bluuebunny/crossref_metadata_2025 huggingface dataset:
When Family Policy Doesn’t Work: Motives and Welfare Attitudes Among Childfree Persons in Poland
Authors: Szelewa Dorota
Published: August 2022

The primary goal of this article was to analyse the welfare attitudes of people self‐declaring as childless by choice alongside the exploration of their social experience as childfree persons in the context of a rapid increase in the generosity of pro‐natalist public policies in Poland. The analysis is based on semi‐structured interviews conducted with 19 respondents recruited via Facebook network groups. Thematic analysis was applied identifying six general themes: “satisfied and never had the need”; “dealing with social pressure”; “family measures—yes, but not this way”; “unfair treatment of the childfree”; “towards welfare state for all”; and “change my mind? Never, even if offered one million dollars.” The research demonstrated that childfree persons present favourable views on state support for families with children. While critical of cash‐based family support, respondents have a clear preference for investing in services enabling women to participate in the labour market. Finally, if public policies aimed at removing barriers to parenthood were strengthened, this would not change the respondents’ minds about procreation.
Hawker Centres: A Social Space Approach to Promoting Community Wellbeing
Authors: Radomskaya Valeriya , Bhati Abhishek Singh
Published: August 2022

This article sets out to examine how the use of social spaces, namely hawker centres, has contributed to community wellbeing during the Covid-19 pandemic. Using an extensive thematic analysis of online conversations, we have identified that the use of social spaces can have a positive influence on individual, relational and social wellbeing. Access to social spaces during stressful events contributes to the feeling of normalcy, supports routines and structured activities, encourages responsible behaviours, facilitates social connectedness, and helps maintain community resilience. We present a new framework for urban social space characterisation containing three dimensions: coaction, copresence, and colocation (the three Cs). Here, coaction is associated with better visibility of community practices, copresence enhances the sense of connectedness, and colocation is concerned with the use of spatial design factors for influencing movement and interactions. The framework is central to our understanding of social space and its impact on wellbeing. Underpinning the three Cs is the notion of the integration of policy, community wellbeing, and various urban agendas. The findings were considered in terms of their relevance for social space development in Singapore.
The Idea of Law in the Context of Technosocial Systems Evolution
Authors: Przhilenskiy V. I.
Published: August 2022

The paper is devoted to the prospects of transformation of the idea and concept of law as a result of technosocial systems development. The author reconstructs genesis and evolution of technosocial systems and substantiates the thesis about connection between these systems and the prospects of understanding the nature and meaning of law. The paper analyzes the latest developments of management theorists, sociologists and philosophers that reveal new contours of the nature-society system and theoretical and legal significance of conclusions to which they lead. The author pays special attention to the correspondence of the orders of action and the orders of knowledge in conditions that are determined by the disciplinary matrix of the science and scientific knowledge, as well as the interaction between theoretical discourse and social practices. In this context, the paper analyzes the impact of technosocial systems on legal awareness, legal worldview, rulemaking and law enforcement practices. The author makes a hypothesis about an essential change of law under the influence of digitalization of social life, hybridization of knowledge and its disciplinary transformation. The author focuses on cultural and historical determinism of the ideas and ideals of humanism and highlights the connection between the natural-scientific revolution of Modern times and the concepts of natural law and social contract. The author analyzes Michel Serres’ concept that proposes to supplement the social contract with another contract — the contract with nature. Another "thought experiment" suggests an essential change in the idea and concept of law.
Digital Intermediation and Consumer Relations: Legal Nature and Responsibility
Authors: Belov V. A.
Published: August 2022

The paper is devoted to the study of the issue of information intermediation in the digital environment, determination of the place of the aggregators’ owners in the system of consumer relations and development of a general rule aimed at creating a uniform formula for determining the scope of rights, obligations and limits of responsibility of digital intermediaries in consumer legal relationships.

Based on the conducted research, the author concludes that consumer relationships when transactions are made with the participation of the owners of aggregators indicate the existence of such a phenomenon as digital (online) intermediation, the manifestation of which has characteristic features depending on the degree of influence (involvement) of the activities of the owners of aggregators on the direct participants of such relations, i.e. on entrepreneurs and consumers. It is also noted that the role and function of a digital intermediary are made dependent on the involvement of the latter in the relationship between merchants and consumers. In order to determine the scope of rights, obligations and limits of responsibility of digital intermediaries, it is permissible to use the following formula: the greater the  involvement of a digital intermediary in the relationship between entrepreneurs and consumers, the more rights, duties and responsibilities arise for the intermediary when interacting with direct participants in consumer relations.
Legal Support of Environmental Safety under the Influence of External Economic Sanctions
Authors: Zhavoronkova N. G. , Shpakovskiy Yu. G.
Published: August 2022

