bluuebunny/crossref_metadata_2025 huggingface dataset:
UNCERTAINTY IN EMPLOYMENT RELATIONS AND EMPLOYEE LOYALTY
Authors: Rogozińska - Mitrut Joanna
Published: August 2022

Maintaining and strengthening this relationship is also directly supported by some of the instruments of the Labor Code, such as employee participation, which is reflected in one of the principles of labor law, as stated in Article 182 of the Labor Code. It is assumed that employees who participate in the running of their employer's business and, even if only in certain matters, decide on its activities, direction of development or restructuring decisions (including personnel decisions), feel responsible and more attached to the employer who employs them.
MARKET OF MEDICAL SERVICES IN UKRAINE: KEY DEVELOPMENT MARKERS AND TRENDS
Authors: Stasiak Jacek , Vepritsky Roman
Published: August 2022

Ukraine is reforming the healthcare system. It introduces a number of changes facilitating access to medical services in accordance with the principle - money follows the patient. It develops new services, monitoring systems and extending the range of services. The article attempts to analyze indicators and trends in the development of the healthcare system.
WAYS TO OVERCOME THE PROBLEM LOW COMPLIANCE IN THE PRACTICE OF A DOCTORSPECIALIST
Authors: Stasiak Jacek , Vepritsky Roman
Published: August 2022

One of the main problems in medicine and health that affects the effectiveness of treatment is the problem of poor patient compliance with the treatment rules. Patients do not follow the rules issued by a doctor, avoid specialist doctors, do not lead a healthy lifestyle, which significantly reduces prevention, diagnosis and treatment effectiveness. The article attempts to define the ways of overcoming this phenomenon on the basis of the work of a doctor - specialist.
SCIENTIFIC AND MEDICAL CLUSTER OF PHYSICAL REHABILITATION: DEEP SPECIALIZATION OR DIVERSIFICATION OF THE PATIENT PROFILE
Authors: Stasiak Jacek , Vepritsky Roman
Published: August 2022

Physical rehabilitation for different groups of patients may relate to such tasks as normalizing the tone of the nervous system, normalizing the tone of the hormonal system, correcting immunity, eliminating or minimizing metabolic disorders, combating pain and inflammation, improving microcirculation, and others. Various private medical aspects of the practical implementation of medical rehabilitation programs are well studied by various medical schools and are successfully used. In the paper, the authors discuss the possibilities of organizing work and the socio-economic potential for the development of a scientific and medical cluster of physical rehabilitation on the example of Lodz, Poland with a diversified portfolio of rehabilitation services.
Cd concentration effect on structural, optical and electrical properties of Cu2(CdxZn1-x)SnS4
Authors: Juárez D. , Castillo García H. E.
Published: August 2022

In this paper we are reporting an in-depth study into the material properties of cadmium incorporated kesterite material Cu2(CdxZn1-x)SnS4 (CZCTS). Though it was reported in the past that CZCTS can be a candidate solar cell material, little is known about the material characteristics of this compound. In this work, the impact of Cd content on structural, morphological, optical, electrical and opto-electronic properties of CZCTS films is studied by XRD, Raman, EDXS, SEM, UV-Vis, Seebeck effect, photoconductivity, I-T, Kelvin probe, and Hall measurements. It was found that the CZCTS band-gap varies almost linearly with the Cd concentration in CZTS lattice. Photosensitivity, carrier concentration and work function showed a clear tendency with respect to Cd content. The in-depth material characterizations and in particular the electrical and opto-electronic data presented in this paper will help designing opto-electronic devices based on this material.
Ramifications of Religious Intolerance and Indian Nation: Tharoor’s Riot
Authors: Pramod Kumari
Published: August 2022

Literature and the nation are inextricably linked. A discipline that originates from a philosophical tradition developed with the notion of the country is the study of literature. Since Bhabha claims that the country and narration are comparable, literary tales have a deep connection to the idea of the nation. The real inspiration for Shashi Tharoor's Riot was the 1992 religious disturbances. These riots between Hindus and Muslims took place to "correct a grievous injustice" from four hundred and sixty years before. But these riots were sparked mainly by political unrest. Politicians appeal to voters on particular religious, caste, and geographic grounds. The current essay examines how a regular person might become a victim of riots between groups of people without their fault and how, during such fights, national integrity is threatened and overlooked. A man without a country seems like an impossibility. Love for humankind is the only remedy for violence. "Distracting interventions" can only be overcome by forgiving and moving forward.
ANOREKTAL MALFORMATSIYALAR TEROTOGENEZIDA EMBRIOGENETIK OMILLARNING ROLI
Authors: Yuldashеv Muzaffar , Toshboеv Shеrzod , Mirzakarimov Baxrom
Published: August 2022

Anorektal malformatsiya (ARM)- bu tug'ma nuqson bo`lib, bolalar jarrohligi amaliyotida tez-tez uchraydigan patologiyadir. Jarrohlik muolajalari anatomik anormalliklarni tuzatsada, operatsiyadan keyingi ichak funktsiyasi har doim ham qoniqarli emas. ARM etiologiyasi noaniqligicha qolmoqda. Bu sharhda embriologik xamda genetik omillarni patogenezga mosligi, nashr etilgan epidemiologik izlanishlar, odam genetik izlanishlari hamda hayvonlar modellari asosida mosligi umumlashtirilgan. Bu omillarni inobatga olinishi kelajakda ARM ni boshqarishda qo`l kelishi mumkin.
Penyelesaian Sengketa Ganti Kerugian Pengadaan Tanah Untuk Pembangunan Jalan Tol Section Binjai-Pangkalan Brandan Berbasis Perlindungan Hukum
Authors: Rahmadani Putri
Published: August 2022

