bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbial load of edible termites (macroterme spp.) from collection to marketing in Serenje District, Central Zambia
Authors: Mumbula I. , Nyunja R. , Chungu D.
Published: October 2021

Edible insects including termites form a suitable alternative for sustainable provision of animal protein to fight protein-energy malnutrition. It is as cardinal to study the food safety of edible termites as it is for any other food stuff. Twenty seven (27) samples were collected and analysed for total viable counts and Enterobacteriaceae. The microbial load was assessed using culture, microscopic and biochemical methods. The isolates identified in this study includeStaphylococcus aureus, Escherichia coli, yeasts other thanCandida albicans andZygomycetes. Investigation of the total viable counts and Enterobacteriaceae of open air traded edible termites revealed loads higher than those recommended for minced meat 5.7 to 6.7 log10 cfu/g. The mean ranges were between 6.87 and 9.29 log10 cfu/g for total viable counts and 6.64 and 8.537 log10 cfu/g for Enterobacteriaceae. The presence ofE. coli suggests faecal contamination of the sample along the value chain whereasS. aureus, yeasts other thanC. albicans, andZygomycetes indicate unhygienic handling of the food samples. Heat treatments can reduce the loads but may not be effective for enterotoxins and recontamination of the sample is possible. Poor hygiene and sanitation by handlers may contribute to contamination and recontamination of Edible termites. Food safety and hygiene education on processing and handling practices that reduce microbial loads at collection sites, transportation and display points are important especially since termites are sold as ready to eat foods in African open air Markets. Legislation on open defecation, use of toilets and promotion of hand washing hygiene can effectively reduce the risk of contamination with gastrointestinal microflora from faecal matter.
Houston, We Have a Workforce Crisis; I Repeat . . . We Are Facing a Workforce Crisis
Authors: Trepanier Sylvain
Published: October 2021

As a result of the cornoavirus disease 2019 (COVID-19) pandemic, the health care industry is facing one of its worse workforce crises in decades. Nurse educators must influence the development and implementation of a strategic workforce plan to mitigate this crisis.

[
J Contin Educ Nurs
. 2021;52(10):452–453.]
Mental Health Issues Among Farmers: An Online Continuing Education Program for Nurses
Authors: Jones M. Susan , Main M. Eve , Garrett-Wright Dawn , Malin Catherine M. , Pennington Alicia
Published: October 2021

Background:

An asynchronous online continuing education (CE) program was created to increase nurses' awareness and knowledge of occupationally related mental health issues among farmers.

Method:

The ADDIE (analysis, design, development, implementation, evaluation) model was followed to create the CE program. Articulate Storyline 3 (Articulate 360), a software tool, was used to build an interactive, e-learning, and virtual training module.

Results:

The course was completed by 113 nurses. Eighty-two (72.5%) of these nurses completed the course evaluation. Of these, 69 (84.1%) reported that the course met their expectations. The majority of respondents indicated that the material was presented in a clear, organized manner (80.0%,
n
= 80) and that all course objectives were met, including being able to identify sources of stress among farmers (86.3%,
n
= 80), recognize manifestations of stress among farmers (86.4%,
n
= 81), understand farmers' mental health status (86.3%,
n
= 80), and identify mental health nursing practices (87.3%,
n
= 79).

Conclusion:

Nurses can provide more salient care to the farming population when they are equipped with an understanding of the culture and stress associated with farming. This online educational program has the potential to improve mental health care for farmers and their families.

[
J Contin Educ Nurs
. 2021;52(10):482–488.]
De la Protohistoria a la Historia en Menorca. Arquitectura y organización espacial en Son Catlar (Ciutadella, Menorca)
Authors: Jiménez Vialás Helena , Torres Gomariz Octavio
Published: October 2021

El poblado de Son Catlar (Ciutadella, Menorca), con sus cinco talayots y su muralla extraordinariamente conservada a lo largo de casi 1 km de perímetro, es uno de los principales núcleos de la Menorca protohistórica y romana. Presentamos en este texto un amplio volumen de datos inéditos, resultado de recientes trabajos de prospección intensiva y estudio arquitectónico, que ilustran sobre la organización espacial de las fases talayótica, postalayótica -incluyendo una refortificación asociada a la segunda guerra púnica‒ y romana. La entidad del poblado y su ocupación aparentemente ininterrumpida a lo largo de este amplio periodo, lo convierten en un ejemplo excepcional a la hora de estudiar la particular evolución de las comunidades baleáricas a lo largo de la Edad del Hierro y en época romana.
Education of Future Green Engineers for Achieving Sustainable Development in Green Manufacturing Industry
Authors: Kirik Vladimir Alexandrovich , Cheng Shanyi , Vyunova Natalia Ivanovna , Galustyan Olga Vladimirovna , Gamisonija Saida Sosoevna , Galustyan Sofia Dmitrievna
Published: October 2021

The article is devoted to education of future green engineers for achieving sustainable development in green manufacturing industry. It outlines that green engineering is an important industry which aim is to reduce consumption, to save resources, and to achieve sustainable development in manufacturing. Green manufacturing puts forward new requirements for the training future green engineers. The article reveals the concepts of educating future green engineers. Specifical attention is paid to the improvement of the teaching system training of future green engineers, strengthening the teaching staff, changing the teaching mode, strengthening teaching practice and practical training for achieving teaching goals. The authors conclude that it is necessary to clarify the goals of training of future green engineers, and to establish reform the teaching content of green engineering course.
The Labor of Digital Privacy Advocacy in an Era of Big Tech
Authors: Holt Jennifer , Parks Lisa
Published: October 2021

