bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of dry eye disease in the patients of allergic conjunctivitis: Hospital-based cross-sectional study
Authors: Mazumdar Shefali , Satsangi Saran Kumar , Garg Mahak , Rajan Payal Goel
Published: April 2023

Purpose:

Allergic conjunctivitis (AC) is commonly associated with dry eye. This study was conducted to assess the prevalence of dry eye in different subsets of AC patients.

Methods:

This observational, cross-sectional study, conducted in the Department of Ophthalmology of a tertiary center in north India, included 132 patients of AC. The diagnosis of dry eye disease (DED) was made on the basis of Ocular Surface Disease Index (OSDI), Schirmer’s test, and tear film break-up time (TFBUT).

Results:

The prevalence of dry eye in AC patients was found to range between 31% and 36%. On OSDI scoring, 20.45% of patients had mild, 18.18% moderate, and 31.81% had a severe grade of DED, respectively. The mean OSDI score was noted to be significantly higher in patients with perennial allergic conjunctivitis (PAC) (29.82 ± 12.41), followed by seasonal allergic conjunctivitis (SAC) (25.35 ± 12.88), and least in the patients of vernal keratoconjunctivitis (VKC) (13.60 ± 8.63) (p < 0.0001), respectively. The TFBUT was found to be less than 10 s in 45.45% of PAC, 30.43% of SAC, and 20% of VKC patients, respectively. The difference between the mean TFBUT among the three groups was statistically insignificant (p = 0.683). Schirmer’s test value of <10 mm was observed in 45.45% of PAC, 43.47% of SAC, and 10% of VKC patients, respectively.

Conclusion:

This study revealed a high prevalence of DED in patients with AC. Among the different types of AC patients, PAC had the highest percentage of DED followed by SAC and least in VKC, respectively.
Dry eye disease and risk factors for corneal complications in chronic ocular graft-versus-host disease
Authors: Kate Anahita , Singh Swati , Das Anthony Vipin , Basu Sayan
Published: April 2023

Purpose:

The current study was carried out to evaluate the clinical features and management outcomes of dry eye disease (DED) in chronic ocular GvHD following allogenic hematopoietic stem cell transplantation (HSCT).

Methods:

A retrospective review of consecutive patients diagnosed with chronic ocular GvHD between 2011 and 2020 was performed at a tertiary eye care network. Multi-variate regression analysis was carried out for identifying risk factors associated with progressive disease.

Results:

A total of 34 patients (68 eyes) with a median age of 33 years [inter-quartile range (IQR) 23–40.5] were studied. The most common indication for HSCT was acute lymphocytic leukemia (26%). Ocular GvHD developed at a median of 2 years (IQR 1–5.5 years) after HSCT. Aqueous tear deficiency was present in 71% of the eyes, of which 84% had a Schirmer value of <5 mm. The median visual acuity at presentation and that after a median follow-up of 6.9 months were comparable at 0.1 log minimum angle of resolution (logMAR) (P = 0.97). Topical immunosuppression was required in 88% of cases, and with this, improvement in corneal (53%, P = 0.003) and conjunctival staining scores (45%, P = 0.43) was noted. A progressive disease was present in 32% with persistent epithelial defects being the most common complication. Grade 2 conjunctival hyperemia [odds ratio (OR): 2.6; P = 0.01] and Schirmer’s value <5 mm (OR: 2.7; P = 0.03) were found to be associated with progressive disease.

Conclusion:

Aqueous deficient DED is the most common ocular manifestation of chronic ocular GvHD, and the risk of the disease progression is greater in eyes with conjunctival hyperemia and severe aqueous deficiency. Awareness among ophthalmologists of this entity is essential for its timely detection and optimal management.
A simple technique of meibography for morphological and functional evaluation of meibomian glands in dry eye conditions
Authors: Mounika Vala , Kamath Sumana J , Tejaswi Pagadala , Kamath Ajay R , Rodrigues Gladys R , Mendonca Teena Mariet
Published: April 2023

Purpose:

Dry eye disease (DED) is because of a decrease in the tear film’s volume or a change in the composition of tears. Evaporative dry eye is the most common type, which is due to meibomian gland dysfunction (MGD). In this study, the morphology of meibomian glands was evaluated in all kinds of dry eyes to look for any loss of meibomian glands, assess the function of remaining glands, and investigate the relationship between anatomy, function, and severity of DED.

Methods:

A total of 300 patients were included in the study, with 150 eyes in the study group and 150 in the control group. Meibomian gland morphology was assessed by examining the tarsal plate after everting the eyelids. Tear film function was evaluated using tear film break-up time (TBUT) and Schirmer’s test (SCH I and II). Meibomian gland morphology was examined with a slit-lamp under magnification, a transilluminator using a small light emitting diode (LED) bulb, and non-contact meibography using an auto refracto-keratometer (ARK).

Results:

Females had a higher prevalence of dry eyes in our study. In all, 103 eyes (68.6%) in the study group had evaporative dry eye, making it the most prevalent type. Among the 150 controls, 104 controls with 69.3% had no dry eye symptoms, and in those with symptoms, the evaporative type was the most common, with a 28% prevalence.

