bluuebunny/crossref_metadata_2025 huggingface dataset:
Indian association of paediatric anaesthesia advisory for pain management in neonates and preverbal children
Authors: Gupta Anju , Sen Indu Mohini , Chandrika Y. R. , Nath Gita , Varghese Elsa
Published: August 2023

In the past, management of pain in neonates was regarded as unnecessary, with the belief that neonates have an immature nervous system and do not perceive pain. Later studies confirmed that neonates certainly do feel pain, though they lack the inhibitory mechanisms that modulate excruciating stimuli, unlike in older children. Repeated painful encounters experienced in the newborn period are associated with poor cognitive and motor development by 1 year of age. Pain in preverbal infants and children is also poorly recognized and often undertreated. Neonates and preverbal children cannot verbally communicate their pain and discomfort but express them through specific behavioral, physiological, and biochemical responses. Several pain measurement tools have been developed for young children as surrogate measures of pain. To achieve optimum postoperative or procedural pain relief, easily understandable tools and a multimodal treatment module should be tailor-made for each health-care facility that cares for neonates and young infants. The aim of this advisory is to outline key concepts of pain assessment in neonates and preverbal children and suggest a rational approach to its management by all anesthesiologists, pediatricians, nursing staff, and other medical personnel caring for these children. The Indian Association of Paediatric Anaesthesia (IAPA) convened an online meeting in April 2020 to formulate the advisory on pain management in neonates and preverbal children under the chairmanship of Dr. Elsa Varghese, President IAPA, and members of the guideline committee. After several such meetings and revisions using feedback from IAPA members, the final guidelines were released in October 2020 on the IAPA website.

Recommendations:

Pain relief should generally be accomplished with a combination of nonpharmacologic approaches and pharmacologic techniques in a stepwise tiered manner by escalating type and dose of analgesia with anticipated increases in procedural pain. Nonpharmacological distraction measures may be sufficient for minor needle procedures like vaccination and venipuncture and may be offered as a first step and to complement other pain management remedies. An interdisciplinary approach involving pharmacologic, cognitive-behavioral, psychologic, and physical treatments should be employed whenever feasible.
Premedication with clonidine and dexmedetomidine as multimodal analgesia for overnight stay laparoscopic cholecystectomy
Authors: Bisht Navneeta , Muniraju Thrishul , Hasan Ashar , Kumar Vivek , Bhaumik Dhrubajyoti
Published: August 2023

Background:

Pain due to pneumoperitoneum after laparoscopic cholecystectomy (LC) may contribute to prolong hospital stay, patient discomfort, and failure of the surgery as an ambulatory procedure. A balanced multimodal analgesia regimen consisting of premedication with selective alpha-2 agonists is gaining popularity for postoperative pain relief for multiple surgeries. Although both clonidine (CLO) and dexmedetomidine (DEX) belong to this group, DEX is seen to have more selective α2 action and better sympatholytic properties. The present study aims to assess the coanalgesic effect of premedication with CLO and DEX for LC, done as an overnight stay procedure, and to compare their efficacy.

Methodology:

This was a prospective, randomized, single-blinded comparative study, conducted between July 2015 and July 2016. A total of 80 patients undergoing LC were randomly assigned to either CLO or DEX groups (n = 40). The patients were premedicated with low-dose (1 μg/kg) bolus intravenous drugs before induction according to the allotted group. Effect of individual drugs on the postoperative visual analog scale (VAS) score was noted, hemodynamic status was monitored, and analgesic-sparing effect to a multimodal analgesic regimen comprising intraoperative fentanyl and postoperative tramadol was noted.

Results:

VAS scores at 15 min postextubation, the number of patients required rescue analgesia, and the number of injections required were all found significantly low with DEX. Systolic as well as diastolic blood pressure was significantly lower in the DEX group.

Conclusions:

Although both the drugs were effective for short hospital stay LC, early pain relief and better hemodynamic stability were seen with DEX. Thus, routine premedication with DEX for ambulatory LC may be recommended.
Evaluation of knowledge and skills of MBBS interns in basic life support/advanced cardiovascular life support and their ability to retain
Authors: Bhavar Tushar Dattatray , Shetti Akshaya N. , Gulve Priyanka B. , Yenurkar Priyal P.
Published: August 2023

Objectives:

Cardiac arrest is a substantial public health problem. The American Heart Association recommends that those whose daily work requires knowledge and skills in advanced cardiovascular life support (ACLS) should not only be trained in ACLS but also be given a refresher course at least every 2 years. We conducted a study to find out how much knowledge and skill was improved in the participants following the workshop and also how much of it they retain after 6 months.

Materials and Methods:

The study, a prospective repeated measures quasi-experimental design, was done to test the knowledge and skill about basic life support (BLS) and ACLS among MBBS Interns at the entry to internship before training, posttraining and 6 months after training. This was done using a structured questionnaire containing 25 knowledge and practice questions and a checklist containing 15 points was used to assess the skills was also assessed using the Laerdal CPRQ Manikin with skill guide using parameters compression score, ventilation score, and compression fraction.

