bluuebunny/crossref_metadata_2025 huggingface dataset:
Etiological Assessment of Splenomegaly by Clinical and Laboratory Methods in Paediatric Age Group (3 Months To 18 Years)
Authors: Srinivas Gandhari  , G. Seshagiri  , Bussa Sandeep  , T. Blessy Tanya
Published: April 2024

Introduction: Splenomegaly is the enlargement of spleen. Splenomegaly is a sign seen in various disease processes in infants and children. So, an attempt was made in the present study to know the various etiological factors and clinical features and clinical outcome of splenomegaly in the cases admitted in Prathima institute of medical sciences, Nagunoor, KarimnagarAim and objectives: 1. To establish the possible etiology of Splenomegaly in children by clinical and laboratory methods.Material and methods: 100 children from 3 months to 18years, with varying grades of Splenomegaly of different etiologies, admitted to paediatric wards of Prathima Institute of Medical Sciences, Karimnagar were studied in this observational study between Decembers 2015 to November 2017. Detailed study of each case including history, thorough physical examination and necessary investigations were done to reach the diagnosis.Results: Male preponderance was seen in present study. Maximum incidence of Splenomegaly was seen between 3 months to 6 years age group (62%). Majority of the cases had moderate Splenomegaly (62%). Fever was the most common presenting feature associated with Splenomegaly. Hepatomegaly was the most common association with Splenomegaly. Infections (42%) were the most common cause of Splenomegaly, followed by hematologic (25%) causes.Conclusions: Infections was the most common cause of Splenomegaly in present study. Male preponderance was seen; majority of cases had moderate Splenomegaly and belonged to preschool age group.
Health Profile of Working Fishermen in Coastal City: A Cross-Sectional Study
Authors: Hemagiri. K  , Karthik R Chandra  , Abhishek Prayag  , Akshay G L  , Nithin Ganesh
Published: April 2024

Introduction: Fishing community is one of the unique, traditional and endemic community. Fishing is one themajor occupation of Uttara Kannada district. Fishermen are a vulnerable group with some unfavourable life styles and vulnerable for injuries, skin and respiratory allergic manifestations and certain other diseases. Local surveys need to be conducted to understand the extent of morbidity patterns among fishermen and thereby devising a policy approach to suit the local needsMethodology: This study was done as a population based cross – sectional study among the fishing community in Karwar which is located at coastal boundary of Uttarkannada district, Karnataka. The study was conducted for a period of 6 months from June to December 2019. All the families of Fishermen community coming under field practice area of Chittakula UHC of the Govt medical college of the district were constituted as a part of our study. A total of 472 families resided in the area constituting of 1419 population of which 724 working members in the occupation of fishing.Result: Among them Percentage of male working members 33.1% (470) and 17.9% (254) were female working members. It was seen that 79.1% of males and 23.3% of females were literates. 32.1% were below the age of 20 years, 37.6% were between 21-40 years ang 30.3% constituted above 40 years. It was found that 64.08% (464) of the working people in fishing sector had one or the other morbidity.Conclusion: There is a high presence of musculoskeletal disorders, respiratory diseases, skin problems, noncommunicable and communicable diseases in the fishermen community.
General Nutrition Knowledge, and Dietary Intake among Sportsmen and Coaches: A Review Study
Authors: Dinesh Dagar  , Mohd Hafizur Rehman Ansari  , Payal Mahajan
Published: April 2024

Nutrition knowledge is an important factor that influences the nutritional status and health of the individual, group or community. Research studies have been trying to develop a reliable tool which can measure nutrition-related knowledge, nutrition-related awareness and its effect on dietary behaviour. Sports nutritionists usually base their dietary interventions on a nutrition education program with dietary guidelines. There are no. of cross-sectional studies for both coaches and athletes, reporting on nutrition knowledge. Achieving optimal physical condition and maximising athletic performance both depend heavily on nutrition. Our diet provides our bodies with the energy and nutrients they need to sustain physical activity, improve muscular function, and aid in recuperation. Any physical fitness program is incomplete without nutrition as it is an integral part of physical fitness. For any sportsman, the dietary goal is to obtain adequate nutrition to improve their health and fitness or performance in sports. A carefully organized nutrition program greatly improves athletic performance. Nutritional status is a crucial factor in determining the physical fitness and training of a sports individual. For sportsmen energy requirement or nutrient requirements are high due to their game. As it is known, appropriate nutrition improves the physical performance of the sportsmen. On the other hand, inadequate intake of nutrients leads to nutrient deficiencies therefore leading to poor performance and health problems. Many studies have provided strong evidence that optimal nutrition supports physical activity, recovery and athlete performance. However Apart from less nutritional knowledge, there are several factors such as restrictive dietary intake or excessive exercise which influence healthy eating. In addition, lack of knowledge, zeal to follow a nutritious diet, lack of money and lack of time, can be a potential reason not to follow a healthy diet. Athletes generally rely on their coaches for nutrition-related guidance. So, when coaches have less knowledge about nutrition it can be a potential problem for athletes to follow a healthy diet. In some Cross-sectional studies, it is found that Coaches Play a key role in providing nutritional-related information. However, they were not aware of the importance of nutrition on performance therefore not giving the necessary importance to their diets. Coaches have inadequate knowledge about sports nutrition and their role is critical as they are prime contact for the athletes to know about their diet to enhance their performance
Heterotopic Ossification at Uncommon Sites: A Case Series of 4 Rare Cases
Authors: Rajashree Pradhan  , Sajeeb Mondal  , Bidisha Chakraborty  , Madhumita Paul
Published: April 2024

