bluuebunny/crossref_metadata_2025 huggingface dataset:
An analysis of the clinical profile of patients with uveitis following COVID-19 infection
Authors: Ganesh Sudha K , Mohanan-Earatt Amanda
Published: February 2022

Purpose:

To describe the clinical profile of patients presenting with uveitis following COVID-19 infection at a tertiary care eye hospital in South India.

Methods:

In this retrospective chart review, all consecutive cases presenting with an acute episode of intraocular inflammation and a history of COVID-19 infection diagnosed within the preceding 6 weeks, between March 2020 and September 2021, were included. Data retrieved and analyzed included age, sex, laterality of uveitis, and site of inflammation. The diagnosis was categorized based on the SUN working group classification criteria for uveitis. Details regarding clinical features, investigations, ophthalmic treatment given, response to treatment, ocular complications, and status at last visit were also accessed. Statistical analysis of demographical data was done using Microsoft Excel 2019.

Results:

Twenty-one eyes of 13 patients were included in this hospital-based retrospective observational study. The study included six male and seven female patients. The mean age was 38 ± 16.8 years. Eight patients had bilateral involvement. Seven patients were diagnosed with anterior uveitis, three with intermediate uveitis, one with posterior uveitis, and two with panuveitis. All patients responded well to treatment and were doing well at their last visit. Two patients had complications that necessitated surgical treatment, following which they recovered good visual outcomes.

Conclusion:

With prompt diagnosis and appropriate management, all the patients with uveitis post-COVID-19 infection recovered with good visual outcomes. Thus, ophthalmologists must be aware of the possible uveitic manifestations following even uneventful COVID-19 infection.
Evaluation of reinforced plication as an alternative to resection in exotropia
Authors: Daga Darshana , Pujari Amar , Sharma Pradeep , Phuljhele Swati , Saxena Rohit
Published: February 2022

Purpose:

To evaluate the surgical efficacy of reinforced plication of the medial rectus muscle to resection as an effective muscle strengthening procedure in exotropia.

Methods:

This is a prospective randomized trial in patients with exotropia who underwent complete orthoptic evaluation followed by random assignment into two groups by using a computer-drawn random number table. Group 1 patients underwent standard resection with recession procedure, and group 2 patients underwent reinforced plication with recession procedure. Follow-up was performed at day 1, 1 week, 1 month, 3 months, and 6 months to assess the surgical efficacy.

Results:

A total of 80 patients were included in the study of which 39 were in group 1 and 41 in group 2. The mean age in group 1 was 23.48 ± 11.94 years and 23.29 ± 10.02 years in group 2. The mean preoperative deviation in group 1 for distance was 50.13 ± 11.95 PD and 50.12 ± 9.79 PD in group 2 (P = 0.499). In group 1 with a mean surgical dose of 5.27 mm medial rectus resection and 8.04 mm lateral rectus recession, a 7.11 ± 3.95 PD deviation was noted at the end of 6 months. Similarly, in group 2 with a mean surgical dose of 5.16 mm medial rectus plication and 8.16 mm lateral rectus recession, a 6.00 ± 2.46 PD deviation was noted at the end of 6 months. Between groups, ocular surface changes, inter-surgeon comparison, and exotropia subtypes did not reveal any significant differences.

Conclusion:

In our observation, the reinforced medial rectus muscle plication showed clinically comparable results as compared to the standard resection procedure at the end of 6 months. Therefore, this innovative modification can be considered as an alternative to standard resection.
Iridodialysis repair – A simplified approach
Authors: Shekhar Madhu , Prasad R Senthil , Anusha A
Published: February 2022

Background:

Iris root is the thinnest and weakest portion of the iris stroma. It can detach easily due to blunt trauma or accidental engagement of the iris during intraocular surgery resulting in glare, photophobia and monocular diplopia. Multiple techniques described for iridodialysis repair such as hang back technique, stroke and dock technique and sewing machine technique are technically challenging.

Purpose:

To describe an simplified approach of iridodialysis repair using 9-0 prolene suture.

Synopsis:

We demonstrate the technique of iridodialysis repair using animation for better understanding. Scleral flap is made adjacent to the iridodialysis area and a paracentesis is made oppsite to the iridodialysis. One arm of the double armed straight needle with 9-0 prolene suture is passed through the paracentesis into the iris root and docked in the 26G needle which is passed underneath the scleral flap 1.5mm posterior to the limbus. Then the needle is pulled out underneath the scleral flap and the manoeuvre is repeated for the second arm as well. The sutures are secured with 5-6 knots under the scleral flap. Intra-operative surgical videos of two patients with traumatic cataract and iridodialysis following blunt trauma are shown. After stabilizing the detached iris using iris hooks, phacoemlsification is done with implantation of foldable acrylic IOL, followed by iridodialysis repair as described above. Both the patients were relieved of their pre-operative symtoms and had good visual recovery.

Highlights:

We describe a simplified approach of iridodialysis repair that can significantly reduce the patient’s troublesome symptoms such as glare and monocular double vision.

Online Video Link:

https://youtu.be/-axYnSfWSb0
Unfolding falciform folds and their consequences - To touch or not to touch
Authors: Boral Subhendu Kumar , Mitra Santanu
Published: February 2022

Background:

Falciform folds are congenital tractional retinal folds due to strong contractile forces and hyperextensibility of retina resulting in temporal dragging of the macula and often associated with familial exudative vitreoretinopathy and retinal detachment (RD). Retinologists are reluctant to treat these entities in view of their poor visual recovery.

Purpose:

To describe a novel surgical technique to unfold the falciform folds.

