bluuebunny/crossref_metadata_2025 huggingface dataset:
Atuação das cooperativas de crédito no processo de inclusão financeira no Brasil
Authors: Greatti Lígia , Meurer Sela Vilma
Published: September 2021

2021RESUMOA proposta deste artigo consiste em analisar a atuação das cooperativas de crédito no processo de inclusão financeira no Brasil, ressaltando sua importância enquanto atores implementadores. O estudo se caracteriza como qualitativo, sendo utilizada para a coleta de dados primários entre-vistas semiestruturadas com atores considerados importantes no processo de inclusão financei-ra, e para coleta de dados secundários pesquisa documental sobre o cooperativismo de crédito em publicações digitais e relatórios de inclusão financeira do Banco Central do Brasil (BCB). As entrevistas foram analisadas por meio da análise de conteúdo, visando uma melhor sistematiza-ção e organização das informações por categorias de análise. A pesquisa evidenciou que a alta capilaridade do cooperativismo de crédito, a capacidade que possuem de manter o capital na localidade, a equalização das taxas de juros que promovem, a democratização nas decisões e a educação financeira que proporcionam são alguns dos pontos principais pelos quais as coope-rativas de crédito são consideradas importantes atores implementadores da inclusão financeira, contribuindo assim para o desenvolvimento de uma determinada localidade.
Disclosure corporativo da água: quais informações são asseguradas externamente?
Authors: Borges Silveira Gabriela , Van Bellen Hans Michael
Published: September 2021

As divulgações acerca das práticas de gestão e dos impactos corporativos relacionados à água podem ter sua relevância fortalecida pela credibilidade atribuída às informações que são asseguradas externamente. Desse modo, esta pesquisa teve como objetivo identificar quais itens do disclosure corporativo da água são submetidos à asseguração externa pelas companhias brasileiras listadas na B3 que asseguraram seus relatórios de sustentabilidade (RS) no período de 2017-2018. Para operacionalização da pesquisa, utilizou-se o Sumário Remissivo da GRI Standards e os Relatórios de Asseguração Independente anexados ao RS para coleta e análise das informações relativas à água divulgadas e asseguradas externamente. Os resultados demonstraram que as informações divulgadas reportam sobre impactos e riscos potenciais associados ao uso da água por parte da organização. Esses indicadores estão diretamente vinculados à qualidade da água, aos custos operacionais e aos impactos ecológicos, e permitem que as organizações avaliem os riscos regulatórios e de reputação. A respeito disso, a predominância de informações físicas sobre água reforça a necessidade de que as informações monetárias sejam incorporadas no desenvolvimento da contabilidade corporativa da água. Além disso, as análises dos sumários remissivos da GRI e dos relatórios de asseguração documentaram a baixa incidência de empresas que sinalizaram a asseguração por conteúdo e a superficialidade dos trabalhos de asseguração realizados. Esses achados sugerem a falta de transparência e reforçam o importante debate sobre a efetiva contribuição da asseguração externa para impulsionar a sustentabilidade dentro das organizações.
Compressive Strength of Steel Fiber Reinforced Polymer Modified Recycled Aggregate Concrete
Authors: Awchat Ganesh D.
Published: September 2021

Demolish existing structures for better economic gains, functional and structural performance, and non-availability of land or disposal sites in nearby areas of all major cities worldwide turned as a significant reason for the crushing demolished concrete instead of using it as landfill. Research work aimed at arriving Recycled Concrete (RC) with the help of two materials, i.e. Steel Fibers (SF) and Styrene-Butadiene Rubber (SBR) latex, as additives to improve strength parameters of it. SF and SBR added in RC to examine & strengthen and termed as Steel Fiber Reinforced Polymer Modified Recycled Aggregate Concrete (SFRPMRAC). For this purpose, 198 cubes each of M20 (trial-1) and M25 (trial-2) cast separately to check compressive strength and its stress-strain behaviour for Natural Concrete (NC), RC & SFRPMRAC. The volume fractions of SF added 0.5%, 1% & 1.5% m3 of concrete and dosages of SBR latex varied from 2.5%, 5% and 7.5% by cement weight for preparation of cubes made of RC. From experimental results, SFRPMRAC with SF volume fraction of 1% m3 of concrete and 5% by cement weight provides an improvement in compressive strength by 8.62 % & 10.73 % for trial -1 and 11.51 % & 12.57 % for trial - 2 at 28 & 90 days when compared with NC. Compression stress-strain behaviour for SFRPMRAC with SF 1% m3 of concrete and 5% by weight of cement shows higher strain values at the peak stress. SFRPMRAC arrests the sudden drop of load due to co-matrix bond formation between SF and SBR in a linear direction compared to a similar NC & RC mix for both trials. It reflects significant improvement and approval of compressive strength for the desired purpose.
The Management of Architectural Heritage Resources
Authors: Trif Andreea Gabriela , Burada Cristian Oliviu
Published: September 2021

