bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of children with diaphyseal femur fractures by closed intramedullar osteosynthesis
Authors: Rozinov V. M. , Yandiev S. I. , Burkin I. A. , Saveliev V. B. , Chogovadze G. A. , Pligina E. G.
Published: March 2022

The experience in treatment of 54 children with diaphyseal femur fractures by closed antegrade intramedullar osteosynthesis is presented The possibility of realization of closed intramedullar osteosynthesis excluding proximal femur growth zone damage is experimentally grounded. It is defined that echography provides all necessary information and allows to limit the irradiation load on the patients and medical staff. Original set of instruments for closed intramedullar osteosynthesis is suggested; recommendations on implant choice depending on the childs age are given. The method is shown to provide a good anatomic functional result in overwhelming majority of children with diaphyseal femur fractures and to give 2.3-3 times decrease of the duration of inpatient treatment and rehabilitation period as compared with conservative treatment.
Total hiparthroplasty by implants of new generation
Authors: Zagorodnyy N. V.
Published: March 2022

Six hundred twenty four consecutive total hiparthroplasties with cement (565 hips), press-fit (35 hips) and hybrid (24 hips) fixation were performed. There were 89 men and 433 women, mean age 52.1 (range from 18 to 84 years). Author reviewed a series of 238 hiparthroplasties with follow-upfrom 12 to 72 months. At control examination the average Harris hipscore was 85.9 (before operation - 30.4). Based on clinical and radiologic data as well as on densitometry, morphologic and biomechanic analysis the success rate of the total hiparthroplasty was 96.6% with no difference between russian and foreign implants.
Use of low-molecular heparine for the prevention of venous thromboses and embolisms in total hipreplacement
Authors: Plotkin G. L. , Petrov A. N. , Nikolayeva I. P. , Domashenko A. A.
Published: March 2022

Thromboembolic complications are consided to be the most common cause of patients mortality with the femur fructures. The use of low-molecular weitght heparine (clexane) is the most adequate concerning effectiveness, safety and simplicity. The activization of biochemical processes of erythrocytes membranes by clexan has been recently found. It facilitates the onset of the oxygen dissociation mechanism, improves oxygen supply to the tissues and its better diffusion. The blood circulation system transforms into hypodynamic regimen, optimising the bodys activity.
Long term outcomes of conservative treatment for femoral head osteochondropathy
Authors: Divakov M. G. , Boloboshko K. B.
Published: March 2022

In patients with femoral head osteochondropathy the long term outcomes of conservative treatment were studied. There were 3 groups of patients: 57 patients who were treated at orthopedic sanatoriums for children; 33 outpatients and 35 patients without treatment. Clinical and radiographic data in three studied groups were compared and likeness of data was obtained. Correlation analysis was performed to detect the factors which statistically reliably defined the long term outcomes. The highest correlation rates were found for disease onset age (-0.47) and the following radiographic data: proximal acetabular index (+0.22), inclination angle of acetabular roof (-0.28) and coefficient of the conformity of femoral head surface and acetabulum (+0.26). Multiple linear regression was used to determine the prognostic index for every patient with femoral head osteochondropathy. There were three degrees of probability of unfavorable long term outcomes in conservative treatment or without therapy and 3 groups of patients with good, doubtful or unfavorable outcomes, respectively. Suggested prognosis method allowed a differential choice of treatment method including surgical correction. In good and unfavorable prognosis the pattern of conservative treatment does not influence the long term outcome so prolonged sanatorium treatment is not expedient.
The classical dynamics of an impulsively driven Morse oscillator
Authors:   , Heagy James Franklin , Yuan Jian-Min
Published: March 2022

We investigate the classical dynamics of a one-dimensional Morse oscillator subjected to periodic impulsive (delta function) forcing. This system serves as a rough model for the interaction of diatomic molecule (or single bond of a polyatomic molecule) with an intense laser field. The dynamics of the system are shown to be governed by an area-preserving map (period 1 return map) of the flow generated by the underlying Hamiltonian. The properties and behavior of this map are the main focus of study. The map is shown to be reversible and we obtain an explicit factorization of the map into a product of two orientation-reversing involutions. The invariant sets (symmetry lines) of these involutions are then determined analytically. The so called dominant symmetry line is identified as one of the symmetry lines. Many of the structures within phase space are organized by the symmetry lines and their iterates under the map. Among these structures are the (Poincare-Birkhoff) periodic orbits, resonance islands, and (primary) homoclinic orbits. We classify all of the Poincare-Birkhoff orbits according to the symmetry lines which they visit. The resonance islands, which are 'built' around these orbits, are similarly organized. We also give a similar symmetry classification for the primary homoclinic orbits. We extend these observations by proving that the homoclinic orbits in all reversible area-preserving maps fall on symmetry lines. Bifurcation behavior is examined in light of the symmetry line structure of phase space. The generation (or destruction) of period one orbits with winding numbers n/1 (n [greater than or equal to] 1), via tangent bifurcations, is found to be governed by systematic rules. These rules relate to the crossing of two symmetry lines as the control parameters of the map (amplitude and period of the driving term) are varied. We generalize some of the symmetry observations to a larger class of 'kicked' Hamiltonian systems. We provide evidence that the dominant symmetry line for this class of systems is determined solely by the form of the coupling function to the periodic forcing term, and we give an expression for the dominant symmetry line. We conjecture that the dominant symmetry line for all maps within this class is given by this expression. Finally, we examine the dissociation behavior of the Morse oscillator as a function of the control parameters. This study results in a boundary in parameter space which separates parameters which lead to dissociation from those which do not. A series of numerical dissociation experiments carried out over successively smaller regions of parameter space reveals that this boundary has a considerable amount of structure, even at very fine scales, and may possibly be fractal.
Pigment-resin interactions in coating systems
Authors:   , Hegedus Charles Raymond , Kamel Ihab L
Published: March 2022

