bluuebunny/crossref_metadata_2025 huggingface dataset:
D'un outil à l'autre. Évolution technique et cadres de pratiques dans l'Auvergne du Moyen Âge central (Xe-XIIe siècle)
Authors: Morel David
Published: October 2023

Pour l’Auvergne médiévale, l’analyse d’un corpus représentatif de monuments édifiés entre le Xe et le XIIe siècle permet de déterminer les principaux choix technologiques opérés par les bâtisseurs et de jalonner l’évolution des techniques de la taille de pierre. Cette analyse met en évidence une transformation progressive de l’outillage et une lente adaptation des pratiques, selon les types architecturaux choisis et selon les principes de mise en œuvre. Les indices archéologiques permettent alors de s’interroger sur l’influence des matériaux (roches d’origines volcaniques et sédimentaires), sur les échanges technologiques entre les différents praticiens (maçons, tailleurs de pierre, sculpteurs), mais aussi sur la circulation des bâtisseurs et sur les orientations économiques et socioculturelles des acteurs de la construction.
Conjuguer les temps. Entre temps long et temps court, les peintures murales de l’ancien diocèse de Clermont et de ses zones limitrophes aux XIIIe, XIVe et XVe siècles
Authors: Charbonnel Marie
Published: October 2023

Le présent article envisage les peintures de l’ancien diocèse de Clermont des XIIIe-XVe siècles à travers les temporalités et les durées que transmettent leurs contenus. Les images de cette période se situent à l’interface entre divin et humain, et, par là même, à l’interface entre plusieurs durées, plusieurs temporalités qu’elles conjuguent dans un même lieu visuel. La pérégrination d’une peinture à l’autre permettra de saisir le temps éternel et universel, le temps long intrinsèque au divin, mais aussi le temps court des crises à travers des peintures manifestant le remerciement ou encore les temps de transition entre histoire individuelle et histoire du Salut que sont la mort et sa préparation.
Regards croisés du géographe et de l’archéologue du bâti sur l’état de santé du patrimoine médiéval du Massif central
Authors: André Marie-Françoise , Phalip Bruno
Published: October 2023

Le présent article constitue la première pierre posée à un édifice qui prend forme dans le cadre du programme de recherche pluridisciplinaire sur la durabilité des matériaux du patrimoine roman en grès, conduit sur un territoire allant du Bourbonnais à la Limagne de Brioude. Certains monuments présentent des signes inquiétants de dégradation qu’il convient d’interpréter dans un dialogue étroit entre le géographe spécialiste de l’érosion des matériaux rocheux et l’archéologue du bâti qui est en mesure de décrypter et de dater les étapes successives de la vie d’un bâtiment. Seront évoqués ici les formes et les causes naturelles ou anthropiques de la détérioration de la pierre, ainsi que les effets pervers de certaines restaurations des Monuments Historiques qui ont assez paradoxalement accéléré la dégradation du patrimoine médiéval roman du Massif central.
O urbano nas margens do campo: por uma sociologia dos espaços e vidas residuais
Authors: Maciel Wellington Ricardo Nogueira
Published: October 2023

Pensada originariamente para descrever e analisar os espaços de extermínio construídos pelos regimes totalitários de meados do século xx, a noção de campo ganhou novos desdobramentos analíticos nas ciências sociais, passando a ser mobilizada também para interpretar o fazer cidade nas fronteiras das urbes do início do século xxi. O presente artigo almeja rediscutir essa noção com base nas transformações do espaço urbano provocadas pelas políticas da vida e da morte na periferia de Fortaleza, Ceará, Brasil. Se as periferias brasileiras sempre foram vistas como espaços de violação de direitos humanos, onde os princípios mais básicos da cidadania nunca se tornaram regra, urge dar atenção às escalas urbanísticas que a necrobiopolítica tem alterado.
Cuestiones éticas en los servicios sociales en España: un estudio de caso
Authors: Úriz María-Jesús , Viscarret Juan-Jesús , Ballestero Alberto
Published: October 2023

Los servicios sociales promueven el bienestar de las personas y las comunidades y potencian la autonomía de las personas usuarias. El artículo presenta un estudio de caso sobre cuestiones éticas en una organización pública de servicios sociales en España, basado en cuestionarios cualitativos rellenados por profesionales que trabajan en dichos servicios. En primer lugar, el estudio detalla cómo la ética de los servicios sociales debe dar soporte a la solución de dilemas éticos, como el respeto a la autodeterminación y la búsqueda del bienestar, los conflictos entre valores individuales y profesionales, y los dilemas derivados de la limitación de recursos. Además, también se explican algunas cuestiones relativas a la toma de decisiones éticas en aspectos como el acceso a recursos y el respeto a la autonomía. Finalmente, se recogen propuestas de mejora para la calidad ética de la atención, como una mayor formación en ética y la creación de comités y espacios de reflexión ética.
Change and Innovation as Viewed by Teachers From Different Generations
Authors: Pruaño Antonio Portela , Medina Miguel Ángel Negrín , Galván Juan José Marrero , Bernárdez-Gómez Abraham
Published: October 2023

