bluuebunny/crossref_metadata_2025 huggingface dataset:
The Myopia Control in Real Clinical Practice: The Results of an Expert Study
Authors: Tarutta E. P. , Proskurina O. V. , Iomdina E. N.
Published: December 2021

The article presents expert study results about myopia control. The study was conducted by Russian eye care practitioners in 2019.

Purpose. to summarize the views of eye care practitioners on the problem of myopia control in Russia.

Methods. The study was conducted by mailing (sending) questionnaires to practitioners. The questionnaire contained 9 questions. Base questionnaire was developed by British Contact Lens Association (BCLA) for global study, translated into Russian and updated with items of interest to Russian practitioners.

Results. 356 questionnaires were received and processed. Concern increasing frequency of pediatric myopia was highest (9.0 ± 0.08 on a 10 point scale). Orthokeratology was perceived to be the most effective method of myopia control, followed by myopia control soft contact lenses and increased time outdoors. Perceived effectiveness rated as percentage was 50.7 ± 1.6 %, 44.9 ± 1.8 % и 42.9 ± 1.7 % respectively. Perifocal spectacles correction was perceived to be the most effective method in the Southern area of Russia (56.8 ± 11.1 %), atropine — in the Northwestern Federal District (39.5 ± 7.1 %), scleroplasty — in the Far East (55.1 ± 7.6 %). Under-correction was perceived to be the least effective method in all areas (11.6 ± 1.0 %). Increased time outdoors was a priority for most practitioners (on average 94.0 ± 7.8 prescriptions per month by one practitioner). Practitioners prescribed single vision spectacles as the primary mode of correction for myopic patients (47.2 ± 3.6 prescriptions per month by one practitioner). Phenylephrine instillation was used often (49.4 ± 3.6 prescriptions per month by one practitioner). This trend was in most areas. Vision therapy was used most frequent in Siberia and the Urals and in the Far East (70.4 ± 11.5 и 20.0 ± 5.2 prescriptions per month by one practitioner respectively). The most common reasons practitioners gave for not adopting myopia control strategies were: they were felt to be uneconomical (42.1 %); they considered there to be inadequate information about the modalities (22.2 %). 45 % practitioners from the Far East called the last reason the main one. 42.9 % practitioners from Northwestern Federal District did not believe that these are any more effective methods then single vision correction.

Conclusion. The active promotion and introduction into everyday clinical practice of myopia control methods that have proven to be highly effective could help reduce the frequency of progressive and degenerative myopia
El sentido iusfundamental de la objeción de conciencia al aborto frente al derecho a la salud sexual y reproductiva en Iberoamérica: perspectiva jurisprudencial
Authors: Leyra-Curiá Santiago
Published: December 2021

En este artículo se pretende valorar el sentido iusfundamental de la OdC al aborto en Iberoamérica frente al que parece reclamar para sí el derecho a la salud sexual y reproductiva reflejado en la jurisprudencia de los últimos años. Para lo cual se estudian brevemente todas las legislaciones de los países iberoamericanos relacionadas con el aborto, distinguiendo aquellos Estados en los que está legalizado de aquellos en los que no, pasando después a estudiar someramente las cláusulas de conciencia que protegen al personal sanitario y/o a las instituciones sanitarias. Se apunta cómo no está demostrado que las cláusulas jurídicas más protectoras guarden correlación con los países con más muertes de mujeres embarazadas, tratando de desmentir la relación de la objeción de conciencia al aborto con la vulneración del derecho a la vida de esas mujeres. Lo cual permite afirmar que la OdC al aborto por parte del personal sanitario realmente es una manifestación del ejercicio de un derecho fundamental que está ejerciendo una función profética (desde el punto de vista sociológico) y de garantía iusfundamental.
A classification study for re-determination of the geographical regions: the case of Turkey
Authors: Durmuş Burcu , İşçi Güneri Öznur
Published: December 2021

The rapid urbanization of the residential areas in an unplanned and irregular manner causes ecological and environmental changes. Understanding this growth is an important criterion for developing environmentally friendly policies and creating new limits. Although determining the boundaries of the region cannot be connected to a single basic principle, a planning can be made by making statistical inferences. In this regard, in this study, Turkey's geographic boundaries are discussed again. A classification analysis was conducted to discuss how the change of environmental and human criteria affects the limits. The study was carried out with two data sets. The first is the provinces that exist in the present, and the second is the selected developing districts. The algorithm that gave the best results for the data was determined. The reason for the provinces classified incorrectly according to this algorithm was discussed and a new border map was proposed.
Diabetic Central Neuropathy: A Cause of Central Sleep Apnea
Authors: Malone John
Published: December 2021

