bluuebunny/crossref_metadata_2025 huggingface dataset:
Metal mixture-induced non-transgenic animal model of Alzheimer’s disease: Pros and cons
Authors: Ashok Anushruti , Rai Nagendra Kumar
Published: September 2023

Alzheimer’s disease (AD) is a multifaceted and heterogeneous age-related disease and represents the most common cause of dementia among the elderly. Over the past two decades, transgenic models of AD appreciably contribute to the understanding of the molecular mechanisms involved in the onset and progression of AD. However, transgenic models generally identify with the familial form of AD that accounts for just 5% of AD cases. Thus, non-transgenic models are also essential to thoroughly understand AD pathophysiology. Environmental exposure to heavy metals has been linked to the pathogenesis of the non-familial, sporadic form of AD. This review summarizes our previously published research that showed a mixture of heavy metals, i.e. Arsenic (As), cadmium (Cd) and lead (Pb) at environmentally relevant doses induced AD-parameters and AD-like pathology in the young rats. Our previous findings suggest that the amyloid beta-42 (Aβ1-42) levels in the As+Cd+Pbmixture treated Postnatal-90 day rat brain were comparable with the intracerebroventricular Aβ1-42 infusion rat model, which is well- established non-transgenic model of AD. Additionally, As+Cd+Pb-mixtureinduced Aβ and amyloid precursor protein could be attenuated by known AD-directed drugs, memantine, and donepezil. These findings helped us to conclude that As+Cd+Pb-treated animals could be utilized as a non-transgenic model of AD. This review also summarizes the merits of a nontransgenic animal model of AD, generated through environmental doses of As, Cd and Pb-mixture and its demerits.
The impact of high-fat diet-induced oxidative stress on micro RNA’s in various tissues
Authors: Jayavaram Manikanta Vinay , Gaddam Dayanand Reddy , Godlaveti Vijay Narasimha Kumar , Chitikela Pullaiah , Saka Vara Prasad
Published: September 2023

Stress is the body’s reaction to any kind of injury or danger. It is linked to the production of oxidative free radicals, which are responsible for a variety of acute, chronic, and potentially fatal illnesses and diseases. Free radicals, due to their extreme reactivity, can harm or even kill cells. A High-Fat Diet (HFD) causes “oxidative stress”, which is characterized by an increase in the body’s generation of Reactive Oxygen Species (ROS) as a result of higher levels of triglycerides and Free Fatty Acids (FFA). HFD-induced oxidative stress alters cellular function by affecting transcriptional factors and mitochondrial enzymes (synthesis/inhibition). ROS and FFA damage the receptors of the epithelium, resulting in epithelial damage that impairs cellular function. ROS levels can harm cells by altering the expression of microRNA (miRNA), a sign of RNA damage. MiRNAs are non-coding RNAs found in animals, plants, and some viruses that play a role in the post-transcriptional regulation of gene expression. These three pathways—RNA cleavage, RNA destabilization, and RNA translation into proteins— all play a role in mRNA expression. The miRNA regulates the up- and downregulation of mRNA expression for cellular function, enzyme synthesis, and receptor modulation. MiRNA regulates cell function by maintaining the balance between cellular ROS levels and cellular damage.
Unlocking the future of drug discovery: navigating challenges and embracing opportunities
Authors: Reddy Challa Siva
Published: September 2023

The world of drug discovery stands at the threshold of an era of unprecedented potential, offering a glimpse into a future where groundbreaking medical breakthroughs could revolutionize healthcare as we know it. However, this journey towards innovation is not without its hurdles, and those at the forefront – the pre-clinical scientists – find themselves navigating a complex terrain of opportunities and challenges....
scRNA-seq reveals that origin recognition complex subunit 6 regulates mouse spermatogonial cell proliferation and apoptosis via activation of Wnt/β-catenin signaling
Authors: Liu Shi-Wei , Luo Jia-Qiang , Zhao Liang-Yu , Ou Ning-Jing , Chao-Yang  , Zhang Yu-Xiang , Bai Hao-Wei , Sun Hong-Fang , Zhang Jian-Xiong , Yao Chen-Cheng , Li Peng , Tian Ru-Hui , Li Zheng , Zhu Zi-Jue
Published: September 2023

The regulation of spermatogonial proliferation and apoptosis is of great significance for maintaining spermatogenesis. The single-cell RNA sequencing (scRNA-seq) analysis of the testis was performed to identify genes upregulated in spermatogonia. Using scRNA-seq analysis, we identified the spermatogonia upregulated gene origin recognition complex subunit 6 (Orc6), which is involved in DNA replication and cell cycle regulation; its protein expression in the human and mouse testis was detected by western blot and immunofluorescence. To explore the potential function of Orc6 in spermatogonia, the C18-4 cell line was transfected with control or Orc6 siRNA. Subsequently, 5-ethynyl-2-deoxyuridine (EdU) and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays, flow cytometry, and western blot were used to evaluate its effects on proliferation and apoptosis. It was revealed that ORC6 could promote proliferation and inhibit apoptosis of C18-4 cells. Bulk RNA sequencing and bioinformatics analysis indicated that Orc6 was involved in the activation of wingless/integrated (Wnt)/β-catenin signaling. Western blot revealed that the expression of β-catenin protein and its phosphorylation (Ser675) were significantly decreased when silencing the expression of ORC6. Our findings indicated that Orc6 was upregulated in spermatogonia, whereby it regulated proliferation and apoptosis by activating Wnt/β-catenin signaling.
Correlation of pain perception and fentanyl consumption after major abdominal surgery with CGRP 4218T/C polymorphism: A prospective interventional study
Authors: Prashant HT , Saxena Kirti N. , Kapoor Seema , Wadhwa Bharti , Kerai Sukhyanti , Gaba Prachi
Published: September 2023

Background and Aims:

Genetic polymorphisms contribute to patients’ variability in pain perception and response to opioid treatment. The present study evaluated the association of calcitonin gene-related peptide (CGRP) 4218T/C polymorphisms with fentanyl consumption over 24 h postoperatively in patients after major abdominal surgery.