Pengadaan tanah untuk pembangunan jalan tol section Binjai-Pangkalan Brandan memiliki sengketa. Sengketa tersebut terjadi dikarenakan pemberian nilai ganti kerugian yang dianggap masih belum layak dan adil kepada masyarakat sebagai pemilik hak atas tanah, dan kompensasi masyarakat sebagai penggarap tanah yang dikuasai PT. Perkebunan Nusantara (PTPN) II dengan alas hak HGU belum terakomodasi dengan baik. Masalah ini perlu diamati, untuk itu diperlukan kebijakan dari pemerintah untuk mengatasi permasalahan tersebut guna mewujudkan perlindungan hukum terhadap masyarakat yang terkena dampak akibat kegiatan pengadaan tanah tersebut. Hasil penelitian ditemukan bahwa terdapat urgensi melaksanakan upaya penyelesaian sengketa dalam pengadaan tanah untuk pembangunan jalan tol section Binjai-Pangkalan Brandan dapat dilihat dari aspek yuridis. Secara yuridis, pemerintah harus memegang teguh prinsip-prinsip rule of law, dimana hak asasi manusia harus dihormati. Upaya yang dapat dilakukan pemerintah dalam penyelesaian sengeketa yaitu melakukan musyawarah dan mediasi kepada masyarakat sebagai pemegang hak atas tanah, namun pemerintah tidak melakukan hal tersebut dan akan melakukan konsinyiasi. Mengenai perlindungan hukum yang diberikan terhadap masyarakat pemegang hak atas tanah dikarenakan pemerintah memiliki sikap yang tegas pada harga yang telah ditetapkan dan konsinyiasi belum dilakukan karena belum tersedianya anggaran. Perlindungan hukum terhadap masyarakat sebagai penggarap juga tidak terwujud, hal ini dapat dilihat dari masyarakat sebagai penggarap yang memiliki kerugian non-fisik belum terakomodasi dengan baik kepentingannya oleh pemerintah.
A UNIQUE STYLE OF SANAE BADAE IN AHMAD FARAZ'S POETRY
Authors: Dr. Muhammad Afzal Safi  , Muhammad Jalal ud Din Nomani
Published: August 2022

Ilma e Badee (Rhetoric) is an important branch of knowledge that deals with poetry. In this branch of knowledge, those tools and standards are discussed which play an important role to evaluate poetry and other related genres. The ways and means to achieve the beauty of poetry are discovered through it. The verse is adorned with the qualities of diction and meaning. These are called “Sana e lafzi and Sana e Manvi".

Though Ahmed Faraz did not deliberately try to use these Sana-e-lafzi-o- Manavi, as the classical master poets used to do, his command over the rules of rhetorics and principles of poetics is unprecedented among his contemporaries. Instead of using these Sanae Badae as that ornaments, Ahmed Faraz uses them to extend their meaning beyond their boundaries. A long-range Sanae Badae is found in his poetry which beautifies his contents and the forms as well.

In this article, 34 Sanae Lafzi (with different kinds) and 18 Sanae Manvi have been identified Faraz`s poetry. His individuality is reflected through this Sanae badae.                 

The particular trait of Ahmed Faraz is that he has not merely used "sanae badae” on a word level, rather he has utilized these “ilm e byaan and ilme e maani” in a broad spectrum. On account of these qualities, his poetry is regarded as a beautiful combination of musicality and meaningfulness. Ahmed Faraz is a modern poet but his modernity is deeply rooted in classical values. He, actually, derives the beauty of poetry from the classical system of values comprising “Sana e lafzi and Sana e Manvi". His individuality lies in blending both of the values of the systems i.e classicism and modernism.
NAALA E SHUB GEER
Authors: Naeema Bibi  , Dr. Robina Parveen  , Ghazal Yaqub
Published: August 2022

Postmodernism is modern contemporary theory. It gave birth to too many theories and ideas. One of the most important theories is feminism. This theory influenced fiction Urdu novels have also been influenced by postmodernism. That is why fiction writers have written postmodern novels. Which are different from Classical novels. The characters in these novels are also different from the traditional characters. Nowadays characters are being created in the novel that can be called postmodernism. Musharraf Aalim Zouqi is one of the greatest novelists of our time. He wrote many novels, one of the most important of these is the novel Naala e Shab Geer. The story of this novel consists of seven parts which have been given different titles. Which are as follows: Dasht-e-Khuf, Atash-e-Gul, Rig-e-Jinnu, Bahr-e-Zalamat, Wadi-e-Israr, Barish-e-Sang, and Safar-e-Akhar-e-Shab. The characters are portrayed in different ways. There is a story hidden in each title.  In his novel Naala-e- shubgeer, he presents the postmodernist concepts of women. Nahid Naz is a rebellious woman who wants to live a life of her own free will. That's why she wants to keep her husband under her control, and she rules over her husband in every way, just as men rule over their wives. She asks her husband to do women's work. Sometimes she wears him a saari, sometimes she asks him to apply lipstick. One night she orders her husband to leave the house and also tortures him, therefore, she emerges as a postmodern woman. This article critically examines Naheed Naz's postmodern behaviour.
MODIFIKASI KOPI ARABIKA MENJADI BECOFFEE SCRUB UNTUK PERAWATAN TUBUH
Authors: Tiadeka Pemta , Nasyanka Anindini , Zahiriyah Arry
Published: August 2022

