bluuebunny/crossref_metadata_2025 huggingface dataset:
Endosonographers performing on-site evaluation of solid pancreatic specimens for EUS-guided biopsy
Authors: Li Shi-Yu , Gao Li , Zhang Ping-Ping , Su Xiao-Ju , Kong Xiang-Yu , Wang Kai-Xuan , Jin Zhen-Dong
Published: December 2021

Objectives:

This study aimed to examine the effects of a training program combining formal cytological curriculum and practical assessments on endosonographers and to determine how many operations were needed for training through learning curves.

Methods:

A formal cytological curriculum was implemented in November 2019 for four endosonographers. The competency of endosonographers before and after the curriculum was judged by quantitative scores. From December 2019 to October 2020, trainees independently examined the adequacy and atypia grade of pancreatic specimens acquired by EUS-guided-fine-needle biopsy based on specific atypical grading criteria. The accuracy of the adequacy and atypia assessment of each trainee was calculated, and learning curves were drawn to evaluate the improvement.

Results:

The median posttraining score improved by 87% from 49 to 91.5 out of 100. Ninety patients were enrolled in the practical assessments. The accuracy for specimen adequacy and atypia assessment of each trainee was 91.7%, 92.8%, 91.0%, and 89.3% and 80.0%, 82.1%, 81.0%, and 78.9%. The learning curves of each trainee showed a steady and significant improvement, and ninety cases were sufficient for satisfactory adequacy assessment.

Conclusions:

Basic knowledge of on-site cytopathologic evaluation can be gained through standardized and systematic training. Practical assessments showed that, at the completion of ninety cases, trained endosonographers reached a satisfactory level of recognizing specimen adequacy, but continue practice was needed for atypia assessment.
Impact of biliary stents on the diagnostic accuracy of EUS-guided fine-needle biopsy of solid pancreatic head lesions
Authors: Crinò Stefano Francesco , Conti Bellocchi Maria Cristina , Antonini Filippo , Macarri Giampiero , Carrara Silvia , Lamonaca Laura , Di Mitri Roberto , Conte Elisabetta , Fabbri Carlo , Binda Cecilia , Ofosu Andrew , Gasparini Enrico , Turri Chiara , Stornello Caterina , Celsa Ciro , Larghi Alberto , Manfrin Erminia , Gabbrielli Armando , Facciorusso Antonio , Tacelli Matteo
Published: December 2021

Background and Objectives:

There is no clear evidence of a negative impact of biliary stents on the diagnostic yield of EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing pancreatic head lesions. We aimed to evaluate the association between the presence of biliary stents and the diagnostic accuracy of EUS-FNB.

Materials and Methods:

A multicenter retrospective study including all jaundiced patients secondary to pancreatic head masses was performed. Patients were divided into two groups according to the presence of a biliary stent placed before EUS-FNB. Pathological results were classified according to the Papanicolaou classification and compared against the final diagnosis. Diagnostic measures in the two groups were compared. Multivariate logistic regression analyses including potential factors affecting EUS-FNB accuracy were performed.

Results:

Overall, 842 patients were included, 495 (58.8%) without and 347 (41.2%) with biliary stent. A plastic or a metal stent was placed in 217 (62.5%) and 130 (37.5%) cases, respectively. Diagnostic sensitivity and accuracy were significantly higher in patients without biliary stent than in those with stent (91.9% and 92.1% vs. 85.9% and 86.4%, P = 0.010 At multivariate analyses, lesion size (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.02–1.09, P = 0.01) and presence of biliary stent (OR: 0.51, 95% CI: 0.32–0.89, P = 0.01) were independently associated with diagnostic accuracy. In the subgroup of patients with biliary stent, the type of stent (plastic vs. metal) did not impact EUS-FNB yield, whereas the use of larger bore needles enhanced diagnostic accuracy (OR: 2.29, 95% CI: 1.28–4.12, P = 0.005).

Conclusions:

In this large retrospective study, an indwelling biliary stent negatively impacted the diagnostic accuracy of EUS-FNB. Preferably, EUS-FNB should precede endoscopic retrograde cholangiopancreatography, especially in the case of small tumors.
Evaluating the Co-relation between Vertical Dimension of Occlusion and the Height of the External Ear
Authors: Dhoot Lekhika Ashok , Sushma R , Patil Krupa Mahesh
Published: December 2021

Background:

Accurate measurement of Vertical Dimension of Occlusion is a very important step for the success of any prosthesis. It maintains the vertical height of the face and overall esthetic appearance of the patient. Various methods have been postulated to determine Vertical Dimension measurements, but no method is more accurate than the other.

Aim and Objective:

To determine a correlation between the Height of external Ear and vertical dimension of occlusion.

Methodology:

This study was conducted on 120 dentate subjects (60 males and 60 females) in the age range of 18-25 years. Each participant included, had all teeth present excluding 3rd molars, Class 1 jaw relation, and a harmonious as well as symmetrical face. Anthropometric measurements were recorded clinically in millimeters using a modified digital Vernier calliper. The data was input into a SPSSV.21 statistical software package for analysis. Pearson's correlation coefficient test was utilized to study the correlation.

Result:

The mean height of external ear was 61.14 mm in males and 58.55 mm in females. The mean vertical dimension of occlusion(VDO) was 62.15 mm in males and 58.55 mm in females. The results showed a significant correlation between the pair.

onclusion:

This is a novel technique, using height of external ear as a guide, for measurement of VDO.
Effect of Different Prosthodontic Treatment Modalities on Nutritional Parameters of Patients in Telangana, India
Authors: Phanindra S.
Published: December 2021

Background:

Oral health is a mirror of general health. Certain risk factors are common between oral and systemic diseases. The absence of teeth also affects oral health by altering the quality of life. Hence, the nutritional changes occurring in elderly patients following prosthodontic rehabilitation are evaluated.

