bluuebunny/crossref_metadata_2025 huggingface dataset:
Romper el silencio. Análisis discursivo de las denuncias de violencia contra las mujeres bajo el #MeLoDijeronEnLaFmed
Authors: Surroca Furtado Mag. Ana Laura
Published: December 2024

En agosto del 2020, en Uruguay se viraliza una oleada de denuncias de violencia contra las mujeres en diversos ámbitos sociales. El #MeLoDijeronEnLaFmed fue el primero en circular por Twitter visibilizando la violencia a la que estudiantes, profesionales y docentes se encuentran expuestas en el ámbito de la Medicina y, en particular, en la Facultad de Medicina de la Universidad de la República. El presente artículo, que forma parte de una investigación más amplia, se enfoca en el análisis de las denuncias, para responder si contribuyen a transformar el problema social estructural. A partir de un abordaje metodológico cuanti-cualitativo, se recopilaron y categorizaron 969 tuits que, posteriormente, se analizaron estadísticamente. A su vez, la investigación se encuentra transversalizada por un análisis crítico de los discursos emergentes. Se identificó que los discursos de denuncias tienen como objetivo visibilizar la violencia contra las mujeres, motivar a otras mujeres a denunciar y exponer un sistema que legitima la violencia a través de mecanismos de omisión y ocultamiento quecontribuyen a la impunidad de los victimarios. Se concluye que, si bien las denuncias en redes sociales contribuyen a visibilizar las distintas formas de opresión y dominación, su efecto transformador a nivel social y cultural puede verse limitado por los propios sesgos de las plataformas y la iniciativa de las instituciones para generar iniciativas, leyes y políticas que promuevan y acompañen un cambio.
PENGARUH PENERAPAN AKUNTANSI LINGKUNGAN TERHADAP CORPORATE SOCIAL RESPONSIBILITY: LITERATURE REVIEW
Authors: Rahmi Audina , Alfikri Rahmatullah , Rizka Nor Rahma , Ulfida Deafatunnizwa , Sinaga Ananda Sabrida Tora Br
Published: December 2024

Corporate Social Responsibility (CSR) mendorong perusahaan untuk mempertimbangkan pengaruh dari kegiatan operasionalnya terhadap komunitas dan lingkungan sekitarnya. Disisi lain, Akuntansi lingkungan hadir sebagai strategi untuk mengelola dampak lingkungan perusahaan dengan mengukur, mengungkapkan, dan mengelola biaya lingkungan secara efektif demi keberlanjutan bisnis. Penelitian ini bertujuan untuk mengeksplorasi secara mendalam kompleksitas hubungan antara akuntansi lingkungan dan CSR. Metode yang digunakan pada penelitian ini adalah literature review yang menerapkan pendekatan systematic literature review (SLR) yang komprehensif dan sistematis. Penelitian ini mengumpulkan data bersumber dari database akademik seperti Google Scholar, dan media lainnya dengan rentang waktu publikasi 2020-2024 yang membahas hubungan antara akuntansi lingkungan dan CSR. Hasil penelitian menunjukkan bahwa sebagian besar penelitian mengindikasikan hubungan positif dan signifikan antara akuntansi lingkungan dan CSR, yang terlihat pada berbagai aspek seperti ekonomi, sosial, dan lingkungan. Namun, tingkat efektivitas hubungan tersebut sangat dipengaruhi oleh sejauh mana perusahaan berkomitmen dalam melaksanakan kedua praktik tersebut.
Kata kunci: Corporate Social Responsibility (CSR), Akuntansi lingkungan, Systematic Literatur Review
Implementing Multigrade and Team-Teaching Approaches to Enhance Holistic Development for Slow Learners in Inclusive Classroom Settings
Authors: Saifuddin Tasneem , Huzaifa Arwa , Ishrat Sonia
Published: December 2024

The purpose of this action research is to better understand how multigrade and team-teaching methods affect slow learners' learning outcomes in inclusive classroom settings. Slow learners often face unique challenges in traditional classroom settings which allow students to receive the learning in passive form. It doesn’t handle specific needs of slow learners. The study focuses on how more individualized and encouraging learning environments can be created through collaborative teaching strategies to meet the various needs of slow learners. The research investigates the efficacy of multigrade teaching in which students from grade levels (4-7) are taught together and team teaching in which several educators work together in promoting academic advancement and engagement among slow learners. Assessments of students’ performance over a predetermined period of time, teacher and student feedback, and classroom observations are all included in the data collection process. Findings suggest that these approaches are also helpful are enhancing learning outcomes. The results are intended to give educators useful guidance on how to modify their pedagogical approaches in future.
Keywords: Multigrade Teaching, Team Teaching, Slow Learners, Inclusive Education, Collaborative Teaching
TO EVALUATE THE CLINICAL AND FUNCTIONAL OUTCOME OF AUGENTATION PLATING IN UNSTABLE INTERTROCHANTERIC FRACTURE
Authors: Verma Rahul , Jain Harshit , Kumar Gupta Rakesh , Bansal Arun
Published: December 2024

