bluuebunny/crossref_metadata_2025 huggingface dataset:
Enrichment of table eggs with lutein
Authors: Kralik Gordana , Galović Olivera , Margeta Polonca , Hanžek Danica , Grčević Manuela , Kralik Zlata
Published: June 2020

For the enrichment of eggs with lutein, a marigold flower extract – MFE (Tagetes erecta L.) was used. The two groups of laying hens were involved in the study – the control group (C) and the experimental group (E), respectively. The laying hens of the control group were fed by the lutein‐free mixture, while the laying hens’ E group consumed the mixture with the 3 g/kg of lutein. The laying hens’ feeding lasted for 31 days, after which the quality of eggs (i.e., the shape index, egg weight and the egg main parts, shell strength and thickness, Haugh units – HU, egg white height, egg yolk color, egg white pH, and the egg yolk pH), as well as the lutein content and Thiobarbituric Acid Reactive Substances (TBARS) values in egg yolks, were determined. The study results have demonstrated that the added MFE exerted an effect of thickness, weight, and eggshell proportion reduction (P<0.001), as well as of the shell strength reduction (P=0.014). It has also reduced the HU value (P=0.039) and has increased the egg white content, egg yolk color, and the egg yolks’ lutein content (P<0.001). A statistically significant difference in TBARS values was found between the fresh and the stored eggs in group C, as well as between the C and E groups in the fresh eggs (P<0.05). Our results indicate that MFE is suitable for the enrichment of table eggs with lutein.
Dipstick urine analysis for detection of renal abnormalities among school children
Authors: Mishra Atindra , Thakur Ruby
Published: June 2020

Background: Urine analysis by dipstick is a useful tool to identify children with asymptomatic renal diseases.  Dipstick urinalysis screening was conducted in asymptomatic school children to detect prevalence of renal disease.Methods: A cross sectional study was carried out in 862 children of age 6 to 15 years studying in different schools of Birgunj, Nepal between January 2019 to June 2019. First morning mid-stream urine samples were obtained from students and tested by dipstick method. Children with abnormal findings were re-tested after fifteen days.Results: Ninety-six (11.13%) children had urinary abnormalities at the first screening; 8 children had specific urinary abnormalities after second screening. 4 children had urinary tract infection, followed by glomerulonephritis, type 1 diabetes, hydronephrosis and nephrotic syndrome. Urinary abnormalities were more common in females than in males.Conclusions: Asymptomatic urinary abnormalities are detected by urine screening program at school age. Further work-up reveals the specific diagnosis and effective interventions help reduce the renal disease in future.
Forecasting the possibility of neonatal early onset sepsis based on perinatal risk factors
Authors: Pankaj Kiran C. , Ganguly Sristi , Upadhyay Manas R.
Published: June 2020

Background: Neonatal sepsis remains a leading cause of neonatal mortality and morbidity, diagnosis of which remains difficult due to variable presentations. With the increasing threat of antimicrobial resistance, it is important to identify perinatal risk factors which are associated with higher incidence of definite sepsis, to initiate empirical antibiotics, while awaiting blood culture reports.Methods: This was hospital based cross-sectional study done in SVPPGIP, Cuttack, Odisha during January 2019 to April 2019, enrolling all neonates  ≥37 weeks gestation and aged less than 72 hours, with suspected early onset sepsis. Neonates with TORCH infections, congenital anomalies, syndromic baby or with surgical conditions were excluded. After obtaining informed consent, blood culture was sent for all and their perinatal risk factors noted. Blood culture positive newborns were considered to have definite sepsis. Data was analysed with Chi-square test and percentages, using SPSS 18.Results: Among the 200 cases, incidence of definite sepsis was 26%. The most common risk factor was low birth weight and birth asphyxia. Majority (67%) had single or lesser risk factor and number of risk factors was significantly associated with definite sepsis. A significant association was seen between blood culture positivity with low birth weight (p=0.003), foul smelling liquor (p= 0.025), birth asphyxia (p 0.018) and premature rupture of membranes (p= 0.016). The combination of maternal fever and unclean vaginal examination was also significantly associated with the same.Conclusions: Protocols for initiating empiric antibiotics need to be formulated, taking into account the significant risk factors, in resource limited settings, to avoid resource and time wastage.
Study the current scenario of hand foot mouth disease an Indian prospective
Authors: Sahota Ravi , Kaur Navpreet , Singh Gurpal , Upadhyay Nisha
Published: June 2020

Background: The hand-foot-mouth disease (HFMD) is an acute communicable disease, mostly affecting children under 5 years of age and caused by human enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). The usual incubation period is 3 to 7 days. Early symptoms are likely to be fever often followed by a sore throat followed by loss of appetite and general malaise. Aim and objectives was to study the trend of hand foot and mouth disease in a private hospital in Uttarakhand over 5 successive years.Methods: This cross-sectional study was carried among 297 cases of HFMD newborn screened at pediatrics department of Sahota Super-specialty hospital, Kashipur, Uttarakhand during year 2015 to 2019 after ethical clearance of institutional ethical committee. Diagnosis is coded with ICD-10. SPSS version 20 was used to calculate frequencies and percentiles.Results: Almost 29 cases of HMFD were picked in 2015, 32 cases in 2016, 43 cases in 2017, 81 cases in 2018, 112 in 2019. Fever observed in 86% cases. Neurological complications were observed in 9 (3%) cases, pneumonitis in 14 (4.7%) cases, cardiomyopathy observed in 3 (<1%) case. One death was reported.Conclusions: It is vital to screen patients with HFMD for these abnormal clinical presentations, allowing timely initiation of appropriate interventions to reduce the mortality. Increased awareness about vaccination in a developing nation like India and vaccination program at the grass root levels have eradicated certain lethal diseases.
Study of correlation between social determinants on mental health status of adolescent school students of Patna, Bihar, India
Authors: Tiwari Anil Kumar , Jaiswal Anil Kumar
Published: June 2020

