bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative study of intravenous diuretics therapy-bolus versus infusion regimen in acute decompensated heart failure
Authors: Diwakar Sanjeev , Kumar Rahul
Published: July 2021

Background: Heart failure (HF) is a growing problem worldwide; more than 20 million people around the world are affected. The objective of the study was to compare the effect of different modes of administration of intravenous diuretic –bolus versus infusion, in acute decompensated heart failure in relation to diuresis and electrolyte balance.Methods: This prospective study was conducted in Darbhanga Medical College and hospital, Laheria sarai between October 2014 to November 2016. Patients of acute decompensated heart failure attending medical emergency ward and Intensive care unit of medicine department of Darbhanga Medical College and hospital, Laheria sarai were selected and grouped randomly as per inclusion and exclusion criteria.Results: The main findings of our study were greater diuresis in the first 24 h of admission with bolus dose. No difference in serum sodium or serum potassium levels between the groups.Conclusions: All three modes of diuretic therapies can be practiced with no difference in worsening of electrolyte levels. Bolus dose administration with its rapid volume loss might be a more effective diuretic strategy in our country with limited health resources.
Virological failure among HIV infected individuals on antiretroviral therapy in Pune, India: a cross-sectional study
Authors: Shidhaye Pallavi , Lokhande Nilima , Kulkarni Smita , Gurav Shraddha , Deoraj Pramod , Ghate Manisha
Published: July 2021

Background: It is important to identify and manage determinants of virological failure among HIV infected individuals on treatment for achieving viral suppression. This study aimed to identify proportion and factors associated with virological failure among HIV infected individuals receiving first line antiretroviral therapy (ART).Methods: A total of 2670 adult HIV infected individuals attending ART centre at ICMR-National AIDS Research Institute, between January 2005 and June 2019 and having their recent viral load done after implementation of guidelines on routine viral load testing were included. Data were reviewed and analysed.Results: Of the 2670 people living with HIV (PLHIV) on first line antiretroviral therapy, 48% were male and 69% were more than 40 years of age. Mean baseline CD4 count at ART initiation was 252 cells/mm3 (SD:210, IQR 116-313) Overall, 13% (340/2670) of the participants showed virological failure. In multivariate analyses, participants with younger age and males retained significant association. Those with baseline CD4 counts of less than or equal to 500 cells/mm3 at treatment initiation (adjusted OR 1.71; 95% CI 1.08-2.70; p=0.022) and ART adherence ≤95% within last three months of recent viral load determination (adjusted OR 1.55, 95% CI of AOR 1.04-2.32; p=0.031) had higher risk for virological failure as compared to others. PLHIV with ART substitution due to various reasons were almost twice as likely to have virological failure (adjusted OR 1.83, 95% CI 1.44-2.33; p<0.001).Conclusions: It is crucial to focus on factors leading to virological failure among HIV infected individuals attending ART centre. Early linkage to treatment and ART initiation along with adherence counselling at every follow up visit play an important role in mitigating virological failure.
Factors associated with blood pressure in end stage renal disease patients receiving regular hemodialysis at Wangaya general hospital, Denpasar
Authors: Nugraha I. Kadek Aditya , Tedjamartono Theodore Dharma , Sunaka Wayan
Published: July 2021

Background: Hypertension is common findings in end-stage renal disease (ESRD) patients receiving hemodialysis, around two third among them are poorly controlled. We analyzed factors affecting blood pressure in patients undergoing regular hemodialysis.Methods:A single center cross-sectional study conducted including 65 patients receiving regular hemodialysis at hemodialysis unit Wangaya general hospital, Bali, Indonesia. Ordinal regression test was performed to analyze the relationship between factor associated with blood pressure in regular hemodialysis patients.Results: Among subjects included, 64 (98.5%) subject had hypertension and 22 (34.4%) subjects had well controlled blood pressure (<140/90 mmHg), 20 (31.3%) subjects had blood pressure between 140/90 to 160/100 mmHg and 22 (34.4%) subjects had blood pressure >160/100 mmHg. Univariate analysis showed statistically significant associated factors were higher number of antihypertensive medications (p=0.002), higher level of hemoglobin (p=0.008), hematocrit (p=0.012) and urea (p=0.041). Multivariate analysis showed higher amount of anti-hypertensive medications and year of dialysis were statistically significant associated with blood pressure in regular hemodialysis patients.Conclusions:Significant factors associated with blood pressure in regular hemodialysis patients were higher amount of anti-hypertensive medications and increased year of dialysis.
Co-infection of COVID-19 and dengue: a case report
Authors: Seputra Desak P. G. S. , Saraswati Kadek S. D. , Dewi Anak A. I. S. K.
Published: July 2021

COVID-19 has now spread to most countries, causing a global pandemic. As the COVID-19 pandemic is still ongoing, some part of the world region with tropical climate is facing a dual burden of infection with the presence of concurrent endemic infectious disease. This endemic dengue infection and the COVID-19 pandemic may turn out into a fatal and hazardous combination. In addition, dengue and COVID-19 possess clinical and laboratory features that are sometimes difficult to differentiate. The possibility of COVID-19 and dengue co-infection has also been a noticeable issue. We present a case of 19-year-old male with COVID-19 and dengue co-infection admitted at Wangaya Regional Hospital Denpasar, Bali. Co-infection of COVID-19 and dengue requires special attention from all health care workers in dengue-endemic countries in order to avoid diagnostic delays and improve clinical outcome. It is also necessary to conduct further research which explores the potential of co-infection between coronavirus and arbovirus.
Euglycemic diabetic ketoacidosis - a rare side effect of sodium-glucose co-transporter-2 inhibitor in a patient of type 2 diabetes mellitus with left ventricular dysfunction: a case report
Authors: Kaur Amolpreet , Singh Parminder , Singh Gifty , Mohan Gaurav , Chopra Gaurav , Singh Rajdeep
Published: July 2021