Educational change and innovation are needed to improve the quality and equity of education around the world. Teachers are therefore expected to make changes and to innovate both in their theoretical approaches and their practice. However, considerable variation can be found in the profession with regard to change and innovation. In particular, differences can be identified depending on teachers' age, career stage and generation. There is a paucity of research on these differences. To address this gap, a qualitative study focused on teacher orientation towards change and innovation was conducted. Data collected from discussion groups and interviews were analysed thematically. The findings indicated that the participants shared a similar understanding of change and innovation. However, data also showed differences regarding participants' orientation towards change and innovation that they attributed to age, professional experience, and various circumstances in their careers that were linked to their professional generations.
Resolving Intergenerational Conflicts
Authors: Alabay Gizem Günçavdı
Published: October 2023

Intergenerational relations have always been an effective aspect of both society and all kinds of organizations. Together with many different generations to be included in professional life, this fact has become felt in a harsh way, since the generational gap between individuals is getting bigger and bigger every day. Inevitably, this fact results in intergenerational conflicts in organizations and societies. This chapter aims to draw attention to these conflicts and try to suggest activities to solve or overcome these conflicts. This chapter was prepared as a handbook and aims to shed light on the minds of those who want to solve intergenerational conflicts and understand them deeply.
New Insight into CO2 Sequestration: A Blended Approach of Artificial Intelligence and Machine Learning Tools
Authors: Gaddamanugu Gayatri , Paku Kamaneeya
Published: October 2023

Recent advances in the fields of artificial intelligence and machine learning have paved a way in solving the unsolved problems embarking into a new dimension, especially, when there is increase in complexity of molecules. Reports have shown the necessity to employ these techniques to address the environmental problems. Herein we report the CO2 sequestration process by means of artificial intelligence (AI) and machine learning (ML) tools. The AI and ML approaches adopted enhance the accuracy of the results and at the same time give scope to explore new strategies in understanding the CO2 sequestration process. Herein we considered the reported active compounds observed in traditional medicinal plants like Oscimum, Azadiracta, Psidium and Ficus leaves and Curcuma and, their interactions with CO2. The crystal structures of the active compounds, collected from NCBI portal, are used for all the calculations. To understand the probable interactions of CO2 with active components AI tool IBMRXN was used and the properties of molecules are evaluated. ML techniques are employed using density functional theory method. Keeping in view the complexity of the molecules, optimization of the molecules is carried out at M062X/6-31G(d) level of theory. HOMO-LUMO energy gaps and binding energies are calculated at M062X/6-311+G(d,p)//M062X/6-31G(d) level of theory.
Investigating Sustainable Materials for AEM Electrolysers: Strategies to Improve the Cost and Environmental Impact
Authors: Discepoli Gabriele , Barbi Silvia , Milani Massimo , Montorsi Monia , Montorsi Luca
Published: October 2023

In recent years, the EU policy identified the hydrogen as one of the main energy vectors to support the power production from renewable sources. Coherently, electrolysis is suitable to convert energy in hydrogen with no carbon emission and high purity level. Among the electrolysis technologies, the anion exchange membrane (AEM) seems to be promising for the performance and the development potential at relatively high cost. In the present work, AEM electrolysers, and their technological bottlenecks, have been investigated, in comparison with other electrolysers’ technology such as alkaline water electrolysis and proton exchange membranes. Major efforts and improvements are investigated about innovative materials design and the corresponding novel approach as main focus of the present review. In particular, this work evaluated new materials design studies, to enhance membrane resistance due to working cycles at temperatures close to 80 °C in alkaline environment, avoiding the employment of toxic and expensive compounds, such as fluorinated polymers. Different strategies have been explored, as tailored membranes could be designed as, for example, the inclusion of inorganic nanoparticles or the employment of not-fluorinated copolymers could improve membranes resistance and limit their environmental impact and cost. The comparison among materials’ membrane is actually limited by differences in the environmental conditions in which tests have been conducted, thereafter, this work aims to derive reliable information useful to improve the AEM cell efficiency among long-term working periods.
Synthesis and Photoluminescence Properties of Aryloxymethyl Coumarin Dyes: An Experimental and Computational Study
Authors: Ingalagondi P.K. , Patil Omanath , Inamdar Sanjeev R. , Sankarappa Talari , Hanagodimath S.M.
Published: October 2023

Here in, we report the synthesis and effect of solvents on photoluminescence properties of 1-(2-Methoxy-phenoxymethyl)-benzo[f]chromen-3-one (2-MPBC) and 1-(3-Methoxy-phenoxymethyl)–benzo[f]chromen-3-one (3-MPBC) molecules through Pechmann cyclisation method. The optical properties of coumarins are studied by employing a various solvents with different polarity and refractive index. The values of ground state dipole moment is 0.71D and 0.49D for 2-MPBC and 3-MPBC respectively. It is found that the ground state dipole moments (μg) comparatively smaller than excited state dipole moments (μe) for the both molecules because of more polar in nature of the excited state. Further, on the basis of solvent polarity parameter ( ), the change in dipole moments (Δμ) is found to 052D and 0.60D for by solvatochromic shift method and 0.61D and 1.23D from theoretical calculation for 2-MPBC and 3-MPBC respectively.
A rare case of asthmatic patient with left Chilaiditi’s syndrome
Authors: Scaramozzino Marco Umberto , Levi Guido , Plastina Ubaldo Romeo , Sapone Giovanni
Published: October 2023