Conclusion:

TBUT should be performed in all patients with detectable MG abnormality. Meibography has high specificity and sensitivity to diagnose MGD and in turn dry eyes and should be considered a routine screening modality.
Evaluation of dry eyes in children with vernal kerato-conjunctivitis using clinical tests and ocular surface analysis
Authors: Gupta Shalini , Rahman Mahmooda , Tibrewal Shailja , Gaur Abha , Ganesh Suma , Sangwan Virender Singh
Published: April 2023

Purpose:

To evaluate dry eyes in children with vernal kerato-conjunctivitis (VKC) and correlate it with symptoms, clinical findings, and ocular surface analysis (OSA) parameters.

Methods:

Children with clinically diagnosed VKC underwent complete ophthalmological examination, Schirmer’s testing, modified ocular surface disease index (OSDI) scoring, Bonini grading, fluorescein tear-film break-up time (TBUT), VKC – Collaborative Longitudinal Evaluation of Keratoconus (CLEK) scoring, and OSA. Children with a TBUT of < 10 s were defined to have dry eyes. The above-mentioned parameters were compared between dry eye and non-dry eye VKC children.

Results:

The mean age of the 87 children included in the study was 9.1 ± 2.9 years. Dry eyes were seen in 60.9% [95% confidence interval (CI); 51% to 71%]. The mean TBUT was 13.4 ± 3.8 and 5.9 ± 1.9 s in non-dry and dry eye groups, respectively (P < 0.001). The mean value of Schirmer’s test was 25.9 ± 9.8 and 20.8 ± 8.6 mm in the non-dry and dry eye groups, respectively (P = 0.01). The two groups did not differ in their OSDI scores, Bonini grading, and CLEK scores. The OSA parameter of non-invasive break-up time (NIBUT) was 8.3 ± 3.2 s in non-dry eye group and 6.4 ± 2.9 s in dry eye group, P = 0.008. The lower lid Meibomian gland (MG) loss was 7.4% in non-dry eye group and 12.2% in dry eye group, P = 0.028. Other OSA parameters did not differ significantly among the two groups.

Conclusion:

Dry eyes are seen in two-thirds of pediatric VKC. Evaluation of dry eyes should be incorporated in their clinical evaluation. Among OSA parameters, NIBUT and lower lid MG loss are associated with dry eyes in pediatric VKC patients.
Type 1–type 2 interferon imbalance in dry eye disease
Authors: Panigrahi Trailokyanath , D’Souza Sharon , Suresh Babu Vishnu , Dickman Mor M , Nuijts Rudy M M A , Sethu Swaminathan , Shetty Rohit
Published: April 2023

Purpose:

Dry eye disease (DED) is characterized by altered ocular surface proinflammatory and antiinflammatory factors. Interferons (IFNs) are a class of pleiotropic cytokines well known for their antimicrobial, inflammatory, and immunomodulatory roles. Hence, this study investigates the ocular surface expression of different types of IFNs in patients with DED.

Methods:

The cross-sectional, observational study included patients with DED and normal subjects. Conjunctival impression cytology (CIC) samples were obtained from the study subjects (controls, n = 7; DED, n = 8). The mRNA expression levels of type 1 IFN (IFNα, IFNβ), type 2 IFN (IFNγ), and type 3 IFN (IFNλ1, IFNλ2, IFNλ3) were measured by quantitative PCR (polymerase chain reaction) in CIC samples. IFNα and IFNγ expression under hyperosmotic stress was also studied in human corneal epithelial cells (HCECs) in vitro.

Results:

The mRNA expression levels of IFNα and IFNβ were significantly lower and that of IFNγ was significantly higher in DED patients compared to healthy controls. The mRNA levels of IFNα, IFNβ, and IFNλ were significantly lower compared to IFNγ in DED patients. An inverse association between tonicity-responsive enhancer-binding protein (TonEBP; hyperosmotic stress maker) and IFNα or IFNβ expression and a positive association between TonEBP and IFNγ expression was observed in CIC samples. The expression of IFNα was lower than IFNγ in HCECs undergoing hyperosmotic stress compared to HCECs without the stress.

Conclusion:

The presence of an imbalance between type 1 and type 2 IFNs in DED patients suggests newer pathogenic processes in DED, plausible ocular surface infection susceptibility in DED patients, and potential therapeutic targets in the management of DED.
Autophagy in dry eye disease: Therapeutic implications of autophagy modulators on the ocular surface
Authors: Jeyabalan Nallathambi , Pillai Aswathi M , Khamar Pooja , Shetty Rohit , Mohan Rajiv R , Ghosh Arkasubhra
Published: April 2023

Dry eye disease (DED) is a chronic ocular surface disorder, associated with inflammation, which can cause severe morbidity, visual compromise, and loss of quality of life, affecting up to 5–50% of the world population. In DED, ocular surface damage and tear film instability due to abnormal tear secretion lead to ocular surface pain, discomfort, and epithelial barrier disruption. Studies have shown the involvement of autophagy regulation in dry eye disease as a pathogenic mechanism along with the inflammatory response. Autophagy is a self-degradation pathway in mammalian cells that reduces the excessive inflammation driven by the secretion of inflammatory factors in tears. Specific autophagy modulators are already available for the management of DED currently. However, growing studies on autophagy regulation in DED might further encourage the development of autophagy modulating drugs that reduce the pathological response at the ocular surface. In this review, we summarize the role of autophagy in the pathogenesis of dry eye disease and explore its therapeutic application.
Role of in vivo confocal microscopy in dry eye disease and eye pain
Authors: Shetty Rohit , Dua Harminder S , Tong Louis , Kundu Gairik , Khamar Pooja , Gorimanipalli Bhavya , D’Souza Sharon
Published: April 2023

