bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Adjustable Intraocular Lens After Cataract Surgery in a Patient With Post-LASIK Ectasia Stabilized With CXL
Authors: Hura Arjan S. , Jee Kathleen J. , Wiley William F.
Published: June 2021

PURPOSE:

To describe a case of a patient who developed corneal ectasia after laser in situ keratomileusis and first underwent corneal cross-linking, followed by sequential cataract surgery with implantation of the Light Adjustable Lens (RxSight).

METHODS:

Case report.

RESULTS:

The patient had a good postoperative outcome with an uncorrected visual acuity of 20/20 at distance and 20/30 at near. The patient reported overall satisfaction with the outcome.

CONCLUSIONS:

Despite careful planning and proper lens selection, refractive surprises are not uncommon when performing cataract surgery in eyes that have had refractive surgery or eyes with corneal ectasia after refractive surgery. In these cases, the Light Adjustable Lens may be a good option to achieve the desired postoperative refractive outcome.

[
Journal of Refractive Surgery Case Reports.
2021;1(1):e2–e5.]
Corneal Cross-linking for Keratoglobus Using Individualized Fluence
Authors: Hafezi Farhad , Torres-Netto Emilio A. , Randleman J. Bradley , Hafezi Nikki L. , Mazzotta Cosimo , Ambrósio Renato , Kollros Léonard
Published: June 2021

PURPOSE:

To present a case of bilateral progressive keratoglobus that was successfully arrested with corneal cross-linking (CXL) applying the sub400 individualized fluence protocol.

METHODS:

Case report.

RESULTS:

A 36-year-old man with bilateral progressive keratoglobus and no history of eye rubbing presented with a corrected distance visual acuity (CDVA) of 20/200 in the left eye. Progression in the left eye was confirmed using previously taken corneal topographies and comparing them to high-resolution Scheimpflug imaging, high-speed dynamic Scheimpflug imaging, and anterior segment optical coherence tomography. Epithelium-off CXL was performed in the left eye using individualized fluence that was adapted to the thickness of the corneal stroma immediately prior to irradiation (sub400 protocol). Postoperative follow-up of 32 months showed stabilization of keratometric values and no endothelial cell loss.

CONCLUSIONS:

The sub400 epithelium-off CXL protocol using individualized fluence may arrest progressive keratoglobus and might represent a novel therapeutic approach for the management of keratoglobus.

[
Journal of Refractive Surgery Case Reports.
2021;1(1):e10–e14.]
$ W^{1,p} $ estimates for elliptic systems on composite material with almost partially BMO coefficients
Authors: Li Caiyan , Li Dongsheng
Published: June 2021

In this paper, we establish uniform \begin{document}$ W^{1,p} $\end{document} estimates for composite material problems which can be described by a divergence form elliptic system on a nonsmooth domain composed of a finite number of subdomains. We want to derive global \begin{document}$ W^{1,p} $\end{document} regularity under the assumption that the coefficients are almost \begin{document}$ (\delta,R) $\end{document}-vanishing of codimension 1 (see Definition 1.2) in each of multiple subdomains and the boundaries of subdomains are Reifenberg flat, moreover the estimates do not depend on the distance between these subdomains.
Orbitally symmetric systems with applications to planar centers
Authors: Bastos Jefferson L. R. , Buzzi Claudio A. , Torregrosa Joan
Published: June 2021

We present a generalization of the most usual symmetries in differential equations known as the time-reversibility and the equivariance ones. We check that the typical properties are also valid for the new definition that unifies both. With it, we are able to present new families of planar polynomial vector fields having equilibrium points of center type. Moreover, we provide the highest lower bound for the local cyclicity of an equilibrium point of polynomial vector fields of degree 6, \begin{document}$ M(6)\ge 48. $\end{document}
On a free boundary model for three-dimensional MEMS with a hinged top plate II: Parabolic case
Authors: Nik Katerina
Published: June 2021

A parabolic free boundary problem modeling a three-dimensional electrostatic MEMS device is investigated. The device is made of a rigid ground plate and an elastic top plate which is hinged at its boundary, the plates being held at different voltages. The model couples a fourth-order semilinear parabolic equation for the deformation of the top plate to a Laplace equation for the electrostatic potential in the device. The strength of the coupling is tuned by a parameter \begin{document}$ \lambda $\end{document} which is proportional to the square of the applied voltage difference. It is proven that the model is locally well-posed in time and that, for \begin{document}$ \lambda $\end{document} sufficiently small, solutions exist globally in time. In addition, touchdown of the top plate on the ground plate is shown to be the only possible finite time singularity.
Les représentations en psychologie du travail, de la formation, et en didactique des disciplines scientifiques
Authors: Rogalski Janine
Published: June 2021