Introduction: Treating unstable intertrochanteric fractures presents challenges due to factors like poor fragment alignment, loss of posteromedial
support, reverse oblique fracture type, and severe comminution. While PFN implants are commonly used for these fractures, complications such as
screw migration, cut-out due to greater trochanteric comminution and coronal split, and insufficient lateral wall support may arise, often requiring
lateral augmentation. This study evaluates the clinical and functional outcomes of augmentation plat Objectives: ing (PFN combined with TBP) in
managing unstable intertrochanteric fractures. This prospective study included 40 patients (aged >18 Methods: ) with unstable intertrochanteric
(IT) fractures involving the lateral wall (primarily AO types A2 and A3), treated at Krishna Mohan Medical College, Mathura, UP, from May 2022
to October 2023. PFN combined with TBP was used for fixation. Patients were followed for two years. F Results: unctional outcomes, measured
using the Harris Hip Score (HHS), showed significant improvement (p=0.001), rising from an average of 80.70 at 3 months to 89.90 at 6 months.
Average blood loss was 164.20 ml, union occurred at an average of 14.88 weeks, and surgeries lasted about 97.80 minutes. No cases of non-union,
implant failure, screw migration, or "Z effect" were observed. However, complications included impingement in 3 patients, infection in 1, and hip
pain in 3, all managed effectively. Repairing the lateral trochanteric wall is crucial for stabilizi Conclusion: ng unstable intertrochanteric fractures.
Combining PFN with TBP provides effective fixation, promoting early healing and alignment while minimizing complications such as screw
migration and cut-out.
RISK FACTOR PROFILE AND ETIOLOGIC CLASSIFICATION (TOAST CLASSIFICATION) OF ISCHEMIC STROKE FROM A TERTIARY CARE CENTER FROM NORTHERN INDIA
Authors: Mushtaq Kanyu Sehar , Mushtaq Shah Mudasir , Ahmad Wani Mushtaq
Published: December 2024

Introduction: Stroke is an etiologically heterogeneous disease, identifying specific cause in every patient is important because
management and long-term strategies to prevent recurrences differ considerably. The TOAST classification has been found to be useful for
early stroke classification and planning management, but such studies are sparse in northern india. Aims And Objective : To determine etiologic
classification of ischemic stroke patients based on TOAST criteria in northern india and study risk factor profile of our stroke patients. Material
And Methods: Our study was an observational, prospective cohort study, conducted in university hospital in Srinagar Kashmir india. Patients
with Ischemic stroke (according to the World Health Organization criteria)1 or transient ischemic attack (TIA)1 were included in study.
Information on demography (age, gender), vascular risk factors were collected on admission. Etiological workup included routine blood
investigations, brain computed tomography/magnetic resonance imaging, carotid and vertebral doppler and echocardiograghic
examination. Results: In our study 800 patients with ischemic stroke were included, 54% (432) were males and 46% (368) were females
(Table 1). The peak age of incidence was 61-70 years; with 19.5% of cases in males and 18.5% of cases in female in this age bracket. On
classification of patients as per TOAST criteria we found that 160 (20%) of patients had atherothrombotic , 312 (39%) had cardioembolic, 176
(22%) had lacunar and 152 (19%) had stroke of undetermined etiology. Hypertension (59.4%) was the most common risk factor, followed by
smoking (52.6%), diabetes (30.1%), obesity (26.3%) and history of stroke (10.5%). Conclusion: This study gives a good insight into etiological
classification and risk factor profile of stroke patients in north india. The etiological classification helps in the immediate treatment decision
making; and risk factor profile helps in long term strategies like secondary prevention of stroke. In our study Hypertension and smoking were the
two most important risk factors in stroke patient whereas cardioembolic stroke was the most common type of stroke according to TOASTcriteria.
TOPICAL 0.5% BAKUCHIOL VS FACIAL EXERCISES IN IMPROVING THE SIGNS OF FACIAL AGEING. A RANDOMISED CONTROL TRIAL.
Authors: M Hariharasubramanian , T. S Rajashekar , Kumar K Suresh , K Hanumanthayya , B. V Vaishnavi , C Madhukiran
Published: December 2024

The natural process of aging is characterized by wrinkles, folds, ridges, and pigmentation in the skin that arise from factors such as photo exposure,
dehydration, and body mass loss. As people age, their skin becomes thinner, less elastic, wrinkled, unevenly pigmented, and has irregular textures.
Both endogenous (gene mutation, cellular metabolism, and hormones) and exogenous (UV, pollution, chemicals, and toxins) factors contribute to
the aging process of the skin. The seeds of the Indian plant Psoralea corylifolia (Babchi) are the primary source of bakuchiol, a pure meroterpene
phenol. It possesses antioxidant, anti-inflammatory, anti-proliferative, and anti-acne properties. It is well known to significantly enhance firmness,
pigmentation, and wrinkles. By stimulating underlying muscle growth, which has recently piqued interest in the community, facial exercise can
also revitalize the aging face. The goal of this study is to compare the efficacy of bakuchiol to facial exercises in treating common signs of cutaneous
aging.
A STUDY ON INSTANT EFFECT OF GUIDED IMAGINARY TECHNIQUES TO RELIEVE STRESS AMONG NURSING STUDENTS AT SELECTED COLLEGE IN TRIPURA.
Authors: Bhadra Debasmita , Lal Kahar Roshan
Published: December 2024

Background: Nursing scholars are frequently involved in notable extents of stress expected to the challenging nature of their academic and clinical
responsibilities. Effective techniques to manage stress are necessary for upgrading their academic performance and well-being. Objective: The
objective of this study is to evaluate the instant effectiveness of guided imagery techniques on stress relief among nursing students. Methods: A
quasi-experimental design was employed with a sample of 100 nursing students randomly ,a 30-minute guided imagery session was provided to the
sample group. Stress levels were assessed using the Perceived Stress Scale (PSS) before and immediately after the intervention. Data were
analyzed using descriptive statistics. Results: Pre-test result is showing mild stress among 17% students, moderate stress among 31% students and
52% were having high perceive stress. Post-test result reveals that mild stress among the students was 63%, moderate stress was 22% and only 15%
was found high perceive stress. Conclusion: Guided imagery techniques are successful in giving instant stress relief among nursing students.
Administering such techniques in educational settings may improve student well-being and adjustment mechanisms.
IMPORTANT TAKEAWAY FROM COVID-19 TRIAL ON NEBULIZATION AND INHALER USE TO DIRECT FUTURE DEVELOPMENTS IN RESPIRATORY DISORDERS
Authors: Sengupta Aditi Munmun
Published: December 2024

