bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual and clinical outcomes after bilateral implantation of a novel extended depth of focus lens post cataract surgery
Authors: Bansal Muskaan , Thakur Anchal , Jeshan Mohammed , Sachdeva Kulbhushan , Malhotra Chintan , Gupta Amit , Jain Arun
Published: August 2024

Purpose:

To assess the visual and clinical outcomes after bilateral implantation of the novel extended depth of focus (EDOF) (AcrySof IQ Vivity) intraocular lens (IOL) using a micromonovision strategy.

Methods:

This was a prospective interventional study at a tertiary care center. Twenty patients (40 eyes) underwent bilateral implantation of AcrySof IQ Vivity IOL. Twelve weeks postoperatively, both uncorrected vision and corrected vision were assessed. Uniocular and binocular defocus curves with and without correction were noted subjectively as well as objectively on I-trace. Contrast sensitivity was assessed with a FACT (Functional Acuity Contrast Testing) machine, and objective parameters like modulation transfer function and Strehl ratio were also measured on I-Trace. Subjective quality of vision using a subjective questionnaire was also evaluated.

Results:

The mean binocular postoperative uncorrected distance visual acuity in LogMAR was -0.03 ± 0.09, the uncorrected intermediate visual acuity was 0.03 ± 0.09, and the uncorrected near visual acuity was 0.28 ± 0.18. All defocus curves were smooth and broad with the uncorrected defocus curve (with the micromonovision strategy) better than the corrected defocus curve. The subjective depth of focus (DOF = 3.73) was more than objective DOF (1.93) (P < 0.05). Photopic contrast was better than mesopic at all frequencies. All aberrations increased at 5 mm pupil size compared to 3 mm pupil size and were statistically significant, except for the total eye spherical aberration, which shows no significant difference at 3 mm and 5 mm pupil size (P = 0.27). Spectacle independence for distance, intermediate, and near was achieved in 100%, 94.7%, and 94.7% cases in this study, respectively.

Conclusions:

Using the micromonovision strategy, the visual performance of this novel EDOF IOL was outstanding both subjectively and objectively.
Bone-anchored maxillary protraction in cleft maxillary hypoplasia: An evaluation of dentoskeletal, soft-tissue, and functional effects
Authors: Tiwari Shreyasi , Mustafa K.
Published: August 2024

Introduction:

Maxillary hypoplasia is a common finding secondary to cleft lip and palate. The resultant Class III skeletal pattern worsens during adolescence due to unaffected mandibular growth. Bone-anchored maxillary protraction (BAMP) involves the intraoral use of orthopedic Class III intermaxillary elastics by means of skeletal anchorage to the zygoma and anterior mandible bilaterally.

Aim:

The aim of this study was to assess the facial esthetic and functional effects of 1-year of BAMP therapy in growing cleft individuals.

Subjects and Methods:

Eighteen subjects (mean age: 11.9 years) with cleft maxillary hypoplasia were selected for BAMP. Cephalometric facial assessment of 26 parameters (by an orthodontist), perceptual and lateral videofluoroscopic instrumental speech analyses (by a speech-language pathologist), and clinical temporomandibular joint (TMJ) evaluation were performed before (T1) and after 12 months of BAMP therapy (T2). Paired t-test and Pearson’s Chi-squared test were used for the statistical analyses of the quantitative and qualitative variables, respectively. Pearson’s correlation coefficients were used to assess the associations between cephalometric parameters.

Results:

Twenty cephalometric variables showed significant change from T1 to T2 toward positive dentoskeletal and soft-tissue Class III facial correction. The mean increase in “SNA” was 3.03°, and maxillary length (“Ptm-A”) and sagittal maxillary position (“N-perp to A”) increments were 3.65 mm and 4.02 mm, respectively. The mean improvement in the dental overjet was 3.86 mm. Backward positioning of the mandible was noted with a mean reduction of “SNB” and “N-perp to Pog” by 1.38° and 1.16 mm, respectively, with a mean 3.8° closure of the gonial angle. The airway changes were insignificant. Speech and TMJ observations remained constant from T1 to T2.

Conclusions:

BAMP therapy in cleft patients exhibited significant orthopedic maxillary protraction with effective sagittal and vertical mandibular growth control. The positive esthetic effects of BAMP did not have any negative influence over the functions of airway, velopharyngeal (speech) mechanism, and the TMJ in the stipulated 12-month period.
A single-center prospective study of perioperative anesthetic complications in cleft lip, alveolus, and palate surgeries in a teaching hospital in Lagos, Nigeria
Authors: Adamson Olawale Olatunbosun , Egbunah Uchenna Patrick
Published: August 2024

Background:

Cleft lip and/or palate are one of the most common congenital craniofacial anomalies that require surgical management. Patients undergoing primary cleft repair are at increased risk of perioperative anesthetic complications due to their young age and anatomical defects.

Aim:

This study aimed to present the frequency of perioperative airway-related morbidities in the anesthetic management of cleft lip, alveolus, and palate surgeries.

Patients and Methods:

This study was conducted at Lagos University Teaching Hospital, Nigeria. Patients undergoing cleft lip, alveolus, or palate repair were prospectively studied from January 2015 to December 2019. Data on patient demography, type of cleft, presence of syndromes and other deformities, and intra- and postoperative complications were collected.

