bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study factors associated with poor glycemic control in type 2 diabetes mellitus patients in tertiary care center
Authors: Mathuriya Anita , Abbas Shahid 
Published: May 2023

Background: Poor glycemic control is a major public health issue among patients with type 2 diabetes mellitus and a significant risk factor for the progression of diabetic complications. This study aimed to assess the magnitude and contributing factors of poor glycemic control among type 2 diabetes patients.
Methods: A cross-sectional study was conducted among 150 type 2 diabetes patients a sample of 150 type 2 diabetics of both sexes was obtained diabetes in medicine OPD, any type 2 diabetes patient at the healthcare facilities over the age of 18 was eligible to participate in the study.
Results: Of the 150 type 2 diabetes patients included in the study, 118 had poor glycemic control. Mean age was 59.67 (SD = 9.617) years; 115 (76.9%) of them were men. Most patients [n = 62 (41%)] used insulin or oral anti-diabetics as monotherapy [n = 32 (21%)] to regulate their blood sugar levels. The glycemic control got worse the longer the patient had diabetes, from 5 to 10 years (OR = 1.74) to more than 10 years (OR = 2.55), compared to patients with less than 5 years of illness. In comparison to patients with co-morbidity, patients without co-morbidity had significantly better glycemic control (OR=1.56).
Conclusions: Gender, age, BMI, occupation, medical history, medication history, triglycerides, HDL, duration of diabetes, type and number of diabetes medications, and HbA1c were significantly associated. These factors can identify patients at risk of poor glycemic control, allowing targeted interventions for optimal outcomes. Adherence, physical activity, diabetes education, and training affect glycemic control, but this study did not.
Clinico-epidemiological profile and treatment outcome of pituitary adenomas: a retrospective study
Authors: Tali Tavseef Ahmad , Amin Fiza , Sofi Shahid Rashid , Khan Nazir Ahmad , Dar Javaid Ahmad , Sofi Mushtaq Ahmad 
Published: May 2023

Background: Aim of this study was to evaluate the clinico-epidemiological profile and treatment outcome of pituitary adenomas.
Methods: This was a retrospective study performed in the department of Radiation Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, India, in which 30 cases diagnosed with pituitary adenoma from January 2016 to December 2021 were studied. There clinical and epidemiological features, treatment, overall survival and follow-up data was analyzed.
Results: Most patients were female in gender 17 (57%), and the incidence rate was higher in female patients than male. Microadenoma was seen in just 4 (13%) patients. Macroadenoma in 12 (40%) and giant tumours in 14 (47%). At three and five years, the overall survival rate was 92% and 83%, respectively. Additionally, patients who got adjuvant radiation had a higher overall survival rate (84% versus 76%, p=.833) than those who did not.
Conclusions: Radiotherapy is an effective treatment for pituitary adenomas, able to achieve excellent disease control. Patients with pituitary adenomas should be identified at an early stage so that effective treatment can be implemented. Initial therapy is generally transsphenoidal surgery with irradiation reserved for patients who do not achieve adequate reduction in tumor size after surgery.
A rare case of recurrent cerebrospinal fluid rhinorrhea
Authors: Karthikeyan Ramalakshmi , Rashid Rahim A. 
Published: May 2023

Cerebrospinal fluid (CSF) rhinorrhea is the leakage of cerebrospinal fluid through the nostrils due to an abnormal communication between the nasal cavity and sub–arachnoid space. CSF rhinorrhoea can be traumatic or spontaneous. CSF rhinorrhea carries a risk of ascending infection leading to meningitis. CSF rhinorrhea is not very common and could be easily mistaken for rhinitis. Physicians need to have a high index of suspicion to diagnose and treat this rare and potentially serious condition. Here we discuss a case of delayed post-traumatic CSF rhinorrhea -an unusual presentation in a primary care setting, focusing on presentation and diagnosis.
Pancreaticoduodenal injuries at a tertiary care centre-clinical profile, associated injuries, management modalities, and outcomes
Authors: Lande Prarthini V. , Quraishi Abdul Haque M. , Umare Girish M. , Hosamani Prashant , Meshram Mohit 
Published: May 2023