The authors of the paper proceed from the premise that environmental problems have long gone beyond national borders and have become an object of not only domestic, but also world politics. Despite the fact that a feature of this policy is the need for ever closer cooperation between states, integrating them into solving environmental problems, improving the mechanism of multilateral management of global environmental security, the United States and the EU countries are pursuing a tough sanctions policy against Russia. The paper examines the impact of economic sanctions on ensuring the environmental security of Russia. It is shown that the next block of problematic areas of the sanctions policy in relation to the country’s environmental security relates directly to the application of effective economic mechanisms for environmental protection and nature management. The authors substantiate specific proposals in the field of legal regulation of ensuring environmental safety in the context of economic sanctions. Among other things, it seems necessary to the authors to rethink the existence and benefits of countless new regulatory legal acts, the practice of adopting dozens of changes in existing environmental laws.
Factors Associated with Revision Surgery in Long Bones Metastases
Authors: Wang Jun , Kharchenko Natalya V. , Zapirov Gadzhimurad M. , Kaprin Andrey D. , Bukharov Artem V. , Derzhavin Vitalii A. , Yadrina Anna V.
Published: August 2022

Background. Bones as an organ are one of the most common targets for tumor metastasis. Currently, the number of patients undergoing surgical treatment for metastatic bone lesions is steadily increasing. In most patients, after surgical treatment, the manifestation of clinical symptoms decreases, primarily pain syndrome, which improves their quality of life. However, it should be noted that the number of patients with bone metastases who underwent revision surgery is also increasing. This article retrospectively analyzes the factors leading to revision after surgical treatment of metastases in long bones.
The aim of this study was to identify factors leading to revision after surgical treatment of patients with metastases in long bones.
Methods. A retrospective medical records analysis of 247 patients who underwent surgical treatment for metastases in long bones on the basis of the P.A. Herzen Moscow Research Institute of Oncology in 20062020 was performed. Of these, 33 patients underwent revision surgery. The median age was 62 years. The localization of the primary tumor was as follows: breast cancer 10 cases, kidney cancer 13, lung cancer 3, prostate cancer 2, rectal cancer 3, liver cancer and Ewings sarcoma with bone metastases 1 case each.
Results. The following factors led to revision surgery: mistakes in preoperative diagnosis (3 patients); postoperative infectious complication (6 patients); dislocation of the endoprosthesis (4 patients); continued growth of solitary metastasis after osteosynthesis (5 cases); aseptic instability after intramedullary osteosynthesis (14 patients); traumatic fracture of the endoprosthesis stem (1 patient).
Conclusions. Revision after surgical treatment of metastases in long bones, in addition to postoperative complications, lead to mistakes in diagnosis and incorrect choice of surgical treatment method. To reduce the risk of revision surgical interventions, a multidisciplinary approach is needed with the development of surgical treatment tactics in consultation and the use of specialized scales of oncological prognosis.
Cultural and legal crisis: transformation of personality in modern society
Authors: Семина Т.В. , Шишкова С.М.
Published: August 2022

Статья посвящена изучению феномена культурно-правового кризиса и ценностно-нравственных ориентиров в современном социуме. Новые информационные коммуникации несут в себе доминирующие информационные возможности, подвергая личность глубинным изменениям, формируя новую шкалу ценностей и убеждений, а в глобальном смысле - формируя общественное сознание. Информатизация и цифровизация формирует совершенно новую культурноэтическую ситуацию в обществе, изменяет поведение индивидов. Проблема национальных культур воспринимается в сегодняшних реалиях, как одна из важных проблем обеспечения национальной и глобальной безопасности в мире.

The article is devoted to the study of the phenomenon of cultural and legal crisis and value and moral guidelines in modern society. New information communications carry dominant information capabilities, the personality undergoes profound changes, forming a new scale of values and beliefs, and in a global sense - forming public consciousness. Informatization and digitalization forms a completely new cultural and ethnic situation in society, changes the behavior of individuals. The problem of national cultures is perceived in today's realities as one of the important problems of ensuring national and global security in the world.
New trends in the development of local self-government in the light of the 2020 constitutional reform
Authors: Чихладзе Л.Т. , Ганина О.Ю.
Published: August 2022

В статье анализируются актуальные вопросы развития системы органов местного самоуправления в свете конституционной реформы 2020 г. Исследовано понятие «местное самоуправление» по Федеральному закону «Об общих принципах организации местного самоуправления в Российской Федерации» и законопроекту о местном самоуправлении. Затронута проблема функционирования органов местного самоуправления в условиях укрупнения муниципальных образований и перехода к одноуровневой системе организации местного самоуправления в Российской Федерации.

New trends in the development of local self-government in the light of the 2020 constitutional reformAnnotation: The article analyzes topical issues of the development of the system of local governments in the light of the constitutional reform of 2020. The concept of "local selfgovernment" according to the Federal Law "On the General Principles of Organization of Local Self-Government in the Russian Federation" and the draft law on local self-government is studied. The problem of the functioning of local governments in the context of consolidation of municipalities and the transition to a single-level system of organization of local government in the Russian Federation is touched upon.
Tax reconstruction is a new increment of tax legal relations.
Authors: Фархутдинов Р.Д.
Published: August 2022

Актуальность вопроса применения в налоговых правоотношениях понятий и дефиницией, отсутствующих в праве, предопределяет необходимость исследования такого научного феномена. Важным и практически необходимым полагаем определить регуляторы, позволяющие защитить частные интересы сторон в договоре, выявив пределы воздействия публичного права в коммерческом договоре.