Heterotopic ossification (HO) is a condition of formation of mature lamellar bone in the extra skeletal soft tissue where bone does not usually exist. It is most commonly seen in muscle tissue and central nervous system following trauma. In this case series, we have reported 4 rare cases of heterotopic bone formations at uncommon sites. One case of HO in clear cell renal cell carcinoma, one case of HO in tendoachilles, one case of HO in intramuscular vascular malformation and one case HO in abdominal incision scar. HO is a rare entity. In most of the cases exact etiology is unknown. Further studies needed for more conclusive information regarding the clinical significance of heterotopic ossification.
A Study on Impact of Smoking on Semen Parameters
Authors: Veena Lakshmi.P  , Sumana.R  , P. Praveena
Published: April 2024

Introduction: Infertility approximately affects 15% of couple in India, among which male factor infertility isassociated as contributing factor causing infertility in 40- 50% of cases and sole cause in 15 -20% of cases. Semen analysis is a standard investigating tool in evaluating male infertility. Lifestyle factors namely diet, obesity, smoking, alcohol, stress, play a major role in health. Among these factors smoking is inevitable, causing detrimental effects on semen parameters and associated with lower fertility rates.Methodology: A cross sectional study was conducted among 295 male partners of women with infertility,attending the fertility Clinic, in reproductive medicine department over 10 months. Two hundred andninety five men satisfying the inclusion and exclusion criteria were selected by simple random sampling technique. The semen parameters of the participants were analysed, entire socio-demographic profile and detailed history was obtained using structured questionnaire and confidentiality was maintained. The results were ascertained using SPSS.Results: Among 295 participants, total 99 (33.55%) men had abnormal semen parameters. Nearly half of thestudy subjects (i.e.) 148 (50%) among 295 subjects were found to be smokers. Among 99 male with abnormalsemen parameters, 60 (61%) men who had abnormal semen parameters were smokers. This study proves a strong association between smoking on male fertility (1.9 times greater risk among smokers). Significant association (x 2 = 6.492, p = 0.0108) was found between smoking, reduced semen parameters and quality.Conclusion: Lifestyle modifications such as cessation of smoking, premarital and pre-conception health checkups, counselling, voluntary fertility testing by male partners, early detection and appropriate intervention the saves the reproductive potential. Men must be health educated for developing knowledge on ill effects of smoking, positive attitude, behavioural change and accept his responsibility for strengthening and caring his female partner amidst the societal pressures. Thus the present study substantiates more evidence to the existing literature.
Association of Cytological and Biochemical Oarameters with Pleural Effusion in Patients attending a Tertiary Care Hospital of Western U.P.
Authors: Siddharth Kumar  , Vibha Nimesh  , Lalit Garg  , Vishwanath Ghoshal  , Shubham Kumar Sharma
Published: April 2024

Background: Pleural effusion is the pathological accumulation of fluid in the pleural space. This study was done to assess the association of cytological, biochemical, radiological and microbiological parameters in the evaluation of pleural effusion.Materials and Methods: Present study was done in Saraswathi Institute of Medical Sciences- OPD/IPD ofRespiratory Medicine department. As per the inclusion /exclusion criteria the study included 70 participants.Ethical clearance was taken before the commencement of study. Data was analyzed using SPSS software version 26.Majority of participants in present study were males. Majority belongs to age group 19-29 years with mean age was found to be 34.93 ± 12.99 years. Majority of patients had exudative type of pleural effusion. Lymphocyteswas found to be higher as compare to neutrophils and other cells in Tubercular cases than Non-TB cases. Similar findings were found in other studies too.Conclusion: The present study suggest that a high fluid ADA is a vital diagnostic tool and suggest its usage as a quick diagnostic method to diagnose Tuberculous Pleural Effusion
Study on Anxiety and Loneliness among General Population in a City of South India
Authors: Swetha R  , Rajesh S S  , Usha Rani S  , Sadvi A S
Published: April 2024

Background: The outbreak of corona virus disease 2019 prompted people to face a distressing and unexpected situation. In particular, restrictions due to the quarantine increased feelings of loneliness and anxiety. The risk of contamination and the experience of social distancing changed people’s behaviors and deeply impacted individual feelings, daily habits, and relationships.Objectives: The objectives of the study are to know the prevalence of anxiety and loneliness among generalpopulation and to study factors associating anxiety and loneliness in Tumkur city.Materials & Methods: This Cross sectional study was conducted in Tumkur, Karnataka state. Study subjects were general population of age 18 yrs to 65 yrs. Study duration was from June 2020 to January 2021. 374 subjects were selected by purposive sampling.Results: In our study, 374 subjects were examined ranging from age 18-65 years situated in, Tumkur. Out of 374 subjects 176 (47.1%) subjects had minimal anxiety followed by mild anxiety in 97 (25.9%) subjects and moderate anxiety in 64 (17.1%) subjects. 9.9% of the subjects had severe anxiety.Conclusion: Mild to moderate anxiety and loneliness was seen among general population. Thus by propercommunication by using the social network, video calling people can stay connected and thereby reducing the anxiety and loneliness during these tough times.
Challenges of Bioterrorism: An Indian Perspective
Authors: Ruchi Verma  , Vinay Bhardwaj  , Shailee Fotedar  , Arun Singh Thakur  , Akshay Thakur  , Gauri Atwal
Published: April 2024

Bioterrorism is the deliberate release of viruses, bacteria, toxins, or other harmful agents to cause illness or death in people, animals, or plants. A biological weapon is useful to terrorists mainly as a method of creating mass panic and disruption to a state or a country. Bioterrorism agents are classified as categories A, B, and C. Bioterrorism imposes particularly heavy demands on the nation’s public health and health care system because ultimately it will be the public health system that will be called on to mitigate and ameliorate the consequences of a bioterrorism attack. India is the second-most populous country in the world and has a diverse demography consisting of various religions, cultures, and languages. The unique nature of India’s population makes it vulnerable to bioterrorism attacks that can result in catastrophic consequences. This review article aims to focus on the challenges of bioterrorism from Indian perspective and to outline the methods on preparedness and prevention of bioterror attacks.
Comparison of Thoracic Analgesia with Epidural Fentanyl and Transdermal Fentanyl Patch: A Comparitive Prospective Randomized Study
Authors: Ayushi Vashisht  , Kumar Parag  , Robina Makker  , Nishith Govil  , Arvind Makker
Published: April 2024

