bluuebunny/crossref_metadata_2025 huggingface dataset:
A comprehensive review of Pratinidhi Dravya from commentaries of Sharangdhara Samhita
Authors: Badyal Sakshi , Tambe Ganesh A. , Yadav Pramod R. , Prajapati Pradeep K.
Published: August 2023

Introduction:

Substitutes (Pratinidhi Dravya) is a known concept since Samhita period but became popular during 16th–17th century. Substitutes are important in the present scenario where the availability of raw drug is a big concern. The current available published data focuses on substitutes described by Bhavpraksha and Yogratnakara. But before these texts, commentators of Sharangdhara Samhita have explained Abhava Dravya under different formulations. No work has been done to highlight their contribution.

Materials and Methods:

A thorough review of entire Sharangdhara Samhita along with its two commentaries, i.e., Deepika and Gudhartha Deepika, has been done along with databases and published literature.

Result and Conclusion:

Through this review, a clear insight of the seers was observed in choosing substitutes by prioritizing the therapeutic profile of the drug or formulation.
A narrative review on use of virgin coconut oil in dermatology
Authors: Umate Nishigandha , Kuchewar Vaishali , Parwe Shweta
Published: August 2023

Background:

Coconut oil is of two varieties: virgin and refined oil. Virgin coconut oil (VCO) is made by cold-pressing the liquid from the fresh part of coconut meat. It has a milky appearance. This oil extraction method prevents the loss of vitamin E, pro-vitamin A, and polyphenols. It has various properties such as analgesic, anti-inflammatory, and anti-cancer. Skin is the general structure of the body. It is the first line of protection against traumatic injuries and microorganisms.

Aim:

This review is focussed on the existing data on the effect of VCO on the skin.

Materials and Methods:

PubMed and Google Scholar were searched for citations for keywords “virgin coconut oil and dermatology” and “virgin coconut oil and skin.” In search of the various databases, 13 articles were found on VCO related to skin.

Result:

Virgin coconut oil is used as antioxidant, anti-inflammatory, as skin protector, in Alzheimer's disease, in wound healing and as moisturizer.

Conclusion:

From this review, it can be concluded that VCO is beneficial for various dermatological disorders. It is antifungal and antibacterial and also acts as an immunomodulator. It also has anti-inflammatory, angiogenic, wound-healing, and skin protective properties.
Management of hypothyroidism with the help of principles of Anukta disease concept
Authors: Suryawanshi Amruta Rajendra , Kulkarni Prasad Vitthal
Published: August 2023

Lack of thyroid hormone and resistance of the body tissue to thyroid hormone with respect to metabolic demand result in disorder called hypothyroidism. As per conventional science, Synthetic thyroid hormone used to manage hypothyroidism makes the patient drug dependent and still not helping in resolving underlying pathology. Hence Ayurveda is opted for study and to manage the conditions like hypothyroidism by means of Ayurvedic principle like anukta vyadhi vichar (Unstated Disease Concept): In this case, a female patient of age 35 yrs old had complainets of shwasakashtata (Breathlessness), mukhashotha (facial puffiness), hrudadrava (Palpitations), daurbalya (Weakness) was examined thoroughly with the help of ayurvedic methodology aspect like Dashavidha pariksha as patient has kaphapitta pradhan hetu and lakshana hence diagnosed as kaphaj pandu awastha as stated in classics. Treatment protocol given in samhita for this particularly diagnosed kaphaj pandu awastha which is samshodhana (Purification), Snehana (oleation) and shamana (internal medicines) was followed and successfully treated. Symptomatic relief and to wean the patient off the synthetic hormone supplement are the intent to treat the condition of hypothyroidism in this patient. This case study concludes that by means principle of Anukta vyadhi vichar, one can diagnose and successfully manage the conditions like hypothyroidism which are not stated in ayurvedic classics.
A critical review of Vishaghna Dravya mentioned in Madanpal Nighantu
Authors: Pandey Chandradev , Kadu Amol Sharma , Sharma Anita , Patel Narsingh
Published: August 2023

Background:

Agada Tantra is the branch of Ayurveda that deals with food poisoning, snakebites, dog bites, insect bites, etc. Envenoming is an important public health problem in India. In modern, there are various treatments including anti-venoms for poisoning. But still, there is a lacuna in treatment due to the side effect of contemporary treatment. But in Ayurveda, various drugs are described, having antitoxic properties, without any side effects.

Aim:

To provide comprehensive information about Vishaghna Dravya (anti-toxic drug) mentioned in Madanpal Nighantu which is used as a medicine for the treatment of different animate, inanimate poison, and metallic poison.

Materials and Methods:

Ayurveda text Madanpal Nighantu in Sanskrit as well as Hindi where the Dravya (drug) of different origins and their antitoxic property are mentioned have been referred for this literary work. Knowing the relevance of drugs in the form of Visha Chikitsa (treatment of poison) and their Vishaghna Guna (antitoxic property). For the discussion, all of the gathered information has been reorganized and critically reviewed, and an attempt has been made to draw certain meaningful insights.

