bluuebunny/crossref_metadata_2025 huggingface dataset:
Algumas considerações para o desenho de uma unidade didática sobre o parlache em Medellín (Colômbia)
Authors: Cardona Zapata Laura
Published: April 2022

Neste artigo, se apresentam os resultados de um trabalho com a metodologia qualitativa de cunho interpretativista feito para refletir sobre o momento atual de ELE na Colômbia e proponer uma unidade didática baseada na perspectiva acional (Puren, 2012) para a abordagem de aspectos sociais de Medellín em estudantes de níveis avançados. O resultado que foi obtido do desenho do material permitiu explorar o ensino do espanhol a partir de novas didáticas e perspectivas, especificamente a partir de uma perspectiva crítica e acional.
Buscando votos: un estudio comparativo de anuncios electorales dirigidos a la comunidad latinx en la campaña presidencial de 2020 en los Estados Unidos
Authors: Moreno de Nicolás Sara
Published: April 2022

El principal objetivo de este trabajo es realizar un estudio comparativo-descriptivo mediante el análisis de anuncios electorales televisivos de los candidatos presidenciales estadounidenses de 2020, Donald Trump y Joe Biden, dirigidos a la comunidad latinx. Se analiza el discurso de los spots como un conjunto formado por elementos semióticos y lingüísticos, atendiendo a recursos verbales, visuales y acústicos. Este estudio demuestra que, partiendo de los elementos comunes en ambas campañas electorales, se identifica un perfil de valores y rasgos distintivos de los latinx en Estados Unidos.
El campo de la novela en el caribe colombiano después de la literatura del boom
Authors: López Noriega Luis Fernando
Published: April 2022

En este artículo estudiamos el campo de producción cultural en el Caribe colombiano. En principio, abordamos el campo literario y su grado de autonomía. Partiendo de ese concepto, resaltamos los polos autónomo y heterónomo. Luego, establecemos el grado de competencia por la legitimidad (Bourdieu, 1995), donde ubicamos a Gabriel García Márquez en una posición central. Finalmente, analizamos los habitus de los ocupantes de las otras posiciones. Desde esa noción, determinamos las circunstancias mediante las cuales Manuel Zapata Olivella, Roberto Burgos Cantor y Germán Espinosa entraron al campo literario, encontraron su capital simbólico y propusieron una reconfiguración cultural del Caribe colombiano.
Peculiarities of Ownership to Sunken Property Located in the Territorial Waters of the Russian Federation
Authors: Koval V. N.
Published: April 2022

The paper is devoted to the analysis of various aspects of the legal regulation of ownership to sunken property located within the territorial waters of the Russian Federation. The following areas of application of the rules governing the ownership to sunken (submerged) property are considered as the subject of regulation of ownership to sunken property and geographical arrangement in relation with regard to maritime areas. The author justifies the expediency of the Russian Federation’s accession to the International Convention on the Removal of Wrecks of 2007 that regulates the universal mechanism of liability insurance for the removal of wrecks. It is concluded that it is necessary for Russian courts to take into account the judicial and arbitration practice of dispute resolution arising from the application of unified norms that have accumulated in the States Parties to international treaties on the law of the sea. Numerous legal gaps have been identified in the special legal regulation of ownership of sunken property that are proposed to be eliminated by legislative amendments. The author dwells on the necessity of defining a clear procedure for the removal and destruction of sunken objects, ways of exercising the rights of persons who accidentally raised sunken property, as well as consideration of the issue of submerged ships and vessels that plays an important role in the protection of the environment from pollution by harmful substances and ensuring the safety of navigation at the state level by adopting a federal program in Russia on raising, removal, disposal of sunken property also as an objective before different departments. As a conclusion, the author emphasizes the need to register all submerged objects in the territorial waters of Russia on a specialized account in order to prevent unauthorized work on such objects, declare by a special government decree all submerged ships and vessels containing the remains of the soldiers killed in action as military graves, as well as conduct systematic scientific and technical studies of all submerged objects in order to identify the real environmental safety of the marine environment.
Formation of a Quasi-Marxist Legal Understanding in Soviet Legal Science in the 1920s–1930s
Authors: Sheptalin A. A.
Published: April 2022

The paper is devoted to one of the clearest examples of misconceptions and falsifications known to the science of the theory of state and law — the ongoing identification of the Soviet (Marxist-Leninist) legal understanding with Marxism. The relevance of the topic is also due to the need to correct the prevailing ideas about «Marxist» (materialistic) concepts of legal understanding and the theory of the origin of the state and law. The subject of the study is the process and general causes of the distortion of the Marxist legal understanding in Soviet jurisprudence in the 1920s-1930s. The aim of the work is to identify the main differences between the authentic Marxist legal understanding and the quasi-Marxist Soviet legal understanding, as well as to attract attention of the scientific community to the problem of their unjustified identification.

Based on a wide range of legal literature of the early Soviet period, the course of the development of the Marxist debate on the understanding of law and the reasons for the appearance of the quasi-Marxist definition of law from 1938, which became the ideological basis and model for subsequent definitions for several decades, is considered. The main contradictions between the Marxist and Soviet understanding of law are shown, primarily related to the «nationalization» of the institution of law, the identification of law and law, ignoring the production and economic conditionality of law, as well as recognition of the key role of state power, force and coercion in the genesis of law.