The thermodynamics of filler particle surface-polymer interactions have been characterized using inverse gas chromotography (IGC) and flow calorimetry. The use of IGC in this new application extends analysis to calculation of the thermodynamic properties of reversible particle-polymer interactions. This technique was used to determine solid surface energies; free energy, enthalpy, and entropy of adsorption; and work of adhesion. The values obtained agree favorably with those obtained from alternate techniques. Non-polar forces provided a large contribution to the free energy and enthalpy of adsorption. Acid-base pairs were found to undergo favorable interactions while acid-acid and base-base pairs were less likely to undergo strong interactions. Flow calorimetry was used to measure the adsorption enthalpies of methyl methacrylate and acrylic acid on TiO2 and SiO₂. The extent of reversibility/irreversibility of the resulting interactions was also assessed. Adsorption of methyl methacrylate (MMA) and acrylic acid (AA) on fillers was strong and irreversible. The adsorption enthalpy of MMA on silica was approximately 27 kJ/mole due to hydrogen bonding. Adsorption enthalpies of AA on alumina-treated TiO2 were higher than that of MMA on silica, indicating stronger acid-base interactions. The interface which resulted from filler particle-polymer interactions was investigated by determining the PMMA adlayer thickness using centrifugation and viscosity measurements. These adlayer thicknesses ranged from 9 to 110 nm. Adlayer thickness increased with particle size and PMMA-filler interaction. Values calculated from viscosity experiments were greater than those from centrifugal packing, leading to a proposed model for the polymer adlayer state. The practical aspect of this study was demonstrated by analyzing coating properties resulting from the formulation of titanium dioxide fillers in PMMA. TiO2 pigments which had more favorable adsorption with MMA resulted in coatings with better dispersion quality and stability, greater resistance to salt spray, and caused a greater increase in the Tg of the PMMA matrix. In contrast, these fillers had detrimental effects on adhesion and flexibility. These results were attributed to extensive interactions between filler and polymer which decrease permeability and increase rigidity of the polymer matrix.
Analysis of the motor vehicle collision factors accounting for location of lesion, brain injury severity and patient outcome
Authors:   , Hillary Frank G. , Chute Douglas L.
Published: March 2022

This retrospective study examined the effects of motor vehicle collision factors on the location and severity of brain injury. Acute care records and police accident reports were analyzed for 168 collisions occurring between 1985 and 1998 in the city of Philadelphia. Injured patients using a seatbelt experienced a shorter duration of loss of consciousness, had better GCS scores in the emergency room and endured shorter acute care hospital stays. Seatbelt efficacy was reduced, however, during lateral collisions. The data revealed that lateral collisions were associated with injury of greater severity when compared to frontal collisions. In addition, brain injury survivors of lateral collisions had poorer long-term outcomes at an average of 1.5 years following the injury. During frontal collisions, unrestrained drivers sustained greater injury when compared to unrestrained passengers. Lesion analysis revealed greater incidence of posterior cortical lesions when the occupant was unrestrained and greater incidence of temporal lobe lesions and skull fractures during lateral collisions. However, the data did not show an increase in subcortical lesions in restrained occupants or occupants of lateral impacts, as hypothesized. Reduced incidence of airbag deployment precluded analysis of this safety restraint system. Future research in this area should be prospective and interdisciplinary in nature. In the future, neuropsychology may play a role in validating the efficacy of newly implemented safety restraint systems and work with accident reconstructivists to determine the physical parameters by which brain injury occurs.
Gestão por Propósito - Identificando as Necessidades Pessoais dos Liderados e Empresarial de uma Cooperativa de Crédito
Authors: Gonçalves Michel Dias , Assunção Ayron Vinícius Pinheiro de , Paula Fernanda Guerreiro de , Souza Camila Ramos de
Published: March 2022

