bluuebunny/crossref_metadata_2025 huggingface dataset:
Pembelajaran Bahasa Bahasa Asing dan Tolerance of Ambiguity: Sebuah Studi Kasus dari penguasaan Grammar
Authors: Gumilar Dudung , Syihabudin Syihabudin
Published: September 2023

Tolerance for Ambiguity (TfA) which is commonly involved in the field of Human Resources in industry has been adopted in the development of the quality of foreign language learning, especially foreign language acquisition by learners. In this study, the reference is French language which is limited by Subject Verb Agreement involving the periodic verb [+Present]. There are two research objectives, namely (1) to describe the tendency of TfA level at the beginning of the lecture and (3) to describe the students' efforts in developing TfA. The results of the study using a qualitative descriptive approach show that, first, the students have a high level of TfA although the students still make mistakes in French but the problem is not too significant because the suffixes representing the features of Tense [+Present], Person [+1P, +2P, +3P] and Number [±Plural] on verbs from the grammar area Subject Verb Agreement (SVA). Secondly, a high level of TfA is well-established by the students because they have the ability to maintain and develop the aspect of efforts to master SVA in French.
making of religious heritage
Authors: Stengs Irene
Published: September 2023

The proliferation of religious heritage seems to flow self-evidently from the processes of de-churching and secularization taking place in many European societies. Although having become redundant or outdated, certain religious buildings, objects or practices may be revalued as religious heritage. This selective setting apart of religious places or practices considered ‘redundant’ as heritage – a value-adding process – involves a form of sacralization. Such processual perspective helps religious heritage to be seen as not just ‘existing’, but, like all heritage, as made. Importantly, the sacredness of religious heritage diverges from the sacredness of religion. With multiple sacralites attributed to it, religious heritage may speak to much larger and diverse audiences as global, national or cultural heritage.
A Study on the Method of Land Use Regulation
Authors:   Korean Public Land Law Association, Seok Ho-Young
Published: September 2023

The Framework Act on the Regulation of Land Use (hereinafter referred to as the “Land Use Regulation Act”) was enacted on December 7, 2005, which stipulates basic matters concerning the designation and management of areas and districts related to land use. Prior to the enactment of the Land Use Regulation Act, the Urban Planning Act enacted in 1962 introduced a use area and use area system for land use regulation. The National Land Use Management Act enacted on December 30, 1972 stipulated the preparation and determination of a land use plan according to the comprehensive national land construction system and its implementation. The National Land Use Management Act was abolished from January 1, 2003 when the National Land Planning and Utilization Act (hereinafter referred to as the “National Land Planning Act”) was enacted. Although there has been a change in the law on land use regulation, there has been no change in land use regulation through the designation of regions, districts, etc. In the attached Table of Article 5 of the Land Use Regulation Act, 243 are listed in 100 laws. Article 5 of the Land Use Regulation Act includes the following subparagraphs (i.e., areas, districts, etc. prescribed by Presidential Decree under the delegation of other laws, areas, districts, etc. under the Prime Minister's decree, ordinances, and municipal ordinances). It stipulates that it cannot be done. The Land Use Regulation Act stipulates restrictions on activities in business districts and restrictions on activities in regions and districts determined by urban and county management plans.
According to the Framework Act on Land Use Regulation and the National Land Planning Act, restrictions on activities in use areas and districts impose a duty of action or omission to limit development activities or obtain approval or permission related to land use. Such restrictions on behavior correspond to academic restrictions on common use. There is a problem of compensation for property rights violations caused by public restrictions, but the Constitutional Court's Green Belt decision takes the separation theory taken by the German Constitutional Court and says that if there are no compensation provisions in individual laws, it cannot be compensated.
This paper aims to examine the types of use areas and use districts, focusing on the basic law on the designation of use areas and use districts, one of the means of land use regulation, and to review the deliberation procedures for the establishment and designation of areas and districts. In addition, we would like to outline the details of restrictions on behavior in business districts, review the theory's position on whether to compensate for losses raised in connection with such restrictions, and present judicial issues while reviewing the position of the theory on the legal nature of development permission to legalize development activities.
Study on Selection of Diesel Engine Exhaust After-Treatment System Materials and Emission Performance for Genset Applications
Authors: SUBRAMANİAN Karthikeyan , KANDASWAMY Annamalai
Published: September 2023

The use of diesel engines for the transportation sector is ubiquitous and covers a broad continuum, like buses, trucks, agriculture, construction equipment, generators, and industrial applications. However, because of their increased use of off-road engines, they contribute more emissions in various sectors than on-road. As a result, worldwide, regardless of ongoing emission control efforts, these off-road, stationary engines also continue to be a substantial source of air pollutant emissions in the United States, European Union and Asian markets. Accordingly, while improving emissions performance, the selection of after-treatment system materials and the use of compatible after-treatment specification selections are also critical. This is only possible by effectively combining clean diesel technologies such as Fuel Injection Equipment (FIE), Turbocharger with Intercooler (TCIC), Cooled Exhaust Gas Recirculation (C-EGR), and after-treatment systems like Diesel Oxidation Catalyst (DOC), Selective Catalytic Reduction (SCR), and Diesel Particulate Filter (DPF). Overall, in this study, the influence of after-treatment system configurations and their effect on emission reduction performance are studied for three different DOC specifications based on emission testing for catalyst and size optimization. With the selected DOC catalyst specification, suitable combinations of DPF and SCR specifications are optimized further using GT-SUIT software simulation. This study was carried out during the conversion of a 15 kW NA engine to a 27 kW TCIC engine to meet diesel engine emission norms.
Nonalcoholic fatty liver disease. New nomenclature. Review
Authors: Manzhalii E. G.
Published: September 2023