Introduction: Despite a lack of published evidence, clinicians are questioning whether nebulizers, an open medication reservoir, should be
avoided in favor of MDIs, an enclosed portable inhaler, due to potentially lower risk of viral transmission, since COVID-19 spreads primarily
through aerosolization of the virus. Aerosol generating medication delivery has been theorized to increase infection transmission. To Aims:
evaluate the clinical relationship between effectiveness of use of inhalers, and nebulisation from qRT-PCR positive patients admitted in hospital.
Materials And Method: The present study was a cross-sectional observational hospital-based study in West-Bengal, India. Total 436 patients
were included in this study. In Case, 6 (2.8%) patients had Inhalers. In Control, 14 (6.4%) patient Result: s had Inhalers. Association of Inhalers
with Group was not statistically significant (p=0.0670). In Case, 6 (2.8%) patients had Nebulisation. In Control, 57 (26.1%) patients had
Nebulisation. Our study showed that, most of patients had Nebulisation in Control Group compared to Case Group but this was statistically
significant (p<0.0001). Conclusion: There is little information on whether nebulized treatment increases the risk of SARS-CoV-2 infection.
Conclusively this research offers important new understandings of the interactions between two aerosol-based treatment modalities and will
suggest a suitable device that is customized to the individual needs and clinical circumstances of each patient. The COVID-19 pandemic has
provided important insights into the long-term pharmacological treatments for respiratory infectious illnesses.The potential for augmenting the
expertise of healthcare practitioners through the use of AI to improve patient outcomes and respiratory care practices in conjunction with
experimental data could result in more precise diagnosis and efficacious treatment plans.
COMPARATIVE EVALUATION OF ANTIBACTERIAL EFFICACY OF DIFFERENT ROOT CANAL IRRIGANTS WHEN ACTIVATED WITH DIODE LASER IN CANALS CONTAMINATED WITH ENTEROCOCCUS FAECALIS: AN IN VITRO STUDY
Authors: Amit Raj K. , Samba Shiva Rao P. , Pratap Kumar M. , Janavathi R. , Deepa J. , Sowmya K.
Published: December 2024

Aim: The aim of this in-vitro study was to evaluate the antibacterial efficacy of different root canal irrigants namely normal saline, 3% NaOCl, 2%
chlorhexidine, 0.2% chitosan with activation by diode laser in elimination of E. faecalis. A total Materials And Methods: of forty extracted single
rooted teeth were decoronated and canal patency was established by #15-K file followed by biomechanical preparation. Enterococcus faecalis
(ATCC 29212) was cultured and inoculated inside these root canals followed by incubation at 37C for 48 hours and divided into five groups (n=8)
namely Group 1- irrigation with normal saline along with diode laser activation, Group 2- irrigation with 3% NaOCl along with diode laser
activation, Group 3- irrigation with 2% chlorhexidine along with diode laser activation, Group 4- irrigation with 0.2% chitosan along with diode
laser activation, Group 5- diode laser activation alone and the samples from the canal were collected with sterile paper points and cultured to
evaluate the number of colonies formed after 24 hours of irrigation. The mean of number of colonies Results: formed after 24 hours were
significantly less in Group 3 higher number of colonies were noted in group 1. From this study, it was Conclusion: concluded that 2% chlorhexidine
along with diode laser activation showed the highest elimination of E. faecalis from the root canals.
UNLOCKING OXYGEN POTENTIAL: THE ROLE OF DEEP BREATHING ON VO₂MAX IN DIVERSE BMI GROUPS
Authors: Kumar Deepak , Ahmad Mudasir , Manzoor Abid , Rathod Sachin , Abbass Adil
Published: December 2024

Background: VO₂max, or maximal oxygen uptake, is a vital indicator of cardiovascular and respiratory fitness, yet research on the impact of deep
breathing exercises on VO₂max across different BMI categories remains limited. Our study addresses this gap by examining both immediate and
short-term effects of deep breathing on VO₂max among young adults with varying BMI levels.Aim: To evaluate the immediate and short-term
effects of deep breathing exercises on VO₂max in young adult males across different BMI groups.Methods: This cross-sectional study was
conducted among 100 male students aged 18-25 years. Participants were divided into BMI groups (normal weight, overweight, obese) and
underwent baseline VO₂max assessment using indirect calorimetry with the Bruce Protocol on Day 1. A deep breathing routine, performed twice
daily for 10 minutes, was continued over four weeks, with VO₂max reassessed on Day 2 (immediate effect) and Day 30 (short-term effect). Results:
Baseline VO₂max showed significant variation among BMI groups (p < 0.05). After a single deep breathing session on Day 2, all groups saw
VO₂max improvements, with the highest increase in the normal-weight group. By Day 30, all groups exhibited statistically significant VO₂max
gains (p < 0.05), especially among normal-weight participants. Conclusion: Deep breathing exercises positively impact VO₂max in young adults,
particularly in those of normal weight, suggesting an effective, non-invasive method for enhancing Cardiorespiratory fitness.
COLLISION TUMOR OF PAPILLARY THYROID CARCINOMA AND FOLLICULAR THYROID CARCINOMA – A CASE REPORT
Authors: Muthuramalingam Muthukumar , M Aarnica
Published: December 2024