Materials and Methods:

A total of 100 patients who underwent prosthodontic treatment for missing teeth were included in the study. Twice measurement of nutritional parameters was done: Initially at the time of diagnosis and then 5 months following commencement of the prosthodontic treatment. Dental analysis, evaluation of the diet, anthropometric assessment, and analysis of serum biochemical values were done in all the patients, and tabulated records were maintained. Independent Student's t-test and Tukey's test were done to assess the level of significance.

Results:

A total of 100 patients were included in the study. The complete denture (CD) group showed the highest alteration in the mean values of the nutritional parameters followed by the removable partial denture group. A significant change was seen in the body mass index, protein, carbohydrate, and iron levels among the different patients who were grouped based on the mode of treatment modality. The CD group showed significantly higher mean change in carbohydrates value compared with mean change in patients receiving fixed treatment.

Conclusion:

Our results conclude that nutrition and diet form an integral part of prosthodontic treatment to maintain the health of elderly population.
The Surge of House Calls
Authors: Patil Vinit Shashikant , Azhar Mubarak K , Jawad Ebn Mohammed Abdulla PP , James Jeslin V , Ahmed Junaid Bin , Rafeeque PA , Siraj MM
Published: December 2021

Elderly, homebound individuals comprise a vulnerable segment of society who have been disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic through a myriad of unique challenges. Home-based primary care or house calls improve the lives of high-cost, frail, homebound patients and their caregivers while reducing costs by keeping patients at home and reducing the use of hospitals and nursing homes. Several forces are behind the resurgence of HBPC, including the rapidly aging population, advancements in portable medical technology, evidence showing the value of house calls, and improved payments for house calls. There are 2 million to 4 million patients who could benefit from house calls, but only few are receiving it. The number of these patients is expected to double over the next two decades and there has been a surge during the COVID-19 pandemic. This requires a larger and better prepared workforce in India. Medical education curricula are necessary for undergraduate and postgraduate students studying medicine to sufficiently develop a future workforce capable of appropriately providing house calls to an increasing number of elderly patients.
Transscleral vs transpupillary diode laser photocoagulation for the treatment of zone II type 1 retinopathy of prematurity: Anatomical and refractive outcomes
Authors: Roohipourmoallai Ramak , Faghihi Shahin , Faghihi Hooshang , Torkashvand Ali , Nabavi Amin , Fooladi Marjan I , Farahani Afsar D , Bazvand Fatemeh , Iyer Siva S R , Ebrahimiadib Nazanin
Published: December 2021

Purpose:

To compare the anatomical and refractive outcomes of transscleral diode versus transpupillary laser photocoagulation for the treatment of zone II type 1 retinopathy of prematurity (ROP).

Methods:

In this prospective comparative interventional case series, infants with type 1 ROP in zone II were assigned to either transpupillary or transscleral laser based on the surgeons’ expertise area. The rate of regression, need for retreatment, and structural and biometric outcomes at month 6 were evaluated and compared between the two treatment groups.

Results:

In total, 209 eyes were enrolled; 145 eyes of 77 infants and 64 eyes of 33 infants and were in transscleral and transpupillary groups, respectively. There was no significant difference in baseline characteristics between the groups. There was no significant difference in retreatment rates (1.6% vs. 3.4%; P = 0.669) and progression to stage 4 (1.6% vs. 2.8%; P = 0.999) between the transpupillary and transscleral groups, respectively. At month 6, the mean spherical equivalent was 0.31 ± 3.57 and 0.44 ± 2.85 diopters, and the axial length was 18.28 ± 6.22 and 18.36 ± 6.87 mm in the transpupillary and transscleral groups, respectively, without a significant difference between groups. There was no significant difference in the rate of myopia (43.8% vs. 33.8%; P = 0.169) and high myopia (4.7% vs. 4.8%; P = 0.965) in transpupillary and transscleral groups at month 6.

Conclusion:

The transpupillary and transscleral laser photocoagulation routes are both effective in the treatment of zone II type 1 ROP and show no significant differences in anatomical or refractive outcomes in relation to the route chosen.
Clinical features and microbiology of post-cataract surgery endophthalmitis with and without intracameral moxifloxacin prophylaxis: Endophthalmitis prophylaxis study report 3
Authors: Dave Vivek P , Singh Vivek M , Reddy Jagadesh C , Sharma Savitri , Joseph Joveeta , Das Taraprasad
Published: December 2021

Purpose:

This study aimed to analyze the clinical presentations, microbiology, and management outcomes of post–cataract surgery endophthalmitis, with and without intracameral moxifloxacin prophylaxis.

Methods:

This study was designed as a retrospective, consecutive, comparative case series. Records of consecutive cataract surgery from January 1, 2015, till June 30, 2020, were analyzed. The cases that developed endophthalmitis were analyzed. The endophthalmitis cases were divided by their prophylaxis treatment into two groups: with intracameral moxifloxacin (ICM) and without (N-ICM). Inclusion criteria were (1) age ≥ 18 years, (2) cataract surgery with intraocular lens implantation, (3) endophthalmitis within 6 weeks of cataract surgery, and (4) cataract surgery in the institute by any of the three methods—phacoemulsification, manual small incision cataract surgery, and extracapsular cataract extraction.

