telemedicine was 93.3%, with the most commonly used telemedicine option being phone call (27.1%) and WhatsApp video call (27.1%). The main management provided during this period was counseling (56.6%). Seventy-nine percent of the participants were satisfied with the result of the management provided through telemedicine options, but the major concern was that of ethical issues (36.2%). Majority (44.2%) of the respondents agree that telemedicine was effective during the COVID-19 lockdown period. There was no association found between gender, age, designation, and perceived effectiveness of telemedicine by respondents in this study (P = 0.88, 0.4, and 0.07, respectively).

Conclusion:

Telemedicine was found to be a useful tool for effective patient's management during the lockdown period although there exist ethical concerns. The formulation of policies guiding its use will ensure the security of information and patient's confidentiality.
Left Ventricular Thrombosis in a Case of Acute Inferior Wall Myocardial Infarction
Authors: Singhi Anil Kumar , Sardar Sandip , Kumar Dilip
Published: April 2021

Left ventricular (LV) thrombosis is caused by multiple etiological factors. Acute anterior wall myocardial infarction tops the list. Acute inferior wall infarction is not commonly associated with LV thrombus formation. A rare case of LV thrombus formation at LV apex due to acute inferior wall myocardial infarction is described in a young adult with successful resolution on medical therapy. Appropriate cardiac imaging is the key in correct diagnosis and treatment.
Assessment of Right Ventricle Function in Children with Pulmonary Arterial Hypertension - Moving Beyond Longitudinal Motion
Authors: Krishna Mani Ram
Published: April 2021

Right ventricular (RV) systolic function is an important determinant of clinical outcomes in patients with pulmonary arterial hypertension (PAH). However, RV function assessment is less well defined than left ventricle function and requires the use of multiple echocardiographic indices. We report a child with severe PAH and RV dysfunction in whom traditional measures of RV systolic function were deceptive.
Acute Electrocardiographic Changes during Smoking and Tobacco Chewing
Authors: Gupta Himanshu , Bhargava Balram , Seth Sandeep , Pruthvi C R , Ramakrishnan Sivasubramanian
Published: April 2021

Background:

Smoking increases the risk of coronary artery disease. Very few studies have evaluated the temporal relationship of electrocardiographic changes with smoking. We sought to study and compare the electrocardiogram (ECG) changes during smoking and tobacco chewing in current smokers and tobacco chewers presenting with atypical chest pain with either negative or mild positive exercise ECG test (treadmill test [TMT]).

Materials and Methods:

We screened male smokers and tobacco chewers with atypical chest pain with TMT. A total of 60 patients, 30 in each group in whom TMT was either negative or mildly positive, underwent a 24-h Holter monitoring. We asked patients to note down their time of smoking and tobacco chewing along with the timing of symptoms if any.

Results:

All patients were male with an average age of 45 years in smokers and 42 years in the tobacco chewer group. The mean number of cigarettes consumed was 6 ± 2.8 and tobacco chewed was 5 ± 4.7 g/day. Heart rate (HR) in smokers increased from 82.5 ± 14.56/min 10 min before smoking to 90.63 ± 15.34/min, during smoking with peak HR achieved at the time of smoking (P < 0.0001). HR in the tobacco chewers peaked at 10 min after chewing from 80.62 ± 13.52/min 10 min before to 87.89 ± 13.86/min 10 min after chewing (P < 0.0001). Smoking was associated with a significant increase in supraventricular ectopics (VEs) from 3.98/h before smoking to 7.43/h during and 6.92/h after smoking (P < 0.0001). Two patients in the smoker subgroup had spontaneous smokeless tobacco -T changes lasting for 10–25 min. Smoking was associated with a significant decrease in HR variability (HRV) index than the controls (P = 0.023). Tobacco chewing was not associated with any significant changes in the HRV parameter.

Conclusions:

Smoking and tobacco chewing both significantly increase the HR acutely. Smoking leads to an increase in both supraventricular and VEs. We observed reduced HRV in patients who smoked cigarettes.
Clinical and Angiographic Outcomes of Coronary Bifurcation Lesions Treated by TAP- Stenting as an Initial Two Stent Strategy
Authors: Parvathareddy Krishna Malakonda Reddy , Karella Naga Chaitanya , Ravi Srinivas , Nagula Praveen , Kolli Jagadeesh Reddy , Imamuddin Syed
Published: April 2021

Context:

The T-stenting with small protrusion (TAP) technique is a relatively new strategy among the bifurcation lesion interventions. Apart from being technically easy, there is complete coverage of the side-branch ostium and minimal overlap of the stent struts.

Aims:

We sought to report the outcomes of TAP technique in the management of the bifurcation lesions.

Settings and Design:

Prospective observational study between December 2017 and December 2019.

Subjects and Methods:

Patients with a diagnosis of coronary artery disease and bifurcation lesion on angiography were included in the study. Patients who underwent intervention with TAP technique were analyzed at baseline and followed up for a period of 1 year. The measured endpoints include major adverse cardiac events (MACE), target vessel revascularization (TVR), stent thrombosis (ST), and binary restenosis at 1-year follow-up.

