bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unexplained Anasarca in Type 1 Diabetes Mellitus
Authors: Vyas Varuna , Khera Daisy , Mittal Aliza , Singh Kuldeep 
Published: May 2022

Background:
Undiagnosed Type 1 diabetes mellitus (T1DM) often presents as diabetic ketoacidosis (DKA). We report a child with newly diagnosed T1DM who developed anasarca and persistent diarrhea following resolution of DKA and was referred to us for the same.

Clinical Description:
We reviewed the clinical history, examination, and investigations that had been undertaken. Our clinical evaluation was in concurrence with the referring hospital-anasarca with probable partially treated spontaneous bacterial peritonitis (SBP). However, the cause of the subacute anasarca and persistent diarrhea was unclear. The child was empirically started on broad-spectrum antibiotics for the SBP, a high-protein diet to build up the protein, and continued the same subcutaneous insulin, on which he was euglycemic. After ruling out usual causes, i.e., renal, hepatic, and cardiac, we reviewed the possibility of celiac disease, tuberculosis, insulin edema, and hypothyroidism.

Management:
When he did not improve despite a good appetite, adherence to management, and all tests were inconclusive, we reviewed the etiopathogenesis. Untreated T1DM had led to chronic negative catabolism that had precipitated severe hypoproteinemia. A vicious cycle had set in which hypoalbuminemia was leading to bowel wall edema, resulting in protein malabsorption, perpetuation of diarrhea, and further hypoproteinemia. Our assumption proved to be correct when a single dose of parenteral albumin broke the cycle, and the child improved drastically with the resolution of diarrhea within 24 h and the edema in a few days.

Conclusions:
This case highlights the implications of severe catabolism in a patient with untreated diabetes and how this may be a self-perpetuating condition.
Immunoglobulin A Vasculitis After a Not So Innocuous Wasp Bite
Authors: Sharma Aditi , Singh Vikram , Kalra Suprita 
Published: May 2022

Background:
Immunoglobulin A vasculitis (IgAV), previously known as Henoch–Schonlein purpura (HSP), is the most common vasculitis in children. Previous studies have identified various triggers of IgAV, with infections being the most common. We present herein a 9-year-old girl who developed IgAV with nephritis following a wasp sting.

Clinical Description:
A 9-year-old girl presented to us with a history of wasp sting 7 days ago, followed by the appearance of reddish, raised rashes over the back of her lower limbs, which later spread all over the body. She also developed edema over the face, abdomen, and lower limbs along with pain abdomen. On examination, she was afebrile, was normotensive, and had periorbital edema and bilateral pedal edema with multiple discrete palpable, nonblanching purpura predominantly over the extensor surfaces of the lower and upper extremities and the trunk. Abdominal examination revealed no tenderness. Complete blood counts, blood urea, serum creatinine, and liver function tests were normal. Urinalysis showed microscopic hematuria and nephrotic range proteinuria. Skin biopsy of the lesions showed evidence of IgA vasculitis. Renal biopsy was suggestive of HSP nephritis class 3.

Management and Outcome:
She was managed with oral corticosteroids, mycophenolate mofetil, and enalapril and had remission of proteinuria. The renal function tests and blood pressure continue to be normal.

Conclusion:
Few case reports exist of IgAV precipitated by insect bites; however, we could not find any previous reports of IgAV with nephritis following a wasp sting in children. This report adds to existing knowledge regarding precipitating factors for IgAV in children.
Myelin Oligodendrocyte Glycoprotein Encephalomyelitis
Authors: Sandhu Nimrat , Kumar B M Sunil 
Published: May 2022

Background:
Myelin oligodendrocyte glycoprotein encephalomyelitis (MOG-EM) includes patients with (i) monophasic or relapsing acute optic neuritis, myelitis, brainstem encephalitis, or encephalitis; (ii) magnetic resonance imaging (MRI) or electrophysiological evidence of central nervous system (CNS) demyelination; and (iii) MOG-immunoglobulin G (IgG) seropositivity.