Synopsis:

This video demonstrates innovative surgical techniques to remove both pre-retinal and sub-retinal adhesions and unfold these folds, managing its consequences and visual recovery. We describe cases of congenital falciform folds with poor visual acuity, where we did vitrectomy, membrane adhesion removal, peeling of the internal limiting membrane (ILM) the macula, mechanical stretching of the folded retina by Tanno scraper or Finesse flex loop, then sub-retinal injection of balanced salt solution (BSS) by 38 gauge sub-retinal needle o create multiple blebs around the folded retina and finally sulphur hexafluoride tamponade. Post-operative macular hole with RD can be a complication. When this falciform fold is complicated by RD, there is risk of intraoperative subretinal migration of infusion cannula and therefore the need for peripheral relaxing retinectomy for redundant retinal fold as well as silicone oil as endotamponade. Vision improved in all our patients after the surgery.

Highlights:

Both long-standing pre-retinal adhesions as well as sub-retinal adhesions are responsible for he tformation of congenital falciform folds. For pre-retinal adhesions, vitrectomy with removal of all the adhesions along with peeling of the sticky ILM and then mechanical stretching of folded retina by Tanno scraper or Finesse flex loop are necessary. To remove sub-retinal adhesions, sub-retinal injection of BSS is necessary to stretch the folded retina from behind, but it should be done away from the retina to avoid formation of macular hole.

Online Video Link:

https://youtu.be/9h8IE3abKIM
Isolated Unilateral Palatal Palsy Secondary to COVID-19 Infection in a Child
Authors: Valdoriya Dwarkesh , Botre Abhijeet , Udavant Prashant
Published: February 2022

Background:

Unilateral acquired isolated palatal paralysis is a very rare entity seen in children. It usually occurs due to isolated involvement of the pharyngeal branch of the vagus nerve. The definite etiopathogenesis is still unclear, but postinfectious immune-associated cranial mono-neuropathy is frequently postulated as plausible cause. We report an Indian girl who presented with isolated right palatal palsy following a coronavirus disease 2019infection. To the best of our knowledge, this has never been described in the literature before.

Clinical Description:

A 7.5-year-old girl child presented with nasal twang of voice and nasal regurgitation of liquids mainly from the right side of her mouth for 7 days. There was no evidence of any other neurological or systemic involvement. There was no history suggestive of any of the common causes usually attributed to palataopharyngeal palsy. Examination revealed right palatal palsy with deviation of the uvula to the left confirming lower motor neuron weakness of the pharyngeal branch of the vagus nerve.

Management:

Routine investigations excluding usual etiological causes were normal. The severe acute respiratory syndrome–corona virus 2 (SARS-CoV-2) immunoglobulin G antibody test was positive. The final diagnosis was postinfectious immune-mediated demyelinating isolated right palatal palsy. The child responded dramatically to a short pulse of methylprednisolone for 3 days and did not display any sequelae on follow-up.

Conclusion:

In the setting of the current pandemic, we recommend including SARS-CoV-2 serology in the routine workup of children presenting with isolated palatal palsy.
Recurrent Pneumonia in a Child
Authors: Reddy Anvesh , Singh Sachin , Mathew Joseph L. , Bhatia Anmol , Rawat Amit , Jayashree Muralidharan , Singh Meenu
Published: February 2022

Childhood pneumonia is a very common cause of morbidity and mortality in children, especially in developing countries. A small proportion of these are due to recurrent pneumonias. This is defined as the occurrence of more than one episode of pneumonia within a single year, or greater than 3 episodes within any duration; with radiographically documented clearing between episodes. A diligent, step-wise clinical approach and judicious laboratory investigations are required to establish clinical diagnosis. In this article, we describe the approach used to establish etiology in a case of recurrent pneumonia.
Fetus in Fetu
Authors: Kazia Athiya Perveen , Mathews Shirbin Joe , Vasu Priya Poickattusseril , Krishnadas Sajitha
Published: February 2022

Background:

Fetus in fetu (FIF) is a rare congenital anomaly in which a parasitic fetus is trapped inside the body of its twin. The incidence is 1 in 500,000 births. Initially, considered as a mature teratoma, it was later identified as a separate entity due to the presence of an axial skeleton and organized limbs.

Clinical Description:

A 48-day-old girl presented with an antenatally detected calcified intra-abdominal mass. She had a palpable retroperitoneal mass measuring 6 cm × 4 cm at the left lumbar area. Sonology showed a heteroechoic cystic mass in the left lumbar region. Serum markers were normal except for a slightly elevated serum lactate dehydrogenase. Contrast-enhanced computerized tomography of the abdomen showed a well-defined cystic lesion measuring 7.6 cm × 6.5 cm × 5.9 cm with enhancing septae, multiple calcific foci, teeth, and bones in the left suprarenal region displacing the left kidney.

Management:

Laparotomy showed a cystic appearing mass with solid components within. Cystic structure was the amniotic covering and solid component turned out to be the FIF with a face, limbs, and umbilical cord. No adjacent infiltration was seen. Pathology confirmed the finding of FIF with an identifiable vertebral column, umbilical cord, pelvis and lower limb bones, skin, and retinal and brain tissue. The infant has been under follow-up for a year and is thriving.

Conclusion:

FIF is a rare condition of infancy which can be diagnosed preoperatively by radiological examination, treated by complete excision, and confirmed by gross and histopathology. Differentiation of FIF from teratoma is mandatory as the latter can be malignant.
An Unusual Cause of Acute Encephalopathy
Authors: Jain Prashant , Prasad Ashish , Sharma Rachna , Vasudevan Vibin
Published: February 2022

Background:

Blood D-lactate levels increase in short bowel syndrome (SBS) and may lead to neurological manifestations.

