bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy vulnerability of residential consumers
Authors: Mihăilescu Adina
Published: January 2023

When countries are forced to use a poverty line assume that such a decision combines the lack of resources of individuals and the financial capacity of the state to grant aid. It is not claimed that such a support is addressed to all the poor, nor that he pulls all out of poverty. There is no sufficiently grounded methodology to set the threshold of "the poorest of the poor." In addition to raising prices, the European directives included some social policy recommendations to protect vulnerable household consumers, the poorest of the poor, by asking Member States to define this social category and to establish clearly the laws national social support. Romania uses a procedural methodology established for the provision of heating aid by a policy decision: a grid based on a poverty line set by the government (615 lei / person in 2013) and a procedure for testing the costs.
The deconstruction of a cathedral: on recent debate about Nuernberg’s St Lorenz church
Authors: Kleinhempel Ullrich Relebogile
Published: January 2023

This presentation is about the background and implications of a recent phenomenon, especially in German Protestantism, of ‘partial profanation of churches’. I propose that it reflects an ‘in-depth’ secularisation in Protestantism, leading to a redistribution of roles of custodianship of the spiritual cultural heritage in society.
A detection method of urban underground geological anomalies in the United Kingdom based on feature fusion
Authors: Liu Xuemei
Published: January 2023

Engineering geological conditions include the nature of rock and soil, geological structure, landform, hydrogeological conditions, and adverse geological processes. Among them, faults, fissures, folds, karst, and lithology changes seriously affect the safety and construction cost of mountain tunnels, hydraulic tunnels, and other projects. For this reason, a new method based on feature fusion is proposed to detect the geological anomalies in London and Sheffield. It established a 3D raster data model oriented to attribute information modeling and visualization of urban underground space to obtain geological data. Based on this acquired data, authors adopted the feature-level fusion extraction method based on the multi-attribute geological abnormal body to extract, fuse, fill and surface the multi-attribute data of underground space geological data. Smooth processing can realize the detection of abnormal geological bodies in underground space. It has been proved that this method can be used in geological data display, feature extraction, feature fusion, and abnormal physical examination.
Dominio léxico y relaciones semánticas: validación de vocabulario para ítems de razonamiento
Authors: Calvo Díaz Karen , Martínez Alpízar Diana , Pérez Rojas Nelson , Rojas Rojas Guaner , Solano Moraga Sigrid
Published: January 2023

​​​El objetivo de esta investigación es generar evidencias sobre el dominio léxico en el contexto de relaciones semánticas de sinonimia, antonimia y temática. Basado en un estudio de enfoque mixto, se construyeron y validaron, mediante juicio de personas expertas, los ítems del instrumento. Posteriormente, este se aplicó a 3864 personas aspirantes que realizaron la Prueba de Aptitud Académica (PAA) para el ingreso a la Universidad de Costa Rica en el 2021 y cuyas edades comprenden de los 17 a los 21 años. Recabados los datos, se analizaron las cargas factoriales, la dificultad, la discriminación, la curva de información y los distractores de cada ítem. Los hallazgos de la investigación señalan que efectivamente el léxico se puede medir en tres categorías que representan relaciones amplias y comunes en el contexto de la lectura. La habilidad para identificar este tipo de relaciones incide en el desempeño de las personas evaluadas al resolver ítems de las categorías de parafrasear, oponer y reducir, propias de la PAA. La resolución de estos ítems depende en cierta medida del nivel léxico. Por lo tanto, es recomendable comprender el dominio léxico ligado a estas relaciones semánticas en sí, libres del contexto, para tener certeza de que no se afecta la medición de las habilidades generales de razonamiento o para encontrar los mecanismos que eviten factores causantes de varianza irrelevante al constructo.
Studies Regarding the Attack of Some Invasive Species on Trees and Shrubs from Landscape Arrangements in Cluj-Napoca Municipality
Authors: ILEA Iuliu , HULUJAN Ionuţ Bogdan , FLORIAN Teodora , OLTEAN Ion
Published: January 2023

Species of ornamental trees and shrubs are frequently attacked by invasive species recently introduced in Romania. Of these, the species Metcalfa pruinosa Say. (Hemiptera: Flatidae), native to the United States, is widespread. It is a polyphagous species. The attack is manifested in the leaves causing damage to the aesthetic value of the attacked plants. During the 2020-2021, the species of trees and shrubs attacked by Metcalfa pruinosa Say were identified and the frequency and intensity of the attack was determined. The studies were carried out in the spaces see and on the street alignments in Cluj-Napoca. Observations were made on all plant species to determine the frequency of the attacked leaves. The species we reported on 47 species that systematically belong to 23 families. Metcalfa pruinosa Say. was reported on most plants, and the most attacked plants were: Ligustrum vulgare L., Fraxinus excelsior L., Robinia pseudoacacia L., Aesculus hippocastanum L., Acer platanoides L., Buxus sempervirens L., Thuja accidentalis L.
Ecological, Agronomic and Anthropogenic Characterization of the Habitat 62C0* Ponto-Sarmatian Steppes in the North of Dobrogea (Romania)
Authors: MARUȘCA Teodor , PĂCURAR Florin , MEMEDEMIN Daniyar , OPREA Adrian , VAIDA Ioana , TAULESCU Elena , NICOLA Nicoleta
Published: January 2023