The relevance of the issue of the application of concepts and definitions that are absent in the law in tax legal relations determines the need to study such a scientific phenomenon. We consider it important and practically necessary to determine the regulators that allow protecting the private interests of the parties in the contract, and the limits of the impact of the law in the commercial contract.
Comparison between Hybrid and Fuel Injection Motorbikes
Authors:   the Department of Mechatronics Engineering, SZABIST University, Karachi, 75600 Pakistan, Bano N. , Younas T. , Khan U. A. , Durrani A. T. , Huzaif M. , Khalid M. R.
Published: August 2022

As the technology is evolving and upgrading, more ways are being founded to tackle global warming and the emission of greenhouse gases. Introducing hybrid cars in 1997 was a milestone towards this initiative, which not only decreased fuel consumption but also lowered the on-road emission of harmful gases. However, in developing countries where masses are using motorbikes as a primary source for commuting. Industries are in process to manufacture hybrid motorbikes which are eco-friendly and light in build. This paper will be addressing the comparative analysis of both types of bikes i.e. the new hybrid bikes and fuel injection motorbikes with associated pros and cons.
Improving Student Learning Outcomes through Mobile Assessment: A Trend Analysis
Authors:   the Faculty of Education, Universitas Negeri Yogyakarta, Indonesia, Herwin Herwin , Senen Anwar , Nurhayati Riana , Dahalan Shakila Che
Published: August 2022

The integration of technology in learning is one of the popular issues today which is an alternative to solve the problems experienced in the difficulty of achieving maximum learning goals for students. This study aims to examine the effectiveness of the application of mobile assessment in learning activities in elementary schools. This research is a quantitative study using descriptive type. The respondents of this study were elementary school students who were at the fifth-grade level. Data were collected through learning outcomes tests using mobile assessment technology. The data analysis technique used is trend analysis. Research findings indicate that there is a positive trend in student learning outcomes when using mobile assessments in learning activities. Based on the model fit, the findings show that the Quadratic Trend Model is the best model with the smallest measurement error.
Development of a TPACK-Based Professional Development Framework for the New Normal in Education
Authors:   the College of Teacher Education at Batangas State University ARASOF-Nasugbu, Philippines, Aquino Anania B. , Dadayan Aleli A. , Rosel Marvin E. , Francisco Michael John V.
Published: August 2022

The role of technology in the delivery of education in this time of pandemic help teachers in the delivery of lessons and student learning. This study examined the competence on online technological pedagogical content knowledge (TPACK) of a sample of faculty members and their online teaching attitude and ability and develop a professional development framework for teachers under the new normal in education. This quantitative research used a questionnaire to collect data from 501 faculty members from Batangas State University as respondents. Findings indicate that pedagogical knowledge, technological knowledge and technological content knowledge are the predictors of faculty members. Online attitude and ability were also considered very important by most faculty members. Thus, a professional development framework in the new normal based on technological pedagogical content knowledge of teachers was prepared.
Computer Anxiety and ICT Utilization of Program Heads in a State University
Authors:   the Computer Science Department of Eastern Samar State University, Borongan City, Eastern Samar, Philippines, Meneses III Jesus M.
Published: August 2022

This study aimed to determine the correlation between ICT utilization and computer anxiety among the program heads of a state university given the increase in ICT usage requirements due to the Covid-19 pandemic. The study was carried out in a correlational survey model. All 33 faculty members designated as program heads across all courses in Eastern Samar State University colleges were involved as respondents. The data were assessed using a computer anxiety test (CARS) and a test for the level of computer utilization. Descriptive statistics and Pearson's r correlation coefficient using MS Excel and free online software calculators were used to analyze the data. The result showed that ICT utilization was generally high, and the majority of the respondents had no computer anxiety. It was found further that a moderate negative linear relationship exists between the respondents' level of computer anxiety and their level of ICT utilization. The increase in ICT utilization may suggest a decrease in computer anxiety among the respondents and therefore reject the null hypothesis. Hence, due consideration of psychological fitness to use ICT in the context of education supervision was suggested. Further study involving other members of the organization was also suggested to explore or strengthen these findings, or otherwise.
Women’s fear of normal delivery and their decision on the mode of delivery: a cross-sectional study
Authors: Sarker Anima , Chowdhury Shamima Haque , Begum Mosammat Shahina , Bhowmik Juthi , Islam Mohammad Shaiful
Published: August 2022

