bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomedical Ethics in Research and Clinical Practice
Authors: Maurya Rashmi
Published: May 2024

Biomedical ethics is an interdisciplinary domain offering holistic guidance of decision making in research and clinical practices. The term “bioethics” was coined by biochemist Van Rensselaer Potter in his book “Bioethics: Bridge to the Future” in 1971. Bioethics systematically examines and applies ethical principles to tackle intricate issues and questions pertaining to medical practice, patient care, research involving humans or animals, healthcare policies, and the advancements in biomedical technologies. In the 21st century, scientific advancements have accelerated in delivering solutions for deadly diseases; however, the ethical dilemma related to moral principles, and values have emerged as significant hurdles for the scientific and healthcare community in implementing new innovation. More than half a century has witnessed phases of bipartite challenges to find a point of balance between technological progress and ethical safety implications.
Comparing Methamphetamine-Induced Psychosis With Positive and Cognitive Symptoms of Schizophrenia
Authors: Uludag Kadir , Jadhav Aalisha , Kara Fatih
Published: May 2024

Psychosis and other symptoms of Schizophrenia (SCZ), predominantly positive symptoms, can be induced by the regular use of methamphetamine (METH), resulting in a diagnosis discourse between SCZ and METH-induced psychosis. Therefore, distinguishing both disorders based on the most prominent positive symptoms is necessary. This review aims to investigate whether the psychosis induced by METH differs from that of SCZ in terms of symptomatology, behavior, genetics, clinical features, and brain imaging analysis that have not been studied comprehensively. A comprehensive search was conducted using the PubMed. A total of 248 studies were retrieved, and through careful evaluation, 18 studies were deemed pertinent to our research objectives. The quality assessment of narrative review (SANRA) was employed to evaluate the rigor and reliability of the included studies. This review showed that psychosis induced by SCZ and METH leads to many common positive symptoms, such as thought disorders, hallucinations, and delusions.
Punctilious on SDGs
Authors: Sa Liow Melissa Li
Published: May 2024

This chapter addresses the imperative for the global tourism sector to embrace the Sustainable Development Goals (SDGs), emphasizing the potential of a circular economy. The approach involves a synthesis of literature, incorporating social exchange and systems thinking. A research framework is constructed to assesses the social, economic, and environmental (SEE) benefits of a circular economy on SDG attainment, considering the mediating role of innovative organizational competence, and how exchange ideology moderates the correlation between innovative organizational competence and sustainable organizational identity. With practical implications geared towards the Singaporean hotel industry, the research aligns with the Hotel Sustainability Roadmap by the Singapore Hotel Association and the Singapore Tourism Board till 2050. Theoretical implications extend to the integration of industrial ecology and organizational psychology and concepts like the Magnet Circular Hotel Industry and Organizational Business Model and the Pineapple SDG Crown for Hotel Circular Economy Practices.
Influencing Factors on the Continuous and Sustainable Development of the Wine Landscape
Authors: Jovanović Radmila
Published: May 2024

Today it is difficult not to notice the influence of human beings and the reduced area of the natural environment: forests are turned into agricultural areas, agricultural land into suburban construction, suburban areas into urban areas. Vineyard landscapes form a unique image of the region, contributing to their uniqueness and identity (they represent cultural heritage, function as trademarks for their areas, attract visitors, inspire art, serve as places for different, spiritual activities). In the chapter, the authors analyze the eco factors that have the greatest influence in the wine-growing area of Serbia: climatic and anthropogeographical. Using the method of comparative analysis, GIS techniques, and cartographic visualization, results were obtained that show that the most environmental changes in Serbia's wine destinations were due to anthropographic factors: land cover use and the least due to climatic factors, although the analysis period is much longer for climatic factors.
Conservation of Biodiversity as a Roadmap for Sustainable Tourism Development in Manas National Park, Assam
Authors: Narzary Reemina , Deb Rajdeep
Published: May 2024