According to the author, the authority of the Lenin’s works, then Stalin’s ones initially influenced the Soviet legal understanding. It later developed along a simplified positivist path and significantly distanced itself from Marxism, because the Soviet theory of state and law was formed post factum on the foundation of state legal practice, consolidating and sacralizing decisions developed during not scientific, but political discussion.
Rasch Analysis of the Physical Activity Enjoyment Scale Among 9th- and 10th-Grade Students
Authors: Shimon Jane , Gao Yong
Published: April 2022

Rasch Model analysis was used to evaluate construct validity and reliability of the Physical Activity
Enjoyment Scale (PACES) in an adolescent population. A total of 349 9th and 10th graders (180 male; 169
female), aged 13 to 15 years (M = 14.13 SD = .793), completed the 18-item PACES scale at the conclusion of
physical education classes. Responses to PACES items were analyzed using Rasch partial credit model. Of the
18 PACES items, five were identified as misfit items and were removed. The remaining 13 good-fit items
(difficulty level ranged from -0.81 for Item #10 to 0.66 logits for Item #18) demonstrated one dimension
which accounted for 62.4% of the variance, with the person separation index was 3.01; however, the 6-point
Likert response format was not appropriate for some remaining items. No items presented differential item
functioning (DIF) between genders. Rasch analysis supported the construct validity and reliability of PACES
to assess PA enjoyment among 9th and 10th grade high school students after removing five misfit items.
Islamic Bank Customer Satisfaction and Services During the COVID-19 Pandemic
Authors: Riduwan Riduwan , Setyono Hendro , Yuliana Monikka , Jannah Siti Salma Miftahul
Published: April 2022

The COVID-19 pandemic has negatively impacted the Islamic banking industry by increasing non-performing financing, decreasing savings, and weakening annual performance. This condition, if not anticipated, can lead to bankruptcy. Therefore, customers need to get the best service so that their loyalty is maintained even though the conditions of Islamic banks are difficult. This study analyses customer satisfaction toward Islamic banks services during the COVID-19 pandemic. The respondents are 308 customers. The sampling method uses purposive sampling, and the data processing uses the Customer Satisfaction Index (CSI) model. The results of this study indicate that customers are satisfied with Islamic banks' services. So, they are willing to recommend other parties to become bank customers, not transfer funds to other Islamic banks, will not move to conventional banks, and not withdraw deposits. However, this study has limitations because it has not included social performance as a factor that affects loyalty. In addition, most respondents are Muslim, so future research is recommended to analyze satisfaction by including these two factors. Furthermore, these findings provide value for policy implications and recommendations for Islamic banks and stakeholders to increase satisfaction and service.
Evaluation of dexmedetomidine as adjuvant to 0.5% ropivacaine in comparison to dexamethasone in supraclavicular block
Authors: Mokkarala Rama Rao , Badugu Jalaja Praveena
Published: April 2022

Background: There are many adjuvants imparting great efficacy and safety to the anaesthetic process. Drugs like steroid, alpha-2 agonist, opioid, epinephrine, midazolam, and naloxone are certain adjuvants used for potentiating block. The aim of the study was to compare the effect of dexmedetomidine and dexamethasone as adjuvant to ropivacaine on various postoperative parameters.

Methods: All the patients were scheduled for elective surgery for forearm and hand under USG guided supraclavicular block. The randomisation was achieved by using block randomisation technique. The patients were randomly divided in to two groups. Group DM were received 15 ml of 0.5% ropivacaine with 100 µg one ml dexmedetomidine and group DS were received 15 ml of 0.5% of ropivacaine with 8 mg dexamethasone. Drug solution was prepared by same individual and was not part of study. Parameters observed were onset of motor block, onset of sensory block, duration of sensory block, duration of motor block.

Results: The mean duration of analgesia was significantly prolong in dexmedetomidine (group DM) than dexamethasone group (DS) (1142.47±28.32 min vs 1045.95±78.55 min). Time for first rescue analgesic requirement was significantly prolong in dexmedetomidine (group DM) than dexamethasone group (DS) (17.44±2.41 hour vs 13.54±1.98 hours).

Conclusions: The duration of sensory and motor block was significantly prolonged in Group DM as compared to Group DS. We have observed that the mean duration of analgesia was significantly prolonged in dexmedetomidine than dexamethasone group. Time for first rescue analgesic requirement was significantly prolonged in dexmedetomidine than dexamethasone group. There was no difference in adverse drug reaction between two groups.
Early termination in single-parameter model phase II clinical trial designs using decreasingly informative priors
Authors: Wang Chen , Sabo Roy T. , Mukhopadhyay Nitai D. , Perera Robert A.
Published: April 2022

Background: To exchange the type of subjective Bayesian prior selection for assumptions more directly related to statistical decision making in clinician studies and trials, the decreasingly informative prior (DIP) is considered. We expand standard Bayesian early termination methods in one-parameter statistical models for Phase II clinical trials to include decreasingly informative priors (DIP). These priors are designed to reduce the chance of erroneously adapting trials too early by parameterize skepticism in an amount always equal to the unobserved sample size.

