bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Management of Adnexal Masses in the Pediatric and Adolescent Age Group
Authors: Luthra Meera , Kumar Chiranjiv 
Published: September 2021

Context:
Adnexal masses in girls represent a wide pathological spectrum. We performed a retrospective analysis of clinical and diagnostic aspects of adnexal masses in girls.

Aims:
To analyze the clinical characteristics and surgical management of adnexal masses in children and adolescents.

Settings and Design:
Retrospective observational analysis from 2000 to 2020.

Subjects and Methods:
This analysis was performed on 28 children under the age of 17 years with adnexal masses who were managed by us at tertiary care centers of Delhi-NCR. Patients were analyzed based on their age at the time of admission, their presenting complaints, clinical and radiological findings, tumor markers, management, and follow-up.

Results:
The age ranged between newborn and 17 years. Abdominal pain, nausea with vomiting, and abdominal lump was the most common presenting complaints. Pelvic ultrasound with or without color Doppler done in all patients and computed tomography, magnetic resonance imaging was performed in seven patients preoperatively. Adnexal masses were unilateral in 26 (92.85%) patients and bilateral in 2 (7.15%) patients. Five babies had antenatal diagnosis of ovarian cysts. Serum alpha fetoprotein (AFP) and beta-human chorionic gonadotropin (b-HCG) were normal in all 19 tested patients. Cancer antigen 125 (CA-125) was raised in three ovarian tumors out of 9 tested patients. Laparoscopy was performed in 23 out of 28 patients (30 ovaries). Ovarian cyst torsion was present in 50% patients. Ovarian cystectomy was done in 10 (33.3%) patients. Six (20%) ovaries were saved by detorsion of the ovary and deroofing of the cyst with or without ovarian biopsy. Oophorectomy was done in five (16.7%) patients. Salpingo-oopherectomy had to be done in seven (23.3%) patients. Histopathology revealed functional nonneoplastic lesions in 18 cases (66.7%), benign neoplastic lesions in 8 cases (29.6%), and malignant neoplastic lesion in 1 case (3.7%).

Conclusions:
Adnexal masses in children are generally benign. AFP, b-HCG, and CA-125 in ovarian torsion are within normal limits. Urgent surgery is required if torsion is established. The ovary should be preserved wherever possible.
Does Preoperative Function Affect the Outcome Following Pyeloplasty in Poorly Functioning Kidneys among Pediatric Population?
Authors: Rudrawadi Sharanbasappa , Kochhar Gaurav , Shekhar P. Ashwin , Laddha Prateek Jugalkishore 
Published: September 2021

Aim:
To determine the efficacy and outcome of pyeloplasty in poorly functioning kidneys in the pediatric population and whether pyeloplasty could be offered as an upfront procedure in such patient population, instead of nephrectomy.

Materials and Methods:
A retrospective data analysis of 83 patients who underwent pyeloplasty in poorly functioning kidneys from 2010 to 2015 was performed. Success was defined based on improvement in symptoms, stable or improved function, and better drainage on post-operative Tc-99m Diethylene Triamine Pentaacetic acid scan instead of DTPA scan renography done after 3 months and yearly thereafter.

Results:
Eighty-three patients with a mean age of 6.8 ± 2.88 years with poor function on isotope renogram (<30%) were included in the study. Three patients were excluded in view of postoperative outflow obstruction. Out of the remaining 80 patients, 56 were male and 24 were female. They were divided into two groups based on preoperative differential renal function (DRF), Group I (n = 26) having preoperative DRF of <10% and Group II (n = 54) having preoperative DRF of 10%–30%. All patients underwent laparoscopic dismembered pyeloplasty with ureteral stenting. The mean DRF improved from 7.58 ± 2.39 to 29.71 ± 5.16 postoperatively in Group I. However, in Group II, DRF improved from 20.81 ± 5.68 to 37.25 ± 7.11 postoperatively. At a follow-up of 24 months, the overall success rate was 98%.

Conclusion:
Pyeloplasty gives good intermediate-term results even in extremely poorly functioning kidneys and an upfront pyeloplasty instead of nephrectomy should be offered to all pediatric patients irrespective of preoperative function.
Head-and-Neck Solid Tumors in Children
Authors: Manogaran Ravi Sankar , Mandelia Ankur , Bhuskute Govind , Mathialagan Arulalan 
Published: September 2021

Objectives:
The aim of this study was to review the clinical profile, management, and outcome of solid tumors in the head-and-neck region in children at our institute.