The current study delves into the conservation of biodiversity and ecotourism activities in Manas National Park (MNP), Assam. It intends to offer a roadmap for sustainable ecotourism with an emphasis on biodiversity conservation and assessing the involvement of local communities in conservation efforts in MNP. The study carefully combines available online sources to investigate the effects of ecotourism on biodiversity conservation and the ongoing conservation initiatives that involve local communities. Furthermore, it investigates eco-friendly tourism strategies that aid in the conservation of biodiversity and provides recommendations for enhancing the situation of local communities and increasing public knowledge of ecotourism. The study seeks to provide a thorough understanding to stakeholders and policymakers of the opportunities and problems related to sustainable ecotourism and biodiversity conservation in MNP and provide valuable insights for regulating ecotourism to ensure the preservation of the park's natural integrity.
Nurturing Nature and Local Well-Being in the Hills of Himachal Pradesh
Authors: Nag Ashish , Kumar Vipan , Choudhary Vishal , Kumar Anuj , Sharma Raveesh
Published: May 2024

The outcome of the heavy rains in Himachal Pradesh has been disturbing, with 300 deaths, 10,000 cracked buildings, and a staggering rain-induced cost of Rs 10,000 crore in 2023. The Himalayan region is at heightened risk due to rising casualties, flood-hit areas, and alarming weather patterns. Despite government initiatives promoting job creation and startup culture, the delicate balance between development and environmental preservation remains a challenge in Himachal. Improper waste disposal and unscientific road construction compound challenges, making daily life difficult for highland residents. Uncontrolled development and tourism in Himachal's mountains have caused severe environmental damage, highlighting the urgent need for sustainable tourism practices. Individuals play a vital role by adopting responsible tourism practices and prioritizing proper waste management to mitigate environmental impact. This chapter highlights the nurturing of nature and local well-being through sustainable tourism practices in Himachal Pradesh.
Application of Artificial Intelligence-Based Technologies for Promoting Sustainable Tourism Practices
Authors: Singh Pramendra , Hassan Viana
Published: May 2024

The chapter delves into the intricate relationship between AI-based technologies and the pursuit of sustainable tourism practices. Drawing on a comprehensive review of secondary sources in the literature, the chapter aims to provide a nuanced understanding of the conceptual framework, current practices, and future implications of employing AI to foster sustainability in the tourism sector by addressing the environmental, social, and economic dimensions of sustainability within the tourism sector. The chapter investigates the diverse array of AI applications that have the potential to mitigate the negative impacts of tourism on the environment and local communities while encouraging the positive impacts of tourism. The chapter aims to be a comprehensive study on interpreting the interconnection of AI and sustainable tourism to help the industry practitioners, policy makers, academia, and all other stakeholders for guiding their activities and actions for the betterment of the industry through technological implementation specially through AI.
Unveiling the Economic Tapestry
Authors: Jeyaprabha B. , Catherine S. , Vijayakumar M.
Published: May 2024

This research analyses the pivotal role of India's travel and tourism sector in its growing economy through comprehensive statistical analysis. Utilizing diverse quantitative data, the study unveils the sector's impact on GDP growth, employment, and foreign exchange. Beginning with an overview of the industry's current state, emphasizing rapid growth and evolving dynamics, the analysis delves into its contributions to various economic facets. Examining statistical data, the chapter underscores the sector's substantial role as a key driver of India's GDP, both directly and indirectly. A thorough exploration of employment statistics highlights the sector's crucial role in job creation. In conclusion, this study synthesizes extensive statistical data to emphasize the significant contributions of the travel and tourism sector to India's economic landscape. Aimed at informing policymakers, industry stakeholders, and researchers, the research facilitates evidence-based decision-making for sustainable economic development.
Impact of Revenge Tourism in Uttarakhand State Post COVID-19 Outbreak
Authors: Dhyani Ashish , Dimri Garima , Dimri Rajat Praveen , Dhyani Archana , Lal Sunil Kumar , Rawat Vivek
Published: May 2024

As the pandemic devastated our lives, everyone learned that revenge travel is essentially a way to make up for lost time. Stepping outside became challenging, and travel and vacations were dearly missed. Revenge travel may have made news in Asia as early as the fall of 2020, according to reports, and is already known worldwide as such. According to Expedia, 54% of travellers intended to spend more than they would have prior to the pandemic. This may be because people conserved money because they were unable to spend much during the lockdowns and limitations. The new face of this vengeance travel is a hardcore business traveller who has been working from home and wants to board the plane as quickly as possible. The tiredness that developed when people were forced to stay inside during the lockdown was one of the most important factors in this journey.
Non-pathological lower urinary tract symptoms in late pregnancy in Teaching Hospital, Anuradhapura, Sri Lanka
Authors: Dissanayake Kumara , Abeyratne Sandani
Published: May 2024

