bluuebunny/crossref_metadata_2025 huggingface dataset:
Jude Stéfan & Emmanuel Hocquard, extrêmes-contemporains de Catulle & Lucrèce
Authors: Servissolle Nicolas
Published: November 2024

Dans la poésie d’Emmanuel Hocquard et dans celle de Jude Stéfan, on trouve maintes références à la littérature latine, qu’elles soient explicites, ou allusives : jeu avec des figures littéraires ou mythologiques, mention ou pratique de genres anciens, convocation de divers hypotextes antiques. Le premier intérêt de ce recours au fonds gréco-latin semble être de constituer, pour eux, un « bouclier de Persée », au sens où il leur permet de se mettre à distance du lyrisme, qui fait retour dans les années quatre-vingt. Dans un premier temps, certes, ce recours peut apparaître contradictoire, dans la mesure où Jude Stéfan se reconnaît dans la figure de Catulle, qu’il considère comme l’un des inventeurs de la poésie subjective, et qu’Emmanuel Hocquard se réclame de l’élégie. Mais le détour par l’antique, chez l’un comme chez l’autre, se double d’une affirmation de modernité : la figure de l’élégiaque est inversée, quant à Catulle, il devient le précédent néotérique d’une génération non véritablement perçue, invisibilisée, mais qui pourrait être celle des novi poetae du vingtième siècle. Cette génération, c’est celle que l’un désigne par le terme de « contre-écriture » et l’autre par l’expression de « modernité négative » et qui se caractérise par un ensemble de refus qui la rend difficilement situable. Or, cette génération manifesterait un changement épistémique, dont témoigne le rapport d’Emmanuel Hocquard à Lucrèce : le réel y demeure une énigme irréductible, le divorce entre les mots et les choses y est réaffirmé et creusé. En outre, le recours à la matière antique révèle une façon nouvelle de considérer la contemporanéité, qui remet en question le continuisme et le causalisme de l’histoire littéraire. Bien plus, en s’affirmant les contemporains « extrêmes » de Catulle et Lucrèce, Jude Stéfan et Emmanuel Hocquard en apparaissent comme les représentants exemplaires : deux « extrêmes-contemporains ».
Религиозность Степана Разина, лидера народного движения 1667-1671 гг.
Authors: Trefilov Evgenii
Published: November 2024

La religiosité de Stepan Timofeevič Razin, meneur de la rébellion de 1667-1671, a fait l’objet de nombreuses recherches, dont les résultats sont diversifiés et parfois diamétralement opposés. Cependant, il n’existe à ce jour aucune analyse approfondie de toutes les sources reflétant les idées de Razin sur la religion. L’article a pour but de combler cette lacune. Il démontre qu’en dépit de la complexité de ses vues, le leader rebelle se voyait comme un chrétien orthodoxe membre de l’église officielle. Cette perception affecta son comportement en le poussant notamment à réduire la violence de ses assauts contre ses coreligionnaires.
«За Сталина, бляди!». Записные книжки Василия Гроссмана как исторический источник
Authors: Budnitskii Oleg
Published: November 2024

L’article examine une sélection des sujets abordés dans les carnets de Vasilij Grossman, carnets frappés d’interdit pendant la guerre et l’ère soviétique. L’auteur étudie le « langage de la guerre » relevé dans les carnets, le défaitisme et la désertion, plus particulièrement au début de la guerre, la violence contre les siens, la présence des femmes dans l’armée et sur le front et le comportement de l’Armée rouge en Allemagne. Il serait erroné de penser que Grossman se concentrait seulement sur le négatif. La victoire sur le nazisme était essentielle pour lui et la recherche de tout ce qui pouvait y mener, des hommes (du simple soldat au commandant) capables de la remporter, était sa thématique principale. Les carnets sont aussi une source sur la biographie de l’auteur, non seulement en ce qui concerne ses actes, mais aussi ses idées sur le bien et le mal, sur les hommes et le pouvoir. Et enfin, en ce qui concerne les stratégies comportementales d’un homme dont la compréhension de la réalité allait bien au-delà de ce qu’il pouvait exprimer ouvertement.
Les retombées du pacifisme dans l’œuvre narrative de Jean Giono
Authors: Giorgi Giorgetto
Published: November 2024

Jean Giono a toujours pratiqué au cours de son existence l’idéologie pacifiste et l’a durement payé par deux incarcérations en 1939 et en 1944. Ce pacifisme revêt toutefois, dans son œuvre narrative, deux aspects nettement différents. Des années vingt du siècle dernier jusqu’au début de la Seconde Guerre mondiale, il nous fait assister à la célébration, dans une certaine mesure utopique, de la vie paisible et préservée de la technique, de l’industrialisation et du profit, que menaient au début du XXe siècle, dans une atmosphère quasi intemporelle, les paysans et les artisans de Haute-Provence. Dans la deuxième partie du siècle, au contraire, notre auteur, fortement marqué par les événements des années trente et quarante, change de cap et, sans renoncer à son pacifisme, décide d’affronter l’histoire. Il décrit alors, surtout dans le « Cycle du Hussard », le pragmatisme amoral des milieux politiques, qui finit par induire le personnage principal du « Cycle » à opter pour une sorte d’anarchisme.
Théâtre et histoire contemporaine chez Stendhal : la politique mise en scène (1802-1804)
Authors: Meynard Cécile
Published: November 2024