Clinical Description:

A 5-year-old boy, postoperative case of SBS, presented with loose stools, generalized weakness, and lethargy for 2 days. The child had undergone significant intestinal resection in the past. On examination, he had some dehydration, and was drowsy, but arousable. Remaining examination was normal. Metabolic abnormalities detected included metabolic acidosis (pH of 7.1, HCO3 7 mmol/L), high anion gap (20 mmol/l), and normal lactate levels (2 mmol/L). Other baseline investigations were normal. He was treated as a case of acute gastroenteritis with some dehydration and metabolic acidosis and improved. He was discharged after 5 days. After 2 months, he was readmitted with drowsiness and unsteady gait. This time there was no diarrhea or dehydration. Investigations again revealed severe metabolic acidosis, high anion gap, and normal lactate levels.

Management:

We considered SBS induced D-lactate encephalopathy but were unable to prove it by assay due to unavailability of tests. The child was kept nil per orally and given bicarbonate infusion, on which he showed dramatic improvement. He was also given a low carbohydrate diet and oral metronidazole. The family was counseled at discharge 5 days later regarding dietary modifications and microsupplementation. The patient had 6 admissions for D-lactic encephalopathy over 4 years that coincided with dietary lapse.

Conclusion:

D-lactate acidosis is an underrecognized condition and its diagnosis and management is challenging. A high index of suspicion should be kept in patients with history of intestinal resection presenting with acute encephalopathy and unexplained metabolic acidosis.
Using Innovative Narrative Therapies with Children who Witness Intimate Partner Violence
Authors: Malhi Prahbhjot , Bharti Bhavneet
Published: February 2022

Background:

Intimate partner violence (IPV) is a form of abuse in which one partner causes physical, psychological, or sexual harm to the other, in the relationship. Exposure of children to this kind of domestic abuse is quite common in India, though not openly discussed. The management of children who present with functional somatic symptoms (suspected to be psychogenic in nature) is extremely challenging, especially since the history of IPV is not easily forthcoming. This case series highlights the evocative power of trauma-creative narrative interventions, such as poetry writing and story-telling, that help children express their fears and distress in a safe environment. This in conjunction with other modalities of management helps in their healing.

Clinical Description:

We present three children presenting with various functional somatic symptoms belonging to dysfunctional families. Comprehensive in-depth interviews, psychological assessment, and kinetic family drawings helped us assess each case, elicit the history of IPV, and understand the nature of the individualized fears and distress being experienced.

Management and Outcome:

The primary interventions used were creative narrative interventions such as asking the children to draw, write poems, and/or tell stories about their family and the situations they were experiencing. This helped them express their feelings of helplessness and latent anger arising from witnessing these violent events. Facing their fears in a safe environment resulted in successful resolution of somatic symptoms of all the three over time. This healing was reflected in the change in expressions via the art, poems, and written/oral narrations. Other strategies like provision of psychoeducation, highlighting the connection between symptoms and the underlying trauma, referral for marital counselling, and improving social support were also used.

Conclusions:

Pediatricians should have a high index of suspicion of the possibility of psychosomatic conditions when their patients display inexplicable manifestations that do not fit into any recognizable clinical phenotype, either by description or after investigation. These children and adolescents should be referred for a psychological evaluation and further eclectic management. The use of creative narrative therapies in conjunction with other modalities can lead to successful resolution of functional somatic symptoms.
Autosegmentation of lung computed tomography datasets using deep learning U-Net architecture
Authors: Mehta Akash , Lehman Margot , Ramachandran Prabhakar
Published: February 2022

Aim:

Current radiotherapy treatment techniques require a large amount of imaging data for treatment planning which demand significant clinician’s time to segment target volume and organs at risk (OARs). In this study, we propose to use U-net-based architecture to segment OARs commonly encountered in lung cancer radiotherapy.

Materials and Methods:

Four U-Net OAR models were generated and trained on 20 lung cancer patients’ computed tomography (CT) datasets, with each trained for 100 epochs. The model was tested for each OAR, including the right lung, left lung, heart, and spinal cord. Dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to assess the agreement between the predicted contour and ground truth.

Results:

The highest of the average DSC among the test patients for the left lung and the right lung was 0.96 ± 0.03 and 0.94 ± 0.06, respectively, and 0.88 ± 0.04 for heart, and 0.76 ± 0.07 for the spinal cord. The HD for these corresponding DSCs was 3.51 ± 0.85, 4.06 ± 1.12, 4.09 ± 0.85, and 2.76 ± 0.52 mm for left lung, right lung, heart, and spinal cord, respectively.

Conclusion:

The autosegmented regions predicted by right and left lung models matched well with the manual contours. However, in a few cases, the heart model struggled to outline the boundary precisely. The spinal cord model had the lowest DSC, which may be due to its small size. This is an ongoing study aimed to assist radiation oncologists in segmenting the OARs with minimal effort.
Approach to Pregnancy in Patient with Chronic Kidney Disease
Authors: Ojha Jai Prakash , Singh Vijay Pratap
Published: February 2022

A close relationship exists between kidney function and a successful pregnancy outcome. Renal disease can affect the outcome of pregnancy, pregnancy can affect the course of preexisting renal disease, and pregnancy itself can cause acute renal impairment. This article will focus on outcomes of pregnancy in patients with CKD and also pregnancy outcome in patients with ESRD on chronic maintenance dialysis.
Myiasis and Extremity Involvement
Authors: Ansari Tariq Akhtar , Dharmshaktu Ganesh Singh
Published: February 2022

