bluuebunny/crossref_metadata_2025 huggingface dataset:
Experience of surgical treatment of patients with severe traumatic brain injury
Authors: Meskhiya N. Sh.
Published: April 2022

The research has been based on surgical experience of multiple decades and on retrospect study of more that 4000 clinical cases, among them 3500 surgical invasion due to different types of traumas. Since it relies on the latter, it shows the evolution of our approaches towards severe cerebral cranial traumon includes different matters regarding diagnostics and surgical treatment with neuropathogenetic approach. We have shown the advantages of certain surgical procedures in cases of cerebral cranial trauma and also the way approaches were changing after introduction of high medical technology and taking into consideration bio mechanisms and pathological data.

Computer diagnostics changed several surgical procedures and opportunities. In cases of traumas impacted in immobilized condition method of choice used to be plastic craniotomy, when in cases of cerebral congestion would cause decompression, placing bone fragment under the skin. 902 surgeries were performed among 1990. In 894 cases surgeries were performed using plastic trepanation, 217 among them was performed with improved modified method. In cases of negligible brain congestion, bone fragment were left in its place without suture fixation and after the congestion resolution fragment would return to its anatomical location. In several times it would be ligated in two – three points.

This method was the most efficient in bifrontal low craniotomy. The need of removing bone fragment was observed in zero cases.

In cases of acceleration traumas, which is characterized by diffuse damage, multifocal hemorrhages and bruises, in 157 cases double decompression method was used, in some case with falcostomy, effective in 49 cases. Trafination and resection trepanation were removed from practice.

Trafination method was sometimes use in cases of chronic hematomas and acute hydromas. In Recurrent and chronic hydromas method was less effective, in such conditions plastic trepanation method was used in order to create extra space for fluid. In singular cases of collapsed brain and for resolving tunica arachnoidea broken surface, we used to infuse 25–35 ml oxygen or 20–25 ml distillate in spinal chord. This method was proved effective in 70 cases.

Therefore, taking into consideration patho-mechanisms and pathology data, using differential pathogenetic methods of surgical invasion and computer monitoring of post-operative period we managed to decrease mortality in severecerebro- cranial traumas to 29–30 % comparing to pre computer periods 36–38 %.
Transcranial duplex sonography in assessing microsurgical treatment outcome for patients with ruptured cerebral artery aneurysms
Authors: Hamidova L. T. , Evgrafov P. G. , Rybalko N. V. , Shetova I. M. , Petrikov S. S. , Krylov V. V.
Published: April 2022

Study objective. To determine the role of transcranial duplex sonography measurements in prognosing the risk of adverse outcome in patients with nontraumatic subarachnoid haemorrhage.

Materials and Methods. In 2010–2020 413 patients admitted to N. V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare Department with aneurysmatic subarachnoid haemorrhage were enrolled into the study, including 201 males (48.7 %) and 212 females (51.3 %). Mean age was 51 ± 12 years. All patients were treated surgically (aneurysm clipping). Patients’ status on admission and before surgery was evaluated according to Hunt and Hess scoring system. Transcranial duplex sonography was conducted in all patients on admission, before surgical treatment and on a daily basis after aneurysm clipping (up to the 10th day after aneurysm rupture, 2,612 examinations in total). The degree of angiospasm in middle cerebral artery, Lindegaard ratio and the presence of diffuse angiospasm in all arteries of Willis circle were assessed according to a previously described classification system. Brain computed tomography scans were used to determine the extent of subarachnoid haemorrhage according to C. M. Fisher scale and volume of ischemic lesions in areas supplied by middle cerebral artery. Outcomes were rated according to Glasgow Outcome Scale. Study sample was divided into two groups according to outcome. Group 1: adverse outcome (Glasgow Outcome Scale 1–3). Group 2: favorable outcome (Glasgow Outcome Scale 4–5). Binary logistic regression was applied to reveal risk factors for adverse outcome. To define long-term treatment outcome 104 patients (68 females, 36 males) were examined using neurologic scoring systems: Modified Rankin Scale, Barthel Index, Mini-Mental State Exam, Hospital Anxiety and Depression Scale.

Results. Favorable outcome (group 2) was ascertained in 221 (53.5 %), unfavorable outcome (group 1) – in 192 (46.5 %) patients. The following independent risk factors for unfavorable outcome were detected: angiospasm in middle cerebral artery before surgery, severe angiospasm in middle cerebral artery and diffuse angiospasm. According to univariate analysis, daily increase in middle cerebral artery peak systolic velocity by 51.6 cm / s was associated with adverse outcome either. Binary logistic regression model was able to predict unfavorable outcome with sensitivity 88.5 %, specificity 76.0 %. Daily increase in middle cerebral artery peak systolic velocity by 58.7 cm / s was associated with Modified Rankin Scale increase by 1 point. Angiospasm proved to be strongly connected with cognitive and self-care ability impairment on follow-up.

Conclusion. Ultrasonic signs of angiospasm in patients with aneurysmatic subarachnoid haemorrhage are independent predictors of adverse outcome and long-term results worsening.
Enhanced recovery after surgery (ERAS) in spine surgery: A systematic review
Authors: Sayfullin A. P. , Aleynik A. Ya. , Bokov A. E. , Israelyan Yu. A. , Mlyavykh S. G.
Published: April 2022

Introduction. In recent years, Enhanced recovery after surgery (ERAS), or Fast-track, has been actively developed and introduced into clinical practice in many industry of surgery in Europe and the USA. However, the ERAS® Society has not yet approved a unified protocol in spinal neurosurgery, and most of the publications on the topic have appeared only in the last few years.