Clinical Description:
A 4-year-old girl presented with fever and excruciating headache for 10 days. Her vitals were stable and systemic examination was normal. Cerebrospinal fluid (CSF) analysis revealed 10 lymphocytes and normal biochemistry. After 5 days, she developed a fever and a seizure. Repeat CSF showed increased cells (60% lymphocytes), normal protein, and sugar. MRI brain was normal. She was managed symptomatically. CSF meningoencephalitis panel was negative. The child improved and was discharged. After 2 weeks, the headache recurred with associated blurring of vision. Bilateral papillitis, MRI brain abnormalities suggestive of acute disseminated encephalomyelitis (EM), and bilateral prolonged latency on visual evoked potential (VEP) were found. Anti-MOG antibodies were positive. The final diagnosis was MOG-EM.

Management:
The child was started on methylprednisolone therapy as per standard protocol. The vision improved and headache disappeared. She is on regular follow-up and is asymptomatic.

Conclusion:
MOG-IgG testing should be done in patients with (i) monophasic or relapsing acute optic neuritis, myelitis, brainstem encephalitis, or encephalitis; (ii) radiological or VEP findings compatible with CNS demyelination; and (iii) at least 1 of 25 delineated findings on MRI, fundoscopy, CSF, histopathology, clinical phenotype, or treatment response.
Preliminary Cytomorphologic Diagnosis of Hematolymphoid Malignancies in Effusions
Authors: Patel Bidish K. , Gochhait Debasis , Jinkala Sreerekha , Rangarajan Vidhyalakshmi , Kannan Narasimhapriyan , Durgadevi S , Siddaraju Neelaiah 
Published: May 2022

Background:
Effusions as part of hematologic neoplasms are rare and as a primary presentation, rarer. In standalone laboratories of developing countries, resorting to techniques such as flow cytometry or immunohisto/cytochemistry may not be possible. A near definitive diagnosis on cytomorphology would, therefore, be an ideal beginning. To that end, we compiled our cases of primary hematolymphoid effusions, devising reproducible reporting categories and looked at their concordance with the final histopathology.

Subjects and Methods:
Fifty-four cases of primary hematolymphoid effusions over 10 years with cytology-histopathology correlation were chosen. Post morphology assessment, the cases were organized into six categories: suspicious of hematolymphoid malignancy, non-Hodgkin lymphoma-high-grade (NHL-HG), low-grade NHL (NHL-LG), Burkitt lymphoma, acute leukemias, and plasma cell dyscrasias. Discordance with histology was assigned as major and minor based mainly on therapeutic implications.

Results:
Concordance was seen in a good number (81.5%) of cases. The NHL-HG and NHL-LG categories contributed to 33.3% each of major discordance. Tuberculosis and epithelial malignancies comprised the bulk of the major discordance. Overdiagnosis of a high-grade lymphoma for a histologically proven low-grade follicular lymphoma was the only case with minor discordance.

Conclusion:
The cytologic categories used are not foolproof for hematologic neoplasms but have a fairly good concordance. A scanty abnormal population should always be viewed with suspicion and definitive labels should be avoided. While morphologic examination is fraught with danger, a good assessment directs the judicious selection of ancillary methods, and hence cannot be supplanted.
Application of the Indian Academy of Cytologists Recommendations for Reporting Serous Fluid Cytopathology in Routine Reporting of Ascitic Fluid Specimen and Assessment of the Risk of Malignancy
Authors: Jha Shilpy , Sethy Madhusmita , Adhya Amit Kumar 
Published: May 2022

Background:
A five-tiered reporting system for effusion fluid cytology has been published by the Indian Academy of Cytologists (IAC). Only a single study has evaluated the applicability of this system in routine reporting.

Aims:
We intend to evaluate the practical utility of this system in routine reporting of ascitic fluid cytology.

Materials And Methods:
Nine hundred and sixty-one cases of ascitic fluid cytology were included in this study. The clinical, radiological, cytomorphological, and follow-up data of these cases were reviewed. All cases were recategorized according to the proposed IAC system, and the risk of malignancy (ROM) for each category was estimated.

Results:
Age of the patients ranged from 1 to 92 years, and fluid volume ranged from 10 ml to 3 l. The number of cases included in each category and their respective ROM were as follows: category 1: 41, 21.42%; category 2: 805, 14.9%; category 3: 5, 33.3%; category 4: 31, 90%; and category 5:79, 96.4%.

