bluuebunny/crossref_metadata_2025 huggingface dataset:
Open thoracotomy and decortication for chronic empyema thoracis: Our experience
Authors: Umar Abubakar , Ismail Salisu , Abdulkarim Aitek Abdullahi , Abdulrahman Aliyu , Galadima Ibrahim , Abbas Aminu , Haliru Tambuwal Sirajo , Ukwuani I. Solomon , Abdullahi Isah , Maishanu Moyijo
Published: October 2021

Empyema thoracis is defined as the presence of pus in the pleural space or a purulent pleural effusion. Chronic empyema is characterized by thickened visceral and parietal peels, which hamper the ability of the affected lung to re-expand and require definitive surgical intervention. In a resource constraint environment like ours, open thoracotomy and decortication is the treatment of choice. We review our experience with cases of chronic empyema thoracis that had thoracotomy and decortication. This is a descriptive, retrospective, and observational study. Medical records of patients who had thoracotomy and decortication on account of chronic empyema thoracis in the Cardiothoracic surgery unit of our hospital between 2012 and 2020 were retrieved and reviewed. The information obtained from the records included sex, age, premorbid conditions, aetiology of empyema, cultures of pleural fluids, histology results of the cortex removed, duration of chest tube drainage, duration of hospital stay, postoperative complications, and outcome. One hundred and eighty-five patients diagnosed with empyema thoracis were seen in the study period. Sixty-five patients had thoracotomy and decortication on account of chronic empyema thoracis while the remaining 120 (64.9%) had closed tube thoracostomy drain insertion. Male: female was 5:1, mean age at presentation 24.24 years with age ranging from 2 years to 70 years. Fourteen (23.33%) were in the paediatric age group while the remaining (76.67%) were adults. The aetiology of empyema was pneumonia in 36 (60%). Strept pneumoniae was the commonest organism isolated from pleural fluids of these patients accounting for 23.33%. All patients underwent thoracotomy and decortication. The mean duration before surgery was 17 days with a range of 2 days to 40 days. The average duration of surgery was 2 hours. Chest tube was removed after an average of 7 days (range 5 to 33 days. Twenty-one patients (35%) had complications. The average duration of drainage was 18.87 days and that of hospital stay was 36.74 days. There were 3 mortalities (5%). The mean duration of follow-up was 3 months. Chronic empyema thoracis is still common in our environment and presentation is usually very late. In our series, open thoracotomy and decortication was found to be an excellent procedure with low morbidity and mortality. The majority of our patients had good functional outcome with few complications.
The role of computed axial tomography in the study of the mummies of Akhmim, Egypt
Authors: Elias Jonathan , Lupton Carter
Published: October 2021

For more than a quarter century, computed axial tomography (CT) has given Egyptologists an increasingly sophisticated, non-invasive means of examining the interior of mummified bodies. What has been lacking from mummy studies to date is a regional focus confining itself to a single, defined population which makes its comparisons within narrowly defined limits of time and space. A study of Akhmimic mummies, hundreds of which entered the museum collections of Europe, America and elsewhere late in the 19th century, promises to greatly benefit the study of Egyptian mummification generally while gathering specific data on Akhmim’s priestly population of the Ptolemaic period (332-30 BC). Recent CT examination of two female mummies from Akhmim has underscored the importance of considering features other than those on the traditional list of mummy contents. While amulets, visceral packets, and linen wadding have been noted for years, it is clear that they existed side by side with objects that, while difficult to classify, were equally deliberate and significant. The Akhmim Studies Consortium has been established to increase our knowledge of these poorly understood aspects of the embalming process as it existed at Akhmim and in surrounding locale
Preservation and identification of ancient M. tuberculosis complex DNA in Egyptian mummies
Authors: Zink Albert R. , Köhler Stephanie , Motamedi Nasim , Reischl Udo , Wolf Hans , Nerlich Andreas G.
Published: October 2021

For years we have investigated the presence and molecular evolution of tuberculosis in Pre Dynastic and Early Dynastic Egyptian mummy material from Abydos (c. 3500-2800 BC), Middle and New Kingdom until the Late Period in Thebes-West (c. 2050 – 500 BC). We have analysed 160 bone and soft tissue samples from different time periods and populations for the occurrence of M. tuberculosis complex DNA. All positive specimens were genetically characterised by spoligotyping and mutation analysis. Molecular analyses revealed excellent state of preservation of the specimens. Research showed a high incidence of M. tuberculosis during all time periods. We further detected specific MTB strain differences with M. africanum in some of the Middle Kingdom samples and “modern” M. tuberculosis strains in the New Kingdom to Late Period material. These results demonstrate that aDNA is excellently preserved in ancient Egyptian mummies allowing the reconstruction of occurrence, frequency, molecular evolution and spread of tuberculosis in Pharaonic populations.
Detection of Plasmodium falciparum ancient DNA in Egyptian mummies
Authors: Cerutti Nicoletta , Santovito Alfredo , Turina Massimo , Crobu Francesca , Rabino Massa Emma
Published: October 2021

The detection of ancient microbial DNA offers a new approach for the study of infectious diseases, their occurrence and host – pathogen interaction in a diachronic view, over the centuries.Moreover, the data that are obtained from the skeletal and mummified tissue may represent an important completion of contemporary phylogenetic analyses of pathogens. [...]
Autopsy on the mummy of "Fin-Renard", Bourges (France)
Authors: Thillaud Pierre , Glon Yves , Charlier Philippe , Vignal Jean-Noel
Published: October 2021