A 42 year old female with type 2 diabetes mellitus (T2DM), presented with angina on exertion and left ventricular (LV) dysfunction (global LV ejection fraction (EF)=26%). Patient was subjected to coronary angiography which revealed triple vessel disease. Patient was started on usual standard of care heart failure (HF) medications, including sodium-glucose co-transporter-2 (SGLT-2) inhibitor dapagliflozin which is promising new class of drug for treating T2DM and HF. Patient was advised myocardial revascularization in form of percutaneous transluminal coronary angioplasty (PTCA). Post angioplasty patient developed metabolic acidosis (high anion gap with normal lactate and increased ketone levels). Patient was diagnosed as case of euglycemic diabetic ketoacidosis (DKA) and patient was treated by volume resuscitation and insulin infusion.
Stevens-Johnson syndrome induced by gabapentin and cilostazol in diabetic patient co-infected with COVID-19
Authors: Nugraha I. Kadek Aditya , Suryana Ketut , Wulandari Dewi Catur , Pemayun Tjokorda Dalem
Published: July 2021

Coronavirus disease 2019 (COVID-19) has been declared as an emergent pandemic. COVID-19 mainly present with fever and respiratory symptoms. Its severity ranges from asymptomatic infection, mild, moderate, severe to critical degrees which is related to the degree of dysregulated inflammatory response and systemic inflammation. Stevens-Johnson syndrome (SJS), on the other hand is a rare, severe, type IV hypersensitivity presenting with epithelial destruction of skin and mucous membranes. This condition also associated with systemic proinflammatory state. We report a case of a 73-years-old woman with dry cough and fever, who recently started treatment with cilostazol and gabapentin, then followed by redness and blistering on her lips, trunk, and genital which subsequently diagnosed with COVID-19 and SJS.
Sero prevalence of SARS-CoV-2 in general population of Nagpur district
Authors: Sharma Sarita K. , Rathod Pragati G. , Ukey Ujwala U. , Narlawar Uday W. , Zodpey Sanjay
Published: July 2021

Background: Population based sero-epidemiological studies help us to determine the burden of COVID-19 infection at the community level and to monitor the trends in transmission of SARS-CoV-2 infection. Antibody based sero-positivity indicates the extent of spread of infection in the given population and forms the basis for strengthening public health mitigation measures. The present study was carried out with the objective of conducting population level serosurvey in Nagpur district to understand the spread of SARS-CoV-2 and to help the designing and implementation of appropriate health system and policy level interventions. This cross-sectional study was carried out in Nagpur District over two weeks in October and November 2020. For the purpose of this survey the Nagpur district was divided into NMC area and Non NMC area.Methods: House to house survey was carried out and data was collected using Google form. For detection of SARS-CoV-2 specific antibodies venous blood was collected from each participant and electrochemiluminescence immunoassay was performed. The data was cleaned, coded and analysed using EPI INFO.Results: The total seroprevalence in Nagpur district was found to be 35.17 %. The seroprevalance in NMC area was 49.7% which was more than twice from that of Non NMC area (20.7%).Conclusions: Considerably large numbers of infections are asymptomatic, however a sizeable proportion of population is still susceptible to the infection and thus there is no time for complacency.
Clinical significance of anti-phospholipid antibodies in Henoch Schönlein purpura
Authors: Gupta Anuj , Agarwal Joshika , Gupta Shilpi , Singh Anurag
Published: July 2021

Background: Henoch Schönlein purpura also known as IgA vasculitis is described histologically by IgA deposition in the blood vessel walls and presents with kidney involvement, palpable purpura, arthralgia, and abdominal pain. Our study aims to evaluate the association between anti-phospholipid antibody, anti-cardiolipin antibody, anti-beta(2) glycoprotein 1 antibody and Anti-phosphatidylserine/prothrombin antibodies and IgA vasculitis. Treatment response with intravenous steroids and cyclophosphamide was also studied based on resolution of antibody titer.Methods: We conducted an observational study in three Rheumatology clinics at Ahmedabad, India. Data was collected for a period of 6 months. Diagnosis of IgA vasculitis was determined based on the International Chapel hill consensus conference 2012. Disease activity was assessed based on antibody titer, histological grading and through a pre-determined clinical form to assess objective clinical symptoms. P value of less than 0.05 was considered significantResults: Study evaluated antibody titer of 178 patients. Sixty one percent of the patient's had positive anti-phospholipid antibody titer with predominant antibody subtype as IgG. Inflammatory markers were significantly higher in patient having anti-phospholipid antibody titer. Anti-phospholipid antibody was present in 100 percent patients who had vascular thrombosis. IgG subtype of anti-cardiolipin antibody were found in 60 percent of the patients with renal complication.Conclusions: Anti-phospholipid antibody have a close association with IgA vasculitis. Anti-phospholipid antibody has a significant role in mounting inflammatory response and vascular thrombosis. Combination treatment of intravenous steroids and cyclophosphamide found to be more effective in resolution of titer
Is Bangalore achieving herd immunity
Authors: Patil Rajeev M. , Kethineni Aparna , Mukhopadhyay Arindam , Thangam Saral
Published: July 2021