Background: Papillary Carcinoma Thyroid and Follicular Carcinoma Thyroid are the most commonly differentiated thyroid malignancies, but the
occurrence of a collision tumor in the thyroid lobe is a very rare event. A 49-year-old female patien Case Presentation: t presented with swelling in
the anterior aspect of neck for 5 years. A fine needle aspiration cytology of the neck swelling done preoperatively revealed a cytological diagnosis
of Follicular Nodular disease. A total thyroidectomy was performed. Histopathological examination of the thyroidectomy specimen revealed a
collision tumor of Papillary Carcinoma Thyroid and Follicular Carcinoma Thyroid in the left lobe of thyroid and Papillary Thyroid
Microcarcinoma in the right lobe of thyroid with a background of Nodular hyperplasia. A case of a co Conclusion: llision tumor of Papillary
Carcinoma Thyroid and Follicular Carcinoma Thyroid in left lobe and Papillary Thyroid Microcarcinoma in the right lobe is a very rare event and
only few cases have been reported in the literature. However, co-existence of both the lesions can occur and can be successfully diagnosed with
histopathological examination.
SUBACUTE INTESTINAL OBSTRUCTION DUE TO EVISCERATION OF APPENDIX IN ABDOMINAL DRAIN – A RARE CASE SCENARIO
Authors: Mehta Alish Rajesh , Gupta Abhaya , Deshmukh Shahaji , Kothari Paras
Published: December 2024

Introduction: The prophylactic application of abdominal drains remains a debated topic. Though it has advantages of prevention of fluid
accumulation, drain related complications has created a cause of concern amongst the surgeons. A rare complication of evisceration of abdominal
organs has been noted following abdominal surgery. Case: We present a case of subacute intestinal obstruction due to evisceration of appendix in
abdominal drain in previously operated paediatric patient. Management included intraoperative drain removal, adhesiolysis with appendectomy.
Conclusion:In order to prevent drain-related complications, the prudent use of abdominal drains in children is essential.
ANTEGRADE AND RETROGRADE APPROACH IN PLANNING VARICOSE VEIN SURGERY USING EVLT : HOW I DO IT ?
Authors: Tiwari Priyanka , Saini Dhanesh , Mishra Shashank
Published: December 2024

Minimal Access Surgery for varicose vein can be done with USG guided catheter based endovenous ablation with RFA or Laser . Surgery can be
performed either with antegrade approach or retrograde approach.The aim of this study is to know the outcome of antegrade and retrograde
approach and also to analyse the anticipation of retrograde approach.
CORRELATION OF NEUTROPHIL LYMPHOCYTE RATIO, PLATELET LYMPHOCYTE RATIO AND MONOCYTE LYMPHOCYTE RATIO IN DIFFERENT STAGES OF BREAST CARCINOMA
Authors: Kumar Kamal , Srivastava Vaibhav , Varma Kachnar , Abhishek Rajul , Singh Sanjay
Published: December 2024

Background: Inflammation is crucial for cancer progression, with systemic inflammatory markers like NLR, PLR, and MLR associated with poor
prognosis in breast cancer, but their correlation with different stages remains unexplored. Aim: This study aims to explore the potential use of pretreatment NLR, PLR, and MLR as biomarkers in various stages of breast cancer. Methods: This was a prospective study was conducted over one
year in the Department of General Surgery, Moti Lal Nehru Medical College, Prayagraj. Atotal of 59 female patients with a confirmed diagnosis of
breast cancer, who met the inclusion criteria, were enrolled. Patients with prior neoadjuvant therapy, blood disorders, or autoimmune conditions
were excluded. Pre-treatment blood samples were collected to determine NLR, PLR, and MLR. Breast cancer staging was performed based on the
AJCC 8th edition criteria. Results:The study population consisted of 60 patients, with the majority aged between 40-49 years. The mean NLR was
2.54, PLR was 115.18, and MLR was 0.18. No statistically significant correlations were found between NLR, PLR, or MLR and the clinical stages
of breast carcinoma (p > 0.05). However, a statistically significant difference in monocyte counts across histological grades was observed (p =
0.011), indicating a potential role for monocytes in disease progression. Conclusion: The study found no significant correlation between NLR,
PLR, and MLR with breast cancer stages, but their variation in monocyte counts suggests further investigation into their role in tumor biology.
EVALUATION OF LEVELS OF PROTEINURIA IN ELDERLY PATIENTS OF CHRONIC HYPERTENSION ASSOCIATED WITH OTHER HORMONAL DISORDERS LIKE DIABETES AND THYROID
Authors: Likhith Garre Lakshmi Srinivasa , Dedeepya Kobaku , Deepthi P Raga , Dulipala Phanindra , Kiran Ravi
Published: December 2024

Background: Elevated BPleads to the risk of stroke and coronary heart disease, heart failure, peripheral vascular disease, renal impairment, retinal
haemorrhage, and visual impairment. Proteinuria is a marker of renal and cardiovascular disease and mortality in diabetic and nondiabetic
hypertensive patients. Aims and Objectives: (I) To estimate the levels of proteinuria in elderly patients with chronic hypertension associated with
other hormonal disorders like diabetes and thyroid. (ii) To determine risk factors associated with the disease. Settings And Design: A crosssectional study was conducted from April to June 2021 among 200 elderly patients attending General Medicine OPD at Katuri Medical College and
Hospital with a history of chronic hypertension in association with diabetes and thyroid disorders. Mid-stream urine samples were collected by
simple random technique from the patients and examined using the dipstick method for spot albuminuria. Data analysis was done using SPSS
software version 20. Results: Out of 200, 168 showed a positive result to urine dipstick and were sent for microalbuminuria estimation. There is a
statistically significant association between smoking and proteinuria; alcohol and proteinuria with p values of 0.043 and 0.039 respectively. There
is no positive correlation between BMI & proteinuria. Conclusion: There is a raise in the trend of proteinuria in hypertensive patients with
associated hormonal disorders.
OPTIC NERVE SHEATH DIAMETER – A MARKER FOR ASSESSING AND PREDICTING INTRACRANIAL PRESSURE IN HEAD INJURY PATIENTS
Authors: Vishnu Shankar M. Naaga , Dhanapandian Joel , Christopher John , S Vignesh Raja , Pazahaniyandi A.
Published: December 2024