Results:

A total of 150 patients were included, with a median age of 15.5 months, and 67 (44.7%) of the patients were <12 months old. Most patients were female (56%), and the most common type of cleft was lip, alveolus, and palate (36.6%). Sixteen (10.7%) of the patients had associated syndromes. Notably, intraoperative complications were observed in 5 (3.3%) patients, including laryngospasm and difficult intubation. Postoperative complications were rare, with one case of nasal bleeding. Significant associations between presence of other deformities and syndromes and intraoperative complications were noted (P < 0.05).

Conclusion:

Patients with orofacial clefts and other deformities tend to be predisposed to anesthetic complications. However, the incidence of anesthetic complications in this study was low (3.3%) probably because the current protocol used in the author’s hospital for cleft surgeries was followed and appropriate.
Breast milk feeding: Trials and tribulations of Indian mothers having infants with cleft lip and palate
Authors: Koppal Deepthi J. , Manaswini V. , Fernandes Sandra Jeswika , Benny Neha Grace
Published: August 2024

Background:

Breastfeeding infants with a cleft is difficult due to underlying anatomical deficits. The success of breastmilk feeding in this population is highly dependent on the mother. Nevertheless, the rate and duration of breastmilk feeding are often poor in this population due to early cessation of breastmilk production. These infants are therefore at high risk for “failure to thrive”.

Aim:

The study aimed to identify the challenges encountered by mothers having infants with cleft in establishing and maintaining breastmilk production.

Objective:

To explore the factors that impact establishing and maintaining breastmilk production viz., a) Mother-infant separation b) Access to Lactation and Feeding consultation c) Breastmilk expression strategies d) Formula supplementation rate e) Motivating or demotivating factors to breastmilk feeding.

Method:

This study was a phone survey conducted on 28 mothers who had availed lactation and feeding consultations between 2019 and 2020.

Results:

Various factors impacting the onset and establishment of breastmilk feeding noted were, separation of mother and infant at birth and the duration of separation, lack of access to professional help in lactation and feeding during stay in hospital, irregular and inappropriate breast milk expression, early formula supplementation demotivation due to various lactation and feeding challenges.

Conclusion:

Support from healthcare professionals specialized in lactation and feeding consultation for mothers having infants with cleft particularly, Speech Pathologists, Nursing staff and Lactation Consultants is critical to increase the rate and duration of breastmilk feeding. Breastmilk feeding should be thus prioritized and supported to enable infants with cleft to thrive.
Superiorly based pharyngeal flap versus myomucosal resection and direct closure of the posterior pharyngeal wall (Mahrous technique) for surgical correction of velopharyngeal insufficiency
Authors: Mohamed Ahmed Mahrous , Khalaf Zeinab , Hakeem Wafaa Helmy Abd El , Mousa Doaa
Published: August 2024

Introduction:

Superiorly based pharyngeal flap is one of the most common surgical techniques described for surgical correction of velopharyngeal disorders. Being a technique-sensitive and owing to its associated complications, a simple technique has been introduced and compared with it.

Aim:

The aim was to compare the surgical results and the phoniatric outcome of the superiorly based pharyngeal flap versus the myomucosal resection and direct closure of the posterior pharyngeal wall.

Patients and Method:

One hundred patients of both sexes were classified into two groups. Group A patients included fifty patients who had velopharyngeal insufficiency (VPI) and were surgically corrected by the superiorly based pharyngeal flap. Group B patients included fifty patients who had VPI and were surgically corrected by myomucosal resection and direct closure of the posterior pharyngeal wall.

Results:

Postoperatively, 13% of Group A patients had open nasality Grade 4 as compared to 0% in Group B patients. Hyponasality and obstructive sleep apnea were not recorded in any case of Group B patients as compared with 10% of Group A patients. With regard to the postoperative velopharyngeal gap during speech, 18% of patients in Group A had velopharyngeal gap 3 mm, while 10% of patients in Group B had velopharyngeal gap 3 mm.

Conclusion:

Myomucosal resection and direct closure of the posterior pharyngeal wall is a simple reliable technique for the correction of velopharyngeal disorders.
Noncompaction Cardiomyopathy: A Reappraisal
Authors: Jindal Mohit , Tandon Rohit
Published: August 2024

The term ’noncompaction’ cardiomyopathy has been traditionally used to define excessive trabeculations of left ventricle free wall associated with dilated cardiomyopathy phenotype on imaging. Further research had delved into genetic origins of this entity. Use of modern imaging modalities suggests that these excessive muscle projections (“trabeculations”) can also be detected in apparently healthy individuals, pregnant females and athletes without evidence of cardiomyopathy. This review delves into the historical nomenclature, updated definitions and clinical relevance of this condition.
Echocardiography in Hypertrophic Cardiomyopathy
Authors: Mehrotra Rahul
Published: August 2024

Hypertrophic cardiomyopathy (HCM) is a common disorder characterized by unexplained left ventricular hypertrophy. The disease can have different phenotypic expressions and can be genetic in nature with autosomal dominant inheritance. It usually runs a benign course in the majority but can lead to heart failure, atrial fibrillation, and sudden cardiac death (SCD). Echocardiography plays a key role in the diagnosis and overall management of the condition. It is useful in diagnosis, differentiation of different types (obstructive vs nonobstructive), in systematic evaluation of associated abnormalities (like mitral regurgitation), helps in selection of appropriate treatment and is helpful in guiding the intervention procedures for the condition. Certain echocardiographic measures are predictors of SCD. The review describes in detail the techniques and nuances of performing a comprehensive echocardiographic evaluation of patients with HCM.
Role of Nuclear Medicine in the Evaluation of Cardiomyopathies
Authors: Christopher Johann , Subramanyam Nukala , Gadepalli Tejonath , Srivastava Madhur Kumar
Published: August 2024