The management of historic buildings is achieved through several types of interventions. The interventions are established in relation to the degree of protection through the List of Historical Monuments, or through its intrinsic value mentioned by the preliminary studies. In principle, within a historical area, cultural values ​​can be exceptional, high, medium and null. Safeguarding historic areas is considered fundamental to the local culture of each settlement. The patrimony of a community represents the accumulation of experiences, of crafts and arts, of its development. Heritage is the legacy left to future generations. Therefore, any intervention in a protected area must be subject to the rules for the protection of the original substance and valuable compositional elements. Another important goal is focused on managing the concept of built value. Thus, it must be borne in mind that any cultural objective must be doubled by a certain value of use. Any space that requires preservation will be better maintained if used. Consequently, the management of cultural value, involves the management of functions, strategies for establishing development directions. This balance can be ensured through intervention regulations that can provide for permitted, conditional and prohibited uses. In the article we present the ways in which interventions on historical monuments can be managed. The main professional concepts must be supported by effective urban instruments, implemented at administrative level. We also aim to present possible strategies for attracting investors and promoting architectural heritage resources. The balance of decisions, the process from the study of cultural value, to the implementation of the intervention categories and to the realization of the projects represent the main focus of the study. Our conclusions will be based on the project made for the protection and restoration of the historical center of Craiova.
Transport Oriented Framework for Context-Aware Services Management
Authors: Drăgănescu Celestin
Published: September 2021

The paper proposes a dynamic adaptive framework that responds to the needs of context-aware services provided by the intelligent transport systems. The executive core of this framework is a software architecture model that ensures the running of an application which is adaptable to context changes. The solution was tested on a case study that highlights provided contextual information through an inter-vehicle communication system.
Methods, Instruments in Evaluating the Satisfaction Index of Passengers in Urban Public Transport
Authors: Serban Alin
Published: September 2021

Understanding the factors that lie beneath travelers’ satisfaction and how they relate with service performance and different improvements is a key issue for operators and public authorities when aiming to maintain existing users and to attract potential users from the car's users. The purpose of the research is to investigate the perceived quality of public transportation in Bucharest, the capital of Romania, a city with over two million inhabitants and additional other two millions of transit citizens. This approach aims to identify the aspects that mostly influence the perception of overall quality of service and to investigate the main methods/instruments for evaluating the passenger satisfaction index. Moreover, the research aims to assess the public transportation users that are ready and available to shift their travelling habits from a fixed and periodic timetable service to the "mobility-as-a-service" approach. Research methodology combines qualitative study based on focus group with quantitative study based on surveys. The representative sample is selected from the Bucharest public transportation’s users. The results of the research could be used by the both public transportation operators and public authorities that have to comply to the national and european regulations in public transportation quality assurance.
Dynamic Systems - Applications in Economy and in Technology
Authors: Bălă Dumitru
Published: September 2021

In this paper, starting from recent data provided by the National Institute of Statistics, we analyze the tourism activity in Mehedinți County. We apply the regression method and analyze some models. We also compare the economic results with those of previous years. Also, in this paper we study the stability of dynamic systems with applications in economics. The stability study is done using the Leapunov function method. The originality of the paper consists in the way we choose the mathematical model in case of regression and in the way we choose the Leapunov function in case of dynamic systems in which we analyze stability.
Sec22b Regulates Inflammatory Responses by Controlling the Nuclear Translocation of NF-κB and the Secretion of Inflammatory Mediators
Authors: Arango Duque Guillermo , Dion Renaud , Matte Christine , Fabié Aymeric , Descoteaux Julien , Stäger Simona , Descoteaux Albert
Published: September 2021

Soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNAREs) regulate the vesicle transport machinery in phagocytic cells. Within the secretory pathway, Sec22b is an endoplasmic reticulum–Golgi intermediate compartment (ERGIC)-resident SNARE that controls phagosome maturation and function in macrophages and dendritic cells. The secretory pathway controls the release of cytokines and may also impact the secretion of NO, which is synthesized by the Golgi-active inducible NO synthase (iNOS). Whether ERGIC SNARE Sec22b controls NO and cytokine secretion is unknown. Using murine bone marrow-derived dendritic cells, we demonstrated that inducible NO synthase colocalizes with ERGIC/Golgi markers, notably Sec22b and its partner syntaxin 5, in the cytoplasm and at the phagosome. Pharmacological blockade of the secretory pathway hindered NO and cytokine release, and inhibited NF-κB translocation to the nucleus. Importantly, RNA interference–mediated silencing of Sec22b revealed that NO and cytokine production were abrogated at the protein and mRNA levels. This correlated with reduced nuclear translocation of NF-κB. We also found that Sec22b co-occurs with NF-κB in both the cytoplasm and nucleus, pointing to a role for this SNARE in the shuttling of NF-κB. Collectively, our data unveiled a novel function for the ERGIC/Golgi, and its resident SNARE Sec22b, in the production and release of inflammatory mediators.
Down Syndrome Cell Adhesion Molecule Triggers Membrane-to-Nucleus Signaling–Regulated Hemocyte Proliferation against Bacterial Infection in Invertebrates
Authors: Li Hao , Jin Xing-Kun , Zhou Kai-Min , Zhao Hui , Zhao Yue-Hong , Wang Qun , Li Wei-Wei
Published: September 2021