La plupart des projets de pièces auxquels Stendhal travaille entre 1802 et 1804, et en particulier les deux plus aboutis, Les Deux hommes et Letellier, ont un lien avec l’histoire contemporaine, de la période révolutionnaire aux débuts de l’Empire : il conserve en effet l’idéal révolutionnaire du théâtre comme « école du citoyen » qui doit amener le public à lutter contre tout despotisme.
Du côté de chez Ferval : Proust s’inquiète d’un précédent du drame du coucher
Authors: Squarzina Anna Isabella
Published: November 2024

Le but que nous nous proposons ici n’est pas de présenter au lecteur une véritable hypothèse, mais, plus modestement, de procéder à une lecture en parallèle de deux textes, qui ont été mis en relation par Proust lui-même, dans une lettre datée de 1908 qu’il adresse à Marguerite de Pierrebourg, alias Claude Ferval, romancière et patronne d’un célèbre salon. Dans cette lettre, il évoque la scène du roman Ciel rouge où la fillette de la protagoniste attend en pleurs le baiser du soir de sa mère, et déclare avoir décrit, dans « des pages déjà un peu anciennes » qu’il compte peut-être publier un jour, un épisode à certains égards similaire. La découverte des Soixante-quinze feuillets remet la question à la une, car, si jusqu’à présent il a été convenu que Proust pensait, en écrivant cette lettre, au drame du coucher du Jean Santeuil, il est désormais manifeste que, comme l’a noté Nathalie Mauriac, à ce moment « Proust ne peut pas ne pas avoir à l’esprit l’épisode qu’il vient de rédiger dans les Soixante-quinze feuillets ».
Les Pouilles Littéraires : itinéraires de l’imaginaire français des Pouilles
Authors: Sollecito Michele
Published: November 2024

Cet article illustre les catégories de l’imaginaire français des Pouilles, caractérisé par la curiosité envers les itinéraires insolites et l’exaltation des expériences sensorielles, à partir de textes de voyageurs français du XVe au XXe siècles. L’ensemble de ces textes a été numérisé et est consultable en ligne : www.lespouilleslitteraires.com.
Apollinaire vivant
Authors: Valeri Diego
Published: November 2024

Diego Valeri dans cet article montre l’importance et l’appréciation du poète Apollinaire, ainsi que son influence sur la poésie française. Il donne la description de quatre livres inédits et d’autres poèmes parus après sa mort, démontrant que le titre qu’André Billy avait donné à son essai, Apollinaire vivant, résulte encore plus significatif à cette époque-là, plutôt qu’à la date de sa parution. La valeur du poète est mise en relief par Valeri à travers de nombreux exemples qui permettent de classer Apollinaire comme un grand poète et un grand artiste. En plus, Valeri n’oublie pas de souligner la dévotion du poète à l’Italie.
La tour d’ivoire : aventures et mésaventures de l’autonomie du littéraire
Authors: Tamassia Paolo
Published: November 2024

L’histoire littéraire française est caractérisée par une alternance de deux positions opposées : d’un côté, la littérature a cherché une légitimation en s’appuyant sur d’autres pratiques culturelles (philosophie, politique, sciences, religion) tandis que, de l’autre, elle a eu tendance à s’affirmer dans une totale autonomie. À partir du Romantisme cette alternance devient plus complexe puisque les deux positions s’affrontent dans une dialectique serrée au point qu’elle se succèdent ou coexistent dans la réflexion et dans la pratique littéraire d’un même auteur et cet affrontement se poursuit au XXe et au XXIe siècle. Il s’agit alors de considérer les différents enjeux à la base du choix ou du refus de l’autonomie du littéraire.
Escritura poética, escritura mediática: entre representación y reproducción de la violencia
Authors: Dominguez Mario Alfonso Alvarez
Published: November 2024

En este trabajo se estudian ocho poemas que tematizan la violencia a través de alusiones anecdóticas a los diarios que reportan informaciones policiacas o, bien, mediante apropiaciones estilísticas de la escritura mediática sobre el crimen. El artículo comienza con una breve digresión sobre el vínculo entre poesía y prensa para sensibilizar al lector con respecto de las influencias mutuas entre ambos tipos de escritura. Este preámbulo funciona, además, como introducción para la nota roja, género periodístico a partir del cual se analiza la representación de la violencia. Los poemas están divididos en dos series: primero, una en la que destaca la expresión marcadamente subjetiva; después, una serie en donde resalta una aparente objetividad en el discurso. Al final se plantea el examen de otras series en las que se podría observar cómo la escritura poética trabaja con la mediatización de la violencia.
Qui a tué l’Animal Liberation Front ? Entre répression d’État et résilience industrielle, une histoire des animalistes aux États-Unis
Authors: Poupelin Mathis
Published: November 2024

Cet article cherche à retracer le parcours et le déclin d’une organisation qui a marqué l’histoire de l’antispécisme états-unien : l’Animal Liberation Front, ou ALF. Si celui-ci a eu une ampleur considérable dans le combat pour l’abolition de l’exploitation des non-humains, sa disparition constitue un objet tout aussi spectaculaire : s’y intéresser permet autant de comprendre la répression d’État que la contre-attaque des industriels de la fourrure, ainsi que les dynamiques internes poussant des activistes à agir, ou à cesser d’agir.
Capturer/és, contrôler/és, rééduquer/és : les prisonniers de guerre allemands face à la défaite totale (1944-1948)
Authors: Théofilakis Fabien
Published: November 2024