Conclusions:
The new IAC guidelines for the serous fluid is representative, informative, and could be easily applied at our institutional level. We used the recommended diagnostic categories for reclassifying the ascitic fluid samples based on their cytosmear findings and conclude that the system has enormous utility at each level starting from the collection of fluid samples till the delivery of the report.
Retinal vasoproliferative tumor regression after intravitreal aflibercept
Authors: Chu Ting-Wen , Tsai Shawn H. , Chen Lee-Jen 
Published: May 2022

Abstract
Retinal vasoproliferative tumors (RVPTs) are rare benign retinal lesions typically located in the inferotemporal peripheral retina. Several treatment options exist for the management of RVPTs, but no consensus has been proposed. There are only a few reports on the use of anti-vascular endothelial growth factor with bevacizumab to treat exudative or neovascular retinal changes secondary to RVPTs. This report describes a 68-year-old female with a history of systemic hypertension that presented with a 2-week history of gradual loss of visual acuity in the right eye. Fundoscopic examination showed a RVPTs with atypical location that had a favorable response to two-intravitreal aflibercept injections 1 month apart, with resulting subretinal fluid absorption and tumor regression.
To assess prevalence of anxiety, depression and its association with coping in females suffering from infertility
Authors: Gupta Abhishek , Dere Shubhangi Sambhaji , Ghildiyal P. Rakesh 
Published: May 2022

Background:
Infertility is a major psychosocial problem having an impact on their emotional and marital life. Among infertile couples, females show higher levels of distress than their male partners.

Aim:
The aim of this study is to assess the prevalence of anxiety and depression in female patients with infertility and to assess its association with various coping strategies used by them.

Methods:
A total of 85 females in the reproductive age group, having primary infertility, drug-naive, and willing to participate in the study were included in the study after obtaining informed consent and institutional ethics committee approval. Those with preexisting psychiatric or medical illnesses which can add to psychological distress were excluded from the study. The patients were assessed for anxiety, depression, and stress coping behavior using the Hamilton Anxiety, the Center for Epidemiologic Studies Depression, and Stress Coping Behavior scales, respectively.

Results:
The prevalence of anxiety and depression was observed to be 27.1% and 55.3%, respectively. Common coping styles used included “active coping” (94.1%), “religion” (91.8%), “acceptance” (90.5%), and “planning” (88.3%) whereas “substance use” and “humor” were rarely used. Females with anxiety significantly used “self blame” and among females with depression, significant association was observed with “positive reframing” (P = 0.001) and “behavioral disengagement” (P = 0.004).

Conclusions:
Anxiety and depression are common and are influenced by coping strategies used by female with infertility. Structured psychological support is essential to improve their emotional well-being and coping with infertility.
Mental health outcome among psychiatric patients due to COVID 19 lockdown induced disruption of access to psychiatric services
Authors: Kethawath Shanti Mohan , Rahman Shagufta , Rahul Venkata , Kashyap Aditya , Pinnoju Harish , Bipeta Rajshekhar , Molanguri Umashankar 
Published: May 2022

Background:
COVID 19 lockdown has an impact on the mental health of the general population, COVID patients, and health professionals. However, knowledge about its impact on psychiatric patients is limited.

Objectives:
To assess the mental health outcomes among psychiatric patients due to disruption of access to psychiatric services caused by the COVID 19 lockdown.

Materials and Methods:
It was a single-center, cross-sectional, observational, pragmatic study conducted at a tertiary care psychiatric hospital. All consecutive psychiatric patients presented to review in the outpatient department for 3 weeks following the relaxation of lockdown were screened, and a total of 305 eligible patients were enrolled. A semi-structured questionnaire was applied to capture the mental health status of the patients.

Results:
More than three-fourths (78.3%) of patients were off medications during the lockdown. During lockdown, more than half (64.3%) of patients' mental health conditions worsened, and significantly more in those who were not on medications. More than half of patients who were doing well before lockdown showed re-emergence of symptoms, and it was more commonly seen in mood disorder patients, followed by schizophrenia and other psychotic disorder patients. Thirty-one (10.1%) patients reported self-harm ideas; six (1.9%) claimed to have made self-harm attempts during lockdown.

Conclusions:
COVID-19 lockdown has worsened the mental health status of psychiatric patients. Strengthening community-based psychiatric care in tie-up with telepsychiatry services and adopting new innovative measures may help face such eventualities in the future.
Impact of the second wave of COVID-19 on psychiatric patients at a tertiary psychiatric hospital in Telangana state of South India
Authors: Chintala Haripriya , Rayirala Anitha , Molanguri Umashankar 
Published: May 2022

Background:
COVID-19, caused by the coronavirus, was declared a global pandemic by the WHO on March 11, 2020. The COVID-19 pandemic hit India, similar to the world, reporting its first case in March 2020. After the first wave, the second wave in India started on March 2021. The impact of the second wave was huge on all tertiary care centers, especially psychiatric care centers, compared to the first wave of COVID-19.