Background: The status of mental well-being is a function of emotional well-being, psychological well-being and social well-being, and includes aspects like cognitive and social skills, emotional capacity, empathy, ability to cope with adverse events, and capability to function within a society. Various studies have found strong correlations between a person’s immediate surroundings to how they perceive their well-being as well as their actual status of mental health. On one hand, social determinants affect the causation, severity and outcome of mental well-being, on the other hand the state of mental well-being affects the social determinants by affecting personal freedom, ability to make healthy life choices etc. This makes the study of social determinants of mental health very significant.Methods: A cross-sectional, exploratory study of qualitative nature was undertaken in Patna among School going students between the ages 13-17. A self-administered peer reviewed questionnaire was used for data collection.Results: Of 400 participants 19% have features of depression and other mental health problems. Females were more affected. Students of low socioeconomic group (41.6%) and of single parent family (40%) were affected.Conclusions: Mental health problems are very common in adolescent school students. Active steps must be taken to increase awareness about depression among teachers and parents. Early intervention can help prevent worsening of depression and its impact on life.
Popliteal pterygium syndrome: case report from rural India
Authors: Desai Vasav D. , Desai Gayatri S. , Raulji Nirav
Published: June 2020

The popliteal pterygium syndrome is a congenital malformation that includes orofacial, musculoskeletal and genitourinary anomalies. It is also known as faciogenitopopliteal syndrome. It is autosomal dominant disorder. It has highly variable expressivity and incomplete penetrance. The incidence of the popliteal pterygium syndrome is 1/300000, which makes it an extremely rare condition. The most striking characteristic of this syndrome is popliteal pterygium, which consists of a net of connective tissue spreading from the ischial tuberosity to the calcaneus.In this study, authors present the case of a 1 day old male patient with cleft upper lip, cleft palate, bifid scrotum, popliteal pterygium and congenital talipes equinovarus (CTEV).
Secondary haemophagocytic lymphohistiocytosis in a child with brucellosis
Authors: Varahala Ajay Mohan , Malava Ranjeet , Veldandi Sravanthi , Boppidi Santosh Avinash , Kolachena Varsha , G. Udaya Rani G. Rani , Nalamalapu Divya , E. P. Rhaj Kumar , Moturi Raviteja , Alladi Aparna
Published: June 2020

Human brucellosis is a zoonotic infection, mostly caused by B. melitensis and usually presents as an acute febrile illness. Once considered rare in children, it is now recognized that brucellosis can affect persons of all ages, especially in areas where B. melitensis is the predominant species. Complications may affect any organ system. On the other hand Secondary Hemophagocytic lymphohistiocytosis (SHLH) can occur due to systemic infections, immunodeficiency, and underlying malignancies. (SHLH) is histologically characterized by excessive proliferation and activation of histiocytes or macrophages. Brucellosis associated with SHLH should be suspected whenever there is a prolonged fever along with hepatosplenomegaly and pancytopenia.
Disc battery in the pediatric oesophagus
Authors: Mubjal Manish , Tuli Nitika , Rishi Porshia , Singh Harjinder , Munjal Shubham
Published: June 2020

The wide usage of disc batteries in toys, in the late seventies presented a new problem. In the form of accidental lodgements in the pediatric aerodigestive tract. The physico-chemical nature of the disc battery necessitates an early removal, so as to avoid a fatal outcome if missed and retained for a long duration. Management of one such case is reported with radiographic documentation.
A prospective study of functional outcome of closed displaced mid-shaft clavicle fractures treated with intramedullary titanium elastic nail system
Authors: Kumar Mallepogu Kiran , Prasad Rajana Siva
Published: June 2020

Background: Clavicle fractures are most common injuries in young and active individuals, especially those who participate in sports where high-speed falls (e.g., bicycling, motorcycles) or violent collisions (e.g., Football, hockey) are frequent. In contrast, in children and elderly, they are related to falls, and they account for approximately 2.6% of all fractures. The most common site of fracture is a middle-third shaft; it accounts for 80% of all clavicle fractures.

Methods: This was a prospective study carried in 20 patients with simple mid third clavicular fractures, who were treated with closed intra-medullary fixation with TENS nailing. Post-operatively range of movements, ability to get back to routine work were assessed and noted. 

Results: At the end of the study, all the 20 patients in the follow-up group with 14 male and 6 female patients. The mean age was 34.9 years (between 22-55 years) in the group. The mean time interval between injury and surgery was 3.55 days (range 1-6 days). All the patients are achieved clinical and radiological union at a mean of 8.6 weeks (range, 6-12 weeks).