The purpose of the study is to present a systematic review of the literature to identify the key elements of the ERAS program and the effect of their use, as well as the impact on complications in the following areas of spinal neurosurgery: deformities, trauma, degenerative, infectious and oncology diseases.

Materials and methods. The authors analyzed and systematically reviewed all published literature on ERAS in spine and spinal cord surgery up to October 10, 2020 using the main databases of medical literature and search resources PubMed and eLibrary according to the PICOS inclusion and exclusion criteria, as well as the recommendations of the protocol for writing systematic reviews. and PRISMA meta-analyses.

Results. We analyzed 13 articles considering the use of ERAS technology in surgery for deformities (n = 3), degenerative (n = 8) and tumor (n = 2) lesions of the spine. The level of evidence of the study is 2a. The publications contain information on the treatment of 2,777 patients, whose average age was 50.5 years (from 14.0 to 72.4 years). The ERAS protocol has been implemented in clinics in the USA (46 %), China (30 %), France (8 %), Russia (8 %) and Great Britain (8 %). The average number of key elements of the ERAS program was 13.7 (range 5 to 24). The most popular are: preoperative patient counseling and education, minimally invasive surgery, multimodal analgesia, early mobilization and enteral loading, as well as active follow-up and care. The introduction of the ERAS protocol in spinal surgery made it possible, compared with the control group, to reduce the duration of hospitalization by 1.8 days (from 0.17 to 3.2 days), the cost of treatment by $ 1,443.75 (from 146 to $ 3,444), the severity of pain syndrome and the use of opioids in 38 % of cases, the consumption of antiemetics after surgery, as well as the time of surgery and blood loss at 29 minutes and 188 ml, respectively. For ERAS-groups, cardiovascular and respiratory complications are more typical, and for control groups – urinary, infectious, thromboembolic complications and liquorrhea. In general, there is a decrease in the total number of complications by 8.5 % (from 2.3 to 9.6 %).

Conclusions. Enhanced recovery after surgery is a promising technology for improving the quality of care for patients in spine surgery.
The Grand River Cayugas and International Arbitration, 1910–1926
Authors: Hauptman Laurence M.
Published: April 2022

For too long scholars have ignored the origins, deliberations, findings and overall significance of the American-British Claims Arbitration Tribunal that operated from 1910 to 1926, which heard a longstanding case involving New York State treaty obligations to the Grand River Cayugas. Also at this time Deskaheh, a Grand River Cayuga sachem, was bringing Hodinöhsö:ni’ (Haudenosaunee/Iroquois Confederacy/Six Nations) grievances to the League of Nations. This article traces the connections between these two cases, part of a larger Hodinöhsö:ni’ effort over the last century to assert sovereignty and gain international recognition for their nationhood as transnational peoples.
American Indian Genes in the Media: Representations of the Havasupai Indian Tribe in Their Case against Arizona State University
Authors: Orr Raymond I. , Reedy Justin , Livingston Dalaki , Spicer Paul
Published: April 2022

The misuse of genomic information has generated considerable concern in American Indian and Alaska Native communities. To understand how issues of genomic research misuse are understood by the public this article focuses on the case brought against Arizona State University by the Havasupai Indian Tribe. To understand how the Havasupai was being framed in the print media, this article examines newspaper articles (N=59) from when the story broke in 2004 until 2019. Our findings suggest that news media rarely engaged the concept of sovereignty and framed the story as an issue of research and scientific ethics.
Hubungan Kredibilitas Typical person Endorser dengan Brand Equity Produk R pada Mahasiswa
Authors: Hakim Gamma Rahmita Ureka , Faradeni Faradeni , Chusniyah Tutut
Published: April 2022

Pembangunan ekuitas produk menjadi hal penting dalam memenangkan kompetisi perusahaan. Salah satu upaya yang sering digunakan adalah dengan memanfaatkan endorser. Penelitian ini bertujuan untuk mengetahui hubungan antara kredibilitas typical person endorser produk R dengan ekuitas merek. Penelitian ini merupakan penelitian kuantitatif dengan metode deskriptif dan korelasional. Penelitian ini menggunakan metode korelasi deskriptif. Populasi penelitian adalah mahasiswa Fakultas Psikologi Universitas Negeri Malang angkatan 2014–2018 berjumlah 697 orang mahasiswa yang memiliki karakteristik: (1) pengguna produk R; dan (2) pernah melihat bintang iklan produk R. Sampel penelitian berjumlah 100 orang merupakan sampel populasi. Terdapat dua instrumen yang digunakan, yaitu: (1) skala ekuitas merek produk yang terdiri atas 19 item; dan (2) skala kredibilitas endorser yang terdiri atas 15 item. Uji hipotesis menggunakan Pearson’s product moment. Hasil uji hipotesis diperoleh data rxy sebesar 0,461 dengan signifikansi 0,000. Dengan demikian, terdapat hubungan positif dan dalam kategori cukup antara kredibilitas typical person endorser dengan ekuitas merek produk R pada mahasiswa. Saran yang diberikan untuk perusahaan, yaitu perusahaan bisa memilih typical person endorser sebagai pendukung merek sekaligus juru bicara dalam iklan yang patut dipertimbangkan. Saran untuk peneliti selanjutnya dapat mendalami penelitian ini pada analisis per aspek kredibilitas typical person endorser.
Análisis de la frecuencia de pasos como indicador de actividad física en escolares ecuatorianos
Authors: Arias Moreno Edison , García-Díaz Edson , Rodríguez-Torres Freddy , Guerrero-González Santiago
Published: April 2022