Dry eye disease is known to have a lot of variability in presentation with overlapping subtypes. Understanding the pathology of this condition will guide therapeutic options. In vivo confocal microscopy is a diagnostic and imaging modality that provides high magnification and high-resolution images of all layers of the cornea and ocular surface. Various structures in the cornea and their alterations due to dry eye have been imaged. The impact of the tear film instability, inflammation, and altered homeostasis on the corneal epithelium, nerves, keratocytes, and dendritic cells have been evaluated across different studies. In addition, key features of IVCM in patients with neuropathic pain have been highlighted in this paper.
Intricate insights into immune response in dry eye disease
Authors: Kaur Ruminder P , Gurnani Bharat , Kaur Kirandeep
Published: April 2023

Dry eye disease (DED) is a complex disorder of the ocular surface with a loss of tear film homeostasis, causing an imbalance in the tear–air interface and leading to ocular discomfort, pain, and vision issues. Immune control issues are a primary factor in dry eye disorder’s origin, progression, and management. The aim of managing DED is to reduce symptoms and improve the life quality of those affected. Despite the diagnosis, up to half of the patients do not get proper care. The scarcity of successful treatments for DED is worrisome, and it is of increasing importance to comprehend the root causes and create more effective therapies to alleviate the distress of those afflicted with the disorder. Therefore, the role of the immune system in the initiation and progression of DED has become the research focus. This paper reviews the current insight into the immune response in DED, the existing treatment methods, and ongoing research to search for better treatments.
A Tale of Two Brothers and the Incumbent Prerogative for a Social Ombudsman
Authors: Verma Rohit
Published: April 2023

Social support stipulates two imperative components: A structural component comprising network size and frequency of social interactions, and a functional component with emotional (such as receiving love and empathy) and instrumental (practical help such as monetary gifts or assistance between providing therapeutic care and social support. I present such a case where my role belonged to more of a social ombudsman for the care receivers mitigating their daily lifestyles rather than a clinician providing only pharmacological upkeep. This case taught me the perspective of devoting time to patients and their family members beyond the call for duty from being a mere prescription provider to be more of a social aid to the debilitated family unit.
Depression among Married Women in Assam: A Qualitative Study
Authors: Bora Debashree , Deuri Sonia Pereira , Saha Apurba
Published: April 2023

Background:

Women are at greater risk for depressive disorders than men. They are also known to be genetically and biologically vulnerable. Indian women mostly express their mental stress as somatic complaints and many other psychosocial factors influence as well as maintain the depressive symptoms. The psychosocial needs of women are often projected through the presentation of their depressive symptoms.

Aim:

The present study aimed to explore the psychosocial problems of married women diagnosed with depressive disorder.

Methods:

The study used a qualitative approach with exploratory research design. This study was carried out in the outpatient department of Lokopriya Gopinath Bordoloi Regional Institute of Mental Health in Tezpur (Assam). Purposive sampling was used and eight women were selected for the study. In-depth interviews were conducted to explore the psychosocial stressors, experiences, and illness narratives (idioms of distress) of these women. Among eight women who consented to participate in the study, six completed the study.

Results:

The salient findings of this study are that the women diagnosed with mild to moderate depressive disorders conveyed their mental health issues through various physical and emotional problems. Women expressed their problems primarily through somatic complaints, typically a variety of aches in different body parts, lethargy, excessive thinking, and decreased enthusiasm. Psychosocial factors centered around various social contexts and interpersonal issues, economic difficulties, marital difficulties and housing problems.

Conclusion:

The women’s narratives focuses predominantly on the socioeconomic and interpersonal difficulties as the underlying cause of their distressing symptoms is projective of psychosocial aberrations. Experiences expressed by women are located in their social world.
Effect of COVID-19 Lockdown on Intrafamilial Relationship in Urban Kakinada, Andhra Pradesh, India
Authors: Ganji Sravanthi , Babu G. Krishna , Prabha K. J. S. Surya , Babji K.
Published: April 2023

Background:

The COVID-19 pandemic has created public health crisis and economic instability globally. However, the pandemic and the nationwide lockdown have a significant impact on the psychosocial status, emotional state, relationships of individuals, family, and community. Families were facing challenges due to lockdown and will do their best to develop adaptive behavior for attaining self-stability. The present study helps to understand the effect of lockdown on family well-being and the shift of intrafamilial relationships during the lockdown.

Subjects and Methods:

A cross-sectional study was done in an urban area of Kakinada from April to June 2020. A convenient sample of 300 families was selected by systematic random method. One parent and one adolescent child from each family, a total of 600 study participants were included under the study. Data were collected using a semi-structured questionnaire, entered in Microsoft Excel and analyzed using IBM SPSS. The mean, frequencies, proportion, and Chi-square test were used to analyze data.

Results:

Adaptability has increased during lockdown by sharing of household work, from 3% before to 91.7%. 97.3% were happy spending time with family members. Communication and satisfaction have increased by a decrease in conflicts, from 19.7% to 7% during the lockdown. Only 3.08% of adults were facing either physical or verbal abuse.

