bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of a single treatment with a Q-switched ruby laser and a Q-switched Nd:YAG neodymium laser for blue and black tattoo removal
Authors: Pinson Igor Y. , Verchoglyad Irina V. , Kirilyuk Tat’yana I.
Published: April 2023

BACKGROUND: Black and blue tattoo pigment are the most commonly used colors and can be injected at different depths. The effectiveness of tattoo removal is related to the selected wavelength, type of laser, energy parameters, number of procedures performed. Q-switched (QS) ruby and neodymium (Nd:YAG) lasers are most effective in removing blue and black tattoos due to their high peak power and ability to break the pigment into small particles that are absorbed by the macrophage system. In the literature available to us, it was not possible to find data on comparative efficacy and adverse events in their application.
AIM: comparison of single treatment of blue and black tattoos with QS ruby laser (wavelength 694 nm) and neodymium Nd:YAG laser (wavelength 1064 nm).
MATERIALS AND METHODS: 35 patients with blue and black tattoos were included in our study. The tattoos were divided into two parts or two adjacent tattoos were used on the same part of the body with the same density and color of the tattoo pigment; one side was treated with a ruby laser and the other with a neodymium laser. The comparison took into account the instantaneous reaction, the result of processing and side effects. Statistical significance was set at a power level 0.05.
RESULTS: Edema and erythema were more common immediately after ruby laser treatment (power 0.05). The neodymium QS laser lightened tattoos better than the ruby QS laser after a single treatment (0.05 power). There was no difference in side effects between the two types of lasers.
CONCLUSIONS: Neodymium Nd:YAG QS laser shows more efficiency and fewer procedures when removing blue and black tattoos. The instantaneous reaction after treatment with this type of laser is less pronounced than after the ruby laser.
Efficacy and safety of early treatment of patients with skin psoriasis and axial arthritis with IL-17 inhibitors
Authors: Pereverzina Natalia O. , Kruglova Larisa S. , Korotaeva Tatiana V.
Published: April 2023

BACKGROUND: On average, within 7 years from the debut of skin psoriasis, patients may develop psoriatic arthritis, characterized by a chronic, relapsing progressive course. Early manifestations of psoriatic arthritis may be axial lesions presenting with inflammatory back pain. Currently, many experts are raising the topic of early prescription of genetically engineered biological drugs for axial lesions in order to prevent disability. Members of the GRAPPA expert group (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) currently do not provide specific recommendations for the treatment of axial lesions in psoriatic arthritis. The most commonly used regimens are those for axial spondyloarthritis and ankylosing spondylitis. There are also no treatment regimens for early manifestations of axial lesions in patients with smooth skin psoriasis without an established diagnosis of psoriatic arthritis. All regimens consider axial lesions in patients who have already been diagnosed with psoriatic arthritis. Thus, it is necessary to form interdisciplinary standardized protocols for the management of such patients.
AIM: to investigate the efficacy and safety of IL-17 inhibitors in axial lesions in patients with skin psoriasis.
MATERIALS AND METHODS: A prospective non-interventional comparative multicenter study was conducted in parallel groups of patients with smooth skin psoriasis (n=87). To study the effectiveness of the developed method of therapy, the formation of comparison groups is provided. 3 variants of therapy were analyzed: IL-17A inhibitors (n=21; group 1, main); methotrexate (n=35; group 2, comparison); standard desensitizing therapy was used in group 3 (n=31; control). The distribution into groups was carried out taking into account the severity, prevalence of the skin process (according to PASI, BSA), the quality of life of the patient (according to DLQI), the patient's wishes and the patient's ability to purchase genetically engineered biological drugs.
RESULTS: According to our results, the use of IL-17A inhibitors shows high efficiency: by week 52, 100% of patients reached the level of PASI 75, 90.5% ― PASI 90 and 85.7% ― PASI 100, NAPSI 100 (Nail Psoriasis Severity Index) was observed in 71.4% patients. All patients reported a reduction of pain at 12, 24 and 52 weeks with a mean BASDAI of 5.9 (SD=2.3), 4.1 (SD=1.3), and 2.7 (SD=0.9), respectively. It was found that 90.5% of patients achieved ACR 20 by the end of the study at week 52. The majority of patients (85.7%) achieved remission or low DAPSA disease activity after 24 weeks of therapy. The mean ASDAS at 12, 24, 52 weeks was 3.07 (0.9), 2.2 (1.0), and 2.3 (0.9), respectively.
CONCLUSIONS: Thus, in patients with skin psoriasis and axial lesions, it is recommended to make the earlier prescription of biologic treatment from the group of IL-17 inhibitors in order to prevent the development of severe forms of psoriatic arthritis and human disability.
Influence of the cream with filaggrin activity modulator for dry and sensitive skin in children with mild to moderate severity atopic dermatitis on objective indicators of skin barrier function and disease severity indices
Authors: Zaslavsky Denis V. , Barinova Anna N. , Plavinskij Sviatoslav L. , Zelyanina Maria I. , Zakharova Irina N. , Berezhnaya Irina V. , Shartanova Natalia V. , Sidorovich Olga I.
Published: April 2023