Results and Conclusion:

In this article, we focused on various Vishahar Dravya mentioned in Madanpal Nighantu, based on Rasa, Guna, Virya, and Vipaka, and out of 500 drugs in Madanpal Nighantu there are 74 drugs having Vishaghna properties. This Nighantu generally describe drugs having action against different type of poisons such as Jangam, Sthavar, and Dhatu Visha. Visha-Upavisha Dravyas from the therapeutic point of view are considered highly valuable in accordance with their quick effectiveness even in smaller doses.
Effect of Yogic management with Ayurveda regimen in underweight
Authors: Kendre Rohini M. , Jain Sumeeta S.
Published: August 2023

Nowadays, everyone is conscious of body fitness and bodybuilding. People experiment with their body by exercising in the gym with heavy workout and with different diet plans. These experiments result in an adverse effect. In this case study, a 27-year-old male patient, lean built since childhood, with low body mass index (BMI), wanted to increase his weight. We took a detailed history to find out the exact cause. The patient was taking an extra amount of food for weight gaining, but because of the slow digestive fire, there was no positive effect of food seen; rather, the patient suffered adverse effects such as sour belching, anorexia, and indigestion. The cause of slow digestion cured with the help of Vaman Dhauti (Yogic therapeutic self-induced emesis) that helped in body detoxification. Drug therapy with do’s and don’ts were advised for 30 days, which subsided Pitta vitiation and increased appetite by increasing digestive fire. After that, the patient needs to take more quantity of food but should be balanced, so a diet plan, Yoga, and Pranayama were explained for the next 60 days. The result was a remarkable improvement in subjective symptoms as well as the weight of the patient increased from 50 kg to 58 kg and the BMI increased from 17.7 (underweight) to 20.5 (normal). With the help of traditional knowledge, we can achieve our targets to live happily and confidently. The combination of Yogic procedures (an easier method for the cleansing body) with Ayurveda principles results in remarkable improvement without adverse effects. This study has a unique intervention; lean patients also need to detoxify their body first for a better relief, then the medication will work out, which needs to be studied on a large scale.
External applications of Shigru (Moringa oleifera Lam)
Authors: Gavadiya Swati K. , Sharma Tarun , Bapna Vidhi M.
Published: August 2023

Background:

Plants are the main source of medicine in traditional system of medicines like Ayurveda. In Ayurvedic literature, there are indications of Basti (drug administration through anal route) and Nasya (drug administration through nasal route) along with oral route. Similarly, for external application, there were many forms such as lepa (external application of paste), Aschyotana (eye drops), Anjana (collyrium), etc. The Ayurveda literature is a treasure of many formulations that can be therapeutically used through various routes in Netra roga (eye disorders), Karna roga (ear disorders), Kustha (skin diseases), Apsmara (epilepsy), Galganda (goitre), and Slipada (elephantiasis). Systematic monographs of single drugs can be very useful for clinical application. Moringa oleifera is a single drug, which is abundantly available as well as therapeutically efficacious; this review is an appraisal to compile and present the external therapeutic uses of Shigru (Moringa oleifera Lam).

Aim:

The aim of the study was to review the Ayurvedic literature to collect information regarding the external therapeutic use of various parts of Shigru.

Materials and Methods:

Extensive review of Shigru involves the study of Veda, Samhita, Chikitsa granth, Ayurvedic compendia, and various databases like database of India, etc., regarding various formulations, dosage form, indications, and useful parts.

Result:

During the literature survey, a total of 149 formulations in 145 dosage forms of Shigru have been recommended for 24 diseases.

Conclusions:

Shigru is extensively useful for external application, and based on the information presented in this literature survey, it can be therapeutically used in many diseases as well as novel formulations and dosage forms using Shigru (Moringa oleifera Lam).
The formulations in Rasayogsagar for treating toxicity
Authors: Pandey Narayan , Sharma Anita , Kadu Amol S. , Das Kishore , Itani Naresh , Pokhrel Saroj M.
Published: August 2023

Background:

In the current era, different toxicants are a major problem for human Owing to industrialization and civilization, people are embedded in the test-tube of toxins. Different kinds of toxicants, which are called xenobiotics, found in the form of chemicals, pesticides, coloring agents, and antibiotics, which enter into the body through different routes such as oral, dermal, and inhalation, play an important role as a etiological factor for the pathology of different diseases such as hypertension, diabetes mellitus, cancer, and so on. All these artificial poisons are considered to be Kritrim Visha, which are also called Gara Visha in Ayurveda, which is described to be one of the causative factors to cause disease conditions. So, it is necessary to identify those preparations or formulations which act as an anti-toxic action. The classical text, i.e., Rasayogsagar, has mentioned thousands of preparations, among them about 74 are Vishaghna Yoga (anti-toxic preparations) which have been specifically indicated either in animate or in inanimate toxicity or in both. These formulations in the modern era have a great importance to reduce the toxicity level in human beings. So, these preparations must be prepared and made available everywhere following the guidelines of preparation mentioned in Rasayogsagar, which could play to pacify the toxic substance and prevent the harmful effects in human beings.

Aims and Objectives:

The aim of this study is as follows: (i) To study the indication of different preparations mentioned in Rasayogsagar for different toxic manifestations. (ii) A detailed literary study of contents and methods of preparations of Vishaghna (anti-toxic) with doses and route of administration.

Materials and Methods:

The article is based on literary review regarding anti-toxic action (Vishaghna) of various kinds of preparations, which has been collected and compiled from Ayurvedic compendium (i.e., Rasayogsagar).