Background: Elevated intracranial pressure (ICP) is a life-threatening complication of head trauma requiring prompt diagnosis. This study
evaluates the utility of optic nerve sheath diameter (ONSD) measurement via ultrasonography (ONUS) as a non-invasive bedside method to
predict elevated ICP in comparison to cranial CT. Methods: In this prospective observational study at a tertiary hospital, 120 adult head injury
patients underwent ONUS and cranial CT. ONSD measurements ≥5 mm were considered indicative of raised ICP. Clinical signs, CT findings, and
neurosurgical interventions were analysed. Sensitivity, specificity, and predictive values of ONUS for raised ICP and surgical necessity were
determined. Results:CTidentified elevated ICPin 87 patients. Mean ONSD was significantly higher in patients with CT-confirmed raised ICP(5.6
± 0.54 mm) compared to those without (3.3 ± 0.74 mm, p < 0.0001). ONUS demonstrated high sensitivity (97.7%) and specificity (96.8%) for
raised ICP, with a positive predictive value (PPV) of 98.8% and a negative predictive value (NPV) of 93.9%. Among 75 patients requiring surgical
intervention for intracranial hematomas, ONUS accurately predicted 85.2% of cases, with a PPV of 98.6%. Conclusion: ONUS provides a
reliable, non-invasive alternative to CT for predicting elevated ICP and guiding surgical decisions in trauma patients. Its portability, rapidity, and
cost-effectiveness make it particularly valuable in resource-limited and emergency settings. ONUS holds potential as a critical tool for triaging and
monitoring head injury patients.
A RARE CASE OF ACQUIRED CAPILLARY HEMAGIOMA OF MEDIAL CANTHUS OF RIGHT EYE
Authors: Kaustubh Dindorkar Avani , Amin Hrishikesh , Pai Vijay
Published: December 2024

Capillary Hemangioma is the most common benign periorbital tumor of childhood and infantile capillary hemangioma is shown to affect up to 5%
of infants below the age of 1 year.[1] Acquired capillary hemangioma of eyelid is very uncommon in adults and very few cases have been reported
in the literature till present.[4] Here we report a case of a 24-year-old female who came with growth in the inner aspect of right eye associated with
itching since 6 months. On examination, 8x7mm red colored mass was noted in the medial aspect of right eye, situated 10mm from nasal limbus
involving palpebral fissure and extending 2mm into the upper palpebral conjunctiva. The mass was soft in consistency, lobulated, did not bleed on
touch and was not tender. It was freely mobile and pulsations were absent. Patient was started on Topical steroids and Timolol Maleate 0.5%
eyedrops but there was no reduction in the size of the lesion and complaints persisted. The patient was managed with surgical excision of mass and
hemostasis with ligation of feeder vessels was done. HPE report of the excised intra-operative specimen was sent which was suggestive of capillary
hemangioma of medial canthus of right eye.
CLINICORADIOPATHOLOGICALASPECTS OF SOLITARY THYROID NODULE: A HOSPITAL BASED CROSS SECTIONAL STUDY IN A TERTIARY CARE CENTRE OF NORTH KARNATAKA.
Authors: Batra Pranav , Satihal S N , Karpoor Sanjay , Jacob Aghil
Published: December 2024

Introduction: Thyroid nodules are prevalent endocrine conditions worldwide, with rates ranging from 4% to 23%. While most nodules are benign,
the primary clinical concern is the potential for malignancy. Fine-needle aspiration biopsy (FNAB) is a critical diagnostic tool for distinguishing
between benign and malignant thyroid nodules. Objectives: 1. To observe the clinical profile of patients with solitary thyroid nodules. 2. To
observe the histological profile of patients with solitary thyroid nodules in the study group. 3. To determine the proportion of malignancy in solitary
thyroid nodules within the study group. Methods: This study involves a detailed examination of patients with solitary thyroid nodules. Clinical
profiles were documented, and histological analyses were conducted postsurgery to determine the nature of the nodules. FNAB was utilized for
preoperative diagnosis, and the accuracy of this method was evaluated. Results: The study found that the majority of thyroid nodules are benign.
Most affected age group was 41-50 years with higher prevalence in females (86.7%).Approximately 13.3% of solitary thyroid nodules were
malignant. The study also highlighted specific ultrasound features indicative of malignancy. Conclusion: Thyroid nodules pose a significant
clinical challenge due to the potential for malignancy. FNAB remains the most reliable diagnostic method, but careful clinical and radiological
evaluation is crucial. Improved diagnostic accuracy has led to better management of benign thyroid lesions and appropriate treatment strategies for
malignant cases.
GIANT GASTRODUODENAL TRICHOBEZOAR: A RARE CASE OF GASTRIC OUTLET OBSTRUCTION
Authors: Thummar Parth , Patel Asit
Published: December 2024

