bluuebunny/crossref_metadata_2025 huggingface dataset:
Ayurveda management of azoospermia
Authors: Garg Sahil , Rajan Sujata , Garg Nisha
Published: July 2023

Background:

Azoospermia is defined as a complete absence of sperm in a given semen sample, which may have several causes behind it. Having no sperm can make it more difficult to conceive naturally and it is becoming a very common cause of infertility nowadays. In Ayurveda, it corresponds to shukrakshaya (diminution of semen).

Aim:

The aim of this study was to evaluate the potential of Ayurvedic approach for treating azoospermia.

Materials and Methods:

In this case report, the patient presented with the complaint of being unable to conceive since 9 years. According to symptomatic presentations and by assessing biological parameters, the case was diagnosed to be of shukrakshaya. Clinical presentation and biochemical parameter, that is, Semen analysis, confirmed the case as Azoospermia according to modern medicine. Traditional ancient Ayurvedic approach was adopted for treating the case incorporating aahar-vihaar (food and lifestyle), shaman (pacifying therapy), and shodhan (detoxification therapy) principles. The case was treated on the line of principles of shukrakshaya. Shodhan chikitsa using mahatikta ghrita and abhyadi modaka was done. Shaman chikitsa including internal administration of herbal and rasaushadhis formulations such as makaradhwajarasa, Pushpadhanva rasa, shakravallabh rasa, and Aamalaki rasayana along with dietary regimen was given to the patient.

Results and Conclusion:

After 5–6 months of treatment, significant changes in semen analysis without any adverse effect were observed in the case. It can be inferred or concluded from the above case that Ayurvedic approach is having valuable potential for treating such disorders and should be adopted as well.
Comparison of insertion characteristics of LMA ProSeal from the front and head-end of the patient: A randomized pilot study
Authors: Salhotra Rashmi , Thakkar Kushal , Rautela Rajesh Singh , Chauhan Jainendra , Ajeeb S
Published: July 2023

Background and Aims:

LMA ProSeal (PLMA) is a commonly used airway maintenance device in elective procedures and is routinely inserted from the head-end of the patient. It is also used in pre-hospital emergencies where it may not always be possible to access the head-end. This study aims to compare the insertion characteristics of PLMA when inserted while standing, either at the head-end or from the front.

Material and Methods:

After institutional ethics committee approval, 60 consenting patients of either sex, between 18 and 60 years, ASA class I/II, and scheduled to undergo elective surgeries were randomly allocated to either group H (head-end insertion) or group F (front-end insertion). Patients with anticipated difficult airway, chronic respiratory disease, obesity, and who were pregnant were excluded. Insertion time, ease of insertion, fiber optic view, ease of drain tube insertion, number of attempts and success rate were noted. Normally distributed quantitative variables were compared using t-test, and qualitative variables were compared using Chi-squared test. A P < 0.05 was considered significant.

Results:

Insertion time in group H (23.76 ± 4.48 s) was lesser than in group F (30.53 ± 6.23s) (P = 0.027). Ease of insertion (P = 0.052), fiber optic view, ease of drain tube placement (P = 1.000), and number of attempts (P = 1.000) were comparable among the groups.

Conclusion:

Although the insertion time from the front is longer than from the head-end, the other insertion characteristics of PLMA including ease of its insertion, placement and success rate of placement are similar when it is inserted from the front or from the head-end. It is an appropriate airway device for securing the airway when the head-end is inaccessible.
Trends of surgical-care delivery during the COVID-19 pandemic
Authors: Jain S , Mahajan A , Patil PM , Bhandarkar P , Khajanchi M
Published: July 2023

Context:

The COVID-19 pandemic and subsequent lockdowns adversely affected global healthcare services to varying extents. To accommodate its added burden, emergency services were affected along-with elective surgeries.

Aims:

To quantify and analyze the trends of essential surgeries and bellwether procedures during the waxing and waning of the pandemic, across various hospitals in India.

Settings and Design:

Multi-centric retrospective study.

Methods and Material:

A research consortium led by World Health Organization (WHO) Collaboration Center (WHOCC) for Research in Surgical Care Delivery in Low-and Middle-Income countries, India, conducted this study with 5 centers. All surgeries performed during April 2020 (Wave I), November 2020 (Recovery I), and April 2021 (Wave II) were compared with those performed in April 2019 (pre-pandemic period).

Statistical Analysis Used:

Microsoft Excel 2019 and SPSS Version 20.

Results:

The total number of surgeries reduced by 77% during Wave I, which improved to a 52% reduction in Recovery I compared to the pre-pandemic period. However, surgeries were reduced again during Wave II to 68%, but the reduction was less compared to Wave I. Emergency and essential surgeries were affected along with the elective ones but to a lesser extent.