Methods:
We retrospectively reviewed children with head-and-neck solid tumors who were treated jointly under the departments of Pediatric Surgery and Otorhinolaryngology at our institute between 2016 and 2019.

Results:
In the study period, 10 children (6 males, 4 females) with a median age of 9.5 years (range 5 days–16 years) were treated by our unit. The patients had four tumors arising from the parotid, 2 from nose/naso-pharynx, 1 each from the tongue, submandibular gland, para-pharyngeal space, and infratemporal fossa. A majority (90%) of the patients underwent complete surgical excision of the tumor, preserving the loco-regional neurovascular structures to minimize postoperative morbidity. Malignant lesions were seen in 4 patients (2 rhabdomyosarcoma, 1 primitive neuro-ectodermal tumor, 1 mucoepidermoid carcinoma) and 6 patients had benign pathology (3 pleomorphic adenoma, 2 mature teratoma, 1 schwanomma). Additional therapy with chemotherapy and local radiotherapy was required in 3 out of 4 patients with malignant pathology. The median follow-up duration is 15 months. At last follow-up, all patients are alive and 9 out of 10 patients (90%) are disease-free.

Conclusion:
Our experience highlights rare and difficult tumors in the head-and-neck region in children. These tumors are not commonly managed by the pediatric surgeon in routine practice. The paper outlines the multi-modality management of these tumors, which is essential for an optimal outcome.
Measurement of Body Temperature in Postsurgical Children
Authors: Jasani Mitul , Jasani Alpa , Shah Anirudh , Shah Amar 
Published: September 2021

Context:
Postoperative fever is known to occur after all surgical procedures irrespective of the type of anesthesia. Thermometry devices that work without touching or disturbing the child seem to be appreciated more than the conventional skin contact thermometers. However, whether this technology is reliable to be adapted for routine pediatric surgical care is debatable.

Aims:
The aim of this study was to study the accuracy of infrared nonskin contact digital thermometer (IRT) compared to the skin contact digital thermometer (DT) and mercury in glass thermometer (MT).

Settings and Design:
A prospective cross-sectional study was done in postoperative patients at a pediatric surgical center over a period of 3 months.

Subjects and Methods:
The forehead temperature was recorded with IRT. This was followed by recording the temperature in one armpit by DT and the other armpit by MT. Readings were promptly documented.

Statistical Analysis Used:
A sample t-test was done which gave the P value and mean. Linear regression analysis was carried out to find correlation coefficients. Bland–Altman test was used to access the concordance between all readings.

Results:
We found a strong correlation between temperature readings taken by DT (mean = −0.03, r = 0.07, slope = −0.04) and IRT (mean = 0.89, r = 0.091, slope = −0.14). However, on comparison of results with the MT, there are wider limits of agreement with the IRT (−0.31–2.09) in comparison to DT (−0.66–0.59).

Conclusion:
Skin contact digital thermometer are more accurate and suitable for checking body temperature as compared to infrared nonskin contact digital thermometer in postoperative pediatric patients.
Implementing Robotic-Assisted Gait Training in Acute Inpatient Stroke Rehabilitation
Authors: Cao Ning , Packel Andrew , Marcy Elizabeth , Sprik Kelly , Harold Erika , Xiao Rui , Esquenazi Alberto 
Published: September 2021

Background:
The recovery of independent walking is one of the major goals of stroke rehabilitation; however, due to the current acute inpatient rehabilitation care paradigm, the intensity of walking practice provided has been far below that recommended for motor recovery to occur. A quality improvement initiative was implemented to encourage the physical therapist (PT) to incorporate various robotic gait training devices as part of the standard allotted PT sessions to improve the intensity of gait training.

Materials and Methods:
After 6 months, a retrospective review was performed to assess the feasibility of the robotic-assisted gait training (RAGT) intervention in limited-ambulatory stroke patients and determine preliminary efficacy of the RAGT program by analyzing Functional Index Measure (FIM) motor gain and accelerometer-based daily step counts in patients who received the RAGT versus a group treated with conventional therapy.

Results:
About 30% of limited-ambulatory patients admitted to the stroke rehabilitation unit received consistent integrated RAGT without safety concerns. Compared to those who received conventional treatment, these patients showed greater mean FIM motor gain (32.30 versus 17.88) at discharge (P < 0.005) and higher number of step counts in PT sessions (P < 0.005). Age, gender, or admission FIM motor were not associated with FIM motor gain.

