bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical preference for aortic root and ascending aortic aneurysm in pediatric patients: single-center experience
Authors: Yılmaz Mustafa , Soran Türkcan Başak , Ecevit Ata Niyazi , Ece İbrahim , Atalay Atakan
Published: March 2024

Purpose: Aortic root and ascending aortic aneurysms are rarely encountered in pediatric patients. Our aim in this study was to compare our surgical approach and results in this patient group with similar studies in the literature.

Materials and Methods: This study retrospective in design and its cohort consists of pediatric patients who were operated on due to the diagnosis of aortic root and/or ascending aortic aneurysm. The etiologies of the patients that caused the aneurysm were investigated preoperatively, and the severity of the disease in the aortic valve and ascending aorta and surgical indications were revealed with detailed imaging methods. Operative data was then retrieved and early postoperative morbidity and mortality, as well as post-discharge aortic valve functions were evaluated. The obtained data was compared with those of similar articles in the literature.

Results: A total of eight pediatric patients were operated on with the diagnosis of aortic root and ascending aortic aneurysm. The average age of the patients was eleven (±4.03) years. The underlying cause of three (37.5%) patients was Marfan syndrome, two (25%) had bicuspid aortic valve and one (12.5%) had Wiscott-Aldrich Syndrome, previously operated sinus valsalva aneurysm and operated truncus arteriosus. There was 3rd degree aortic valve insufficiency in six patients (75%). The average aortic annulus diameter, mean sinus of valsalva diameter and ascending aorta diameter of the patients were 26.7 mm (±5.3), 40.9 mm (±9.7) and 37.8 mm (±9.2), respectively. The David I procedure was performed in three (37.5%) patients, while the Bentall procedure or aortic valve and ascending aorta replacement was performed on the other five patients. Non-cardiac mortality was observed in one (12.5%) patient, whereas native and mechanical valve dysfunction was not observed in any patient after discharge.

Conclusion: Both valve-sparing surgical procedures and other replacement techniques can be used safely in pediatric patients with aortic root and ascending aortic aneurysms.
Protective effects of jervine purified from Veratrum album on paracetamol-induced liver toxicity in rats
Authors: Yiğit Serdar , Aydın Tuba , Bitiktaş Soner , Bingöl Seyit Ali , Yayla Muhammed , Duysak Lale , Yeşilyurt İsa , Kahraman Ali Alper
Published: March 2024

Purpose: Since paracetamol toxicity is a very common type of poisoning, we planned to investigate whether Jervine has an effect on paracetamol toxicity by utilizing its anti-inflammatory effect.

Materials and Methods: In our study, 42 Sprague Dawley rats of 8 weeks of age were used. Seven groups were formed with 6 animals in each group. At the 24th hour of the study, all groups underwent laparotomy under anesthesia, and liver dissection was performed. Hematoxylin and Eosin (H&E) staining was performed to evaluate liver histopathology. SOD, CAT, GSH, and MDA levels were analyzed biochemically.

Results: Histopathological, while liver tissues were normal in the control group, we observed degeneration areas, inflammation, and hemorrhage in the paracetamol group. Jervine reduced the severity of paracetamol toxicity and prevented liver damage. Jervine significantly increased SOD levels. Paracetamol administration significantly decreased CAT levels. Paracetamol significantly decreased GSH levels compared to the control group.

Conclusion: Jervine reduced the adverse effects of paracetamol toxicity on liver tissue, such as degeneration, inflammation, and hemorrhage. Jervine increased antioxidant activity and reduced the harmful effects of NAPQI, the toxic metabolite of paracetamol, on liver tissue.
Prevalence and association of high-intensity lesions with degenerative processes in lumbar intervertebral discs
Authors: Soydan Zafer , Bayramoğlu Emru
Published: March 2024

Purpose: This population-based cross-sectional study examined the prevalence of high-intensity zones (HIZ) in the lumbar spine and their relationship to age, gender, disc degeneration, disc displacement (bulging or herniation), and facet joint degeneration.

Materials and Methods: A retrospective analysis was conducted on MRI studies of 800 patients (4000 discs) who were admitted to the hospital with subacute-chronic low back pain (LBP) and presented with axial pain (musculogenic-discogenic-mechanic) at outpatient clinics. The frequency of speed was determined by considering a total of seven age categories in decades. Correlation analyses were performed between HIZ and other variables.

Results: The prevalence of HIZ was 30%, highest in the >70 years age group and lowest in the
The association between C-reactive protein to albumin ratio and infarct location in patients with ST-segment elevation myocardial infarction
Authors: Tanrıverdi Zülkif , Fedai Halil
Published: March 2024

Purpose: Inflammation has a crucial role in the pathogenesis of ST segment elevation myocardial infarction (STEMI). Recently, the C-reactive protein to albumin ratio (CAR) has emerged as a novel parameter of systemic inflammation. Although studies have demonstrated the that anterior STEMI location is associated with a higher infarct size and worse prognosis, no study has investigated the CAR in relation to infarct location. We herein aimed to evaluate whether there is a difference regarding the CAR between patients with anterior and non-anterior STEMI location.

Materials and Methods: The study population comprised 273 consecutive STEMI patients who were divided into 2 groups based on the STEMI location, as the anterior STEMI group (n=114) and non-anterior STEMI group (n=159). Baseline characteristics were recorded, and the CAR was calculated for all patients.