BACKGROUND: Atopic dermatitis is a chronic, relapsing and severely itchy dermatitis that usually occurs in childhood and has a characteristic age-related distribution. Atopic dermatitis is relatively frequent, affecting 1020% of children in developed countries. Atopic dermatitis in children associated with poor school performance, low self-esteem and family problems. Recent studies show importance in atopic dermatitis pathogenesis of protein filaggrin and modulation of its activity may be a promising direction in the pathogenic therapy of atopic dermatitis.
AIM: to study the effect of a cream for dry, sensitive and atopic skin with a modulator of filaggrin activity on the course of mild and moderate atopic dermatitis.
MATERIAL AND METHODS: An open, prospective, multicentre, non-comparative, single-group clinical trial was organized to test the effectiveness of a cream with a filaggrin activity modulator. The study was on outpatients in the participated centers and included 5 visits with a screening visit 1, and 5th visit ― therapy completion. Cream was used for 12 weeks. In total, the study involved 60 children aged 3 to 18 years with diagnoses of atopic dermatitis of mild and moderate severity. The severity of atopic dermatitis was measured with the SCORAD, EASI, IGA scales, also measured was skin pH and transepidermal water loss (TEWL), as well as the severity of xerosis according to visual analogue scale.
RESULTS: The severity of atopic dermatitis in children whose therapy regimens included Admera cream decreased by 19.6 points according to the SCORAD index, including in children who did not receive mometasone furoate in the therapy schemes, the SCORAD index decreased statistically significantly compared to the baseline data (p 0.001). The overall decline in the EASI index ― by 3.0 points, the IGA global assessment index ― by 2.0 points, the severity of xerosis decreased by 3 points (in all cases, p 0.001). Transepidermal water loss decreased (by 4.5 g/m2 per hour, p 0.001); Skin pH did not change (difference 0.02, p=0.34). The smell was rated as "excellent" by 86.7% (95% CI 75.494.1), the consistency ― by 83.3% (95% CI 71.591.7) of the respondents, and overall satisfaction was noted by ― 88.3% (95% CI 77.495.2) of the respondents.
CONCLUSION: Сream for dry and sensitive skin with a modulator of filaggrin activity during the study showed good efficacy and tolerability and can be used in atopic dermatitis treatment regimens as a basic care product, both during exacerbation and remission.
Restoration of elbow active flexion in children with amyoplasia: What is the better age to do the operation?
Authors: Agranovich Olga E. , Petrova Ekaterina V. , Trofimova Svetlana I. , Batkin Sergey F. , Kochenova Evgeniya  A. , Kenis Vladimir M. , Sapogovskiy Andrey V. , Melchenko Evgenii  V. , Afonichev Konstantin A. , Blagoveschenskiy Evgeniy D.
Published: April 2023

BACKGROUND: The absence of active elbow flexion is the most common problem in children with amyoplasia, leading to daily living difficulties. Many variants of muscle transfer are used for the restoration of active elbow flexion. The pectoralis major and latissimus dorsi muscles are the most used muscles for this purpose; however, the optimal age for these operations is not reported in the literature.
AIM: This study aimed to determine the optimal age of children with amyoplasia for the restoration of active elbow flexion.
MATERIALS AND METHODS: The retrospective study involved 61 patients (90 upper limbs) with amyoplasia (30 [49%] girls and 31 [51%] boys) who were examined and treated between 2011 and 2020. In 46 (51.1%) cases, we used major muscles, and in 44 (48.9%) cases, the latissimus dorsi muscle was used as a donor muscle. All patients were divided into four groups: group 1 included children aged 13 years (n = 17, 27.9%); group 2, 37 years (n = 30, 49.2%); group 3, 711 years (n = 8, 13.1%), and group 4, 1218 years (n = 6, 9.8%). The clinical examination of the patients was conducted before and after the operation (6 months). Statistical data processing was performed using Statistica 10 and SAS JMP 11. To describe the numerical scales, the average value and standard deviation (M SD) were used.
RESULTS: The age of the patients at the time of surgery was 5.16 3.72 years, and the postoperative follow-up period was 41.93 30.13 months. Elbow flexion contractures were observed mainly in groups 13 (p 0.05). The greatest changes in indicators such as the strength of forearm flexor muscles, active elbow flexion, and function of the elbow were noted in group 1 (p 0.05). The same postoperative indicators were worse in group 4 than in younger patients (p 0.05). Groups 3 and 4 had less strength of the donor muscles than groups 1 and 2 (p 0.05).
CONCLUSIONS: The retrospective analysis of the results of the restoration of active elbow flexion in children with amyoplasia allowed us to recommend these operations in children aged 13 years. The prevention of elbow flexion contractures and the formation of a new stereotype of movement help improve the self-ability of these patients and the treatment results.
Results of the first Russian Delphi survey on the diagnosis and treatment of flatfoot in children
Authors: Dimitrieva Alena Yu. , Kenis Vladimir M. , Klychkova Irina Yu. , Sapogovskiy Andrey V. , Kozhevnikov Vadim V.
Published: April 2023