Body scrub merupakan salah satu bentuk perawatan tubuh dalam keadaan tubuh basah dengan menggunakan berbagai ramuan yang bertujuan mengangkat sel kulit mati, kotoran, dan membuka pori-pori sehingga pertukaran udara bebas dan kulit menjadi lebih cerah dan putih. Dengan memakai body scrub, tubuh akan memiliki kulit yang bersih, sehat dan terawat. Berbagai macam bahan termasuk herbal telah dikembangkan sebagai bahan utama dari body scrub. Salah satu contohnya adalah kopi. Kopi arabika banyak digunakan dalam kosmetik karena sifat aktivitas biologisnya tinggi dan kemampuan menembus barrier kulit. Penelitian ini bertujuan untuk melakukan modifikasi formula body scrub berbahan baku kopi arabika sehingga terbentuk produk yang stabil, nyaman dan sehat untuk diaplikasikan pada tubuh. Metode yang digunakan pada penelitian ini yaitu ekstraksi dan maserasi dari berbagai variasi formula konsentrasi ampas kopi 5%, 10%  dan 20%. Berdasarkan hasil uji organoleptis menunjukkan bahwa  F1 memiliki bentuk cream, warna coklat, berbau khas kpi dan sifatnya stabil, sedangkan F2 dan F3 memiliki kriteria sama namun warna cream nya adalah coklat tua. Semua produk becoffee scrub memiliki pH 7 sehingga aman diaplikasikan di kulit. Uji hedonisme terhadap warna, aroma, tekstur dan kesan pemakaian semua produk juga memperlihatkan sebagian besar responden menyukai produk dengan F3 yaitu formula 20%. Disamping itu, uji homogenitas mengindikasikan sediaan memiliki susunan homogen dan tidak ada butiran kasar sedangkan evaluasi tipe emulsi menunjukkan bahwa semua sediaan body scrub mempunyai tipe emulsi m/a. Uji daya sebar dari semua sediaan menunjukkan produk yang memiliki daya sebar yang paling besar adalah formula F1 ampas kopi 10%
Perbandingan Carbomer dan CMC-Na Sebagai Gelling Agent Pada Formulasi Hand Sanitizer Aloe Vera
Authors: Mochtar Muhammad , Nasyanka Anindi , Tiadeka Pemta
Published: August 2022

Pada tahun 2021 angka penyebaran virus Covid-19 semakin meningkat, sehingga masyakarat diwajibkan untuk mematuhi protokol kesehatan agar terhindar dari virus tersebut. Salah satu cara yang dapat digunakan adalah memebrsihkan tangan menggunakan hand sanitizer. Hand sanitizer merupakan produk yang digunakan untuk menghilangkan mikroorganisme dari tangan untuk mencegah mikroorganisme penginfeksi dan mengurangi pertumbuhan dari mikroorganisme yang menyebabkan infeksi penyakit. Di sisi lain, lidah buaya (Aloe vera) memiliki kandungan Aloeverose yang berkhasiat dalam penyembuhkan luka.. Penelitian ini bertujuan untuk mengetahui perbandingan gelling agent Carbomer dan CMC-Na pada formulasi dan evaluasi fisik hand sanitizer lidah buaya (Aloe vera). Selanjutnya, kedua bahan tersebut dibandingkan untuk mendapatkan formulasi yang terbaik Hasil penelitian menujukkan bahwa formula 2 (F2) memiliki kestabilan yang lebih baik dari formula 1 (F1). Evaluasi mutu fisik kedua produk memperlihatkan bahwa keduanya memiliki bentuk semisolid dan berbau khas lidah buaya. F1 bewarna agak keruh sedangkan F2 bening. Selanjutnya, uji pH menunjukkan kedua produk berada pada rentan pH toleransi untuk kulit yaitu 5,6 serta daya sebar yang memenuhi parameter sediaan gel. Uji hedonisme yang mengindikasikan bahwa F2 lebih banyak disukai daripada F1 dari segi bentuk, warna, bau dan daya lekat.
IDENTIFIKASI SENYAWA METABOLIT EKSTRAK ETANOL DAUN BELUNTAS (Pluche Indica) SECARA KUALITATIF DENGAN KROMATOGRAFI LAPIS TIPIS
Authors: Sari Fita , Hasanah Fathul , Kristianingsih Ida , Sukmana Angelia
Published: August 2022

Tanaman herbal di Indonesia saat ini berkembang dengan pesat dan banyak diminati untuk pengobatan. Contoh tanaman herbal yang mudah dibudidayakan adalah beluntas dengan berbagai kandungan senyawa kimia untuk mengobati berbagai jenis penyakit. Tujuan penelitian ini mengetahui kandungan senyawa metabolit ekstrak etanol daun beluntas dan pengujian parameter spesifik dan non spesifiknya. Metode penelitian ini dilakukan dengan cara pengumpulan bahan lalu pembuatan ekstrak dan identifikasi senyawa. Beluntas diperoleh dari daerah Ngantru kabupaten Tulungagung propinsi Jawa Timur. Sampel yang digunakan adalah bagian daun dibuat simplisia dan dilakukan ekstraksi dengan etanol 50%. Hasil diperoleh bahwa dari pengujian senyawa metabolit dengan skrining fitokimia berupa flavonoid, saponin dna tannin. Identifikasi senyawa kimia dengan KLT diduga bahwa ekstrak daun beluntas mengandung flavonoid yang mirip dengan kuersetin. Hal ini berpengaruh pada bentuk dan warna bercak serta harga Rf yang sama antara sampel dengan kuersetin. Hasil pengujian bobot jenis dan kadar air sesuai dan memenuhi persyaratan yang tercantum dalam Farmakope Herbal Indonesia. Kesimpulan penelitian ini adalah hasil identifikasi senyawa metabolit ekstrak daun bekuntas terdiri dari flavonoid, tannin dan saponin, uji penegasan KLT untuk senyawa kimia daun beluntas menghasilkan bentuk dan warna bercak serta harga Rf sama dengan kuersetin.
Prevalensi Infeksi Soil Transmitted Helminths Pada Feses Siswa SDN Plosokerep 2 Kota Blitar Setelah Pengobatan Albendazole
Authors: Shofi Muh. , Munawaroh Siti , Malasari Tri Nanda
Published: August 2022