Background: Caesarean section, C-section, or caesarean birth is the surgical delivery of a baby through a cut (incision) in the mother's abdomen and uterus. It's a surgical procedure utilized when a vaginal delivery isn't possible or safe, or when the health of the mother or infant is at risk. Caesarean section rates range from 0.4 to 40% in different countries, and the trend has been growing over the previous 30 years. These increases have been linked to a number of factors. The purpose of this study was to learn more about these factors in the context of Bangladeshi demographics. Aim of the study was to investigate the women’s Fear of normal delivery and their decision on the mode of deliveryMethods: This cross-sectional observational study was conducted at the department of obstetrics and gynecology in Uttara Adhunik medical college and hospital, Bangladesh. The study duration was from 1February 2021 to 30 November 2021. The present study was carried out with a total of 63 women who had undergone caesarean section during the study period. A convenient sample selection method was done for the selection of the participantsResult: Among the participants of the present study, 47.62% were aged between 25-29 years, 76.19% were Muslims, and 76.19% stayed at the hospital for 3-4 days. 90.48% had been pregnant for 36-40 weeks. Lower abdominal pain and labor pain was observed in 20.63% of the participants. The majority of the participants underwent caesarean delivery due to fear of labor pain and episiotomy.Conclusion: The fear of childbirth or labor pain is the most common cause in patients undergoing caesarean section, followed by doctor advice due to medical comorbidities and fear of episiotomy.
Prediction of perinatal outcome in high-risk pregnancy by Doppler ultrasound: a prospective cohort study
Authors: Karena Zalak V. , Mehta Aditya D. , Vaghela Hetvee M. , Shah Harsh R.
Published: August 2022

Background: Doppler study of uterine and fetal vessels assesses the feto-maternal circulation. An abnormal Doppler study is a sign of placental dysfunction and fetal damage. This study aims to study the relationship of Doppler velocimetry of the uterine artery, umbilical artery, and middle cerebral artery to perinatal outcomes in normal and high-risk pregnancies.Methods: A prospective cohort study was conducted in a tertiary health care center. A total of 150 patients aged 18–35 years with the gestational age of 28 to 40 weeks in 2 cohorts, 75 in high risk and 75 in the non-high-risk cohort were included. Pregnant women with gestational hypertension, intrauterine growth restriction, preeclampsia, preeclampsia plus IUGR were included in high-risk cohort. Doppler study was carried out, data was collected, and was analyzed.Results: Doppler parameters and their association with perinatal outcome were measured. The sensitivity of umbilical artery index (79.4%) was found to be highly predictive of poor neonatal outcomes compared to middle cerebral artery Doppler (58.8%) and cerebroplacental ratio (41.2%) parameters. A high positive predictive value for unfavourable perinatal outcomes with an accuracy of 93% using umbilical artery indices, 95% using MCA Doppler, and 93% CPR was found in the study. Specificity of umbilical artery Doppler was 87.5%, MCA Doppler was 93.75% and CPR was 93.75%.Conclusions: When incorporated into evaluating high-risk pregnancies complicated by pregnancy-induced hypertension, preeclampsia, and IUGR in the third trimester, screening the fetuses for well-being with Doppler helps in timely intervention and improves the perinatal outcome.
Intraoperative cystoscopy in major gynaecological surgeries: necessary skill for a gynecologist
Authors: Mishra Vineet V. , Solanki Smit B. , Aggarwal Rohina , Choudhary Sumesh , Shah Kunur , Anusha M.
Published: August 2022

Background: The goal of this study is to find out: how important it is to utilize intraoperative cystoscopy liberally in normal gynaecological procedures to detect urinary tract injuries, how long it takes to do intraoperative cystoscopy and what problems are linked with cystoscopy.Materials: The study is from the year 2016 to 2022 involving around 1221 patients. In a tertiary care facility, retrospective observational research was conducted. The study comprised patients receiving all gynaecological and urogynaecological operations. Malignancy was ruled out. Following gynaecological surgery, a 20-F-30-degree telescope was used to perform a cystourethroscopy. To record case information, a study proforma was created.Results: Intraoperative cystoscopy detected four bladder injuries during anti-incontinence surgery (TVT) and hysterectomy. After a thorough laparoscopic hysterectomy with normal cystoscopy, one patient returned one month later with right ureteric injury. A urinary tract infection struck fifteen people shortly after surgery. After surgery, one patient suffered flank pain and a fever for 48 hours. There was no sign of urinary tract injury on a CT-IVP scan. She was handled with care.Conclusions: For early diagnosis of urinary tract injuries, gynaecologists should have a low threshold for performing intraoperative cystoscopy during gynaecological procedures. Early detection and treatment of urinary tract injuries reduces the patient's morbidity, with a successful repair outcome at the time of detection. Performing an intraoperative cystoscopy during gynaecological procedures allows for this.
Successful management of pump twin
Authors: Rajamanikkam Hemamalini , Hamshadhwanaa Anupritha Arudhra
Published: August 2022

Acardiac twinning is one of the rare but important complication of monochorionic twin pregnancies leading to increased perinatal mortality of both twins. Since one of the twins did not have well developed cardiac structure it depended on the co-twin for blood supply. This increases mortality of co twin. We reported a case of acardiac twin diagnosed at proper time managed with interstitial laser occlusion of cord at appropriate time with successful outcome of normal co-twin. This case highlighted the importance of early diagnosis, proper timing and selection of vascular occlusion procedure to occlude blood flow to acardiac twin and close surveillance and delivery of donor twin, to improve perinatal outcome.
A rare case of giant condyloma acuminata during pregnancy
Authors: Choudhary Neeraj , Verma Savitri , Gandhi Sudha , Sharma Anuj Kumar , Kumari Asha
Published: August 2022

