bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of exercise therapy and self-management education to improve physical activity levels in patients with acute exacerbations of chronic obstructive pulmonary disease: protocol of a systematic review and meta-analysis v1
Authors: Yamamoto Koki , Takayama Mami , Nonoyama Tadayoshi , Kon Yusuke , Saimon Yoshiki , Kitagawa Takashi
Published: February 2022

We aimed to evaluate the effectiveness of exercise therapy and self-management education in improving physical activity levels (PA) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and to provide future research directions. We plan to include all randomized controlled trials (RCTs) of exercise therapy and self-management education or either intervention alone designed to improve PA in patients with AECOPD. We will determine the differential effects of exercise therapy and self-management education interventions on daily steps, moderate to vigorous activity time (MVPA), and sedentary equivalent time (SB) (P: AECOPD, I: 1. exercise therapy, 2. self-management education, 3. exercise therapy and self-management education, C: usual care, O C: usual care, O: steps per day, MVPA, SB). In this review, we plan to use five databases. Two reviewers will screen articles to identify studies for inclusion.For risk of bias assessment, we will use Risk of Bias 2 tool.
[RETRACTED] Hazel Hills CBD Gummies Shark Tank & Reviews - Tinnitus & Quit Smoking 2022 v1
Authors: not provided hazelhillssharkking
Published: February 2022

[RETRACTED]

Hazel Hills CBD Gummies Shark Tank & Reviews - Tinnitus & Quit Smoking 2022
Quick Protocol for DNA Cleanup and Concentration Using the Monarch® PCR & DNA Cleanup Kit (5 μg) (NEB #T1030) v6
Authors: England Biolabs New
Published: February 2022

This is the "quick" version of Monarch® PCR & DNA Cleanup Kit (5 μg) Protocol (NEB #T1030) DNA Cleanup and Concentration. For the full protocol, please clickhere.
Examining the Relationship between Sensation Seeking, Positive and Negative Experiences, Emotional Autonomy and Coping Strategies in Adolescents
Authors: Çelik Eyüp , Çalık Merve
Published: February 2022

The research aims to examine the relationships between sensation seeking and positive and negative experience, emotional autonomy, and coping strategies in adolescents. The study group consisted of 371 adolescents who attended middle and high schools; the ages ranged from 11 to 17. 55.7 % of participants were female (N=137), and 44.3% were male (N=109). Data were collected via Adolescent Coping Scale (KIDCOPE), Emotional Autonomy Scale, Adolescent Positive and Negative Experiences Scale, and Short Sensation Seeking Scale. The relationships between the study variables were analyzed via correlational analysis and regression analysis. The correlation analysis revealed a statistically significant negative correlation among sensation seeking, emotional autonomy, active coping, and positive experience. On the other hand, a statistically significant positive correlation among sensation seeking, avoidant coping, negative coping, and negative experience. The regression analysis results showed that emotional autonomy, avoidant coping, negative coping, and negative experience predict sensation seeking, yet active coping and positive experience variables did not predict.
Orientations to Happiness and University Students’ Engagement during the COVID-19 Era: Evidence from Six American Countries
Authors: Durón-Ramos Maria , Perez Miguel , Chacón-Andrade Edgardo René
Published: February 2022

Positive personal characteristics such as happiness or wellbeing can motivate students to elevate their school performance in higher education. Orientation to happiness is a construct that combines three sources of happiness: pleasure, meaning, and engagement, all of which have been identified as a predictor of university student’s engagement. However, most research in this area has been conducted during ideal situations or face-to-face education, and no cross-country research has been published examining the relationship between these two concepts during the COVID-19 era, where online education was predominant. This study aimed to investigate the relation between orientation to happiness and student engagement after twelve months of distance education in a sample of 1723 students from six American countries, including the USA, Mexico, El Salvador, Colombia, Peru, and the Dominican Republic. Results indicate that university student´s' engagement is influenced by the orientation to happiness. Further implications of these results are discussed.
The Inclusion of Students With Disabilities: Challenges for Italian Teachers During the Covid‐19 Pandemic
Authors: Colombo Maddalena , Santagati Mariagrazia
Published: February 2022

In March 2020 all schools in Italy were closed due to the Covid‐19 pandemic, and the novelty of distance learning was introduced. During the 2020–2021 school year, pre‐primary and primary schooling was carried out in situ, while secondary education was re‐organized into a mixed system, with students spending 50% of their time attending classes from home, in distance learning. This reconfiguration was a challenge to students, teachers, and parents, affecting the learning experience of the most vulnerable students and students with disabilities, particularly. It necessarily brought into question Italy’s “progressive” legal framework for “school inclusion.” The scope of the present article is to analyze the teaching activities carried out with students with disabilities in Italy during the first wave of the emergency lockdown and their consequent challenges for school inclusiveness. An overview of the Italian inclusive model in education and the national measures adopted to guarantee the right to education during times of school closure/restriction is outlined. We have sought to test the hypothesis that distance learning may introduce many risks for inclusion (resulting in a “downgrading inclusion,” that is, a decline of the level of inclusion already reached for students with disabilities), but it may also present an improvement in how teachers address these students and their needs. To this end, after reporting data from the available studies on this target, we provide insights from a web questionnaire submitted to a non‐probabilistic sample of nearly 150 primary and (lower and upper) secondary school teachers. Results showcase that, though with a general worsening of school inclusion, in some cases, teachers were actually able to support students with disabilities and their families in a new, customized, empathetic, and more attentive manner.
Benefits and Concerns Abound, Regulations Lack in Collegiate Athlete Biometric Data Collection
Authors: Rush Chelsea , Osborne Barbara
Published: February 2022