Results:

During the study period, 152 bifurcation lesions in 148 patients were treated by percutaneous coronary intervention using drug-eluting stents. Of these, 15 patients (10.13%) underwent TAP stenting. The median age was 60 years. The procedural success was 100% in all the patients. At 1-year follow-up, MACE was seen in 13.3%, TVR in 6.66%, and binary stenosis in 6.66%.

Conclusion:

The TAP stenting as an initial two-stent strategy is associated with acceptable clinical outcomes (MACE and in-stent restenosis). There was no case of definite ST.
Critical Care Preparedness and Conduct in COVID-2019 Crisis
Authors: Sahu Manoj Kumar , Vaswani Prateek
Published: April 2021

Background:

COVID-19 pandemic has stirred an unexpected turmoil in health care worldwide. The strategic conduct of critical care would warrant an effective preparedness plan, thorough knowledge of the disease manifestations, and relevant therapeutic strategy to sail through this crisis.

Methods:

English medical literature with MeSh database was searched using the key words such as “COVID-19 pandemic,” “ICU preparedness,” “COVID-19 management,” “COVID-19 therapy,” and “COVID-19 systemic effects.” The relevant studies were included with significant inputs from interdepartmental meetings for the formulation of a plan.

Results:

The analysis of the respective studies highlighted the requirements of COVID-19 designated intensive care units (ICUs) with special provisions and the therapeutic agents being used in critical patients with emphasis on Remdesivir, Dexamethasone, Convalescent Plasma, and insight into newer agents. The systemic manifestations of COVID-19 requiring ICU care such as acute respiratory distress syndrome, myocardial injury, arrhythmias, hypercoagulable state, and acute renal dysfunction have been highlighted. The need of updating records with research protocols cannot be disregarded. The care of patients should not compromise the health-care personnel requirements.

Conclusion:

The evidence-based preparedness strategy can curtail the critical care crunch in COVID-19 management; however, institutional specific approach should be formulated.
Calcific Severe Rheumatic Mitral Valve Stenosis Disguising as a “Pseudoprosthesis”
Authors: Ahmed Akhlaque , Sahu Ankit Kumar , Kapoor Aditya
Published: April 2021

We present an interesting cardiac fluoroscopic image representing a severe rheumatic mitral restenosis with heavily calcific mitral valve leaflets having a striking resembling to the valve leaflets of bileaflet mechanical valve on cineangiography with respect to size, shape, motion, and position.
Implications of the Use of Hydroxychloroquine on Cardioactive Drugs
Authors: Ghosh Soumitra , Yadav Ashutosh , Francis Cliojis , Gupta Anunay , Gupta Preeti , Agstam Sourabh
Published: April 2021

Hydroxychloroquine (HCQ) is a relatively safe drug, and has been emerged as one of the treatment options for the management of COVID-19. This review is from the viewpoint of cardiologists, and it covers the pharmacokinetics, pharmacodynamics, and mechanism of drug interaction of HCQ with the commonly used cardioactive drugs.
Left Ventricular Thrombus in Patients with COVID-19 – A Case Series
Authors: Jariwala Pankaj , Punjani Arshad , Boorugu Harikishan , Reddy Mari Ajay
Published: April 2021

Scarred culprit vessel territory secondary to nonreperfused myocardial infarctions (MIs), nonischemic cardiomyopathy, left ventricular (LV) noncompaction, endomyocardial fibrosis, and long-standing arrythmias are usually causes of LV thrombus (LVT) formation. However, in the setting of MI, large infarctions, apical akinesia or dyskinesia, LV aneurysms are often predisposed t'o the formation of LVT. The hypercoagulable or inflammatory disorder can rarely predispose to the formation of LVT. In early prethrombolytic and thrombolytic periods, LVT was present in 20%–50% of patients in the context of acute MI, more commonly in acute anterior or apical MI. While the incidence of LVT has dropped in recent times, its identification is expected to rise during the COVID-19 pandemic. Patients with chest pain are more likely to delay initial hospitalization because of a fear of contracting COVID-19. Infection with COVID-19 was associated with the remarkably hypercoagulable state which increased the risk of the early development of LVT in the setting of MI or underlying prethrombotic conditions. We present a series of four cases in which COVID-19 and cardiovascular disease were characterized by various configurations of large LVT.
Assessment of Thirst Intensity and Thirst Distress and the Practices for its Management among Heart Failure Patients Admitted to the Cardiology Unit
Authors: Thapa Karuna , Das Smita , Pathak Pragya , Singh Sandeep
Published: April 2021

Background:

Thirst is reported as a troublesome symptom in patients with heart failure (HF), and very few studies have been done to assess thirst in these patients. Therefore, this study aims to assess thirst intensity, thirst distress, and practices of HF patients to manage thirst.

Methods:

A descriptive, cross-sectional study was conducted on 75 HF patients admitted to the cardiology department. Purposive sampling technique was used for collecting data from July 2019 to November 2019. Visual analog scale (0–100 mm) was used to assess thirst intensity, and 8-item thirst distress scale was used to assess thirst distress. The practices of the participants were assessed using a self-developed questionnaire.

