bluuebunny/crossref_metadata_2025 huggingface dataset:
EVALUATION OF ROLE OF LIMB RECONSTRUCTION SYSTEM FIXATOR (LRS) IN MANAGEMENT OF NONUNION TIBIA WITH IMPLANT FAILURE
Authors: Pandey Krishna Kumar , Ahirwar Rahul
Published: April 2024

Introduction; The management of non-unions tibia pose many challenge to the orthopedic surgeons. Challenges
include recalcitrant infection, complex deformities, sclerotic bone ends, large bone gaps, shortening, and joint stiffness.
Improper management leads to multiple surgeries and disability in patients. The ASAMI classification helps decide
treatment. Co-morbid factors such as smoking, diabetes, non steroidal anti-inflammatory drug use, and hypo vitaminosis
D influence the choice and duration of treatment External fixation using limb reconstruction system (LRS) is one of the
options in the management of these conditions. Compression at nonunion site achieves union. It can be combined with a
corticotomy at a distant site for equalization. Soft tissue deficit has to be covered by flaps, either local or microvascular.
Bone gaps are best filled with the reliable technique of bone transport. Regenerate bone may be formed proximally,
distally, or at both sites. Acute compression can fill bone gaps and may need a fibular resection. When bone ends dock,
union may be achieved by vertical or horizontal compression. We are presenting a series of 03 cases Case Series; of
non-union tibia with implant failure managed with LRS fixator. 02 patients were managed initially with AO external
fixator, one with plating. Out of three cases, two cases were non infected non unions and one case was infective non
unions. All the three patients were managed secondarily with LRS fixator with less complications and good outcome.
Conclusion; LRS fixator is one of the best options in the management of both infective and non-infective non unions of
the tibia. It helps in both compression and distraction in a single frame with minimal complications. It gives good stability
in the bone which helps in early weight bearing and adjacent joint range of motion
IS HEROISM MASCULINE? A STUDY OF HEROIC POEMS OF CHĀRAN LITERATURE
Authors: Mohan Gadhavi Ashariya
Published: April 2024

This paper attempts to understand the concept of heroism in the heroic poems of Chāran literature.Dingal language,an
art of rendering poetry with its distinct meters and rhythms,was primarily used by the Chāran poets to motivate the kings
and their troops in the battlefield.Since heroism is primarily associated with masculinity,the heroic poems vividly depict
valor and courage as quintessential masculine virtues,highlighting the embodiment of these traits in the protagonists of
Chāran literature. By employing the masculinity studies and heroism as theoretical bases, the paper will illustrate how
the connection of heroism and masculinity is established in the heroic poems of Chāran literature.
MENTAL HEALTH SERVICES IN INDIA: A FALLACY BEHIND M PHIL COURSES
Authors: Mishra R K
Published: April 2024

The development of national mental healthcare infrastructure's capabilities will be significantly shaped by external
linkages. The achievement of the population's Comprehensive Mental Health is largely dependent on the inter-sectoral
collaboration across various Ministries, which is essential to the formulation of public mental health policies. Following
the implementation of the National Mental Health Programme (1982), the Indian government established the National
Mental Health Policy in 2014. In order to safeguard the rights and dignity of people with mental diseases (PwMI), we were
compelled by our commitment to the United Nations Convention on the Rights of Persons with Disabilities to update the
Mental Health Act (1987) and notify the new Mental Healthcare Act (2017). Treatment for mental disorders is now
included in the Jan Arogya Yojna (ABPM-JA) under the Ayushman Bharat Pradhan Mantrai. This new policy approach,
known as National Tele Mental Health Programs (TELE MANAS), aims to give the District Mental Health Programme
(1996) a digital arm to combat the rising rate of mental illness at the local level. It has demonstrated its effectiveness in
ensuring that mental health services are accessible and available at the patient's bedside. The Mental Health Service
System must be strengthened by 2030, and this requires enthusiastic announcements of launching TELE MANAS for our
armed forces personnel and expanding the coverage to various districts India. More mental health specialists,
particularly clinical psychologists and psychiatric social workers, are needed at Ground Zero to realize the objective for
providing fair and high-quality mental healthcare. In accordance with NEP 2020 guidelines, UGC terminated the
Masters in Philosophy (M Phil) program. The validity of the M.Phil. programs in Clinical Psychology and Psychiatric
Social Work was recently extended by the UGC to 2025–2026. However, will this be enough to start offering high-quality
training at our colleges and universities at the start of the 2026–2027 academic year? Will there be enough Clinical
Psychologists and Psychiatric Social Workers available at this time to support Mental Healthcare and meet the
requirements of the International standard for Mental Healthcare and Mental Health Systems? The only major concerns
for Mental Healthcare are the Vulnerable Groups, which include the elderly, young people and transgender. The mere
declaration of a two-year extension to move India closer to being a Viksit Bharat is debatable if there are insufficient of
those MHPs in a nation of 1.45 billion people with diverse demands in every sector. This is an attempt to explore the roles
that Psychiatric Social work and Clinical Psychologist play in providing services in the field of Mental Health. Is the
nation prepared to use "efforts by all" to create a long-lasting mental health care system by 2026?
CASE SERIES OF CYSTIC LYMHANGIOMAS
Authors: B. Amin Alpesh , D. Ahir Jignesh , A. Parmar Karan.
Published: April 2024