Methods:

Eighty-five patients undergoing major abdominal surgery under general anaesthesia were recruited. For postoperative analgesia, epidural fentanyl and intravenous paracetamol were provided. The CGRP 4218T/C genotype was analysed, and the association between the genotype of the patient and the total consumption of fentanyl in the first 24 h after surgery was assessed. The association between different genotypes, the severity of postoperative pain and the side effects of opioids were also studied.

Results:

Our study population distribution included 52.9% of the T/T genotype (wild homozygote), 35.3% of the T/C genotype (heterozygote) and 11.8% of the C/C genotype (mutant homozygote). Mean (standard deviation) total fentanyl consumption in the first 24 h was found to be highest in the C/C group (212.0 [7.5] μg), followed by the T/T group (182.8 [9.9] μg) and was the least in the T/C group (159.6 [7.5] μg). The C/C group reported higher pain scores in all the study periods. There was no significant difference in the side effects of opioids, such as nausea, vomiting, sedation among different genotypes of CGRP 4218T/C.

Conclusion:

The polymorphism of CGRP 4218T/C affects postoperative pain perception and analgesic consumption. Patients with the C/C genotype had higher postoperative fentanyl consumption and pain scores.
A single-arm, prospective study comparing translaryngeal ultrasonography with direct visualisation by flexible laryngoscopy for vocal cord assessment in patients undergoing oesophagectomy or mediastinoscopy
Authors: Shetmahajan Madhavi , Vignesh M , Patil Vijaya , Parab Swapnil Yeshwant , Ranganathan Priya
Published: September 2023

Background and Aims:

Translaryngeal ultrasonography (TLUSG) for diagnosis of vocal cord palsy, a relatively new, safe and noninvasive bedside technique with minimal risk of respiratory infection transmission, has been effective in patients with thyroid disease. We studied its use as an alternative method to visual inspection by flexible laryngoscopy (FL) for vocal cord assessment in patients undergoing thoracic surgeries.

Methods:

After Institutional Ethics Committee approval and trial registration, in this single-arm, prospective study, the vocal cord function of 110 patients who underwent either total oesophagectomy or mediastinoscopy was assessed immediately after extubation by both FL and TLUSG. A follow-up assessment was done by laryngoscopy using Hopkin’s endoscope (HL) and a repeat TLUSG. The primary outcome was the concordance between direct visualisation (FL or HL) and TLUSG.

Results:

Vocal cords were successfully visualised by TLUSG in 90% of male and all female patients. Findings of FL and TLUSG done at the first assessment matched in 89 (86.4%) out of 103 patients, and the degree of concordance was 0.69 (95% confidence interval [CI] =0.52–0.83). At the second assessment, HL and TLUSG findings matched in 83 (94.3%) out of 88 patients, and the degree of concordance was 0.89 (95% CI = 0.77–0.98).

Conclusion:

TLUSG is an effective noninvasive alternative to direct visualisation for vocal cord assessment in both male and female patients undergoing thoracic surgery.
Conjunctival impression cytology and its varying patterns in controlled and uncontrolled diabetic patients
Authors: Mahadevan Gayathri , Hatti Ajay S. , Shashikala P. , Kumar Shanthala Arun , Barki Renuka
Published: September 2023

Context:

Diabetes mellitus (DM) is the most common endocrine disorder and is a significant cause of ocular morbidity, unstable refraction, corneal abnormalities, neovascular glaucoma, nerve palsies, and diabetic retinopathy (DR); it is being increasingly recognized that even the ocular surface is adversely affected in diabetic patients.

Aims:

The present study was undertaken to analyze the conjunctival surface changes by conjunctival impression cytology (CIC) and correlate them with glycosylated hemoglobin (HBA1c) levels.

Settings and Design:

Known cases of DM satisfying the inclusion criteria were included in this nonrandomized prospective study, which was undertaken after ethical clearance was obtained from our institutional ethical review board.

Subjects and Methods:

Eighty patients with DM who presented to the Department of ophthalmology at our center were included in the study; they were divided into Group 1 (HbA1c ≤6.5%) and Group 2 (HbA1c >6.5%). A detailed history, general physical examination, complete ophthalmological examination, and CIC were performed in all of the participants.

Statistical Analysis Used:

Data were analyzed using Chi-square test and statistical software EPI INFO Version 6 and Microsoft Excel. P < 0.05 was considered statistically significant.

Results:

CIC technique revealed that, after age and gender adjustment, there was a significantly higher percentage of uncontrolled diabetic patients (77.7%) who had lower goblet cell density and higher Nelson grades of conjunctival squamous metaplasia. This difference was significant for all age groups and both sexes (P < 0.001), and it was also significantly related to the duration of DM. In addition, there was a positive correlation between DR and decreased corneal sensation when associated with poor glycemic control (HbA1c >6.5%).