Cardiomyopathies are a distinct group of diseases which are unique in their natural history causing considerable disability, mortality and increase in healthcare costs. The diagnosis is crucial in order to initiate treatment early and hopefully alter the prognosis. There are different diagnostic modalities that are available to evaluate this entity. Nuclear techniques, especially gated myocardial perfusion single photon emission computed tomography and postron emission tomography imaging, have the unique ability to offer a cost effective, easily available technique to assess ventricular function, dyssynchrony and viability on the same test, assess prognosis and give unique management options to the treating physician.
Efficacy and Clinical Outcome of Single and Combined Therapies for Refractory Meibomian Gland Dysfunction: Probing, Intense Pulsed Light, and Thermal Pulsation Treatments
Authors: Weng Tzu-Heng , Chang Yu-Ming , Chien Ke-Hung , Chen Yi-Hao , Tai Ming-Cheng , Feng Kathy Ming
Published: August 2024

Background:

Refractory meibomian gland dysfunction (MGD) is a prevalent condition characterized by chronic functional abnormalities of the meibomian glands, leading to altered tear film and ocular discomfort despite medical treatments. Traditional management strategies include various single-modality treatments, although there is growing interest in the efficacy of combined therapies.

Aim:

The aim of this study was to evaluate the efficacy of regimens used individually and in combination for the treatment of refractory MGD.

Methods:

This retrospective study involved pre- and posttreatment evaluations of the ocular surface and symptoms in patients with refractory MGD. Treatments included meibomian gland probing (MGP), intense pulsed light (IPL) therapy, thermal pulsation (LipiFlow), IPL + MGP, and MGP + LipiFlow.

Results:

In total, 325 eyes of 241 patients with refractory MGD were assessed. The MGP group showed significant improvements in the ocular surface disease index (OSDI), tear meniscus height (TMH), corneal and conjunctival staining, lid wiper epitheliopathy (LWE), and meibomian gland expression (MGX) score. The IPL group showed significant improvements in OSDI, TMH, redness, conjunctival staining, and MGX score. IPL + MGP resulted in significant improvements in corneal and conjunctival staining, LWE, and MGX score, while LipiFlow significantly improved conjunctival staining, LWE, and MGX score. No significant improvements were observed in the MGP + LipiFlow group.

Conclusion:

IPL or MGP alone could alleviate the signs and symptoms of refractory MGD, while LipiFlow and IPL + MGP could improve the ocular surface parameters. However, no significant improvements were observed with MGP + LipiFlow. These findings provide a valuable guide for ophthalmologists for the selection of effective treatment modalities for refractory MGD, suggesting a potential advantage of combined IPL + MGP to maximize therapeutic benefits.
Antiviral Activity of Rhein against Enterovirus 71 through Inhibiting Viral Replication and Stability
Authors: Lai Zheng-Zong , Yang Hung Chen , Lee Yen-Mei
Published: August 2024

Background:

Enterovirus 71 (EV71) is one of the most prevalent pathogens responsible for hand, foot, and mouth disease in the Asia-Pacific region. Severe EV71 infections can be fatal in children under the age of 5. As of now, there are no proven anti-EV71 drugs available. Rhein is an anthraquinone derivative, mainly derived from rhubarb plants. Several beneficial pharmacological properties of rhein have been linked to anti-inflammatory, antioxidant, anticancer, and antiviral effects.

Aim:

This research aims to evaluate rhein’s antiviral activity against Enterovirus EV71 in vitro.

Methods:

The cytotoxicity of rhein was assessed using a Cell Counting Kit-8 kit. The antiviral activities of rhein were characterized by viral RNA level, protein expression level, and infectious ability using quantitative reverse transcription polymerase chain reaction, Western blot assay, and immunofluorescence assay, respectively. The mechanism by which rhein suppresses virus life cycles was examined utilizing a time-of-addition assay. An inactivation assay was performed to evaluate whether rhein directly impaired the virion stability.

Results:

The findings indicated that rhein exhibited anti-EV71 activity by reducing viral RNA synthesis, protein expression, and infectivity. Rhein demonstrates potent antiviral effects against EV71 at the late-life stage and inhibition of virion stability.

Conclusion:

Our findings strongly support further research into rhein as a potential treatment for EV71.
Analgesia Nociception Index Monitor is an Objective Monitor for Predicting Successful Treatment after Epidural Blood Patch in a Spontaneous Intracranial Hypotension Patient - A Case Report
Authors: Wang Chia-Hung , Lin Chia-Yu , Cheng Kuang-I , Wu Zhi-Fu
Published: August 2024