Genital warts (Condyloma acuminata) are a benign lesion caused by human papillomavirus (HPV) type-6 or type-11 and are usually transmitted sexually. During pregnancy, condyloma has a tendency to proliferate and may have recurrence. We have a case of G2P1L1 38 weeks previously normal vaginal delivered patient in our hospital with extensive genital warts. Patient was successfully managed by surgical excision and after that in follow up after 2 months for podophyllin resin application on remaining lesions. HPV infection presentation can range from asymptomatic to cervical cancer. Small genital wart lesion may become extensive and cumbersome during pregnancy and again regress after delivery in due course of time. HPV vaccination, sex education and early treatment of condyloma lesions should prevent and, in any case, improve the prognosis of this disease.
Interesting rare case of recurrent puerperal uterine inversion: a case report
Authors: Kharkwal Sushila , Jain Divya , Agarwal Sippy , Pandey Divya
Published: August 2022

Uterine inversion is a rare obstetric emergency that may lead to severe haemorrhage, shock and eventually death. The incidence of uterine inversion varies from one in 2,000-20,000 deliveries. Recurrent uterine inversion is still rare with no exact reported incidence so far. We report a case of a near miss patient, 28 years old primiparous with complete uterine inversion with atonic postpartum haemorrhage and shock, managed by manual repositioning and tamponade insertion which got corrected. Patient had recurrent uterine inversion twice in the puerperal period on 5th and 7th postpartum day. A new approach to management was taken. Rather than going for laparotomy, vaginal manual correction followed by intrauterine tri-way foley catheter insertion was done. Gradual deflation was done leading to final permanent correction. Uterine inversion is a rare but potentially deadly complication post vaginal delivery. Mortality and morbidity can be reduced by rapid recognition and immediate replacement. For recurrent inversion prolonged intrauterine balloon placement may be needed in rare cases.
An obstetrician's own experience of having an extremely preterm baby: an autoethnography
Authors: Mangla Mishu
Published: August 2022

Parental stress after the birth of a preterm baby is well known. Being an obstetrician who herself had an extremely premature delivery, the author thought of narrating self-experience regarding delivering a preterm baby. The objective is to engage the reader both cognitively and emotionally regarding aspects of preterm birth that obstetricians often disregard. Autoethnography is a unique form of research that examines an interplay between self and cultural norms. The role of narrating self-experience by the author, though well established in mental health issues, has not been explored much in maternal and child health. Mothers of preterm babies go through a mixed bag of feelings. The feelings of happiness and delight are in no time transformed into anxiety, guilt, sufferance, and sometimes even frank depression. Preventing preterm births as far as possible should be the goal of every obstetrician.
Idiopathic spontaneous rupture of unscarred uterus in a primigravida
Authors: Mishra Mona
Published: August 2022

We present a case of spontaneous rupture of unscarred uterus in a primigravida with no known risk factors. Rupture was diagnosed when patient was in second stage of labour. Diagnosis was made when there was cessation of contractions, loss of station and loss of foetal heart sound. On exploratory laparotomy, hemoperitoneum of 100 ml and a 10 cm tear was found in left posterolateral aspect of an anatomically normal uterus, extending deep into the lower uterine segment. The tear was repaired successfully and patient had a normal post- operative course with no requirement of blood transfusion. High index of suspicion, quick diagnosis and timely laparotomy is the cornerstone of treatment in such cases. Any delay, could lead to significant fetomaternal morbidity and mortality.
Vaccination hesitancy as a cause of COVID-related mortality
Authors: Kılıç Jehat , Yıldırım M. Serdar , Alakuş Ömer Faruk , Kiliç Delyadil Karakaş , Y. Nurettin A. , Ebik Berat
Published: August 2022

Background: In this study, our aim was to draw attention to the vaccine hesitation as a cause of unvaccination and evaluate the vaccinated and unvaccinated patients in the intensive care unit in terms of morbidity and mortality.Methods: A hundred and ninety-nine patients between the May 2021-September 2021 admitted to the intensive care units in our hospital were included in this study.  We included the patients with COVID-19 infection as assessed by reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay.Results: Despite the availability of eligible vaccines in our region, the most of included patients in this study were unvaccinated (n:119). Eighty patients were vaccinated. The vaccinated patients were divided into six groups according to their vaccination status such as subgroup 1: one-dose Coronavac, subgroup 2: two-doses Coronavac, subgroup 3: three-doses Coronavac, subgroup 4: 2-doses Coronavac+ One-dose BNT162b2, subgroup 5: one-dose BNT162b2, subgroup 6: two-doses BNT162b2 (Numbers of patients: 7-61-3-1-10-0 respectively for each group). Between the vaccinated and unvaccinated groups, there was no significant difference in terms of mortality (p>0,05). The majority of patients in the vaccinated group were the patients vaccinated with Coronavac (subgroup 2:59), and there was no full dose vaccinated patient with BNT162b2.Conclusions: While both vaccines are effective to reduce the morbidities and mortality related to COVID-19, there might not be efficacy in these vaccines, particularly Coronavac, following the admission to the intensive care unite in the more vulnerable population. And despite the availability of vaccines, vaccine-hesitancy may be one of the significant reasons for the hospitalization process.
Evaluation of serum lipoprotein(a) level in type 2 diabetic patients and non-diabetic people
Authors: Karmakar Pijush , Zohora Fatema Tuz , Farzana Taposhi
Published: August 2022