Natural habitat of Community interest 62C0* Ponto-Sarmatian steppes is very important at European level due to its high biodiversity. The aim of the paper is to study the grassland systems within the habitat 62C0* Sarmatic pontoon steps and to characterize them from an ecological and agronomic point of view. The floristic studies were carried out on the permanent grasslands of the biogeographical region ROSCI 0201 North Dobrogean Plateau, which for the most part belong to the Natural Habitat of Community Interest 62C0 * Sarmatian pontoon steps. Following the classifications (cluster) resulted 4 groups such as: type Cynodon dactylon, type Bothriochloa ischaemum - Festuca valesiaca, type Festuca valesiaca and type Festuca valesiaca - Stipa capillata.
Monitoring of Diurnal Pasture Lepidopterans Located in Bilbor Commune, Harghita County
Authors: HÂNGAN Ilie Daniel , HULUJAN Ionuţ-Bogdan , FLORIAN Teodora , OLTEAN Ion
Published: January 2023

During the monitoring period of the lepidopteran entomofauna we collected 29 species, which systematically belong to the following families: 7 from the Lycaenidae, 17 from the Nymphalidae and 5 from the Pieridae. The species with the highest abundance are: Maniola jurtina L., Boloria selene Denis and Schiffermüller, Argynnis paphia L., Pieris mannii Mayer, Pseudophilotes schiffermuelleri Hemming and Coenonympha pamphilus L. The relatively good state of biodiversity conservation in the area is confirmed by the fact that in Pseudophilotes schiffermuelleri Hemming, Argynnis paphia L. and Coenonympha pamphilus L. which are potentially threatened taxa in Romania, in this area the population is well represented. From the Nymphalidae family, Boloria selene Denis and Schiffermüller is one of the most vulnerable taxa in the country, in the Bilbor area it is a well-represented species. Colias myrmidone Esper, which is in decline in Europe and is on the verge of extinction, still has a very small population only in the Bilbor and Gheorgheni area at an altitude of about 1000 m. Lycaena dispar rutile Werneburg, Lycaena thersamon Esper and Colias australis Verity considered considered vulnerable taxa in the country, in the Bilbor area still have a very small population.
Ecological and Experimental Public Spaces of the Future: The SPIRE research project
Authors: PLEȘA Anca , VIDICAN Roxana , MIHĂIESCU Tania , MĂLINAȘ Anamaria , POP Bianca , PAPINA Codruț
Published: January 2023

Most of the ecological experiments conducted so far resulted in limited dissemination and replication of the research results, zero involvement of the citizen in the ecological design, and no educational value of the experiment. Considering these concerns, the aim of our study is to present a novel framework for co-designing urban landscapes polluted with heavy metals (HM). The designed experiments are located inside the city of Baia Mare (Romania), and include 5 brownfields, characterized by different levels of soil HM contamination. At the core of the urban design process stands an interdisciplinary approach which partners scientists from multiple fields related to life sciences (ecologists, agronomists, microbiologists, soil scientists) with urban designers, IT specialists, local municipalities and citizens. The revolutionary approach applied to the ecological and experimental public spaces from Baia Mare city consisted in a co-design process which combined the phytoremediation with future valorization of the biomass produced (via a local environmental bonification system), and the educational value of the ecological experiment.
Phenotypic Characterization of Sheep Population in Aures, Hodna and Ziban Zones, Algeria
Authors: MOHAMMEDI Kenza , LAIADI Ziane , TITAOUINE Mohamed
Published: January 2023

This study aims to characterize the sheep population phenotypically in three zones in northeastern Algeria: Aures, Hodna and Ziban. A total of 160 female animals of 2 to 4 years of age were subject to 4 quantitative linear body measurements (body length BL, withers height WH, tail length TL and wool weight WW) and 9 qualitative physical traits (head length HL, ear orientation EO, horn presence H, neck length NL, wool extent WE, tail texture TT, eyes shape ES, head color HC and wool color WC). The results indicate that the sheep population in these areas belonged to the Ouled Djellel sheep breed with some abnormal phenotypes, which refers to uncontrolled crossbreeding. Body measurements show moderate variation coefficient values, with the highest value reported for WW (7.37%). However, despite the weak correlations found in this study, clear ones were revealed between WH and TL (0.30) and BL and WW (0.26). The Hierarchical Agglomerative Clustering analysis sub-divided the sheep population into three classes, in which an overlap, according to body measurements, was remarked between Hodna and Ziban and between Aures and Ziban but not between Aures and Hodna.
Potentials of Exogenous Melatonin Administration on Growth and Performance of West African Dwarf bucks
Authors: WILLIAMS Tolulope Julius , YUSUF Olasupo Idris , JAMES Ikechukwu Joseph , ISAH Olubukonla Ajike , OKWELUM Ngozi , OKE Oyegunle Emmanuel , DARAMOLA James Olamitibo
Published: January 2023

The effect of exogenous melatonin (EM) on growth, physiological and haematological parameters of West African dwarf (WAD) bucks was evaluated in the experiment. Intact selected sixteen WAD bucks were distributed into 4 treatment groups of 0, 3, 6 and 9 mg EM. Bucks were orally dozed with EM 3 times per week for 16 weeks. Blood samples were collected at 0th week, 8th week and 16th week of experiment for evaluation of haematological parameters. Analysis of Variance was carried out and significant means were separated using SAS. Results showed bucks given 6 mg EM had higher average daily weight gain of 31.3 g compared with others. Feed and water intake were similar across treatments, but feed conversion ratio was significantly lower in bucks given 6 mg EM. Values recorded in the morning of data collection days showed pulse and respiratory rates to be significantly different, with bucks given 6 mg of EM having lowest values.  6 mg group was also different for packed cell volume (32.57%), haemoglobin (10.72g/dl), red blood cell (11.38 1012 /L), neutrophil (35.50%) and lymphocyte (64.30%). Therefore, dose of 6 mg/animal EM influences growth performance, physiological and haematological parameters of WAD bucks positively and is therefore recommended for WAD bucks for optimal performance.
The Study of Nutraceutical Effects of the Whey Zonar and of Lyophilized Concentrate Obtained from Zonar in C26 Colon Carcinoma Grafted Subcutaneously in Balb/C Mice
Authors: DREANCA Alexandra , SARPATAKI Orsolya , POPESCU Andra , TOMA Alexandra Gabriela , MOLDOVAN Marioara , PRODAN Doina , NAGY Andras , SEVASTRE Bogdan , MARCUS Ioan
Published: January 2023