The following case report aims to highlight the rarity of the case in question, in which there is left Chilaiditi syndrome in a patient with bronchial asthma. The patient is a 79-year-old woman who arrived in January 2023 at my facility for episodes of recurrent dyspnea, chest heaviness, wheezing, eructation, dysphagia, epigastric abdominal pain associated with frequent episodes of bronchitis. He performed simple spirometry which showed mixed mild-moderate ventilatory deficit with reduction of small airway volumes, reduced peak expiratory flow and negative broncho reversibility tests for asthma. At 3 months, the patient returned to my attention with a chest radiograph showing marked elevation of the left hemidiaphragm with deviation of the cardiac shadow to the right. He repeated the spirometry which resulted in a clear improvement compared to the previous control with an important variation of the peak respiratory flow during ICS/LABA, the objective finding previously found disappeared, this indicating the presence of an underlying bronchial asthma. The radiological picture was identified by me as Left Chilaiditi Syndrome, as the patient had gastrointestinal symptoms which accompanied the procession of respiratory symptoms. The diagnostic suspicion must be early in these pathologies and the proton pump inhibitors and new generation alginates with the presence of hyaluronic acid and melatonin must also be included in the treatment of the symptoms, which have an important action on gastroesophageal reflux disease (GERD) secondary to this herniation of the viscera into the thoracic cavity. The rarity is represented by the left localization of the diaphragmatic pathology.
The Effect of Clonidine and Tramadol on Post-spinal Anaesthesia Shivering in Hysterectomy Patients: A Comparative Study
Authors: Baria Tushar , Chudasama Palak Anilkumar , Mehta Milan
Published: October 2023

Introduction:

Spinal anaesthesia is most commonly used as a secure anaesthetic method in elective and emergency operations. Shivering is noted in 40%–70% of patients undergoing surgery under spinal anaesthesia. The study aims to compare the efficacy, haemodynamic effects and side effects of clonidine with tramadol for the control of shivering.

Materials and Methods:

This prospective study was conducted from April 2016 to November 2016. Using a convenient sampling technique, a total of 60 adult patients of the American Society of Anaesthesiologists (ASA) physical status Grade I or II, aged ≥18 years, of either sex who were scheduled hysterectomy administered with clonidine vis-à-vis tramadol for spinal anaesthesia were selected for the study after informed consent. All the patients were randomly allocated into one of the two groups using computer generated random number table: Group C: Injection clonidine 75 µg slow intravenous (IV) injection and Group T: Injection tramadol 1 mg/kg slow IV injection.

Results:

Non-significant association was found between age, ASA grade, level of sensory block, shivering grade and mean systolic blood pressure amongst the participants of group clonidine and tramadol. Group C had significantly early control of shivering, less time for complete loss of shivering and fewer adverse events were noted compared to the tramadol group.

Conclusion:

Both clonidine (75 µg) and tramadol (1 mg/kg) effectively treat patients with post-spinal anaesthesia shivering, but tramadol takes longer time for complete cessation of shivering than clonidine. Clonidine offers better thermodynamics than tramadol, with fewer side effects. The more frequent incidence of the side effects of tramadol, such as nausea, vomiting and dizziness, may limit its use as an anti-shivering drug.
Laboratory Assessment of Antibacterial Efficacy of Five Different Herbal-based Potential Endodontic Irrigants
Authors: Oak Anjali A , Attur Kailash , Bagda Kamal , Mathur Nitish , Mohammad Lubna , Attar Nikhat M
Published: October 2023

Introduction:

Studies in the pharma industry have shown herbal plants as a potential source of bioactive compounds and antibacterial efficacy. These medicinal plants are also used in manufacturing modern medicines. This study is to evaluate the antibacterial efficacy of various herbal extracts such as Azadirachta indica, Ocimum tenuiflorum, turmeric, Aloe vera and Morinda citrifolia as an endodontic irrigant against Enterococcus faecalis and compare with the sodium hypochlorite alone and that with ultrasonic irrigation – an in vitro study.

Materials and Methods:

A firsthand study was conducted to find the bacterial inhibition of E. faecalis of herbal extracts. For this purpose, 30 samples were extracted and suspended with E. faecalis for each of the seven groups. The irrigating groups were divided into five herbal groups: A. indica, O. tenuiflorum, turmeric, Aloe vera and M. citrifolia. It was formed to determine the alternative against the two other groups, sodium hypochlorite alone and sodium hypochlorite, with ultrasonic irrigation. The readings (zone of inhibition) obtained from the agar well diffusion method were subjected to the statistical analysis using the SPSS software (19.0), wherein analysis of variance was used. The P value was set at 0.05.

Results:

The study demonstrated that A. indica was highly efficient amongst the herbal groups studied against E. faecalis. It was better than other extracts and comparable to sodium hypochlorite alone and with ultrasonic irrigation. The average zone of inhibition for the stated herbal ingredient was better than the commercially used chemical ones. However, there was no statistically significant difference (P < 0.05) between all the groups studied. The null hypothesis was hence not rejected.

