bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative outcome analysis of lateral mass fixation and trans-facet fixation with posterior decompression in the management of cervical spondylotic myelopathy
Authors: Singh Deepak Kumar , Kumar Vijay , Yadav Kuldeep , Mohammad Kaif , Sharma Prevesh Kumar
Published: September 2022

Aims and Objectives

Posterior subaxial cervical fusion with lateral mass screw and rod instrumentation is a well-established fixation technique. Subaxial transarticular facet fixation is a lesser known fusion technique that has been shown to be biomechanically equivalent to lateral mass screws. The aim of this study was to evaluate the outcome of cervical decompressive laminectomy with lateral mass fixation compared with decompressive laminectomy with trans-facet fixation.

Materials and Methods:

The study was conducted with 20 patients operated for cervical decompressive laminectomy with lateral mass fixation compared with 20 patients operated with trans-facet fixation. The modified Japanese orthopedic association score (mJOA) scale, Nurick's functional grading and neurological recovery rate (NRR) was used as the functional outcome measurement. The clinical follow-up period was 6 months.

Results:

In Group I, the mean preoperative and postoperative mJOA scores in Group I and II were 8.2 ± 2.1 and 12.7 ± 2.8 and 9.3 ± 1.9 and 13.5 ± 1.88, respectively, were statistically significant (P < 0.05). Postoperative NRR at the end of the follow-up period was satisfactory (excellent and good) 55% in Group I and 60% in Group II. Fusion was documented in all 40 patients. No patients experienced neural or vascular injury as a result of screw position.

Conclusions:

Both trans-facet and lateral mass fixation techniques are simple, safe, and effective procedures in achieving relief and improvement in patients with multilevel cervical spondylotic myelopathy. Trans-facetal fixation can provide a reasonable alternative to lateral mass fixation.
Polymorphisms in paired box 1 gene were associated with susceptibility of adolescent idiopathic scoliosis
Authors: Pedrosa Antônio Eulálio , Azevedo Gustavo Borges Laurindo de , Cardoso Jessica Vilarinho , Guimarães João Antonio Matheus , Defino Helton Luiz Aparecido , Perini Jamila Alessandra
Published: September 2022

Background

Association of genetic polymorphisms in paired box 1 (PAX-1) gene can influence the development of adolescent idiopathic scoliosis (AIS). PAX-1 is mainly expressed in the region of the vertebral bodies and intervertebral discs, being important for the proper formation of spinal structures.

Objectives:

The objective of this study was to evaluate the association of polymorphisms in PAX-1 gene with the susceptibility of AIS.

Settings and Design:

This was an analytical observational case–control study.

Materials and Methods:

Samples of 59 AIS indicated for surgical treatment, and 119 controls, without spinal disease were genotyped for PAX-1 rs6137473 and rs169311 polymorphisms.

Statistical Analysis:

The association of the polymorphisms with AIS was evaluated by a multivariable logistic regression model, using odds ratios (OR) and 95% confidence intervals (CI).

Results:

According to Lenke's classification, 89.8% had Type I and 10.2% II curves. The mean value of the Cobb angle of the proximal thoracic curve was 30.8°, 58.7° thoracic, and 30.4° for the lumbar and on the bending films 14.6°, 40.7°, and 11°, respectively. Among the AIS group, there was a predominance of females (8.8:1). The PAX-1 rs169311 and rs6137473 polymorphisms were positively associated with developing the AIS (OR = 1.98; 95% CI = 1.2–3.3 and OR = 3.16; 95% CI = 1.4–7.3, respectively). The rs6137473 polymorphism was associated with the lumbar modifier B and C compared to A (OR = 2.52; 95% CI = 1.1–5.8).

Conclusions:

PAX-1 polymorphisms were associated with an increased risk of developing the AIS and with curve severity and can be used as a biomarker to map the risk of developing surgical-grade AIS, guiding the treatment of patients.
Magnetic resonance imaging anatomy of the craniovertebral ligaments
Authors: Osmotherly Peter Grant , Cowin Gary J. , Rivett Darren A.
Published: September 2022

Background

Descriptions of the radiological appearance of the craniovertebral ligaments often lack detail. This study aimed to provide an accurate description of the morphology and radiological appearance of the alar and cruciform ligaments with confirmation of findings by fine dissection.

Materials and Methods:

Six embalmed human cadaveric specimens were reduced to an osseoligamentous arrangement spanning the C2/3 disc to the occiput. Specimens were imaged on a 4.6T Bruker magnetic resonance (MR) system using a 3D RARE multiple SE sequence with acquisition time 18 h 24 min. Acquired images were viewed in three planes, and detailed descriptions and morphometric measurement of the ligaments were obtained. Specimens were then examined and described using fine dissection. Direct comparison of the descriptions of each method was undertaken.

Results:

From imaging, detailed features of all alar ligaments could be identified in all specimens. Consistency in shape, orientation, and attachments is described. Attachment to the medial aspect of the atlantooccipital joints was evident in all specimens. Five of six alar ligament pairs contained fibers that traversed the dens without attachment. Ascending cruciform ligaments could be clearly identified in four of six specimens. No descending cruciform ligaments could be clearly delineated. Detailed features of the transverse ligaments could be identified and described in all planes. Dissection findings were mostly consistent with descriptions obtained from MR images.