Results:

The mean age of the participants was 44.83 ± 15.51 years and the majority (72%) was male. The majority of the participants (82.7%) had fluid restriction, and almost 97.3% of all of the participants were receiving diuretics. The median (interquartile range) thirst intensity was 33 (16–50) mm. About 66.7% of the participants had moderate-to-severe thirst distress. Both thirst intensity and thirst distress were associated with fluid restriction, New York Heart Association functional class, and serum urea level. The participants reported that they drink a small amount of water frequently, gargle with water, eat cucumber, drink buttermilk, lemon juice, and coconut water. Very few participants had made changes in their food habits and lifestyle.

Conclusion:

Two-thirds of the participants had moderate-to-severe thirst distress. Fluid restriction was associated with both thirst intensity and thirst distress. Thus, nurses are responsible to assess thirst among HF patients and help them to manage their thirst effectively.
A Comparative Assessment of the Severity of Coronary Artery Disease in Patients with Low Ankle–Brachial Index and Normal Ankle–Brachial Index
Authors: Sharma Awadhesh Kumar , Kejriwal Mohit P , Sinha Santosh Kumar , Razi M M , Pandey Umeshwar , Shukla Praveen , Thakur Ramesh , Verma C M , Krishna Vinay
Published: April 2021

Objectives:

The ankle–brachial index (ABI) is an efficient tool and an indicator of generalized atherosclerosis. Still, there is uncertainty regarding the severity of coronary artery disease (CAD) in patients having low ABI. The uniqueness of this study is that it is the first largest study done with the aim to determine the severity of CAD in the form of a number of involvements of coronary vessel in patients with low ABI.

Materials and Methods:

It is a hospital-based cross-sectional observational-analytical study. A total of 500 patients of suspected CAD were recruited. ABI was measured first and then all patients were sent for coronary angiography. Based on ABI values, patients were divided into two groups, i.e., Group A (patients with low ABI or ABI ≤0.9) and Group B (patients with normal ABI or ABI >0.9).

Results:

Twenty-three, i.e., 4.6% of patients had ABI <0.9. All patients having low ABI had CAD. In assessing CAD severity, it was reported that in Group A, triple-vessel disease (TVD) was present in 65.2% (P = 0.0001), double-vessel disease in 21.7% (P = 0.72), single-vessel disease in 8.6% (P = 0.06), and noncritical CAD in 4.3% (P = 0.9) as compared to Group B. In patients with Group A, 52.1% were smoker (P = 0.01), 69.5% have increased body mass index (P = 0.71), 43.4% have a history of hypertension (P = 0.73), and 60.8% were diabetic (P = 0.0005).

Conclusion:

CAD is widely prevalent almost in all patients with low ABI and more than half of these patients have TVD on angiographic assessment.
Pedicled Omental Wrapping of Ascending Aortic Graft Following Mediastinitis
Authors: Arora Yatin , Devagourou Velayoudam , Kumar Ratnesh
Published: April 2021

A 51-year-old male patient post-Aortic valve replacement (#25 SJM) underwent redo supra-coronary ascending aorta replacement for ascending aortic aneurysm developed a peri-graft purulent collection 2 months later post surgery. He was successfully treated by debridement of infected tissues, antiseptic irrigation with povidone, and omental wrapping of graft. The patient was discharged after full course of antibiotics. Quick diagnosis with debridement, irrigation, and omental wrapping can be effective in the treatment of mediastinitis following graft replacement of the ascending aorta for preventing catastrophic complications
Barriers to pulmonary rehabilitation – A narrative review and perspectives from a few stakeholders
Authors: Augustine Anulucia , Bhat Anup , Vaishali K , Magazine Rahul
Published: April 2021

Pulmonary Rehabilitation (PR) is an essential and comprehensive intervention recommended in the management of people with chronic respiratory diseases (CRD). Scientific evidence suggests significant health benefits with respect to repeated hospital admissions, exercise tolerance and Health Related Quality of Life (HRQoL). However, the uptake and completion of PR programs are globally low. In order to understand the factors contributing to underutilization of PR, it is important to review and recognize the barriers to PR program. A literature search was conducted on Medline (PubMed) database. After reviewing the title and abstracts, full text articles were scrutinized for their relevance. Twenty-two studies involving factors affecting the uptake, participation and completion of PR program were included in this review. Reported barriers to PR were healthcare system, healthcare professional and patient related factors. Primary factors related to healthcare system and healthcare professionals were fewer PR centers, accessibility inconvenience, lack of awareness of PR program, low knowledge of referral process and lack of interdisciplinary teamwork. Difficulties faced by patients to take up and/or to complete PR programs were lack of transportation, co-morbidities, lack of perceived benefits, socio-economic status and lack of funding facilities. Identified and reported barriers resulted into discontinuity between knowledge of health benefits and utilization of PR service for patients with CRDs. Addressing the barriers would accelerate the healthcare professionals' referral and patients to avail the health benefits of rehabilitation service.
A survey of medical thoracoscopy practices in India
Authors: Madan Karan , Tiwari Pawan , Thankgakunam Balamugesh , Mittal Saurabh , Hadda Vijay , Mohan Anant , Guleria Randeep
Published: April 2021

Background:

Medical thoracoscopy (MT) is a useful diagnostic and therapeutic procedure for a variety of pleural conditions. There is a lack of literature on prevalent practices of MT in India.

Aims and Objectives:

The objective of the study was to study the prevalent practices of MT in India.

Materials and Methods:

A structured online survey on various aspects of thoracoscopy was designed on the “Google Forms” web software.