At the international hepatological congress of the European Association for the Study of the Liver (EASL), which took place in Vienna on June 21 — 24, 2023, a new classification and nomenclature of fatty liver disease was adopted. Leading scientists‑hepatologists proposed to replace the term «non‑alcoholic fatty liver disease» to the term «metabolic dysfunction‑associated steatotic liver disease» (MASLD). This diagnosis is established in patients with confirmed hepatic steatosis and one of the five cardiometabolic risk factors. MetALD is a new category of steatosis defined in patients with MASLD who consume excessive amounts of alcohol per week (140 and 210 g/ week for women and men, respectively). Cryptogenic steatohepatitis is present in patients with an undetermined disease etiology of the disease or without any metabolic risk factors. The concept of «non‑alcoholic steatohepatitis» (NASH) has been changed to the concept of «metabolic dysfunction‑associated steatohepatitis» (MASH).
In the 21st century the problem of diagnosis and treatment of non‑alcoholic fatty liver disease has become especially urgent since it occurs in almost 35% of the population of the planet Earth. In industrialized countries, the percentage of the population affected with this disease is 20 to 40%. Approximately 10 — 20% of patients have associated symptoms of NASH. In Western European countries, the prevalence of NASH is 2 — 6%, and in the USA it is as much as 5 — 6% of the total population.
MASH is the most common chronic liver disease that does not depend on age or race. This pathology is directly related to obesity, type 2 diabetes mellitus, insulin resistance, hyperlipidemia, and atherosclerosis. NAFLD is diagnosed 3 — 5 times more often in men than in women. Gender differences are related to the fact that body mass index of men is slightly higher than that in women. The fact that men with this disease often consume more alcohol than women, plays a certain role, too.
Domestic researchers who have made important contributions to the study of digestive system diseases: images in art. Maks Moiseyevich Gubergrits
Authors: Gubergrits N. B. , Byelyayeva N. V. , Linevska K. Y. , Suprun O. O.
Published: September 2023

A few main directions can be distinguished in the scientific and practical activities of M. M. Gubergrits. Even his first studies contributed to the history of the development of domestic cardiology. He continued the work started by V. P. Obraztsov on the III normal heart sound, studied changes in heart tones and the formation of a gallop rhythm, the rhythm of a neurasthenic quail, was one of the first to evaluate the clinical significance of the electrocardiographic technique, and tried to use it for better understanding the effect of certain drugs on the heart. He described disorders of the cardiovascular system in severe infectious diseases (epidemic typhus, relapsing fever, and typhoid fever) and thrombosis of the splenic vein.
An important part of the scientific activity of M. M. Gubergrits was the pain problem. An outstanding humanist scientist could not ignore this human suffering from various diseases. He was interested not only in the origin of pain in diseases of the heart, liver, and kidneys but also in pain as a general problem of physiology and pathology.
However, he most clearly revealed himself as a talented clinician in gastroenterology by constantly combining thoughtful observation at the patient’s bedside with clinical and physiological experimentation. Back in 1929, in his work on the mechanism of gastric secretion, he established the effect of mechanical irritation of the gastric mucosa on the secretion of gastric juice. He described a unique palpatory symptom of a bigastric stomach (changes in the position of the lower border of the stomach, re‑determined by splashing noise). He had a keen interest in peptic ulcer disease.
His studies on pancreatic physiology and pathology have retained their value to the present day: data on excretory function, the adaptability of exocrine function to different diets, the possibility of a partial violation of this function (dyspancreatism), as well as the organ’s functional study technique developed in his clinic. M. M. Gubergrits described the pain zone in the pathology of the head and body of the pancreas. In addition, he described concomitant diseases of the liver and pancreas and the liver’s involvement in the pathological process in gastric, duodenal, and large intestinal diseases. The studies by M. M. Gubergrits on the clinical picture of pancreatic diseases played a significant role in the further research. To a large extent, his statements on the diagnosis of pancreatitis have retained their significance. He emphasized the importance of such symptoms as pathological hunger, thirst, polyuria, weight loss, pain in the epigastric area, sometimes jaundice, diarrhea with creatorrhea and steatorrhea, and changes in the blood and urine.
Pemahaman Tentang Kelembagaan Penanggulangan Bencana Oleh Masyarakat di Wilayah Pondok Cabe Ilir Tangerang Selatan Banten Sebagai Upaya Strategi Manajemen Bencana
Authors: Arbitera Cahya , Amir Amrullah Afif
Published: September 2023