Conclusions: Thus, the intramedullary fixation of a displaced midshaft clavicle fracture is a safe minimally invasive technique. The present study advises the use of minimally invasive antegrade titanium elastic nail for fixation of displaced midshaft clavicle fractures. Although, for comminuted fractures plating remains the procedure of choice.
Evaluation of patients with cervical spine injury and predicting the risk and severity of acute spinal cord injury after a minor trauma
Authors: Maloth Ramdas
Published: June 2020

Background: Acute spinal cord injury (SCI) after a minor trauma to the cervical spine has been reported in patients without preceding neurologic symptoms. Spinal canal stenosis may be the reason for the discrepancy between the severity of the injury and that of the trauma. The objective of this study was to investigate MRI parameters of the cervical spine in patients suffering from acute SCI and to investigate the use of these parameters for predicting the risk and severity of acute cervical SCI after a minor trauma to the cervical spine.  

Methods: Retrospective radiological study was conducted in Meenakshi Medical College and Research Institute Kanchipuram with fifty patients suffering from acute cervical SCI and 130 patients showing no neurologic deficits after a minor trauma to the cervical spine. The following calculations were performed using measurements from MR images the spinal canal to vertebral body ratio, the space available for the cord, and the canal-to-cord ratio. SPSS version 21 was used for analysis.

Results: All investigated MR image parameters in the SCI group were significantly (p<001) smaller compared with the control group. However, there was no significant difference in any parameter among the different American spinal injury association impairment score groups. A cut-off value of 8.0 mm for the minimal sagittal disc-level canal diameter yielded the largest positive predictive value and likelihood ratio for predicting SCI.

Conclusions: Patients at risk of acute SCI after a minor trauma to the cervical spine can be identified by applying a disc-level canal diameter cut-off value measured on MR images. Supplementary factors to the radiological characteristics of the spinal canal affect the severity of acute SCI after trauma.
Extremity chronic osteomyelitis in a population of North East India: epidemiology, clinical characteristics and management
Authors: Khonglah Tashi G. , Borgohain Bhaskar , Khongwir Wanlamkupar , Ahmed Kashif A.
Published: June 2020

Background: The purpose of this study was to review the epidemiology, clinical features and the management of extremity chronic osteomyelitis in a population of North East India and to provide evidenced based guidelines for early diagnosis and treatment.

Methods: We retrospectively reviewed patients who were diagnosed and treated for extremity chronic osteomyelitis at a tertiary care hospital at Shillong in North East India. Medical records for all patients were analysed and details on gender, age at incidence, anatomical site, infecting organisms, levels of inflammatory markers, and the various treatment modalities were evaluated.

Results: A total of 131 patients (96 males and 35 females) were included in this study. The median age at first diagnosis was 17 years for all. Infections caused by hematogenous osteomyelitis was found to be slightly more than those of traumatic origin. All patients had single site infections with a majority of lesions affecting the lower extremities. The tibia was the most common site in traumatic osteomyelitis while the femur was mostly involved in hematogenous osteomyelitis. The positive rate for all cultures was at 57.25% with the most commonly encountered organism being Staphylococcus aureus. Treatment methods used in our study included radical debridement with the use of local and systemic antibiotics and reconstruction of bony or soft tissue defects. The overall infection control rate was 96.18%.

Conclusions: The findings from this study can provide information for early diagnosis and treatment of this form of bone infection particularly in this part of the country. 
A prospective comparative study of mini-open versus arthroscopic repair of supraspinatus tear
Authors: Chebbi Pavan Kumar , Rana Manik , M. Muthu Kishore
Published: June 2020

Background: Supraspinatus tear is very common and more frequent among older individuals. Before the arthroscopy came into high demand, the open repair of supraspinatus tear was the preferred method of surgery. Recently, the mini-open technique of repair has also gained popularity because of certain factors like better repair strength, requires less expertise and facilitates early active mobilization. Still, the gold standard modality of repair is yet to be determined as both modalities are associated with good clinical outcomes and both have their pros and cons. We decided to compare functional and clinical outcomes of arthroscopic and mini-open repair.

Methods: This was a randomised study with 32 patients in each group, aged between 18 and 60 years and all patients were cases of traumatic tear of Supraspinatus tendon. From January 2016 to March 2018, alternate patients were selected for mini-open and arthroscopic repair who fulfilled our criteria.

Results: Follow up was done after 12 months postoperatively and the results were evaluated using University of California Los Angeles (UCLA) shoulder score. None left the study. In arthroscopic group, out of 32 patients, 28 got excellent or good result whereas in mini open out of 32 patients 27 achieved excellent or good outcome.

Conclusions: Arthroscopic method provides better visualization of shoulder anatomy whereas Mini-open method has better repair strength and is affordable. The necessity of an arthroscopy set up might not be required for supraspinatus repair as both the modalities show similar functional and clinical outcomes, reducing the economic burden on the patients.
Comparative study on functional outcome, complication and readmission rate in bilateral simultaneous versus staggered versus staged total knee replacement: a retrospective study
Authors: Pushkarna Vishal Ashokraj , Reddy A. V. Gurava
Published: June 2020

Background: An important source of debate in orthopaedic practices is the choice of performing simultaneously, staggered or staged bilateral total knee arthroplasty (BTKA). Many studies are available which compare bilateral simultaneous vs staged TKA in terms of functional outcome. But still there are no studies which include staggered BTKA (done in a single hospital stay) and compared their functional outcome, associated complication with a 90 days readmission rate.

Methods: A retrospective review of 300 TKAs patients who underwent bilateral TKA. Patients were divided into three groups with 100 patients each in simultaneous, staggered, staged group. We use hospital electronic health records database to compare the complication and readmission rates in all three groups. Functional outcome was evaluated pre-operatively using knee society score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford knee score, Kujala score and range of motion.