Cystic lymphangioma (CL) in adult is a very rare pathology. Its
etiology remains unclear, but it is supposed to be congenital
or to be a result of obstruction and lymph fluid retention of
developing lymphatic vessels. It generally occurs in the head
and neck region, probably because of the rich lymphatics in
this area. It can be easily misdiagnosed with other
cervicofacial masses.Head and neck is the mainly affected
region and symptoms due to local compression can occur
related to the location and the size of the tumor.
E-LEARNING: A PARADISM SHIFT IN INDIAN EDUCATION
Authors: Das Ipsita , Pawar Vindeshwari
Published: April 2024

The National Educational policy (NEP 2020),the first education strategy of the twenty-first century, recognises the value
of exploiting technology's benefits while being aware of its possible drawbacks and risks. We are living in a modern
technological age when technology is present in all aspects of life,including business,industry,agriculture,and health.
Using contemporary information and communication technology for teaching and learning is crucial for the field of
education.This paper evaluates the academic literature and provides a theoretical framework for investigating the idea
of e-learning, specifically its benefits and drawbacks in higher educational institutions.Many online platforms are used
to facilitate e-learning in higher education.Online learning has been described using a variety of terms over the years,
including Computer-mediated learning,Web-based training,E-learning systems,and Learning Management Systems.
Despite of their names, these systems all utilise the Internet and share a few characteristics that enable registration,
evaluation of students' and teachers' actions, as well as lecture delivery and interaction between students, their peers,
and teachers. Among the most crucial features of online learning platforms are forums that enable asynchronous
student-teacher contact and collaboration,web conferences that provide video,audio,and written communication,and
chat,where users can send messages and get responses in real time.It examines several researchers' interpretations of
what e-learning is and how it functions in higher education institutions
DIGITIZATION OF INDIAN EDUCATION: GOVERNMENT INITIATIVES
Authors: Das Ipsita , Pawar Vindeshwari
Published: April 2024

All of us have lately experienced the COVID19 pandemic.The global community as a whole has been impacted by the
corona virus disease. Every aspect has been influenced, including education, economy, social life, etc. Digital
technology is now being used in every industry. As a result of this technological shift, numerous stakeholders in our
educational system are encountering a variety of problems and difficulties. The necessity of the hour is to increase
digital agility through digital education.To ensure the success of digital education, instructors must receive adequate
and effective training that enables them to feel at ease using these cutting-edge delivery systems.To fully profit from this
style of instruction, this should be made available along with well-equipped infrastructure and internet connections in
the most remote regions of the nation.The less fortunate members of society should have access to affordable electronic
devices and technology,which will make online education more accessible and provide everyone with an equal chance.
Between the student and the teacher, learning can be made more dynamic and interesting through this medium. The
tremendous cultural and linguistic variety of India will be greatly helped by digital education. The present study
summarizes government initiatives on fostering digital education, the scope and challenges faced by students in this
virtual classroom environment. This paper primarily based on secondary sources of information that were found on
numerous websites,academic papers,news pieces,and magazine articles.
INTERNET ADDICTION IN YOUNG MEDICAL STUDENTS USING YOUNG'S INTERNET ADDICTION TEST: A CROSS-SECTIONAL STUDY
Authors: Khan Soham , Jha Pratyush , Joshi Sumedha , Velankar Deepa
Published: April 2024

Internet has become an indispensable necessity of modern
times offering multiple benefits such as information,
recreation and communication. However, excessive usage of
Internet has been found to be associated with a host of
problems in some individuals affecting their personal,
professional and social lives.This “loss of control”or “inability
to regulate Internet use” has been termed as “Internet
addiction” at its extreme, and has been compared to a
phenomenon akin to substance abuse leading to an inquiry
into its mechanism, whether its disadvantages outweigh its
advantages and if it can be regulated or minimized by
intervention. It has been found recently by imaging
techniques that prolonged Internet use may result in grey
matter atrophy causing decrease in concentration, memory
1
and executive ability .
IMPACT OF GENDER DISCORDANCE ON OUTCOMES IN LIVING DONOR LIVER TRANSPLANTATION
Authors: N Mehta Naimish , Kirit Akhani Milind , Kumar Karan , Nagar Anand , Mahala Vinay Kumar , Saraswat Vivek Anand
Published: April 2024

Liver transplantation (LT) is a highly effective treatment for
well-selected recipients with end stage liver disease,
fulminant hepatic failure and hepatocellular carcinoma
(HCC).The number of patients awaiting LT continues to grow
[1]. Unfortunately, the tremendous burden of end-stage liver
disease and HCC has not been met with a proportional growth
in organ donation and transplantation. Efforts to continually
refine organ allocation practices to ensure optimal use of this
scarce resource are of paramount importance. Previous
studies have identified gender discordant hepatic
transplants—specifically female (F) donors to male (M)
recipients (FM transplantation)—as resulting in inferior
patient and graft survival rates as compared with gender
concordance (FF or MM) [2].
Towards a Standard Framework for Blockchain Interoperability: A Position Paper
Authors: Belchior Rafael , Scuri Sabrina , Nunes Nuno , Hardjono Thomas , Vasconcelos Andre
Published: April 2024

Decentralized ledger technology (DLT) is becoming ubiquitous in today’s
society. However, organizations need to connect their existing systems
and processes to blockchains (centralized, decentralized) securely and
reliably, sometimes also implying that they need to connect blockchains
(decentralized, decentralized). This challenge is known as blockchain
interoperability.