Results:

One hundred and eight responses were received, of which 100 respondents performed MT. The majority were pulmonologists, and most had started performing thoracoscopy within the last 5 years. Rigid thoracoscope was the most commonly used instrument. The common indications of procedure included undiagnosed pleural effusion, talc pleurodesis, and adhesiolysis. Local anesthesia with conscious sedation was the preferred anesthetic modality. Midazolam, along with fentanyl, was the most widely used sedation combination. 2% lignocaine was the most commonly used concentration for local infiltrative anesthesia. Nearly two-thirds of the respondents reported having encountered any complication of thoracoscopy. Significant reported complications included empyema, incision/port-site infection, re-expansion pulmonary edema, and procedure-related mortality.

Conclusion:

MT is a rapidly evolving interventional pulmonology procedure in India. There is, however, a significant variation in practice and variable adherence to available international guidelines on thoracoscopy. Formal training programs within India and national guidelines for pleuroscopy considering the local resources are required to improve the safety and yield of this useful modality.
Conservative treatment of postintubation tracheal laceration with pneumomediastinum, bilateral pneumothorax, and massive subcutaneous emphysema
Authors: Romic Marijan , Becejac Tomislav , Grbavac Dario , Romic Renata , Romic Ivan
Published: April 2021

Postintubation tracheal laceration (PITL) is a rare, potentially life-threatening complication requiring prompt diagnosis and treatment. Patients typically present with subcutaneous emphysema and pneumomediastinum, whereas concomitant pneumothorax is rarely reported. A conservative treatment is indicated in selected respiratory stable patients with small lacerations. Herein, we reported an unusual case of PITL with bilateral pneumothorax that was treated with chest tube drainage and conservative measures in the intensive care unit. The key success of the PITL management is early recognition of signs and symptoms and an adequate selection of management approaches.
Survival predictors of interstitial lung disease in India
Authors: Singh Sheetu , Bairwa Mohan , Collins Bridget F. , Sharma Bharat Bhushan , Joshi Jyotsana M , Talwar Deepak , Singh Nishtha , Pilania Khushboo , Bhattacharya Parthasarathi , Gupta Neeraj , Chetambath Ravindran , Ghoshal Aloke G. , Kant Surya , Koul Parvaiz A , Dhar Raja , Swarnakar Rajesh , Singh Virendra , Raghu Ganesh
Published: April 2021

Background:

Predictors of survival for interstitial lung disease (ILD) in the Indian population have not been studied. The primary objective of the study was to assess the Modified-Gender Age and Physiology (M-GAP) score to predict survival in patients with ILD seen in clinical practice. We also analyzed the role of demographic and radiological characteristics in predicting the survival of patients with ILD.

Materials and Methods:

In the ILD India registry, data were collected from 27 centers across 19 cities in India between March 2012 and June 2015. A single follow-up was conducted at 18 centers who agreed to participate in the follow-up in 2017. M-GAP score (range 0–5) was calculated with the following variables: age (≤60 years 0, 61–65 years 1, and >65 years 2), gender (female 0, male 1), and forced vital capacity% (>75% 0, 50%–75% 1, and >75% 2). A score of 0–3 and score of 4 and 5 were classified into Stage 1 and 2, respectively. Other predictors of survival, such as the history of tuberculosis, smoking, and the presence of honeycombing on computed tomography scan, were also evaluated.

Results:

Nine hundred and seven patients were contacted in 2017. Among them, 309 patients were lost to follow-up; 399 were alive and 199 had died. M-GAP was significantly associated with survival. Similarly, other predictors of survival were ability to perform spirometry (hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.34–0.72), past history of tuberculosis (HR: 1.57, 95% CI: 1.07–2.29), current or past history of smoking (HR: 1.51, 95% CI: 1.06–2.16), honeycombing (HR: 1.81, 95% CI: 1.29–2.55), a diagnosis of connective tissue disease -ILD (HR: 0.41, 95% CI: 0.22–0.76), and sarcoidosis (HR: 0.24, 95% CI: 0.08–0.77).

Conclusion:

In a subgroup of patients with newly diagnosed ILD enrolled in ILD India registry and who were available for follow-up, M-GAP score predicted survival. Honeycombing at the time of diagnosis, along with accurate history of smoking, and previous history of tuberculosis were useful indices for predicting survival.
Small-bore catheter is more than an alternative to the ordinary chest tube for pleural drainage
Authors: Hamad Abdel-Mohsen Mahmoud , Alfeky Seham Ezzat
Published: April 2021

Background:

Pleural collection is a common medical problem. For decades, the chest tube of different designs was the commonly used toll for pleural drainage. Over the past few years, small-bore catheter (SBC) has gained more popularity. We present our experience of using SBCs for the drainage of pleural collection of different etiologies.

Patients and Methods:

A total of 398 small-bore pleural catheters were inserted in 369 patients with pleural collection during the period from January 2013 to October 2019. Data were collected regarding the efficacy of drainage, experienced chest pain, duration of drainage, and the occurrence of complications.