Conclusions:

Dry eye disease and ocular surface disorders are increasingly recognized in patients suffering from DM. The ocular surface evaluation must be included in the routine examination of all diabetic patients. CIC is a safe, minimally invasive procedure with no side effects and can serve as one of the diagnostic tools for the evaluation of the ocular surface.
Evaluation of retrobulbar circulation in diabetic patients using color Doppler imaging
Authors: Shankhwar Amit , Shankhwar Neetu , Mathur Suraj , Ananthan Anurag , Chaudhary Pallavi
Published: September 2023

Background:

Diabetic retinopathy (DR) is a microvasculature disorder of the retina. Color Doppler imaging is a new method that allows simultaneous two-dimensional anatomical and Doppler evaluation of hemodynamic characteristics of the retinal artery.

Aim:

The aim of the study is to compare retrobulbar vessel Doppler indices in DR and diabetic with no retinopathy (DNR) using color Doppler sonography.

Materials and Methods:

A time-limited, hospital-based study was conducted at a tertiary care hospital in Indore, Madhya Pradesh. The study included DR and DNR who were referred from the ophthalmology outpatient department to the radiology. Ophthalmologists performed baseline fundoscopy to categorize patients into different levels of retinopathy severity based on the International disease severity scale proposed by Wilkinson, which has five levels ranging from none to proliferative DR, indicating the risk of progression.

Results:

In the DR group, 26 (74.25%) patients had hemoglobin A1c (HbA1c) levels ranging from 7 to 7.9 and in the DNR group, 9 (26%) patients had HbA1c levels ranging from 6 to 6.9. Among 35 patients with DR, 25 (71%) patients and 7 (20%) had mild DR and moderate DR, respectively, and only 3 (8%) patients belonged to severe DR. The median resistive index (RI) of the ophthalmic artery in DR and DNR groups was 0.83 and 0.73, respectively. The median RI of the central retinal artery in DR and the DNR group was 0.8 cm/s and 0.6 cm/s, respectively. In the posterior ciliary artery, the median RI was higher in the DR group, i.e. 0.78, compared to the DNR group, i.e. 0.63. As RI depicted increased vascular resistance, it was higher in the DR group than in the DNR group. A weak positive correlation was found between HbA1c and peak systolic velocity, end-diastolic volume, and RI of all three arteries (ophthalmic artery, central retinal artery, and posterior ciliary artery) as inferred from the Spearman’s rank correlation coefficient among both groups.

Conclusion:

Color Doppler ultrasonography can be used to assess these microvascular changes and provides the association between the altered ocular blood flow and the severity of retinopathy. It helps us to predict even before DR appearance, enabling early diagnosis of DR and early intervention.
Large intraorbital transnasal wooden foreign body sparing vital structures
Authors: Mahapatra Santosh Kumar , Mohanty Anuja , Nayak Manasi , Das Ayantika
Published: September 2023

Orbital foreign bodies are not uncommon but a large wooden foreign body involving ipsilateral orbit, nasal cavity and opposite maxilla is not only rare but potentially vision threatening and can be life threatening too. A 43-year-old gentleman presented with injury to his left eye with a tree branch while riding a motorcycle. Examination revealed a left upper eyelid laceration with a hard wooden foreign body lodged between supraorbital rim and upper eyelid, ipsilateral ptosis and periorbital oedema. CT scan showed a transnasal intraorbital foreign body extending from left orbit medially towards opposite maxilla. Exploration was done under general anesthesia and a large linear wooden foreign body measuring 11.5 x 2 x 1.5 cm3 was removed from left orbit without any evidence of damage to vital structures. This is one of the largest reported intraorbital wooden foreign body to the best of our knowledge, hence the report.
Isolated homonymous hemianopia
Authors: Kadri Rajani , Jain Shreeya K. , Sampritha U. C. , Kudva Ajay A.
Published: September 2023

The purpose of this study was to describe five case series of patients who presented with isolated homonymous hemianopia (HH) heralding the ministroke. This was a retrospective observational case series. This was a retrospective case series of five patients who presented to the outpatient department with isolated HH and was followed up for 6 months. 30-2 Humphrey’s perimetric analysis and neuroimaging was done. Patients also underwent 2D ECHO and 24 h holter monitoring. These patients who presented with isolated HH had best corrected visual acuity of 6/6, N6 with Snellen’s chart. Pupils and color vision were normal. On neuroimaging, one patient had infarction only in the occipital lobe. Two had infarction in the cerebellar hemispheres along with the occipital lobe and one patient had infarction in the deep white matter of temporal lobe, corona radiata, and the last patient also had chronic infarct in the frontal lobe. But all these patients presented with isolated HH. 2D ECHO and 24 h holter monitoring were within normal limits and had no neurological deficits. They were put on oral antiplatelets, statins and nutritional supplements, followed up by neurologists for 6 months and showed no neurological deficits on follow up. On finger confrontation test, hemianopia was still persistent. Isolated visual symptoms may be an early presenting characteristic of stroke. As there is a finite window of time during which therapy for stroke is effective, prompt identification of such atypical symptoms is crucial.
A Rare Differences of Sex Development
Authors: Singhania Pankaj , Ghosh Arunava , Das Debaditya , Neogi Subhasis , Bhattacharjee Rana , Datta Dipanjana
Published: September 2023