Conclusions:

The five strong herbal irrigants such as A. indica, O. tenuiflorum, turmeric, Aloe vera and M. citrifolia were found to be the better alternatives against sodium hypochlorite alone and sodium hypochlorite with ultrasonic irrigation. The experiment conducted proved positive with mean results.
The Endocrine Function of the Skin: An Analytical Narrative
Authors: Gorai Surajit , Kumari Jyoti , Das Kinnor
Published: October 2023

Background:

Historically regarded as a protective barrier organ, the skin is now recognized as an active endocrine organ capable of synthesizing, and secreting diverse hormones and signaling molecules. This review intends to investigate the endocrine function of the epidermis, focusing on its role in hormone synthesis, metabolism, and signaling pathways.

Objective:

This article aims to provide a comprehensive overview of the endocrine function of the skin, including the identification of key hormones generated in the skin, their regulation, and their physiological significance. In addition, it intends to investigate the relationship between the epidermis and the endocrine system to elucidate the mechanisms underlying hormonal communication within the body.

Methodology:

Using electronic databases, including PubMed, Scopus, and Web of Science, a comprehensive search of the literature was conducted. Included are relevant studies, evaluations, and articles published between 1990 and 2023. The search strategy centered on the epidermis, endocrine function, hormones, and signaling pathways-related keywords. The retrieved literature was evaluated, and significant findings were analyzed.

Results:

The epidermis produces and responds to numerous hormones, including corticosteroids, sex hormones, thyroid hormones, Vitamin D, and growth factors, according to the findings. These hormones influence processes, including hair growth, wound healing, immune response, inflammation, and cell proliferation. In addition, the epidermis functions as a target for circulating hormones, participating in feedback loops, and regulating endocrine homeostasis.

Conclusion:

The skin’s endocrine function extends beyond its barrier function to play a significant role in hormonal regulation and communication. Enlightening the precise mechanisms and clinical implications of the endocrine function of the epidermis is necessary for the development of novel therapeutic approaches and interventions.
Comparison of WHO Pain Ladder Management versus Severity-based Pain Management in Patients Presented with Acute Abdominal Pain Visiting Emergency Department
Authors: Choudhury Mahasweta , Mathiazhagan Nithyanand , Reddy J. Shiva Ranjan
Published: October 2023

Aimand Objectives:

The present study was undertaken to evaluate whether patients that are administered analgesics depending on their initial pain severity are more satisfied with their treatment than those who are given analgesics in accordance with the WHO pain ladder management protocol.

Materials and Methods:

First consecutive 100 patients (Group I) with abdominal pain were treated with WHO pain ladder management and for the next 100 patients (Group II), the pain management was done based on their intensity of pain. All patients were assessed for relief of pain every 15 min based on visual analog scale (VAS).

Results:

The visual analog pain score started decreasing after the administration of analgesics in both groups. The VAS was monitored once every 15 min for 60 min and in each measurement, the score was slightly lower in Group II in comparison to Group I ( P > 0.05). At the end of 60 min, the mean score was <4 in both groups. Eighty-six percentage of the patients in Group II and 79% of the patients in Group I were satisfied with their pain relief. Although the satisfaction level of patients was higher in Group II, it was not found to be statistically significant ( P = 0.282).

Conclusion:

The usage of analgesics for pain management can be decided based on the severity of the pain instead of following the pain ladder management proposed by WHO. This can prevent the unnecessary usage of analgesics such as paracetamol and certain side effects due to that.
Health-care-seeking Behavior of Postmenopausal Women in an Urban Slum of Srikakulam Town
Authors: Roy Paromita , Bose Saptarishi , Suvvari Tarun Kumar , Sivaraj Nagarjuna
Published: October 2023

Introduction:

The majority of Indian women tend to ignore and neglect their menopausal symptoms, which can diminish in intensity over time, leading to a reduced health-related quality of life. We aimed to assess the health-care-seeking behavior of postmenopausal women in light of the increasing burden of menopausal symptoms.

Methodology:

A cross-sectional study was carried out within urban neighborhoods, involving 384 postmenopausal women aged 45–60, to investigate the health-related issues they faced. The Menopause Rating Scale (MRS) was used to assess the symptoms experienced during the postmenopausal stage. In addition, a predesigned and pretested questionnaire was used to gather information on their health-care-seeking behavior. The participants underwent a comprehensive physical examination, including anthropometric measurements. To analyze the data, descriptive statistics were used.

Results:

The results showed that 34% of the 384 women were between the ages of 45 and 49 years. Based on the MRS assessment, it was found that around 70% of women experienced mild symptoms, whereas 24% had moderate symptoms, and a mere 2% reported severe symptoms. Regarding treatment, approximately 85% of women had sought medical intervention. However, satisfaction with the treatment was reported by only 71% of the participants. Among the women with modest symptoms, 70% received medical care, compared to 28% of the women with moderate symptoms. Women who were employed, widowed, three-generation family women, and Class IISES women made the most use of health-care facilities, with 90%, 89%, 88%, and 97%, respectively.