Results and Conclusion:

In total, 74 anti-toxic (Vishaghna) formulations have been found in Rasayogsagar. Most of them have found to be specifically indicated in anti-toxic action-specific (Visha Rogadhikar) and some of them have been indicated in other disease conditions but have anti-toxic properties (Vishaghna) also.
Low back pain
Authors: Verma Piyush , Kanaujia Shiwangi , Pathak Ashutosh K.
Published: August 2023

Introduction:

Low back pain affects 70–85% of the adult population at some point in life. In total 45–75% of patients continue to experience pain after 12 months of onset. Low back pain is a major health hazard in today’s technological era. The history of low back pain is as ancient as human civilization. There are pieces of evidence of low back pain and sciatica in the past era, which was a problematic concern for the population of that time. There was a practical approach of different cultures toward the low back and sciatic pain at that time. The rich history of Indian medicine guides us to the classic developments and thoughts of that era.

Aims and Objectives:

This study aims to illuminate descriptions and understandings of low back pain from previous historical reviews as well as fill gaps in previous reviews that ignored the hidden knowledge of low back pain from ancient Indian literature.

Materials and Methods:

Here published scientific articles in reputed journals regarding the historical background of low back pain, sciatica, and lumbar radiculopathy have been reviewed from PubMed, Google Scholar, Scopus, and so on, and low back pain conditions from ayurveda classics have been extracted and conceptual understanding to low back pain by ancient Indian ayurvedic scholars have been revealed. The lacunae in previous reviews of missing the knowledge of ancient Indian ayurvedic texts have been tried to fill by this work.

Observations and Results:

The review showed that the understanding of various conditions associated with low back pain such as katishoola, katigraha, gridhrasi, trikshoola, trikvedna, and so on. and its pathophysiology was well developed in ancient Indian culture.

Conclusion:

Numerous earlier studies on low back and sciatic pain have overlooked the historical significance of the Indian subcontinent. The existing information must therefore be revealed along with these crucial descriptions. The world’s focus will be directed toward ayurvedic medicines and low back pain management solutions when the concepts of ayurveda are revealed historically. As a result, this article will aid in promoting the traditional Ayurvedic medical method.
Management of Vicharchika through Panchakarma
Authors: Kavita Kumari , Meher Alok K. , Bhatted Santosh K.
Published: August 2023

Background:

Vicharchika is a type of skin disorder; as per our ancient Acharyas, all skin disorders are described under Kushtha, which is further divided into two subcategories MahaKushtha and KshudraKushtha. Vicharchika is one of the types of KshudraKushtha as mentioned in Ayurveda texts. The clinical presentation of Vicharchika is similar to that of atopic dermatitis.

Aim:

As modern system of medicines is no safe and permanent solution, Ayurveda provides a wide range of treatment protocols such as Shamana (medication of disease), Shodhana (purification), and Rasayana (rejuvenation) therapies. In this single case study, Ayurveda Panchakarma treatment was used to understand its effectiveness and safety.

Materials and Methods:

The patient was given treatment for a period of 15 days along with a follow-up period of 15 days. The treatment protocol included DeepanaPachana, Snehpana, Sarvanga Abhyanga, SarvangaBaspaSwedana followed by Virechana (purgation therapy) through NimbamruthadiErandaTaila, Triphala, and TrivrutChurna.

Results:

A significant improvement was seen in all assessment criteria, i.e., Eczema Area and Severity Scale, Scoring Atopic Dermatitis, and Ayurveda Signs and Symptoms. An average improvement of 86.87%was recorded in all assessment criteria.

Conclusion:

Ayurveda Panchakarma procedures have immense potential even in chronic cases and can be used as a treatment plan for skin disorders. Considering the chronicity of the case and substantial improvement found, this case was worth sharing with scientific domain for betterment of science.
Venous Thromboembolism and Cardiopulmonary Involvement in Covid 2019 Patients: A Retrospective Observational Study
Authors: Kumar Viveka , Anand Reena , Dhir Sangeeta , Aggarwal Bharat
Published: August 2023

Context:

The context of the study was venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19) patients.

Aim:

The purpose of the study was to understand the prevalence of thrombotic events (pulmonary embolism [PE] and deep-vein thrombosis [DVT]) and right ventricular (RV) dysfunction (RVD) in patients with COVID-19.

Settings and Design:

Retrospective observational study, Max Hospital, New Delhi, India.

Materials and Methods:

This study was undertaken in 504 diagnosed COVID-19 adult patients of both genders in the age groups (>40 years and 40 years) during the COVID first and second waves in India. The hospital EMR database of the admitted COVID patients was extracted. Based on the study criteria, the parameters assessed were: D-dimer, CTSS scoring, DVT, RVD, and nature of hospitalization.

Statistical Analysis Used:

Quantitative variables were expressed in terms of mean and standard deviation. The significance of the association between different variables was evaluated by the Chi-square test. The significance of the difference in age and CTSS score between different categories of PE and DVT was tested by the Student’s t-test.

Results:

The mean age of the patients was 57.13 years. The mean D-dimer level was 502.95 ng/mL. A PE was reported in 101 patients. The severity of the lung involvement as assessed on computed tomography pulmonary angiography was predominant in the bilateral segmental branch (70%), with a mean CTSS score of 14.47, 7.37. DVT was reported in 48 (9.5%) patients. RVD was observed in 14 (2.8%) patients. A significant correlation was found between PE and hospitalization (83.2%, P = 0.003), CTSS (20.07%, P = 0.037, confidence interval 0.10–3.31), and DVT (33.7%, P = 0.001). The prevalence of PE (20.03%) and VTE was 6.7%. RVD was reported in 2.8% of the cases.