BACKGROUND: To date, there is no consensus regarding the diagnostics of flatfoot in children and approaches to its classification and treatment.
AIM: This study aimed to demonstrate the results of the first Russian consensus, performed according to the Delphi method, for the diagnostics and treatment of flatfoot in children.
MATERIALS AND METHODS: The study was conducted in accordance with the principles of the Delphi survey and the RAND/UCLA and participated by 22 experts in their field. The questionnaire consisted of four main sections, namely, general clinical assessment, flatfoot diagnosis, classification approach, and treatment, including 179 close-ended and 11 open-ended statements in both rounds. A 5-point Likert scale was used to rank responses. The level of agreement was determined as follows: 70% of the experts agrees, the statement is accepted; 55%, rejected; 55%69%, reassessment by experts in subsequent rounds. To assess agreement among experts, parameters such as general agreement, agreement without doubt by experts, and percentage of doubting experts were calculated. Mean (M), standard deviation (SD), and Cronbachs alpha were calculated.
RESULTS: The statement was accepted with an agreement without doubt by experts 70%, with Cronbachs alpha of 0.8. According to the survey data, in the two rounds using 179 close-ended statements, 96 statements were accepted, 63 were rejected, and no consensus was reached on 20.
CONCLUSIONS: This scientific work presents the results of the first Russian Delphi survey on the diagnosis and treatment of flatfoot in children with a unique number of experts (n = 22). The lack of agreement on some of the statements, even among experts, showed that consensus was a necessary first step toward standardizing the diagnosis and treatment of flatfoot in children.
Enthesitis-related arthritis in children: A literature review of the clinical features and differential diagnosis
Authors: Raupov Rinat K. , Vissarionov Sergei V. , Babaeva Gumru A. , Noyanova Yulia G. , Sorokina Lubov S. , Kostik Mikhail M.
Published: April 2023

BACKGROUND: Enthesitis-related arthritis is one of the subtypes of juvenile idiopathic arthritis and is characterized by the involvement of the joints, enthesitis, and axial skeleton (sacroiliitis and spondylitis). The clinical variability of enthesitis-related arthritis and similar manifestations with orthopedic diseases present difficulties in diagnosis.
AIM: To present the clinical features of enthesitis-related arthritis and issues of differential diagnosis based on literature analysis.
MATERIALS AND METHODS: A literature search was conducted in the open electronic databases of eLibrary, PubMed, and Cochrane Library. In total, 46 foreign and 4 Russian publications were analyzed, which were limited to 19812021. The keywords used in the literature search were as follows: enthesitis, enthesitis-related arthritis, juvenile spondyloarthritis, and SAPHO syndrome. Own archive data for instrumental investigations were used in the article.
RESULTS: The clinical manifestations can be variable, and laboratory tests do not always allow us to prove the inflammatory nature of the pain syndrome. The most priority diagnostic tests were imaging methods, namely, magnetic resonance imaging and ultrasonography. The greatest diagnostic difficulty was found in patients in whom enthesitis prevailed over arthritis, and in some cases, it was the only disease manifestation. The classification criteria used for the diagnosis of EAA were considered. The differential diagnosis of enthesitis included various orthopedic diseases. Ultrasound diagnostics of joints and enthesis should be performed in every patient with local pain musculoskeletal symptoms, which allows patients to be correctly routed.
CONCLUSIONS: The alertness of both orthopedists in relation to enthesitis-related arthritis and the awareness of rheumatologists of the most common orthopedic diseases that affect the entheses are necessary.
Footprint analysis in flatfoot assessment
Authors: Sapogovskiy Andrey V. , Ovechkina Alla  V. , Abramov Ilya  A. , Agranovich Olga  E. , Shubina Anastasia  I. , Budkevich Tatyana  G.
Published: April 2023

BACKGROUND: A flatfoot is the most common condition in the practice of a pediatric orthopedist. A flatfoot is primarily diagnosed based on the assessment of the degree of the foot flattening. Along with clinical examination, footprint analysis is often used in practice due to the safety of this study and convenience and ease of implementation.
AIM: This study aimed to determine how much footprints can correlate with the clinical assessment of flatfoot in children and which footprint indices are the most valuable in flatfoot assessment.
MATERIALS AND METHODS: The study included the survey results of 76 children aged 715 years of the St. Petersburg 49th school School of Health for 20212022. In this study, anthropometric data, clinical parameters (value of the heel valgus, arch angle, and Friedland index) and footprint indices and angles (Schwartz and Clarke angle, ChippauxSmirak index, Staheli index, Cavanagh and Rodgers index, and Irwin index) were analyzed. In the study, the average values were calculated, and correlation and regression analyses were performed.
RESULTS: The footprint parameters did not have moderate and strong correlations with clinical parameters. Footprint parameters that assessed the area of the barefoot zone on the footprints (Irwin index and Cavanagh and Rodgers index) showed statistically significant moderate and strong correlations among plantographic parameters. Among linear and angular footprint parameters, the ChippauxSmirak index showed statistically significant moderate and strong correlations.
CONCLUSIONS: The footprint criteria weakly correlated with the foot shape criteria in a clinical assessment, which does not allow us to interpolate the footprints data to the clinical evaluation data of the foot. The Cavanagh and Rodgers index, Irwin index, and ChippauxSmirak index had statistically significant moderate and strong correlations with other indices, which makes them more valuable in the assessment of feet according to the footprint analysis.
A clinical case of transient diabetes insipidus with high spinal trauma
Authors: Sibiryakov Dmitrii A. , Pavlova Maria S.
Published: April 2023