Results:

In the study period, 66,967 cataract surgeries were performed; 48.7% (n = 32,649) did not receive ICM. There was no difference between the N-ICM and ICM groups in the incidence of clinical (n = 21, 0.064% and n = 15, 0.043%; P = 0.23) and culture proven (n = 19, 0.033% and n = 11, 0.023%; P = 0.99) endophthalmitis, respectively. Greater number of patients in the N-ICM group had lid edema (76.2% vs. 40%; P = 0.03), corneal edema (71.4% vs. 33.3%; P = 0.03) and lower presenting vision with available correction (logMAR [logarithm of the minimum angle of resolution] 1.26 ± 1.2 vs. logMAR 0.54 ± 0.85; P = 0.02). The final best-corrected visual acuity following treatment was worse in the N-ICM group (logMAR 1.26 ± 1.2 vs. 0.54 ± 0.85; P = 0.02).

Conclusion:

Endophthalmitis after intracameral moxifloxacin may have relatively milder signs and symptoms and may respond better to treatment.
A study of referral pattern to pediatric ophthalmology department in a tertiary eye-care center of South-India
Authors: Kalita Iva R , Veena K , Mouttappa Freidrick , Singh Harsh V
Published: December 2021

Purpose:

The study was aimed at finding out the present pattern of referrals to the Pediatric Ophthalmology outpatient department (OPD) in a tertiary eye care hospital and thus identify the discrepancy of referral, if any, which would help to modify and enhance the practice guidelines.

Methods:

The study was conducted by retrospectively collecting data from all referral letters that were already uploaded in the Electronic Medical Report (EMR) against all patients from June 2019 to December 2019. All pediatric patients in the age group of 0–16 years were included in the study. The practicing field of referring clinicians was noted along with the maximum information that could be collected from the referral letter and were thus assessed for the quality, accuracy, and timely referral.

Results:

Out of 77 referrals received in the study period, six referral letters neither had any mention of the designation of the referring clinician nor any specific diagnosis or details. Thus, only 71 patients were included for further study. The referring clinicians were mainly ophthalmologists, pediatricians, general practitioners (GPs), and others (cardiologists, neurologists). Maximum patients were referred by ophthalmologists (76%) but visual acuity was noted only for 30% of these patients. Almost half of the referral diagnosis was accurate. Pediatrician referrals were found to be more detailed and précised.

Conclusion:

There is a need for a standardized hospital-specific format of referrals and basic training to primary care providers on some simple tests (Lights reflex tests) for identifying the “red flags” in pediatric eye examination and thus enhancing the quality and timely referral per
se.
Glabellar flap technique in oculoplastic surgery
Authors: Balchev Georgi , Balabanov Chavdar , Murgova Snezhana
Published: December 2021

Facial skin defect reconstruction in medial-canthal area of the lids can be a challenge even when performed by a skilled surgeon. The excision of large tumors in this area leads to significant surgical defects that cannot be repaired by merely closing the wound. The glabellar area provides a source of redundant skin with similar characteristics to that of the medial-canthal lid area. The purpose show the possibility of the glabellar flap technique surgery in patients after tumor excision in the medial canthal area with the formation of a large surgical defect and especially those with defect under the medial canthal tendon. We selected 15 well-documented retrospective cases of patients operated over 2 years and followed up for a minimum of 36 months, who underwent surgery with a glabellar flap technique. Patients were operated with V-Y glabellar rotation, advancement, or combined transposition flap techniques. According to the defect’s location, we divided the patients into three groups: upper, medial, and lower surgical defects. A satisfactory functional result was obtained in all the patients. In most of them, the cosmetic results were also good. No additional surgical procedures were required in any of the patients. Our experience showed excellent results with the glabellar flap technique in all three types of lesions in the medial canthal zone—upper, medial, and especially lower which until recently was thought to be inappropriate.
Binocular summation in comitant exotropia: Change after surgery
Authors: Verma Shaurya , Mishra Pallavi , Agrawal Siddharth , Srivastava Rajat M , Singh Vinita
Published: December 2021

Purpose:

To assess the change in binocular summation (BiS) in comitant exotropia (XT) after strabismus surgery.

Methods:

This is a prospective study on 20 patients who underwent surgery for comitant XT over a one year period. Patients with sensory exotropia and nystagmus were excluded. Best-corrected visual acuity (VA) and contrast sensitivity (CS) of both eyes separately and together (binocularly) were recorded. BiS score was calculated as binocular score minus better eye score. BiS score at the end of 3 months was compared with the preoperative data.

Results:

The mean ± SD of BiS score increased from 2.95 ± 0.88 to 4.55 ± 0.68 (P-value < 0.0001) for VA (on ETDRS letters) and from 2.75 ± 0.44 to 4.5 ± 0.76 (P-value < 0.001 for CS (on Pelli–Robson chart) after surgery.

Conclusion:

There is significant improvement in BiS in XT after strabismus surgery. Authors recommend its inclusion in evaluation of functional outcome of XT surgery.
Impact of online classes and home confinement on myopia progression in children during COVID-19 pandemic: Digital eye strain among kids (DESK) study 4
Authors: Mohan Amit , Sen Pradhnya , Peeush Parimal , Shah Chintan , Jain Elesh
Published: December 2021

Purpose:

This study was performed to compare the rate of progression of myopia before and during the COVID-19 pandemic and to assess the risk factors of hastened progression.

Methods:

All children with myopia of spherical equivalence ≤ −0.5 D with at least two prior documented refractions 6 months and 1 year before were included. The annual progression rate before COVID-19 and during COVID-19 was calculated. Annual myopia progression was categorized as no progression (0), slow progression (<1 D), and fast progression (≥1 D).