Results: Both groups were similar in terms of the baseline clinical characteristics. However, syntax score (p
Perde duvarların yanal yük dayanımı üzerine kaplama elemanı ve yalıtım malzemesinin etkisinin araştırılması
Authors: Yücesoy Duygu , İlhan Okan , Birinci Abdullah Uğur , Demirkır Cenk
Published: March 2024

Hafif karkas ahşap yapı sistemlerinde perde duvarlar; masif malzemenin genellikle kullanıldığı iskelet sistemi, kaplayıcı ya da örtücü eleman ve bağlantı elemanlarından oluşmaktadır. Kaplama eleman olarak, deprem ve rüzgâr gibi yapının yer değiştirerek uğradığı yatay deformasyona direnç göstererek çökmesini engellediği için kontrplaklar kullanılmaktadır. Perde duvarın yapısal özelliklerini ve kontrplakların teknolojik özelliklerini etkileyen birçok faktör bulunmaktadır. Ağaç türü, levha kalınlıkları, lif yönü, kusurlar, bağlantı elemanlarının türü, konumu ve aralarındaki mesafeler gibi faktörler, perde duvarın dayanıklılığı, mukavemeti ve yatay deformasyon miktarı üzerinde etkilidir. Bu faktörlerin bir araya gelmesi, perde duvarın genel performansını ve yatay deformasyon miktarını belirlemektedir. Bu çalışmada, yanal yük altındaki perde duvarlardaki yatay deformasyon miktarlarının belirlenmesi amaçlanmıştır. Çalışma, karaçam ve ladin ağaç türlerinden yapılan kontrplak kaplı perde duvarlarda yapısal ve teknolojik faktörlerin etkisini incelemektedir. Araştırmada, ağaç türü (karaçam ve ladin), kontrplak levha kalınlıkları, lif yönelimi (liflere dik ve paralel), kusurlar, bağlantı elemanı ölçüsü (6d ve 8d) gibi bir dizi değişken değerlendirilmektedir. Perde duvarlarda kullanılan yalıtım malzemeleri (Ekstrüde Polistiren (XPS), Ekspande Polistiren (EPS) gibi) de dikkate alınmış ve yanal yük altındaki yatay deformasyon miktarları belirlenmiştir. Araştırma sonuçları, karaçam kontrplaklarla kaplanan perde duvarların genel olarak ladinlere göre daha fazla yatay deformasyona uğradığını ve liflere paralel olarak üretilen perde duvarların genellikle daha yüksek yatay deformasyon değerlerine sahip olduğunu göstermiştir.
Çanakkale-Kilitbahir Kale Müzesi ve çevre peyzajının değerlendirilmesi
Authors: Alkan Yavuz
Published: March 2024

Müzeler, tarihsel süreçte ulusal ve uluslararası kültürün yayılmasında, nesilden nesile aktarılmasında ve kültürler arası etkileşimin ve bilincin güçlenmesinde önemli rol üstlenmiştir. Bu yönüyle Kilitbahir Kale Müzesinin mercek altına alındığı bu çalışmada kale içi ve yakın çevresi peyzaj değerleri kapsamında incelenmiştir. Müzeyi sınırları içinde bulunduran Kilitbahir köyü Çanakkale iline karşı konumlanmıştır. Çanakkale Boğazı tarafından ayrılan bu köyle siyasi olarak bağlı olduğu Çanakkale ili arasındaki uzaklık yaklaşık 3 km’dir. Müzenin peyzaj kriterleri kapsamında incelenmesi iki adımda gerçekleştirilmiştir. İlk olarak alanda yapılan gözlemlere bağlı olarak yapısal ve bitkisel analize yer verilmiştir. İkinci adımda ise kullanıcı faktörünün araştırma alanı üzerindeki rekreasyonel yaklaşımlara bağlı olarak görüş ve düşünceleri ortaya konmuştur. Bunun için tesadüfi olarak 75 ziyaretçi ile karşılıklı görüşme sağlanmıştır. Anket uygulaması ile ulaşılan sonuçlar SPSS 15.0 istatistiksel analiz programı kullanılarak değerlendirilmiştir. Söz konusu değerlendirmenin esasını kullanıcı memnuniyeti/bağımlı değişken ve bunu etkileyen yapısal ve bitkisel peyzaj unsurları/bağımsız değişkenler oluşturmuştur. Analize göre değişkenler arasındaki ilişkinin anlamlılık düzeyi 0,000 ve R kare değeri 0,825 bulunmuştur. Bu ve benzer sonuçlar ışığında araştırma alanının optimal kullanımına katkısı olabileceği üzerine kurgulanan bu çalışmada, metoda bağlı olarak izlenen her iki stratejiden varılan ortak ya da benzer yaklaşımlarla öneriler geliştirilmiştir.
Facility layout planning through the ALDEP Method in the wooden cable reels industry
Authors: İnce Melike Nur , Taşdemir Çağatay
Published: March 2024