This paper investigates the nutraceutical properties of the whey Zonar and of lyophilized concentrate obtained from Zonar in C26 tumor bearing BALB/C mice. The experiment was conducted on 30 female mice, divided into 6 groups (n=5). Groups 4, 5 and 6 were injected subcutaneously with 1*106 C26 carcinoma cells. Groups 2,3, 5 and 6 received a diet based on Zonar products. The evolution of body mass and tumor volume was assessed weekly. At the end of the 21-day study, blood samples for hematological, biochemical and oxidative stress analysis were drawn and tumor tissue samples were collected for histopathological examination. After 21 days, a significant in vivo reduction of the tumor volume in groups 5 and 6 was recorded. The biochemical analysis showed Zonar's protective muscular effects, due to decreases of the creatine-kinase level in groups 5 and 6. Further investigations revealed an increased level of glutathione in all groups which received Zonar, eliciting its antioxidant potential. Histopathologically, increased necrotic areas highlighted the anti-tumoral effect of the synergism between Zonar and the lyophilized concentrate. The results of this experiment implies that whey Zonar & the lyophilized whey prevents tumor cachexia, as well as other cancer associated adverse effects.
Evolution of some Haematological Parameters during the Process of Spontaneous Moult in Hy-Line Brown Hens
Authors: GENES Cristiana , GURĂU Maria Rodica , CREȚU Dana Mihaela , DOJANĂ Nicolae
Published: January 2023

The purpose of this paper was to find out the evolution of the main haematological parameters in Hy-Line var. Brown hens raised in industrial system, during a natural moult process. The process of spontaneous moult started towards the end of the laying cycle (63 weeks of age) and lasted about seven weeks. Two groups were set up for monitoring: a control group of hens that did not show signs of moult and an experimental group of spontaneously moulted hens. Blood was sampled weekly, from the moment of observing the onset of moult, to the complete re-dressing with feathers, respectively a period of seven weeks. Haematological parameters showed a specific dynamic during this process. This dynamic is dominated by a decrease in red blood cells, packed cell volume and haemoglobin (P<0.05), on the one hand, and a decrease in the white cell number and in the percentage of lymphocytes (P<0.05) on the other. These changes take place predominantly in the first three weeks of the moult period. In the next period of the process, the modified haematological parameters return to the values comparable to those of the control (P > 0.05).
Simple Continuous Versus Cushing Suture for Jejunal end-to-end Anastomosis in the Dogs: a Comparative Study
Authors: IGNA Cornel , DASCĂLU Roxana , ZAHA Cristian , SICOE Bogdan , BRUDIU Ileana , SCHUSZLER Larisa
Published: January 2023

For the anastomosis of canine jejunum, single-layer appositional closures are preferred to inverting or everting patterns, whereas inverted or everted closures require second-intention healing and increase the risk of luminal stenosis or anastomosis site leakage. Nevertheless, following simple continuous sutures, the dehiscence rates remain high. Our objectives were to compare the appositional simple continuous sutures with the inverting Cushing sutures, investigating: suture resistance, bursting pressure, lumen diameters on canine cadavers, as well as survival and complication rates in canine clinical cases. Our ex vivo experimental results indicate that: the efforts to which sutures are submitted to in anastomoses are minimal for the Cushing suture, the differences between the bursting pressure measured for the two types of sutures indicate the superiority of the Cushing suture, the difference in size of the anastomoses’ lumen between the two sutures are minimal. The retrospective analysis of intestinal end-to-end anastomoses (123 - simple continuous sutures and 388 - Cushing sutures) revealed 7 anastomotic complications, all following simple continuous anastomoses. Our results reveal the superiority of the Cushing suture, compared to simple continuous suture, which emphasizes the fact that the Cushing suture should be considered a good option when performing end-to-end jejunal anastomoses in canine patient.
Carici arctisibiricae–Hylocomietea alaskani – a new class of zonal tundra vegetation
Authors:   Komarov Botanical Institute RAS, Matveyeva Nadezhda V. , Lavrinenko Olga V. ,   Komarov Botanical Institute RAS,   Nenetskii State Nature Reserve
Published: January 2023