Diabetes Mellitus, prolonged hyperglycemia, causes peripheral and central nervous system dysfunction. Chronic hyperglycemia causes changes in the sorbitol, inositol and taurine content of peripheral and central nervous system tissue. The proteins in these tissues are also altered by glycosylation end products. The changes in metabolites impair growth and development of nerves and the increased glycosylation end products make the proteins stiff, sticky and prone to physical injury. This activity stimulated by hyperglycemia impairs the normal function of the peripheral and central nervous system. Manifestations of this tissue injury have been loss of sensation and increased pain in the extremities, loss of proprioception when standing, dysregulation of gastrointestinal motility, and heart rate. Also noted in children are delayed maturation of cognitive function during childhood and more rapid decline of cognitive function with increasing age and increasing HbA1c. Sleep apnea has become an important cause of heart failure and death commonly linked to type 2 diabetes and obesity. Continuous pressure airway pressure (CPAP) does overcome the periods of obstruction and prevents the morbidity associated with obstructive sleep apnea (OSA). Forty-Six percent of type 1 diabetic patients have absence of effort sleep apnea which means it is a central lack of drive to breath. There is evidence of change of structure in the medulla of subjects with type 1 diabetes as well as evidence of injuries in the medulla that cause cessation of breathing. These observations indicate that central neuropathy caused by hyperglycemia does cause central sleep apnea and possibly death.
Radiation Therapy Post Prostatectomy Using Axumin Imaging for Target Definition
Authors: Trifone Julie , Britton Maureen , Taylor Joshua , Croos Marious , Quinn Thomas , Figura Katie , Nochomowitz Bashera , Higgins Shannon , O’Connor Linda , Suhl Sherri , Briggs Kathleen , Quigley Jean , Reifler Heather , Ulin Kenneth , Smith Koren , Bradford Carla , Kuo I-Lin , Fan Yankhua , Yu Suhong , Bushe Harry , Saleeby Jonathan , Liu Fenghong , Khalifeh Abdulnasser , Ding Linda , Bishop-Jodoin Maryann , FitzGerald Thomas
Published: December 2021

Radiation therapy delivered post-prostatectomy can provide durable disease-free clinical outcomes. There remains debate as to whether the radiation should be applied to patients with high risk features post-surgery or deferred until there is biomarker evidence of clinical recurrence. Prior to the development of advanced-technology metabolic and anatomic imaging, the radiation therapy treatment fields were applied based on historical models of patterns of failure including the former capsule region, undersurface of the bladder, and the bladder urethral anastomosis. Although outcomes of therapy were good, the choice of the target was not image directed. Modern imaging has provided an advantage for targeting as radiation oncologists can be more secure of high-risk areas and in turn titrate dose to regions deemed of intermediate and low risk. In this paper we describe strategies for application of modern axumin imaging for patient care with radiation therapy post prostatectomy.
Relationship between pregnancy rate and number of intrauterine insemination cycles during the study of comparative efficacy of letrozole and clomiphene citrate adjuvants to gonadotropin stimulation in controlled ovarian stimulation cycles combined with intrauterine insemination therapy
Authors: Sharma Pankaj , Verma Ashok , Katoch Kritika
Published: December 2021

Background: Infertility is commonly defined as the failure of conception after at least twelve months of unprotected intercourse. Factors contributing are both male and female in which unexplained etiology accounts for 51%, male factor 28%, endometriosis 17% and ovulatory disorders 4%.Methods: Prospective, randomized study was conducted at DRRPG medical college, Tanda, Kangra, Himachal Pradesh. In our study, patients were randomized into two groups of 30 each. Women in group A received clomiphene citrate 100mg/day and group B received letrozole 2.5 mg/day from day 3-7 of menstrual cycle. All the patients received human menopausal gonadotropin 75 U given every alternate day from day 5 until HCG administration. Ovulation was triggered with recombinant HCG (5000 IUIM) when the dominant follicles reached 18 mm in diameter. A single IUI was performed 36 hours later. A maximum of four cycles were given.Results: In our study, total number of induction cycles given in group A and B were 120 and 114 respectively. Out of these, 112 and 111 IUI cycles were done in group A and B respectively. A pregnancy rate of 1.66% and 7.87% per IUI cycle was observed in group A and B respectively.Thus it is concluded that the pregnancy rates were significantly higher in letrozole group (30%) in comparison to clomiphene citrate group (6.66%).Conclusions: Aromatase inhibitor letrozole appears to constitute a good alternative to clomiphene citrate in patients with unexplained infertility undergoing gonadotropin-stimulated COS cycles combined with IUI therapy.
To assess ovulation in infertile women using urinary luteinizing hormone surge kits versus transvaginal ultrasonography
Authors: Karya Urmila , Chauhan Vibha , Rani Anupam
Published: December 2021

Background: The study was conducted to evaluate the efficacy of urinary LH surge kits and TVS to detect ovulation in induced cycles and to compare the ovulation rates by both methods.Methods: Prospective experimental randomized control trial on 72 women with an ovulatory infertility aged 18-35 years, fulfilling the inclusion criteria were given letrozole for ovulation induction. All were randomly divided in two groups. Group 1 woman were asked to check ovulation by urinary LH surge kits and group 2 women were called for follicle monitoring by TVS.Results: Letrozole has no negative effect on endometrium; induced cycle has larger diameter of follicle (median: 22 mm). In induced cycle ovulation occurs later compared to normal cycle (D-16) and half of the women had a BMI more than the recommended WHO criteria (average was 25.28 kg/m2). Number of letrozole cycles (p=0.2642), dose requirement (p=0.0812) and pregnancy rates (10.26% versus 18.19%) were comparable in both groups.Conclusions: TVS is objective, accurate and thus standard modality for ovulation detection. LH surge kit is subjective, having more chances of error but can be used as a good alternative in certain settings like woman of remote area, woman having fear of invasive modality and COVID era woman who are afraid to visit hospital repeatedly.
A case study of caesarean sections in referred cases
Authors: Shah Devanshi , Patel Arti , Mandaliya Maitry
Published: December 2021

