bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between skill-related fitness performance and birth quartiles among children at age 12 years
Authors: Mat-Rasid Siti Musliha , Low Jeffrey Fook Lee , Elumalai Gunathevan , Shahril Mohd Izwan , Ahmad Mohamad Azri Ismail , Musa Rabiu Muazu , Kosni Norlaila Azura
Published: September 2024

Background: The birth year is a criterion for grouping competitive categories in various sports. Children born in the early months of the calendar can benefit during their formative process because they have a higher chronological age and are more likely to be in more advanced stages of biological maturation. Objectives: To test the association between skill-related fitness performance and birth quartiles for understanding the relative age effect (RAE) among 12-year-old children in Malaysia.Method: A total of 462 school children (226 boys and 236 girls) with mean age of 12.5 ± 0.5 years were involved in this study. The children underwent four skill-related fitness assessments: 30-metre run, agility t-test, stork balance stand test, and standing broad jump test. Agglomerative hierarchical clustering (AHC) was used to assign participants to the high performance (HPG), moderate performance (MPG), and low-performance (LPG) groups. The groups were split into a contingency table according to four quartiles: Q1 (January to March), Q2 (April to June), Q3 (July to September), and Q4 (October to December). The Chi-square test was used to test the association between performance groups and birth quartile variables.Results: Among the boys, the HPG, MPG, and LPG comprised 105, 81, and 40, children respectively. Among the girls, the HPG, MPG, and LPG comprised 104, 77, and 55 children, respectively. Results of the Chi-square revealed the p-values (0.016) and (0.032) for boys and girls, respectively, were lower than the significance level of alpha = 0.5, demonstrating that the presence of a performance group depends on the variety of birth-month quartiles.Background: The birth year is a criterion for grouping competitive categories in various sports. Children born in the early months of the calendar can benefit during their formative process because they have a higher chronological age and are more likely to be in more advanced stages of biological maturation.Conclusions: The relative age cut-off point has an impact on children's skill-related fitness performance in both boys and girls.
Multiple Mediation and Moderation Variables Effect and Review: Statistical Analysis with a Multiple Independent Variables
Authors: Sivalogathasan V. , Jahufer A.
Published: September 2024

This study briefly discusses the process of mediating and moderating analysis in a management research process. The modern approaches to statistical mediation and moderation analysis focus on estimation and inference about the indirect effect of independent variables X on dependent variable Y through proposed intervening variable M and moderation variable Z. Mediators and moderators are often overlooked in research designs, or the terms are used incorrectly. To date, virtually all discussions of these approaches have assumed X is either dichotomous or continuous, even though investigators frequently are interested in testing mediation hypotheses involving multiple independent variables. The aim of the research study is to learn from past practice and to use that knowledge to signal to researchers the importance of correctly applying mediation and moderation tests as well as to facilitate the valid testing of mediation and moderation models and the reporting of mediations and moderators results in future management research studies. This research article summarizes the conceptual differences between mediators and moderators. The statistical analysis of mediators and moderators in multiple regressions is briefly described and presented. The authors describe the estimation of indirect effects in statistical mediation analysis with a multi-independent variables and moderation variables. The authors introduce the concept of the relative indirect effects, show how relative indirect effects are estimated in multiple regressions and structural equation modeling and how they are interpreted as functions of how the variables are analyzed. The authors describe inferential tests for the relative indirect effects and provide examples.
Microsurgical Clipping of Recurrent A1 Segment Aneurysm Post Coiling
Authors: Huggi Mallappa , Panigrahi Manas
Published: September 2024

ABSTRACT

Cerebral aneurysm is a common cause of intracranial haemorrhage. It can be treated either by coiling or clipping. Both modalities have their pros and cons. There are chances of recurrence of aneurysm post-coiling. Clipping is a viable option in some cases of recurrence of aneurysm post-coiling. A 66 year old female, known hypertensive, with hypothyroidism, presented with severe headache for 2 days computed tomography (CT) suggestive of subarachnoid haemorrhage. She underwent DSA which was suggestive of left A1 aneurysm. She underwent coiling of aneurysm with complete obliteration. Four weeks later, the patient developed a sudden onset of headache and vomiting. CT brain was suggestive of rebleed. DSA was done suggestive of regrowth of left A1 aneurysm. The patient underwent microsurgical clipping of recurrent aneurysm. Surgery and post-operative period were uneventful, and the patient had good recovery. Follow-up angiogram showed complete aneurysm obliteration.
Spontaneous Intracerebral Haemorrhage during Pregnancy: Management Concerns
Authors: Pradhan Aseem , Baxi Udgam , Menon Girish
Published: September 2024

ABSTRACT

Spontaneous intracerebral haematomas in the obstetric setting pose considerable challenges. Decision-making involves deliberations on the gestational age, neurological status of the mother, clot volume, underlying pathology, timing of surgery if indicated, maternal positioning during neurosurgery, anaesthesiologic strategies, monitoring of the pregnancy during surgery and the mode of delivery. We present the case history of a 36-year old female homemaker (G2 P1 L1) who presented to the emergency in her 29th week of gestation with a large putaminal bleed. The report discusses the management and ethical dilemmas encountered during the management of obstetric patients with spontaneous intracerebral hematomas.
Fatal Cardiac Tamponade following Road Traffic Accident
Authors: Kumar G. N. Pramod , Rani Smitha , Bakkannavar Shankar M.
Published: September 2024