Discovered in 1908 in a lead coffin conserved in a stone sarcophagus, the mummy of the “Fin-Renard” from Bourges, central France, was immediately identified as that of a gallo-roman child. The circumstances of his death as the extraordinary conservation of his body were the object of many conclusions related to contemporaneous medicohistorical knowledge and limited by partial investigation potentiality. The preparation of the exhibition Maternité et petite enfance dans l’Antiquité Romaine” (“Maternity and childhood in Roman Antiquity”) presented at the Museum d’Histoire Naturelle at Bourges in 2003/2004 necessitated the reexamination of the body. The application of the most actual paleopathological methods and techniques permitted a more precise observation of this unique but surprising French specimen. However, after many radiographic, scannographic, fibroscopic and microscopic studies, the little mummy conserves many of its mysteries
Forensic, anthropological and pathological analysis of the Guanche mummies from Necoche (Argentina)
Authors: Rodríguez-Martín Conrado , Guichón Ricardo , Flegenheimer Nora , Martín-Oval Mercedes
Published: October 2021

The two Guanche mummies sold to Argentinean businessmen at the end of the 19th century are known as NEC-1 and NEC-2. NEC-1 is a young female, very gracile, showing severe stress markers. NEC-2 is a young male, tall and robust for the time in which he lived, and shows a lethal lesion in the skull with a trephination in the base. In this paper we present the most prominent forensic anthropological data of both mummies, as well as the pathologies observed, the differential diagnosis of the lesion in NEC-2, and the possible causes of death of both individuals along with the methods used in these studies.
Pollen analysis from the resin used for embalming a mummy from the Roman period of I century AC – Museu Nacional (MN/UFRJ), Brazil
Authors: Chaves Sérgio A. de Miranda , Brancaglion Jr Antonio
Published: October 2021

Human embalming was practiced widely by the Egyptians using resins extracted from shrubs, trees, or by the use of propolis – also known as bee’s glue. These resins that formed from terpenic derivates, retain a variety of remains: the epidermis of plants, grains of sand, pieces of coal, and grains of pollen.Pollen analyses were made on a mummy belonging to the Egyptian collection of the Museu Nacional: the “Singer of the Temple of Amon”, dated around 750 AD. This is a rare mummy from the Roman period because the limbs were buried separate from the body. We can find only seven mummies buried in this way in the European collections. Our results expand our knowledge about the use of plants which were given as offering or presented at the moment of burial, as indicated by pollen grains through the time.
The tools of the Ancient Egyptian embalmers
Authors: Brier Bob , Wade Ronald S.
Published: October 2021

Although a considerable amount has been written about mummification techniques used in ancient Egypt, surprisingly little has been said about the tools the embalmers used. We survey the literature, discuss archaeological finds including embalmer’s caches, and then present some findings based on an experimental mummification of a human cadaver.
Too small to be noticed? Children mummies reveal they stories
Authors: Bourbou Chryssi
Published: October 2021

The study of sub-adult remains, either skeletal or mummified, has been always a fairly neglected subject of bioarchaeology. Regarding mummified subadult remains, it mainly seems that fascinating stories (i.e., mountain sacrifice mummies) are usually discussed in detail. However, whilst childhood is a biological stage of human development, it is also a social construct and many past and present societies assign different values and meanings (i.e., cultural beliefs, social tensions) to the dead child. This presentation addresses the biocultural context of children mummies based on a meticulous survey of up-dated published reports. In addition, paleopathological observations are discussed, as well as the future need for systematic studies of subadult mummies (i.e., mortality patterns, maternal mortality).
The international ancient Egyptian mummy tissue bank
Authors: Lambert-Zuzulak Patricia I.
Published: October 2021

This paper will present an outline of the history and purpose of the setting up of the International Ancient Egyptian Mummy Tissue Bank at the University of Manchester. Initiated in the context of the worldwide Schistosomiasis Research Project, the Tissue Bank aims to locate ancient Egyptian human remains worldwide outside of Egypt. Where it is possible, and when permission can be granted, the Tissue Bank collects deposits of small samples of mummy tissue, in order that they may be available for use in appropriate scientific research projects. Non-destructive sampling techniques, including endoscopy, are applied in order to preserve the conservation of mummies and to handle and store human remains ethically. Research facilitated by the large numbers of samples deposited in the Tissue Bank includes the palaeoepidemiology of schistosomiasis and other diseases, as well as the study of lifestyle and cultural factors, including insights into medical practices and embalming techniques.
Egyptian and Middle Eastern mummies in public museums outside Egypt
Authors: El-Bcherauoi Charbel , Dutour Oliver , Boetsch Gilles
Published: October 2021

The issue of this work is to locate the collections of Egyptian and Middle Eastern mummies around the world. To do so, we have taken contact with several museums around the world (we can mention the British Museum, the Louvre, the Smithsonian Institution, the museum of Torino…), consulted many publications concerning these mummies in addition to visiting lots of net sites build about this subject. In result, we have approximatively succeeded to get the number of these mummies, their taphonomy - trying to show the degree of concern between the museums and the methods of their conservation - and the documentations made about them. This work puts the light mostly on mummies not really known worldwide.
New aspects to the diet of the Neolithic Tyrolean Iceman “Ötzi“
Authors: Oeggl Klaus , Kofler Werner , Schmidl Alexandra
Published: October 2021