Conclusion:

4.6T MR images provide accurate detail of the structure, dimensions, and attachments of the craniovertebral ligaments. The morphology of the craniovertebral ligaments assessed radiologically was consistent with findings on gross dissection.
Cervical deformity patients with baseline hyperlordosis or hyperkyphosis differ in surgical treatment and radiographic outcomes
Authors: Passias Peter Gust , Alas Haddy , Kummer Nicholas , Tretiakov Peter , Diebo Bassel G. , Lafage Renaud , Ames Christopher P. , Line Breton , Klineberg Eric O. , Burton Douglas C. , Uribe Juan S. , Kim Han Jo , Daniels Alan H. , Bess Shay , Protopsaltis Themistocles , Mundis Gregory M. , Shaffrey Christopher I. , Schwab Frank J. , Smith Justin S. , Lafage Virginie , International Spine Study Group
Published: September 2022

Background

Patients with symptomatic cervical deformity (CD) requiring surgical correction often present with hyperkyphosis (HK), although patients with hyperlordotic curves may require surgery as well. Few studies have investigated differences in CD corrective surgery with regard to HK and hyperlordosis (HL).

Objective:

The objective of the study is to evaluate patterns in treatment for CD patients with baseline (BL) HK and HL and understand how extreme curvature of the spine may influence surgical outcomes.

Materials and Methods:

Operative CD patients with BL and 1-year (1Y) radiographic data were included in the study. Patients were stratified based on BL C2–C7 lordosis (CL) angle: those >1 standard deviation (SD) from the mean (−6.96 ± 21.47°) were hyperlordotic (>14.51°) or hyperkyphotic (<−28.43°) depending on directionality. Patients within 1SD were considered control group.

Results:

102 surgical CD patients (61 years, 65% F, 30 kg/m2) with BL and 1Y radiographic data were included. 20 patients met definitions for HK and 21 patients met definitions for HL. No differences in demographics or disability were noted. HK had higher estimated blood loss (EBL) with anterior approaches than HL but similar EBL with posterior approach. Operative time did not differ between groups. Control, HL, and HK groups differed in BL TS-CL (36.6° vs. 22.5° vs. 60.7°, P < 0.001) and BL-SVA (10.8 vs. 7.0 vs. −47.8 mm, P = 0.001). HL patients had less discectomies, less corpectomies, and similar osteotomy rates to HK. HL had 3x revisions of HK and controls (28.6 vs. 10.0 vs. 9.2%, respectively, P = 0.046). At 1Y, HL patients had higher cSVA and trended higher SVA and SS than HK. In terms of BL-upper cervical alignment, HK patients had higher McGregor's slope (MGS) (16.1° vs. 3.3°, P = 0.002) and C0–C2 Cobb (43.3° vs. 26.9°, P < 0.001), however, postoperative differences in MGS and C0–C2 were not significant. HK drivers of deformity were primarily C (90%), whereas HL had primary CT (38.1%), UT (23.8%), and C (14.3%) drivers.

Conclusions:

Hyperlodotic patients trended higher revision rates with greater radiographic malalignment at 1-year postoperative, perhaps due to undercorrection compared to kyphotic etiologies.
Os odontoideum
Authors: Cho Sia , Shlobin Nathan A. , Dahdaleh Nader S.
Published: September 2022

Os odontoideum (OO) is a rare craniocervical anomaly that is characterized by a round ossicle separated from the C2 vertebral body. With a controversial etiology and unknown prevalence in the population, OO may be asymptomatic or present in patients with myelopathic and neurological symptoms. In this literature review, we aimed to investigate epidemiology, embryology, pathophysiology, clinical presentation, and the role of diagnostic radiography in OO. By providing an overview of different management strategies, surgical complications, and postoperative considerations for OO, our findings may guide neurosurgeons in providing proper diagnosis and treatment for OO patients. A literature review was conducted using the PubMed, EMBASE, and Scopus databases. A search using the query “os odontoideum” yielded 4319 results, of which 112 articles were chosen and analyzed for insights on factors such as etiology, clinical presentation, and management of OO. The presentation of OO varies widely from asymptomatic cases to severe neurological deficits. Asymptomatic patients can be managed either conservatively or surgically, while symptomatic patients should undergo operative stabilization. Although multiple studies show different techniques for surgical management involving posterior fusion, the diversity of such cases illustrates how treatment must be tailored to the individual patient to prevent complications. Conflicting studies and the paucity of current literature on OO highlight poor comprehension of the condition. Further understanding of the natural history of OO is critical to form evidence-based guidelines for the management of OO patients. More large-center studies are thus needed to promote accurate management of OO patients with optimal outcomes.
Development of neural network models for prediction of the outcome of COVID-19 hospitalized patients based on initial laboratory findings, demographics, and comorbidities
Authors: Pasic Mirza , Begic Edin , Kadic Faris , Gavrankapetanovic Ali , Pasic Mugdim
Published: September 2022

Background:

During the process of the treatment of COVID-19 hospitalized patients, physicians still face a lot of unknowns and problems. Despite the application of the treatment protocol, it is still unknown why the medical status of a certain number of patients worsens and ends with death. Many factors were analyzed for the prediction of the clinical outcome of the patients using different methods. The aim of this paper was to develop a prediction model based on initial laboratory blood test results, accompanying comorbidities, and demographics to help physicians to better understand the medical state of patients with respect to possible clinical outcomes using neural networks, hypothesis testing, and confidence intervals.