Results:

A total of 133 children (266 eyes) aged 6–18 years were included in the study. Mean annual myopia progression was found to be statistically significant during COVID-19 as compared with pre-COVID-19 (0.90 vs 0.25 D, P < 0.00001). A total of 45.9% of children showed an annual progression of ≥1 D during the pandemic as compared with 10.5% before the COVID-19 (p < 0.00001). In multivariate analysis, history of rapid progression in pre-COVID-19 era (P = 0.002) and sun exposure <1 h/day (P < 0.00001) were found to be independent risk factors for rapid myopia progression.

Conclusion:

Parents should consider risk of rapid myopia progression in children during current pandemic and children should be provided with socially distant outdoor activities to increase their sun exposure and diminish the rate of myopia progression.
Harada-like syndrome post-Covishield vaccination: A rare adverse effect
Authors: Reddy Yogya , Pandey Anamika , Ojha Ayushi , Ramchandani Suresh
Published: December 2021

Covishield is in wide use in India with about 80% efficacy. Serious side effects are still under study. A 30-year-old female presented to us 7 days post-vaccination with a 5-day history of sudden diminution of vision in both eyes. The clinical findings were suggestive of the Vogt-Koyanagi-Harada (VKH) syndrome. She was treated with high-dose oral steroids. At this juncture, the association was unclear. However, it was justified by an acute flare-up of uveitis on day 2 post the second dose of vaccination despite ongoing steroids. A direct correlation of Harada-like syndrome with the Covishield vaccine is observed here.
A comparative study of knotless versus knotted transscleral suture-fixated intraocular lens implantation
Authors: Yilmaz Sami , Mavi Yildiz Aysegul , Avci Remzi
Published: December 2021

Purpose:

To compare functional outcomes and complication rates of two scleral fixated intraocular lens implantation (SFIOL) techniques.

Methods:

In this retrospective study, there were 30 eyes of 30 patients who underwent SFIOL implantation for dislocation of the IOL or crystalline lens. Group 1 (n = 17) comprised patients who received scleral-fixated polymethylmethacrylate (PMMA) IOL implantation through a self-sealing sclerocorneal tunnel with the suture burial technique, and group 2 (n = 13) comprised patients who received scleral-fixated foldable acrylic IOL implantation with a cartridge using a self-sealing clear corneal incision (CCI) with knotless Z-suture technique between 2014 and 2019. Surgical outcomes concerning safety, efficiency, visual function, induced astigmatism with vector analysis, and complications were compared.

Results:

The indications were dislocated crystalline lens (n = 5/30), dislocated IOL (n = 17/30), and dropped nucleus (n = 8/30). The mean follow-up time was 50.65 ± 14.02 months in group 1 and 15.69 ± 3.71 months in group 2 (P < 0.001). The postoperative visual acuity improvement was statistically significant in both groups (P < 0.001). Surgically induced astigmatism was significantly higher in group 1 (2.68 ± 1.04 D) compared with group 2 (1.6 ± 1.0 D) at month 12 (P = 0.001). Postoperative complications included suture exposure (n = 1 in group 1) and cystoid macular edema (n = 1 in group 1; n = 1 in group 2).

Conclusion:

Both SFIOL techniques are safe and effective in the absence of adequate capsular support. However, the knotless Z-suture technique appears to be superior to the suture burial technique with regard to suture exposure-related complications. In addition, self-sealing CCI appears to be superior to self-sealing sclerocorneal tunnel with regard to surgically induced astigmatism.
Prophylactic corneal crosslinking in myopic small-incision lenticule extraction - Long-term visual and refractive outcomes
Authors: Sánchez-González José-María , Rocha-de-Lossada Carlos , Borroni Davide , De-Hita-Cantalejo Concepción , Alonso-Aliste Federico
Published: December 2021

Purpose:

To analyze the efficacy, safety, predictability, and stability in myopic and astigmatic small-incision lenticule extraction (SMILE) with simultaneous prophylactic corneal crosslinking (CXL) in thin corneas.

Methods:

A total of 48 eyes from 24 patients who underwent myopic and astigmatism SMILE with simultaneous prophylactic CXL were included in this retrospective study. All patients had a 24-month follow-up. A femtosecond laser was performed with VisuMax (Carl Zeiss Meditec). CXL treatment was applied when the predicted stromal thickness was less than 330 μm.

Results:

The patients’ mean age was 31.58 ± 6.23 years. The previous mean spherical equivalent was − 6.85 ± 1.80 (−9.75 to − 2.00) D. The postoperative mean spherical equivalent was − 0.50 ± 0.26 (−1.00 to + 0.25) D; 60% of the eyes had 20/20 or better; 19% lost one line; 58% were within ± 0.50 D; and 8.3% of the eyes changed 0.50 D or more between 3 and 24 months.

Conclusion:

Prophylactic CXL with simultaneous SMILE for myopia and astigmatism femtosecond laser surgery technique appears to be partially effective, safe, predictable, and stable after 24 months of follow-up.
Correlation between choroidal thickness and intraocular pressure control in primary angle-closure glaucoma
Authors: Singh Nishtha , Pegu Julie , Garg Prerna , Kumar Brajesh , Dubey Suneeta , Gandhi Monica
Published: December 2021

Purpose:

To study the correlation between choroidal thickness (CT) and IOP control in primary angle-closure glaucoma (PACG).