Background: Pancreaticoduodenal injuries are considerably associated with high morbidity and mortality due to delayed diagnosis and subsequent delay in treatment. This makes the treatment of these injuries challenging. We have studied the presentation, diagnosis, management and outcome of these complex injuries.
Methods: A prospective observational study was done at general surgery department, Government medical college Nagpur from October 2020 to September 2022. Mortality, morbidity, and various treatment modalities were evaluated.
Results: Thirty two patients presented to the Trauma care center with history and symptoms suggestive of isolated pancreatic, duodenal, and combined pancreaticoduodenal injuries. Most of the injuries were blunt trauma cases. The ratio of hemodynamically stable: unstable was 1:1. Majority injuries were to pancreas followed by duodenum and combined organ injuries. Most of cases were diagnosed by CT scan. In this study 56% of cases had a non-operative line of treatment while 44% underwent surgical intervention. Among the patients operated 5 died, within 7 days of admission due to post-operative complications-hemorrhage, sepsis, aspiration pneumonia, and anastomotic leak. Two patients died due to delayed complications due to the development of pancreatic fistula and enterocutaneous fistula. Mortality rate was 27.2% in this study.
Conclusions: Early presentation and prompt diagnosis is the key to the management of such injuries. Patients managed conservatively need close monitoring, repeated assessments, and long-term follow-up.
Intra-articular distal humerus fracture – TRAP or olecranon osteotomy
Authors: Jain Rohit , Frank H. C , Dutta K. K , Hazarika Kishore 
Published: May 2023

: Intra-articular distal humeral fractures can be approached in a variety of ways. The purpose of this study is to evaluate and compare the functional outcomes of two approaches: one with olecranon osteotomy and other with triceps-lifting approach; for the treatment of intra-articular distal humeral fractures.: In this study, 10 patients in Group A were compared with 10 patients in Group B. Both the groups were comparable in terms of age, gender, duration of injury and degree of comminution of the fracture. Results were compared in terms of operative time, hospital stay, union, range of motion and complications. Functional evaluation was done using the Mayos’ elbow performance score (MEPS).: Patients were followed for a minimum of 12 months. Fracture union was seen at or before 4 months in all the patients of both the groups, except in 1 case of Group A where it was seen at 7 months. Average time to union was comparable in both the groups. In Group A, mean range of flexion was found to be 118 degrees (SD 7.33) and extension lag was found to be 11 degrees (SD 3.84). In Group B, mean degree of flexion was found to be 118.25 (SD 4.94) and extension loss of 12 degrees (SD 4.70). Average range of motion was comparable in both groups. There were no significant differences noted between the two groups in terms of mean MEPS (p= 0.573). The overall complication rate was 40% in the TRAP group and 30% in the olecranon osteotomy group.: Intra-articular distal humerus fractures mandate surgical fixation for best functional outcomes. Although technically demanding, TRAP exposure can prove to be as effective as olecranon osteotomy approach. Both approaches appear to yield no significant differences in clinical and functional results for intra-articular distal humerus fracture management.
Study of functional outcome of dorsolumbar spine fractures treated with minimal invasive spine surgery
Authors: Deokate Pravin D , Gaikwad Anant Nathrao , Katkar Minish , Mane Sushilkumar 
Published: May 2023

Spinal trauma is a common problem in modern Orthopedics. Spine surgery has recently been transformed significantly by the growth of minimally invasive surgery (MIS). Easily acceptable to patients as less invasive with smaller incisions, MIS is often perceived as superior to traditional open spine surgery. This study aims to study the functional outcome of minimally invasive surgery (MIS) in posterior thoracolumbar instrumentation in spine fractures. Present study was prospective in nature conducted among 35 patients. All patients fulfilling inclusion criteria and exclusion criteria were taken up for the study. Study was carried out over a period of 1.5 years. Majority of the patients was in the age group of 30-50 years and most of them were male. Mean VAS score & ODI functional outcome scores significantly reduced after MIS. Incidence of complications after MIS was 5.71%. 86% patients had excellent to good outcome after MIS according to McNab criteria. Minimal invasive surgery is safe and effective procedure with minimal complications and good post-operative outcome.
Functional outcome of intra-articular distal humerus fractures treated with locking compression plates – A prospective study
Authors: Sagar  , Gupta Gagandeep , Khan Sameer 
Published: May 2023