Provinsi Banten merupakan termasuk wilayah yang rawan terjadinya bencana alam diantaranya bencana gempa bumi. Salah satu wilayah di Kota Tangerang Selatan yang termasuk dalam Provinsi Banten yang juga terdampak dan ikut merasakan apabila terjadi gempa yaitu kelurahan Pondok Cabe Ilir. Adapun tujuan dari penelitian ini adalah untuk melihat tingkat pemahaman warga tentang kelembagaan penanggulangan bencana khususnya gempa bumi sebagai upaya strategi manajemen bencana di wilayah kelurahan tersebut. Metode yang digunakan adalah semi kualitatif dengan pengambilan data pengisian melalui kuesioner tentang pemahaman kelembagaan penanggulangan bencana yang mencakup jenis, dampak, dan penanganannya kepada kader Posyandu, perwakilan warga sekitar, dan perwakilan pegawai kelurahan. Kegiatan dilaksanakan pada bulan Mei sampai dengan Juni 2023. Responden berjumlah 37 orang yang terdiri dari kader Posyandu, perwakilan warga sekitar, dan perwakilan pegawai kelurahan. Melalui kegiatan ini dapat diketahui bahwa pemahaman masyarakat di wilayah Pondok Cabe Ilir Tangerang Selatan Banten sudah baik yaitu dengan rata-rata tingkat pemahaman baik 25 orang (65%) dan kurang 8 orang (22%), namun kegiatan ini harus lebih sering dilaksanakan secara rutin dan berkala dengan tema-tema baru yang terkait serta objek penelitian yang lebih banyak dan bervariasi.
UAV Architecture for Patrolling Air in Geotourism Zone at Disaster Risk with the Characteristics of GPS Signal Limit
Authors: Sartono Sartono , Hermawan Iwan , Hindrawati Gita
Published: September 2023

The development of geotourism is a trend in the field of tourism that is always being developed. The exoticism of natural tours in the environment of geothermal and volcanology activities will be proportioned to the potential risks that appear. The records of tracking from several countries show the fatal conditions from the effects of carbon dioxide emissions such as H2S, SO2, and CO that are emitted from unexpected geophysical activity, odorless so that they are not detected properly in geotourism zones that cause casualties of inhabitant and tourist. The aim of this paper is to provide a reference of the framework for the drone explore architecture for the requirement of monitoring in the environmental conditions of the limited GPS signal. This study implemented the Research & Development (R&D) method by using the Zachman framework. The study found that the development of the Early Warning System (EWS) as a part of mitigation using robotic technology such as the UAV drone becomes the solution requirement of the problem because the drone is capable of carrying sensors that detect harmful gases with a radius that is relatively low. The drone sensor will process the gas data with the permitted threshold gas ratio and send the collected data to the administration system. This case becomes a part of the disaster mitigation process in the geotourism field.
Gestión editorial del tiempo: plazos de revisión y otras fechas clave en las revistas científicas españolas de Comunicación
Authors: Segarra-Saavedra Jesús , Hidalgo-Marí Tatiana , Tur-Viñes Victoria
Published: September 2023

El objetivo principal de la presente investigación reside en identificar las prácticas editoriales relacionadas con la gestión del tiempo en las revistas científicas españolas de Comunicación y conocer si existe homogeneidad en la gestión del tiempo, detectar revistas más ágiles, conocer si existen diferencias entre publicaciones generales y monográficos específicos e identificar praxis que agilicen los procesos de publicación. Para ello, se ha trabajado en una metodología de corte exploratorio, centrada en el análisis de contenido. La muestra analiza los 1581 artículos publicados en 2021 por las 62 revistas científicas de Comunicación del Índice Dialnet de Revistas 2020, diferenciando entre aquellos que han sido publicados en la sección “Miscelánea” de aquellos que aparecen publicados en “Monográfico”, con la finalidad de centrar la atención en los plazos transcurridos desde que las revistas reciben los artículos hasta que finalmente son publicados. Los resultados evidencian escasa homogeneidad en la política relativa a la información sobre fechas y constata promedios de más de seis meses en la duración del proceso, siendo más ágiles los procesos de la publicación en “Monográfico”. El punto fuerte de este trabajo se encuentra en la manifestación de la necesidad de trabajar en políticas comunes que permitan, por una parte, agilizar los procesos de publicación y, en segundo lugar, acelerar la visibilización de los resultados de investigación, con el fin de beneficiar a la comunidad científica y la sociedad.
The cost of regulating effort: Reward and difficulty cues with longer prediction horizons have a stronger impact on performance
Authors: Kukkonen Nanne , Braem Senne , Allaert Jens , Eayrs Joshua , Prutean Nicoleta , Steendam Susanne Tabitha , Boehler C. Nico , Wiersema Jan R. , Notebaert Wim , Krebs Ruth
Published: September 2023

Many theories on cognitive effort start from the assumption that cognitive effort can be expended at will, and flexibly up- or down-regulated depending on expected task demand and rewards. However, while effort regulation has been investigated across a wide range of incentive conditions, few investigated the cost of effort regulation itself. Across four experiments, we studied the effects of reward expectancy and task difficulty on effort expenditure in a perceptual decision-making task (random-dot-motion) and a cognitive control task (colour-naming Stroop), and within each task comparted cues between short (cueing the next trial) and long (cueing the next six trials) prediction horizons. We found that participants used the cue information only when it was valid for multiple trials in a row. In the random-dot-motion task, a high reward expectancy resulted in better accuracy, especially in easy trials, but only with long prediction horizon. Similarly, in the Stroop task, the reward facilitation of reaction time was only observed after reward cues with a long prediction horizon. Together, our results indicate that people experience a cost to effort regulation, and that lower adjustment frequency can compensate for this cost.
LIKA-LIKU BERSATU Dikala Menimba dan Menyalurkan Ilmu
Authors: nuryadi  , Farida Nur
Published: September 2023