Conclusion:

The prevalence of faint symptoms was significantly higher than that of moderate and severe symptoms. Although most women sought treatment, many were unsatisfied with it. Therefore, behavior modification communication is necessary among postmenopausal women who seek medical care. In addition, the National Health Mission should incorporate components addressing the specific health requirements of postmenopausal women.
Web-based intervention in improving the mental health status among patients with type 2 diabetes in Southern India
Authors: Anil Deepak , Kumar D. Sunil , Shivaswamy Rajendra Prasad , Arun Vanishri , Gopi Arun , Yadav Deepika , Prakash Hari , Murthy M. R. Narayana
Published: October 2023

Background:

Diabetes is one of many medical diseases that correlate with depression. This disease impacts several life implications due to its complications, ranging from economic burden to lifelong dependency. The present study was conducted to assess the effectiveness of a web-based model in improving the mental health status among patients with type 2 diabetes mellitus (T2DM) attending a tertiary care hospital in Mysuru, southern India.

Methodology:

A 3-month quasi-experimental study was conducted among 545 T2DM patients attending the outpatient department of a tertiary care hospital in Mysuru, southern India. Patients were asked to use diabetes care (https://www.diabetes-care.co.in/), a website that can predict the risk for uncontrolled diabetes and recommends lifestyle changes. The Depression, Anxiety, and Stress Scale-21 items questionnaire was used to assess participants’ mental health at the beginning of the study and 3 months later.

Results:

Depression (moderate depression from 3.7% to 2% and severe depression from 0.4% to 0%), anxiety (severe anxiety from 1.3% to 0.2%), and stress (moderate stress from 5% to 0.7%). scores showed a reduction during post assessment period compared to the initial assessment. However, this difference was not statistically significant (<0.05). There was a negative correlation between all domains of quality of life (QoL) and depression, anxiety, and stress scores, implying that lower QoL scores were associated with more depression, anxiety, and stress scores and vice versa.

Conclusion:

Patients with T2DM using the web-based model that predicts the risk of uncontrolled diabetes and suggests lifestyle changes experienced an improvement in their mental health status 3 months’ postintervention.
Introduction to Psychodermatology
Authors: Latheef Ettappurath N Abdul , Hafi Bishrul N A
Published: October 2023

Psychodermatology is an emerging newer subspecialty of dermatology, which comprises dermatology, psychiatry, and psychology. Eventhough the concept is old this dictum has acquired tremendous importance in recent decades. The mind and body are considered as a single unit instead of mind versus body dualism, and this stresses the need for holistic approach of disease management. Formerly, the biomedical concept of disease was very prevalent, which compared the human body to a machine and the doctor was like a technician doing the repair work of human machine, where the mind was completely neglected. But in this recent concept the mind has very important role in health, disease causation and healing. Skin is a part of neuro-immuno-cutaneous-endocrine system. So any disease affecting skin can affect the mind and vise versa. The psycho physiological conditions are highly stress related and secondary psychiatric comorbidities are very common in dermatological conditions especially on visible part of our.
Psychological Interventions in Psychodermatological Practice
Authors: Latheef Ettappurath N Abdul , Hafi Bishrul N A
Published: October 2023

There is a well-established connection between the skin and the mind. Based on current evidence, many dermatological conditions are triggered or exacerbated by stress. Therefore, intervention needs to target stress, anxiety, and other psychiatric comorbidities which may be secondary to skin conditions or may lead to aggravation of the illness. Psychological interventions should be based on the underlying emotional issues that may affect the way skin problems respond to medical treatment. Before starting the intervention, it is very important to know which psychodermatological conditions will be targeted. In primary psychocutaneous illness (delusion of parasitosis, obsessive-compulsive disorder, dysmorphophobia, etc.) the target is to modify or eliminate the symptoms of illness with specific models and approaches. If stress is playing an active role in the etiology and course of skin conditions (e.g., psoriasis, atopic dermatitis, and urticaria) or it is delaying the improvement, then the aim should be to apply stress reduction techniques. In some skin conditions (pemphigus vulgaris, Hansen’s disease, etc.), the aim of the intervention should be to strengthen the defenses and teach new and better mechanisms to maintain control. The common psychotherapy procedures useful in dermatology practice include psychoeducation, behavior therapy, habit reversal, relaxation procedures, biofeedback, cognitive behavior therapy, hypnotherapy, and group therapy.
A Hospital-based Cross-sectional Study of Clinical, Wood’s Lamp, and Dermoscopic Findings in Melasma
Authors: Herle P. M. Amrutha , Doshi Bhavana Ravindra
Published: October 2023

Background:

Melasma is a common pigmentation disorder with female predominance. Depending on melanin depth, it can be epidermal, dermal, and mixed type. Assessment of this helps to chalk out a proper treatment plan. Dermoscopy is a device which helps to examine and assess pigment color and depth.

Objective:

Due to the relative dearth of literature on the correlation between clinical, dermoscopy, and Wood’s lamp findings, we undertook this study to classify melasma and correlate dermoscopic features with clinical and Wood’s lamp findings.

Materials and Methods:

Clinical, Wood’s lamp, and dermoscopic examination with Dino-Lite Premier AM4113ZT were conducted in 160 patients of clinically diagnosed melasma. Findings of light-brown network and perifollicular sparing were considered for diagnosing epidermal melasma; gray-to-brown pigmentation, perifollicular or arciform pattern of hyperpigmentation for diagnosing dermal melasma. Patients with a combination of both were classified into mixed melasma. This was correlated with clinical and Wood’s lamp findings.