El podómetro es considerado una herramienta eficaz, para el control y medición de la actividad física, transformándose en una herramienta motivadora para el incremento del número de pasos en niños y adolescentes. El objetivo de este estudio es analizar las diferencias en la actividad física de los escolares ecuatorianos, a través de la medición y control de la frecuencia de pasos realizados en el transcurso de un día; considerando para ello género, edad, presencia o ausencia de la clase de Educación Física y las recomendaciones actuales de pasos/día. La muestra estuvo compuesta por 50 escolares (27 hombres y 23 mujeres, media ± desviación estándar: 1,46 (+0,5), alumnos de primero de bachillerato del Centro Educativo “Don Bosco La Tola” de Quito-Ecuador. Se utilizó un podómetro Omron HJ-152-E; analizando a los jóvenes en función del cumplimiento de las recomendaciones establecidas (11.000 pasos/día). Se realizaron análisis descriptivos, así como análisis de frecuencias, para ver si existían diferencias significativas, se realizó la prueba T-student para las variables de género, edad y datos emparejados. Los resultados muestran que los adolescentes cumplen con las recomendaciones mínimas cuando realizan las clases de Educación Física (Día+EF1= 11.067 p/d y Día+EF2= 11.413 p/d); evidenciándose la necesidad de plantear estrategias para promover la actividad física en los días que no se realiza la clase de Educación Física.
Carbon Footprint of 3D-Printed Bone Tissue Engineering Scaffolds: An Life Cycle Assessment Study
Authors:   the Department of Mechanical Engineering Technology, Faculty of Engineering Technology, Universiti Tun Hussein Onn Malaysia, Pagoh Campus, KM 1 Jalan Panchor, 84600 Pagoh, Johor and School of Mechanical Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia, Tajurahim Nurul Ainina Nadhirah , Mahmood Salwa , Saman Muhamad Zameri Mat , Ngadiman Nor Hasrul Akhmal
Published: April 2022

The bone tissue engineering scaffolds is one of the methods for repairing bone defects caused by various factors. According to modern tissue engineering technology, three-dimensional (3D) printing technology for bone tissue engineering provides a temporary basis for the creation of biological replacements. Through the generated 3D bone tissue engineering scaffolds from previous studies, the assessment to evaluate the environmental impact has shown less attention in research. Therefore, this paper is aimed to propose the Model of life cycle assessment (LCA) for 3D bone tissue engineering scaffolds of 3D gel-printing technology and presented the analysis technique of LCA from cradle-to-gate for assessing the environmental impacts of carbon footprint. Acrylamide (C3H5NO), citric acid (C6H8O7), N,N-Dimethylaminopropyl acrylamide (C8H16N2O), deionized water (H2O), and 2-Hydroxyethyl acrylate (C5H8O3) was selected as the material resources. Meanwhile, the 3D gel-printing technology was used as the manufacturing processes in the system boundary. The analysis is based on the LCA Model through the application of GaBi software. The environmental impact was assessed in the 3D gel-printing technology and it was obtained that the system shows the environmental impact of global warming potential (GWP). All of the emissions contributed to GWP have been identified such as emissions to air, freshwater, seawater, and industrial soil. The aggregation of GWP result in the stage of manufacturing process for input and output data contributed 47.6% and 32.5% respectively. Hence, the data analysis of the results is expected to use for improving the performance at the material and manufacturing process of the product life cycle.
Ecological Risk Assessment for Heavy Metals Occurrence in Rice Cultivation Areas in An Giang Province, Vietnam
Authors:   College of Environment and Natural Resources, Can Tho University, Can Tho 900000, Vietnam, Giao Nguyen Thanh
Published: April 2022