Conclusions:

The present study has quantified the effects of the pandemic on surgical-care delivery across a timeline and documented a reduction in overall surgical volumes during the peaks of the pandemic (Wave I and II) with minimal improvement as the surge of COVID-19 cases declined (Recovery II). The surgical volumes improved during the second wave compared to the first one which may be attributable to better preparedness. Cesarean sections were affected the least.
Development and validation of a postoperative pulmonary infection prediction model for patients with primary hepatic carcinoma
Authors: Lu Chao , Xing Zhi-Xiang , Xia Xi-Gang , Long Zhi-Da , Chen Bo , Zhou Peng , Wang Rui
Published: July 2023

Esophageal cancer (EC) is one of the most common digestive system malignancies in the world. The combined modality treatment of EC is usually surgery and radiation therapy, however, its clinical efficacy for advanced patients is relatively limited. Ferroptosis, a new type of iron-dependent programmed cell death, is different from apoptosis, necrosis and autophagy. In recent years, many studies have further enlightened that ferroptosis plays an essential role in the occurrence, development and metastasis of tumors. Targeting ferroptosis stimulates a new direction for further exploration of oncologic treatment regimens. Furthermore, ferroptosis has a critical role in the immune microenvironment of tumors. This paper reviews the mechanism of ferroptosis and the ferroptosis research progress in the treatment of EC. We further elaborate the interaction between ferroptosis and immunotherapy, and the related mechanisms of ferroptosis participation in the immunotherapy of EC, so as to provide new directions and ideas for the treatment of EC.
Design Guidelines for Air-Conditioning Systems for Off-Road Operator Enclosures
Authors:   HFTC6, Operator Accommodation
Published: July 2023

The purpose of this document is to establish air-conditioning design guidelines that will apply to most systems rather than the specific design of any particular system. Operating conditions and characteristics of the equipment will determine the design of any successful system; since these characteristics and conditions vary greatly from one application to another, the designer shall determine the goals expected to be reached under the conditions encountered. To determine the capacity of such items as blowers, condenser fans, condenser coils, evaporator coils, filters, compressors, etc., will require the adherence to several guidelines, some of which are outlined in the following paragraphs.
Association of Personality Trait with Auditory and Visual Reaction Time among Young Healthy Subjects
Authors:   Department of Physiology, SMS Medical College, Jaipur, Rajasthan, India, Sankhla Manisha , Yadav Anuradha , Pnjabi Poonam , Yadav Kavita
Published: July 2023

Background: Personality traits along with well-known factors like socioeconomic status and cognitive ability, predict important life outcomes such as health and lifespan, educational and occupational attainment, and may promote specific types of task effectiveness, which occurs in part via the processing of information. Reaction time provides an indirect index of the central nervous system’s integrity and processing ability. Material and Methods: The 111 healthy subjects (aged 17 -23 years) interviewed to pre-designed proforma regarding socio-demographic profile, “Glazer-Stress Control Lifestyle” questionnaire for personality trait and reaction time recorded by “Audio-Visual reaction time apparatus”. Statistical analysis was done using IBM SPSS Statistics 20, and the P-value <0.05 was considered significant. Results: The mean age of the study participants was 19.21±1.40 years, with a mean body mass index 20.65±4.32 kg/m2. Male subjects (68%) outnumbered the female participants (43%), and more than half of the subjects doing exercise. The nuclear family was the preferred mode of living belonging to class-II socioeconomic status (86%). The association of personality traits with auditory (low and high frequency) and visual (red and green light) reaction time was non-significant. Type-A personality subjects were maximum (13/20th), followed by Type-AB (6/20th) and least of Type-B personality (1/20th). Conclusion: The personality trait has no impact on auditory and visual reaction time. Though maximum participants belong to type A personality, still ambitious, proactive, and competitive nature does not influence the basic neurophysiological characteristics of the human body. Keywords: Auditory reaction time, Personality trait, Visual reaction time
A Comparative Study of Inflammatory Markers in Patients with Alcoholic-Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease
Authors:   Department of Physiology, Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal, India, Devi Laishram Sureiya , Rajkumari Rolinda , Keithellakpam Susie , Singh Khumukcham Lokeshwar , Akham Ngamba
Published: July 2023

Background: Fatty liver disease has been associated with increased levels of various circulating inflammatory markers. Difference in the level of increased inflammatory markers between patients with AFLD and NAFLD is still unclear. Aim & Objectives: The aim of the present study was to compare the inflammatory markers between patients with alcoholic-fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD) and also to see if any correlation exists between inflammatory markers and liver enzymes. Materials & Methods: This study was conducted on 70 patients with fatty liver disease (35 AFLD and 35 NAFLD) and 35 healthy controls. Venous blood samples were taken and the required blood parameters (total leukocyte count, neutrophil count, lymphocyte count, ESR) and liver function test were determined. Statistical analysis was done by using Student’s t test and Pearson correlation test. Results: The TLC, Neutrophil count, N/L ratio and ESR were significantly higher while the lymphocyte count was significantly lower in patients with fatty liver disease when compared with the controls. The TLC, Neutrophil count, lymphocyte count, Neutrophil-lymphocyte ratio and ESR of patients with AFLD when compared to patients with NAFLD showed no statistically significant differences. There was a significant positive correlation between the value of ALT with TLC in patients with AFLD. Conclusion: Fatty liver disease is associated with increased inflammatory markers. Since increased inflammatory marker in fatty liver disease is indicative of liver injury, due importance should be given to assessment of inflammatory markers in the management of patients with fatty liver disease. Keywords: Fatty liver disease, Total leukocyte count, Neutrophil-lymphocyte ratio, Erythrocyte sedimentation rate, Alanine aminotransferase
Quantification of Sickle Cells in the Peripheral Smear as a Marker of Disease Severity in Sickle Cell Disease in Paediatric Patients
Authors:   Department of Pathology, Osmania Medical College, Hyderabad, Telangana, India, Krishna O H Radhika , Bapanpally Narahari , Fatima Syeda Sumaiya , Padmaja G J Vani
Published: July 2023