Background: Type 2 diabetes mellitus has high morbidity and results in increased risk of mortality mainly due to cardiovascular diseases. Different factors have been found to be responsible for the increased prevalence of coronary artery disease in T2DM. One of these factors includes raised serum level of lipoprotein(a) (Lp(a)). The purpose of the present study is to assess the serum level of Lp(a) in type 2 diabetes mellitus patients and non-diabetic people with find the difference of serum Lp(a) between good and poor glycaemic control.Methods: This cross-sectional study was carried out in the department of Biochemistry and Endocrinology, Chittagong Medical College Hospital, Chattogram from July 2017 to June 2018. We assess a total of 100 type 2 diabetic patients and a group of 50 non-diabetic people with the age range 31-60 years. Blood samples were collected in fasting state and analysed for FPG, HbA1c%, serum lipid profile (TC, TG, LDL & HDL) and Lp(a). Data were analysed by T-test and chi-square test.Results: The serum Lp(a) levels were significantly elevated in type 2 diabetic patients compared to non-diabetic people (44.32±2.6 vs. 13.02±0.81). There were also significant difference of serum Lp(a) between good and poor glycaemic control.Conclusions: Lp(a) is an independent risk factor for atherosclerosis and has elevated level in diabetic patients. So, selective screening with lowering its concentration would help prevention of coronary artery disease, a known cause of death in diabetic patients.
The prevalence of atopic dermatitis among children aged between 6 months and 12 years attending primary health care clinics in Qatar 2018-2019
Authors: Oommen Boby John , Kadori Waad Ibrahim Majeed , Abdulmajeed Jazeel , Krishnan Jeyaram Illiayaraja , Veettil Shajitha Thekke
Published: August 2022

Background: The prevalence of atopic dermatitis among children appears to have increased dramatically over the past decades. Such rapid increase in prevalence cannot be explained fully. Genetic factors, microbiomes (especially staphylococcus aureus infection), food allergy and environmental factors might play a role in such an increment. This study aimed to report the prevalence of atopic dermatitis among children aged 6 months to 12 years attending primary health care centers in Qatar during the year 2018 and 2019.Methods: Cross-sectional retrospective data analysis of all registered cases having at least one visit in any of the 28 health centers dermatology clinics operated by PHCC with a verified diagnosis of atopic dermatitisResults: Out of 4521 patients dermatology clinic visit, 1359 had atopic dermatitis during the period of 2018 and 2019, and the prevalence rate is 30.06 (95% CI 28.72-31.42). In this 1359 atopic dermatitis cases, mean age of patients was 5.09±3.53 years and ranged from 6 months to 12 years. In this 18.9% was <1 years, 41.43% was 1-5 years, 19.35% was 5-8 years and 21.04% was 8-12 years. Prevalence of AD is high in boys 31.42% than girls 28.81% and is high in Qatari population 34.4% than the non-Qatari population 28.7%. The most frequently prescribed medication group was topical emollients (89.8%) followed by antihistamine (81.24%) and antibiotics (56.73%). Steroids were prescribed only for 7.3% of cases.Conclusions: In this study the prevalence of atopic dermatitis was remarkably very high in young children in Qatar. Further prospective research and more efforts are needed to develop a standard treatment regimen for allergic diseases in Qatar.
Impact of health management information systems on service delivery among healthcare workers at Iten County Referral Hospital
Authors: Kilimo Stanley K. , Walekhwa Michael N. , Otieno Filex O.
Published: August 2022

Background: Decision-making process and effective planning within the health sector relies majorly on availability of reliable, accurate and prompt information. Most referral healthcare facilities in Kenya utilize health management information systems (HMIS) yet delivery of effective services remains relatively challenging. Against this backdrop, we assessed the impact of use of HMIS on service delivery among healthcare workers at Iten County Referral Hospital (ICRH).Methods: This study used a cross-sectional study design target population was all healthcare workers at ICRH. Closed and open-ended questionnaires were used to obtain data. Purposive and stratified sampling techniques were used to select study site and participants respectively. The sample size was 185 healthcare workers but 142 participants filled out the questionnaire.Results: Most respondents were nurses (37.4%). Least cohort were pharmacists (1.40%). About 62.7% were diploma-holders, 26.8% had a bachelor’s degree. Further, 66.9% of participants had <10 years working experience, 22.5% had 11-20 years while; 10.6% had 21-30 years. Participants (26.1-47.2%) agreed that using HMIS is efficient and effective for managing hospital data. Majority were undecided whether HMIS can be used for managing financial imperatives and providing epidemiological data. Participants (77.5%) rated HMIS as being user-friendly. Remarkably, 22.5% rated the HMIS as suitable for use as a centralized planning system for the hospital. Data also showed that HMIS is yet to be fully integrated into the hospital system.Conclusions: The use of HMIS has positively impacted service-delivery at ICRH. We therefore recommend that healthcare facilities integrate the use of HMIS in management of hospital data.
Clinicopathological features and prognostic factors in endometrial carcinoma: a retrospective analysis from a tertiary cancer centre
Authors: Angadi Veerendra , Praisy Esther , Tatineni Tushar , Karpurmath Shashidhar V. , Nandennavar Manjunath I.
Published: August 2022