We put the case forward that academia and industry must propose
evaluation frameworks for blockchain interoperability solutions that
address the three interoperability modes. Those are data transfers,
asset transfers, and asset exchanges. In this position paper, we
illustrate the remaining challenges of interoperability, focusing on the
systematic evaluation of interoperability mechanisms based on the state
of the art and our own experience. Our evaluation is a systematic online
survey of 17 items targeting blockchain specialists. Our quantitative
analysis shows that several interesting metrics can show promising
directions for systematically evaluating integration solutions.
Disproof of Hodge Conjecture by Graph Theory
Authors: Yoon Jihyeon
Published: April 2024

Hodge conjecture is turned out to be false in extension of graph theory based on its algebraic attribute.
A Brief History of Blockchain Interoperability
Authors: Belchior Rafael , Süßenguth Jan , Feng Qi , Hardjono Thomas , Vasconcelos André , Correia Miguel
Published: April 2024

Blockchain interoperability conflates the need for distributed systems
to communicate with third- party systems without the existence of a
canonical chain or orchestration layer. As there is not “a chain to
rule them all” (due to reasons such as performance, privacy, and market
forces), these distributed systems rely on exchanging data and value
across network boundaries. Interconnected systems achieve a higher value
than the sum of their parts, similar to how the Internet emerged as a
set of isolated Local Area Networks (LANs) - and, by force of surprising
synergies, such networks fundamentally transformed society, forever.
Concurrently, in the last decade, we have witnessed the astonishing
development of blockchain technologies, which seem more connected than
ever: via bridges [13, 15, 16, 31], oracles [45], and other
interoperability mechanisms [4, 9, 17, 48, 89]. These recent
developments have, slowly but steadily, contributed to the improvement
of the scalability of blockchain networks, as well as providing new
functionality and use cases [66], but there is still a long way to
go until mass adoption. In this paper, we will dive into the rabbit hole
of blockchain interoperability and explain why it is needed, what has
been done in the last decade, and where it is going.
Speranza: femminile plurale.
Authors: Tosel Natascia
Published: April 2024

Il pensiero critico appare oggi, in molti casi, relegato a circolare in luoghi chiusi ed asfittici. Tale condizione sembra risentire di un mancata connessione con l’ambiente che, attraverso le riflessioni di Deleuze e Guattari sulla geofilosofia, verrà definito come il luogo dell’accadere, ossia dell’incontro con il possibile. Mentre i due autori francesi sceglievano di nominare tale connessione – oggi deficitaria – tra il pensiero e l’ambiente “utopia”, l’articolo proporrà di sostituire tale termine con quello di “speranza”: è di quest’ultima che la critica ha bisogno per tornare a respirare. La speranza verrà declinata, in particolare, in chiave postcritica come postura teorica situata  nello spazio comune, come domanda aperta ai rischi della contingenza e come affetto performativo capace di una “careful translation” del nostro lessico politico.
PELATIHAN PENGELOLAAN KEUANGAN DAN PROMOSI DIGITAL UNTUK UMKM
Authors: Ardiansyah Lalu Yayan , Palit Juliana , Prasetyo Rahman
Published: April 2024

Small and medium businesses are increasingly developing along with advances in industrial technology and tourism in Lombok. Based on data from the Central Statistics Agency, the city of Mataram ranks first in the number of MSMEs in NTB with a total of 22,473 as of July 2021. MSME problems in the city of Mataram are still constrained by capital, licensing, raw materials, product marketing, financial management and innovation. Findings from research conducted by the Bumigora University Community Service Team, from a total of 100 MSMEs that have been surveyed, state that capital is the biggest obstacle for MSME players in developing business with a percentage of 37%, financial management 30%, promotion 17%, raw materials 15 %, and others 11%. Based on observation data, action is needed to overcome MSME problems and help develop the businesses of MSME actors in Mataram City. The Bumigora University Community Service Team tries to facilitate MSMEs in facing challenges, especially those related to financial management and promotion by conducting training for MSME players. MSME training is packaged in the form of workshops accompanied by practice in making financial reports and carrying out digital promotions as a follow-up to this training.
Research on Accounting Revenue, Costs and Business Results in Some Countries around the World and Lessons Learned for Vietnamese Businesses
Authors: Duong Thi Quynh Lien , Vo Thi Mai Huong , Hoang Thi Thanh Hue , Nguyen Thi Hoai , Tran Thi Khanh Huyen , Nguyen Thi Phuong Trinh
Published: April 2024

The article is based on the study of influencing factors, accounting models, standards, accounting work in general and characteristics of accounting for revenue, costs and business results in countries around the world gender in particular. From there, lessons learned will be drawn to help information users determine their economic benefits and make decisions appropriate to each subject's unique needs and goals. Correctly determining and providing accurate information about revenue, costs and business results contributes to improving the efficiency and business reputation of the enterprise. The important factor contributing to ensuring safety, enhancing competitiveness as well as the ability to achieve high efficiency when making business decisions to help businesses develop is thanks to good management of revenue and expenses. Costs and business results. By using the method of researching secondary documents, including documents and textbooks on accounting theory of revenue, costs and business results, on the basis of dialectical and materialist methodology. Historically, the article has used a number of different research methods such as: investigation, analysis, and systematization methods; Comprehensive method to research, evaluate and present issues related to accounting for revenue, costs and business results in countries around the world, thereby drawing lessons for businesses Vietnam.
Beyond Reuse, Reinvent: Circular Innovations Reshaping Musandam's Food Sector
Authors: Ines Joefrelin C. , Funtinilla Reynald A. , Shahri Ahmed Al , Matroshi Gharib Al , Shehhi Ali Al , Shehhi Khalid Al
Published: April 2024