Background: Sickle cells are easily identified on the peripheral smear however quantification of sickle cells is seldom done. This study attempts to understand the importance of the sickling index in the reporting of peripheral smear in patients with SCD. Objectives: This study aims to standardize the methodology of quantification of sickle cells on the peripheral smear in paediatric SCD cases and study its relation to the patient characteristics like age and sex, SCD genotype, and treatment. Materials and Methods: A prospective study of 6 months duration was conducted at a tertiary paediatric referral hospital for 6 months. 30 known cases of SCD were admitted during this period. Routinely studied peripheral smears were used in the study. 30 normal smears of age-matched patients were also used for comparative purpose. The sickling index was calculated in both patient and age matched smears. The sickling index was compared in both the groups and also the index in the known SCD cases was studied in relation to the patient's age, SCD genotype, and treatment with blood transfusions or hydroxyurea. Statistical analysis: Descriptive statistics were used in the study Results & Conclusion: Hb SS was the commonest genotype seen in 69% of the cases. Higher sickling index was noted in older children, SS genotype and those on treatment with blood transfusions or Hydroxyurea. Sickling index is an interesting prospect which may provide helpful information regarding cases with increasing hemolysis and vasocclusive crises and also help in follow up of patients on treatment. Keywords: Paediatric, Disease severity, Sickling index
Role of Procalcitonin, C-reactive Protein and Total Leucocyte Count in Suspected Cases of Sepsis
Authors:   Department of Microbiology, Rajarajeswari Medical College & Hospital, Bangalore, Karnataka, India, Archana Banur Raju , Sangeetha Sampath
Published: July 2023

Background: Sepsis is a life-threatening infection, responsible for tremendous morbidity, mortality and healthcare expenditure worldwide. Sepsis is characterized by non-specific symptoms and clinical diagnosis remains difficult. C Reactive protein (CRP) and procalcitonin (PCT) are now days used as surrogate markers of sepsis. Aim: To determine PCT levels in patients with suspected sepsis and its correlation with CRP and total leucocyte count (TLC). Material & Methods: The retrospective study was conducted in tertiary care hospital in India. Adults patients (> 18 years) admitted to Intensive care unit in the hospital during study period, fulfilling the ACCP criterion for the diagnosis of sepsis were included in the study. Data was collected using laboratory software maintaining confidentiality. Results: The study comprised of 190 patients. Patients were divided into four groups based on PCT values and severity of sepsis. Out of 190 patients, PCT was positive in 135 patients. The CRP and TLC levels were distributed into the four PCT groups and their correlation with PCT was studied. For PCT values between 2-10ng/ml, >10ng/ml CRP showed statistically significant correlation with p value <0.05, whereas correlation of TLC with PCT was poor. Conclusion Procalcitonin along with CRP is a better diagnostic tool for sepsis but their correlation in context to TLC was poor. Due to lack of an ideal isolated marker, our study mandates multidisciplinary approach for diagnosis of sepsis. Keywords: Sepsis, Procalcitonin, C reactive protein, Total leucocyte count, Culture
Diagnostic Usefulness of Tru Cut Biopsy at a Tertiary Care Centre
Authors:   P.S. Medical College, Bhaikaka University, Gujarat, India, Kinjal J Sagathia , Faruq I Mulla , Gupta Monica
Published: July 2023

Context: Tru cut biopsy is a minimally invasive procedure because of its low morbidity and low cost and are preferred standards of care to initially access cells from tumours and other lesions for diagnostic assessment. Aims: To evaluate the usefulness of Tru cut biopsy for various tissue diagnosis and to analyse its sensitivity, specificity, positive and negative predictive values and the accuracy. Settings and Design: The present study is a prospective and retrospective observational study for patients undergoing Tru cut or excisional biopsy. Methods and Material: The present study was undertaken at the Department of Histopathology, Central Diagnostic Laboratory, Pramukhswami medical college and Shree Krishna Hospital, Karamsad, Anand for a period from April 2014 to March 2021 that included 497 samples of Tru cut biopsy. Data was retrieved from the Laboratory Information System of the hospital according to the proforma. Statistical analysis: Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Accuracy were found. Results: Of the 497 Tru cut biopsy samples, 105 excision biopsy were received. For the remaining 392 samples, descriptive analysis was done. Mean age of participants in excision biopsy group was 55.2±14.4 years with female participants (n=92, 87.6%) outnumbering males (n=13, 12.4%) and breast being the most common site of biopsy. There were 6 discordant and 99 concordant cases. Sensitivity, Specificity, Positive predictive value, Negative Predictive value and Accuracy were 96.73%, 92.30%, 98.8%, 80% and 96.1% respectively. Conclusions: Thus, for solitary or diffuse tissue lesions, needle biopsies provide precise localization and are much more likely to yield representative samples cost-effectively with a good safety profile. Keywords: Tru cut biopsy, Excision biopsy, Concordance, Discordance, Sensitivity
Integration of Point of Care Ultrasound during Rapid Sequence Intubation in Trauma Resuscitation
Authors:   Department of Emergency Medicine, JSS Medical College and Hospital, Mysuru, 570004, Karnataka, India, Sriharsha J , Adarsh S B , Srinivasarangan Madhu , Omar S Ruben
Published: July 2023

