bluuebunny/crossref_metadata_2025_split huggingface dataset:
From withdrawal to return in the first decade of the Ab Vrbe condita: An example of Livian dialectic of contrasts
Authors: Meunier Nicolas L.J. 
Published: March 2024

AbstractLivy's narrative, far from being a faithful and scrupulous account of historical facts, is first and foremost a piece of literary, a narration, a collection of exempla that should serve as models or anti-models for readers, as Livy himself says in his Praefatio (Liv. Praef. 10). In his writing work, he follows guiding principles, the most important of which is the dialectic of contrasts, inspired by oratory and rhetoric. On the basis of different examples from the first decade of Ab Urbe condita, the objective of this article is to examine how this principle of writing was applied to the theme of Returns (a motif well known in the imaginary and literature of classical Antiquity). Thus, it appears that each episode of return or attempt to return is systematically preceded by an episode of withdrawal from the civic community, with which it is contrasted in various ways. Examples of such withdrawal-return antagonist pairs are numerous, and they concern both individual characters (Tarquin the Proud, Coriolanus, Cincinnatus, Kaeso Quinctius, etc.) and collective ensembles (in the form of a secessio of an entire ordo).
Clinical and pathological study of patients with fibrocystic disease of breast in tertiary care hospital of Gurugram, Haryana
Authors: Goel Sapna , Singhal Bhumika , Kumar Anil , Singh Kanwar , Arora Tanay , Narayan Aditi 
Published: March 2024

A fibrocystic breast disease group of benign breast diseases that consists of fibrocystic breast disease, breast cyst, breast abscess, duct ectasia, cyclic and non-cyclic mastalgia, Gynaecomastia and Mondor's disease. Abnormal hormonal balance and cellular interactions mediated growth factors leading to ductal and cellular hyperplasia is the main pathophysiological cause of the disease. This prospective observational study was conducted on 100 SGT medical college and hospital patients from January 2021 to august 2022 to assess the detailed clinicopathological study of patients with fibrocystic disease breast diagnosed clinically with relevant investigations. In our study, we found that fibroadenoma is the maximum among all Fibrocystic breast diseases, i.e. 34%, with the majority between 11-30 years. It rises in the 2 decade of life and peaks in the 4 decade. Non-cyclic mastalgia constituted 29% of the total cases, with most patients lying in the age group of 31-50 years, where mastalgia was the presenting complaint in most cases. Inflammatory breast diseases formed 4% of the total, with the main presenting symptoms being mastalgia, fever and nipple discharge. Again, it mainly included patients from the age group of 31-50 years. Gynaecomastia and breast abscess were diagnosed in 3 cases, with all lumping on the right side of the breast.Our study attempted to derivate the spectrum of breast diseases in different age groups among patients reporting to SGT medical college and hospital, SGT University, Gurugram, Haryana. Apart from the incidence of various fibrocystic diseases, various other facts were recorded. Benign breast lesions were recorded to comprise the bulk of the patients presenting with breast disorders and were maximum in the reproductive age group. Breast sclerosing adenosis should be identified by excluding the malignancy. Most Fibrocystic breast diseases have been managed conservatively.
To determine the effectiveness of Tofacitinib on treatment outcome in patients hospitalised with COVID-19 pneumonia- A longitudinal observational study in a tertiary care Hospital Mandya
Authors: K M Vaishak , G V Anikethana , C K Mohankumar 
Published: March 2024