Three surgical interventions on the Tyrolean Iceman “Ötzi” conducted in 1995, 1997 and 2000 resulted in the collection of five ingesta samples. These samples constitute a sequence from different consecutive locations of the intestinal tract: the ileum, the transverse and descendent colon, as well as the rectum. The samples encompass at least three different meals consumed of the Iceman during his last two days, which is shown by numerical analysis of the pollen flora and muscle fibres incorporated in the different ingesta samples. The macro and pollen analyses of these samples reveal that the Iceman consumed a well balanced omnivore diet. Surprising is the strong correlation between bracken (Pteridium aquilinum) spores and human whipworm (Trichuris trichiura) eggs as well as wheat (Triticum) pollen. This indicates an intentional consumption of bracken as anthelminthic or as starch plant.
Studying the Effect of Particulate Matter as SARS-CoV-2 Transmitters
Authors: Hakami Abdulrahim R. , Dobie Gasim
Published: October 2021

Background

Studies of risk factors are especially valuable at this difficult time in the midst of a pandemic. High levels of particulate matter (PM) represent a serious risk factor on health. While this is a direct impact on health, indirect effects are worth considering too.

Design and methods

The aim of this study was to investigate the role of PM in the transmission of viruses, especially SARSCoV- 2. Also, we sought to understand dynamics of PM in still air at high and low altitudes. Historic AQI and physical PM measurements were collected between August and September 2020 using air quality detector. Potential correlations between the number of total confirmed COVID-19 cases and average air quality index (AQI) from varied geographic locations were also assessed.

Results

Airborne PM levels were weakly associated with COVID-19 cases after analysing 77 territories. PM remained longer in the air at high altitudes compared to measurements made at sea level. This suggests that the link between PM and COVID- 19 transmission could be aggravated in areas of high altitude.

Conclusions

This article highlights that particulate matter can be involved in SARS-CoV-2 transmission. However, confounding factors may have impacted the association between the two variables. These findings can serve as a foundation for future studies on the effect of air pollutants and fine particulate matter on viral transmission.
Looking ahead
Authors: Dart Raymond Arthur
Published: October 2021

Na abstract available.
Anterior Subconjunctival Anesthesia for Manual Small Incision Cataract Surgery
Authors: Ajay K. , Subhasree Revuru Kanaka , Poka Avinash
Published: October 2021

Purpose:

To compare the effectiveness of anterior subconjunctival anesthesia (ASCA) with sub-tenon's anesthesia (STA) for manual small incision cataract surgery (MSICS), regarding pain, akinesia, surgeon comfort, and complications.

Methods:

This trial randomized 164 patients into two groups. Group 1 received ASCA, and Group 2 received STA. MSICS was performed on all patients. Any complications of anesthesia were noted before starting surgery. Patient ocular motility during surgery was scored between 0 and 4 based on the number of directions of gaze in which movement persisted. Following surgery, patients scored pain felt during surgery on a visual pain-score analog, and the surgeon graded for “discomfort” felt during surgery from 0 (Nil) to 4 (additional anesthesia needed).

Results:

Chemosis due to anesthesia and persistence of ocular motility in all four gaze directions were seen in all 82 patients of Group 1, but these did not prevent the surgeon from performing MSICS. Seventy-seven patients (94%) in Group 1 and 79 (96.4%) in Group 2 had no or mild pain during surgery. The surgeon had moderate-to-severe discomfort in 14 (17.2%) Group 1 patients and 3 (3.6%) Group 2 patients, most of whom had deep-set eyes or exhibited excessive eye movements. Two patients in Group 1 and one patient in Group 2 were converted to peribulbar block.

Conclusion:

ASCA is a safe and effective alternative for performing MSICS. It does not induce akinesia but provides adequate anesthesia for the surgery in most patients, except those with deep-set eyes, especially if displaying increased anxiety.
Oromandibular Dystonia – A Systematic Review
Authors: Saraf Udit , Chandarana Mitesh , Divya K. P , Krishnan Syam
Published: October 2021

Oromandibular dystonia (OMD) is a clinical problem which is commonly encountered in the practice of movement disorders. OMD results from a variety of genetic and acquired etiologies and can occur as an isolated manifestation, or as part of an isolated generalized or a combined dystonia syndrome. There are only very few systematic reviews on this condition which often causes significant disability. We review here the etiology, clinical features, diagnostic approach and management of OMD.
COVID-19 Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) and Cerebral Venous Sinus Thrombosis (CVST)- Lessons for India
Authors: Khan Erum , Bavishi Shriya , Sharma Arvind K. , Sharma Vijay K. , Goyal Vinay
Published: October 2021