Introduction: Rapid Sequence Intubation (RSI) is the definitive modality of airway management when resuscitating trauma patients in the Emergency Department (ED). This study was done to evaluate the utility of POCUS in RSI and its efficacy in confirming tube placement as compared to conventional methods. Aims & Objectives: Primary Objectives - Time taken for airway evaluation and identifying potentially fatal conditions using POCUS guided Intubation Algorithm (PA) during RSI. Proper placement of the endotracheal tube and confirmation of the same was also assessed and compared with the conventional technique. Methodology: A prospective, randomized single-centred study was conducted in 100 trauma patients requiring emergent airway management, presenting to the ED. The time taken and efficacy of confirmation of tube placement is recorded and compared in two arms. Results: In our study we found the mean procedure time for ETT placement was less in the PA arm compared to the CE arm (45 vs 91.36 seconds, p<0.0001). Oesophageal intubations were detected in the PA arm in 22 seconds vs 114 seconds in CE arm with a p< 0.0001 and the time taken for effective reintubation was 26.67 vs 55 seconds in the PA and CE arm with a p value < 0.007 respectively. Conclusion: POCUS detected oesophageal intubations and confirmed proper tube position in less time when compared to standard techniques such as five-point auscultation and capnography. The results of this study have proved that POCUS is a useful adjunct to the Emergency physician to improve quality of care in trauma patients. Keywords: Point of care ultrasound, Rapid sequence intubation, Trauma, Emergency department, Emergency physician, Endotracheal tube, End tidal carbon dioxide, Ultrasound, Clinical examination
Comparative Study to Determine Antimicrobial Property of Neem Leaves (Azadirachta indica) Extracts Using Various Solvents Obtained from Two Geographical Area
Authors: Megha S , Indradhanush . , Venkatesha D
Published: July 2023

Background: Plants have been the basis for many medicinal compounds that are used in modern-day medicine, screening for medicinal plants for bioactive compounds is a way of identifying and developing new antimicrobials that are less expensive and with improved safety and efficacy. Objective: The objective of this study was to investigate the in vitro antimicrobial activity of Azadirachta indica (neem) using leaf extracts of Ethanol, Petroleum ether, and Ethyl acetate and testing them on E.coli, Klebsiella, S.aureus, MRSA and C.albicans. Materials & Methods: Minimum inhibitory concentration (MIC) was found using the serial dilution method and antimicrobial susceptibility testing (AST) was done using the disc diffusion method. Results: Ethanolic extract showed better results against Klebsiella and S.aureus, Ethyl acetate extract showed better results against E.coli and MRSA, whereas both ethanolic and petroleum ether extract showed activity against C.albicans. 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) assay showed that all the extracts have antioxidant property and variations were noted in the antimicrobial activity on comparing samples taken from different locations. Conclusion: Further studies are needed into the bioactive compounds of neem in order to explore their antimicrobial activity. Keywords: Antimicrobial susceptibility, Azadirachta indica, Ethanol, Ethyl acetate, Disc diffusion, MIC, Petroleum ether
Stroke Volume Variation Directed Versus Conventional Fluid Therapy for Postoperative Acute Kidney Injury after Percutaneous Nephrolithotomy - A Randomized Pilot Study
Authors:   Department of Anesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, 110095, Delhi, India, Mohan Aparna , Gulabani Michell , Tyagi Asha , Jakhar Jubin , Kumar Mahendra
Published: July 2023

Background: Percutaneous nephrolithotomy (PCNL) surgery may be associated with postoperative Acute Kidney Injury (AKI). Commonest intraoperative risk factors for postoperative AKI include hypotension and hypoperfusion. Intravenous fluids are administered during surgery to optimize intravascular status and thus prevent hypotension. Conventionally, intravenous fluids are administered during surgery using pre-calculated volumes based on maintenance needs. Alternatively, goal-directed fluid therapy using Stroke Volume Variation (SVV) can be used to decide the volume of intravenous fluids. We compared early postoperative AKI following intraoperative use of conventional (group C, n=15) versus SVV directed fluid therapy (group S, n = 17) in patients undergoing PCNL surgery. Methods: This double-blinded pilot study involved 32 adult patients, randomised to two groups according to type of intraoperative fluid therapy (group C or group S). Postoperative AKI was diagnosed as per KDIGO guidelines. Results: Incidence of early postoperative AKI was clinically higher for group S, though statistically similar, as compared to group C (47.1% versus 26.7%) (P = 0.234). Postoperative increase in eGFR, and 24-hour urine output were clinically greater for group S (P > 0.05). Volume of intraoperative fluids infused was significantly lesser for group S (P = 0.000). The incidence of hypotension and requirement of vasopressor to maintain blood pressure was clinically lesser, though statistically similar for group S as compared to group C (P = 0.659). Conclusions: There appears to be a clinical trend of greater incidence of AKI with use of SVV guided therapy despite better intraoperative hemodynamic stability and greater improvement in postoperative urine output and eGFR in the first postoperative day. Keywords: Percutaneous nephrolithotomy, Acute kidney injury, Fluid therapy, General anesthesia, Blood pressure
Algorithmic Approach in Cytopathology : A Mode of Training the New Residents
Authors:   Department of Pathology, JJM Medical College, Davangere, Karnataka, India,, Neethu G V , Mounika T S , Rashmi P , Kulkarni Vardendra G
Published: July 2023