Method: We show how to parameterize these priors based on effective prior sample size and provide examples for common single-parameter models, include Bernoulli, Poisson, and Gaussian distributions. We use a simulation study to search through possible values of total sample sizes and termination thresholds to find the smallest total sample size (N) under admissible designs, which we define as having at least 80% power and no greater than 5% type I error rate.

Results: For Bernoulli, Poisson, and Gaussian distributions, the DIP approach requires fewer patients when admissible designs are achieved. In situations where type I error or power are not admissible, the DIP approach yields similar power and better-controlled type I error with comparable or fewer patients than other Bayesian priors by Thall and Simon.

Conclusions: The DIP helps control type I error rates with comparable or fewer patients, especially for those instances when increased type I error rates arise from erroneous termination early in a trial.
Effectiveness of a psycho-educational intervention for people with suicidal conduct in the prison environment, N’viu project: a randomized control trial
Authors: Foguet-Boreu Quintí , Capdevila-Capdevila Manel , Riesco- Miranda Lola , Torres Ana Sanjuan , Framis-Ferrer Berta , Pons-Baños Judit , Muñoz Saray Valdivieso
Published: April 2022

Background: Suicide rates are higher in the prison environment than in the general population. Prevention involves strategies to promote mental health, early diagnosis, treatment and identification of precipitating factors. The aim of this study is to evaluate the effectiveness of a psychoeducational group intervention performed by rehabilitation professionals to decrease the number of suicidal behaviors in the penitentiary environment.

Methods: This study has been designed as a multicentric, randomized, two parallel-group, controlled trial. The study population will be male and female inmates of nine prisons of Catalonia (Spain). The primary outcome will be the total number of suicidal behaviours for 12 months of follow-up. Secondary outcomes will be suicide risk evaluated with the international neuropsychiatric interview (MINI); the severity of suicidal ideations assessed with the Columbia-suicide severity rating scale (C-SSRS), the presence of depressive and anxiety symptoms [Hamilton depression rating scale (HDRS) and Hamilton anxiety rating scale (HARS)] and health-related quality of life (EQ-5D). Other variables will be clinical and socio-demographic. Intervention will consist of 17 psychoeducation sessions for the intervention group and information on suicide for the control group. 

Conclusions: This project aims to assess the effectiveness of a psycho-educational intervention on reducing the number of suicidal behaviours in the prison environment. If positive, the prison community will have a new tool to curb suicide in prisons.

Trial registration: The trial was registered on clinicalTrials.gov on 19 January 2022 (NCT05195554).
A study of clinical profile and outcome of COVID-19 in children
Authors: M. V. Nagaraj , Chikkanna Somashekhar , Muniraju Geetha Nithin Raj , Shivegowda Sushma Gowda , Govindappa Monika
Published: April 2022

Background: COVID-19 has become a major public health crisis around the world. This study aimed at identifying the different clinical presentations of children who were tested positive for SARS-COV-2.Methods: Descriptive and prospective study of the children who were seen over the fever clinic and were admitted to the Sapthagiri institute of medical science and research centre over a period of 4 months from November 2021 to February 2022.Results: Among the 251 children admitted to the hospital majority of them were males 52.5% and the age group of 1-5 years were highest affected 46.2%. The most common symptoms noted were fever 60.5%, followed by pain abdomen 45.8%, vomiting 43.8%, running nose 39%, cough 38%, diarrhoea 30.6%, decreased appetite 26.7% and the least common symptom was skin rash 0.3%. Children with comorbidites had higher risk of ICU admission. No deaths were noted during the study period.Conclusions: The study concludes that males and children of age group 1-5 years were more affected. Children with co morbidities were more severely affected. children who were positive presented with other system involvement like gastrointestinal system. Household contact were the make cause of infection among children.
Study of complications of congenital heart diseases with special reference to pulse oximetry and anthropometry
Authors: Mehta Charul R. , Chaudhari Dhruvika G.
Published: April 2022

Background: This study was done to determine prevalence of congenital heart disease (CHD), its complications especially effect on growth parameter and role of pulse oximeter as a diagnostic modality.Methods: This study was a hospital based prospective observational study conducted on hospitalized children in paediatric wards and PICU of Civil hospital, B. J. medical college Ahmedabad, for one year which is a tertiary care teaching hospital.Results: Prevalence of CHD in our institute was 1.2% during the period of one year. Signs of failure (tachycardia, tachypnoea, pallor and hepatomegaly) were seen in more than 50% of patients. Nearly 29.5% patients had hypoxia on arrival on pulse oximeter reading while 74% patients had normal saturation. Complications commonly found in CHD are congestive heart failure and growth failure.Conclusions: CHD is a chronic disease and has all its consequences; complications are commonly found in congenital heart diseases are congestive heart failure and growth failure. Pulse oximeter can be used as screening test but not as the reliable diagnostic method.
Variable manifestations of minor blood group incompatibility
Authors: Chaudhary Pankaj , Devi Risha , Charan Gugloth Krishna , Syed Zikra , Kaur Daljit , Priyadarshi Mayank
Published: April 2022