Headache induced by spontaneous intracranial hypotension (SIH) is a secondary headache syndrome. An epidural blood patch (EBP) serves as a treatment option when conservative measures fail. Analgesia nociceptive index (ANI) monitoring has been demonstrated to have advantages over standard clinical practice during general anesthesia and for detecting nociceptive stimulation during surgery. However, few studies have investigated ANI in postural headache patients. We presented a 38-year-old woman who experienced postural headache and was subsequently diagnosed with SIH. Despite her receiving conservative treatment, including hydration and analgesics, she continued to suffer from postural headaches. EBP was performed under ANI monitoring. Monitoring with the ANI revealed a rise in the mean ANI (ANIm) value from 44 to 93 during the EBP, which was correlated with headache relief. Two days post-EBP, the ANIm value reached 84. This case highlights the potential utility of ANI monitoring for objectively assessing SIH treatment outcomes and guiding therapeutic interventions.
The Clinical Efficacy of Imiglucerase versus Eliglustat in Patients with Gaucher's Disease Type 1
Authors: Nabizadeh Azita , Amani Bahman , Kadivar Maliheh , Toroski Mahdi , Asl Akbar Abdollahi , Bayazidi Yahya , Mojahedian Mahdi , Davari Majid
Published: August 2024

Gaucher's disease (GD) is one of the most common lysosomal diseases in humans. It results from β-glucosidase deficiency and leads to necrosis, especially in macrophages with the accumulation of glucosylceramidase in cells. Most of the deleterious effects of the disease are seen in the liver, spleen, and bone marrow. The aim of this study was to compare the efficacy of Imiglucerase with Eliglustat in treating patients with GD. PubMed/Medline, Cochrane Library, Scopus, Web of Science, Embase, and Google Scholar were searched from inception to August, 2018. Predefined inclusion criteria for included studies were based on search methodology and are as follows: All randomized, quasi-randomized controlled, and cohort studies about patients with GD Type 1 that Imiglucerase was compared with Eliglustat were included. Two authors independently choose the papers based on the inclusion criteria. From 2979 recognized studies, three studies including two randomized clinical trials and one cohort study were recognized to meet the inclusion criteria. The primary outcomes were hemoglobin level, platelets count, liver, and spleen size, and the secondary outcomes were the immunological side effects of the medicines and bone complications. The results showed that there is no meaningful difference between the two medicines in terms of increasing blood hemoglobin, platelets count, and reducing the liver and spleen size. The findings of this review showed that both medicines are effective in the treatment of GD Type 1 and there is no statistically significant difference between their efficacies.
Factors Affecting Outcome in Surgically Clipped Ruptured Anterior Circulation Aneurysms – A Retrospective Analysis
Authors: Sivanandan Jyothish , Shaan Abdul Rahim , Soman Biju
Published: August 2024

Introduction:

Ruptured cerebral aneurysm is a life-threatening condition that requires urgent medical attention. Failure to diagnose, delay in admission to a neurosurgical centre and lack of facilities could lead to poor surgical outcomes.

Aim:

The purpose of this study was to identify the factors that predict the outcome of patients undergoing a surgical clipping of ruptured anterior circulation aneurysms.

Materials and Methods:

This was a single-centre retrospective study with review of medical records of 306 patients, who were surgically treated for ruptured intracranial aneurysms in a tertiary care centre from January 2011 to June 2018. Information collected were the patient demographic data, Glasgow Coma Scale prior to surgery, World Federation of Neurosurgical Societies Scale and timing between subarachnoid haemorrhage (SAH) ictus and surgery. The outcomes at discharge and 6 months post-surgery were assessed using the modified Rankin Scale (mRS). Only cases of proven ruptured aneurysmal SAH involving anterior circulation that underwent surgical clipping were included in the study. The data collected were analysed statistically.

Results:

The mean duration between ictus and time of surgery was found to be 9.89 days, maximum being 43 days. Patients with persisting disabilities (according to mRS) at the 1st month and 3rd month post-surgery had a mean duration of 16.69 and 16.95 days, from ictus to surgery.

Conclusions:

Delay in surgical clipping of anterior circulation aneurysms and poor grade at presentation were found to have unfavourable outcomes. Health education and training should be incorporated in primary healthcare setups regarding the identification of probable aneurysm rupture in early stage, so that prompt referral to higher centre can be carried out and delay in intervention be curtailed.
A cross-sectional study to correlate nuclear fixative properties of formal saline and clarke’s fluid for histomorphology evaluation of human tissues
Authors: Venugopal Lakshya , Kulkarni Vasudha
Published: August 2024

Background:

Formal saline is an extensively used cheapest and easily available tissue fixative. However, formalin has been proven to have carcinogenic effects. Clarke’s fluid is an alternative to formal saline and is effective in maintaining the morphological and cellular architecture.

Objectives:

The objective of the study was to compare the nuclear fixative properties of Clarke’s fluid and formal saline.

Materials and Methods:

The fresh human tissues of thin skin, large-sized arteries, lymph nodes, spleen, and ileum were obtained from the fresh cadaver. The tissues were fixed in two different fixatives namely 10% formalin and Clarke’s fluid. Then, the tissues were histologically processed. The hematoxylin and eosin-stained serial sections of tissues were graded based on the ease of microtomy, cytoplasmic, and nuclear staining scores.

Results:

The nuclear properties of all the tissues immersed in Clarke’s fluid showed a median score of 3 and Grade 2 for formal saline; cytoplasmic properties for spleen and skin were median scores of Grade 3 for Clarke’s fluid. The artery was graded 3 for both the fixatives. The Kruskal–Wallis test when applied to nuclear properties, cytoplasmic adequacy, and tissue shrinkage for tissues stained with Clarke’s fluid was statistically significant (P < 0.01). This inferred that Clarke’s fluid is a better nuclear fixative than formal saline.