Objectives: To compare the traditional teaching with algorithm or flowchart-based teaching method in cytology and to assess the performance of newly joined residents in cytopathology after training them with algorithm-based approach. Materials & Methods: The study included 20 newly joined residents who were divided into two groups I.e., group A and group B and was conducted in two different sets. In set 1, group A residents were trained with the algorithmic approach and group B residents by theoretical method for 10 different cytological cases of thyroid and breast. In set 2, group B residents were taught the algorithmic approach and group A residents by theoretical method for 10 different cytological cases of salivary gland and lymph node. The performance of the residents in both the sets was assessed and pre-test and post-test scores were given based on their ability to diagnose the lesions before and after the training. The feedback on the utility of algorithmic approach in cytopathology was received from the participated residents after the study. Results: The performance of the residents was compared using Mann Whitney U test of post-test scores and was found that in set 1, group A residents’ performance was greater than that of group B residents. Similarly for the set 2, the performance of group B residents was greater than group A residents. The performance of group A residents in set 2 was found to be better than their performance in set 1. Conclusion: The algorithm or flowchart-based teaching is a unique teaching method which enhances case solving skills and effective reasoning in the residents. Keywords: Algorithm based approach, Cytopathology, FNAC, Pathology resident training
Comparison of in-vitro Antibiotic Susceptibility of Ciprofloxacin, Cefotaxime, Ceftazidime and Cefepime against Gram Negative Bacilli Infections - A Study from Tertiary Care Centre
Authors:   Department of Microbiology, Rajarajeswari Medical College and Hospital, Kambipura, Mysore road, Bengaluru, 560074, Karnataka, India, Vishwajith .
Published: July 2023

Introduction: Infections from gram negative bacilli is a challenge for clinicians and laboratory personnel. Treatment of these infections remained as an area of concern. Both fluroquinolones and cephalosporins are most common choice of antibiotics. Despite Cephalosporins, being drug of choice they are expensive also showed many adverse reactions. This study, compares and reevaluates the susceptibility of gram negative bacteria to fluroquinolones (ciprofloxacin) compared to cephalosporins. Method: Various samples(pus, sputum, urine, blood and bodyfluids) were processed according to standard protocols. Antibiotic done susceptibility by using Kirby-baur disc diffusion method. ESBL and Amp C producers were identified using CLSI guidelines. Result: Among 400 isolates, majority were from pus followed by urine, sputum. The most common organism isolated was Klebsiella spp, (33.25%) Escherichia coli (29.5%), Pseudomonas spp (27.25%), Enterobacter spp (6.25%), Citrobacter 5 (1.25%), and Acinetobacter spp (2.5%). Isolates showed 20-80% susceptibility to ciprofloxacin, 30-60% to third and fourth generation cephalosporins. Klebsiella and Pseudomonas showed 64% and 31% susceptibility to ciprofloxacin. Acinetobacter spp showed 30% susceptibility to cefipime and 20% to ciprofloxacin. 34 isolates were ESBL 18 were AmpC producers, of which 15(44%) ESBL and 7(38%) of AmpC producers were ciprofloxacin susceptible. Conclusion: Ciprofloxacin was found to be more effective than the fourth generation cephalosporin (cefepime) against gram negative bacilli. Ciprofloxacin can be considered for treatment as it is more active and cost effective when compared to cephalosporins. Keywords: Fluroquinolones, Cephalosporins, Multidrug resistant, ESBL, Amp C
Lymphocytic Mastitis with Fibroadenoma – A Case Report
Authors:   Department of Pathology, Government Kilpauk Medical College, Chennai, India, Boopathy Teleflo , Kanimozhi S , Ramya V , Piriya P Lakshmi
Published: July 2023

Diabetic mastopathy is an uncommon fibrous tissue lesion of the breast which is usually seen in patients with longstanding type 1 diabetes mellitus. We report a case of diabetic mastopathy in an insulin dependent type 2 diabetes mellitus patient. 47-year-old postmenopausal woman, presented with two lumps, one firm mobile mass and another, a firm-hard mass in the upper inner quadrant of the left breast. Mammography and ultrasonography came out to be BIRADS III lesion. Fine-needle aspiration cytology [FNAC] was performed showing features of fibroadenoma with fibrocystic change. Histopathological examination and Immunohistochemistry studies revealed it to be fibroadenoma along with lymphocytic mastopathy. Keywords: Fibroadenoma, Lymphocytic mastitis, Mimicker, Diabetes
Diagnostic Utility of TTF-1 and P40 Immunohistochemical Markers for Subtyping of Non-Small Cell Lung Carcinoma
Authors:   Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, India, Agrawal Mayank , Goyal Vibhuti , Arya Anjana , Katiyar G D , Mohan Nitesh
Published: July 2023

Background : Lung cancer is the leading cause of cancer-related mortality over worldwide. Although the pathological diagnosis of lung carcinoma is limited as only small specimen available for diagnosis, the availability of targeted therapies has created a need for precise subtyping of non-small cell lung carcinoma. Several recent studies have demonstrated that the use of immunohistochemical markers can be helpful in differentiating squamous cell carcinoma from adenocarcinoma not only on surgically resected specimen but also on small biopsy samples. Material and Methods: A cross-sectional study of one year duration including 50 cases of lung carcinomas on guided biopsies were first reported on Haematoxylin and Eosin sections and later subjected for IHC using relevant markers TTF-1 and p40. Results: In our study IHC with TTF-1 and p40 aided in subtyping of 35 (92.1%) cases of non-small cell lung carcinoma and this diagnostic accuracy was found to be statistically significant with p value <0.001. On statistical analysis, p40 showed 100% sensitivity and 85.7% specificity for squamous differentiation whereas TTF-1 showed sensitivity of 85.7% and specificity of 100% for adenocarcinoma. Out of 50 cases, after IHC, 29 (58%) were diagnosed as squamous cell carcinoma, 18 (36%) as adenocarcinoma, 3 (6%) as non-small cell lung carcinoma. Conclusion: The minimalist IHC based model of p40 and TTF-1 on biopsy samples were effective to correctly subtype most cases of non-small cell lung carcinoma and contribute in sparing material for molecular testing. Keywords: Non-small cell lung carcinoma, immunohistochemistry, squamous cell carcinoma
Role of FNAC in Early Detection and Diagnosis of Lung Lesions with Histo-radiological Correlation and Clinical Insights in a Tertiary Care Centre
Authors:   ESI-PGIMSR, ESIC Medical College & Hospital, Kolkata, India, Banik Trisha , Bhattacharyya Rajarshi , Basu Nandita , Maje Sabya Sachi
Published: July 2023