Kuliah Kerja Nyata (KKN) merupakan program tahunan yang dilaksanakan oleh setiap Perguruan Tinggi yang merupakan penerapan dari Catur Dharma Perguruan Tinggi. Dengan dilaksanakannya KKN ini memberikanmanfaat yang luar biasa bagi mahasiswa serta masyarakat karena hasil yang akan diperoleh dari pelaksanaan KKN ini sangatlah besar seperti sebuah pengalaman yang didapatkan oleh mahasiswa berupa bagaimana cara hidup dengan masyarakat pada semestinya dan masih banyak lagi. Dalam kegiatan KKN ini melibatkan banyak elemen seperti perguruan tinggi (termasuk mahasiswa yang melaksanakan KKN serta Dosen Pembimbing Lapangan, masyarakat, dan pemerintahan daerah Kepala Desa beserta stafnya).Pengabdian Masyarakat merupakan kegiatan intrakurikuler yang memberi kesempatan kepada mahasiswa untuk belajar dan bekerja bersama-sama dengan masyarakat. Pengabdian masyarakat yang dilakukan oleh mahasiswa bukan berarti mengajar masyarakat tentang sesuatu yang terbaik untuk mereka, tetapi melakukan pemberdayaan sebagai sebuah proses pencarian yang dilakukan bersama?sama untuk mencari jalan terbaik dalam penyelesaikan persoalan yang mereka hadapi. Mahasiswa melakukan tugas pendampingan terhadap apa yang dibutuhkan oleh masyarakat dalam menghadapi problem sosial yang ada di tengah-tengah mereka.
A comparative analysis of computed tomography and ultrasonography in diagnosis of neck masses
Authors: Aqib Mohd , Tayyaba Zohda , Rahman Abdur , Sharma SC  , Aftab Mohd
Published: September 2023

Background: Neck swellings constitute the chief complaint of many patients coming to ENT outpatient department. Adequate evaluation of all cases with assistance from radiological, cytopathological, and histopathological is necessary.
Aims and Objectives: The present study aims to evaluate the role of clinical, radiological, and cytopathological evaluation to reach the diagnosis and the accuracy of these tools.
Materials and Methods: The study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery and the Department of Radiodiagnosis, AMU, and included 100 patients with neck swelling.
Results: Maximum number of patients were of lymph node masses (44%), followed by thyroid masses (26%) and salivary gland pathologies, congenital neck masses, and others. 78% were benign masses while only 22% were malignant. Out of all cases, the maximum were reactive lymphadenitis (16%), followed by metastatic lymph nodes (12%) and pleomorphic adenoma (10%). The correlation between clinical diagnosis and ultrasound (USG) was 70.93 with a diagnostic accuracy of 86%; with fine-needle aspiration cytology (FNAC) accuracy being 82%. 91% of metastatic lymph node swellings were accurately diagnosed by these two modalities alone. The sensitivity and specificity of FNAC with computed tomography (CT) were 62.25% and 98.59%, respectively; while with biopsy were 84.63% and 97.10%.
Conclusion: Clinical evaluation remains the utmost important step in the management of patients with neck swellings. USG provides the necessary information to guide further management, followed by FNAC. Although CT and histopathological evaluation provide detailed information, it was rarely needed in our study to reach the clinical diagnosis however their need in the management of pathology could not be ruled out.
Clinical profile and outcome of patients of common krait bite with features of neurotoxic envenomation, treated with intravenous calcium gluconate infusion in conjunction with AVS, a tertiary care center-based study
Authors: Shyamash Mandal  , Supriyo Gope  , Nilanjan Saha  , Subhrajyoti J Mitra  , Tanmay Chowdhury  , Atanu Chandra  , Souvik Das
Published: September 2023

Background: Snake bite is one of the most neglected diseases in South East Asian region. Common Krait (CK) (Bungarus caeruleus) is the deadliest snake found in the dry zones of India. With the polyvalent anti-venom serum (AVS) remaining the cornerstone of treatment of neurotoxic snake envenomation, there is no universally accepted treatment for CK envenomation-associated neuroparalysis, except supportive measures.
Aims and Objectives: Our study was conducted to describe the epidemiology, define clinical features, study outcome, and apparent efficacy of calcium gluconate in preventing or reversing neuromuscular paralysis with respiratory failure in CK bite patients.
Materials and Methods: This study is a prospective observational study done on 52 CK bite patients. Patients were enrolled according to inclusion and exclusion criteria and were treated with AVS and calcium gluconate infusion according to National Standard Guideline, 2016. Patients developing severe respiratory muscle paralysis were offered mechanical ventilation.
Results: Patients developed ptosis and dysphagia, pain abdomen, cyanosis, paralysis of jaw and tongue, perioral numbness, altered sensorium, dysphonia, ophthalmoplegia, and paradoxical breathing. 21.15% of patients developed respiratory failure and needed ventilator support with average critical care unit stay of 3 days and average stay on a ventilator of 2 days. 3 patients expired (case fatality rate 5.77%). The average hospital stay was 3.33 days.
Conclusion: Our study shows that early intervention in patients of CK bite with neurotoxic envenomation, with calcium gluconate infusion, leads to less mortality and morbidity compared to other relevant studies. Further large-scale studies are required for better understanding and implementation.
A randomized comparative study to estimate the safety and effectiveness between laryngeal mask airway supreme and I-gel in patients undergoing elective surgeries
Authors: Kaushal Kabir  , Keshav Middha  , Arora KK  , Sharma Aseem
Published: September 2023