Conclusions:
Across a 6-month initial implementation period, RAGT was feasible and was associated with higher repetition of walking practice and also with improved FIM motor scores in limited-ambulatory individuals in an acute inpatient stroke rehabilitation program. However, the frequency of RAGT and the percentage of patients participating need to further improve. Some strategies to address these concerns were identified.
Impact of COVID-19 pandemic on bariatric surgery in India
Authors: Bhasker Aparna Govil , Khaitan Manish , Bindal Vivek , Kumar Amardeep , Rajkumar Anirudh , Kaushal Anshuman , Prasad Arun , Parikh Chirag , Sethi Daksh , Goel Deep , Hareendran Deepak Thampi , Bedi Digvijay , Jammu Gurvinder Singh , Leo Jayanth , Kular Kuldeepak , Narwaria Mahendra , Chikkachanappa Mahesh , Motwani Manish , Bharucha Manoj , Ismail Mohamed , Dukkipati Nandkishore , Shah Neha , Tantia Om , Patel Parag , Padmakumar R. , Singh Rahul , Palaniappan Raj , Shrivastava Rajesh , Rajput Ram Raksha Pal , Goel Ramen , Wadhawan Randeep , Garg Rohit , Aggarwal Sandeep , Patolia Sanjay , Baig Sarfaraz J. , Shah Shashank , Shivaram H. V. , Dhorepatil Shrihari , Saggu Sukhvinder Singh , Ugale Surendra , Perungo T. , Soni Vandana 
Published: September 2021

Background:
Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS).

Methods:
A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines. Google Form was circulated to all surgeon members through E-mail and WhatsApp™. In the second phase, clinical details were captured from surgeons who reported positive cases.

Results:
One thousand three hundred and seven BMS were reported from 1 January 2020 to 15 July 2020. Seventy-eight per cent were performed prior to 31 March 2020 and 276 were performed after 1 April 2020. Of these, 13 (0.99%) patients were reported positive for COVID-19 in the post-operative period. All suffered from a mild disease and there was no mortality. Eighty-seven positive cases were reported from patients who underwent BMS prior to 31 December 2019. Of these, 82.7% of patients had mild disease, 13.7% of patients had moderate symptoms and four patients succumbed to COVID-19.

Conclusion:
BMS may be considered as a safe treatment option for patients suffering from clinically severe obesity during the COVID-19 pandemic. Due care must be taken to protect patients and healthcare workers and all procedures must be conducted in line with the safe practice guidelines.
KAJIAN FRASA PADA NOVEL TRAUMA KARYA BOY CANDRA
Authors: Rosyidah Ulfa , Hasanudin Cahyo , Amin Ahmad Kholiqul Amin 
Published: September 2021

Frasa merupakan objek kajian sintaksis yang bersifat nonpredikatif. Penelitian ini bertujuan untuk: 1) mengetahui bentuk frasa pada novel Trauma karya Boy Candra, dan 2) mengetahui relevansi hasil penelitian dengan pembelajaran bahasa di SMA. Penelitian ini merupakan penelitian deskriptif kualitatif. Data penelitian ini berupa bentuk frasa dengan sumber data didapat langsung dari novel Trauma karya Boy Candra. Prosedur penelitian ini menggunakan teknik simak bebas libat cakap, teknik catat, dan teknik wawancara. Teknik analisis data melalui 3 tahapan yaitu, reduksi data, penyajian data penarikan kesimpulan atau verifikasi. Validasi data yang digunakan dengan teknik triangulasi sumber. Hasil penelitian ini yaitu 1) novel Trauma karya Boy Candra mengandung bentuk frasa endosentris, frasa eksosentris, frasa verba, frasa nomina, frasa numeralia, frasa idiomatik dan frasa ambigu, dan 2) kandungan frasa pada novel Trauma relevan dengan pembelajaran bahasa di SMA, khususnya sebagai sumber belajar pada materi jenis-jenis frasa dan kontruksi frasa dalam kalimat.
Historical aspects of the medical education system transformation
Authors: Kagramanyan I. N. , Tarasenko A. I. , Kupeeva I. A. , Yanushevich O. O. , Pashkov K. A. , Efimov A. O. 
Published: September 2021