Facility layout planning plays a pivotal role in manufacturing system design, impacting vital metrics such as lead time, handling costs, and space optimization. While a significant portion of research has been invested in refining existing facility layouts, there is a noticeable research gap in devising optimized layouts for new establishments, especially in the value-added wood products domain. Addressing this lacuna, this research focused on designing an efficient department-level layout for a wooden cable drums manufacturing facility in an area of 4150 m2. This facility included both office and production areas. The investigative process was segmented into four distinct phases: Deciding the strategic positioning of the facility on the available plot, defining the functional and spatial requirements for each department, establishing the intricate relationship dynamics between these individual units, and rigorously documenting the most optimal department-level facility layout. For precision in layout creation, the ALDEP algorithm was employed, which was further visualized to offer a comprehensive three-dimensional representation. The final layout seamlessly organized seven departments within the 1st Floor Office Area, eight in the 2nd Floor Office Area, and thirteen within the Production Floor. Efficiency evaluation of these areas yielded scores of -811, 184, and -318, respectively. Conclusively, this research furnished actionable insights for manufacturers within the wood products sector and was expected to be an invaluable reference for academics delving into facility planning and value-added wood products manufacturing.
A bibliometric evaluation on furniture joints studies
Authors: Demirel Samet , Eyüboğlu Hande
Published: March 2024

Furniture joint one of the most critical point in furniture construction and it is one of the most governor part of the furniture construction. Therefore, many studies focuses on furniture joint from USA to China. This study aims to reveal the current structure of studies conducted in the literature on furniture joints. The study is structured in three basic stages. Firstly, a comprehensive literature study on furniture joints was carried out. Then, the sample of the study was determined as 253 articles with the keyword furniture joint in the Web of Science database. In the third stage, bibliometric analyzes were carried out. VOSviewer and Biblioshiny programs were used in the analysis, and the sample group was determined according to some parameters such as country, author, study year, university and study name. The results indicated that 2018 was the year for the highest numbers of furniture joint studies. Eckelman, Zhang, and Erdil were the pioneers authors on furniture joints studies. USA and Canada were the first countries where furniture joints studies initiated. Currently, Türkiye is the leading country on furniture joint studies, and China is getting popular country in the subject of the study. Besides, Purdue University and Mugla Sitki Kocman University is the accommodations which published the highest number studies on furniture joints. Additionally, the biometric analisys of the study showed that Forest Products Journal published the highest number furniture joint papers.
Current situation of Citrus Longhorned Beetle [Anoplophora chinensis (Forster, 1771)] (Coleoptera: Cerambycidae) in Türkiye and the world
Authors: Oğuzoğlu Şükran , Harman İsmet , Avcı Mustafa
Published: March 2024

The citrus longhorned beetle Anoplophora chinensis (Forster, 1771) (Coleoptera: Cerambycidae), which is considered to be one of the most important pests in the world, is listed in the Plant Quarantine Regulation of Türkiye as a "quarantine pest whose presence in Türkiye is limited and which constitutes an obstacle to import". After this species was first detected in Istanbul in 2014, it was found in Antalya, Bartın, Diyarbakır, Sakarya and Trabzon. Anoplophora chinensis which was seen on many tree species, but it prefers generally Acer spp., Platanus orientalis and Corylus spp. in Türkiye. So far, the species has been observed in parks, nurseries and hazelnut production areas. Since it is a polyphagous species and its main host in its native distribution areas is citrus fruits, it is an important threat for ornamental plants and agricultural sectors. It may also pose a threat to broad-leaved species in forest areas in terms of biodiversity. In this study, the current situation of A. chinensis in Türkiye and in the world is discussed in detail.
Smart Cities and Tourism: A Paradiplomatic Approach Between Jakarta and Galicia
Authors: Rafi Ferdilianto  , Bariq Akmal Malik  , Christopher David Evans  , Fira Najwah BSA  , Nadira Refiana
Published: March 2024

This study investigates the role of paradiplomacy in fostering enhanced cooperation between Jakarta, Indonesia, and Galicia, Spain, focusing on smart city initiatives and tourism development. Sub-state actors such as city, NGO and MNC nowadays have the rights to participate in the national agenda. In this area, Jakarta and Galicia both are a good example, in which those cities have multiple similarities in achieving their national agenda.  Jakarta is known as a capital city of Indonesia, who become the main area of national economy improvement. Also in the other hand, Jakarta applied a concept of smart city in order to maximize the potential of its own area. Jakarta has sucessfully applied the concept correctly, which it answered by the infrastructure sector Jakarta made MRT and LRT which one of the goals of the concept. Galicia is known as city who has huge potential in its tourism sector and, also the management of the sector is rather quite neat. this paper explores the potential for bilateral paradiplomatic engagement to promote economic and infrastructural development. The findings suggest that paradiplomacy not only serves as a vital instrument for urban development but also paves the way for sustainable and mutually beneficial international collaborations.
Efficacy of rifaximin among non-constipated irritable bowel syndrome patients with or without small intestinal bacterial overgrowth: a randomized, double-blind, placebo-controlled trial
Authors: Podder Subrata , Masudur Rahman M. , Hossain Mohammad Iqbal , Datta Raj , Alam Jane , Golam Kibria M.
Published: March 2024