Aim:
The aim of this study is to study the impact of COVID-19 on psychiatric patients at a tertiary psychiatric hospital in Telangana state of South India.

Methodology:
A retrospective chart review of all patients who got infected with COVID-19 during the second wave was done. We screened all the inpatient cases who were under admission during the second wave. For the study, a semi-structured intake pro forma was used. Sociodemographic variables, clinical variables, treatment variables, and outcomes of COVID-19-infected psychiatric patients were studied.

Results:
The current article compiles the management of the COVID-19 outbreak in the Institute of Mental Health in inpatient care and the challenges and experiences during the management of psychiatric inpatients with COVID-19 in a tertiary care center in Telangana.
Penerapan Teknik Forward Chaining dan Certainty Factor Untuk Mendeteksi Penyakit Gastroesophageal Reflux Disease (GERD)
Authors: Dewantika Putri , Lubis Adi Prijuna , Putri Pristiyanilicia 
Published: May 2022

In this day and age, the lifestyle of people who always want to be practical and always delay eating time causes the body susceptible to disease, this unhealthy habit that makes the stomach produce excess acid that triggers the onset of Gastroesophageal Reflux Disease (GERD). Gerd disease is often considered mild by the public, but if left unchecked then the disease becomes very dangerous because it can irritate the lining of the esophagus and make it become inflamed. Over time, inflammation can damage the lining of the esophagus causing complications such as bleeding, narrowing of the esophagus, and can attack other organs of the body. Early detection of GERD in the stomach needs to be done to prevent the disease. But because of the lack of public knowledge about the symptoms of this disease and the frequent errors in diagnosing GERD, therefore it is necessary to build an expert system to diagnose GERD-based web. Research conducted by Bandar Pasir Mandoge Health Center because GERD disease is a type of disease that is often experienced by the community, and this type of disease is a disease that has the most number of patients in Bandar Pasir Mandoge Health Center with the number of patients as many as 534 in 2021. The purpose of this study is not to replace the role of humans, but to sub substitution human knowledge into the form of a system, so that it can be used by many people (experts and the general public) in dealing with GERD disease. In the preparation of expert systems, a combination of inference rules with a certain knowledge base is provided by one or more experts in a particular field. Several methods can be used, one of which is Forward Chaining which is a reasoning that starts from the facts to get the conclusion of the fact. The results of web-based expert system research using this forward chaining method can act as an expert to detect types of GERD disease and advice for prevention
Pengaruh Motivasi dan Lingkungan Kerja terhadap Kinerja Pegawai di Dinas Perdagangan Kota Makassar
Authors: Akbar Akbar , Irawan Heri , Ansar Ansar , Dahlan Siti Sumayah 
Published: May 2022

Pengaruh Motivasi dan Lingkungan Kerja terhadap Kinerja Pegawai di Dinas Perdagangan Kota Makassar. Penelitian ini dilaksanakan dengan tujuan: (1). Untuk mengetahui pengaruh motivasi terhadap kinerja pegawai Dinas Perdagangan Kota Makassar. (2). Untuk mengetahui pengaruh lingkungan kerja terhadap kinerja pegawai. (3). Untuk mengetahui variabel yang paling dominan berpengaruh terhadap kinerja pegawai. Penelitian ini termasuk jenis penelitian kuantitatif. Data penelitian diperoleh dengan penyebaran kuisioner terhadap 45 orang pegawai ASN Dinas Perdagangan Kota Makassar. Data penelitian dilakukan uji regresi berganda. Hasil penelitian menunjukan bahwa: (1). Motivasi kerja berpengaruh positif dan signifikan terhadap kinerja pegawai. Artinya, setiap peningkatan nilai motivasi kerja sebesar 1 satuan, akan meningkatkan pula kinerja pegawai Dinas Perdagangan Kota Makassar sebesar 0,335. (2). Lingkungan kerja berpengaruh positif dan signifikan terhadap kinerja pegawai. Artinya, setiap peningkatan nilai lingkungan kerja sebesar 1 satuan, akan meningkatkan pula kinerja pegawai Dinas Perdagangan Kota Makassar sebesar 0,292. (3). Dari kedua variabel bebas, yang memiliki pengaruh lebih dominan terhadap kinerja pegawai adalah variabel motivasi kerja dimana nilai koefisien yang ditunjukkan oleh variabel motivasi kerja lebih dominan.
EFFICIENCY OF USE OF HUMATE-CONTAINING WASTES FROM HUMIC PREPARATIONS PRODUCTION IN POND FISHERIES
Authors: Naumova G. V. , Panteley S. N. , Sennikova V. D. , Zhmakova N. A. , Makarova N. L. , Ovchinnikova T. F. , Makeenko A. A. 
Published: May 2022