46, XX testicular differences of sex development (DSD) is a rare cause of DSD presenting as a phenotypical male with chromosomal sex of 46, XX. Sex-determining region of the Y chromosome (SRY)-positive 46, XX DSDs have a well-characterized pathogenetic mechanism, whereas in SRY-negative 46, XX DSDs, the pathogenesis is not clearly delineated. Herein, we present a case of a 3½-year-old child who presented with ambiguous genitalia and bilateral palpable gonads. On the basis of a karyotype and fluorescent in situ hybridization, we arrived at a diagnosis of SRY-negative 46, XX testicular DSD. Basal serum estradiol and human menopausal gonadotrophin stimulated estradiol levels and inhibin A blood levels were against the presence of any ovarian tissue. Imaging of the gonads showed bilateral normal-looking testis. A clinical exome sequencing revealed a heterozygous missense variant NR5A1:c275G>A (p. Arg92gln) located at exon 4 in the affected child. Protein structure analysis was further performed, and the variant was found to be highly conserved. Sanger's sequencing showed that the mother was heterozygous for the variant detected in the child. This case highlights the rarity of SRY-negative 46, XX testicular DSD with a unique variant. Largely under characterized, this group of DSDs needs to be reported and analyzed to add to the spectrum of presentation and genetic characteristics. Our case is expected to add to the database, knowledge, and approach to cases of 46, XX testicular DSD.
Fetus-In-Fetu
Authors: Nandan Ruchira , Kachhap Seth , Sengar Pratishtha , Ghosh Amrita , Pandey Vaibhav , Indal Manish
Published: September 2023

A 7-day-old male child presented with abdominal distention and jaundice. Radiological investigations revealed an encapsulated sac encasing three fetus-in-fetu (FIF) in the retroperitoneum. Laparotomy revealed a sac occupying almost the whole of the abdomen. The sac was stretching the duodenum and barely visible common bile duct, which were carefully separated. The rest of the bowel was displaced to the left. The sac containing three FIFs was excised intact. One of the fetuses was highly differentiated and had thoracic meningomyelocele, which has never been reported in FIF.
Glans Anthropometry for Preputial Reconstruction in Hypospadias
Authors: Sharma Nitin , Sharma Shipra , Memon M. Amin , Sharma Mini
Published: September 2023

Background:

Cases of hypospadias present for poor stream or cosmetic appearance. The main aim is to provide a visibly normal phallus. Preputial reconstruction is technical. A properly planned reconstruction based on anthropometry may improve the result. We are presenting our experience of reconstruction based on glans anthropometry.

Aim:

The aim of the study was to evaluate the importance of glans anthropometry in preputial reconstruction in cases of hypospadias.

Materials and Methods:

All cases of hypospadias operated between June 2014 and March 2022 were included. Glans width was measured at the base. The marking sutures for preputial reconstruction were taken at distance thrice the glans width at base. Those requiring religious circumcision along with repair, associated significant chordee, catheter came out before 2 weeks, or history of any previous penile surgery were excluded. All the cases were subjected to urethroplasty, meatoplasty, and preputioplasty. The results obtained were analyzed.

Results:

One hundred and forty-eight out of 159 cases formed the study group. There were 31 glanular, 42 distal penile, 58 mid–penile, and 17 proximal penile hypospadias. Mean glans width at base was 16 mm (range: 11–21 mm). Mean distance of marking suture at prepuce was 38 mm (range: 33–63 mm). Mean follow-up was 12 months (range: 1–36 months). Mean age at presentation was 23 months (range: 14–72 months). Mean operating time was 50 min (range: 45–60 min). Fistula at the base of preputioplasty was seen in four. Dehiscence of preputioplasty was seen in six. Meatal stenosis was seen in three cases.

Conclusion:

Preputial reconstruction improves the cosmetic appearance of the hypospadiac penis. Reconstruction based on glans anthropometry improves the result and avoids complications.
Nonhypertrophic Pyloric Stenosis in a Neonate
Authors: Jayakumar T. K. , Rathod Kirtikumar J. , Sinha Arvind , Yadav Taruna
Published: September 2023

Gastric outlet obstruction in neonates due to nonhypertrophic pyloric stenosis (NHPS) is a rare cause. We report the case of a 37-day-old baby boy who presented with complaints of vomiting for the last 2 weeks and an inconsolable cry over the last 2 days. He has been vomiting seven to eight times a day, a few hours after breastfeeding. On ultrasonography, the stomach was distended, while the pylorus was not hypertrophied. An upper gastrointestinal (GI) contrast study was done, which was suggestive of gastric volvulus. We performed a laparoscopy for the same. Intraoperatively, the volvulus was already resolved. We performed gastropexy. Postoperatively, he had persistent symptoms, for which an upper GI endoscopy was performed. It demonstrated a narrow pylorus, consistent with the NHPS. We performed a laparoscopic Heineke–Mikulicz pyloroplasty. The patient's symptoms had improved postoperatively. He was discharged after 5 days.
Ovarian Sarcoma a Diagnostic Dilemma– A Case Report
Authors: Zulpi Prashant K , Kalavant Akshay B , Halgeri Anil B , Priyanka P
Published: September 2023

Primary sarcoma of the ovary is extremely rare. There are inadequate data in the literature regarding ovarian sarcoma in the pediatric age group. We report a case of an 8-year-old girl presenting with large abdominal mass and cachexia. Raised alpha-fetoprotein levels suggested germ cell tumor. Tru-cut biopsy histopathological report suggested a spindle cell tumor. The IHC staining suggested non rhabdomyosarcoma. As tumour was large and ovarian pediatric non rhabdomyosarcoma was not reported in the literature, we started on rhabdomyosarcoma neoadjuant regimen. Good response was noted for neoadjuvant chemotherapy, which was followed by complete surgical excision of the tumor and radiotherapy. At present, the overall outcome of the disease is dismal. Increased available data and gaining more evidence may help in improvising the treatment option.
Posterior Sagittal Approach for Nonanorectal Malformation
Authors: Parelkar Sandesh V. , Sanghvi Beejal V. , Tiwari Pooja , Gupta Rahul , Shah Rujuta
Published: September 2023

Background:

Posterior sagittal is a very well accepted approach in the treatment of anorectal malformations. This approach provides good access and exposure through the perineum to the deep pelvic structures. It reduces risk of injury to important structures as dissection remains in midline.