Background: Referral is a coordinated movement of healthcare seekers through the health system to reach a high level of care in a small and often fatal window of time. Even physiological processes like pregnancy and childbirth are not free of complications. The purpose of this study is to understand maternal and foetal outcome in caesarean sections in referred cases.Methods: A prospective study was carried out in the OBGY department of SMT.SCL HOSPITAL, NHL Municipal medical college from April 2020 to April 2021. All referred antenatal and intranatal patients to our tertiary care centre with >20 weeks of gestation who underwent caesarean section with referral note.Results: A total 64% patients were referred from community health center. 63.5% patients were referred due to lack of high-risk management services. 211 patients underwent caesarean section while 69 patients had normal vaginal delivery. Difficulty in delivery of the baby was encountered in 53% of cases due to deep engagement of the fetal head. Major cause of admission in NICU was sepsis (38.6%) followed by prematurity (23.8%).Conclusions: Cesarean section is one of the quickest and most efficient method in the delivery of the baby and thus should in considered in patients in critical situations .The millennium development goals defined by united nation includes one goal (MDG 5) towards improving maternal health which still remains a challenge. Thus, improving knowledge of women regarding good antenatal care and strengthening referral services will play a big role in this.
Comparison of transvaginal sacrospinous ligament fixation with abdominal sacrocolpopexy in treatment of post-hysterectomy vault prolapse-a prospective randomized study
Authors: Dash Kamal Kumar , Dasgupta Anjan , Pal Abirbhab , Chakraborty Ayantika , Dash Barsarani , Ghosh Partha
Published: December 2021

Background: Vaginal vault prolapse is a common condition following abdominal or vaginal hysterectomy causing negative impact on women’s quality of life. The study compares the efficacy of abdominal and vaginal route surgery in correcting post-hysterectomy vault prolapse by postoperative assessment and at least twelve months follow up.Methods: A prospective comparative study among post-hysterectomy patients attending the GOPD of Midnapore Medical College diagnosed as vaginal vault prolapse at least stage2 between January 2013 to December 2019. The study population included 31 women divided into two groups-group A included 16 women underwent unilateral sacrospinous ligament fixation (SSF) and group B included 15 women underwent abdominal sacrocolpopexy (ASC).Results: There was no significant difference between the two groups in terms of mean age, mean weight, mean parity and BMI, hence both groups are comparable. The mean operating time was 117±19.68 min in ASC group and 83.25±11.28 min in SSF group (p<0.005); significant mean blood loss was reported in ASC group (373±97.79 ml in ASC group versus 193.125±98.97 ml in SSF group, p<0.005), more hospital stays in ASC group (p<0.005) and more post operative complications in ASC group than SSF group. At follow up, the mean vaginal length showed significantly longer for ASC group than that of SSF group (p<0.005).Conclusions: ASC and SSF, both techniques are effective in management of vault prolapse in hands of an expert though recovery time is much quicker in SSF group.
Fetal and maternal outcomes among pregnant women with placental abruption associated with disseminated intravascular coagulation attending a rural tertiary care centre
Authors: Mallidi Sudha , M. Munikrishna
Published: December 2021

Background: Placental abruption is the separation of the placenta from the uterine wall before the delivery of the fetus, and its frequency varies between 0.4 and 1%. The objective of this study was to determine risk factors and maternal and fetal complications in cases of abruptio placentae.Methods: A record-based study was conducted in the Obstetrics and Gynaecology department at a rural tertiary care centre between January 2015 and December 2019. All 72 pregnant women admitted with suspicion of placental abruption at 28 weeks of gestation and beyond were included in the study. All data were retrieved from the maternity register, patient files. The maternal outcome was assessed by mode of delivery, need for blood transfusion, parity, and any complications. Neonatal outcome was assessed by neonatal intensive care unit admission, still and live births. Data collected was entered and analysed by using coGuide software.Results: A total of 72 subjects were included in the final analysis. Most 58 (81%) of them were 21-30 years old. Forty-three patients (59.72%) were diagnosed to be preeclamptic. Forty-three (59.72%) of them had a vaginal delivery. Out of 72, 66 (91.67%) patients did not have any maternal complications. Most 41 (56.94%) births were stillbirths, and only 7 (9.72%) newborns required intensive care unit (ICU) admission.Conclusions: Placental abruption is one of the major threats to the well-being of pregnant women, with an alarmingly high rate of 41 (56.94%) stillbirths.
A retrospective analysis of maternal mortality in an urban tertiary care hospital
Authors: Bhushan Nishu , Manhas Aakriti , Dogra Anju
Published: December 2021