: To evaluate the clinical and functional outcome of intra-articular distal humerus fractures treated with locking compression plates.: A total number of 25 patients with intraarticular fractures of the distal humerus, from March 2021 to September 2022 were enrolled in the study. All patients were subjected to relevant investigations after which were taken up for surgical fixation of the fracture with bicolumnar distal humerus locking compression plates applied in orthogonal configuration through a posterior transolecranon approach. Patients were followed up at intervals of 6 weeks, 3 months and 6 months for assessing union and the functional recovery at each follow-up.: The study population consisted of 19 men and 6 women with mean age of 43.08±11.89 years. Motor Vehicle Accidents (MVA) were the most common cause of injury accounting for 56% of the cases. Most common fracture pattern was AO 13C2, which was observed in 44% of the cases. Mean duration of the fracture healing was 13.40 ± 1.83 weeks. Mean range of flexion arc was 111.20 ± 14.53 degrees. There were 16 patients with excellent MEPS outcome while six patients had good outcome and three patients had reported fair outcome. There were three cases of joint stiffness though had fair MEPS score. Two cases had superficial skin infection and two cases had reported hardware irritation.: Bi columnar distal humerus locking compression plate is a stable and safe implant for management of intraarticular fractures of distal humerus. The present study shows promising results when the plates are applied in orthogonal configuration through posterior chevron osteotomy approach. A good anatomical fixation allows early mobilization which improves the functional outcome.
Comparative study of open fractures of tibia (Interlocking v/s External fixator)
Authors: Vernekar Anish 
Published: May 2023

: Open/Compound fractures of tibia are the most common type of fracture to occur following road traffic accidents; however, sports injury, fall from height can also frequently produce these fractures. Open fractures of tibia (Type 3B) are quite challenging to treat, with respect to associated soft tissue injury and the decision for type of implant to be used by an orthopaedic surgeon. The decision making is based on the wound condition, the amount of muscle and soft tissue damage, type of fractures, and availability of equipments. This study was undertaken to evaluate the most optimal method for the management of compound fractures of tibia vis a vis comparing reamed tibia interlocking nail and external fixator in the management of type 3b compound fractures of tibia.Controversy exists over whether the use of external fixation or tibial intramedullary nailing is optimal for the treatment of open tibial fractures. The aim of this study was to compare clinical outcomes in terms of postoperative infection, malunion, delayed union, nonunion and hardware failure between these two treatment methods. : The study was undertaken in the Department of Orthopedics, Goa Medical College. The study involved both male and female patients with open fractures of tibia, (Gustillo and Anderson, Type 3B). This was a prospective study conducted from month of September 2017 onwards. Hundred patients who had compound fracture of tibia (Type 3B) were evaluated. The patients were followed-up for duration of 6 to 10 months (Average 8 months).Detailed analysis of function of the patient was done on the basis of following criteria by Johner and Wruh.: The study conducted on 100 patients, who suffered from compound fracture tibia (Type 3b), it was reported that patients who were operated with reamed tibia interlocking nail had better outcome and decreased morbidity, as compared to patients treated with external fixator.
Ileum neuroendocrine tumor: Case report and literature review
Authors: Jagtap Sunil Vitthalrao , Jagtap Shubham Sunil , Shah Pranjal , Borade Devika , Goswami Nidhi 
Published: May 2023