Results:

Malignant associated (59.24%) and parapneumonic (19.57%) effusions constituted the most common causes. The drainage was successful in 382/398 (95.98%) occasions; six cases had incomplete fluid evacuation that required decortications; five cases (1.26%) had nonexpendable lung. Catheter reinsertion was needed due to dislodgment in 2 (0.50%) cases and obstruction in 3 (0.75%) cases. Sixty-two cases (15.58%) experienced chest pain. No patient developed empyema or cellulites at the site of catheter insertion. The duration of drainage ranged from 2 to 7 days, with an average of 3.5 days.

Conclusions:

SBC is equivalent to conventional chest tube for the drainage of pleural collection. Moreover, it has the advantages of less associated pain, versatility of insertion site, and relative safety of the technique in some risky and difficult situations.
Lung preservation in mucoepidermoid carcinoma of tracheobronchial tree
Authors: Bishnoi Sukhram , Puri Harsh Vardhan , Asaf Belal Bin , Pulle Mohan Venkatesh , Kumar Akhil , Kumar Arvind
Published: April 2021

Introduction:

Mucoepidermoid carcinoma (MEC) is a primary salivary gland tumor also arising from nonsalivary gland organs of the body such as submucosal glands of tracheobronchial tree. Surgical resection with negative margins is the treatment of choice. All efforts should be made to preserve as much lung parenchyma as possible, by various bronchoplastic procedures. We present our experience with mucoepidermoid tumors and review their management options including lung preservation techniques and outcome of surgery.

Materials and Methods:

This is a retrospective analysis of prospectively maintained data of 14 patients who underwent surgery for MEC. Their demographic data; clinical presentation; and preoperative, intraoperative, and postoperative details were recorded. All patients underwent contrast-enhanced computed tomography of chest and bronchoscopy as part of workup for diagnosis and to assess the location, size, and extent of tumor; extraluminal component; and status of distal lung parenchyma.

Results:

There were eight male and six female patients. The median age at the time of surgery was 28.36 years (range 22–45 years). The procedures performed included right upper lobectomy and right pneumonectomy in one patient each, left main bronchus sleeve resection in six patients, left upper sleeve lobectomy in three patients, and carinal resection and reconstruction of neo carina in three patients. Twelve (85.7%) of our patients underwent lung-preserving surgery. The median hospital stay and chest tube removal duration was 4 and 3 days, respectively. The median tumor size was 1.91 cm (range 1–8 cm). The median follow-up was 24 months (ranging from 6 to 78 months).

Conclusion:

Radical surgery to achieve R “0” resection with aggressive emphasis on lung preservation is the mainstay of treatment of MEC. Greater awareness of these tumors is necessary to avoid misdiagnosis and to prevent delaying of potential complete resection of MEC.
Accidental breakage of needle tip during endobronchial ultrasound-guided transbronchial needle aspiration
Authors: Bante Nikhil , Singh Abhijeet , Gupta Ayush , Mittal Anshul , Suri Jagdish Chander
Published: April 2021

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is commonly recommended for the diagnosis of mediastinal lymphadenopathy with malignant and nonmalignant etiology. EBUS-TBNA has been preferred over mediastinoscopy because of several advantages such as comparable diagnostic accuracy, safety, cost-effectiveness, and less invasiveness. Hemorrhage, mediastinitis, pneumonia, mediastinal abscess, empyema, lung abscess, pericarditis, and pneumothorax have been reported as major complications of EBUS-TBNA. Equipment malfunction has been observed mostly in the form of breakage of EBUS scope parts such as working channel, optical fibers, and ultrasound probe. Needle malfunction either involving assembly leading to inability to retract the needle within the sheath or accidental breakage of the needle tip has also been reported but the evidence is still limited. We encountered an accidental breakage of needle tip while performing EBUS-TBNA procedure in a 58-year-old male having subcarinal lymphadenopathy suspected to have lung cancer. We were able to successfully retrieve the broken fragment bronchoscopically without any complications.
A Systematic Literature Review: Discipline-Specific and General Instructional Practices Fostering the Mathematical Creativity of Students
Authors: Bicer Ali
Published: April 2021

The purpose of this systematic review is to reveal the research findings that suggest instructional practices to foster the creativity of students in mathematics. Although several studies have investigated the effects of various instructional practices influencing the mathematical creativity of students, little is known about how the findings of this collective body of research contribute to the understanding of what instructional practices should be integrated into a mathematic classroom to further foster the mathematical creativity of students. In this systematic review, the knowledge of instructional practices that foster the mathematical creativity of students were categorized under two main factors including: 1) discipline-specific instructional practices and 2) general instructional practices. The discipline-specific instructional practices were problem-solving, problem-posing, open-ended questions, multiple solution tasks, tasks with more than one correct answer, modeling/model-eliciting activities, technology integration, extendable tasks, and emphasizing abstractness of mathematics. The general instructional practices were providing students with ample time to think creatively about real-world related mathematical problems in a judgment free and collaborative classroom environment so that they take risks to share their mathematical ideas and use informal words. Integrating all of these instructional practices into mathematics classrooms can provide opportunities for students to discover their potential creative abilities in mathematics.
Covid-19 Sürecinin Türkiye’nin Elektrik Enerjisi Üzerindeki Etkilerinin İncelenmesi
Authors: BULUT Mehmet
Published: April 2021