Cardiac tamponade following blunt trauma results from cardiac rupture, leading to death even before the patient can receive medical attention. In such cases, the collected fluid (blood) in the pericardium inhibits the diastolic filling compressing the myocardium resulting in obstructive shock. We are reporting the case report of a 30-year-old male who was brought dead to the hospital with a history of road traffic accidents. The investigating officer informed that the deceased driver was not wearing a seat belt. Autopsy findings showed fresh blood clots of 600 g in the pericardial sac with rupture of the left ventricular wall of the heart. There were contusions on the anterior aspect of the vertebrae corresponding to the heart level. Although it is impossible to prevent all the cases of cardiac tamponade, we can avoid the ones resulting from trauma. This case intends to stress the importance of wearing a seat belt while driving a car to prevent fatal injuries.
IndiGen Project and Its Application in Criminal Law in India
Authors: Sharma Abhinav Vardhan , Bhardwaj Somdutt
Published: September 2024

India has more than 4500 distinct population which are different based on caste, tribe, religion, locations, physical features, social beliefs, and language. Genome India project was approved in February 2020 by the Ministry of Science and Technology to aim gene-mapping of 10,000 samples across India. The IndiGen program achieved the entire genome sequencing of the 1029 healthy Indians. Gene sequencing at population scale can now be benchmarked using this method. The ability to decode the genetic blueprint of Indians for diagnosis and treatment of rare diseases will be emerged further on. A national of different deoxyribonucleic acids (DNAs) is maintained by the government for the purpose of medical and matching the criminal DNAs during trials. The UK established its National DNA Database in 1995 by the name of National DNA Database. Australia has almost 8.37 million DNA profiles, which they are using as forensic data. It involves novel methods for monitoring and controlling behavior as well as redesigned means of administering justice, all of which contribute to the construction of new ideas of justice and social governance. DNA phenotyping can be included in the criminal justice system by the project to make it DNA database and DNA databank for the law. This goal can be accomplished by determining the distribution of the data of the genetic outlines by geographical zone and the following closeness of the reference sample to a probable area of origin.
The Impact of Different Stain Carriers on the Mrna Profiling from Bloodstains
Authors: Zhao Hemiao , Lin Qingluan , Zhang Qi , Chen Jing , Tu Zheng , Yang Ruiqin , Hu Lan , Wang Chong
Published: September 2024

Unlike DNA profiling, mRNA profiling is greatly affected by external factors. To analyze the influence of different stain carriers on the detectability of mRNA markers from bloodstains, this study examined 10 carriers, including a knife, cotton swab, paper, plastic, leather, cement, chopsticks, clothes, ceramic block, and wall. After detecting five specific mRNA markers (HBA, HBB, ALAS2, GYPA, and SPTB) and the housekeeping gene B2M in peripheral blood samples, no statistically significant differences in the effects of the carriers were found. The results suggest that when performing mRNA testing on bloodstains, the effect of the stain carrier has little influence.
Evidence for Cerebral Microvascular Injury in Head Trauma Involving Infants and Young Children
Authors: Castellani Rudolph J. , Scholl Ashley Rose , Schmidt Carl J.
Published: September 2024

Background:

The pathophysiology of lethal head trauma in infants and young children involves repetitive rotational forces of sufficient magnitude to produce subdural hemorrhage and brain swelling, which leads to considerable morbidity and mortality. The precise mechanism for brain swelling is unclear.

Materials and Methods:

We examined cerebral tissue from ten pediatric deaths due to blunt force trauma, along with seven control infants who asphyxiated in unsafe sleep environments. To assess the competence of the blood–brain barrier, we performed immunohistochemical stains for albumin and immunoglobulin G (IgG).

Results:

IgG and albumin were increased in subpial and superficial perivascular tissue in those cases due to blunt force trauma, and in particular, the blunt force trauma associated with subdural hematoma. This included two deaths at the scene without hospital survival time.

Conclusions:

Our findings suggest disruption of the blood–brain barrier with vasogenic edema as an early event in head trauma involving young children upstream of global ischemic brain injury. We hypothesize that mechanical injury to the cortical vasculature results in vasogenic edema by oncotic (increased plasma proteins in the cortical interstitium) and hydrostatic (increased capillary pressure) mechanisms, with subsequent cortical ischemia. This may explain why ischemic sequelae appear to occur in head trauma involving young children, regardless of whether anoxia, hypotension, or cardiac arrest complicate the disease course and may in part underlie the high morbidity and mortality of head trauma in early childhood.
Asian Crocodile Poaching
Authors: Mitra Ishani , Roy Soma , Haque Ikramul
Published: September 2024