A new class, Carici arctisibiricae–Hylocomietea alaskani class nov. is described for vegetation of the tundra zone on a circumpolar scale. This higher unit in the system of Braun-Blanquet floristic (= floristic-sociological) classification unites the zonal vegetation in the intermediate habitats with respect to the substrate moisture, pH and texture, the snow cover thickness and duration, the depth of seasonal frozen ground thawing, and the growing season length on the interfluves (upland surfaces) within the tundra zone (CAVM subzones B, C, D, E = arctic, typical and southern tundra subzones in Russian zonal subdivision). Communities of the class are distributed on plains north of the tree line on two continents (Eurasia and North America), as well as on the archipelagos (Spitsbergen, Novaya Zemlya, New Siberian Islands, the Canadian Arctic Archipelago) and the large and small islands (Kolguev, Dolgy, Vaygach, Bely, Bolshoy Begichev, Ayon, Wrangel, Greenland) in the Arctic Ocean. The class comprises 3 new orders and 6 alliances. The diagnoses of higher rank units are given. Difficulties in describing and classifying zonal communities due to the specificity of their species composition and horizontal and vertical structure are discussed. The criteria distinguishing the new class from the known ones in the Europe and Asia mountains, in which zonal tundra communities are being placed until now, are presented.
Análisis de la Representatividad de las Mujeres en el Arte: Producción y Gestión. El Caso de los Museos y Centros de Arte en Alicante, 2011-2021
Authors: Guirao Cristina , Mira Enric
Published: January 2023

A pesar de que en los últimos tiempos han tenido lugar avances considerables en la paridad y en la representación de las mujeres en las industrias culturales, todavía existen sectores de este ámbito, en concreto el sector artístico, donde persiste la subrepresentación de los bienes producidos por mujeres. El objetivo principal de este artículo es investigar la persistencia de este sesgo en los principales espacios de legitimación de los bienes artísticos como son los museos, instituciones y centros culturales que programan arte contemporáneo en los últimos diez años. Para ello, se ha procedido metodológicamente a realizar un análisis cuantitativo sobre la tasa de mujeres que exponen su obra artística, la tasa de mujeres comisarias y la de puestos de dirección y gestión, tomando como caso de estudio las principales instituciones artísticas de la ciudad de Alicante desde 2011 a 2021. Como resultado del presente trabajo, cabe mencionar, una ligera mejora hacia la presencia equilibrada de mujeres y hombres en las exposiciones de arte analizadas en el periodo estudiado.
Advanced predator-prey Modelling for Work and Employment Scenarios: Brazil in Focus
Authors: Serpa Nilo , Steiner José Roberto Costa
Published: January 2023

The broad application range of the predator-prey modelling enabled the conjecture that it may be applied to represent the dynamics of the work-employment system in Brazil. The simulations performed showed more chaotic dynamics at the beginning of the time series, tending to less perturbed states, as time goes by, due to public policies and hidden intrinsic system features. Basic Lotka-Volterra approach was revised and adapted to the reality of the study. The aim of this article is to show that the work-employment system in Brazil admits a predator-prey modelling, providing decision makers with generalized theoretical elements that allow to a more accurate and deterministic understanding of the relations between employer and employee in that country.

Keywords: Predator-prey model; Chaotic dynamics; Work-employment
system; Perturbed states; Evolution.

=====================================================================

O amplo campo de aplicação da modelagem predador-presa permitiu conjecturar que esta pode ser usada para representar a dinâmica do trabalho-emprego no Brasil. As simulações realizadas exibiram uma dinâmica mais caótica no início da série temporal, tendendo a estados menos perturbados, com o passar do tempo, devido às políticas públicas e às características intrínsecas do sistema. A abordagem básica de Lotka-Volterra foi revisada e adaptada à realidade do estudo. O objetivo deste artigo é mostrar que o trabalho-emprego no Brasil admite uma modelagem predador-presa, fornecendo aos tomadores de decisão elementos teóricos generalizados que permitem uma compreensão mais precisa e determinista das relações entre empregador e empregado no país.

Palavras-chave: Modelo predador-presa; dinâmica caótica; trabalho-emprego;
estados perturbados; evolução
Formas de tratamiento de segunda persona singular en el español de Medellín, Colombia: producción y actitudes lingüísticas
Authors:   Minnesota State University-Mankato, Denbaum-Restrepo Nofiya , Restrepo-Ramos Falcon
Published: January 2023

En el español de Medellín, Colombia, existe un sistema tripartito de formas de tratamiento de segunda persona: tú, usted, y vos. Estudios anteriores se han enfocado en el uso de formas de tratamiento de segunda persona en Colombia. Sin embargo, el estudio de actitudes implícitas hacia formas de tratamiento en estos sistemas tripartitos ha recibido poca atención. Este trabajo expande los resultados de estudios previos al usar una tarea de compleción del discurso y una técnica de máscaras emparejadas para comparar el uso y las actitudes lingüísticas hacia las formas de tratamiento de segunda persona en Medellín. Los resultados sugieren que los jóvenes favorecen vos, lo cual, junto con los resultados de las actitudes lingüísticas, muestran un cambio en el sistema de formas de tratamiento y un avance en ciertos grupos sociales. Este estudio no sólo demuestra el beneficio de usar métodos combinados para examinar datos sociolingüísticos, pero también confirma la interacción entre el uso y las actitudes lingüísticas.
Challenges and prospects of neurosurgical services in Bauchi, north-east Nigeria
Authors: Ogunleye Olabisi O. , Alfin Jeneral D. , Ogunleye Oluchukwu B. , Jauro Abdulkadir A.
Published: January 2023