İnsanlık, 2020 yılına girerken, ilk olarak Çin’de gözüken ve tüm dünyaya yayılan Covid-19 salgını sürecinde alınan tedbirler sebebiyle yeni yaşam tarzını beraberinde getirdi. İlk vakaların görüldüğü ülkelerde acil olarak alınan tedbirler, insanları farklı bir durum ile karşılaşmanın ötesinde hayatlarını yeniden düzenlemek zorunda bıraktı. Bu durum enerji türlerinin hemen tüm türlerinde bir talep değişikliği ve tüketim düşüklüğüne sebep oldu. Bu çalışmada Türkiye’nin enerji tüketimi, geçmiş yılların aynı aylardaki elektrik tüketim alışkanlığı ve kaynak kullanımı incelenerek, bu dönemin elektrik kullanımı ve elektrik üretim kaynakları üzerindeki etkileri incelenmiştir. İlk vaka göründüğü 11 Mart 2020 tarihinin içinde bulunduğu ayda sanayide üretimi etkilemez iken, evde kal uyarıları ile birlikte evsel elektrik tüketimi 105 Milyon kWh’lık artmış meydana gelmiştir. Bu çalışma, Covid19 etkisinin Türkiye’deki elektrik talebine etkisinin incelenmesi bakımından ilk çalışma niteliğindedir.
Sistem Informasi Tenaga Kerja Kontrak Pada Biro Jasa Di PT. Villa Jaya Abadi
Authors: Pahlevi Heru , Zulham Zulham , Rusydi Ibnu
Published: April 2021

Abstrak - PT. Villa Jaya Abadi adalah perusahaan yang bergerak dibidang penyediaan tenaga kerja yang telah berkerja sama dengan banyak perusahaan besar. PT. Villa Jaya Abadi menyediakan tenaga kerja, Buruh Harian Lepas (BHL), Kontrak Kerja Waktu Tertentu (Proyek), Pekerjaan Borongan, Karyawan Tetap, Satuan Pengamanan (Satpam), Cleaning Service, Office Boy, Office Girl, dan Driver. Penggunaan Microsoft Exel dalam pengolahan proses bisnis pada PT. Villa Jaya Abadi masih kurang efektif dan efesien dalam melakukan pendataan absensi dan perhitungan gaji pada karyawan, hingga ke pembuatan laporan. Namun pada proses absensi, perusahaan masih menggunakan absensi manual dengan mencatat absen pada setiap harinya. Absen yang dilakukan untuk menghitung jam kerja mereka yang diperlukan pada saat penggajian. Karena proses absensi yang masih di data dalam manual membuat data yang diterima oleh pimpinan perusahaan masih sangat lambat dan dapat beresiko kehilangan data, sehingga pemrosesan untuk menghasilan informasi pun menjadi lambat. Untuk mempermudah dalam pengolahan data dan informasi tenaga kerja kontrak yaitu absensi, penggajian dan pembuatan laporan. Maka di butuhkan sebuah sistem yang dapat memudahkan perusahaan untuk mengelola data dan informasi tenaga kerja kontrak pada PT. Villa Jaya Abadi. Kunci : Sistem Informasi Kepegawaian, Tenaga Kerja Kontrak, PT. Villa Jaya Abadi
Benefit Sharing in Community Based Conservation Programs: The Case of Makao Wildlife Management Area, Tanzania
Authors: B. Lwankomezi Emmanuel , Kisoza James , Patrobas Mhache Emmanuel
Published: April 2021

Wildlife Management Area establishment around protected areas in Tanzania have been faced with various challenges including failures to adequately involve local populations in planning, governance and management of wildlife related resources. This study examined the benefit sharing mechanisms in Community Based Conservation programs, the case of Makao Wildlife Management Area in Meatu District, Tanzania. The study was conducted in Jinamo, Mwabagimu and Makao Villages. Data were collected from 281 heads of households using a survey design within the mixed approach. The study used simple random sampling based on the names of all heads of the households in each study village who were obtained from the village households as registered by village chairs. The major findings indicate that in the past five years, there is a considerable increase of income generated from wildlife investment in the study area which is used for payment of VGS salaries, food and other expense for VGS, community development and sharing among member villages. The study further shows that, inadequate involvement in the WMA activities results in local people having low perception on the WMA accrued benefits. The study recommends that it is essential to involve the local community in the WMA design and management in order to improve its acceptability and ownership. Benefit sharing in the WMAs should be designed as a strategy to offset conservation costs and build support for biodiversity conservation among conservation actors mainly local communities.
Exploring the Adventist Health-lifestyle: A Social Marketing Perspective
Authors: Sigauke Innocent , Swansi Kenneth , Dlamini Christinah
Published: April 2021

Some studies have linked the Seventh-day Adventist (SDA) church health-lifestyle with better wellbeing and longevity. However, there are suggestions that current initiatives by the SDA-church to prompt health behavior modifications have been inadequate. Current attempts seem to be largely downstream approaches without clear marketing guidelines. While social marketing has been noted to be a key success factor in behavior modification initiatives, it does not seem to have been used in promoting SDA health-lifestyle initiatives. Hence the study sought to bring in a social marketing perspective to the current initiatives being done to make the SDA health-lifestyle modifications attainable for more people. A multi-method design combining grounded theory and appreciative inquiry was used. Data was collected from SDA-public health academics and practitioners, health-lifestyle program participants as well as social marketing extant studies and models. The sources of data were 30 interviews, 20 extant studies on social marketing, 5 social marketing models and 5 forum presentations. The major finding of the study is a social marketing theory for SDA health-lifestyle modification suggesting that health-lifestyle behavior modification is driven by centers of influence that run benchmarked programs shaped by distinctively Adventist worldview, and guided via marketing design criteria. Social marketing is suggested as the missing link that makes it easier to implement health-lifestyle behavior adoption efforts.
Analisis SWOT sebagai Dasar Perumusan Strategi Pemasaran Berdaya Saing (Studi Kasus pada Dasom Beauty & Me Nail Surabaya)
Authors: Halawa Erniwati
Published: April 2021