Crocodiles, gharials and alligators (order Crocodilia), are aquatic reptiles that live in the tropics of Asia, America, Africa, and Australia. Asian countries such as India, Indonesia, Malaysia, and tropics of Australia are the stronghold of the family Crocodylidae. Among all 23 crocodile species, nine species occur in Asia and its surroundings, including the only member of Gavialidae and Alligatoridae family. They are “mugger” or “Crocodylus palustris,” “saltwater crocodile” or “Crocodylus porosus,” “Philippine crocodile” or “Crocodylus mindorensis,” “New Guinea crocodile” or “Crocodylus novaeguineae,” “Siamese crocodile” or “Crocodylus siamensis,” “gharials” or “Gavialis gangeticus,” “false gharial” or “Tomistoma schlegelii,” and “Chinese alligator” or “Alligator sinensis.” All of these species have been encompassed in “Appendix I” and “Appendix II” of the “Convention on International Trade in Endangered Species of Wild Fauna and Flora,” which prevents any kind of trade involving crocodilian species. However, it has been observed that these crocodiles are illegally poached and trafficked for their lucrative skin, meats, eggs, snouts, and bones in medicinal and cosmetic industries. Although many molecular biologists have come forward for the conservation of these species, lack of knowledge about the available, fast, and dependable techniques makes it difficult for forensic identification of seized or confiscated. It has been a major problem for the implementation of the “Wildlife Protection Law” on illegal trade. This article focuses on molecular techniques developed till date for the rapid and reliable species identification and conservation study of them.
Clinicosocial Profile of People Who Inject Drugs Receiving Opioid Substitution Therapy at New Delhi
Authors: Naveen Alagarasan , Naik Shrabana Kumar , Kataria Dinesh , Murari Atul
Published: September 2024

Introduction:

Injecting drug use is a public health concern due to its clinical, social, economic, and legal consequences.

Objective:

(1) To evaluate the prevalence of infections associated with injecting drug use; and (2) To assess the social profile of substance users and high-risk behaviors among people who inject drugs (PWID) receiving opioid substitution therapy (OST).

Materials and Methods:

A cross-sectional study was conducted among 100 PWID who were deemed eligible using inclusion and exclusion criteria. Data were collected through an interviewer-administered structured questionnaire after obtaining informed written consent.

Results:

The results revealed that 14% of PWID had human immunodeficiency virus (HIV), 7% had tuberculosis, and 2% had hepatitis B virus (HBV). None of the PWID self-reported hepatitis C virus (HCV) infection. Importantly, 71% of PWID were living on the streets (i.e. homeless), and 41% of PWID had a history of sharing needles with other users in the preceding 3 months. Unmarried or single PWID had significantly increased risk of homelessness (χ2 = 4.570; P = 0.032) and reported high-risk sexual practices with commercial sexual partners in the preceding 3 months (χ2 = 4.163; P = 0.041). Homeless PWID had significantly increased frequency of injecting practices (P = 0.020).

Conclusion:

Despite the higher global prevalence of HCV compared with HBV and HIV among PWID, HCV testing is not currently conducted at most OST centers in India. Access to free needles and syringes should be enhanced to reduce the morbidity associated with injecting drug use.
Pilot Study on Associating Pen Pressure with Pen Holding Position Using Three-Dimension Property of Stroke Indentation
Authors: Guo YingXiu , Li Bing
Published: September 2024

Objectives:

The author collected several samples with Chinese characters and utilized the 3D property of stroke indentation to explore how pen strokes left on the paper can assist with forensic investigation.

Methods:

We chose to collect the three-dimension property of handwriting strokes and analyze strokes indentation. In this study, the author extracted stroke indentation through focus variation microscopy as implemented by AB8000.

Results and Conclusion:

Upon experimenting with different types of pens and different writing surface, the author found that this result can tell with a great degree of certainty whether the sample is formed with a left-hand or right-hand writer and how the pen was being held. Although there are variations among the test results, the discovered pattern generally holds for different types of pens and writing surfaces, except that the result from using felt tip pens or extremely hard surfaces are less satisfactory. These findings are expected to be able to assist in narrowing down who wrote a certain handwriting sample.
An Acoustic Analysis of Fluctuations for Inter- and Intra-Speaker Variability in Speech Sounds
Authors: Kaur Jasdeep , Juglan Kailash Chandra , Sharma Kush , Sharma Vishal
Published: September 2024

Background:

Variation in the speech of speakers is a crucial issue for the forensic system. The main reason behind incorrect speaker identification is greater intra-speaker fluctuation. In the forensic state of play, a lot of research has been carried out on speaker identification. However inter variations and intra fluctuations in speakers for the Punjabi language is still a grey area.

Aims and Objectives:

Our aim is to study acoustic analysis of fluctuations for inter and intra speaker variability in speech sounds. In our study, we will consider Punjabi vowel with consonants. The Statistical methods will be applied to analyze the data; firstly, the Shapiro-Wilk test will be checked for normality and then Levene’s Test to assess the equality of variances.

Materials and Method:

Five vowels were selected with different consonants. They were combined to make meaningful words. Then these meaningful words were embedded in sentences. Ten speakers participated voluntarily. All are students of A.S College at Khanna in Punjab. The individuals were aged between 20-22 years with no hearing or speech disorder. The voice samples were recorded with help of good quality microphone and by Goldwave software in the sound proof lab.Samples were introduced directly into PRAAT software by the use of a Sony microphone and with sampling rate of 44100 Hz frequency. Acoustic Analysis has been done with help of Goldwave software in form of spectrograms.