Conclusion:

The imminent risks associated with formal saline paved us to explore substitute fixatives, which could provide better results and safety for laboratory workers. Clarke’s fluid is an excellent substitute for formal saline as a nuclear fixative.
Prevalence of Type 2 Diabetes Mellitus and its Associated Risk Factors in an Urban Slum of a Metropolitan City
Authors: Qureshi Kamran F. , Karnedy Mrudula , Pawar Ankush , Totala Yashowardhan V. , Qureshi Saniya S.
Published: August 2024

Introduction:

The study aimed to estimate the prevalence of Type 2 DM and associated risk factors in urban slums.

Materials and Methods:

A cross-sectional study was done in the urban slum of the city involving adults aged >18 years. A sample of 300 participants was selected by systematic random sampling. Consent was taken and data were collected using pre-structured questionnaire. The data were entered in Excel and analysed using SPSS.

Results:

Majority of participants were females with a mean age being 45.21 years. The prevalence of Type 2 DM was 27.3%. Statistical significance was observed between diabetes and age, gender, religion, diet intake, oil consumption, physical activity, obesity and central obesity.

Conclusions:

The risk factors associated include advancing age, male gender, inadequate diet intake, excessive oil consumption, lack of physical activity, obesity and central obesity.
Epidemiology of Double Burden of Malnutrition: Causes and Consequences
Authors: Takhelchangbam Nilima Devi , Saxena Deepanshi , Singh Naresh Pal , Singh Anamika
Published: August 2024

Childhood malnutrition, with its long-lasting repercussions, not only affects individual lives but also extends its reach through generations, often resulting in issues like stunted growth. This overarching problem is encapsulated by the term ‘double burden of malnutrition (DBM)’, which encompasses both undernourishment indicators such as stunting and the rising prevalence of overweight and obesity. In an effort to thoroughly understand this complex issue, this article conducts a comprehensive review, shedding light on its epidemiological and economic dimensions. By conducting extensive literature searches, utilising MeSH terms and various information sources, particularly through PubMed, this review aims to provide a nuanced understanding of the DBM. The profound impact of this phenomenon on children reverberates through future generations and has significant implications for a nation’s economy. Addressing this multifaceted challenge requires a holistic approach, prioritising adequate nutrition, addressing socio-demographic factors and improving socioeconomic status. While numerous health policies and initiatives exist, their successful implementation is now more crucial than ever in breaking the cycle of malnutrition.
Loss of vision post dacryocystectomy surgery
Authors: Jawade Sandeep V. , Rehman Obaidur , Kumar Akash , Das Sima
Published: August 2024

Dacryocystectomy (DCT) is a relatively minor oculoplastic procedure with specific indications and remains a common lacrimal surgery in the Indian subcontinent. A 66-year-old hypertensive female with a mature cataract complained of painful vision loss on postoperative day 1 of DCT surgery. Visual acuity of nil light perception in the right eye with proptosis and limited extraocular motility was noted. Despite an urgent lateral canthotomy with cantholysis and intravenous steroid injection, there was no improvement in vision. Computed tomography of the orbits revealed an orbital hematoma on the right side with proptosis and optic nerve straightening. Orbital injury following a breach of the periorbita was deemed the probable cause. Vision loss due to orbital compartment syndrome is an uncommon but devastating complication following DCT surgery. Although DCT is considered to be a minor procedure, improper surgical technique and dissection may have catastrophic consequences.
Bridging the Gaps and Improving Care: Comprehensive Medication Management for Transgender Patients
Authors: Stephens Karmen , Morris Lisa
Published: August 2024

The consequences of mismanaged medications for the nearly 1.4 million adults in the United States who identify as transgender can be severe. Hormone therapy, pre- or post-gender affirming surgical therapies, and concurrent management of chronic conditions like diabetes or hypertension necessitate careful medication oversight. Without tailored care, these individuals are at risk for poor health outcomes and increased health care costs. Pharmacists are in a unique position to provide inclusive, gender-affirming health care to transgender individuals. Comprehensive Medication Management integrates pharmacists into the health care team to ensure medications are appropriate, effective, safe, and able to be taken as intended.
Heart Failure in Older People Part 1: Disease State Review and Lifestyle Interventions
Authors: Lancaster Jason W.
Published: August 2024

The care for patients with heart failure (HF) has evolved greatly over the past decade. While new guidelines have provided more clarity on categorization and staging, and novel agents have been approved for use, there are still questions surrounding the optimal strategies as they relate
to diet and exercise. Additionally, overall health care costs have increased for patients, driven in part by medication therapy. Given the myriad comorbidities associated with the diagnosis of HF, senior care pharmacists are positioned to positively impact the care for patients with HF, regardless
of setting. As the guidelines continue to evolve, addressing a wider spectrum of the disease, including iron deficiency, mental health, and pain, so must the pharmacist’s role in caring for patients with HF. Senior care pharmacists engaged in the management of older people with HF must
be especially attuned to the unique and individualized care each patient needs, offering guidance and education in balancing treatment modalities across all aspects of care. In this three-part series, we will explore a number of areas central to the management of HF. This first section will
focus on the cost of treatment, pathophysiology, and non-pharmacologic management. Series two and three will address guideline-directed medication therapy and special population management, respectively.
Supreme Court Strikes Down the Chevron Doctrine: Why Health Care Providers Need to Care
Authors: Davitian Leigh
Published: August 2024