Down syndrome cell adhesion molecule (Dscam) generates tens of thousands of isoforms by alternative splicing, thereby providing crucial functions during immune responses. In this study, a novel Dscam signaling pathway was investigated in crab, which remains poorly characterized in invertebrates. Bacterial infection induced the cytoplasmic cleavage of Dscam intracellular domains (ICDs) by γ-secretase, and then the released ICDs carrying specific alternatively spliced exons could directly interact with IPO5 to facilitate nuclear translocation. Nuclear imported ICDs thus promoted hemocyte proliferation and protect the host from bacterial infection. Protein-interaction studies revealed that the ectodomain of Dscam bound to a disintegrin and metalloprotease domain 10 (ADAM10) rather than ADAM17. Inhibition or overexpression of ADAM10 impaired or accelerated Dscam shedding activity post–bacterial stimulation, respectively. Moreover, the shedding signal then mediated Dscam with an intact cytoplasmic domain to promote the cleavage of ICDs by γ-secretase. Furthermore, the transcription of ADAM10 was regulated by Dscam-induced canonical signaling, but not nuclear imported ICDs, to serve as a feedback regulation between two different Dscam pathways. Thus, membrane-to-nuclear signaling of Dscam regulated hemocyte proliferation in response to bacterial infection.
Lesson learned by COVID-19 outbreak: multilevel triage strategies in patients admitted to the emergency room in southern Italy
Authors: Di Micco Pierpaolo , Imparato Michele , Iannuzzo Maria Teresa , Fontanella Andrea
Published: September 2021

After identifying a novel disease inducing a severe acute respiratory syndrome-related to coronavirus 2 (SARS-CoV-2) for epidemic pneumonia in China, the diffusion of infection is ongoing around the world, and Italy has been the second country in which an epidemic has been demonstrated. Clinical features of this infection may be summarized in viral pneumonia that SARS or acute respiratory distress syndrome (ARDS) may complicate. For this reason, this epidemic has been considerably more aggressive than the previous epidemic of SARS and Middle-East respiratory syndrome. Coronavirus disease 2019 (COVID-19) showed an easy diffusion from human to human and also showed to be more contagious than other viruses. So human contact should be avoided at the emergency room and for inpatients too. The Triage should be adapted to these new features in order to speed up procedures for the care of infected patients at high risk of morbidity and mortality for SARS and ARDS and for traditional access to the emergency room. Based on our experiences, this flow chart has been designed with a multi-level triage in which patients have been divided for admission to the emergency room into patients with fever/respiratory symptoms and patients without fever\respiratory symptoms, to improve medical performances while treating COVID-19. This organized, multilevel triage permitted a good selection of patients admitted to the emergency room during the epidemic of COVID-19 in Southern Italy.
Substitution of Local Indonesian Varieties of Brown Rice on Anthropometry and Blood Glucose Level Improvement in type 2 DM Patients: A Pilot Project
Authors: Handayani Dian , Kusumastuty Inggita , Inayah Alma Maghfirotun , Retnaningtyas Ekowati , Sulistyowati Etik , Sasiarini Laksmi , Rudijanto Achmad
Published: September 2021

Background

Diabetes mellitus (DM) is a metabolic disorder whose prevalence increases globally. Medical nutrition therapy (MNT) is one of the DM management pillars to control blood glucose. Local Indonesian brown rice is proven to contain high fiber and magnesium levels thus could improve obesity, fasting blood glucose, and HbA1c. This study aims to prove the benefits of brown rice on anthropometric parameters and blood glucose control.

Design and methods

Respondents were overweight women older than 40 years with type 2 diabetes who were given three main meals and three snacks six days a week for 12 weeks. Anthropometric and blood glucose control data were collected before and after the intervention. Diet and intake data before the intervention were obtained through a semi quantitate food frequency questionnaire. Intake data during the intervention were recorded using the 24-hour food record and analyzed using modified NutriSurvey 2007 software.

Results

Brown rice intervention significantly reduced body weight, BMI, body fat percentage, and abdominal circumference (p<0.05), also in fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and HbA1c (p<0.05). From the Pearson's test results, an increase in fiber intake correlated with a decrease in BMI and abdominal circumference (p=0.03; r = -0.511 and p=0.006; r = -0.619, respectively). Meanwhile, magnesium intake and changes in BMI showed a negative correlation.

Conclusions

The substitution of brown rice as a staple food for 12 weeks improves anthropometric parameters and blood glucose control in respondents with type 2 diabetes.
Informal Caregivers and Psychosocial Support: Analysis of European Dementia Policy documents
Authors: Tokovska Miroslava , Nour Magde Mohamed , Sørensen Anette , Småland Goth Ursula
Published: September 2021

Various countries in Europe have different strategies for promoting care solutions for dementia challenges. The different approaches of Austria, Belgium, Czechia, Denmark, Finland, Germany, Gibraltar, Ireland, Israel, Malta, Nederland, Norway, Sweden and the United Kingdom (Scotland and Wales) were investigated. Dementia has a significant social, psychological and economic impact on the individual, family and society. As the disease progresses dementia sufferers become increasingly dependent. As many dementia sufferers are at home during the initial stages, the physical, emotional, and social demands of the dementia sufferers are often covered by informal caregivers. This study, therefore, aims to investigate the integration of psychosocial interventions for comprehensive care pertaining to informal caregivers of people with dementia in Europe. Furthermore, the study will highlight how implementation of technologies might enable psychosocial support of informal caregivers. The data is based on 15 national dementia strategies from various European countries. Data was based on preexisting coding systems with the predefined keywords and analyzed by qualitative content analysis by four of the authors. Our results show that psychosocial support is provided in various modalities and that informal caregivers need to be supported by a psychosocial approach. Due to this need the national dementia strategies should include measures to reduce the emotional burden of informal caregivers. Psychosocial support provided to informal caregivers in a comprehensive and systematic way is likely to enable informal caregivers to handle the emotional, cognitive, and behavioral consequences of the disease and its treatment, while helping to maintain their work-life balance.
The power of narrative health communication: Exploring possible effects of first-hand experiential stories on cancer awareness amongst university students
Authors: Sitto Karabo , Lubinga Elizabeth , Geya Molemi
Published: September 2021