Methods:

The research had retrospective-prospective, descriptive, and analytical character. As inputs for this research, 12 components of laboratory blood test results, six accompanying comorbidities, and demographics (age and gender) data were collected from hospital information system in Sarajevo for each patient from a sample of 634 hospitalized patients. Clinical outcome of the hospitalized patients, survival or death, was recorded 30 days after admission to the hospital. The prediction model was designed using a neural network. In addition, formal hypothesis tests were performed to investigate whether there were significant differences in laboratory blood test results and age between patients who died and those who survived, including the construction of 95% confidence intervals.

Results:

In this paper, 11 neural networks were developed with different threshold values to determine the optimal neural network with the highest prediction performance. The performances of the neural networks were evaluated by accuracy, precision, sensitivity, and specificity. Optimal neural network model evaluation metrics are: accuracy = 87.78%, precision = 96.37%, sensitivity = 90.07%, and specificity = 62.16%. Significantly higher values (P < 0.05) of blood laboratory result components and age were detected in patients who died.

Conclusion:

Optimal neural network model, results of hypothesis tests, and confidence intervals could help to predict, analyze, and better understand the medical state of COVID-19 hospitalized patients and thus reduce the mortality rate.
Hospital-Based Retrospective Cross-sectional Study to Analyse the Causes of Maternal Deaths at a Tertiary Health Care Facility
Authors: Singh Naresh Pal , Jain Pankaj Kumar , Saxena Deepanshi , Takhelchangbam Nilima Devi , Singh Anamika
Published: September 2022

Context:

Maternal mortality is considered a key health indicator of Maternal and Child Health. Considering the fact that complications are preventable and most of them are modifiable, the study has been planned to analyse maternal deaths in order to suggest recommendations for preventing it. There are various delays according to the three-delay model at primary and secondary level; therefore, interventions are needed at those levels to prevent maternal deaths.

Aims:

To determine the various direct and indirect causes of maternal deaths, analyse the association of medical and social factors with maternal deaths and ^to determine the predictors of maternal deaths.

Settings and Design:

Hospital-based retrospective cross-sectional study of all the maternal deaths occurring in the last 4 years at a tertiary health care facility.

Methods and Material:

Data were collected from the Facility Based Maternal Death Review forms.

Statistical Analysis Used:

Data were entered and analysed by IBM SPSS version 25.0 software.

Results:

For maternal deaths, direct obstetric causes were responsible in 128 (74.4%) and indirect causes in 45 (26.2%) cases followed by unspecified causes in 78 (45.3%) and 1 (0.6%) coincidental cause. Statistically significant associations were observed between maternal death and period of gestation, mode of delivery and outcome of delivery (P = 0.12, P = 0.04 and P < 0.001, respectively).

Conclusions:

The health professionals of primary and secondary level should be well equipped to diagnose the complications and to manage it as early as possible. Thus, maternal mortality rates can be decreased to significant level.
Evaluation of the diagnosis and treatment options for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Authors: Kouhpayeh Hamidreza
Published: September 2022

Viruses are non-living organisms that cause many problems for human societies annually. The outbreak of some dangerous viruses causing acute pneumonia has been the leading cause of death in the world. The epidemiological findings showed that the virus is developing different and dangerous species by creating new mutations, which makes it difficult to treat. The diagnosis and treatment of corona virus disease (COVID-19) has been one of the most important topics in the scientific community for the past 2 years. There are several diagnostic methods available for the detection of COVID-19 that are highly accurate and require less time. The use of some therapies such as remdesivir with basic therapy has shown high therapeutic effectiveness, but the therapeutic side effects such as decreased glomerular filtration rate, decreased lymphocyte count, respiratory failure, and increased blood creatinine levels in most treatments have been observed. The COVID-19 infection and the associated deaths are still very worrying, therefore, rapid diagnosis and timely management of this deadly infection and the necessary measures for eradicating COVID-19 are important.
The epidemiology and dynamics of COVID-19 disease transmission among healthcare workers of a tertiary healthcare setting in India
Authors: Singh Mahendra , Dhankar Anushikha , Sharma Megha , Agarwal Shreya , Panda Prasan K. , Bahurupi Yogesh , Aggarwal Pradeep
Published: September 2022

Context:

The novel coronavirus disease 2019 (COVID-19) that has emerged as a pandemic now has put health care workers (HCWs) at great risk as they are the warriors in frontlines screening and treating the infected patients. When a COVID-19-positive HCW is identified, its contacts need to be traced to check the spread of the infection among patients and other HCWs.

Aims:

This study was aimed to study epidemiology and risk factors associated with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection among HCWs and to quantify the risk of infection among HCWs in a tertiary level health care setting.

Settings and Design:

This cross-sectional study enrolled all the HCWs who were exposed to a patient with COVID-19 in a tertiary level health care center, Rishikesh, Uttarakhand from 1st May to 30th July, 2020.

Methods and Material:

All the exposed HCWs were followed up for 14 days after the last exposure to a patient with confirmed COVID-19 infection. Epidemiological data were obtained using structured interviews.