ResumoOs gestores cada vez mais estão sendo desafiados pelas empresas a liderarem equipes vencedoras e multidisciplinares, porém não basta apenas entregas numéricas, o comportamento das pessoas é essencial para longevidade das instituições. Empresas que não se preocuparem com o bem-estar dos seus colaboradores e seus valores não terão vida longa. Assim fez necessário neste trabalho conhecer os liderados e saber o que eles esperam da gestão e bem como acreditam que um líder deve se portar perante sua equipe. A busca por essa informação se desenvolveu através de pesquisa de percepção e construção compartilhada de um modelo de gestão por propósito, onde não somente os objetivos da empresa são levados em consideração, mas também os objetivos dos colaboradores que a compõe, respeitando suas individualidades e comportamento da geração que nasceram.
Palavras-chave: Gerações. Gestão. Propósito.
AbstractManagers are increasingly being challenged by companies to lead winning and multidisciplinary teams, but not just numerical deliverables, people's behavior is essential to the longevity of institutions. Companies that do not care about the well-being of their employees and their values will not live long. Thus it was necessary in this work to know the leaders and know what they expect from management and how they believe that a leader should behave before his team. The search for this information was developed through perception research and shared construction of a management model by purpose, where not only the company's objectives are taken into consideration, but also the goals of its employees, respecting their individuality and behavior. of the generation that were born.
Keywords: Generations. Management. Purpose.
Efecto del liderazgo ético sobre la creatividad de los empleados: una revisión del estado de la investigación
Authors: Esguerra Gustavo A.
Published: March 2022

Este artículo presenta una revisión de la literatura y del estado de investigación sobre la relación entre liderazgo ético y creatividad en el trabajo. La metodología comprendió la búsqueda, organización, selección y análisis de artículos incluidos en las bases de datos EBSCO, Web of Science y Scopus. Se describen las características de los estudios, instrumentos de evaluación, teorías de soporte y principales resultados, y se discuten las perspectivas de investigación. A partir de los hallazgos reportados, se concluye que las prácticas de liderazgo ético en las organizaciones tienen efecto favorable sobre la creatividad de los trabajadores. Esta revisión sirve como insumo para estudios futuros y también como soporte para señalar la importancia en la toma de decisiones éticas como factor generador de comportamiento creativo.
Explaining green consumption: A cross-cultural study on young adult consumers through a multi-group comparison
Authors: Cavazos-Arroyo Judith , Sánchez-Lezama Ana Paola
Published: March 2022

This research compared, through a multigroup analysis, green consumption among young adult consumers in Mexico and Spain. Thus, the effect of their connection to nature, environmental citizenship, activism and environmental social identity on green consumption was analyzed. A quantitative, explanatory, and cross-sectional methodology was developed, which involved the application of an instrument to 447 Mexican and 120 Spanish young adults. The primary results related to green consumption did not suggest different environmental behavior patterns between the samples. When combined, it was found that environmental social identity and environmental citizenship did not always translate into green consumption. However, young adult consumers who were more connected to nature were more likely to consume eco-friendly products.
A Study on the Factors Affecting Intention of Learning Python Programming: For Non-majors in University
Authors:   the Information Systems Department, Hanyang University, Seoul, Korea, Cheon Minjong , Lee Ook , Mun Changbae , Ha Hyodong
Published: March 2022

In an industry, society gets more interest in software. In accordance with this trend, in the process of composing the university's curriculum, it is increasingly emphasized that problem-based learning through computational thinking and programming ability based on logical thinking is weighted. This study conducted a study on how to identify students' educational characteristics and study intention. In particular, a methodology to explore the study intention for Python programming from the characteristics of each student was reviewed. For this analysis, the relationship between new technology from their point of view and factors is analyzed, factors are identified for methodologies, and statistical methodologies are used to verify them. The purpose of this study is to find improvements for software education operation and to provide help in educational policy decision-making of university members who conduct computer software education.
Identifying the Impact of Online Tests in Learning Management Systems on Learning Success
Authors:   Mittweida University of Applied Sciences, 09648 Mittweida Germany, Wittrin Ruben T. , Wüstenfeld Viktoria , Spranger Michael , Tolkmitt Volker
Published: March 2022

The digital transformation of higher education demands effective and efficient methods for learning assessment. Research has shown that tests have the potential to be an appropriate medium not only to diagnose learning success but to improve learning outcomes/processes in general. In this study, we examine possible connections between the use of digital tests and learning success. Based on a survey (n=71) and a quantitative analysis (n=214) with logging and exam assessment data, we find three points that indicate positive correlation: Firstly, students perceive digital tests as motivating and useful. Secondly, we detect a positive relation between the points students achieved in the online tests and the exam results (Spearman correlation coefficient of 0.39), and thirdly, students who participated continually in the digital testing system on average succeeded and passed the exam. The results show the importance of systematic digital testing in learning management systems, but also the need for more research with respect to other contexts and domains.
Short-term voiding patterns after vaginal hysterectomy and pelvic floor repair
Authors: Lim Poh T. , Lee Jill C. S. , Han How C.
Published: March 2022