Narrative health communication has the potential for effective health promotion about cancer amongst youth from low- and middle-income countries such as South Africa. Sub-Saharan Africa experiences a rising cancer-related disease burden with predicted increase of over 85% by 2030. Whilst promotion through communication, of cancer prevention strategies targeting 18–29 year olds remains scanty, it is crucial for cancer prevention behaviour before the disease develops. The study aimed at examining how narrative storytelling can create cancer awareness amongst students at the University of Johannesburg. A qualitative approach was adopted. During October 2019, an awareness session that formed part of a month-long health campaign involving various activities for students, promoted preventative behaviour leading to early cancer detection. Campus Health Services in collaboration with other University departments invited six cancer survivors and experts to share stories about their various cancer experiences with students and staff. Many of the participants aged between 18 and 49 years, indicated that they did not know how to engage in self-examination of their bodies and had never taken any cancer tests. Most of the participants expressed a willingness to engage in frequent self-examination and visiting health facilities to receive regular professional tests as a result of storytelling. Results may assist health promotion organisations with the construction of effective cancer health messaging especially for hard-to-reach groups such as youth in developing countries.
The other’s humanity with or without the other’s religiosity? Reflections on the affirmation and limitation of human dignity in early Afrikaner missionary discourse in Central Africa
Authors: Müller Retief
Published: September 2021

Taking Wentzel van Huyssteen’s work on early human uniqueness in relation to symbolic or religious awareness as a starting point, this article raises a question whether an implicit connection between humanity and the capacity for religiosity had anything to say about how one could evaluate the so-called other’s religion and their humanity. Does the recognition of the other’s full humanity demand an equal recognition of their religiosity, or are these separable? Rather than attempting to answer this hypothetically, the question is approached historically. The article touches on how the capacity to evaluate religion from the outside emerged in modernity and discusses some of the ways this capacity played out in Christian theology. In reference to the colonial era Afrikaner missionaries in Central Africa, the article argues that even partial recognition of the other’s religiosity might have detrimental consequences particularly where this is tied to a partial recognition of their humanity as had happened during the apartheid and proto-apartheid periods.Intradisciplinary and/or interdisciplinary implications: The article challenges both critical and affirmative scholarly views of religiosity by positing an essential link between humanity and religiosity whilst simultaneously suggesting that a scientific approach to religiosity, which has uncovered important relationships between religiosity and humanity, might be the appropriate approach for full recognition of the other’s humanity.
Utility of Transcranial Magnetic Stimulation and Diffusion Tensor Imaging for Prediction of Upper-Limb Motor Recovery in Acute Ischemic Stroke Patients
Authors: Kumar Pradeep , Prasad Manya , Das Animesh , Vibha Deepti , Garg Ajay , Goyal Vinay , Srivastava Achal K.
Published: September 2021

Background:

The recovery of the upper-limb (UL) motor function after ischemic stroke (IS) remains a major scientific, clinical, and patient concern and it is hard to predict alone from the clinical symptoms.

Objective:

To determine the accuracy of the prediction of the recovery of UL motor function in patients with acute ischemic middle cerebral artery (MCA) stroke using individual clinical, transcranial magnetic stimulation (TMS) or diffusion tensor imaging (DTI) parameters or their combination.

Methods and Material:

The first-ever acute ischemic MCA stroke patients within 7 days of the stroke onset who had an obvious UL motor deficit underwent TMS for the presence of motor-evoked potential (MEP) and DTI to evaluate the integrity of corticospinal tracts. Multivariate logistic regression analysis was done to test for the accuracy of the prediction of the recovery of UL motor function.

Results:

Twenty-nine acute ischemic MCA stroke patients (21 males and 8 females) with a mean age of 51.45 ± 14.26 years were recruited. Model-I included clinical scales (Fugl-Meyer Assessment [FMA] + Motricity Index [MI]) + TMS (MEP) + DTI (fractional anisotropy [FA]) were found to be the most accurate predictive model, with the overall predictive ability (93.3%; 95% confidence interval [CI]: 0.87–0.99) and sensitivity: 94.9% (95% CI: 0.87–1.0) and specificity: 95.8% (95% CI: 0.89–1.0); respectively.

Conclusion:

The accuracy of UL motor recovery can be predicted through the clinical battery and their elements as well as TMS (MEP) and DTI (FA) parameters. Further, well-designed prospective studies are needed to confirm our findings.
Evaluation of Barrett Universal II, SRK-T, and Haigis formulae for intraocular lens power calculation in myopes using optical biometry
Authors: Aziz Demiana W. , Osman Moataz H. , Hassan Nihal A. , Bahgat Nermeen M.
Published: September 2021

Objective

To assess the precision of Barrett Universal II, SRK-T, and Haigis formulas in high myopic eyes for the estimation of intraocular lens power, using optical biometry.

Patients and methods

This is an interventional prospective study that included 34 eyes with an axial length more than or equal to 26 mm, who underwent uneventful phacoemulsification. One month after the surgery, we recorded the postoperative refraction. Refractive prediction error (RPE), median absolute error (Med AE), and proportion of eyes with postoperative myopic and hyperopic outcomes were compared.