Methods:

In total, 61 patients (102 eyes) with PACG underwent subfoveal CT (SFCT) scanning using enhanced depth imaging–optical coherence tomography. The subjects with PACG were further grouped as controlled IOP (≤21 mm Hg on maximal medical therapy) and uncontrolled IOP (>21 mm Hg on maximal medical therapy). The average CT of the PACG eyes was calculated and compared between both groups. A correlation analysis was done between CT and intereye difference in CT with the disease parameters.

Results:

The mean CT was 274.38 ± 42.10 μm in 102 PACG eyes. SFCT was significantly increased in the uncontrolled IOP group as compared with the controlled IOP group. The mean SFCT was 245.57 ± 62.10 μm in the controlled group and 294.46 ± 51.05 μm in the uncontrolled group (P < 0.01). Factors associated with a thicker choroid were younger age, high IOP, and higher optic nerve head cupping (P < 0.001). Neither the visual field-mean deviation (VF-MD) nor pattern standard deviation (PSD) was found to be associated with overall CT. The intereye asymmetry between CT was significantly associated with poor VF-MD and PSD.

Conclusion:

PACG eyes with thicker choroid may be a risk factor for poor IOP control on medical anti-glaucoma therapy. Thicker choroid as compared to the fellow eye is a poor prognostic sign and these eyes should be monitored closely.
A double-blinded randomized clinical trial for pain perception: The efficacy and safety of topical cold saline solution anesthesia in phacoemulsification
Authors: Demir Mehmet , Akpolat Cetin , Karapapak Murat , Sendul Selam Yekta , Guven Dilek
Published: December 2021

Purpose:

To compare the efficacy and safety of cold saline solution (0.9% NaCl) with topical ophthalmic proparacaine for maintaining topical anesthesia of patients undergoing phacoemulsification surgery.

Methods:

The prospective, double-blinded, and randomized clinical study was randomly assigned to two groups that underwent phacoemulsification surgery due to cataracts. The cold saline group included 86 eyes of 86 patients with topical anesthesia of cold saline solution alone. The proparacaine group included 84 eyes of 84 patients with topical ophthalmic proparacaine (room temperature) anesthesia alone. The patients were scored according to a pain survey questionnaire of Visual Analog Scale (VAS) ranked between 0 and 10. The surgeon scored surgical experience by a Surgeon Questionnaire Scale (SQS) in three parameters, each of which was ranked from 1 to 3 based on questions regarding ease and comfort during the surgery.

Results:

The mean VAS scores were 1.29 ± 0.65 and 1.22 ± 0.66 for the cold saline and proparacaine groups, respectively (P = 0.182). The mean scores of SQS (lower values represented favorable results) were 4.11 ± 0.76 and 3.97 ± 0.74 in the cold saline and proparacaine groups, respectively (P = 0.163). Ten patients in the proparacaine group experienced corneal epitheliopathy in the postoperative period.

Conclusion:

As an easily accessible and cost-effective method, cold saline solution alone might be an alternative to topical ophthalmic proparacaine alone with comparable safe and effective results. The absence of allergic or toxic effects also provided a significant advantage in the cold saline application.
Clinical profile, imaging features and short term visual outcomes of Indian optic neuritis patients with and without seromarkers for myelin oligodendrocyte glycoprotein and neuromyelitis optica
Authors: Ambika Selvakumar , Durgapriyadarshini Santhakumar , Padmalakshmi Krishnakumar , Noronha Veena , Arjundas Deepak
Published: December 2021

Purpose:

To analyze clinical profile, imaging features, and short-term visual outcomes of optic neuritis patients in Indian population with and without seromarkers for myelin oligodendrocyte glycoprotein (MOG)/neuromyelitis optica (NMO).

Methods:

Electronic medical records of 203 optic neuritis patients who presented between June 2018 and December 2019 to the Neuro-ophthalmology services of a tertiary care center in India were retrospectively analyzed.

Results:

Of 203 patients, 57 patients (28.08%) were positive for MOG-antibody and 20 patients (9.85%) were positive for NMO antibody. 114 patients (56.16%) were double-negative (negative for both antibodies) and 12 patients (5.91%) were diagnosed as multiple sclerosis (MS). None of the patients had both antibodies. Mean age of presentation was 31.29 ± 1.035 years. There was female preponderance in NMO-optic neuritis (NMO-ON) and MS-optic neuritis (MS-ON) groups (1:5). Mean vision on presentation was worse (logMAR 1.570 ± 0.863) in NMO-ON group. The mean visual acuity showed statistically significant recovery (logMAR 0.338 ± 0.639) in the final follow-up in MOG-optic neuritis (MOG-ON) group. Multivariate logistic regression analysis revealed poor visual outcome in patients presenting with retrobulbar neuritis, optic disc pallor, bilateral sequential optic nerve involvement, and with positive NMO antibody. Optic neuritis patients presenting with disc edema associated with pain and positive for MOG antibody were found to have a better visual outcome.

Conclusion:

In this Indian optic neuritis cohort, the prevalence of MOG-ON was higher than NMO-ON. MOG-ON had a better visual outcome than NMO-ON. The incidence of MS-ON was less compared to the western literature. A significant number of patients (114 patients, 56.16%) were double negative for both seromarkers and yet had presented with optic neuritis with no clinical or imaging features suggestive of MS/MOG associated disease (MOG AD)/NMO spectrum disorder (NMO SD).
To Study the Prescription Patterns and Adequacy of Use of Statins at a Tertiary Care Center of North India
Authors: Khanal Suraj , Atwal Shilpa , Dutta Pinaki
Published: December 2021

Background:

The role and benefits of lipid-lowering drugs in active management of dyslipidemia are well established. However, a little is known about whether these drugs are prescribed as per the recent guidelines and the desired effect is achieved or not in routine clinical practice. The aim of this study was to evaluate the prescription patterns and adequacy of use of statins at a tertiary care hospital.