The COVID-19 pandemic evolved rapidly, overwhelming health care systems around the world. The cost to life and socioeconomic burden prompted a search for new treatments and vaccines. Several collaborations developed and could deliver state-of-the-art vaccines with acceptable efficacy and safety in record time. Recently, vaccination with Oxford-AstraZeneca and Johnson and Johnson vaccines was halted due to the reported adverse effects of vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST). Although a detailed risk-benefit analysis led to their reinstitution, physicians across the world are still trying to understand the pathophysiology and mechanisms of these neurological adverse effects in order to better identify, diagnose, and treat them. One of the mechanisms that have been implicated is related to the adenovirus-based vector of these vaccines. COVISHIELD, which is the most widely administered vaccine in India, also shares the same vector. As India enters the next phase of vaccine distribution for younger adults, there are chances that such adverse effects may emerge. In this review, we analyze the temporary suspension of the administration of the vaccines due to VITT/CVST, summarize the existing guidelines about diagnosis and treatment of these neurological disorders as well as the need for increasing pharmacovigilance and awareness among physicians. Screening for potential risk factors, avoiding aggravating factors like dehydration, and providing choices in vaccinating the high-risk populations could help in avoiding these rare but potentially fatal adverse outcome.
Management of patients with synchronous head-and-neck and lung cancers
Authors: Paleiron Nicolas , Gervais Radj , Rousseau-Bussac Gaelle , Game Laurence Bigay , Chiappa Anne Marie , Lamy Regine , Guisier Florian , Le Caer Hervé , Robinet Gilles , Bizieux Acya , Chouaïd Christos
Published: October 2021

Purpose:

Few data have been published on the management of patients with synchronous head-and-neck cancer (HNC) and lung cancer (LC). This observational study was undertaken to describe the management of these patients in multiple centers.

Materials and Methods:

All patients consecutively diagnosed with synchronous HNC and LC in 26 French centers were included. Information was collected on patients' clinical characteristics, management, and outcomes. Those characteristics and treatments were analyzed descriptively. Kaplan–Meier progression-free and overall survival probabilities were estimated.

Results:

The study included 132 patients: 83% male; median age: 63.7 (range: 62.1–65.4) years; all current or former smokers; Eastern Cooperative Oncology Group performance status: 0 or 1 for 21.9% or 65.9% of the patients, respectively; cardiovascular comorbidities: 63%; chronic obstructive pulmonary disease: 33%; and previous cancer: 11%. HNC histology was 98% squamous: 23.5% oral cavity, 26.5% oropharyngeal, 22.0% hypopharyngeal, and 28.0% laryngeal. LCs were mainly localized (47.7% Stage I and 9.9% Stage II): 38% squamous, 49% adenocarcinomas, and 13% others. LC diagnosis impacted HNC management for 38% of the patients, with a median time from HNC diagnosis to first HNC treatment of 40 days. HNC impacted LC management for 48% of the patients, with a median time from LC diagnosis-to-LC treatment interval of 41 days.

Conclusions:

Synchronous LC at HNC diagnosis impacted management and outcomes of both cancers. Specific recommendations should be elaborated to improve the management of these patients.
Evaluation of the quality of life of patients with maxillofacial defects after prosthodontic rehabilitation
Authors: Matapathi Neelanjali , Shenoy Vidya K. , Shenoy Ramya , Miranda Glynis A. , Upadhya Mithun , Mehendale Avinash , Bangera Blessy , Shenoy K. Kamalaksh
Published: October 2021

Context:

Oral cancer surgery leads to hard- and soft-tissue loss which can affect the quality of life of the individuals. Maxillofacial prosthodontics focuses on optimizing the disrupted oral function of individuals whose rehabilitation will serve as a psychosocial therapy.

Aim:

The aim of this study was to assess the oral health-related quality of life (OHRQoL) after the maxillofacial prosthetic rehabilitation following cancer resection surgery.

Settings and Design:

The sample comprised 15 oral cancer patients who agreed to maxillofacial prosthesis (MFP) after surgery.

Materials and Methods:

Oral function and OHRQoL were evaluated pre- and postmaxillofacial prosthetic rehabilitation. The masticatory function, swallowing function, and articulatory function were evaluated. The OHRQoL was evaluated by OHIPJ-14 questionnaire. Descriptive methods such as frequency, percentage, mean, and standard deviation were calculated.

Statistical Analysis:

Descriptive statistics was used to analyze the results.

Results:

A statistically significant difference was observed between prescores and postscores of dysphagia score (P = 0.05) and OHIP-J14 score (P = 0.00). No statistically significant differences were evident in perceived chewing ability (P = 0.29) and intelligibility score (P = 0.43). A statistically significant difference was evident in the prescore and postscore of OHIP-J14 subscales: functional limitations (P < 0.05), physical pain (P < 0.05), psychological discomfort (P < 0.05), physical disability (P < 0.05), psychological disability (P < 0.05), and handicap (P < 0.05), before and after maxillofacial prosthetic treatment except for social disability (P > 0.05).

Conclusion:

OHRQoL significantly improved with maxillofacial prosthetic rehabilitation.
Comparative outcomes of short-term and long-term fractionation with temozolomide in older glioblastoma patients
Authors: Uysal Bora , Gamsiz Hakan , Sager Omer , Dincoglan Ferrat , Demiral Selcuk , Ozcan Fatih , Colak Onurhan , Beyzadeoglu Murat
Published: October 2021

Background:

The main goal of our study is to comparatively evaluate outcomes of hypofractionation and long-term fractionation with temozolomide (TMZ) in glioblastoma patients older than 65 years.