Background: Thoracic epidural analgesia (TEA) is used for analgesia following lower abdomen or orthopaedic surgeries. The aim of study was To compare the effects of 0.125% Bupivacaine with 2mcg/ml of Fentanyl infusion (group A) and 0.125% Bupivacaine with fentanyl patch (group B). Methods: Patients undergoing elective surgery were randomized in a non-blinded fashion to receive postoperative analgesia at a single teaching hospital. A nested qualitative study (reported elsewhere) explored the dual primary outcome of patient experience and acceptability. Secondary outcome measures included rest and movement pain scores over 72 h, functional analgesia, analgesia satisfaction, opiate consumption, functional recovery, morbidity, safety, and cost-effectiveness. Results: A total of 40 patients were randomized. The median (interquartile range; i.q.r.) dynamic pain score at 24 h was significantly lower after TEA than RSCA (33 (11–60) versus 50.5 (24.50–77.25); P = 0.018). Resting pain score at 72 h was significantly lower (4.5 (0.25–13.75) versus 12.5 (2–13); P = 0.019). Opiate consumption on postoperative day 3 (median (i.q.r.) morphine equivalent 17 (10–30) mg versus 40 (13.25–88.50) mg; P = 0.038), hypotension, or vasopressor dependency (29.7 versus 49.2 per cent; P = 0.023) and weight gain to day 3 (median (i.q.r.) 0 (−1–2) kg versus 1 (0–3) kg; P = 0.046) were all significantly greater after TEA. Conclusions: TEA provided superior initial postoperative analgesia but only for the first 24 h. By 72 hours and provides superior analgesia, is associated with a lower incidence of unwanted effects, and may be more costeffective.
Spectrum of the Oral Lesions in a Rural-based Tertiary Care Teaching Hospital in Central India
Authors: Mamta Gupta  , Abhiraj Ramchandani  , Monika Singh Parihar  , Mahendra Singh Hora
Published: April 2024

Background: The oral cavity is a common site for pathological lesion with a wide spectrum of neoplastic and nonneoplastic lesions. They are either symptomatic or asymptomatic. Some lesions may prove to be premalignant and may be a cause of malignancy in future. Histopathological reporting is very important and essential part because the core finding we provide in reporting significantly influences the treatment part.Material and Methods: This study was carried out in the Department of Pathology, Amaltas Institute of Medical Sciences, Dewas (Madhya Pradesh) from May 2021 to March 2023. The study included all the patients admitted in ENT, Surgery and Oncology wards of hospital presenting with oral pathology and given written informed consent. A total 80 cases were taken in to account and were studied, in relation with age, sex, site predilection.All biopsy specimens and resected tissues/organs were received in 10% formalin solution and were processed as per standard protocol and slides of standard thickness were prepared for histopathological examination. After thorough microscopic study, the diagnosis was made and categorized into major groups (non-neoplastic, benign, borderline and malignant) and subgroups according to type of lesion on histopathological examination.Results: The site of involvement of various lesions shows maximum involvement of buccal mucosa 43(53.75%),followed by tongue 19(23.75%), tonsil 7(8.75%), alveolus 4(5%) , floor of mouth 3(3.75%) and least involvement of lip and palate with 2(2.5%) cases in each. Of the inflammatory lesions tonsils were the commonest site of involvement.Conclusion: We conclude our study with the findings that lesions of buccal mucosa is commonest site andsquamous cell carcinoma was the commonest entity with diversity in lesions and a wide age group of presentation. This emphasizes the role of histopathological study and diagnosis in oral lesions and provides us with valuable information of the lesion being neoplastic or non-neoplastic and timely intervention could be planned.
Chest X Ray and C-reactive Protein as Diagnostic Modalities for Monitoring Complications of Mild to Moderate COVID-19 Infections: Experience from a Dedicated COVID Hospital, Kolkata
Authors: Soumyasarathi Mondal  , Arup Chakraborty  , Ria Mukherjee  , Adwitiya Das
Published: April 2024

Introduction: SARS-COV-2 has created havoc during 2019-2021. Diagnosis and managing complications needed both laboratory investigations and imaging modalities.Aims and objectives: To find out the association between socio-demographic and clinical profiles of the studysubjects with their different laboratory investigations and imaging modalities and to compare normal investigations with their gold-standard variants.Materials and Methods: During the first wave of COVID-19, a descriptive, observational, and cross-sectionalstudy was carried out on 120 consecutive samples of mild to moderate COVID patients using a conveniencesampling technique in a COVID indoor ward of Medical College, Kolkata. The semi-structured data collectionform used in the study was predesigned, pretested, face and content validated. SPSS version 25 and Microsoft Excel version 19 was used for data analysis after coding. Ethical approval was taken. (Ref No. MC/KOL/IEC/ Non-Spon/842/11/2020).Results: Old age, uncontrolled diabetes and hypertension, presence of symptoms especially shortness of breath is significantly associated with low levels of SpO2, elevated C reactive protein (CRP) and D-dimer, abnormal Chest X-ray (CXR) and CT Thorax. A Kappa analysis suggested CRP and CXR can also be done instead of D-dimer and CT Thorax respectively, in a COVID patient for monitoring complications.Conclusion: CRP and CXR are cost-effective alternatives and can be used as diagnostic modalities for monitoring of complications of mild to moderate COVID-19 infections.
Use of ABGA Parameters as predictive tool for Evaluation Of Outcomes Of Perinatal Asphyxia in Term And Preterm Newborns from central India: A Prospective Observational Study
Authors: Anil Mori  , Monica Lazarus  , Lalit Malviya  , Vidya Kumari Saurabh
Published: April 2024