The study was conducted to assess the occurrence and ecological risk of heavy metal concentrations (Cu, Zn, Pb, Cd and As) in the soil of paddy fields in An Giang province in 2020. Soil samples were collected at 112 locations in seven paddy fields. Cluster analysis (CA) was used to present the spatial distribution of heavy metals. Ecological potential risk index (RI) was used to determine risk levels caused by heavy metals. The results showed that Cu, Zn, Pb and As in all soil samples ranging from 1.83-124.04, 4.87-114.18, 7.87-39.22 and 4.66-16.32 mg/kg, respectively. Cd was not detected in the soil samples. All heavy metal values were within the allowable limits of Vietnamese technical regulation on heavy metals in the soils. However, Cu concentration at the rice area in An Hoa hamlet, Khanh An commune, An Phu district (D10) and As concentration at D11 (An Hoa hamlet, Khanh An commune), D33 & D36 (Hoa Ha hamlet, Kien An commune, Cho Moi district) and D38 (Phu Thuong 2 hamlet, Kien Thanh commune, Cho Moi district) exceeded the allowable limits. The CA results revealed that soil quality at 112 study sites was classified into 12 soil quality groups, possibly reducing the soil monitoring cost by 72.32%. As is the most significant contributor to potential ecological risks in soils, although RI values still showed that heavy metals pose a low risk in rice cultivation areas. However, heavy metals in soils could degrade soil quality, accumulate in agricultural commodities, and eventually humans through the food chain. Therefore, the frequency of the monitoring can be considered to increase to two or three times per year to evaluate the seasonal variation of the heavy metals.
Green Kenaf-Based Adsorbent for Adsorption of Pb (II) Ions in Water
Authors:   the School of Civil Engineering, College of Engineering, Universiti Teknologi MARA (UiTM), 40450 Shah Alam, Malaysia, Anuar N. A. S. , Abdul-Talib S. , Chia-Chay T. , Abdullah S. , Jaafar J. , Lokman N. F.
Published: April 2022

Excessive toxic metals are commonly found in polluted water bodies. This study aimed to synthesise kenaf-based adsorbents for the adsorption of lead (II) ions. The physical and chemical characteristics of the kenaf (KNF) core and fibre were determined using field emission scanning electron microscope (FESEM), thermogravimetric analysis (TGA), and Fourier-transform infrared spectroscopy (FTIR). The further synthesised kenaf-chitosan-alginate (KNF-CHT-ALG) beads were characterised through FESEM and FTIR, while inductively coupled plasma (ICP) was employed to determine the percentage of adsorption. The FESEM analysis demonstrated that the KNF core had a rougher surface morphology than the KNF fibre. The TGA analysis confirmed that the KNF core was coarser and contained a higher residue of approximately 75.91%. The FTIR spectra established intense functional groups in the KNF core, such as hydroxyl and carboxyl, attracting more Pb (II) ions. The KNF core was then used to synthesise KNF-CHT-ALG beads. The beads confirmed the enhancement in surface morphology and the existence of numerous functional groups for Pb (II) ions to bind. The ICP analysis demonstrated 95% of Pb (II) ion adsorption. Additionally, batch adsorption experiments were conducted at pH 2–7 and the contact time was within 5–60 minutes. The kinetic study of the adsorption followed the pseudo-second order model with an R2 value of 0.9999. The KNF is a crop found in abundance in Malaysia, which could reduce the production cost of adsorbents. The significant outcomes would minimise the dependency on chemical adsorbents and accelerate the removal process of heavy metals in natural bodies of water.
Application of Augmented Intelligence Technology with Human Body Tracking for Human Anatomy Education
Authors:   Electrical Engineering Department, Politeknik Elektronika Negeri Surabaya, Indonesia, Fajrianti Evianita Dewi , Sukaridhoto Sritrusta , Rasyid M. Udin Harun Al , Suwito Bambang Edi , Budiarti Rizqi Putri Nourma , Hafidz Ilham Achmad Al , Satrio Naufal Adi , Haz Amma Liesvarastranta
Published: April 2022

Technological developments have a positive impact on humans to improve their abilities in line with innovations in the field of education which are increasing day by day. One of them is by increasing intelligence through collaboration between humans and technology called augmented intelligence. In this study augmented intelligence is applied to assist humans in studying human anatomy by utilizing augmented reality technology to perform motion tracking that can control 3D assets to follow it. The anatomy learning platform that was built was named AIVE (Artificial Intelligence on Virtual Education) with an architectural system consisting of a frontend for interface needs and AR platform development, there is also a backend for streaming databases and AI algorithms. Measurement of satisfaction and interest based on the PIECES framework is also carried out to determine the user’s response to the platform being built. The results show a satisfaction level of 4.12 and an interest of 4.10 which means that users are satisfied and interested in the human anatomy tracking platform that is accessed via smartphones.
Gamification Approach towards Engineering Students' Engagement in Online Learning
Authors:   Universiti Malaysia Sarawak, Faculty of Engineering, Electrical and Electronic Department, 94300 Kota Samarahan, Malaysia, Kho Lee Chin , Ngu Sze Song , Joseph Annie , Mat Dyg Azra Awang , Ng Liang Yew , Hau Ji Liang
Published: April 2022

Many engineering students might encounter difficulties understanding certain topics of related courses. They feel frustrated when the teaching method is dull, and the teaching materials are not attractive. All these may lead to the demotivation of the students toward the courses. Fortunately, there are tons of teaching techniques that are introduced to help in boosting students' engagement in the classroom, such as inquiry-based learning, project-based learning, service-based learning, and others. These techniques require the student's engagement, which eventually improves students' concentration while motivating them to practice critical thinking skills. It may promote positive learning experiences. However, engineering courses comprised of various complicated theories, calculations, projects, and assignments, which may burden some students. Furthermore, in addition to the COVID 19 pandemic, the students only attend their classes online, making the learning process even more independent and challenging. Therefore, this study aims to explore the gamification approach for engineering students to increase their engagement while learning online. A batch of 116 students from the Bachelor’s Degree of Engineering in Electrical and Electronics offered by Universiti Malaysia Sarawak (UNIMAS) are invited to participate in this study. A gamified learning model that consists of four stages is created in the online platform for the second-year KNR2443 Electrical Engineering Technology (EET) course. This gamified learning model integrates students’ rank, interactive map, and video guide. A survey related to gamification is collected from the EET students who completed the gamified learning model. The results are generally positive and indicate the gamification approach can potentially improve the engineering students’ engagement and enjoyment in the learning process.
Emergency Remote Teaching in Unequal Contexts: Reflections on Student Feedback on Two Online Courses during the Covid-19 Lockdown in South Africa
Authors:   the University of the Witwatersrand School of Education in Johannesburg, South Africa, Andrews Grant , Fouche Ilse
Published: April 2022