The effectiveness of Tofacitinib, a Janus kinase inhibitor, in patients who are hospitalised with coronavirus disease 2019 (COVID-19) pneumonia are unclear hence this study is conducted to evaluate the efficacy of Tofacitinib on treatment outcome in patients hospitalised with COVID-19 pneumonia.All diagnosed cases of SARS COV2 who required O2 therapy at the start of the study will be undergoing routine investigations according to COVID 19 management guidelines and will be treated with adequate immunosuppression with corticosteroids. Those patients whose inflammatory markers (CRP, S LDH, D DIMER) are not decreasing after 48 hours of corticosteroids therapy may be given Tab Tofacitinib 10mg bid for a period of 14 days or till the decrease in inflammatory markers, whichever is earlier. Oxygen requirement and inflammatory markers were assessed every 3 day. Out of 27 patients who didn’t respond for corticosteroids 20 were given the drug tab tofacitinb 10mg BD. CRP in the both the steroid non responders and steroid responders groups was high till day 9, on day 14 the CRP levels were normal in 50% of steroid non responders. S LDH levels in the steroid non responders group was in the decreasing trend i.e., on day 14 it was normal in 70% of patients.. The levels of D DIMER in tofacitinib group was high till day 6, and on day 14 the D-DIMER levels were normal in 40% patients. Oxygen requirement showed drastic changes in the steroid non responders group. Among patients hospitalized with COVID-19 pneumonia, addition of Tofacitinib to steroid non responders group showed early improvement in their clinical and biochemical levels. Hence, Tab tofacitinib can be recommended an adjunct to steroids for early clinical and biochemical improvement for treatment of moderate to severe cases of COVID-19.
Prevalence of stress, anxiety and depression amongst 1st year medical students in a medical college
Authors: Bhardwaj Atul , Singh Manpreet , Arora Deepti , Pahuja Hardik , Shalika  
Published: March 2024

There is a high psychological morbidity that is reported in undergraduate medical students. This can range from stress, anxiety, interpersonal problems, suicide to psychiatric disorders. The objective of our study was to assess the prevalence of depression, anxiety and stress amongst the first year undergraduate students in a medical college. A cross sectional study was undertaken after approval from institutional ethical committee which included the 150 undergraduate medical students of 1 year. A semi structured performa which included socio demographic profile was used along with Depression, Anxiety and Stress Scale (DASS 42) for assessment. Most of the participated students were females (57.5%). All of the students (100%) were residing in hostel and were unmarried. Stress was reported by majority (86.7%) of the students with few reporting low social support (7.3%). Single responses to causes of stress were in majority (74.6%). Prevalence of depression, anxiety and stress was 56%, 68.7% and 61.3% respectively. A considerable number of undergraduate medical students are affected and suffer from anxiety, stress and depression. There is an urgent need to address the issue and give more attention towards mental health of students.
Study the beneficial effects of oxygen blender during cardiopulmonary bypass in reducing lactate levels in patients undergoing open-heart surgery
Authors: Karthikeyan B , Rajesh B , Mughilan A S , Anbukumar P , Baylis Marwin Manoa 
Published: March 2024

Serum lactate levels rise during Cardio-Pulmonary Bypass (CPB) surgery for a variety of reasons, including peripheral circulatory failure, haemodilution, or excessive use of inotropic agents. Additionally, it has been reported that elevated serum lactate levels during the perioperative period are strongly associated with the worst postoperative outcomes, including mortality.To find out the beneficial effects of an oxygen blender during cardiopulmonary bypass in reducing lactate levels in patients undergoing open-heart surgery.This Prospective comparative study was done on 150 patients who underwent open-heart surgeries. Patients were divided into group A-75 patients: with direct oxygen flow without oxygen blender, group B- 75 patients: with oxygen blender. The serum lactate levels during CPB, postoperative levels and outcomes were monitored and both the groups were compared.Average FIO2 of 38 % was enough to maintain PO2 of 168 mm Hg by using the oxygen blender with the flow rates. Group A showed severe hyperoxemia (p-value &#60;0.0001) and hypocarbia, resulting in severe respiratory alkalosis during CPB and severe acidosis in the immediate postoperative period in most of the cases. Group B showed a significant reduction in the serum lactate value at CPB one hour with 3.1 mmol/l reductions, 3.8 mmol/L reductions at 2 hours and 4.4 mmol/L reductions at ICU arrival (p-value &#60;0.0001).Serum lactate values reduced significantly in the patients with oxygen blender. Study proved that application of an oxygen blender during CPB improved the postoperative results following open-heart surgeries. The researchers conclude that using an oxygen mask was beneficial.
HRCT chest: A valuable tool to differentiate other pneumonias from covid-19 pneumonia
Authors: Dhok Avinash Parashuram , Shinde Nitin Suresh , Rathi Simran , Mitra Kajal Ramendranath 
Published: March 2024