Results: The study consists of 234 females and 66 males, among which maximum females were in a simultaneous group while male where more in staggered group. Mean age group in our study was 62.25%. ASA score of 3 was significantly more in staged group. Patient in the staggered group had a better KSS and Kujala score with better range of motion and less readmission and complication rate. Simultaneous BTKA had slightly higher complication rate.

Conclusions: This study demonstrates that there is not big significant in functional outcome when comparing simultaneous, staged and staggered bilateral TKA, but still staggered group shows better postoperative functional outcome.
Proximal phalanx shaft fracture with entrapment in the transverse retinacular ligament: a case report
Authors: Higginbotham Devan O. , Tsai Andrew G.
Published: June 2020

We report the interesting case of a 33 years old male who underwent operative intervention for a left oblique proximal phalanx shaft fracture of the third finger which penetrated the transverse retinacular ligament (TRL). This patient required operative intervention due to entrapment of the bony fragment in the TRL which acted as a noose with traction on the fractured segment. The fracture was irreducible through a closed maneuver. The use of a dorsal approach allowed visualization of the fracture site and implementation of screws for fixation was deemed adequate secondary to the patient’s bone quality. He was placed in a volar splint at the conclusion of the case to allow for immobilization and protection of the repair. At follow-up, the patient’s radiographic images appeared appropriate and was progressing as expected. We report lessons learned from this case and describe a previously unreported fracture pattern and a possible method of reduction and fixation through a surgical approach in this report.
COVID-19: considerations for optimum surgical team protection before, during and after operation
Authors: Punia Gaurav , Kharb Sunaina , Gulia Anil , Bansal Sanjeev , Chandan Shashipal , Kumar Mahesh
Published: June 2020

SARS CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19), has caused a global pandemic. Surgeons’ obligation, as always, will be to provide timely, high-quality surgical care that achieves the best outcomes for patients. It is imperative to ensure the safety of health-care workers not only to safeguard continuous patient care but also to ensure they do not transmit the virus further. Viral particles have been found in nasal swabs, pharyngeal swabs, sputum, bronchial swabs, gastrointestinal tissue, blood, and stool.Surfaces in isolation rooms and even clinician shoe covers have tested positive as well. Some key considerations for protecting surgical teams; structure frequent communication before key events; assume the entire operation theater will be contaminated; choose personal protective equipment (PPE) effective against aerosolized particles; adapt surgical technique to reduce exposure risks; use a “buddy system” for donning and doffing; after operation/recovery; going home – what should be done to keep your family safe. Though careful planning and appropriate PPE are essential, the most effective way to prevent viral exposure is to avoid performing non-essential surgical procedures. Non-operative approaches may be a safe alternative to surgery for some patients. Many patients, however, will require emergency operative intervention.
Clinico-pathological study of cases of histoid leprosy
Authors: M. Kaveri , Wali Vishal V.
Published: June 2020

Background: Rare variants of leprosy pose a diagnostic challenge and histoid leprosy is one such form of disease with unique clinical and histopathological features. The objective of the study was to study clinical and histopathological features of histoid leprosy.

Methods: A prospective observational study was conducted at M. R. Medical College and Basveshwar teaching and general hospital, Kalaburagi from July 2018 to October 2019. Newly diagnosed and histologically proven cases were included.

Results: Histologically confirmed histoid leprosy accounted for 8 cases (7 males and 1 female). Mean age of the patients was 44.5 years. Patients presented with papules, plaques and nodules over an apparently normal skin. Bacterial index ranged from 4+ to 6+ according to Ridley index. Histopathology showed circumscribed lesion with free sub-epidermal grenz zone and spindle shaped cells.

Conclusions: As bacillary load is very high in these patients, they can form a potential reservoir of infection in the community especially in post leprosy elimination era.
Role of autoinoculation in the management of cutaneous warts: a comparison study with 100% tricholoroacetic acid application
Authors: Faleiro Karla N. , Shukla Pankaj
Published: June 2020

Background: Persistent and recurrent warts pose a challenge to physicians despite the availability of multiple treatment options. Autoinoculation exposes HPV antigens to the dermis and vasculature thereby activating a delayed hypersensitivity response, facilitating clearance of both local and distant warts. The aim of this study was to assess the efficacy of autoinoculation and compare it with chemical cautery using 100% trichloroacetic acid.

Methods: A non-blinded interventional study was conducted at Goa Medical College, a tertiary care centre. Non-immunocompromised patients with 5 or more non-genital warts were included. Group 1: a wart was removed by punch biopsy, minced and implanted in the dermis. The procedure was repeated at 4 and 8 weeks. Group 2: weekly trichloroacetic acid (100%) application. Response was assessed at 4, 8 and 12 weeks in terms of percentage reduction in the number of warts. Statistical correlation with respect to age, sex, duration, number and type of warts was assessed using Welch ANOVA.

Results: In group 1, 63 patients and in group 2, 54 patients completed the study. Post autoinoculation, complete clearance was seen in 46.0% and 3.2% had partial clearance. With TCA application, 33.3% patients had complete and 13% had partial clearance. Response differed with the type of warts. Palmoplantar, periungual warts and verruca vulgaris showed better response to autoinoculation. Filiform and plane warts showed better response to TCA.