Background: IBS is a functional gastrointestinal disorder marked by abdominal pain and changes in stool frequency or form. Recent studies indicate a link between IBS, especially the diarrhea-predominant subtype, and small intestinal bacterial overgrowth. This study aimed to evaluate symptom resolution among IBS patients with or without SIBO on rifaximin treatment as compared with placebo.
Methods: A double-blind, placebo-controlled, randomized clinical trial took place at the Department of Gastroenterology, Dhaka Medical College and Hospital, from January to December 2019. In the study 104 non-constipated IBS patients were assessed for SIBO using gut aspirate culture. Those with SIBO (≥105 CFU/ml) and those without were randomly assigned (computer-generated) to receive either 1500 mg/day of rifaximin for 14 days or a placebo.
Results: Among 104 non-constipated IBS patients, 39% had SIBO, with IBS-D patients more associated (83% vs. 60%). Rifaximin significantly improved symptoms in the SIBO group at 4 and 16 weeks (90% vs. 20%, p<0.001; 66% vs. 15%, p<0.001). In the non-SIBO group, significant improvement was observed at 4 weeks (38.7% vs. 18.8%, p<0.001) but not at 16 weeks (25.8% vs. 18.8%, p=0.501). Rifaximin significantly improved abdominal pain, stool form, and frequency in the SIBO group compared to placebo. However, there was no significant improvement in the non-SIBO group.
Conclusions: Rifaximin is superior to placebo in relieving symptoms of non-constipated IBS patients with SIBO.
Characteristics of intracranial atherosclerosis disease in stroke cases in Indonesia utilizing cerebral digital subtraction angiography
Authors: Usman Fritz S. , Kastilong Merlin P. , Susanto David , Dafif Muhammad Welly , Sirait Gomgom Henrico
Published: March 2024

Background: Intracranial atherosclerosis disease is a cause of ischemic stroke. Risk factors of ICAD included age, gender, race/ethnicity, hypertension, diabetes mellitus, and dyslipidaemia. This study aimed to describe the profile of ICAD in first-ever stroke and its association of recurrent stroke.
Methods: The was a prospective cohort study conducted at a private hospital in Indonesia between January 2021 and June 2022. Inclusion criteria included patients with first-ever stroke and intracranial stenosis confirmed through digital subtraction angiography. The incidence of recurrent stroke was observed at six-month follow-up.
Results: Of 40 subjects, 25 (62.5%) were females and most ages ranged from 20 to 40 years old. The prevalent site of intracranial stenosis were internal carotid artery in 19 (23.2%) and anterior cerebral artery in 19 (23.2%) subjects. Following six-month follow-up, there was only a patient with recurrent stroke.
Conclusions: In first-ever stroke in Indonesia, ICAD was predominantly described in younger men within 41-60 years old. Stroke recurrence was observed in a patient who was old and had multiple comorbid. Further studies using a larger area and longer duration of follow-up may be considered to provide a more generalized description of ICAD in Indonesia.
Patterns of aldosterone, renin level and aldosterone/renin ratio in young hypertensive patients
Authors: Saha Sumanta Kumer , Moni Tamanna Tabassum , Rezaul Kadir M.
Published: March 2024

Background: Hypertension is a common disease that affects a vast and diverse patient group. Aldosterone, the primary human mineralocorticoid, is increasingly recognized as playing a key role in cardiovascular morbidity, and its involvement in hypertension has lately been evaluated by studies. It is estimated that it accounts for up to 13% of all hypertension patients and 20% of resistant hypertension cases. This study aimed to observe the patterns of aldosterone, renin level, and aldosterone/ renin ratio in young hypertensive patients.
Methods: This was a retrospective observational study and was conducted in the Department of Medicine Popular Medical College Hospital, Dhaka, Bangladesh during the period from June, 2023 to December, 2023. In our study, we included 124 hypertensive patients who visited the outdoor department of medicine of our hospital.
Results: In our study, we found mean age was 33.38±4.49 years. The majority (75%) of our patients were male. The mean SBP and DBP were 136.77±17.54 and 88.58±10.72 mmHg respectively. The mean aldosterone level was 148.74±125.91 pmol/L. The mean plasma renin activity and aldosterone to renin ratio were 10.03±12.04 ng/mL/hr and 22.98±28.66 respectively.
Conclusions: In our study, we aimed to determine the pattern of ARR ratio in young hypertensive patients. We found that aldosterone renin ratio (ARR) levels play a crucial role in identifying the etiological patterns of young hypertensive patients e.g. Conn's syndrome, Liddle's syndrome, etc.
Observation of cardiac profile among the adult population of Sreemangal
Authors: Nazem Al Qureshi M. , Anisuzzaman A. H. M. , Das Niloy Chandra , Roy Arpita , Al Mamun Abdullah , Anwarul Amin M. , Hasan Ali M. , Tahite Dihan
Published: March 2024

Background: Cardiovascular diseases are a leading cause of morbidity and mortality worldwide. The prevalence and risk factors of CVDs vary across different populations and regions. This study aimed to observe the cardiac profile among the adult population of Sreemangal, Bangladesh, to identify the prevalence and risk factors of CVDs in this population.
Methods: This prospective observational study was conducted over a six-month period at a public health camp in Sreemangal, Bangladesh. A total of 137 adult participants were purposively selected. Data were collected through a structured questionnaire and physical examination, including measurements of blood pressure and laboratory analysis of blood samples.
Results: The study found that 44.53% of participants had elevated blood pressure, and 21.90% had stage 1 hypertension. Interestingly, 36.50% of participants were unaware of their hypertension status. Furthermore, 26.28% of participants had a known history of diabetes, but blood glucose level analysis revealed an additional 14.85% of participants were prediabetic, and 6.93% were diabetic based on fasting blood glucose levels. A statistically significant association was found between increasing age and the stage of hypertension (p<0.001), and between fasting and normal blood glucose levels and the stage of hypertension (p<0.005 and p<0.05, respectively).
Conclusions: The findings of this study underscore the need for targeted interventions to prevent and manage CVDs in the adult population of Sreemangal, Bangladesh. These interventions should include regular screening for CVD risk factors, health education to increase awareness of these risk factors, and strategies to promote healthy lifestyle behaviors.
Outcome of perforator propeller flap for the coverage of soft tissue defects over middle and distal part of leg
Authors: Nazrul Hossain Mullah M. , Ruhul Amin M. , Noor-E-Alam M. , Sultan Istiaq , Khan Mosabbir Ahmad , Nahar Lailun , Uddin Hasan Nazir , Ahmed Tanveer
Published: March 2024