Background: Nigeria has few neurosurgeons and her population has little or no access to neurosurgical services. Neurosurgical care has become the vital components of tertiary health care delivery. Within the last three (3), we have pioneered the neurosurgical services in our centre though with lack of materials and manpower. Our objectives was to recount our previous experiences and challenges.
Methods: A retrospective observational study of all in-patient neurosurgical cases managed from September 2018 to September 2021. Descriptive data analysis was used for the data obtained.
Results: A total of 1714 patients were managed with male:female ratio of 2.5 to 1.74% were age 40 years and below. Trauma is the leading cause of admission accounted for 83% while vascular lesions accounted for the least (0.06%).
Conclusions: Pioneering a neurosurgical service is a herculean task, it takes a huge sacrifice. There is an urgent need to deploy materials and manpower to sustain and improve these services. Collaborative effort among public, private and donor agencies will brighten our future neurosurgical practice.
Retrospective evaluation of outcome of percutaneous nephrolithotomy at a tertiary care center in eastern Nepal
Authors: Karkee Rikesh Jung , Chaudhary Samir , Kafle Awaj , Maharjan Shailesh , Haque Raque Inzmamul , Devkota Karun , Prasad Sarraf Deependra
Published: January 2023

Background: Percutaneous nephrolithotomy (PCNL) is considered as the standard treatment for renal tract stones. It is a successful procedure with low complication rate. Objective was to evaluate the outcome measures in large renal stone including stone free rates and complications in patients underwent PCNL.
Methods: A retrospective study was conducted in 120 patients who underwent PCNL for renal stone size 2 to 2.5 cm, between 2019 and 2021. Ethical clearance was obtained from the institutional review committee (IRC/2430/022). The data were collected from the records available in the medical record section. The data were analyzed for patient demographics, investigations, site of puncture, stone-free rates (SFRs), type of nephroscope, use of nephrostomy tube, blood transfusion, hospital stay and complications.
Results: Out of 120 cases, 64 (53.3%) were males and 67 (55.8%) presented with renal stone on the right kidney. Renal stone was in pelvis in 47 (39.2%) patients. In 47 (39.2%) cases puncture was made in the lower pole. Stone free clearance rate was 92.5% and 4.2% patients required blood transfusion. There was no statistical difference in intraoperative complication like bleeding in supracostal puncture group and subcostal puncture group [25% vs 13.2%; p=0.13] and in tube group and tubeless group (43.9% vs 3.8%; p<0.001). There was significant difference in length of hospital stay and duration of Foley’s catheter removal between supracostal group vs subcostal group and tube group vs tubeless group (p<0.05). Postoperative complications like fever were seen in 14 (23.0%) and four (6.8%) patients with standard nephroscope group and mini nephroscope group respectively and it was statistically significant (p<0.05).
Conclusions: Mini and tubeless PCNL had a good success rate with minimal complication. The total stone clearance rate in our study was 92.5%.
Epidemiology of hand surgical cases operated in tertiary referral centers in Dhaka
Authors: Akter Sumi Sharmin , Mohammad Manzur Raquib , Debnath Shuva , Sharkhar Kar Subrata , Reza Faruquee Sajedur , Kalam Abul , Rajaratnam Vaikunthan
Published: January 2023

Background: Hand surgical cases in Bangladesh are managed both by orthopedic and plastic surgeons. There are very limited number of hand surgeons available in the country. Tertiary referral centers especially in the city of Dhaka cater for most of the hand surgery patients treated in the country. Objective were to understand the needs of the community for hand surgery.
Methods: This rretrospective study spanning July, 2017 to June, 2018- used data from the operation register of the Burn and Plastic surgery department, DMCH (Dhaka medical college and hospital) and hand surgery department, NITOR (National institute of traumatology and orthopedics).
Results: Of the sample of 2000 cases, 1000 data were collected from Dhaka medical college hospital, of which 670 (67%) were routine cases and 330 (33%) were emergency department cases. Of the 1000 cases from NITOR including 317(31.7%) routine cases and 683 (68.3%) cases from emergency department. Demography of the population 76% male and 24% female cases from DMCH; and 80% male and 20% female from NITOR. In Burn and Plastic surgery department of DMCH the percentage of diagnosed cases-acute burn (55%), acute trauma (9.5%), PBSC (21.5%), post trauma deformity (9%), and congenital cases (5%) and in NITOR- acute burn (1%), acute trauma (68%), PBSC (9%), post trauma deformity (20%), and congenital cases (2%) respectively.
Conclusions: This study shows the needs of the community for hand surgery and the portfolio of cases performed would be guide for an evidence-based approach to the development of services and training of hand surgeon in Bangladesh.
Thickness of subcutaneous fat in the right iliac fossa as a predictor of surgical site infection in open appendicectomy- a single centre prospective study
Authors: L. Lakshmi Kandhan , Karthick P. , Arsath Mohamed
Published: January 2023

Background: Acute appendicitis is the acute inflammation of appendix accounting to 7-10% of acute abdomen cases. The complications vary from surgical site infection to enterocutaneous fistula and stump appendicitis. The surgical site infections after appendicectomy are postoperative nosocomial infections affecting the incision site, deeper tissues and organs at the operative site within 30 days of surgery. The study was aimed at predicting subcutaneous fat thickness causing surgical site infection in open appendicectomy wounds.
Methods: This prospective study was conducted in Trichy SRM Medical College Hospital and Research Centre, Tamil Nadu from January to June 2021 in 82 patients. Patients who underwent open appendicectomy for uncomplicated acute appendicitis were included. Patients underwent preoperative Ultrasound abdomen to measure the subcutaneous fat thickness in right iliac fossa and was correlated with post operative surgical site infection for 1 month. The subcutaneous fat thickness was divided into three groups; I- 5.5 mm and below, II- 5.5 to 7.5 mm and III- more than 7.5 mm.
Results: The results show that there was an increased association of surgical site infection in patients with increased subcutaneous fat thickness at incision site with mean of 6.25 and SD of 1.49.
Conclusions: The study showed that subcutaneous fat thickness is a predictor for development of surgical site infection in open appendicectomy wounds. The subcutaneous fat thickness association in causing surgical site infection in open appendicectomy wounds is of linear association.
Comparative study of complications using electrocautery versus conventional scissors for raising flap in modified radical mastectomy
Authors: Aheer Ruby , Singh Bhangu Gurpreet
Published: January 2023