Statistical analysis has long been a staple in sports, helping teams, athletes, physicians, fans, and others understand and predict athlete performance and develop training programs. The rise of connected, wearable devices, however, has enabled the collection and analysis of unprecedented types and amounts of athlete data. Various benefits accompany this augmented data collection ability, such as the creation of robust, individualized training and recovery programs. Conversely, such substantial data collection also leads to significant concerns related to athlete privacy, misuse of data, and exploitation. While data collection is prevalent in both professional and amateur sports, this article focuses on data collection in the nuanced landscape of intercollegiate athletics. The discussion begins with an overview of the ways athlete data is collected and used, then delineates the concerns specific to intercollegiate athletics. The various existing regulatory frameworks that apply to this space are then explored to determine how, if at all, the frameworks may provide protections against the various concerns. To conclude, numerous recommendations for curing the shortcomings of these regulatory frameworks and ensuring protection of athlete interests are provided.
Non-Fungible Tokens, Sports, and Intellectual Property Law Issues: A Case Study Applying Copyright, Trademark, and Right of Publicity Law to a Non-Traditional Ownership Vehicle
Authors: Conrad Mark
Published: February 2022

Non-fungible tokens (“NFTs”) are a recent addition to the cryptocurrency universe and have attracted the attention of different stakeholders in the sports world over the last two years. Because they can identify and authenticate particular content, NFTs have become a hot commodity among collectors and investors, in some cases selling for millions of dollars. The sports industry has been a major contributor to NFTs, with athletes, teams, colleges, and leagues issuing or planning to issue NFTs. Because of their recent vintage, NFTs are creating novel and significant intellectual property law issues. This article will explore some of the key issues by utilizing a case study of a hypothetical NFT production of an image found in a painting, which is based on a copyrighted news photo. The article will analyze the copyright issues—whether the NFT can be copyrighted, whether it constitutes a “transformative work,” and whether there are grounds to consider it a derivative or secondary work. This article will also discuss traditional concepts and dilution issues by trademark holders and publicity rights claims against the issuer of the NFTs by the estates of the athletes portrayed based on various state laws. It will then examine the balancing between the rights of estates to protect and profit from their images, and the free expression rights of the creator of the NFT. It will compare two principal standards for making this determination—the “transformative use” test adopted by the majority of federal circuits and the “predominant use” test utilized in Missouri. Recent case law will be cited, in addition to key statutes.
Ten-year review of the clinical presentation and treatment outcome of Asherman’s syndrome in university of Maiduguri teaching hospital, Borno State, Nigeria
Authors: Geidam Ado Danazumi , Malgwi Adamu
Published: February 2022

Background: Asherman’s syndrome (AS) is an important gynaecological disorder characterized by a menstrual abnormality (hypomenorrhea/amenorrhea) and infertility that is usually caused by activities that traumatize the endometrium. Objective of current study was to determine the prevalence, clinical presentation and treatment outcome of Asherman’s syndrome in our hospital.Methods: A retrospective review of patients with Asherman’s syndrome managed at the University of Maiduguri Teaching hospital over 10 years (January 2008 to December 2017). Data about the patients were obtained and analyzed using Microsoft office excel 2007 and SPSS version 25 (IBM SPSS, Statistics) to generate descriptive statistics (frequencies, ratio and percentages) which were presented as tables.Results: The prevalence of AS is 5.3%. Most of the patients were in the 25-34 age group (69.1%) and the majority (94.5%) were married. Dilatation and curettage (D & C) constituted the commonest risk factor for Asherman’s syndrome (21/55, 38.2%) and infertility alone (29, 52.7%), and hypomenorrhea with infertility 10 (18.2%) were the commonest presentation. Twenty-five percent of the patients (14/55) achieved normal menses and 11 (20%) achieved pregnancy following treatment.Conclusions: AS is not uncommon in our environment. D&C is the commonest risk factor and the patients usually present with infertility and hypomenorrhea.
Sildenafil citrate for the management of asymmetrical intrauterine growth restriction and its effect on umbilical artery Doppler
Authors: El Fatah Laila E. Abd , Elnashar Diaa A. , Elabass Zeinab M. Abo , Ait-Allah Abdou S.
Published: February 2022