Cet article propose un tour d’horizon du terme et de la notion de « représentation » dans le cadre de la psychologie cognitive ; on en rappelle la polysémie et le caractère multidimensionnel. Ce cadre posé, on aborde deux problématiques actives en psychologie ergonomique et didactique professionnelle, et en didactique des disciplines scientifiques. On discute d’abord des relations entre représentations « internes », « états mentaux » d’un sujet, et représentations « externes », exprimées dans une diversité possible de registres sémiotiques. Les représentations internes sont des « constructs » inférés par l’analyste à partir des conduites du sujet (incluant les représentations externes qu’il produit, dont les verbalisations). Les représentations externes sont une forme de réalisation (donc matérialisée) de ce qui est représenté, manipulable dans le(s) registre (s) utilisé(s) : elles ont de ce fait des caractères producteurs mais aussi des caractères réducteurs, dont on discutera des effets didactiques. On présente ensuite une organisation de systèmes de représentations mettant en relation des représentations, épistémiques ou pragmatiques, socio-historiquement produites par des communautés de référence (de pratiques professionnelles ou d’enseignement) et les représentations du sujet, opérateur ou élève, et les représentations du point de vue de l’analyste. On conclut par deux questions vives : l’utilisation des représentations externes comme outils pour la formation, et le statut des représentations dans les activités collectives.
Caractérisation pragmatique des phases et déterminants de l’enrôlement des élèves en difficulté par des professeurs des écoles
Authors: Saillot Éric
Published: June 2021

Cet article présente la caractérisation pragmatique de l’enrôlement des élèves en difficulté qui est issue d’une recherche descriptive et compréhensive de l’activité d’enseignement de cinq professeurs des écoles en situation d’aide personnalisée (Saillot, 2011), dispositif de soutien pédagogique institutionnalisé en France de 2008 à 2013. Menée dans la perspective de la didactique professionnelle (Pastré, Mayen, Vergnaud, 2006 ; Vinatier, 2009) de l’analyse de l’activité d’enseignement basée sur l’analyse pragmatique des discours-en-interaction (Kerbrat-Orecchioni, 2005), et spécifiquement sur le traitement des actes de langage (Austin, 1970 ; Kerbrat-Orecchioni, 2008) des professeurs des écoles lorsqu’ils communiquent à l’oral avec leurs élèves au cours des séances d’aide personnalisée, cette étude nous a permis de décrire du point de vue langagier les trois principales phases ainsi que les cinq principaux déterminants de l’enrôlement des élèves en difficulté.
Thermal Tactile Perception
Authors: Bai Junjie , Peng Jun , Tang Dedong , Li Zuojin , Luo Kan , Li Jianxin , Zhang Xue
Published: June 2021

Using thermal tactile sensing mechanism based on semi-infinite body model, and combining with the advantages of maximum proportional controller, fuzzy and PID controller, a thermal tactile perception and reproduction experiment device (TTPRED) was designed based on the composite control strategy of threshold switching. The finger difference threshold measurement experiment of thermal tactile was carried out and the finger thermal tactile difference threshold was measured. The relationship between thermal tactile sensation and emotion based on temperature cues has been explored. The experiment results show that, the temperature control range of TTPRED is from -10℃ to 130℃, the temperature resolution and precision are 0.01℃ and ±0.1℃ respectively, the maximum heating or cooling rate is greater than 12℃, and the TTPRED can realize the temperature output of the specific waveform quickly and accurately. The experiment results of psychophysical experiment will provide the experimental foundations and technical support for the further study of thermal tactile perception and reproduction.
ICT Use and Its Influence in Family Functioning With Reference to Process and Structure of Families
Authors: Dinesh Kumar J.  , Sriram Arulchelvan
Published: June 2021

ICT use in family functioning is an important area to study as the impact changes when technology grows over years. This research analyzed the role of ICT use in process & structure of families using the factors present in Hertlein multitheoretical model. The additional factor ‘family communication pattern’ was introduced and tested along with the process factor to know its importance. The study has taken 756 samples (both parents & children) in Chennai and tested two hypothesis. Structural Equation Model (SEM) was used to analyze the data. The result shows that ICT has influenced the process changes of the families. The structural changes in families are slowly started occurring and that is not as significant as process changes. The added new factor has loaded positively with existing factors shows that family communication is important for family process and thus contributed for theoretical development.
Determinants of Web Search Effectiveness From the Perspective of Library and Information Science Students
Authors: Tella Adeyinka , Oyeniran Saheed , Ibironke Ebenezer Sanya
Published: June 2021

This study examined an empirical analysis of the determinants of library and information science students’ web search effectiveness at the University of Ilorin, Nigeria. A total enumerative method was used where the entire 146 year three and four undergraduate students of the Department of Library and Information Science represent the sample. Through a survey approach, a questionnaire was developed and used for the collection of data. Three research questions were developed to guide the study. The results demonstrate that determinants such as internet and computer self-efficacy, information literacy skills, use of Boolean operators and use of appropriate search terms significantly correlate with and determine web search effectiveness.
Using Customer Review Systems to Support Purchase Decisions
Authors: Changchit Chuleeporn , Klaus Timothy , Treerotchananon Alicha
Published: June 2021