Results and Conclusion:

Each formant shows a different value for inter variations and inter speaker fluctuations. F1 and F2 shows lesser speaker variation than the high-frequency region in F3 and F4, so we can say that in comparison with the lower part, high-frequency regions are more valuable. The assumptions for TWO-WAY ANOVA is violated and hence, we have used the non-parametric Friedman Test and performed its Post hoc analysis. From Posthoc analysis, we can say that F1 and F2 (p >0.05) and F2 and F3 (p>0.05) gave the same type of results. Hence, from the results of these statistical tests, we can conclude that F1 is recommended over F2, F3, and F4. As the frequency of F1 is high as well as in line with the results of statistical tests. Because we prefer more variation among frequencies so that we can easily distinguish different speakers and it would be more beneficial for inter variations and intra fluctuations.
Distinctive Bullet Impact Holes by 9-mm Caliber Projectile on Sheet Metal Surfaces
Authors: Abd Malik Syamsul Anuar , Nordin Farah Ad-din , Mohd Ali Saiful Fazamil , Lim Abdullah Ahmad Fahmi , Chang Kah Haw
Published: September 2024

Introduction:

A comprehensive scene reconstruction requires forensic investigators to examine the impact marks left on various surfaces to identify whether a projectile produces a specific hole. Subsequently, it is further necessary to determine whether a particular ammunition has caused the impact. Throughout history, designs of ammunition have evolved with the intended effects, which could leave different impact marks on a target surface, especially by ammunition with a nonconventional design. Careful examination on impact marks and determination of their specific characteristics on sheet metal of vehicle would provide crucial forensic information.

Aim:

This study was aimed to physically characterize bullet impact holes made by 11 types of 9-mm caliber ammunitions.

Materials and Methods:

Two automotive doors were shot with different ammunitions from the same firearm, and the morphological features of bullet impact holes were observed and compared.

Results:

Bullet impact holes produced by the various ammunitions could be differentiated through careful observation of bullet hole circumferences, presence of petalling effect, metallic ring and triangular peak at the edge, and deposition of residue at the peripheral area of bullet impact holes. Ammunitions with nonconventional design such as Inceptor-Polycase and GECO Hexagon showed observable morphological differences and discriminated them from bullet impact holes made by conventional ammunitions.

Conclusion:

A thorough physical examination could aid in distinguishing bullet impact holes and predicting the possible types of ammunition that had made an impact hole on a surface.
Road Traffic Accident Fatalities and its Association with Key Sociodemographic Determinants in Nashik, Maharashtra
Authors: Chhetri Tej Bahadur , Ahmed Syed Meraj
Published: September 2024

Background:

Road traffic accidents are not a new phenomenon, rather it's a disturbing occurrence which shows no sign of abating very soon. Rather, it remains one of those public health issues which even the most educated and civilized populations tend to ignore, primarily for the thrill of it. This study aims to identify the outcome associated with vehicular accidents and its association with socio-demographic factors.

Method:

This is a retrospective, record-based study of victims of road traffic accidents admitted in a tertiary care hospital in Nashik, Maharashtra. The data would include records from the 2018 to 2019. The variables will include the socio-demographic factors, site of injuries and its severity. A descriptive analysis would be done by SPSS software to find out the prevalence of vehicular accidents, association of site of injury with age and severity of the trauma. Ethical approval would be taken before the initiation of the study.

Result:

A total of 486 victims of RTAs were included from the medical records of the casualty of a tertiary care hospital, out of which 330 were from the year 2018 and 156 from 2019. A look at the sociodemographic profiles of the RTA victims showed that females comprised only 19.3% (2018) and 18.6% (2019) of the total victims in road traffic accidents, while majority, 80.6% (2018) and 81.4% (2019) were males during the same period. Overall, we can also observe that both in 2018 (38.5%) and 2019 (50.6%) most of the road traffic accidents among the victims were of moderate grade.

Conclusion:

The need of the hour is to bring about a change from within through self-reflection of lawmakers, strict implementation of traffic rules and guidelines with hefty fines, lockup, and criminal punishment to habitual wrongdoers.
Histological, Ultrastructural, and Genetic Investigatory Comparison between Different Types of Experimentally - Induced Antemortem Burns
Authors: El Euony Omnia I , Wisely Youstina W , Nazem Ashraf M , El Okle Osama S
Published: September 2024

Background:

Burn is a cutaneous injury that is caused by heat, electricity, chemicals, freezing, and radiation.

Aims and Objectives:

This study aimed to differentiate between dry heat burn injury and other common cutaneous burn injuries.

Materials and Methods:

For this, different types of dermal burns were created experimentally in four groups of rats, 5 rats for each, as the following: dry heat burn model, scalding model, chemical burn model, and electrical burn model. The burnt skin and hair samples were subjected to scanning electron microscopic examination, molecular assay of aquaporin-3 (AQP-3) gene expression, and histopathological investigation.