Kasus kecacingan masih banyak ditemukan di Indonesia khususnya pada anak usia sekolah dasar. Sebab pada usia tersebut masih kurang sadarnya menjaga kebersihan. Salah langka untuk mencegah terjadinya kecacingan yaitu dengan cara memberikan obat albendazole. Tujuan penelitian ini untuk mengidentifikasi STH pada siswa di SDN Plosokerep 02 Kota Blitar setelah pemberian obat albendazole serta mengetahui apakah obat albendazole dapat membantu menurunkan angka kecacingan pada siswa di SDN Plosokerep 02 Kota Blitar. Desain penelitian ini adalah penelitian deskriptif dengan jumlah sampel sebanyak 33 sampel menggunakan teknik sampling purposive sampling. Sebanyak 33 sampel feses yang didapatkan kemudian diperiksa dengan teknik sedimentasi untuk melihat adanya telur dan atau larva cacing. Berdasarkan hasil penelitian dikethaui bawa angka kecacingan pada siswa mengalami penurunan sebanyak 97% setelah pemberian obat albendazole dan hanya 1 siswa saja yang masih positif kecacingan. Feses siswa yang positif kecacingan ditemukan telur cacing Ascaris lumbricoides pada fesesnya. Ditemukannya telur cacing Ascaris lumbricoides pada feses murid SD disebabkan oleh anak yang kurang menjaga kebersihan diri sendiri, kurangnya perhatian orang tua dalam menjaga hygiene sanitasi mereka seperti mencuci tangan dan kaki, serta tidak adanya Pengawas Minum Obat ketika anak sudah diberikan terapi albendazole.
KADAR GAMMA GLUTAMYL TRANSFERASE (GGT) PADA NELAYAN PEMINUM TUAK DAN ARAK
Authors: Putri Mardiana Prasetyani
Published: August 2022

Tuak dan arak merupakan salah satu jenis alkohol yang dikonsumsi oleh nelayan di desa Tambakrejo. Alasan pengkonsumsian alkohol tersebut untuk menghangatkan badan, menghilangkan rasa kantuk, membuat nelayan tidak mudah lelah dan mengurangi stres jika tangkapan yang diperoleh tidak banyak. Alkohol termasuk dalam zat adiktif yang dapat menimbulkan ketagihan dan ketergantungan. Alkohol yang dikonsumsi secara terus menerus menyebabkan metabolisme alkohol dalam tubuh cepat dan merangsang peningkatan enzim mikrosomal memproduksi banyak enzim dan mengakibatkan peningkatan kadar Gamma-Glutamyl Transferase (GGT), jika kadar GGT tinggi maka ada kerusakan di dalam hati. Penelitian ini bertujuan untuk mengetahui kadar GGT nelayan peminum alkohol di desa Tambakrejo. Metode penelitian ini yaitu deskriptif dengan pendekatan cross sectional. Pengambilan sampel dilakukan dengan metode total sampling. Digunakan 30 sampel dalam penelitian ini.  Berdasarkan hasil penelitian diperoleh kadar Gamma-Glutamyl Transferase (GGT) pada nelayan peminum tuak dan arak sebesar 25 orang (83,33%) memiliki kadar GGT normal sedangkan 5 orang (16,67%) memiliki kadar GGT rendah. Berdasarkan hasil pemeriksaan kadar GGT diperoleh nilai minimum 8 U/L, nilai maksimum 60 U/L, nilai median 18 U/L, nilai rata-rata 19,77 U/L. Berdasarkan penelitian yang telah dilakukan kadar Gamma-Glutamyl Transferase (GGT) sebagian besar nelayan desa Tambakrejo adalah normal (83,33%).
The Effect of Swimming Training with Cinnamon Consumption on β3-AR and ERK2 Gene Expression in the Visceral Adipose Tissue of Diabetic Rats
Authors: Mohammadi Kianoosh , Khajehlandi Ali , Mohammadi Amin
Published: August 2022

Background: β3-AR is an important factor involved in the activation of ERK protein signaling cascade, which can positively contribute to the regulation of adipose tissue metabolism and its conversion into brown adipose tissue. Diabetes mellitus can lead to dysfunction of these factors. Objectives: The current study aimed to investigate the effect of swimming training combined with cinnamon consumption on β3-AR and ERK2 gene expression in the visceral adipose tissue from diabetic rats. Methods: In this experimental-fundamental study, 35 male Wistar rats (mean weight: 200 ± 20 g) were selected and randomly assigned into four groups after the induction of diabetes by streptozotocin. These groups included: (1) healthy control, (2) control, (3) swimming, (4) cinnamon, and (5) swimming cinnamon (n = 7 in each group). The training groups were put through a five-days-a-week workout for four weeks according to the training protocol. Gene expression levels were measured by in vitro real-time PCR. The collected data were analyzed using one-way ANOVA and Tukey’s post hoc test. Results: The expression levels of β3-AR and ERK2 protein genes in the visceral adipose tissue of diabetic rats (P = 0.0001) were significantly affected by swimming training and cinnamon consumption. Conclusions: It was shown that cinnamon supplementation may have increased β3-AR levels, which was more effective than training, while training had a greater effect on ERK2 levels and increased them. Therefore, it was concluded that cinnamon consumption combined with training may have greatly contributed to the conversion of white adipose into brown adipose tissues.
Effect of Competition on the Salivary Cortisol Level in Elite Boy Swimmers
Authors: Hooshmand Farhang , Rahmanian Karamatollah , Rahmanian Vahid , Shakeri Masihollah , Sotoodeh Jahromi Abdolreza
Published: August 2022