Background: The aims of the study were to generate information regarding causes and complications leading to maternal deaths in an urban tertiary care centre and to find if any of the causes are preventable.Methods: The medical records of all maternal deaths occurring over a period of 4 years between January 2015 and December 2018 were reviewed.Results: Maternal mortality ratio ranged between 127 and 48 per 1, 00,000 births in the study. The causes of deaths were haemorrhage (29.47%), pregnancy-induced hypertension (PIH) (28.42%), anaemia (12.63%), sepsis (9.47%), thromboembolism (6.31%), hepatic causes (5.26%), blood reactions (3.15%), heart diseases (2.10%), central nervous system (CNS) related (1.05%) and others (2.10%). Maximum deaths occurred in women between 21-30 years of age. Mortality was highest in post-natal mothers (70.52%).Conclusions: Overall maternal mortality due to direct obstetric causes was (73.68%), indirect obstetric causes (22.10%) and unrelated causes (4.2%).
The Mostafa Maged hemostatic flipping-over technique to control and prevent the post-partum bleeding from the lower uterine segment in placenta previa cases
Authors: Ali Mostafa Maged
Published: December 2021

Post-partum hemorrhage is still a headache to all obstetricians around the whole world. Every obstetrician exerts his own full effort to control bleeding which can occur post-partum by applying all maneuvers to preserve the fertility and the uterus for the patient. We demonstrate a new technique (Mostafa Maged) technique to control and prevent post-partum hemorrhage. It is so simple maneuver and easy to be applied within short period of time. Satisfactory hemostasis can be assessed after application. The aim of this technique is to see the Success in Controlling and prevention of the bleeding from placenta previa cases from lower uterine segment. The average duration of this new technique is (5-7) minutes. The results have shown that the hysterectomy done to one patient with new technique (1/13) (7.6%) cases because of the uncontrollable bleeding, blood was creeping down from the flipped sutured lower uterine segment. All of patients are introduced to the operating room as first-time cesarean section. One patient (7.6%) out of thirteen patients were tachycardiac post-operatively due to the more loss of blood as the new (Mostafa Maged) technique took a long time in these two patients (8 minutes). The tests of success were expected if hemostasis is done by the bimanual compression at first place.
Synchronous papillary endometrial and ovarian cancer in a 64-year-old woman
Authors: Bharaswadkar Ganesh B. , Babacan Nalan
Published: December 2021

Obesity, nulliparity, and comparatively younger age may attribute a “hormonal field effect” which leads to the development of synchronous endometrioid cancers. The morphological unit consisting of the uterus, fallopian tubes, and ovary as part of the Mullerian system may explain the synchronous appearance of these malignancies. Synchronous endometrial and ovarian cancer (SEOC) is defined as the simultaneous presence of these dual cancers at the time of diagnosis as opposed to metachronous cancer where these two cancers are diagnosed at different chronologic time points. Synchronous malignancies in the female genital tract are very rare entities. Synchronous endometrial and ovarian tumors must be differentiated from either primary endometrium or ovarian tumors with metastasis. The landmark criteria for diagnosing such cases have been laid down by Ulbright and Roth.
Absence of Wharton's jelly around an umbilical artery
Authors: Wade Mouhamadou , Gueye Mamour , Mbodji Aissatou , Ndiaye Mame D.
Published: December 2021

Wharton's jelly is a mucoid, avascular and connective tissue which plays the role of umbilical vessels protection. Its absence exposes to poor neonatal outcomes or fetal death. We report a rare case of Absence of Wharton’s Jelly, diagnosed by examination of the placenta the examination with a live fetus.
Histomorphological spectrum of central nervous system lesions in a tertiary care hospital
Authors: Shah Hetal Kirit , Dongre Suryakant , Karle Ravindra
Published: December 2021

Background: Central nervous system (CNS) lesions show considerable geographic and racial variations with respect to the incidence and their pattern of distribution. CNS neoplasm account for 2% of all cancers. There has been a rapid increase in incidence of CNS tumors. Many non-neoplastic CNS lesions can clinically and radiologically mimic brain tumors and to differentiate them histopathological examination is necessary.Methods: This was a descriptive cross-sectional study of 30 cases, carried out from March 2020 to February 2021, in a tertiary health care hospital. The cases were diagnosed histopathologically and categorized according to the WHO 2021 classiﬁcation.Results: The study included 30 cases. 3 (10%) of them were non-neoplastic while 27 (90%) were neoplastic with glioblastoma and diffuse astrocytoma being the most common. Overall, tumors of neuroepithelial tissue (60%) was the most common entity. Frontal lobe was the most commonly observed site in the neoplastic lesion. Headache was the most common presentation. Age range varied from 7 years to 66 years with the mean age of 32.7 years.Conclusions: The spectrum of neoplastic lesions were astrocytoma, glioblastoma, ependymoma, hemagioblastoma, medulloblastoma, meningioma, non-hodgkins lymphoma, oligodendroglioma, pitutary adenoma, schwannoma and non-neoplastic were A-V malformation, brain abscess, subdural empyema.
Buccal mucosal graft urethroplasty in the treatment of urethral strictures: a prospective study
Authors: Baragi Chetan , Totad Raveendra , Patil Shankarsnehit , Takkalaki Nandini
Published: December 2021