The Supreme Court's creation of the "Chevron deference" or "Chevron doctrine" (Chevron) is arguably one of the most significant in American administrative law-fundamentally changing how the federal agency apparatus operates. Like many legal doctrines, it was largely unknown to the public until the Supreme Court's recent surprise overturning of Chevron. Now, it is making national headlines, appearing on many social media platforms, and reaching non-lawyers and everyday Americans. To participate in the ongoing debate surrounding Chevron within the press, media, and possibly your own colleagues, it is essential to understand the basic facts and principles regarding this monumental Supreme Court ruling. This article will delve into Chevron's 40-year influence on federal agencies, its recent overturning, and the profound impact it will have on the health care industry.
Community based study of awareness of eclampsia amongst rural pregnant women of remote communities
Authors: S Chhabra , N Shinde
Published: August 2024

Background: Eclampsia, severe form of hypertensive disorders during pregnancy (HDsP), characterized by seizures, which may progress to life-threatening cerebral hemorrhage, HELLP syndrome, multi-organ failure also. It places women and babies at higher risk of adverse outcomes with severe maternal and fetal morbidity and mortality globally.

Objective: Community based study was conducted to know awareness of eclampsia amongst rural pregnant women.

Material and Methods:

Study setting- Study was conducted in 140 villages around village with study headquarters.

Study sample- A total of 2,000 subjects, aged 15-45 years, and a minimum of 10 subjects from each village were randomly included.

Study design- This is an observational cross-sectional study.

After Institute's ethics committee's approval, information of awareness about eclampsia amongst pregnant women was collected by interviews at mutually convenient places, recorded using a pre-designed tool with some questions having yes/no answers, others short answers.

Results: Out of 2,000 study subjects, 70.3% had availed antenatal care (ANC). More than half were aged 20-29 years, low economic class, and agricultural laborers. Irrespective of gestation, ANC received, mainly at Anganwadi- Accredited Social Health Activist (ASHAs), Primary Health Centre (PHCs), Sub centers (SCs), 61.1% were aware of possibilities of convulsions, 44% during labor, 32% during pregnancy, and 24% post birth. Age and parity were not significant factors, but education, profession, and economic status were significant. Some had awareness about consequences of convulsions like bleeding, severe morbidity, and death of baby. 72.1% of women had some awareness, knew prevention was possible, most by proper ANC and blood pressure control.

Conclusion: Even during pregnancy, around one-third women were unaware of possibilities of convulsions. Among those who were aware, most were oblivious about dangerous consequences, unaware of prevention of convulsions. Education and economic status had significant linkage with awareness. Community workers and nurses were sources of information in the majority. It is imperative to keep them in the net and mobilize individuals from communities for awareness of dangerous disorders like Eclampsia.
The interplay of regulatory T cells, endoplasmic reticulum stress, and unfolded protein response activation in post-transplant alloimmune hepatitis and autoimmune hepatitis
Authors: Subramanian Kumar , Ekong Udeme D.
Published: August 2024

Autoimmune hepatitis and post-transplant alloimmune hepatitis are inflammatory conditions observed in the native and transplanted liver respectively. Regulatory T cells play a crucial role in the maintenance of immune tolerance and prevention of autoimmunity. Endoplasmic reticulum stress with unfolded protein response activation have been reported in circulating regulatory T cells suggesting a possible link between them. This review explores the role of regulatory T cells in autoimmunity focusing on their function and regulation in the liver. It also highlights the involvement of endoplasmic reticulum stress and unfolded protein response activation in autoimmune diseases. Understanding the interplay between endoplasmic reticulum stress, unfolded protein response activation and regulatory T cells may provide insights into disease pathogenesis and identify novel therapeutic targets for treatment of autoimmune liver diseases.
Investigation of particulate matter Air Quality Index (AQI) and risk assessment in some locations in Nigeria
Authors: Odubanjo O. F. , Falaiye O. A. , Orosun M. M. , Sanni M.
Published: August 2024

Air pollution issues specifically with Particulate Matter (PM), have turned out to be a critical and pressing concern, posing grave threats to human health, the ecosystem and the environment which tragically resulted in millions of premature deaths worldwide. The study investigated the ambient air mass concentration of PM1, PM2.5 and PM10 in Lagos, Abuja, Osogbo, Anyigba and Benin City in Nigeria from 1st of May, 2021 to 30th of April, 2023. Air Quality Index (AQI) due to PM2.5 and PM10 were evaluated for all the locations with the rationale for establishing characterization for health impact and risk of exposure’s assessment. Hourly measurement of PM concentrations was collected from the Purple Air Real-Time Air Quality Sensors Network for all selected locations. The results revealed an increase in the daily average spatial variation of PM concentration across studied locations in order of Anyigba, Osogbo, Lagos, Abuja, and Benin City. The average daily AQI due to PM2.5 and PM10 for Lagos, Abuja, Anyigba, Osogbo, and Benin City are 98.07 and 36.95, 108.77and 43.22,47.66 and 14.35, 85.02 and 32.29 and   114.26 and 46.35 respectively. For the risk of exposure’s assessments, locations are at varying levels of risk of PM 2.5 exposure, Benin city was identified with the highest level of risk having some days with AQI ranging from unhealthy to very unhealthy even to Hazardous. PM10 air quality in all locations portends little or no risk of exposure to the public. Across all the studied locations, distinct seasonal difference was observed, characterized with higher monthly average AQI during the dry season compared to the rainy season
CONCEPTUAL STUDY OF HYPERTHYROIDISM AND BHASMAKA ROG
Authors: Rana Pooja , Chadha Tanya , Deoli Tarun , Rani Agarwal Ruby
Published: August 2024