Online reviews have emerged as influential sources of information which greatly affect customers’ pre-purchase decision. Some studies have found that culture impacts online reviews, but many aspects of online review usage are still not well-understood. This study seeks to understand: What factors influence the usage of online reviews and consumers’ intention to use online reviews influenced by culture? This study collects data from U.S. and Thai consumers to examine what factors affect user attitudes and intentions. Structural Equation Modeling is used to analyze the data and the findings reveal that most of the proposed factors influence online review adoption for these two nationalities. One significant difference was found between the respondents of the two countries. The results should help online businesses gain a better understanding of these factors, and thus direct their efforts to develop features which positively influence online review usage.
Expert consensus on prevention and cardiopulmonary resuscitation for cardiac arrest in COVID-19
Authors: Song Wei , Wei Jie , Jian Xiangdong , Wang Deren , Ouyang Yanhong , Liu Yuanshui , Du Xianjin , Chen Ying , Zhang Yingqi , Xu Heping , Xianyu Shuming , Ning Qiong , Li Xiang , Han Xiaotong , Zhan Feng , Yu Tao , Chen Wenteng , Zhang Jun , Cai Wenwei , Zhou Sheng’ang , Yi Shengyang , Cao Yu , Chen Xiaobei , Xu Shunjiang , Liang Zong’an , Wu Duohu , Ai Fen , Wang Zhong , Meng Qingyi , Mi Yuhong , Zhang Sisen , Yang Rongjia , Yan Shouchun , Han Wenbin , Lin Yong , Qian Chuanyun , Zhang Wenwu , Xiong Yan , Lv Jun , Liu Baochi , Cao Yan , He Xiaojun , Sun Xuelian , Cao Yufang , Zhou Tian’en
Published: June 2021

Background:

Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients.

Main recommendations:

1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control.

Changes in management:

The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.
Crimean-Congo hemorrhagic fever from the immunopathogenesis, clinical, diagnostic, and therapeutic perspective
Authors: Hamidinejad Mohammad Ali , Ghaleh Hadi Esmaeili Gouvarchin , Farzanehpour Mahdieh , Bolandian Masoumeh , Dorostkar Ruhollah
Published: June 2021

Crimean-Congo hemorrhagic fever virus (CCHFV) is responsible for widespread tick-borne zoonotic viral disease CCHF in African, Middle Eastern, Asian, and European countries. CCHFV can be spread to humans through tick bites or contact with infected animals or humans, and it often progresses from asymptomatic to severe/lethal illness, with fatality rates ranging from 10% to 40% in humans. Today, CCHF is growing into a significant public health concern due to its very high prevalence, severity of the condition, and lack of available vaccines and specific treatments. Recent research has been drawn towards a more accurate study of CCHFV characteristics, including the structure, genetic diversity, mechanisms involved in pathogenesis and immunopathogenesis, and clinical features. In addition, the use of animal models (mouse and non-human primates) and advanced diagnostic tools in recent years has resulted in a significant advance in CCHF related studies. In this context, we summarized the latest findings about CCHF research, its health complications, animal models, current diagnosis, vaccination, and CCHF treatments, and therapeutic strategies. Furthermore, we discussed existing deficiencies and problems in CCHFV analysis, as well as areas that still need to yield conclusive answers.
A nomogram for predicting acute respiratory distress syndrome in COVID-19 patients
Authors: Ding Ning , Zhou Yang , Yang Guifang , Chai Xiangping
Published: June 2021

Objective:

To predict the in-hospital incidence of acute respiratory distress syndrome (ARDS) in COVID-19 patients by developing a predictive nomogram.

Methods:

Patients with COVID-19 admitted to Changsha Public Health Centre between 30 January 2020, and 22 February 2020 were enrolled in this study. Clinical characteristics and laboratory variables were analyzed and compared between patients with or without ARDS. Clinical characteristics and laboratory variables that were risk factors of ARDS were screened by the least absolute shrinkage and selection operator binary logistic regression. Based on risk factors, a prediction model was established by logistic regression and the final nomogram prognostic model was performed. The calibration curve was applied to evaluate the consistency between the nomogram and the ideal observation.

Results:

A total of 113 patients, including 99 non-ARDS patients and 14 ARDS patients were included in this study. Eight variables including hypertension, chronic obstructive pulmonary disease, cough, lactate dehydrogenase, creatine kinase, white blood count, body temperature, and heart rate were included in the model. The area under receiver operating characteristic curve, specificity, sensitivity, and accuracy of the full model were 0.969, 1.000, 0.857, and 0.875, respectively. The calibration curve also showed good agreement between the predicted and observed values in the model.

Conclusions:

The nomogram can be used to predict the in-hospital incidence of ARDS in COVID-19 patients.
“Deck Chair Sign” Presenting in Type 1 Lepra Reaction
Authors: Asfiya Amina , Shenoy Manjunath Mata , Amin Vishal B. , Pinto Malcolm , Hegde Spandana Prakash , Razak Ashmiya Abdul
Published: June 2021

Deck chair sign (DCS) was first described in papuloerythroderma of Ofuji as the characteristic pattern of sparing of the skin folds which resembles the narrow strips of a deck chair. The sparing of skin folds includes areas such as the inguinal, axillary, sub-mammary, and flexural regions. Although first described in papuloerythroderma of Ofuji, it is also seen in other inflammatory dermatoses. We report a case of borderline leprosy in type 1 reaction who presented with the DCS involving the abdominal folds which to the best of our knowledge is the first of its kind.
Defining Medical Education Scholarship
Authors: Wooster Elizabeth M. , Wooster Douglas L. , Maniate Jerry M
Published: June 2021