Statistical Analysis Used:

The data were analyzed using SPSS 23.0. Frequencies and proportions were calculated for descriptive variables, and risk ratios were calculated for risk factors affecting the transmission of disease.

Results:

We observed that 1,141 HCWs of the tertiary level health care hospital were exposed to COVID-19 patients during the study period. A total of 22 HCWs were tested COVID-19 positive among these exposed HCWs. Univariate analysis revealed a high risk of exposure to be significantly associated with a higher secondary attack rate of SARS CoV-2.

Conclusions:

The study demonstrates the risk of COVID-19 transmission through asymptomatic carriers. Therefore, periodic testing of all health care workers is necessary to ensure early mitigation of the shortage of health care providers.
Knowledge of the primary healthcare physicians in the Al-Baha Region about COVID-19 personal protective measures
Authors: Alzahrani Mona Saeed , Hakeem Alaaeden A. L. , Talmesany Terad A.
Published: September 2022

Background:

Healthcare professionals are particularly more vulnerable to Covid-19 pandemic infection, since they are on the front lines. The relatively high morbidity and mortality among healthcare workers all over the world because of Covid-19 is a major cause of concern.

Objectives:

To explore the awareness of the healthcare workers in primary care settings regarding COVID-19 as well as the role of personnel protective equipment (PPE) as protective measures and to discover any defects for further intervention.

Material and Methods:

Cross-sectional study design was carried out in the Al-Baha Region, Southwest of Saudi Arabia. It included a representative random sample of healthcare workers working at primary health care (PHC) centers belonging to the Ministry of Health. A self-administered valid questionnaire was utilized in the present study, which included three main parts: demographic data of the healthcare workers; questions to assess their knowledge about the current COVID-19 pandemic (four multiple choice questions); and questions to assess knowledge about personal protective measures and hand hygiene (ten questions).

Results:

The study included 451 participants. The age of more than half of the participants (51.7%) ranged between 31 and 45 years. Females represented 53.2% of them. Physicians, nurses, and pharmacists represented 36.1%, 24.2%, and 23.3% of the participants, respectively. History of attending infection control training activity in the previous 12 months was reported by 38.1% of the participants. Overall, 74.5% and 19.1% of the participants expressed a poor level of knowledge regarding the current COVID-19 pandemic and PPE/personal hygiene, respectively. Older healthcare workers (HCWs) (> 45 years), non-Saudi nationals, dentists, moderately experienced healthcare workers (6–10 years), and those who attended infection control training courses were more knowledgeable about the current COVID-19 pandemic and its self-protective measures compared to others.

Conclusion:

Most of the primary healthcare staff in the Al-Baha Region expressed a poor level of knowledge about the current COVID-19 pandemic and a moderate level regarding PPE and personal hygiene. Some indicators for poor knowledge were identified.
Primary hepatic tuberculosis presenting as fever of unknown origin diagnosed by Positron emission tomography/computed tomography scan (PET/CT)
Authors: Puri Saurabh , Grover Ashok , Choudhary Pankaj Nand , Singh Purneetha , Gupta Arjun Prem
Published: September 2022

Tuberculosis (TB), especially extrapulmonary tuberculosis (EPTB), is an important cause of fever of unknown origin (FUO) in areas endemic to TB. Liver involvement in TB in the absence of miliary TB is rare. A definitive diagnosis of primary hepatic TB can be challenging and relies on the histological and/or bacteriological findings of the liver tissue obtained by biopsy. TB should be considered in the differential diagnosis of space-occupying lesions and abscesses of the liver. In our case of a 52-year-old adult male with FUO, a positron emission tomography/computed tomography (PET/CT) scan was used, due to lack of any potential diagnostic clues, and a focal lesion was identified as a potential biopsy site.
Oral health knowledge, attitude and practice among children and adolescents with type 1 diabetes
Authors: Meshki Razie , Khataminia Masoumeh , Jokar Zeinab , Veisi Mohammad Salehi
Published: September 2022

Introduction and Objective:

The prevalence of tooth decay and chronic gingivitis is higher in people with diabetes than in healthy people. The aim of this study was to evaluate the knowledge, attitude and practice (KAP) of children and adolescents with type 1 diabetes towards oral diseases.

Methods:

A descriptive-analytical cross-sectional study was performed on 182 patients less than 25 years of age with type 1 diabetes referred to Golestan Clinic in Ahvaz during 2015-2020. The questionnaire consisted of four sections of demographic information, different dimensions of KAP questionnaire was used to collect data about oral health. Statistical analysis was performed using SPSS software version 22 using Mann-Whitney, Kruskal-Wallis and Chi-square tests. The significance level was considered of P < 0.05.

Results:

The results of the present study showed that 65% of patients had a moderate and low level of knowledge and attitude. Only 13.7% of patients with diabetes reported good levels of oral health performance. Parent’s level of education, patient age and urbanization significantly improved the level of KAP of children and adolescents with diabetes towards oral health (P < 0.05). The effect of knowledge on attitude and practice of individuals and also the effect of attitude on practice was positive and significant (P < 0.05).