To assess how COVID-19 pneumonia differs from other pneumonias in terms of the chest computed tomography features.In this study we included 170 clinically diagnosed cases pneumonia referred to department of radio diagnosis subjected to HRCT thorax which include out patients and in patients out of which 127 patients tested RT-PCR positive for Covid 19 pneumonia for a total duration of 1 year. (March 2020 to March 2021). The parenchymal abnormalities including Ground glass opacities (GGO), ground glass opacities with interlobular septal thickening (crazy paving), GGO with consolidation, consolidation, pulmonary nodules, tree in bud appearances, bronchiolar wall thickening, interlobular septal thickening , halo sign, reverse halo sign, cavitation and pleural effusion and were observed and categorized along with determination of pattern of distribution on chest CT.127 patients who tested positive for COVID 19 and 43 patients with other pneumonia (such as community-acquired pneumonia) were visited, and CT scans were analysed to determine the presence and distribution of the disease pattern.Patients with COVID 19 pneumonia primarily have peripheral-based lesions (90%), whereas patients with other pneumonias primarily have mixed patterns (70%)—a difference that is statistically different (p 0.05).Statistics show that COVID 19 had higher bilateral involvement than other pneumonia (p&#60;0.05). In COVID-19 pneumonia, GGOs, GGOs with interlobular septal thickening (crazy paving), and GGOs with consolidation with peripheral and basal predominance in bilateral lung parenchyma are the most common imaging patterns and findings. These findings will help us distinguish COVID-19 pneumonia from other causes of pneumonia. There is less evidence of tree in bud, pure consolidation, cavitation, and bronchiolar wall thickening.
Evaluation of thyroid nodules by high resolution ultrasonography (HRUSG) and its cytological correlation in a teaching hospital
Authors: Golmei Tinaimeiru , Babu Kodithyala Raghavendar 
Published: March 2024

Thyroid nodules are a frequent occurrence. With the widespread use of sensitive imaging methods, a growing number of thyroid nodules are being discovered by chance. High resolution ultrasonography (HRUSG) has emerged as the most appropriate imaging modality for the assessment of thyroid nodules.To Evaluate thyroid nodules by of high resolution ultrasonography (HRUSG) and its correlation with Fine needle aspiration cytology (FNAC). Prospective study done in the department of radiology at Maheshwara medical college and Hospital, Chitkul, near Isnapur, Patancheru, Sangareddy, Telangana for duration of 3 years. A total of 80 cases were studied.HRUSG was done in all cases and Fine Needle Aspiration cytology was done. Radiological and pathological correlation was done and Sensitivity, specificify PPV, NPV and accuracy were calculated. Females were predominant (62.5%) when compared to males (37.5%). Among 80 thyroid nodules , colloid nodule noted in 42.5% cases, Nodular goitre in 27.5%, Hashimotos thyroiditis and follicular adenoma in 12.5%cases and Malignancy in 5% cases HRUSG is a sensitive and specific imaging technique that has a high level of accuracy in the evaluation of thyroid nodules. Solid composition, hypoechogenicity, taller-than-wider form, ill-defined edges, and the presence of calcification are the most effective sonographic markers for predicting cancer.
Role of USG and MRI to detect the rotator cuff injury and to compare the efficacy of both
Authors: K Lohith , Gowda Vinaya Manohara , C N Pradeep Kumar , B S Sriviruthi 
Published: March 2024

The objectives of this study were to detect the rotator cuff injury using high-resolution ultrasonography in clinically suspected patients, compute MRI findings and compare the effectiveness of ultrasound and MRI diagnostically in such patients. 30 patients who were suspected to be suffering from rotator cuff injury were referred to the Department of Radiodiagnosis, Medical Trust Hospital, Kochi, Kerala. MRI and high-resolution ultrasonography were used to evaluate them after taking their written consent. The present study was carried out from November 2018 to October 2019. In partial thickness tears, the specificity of ultrasound was 87.5% and sensitivity was 72% whereas it was 83.3 % and 95.8% respectively for full-thickness tears. MRI was more sensitive than USG in evaluating the capsular and labral pathologies. MRI was the most sensitive and specific modality in the evaluation of shoulder pain. A specificity of 94% and a sensitivity of 92.3% was seen in relation to MRI in case of partial thickness tears; whereas in full thickness tears a specificity of 95.8% and a sensitivity of 100.0% were seen. In calcific tendinitis, picking bursal fluid and impingement, MRI was better than USG and also highly sensitive for labral tears. In the evaluation of shoulder pain, MRI is the most appropriate evaluation modality and in case of labral tears it is highly sensitive. When compared to USG, MRI is better in picking bursal fluid, impingement as well as calcific tendinitis and also in evaluating labral and capsular pathologies.
Morbidity pattern based on clinico-biochemical profile of neonates admitted in NICU of a tertiary care hospital in the mid north bank region of Assam
Authors: Barthakur Chinmayee , Sarmah Julie , Saharia Niru Prabha 
Published: March 2024