Background: The effect of exercise on serum and salivary cortisol levels depends on the intensity of sports. So far, no study has evaluated the effect of acute exercise on cortisol levels. Objectives: This study aimed to determine and compare the salivary cortisol concentration two weeks and 30 minutes before competition in elite adolescent boy swimmers. Also, we determined the association between anxiety and salivary cortisol levels. Methods: We included 14 elite boy swimmers aged 10 - 13 years old. Anxiety was assessed using the Sports Competition Anxiety Test (SCAT) 30 minutes before the competition. Saliva samples were measured two weeks and 30 minutes before the swimming competition. The enzyme-linked immunosorbent assay (ELISA) technique was used to assess salivary cortisol levels. Using paired t-test, we compared salivary cortisol levels 30 minutes and two weeks before the competition. Also, we used linear regression to examine the effect of anxiety on salivary cortisol levels before the competition. Results: Our results showed a significantly elevated cortisol level 30 minutes before the competition compared to two weeks before the competition (5.24 ± 1.97 vs. 3.47 ± 1.03 µg/dL, P = 0.007). However, pre-competition salivary cortisol levels were not significantly related to SCAT, somatic, and cognitive anxiety (P > 0.05). Conclusions: According to the results of this study, swimming competition influenced salivary cortisol response before the competition.
Serum TSH Levels as a Predictor of Thyroid Malignancy in Euthyroid Patients with a Thyroid Nodule- A Cohort Study
Authors: Ramole Yashpal , Choudhary Anuradha , Sharath AP , Ramole Archana
Published: August 2022

Introduction: Palpable thyroid nodules are a common disorder in the general population. In many cases, the initial presentation of thyroid cancers can be a thyroid nodule. Hence, this is important to distinguish between a benign and a malignant nodule. Fine Needle Aspiration Cytology (FNAC) is the gold standard for evaluating a thyroid nodule. Currently, FNAC is a much more reliable diagnostic technique. However, there are certain limitations of FNAC, which makes the serum Thyroid Stimulating Hormone (TSH) an essential marker in evaluating the thyroid nodule. It has been observed that the frequency of malignancy varies by the serum TSH levels within its normal range itself. Hence, in the present study, authors aim to assess the role of preoperative serum TSH in predicting the malignancy associated with thyroid nodules. Aim: To evaluate the usefulness of preoperative serum TSH levels in patients with ‘nodular thyroid disease’, in prediction of malignancy. Materials and Methods: This is a cohort study conducted over 7 years from January 2014 to December 2020 by the surgery Department of Gandhi Medical College and associated Hospital, Bhopal, India. A total of 50 patients with thyroid nodule(s) having preoperative serum TSH levels within the normal range were included in this study. Serum TSH levels were measured by Electrochemiluminscent Immunoassay (ECLIA). In additaion, patients’ postoperative tissue biopsies were analysed and associated with preoperative serum TSH levels statistically using student’s t-test, Wilcoxon Mann Whitney U-test, Fisher’s exact test, or Chi-square test. Results: A total of 50 patients were included in the study. The age (years) ranged from 19 to 70. Out of 50 patients who participated in the study, 46 (92%) were female. All 50 (100%) patients had thyroid swelling as their initial presentation. Authors subdivided the sample into three groups by the TSH level distribution of the study (category A 0.4-1.4, category B 1.41- 2.5, and category C 2.51-4.0 mIU/L). The serum TSH category C participants had the largest proportion of biopsy impressions as malignant (p-value <0.001). A cut off level of TSH 2.86 mIU/L showed a sensitivity of 58.8% and specificity of 100%. Conclusion: In patients with thyroid nodule/s having serum TSH levels within their normal range, the higher limits of serum TSH levels are associated with an increased risk of thyroid cancer. Preoperative serum TSH levels can be used as an adjunctive diagnostic test for identifying the risk of malignancy associated with a thyroid nodule. It may aid in decision making on diagnostic approaches and may help in making the best therapeutic plans.
Paratyphi PneumoniaDoes What You Eat Matter?
Authors: Vineeth VK , Nambi P Senthur , Chandrasekaran Jagadeesh , Asokan Aarthee
Published: August 2022

Most common signs and symptoms of typhoid are localised to gastrointestinal system. Less commonly, extraintestinal infectious complications occur with enteric fever. This case report is about a 29-year-old female, without risk factors, who presented with fever, loose stools and cough of five days duration. The patient was diagnosed to have paratyphi A bacteraemia, with clinical and radiological features of pneumonia. Her sputum cultures were sterile, and hence paratyphi A pneumonia was diagnosed. She received 14 days of antimicrobial therapy and recovered. Vi-based monovalent vaccines do not offer protection against most paratyphoid fever, because only Salmonella serovars Typhi, and paratyphi C carry the Vi antigen. Further studies are needed on bivalent and polyvalent typhoid vaccines covering all serovars.
Role of Vitamin D and Hemoglobin Levels in Prediabetic PatientsA Retrospective Study
Authors: Nair Deepa K , Shanthi B , Bupesh Giridhar
Published: August 2022