Conclusions: Autoinoculation is an efficacious treatment modality which can be performed routinely especially for palmoplantar and periungual warts which are particularly challenging to treat with other modalities.
Unilateral nevus comedonicus associated with epidermoid cyst
Authors: Vallabhareddy Umadevi , Rao G. Venkateswara , Bikkireddy Thanuja , Madala Hyndavi
Published: June 2020

Nevus comedonicus (NC) is a type of an epidermal nevus which was first described in 1895 by Kofmann. Clinically, it is characterized by linear lesion comprising numerous dilated follicular openings with keratinous plugs resembling classical comedones, seen mainly on the head and neck area followed by trunk and upper arm. Treatment options of NC include topical therapy, laser, and surgery. NC associated with epidermoid cyst is rare. We report here a case of NC affecting left side of trunk, left lower limb with epidermoid cysts.
Human infestation with pubic lice
Authors: Maheshwary Ankush
Published: June 2020

Pediculosis pubis is caused by Phthirus pubis (diptera: anoplura) commonly known as crab louse, an obligatory ectoparasite, found on human hair and requires human blood to survive. Pubic lice can be found on pubic hair, underarms, thigh and leg hair, beard and rarely on eyebrows and eyelashes. They are rarely found on scalp hair. Spread of lice occurs mostly by sexual contact but spread via non-sexual contact although rare has also been reported. I present the case of a middle-aged woman with pubic lice. No lice/nits were found in underarm hair, eyebrows or eyelashes. A review of literature is enclosed.
Skin manifestation of angioimmunoblastic T-cell lymphoma mimicking Hansen’s disease on histology
Authors: Shukla Anju , Dabadghao Sunil Sharad , Gupta Surbhi , Jain Priyanka
Published: June 2020

Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon form of peripheral T-cell lymphoma now put under the category of nodal T-cell lymphoma with follicular T helper phenotype. 50% cases of AITL have varied cutaneous manifestations including macules, papules, petechiae, purpura, nodules, non-specific rash and urticaria. Herein we present a case of AITL initially presented as maculopapular rash which on histology was mimicking as Hansen’s disease with perineural and perivascular inflammation; however, an infective organism could not be demonstrated. Later on, a delayed diagnosis was made on lymph node biopsy and immunohistochemistry and patient responded well with chemotherapy.
Psoriasis of oral cavity- A review
Authors: Ali Hassan Shaik , Bhateja Sumit
Published: June 2020

Psoriasis is a chronic, genetically seen, scales, and inflammatory disease of the skin. Oral manifestations of psoriasis are rare and are often difficult to diagnose. Elbows, knees, sacral portion, and scalp are usually infected. Nail association is commonly more occurring. oral inclusion is uncommon. A few doctors question whether psoriasis influences the oral mucosa, especially because early reports of oral psoriatic lesions needed histologic affirmation. In this review article, we will show what are various parts of the oral cavity affected by psoriasis.
Cutaneous manifestations in patients with chronic renal failure on hemodialysis
Authors: P Premananth , R Gnanasekaran , R Saravanan , A S Krishnaram , K Shanmugarpriya
Published: June 2020

Chronic renal failure (CRF) associated with many cutaneous manifestations starts from xerosis, dark pigmentation, to life threatening severe uncontrolled itching. Cutaneous problems with CRF having different and newer manifestations after hemodialysis interventions.

To assess the prevalence of cutaneous manifestations including hair and nails in chronic renal failure (CRF) patients on hemodialysis .

One hundred patients of CRF undertaking hemodialysis were examined for various cutaneous presentations.

cutaneous manifestations seen in eighty six patients. The commonest finding was xerosis (81%),had wide range of clinical presentation with pruritus (56%) produced distress symptoms skin color changes presented commonly as pallor (65%), and cutaneous hyperpigmentation (53%) manifesting physical and psycological disturbance s respectively. Othera skin problem found peculiar to chronic renal failure are acquired perforating dermatoses of kyrles diease (20%); prevalence of cutaneous infections especially dermatophytosis and other superficial fungal infections (28%), pyoderma(10%) and viral (13%) infections; other important cutaneous manifestation are purpura (10%); and eczema(2%). The nail changes sharing significant presentations in majority of renal failure patients which included half and half nail (20%),as important clinical marker followed by koilonychia (16%), onychomycosis (16%), onycholysis (11%), Mees’ lines (7) Hair changes also contributing significant clinical finding as sparse body hair (27. Wide array of oral mucosal changes presented mainly as macroglossia (36%), xerostomia (28%), ulcerative stomatitis (27%), and uremic odour(7%).

CRF had a significant cutaneous changes mainly as xerosis, pruritus acquired perforating dermatoses, uraemic odour and hyperpigmentation. These changes served as clinical clue in diagnosis and therapeutic management. These changes were attributed by disease (CRF) as well as hemodialysis. Management aimed as alleviation of sufferings and improve life quality.
Clinical study of cutaneous lesions in neonates at a tertiary care centre
Authors: Ravindra Kumar P , Dyavannanavar Veeresh , Malkud Shashikant
Published: June 2020

Cutaneous problems in neonates have always been a significant part of paediatric dermatology. They range from physiological transient conditions at one end to serious pathological entities at the other.

To study the clinical pattern of various dermatoses in neonates at a tertiary care centre.

This is a hospital based cross-sectional observational study conducted at tertiary care centre. Total 100 neonates (≤ 28 days old) having any kind of cutaneous lesion were included in the study. Detailed history, clinical examination was done in all neonates followed by recording each finding and their statistical analysis.