L’article analyse la dynamique transformatrice que peut contenir la défaite en considérant la captivité des quelque 800 000 soldats allemands détenus par les Français entre 1944 et 1948. L’étude de la fin de la Seconde Guerre mondiale à l’aune des rapports entre vainqueurs et vaincus se déploie d’abord à l’échelle du front à partir des modalités de la capture qui transforme le combattant en vaincu, puis à l’échelle de la zone française d’occupation en interrogeant les perceptions des populations allemandes désormais occupées par ceux qui détiennent un proche entre leurs mains, enfin à une échelle plus large, celle des projets de réorientation intellectuelle ‑ autour du « séminaire des barbelés » à Chartres ‑ dont le but est d’assurer la sécurité de la France en résolvant le « problème allemand ».
L’État français face à l’arrivée de réfugiés en provenance d’Ukraine depuis le 24 février 2022 : mobilisation, actions et renouvellement des pratiques
Authors: Delorme Isabelle
Published: November 2024

En novembre 2024, environ 110 000 réfugiés en provenance d’Ukraine, principalement des femmes et des enfants, bénéficient en France d’un statut européen spécial, la protection temporaire. Dans un contexte de solidarité inédit, un nombre exceptionnel d’acteurs, agissant à titre individuel et/ou à titre collectif, formel et/ou informel, se sont mobilisés dans le pays afin de faciliter leur accès à l’hébergement, au logement, à l’éducation, aux soins médicaux et psychologiques, au travail, à un statut juridique adapté. Dans ce contexte, l’État français s’est imposé comme acteur incontournable et pivot de l’accueil des réfugiés en provenance d’Ukraine. La mobilisation de l’État français, qui s’inscrit dans une politique de l’asile développée au cours du XXe siècle, s’est notamment appuyée sur les préfectures, relais de l’État dans les départements et les régions. Le ministère de l’Intérieur et des Outre-mer a joué un rôle clé dans l’accueil et l’intégration des réfugiés en provenance d’Ukraine en France, relayé par les ministères sociaux et d’autres ministères et délégations interministérielles. La réactivité et l’adaptabilité de l’État à cette situation inédite a été facilitée par la création d’une structure spécifique, la cellule interministérielle de crise Ukraine (CIC Ukraine), dont l’action a été essentielle, ainsi que par des cellules de crises dans différentes structures de l’État.
Mid-term outcomes of double-balloon technique for balloon aortic valvotomy: Experience from a tertiary care center in India
Authors: Yenduri Naimisha , Sasikumar Navaneetha , Patel Asha , Kumar Raman Krishna
Published: November 2024

We hypothesized that a double-balloon technique would be associated with a lower likelihood of aortic regurgitation (AR) following balloon aortic valvotomy (BAV). We present the short- and mid-term outcomes of the double-balloon technique for BAV. Fifty consecutive patients (median age: 6.5 years; interquartile range (IQR): 3.8–13.2) underwent BAV using double balloons. Prior AR was present in 17 (34%). Following BAV, the peak-to-peak gradient reduced from 80 (66.5–100) mm Hg to 24 (16–35) mm Hg (P < 0.0001); 10 (20%) had trivial AR, 18 (36%) had mild AR, 10 (20%) had moderate AR and none had severe AR. Four (8%) had transient arterial occlusion requiring anticoagulation. There was no procedure-related mortality or requirement for emergency open-heart surgery. The double-balloon technique offers a safe and effective alternative option for BAV in patients beyond infancy with relatively large annulus sizes. There is a low likelihood of postprocedural severe AR and the need for repeat procedures. Further long-term follow-up of this cohort is needed to ascertain long-term outcomes.
Moderate mitral regurgitation in association with ventricular septal defect in children: Does it warrant mitral valve repair?
Authors: Ong Hao Siang , Krishnasamy Sivakumar , Rajandram Retnagowri , Amirthalingam Asthika , Yusof Tengku Nazim Tengku , Sivalingam Sivakumar
Published: November 2024

Background:

The management of ventricular septal defect (VSD) alongside mitral regurgitation (MR) in pediatric patients remains a contentious issue due to the intricacies of cardiac surgery and the need to minimize ischemic time. Despite observations of MR regression following VSD closure, definitive guidelines for this patient subset are lacking, particularly concerning the management of the subgroup of patients with moderate MR. The objective of the study is to explore the factors influencing the choice between surgical intervention and conservative management for the mitral valve (MV) in VSD patients with moderate MR.

Materials and Methods:

A retrospective cohort study from January 2000 to December 2015, we analyzed management trends and focused on 53 patients with both VSD and moderate MR. This cohort was subdivided into four groups: first by their MV pathology, and then stratified by the receipt of intervention towards the diseased MV. Our primary goal was to identify correlations, especially concerning surgical outcomes such as mortality and need for re-operation. Statistical significance is determined when the P value is lower than 0.05.

Results:

There were no notable differences in preoperative variables across four cohort groups, apart from the cross-clamp duration which was longest in Group B intervention. Outcome analysis showed survival rates that were higher in cohort groups that underwent intervention toward the disease MV regardless of existing MV morphology, although results were not statistically significant. Cox model analysis found no correlation between the cohort groups and postoperative outcomes, but cross-clamp duration significantly correlated with mortality.