The history of medical and pharmaceutical education development is part of the social history. The quality of medical personnel training determines the efficiency of the entire health care system and has been a priority area of development throughout the history of the Russian state. The paper reflects the main stages of the medical education system development in the period from the 17th century to the present. The training of medical personnel in Russia began in the second half of the 17th century, when, under the Pharmaceutical Order, a medical school was established in 1654to train doctors for the needs of the army.The need to provide qualified medical personnel remains relevant, both in wartime and in peacetime. The reforms of medical education that have been taking place over the centuries make it possible to diversify educational programs, as well as the to introduce new educational technologies, considering modern requirements and global trends. The study of the historical aspects of domestic medicine determines a more competent approach to the development of the health care system and medical education.
Causes of death in patients with tuberculosis and human immunodeficiency virus co-infection
Authors: Frolova O. P. , Butylchenko O. V. , Stakhanov V. A. , Enilenis I. I. , Romenko M. A. , Martel I. I. 
Published: September 2021

Objectives. The aim of the study was to investigate the cause of death of tuberculosis patients infected with the human immunodeficiency virus (HIV). Many researchers and experts note the urgency of the problem of tuberculosis combined with HIV infection in the world and in Russia. One of the main criteria for assessing the effectiveness of medical care for tuberculosis patients infected with the human immunodeficiency virus is the mortality rate.Materials and methods. For a detailed study of the causes of death of patients with tuberculosis in combination with HIV infection, we analyzed the causes of death of this contingent of patients in 5 regions of the Russian Federation.Results. The social characteristics of patients, the forms and course of the disease, the main and immediate causes of death of 223 patients with co-infection with HIV and tuberculosis were studied.Conclusion. Half of the deaths of tuberculosis patients infected with human im­munodeficiency virus were not associated with tuberculosis. Among these cases, there was either the presence of several infections at the same time, equally leading to death, or separate opportunistic infections (candidiasis, Pneumocystis pneumonia, toxoplasmosis), or cancer. In addition, the lifestyle of patients often became the cause of deaths, namely: drug poisoning and accidents, or cirrhosis of the liver, which develops as a result of alcoholism or hepatitis C infection which occurred during intravenous administration of drugs.
Features of hospitalization of patients in the trauma and orthopedic center in the context of the second wave of the COVID-19 pandemic
Authors: Nikolaev N. S. , Belova N. V. , Preobrazhenskaya E. V. , Malyuchenko Yu. A. , Dobrovol’skaya N. Yu. , Andronnikov E. A. 
Published: September 2021

The algorithm for examining patients for SARS-CoV-2 during admission to non-infectious hospitals, a unified route scheme for patients taking into account the potential infectious hazard is not regulated.The aim of the study is to identify the features of the diagnosis of SARS-CoV-2 during planned hospitalization in the field of “traumatology and orthopedics”; to present schemes for examining patients for SARS-CoV-2 during hospitalization and patient routing in the clinic.Materials and methods. The route and procedure of examination to exclude the nosocomial spread of COVID-19 in patients hospitalized for three months is described. 3366 survey results were analyzed.Results. Positive PCR tests for COVID-19 before hospitalization were obtained in 4.5 % of patients. High titers of IgM are found in 7.8 % of cases. At the level of the Pass Office, 10.5 % of arrivals were denied hospitalization. The CT scan of the chest organs, which was then carried out, revealed among the examined 9.1 % of asymptomatic pneumonia, of which 93.5 % – with radiological signs of COVID-19, 2/3 of “covid” pneumonia – with a CT-0 degree. Another part of hospitalizations was postponed due to somatic contraindications during clinical examination. After all the selection stages, 73.2 % of planned hospitalizations ended up. In the hospital, 12 cases of COVID-19 were detected in the postoperative period, more often on the 4th day after the operation. A total of 2,328 patients were discharged during the study period – 69.2 % of planned hospitalizations, a third of patients received a medical withdrawal from hospitalization due to COVID-19.Conclusions. The peculiarities of admitting patients to planned hospitalization in the traumatology and orthopedics profile is the difficulty of reliably detecting COVID-19 in a limited time. In some cases of asymptomatic course, the disease is detected only with the help of CT diagnostics. In 0.5 % of cases, COVID-19 is detected in the postoperative period. The described patient routing scheme, multistage diagnostics to exclude COVID-19 are able to ensure maximum infectious safety of patients and staff in the clinic.
War, refugees and regional implications: The impact of Afghan refugees on local society of Khyber Pakhtunkhwa, Pakistan
Authors: Khan Asghar , Khan Irfan , Khan Noor Ullah 
Published: September 2021