Background: Post-operative transient voiding dysfunction is a known complication of vaginal hysterectomy (VH) with pelvic floor repair (PFR). This study aims to determine the duration of urinary catheterization prior to resumption of normal voiding and hospital length of stay for patients who have undergone VH, PFR with or without concomitant application of transvaginal mesh (TVM) and/or mid-urethral sling (MUS).Methods: This is a retrospective cohort study of women who underwent VH with PFR at a single urogynaecology centre in Singapore between 01 October 2016 and 30 September 2017. Patients’ files were reviewed for data collection and analysis.Results: A total of 238 women with VH with PFR were studied, of whom 68 (28.6%) did not have any implant, 60 (25.2%) had only TVM, 50 (21.0%) had only MUS, and 60 (25.2%) had both TVM and MUS. Overall, 1/68 (1.5%) patients without implants, 16/110 (14.5%) patients with one implant and 13/60 (21.7%) patients with two implants failed at least 1 inpatient voiding trial. Patients undergoing VH PFR without implants had shorter duration of catheterization compared to those with concomitant implants (2.2 versus 5.6 days, p<0.01). Duration of catheterization was shorter in patients with only MUS compared to patients with only TVM (3.5 versus 4.7 days, p<0.01). Patients with single implant had significantly shorter duration of catheterization compared to those with two implants (4.2 versus 5.6 days, p=0.001).Conclusions: One in 68 patients with VH with PFR without implants experienced short term voiding difficulties. This risk increased to 1 in 5 when concomitant implants were inserted.
Contraception use among Muslim women in Alexandria, Egypt: a descriptive pilot study
Authors: Abdelkarim Maryam , Namoos Asmaa , Khamis Assem M. , Zook Salma , Bader Norhan , Abosamak NourEldin , Ramadan Dina , Ramadan Rana , Abdou Mostafa , Faried Ola , Fawzy Abd El-Moneim A. , Gal Tamas S.
Published: March 2022

Background: This pilot study aimed to create a questionnaire survey directed to understand knowledge gaps related to contraception among Muslim women in Alexandria, Egypt, so potential interventions could be designed to enable more informed decision-making. The project was a mixed-method, cross-sectional study using a questionnaire survey.Methods: Participants were randomly selected at outpatient clinics at Alexandria university hospitals in September and October 2020. The inclusion criteria were to be an 18 year old or older woman and able to give consent. The recruitment goal for this pilot study was 100 participants. The consented participants were interviewed about demographics, socio-structural and contraception use. The questionnaire was tested using a focus group of 11 women. The study data was collected using KoBoToolbox and exported to the SPSS software for descriptive analysis. The primary outcome was to validate the survey questionnaire and the secondary outcome to assess knowledge regarding contraception methods and emergency contraception.Results: The age of study participants ranged from 18-60 with a mean of 34 years. Almost all participants had previously heard of various contraceptive methods and 75% used them before. The majority did not know about emergency contraception. Most respondents had a favorable attitude toward family planning, and their primary sources of information were family and friends.Conclusions: Preliminary findings show that most women knew about contraception methods, though few of them heard of emergency contraception. Because of the patriarchal nature of Egyptian society, family planning education should target the whole population.
Manual removal versus spontaneous delivery of the placenta at caesarean section: a randomized controlled trial
Authors: Abdelfattah Laila Ezzat , Bastawy Abdullah Mohammed Abdullah , Fahmy Mohamed Salah El Deen
Published: March 2022

Background: Cesarean section (CS) is a life-saving surgery when certain complications occur during pregnancy and childbirth. The method of placental removing is one such procedure that can affect outcomes of cesarean delivery, such as the amount of bleeding during intraoperative and postoperative, the time of operation, the occurrence of postoperative endometritis, and may contribute to an increase or decrease in the incidence of CS. The objective of the study was to compare the manual removal of the placenta and spontaneous placental delivery at caesarean section.Methods: One hundred twenty sex consented to participate and divided randomly into two groups: Group A: included 63 pregnant women underwent elective caesarean section, the placental left in situ and the uterus massaged waiting spontaneous placental separation and Group B: included 63 pregnant women underwent elective caesarean section in which placenta was removed manually.Results: We found that women who had manual removal of the placenta lost significantly more blood than those who had spontaneous separation. A significant drop in hemoglobin was observed in manual separation group compared to spontaneous separation group. The median duration of placental delivery was shorter in manual separated group than spontaneously separated group. There was a statistically significant difference between both groups was found as regard the need for blood transfusion. There was a statistically significantly longer hospital stay with manual delivery of the placenta.Conclusions: Spontaneous separation of the placenta during cesarean section is more beneficial than manual separation.
Study frequency of the first time C-section and its medical indications in Ardabil city, 2021
Authors: Ghavami Zahra , Amani Firouz , Hosseindust Marzieh
Published: March 2022