Results

The lowest mean RPE (−0.11±0.90 D), Med AE (0.15 D), and proportion of eyes with hyperopic outcomes (44.1%) were reported with the Barrett Universal II formula. They were all statistically lower than the results of SKR/T and Haigis formulas (mean RPE 0.16±0.99 and 0.31±0.98 D, respectively; Med AE 0.47 and 0.40 D, respectively; and percentage of hyperopic outcome 70.6 and 76.5%, respectively).

Conclusion

We concluded that the lowest mean RPE, median AE, and the lowest percentage of hyperopic outcome were reported with the Barrett Universal II formula.
Intraoperative breakage of a 25-G vitrectomy probe tip
Authors: Akeely Adel Al , Alhazimi Amro
Published: September 2021

We report breakage of the tip of a 25-G advanced ULTRAVIT vitreous cutter during vitrectomy for vitreous hemorrhage. During the procedure, we noticed that the cutter tip broke. We switched to another vitrectomy pack of the same brand, and the procedure continued without further complications. Intraoperative and postoperative examinations revealed no broken pieces remaining in the eye. Breakage of 25-G instruments intraoperatively during vitrectomy is a rare occurrence that can lead to complications. Keeping the vitrectomy probe at a safe distance from the light pipe and inspecting the instruments while working inside the eye can help avoid such an event.
Assessment of outcomes of a hospital-based tobacco cessation intervention program
Authors: Torwane Nilesh Arjun , Dayma Ashwini , Hongal Sudheer , Ahire (Torwane) Priyanka Anil
Published: September 2021

Background:

Tobacco use among adult Indian population is 34.6% by Global adult tobacco survey (2016–2017) reported 6.8 crores urban, 19.9 crores rural Indians are tobacco consumers. M. P state fact file declares highest tobacco consumers residing in Madhya Pradesh.

Methodology:

The current study is an individual as well as community-based tobacco intervention program, to evaluate the trends of tobacco use, awareness related to tobacco hazard, quit tobacco regime, withdrawal, relapse in post intervention follow-up.

Results:

In the total regime of 3 months starting from detox groundwork of body for cessation to behavior modification, phase of nicotine replacement therapy (NRT) to pharmacological intervention at spaced out follow-up the graph gradually declined down of individuals positively motivated for quitting.

Conclusion:

Tobacco cessation (quitting) with behavior modification, NRT, and Pharmacological mode is a relatively novel approach of tobacco control in India. It is considered to be the most cost-effective intervention as compared to other tobacco control programs and other approaches of reducing tobacco menace.
Awake Repositioning among COVID Patients
Authors: Sharma Tarika , Singh Jitender , Ahwal Sarita
Published: September 2021

Awake repositioning has been recommended in various national and international guidelines for the management of COVID-19 as patients with moderate-to-severe acute respiratory distress syndrome appear to have responded well to treatment in the position changes. It involves moving patients' positions in such a way that led to improve the respiratory status. Awake repositioning among COVID patients improves ventilation, reduces hypoxemia, and improves secretion clearance. Nurses must be aware of the correct technique of awake repositioning and must educate the community at large on how to perform the awake positioning using mass media or telenursing services. The current review highlights the significance of awake repositioning in patients with COVID-19 along with nursing considerations.
Comparison of the influx of bacterial-sized particles in single plane versus multiplane femtosecond laser incisions
Authors: May William , Al Mutlak Mohammed , Aalam Waseem , Rashidi Sultan , Khandekar Rajiv
Published: September 2021

Purpose:

To present ingress of dye particles that are of size of bacteria though single and multi-planar corneal incision created by femtosecond laser in donor eyes.

Setting:

A tertiary eye Hospital, Central Saudi Arabia.

Design:

Ex vivo experimental study.

Methods:

This ”as ex vivo experimental study. Eyes acquired from an eye-bank that ”ere deemed unsuitable for corneal transplant ”ere used to create single as ”ell as multi-planar corneal incision using LenSx femtosecond laser. Each eye received single plane (SP) and one of the multiplanes either default multi-planar (DMP) or a right-angled multi-planar (RAMP) incision. After maintaining intraocular pressure (IOP), India ink ”as placed on the ”ound. Length and ”idth of ingress dye ”ere photographed and measured for different types of ”ound.

Results:

A total of 10 eyes ”ere used for this experiment. At physiologic IOP, the median and 25% quartile of length”ise invasion ”as 0.29 mm for the SP group (10 eyes), 0.23 mm for the DMP group (5 eyes), and 0.22 mm for the RAMP group (5 eyes). The difference of ingress bet”een the SP and RAMP groups as ”ell as SP and DMP group ”ere statistically significant (P = 0.005). The difference in length”ise and area ”ise invasion bet”een the DMP and RAMP groups ”as not statistically significant (P = 0.5).