The migration of Afghan refugees into Pakistan started in the wake of Saur (Red) Revolution in 1978, as a result of reforms introduced by the communist regime in Kabul, Afghanistan. However the large influx of refugees to Pakistan took place soon after the invasion of Soviet Union in 1979. Pakistan provided asylum for the approximately 4.2 million refugees. They were settled in 386 camps mostly in rural as well as in urban areas of the country. But the most populous province that has large number of Afghan refugees was Khyber Pakhtunkhwa (KP) (that time N.W.F.P), which has long border (Durand line) with Afghanistan, and also has cultural, religious, and linguistics ties. This large number of immigrants generated grave consequences for Pakistan, especially for Khyber Pakhtunkhwa. They have affected the socio-economic and political life of the province. The main objective of the study was to find out the socio-economic impact of Afghan Refugees living for more than three decades in the host society of KP. An empirical and analytical methodological approach was adopted for this study. To conclude the findings, the research reveals that that Afghan Refugees have not only affected the social set-up but also the economy of the local host society by introducing various type of social evils like begging, drugs culture, Kalashnikov culture (AK-47), Galemjum culture (prostitution) and corruption.
The effect of Thymbra spicata extract and its bioactive component Thymol on non-small-cells lung cancer cell line A549
Authors: Moayeri Ardeshir , Mohammadpour Shahram , abbasi Naser , Aidy Ali , Karimi Elahe , Ghaneialvar Hori 
Published: September 2021

IntroductionAlternative medicine is important in cancer treatment. The apoptotic effect of Thymol and extracted Thymol from Thymbra spicata on non-small-cells lung cancer was studied.Material and methodsThymol was evaluated in Thymbra spicata extract by HPCL. Cell viability was assessed by MTT method. DCF and flu3-AM probe was used for ROS and cai2+ analysis, respectively. Western blotting was performed to measure NOX2 and Bax/Bcl-2 ratio.ResultsObtained data showed that Thymol was 1.51 mg/g in Thymbra spicata extract. Treatment with Thymol and extracted Thymol from Thymbra spicata resulted in cell death at high concentrations [LC50= 111±4.5 and 119±5.2 μM, respectively]. Subsequently, Thymbra spicata extract and its bioactive component increased ROS and Cai2+ production, NOX2, and Bax/Bcl-2 ratio.ConclusionsThis study revealed the anticancer effects of Thymol and Thymbra spicata extract on non-small-cells lung cancer and at least part of that effect was related to the increase in the NOX2 and Bax/Bcl-2 ratio. Our results demonstrated that TSE and Thymol at high concentrations (180, 120, and 80 μM) decreased the growth of A549 cells. It appeared that cytotoxic activity was exerted through activation of NOX2, ROS generation, increase in Cai2+, and Bax/Bcl-2 ratio. Present results demonstrated that TSE and thymol may be potential therapeutic agents for human lung cancer.
Different sonographic features of peripheral thyroid nodule calcification and risk of malignancy: a prospective observational study
Authors: Nabahati Mehrdad , Ghaemian Naser , Moazezi Zoleika , Mehraeen Rahele 
Published: September 2021

IntroductionTo investigate the association of peripheral calcification, as well as its sonographic features, with thyroid nodule malignancy.Material and methodsThis study was prospectively conducted during 2015-2020 on patients diagnosed with thyroid nodule undergoing ultrasound-guided fine-needle aspiration in Shahid Beheshti teaching hospital or private offices in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as the cytological findings, were recorded. Regression analysis was used to assess the relationship between sonographic results and malignancy. We also used receiver operator characteristics (ROC) analysis to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC).ResultsA total of 1857 thyroid nodules were finally included, of which 84 were peripherally calcified nodules. There was a significant positive association between the nodule malignancy and peripheral calcification (OR = 2.23, 95% CI: 1.13-4.35). In the nodules with peripheral calcification, significant positive associations were seen between malignancy and lobulated margin (OR = 3.85, 95% CI: 1.02-14.54) and solid composition (OR = 4.05, 95% CI: 0.99-16.53). The ROC analysis indicated that AUC for lobulated margin and solid composition was 63.8% and 66.5%, respectively, in predicting malignant thyroid nodules.ConclusionsThe findings showed that peripheral calcification on sonography can be a potential indicator of malignant thyroid nodules. Also, the presence of lobulated margin and/or solid composition, besides peripheral calcification, can be helpful in better distinguishing malignant from benign nodules.