bluuebunny/crossref_metadata_2025 huggingface dataset:
An Evolutionary Vision for an Indigenous Festival in Rajasthan
Authors: Maheshwari Alka , Jasrotia Aruditya
Published: August 2024

Indigenous festivals operate in an increasingly competitive environment hence the implementation of effective marketing approaches is a priority. This chapter focuses on a home-grown indigenous festival and provides insights into the existing practices embraced indigenous Bheel tribe of Mewar Estate of Rajasthan. Partnerships with important stakeholders such as the national tourism organization of India, the Rajasthan State tourism office, and other key local stakeholders who are interested in promoting it as an important part of the region heritage tourism portfolio are explored. In summary, this study extends the work of existing scholars by using a case study approach to identify the socio-cultural benefits of the Gavari and evolutionary practices to support/promote the festival. This field of inquiry is important because such festivals can serve as effective vehicles with which to not only showcase Indigenous culture, but which can flourish through art, storytelling, dance, and community gatherings, but to also create awareness and interest in indigenous tourism.
A Virtual Visit to Museums Through Augmented Reality Is an Innovative Strategy to Increase Tourism
Authors: Ruiz Gerardo Reyes
Published: August 2024

New technologies have made inroads in many everyday areas, but even these technologies can make a space be revalued, as is the case of museums. Museums are educational spaces, where it is important to have informative resources that are innovative to motivate visitors to enter them, either to appreciate their physical learning resources or to learn more about them quickly and interestingly. Augmented reality helps in this dynamic by showing through multimedia content the three-dimensional space of the museum, highlighting the categories and classifications of its contents, so that the visitor can quickly observe them and, therefore, feel surprised and motivated by each of the virtual tours that can be made inside the museum. This work shows that augmented reality, applied in museums, can increase tourism considerably.
Hotel Management Models
Authors: dos Reis Felipa Lopes , Pimentel Helena , Perestrello Francisco
Published: August 2024

The present study aims to understand different hotel management models, as well as their advantages and disadvantages. The fact that there is not much literature on hotel management models makes it important and relevant to increase the field of research on the subject. The aim of the study is to identify which hotel management model best suits the strategy of the Palácio do Estoril Hotel, Golf, and Wellness, as well as its advantages and disadvantages, and the strategy carried out by the hotel. To this end, a case study methodology with a qualitative-exploratory approach was adopted, in which interviews were conducted with some senior managers to gain real insights into hotel management models and hotel strategy. The results revealed the existence of six hotel management models, and the self-management model, which involves ownership and management, was identified as the most suitable for the strategy of the hotel under study, due to the desire for total control of business, between personalization of services and experiences.
The Influences of 4E's Marketing and Service Expectations of 3-Star Smart Hotels
Authors: Krongyut Khwanruethai , Sangwan Nathamon , Utchaya Nakharet , Keawnet Paripan
Published: August 2024

4E's marketing focuses on delivering a good experience to customers. It is a concept developed from 4Ps and 4Cs in response to current purchasing and service decision behavior. The 4E's focus on customer needs and desires, creating memorable experiences, and connecting brands with customers through experiences to foster brand loyalty. This study explores the nexus between 4E's (experience, exchange, everywhere, evangelism) and service expectations of 3-star smart hotels. The data was surveyed by 400 customers of 3-star hotels in Chiang Rai Province, Thailand. The influence of variables was analyzed using multiple regression statistics. The study indicates that only the convenience in using the service factor and skills and personality of staff affect the expectation of using 3-star accommodation services. This study reflects that no matter how advanced technology is, impressing customers still requires the service provider's skills and providing amenities for customer convenience.
Analyzing the Impact of Annealed Steel Sludge Doses on the Physicochemical Properties of Biochar Obtained from Waste Date Palm Frond
Authors: Almarri Hana Mohammed , Alluqmani Saleh M. , Alshammary Moudhi , Alenzi Sana , Alabdallah Nadiyah
Published: August 2024

Large quantities of date palm frond waste generated from the pruning process are accumulated or burned in burn barrels, harming the environment and having very little economic value. However, because of the lack of data revealing the characteristic magnetic properties of biochar derived from date palm fronds, further research on low-cost and sustainable strategies could offer a new composite material and serve to extend the way for novel applications. In this study, we prepared biochar derived from palm fronds via pyrolysis under a limited-oxygen atmosphere at a lower temperature of 300 °C for 2 h. We introduced a facile strategy for the production of magnetic biochar with various doses of annealed steel sludge material via ball milling. Various amounts of annealed steel sludge material (5%, 15%, and 25% w) were added to date palm frond biochar, and the obtained product was fabricated by ball milling. The physicochemical characteristics of the magnetic biochar composite were subsequently analyzed using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR) spectroscopy, and UV-vis spectroscopy. Our findings showed that the ball milling method is a successful step for producing date palm fronds with magnetic biochar material possessing rough and packed pores, as shown by SEM. XRD patterns assumed the existence of magnetic phases of iron oxide (magnetite (Fe3O4), hematite (α-Fe2O3), and maghemite (γ-Fe2O3) at different generated peaks. FTIR outputs exhibited the abundant presence of various oxygen-containing functional groups (- COOH and -OH) on the surface of magnetic biochar material, which help to create chemically reactive sites to adsorb potential surrounding species. The UV spectra showed a noticeable enhancement of the optical properties of the magnetic biochar with an increase in the sludge dose for light absorption in the visible region from wavelengths of 400 – 700 nm . This result signifies the synthetic optimization and potential application of magnetic biochar materials for composites that could be employed in targeted uses including soil amendment, water remediation and energy applications.
SNDM Study of the MOS Interface State Densities on the 3C-SiC / 4H-SiC Stacked Structure
Authors: Nagasawa Hiroyuki , Cho Yasuo , Abe Maho , Tanno Takenori , Musya Michimasa , Sakuraba Masao , Sato Yusuke , Sato Shigeo
Published: August 2024