Introduction: The 25-hydroxy (OH)D3 (Vitamin D, Cholecalciferol) and Hemoglobin (Hb) level have a significant role in the regulation of immune response. A decrease in Vitamin D and hemoglobin concentrations is a common risk factor for diabetes. The link between Vitamin D and insulin resistance has been studied more thoroughly in patients with diabetes mellitus, although data from people with prediabetes is scarce. Aim: To study the association of Vitamin D and Hb levels in prediabetes patients. Materials and Methods: This retrospective study was conducted in the Sree Balaji Medical College and Hospital, Chennai from July 2020 to December 2020. Total 100 subjects with prediabetes conditions were included and their Vitamin D and Hb levels were measured. The patients who gave written informed consent for prediabetes screening according to ADA2020 recommendations for prediabetes were included and their Vitamin D and Hb level done as part of the routine check-up were collected. Data were statistically analyzed using Analysis of Variance (ANOVA) and Chi-square test. Results: Data of total 100 patients was analysed, including 68 female patients and 32 male patients. Out of 100 patients, 84 were aged between 25-50 years and 16 were aged between 51-65 years. The difference between male and female were statistically significant with p value <0.01 (for Hb) and p value 0.05 (Vit-D) respectively. A significant difference in mean Hb level when compared among Vitamin D deficient (0.0-19.99 IU/mL) level, insufficient (20-29.99 IU/mL) & sufficient (30-99.99 IU/mL) subjects (p=0.008) was observed. Conclusion: Low levels of Vitamin D is significantly associated with low Hb level. The patients with deficient Vitamin D level showed a significantly low mean Hb level compared to insufficient and sufficient Vitamin D level.
Correlation of Heart Rate Variability and Inflammatory Markers in Patients with Depression: A Cross-sectional Study
Authors: Jangpangi Deepti , Mondal Sunita , Bandhu Rajiv , Kataria Dinesh , Bhattacharjee Jayashree
Published: August 2022

Introduction: Depression has been found to be associated with cardiovascular morbidity and mortality. Autonomic dysregulation and inflammation have been implicated as the possible mechanisms. A cross-talk between the autonomic nervous system and inflammatory pathways has been observed in different clinical studies. Aim: To examine the inter-relationship between Heart Rate Variability (HRV), a measure of autonomic function, and inflammatory biomarkers measured by high sensitivity C-Reactive Protein (hsCRP) and Interleukin-6 (IL-6) in patients with depression, without any co-morbid conditions. Materials and Methods: This cross-sectional study was conducted in Department of Physiology, in collaboration with the Department of Psychiatry and Biochemistry, Lady Hardinge Medical College, New Delhi, India, from November 2010 to March 2012. Total 30 drug naive cases (without any comorbid diseases) diagnosed with depression (mild, moderate and severe depression) as per International classification of diseases-10 (ICD-10) guidelines, in the age group of 20- 45 years old were included in the study. Heart rate variability measures were recorded and analysed, frequency domain measures Low Frequency (LF), High Frequency (HF) and time domain measures like Standard Deviation of all NN interval (SDNN) and Root Mean Square of Successive differences of NN intervals (RMSSD). The IL-6 and hsCRP levels were also measured and severity of depression by Hamilton Depression Rating Scale (HDRS) was also assessed and correlated. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 16.0. Normality of data was assessed using the Shapiro-Wilk test. Results: The mean age of the cases was 30.33±6.97 years. There were 14 males and 16 females. There was no significant correlation found between the HRV measures and inflammatory biomarkers (LF vs hsCRP: p-value=0.781, HF vs hsCRP: p-value=0.713, SDNN vs hsCRP: p-value=0.262, RMSSD vs hsCRP: p-value=0.50, LF vs IL-6: p-value=0.477, HF vs IL-6: p-value=0.425, SDNN vs IL-6: p-value=0.137, RMSSD vs IL-6: p-value=0.328). Correlation of HDRS with HRV measures or inflammatory markers was not found to be significant. Conclusion: Future studies with larger sample size and wide array of inflammatory biomarkers besides IL-6 and hsCRP is warranted. No significant correlation was observed between
COVID-19 Vaccination Status among Patients with Chronic Respiratory Diseases: A Cross-sectional Study from a Tertiary Care Centre in Southern India
Authors: Kodavala Anil Kumar , Tadisetti Surekha , Badusha MD , Kuruganti Prasannapurna
Published: August 2022

Introduction: Pre-existing respiratory diseases were recognized as risk factors for COVID-19 associated morbidity and mortality. One year after the launch of vaccines against COVID-19, vaccination status in specific population was not clear. Vaccination of population at risk is crucial for COVID-19 control. Aim: To estimate the COVID-19 vaccination status and to detect the reasons for vaccine hesitancy among people with chronic respiratory diseases. Materials and Methods: This cross-sectional observational study was conducted in Respiratory Medicine Department at Narayana Medical College, Nellore, Andhra Pradesh, India, from January and February 2022. All the patients above 18 years of age, who presented with chronic respiratory diseases, were included in the study. After taking informed consent, their responses were noted using a validated questionnaire containing data like demographic data and details of vaccination against COVID-19 and reasons for refusal/hesitancy. Results: Out of total 755 subjects, 48.47% were of Chronic Obstructive Pulmonary Disease (COPD), 42.38% were of asthma, 9.40% were of pulmonary tuberculosis sequelae, 5.16% were of bronchiectasis, and 1.72% were of Interstitial Lung Disease (ILD). Mean age of study population was 51.37±15.30 years, 58% were male and 42% were female. Overall, 75% subjects received at least single dose of COVID-19 vaccine. Higher vaccine acceptance was noted among 31-42 years age group, males, residents of rural area, graduates, subjects with income more than one lac per month and smokers. Vaccine hesitancy was 25%. Intake of a native medicine (72.87%) was the most common cause for vaccine refusal among these subjects. Other reasons for vaccine hesitancy were, worries about sideeffects (63.3%), associated multiple co-morbidities (44.15%), lack of confidence in vaccines (15.96%) and fear of injection (14.89%). Conclusion: Vaccine acceptance against COVID-19 is nearly 75% among people with chronic respiratory diseases in India. Nonetheless, some people were still hesitant to receive vaccine. Continuous health education at every level is needed to achieve vaccination targets.
Incidentally Detected Anomalous Renal Arteries during Angiogram- A Case Series
Authors: Mutnuru Phani Chakravarty , Susarla Rammurti , Devraj Rahul
Published: August 2022