Conclusions:

In cases of VSD with moderate MR with associated pathologies of the valvular apparatus, opting for MV repair (MVr) appears to improve survival outcomes without significantly increasing postoperative morbidity. Similarly, for patients with moderate MR and isolated annular dilatation, surgical MVr is observed to have better survival trend compared to the control group.
Neonatal death of siblings with Uhl’s disease and KCNH2 mutation - A rare association
Authors: Ventura Francesco , Barranco Rosario , Buffelli Francesca , Fulcheri Ezio , Coviello Domenico , Palmieri Antonella
Published: November 2024

Uhl’s disease is a rare disorder secondary to the uncontrolled destruction of right ventricular myocytes during the perinatal period. We present here the case of a 1-month-old child who died suddenly of Uhl’s disease, which was only diagnosed at autopsy and histological examination. From an anamnestic point of view, the child’s sister had also died at about 1 month of age from the same pathology. In both cases, genetic tests showed a heterozygous mutation in the KCNH2 gene. The case that we presented is particularly significant as very few familial cases of Uhl disease have been described in the literature, and genetic analyses have been conducted in very few cases. It is possible that the observed mutation played a role in the onset of the disease process. However, further scientific studies with larger case series are needed to confirm our results.
Anomalous left coronary artery origin from the nonfacing sinus of pulmonary artery – Successful repair of a rare entity
Authors: George Anciline , Pavithran Sreeja , Sivakumar Kothandam , Agarwal Ravi
Published: November 2024

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease, presenting either in isolation or with other cardiac anomalies. The most common presentation is congestive heart failure in infancy, though some may remain asymptomatic till adulthood. A 5-month-old infant with congestive heart failure was diagnosed to have ALCAPA with severe Left ventricular (LV) dysfunction. Unlike the more common variants where the left coronary artery (LCA) arose from the facing sinuses, the LCA arose from the left anterior nonfacing sinus of the pulmonary artery at a considerable distance from the left aortic sinus. This made direct reimplantation of LCA to the aorta challenging. LCA was reimplanted to the aorta using an extrapulmonary baffle made of an autologous pulmonary flap. The postoperative period was uneventful. The LV contractility improved during the follow-up. Early diagnosis and intervention with a novel surgical technique prevented irreversible cardiac complications and mortality.
Fetal bradycardia associated with left ventricle noncompaction diagnosed as HCN4 mutations
Authors: Yonehara Kosuke
Published: November 2024

A 35-year-old pregnant woman was referred to our hospital because of fetal bradycardia. Fetal echocardiography revealed a normal fetal heart except for slightly prominent trabeculae in the left ventricle, normal cardiac function, and fetal sinus bradycardia with a heart rate of 100 bpm. Electrocardiography (ECG) after birth revealed sinus bradycardia with a heart rate of 70–80 bpm. Transthoracic echocardiography revealed left ventricular noncompaction localized in the apex with normal cardiac function. A 24-h Holter ECG showed a heart rate range of 62–169 bpm without a pause of more than 2 s. A genome analysis performed during the neonatal period revealed a heterozygous inflame variant p.(Ser672_Asp676del)[chr15:g. 73324203_733242] in HCN4 gene. Fetuses with a heart rate less than the 3rd percentile of the gestational age should be followed and screened for congenital heart disease and cardiomyopathy. In addition, inherited arrhythmia syndrome should be considered.
Transcatheter pulmonary valve implantation with custom-made 35-mm Myval™ transcatheter heart valve
Authors: Ramakrishnan Sivasubramanian , Faisal Nabeel Valappil , Kadiyani Lamk , Gupta Saurabh Kumar , Sivaprakasam Muthukumaran Chinnasamy
Published: November 2024

Transcatheter pulmonary valve implantation (TPVI) is the standard of care in patients with repaired tetralogy of Fallot (rTOF) presenting with right ventricular outflow tract (RVOT) dysfunction. However, the feasibility of TPVI is limited by the high cost and nonavailability of larger-sized valves for dilated native RVOT of rTOF patients. We report the first successful TPVI with a custom-made 35 mm balloon-expandable valve (Myval™) in a 30-year-old rTOF patient with severe pulmonary regurgitation and RV dysfunction.
Pediatric cardiac interventions: Innovations from India
Authors: Mantoo Mohsin Raj , Ramakrishnan Sivasubramanian
Published: November 2024

India, owing to its population structure, faces an enormous burden of children born with congenital heart disease (CHD). Systematic challenges such as limited public health infrastructure, a shortage of trained specialists, and high out-of-pocket expenditures hinder uniform access to comprehensive CHD care. Despite these limitations, Indian pediatric cardiologists have delivered innovative and often cost-effective solutions to challenging clinical problems. Indigenous devices such as the MyVal transcatheter heart valve, Konar-MF (multifunction) occluder, and Zephyr large-diameter stents are significant achievements in their respective fields. Static balloon dilatation of interatrial septum and balloon-assisted atrial septal defect (ASD) device implantation are prime examples of many innovations that were established by Indians and followed across the world. India also helped consolidate significant interventions in children, such as percutaneous transvenous mitral commissurotomy and interventions for aortoarteritis. Notably, Indian centers have published some of the largest series on transcatheter closure of sinus venosus ASD and ruptured sinus of Valsalva aneurysm. Close collaboration with adult coronary interventionalists has facilitated innovations borrowed from coronary chronic total occlusion hardware and techniques to recanalize ductus arteriosus or membranous-type pulmonary atresia. This manuscript discusses some of India’s innovative contributions to the field of pediatric cardiac interventions.
Circumaortic duplicated left brachiocephalic vein in a patient with Tetralogy of Fallot – A rare venous ring
Authors: Jain Shantanu , Gangopadhyay Debasree , Roy Mahua , Das Shubhajit , Behera Sukanta Kumar , Khan Areeb Ahmed
Published: November 2024

The left brachiocephalic vein (LBCV) usually passes superior and anterior to the aortic arch. In rare cases, this vein follows an anomalous course. We present a case of duplicated circumaortic LBCV in a 10-year-old child with Tetralogy of Fallot.
Complete surgical correction of tetralogy of Fallot with Ebstein’s anomaly
Authors: Rangwala Zarin S. , Ramachandran Kaushik , Sagar Sunil , Sukesan Subin , Dharan Baiju S.
Published: November 2024