Background: Asymmetrical intrauterine growth restriction IUGR occurs when there is uteroplacental insufficiency. Sildenafil citrate phosphodiasterase-5 inhibito is a potent vasodilator, which selectively inhibits phosphodiesterase-5 and, as a consequence, enhances the action of cyclic guanosine monophosphate which is the second messenger of NO. Hence, the trial was used for improving uteroplacental perfusion through enhancing vasodilatation of myometrial small arteries boosting flow within uteroplacental bed. The aim was to evaluate the efficacy of adding sildenafil citrate to low dose aspirin in treatment of asymmetrical IUGR through its effect on uteroplacental blood flow guided by Doppler ultrasound.Methods: Our study was a prospective double-blinded, randomized, controlled trial. Recruitment of participating women was from the obstetric outpatient clinic of Aswan university hospital. 100 patients included in the study and randomized in two groups. The first group was 50 patients assigned sildenafil with low dose aspirin and the second group was 50 patients assigned placebo with low dose aspirin.Results: As regard the outcomes, the study demonstrated that using of SC and LDA were effective in increasing estimated fetal weight and in improvement of umbilical artery umbilical artery Doppler (UAD) indices RI and PI for pregnancy complicated with IUGR compared with the control group.Conclusions: Sildenafil citrate is a promising treatment for IUGR fetuses with prolongation of pregnancy and improvement of fetal birth weight, umblical Doppler indices UDI, decreases days needed in PCU.
Acanthosis nigricans in adolescents with polycystic ovary syndrome
Authors: Khan Bijay , Basu Ranjan
Published: February 2022

Background: In this study we compared the clinical and biochemical variables of adolescent females with PCOS (polycystic ovarian syndrome) and its association with or without acanthosis nigricans (AN).Methods: Adolescent girls (14-19 years) with oligomenorrhoea and hyperandrogenism were studied. Clinical parameters like blood pressure (BP), body mass index (BMI), abdominal circumference (AC), presence or absence of acne and AN and hirsutism score were noted. Biochemical tests included serum total testosterone (TT), sex hormone binding globulin (SHBG) levels and free androgen index (FAI). Postprandial plasma insulin (PPI) and glucose (PPG) levels were measured to assess insulin resistance and glucose tolerance respectively.Results: Significant differences were observed in BMI, AC, DBP, TT and FAI between the two groups. The difference in the prevalence rate of abnormal glucose tolerance and insulin resistance between the two groups was insignificant. Logistic regression modelling with AN as the response variable of interest and BMI, AC, SBP, DBP, testosterone level, PP insulin and PPG levels as its predictors yields BMI, testosterone, PP sugar, PPI, SHBG as main determinants. The model signifies positive impacts of BMI and testosterone level, while negative influence of PP sugar, PPI level and SHBG levels on AN. This analysis was an evidence for a strong relation between BMI and AN.Conclusions: AN in adolescent girl with PCOS is another clinical marker of obesity but not an indicator of underlying insulin resistance or glucose intolerance. Further studies are needed to detect how many of them ultimately develop insulin resistance or diabetes in future.
A prospective study of predictors of metabolic syndrome in women with polycystic ovary syndrome
Authors: Gupta Jubie , Minhas Santosh , Jindal Monika
Published: February 2022

Background: Polycystic ovary syndrome (PCOS) is a well-known gynecological hormonal imbalance. The consequences of PCOS pose a substantial risk for the development of metabolic and cardiovascular abnormalities similar to those that make up metabolic syndrome (MBS). Therefore, there was a need to identify predictors for MBS in PCOS subjects and study their strength of association.Methods: A prospective observational study was carried on 100 PCOS subjects for having features of MBS. MBS was diagnosed by National cholesterol education program’s adult treatment panel III 2001 criteria. Student’s independent t test, Chi square test and Fisher’s exact test were used for statistical analysis.Results: The present study estimated the prevalence of MBS in women with PCOS to be 31%. MBS in PCOS was more prevalent in non-vegetarians (51.6%). The individual components of MBS criterion had a statistically significant p value (p=0.001 to 0.008) for development of PCOS. Raised levels of triglycerides, fasting blood sugars and fasting insulin tests were related directly to MBS development, with statistically significant p values (<0.001, <0.001 and 0.005), respectively.Conclusions: Women with PCOS have a high prevalence of MBS and its individual components, particularly raised laboratory values of triglycerides, fasting blood sugars and fasting insulin. MBS in PCOS women is associated with advancing age and obesity.
Female cancer awareness and screening: evaluation from tertiary hospital in Eastern India
Authors: Ray Payal Banerjee , Ray Amitabh
Published: February 2022

Background: Cancer awareness and emphasis on preventive oncology is an essential weapon in our war against cancer. Globally the approach towards cancer awareness is non-targeted with mass media and social media coverage being unselective. This study aimed to demonstrate the disparities prevalent in society especially in a developing country with regard to cancer awareness for two of the commonest female cancers and suggested measures to increase the efficacy of awareness programs in the urban and suburban population of a typical third world Indian metropolitan city.Methods: In a cross-sectional study conducted between January 2021 to June 2021, 119 suitable female patients attending the gynaecology OPD of a medical college and hospital were randomly selected. Informed consent was taken and their knowledge/awareness about preventive oncology in carcinoma breast and carcinoma cervix (two most common cancers in Indian women) was documented using pre tested and pre structured questionnaire. The results were analysed by suitable statistical tests.Results: Higher education and socio-economic condition was associated with increased levels of awareness for preventive measures of carcinoma breast and carcinoma cervix. Within each educational strata, higher socio-economic status predicted for increased awareness for risk factors, screening tests and vaccination.Conclusions: Subtle differences in the patterns and degree of awareness in common female cancers were noticed with regard to educational and socio-economic standards in the studies population. These have widespread implications in planning awareness programs in resource constrained setting to ensure most efficacious utilization of Cancer awareness and Prevention programmes.
A study of factors associated with tokophobia and its effect on pregnancy
Authors: Ramalingappa Padmasri , Gowda Raksha S. , Srinivasamurthy Shruthi Holavanahalli
Published: February 2022