The layer structure of 3C-SiC stacked on 4H-SiC is implemented by simultaneous lateral epitaxy (SLE). The SLE, involving spontaneous nucleation of 3C-SiC(111) on the 4H-SiC(0001) surface followed by step-controlled epitaxy, facilitates the creation of a single-domain 3C-SiC layer with an epitaxial relationship to the underlying 4H-SiC, establishing a coherent (111)//(0001) interface aligned in the basal plane. An extremely low state density at an interface between thermally grown SiO2 and SLE-grown 3C-SiC layer is revealed by local deep level transient spectroscopy (local-DLTS) based on scanning nonlinear dielectric microscopy (SNDM).
Biomechanical Effects of Titanium Alloy Based Single versus Dual Cage Fusion Devices
Authors: Singh Nitesh Kumar , Verma Rati , Kumar Pradeep , Singh Nishant Kumar
Published: August 2024

Degenerative disc disease is an increasing problematic complication following lumbar fusion surgeries. Posterior lumbar interbody fusion (PLIF) is a well-established surgical method for spine stability following intervertebral disc removal. The position and number of titanium cages in PLIF are remain contingent on individual surgeon experience. Thus, a systemic investigation of the efficacy of titanium single mega cage versus two cages in treating degenerative lumbar spinal diseases is imperative. A biomechanical study was aimed to compare the stability achieved in PLIF through interbody reconstruction using a single mega cage (32 mm) Vs. a dual cage (22 mm). Normal intact finite element model of L3–L4 was developed based on computed tomography images from a healthy 27-year-old male volunteer. The study tested the intact model (Model A) and its surgically operated counterparts using four PLIF implantation methods: single transverse cage (Model B), single transverse cage with bone graft (Model C), dual transverse cage (Model D), and dual transverse cage with bone graft (Model E). Combined loads simulating physiological motions—flexion, extension, axial rotation, and lateral bending —were applied across all loading directions. The assessment includes all model range of motion (ROM), micromotion between the cage and endplate, and stress on the cage and internal fixation system (screw and rod). The ROM between Models B, C, D and E were consistently reduced by over 71% compared to intact Model A under all motion scenarios. Model D exhibited the highest peak stress of 115 MPa on the cage during flexion, surpassing Model C and E (Flexion) by fourfold. Model E demonstrated the lowest cage stress (20 MPa) during extension, outperforming the other models. Notably, Model E exhibited minimal endplate stress (2 MPa), cage stress (21 MPa), micromotion (13 µm) during extension, and screw-rod stress (56 MPa) during flexion, making it superior to other implantation methods. In the context of PLIF, Model E showed enhanced biomechanical stability, reducing ROM, stress on the endplates, cage, screw-rod system and micromotion. Alternatively, Model C may be a viable alternative in standard PLIF, especially in cases with limited intervertebral space, providing efficient clinical outcomes with shorter operative times and reduced costs and ease of implantation. Also, this computational study provides valuable understandings into optimizing cage implantation strategies for improved outcomes during PLIF.
Suppressing the Memory Effect in Al Doped 3C-SiC Grown Using Chlorinated Chemistry
Authors: Colston Gerard , Renz Arne Benjamin , Perera Kushani , Gammon Peter Michael , Antoniou Marina , Mawby Philip  Andrew , Shah Vishal Ajit
Published: August 2024

The memory effect of Al doping in 3C-SiC prevents sharp interfaces between layers of different doping levels and can lead to unintentional doping of subsequent epilayers and even growth runs. Introducing HCl into the growth phase of 3C-SiC reduces the Al incorporation but has a significant impact on Al dopant decay rates and background levels within the chamber, resulting in far sharper doping profiles. The impact of relatively high flow rates of HCl is low within a chlorine-based growth system giving fine control over its influence on the growth process and memory effect.
Estimation of Influence on Carbon Vacancy Regarding 4H-SiC Substrate Grown by HTCVD Method
Authors: Uehigashi Hideyuki , Okamoto Takeshi , Horiai Akiyoshi , Fujibayashi Hiroaki , Kanda Takahiro , Kanemura Takashi , Tsuruta Kazuhiro
Published: August 2024