Methods:

Eighty patients with glioblastoma meeting the eligibility criteria of >65 years of age, the Karnofsky performance score (KPS) >60, no previous radiotherapy (RT) to the brain referred to our department between October 2009 and October 2016 for adjuvant chemoradiotherapy after surgery were studied. The first group of patients received a dose of 6000 cGy in 30 fractions and the second group was delivered 4000 cGy in 15 fractions All patients used TMZ concomitantly with RT. We used the paired t-test and the Wilcoxon signed-rank test with Statistical Package for the Social Sciences, version 15.0 (SPSS, Inc., Chicago, IL, USA) software for statistical analysis.

Results:

Forty-six patients were men (57.5%), and 34 patients (42.5%) were woman. Median age was 68 years (range 66–87). Median KPS was 75 (range 60–100). Median follow-up time was 12 months (range 6–30). Median overall survival was 15.2 months and 14.3 months for patients with hypofractionation and conventional fractionation, respectively, with no statistical significance (P = 0.13).

Conclusion:

Hypofractionation should be recommended to the elderly glioblastoma patients older than 65 years because of the short treatment time, reduced acute adverse effects of both TMZ and RT compared to long-term fractionation.
A Case Report of Coinfection of Cytomegalovirus Colitis and Tuberculosis of the Intestine in an Older Patient with Heterozygous Beta-Thalassemia-Induced Immunodeficiency
Authors: Singhal Sunny , Desai Gaurav , Dey Aparajit Ballav
Published: October 2021

While thalassemia major is a known immunodeficient state, reports of thalassemia minor presenting with immunodeficiency are rare. We present a 66-year-old male with acute abdomen, hemorrhagic colitis, and septic shock. He was diagnosed with coinfection of intestinal tuberculosis and cytomegalovirus colitis secondary to an immunodeficient state due to heterozygous beta-thalassemia.
Online Course in Geriatrics for Final-Year Medical Students
Authors: Bhatt Arun N. , Ganesh Gayatri , Adhikari Prabha , Ganesh Alka
Published: October 2021

Background:

The new competency-based MBBS undergraduate curriculum articulates 24 competencies in geriatrics. Acknowledging the dearth of faculty in the country, a group of geriatricians developed and conducted an online modular course for final-year medical students.

Methods:

This 6-week online course included 13 modules and the study materials were developed through a two-stage vetting process. The course was advertised to potential students through social media and was delivered over Google classroom platform. Students' learning was assessed by multiple-choice questions (MCQs), and the course was evaluated with comparison of pretest and posttest, feedbacks from students with both structured and open-ended questionnaires.

Results:

Out of 200 eligible students from 38 medical colleges who applied, 142 students joined the course. Out of 142 students joined, 98 (69%) completed the course with 80% attendance; 91 (64.1%) secured scores above 50%; and 46 (32.4%) secured scores above 80% in MCQ test. Posttest scores were significantly higher than pretest scores (P < 0.001) with medium Cohen's effect size. Median scores of feedbacks on 20-point Likert scale for all modules were 15 or 16. Content analysis of qualitative feedback showed appreciation for the structure and content of the course, praise for the expertise and commitment of the faculty in delivering it effectively, scope for further improvement, and positive change in attitude toward discipline of geriatrics.

Conclusions:

This endeavor shows that short online course will be helpful for motivated medical students to expand their knowledge in geriatrics.
Knowledge, Attitudes, and Practices among Older Adults of Urban Rajasthan toward COVID-19
Authors: Goyal Laxmi Kant , Sharma Dharmesh Kumar , Wadhwani Dileep , Singhal Sunny , Mathur Arvind
Published: October 2021

Introduction:

With no effective treatment in sight, preventive measures are the only effective way to fight coronavirus. As older adults are highly vulnerable in this pandemic, it is essential to understand and identify gaps in their knowledge, attitudes, and practices (KAP) regarding COVID-19 to address them. The study aimed to assess KAP among older adults of urban Rajasthan toward COVID-19 infection and its vaccination.

Materials and Methods:

The online cross-sectional survey was conducted in June 2021 using a questionnaire with close-ended questions on COVID-19 infection and vaccination with a convenience sample of 100 older adults above 60 years residing in Rajasthan. The questionnaire was developed and validated using Google Forms and circulated via social media.

Results:

The mean age of the participants was 68.2 years. Seventy-four were male and 72 had educational qualification graduate and above. They demonstrated a moderate level of KAP toward the coronavirus infection. However, <5% had completely correct score on either knowledge, attitude, or practices. Knowledge, attitude and practices of subjects regarding vaccination were good. 97% of the participants received at least one dose and 95% agreeing to recommend it to others too. However, only 36% knew that vaccine does not decrease immunity.

Conclusion:

Although older adults had reasonably good KAP relating to coronavirus infection and its vaccination, there are still some misconceptions and malpractices. Further, information, education, and communication activity can promote their positive attitude toward preventive measures into good practice of self-imposed lockdown.
Role of enhanced recovery after surgery in total laparoscopic hysterectomy
Authors: Inania Mili , Sharma Priyanka , Parikh Manoj
Published: October 2021

Introduction:

Enhanced recovery after surgery (ERAS) principles is an evidence-based surgical management approach that requires cooperation across various medical specialties. In this study, we applied ERAS principles in total laparoscopic hysterectomy (TLH) and the post-operative outcomes like post-operative pain, nausea and vomiting, opioid requirement, day of discharge, and any other complaints were studied.