The human myiasis or infestation of larvae of various species of fly bots is uncommon but interesting health challenge in some parts of the world. The basic knowledge of this disease, however, should be beneficial to clinicians across disciplines as a spectrum of manifestations involving various organs are described in the medical literature. The extremity involvement is rather uncommon and is often found with underlying associated conditions. The diagnosis and identification of the causative species is important for documentation and management. Clinical suspicion, wound lavage, dressing, and debridement are important steps in optimal management. Appropriate systemic pharmacotherapy is supplemented for quick recovery. Prevention, however, coupled with avoidance of predisposing factors is the best management in both community and health-care settings. As the disease is more commonly noted in lower socioeconomic conditions and rural settings, the working knowledge of this condition should come in handy in anticipating, suspecting, and thus diagnosing the condition early for a prompt recovery.
Taxane-induced acute interstitial pneumonitis in patients with breast cancer and outcome of taxane rechallenge
Authors: Anoop T M , Joseph Rona , Unnikrishnan P , Thomas Flowerlit , Venugopal M
Published: February 2022

Background:

Although rare, taxane-induced interstitial pneumonitis is a well-recognized toxicity following chemotherapy. Data on taxane rechallenge in patients who developed taxane-induced interstitial pneumonitis following chemotherapy are limited. Here, we share our experience of acute interstitial pneumonitis following taxane chemotherapy for breast cancer and its clinical outcome following steroids and subsequent rechallenge with taxanes in selected patients without residual lung abnormalities on imaging following steroid treatment.

Objectives:

To study the taxane-induced acute interstitial pneumonitis in patients with breast cancer receiving chemotherapy and outcome of taxane rechallenge in these patients.

Materials and Methods:

Patients with breast cancer who developed taxane-induced acute interstitial pneumonitis following chemotherapy either with paclitaxel or docetaxel were included.

Results:

Among 1240 patients with breast cancer, who received chemotherapy with either docetaxel or paclitaxel, 41 patients developed taxane-induced acute interstitial lung disease (ILD) during the study period. The interstitial pneumonitis was more seen with docetaxel. Among paclitaxel regimens, weekly schedules showed more cases of ILD than 2 weekly paclitaxel. After steroid pulse/maintenance treatment, complete resolution of lung abnormalities was seen in 76%, but residual interstitial pattern on imaging was noted in 24% of patients. Taxane rechallenge was done in 20 (49%) patients. Agents used were paclitaxel, nab-paclitaxel, or docetaxel. All rechallenged patients received short-course oral steroids for one week following taxane rechallenge as a safety measure. Rechallenge was not done in 51% either due to patient unwillingness for rechallenge (27%) or patient with residual interstitial pattern on imaging (24%). None of the patients experienced any recurrence of pneumonitis or any mortality following taxane rechallenge.

Conclusion:

Acute interstitial pneumonitis is a well-known toxicity following taxanes in breast cancer and taxane rechallenge is an option in those patients without any residual pneumonitis following steroid pulse/maintenance. We also advise short-course oral steroids for 1 week following taxane rechallenge as a safety measure. We strongly do not recommend rechallenge in patients with residual lung abnormalities after steroids.
Critical COVID-19-associated pulmonary mucormycosis: The underreported life-threatening spectrum of the mucormycosis epidemic
Authors: Mehta Ravindra M , Bansal Sameer , Kalpakkam Hariprasad
Published: February 2022

The explosive rise in angioinvasive mucormycosis (MM) in India and other parts of the world has been described as the “epidemic following the COVID-19 pandemic,” with the majority being rhino-orbital-cerebral MM. We report a case series of five COVID-19-associated pulmonary MM (CAPM) with an aggressive clinical course. Clinical and radiological clues were limited, and the initial suspicion of CAPM was the morphological appearance on bronchoscopy, which led to the diagnosis. Histopathology was consistently positive in all cases, while other microbiological and molecular tests had varying sensitivity. Most patients had a fulminant and fatal course. Also noted was dual fungal infection in 3/5 cases with coexisting multidrug resistant bacterial infection in all cases. CAPM is the hidden part of the COVID-MM epidemic and warrants a high degree of suspicion with early diagnosis and treatment.
Long-term oxygen therapy prescription in India: Evaluation of compliance, factors affecting compliance, indications, and survival
Authors: Patro Mahismita , Gothi Dipti , Anand Shweta , Agarwal Mohit
Published: February 2022

Introduction:

The international data shows that long-term oxygen therapy (LTOT) compliance is insufficient and variable. We conducted the first study from India on LTOT compliance, factors affecting compliance, indications, and survival through oxygen concentrator.

Materials and Methods:

Our organization from Delhi had given 378 oxygen concentrators over the last 5 years. We evaluated 120 patients randomly for participating in the study. Compliance was defined as the use of LTOT for at least 15 h/day.

Results:

Ninety-seven patients were included in the final analysis after exclusion criteria. The compliance to LTOT was seen in 45.36% (44/97). The commonest cause of noncompliance was lack of instructions (49.06%) followed by electricity issues, social stigma, and workplace constraints. A higher PaCO2 was associated with significantly lower compliance (PaCO2 53.18 vs. 44.98 mmHg, P = 0.036). Interstitial lung disease was associated with significantly higher compliance. Oxygen prescription was titrated with arterial blood gas analysis in only 4.12%. The indications for LTOT were chronic obstructive pulmonary disease (49.48%), posttuberculous obstructive airway disease (20.6%), and interstitial lung disease (12.37%). We found a significant reduction in the mean number of exacerbations/year from 3.91 to 1.93 (P < 0.0001). 61.86% of the patients were surviving on LTOT with a median survival time of 12 months.

Conclusion:

The adherence to LTOT in Indian patients is suboptimal mainly due to lack of instruction and is associated with a higher PaCO2. The practice of titration needs to be followed. The development of a national registry to monitor LTOT should be the long-term target.
Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19
Authors: Scialpi Michele , Scalera Giovanni Battista , Bellini Alessandro , Biagelli Andrea , Chiodi Marino , Nicola Refky
Published: February 2022

Background and Objectives:

There are scant data available in the published literature providing chest computed tomography (CT) findings on pulmonary interstitial emphysema (PIE), complications and associated parenchymal abnormalities. We report the incidence of PIE and complications by chest CT in patients with COVID-19.