Background: Bezoars are collections of non-digestible matters that usually accumulates in stomach and can extend to small bowel. A trichobezoar
(concretions of condition despite being reported in many ages, they predominate in young females diagnosed with bezoars and are usually
associated with abnormal psychiatric behaviour of eating hairs and nails (trichophagia). Trichobezoar usually develop insidiously and hence at
presentation are large in size and can be complicated with potentially serious conditions such as gastric outlet obstruction, gastric bleeding,
intussusceptions, and perforation peritonitis. To assess the effect of laparotomy and anterior gastr Aim & Objective: otomy in the management of
trichobezoar. In this case study A female patient age 36 yrs., diagnosed and non-operated case of gi Material and Methods: ant gastro duodenal
trichobezoar with history of trichophagia, came to General Surgery OPD of L.G. hospital Ahmedabad with chief complaints of upper abdominal
pain with epigastric fullness, nausea and vomiting since last 4-5 months, associated with upper abdominal lump. Patient was managed by
exploratory laparotomy and anterior gastrotomy. Post operatively she recovered well and was discharg Observation: ed in satisfactory condition
with advice for psychiatric follow up. Bezoars, an already rare entity, can occasionally lead to gas Discussion: tric and small bowel obstructions.
Small collections of ingested hair build up in the intestinal tract causing significant symptoms. These obstructions sometimes be treated through
minimally invasive techniques but, in our case described, it is unlikely to have been treated any other way due to the substantial size of the
trichobezoar. The present paper intends to highlight the management of giant gastroduodenal trichob Conclusion: ezoar. After the treatment it can
be concluded the exploratory laparotomy and anterior gastrotomy can be used as effective treatment in the management of giant gastroduodenal
trichobezoar.
EVALUATION OF THE EFFECTIVENESS OF CHLORHEXIDINE MOUTHWASH ENRICHED WITH HYALURONIC ACID: A RANDOMIZED CLINICAL TRIAL
Authors: Gavhale Pandurang , Sah Nupur , Tarase Tulsi , Sarode Prashasti
Published: December 2024

Introduction: Hyaluronic acid is known to have anti-inflammatory, bacteriostatic, antioxidant and antibacterial action by inhibiting the growth
and attachment of various microorganisms. OBJECTIVE: To evaluate the efficacy of chlorhexidine mouthwash enriched with hyaluronic acid and
chlorhexidine mouthwash alone in subjects with mild to moderate gingivitis at baseline, 7 days and 21 days. Methodology: A randomized
controlled trial was conducted in 20 participants diagnosed with plaque induced gingivitis. Subjects were randomly allocated to the test group and
control group and assessed at three time points over the course of the study by the same operator. The follow-up of the patients were done after 7
days and 21 days and clinical parameters evaluated though plaque Index, gingival Index, and wound healing index. Results: It was found that CHX
mouthwash enriched with hyaluronic acid was more effective in maintaining gingival health as compared to CHX mouthwash alone. Plaque index,
gingival index and wound healing index showed statistical difference when compared with the control group (p value less than 0.05). Conclusion:
This study concludes that chlorhexidine mouthwash enriched with hyaluronic acid is more effective in reducing plaque induced gingivitis.
ENCEPHALOPATHY: A COMPREHENSIVE CASE SERIES OF FIVE PATIENTS WITH MRI INSIGHTS.
Authors: Gupta Rohit , Shrinuvasan Shrinuvasan
Published: December 2024

Encephalopathy encompasses a variety of brain dysfunctions caused by factors such as metabolic imbalances, toxins, infections, or ischemia. It
presents with symptoms like confusion, cognitive changes, and motor deficits. Radiological imaging, particularly MRI, is crucial for diagnosing
encephalopathy, revealing abnormalities like edema, ischemia, or metabolic changes. Common findings include hyperintensities on T2-weighted
and FLAIR images, and restricted diffusion on DWI, which help identify specific causes such as hypoxic-ischemic or metabolic encephalopathies.
Early diagnosis through imaging is essential for appropriate treatment and management.
COMPARATIVE EVALUATION OF THE EFFECT OF TWO DIFFERENT IRRIGATION PROTOCOLS USING ACTIVATED AND CONVENTIONAL NON-ACTIVATED IRRIGATION ON ELASTIC MODULUS OF ROOT DENTIN- AN INVITRO STUDY
Authors: Singh Neevika , K. B Jayalakshmi , I Bhat Sujatha , B Kasal Vignesh
Published: December 2024

Aim: To evaluate the effect of 2 different clinically used irrigation protocols on elastic modulus of root dentin from coronal to apical and from canal
lumen to outer root dentin and to evaluate the relation of this effect using 2 different irrigation methods. : Forty single-rooted premolar Methods
teeth were selected, cleaned with 0.01% NaOCl, and stored in distilled water at 4°C. The crowns were sectioned to standardize root length at 15
mm, and root canals were accessed with an ISO #10 K-type file. Working length was determined, and a closed environment was created by sealing
the root apex with wax. Teeth were divided into four groups (n=10) for different irrigation protocols using ProTaper rotary files up to size F4 and a
30-gauge needle.Groups:Group 1: Non-activated irrigation- 1a: 3% NaOCl + 17% EDTA + 3% NaOCl, with distilled water between NaOCl and
EDTA.1b: 9% HEDP (Twin Kleen) + 3% NaOCl mixture.Group 2: Activated irrigation with EndoActivator (same as Group 1 protocols but with
activation).After preparation, the roots were split, embedded in epoxy resin, and polished. Nano indentation testing measured the elastic modulus
at 2.5, 5.5, and 8.5 mm from the root canal at three depths per region, totaling 45 indentations per group. All irrigation protocols affected Results:
the elastic modulus of root dentine. 9% HEDP (Twin Kleen) + 3% NaOCl mixture showed highest elastic modulus values (P > 0.05) Conclusion:
Within the limitations of this study it was concluded that Different clinically used irrigation protocols affect the root dentin elastic modulus.
A RARE CASE REPORT OF ANTI-NMDAR ENCEPHALITIS
Authors: Karunakaran Indhuja , Arulnambi Thamil Pavai , G Balaji , S Hariharan
Published: December 2024