Conclusion:

Our study validates the increased risk of VTE in COVID-19 patients. These findings will be useful to researchers and medical practitioners caring for COVID-19 patients.
Leadless Pacemaker – A Savior in Crisis
Authors: Tumkur Ashwin , Sudhakar Golla
Published: August 2023

The current case describes the successful implantation of a leadless pacemaker in an elderly patient with multiple complexities. The patient had an in situ cardiac pacemaker with a suspected displaced right ventricular lead and was stabilized using temporary pacemaker implantation. The angiogram revealed obstructed subclavian veins; hence, a leadless pacemaker was successfully implanted.
Platelet Parameters May be Predictors of Coronary Artery Disease in Prediabetes: Rural Hospital-based Cross-sectional Study
Authors: Talwar Dhruv , Kumar Sunil , Acharya Sourya , Wanjari Anil , Bawankule Shilpa , Agrawal Sachin
Published: August 2023

Introduction:

Prediabetes is a state of impaired glucose tolerance that often precedes overt diabetes mellitus and is frequently underdiagnosed. Glycation of platelet proteins leads to increased platelet reactivity which can be an essential predisposing event in the pathogenesis of coronary artery disease (CAD). Although research has been conducted to diagnose CAD in prediabetes and to assess platelet indices in prediabetes, there has been no attempt to assess platelet indices in prediabetic patients who have CAD.

Methods:

This cross-sectional study was carried out in a rural tertiary care center in Central India from September 2019 to August 2021. A total of 180 patients were enrolled in this study, having documented CAD in coronary angiography (CAG) and blood glucose levels in the diagnostic range of prediabetes by the criteria set by the World Health Organization. Platelet indices, glycosylated hemoglobin, blood sugar levels, and CAG findings were documented for all participants.

Results:

The mean platelet volume (MPV) in our study population was 9.58 ± 1.14 fL, platelet distribution width (PDW) was 15.69% ± 1.36%, plateletcrit was 0.3% ± 0.07%, and platelet count was 319 ± 44 × 103 cells/mm3. PDW was the best tool to predict double-vessel disease (P < 0.0001), while MPV (P = 0.6146) and PDW (P = 0.0266) were best predictors of triple-vessel disease.

Conclusion:

Platelet indices that are readily available investigations prescribed by clinicians routinely are significantly associated with blood sugar levels and can predict the severity of CAD in prediabetics in terms of the number of vessels involved. Early assessment of platelet indices in prediabetics can aid in the diagnosis and prognosis of CAD, thereby helping in planning early intervention.
Acute Coronary Syndrome in Young (≤45 Years) Patients: An Observational Study
Authors: Pandey Chandrashekhara , Singh Reena , Talokar Pankaj Kumar Vasantrao , Parikh Rujuta , Singh Gaurav
Published: August 2023

Background:

Acute coronary syndrome (ACS) is witnessing a demographic transition with increasing prevalence among younger individuals (≤45 years). Hence, this study was designed to evaluate the clinical features, risk factors, and angiographic profile of young (aged ≤ 45 years) patients with ACS and to compare it with the older (aged >45 years) patients with ACS.

Materials and Methods:

An observational study was conducted at a tertiary care center in India from July 2020 to December 2021. A total of 157 patients were enrolled, among which 90 patients were included in cases (group-I). The inclusion criteria were patients presenting with ACS aged between 18 and 45 years. There were two control groups, including 34 patients with ACS (aged >45 years) in Group II and 33 healthy volunteers in Group III (aged 18–45 years). Baseline demographic details, risk factors, and angiographic profile of patients with ACS in each group were recorded and compared.

Results:

Mean age of Group I was 39.79 ± 5.15 years and of Group II was 59.74 ± 8.21 years. Smoking (P = 0.027) and family history of coronary artery disease (P = 0.022) were the significant risk factors of ACS in Group I. Compared to non-ST elevation myocardial infarction (16.7%), ST-elevation myocardial infarction (83.3%) was predominant among younger patients with ACS. Single-vessel disease was prevalent among younger patients (62.2%) as compared to older patients with ACS (41.20%).

Conclusion:

Younger patients with ACS exhibited a distinct clinical and angiographic profile compared to older patients with ACS.
Efficacy and Safety of Rivaroxaban in Prevention and Therapy of Thromboembolic Events in Patients with Nonvalvular Atrial Fibrillation
Authors: Preradović Tamara Kovačević , Miljković Siniša , Kos Ljiljana , Šukalo Aziz , Glamočlija Una , Avdić Amna Tanović , Mehić Meliha
Published: August 2023

Context:

Rivaroxaban is an oral direct factor Xa inhibitor reducing the risk of systemic embolism and stroke in patients with nonvalvular atrial fibrillation.

Aims:

The primary objective was to evaluate the effectiveness of rivaroxaban therapy in reducing the risk of systemic embolism and stroke in patients with nonvalvular atrial fibrillation, whereas secondary objectives were to monitor therapy safety and the patients’ adherence to treatment.