Introduction: Lower urinary tract symptoms (LUTS) can frequently be seen in pregnant women and adversely affect their quality of life (QoL). This study was conducted to assess the prevalence of LUTS in late pregnancy and compare them between nulliparous and multiparous women admitted to teaching hospital, in Anuradhapura, Sri Lanka.Methodology: This descriptive cross-sectional study was carried out in a total of 455 pregnant women aged between 19 to 42 years admitted to the antenatal ward, professorial unit, teaching hospital Anuradhapura, Sri Lanka. International Consultation for Incontinence Questionnaire (ICIQ)-FLUTS was used to assess the prevalence of LUTS among pregnant women.Results: The mean age and gestational age of the participants were 28.74 ± 5.44 years and 37.29 ± 1.61 weeks respectively. The most commonly reported LUTS was nocturia (33.4%) followed by hesitancy (25.7%), straining (24.2%), and frequency (23.5%) whereas less than 20% reported bladder pain, dysuria, intermittency, and urinary incontinence. All assessed LUTS except nocturia and frequency were significantly more prevalent within multiparous than nulliparous women.Conclusion: Though in the Sri Lankan context, we are not paying much attention to non-pathological LUTS, clinicians/obstetricians should pay special attention aiming to improve the QoL among pregnant women.
Acute superior mesenteric artery thrombosis in a 34-year-old male with thrombophilia: a case report
Authors: Siddiqui Tabish Wajih , Siddiqui Raqshan Wajih , Alzaabi Asma Abdullah Bin Humaidan , Alzaabi Fatema Marwan , Mohammed Hajir Maher , Elhusain Elshaffie Emadadin Abdelrohman
Published: May 2024

Introduction: Thrombophilic state, marked by extensive formation of blood clots within the vascular system poses a formidable peril, leading to loss of circulatory integrity and systemic well-being. Superior mesenteric artery (SMA) thrombosis is a serious medical disorder characterized by the obstruction of the arterial blood flow to the gastrointestinal tract, which is associated with significant morbidity and mortality. The condition has a plethora of etiological causes. Vague abdominal pain is a common clinical manifestation, and there is a very high mortality rate.Case Presentation: A 34-year-old Pakistani male presented with rapidly worsening acute abdominal pain over a 10-hour period. Clinical examination revealed elevated blood pressure, while other vital signs remained within normal limits. Abdominal examination findings were inconclusive compared to the patient's severe abdominal pain complaint. Contrast-enhanced CT scan indicated a large thrombus in the superior mesenteric artery with radiological features suggestive of intestinal ischemia, extending from the duodeno-jejunal flexure to the mid-transverse colon. Subsequently, the patient underwent exploratory laparotomy with extensive bowel resection and received anticoagulant therapy. He subsequently experienced compensated right lower limb ischemia, treated conservatively with high-dose anticoagulant therapy. Within days, bowel anastomotic leak developed, requiring multiple surgeries. Eventually, the patient progressed to septic shock, followed by multiorgan failure, culminating in a fatal cardiac arrest.Conclusion: Acute mesenteric ischemia, a rare abdominal emergency with an incidence of 6 per 100,000, is associated with a substantial mortality rate, ranging from 58% to 93% among diagnosed cases. The challenges posed by SMA thrombosis include diagnostic complexities, as it frequently manifests with symptoms disproportionate to clinical signs, and results in catastrophic complications, necessitating high suspicion index and prompt intervention.
Effect of Postpartum EwesWeight and Adding Turmeric to the Ration on Productive Performance and Lambs Growth
Authors: Al-Juwari M. F. , Al-Shaar N. M. , Al-Mallah O. D. , Saadi A. M.
Published: May 2024