The emergence of a novel coronavirus (SARS-CoV-2) in late 2019 has led to millions of infections and substantial morbidity and mortality across the world. COVID-19 caused by SARS-CoV-2 infection ranges from mild self-limiting disease to acute respiratory distress syndrome and death. India is presently reeling under the second wave of COVID-19 pandemic with more than 2,52,28,996 cases and 2,78,719 deaths as of 18 May, 2021 making it the country with highest reporting cases in the world. Till that date, Bangalore, the capital city of Karnataka alone reported a total of 22,42,065 COVID-19 positive cases overstretching Indian Health care system in this pandemic situation. Considering its high population densities and contact rates it poses a challenge for controlling COVID-19 which is transmitted directly from person to person. The question of herd immunity and how soon it would develop therefore appears to be highly relevant in the context of disease elimination programs.
Study on proximate composition of four genotypes of Arachis hypogea l. (groundnut)
Authors: Abdullahi Yusuf M. , M. Abuhuraira Ado , Baba Ibrahim , Garba Hamza , Salihu Muhammad N. , Lawal Mamman M. , Umar Maryam D. , Muhammad Faisal
Published: July 2021

Background: Groundnut (Arachis hypogea L.) also known as peanut is one of the world’s principal oilseed crop. The plant originated in South America, but is widely distributed throughout the tropic and warm temperate areas in Asia, Africa, Oceania, North and South America and Europe. This study aimed to evaluate the proximate content of some genotype of groundnut (Arachis hypogea L.).

Methods: A total of four different groundnut varieties were used in this study; the varieties were obtained from international crop research institute for the semi-arid tropic (ICRISAT) Kano station. Samples selected were Samaru nut 11 (Samnut-11); Samaru nut 22 (Samnut-22); Samaru nut 23 (Samnut-23); and Samaru nut 24 (Samnut-24). The analysis was conducted in the animal laboratory faculty of Agricultural sciences, in Bayero University Kano, Nigeria. The moisture, ash, crude protein, crude fat, crude fiber and nitrogen free extract of the samples were detected using a standard procedure adapted from official methods of analysis 1990. Data was analyzed using the analysis of variance (ANOVA) and means were separated using Student-Newman-Keuls (SNK) in SAS version 9.3.  

Results: The higher content of ash was found in Samnut-24 (4.4%), and Samnut-23 (11.8%) was found to have highest moisture. Samnut-23 has the highest content of crude protein (30.6%) and crude fiber (4.7%). A higher content of fat and oil (ether extraction) was found in Samnut-23 (40.0%) and a higher content of soluble carbohydrate (NFE) was found in Samnut-11(27.4%) and Samnut-22 (27.4%).

Conclusions: Groundnut characteristically contained high level of oil and protein with low level of moisture, ash and carbohydrate; this makes it a potential source of edible-oil. The high protein of the defatted groundnut makes it good as cake for human consumption and useful as animal feeds. Samnut-23 has enriched edible-oil content and the crude protein, while Samnut-22 has low oil content and protein, but has enriched with NFE. Based on the conclusion it was recommended that further research should be carried out on the quality of proximate content of groundnut between the four varieties.
Hepatoprotective effects of partially purified fractions of Senna occidentalis ethanolic extract on diethyl nitrosamine-induced toxicity in Wistar rat
Authors: Yakubu Ojochenemi E. , Ojogbane Eleojo B. , Atanu Francis O. , Udeh Chukwuka S. M. , Ale Morayo E. , Bello Blessing H.
Published: July 2021

Background: Induction of toxicity using nitrosamines provides a reliable animal model for the study of oxidative damage to lipids, cellular membranes, proteins and DNA. In the present report, the effects of partially purified fractions of Senna occidentalis leaves on diethylnitrosamine intoxicated rats were studied.

Methods: Fractions obtained from eluting the column with solvents of increasing polarity, n-hexane, chloroform, ethyl acetate, ethanol, methanol and distilled water were subjected to in vitro for their ability to scavenge 1, 1-dipheny l, 2-pycryl hydrazyl (DPPH) radical. Fraction 6a eluted with ethyl acetate:ethanol (50:50) possessed the highest antioxidant activity, this fraction was therefore selected for in vivo studies. Twenty rats, each weighing between 150 to 250 g were randomly allocated into four groups of five rats each. Hepatotoxicity was induced using a single intraperitoneal injection of diethylnitrosamine (DEN) at the 200 mg/kg body weight. Treatment was carried out for 3 weeks by oral gavage as follows: group A, normal control, group B, DEN control, group C, DEN+fraction (10 mg/kg), group D, DEN+silymarin (5 mg/kg).

Results: The results showed that DEN toxicity significantly (p<0.05) increased alanine transaminase (ALT) and aspartate transaminase (AST) activities and increased the level of thiobarbituric acid reactive substance (TBARS) in the liver. In contrast, the levels of bilirubin, total protein (TP) and albumin (ALB) decreased. However, treatment of rats with the extract significantly (p<0.05) reduced the concentrations of TBARS, ALT, AST and bilirubin, but increased the concentration of TP and ALB.