In the 100 neonates analysed, 53 were females (53%) and 47 (%) were males. 15 patients were born preterm, 78 in term and 7 in post term. Most of the skin lesions were asymptomatic but only 16 were having symptomatic skin lesion. Skin lesions in the study were physiological in 70%, pathological in 20% and mixed in 10%.

Studying neonatal skin lesion is important to all dermatologists so that they are able to differentiate physiological and pathological conditions, thereby avoiding unnecessary therapy for neonates in circumstances not requiring any and also facilitating to allay undue anxiety among parents.
Repositórios Digitais na Educação a Distância: Dialogando com Percepções de Docentes da UAB
Authors: Silva Ivanda Maria Martins , Felix Jaciara Maria
Published: June 2020

No cenário dinâmico da Educação a Distância (EaD), as inovações tecnológicas surgem e assumem papel de destaque para apoiar processos de ensino-aprendizagem, a exemplo dos repositórios digitais (RD). Tendo em vista a importância dos RD na era da cibercultura, esta pesquisa tem como objetivo principal analisar as percepções de docentes da Universidade Aberta do Brasil (UAB) sobre repositórios digitais como recursos educacionais de apoio aos processos de ensino-aprendizagem no contexto da EaD. Em termos metodológicos, a pesquisa revela-se predominantemente qualitativa, embora recorra a dados quantitativos na contextualização dos resultados. O público-alvo é formado por docentes dos cursos de licenciatura ofertados na modalidade a distância pelo programa da Universidade Aberta do Brasil de uma instituição pública federal de ensino superior. Como instrumento de coleta de dados, foi utilizado questionário misto, disponibilizado em meio digital. Por meio das respostas obtidas, foi possível realizar análises e reflexões sobre a importância de haver a necessidade de um trabalho para orientação e uso dos repositórios para que os docentes conheçam a finalidade dos RD e sua relevância no âmbito de uma instituição de ensino superior.
Palavras-chave: Educação a distância. Universidade Aberta do Brasil. Repositórios digitais. Inovações tecnológicas.
RARE BIRDS IN ECUADOR: THIRD REPORT OF THE COMMITTEE FOR ECUADORIAN RECORDS IN ORNITHOLOGY (CERO)
Authors: Freile Juan F. , Solano-Ugalde Alejandro , Brinkhuizen Dušan Milan , Greenfield Paul J. , Lysinger Mitch , Nilsson Jonas , Navarrete Lelis , Ridgely Robert Sterling
Published: June 2020

Presentamos nuevos registros de distribución de aves del Ecuador que han sido presentados al Comité Ecuatoriano de Registros Ornitológicos (CERO) entre abril 2014 y agosto 2015. Incluimos reportes de seis especies nuevas para Ecuador (Anas crecca, Thalassarche bulleri, Puffinus puffinus, Morus sp., Numenius americanus y Elaenia strepera), una especie nueva para el Ecuador continental (Fregetta grallaria), cuatro especies con primera documentación en Ecuador (Calidris alpina, Larus argentatus, Stercorarius longicaudus, Tyrannus dominicensis), extensiones considerables de distribución de 14 especies (Podilymbus podiceps, Pterodroma phaeopygia, Charadrius semipalmatus, C. collaris, Bartramia longicauda, Calidris alba, Limnodromus scolopaceus, Phalaropus fulicarius, Stercorarius longicaudus, Sternula superciliaris, Chlidonias niger, Galbula dea, Elaenia spectabilis y Geothlypis philadelphia) y nuevos reportes de 12 especies raras (Aythya affinis, Sula leucogaster, Busarellus nigricollis, Stercorarius chilensis, Chordeiles minor, Psittacara wagleri, Philydor fuscipenne, Muscisaxicola fluviatilis, Pyroderus scutatus, Passerina caerulea, Vermivora chrysoptera y Setophaga castanea) y el primer reporte moderno de Oreopholus ruficollis. Además, presentamos el primer registro en Ecuador de Lurocalis semitorquatus semitorquatus y el segundo registro de la subespecie Petrochelidon pyrrhonota melanogaster. Finalmente, invalidamos los registros previos de Picumnus castelnau, especie que no habita en Ecuador. CERO revisa y actualiza el listado nacional de aves, que en la actualidad alcanza las 1678 especies (1626 confirmadas y documentadas, y 52 no documentadas).
THE NEST AND EGGS OF BLACK-CAPPED SPARROW ARREMON A. ABEILLEI (PASSERELLIDAE) IN SOUTHWESTERN ECUADOR
Authors: Greeney Harold Francis
Published: June 2020

I describe the nest and egg of Black-capped Sparrow (Arremon a. abeillei), providing the first substantiated information on its reproductive biology and the first report of brood parasitism by Shiny Cowbird (Molothrus bonariensis). I studied 7 nests at two locations in southwestern Ecuador. Nests are enclosed, oven-shaped structures with a side entrance, concealed amongst leaf litter on either flat sloping ground. Confirmed clutch size at one nest was 4 eggs, and 13 eggs varied from very pale buff to pure white, sparsely marked with dark brown or black flecks, small spots, and short scrawls. Nest architecture is similar to that of congeners traditionally placed within Arremon and Lysurus, and to members of the genus Arremonops, but differs from the open-cup nests of congeners historically placed in the genera Buarremon or Atlapetes. Egg coloration reflects similar relationships within these genera.
PRIMER REGISTRO DE NIDO Y ASPECTOS SOBRE LA BIOLOGIA REPRODUCTIVA DEL ZAMARRITO PECHINEGRO (Eriocnemis nigrivestis) (APODIFORMES: TROCHILIDAE)
Authors: Juiña Mery Elizabeth , Hickman III Bertram Raymond
Published: June 2020