Purpose: This study was conducted to estimate the effect of adding turmeric to the diet of ewes with differing body weights on milk yield and its components, some biochemical blood characteristics, and lamb growth in Awassi sheep.Research Method: Twenty Awassi ewes aged 2-4 years were distributed into two main groups according to their weight; heavy and low weight (10 ewes). They were again grouped into two secondary groups, (5 ewes) in each and fed on the standard ration with or without the addition of 7 gm of turmeric/ewe/day.Findings: The data revealed a significant (p≤0.01) increase in milk yield during the periods 30-60 and 1-60 days in ewes supplemented with turmeric; also, milk yield increased (p≤0.01) in the heavy ewes compared to the low-weight ewes. The ewes treated with turmeric and kept at a low weight were significantly superior in milk fat. Body weight change was significantly (p≤0.01) lower in low weights compared to heavy-weight ewes, and the decrease in weight was 3.31 and 6.40 kg, respectively.Research Limitations: There were some practical limitations in the estimation of antioxidant activity in the blood and local turmeric due to its high cost.Originality/ Value: The addition of turmeric to the diet resulted in enhanced antioxidant activity; this was clear in low weight-ewes.
Effects of Integrated Use of Lantana camara, Calliandra calothyrsus and Cow Manure with Diammonium Phosphate and Potassium Chloride on Haricot Bean Yield in the Northern Part of Burundi
Authors: Nijimbere S. , Kaboneka S. , Irakoze W. , Ntukamazina N. , Nduwayezu D.
Published: May 2024

Purpose: The use of composts in agriculture has many advantages on soil properties and the productivity of cultivated plants. This study aims to evaluate the response of the bean crop to organic fertilization consisting of composts from Lantana camara Linn, Calliandra Calothyrsus Meisn, and cow manure in combination or not with chemical fertilizers.Research Method: The experiment was carried out in a randomized complete block design on a very acidic ferralsol of Matongo commune in the northern part of Burundi. Each experimental plot corresponded to an application of a specific compost or cow manure combined or not with chemical fertilizers (dose N-P2O5-K2O: 18-46-30).Findings: Adding chemical fertilizers to cow manure and Lantana compost significantly increased the number of leaves, flowers, pods, and seeds, the total biomass, and the weight of seeds. These two treatments recorded the highest grain yields (1067 kg.ha-1 and 999 kg.ha-1 respectively). They were followed by the application of cow manure alone (582.90 kg.ha-1). The lowest yields were observed when applying Calliandra alone (167 kg.ha-1) or combined with chemical fertilizers (371 kg.ha-1), Lantana alone (338.15 kg.ha-1), chemical fertilizers alone (100.79 kg.ha-1), and on unfertilized soil (0.67 kg.ha-1).Originality/ Value: The Lantana camara compost can effectively replace farmyard manure for bean production on an acidic ferrallitic soil, and thus be useful to livestock-less farmers.
Effect of Organic Nutrient Solutions on Growth and Yield Performances of Green Bean (Phaseolus vulgaris L.) in Red Yellow Podzolic Soil in Sri Lanka
Authors: Madushani G. H. K. , Karunarathna Brintha
Published: May 2024

Purpose: Liquid Organic Fertilizer (LOF) is one of the essential ways to add extra quantities of minor and major nutrients, plant hormones, stimulants, and other useful ingredients for soil cultivation.Research Method: The experiment was set up using a Randomized Complete Block Design (RCBD) with seven treatments and four replicates. The treatments were recommended basal and topdressing (Control T1), 5t/ha poultry manure as basal with foliar spray of 0.5% (T2), 1% (T3), 1.5% (T4) of Vermiwash, 0.5% (T5), 1% (T6), 1.5% of vegetable waste solution (T7). Vermiwash and vegetable waste solution were applied at 1st, 3rd, 5th, and 7th week after planting.Findings: The study showed that leaves per plant and number of branches per plant, plant height, number of flowers per plant, dry weight of leaves, and dry weight of stem and roots were significantly (P<0.05) increased in T2 at the 8th week after planting. The total pick yield achieved in T2 was higher than in tested treatments.Originality/ Value: This study suggests that the application of 5t/ha poultry manure with 0.5% vermiwash (T2) would be preferable for growing green beans in red-yellow podzolic soil.
On-Farm Crop Productivity and Economic Assessment of Mungbean-Sorghum Intercropping System Under Integrated Nutrient Management
Authors: Fayyaz F. A. , Anwar A. , Yousaf G.
Published: May 2024