Anti-N methyl D aspartate receptor encephalitis (anti-NMDAR encephalitis ) is one of the most common forms of autoimmune encephalitis, that is
frequently underreported. It can be triggered by a variety of causes like ovarian teratoma, and viral encephalitis like herpes simplex encephalitis,
etc., Neuropsychiatric features, cognitive impairment, seizures, and movement disorders are some of the various clinical manifestations of this
autoimmune encephalitis. Females are affected more often than males. A high index of suspicion based on clinical features is needed to diagnose
this autoimmune condition. If identified early and treated appropriately, good outcomes can be expected in a majority of cases. This case report
details anti-NMDAR autoimmune encephalitis provoked by a preceding mumps infection in a thirteen-year-old boy. His predominant
manifestations were a combination of movement disorders including myoclonus and chorea. He was treated with immunotherapy and improved
clinically over a span of one month.
A CASE REPORT OF EPIDERMOLYSIS BULLOSA PRURIGINOSA (EBP) OF ESOPHAGUS IN A YOUNG BOY – RARE CASE REPORT
Authors: Kumar P Arun , Mathew Praveen , Ramesh Aruna Dakoz , Y Kanni Prashant , Chandrababu D , Naidu B Sidhartha
Published: December 2024

Introduction: Epidermolysis bullosa is a genetically inherited disorder which can be autosomal dominant or recessive in inheritance. It is
characterized by skin blistering and scarring after a minor trauma. It affects around 0.2 cases per 1 million people. Epidermolysis bullosa
pruriginosa (EBP) is even rare. It can involve ears, eyes, nose, genitalia or gastrointestinal tract (GIT). GIT insult results from the trauma caused by
the passage of solid or hot foods. And when the lesions heal, results in scarring with segmental stenosis. A 15-year-old boy presented with Case:
history of difficulty in swallowing for 6 months, initially for solids followed by difficulty to swallow liquids also. He complained a weight loss of
5kgs in 6 months. Parents gave the history of blistering skin disease since the age of 1 year. Barium swallow was done and showed a long segment
stricture of mid and distal esophagus. Skin biopsy and genetic testing were done which were s/o epidermolysis bullosa pruriginosa. Endoscopic
CRE balloon dilatation was done and oral budesonide therapy was given after which he showed significant symptomatic improvement.
Conclusion: In conclusion, we report a very rare case of Epidermolysis bullosa pruriginosa (EBP) presented with mid esophageal stricture treated
by CRE balloon dilatation and oral Budesonide therapy. Patient is doing well after 8 months.
CASTLEMAN'S DISEASE PRESENTING AS A RARE ABDOMINAL WALL MASS: A CASE REPORT AND SURGICAL APPROACH
Authors: Patil Amit , Karna Vinit , Patankar Shilpa , Bunglowala Seema
Published: December 2024

Castleman's disease (CD) is a rare, nonclonal lymphoproliferative disorder of uncertain etiology that affects lymph nodes. It is classified as either
unicentric (localized) or multicentric (systemic) based on clinical and radiological findings. Pathologically, CD is further categorized into hyaline
vascular, plasmacytic, or mixed subtypes. Unicentric CD typically presents in the 3rd to 4th decade, while multicentric CD is more common in the
5th to 6th decade, often associated with immunocompromised individuals, especially those with HIV and HHV-8. We present the case of a 45-yearold male with a long-standing abdominal mass, diagnosed as unicentric Castleman's disease. Surgical excision led to complete resolution with no
recurrence on follow-up. This report highlights the diagnostic challenges and emphasizes the importance of histopathological confirmation in
managing CD.
On the maxillary dentition of the Western whip snake, Hierophis viridiflavus (Lacépède 1789): heterodonty is not opisthoglyphy
Authors: Di Nicola Matteo Riccardo , Delfino Massimo
Published: December 2024

The Western whip snake (Hierophis viridiflavus) is a colubroid snake typically considered aglyphous and non-venomous, although this is currently a subject of debate. Indeed, the maxillary dentition of this species has recently been described as opisthoglyphous due to the presence of enlarged rear maxillary teeth, reportedly characterised by prominent grooves and ridges. Aiming to test the actual presence of these structures and provide a clearer characterisation of the species' maxillary dentition, we analysed 17 dry-prepared and disarticulated H. viridiflavus specimens using both scanning electron and traditional microscopy. The imaging confirmed the presence of posterior, enlarged maxillary teeth displaying a distal carina, highlighted by shallow longitudinal inflections on the postero-labial and postero-lingual surfaces of the tooth. Nonetheless, the analysis revealed the consistent absence of the meso-labially placed groove typical of opisthoglyphous taxa. Based on the results of our study, the maxillary dentition of the Western whip snake is heterodont, specifically opisthomegadont, and is confirmed to be aglyphous.
Normal Pressure Hydrocephalus in a Girl Child with Blake's Pouch Cyst
Authors: Choudhury Krishnendu
Published: December 2024

A 4 yrs old baby girl presented with history of gait instability with recurrent fall without loss of consciousness since last 1 yr. with recently having urinary and fecal incontinence off and on after being continent earlier. She did not have any febrile illness or convulsion or vomiting. There was no history of consanguinity or birth injury. Examination revealed no facial dysmorphism; her speech and language were delayed with borderline delayed developmental milestones. Her gait was ataxic with hesitant steps, magnetic in nature characteristic of frontal gait disorder. She was provisionally diagnosed as normal pressure hydrocephalus. MRI brain images revealed infracerebellar Blake's pouch cyst with dilatation of lateral, 3rd and 4th ventricles with normal subarachnoid bathing. She was referred to pediatric neurosurgeon for assessment and intervention for possible 3rd ventriculostomy.
Is the Shoestring Bridge Technique an Effective Option to Treat Massive Rotator Cuff Tears?
Authors: Bizarro Pedro , Bernardino Daniel , Almeida João Fragoso de , Ramos Jorge Teixeira , Ramos Acácio , Neto Pedro Quinaz , Gomes Diogo Silva , Cartucho António
Published: December 2024