Conclusion:

Bacteria size particle ingress seems to be more likely through SP incision compared to multi-plane corneal incisions created ”ith a femtosecond laser.
Posterior-segment intraocular foreign body removal preserving intraocular lens – A novel technique
Authors: Bindra Chahveer Singh , Bindra Parminder Singh , Bindra Preeti
Published: September 2021

We report a case presenting with corneal tear with vitreous incarceration with intraocular foreign body (IOFB) impacted in the retina following hammer chisel injury. Following anterior-segment repair and anterior vitrectomy, standard 23G pars plana vitrectomy was performed, and impacted foreign body was released. Metallic IOFB was retrieved with the help of 23G magnet just behind the intraocular lens (IOL) following which serrated forceps was used for grasping. 23G magnet was now used via limbal incision to retrieve the foreign body in the anterior chamber through the preexisting posterior capsular rent. After stabilization of the anterior chamber with viscoelastic injection, IOFB extraction was done with the help of serrated forceps by extending the side port. This surgical technique appears to be safe and effective for retrieving fragile, slippery, large IOFB without explanting the IOL and extension of scleral incision with prompt recovery.
Leukemic retinopathy with rare presentation in B-cell acute lymphoblastic leukemia
Authors: Bodhankar Paurnima U , Balakrishnan Divya , Basheer Nadhna , Gopalakrishnan Mahesh , Anantharaman Giridhar
Published: September 2021

A 14-year-old male presented with blurring of vision, headache, and bilateral serous macular detachment (SMD) with thick choroid without any significant leak on fluorescein angiogram. As the imaging was inconclusive, we advised him thorough systemic evaluation. His platelet count was significantly reduced with a higher percentage of blast cells on peripheral smear. The diagnosis of B-cell acute lymphoblastic leukemia was confirmed by an oncologist on flow cytometry and was immediately started on chemotherapy. After a month, SMD resolved completely with the restoration of visual acuity. This case highlights the role of early diagnosis and urgent treatment before systemic manifestations reducing disease mortality.
Ologen collagen matrix for bleb repair in long standing sweating bleb- A case report with histopathological correlation
Authors: Rao Aparna , Dcruz Rakhi P. , Sahoo Nibedita
Published: September 2021

A 68-year-old man, presented with reduced vision and hypotony 6 years after combined cataract + glaucoma (phacoemulsification + trabeculectomy + intraocular lens) surgery with Mitomycin-C, clinical evaluation depicted a sweating bleb. Surgical repair was done with the use of donor scleral patch graft and collagen matrix implant along with conjunctival advancement. Histopathology of the excised thinned-out bleb wall showed a single layer of metaplastic conjunctival epithelium with the complete absence of goblet cells. The use of adjuvant mitomycin-C in trabeculectomy is known to cause bleb leak and associated complications in the long run. However, the histopathological features of sweating blebs and their surgical management is not well defined in the literature.
Inflamed pedunculated giant molluscum contagiosum of eyelid in an immunocompetent child
Authors: Surya Divyalakshmi Kaiyoor , Arunachalam Cynthia
Published: September 2021

Molluscum contagiosum (MC) is a skin infection caused by a member of the Poxvirus family. It typically affects young or immunocompromised individuals.[1]. Lesions are localised localized on the face, arms, legs, and anogenital region. Typically, it presents as single or multiple umbilicated papules or nodules on the skin and eyelid margin and conjunctiva.[2] There are very few reports of giant molluscum presenting as an inflammatory lesion in an immunocompetent patient. Here, we are presenting a case of solitary giant MCmolluscum contagiosum presenting like an inflamed pedunculated mass of eyelid in an immunocompetent child.

A one 1½and half -year- old immunocompetent child presented with an inflamed large umbilicated lesion in upper eyelid which was excised in toto. Excision revealed a gyriform lesion and histopathologic confirmation was done.
Risk factors for thyroid-associated orbitopathy due to Graves' disease
Authors: Nabi Tauseef , Rafiq Nadeema , Dar Imtiyaz Ahmad
Published: September 2021

Background:

Thyroid-associated orbitopathy (TAO) is the principal extrathyroidal manifestation of Graves' disease (GD). TAO is described as chronic inflammation of orbital and periorbital tissue. Environmental risk factors variably influence the development of TAO and risk factors vary with ethnicity and geographical region.

Aims:

To evaluate the clinical factors for TAO in patients with GD.

Setting and Design:

This was a hospital-based cross-sectional study done on consecutive 76 newly diagnosed patients of GD documented by thyroid 99mtechnetium-pertechnetate scan.

Materials and Methods:

Patients were subjected to a complete clinical workup and thyroid profile. The diagnosis of TAO was based on the criteria of Bartley and Gorman. Fifty-two TAO patients were compared with 24 non-TAO patients (controls) for risk.

Statistical Analysis Used:

All analyses were performed using SPSS software (version 21.0).

Results:

TAO was present in 52 (68%) of patients with GD. TAO was bilateral in 50 (96%) patients. Majority of the patients had mild orbitopathy (34, 65.4%) and none of the patients showed any signs of sight-threatening disease. Clinical activity score was active in 13.5% of the study group. There was significant female preponderance in TAO. Current smoking increased the risk of TAO (P = 0.023). Total triiodothyronine (T3) and mean intraocular pressure (IOP) in primary and upward gaze were significantly elevated at baseline in TAO patients. Braley's sign was seen in 30.7% of patients with TAO and in 8.3% of patients in the control group (P = 0.033). Current smoking, total T3 >4 ng/dl, and differential IOP >6 mmHg were found to be associated with the risk of TAO.

Conclusion:

TAO was clinically inactive and of mild severity in most cases. This study identified current smoking, total T3 >4 ng/dl, and differential IOP > 6mmHg as risk factors for TAO.
Strabismus surgery in poor binocular potential
Authors: Khurana Rolli , Agrawal Siddharth , Singh Vinita , Agrawal Mohini
Published: September 2021

Background:

Previous studies prove improvement in quality of life (QOL) after strabismus surgery.