Results:

Data analysis by statistical software R version 4.0.2 and Microsoft Excel showed female predominance (80%, n = 128). On clinical and Wood’s lamp examination, the majority had mixed type of melasma; this was followed by epidermal and dermal melasma, respectively. Dermoscopic examination showed a mixed type of melasma in majority, followed by dermal and epidermal type. By Cohen’s kappa, there was substantial agreement present between dermoscopic impression and Wood’s lamp examination (K = 0.6112, P < 0.00001).

Conclusion:

Dermoscopic evaluation as a noninvasive tool provides a better insight on classifying the melasma patterns versus clinical and Wood’s lamp examination and hence decides upon its further management.
How and when to Use Psychotropic Drugs in Psychodermatology
Authors: Deshpande Sharmishtha S. , Bhailume Sanket
Published: October 2023

A significant number of patients coming to dermatologists have psychiatric symptoms as predisposing, precipitating, and perpetuating factors. Assessment and treatment of these conditions is complex. However, looking at the number of patients with these problems, dermatologist needs to be well versed with an assessment of these patients and use of some of the psychotropic drugs. Some such drugs are discussed here along with a discussion about the decision to use them. Benzodiazepines such as clonazepam and lorazepam, doxepin, selective serotonin reuptake inhibitor like fluoxetine, escitalopram, and low dose of antipsychotics like risperidone, haloperidol, and olanzapine are discussed. As the patients are often reluctant to visit a psychiatrist, a dermatologist needs to help in allaying the initial anxiety and to provide understanding about the psychiatric conditions and available options for treatment. In long term, liaison with a psychiatrist can be established and joint treatment by both consultants can be continued.
The Primary Psychiatric Conditions: Clinical Characteristics
Authors: Prabhu Smitha S , Goyal Shivam
Published: October 2023

Primary psychiatric conditions are those conditions, wherein the cutaneous manifestations are secondary to functional psychopathology in the brain. These comprise of psychiatric disorders with dermatologic manifestations and include conditions such as dermatitis artefacta, delusions of parasitosis, obsessive–compulsive disorders, body-focused repetitive behavior disorders, or somatoform disorders. Herein, we describe the clinical features and diagnostic methods of the individual primary psychiatric conditions, most of which have definitive diagnostic criteria in Diagnostic and Statistical Manual of Mental Disorders, and discuss the differential diagnoses encountered in clinical practice, in brief.
Association of Mastoid Pneumatization with Deviated Nasal Septum: A Clinicoradiological Study
Authors: Basuroy Siddhartha , Goel Leena , De Sa Carnegie , Goel Megha , Varughese Kevin Mathew , Vernekar Sunidhi Mohandas , Vijaykumar Rashmi
Published: October 2023

Background:

Deviated nasal septum (DNS) has been reported to jeopardizing the nasal aerodynamics. This in turn may affect the pressure dynamics in the nasopharynx and eventually affect the development and pneumatization of mastoid air cells. Few studies done previously have shown a positive correlation between nasal pathologies and mastoid pneumatization.

Objectives:

This study was undertaken to see for the possible association of mastoid cell pneumatization, with DNS. Materials and Methods: Limited high-resolution computed tomography temporal bone and computed tomography nose and paranasal sinuses were used to calculate the mastoid air cell volume and angle of septal deviation. The degree of septal deviation was graded into mild, moderate, and severe. The mastoid air cell system volume was calculated on the side of the convexity of the septal deviation and the other side.

Results:

It was found that there is a statistically significant difference in the mastoid volume on the affected side of the DNS vis a vis the unaffected side. Further, the degree of reduction of the volume was not a linear function of the degree of septal deviation.

Conclusions:

Septal deviation significantly reduces the mastoid air cell volume on the affected side Thus, early correction of pathological DNS in adults, irrespective of the etiology, is important, so as to avoid the chances of developing chronic ear pathologies in later life.
Evaluation of Cognitive Function Using P300 Latency and Amplitude in Children with Profound Sensorineural Hearing Loss Using Hearing Aids: A Comparative Cross-sectional Study
Authors: Aryanti Gita , Zizlavsky Semiramis , Soebadi Amanda , Hendrawan Donny , Prihartono Joedo , Suwento Ronny , Sriyana Ayu Astria
Published: October 2023

Introduction:

As hearing function is directly linked to language and communication abilities, hearing loss may negatively affect children’s cognitive development. Therefore, it is important that hearing-impaired children undergo cognitive function assessments to better understand how to alleviate this comorbidity. The P300 event-related potential measurement is a neurophysiological test increasingly used to objectively measure cognitive function.

Aim:

The aim of the study was to compare the latency and amplitude of P300 waves in children with profound sensorineural hearing loss (SNHL) with hearing aids and normal-hearing children aged 7–15 years old.

Methods:

A comparative cross-sectional study involving 15 children with profound SNHL and 15 children with normal hearing was conducted. The latency and amplitude of P300 waves in these children in response to auditory and visual stimuli were recorded and analyzed.