BACKGROUND: Diabetes insipidus is characterized by the kidneys inability to absorb water and concentrate urine, which is based on a defect in the synthesis or secretion of vasopressin and is manifested by severe thirst and excretion of large volumes of diluted urine. Data on diabetes insipidus in adults with isolated spinal injury are presented in single works of foreign authors, and no domestic and foreign publications have focused on diabetes insipidus in children. Available publications are descriptions and evaluations of the diseases clinical picture according to clinical and laboratory abnormalities and analyzed therapy in the postoperative period.
CLINICAL CASE: This study presents a clinical case of transient diabetes insipidus in a 12-year-old patient with high-level spinal cord injury after shrapnel and explosive trauma. A detailed description of the clinical picture is provided.
DISCUSSION: Polyuria, polydipsia, and low urine density were noted on day 14 after surgical correction and stabilization of post-traumatic spinal deformity with spinal cord rupture at the CVICVII level. The condition was considered a transient diabetes insipidus. Clinical and laboratory recovery was achieved on day 12 after surgery thanks to treatment by desmopressin.
CONCLUSIONS: This clinical case presents that diabetes insipidus may develop in pediatric patients with isolated spinal injury. Given the insufficient understanding of the causes of this rare disease, differential diagnosis is necessary for pediatric patients with high-level spinal cord injuries associated with polyuria and low urine density. Moreover, treatment with desmopressin should be prescribed appropriately.
Military consequences of economic sanctions against Russia
Authors: Czitadze Nika
Published: April 2023

The military Industry of Russia is a strategically important sector and a large employer in Russia. Before the Russia-Ukraine war, the number of employees in the defense industry was about 23.5% of the total number of employees in the country. About 2 million people produced direct weapons and military equipment. It is also a significant player in the global arms market, with Russian Federation being the second largest conventional arms exporter after the United States, with more than $13 billion worth of exports annually within the second decade of the XXI Century. At the same time, due to the economic sanctions and unsuccessful military operation in Ukraine, Russia’s military capabilities have suffered irreparable losses after Eight months of the war. In this regard, the question is the following: Is the military-industrial complex in Russia ready to recover the lost weaponry fast enough? According to the experts, the country needs at least 10 years to make up for the losses.
3D-Printed multi-material liver model with simultaneous mechanical and radiological tissue-mimicking features for improved realism
Authors: Jaksa Laszlo , Aryeetey Othniel James , Hatamikia Sepideh , Nägl Katharina , Buschmann Martin , H. Pahr Dieter , Kronreif Gernot , Lorenz Andrea
Published: April 2023

Anatomic models have an important role in the medical domain. However, soft tissue mechanical properties’ representation is limited in mass-produced and 3D-printed models. In this study, a multi-material 3D printer was used to print a human liver model featuring tuned mechanical and radiological properties, with the goal of comparing the printed model with its printing material and real liver tissue. The main target was mechanical realism, while radiological similarity was a secondary objective. Materials and internal structure were selected such that the printed model would resemble liver tissue in terms of tensile properties. The model was printed at 33% scaling and 40% gyroid infill with a soft silicone rubber, and silicone oil as a filler fluid. After printing, the liver model underwent CT scanning. Since the shape of the liver is incompatible with tensile testing, tensile testing specimens were also printed. Three replicates were printed with the same internal structure as the liver model and three more out of silicone rubber with 100% rectilinear infill to allow a comparison. All specimens were tested in a four-step cyclic loading test protocol to compare elastic moduli and dissipated energy ratios. The fluid-filled and full-silicone specimens had initial elastic moduli of 0.26 MPa and 0.37 MPa, respectively, and featured dissipated energy ratios of 0.140, 0.167, 0.183, and 0.118, 0.093, 0.081, respectively, in the second, third, and fourth loading cycles. The liver model showed 225 ± 30 Hounsfield units (HU) in CT, which is closer to real human liver (70 ± 30 HU) than the printing silicone (340 ± 50 HU). Results suggest that the liver model became more realistic in terms of mechanical and radiological properties with the proposed printing approach as opposed to printing only with silicone rubber. Thus, it has been demonstrated that this printing method enables new customization opportunities in the field of anatomic models.
An inkjet-printed bendable antenna for wearable electronics
Authors: Yu Hang , Zhang Xingguo , Zheng Hao , Li Dachao , Pu Zhihua
Published: April 2023

Flexible antennas, which can conform to the skin and transfer signals to terminals, are particularly useful for wearable electronics. Bending, which frequently occurs to flexible devices, significantly affects the performance of flexible antennas. Inkjet printing has been used as an additive manufacturing technology for fabricating flexible antenna in recent years. However, there is little research on the bending performance of inkjet printing antenna in both simulation and experiment. This paper proposes a bendable coplanar waveguide antenna with a small size of 30 × 30 × 0.05 mm3  by combining the advantages of fractal antenna and serpentine antenna, which realizes the ultra-wideband feature and avoids the problems of large dielectric layer thickness (greater than 1 mm) and large volume of traditional microstrip antenna at the same time. The structure of the antenna was optimized by simulation using the Ansys high-frequency structure simulator, and the antenna was fabricated on a flexible polyimide substrate by inkjet printing. The experimental characterization results show that the central frequency of the antenna is 2.5 GHz, the return loss is −32 dB, and the absolute bandwidth is 850 MHz, which is consistent with the simulation results. The results demonstrate that the antenna has antiinterference capability and can meet the ultra-wideband characteristics. When the traverse and longitudinal bending radius are greater than 30 mm and skin proximity greater than 1 mm, the resonance frequency offsets are mostly within 360 MHz, and return losses of the bendable antenna are within the −14 dB compared with the no bending condition. The results exhibit that the proposed inkjet-printed flexible antenna is bendable and promising for wearable applications.
Manufacturability of functionally graded porous β-Ti21S auxetic architected biomaterials produced by laser powder bed fusion: Comparison between 2D and 3D metrological characterization
Authors: Emanuelli Lorena , Jam Alireza , Plessis Anton du , Lora Carlo , Biasi Raffaele De , Benedetti Matteo , Pellizzari Massimo
Published: April 2023