Methods:

The study was conducted in a private healthcare setup in Jodhpur, Rajasthan, India. In this non-randomised controlled study 103 patients who underwent TLH over a period of 1 year were alternatively allocated to the study group and the control group. There were 51 patients in the study group in whom ERAS principles were applied and 52 patients in control group in whom traditional post-operative care was given.

Results:

Post-operative nausea and vomiting and opioid requirement were significantly reduced in the study group (P < 0.05). The post-operative pain was similar in both groups. The majority of patients in study group were discharged within 24 h as compared to the routine discharge after 48 h.

Conclusion:

Following ERAS principles in TLH results in decrease in post-operative nausea and vomiting, post-operative opioid requirement and hospital stay. Hence, the ERAS principles should be the standard practice in TLH even in a developing country setup.
Temporalis Fascia for the Management of Medial Rectus Damage Secondary to Endoscopic Sinus Surgery
Authors: Bagheri Abbas , Veisi Amirreza , Tavakoli Mehdi
Published: October 2021

Purpose:

To report a challenging case of medial rectus (MR) damage secondary to endoscopic sinus surgery (ESS).

Methods:

A 37-year-old woman presented with diplopia, exotropia, and adduction deficit of the right eye due to the right MR injury secondary to the ESS.

Results:

As a stepwise approach, she respectively underwent repairing of the damaged MR plus ipsilateral lateral rectus recession, half-tendon vertical rectus transposition to the MR insertion, and eventually nasal globe fixation with temporalis fascia that ultimately provided a single vision in the primary position with orthophoria.

Conclusions:

Re-establishment of an acceptable field of a single binocular vision in the context of iatrogenic MR injury is challenging and often requires multiple step-wise operations. Temporalis fascia is a safe and strong autogenous material, which can be used for globe fixation in this setting.
In Vivo Confocal Microscopic Evaluation of Corneal Changes in Acute Endothelial Rejection
Authors: Latifi Golshan , Katoozpour Ramon , Ghaffari Reza , Abdi Parisa , Kasiri Maryam , Berijani Sahar
Published: October 2021

Purpose:

To evaluate the microstructural corneal changes during acute endothelial graft rejection and following treatment using in vivo confocal microscopy (IVCM).

Methods:

Patients with a clinical diagnosis of severe acute endothelial graft rejection following penetrating keratoplasty were included in this study. IVCM was performed on the 1st day the patient presented with rejection signs and at the time of clinical resolution.

Results:

Twenty-three patients were included in this study. Inflammatory cells appeared as dendritic cells (DCs) and less frequently, as non-DCs in basal epithelial and subbasal areas. Activated keratocytes (AKs) (type 1: large cells with visible cytoplasmic processes; type 2: elongated and spindle-shaped keratocytes) were visible in acute phase. Following resolution, type 1 AKs considerably reduced, but type 2 cells were more often persisted. Multiple types of keratic precipitates (KPs) were also visible in acute phase which resolved following resolution of rejection.

Conclusions:

Acute graft rejection was associated with an increase in the number of DCs, activation of keratocytes, and aggregation of various types of KPs. Inflammatory process subsided in almost all cases, but the IVCM changes did not return to normal early after clinical resolution of rejection.
Vitreoretinal Surgery Amid Coronavirus Disease 2019 Pandemic Restrictions
Authors: Ilhan Cagri , Citirik Mehmet , Teke Mehmet Yasin
Published: October 2021

Purpose:

To define the characteristics of vitreoretinal surgeries amid coronavirus disease 2019 (COVID-19) pandemic restrictions in Turkey.

Methods:

This descriptive, cross-sectional study was conducted for vitreoretinal surgeries during the 10-week period (during this period, all elective surgeries were postponed across the country by the order of the Republic of Turkey Ministry of Health) in a single tertiary referral hospital in Ankara, Turkey. The number of surgeries, surgical indications, risk factors, etiological factors, and associated conditions were investigated and compared with the clinical features of the patients who underwent vitreoretinal surgery in the same period of the recent year.

Results:

During this period, vitreoretinal surgery was performed more commonly for the male population (P < 0.001). The number of vitreoretinal surgeries was statistically significantly correlated with the number of COVID-19 cases (P = 0.006 and r = −0.791 for weekly numbers of new surgeries and cases, and P < 0.001 and r = 0.929 for cumulative numbers of surgeries and cases). Diabetes mellitus in 26 patients (32.9%) was the most common systemic comorbidity. The most common indication for vitreoretinal surgery was rhegmatogenous retinal detachment in 44 patients (55.7%) followed by diabetic retinopathy complications in 21 patients (26.6%). No one was operated on for vitreoretinal interface disorders during this period, and the rate of rhegmatogenous retinal detachment was higher than the same period of the recent year (P = 0.003).

Conclusions:

Amid COVID-19 pandemic restrictions in Turkey, the number of vitreoretinal surgeries was inversely associated with the number of confirmed COVID-19 cases. The male population needed more vitreoretinal surgery, and rhegmatogenous retinal detachment was the most common indication for all patients.
Pterygium Recurrence Rates in the Hispanic Population in the Northeastern United States
Authors: Fam Anthony , Vohra Reshma , Vadhar Neil R , Dastjerdi Mohammad H
Published: October 2021

Purpose:

To determine the rate and factors affecting pterygium recurrence in the Hispanic population of the Northeastern United States, based on patient demographic information.