Musandam's vibrant food service industry is integral to its tourism, facing challenges with substantial waste and inefficiencies in resource management. The study transcends conventional reuse strategies, focusing on pioneering circular innovations poised to revolutionize small and medium-sized enterprises (SMEs) for a sustainable and prosperous future. Examining the implementation and potential of circular economy innovations among SMEs, the study investigated cutting-edge technologies and business models to drive resource efficiency, create fresh economic opportunities, and nurture sustainability. It aimed to blueprint a successful transition to a circular economy through empirical analysis, aligning with national sustainability objectives and environmental conservation. The study assessed resource utilization and waste streams across diverse SME sectors, identified promising circular innovations, developed a comprehensive roadmap for a successful circular transition, and evaluated these innovations' economic, environmental, and social impacts. The research hypothesis posits that these innovations significantly enhance resource efficiency, diminish waste, and elevate performance compared to traditional methods. Employing a holistic framework informed by circular economy theory, sustainability frameworks, and quantitative method data analysis, the research considered technological advancements tailored to various sectors' specific needs. This approach aims to foster a sustainable and thriving future for Musandam's SMEs, harnessing the transformational potential of circular innovations. The study culminated in a comprehensive roadmap, encompassing technical guidance and policy frameworks to empower the entire sector. Beyond waste reduction, it scrutinized effects on employment, profitability, and community well-being, ensuring a sustainable trajectory for Musandam's food service sector aligned with Oman's Vision 2040 goals. Equipping businesses with tools .........
Integration of Internally Displaced Children in the Labour Market During a Period of Crisis Related to Cultural Depravity in the Mayo Tsanaga Division - Far North Region of Cameroon
Authors: Damien Noma Eloundou , François Edongo Ntende Pierre
Published: April 2024

Objective: This article takes a holistic look at the integration of internally displaced children, who have graduated or are in the final stages of a general education course, into the labour market in a crisis situation in the Department of Mayo Tsanaga. Method: This anthropological research is based on empirical data collected from students, MINEDUB/MINAS officials, NGOs and members of the host community. Before going into the field, an information note indicating the purpose of the study, the period of the study and the profile of the interviewer was sent to the administrative authorities. As in all qualitative research, the saturation point was reached after ten interviews, i.e. until it seemed that no new information could be obtained. The interviews were conducted individually in the locations requested by the respondents, and then recorded using a Dictaphone, and sometimes by Android telephone. Results: This article takes a holistic look at the integration of internally displaced children who have completed their schooling into the labour market. The analysis shows that no specific measures are being taken by the Cameroon government and its implementing partners in charge of education to recruit this vulnerable group who, despite the difficulties they face as a result of forced displacement, have nonetheless managed to complete their schooling. Discussion: The particularity of this article is that, in addition to being situated between forced displacement, terrorism and formal education, as UNESCO states, "in a crisis situation you have to save education". With cultural connectivity as its Ariadne's thread, this article mobilises the measures taken by stakeholders to encourage or compel parents to contribute to their children's education despite the hostilities, insecurity and armed conflicts that have arisen. Conclusion: The IDPs who are the subject of this study come from villages and communities in the Mayo Tsanaga department, with different cultures and d
The Dynamics of Caring for the Education of Internally Displaced School-Age Children: Teaching During a Crisis in the Mayo Tsanaga Department
Authors: Damien Noma Eloundou , Luc Pr Mebenga Tamba
Published: April 2024

Objective: The aim of this article is to examine the changes made by stakeholders in the provision of education for internally displaced school-age children during periods of crisis in the Department of Mayo Tsanaga. Method: Data was collected using development anthropology techniques from basic education authorities responsible for the education of displaced school-age children, implementing partners, parents or families of IDPs, pupils and informants likely to provide relevant information on this target group in the department of Mayo Tsanaga. The data was collected during the writing of our PhD thesis in Anthropology. Documentary research was also carried out. A total of 20 in-depth interviews were conducted in the locality of Zamai and surrounding villages with a split between urban and rural areas over a period from 15 November 2021 to the present day. Results: It has been shown that controlling the numbers of these displaced persons is a prerequisite for better planning and better integration into the education sector. The different forms of education will not eliminate the risk of conflict between individuals or groups of individuals, but they will enable people to know how to manage them and prevent them from degenerating into armed conflict, civil war or even genocide. Discussion: The particularity of this article is that, as well as being situated between forced displacement, terrorism and formal education, it takes a holistic look at the measures taken by stakeholders to encourage or compel parents to contribute to their children's education despite the hostilities, insecurity and armed conflicts that have arisen. Conclusion: The IDPs who are the subject of this study come from surrounding villages and Districts, with different cultures and differing apprehensions about formal education for their children.
Analysis of Factors Affecting the Occurrence of Burnout Syndrome among Healthcare Workers in Batakte Health Center, Kupang Regency
Authors: Ke Hellen Tryani Mone , Lerik Dinah Charlota , Berek Noorce Christiani , Ratu Jacob M. , Ruliati Luh Putu
Published: April 2024