Background: Caesarean section is a surgical intervention to prevent or treat life-threating maternal or perinatal complications but unnecessary caesarean section can put mothers and babies at serious risks. World Health Organization (WHO) recommends a caesarean section rate of about 15 percent or less. Although most countries are trying to stop the increase in caesarean section rates to achieve to the rate proposed by the WHO but in many countries, including Iran, has been much higher. The rate of C-section in Iran has increased from 19.5% in 1976 to about 48% in 2010. This figure has reached 60% in 2013. As repeat caesarean is the most common indication of c-section in Iran, the most practical way to reduce the rate of c-section will be reduction of first-time c-section. Obviously, it is necessary to know indications of first-time c-section to reduce the rate of c section in our country. For this purpose, designing a study to recognize the indications of first-time c-section seems useful. Evaluation of frequency of the first time C-section and its medical indications in Alavi Hospital, in Ardabil, 2021.Methods: In this cross-sectional study, all data of caesarean sections performed in Alavi medical center in 2021 were studied. Among the performed c-sections, all the first caesarean sections were selected and their information and indications were collected. The collected data were entered into Statistical package for social sciences (SPSS) software and analyzed by using tables, graphs, numbers and percentages to evaluate the frequency and indications of first-time c-section.Results: Among all CS performed (2075 patients), 940 mothers, underwent caesarean section for the first time, were included in the study. The frequency of caesarean section for the first time was 45.3%. The mean age of the samples was 27.9 years with a standard deviation of 6.94 years. The minimum age was 14 and the maximum age was 47 years. The number of maternal pregnancies ranged from 1 to 8.Conclusions: The most medical indications for first-time caesarean section with 587 cases (65.7%) and 156 cases (17.5%) were related to fetal distress and lack of labor progression, respectively.
Improvement of semen quality after treatment with folic acid and zinc in subfertile men in a tertiary hospital
Authors: Begum Nurjahan , Anwary Shaheen Ara , Alfazzaman M. , Mostofa Munshi Akid , Mahzabin Zeenat , Rahman M. M. Mafizur , Akter Mahbuba , Iqbal Kazi Sohel , Akhter Rehena
Published: March 2022

Background: The 50% of all male infertility is idiopathic, and there is currently no recognized treatment. The effectiveness of a nonprescription nutraceutical comprising eight nutrients on sperm quality in males with idiopathic infertility was studied. The aim of the study was to evaluate improvement of semen quality after treatment with folic acid and zinc in subfertile men. Methods: This prospective observational study was carried out in the infertility unit, department of obstetrics and gynaecology, Bangabandhu Sheikh Mujib medical university (BSMMU), Dhaka, Bangladesh from January 2018 to June 2020. Approval from local ethics committee was obtained for this study.Results: One hundred and twenty-five male subfertile patients were included in this study. Most men, 99 (79.2%) belong to more than 30 years, followed by 26 (20.8%) less than 30 years, range was 25 to 50 years. Mean ± SD age was 35.3±5.1 years. Rapid linear (RL) before treatment were 16.06±14.46 (mean ± SD) and after treatment were 22.82±13.40 (mean ± SD). Slow linear (SL) before treatment were 17.56±12.06 (mean ± SD) and after treatment were 19.75±9.25 (mean ± SD). Non progressive (NP) before treatment were 10.82±8.95 (mean ± SD) and after treatment were 10.12±7.34 (mean ± SD). Morphology of the sperm before treatment were 19.43±15.48 (mean ± SD) and after treatment were 30.18±19.12 (mean ± SD).Conclusions:  Our research findings fully correspond to the above research results, so it can be said that treatment of subfertile men with micronutrients like folic acid and zinc sulfate causes increase of semen quality and thus plays a key role in treatment of male subfertility.
Retrospective audit of genital prolapse management
Authors: E. Rohini , Indu N. R. , A. Shameera Banu , P. B. Hiremath , Hiremath Reshma
Published: March 2022

Background: Pelvic organ prolapse is a descent of the pelvic organs into the vagina, frequently associated with local pelvic symptoms. Pelvic floor support is essential to maintain the normal anatomy. Recent studies of genital prolapse suggests that it is more important to improve the patient satisfaction and reduce complication than to achieve anatomical success. The purpose of the audit of genital prolapse management in this retrospective study is to know and understand the decision making, selection of patients for a particular surgery and to know and avoid the complications of genital prolapse management.Methods: This retrospective descriptive study was conducted at SVMCH and RC during the period of January 2020 to December 2021. The detailed analysis of the cases, symptomatology, surgical methods, complications and follow up were studied.Results: We managed 110 cases of genital prolapse. 35 patients had massive/ huge genital prolapse (POP Q Stage 4). 75.4%were found in the age group beyond 55 years, 66.3% were multiparous. 31% of the patients came with massive prolapse (POP Q-stage IV), 5% showed cervical elongation ,7% showed vault prolapse, Majority of our patients (63%) were managed by vaginal hysterectomy with pelvic floor repair. Followed by pessary, Fothergill’s surgery, Purandare’s surgery, Le forte’s, sacrospinal fixation, hysterosacropexy, pessary with thiersch stitch.Conclusions: The choice of management of genital prolapse has to be tailored according to the patients needs and pathology. The younger trainees have to be trained to get the skills of various surgeries of genital prolapse.
Co-existence of hypertensive urgency and hemolysis elevated liver enzymes and low platelets syndrome in a parturient with myasthenia gravis: a therapeutic challenge
Authors: Jha Nivedita , Bhukya Divya , Subhedhar Shruthi Shreenivas , Rengaraj Sasirekha , Sagili Haritha , P. Veena
Published: March 2022