Background: Anterior urethral strictures develop due to a process of fibrosis and cicatrix formation of the urethral mucosa and the surrounding tissues. Its surgical management is a challenging problem, and has changed dramatically in the past several decades. Open surgical repair using grafts has become the gold standard procedure for anterior urethral strictures that are not amenable to excision and primary anastomosis. Oral mucosa harvested from the inner cheek (buccal mucosa) is an ideal material, and is most commonly used for substitution urethroplasty. Objective of current study was to establish the efficacy of the buccal mucosal graft urethroplasty by different onlay techniques in anterior urethral strictures.Methods: The study was a prospective study, done between August 2009 and December 2011. 25 cases of long anterior urethral strictures were managed by onlay urethroplasty by different techniques. Follow up ranged from 8-20 months.Results: 3 patients lost follow up after first visit. Post operative uroflowmetry was done in all patients after 1 month at the time of first follow up visit. Of 25 cases 21 (84%) were successful and 4 (16%) failed.Conclusions: In our study we have found that buccal mucosal graft can be safely used for substitution urethroplasty in all long anterior urethral strictures including cases with balanitis xerotic obliterance. It was very efficient in terms of less graft shrinkage or contracture as it is a full thickness graft.
A study to assess the degree of depression among parents of mentally challenged children
Authors: Ashraf Mir Uzma , Chaudhary Priyanka
Published: December 2021

Background: Raising a mentally challenged child is a challenging and exhausting task. Families can easily become overwhelmed by the process of finding and funding appropriate services. They are faced with the stress of continually witnessing their loved one's struggles to complete everyday tasks, social interactions and education. They must live with the knowledge that there is no end to these struggles.Methods: The study was descriptive study to assess the degree of depression. 200 parents of mentally challenged children in different special educational institutions of Jammu and Kashmir were chosen by convenient sampling method and data was collected with the help of questionnaire (modified becks depression inventory II).Results: Findings of the study revealed that majority 9 (4.5%) were normal ,63(31.5%) had mild depression, 92 (46%) parents had moderate depression and 36 (18%) of parents had severe depression. Significant association was found between relationship with child (p<0.005), religion (p<0.001), education (p<0.001), occupation (p<0.00), monthly family income (p<0.000) and the degree of depression among parents of mentally challenged children.Conclusions: This study revealed that majority of the parents of mentally challenged children were having moderate depression.
Comparative study of use of 32-F, multi-perforated tube drainage of subcutaneous plane versus no drainage, in laparotomy
Authors: Kaur Harpreet , Ray M. S. , Malhi S. S. , Thakore Digpal , Modi Naresh
Published: December 2021

Background: We are concerned about the wound management and wound healing amongst post-operative patients, as wound complications increase the morbidity of patients post-surgery. Most common wound complications post-surgery are wound seromas, hematomas and surgical site infections (SSIs). SSIs lead to increased hospital stay and increased morbidity alongside increasing unnecessary patient suffering and a decreased quality of life. The underlying principle for the use of subcutaneous drains is based on the belief that removal of serum or debris and eradication of dead space in subcutaneous plane will bring down the rate of infection and wound complications.Methods: A randomized control study was conducted at the General Surgery Department at SGT Medical College, Gurgoan, Haryana. In total, 60 patients were selected (after taking informed written consent) among those admitted to the Surgery Department for laparotomy procedure. Patients were divided randomly into two groups i.e., group-A (study group) and group-B (control group). In group-A patients, subcutaneous wounds were closed over a drain (32-F multi-perforated drain), while in group-B patients no drain was used. Intra-operative and post-operative findings were recorded and analysed to draw study conclusions.Results: SSIs were observed significantly higher among patients without subcutaneous drain (group-B). Patients of group-B had significantly higher incidence of seroma and pus as compared to group-A patients. Experience of pain was reported higher among the patients without subcutaneous drain (group-B).Conclusions: Subcutaneous drains play an important role in reducing the incidence of SSIs, wound complications, wound pain; thereby lead to better healing of the surgical wound.
Long segment “Hanging-snout” end ileosotmy a safe “Surgical disaster mitigating” technique for an “Un-brookeable” end ileum: a study of 23 cases over 12 years
Authors: Ray M. S. , Malhi Sarvpreet Singh , Asopa Jayum , Kaur Harpreet , Grewal Manvinder Singh , Modi Naresh , Thakore Digpal , Ray Rashmi
Published: December 2021

Background: In 1952, Professor Bryan Brooke described his technique for everting an ileostomy in order to minimise skin excoriation1. Pouting, mucosa-everting Brooke’s ileostomy have been accepted as the best technique for stoma formation in almost all cases, save a few difficult situations – such as edematous friable bowel with bulky short mesentry! In such cases formation of standard Brooke’s ‘Pouting’ ileostomy is not only difficult, but an impossible and a dangerous surgical exercise! In these situations where the bowel is “Un-Brookeable” due to aforementioned causes. Over a period of 12 years we could device a formula – “Ray’s Criteria” to decide at operation, if a given ileum in a particular patient, is safely “Brookeable” (i.e. evertable into a neat Brooke, spouting ileostomy) or is   “Un-Brookeable”.Methods: 23 patients were included in this study over 12 years, who due to the peculiarity of their body morphology (obesity or thick abdominal fat), edematous friable bowel with bulky mesentry, the ileum could not be drawn outside the abdomen and everted as Brooke’s ileostomy. The “Brookeability” of the exteriorized ileum was decided based on satisfying two issues of Ray’s criteria.Results: By using “Ray’s criteria”, we could seggregate patients safely as “Brookeable” and “Un-Brookeable”. Those deemed “Un-Brookable” underwent “Long segment Hanging snout” end ileostomy, which is the theme of our study.Conclusions: We are emphatic in stating that by using “Ray’s criteria” we could accurately segregate cases into “Brookeable” and “Un-Brookeable” ileum.
Closure of skin in surgical wounds with skin stapler and conventional sutures: a comparative study
Authors: Rabha Pinky , Srinivas Shradha , Bhuyan K.
Published: December 2021