Modern medical society is witnessing increased surgeries for various renal pathologies like renal transplantation and vascular abnormalities. Anomalous origin of renal vasculature might interfere with surgical procedures and outcomes. Hence, accurate roadmap of renal vasculature is necessary for surgeons. Non invasive or minimally invasive imaging techniques help in accurate demonstration of renal vasculature and aid in minimising trauma during surgeries. Preoperative assessment of live renal donor by conventional angiography is a protocol in the institute. A retrospective analysis of anomalous renal arteries was done in a total of 381 cases that were being done in Digital Subtraction Angiography (DSA) suite in Radio Diagnosis Department from 2015 to 2021. In this case series of four patients, different types of anomalous renal arteries have been presented that were incidentally detected during angiograms. Single accessory renal artery was the most common finding in our study followed by multiple accessory renal arteries. Supra coeliac origin of right renal artery was noted in one case which was a rare finding with very few similar case reports in literature. In addition, there was an extremely rare case presentation showing bilateral lower polar accessory renal arteries. They had one common origin, arising from abdominal aorta at the level of aortic bifurcation. No similar case reports have been found in literature and probably the present one is first one of this kind. Knowledge of various anomalies is of utmost importance for the awareness of clinicians and for surgical success.
Adverse Reactions to Blood Components- A Twelve-Year Retrospective Study- A Step towards Prevention
Authors: Vidula C , Shanmugasundaram Sakthisankari , Kumar Prasanna N
Published: August 2022

Introduction: The transfusion of blood and blood components is a life-saving procedure in clinical practice. However, it is associated with risks that can range from trivial self-limited Allergic Reactions (AR) to life endangering anaphylactic or haemolytic transfusion reactions. Aim: To analyse the pattern and incidence of transfusion related adverse events and to develop preventive strategies. Materials and Methods: This was a retrospective, observational study conducted at Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, on data of Adverse Transfusion Reactions (ATR) reported to the blood bank over a period of 12 years from January 2006 to December 2018. The ATRs were analysed with respect to gender, type of blood component, and nature of the reaction. The data collected were tabulated and the analysis was done using percentages. Results: A total of 1,60,914 units of Whole Blood (WB) and blood components were issued during the study period. A 271 adverse reactions (129 reactions in females and 142 reactions in males) were documented constituting 0.168% of the total products issued, majority were due to packed red cells (0.29%). The incidence of AR was the maximum, accounting for 63.1% of the reactions (n=171, 75 in females and 96 in males) followed by Febrile Non Haemolytic Transfusion Reactions (FNHTR) which were 33.57% (n=91, 42 in males and 49 in females). There were four cases of Transfusion Associated Acute Lung Injury (TRALI), all in males, accounting for 1.48% of the reactions, three cases of anaphylactoid reactions (2 in females and 1 in male) accounting for 1.11% of the total reactions and two cases of haemolytic transfusion reaction (0.73%). Conclusion: The frequency of adverse reactions in the present study is 0.168% (271 out of 1, 60,914 units), majority were due to packed red cells (0.29%). No adverse reactions due to bacterial contamination occurred during the study period. It is important to ensure education of nursing staff, interns, and residents regarding the correct procedure of blood transfusion, identification of adverse reactions and appropriate remedial measures for the same.
Association of ABO Blood Group Status in Patients with Breast Lesions and Emphasis on Invasive Breast Carcinoma
Authors: Shaik Shahanaz , Kumarguru BN , Ramaswamy AS , Anegundi Reshma , Janakiraman P
Published: August 2022

Introduction: The ABO blood group antigens are expressed on the erythrocyte membrane and on the surface of other normal and pathological cells. Recently, there has been an increasing research interest in the association between ABO blood group antigens and certain type of human cancers. Aim: To determine the association of ABO blood group and Rh blood type in patients with breast lesions. Materials and Methods: It was a retrospective observational study done at a rural tertiary care referral institute, PES Institute of Medical Sciences and Research (PESIMSR), Kuppam, Andhra Pradesh, India, from January 2015 to December 2018. Apparently healthy female voluntary blood donors constituted the control group (n=222). Patients with breast lesions constituted the study group (n=125). The association of the breast lesions with ABO blood group and Rh blood type was analysed. Frequencies, Chi‑square test and crosstabs were the statistical tools used for data analysis. All the statistical calculations were performed through Statistical Software for Data Science (STATA) version 14.1. Results: Total 125 cases of breast lesions were analysed. Neoplastic lesions 113 (90.4%) were more common than the non neoplastic lesions 12 (9.6%). Blood group “O” was the most common blood group in malignant neoplasms and was statistically significant (p=0.045). Blood group B was the most common blood group in grade II invasive breast carcinoma and was statistically just significant (p=0.05). Conclusion: A definite change in the pattern of distribution of ABO blood group was observed in grade II malignant neoplasms. It may be hypothesised that knowing the blood group of breast cancer patients may be beneficial in order to triage the patients for the purpose of efficient management.
Identification of Bacterial Agents causing Meningitis in Adult Population using BACTEC FX40 System
Authors: Saini Ajay , Prakash Ved , Verma Deepika , Sonkar Lautika , Agarwal Saumya , Jafar Haniya
Published: August 2022