In order to increase productivity and reduce the cost of wafers, we have developed a high temperature chemical vapor deposition (HTCVD) method that can realize the high-speed growth of 4H-SiC crystals. Tokuda et al. reported an interesting study in which the carrier lifetime of a substrate grown by HTCVD (HTCVD substrate) was considerably shorter than that of the substrate grown by physical vapor transport (PVT); moreover, bipolar degradation was highly suppressed when the HTCVD substrate was applied to PiN diodes [1]. Herein, we demonstrate that the short carrier lifetime of the HTCVD substrate is mainly attributable to the carbon vacancy (VC) and that VC particularly diffuses from the HTCVD substrate to the epitaxial layer.
Review on Mathematical Modelling of Boomerang for Novel Outfield Applications
Authors: Ratheesan R. , Kumara K. J. C. , Annasiwaththa A. W. B. I. , Baduge S.
Published: August 2024

A boomerang is an aerodynamically built object that, when thrown precisely, makes a quasi-circular flight and returns closely to its starting position. Numerous academics have analysed the boomerangs' motion and aerodynamics. None of the researchers in the field investigated the possibility of using the boomerangs for novel field applications rather than hunting and playing. Using boomerangs for field applications is beneficial in several ways because, unlike general drones, these boomerangs do not consume power continuously and low manufacturing cost. Using a boomerang in outfield applications is challenging because the external field is always unsteady and turbulent; therefore, a boomerang should be mathematically modelled for unsteady environment for precisely predict the trajectory. Few steady mathematical models were developed and validated in the reported literature and an unsteady mathematical model of boomerang was developed recently though it was not experimentally validated. The article reviews the mathematical modelling of boomerangs for certain novel outfield applications like agricultural inspection and weather monitoring. The depth of study in the mathematical modelling of boomerang is insufficient for developing novel applications. The article will aid the industrialists and researchers to advance in the field, and they can see the possibility of replacing the drones in novel outfield applications.
Enhancing the Seismic Performances of Concrete Filled Steel Box Columns by Improving Confinement Effect: A Numerical Approach
Authors: Alahakoon A. M. Y. D. , Malalage V. P. , Pigera A. C. D. , Jayasinghe J. A. S. C.
Published: August 2024

Highway piers are essential in elevated roadways, and they are widely used in industrialized nations. Therefore, designing piers that can withstand severe seismic loadings is critical, especially in regions where earthquakes are common. Because of their remarkable seismic resilience, concrete-filled steel tubular (CFST) columns have become more popular. Numerous investigations have been carried out to enhance the seismic performance of CFST columns. The goal of this study is to alter the stiffener arrangements of concrete-filled steel box columns in order to increase their strength, ductility, energy absorption capacity and hence enhance their overall performance by enhancing the confinement effect. A comprehensive finite element model of CFST column with stiffeners was developed and validated using past experimental data. By adopting the same modelling procedure, ten models of CFST columns with modified cross sections by changing the stiffener length, stiffener arrangement and flange to web ratio of stiffeners were numerically tested under lateral cyclic loads with constant axial loads to understand the effective cross section for the confinement effect. Results revealed that the T arrangement of stiffeners shows an increment in confinement effect which results in enhancement of lateral performance of the column. Further enhancement of the confinement was obtained by changing the flange to web ratio (Lf/Lw) of the stiffeners. Finally, the obtained force-displacement curves were compared to investigate the effect of confinement and it was revealed that the cross-section having the ratio of Lf / Lw = 2.0 performs better than the other cross-sectional arrangements in strength and for the energy absorption capacity, while Lf / Lw = 1.0 is the best arrangement for the ductility.
Gender Diversity in Corporate Boards: A Systematic Literature Review
Authors: Perera Madumi , Prasad P.M.J. , Semage Nuwan D.
Published: August 2024

This study reviews the extant literature on gender diversity on corporate boards (board gender diversity) and the theories and variables that affect financial performance compared to developed and emerging economies. This systematic literature review was based on the 39 peer-reviewed articles retrieved from the Google Scholar, Scopus, and Science Direct databases on gender diversity in corporate boards. This review found stern debates about the effect of board gender diversity on the firm's financial performance, and the results are ambiguous from the early to recent studies. Different indicators such as ROA, ROE, and Tobin Q are used to measure the firm financial performance implication of having female directors on corporate boards, and findings are no significantly proven direct association between women's representation on the board and the firm performance in both developed and emerging countries. However, on the contrary, the literature supported the conclusion that certain traits of women, risk aversiveness, detailed and depth analysis and monitoring, independence, unique skills, and functional expertise have positively influenced to enhance the firm's financial performance as a mediating factor. This paper contributes to the growing literature on board gender diversity, providing a further understanding of genetic factors that influence the firm's financial performance. It also offers insights to regulators on potential limitations and the benefits of gender quota legislation. However, future researchers must expand on women's empowerment toward governing structure changes.
Perception of speech therapists and parents on use of telepractice for paediatric speech therapy in Sri Lanka
Authors: Adikaram W.K.D.S.Y. , De Silva M.D.K.
Published: August 2024