Association of Ebstein’s anomaly of tricuspid valve (TV) with tetralogy of Fallot (TOF) is extremely rare. Their coexistence is unique as they modify each other’s physiology. We report a case of a girl child having this rare combination along with Diamond–Blackfan syndrome awaiting a bone marrow transplant. She underwent intracardiac repair for TOF along with cone reconstruction of the TV, as tricuspid regurgitation of Ebstein’s anomaly would worsen with TOF correction alone. Through this surgery, we aimed to achieve a competent pulmonary valve using a transannular patch with a monocusp and adequate relief of the right ventricular tract obstruction, thus preserving the right ventricular function, as both can affect the repaired TV function in the long term. The child had an uneventful postoperative course and is asymptomatic on follow-up.
A Study of Indications, Clinical Applications, and Effects of Therapeutic Phlebotomy at a Tertiary Care Hospital Navi Mumbai
Authors: Gupta Sonal Suresh , Dhote Shweta Wasudeo , Lad Shubhangi , Dey Damayanti Radhashyam
Published: November 2024

ABSTRACT

Background and Objectives:

The removal of blood from the body is known as phlebotomy, venesection, or bloodletting. Therapeutic phlebotomy is the preferred treatment for blood disorders where removing red blood cells or serum iron is the most effective way to manage symptoms and complications. In current medical practice, therapeutic phlebotomy is a clinically-supervised intervention for diseases such as polycythemia vera, hemochromatosis, porphyria cutanea tarda, nonalcoholic fatty liver disease, and sickle cell crisis. The aim of this study was to analyze the indications for therapeutic phlebotomy and its effects on hematocrit and hemoglobin.

Methods:

A retrospective study spanning 5 years was conducted in the department of immunohematology and blood transfusion, collecting patient clinical details, including name, age, gender, symptoms, and diagnosis.

Results:

A progressive decline in hemoglobin and hematocrit levels was noted in patients undergoing different numbers of therapeutic phlebotomy sessions. Hematocrit reduction was significantly greater in patients with four or more sessions (P < 0.001), while hemoglobin levels decreased more significantly after three sessions (P < 0.001). In conclusion, it required more phlebotomy cycles to reduce hematocrit compared to hemoglobin.

Conclusion:

Therapeutic phlebotomy is an essential part of the treatment of various diseases, especially those associated with secondary polycythemia. It is safe and cost-effective that should also be considered for use as adjunctive therapy.
Detection of Rare Weaker A Subgroup: Aend
Authors: Afroz Tamanna
Published: November 2024

ABSTRACT

Subgroups of A are very rare phenotypes. Weaker subgroups give rise to discrepancies between forward and reverse grouping. Conventional methods could misread these rare and weak subgroups occasionally. Weaker A subgroups that have been reported so far are mainly A3, Ax, Aend, Am, Ay, and Ael. Here, we report one interesting case of a rare weaker A subgroup in a patient who was wrongly typed as Group O. After performing the initial blood grouping, a detailed analysis was done including absorption elution tests and saliva tests. The serological characteristics of the patient’s red cells were similar to the Aend subtype. The patient was a secretor having only H substance. Anti-A1 was absent in the serum. This report highlights the importance of routine forward and reverse grouping in solving blood group discrepancy.
Low-Level Laser Therapy with Pharmacotherapy in the Management of Myofascial Pain Dysfunction Syndrome with or without Other Temporomandibular Disorders
Authors: Shah Jigna S. , Poojary Manish K.
Published: November 2024

Background and Aim:

Myofascial pain dysfunction syndrome (MPDS) is one of the most important facial muscle disorders comprising signs and symptoms including pain during function, tenderness in the muscles of mastication and restricted jaw movement. The purpose of this study was to assess and compare the effectiveness of low-level laser therapy (LLLT) and combination therapy of LLLT and pharmacotherapy in the treatment of myofascial pain with or without other TMD (temporomandibular disorders).

Materials and Methods:

Forty patients with MPDS were randomly divided into two groups. Group 1 received LLLT (BiolaseTM; GA-Al-As; 940 nm) in 12 sessions. Group 2 received a combination of LLLT with the drug Aceclofenac 200 mg till the end of the 12th session. Following each session and after two months, the pain intensity, maximum mouth opening, clicking sound and jaw deviation were evaluated in both groups. Data were collected and analysed using the independent t test, Mann–Whitney U test and Friedman test (a = 0.05).

Results:

Both group 1 and group 2 showed a significant reduction in pain and a significant increase in mouth opening, which was faster in group 2 compared to group 1.

Conclusion:

Both LLLT and a combination of LLLT and drug therapy are effective in the management of myofascial pain. LLLT + pharmacotherapy combination is more efficient at improving pain and mouth opening.
Pulmonary Arteriovenous Malformations Unmasked by Refractory Hypoxia: An Unusual Presentation in Hereditary Hemorrhagic Telangiectasia
Authors: Sankar Sharmila , Rajakumar P. S. , Shuba S. , Shanmugam Vimalnath , Sekar Sabarish , Rathinasamy Jebaraj
Published: November 2024

Background:

Hereditary hemorrhagic telangiectasia (HHT) is a rare genetic disorder usually known to manifest with epistaxis, mucocutaneous telangiectasia, and visceral arteriovenous malformations (AVMs).

Clinical Description:

A 12-year-old girl presented with altered sensorium on hand ventilation, referred as a case of an acute cerebrovascular event due to cerebral AVM. She was afebrile with labored breathing and profound hypoxia. General and systemic examinations were unremarkable, except for clubbing in all digits.