Background: Tokophobia is pathological fear of childbirth which has bearing on the women’s health with the physical and psychosocial morbidity. It includes fear of injury to the baby, genital tract, death and is a common cause for which a woman opts for caesarean section. Recognition of tokophobia and close liaison with  obstetricians/specialists can help to reduce its severity and ensure treatment. Aim of the current study was to assess the incidence of tokophobia and correlation with the sociodemographic variables to evaluate the possibility of reducing the requests for caesarean section.Methods: 150 pregnant women attending the antenatal OPD and labour ward in a tertiary care centre constituted the study population. Data was gathered using standard questionnaire to assess fear of child birth, anxiety associated and was analysed with chi-square test for statistical significance.Results: 150 women included in the study, the incidence of tokophobia was 55.3% and severe tokophobia was 30.7%. Of these 62% were primigravidae and 38% multigravidae.15.3% of the total requested for caesarean section with the major reason being fear of childbirth. However, 84.7% of the study population did so without any such request for caesarean section. Higher incidence of tokophobia was observed in women with intermediate education as against those who completed their graduation and post-graduation.Conclusions: Tokophobia is associated with pregnant women in different severity. It’s influenced by sociodemographic variables like educational and socioeconomic status. Improvement in sociodemographic conditions could reduce tokophobia.
Performance of hemodynamic stability parameters as predictors of ectopic pregnancy, with emphasis on shock index
Authors: Khan Bijay , Chakraborty Mayoukh Kumar , Basu Ranjan
Published: February 2022

Background: A study was conducted to determine the utility of shock index in the diagnosis of acute rupture ectopic pregnancy (EP).Methods: A retrospective review of all ruptured ectopic pregnancy at KPC medical college and hospital a tertiary private health care centre was performed for two years (May 2018 to April 2020). During this study, we used data of 35 cases of EP among 1150 pregnant ladies admitted from time to time under emergency.Results: The mean age of the study population was 29.49±0.74 (mean±SEM) years (range 22-38 years) and mean gestational period of pregnancy was 42.2±2.0 days (range 28-90 days). The commonest presentation of clinical symptoms associated with EC was abdominal pain (91%), vaginal bleeding (89%), amenorrhea (86%), dizziness/fainting attack (17%) and shock (68%). In majority (92.3%) of the patients the shock index was >0.70 with an average of 0.9±0.03. In 60.7% of the cases the amount of haemoperitoneum found at laparatomy was >1000 ml. It was observed that most patients with EP had hemoperitoneum above 1000 ml (1140±113.6).Conclusions: Pulse rate or systolic blood pressure alone are not a good predictor to access the amount of blood loss in EP. But when they were used to calculate the SI (shock index), it was more accurate and simpler predictor for diagnosis of EP. SI may be used in guiding clinicians in providing appropriate management for EP patients especially in low-resource settings or hospitals with limited facilities.
Scar endometriosis: an uncommon surgical aftermath
Authors: Pathade Sumedha , Panchbudhe Shruti , Deshmukh Prasad , Nayak Arun
Published: February 2022

Endometriosis is a benign condition wherein endometrial tissue lies outside the uterine cavity. Abdominal scar endometriosis is a rare entity following pelvic surgeries caused as a result of deposition of endometrial tissue at scar site. Patient usually presents with triad of presence of mass over scar site, cyclical pain during menses and bleeding. Histopathological examination remains gold standard for diagnosis in which the presence of endometrial glands, stroma and hemosiderin laden macrophages can be seen. We presented a case of 35 years old lady with history of caesarean section done 3 years back who came with complaints of swelling over the scar site and cyclical pain with tenderness present over lump. Ultrasonography revealed presence of firm mass which was removed by wide local excision and histopathology confirmed the diagnosis of scar endometriosis.
Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in pregnancy in a known case of antiphospholipid antibody syndrome
Authors: Dhungat Nitin Pai , Kaur Shubhdeep
Published: February 2022

Thrombotic thrombocytopenic purpura is a haematological disorder which may be severely life-threatening. It affects the microcirculation of multiple organ systems. One of the precipitating factors for thrombotic thrombocytopenic purpura is pregnancy. The case report describes a 32 years old patient who presented with antepartum TTP-HUS and was initially treated as a case of HELLP syndrome without any improvement. The introduction of aggressive treatment with plasma transfusion and plasmapheresis has improved maternal and fetal survival rates in these cases. thrombotic thrombocytopenic purpura-haemolytic uremic syndrome is a rare complication of pregnancy and parturition, that may simulate the more common obstetric complications, namely, preeclampsia and the syndrome of haemolysis, elevated liver functions tests, low platelets. Review of the previously reported cases of pregnancy-related TTP and the current treatment options for this rare condition are also discussed. Careful diagnosis, monitoring, and treatment in congenital and acquired TTP have assisted in excellent pregnancy outcomes.
Unsuspected rupture in unscarred uterus at an early gestation: a clinical dilemma
Authors: Singh Neeta , Kulshrestha Vidushi , Dhiman Soniya , Kaur Tarang Preet , Meena Jyoti , Mathur Sandeep
Published: February 2022