This article explores the labor of contemporary digital privacy advocates and their myriad efforts to protect and preserve public interests during the era of Big Tech companies. It is based on qualitative interviews with professional staff, lawyers, and policy analysts at multiple major advocacy organizations in Washington, DC. We have employed a grounded theory approach to address four labor-related themes that consistently emerged across our interviews: coalition building, agenda formulation, the art of navigating public- and private-sector relationships, and balancing a domestic and global policy landscape. In the current policy landscape, there is an intensifying degree of advocacy–industry coordination taking place, in part because of US regulatory roll-backs under the Trump administration and a gridlocked Congress. As a result, advocacy organization staff members often rely on companies for information to do their assessment and agenda-setting work. They also apply pressure to these companies and force them to think about how their technologies and operations impact users and publics around the world; they mount legal challenges to various media and tech initiatives to ensure public interests are protected; and some end up working with or for these companies in ways that may impart and integrate the values of advocacy organizations within profit-driven organizations. This article explores the multiple dimensions of advocacy labor which itself is often excluded from media policy and industry analysis.
Otra narrativa de la Transición : las crónicas de sucesos de Margarita Landi en la revista Interviú
Authors: Ortega Muñoz Víctor J.
Published: October 2021

De multiples discours convergent sur la scène publique espagnole pendant la période de transition. Au-delà des questions politiques et des récits officiels largement étudiés, nous voulons attirer l'attention sur des thèmes inhabituels : les faits divers publiés par la précurseure Margarita Landi dans Interviú. Ce magazine a assumé dès le départ les nouvelles libertés politiques et morales qui surgissent avec la Transition vers la démocratie, combinant l'information politique et la dénonciation avec l'érotisme, éléments novateurs qui s'additionnent pour obtenir une base de lecteurs considérable et devenir l'un des médias de référence. Dans sa configuration, l'inclusion de faits divers représente un élément essentiel. Le pari pris pour cette section sera confirmé en 1980 avec la signature de la journaliste vedette d'El Caso, Margarita Landi, une professionnelle reconnue, qui jouit de la faveur du lectorat. À travers son regard acéré et les exemples de rupture de la normalité rassemblés dans les pages d’Interviú, nous abordons la société actuelle et ses problèmes.
El 23-F online : tratamiento de la retransmisión de la « noche de los transistores » en las webs de radio españolas
Authors: García-Gil Samuel , Berdón-Prieto Pablo
Published: October 2021

La radio en Espagne a connu un événement social majeur entre les 23 et 24 février 1981 lui permettant de faire un bond en avant en termes de média d’information. La retransmission du coup d'État manqué du 23-F a été nommée comme « la nuit des transistors », un des événements les plus importants de l'Histoire de la radio en Espagne. Le but de cette recherche est d'analyser le traitement de cette émission faite par les sites des quatre chaînes radio les plus importantes d'Espagne : Cadena SER, Cadena COPE, Onda Cero et Radio Nacional de España. Des témoignages des journalistes et travailleurs qui ont vécu cette nuit, en plus des morceaux et résumés de l'émission originale, ont été retrouvés. Cependant, aucune des chaînes susmentionnées n’a mis à disposition des usagers l'enregistrement intégral de façon permanente et accessible.
The Dancing Moominvalley: A Choreographic View on Tove Jansson’s Illustrations and Texts
Authors: Happonen Sirke
Published: October 2021

Cet article vise à mettre l’accent sur un aspect de la littérature de Tove Jansson, qui est lié à la danse et au mouvement. Il s’intéresse à son travail en tant que constructions chorégraphiques, aux images et textes qui renvoient à la danse. Cette dernière était une forme d’expression personnelle importante chez Tove Jansson, que l’on peut retracer dans son œuvre. Dans les livres sur les Moumines, l’acte de danser exprime différents sentiments et phases de la narration – joie de vivre, envie de s’échapper, rébellion et libération. Cependant, Jansson utilise aussi ces formes d’expression chorégraphiques lorsqu’elle décrit et illustre des événements qui sont associés à la danse, à l’instar de certains mouvements de la nature, de positions et postures humaines qui semblent particulièrement expressifs et esthétiques. De nombreux personnages dans l’œuvre de Jansson ont un langage qui renvoie au mouvement qui leur est propre. Lorsqu’elle retranscrit ces impressions, Jansson emprunte aux conventions de la danse de salon, du ballet et de la danse moderne. À travers ces registres de la danse ou apparentés, elle met en scène des nuances exceptionnelles dans sa narration et son art et parvient ainsi à exprimer son sens de l’humour très personnel.
Numerical and Experimental Investigation into the Aerodynamic Benefits of Rotorcraft Formation Flight
Authors: Duivenvoorden Ramon , Voskuijl Mark , Morée Lars , de Vries Jan , van der Veen Finbar
Published: October 2021