Background: Perinatal asphyxia (PNA) is one of the three major cause of morbidity and mortality in India. ABG analysis may help to predict outcome of babies with Perinatal asphyxia. Aim of study was to identify Arterial blood gas analysis parameter as a predictor of outcome of newborns with perinatal asphyxia.Methods: We included 144 newborns, with perinatal asphyxia who were born in our tertiary health care centre during March 2021 to September 2022. Extremely low birth weight babies and any baby with major congenital malformation were excluded from study. Babies were resuscitated in delivery room, then shifted immediately to NICU, stabilised and sample for arterial blood gas analysis (ABGA) was taken within first hour of life, then the babies were intervened accordingly. The outcomes were analyzed, correlated with the initial ABGA and compared among the study group.Conclusion: We found that pH and HCO3 are better markers in predicting the outcome of perinatal asphyxiain newborns. HCO3 had the highest specificity (99.18%) followed by pH (97.54%). Discharge was higher withHCO3(mmol/L) >10 while death was significantly higher in HCO3(mmol/L)<10.This study gives an advantageover other studies conducted on cord blood sampling at birth as resuscitation of the baby is of more priority than sampling for the outcome while the amount of time taken for result and interpretation is the same. Along with the APGAR score, Arterial blood gas analysis within one hour can be used as a better predictive tool for outcome in newborns with perinatal asphyxia.
ОСОБЕННОСТИ ЗАЩИТЫ ЭЛЕКТРИЧЕСКОЙ МАШИНЫ ОТ ПЕРЕГРЕВА
Authors: Алимамедова С.Д.
Published: April 2024

В статье анализируется особенности защиты электрической машины от перегрева. Даются несколько основных методов защиты от нагрева, обеспечивающие эффективную защиту от нагрева электрической машины, обеспечивая ее безопасную и надежную работу
ВЛАГОЗАЩИТНЫЕ СВОЙСТВА ПОКРОВНЫХ НАГРЕВОСТОЙКИХ ЭЛЕКТРОИЗОЛЯЦИОННЫХ ЭМАЛЕЙ
Authors: Исмаилова Ш.И.
Published: April 2024

Безаварийная работа и срок службы изоляции электрических машин и устройств во многом зависят от эффективности защиты изоляции от влаги. Электроизоляционные обработки, наносимые на поверхность готовой системы изоляции, широко применяются в производстве электрооборудования и имеют большое значение в обеспечении влагостойкости электрических машин и устройств. Эти вопросы рассмотрены в статье.
MACROECONOMIC FACTORS OF ECONOMIC GROWTH IN LOW DEVELOPING COUNTRIES FOR EXAMPLE ZAMBIA
Authors: Муленга Р. , Сарлос Т. , Федюнин А.С.
Published: April 2024

Currently, the issue of the influence of economic growth factors in low-development countries on the policy of improving economic well-being is widely discussed. The study showed that to the extent that government spending and rents on natural resources have a beneficial effect on GDP growth per capita, private direct investment affects economic growth significantly more than public investment. On the contrary, the increase in labor resources and inflation are holding back economic growth in these countries. This article examines the dynamics of Zambia's economic development, which has historically faced various problems, including dependence on copper exports, severe economic fluctuations and a low level of human capital quality. The authors emphasize the importance of diversification beyond the copper industry, as well as initiatives that promote agriculture, tourism, cultural development and renewable energy sources become potential paths for sustainable growth. The article also reviews the role of technology and innovation in moving Zambia towards a knowledge-based economy, contributing to increased competitiveness on the global stage. The Government should focus on improving infrastructure, especially in the fields of education and health, which play a key role in building up the country's human capital and export potential.
ТВОРЧЕСКИЙ И КОМПЛЕКСНЫЙ ПОДХОД ПЕДАГОГА-МУЗЫКАНТА К ПОДГОТОВКЕ И ПРОВЕДЕНИЮ УРОКА
Authors: Соколова С.А.
Published: April 2024

В данной статье рассматривается аспект взаимодействия учителя и ученика на уроках в современной музыкальной школе, а также присутствуют размышления, связанные с накопленным педагогическим опытом. Акцентируется необходимость разностороннего и индивидуального подхода не только к воспитанию творческих навыков у маленьких музыкантов, но и к формированию новых путей решения музыкантских и психологических задач самого педагога при работе с учеником, а также поиском путей саморазвития для улучшения своих профессиональных навыков.
НЕФАРМАКОЛОГИЧЕСКАЯ ТЕРАПИЯ КОГНИТИВНЫХ РАССТРОЙСТВ У ЛЮДЕЙ СТАРШИХ ВОЗРАСТНЫХ ГРУПП
Authors: Соловьев Д.А. , Колмакова К.А. , Кулиева Э.К.
Published: April 2024

В настоящей работе на основе анализа доступной литературы и результатов различных исследований проведен обзор современных методов нефармакологической терапии когнитивных расстройств у людей старших возрастных групп и выявлены наиболее значимые и эффективные из них на сегодняшний день.
СИНДРОМ ГОЛЬДЕНХАРА У НОВОРОЖДЕННЫХ В КЛИНИЧЕСКОЙ ПРАКТИКЕ
Authors: Поликарпова И.И. , Силуанова Н.Ю. , Карпова С.Ю. , Куликова Ю.В. , Поликарпов В.В.
Published: April 2024

Деформации лица, связанные с нарушением развития первой и второй пар жаберных дуг, характеризующиеся недоразвитием одной половины лица, объединяются общим термином «гемифациальная микросомия» (HFM). Нередко синдром Гольденхара сопровождается патологией других органов и систем: позвоночника, ребер, сердечно-сосудистой системы. В научной статье рассматриваются причины, клинические проявления, основные методы диагностики и принципы лечения синдрома Гольденхара у новорожденных. Представлен клинический случай данного синдрома у мальчика возраста 3-х дней. Интерес к данной проблеме вызван малой частотой встречаемости этого синдрома и, как следствие, затруднением при его диагностике в рутинной клинической практике, в то время как сами по себе аномалии развития черепа являются достаточно часто встречаемыми патологиями. Особое внимание уделено проблеме современной диагностики окуло-аурикуло-вертебральной дисплазии у новорожденных. Компьютерная томография височных костей и лицевого скелета, на наш взгляд, является одним из наиболее информативных методовдиагностики данной патологии.
Влияние внедрения автоматизированного тестирования в проект
Authors: Никифоров М.Б. , Макаровская Е.О.
Published: April 2024