Spontaneous uterine rupture in early second trimester is extremely rare specially in absence of predisposing factors. A pregnant patient presented at 15 weeks’ gestation with lower abdominal pain and vomiting since two days. Ultrasound findings and deranged liver function tests reinforced the diagnosis of chronic liver disease with pregnancy. Clinical course a day later raised suspicion of ruptured uterus and patient was immediately taken for laparotomy. Intra-operatively, hemoperitoneum and 4 cm fundus rent was found. Total hysterectomy was performed and histopathology revealed placenta percreta as the probable cause of spontaneous rupture. The case highlights that a high index of clinical suspicion, an attentive daily clinical examination and immediate surgical management can avert life-threatening catastrophe.
Management of trans-anal extrusion of distal ventriculoperitoneal shunt catheter in children
Authors: Ghritlaharey Rajendra K.
Published: February 2022

Background: The objectives of this study were to review the demographics, clinical characteristics, surgical procedures executed, and the outcome of children operated upon for trans-anal extrusion of the distal VPS (ventriculoperitoneal shunt) catheter.Methods: Case records of children under 12-years, operated upon for the trans-anal extrusion of the distal VPS catheter, were reviewed in detail.Results: This study comprised of, n=25 children and included, n=14 boys and, n=11 girls. The interval from the primary VPS insertion/VPS revision to the diagnosis of trans-anal extrusion of the distal VPS catheter ranged from 2 to 49-months, with a mean of 10.04 (11.58 SD/ months. Clinically, all children presented with trans-anal extrusion of the distal VPS catheter. None of them had clinical features of peritonitis, intestinal obstruction, or meningitis. Operative procedures performed in the following order of frequency; (a) removal and immediate revision of the peritoneal/distal VPS catheter n=15 (60%), (b) removal of entire VPS catheter and delayed re-VPS insertion n=4 (16%), (c) removal of peritoneal/distal VPS catheter, external ventricular drainage (EVD) followed by delayed re-VPS insertion n=3 (12%), (d) removal of entire VPS catheter and immediate re-VPS insertion n=1 (4%) and (e) removal of entire VPS catheter alone n=2 (8%).                          Conclusions: Trans-anal extrusion of the distal VPS catheter is well-known, but rare complication of the VPS insertion done in children. In sixty percent of children, removal and immediate revision of the peritoneal/distal VPS catheters were done safely by mini-laparotomy. During the management, formal abdominal explorations were neither executed nor required in any case.
A comprehensive analysis of serum D-dimer and Ferritin levels, in 347 patients with severe (breathlessness and chest discomfort) corona virus disease 2019
Authors: Jangamgudem Sudharani
Published: February 2022

Background: This study aimed to evaluate the association between serum D-dimer and Ferritin levels, in patients with severe (Breathlessness and chest discomfort) corona virus disease 2019.Methods:  The present study included a 347 (out of 1500) patients with severe Breathlessness and Chest discomfort age between 40 to 60 years who were confirmed to have Covid-19 based on RTPCR in a GVPIHC&MT referral hospital between 2020 June and 2020 August, were analysed.Results:  A total No of 694 cases were studied by dividing them into two groups controls 347 and cases 347. The results so obtained compare with 347 healthy controls included in this study.  Statistical evaluation was carried out to confirm any deviation from the normal values.  The Mean± SD Serum FERRITIN Cases (654.45±317.45), controls (157.03±87.43), D-dimer values of cases (6.1517±3.4270), controls (0.2204±0.1083) and both serum Ferritin and D-dimer values in cases (3.443230±3.625471), controls (0.201372±0.121560). This increase is statistically P value highly significant (<0.001)Conclusions:  It has been shown from this study with, the serum activities of D-Dimer and Ferritin levels were markedly increased in Severe Breathlessness and Chest discomfort in male and female COVID-19 patients.
An analysis of vitamin D levels and the factors affecting vitamin D levels among the adult population attending a tertiary care hospital
Authors: A. Amitha T. , S. Lekshmi G. , Roy Jyothi
Published: February 2022