Results:

There were crakes, holes, and cuticular irregularity in hairs exposed to both dry heat and sulfuric acid (chemical burn), while the major lesion observed in hairs exposed to boiling water (scald injury) was cuticular cell loss. On the other hand, dry burnt skin showed empty orifices of the hair and sebaceous gland with overlapped smooth lamella, while scald induced irregularity of collagen fibers. The sulfuric acid produces separation of the epidermis from the dermis and irregularity in collagen fiber. Rat skin exposed to electric current appears with fissure, lacerated edges, and erected broken hairs. Despite AQP-3 gene expression was significantly upregulated in the burnt skin of all experimental models in comparing with control rats, dry heat burned skin showed the highest upregulated level. In addition, the coagulation of the dermoepidermal cells and vesicles formation were the most pronounced lesions observed in all types of burns, while scald was distinguished by appearance of elongated cellular nuclei.

Conclusion:

These observations suggest the possibility to differentiate between dry thermal burn, scald injury, chemical burn, and electrical burn using the combination between scanning electron microscopic examination, analysis of cutaneous AQP-3 gene expression, and histological investigation.
Sudden Death in Goldenhar Syndrome
Authors: Hugar Basappa Subhas , Hosahally Jayanth S. , Kumari Kalpana , Chisti Samiya
Published: September 2024

Goldenhar syndrome (GS) is a rare congenital disorder that is characterized by incomplete development of the ear, eye, nose, soft palate, lip, and jaw. It is also called oculo-auriculo-vertebral syndrome of Goldenhar, the name describes the common structural problems seen with the eyes, ears, and vertebrae. The outlook for children with GS varies but is generally very positive. Most children can expect to live a healthy life once treatments have been administered. However, certain congenital heart defects seen in this syndrome such as ventricular septal defect (VSD), persistence of arterial conduct, tetralogy of Fallot, and big vessel transposition can lead to sudden death during childhood. These defects are usually diagnosed during intrauterine life by means of fetal echography, leading to termination of such pregnancy or necessary corrective measures after the birth of such child. If such a child dies, it will be certified by the treating pediatrician. Thus, an autopsy pathologist rarely comes across such deaths. One such case of a 45-day-old female infant suffering from craniofacial deformity who became breathless, cyanotic, and died on the way to the hospital is being discussed here. The right ventricle showed double outlets, arising from it were the pulmonary artery and aorta. A small subaortic VSD was seen. Generalized hypoplasia of all internal viscera on the right side was observed.
Exergaming as a mental health intervention in the elderly
Authors: Bhattacharya Ishita , Ambetkar Divya , Patil Vishakha , De Sousa Avinash , Karia Sagar
Published: September 2024

Exergames is a new arena of mental health intervention in the elderly. The present article is a clinical review on various areas where exergaming has been used to enhance mental health in the elderly. The review looks at the use of exergames in dementia, geriatric depression, as a tool for movement and to improve memory and cognition. The role of exergames in improving intellectual function, instability and falls in the elderly is also discussed. The role of exergames to improve fragility is mentioned. The review looks at the advantages and disadvantages of exergames in the elderly and the limitations of various studies done so far from a clinical and scientific rigor standpoint. The future research needs are also discussed. Exergames is a mental health intervention area in geriatric mental health that will be used more in the years to come.
A study of handwriting sample in geriatric population with cognitive impairment
Authors: Heijebu V. Suresh , Singh Bhupendra , Srivastava Shrikant , Singh Shivendra Kumar
Published: September 2024

Objectives:

Cognitive impairment in the geriatric population often remains undiagnosed until progressed enough to cause interruptions in activities of daily living. Routine tests are time taking, requiring a specialist. Handwriting function reflects the brain's cognitive capacity by involving it's both halves. It is easy to collect and does not strain the participant, and can aid in the faster diagnosis of cognitive impairment.

Materials and Methods:

To study handwriting parameters collected with Livescribe Echo Smart Pen and compare them with cognitive scores of Montreal Cognitive Assessment-Hindi (MOCA-H) and Addenbrooke's Cognitive Examination-Hindi (ACE-H) in a cross-sectional observational study. Handwritten parameters differentiating both cognitive groups were identified and analyzed.

Results:

The mean age of the study population was 66.4 (5.3) years. The mean MOCA score in the cognitively impaired (CI) and noncognitively (NCI) group was 22.67 and 27.00, respectively. The mean ACE-H score in CI and NCI group was 80.68 and 93.05, respectively. In all handwriting tasks (T1-T3), higher scores were obtained on all parameters in the CI group except text width (TW), stroke frequency (SF), and writing speed (WS). In handwriting task 3 (single letter repetition), WC (word count) was found to be higher in the NCI group. Handwriting parameters of the whole task (TOT, PSPS, TW, TH, NOL, and WS) and text line (MTOL and MTOSS) were found to be helpful in group differentiation in all three tasks. There was a moderate degree of positive correlation with handwriting parameters (PSPS, WS, and WC) and a negative correlation with handwriting parameters (NOPS, TOT, TH, NOL, MHOL, MTOL, and MTOSS) across the tasks with MOCA and ACE scores.

Conclusion:

Inclusion of quantitative handwriting analysis in neuropsychological assessment can be one step forward towards a simple, reliable, and faster diagnosis of geriatric cognitive impairment.
Assessment of alexithymia and cognition in elderly patients with depression
Authors: Faye Abhijeet , Tadke Rahul , Gawande Sushil , Bhave Sudhir , Kirpekar Vivek , Chatterjee Anirban
Published: September 2024

Objectives:

Depression is the most common psychiatric illness in the elderly. Alexithymia and cognitive impairment can be independently associated with depression and old age. This study aims to assess the alexithymia and cognitive dysfunction in geriatric patients with depression.