Conclusions:

During the lockdown period, the family members spent quality time together acquired new skills, and conflicts among them were reduced. Domestic violence is low in this particular study area and familial bonding is high.
Comparison of NLR (neutrophil/lymphocyte ratio) and PLR (platelet/lymphocyte ratio) as inflammatory markers in 1st episode mania and bipolar mania: A preliminary study
Authors: Goyal Manish K. , Solanki Ram K. , Jain Akhilesh , Yadav Kuldeep S.
Published: April 2023

Background:

There are various factors including inflammation that have been studied in bipolar disorder. NLR (Neutrophil to lymphocyte ratio) and PLR (platelet to lymphocyte ratio) are one of them. Various psychotropic drugs can affect the inflammatory state.

Aim:

This study was planned to find NLR and PLR in bipolar disorder (mania) and psychotropic drug naïve 1st episode mania.

Materials and Methods:

Total of 120 subjects were chosen including, 40 bipolar mania, 40 drugs naïve 1st episode mania, and 40 healthy controls. The severity of mania was assessed by the Young Mania Rating Scale. Blood samples were collected in the morning hours in order to get blood counts.

Results:

A significantly higher values of neutrophil counts and NLR, while the significant lower values of lymphocyte counts in both 1st episode and bipolar mania compared to healthy control were observed. The first episode mania group had significantly higher neutrophil counts and NLR in comparison to bipolar mania.

Conclusion:

Results suggest a possible inflammatory pathophysiology of mania. Psychotropic medicines may have an anti-inflammatory effect, signified by the fact that 1st episode mania group has a greater level of inflammation in comparison to bipolar mania.
Teachers’ perceptions of the impact of COVID-19 pandemic and virtual teaching on the physical and mental health of children in Kashmir: A qualitative study
Authors: Bashir Khalid , Kausar Zeenat , Khan S. Muhammad Salim , Qurieshi Mariya Amin , Haq Inaamul
Published: April 2023

Background:

Children inherently want to remain engrossed in the activities as easily as possible within their ecological environment and academic curricular ambit. Covid-19 adversely affected our physical, social, and mental conditions and children were no exception.

Objectives:

To understand the experiences of teachers who have been doing virtual teaching to children during COVID-19; To understand the impact of virtual teaching and COVID-19 on physical and mental health of children.

Materials and Methods:

The qualitative study was conducted in the Kashmir valley and school teachers teaching students from class Ist to class 8th were involved in the study. Participants were selected purposefully based on the inclusion criteria. One-to-one in-depth interviews were conducted with sixteen (16) school teachers, using a preformed interview guide. Data analysis was performed using the thematic analysis method.

Results:

Data analysis yielded four overarching themes and twelve subthemes viz:- 1) Attitudes towards online sessions among teachers (2) factors affecting the physical and mental health of children (3) Effectiveness of online classes for individual lines of children’s mental development (4) External and internal factors impacting child development and pedagogy.

Conclusion:

The study result explicitly showed mental and physical health of children got considerably affected by online teaching during the Covid-19 pandemic. Online teaching especially to children is less yielding in terms of effective academic consequences. Nevertheless, blending online teaching with pedagogy can enhance certain multidimensional capabilities of the children.
A study of beliefs towards mental illness among teachers in Sikar city, Rajasthan
Authors: Kaur Navneet , Behere Nilam S. , Kulkarni Anjali S.
Published: April 2023

Background:

Understanding the significance of adolescents’ mental health, school-based mental health interventions are being implemented with the help of teachers globally.

Aim:

Owing to the dearth of literature concerning the beliefs, and stigma among the teachers, the present study was conducted with an aim to study the mental health beliefs among teachers.

Methods:

This is a cross-sectional study conducted among randomly selected teachers teaching in government and private schools of Sikar city of Rajasthan. A general sociodemographic questionnaire, Beliefs Towards Mental Illness Scale, and a questionnaire about prior exposure to mental health issues was administered. Stata 15.0 was used for statistical analysis, and independent t-test and one-way analysis of variance test were applied to find out associations.

Results:

Majority of the participants were in age group of 31-40 years, married, and postgraduate. The mean Beliefs Towards Mental Illness Scale score of 147 teachers was 49.95 ± 17.34 of 105. Only 2% of the study participants have ever received training related to mental health issues. Teachers who had prior exposure to mental health issues, residing in semi-urban and urban areas showed more positive beliefs.

Conclusion:

Study participants have displayed negative beliefs toward mental health. This brings to light the important interventions like creating knowledge and awareness among the study population by conducting trainings. More research is needed to explore the mental health beliefs among the teachers.
Family intervention for expressed emotion in schizophrenia: Indian context
Authors: Shetty Kannappa V. , Math Suresh B. , Marimuthu Palaniappan , Rawat Vikram S.
Published: April 2023

Background:

Expressed emotion (EE) being a part of the family environment could adversely affect the course and prognosis of schizophrenia.

Aim:

This study aimed to assess the effects of family intervention among the caregivers of persons with schizophrenia.