Hyperthyroidism is a common endocrine disorder characterised by an overactive thyroid gland, leading to an excessive production of thyroid hormones. This condition can result in a wide range of systemic effects on the body,
affecting metabolism, cardiovascular function, and various organ systems. Bhasmakarog, a concept from Ayurveda, refers to an individual's sharp and intense metabolic capacity, which closely parallels the hypermetabolic state
observed in Hyperthyroidism. This abstract explores the relationship between hyperthyroidism and Bhasmakarog,
emphasising their commonality regarding heightened metabolic activity and its effects on the body. Both conditions involve an increased basal metabolic rate (BMR), leading to symptoms such as weight loss, increased heart
rate, anxiety, and heat intolerance. Understanding the intersection of hyperthyroidism and Bhasmakarog can provide valuable insights for healthcare practitioners in optimising treatment strategies and improving the quality of
life for patients dealing with this challenging condition.
AYURVEDA APPROACH IN THE MANAGEMENT OF ENDOMETRIOSIS
Authors: Alawa Sugam , Pinge Chandraprabha , Ray Sucheta , Singh Parihar Ekta , Hajare Priyanka
Published: August 2024

Endometriosis is the functioning endometrium in a site other than the uterus. It can be either the endometriosis externa or interna. External refers to endometriosis of any part of the body except the myometrium. It primarily affects women who are of reproductive age and is a significant contributor to infertility and pelvic pain. Dyspareunia, cyclic menstrual pain, can be correlated with different Yonivyapada based on other symptoms. Ayurvedic management can be done based on Tridosh theory in which Vata is responsible for displacing endo-metrial cells from their original location in the uterus to places outside the uterine cavity. Pitta is responsible for the involvement of blood, hormones, and menstruation, as well as the inflammatory nature of the disease. Kapha is responsible for increasing the buildup of cells and forming adhesions in between organs so that the treatment approach can be Amapachana & correction of Agni, Vaatanulomana, Mridu Virechana, Vatashamaka, Raktasra-varodhaka, Granthihar and Shothhara Chikitsa. This paper will review endometriosis and its Ayurvedic per-spective, preventive & curative aspects.
SPICE UP YOUR CONSTITUTION: THE AYURVEDIC GUIDE TO KITCHEN HERBS
Authors: Gupta Sonam , Sharma Kajal
Published: August 2024

The Indian kitchen is a treasure trove of spices that add elegance, flavour and taste to meals. India, the largest
producer of spices due to its diverse climatic conditions, offers spices that hold significant medicinal value in alternative medicine systems, including Ayurveda. These spices serve as simple home remedies for managing various disorders and diseases. This review explores the effect of spices commonly used as Indian kitchen ingredients
based on Prakruti of person. The objective is to study the medicinal value of spices used in the Indian kitchen, as
described in the latest studies as per Ayurveda. Ayurvedic texts were meticulously analysed, and information on
spices was systematically collected. Research on the pharmacological actions of the active principles of these
spices was examined through various journals. Additionally, the effects of these spices on different doshas in humans were detailed based on their nature.
AYURVEDIC MANAGEMENT OF RIGHT ATAXIC HEMIPARESIS (MAR-GAVARANAJANYA PAKSHAGHATA): A CASE REEPORT
Authors: Kamath T Shrilatha , K.S Swathi
Published: August 2024

Cerebrovascular accidents are the fourth leading cause of death and fifth leading cause of adult disability. It can
be defined as a focal neurological deficit due to a vascular lesion lasting longer than 24 hours. The incidence of
stroke in India ranges between 105 and 152/1 lakh people per year. The present articles deal with a diagnosed case
of Right ataxic hemiparesis presenting with right sided hemiparesis with acute infarct in the left half of the pons.
The Ayurvedic diagnosis of Marmabhighatajanya Dakshina Pakshaghata was made and managed with Alepa,
Nithya Virechana, Sarvanga Abhyanga followed by Shashtika Shali Pinda Sweda, Nasya, Physiotherapy along
with Shamana Oushadhi. Assessment of the patient was made before and after treatment using National Institute
of Health Stroke Scale (NIH-SS), Modified Rankin Scale (MRS) and Barthel Index Score. Maximum improvement was seen in Dysarthria, fine movements and facial palsy. At the end of treatment, he was able to walk without support and able to look after own affair without support. Ayurvedic treatment procedures along with Shamana Oushadhi have a significant role in the management of Pakshaghata.
Creación de diversos cuestionarios de autoevaluación vocal pediátrica a nivel mundial: una revisión de alcance
Authors: Correa Soledad , Azevedo Renata , Alfaro Bugueño Millaray , Urbina Paula , Varas González Alexandra , Vásquez Castillo Valentina
Published: August 2024