In settings with adequate coverage of anti-D immunoglobulin, minor blood group incompatibility has become an important cause of hemolytic disease of the newborn (HDN). We presented a series of cases of HDN of varying severities caused due to presence of anti-E and anti-C antibodies. Two neonates with anti-E antibodies developed jaundice requiring intensive phototherapy, while the course of the third neonate born to mother with Rh D isoimmunization was complicated by presence of anti-C antibodies, who needed double volume exchange transfusions for jaundice and packed red cell transfusions for anemia. Hearing screening and neurological examination at discharge were normal for all three neonates. These cases highlighted the need for appropriate testing for minor blood group incompatibility in unusual cases of HDN to initiate timely therapy and prevent neonatal morbidity and mortality.
A rare case of early onset childhood schizophrenia with predominant negative symptoms
Authors: Raja Sravya , Kotturu Mounika Katyayani , Kandriga Vamsi Krishna Reddy , Potla Vamsi Krishna
Published: April 2022

Early onset childhood schizophrenia (<13 years) is often a rare disorder with an estimated prevalence of 1 in 30,000 children. The disease is characterized by hallucinations, delusions and cognitive impairments. It tends to present insidiously with a premorbid period of developmental delay or regression with declining academics. Often, the diagnosis of early onset schizophrenia is missed or sometimes misdiagnosed as pervasive developmental disorders. We here present a rare case of 10-year-old boy who showed behavioural abnormalities suggestive of psychosis.
A study of the course and outcome of COVID-19 patients with acute kidney injury admitted in an intensive care unit
Authors: Konnur Abhishek , Rao Gurukanth , B. Jayaprakash
Published: April 2022

Background: COVID-19 is a disease which predominantly affects the lung resulting in ARDS and respiratory failure. We described the factors associated with the development of AKI (acute kidney injury) and explored the relation of AKI and mortality in patients with severe COVID-19 admitted in intensive care unit of our hospital.Methods: A retrospective observational study was conducted in our hospital during the period of April 2021 to June 2021. 182 patients were selected for the study. Ethical committee approval was obtained. Data was analysed using SPSS 20.0Results: Among the 182 patients, AKI occurred in 99 (54%) patients; 18 (18%) of the patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 56%, 22% and 21%, respectively. Upon analysis, TC, CRP, D-dimer were significantly higher in patients with AKI compared to non-AKI. Of the 99 patients with AKI, urine studies showed 59% as having proteinuria and 22% having haematuria. Independent predictors of severe AKI were male gender and higher serum potassium at admission. In-hospitalized patients’ mortality was 37% among patients with AKI versus 5% among those without AKI.Conclusions: AKI complicated the course of nearly 1 in 3 patients hospitalized with COVID-19. Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities which are risk factors for mortality in patients with COVID-19 in the general population are also related to in-hospital mortality in patients with AKI.
A study of serum albumin levels in acute coronary syndrome and its correlation with clinical outcome
Authors: Dhanju Avtar Singh , Chhina Gurpreet Singh , Manekar Praneet , Sandhu Pashaura Singh
Published: April 2022

Background: Coronary artery disease (CAD) is major cause of death and mortality in the developed world. Coronary atherosclerotic disease involves the epicardial coronary arteries and may manifest as an acute or chronic coronary syndrome. Acute coronary syndrome (ACS) arises from atherosclerotic plaque rupture leading to coronary thrombosis and/or spasm.Methods: The present study was conducted in department of medicine, Guru Nanak Dev hospital attached to government medical college, Amritsar from May 2021 to December 2021. This was a prospective observational study in which a total of 50 patients of ACS were enrolled. Serum albumin levels of the patients were recorded and clinical outcomes based on the albumin levels were compared between the patients.Results: The patients with low serum albumin levels had worse outcomes. The mean serum albumin level of STEMI and NSTEMI patients in hypoalbuminemia group was 2.88±0.11 g/dl and 3.15±0.26 g/dl (p=0.047). The mean serum albumin level of patients having mortality in hypoalbuminemia group was 2.87±0.06 g/dl and those who didn’t have mortality was 3.19±0.21 g/dl (p=0.013). The mean serum albumin level of patients developing new onset heart failure in hypoalbuminemia group was 2.85±0.06 g/dl and those not developing had 3.11±0.19 g/dl (p=0.021).Conclusions: We conclude that ACS patients presenting with hypoalbuminemia are more likely to develop worse outcomes in the form of heart failure, cardiogenic shock and mortality. ACS patients presenting with low serum albumin levels have more chances of developing STEMI.
Early cognitive decline and its assessment in idiopathic Parkinson disease and its correlation with duration of illness
Authors: Gupta Ajesh C. , Shukla Pooja , Giri Richa
Published: April 2022