Results:

Knowledge mean total score for pretest, immediate posttest, and 6 months posttest was 10.9, 23.54, and 15.77, respectively, and skill mean score for pretest, immediate posttest, and 6 months posttest was 3.55, 12.99, and 9.06, respectively. Knowledge and skill assessed for immediate posttest was significantly higher than the pretest score. Six months posttest total score was significantly higher than the pretest total score but was significantly lower than posttest score in regard to both knowledge and skills.

Conclusion:

We found that there is gross lack of knowledge and skills among interns, which needs to be looked at with proper BLS and ACLS training and periodic reinforcement of the same with trainings as there is a significant decrease in both knowledge and skills at 6 months. The skill guide can be considered for skill assessment.
Analgesic efficacy of ultrasound-guided erector spinae block and pectoral nerve block in patients undergoing modified radical mastectomy
Authors: Singariya Geeta , Pahuja Himani , Kamal Manoj , Choudhary Kusum , Meena Saroj , Saini Pradeep
Published: August 2023

Background and Aims:

Modified radical mastectomy (MRM) is the commonest surgical procedure performed for carcinoma breasts. MRM is associated with considerable postoperative pain. This study was aimed to compare the analgesic efficacy of erector spinae plane (ESP) block and pectoral nerve (PECS) block.

Materials and Methods:

A total 70 female patients, American Society of Anesthesiologist Physical Status I-II, aged between 18 and 65 years, undergoing MRM surgery. Patients were randomly divided into two equal groups of 35 each, by computer-generated random number table. Group E patients, received ESP block with 20 mL of 0.25% levobupivacaine, and Group P patients, received PECS block with 30 mL of 0.25% of levobupivacaine. The surgical procedure was conducted under general anesthesia in both groups. The primary objective was total morphine consumption in the first 24 h and secondary objectives were intraoperative fentanyl needed, duration of analgesia, numeric rating scale (NRS) score, postoperative complications, and patient's satisfaction. The Statistical Package for the Social Science (SPSS) software version 22.0 used for statistical analysis.

Results:

Demographic data, hemodynamic parameters, and intraoperative fentanyl consumption were comparable between the two groups (P > 0.05). Postoperative morphine consumed in the first 24 h was less in the Group P compared to Group E (P = 0.018). The duration of analgesia was significantly prolonged in the Group P than Group E (P < 0.0001). The NRS score, postoperative complications, and patient's satisfaction were comparable.

Conclusion:

The PECS block is more effective analgesic modality compared to ESP blocks in patients undergoing MRM surgeries.
Comparison of ketofol (ketamine and propofol) and etomidate in electro convulsive therapy
Authors: Joshi Chhaya P , Thapisrija  , Ayyanagouda Basavaraja , Mutalik Narayan , Hulakund Shivanand Y. , Jalapati Harini
Published: August 2023

Background and Aims:

Electroconvulsive therapy (ECT) is the most effective treatment modality for severe and medication-resistant psychiatric disorders. ECT provokes generalized tonic-clonic seizures. Induction of optimal seizures (duration of motor seizures >15 s) is considered as an important goal during the ECT procedure. We compared ketofol and etomidate as induction agents in ECT with respect to the seizure duration and seizure threshold as there is less information available in the literature.

Methods:

One hundred and twenty patients posted for ECT were randomized into two groups. Group A received ketofol 1:1 (ketamine 0.5 mg/kg + propofol 0.5 mg/kg), while as Group B received etomidate 0.2 mg/kg. After administration of the muscle relaxant (succinylcholine 0.5 mg/kg) ECT was delivered. The primary outcome was seizure duration, and secondary outcomes such as seizure threshold, hemodynamic parameters, recovery profile, and any complications were noted. Motor seizure duration was recorded as the time interval between starting of the seizure episode until the cessation of tonic-clonic motor activity in the isolated upper limb. Data were entered in MS-Excel and analyzed in SPSS V22. Descriptive statistics were represented with percentages, and parametric data were represented with mean with standard deviation. The statistical analysis was carried out using the Chi-square test, independent t-test. A Probability (P) value <0.05 was considered statistically significant.

Results:

There was a statistically significant difference in seizure duration between two groups with Group A having less meantime 38 ± 14.9 s compared to Group B 45.3 ± 17.5 s with P = 0.014. Seizure threshold, hemodynamic parameters, recovery profile, and complications except myoclonus were not statistically significant between the two groups.

Conclusion:

Etomidate has the definite advantage of longer seizure duration compared to ketofol, and hence, etomidate is a better induction agent in patients with psychiatric disorders undergoing ECT.
A randomized, double-blinded comparative study of phenylephrine infusion and norepinephrine infusion for the prevention and treatment of spinal anesthesia-induced hypotension in elective and emergency cesarean deliveries
Authors: Berawala Payal Kalpesh , Mehta Sanket Hirenbhai , Chaudhari Madhavi Sanjay , Shinde Mayur Kiran
Published: August 2023

Context and Aims:

Among vasopressors used to treat postspinal hypotension (PSH) in cesarean sections (CS), phenylephrine (PE) is the preferred drug at present but reflex bradycardia and thus reduction in cardiac output still pose a concern. Norepinephrine (NE), with its better pharmacological properties, may be a better alternative to overcome this risk. Hence, we did this study intending to compare both the drugs.