Conclusion:

Considering that the KAP of 50% of patients were at low and medium levels, therefore it seems necessary to provide an appropriate solution in order to improve the level of KAP of diabetic patients in relation to oral health.
Prevalence of tobacco-associated oral mucosal lesion in Hazaribagh population: A cross-sectional study
Authors: Choudhary Anand , Kesarwani Pallavi , Chakrabarty Sagnik , Yadav Vijay K. , Srivastava Parul
Published: September 2022

Background:

Smoking and chewing tobacco carry significant risks for the development of oral cancer and premalignant lesions. The present study was conducted to find the prevalence of tobacco-related habits in Hazaribagh population and its association with oral mucosal lesion.

Methodology:

The present study was carried out on patients who visited the Department of Oral Medicine And Radiology, Hazaribagh College of Dental Sciences And Hospital. A total of 5,000 subjects were screened for tobacco-related habits and associated mucosal changes. Detailed clinical history about tobacco-related habits was obtained. Oral mucosal lesions were screened using the WHO format for diagnosis of oral lesions. The findings were tabulated and analyzed statistically.

Results:

Of the 5,000 subjects enrolled for the study, 1,085 (21.7%) used tobacco in some forms. Habit of smoking tobacco was present among 273 (25.2%) and using smokeless tobacco among 811 (74.7%) individuals. Tobacco pouch keratosis (46.1%) was found to be most common lesion, followed by oral submucous fibrosis (OSMF) (16.1%), lichenoid reaction (14.1%), smokers palate/melanosis (12.2%), leukoplakia (7.2%), erythroplakia (2.3%), and oral cancer in (2%).

Conclusion:

The results provide insight into prevalent tobacco habits and associated oral mucosal lesions in Hazaribagh population. These may act as baseline data for the formulation of preventive programs and help future studies explore the prevalence of tobacco-associated lesions in vulnerable populations. Current knowledge, including findings from the present study, about the prevalence of tobacco use and various oral lesions associated with it may help primary health care physicians to promote among patients visiting them the awareness about the adverse effects of tobacco consumption and treatment options available for tobacco-related lesions at the early stage.
A rare presentation of gastrointestinal stromal tumor arising from a meckel’s diverticulum: A case report
Authors: Patel Aditya , Yeola Meenakshi , Gharde Pankaj
Published: September 2022

The most common congenital gastrointestinal tract abnormality is Meckel’s diverticulum, affecting 1% to 2% of the population. Meckel’s diverticulum can sometimes house a gastrointestinal stromal tumor (GIST), which is a rare malignant tumor. A 63-year-old man presented with occult melena. It turns out to be a GIST developing from Meckel’s diverticulum after an exploratory laparotomy. Occult melena is one of the causes of unexplained and intractable anemia. Every family and general physician should keep in mind the possibility of occult blood loss via the gastrointestinal tract when treating the patient.
Chest CT severity score as a predictor of mortality and short-term prognosis in COVID-19
Authors: Jayachandran Ajith K. , Nelson Vincy , Shajahan Mohammad Easa
Published: September 2022

Background:

As India was slowly coming out of shock from the second wave wrecked by the Delta strain, the world population is now struck once again with a new strain of coronavirus disease 2019 (COVID-19), designated as B.1.1.529, named as OMICRON. Though several international studies have evaluated the role of computed tomography (CT) in diagnosis, predicting prognosis, and monitoring the progression of disease, to our best knowledge, there are no Indian studies published in this context.

Objective:

(1) To determine the use of chest CT severity score as predictor of mortality in COVID-19 patients. (2) To determine the prognosis based on length of hospital stay.

Materials and Methods:

A observational cohort study was done at Travancore Medical College Hospital. A retrospective analysis of patients who presented to the Emergency Medicine Department with a positive COVID antigen or reverse transcriptase-polymerase chain reaction (RT-PCR) results and those who underwent a CT chest at the time of presentation was conducted. Data was analyzed by using Statistical Package for Social Sciences (SPSS) version 16. Descriptive statistics such as mean, frequency, and percentages were calculated. Chi-square test was used to find the statistical significance. The Kaplan–Meier method was used to evaluate the relationship between CT score and mortality, which was compared with the log-rank test.

Results:

A total of 252 patients with positive COVID antigen or RT-PCR who underwent CT chest were included in our study. Our study population was composed of 139 (55.2%) males and 113 (44.8%) females. Only one patient with mild CT severity score required >14 days of ICU stay, whereas two (2%) and five (9.6%) patients with moderate and severe CT severity score, respectively, required ICU stay for >14 days. The P value was 0.001, which again is statistically significant. In our study, out of 44 patients categorized under mild CT severity score, only two (4.5%) patients had expired. Out of 98 patients categorized under moderate CT severity score, 14 (14.3%) patients had expired, whereas out of 52 patients categorized under severe CT severity score at the time of admission, 25 (48.1%) patients had expired. The P value was 0.001, which is statistically significant.

Conclusion:

Our study could prove that patients with CT severity score ≥15 had high risk of mortality and required prolonged ICU stay of >5 days. CT severity score helps the primary care physicians to predict probable outcome and length of hospital stay at the time of admission itself and allocate the limited resources appropriately.
Assessment of response of neoadjuvant chemotherapy in carcinoma breast patients by high-frequency ultrasound
Authors: Dighe Sajika , Shinde Raju , Shinde Sangita , Verma Prince
Published: September 2022

Aim:

To assess the response of neoadjuvant chemotherapy in carcinoma breast patients by high-frequency ultrasound.