The Covid-19 pandemic has caused many universities to move instruction online. For the most part, this move has not been based on sound principles and best practices of online teaching, but can instead be characterised as emergency remote teaching (ERT) that aims to continue instruction despite the substantial drawbacks of insufficient planning or training. Research has looked at challenges inherent in ERT, as well as considered the benefits of online instruction for flexible learning environments. However, little research has looked at the experiences of students from diverse socioeconomic backgrounds during ERT. This paper explores student feedback on two courses taught in 2020 at a South African university, collected during routine course evaluations. The two courses employed universal design for learning (UDL) principles in order to attempt to make the courses as accessible and equitable as possible for all students. Data were analysed using thematic content analysis. The themes comprised the various roles that lecturers are expected to adopt in online environments under four dimensions: pedagogical, technological, managerial and affective. Findings indicate that despite the lecturers’ intentions to incorporate UDL, students from underresourced backgrounds faced unique challenges that exacerbated the problems in ERT. We thus conclude that ERT does not offer a good foundation for building effective, long-term online learning environments in unequal contexts, and that online learning needs to be reconceptualised if it is to become a long-term strategy for universities. Instructors in all contexts must be aware of the multiple ways that vulnerable students might be excluded from full participation in online courses in order to ensure socially just online pedagogies.
Revisiting Transactional Distance Theory in e-Learning Environment during COVID-19: Perspective from Computer Science Students
Authors:   the College of Education, National Chung Cheng University, Min-Hsiung, Chia-Yi, Taiwan, Batita Maurish S. R. , Chen Yau-Jane
Published: April 2022

This study is based on the separation of teachers and learners caused by the COVID-19 pandemic, and the implication of Moore’s Transactional Distance Theory, which proliferated for nearly 30 years but has been inconsistently validated empirically. The quantitative approach was employed, with questionnaires distributed based on the learners’ perspectives. The subjects of the study include 153 respondents from computer science department of an Indonesian public university. Three key tenets of transactional distance include dialogue, structure, and learner autonomy were specifically addressed and validated as significant predictors in this study. The findings elucidated an inverse relationship between dialogue and learner autonomy respectively with transactional distance, and a less rigid course structure capable of contributing to lessen the perceived degree of transactional distance in the e-learning environment. Furthermore, this study discovered that e-learning satisfaction and internet connection speed had an impact on the extent of transactional distance.
Technology Enhanced Learning and Student Academic Performance at a Public University in Peru
Authors:   Universidad Nacional San Luis Gonzaga, Peru, Arones Maritza , Curro-Urbano Olga M. , Saavedra Carmen Luisa Chauca , Phun-Pat Ynés
Published: April 2022

The adaptation of the teaching-learning process to virtuality, supported by the use of the academic platform in order to continue with educational activities, has gradually improved and has been reflected in the student's academic performance. The objective of the research was to analyze the learning strategies used by university students during the learning process enhanced by technology, to identify those used most frequently, as well as the relationships they have with the grade point average obtained in their academic performance. The study group was represented by a sample of 486 students from four academic programs of the Public University of Peru (Universidad Nacional San Luis Gonzaga). It was a mixed-focus study that worked with the ACRA-Abridged questionnaire that was virtually delivered to the student to collect the strategies used for their virtual learning. It is concluded that, despite various problems related to connectivity, they are always motivated to successfully achieve learning, likewise, the training process of the platform's digital tools must continue, as well as guiding the student in their learning virtual.
Incidentally diagnosed placenta accreta managed conservatively in a primigravida: case report and review of literature
Authors: Kumari Om , Gaurav Amrita , Khoiwal Kavita , Gupta Anshu , Kapur Dhriti , Halder Rashmi , Chaturvedi Jaya
Published: April 2022

Placenta accrete spectrum (PAS) disorder is rarely reported in primigravida woman without recognisable risk factors. It can be encountered intraoperatively without prior suspicion. Massive obstetric haemorrhage and increased maternal morbidity and mortality is often associated with emergency caesarean hysterectomy. We presented a 26-year-old primigravida who was presented to our institute as post-dated pregnancy in labour with no other comorbidities. She was taken up for cesarean section in view of prolonged labor. After birth of the baby, the placenta failed to separate on its own and could not be delivered with gentle controlled cord traction and uterine massage. Placenta was seen bulging out at left cornuo-fundal site as boggy mass in serosa of uterus as bluish distended placental bulge suggestive of placenta accreta. Placenta was left in situ and postoperatively uterine artery embolisation was done. Post-operatively patient did not develop any complications and follow up period of 6 months was uneventful. Conservative management of PAS can be judiciously contemplated in primiparous women desirous of fertility preservation and uterus conservation. The woman needs to be emphasised upon need for close follow up and risk of haemorrhage and sepsis till complete resorption of placenta occurs.
Sirenomelia (mermaid baby)
Authors: Rengaraj Nithya , Annal Anjana
Published: April 2022