Background: Plastic surgery is a constant battle between blood supply and beauty. The end result of a reconstructive procedure is primarily attributable to the stability of the vascular component, which is fundamental in that it ensures survival and proper functioning of tissues that have been transferred to the recipient site. The aim of the study was to evaluate the clinical outcome of perforator propeller flap for coverage of soft tissue defects in middle and distal legs.
Methods: This was a prospective observational study and was conducted in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from September 2018 to February 2020. The study population includes the total of 30 patients having soft tissue defects of the middle and distal thirds of leg necessary for flap coverage in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Results: In total 30 patients maximum 11 (36.7%) were in 31-40 years age group. Majority 27 (90%) were male and 3 (10%) were female in our study. Out of 22 flaps in distal leg necrosis occurred in 4 (18.19%) and among 8 flaps in middle leg necrosis occurred in 1 (12.5%).
Conclusions: This study observed that that perforator propeller flaps are ideal in reconstructing soft tissue defects of the middle and distal third of the leg, being safe, easy to perform, providing similar tissue in texture and thickness of damaged tissues, with low donor site morbidity.
Evaluation of current physical symptoms and psychological sufferings of patients during attending department of palliative medicine in a tertiary care hospital
Authors: Urmy Sabikun Naher , Alam Afroja , Sharmin Shah Noor , Aktar Mossa Nupur , Noor Rahat , Sultana Rakiba , Shaidur Rahman M. , Haque Kazi Sanzida
Published: March 2024

Background: Empirical evidence indicates that anxiety and depression in cancer patients are often overlooked, leading to insufficient assistance for their psychosocial needs. Distinguishing between clinical anxiety and depression and the typical emotional distress post-cancer diagnosis can be challenging but holds significant implications for coping strategies and outcomes. The aim of this study was to assess current physical symptoms and psychological sufferings of patients’ during attending in a Palliative care department of a tertiary care hospital.
Methods: This cross‐sectional study was conducted among 191 patients with cancer attending the department of palliative medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from November 2021 and March 2022. Data was collected by face‐to‐face interview using a structured questionnaire. Depression and anxiety were evaluated using a modified version of the primary care evaluation of mental disorders guide.
Results: 47 participants (20.7% prevalence of depressive disorders and 13.9% prevalence of anxiety disorders) met the diagnostic criteria for at least one anxiety or depressive disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The 95% confidence interval for these results was between 20.2 and 29.0.
Conclusions: In summary, depression and anxiety disorders are prevalent among patients in palliative care, significantly reducing the quality of life for those facing cancer-related mortality.
Clinico-pathological profile of breast cancer patients in a radiation therapy centre
Authors: Rahman M. Masudur , Shams Mohammad Jahan , Haque Mostafa Sanaul , Biswas Shourov
Published: March 2024

Background: The aim of the study was to evaluate the clinico-pathological characteristics of patients with breast cancer at the Radiation Center of Bangabandhu Sheikh Mujib Medical University (BSMMU), a tertiary‑care cancer center in Dhaka, Bangladesh.  
Methods: This descriptive study was conducted from March 2021 to February 2022 where patients receiving radiotherapy for breast cancer were included. Data were collected from face-to-face interviews with patients and from their investigation reports. Data regarding age, presenting symptoms, histological type, tumor size, involvement of regional nodes, hormonal receptor status, and human epidermal growth factor receptor 2 (HER2) amplification were recorded and then analyzed.
Results: The mean age of the patients was 52.53 years. Most of the patients (93%) were multiparous and 62.24% were postmenopausal. The most common symptom was breast lump (91.6%). Infiltrating ductal carcinoma and lobular carcinoma were seen in 136 (95.1%) and 7 (4.9%) cases respectively. The TNM stage distribution was stage I, 6 (4.2%); stage II, 52 (36.36%); stage III, 76 (53.15%); and stage IV, 9 (6.29%). Locally advanced breast cancer constituted 42.66% of the cases. Among the patients 90 (62.94%) patients were ER/PR positive and 42 (29.37%) patients were HER2 positive. Triple negative breast cancer (TNBC) constituted 25.17% (36) of the study population. All receptors were positive in 25 patients (17.48%).
Conclusions: Majority of our patients receiving breast radiotherapy at our center are middle aged and have advanced disease. TNBC and HER2 positive breast cancer are more common in our population.
Versatility and modifications of the cross-finger flap in reconstruction of digital soft tissue defect
Authors: Ruhul Amin M. , Nazrul Hossain Mullah M. , Noor-E-Alam M. , Khan Aleem-Al-Razee , Nahar Lailun , Ashiqur Rahman M. , Nasrin Shafia , Salah Uddin M.
Published: March 2024