The use of formation flight to achieve aerodynamic benefit applied to rotorcraft has, unlike its fixed-wing counterpart, received little attention in the literature. This document presents a proof-of-concept of rotorcraft formation flight from two independent investigations: a numerical
study of a fully articulated helicopter influenced by an upstream helicopter wake and a wind-tunnel experiment featuring two small-scale helicopter models with fixed-pitch blades. Both cases feature a representation of two helicopters in a diagonal, staggered formation aligned on the advancing
side of the main rotor, but do not simulate directly comparable flight conditions. The vertical and lateral alignment of the two helicopters is varied in order to observe the achievable reductions in main rotor power required during cruise flight. The wind-tunnel experiment data yield an estimated
maximum total power reduction for the secondary aircraft of approximately 24%, while the numerical models yield reductions between 20% and 34% dependent on flight velocity. Both experiments predict a higher potential for aerodynamic benefit than generally observed for fixed-wing formations,
which is attributed to the asymmetric velocity profile induced by the wake of the upstream rotor. Optimal lateral alignment of both experimental and numerical results is found to feature overlap of the rotor disk areas, rather than tip-to-tip alignment, as a result of the circular rotor disk
area. Experimental data show an optimal vertical alignment of the secondary rotorcraft below the primary, due to the self-induced vertical displacement of the rotor wake, which is absent from the numerical results due to the application of a flat wake assumption. The results show a promising
potential for rotorcraft formation flight, though due to the limited nature of the models used, conclusions cannot be generalized. The potential aerodynamic benefit indicated by the present study invites further research in the field of rotorcraft formation flight.
Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study
Authors: Patil Supriya , Patil Yamini , Patil Sanjay Kumar
Published: October 2021

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.
The ticking time-bomb. Health literacy in the context of genetic risk prediction in familial breast-ovarian cancer; A qualitative study
Authors: Lorke Mariya , Harzheim Laura , Rhiem Kerstin , Woopen Christiane , Jünger Saskia
Published: October 2021

Personalised methods of predicting breast and ovarian cancer risk through genetic testing increasingly demand a person’s understanding and critical appraisal of risk-related information, as well as decision-making and acting upon disclosure of a positive test result. The current study aims at understanding health literacy (HL) among persons at risk of developing familial breast-ovarian cancer (FBOC) from a bottom-up perspective—incorporating their viewpoints into the research process. Its qualitative design integrates an ethnographic-narrative approach and findings from 10 narrative interviews with women who have undergone genetic testing, analysed by using reflexive grounded theory. The collected data reveal the entanglement of the women’s perceptions concerning the risk of getting ill, their identity, and their strategies of managing health. The analysis of this interplay provides an empirical basis for approaching HL in its communicative dimension, considering individuals’ understandings of health and illness, and emphasizing the role of critical HL.
Translations and interpretations of baptizontes (Mt 28:19–20) in some Ghanaian mother tongue translations of the Bible
Authors: Kuwornu-Adjaottor Jonathan E.T.
Published: October 2021

Scholars have written on Jesus’ command to make disciples, but little work has been done on the translation of baptizontes. Using the mother-tongue biblical hermeneutics approach, this article analyses the translation of baptizontes in 12 Ghanaian mother tongue Bibles. The findings are that the various Ghanaian mother tongue translations of Matthew 28:19 render baptizontes variedly, to suit the indigenous Bible readers. Translators sometimes use religiocultural words and phrases that express a similar idea in their contexts to translate the word. Thus, Bible translation always involves interpretation. Translators sometimes coin their own words or consult mother tongue speakers for information in order to render words and phrases that are difficult to translate. This article has added an African (Ghanaian) interpretation of baptizontes in Matthew 28:19. This fits into the overall aim of the journal to promote African theology.Contribution: This article makes a contribution to the Special Collection ‘Africa Platform for NT Scholars’ on the Ghanaian (African) interpretations of baptizontes in Matthew 28:19–20.
The power of forgiveness in a broken world: An understanding of forgiveness in Ephesians
Authors: Cornelius Elma M.
Published: October 2021

South Africans live in a broken country where hatred leads to violence and destroys the relationships between people. The pertinent question here is: Is forgiveness between South Africans possible? This article is an attempt to understand ‘forgiveness’ in Ephesians, and to discuss the power of such forgiveness in a violent and broken South Africa. Ephesians 4:23 demands a change in the people’s mindset in order to be able to, inter alia, be kind and compassionate when they forgive each other (Eph 4:32). This forgiveness means to take control as a believer and to use one’s power as a Christian to forgive because God forgave us. We need to be the initiators of the transaction. Forgiveness is a ‘means for imitating God’, for ‘carrying out God’s plan’, and ‘enhancing one’s relationship’ with God. Forgiveness will restore relations; it is a gift to oneself and to others, to society, to one’s country. Ephesians advises to no longer rehearse and re-think the memories of pain, to stop harbouring and nursing grudges, to stop playing the victim and perpetuating negative emotions associated with this rehearsing, and to break people’s commitment to remain angry.Contribution: Ephesians aims to persuade believers that forgiveness is a choice to imitate God. Forgiveness is an act out of grace, kindness, and compassion.
Complete Rockall Score in Predicting Outcomes of Elderly Patients with Acute Non-Variceal Upper Gastrointestinal Bleeding
Authors: Bhattacharyya Ankur , Das Subha Lakshmi
Published: October 2021

Background:

Upper gastrointestinal bleeding (UGIB) is a common life-threatening emergency with an overall mortality rate of around 10%. Complete Rockall score is designed to identify patients who are at greater risk of adverse outcome. The aim of this study was to assess the Rockall score as a predictor of adverse outcome in elderly population presenting with non-variceal UGIB.