Background: Parkinson disease (PD) is one of the most common age-related brain disorders, with cardinal symptoms rigidity, bradykinesia, resting tremor and postural instability. These are dopamine-related motor symptoms. PD is increasingly recognized as heterogeneous multisystem disorder involving other neurotransmitter associated with nonmotor symptoms. In which cognitive decline is the most common and important NMS. cognitive decline in PD makes profound effect on patient quality of life and imposes significant burden on the caregiver.Methods: Hospital based cross sectional study conducted among 52 patients of idiopathic Parkinson disease, 61 to 80 years of age (fulfilling UKPDS brain bank criteria) at GSVM medical college, Kanpur during February 2020 to October 2021 using SCOPA COG scale.Results: Using SCOPA COG score in 52 patients, 17 (33%) patients found with declined cognition There was weak negative correlation between total score and duration of illness (p=0.091), weak negative correlation between executive function (assessed by dice) and duration of illness (p=0.047) and a moderate negative correlation between visuospatial function (assessed by assembling pattern) and duration of illness (p=0.003).Conclusions: Significant cognitive decline found with increase in duration of illness in terms of visuospatial function.
Anomalous right coronary artery from distal left circumflex coronary artery: a rare case report
Authors: Bagga Ashima , Kaul Diptiman , . Shubham
Published: April 2022

Coronary artery anomalies (CAAs) being a group of congenital disorders, present with highly variable manifestations and have diverse pathophysiological manifestations. In middle aged to elderly patients, a coronary anomaly is often an incidental finding. We presented a case of 65-year-old female with history of diabetes for past 9 years who presented to our emergency department with history of exertional chest pain for past 4 weeks. Anomalous origin of right coronary artery (RCA) from distal left circumflex artery (LCX) was observed on coronary angiography. Patient was managed with optimised medical therapy (OMT).
Diagnostic approach of liver abscess
Authors: Putra Putu Arthana , Suardamana Ketut
Published: April 2022

Liver abscess is an infection of parasitic or bacteria into the liver parenchyma which causes encapsulation of suppurative material surrounded by inflammatory tissue. Liver abscess is an important health problem especially in low-middle income countries. It is not easy to diagnose liver abscess due to non-specific clinical signs. This case report, we presented a 46-year-old man who was hospitalized with suspected pulmonary infection. However, in the course of the patient's disease, we found a liver abscess.
A review of the relationship between stroke and neutrophil-lymphocyte ratio
Authors: Ahmed Mustaq , Reddy Dhruvi , Green Siva Ranganathan
Published: April 2022

Neutrophil-lymphocyte ratio (NLR) has been a novel biomarker in the literature over decades to assess systemic inflammation. This easily available and cost-effective marker has shown clinical significance in various disease conditions such as infections, sepsis, malignancies, cardiovascular events and even in SARS-COVID-19 pneumonia. NLR has a major association in ischemic stroke patients. Inflammation is a crucial step in the development of ischemic stroke, with neutrophils and lymphocytes comprising the first line defence mechanism. It has a role in stroke initiation, progression of injury, and recovery. This article showed significant correlation between NLR and stroke patients in terms of days of hospital stay, severity and prognosis. High NLR values were found to be associated with higher risk of stroke, prolonged hospital stay and a worse 3 month mortality rate. NLR can thus be integrated into any clinical practice, having an impact on early diagnosis in many clinical scenarios.
Evaluation of bone density and its relation with radiographic stage in knee osteoarthritis, 2016-2017
Authors: Anari Hasan , Enteshari-Moghaddam Afsaneh , Pourfarzi Farhad , Safarzadeh Neda
Published: April 2022

Background: Osteoarthritis (OA) is the most common arthritis and its incidence is directly related to age. According to the related research in the last 30 years, a relationship is reported between severity of osteoarthritis and bone density. The aim of this study was to investigate the bone density and its relation with radiographic stage in knee OA.

Methods: In this descriptive cross-sectional study, 123 patients with knee OA diagnosis who referred to rheumatology clinic at Imam Khomeini hospital in Ardabil, were selected to participate in our study. Age, sex, weight, height and other variables were collected and analyzed with SPSS version 21.

Results: A significant correlation was found between T-score and age of the patients (r=-0.38, p=0.001). A significant correlation was found between T-score and BMI. The correlation of T-score and radiographic stage of patients with osteoarthritis was indirect and non-significant (r=-0.22, p=0.06). Multivariate regression models showed that among variables, only two variables BMI and age had significant relation with T-score.

Conclusions: Results showed that the relation between radiographic stage and T-score was significant and BMI and age had a significant effect on T- score.
Clinical and functional outcome of isolated posterior cruciate ligament avulsion fractures treated by open reduction and internal fixation
Authors: Juneja Johney , Asiger Mohzin , Kumar Dinesh , Sharma Anamendra , Jain Mahendra Prakash , Talesra Anurag , Pratap Vishnu , Sen Ramesh , Mehra A. K.
Published: April 2022

Background: PCL ligament avulsion fracture injuries constitute about 3-20% of all the knee injuries. Isolated posterior cruciate ligament injuries are uncommon and often go undiagnosed in acutely injured knees. fracture. In the long run they cause severe functional disability of the knee joint. There is no consensus concerning the optimal surgical treatment approach for these injuries. Our study was to assess the functional and clinical outcome of isolated PCL avulsion fractures with open reduction and internal fixation.

Methods: This is a prospective study of 27 patients with isolated PCL avulsion fractures, done in the department of orthopaedics in RNT medical college over a 2-year period. All were treated with open reduction and internal fixation with 4 mm cannulated cancellous screw and washer. Postoperatively, patient leg was immobilized in posterior POP slab for 2 weeks, allowing toe touch weight bearing. All patients were regularly followed-up. 3 cases of post operative wound infection were detected.