Management and Outcome:

Investigations were largely normal, except for elevated hematocrit. Chest-X-ray showed mild infiltrates, while echocardiography was unremarkable. After stabilization and improvement of the sensorium, the child continued to have refractory hypoxemia, even with high ventilatory settings. The presence of digital clubbing and elevated hematocrit, in the background of cerebral AVM, led to suspicion of pulmonary AVM, the latter being detected by bubble contrast echocardiography and digital subtraction angiography (DSA). Genetic analysis confirmed a likely pathogenic variant in the ENG gene. Coil embolization of the pulmonary AVMs was done in stages, following which saturations improved and the child became asymptomatic.

Conclusion:

Persistent hypoxemia, in a child with cerebral AVMs, should raise suspicion of pulmonary AVMs, as a part of the disorder of HHT. Appropriate investigations can identify the AVMs and prompt intravascular intervention can be successful. Genetic analysis confirms the underlying HHT.
Long-standing, Untreated Case of Autosomal Recessive Hypercholesterolemia in a Child
Authors: Goel Neha , Kumar Akash , Chhabra Suhail , Chopra Nidhi , Agrawal Meetu
Published: November 2024

Background:

Autosomal recessive hypercholesterolemia (ARH), a genetic disorder of the affecting lipid metabolism. We present a child with this disorder wo was long undiagnosed, for many years.

Clinical Description:

An 8-year-old girl presented with multiple soft, painless, progressively increasing since the age of 2 years. Although lipid profiles had been found to be abnormal, she was not evaluated nor treated till 8 years of age. On examination, the swellings were present over upper and lower limbs and buttocks.

Management and Outcome:

Low-density lipoprotein (LDL) levels were elevated. Histopathology of the lesions confirmed xanthoma with immunohistochemistry being positive for CD 68 and ki67 index - 15%–20%. Next-generation sequencing homozygous mutation involving intron 15 of chromosome variant c2312-1G > A, causing loss of function variant in gene LDL receptor. The child was treated with gradually increasing doses of atorvastatin, with periodic echocardiography. There was progressive lowering of LDL over 6 months.

Conclusion:

Ignorance among pediatricians regarding this rare entity of ARH may result in lack of initiation of treatment for years, which may lead to detrimental cardiovascular complications in later life. Genetic analysis and prompt treatment can help in improving lipid parameters.
Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome
Authors: Jain Mansi , Patnaik Lavina , Mangla Pragya , Raizada Nishant
Published: November 2024

Background:

Precocious puberty (PP) is common in children and manifests commonly with increased linear growth. Van Wyk–Grumbach (VWG) syndrome is a rare cause of PP with short stature and delayed bone age.

Clinical Description:

An 11-year-old girl presented with early menarche, menorrhagia, and stunted height. Examination revealed pallor, dry skin, absence of axillary and pubic hair, and the presence of breast development (Tanner stage 3). A magnetic resonance imaging of the brain by a primary physician revealed a pituitary mass and was referred to neurosurgery, who, however, referred the child to us endocrinologists.

Management and Outcome:

Standard protocol-wise approach showed short stature with delayed bone age, high levels of thyroid-stimulating hormone, follicle-stimulating hormone and prolactin, raised antithyroid peroxidase antibodies along with multicystic ovaries bilaterally, thus cliniching the diagnosis of VWG Syndrome. The patient was started on levothyroxine and showed remission of symptoms and normalization of thyroid function tests as well as pituitary size.

Conclusion:

It is important to be aware that VWG syndrome may be a cause of PP in which the increase in size of the pituitary is reversible with initiation of thyroxine therapy along with complete resolution of all symptoms, avoiding unnecessary surgical interventions.
Should premenstrual syndrome and premenstrual dysphoric disorder coexist in diagnostic manuals: Exploring the answer through citation analysis
Authors: Paul Sayanti , Pal Arghya
Published: November 2024

Background:

Premenstrual syndrome (PMS) and premenstrual dysphoric disorders (PMDDs) both represent the most studied premenstrual disorders. Most studies have substantial prevalence of both PMS and PMDD, though the current understanding of the disorders reflects that PMDD is the more severe disorder of the two. However, there is substantial overlap in the etiopathogenesis and treatment approach of both these disorders.

Aim:

The current study thus explored trends of the use of PMS and PMDD as diagnostic entities.

Materials and Methods:

The study was conducted using Harzing’s Publish or Perish for identifying top 50 cited articles on PMS and PMDD, published between 2013 and 2023. The search and the citation metrics were obtained from Google Scholar through the mentioned software. The citation metrics of the two groups of studies were compared, and appropriate statistical maneuvers were used.

Results:

The PMS studies had a higher mean number of citations than PMDD studies. The PMDD studies tended to have a higher number of authors from Psychiatry or related background. The PMDD studies also had higher representation of institutions from the United States of America.

Conclusion:

Using citation analysis to study the utilization trends of diagnostic label is a novel approach. This study shows that there is a need for a unique diagnostic entity to represent the premenstrual disorders, and the coexistence of PMS and PMDD is redundant.
Control of Noncommunicable Diseases and Decentralization in Kerala: Results from a Qualitative Study
Authors: Fernandez Bhavya , Ravindran Rekha M. , Anju R. , Sumitha T. S. , Lakshmi G. G. , Krishnan S. Athira , Kodickal George Joseph , Nujum Zinia T. , Iype Thomas , Varma Ravi Prasad
Published: November 2024

Introduction:

In Kerala, strategic thinking on noncommunicable diseases (NCD) control began in the early 2000s with several localized programs being implemented, involving different levels of administration. This study was conducted to explore how the local governments are complimenting the national- and state-level programs in combating NCDs.