Methods:

In this retrospective cross-sectional study, data were collected on ethnically Hispanic patients from 2013 to 2018 who had primary single-headed pterygia excision and conjunctival autograft, with the minimum of 4-month follow-up time. This study was conducted in an academic institution in the Northeastern United States, with all patients being from the surrounding community.

Results:

In 168 Hispanic patients with confirmed primary single-headed pterygium, most pterygia occurred nasally (161/168). The average age of presentation was 46.3 ± 12.0 years (range, 23–77 years). There were 22 recurrences (13.1%), occurring at an average of 3.0 ± 1.6 months (1–8 months). This cohort demonstrated a unimodal recurrence distribution. Age is significantly inversely correlated with the incidence of recurrence (r = −0.219, P = 0.004), but not with the size of the recurrent pterygia (r = −0.112, P = 0.621). There was no significant difference between recurrence based on gender (P = 0.265), location (P = 0.824), or laterality (right or left eye) (P = 0.213). Mean corrected visual acuity improved from 20/40 to 20/32 after pterygium excision (P < 0.001). Cox regression analysis for age groups shows the risk of recurrence for patients aged 20–29 is 11.4-time that of patients aged 50 and above (P < 0.001).

Conclusions:

Recurrence occurred unimodally at around 3 months postoperatively. Younger patients are significantly more susceptible to recurrence. Future studies may seek to determine the incidence of pterygia and their recurrence patterns in relation to occupations and sun exposure time in a geographic area.
Ramsay Hunt syndrome in a young COVID-19 patient
Authors: Alonzo-Correa Claudia P. , Camacho-Martínez Eduardo , Bustamante-Arias Andres , Rodriguez-Garcia Alejandro
Published: October 2021

The severe acute respiratory syndrome caused by coronavirus-2 can present with a broad spectrum of clinical manifestations, mainly respiratory, but also with different neurologic symptoms. On the other hand, the Ramsay Hunt syndrome (RHS) is a complication of varicella-zoster virus (VZV) reactivation presenting mainly in older patients, patients under stress, infection, or an immunocompromised state. We report a case of RHS in a young Mexican female patient who tested positive for SARS-CoV-2 in whom we believe that there is a strong possibility that VZV's unusual reactivation, presenting as RHS in a young patient, might have been a consequence of the immunological alterations induced by this coronavirus.
Impact of medical conditions and medications received during pregnancy on adverse birth outcomes
Authors: Undela Krishna , Gurumurthy Parthasarathi , Sujatha M. S.
Published: October 2021

Purpose:

In view of the raising rate of adverse birth outcomes (ABOs) across the globe, this study was conducted to assess the impact of medical conditions and medications received during pregnancy on ABOs.

Materials and Methods:

A prospective case–control study was conducted at the Department of Obstetrics and Gynecology of a tertiary care hospital over a period of 3 years from July 2015 to June 2018. Liveborn and stillborn neonates included in the study were categorized into cases and controls based on the presence or absence of composite ABOs, respectively. Binary logistic regression analysis was used to identify the risk factors for ABOs among medical conditions and medications received by mothers during their current pregnancy.

Results:

Among 1214 neonates included in the study, 556 (45.8%) were identified with composite ABOs, the majority were low birth weight (320 [26.4%]) and preterm birth 300 (24.7%). After adjusting for confounding factors, it was identified that hypertension (adjusted odds ratio [aOR] 7.3), oligohydramnios (aOR 3.9), anemia (aOR 3.2), nifedipine (aOR 10.0), nicardipine (aOR 5.3), and magnesium sulfate (aOR 5.3) were the risk factors for overall and specific ABOs like preterm birth and low birth weight. It was also identified that the early detection and management of hypertension with antihypertensives like labetalol and methyldopa can reduce the risk of preterm birth by 93% and 88%, respectively.

Conclusion:

Medical conditions such as hypertension, oligohydramnios, and anemia and medications such as nifedipine, nicardipine, and magnesium sulfate during pregnancy were identified as the risk factors for overall and specific ABOs like preterm birth and low birth weight.
Hand Hygiene and Mask-Wearing Practices during COVID-19 among Healthcare Workers: Misinformation as a Predictor
Authors: Wang Senhu , Li Lambert Zixin , van Antwerpen Natasha , Suparman Sutrisno , Gayatri Mergy , Sari Ningrum Paramita , Zhang Stephen X.
Published: October 2021