Conclusions: These results show hepatoprotective potentials of the fraction. Furthermore, GC-MS fingerprinting of fraction 6a revealed the presence of compounds with anticancer, antioxidant and anti-inflammatory properties confirming its high chance for exploration as a medicinal agent.
A short report on the tumor suppressor role of BIRC7 in pancreatic cancer
Authors: Khan Aamir A. , Liu Xin H. , Li Huan , Pan Ruining , Din Rahman U. , Ullah Naeem , Huang Hua
Published: July 2021

Pancreatic cancer (PC) is accepted to be an aggressive malignancy among all type of cancers due to its poor prognosis and high cancer-led mortality ratio mostly affecting male community in older age. Multiple genes are involved in PC initiation, progression and metastasis including K-RAS, CDKN2A, p53, SMAD4. Baculoviral IAP repeat containing 7 (BIRC7) commonly known as Livin, an inhibitor of apoptosis protein (IAP) involved in the inhibition of cell death via apoptosis by preventing caspase activity through various approaches. The biological role of BIRC7 was previously identified in multiple cancers but ill investigated in PC. In this study, we investigate the function role of BIRC7 in PC. Multiple phenotypic tests including wound healing assay, CCK8 assay, trans-well assay and colony formation assay was run to rule out BIRC7 gene effect on PC genesis. We for the first time indicated that, overexpression of BIRC7 significantly reduced the proliferation, development, progression and metastasis of PANC-1 cell in vitro. Therefore, we anticipated that BIRC7 gene is a suppressor gene and might be a suitable candidate gene for therapeutic purposes in PC.
Impact of COVID-19 on rhinology practice: a global survey
Authors: Batra Ankur , Goyal Megha , Rokade Ashok
Published: July 2021

Background: The impact of COVID-19 on healthcare services has resulted in significant changes in day to day practice in order to reduce the virus transmission and protect the public and the healthcare professionals. Rhinologists are at higher risk of contracting the virus as they are regularly exposed to the aerosols generated during out-patient and surgical procedures. The aim of the survey was to identify the impact of COVID-19 on various aspects of rhinology practice and the changes instituted to mitigate the risks.

Methods: An anonymous email survey was developed and circulated among otolaryngologists from around the world.  

Results: A total of 162 responses from 44 countries were included in the analysis. 63% of the respondents attended only emergent, urgent and time sensitive cases in the outpatient setting with introduction of various screening methods. Over 88% respondents were carrying out aerosol-generating procedures (AGPs) in their rhinology clinics. 67.39% respondents had not operated on any COVID-19 positive patient at the completion of the survey. Preoperative COVID testing and self-solation protocols differed as per the local hospital policy. 16 rhinologists reported a member of their team becoming positive after AGPs and 9 becoming positive after being involved in surgical procedures. Online teaching sessions were the most preferred (74.38%) mode of continued medical teaching/ training around the world.

Conclusions: Data analysis revealed that most rhinologists followed the suggested guidelines by various ear, nose and throat (ENT) national organisations like ENTUK, the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) etc. in their practice and also provided insight into some of the deficiencies which need improvement as the pandemic continues to affect the global practice.
A study on changes in phonetics in completely edentulous patients before and after rehabilitation with conventional and customized complete dentures
Authors: Niyogi Soumadip , Bhattacharyya Jayanta , Das Samiran , Ghosh Soumitra , Goel Preeti , Chatterjee Indranil
Published: July 2021

Background: A realistic approach to the phonetic aspect in complete denture construction is most often subdued by various factors. The palatal rugae, an important landmark in speech orderliness, are frequently affected due to lack of proper texture on a complete denture. Establishing a correlation between customized palatal surfaces of complete dentures and speech improvement will help to ameliorate post insertion appointments of articulation deficiencies.

Methods: Ten completely edentulous subjects of either sex with a mean age range of 50-70 years, fulfilling the inclusion criteria were included in this study. All the participants received three sets of dentures, followed by assessment of speech using photo articulation test, speech intelligibility and acoustic analysis in edentulous state and subsequently after insertion of conventional denture, denture with customized rugae, and denture with customized metallic base.

Results: The data collected was subjected to statistical analysis using SPSS 24.0 version and GraphPad Prism version 5. The statistical analysis was carried using ANOVA and student t-test. On evaluating the error patterns, distortion was maximum followed by substitutions. These errors were maximum in edentulous state and decreased subsequently, with the least errors in customized rugae dentures. A statistically significant positive correlation (p<0.0001) was found.