Background: Carcinoma of lung has now become increasingly frequent during the last 60 years; this increase is seen in males and especially in the females. Cytological evaluation from respiratory tract is the initial investigation along with radiological investigations in patients suspected to have pulmonary diseases. The various cytological samples included transbronchial needle aspiration, guided fine needle aspiration cytology (FNAC) smears and pleural fluid. Present study was undertaken to study the spectrum of lesions diagnosed by cytomorphological analysis of various cytological samples and correlation of the histopathology, cytology and radiology of lung lesions. Materials and Methods: Centrifuged and direct smears from received samples were stained with MGG and PAP stain. Cytohistological correlation was done when biopsy was available with radiological correlation & comparison of topographic display. Results: Present study was carried out during the period of December 2018 to November 2019. During this period, of total 52 cases, 36 (69.2%) were males and 16 (30.8%) were females. Their age ranged from 26 years to 73 years, most patients (53.8) belonged to the age group of 56 – 65 years. The literacy status of the patients was assessed. 2 out of 52 (3.8%) patients were illiterate, 8 out of 52 (15.4%) patients were educated above H.S. level. Adenocarcinoma was seen to be the most prevalent 29 (55.7%) followed by squamous cell carcinoma 12 (23.0%) among the cases studied. Smoking was seen to be the most common addiction i.e. 34 out of 52 cases (65.4%). Among non-smokers 66.7% presented with adenocarcinoma and 16.6% cases with squamous cell carcinoma. The topography of the neoplasms within the lungs was assessed radiologically. On chest X ray (82.6%) lung lesions were identified; (48%) of patients were found to have pleural effusion. By using CT SCAN, all masses were located definitely. Conclusion: A good correlation between cytology and histopathology is revealed in our study. Guided FNAC helps in early detection and diagnosis of lung lesions and facilitates appropriate management of patients. Keywords: Lung, Carcinoma, Detection, Diagnosis, Fine needle aspiration, Cytology, Histopathology, Radiology, Correlation
Factors Influencing Infant Morbidity in the Urban Field Practice Area of a Medical College in Bangalore
Authors:   Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India, Chethana R , Thenambigai R , Anwith H S
Published: July 2023

Background: Infants constitute 2.92% of the total population in India. Health of infants is considered as a sensitive indicator of health status and level of socio-economic development of a country. In India, the infant morbidity and mortality are in decline, but the pace of decline is not sufficient to attain the target goals of National Health Mission. Objective: To assess the factors influencing infant morbidity in the urban field practice area of a medical college in Bangalore. Methods and Material: This was a population based cross sectional study done at an urban poor locality in Bangalore. The study was conducted between April 2018 to September 2019 with a sample size of 300 after obtaining the approval from Institutional ethics committee. Population proportion to size was used to ensure equal representation. Data was collected using pre tested semi structured questionnaire & analysed using open epi like descriptive statistics with univariate & multi variate logistic regression were used. Results: Total of 165(55%) subjects were females, with majority 206(68.7%) Muslim by religion and 161(53.7%) lived in the nuclear family. The prevalence of morbidities among infants was 209(69.7%). The most common infant morbidities reported were 121(40.3%) ARI, 85(28.3%) fever and 45(15%) diarrhea. Infants with perinatal complications, faulty feeding practices like delayed initiation of breast feeding, bottle feeding and immunization had significant association with infant morbidities. Conclusions: To conclude there is a statistically significant association between perinatal complications, bottle feeding & partial immunization with infant morbidity. Keywords: Infant, Immunization, Breast feeding, Morbidity
The Role of Small Dense LDL Cholesterol and Ischemia Modified Albumin in Patients with Hyperlipidemia
Authors:   Department of Internal Diseases, Ufuk University Dr. Ridvan Ege Hospital, Ankara, Turkey, Kalay Sebnem , Candar Tuba ,   Department of Medical Biochemistry, Ufuk University Dr. Ridvan Ege Hospital, Ankara, Turkey
Published: July 2023

Background: The analysis of lipid profiles is a crucial step for cardiovascular risk evaluation, prevention, and therapeutic management. Small dense LDL (sdLDL) is one of the distinct subfractions of LDL and is established to have pro-atherogenic properties. Ischemia-modified albumin (IMA) is an early biomarker arising as a result of oxidative stress and ischemia. Objective: This study aimed to determine serum levels of sdLDL and IMA in patients with hyperlipidemia. Methods: Seventy-four patients with hyperlipidemia and 35 healthy controls were included. sdLDL was determined by the heparin-magnesium precipitation method. IMA was measured quantified manually with the colorimetric method. The patient group was divided into three groups: HyperTG (n=11), HyperLDL (n=38), and combined hyperlipidemia (n=25). Results: Median serum sdLDL and IMA levels were higher in patients with hyperlipidemia than healthy participants (both, p<0.001). Elevated sdLDL levels were observed in the HyperLDL group compared to the HyperTG group and the combined hyperlipidemia group (p<0.001). Cut-off values for the detection of patients with hyperlipidemia were >70 mg/dL for sdLDL and >0.7 AU for IMA, and both parameters showed considerably high levels of sensitivity and specificity. Multiple logistic regression analysis revealed that high sdLDL (p=0.042) and high IMA (p<0.001) were independently associated with hyperlipidemia after adjusting for age and sex. Conclusion: Serum sdLDL and IMA levels could be used as biomarkers for dyslipidemia-associated diseases. Further studies with larger sample size are needed to validate the impact of sdLDL on the pathogenesis of atherogenesis, and its value in the diagnosis and prognosis hyperlipidemia. Keywords: Small dense LDL, Lipoprotein, Ischemia modified albumin, IMA, Atherosclerosis
The Evolution and Environmental Benefits of the All Wales Stroke Meeting (AWSM), a Video Conference Multidisciplinary Meeting for Stroke Physicians
Authors:   Geriatric and Stroke Medicine, Cardiff and Vale University Health Board, Wales, Jelley Benjamin J , Hughes Tom A T , Jones Phil
Published: July 2023