Ileal neuroendocrine tumors are rare primary epithelial neoplasm arising from enterochromaffin cells. A 65-year-old male presented with complaints of recurrent abdominal pain of 1 year duration. The pain was more aggravated in last 7 days associated with vomiting, loss of appetite and diarrhea. On radioimaging ultrasonography finding impression of small bowel mass lesion suggestive of ileac carcinoid tumor with ischemic bowel disease was given. Computerized tomograph abdomen pelvis showed a well-defined hypodense, round, hetergenous, enhancing mass measuring 2.6x1.6x1.2 cm., showing arterial enhancement in mesentery in close relation to ileum and metastatic lymph node mass- indicating likeness of neuroendocrine tumor. The surgical resection of ileum with mass and enlarged mesenteric nodes were done. On gross examination ileum specimen on cut open showed multiple, irregular mucosal thickenings with foci of ulceration. The submocosa showed single, circumscribed, round tumor measuring 3 x 2.5x1.5 cm. Cut section of tumor was yellowish, tan, well circumscribed and solid. The mesenteric lymph nodes were enlarged. The microscopic examination ileum showed a tumor composed of uniform, round cells having to oval nuclei with salt and pepper chromatin. Tumor cells were arranged in trabecular, nests, ribbons and in areas pseudo glandular pattern. Increased mitotic activity was noted (4/10 high power field). Mesenteric lymph nodes were involved by tumor. On histopathology reported as Well-differentiated neuroendocrine tumors (NET), G2, intermediate grade of ileum. The immunohistochemical stain were positive for synaptophysin, chromogranin A. The Ki-67 expression was &#60;1%. Herewith we are presenting rare case of well-differentiated neuroendocrine tumor NET, G2, intermediate grade of ileum for its clinical, radio imaging ,pathological features and management.
EPANET-IRRIG: aperfeiçoamento do EPANET para aplicações em sistemas de irrigação
Authors: Lucena Kennedy Flávio Meira de 
Published: May 2023

<p>O dimensionamento de sistemas de irrigação exige a análise de muitas alternativas para que se obtenha a opção mais viável técnica e economicamente, o que requer na maioria das situações o auxílio de modelos computacionais. Existem diversos modelos computacionais disponíveis para o dimensionamento e análise de redes hidráulicas, mas com uso mais difundido no meio acadêmico. Neste trabalho, faz-se uma apresentação do modelo computacional denominado EPANET-IRRIG versão 1.0, que é um aperfeiçoamento do software EPANET 2.0, no qual foram inseridas novas funcionalidades que dizem respeito à melhoria de interface e, principalmente, ao desenvolvimento de um módulo para o dimensionamento hidráulico-econômico e a avaliação de redes hidráulicas. Os primeiros resultados <br />obtidos com o EPANET-IRRIG já permitem ao usuário confiabilidade para o dimensionamento e a avaliação de sistemas de irrigação por gotejamento, microaspersão e aspersão. A interface criada para o módulo de irrigação permite agora que extensas redes, com numerosos pontos emissores, sejam mais facilmente modeladas. Os custos da rede de irrigação e da energia podem ser detalhadamente identificados, permitindo uma análise mais criteriosa do projeto com grande versatilidade.</p>
A Rare Cause of Unexplained Left Flank Pain: Nutcracker Syndrome
Authors: KABA Ayşe , KABA Esat , ARDIÇ Cüneyt 
Published: May 2023

Nutcracker syndrome refers to the compression of the left renal vein, usually between the aorta and the superior mesenteric artery. Flank pain is the most common complaint and hematuria can be seen among the laboratory findings. This syndrome, which is more common in women with low body mass index, can be difficult to diagnose.
A 41-year-old female patient with persistent left flank pain was admitted to our family medicine outpatient clinic. There was no finding that could explain the pain in the patient, who did not have any features in his history, despite many polyclinic applications. Computed tomography requested in our family medicine outpatient clinic revealed that the left renal vein was compressed between the aorta and the superior mesenteric artery, and the patient was diagnosed with nutcracker syndrome.
Nutcracker syndrome is an exclusion diagnosis that should be considered in patients who present with atypical left flank pain that is difficult to diagnose.
In the treatment, depending on the severity of the symptoms, a wide range of methods are applied, from conservative treatment to endovascular stenting and surgical treatment.
Flaxseed Oil for Omega 3 Fatty Acids Enrichment in Eggs and Performance in Laying Chickens
Authors: Prakash B. , Rao S.V. Rama , Raju M.V.L.N. , Paul S.S. , Kannan A. , Praduman Y. , Santosh P.K. 
Published: May 2023