Material and Method:

The current single blind, observational study was conducted at rural tertiary healthcare center of Acharya Vinoba Bhave Rural Hospital from October 2018 to Sept 2020. We incorporated breast cancer patients with TNM stages IIIA and IIIB who received neoadjuvant chemotherapy with Cyclophosphamide/Adriamycin/5 FU and Paclitaxel respectively followed by standard surgical procedure modified radical mastectomy. Successive ultrasound examination of the breast malignancy and the axilla was done after 21 days of either of any neoadjuvant chemotherapy for 3 cycles. Assessment of response to neoadjuvant chemotherapy was applied in terms of reduction in the breast tumour volume on ultrasound and percentage of tumour response calculated by Response Evaluation Criteria for Solid Tumours (RECIST). Data were analysed using SPSS version 24.0.

Results:

Higher frequency of patients was invasive ductal breast cancer. In our study, Paclitaxel group showed better response in terms of CR and PR than CAF group. Our study noticed a consistent decrement in tumour volume after every cycle of either CAF or Paclitaxel NACT. Axillary ultrasound was able to predict the response of axillary lymph nodes in terms of increase or decrease in number and morphological changes after 3 cycles of NACT with similarity on final histopathology.

Conclusion:

It can be concluded from the results of the present study that high-frequency ultrasound is appropriate tool for assessment of response of primary breast malignancy and lymphnode metastasis in the axilla after neoadjuvant chemotherapy.
Guillain–barré syndrome without limb weakness: A rare variant with acute bulbar palsy
Authors: Chavada Ishan J. , Thampi Siddhant J. , Babu Dinesh , Natarajan Vasanthi
Published: September 2022

A 76-year-old male was brought to the emergency room with an acute onset of breathlessness and difficulty swallowing. Examination revealed bilateral ptosis, bilateral vocal cord abductor palsy with diaphragmatic paralysis. He did not have any limb weakness. A diagnosis of acute bulbar palsy was made. Cerebrospinal fluid showed albumino-cytological dissociation. Magnetic resonance imaging of the brain (MRI) was normal, and a nerve conduction study (NCS) showed Acute Motor and Sensory Axonal Neuropathy (AMSAN). Guillain–Barré syndrome with acute bulbar palsy was considered. Here, we report a case of suspected Acute Bulbar Palsy plus (ABPp) syndrome. ABPp may be considered as a variant of GBS between the Miller–fisher and Pharyngeal-cervical-brachial variant and does not have any definite limb weakness. This patient also had ABPp with diaphragmatic palsy. However, whether this syndrome is an isolated variant of GBS or a continuum between the Miller-fisher syndrome (MFS) and Pharyngo-cervical brachial (PCB) variants remains to be elucidated. This case is relevant to primary care physicians as the disability with GBS remains high and may render a large burden to carers. The initial symptom of acute dysphagia must lead on the primary care physician to keep this disease in mind to prevent an unwarranted delay in diagnosis.
COVID-19 management: Opportunity to reassess protocols?
Authors: Sodhi Jitender , Arora Pankaj , Biswal Manisha , Bhogal Ranjitpal S. , Talati Shweta , Dhaliwal Navneet
Published: September 2022

The COVID 19 pandemic ravaged the globe with a remarkable ferocity and has not entirely abated till now with cases flaring up at various places at different times. The expected course is for it to become endemic with recurring exacerbations. Over the past two years, we have become wiser to its pathology, diagnosis, and treatment. However, it is imperative for us to regularly and consistently reassess our protocols to assimilate the current and ever-growing knowledge in this direction. Doing so will help us to use our resources judiciously, improve patient care, and enhance the overall benefit to stakeholders. In this article, we aim draw the researchers’ attention to few issues which may not be at the forefront at this point in time but important nevertheless. These include the use of personal protective equipment (PPE), universal gloving, isolation criteria, and handling of dead bodies, among others. We hope that a reassessment of the challenges involved in the said procedures will help us to be better prepared to face and tackle potential future waves and the multiple challenges that would potentially ensue post-spikes in infection incidences.
Blood-based biomarkers for diagnosis, prognosis, and severity prediction of COVID-19: Opportunities and challenges
Authors: Mittal Rishabh , Chourasia Nidhi , Bharti Vivek K. , Singh Snigdha , Sarkar Poulami , Agrawal Amit , Ghosh Amrita , Pal Ranabir , Kanwar Jagat R. , Kotnis Ashwin
Published: September 2022