Background: Application of suture is the technique of choice for apposition of skin edges in surgical wounds. The same procedure performed with application of staplers is faster and produce better cosmetic outcomes. A comparative study between conventional suture and stapler closure of skin in abdominal surgical wounds was undertaken to study the merits and demerits of the techniques. The aim was to study the time required for closure of surgical wounds, aesthetic outcome, post-operative complications and patient’s compliance.Methods: This was a single centre, prospective, observational study, conducted upon 100 patients undergoing abdominal surgeries. 50 patients were selected for skin closure of surgical wounds with stapler and the other 50 patients for closure with conventional nylon sutures. Data were collected for time required for closure of skin, aesthetic outcome, post-operative complications and patient’s compliance for both the groups for comparison. Data were analysed using student t test for comparison and chi square test of significance. Results: There was significant better results in stapler group in terms of cosmetic outcome (96% vs 88%, p<0.001), time taken during closure (60 vs 219 seconds, p<0.001) and patient’s compliance VAS of 1.44 vs 4.58 p<0.001).Conclusions: Closure of skin with stapler is a faster method. Patient’s compliance with stapler closure is better. It produces cosmetically acceptable scar and less discomfort or pain during its removal.
Intraoperative scoring system for grading severity of cholecystitis at laparoscopic cholecystectomy
Authors: Ansari Shefa Tanwir , Bedi Karamjot Singh , Sahu Shantanu Kumar
Published: December 2021

Background: Various studies had been carried out to evaluate the risk of preoperative conversion in laparoscopic cholecystectomy. However, there was no grading or scoring of operative findings during surgery at present, making it difficult to compare the publications citing outcomes, including the conversion to open surgery. Sugrue in 2015 devised a scoring system based upon the intraoperative findings in Laparoscopic cholecystectomy. Aim of the study was to grade the severity of cholecystitis during laparoscopic cholecystectomy using intraoperative scoring system, to evaluate the spectrum of cholecystitis in cases of laparoscopic cholecystectomy in a tertiary center using the grades of intraoperative scores and to validate the scoring system devised by Michael Sugrue.Methods: This prospective cross sectional observatory study of 200 patients admitted for laparoscopic cholecystectomy was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India over a period of 12 months. All patients directly planned for open cholecystectomy and carcinoma gall bladder were excluded from the study. Patients were subjected to the intra operative grading system for cholecystitis severity as devised by Micheal Sugrue and the grades were classified with a score of <2 - mild; 2 to 4 -moderate, 5– 7- severe and 8 to 10 – extreme.Results: The operative grading system showed a positive correlation with the severity of cholecystitis.Conclusions: Use of this intra-operative scoring system will help us to provide a trigger for a prompt early conversion to avoid intra-operative complications associated with difficult laparoscopic cholecystectomy.
Proportion of colonic carcinoma in cases presenting with acute intestinal obstruction: a cross sectional study
Authors: Joseph Pauly T. , Thomas Rajiv Sajan , V. Sutharjivel
Published: December 2021

Background: Acute intestinal obstruction is one of the most common emergencies encountered by the general surgeon in routine practice. Although historically, obstructed hernia has been the most common cause, recent studies have shown that adhesive intestinal obstruction is now the commonest reason. Malignant bowel obstruction is also on the rise especially with the change in dietary habits. This study aims at identifying the proportion of colonic carcinoma in cases presenting with acute intestinal obstruction.Methods: The patients with acute intestinal obstruction which was diagnosed clinically and radiologically were studied. Based on operative and clinical findings along with investigation results, the etiology was identified. The patients having colonic neoplasms were identified and the data was compared with other etiological factors to find out the proportion of colonic carcinoma in the cases.Results: The proportion of colon cancer in patients presenting with acute intestinal obstruction was around 15%. The most common cause was obstructed hernia followed by post-operative adhesions. Males were more commonly affected than females. Most of the cases underwent operative management. The most common age group affected was around 50-60 years.Conclusions: This study confirms that there is a definite rise in the number of cases of colon cancer presenting as acute intestinal obstruction. There is also a skewing of the age at presentation towards younger age groups. Small bowel obstructions were much more common mainly due to adhesions and obstructed herniae.
Analysis of intraoperative findings with clinico-pathological features in appendicitis-an observational study
Authors: Lakshman Kumar , Shekar Shilpashree Channasandra , Narayan Naveen , Gowda Suhas NarayanaSwamy , Ghanteppagol Veena , Fiyaz Sumaiya , Rani Selva , Raghavendra Pallavi Hosadurga
Published: December 2021