Poor public health information is a hurdle in infectious disease control. The study aims to examine whether healthcare workers adhere to hand hygiene and mask-wearing guidelines during the COVID-19 pandemic and to explore their exposure to misinformation about the pandemic as a predictor. A cross-sectional survey was sent to 518 healthcare workers across Indonesia, the fourth largest nation in the world, in September 2020 during the COVID-19 pandemic. The respondents reported whether they adhered to the guidelines of hand hygiene and mask wearing and whether they believed in four pieces of misinformation about the origin, severity, contagion, and prevention of COVID-19. The association between misinformation and hand hygiene and mask wearing was tested with logistic regression models controlling for demographic and health-related covariates. Approximately 25% of healthcare workers did not always adhere to hand hygiene guidelines and approximately 5% did not adhere to mask-wearing guidelines. There are significant associations between all four pieces of misinformation and hand hygiene and mask wearing. It is important to improve public health information about COVID-19, which may hold key to healthcare workers’ hand hygiene and mask wearing and to protect their health and patients’ safety.
Long COVID 1 year after hospitalisation for COVID-19: a prospective bicentric cohort study
Authors: Becker Christoph , Beck Katharina , Zumbrunn Samuel , Memma Valentina , Herzog Naemi , Bissmann Benjamin , Gross Sebastian , Loretz Nina , Mueller Jonas , Amacher Simon A. , Bohren Chantal , Schaefert Rainer , Bassetti Stefano , Fux Christoph , Mueller Beat , Schuetz Philipp , Hunziker Sabina
Published: October 2021

AIMS OF THE STUDY: There is increasing interest in better understanding of long COVID, a condition characterised by long-term sequelae — appearing or persisting after the typical convalescence period — of coronavirus disease 2019 (COVID-19). Herein, we describe long-term outcomes regarding residual symptoms and psychological distress in hospitalised patients 1 year after COVID-19.
METHODS: This prospective cohort study included consecutive adult patients hospitalised for confirmed COVID-19 in two Swiss tertiary-care hospitals between March and June 2020. The primary endpoint was evidence of long COVID 1 year after discharge, defined as ≥1 persisting or new symptom related to COVID-19, from a predefined list of symptoms. Secondary endpoints included psychological distress and symptoms of post-traumatic stress disorder (PTSD).
RESULTS: Among 90 patients included in the study, 63 (70%) had symptoms of long COVID 1 year after hospitalisation, particularly fatigue (46%), concentration difficulties (31%), shortness of breath (21%) and post-exertion malaise (20%). Three predictors, namely duration of hospitalisation (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.00–1.22; p = 0.041), severity of illness (OR 1.19, 95% CI 1.04–1.37; p = 0.013), and self-perceived overall health status 30 days after hospitalisation (OR 0.97, 95% CI 0.94–1.00; p = 0.027) were associated with long COVID. Regarding secondary endpoints, 16 (18%) experienced psychological distress and 3 (3.3%) patients had symptoms of PTSD.
CONCLUSION: A high proportion of COVID-19 patients report symptoms of long COVID 1 year after hospitalisation, which negatively affects their quality of life. The most important risk factors were severe initial presentation of COVID-19 with long hospital stays.
Using Machine Learning for Prediction Students Failure in Morocco: an Application of the CRISP-DM Methodology
Authors: Lebkiri Nada , Daoudi Mohamed , Abidli Zakaria , Elturk Joumana , Soulaymani Abdelmajid , Khatori Youssef , El Madhi Youssef , Benattou Mohammed
Published: October 2021

Student failure prediction is one of the main topics in university learning contexts, as it helps to avoid failure in higher education institutions and provides a basis to make the teaching and learning process more effective, efficient and reliable. The overall aim of this study is to identify students who are susceptible to fail a given university course. This research paper reports the implementation of an Educational Data Mining project based on the CRISP-DM methodology. The data was collected from the APOGEE system of Ibn Tofail University, a form and specifications of the tested courses. The business goal of this paper is to develop a model that can identify students who are susceptible to failure in a given academic course. Such a model helps prevent failure in higher education institutions and provides a basis for making the teaching and learning process more effective, efficient and reliable. Most common machine learning algorithms in the field of Educational Data Mining were used. The results of our research showed that the proposed method was able to achieve an overall accuracy of 97% in predicting students at potential failure.
Formation of Psychological Readiness of the Teacher to Implement Information and Communication Technologies in Professional Activities
Authors: Honchar Liudmyla , Derkachova Olga , Shakhrai Valentyna , Saienko Volodymyr , Hladoshchuk Olexandr , Voropayeva Tatiana
Published: October 2021

The relevance of discussing the components of the psychological strategy for teachers’ use of Information and Communications Technology (ICT) at General High School Educational Institution (GHSEI) involves the categories of cooperation, reflexive, motivational and informational parts of the strategy have been developed and characterized as components of teacher readiness for professional activity in a multidisciplinary environment. The aim of the research is to develop a pedagogical strategy for psychological readiness of teachers to use ICT to eliminate internal and external barriers that interfere with the intensive exchange of information among and behind the educational team. Methodology. Sociological survey (number of participants 1200) on the platform “Online Test Pad” among teachers of GHSEI (Ukraine). Results. The list of components in the structure of psychological readiness of students to implementation of educational innovations, including emotional-motivational, cognitive-motivational, orientational, activity-operational, moral, communicative, volitional, mobilizing, evaluative-resulting. The article outlines the stages of solving the main psychological barriers to innovation in the use of information and communication technologies. Presented is the assessment of the components of psychological readiness to the implementation of ICT through the respondents’ free responses. The article revealed the criteria of psychological actualization of personal achievements in the use of ICT in professional activity. The conditions of psychological readiness for the use of ICTs in pedagogical activity as well as the professional tasks of ICT use were determined. The practical value of the study was the presentation of the recommended strategy for implementation of ICT-warehouses in professional activities with the use of information on the psychological readiness of the teacher.