The reasons for high morbidity and mortality with Corona virus disease (COVID-19) disease remain unanswered with extremes of manifestation and uncertainty of modes of transmission for which biomarkers are urgently needed for early prediction of severity and prompt treatment. We have reviewed publications from PubMed (years 2019–2021) analysing the biochemical, immune-inflammatory, nucleic acid, and cellular biomarkers that predict infection, disease progression in COVID-19 with emphasis on organ-specific damage. Our analysis of 65 biomarkers assessing the impact of SCoV-2 infection on five organs (lung, liver, cardiac, kidney, and neural) reported that increased levels of CRP, TNF-a, ferritin, IL-6, D-dimer, Procalcitonin, Fibrinogen to Albumin Ratio (FAR), and decrease platelet count (PC), lymphocyte count, leukocyte count, and CD4+/CD8
+
ratio shows promising association in the early diagnosis, prediction of prognosis and severity disease and also correlates with cytokine storm a cardinal feature of COVID-19 progression. In the above scenario, this review has put forth the most promising biomarkers for COVID diagnosis and prognosis based on the reported literature. In recent year’s chemically synthesized antibody-like biomolecules, aptamers were also used in the diagnosis of COVID-19 which could be preferably used for diagnosis over antibodies. Biomarkers including increase in free DNA and Fibrinogen-to-Albumin Ratio, CRP, PCT, and Ferritin along with a consequential decrease of CD3+ T, CD4+ T, CD8+ T, NK cells with corresponding increase in CD4+/CD8+ ratio following SARS CoV-2 infection has been consistently correlated with disease severity. Despite the two waves of COVID-19 pandemic, currently there is no standard clinical practice guideline for evaluating the severity of the devastating pandemic of COVID-19, hence these biomarkers will have immense relevance for the third and subsequent wave of COVID-19 and related pandemic.
Medical education in the first university of the world, the Jundishapur Academy
Authors: Daneshfard Babak , Naseri Mohsen , Ghaffari Farzaneh
Published: September 2022

The Academy of Jundishapur was the world’s first university established during the Sassanid Empire in old Persia. Some of the important features of this scientific center of the ancient world include a policy of tolerance, conducting annual international congresses, compiling the first comprehensive medical textbook, doing the hospital rounds, physician licensure exam, special attention to the ethics, and using an educational curriculum. Moreover, its unique style of education made Jundishapur a brilliant school in the history of science. This outstanding academy maintained its impact on the scientific movement of that era for four centuries. It finally declined after transmission to Baghdad medical school. In this study, we have discussed the features of the Jundishapur school which made it a successful model for medical education.
Helicopter parenting, from good intentions to poor outcomes. What parents needs to know?
Authors: Shaki Omna , Gupta Gayatri K. , Yadav Prateek , Faisal Faisal A.
Published: September 2022

Background:

A single child is precious for every parent. There is an increasing demand for children to perform and to excel in all aspects of their lives. Due to increased unemployment and less job opportunities, tough competition to get admission in good school and college and to get respectable job put every parent under constant stress. These circumstances lead to parents starting micromanagement of their children. This micromanagement can be harmful to the mental and emotional wellbeing of the child, and is especially seen in single-child parents.

Objective:

This study aimed to ascertain if parents of single child show behavior of helicopter parenting as compared to patents having more than one child.

Methods:

This is an open-ended observational study, wherein 100 families with single child and 50 families with more than one child were interviewed based on self-explanatory questionnaire methods.

Results:

We noted that 83% parents showed behavior of helicopter parenting, especially those who have single child as compared to those having more than one child.

Conclusion:

Based on our survey, we can conclude that parents of single child showed behavior of helicopter parenting as compared to patents having more than one child because only child is precious and center of attraction in the families especially in Indian culture. However, large studies are required to reach a definitive conclusion.
A rare case of acrogeria, Gottron type with borderline personality disorder
Authors: Sawant Neena , Mehta Anjali , Chaturvedi Hemashri
Published: September 2022

Acrogeria is a rare disorder that is characterized by premature aging of the distal extremities. It was first described by Gottron in 1941. Only about 50 cases have yet been reported worldwide. It is diagnosed clinically, and patients have a normal life expectancy. The disorder is seen from birth and could have an autosomal dominant or recessive inheritance. The classic features include a characteristic pinched face, thin lips, fine hair, skeletal defects, and thin, taut parchment-like skin of the extremities. We describe a case of Acrogeria, Gottron type, who also had a borderline personality disorder. However, there is very little information on the prevalence of psychopathology in patients having syndromes of premature aging.
Intramedullary spinal teratoma
Authors: Sharma Manoj Kumar , Agarwal Ratika B , Sankhla Karan , Sankhla Suresh K
Published: September 2022

Mature spinal intramedullary teratomas are benign germ cell tumors that are associated with an excellent long-term outcome following early treatment with radical surgical resection. However, the preoperative diagnosis is often difficult and delayed due to their rare occurrence in the spinal cord, especially when the typical clinical and imaging features are not present. We report a case of intramedullary teratoma in a young adult female who presented with unusual clinical and preoperative radiographic findings. The final diagnosis was made on histopathological examination postoperatively. Variations in clinical presentations, imaging, optimal treatment strategies and histopathological characteristics of this rare tumor are discussed here with a review of the literature.
Family Care Burden and its Association with Psychological Distress Among Caregivers of Chronic Patients with Schizophrenia
Authors: Ranjan Lokesh Kumar , Gupta Pramod R. , Kiran Manisha , Singh Narendra Kumar
Published: September 2022

Background:

Family burden among caregivers of patients with schizophrenia encounter comprehensive caregiving challenges to maintain their own physical as well as psychological distress and it can deteriorate the family functioning.

Aim:

The aim of this study is to assess the relationship between family care burden and psychological distress among caregivers of chronic patients with schizophrenia.

Methods and Materials:

The study was cross-sectional. It was conducted at the outpatient department of the Central Institute of Mental Health and Neuro Sciences, Dewada, Rajnandgoan, Chhattisgarh, India. A total of 260 samples were selected through a purposive sampling technique and informed about the study after giving their informed consent. Sociodemographics, a burden assessment schedule, and depression, anxiety, and stress scale were all part of the interview.