Conclusions: Apart from retention, stability and support, equal amount of emphasis has to be laid down on phonetical aspects to improve the overall psychological well-being and social upliftment for patients. The improvement in verbal proficiency for completely edentulous patients can be minimized considerably by customizing the palatal portions.
Management of large mandibular periapical cyst by cortical bone preservation: a case report
Authors: Ahmed Syed Sayeed , Kumar Ranjith , Rahman Tabishur , Ansari Md Kalim
Published: July 2021

 
Management of large periapical cysts often require removal of overlying lateral cortical bone to gain access. We report a case in which huge periapical cyst was treated using a novel technique to preserve the overlying lateral cortical bone to facilitate faster healing of the defect. 
Diagnostic dilemma in a case of chronic invasive fungal sinusitis solved using a novel diagnostic test
Authors: Suresh Malavika , Ganamukhi Maneesh Shivaputra , Ganamukhi Maneesh Shivaputra , Chandran Sobhana , Chandran Sobhana , Sasikumar Saranya , Sasikumar Saranya
Published: July 2021

Fungal infections of the paranasal sinuses are a spectrum of diseases rather than one distinct entity. The prevalence of fungal sinus disease has been increasing in recent decades, especially in immunocompetent individuals. The indiscriminate use of antibiotics and immunosuppressive drugs has partially been attributed to this. The diagnosis of invasive fungal disease still imposes a challenge to medical professionals occasionally. Here we present an interesting case of a middle-aged immunocompetent male who presented to us with non-specific symptoms of chronic invasive fungal sinusitis. The routine investigations for diagnosing fungal sinusitis turned out to be futile and the result of serum galactomannan test helped to identify and treat his condition. 
 
Multifocal facial Rosai Dorfman disease with postsurgical recurrence
Authors: Sen Ishita , Chowdhury Subhadeep , Debnath Tithi
Published: July 2021

Rosai Dorfman disease (RDD) is a histiocytic proliferative disorder with massive painless lymphadenopathy that though is rare yet has been reported more than seldom. Our report aimed to emphasis on a case with multifocal facial involvement with postsurgical recurrence, which had not yet been reported and an approach to alleviate the patient’s symptoms and avert a fatal outcome. This study was a case report and literature review. A 19 year old female presented with swelling involving right sided cheek, periorbital region and bilateral nasal cavity with palatal perforation for last 6 months. She had a past history of debulking of orbital RDD. Contrast enhanced computed tomography revealed an extraconal mass of the right orbit and left nasal mass extending to the nasopharynx. Biopsy taken from the nasal masses showed RDD on histopathology and immunohistochemistry. Though the disease was self-resolving, this patient required radiotherapy as debulking was not sufficient for its multifocal presentation and was followed by palatal reconstruction.
Epiglottic dermoid cyst: a rare case report
Authors: . Ramchandra , Nandyal C. B. , Deshmukh Kiran
Published: July 2021

Epiglottis dermoid cysts are generally benign lesions, which can affect all the age groups. Dermoid cysts arising from the head and neck region are rare, slow growing, and well-circumscribed neoplasm. Symptoms are non-specific and usually related to the size and the location of the lesion. A dermoid cyst of the epiglottis is extremely rare. To the best of our knowledge, only one case has been previously reported in the English literature and a total of three cases were presented in Russian literature in two studies. In our report, a middle-aged male presented with foreign body sensation in throat for 1-year and difficulty in swallowing for three months, mainly for solids. Thorough history, clinical examination and relevant investigation were done. Direct laryngoscopy was done and complete surgical excision was done. The aim of the case report is to present a rare case of epiglottic dermoid cyst, its clinical presentation, radio-logical features and surgical management.
Neonate with congenital absence of the nose: case report
Authors: Nieto-Sanjuanero Adriana , García-Ramírez Arturo , Martínez-Cobos María , García-Martínez Edmundo , De la O-Cavazos Manuel , Quintanilla-Loredo Ramón , Rodríguez-Garza Claudia , Méndez-Sáenz Marco
Published: July 2021

The congenital absence of the nose is called arrhinia and according to the Losee et al classification, it is type I. Total arrhinia is considered if it is associated with the absence of the olfactory system (olfactory tracts and bulbs). In Mexico, there is only one reported case of arrhinia. In this case report, we presented a neonate with a congenital absence of the nose. The absence of olfactory tracts and bulbs was verified with imaging and pathological studies, classifying it as total congenital arrhinia. This case was the first of its type in our country. Since it was a rare condition, there was little bibliography on its management, therefore, coordination between the different specialties is important for proper management.
Oral cavity manifestations by COVID-19 infections: a review
Authors: Swain Santosh Kumar , Debta Priyanka , Sahu Ansuman , Lenka Smarita
Published: July 2021

Coronavirus disease 2019 (COVID-19) is a threat to the global health caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The lungs are the primary site of infection in COVID-19 patient and the symptoms ranges from mild flu like manifestations to fulminant pneumonia and respiratory failure. COVID-19 infection also significantly affects the oral cavity and salivary glands with oral mucosal manifestations. Other than airway manifestations, COVID-19 patients are presenting with oral cavity lesions such as aphthous like ulcers, glossitis, oral mucositis or stomatitis, oral candidiasis and herpetic recurrences. These oral lesions are often associated with immunocompromised patients and elderly age. Direct involvement of the SARS-CoV-2 virus for development of oral ulcers remains uncertain. The salivary gland related symptoms and taste disturbances are highly common in COVID-19 patients. In COVID-19 patient, certain presentations like ulcers or blisters or diffuse reddish lesions affect both keratinized and non-keratinized tissues of the oral cavity. These lesions are found in palate, lip mucosa, buccal mucosa and tongue. The ulceration and blisters of the oral cavity are more often seen. There is still a gap of knowledge related to the oral manifestations of the COVID-19 infections and its impact on the oral cavity. This review article discussed the details of the oral cavity lesions in COVID-19 patients.
Venomous snakebite — Significance of the bite site and local reaction
Authors: Venugopalan Ajith , Vijaykumar Smrithi , Sreekumar G. , Karunanithi Kripanadhi , Prasad Bharath , Sreekrishnan TP , Kumar KP Gireesh
Published: July 2021

Snakebite is an environmental and occupational hazard in India. Death and disabilities due to snakebite remains a major public health challenge. For the fight against this battle a greater investment should be focused on the preventive measures. This includes understanding of the common seasons of snake bites, location and also the site of snake bite. Understanding these will help in taking better preventive measures.