Settings and Design:

The prospective, postmarketing clinical trial was conducted on patients with nonvalvular atrial fibrillation with one or more risk factors, such as congestive heart failure, hypertension, and diabetes mellitus, who suffered a stroke or a transient ischemic attack.

Subjects and Methods:

At the baseline visit, the CHA2DS2 score was determined, and therapy was introduced. At three control visits (1, 3, and 6 months after baseline), systemic embolism, stroke, bruises, or bleeding occurrences were recorded. Furthemore, adverse events were monitored, and the Morisky score (MMAS-8) for treatment compliance was determined. Results were compared to previous studies.

Results:

The study included 471 patients. The incidence rate in events per 100 patient-years (95% confidence interval) was 2.6 (0.1–5.1) for systemic embolism and 4.3 (1.6–7.0) for stroke. The most common form of bleeding during rivaroxaban therapy was epistaxis. Adverse events were reported in 12 (2.7%) patients. Therapy adherence was in the range of medium adherence for the entire study period, with the average score decreasing significantly from the 1st to 6th months (P < 0.001).

Conclusions:

Rivaroxaban showed good efficacy and safety in reducing the risk of systemic embolism and stroke in patients with nonvalvular atrial fibrillation including patients with comorbidities.
Radial Artery Pseudoaneurysm Following Transradial Percutaneous Coronary Intervention
Authors: Konda Bharath Kumar Reddy , Parvathareddy Krishna Malakonda Reddy , Nagula Praveen , Hussain Zia
Published: August 2023

Cardiac catheterization is performed for both therapeutic and diagnostic reasons. Like any invasive procedure, cardiac catheterization is associated with complications; hence, the decision to undertake the procedure should be based on the risks and benefits. In terms of vascular problems, the radial artery approach to cardiac catheterization is preferable to femoral artery access. Rare cases of radial artery pseudoaneurysms (PSAs) have been documented. The incidence of radial PSAs, a recognized complication of radial access, has been gradually rising due to the increasing number of radial procedures in cardiology. We report a case of a 67-year-old female who had a large radial PSA following transradial (TR) coronary angioplasty with stenting. She was managed conservatively with TR band application, intermittent manual compression, and dressing.
A conventional case of herpes zoster ophthalmicus with curious findings
Authors: Yaragani Aravind , Subramanian Kamala
Published: August 2023

A 49-year-old female presented with complaints of right-sided headache, right eye severe pain, and diminution of vision since 1 month. Examination revealed healed skin rashes over the right side of the forehead, right upper lid mechanical ptosis, unilateral restriction of movements, corneal edema, total hyphema, and thickening of retino-choroido-scleral (RCS) complex with subtenon fluid on ultrasonography. A diagnosis of herpes zoster uveitis with total hyphema with posterior scleritis was considered. She was started on topical steroids and intraocular pressure (IOP) lowering agents. But, she was lost to follow up and 6 months later, the eye was phthisical. Here, we present a relatively rare case of herpes zoster ophthalmicus (HZO) with hyphema and posterior scleritis.
Malignant glaucoma: A therapeutic challenge
Authors: Anuradha A. , Devi M. Vidhya , George Rose Mary , Kumar N. Manoj , Gupta Priyam
Published: August 2023

Malignant glaucoma is a rare condition characterized by an acute rise of intraocular pressure rise with a very shallow anterior chamber, generally following anterior segment surgery. The mechanism leading to malignant glaucoma is that in an anatomically predisposed eye, the anterior rotation of the ciliary body induces misdirection of aqueous flow into or behind the vitreous body, increasing vitreous volume, resulting in anterior displacement of the iris–lens diaphragm, axial and peripheral anterior chamber flattening, and secondary angle closure. The aim of this article is to report a case of malignant glaucoma to discuss about the risk factors involved and therapeutic approaches that are useful in managing such cases.
Macular morphological changes in retinal vein occlusion with macular involvement and their association with macular ischemia
Authors: Rawat Renuka , Chalisgaonkar Charudatt , Tripathi Divya , Jain Shashi
Published: August 2023

Aim:

The aim is to study the association between macular morphological changes and macular ischemia in retinal vein occlusion (RVO) involving macula by spectral domain-optical coherence tomography (SD-OCT).

Settings and Design:

Observational cross-sectional study.

Materials and Methods:

The study included a total of 31 eyes of 30 RVO patients involving macula divided into two groups on the basis of fundus fluorescein angiography: Group A (RVO with macular ischemia) and Group B (RVO without macular ischemia). In each patient, macular cube and horizontal HD raster scans of the macula were performed to evaluate quantitative (central foveal thickness [CFT]) and qualitative (loss of inner retinal layers, loss of foveal inner segment/outer segment [IS/OS] junction, and prominent middle-limiting membrane [p-MLM] sign) macular morphological changes, respectively.

Statistical Analysis:

The continuous and categorical data were analyzed using unpaired t-test and Fisher’s exact test, respectively, with GraphPad Prism 9 software.

Results:

The mean CFT was thinner in Group A (432.71 ± 172.30 µm) as compared to Group B (564.57 ± 151.16 µm) and the difference between the two groups was statistically significant (P < 0.05). In this study, we found that the loss of inner retinal layer and loss of foveal IS/OS junction were more commonly associated with the macular ischemia group and this difference was statistically significant P = 0.0245 and 0.0292, respectively. We did not find any significant relationship between p-MLM sign with macular ischemia.