Background: In the current scenario of rapid advancement in the field of surgery, the intraoperative and post-operative complications have reduced drastically by the use of effective surgical techniques in the modified radical mastectomy. Previously scissors were used for raising flap, today electrocautery is used by most of the surgeons for raising flap in modified radical mastectomy. Now electrocautery and conventional scissors are the two most widely used technique for raising flaps in modified radical mastectomy.
Methods: The study was conducted on 60 patients admitted in surgical wards of Sri Guru Ram Das institute of medical sciences and research with carcinoma breast. The study will be conducted to identify the complications using electrocautery versus conventional scissors for raising flap in modified radical mastectomy. The study participants were divided into two groups.
Results: Seroma and flap necrosis consequences were comparable in both research groups; however, electrocautery surgery took less time than scalpel dissection. Seroma development after four weeks of surgery and flap infection complications were comparable.
Conclusions: Dissection in MRM by scissors took longer operative period and drain output was more and the patient had longer hospital stay.
Analysis of the histopathological findings of lymph node biopsies at a tertiary care centre
Authors: Shah Bimal , Degloorkar Sarang , Parab Sanjay , Shah Mita , Vijay Ria
Published: January 2023

Background: Lymph nodes are spread throughout the body and are routinely checked for abnormalities. These lymph nodes have the potential to become infected or malignant. The swelling of lymph nodes and the nodes which are abnormal in terms of size and/or number is commonly known as lymphadenopathy. One of the most common causes of lymphadenopathy observed is reactive lymphadenitis followed by granulomatous lymphadenitis. For diagnosis of lymph node biopsies, excisional biopsy and histopathological analysis are considered as the ‘gold standard’.
Methods: This is a retrospective, descriptive and a cross-sectional study of all the patients with lymph node biopsies seen in Bhaktivedanta Hospital and Research Institute from January 2018 till March 2022. Histopathology reports of lymph node biopsies of patients required at Bhaktivedanta Hospital and Research Institute were included in the study.
Results: The most common diagnosis is of tuberculous lymphadenitis which accounted for 251 (53.2%) of the total 469 cases. Tuberculous lymphadenitis was most commonly observed in females (68.92%) as compared to males (31.07%). Cancer cases which accounted for 83 (17.70%) cases formed the second most common diagnosis in which females (53.01%) accounted for most cases as compared to males (46.99%).
Conclusions: Enlarged lymph nodes should undergo fine needle aspiration cytology (FNAC), truecut biopsy and/or excisional biopsy for correct diagnosis. The diagnostic spectrum ranges from benign reactive to TB and also malignancies.
Histopathological analysis of appendix biopsies in patients at a tertiary care centre
Authors: Shah Bimal , Parab Sanjay , Degloorkar Sarang , Shah Mita , Vijay Ria
Published: January 2023

Background: One of the most common problems associated with the abdomen is appendicitis. The acute cases of appendicitis are generally treated with appendectomy. The surgical process of removal of appendix, that is, appendectomy, helps in diagnosis of appendicitis. However, the appendix which looks normal macroscopically can actually harbour pathological findings when histopathological assessment is done. Appendiceal tumours or any type of parasitic function can occur in a normal looking appendix.
Methods: This is a retrospective, descriptive and a cross-sectional study of all the patients with appendix biopsies seen in Bhaktivedanta Hospital and Research Institute from January 2018 till March 2022. Ethical approval from the Institutional Ethics Committee was obtained for this study. Histopathology reports of appendix biopsies of patients required at Bhaktivedanta Hospital and Research Institute were included in the study.
Results: Out of the total 359 cases of appendix biopsies, 209 (58.2%) cases of acute appendix were found to be the most common. Males accounted for 216 (60.17%) cases of appendix biopsies which are in majority in comparison to 143 (39.83%) cases of female appendix biopsies. Based on age grouping, the age group of 11-20 showed majority (25.1%) cases of appendix biopsies.
Conclusions: All appendix specimens should be sent for histopathological analysis to document the removal of appendix, to know the pathology diagnosis and to rule out malignancy in the appendix.
An observational study to evaluate efficacy and safety of ultrasound guided foam sclerotherapy for treatment varicose veins
Authors: Bochiya Girish P. , Bhavsar Ashlesh , V. Modi Jenish , Trivedi Mitesh
Published: January 2023