Materials and Methods:

This study was an observational study conducted in 116 patients of age >60 years. After stabilizing the patient, endoscopy was performed using a Pentax endoscope. Severity of bleeding was assessed with complete Rockall scoring. The statistical significance was fixed at 5% level (P-value <0.05).

Results:

The mean age of the study population was 70.16 ± 6.01 years with male-to-female ratio of 2.63:1. Majority of patients (55.17%) presented with both hematemesis and melena. The most common lesion was duodenal ulcer (33.62%). The mean blood transfusion was 1.56 ± 1.14 U. The mean Rockall score was 4.37 ± 2.12. The mean hospitalization was 3.26 ± 1.69 days. Rebleeding occurred in 12.93% of the patients and 8.62% of the patients expired during hospitalization. Out of the 10 patients expired, 20.0% belonged to the moderate-risk and 80.0% belonged to the high-risk Rockall groups, which were found to be statistically significant (P-value <0.001).

Conclusion:

Acute UGIB is a medical emergency and Rockall score is ideal to stratify elderly patients to anticipate outcome and prognosis.
Donor Selection and Deferral Pattern in Convalescent Plasma Donor in Plasmapheresis Unit of a Tertiary Care Hospital
Authors: Sharma Adity , Ahmed Zarika , Rahman Mustafizur
Published: October 2021

Context:

The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Wuhan, China, in December 2019. The management plan is supportive care with oxygen supplementation and mechanical ventilation. US FDA approved convalescent plasma (CP) for COVID-19 for clinical trials and as an emergency investigational new drug. Although numerous trials are currently investigating the safety and efficacy of CP in COVID-19 patients, there is a paucity of ongoing and published studies evaluating the CP donors' side. This retrospective study reports the CP donors' selection and deferrals.

Aim:

To evaluate and analyze the donor deferral pattern and its causes among CP donors in a tertiary care hospital blood bank apheresis unit.

Settings and Design:

Hospital-based retrospective analysis.

Subjects and Methods:

Donors aged 18–65 years who had recovered from COVID-19 at least 4 weeks previously coming for plasma donation were retrospectively analyzed from July 25, 2020 to January 24, 2021 for a period of 6 months at blood bank apheresis unit, Assam Medical College and Hospital.

Results:

A total of 396 potential plasma donors were screened during the study period. The donor deferral rate was 39.1%. The permanent deferral was 36.8%, and the temporary deferral was 63.2%. The maximum number of donors deferred because of low antibody (18.7%) followed by low hemoglobin (14.8%). Associated comorbidities, low platelet count, repeat reverse transcription-polymerase chain reaction positivity, transfusion transmitted infection reactivity, intake of medicines, infections, vaccination, and underweight were other causes identified.

Conclusion:

The pattern of donor deferral is an important tool for blood safety and also provides key areas to focus on a demographic region or policy formulation for donor selection as well as to ensure donor safety.
A Case of Ovarian Hyperstimulation Syndrome with Diffuse Cortical Necrosis
Authors: Kakoti Sweety , Choudhury Dhruvajyoti , Das Tonmoy
Published: October 2021

Ovarian hyperstimulation syndrome is an iatrogenic, serious complication of controlled ovarian hyperstimulation, usually self-limited, but occasionally life threatening and typically occurs with gonadotropin. A 32-year-old married female [Para 0+1, 30 weeks (intra-uterine death)—2016], who underwent ovum pick up procedure for secondary infertility, presented to the Department of Nephrology, Apollo Hospital, Guwahati with the complaints of pain in the abdomen, anuria, breathing difficulty, bleeding per vagina on the next day. On investigating the case, the patient had thrombocytopenia, leucocytosis, anemia, normal morphology in peripheral blood smear, raised inflammatory markers, hepatic transaminases, lactate dehydrogenase, and rapidly progressive renal failure, metabolic acidosis with negative serological markers for connective tissue disease. Radio imaging suggested bilaterally enlarged ovaries with multiple hemorrhagic cysts, pleural effusion, and ascites. Ultrasound showed normal sized kidneys with increased echotexture and hypoechoeic cortical rim. Renal biopsy showed diffuse renal cortical necrosis. Supportive management started with a target to correct volume depletion, monitoring, and electrolyte abnormalities. Patient was hemodynamically stabilised and discharged on thrice weekly maintenance dialysis.
Prevalence of Antimicrobial-Resistant Infection Among Patients Attending Assam Medical College and Hospital, Dibrugarh
Authors: Gogoi Gourangie , Dutta Mousumi , Choudhury Gargi
Published: October 2021

Background:

The burden of antimicrobial resistance (AMR) is increasing globally at an alarming rate, especially among hospitalized cases. However, there is still lack of knowledge about morbidity and mortality due to AMR infections among different populations. The present study was aimed to provide a brief insight on the prevalence of AMR infection among the patients attending Assam Medical College and Hospital, Dibrugarh, Assam, India.

Materials and Methods:

A retrospective cross-sectional study was conducted among the patients admitted in the hospital from April 2018 to April 2019. Blood culture reports of AMR-positive cases were collected from the Microbiology Department and hospitalization records including clinical and demographic data were retrieved from the Medical Records Department.