Methods and Materials:

The experimental research design was used for 80 caregivers of persons with schizophrenia. Sociodemographic interview schedule of caregivers, family emotional involvement and criticism scale, and mini international neuropsychiatric interview (MINI 6.0) were used for data collection. A standardized family intervention program involving 10 sessions was provided to caregivers. The intervention included six sessions of family psychoeducation, two sessions of communication training, one session of stress management, and one session on recap and referral services over a period of 2-3 months. The intervention used methods of social case and group work, social work principles, and therapeutic activities. The methodologies adopted a brainstorming technique, case vignettes, role plays, and video clippings concerning the topics of the day. Brief handout on intervention was given.

Results:

The RMANOVA score (F = 35.892; P =0.001) revealed that there was a significant reduction in EE of the caregivers of the intervention group who underwent the family intervention program in comparison with the control group.

Conclusion:

Family-based intervention was found to be effective for reducing EE in schizophrenia.
Comparison of Ultrasound Measured Gastric Volume in Term-Pregnant Patients Posted for Elective Cesarean Section with Nonpregnant Elective Surgery Patients---An Observational Study
Authors: Bellapukonda Snigdha , Podder Subrata , Kajal Kamal , Prasad G.R.V
Published: April 2023

Background:

The pregnant patients undergoing anesthesia are at increased risk of aspiration due to decreased lower esophageal sphincter tone and mass effect of gravid uterus on gastric antrum. Ultrasound used as a noninvasive bedside imaging tool to measure gastric volume in term pregnant patients immediately before elective caesarian section (CS) may help in reducing aspiration induced morbidity and mortality.

Methods:

This observational prospective case--control study was conducted in 33 nonlaboring term pregnant patients immediately before elective CS and 30 nonpregnant patients immediately before elective surgeries, enrolled according to inclusion and exclusion criteria. A 2-5 MHz curvilinear probe was used to scan the participants in supine and right lateral decubitus (RLD) position in pre-recovery room. Visibility, qualitative grading (0,1, 2), anteroposterior (AP), and craniocaudal (CC) diameter, and cross-sectional area (CSA) of gastric antrum was measured. Gastric volume was derived from CSA using equations formulated by previous investigators.

Results:

Gastric antrum was visible in 27 (82%) of pregnant and 30 (100%) of nonpregnant patients in supine position (P = 0.014). In RLD position, 25 (75.7%) pregnant and 29 (96.7%) nonpregnant patients had antrum visible (P = 0.018). The qualitative grading was comparable (P = 0.064) in both the groups. In supine position, (P = 0.615), CSA in cm2 was 3.37 ± 1.31 and 3.54 ± 1.33, while in RLD position (P = 0.012), CSA was 3.98 ± 1.13 and 5.09 ± 1.85, in pregnant and nonpregnant patients, respectively.

Conclusion:

Gravid uterus sometimes impedes visualization of antrum by ultrasound in term pregnant patients immediately before elective CS and shows clinically similar gastric CSA when compared to nonpregnant patients, though statistically different in RLD position.

Trial registration number- NCT03380637
Effect of Intra-Abdominal Pressure on Maximum Level of Intrathecal Sensory Block: A Preliminary Randomized Controlled Trial
Authors: Jakhar Jubin , Gulabani Michell , Tyagi Asha , Sethi Ashok K.
Published: April 2023

Objectives:

Increase in Intra-Abdominal Pressure (IAP) is commonly accepted as a cause for intrathecal dose sparing and consequently higher level of sensory block during pregnancy. There is however very little actual data evaluating the relationship. Thus, we aimed to evaluate association between IAP and maximum level of sensory block following intrathecal injection of hyperbaric bupivacaine as well as plain levobupivacaine for cesarean section.

Methods:

Preliminary randomized controlled blinded trial included females aged 18-40 years, scheduled for elective cesarean section under single-shot subarachnoid block. After randomization, they received either intrathecal hyperbaric bupivacaine (group H) or plain (isobaric) levobupivacaine (group P) in a dose of 12.5 mg (n = 40 each). IAP was measured before and after the spinal block, using the recommended intravesical technique. The maximum level of sensory block and the IAPs were measured in each patient.

Results:

There was no significant correlation of IAPprespinal with maximum level of sensory block for group H (P = 0.334; rs = -0.157) or group P (P = 0.637; rs = -0.078). Similarly, there was no significant correlation of the IAPpostspinal: group H (P = 0.370; rs = -0.145); and group P (P = 0.714; rs = -0.061). Both group H and group P had similar IAPprespinal (15.9 [14.3-18.2] and 15.3 [14.3-17.4] mmHg, respectively) (P = 0.474); as well as IAPpostspinal (15.2 [13.8-17.2] and 14.6 [13.4-16.0] mmH, g respectively) (P = 0.239). Among ancillary observations, duration of sensory block was significantly longer for group P versus group H (133.6 ± 24.2 and 103 ± 23.4 mins; P < 0.000). However, the maximum levels of sensory and motor block, respective times required to achieve them, as well as incidences of intraoperative hypotension and bradycardia were statistically similar between group H and group P (P > 0.05).