Исследование направлено на ускорение тестирования, уменьшения затрат и увеличения качества разработки ПО при внедрении автоматизированного тестирования в организацию.
РАЗВИТИЕ ИНТЕЛЛЕКТУАЛЬНОЙ ОДАРЕННОСТИ ШКОЛЬНИКОВ В ПРОЕКТНО-ИССЛЕДОВАТЕЛЬСКОЙ ДЕЯТЕЛЬНОСТИ НА УРОКАХ ИСТОРИИ
Authors: Мичурина А.В.
Published: April 2024

В статье рассмотрены теоретические аспекты интеллектуальной одаренности и ее развития в рамках проектно-исследовательской деятельности на уроках истории в 6-7 классах. Рассмотрены определения понятия «интеллектуальная одаренность» и «проектно-исследовательская деятельность», дано собственное определение интеллектуальной одаренности. Отмечена актуальность данной тематики как с теоретической, так и практической точек зрения. Приведены методы, технологии и приемы развития навыков учащихся на уроках истории с одаренными детьми. Отмечена важность педагогического сопровождения одаренных детей
THE IMPACT OF CLAN LEADERS ON SOMALILAND STATE SECURITY
Authors: JAMA GULEID , JEMAL KEDIR , BADE ZAKI
Published: April 2024

Somaliland, a self-declared independent state in the Horn of Africa, operates within a complex socio-political landscape deeply rooted in clan-based structures. Clan affiliations are central to the region's political, social, and economic fabric. Clan leaders, influential figures within their respective clans, wield significant authority and play crucial roles in maintaining security, resolving conflicts, and providing essential governance functions. This study delves into the multifaceted dynamics of clan leaders in Somaliland's security context. It's noteworthy that the analysis is more in alignment with the "Fragile States Theory" than the "Constructivism Theory." The Fragile States Theory aptly describes the vulnerabilities and challenges faced by regions like Somaliland, characterized by weak governance, limited institutional capacity, and the absence of a strong central government. In this context, clan leaders emerge as key actors in maintaining order, bridging governance gaps, and addressing security issues due to the state's fragility. They navigate intricate clan networks and act as mediators and decision-makers, contributing significantly to societal stability. In contrast, while Constructivism Theory focuses on the role of ideational factors, norms, and identity in state behavior, it's not as directly applicable in explaining the specific role of clan leaders in Somaliland's security dynamics. The analysis concludes that the Fragile States Theory offers a more fitting framework for comprehending the dynamics in Somaliland and the vital role clan leaders play in security and governance, particularly within the context of a fragile state with limited formal government capacity
Siyasi Liderlikte Algı ve İmaj Yönetimi
Authors: Ünsal Tuğba
Published: April 2024

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The Future Career Choices of Pre-Registered House Officers and House Surgeons: a Multicenter Study
Authors: Khan Niama , Ahmad Tauqir , Khan Mohsin , Aftab Ahmed , Bibi Ezzah , Khan Muhammad Zubair , Ali Izaz
Published: April 2024

OBJECTIVES
This study aimed to determine the future preferences of house officers when choosing a medical speciality.
METHODOLOGY
The cross-sectional study was conducted from January to June 2023 at three teaching hospitals in Abbottabad. 250 participants were selected as the study sample. The data was collected from house officers on a predesigned, self-structured written questionnaire. The data was analyzed using SPSS version 21.
RESULTSOf 250 individuals, 224 met inclusive criteria; 65% (146) were male and 35% (78) were female. The mean age was 25 years ±1.01. The first preference of the house officer was medicine (44% (100), the second was surgery (31.5%) (70), and the third was obstetrics and gynaecology. Among medicine specialities, only 0.9% (02) opt endocrinology and gastroenterology, while among surgical specialities, 0.4% (01) opt urology and 0.9% (02) opt neurosurgery. 150 individuals (70%) planned residency in the future, among whom 47% (106) set a caveat for residency abroad. The most favourite place abroad was the UK, with 42% (45/106). 180 house officers (80%) are satisfied with their academic abilities.
CONCLUSION
The study revealed that house officers have no awareness of new specialities and are least interested in specialities like endocrinology, gastroenterology, neurosurgery, and urology. In contrast, no influence was noted toward specialities like haematology, public health and community medicine. Most students are satisfied with their medical education but plan to do their residency abroad.
COVID 19- Biochemical and Other Mechanisms associated with Neuropathy and Stroke.
Authors: Umedani Loung V , Javaid Quratulain
Published: April 2024

The Coronavirus (SARS-C0V-2) caused COVID 19 disease, commencing from China in December 2019 and soon in 2020 its neurological manifestations were noted. The viral spike (S) protein binding with host cell receptor angiotensin-converting enzyme 2 (ACE2) with assistance of membrane fusion protease (TMPRSS) caused viral entry in host cells. We searched 47 articles using PubMed from January 2021 to January 2023. The initial pooling of virus in nasal mucosa was followed by spread to respiratory and other tissues. This review highlights the neuropathy and stroke mechanisms. The role of receptors, enzymes, proteins and genes in neuropathological mechanisms are highlighted. Vascular endothelial effects, choroid plexus and Blood Brain Barrier disruptions were noted. The epigenetic neuropathological mechanisms need to be explored further to help in designing new therapeutic modalities. The post vaccination neurological manifestations as well as the post COVID effects both need further attention to promptly diagnose and start timely treatment.
Comparison of the Effectiveness of Rivaroxaban Versus Vitamin K Antagonist in Patients with Lower Limbs Deep Vein Thrombosis
Authors: Ullah Safi , Atif Durkho , Badshah Aliena , Khan4 Muhammad Shadab Aslam
Published: April 2024