Sirenomelia is a rare congenital malformation wherein the two lower limbs are fused to give an appearance of a mermaid. It is almost always lethal and is associated with several other defects like anorectal malformations, renal agenesis, umbilical cord vessel abnormalities and gastrointestinal defects. Reporting this case of sirenomelia from our institution in a preterm baby born alive to a primigravida at 36 weeks of gestation, who presented in labour.
Pathway analysis to characterize the relationships between healthcare access and healthcare visits in the United States using the health information national trends survey
Authors: Hu Qinglin , Li Xiaobing , Morales-Alemán Mercedes M.
Published: April 2022

Background: Americans had fewer healthcare visits compared to their counterparts in other developed countries. The lack of regular check-ups can contribute to worsening health conditions. Insurance coverage, access to transportation to healthcare services, and having accessed health information via the internet are known to be associated with frequency of healthcare visits. However, there is limited literature detailing the direct and indirect influences of these variables on frequency of patients’ healthcare visits. We aimed to understand the interactive relationship between insurance coverage, access to transportation to healthcare services, and having accessed health information via the internet on frequency of patient healthcare visits.Methods: We used data from the 2018 Health Information National Trends Survey (N=3504), the only survey year providing the source for information on insurance coverage, access to transportation to healthcare services, and having accessed health information via the internet. We used descriptive statistics, random parameter binary logistic regression, and pathway analysis to describe and analyze the associations between these determinants of healthcare access and healthcare visits.Results: Results indicated that access to transportation to healthcare services (18.32%) and having insurance coverage (27.89%) were directly associated with healthcare visit frequency whereas the association between having accessed health information via the internet and reporting a healthcare visit, compare to the former two, was weaken (10.87%). Residential area (rural/urban), health conditions, age, race/ethnicity, employment status were directly associated with visit frequency whereas income status and education level were associated with healthcare visits indirectly through insurance.Conclusions: Better understanding interactive relationships between healthcare access determinants will be key to the development of healthcare access interventions aimed at reducing healthcare disparities.
Parental actions that correlate with preschoolers requesting larger portions of food when away from home
Authors: Wansink Brian , Wansink Audrey
Published: April 2022

Background: How does a parent’s action at home sabotage the way their child eats when they are not at home? This two-part study explored which parental behaviors at home were most correlated with 75 preschooler’s requests for larger servings of snacks when away from home and away from parental scrutiny.Methods: Primary meal providers of three- to five-year old children completed surveys describing how they served food and snacks at home (such as whether they were always available in any amount a child wanted) and a wide range of questions about snacking habits of their children. Two weeks later, their children were met (without their parents present) and asked to indicate how much Froot Loops (a popular pre-sweetened cereal) they wanted for their morning snack. Correlations between how much they served and household snacking behaviors were then explored.Results: Boys who were often required to clean their plates at home requested more cereal during snack time when away from home (p<0.05), and daughters who were able to snack at home whenever at home whether they wanted also requested more (p<0.05). Girls who were frequently given fruit as a snack at home requested less presweetened cereal when away from home (p<0.01).Conclusions: Parent actions in the home might have an unexpected impact on how much of less healthy foods children request when they away from such parental oversight. Care must be taken so a parent does not win a food battle at home just to lose any away-from-home food war.
Tobacco use, determinants and effects on treatment among persons living with HIV/AIDS at Military Hospital in Makurdi, Benue State, Nigeria
Authors: Aniwada Elias C. , Ezema Godian C. , Onwasigwe Chika N.
Published: April 2022

Background: Tobacco use is a leading avertable cause of premature death globally. It is commonly used among PLWHIV and with mortality tripling compared to the general population. Its impact on them is multifactorial. This study aims to assess the prevalence, determinants and effects of tobacco and its related products on treatment among persons living with HIV at a military hospital in Makurdi, Benue State, NigeriaMethods: The study was among HIV positive clients ≥18 years who have accessed care for ≥12 months at Nigerian air force hospital, Makurdi of Benue state, Nigeria. A descriptive cross-sectional study was done using adopted WHO ASSIST (V3.0) questionnaire. Simple random sampling method was used to select 700 clients studied.Results: About 138(19.7%) have used Tobacco products and 66 (9.4%) in past 3 months of which 10 (90.3%) were mild users. Of those that ever-used tobacco 114 (82.6%) used Tobacco and other substances; 90 (79.0%) Alcohol, 73 (64.0%) Kola nut, 8 (7.0%) Cannabis and 5 (4.4%) Cocaine. Determinants of use were male gender (AOR 0.23; 95% CI 0.15-0.35) and earning <18,000 (AOR 2.23; 95% CI 1.05-4.70). There were no associations of tobacco use with viral load and CD4 count.Conclusions: Prevalence of Tobacco use was higher than general population. Male gender and low socioeconomic status were determinants of use of tobacco. Addressing this menace of tobacco use is an important political and public health issue.
Gravidity, contraceptive use and acceptability of a proposed three-baby policy in a municipality of Ghana
Authors: Ametefe Vivian , Appiah-Brempong Emmanuel , Okyere Paul , Vampere Hasehni , Obeng Nyarko Gloria , Aggrey Priscilla Aba , Dadzie Mintah Francis
Published: April 2022