Background: There are various minimally invasive techniques for varicose veins. Tessari has invented simple method to create sclerosant foam that has become popular nowadays as treatment for varicose veins. Aim was to describe the efficacy and safety of ultrasound guided foam sclerotherapy for treating varicose veins.
Methods: The observational study was carried out in 50 patients between July 2020 to June 2021. Sclerosant foam was made by Tessari method using polidocanol was introduced under ultrasound guidance in to affected veins. After 3 days looked for any residual varicosities and complications. All patients were followed up at 3 days, 1 month, 3 month and 6 months after treatment.
Results: 37 patients were treated with 3.0% of polidocanol. Rest 13 patients (26.0%) were treated with 1.0% of polidocanol. Six (12.0%) and eight patients (16.0%) received three and four sessions of sclerotherapy respectively. After 1 month, 41 patients (82.0%) achieved complete occlusion, in 5 patients (10%) partial occlusion was seen. After 3 months, 47 patients (94%) achieved complete occlusion without any symptom and three patients (6.0%) had partial occlusion. At the end of 6 months 48 patients (96.0%) achieved complete occlusion without any symptoms. Four patients (8.0%) developed SVT blurred vision in 3 patients (6.0%) and pain with redness at injection site was observed in one patient (2.0%).
Conclusions: Ultrasound guided foam sclerotherapy is safe and effective in obliterating varicosities of lower limb including perforators using polidocanol sclerosant agent with less complication, low recurrences and good cosmetic outcome.
Fat grafting: an adjunct in management of chronic leg ulcers
Authors: Saroha Ravi , Langer Vijay , Singh S. K.
Published: January 2023

Chronic leg ulcers (CLU’s) are one of the most challenging medical conditions, mostly resistant to conventional therapy. Several treatment modalities are present but none have become standard of care. Autologous fat contains adipose derived stem cells (ADSC’s) which is believed to have abundant growth factors (GF’s) required for its regenerative and reparative properties. Our observational study was conducted to see the feasibility and efficacy of fat grafting in management of CLUs with complete wound healing as final outcome. 14 patients with CLUs (any etiology, >3 months and multiple ulcers were counted as individual cases if >3 cm apart) were included with coagulopathies, uncontrolled diabetes mellitus (Hba1c>9 mmol/mol) being the exclusions. Fat was harvested using standard Coleman’s technique. Study was conducted from December 2015 to December 2017 in tertiary care hospital and patients were followed up for next 24 months. All cases were evaluated clinically. Average age of wounds before intervention was 33.34 months, average wound size 16.46 cm2 and 4.9 cc of average fat was transferred underneath the ulcer. 11 out of 14 wounds healed completely within average 27.4 days and final outcome was not achieved in 3. Pain assessed using visual analogue scale (VAS) in immediate post operative period till 48 hours (telephonically). Patients were evaluated at 1 week, 1 month, 3 months and 6 months after procedure for pattern of wound healing and related complications. Fat grafting is easy, safe, effective and a minimally invasive OPD procedure with short recovery time for managing CLUs.
A novel approach for weight reduction after Roux-en-Y gastric bypass
Authors: Kumar Birbal , S. Mitra Dipankar
Published: January 2023

Diabesity constitutes coexistence of both diabetes and obesity has become a modern epidemic now. It can be linked with insulin resistance and hyperinsulinaemia by various pathophysiological mechanism. Bariatric and metabolic surgery is a safe and effective treatment option for those affected by severe obesity and with its comorbidities like hypertension, diabetes mellitus, sleep apnoea, knee problems etc. These same procedures have also been recognized for their impact on metabolic or hormonal changes that play a major role in hunger (the desire to start eating) and satiety (the desire to stop eating) as well as improvement and/or resolution of conditions like diabetes mellitus, hyperlipidaemia which is associated with severe obesity. Bariatric surgery is a recognized and accepted approach for both weight-loss and many of the conditions that occur as a result of severe obesity.
A rare case of primary gastrointestinal stromal tumour of the stomach presenting as perforation peritonitis
Authors: Majhi Harekrishna , Santhosh Arsha , Ethiraj Suraj , Nayak Sailesh , Chattarjee Debi Prasad
Published: January 2023

Presentation of gastrointestinal stromal tumours (GISTs) as perforation peritonitis is a rare entity with only few cases reported in literature. Here we present a case of a 50-year-old male with acute abdomen and signs of peritonitis. Abdominal radiography revealed dilated small bowel loops in the absence of any free intraperitoneal air. Exploratory laparotomy revealed a growth arising from the stomach wall at the distal part of the body along the greater curvature. Wide excision of the lesion was done with rent closure. Histopathological examination further confirmed the diagnosis of a GIST of the stomach. Post operatively patient received Imatinib therapy and is doing well on follow up. Although rare, GISTs should be considered in the differential diagnosis of perforated GI lesions.
An unusual presentation of coexisting parathyroid carcinoma and papillary carcinoma thyroid: a case report and literature review
Authors: Puthen Veetil Pradeep , Puzhakkal Shikhil , Narayanan Niya , Chakko Anju
Published: January 2023

Parathyroid carcinoma is the rarest endocrine cancer with aggressive behaviour. It may be presented as a feature of severe hypercalcemia, musculoskeletal involvement and a neck mass. There should be a high clinical suspicion if there is marked hypercalcemia, very high parathyroid hormone levels, palpable neck mass, recurrent laryngeal nerve palsy due to invasion and severe bone and renal symptoms. Thyroid pathology has been seen in 15-70% of patients with primary hyperparathyroidism (PHPT) especially with parathyroid adenoma. Medullary thyroid carcinoma is common with PHPT as in MEN 2 syndrome and rarely co-existed with non-medullary thyroid carcinoma. Parathyroid carcinoma and papillary thyroid carcinoma is extremely rare. Only 16 cases are reported in the literature.
Valentino’s syndrome: a formidably deceptive tale of peptic ulcer
Authors: Komatreddy Gagandeep Reddy , Gangam Venkat Poojitha Reddy , Sai Teja Katra , Punyapu Sridhar
Published: January 2023