This is a 6-year retrospective observational study of 70 venomous snake bite cases admitted to a tertiary care center in South India. Inclusion criteria has been all confirmed case of envenomation by venomous snake bite. Chi square test was done to find the association between categorical variables.

The study sample size is 70. Mean age in our study is 34.66 ± 18.57 years. 57.1% were male. 79% snake bites occurred outdoor. 57.1 % patients had local reaction along with hemotoxic/neurotoxic symptoms. 28.5% patients had only local reaction. 84% bites occurred in lower limb. 43% bites occurred in the foot. Statistically borderline significant correlation between site of bite and local reaction alone (p=0.05). We could not find a statistically significant correlation between site of bite and local reaction with hemotoxic / neurotoxic symptoms (p=0.236). 59% snake bites occurred during Monsoon season this was followed by post monsoon season.

Snakebite is a neglected tropical disease and remains as an underestimated cause of accidental death in modern India. Significance of bite site along with seasonal variations in snakebites helps in formation of effective preventive strategies, which along with prompt primary treatment holds the key in reducing the impact of venomous snakebite.
Recent advances in thyroid eye disease: An overview
Authors: Agrawal Sahil , Maurya Rajendra Prakash , P R Ananya , Kadir Syeed Mehbub UL , Singh Virendra Pratap , Das Deepsekhar , Gupta Saloni , Singh Vibha , Roy Meghna
Published: July 2021

Thyroid eye disease (TED) is a chronic debilitating condition which causes physical discomfort, oculo-facial disfigurement and compromised visual function. Around 25% of people with Graves’ hyperthyroidism are affected by TED, where 1 in 20 patients might report with moderate-to-severe, active disease that will require medical management for reducing both TED activity and severity. The mainstay of medical management involves intravenous corticosteroids for active moderate-to-severe TED. After accurate understanding of the mechanism and pathophysiology of this disease, investigations and randomized clinical trials have been conducted. The role of immunotherapy targeting and influencing different biomolecular pathways including that of T cells, B cells, cytokines and cell surface receptors have been investigated in various randomized clinical trials. This review article addresses the epidemiology, associated risk factors, recent advances in pathophysiology, newer diagnostic tools and current management options available for TED which include the use of immunosuppressive drugs like rituximab (RTX), tocilizumab, infliximab (IFX), etanercept ( ETN) and teprotumumab etc.
Management of impacted corneal foreign bodies: A review
Authors: Das Deepsekhar , Agrawal Sahil , J S Raj Sandton , Modaboyina Sujeeth , Bafna Rahul , Gupta Saloni
Published: July 2021

Corneal foreign bodies are commonly seen in an ophthalmology emergency. The most common cause of this condition is a workplace-related injury. In these situations, the management differs from patient to patient and depends on a wide range of variables. In this article, we aim to review the literature on corneal foreign bodies in the past 50 years and classify them based on their level of impaction and elaborately discuss all the management options described for each.
Sex hormones and dry eye disease: Current update
Authors: Prakash Maurya Rajendra , Gupta Ashish , Verma Shivani , P Singh Virendra , Singh Anup , Singh Vibha , Roy Meghna , Mehla Lokesh , Kumar Rahul
Published: July 2021

Dry eye disease (DED) is a multifactorial disorder of the ocular surface that results in ocular discomfort, visual disturbance and damage to the ocular surface. It is one of the most common complaints in daily ophthalmic practice. The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. Sex hormones; estrogen and androgens influence production of all components of the tear film including aqueous layer, lipid layer, and mucin layer. Various mechanisms such as decrease in hormonal levels, shift in feedback mechanisms, and changes in receptor receptivity interplay to alter the ocular surface homeostasis and subsequently result in DED. The purpose of this review is to briefly outline current scientific evidence on the influence of androgen and estrogen on the lacrimal and meibomian glands as well as on the ocular surface epithelia including conjunctival goblet cells during reproductive and menopausal periods. This article also outlines the updates regarding role of gonadal hormones in the treatment of dry eye.
Epidemiology, clinical profile, complications and treatment outcomes of chronic dacryocystitis in a tertiary care hospital in post lockdown era: An observational study
Authors: Ghosal Antarlin , Khilar Jyotish , Rout Nirupama , Chaudhury Pranati , Kumar Siddharth
Published: July 2021

to study the epidemiological factors, clinical features, complications and treatment outcomes of chronic dacryocystitis in Odisha after nationwide lockdown in 2020.

An observational study was designed from July 2020 to December 2020 in Regional Institute of Ophthalmology, Cuttack, Odisha. Total of 187 patients presenting with chronic dacryocystits were evaluated thoroughly in various epidemiological parameters. The history and clinical features were noted. After proper evaluation and conservative treatment, those patients were subjected for surgery and the surgical outcomes are followed-up upto 3 more months, i.e. March 2021.