Materials and Methods:

A cross-sectional study was conducted on 100 participants of >60 years with depression. Participants were assessed using semi-structured pro forma, Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20) having 3 subscales – “difficulty describing feeling” (DDF), “difficulty identifying feeling” (DIF), and “externally oriented thinking,” and Montreal Cognitive Assessment (MoCA). Statistical analysis was done using Chi-square/Fisher's exact test, Pearson's correlation, and t-test.

Results:

The mean age of the participants was 67.35 years with equal gender distribution. Thirty-four percent were >70 years of age and 53% from rural area. The median duration of depression was 30 months with a median duration of untreated illness, 6 months. Anxiety was the most common psychiatric comorbidity (43%). Seventy-one percent had alexithymia whereas 77% had cognitive impairment (MoCA score <26). Scores on GDS, HDRS, TAS-20, DIF, DDF, and MoCA (<26) were significantly higher in elder participants (P < 0.05) and those from rural area (P < 0.05). Higher TAS-20 score correlated with lower MoCA score (P < 0.01). Furthermore, severe depression correlated with higher TAS-20 and lower MoCA score.

Conclusion:

More than two-third of participants had alexithymia and cognitive dysfunction. Higher alexithymia was associated with poor cognition. Severe depression correlated with higher alexithymia and cognitive impairment. Alexithymia and cognitive dysfunction were higher in the elderly from rural region.
Relationship between disability, caregiver burden and coping with depression in stroke survivors
Authors: Nagaraju Saraswathi , Saroja Aralikatte Onkarappa , Naik Karkal Ravishankar , Harbishettar Vijaykumar
Published: September 2024

Background:

Post-stroke depression (PSD) is seen in up to 35% of stroke survivors, contributing to morbidity and caregiver burden, that could deter the acute and rehabilitation treatment. Depression in stroke contributes to more disability and caregiver burden. Understanding coping methods of caregivers in PSD results in better caregiving, reduces stress and improves family relationships. There is paucity of studies examining PSD and its determinants in Indian context.

Objectives:

The objective is to study the association of PSD with disability, with caregiver burden, and coping methods adopted by the caregivers.

Methods:

Consenting participants (and their caregivers) attending Neurology outpatients with the first episode of Stroke (N=226) in a tertiary care center in a tier 2 city in South India, with 56% participants from rural background, were evaluated between three and six months of stroke. Two groups namely PSD (n = 67) and post-stroke without depression (PSwD, n = 159) based on cutoff score of 9/10 on a valid Hamilton Depression Rating Scale were compared for their demographics, social, physical, and functional factors. Barthel Disability Index (BDI) for disability, Zarit Burden Interview (ZBI) for caregiver burden and coping checklist (CCL) by Rao et al. on caregivers particularly prepared for studying in the Indian context were also administered.

Results:

The rate of PSD was found to be 29.6%. PSD group were older and had relatively more common in females (p < 0.001). The type of stroke and site of vascular lesion were not associated with PSD (p = 0.68 and p = 0.24). Stroke severity scores were higher in PSD group (p < 0.001). Disability as per BDI scores was greater in PSD group against PSwD group (p < 0.001). ZBI scores show greater caregiver burden in PSD group than PSwD (p < 0.001). Measures were significantly higher in all CCL sub-categories in caregivers of PSD group compared with PSwD.

Conclusion:

PSD prevalence of close to one third in stroke survivors, with female gender, older age, stroke severity, and functional disability as its key determinants. Furthermore, the PSD was significantly associated with caregiver burden and study also found preferred coping methods were adopted by caregivers of PSD group. Early identification and treatment of PSD is of utmost important to minimize disability, reduce caregiver burden and improvise coping methods.
Understanding geriatric binge-watching from a case-based perspective
Authors: Sharma Manoj Kumar , Amudhan Senthil , Arya Sidharth , Anand Nitin , Sahu Anamika , Kumar Rajesh , Tripathi Ravikesh
Published: September 2024

Binge-watching is a new phenomenon characterized by watching TV/online series continuously. The relatively sedentary way of life and its associated psychological factors among the elderly may make them vulnerable to technology misuse and potential problematic binge-watching. We describe a case of a 72-year-old male professional who sought help to manage problematic binge-watching of teleseries. The clinical evaluation highlighted the mediating role of motivation factors (need for self-absorbing activities, compensatory motivation to manage low mood and loneliness) in binge-watching. This case study provides insights into the motives of the elderly for binge-watching and highlights the need to promote behavioral strategies for strengthening the healthy use of technology among the elderly, allowing them to age healthily with advancing technologies.
Identification of a Novel KIF11 Variant p.(Leu804Thrfs Ter13) in a Case with Isolated Microcephaly
Authors: Yalcintepe Sinem , Guler Hazal Sezginer , Zhuri Drenushe , Eker Damla , Gurkan Hakan
Published: September 2024