Aims and Objectives:

To access feasibility of posterior sagittal approach for non-anorectal malformation indications and to widen the spectrum.

Material and Methods:

We present a series of 10 cases of non-anorectal malformations operated by this approach for 4 years.

Results:

Six patients included in the study were of Disorders of Sexual Differentiation with pseudovagina, three of Y duplication of the urethra, and one of cervical atresia. All patients had good results.

Conclusion:

Posterior sagittal approach is feasible, safe with minimal bleeding, and no postoperative incontinence. It can safely be used for non-anorectal indications.
Evaluation and Management of Achalasia Cardia in Children
Authors: Kumar Nitin , Gadgade Bahubali Deepak , Shivapur Achyuth Ananth , Radhakrishna Veerabhadra , Vasudev Raghunath Bangalore
Published: September 2023

Background:

Achalasia cardia is a neuromuscular disorder of unknown etiology characterized by aperistalsis of the body of the esophagus and failure of relaxation of the lower esophageal sphincter. The diagnosis of achalasia cardia is delayed due to the rarity and the ability to mimic other common conditions in children. Hence, a study was conducted to evaluate the clinical presentation and the management of achalasia cardia in children.

Materials and Methods:

A retrospective observational study was conducted in the department of pediatric surgery at a tertiary center. The children with achalasia cardia who presented between January 2014 and December 2021 were included.

Results:

A total of 12 patients were treated for achalasia cardia during the study period. All children presented with recurrent episodes of vomiting, whereas dysphagia was seen in six (50%) children. Eighty-three percent of the children presented with a history of weight loss, whereas failure to thrive was seen in nine (75%) children. Five (42%) children were managed as gastroesophageal reflux disease (GERD) for more than a year before presenting to us. Three (25%) children underwent open cardiomyotomy with Thal fundoplication and the rest nine (75%) underwent laparoscopic cardiomyotomy. All are thriving well.

Conclusion:

Achalasia is an important differential diagnosis in children with suspected GERD. The most common symptom of achalasia cardia is vomiting followed by dysphagia. Weight loss and failure to thrive are important presenting features in children with achalasia which are uncommon in adults. Cardiomyotomy without fundoplication is safe and effective to treat achalasia cardia in children without having any extra complications.
Total Glans Amputation in a Child following Ritual Circumcision – Report of a Case and Review of Literature
Authors: Shah Amar , Shah Anirudh
Published: September 2023

Ritual circumcision in children remains a trivialized procedure in some countries, especially in rural areas. It is often performed by unqualified paramedical personnel, or even by religious workers whose notions of surgery and asepsis are uncertain. Although it is thought to be a minor procedure, major complications with sexual or even life-threatening prognosis can occur. Amputation of the glans during circumcision is a rare incidence secondary to poor application of operating principles. We report the case of a 1½-year-old boy who underwent a progressive amputation of the glans after a ritual circumcision by a religious worker. The child was brought 10 days after the procedure with totally amputated, nonsalvageable glans. A urethral meatoplasty was performed to enable proper voiding and prevent meatal stenosis. The child has been in follow-up for the past 6 months without any urinary symptoms.
Is an Antireflux Procedure Necessary for a Successful Appendicostomy? The Simplified Malone Antegrade Continence Enema Procedure
Authors: Karmarkar S. J. , Sushma Achugatla , Bangar A. P. , Krishnan J.
Published: September 2023

Aim:

The aim of this study was to present the long-term institutional experience and outcomes of our Malone antegrade continence enema (MACE) procedure using the proximal appendix without any antireflux procedure.

Materials and Methods:

A single-center prospective study of 29 children undergoing a simplified Malone antegrade continence enema (SMACE) procedure from 2006 to 2017 was conducted using the appendix, whole or split. The mean follow-up period was 11.5 years (ranging from 5 to 16 years).

Results:

In 25 children, the proximal appendix was used, and in 4 cases, the whole appendix was used as a conduit. On follow-up, the MACE channel has been working well in 29/29 patients. Among the complications, seven patients had stomal stenosis, which was managed by home dilatation. There was no reflux of stools seen in any of the patients.

Conclusion:

The SMACE procedure, without incorporating an antireflux mechanism, is technically simpler and saves operative time. Most importantly, the results are satisfactory and comparable with procedures using antireflux techniques.
Determining the Clinical Value of Routine Post Operative Follow up in Common Paediatric Surgical Conditions
Authors: Menon Revathy , Pathak Manish , Nayak Shubhalaxmi , Gupta Manoj Kumar , Saxena Rahul , Jadhav Avinash , Rathod Kirtikumar , Sinha Arvind
Published: September 2023

Background:

The traditional postoperative visit consists of an in-person hospital visit at a predetermined date which requires the investment of time and resources. This implies a need to prioritize visits rather than mandating them, which can be assessed by the requirement of clinical intervention at the time of follow-up. The purpose of this study is to determine the clinical value of routine postoperative physical follow-up in common pediatric surgery conditions, to identify factors determining follow–up, and to estimate the cost of routine follow-up.

Materials and Methods:

Surgical data of 226 patients admitted for routine pediatric surgical procedures were collected. The postoperative period was documented in detail and interventions done either physically or telephonically at the time of follow-up were used as a proxy measure of clinical value.