Background: Hand injuries can cause major functional and cosmetic concerns. The cross-finger flap (CFF) is an effective treatment for complex finger defects. While CFF has typically been employed to treat volar aspect abnormalities, new versions now address a larger variety of digital soft tissue defects. The aim of the study was to evaluate the clinical outcome of various modified techniques of cross-finger flap which are used to reconstruct different soft tissue defect of fingers.
Methods: This was a prospective observational study carried out in the department of Burn and Plastic Surgery at Dhaka Medical College Hospital, Dhaka from September 2018 to February 2020. Forty (40) patients who presented with different soft tissue defect of fingers included in this study according to inclusion and exclusion criteria.
Results: The study involved predominantly male participants (80%), with a mean age of 31.70±14.28 years. The most common soft tissue defect site was the volar area (47.5%), and various modified cross-finger flap techniques were employed. The majority of patients achieved excellent functional outcomes, with 82.5% classified as good, 12.5% as satisfactory, and 5.0% as poor.
Conclusions: The modifications of the cross-finger flap are versatile and useful for different sites of digital injuries with good functional outcome.
Evaluation of antimicrobial activity of Lactobacillus acidophilus and Lactobacillus rhamnosus against clinically isolated Klebsiella pneumoniae: an in vitro study
Authors: Anil Anju , Raj Ananthu , M. M. Azhar , Kuriakose Nithyamol , Murali Radhika , Kumar K. S. Harish
Published: March 2024

Background: Klebsiella pneumoniae are Gram-negative opportunistic pathogen, belonging to the family Enterobacteriaceae that can cause severe nosocomial infections particularly in immuno-compromised individuals. They exhibit co-resistance to multiple antibiotics which emphasize the need for non-antibiotic therapies. The goal of the presented study was to investigate the antimicrobial ability of probiotic Lactobacilli on clinical isolates of K. pneumoniae.
Methods: In this cross-sectional study, antimicrobial activities of probiotic L. acidophilus and L. rhamnosus on K. pneumoniae were evaluated by Agar overlay interference technique. Clear zone around Lactobacilli were taken as positive inhibition. Antibiotic susceptibility profiles of K. pneumoniae were determined by Kirby-Bauer disk diffusion method, analyzed using interpretive standards of CLSI M100-S33 and categorized into MDR, XDR and Non MDR groups. Statistical analysis was done using descriptive statistics such as mean and standard error and inferential statistics such as ANOVA single factor.
Results: K. pneumoniae exhibited positive inhibition with both the probiotic strain. On comparing the zone of inhibition of L. acidophilus and L. rhamnosus (both treated-pH adjusted and untreated), L. acidophilus had greater zone of inhibition against K. pneumoniae but concluded that statistically the values are insignificant (p>0.05). Based on antibiotic susceptibility pattern of K. pneumoniae, 63% of isolates were XDR, 3% were MDR and 34% were Non MDR
Conclusions: It can be concluded that L. acidophilus and L. rhamnosus had significant inhibitory effect against K. pneumoniae in vitro and should be further studied for their human health benefit.
Prognostication of Bell’s palsy: a new perspective
Authors: Poovathingal Mary Anne , Gilvaz Percival , Chacko Fiju , Baby Neena
Published: March 2024

Background: Bell’s palsy is considered as the most frequent cranial neuropathy. Early and adequate risk stratification may help both the patients and the treating physicians in taking informed decisions regarding treatment and understanding their outcomes. We aimed to formulate accessible and sensitive methods of risk stratification in Bell’s palsy by utilizing electrophysiological and hematological parameters.
Methods: We prospectively followed up 101 patients with Bell’s palsy over a period of 18 months. Electrophysiological parameters were measured thrice i.e., on the first evaluation and after the first week and first month. The N/L, P/L ratio, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were documented in steroid naïve cases. Patients were graded in severity based on the Sunnybrook and House Brackmann systems.
Results: The mean SB and HB grades at admission were 53.89±24.725 and 3.92±1.04 indicating moderate severity. The mean N/L, P/L ratios and ESR on the first day was 3.46±3.45, 145.42±162.84 and 22.51±21.105 respectively. There was no statistical correlation with severity at any time point. The mean CMAP indices on the 1st day, 1st week and 1st month were 0.585±0.31,0.43±0.26 and 0.45±0.23 respectively. The CMAP index at 1 month was correlating with severity. Blink amplitude ratios were correlating with the HB scores at 1 week and 1 month (p<0.0001 both) and the SB score at 1 month (p<0.0001).
Conclusions: Hematological parameters were not correlated to disease severity. However, electrophysiological parameters are correlated to disease severity at one week and one month. Blink amplitude ratio may be a useful indicator for risk stratification of Bell’s palsy patients.
Efficacy of Dr. SKS hair booster serum for the treatment of hair loss in COVID-19 induced persistent telogen effluvium
Authors: Khare Stuti
Published: March 2024

Background: Excessive hair shedding occurs in patients with coronavirus disease 2019 induced telogen effluvium. Dr. SKS hair booster serum has demonstrated encouraging benefits in different types of alopecia in previous studies. We sought to evaluate the efficacy of Dr. SKS hair booster serum for the treatment of COVID-19 induced persistent TE.
Methods: A total of 500 patients aged 18 to 60 years who had recovered from reverse transcription-polymerase chain reaction proven COVID-19 infection but experienced sustained hair fall even after 6 months were included in the study. One millilitre of Dr. SKS hair booster serum injection was administered intradermally in scalp per session. Efficacy and safety outcomes were evaluated at baseline, 3 and 6 months after the treatment.
Results: Approximately half of the patients demonstrated excellent improvement in expert panel global photographic assessment at 3 months (vertex area; 43.6% and frontal area; 46%) that was increased at 6 months (vertex area; 48% and frontal area; 50%). Each patient's clinical condition improved. All patients were satisfied with the results in terms of mean total hair growth satisfaction scale score of five aspects at 3 and 6 months treatment.
Conclusions: Intradermal injection of Dr. SKS hair booster serum proves to be effective treatment for hair loss in COVID-19-induced persistent TE.
Lower urinary tract symptoms evaluation with uroflowmetry in patients with benign prostatic hyperplasia
Authors: Agrawal Shivendra , N. Srinath , Prathvi  , Reddy Sreedhar , L. N. Raju , Bolbandi Deepak
Published: March 2024