Result:

The study results showed a high level of care burden (70.8%) in the caregivers of patients with schizophrenia. The majority of the caregivers reported a severe level of stress (59.2%), anxiety (56.2%), and depression (48.5%). The result of the study indicated a significant positive relationship between family care burden and stress, anxiety, and depression among caregivers of chronic patients with schizophrenia.

Conclusion:

The study suggests the high prevalence of care burden which strongly contributes to psychological distress. These caregivers need psychosocial interventions to enhance the overall family environment to have a better adaptive state among families.
How to set up your Google Scholar Profile
Authors: Mondal Himel , Mondal Sarika , Mondal Shaikat
Published: September 2022

Google Scholar is a free search engine that provides information about scholarly articles available on the Internet. An author can track the citations and other author-level metrics such as the h-index and i10-index in the Google Scholar profile. Opening an account in Google Scholar is free. An author can open the account with the Google account (e. g., Gmail account credential) details. If an institutional e-mail address is available, the author can verify the e-mail address. However, this is not a prerequisite for opening an account. In this article, we provide a brief technical guide on the creation of a Google Scholar profile.
Over-the-Top Platform
Authors: Panda Prem Sagar , Salim Sania
Published: September 2022

COVID-19, an unprecedented global pandemic, has changed the way of media consumption by the audience. A new trend surfaced during this period – prioritizing over the tops (OTTs) over normal ongoing media channels. This points to the growing market and consumer appetite for content of choice available on OTT platforms. OTTs offer a naïve and consumer-friendly advantage – choice of content, simple access, and choice of device/mediums (hand phone, laptop, tablet, or TV screen). However, its rampant usage has also affected the mental and physical health of people of all generations. It is imperative to know the impact of growing content consumption on psychological behaviors across generations (children, adults, and elderlies) as there is limited censorship within the OTT space. As the mental health issues are on rise, the primary care physicians are the key role players to address this issue as they meet number of subjects as a primary contact. Hence, to find out the impact of OTT, an extensive literature search was done from PubMed and Google Scholar, and the relevant findings were noted down.
An Overview of IoT Solutions in Climate Smart Agriculture for Food Security in Sub Saharan Africa: Challenges and Prospects
Authors: Dibal Peter , Onwuka Elizabeth , Suleiman Zubair , Salihu Bala , Nwankwo Emmanuel , Okoh Supreme
Published: September 2022

INTRODUCTION: Climate smart agriculture (CSA) which involves the integration of IoT and cloud computing is an emerging agricultural paradigm that is foreseen to be the main driver of agriculture as the 21st century progresses. Sub-Saharan Africa lags in this regard and therefore deserves a special focus. OBJECTIVES: This paper presents an overview of Internet-of-Things (IoT) solutions in CSA in the context of food security in sub-Saharan Africa (SSA) METHODS: An overview of the status of food insecurity in SSA and associated factors is presented. The paper then focused on IoT as a technology and how it can be used for CSA in SSA through use cases; possible challenges were also examined. RESULTS: The paper showed that with CSA, SSA can become a net exporter of food. CONCLUSION: The paper concludes with open issues like the funding of research and development which must be addressed if SSA is to leverage IoT technology to attain food security.
Landscape of EGFR mutations in lung adenocarcinoma: a single institute experience with comparison of PANAMutyper testing and targeted next-generation sequencing
Authors: Lee Jeonghyo , Han Yeon Bi , Kwon Hyun Jung , Lee Song Kook , Kim Hyojin , Chung Jin-Haeng
Published: September 2022

Background: Activating mutations in the tyrosine kinase domain of epidermal growth factor receptor (EGFR) are predictive biomarkers for response to EGFR–tyrosine kinase inhibitor (TKI) therapy in lung adenocarcinoma (LUAD). Here, we characterized the clinicopathologic features associated with EGFR mutations via peptide nucleic acid clamping-assisted fluorescence melting curve analysis (PANAMutyper) and evaluated the feasibility of targeted deep sequencing for detecting the mutations.Methods: We examined EGFR mutations in exons 18 through 21 for 2,088 LUADs from July 2017 to April 2020 using PANAMutyper. Of these, we performed targeted deep sequencing in 73 patients and evaluated EGFR-mutation status and TKI clinical response.Results: EGFR mutation was identified in 55.7% of LUADs by PANAMutyper, with mutation rates higher in females (69.3%) and never smokers (67.1%) and highest in the age range of 50 to 59 years (64.9%). For the 73 patients evaluated using both methods, next-generation sequencing (NGS) identified EGFR mutation–positive results in 14 of 61 patients (23.0%) who were EGFR-negative according to PANAMutyper testing. Of the 10 patients reportedly harboring a sensitizing mutation according to NGS, seven received TKI treatment, with all showing partial response or stable disease. In the 12 PANAMutyper-positive cases, NGS identified two additional mutations in exon 18, whereas a discordant negative result was observed in two cases.Conclusions: Although PANAMutyper identified high frequencies of EGFR mutations, targeted deep sequencing revealed additional uncommon EGFR mutations. These findings suggested that appropriate use of NGS may benefit LUAD patients with otherwise negative screening test results.