Results:

There were 226 patients enrolled, of which 64.60% followed up physically in outpatient department and 35.40% followed up telephonically. Maximum percentage of patients with postoperative complications belonged to the group of laparotomy at 22.22%, followed by complicated appendicitis at 15.62%. 13.27% of patients required clinical intervention at the time of follow-up.

Conclusion:

Patients undergoing simpler procedures such as inguinal hernia, hydrocele, and orchidopexy have lesser rate of complications which translates to requirement of fewer clinic visits, whereas those undergoing procedures such as appendectomy and laparotomy require a physical visit after discharge since they are more susceptible to develop complications requiring interventions. By selecting patients for physical visit, we can potentially eliminate unnecessary visits in patients who have low chance of developing complications.
Mysterious Late Presentation of Congenital H-type Tracheoesophageal Fistula in Teenage – Teamwork and Operative Planning
Authors: Kotcharlakota Venkata Vijay , Shoor Gunjan , Singh Vishal , Kumar Ritesh , Joseph Keziah
Published: September 2023

Congenital tracheoesophageal fistula (TEF) is a result of the failed fusion of tracheoesophageal ridges during the 3rd week of gestation. Commonly, TEF is associated with esophageal atresia, which is detected and treated in newborns. Isolated TEF is rare with an overall incidence of 1 in 80,000 live births. Very rarely, they can present in adulthood. This report is adding one such patient at the age of 17 years who presented with the first episode of aspiration pneumonia and a history of retrosternal discomfort and regurgitation since childhood to the limited world experience.
Thoracoscopic Repair of Iatrogenic Bronchial Injury in a Neonate during Bronchogenic Cyst Excision
Authors: Menon Revathy , Rathod Kirtikumar J. , Rathod Darshana , Kumar Prawin , Yadav Taruna , Sinha Arvind
Published: September 2023

Thoracoscopic surgery was not previously accepted in the neonatal population due to inappropriate instrumentation and lack of experience. However, our experience in the last few decades has slowly yet steadily established its safety and efficacy. The major advantages that thoracoscopy offers are early recovery and fewer long-term complications. However, we are aware that this comes at the cost of a steep learning curve and the potential challenge of facing certain complications which may compel a conversion to open. There is a paucity of literature regarding intraoperative complications of neonatal thoracoscopy and its management. Conversion to open thoracotomy is appropriate, keeping patient safety in mind, and any decision made to continue management of a complication thoracoscopically is technically demanding. Iatrogenic bronchial injury is one such rare complication of thoracoscopy with a limited mention in literature. We describe below a 25-day-old patient with a bronchogenic cyst who sustained injury to the left bronchus during thoracoscopic cyst excision, which was successfully repaired thoracoscopically.
Diarrhea after kidney transplantation
Authors: Patil AD , Saxena NG , Thakare SB , Pajai AE , Bajpai D , Jamale TE
Published: September 2023

Background:

Diarrhea in kidney transplant recipients (KTRs) can be associated with significant morbidity.

Material and Methods:

We evaluated 198 KTRs for a history of diarrhea post-kidney transplant at a tertiary care center in western India over 1 year. A protocol-based evaluation of diarrhea was done with respect to clinical features, diagnostic evaluation, associated acute allograft dysfunction, and its impact on long-term allograft function. Primary outcomes of interest were: chronic allograft injury (CAI) and the need for mycophenolate mofetil (MMF) withdrawal. We also assessed the effect of MMF withdrawal on the risk of the development of CAI.

Results:

Eighty-five of 198 (42.5%) recipients experienced diarrhea and a total of 140 diarrheal episodes were evaluated. The mean age of these 85 recipients was 38 ± 12 years and 72 (84.7%) were males. 73 of 85 recipients were on MMF at the time of diarrhea and in 35 (48%) of them MMF withdrawal was needed for chronic and persistent symptoms. Diarrhea was attributed to infective etiologies in 90 of 140 (64.2%) cases. Among the microbiologically confirmed infective diarrheal episodes, giardia and cryptosporidium were the common pathogens in 11/28 (39%) and 6/28 (21.4%) episodes respectively. One hundred and twenty-eight episodes out of 140 (91.4%) episodes were complicated by acute allograft dysfunction. Forty-one of 85 recipients (48.2%) developed chronic allograft injury and 12 (14.1%) developed allograft rejection (acute and/or chronic). Probability of chronic allograft injury was higher in those with MMF withdrawal.

Conclusion:

Diarrhea post-kidney transplant adversely affects graft function, especially after MMF withdrawal.
Assessment of Institutional Implementation Research Capacity of the National Institutes of Health D43 Network
Authors: Xiang Bingtao , Peterson Caryn E. , Dykens J. Andrew
Published: September 2023

Implementation science enhances the efficient practice of solutions from research to real-world application. Low- and lower- to middle-income countries may benefit significantly from implementation research given their limited resources. The National Institutes of Health Fogarty International Center D43 network consists of partnerships between foreign and U.S.-based institutions and aims to strengthen global health research. This paper assesses the D43 network’s implementation research focus and training capacity. A survey was distributed to 387 program directors of ongoing and completed D43 projects. Preliminary results show 51.7% of respondents describe “increasing implementation research capacity” as a “high priority.” Only 24.8% of faculty in implementation science received formal training, and 60.3% of D43 programs lacked an implementation research training program. Results show there is an increasing need for implementation research but that more can be done to develop implementation research capacity and training. The low response rate of 18% is a limitation of this study.
Demystifying China’s trade secrets law in action: a statistical analysis
Authors: Chen Yang
Published: September 2023