OBJECTIVES
To compare the effectiveness of rivaroxaban and vitamin K antagonists in patients with lower limbs deep vein thrombosis.
METHODOLOGY
This quasi-experimental study was conducted in the Department of General Medicine in Khyber Teaching Hospital, Peshawar for six months with a sample size of sixty. Thirty patients were given Rivaroxaban (Group A) and the other thirty patients were given Vitamin K antagonist (Group B). In the Rivaroxaban group, patients had received 15mg twice daily for the first 3 weeks, 20 mg once daily from 3 weeks to 3 months, and followed by 10 mg once daily. In the Vitamin K antagonist group, patients had received a dose of warfarin of 2.5-5mg once daily, with a goal INR between 2-3. Patients were followed up for 3 months, every month and the effectiveness of both drugs was recorded.
RESULTSOur study shows that in group A (Rivaroxaban), the mean age was 34 years with SD ± 10.77 and in group B (Vitamin K antagonist), the mean age was 36 years with SD ± 11.09. In Group A, 12(40%) patients were males and 18(60%) were females. In Group B, 11(37%) patients were males and 19(63%) were females. Moreover, group A was effective in 27(90%) patients while group B was effective in 25(83%).
CONCLUSION
Rivaroxaban is more effective than vitamin K antagonist in the treatment of lower limbs deep vein thrombosis.
Conocimientos sobre Reanimación Cardiopulmonar en Personal de Enfermería de una Institución de Salud del Bajo Cauca Antioqueño
Authors: Vergara Ealo Sebastián , Salas Navarro Claudia , Salas Navarro Jennifer
Published: April 2024

Objetivo: el objetivo del presente artículo de investigación es describir el nivel de conocimiento acerca de soporte vital básico, del personal de enfermería de una institución de salud del Bajo Cauca Antioqueño en el año 2024. El paro cardiaco se define como la perdida brusca de la actividad mecánica del corazón, junto con el pulso y el conocimiento, secundaria a una falla en la capacidad del miocardio para bombear sangre hacia la circulación sistémica. Materiales y métodos: Se realizó un estudio de corte transversal mediante cuestionario supervisado y auto diligenciado. Los investigadores acordaron de forma arbitraria clasificar el nivel de conocimiento como inadecuado, aceptable y adecuado. Resultados: se aplicó el cuestionario a 56 personas. La mayoría del personal tuvo nivel de conocimiento inadecuado (73,21%) seguido por aceptable (25%). Solo un 1,76% fue calificado como adecuado. Conclusión: la literatura científica es clara en afirmar que la capacitación continua y frecuente, la práctica de lo aprendido y la utilización de guías de manejo de alta calidad mejora los niveles de conocimiento y el desempeño del personal en reanimación cardiopulmonar básica.
Reporte de Caso de un Tumor del Estroma Gastrointestinal Rectal
Authors: Esquivel Treviño Reynaldo , Partida Cota Gabriel
Published: April 2024

Introducción: Los tumores del estroma gastrointestinal (GIST) son un grupo de neoplasias poco comunes del sistema digestivo que se originan en las células intersticiales de Cajal. El artículo aborda un caso de GIST rectal de gran tamaño inicialmente diagnosticado como pólipo inflamatorio. El objetivo radica en exponer un caso que ejemplifica la dificultad diagnóstica, potencial agresivo y pronóstico adverso de los GIST. Se presenta el caso de un hombre de 68 años con GIST rectal de gran tamaño, diagnosticado finalmente en etapa IV tras una segunda biopsia. El paciente recibió derivación intestinal y cuidados paliativos, pero tuvo una evolución tórpida con metástasis y complicaciones respiratorias, falleciendo a los 2 meses. Conclusiones: El caso resalta la necesidad de más investigación sobre GIST para mejorar su detección y manejo. Amplía el conocimiento sobre su potencial metastásico, respuesta limitada a terapias y mal pronóstico en etapas tardías.
Síndrome de McKittrick-Wheelock una Causa Infrecuente. Reporte de Caso
Authors: Zumba Nagua Ana Magaly , Bravo Loor Luis Alejandro , Jaramillo Flores Paola Daniela , Paz Ceron Yesenia Margarita , Alvarez Saltos Miguel David
Published: April 2024

El síndrome de McKittrick-Wheelock es un trastorno poco común causado por una secreción excesiva de líquido y electrolitos por tumores rectales. Los pacientes pueden desarrollar síntomas caracterizados por deshidratación grave, hiponatremia, hipopotasemia y acidosis metabólica. Síndrome de agotamiento. La diarrea secretora generalmente se define como cualquier enfermedad diarreica en la que la pérdida de líquido intestinal excede los 10 ml/kg/día. La causa puede ser infecciosa o no infecciosa. El raro síndrome de McKittrick-Wheelock, descrito por primera vez en 1954, se caracteriza por una depleción grave de electrolitos y líquidos secundaria a diarrea de las mucosas causada por tumores rectales, especialmente adenomas vellosos. Se han notificado casos de hipersecreción de moco en adenomas calcificados, que provocan deshidratación, hiponatremia, hipopotasemia e hipocloremia. Paciente masculino de 60 años presenta deterioro cognitivo, caquexia y diarrea acuosa de tres meses de duración, con una deshidratación hiponatrémica severa. El principal hallazgo durante el estudio fue una gran masa en región rectal.
Competencias andragógicas de las enfermeras y enfermeros que actúan como tutores en las prácticas de la carrera de enfermería, Universidad de las Américas, Quito, enero-agosto 2021
Authors: Cóndor Chano Byron Santiago , Álvarez Morejón Estefany Pamela , Gómez Torres Jessica Beatriz , Cóndor Chano José Vinicio
Published: April 2024