Background: Endometrial carcinoma (EC) is most common gynecological malignancy. The incidence of endometrial cancer is rising rapidly with only limited evidence on the clinicopathological features, survival data and prognostic factors. The study aimed to evaluate the clinicopathological features, treatment, recurrence pattern, survival and to assess the prognostic factors in patients with endometrial carcinoma.Methods: After obtaining approval from institutional ethics committee, 94 patients who were diagnosed with EC were included in the study. The data were presented as proportions and survival curve analysis was done using the Kaplan Meir curve and significance using log rank tests.Results: A total of 94 patients diagnosed with EC were included in the study with a mean age of 55.1 years. The Myometrial invasion was observed in 46.9% of the patients with 35.2% having lymphovascular involvement. Clinical characteristics of the patients showed grade 1 (35.1%) followed by grade III (17.02%). Survival analysis showed that elderly age, multi parity, advanced disease stage, more than 50% of myometrial invasion, grade II and grade III tumors, lymphovascular space invasion, adversely affected long‑term survival when analyzed by log-rank test. The disease-free survival (DFS) at 5 years was found to be 77% and overall survival (OS) at 5 years was 79.7%.Conclusions: Endometrial carcinoma is seen commonly in postmenopausal women wherein delaying the treatment significantly affects the long‑term survival. Therefore, early diagnosis reduces the mortality and increases the disease-free survival in these patients.
Comparison of the model for end-stage liver disease and disease sodium values in prognosticating short term 3-month mortality in chronic liver disease
Authors: Nandalike Prathvi , Fathima Nimrah , Reddy Machandra , B. Sandhya Rani , P. Srinivas
Published: August 2022

Background: Chronic liver disease (CLD) cirrhosis of liver is one of the common non communicable disease, accounting for significant morbidity and mortality in developing countries like India. several prognostic scoring systems have evolved from the need to prioritize patients for liver transplantation model for end-stage liver disease (MELD) and its variant, which includes sodium values (MELD-Na) have been recently popularized.Methods: Prospective observational study with follow-up telephone call every month for 3 months, with ppurposive sampling done on 60 patients admitted to AIMS BG Nagara Mandya district Karnataka India. Statistical analysis included the strength of association was assessed using Pearson's correlation and the ROC curve was drawn to assess the accuracy and diagnostic utility of the two models. A p<0.05 was considered statistically significant.Results: In the present study, the mean age of patients was 49.68±9.89 years of age. The strength of association between the MELD score and MELD-Na score was found to be a very strong positive strength of association (r=0.904, p<0.05). The mean MELD score and MELD-Na score was found to be higher in non-survivors’ group (28.5 and 30.5) compared to survivors group (22.03 and 25.67) which was statistically very significant.Conclusions: MELD-Na score was higher among the patients with outcome of death compared to the MELD score among the patient. The ROC curve showed a comparable result with MELD and MELD-Na scores. There was a relation of severity of hyponatremia with the child-Pugh scores.
Incidence of pelvic inflammatory disease in females presenting with low backache in orthopedic OPD
Authors: Deshpande Juhi , Singh Chanchal Kumar
Published: August 2022

Background: Low backache (LBA) is one of the major global public health problems. It causes great disability and distress among females and hampers their day-to-day activities. Pelvic inflammatory disease (PID) is one of the major causes for LBA. Early diagnosis and treatment of PID leads to significant improvement in symptoms of LBA and prevents complications related to PID. The aim of the study was to determine the incidence of pelvic inflammatory disease (PID) in females attending orthopaedics OPD with complaints of low backache (LBA).Methods: A prospective epidemiological study was done on 200 female patients attending orthopedics OPD. Detailed history was taken followed by thorough examination. Patients were interviewed regarding their age, parity, demographic parameters, associated complaints, type of contraceptive use and addiction status.Results: Out of 200 female patients with LBA, PID was found in 55 (27.5%) patients. Majority (37%) of patients were from the age group of 40-49 years. 65% of patients were of low socio-economic status, 75% females were illiterate, 63.5% females were obese, 28% females were addicted to smoking, 24% tobacco chewing and 76.5% were parous. 53% of patients complained of discharge per vaginum. 42.5% females used oral contraceptive pills and 25.5% females had an intrauterine contraceptive device inserted.Conclusions: The study suggests that PID is a major contributing factor of LBA in female. Therefore, gynecological opinion should be taken for the complete management of LBA among females.
Effect of casirivimab-imdevimab on mild COVID-19 patients with diabetes in reducing oxygen supplementation at 28 days: an observational study
Authors: T. Bhagyanath , R. Remitha K. , R. Akshay C. , P. Aswin , S. Deepak , R. Jithesh
Published: August 2022