The article presents the results of testing of solid wastes generated during liquid humic preparations production as biologically active additives in fish ponds. The tests were carried out in 2019 season in the nursery ponds of the SPU “Isobelino” and in the feeding ponds of the KhRU “Vileika” control of pond water in reservoirs showed that the introduction of humate-containing additives into fish ponds does not violate the hydrochemical regime of their functioning, all indicators are within the normative limits. As a result of the study of the aquatic biota, more efficient development of phyto- and zooplankton was revealed, as well as an increase in fish productivity, both in feeding and nursery ponds compared to the control ones. A production check carried out at OJSC "Beloye" Experimental fish farm" of Gomel region in 2020 showed that the use of humate-containing wastes of humic production makes it possible to achieve higher fish productivity in comparison to the traditional scheme of intensification measures, with 50 % savings of applied
organic fertilizers, 25 % savings in ammophos and 100 % savings in ammonium nitrate. The increase in fish productivity is 6‒7 %.
SINERGI KRUSIAL DALAM PEMBELAJARAN PENDIDIKAN AGAMA KRISTEN PADA MASA PANDEMI COVID 19
Authors: Benyamin Benyamin 
Published: May 2022

Pembelajaran selama masa pandemi covid 19 mengalami perubahan dimensi yang sangat signifikan dan memiliki berbagai aspek kelemahan yang mengikutinya sehingga menimbulkan masalah baru dalam proses belajar-mengajar, hal ini merupakan sesuatu yang wajar, namun dalam penelitian yang diamati oleh penulis topik yang banyak diteliti adalah tentang kelemahan dari metode belajar daring tersebut, sehingga dari sejumlah penelitian yang ada masih sedikit pembahasan tentang bagaimana cara mensinergikan peran orang tua dan guru belum penulis temukan. Tujuan penelitian ini berusaha untuk membuat sebuah penelitian yang menjelaskan salah satu cara untuk meminimalisir kelemahan yang timbul pada saat proses belajar daring berlangsung yaitu dengan cara membuat suatu kerjasama/sinergi antara guru dan orang tua untuk mengawasi keberlangsungan dan keberhasilan suatu pembelajaran. Metode penelitian yang digunakan adalah metode penelitian kualitatif atau kepustakaan. Dalam penelitian ini, pengumpulan data diperoleh dari buku dan artikel pada jurnal online. Peneliti melakukan penelusuran artikel dengan menggunakan kata kunci yaitu “Pembelajaran, Pendidikan Agama Kristen, Covid-19”. Hasil dari penelitian ini adalah tumbuhnya kesadaran bagi orang tua dan guru akan fungsi mereka yang sangat penting di dalam mendukung terciptanya kerjasama di dalam proses belajar-mengajar yang sarat dengan kelemahan-kelemahan yang ditimbulkan oleh pembelajaran jarak jauh saat ini.

Learning during the COVID-19 pandemic experienced a very significant dimensional change and had various aspects of weakness that followed it, causing new problems in the teaching and learning process, this is something that is natural, but in the research observed by the author, the topic that was widely studied was about weaknesses. from the online learning method, so that from a number of existing studies there is still little discussion about how to synergize the roles of parents and teachers, the authors have not found. The purpose of this study is to make a study that explains one way to minimize weaknesses that arise during the online learning process, namely by creating a collaboration/synergy between teachers and parents to monitor the continuity and success of learning. The research method used is a qualitative research method or literature. In this study, data collection was obtained from books and articles in online journals. Researchers searched articles using keywords, namely "Learning, Christian Religious Education, Covid-19". The result of this research is the growing awareness for parents and teachers of their very important function in supporting the creation of cooperation in the teaching and learning process which is full of weaknesses caused by distance learning today.