Results: Of the 27 patients, there were 19 males and 8 females. All the cases showed good fracture union in an average of 12 weeks post operatively. In the first 6 weeks, all of them acquired an average knee flexion of 90 degrees and by 3 months, all of them had 125 degrees of free flexion possible.2 cases showed negative posterior draw sign. The knee scoring system assessment showed 21 cases of excellent result, 4 cases of good result and 2 cases of fair result.

Conclusions: Though rare, PCL avulsion fractured are to be managed properly and treated surgically. PCL tibial avulsion fractures treated through Burk and Schaffer approach with open reduction and internal fixation produces good results.
Comparative study to assess the functional outcome in management of inter-trochanteric fractures by proximal femoral nail versus proximal femoral nail anti-rotation
Authors: Singh Harpreet , Jain Pranjal , Agarwal Kamal K. , Oza Bineet , Patel Meet , Makadia Prashant
Published: April 2022

Background: Proximal femoral fractures are one of the most common fractures occurring in elderly due to osteoporosis and increase in life expectancy. The management of these fractures poses a serious challenge in terms of obtaining a stable fixation and a good post-operative outcome. In this study, we compare two intramedullary devices: Proximal femoral nail (PFN) and proximal femoral nail anti-rotation (PFN-A), used commonly for the fixation of proximal femoral fractures.

Methods: Patients presenting with inter-trochanteric fractures were included and randomly allocated to two groups for treatment with either PFN or PFN-A. Pre-operative radiographs of normal side were used to grade osteoporosis by Singh’s index. Post-operative radiographs were used to assess the tip-apex distance and quality of reduction. Functional outcome was compared on the basis of Harris hip score at final follow-up. Patients were followed up at an interval of 1, 3 and 6 months respectively.

Results: The study included 30 patients with 15 patients in each group. The duration of surgery and blood loss was significantly less in PFN-A group as compared to PFN. Functional outcome as assessed by Harris hip score was similar in both the groups. Implant related complications, though less in PFN-A group, had statistically insignificant difference.

Conclusions: It can be safely concluded that, in spite of no differences in functional outcome between the two groups, a shorter duration of surgery and less blood loss would still make PFN-A a better choice in such patients, especially the elderly and co-morbid/compromised patients.
Comparative study between delto-pectoral and deltoid splitting approach in surgical treatment of proximal humerus fractures using philos plating
Authors: Singh Harpreet , Agarwal Kamal K. , Patel Meet , Makadia Prashant , Jain Pranjal , Oza Bineet
Published: April 2022

Background: The present study was done to compare the two approaches of proximal humerus PHILOS plating on the basis of functional outcome of patients and other perioperative parameters.

Methods: 40 patients with type 2 and type 3 proximal humerus were assigned to group A and B pre-operatively using random alternate allocation. Patients in group-A were operated with deltoid splitting approach while patients in group-B were operated with delto-pectoral approach. Functional outcome was assessed at 6 weeks, 3-months and 6-months. Perioperative parameters like duration of surgery, associated complications, and hospital stay were also noted and compared.

Results: In each group, there were 12 two-part fractures and 8 three-part fractures. For 2-part fractures the mean duration of surgery was 51.33 min for group A and 63.37 min for group B. While for 3-part fractures it was 67.5 min and 80 min respectively. Irrespective of fracture type, there was statistically significant difference between the constant scores in both groups at 3 months (2-part: group A: 67.67; group B: 44.7; p value=0.001. 3-part: group A: 66; group B: 48; p value=0.001). However, the difference between two groups at 6 months was not statistically significant.

Conclusions: Both approaches show satisfactory outcomes over a long period. However, the significantly less operative time and minimal soft tissue dissection in deltoid splitting approach can be used as an advantage in particular cases. Moreover, there was an early return to day-to-day activities for the deltoid splitting group which should be considered when treating an active individual.
Hip fractures associated with concomitant upper limb fractures: a case series
Authors: Mahajan Neetin P. , Patil Tushar , Chaudhari Kunal , Pande Kartik
Published: April 2022

Elderly patients are at risk of fractures of distal radius, proximal humerus, spine and hip even due to trivial low energy falls. Hip injuries are commonly associated with concomitant ipsilateral upper limb injury because of a protective reflex of shielding their body from fall using their shoulder or outstretched hand. Here we presented a case series of 3 elderly patients who came to us with hip fractures and concomitant ipsilateral upper limb fractures. The injuries were adequately managed with splintage and operative procedures. Post-operatively mobilization was challenging. But patients were successfully mobilized with the help of relatives and physiotherapists. Concomitant hip fractures with associated ipsilateral upper limb fractures are quite common in elderly and difficult to treat. Post-operatively mobilization of patient and functional outcome is hampered. Proper counselling by operating surgeon, physiotherapy and postoperative rehabilitation with the help of relatives and assisting devices provides good outcome. In cases of hip trauma in old age, one should always thoroughly examine and screen for upper limb injuries. So that early appropriate treatment and mobilization can be done with good functional outcome.
Management of post traumatic posterior acetabular labral tear: a case report
Authors: Kulkarni Shrihari L. , Daragad Manjunath , Patil Arvind D. , Patil Naveenkumar , Nuhman Mohammed
Published: April 2022