Objective: Numerous surgical strategies have been proposed to treat non-arthritic irreparable massive rotator cuff tears and the comparative efficacy of these treatments remains unclear. The purpose of our study is to clarify the role of this type of repair. Methods: We report the medium-term clinical outcomes of a retrospective study that includes 21 patients submitted to an arthroscopic side-to-side repair technique in the configuration of a shoestring using one single suture anchored to the tendon footprint, for large and retracted posterosuperior rotator cuff tears. Results: All the range of motion measurements have significantly improved after surgery, except external rotation. A mean Constant score of 68.8 was obtained (SD 15.46). Both functional scores (QuickDASH and ASES) have improved significantly (QuickDASH Z = -3.877, p = .001; ASES Z = -4.016, p = .001). The absence of symptomatic improvement was defined as failure and a rate of 20.8% was found. Conclusions: According to our findings, this technique can offer good results in terms of range of motion and functional scores. It should be seen as an effective option for large and retracted posterosuperior rotator cuff tears in which an anatomic primary repair cannot be achieved. Other advantages are its low potential for complications, low cost and not compromising future treatment options that may be required in case of failure.
Functional Outcomes of Femoral Shaft Fractures in Children Treated with Titanium Elastic Nailing
Authors: Uddin Dr. Md. Minhaz , Islam Dr. Tasmia , Hossain Dr. Md. Sharif , Rashid Dr. Md. Harun Are , Bose Dr. Barshan , Rana Dr. Md. Sohel
Published: December 2024

Background: Pediatric femoral shaft fractures are common injuries with significant implications, requiring careful management to stabilize the fracture, maintain alignment, and reduce complications for the child and their family. This study aims to evaluate the functional outcomes of femoral shaft fractures in children treated with Titanium Elastic Nailing (TEN), focusing on its effectiveness as a minimally invasive treatment modality. Aim of the Study: The aim of the study was to evaluate the functional outcomes of femoral shaft fractures in children treated with titanium elastic nailing. Methods: This prospective observational study was conducted at the Department of Orthopedics and Traumatology, Dhaka Medical College Hospital, Dhaka from July 2017 to June 2019, involving 30 children aged 6-14 years with mid-diaphyseal femoral fractures. Preoperative evaluations and postoperative management, including limb rest, exercises, antibiotics, and pain management, were conducted. Data were analyzed with SPSS version 17, and ethical approval was obtained. Results: Among 30 patients, 66.7% achieved union within 7-10 weeks and 90.0% full weight bearing within 8-12 weeks. Only 6.7% had minor complications, and 76.7% showed no leg length discrepancies or malalignments. Most patients (70.0%) had knee motion >130°, with 73.3% returning to pre-injury activities. Flynn’s TEN Scoring Criteria indicated predominantly excellent outcomes with minimal complications or pain. Conclusion: Titanium elastic nailing effectively treats pediatric femoral shaft fractures, promoting timely recovery and excellent functional outcomes with minimal complications.
Intra-Abdominal Desmoplastic Small Round Cell Tumor: A Case Report and Review of Literature
Authors: Houzi Asmaa , Driouech Maroua , Wassi Anas El , Mellouki Abderrahmane , Chekrin Tarik , Bouchbika Zineb , Benchakroun Nadia , Jouhadi Hassan , Tawfiq Nezha , Sahraoui Souha
Published: December 2024

Introduction: Desmoplastic small round cell tumor is an uncommon and aggressive sarcoma affecting young males, its symptomatology is non-specific. Abdominal and pelvic CT scans help to orient, while anatomopathological and cytogenetic studies provide a definitive diagnosis. Case Report: We report a case of a 21 years old male who complains of left hypochondral pain, physical examination revealed a painful mass on left hypochondrium. Abdominal computed tomography revealed intersplenorenal mass and one on left iliac fossa. He underwent a laparoscopic exploration and the resultant biopsy revealed a desmoplastic small round cell tumor. He underwent a neoadjuvant chemotherapy followed by surgery and consolidative radiochemotherapy with no recurrence during the 6 months follow up. Discussion: Desmoplastic small round cell is very rare mesenchymal tumor, it is described as a result from the chromosomal translocation t (11; 22) (p13; q12) by Gerald and Rosai in 1991, it affects usually young male, patients consult for abdominal pain or mass, Computed abdominal and pelvic tomography is the first examination to request, it allows diagnostic orientation and classification, while exploratory laparoscopy and biopsy establish diagnosis with certainty showing Well-defined islands of small, round cells, embedded in abundant desmoplastic stroma with the expression of epidermal markers (cytokeratin, Epithelial Membrane Antigen), mesenchymal markers (desmin, vimentin) and neural markers (neuron specific enolase reactivity). The current treatment is based on neoadjuvant chemotherapy followed by surgery and consolidative radiochemotherapy, but the prognosis is poor. Conclusion: Desmoplastic round cell tumor is an uncommon tumor of the young subject, it must be evoked in the presence of adequate imaging, the multimodal treatment is the current standard, but the prognosis remains poor. Future genetic therapies focused on developing targeted immunotherapy, might promise more optimistic ...
A Metachronous Pancreatic Metastasis of a Clear Cell Renal Carcinoma, Case Report and Literature Review
Authors: Debbagh A. , Slimani K. Alaoui , Sbitti Y. , Tanz R.
Published: December 2024

Introduction: Pancreatic metastases are rare (2 to 3% of pancreatic tumors) [1]. Among them, metastases pancreatic kidney cancers have a specific diagnostic, prognostic and therapeutic particularity. We report the case of a patient who presented with a pancreatic tumor revealing renal carcinoma. Case Report: 60-year-old patient operated on ten years ago for nephrectomy related to renal cell carcinoma. She currently presents with a pancreatic tumor whose biopsy is related to pancreatic metastasis of clear cell renal cell carcinoma. Conclusion: pancreatic metastases from clear cell adenocarcinomas of the kidney are rare and may occur several years after nephrectomy. They are often accessible to curative surgical treatment allowing good long-term survival.