Functionally graded porous structures (FGPSs) are attracting increasing interest in the manufacture of prostheses that benefit from lower stiffness and optimized pore size for osseointegration. In this work, we explore the possibility of employing FGPSs with auxetic unit cells. Their negative Poisson’s ratio was exploited to reduce the loss of connection between prosthesis and bone usually occurring in standard implant loaded under tension and therefore undergoing lateral shrinking. In addition, to further improve osseointegration and mitigate stress shielding effects, auxetic FGPSs were fabricated in this work using a novel β-Ti21S alloy characterized by a lower Young’s modulus compared to traditional α + β Ti alloys. Specifically, two different auxetic FGPSs with aspect ratio equal to 1.5 and angle θ of 15° and 25° with a relative density (ρr ) gradient of 0.34, 0.49, 0.66 and of 0.40, 0.58, 0.75 were designed and printed by laser powder bed fusion. The 2D and 3D metrological characterization of the as-manufactured structures was compared with the design. 2D metrological characterization was carried out using scanning electron microscopy analysis, while for the 3D characterization, X-ray micro-CT imaging was used. An undersizing of the pore size and strut thickness in the as-manufactured sample was observed in both auxetic FGPSs. A maximum difference in the strut thickness of −14 and −22% was obtained in the auxetic structure with θ = 15° and 25°, respectively. On the contrary, a pore undersizing of −19% and −15% was evaluated in auxetic FGPS with θ = 15° and 25°, respectively. Compression mechanical tests allowed to determine stabilized elastic modulus of around 4 GPa for both FGPSs. Homogenization method and analytical equation were used and the comparison with experimental data highlights a good agreement of around 4% and 24% for θ = 15° and 25°, respectively.
INSTRUCTIONAL LEADERSHIP PRACTICED BY HIGH SCHOOL PRINCIPALS IN VIETNAM
Authors: Trinh Thi Quy , Dao Thi Minh Chau
Published: April 2023

This article presented a part of the research about instructional leadership practiced by high school principals with a sample of 290 high school principals in Vietnam; semi-structured interviews with certain principles; an approach of portrait description; case study. Sharing research results as: The perception of high school principals about the concept of instructional leadership; The situation of principals creating and promoting the school's mission, values, vision, and goal system; Current situation of high school principals implementing school education curriculum leader according to the instructional leadership approach. The research observations detailed below will help to demonstrate the need for instructional leadership in schools generally and high schools specifically. As a result, we recommend several ideas that could improve instructional leadership efficiency in the framework of educational innovation in Vietnam.
SALIENT REGULATIONS ON THE PREVENTION AND REDUCTION OF CHILD LABOR IN THE WORLD AND VIETNAM
Authors: Hoang Thi Hai Yen , Nguyen Thi Nhung , Nguyen Thi Thu Trang
Published: April 2023

Child labor refers to children's illegal participation in labor and the labor activities that hinder or negatively affect the physical, intellectual, personality and comprehensive development of children. Child labor causes serious consequences affecting the development of children, families and society in all the different countries around the world. Faced with that situation, international law in general and the laws of countries in particular, including Vietnam, have stipulated specific regulations on the prevention and reduction of child labor. These legal documents are an important basis for conducting and implementing activities in the identification, prevention, intervention, reduction and elimination of child labor. The content of this paper will focus on studying a number of important international and Vietnamese legal documents regulating the prevention and reduction of child labor. In addition, this article also mentions a number of shortcomings in the current legal provisions on child labor in Vietnam, and the demand for amendments and supplements to improve the legal framework governing this issue.
Retrospective analysis of causes of death in severe PIH, Preeclampsia & Eclampsia cases in a tertiary medical care centre from January 2015 to December 2016
Authors: Misra Malabika , Sarkar Chaitali , Roychowdhury Ranita
Published: April 2023

: PIH, preeclampsia and eclampsia cases are one of the leading cause of maternal death especially in underdeveloped countries. Substandard maternity care is thought to be the reason behind it. Hypertensive disorders in pregnancy is a multi-organ involving disease of unknown etiology. Early detection, timely intervention, strict vigilance and intensive monitoring is needed to prevent maternal mortality and morbidity.

: Our aim was to detect the cause of death among pregnant women admitted with hypertensive disorders so that measures can be taken to improve the maternity service.

: It was a Retrospective analytical study of causes of maternal death among hypertensive disorders in pregnancy cases admitted in our institution from 1 January 2015 to 31 December 2016.

Data were collected from case sheets, death certificates and review report on maternal death cases and were analysed and presented.