Materials and Methods:

This was a qualitative study incorporating a review of documents, key informant, and in-depth interviews with relevant stakeholders who had central roles in implementing NCD control activities in the state.

Results:

A myriad of innovations had been implemented by local self-governments (LSGs) at the primary, secondary, and tertiary levels of prevention across the state. LSGs often stepped in to provide human resources and medicines and improve the infrastructure and services, including laboratory services, to support the functioning of family health centers. Involvement of LSGs assisted in tackling the social determinants of health through intersectoral coordination and increased community participation.

Conclusion:

Overall, this exploration into the role of LSGs in NCD control revealed many successful models of how LSGs can contribute to the control of NCDs. If certain inadequacies like, the lack of sustainability of interventions and a heightened emphasis on secondary prevention, are addressed, the initiatives of the LSGs can assist in achieving the sustainable development goals of the state in NCD control. Training is essential for the elected leaders along with the health-care workers to analyse and interpret the locally available data, with mapping of good practices and scaling up to improve the health outcome of the population.
Therapeutic Efficacy of Flavonoid Morin against Dyslipidemia and Renal Damage in Diabetic Rat
Authors: Shali Kochuvelickakathu Sivan , Mini Saraswathy
Published: November 2024

Background:

Dyslipidemia is a common metabolic abnormality in diabetic patients and is a major contributor of diabetic kidney disease. The current study assessed the impact of morin, a flavonoid present in fruits and vegetables on serum lipid profile and renal function markers in rats with diabetes induced by streptozotocin.

Methodology:

Streptozotocin (40 mg/kg body weight [bwt], intraperitoneally) is used to induce diabetes in male albino Sprague–Dawley rats. After 3 days, those having blood sugar levels over 250 mg/dL were regarded as diabetic. Five distinct groups of experimental animals were constituted: Group 1: Normal control (N); Group 2: Normal rats administrated with morin at 50 mg/kg bwt (N + Mo); Group 3: Diabetic control (D); Group 4: Diabetic rats administrated with morin at 50 mg/kg bwt (D + Mo); and Group 5: Diabetic rats administrated with metformin at 100 mg/kg bwt (D + Met). Morin and metformin were provided once daily for 60 days. Blood samples of the rats were gathered for biochemical testing and results were statistically analyzed.

Results:

The elevated levels of total cholesterol, triglyceride, and low-density cholesterol of diabetic animals were significantly (P < 0.05) ameliorated by morin. While morin treatment could enhance high-density lipoprotein cholesterol (P < 0.05). Furthermore, morin decreased the serum renal function markers such as urea, uric acid, creatinine, and blood urea nitrogen.

Conclusion:

This study proved that morin improved the alternations in serum lipid profile and kidney function parameters in streptozotocin-induced diabetic rats.
Comparison of single-dose erector spinae plane block versus paravertebral block for pyeloplasty surgery in children – A prospective, randomized study
Authors: Kundal Raksha , Hayaran Nitin , Kant Vishal , Pandey Maitree , Kundal Vijay K.
Published: November 2024

Background and Aims:

Open pyeloplasty in children is associated with considerable postoperative pain. The paravertebral block (PVB) is commonly performed to control postoperative pain in such surgeries. Erector spinae plane block (ESPB) has recently been described as effective in providing postoperative analgesia in pediatric abdominal surgeries. This randomized, assessor-blinded study compared postoperative analgesic effects between ESPB and PVB in children undergoing pyeloplasty.

Material and Methods:

Eighty pediatric patients scheduled for elective pyeloplasty were randomly allocated to receive either ultrasound-guided (USG) ESPB or PVB. Postoperative pain evaluation was done using the face, legs, activity, cry, and consolability (FLACC) scale for children up to 7 years of age and the visual analog scale (VAS) for children in the age group between 7 and 10 years at 0, 2, 4, 8, 12, and 24 h. The time of first rescue analgesia, the number of doses of analgesic, successful first puncture rate, and block-related complications were noted.

Results:

No significant differences were noted in the FLACC/VAS scores, duration of time to first rescue analgesia (575.90 ± 118.81 vs. 617.05 ± 144.20, P = 0.168), the number of rescue doses once and twice over 24 h was 72.5% versus 67.5% and 27.5% versus 32.5% (P = 0.626) between ESPB vs PVB. The incidence of hematoma at the block site was higher in the PVB group (10%) compared to the ESPB group (0%) (P = 0.04). The incidence of first puncture success in the block was better in ESPB (P = 0.003).

Conclusions:

Both ESPB and PVB can be effectively used for controlling post-pyeloplasty pain in children. The ease of performing the block and the relatively lower incidence of hematoma at the block site make ESPB more advantageous.
Controlling Oxidative Stress and Inflammation in Chronic Kidney Disease: The Role of Nutritional Interventions
Authors: Anandh Urmila , Saxena Anita
Published: November 2024