Conclusions:

The IAP was raised to the level of conventionally defined intra-abdominal hypertension (>12 mmHg) in patients scheduled for elective cesarean section. However, despite being increased, the IAPprespinal or IAPpostspinal did not show any significant association with the maximum level of sensory block (P > 0.05).
Ultrasound-guided Subarachnoid Block in Kyphoscoliotic Parturient Posted for Urgent Caesarean Section
Authors: Jain Richa , Bansal Kamya , Jain Kanupriya , Singh Mirley Rupinder , Grewal Anju
Published: April 2023

Parturient with kyphoscoliosis poses a major challenge in the administration of spinal anaesthesia owing to changes in the anatomy of the spine and physiological changes associated with pregnancy. Recently, ultrasound guidance has proved to be a boon for regional anaesthesia techniques. We report the successful anaesthetic management of a 43 year-old primigravida with kyphoscoliosis who was posted for emergency caesarean section using an ultrasound-guided subarachnoid block.
Allergic Rhinitis in Covid-19 Patients
Authors: Doblan A , Semih AK , Uzun T , Müderris T
Published: April 2023

ABSTRACT

Background:

Coronavirus disease-2019 (Covid-19) is transmitted by respiratory droplets and causes upper respiratory tract symptoms. These features of Covid-19 are essential regarding its potential association with allergic rhinitis (AR).

Aim:

This study aimed to investigate the relationship between Covid-19 and AR and the effects of Covid-19 in patients with AR.

Patients And Methods:

Between April 2020 and June 2020, in Sanliurfa Mehmet Akif Inan Training and Research Hospital, 322 patients who were diagnosed with Covid-19 with polymerase chain reaction (PCR) positive oropharyngeal and nasopharyngeal swab samples and with AR in their medical history were detected using the hospital’s automation system. Demographic data including age, gender, and additional data such as main complaints, physical examination findings, duration of inpatient floor, and intensive care unit (ICU) stay were recorded. The medical history of the patients was reviewed and patients with previously diagnosed AR were identified. These patients were called by phone and their AR diagnoses were confirmed by performing the Score for Allergic Rhinitis (SFAR) questionnaire.

Results:

The study population consisted of 322 patients aged between 18 and 85. Among these patients, 186 (57.8%) were male and 136 (42.2%) were female. Nineteen (5.9%) of these patients had a history of AR. There was no difference between the patients with and without a history of AR concerning age, gender distribution, type of presentation, ICU referral rate, duration of inpatient floor, and ICU stay (P > 0.05).

Conclusion:

We conclude that the prognosis of Covid-19 was similar between patients with and without AR. The incidence of AR was relatively lower among patients with Covid-19.
Dimensions of popcorn-like pyramid sets
Authors: Banaji Amlan , Chen Haipeng
Published: April 2023

This article concerns the dimension theory of the graphs of a family of functions which include the well-known ‘popcorn function’ and its pyramid-like higher-dimensional analogues. We calculate the box and Assouad dimensions of these graphs, as well as the intermediate dimensions, which are a family of dimensions interpolating between Hausdorff and box dimensions. As tools in the proofs, we use the Chung—Erdős inequality from probability theory, higher-dimensional Duffin—Schaeffer type estimates from Diophantine approximation, and a bound for Euler's totient function. As applications we obtain bounds on the box dimension of fractional Brownian images of the graphs, and on the Hölder distortion between different graphs.
CFD Modelling of a Two Stroke Engine to Predict and Reduce Short Circuit Losses
Authors: Garg Manish , Kumar Davinder , Syed Madani , Nageswara Siva
Published: April 2023

One of the major reason for lower efficiency and higher unburned hydrocarbon and carbon monoxide emission for two stroke engine is short circuit losses during the scavenging process. An attempt has been made in this study to understand and improve this phenomenon. A three dimensional transient CFD model is developed for a loop scavenged, Schnullar type, 70 cc two stroke engine. Three major processes, namely, blow down (expansion); scavenging and compression have been modelled. The model is validated with PIV measurement done in motoring mode. Model is also validated with experimental data for trapping efficiency with Watson method and for in-cylinder pressure during expansion, blow down and intake events. A good correlation is observed between experimental and simulation results. CFD model is used to quantify various parameters, such as, delivery ratio, trapping efficiency, scavenging efficiency, and amount of fresh mass short circuit at different load and speed points. Around 20 to 25% short circuit losses are observed at all the load cases analyzed. The mechanism for this short circuit loss is understood with the help of a passive scalars based visualization method. Two major root causes identified are, port design and exhaust pressure wave dynamics. Three different designs of ports are analyzed. With the best design, the short circuit loss is reduced by 12%. Same design has been tested on a chassis dynamo-meter, that resulted into a reduction of 10% in HC (hydro-carbon) emission in a mass emission test on a drive cycle and 10% to 25% improvement in WOT (wide open throttle) wheel force in mid and higher speed operating points.
Unique Needs of Motorcycle and Scooter Lubricants and Proposed Solutions for More Effective Performance Evaluation
Authors: Marcella Mike , Michlberger Alex
Published: April 2023

The operating conditions of a typical motorcycle are considerably different than those of a typical passenger car and thus require an oil capable of handling the unique demands. One primary difference, wet clutch lubrication, is already addressed by the current JASO four-stroke motorcycle engine oil specification (JASO T 903:2011). Another challenge for the oil is gear box lubrication, which may be addressed in part with the addition of a gear protection test in a future revision to the JASO specification. A third major difference between a motorcycle oil and passenger car oil is the more severe conditions an oil is subjected to within a motorcycle engine, due to higher temperatures, engine speeds and power densities.