This study aims to analyze the factors that influence Burnout Syndrome in health workers at the Batakte Health Center, Kupang Regency. The method used is a quantitative research method with a cross sectional design. The sampling technique uses total sampling. The results showed that the results of the chi-square analysis showed no effect of age (p = 0.771), gender (p = 0.375), education (p = 1.000) on the incidence of burnout syndrome in health workers in the Working Area of the Batakte Health Center, Kupang Regency. There is an influence of marital status (p = 0.033), length of work (p = 0.002), workload (p = 0.001), social support (p = 0.002) on the incidence of burnout syndrome in health workers in the Working Area of the Batakte Health Center, Kupang Regency. Simultaneously, the variables of length of work (OR 6.352), workload (OR 6.647) and social support (OR 4.555) have an influence on the incidence of burnout syndrome in health workers in the Working Area of the Batakte Health Center, Kupang Regency. The workload variable is the most dominant variable that has an influence on the incidence of burnout syndrome in health workers with OR (7.163), p=0.000, CI=2.466-20.808. In conclusion, the factors that influence Burnout Syndrome in health workers are workload.
Visual and Surgical Outcomes in Late Presentation of Retinal Detachment
Authors: Talpur Bibi Rafeen , Fariha Sher Wali  , Memon Shahzad , Surhio Waqas Ali , Younus Maryam
Published: April 2024

Purpose:  To evaluate the frequency of treatment success in terms of visual and surgical outcomes in patients with late presentation of retinal detachment.
Study Design:  Quasi experimental.
Place and Duration of Study:  Sindh institute of Ophthalmology and visual Sciences from June 2022 to January 2023.
Methods:  A total of 50 eyes of 50 patients with delayed presentation of retinal detachment who underwent Pars Plana Vitrectomy (PPV) were included and followed up for 6 months. Preand post-surgery Best Corrected Visual Acuity (BCVA) and anatomical attachment of retina were comprehensively analyzed. Factors affecting an atomical success were also studied.
Results:  Mean age of patients was 47±18 years. Twenty seven patients were (54%) were more than 45 years of age and 32(64%) were males. Thirty eight (76%) patients achieved successful anatomical attachment of retina at 6th month follow-up. Post-operative BCVA also showed improvement in vision.Risk factors identified for poor anatomical and visual outcome following PPV for retinal detachment are; PVR advance stage, longer duration of visual symptoms and poor-presenting BCVA. Age, sex, laterality, Pre-operative BCVA, lens status, diagnosis, and type of surgery showed insignificant associations (P >0.05).
Conclusion:  Anatomical failure and poor functional outcomes appear to be mostly caused by PVR. PVR, longer duration of visual symptoms and poor-presenting VA are risk factors for poor anatomical and visual outcome following PPV surgery for RD. Late presentations to clinics can decrease with mass awareness. The frequency of  proliferative vitreoretinopathy would decline, and visual results would be improved.
Late-Onset Capsular Block Syndrome: A One Year Follow-up Case Report
Authors: Ludovico Iannetti1  , David Shaholli  , Mauro Salducci
Published: April 2024

We report a case of late Capsular Block Syndrome (CBS) in a patient who underwent cataract surgery 12 years back. It was diagnosed with slit-lamp examination and by using anterior segment optical coherence tomography (AS-OCT) that showed hyper-reflective material trapped in the capsular bag, between the IOL posterior surface and the posterior capsule. Anterior capsule fibrosis was seen in both eyes but in the left eye capsulorhexis showed irregular margins and had a smaller diameter compared to the right eye. The CBS was treated with Nd:YAG laser capsulotomy allowing rapid evacuation of liquid towards the vitreous chamber. Complete resolution of CBS was confirmed by AS-OCT. Best Corrected Visual Acuity (BCVA) of left eye improved from 0.2 logMAR before treatment to 0.0 logMAR one week  after treatment. BCVA remained unchanged after one year of follow-up with no sign of new posterior capsular fibrosis.
Role of Optical Coherence Tomography Angiography in Predicting Risk of Progression of Diabetic Retinopathy
Authors: Ghazipura Arifa , Achakzai Najeebullah , Gaintry  , Aziz ur Rehman  , Alyscia Marium Cheema
Published: April 2024