Materials and Methods:

A double-blinded, randomized, controlled trial (RCT) was carried out on 70 patients, 35 in each group-group P (PE) and group N (NE) undergoing CS, to compare and evaluate the efficacy of both drugs for preventing and treating PSH. Patients in Group P and Group N were given intravenous infusion of PE at the rate of 50 μg/min and NE at the rate of 2.5 μg/min, respectively, after the intrathecal injection of bupivacaine. The number of intermittent bolus doses required, heart rate, and mean arterial pressure (MAP) at predefined intervals were noted.

Results:

The incidence of hypotension calculated from the number of bolus doses required was lower in Group N than in Group P for the initial 15 min (P < 0.05). The incidence of bradycardia and vomiting was higher in Group P but were not statistically significant, while the incidences of nausea (P = 0.004) and oxygen requirement (P = 0.03) were statistically significantly higher in Group P.

Conclusion:

This study suggests that NE infusion is superior to PE infusion when used in the potency ratio of 20:1, to prevent and treat PSH in CS, with a lesser number of side effects.
Serum serotonin level as a predictor of presence of gastroesophageal varices in patients with liver cirrhosis
Authors: Adam Tasnim F. , Abdelsamea Mahmoud Z. , Abd-Elsalam Sherief M. , Elserougy Hesham A. , Wasfy El Sayed Ahmed
Published: August 2023

Background

Portal hypertension is one of the most important complications of liver cirrhosis, leading to the development of esophageal varices (OV). Variceal bleeding carries high morbidity and mortality. The frequency of varices in patients with cirrhosis is unfixed, extended from 24 to 80%; therefore, endoscopic examination of all cirrhotic patients would lead to unnecessary additional burdens to endoscopic units.

Aim

The aim of the study was to evaluate the serum serotonin level as a noninvasive predictor of presence of gastroesophageal varices in patients with liver cirrhosis.

Patients and methods

The study was performed on 60 cirrhotic patients recruited from the endoscopy unit of Tropical Medicine and Infectious Diseases Department in Tanta University Hospitals. In addition, 20 physically fit participants served as a control group within the period between April 2020 and April 2021.

Results

Serum serotonin is significantly increased in cirrhotic patients with varices. Serum serotonin correlated well with severity of liver insult in patients with cirrhosis assessed by Child, Model for End Stage Liver Disease, fibrosis-4, and aspartate aminotransferase/platelet ratio index scores as well as OV grade.

Conclusion

Serum serotonin had a good power of prediction for development of OV.
The possible association between blood level of free cholesterol and the severity of steatosis in patients with nonalcoholic fatty liver disease
Authors: Elsawy Abdallah A. , Hodeib Hossam , Selim Ahmed F. , Sarhan Mohamed E. , Elhadidy Ahmed A. , Sameir Heba M. , Selim Amal , Tawfik Mohamed A.
Published: August 2023

Background

The global rising prevalence of nonalcoholic fatty liver disease (NAFLD) highlights the need to understand the risk factors related to its pathogenesis and its related complications. NAFLD is mediated by lipotoxicity that results from an imbalance in hepatic lipid metabolism. Emerging evidence suggests that lipotoxicity mediated by hepatic free cholesterol (FC) overload may result in steatohepatitis. Lipotoxicity is not only associated with the pathogenesis of NAFLD, but also related to increased risk of atherosclerosis and cardiovascular complications, the main leading causes of mortality in NAFLD.

Aim

The study tried to clarify the possible association between serum levels of FC and the severity of hepatic steatosis in NAFLD.

Patients and methods

This cross-sectional study included 120 participants, who proved to have different stages of hepatic steatosis using elastography with controlled attenuation parameter (CAP). The correlations between different lipid parameters as well as serum FC levels and CAP values of hepatic steatosis for all participants were assessed using multivariate linear regression analysis.

Results

The most independent significant lipid parameters associated with CAP values were FC, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (P<0.001 for all). Moreover, the discriminately performance of those parameters as risk factors for steatosis using receiver operating characteristics showed an area under the curve of 0.991, 0.957, and 0.861, respectively, with a significant performance (P<0.001 for all).

Conclusion

We could conclude that increased serum levels of FC along with increased levels of low-density lipoprotein cholesterol and decreased levels of high-density lipoprotein cholesterol have significant correlations to the increased severity of hepatic steatosis in NAFLD.
The potential role of omega-3 on the effect of the energy drinks on testis of adult male albino rats: a histological and immunohistochemical study
Authors: Maksoud Mangoud Rana A.K.A. , El-Aziz El-Deeb Safwat A. , El-Khalek Mahdy Amal A. , El-Hanafy Hend A.M.
Published: August 2023

Background

Consumption of energy drinks rich in caffeine has increased between individuals. Health problems related to caffeine such as reproductive diseases have occurred.

Aim

The objective of this work was to study the potential role of omega-3 on the effect of energy drinks on the testis of adult male albino rats.

Material and methods

A total of 40 adult male albino rats were used in this study. Rats were divided into four main groups: control group (I) included 10 rats that received no treatment for the same periods as the experimental animals; omega-3 group (II) included 10 rats that received 300 mg/kg body weight of omega-3 orally using a gastric tube once daily for 3 months; energy drink group (III) included 10 rats that received 1.07 ml/100 g body weight of energy drink orally using a gastric tube once daily for 3 months; and energy drink and omega-3 group (IV) included 10 rats that concomitantly received both energy drink and omega-3 at the same dose, route, and duration as groups II and III. Testicular specimens were subjected to histological and immunohistochemical examinations. The data were analyzed statistically.