Background: Supreme laryngeal mask airway (SLMA) and i-gel airway devices are second generation supraglottic airway devices (SAD) and are good alternatives to intubation during elective surgeries.
Aims and Objectives: This study was conducted with the objective of comparing the two SAD with respect to ease of insertion, number of attempts of insertion, insertion time, ease of gastric tube insertion, accompanying hemodynamic changes, incidence of adverse effects like regurgitation, lip and dental trauma, post-operative sore throat, dysphagia, and hoarseness.
Materials and Methods: This study was conducted at M.G.M. Medical College and M.Y. hospital, Indore. Eighty patients belonging to ASA class 1 or 2, with Mallampati grading 1 or 2, between age group of 18–60 years and with BMI <30 kg/m2 were selected for the study. After induction of anesthesia, one of the SAD’s (SLMA or i-gel) was inserted following randomization, and accordingly, the patients were divided into two groups of 40 each. Insertion parameters, hemodynamic, and respiratory parameters were noted. Patients were also observed for any possible complication at 1 h and 24 h postoperatively.
Results: The Two groups showed no statistically significant difference in terms of demographic characteristics, insertion parameters, hemodynamic, or respiratory parameters (P>0.05). Postoperatively, no significant complications were observed in terms of dental injury, laryngospasm. Ease of gastric tube insertion was found to be more in SLMA group than i-gel and the difference was statistically significant (P=0.0057). Incidence of sore throat after 1 h was found to be more in SLMA group than i-gel group (P=0.048).
Conclusion: There was no significant difference between SLMA and i-gel in terms of insertion characteristics and hemodynamic changes. Ease of gastric tube insertion was found to be significantly more in SLMA group than i-gel. Incidence of post-operative sore throat at 1 h was more with SLMA as compared to i-gel.
A randomized clinical study to compare postoperative pain relief in ilioinguinal nerve block versus transversus abdominis plane block following inguinal hernia repair surgery
Authors: Jay Kumar Kolewar  , Jitendra Agrawal  , Sourabh Shrivastava  , Isha Jain  , Preeti Goyal
Published: September 2023

Background: Inguinal hernia surgeries are associated with postoperative pain and discomfort. Transversus abdominis plane (TAP) block and Ilioinguinal/Iliohypogastric (IIIH) nerve blocks are widely used to control postoperative pain. In this study we have compared postoperative pain relief between TAP block and IIIH nerve block in the patients undergoing inguinal hernia surgery under spinal anesthesia.
Aims and Objectives: The primary aim of this study was to compare postoperative pain relief of TAP block and IIIH block in patients undergoing inguinal hernia surgery. Secondary objectives were to observe hemodynamic parameters and to observe for postoperative side effects if any.
Materials and Methods: Sixty patients of age group 18–65-year-old males, ASA grade I, II, were randomised into two groups TAP group (n=30) and IIIH group (n=30). TAP group received 30 mL of 0.25% ropivacaine TAP block and group IIIH received 20 mL, and wound infiltration with 10 mL of 0.25% ropivacaine. Duration of analgesia was recorded, visual analogue scale (VAS) score compared in first 24h postoperatively. Perioperative haemodynamic parameters were recorded.
Results: VAS score was found significant at 1, 2, 3, 4, 5, 8, 10, 16 h (P<0.001). The mean duration of analgesia was found to be 4.64±1.16 h and 6.3±1.84 h for IIIH group and TAP group respectively which was statistically significant (P<0.001). Haemodynamic were stable and no complication was there in both the groups.
Conclusion: As a part of multimodal analgesia regimen both TAP block and IIIH block provided good pain relief postoperatively in patients undergoing inguinal hernia. In this study TAP block provided prolonged pain relief than IIIH block after inguinal hernia repair.
A prospective observational study on etiology and management influencing outcome in operatively managed cases of acute intestinal obstruction in adults
Authors: Dipan Mukhopadhyay  , Anupam Banerjee  , Subhadeep Datta  , Partha Sarathi Dutta
Published: September 2023

Background: Acute intestinal obstruction (IO) is an important cause for acute abdomen in surgery which presents as abdominal pain, vomiting, distension, and constipation depending on the level and extent of obstruction of gastrointestinal tract. Early diagnosis of acute IO with understanding of various etiologies, use of better diagnostic techniques, and skillful operative management and good postoperative care, carries a good outcome.
Aims and Objectives: The objective of the study was to find out the prevalence of various etiologies of acute IO and to study the various post-operative morbidity and mortality.
Materials and Methods: This was a hospital-based observational study in the Department of General Surgery of Calcutta National Medical College and Hospital among patients with a diagnosis of acute IO during the study period of December 2016-April 2018.
Results: Acute IO commonly affects male with a male: female ratio 7:3 and the most common occurrence in the age group of 40–59 years (30%). The most common etiology was obstructed/strangulated hernia (36%), followed by large bowel neoplasm (18%), adhesion (16%), intestinal tuberculosis (12%), and volvulus (10%). The most common surgical procedure performed was the resection of gangrenous bowel and creation of stoma (30%), followed by prosthetic repair of hernia (28%). The mortality rate of the present study was 12%. The morbidity rate was 46%attributing mainly to respiratory complications (30.4%) and surgical site infections (26.08%).
Conclusion: This study demonstrates that the pattern of IO differs from the Western world with obstructed hernias being the most important cause and also emphasizes the fact that intestinal tuberculosis assumes a prominent role.
Gender-related differences in the morphometry of the corpus callosum: MRI study
Authors: Garima Sehgal  , Anupam Kumar  , Navneet Kumar  , Nikhil Aggarwal
Published: September 2023