Purpose:  To determine the role of Optical Coherence Tomography Angiography (OCTA)in predicting risk of progression of diabetic retinopathy.
Study Design:  Descriptive observational study.
Place and Duration of Study:  Jinnah Post graduate Medical Center, Karachi, from June 2022 to June 2023.
Methods:  Patients with type 1 or 2 diabetes were included. Base line investigations were done including Central subfield thickness and OCTA at first visit. Second visit was conducted at 6th month and patients were followed for 24 months.OCT images of poor quality, motion artifact, inaccurate partition of tissue layers and blurry images were excluded.
Results:  Among 97 enrolled patients, 88 cases finished the complete 24-months follow up. Out of 88 patients, 16 (18.18%) patients showed progression of diabetic retinopathy (DR), 9 (10.22%) patients developed DME, two showed both DR and DME .In univariate analysis, greater FAZ area, reduced FAZ circularity, Fractal dimension (FD) and vessel density (VD) of the deep capillary plexus (DCP) were significantly related to the advancement in DR. Among these, FAZ area, VD, and FD remained significant in the multivariate analysis. Whereas, only decreased VD and FD of superficial capillary plexus (SCP) were significantly related to advancement in DR and DME.
Conclusion:  Changes in OCTA parameters is significantly associated with progression of diabetic ocular complications including diabetic retinopathy and diabetic macular edema. High risk subjects can be identified by this method for more rigorous treatment.
Awareness and Knowledge About RefractiveSurgery Among Medical Students in Baghdad
Authors: Suzan Amana Rattan  , Muayad Ridha Ruba , Qhatan Majeed Batool , Zaki  Hussien , Zahraa , Ali Abdullah Nabaa
Published: April 2024

Purpose:  Refractive error represents a common eye disorder that can significantly impact an individual's visual function and overall well-being. There are several methods of correcting refractive errors and objective of this study was to assess the awareness of refractive surgery and the preferred methods of refractive error correction among medical students in Baghdad.
Study Design:  Cross sectional survey.
Place and Duration of Study:  University of Baghdad Al-Kindy College of Medicinefrom November 2022 to March 2023.
Methods:  Medical students from six Baghdad medical colleges with total sample size of 350 were included. Students who had undergone refractive surgeries and fifth and sixth year medical students were also excluded. Level of knowledge was categorized as; <50% (0-5) poor knowledge, 50-70% (6-8) moderate knowledge and >70% (9-12) good knowledge.
Results:  Among the students with refractive errors, 82% had knowledge about their refractive error. Forty percent had myopia, 12% had astigmatism, 15 % had myopia and astigmatism, 10%  had hyperopia, 5% had hyperopia and astigmatism. Among them 57.8% were not willing to undergo refractive surgery due to fear of complications. Forty eight percent had poor knowledge,43.1% had moderate and only 8.26% had a good knowledge of refractive surgeries. The majority preferred eyeglasses (82.6%) followed by both eyeglasses and contact lenses.
Conclusion:  Students had good awareness about refractive surgery but their familiarity and knowledge about it remained poor because of complications. An overwhelming majority of students still preferred spectacles as the method for vision correction.
Comparison of α-Smooth Muscle Actin (α-SMA) and Collagen Type III Expression after Conjunctival Excision Between Platelet-Rich Fibrin (PRF) Membrane and Conjunctival Autograft Treatment: An Animal Model Experimental Study on Oryctolagus cuniculus
Authors: Indri Wahyuni  , Reni Prastyani  , Agung Bhakti Wiratama  , Ismi Zuhria  , Thomas Valentinus Widiyatno
Published: April 2024

Purpose: To evaluate the impact of Platelet-Rich Fibrin (PRF) membrane and conjunctival autografts on α-Smooth Muscle Actin (α-SMA) and type III collagen expression following conjunctival excision in Oryctolagus cuniculus.
Study Design: Experimental study with a randomized post-test only design.
Place and Duration of Study: Airlangga University, Surabaya in November 2022.
Methods: Twenty rabbit eyes were categorized into two groups: those sutured with PRF membrane and those sutured with conjunctival autografts after temporal conjunctival excision. The study assessed α-SMA and type III collagen expression through the Immunoreactive Score (IRS) method.Data analysis is conducted using appropriate statistical methods, such as the t-test or Mann-Whitney U test, to compare the expression of α-SMA and collagen type III between the two groups.
Results: The data for each sample represented the average IRS value observed at 200x magnification. In the conjunctival autograft group, the mean IRS of α-SMA expression was 5.52 ± 0.84,
Coexistence of Diabetic Retinopathy and Diabetic Foot in Patients Admitted at Indoor Facility of a Tertiary Care Center
Authors: Matloob Rana Afia , Yousafzai Erum , Gul Humara , Akhter Waseem
Published: April 2024

Purpose:  To determine frequency of “diabetic retinopathy (DR)” in patients admitted at a tertiary care hospital with diabetic foot.
Study Design:  Cross sectional study.
Place and Duration of Study:  HBS medical and dental college, Islamabad from November 2022 to November 2023.
Methods:  Sixty two patients admitted with “diabetic foot ulcer”(DFU) were included in this study. Severity of DFU was assessed using . Patients were assessed for presence of “diabetic retinopathy (DR)” as well as its severity. Data was analyzed using SPSS 22.
Results:  Mean age was 49.37 ± 11.02 years. There were 34 (54.84%) males and 28 (45.16%) females. Mean HbA1C% was 9.46 ± 1.11%. Mean duration of diabetes was 10.06 ± 5.53 years. Forty five percent patients had diabetic retinopathy (DR). Amongst these patients diagnosed with DR (n = 45), 6 (13.33%) had mild non-proliferative DR, 20 (44.44%) had moderate non-proliferative DR, 14 (31.11%) had severe non-proliferative DR and 5 (11.11%) had proliferative DR. According to Wagner Grade there were 32 (51.61%), patients with grade 2 DFU, 19 (30.65%) had grade 1 and 11 (17.74%) had grade 3. Coexistence of diabetic retinopathy and diabetic foot in patients admitted at indoor facility was 72.58%.
Conclusion:  Prevalence of “diabetic retinopathy (DR)” in patients admitted with diabetic foot was 72.58%. Presence of diabetic foot can be considered as strong predictor of presence of concomitant “diabetic retinopathy”.
RECONSTRUÇÃO FACIAL PÓS-TRAUMA E SUAS IMPLICAÇÕES PSICOSSOCIAIS
Authors: Araújo Waléria Pinheiro de , Justino Pedro Henrique de Souza Honório , Honório Renata Mendes de Abreu , Alencar Maria Idaiana Carvalho , Barros Artur Henrique Oliveira , Nascimento Aline Vieira do , Bortolato Leila da Silva , Leu Natasha Simoes De , Franco Ester Denyse da Silva , Silva Paula Eloíse Duarte , Júnior Paulo César Gajo , Leão Larissa Viana Vasconcelos Carneiro , Souza Marco Antonio De Bem de , Soares Vinícius Belém Rodrigues Barros , Silva Leandro Campos , Marques Diego César , Ramires Marcelo André , Ramires Roseane Del Arco , Martins Iago Sarti , Soares Giselle Amiska
Published: April 2024