Aims:

The aim is to study the change in QOL and binocular functions after strabismus surgery in patients with poor binocular potential.

Setting and Design:

A tertiary care center-based prospective study was done over a period of 1 year to evaluate the change in scores of adult strabismus-20 (AS-20) questionnaire after successful strabismus surgery.

Materials and Methods:

All patients above 10 years attending the orthoptic clinic with horizontal squint were evaluated for their probability of gaining binocularity on binocular potential score and were graded into four categories. Those with poor grade of binocular potential, having a poor chance of regaining binocularity after surgery, were included in the study. They underwent surgical ocular alignment and answered the AS-20 questionnaire for QOL preoperatively and 3 months postoperatively.

Statistical Analysis Used:

Comparison of preoperative scores was done using unpaired t-test. The mean pre- and post-operative scores were compared using paired t-test. Two-sided significance level with P < 0.05 was considered statistically significant.

Results:

Out of 53 patients, surgical outcomes of 5 were outside successful limits. Of the remaining, 18 (37.5%) were esotropic and 30 (62.5%) had exotropia. Improvement in the mean psychosocial and functional scores was 13.1 ± 6.0 and 7.6 ± 6.3, respectively. Mean overall, psychosocial, and functional QOL scores were significantly higher after successful surgical ocular alignment.

Conclusion:

Statistically significant improvement occurs in psychosocial and functional QOL of strabismus patients (on AS-20) with poor binocular potential undergoing successful strabismus surgery. Thus, ocular alignment in such cases can be a feasible option for improving QOL rather than mere cosmetic comeback.
Estimation of Postmortem Interval by Postmortem Myocardial Computed Tomography Value
Authors: An Zhiyuan , He Hongxia , Niu Qing , Zhu Haibiao , Wang Yucong , Liu Ran , Hou Weiliang , Tang Peng , Yang Tiantong , Zhao Dong
Published: September 2021

Background:

The estimation of postmortem interval (PMI) is one of the most important topics in forensic medicine research. We speculate that with an increased PMI, the computed tomography (CT) values of different tissues may show regular changes.

Purpose:

To use postmortem computed tomography (PMCT) to measure the myocardial CT value (unit: Hounsfield Unit, HU) of the heart to explore its pattern in postmortem change, and to discuss whether it can serve as a new parameter for PMI estimation.

Methods:

A total of 10 healthy adult New Zealand rabbits were selected and then put into a 20°C incubator after being sacrificed. Within 0–156 h after death, CT scans were performed every 12 h to detect changes in the myocardial CT value of the heart over time. Regression analysis was used to determine the relationship between the myocardial CT value of the heart and PMI. At the same time, HE and Masson were used to stain the cardiac tissue sections detected by PMCT at 0h, 48h and 156h, respectively.

Results:

During 0–156 h, the overall myocardial CT value showed a trend of first rising and then decreasing with the increase of PMI. The fitting regression equation was y = −2873.193 + 143.866x − 1.728x2 (x: myocardial CT value, unit: Hu; y: PMI, unit: h, R2 = 0.466, P < 0.05). During 48–156 h, the overall myocardial CT value decreased gradually with the increase of PMI. The fitting regression equation was y = −93.038 + 18.700x − 0.321x2 (x: myocardial CT value, unit: Hu; y: PMI, unit: h, R2 = 0.963, P < 0.001). The results of the morphological changes of the myocardial tissue structure after death showed that the myocardial cell structure was relatively complete at 0−48 hours after death; and the myocardial cell structure disappeared at 156 hours after death.

Conclusions:

Our results revealed evident postmortem changes in the myocardial CT value of the heart. Accordingly, measuring the myocardial CT value through PMCT shows promise for being used as a parameter for PMI estimation in forensic medicine and is worthy of further studies. The morphological changes of the myocardial tissue structure after death provide morphological basis for postmortem changes of tissue density, and further prove the reasons for the changes of CT value.
Knowledge, attitude, and practice of Ayurveda pharmacists toward pharmacovigilance and adverse drug reaction reporting
Authors: Naik Raghavendra , Shubhashree MN , Chandrasekharan Chandini , Bhat Sulochana
Published: September 2021

Background:

Reporting adverse drug reactions (ADRs) is an important part of pharmacovigilance practice. Considering the significance of this area, the Ministry of AYUSH has introduced a new Central Sector scheme for promoting pharmacovigilance of Ayurveda, Siddha, Unani and Homoeopathy (ASU&H) drugs. Being key health-care professionals, physicians, pharmacists, technicians, and nurses have immense responsibility in effective implementation of pharmacovigilance programs through the surveillance and reporting of ADRs.

Objective:

The present study was planned with an objective to evaluate the knowledge, attitude, and practice (KAP) of Ayurveda pharmacists toward pharmacovigilance and ADR reporting.

Materials and Methods:

A total of 22 pretested questions about KAP regarding ADRs and pharmacovigilance in a Google form were made available to 170 Ayurveda pharmacists at their workplace by e-mail.