This article attempts to conduct a detailed empirical study on trade secrets litigation in China. In a nutshell, using 33 coding criteria, this article studied 2810 judicial documents published between 2013 and 2021 related to trade secrets litigation. Of the 2810 documents, 745 concerned substantive trade secret issues, with 885 trade secret claims addressed by Chinese courts. The article mainly aims to fill two research gaps in the current literature. First, it is unclear whether, during the past two decades, China indeed provided inadequate trade secrets protection in practice because of its ‘defective’ statutes, as alleged by the US government. Empirical evidence is needed to test whether the previous US criticisms conformed with the working situation of China’s trade secrets litigation. Second, the enforcement level of trade secrets law in books in China remains a myth. The argument that China has adopted a strict trade secret law in books similar to the US has little practical value if China did not enforce the trade secrets law in practice. Empirical evidence is required to demystify the enforcement situation of trade secrets law. This article, thus, fills these two gaps by presenting empirical findings on trade secrets litigation from 2013 to 2021 in China.
Selected criminal trade mark cases in the annual Top Ten Intellectual Property Cases of the Supreme People’s Court of China
Authors: Lu Tian
Published: September 2023

Since 2009, the Supreme People’s Court of China (SPC) has annually reported the Top Ten Intellectual Property Cases (TTIPCs) on and around World Intellectual Property Day in April. The individual cases involve the past year’s countrywide intellectual property cases and form a key component of China’s national case guidance system. Due to their conciseness and regularity of release, as well as their role as explicit guidance provided by the SPC, the TTIPCs encompass a particularly valuable observational window into Chinese law and its applications.

In contrast to holistic empirical research involving numerous cases, this study embarks on a new course by investigating the specific intersection of TTIPCs and trade mark criminal offences. A longitudinal sampling method of past TTIPCs has been used to extract all criminal trade mark cases. These cases were subsequently analysed within the prevailing social context during adjudication and the evolution of China’s trade mark criminal legislation. This study aims to reveal the characteristics, functions, and limitations of TTIPC criminal trade mark cases.
Steam: Una breve conceptualización de una metodología orientada al desarrollo de competencias del siglo XXI
Authors: Díaz Cedeño Valentina Teresa , Salazar Caraballo Inés María , López Brito Rainner
Published: September 2023

En una sociedad cada vez más influenciada por la tecnología, la educación enfrenta la tarea de preparar a los jóvenes para afrontar los retos que esto representa. La metodología STEAM beneficia el proceso de enseñanza-aprendizaje de estudiantes de educación básica, ayudándoles a alcanzar las competencias necesarias para el futuro. Por tanto, este artículo presenta una revisión documental que tiene como propósito conceptualizar la metodología STEAM; analizar las características de su proceso de enseñanza y los recursos necesarios para su aplicación; presentar su sistema de evaluación; y finalmente reflexionar sobre los beneficios de esta.
PHARMACEUTICO-ANALYTICAL STUDY OF KUSHMANDADIGRANULES – A
NEW DOSAGE FORM
Authors: patil Sanketha , pai Surekha , Padyana Subrahmanya
Published: September 2023

The concept of Smriti has been discussed in various Ayurvedic texts in wider aspects. Smriti is discussed as one
among Ashta Aishwarya. Acharya Chakrapani explains Smriti as a component of Buddhi& relation with Atma,
Manas. The Ayurvedic classics identified the importance of higher faculties dealing with memory and introduced
a separate group of drugs namely Medhya Rasayanas. Kushmanda & Brahmi both are well known Ayurvedic
herbs for their actions on the central nervous system, especially to enhance intellect, memory, and other mental
faculties. Materials and methods: Granules preparation was carried out as per the general method of preparation.
Result: physio chemical analysis of the present study shows pH of 7.54, 7.23, 6.57. Loss on drying(%) 20.2, 12,
3.6. Total Ash (%)0.42, 0.58, 1.34. Total fat 3.4%, 3.9%, 4.1%. respectively for three batches of Kushmandadi
Granules.
PHARMACOLOGICAL ACTIVITY AND MEDICINAL VALUE OF SHAMI
(PROSOPIS CINERERIA)- A REVIEW
Authors: Sharma Nikita , Singh Chandan , Prasad Purvia Rajendra , Adlakha Manoj , Mahawar Manoj
Published: September 2023

Prosopis cineraria Druce of family Mimosaceae is an indigenous plant which has mentioned in Ayurveda with
several clinical properties. Prosopis cineraria is also the national tree of Telangana, Rajasthan, and Western Uttar
Pradesh in India. In Rajasthan, it is known as Khejri, and in Western Uttar Pradesh as Chhonkara. A violent environmental conflict occurred in the Rajasthani village of Khejarli near Jodhpur in 1730 AD. In an effort to save some
Khejri trees that Maharaja Abhay Singh had ordered cut down to make room for his new palace, Amrita Devi and
her three young daughters sacrificed their lives. Widespread defiance resulted from this, and 363 people were killed
while attempting to save the trees. The Chipko movement was born in the 1970s as a result of this sacrifice memory.
This tree is referred to as ‘Kalpataru' and "the king of the desert. This plant has valuable properties for nutrition,
INTERNATIONAL AYURVEDIC
MEDICAL JOURNAL
Nikita Sharma et al: Pharmacological Activity and Medicinal Value with Clinical Reference to Shami- A Review
doi:10.46607/iamj1811072023 | IAMJ July 2023 | www.iamj.in 1601
animal feed, and "medicine." Prosopis cineraria (L) Druce, also known asshami, is a member of the Fabaceae family
and is used for spiritual purposes in India. It is referenced in practically all of the Nighantu's of Ayurveda. It only
occurs in hot, dry, and arid areas of India. Even while practically all of the components of Shami, especially the
Bark and Fruit, have pharmacological effects.
ADRAVYABHOOTA CHIKITSA IN AYURVEDA: A REVIEW ARTICLE
Authors: P.S Swathilakshmi , Shetty Susheel , Paul Babu
Published: September 2023