Background: The aim of the study was to determine the vitamin D levels and the factors affecting vitamin D levels among the adult population attending a tertiary care hospital.Methods: An observational cross-sectional study was conducted among 568 adult individuals attending various outpatient departments at Sree Gokulam Medical College and Research Centre, Venjaramoodu over a period of 3 months from 1st January to 30th March of 2021. 119 males and 449 females were recruited in the study. Only adult patients between the age of 18 to 70 were included in the study. Blood samples were collected randomly from patients attending different OPDs. Serum 25-hydroxyvitamin D (25(OH) D) level was measured using electrochemiluminescence immunoassay (ECLIA) in Roche Cobas e 411 fully automated analyzer.Results: Among the study population, 52.9% of males had Vitamin D deficiency and 70.8% of females had vitamin D deficiency with a p value 0.001. Based on age, the study population was subdivided into three groups-young, middle age and old age groups. 76.9% of the young age group had vitamin D deficiency. 57.2% of middle age group and 56.8% of old age group were Vitamin D deficient with a p value 0.0001.Conclusions: Age and gender are significantly related to Vitamin D levels. While individual’s occupation, BMI and their religion are less significant factors correlated to vitamin D levels in an individual.
Endoscopic balloon dilatation in caustic-induced gastric outlet obstruction: case report
Authors: Morales-Moreno Sergio , Rivero-Yañez Fernando , Escandon Espinosa Yoeli Marisa , López García Katia Daniela , García-Arredondo Carlos , Abundez-Pliego Ana Lilia , Valderrama-Treviño Alan Isaac
Published: February 2022

The ingestion of caustic substances is a not infrequent problem that requires multidisciplinary, medical, surgical and endoscopic management, since it can cause minor burns to total necrosis of the digestive tract wall. A 76 years old male patient with a history of chronic alcoholism presented to the emergency department complaining of heartburn and abdominal pain after ingesting muriatic acid, accidentally mistaking it for alcohol. Computed tomography (CT) scan showed no signs of perforation and endoscopy revealed grade IIIB stomach burns. On day 45 a new endoscopy was performed, documenting fibrosis scars in the antrum with significant retraction and secondary pyloric stenosis, which was managed with endoscopic balloon dilatation (EBD) without complications. In this case, as in most patients with caustic-induced gastric outlet obstruction (GOO) can be successfully treated by EBD.
A cross-sectional study of diseases prevailing in an orthopaedic OPD at a tertiary care hospital in the Mumbai metropolitan region
Authors: Rathod Girish , Borole Pushkar , Shetty Chandan , Raut Nitin , Britto Namrata , Gawali Vijaykumar
Published: February 2022

Background: The orthopaedic out-patient department of a tertiary care hospital plays a crucial role in the health care system as it attends to a large number of patients. The goal of the study is to observe the etiological patterns of common issues that prevail in an Orthopaedics OPD of a hectic tertiary care hospital, which could in turn help to understand the distribution of illnesses in a particular geographical area.

Methods: Analysis of 1605 patient records was carried out from the period July 2020 to December 2020, to assess the orthopaedic out-patient load and prevailing diseases. Initial medical records of the patients were analyzed and the data collected were subjected to statistical analysis using IBM SPSS software version 1.0.

Results: The primary diagnosis of patients visiting the orthopaedic OPD during the Covid-19 period are observed to be as follows: acute and chronic back ache (27.29%), arthritis (26.23%), joint stiffness (10.03%), ligamentous sprains (9.84%), neck-related problem (6.92), tendinopathies and enthesopathies (6.60%), non-specific body aches (5.11%), post-operative follow-up (4.05%),bone fractures (2.37%), soft tissue injuries (0.93%), and neuropathies (0.62%).

Conclusions: The study presenting the overview of diseases prevailing in an orthopaedic OPD in a tertiary care center could help in formulating better prevention and treatment strategies to overcome such medical conditions irrespective of the presence of a pandemic.
Functional outcome of peritrochanteric fracture fixation with modified gamma nail using tri-wire anchorage
Authors: Mukherjee Jayanta , Ahmad Mujatba , Jash Swagatam , Nasipuri Kartick , Kushwaha Pankaj K.
Published: February 2022

Background: Pertrochanteric fractures comprise almost 50% of all proximal femoral fractures. Being common in elderly people, the quality of life deteriorates until the fracture is stabilized, followed by early mobilization. Intramedullary devices have been proven to improve biomechanics. In our study, we adopted modified gamma nail with additional tri-wire anchorage construct, which further stabilizes the rotational torque.

Methods: A prospective study was undertaken on 39 skeletally mature patients of both sexes, with per-trochanteric fracture, from January 2019 to April 2020. The study included 23 females and 16 males. the 34 underwent CRIF while 5 underwent ORIF. One patient was lost to follow-up. Clinico-radiological evaluations of the patients were done for 12 months. Functional evaluation was based on the modified Harris hip score (mHHS). Statistical analysis was done by SPSS (version 27.0; SPSS Inc., Chicago, IL, USA) and GraphPad Prism version 5. 

Results: The study showed 100% union rate. Radiologically at 3 months, the fracture united in all patients. At 6 months postoperatively all patients were ambulatory with or without walking aids. One patient had tri-wire cut through and one had tri-wire back-out. HHS was an average of 79 at 3 months representing a fair outcome. This increased to 90 at 6 months representing an excellent outcome.

Conclusions: Modified gamma nail with tri-wire anchorage has distinct advantages over other techniques. It allows for early weight-bearing and mobilization with lesser complications. The tri-wire construct further provides additional rotational stability in osteoporotic bone.

nal stability in osteoporotic bone.
Functional outcome of elbow after comminuted radial head fractures treated with radial head excision arthroplasty versus radial head prosthesis
Authors: Kumar Priyambada , Patil Nitin S. , Nikam Mithilesh A.
Published: February 2022

Background: Aim of the study was to compare the functional outcome of the elbow after treating a Mason type III radial head fractures with radial head excision arthroplasty versus radial head arthroplasty with prosthesis and to study the complications which occur in both techniques.