La formación profesional del estudiante de enfermería demanda la adquisición de competencias y destrezas prácticas, sustentadas en la experiencia directa en una entidad de salud, sin embargo, no siempre el enfermero que ejerce el rol de tutor, aunque tenga una vasta experiencia, posee las competencias andragógicas necesarias para la enseñanza de adultos. El objetivo de esta investigación es: Determinar la brecha entre las competencias andragógicas actuales y las competencias esperadas en las enfermeras y enfermeros que se desempeñan como tutores de las prácticas de la carrera de enfermería, en la Universidad de las Américas, Quito. El estudio se desarrollará mediante un diseño descriptivo, no experimental, y de corte transversal. La población de estudio estuvo compuesta por 350 estudiantes y 45 enfermeros y enfermeras que actúan como tutores en las prácticas de la carrera de enfermería de la Universidad de las Américas, en Quito. Se calculó una muestra al 5% de error y 95% de confianza, dando un tamaño muestral de 183 estudiantes. Como técnicas de investigación se utilizó la encuesta como técnica cuantitativa y la entrevista como técnica cualitativa. Existen brechas entre el perfil andragógico de los docentes que alcanzó 4,16 sobre 5 puntos, respecto de lo percibido por los estudiantes, que de manera global alcanzó el puntaje de 3,86. Existe la necesidad de mejorar algunos aspectos del perfil andragógico de los tutores de enfermería. Desde la perspectiva de los docentes se aplican métodos y estrategias de aprendizaje activo, experiencial y participativo, pues indican tener la capacidad de involucrar a los estudiantes en el aprendizaje, sin embargo, no hay mención sobre el uso de TIC para educación.
Evaluación de Confiabilidad y Validez del Cuestionario que Mide el Nivel de Satisfacción: Hacia un Modelo Predictivo Efectivo
Authors: Guerrero Luzuriaga Aura del Cisne , García Ancira Claudia
Published: April 2024

El presente escrito tienen como fin, decribir solventemente el proceso de evaluación de la confiabilidad y validez del cuestionario desarrollado para registrar información sobre el nivel de satisfacción de los agentes involucrados en los procesos que incluyen la convocatoria, desarrollo e implementación de los proyectos de investigación. El describir detalladamente este proceso permite ofrecer a la comunidad académica un instrumento para realizar otras validaciones cumpliendo cabalmene los pasos que incluyen: evaluación de expertos, evaluación de constructo, evaluación de confiabilidad y validez aplicando técnicas estadísticas multivariantes. Aplicar un instrumento debidamente elaborado y validado permitirá a investigadores realizar estudios que tributen a enriquerer la calidad de la investigación, realizar metá análisis, entre otros insumos que tributaran a dar soluciones efectivas a problemas reales en búsqueda de una transformación social sostenible y sustentable.
Bisiklet Kullanıcılarının Karşılaştıkları Sorunların İncelenmesi
Authors: Noyan Elçin , Güçlütürk Baran Günseli
Published: April 2024

Çevrenin korunması, sürdürülebilir çevre farkındalığı, spor yapma bilincinin gelişmesi, ulaşımda kolaylık sağlama gibi nedenlerle bisiklet kullanımı giderek artmaktadır. Çalışmanın temel amaçları, bisiklet sürme nedenlerini tespit etmek ve bisiklet kullanan bireylerin karşılaştıkları sorunları ortaya koymaktır. Çalışmanın evrenini Fethiye’deki bisiklet kullanıcıları ve örneklemini, Fethiye’de 10 bisiklet kullanıcısı oluşturmaktadır. Çalışmada karma araştırma deseni kullanılmıştır. Veriler, yüz yüze görüşmelerden elde edilmiş, kriterler ağırlık derecelerine göre Çok Kriterli Karar Verme (ÇKKV) yöntemlerinden Entropi yöntemi ile sıralanmıştır. Katılımcıların karşılaştıkları sorunlar: motorlu taşıt sürücülerinin duyarsız, aceleci ve saygısız olmaları, bisiklet yollarının elverişsiz olmaları, bisiklet ekipmanlarının pahalı olmaları, bisiklet yollarına yakın yerlerde tamirhanelerin bulunmaması, bisiklet yollarının yayalar ve motorlu taşıtlar tarafından kullanılmaları, bisiklet yollarına motorlu araçların park etmeleri, yollara çöp vb. koyulması, motorlu taşıt sürücülerinin bisiklet takip mesafesine uymamaları, toplu taşıma araçlarında bisiklet taşıma aparatlarının bulunmaması ve güvenlik sorunları olarak belirlenmiştir. Bulgularda yüksek önem derecesine sahip olan ‘toplu taşıma araçlarına bisiklet taşıma aparatlarının yerleştirilmesi’ kriteri ile ilgili uygulamalara öncelik verilmelidir. Motorlu araç sürücülerine farkındalık kazandırılması, bisiklet yollarının bakımlarının yapılması ve bisiklet kullanımını teşvik edici çalışmaların yapılması önerilmektedir.
Huyết khối tĩnh mạch sâu chi dưới sau nhiễm trùng Burkholderia Cepacia: Nhân một ca lâm sàng hiếm gặp
Authors: Trần Nguyên
Published: April 2024

TÓM TẮT

Đặt vấn đề: Burkholderia cepacia là trực khuẩn gram âm và là tác nhân gây bệnh nhiễm trùng cơ hội, với biểu hiện lâm sàng đa dạng. Tuy nhiên huyết khối tĩnh mạch sâu sau nhiễm khuẩn Burkholderia cepacia ít khi được ghi nhận trong y văn. Chúng tôi xin trình bày ca bệnh huyết khối tĩnh mạch sâu chi dưới sau nhiễm B. cepacia nhằm mô tả các đặc điểm ca bệnh và đối chiếu y văn với các trường hợp nhiễm khuẩn B. cepacia có kèm huyết khối tĩnh mạch .