Understanding the definition of medical education scholarship and its underlying theoretical constructs is essential to constructing medical education and supporting learning across the continuum. There continues to exist uncertainty surrounding defining and enacting medical education scholarship. This uncertainty results in an inability for educators to conduct medical education and scholarship and may result in missed opportunities for educators and learners across the continuum. For this paper, the authors define medical education scholarship as endeavours that are purposefully undertaken and may surpass the borders of those traditionally defined as research or innovation. Medical education may take place in areas of discovery, integration, application, teaching, and engagement. This definition is based on works by Boyer, Glassick and Shulman. This paper describes the contribution that each of these seminal works has made to advance the definition of medical education scholarship. The differences between medical education scholarship and creative professional activities as well as daily work are explored throughout the paper. The paper concludes with a call to develop, demonstrate, promote and support medical education scholarship and the faculty who are focused on undertaking related activities.
Rhino-Orbito-Cerebral Mucormycosis in COVID-19
Authors: Suri Harsh , Rajmohan Deekshith , Subramaniam Vijayalakshmi
Published: June 2021

COVID-19 is associated with a wide range of opportunistic bacterial and fungal infections Mucormycosis is a fatal fungal infection mainly involving the nose, paranasal sinuses, orbit and brain with a high mortality rate.
History of Brain Tumor Surgery – A Global and Indian Perspective
Authors: Shah Shreykumar P. , Biren K. P. Patel , Darshan R. Hirisave , George C. Vilanilam , Easwer V Harihara
Published: June 2021

Brain tumor surgery has grown exponentially in the last century, aided by sophistication, globalization, and training initiatives. With progress in cerebral localization, antisepsis, anesthesia, and hemostasis, brain surgery took off in a cautious manner and soon gained momentum. The earliest brain tumor surgery based on cerebral localization dates back to the 19th century and is older than imaging techniques such as X-rays, computed tomography, or magnetic resonance imaging scans. In India, formal neurosurgery started in the post independence era in 1949 at CMC, Vellore and Chennai. With over 2000 practicing neurosurgeons today, India has contributed immensely to global advancements in brain tumor care. The advent of microneurosurgery in the late 60s has been a landmark in the history of brain tumor surgery, advancing safety profiles and elevating outcomes. Further on, advances in brain tumor imaging, surgical gadgetry (neuronavigation and intraoperative imaging), adjuvant therapy, and molecular tumor profiling have improved prognosis and survival. We examine the rich legacy of brain tumor surgery from a global and Indian perspective with five epochs of historical development – premodern (before 1879), incubational (1879–1919), modern (1919–1967), microsurgical (1967–1999), and new millennial (2000 onward). Several path-breaking advancements and an exciting future await brain tumor surgery, translating into superior surgical outcomes and quality of life.
Odontogenic Keratocyst with Horizontal Impaction of Third Molar
Authors: Maryam Hannah , Ratnakar Harshita Bejai , Rithul P. , Majumder Bhargabi Paul , Varghese Anita M , Poonja Preethi A. , Rao Prasanna Kumar , Kini Raghavendra , Gonsalves Nithin
Published: June 2021

Odontogenic keratocyst (OKC), previously known as keratocystic odontogenic tumor, are benign cystic lesions involving the mandible or maxilla and are believed to arise from dental lamina. What makes this cyst special is its aggressive behavior and high recurrence rate. This cyst is predominantly seen in younger patients (2nd–3rd decade) and may be seen in either the body or ramus of the mandible or maxilla. The distribution between sexes varies from equality to a male-to-female ratio of 1.6:1, except in children. There may be male predilection. Radiographically, it appears as unilocular or multilocular lesions with scalloped contour. This cyst is commonly detected incidentally. When symptomatic, jaw swelling and pain are common symptoms associated with this tumor. Less commonly, trismus and paresthesia may occur. Here, we present a case of OKC in a young male patient associated with an impacted right mandibular third molar.
Dental Students' Perception Towards Feedback during Clinical Training
Authors: Nerali Jayashri Tamanna , Chakravarthy Pishipati Vinayak Kalyan , Telang Lahari Ajay , Telang Ajay
Published: June 2021

Background and Aim:

Feedback is an essential element in the clinical training of dental students which paves way for the achievement of learning outcomes and also to improve their future performance. The aim of this study was to analyze dental students' perceptions of importance, process, and content of feedback received during their clinical training.

Materials and Methods:

A cross-sectional, questionnaire was developed and validated and distributed to dental students (n = 178) of years 3, 4, and 5. Descriptive analysis and one-way ANOVA were used to compare the mean scores between the three groups. Open-ended responses were analyzed qualitatively.

Results:

The majority of students agreed that feedback on clinical performance is needed to improve learning and identify areas for improvements. Most of the students prefer one-to-one feedback, in a timely and regular manner and immediately after the clinical session. Eighty-six percent believed that feedback should be given with mutual respect. Most of the students disagree (80%) that marks/grades are an important part of the feedback. Students preferred feedback with positive and negative comments about their clinical work (93%), which would help them to engage in the process of learning and to make an action plan for future learning process.