Methods:

We retrospective analyzed 897 chest CT scans performed with 64-slice CT scanners during the COVID-19 pandemic period from March 2020 to September 2021. Two radiologists and two physicians in training in diagnostic radiology, independently and in consensus, assessed PIE as air within the perilobular (low-attenuation area) and perivascular interstitium such as its complications, parenchymal anomalies and pleural effusion; in addition, the complications of PIE, parenchymal anomalies and pleural effusion were evaluated. Descriptive statistics were used to summarize the data, and the results were expressed as counts and percentages.

Results:

PIE was revealed in 25 out of 897 patients (2.8%) and associated with pneumomediastinum, subcutaneous emphysema, and pneumothorax in 25 (100%), 16 (64%), and 7 (28%), patients, respectively. Out of 25 patients, 24 patients had ground-glass opacity (GGO), 23 patients had crazy paving, 22 patients had consolidation and 2 patients had pleural effusion. Eighteen out of 25 patients had noninvasive ventilation before CT scan, initially treated with continuous positive airway pressure (positive end expiratory pressure [PEEP] of 10 cmH2O) and subsequently with bilevel positive airway pressure (range PEEP of 8–12 cmH2O). The remaining seven patients had invasive mechanical ventilation via orotracheal intubation (pressure plateau at approximately 25 cmH2O). Six out of 25 (24%) patients died.

Conclusion:

Chest CT allows the detection of complications associated with PIE and parenchyma abnormalities. The timely detection of PIE and minimal pneumomediastinum could aid the optimization of ventilation modalities and parameters based on patients clinical status therefore potentially reducing complications.
Association of comprehensive correct HIV/AIDS knowledge among caregivers of children living with HIV and disclosure of HIV status
Authors: Kodyalamoole Nishanth Krishna , Badiger Sanjeev B
Published: February 2022

Context:

Knowledge regarding HIV/AIDS results in better self-care and lesser risk behavior. For children living with HIV (CLHIV) since birth, the caregivers need to disclose the HIV status for them to know regarding HIV. Poor knowledge among caregivers is a barrier to the disclosure of HIV status.

Aims:

The aim is to assess the knowledge among caregivers of CLHIV regarding HIV/AIDS and to evaluate the association between comprehensive correct HIV/AIDS knowledge (CCAK) among caregivers of CLHIV and disclosure of HIV status.

Settings and Design:

A cross-sectional study was conducted among 91 caregivers of CLHIV in an antiretroviral therapy center in southern coastal Karnataka between October 2014 and July 2015.

Subjects and Methods:

The data were collected using a structured questionnaire by interview method.

Statistical Analysis Used:

Frequencies were calculated for the categorical data. For scoring, the correct answers and wrong answer and “Don't know” options were given one mark and zero marks, respectively. Chi-square test was done to check for the association between knowledge and disclosure of the child's HIV status.

Results:

The knowledge regarding HIV/AIDS was good in 90% of the cases and moderate in the remaining 10%. However, the CCAK was present in only around 40% of the caregivers. The lowest knowledge was regarding the benefits of condom in preventing transmission of HIV. There was no association between CCAK and disclosure of HIV status to the CLHIV in the present study.

Conclusions:

Although the overall knowledge regarding HIV/AIDS was good among caregivers, they lacked CCAK. There was no association between CCAK and disclosure of the HIV status to the child.
“Clinical Profile of Neonates with Patent Ductus Arteriosus and Factors Predicting Prolonged Paracetamol Treatment and Outcome” – A retrospective Study
Authors: Shilpa K. , Praveen B. K. , Alva Prem
Published: February 2022

Introduction:

Patent ductus arteriosus (PDA) comprises 5%–10% of all congenital heart diseases, excluding premature infants. It is more common in females than in males. Clinical evidence of PDA appears in 45% of neonates with a birth weight of <1750 g and in about 80% of neonates with a birth weight of <1200 g. Significant PDA occurs in 15% of premature infants with a birth weight of <1750 g and in 40%–50% of those with a birth weight of <1500 g.

Materials and Methods:

The present study was a retrospective, observational, descriptive, record-based study conducted in the department of neonatology of our medical college from March 2015 to April 2020. All the clinical parameters, echo details, and treatment histories were obtained from the patients' case records and were analyzed.

Results:

In the present study, a total of 56 cases of hemodynamically significant PDA were evaluated. Thirty-seven of them had primary closure, 17 of them had secondary closure, and 2 of them had no closure.

Conclusion:

From the present study, we conclude that the larger the size of PDA, the longer is the duration for closure. The presence of complications such as pulmonary hemorrhage and prolonged ventilation were associated with delayed closure.
Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea
Authors: Keita Mory , Cherif Mahamoud Sama , Sivahera Billy , Boland Samuel T. , Banza-Mutoka Freddy , Kourouma Mamadou , Camara Alseny Modet , Sidibe Youssouf , Kimenyi Jean Paul , Diassy Lamine , Loua Angelo , Fofana Ibrahima Sory , Kandako Youba , Onivogui Dobo , Koivogui Enogo , Millimono Tamba Jacques , Diakite Fode , Balde Mamadou , Houndjo Bienvenu , Nsenga Ngoy , Talisuna Ambrose , Delamou Alexandre , Keiser Olivia , Ki-Zerbo Georges Alfred , Gueye Abdou Salam
Published: February 2022