Introduction. Childhood dysphonia can affect emotionally, socially and/or academically the infant's life, so it is essential to obtain a complete evaluation at vocal level, considering voice self-assessment.
Objective. To know and describe the characteristics of pediatric vocal self-assessment instruments created worldwide.
Method. A review of the scope was conducted in accordance with the methodologically established search criteria. The data analysis was performed after the search in several scientific database platforms. Twelve articles were incorporated into the final review and, based on the results obtained, 17 vocal self-evaluation questionnaires were described, indicating their evaluation objectives, structural conformation, target population, country of creation, methodological construction and psychometric characteristics.
Results. 17 original vocal self-assessment questionnaires were found, published in Italian, English, Portuguese, and Spanish. The studies considered several vocal pathologies and variable age ranges, including population from 0 to 21 years of age, The sample used was variable, with 3 publications with an experimental group of less than 100 subjects. 4 investigations presented adaptations of questionnaires originally created for adult voice and 2 investigations presented abbreviations of original questionnaires for pediatric voice. Considering the description of psychometric measures, 1 questionnaire presented sensitivity and specificity, 2 questionnaires presented validity and reliability, 4 questionnaires presented only reliability, 6 questionnaires presented specificity, sensitivity, and efficiency, and 4 questionnaires described reliability, validity, specificity, and sensitivity.
Conclusion. 17 original pediatric vocal self-assessment questionnaires were identified and described.
Impacto de la identidad nacional en la seguridad de la nación en Venezuela
Authors: Rodríguez Jesús Manuel , Canton Rodrigues Guillermo
Published: August 2024

El objetivo de esta investigación es analizar el impacto de la identidad nacional en la seguridad de la nación en Venezuela, es  innegable que la construcción de la identidad nacional se inicia con el proceso de independencia, hito histórico en el cual se inicial una serie de expresiones identitarias de la venezolanidad que son el resultado de la aglutinación de diferentes regiones que se extrapolan al resto, la característica esencial de la sociedad venezolana es precisamente la multiculturalidad de los ciudadanos que permite la interacción entre los diversos grupos sociales, en torno esta dinámica societal se construyó la ciudadanía venezolana. La metodología se enmarca en un diseño no experimental, nivel descriptivo, el tipo de investigación se enmarca en un proyecto factible sustentado en una investigación de campo; dado que, información se recopiló a través de la técnica de la encuesta mediante la aplicación de un cuestionario a una muestra de 385 personas. Como resultados es necesaria la el fortalecimiento de la identidad nacional. Como Conclusiones es necesario desarrollar estrategias para el fortalecimiento de la identidad nacional.
Kinerja Karyawan: Peran Produktivitas sebagai Variabel Moderasi pada Mahasiswa yang Bekerja
Authors: Elmitasari Samantha , Widyaningrum Mahmudah Enny , Qomari Nurul
Published: August 2024

Tujuan penelitian adalah untuk mengevaluasi pengaruh komunikasi, teknologi informasi dan work from home terhadap produktivitas kerja melalui kinerja karyawan pada mahasiswa yang sudah bekerja. Sampel penelitian adalah 344 mahasiswa STIE Mahardhika Surabaya yang telah bekerja. Teknik pengambilan sampel yang digunakan ialah non probability sampling dengan teknik sampel jenuh yang menggunakan seluruh populasi. Metode pengumpulan data dilakukan melalui penyebaran kusioner. Teknik analisis data yang digunakan ialah Partial Least Square (PLS). Hasil penelitian ini menjelaskan bahwa komunikasi, teknologi informasi dan work from home berpengaruh terhadap kinerja karyawan terhadap produktivitas, dan komunikasi, teknologi informasi dan work from home berpengaruh terhadap produktivitas melalui kinerja karyawan.
Molecular Diagnosis of Resistant Tuberculosis Against Rifampicin to the Patients of the Centre Hospitalier Universitaire de Référence Nationale (CHU-RN): Preliminary Study During the COVID-19 Pandemic Period in N'Djamena, Chad
Authors: Doungous Djamalladine Mahamat
Published: August 2024

Background: The fight against Tuberculosis (TB) remains a challenging public health problem worldwide. Nowadays, resistance forms increase sharply in developed countries. With a rifampicin resistance rate of 7.2% higher than the World Health Organization (WHO) level, the Tuberculosis Control Program in Chad has many challenges to overcome in the fight against resistant and multiresistant forms of TB. This present study aims to evaluate the proportion of resistant tuberculosis against rifampicin at the Centre Hospitalier Universitaire de Référence Nationale (CHU-RN) of N’Djamena in Chad.

Material and Methods: From August 1st to December 31st, 2020, sputum samples collected in the laboratory of CHU-RN were automatically included in our study. We directly analyzed sputum samples using the GeneXpert MTB/RIF, which is a molecular diagnosis method, to identify the sensitivity of the Mycobacterium tuberculosis complex to rifampicin.

Results: The study population consisted of 680 sputum samples collected. It was mainly represented by men (66.62%), with a ratio sex of about 1.99. The age range varies from 2 to 85 years old. Most of the patients in the study lived in N’Djamena (95.68%), and 4.32% were from other localities. Mycobacterium tuberculosis Complex (MTBC) was detected in 51.63% (N = 696), including 244 men and 104 women (a sex ratio of 2.35). Many tuberculosis patients are young people aged 15–34 (49.14%). Children whose samples tested positive for TB accounted for 2% of the 348 MTBC-positive samples, 7.18% (20 males and 5 females) were resistant to rifampicin, confirming a rifampicin sensitivity of 92.53%. Among these 25 cases of rifampicin resistance, 15 patients (4.31%) were already treated, and the other 10 patients represented new cases of TB (2.87%).

Conclusion: This study showed 7.18% resistance to rifampicin. These results highlighted the question linked to the post-COVID-19 period. The DOTS strategy should include the use of Xpert MTB/RIF® technology in all provinces of Chad. This will lead to the early detection of new cases of TB and MDR-TB. Overall, it will provide rapid treatment, as recommended by the WHO for developing countries like Chad.