Results

Group III showed disturbed normal histological architecture of the testicular structure, but group IV omega-3 resulted in preservation of the normal histological architecture. Moreover, the cyclooxygenase 2 immune stain and the statistical analysis confirm these results.

Conclusion

There is a correlation between omega-3 and reduction of the testicular damage induced by energy drinks in adult male albino rats. Omega-3 leads to protection of the testis.
Amniotic membrane transplantation with intra-stromal Voriconazole versus amniotic membrane transplantation with argon laser photocoagulation for treatment of resistant fungal keratitis
Authors: Khater Mohammad M. , Sharaf Amr F.
Published: August 2023

Background

Fungal keratitis is a serious problem that may affect vision. Many procedures like argon laser, voriconazole injection, and amniotic membrane transplantation (AMT) may be used to control infection.

Aim

To compare between intrastromal voriconazole injection with AMT and argon laser photocoagulation with AMT as treatment for fungal keratitis.

Patients and methods

Mycotic keratitis cases were divided in two groups, with 15 cases each. In one group, intrastromal voriconazole injection and AMT in the same setting was done, and in the other group, argon laser photocoagulation and AMT in the same setting was done. The studied cases included 21 cases with mixed infection and nine cases were pure fungal keratitis according to culture results. In the voriconazole group, intrastromal injection followed by AMT was done, whereas in the argon group, the corneal ulcer was irradiated with argon after fluorescein staining followed by AMT in the same settings.

Results

Healing was achieved in both groups in 2–6 weeks in all cases. Less than 50% of cases of the voriconazole group healed by the third week, whereas 80% of cases of the argon laser group healed by the third week. Vision was increased in four (26.7%) patients in the voriconazole group, whereas in six (40%) cases in the argon laser group.

Conclusions

Argon laser with AMT gives better results than intrastromal voriconazole injection with AMT for the treatment of resistant mycotic keratitis.
Fetal main pulmonary artery Doppler and prediction of lung maturity
Authors: Kandil Safaa A. , Elshafey Rasha A. , Eltokhi Hesham M. , Eldeeb Basma S.
Published: August 2023

Background

Respiratory distress syndrome (RDS) in newborns occurs owing to surfactant deficiency. Decrease in quantity and quality of surfactant in lungs results in diminished surfactant activity. It affects not only preterm neonates but also term ones. RDS is a serious condition as it can lead to many neonatal comorbidities and even death. Doppler ultrasound is a noninvasive tool used for assessment of fetal biometry, so Doppler of pulmonary artery can be used safely in assessment of fetal lung maturity.

Aim

The purpose of our study was to assess the significance of fetal pulmonary artery Doppler in predicting lung maturity.

Patients and methods

A total of 50 pregnant women participated in this study with gestational age ranging from 34 to 39 weeks who were referred to the Diagnostic Radiology Department at Tanta University Hospitals during the period between December 2019 and December 2021.

Results

From the 50 pregnant women included in this study, six fetuses developed RDS. The greatest correlation was found with acceleration time/ejection time (AT/ET) ratio and resistive index (RI) with high sensitivity and specificity (P=0.000 and P<0.001, respectively). A cutoff value AT/ET less than 0.297 and RI more than 0.889 predicted RDS with sensitivity of 94.8 and 89.1%, respectively, and specificity of 83.5 and 78.2%, respectively.

Conclusion

Neonatal RDS can be predicted by pulmonary artery AT/ET ratio and RI with high sensitivity and specificity.
Endostatin level in coronavirus patients: a prospective study
Authors: Zahra Ahmed M.K. , Abd-Elall Mohamed , Hantera Mohamed , Sakran Alaa , Zahra Mohamed K.
Published: August 2023

Background

Endostatin is a protein linked to the C-terminal of collagen in the basement membrane of endothelial cells. It functions as an antiangiogenic protein. It inhibits endothelial proliferation, migration, and tube formation. Studies have observed that it downregulates endothelial-signaling pathways of proangiogenic activity as well as upregulates the angiogenic gene.

Aim

This work was designated to explore the levels of endostatin in coronavirus disease 2019, trying to investigate its role as a prognostic marker.

Patients and methods

Patients with positive PCR for SARS-CoV-2 were divided into two groups (survivors and nonsurvivors). Computed tomography chest was for each patient. The nonsurvivor group comprised 19 patients and the survivor group had 31 patients. In addition, 50 normal volunteers participated in this study and served as a control group. Serum endostatin was measured by ELISA and was compared with other measured laboratory parameters.

Results

Endostatin was statically increased in nonsurvivors than both survivors and normal volunteers (P
1=0.007, P
2=<0.001). However, this significant increase was still observed in survivors on comparing with normal individuals. There was a correlation between endostatin and different parameters in coronavirus disease 2019 patients.

Conclusion

The high level of endostatin in this prospective study and its correlation with laboratory makers and clinical manifestations leads us to consider it as a valuable prognostic factor. Moreover, it can predict mortality and severity of patients. It was important to conduct a study on large scale to confirm this value.
Cardiac dysrhythmia in drug-resistant epileptic children
Authors: ElNawasany Mohamed A. , Basiouny Mohamed A. , Khalfallah Mohamed , ElGammal Tarek M.
Published: August 2023

Background

Drug-resistant epilepsy is one of the most common neurological conditions associated with high mortality and morbidity rates.