Background: The size and shape of the adult corpus callosum (CC) may vary with gender. There is, however, less literature available on data involving the morphometry of CC among the Indian population.
Aims and Objectives: To measure the size of CC using magnetic resonance imaging (MRI) scans of normal Indian adult females and males and identify gender-related differences, if any.
Materials and Methods: The dimensions of CC were measured on MRI scans on a midsagittal section view belonging to 150 (59 females, 91 males) normal Indian adults (North India) using e-measurement tools. The measurements included the maximum length and height of CC, the thickness of various parts of CC, the CC index (CCI), and the distance of CC from the frontal and occipital poles of the cerebral hemisphere. The study was carried out in the Department of Anatomy in collaboration with the Department of Radiodiagnosis, King George’s Medical University, U.P., Lucknow, India. The data was analyzed using the statistical package for social sciences, 23rd version. Means were compared for significant differences using the independent unpaired t-test.
Results: The mean length of the CC was found to be 6.94±0.63 cm; mean height was 2.57±0.43 cm; the mean thickness of the genu was 9.16±2.26 mm; the mean thickness of the body was 5.09±0.99 mm; the mean thickness of splenium was 9.10±2.22 mm; the mean distance from the frontal pole was 3.66±0.35 cm; the mean distance from the occipital pole was 5.70±0.74 cm; and the mean CCI calculations showed to be 3.37±0.56. All measurements were found to be greater in males as compared to females except mean height (males 2.56±0.47 cm; females 2.59±0.37 cm) and mean thickness of the body (males 5.04±0.94 mm; females 5.17±1.06 mm). A statistically significant difference was observed in the distance of CC from the frontal pole in our population with respect to gender (P=0.03).
Conclusion: Based on observations made in the study, normative data of CC measurements was generated, and it was found that there was no significant gender-related difference in the morphology of CC; the only significant difference was in the distance of the genu from the frontal pole, which was greater in females as compared to males.
Awareness on human papilloma virus vaccine among medical students in rural area
Authors: Manchaiah Sanjay , Manuja L Manchegowda  , Vinayak H Kashyap  , Prajwala Nagaraju
Published: September 2023

Background: Cervical cancer, with an estimated 604,000 new cases and 342,000 deaths in 2020, is the fourth most common cancer among women globally. Low- and middle-income countries accounted for 90% of the new cases and deaths worldwide in 2020. Cervical cancer in females can be prevented to a great extent by vaccination. Implementation of the human papillomavirus (HPV) vaccine is still facing challenges, but it has the potential to address the challenges of cervical cancer screening in India. Implementation of HPV vaccination faces barriers of acceptance and lack of awareness, along with a high vaccine cost.
Aims and Objectives: To assess the knowledge, attitude, and practise of the HPV vaccine among 1st and 2nd year medical students in a rural medical college.
Materials and Methods: A descriptive cross-sectional study was conducted among 240 study subjects using a pre-tested, semi-structured questionnaire. The results were expressed in descriptive statistics like proportions and percentages.
Results: 94% of the students were aware that cervical cancer is preventable, whereas 87% of them knew that cervical cancer can be prevented by a vaccine. 84% of the students had the knowledge that HPV vaccine is available in India. The maximum number of students were unvaccinated (92%), whereas 67% were ready to take the HPV vaccine in the future.
Conclusion: Sensitization regarding the importance of the HPV vaccine to the general public can be achieved only when health care professionals are adequately aware of the safety and efficacy of the HPV vaccine. The first step in this direction is to educate the students who will form the backbone of our health care system in the future.
Clinical and functional outcomes of open versus minimally invasive surgeries in single-level prolapsed intervertebral disc in lumbar region at tertiary care center: A prospective study
Authors: Jolly Sinha  , Vivek Kumar Kankane  , Avdhesh Shukla  , Avinash Sharma
Published: September 2023

Background: Spine surgery has been transformed significantly by the growth of minimally invasive surgery (MIS) procedures. Modern MIS techniques allow spine surgeons to achieve the same goals of open surgery while minimizing the collateral damage associated with the open approaches.
Aims and Objectives: The aim of MIS is to do an efficient “Target Surgery” with a minimum of iatrogenic trauma.
Materials and Methods: This is a prospective study done in the Department of Neurosurgery, JA group of hospitals, Gajra Raja Medical College, Gwalior, from July 2021 to July 2022. Study was conducted on 30 randomly selected patients whose presentation and imaging showed indication for surgery.
Results: Better symptomatic relief was seen in patients with MIS at 7 days with about 80% of them having a visual analog scale score between 0 and 2; however, not much difference was noted at 1 month. Not much difference was noted for wound status, neurological improvement, and Oswestry Disability Index at 1 month. However, gross difference was noted at the rate of return to work by the patients with approximately 93.3% of patients undergoing MIS returning to work within 1 month in comparison to only 20% in case of open surgery.
Conclusion: Minimally invasive techniques are remarkably better option to traditional open surgeries, as these procedures showed a significant reduction in immediate post-operative pain, duration of hospital stay, and return to work by the patient. However, not much difference was noted in status of pain at 1 month, rehospitalization, degree of disability at 1 month, wound status, and neurological improvement of the patient.
To compare the efficacy of intrathecal 0.75% heavy ropivacaine and 0.5% heavy bupivacaine for lower abdominal and lower limb surgery
Authors: Harshad Mangaldas Mahajan  , Sandipbhai Jivanbhai Patel
Published: September 2023