Patients and Methods:

Patients aged ≥18 years eligible to receive statin therapy for primary or secondary prevention according to the American Heart Association 2018 guidelines were included in the study. Clinical records of all the cases were reviewed for indications of statins, and lipid profile was done at baseline and after 3 months of statin therapy.

Results:

There were 140 men and 103 women with a mean age of 52.24 ± 12.01 years. 109 (44.9%) patients received statins for primary prevention, whereas 134 (55.1%) patients received statins for secondary prevention. A total of 179 (73.7%) and 64 (26.3%) patients each received atorvastatin and rosuvastatin. 81.9% of the study population received statins according to the guidelines. After 3 months of statin therapy, there was a statistically significant change in the lipid profile in both primary and secondary prevention groups.

Conclusions:

There are some irrational prescribing practices among physicians affecting the performance of statin therapy in primary and secondary prevention of atherosclerotic cardiovascular disease. A need to rationalize the prescription practices by keeping abreast with the latest recommendations as well as effective patient counseling and education seems warranted.
Brucella Endocarditis of Bicuspid Aortic Valve
Authors: Devi Sujata , Kar Nilanjan , Sahoo Debananda , Das Tutan , Acharya Debasis , Das Debasish
Published: December 2021

We present a rare case of Brucella endocarditis in a case of the bicuspid aortic valve in a 51-year-old male presenting with pyrexia of unknown origin for the last 2 months. Infective endocarditis caused by Brucella melitensis is rare to encounter in routine clinical practice. Although we routinely think of Mycoplasma, Legionella, and Coxiella in the cases of blood culture-negative endocarditis, one should think of Brucella melitensis and Scrub typhus as the last arrow to reach the final etiology of infective endocarditis in the subset of diseased aortic or mitral valve. We successfully treated the patient with a combined regimen of rifampicin, gentamicin, and doxycycline therapy; during follow-up, the vegetation of the aortic valve was shrunken and calcified and the patient was asymptomatic.
Detection of Mandibular Canal in Human Dry Mandibles with Cone Beam Computed Tomography using 270° and 360° Protocols under Continuous and Pulse Modes – A Comparative Study
Authors: Karishma  , Annaji A G , Rakesh N , Upasana L , Abhinetra M S
Published: December 2021

Background:

Cone beam computed tomography (CBCT) enables practitioner to accurately localize and mark the nerve canal. The rotation of the X-ray tube and the detector around the patient's head produces multiple projection images. A high number of projections is associated with increased radiation dose to the patient, higher spatial and contrast resolution. Shorter scan arc results in reduced scan time, reduced dose and smaller file sizes. The pulsed X-ray beam reduces the actual exposure time than the scanning time and the patient radiation exposure. Aim: (1) To assess and compare the diagnostic efficacy between pulse mode and continuous mode (2) To assess and compare the diagnostic efficacy between 270° and 360° CBCT rotational protocols

Subjects and Methods:

A total of 30 Intact Dentate or Partially dentate dry human mandibles consisting first, second, and third molars were subjected to a total of 4 CBCT scans: 270° rotation scans under continuous and pulse mode, 360° rotation scans under continuous and pulse mode using two CBCT units. Distance from the inferior cortical border of mandible (ICBM) to the roof of the inferior alveolar nerve canal (IANC) was measured at four locations: mental foramen, first, second and third molar. The results were then compared.

Results:

Comparison of the IANC length measurements for the two modes revealed no significant difference.

Conclusion:

Shorter scan arc and pulse mode can be adopted in patients finding it difficult to remain stable for prolonged periods of time, while maintaining appreciable clarity and quality of image. This could apply to geriatric patients, children, mentally challenged, in patients with trauma, neurological diseases, anxiety, claustrophobia, wherein the patient's movements might need re-scanning, which would lead to an extra radiation dose to the patient.
Oral Manifestations in Diabetes Mellitus- A Review
Authors: Kumari Subham , Gnanasundaram N.
Published: December 2021

This article deals with the characteristic of clinical findings of diabetes mellitus (DM) in the mouth and teeth. Identification of these findings in the examination of the mouth will help to diagnose DM. Symptoms such as dryness of the mouth (xerostomia), burning sensation, painful gingival swelling, and mobility of teeth due to uncontrolled DM are explained. Signs such as gingivitis, periodontitis, multiple periodontal abscesses, and fungal lesions such as Candidiasis are explained. Oral symptoms and signs may enable medical and dental specialists to diagnose diabetes. Proper diagnosis will ensure proper treatment. “Diabetes is a good disease with bad companions” quoted Dr. Sam G. P. Mosses, a renowned diabetologist in India. It is true. Diabetes is a biochemical disorder where there is a failure of peripheral utilization of sugar in cells due to insulin deficiency or defectiveness causing accumulation of excess sugar in the tissues, thus leading to hyperglycemia, glycosuria, polyuria, polyphagia, and polydipsia. It is difficult to find out when exactly the disease develops with a hyperglycemic state and how to identify the disease in the early stages. Diabetes is a reversible disease and can be controlled by restoring sugar metabolism by correcting insulin deficiency or defectiveness. Thus, the complications are considered as the bad companions of this disease. DM is a disease with systemic involvement affecting various structures and organs. The mouth is also affected by DM. If a medical or dental specialist is fully familiarized with Oral changes in DM, they can diagnose the undiagnosed diabetes through the examination of the mouth. Further confirmation of diagnosis can be made by a biochemical study of blood and urine.