Conclusion:

SD-OCT parameters such as CFT, loss of inner retinal layer, and loss of foveal IS/OS junction were observed to predict macular ischemia to some extent.
Corneal component surgery: Expanding the indications
Authors: Nagpal Nimisha , Prasher Pawan
Published: August 2023

Despite immense progress in eye banking and corneal transplantation in the past few years in India, we still have a long way to go. The acute shortage of good-quality donor corneal tissues calls for innovative methods to ensure optimum utilization of the available resources including corneal tissues. The recent advances in lamellar surgery techniques have enabled use of one donor corneal tissue in multiple recipients. The authors discuss their experience of using one cornea in three patients with different corneal pathologies. Component corneal surgery is bound to play a key role in combating corneal blindness in India.
Ophthalmic prostaglandin analogs revisited - A systematic review of commonly used formulations
Authors: Feroze Kaberi Biswas
Published: August 2023

Aim:

To systematically review the randomized control trials (RCTs) of the various prostaglandin(PG) analogues, comparing the effectiveness in treating glaucomas, safety and adverse effects of the individual agents.

Methods:

Articles were searchedusing the following key words “PG analogues”, “Latanoprost”, “ Bimatoprost”, “Travoprost”, “ Tafluprost”, “Unoprostone”, “ophthalmology”, “randomized controlled trial”, either singly or variably combined. Databases searched included Pubmed, Embase, Cochrane library, and Science direct. The search strategy was to identify randomized control trials (RCTs), either singly or variably combined.

Results:

24 Randomised control trials that had evaluated the efficacy and adverse effects of different PG analogue agents were selected and were used in this review Average JADAD value of the researches was found to be 2.83. Bimatoprost was found to be the most effective agent in IOP lowering efficacy but it had the maximal incidence of local adverse effects. Latanoprost, Travoprost and Tafluprost had similar efficacy. Latanoprost had the best tolerability. Unoprostone had weaker antiglaucoma action, compared to the other agents.

Conclusions:

Bimatoprost is probably one of the best antiglaucoma medications available at present. Its tolerability could be improved by using preservative free formulations. Latanoprost is a well tolerated agent with reasonably good antiglaucoma action.
“Ousted little elf”—Secondary glaucoma in Weill-Marchesani syndrome
Authors: Karthya Devi
Published: August 2023

Ocular features of Weill-Marchesani syndrome include ectopia lentis, myopia, and pupillary block glaucoma. The purpose of this case report is to describe a case of secondary glaucoma in an 18-year-old female with suspected Weill-Marchesani syndrome.
Awareness and attitude regarding eye donation among undergraduate students of an engineering institution and its implication in Tamil Nadu
Authors: Subramaniam Gnaneswaran , Kumarasamy Murugan , Siraja Ameenah A. H.
Published: August 2023

Background:

Corneal blindness is estimated to be the second most prevailing cause of blindness in developing nations. Visual rehabilitation by corneal transplantation is the main choice for the restoration of vision in these cases. The corneal transplant success relies on the availability of high-quality donor eyes. At present, there is a gap between the demand and supply of donor corneal tissues in the developing world. Our study aims to assess the awareness and willingness to eye donation among undergraduate students, especially those from a non-medical background.

Methods:

A single-center, cross-sectional study was conducted on engineering undergraduate students studying in a reputed Multi-disciplinary Institution, located in rural Tamil Nadu during the period August 2018 to March 2019 (8 months). Using random sampling, 507 students were selected for the study. A structured questionnaire was administered to all the participants. For statistical analysis, SPSS software, version 22, was used.

Results:

A total of 507 students participated in the study. The mean age of participants was 19 ± 2 years. In the study group, more than half (499) of the students had awareness about “eye donation,” but only 62.2% of students were willing to donate eyes. Among the study participants, 74% showed a poor attitude toward eye donation. Lack of knowledge regarding the process of eye donation was seen as the major cause attributing to this poor attitude.

Conclusion:

We conclude that if more intensive awareness program activities are carried out to make the younger generation, making them more aware of the process of eye donation, we can significantly increase the rate of eye donation in India.
Clinical and microbiologial profile of bacterial and fungal keratitis: A comparison of patients with and without diabetes mellitus
Authors: Paul Jincy Mariya , Jyothi P. T.
Published: August 2023

Aims:

The aim of the study was to evaluate the predisposing factors, clinical features, causative microorganism, and response to treatment, among persons of infective keratitis, with and without diabetes mellitus and to determine differences between the two groups.

Subjects and Methods:

This prospective study enrolled 26 patients of infective keratitis who had diabetes mellitus and 52 patients without diabetes mellitus, by consecutive sampling who attended the ophthalmology department at a tertiary care institute. Detailed clinical evaluation and microbiological evaluation were done. Treatment was initiated according to clinical diagnosis. The patients were followed up at 2 weeks, 1 month, and 3 months.

Statistical Analysis Used:

Statistical testing was done using Chi-square test and Fisher’s exact test for qualitative variables. Quantitative variables were expressed as means and standard deviations. The variables between the two groups were compared using Student’s t-test and Wilcoxon test, where appropriate. Shapiro–Wilk test was used to test normality of data. Analysis was done using the SPSS software.