O objetivo deste artigo é revisar criticamente a literatura atual sobre da reconstrução facial pós-trauma e suas implicâncias psicossociais. Realizou-se uma extensa revisão da literatura para identificar estudos relevantes acerca da proposta do presente estudo. Bases de dados eletrônicas, como PubMed, Scielo e Google Acadêmico, foram consultadas para obter artigos publicados. O estudo enfatizou a importância de abordagens integradas e multidisciplinares no tratamento da reconstrução facial pós-trauma. Os resultados destacaram o papel fundamental de procedimentos cirúrgicos e terapias de reabilitação na restauração da função e estética facial, assim como a necessidade de intervenções psicossociais para promover o bem-estar mental dos pacientes. O suporte social e familiar foi considerado crucial para fortalecer a resiliência dos indivíduos e facilitar sua adaptação às mudanças físicas e emocionais. Conclui-se que uma abordagem holística é essencial para garantir uma recuperação completa e uma melhor qualidade de vida para os pacientes submetidos à reconstrução facial pós-trauma.
TERAPIAS CONSERVADORAS PARA LA FISURA ANAL: ABORDAJE DESDE LA ATENCIÓN PRIMARIA.
Authors: Alban Miguel Anderson Tayupanta , Roballino Zully Stefania Cedeño , Polo Jazmin Natalie Gallegos , Almeida Josselin Fabiola Chávez , Ponce Arianna Lissette Muñoz , Frias Paula Katherine Soria , Ramón Dayanna Briggitte  Obando , Chaguay Lissett Stefania Condo , Jiménez Paola Anabel Hurtado , Antepara Bismarck Stiven Pazmino , Romero Santiago Paul Lopez
Published: April 2024

El diagnóstico y tratamiento de la fisura anal en el entorno de atención primaria requiere estrategias específicas que incluyen la anamnesis detallada, el examen físico y en algunos casos pruebas complementarias.  Además, el manejo terapéutico inicial se centra en medidas conservadoras y farmacológicas para aliviar los síntomas y promover la curación de la fisura anal. Objetivo: El propósito de esta revisión bibliográfica es evaluar de manera integral las terapias conservadoras utilizadas en el abordaje de la fisura anal, con un enfoque particular en su aplicación en el entorno de la atención primaria. Metodología: Se realizó una búsqueda exhaustiva en bases de datos como PubMed, Scopus y Web of Science utilizando descriptores de salud y se analizaron un total de 12 artículos relevantes y finalmente se llevó a cabo un análisis narrativo para sintetizar los resultados, destacando las tendencias y conclusiones más relevantes encontradas en la literatura revisada Resultados: La anamnesis detallada y el examen físico son cruciales para el diagnóstico preciso de la fisura anal, mientras que las pruebas complementarias se reservan para casos más complejos. El tratamiento inicial no quirúrgico se basa en cambios en la dieta, baños de asiento y el uso de medicamentos tópicos, con el objetivo de reducir el tono muscular anal y promover la curación. Conclusión: Las estrategias de diagnóstico y tratamiento de la fisura anal se centran en un enfoque integral que combina la evaluación clínica, el manejo conservador y el uso selectivo de pruebas complementarias, permitiendo un abordaje efectivo y seguro.
INFLUÊNCIA DO PARTO POR CESÁREA NO DESENVOLVIMENTO DO TRANSTORNO DO ESPECTRO AUTISTA (TEA): UMA ANÁLISE DOS POSSÍVEIS IMPACTOS NEUROBIOLÓGICOS
Authors: Jarussi Mariana Benicio
Published: April 2024