This article elaborates and explains the various mouth changes in diabetics for diagnosis and management.
Stem Cells Application in Oral Mucosal Disorders
Authors: Rajbhoj Ashwini Nerkar , Khare Vikram V. , Aditya Amita , Pande Suhas , Happy Daisy , Anasane Nayana
Published: December 2021

Background:

Regenerative medicine, tissue engineering, and surgery coupled with advances in materials science form an alliance of emerging interdisciplinary fields that combines the principles of cellular and molecular biology and biomedical engineering to support intrinsic healing and replace or regenerate cells, tissues, or organs, with the restoration of impaired function. The present-day treatment modalities for oral mucosal lesions are not satisfactory. Various studies have shown the successful role of stem cell therapy in the treatment of precancerous conditions, oral ulcers, wounds, and mucositis. The awareness among and knowledge of oral medicine and radiology (OMR) specialists regarding the therapeutic application of stem cells for the treatment of oral mucosal disorders is a relatively unexplored arena.

Aim and Objectives:

The present study was conducted to assess the awareness among and knowledge of OMR specialists regarding the application of stem cells for the treatment of oral mucosal disorders and compare the results based on age, area of work, and years of experience of the participants.

Materials and Methods:

The present study included a rapid, short, cross-sectional online survey. It was conducted using a web-based survey platform called Google Forms. A total of 203 OMR specialists were selected by simple random method for participating in the study. A self-administered, 10-point questionnaire in the form of an online survey was used to assess the awareness and knowledge of OMR specialists. A Chi-square test was used for statistical analysis.

Results and Conclusions:

Overall, awareness and knowledge were found to be more in the participants below 29 years of age, doing specialty practice, and with an experience of fewer than 5 years. A significant association of age, and area of work with awareness and knowledge was observed.
An Ambiguous Clinical Presentation of a Gingival Plasma Cell Granuloma – A Case Report
Authors: Shahid Areeba , Singh Priya , Misra Neeta , Umapathy Deepak
Published: December 2021

Plasma cell granuloma (PCG) is a rare localized benign proliferation of polyclonal mature plasma cells. The etiopathogenesis of the PCG remains inexplicit. Although it primarily occurs in the lungs, intraoral variants, involving the gingiva, tongue, buccal mucosa, have been reported too. Here we report a case of a 19-year-old female patient with mandibular anterior gingival exophytic growth that gave an impression of pyogenic granuloma clinically. The overgrown tissue was excised and histological examination revealed inflammatory cell infiltrate containing sheets of plasma cells. This case highlights the presence of a PCG having a periodontal origin. As intraoral occurrences of PCG are uncommon, such observations should be well documented and added to the existing literature. Advanced investigations such as immunohistochemistry can be done, which rule out the possibility of any malignancy, as seen in cases of plasmacytoma that mimic PCG (no malignant potential).
COVID-19 in India
Authors: Sharma Sweety
Published: December 2021

COVID-19 remains a serious global public health emergency. As of June 18, 2021, there had been 177,108,695 confirmed cases of COVID-19 worldwide, with 3,840,223 deaths. India is currently experiencing the world's worst outbreak, with the new emerging cases. This pandemic has a negative impact on India's public health, primary care, economic activity, and research. There are no proven treatments, and medicines have only been approved for emergency use or as an off-label drug. The growing number of COVID-19 cases causes a shortage of health-care resources such as medicines, testing, hospital beds, oxygen support, ventilators, and so on. The abrupt change in scenario has exacerbated mental health issues. Several clinical trials are underway, and many Indian companies are expected to begin supplying vaccine doses in July, with the hope that the crisis will be under control by the end of the year. This review focuses on the current state of COVID-19 in India in terms of research, public health, primary care, and prevalence.
Effect on Mental Health of Health-care Providers during COVID-19 Pandemic
Authors: Sharma Arvind , Dubey Priyanka , Soni Deepali , Sharma Richa , Bharti Aditi , Singh Tej Pratap
Published: December 2021

Background:

Health-care providers played a crucial role in responding to the public health emergency due to COVID-19 pandemic. Therefore, our study aimed to assess depression, anxiety, and stress (DAS) levels among the health-care providers in a COVID-19 dedicated health-care facility.

Methodology:

From the month of August to December 2020, a cross-sectional study was conducted on health-care providers who were involved in providing health-care services to COVID-19 patients in a tertiary care institute of Jabalpur by purposive convenient sampling through online Google Forms. The study tool used was validated depression, anxiety, and stress scale-21 having a good internal consistency having Cronbach's alpha value 0.85.

Results:

From 112 health-care providers, higher level of anxiety was found (29.46%) followed by depression (17.85%) and stress (16.07%). Mild, moderate, severe, and extremely severe anxiety were found in 18.75%, 7.14%, 1.78%, and 1.78%, respectively. Mild and moderate depression were found in 9.82% and 8.03%. Mild, moderate, and severe stress were found in 8.92%, 6.25%, and 0.89% of health-care providers, respectively. A significant association of depression, stress, and anxiety with designation of the participants was found (P < 0.001).