Hemolysis elevated liver enzymes and low platelets (HELLP syndrome) is an obstetric emergency developed in the settings of hypertensive disorder of pregnancy and it is associated with a heightened risk of adverse fetomaternal outcomes. Obstetric and anaesthetic management is indeed challenging in HELLP syndrome. The presence of myasthenia gravis further complicates the managements issues in these women. Here, in this report, we describe a 35 years G2P1L1 known case of myasthenia gravis, who presented in emergency with uncontrolled hypertension, imminent eclampsia and HELLP syndrome at 29+1 weeks of gestation. Antihypertensive medication included hydralazine, alpha methyldopa, infusions of labetolol and nitroglycerine. She underwent successful vaginal delivery using fentanyl as labour analgesia. Prompt decision making using multidisciplinary team appeared vital in controlling the hypertension adequately and quickly without aggravating myasthenic crisis.
Painful scar endometriosis after caesarean section
Authors: Gaur Indu , Kumar Kanishka
Published: March 2022

Scar endometriosis is an extremely rare phenomenon. We presented a case of scar endometriosis in a thirty one year old patient (P2L2) who developed swelling and cyclical pain in the previous suprapubic caesarean scar (of previous two caesarean sections) area lasting for 10 days every month for last 2 years. On abdominal examination she had a small swelling at right margin of the wound which was firm and tender on examination with dull aching constant pain at the site of examination. This pain used to aggravate with menses. Investigations suggested scar endometriosis and she was treated medically with oral contraceptives and GnRH but symptoms recurred on stopping the treatment. Patient underwent surgery. A dense fibrotic tissue of 5×4×5 cm size including the rectus sheath, part of rectus muscles and subcutaneous tissue was found on the right side of the old previous scar beneath the skin which was excised and sent for histopathological examination which reconfirmed the diagnosis of scar endometriosis with presence of glands and stroma in the excised tissue. Post-operative period was uneventful.
Postmenopausal spontaneous rupture of pyometra
Authors: Verma Aruna , Maheshwari Raghavi
Published: March 2022

Spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon, ranging from 0.01% to 0.5%. Herein, we report the case of a 55 year old postmenopausal woman, presented with acute abdominal pain, distended abdomen, and inability to pass flatus and feces, and purulent vaginal discharge. In view of generalized peritonitis, laparotomy was performed on which 3000 cc pus was suctioned out and necrotic tissue was found on the surface of liver and intestines. The uterus was found to have a 2×2 cm sized perforation at fundo-posterior surface from which purulent material was seen exuding. Thus, a diagnosis of perforated uterus due to pyometra was made. A total abdominal hysterectomy with bilateral salpingo-oophorectomy with thorough peritoneal lavage was done. Histopathological examination revealed perforated uterus with pyometra, but there was no evidence of malignancy, and the cervical canal was patent. The patient had burst abdomen on 6th postoperative day and subsequent resuturing was done. She was discharged on 17th postoperative day in satisfactory condition. Thus, rarely, perforation of uterus due to pyometra can cause peritonitis in postmenopausal females with signs of acute abdomen.
A review of caesarean section rates in India: causes for increased prevalence and suggestions for a rational approach
Authors: Balla Patricia Christina , Nallapu Samson Sanjeeva Rao
Published: March 2022

An increasing Caesarian Section (CS) rate places a clinical and economic burden on health care services of the country. When balancing an optimal CS rate, maternal and pediatric outcomes of pregnancy such as maternal morbidity and birth complications should be considered. A CS can be a life-saving intervention when medically indicated, but this procedure can also lead to short-term and long-term health effects for women and children. For society, a caesarean section is more costly than a vaginal delivery. The increased rate of CS can be attributed to medical and non-medical factors like increases in maternal age and body mass index as well as changes in obstetric practice and technology. The WHO has recommended the Robson 10 Group classification as a global standard tool for monitoring CS. This system classifies CS into 10 mutually exclusive groups based on the parity, gestational age at admission, onset of labour, fetal presentation and number of fetuses. The WHO also emphasises that the focus should be to provide caesarean sections to all women in need rather than striving to achieve any specific rate at the population level. It also encourages a shift in the focus from optimal caesarean section rates to more practical proposals which are amenable to action. In the private healthcare setup, commitment to improvement and strategies such as full time availability of obstetricians, better midwife support and regular audits will help move towards an acceptable CS rate. In conclusion, the onus must not be on just reducing CS rates but on scientific methods of deciding when a woman needs the surgery and to ensure safe healthcare environments for the same. Training in obstetrics for specialists must not neglect appropriate procedures like instrumentation.
Assessment of the emotional intelligence and its dimensions of students at beginning of their medical profession education
Authors: Singh Harmesh , Singh Ishneet , Soni R. K.
Published: March 2022