Results:

Urban population, monsoon season, and outdoor work were associated more commonly with microbial keratitis. Ocular trauma (69.2%) was the most common risk factor. A greater proportion of patients with diabetes (46.2%) did not have a history of ocular injury compared to those without (23.8%). Poor glycemic control increased severity of keratitis (P = 0.023). Redness and pain were the most common symptoms in both groups. Corneal sensations were significantly reduced in patients with diabetes mellitus. Diabetes mellitus was significantly associated with central ulcers (46.2%), hypopyon (50%) in anterior chamber, and fungal keratitis (35%). Hypopyon and depth of ulcer were significant predictors (P = 0.018 and 0.006) of the time taken for the infective keratitis to heal. Pseudomonas aeruginosa (19.2%) was the most common bacteria isolated in diabetic patients and Methicillin-sensitive Staphylococus aureus (10.3%) among nondiabetic patients. Fusarium was the most common fungus isolated among both groups. Ulcers healing with leukomatous opacities were higher, and the frequency of perforated corneal ulcers was also higher among diabetic patients (P = 0.026). Posttreatment visual acuity showed a statistically significant improvement only in patients without diabetes mellitus.

Conclusions:

Significant differences existed between the two groups regarding clinical and microbiologial profile. Aggressive treatment, strict glycemic control, and high index of suspicion for fungal keratitis are important in managing microbial keratitis patients with diabetes mellitus.
Evaluation of the Relationship Between Dental Caries and Dermatoglyphics in 3 to 6-Year-Old Iranian children
Authors: Mokhtari S , Mokhtari S , Sabour S , Hosseini Z
Published: August 2023

Background:

As enamel and finger buds have an ectodermal origin and grow at the same time, it might be supposed that factors and agents that affect dental caries might give rise to the diversity of dermatoglyphic dermal ridge patterns.

Aim:

The present study aimed to evaluate the relationship between dental caries and dermatoglyphics in 3 to 6-year-old Iranian children.

Methods:

The present case-control study was performed on 3 to 6-year-old children. The decayed, missing, and filled teeth (dmft) scale was used to evaluate the oral and dental health status in the participants. Then, the patients were divided into two groups: 1) The case group: patients with a dmft of ≥3 (101 cases); 2) the control group: those with dmft value of zero (86 cases). Afterward, using a fingerprint recording device, the fingerprints were obtained from both hands of the participants.

Results:

There was no significant relationship between the patterns of fingerprints and dental caries. The percentages of whorls, loops, and arches in the case group were higher than those in the control group; however, these differences were not statistically significant.

Conclusion:

Dermatoglyphic patterns could not be used as a variable for the detection or prediction of dental caries in Iranian children.
The Effect of Different Positions of Unerupted Lower Third Molar Teeth on the Fragility of Mandibular Angle
Authors: Seyrek NK , Kahraman OE
Published: August 2023

Background:

The mandibular bone is the largest and strongest bone in comparison to the other bones in the face skeleton. However, it is the most commonly fractured in facial injuries. The location of the fracture in mandible depends on various factors. The relationship of the impacted lower third molar teeth to mandibular angle fracture has been the subject of many epidemiological studies. It is argued that the risk of fracture in mandibular angle is two to four times more when there are particularly an impacted or partially impacted third molar teeth. However, the effect of the position of the impacted tooth on mandibular angle fracture is not clear yet.

Aim:

This study seeks to reveal the effect of third molar teeth that are impacted in various positions on the angle fragility.

Materials And Methods:

This study was performed using three-dimensional finite element stress analysis and static linear analysis methodology. Computed tomography (CT) images obtained previously from a patient were used to construct models of the bone tissue. An ILUMA CBCT device (3M Imtec, OK, USA) was used for tomographic scans. Impacted teeth in various positions were digitally modeled separately. Different direction forces were applied to the mandible, the stress values on the bone surrounding the third molar teeth impacted in different positions were determined.

Results:

Third molar teeth are impacted in mandibular bone in the following positions: mesioangular, vertical, horizontal, and distoangular positions. The study showed that the force that created the highest stress in the Mandibular angle among the modelled groups is the force by ipsilateral angle.

Conclusion:

For all kinds of impacted teeth, there was more stress accumulation in the buccal area than in the lingual area when the force is from the symphisis.
Noninvasive Ventilation with Nursing Perspective
Authors: Yaman Ö , Aygün M , Erten H
Published: August 2023

Background:

The success of noninvasive ventilation (NIV) treatment is closely related to high levels of clinical support.

Aims:

In this study, we sought to analyze patient mask compliance and minor side effects and to evaluate additional nursing workload needed for the NIV care.

Materials and Methods:

The study was designed as a prospective and observational. The data were collected from an intensive care unit. Clinical and physiological data, patient tolerance and adverse effects, subjects' complaints about their experience, and additional nursing workload associated with NIV treatment were assessed.

Results:

Statistically significant improvements were obtained in arterial blood gas analysis, respiratory rate, and heart rate during treatment. In the first 2 h, 65% of subjects had poor mask compliance, patients' comfort scores were poor, and incompliance was associated with discomfort. The ratio of skin problems was 15% in the first 24 h and reached 60% at 48 h. The pain rate due to mask ties was 80% and then increased to 90% at 48 h. There was a significant relationship between the problems detected by the nurses and problems described by the subjects. Additional nursing workload was found as 110 min for 0–6 h.