Introduction: Bacterial meningitis among adults is a medical emergency and requires immediate diagnosis as well as immediate treatment. As clinical diagnosis is not always reliable, laboratory isolation along with antimicrobial susceptibility results are crucial. Conventional agar culture methods gives poor sensitivity and delayed results. Automated culture methods like BACTEC are suitable option for culture of sterile fluids beside blood culture. Aim: To determine the bacterial agents causing meningitis in this region, along with their antibiogram by using automated culture system BACTEC FX40. Materials and Methods: This cross-sectional, observational study was conducted between October 2019-September 2020 in Department of Microbiology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. Cereospinal Fluid (CSF) samples received from medicine Intensive Care Unit (ICU) and wards were processed by inoculating them on BD BACTEC Peds Plus/F bottle and then incubating them on BACTEC BD FX40 system. The bottles flagged and positive were subcultured and further processed according to standard laboratory procedures. The antibiotic sensitivity test was performed from isolated organisms by Kirby-Bauer Disc Diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: A total of 108 CSF were received for culture by automated methods from patients suspected of meningitis during the study period. Out of them 84 (77.8%) beeped as positive while 24 (22.2%) were sterile. From the positives, 77 showed growth of gram positive cocci, three were gram negative bacilli and four showed growth of environmental and skin contaminants that were excluded from the study. All gram positive cocci were identified as Staphylococcus aureus (S. aureus). The antibiotic sensitivity testing showed 100% sensitivity to vancomycin and linezolid. Only 25 isolates of S. aureus were sensitive to cefoxitin. Both the isolates of Escherichia coli (E. coli) were sensitive to cefazolin, ceftazidime, aztreonam. Pseudomonas aeruginosa (P. aeruginosa) was sensitive to amikacin and piperacillin/tazobactum. Conclusion: A shift in the trend was observed in the aetiology of bacterial meningitis with Methicillin Resistant Staphylococcus aureus (MRSA) as the most predominant isolate among adult population. BACTEC FX40 system was found more sensitive in detecting pathogens over the conventional methods with reduced time to positivity. Early detection of causative organism will facilitate early initiation of suitable antibiotic therapy, thereby reducing mortality and meningitis associated complications.
Evaluation of Cytological Scoring and Comparison with Histopathological Finding in a Palpable Breast Lump
Authors: Joseph Margaret Theresa , Banu Fathima Jackia , Rakesh Gerard
Published: August 2022

Introduction: Breast cancer is the commonest malignancy worldwide in women. Preoperative evaluation of breast lump plays a major role in the early diagnosis and management of the breast lesions. This study helps in subgrouping the breast lesions into various categories and provides the line of management of each category accordingly. Aim: To evaluate the cytomorphology of various breast lesions, to compare with histopathological findings and to assess the usefulness of Modified Masood’s Scoring Index (MMSI) in palpable breast lumps. Materials and Methods: This was a cross-sectional study done in 61 female patients presented with palpable breast lump between March 2019 and February 2021 at Pathology Department, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India. Cytological examination along with MMSI was applied on Fine Needle Aspiration Cytology (FNAC) aspirates, followed by histological confirmation. Under MMSI, the breast lesions were categorised into four groups: Non Proliferative Breast Disease (Non PBD), PBD without atypia, PBD with atypia and carcinoma breast. The data were collected and complied in Microsoft excel programme, appropriate graphs were made and percentages were calculated. Results: Total of 61 cases were analysed, females with age range of 23 to 64 years, mean age of 38 years. Majority of the cases presented with unilateral breast lump (92.5%). In MMSI Scoring, 15/61 (24.5%) were found with the score of 6 followed by 12/61 (19.6%) score of 8 which falls under NPBD. Total of cases 2/61 (3.2%) score of 24 while 3/61 (4.9%) with the score of 23 fell under Carcinoma breast category. Overall concordance observed between MMSI and histopathology was 59/61 cases which is 96.72%, which indicates the high degree of concordance with histopathological diagnosis. Conclusion: MMSI is a simple and reliable scoring system and can be applied on FNAC aspirates. MMSI increase the diagnostic accuracy and provide better concordance with histopathology.
Histopathological Spectrum of Endoscopic Gastrointestinal Biopsies: An Experience from a Tertiary Care Centre, Uttarakhand, India
Authors: Bahal Neelima , Malviya Avneesh , Ahuja Sana
Published: August 2022

Introduction: The Gastrointestinal Tract (GIT) is the site of numerous pathological lesions from inflammatory to malignant. Endoscopic biopsy plays an important role in detection of early- stage cancers and precursor lesions. It also aids in determining the extent of disease, monitoring response to therapy and for early detection of complications. However, histopathological evaluation serves as gold standard for diagnosis and aids the clinician in deciding further management. Aim: To determine the histopathological spectrum of gastrointestinal lesions and assess the frequency of benign and malignant tumours in GIT in a tertiary care center in North India. Materials and Methods: It was a retrospective study in which all endoscopic gastrointestinal biopsies received in Department of Pathology at Shri Guru Ram Rai Institute of Medical and Health Sciences from January 2015 to December 2017 were retrieved. The lesions from oropharynx, oesophagus, stomach, small intestine, large intestine, rectum and anal canal were categorised as neoplastic (further divided as benign and malignant) and non neoplastic. The results were tabulated and expressed as frequencies and percentages. Results: Of the 867 cases, 582 were males and 285 were females with a male to female ratio of 2.1:1. The most common age group was sixth decade with a mean age of 53.8 years. Out of a total of 7782 specimens received, 867 (11.1%) were endoscopic gastrointestinal biopsies. Among all the biopsies evaluated, 116 (13.4%) were from oropharynx, 55 (6.3%) oesophageal, 97 (11.2%) from stomach and Gastro-Oesophageal (GE) junction, 138 (15.9%) small intestinal and 461 (53.2%) from colorectum and anal canal. Out of 867 biopsies, 670 (77.3%) were classified as non neoplastic and 197 (22.7%) were neoplastic. Incidence of malignancy was highest in gastric (29%) and oropharyngeal (28.4%) biopsies while it was least in small intestinal biopsies (4.3%). Conclusion: In the current study, squamous cell carcinoma and ulcerative colitis were the most prevalent neoplastic and non neoplastic lesions, respectively. It is advisable to interpret and correlate endoscopic findings with histopathology to arrive at a final diagnosis and aid the clinician for further management.