Background: Medicine involves not only prescriptions but also a well-developed emotional intelligence (EI). The assessment of EI of students at their entry to medical professional training may identify weaknesses, if any, so as to be taken care during the course. Thus, it may be relevant to explore it and its dimensions because it is still a nascent field of research, hence this study was planned.Methods: Objectives were to assess the EI and its dimensions of first year MBBS students. Study design was a descriptive and cross-sectional study. Study sample were 150 first year MBBS students. Ethical approval from institutional ethics committee and informed written consent from participants obtained; administered a questionnaire based EI test. Data obtained was analysed by ANOVA. Results: The 53.1 % participants were females and 46.9% males. The 73.1% were 17-18 years of age and 26.9% were 19-21 years old. The mean total EI score was 353.01. Among the emotional dimensions sensitivity was significantly low (p=0.047) in males (87.35±15.34) than females (92.49±9.071). The emotional competency was significantly low (p=0.055) in the elder group (153.59±26.99) than the younger one (160.61±15.762).Conclusions: The study identified certain gender and age differences in the EI and some weaknesses among first year medical students. Emotional sensitivity was significantly low in males and emotional competency was significantly low in the elder age group.
Penile duplication or diphallia: case report of a very rare disease
Authors: Srivastava Sandesh , Kumar Rahul , Sachdeva Money , Raj Richa , Singh Om Prakash
Published: March 2022

Diphallia or penile duplication is an extremely rare congenital malformation. The presentation of penile duplication and the number of other associated anomalies, range from a double glans from a penis with no associated anomaly up to complete penile duplication associated with multiple anomalies.
Comparison of rapid antigen testing and RT-PCR in the diagnosis of COVID-19 in Kashmir division
Authors: Magray Tahir A. , Jabeen Talat , Rather Rouf H. , Nazir Umar , Kumar Muneer A. , Wani Feroz A.
Published: March 2022

Background: Accurate diagnosis and widespread use of diagnostic tests with easy access is important to contain the spread of SARS-CoV-2. A Real-time reverse transcription polymerase chain reaction (RT-PCR) has high cost and can be performed in special laboratories. There have been several easy to perform rapid antigen detection tests developed and recommended to use at point of care for timely detection of positive patients and their isolation to limit the spread of infection. The aim of the study was to compare the cost effectiveness and the role of RT-PCR and rapid antigen testing in diagnosing different suspects of COVID-19.Methods: In this cross-sectional study the data of all the suspected cases who underwent COVID-19 testing over a period of seven weeks at divisional level was used for analysis.Results: The widespread use of rapid antigen testing makes it more cost effective in detecting COVID-19 cases than the highly sensitive and specific RT-PCR testing.Conclusions: Rapid antigen tests can be used as a screening testing tool in high-risk groups to identify the infected persons quickly and for preventing the transmission of infection particularly in low resource settings.
Bowel angina: Henoch-Schonlein purpura in adult patient based on clinical approach: a case report
Authors: Harnumningrat D. Putu Ayu Eramitha , Suryana Ketut
Published: March 2022

The GI involvement of Henoch-Schonlein purpura (HSP) has often been described as self-limiting, with no long term morbidity.GI manifestation is higher in adult patient. HSP is an autoimmune disorder characterized by the deposition of IgA immune complexes in the wall of small to medium size arteries. We present a 41-year-old patient with GI involvement (Bowel angina) in HSP case admitted at Wangaya Regional Hospital Denpasar. The case are treated by steroid and symptomatic treatment. Diagnosis is established through a clinical approach with EULAR criteria. The patient recovered with supportive treatment and had a favourable clinical outcome.
The psychological impact of the COVID-19 pandemic on physiotherapists in Sri Lanka: a cross-sectional online-based study
Authors: Samarakoon Jithmi N. , Wettasinghe Asha H.
Published: March 2022

Background: The COVID-19 pandemic is currently a severe challenge for healthcare workers, with significant implications for their mental health. Physiotherapy is one of the healthcare professions on the frontline managing this pandemic and is directly exposed to the virus. The aim of the study was to determine the impact of this pandemic on the psychological health of physiotherapists in Sri Lanka.Methods: A descriptive cross-sectional study was conducted among physiotherapists who were recruited from government and private hospitals via purposive sampling.  Depression-anxiety-stress scale-21 was used to assess psychological health and was distributed online.Results: The sample comprised 48 participants (males=33.3%; females=66.7%; age=30.2±3.8 years). The rates with extremely severe, severe, moderate and mild stress were 4.8%, 33.3%, 35.7% and 16.7% respectively and 9.5% of them had no stress perceived. No physiotherapists were found in normal or mild anxiety and depression categories. Moderate, severe and extremely severe anxiety levels were found in 9.5%, 28.6% and 61.9% of physiotherapists respectively. There were 28.6% physiotherapists with extremely severe depression, 19.0% with severe depression and 52.4% with moderate depression. There was a positive correlation and a significant association of stress with depression (r=0.876, p<0.001), stress with anxiety (r=0.780, p<0.001) and anxiety with depression (r=0.752, p<0.001).  Stress, anxiety and depression had no significant associations with age and gender (p>0.05). Fear of infecting family members was found as the main cause of stress (81%).Conclusions: Physiotherapists had elevated levels of anxiety, depression, and stress, highlighting the significance of systematically monitoring physiotherapists’ mental health and implementing supportive measures to improve their well-being during the crisis.
The effects of the COVID-19 lockdown on physical activity and sleep quality among university students: cross sectional study
Authors: Rehman Mehroze , Shaikh Areeba , Maheen Maryam , Nini Duaa , Zulfiqar Bushra , Fawad Bina
Published: March 2022