Methods: This prospective study comprised of 30 patients, with each group comprising of 15 patients each (n=15). Randomization was done; group A comprised of patients with Mason type 3 radial head fractures treated with excision arthroplasty and group B included patients with Mason type 3 radial head fractures treated with radial head arthroplasty with prosthesis. Post operatively the operated limb was immobilized in an above-elbow plaster of Paris slab for 3 weeks in all patients.

Results: Mean disabilities of the arm, shoulder and hand (DASH) score at 6 weeks was noted to be 30.13 for patients belonging to group A and 13.06 for patients in group B. The mean DASH score at 3 months follow up was calculated as 22.53 for group A and 10.66 for group B. The mean DASH score at 6 monthly follow up was noted to be 13.86 for patients in group A and 5.2 for patients in group B.

Conclusions: As evident from the radiological findings and the clinical follow up, it is safe to say that radial head arthroplasty with prosthesis produces more convincing results in terms of stability of the elbow joint, range of motion and pain as compared to radial head excision arthroplasty for the treatment of Mason type III radial head fractures. 
The biomechanical strength of olecranon fixation constructs: a systematic review and meta-regression
Authors: Cutter Brenden , Kelly Shayne R. , Beckett Charles R. , Huish Eric G.
Published: February 2022

Olecranon fractures are often operative when displaced over 2 mm, but the most stable fixation construct is debated. The purpose of this study was to provide an overview of biomechanical properties of the most commonly used surgical fixations of olecranon fractures. This systematic review included 13 biomechanical studies comparing displacement during cyclic loading of olecranon fractures fixated with either tension band wiring (TBW), intramedullary screw, or plate fixation. In regard to overall gapping, plates displayed (and screws trended towards) increased stability versus TBW. However, there was no difference between the constructs in gapping at the articular surface. Plating displayed increased stability along the posterior surface. No construct allowed gapping over 2 mm, suggesting safe early post-operative motion with any of the techniques.
A displaced T type intercondylar distal humerus fracture with radial nerve palsy in a 10-year-old treated by closed reduction and K wire fixation
Authors: Nair Nikhilesh , Sameer Mohamed , Giriraj J. K. , Navaneeth Ghantasala
Published: February 2022

T type intercondylar fractures of the distal hummers in the pediatric age group is an extremely rare injury. These fractures are difficult to diagnosed as they can be mistaken for extension type injuries. The few clinal trials on the management of the fracture, it is widely regarded that the accepted method of treatment is open reduction and rigid internal fixation. It is easier to ensure stable articular reconstruction of the intra articular fragments by this method. Open reduction and internal fixation of there fractures are associated with high complication rate, which include wound site problems, non-union due to periosteal stripping, heterotrophic ossification and iatrogenic nerve injury. Large soft tissue dissection can also lead to vascular compromise and significant scar tissue which is associated with a stiff elbow. We present a case of a 10-year-old boy who sustained an intercondylar fracture with radial nerve palsy which was treated by closed reduction and Kirshner wire fixation with excellent results at 1 year follow up.
Concomitant bilateral medial malleolus stress fracture: a case report and review of literature of an extremely rare injury
Authors: Philip Vivek Mathew , Shekhar Raj , Sharma Saurabh , Padhi Prashant Pratim
Published: February 2022

Medial malleolus stress fractures are rare stress injuries and account for 4% of all the stress fractures. Bilateral medial malleolus stress fracture (MMSFs) is extremely rare with only five such cases reported in existing literature. We report an extremely rare injury pattern in the form of concomitant bilateral MMSF in a young military recruit who presented with severe pain in both his ankles for one month. A 20-year military recruit undergoing rigorous physical training presented to us with severe bilateral ankle pain of one month duration. Clinico-radiological examination revealed bilateral MMSFs. He was managed with open reduction and internal fixation using a one-third tubular plate in buttress mode. Patient was gradually rehabilitated and on one-year follow up, he is asymptomatic and performing all strenuous physical activities. Bilateral MMSFs are extremely rare injuries with only five such cases reported in existing medical literature and this is the fourth instance where bilateral MMSFs were diagnosed at the time of clinical presentation and managed simultaneously, in the same surgical setting.

 
Inter-American Development Bank Annual Business Review 2021
Authors:   Inter American Development Bank
Published: February 2022

The 2021 Annual Business Review (ABR) provides an overview of the IDB's performance on sovereign-guaranteed outputs and lending program priorities. The ABR identifies trend deviations from IDB portfolio targets to support Bank managements efforts to identify and implement corrective measures. This edition compiles data for all quarters in 2021.
CHOSEN SOCIOLINGUISTIC COMPETENCIES IN STUDENTS IN SECONDARY SCHOOL
Authors: Vnucko Gregor , Reid Eva
Published: February 2022