Conclusions:

We observed that the mask compliance and comfort levels of the subjects were poor. Skin breakdowns increased depending on the duration of treatment. Treatment would require continuous nursing support in seven areas. NIV treatment generated a significant amount of workload for nurses. Additional nursing workforce planning is required for NIV units for successful NIV treatment.
Complex Congenital Heart Diseases Among Children Presenting for Cardiac Surgery in a Tertiary Health Facility in Enugu; South-East Nigeria. A rising trend
Authors: Ujunwa FA , Ujuanbi IS , Chinawa JM
Published: August 2023

Background:

Complex cardiac anomalies are a set of associated heart structural anomalies requiring some adaptive mechanism to maintain life.

Objectives:

This is to determine pattern and prevalence of common complex cardiac anomalies among children presenting for cardiac surgery in Enugu.

Methodology:

The children that present for cardiac surgery in our center over a six-month period were admitted and rescreened using a standardized echocardiographic method, information on biodata, oxygen saturation and 2D echo diagnosis were recorded in a proforma.

Results:

A hundred and one (101) children with different structural heart diseases presented for cardiac surgery, 53 females and 48 males, 99 (98%) had congenital heart defects (49 cyanotic and 50 acyanotic). Complex cardiac anomalies were noted among 49 and 50 were non-complex, 6 (12.2%) acyanotic, and 43 (87.8%) cyanotic complex P < 0.01. This was noted among 21 females and 28 males. Children less than 3 years had 31 cases (63.3%) of the complex heart diseases while children between 5 years to 18 years had 14 (28.6%). The top three complex congenital heart disease were complex Tetralogy of Fallot which was found among 26 (53%) subjects. Tricuspid atresia and Truncus arteriosus were found in 3 children with congenial heart disease each, Shone complex was found in a child, Hypoplastic left heart syndrome was also noted in a child.

Conclusion:

The incidence of complex congenital heart diseases among prospective Paediatric cardiac surgery patients is high. Efforts should be made to improve access to preventive cardiology in order to curb these diseases.
Thoracoscopic Repair of Congenital Diaphragmatic Hernia in Neonates
Authors: Sundaram J , Ramasundaram M , Agarwal P , Barathi S , Rajan M
Published: August 2023

Background:

Congenital diaphragmatic hernia (CDH) is an anomaly with significant morbidity in neonates. It has been traditionally managed by an open approach with a recent trend toward a minimally invasive approach.

Aim:

This is a retrospective study of our institutional experience with neonatal thoracoscopic management of CDH, with the impact of few technical nuances.

Patients and Methods:

The data was collected on neonatal thoracoscopic CDH repair between January 2015 and December 2018, in terms of the demographics, intra-operative parameters, post-operative status, recurrence, and mortality. While analyzing data, we found few technical modifications adopted by the surgeon such as trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO2, maximal use of muscle relaxant, extra-corporeal corner hitch stitch at some point, and continuation for further cases. An internal comparison was made to analyze the technical modifications influencing the outcomes, by dividing them into two groups, those with (group A) and without modifications (group B). The data was analyzed using SPSS software (IBM, Version 23). A P value of <0.05 was considered statistically significant.

Results:

Out of 45 newborns 64.4% were males with an average birth weight of 2.6 kg. Baseline variables were comparable between the groups. The operating time significantly reduced after a higher-level camera port was used (P-value: 0.0001). The mean follow-up was 30.8 months. There were totally seven recurrences (6 in group A and 1 in group B), all within 12 months. Seven parents gave the overall post-treatment feedback as “unsatisfied”. The operating time, recurrence rate, and parental satisfaction feedback were significantly less in group B (P-value: 0.001).

Conclusion:

We recommend trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO2, maximal use of muscle relaxant, extra-corporeal corner hitch stitch to reduce the operating time, and recurrence after thoracoscopic CDH repair.
Change in Surface Characteristics and Permeability of Human Enamel after Subjecting to Radiation Therapy
Authors: Suri S , Raura N , Thomas MS , Kumar PS , Lewis AJ
Published: August 2023

Background:

Radiation-related caries is a complex destructive lesion leading to uncompromising damage of enamel and dentin in patients suffering from head and neck cancer managed with radiotherapy.

Aim:

The purpose of this study was to evaluate the changes in the permeability of enamel and to assess the morphological and chemical changes of teeth surface subjected to 6 MV photon beam irradiation.

Materials and Methods:

For this in vitro study, coronal portion of 20 premolars were sectioned mesiodistally into halves and then grouped into two. Samples in group 1 (control) were not subjected to cycles of irradiation and those in group 2 (experimental) were subjected to a cumulative uniform radiation dose of 70 Gray fractioned in 35 fractions with 6 MV photons. The silver nitrate penetration method was used to assess the change in permeability of enamel. The variations in surface topography and mineral content were assessed using scanning electron microscopy with energy dispersive X-ray analysis. Dye penetration scores of surface texture changes were compared between the two groups utilizing the Chi-square test. The change in the elemental levels between enamel surfaces of the two groups was compared using an independent t-test.

Results:

The application of 6 MV photon radiation did not change enamel permeability and surface topography. However, a noteworthy reduction in the carbon content (P = 0.002) was observed in teeth subjected to irradiation.

Conclusions:

Though radiation exposure did not alter the enamel permeability and surface topography, it had caused significant chemical compositional changes. Carbon content was significantly reduced in irradiated enamel samples.