Background: Appendectomy is the most common abdominal surgery performed today. Appendicitis consists of vast spectrum ranging from acute to chronic to recurrent forms however existence of recurrent and chronic appendicitis is still doubted by many. In spite of various scoring systems and appendectomy being the ultimate treatment, its timing remains still controversial especially in chronic and recurrent variants of appendicitis.Methods: A total of 100 consecutive cases of suspected appendicitis who were admitted investigated and treated at our centre were taken up for this observational study. Data pertaining to clinical, operative and histopathological findings were collected and tabulated. Mean and SD were used for continuous data and for categorical data, frequency and percentages were calculated. A chi-square test was used for categorical data to find statistical significance.Results: Per operatively the appendix appeared non-inflamed in 57% of patients suggestive of chronic (recurrent) form and inflamed in 43% of patients suggestive of an acute form of appendicitis. The histopathological studies revealed chronic inflammatory cells in 63% of the resected specimens, suggestive of chronic appendicitis and acute inflammatory cells in 37% of the specimens, suggestive of acute appendicitis.Conclusions: We conclude that the correlation of clinical findings, operative findings and the histopathological findings correlate with one another (p<0.001). The surgeon’s clinical and operative findings have specificity of around 87.30% and 90.47% respectively. Hence the diagnostic accuracy of the surgeon is directly dependent on the surgeons’ expertise and there is no substitution for an experienced surgeon’s judgement.
Prevalence of undiagnosed hypothyroidism in patients with gall bladder stones in Belagavi
Authors: Koujalagi Ramesh S. , Karagi Vinod , Gogate Abhijit S. , C. Athira
Published: December 2021

Background: Contribution of hypothyroidism to gallstone formation is debated over years. With this background, the study intended to analyze the prevalence of undiagnosed hypothyroidism in patients with cholelithiasis. The aim is to understand the prevalence of hypothyroidism in patients with gallstones.Methods: A prospective, hospital-based study was done on 100 patients admitted for the management of gall stone disease in Belagavi. After initial screening, a detailed history was obtained with special reference to symptomatology and the risk factors as per proforma from patients meeting selection criteria. Thyroid function test was done on all eligible patients. Patients were divided into three groups of Euthyroid, Subclinical hypothyroid and clinical hypothyroidism. Statistical analysis used. Percentage of gall stones in different age groups and gender of the study population was calculated followed by prevalence of hypothyroidism and subclinical hypothyroidism in all the patients included.Results: Among the study population, 40% were male and 60% were female. 23 of them have subclinical hypothyroidism and 6 of them were diagnosed with hypothyroidism. Majority of subclinical hypothyroid patients (39.13%) were aged 41-60 years. Hypothyroid symptoms were shown by the study population with unknown thyroid status.Conclusions: The prevalence of hypothyroidism in cholelithiasis is 29% in the study and is significant. The study demands further studies to consider hypothyroidism as a cause /risk factor for biliary calculus.
A comprehensive study of diabetic foot ulcer with special reference to magnetic resonance imaging
Authors: Kumar Manoj , Chandra Akash , Gopal Krishna
Published: December 2021

Background: This pictorial review aims to illustrate the various manifestations of the diabetic foot on magnetic resonance (MR) imaging. The utility of MR imaging and its imaging features in the diagnosis of pedal osteomyelitis are illustrated. There is often difficulty encountered in distinguishing osteomyelitis from neuroarthropathy, both clinically and on imaging. By providing an accurate diagnosis based on imaging, the radiologist plays a significant role in the management of patients with complications of diabetic foot.Methods: This is a prospective and observational study conducted on 50 patients with diabetic foot ulcer admitted in general surgical ward of Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar. Required pathological or biochemical assessments like complete blood count (CBC), fasting blood sugar (FBS), post prandial blood sugar (PPBS), random blood sugar (RBS), hemoglobin A1c (HbA1C), liver function test (LFT), kidney function test (KFT), serum electrolytes and other relevant investigations will be done on admission. Further magnetic resonance imaging (MRI) will be done in radiological investigations and findings will be noted.Results: In the case of early osteomyelitis, the rate and accuracy of detection is at best 50–60%, as the soft tissues are not adequately demonstrated. For the assessment of soft tissue infection and osteomyelitis involving the foot, MRI is the modality of choice.Conclusions: It has been shown that MRI, in combination with radiography, is the most accurate in the detection of diabetic pedal osteomyelitis and its differentiation from neuroarthropathy. Males are more affected than females in case of soft tissue infections and joint complications.
A comparative study of negative suction drainage in inguinal hernia operations at Saraswathi Institute of Medical Sciences, Pilkhua, Hapur Uttar Pradesh
Authors: Singh Desh Pal , Goel Saurabh , Kumar Surendra
Published: December 2021

Background: The inguinal area is the weakest region of the abdominal wall. So, this is the most common site for the development of hernias. Inguinal hernias are the commonest amongst all the hernias and hernia repair is the most frequently done operation worldwide. There is no agreement among surgeons regarding the need for drains. Some use sparingly and some use it routinely. This study aims to evaluate the use of negative suction drain in inguinal hernia surgery.Methods: We studied sixty patients of inguinal hernias both direct and indirect for one year and followed up for next 1-2 years. This prospective study aimed to see the effect of negative suction drainage in hernia surgery.Results: Both the groups did well postoperatively. It was beneficial to put a negative suction drain in those patients who had a bigger hernia, fatty patients with the thick fatty lower abdominal wall and older patients.Conclusion: It is advisable to put a negative suction drain in inguinal hernia surgery and strongly advocated if the dissection had been difficult, old patients and fatty lower abdominal wall
Blunt abdominal trauma: initial resuscitation followed by clinical and focused abdominal sonography assessment important diagnostic tools of organ injury due to restricted use of CT-scan in a tertiary care in India
Authors: Ali S. K. Sekendar , Mukhopadhyay Narendra Nath , Bhattacharya Jyotirmoy , Chattopadhyay Madhusudan
Published: December 2021