Traumatic acetabular labral tears causing hip instability are rare. Surgical management of posterior labral tear is essential to prevent chronic hip instability and secondary arthritis. We report a 27-year-old female presented following RTA, with posterior hip dislocation along with posterior labral avulsion, managed by surgical repair using suture anchors. Patient had excellent functional outcome at 12 months of follow-up. High index of suspicion for labral injuries is required in patients with posterior hip dislocation and posterior wall fractures. Early surgical repair of torn labrum is must for excellent functional outcome.
Breaking the code of guided implant surgery with an innovative blend of convenience & precision: A pilot study on accuracy of an ingenious 3d implant surgical guide
Authors: Hazra Ranjoy , Srivastava Ayush , Kumar Dinesh , Khattak Amit , Legha V S , Kalia Deepak , Verma Kamal
Published: April 2022

The aim in our pilot research study is to evaluate accuracy of implant placed using guided surgery with an ingeniously developed guide, therefore the deviation between the virtual planning and the postoperative implant position has to be evaluated.

7 patients were randomly selected from the Out Patient Department of our hospital and 10 implants were placed in them with the help of an indigenously developed 3D surgical guide. Pre-operative & Post-operative CBCT was compared in a software for the evaluation of precision. Site specific comparative evaluation was done in 4 parameters i.e., entry deviation, apex deviation, depth deviation in single plane and angulation between long axis of placed and planned implants.

The results were tabulated and standard statistical analyses were done. Mean ± Standard deviation of entry deviation were 0.4 ± 0.29 mm., exit deviation 0.7 ± 0.33 mm., angulation deviation 3 ± 1.7 deg. And depth deviation 0.2 ± 0.13 mm. All the P values were < 0.001. So statistically highly significant fewer chances of errors are seen in cases where this surgical guide was used.

This evidence backed ingeniously designed implant template reliably guides precise & predictable implant placement in each & every case thus promulgating the best care for all concept further with a vision for the future.
Effect of smoking and dental fluorosis as environmental risk factors in periodontal disease — An observational study
Authors: Aditya Vangara , Vandana Kharidi Laxman , Reddy Manchala Shesha , Aswin Prasad Sakthidharan
Published: April 2022

To assess the periodontal status of smokers and non-smokers in dental fluorosis subjects from endemic water fluoride areas of Davangere district, Karnataka. A stratified random sample study (n=338) was performed to obtain an equal number of subjects in tobacco and non-tobacco users. Participants had similar perceived oral health status (including self-reports of bleeding gums, loose teeth, and receding gums) low to medium socioeconomic status, and education. The sample for the present study on the tobacco effect consisted of 338 subjects aged 15-74 years. The periodontal status was assessed by clinical parameters Oral Hygiene Index — Simplified (OHI-S), Jackson’s Fluorosis Index (JFI), Community Periodontal Index Treatment Needs (CPITN). Overall, periodontitis is significantly higher among smokers as compared to non-smokers. Although dental fluorosis is a risk factor compared in relation to age, sex was statistically not significant. OHI-S, JFI, and CPITN show statistical significance among smokers and tobacco chewers. The risk determinants such as age, sex followed by risk factors such as smoking and oral hygiene status for periodontal disease would make no difference from high to low fluoride areas but the current study concept on tobacco use in dental fluorosis subjects is thought-provoking and has to be considered in further studies.
Effect of different angulation of forces on mini implant and abutment at various levels
Authors: Ramagoni Naveen Kumar
Published: April 2022

The objective of the study was to evaluate the effect of varying loads of forces at different angulation at various levels of orthodontic mini implant system by using finite element analysis.

A 3-dimensional model of the mini implant was constructed to simulate force magnitudes and directions, screw diameters and lengths, and implanted depths of mini implants. Finite element study was conducted with horizontal forces of 100, 150, and 200 g were applied to the mini implant and abutment at angulations 90° and 120. Von Mises stress, strain and displacement values were then evaluated using the ANSYS software.

Both stress and displacement increased with increasing the amount of loading force. These 2 indexes were linearly proportional to the force magnitude and produced the highest values when the force was 200 g applied at 120° to the long axis of the miniimplant. The peak deformation and von Mises stress was concentrated on the miniscrew at the cervical level under 200 g at 120°. A wider screw diameter provided superior mechanical advantages. No remarkable differences in the strain distribution were observed at both angulations. However, the stress distribution of the abutment models showed a remarkable difference as compared with the models of mini implant. The high-level area (shown in orange) was localized to the head of the implant and the abutment (cervical part). Compared with 90° group, the orange coloured area was easily observed more in the cervical part of abutment.