Background: Uroflowmetry, a non-invasive urodynamic technique, is commonly employed in evaluating patients with potential lower urinary tract dysfunction. Accurate assessment of the severity of lower urinary tract symptoms (LUTS) can be achieved through the utilization of various validated questionnaires, such as the International Prostate Symptom Score (IPSS). The objective of this study was to investigate the correlation between uroflowmetry parameters and the severity of symptoms.
Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation from May 2022 to December 2023. The correlations between these parameters were quantified by means of Spearman correlation co-efficients.
Results: Significant statistical correlations were identified between the IPSS and uroflowmetry outcomes, including peak flow rate, average flow rate, and post-void residual urine. However, no correlation was observed between the IPSS and measurements of prostate volume.
Conclusions: A positive correlation was observed between the measured peak flow rate through uroflowmetry and the severity of lower urinary tract symptoms.
A study to evaluate the immediate effect of proprioceptive neuromuscular facilitation verses active dynamic stretching during warm-up on 20-meter sprint in amateur soccer players
Authors: Dsouza Carol D. , Kumar Neeraj
Published: March 2024

Background: Soccer is a highly popular sport and is played worldwide. It is an explosive sport and has a high incidence of injuries. In soccer, sprinting dominates the majority of the game, and it imposes a demand on players to have strong, flexible, and dynamic lower limbs. Amateur soccer players don’t usually practice warm-ups before their matches; hence, an appropriate warm-up protocol is required that can be incorporated into the training routine of players to avoid injuries and improve performance. The current study aims to evaluate and compare the immediate effect of PNF stretching versus active dynamic stretching during warm-up on 20-meter sprint performance in amateur soccer players.
Methods: According to the inclusion criteria, 80 amateur soccer players participated in this cross-sectional study design. They were randomly distributed into 2 groups: A) PNF stretching (N = 40) and B) active dynamic stretching (N = 40). Participants in both groups performed the 20-meter sprint test initially, followed by their respective warm-up intervention, after which the 20-meter sprint test was repeated and new readings were recorded.
Results: Both Group A and Group B showed improved performance; however, Group B was significantly better. (p value<0.05).
Conclusions: This study therefore concludes that both PNF and active dynamic stretching can be used as a warm-up protocol. However, according to the inter-group comparison, active dynamic stretching shows a noteworthy improvement in 20-m sprint performance in amateur soccer players.
The universal immunization programme coverage and determining factors among tribal children under the age of five in the Wayanad district of Kerala, South India
Authors: S. R. Arun Krishna , A. S. Hemapriya , S. Kalpana
Published: March 2024

Background: Globally an estimated two to three million deaths occur every year in all age groups, from six major vaccine-preventable diseases and accounts for almost a quarter of all deaths in children under the age of five years. As Immunization is one of the most successful and cost-effective methods for preventing infectious diseases, the Indian government initiated a vaccination programme to reduce infant mortality and morbidity owing to vaccine-preventable diseases, and achieve vaccine self-sufficiency. In Kerala, about 1.5% of the total population makes up Scheduled Tribes, a socioeconomic group with continuously poor health indicators.
Methods: Through a community-based cross-sectional study using cluster sampling technique, this study intends to determine the coverage of the universal immunization programme among tribal children (0-59 months), the factors affecting vaccination coverage as well as the reasons for partial immunization in Noolpuzha Panchayat, Wayanad. A semi-structured questionnaire was used to collect information from caregivers/mothers.
Results: Out of 289 study population, 64.4% were fully immunized and 35.6% were partially immunized. Children's age and the father's education were found to affect immunization.
Conclusions: As a lack of knowledge about immunizations and subsequent doses was the primary reason for partial immunization. There is a need to create awareness about the importance of vaccination and the subsequent doses among the tribal people of Wayanad.
A comparative study on prevalence of uropathogens and their antibiogram in diabetics and non-diabetics attending a tertiary care hospital
Authors: Anne Tanmay , Suryadevara Vijayadurga , B. Anuradha
Published: March 2024

Background: Urinary tract infection (UTI) is a significant problem in both diabetics and non-diabetics. High glucose may create a culture medium for growth of the virulent organisms. Diabetics are at greater risk for developing complications of UTI. Extensive and improper use of antibiotics has caused widespread anti-microbial resistance among uro-pathogens. Indiscriminate use of antibiotics during Covid-19 pandemic might lead to more resistant uro-pathogens which might further complicate the treatment of UTI. This study will help to determine resistance patterns of common uro-pathogens, which is essential for proper patient care.
Methods: Clean voided midstream urine samples were collected from 91 patients (67 diabetic and 24 non-diabetic). Urine cultures were performed using semi-quantitative technique and pathogens were identified using phenotypic methods. Those with colony forming units (CFU) ≥105 CFU/ml were subjected to antibiotic sensitivity testing by Kirby-Bauer disk diffusion method and the isolates were classified as sensitive, and resistant according to CLSI guidelines.
Results: E. coli (53.84%) and Enterococci (29.67%) were the most commonly isolated pathogens of UTI in both diabetics and non-diabetics. E. coli resistance to imipenem was statistically more in diabetics when compared to non-diabetics (p=0.012). Resistance patterns of other organisms were similar in both the groups.
Conclusions: E. coli was the most common pathogen isolated in both groups followed by Enterococci and Klebsiella. Diabetics showed statistically significant higher resistance (100%) to imepenem than non-diabetics. Other organisms isolated in this study did not show any statistically significant difference in their antibiogram.
Factors associated with clinical competency of nursing students
Authors: Yoeum Bonsak , Koy Virya , Sam Rany
Published: March 2024