Background: Monoclonal antibody therapy is one of the most promising treatments for COVID-19 infection. Casirivimab-imdevimab is a monoclonal antibody cocktail which is approved for high-risk patients with mild to moderate COVID-19 infection. The aim of the study was to determine the safety and efficacy of casirivimab-imdevimab on diabetic patients with COVID-19.Methods: This was an observational study conducted on diabetic patients admitted with mild to moderate COVID-19 infection. The patients were divided into 2 groups. While 101 patients were administered with casirivimab-imdevimab (test group), 100 of them were provided with standard treatment (control group). Regular follow-ups ensued for 10 days during the period of their hospitalization and finally on the 28th day through a telephonic enquiry. Apart from this, safety of administering the drug was assessed in all patients who belonged to the test group.Results: One of the patients who were administered casirivimab-imdevimab developed anaphylactic reaction. Three fourth of the patients who participated in the study were vaccinated and the oxygen requirement up to 10 days of admission was significantly lower in the vaccinated group (p=0.018). Oxygen requirement, mechanical ventilation and death up to 10 days of admission were less for patients who were administered monoclonal antibody, but it was not statistically significant. Oxygen requirement, and death after 10 days up to 28 days were also less for patients who were administered monoclonal antibody, even though not statistically significant.Conclusions: Casirivimab-imdevimab was not found to be beneficial in diabetic patients with mild COVID-19. More studies with higher sample size are required to prove the clinical benefit of casirivimab-imdevimab beyond doubt.
Unilateral enlarged and bifid transverse process of an atypical lumbar vertebra: a case study
Authors: Nayak Gyanaranjan
Published: August 2022

Sometimes the atypical lumbar vertebra (L5) may articulate with underlying bones like ilium and sacrum. This may give rise to low back pain in the concerned subject. An atypical lumbar vertebra with unilateral bifid transverse process was encountered by the author during routine osteology classes of MBBS students and it was thoroughly examined. On gross examination of the said vertebra, a facet measuring 1.9 cm in maximum length and 0.8 cm in maximum breadth could be observed on the inferior surface of the anterior part of the bifid transverse process. The altered morphology of the vertebra indicates the possible articulation of its transverse process with the underlying ilium or sacrum leading to low back pain (probable cause of Bertolotti’s syndrome).
A rare case of paraneoplastic neurological syndrome with ovarian teratoma
Authors: Kumar Anita , Dabral Anjali , Panwar Megha , Bajaj Bindu , Sanapala Sukanya , Sharma Deepti
Published: August 2022

Paraneoplastic neurological syndrome (PNS) is a neuropathological disorder of central nervous system, in this the patient presents with a tumor anywhere in the body with diverse neuropsychiatric symptoms. The clinical manifestation of the tumor may be preceded by PNS. We are reporting a case of a 23-year-old married nulliparous female who came to the gynaecology outpatient department (OPD) with the history of mass per abdomen for the past four months and also undergoing treatment for acute psychosis, memory loss and cognitive impairment for the past five months. Her symptoms were not relieved on treatment. After clinical, laboratory and radiological evaluation possibility of paraneoplastic neurological syndrome associated with ovarian teratoma was made. Patient was taken up for staging laparotomy with U/L salpingoophrectomy. After surgical treatment her psychiatric symptoms rapidly improved and her psychiatric medications doses was reduced. PNS should be suspected in female patients presenting with an acute history of neuropsychiatric symptoms. Tumor resection should be performed at the earliest to improve patient outcomes.
Atypical presentation of scrub typhus encephalitis with cerebral hemorrhage
Authors: Mukhopadhyay Arka , Bandyopadhyay Dipanjan , Chakrabarti Debasis , Bhadra Anamika
Published: August 2022

Scrub typhus, an arthropod borne infection caused by the rickettsial organism Orientia tsutsugamushi, is a fairly common disease in north-eastern sub-Himalayan India, particularly the forest areas, and is known to manifest with varied presentations ranging from non-specific fever to severe multi-organ complications. Hemorrhagic manifestations described in the literature are mostly gastrointestinal and genitourinary, secondary to vasculitis and/or thrombocytopenia, but reports of cerebral hemorrhage have been extremely rare. We report a case from sub-Himalayan eastern India where a 23 years old male tea plantation worker presented with recurrent convulsions with magnetic resonance imaging (MRI) brain showing multiple parenchymal hemorrhages with encephalitis involving both the cerebral hemispheres. Although patient developed fever and acute kidney injury later in the course, these were not the presenting complaints despite fever being the most consistent sign of a scrub typhus infection. We suggest consideration of scrub typhus as a differential diagnosis of a cerebral hemorrhage in endemic regions.
Long COVID and its effects on the cardiovascular system: a literature review
Authors: Itua Blessing , Chukwuka Columba
Published: August 2022

A significant cardiac burden exists post COVID-19. This is evident by persistent chest pain, palpitations, dyspnea, exertional fatigue, presence of new-onset heart failure or arrhythmia. Persistent COVID-19 symptoms in the cardiovascular system may be caused by a combination of processes that either increase inflammation or tamper with the autonomic nervous system. The inflammation can be caused by viral load persistence leading to tissue damage. The presence of cytokines and chemokines results in a state of hyper inflammation, immune exhaustion, organ damage during the infectious state and post-viral autoimmunity. The current review aims to discuss the risk factors, pathophysiology and treatment of the protracted form of COVID-19 in relation to the cardiovascular system.