Background: Spinal anesthesia is the most popular regional anesthesia technique for lower limb and lower abdominal surgery. Bupivacaine 0.5% heavy is commonly used for intrathecal use. New long-acting local anesthetic agents such as ropivacaine have claimed benefits of reduced cardiac toxicity on overdose and more specific effects on sensory rather than motor nerve fibers. The use of intrathecal hyperbaric ropivacaine is not much studied. With this background, we studied intrathecal ropivacaine hyperbaric 0.75% against intrathecal bupivacaine hyperbaric 0.5% for lower abdominal and lower limb surgery.
Aims and Objectives: To note the effectiveness of intrathecal ropivacaine and bupivacaine on characteristics of subarachnoid block such as sensory block, motor block, hemodynamic parameters, and complications if any.
Materials and Methods: We randomized patients undergoing lower abdominal surgeries and lower limb orthopedic surgeries under spinal anesthesia into two groups so as to receive intrathecal either ropivacaine 0.75% hyperbaric (3 mL) or bupivacaine 0.5% hyperbaric (3mL) and noted study parameters.
Results: Time of sensory block onset (P=0.0005), peak sensory level (P=0.0029), and onset of L1 bromage-3 motor block (P=1.27E–08) was significantly delayed in the ropivacaine group as compared to bupivacaine group. However, maximum sensory level achieved (T6), time required for two-segment sensory regressions (P=0.1162), and time of onset of pain (P=0.1162) were comparable in both groups.
Conclusion: Intrathecal ropivacaine 0.75% hyperbaric produced slow onset sensory and motor block than 0.5% hyperbaric bupivacaine with comparable cephalic spread and duration of sensory block.
A randomized, open-label, controlled, parallel-group comparative study of two varieties of Carica papaya leaves in dengue-induced thrombocytopenia
Authors: Shreeharsha ER  , Vani Jayaraman  , Kavitha S  , Goothy Sai Sailesh Kumar , Ravishankar SN
Published: September 2023

Background: Dengue-induced thrombocytopenia can be life-threatening. However, supportive and symptomatic treatment is the current management protocol. The leaf extract of papaya has shown promising results in improving the platelet count. There are many varieties of Carica papaya such as Washington, Honeydew, Coorg honeydew, Solo, Surya, Red lady, C0-1, CO-3, CO-5, C0-6.
Aims and Objectives: The aim is to evaluate the efficacy and safety of two varieties (“Red Lady” and “Solo”) of C. papaya fresh leaf extract in patients diagnosed with dengue-induced thrombocytopenia.
Materials and Methods: The study was conducted for 2 months, and 18 dengue-confirmed inpatients with thrombocytopenia (platelet count <1,50,000/μL) were enrolled. The study participants were grouped into the standard “Control” group, “Solo” group who received fresh papaya leaf extract “Solo” and “Red Lady” group who received fresh papaya leaf extract of “Red Lady.” About 30 mL of leaf extract was given thrice daily for 5 days.
Results: The mean change from the baseline value of platelets was found to be 59,168/µL for the control group and 57,000/µL for Red Lady, and 93,167/µL for the solo group. The study showed a positive trend with improvement in platelet count in “Solo” Variety group when compared to “Red Lady” group and the control group. The safety results showed that both the papaya leaf extracts have a favorable safety profile.
Conclusion: There was an improvement in platelet count in “Solo” variety group when compared to “Red Lady” and the control group. However, the results were not statistically significant. No adverse events were observed during the study.
A clinical study with changes in microbiological flora in chronic rhinosinusitis
Authors: Nainsi Gupta  , Adil Raza  , Rubina Galib  , Kamlesh Chandra
Published: September 2023

Background: Chronic rhinosinusitis (CRS) is characterized by mucous membrane inflammation that lines the paranasal sinuses and nasal cavity for at least twelve consecutive weeks. Microbes play a major role in pathogenesis. The treatment objectives are to reduce mucosal edema, restore paranasal sinus ventilation, and eliminate infectious pathogens.
Aims and Objectives: (1) To study the presenting clinical features of chronic sinusitis. (2) To study the changes in microbiological flora.
Materials and Methods: The study was conducted on 202 patients in the Department of ENT and Microbiology (JNMCH) from December 2020 to 2022. Patients above the age of 10 years were evaluated in this study. Those who received antibiotics in the last week of the presentation and those resistant to medical therapy were excluded. Patients were subjected to a detailed history, the clinical examination, and a radiological examination. Under all aseptic precautions and after the patient’s informed consent, the sample was taken from the middle meatus area for culture and sensitivity.
Results: The study had a male predominance (71.28%), with the maximum number of patients in the age group 21–30 years (38.11%). The most common clinical features were nasal obstruction (96.03%) and mucopurulent discharge (100%). The most common isolate was Staphylococcus aureus (45.13%).
Conclusion: Bacterial infection is a major etiological factor in CRS. Screening for S. aureus carriers may be an alternative to decrease the infection of S.aureus. There is a statistically significant increasing trend for methicillin-resistant S. aureus (19.46%) and fungal sinusitis (13.36%).
Umbilical cord diameter study on microscopic tissue in gestational diabetes mellitus and its correlation to fresh tissue diameter and fetomaternal parameters
Authors: Seema Valsalan E  , Jumi Jacob  , Akhil P Pushkar  , Mahesh Kumar D  , Sai Sailesh Kumar Goothy
Published: September 2023