A critical priority and challenge in nursing education today is caused by the variability of the healthcare environment. This systematic review reported findings on the independent variables that are associated with nursing students' clinical competency. A literature review search was conducted using Mendeley’s website in 2023 with using keywords such as nursing clinical competency and nursing student. The Mixed Methods Appraisal Tool (MMAT) was used to appraise and describe the methodological quality. A narrative report was given on the synthesis of the results. Based on the inclusion and exclusion criteria, 16 papers were retained out of 1162 identified research publications. Among 16 papers, the common predictive factors mentioned in the reviewed articles on the clinical competency of nursing students include clinical learning environment, self-efficacy, and self-awareness. Other factors such as clinical training program, type of learning-teaching, learning experiences, and socio-demographics were involved as the significant variables toward clinical competency. There are several other characteristics or predictors of clinical competency that require further investigation.
Clinical spectrum and treatment outcomes in variants of Guillain-Barré syndrome: a case series
Authors: M. Yashfeen , K. Mugundhan
Published: March 2024

Guillain-Barré syndrome (GBS) is an autoimmune polyradiculoneuropathy that is acute, typically severe, and fulminant. GBS has an incidence of 0.81-1.89 (median 1.11) per 100,000 person-years, and men are slightly more susceptible to GBS than females. 70% of individuals acquire this acute flaccid paralysis condition within 1-4 weeks following a respiratory infection or diarrhoea (especially Campylobacter jejuni). There are several identified subtypes of GBS, with acute inflammatory demyelinating polyneuropathy (AIDP) being the most prevalent. Additionally, there are two "axonal" subtypes: acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN), both of which are clinically severe. The clinical trial of ophthalmoplegia, ataxia, and areflexia characterizes a different subtype called Miller Fisher syndrome (MFS) linked to anti-GQ1b antibodies. The patient's medical history, along with neurological, electrophysiological, and cerebrospinal fluid tests, are used to diagnose GBS. Intravenous immunoglobulin (IVIG) and plasma exchange are effective treatments; however, newer approaches are required because 25% of patients eventually need mechanical ventilation, 20% are unable to walk, and 2-5% of patients may experience relapses.
Yolk sac tumor in children and the resulting biopsychosocial and spiritual aspects
Authors: Hidayatullah  , Savitri Irma , Lisal Lenny M.
Published: March 2024

Yolk sac tumor is a rare germ cell tumor in children, accounting for only about 3.5% of pediatric cancers. However, the yolk sac tumor is a malignant tumor that requires chemotherapy, but the side effects of chemotherapy can have an impact on the biopsychosocial and spiritual aspects of the child. This case report presents the negative impacts on the biopsychosocial and spiritual aspects of a child diagnosed with a yolk sac tumor. 11-year-old girl experienced symptoms of an enlarged abdomen, feeling bloated, pain, and frequent urination. The pathological examination revealed a yolk sac tumor, and the examination of ascites showed malignant cells. The patient was diagnosed with a yolk sac tumor, Stage 1C3, and was to undergo chemotherapy. She scored 15, indicating that the patient experienced anxiety due to the yolk sac tumor diagnosis and was anxious about the side effects of chemotherapy. Examination of the biological, psychological, social, and spiritual aspects in pediatric patients with a yolk sac tumor can assist in addressing the adverse effects of the diagnosis and the anxiety about chemotherapy in a more comprehensive manner.
Amyand's hernia: an uncommon entity
Authors: Silva-Zamora Jorge , Romero Macias Arturo , Baigts Arriola Luis A. , Dámazo Escobedo Cristian A. , Vizcarra Rendón Adriana G. , Sevilla Flores Jose G.
Published: March 2024

A 60-year-old male case whose condition began 6 months prior to admission to the emergency department, presenting an increase in volume in the right inguinal region, with intermittent pain, colic type, with an intensity rating of 8-10/10. On physical examination we found increased volume in the right inguinal region when standing, tumor measuring approximately 5x5 cm, hernia defect approximately 4 cm in diameter, non-painful and reducible. Patient was diagnosed clinically as direct right inguinal hernia and ultrasound confirmed the diagnosis with the presence of the appendix in the sac. A pre-operative diagnosis of right inguinal hernia was made and was planned for hernia mesh repair, during surgery under spinal blockage, the hernia sac was found to contain an appendix without signs of inflammation, so we decided to close the defect and repair with a Lichtenstein mesh hernioplasty without doing an appendectomy. In this case we treated a rare clinical entity called Amyand's hernia. This case highlights the importance of considering Amyand's hernia in the differential diagnosis of inguinal pathologies and the role of imaging modalities in pre-operative diagnosis. Various classification systems have been proposed, including those by Losanoff and Bason, later modified by Rikki et al offering insights into surgical management strategies based on the condition of the appendix and concomitant pathologies. Despite efforts to standardize treatment approaches, consensus on the optimal management strategy remains elusive, necessitating further research to refine diagnostic and therapeutic guidelines.