The use of communication technology to deliver speech therapy (telepractice) was highly considered during the COVID-19 pandemic. However, a few Speech and Language Therapists (SLTs) and parents engaged in telepractice in Sri Lanka. Therefore, it was essential to identify the factors that encouraged and prevented the successful implementation of telepractice. A descriptive cross-sectional study was followed using a sequential mixed-method approach. Thirty SLTs and sixty-two parents who use telepractice services participated in the study. Quantitative data were collected through a self–administered online survey and analysed using descriptive statistics. The telephone interviews were conducted to obtain qualitative data from five SLTs and ten parents, on which thematic analysis was performed. Sixty percent of SLTs and 84% of parents considered telepractice an effective procedure similar to face–to–face therapy. However, SLTs emphasised that telepractice is applicable, subject to the child’s condition and other factors. Participants’ perception of telepractice was mainly based on their experience. Parent involvement in the speech therapy sessions was found to be high because of the implementation of asynchronous and hybrid modes of telepractice. Providing appropriate training in therapy strategies and educating parents on the use of technology may improve speech therapy services through telepractice in Sri Lanka.
Analyzing mobile app data demand and usage behavior in Sri Lanka
Authors: Arambepola Nimasha , Munasinghe Lankeshwara
Published: August 2024

Owing to the rapid advancement of mobile computing, daily human practices have become more efficient and convenient. Consequently, the number of mobile app users has increased drastically over the last ten years, and a significant amount of energy is consumed by those mobile apps where the energy consumption depends on the data usage of the apps. Therefore, it is important to optimize data consumption to ensure sustainable digitalization. Mobile app personalization is one of the vital areas to optimize the data consumption of mobile apps. In this research, mobile app data usage and user experience data were collected and analyzed quantitatively and qualitatively. The data were collected from 40 Android smartphone users in Sri Lanka. Primarily, semi-structured interviews were conducted to collect qualitative data to identify mobile app usage patterns. In addition, data usage of each mobile app was collected using the in-built data usage tracker in Android smartphones for four months. Descriptive and correlation analyses were used to analyze quantitative data, whereas thematic and content analyses drew insights from the collected qualitative data. Our findings show the most data-demanding mobile app categories in terms of data consumption as social media, video players & editors, and communication. Moreover, users aged between 21 to 30 contribute to the high data consumption in mobile app usage. In addition, qualitative analysis shows that app usage behavior varied during and after the pandemic, and elderly (51-65 years) mobile app users use only a limited number of features from an app.
International Classification of Functioning, Disability and Health and goal attainment scale approach as academic tools at student-run free clinic for diabetic patients with international collaboration
Authors: Hoxha Faton T. , Hoxha Arb F. , Harra Toini , Myllyharju-Puikkonen Anu , Hoxha Nart F. , Ukëhaxhaj Antigona
Published: August 2024

The prevalence of diabetes is rising globally these days. Multidisciplinary teamwork for diabetes patients in nursing care is essential to preventing both acute and long-term complications. Additionally, this method of providing services will give students access to modern medical practice while they are in school. 120 students were enrolled in the post-piloted courses and 133 students took the pre-test. Through the Erasmus+ project with international cooperation, we established a “student-run free clinic for diabetic patients” to support the treatment of diabetes, which makes use of the goal attainment scale method and the International Classification of Functioning, Disability and Health framework. Students are ready to offer free services for educational opportunities for other new generations of medical students and medical care to diabetic patients, according to the questionnaire for the student evaluation of the quality insurance of the piloted courses. In addition to offering diabetic patients and their families access to ongoing medical education, the “student-run free clinic for diabetic patients” also offers diabetic patients medical care.
Noninvasive method to reduce vitreous reflux following intravitreal injection
Authors: Gaber Raouf , Nassif Mina , Shalaby Wesam S. , Sorour Osama
Published: August 2024

Aim

To investigate the role of pre-injection antiglaucoma medications as a noninvasive method to prevent reflux following intravitreal injection (IVI).

Patients and methods

This single-center prospective randomized study included patients who were planned to receive an IVI of anti-vascular endothelial growth factor ranibizumab 0.05 ml for macular edema for diabetic macular edema, branch retinal vein occlusion, or choroidal neovascular membrane. Patients were randomized into five groups: no intervention (group 1), pre-injection topical brimonidine (group 2), pre-injection oral acetazolamide (Diamox) (group 3), pre-injection topical brimonidine and oral Diamox (group 4), and pre-injection paracentesis (group 5). The primary outcomes were the occurrence and degree of reflux following IVI. In addition, the evaluation of conjunctival bleb estimated the degree of reflux. Patient self-rated pain and early complications were secondary outcome measures.

Results

A total of 150 eyes of 150 patients were included. Vitreous reflux occurred in 13 (43%), 14 (46.7%), 19 (63.3%), six (20.0%), and four (13.3%) eyes in groups 1–5, respectively (P<0.001). Additionally, higher degrees of reflux were observed in group 1 compared with other groups.