Scooters, utilizing a transmission not lubricated by the crankcase oil, also place higher demands on an engine oil, once again due to higher temperatures, engine speeds and power densities. However, because scooter oils do not need to lubricate a wet clutch or protect gears, scooter oils can provide more fuel economy benefits than motorcycle oils, when properly formulated.

First, this study compares the piston deposit performance of motorcycle oils and passenger car oils in the API Sequence III Test and in a fired-engine motorcycle piston deposit evaluation. While the API Sequence III Test is certainly an effective tool for ensuring passenger car motor oil piston deposit performance, the results show that some oils formulated to meet the performance requirements of the Sequence III test do not match the performance of motorcycle-specific oils in a motorcycle piston deposit evaluation.

Second, this study compares the performance of different oils in the JASO clutch friction test (SAE#2) and in a fired-engine Scooter Fuel Economy Test. The results indicate that JASO MB performance, as determined by the SAE#2 clutch friction test, is not necessarily a predictor of real fuel economy benefit.
Experiments and Simulations of a Lean-Boost Spark Ignition Engine for Thermal Efficiency Improvement
Authors: Ratnak Sok , Kusaka Jin , Daisho Yasuhiro , Yoshimura Kei , Nakama Kenjiro
Published: April 2023

Primary work is to investigate premixed laminar flame propagation in a constant volume chamber of iso-octane/air combustion. Experimental and numerical results are investigated by comparing flame front displacements under lean to rich conditions. As the laminar flame depends on equivalence ratio, temperature, and pressure conditions, it is a main property for chemical reaction mechanism validation. Firstly, one-dimensional laminar flame burning velocities are predicted in order to validate a reduced chemical reaction mechanism. A set of laminar burning velocities with pressure, temperature, and mixture equivalence ratio dependences are combined into a 3D-CFD calculation to compare the predicted flame front displacements with that of experiments. It is found that the reaction mechanism is well validated under the coupled 1D-3D combustion calculations. Next, lean experiments are operated in a SI engine by boosting intake pressure to maintain high efficiency without output power penalty. The peak indicated thermal efficiency are finally achieved under λ=1.3 with intake manifold absolute pressure 150 kPa in experiment. Data of in-cylinder pressure and rate of heat release from the 3D-CFD simulations combined with the validated chemical reaction mechanism are reproduced. NOx emissions from experiment and simulation are also in good agreements under the lean-boost combustion. Further thermal efficiency improvements of the lean-boost SI engine are investigated numerically by using dilution rate, high induced in-cylinder flow, and high knock resistant fuel. The peak indicated thermal efficiency and load of the SI engine is achieved. In addition, methods to prevent knock for high efficiency spark ignition engine are also discussed.
Prediction of Fatigue Strength of Motorcycle Exhaust System Considering Vibrating and Thermal Stresses
Authors: Kuribara Hiroshi , Horikawa Hiroshi , Teraguchi Takashi , Nagata Takanori , Kitamura Daisuke
Published: April 2023

A method applicable in the design stage to predict fatigue strength of a motorcycle exhaust system was developed. In this prediction method, a vibrating stress, thermal stresses, stresses resulting from the assembling of the exhaust system components and a deterioration of fatigue strength of materials originated from high temperature were simultaneously taken into account. For the prediction of the vibrating stress, flexible multibody dynamics was applied to get modeling accuracy for vibration characteristics of the entire motorcycle and the exciting force delivered from engine vibrations. The thermal conduction analysis and the thermal deformation analysis based on finite element method (FEM) were applied for the prediction of thermal stresses in the exhaust system components. The temperature distribution on the surfaces of the exhaust system components is required for calculations of the thermal stresses. The heat transfer analysis, which was composed by combing a one-dimensional (1D) engine cycle simulation and an air flow simulation around the vehicle by 3D-CFD, was used for the estimation of temperature distributions. To validate the developed method, the correlations between the simulations and the actual measurements were analyzed for the vibrating stress, the temperature distribution, the thermal stresses and the fatigue safety factor. High correlations were yielded between them proving the validity of the new method.
High Performance Powder-Forged Connecting Rods for Direct Injection Turbocharged Engines
Authors: Ilia Edmond , Lanni Giorgio , Tutton Kevin , Sinclair Doug , Suemasu Michinari
Published: April 2023

The introduction of direct injection turbocharged engines has increased the need for higher performance connecting rods, able to withstand higher compressive loads in operation. In this respect, new materials with high compressive yield strength and fatigue performance for powder-forged connecting rods, such as HS150, HS160, and HS170M, were developed and successfully introduced in production. Among them, HS170M, currently used to manufacture connecting rods for several high performance engines, not only has exceptional strength, but less variation in mechanical properties as a function of its chemical composition variation within the specified limits compared to other powder-forged materials. Furthermore, recent strength tests conducted at engine operating temperatures on specimens machined from connecting rods have shown some very interesting results: despite the fact that the mechanical properties of most steels decrease at higher temperatures, the strength of Cu-rich HS materials increases due to second phase strengthening provided by nano size Cu precipitates. For this reason, powder-forged connecting rods manufactured with HS170M are stronger than their drop-forged counterparts manufactured with micro alloyed steels. Additionally, advancements in design and manufacturing, such as design optimization, post-delubrication shot peening, enhanced shot peening, etc., have resulted in higher performance powder-forged connecting rods and, as a result, in mass reductions, thus further contributing to fuel economy and reduced emissions.
Chemical Reaction Processes of Fuel Reformation by Diesel Engine Piston Compression of Rich Homogeneous Air-Fuel Mixture
Authors: Asai Go , Watanabe Yusuke , Ishiguro Shuntaro , Shibata Gen , Ogawa Hideyuki , Kobashi Yoshimitsu
Published: April 2023