Purpose: The small-holding farmers tend to follow traditional farming systems over sustainable systems of productivity. A strategy was devised to introduce an agricultural system that ensures sustainable yield production and restores diversity in the agroecosystem. The research trial was performed to evaluate the net productivity and economic viability of the sorghum and mungbean intercropping system using an integrated nutrient management strategy.Research Method: The study comprised both split and combined doses of nationally recommended organic and mineral sources of fertilizers using mungbean and sorghum as sole and intercrops in the following sequence of treatments; T0 = unfertilized, T1 = 100% compost, T2 = 100% farmyard manure, T3 = 50% N & 50% P2O5, T4 = 50% compost + 25% N & 25% P2O5, T5 = 50% farmyard manure + 25% N & 25% P2O5.Findings: The results revealed that the sole cropping system was dominant over intercrop with a maximum grain or seed yield of 2229.1 kg ha-1, a biological yield of 7230.3 kg ha-1, and a harvest index of 30.34% of mungbean was obtained in sole standing of the crop. Similarly, the sole culture of sorghum gave a maximum grain or seed yield of 2779.8 kg ha-1, a biological or biomass yield of 10473 kg ha-1, and a harvest index of 25.63% compared to the mixed culture of sorghum and mungbean. The treatments with integrated nutrient supply gave significant results (P≤0.05) of all yield parameters in mungbean and sorghum compared to those where these fertilizers were applied in split doses. The economic analysis showed that mungbean-sorghum intercrop gave maximum net income benefits of PKR 225628 ha-1 and PKR 218635 ha-1 and the highest benefit-cost ratio of 1.91 and 1.90 in NP + compost and NP + farmyard manure, respectively.Research Limitations: A particular cereal might not be compatible with a legume, so further studies at the farmer field level in different locations are needed to ensure the compatibility of the crops and the suitability of the cropping system.Originality/Value: The short-duration growth pattern of cereal and legume grown in proximity affirms maximum yield and income benefits per unit area of land and thereby has great significance for farming communities to get more returns with limited available resources.
Building Resilience: Charting the Future of Sri Lanka's Healthcare
Authors: Panapitiya Lal
Published: May 2024

No abstract available
Cost of patient and staff diet in Teaching Hospital Karapitiya, Galle
Authors: Sabhapathige R. , Anuradha L. , Deerasinghe D. , Ubeysekara H. , Ubeysekara N. , Kumari S.
Published: May 2024

Background: Government hospitals in Sri Lanka offer all services free of charge including the patient diet. Currently patient care services are affected by increasing health care cost in state hospitals. Cost cutting measures are essential in health care management in public sector without sacrificing the standards of care provision. Analysing hospital diet costs is crucial to figuring out how to save indirect operating costs while maintaining service quality and standards.Objective: To determine the cost of diet for patients and staff in the Teaching Hospital, Karapitiya.Methods: A descriptive cross-sectional study was carried out retrospectively to determine the cost of patient and staff diet. The step-down costing method was used in this study, and secondary data was collected from kitchen records, the diet branch and the finance branch during the month of August 2023.Results: The total expenditure for the diet during the period was 9,864,157 LKR and per unit cost was 182.76 LKR to provide diet for patients and staff. The cost of breakfast, lunch and dinner was, 117 LKR, 225.39 LKR and 179.5 LKR respectively.Conclusion: The unit cost for diet was higher compared to previous Sri Lankan hospital study findings but lower than the present market price. Separate registers to record capital items and consumables are recommended to determine the diet cost in future and for the interventions to improve quality and reduce the cost.
Resilience of Health Systems in Sri Lanka: A Comprehensive Assessment and Implications for Future Preparedness
Authors: Wijesuriya W. M. N. K. L. , Rahulan K. , Wimalagunarathne K. W. R. , Jayalath M. P. , Jayathilaka A. , Panapitiya L.
Published: May 2024