Discussion

In our study, we raised the question of whether the intraocular pressure (IOP) before injection affects vitreous reflux. Therefore, we compared the effect of different antiglaucomatous medications on lowering the pre-injection IOP, and so decrease the vitreous reflux. We found that in both the paracentesis group and group of combined topical brimonidine and oral Diamox group, vitreous reflux rate is reduced significantly (P<0.001) because in these two groups, the IOP just before the injection was the lowest. Unfortunately, we could not measure the IOP after paracentesis and before the injection to avoid any risk of endophthalmitis, but we consider the paracentesis as a gold standard group for lowering IOP, although it is an invasive procedure. Interestingly, the self-rated pain rate was the same in all groups.

Conclusion

Pre-injection topical brimonidine combined with oral Diamox may be an effective and noninvasive method to prevent/reduce vitreous reflux following IVI.
Endocervical cancer: To demonstrate the utility of hysteroscopy
Authors: Singh Tanvir , Meeta Meeta , Singh Akanshi
Published: August 2024

A 50-year-old perimenopausal female had a history of persistent watery discharge per vagina for 1.5 years. A per speculum showed a hypertrophied cervix with a clear watery discharge. Liquid-based cytology revealed atypical glandular cells, and human papillomavirus DNA 18 was positive. A same-day ultrasound was performed, and an irregular endocervical growth was seen. Same-day hysteroscopy revealed an endocervical irregular polypoidal growth, which was biopsied and reported as moderately differentiated adenocarcinoma. In this case, an ultrasound and an office hysteroscopy performed on the same date as her visit led to an early leading diagnosis which was delayed on routine testing.
Interstitial ectopic pregnancy after in vitro fertilization in a case of recurrent implantation failure with repeated hydrosalpinx: Aftermath of multiple surgeries
Authors: Jampala Mounika , Louis T. Fessy
Published: August 2024

Among tubal ectopic, interstitial ectopic constitutes a rare and difficult diagnostic entity occurring in nearly 5% of tubal ectopic cases.[1,2] It can lead to massive hemorrhage and possibly uterine rupture in the second trimester if not rightly diagnosed. This is a rare case of premature ovarian failure with a history of multiple surgeries on bilateral ovaries owing to the presence of ovarian cysts. The patient underwent 4 donor in vitro fertilization cycles with 3 fresh embryo transfers and two frozen embryo transfers. She was positive with the last straw of embryos; however, it ended up as interstitial ectopic pregnancy diagnosed ultrasonographically and managed medically.
Abdominal mouse in a patient with endometriosis post GnRH therapy
Authors: Desai Gaurav Shyam , Desai Shyam V.
Published: August 2024

A 26-year-old unmarried woman complained of pelvic pain and dysmenorrhea. On pelvic examination, her cervix was pulled up with bilateral forniceal tenderness. On ultrasonography, her left ovary showed two 4 cm × 4 cm endometriosis cysts and a negative sliding sign. She was placed on three cycles of GnRH analogs and on laparoscopy showed the presence of peritoneal loose bodies in the pelvis [Figures 1 and 2].
Postcesarean disasters – Isthmocele, ventrofixed uterus, and cesarean scar pregnancy: A case series
Authors: Desai Prabha D , Kamashetty Nikita S , Desai Dhanesh L. , Gupta Apurva S.
Published: August 2024

Isthmocele is a niche defect in the area of previous cesarean scar. It is any indention representing myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall, with the base communicating to the uterine cavity at the site of the previous cesarean section (CS) scar. Ventrofixed uterus is an adhesion between anterior surface of uterus and anterior abdominal wall secondary to Caesarean section. Cesarean scar pregnancy (CSP) pregnancy at a scar site is trouble either causing scar rupture or placenta accreta syndrome. Here are the seven cases of having a problem of isthmocele or ventrofixed uterus or both. All these cases had previous CS done at peripheral hospitals. The intension of this case series is to study preoperative symptoms, clinical and investigation findings, intraoperative presentation, and challenges with postoperative recovery in cases of previous CS-related problems. All these cases presented with us post-CS either lower abdominal pain, intermenstrual spotting, menorrhagia, or secondary infertility, and one had emergency abdominal pain with pregnancy. On hysteroscopy, a large niche at CS scar with trenches was detected in five cases, and on laparoscopy, ventrofixed uterus in five cases, and four cases have both. One has multiple fibroids, one has associated ventrofixed ovarian endometrioma. One case has ruptured CSP. After corrective hysterolaparoscopy surgery, all patients recovered well. Hysterolaparoscopic corrective surgery is a real need and challenge in cases of symptomatic ventrofixed uterus and isthmocele. The incidence and prevalence of isthmocele are greater than most gynecologists realize. It is imperative to understand the etiology and adopt preventive measures during CS to reduce its incidence and also to reduce the incidence of CSP.
My Chest Hurts: Late-onset Post-traumatic Intercostal Neuralgia
Authors: Bhargava Megha , Shukla Aradhana , Gonnade Nitesh Manohar
Published: August 2024