Conclusions:

Students are aware of the purpose and importance of feedback and preferred timely, structured, and constructive feedback on their clinical performance. The dental clinical environment is stimulating and dynamic and the role of faculty feedback is crucial for students to reflect on their learning and improve future performance.
Can Hospital Doctors Provide Quality Palliative Care Informed by End-of-Life Care Legislation
Authors: Wong Aaron K. , Carey Susan E. , Kenner David J.
Published: June 2021

Background and Aim:

Approximately 50% of deaths in Australia occur in hospitals, and this number is growing. Studies consistently show that doctors have poor knowledge of end-of-life decision making; however, this has not been examined in specific groups of hospital doctors. We examined hospital doctors' knowledge of key elements of end-of-life care legislation.

Materials and Methods:

We conducted a prospective, observational, cross-sectional study of doctors from a large Australian public tertiary health network using six questions formulated on basic key elements of the legislation. Demographic data collected included years of work experience, clinical unit, and proportion of work hours spent with dying patients.

Results:

Of the 201 doctors censored, senior doctors (>10 years' experience) were the least knowledgeable group. Only approximately 20% of doctors correctly answered all questions. Thirty-two percent would potentially provide futile treatment if demanded by a competent patient. Fifty percent did not know how to locate an advance directive in the hospital record. There was confusion regarding the role of the substitute decision-maker.

Conclusions:

Approximately a quarter of hospital doctors practise with a poor understanding of the law over the various domains. The urgent call for education is further highlighted not only for students and junior doctors but also for senior doctors who scored poorly. Educational efforts could begin from addressing the simple key areas of legislation covered in the survey.
Multisystem Inflammatory Syndrome in Children Associated with Coronavirus Disease-2019
Authors: Kar Subhranshu Sekhar , Dube Rajani
Published: June 2021

Coronavirus disease-2019 has been ravaging the world since the past several months with devastating consequences. Although it is seen that specific categories of patients with comorbidities are especially vulnerable, the risks from the acute disease in pediatric population have been consistently lower. However, the alarming rise in pediatric admissions in intensive care units with varied clinical presentation during this pandemic gave an insight to a new hyperinflammatory response called as multisystem inflammatory syndrome in children. Although overlapping symptoms may mimic toxic shock syndrome, macrophage activation syndrome, secondary hemophagocytic lymphohistiocytosis, myocarditis, or Kawasaki-like illness, clinical findings are relatively consistent across geographically distinct regions. Diagnosis is essentially clinical, and laboratory investigations are suggestive of increased inflammatory markers. Early recognition and appropriate institution of inotropes, intravenous immunoglobulins, corticosteroids, and antibiotics apart from general supportive treatment are required for a favorable outcome.
Role of Biofilms in Otorhinolaryngological Diseases
Authors: Suri Harsh , Haswani Neha Vijay , Somayaji Gangadhara
Published: June 2021

Biofilms over the years have been implicated to play a major role in the development of various diseases particularly Otorhinolaryngology. It is one of the topics with great interest within the field of medicine. A thorough review of the literature reveals the association of various infectious conditions of ENT practice is associated with biofilm-producing bacteria. Infections associated with biofilms are usually chronic due to the resilience of bacteria, to the innate and acquired immune system of the host and antibiotic therapy. This review article is written to evaluate and understand various aspects of biofilm-related infections in ENT.
Prevalence of Psychological Morbidities and their Influential Variables among Nurses in a Designated COVID-19 Tertiary Care Hospital in India
Authors: Garg Sunny , Yadav Megha , Chauhan Alka , Verma Dinesh , Bansal Kirti
Published: June 2021

Background and Aim:

Nurses are the main part of the health work force, performing their duties as frontline warriors against the novel coronavirus pandemic. Nurses involved in the care of infected (COVID-19) patients, may feel more discomfort physically, and experience greater psychological morbidities. The main aim of the study is to evaluate the prevalence of anxiety and stress among nurses in a designated COVID-19 hospital and variables that influence these psychological problems.

Materials and Methods:

Nurses working in the designated tertiary care hospital were invited to participate in an online cross-sectional survey (dated, 5–15 September 2020). A total sample size of 236 was calculated. A self-administered questionnaire regarding sociodemographic characteristics, COVID-19-related experiences, perceived threat regarding COVID-19 and two scales (Generalised Anxiety Disorder-7 and Perceived Stress Scale-10) for assessment of anxiety, and stress was applied to nurses. Chi-square test and multiple regression analysis were used to investigate the predictors (risk and protective) of psychological morbidities in nurses.

Results:

On analysis of 209 participants, it was revealed that 65 (31.1%) participants have anxiety symptoms and 35.40% have moderate-to-high level of stress. Being proud of working in this profession was the only protective factor from such psychological morbidities. The identified risk factors for greater anxiety symptoms and moderate-to-high level stress were working experience of more than 10 years (odds ratio [OR] = 3.36), direct involvement in care of suspected/diagnosed patients (OR = 3.4), feeling worried about being quarantined/isolated (OR = 1.69), and high risk of being infected at job (OR = 2.3 for anxiety and OR = 2.1 for moderate-to-high stress).