Aim

To assess heart rate variability among drug-resistant epileptic children.

Patients and methods

This observational cross-sectional case–control study included 60 epileptic children. Cases were assigned into two equal groups: group 1 (drug-resistant group) included children presented with drug-resistant epilepsy and group 2 (control group) included cases with controlled primary epilepsy who achieved sustained seizure freedom for at least 6 months on one antiepileptic drug, matched with the patient group regarding age and sex. All patients were subjected to history taking and clinical and radiological investigations including computed tomography (CT) and/or MRI and electroencephalogram (EEG) monitoring. ECG monitoring was using Holter ECG.

Results

MRI, EEG, and ECG abnormalities are significantly more common in drug-resistant epilepsy. Interictal tachycardia was the most prevalent abnormality among group I (93.3%). ECG structure was abnormal in 33.3% in group I, in the form of prolonged QTc interval, ST segment abnormalities, P wave dispersion, and T wave alternans. Tachycardia associated with prolonged QTc interval was present in patients with focal or temporal EEG abnormalities, and patients with multifocal EEG abnormalities.

Conclusion

ECG monitoring is important in drug-resistant epileptic children to detect any autonomic changes occurring in the heart either ictally or interictally. Heart rate is significantly higher and RR interval is significantly shorter ictally than interictally. Careful monitoring of these changes may help in predicting the risk of sudden unexpected death.
Evaluation of antagonistic activity of an Egyptian probiotic Lactobacillus plantarum against bacteria isolated from ready-to-eat meat products
Authors: Radwan Aya G. , El Naghy Wageih S. , Shahbab Abeer A. , Hassan Aziza M.
Published: August 2023

Background

The increase in the incidence of antibiotic-resistant pathogens calls for strenuous efforts to substitute the administration of antibiotics with the use of probiotics.

Aim

The aim of the study was to evaluate the bacterial contamination of ready-to-eat meat products in Tanta city, determine the antibiotic susceptibility of the isolates, determine in vitro antagonistic effect of a probiotic Lactobacillus plantarum (L. plantarum) against isolates, and compare this effect with the inhibitory effect of the commonly used antibiotics.

Materials and Methods

The samples were collected in stomacher packs, homogenized, and serially diluted. Identification of pathogenic bacteria was done via standard microbiological methods. Antibiotic-sensitivity tests were done by disk-diffusion method. The results were compared with the inhibitory effect of L. plantarum done by well-diffusion and overlay methods.

Results

The total rate of bacterial contamination of the collected samples was 72/90 (80%), while the contamination rates from good sanitation-state (GS) outlets and poor sanitation-state (PS) outlets were 27/37 (72.9%) and 45/53 (84.9%), respectively. The most isolated bacteria were Escherichia coli (E. coli) (29%) followed by Staphylococcus aureus (21%). L. plantarum showed inhibitory effect against both Gram-positive and Gram-negative isolates. Its activity was maximum against E. coli and least for Klebsiella spp. in both well-diffusion and overlay methods.

Conclusion

The presence of pathogenic bacteria in ready-to-eat products is a great public health issue; also, this research supports the promising use of the tested L. plantarum and its products as antimicrobial agents against foodborne pathogen.
Perineural and Lymphovascular Invasion as Histologic Predictors of a 5-Year Local Recurrence After Curative Resection of Stages II and III Rectal Cancer
Authors: Behboudi Behnam , Ahmadi-Tafti Seyed M. , Heidari Mostafa , Fazeli Mohammad S. , Kazemeini Alireza , Keshvari Amir , Heirani-Tabasi Asieh , Poursalehian Mohammad , Notash Aidin Yaghoubi , Keramati Mohammad Reza
Published: August 2023

Background:

Distinguishing predictors of local recurrence after surgery is important following curative resection of rectal cancer.

Objectives:

This study aimed to evaluate the correlation between perineural and lymphovascular invasion with local recurrence after curative resection of rectal cancer.

Design:

Prospective Cohort Study.

Patient and Methods:

Patients with stages II and III rectal cancer operated on between January 2011 and December 2015 were included. Data including demographic information and pathologic characteristics of the primary tumor, including perineural and lymphovascular features, were collected. The patients were followed-up for at least 5 years for any evidence of tumor recurrence.

Main Outcome Measure:

Perineural invasion (PNI) and Lymphovascular invasion (LVI).

Sample Size:

202 patients (including 77 women and 125 men).

Results:

PNI and LVI were found in the histologic features of the tumors of 34 (16.8%) and 56 (27.7%) patients, respectively. 85.3% of the patients with PNI and 67.9% with LVI had developed recurrence within 5 years after curative surgery. Twenty-four patients had concurrent PNI and LVI, which showed a recurrence rate of 87.5%.

Conclusion:

This study found a significant correlation between tumor recurrence and PNI or LVI in male patients with stage II or III rectal cancer. In addition, a significant relationship was found between PNI and tumor recurrence in female patients; however, there was no significant correlation between LVI and tumor recurrence in these patients.