Background: Umbilical cord is the only vital link between the mother and the fetus and is essential for maintaining the fetomaternal exchange of oxygen, nutrients, and waste products. Clinical studies have shown that umbilical cord diameter (UCD) is larger in gestational diabetes mellitus (GDM) and UCD analysis based on microscopic tissue (dry) provides more accurate information.
Aims and Objectives: The present study was conducted to measure the UCD using microscopic tissue in GDM and normal cases and ascertain its correlation with fresh tissue (wet) diameter, fetal weight, maternal BMI, and gestational weight gain.
Materials and Methods: The study included 111 subjects. They were divided into two groups. Group I consisted of umbilical cords obtained from non-diabetic pregnant women (n=52) and Group II comprised umbilical cords obtained from mothers with GDM (n=59). UCD was measured using Vernier calipers and all the other parameters were assessed through standard methods.
Results: UCD in microscopic (P=0.005) and fresh tissues (P=0.0001) was significantly higher in GDM patients. Although microscopic tissue measurements tended to underestimate fresh-tissue measurements of UCD, these measurements had a positive correlation with each other in both groups. UCD also had a statistically significant positive correlation with maternal BMI and a negative correlation with gestational weight gain.
Conclusion: UCD in GDM was statistically higher in both microscopic and fresh tissues and thus may be considered for GDM screening. The correlation of wet and dry specimens can also provide useful insights in clinical situations centered around variations in UCD.
Non-invasive ventilation using RAM’S cannula in neonates-what difference does it make?
Authors: Anjuri Sharma  , Monica Lazarus  , Asha Tiwari  , Lalit M Malviya  , Vidya K Saurabh
Published: September 2023

Background: Neonates undergo transition at birth from breathing fluid to breathing air. If this change is not tolerated by neonate, need of assisted ventilation arises. Non-invasive ventilation (NIV) refers to any mode of respiratory support provided through nasal airway. Using RAM’S cannula as an interface, complications of invasive ventilation can be prevented, and therefore it can be impactful in improving respiratory care in neonates.
Aims and Objectives: The aim of the study was to find the association of clinicoetiological factors and the outcome of NIV using RAMS’s cannula in neonates.
Materials and Methods: This prospective observational study was done from March 1, 2021 to August 31, 2022 at Neonatal Intensive Care Unit of a Tertiary care center in Central India. Neonates given NIV through Ram’s cannula were enrolled. Primary diagnosis of subjects and clinical parameters - birth weight, gestational age, duration of NIV given, and severity of respiratory distress were recorded and analyzed to find an association with the outcomes. Informed consent was obtained from parents.
Results: 100 neonates (62 male) were given NIV. 78 neonates were weaned off from NIV and 22 needed intubation. Duration of NIV, gestational age, severity of respiratory distress, and birth weight were found to be statistically significant. Weaning was more in gestation >34 weeks, weight >1 kg, duration of NIV given <3 days, and neonate having mild respiratory distress.
Conclusion: NIV through RAM’s cannula is useful in both respiratory and non-respiratory illness. Higher rates of NIV failure were seen in the duration of NIV >7 days, weight <1 kg, and gestation <34 weeks.
Comparison between transcutaneous electrical nerve stimulation and metoclopramide in preventing postoperative nausea and vomiting after gastrointestinal laparoscopic surgery-A prospective and randomized study
Authors: Shalini Jain  , Ruchi Agrawal  , Ravi Barde  , K K Arora
Published: September 2023

Background: Postoperative nausea and vomiting is a common complication after laparoscopic surgery and general anesthesia. It increases the patient’s discomfort and compromises the surgical outcome.
Aims and Objectives: The study aimed to compare the effectiveness of Transcutaneous Electrical Nerve Stimulator (TENS) and Injection of Metoclopramide for the prevention of post-operative nausea and vomiting in patients undergoing gastrointestinal laparoscopic surgery. The secondary objective of the study was to find out the percentage of cases needed rescue antiemetic drug (Inj. Ondansetron) when prophylaxis failed.
Materials and Methods: The study was a prospective, double-blind, randomized trial conducted at M.G.M. Medical College and M.Y. Hospital, Indore. 90 patients of 18–60 years of age, ASA physical status I-II, undergoing elective laparoscopic gastrointestinal surgery were included. Patients were allocated randomly into two equal groups. Group T received TENS (the stimulation group) at P6 acupressure point, whereas group M received an injection of Metoclopramide before induction of anesthesia. Patients in both groups were observed for 24 h postoperatively for the incidence of nausea and vomiting and the requirement for rescue antiemetic.
Results: The percentage of Postoperative Nausea Vomiting (PONV) and requirement of rescue antiemetics in both the groups were comparable in the first 6 h following laparoscopic gastrointestinal surgeries (P=1.000). There was no significant difference in PONV and rescue antiemetic requirement at 24 h in both the groups.
Conclusion: TENS stimulation at P6 acupressure point is comparable to injection of Metoclopramide in preventing postoperative nausea and vomiting after laparoscopic gastrointestinal surgeries.