The incidence of peptic ulcer disease (PUD) has steadily declined with the advent of H2 blockers and proton pump inhibitors (PPIs). The combined use of PPIs and endoscopic treatment has further decreased the need for emergency surgeries. Perforated ulcers are a rare cause of abdominal pain, and may not even be considered when the patient presents with right lower quadrant (RLQ) pain. In this article we report a case of 50-year lady, who presented with symptoms and signs of appendicitis accompanied by elevated inflammatory markers. Proper history taking, explicit knowledge regarding differentials, accurate radiological diagnosis and skilful surgical repair is paramount in its management and to prevent morbidity and mortality.
Dermatofibrosarcoma protuberans - an atypical tumor with a typical diagnostic dilemma: a case report
Authors: Kumar Manoj , Gupta Rohit , Kumar Manoj , Jha Ashesh
Published: January 2023

Dermatofibrosarcoma protuberans (DFSP) is a rare tumor of dermal fibroblast. Diagnosis poses a challenge to every surgeon. Its propensity to recur can be attributed to its characteristic finger-like projections, misdiagnosis, and incomplete excision. Wide local excision with adequate margins may lead to functional defects and cosmetic blemishes. Most cases undergoing second surgery warrants reconstructive procedure which might further complicate the management. We report a case of DFSP, initially misdiagnosed and underwent incomplete excision, later presented with recurrence and atypical features. High-grade suspicion is of paramount importance for ascertaining the diagnosis of DFSP and its appropriate treatment.
Condyloma acuminata on the breast: a case report
Authors: Kumar Birbal , Gupta Balkishan , Mitra Dipankar S.
Published: January 2023

Condyloma acuminatum (CA) is a benign tumor primarily caused by infection with human papillomavirus (HPV) type-6 or type-11, lesions of which are most frequently found on the genital and perianal squamous mucosa and skin. CA outside the genitals is not common. The woman underwent successful surgical excision and reconstruction for breast nipple condyloma. Breast nipple condyloma pose a management dilemma. It is possible that the pathogenesis of these lesions is through both direct contact spread as well as haematogenous dissemination of the human papillomavirus.
Post-mastectomy breast reconstruction: an overview of the state of the art, challenges, and prospects
Authors: Ghazal Ismat D. , Eleweke Chimdi , Aladesanwa Francisca O. , Onabajo Bayowa O.
Published: January 2023

Breast cancer, which affects approximately 12% of women worldwide, is a leading cause of death and morbidity, and the majority of cases are treated surgically. The loss of one or both breasts to cancer can be devastating and it often has negative physical and psychological impact on women. In order to maintain an outward breast contour, some women turn to temporary solutions, such as breast pads, which are often unsatisfactory. Over the years, patients' perceptions of their bodies, self-esteem levels and quality of life have all improved as a result of less radical breast cancer surgeries and the growing popularity of post-mastectomy breast reconstruction. Therefore, it is recommended that women undergoing breast cancer surgeries be given the choice of breast reconstruction. Nevertheless, accessibility, acceptability, and affordability of breast reconstruction still pose a challenge. Although these limitations exist globally, they are most noticeable in low- and middle-income nations. This article gives an overview of the various considerations and surgical options for breast reconstruction after breast cancer surgery. In addition, it examines some of the challenges to breast reconstruction faced worldwide and discusses recent and future trends which are bound to improve post-mastectomy breast reconstruction techniques and outcomes globally.
Do postgraduate research degrees contribute to positive outcomes for surgical doctors? An evaluation of relevant literature
Authors: Flynn Matthew F.
Published: January 2023

Doctorates as part of surgical training are gaining popularity and diversity within the global market. The costs of these degrees need weighed against anticipated benefits for the individual and healthcare systems. This review considers the drivers, impact and future of higher research degrees in surgery.
Evaluation of in vitro anti-acne activity of methanolic extracts of Cyperus rotundus and Nymphaea nouchali
Authors: Ranasinghe Baladara H. T. S. , Weeraratne Dinasha R. , Maddumage Ridmi S. , Perera Heeraluge F. H. , Fernando Rathugamage S. P. , Silva Athige R. N.
Published: January 2023

Background: The objective of this study was to evaluate in vitro anti-acne activity against Staphylococcus aureus (S. aureus), Staphylococcus epidermidis (S. epidermidis), and Escherichia coli (E. coli) using the agar well diffusion method.
Methods: Air-dried and ground, matured rhizomes of Cyperus rotundus (CR), petals and pollen of Nymphaea nouchali (NN) were macerated in methanol. The resultant extracts were concentrated using a rotary evaporator. The anti-bacterial activity was performed against Staphylococcus aureus (ATCC 25923), Staphylococcus epidermidis (ATCC12228), and Escherichia coli (ATCC 25922) using the agar well diffusion method, and gentamicin was used as a positive control. The whole experiment was done in triplicates.
Results: The data obtained from dose-response curves, methanolic extracts of Cyperus rotundus rhizomes against staphylococcus aureus (IC50=819.2 µg/ml), Nymphaea nouchali pollens against Staphylococcus epidermidis (IC50=787.7 µg/ml) and combination against Escherichia coli (IC50=813.6 µg/ml) were exhibited the highest potency. A strong positive statistically significant correlation was exhibited between the zone of inhibition and the concentrations of all plant extracts. The p value was less than 0.05 (p<0.05) and all the R2 values were around 1.
Conclusions: The maximum anti-bacterial potency against gentamicin equivalent was observed in S. aureus, S. epidermidis, and E. coli at the concentration of 15625 µg/ml in combination. The present study might bring progress in the treatment of acne using herbs and in developing herbal formulations for safe and effective management of the disease.