Results:

Overall, 251 blood culture reports positive for AMR infection were obtained during the study period. Of this, 96 cases (38.25%, 96/251) were females and 155 (61.75%, 155/251) were males. AMR infection was mostly prevalent among younger age group (0–1 month) with 85.65% (215/251). Methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, and Klebsiella pneumonia were the most frequently identified AMR pathogens in the study population with 31.47% (79/251), 23.90% (60/251), and 17.93% (45/251), respectively.

Conclusion:

The identified AMR pathogens were mostly prevalent among young infants and characterized with multidrug resistance. However, the extended study in increased population mostly among hospitalized cases may provide insights for understanding the burden of AMR and associated risk factors.
Effect of diffusion of anaesthetic gases on fibre-optic view change of laryngeal mask airway and post-operative laryngo-pharyngeal morbidity in children – A randomised controlled trial
Authors: Bharti Neerja , Bala Indu , Lokala Revathi , Sahni Neeru , Samujh Ram
Published: October 2021

Background and Aims:

The diffusion of nitrous oxide (N2O) into the air-filled cuff of the classic laryngeal mask airway (LMA) may lead to an increase in cuff pressure (CP) and displacement of LMA affecting its performance. This study was conducted to evaluate the change in optimal position of LMA by fibre-optic bronchoscope, the changes in cuff pressure and oropharyngeal leak pressure (OLP), and post-operative laryngo-pharyngeal morbidity during N2O–oxygen (O2) anaesthesia in children.

Methods:

After ethics committee approval and written informed consent, 84 children, aged 2 to 8 years undergoing lower abdominal surgery using LMA were included. Anaesthesia was induced with sevoflurane and maintained with either 33% O2in air (Group 1) or with 33% O2in 67% N2O (Group 2) along with sevoflurane. The position of LMA using fibre-optic bronchoscope, CP and OLP were recorded at 30, 60 and 90 minutes and at the end of surgery. The incidence of post-operative sore throat, hoarseness of voice and dysphagia was assessed for 24 hours.

Results:

A mild (Grade 1) change in fibre-optic position of LMA was observed in 6 out of 42 children maintained with N2O–O2anaesthesia. The cuff pressure was higher than baseline in group 2 at all three time points with the maximum at 90 minutes (93.23 ± 14.86 cm H2O vs. 39.78 ± 7.75 cm H2O;P< 0.05). The OLP was comparable between the groups during the initial 60 minutes and then increased in group 2. The incidence of post-operative sore throat was significantly higher in group 2 (P= 0.008).

Conclusion:

The diffusion of anaesthetic gases into the air-filled cuff does not change the fibre-optic position of the LMA significantly but increases the cuff pressure and incidence of post-operative laryngo-pharyngeal complications in children.
NUTRIC score as a predictor of outcome in COVID-19 ARDS patients: A retrospective observational study
Authors: Kumar Neeraj , Kumar Abhyuday , Kumar Ajeet , Pattanayak Arunima , Singh Kunal , Singh Prabhat K.
Published: October 2021

Background and Aims:

The Nutrition Risk in Critically ill (NUTRIC) score is an appropriate nutritional assessment tool in mechanically ventilated patients. We retrospectively observed the applicability of the NUTRIC score for predicting outcomes in coronavirus disease (COVID)-19 acute respiratory distress syndrome (ARDS) patients.

Methods:

All adult COVID-19 ARDS patients admitted to the intensive care unit and requiring various forms of oxygen therapy were included in the study. The demographic characteristics and clinical information about the patients were obtained from the hospital’s medical records department. The nutritional risk for each patient was assessed using the NUTRIC score at 72 hours of ICU admission. The discriminating power and ability of NUTRIC score, Sequential Organ Failure Assessment (SOFA) score, age and Acute Physiology and Chronic Health Evaluation (APACHE) II to predict the 28-day mortality and need for mechanical ventilation (MV) was calculated using receiver operating characteristic curves and area under this curve.

Results:

A total of 80 COVID-19 ARDS patients fitted into the inclusion criteria. Among non-survivors, the median Glasgow Coma Score, APACHE II score, NUTRIC score and SOFA score were 10, 16, 6 and 4, respectively. The cut-off values for NUTRIC score, SOFA, and APACHE II to predict 28-day mortality and need for MV was obtained as 3.5, 3.5 and 11.5, respectively. These cut-off values of NUTRIC score, SOFA score, and APACHE II have a sensitivity of 62%, 72.5% and 75.5%, respectively, and specificity of 95%, 72% and 83% for predicting mortality.

Conclusions:

Most COVID-19 ARDS patients requiring MV in the ICU are at nutritional risk, and a high NUTRIC score is associated with higher mortality.
Comparison of post-cataract surgery endophthalmitis rates using syringing or regurgitation on pressure over the lacrimal sac as a preoperative screening tool for nasolacrimal duct obstruction: An impact assessment of protocol alteration due to the COVID-19 pandemic
Authors: Shenoy Pratik , Mehta Sonali , Shah Chintan , Joshi Rajesh , Sen Pradhnya , Patidar Narendra , Kohli Gaurav Mohan , Sen Alok
Published: October 2021

Purpose:

To compare the post-cataract endophthalmitis (PCE) rates among eyes undergoing syringing or regurgitation on pressure over the lacrimal sac (ROPLAS) test prior to cataract surgery.