Conclusions:

Deteriorating psychic health of nurses is one of the major outcomes during COVID-19 pandemic in India which warrants the necessity of providing psychological support to all the nurses particularly those who are frontline workers and have working experience of more than 10 years and controlling the risk factors related to these problems.
Artificial Intelligence in Medicine and Health Sciences
Authors: Hegde Parameshwar R. , Shenoy Manjunath Mala
Published: June 2021

Artificial intelligence (AI) is being used in almost all aspects of life. The AI can assist medical consultants, primary health workers, and hospital administrators to understand analyze and interpret the medical data. The concepts such as data mining, image and signal processing, computer graphics, and machine learning are being utilized or being tried to implement in different health science areas such as dermatology, radiology, anesthesiology, psychiatry, surgery, and medical records. This article throws lights on some of the AI-related works that were carried out, especially in dermatology and radiology. This review has discussed its utility in other fields and the advantages such as faster execution, reliable results, and advantage over the manual process in certain aspects of healthcare. There are challenges, but further research and advances in technology in AI are likely to enormously benefit mankind.
A Study on Depression, Anxiety, Stress, and Life Quality among Medical Aspirants and Medical Students of Aligarh City in North India
Authors: Khursheed Manal , Naseem Sufia
Published: June 2021

Background and Aim:

Rapid intellectual and psychosocial development occurs mainly during young adulthood. Coincidently, decisions regarding collegiate and professions are taken during this period. Thus, adulthood is vulnerable to psychological disorders. Contrary to most other professions, medical education is more likely to affect mental health. The present explicates the prevalence of depression, anxiety, and stress among premedical and medical students of Aligarh city, and various coping mechanisms they adopt to mitigate above symptoms. Assessment on students' quality of life (QOL) has also been made.

Materials and Methods:

The study sample (220) consisted of 11th and 12th pursuing and 12th passed students preparing for medical entrance examinations and those pursuing the medical course. The study protocol was approved by the Institutional Ethics Committee. The method of online survey was questionnaire through Google forms. Study lasted for 3 months. We used Depression Anxiety Stress Scale and World Health Organization QOL (WHOQOL)-BREF (QOL assessment scale developed by WHO) questionnaires.

Results:

Our study suggests that levels of extremely severe anxiety (37.7%) and depression (20%) were relatively higher than stress (10.9%) in the respondents. The Pearson's Chi-square alpha and the P value indicated that depression, stress and anxiety were quite gender centric. We also found significantly higher levels of depression, stress, and anxiety in 11th, 12th pursuing, 12th passed students preparing for medical entrance, final professional (Part 2) students, and interns. Furthermore, physical domain of QOL score showed strong negative correlation with depression, stress, and anxiety.

Conclusion:

The present study found that depression, stress, and anxiety are present among medical as well as premedical students. It is a matter of concern, as the conditions may severely affect the health as well as the performance of students.
Topical 0.1% Adapalene Gel Versus 0.1% Adapalene and 2.5% Benzoyl Peroxide Combination Gel in the Treatment of Mild-to-Moderate Acne Vulgaris
Authors: Amrutha Madai Puthiyaveedu , Bifi Joy , Anoop Thyvalappil , Ajayakumar Sreenivasan , Radhakrishnan K. , Rajiv Sridharan
Published: June 2021

Introduction:

The combination of adapalene (ADA) benzoyl peroxide (BPO) offers a safe and effective alternative avoiding long-term antibiotic use in the management of acne vulgaris.

Aims:

The aim of this study was is to compare the clinical efficacy and tolerability of 0.1% ADA with combination of 0.1% ADA and 2.5% BPO in the treatment of mild-to-moderate acne vulgaris.

Methods:

All patients were instructed to apply the given topical medications to whole face, excluding lips and eyelids, once a day at night after washing and moistening the facial skin. Follow-up was done once every 4 weeks up to 12 weeks from the start of treatment. Efficacy of treatment arms was assessed by 4 parameters, namely percentage change of total lesion counts (TLCs), Acne severity index, success rate, and response rate. Statistical analysis was performed using the SPSS software version 16.0. Data were analyzed using the Chi-square test, Fisher's exact test, and Mann–Whitney U test. P < 0.05 was considered to indicate statistical significance.

Results:

Thirty-eight patients were in Group A (ADA-BPO) and 38 patients in Group B (ADA alone). At the end of 12 weeks, Group A had significantly less TLC as well as significant percentage change in total lesions than Group B. Group A was significantly better than Group B in TLC response rate also.

Conclusions:

The combination gel of 0.1% ADA and 2.5% BPO was superior to 0.1% ADA gel in terms of efficacy. Tolerability was comparable for both the drugs.
Role of Physiotherapy in Management of Orofacial Diseases
Authors: Ostwal Priyanka P. , Johar Anisha Kaur , Gupta Shubham , Patangankar Swagata A. , Surana Pratik , Gopal Ruchi
Published: June 2021

Physical therapy (PT) also known as physiotherapy is concerned with the evaluation, diagnosis, management of disease, and disability through physical means. Physiotherapy can be used for management of various orofacial diseases such as temporomandibular joint disorder, facial paralysis, myofacial pain dysfunction, oral submucous fibrosis, and trismus. It is a noninvasive, safe, convenient, and cost-effective treatment option that can be used as simultaneously with other treatment procedures. The present article provides insight of physiotherapy as an adjunct therapy in the treatment of oral-facial diseases.
Recent Advances in Pulpotomy Medicament
Authors: Surana Pratik , Khandelwal Ankita , Gopal Ruchi , Koppalkar Rohit R. , Aafreen Sadia , Gupta Shubham
Published: June 2021