In this case report, we describe a clinical presentation and therapeutic history of a unique case diagnosed with Lassa fever and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a 23-year-old man from Yomou prefecture in southeast Guinea identified with suspected Ebola Virus Disease (EVD) in the midst of an ongoing outbreak of that disease in the same region. On May 3, 2021, he was admitted to the Nzérékoré Epidemic disease treatment center where his clinical condition deteriorated significantly. Laboratory testing performed on the same day reveals a negative EVD polymerase chain reaction (PCR). Three days later, the patient was tested positive for SARS-CoV-2 and Lassa fever by reverse transcriptase PCR (RT-PCR) assays. Laboratory examination also indicated severe hematological and biochemical deteriorations in the patient. This case substantiates the need for systematic differential diagnosis during epidemic-prone disease outbreaks to better manage severely unwell patients.
Sources for Psychotherapy’s Improvement and Criteria for Psychotherapy’s Efficacy
Authors: Laddis Andreas
Published: February 2022

The publication of the first issue of Frontiers is a happy occasion. In this editorial, I take the opportunity to share my vision of it becoming the forum for clinicians to test their insights and interventions with colleagues of various theoretical views, by means of thoughtful articles and follow-up commentaries. I also share how I use the principles of the journal’s mission statement in my clinical practice and writings. Among other expectations and suggestions, that statement encourages authors to (a) demonstrate how related disciplines help us improve psychotherapy for persons with complex trauma-related disorders related disciplines; (b) report the psychological, behavioral and/or social outcomes that they use as criteria for success. Here, I share my gratification with using concepts and findings from social psychology and anthropology, how they helped me understand the interpersonal operations of power abuse. I learned about the function of intimacy in good caretaking. When a child fears reasons like selfishness or neglect for the caretaker’s failure to fulfill the child’s expectations, caretakers ordinarily relinquish their power to deceive the child. Instead, they disclose such reasons and promise to prove their intention to remedy them, as the child understands proof of that intention. I learned how untrustworthy caretakers abuse that principle of intimacy. That, in turn, helped me discern my patients’ specific fixation from such childhood experience, a flawed working model about the interpersonal operations of intimacy. I have treated it as their fundamental impairment while they suffer disorder during crises of trust in later relationships. Therefore, I measure my psychotherapy’s efficacy in degrees of correcting that impairment. I measure it in my patients’ competence to cultivate intimacy for restoration of trust in their troubled relationships.
El efecto de la monensina en la función productiva de vacas lecheras (Holstein)
Authors: Aguado Paola Isaira Correa , Berumen Fabiola Lydie Rochin , Flores Carlos Fernando Aréchiga , Delgado Romana Melba Rincón , Vidauri Zimri Cortés
Published: February 2022

Se evaluó el ionóforo Monensina (MON) sobre la salud y función productiva de vacas lecheras (Holstein; n=56) de un establo comercial de Aguascalientes, México.  El grupo Testigo (TES) recibió la ración alimenticia y al Grupo Monensina (MON) se le agregaron 200 mg/día de monensina en la ración,  21 días preparto a 50 días postparto.  Se registraron alteraciones del periparto como Cetosis clínica (CET), Retención de Membranas Fetales (RMF), Abortos (AB), Mastitis (MAST) y otras como fiebre y neumonía. La concepción se presentó a partir del día 40 posparto. Las vacas que recibieron MON tendieron a concebir antes que las hembras del grupo testigo (TES).  Se concluye que La Monensina incrementó ligeramente la eficiencia reproductiva de las vacas. No influyó en el intervalo del parto al primer servicio (IPPS), pero redujo ligeramente el intervalo del parto a la concepción (IPC). La incidencia de Cetosis y Retención de Membranas Fetales fue similar.
Social deficiencies in the tourist municipalities of the riviera maya in the state of Quintana Roo, Mexico
Authors: Canul Carlos Alberto Pérez , Chiquini Charlotte Monserrat Llanes , Cortés Roger Manuel Patrón , Ovalle Thania del Carmen Tuyub
Published: February 2022

El estado de Quintana Roo con la fundación de la ciudad de Cancún en 1970, se convirtió en el principal sitio turístico de México. Esta situación origino que se desarrollara el corredor turístico conocido como Riviera Maya y que actualmente es uno de los principales polos turísticos del país. Ciudades como Playa del Carmen y Tulum han tenido un desarrollo importante y actualmente son lugares con un gran impacto para la industria turística. Es importante destacar que la región ha tenido un desarrollo económico en los últimos 50 años, pero diversas regiones del país no se desarrollaron de la misma manera, la mayoría de los estudios sobre el desarrollo de México muestran que el país ha sido regionalmente desequilibrado y la tendencia apunta a un agravamiento de esos desequilibrios en el futuro, por lo que frente a este panorama son los gobiernos estatales y los actores de la sociedad civil los que deben asumir una posición de liderazgo proactivo que permita combatir los problemas sociales.  En una primera etapa es importante partir de un análisis claro de la situación de la pobreza en cada entidad federativa analizando las diversas variables que influyen en esta situación. Este documento presenta los resultados de la investigación “Carencias sociales en los municipios turísticos de la Riviera Maya en el estado de Quintana Roo, México”. El cual propone un análisis de diversas variables que influyen en la medición de la pobreza, mediante el índice de Rezago Social (IRS) diseñado por el Consejo Nacional de Evaluación de la Política de Desarrollo Social (CONEVAL) para determinar las carencias sociales existentes en cada municipio de la región de la Riviera Maya del estado de Quintana Roo, México
PENGARUH BEBAN KERJA DAN KESELAMATAN KERJA TERHADAP PRODUKTIVITAS KERJA PADA PEGAWAI PELABUHAN PERIKANAN NUSANTARA KARANGANTU DIKOTA SERANG
Authors: Khairusy Mirza Abdu , Saputra Ahmad
Published: February 2022

Penelitian ini bertujuan untuk mengetahui Pengaruh Beban Kerja dan Keselamatan Kerja Terhadap Produktivitas Kerja Pada Pegawai Pelabuhan Perikanan Nusantara Karangantu Serang Banten. Latar belakang penelitian ini berkaitan dengan kurangnya perhatian kepada sumber daya manusia, beban kerja yang belum sesuai dengan tanggung jawab pekerjaan dan keselamatan yang masih tergolong rendah yang mana belum terfokus pada keselamatan dalam memberikan pemahaman untuk meningkatkan produktivitas kerja.