Conclusion:

To combat DAS, it is necessary to cascade awareness and knowledge should be disseminated. Regular screening of health-care providers, counseling, and stress management programs should be conducted.
Use of Intermittent Preventive Therapy and Incidence of Acute Malaria in Pregnancy among Postpartum Women at University College Hospital, Ibadan, Nigeria
Authors: Ifebude Joshua Ebuka , Idowu Caleb Oluwasegun , Awolude Olutosin A.
Published: December 2021

Background:

Malaria in pregnancy remains a significant cause of feto-maternal morbidity and mortality especially in regions of high prevalence like Nigeria. Intermittent preventive therapy (IPT) for malaria is an important measure to abate this menace.

Aim:

The aim is to determine the uptake and effectiveness of IPT in relation to the occurrence of malaria, despite the use of IPT in pregnancy.

Patients, Materials and Methods:

This was a cross-sectional study conducted in UCH, Ibadan from October 1, to December 31, 2020. A total of 150 postpartum women were selected using the total sampling technique of all consenting participants. Structured questionnaires were used for data collection.

Results:

About 87.7% of the respondents took IPT in the index pregnancy. Of these, 15.4%, 50.8%, and 33.8% of participants took one, two, and three doses, respectively. The factors that determined intermittent preventive treatment for malaria in pregnancy (IPTp) uptake include occupation (P = 0.001), booking status (P = 0.002), antenatal care attendance (P = 0.001), and level of IPTp awareness (P = 0.002). About 48.0% of respondents indicated that they were treated for malaria in the index pregnancy. Meanwhile, only about 15.3% of those who took IPT were treated for malaria in pregnancy. It was found that the use of IPT (P = 0.03) and an increasing number of IPT doses used (P = 0.03) were associated with a reduction in the prevalence of malaria in pregnancy.

Conclusion:

The uptake of the current recommendation for IPT-SP that stipulates the use of monthly doses of IPT till delivery with a target of a minimum of three doses was quite poor. There is therefore an urgent need for widespread awareness and implementation of the World Health Organization and national guidelines on prevention of malaria. The prevalence of malaria declined with the number of doses of IPT-SP used by the respondents. This emphasizes the need for adequate dosing of IPT.
Trudinger’s inequalities for Riesz potentials in Morrey spaces of double phase functionals on half spaces
Authors: Mizuta Yoshihiro , Shimomura Tetsu
Published: December 2021

Our aim in this paper is to establish Trudinger’s exponential integrability for Riesz potentials in weighted Morrey spaces on the half space. As an application, we obtain Trudinger’s inequality for Riesz potentials in the framework of double phase functionals.
Об особых компактификациях лог-Калаби-Яу моделей Ландау-Гинзбурга
Authors: Przyjalkowski Victor Vladimirovich
Published: December 2021

Рассмотрена процедура построения компактификаций лог-Калаби-Яу слабых моделей Ландау-Гинзбурга многообразий Фано. Эта процедура применена к поверхностям дель Пеццо и накрытиям проективных пространств, имеющим индекс 1. Если индекс накрытия больше $2$, такие компактификации особы; кроме того, не существует гладких проективных компактификаций лог-Калаби-Яу.
Также в рассмотренных случаях доказана гипотеза о том, что число компонент слоев над бесконечностью равно размерности антиканонической системы многообразия Фано.
Библиография: 46 названий.
Свободно-осцилляторная реализация полиномов Лагерра
Authors: Odake Satoru
Published: December 2021

Радиальный осциллятор рассматривается с точки зрения свободно-осцилляторной реализации. С использованием свободного осциллятора, а именно операторов рождения и уничтожения для гармонического осциллятора, построен оператор, который переводит собственные функции гармонического осциллятора в собственные функции радиального осциллятора. Как полиномиальная часть соотношения для собственных функций получается оператор, который переводит полиномы Эрмита в полиномы Лагерра.
Pogled na nekatere anglicizme v italijanskem jeziku v času Covid-19
Authors: Brecelj Kaja Katarina
Published: December 2021

Pandemija Covid-19 je nepričakovano vstopila v naša življenja, povzročila velike družbene spremembe in pustila sledi tudi v jeziku, in sicer z besedami, ki so tako silovito in nenadoma vstopile v naša življenja kot sam virus. V italijanskem jeziku je večina teh besed anglicizmov, ki so od 20. stoletja najštevilčnejše izposojenke.
V tem prispevku smo se osredotočili na anglicizme, kot so Covid hospital, hub, lockdown, smart working, distanziamento sociale, delivery, rider, green pass in recovery fund, ki so bili po našem mnenju v medijih pogosto uporabljeni za opis obdobja pandemije na škodo njihovih italijanskih različic. Analiza se je osredotočila na pogostost anglicizmov in njihovih italijanskih ustreznic v elektronski različici časopisov La Repubblica in Corriere della Sera ter na razloge za njihovo široko razširjenost. Rezultati potrjujejo njihovo prevlado v novinarskem jeziku in kažejo na njihovo uveljavitev nad italijanskimi različicami. Razloge za ta pojav je potrebno iskati tako na jezikovnem kot zunajjezikovnem področju. Sprva je dotok verjetno spodbujala hitrost in naglica dela. Njihova uveljavitev pa je bila posledica različnih dejavnikov: v primeru hub, delivery in rider zaradi njihove kratkosti in zgoščenosti; v primeru Covid hospital zaradi bolj omejene semantike; v primeru lockdown in distanziamento sociale, ker gre za krovna izraza, ki se nanašata na sklop ukrepov za zmanjšanje okužbe in sta vezana izključno na pandemijo; v primeru smart working zaradi prestiža, ki ga ima angleški jezik v italijanski družbi; v primeru green pass in recovery fund, ker sta bila izraza uvedena v italijanski novinarski jezik neposredno prek tujih medijev.