El Zamarrito Pechinegro Eriocnemis nigrivestis es una especie endémica del Ecuador, calificada como En Peligro Crítico de extinción. Se distribuye entre 2850 y 3500 m de altitud en el bosque siempreverde montano alto de las provincias de Pichincha e Imbabura. Se han realizado varios estudios sobre la especie, en particular de su dieta, pero todavía no se conoce su biología reproductiva. El presente trabajo se realizó en la reserva Verdecocha, en las estribaciones noroccidentales del volcán Pichincha, entre 2008–2016. Encontramos que el periodo reproductivo de E. nigrivestis se desarrolló entre noviembre y abril, periodo en el cual los machos establecieron territorios y realizaron maniobras de cortejo, y las hembras construyeron sus nidos y cuidaron de la prole. Además, encontramos un marcado dimorfismo sexual en juveniles de una misma nidada, un patrón poco conocido para el género Eriocnemis. Conocer sobre la biología reproductiva de E. nigrivestis nos permite inferir sobre los requerimientos de hábitat de la especie e inferir los factores bióticos y abióticos que moldean su ciclo reproductivo. Esta información es útil para entender sus relaciones ecológicas y evolutivas, y para diseñar políticas de manejo eficientes que faciliten la conservación de su hábitat.Palabras clave:dimorfismo sexual, Eriocnemis nigrivestis, nido, Pichincha, reproducción. First nesting record and notes on the breeding biology of Black-breasted Puffleg Eriocnemis nigrivestis (Apodiformes: Trochilidae) AbstractBlack-breasted Puffleg Eriocnemis nigrivestis is endemic to Ecuador and currently classified as Critically Endangered. It ranges between 2850–3500 m elevation, in the montane forests in the provinces of Pichincha and Imbabura. The is an important amount of research about the species feeding ecology, but its breeding biology remains unknown. This study was carried out in Verdecocha Reserve, in the northwestern slopes of Pichincha volcano, in 2008–2016. We found that the breeding season of E. nigrivestis was between November and April, when males established territories and performed courtship displays, and females build nest and raised offspring. We observed sexual dimorphism in juveniles of the same clutch, a pattern little known for the genus Eriocnemis. Information about the breeding biology of E. nigrivestis allows us to understand its habitat requirements and to infer biotic and abiotic factors the can shape its breeding cycle. This information is useful to understand its ecological and evolutionary relationships, as well as to design efficient management policies for the conservation of its habitat. Keywords:breeding behavior, Eriocnemis nigrivestis, nest,Pichincha, sexual dimorphism.
NOTAS SOBRE LA DIETA, DESARROLLO DE JÓVENES Y DISTRIBUCIÓN DEL BÚHO ESTIGIO ASIO STYGIUS (STRIGOFORMES: STRIGIDAE) EN ECUADOR
Authors: Cadena-Ortiz Héctor , Bedoya Jorge , Pozo-Zamora Glenda M. , Watson Julie , Brito M. Jorge
Published: June 2020

Presentamos el primer aporte al conocimiento sobre la dieta del Búho Estigio Asio stygius en Ecuador. El estudio se realizó a partir de 38 egagrópilas y 127 g de material disgregado colectado en dos localidades urbanas y una rural de la provincia de Pichincha entre 2015 y 2016. Encontramos 157 ítems-presas agrupadas en 8 taxones. Las aves fueron predominantes en la dieta de este búho, numéricamente y en biomasa, por lo que consideramos a A. stygius como un depredador especialista en aves. Adicionalmente, en esta publicación presentamos información sobre el desarrollo de dos jóvenes de este búho, y compilamos los registros de distribución existentes de A. stygius en Ecuador, los cuales están principalmente concentrados en la provincia de Pichincha. AbstractWe present the first contribution to the knowledge about the diet of the Stygian Owl Asio stygius in Ecuador. We studied 38 pellets and 127 g of disaggregated material collected in two urban and one rural localities in the province of Pichincha between 2015 and 2016. We found 157 prey-items grouped in 8 taxa. Birds were prevalent, numerically and in terms of biomass, thus we consider A. stygius as a bird specialist predator. Additionally, herein, we present information on the development of two juvenile Stygian owls, and compile distribution records of A. stygius in Ecuador, which are main concentrated in the province of Pichincha.
FIRST RECORD OF THE MOUSTACHED PUFFBIRD Malacoptila mystacalis (BUCCONIDAE) IN ECUADOR
Authors: Loaiza José María , Crespo Juan Carlos , Boas Alex , Molina Pablo
Published: June 2020

We present the first Ecuadorian record of Moustached Puffbird Malacoptila mystacalisbased on observations, supported by photographs, videos and audio recordings, of four individuals at El Chical, northwest Carchi province. This record represents a southwards range extension in northern South America. We describe the habitats where two pairs where found in the Dracula Reserve, discuss distinctive field marks and analyze vocalizations, characteristics to separate from White-whiskered Puffbird M. panamensis,withwhich it might overlap in the lowlands and foothills. This record is not entirely unexpected given the collection of specimens in Ricaurte and Guayacana, Nariño Department, Colombia, only 39.5 km north of El Chical.
OBSERVATIONS ON THE PARENTAL CARE OF THE YELLOW-BELLIED ELAENIA Elaenia flavogaster subpagana
Authors: Voth Francine , Port Jeffrey , Greeney Harold
Published: June 2020