: The prevalence of chronic dacryocystitis was around 1.224%. Among the 187 patients, 112 were females (59.9%). The disease was found in highest proportion in the age group of 51-60 years (30.5%) followed by 25.7% in the age group of 61-70 years. 90.4% were from rural population. Socioeconomic status and living standard was found to be a significant factor, people belonging to class 4 & 3 were affected more. Majority of the affected were housewives (39.6%) and farmers (21.9%) followed by small businessmen (13.9%) and wage laborers (12.9%). Epiphora was the commonest presenting symptom in 71.6%, followed by mucopurulent discharge in 29.9% and swelling near the medial canthus in 12.3% cases. Complications like conjunctivitis, keratitis, preseptal cellulitis, cutaneous fistula were present in 6.4%, 8.4%, 7.5% and 5.9% cases respectively in our study group. The success rate of external DCR was reported as 85.8% in this study.

Chronic Dacryocystitis, though a common problem of lacrimal drainage system, is much less recognized disease, specially in rural population and in lower socio-economic community in Odisha. Thus patients may present late with one or more complications, e.g. conjunctivitis, keratitis, preseptal cellulitis, lacrimal abscess, mucocele, cutaneous fistula, which is the current scenario in post-lockdown 2020 era. Maintaining all precautions and guidelines for COVID-19, we should not delay treating these patients with surgical measures. The surgical success rate (85.8%) however was not affected much in spite of all these factors.
Ocular manifestations in road traffic accidents
Authors: Bokhari Syed Saifullah , Sujatha M.A Rani
Published: July 2021

Road traffic accidents (RTAs) are the most common cause of polytrauma. This study aims to evaluate the various ocular manifestations in cases of RTAs.

A retrospective review of patients who were treated for RTAs in a tertiary hospital in 6 months from December 2018 to May 2019. A total of 126 patients were reviewed. Age ranged from 2 to 85 years. The mean age was 32 years.

Ophthalmological examination was undertaken in all patients involved in RTA. Out of 126 patients, 112 were males and 14 were females. Young adult males (21-30 years) were most vulnerable to RTAs. Soft tissue injuries were the most common manifestations (57.93%) followed by neuro-ophthalmic manifestations (26.98%) and orbital fractures (15.07%). The presence of CT abnormalities especially intra cranial haemorrhage was associated with neuro-ophthalmic deficits.

Soft tissue injuries were the most common ocular manifestations. It was found that head trauma causes many neuro-ophthalmic manifestations. Relative afferent pupillary defect (RAPD) was the most common neuro-ophthalmic manifestation. The most common cranial nerve involved was found to be oculomotor nerve. Retrobulbar neuritis was a rare finding.
Ophthalmic manifestations in head injury- A prospective study
Authors: Amudhavadivu S , Rosita J Helen , Gnanselvan J
Published: July 2021

The eye because of its location in the head and its proximity and neuronal connection with the brain, makes it more vulnerable in head injuries. An increase in the affordability and the attitude of younger generation has lead to the increased incidence of head injuries. Most of the times the ophthalmic manifestations are missed in early stages, where life saving assures the prime importance. This results in grave ocular complications when the patient survives.

Various patterns of ophthalmic manifestations following head injury are studied. The grave situations are explored and importance of safety measures may be emphasized.

All patients who sustained head injury with ophthalmic manifestations were enrolled in this study. They were subjected to thorough clinical evaluation, tests for visual acuity, color vision, examination with slit lamp, ophthalmoscope, ultrasound b scan, gonioscopy and various imaging techniques, other specialty opinion was also obtained whenever required.

Distribution of cases according to the age, sex, mode of injury, laterality of the eyes was studied. Various ophthalmic presentations associated involvement of the orbital walls and cranial nerves were analyzed. Visual acuity at the time of presentation was correlated.

The common mode of head injury which had considerable morbidity was found to be Road traffic accident. Precautionary measures should be initiated that may decrease these kinds of morbidities. These patients should be properly evaluated, monitored and managed.
A clinical study on dry eye
Authors: Prakash Kinikar Vijay , Pendyala Yashaswi , Vijay Kumar K
Published: July 2021

The purpose of this study is to evaluate prevalence risk factors, symptoms, signs, objective tests of dry eye diagnosis in patients attending to Out Patient Department of Mamata General Hospital, Khammam.

All patients presenting with dry eye symptoms to ophthalmology outpatient department, Mamata Medical College over a period of one and half year. A prospective study was conducted for a period of 18 months from June 2018 to Jan 2021 among patients attending ophthalmology Out Patient Department unit with symptoms of dry eye.

Among the 100 patients studied, prevalence of dry eye was found to be as high as 23%.The prevalence of dry eye increased with increase in age and was significantly higher among people more than 40 years of age. Prevalence was higher among females when compared to males. Conjunctival congestion was found to be reliable sign of dry eye with a strong positive association. Foreign body sensation was found to be the most common symptom associated with dry eye. People with refractive errors, with or without history of spectacle use, had a higher incidence of dry eye compared to emmetropes. OSDI was found to be reliable measure of dry eye symptoms. Higher, scores of OSDI, indicating severe dry eye, correlated well with diagnostic tests for dry eye. TBUT test showed a high sensitivity and specificity, followed by Schirmers test and impression cytology. Impression cytology was a reliable measure for detecting ocular surface changes. Many patients showed grade 2 or 3 changes. These changes were more among those with schirmer less than 5mm.