Post-traumatic intercostal neuralgia is underdiagnosed and rarely reported. Amongst the cases reported – acute damage to the thoracic wall and post-thoracotomy period remain the most common causes of intercostal neuralgia. We report a case of a young male who developed neuropathic intercostal chest pain 3 years after a history of trauma. Our case underlines the atypical presentation of delayed-onset intercostal neuralgia, successfully managed by a definite intercostal nerve block after a positive diagnostic block.
Psycho-social Sequelae Following Spinal Cord Injury amongst Children: A Systematic Review
Authors: Srikanth Pallerla , Sravanti Lakshmi , Krishnareddy Shanivaram Reddy , Nirmala Berigai Parthasarathy , Janardhana N. , Gupta Anupam
Published: August 2024

Psycho-social problems are consistently reported following spinal cord injury (SCI) and are highly prevalent, especially in the long-term post-injury in children. This review aims to comprehensively study psycho-social issues experienced by children with SCI and highlight their importance and inform management practices. A search strategy was designed to identify studies that evaluated psycho-social outcomes of SCI among children. Five electronic databases were searched. All articles written in English published in peer-reviewed journals between 2000 and 2020, and available in the public domain were considered as per the eligibility criteria. A total of nineteen studies were included for the review as per the inclusion and exclusion criteria. This review has included studies focusing on various psycho-social issues such as depression, anxiety, post-traumatic stress disorder, coping, quality of life, participation, sexuality, substance abuse, life satisfaction, suicide, family dynamics, and education. Children with Spinal Cord Injury (CwSCI) experience diverse psycho-social issues that cause significant morbidity in various domains of life. Understanding the unique nature of several psycho-social issues among children with spinal cord injury is crucial for clinicians and health care workers involved. We recommend a multi-disciplinary team approach for comprehensive management of children with spinal cord injury at trauma and rehabilitation centres for better psychosocial outcomes and overall quality of life.
Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study
Authors: Sharma Anil , Negi Nidhi , Joshi Mrinal
Published: August 2024

Context:

Knee osteoarthritis (KOA) is the most common type of lower extremity osteoarthritis (OA), with pain being the predominant symptom, leading to significant morbidity and impaired quality of life.

Objectives:

This study was designed to ascertain the effectiveness of ultrasound-guided adductor canal block (ACB), ensuing functional improvement and change in the quality of life in KOA patients with anteromedial knee pain and compare it with conservative treatment.

Materials and Methods:

A total of 196 patients were recruited for this trial and initially treated conservatively with oral analgesics and exercise. At the end of 2 and 4 weeks from the inclusion date, they were offered a crossover to the intervention with ACB for the saphenous nerve. The outcome measures, such as Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Timed Up and Go test, number of analgesics ingested per day and World Health Organization Quality of Life-BREF (WHOQoL-BREF) scores, were recorded at pre-decided time points.

Results:

After multiple structured follow-ups, 76 and 86 patients were analysed in the intervention and conservative groups, respectively. The two groups had no significant differences in the demographic and clinical patterns. The intervention group showed improvements in VAS (at week 2) (P < 0.05), WOMAC and the number of analgesics ingested per day (weeks 2 and 4) (P < 0.05). At ‘week 8’ follow-up, most patient outcomes including physical health and psychological domains of WHOQoL-BREF scores were better for conservative group (P < 0.05). The rest of the outcome measures were comparable for both groups at all time points. No adverse events were reported.

Conclusion:

This study suggests that ACB is effective only for a short duration and does not offer any significant advantage over conservative management in the long run.
Platelet-rich Plasma versus Corticosteroid Injection for the Treatment of Lateral Epicondylitis – A Prospective Randomised Controlled Study
Authors: Kalluraya Suryakanth , Varma Anand , Yeswanth Gujjala Venkata Naga
Published: August 2024

Introduction:

Lateral epicondylitis, commonly known as tennis elbow, is one of the most common chronic disabling painful conditions that affect the forearm’s common extensor tendons. This study aimed to compare the effectiveness of platelet-rich plasma (PRP) versus corticosteroid injection in the treatment of lateral epicondylitis.

Aims:

The purpose of this study is to compare the efficacy of PRP versus corticosteroid injection in the treatment of lateral epicondylitis, focusing on the early response.

Settings and Design:

This was a prospective randomised controlled study.

Materials and Methods:

This study was a prospective randomised control trial of 100 patients, clinically diagnosed with lateral epicondylitis in Karnataka Institute of Medical Sciences Hospital, Hubli. Patients were randomly allocated (1:1) using computer-generated random numbers to two groups. Group A received corticosteroid injection. Group B received PRP injection. Outcome assessment was done using the Oxford Elbow Score (OES), Visual Analogue Scale (VAS), Patient-rated Tennis Elbow Evaluation (PRTEE) and Disabilities of Arm, Shoulder and Hand Score (DASH). All patients were followed up at regular intervals of 2 weeks, 4 weeks, 3 months and 6 months post-injection.