We observed three nests of Yellow-bellied Elaenia Elaenia flavogaster subpagana in La Selva, Costa Rica. One nest had a single nestling, which was observed for 21 h in order to document incubation, breeding and feeding behaviors. We quantified number of visits per h to the nestling, as well as food transfer events and fecal sac removal, and confirmed that two parents fed the nestling. Adults visited the nest 4.9 ± 0.6/h/nestling on average. We observed 18 feeding events between adults, and five food transfer episodes of the incoming adult to the incubating adult, and then to the nestling. Food items brought to the nest included Diptera, Coleoptera, Phasmatodea, Hymenoptera, Araneae and berries.
Scleral Dellen: Early Complication Of Pterygium Surgery And Literature Review
Authors: Boui Hatim , Mouzari Yassine , Boui Meriem , Al Asri Fouad , Reda Karim , Oubaaz Abdelbarre
Published: June 2020

Introduction :

Severe Scleral Dellen is a rare and early postoperative complication of pterygium surgery.

The various cases reported in the literature are mostly related to this surgical technique; simple excision of the conjunctiva, notably either without adjuvant treatment or using mitomycyine C in preoperative or otherwise beta radiation.

The particularity of our case is that the scleral Dellen is associated with excision and simple suture of the conjunctiva without adjuvant treatment or cauterization of the vessels. The other particularity of this case is that it is to our knowledge the first case of scleral dellen reported in Morocco, and even at the African level.

Case report

This case is a 38-year-old military patient with no medical history

The patient was scheduled for pterygium surgery.

16 days later, the patient came back after noticing the appearance of a blackish brown spot at the nasal side of the right eye associated with mild eye pain.

The slit lamp examination of the involved eye revealed a severe scleral thining, surrounded by an oedematous conjunctiva and the visualization of the ciliary body through the fine sclera. The conjunctival sutures were no longer in place.

After three days and with treatement, we observed a scleral cicatrization, followed by a gradual covering of the sclera by conjunctiva.

Discussion :

In our case as in that described by Garcia-Medina and collaborators, we performed a conjunctival suture with two stitches to cover the sclera. Otherwise, both of the stitches were not found later, which suggests that, like in the Garcia-Medina report; a bad handling by the patient  (eye rubbing), loose stitches or even both.

Thus, the sclera would have been exposed in the two cases.

Regarding the treatment of this complication, the graft of a conjunctival flap was performed in two cases with favorable evolution.

In all other cases, only medical treatment has been successfully initiated.

In our case we opted for medical treatment only, including local antibiotic therapy, intensive lubrication with artificial tears (hourly drop) and the occlusion of the eye. The evolution was also favorable under this treatment.

Hence, our case is similar to the Garcias-Medina and collaborators one, concerning the surgical technique, and also the scleral Dellen treatment. Although the difference and the particularity of our case was the absence of cauterization use during the surgical act.

Conclusion:

Scleral Dellen is rare complication of pterygium surgery, which occurs early after the surgical act.

Its exact physiopathology remains unknown, but some factors may be incriminated; first of them is the surgical technique as a simple excision with exposed sclera.

This complication can occur in patients, without any particular medical or ophthalmological history or any underlying pathology. It could also occur for primary pterygium. Medical treatment alone may be appropriate to manage this complication.
SURGICAL TREATMENT OF THE CONGENITAL HYPERINSULINISM: A PRELIMINARY ANALYSIS
Authors: Sukhotskaya A. A. , Bairov V. G. , Nikitina I. L. , Ryzhkova D. V. , Mitrofanova L. B. , Amidkhonova S. A.
Published: June 2020

Introduction. Advances in molecular genetics, imaging techniques (PET/CT), medicamentous therapy and surgical treatment in the recent decades have improved hypoglycemia control and , thus, improved treatment outcomes in children with congenital hyperinsulinism. Purpose. To define indications for different techniques of surgical correction in patients with congenital hyperinsulinism depending on the disease form. Material and methods. 23 children were operated on for congenital hyperinsulinism in the department of pediatric surgery in the Almazov Medical Research Center from 2011 till 2018. In 2011-2016, 5 children were operated on by the standard approach which included subtotal pancreas resection (95%). Since 2017, PET tomography with 18-F-DOPA and intraoperative rapid biopsy of the pancreas have been introduced into the curative algorithm. In 2017-2018, 18 children were operated: 6 patients with the diffuse form and 10 - with the focal one. Two more children had controversial outcomes. Results. Fifteen children (83%) had complete hyperinsulinism control and significant improvement in their psycho-motor function. Out of 18 children, 10 (56%) had a complete recovery: among them - 8 (89%) out of 9 children with the focal form of hyperinsulinism and 2 (22%) out of 9 children with the diffuse form. Two children (11%) had a marked positive dynamics. Six patients (33%) needed insulin therapy with minimal dosages - all were children with the diffuse form of hyperinsulinism (6 (67% ) out of 9). Conclusion. Partial pancreatectomy in patients with focal forms or subtotal pancreatectomy in patients with diffuse and atypical forms allow to eliminate hypoglycemia caused by the congenital hyperinsulinism and to prevent damage to the central nervous system in newborns and infants.