Populasi penelitian adalah semua pegawai Pelabuhan Perikanan Nusantara Karangantu sebanyak 60 orang dengan seluruh populasi akan dijadikan sampel sebanyak 60 responden. Metode yang digunakan dalam penelitian ini adalah metode Assosiatif Kasual dengan pendekatan Kuantitatif. Teknik analisis data yang digunakan adalah analisis regresi linier berganda.

Hasil penelitian menunjukkan bahwa beban kerja dan keselamatan kerja memberikan pengaruh sebesar 49,1% terhadap produktivitas kerja, angka 49,1% disini artinya setiap perubahan produktivitas kerja sebesar 49,1% dipengaruhi oleh perubahan variabel beban kerja dan keselamatan kerja. Adapun sisanya sebesar 50,9% disebabkan oleh variabel – variabel lain diluar kedua variabel tersebut yang tidak dilibatkan dalam penelitian ini, antara lain kepemimpinan, kondisi kerja.
TINGKAT PELAYANAN KESEHATAN IBU DAN ANAK: KEPUASAN PASIEN IBU HAMIL DALAM PROSES RUJUKAN DI PUSKESMAS KEBAYORAN BARU, JAKARTA SELATAN
Authors: Kurniawati Riska , Ansari Dien
Published: February 2022

Jakarta memiliki banyak fasilitas kesehatan dan masih bekerja keras untuk mengurangi jumlah kasus kematian ibu. Puskesmas Kebayoran Baru, Jakarta Selatan telah mengembangkan sistem rujukan Pelayanan Obstetri Neonatal Neonatal Esensial Dasar yang terorganisir untuk pasien hamil, namun sampai saat ini belum ada evaluasi kepuasan pasien hamil yang dirujuk. Tujuan dari penelitian ini adalah untuk menganalisis kepuasan pasien hamil. yang dirujuk dari Puskesmas Kebayoran Baru, Jakarta Selatan. Penelitian ini merupakan penelitian potong lintang dan unit analisis dalam penelitian ini adalah pasien hamil yang dirujuk dari Puskesmas Kebayoran Baru, Jakarta Selatan. Hasil analisis sebagian besar pasien hamil menyatakan puas dengan proses rujukan baik informasi dari bidan, jarak tempuh rujukan, pelayanan rujukan, pemberian rujukan, pelayanan di rumah sakit penerima rujukan dan manfaat dari proses rujukan. Dalam penelitian ini, pasien juga menyatakan kurang puas dengan administrasi proses rujukan karena proses administrasi masih dianggap sulit sehingga administrasi rujukan mendapat nilai komposit terkecil. Disimpulkan bahwa Puskesmas Kebayoran Baru, Jakarta Selatan dapat menyelenggarakan mekanisme proses pelayanan berjenjang rujukan dengan baik dan sesuai dengan prosedur meskipun masih perlu perbaikan.
MUTU PELAYANAN KESEHATAN MENINGKAT DENGAN MENERAPKAN KESELAMATAN PASIEN DI PUSKESMAS
Authors: Ferial Linardita , Wahyuni Nova
Published: February 2022

Keselamatan pasien merupakan salah satu indikator kualitas pelayanan kesehatan. Meskipun data insiden keselamatan pasien di fasilitas pelayanan kesehatan tingkat pertama belum akurat di Indonesia, namun keselamatan pasien menjadi isu penting dalam peningkatan kualitas pelayanan. Puskesmas “X” Kota Serang adalah salah satu fasilitas pelayanan kesehatan yang menerapkan upaya keselamatan pasien sebagai salah satu bentuk upaya peningkatan mutu pelayanan kesehatan sebagaimana dimaksud dalam Undang-Undang Republik Indonesia Nomor 36 Tahun 2009. Tujuan penelitian ini yaitu mengidentifikasi penerapan upaya keselamatan pasien di Puskesmas “X” Kota Serang untuk meningkatkan kualitas pelayanan. Teknik pengumpulan data yang digunakan adalah observasi, wawancara, dan studi literatur. Pengambilan data dilakukan di Puskesmas “X” Kota Serang pada bulan April-Mei 2021. Hasil analisis data menunjukkan bahwa pelaksanaan upaya keselamatan pasien Puskesmas “X” Kota Serang disesuaikan dengan standar penilaian akreditasi Puskesmas. Namun, dalam realisasinya masih terdapat hambatan dan kekurangan dalam pemenuhan standar upaya keselamatan pasien di Puskesmas “X” Kota Serang sehingga perlu optimalisasi penerapan upaya keselamatan pasien dari seluruh pihak yang terlibat sehingga puskesmas harus menyediakan pelayanan yang aman dan bermutu untuk mewujudkan kecamatan sehat. Puskesmas perlu untuk meningkatkan keselamatan pasien sesuai dengan Permenkes Republik Indonesia Nomor 36 Tahun 2009.
The Acute and Delayed Effects of Foam Rolling Duration on Male Athlete’s Flexibility and Vertical Jump Performance
Authors: Blades Callum , Jones Thomas , Brownstein Callum , Hicks Kirsty
Published: February 2022