Methods:

We performed a single-center, retrospective, comparative analysis of eyes developing PCE who underwent syringing prior to cataract surgery (group A) in the pre-COVID-19 era between November 1 2019 and January 31, 2020 and the eyes that underwent ROPLAS test prior to cataract surgery (group B) in the COVID-19 era between November 1, 2020 and January 31, 2021.

Results:

A total of 87,144 eyes underwent cataract surgery during the two time periods of the study. Syringing was performed in 48,071 eyes, whereas ROPLAS was performed in 39,073 eyes. In group A, 19 eyes (0.039%) developed PCE, whereas 20 eyes (0.051%) developed PCE in group B (P = 0.517). Between the two groups, the grade of anterior chamber cellular reaction (P = 0.675), hypopyon (P = 0.738), and vitreous haze (P = 0.664) were comparable. Gram-positive organisms were detected in 4 eyes in group A and 6 eyes in group B; 2 eyes in group A had gram-negative bacilli. The presenting visual acuity (Group A: LogMAR 1.42 and Group B: LogMAR 1.30) and final visual acuity (Group A: LogMAR 0.52 and Group B: LogMAR 0.5) were comparable between the two groups. (P = 0.544 and 0.384, respectively).

Conclusion:

The rates of PCE were comparable among the eyes undergoing either syringing test or ROPLAS prior to cataract surgery.
Bilateral paracentral acute middle maculopathy and acute macular neuroretinopathy following COVID-19 vaccination
Authors: Vinzamuri Sirisha , Pradeep Thanuja Gopal , Kotian Rachana
Published: October 2021

A 35-year-old male patient presented with blurring and black spots in vision after 1 month of the second dose of Covishield vaccination. His visual acuity was 6/6; both eyes and anterior and posterior segment examinations were normal. The optical coherence tomography (OCT) showed multiple hyperreflective lesions involving the nerve fiber layer with back shadowing. In addition, there were hyperreflective spots in the ganglion cell layer and outer plexiform layer with focal loss of external limiting membrane and an intact inner segment/outer segment junction involving the posterior pole in both eyes. The patient was diagnosed with paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) and advised observation. PAMM and AMN are unreported manifestations following the COVID-19 vaccination.
Unveiling endophthalmitis post COVID-19 – A case series
Authors: Khatwani Paras R , Goel Nikita P , Trivedi Kinjal Y , Aggarwal Somesh V
Published: October 2021

Since December 2019, coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has become a global pandemic. There has been a resurgence in complications involving various organs in patients recovered from COVID-19, and endophthalmitis is one of them. Endophthalmitis—an inflammation of intraocular tissues leading to loss of vision or even loss of eye—has been a rare occurrence in the past, but has been on the rise in the post-COVID-19 times. Here we report seven such cases.
Low-tech intraocular ophthalmic microsurgery simulation: A low-cost model for home use
Authors: Golash Vidushi , Kaur Simerdip , Naveed Hasan , Nanavaty Mayank A
Published: October 2021

In order to maintain manual dexterity and surgical skills, trainees are encouraged to partake in regular simulation. Current options for intraocular surgical simulation require specialist microscopic equipment which is expensive and requires access to simulation facilities. A set of core simulation exercises and basic surgical skills of performing the corneal incisions, capsulorhexis, improving the manual dexterity, and suturing were identified, discussed, and agreed among authors before designing this simulation exercise. In this paper, we propose a smartphone-based, low-cost, low-tech model with corresponding exercises for intraocular simulation that can be used at home for the above-mentioned surgical skill set. This model provides an easy, portable, and reproducible method of simulation and can serve as an adjunct to patient-facing surgical training, especially in the current pandemic, where the excess to the simulation facilities or setup of these facilities may be difficult.
Surgical outcomes for esotropia in children with high accommodative convergence/accommodation ratio
Authors: Dass Sabrina E , Cheng Monique , Bahl Reecha S
Published: October 2021

Purpose:

To assess if high accommodative convergence/accommodation (AC/A) ratio impacts surgical outcomes in children with esotropia (ET), and evaluate the appropriate target angle in surgical dosing in the presence of high AC/A ratio.

Methods:

A retrospective chart review identified patients who underwent primary bilateral medial rectus (BMR) recessions for ET. Patients were excluded if follow-up was ≤2 months. Basic demographic information, visual acuity, stereopsis, alignment, and target angle for surgery were collected. High AC/A was defined as ≥10 prism diopter (Δ) deviation at near compared to distance. Outcome parameters were near and distance deviations ≤10Δ within orthophoria, and/or stereopsis postoperatively. Yates’ continuity correction, unpaired t-test, regression analysis, and one-way ANOVA were used.

Results:

We identified 103 patients, 23 with high AC/A and 80 with normal AC/A, preoperatively. Mean age was 4.0 ± 2.5 years. Surgical success measured by postoperative alignment was 48% and 45% in the high AC/A and normal AC/A groups, respectively (P = 1.0). There was a statistically significant difference in preoperative near deviation between high AC/A and normal AC/A groups (P = 0.0015); however, there was no significant difference in preoperative distance deviation (P = 0.061). In addition, there was not a significant difference in preoperative or postoperative stereopsis between high AC/A and normal AC/A groups (P = 0.88 and P = 0.44, respectively). There was a significant difference in the normal AC/A and high AC/A groups when target angle was directed toward preoperative near deviation as determined by one-way ANOVA (F = 170.88, P < 0.0001 and F = 14.61, P = 0.0010, respectively).