The neonatal period carries the highest risk of death per day compared to any other period during childhood. Of all newborn deaths three fourths result from three preventable and treatable conditions– complications due to prematurity, intrapartum related deaths (including birth asphyxia) and neonatal infections. The study was to describe the morbidity pattern with outcome, based on clinical diagnosis and relevant biochemical parameters amongst neonates admitted in NICU in the tertiary care hospital. A retrospective case record analysis of all the NICU admissions between January 2021 to March 2021 was done based on both electronic and hard data. The neonates with complete records of clinical presentation, relevant biochemical investigations were included in the study. Out of 624 neonates admitted in NICU during the study period, 622 were included in the final analysis. The proportion of fullterm and preterm among inborns (77.6% &18.8%) and outborns (76.2% & 21.8%) were similar, but the proportion of low-birth-weight babies in outborns was higher than in the inborns. The overall discharge rate was 85.5%. It was higher for inborn neonates as compared to outborn neonates (88.7% vs 79%). The death rate was higher in outborns than in inborns. The highest no of NICU admission was due to asphyxia related conditions followed by neonatal jaundice in both genders and in all inborn and outborn neonates. Out of total admissions in NICU, 72(11.6%) was due to infections causing neonatal sepsis, meningitis and acquired pneumonia. While neonatal jaundice has a lower mortality rate, preventable conditions like birth asphyxia and infections remain major concerns for neonatal morbidity and mortality in this region. The study emphasizes the need for strengthened antenatal care, improved infection control, and increased access to trained neonatologists to ensure better outcomes for newborns.
Comparison of dexmedetomidine and propofol infusion on intraoperative haemodynamics during functional endoscopic sinus surgery under general anaesthesia- A randomized controlled trial
Authors: Garg Sahil , Kaur Hersimran , Singh Amandeep , Bansal Pankaj , Garg Manvi , Prasad Seema 
Published: March 2024

Functional endoscopic sinus surgery (FESS) is a surgical technique to treat sinonasal diseases. Intraoperative bleeding is one of the major challenges, which hinder the confined area of visibility and prolongs the procedure. Intraoperative induced hypotension can reduce intraoperative bleeding, to provide clear surgical field for dissection and hence decreasing operative time. So, we compared effect of dexmedetomidine and propofol infusion on the intraoperative haemodynamics during functional endoscopic sinus surgery (FESS). To study the effect of intravenous (IV) dexmedetomidine and propofol infusion on intraoperative haemodynamics under general anaesthesia in functional endoscopic sinus surgery(FESS). Secondary aim was to study estimated blood loss if any. To study the effect of I.V. dexmedetomidine and propofol infusion on intraoperative haemodynamics under general anaesthesia in functional endoscopic sinus surgery (FESS). Patients were divided randomly by sealed envelope method into two groups with 30 patients in each group. Group D patients received dexmedetomidine 1ug/kg as a loading dose over 20 minutes followed by 0.3 ug/kg/hr infusion for maintainence. Group P patients received propofol 2mg/kg as a loading dose followed by 100-200 ug/kg/min infusion for maintenance. The findings in our study highlights that dexmedetomidine infusion decreases haemodynamic parameters like arterial blood pressure and heart rate more as compared to propofol infusion during FESS. The effect on hemodynamics sustained and consistent without requirement of additional hypotensive agents. So altogether, this lead to better surgical field. Use of dexmedetomidine is a safe and effective method to control bleeding and improve the quality of surgical field and intraoperative haemodynamics.
Correlation of serum biomarker (LDH, CRP, IL-8) levels in pre-malignant and malignant lesions of head and neck
Authors: Faiz S M , Singh Harsha , Parveen Mariyam , Bhatt Kriti , Singh Abhijeet , Samiullah  
Published: March 2024