Statistical Analysis Used:

Using SPSS Statistics version 25 software, statistical analysis was done.

Results:

Pre–injection, the mean OES, VAS, PRTEE and DASH scores were similar in both the groups with insignificant P value. The mean pre-injection OES, VAS, PRTEE and DASH scores in the corticosteroid group were 11.22, 7.88, 75.950 and 69.364, whereas in the PRP group, it was 10.66, 7.96, 76.170 and 69.466, with P = 0.165, 0.322, 0.834 and 0.869, respectively. At the end of 6 months in the corticosteroid group, the mean score of OES increased from 11.22 ± 1.71 to 38.94 ± 5.17, VAS decreased from 7.88 ± 0.385 to 1.74 ± 1.24, PRTEE decreased from 75.95 ± 4.86 to 24.3 ± 12 and DASH decreased from 69.36 ± 2.90 to 23.31 ± 11.5, with a significant P < 0.005. At the end of 6 months in the PRP group, the mean scores of OES increased from 10.66 ± 2.07 to 45.38 ± 1.41, VAS decreased from 7.96 ± 0.45 to 0.06 ± 0.31, PRTEE decreased from 76.1 ± 5.04 to 7.47 ± 3.16 and DASH decreased from 69.47 ± 3.44 to 7.78 ± 2.65, with a significant P < 0.005.

Conclusion:

We concluded that patients treated with PRP had significantly reduced pain, increased functional activity, less recurrence and without requirement of any further intervention, outperforming corticosteroid injection effect at the end of 6 months follow up.
Post-surgical Rehabilitation Protocol and Outcome in Tendoachilles Rupture with Large Defect: A Case Series
Authors: Biswas Anurug , Pandey Sanjay Kumar , Kumar Anjani , Kumar Sanyal , Pandey Jyoti , Roy Madhumita Singha
Published: August 2024

Achilles tendon (AT) is the strongest and one of the commonly ruptured tendons. For AT rupture with large defect, surgery is arguably better option than conservative one. However, rehabilitation protocol and outcome after surgery for AT rupture with larger defects is not mentioned well in the literature. In this series, 11 cases of AT rupture with large defect are studied retrospectively from the hospital records. All of the cases received uniform structured rehabilitation and orthotic management following repair surgery and were followed up at 6 months and 1 year. Significant improvement in pain, function and strength was noted and temporal association is found between symptomatic change and day of presentation. However, there was no report of re-rupture and there was no difference in outcome with intraoperative platelet-rich plasma injection.
Impact of socio-vocational rehabilitation on work productivity and social behavior of inpatients with chronic schizophrenia
Authors: Kumari Sushma , Chakraborty Prashanta K.
Published: August 2024

Background:

A large proportion of persons with schizophrenia are either abandoned by their family members in mental hospitals or do not have any family members to look after them. Therefore, almost 2/3rd of hospital beds are occupied by chronic schizophrenic patients. Very few beds are available for the treatment of acute mental patients who need urgent hospitalization.

Aim:

To assess the impact of a comprehensive socio-vocation rehabilitation package on the work productivity and social behavior of persons with chronic schizophrenia.

Materials and Methods:

Sixty chronic schizophrenic inpatients were included in the present study. Sociodemographic and clinical details were collected on a specially designed Performa for the study. Each patient was rated on a job-up-to-date form at baseline, 3 months, and 6 months after intervention. Data related to the vocational outcome were collected on the supervisor’s evaluation form at the end of the first month and then after every month till the end of 6 months after intervention. The patient’s social behavior was measured on the Social Behavior Schedule at baseline, 3 months, and 6 months after intervention.

Results:

Significant improvement was found in the area of vocational outcomes when a comparison was made from the 1st month to the 6th month. Marked improvement was also noticed in their social behaviors after social and vocational rehabilitation.

Conclusion:

The overall results suggest that chronic schizophrenic inpatients can be properly rehabilitated if opportunity is provided to them.
Transcranial direct current stimulation as an augmentation therapy in patients with obsessive-compulsive disorder: A case series
Authors: Basu Ipsita , Panda Srikrishna Prasad , Yadav Prateek
Published: August 2024

Obsessive-compulsive disorder (OCD) is characterized by intrusive, distressing thoughts and/or repetitive behaviors. Transcranial direct current stimulation (tDCS) is a promising neuromodulation technique for augmenting pharmacotherapy in OCD. This case series identified patients diagnosed with OCD, who showed residual symptoms even after two adequate trials of pharmacotherapy corroborated using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (score of eight and above taken as cutoff). tDCS was given in the form of two milliamperes current with anode at SMA and cathode at the right orbitofrontal area, for twenty minutes, for six sessions (one session per day) in addition to pharmacotherapy. Clinical assessment was performed using the Y BOCS at baseline and post treatment. The results revealed a reduction in OCD symptom severity in all the patients (as per both subjective report and Y-BOCS scores). The patients did not have any severe adverse effects. tDCS appears to be a potential augmentation therapy for individuals with OCD. However, further research is warranted to optimize stimulation parameters and elucidate the long-term effects of tDCS as part of a comprehensive treatment approach for OCD.
Raising a child with cancer: Impact on parents’ health-related quality of life
Authors: Zeeshan Mohammad , Singh Krishna Kumar , Sinha Niska , Madhawi Richa , Zubair Mohd. Yasir , Kumar Santosh
Published: August 2024

Background:

Having a child with a serious illness like cancer has a detrimental and negative impact on the parents’ health-related quality of life (HRQOL). Many factors have been identified as being associated with poorer HRQOL. Acquiring knowledge about these factors is essential to enhancing the quality of life (QOL) of children as well as their parents.