Limitations:

Limited sample size.

Conflict of Interest:

The authors have no conflict of interest to declare.
A View from the Shoulders of Giants
Authors: Blears Elizabeth Ellen , Fortunato Richard
Published: August 2023

Although minimally invasive surgery has reduced postoperative pain and length of hospital stay after right hemicolectomy, identification of anatomic landmarks is critical in ensuring safe technique through the narrow lens of the laparoscope. Well-known anatomical eponyms, such as the fold of Treves and Gerota's fascia, are commonly referenced during the teaching of this procedure when performing mobilization of the right colon off the peritoneal wall and entry into the lesser sac. In addition, there are lesser-known landmarks involved in this procedure, such as the Bouchet area and Fredet's fascia, that facilitate access to the lesser sac and bloodless dissection planes. However, little is usually known about the biographical information of the physicians after whom these landmarks are named. To enhance the teaching of this procedure, the steps involved in a right hemicolectomy with their corresponding eponymous landmarks are narrated alongside the biographical background of each of the physicians after whom they are named.
Prevalence of Soil-Transmitted Helminths at Baseline and after Albendazole Treatment in the School-Age Children of Forcibly Displaced Myanmar Nationals in Bangladesh
Authors: Noor Zannatun , Hossain Biplob , Khan Shaila Sharmeen , Kabir Mamun , Bhuiyan Abu Toha Md Rezuanul Haque , Alam Mohammad Shafiul , Faruque Abu Syed Golam , Haque Rashidul
Published: August 2023

The forcibly displaced Myanmar nationals (FDMNs) known as Rohingya refugees are the largest group of stateless individuals globally. According to the emergencies humanitarian actors at the United Nations Office for the Coordination of Humanitarian Affairs, the worldwide refugee crisis involving FDMNs is intensifying at the fastest rate in history. Growing public health demands are being exacerbated by current difficulties in addressing poor access to health services, severe food shortages, and a lack of adequate housing. Infectious diseases constitute a major public health emergency in this vulnerable population. A study was carried out in FDMN children to investigate common soil-transmitted helminth (STH) infection at the time of enrollment and prospectively followed-up to 12 months after 2 doses albendazole treatment. At baseline, the prevalence of STH infection with at least one species was found to be 91.7% and 87.3% for Kato–Katz (KK) and quantitative polymerase chain reaction (qPCR) methods, respectively. Similarly, for follow-up children, the overall infection rate was 95.3% and 91.5%, respectively. Trichuris trichiura was the most predominant STH infection by both KK (baseline 87%, follow-up 89.1%) and qPCR (baseline 77.5%, follow-up 82.9%). The overall prevalence of stunting in the children was 37.8% at baseline and rose to 51.3% at 12 months. Alpha-1 antitrypsin (r = 0.13, P = 0.01) and myeloperoxidase (r = 0.12, P = 0.01) levels showed a positive correlation with Aascaris lumbricoides egg count per gram at baseline. An in-depth investigation is urgently needed to identify the underlying protective measures and the root cause of STH infections to improve the health of FDMN children.
Characteristics of Soil Heavy Metal Contamination in the Intensive Livestock Farming Watersheds
Authors: Baek Un-il , Kim Deok-Woo , Chung Eu Gene , Na Eun-Hye , Kim Yongseok
Published: August 2023

Soil contamination of agricultural watersheds can increase to deteriorate water quality, human health, crop production and aquatic ecology. In particular, it is important to understand the impacts of soil heavy metal contamination from livestock excretion because the excretion has been gradually increasing due to the rapid growth of the livestock industry. In this study, to analyze the characteristics of soil heavy metal contamination in intensive livestock farming watersheds, we selected intensive livestock farming watersheds where livestock heads and amount of livestock excretion by species were spatiotemporally surveyed. We also investigated the characteristics of five soil heavy metals (As, Cd, Pb, Cu, Zn) contamination. The Cheongmi Stream watershed in Anseong, Kyungi-do and Gwangcheon Stream watershed in Hongseong, Chungcheongbuk-do, Korea were one of the most intensive livestock rearing regions where there were very large amounts of livestock excretion. It was also found that Cu and Zn among heavy metals exceeded the soil contamination concern standard at two of the sampling points in the Gwangcheon Stream watershed. Compared to the national soil measurement network data, it was showed that the concentrations of Cd, Cu, and Zn in the intensive livestock farming areas such as both Cheongmi Stream and Gwangcheon Stream watersheds were higher than in other areas. Thus, we suggested that the soil in intensive farming watersheds was contaminated by heavy metals compared to other areas. Therefore, it is necessary to manage not only livestock excretion, but also animals’ welfare, humans, and the environment to use less heavy metals in their feeds. We also believed that various impacts of livestock excretion on the environment need to be studied soon.
Veganomics: Current Status and Challenges
Authors: Oh Juahn , Park Chaeyeong , Ahn Dagyeong , Byun Jaeeun , Jung Sokhee P.
Published: August 2023