Dry eye evaluation with an appropriate and standard questionnaire along with standard tests for dry eye helps in diagnosis and treatment. This will go a long way in the effective and successful management of patients with dry eye, specially so as the disease is chronic and needs long term treatment. Early and appropriate management will provideocular comfort and satisfaction with a better quality of life.
Treatment of cystoid macular edema in a patient with primary open angle glaucoma and diabetic retinopathy by withdrawal of travoprost
Authors: Sagar N Shiv , Kalpana BN , YD Shilpa
Published: July 2021

To study the association of cystoid macular edema (CME) and Travoprost eye drops in a patient with diabetic retinopathy (DR).

The study was carried out on a 65yr old patient on a regular follow up from 2009-2018.

A 65yr old patient of a DR of both eyes who had received 3 sittings of pan retinal photocoagulation (PRP) laser in both eyes and grid laser to his right eye. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Patient was also on topical antiglaucoma medication and had prophylactic YAG-PI done both eyes. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Right eye showed macular edema (ME) in 2014 and underwent OCT and FFA. Patient refused for intravitreal injection and preferred laser treatment, so patient underwent micropulse laser treatment in 2014. His edema persisted even after micropulse treatment. His systemic control was good and patient continued to use Travoprost eye drops. So in 2017 suspected CME secondary to topical prostaglandin (PG) analogue as he had strict glycemic control and was no fluctuation in ME. Hence topical PG analogue was withdrawn and stopped. On subsequent follow up after 2 months CME had completely disappeared and the foveal contour returned to normal on OCT. LE was status quo. Patient was followed up for more than 1 year and continuously followed up, 15 days back in June 2018 had no evidence of CME and vision was 6/9 in both eyes.

: Differentiation of DME and CME secondary to PG analogue should be made at the earliest.
Severe dry eye associated with Steven Johnson Syndrome: A case report
Authors: Shree Namrata , Deka Baby , Bhattacharjee Rajneel
Published: July 2021

: Stevens-Johnson-Syndrome (SJS), and its severe variant, toxic epidermal necrolysis (TEN), are life-threatening diseases of skin and mucous membranes. Cases with pseudo-membrane formation and epithelial defects, have higher risk of ocular sequelae. Severe dry eye in SJS includes three mechanisms: (1) aqueous tear deficiency, (2) decreased wettability of corneal surface, and (3) increased evaporation.

: A 47-year-old male patient presented in OPD with chief complaint of severe discomfort and grittiness in both eyes since last 21 years. Proper history taking and examination was done. Patient was given conservative treatment and was explained about recent advancements of treatment that can help in improving his condition.

: In SJS patients, dryness causes eye pain, and unstable tear film causes diminution of vision. After acute stage reactions, visual impairment and severe dry eye are observed as ocular sequelae.
The Reconstruction of Russian Prototype of Greek Life of Saint Metrophanes of Voronezh
Authors: Bibikov Mikhail
Published: July 2021

The article presents a reconstruction of the Russian Life of Saint Metrophanes of Voronezh which became the basis for a Greek translation made at Athos. Saint Metrophanes, a famous fellow-champion of Emperor Peter the Great, died in 1703 and was canonized in 1832. The manuscript of the Life was has been recently discovered in the archives of the Russian Saint Panteleimon monastery on Athos and introduced into academic use. The author and copyist of the text was the Athos monk Iakobos Neasketiotes. “The Athonias” has survived in four manuscript copies, all of them autographs of Iakobos Neasketiotes, which are preserved in the archives of Athonite monasteries, namely the Skete of Saint Anna and the Saint Panteleemon and Vatopedi monasteries. They are dated to the years 1848, 1855, 1860 and 1865.
A View from the East. The Council of Florence (1438—1439) in Russian Historiography and Theology of the 19th and20th Centuries
Authors: Mainardi Adalberto
Published: July 2021

Sergius Bulgakov considered the Council of Florence as the theological and spiritual foundation for the real, though invisible, unity of the Churches of East and West. He was following in the footsteps of Vladimir Solovyev, who deemed the Council of Florence one of the historical preconditions for the reunion of the Churches. After a survey of Old Russian sources on the Council of Florence and a short discussion of codicological studies on them, the article offers a reconstruction of the events connected to Russian participation in the Council. In the second part, different historical-critical accounts and theological reinterpretations of the Council in Russian theology from the nineteenth and twentieth centuries are analyzed.
The Embassy Headed by Petr Mansurov and Semen Samsonov (1615—1619) and the “Greek” Secular Migration
Authors: Oparina Tatiana
Published: July 2021

The article studies the lives of immigrants who came from the Ottoman Empire to Russia with the Embassy of Petr Mansurov and Semen Samsonov. The archival material allows us to trace the lives of the immigrants and their descendants in Russia up to the mid/late 17th century. The documents also offer a possibility to reconstruct the social status of the immigrants in the Ottoman Empire. Almost all of them belonged to the military class and had previously moved from the Balkans to the Danube principalities. In Russia, they retained their social status and were engaged by the Office for foreign military servants affairs (Inozemsky Prikaz). Many died while guarding Russia’s southern borders. Only one person lived a long life in Russia — Nikolai Kralev, who rose to the rank of captain. He spent about 33 years in Russia. The obtained information expands our understanding of the mechanisms of adaptation and the ways of naturalization of “Greek” immigrants in Russian society.