Dasom Beauty & Me Nail Surabaya berada pada kuadran 1, posisi ini menandakan perusahaan yang kuat dan berpeluang maka strategi yang harus diterapkan adalah SO yaitu : Meningkatkan kualitas pelayanan kepada pelanggan dan membangun hubungan dekat sehingga pelanggan tetap kembali karena pelayanan adalah hal dasar untuk memasarkan suatu  produk, Meningkatkan produk yang beragam  sehingga dapat menjadi nilai tambah terhadap pelanggan, Mempertahankan sistem administrasi sehingga proses dalam setiap treatment lebih efesien dan efektif. Adapun strategi bersaing menggunakan Matrik Internal-Eksternal yaitu : Memberikan potongan atau diskon di waktu tertentu sehingga dapat bersaing dengan perusahaan yang sejenis, meningkatkan pengembangan inovasi model kecantikan serta cara treatment baru, meningkatkan pengetahuan dan penguasaan terhadap karyawan, karna karyawan adalah ujung tombak jalannya perusahaan, meningkatkan produk yang beragam  sehingga dapat menjadi nilai tambah terhadap pelanggan.
Pengaruh Diskon, Kualitas Pelayanan dan Atmosfer Toko terhadap Pembelian Impulsif di Jungkir Balik Eat & Coffee Sidoarjo
Authors: Faustin Mayrine Aulia , Widiana Muslichah Erma , Istanti Enny
Published: April 2021

Penelitian ini bertujuan untuk mengetahui pengaruh diskon, kualitas pelayanan dan atmosfer toko terhadap pembelian impulsif di Jungkir Balik Eat & Coffee Sidoarjo. Penelitian ini menggunakan variabel independen yaitu diskon, kualitas pelayanan dan atmosfer toko. Variabel dependennya adalah pembelian impulsif. Sampel penelitian ini adalah konsumen Jungkir Balik Eat & Coffee Sidoarjo. Teknik pengambilan sampel dilakukan dengan metode simple random sampling. Pengumpulan data dilakukan dengan penyebaran kuesioner yang diberikan kepada 65 konsumen Jungkir Balik Eat & Coffee Sidoarjo. Metode analisis dilakukan dengan menggunakan analisis regresi linear berganda. Pengujian hipotesis menggunakan uji statistik F, uji statistik t dan uji dominan. Hasil penelitian ini menunjukkan bahwa diskon, kualitas pelayanan dan atmosfer toko secara simultan berpengaruh positif dan signifikan terhadap pembelian impulsif di Jungkir Balik Eat & Coffee Sidoarjo. Diskon dan atmosfer toko secara parsial berpengaruh positif dan signifikan terhadap pembelian impulsif di Jungkir Balik Eat & Coffee Sidoarjo sedangkan kualitas pelayanan secara parsial tidak berpengaruh dan tidak signifikan terhadap pembelian impulsif di Jungkir Balik Eat & Coffee Sidoarjo. Variabel independen yang berpengaruh dominan terhadap pembelian impulsif di Jungkir Balik Eat & Coffee Sidoarjo adalah atmosfer toko.
Analisis Kinerja Keuangan Bank Umum Syariah di Indonesia berdasarkan Islamicity Performance Index Periode 2015-2019
Authors: Kurniawan Fakhry Hafiyyan , Mahri A. Jajang W. , Al Adawiyah Rumaisah Azizah
Published: April 2021

Islamic Commercial Banking in Indonesia generally has not fully carry out business activities in accordance with sharia provisions. Therefore, there is a need for a performance measurement tool that is able to express spiritual and social values embodied in Islamic banks. The purpose of this study is to describe the performance of Islamic banking based on Islamicity Performance Index. This research is a quantitative research using descriptive analysis. The data used in this research is secondary data. The study population was Islamic banks in Indonesia during the period 2015-2019, with a sample of twelve banks. Sampling was done by using purposive sampling method. The results showed Panin Dubai Sharia Bank was the best bank in the Profit Sharing Ratio (PSR) indicator. The value of Zakat Performance Ratio (ZPR) in Islamic banking in Indonesia is still low. BNI Sharia is the bank with the highest average value for the ZPR indicator. Equitable Distribution Ratio (EDR) indicates that Mandiri Sharia Bank has the highest average value. Directors-Employees Welfare Ratio (DEWR) shows that BTPN Sharia have fairly high levels of disparity between directors and employees. IIR and IsIR shows  that in general Islamic commercial banks in Indonesia have carried out businesss performance in the halal sector. Meanwhile, overall, it received a satisfactory predicate. This research is expected to be taken into consideration for the related institutions to apply the performance measurement of Islamic Commercial Banking in accordance with the concept of Islamicity Performance Index, and be taken into consideration in taking policy measures in accordance with the concept of sharia that will be used in the future.
Türkçe Öğretiminde Web 2.0 Uygulaması Olarak LearningApps’ın Kullanımı
Authors: KARADAĞ Bilal Ferhat , GARİP Soner
Published: April 2021