It was found that pulmonary oedema was the most common (75%) cause of maternal death in PIH cases. Improper antepartum care and delay in seeking medical help, moreover, lack of proper utilization of maternity services was the main cause behind the high maternal mortality in PIH cases (89.6%).

: Substandard maternity care was found to be responsible for so high maternal death in PIH cases. This result was similar to the other studies in this context. These deaths are preventable to a large extent.
Significance of serum copper zinc ratio in smear negative pulmonary tuberculosis cases in Rohilkhand region
Authors: Sumeru Samanta , Ranadip Mukherjee , Joshi Basant , Trivedi Tanushree , Sharma Ashish
Published: April 2023

Tuberculosis being a highly contagious chronic pulmonary and systemic disease is explicit cause of morbidity and mortality worldwide. There is a direct relationship between zinc and copper in maturation of immunity, Cu/Zn ratio in serum serves to assess levels of oxidative stress in infectious diseases and thus could be used as a diagnostic tool in early diagnosis of smear negative tuberculosis.

To study and evaluate significance of serum Cu and Zn concentration and Cu/Zn ratio in smear negative pulmonary tuberculosis patients in comparison to apparently healthy controls.

Observational case control study was carried out on patients attending IPD and OPD, Department of Pulmonary Medicine, RMCH. Fifty cases of smear negative PTB patients(group A) was taken and compared with fifty age and sex matched apparently healthy controls(group B). Serum Cu and Zn were estimated in both groups by colorimetric method using EM Chem5Plus V2 Semi autoanalyzer.

Data is presented as mean ± SD. Comparison of serum levels of the parameters between the two groups was performed by Student’s‘t’ test. The p value <0.05 was considered as statistically significant.

We found serum Zinc to be significantly lower in group I than group II(p<0.00), serum Copper & Cu/Zn ratio to be significantly higher in group I than II(p<0.00).

The results suggests that early estimation of serum Cu, Zn & Cu/Zn ratio serves as useful diagnostic marker for smear negative pulmonary TB cases though more extensive multicentric study will provide more insights.
Phenotypic characterization and antibiotic suceptibility patterns of extended spectrum beta-lactamase producing enterobacteriaceae
Authors: Jain Vikas , Jain Swati
Published: April 2023

The rise of Enterobacteriaceae strains that produce an extended spectrum b-lactamase (ESBL) has become a global concern for epidemiological surveillance and the prevention of nosocomial acquired infections in the modern era. The choice of appropriate antibiotics to be employed in the treatment of infections brought on by ESBL-producing bacteria relies greatly on the detection and identification of these ESBLs in the laboratory. Limitations in ESBL detection have aided in the unbridled emergence of bacterial resistance and constitute a major health concern.

Isolation and identification of ESBL among Enterobacteriaceae by phenotypic methodswith their Antibiogram.

Phenotypic techniques were used to identify ESBL-producing Enterobacteriaceae (ESBLs-E) isolates from diverse clinical samples. Kirby Baur disc diffusion technique was performed to determine antimicrobial's susceptibility.

Among 212 Enterobacteriaceae isolates 124(58.3%) were positive for ESBL production. E.coli(74.5%) & K.pneumoniae (52.2%) two main isolates that produce ESBLs. Maximum ESBL producing Enterobacteriaceae isolates were obtained from blood samples 82% (41/50) followed by urine 59 % (62/105). Meropenem (96.7%), Amikacin (82.1%), and Cefoxitin were most susceptible antibiotics for ESBL-producing isolates while high resistance was observed in ceftazidime (62%), followed by Ciprofloxacin (60%).

The majority of ESBLs-E was mostly found in urine and blood samples.It was observed that E.coli produced the most ESBLs. There was a high prevalence of ESBLs-E in tertiary care hospital of central India. Therefore, strong infection control strategies must be implemented in hospital settings
Latissimus dorsi myocutaneous flap for cover of post mastectomy defects: Experience of a single surgeon in regional cancer centre Telangana, India
Authors: Gurram Rangaswamy , Bora Akshay Kantilal , Khan Temoor Mohammad
Published: April 2023

The majority of oncological operations for breast tumors need substantial excision of locally advanced breast tumors, as well as high volume flaps for defect repair.

The function of the latissimus dorsi myocutaneous flap (LDMF) in oncoplastic replenishment of major soft tissue lesions involving the breast, as well as the rate of success and complications of the flap, were investigated in this series.

all patients in this study were operated by single faculty at a regional cancer centre in Telangana, India. During the period from 2018- may, to 2020 December. This series includes 33 cases of LDMF repair done at our center.

The patients ranged in age from 30 to 70 years old, with a 6-month follow-up period. The main problem was immediately repaired in all of the patients. In our group of 33 patients, the flap had healed mainly without flap congestion in 27 of them. Wound infection with skin bride necrosis in one patient, flap marginal necrosis in four cases, and seroma development at the defect location in four patients were all mild postoperative problems.

In autologous reconstruction, LDMF can offer tissue volume as well as a stable vascular pedicle. When compared to the TRAM flap, DIEP flap, and other breast reconstructive methods, the percentage of postoperative problems is acceptable. LDMF should be used more frequently since it is a technically simple technique that gives appropriate coverage of a wide range of abnormalities, acceptable aesthetic results, and few postoperative problems.
Histopathological study of neuroepithelial tumors of central nervous system
Authors: Reddy Sama Snehaja , Dinusha Pakam , Sai Viswanath , Kumar V.Krishna , Reddy G. Mahender
Published: April 2023

Central nervous system tumours have diverse histomorphological appearances. Accurate characterization of space-occupying lesions by histology is important for appropriate treatment.