Foam rolling (FR) durations totaling ≤60 s per muscle are reported to acutely increase flexibility and vertical jump performance. However, limited research has investigated whether these benefits can outlast the inactive post-warmup preparatory period that typically separates warmups from the start of sporting competition. Eleven male athletes (height 1.77 0.09 m, body mass 78.0 17.0 kg, age 22 2 years) completed familiarization, followed by three experimental trials in a randomized and counterbalanced repeated measures crossover design. Trials commenced with 5 min jogging, before ankle dorsiflexion range of motion (ADF-ROM), sit and reach (S&R), countermovement jump (CMJ) and squat jump (SJ) baseline testing. Participants then sat inactively for 10 min (control) or performed lower extremity FR totaling either 30 (30FR) or 60 s (60FR) that targeted four agonist-antagonist leg muscles. Testing was then repeated before and after a simulated inactive 15 min post-warmup preparatory period to establish the acute and delayed effects of FR on performance. A two-way repeated measures analysis of variance was used to identify any significant interaction effects between conditions (30FR, 60FR, control) and timepoint (baseline, acute, delayed). No significant condition x timepoint interaction effect was detected for the ADF-ROM (f = 1.63, p = 0.19), S&R (f = 0.80, p = 0.54), CMJ ((f = 0.83, p = 0.99) or SJ (f = 0.66, p = 0.99). Therefore, FR totaling ≤60 s appears insufficient to enhance flexibility or vertical jump performance in male athletes.
ÖZEL ÖĞRENME GÜÇLÜĞÜ OLAN ORTAOKUL ÖĞRENCİLERİNİN OKUL YAŞANTILARINA İLİŞKİN GÖRÜŞLERİ
Authors: SEZGİN ELBİR Neslihan , TAYMAZ SARI Oktay
Published: February 2022

Bu araştırma özel öğrenme güçlüğü (ÖÖG) olan ortaokula devam eden kaynaştırma ortamında yer alan öğrencilerinin okul yaşantılarına ilişkin görüşlerini belirlemek amacıyla 2018-2019 eğitim öğretim yılında gerçekleştirilmiştir. Araştırmanın çalışma grubu İstanbul ilinde rehabilitasyon merkezine devam eden ÖÖG olan 12 ortaokul öğrencisinden oluşmaktadır. Araştırmada nitel araştırma yöntemlerinden olgu bilim (fenomenoloji) deseni kullanılmıştır. Katılımcılar uygun durum örnekleme yöntemine göre seçilmiştir. Veriler yarı yapılandırılmış görüşme tekniğiyle toplanmıştır. Verilerin analizinde betimsel analiz yöntemi kullanılmıştır. Öğrencilerin okul yaşantılarına ilişkin görüşleri; okula, derslere, arkadaşlarına, öğretmenlerine ve kendilerine ilişkin görüşleri ana temalarından oluşmaktadır. Araştırma bulgularına göre, ÖÖG olan öğrenciler okulda ve okul dışında arkadaşlarıyla birlikte vakit geçirmekten keyif almaktadır. Öğrencilerin öğretmenlerine ve arkadaşlarına ilişkin olumlu görüşleri bulunmaktadır. ÖÖG olan öğrenciler sosyal ortamlarında tercih edildiklerini ve yakın arkadaş ilişkilerinin olduğunu düşünmektedirler. ÖÖG olan öğrencilerin gelecekten beklentileri daha çok meslek sahibi olmakla ilgilidir. Gelecek beklentilerinde okulun etkisi olduğunu düşünmektedirler. Araştırma bulguları ışığında, ÖÖG olan öğrencilere okul içerisinde kendilerini ifade etmelerinde yardımcı olacak sınıf veya okul temsilciliklerine aday olmalarında, konuşma yapmalarında yardımcı olunabilir. İleri araştırmalar için, araştırma farklı yaş grubundaki ve farklı kademelerdeki öğrencilerle gerçekleştirilebilir.
O PROGRAMA NACIONAL DE FORTALECIMENTO DA AGRICULTURA FAMILIAR NO ESTADO DO PIAUÍ (2015-2020)
Authors: Carneiro Joabe , Cardoso Ana , Sousa Gabriel , Vargas Juliano
Published: February 2022

RESUMO
O objetivo neste artigo é analisar o crédito no domínio do Pronaf no estado do Piauí (PI),
evidenciando sua evolução quanto aos contratos, volume de recursos e condições de créditos
acessados entre 2015 e 2020. A metodologia é do tipo exploratória e qualitativa. Os dados foram
obtidos nos websites do Banco Central do Brasil, Banco do Nordeste do Brasil, Instituto Brasileiro
de Geografia e Estatística e literaturas especializadas. Os resultados apontam que: a) o crédito
para agricultura familiar é atrativo devido ao juro baixo, prazo e carência favoráveis ao produtor; b)
houve ocorrências de secas frequentes e intensas; c) teve aumento do produto interno bruto (PIB)
no PI com a oscilação do Pronaf em todo período estudado. Conclui-se que a política de crédito, via
Pronaf, é bastante importante para produção de alimentos e o crescimento do PIB no PI.
Palavras Chaves: políticas públicas; agricultura familiar e crédito rural.
ABSTRACT
The objective in this paper is to analyze the credit in the Pronaf domain in the state of Piauí (Brazil),
showing its evolution in terms of contracts, volume of resources and credit conditions accessed
between 2015 and 2020. The methodology was exploratory and qualitative. Data were obtained
from the websites of the Central Bank of Brazil, Banco do Nordeste do Brasil, Brazilian Institute
of Geography and Statistics and specialized literature. The results show that: i) credit for family
farming is attractive due to the low interest rate, favorable term and grace period for the producer; ii)
there were frequent and intense droughts; iii) there was an increase in the gross domestic product in
PI with the oscillation of Pronaf throughout the studied period. It is concluded that the credit policy,
via Pronaf, is very important for food production and gross domestic product growth in PI.
Keywords: public policies; family farming and rural credit