Conclusion:

In the setting of ET treated with BMR recession, the presence of high AC/A does not affect surgical success as measured by alignment and stereopsis. In addition, when high AC/A is present, surgical dosing with a target angle toward near deviation was found to yield the best surgical outcomes in our patient population.
Femtosecond laser-assisted peripheral additive stromal keratoplasty for treatment of primary corneal ectasia: Preliminary outcomes
Authors: Jafarinasab Mohammadreza , Hadi Yasaman
Published: October 2021

Purpose:

To report the preliminary results of a new surgical modality for the treatment of primary corneal ectasia, which consists of implanting allogeneic corneal tissue into the peripheral corneal stroma using a femtosecond laser system or femtosecond laser-assisted peripheral allogeneic stromal additive keratoplasty or FA-PASAK.

Methods:

This prospective, noncomparative case series includes patients with primary corneal ectasia including keratoconus and pellucid marginal degeneration. In the operating room, one or two ring or crescent-shaped allogeneic corneal segments were prepared using a handmade double-bladed punch, which were then implanted by a specially designed device, into stromal channels in the peripheral recipient cornea fashioned with a femtosecond-laser system.

Results:

A total of 15 eyes of 13 patients with mean age of 31.73 years were operated. There were significant improvements in uncorrected (0.68 to 0.3 logMAR) and corrected (0.44 to 0.16 logMAR) visual acuity, mean sphere, mean spherical equivalent refractive error, and mean keratometry (steep, flat, and average). Topographic and refractive astigmatism did not change significantly. Complications included a single case of bacterial keratitis secondary to epithelial defect, which was controlled with topical antibiotics eventually leading to an uncorrected vision of 20/25 one year after surgery.

Conclusion:

The use of allogeneic corneal ring or crescent shape segments may be a safe and cost-effective treatment for primary corneal ectasia, whereas a nomogram is necessary to be devised for general use of the technique.
Retrospective analysis of the comparison between carbon dioxide laser-assisted deep sclerectomy combined with phacoemulsification and conventional trabeculectomy with phacoemulsification
Authors: Raja S Vidya , Ponnat Arvin Kurian , Balagiri K , Pallamparthy Srilekha
Published: October 2021

Purpose:

To compare outcomes of laser assisted deep sclerectomy (LADS) and conventional trabeculectomy both combined with phacoemulsification.

Methods:

We divided 36 eyes into 2 groups, one group with LADS and the other Trabeculectomy. Patients were measured post operatively at 1, 3, 6, 9 months, 1, 2, 3 years for intraocular pressure (IOP), best corrected visual acuity (BCVA) and number of medications.

Results:

In the trabeculectomy group, after 3 year follow up, IOP was 14.67 ± 3.14, 15.27 ± 4.28 and 17.00 ± 7.79, BCVA improved to 0.17 ± 0.18, 0.24 ± 0.20 and 0.24 ± 0.27 and number of medications reduced to 0.6 ± 0.6, 1.1 ± 1.2, and 1.5 ± 1.5. Complete success rate after 3 years was 100%, 80.0% & 80.0% and Qualified success rate was 100%, 88.9% & 88.9%. In the LADS group, after 3 years follow up, IOP was 14.11 ± 3.91, 16.07 ± 5.51, 15.80 ± 6.07, BCVA improved to 0.13 ± 0.11, 0.10 ± 0.15, 0.11 ± 0.13 and medications reduced to 1 ± 1.1, 1.5 ± 1.0 and 1.8 ± 1.0. Complete success after 3 years was 85.7%, 57.1% & 57.1% whereas qualified success was 92.3%, 84.6% & 84.6%.

Conclusion:

Main limitations of our study were small sample size and lack of prospective comparison. However we were able to perfom the surgery comfortably due to the relatively shorter learning curve compared to conventional NPDS.
Subjective and objective assessment of the eye drop instillation technique: A hospital-based cross-sectional study
Authors: Usgaonkar Ugam , Zambaulicar Viraj , Shetty Aksha
Published: October 2021

Purpose:

To objectively and subjectively evaluate eye drop technique and assess communicated instructions, and reported problems with eye drop instillation among tertiary care sample eye drop users.

Methods:

A cross-sectional, observational study was carried out among patients attending our outpatient clinic from June to September 2020. Eligible participants obtained through convenient sampling were assessed for their eye drop instillation performance. The objective evaluation was made using observation of a demonstration and subjective assessment through responses to an interview. Patient inclusion criteria were being aged ≥18 years and using eye drops for ≥ one month; excluded if having a disability in communication or physical barriers in using eye drops. The patient reported difficulties and previous education about the instillation were also obtained.

Results:

Participants (n = 84) had a mean age of 50.3 ± 14.0 years. During the demonstration, almost everyone (86.9%) successfully instilled at least one drop in the eye. None of the participants exhibited a perfect drop technique. The most common deviations were failing to close the eye (60.7%), touching the bottle to the eye or eyelid (36.9% of patients), and multiple blinks after drop instillation without nasolacrimal occlusion (25.0%). Forty percent of patients reported ≥1 problem and only a small sample recalled having had education in the eye drop instillation technique.