To extend the operational range of premixed diesel combustion, fuel reformation by piston induced compression of rich homogeneous air-fuel mixtures was conducted in this study. Reformed gas compositions and chemical processes were first simulated with the chemistry dynamics simulation, CHEMKIN Pro, by changing the intake oxygen content, intake air temperature, and compression ratio. A single cylinder diesel engine was utilized to verify the simulation results. With the simulation and experiments, the characteristics of the reformed gas with respect to the reformer cylinder operating condition were obtained. Further, the thermal decomposition and partial oxidation reaction mechanisms of the fuel in extremely low oxygen concentrations were obtained with the characteristics of the gas production at the various reaction temperatures.

The main reformed products were hydrogen (H2), carbon monoxide (CO), carbon dioxide (CO2), methane (CH4), and ethylene (C2H4) and the results indicated that the reforming depends on the maximum temperature in the cylinder, however, the amount of reformed gas is lower than the values predicted by the CHEMKIN simulation.
Study on Influencing Factors of Hippocampal Injury in Closed Head Impact Experiments of Rats Using Orthogonal Experimental Design Method
Authors: Wang Peng , Song Xuewei , Zhu Xiyan , Qiu Jinlong , Yang Shuaijun , Zhao Hui
Published: April 2023

The hippocampus plays a crucial role in brain function and is one of the important areas of concern in closed head injury. Hippocampal injury is related to a variety of factors including the strength of mechanical load, animal age, and helmet material. To investigate the order of these factors on hippocampal injury, a three-factor, three-level experimental protocol was established using the L9(34) orthogonal table. A closed head injury experiment regarding impact strength (0.3MPa, 0.5MPa, 0.7MPa), rat age (eight- week-old, ten-week-old, twelve-week-old), and helmet material (steel, plastic, rubber) were achieved by striking the rat's head with a pneumatic-driven impactor. The number of hippocampal CA3 cells was used as an evaluation indicator. The contribution of factors to the indicators and the confidence level were obtained by analysis of variance. The results showed that impact strength was the main factor affecting hippocampal injury (contribution of 89.2%, confidence level 0.01), rat age was a secondary factor (contribution of 8.9%, confidence level 0.05), and helmet material had no significant effect on hippocampal injury (contribution less than 1.9%). This paper provides a method to distinguish factors affecting hippocampal injury.
Examination of Bendix® Data Recording (BDR) Records for Use in Crash Analysis
Authors: Cheek Timothy , Grimes Wesley , Plant David , Austin Timothy , Steiner John , Higgins Bradley , Lombardi Kristina , Getz Charles
Published: April 2023

Electronic control units of Bendix® ABS/ESC and Collision Mitigation Systems have the capability to record event data in the ABS/ESC control unit. Bendix refers to this event data recording functionality as the Bendix Data Recorder (BDR). This paper presents an overview of the BDR functionality and examines the range and resolution of data elements, the synchronicity or timing of the recorded data, and application of the data for use in analyzing crashes. Various tests were performed using trucks equipped with Bendix® Wingman® Fusion™ and were conducted in a manner to trigger BDR records. BDR data was compared to data collected from the J1939 CAN Bus and from Racelogic VBOX data loggers.
Road Snow Coverage Estimation Using Camera and Weather Infrastructure Sensor Inputs
Authors: Kadav Parth , Goberville Nicholas A , Prins Kyle , Siems-Anderson Amanda , Walker Curtis , Motallebiaraghi Farhang , Carow Kyle , Fanas Rojas Johan , Hong Guan Yue , Asher Zachary
Published: April 2023

Modern vehicles use automated driving assistance systems (ADAS) products to automate certain aspects of driving, which improves operational safety. In the U.S. in 2020, 38,824 fatalities occurred due to automotive accidents, and typically about 25% of these are associated with inclement weather. ADAS features have been shown to reduce potential collisions by up to 21%, thus reducing overall accidents. But ADAS typically utilize camera sensors that rely on lane visibility and the absence of obstructions in order to function, rendering them ineffective in inclement weather. To address this research gap, we propose a new technique to estimate snow coverage so that existing and new ADAS features can be used during inclement weather. In this study, we use a single camera sensor and historical weather data to estimate snow coverage on the road. Camera data was collected over 6 miles of arterial roadways in Kalamazoo, MI. Additionally, infrastructure-based weather sensor visibility data from an Automated Surface Observing System (ASOS) station was collected. Supervised Machine Learning (ML) models were developed to determine the categories of snow coverage using different features from the images and ASOS data. The output from the best-performing model resulted in an accuracy of 98.8% for categorizing the instances as either none, standard, or heavy snow coverage. These categories are essential for the future development of ADAS products designed to detect drivable regions in varying degrees of snow coverage such as clear weather (the none condition) and our ongoing work in tire track detection (the standard category). Overall this research demonstrates that purpose-built computer vision algorithms are capable of enabling ADAS to function in inclement weather, widening their operational design domain (ODD) and thus lowering the annual weather-related fatalities.