Background: Since the commencement of the lockdown, universities shifted their teaching online as an all-out effort to prevent transmission of the infection. This confinement has resulted in poor sleep quality (SQ) and low physical activity (PA) levels. The aim of this study is to determine the effects of the lockdown on SQ and PA levels and investigate their association amongst university students.Methods: 404 students filled out an online questionnaire, the International physical activity questionnaire (IPAQ) and the Pittsburgh sleep quality questionnaire (PSQI), which were used to assess both the parameters.Results: The pandemic resulted in participants indulging in reduced PA and poor global PSQI scores. It was found that females had worse global PSQI scores than males. Furthermore, a significant association was analyzed between SQ and PA where it was seen that participants with worse SQ were involved in low PA during lockdown.Conclusions: The lockdown has been an unfamiliar period in which many lifestyle changes were noted. This study bridges the gap existing in the health education sector and increases awareness among young adults regarding healthy lifestyle choices during this pandemic and forthcoming events.
A report of measles outbreak investigations conducted in two rural communities in a state in southwest Nigeria, 2021
Authors: Olaoye Itse , Fatiregun Akinola A. , Adewale Adejugbagbe , Modupeola Dosumu , Zubairu Mahmud , Adeleke David , Jacdonmi Tsemaye , Opeyemi Ekun , Adesokeji Aladesawe T. , Gboyega Famokun , Akinpelumi Adefesoye V.
Published: March 2022

Background: Despite the availability of an effective vaccine, measles outbreaks continue to occur. According to the World Health Organization (WHO), a confirmed outbreak of measles is defined as if any 3 or more of blood specimens collected from a local government area (LGA) and within one month, having reached the laboratory in good condition, is IgM positive. This paper describes the outbreak investigation in two rural communities in a southwestern state in Nigeria.Methods: This was a descriptive cross-sectional study design. The outbreak investigation was conducted by a team of multi-disciplinary experts. Detailed case investigation of index cases, active case finding, vaccination coverage surveys and social mobilization activities were carried out. Descriptive analysis was using Microsoft excel and quantum geographic information system (GIS) was used to represent cases geographically.Results: A total of 42 measles cases were detected based on the WHO measles case definition. Blood samples were collected from 12 of the suspected cases for IgM determination, out of which 7 cases were IgM+. Majority of cases were <5 years old. Sixty-nine percent of the cases had received Measles vaccine. Socio-cultural and traditional beliefs were not unconnected to the poor uptake of vaccination.Conclusions: We confirmed the occurrence of measles outbreaks in Akotogbo and Ala-Elefosu communities, in Ondo State. Both communities had suboptimal measles vaccination coverages, highlighting the need to strengthen routine immunization (RI) services but also immediately addressing the sociocultural factors responsible for poor health seeking behavior and utilization of RI and primary health care (PHC) services.
Preventive health practices and the mass media in view of the COVID-19 pandemic
Authors: Ofiaeli Ogochukwu C. , Ebenebe Joy C. , Nnamani Chioma P. , Ofiaeli Ogochukwu R. , Udigwe Ifeoma B. , Ofiaeli Chika I. , Chigbo Chisom G.
Published: March 2022

Background: The COVID-19 pandemic is a highly infectious disease caused by a novel corona virus. Preventive strategies are vital in controlling its spread and the mass media play a central role in disseminating needed information to the public. This study was carried out to determine how mass media has impacted on the health behaviour of individuals globally in view of the COVID-19 pandemic.Methods: This was a cross-sectional study targeting individuals in all inhabited continents of the world using an online anonymous pre-tested self-administered questionnaire.Results: The data of 485 respondents were analysed. Respondents who had heard of COVID-19 were 98.4% (477) and those who knew it was a disease caused by a new corona virus were 92.4% (448); 81.9% (397) believed COVID-19 had no cure. Information on COVID-19 was from the mass media 77.5% (376); 52.8% (256) was from the internet while 23.5% (114) was from the television. All information on COVID-19 were thought to be authentic and believable 58.8% of the time (285). Respondents would always use a face mask when away from home 47.8% (232), maintain at least an arm length from others in public 32.4% (157), wash their hands with soap and water 58.6% (284) or use an alcohol based hand-sanitizer 45.2% (219). Source of information was significantly associated with knowledge on COVID-19 (p=0.002).Conclusions: Preventive practices to militate against the spread of COVID-19 are suboptimal in view of the spread and severity of this pandemic. Most information on COVID-19 were obtained from mass media. The mass media can therefore be actively and better mobilized as means of disseminating vital information on COVID-19.