Conclusion:

Most participants failed to properly execute the eye drop technique. A proactive role of the prescribing practitioner to assess a patient’s ability to instill eye drops correctly could be helpful.
Short term changes in corneal stress-strain index and other corneal biomechanical parameters post-laser in situ keratomileusis
Authors: Kenia Vaishal P , Kenia Raj V , Pirdankar Onkar H
Published: October 2021

Purpose:

To report the short-term changes in a corneal stress-strain index (SSI) and other corneal biomechanical parameters post-laser in situ keratomileusis (LASIK) surgery.

Methods:

A retrospective study was conducted at a tertiary eye care center wherein patients who had undergone LASIK (microkeratome blade and femtosecond bladeless LASIK) between July and December 2019 were enrolled. Patients of age group 20–40 years, best-corrected visual acuity of 20/20, intraocular pressure (IOP) <22 mmHg, pre-LASIK pachymetry >500 microns, and corneal astigmatism ≤3.00 D were included. Subjects with a prior history of refractive surgery, any other ocular or systemic disease, poor-quality scans, intraoperative complications, and missing data were excluded. Corneal biomechanical properties including SSI were analyzed using Corvis ST and compared using the Paired T-test for each group separately at pre-LASIK, and 1-month post-operatively.

Results:

Overall, 202 eyes were reviewed, and 79 eyes fulfilled the inclusion criteria. Forty-three and 36 eyes had undergone Microkeratome Blade LASIK (Group I) and Femto LASIK (Group II), respectively. Overall, 29 and 26 corneal biomechanical parameters out of 33 changed significantly post-Microkeratome Blade LASIK and Femto LASIK, respectively. Statistically significant changes were noted in all the parameters at A1, maximum and Vinciguerra screening parameters (P < 0.001), however, no changes were noted in SSI in both the groups when compared with the pre-surgery data.

Conclusion:

Though the reduction in SSI was not statistically significant, other biomechanical parameters showed significant biomechanical changes pre- and post-LASIK surgeries in both the groups. However, a long-term study with a larger sample size would be required to understand the changes and stability in SSI post-refractive surgery.
Efficacy of blink software in improving the blink rate and dry eye symptoms in visual display terminal users – A single-blinded randomized control trial
Authors: Ashwini D L , Ve Ramesh S , Nosch Daniela , Wilmot Natoya
Published: October 2021

Purpose:

Dry eye disease (DED) is a multifactorial disease, more prevalent among visual display terminal users. Reduced blink rate is a risk factor to dry eye disorder, innovative means to remind to blink while using computers can be helpful.

Methods:

Single-blinded Randomized Control Trial enrolled computer users with dry eye. Allocation concealment was done using opaque envelope and principal investigator was blinded. After baseline examination, eligible participants were randomized to intervention group (appearance of bars is 8 times/min) and control group (appearance of bars is 1 time/min). Participants from both groups used the software for 15 days, came for first follow up, and did not use the software for next 15 days until second follow-up examination. During each visit, detailed eye examination was done including blink rate, tear film break up time, and Ocular Surface Disease Index score.

Results:

Forty-six participants (women n = 31; men n = 15) with a mean age of 28.02 (±6.295) years completed the study. Four participants were excluded from analysis because of early dropout. In the intervention group (n = 23) and control group (n = 23), participants were allocated. At the end of first phase, there was statistically significant difference in OSDI score (P = 0.021). Statistically significant difference was noticed in OSDI (P = 0.014) and blink rate (P = 0.049) as baseline, and final visit data were compared.

Conclusion:

“Blink–Blink” software with 8 reminders/min improved DED-related symptoms by increasing the blink rate. The carry-over effect after cessation of Blink-Blink software in improving blink rate was maintained even after 1 month.

Trial Registration
: Clinical Trials Registry-India (CTRI): CTRI/2018/08/015176
Clinical implications of energy used in Neodymium: Yttrium Aluminum Garnet posterior capsulotomy on intraocular pressure
Authors: Chawla Harshika , Singh Manav Deep , Vohra Vishal
Published: October 2021

Purpose:

To study the trend of the rise of intraocular pressure (IOP), with the energy used during Neodymium: Yttrium Aluminum Garnet (Nd: YAG) posterior capsulotomy.

Methods:

This is a prospective interventional study undertaken at a tertiary care center. The study was conducted on 221 non-glaucomatous eyes that underwent Nd: YAG posterior capsulotomy, of which 181 patients completed the study. IOP was recorded before laser and at 1, 2, 3, 4 hours, one day, one week, and one month during the post-laser period. Patients were grouped, depending on the amount of energy used, into Group 1 (≤ 40 mJ), Group 2 (40–80 mJ), and Group 3 (>80 mJ).

Results:

Raised IOPs were noted in all the groups at various time points; however, such cases were more in Group 3 (P = <0.001). IOP was noted to peak at the fourth hour and declined to reach baseline by one week in Group 2 and by one month in Group 3.

Conclusion:

There exists a relationship between the quantum of energy used and the amount of rising of IOP following Nd: YAG laser capsulotomy. In uncomplicated cases without preexisting glaucoma, if the amount of energy for posterior capsulotomy is limited to 40 mJ, routine use of ocular hypotensive medication can be avoided.