Any type of activity done for bringing the Dosha, Agni, Dhatu, and Mala into an equilibrium state is called
Chikitsa. In Ayurveda, we can get many types of Chikitsa in the context of different Vyadhi. Dwividha chikitsa
bheda includes Dravyabhoota chikitsa and Adravyabhoota chikitsa. Adravyabhoota Chikitsa includes all those
treatments wherein no pharmacological approach is involved. This treatment may be in different forms like physical activities, mental activities, spiritual activities, religious activities, etc. Adravyabhoota Chikitsa complements
therapy in some diseases and also be a mainstay approach in some conditions. Both types of treatments have their
importance to different degrees in different places. This review article explains the concept of Adravyabhoota
chikitsa in Ayurveda.
EVALUACIÓN DE LA CALIDAD DE LOS SERVICIOS DEL GADM DEL CANTÓN PUERTO LÓPEZ MEDIANTE LA APLICACIÓN DEL MODELO SERVPERF
Authors: Anchundia María Elizabeth
Published: September 2023

La evaluación del servicio al usuario en las entidades públicas se convierte en una de las herramientas fundamentales para la evaluación de la eficiencia y eficacia de estas instituciones, por lo que, la presente investigación tiene como objetivo evaluar la calidad del servicio brindado a los usuarios por parte del Gobierno Autónomo Descentralizado Municipal del Cantón Puerto López, entidad que carece de un indicador establecido de la calidad del servicio. La metodología utilizada es de tipo descriptiva, con base a la información cuantitativa obtenida de una encuesta de 22 preguntas efectuada a los usuarios de los servicios evaluados, esto mediante el modelo SERVPERF como herramienta de evaluación. Los resultados obtenidos evidencian que los usuarios en relación con la satisfacción al cliente consideran que la institución brinda un buen servicio, tiene atención personalizada y la atención fue lo que esperaban. En este contexto, se concluye que de las dimensiones analizadas es la empatía la que mantiene una mayor relación con la satisfacción al cliente en el GAD de Puerto López.
EVALUACIÓN DEL COMPROMISO Y SATISFACCIÓN LABORAL EN DOCENTES DE UNA INSTITUCIÓN EDUCATIVA PÚBLICA EN EL ECUADOR
Authors: Villamizar Andrés
Published: September 2023

El objetivo del presente trabajo de investigación es evaluar el compromiso y la satisfacción laboral en docentes de una institución educativa pública, e identificar la existencia de una relación entre ellas, mediante la realización de cuestionarios validados UWES-9 y S20/23, para el planteamiento de acciones de mejora.  Mediante el análisis de los datos obtenidos, se identificará las posibles problemáticas sobre los aspectos estudiados en los docentes de la institución, y así mediante un plan de acción proponer soluciones. El tipo de estudio que se utilizó para esta investigación fue cuantitativo, de corte transversal, descriptivo y correlacional. El cual alcanzo a una muestra de 61 docentes que laboran en una institución educativa pública, los resultados muestran una prevalencia mayor en la categoría media, tanto para el compromiso laboral (62,3%) como para la satisfacción laboral (50,8%), sin embargo, muestran una correlación positiva entre las dos variables, en conclusión, a medida que aumenta la satisfacción laboral de los empleados, también aumenta su nivel de compromiso en el trabajo.
Pengaruh Kompensasi, Disiplin Kerja dan Motivasi Terhadap Produktivitas Karyawan
Authors: Albert Albert , Nefianto Tirton , Rojuaniah Rojuaniah
Published: September 2023

Kompensasi diartikan sebagai sesuatu yang diterima para karyawan sebagai balas jasa untuk kerja mereka. Disiplin kerja dijelaskan sebagai suatu kesadaran dan kesediaan seseorang mentaati semua peraturan yang ada dan norma-norma sosial yang berlaku. Motivasi sebagai proses yang menjelaskan intensitas, arah, dan ketekunan individu dalam upaya mencapai tujuan. Produktivitas kerja adalah suatu perbandingan kualitas dan juga kuantitas dari pekerja dalam suatu waktu tertentu agar bisa mencapai hasil ataupun prestasi kerja yang efisien dan efektif sesuai dengan sumber daya yang digunakannya. Penelitian ini menggunakan 4 variabel dan memiliki tujuan untuk membuktikan pengaruh kompensasi, disiplin kerja, dan motivasi kerja terhadap produktifitas karyawan dari PT Blue Bird. Teknik pengumpulan data menggunakan kuisioner yang dibagikan kepada 134 responden. Data pada penelitian ini menggunakan data primer dengan menggunakan  36 pertanyaan yang berbentuk pernyataan didalam kuisioner dengan skala likert 5 point. Data dianalisis dengan menggunakan analisis regresi linear berganda. tujuan dari penelitian ini adalah ingin mengetahui pengaruh kompensasi, disiplin kerja dan motivasi terhadap produktivitas kerja pada Perusahaan PT Blue Bird Group. Hasil penelitian ini menunjukan bahwa kompensasi berpengaruh positif terhadap produktivitas karyawan. Disiplin kerja berpengaruh positif terhadap produktivitas karyawan. Motivasi kerja berpengaruh positif terhadap produktivitas karyawan. Kompensasi, disiplin kerja, dan motivasi kerja berpengaruh positif secara bersama sama terhadap produktivitas karyawan.