Results:

In the present study, total, 80 responses were received, yielding a response rate of 47%. Most of the participants (81.5%) had knowledge about the pharmacovigilance program for ASU&H drugs and also the location of their nearest pharmacovigilance center. At the same time, 34.6% among them were not aware that a specific format is available for reporting ADRs and only 42% had the knowledge that the Ministry of AYUSH is monitoring the pharmacovigilance program for ASU&H drugs in India. However, most of them (95.1%) thought that it was their responsibility to report ADRs and 92.6% of the participants wanted to make ADR reporting mandatory to pharmacists. More than half of the participants (55.6%) had come across ADRs at their workplace, and the majority of them (72.8%) had reported them. More than half of the pharmacists (51.9%) who were involved in the program revealed that they had faced problems while reporting ADRs at their workplace.

Conclusion:

Even though there was a positive attitude toward ADR reporting, limited knowledge about the importance of the program needed to be addressed through educational initiatives, regular sensitization, and awareness programs.
Prevalence of Chittodvega (anxiety disorder) symptoms in Indian village of Nagnur in Telangana
Authors: Ranade Manjiri A.
Published: September 2021

Introduction:

Charaka has described Chittodvega (anxious state of mind) as Manas Dosha Vicar (mental disorders). The signs and symptoms described by charaka are very much similar to an anxious state of mind. Still, the studies done in Ayurveda to assess the prevalence of Chittodvega have used modern definitions of Chittodvega. Hence it is suggested that assessing the prevalence of Chittodvega based on Acharya Charaka symptomatology and assigning a numerical rating scale (NRS) to it.

Materials and Methods:

This is a community-based cross-sectional study done in the Nagnur Village in Karimnagar District in Telangana. The symptoms described by Charka were tested on a 10-point Likert NRS. The NRS less than 4 is considered mild Chittodvega, 4–7 is considered moderate Chittodvega, and more than 7 is considered severe Chittodvega. The data thus obtained were analyzed.

Results:

Chittodvega was equally distributed among various age groups and different sociodemographic status among 100 study participants. The prevalence of Chittodvega assessed by different symptomatology varied between 16% and 55%. Nidra Nasha (lack of sleep) and Krodha (anger) were the most common symptoms, whereas Udvega (distress) was the least common symptom.

Conclusion:

There is a high prevalence of Chittodvega symptoms in the rural population. There is an urgent need to tackle this hidden problem in the population, as it can burden normal living beings. Our study gives an insight into making decisions regarding the need for agencies to make targeted efforts to tackle this rarely explored but very common mental health issue.
Efficacy of Ayurveda treatment modalities in the management of hypothyroidism
Authors: Varsakiya Jitendra , Kathad Divyarani , Kumari Ritu
Published: September 2021

Hypothyroidism is a metabolic disorder resulting from insufficient synthesis of thyroid hormones, which are one of the key factors for the maintenance of metabolism. India has a high prevalence of hypothyroidism, which is about 9.4% subclinical cases, and this is more common in females than males. In Ayurveda classics, the functions of metabolism depend on Agnimandhya (weak digestive fire), mainly Medo Dhatwagni Mandya (decreased metabolic factors located in fat tissues). The normal metabolism of tissues is achieved by the management of Agni. A case of hypothyroidism was treated with bio-cleansing therapy, which included Virechan Karma (therapeutic purgation) along with oral medication Kanchnaar Guggulu with Varunadi Kashaya on an empty stomach. The result was assessed on the basis of the level of thyroid stimulating hormone (TSH) and the improvement in the general condition of the patient. The level of TSH decreases from 64.4 µIU/mL to 2.65 µIU/mL during the duration of six months, with an overall subjective perception of feeling well. The present case study demonstrates that hypothyroidism can be managed by the Ayurveda treatment modality.
Rhabdomyolysis and acute kidney injury following multiple bee stings in a child
Authors: Rauf Abdul , Vijayan Ajay , Hashitha V. M. , John Shaji Thomas , Peringat Jayameena
Published: September 2021

Multiple bee stings commonly cause allergic and anaphylactic reactions, but it can also cause serious complications such as intravascular hemolysis, rhabdomyolysis, acute kidney injury (AKI), and even death. Mortality related to AKI following multiple bee stings can be as high as 25%. Hence, patients should be monitored for rhabdomyolysis and AKI during the first few days following the stings. We report the case of a 3-year-old boy who developed AKI due to rhabdomyolysis following multiple bee stings. He required pediatric intensive care support including mechanical ventilation and renal replacement therapy in the form of multiple sessions of hemodialysis. His renal function improved gradually. He was discharged after 3 weeks with normal renal function and he remained well on 6 months follow up. The treatment of multiple bee stings should be considered as a medical emergency, and these cases should be admitted in a pediatric intensive care unit and monitored for at least 48 h for the occurrence of rhabdomyolysis, myoglobinuria, and AKI.
A cardiogenic shock in PICU turned out to be a bilateral pheochromocytoma
Authors: Shah Jay , Patel Zinkal , Patel Shradha , Kumar Amit
Published: September 2021

Pheochromocytomas (PCCs) are rare catecholamine-secreting tumors arising from adrenomedullary chromaffin cells, usually causing hypertension, palpitation, and headache. It is usually investigated as a secondary cause of hypertension. However, rarely it can present in hypotension. In “PCC crisis,” the patient presents with hypotension, multiple organ dysfunction, leaving the physician with diagnostic difficulties. In this case, we present an adolescent male presented with hypotensive cardiogenic shock, and multiple organ dysfunction on admission, which during investigation turned out to be bilateral PCC.