Results:

The mean P300 wave latency in children with SNHL was slightly longer than that in children with normal hearing, albeit insignificant (P = 0.578). Similarly, the amplitude of the P300 waves was not significantly smaller in children with SNHL (P = 0.885).

Conclusions:

SNHL children with hearing aid habilitation have comparable P300 amplitude and latency compare to normal-hearing children.
Efficacy of Oral versus Intratympanic Steroids in the Treatment of Idiopathic Sudden Sensorineural Hearing Loss: A 1-year Randomized Control Trial
Authors: Tejaswini J. S , Walia Manwinder , Bansal Sandeep , Soni Samanvaya
Published: October 2023

Background:

Sudden sensorineural hearing loss (SSNHL) is a common otologic emergency, with hearing loss of 30 dB or greater at three contiguous frequencies, and an abrupt onset within 3 days or fewer, with no recognizable cause.

Aims and Objectives:

In this study, the efficacy of intratympanic (IT) injections of dexamethasone are compared with oral prednisolone and the behaviour of the different audiometric curves in response to both the steroid therapies in studied.

Materials and Methods:

Patients presenting with SSNHL to the Department of ENT, Head and Neck Surgery at Government Multi Speciality Hospital, Chandigarh, were subjected to routine tests. Informed written consent was taken from each patient, and cases meeting the selection criteria were included in the study. Pure-tone audiometry was done before starting treatment. Patients were randomly assigned into two groups based on their enrollment number. Those in Group 1 were treated with three doses of 0.3–0.6 mL IT injections of dexamethasone (4 mg/mL) on alternate days and those in Group 2 received OP 1 mg/kg/day with tapering doses. Pure-tone audiogram (PTA) will be repeated after 2 weeks, 4 weeks, and 8 weeks from the first dose.

Results:

In the IT dexamethasone group, the pretreatment PTA was 61.05 dB while the posttreatment PTA was 37.45 dB. The hearing gain was 23.6 dB. In the oral steroid group, pretreatment PTA was 66.79 while posttreatment PTA was 47.36 dB. The hearing gain was 19.43 dB. The hearing gain in both the groups was statistically significant; however, there was no statistical difference between the two in terms of superiority of efficacy (P > 0.05).

Conclusion:

The treatment of SSNHL still remains a challenge among the otologists. The present study establishes that the efficacy of IT steroids was as good as the oral steroid therapy for the management of SSNHL as both the modalities showed significant hearing improvement. Hence, IT steroid can be used as a first-line therapy in patients with. Our study also uncovered the fact that patients who come with shorter duration of onset recover quickly compared to those patients who delay their treatment. Hence, IT steroid can be used as a primary modality of treatment instead of a salvage therapy in the selected group of patients.
Temporomandibular Joint Fistula to External Auditory Canal: A Rare Case
Authors: Aditomo Rano , Yanuarista Gabrina Selvi
Published: October 2023

Spontaneous fistula between temporomandibular junction and external ear canal is such rare case. External ear disease commonly relate to this disease. This case report aimed to know further about patophisiology of temporomandibular joint (TMJ) fistula. case of temporomandibular fistula happened in a 63-year-old woman with 10 years symptoms of discomfort in external ear canal. The patient told that the only symptom of her disease was “bleb” sound like a bubble pop in her right ear. The patient never seeks for medical help before. During physical examination, we found fistula in her external auditory canal (EAC). After we did computed tomography scan, it confirmed that the fistula was connecting EAC with TMJ. Is there any relation between symptoms and etiology of TMJ fistulae? this case report explored the literature about TMJ fistula through Cochrane, PMC, PubMed, and Google Scholar. we found total 11 articles related to our topic. The symptoms felt by patients with TMJ fistulae to the EAC may vary. Although some of them can be such a clue of the etiology from disorder that appears, some symptoms can overlap. It is important for clinicians to know the symptoms that appear and determine the most likely etiologies that might cause the condition.
A Rare Case of Stapes Anomaly with Ossified Stapedius Tendon in a Patient with Turner Syndrome
Authors: Fauzi Nurul Anis Mohd , Jamali Ahmad Aizudin Mohd , Haron Juhara , Othman Nik Adilah Nik , Daud Mohd Khairi Md.
Published: October 2023

Congenital anomaly of ossicles in the middle ear is rare. We present a patient with Turner syndrome who presented with hearing loss. Pure-tone audiometry revealed bilateral moderate-to-severe hearing loss with conductive type at the lower and mixed type at the higher frequencies. There was a bone threshold dip at 2 kHz on both sides. The patient was diagnosed as having bilateral otosclerosis and underwent left middle ear surgery. Intraoperative findings showed an ossified stapedius tendon and a fixed monopod stapes with obliterated obturator foramen. The stapedius tendon was divided causing the footplate of the stapes to be mobile. This resulted in improved hearing with the closure of air-bone gap by around 40–50 dB. Stapes anomaly and ossified stapedius tendon causing stapes fixation may results in hearing loss with Carhart’s notch on pure-tone audiometry and misdiagnosed as otosclerosis. Surgery in which the ossified stapedius tendon is divided may help improve the patient’s hearing.
Fibrous Dysplasia of the Temporal Bone: A Case Series
Authors: Madan Tanuj , Goyal Sunil , Dwivedi Mandavi , Swami Himanshu
Published: October 2023