Báo cáo ca bệnh: Bệnh nhân nam 80 tuổi nhập viện với biểu hiện sốt, lơ mơ, khó thở 2 ngày. Xét nghiệm ban đầu cho kết quả nhiễm toan ceton đái tháo đường và bệnh nhân đã được điều trị theo phác đồ. Quá trình điều trị ghi nhận sưng phù khu trú chân trái, bệnh nhân sau đó được chẩn đoán là huyết khối tĩnh mạch sâu chi dưới bên trái. Kết quả cấy máu cho ra vi khuẩn B. cepacia và bệnh nhân được điều trị kháng sinh (Ceftazidime phối hợp Trimethoprim/ Sulfamethoxazole) theo kháng sinh đồ và chống đông cho huyết khối tĩnh mạch. Tuy nhiên, mặc dù đã được điều trị tích cực, tình trạng bệnh nhân vẫn xấu đi nhanh chóng và tử vong sau 2 tuần nhập viện.

Kết luận: Ở các bệnh nhân nhiễm khuẩn B. cepacia, các xét nghiệm tầm soát huyết khối tĩnh mạch cần làm nhanh chóng nếu lâm sàng nghi ngờ để đưa ra chiến lược điều trị hợp lí.

ABSTRACT

Lower - Xxtremity deep vein thrombosis secondary to Burkholderia Cepacia infection: a rare case report

Background: Burkholderia cepacia is a gram - negative bacillus and the causative agent of opportunistic infections, with various clinical manifestations. However, deep vein thrombosis following Burkholderia cepacia infection is rarely reported in the literature. We reported a case of deep vein thrombosis of the lower extremity with diabetic ketoacidosis after B. cepacia infection to describe the characteristics of the case and compare the literature with cases of B. cepacia infection accompanied by venous thrombosis.

Case report: An 80 - year - old male patient was admitted to the hospital with fever, lethargy, and shortness of breath for 2 days. Initial investigation showed diabetic ketoacidosis and the patient was treated according to the regimen. During the treatment, localized swelling of the left leg was noted, and the patient was later diagnosed with deep vein thrombosis of the left lower extremity. The culture of his blood grew B. cepacia and the patient was administrated with antibiotics (Ceftazidime in combination with Trimethoprim/Sulfamethoxazole) according to the antimicrobial susceptibility testing and anticoagulation for venous thrombosis. However, even after intensive appropriately treatment, the patient deteriorated rapidly, and died 2 weeks after admission.

Conclusion: In patients infected with B. cepacia infection, venous thromboembolism screening tests should be performed promptly if clinically suspected to provide an appropriate treatment strategy.
Các biến thể động mạch của đại tràng phải khảo sát qua phẫu thuật nội soi cắt toàn bộ mạc treo đại tràng
Authors: Dương Lập
Published: April 2024

TÓM TẮT

Đặt vấn đề: Nghiên cứu nhằm mục đích khảo sát các biến thể giải phẫu có thể xuất hiện của hệ thống động mạch đại tràng phải trong lúc phẫu thuật nội soi cắt đại tràng phải theo kỹ thuật cắt toàn bộ mạc treo đại tràng (Complete Mesocolic Excision) và thắt mạch máu tận gốc (Central Vascular Ligation).

Đối tượng, phương pháp: Nghiên cứu hồi cứu, mô tả cắt ngang 44 trường hợp phẫu thuật nội soi cắt đại tràng phải lấy toàn bộ mạc treo đại tràng và thắt mạch máu tận gốc để điều trị ung thư đại tràng phải tại Khoa ngoại tiêu hóa Bệnh viện Bình Dân từ tháng 1 năm 2017 đến tháng 1 năm 2020.

Kết quả: Động mạch và tĩnh mạch mạc treo tràng trên đều có mặt trong mọi trường hợp; động mạch mạc treo tràng trên nằm bên bên trái tĩnh mạch mạc treo tràng trên. Động mạch và tĩnh mạch hồi đại tràng xuất hiện trong 100% các trường hợp (44/44). Trong số đó, 22 trường hợp (50%) động mạch hồi đại tràng bắt chéo trước tĩnh mạch mạc treo tràng trên. Động mạch đại tràng phải xuất hiện trong 17 trường hợp (38,6%). Tỉ lệ hiện diện động mạch và tĩnh mạch đại tràng giữa là 100%

Kết luận: Các biến thể động mạch của đại tràng phải ghi nhận trong lúc phẫu thuật nội soi cắt đại tràng phải theo kỹ thuật cắt toàn bộ mạc treo đại tràng khá đa dạng. Những thông tin này có thể giúp ích cho phẫu thuật viên đại trực tràng tránh các biến chứng mạch máu khi thực hiện kỹ thuật thắt mạch máu tận gốc

ABSTRACT

Variations in right colic arterial anatomy in laparoscopic right colectomy with complete mesocolic excision

Background: This study aimed to analyze right colonic arterial variations in laparoscopic right colectomy with complete mesocolic excision and central vascular ligation.

Methods: A descriptive and longitudinal study on 44 patients had been performed laparoscopic right colectomy with CME (complete mesocolic excision) and CVL (central vascular ligation) due to right - side colon cancer in Gastrointestinal Surgery Department of Binh Dan Hospital from Jan 2017 to Jan 2020.

Results: The superior mesenteric artery and vein were present in all cases; the superior mesenteric artery was on left side of the superior mesenteric vein. The ileocolic artery and vein occurred in 100% (44/44). The ileocolic artery crossed anterior to the superior mesenteric vein in 22 of 44 cases (50%). Right colic artery appeared in 17 of 44 cases (38,6%). Middle colic artery and middle colic vein were found in all cases.

Conclustion: The variations of vascular recorded during laparoscopic right colectomy with CME are quite diverse. This information may be helpful for colorectal surgeons to reduce vascular complications when performing laparoscopic right colectomy with CME and CVL.