Microcephaly is a rare neurological condition, and it is characterized by a smaller head than other children of the same age and sex. Microcephaly with or without chorioretinopathy, lymphedema, or mental retardation (MLCRD) is a syndrome with a varying spectrum that occurs as a result of variants of KIF11 gene. A 3-year-old girl was presented to our clinic with microcephaly; she had no motor or growth retardation except microcephaly. After obtaining a normal karyotype and microarray result, Trusight One-Expanded Panel analysis showed NM_004523.4 (KIF11): c. 2409dupA (p. Leu804Thrfs Ter13) heterozygous pathogenic novel variant. Patients who have KIF11 mutation often also have different clinical features; in our case, the motor development is consistent with its peers and has a history of prenatal and postnatal microcephaly. Microcephaly can be caused by a variety of genetic mutations. In our case, firstly we identify the association of a novel de novo KIF11 gene duplication variant related to isolated microcephaly.
Hemostatic and Hemodynamic Effects of Topical Administration versus Intranasal Injection of Adrenaline during Endoscopic Sinus Surgery
Authors: Rasheed Muhammed , Felix Vinod , Narendrakumar Veerasigamani
Published: September 2024

Aim:

The study intents to compare the hemostatic and hemodynamic effects of topical application versus intranasal injection of adrenaline during endoscopic sinus surgery (ESS) under general anesthesia (GA).

Materials and Methods:

This is a tertiary hospital-based, 1-year prospective observational study in fifty adults, within the age group of 18–70 years of both sexes with bilateral similar sinonasal pathology, who underwent ESS under GA. Intraoperative hemostatic and hemodynamic parameters following topical application and intranasal injection of adrenaline were analyzed.

Results:

It was found that Fromme–Boezaart grading for hemostasis did not show any statistically significant difference (P > 0.05) between topical versus injection adrenaline. Out of fifty patients, 74% showed <10-ml difference in blood loss and only 6% of the study population showed more than 20-ml difference in blood loss. The heart rate and mean arterial pressure were found to be increased following intranasal injection of adrenaline (P < 0.001). Six percent of the study population developed electrocardiogram variation in the form of sinus tachycardia following local infiltration of adrenaline.

Conclusions:

Topical application of 1:2000 dilution of adrenaline gives similar hemostatic effects compared to intranasal infiltration of 1:100,000 dilution of adrenaline during ESS, and thus, we can avoid the systemic adverse events such as tachycardia, arrhythmia, and mean arterial pressure changes due to adrenaline infiltration.
Platelet Rich Fibrin for Post Covid Nasal Swab Cerebrospinal Fluid Leak
Authors: Sree Lalitha , Pinki Sanooja S , Vinod Felix , Niharika Senthilkumar
Published: September 2024

Nasopharyngeal swab collection procedure has been used as a part of COVID-19 testing. Few cases of cerebrospinal fluid (CSF) leak following nasopharyngeal swab have been reported so far. Here, we report an interesting case of CSF leak following nasopharyngeal swab for COVID testing which we repaired using platelet-rich fibrin as an outpatient department procedure.
“Race for SARS-CoV2 Vaccine
Authors: Shahid Areeba , Misra Neeta , Channaiah Shivakumar Ganiga , Narayanappa Sumalatha Masineni
Published: September 2024

In today's pandemic era, the public is eyeing eminent scientists to develop a successful vaccine against the highly contagious SARS-CoV2 infection, commonly known as COVID-19. It will be a relief to the overwhelmed medical fraternity. The oral cavity can be a great medium to deliver needle-free vaccination, which is psychologically beneficial to the general public. It is the most exigent vaccination method and still lacks protocols to investigate the efficacy of these systems. However, oral vaccination seems promising, offers several benefits at the societal level, is economically beneficial and hints at the possibility of rendering both cellular and antibody-mediated immunity. Here, this review article gives an overall view of oral vaccination, its challenges, and possibilities, with a focus on vaccine development against SARS-CoV2, administered via the oral route.
Contralateral Neck Dissection in Oral Cavity Cancers Crossing Midline
Authors: Wani Sachin , Modi Nishith , Srinitya M. , Bhatt Rajiv , Shah Shishir , Shah Ankit , Choksi Nikita
Published: September 2024

Introduction:

Oral cavity cancer is the most common cancer in our country. In patients with oral cavity squamous cell carcinoma (OCSCC) elective neck dissection results in higher rates of overall survival and disease-free survival. Nodal metastasis in OCSCC is related to poor prognosis. Elective ipsilateral node dissection is recommended in all patients. Contralateral nodal metastasis is associated with poorer prognosis. The purpose of our study is to identify the predictors and factors associated with bilateral or contralateral nodal metastasis in oral cavity cancers reaching or crossing the midline.

Materials and Methods:

All patients of oral cavity cancer where the primary cancer was reaching or crossing the midline, operated during 3 years in a single institute were taken up for the study. All patients underwent surgery of primary cancer and bilateral neck dissection. Patients with truly lateral disease not approaching midline, history of any previous oncologic treatment, and recurrent cancers, and patients with two or more primaries were excluded from the study.