Background: The beneficial effects of omega-3 fatty acids on growth, health and immune function for human is well established. Supplementation of various n-3 fatty acids into the diet of laying hens is a nutritional attempt to increase the levels of n-3 PUFA in the eggs. Therefore, the present study was carried out to determine the effect of dietary supplementation of flaxseed oil (SFO) as a source of omega-3 polyunsaturated fatty acids, on the fatty acid composition of egg, laying performance and egg stability upon storage in laying hens. Methods: Laying hens of 30-week age (n=168) were selected and randomly distributed into two dietary groups consisting of 14 replicates each having 6 birds in each replicate. Iso-nitrogenous and iso-caloric two diets were prepared with and without FSO. Daily recording of eggs, feed intake and egg collection was carried out throughout the experiment. The eggs were subjected for fat extraction and estimation of fatty acid composition. Result: The higher (P less than 0.05) feed intake and lower (P less than 0.05) egg production in groups fed FSO supplemented diet compared to those groups fed control diet. Further, improved (P less than 0.05) feed conversion ratio among the groups fed control diet compared to those groups fed FSO supplemented diet. Eggs contained higher (P less than 0.05) á-linolenic acid, eicosenoic acid, n3 fatty acids in groups fed FSO supplemented diets compared control diet. The stability parameters did not differ by supplementing FSO compared to groups fed control diet. Therefore, it is concluded that FSO can be supplemented up to 6% for feeding of laying hens for producing higher omega 3 fatty acids in eggs. Further, supplementation of 6% FSO did not affect the egg quality parameters upon storing for 21 days at 4°C. Background: The beneficial effects of omega-3 fatty acids on growth, health and immune function for human is well established. Supplementation of various n-3 fatty acids into the diet of laying hens is a nutritional attempt to increase the levels of n-3 PUFA in the eggs. Therefore, the present study was carried out to determine the effect of dietary supplementation of flaxseed oil (SFO) as a source of omega-3 polyunsaturated fatty acids, on the fatty acid composition of egg, laying performance and egg stability upon storage in laying hens.
Dinamika Pembebanan Jaminan Fidusia Terkait Dengan Prinsip Spesialitas
Authors: Manggala Ferdiansyah Putra 
Published: May 2023

The principle of specializing fiduciary guarantees in consumer financing agreements is one of the principles that must be fulfilled, in order to provide legal certainty to both fiduciary recipients and fiduciary recipients, particularly regarding the right to ownership of collateral. If the consumer financing agreement is not fulfilled by the principle of specialization, then there is no legal certainty in the agreement. Every object that is burdened with a fiduciary guarantee must be registered at the fiduciary registration office for the birth of the fiduciary guarantee. A new fiduciary guarantee is said to be born if it has been registered so that a fiduciary certificate is issued which has executive power if in the future the debtor defaults. So that the creditor in the settlement of default is not based on a power of attorney but based on a fiduciary certificate which has the same strength as a court decision that has permanent legal force. The methodology used in this study is the normative juridical methodology and the approach used is a conceptual approach and a statutory approach. The thinking framework used is descriptive method in this study.
KEYWORDS: Principle, Specialization, Fiduciary
La Ley 15/2022, de 12 de julio, integral para la igualdad de trato y no discriminación. La inclusión de nuevas causas autónomas de prohibición de discriminación
Authors: Grau Pineda Carmen 
Published: May 2023

Nueve meses han transcurrido ya desde la aprobación de la Ley 15/2022 y, este mes de marzo, vuelven los ecos de las expectativas que su aprobación generó. Se está en presencia de la primera ley española de derecho antidiscriminatorio que viene a dar cobertura tanto a las discriminaciones que existen como a las que están por venir, una ley que persigue el doble objetivo de prevenir y erradicar cualquier forma de discriminación y de proteger a las víctimas y que, por ello, merece la consideración de ley de garantías, ley general y ley integral.
Tomando como referencia el art. 14 CE y, junto a los seis motivos “clásicos” de discriminación recogidos en la normativa comunitaria -nacimiento, origen racial o étnico, sexo, religión, opinión, cualquier otra condición o circunstancia personal o social-, incorpora expresamente los de edad, orientación o identidad sexual y expresión de género, discapacidad, enfermedad o condición de salud, estado serológico y/o predisposición genética a sufrir patologías y trastornos, lengua y situación socioeconómica. Pretende esta aportación llevar a cabo una primera aproximación a las causas que como más controvertidas se presentan y que, a buen seguro, generarán un extenso y prolijo debate tanto doctrinal como jurisprudencial en el futuro inmediato.