Background: Childbirth and high total fertility rate among women is traditionally held in high esteem in many African societies. However, the menace of large families and increasing populations has triggered both global and National actions towards population control. This study determined the factors associated with gravidity, the acceptability of a proposed three-baby per couple policy and the prevalence of modern contraceptives in a Ghanaian municipality.Methods: A descriptive cross-sectional study design was adopted and involved 350 women of reproductive age who had a history of past or present pregnancy. Data were collected using a structured questionnaire and analysed using descriptive and inferential statistical analysis with the aid of STATA version 14.Results: The results indicated that 97.39% of the participants had knowledge of modern contraceptives and 33.91% were current users of modern contraceptives. Gravidity showed significant association with age, marital status, educational level, employment status and source of contraceptive (p<0.001). Participants with no formal education had the highest gravidity (Mean±SD=6.0±1.7). Also, 86.29% were aware of the proposed three-baby policy but only 28.37% were willing to accept the policy. A linear regression analysis showed a negative association between age and gravidity (p=0.018; β=-0.008). The participants’ desired number of children was also statistically significant with gravidity (p<0.001­).Conclusions: Efforts towards population control can be challenging due to the low use of modern contraceptives which is effective in reducing the TFR. Also the low acceptability of the proposed three-baby policy amongst reproductive women suggest their desire for more children.
The determinants of pregnancy health literacy among youth in Bogalay Township, Ayeyarwaddy Region, Myanmar
Authors: Lat Tun W. , Lynn May P. , Mya Kyaw S.
Published: April 2022

Background: Focusing on adolescent reproductive health is very important, as 16% of the world's population is adolescents. This study aimed to identify the determinants of teenage pregnancy health literacy among youth and explore the perception of teenage pregnancy among youth and their guardians.Methods: We conducted a cross-sectional study with a mixed-method approach to identify the determinants and perception of pregnancy health literacy among youth in Bogale Township, Ayeyarwaddy region, Myanmar, between July and December 2020. We did the face-to-face personal interviews with guided self-administered questionnaires among 310 youth and individual depth interviews with 12 youth and 12 of their parents.Results: About 43% (95% CI 37.1%, 48.1%) were well-versed in pregnancy health literacy issues. This study discovered that youth with high school education and less had a 6.8 (95% CI =1.4, 34.7) fold increase in odds of having poor pregnancy health literacy compared to those with higher education. Moreover, youth who could not earn their income was approximately 5.7 times more likely to have poor pregnancy health literacy than those who could earn. The majority of youth requested to disseminate reproductive health information through various media and channels and that health facilities be well-equipped to provide reproductive health care services to teenagers.Conclusions: Sexual and reproductive health education/teaching programs and adolescents-friendly reproductive health services should be effectively implemented to prevent teenage pregnancy and ensure safer sex practices among teenagers. School-based sexual education programs must involve and assist parents and teachers in taking a more active role in SRH education in schools.
Effect of training on frontline health workers’ knowledge and attitude towards tuberculosis screening and case finding in Oyo state, Nigeria
Authors: Akinbiye Dora O. , Olaoye Titilayo , Adeniran Adeniyi A.
Published: April 2022

Background: Nigeria accounts for 11% of all undetected, ‘missing’ Tuberculosis cases. TB control is better achieved by improving the knowledge and attitude of frontline health workers (FLHWs) and this study aims to examine the effect of training on the level of knowledge and attitudinal disposition of FLHWs towards TB screening in Oyo State, Nigeria.Methods: Fifty-one (51) FLHWs enrolled on both intervention and control arms were trained on TB and Hypertension respectively. Outcomes were scores from each construct of the questionnaire administered at baseline and 8 weeks post intervention. The study was approved by Babcock University and Oyo State Ministry of Health.Results: Results showed that about 88% were females, CHOs were the most prominent cadre- 64%. At baseline, mean knowledge score at the intervention arm was 10.80 (control 10.61), range was 8-13 (control 7-13) and 61% had good knowledge (control 27%); this difference was however not statistically significant, p=0.55. Post intervention, all participants (100%) on the intervention arm had a good knowledge (control 73%), 47% of participants had good attitude score (control 12%). Mean knowledge score was 15.73 (control 11.92) and mean attitudinal score was 11.06 (control 8.86). Knowledge and attitude scores were statistically significantly higher in the intervention group <0.001.Conclusions: The study provides valuable information on the existing training gap at the lower levels of care towards TB control. Further study would be required to determine the effect of a change in knowledge and attitude on TB case finding.
The outcome of a Yoga Prana Vidya® health and healing camp conducted in Indri village, Haryana
Authors: Gupta Vishal , Gupta Meenakshi , Sharma Kavita , Prajapati Rahul Charanjitsingh , Nanduri Venkata Satyanarayana
Published: April 2022