Pulpotomy is the most commonly used treatment modality used in cariously involved primary vital primary teeth. Formocresol shows a good clinical success rate over the period of years but concerns raised due to its toxicity, mutagenicity, and carcinogenicity. The current review of literature provides an overview of recent advances in pulpotomy medicament that can be used as an alternative to formocresol.
A Comprehensive Review on Vitiligo and Its Pharmacotherapy
Authors: Moafa Asmaa , Khalawi Fahad , Sreeharsha Nagaraja
Published: June 2021

Approximately 1% of population in the world is affected by an intriguing skin depigmentation disorder, vitiligo. Typically, a vitiligo lesions are seen as white milky, nonscaly patches with separate edges. Vitiligo is caused by a selective loss of epidermal melanocytes. In vitiligo, there is impaired melanocyte regeneration and/or multiplication. Although the proportion of the population affected by this disease is very low, the disease is associated with a lot of social stigmas. This defect has an important effect on the life of the patient and still a persistent load.
Endophthalmitis management study. Report #1. Protocol
Authors: Das Taraprasad , Dave Vivek P , Dogra Avantika , Joseph Joveeta , Sharma Savitri ,   on behalf of the EMS working group
Published: June 2021

To date, the Endophthalmitis Vitrectomy Study (EVS) has remained the hallmark of evidence-based management of acute bacterial endophthalmitis after cataract surgery with an intraocular lens. In the last quarter-century since its publication, several studies have reported that the microbiological spectrum of endophthalmitis is not the same across the world; there is emerging antibiotic resistance of gram-negative microorganisms to the EVS recommended antibiotics; there are newer molecules that could cross the blood-retinal barrier; the advances in vitreous surgery have become safer than before, and there are newer methods of microbiological evaluation. One of the often-mentioned drawbacks of the EVS was not recruiting grossly infected eyes with poor visibility of the iris and vitreous. Keeping these factors in mind, a new prospective multi-centered randomized study, the Endophthalmitis Management Study (EMS), is designed. The EMS will recruit all post-cataract surgery endophthalmitis patients irrespective of severity (including suspected fungal infection); the EMS will use quantifiable inflammatory score instead of the presenting vision to allocate for surgery, randomize the eyes to two different combinations of intravitreal antibiotics and use the newer microbiological diagnostic techniques. We believe the EMS findings will complement the EVS recommendations.
Optic disc morphology in primary open-angle glaucoma versus primary angle-closure glaucoma in South India
Authors: Parikh Rajul , Kitnarong Naris , Jonas Jost B , Parikh Shefali R , Thomas Ravi
Published: June 2021

Purpose:

The aim of this study was to investigate the optic disc morphology in primary angle-closure glaucoma (PACG) versus primary open-angle glaucoma (POAG) in South Indians.

Methods:

A total of 60 patients (60 eyes) with PACG and 52 patients (52 eyes) with POAG were included in a cross-sectional observational study. The glaucoma diagnosis was based on a glaucomatous appearance of the optic disc correlating with visual field defects. The glaucoma was graded as early, moderate, or severe, depending upon perimetric loss. All patients underwent an ophthalmic evaluation, including visual field examination and planimetric analysis of 30° stereoscopic color optic disc photographs.

Results:

The POAG and PACG groups did not differ significantly in a disc or rim area, rim width, and frequencies of disc hemorrhages or rim notches. However, early POAG group (n = 15) had a significantly deeper cup depth (P = 0.01), larger beta zone (P = 0.01), and a higher frequency of localized retinal nerve fiber layer (RNFL) defects (P = 0.02) than early PACG (n = 20).

Conclusion:

In the early stage of the disease, POAG compared to PACG may be characterized by deeper disc cupping, a larger beta zone of peripapillary atrophy, and a higher frequency of localized RNFL defects. Such differences in early glaucoma may suggest differences in pathophysiology in POAG and PACG.
Is the high contrast visual acuity chart a good predictor of improvement in visual acuity with low vision aids?
Authors: Sahu Anupam , Agrawal Deepshikha , Bhatia Priyavrat
Published: June 2021

Purpose:

To assess whether the objective improvement seen with HCVA chart using LVAs correlates with subjective improvement in the quality of life as measured on low vision quality of life (LVQOL) questionnaire of such patients.

Methods:

This was a prospective, consecutive, observational study. Objective improvement in visual function was assessed using LVAs with high contrast LogMAR visual acuity chart for near and distance. Subjective improvement for distance was assessed using LVQOL score for “distance mobility and lighting”, whereas for near it was assessed using the LVQOL score for “near and fine work”. A total of 46 patients completed one follow-up after low vision trial and were included in the study.

Results:

Improvement in objective visual acuity was highly significant for both near and distance (P < 0.001) with LVAs. LVQOL score improved from 65.85 to 76.83 after one of using low vision aids (P < 0.001). The improvement in LVQOL score for distance and mobility was also highly significant (2.55; P < 0.001); and so was for near and fine work (5.89; P < 0.001). However, Spearman rank correlation coefficient showed no correlation between improvement in visual acuity for distance and LVQOL score improvement for distance (r
s = –.086; P = 0.57). For near also, improvement in acuity did not correlate with the LVQOL score improvement for near and fine work (r
s = 0.036; P = 0.81).