In this paper, we are concerned with one of the factors of intercultural communicative competence – sociolinguistic competence. First, we lay theoretical background for our research, explain the underlying methodology and after conducting the research, we analyse the data. Because we acquired the data from three different sources of the same information, we also explained the relations among them. Our research sample are students from 2.A from Golianove Gymnázium in Nitra and their teachers. This is a class which has more English lessons than usual and a native teacher. We created semi-structured interviews, based on two documents: The Council of Europe’s CEFR (2001) and Reid’s “Communicative competence connected with culture” (In Reid, 2014: 64). In our research results, we learnt that the students have very good socio-linguistic competence as they identified several examples to each of the chosen categories (greetings, titles and addressing, accents and dialects and colloquialisms, slangs and dialectisms). Every student interviewee also uses different multimedia on daily basis and the majority students state, that they consider being the main source of their socio-linguistic competence the multimedia. However, even though the relations between the specific phrases were not found within some categories (slang words and colloquialisms), teachers claim to have implemented activities that focus on these categories of socio-linguistic competence. To precisely identify the source of the students’ socio-linguistic competence, further research would be necessary.
RECEIVING TRAINING TO TEACH THE 'PROHIBITED LANGUAGE: THE ATTITUDE OF STUDENT TEACHERS MAJORING IN A GHANAIAN LANGUAGE (AKAN) IN THE COLLEGES OF EDUCATION IN GHANA
Authors: Akuamah Abdulai , Gyampoh Faustina , Asamoah Leticia
Published: February 2022

Lecturers, teachers, and students often consider students majoring in indigenous languages in Ghana as academically weak. However, some students still pursue it as a major in the Colleges of Education in Ghana. The present study investigates the attitude of student teachers majoring in an indigenous language Akan in the Colleges of Education in Ghana. To do so, three colleges, namely, St. Joseph's College of Education, Abetifi Presbyterian College of Education, and Fosu College of Education, were purposefully selected. A total of 212 students comprising 101 males and 111 females were recruited for the study. The data were quantitatively analyzed. The results showed that most participants have a positive attitude toward the study of Akan in general at the College of Education level. Similarly, student teachers' attitude toward majoring in Akan was positive since the overwhelming majority are not perturbed by the stigma associated with studying the Akan language in general. Finally, although a slight majority believed that they would allow their loved ones to pursue Akan in the future, other responses indicated participants had diverse opinions. This attitude will go a long way to change the negative perceptions others have about the study of indigenous languages in Ghana.
Trend Analysis and GARCH Model for COVID-19 National Weekly Confirmed Cases in Nigeria for Abuja and Lagos State
Authors: O O Lawal , M T Nwakuya , O E Biu
Published: February 2022

The trend analysis and GARCH model for COVID-19 pandemic spread between FCT/Lagos and the National Weekly confirmed pandemic cases were carried out using the statistical software Minitab17 and Gretl. Four models trend behavior were considered, which are linear, quadratic, cubic and quartic trends with respect to R-square value, Adjusted R-square value, Analysis of Variance (ANOVA) p-value and the estimated coefficients p-values. In addition, GARCH(0,1),GARCH(1,0) and GARCH(1,1) models were built separately for both FCT/Lagos on the Nigeria National Weekly confirmed pandemic cases; to determine which model has best fit for predicting weekly confirmed cases of COVID-19 pandemic in those areas. The four common information criteria was used to selected the best model, which are the Akaike Information Criteria (AIC), Schwarz-Bayesian Information Criteria (BIC), Hannan-Quinn Information Criteria (HQC) and Likelihood Criteria (LKH).This study established the quadratic trend and GARCH(1,0) as the best model that describes the data sets for FCT. Hence, both models can be used to forecasts the weekly pandemic confirmed cases in these areas.
Characterization and Storage Stability Study of Guava and Mango Wood Smoked Induced Spiced Cultured Milk (Raita)
Authors: Chaudhuri Arghya , Aditya  , Mishra Himanshu , Patidar Sachin , Rehman Hameedur , Choudhary Lokesh , Kumar CTM
Published: February 2022

A study was conducted to evaluate the effect of the smoking of raita with guava and mango wood on its functional properties and storage stability. The raita was smoked with guava and mango wood for 2.5, 5, 7.5, and 10 min in a closed chamber. The smoked raita was evaluated for change in titratable acidity (TA), pH, total phenolic content (TPC), antioxidant activity (DPPH), colour (L*, a*, and b*), and sensory attributes. Both guava and mango wood smoked samples didn’t show significant changes (P<0.05) in TA, pH, TPC, and antioxidant activity. All colour values (L*, a* and b*) of smoked samples were significantly (P<0.05) higher than the control sample, particularly, the yellowish attribute (b*) was very high in smoked samples. The sample that smoked for 7.5 min had very high overall acceptability scores in both kinds of wood and which is considered as an optimum smoking time for raita. The selected raita samples were stored for 9 days at 4°C and assessed for TA, pH, and standard plate count (SPC) at 3 days of interval. During the storage period, a significant reduction (P<0.05) in pH and a significant increase (P<0.05) in TA was seen till the 6th day of storage. The smoked samples had considerably lower SPC than the control sample and SPC was decreased significantly (P<0.05) with an increase in storage days in all the samples. The preparation is simple and can be served in Pubs/Bars, Casual Dining Restaurants & QSRs (Quick served restaurants).