Results:

Out of 93 patients, 43% of the buccal mucosa – gingivobuccal sulcus region and 57% of the tongue – floor of mouth region. Out of 46 patients having nodal metastasis (50%), 26.8% of patients had bilateral nodal metastasis, but none had isolated contralateral nodal metastasis. On univariate and bivariate analysis, we found tumor grade, stage, site of ENE, and presence of multiple ipsilateral positive nodes were significant factors predicting contralateral nodal metastasis.

Conclusion:

Surgical management of the contralateral neck in oral cavity cancer is a complex issue. The simplistic approach of doing contralateral neck dissection in all oral cavity cancers when disease crosses midline is not sufficient. The presence of contralateral neck node metastasis in the absence of positive ipsilateral neck is very rare (0% in our study). There are other important clinic radiological factors such as DOI >10 mm, involvement of skin and bone, and presence of extranodal extension and location of primary tumor which also need to be considered in decision-making algorithm.
Diagnostic Role of Galectin-3 Immunohistochemistry in Thyroid Lesions
Authors: Sarin Karishma , Bhagat Ranjeev , Punia R. P. S. , Das Arjun , Handa Uma
Published: September 2024

Background:

Galectin-3 (Gal-3) is a good diagnostic marker for thyroid cancer. Evaluation of diagnostic accuracy of this marker complements the morphological assessment of a particular thyroid lesion. The aim of this study was to evaluate the immunohistochemical expression and diagnostic role of Gal-3 in various surgically resected thyroid lesions.

Materials and Methods:

Surgically resected thyroid specimens from 50 patients with hematoxylin and eosin (H and E)- and Gal-3-stained sections were studied.

Results:

The age of the patients ranged from 14 to 64 years. Of the 50 patients, 12 (24%) were male and 38 (76%) were females. Various histopathological diagnoses included were inflammatory lesions 8 (16%), hyperplastic lesions 15 (30%), and benign 2 (4%) and malignant 25 (50%) lesions. On quantitative analysis of Gal-3 immunostaining, 16/16 (100%) of the papillary thyroid carcinoma (PTC) cases showed a positive expression. In the rest of the malignant cases, 5 (20%) of follicular thyroid carcinoma, 3 (12%) of medullary thyroid carcinoma, and 1 (4%) of anaplastic thyroid carcinoma showed a negative expression. The PTC cases showed a statistically significant difference from the rest of the benign lesions (P = 0.000). In PTC cases, the sensitivity of Gal-3 came out to be 100%, specificity was 64%, positive predictive value was 75.3%, negative predictive value was 100%, and accuracy was 82%.

Conclusion:

The data thus obtained indicate that Gal-3 is a valuable marker for differentiating classical PTC and its common variants (follicular variant and microcarcinoma in our study) from the other benign and malignant lesions. Gal-3 as a diagnostic marker for thyroid cancer can lead to improved outcomes for individuals diagnosed with equivocal or suspicious lesions.
Malignant Proliferating Trichilemmal Tumor in Neck
Authors: Prasad K. U. Raghavendra , Harish A. T. Fida
Published: September 2024

Background:

Proliferating trichilemmal tumor is a rare cutaneous neoplasm derived from the outer root sheath of the hair follicle which usually presents as a solitary lesion, in fourth to eighth decades of life, and has a predilection for women. The scalp is the most common site of occurrence of this tumor. Malignant proliferating trichilemmal tumor (MPTT) invades surrounding tissues or metastasizes with features of cellular pleomorphism and nuclear atypia. Local recurrences have been occurred in about 3.7%–6.6%. Complete surgical excision with a margin of normal tissue is the standard treatment.

Aim:

To present a rare case of MPTT over the upper part of the neck which presented to our ENT department and to review about 50 cases of this entity in terms of age, sex, location, treatment, and outcome.

Methods:

The detailed description of the case of MPTT presented over the upper part of the neck to our ENT department will be given. Literature was reviewed for similar cases of this entity and was studied in terms of age, sex, location of tumor, treatment, and outcome.

Results:

Out of the 50 cases reviewed, majority of the patients were females, between the age group 40 and 80 years. The scalp was the common site of tumor. All the cases were treated surgically.

Conclusion:

MPTT is a rare neoplasm which carries a diagnostic dilemma and is often confused with squamous cell carcinoma. Wide excision of MPTT with an adequate clearance margin is the treatment of choice.
Approach to T4b Oral Cancers – A Surgeon's Perspective
Authors: Thaduri Abhinav , Panuganti Achyuth , Maharaj Dileep Dungala , Kaul Pallvi , Majumdar Kinjal Shankar , Usmani Shahab Ali , Garg Pankaj Kumar
Published: September 2024

T4b oral cancers are considered unresectable tumors according to most of the standard treatment guidelines. However, from a head-and-neck surgeon's perspective number of factors has to be considered before labeling a T4b cancer as unresectable. This narrative review aims to emphasize various aspects of decision-making in treating a T4b oral cancer, in particular tumors involving infratemporal fossa (ITF). We conducted a literature search in PubMed for articles published between January 1990 and December 2021 using the following key terms: Oral cancer, advanced oral cancer, Head and Neck cancer, T4b oral cancer, ITF, and Compartment surgery. Then, some of these terms were used in combination for the search. Finally, a result was manually checked for relevant articles. A narrative review is presented from the surgeon's perspective in the management of T4b oral cancer.