Background: Blunt abdominal trauma (BAT) is one of the common causes of admission in surgical ward in any hospital. It requires high level of suspicion, urgent evaluation and timely management to decrease morbidity and mortality. Objective was to evaluate the role of clinical and ultrasound assessment in early diagnosis of intra-abdominal injury following blunt abdominal trauma and follow up in patients with intraabdominal injury for detecting complications.Methods: 130 patients who presented to the emergency room were evaluated by clinical and focused abdominal sonography for trauma (FAST) and follow-up sonography was done after 6-12 hours upto 72 hours.Results: In our study, road traffic accidents (RTA) were the most common cause of blunt abdominal trauma (70.76%) with 75% patients being were males. X-ray erect abdomen and ultrasound of the abdomen were the most sensitive investigation for hollow viscous injury and solid organ injuries, respectively, with bowel (38.33%) and liver injury (26.67%) being the most common organ involved in this study. This study found sensitivity (93.7%) and specificity (98.5%) of focused abdominal ultrasonography (FAST).Conclusions: Initial resuscitation followed by clinical and ultrasonography assessment is considered the best modality in initial evaluation of blunt abdominal trauma patients as it is noninvasive, readily available, and requires minimal preparation time and also due to restricted use of modern amenities such as CT-scan in tertiary care in India.
Laparoscopic versus open surgery in the treatment of colorectal cancer
Authors: Abd-Elshafy Yasser Mohammad , Mohammad Islam Mohammad , Ashry Hazem Nour Abdelatif , Zaitoun Mohammad Abdullah
Published: December 2021

Because of the initial case study results suggesting high recurrence rates at port sites, adoption of the laparoscopic approach for colorectal cancer treatment was slow. Surgical resection remains the cornerstone and most important facet in management of colon cancer. The use of minimally invasive approach in colorectal surgery has been reported by several authors in the literature. Some difficult about the use of laparoscopic surgery for colorectal cancer still raises, particularly with the technique’s complexity, learning curve and longer duration. Scientific literature published from January 2010 to April 2020 was reviewed. Phase III randomized clinical trials were included. Analysis of the scientific literatures confirmed that for the curative treatment of colon and rectal cancer, laparoscopy is not inferior to open surgery with respect to overall survival, disease-free survival and rate of recurrence. Laparoscopic resection can be considered an option for the curative treatment of colon and rectal cancer; but must take into consideration surgeon experience, tumour stage and potential contraindications; and that laparoscopic resection for rectal cancer be performed only by appropriately trained surgeons.
Premenarche bilateral giant juvenile fibroadenoma of breast: literature review with a case report
Authors: Raleng Mezhuneituo , Anand Sameer , Kannur Shailesh
Published: December 2021

Fibroadenoma is a common abnormality which every surgeon has been exposed to, and there are several international guidelines regarding its management. However giant fibroadenomas, especially in the premenarche setting has been a rare occurrence, even for the experienced surgeon. Various reports have shown that we need to treat this condition more aggressively than the normal fibroadenoma, and issues of cosmesis in a developing breast along with the aim to preserve lactation functionality becomes an issue. Since these cases remain a single life time experience for most surgeons, there is a sparsity of treatment protocols even in literature. Through this paper we hope to shed some valuable insight to this rare disorder and help surgeon colleagues, when dealing with similar cases.
Theodosian Town Governor Semen Mikhailovich Bronevsky: New Documents for the Biography
Authors: Tunkina Irina
Published: December 2021

According to archival documents, the biography of the Theodosian town governor (1810—1816), state councilor Semen Bronevsky, in whose house Pushkin and Raevsky stayed in 1820, was reconstructed. The stages of his military and civil service, the circumstances of disgrace and resignation were traced. Bronevsky is the author of books and notes on the history of Russian-Caucasian relations of the 16th — 19th centuries, which had a significant impact on the works of A. S. Pushkin and M. Yu. Lermontov devoted to the Caucasus and all subsequent historiography of Caucasian studies. As the town governor of Theodosia, Bronevsky did a lot for the improvement of the city, initiated the creation of the first municipal archaeological museum in the Russian Empire — the Theodosia Museum of Antiquities (1811) and the first excavations by the «father of Bosporan archeology» Paul Dubrux in the Eastern Crimea and on the Taman Peninsula.
Methodological Aspects of Soviet Studies
Authors: Bezborodov Alexander
Published: December 2021

In contemporary Russia there is an ongoing discussion about the nature of the Soviet era and its historical significance in a framework of a national identity search. Making sense of the Soviet past is challenging. It should be based primarily on objective knowledge obtained as a result of research, as truly scholar activities of Russian and foreign scholars of the social and humanitarian profile. This article examines various methodological aspects of Soviet studies. The central place in Soviet studies is given to the systems theory. Description, analysis, modeling, as well as such general historical methods of scientific research as historical-genetic, historical-comparative, historical-typological and historical-systemic methods are also very important for Soviet. The article pays special attention to the methodological problem of the relationship between the past and the present, the problems of socialization of historical memory in post-Soviet Russia.