O presente trabalho teve como objetivo geral analisar os possíveis impactos neurobiológicos do parto por cesárea no desenvolvimento do Transtorno do Espectro Autista (TEA). Como objetivos específicos: abordar a definição e classificação desse transtorno; investigar os mecanismos neurobiológicos propostos que podem explicar a relação entre o parto por cesárea e o risco de TEAs. Esta pesquisa é relevante devido à importância de compreender os fatores que podem contribuir para o desenvolvimento do TEA, uma condição complexa e multifatorial. A análise dos possíveis impactos neurobiológicos do parto por cesárea nesse contexto pode fornecer informações valiosas para a prevenção e intervenção precoce no TEA, além de destacar a necessidade de abordagens mais personalizadas na assistência obstétrica para promover a saúde neurológica e o bem-estar das crianças. Constituíu- se de uma revisão de literatura como método de pesquisa. O estudo foi realizado por meio de busca on-line com levantamento bibliográfico de reproduções científicas, no período de 2017 a 2023, disponíveis em artigos na Scielo, Lilacs, Medline. Na busca foram utilizados os seguintes descritores: parto cesáreo; aspectos neurobiológicos; transtorno do espectro autista. Após uma análise criteriosa dos estudos disponíveis, é possível concluir que a relação entre cesárea e TEA é complexa e ainda carece de esclarecimentos definitivos. Embora alguns estudos sugiram uma associação entre a cesárea e um maior risco de TEA, outros não encontram essa ligação de forma consistente, ressaltando a necessidade de mais pesquisas longitudinais e estudos controlados para validar essas descobertas.
POLUIÇÃO AMBIENTAL E A OCORRÊNCIA DO AVC NO MUNDO: PERSPECTIVAS PARA O BRASIL
Authors: PEREIRA DA SILVA RICARDO , Silva Costa de Moraes Raquel Gabrielle , Domingos da Silva Érica , Pereira de Santana Gabriel , De Souza Araujo Ana Caroline , Morena Soares Oliveira Santos Bárbara , De Andrade Macêdo Flávia , Meira Monteiro Martha , Pires Cruz Diego
Published: April 2024

Objetivo: analisar as associações entre poluição do ar e a ocorrência de AVC no mundo, com perspectivas para a realidade brasileira. Métodos: Trata-se de uma revisão integrativa da literatura, de cunho qualitativo e descritivo cuja construção obedeceram as seguintes etapas: escolha do eixo temático, identificação do tema, definição dos descritores, seleção dos artigos escolhidos, interpretação dos assuntos abordados e discussão das sínteses compreendidas. Resultados: Nesse contexto, percebeu-se que o risco de AVC isquêmico e de hemorrágico associados à poluição da atmosfera tem maior pronunciamento em países de rendimento baixo e médio. Dessa maneira, poluentes a exemplo do PM10 e do dióxido de Azoto tiveram concentrações atmosféricas mais elevadas em países de baixa e média renda. Já em países de alta renda, mesmo com concentrações comparativamente baixas de poluentes e, consequentemente, menor risco associativo de AVC do que as unidades federativas de condição socioeconômica inferior, a exposição a níveis de Carbono Negro e PM2,5 tiveram relação significativa com a ocorrência de acidente vascular cerebral. Conclusão: Conclui-se que os estudos recentes acerca da poluição ambiental se relaciona com a ocorrência de AVC no mundo e aponta a existência de uma relação maléfica entre o contato com poluentes atmosféricos, em especial o material particulado fino que, ao interagir com o organismo humano, é capaz de colaborar para o desenvolvimento do AVC.
CROHN'S DISEASE AND GASTROINTESTINAL REPERCUSSIONS: A DETAILED STUDY OF COMORBIDITIES AND CLINICAL IMPLICATIONS
Authors: Ramos Júlia Cristina de Sousa , Rezende Eduardo Henrique Mendes , Filho Murilo Dell Eugenio Costa , Silva Daniel Oliveira , Schimin ⁠Mayra Algeri , Araújo Lucas Torres de , Alves Natana Carol , Pinheiro Bruno Barbosa , Lemos Pedro Henrique Kuert
Published: April 2024

Crohn's disease is a chronic inflammatory condition that affects the gastrointestinal tract, characterized by transmural and segmental inflammation that can involve any part of the digestive system, from the mouth to the anus. This pathology presents a wide range of clinical manifestations, including abdominal pain, diarrhea, rectal bleeding, fistulas, strictures and even extraintestinal complications. The complexity of Crohn's disease lies not only in its varied clinical presentation, but also in its comorbidities and clinical implications, which can significantly affect patients' quality of life and require multifaceted therapeutic approaches. Objective: To identify and synthesize the evidence available in the scientific literature over the last 10 years on the comorbidities and clinical implications of Crohn's Disease, in order to provide a comprehensive and updated view of this aspect of gastrointestinal pathology. Methodology: The systematic review was carried out in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scielo and Web of Science databases were used to identify relevant studies published in the last 10 years. The descriptors used were "Crohn's disease", "gastrointestinal manifestations", "comorbidities", "clinical implications" and "systematic review". The inclusion criteria involved studies that specifically investigated the comorbidities and clinical implications of Crohn's Disease, with results available in English, Spanish or Portuguese. Exclusion criteria included duplicate studies, case reports and studies with small samples or less robust methods. Results: Analysis of the selected studies revealed a wide variety of comorbidities associated with Crohn's disease, including arthritis, dermatitis, uveitis, osteoporosis and liver disorders. Furthermore, the significant clinical implications of Crohn's disease were highlighted, such as increased risk of hospitalizations, need for intestinal surgeries and impact on patients' quality of life. Conclusion: Crohn's disease presents a clinical complexity that goes beyond intestinal manifestations, with a series of comorbidities and clinical implications that require an integrated and multidisciplinary approach in its management. This review highlights the importance of understanding these aspects to improve the care and quality of life of patients with this chronic gastrointestinal condition.