Multiple factors impact the kidney health. Underlying comorbidities (diabetes and hypertension), medications, genetic predisposition, autoimmunity, and environmental insults play an important role. The vulnerability of the kidneys is to some extent because of the large proportion of blood it receives. It is the recipient of multiple deleterious substances with very little defense mechanisms. Over the years, low-grade subclinical inflammation and oxidative stress have been shown to play an important role in the progression of chronic kidney disease (CKD). Kidneys unfortunately have very little antioxidative defense mechanisms. Furthermore, there is a complex interplay of multiple factors, resulting in persistent inflammation in patients with CKD. Both oxidative stress and inflammation worsen as the glomerular filtration rate declines. Researchers involved in this area have tried many medications, probiotics, and dietary interventions to mitigate both oxidative stress and inflammation in patients with CKD with little success. There has been considerable research in this area and this review summarizes the interventions available to clinicians taking care of these vulnerable patients.
To Assess the Role of Intradialytic Parenteral Nutrition on Malnutrition in End-Stage Renal Disease Patients on Maintenance Hemodialysis – A Study from Tertiary Care Center in North India
Authors: Upadhyay Avinash , Nigam A. K. , Jain Apoorva , Sinha Archana , Yadav Subhash Chandra , Singh Akhilesh Kumar , Chauhan Niteesh Singh , Chaudhary Omprakash , Agarwal Niharika
Published: November 2024

Background:

Chronic kidney disease (CKD) is a progressive condition. The global estimated prevalence of CKD is 13.4% (11.7%–15.1%), and for patients with end-stage kidney disease needing renal replacement therapy is estimated between 4.902 and 7.083 million. The prevalence of malnutrition among chronic hemodialysis patients ranges from 10% to 70%. Intradialytic parenteral nutrition (IDPN) is the cyclical therapy, in which patients with protein-energy wasting are provided with 3-in-1 parenteral nutrition formula containing glucose, lipid emulsion, and essential and nonessential amino acids. Studies have shown that IDPN led to increase in appetite, increased calorie and protein intake, and increase in body weight, arm muscle circumference, serum transthyretin, and albumin concentrations. Therefore, the role of IDPN in treating malnutrition in end-stage renal disease (ESRD) patients on maintenance hemodialysis is pivotal and is the subject of increasing interest.

Aim:

The aim of this study was to assess the role of IDPN on malnutrition in ESRD patients on maintenance hemodialysis.

Materials and Methods:

This was an observational analytical study with follow-up and was conducted in Postgraduate Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh. All patients undergoing maintenance hemodialysis for ≥3 months were eligible for participation in the study. Dietary intake in terms of calories, protein, fat, carbohydrates, sodium, potassium, and phosphorus was calculated using Diet*Calc software. Patients’ nutritional status was assessed with the 7-point subjective global assessment tool (considered the gold standard for assessment of malnutrition) and by anthropometric and biochemical parameters. The primary endpoints of the study were a rise in serum albumin, and a decrease in C-reactive protein (CRP), with improvement in anthropometric parameters of malnutrition.

Results:

In the present study, the prevalence of malnutrition was 38.29%–96.8% depending on the criteria used for the assessment of nutritional status. Of the total 94 maintenance hemodialysis patients who participated in the study, 21 (22.34%) patients received IDPN therapy, for 3 months. Statistically significant rise in mean calorie (kcal/d), protein (g), and fats (g) intake and rise in serum albumin and serum total protein, and decrease in CRP was seen during follow-up at 6 months during the study period.

Conclusions:

IDPN therapy is associated with significant improvement in nutritional parameters and thus should be indicated in patients with malnutrition despite adequate dietary counseling or inability to tolerate oral nutritional supplements.
Assessment of Nutritional Status through InBioZ Wearable Body Composition Monitor and Handgrip Dynamometer Correlating with Subjective Global Assessment and Biochemistry in Maintenance Hemodialysis Patients
Authors: Abraham Georgi , Nagaran Vijayashree , Mathew Milly , Champannoor Cherin Josi , Jain Khusi
Published: November 2024

Introduction:

Malnutrition is highly prevalent in hemodialysis (HD) patients and results in impaired health-related quality of life, as well as increased risks of hospitalization, morbidity, and mortality. Muscle mass wasting is the main manifestation of malnutrition for dialysis patients, so it is important to distinguish fat and muscle mass when performing nutritional assessment. However, the body composition analyzers available in the market are very expensive and not easily movable. Hence, the advantages of body composition monitor (BCM) are not utilized in most hospitalized patients, including chronic kidney disease (CKD) not on dialysis, CKD on HD, and peritoneal dialysis patients.

Aim:

The current research was undertaken to find out the body composition and handgrip strength (HGS) to determine the nutritional status of the patients on maintenance HD (MHD) and correlate the results with subjective global assessment (SGA) and biochemistry.

Methodology:

Thirty patients who gave consent (60% of males and 40% of females) undergoing HD were randomly selected for the study and nutritionally assessed using SGA, InBioZ wearable BCM device, handgrip dynamometer, and biochemistry.

Results:

The SGA diagnosed 33.3% of the patients are moderately malnourished, with 40% of them having a weight loss of 2%–5%, 26.6% with suboptimal nutrient intake, 26.6% had a loss of appetite and nausea, 36% of them had loss of muscle, and 26.6% had mild-to-moderate fat loss. This was evidenced by the body composition, showing 15% of the patients having lower body fat percentage, 53.3% with lower muscle mass, and 31.7% with low body protein. We found that serum albumin levels were lower, 25% of the patients have hypoalbuminuria with <3.5 g/dL. The HGS showed that 60% of them have below average HGS (in the non- arteriovenous fistula [AVF] arm) and 36% had average muscle strength.

Conclusion:

Prevalence of malnutrition is found in 33% of the selected MHD patients. Early nutritional assessment and medical nutrition therapy are beneficial in managing malnutrition in these patients. Patients who are identified as malnourished through the SGA and biochemistry also showed low muscle mass and muscle strength. Along with SGA and biochemistry, simple wearable BCM and HGS can be useful in diagnosing malnutrition and further nutritional management.