Aim:

This study aims to analyze HRQOL in parents of children with cancer and to explore relationships between parent and child variables and parental quality of life.

Materials and Methods:

A total of 80 parents of children with cancer were enrolled in this cross-sectional study. To evaluate the parental HRQOL, the Short Form 36 Health Survey Questionnaire (SF-36) was used.

Results:

Child age and time since diagnosis showed a positive correlation with all domains of HRQOL on Spearman’s correlation. A statistically significant difference in SF-36 scores across four cancer groups was seen on the Kruskal–Wallis test. Mothers showed poorer quality of life in the physical role functioning domain as compared to fathers (U = 248, P < 0.01).

Conclusion:

The present study shows poor HRQOL for parents of children with cancer, despite learning to cope and adjust over time. Parents of children with retinoblastoma demonstrate a poorer QOL as compared to other cancer groups. The study suggests close monitoring of parents’ QOL and the provision of appropriate treatment and psychosocial support for parents along with the treatment of children.
Relation of Supraventricular Arrhythmias Detected by Implantable Cardioverter Defibrillator and Air Pollutants
Authors: Shahabi Javad , Azhari Amirhossein , Rahimi-Pordanjani Amin , Safari Mohsen
Published: August 2024

Introduction:

One of the therapeutic approaches in cases with high-risk heart disease, particularly heart failure, is the implantation of an implantable cardioverter defibrillator (ICD) to avoid unexpected death. Supraventricular arrhythmias (SVAs) are one of the most common events in aforementioned subjects and it has been proposed that air pollution plays a substantial role in deteriorating of condition.

Materials and Methods:

The present investigation was performed from April 2018 to March 2019 in Chamran Hospital of Medical University of Isfahan, Isfahan, Iran on the 100 cases who had ICD and lived in Isfahan. We recorded the residence of participants to be matched to the reports of the Isfahan Meteorological Organization, and then comprehensive valuations associated with SVAs were done in them.

Results:

There was no significant difference between age and sex with the incidence of SVAs (P = 0.15 and 0.57, respectively). There is no significant difference between the presence of comorbidities and the incidence of SVAs (P = 0.57). The relationship between SVA and air pollution was significant (P = 0.008). Furthermore, based on the correlation test results, the aforementioned relationship was significant with a Spearman correlation coefficient of 0.29 and P = 0.003.

Conclusion:

The severity of air pollution is associated with an increase in SVAs in patients with ICD. In the present study, due to the insignificance of confounding variables such as smoking and diabetes, it is largely reliable, but what is certain to make a definite statement about this relationship, is conduct a study with a larger sample size and also in several centers is necessary.
Impact of Non-surgical Periodontal Therapy on Oral Health-related Quality of Life amongst Primary Dental Care Patients: A Prospective Cohort Study
Authors: Planisamy Vanaja , Yin Ee Ai
Published: August 2024

Aim:

The aim of this study was to determine the impact of non-surgical periodontal therapy (NSPT) on oral health-related quality of life (OHRQoL) of a selected group of the Malaysian population at the primary dental care setting.

Participants and Methods:

This study was conducted from year 2021 to 2022. Patients attending four government dental clinics in Kinta district were included in the study after basic periodontal examination was conducted. The sample size was calculated using the NCSS PASS 11 power analysis and sample size, and a final sample size of 94 was used. A short version of the Malaysian Oral Health Impact Profile (S-OHIP[M]) questionnaire was given as a baseline before the intervention. NSPT was provided in a single session or by a quadrant approach. Patients were then called for review after 6 weeks during when they were required to complete the S-OHIP(M) questionnaire again. All data were then entered and analysed using SPSS version 26.0.

Results:

The prevalence of impact decreased significantly post-treatment (n [%] pre vs. post: 91 [96.8%] vs. 70 [74.5%]; P < 0.001). A significant decrease was observed in the severity of impact (additive score) (median [interquartile range (IQR)] pre vs. post: 8.5 [5.0–15.0] vs. 2.0 [0.0–6.0]; P < 0.001) and extend of impact (simple count score) (median [IQR] pre vs. post: 0.5 [0.0–2.0] vs. 0.0 [0.0–0.0]; P < 0.001) post-treatment compared to pre-treatment too.

Conclusion:

The OHRQoL status amongst gingivitis and mild-to-moderate periodontitis patients in primary care has improved after treatment.