Background: The All Wales Stroke Meeting (AWSM) is a multidisciplinary stroke meeting. Stroke clinicians can present cases to review the neuroradiology and discuss the clinical story to further clinical care, seek consensus views on the management in specific rare or complex cases or provide an educational opportunity for the group centred around a rare case or specific feature of the case. Methods: The meeting was created to pool the knowledge of clinicians working across Wales to benefit patient care throughout the country. Here we describe the development, structure and personnel involved in the meeting. There is a focus on the technological requirements of the meeting and how utilising newly introduced IT solutions further improved the meeting’s accessibility. Results: There is a positive economic and environmental impact of delivering multidisciplinary meetings through videoconference technology. The AWSM is estimated to annually save 97.16 days of clinician time and £13,087.18 in travel expenses. We estimate a reduction of carbon footprint of 15,792.38–19,722.44 kg CO2. Conclusion: The AWSM has been an invaluable component of stroke healthcare in Wales since 2009. We think this is an example of where collaborative working and innovative use of technologies can benefit clinicians, patients, NHS services and the environment. Keywords: Stroke, Stroke evaluation, Video conference, Neuroradiology, Continued professional development, Education, Multidisciplinary meeting
Mental Health Care Experiences in Prehospital and Community Settings: A Scoping Review
Authors: Mahato Preeti , Rolfe Ursula
Published: July 2023

Background Mental health issues are among the top ten causes of disease burden worldwide. Many people waiting for mental health treatment are being resorted to emergency or crisis services and evidence points to low levels of satisfaction with these services. The purpose of this scoping review is therefore to explore the experiences of mental health patients accessing prehospital settings, for example emergency care through ambulance use and emergency medical services, and community care.Data and Methods To identify a knowledge gap and sources of evidence, a scoping review was conducted that examined research about the experiences of people accessing prehospital and community care. A scoping review using a systematic and comprehensive literature search of databases resulted in the inclusion of 10 articles. These articles were synthesised using thematic analysis and resulted in five different themes related to access of community and prehospital based sources.Results The themes identified were: (i) communication; (ii) relationship with patients and family members; (iii) attitude of providers and trust established; (iv) care and support; and (iv) satisfaction. Some themes overlap and were interrelated. For example, attitudes of healthcare staff determined the type of communication with patients: either positive or negative. In turn, communication by healthcare staff also affected the relationship formed with the patients and the trust established with them. In addition, results of quantitative studies were presented separately.Conclusion The review identified that mental health service users accessing prehospital and community-based services are seeking support because of dissatisfaction with immediacy of responses elsewhere. To meet this increased demand, paramedics need further education and support on mental health to ensure the appropriate care of these service users. Keywords prehospital, community mental health services, mental health, paramedics
FERMAN GAZETESİ’NDE 1973 DÜZCE MAHALLİ SEÇİMLERİ
Authors: TEKİN Ahmet Coşkun
Published: July 2023

Bir ülkede siyasetin seyri, yerel siyasetin analizi sonucunda ortaya çıkarılabilir. Çünkü yerel yönetimlerin siyasi yapısı, genel politikanın geçerliliğini ve devamlılığını doğrudan etkileyen belirleyiciler arasındadır. Ayrıca kamu hizmetlerinin vatandaşa en yakın şekilde sunulması, yönetimde faaliyet ve verimliliğin sağlanması noktasında yerel yönetimler merkezi bir konuma sahiptir. Yerel yönetimler, demokrasinin gelişmesi açısında da büyük öneme sahip olan mahalli seçimler neticesinde belirlenmektedir. Yerel siyaset çalışmalarında, mahalli seçimler ülkenin genel siyasi sürecini anlamak açısından ayrı bir önem taşımaktadır. Ancak siyasi tarih çalışmaları ağırlıklı olarak genel seçimler üzerinde yoğunlaşmıştır. Bu bağlamda Türkiye’de hükümet krizinin yaşandığı bir dönemde yapılan 9 Aralık 1973 mahalli seçimleri Düzce özelinde incelenmiştir. Öte yandan Düzce’deki mahalli seçimlere ilişkin az sayıda çalışmanın olduğu tespit edilmiştir. Bu doğrultuda literatürdeki mevcut boşluğu doldurmak amacıyla hareket edilmiştir. Yerel tarih çalışmaları için büyük önem taşıyan yerel basın kaynaklarına ulaşılmaya çalışılmıştır. Ancak çalışmaya konu olan 9 Aralık 1973 mahalli seçimleri zamanında Düzce’de yalnızca Ferman Gazetesi yayınlanmaktadır. Bu nedenle de Ferman Gazetesi çalışmanın en önemli kaynağı haline gelmiştir. Neticesinde başta Ferman Gazetesi olmak üzere, ulusal basın, telif ve tetkik eserler incelenerek, Düzce’de 9 Aralık 1973 tarihinde yapılan mahalli seçimler incelenmiştir. Mahalli seçimler öncesi yapılan çalışmalar, seçim sonuçları, bu süreçte yaşanan olaylar ve Düzce halkının siyasi eğilimleri tespit edilmeye çalışılmıştır.
Educação Física, esporte e lazer no Brasil: percurso histórico no subcampo político/burocrático e características atuais
Authors: Oliveira Christian , Oliveira Eduardo Henrique de , Nunomura Myrian
Published: July 2023