Conclusion:

No statistical correlation was observed between the improvements measured by objective HCVA charts and subjective improved as perceived by the patient after use of low vision devices.
High power custom toric intraocular lens for correcting high corneal astigmatism in post-keratoplasty and keratoconus patients with cataract
Authors: Reddy J K , Pooja C M , Prabhakar G V
Published: June 2021

Purpose:

To analyze the outcomes of phacoemulsification with high power customized toric intraocular lens implantation (IOL) in patients with high corneal astigmatism (6-10 D Cyl) post keratoplasty and keratoconus eyes with cataract.

Methods:

Five eyes post keratoplasty with clear graft, four eyes with stable keratoconus, one eye with pterygium excision scar with visually significant cataract were included in this retrospective study. Phacoemulsification was done followed by implantation of custom made high power toric IOL in all patients. Outcomes included uncorrected and best-corrected distance visual acuity (UDVA, BCVA), pre-operative astigmatism at the corneal plane and IOL plane, post-operative residual astigmatism, mean torus of all IOLs used were calculated.

Results:

The minimum follow-up time was 12 months. At the last follow-up visit, there was a significant improvement (pre-operative vs post-operative) of UDVA (1.5 ± 0.47 vs 0.28 ± 0.14 logMAR; P < 0.05), cylindrical refraction (-9.0 ± 1.80 D vs - 1.1 ± 0.45 vs ; P < 0.05). Range of IOL powers used was 1.0-26.50 DSph and 9.0-15.5 DCyl. Post-operative mean residual spherical equivalent was 0.75 ± 0.5.

Conclusion:

This novel study describes the effectiveness of custom toric IOLs in high astigmatism in the range of 9.0-15.5 DCyl. Phacoemulsification with implantation of a customized high power toric IOL was effective in correcting high astigmatism in complex cases in our study.
Capsular tension ring assisted phacoemulsification of morgagnian cataract
Authors: Bardoloi Narayan , Sarkar Sandip , Burgute Pankaj Suresh , Ghosh Debaruna , Deb Amit Kumar
Published: June 2021

Purpose:

To describe a novel technique of phacoemulsification in morgagnian cataract using capsular tension ring (CTR).

Methods:

This was a retrospective, non-comparative, clinical interventional study. Patients with hypermature morgagnian cataract who had undergone CTR-assisted phacoemulsification were included in the study. After capsulorhexis, CTR was inserted in a clockwise manner to stabilize the capsular bag in each case. Phacoemulsification was then performed using either horizontal chopping or vertical chopping. We have used the CTR in these cases without any obvious lens subluxation in order to perform safe emulsification of the nuclear pieces in the capsular bag. We have performed the procedure successfully in eleven eyes with hypermature morgagnian cataract.

Results:

The mean corrected distance visual acuity (CDVA) improved from 2.62 ± 0.25 Log MAR to 0.35 ± 0.28 Log MAR at 3 months postoperatively (P = 0.00008). Total nine out of 11 patients gained CDVA of 20/40 or better at 3 months postoperatively. No intraoperative complications such as posterior capsular rupture, zonular dialysis, iris trauma, vitreous loss were noted. The mean endothelial cell loss was 148.82 ± 41.52 cells/mm2 after 3 months of surgery.

Conclusion:

The main culprit for intraoperative complications during phacoemulsification in a morgagnian cataract is the vulnerable capsular bag. Following insertion of a CTR after capsulorhexis, the bag becomes stable and the subsequent steps of the surgery become uneventful, thereby, preventing any further complications.
Assessment of precision of astigmatism measurements taken by a swept-source optical coherence tomography biometer - IOLMaster 700
Authors: Sharma Ajay , Batra Akanksha
Published: June 2021

Purpose:

To assess the repeatability of ocular measurements, particularly astigmatism, taken using the latest version of an swept-source optical coherence tomography (SS-OCT) device, IOLMaster 700.

Methods:

This prospective observational study done in a private eye care centre. Study included 213 eyes of 152 patients diagnosed with cataract. Axial length (AL), Anterior corneal astigmatism (ΔK), Total corneal astigmatism (ΔTK), Aqueous depth (AD), Lens thickness (LT), Iris barycentre distance (IBD) and White to white distance (WTW) were analysed; three measurements were taken for each patient in the same sitting by the same examiner in an undilated state using the SS-OCT device. Repeatability was analysed using intraclass coefficient (ICC) and coefficient of variation (CV) measures, and astigmatism values were transformed into vector components (J0/J45) and categorised based on magnitude.

Results:

Astigmatism vector components (J0/J45) showed poor repeatability (ICC < 0.5 and CV > 0), while iris coordinates (IBD) and astigmatism magnitude had good correlation (ICC > 0.9) but more variations between the readings which was least for magnitude ≥ 1.5D; however, rest of the parameters demonstrated excellent repeatability (ICC > 0.9 with P value < 0.05).

Conclusion:

IOLMaster 700 demonstrated good reliability for the parameters measured, although, for astigmatism and iris barycentre distance, more number of readings and cross reference with other devices may be required to get clinically accurate results.