Eğitimde yeni arayışlar her zaman var olmuş ve sık sık farklı yöntem ve teknik arayışına gidilmiştir. Teknolojinin gelişmesiyle eğitim de bu alana doğru kaymış ve çeşitli Web 2.0 araçlarına öğretim ortamlarında başvurulmuştur. LearningApps da bu araçlardan bir tanesidir. Çalışmanın amacı, Türkçe derslerindeki pekiştirme çalışmalarında LearninApps’ın kullanımını öğrenci görüşleriyle değerlendirmektir. Çalışma nitel araştırma yöntemi çerçevesinde fenomenolojik desenle gerçekleştirilmiştir. Çalışma grubu tek şubeli bir ortaokulun altıncı sınıfında öğrenim gören on beş öğrenciden oluşmaktadır. Araştırmanın verileri yarı yapılandırılmış görüşme formu ile toplanmıştır. Verilerin analizi içerik analiziyle gerçekleştirilmiştir. Yapılan görüşmeler neticesinde, öğrencilerin LearningApps’ı çok beğendikleri, eğlenceli, iç açıcı olduğu ve bireysel değerlendirmeye fırsat tanıdığını belirttikleri ve gelecek derslerde de pekiştirme çalışmalarında bu uygulamanın kullanılabileceğini ifade ettikleri belirlenmiştir. Sonuç kısmında Türkçe derslerinde eğlenceli ve öğretici bir ortam için LearningApps uygulamasından faydalanılabileceği, pekiştirme çalışmalarında tekrar ve bireysel değerlendirme için bu uygulamaya başvurulabileceği ve alıştırma kâğıtlarına alternatif olarak bünyesindeki etkinlikler yoluyla LearningApps’tan istifade edilebileceği gibi önerilerde bulunulmuştur.
SINIF ÖĞRETMENLERİNİN AKIL ve ZEKÂ OYUNLARININ İLKOKULDA KULLANIMINA YÖNELİK DEĞERLENDİRMELERİ
Authors: GÜNEŞ Dilek , YÜNKÜL Eyup
Published: April 2021

Bu araştırmanın amacı öğretmen görüşlerine dayalı olarak akıl ve zekâ oyunlarının ilkokul öğrencileri üzerindeki etkilerini belirlemektir. Araştırmada nitel araştırma desenlerinden olgubilim deseni kullanılmıştır. Araştırmanın çalışma grubunu çok aşamalı örnekleme yöntemiyle seçilen 16 ilkokul öğretmeni oluşturmuştur. Araştırmada veri toplama aracı olarak araştırmacı tarafından geliştirilen yarı yapılandırılmış görüşme formu kullanılmıştır. Çalışmada elde edilen veriler içerik analizi tekniği kullanılarak analiz edilmiştir. Araştırma bulgularına göre örneklem grubundaki öğretmenlerin cevapları doğrultusunda strateji oyunlarının en çok oynatılan oyun kategorisi olduğu sonucuna ulaşılmıştır. Araştırmadaki öğretmenler akıl ve zekâ oyunlarını genellikle serbest etkinlikler ve oyun ve fiziki etkinlikler derslerinde oynattıklarını belirtmişlerdir. Öğretmenler akıl ve zekâ oyunlarını en çok matematik derslerinde kullandıklarını ve matematik dersinde de akıl ve zekâ oyunlarından çoğunlukla geometrik cisimler konusunda yararlandıklarını ifade etmişlerdir. Öğretmenlerin sınıfta genellikle dijital oyunlar oynattıkları ve bu oyunların sınıf düzeylerinde çeşitlilik gösterdiği ve en çok tercih edilen dijital yazılımın ise EBA olduğu sonucuna ulaşılmıştır.
LISTENING COMPREHENSION STRATEGIES OF TURKISH EFL LEARNERS AT UNIVERSITY
Authors: GÖKÇE Sevgi
Published: April 2021

Listening has been defined as a receptive skill so far, but seeing that English language learners in Turkey expend considerable effort to understand listening texts, it may be misleading to view listening as passive on part of learners. By means of using listening strategies, it may become an active skill in which learners orchestrate several cognitive processes. Therefore, this study was carried out to look into Turkish students’ use of listening strategies at the preparatory school of a public university in Turkey. With this purpose in mind, The Metacognitive Awareness Listening Questionnaire (Goh, 2008; Vandergrift et al., 2006) and retrospective accounts were used to collect data from intermediate-level students. The results indicate that out of four subcategories of listening strategies, learners appeared to prefer two of them, namely directed attention and mental translation more than planning-evaluation and problem solving strategies. In addition, they were found to have more difficulty in answering implicit listening questions and verbalizing how they answered them than explicit listening questions. Possible reasons behind these findings might be lack of systematic strategy training for both teachers and learners and backwash effects of listening tests in Turkey. Therefore, familiarizing teachers and learners with listening strategies and improving listening tasks and tests are suggested.