A precancerous lesion is often defined as morphologically altered tissue during which the occurrence of carcinoma is more likely than its normal counterpart. Head and neck cancers include cancers of the mouth and therefore the larynx, also as some rarer cancers like cancer of the sinuses, salivary glands, nose, and tympanic cavity. Head and neck cancers are often described as consistent with the sort of cell they begin with. A biomarker could be defined and interpreted as biological molecule which is mostly found in body fluids, blood or even tissues that indicates abnormalities of our body. Here we've taken three biomarkers (LDH, CRP, IL-8) to gauge their level rise in pre-malignant and malignant lesions which are present in our head and neck. Patients attending ENT OPD with primary symptoms indicating premalignant and malignant lesions in the region of head and neck had been included for the analytical study. Complete ENT examination followed by biopsy of the suspicious lesion and blood sample collection was done. A complete of 30 patients were included in each group of premalignant and malignant lesions. No mean serum rise of serum LDH was noted in premalignant and malignant lesions. A mean serum rise of serum CRP was noted in premalignant lesions but was not noted in malignant lesions. However, both premalignant and malignant lesions noted a mean serum rise of IL-8. From a future perspective serum evaluation of biomarkers can become a replacement diagnostic modality for the early evaluation of premalignant lesions and malignant lesions and for monitoring the prognosis of an equivalent.
A hospital based study to evaluate etiology and epidemiology of occupational corneal foreign bodies
Authors: Nagar Vipul Kumar , Choudhary Nahar Singh 
Published: March 2024

Occupational injuries to eye are very common. Corneal foreign bodies (CFB) are common occupational eye injury. Studies on corneal foreign bodies due to occupational exposure are ignored in developing countries like India.Our study objective was to determine various occupations related to corneal foreign bodies and demographics, level of education and awareness of patients presenting with CFB acquired during occupational work.A hospital based cross sectional study at a tertiary hospital at Pali, Rajasthan.Patients presenting with CFB were asked about their occupation, level of education, awareness about complications of CFB and use of protective equipments at workplace.We examined total 62 patients with CFBs. All patients were male. 34% were in the age group of 18-29 yrs and 58% were in the age group of 30-45 yrs. Metal work industry was responsible for 29% of presentations and construction work industry for 26% of cases. Only 18% were using protective equipments during occupational activity. 58% patients attempted self-removal of foreign body.CFBs are common among various occupations. The sufferers are commonly young males who are poor and have low education. This occupational hazard can have blinding complications and is generally overlooked. Awareness regarding protective measures must be increased and access to eye care hospital must be increased.
Study of vesicular mole and its outcomes
Authors: Chaudhari Shilpa , Sasane Aparna , Hol Kishor , Navadia Dyuti 
Published: March 2024

Vesicular mole is defined as the premalignant form of gestational trophoblasticneoplasia. I5-20% of complete moles and &#60;5% of partial moles will develop into Gestational Trophoblastic Neoplasia. It is of clinical and epidemiological interest because of its potential for significant consequences on women's health. The study aims to determine the incidence, outcomes and complications of pregnancy with vesicular mole at SKNMC hospital, Pune. It was a retrospective study. Approval for the study was obtained from institutional ethical committee. Data was collected from OPD, OT register and Indoor patient record file from August 2015 to August 2020. Proformas were filled. All the collected data was compiled in a master chart, analysed and outcomes of different variables under study have been expressed in the form of mean, frequencies, percentages and charts. The incidence of molar pregnancy was 0.17% or 1 in 561 deliveries. Vesicular mole occurred more in the age group 16 to 25 years, was lowest in age group 31-35yrs. Vesicular mole was most common in nulliparous women. The mean gestational age of the patients at presentation was 9.4 week. Hemorrhage after suction and evacuation was seen in 26% cases needing intra and post-operative blood transfusion. 6% of patients developed thyrotoxicosis. During follow up invasive mole was diagnosed in 2 cases (6%). The case fatality rate is 2.9% in our study. 1 patient (3%) developed choriocarcinoma and died within 6months after hysterectomy and chemotherapy. The incidence of 1 in 561 deliveries which is higher than non-Asian countries 1/752 but lower than other Asian countries 1/387. The routine first trimester ultrasonography helps in early detection of asymptomatic women. If not followed up regularly it can be life threatening.