Background: Free health checkup and treatment camps help villagers with health awareness and management of illnesses at no cost. This paper presents one such health camp conducted by Yoga Prana Vidya® (YPV®) healing team for 5 days in a village in the state of Haryana, India and with documented data and successful outcomes to the participants in the camp.Methods: An intervention with YPV® system healings was conducted, and patient data and feedback collected before and after the healings in the camp.Results: A total of 216 patients were registered in this camp with 20 types of illnesses identified for which treatment was sought by the patients. A group of 11 healers rendered healing services to all registered patients successfully.Conclusions: The camp served the intended purpose of rendering free service to the villagers in health awareness and improvements through YPV® healing techniques and protocols. Continuous increase in the number of participants in the camp and its popularity confirms the relief people got through healing during the camp. Many people got major relief in the ailments they were suffering over a time. It is the achievement of quick relief which drove many students’ and teachers’ interest in learning the healing techniques, and the teachings of YPV® were received by them with great enthusiasm.
Call based enquiry for COVID-19 vaccine (Covishield) adverse events in a tertiary care government hospital in India
Authors: Priya Adity , Gupta Pratibha , Kumar Vijay , Srivastava Salil Kumar , Yadav Yogesh Kumar , Srivastava Arshita
Published: April 2022

Background: Vaccination is one of the crucial intervention to fight against the ongoing COVID-19 pandemic. The ongoing vaccination drive aims for achieving national vaccination coverage. Due to the expedited roll out of COVID-19 vaccine, there has been a fear and concern regarding its safety. The present study aims to enquire actively about the adverse events after COVID-19 vaccination and disseminate this information to the public to promote vaccine acceptance.Methods: A call based active enquiry was done to know the frequency and severity of various adverse events among the recipients of COVID-19 vaccine’s Covishield (SII-ChAdOx1 nCoV-19) first dose. Call based enquiry was done for local as well as systemic adverse events on day 1, 3 and 7 of vaccination.Results: Out of the total of 1201 who responded to calls on all three days, 766 (63.7%) of them had at least one of the adverse event. There were only 4 (0.33) recipients who had severe/serious events. The most frequent systemic and local AEFI reported was body ache/ malaise and pain at injection site in 309 (25.7%) and 664 (55.3%) participants respectively. Most of the AEFI’s improved over a week with only 17 (1.4%) participants reporting persistence of any adverse event on day 7 of vaccination.Conclusion: Our study can provide scoping base for development of a proper surveillance program to monitor the AEFI by ‘active’ query and use of a call-based system especially for novel vaccines.
A review of COVID-19-associated mucormycosis in India
Authors: Khadke Sumanth , Khadke Vidhatri , Tomar Shubham , Khanuja Purvi K. , Suresh Surya , Sohail Muhammad R. , Khanna Arjun
Published: April 2022

The resurgence of COVID-19 with the delta variant has accompanied a doubling in the prevalence of COVID-19-associated mucormycosis (CAM) in India. The prevalence grew to 80 times that of the global average. In this review, we describe the epidemiology, the clinical presentation, and treatment of CAM. We conducted a literature search on the PubMed, Google Scholar, Embase, and Harvard Library databases. The cytokine storm with high interleukin-6 (IL-6), hyperglycemia, ketoacidosis culminates into impaired endothelial and immune response, causing improved survival of the fungus. The most common presentation is rhinoorbital cerebral mucormycosis followed by pulmonary mucormycosis in patients with COVID-19. CAM patients have active or prior pulmonary tuberculosis, hyperglycemia, or a prolonged stay in the intensive care unit (ICU). A recent history of steroid medications and a high prevalence of tuberculosis (TB) may have contributed to an increased prevalence of CAM infections. Hypoxemic COVID-19 patients have a substantial improvement with steroid treatment but increases the risk of opportunistic infections. Although radiological signs have been described but the most common presentation is a subtle sign of eye, nasal, oral cavity, or pulmonary symptoms which requires high index of suspicion. Hence, one should not rely on radiological signs alone. Amphotericin B or isavuconazole along with surgical debridement is the treatment of choice for CAM. Early admission, diagnosis, and treatment lead to favorable outcomes.
Does mHealth suitable for the Indian population? analysing criticisms and possibilities
Authors: Gunamany Susanna
Published: April 2022

India is the second-largest country globally in terms of population, with two-thirds of the population living in rural areas. India has made a significant pace in improving the overall health scenario even with several existing hurdles like vast geographical area, lack of quality transport facilities, high population density and nutrition, illiteracy, and poverty in the past decade. India has an exponential increase in mobile phones that have covered a substantially higher number of rural households. Even though technological innovations, especially mHealth platforms, are growing in developing countries like India, it faces many criticisms. This paper aims to analyse whether mHealth is a potential tool for the Indian population or not. mHealth interventions can be used in different domains to improve the performance of health workers, such as data collection and reporting, decision support and training, emergency referrals, alerts and reminders and supervision and interaction with other members of the healthcare system. It also helps the health system manage the problem of healthcare personnel absenteeism and can be used as an alternative to telemedicine. However, mHealth apps may not be broad enough to provide a healthy environment that enables individuals and populations to adopt a healthy life. Our study highlights the importance of integrating beneficiary-specific factors in developing mHealth interventions. The pathways linking access to, and use of, mobile services with healthcare utilisation need an in-depth study to ensure effective planning, designing and implementation of mHealth interventions.