Fibrous dysplasia (FD) is a benign and chronic abnormal proliferation of fibrous tissue and bone. It presents as a growth; however, most authors do not consider it to be true neoplasia. Despite its affinity to affect craniofacial bones, it usually remains asymptomatic and, sometimes, presents with deformity. Owing to its rarity, diagnostic difficulty, scarce literature, and staggered opinions on optimal management, it still interests otolaryngologists. FD involving temporal bone is even rarer. The most common initial findings are stenosis of the external auditory canal and conductive hearing loss. Most cases involve a single bone; however, about 20% of patients have polyostotic involvement often with extraosseous abnormalities. This disease produces widely variable radiographic images. Radio imaging is highly suggestive; however, the diagnosis is clinched only by histopathology with a surgical specimen. Here, we present a series of two cases of temporal bone FD with its management and outcomes.
Reconditioned and new pacemakers in low-resource countries: A pilot study
Authors: Edafe Emmanuel Auchi , Sotonye Dodiyi-Manuel , Iseko Iseko Iyoko , Akpa Maclean R. , Sani Mahmoud Umar , Ocheli Emmanuel , Alasia Datonye Dennis , Crawford Thomas Christopher , Puroll Eric , Dunning Joel
Published: October 2023

Introduction:

Cardiac pacemakers have brought a paradigm shift to the management of symptomatic bradyarrhythmia. It has led to a dramatic reduction in morbidity and mortality from cardiovascular disease over the many decades. Despite these merits, pacemakers remain unaffordable and beyond reach for many patients in low-and middle-income countries (LMICs) including Nigeria. These challenges and regulatory obstacles may be overcome with postmortem pacemaker reuse if they are proven to be feasible and safe as cost-effective strategy to provide life-saving therapy to patients in LMICs. The aim of this pilot study was to review the usefulness of reconditioned pacemakers among patients that could not afford new devices.

Materials and Methods:

A total of 16 patients were recruited for the pilot study. These included patients with a pacing indication who could not afford a new pacemaker or a battery change. The 16 patients were grouped into A and B. Group B had 8 patients that received new pacemaker batteries. Group A comprised 8 patients who received refurbished pacemaker batteries. All the pacemaker leads used in the study for both the groups were new. Implant charges were free. Ethical approval was got from the University of Port Harcourt Teaching Hospital, and the Cardiocare Multispecialty Hospital, Abuja, before commencement of the study. The refurbished pacemaker batteries were donated by the relatives of deceased patients, with a minimum 70% of remaining battery life. The donated pacemaker batteries were received from Pace4 life and My Heart Your Heart, University of Michigan, Michigan, United States. These reconditioned batteries were resterilized. Pacemaker functions were rechecked before and after sterilization. The devices were programmed on nonpacing (ODO) mode with adaptive pacing mode swift off. These devices were shipped to us for use. All sterile techniques were followed during implantation. Data were collected on wound healing and device malfunction during implant and follow-up for 3 months.

Results:

The average age for the patients was 62 ± 13 years. There was no pocket hematoma among both the groups. There were no complications during the 1–3-month follow-up period. There was no evidence of lead or battery malfunction among the two groups. The means of battery longevity for the new and refurbished pacemakers were 10.38 and 10.57 years, respectively. There was no statistical difference between the pulse generator longevity among new and refurbished pacemakers with P = 0.681. There was no infection and device malfunction in the 3 months.

Conclusion:

The reused pacemaker batteries are safe and do no increased risk of infection and malfunction. This provides an effective option for patients who cannot afford a new device or a replacement battery.
Statistical determination of COVID-19 mortality in age groups in the Ecuadorian Highlands
Authors: Santillán-Lima Juan , Molina-Granja Fernando , Santillán-Lima Patricio , Caichug-Rivera Daniela , Lozada-Yánez Raúl , Luna-Encalada Washington
Published: October 2023

INTRODUCTION: A problem plaguing humanity is the countless deaths from COVID-19. Conducting a statistical study based on deaths data during the pandemic will allow us to identify the age groups most vulnerable to death. This information can be used by public and private health organizations to take preventive measures in the most vulnerable population. OBJECTIVES: To determine the age groups most vulnerable to COVID 19 in the Ecuadorian highlands during the periods 2020-2021. METHODS: The "Bootstrap method to calculate the confidence interval for proportions" was applied to the age groups of those who died from COVID in the Ecuadorian highlands in 2020 and 2021. The method is implemented in R Studio. RESULTS: The adjusted confidence intervals suggest that there is a 95% confidence that the age group most prone to death from COVID-19 is the Elderly with a point estimate of 72.70% in 2020 and 76.61% in 2021. The main subgroup of 80 to 90 years followed by 65 to 70 years. CONCLUSION: Adjusted confidence intervals indicate that there is a 95% confidence that the age subgroup most prone to death from COVID-19 is 80 to 90 years with a point estimate of 16.13% in 2020 and 16.85% in 2021. And 65 to 70 years with a point estimate of 12.98% in 2020 and 12.57% in 2021.