The present study is an attempt to evaluate the histomorphological patterns of the neuroepithelial tumors of central nervous system in order to provide accurate pre-therapeutic neuro-anatomic data and to facilitate better therapeutic results after surgery.

To study the spectrum of neuroepithelial tumors presenting as space occupying lesions in the central nervous system.

This was a prospective study carried out in the department of Pathology at Mediciti Institute of Medical Sciences over a two year period. Histopathological study of tissue specimens from neuroepithelial tumors from CNS was done. The tissue specimens were analysed for type of tumour, tumour grade and their distribution according to age, gender and topographic location.

A total of 231 neoplastic space occupying lesions were studied of which neuro-epithelial tumours comprised 96 (41.5%) cases. The patient age for neruepithelial tumors ranged from 2 years to 78 years and the male to female ratio was 1.2:1. Astrocytomas were the most frequent (75%), followed by oligodendrogliomas (8.3%), oligoastrocytomas and ependymal tumours. Astrocytoma, grade IV was most common and affected the fifth decade more commonly. Astrocytomas commonly affect the frontal, temporal and parietal regions.

Histopathological examination is mandatory for all space occupying lesions of CNS for correct categorization and grading of tumors. Astrocytomas are the most common of all neuroepithelial tumors. Grade IV astrocytomas most commonly affect men in fifth decade.
Anemia in pregnancy: A case control study from India
Authors: Bhalerao Muktpal Marotrao , Vikhe Balasaheb B , Sanap Amol D , Vikhe Rahul B
Published: April 2023

According to the World Health Organization (WHO) in pregnancy hemoglobin (Hb) less than 11gm/dL refers to be anemia. Anemia is the most common nutritional deficiency affecting the pregnant women. In India prevalence of anemia in pregnant woman is about 65% to 75%. Anemia during pregnancy causes negative and harmful effects on mother as well as on child. Anemia increases the risk of maternal and perinatal mortality. India had the highest prevalence of anemia in pregnancy. The Highest number of anemic pregnant women in the world are in India. So the present study was planned with aim to study the anemia in pregnant women.

The present case-control study was carried out in Department of Physiology at Rural Medical College Loni in Ahmednagar district of Maharashtra. The study was approved by Institutional Ethical Committee. Total 644 subjects were recruited for the study. 161 non-pregnant women were taken as control and 483 pregnant women were taken as the cases. Hemoglobin measurements of the pregnant woman was done by Sahali’s method. Hb concentration of <11 gm/dL taken as anemia.

The prevalence of anemia in pregnant and non-pregnant women were 62.93% and 82.60% respectively.

Pregnant as well as non-pregnant women in India are at high risk of developing anemia. The various national programmes aimed at prevention of anemia reduced the prevalence as well as severity of anemia during pregnancy.
Outcome of normal saline versus collagen dressing in management of diabetic foot ulcer – A comparative study
Authors: A Ramesh. , Rajendran G. , D Uma. , Venkatesh Prasanna
Published: April 2023

: Diabetic Foot ulcer is a major disease-causing disability to many patients around the world. Treatment of diabetic foot ulcers (DFU), which is the most common reason for lower-extremity amputation, remains a serious healthcare problem.

: To compare the normal saline dressing with collagen dressing in diabetic foot ulcer treatment.

: This comparative study was conducted on 100 patients, randomised into 50 patients in each group, Normal saline dressing and Collage dressing. The ulcer was evaluated after every 3 days to reduce the size, formation of granulation tissue and epithelisation until the ulcer healed completely or up to 8 weeks, whichever is earlier.

: In both, groups male patients were more than female, i.e. CG group with 60% and NS group with 66%. The mean wound size was 47.93 cm for CG and 45.45 cmfor the NS group. The mean percentage improvement of ulcer size (73.43% VS 54.50% in 5 week), presence of granulation tissue (90% VS 0% patients in1 week) and presence of epithelial tissue (74% VS 4% patients in 1 week) were significantly better in CG than in NS group.

: From the above study, the collagen dressing is superior compared to normal saline dressing in management of diabetic foot ulcers.
Study of assessing diagnostic efficacy of squash smear technique and frozen section by comparing with histopathology in CNS lesions, with special reference to IHC
Authors: Reddy Sama Snehaja , Dinusha Pakam , Thejaswini Vallapureddy , Kumar V. Ananta Kiran , Reddy A. Janakiram
Published: April 2023

Central nervous system (CNS) squash cytology (CSC) has established itself as a technically simple, rapid, inexpensive, fairly accurate, and dependable intraoperative diagnostic tool. It helps neurosurgeons immensely when management is dependent on it.

: To asses the efficacy of squash cytology in the intraoperative diagnosis of CNS lesions by comparing with histopathological diagnosis.

The present study is a prospective study done for one and a half year includes 43 patients who presented to the department of neurosurgery with complaints of a headache, backache, epilepsy and radiologically diagnosed to have a space occupying lesion. Only the cases where either squash cytology or frozen section was performed were included in the study.