Products introduced as vegan are recognized by consumers as ethical consumption that protects animals and the environment, so they are becoming a trend in recent marketing strategies. However, consumers are confused by the claim that veganism consumption is not environmentally friendly, contrary to consumers' perception of animal protection and environmental protection. Vegan leather, which appeared as an alternative to natural leather, emits harmful substances during the manufacturing and disposal process, is less durable than natural leather, and has a shorter lifespan, resulting in a problem of fast fashion. Substitute meat is emerging as a food of the future due to environmental problems caused by raising livestock. However, considerable carbon is generated during the production of substitute meat, and there is a problem in verifying the safety of fiber materials such as various additives used during the production process. In the case of vegan cosmetics, they use only eco-friendly ingredients derived from nature instead of animal ingredients and do not test on animals, so the impact on the environment is minimal. Overall, bigonomics products generate relatively less environmental pollutants and cause less environmental pollution, but there are still limitations to be overcome. It is thought that the limitations of bigonomics can be overcome through social collective practice such as education and investment in parallel with individual practice in daily life. Furthermore, I think that if there is a correct understanding of vegannomics and communication about its value, the vegan industry will be able to take its place as a major industry in society. In this review, the current status of bigonomics in the food, cosmetics, and fashion industries, which are being developed by consumers' ethical consumption, is reviewed and prospects are presented. This review will help set the direction in each industry pursuing vigenomics.
Recycling and Reuse of Waste Batteries from Electric Vehicles: A review
Authors: Jung Jiwoo , Choi Jinyeong , Lee Hyejin , Park Ahhyun , Jung Sokhee P.
Published: August 2023

As sales of electric vehicles rapidly increase, the amount of waste batteries is also rapidly increasing. Accordingly, social interest in the recycling and reuse of waste batteries is rapidly increasing. Waste battery recycling refers to the process of reprocessing waste batteries and extracting valuable water for reuse. Reuse of waste batteries refers to the process of using them again for the same purpose after undergoing a slight conversion process. Currently, related technology development is required, and related policies are insufficient. Looking at the global trend, a waste battery collection system is being established through the labeling system and producer responsibility recycling system, battery performance and safety evaluation standards are being established, and efficient and safe transportation systems are being established. Since it is not clear who is responsible for each stage of the problem in the disposal of waste batteries, a history management system is needed. It is important to efficiently extract and recycle waste battery resources, but it is also necessary to develop battery technology free from resource scarcity. In this review, recycling and reuse-related technologies of waste batteries, battery-related policies, and rare metal replacement technologies were explored, and directions for future waste battery policies were presented.
Understanding Gender and Sex: Clarifying Terminology and Exploring Human Variations
Authors: Laajili Taysir , Lukács Andrea
Published: August 2023

This scientific paper aims to clarify the confusion surrounding various notions related to gender and sex by providing simple explanations, and emphasize their independent significance; additionally, it seeks to bridge the gap between scientific terminology and everyday understanding. This paper explores also the concept of sexual orientation and the diverse terms associated with it, by examining existing literature and research findings, this study provides a comprehensive analysis of these interconnected concepts, revealing their significance in understanding human diversity and fostering inclusivity, it cites relevant research and expert opinions to provide a comprehensive understanding of human variations.
Prevalence of Premenstrual Syndrome In Females of Gujranwala Division And Its Associated Risk Factors
Authors: Saba Zahid  , Ayesha Riaz  , Kalsoom Sughra  , Ahmed Ali  , Muhammad Naeem Raza
Published: August 2023

Introduction: Premenstrual syndrome (PMS) is characterized by cyclic reoccurrence of distressing somatic and psychological manifestations, during luteal phase of menstrual cycle. Present research work aims to investigate prevalence of PMS in females of Gujranwala division Pakistan and to explore various risk factors associated with this syndrome. Methods: The study included self-administered questionnaire, for diagnosis of PMS and PMDD. Participants were analysed for socio-demographic characteristics and menstrual history, serum cholesterol and haemoglobin levels of patients and control were measured. Results: In the present study, 56% females were screened positive for PMS while Prevalence PMDD was 18%. Most common physical symptoms of PMS were abdominal bloating (63.2%), muscle pain (71.73%), lack of energy (85.85%) and appetite change (79.15%) whereas major distressing psychological were Irritability (82.32%), anger (74.55%), depression (49%) and anxiety (63.2%). Prevalence of PMS was 22.6% in underweight, 50.1% in participants having normal weight, 15.5% in overweight individuals and 11.6% in obese. Anaemia (P = 0.00), fatigue (P = 0.00), dysmenorrhea (P = 0.00), family history of PMS (P = 0.00) and residential area (P = 0.047) were major risk factors for development of different symptoms of PMS. Conclusion: Statistically significant association was not confirmed between PMS, obesity and blood cholesterol level. PMS is a common menstrual disorder among reproductive females of Gujranwala division, Pakistan. Findings of the study revealed that anemic females were at risk to develop PMS symptoms.
Effectiveness Of Double J Stent With Extracorporeal Shockwave Lithotripsy: An Analysis Of Stone-Free Rates
Authors: Jaffery Syed Ali Raza , Jatt Javed Altaf , Memon Waqar Ahmed , Ghanghro Abdul Qayoom , Arain Ahsan Ali , Arain Adeel Hyder , Tariq Sana
Published: August 2023