The von Mises stress values in the MI, were found to be lowest under 100 g force at 90°. Higher initial loading on the mini implant should be avoided and horizontal force on the cervical level of MI should be prevented or minimized for better stability. The abutment has maximum stress concentration which is significantly useful in decreasing the stress concentration on the bone, and has a buffering action on MI. Force range used is within clinically recommended levels; however, the increase in load causes a proportional increase in the stress values.
Adenomatoid odontogenic tumor in mandible — A rare case report
Authors: Sharma Malvika Panchal , Srivastava Dhirendra , Srivastava Binita
Published: April 2022

Adenomatoid Odontogenic tumor (AOT) is an uncommon histologic type of Odontogenic tumor which is characterized by formation of duct-like structures by epithelial component of lesion. It is a non-invasive type of lesion with slow but progressive growth. A 15-year old patient reported to facio-maxillary and dental health center with chief complain of crowding in lower anterior segment. Radiographic examination revealed a radiolucent lesion in relation to lower left unerupted canine. The boundary of lesion was well defined. Enucleation of lesion was done along with removal of canine and defect was filled with bone graft material, R.T.R (Septodont) which consists of Beta-Tricalcium phosphate. Excisional biopsy was performed for excised tissue. Histopathology was suggestive of AOT. The effective treatment of AOT is conservative surgical enucleation guided by tissue regeneration with membrane technique.
Tinea Incognito due to Over the Counter Drug Application: A Case Report
Authors: Rathi Shwetal , Zawar Vijay , Kote Rahul , Nikam Vivek
Published: April 2022

Tinea incognito caused by of over the counter and overuse of topical steroids resulting in various clinical presentations making it difficult to diagnose. Now-a-days over the counter use of topical combinations containing steroids have increased. We present here a case of an adult female presented with lichenified plaque over both bottocks, abdomen and lower limbs associated with itching with history of over the counter application of topical steroid containing combination on her own. KOH mount of skin scraping confirmed the diagnosis. Treatment with systemic and topical antifungals for 6 weeks resulted into remarkable improvement.
Study of Single Dose of Antibiotic Prophylaxis in Clean Surgeries at a Tertiary Care Centre
Authors: Hemantkumar Borse , Ameya Arolkar
Published: April 2022

Background: Pre-operative single dose antibiotic prophylaxis has shown to reduce the incidence of surgical site infections and thereby patient morbidity. Aims: To evaluate effectiveness of single dose antibiotic prophylaxis in clean surgeries at a tertiary care hospital. Material and Methods: A total of 72 patients undergoing clean surgeries were included after they satisfied the inclusion and exclusion criteria. Results: Single dose of an intravenous prophylaxis of ceftriaxone in clean surgeries excisional biopsy of lipoma, dermoid cyst, sebaceous cyst, enucleation of fibroadenoma, herniotomy, eversion of hydrocele etc. was efficacious in preventing surgical site infection. Surgical site infection was associated with patient’s age, lower haemoglobin levels and longer hospital stay in 3 out of 72 patients. Conclusion: In the present study it was observed that prophylactic single shot of antibiotic is efficacious in averting surgical site infection and is economical for patients undergoing clean surgeries. Factors associated with surgical site infection were patient’s age, haemoglobin and associated co-morbidity like diabetes.
Study of Insomnia in Chronic Obstructive Pulmonary Disease Patients at a Tertiary Care Centre
Authors: Khandpur Jaspreet Singh , Dugad Sushama , Shinde Ravindra , Raj Nikhil , Subbarao Kappagantu Surya Chaitanya Neeladrirao , Kadukar Juhi
Published: April 2022

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities caused by significant exposure to noxious particles or gases. Aims and Objectives: 1. To estimate the proportion of insomnia in Chronic Obstructive Pulmonary Diseases patients, 2. To study the association of insomnia with severity of Chronic Obstructive Pulmonary Diseases among study participants and 3. Assessment of Quality of Life among study participants. Materials and Methods: This prospective observational study was conducted in Department of Respiratory Medicine in a tertiary care center and medical college. Written informed consent was taken from all the study participants and those who give consent were enrolled in the present study. Total 159 COPD patients were included in the study, after satisfying the eligibility criteria. The COPD patients were enrolled after satisfying the eligibility criteria given GSAQ Questionnaire to find the presence of insomnia, PSQI for quality of sleep and then SF-36 score questionnaire to assess Quality of Life. Study was conducted for duration of 2 years (August 2018 to December 2020). Observation and Results: The most common age group amongst study population was 51 to 60 years (42%) followed by 40 to 50 years (29%) and more than 60 years (29%). There was male predominance (54.5%) in the study population as compared to females (45.5%). The most common occupation amongst study population was farmer (28%) followed by Shopkeeper (23%) and Driver (19%) and most of the study population were obese (65.2%) followed by normal BMI (28.8%) and underweight (6.1%). Most of the study population were Grade 2 dyspnea (36%) followed by Grade 3 (34%) and Grade 4 (16%). Most of the study population were Moderate COPD (45.5%) followed by severe COPD (27.3%) and very severe (21.2%). Comorbidities like Diabetes and Hypertension was observed in 11% and 28% of study population. 29% of study population was ex smokers. 69.57% of ex smokers had more than 20 pack years while 30.43% had less than 20 pack years. The prevalence of insomnia in our study population was 43%. The prevalence of insomnia was most commonly observed in severe COPD (40%) followed by Very severe COPD (35%), Moderate COPD (19%) and mild COPD (6%) and the difference was statistically significant. Mean Physical health score and Mental health score was significantly lower in insomnia patients as compared to non insomnia patients. Mean PSQI was significantly higher in insomniac patients as compared to non insomnia patients. Conclusion: 40% of our patients with COPD experienced poor sleep quality. Presence of insomnia in patients with COPD is also associated with increased day time sleepiness and worse QOL.