: In the present study, it is observed as Out of 43 cases, squash cytology is performed in 42 cases in which histopathological diagnosis is correlated in 36 cases with a diagnostic accuracy of 85.7%. The diagnostic accuracy of squash cytology in common CNS tumors gliomas and meningiomas was 92.8% and 100% respectively. Out of the 43 cases, the frozen section is performed in 42 cases of which histopathological diagnosis is correlated in 37 cases with a diagnostic accuracy of 87%. The diagnostic accuracy of frozen section in common CNS tumors gliomas and meningiomas was 85.7% and 100% respectively. The sensitivity and specificity of frozen section in the identification of tumor was 94.7% and 100%. The positive predictive value and negative predictive value of the frozen section in the identification of the neoplastic lesion was 100% and 66.6% respectively.

Squash cytology and frozen section are preliminary diagnostic methods, which should always be followed by a definitive histopathological diagnosis.
Rocky mountain spotted fever- A case series
Authors: R Archita
Published: April 2023

Rocky mountain spotted fever caused by Rickettsia rickettsii, is a life threatening tick transmitted infection, which is the most prevalent rickettiosis. It remains a diagnostic challenge because of its varied clinical presentation and the overlap of signs and symptoms with other diseases. Under diagnosed and misdiagnosed rickettsial infections are important public health problems. There is neither an effective vaccine nor an assay that is diagnostic during the early stages of the disease when treatment is most effective. Here, we report three cases with varied clinical manifestations.
Interesting case series on distinct histopathological findings of six cases of epididymo-orchitis
Authors: Jaju Nikita , Sangeetha Shubha , Garg Prakhar , Y A Manjunatha
Published: April 2023

Several clinicopathological illnesses impact the testis and paratesticular area, which are divided into non-neoplastic and neoplastic diseases. Despite the availability of imaging and tumor marker testing, histopathological examination is the primary method for diagnosing testicular lesions. Common indications of orchidectomy for non-neoplastic lesions are cryptorchidism, epididymitis and testicular torsion. Few non- neoplastic lesions present as mimickers of neoplasm with commonest being granulomatous orchitis and AFB positivity detected only in 2.1% of cases with bilateral presentation being rarest.

We report here a series of six cases of epididymo-orchitis to discuss the histopathological spectrum with varied etiologies.

Age of the patients ranged between 33-65yr old males. Amongst six cases, two of them were clinically and radiologically suspected as neoplastic lesions, which were histopathologically diagnosed as granulomatous epididymo-orchitis with one among it showing strong positivity for AFB, and two cases as testicular torsion with orchitis and one of the case was diagnosed as cryptorchid testis with foci of atypical germ cell and last case was reported as mild non-specific orchitis, for surgical castration. In this study, we also noted unilateral presentation being the commonest, specifically of Right side.

Knowledge of histopathological spectrum of epididymo-orchitis is of prime importance to detect underlying specific etiology for targeted therapy and prevent undue orchidectomy.

In this study, two cases which were clinically suspected as neoplastic lesions, were confirmed as granulomatous epididymo-orchitis on histopathological examination with one case showing strong AFB positivity.

In this study, we noted late presentation (5th decade) of cryptorchidism with some atypical germ cells which are forerunner of malignancy.
The Arctic in 2022: results and prospects
Authors: Zhuravel Valerii
Published: April 2023

The article examines various aspects of the Arctic in 2022, analyzing the withdrawal from Arctic projects of several large European and Asian multinational companies, the termination of scientific cooperation and the fundamental changes in the activities of the Arctic Council (AC). The results of the development of the Russian Arctic are summarized (growth in cargo turnover, approval of the plan for the development of the NSR until 2035, development of the Arctic territories). Particular attention is paid to the threats in the Arctic, defense, and security issues.
The Arctic agenda for Canada and the interests of Russia
Authors: Issraelyan Evgenia
Published: April 2023

In recent decades, cooperation in the Arctic has been the most promising area of Russian-Canadian relations. This was explained by the common approaches to solving some Arctic problems. Achievements in the development of Arctic cooperation were actually crossed out by the Ukrainian crisis of 2022. The article concludes that the termination of cooperation between Russia and Canada in the Arctic is not only unprofitable for both sides, but also adversely affects the development of the entire region. The author believes that to resume the interrupted interaction, negotiators should try to use all possible channels and mechanisms.
The place of the Republic of Karelia in the Arctic zone of the Russian Federation
Authors: Obynochny Yaroslav
Published: April 2023

The article analyzes the current state and prospects of development of the Republic of Karelia, which is one of the Arctic regions of the Russian Federation. The changes in various spheres of life of the republic, as well as practical steps of the leadership of the region and the federal center aimed at improving the quality of life of the local population are considered. Special attention is paid to the factors that have both a positive and negative impact on improving the well-being of the region.
Russia, the USA and the Arctic. Part 1. Climate changes: economic opportunities and ecological challenges
Authors: Rogov Sergey
Published: April 2023

The article is devoted to the analysis of the primary background issues for the growth of the conflict potential of the US-Russia relations in the Arctic region. The author focuses on the great importance of the region for Russia, paying special attention to the huge reserves of natural resources, as well as the historical context of the Arctic development. He describes the significance of the Northern Sea Route and its role as an energy corridor. In conclusion, the article highlights several environmental problems, primarily climate change and ice melting. Their solution creates common interests for Russia, the United States of America and other Arctic countries.