Introduction: Preservation of renal function and integrity is of profound importance and therefore renders stent-related symptoms a secondary concern. The usage of DJ stent is known for decades to support stone removal, this study aims to assess the effect of DJ stent after extracorporeal shock wave lithotripsy for stone removal and DJ stent-related complications in adult patients. Methods: This is a prospective, comparative study, Patients were selected after being diagnosed with established radiological evidence of a single radio-opaque stone ≤ 2 cm. The presence of the visible radio-opaque shadow post-procedure indicated residual stones and negative results. Primary follow-up was recommended after 2 weeks post-procedure and participants were inquired about all the anticipated complications, data was entered on SPSS version 23.0 for analysis. The chi-square test was applied to assess the significance and a p-value ≤ 0.05 was deemed significant for our results. Results: The sample size of the study was 150, sorted equally into two separated groups categorized by presence and absence of DJ stent after ESWL, stone size was almost similar to avoid any confounding factor with the mean value of 1.24 ± 0.2 in group A and 1.6 ± 0.1 in group B, with a p-value of 0.05. Hematuria was categorized within mild 6(4%) & 7(4.6%), moderate 6(4%) & 5(3.3%) while gross hematuria was reported in 1(0.6%) & 2(1.3%) in group A and B respectively. Conclusion: This study concluded that using a DJ stent with ESWL does not help in the stone passage or improve stone-free rates of stone removal after breaking the calculi with shockwave lithotripsy.
Perceived Health Status and Health Promoting Behaviors among Pregnant Women in Bangladesh
Authors: Mazumdar Bandana , Mallick Dipali Rani , Begum Taslima , Anowar Mohammad Nurul
Published: August 2023

Background: Worldwide, approximately 99% of maternal death occurred in developing countries among 358000 maternal deaths. Perceived health status and health-promoting behaviors are the factors that can increase awareness and decrease the health risk of the mother and child. Nurses have the opportunity to provide information related to healthy lifestyles through health promotion programs to reduce maternal morbidity and mortality. Objective: The purpose of this study is to examine the level of perceived health status and health-promoting behaviors among pregnant women in Bangladesh. Method: A descriptive cross-sectional type of study was conducted among 148 pregnant women by convenience sampling technique with three tertiary level hospitals, in Dhaka. The instrument consisted of three parts: Socio-demographic, perceived health status, and health-promoting behaviors questionnaire. 14 items with a 5-point Likert Scale and 44 items with a 4-point Likert were used respectively. Data were collected through a structured questionnaire with face-to-face interviews. Data were analyzed by a computer software program using T-test, ANOVA, and Pearson product-moment Correlation. Result: The result shows that the mean score of perceived health status (M = 55.99, SD = 10.83), and HPBs (M = 144.78, SD = 14.10). Perceived health status is significantly moderately correlated with HPBs (r = .517, p = .000). Following demographic characteristics are those significantly associated with HPBs; education (F = 6.154, p = .003), monthly family income (r = .422, p = .000), distance from hospital to residence (r = -.172, p= .037), and pregnancy trimester (F = 12.427, p = .000). Conclusion: The study concluded that overall perceived health status and HPBs were at good level of HPBs of the pregnant women. It should be taken into account that perceived health status and socio-demographic characteristics are the influencing factors on the health-promoting behaviors of pregnant women in Bangladesh.
Analysis of the Use of Circular Motion Physics Concepts on Game Rides in Jawa Timur Park 1
Authors: Arzak Kirana Aureola , Neswary Shalsa Billa Ardhana , Fitriyah Hana
Published: August 2023

In general, physics has been widely spread well in everyday life, one of which is used as a concept in holiday destinations in Indonesia. In East Java, Jatim Park group has been established by a combination of education and entertainment, resulting in the concept of learning while playing. Jawa Timur Park 1 is one of the eduparks in Indonesia with the first playground in the East Java area, especially Batu City. This research aims to analyze the use of circular motion physics concepts on Sky Swinger, Superloop Coaster, Enterprise, Tornado and Pendulum 360 in Jawa Timur Park 1, Batu. Research is carried out using literature study methods by outlining the problems discussed clearly and in detail related to the concepts of physics contained in the game rides.   The data collection method used in this study used review and observation journals.   Observation is done using social media in the form of Youtube.  In this study, it was concluded that in the Pendulum 360, Sky Swinger, Enterprise, Tornado, and Superloop Coaster Rides at Jatim Park 1 Batu there is a physical concept in the form of circular motion, and there is centripetal force, centrifugal force, and centripetal acceleration.
An Analysis of Physics Concepts in Several Rides at Batu Night Spectacular (BNS) Indonesia
Authors: Ariantoro Alvian , Cahyani Tia Rahmi , Ramandani Risqilia , Prahani Binar Kurnia , Dwikoranto
Published: August 2023

Edutainment can simply be defined as a learning designed by combining educational content with entertainment. This study was conducted with the aim of analyzing the physics concepts contained in several rides at the Batu Night Spectacular (BNS) amusement park. This research uses a qualitative approach and is a case study. The data collection technique used is documentation in the form of images or articles on online media. There are three rides analyzed, namely Flying Swinger, Megamix, and Gravitron. From the data and the results of the analysis that has been done, it can be concluded that, Flying Swinger, Megamix, and Gravitron work based on the concept of force or having the concept of force on them. The forces that were analyzed on the three rides were centripetal force, centrifugal force, gravitational force, frictional force, and string tension force