Este artigo visa analisar o contexto histórico das políticas públicas relacionadas ao esporte, lazer e Educação Física, adentrando no subcampo político/burocrático para compreender como o clientelismo e o populismo afetam as decisões legais da área de Educação Física até os dias atuais. A metodologia utilizada foi a revisão bibliográfica de estudos que analisaram o processo histórico do subcampo político/burocrático do esporte, lazer, Educação Física e a análise de um trabalho de mestrado relativo ao tema.Os resultados mostram como o Estado foi moldando a área esportiva brasileira e o estudo traz em sua conclusão que os agentes burocratas do Estado ditaram (e ainda ditam) as decisões no campo esportivo brasileiro, inclusive educacional. No entanto, ainda existe esperança de mudanças conforme é possível constatar através de estudos analisados que mostram experiências no Chile, na Espanha e no Brasil que levaram em consideração discussões técnicas e a participação da população na elaboração das políticas públicas para a área esportiva, do lazer e da Educação Física.
A prática do calejamento na perspectiva de praticantes de karatê
Authors: César Mateus de Castro , Oliveira Marcelo Alberto de , Telles Thabata Castelo Branco , Nagamine Kazuo Kawano , Lage Victor
Published: July 2023

O calejamento é um método de treino inserido dentro do Hojo Undo, ou exercícios complementares. O objetivo deste estudo foi buscar compreender o fenômeno da prática do treino de calejamento no karatê a partir de faixas pretas (ou Senseis). A pesquisa foi qualitativa e de abordagem transversal, os dados foram coletados por entrevista semiestruturada, transcritas na íntegra e analisadas com base na fenomenologia existencial. Foram construídas três categorias: i) Aperfeiçoar-se para o combate; ii) Calejamento para a saúde; iii) Calejamento como parte do treino e da vida. Os relatos dos voluntários mostraram que o calejamento é visto como importante para a saúde e para o combate, algo intrínseco ao karatê, e que pode ser transferido para outras experiências, fora do treinamento no dojo.
Análise longitudinal do nível de atividade física de pacientes em hemodiálise
Authors: Pedrotti Anthony Matteo Brezolin , Dutra Thais Severo , Vieira Cleide Dejaira Martins , Krug Moane Marchesan , Krug Marilia de Rosso , Krug Rodrigo de Rosso , Kupske Juliedy Waldow
Published: July 2023

A doença renal crônica (DRC) se caracteriza pela perda da capacidade de filtração do sangue e de manter a homeostase devido à perda progressiva da função dos néfrons. A atividade física é importante para minimizaras consequências associadas a patologia e ao tratamento. Desta forma, o presente estudo teve como objetivo verificar os fatores associados a permanecer ativo fisicamente no período de 2018 a 2020 de pacientes em hemodiálise (HD). Tratou-se de um estudo longitudinal retrospectivo com 91pacientes em hemodiálise na Clínica Renal do Hospital São Vicente de Paulo do município de Cruz Alta/RS. Foram analisados: o nível de atividade física (utilizando pedômetro), características sociodemográficas e de saúde (através de um questionário fechado), aptidão cardiorrespiratória, força de preensão manual, resistência muscular localizada de membros inferiores, independência funcional, depressão e o nível de atividade física (NAF). Para verificar os fatores associados ao nível de atividade física foi utilizado Teste Exato de Fisher com p≤0,05. Como resultado desse estudo, verificou-se que indivíduos com maior grau de escolaridade, sem depressão, independentes nas atividades de vida diária (AVDs) e que não apresentam fragilidade possuíram maior NAF. Concluiu-se que o NAF se relaciona diretamente com os fatores citados; além disso, ressaltou a importância da atividade física e de um programa de treinamento físico para doentes renais visando a promoção da saúde e a disposição da equipe profissional de divulgá-lo para que os pacientes se sintam motivados.
La postura del profesorado de Educación Física frente a la diversidad de género (Trans-Queer)
Authors: Guavita-Ocampo Carlos Orlando
Published: July 2023

La Educación Física sustenta muchos de sus contenidos en las ciencias, reconociendo las diferencias y semejanzas entre hombres y mujeres. La teoría del género (trans-queer), se le contrapone y enfatiza la igualdad en todos los sentidos pretendiendo eliminar el concepto binario. La UNESCO insta a que la perspectiva de género e igualdad de género sean ejes transversales en la escuela, en la educación física y en la formación de docentes. El presente artículo tiene por objeto realizar una revisión de la literatura con el objetivo de conocer la postura del profesorado de educación física frente a la diversidad de género, específicamente lo trans-queer. La revisión ha sido llevada a cabo en diferentes bases de datos y fuentes de indización: Dialnet, Scopus, EBSCOhost,Scielo, ProQuest y TESEO. Se halló un sólo resultado que aborda el tema, en el que se evidencia la falta de claridad del término género y la necesidad de formar y capacitar a los profesores. La limitada y reducida literatura demuestra que esta temática está pendiente de investigación.