Background: The COVID-19 pandemic underscored the critical importance of resilient health systems capable of withstanding and responding to crises. Despite the unprecedented challenges faced globally, Sri Lanka's health system emerged as a success story, maintaining routine healthcare services amidst the pandemic while demonstrating resilience in the face of past crises such as civil war and natural disasters.Objective: To assess the current level of health system resilience and identify gaps for improvement.Methods: Using a customized evaluation tool from the World Health Organization, data was collected through literature review, questionnaires, and expert discussions.Results: The assessment focused on four dimensions: Leadership and Governance, Financing, Resources, and Service Delivery. Results revealed commendable resilience levels across these dimensions, with an overall score of 70%. Critical gaps were identified, including legislative shortcomings, information sharing deficiencies, and disparities in resource distribution.Conclusion: Despite its achievements, Sri Lanka's health system can further enhance resilience by addressing these gaps and pursuing continuous improvement.By prioritizing Universal Health Coverage and Sustainable Development Goals, Sri Lanka can solidify its position as a leader in healthcare resilience, ensuring the health and well-being of its population in the face of future challenges.
An Assessment of Job Satisfaction of Janitorial Staff in Two Tertiary Care Hospitals in Kandy District, Sri Lanka
Authors: Weliwita R. P. , Dolamulla S. S.
Published: May 2024

Background: The significance of janitors in elevating the quality of hospital environments is paramount. Assessment of Job Satisfaction among janitorial staff in healthcare institutions is a multifaceted inquiry that encapsulates both the well-being of the workforce and its consequential impact on the quality of healthcare delivery [1]. In the context of two prominent tertiary care hospitals situated in the Kandy District, Sri Lanka, this academic article navigates through the nuanced dimensions of job satisfaction among janitorial staff and its intrinsic relationship with overall hospital performance.Objective: To assess the job satisfaction and performance of janitorial staff in two tertiary care hospitals in Kandy district, Sri Lanka.Methods: The study adopts a robust mixed-methods approach, combining descriptive cross-sectional analysis and qualitative methods, offering comprehensive insights into the nuanced dimensions of janitorial services. The demographic analysis provides a foundation, revealing key factors influencing job satisfaction, including gender distribution, age representation, income categories, and educational background.Results: The detailed statistical analysis, presented in Table 4, uncovers positive perceptions among janitorial staff across various dimensions, such as facilities, colleague support, and overall job satisfaction. Colleague support emerges as a notable strength, contributing to a positive work environment, and indicating potential for enhancing teamwork. The findings not only provide a benchmark for local contexts but also contribute to the global discourse on job satisfaction in healthcare services. The research highlights the significance of addressing unique challenges faced by janitorial staff, filling a crucial gap in the literature.Conclusion: The study offers practical implications for hospital administrators, policymakers, and researchers. By leveraging identified strengths and addressing specific areas for improvement, interventions can be implemented to enhance the well-being and performance of janitorial staff. This research not only addresses immediate challenges in the Kandy District but also contributes valuable insights to the broader discussion on job satisfaction in healthcare, paving the way for future research and interventions globally.
Comparative Analysis of the Medical Equipment Management Process in Colombo Gampaha and Kaluthara Districts
Authors: Prathapasinghe I. D. , Gajanayaka C. , Ariyadasa D. K. , Perera G. S. E. , Rajapaksha N. K. , Geethananda O. , Jayalath K. D.
Published: May 2024

Background: Bio Medical Engineering (BME) professionals need to continuously review and improve their management strategies to keep up with enhancement in equipment technology, as well as with increasing expectations of health care organizations. In the last two decades, management strategies have evolved from the initial observation of electrical safety to flexible criteria that fit the individual institution's needs. The focus should be on the risks caused by equipment failure, rather than on equipment with highest maintenance demands.Objective: To explore the Medical Equipment Management process in the Department of Health Western Province.Methods: A retrospective cross-sectional study was conducted. Study period was from 1st January 2022 to 31st December 2022. Retrospective documentary data was obtained from the records maintained by the three Bio Medical Engineering offices in Colombo, Kaluthara and Gampaha. Data analysis was performed in an Excel sheet. Since the availability of a huge volume of equipment categories, researchers had to exclude some equipment such as blood pressure monitors due to time constraints.Results: Lowest preventive maintenance has been performed by Kaluthara BME Unit. It is confirmed that 100% Preventive maintenance has been performed by the local agent in Kaluthara District.Conclusion: Lowest performance in preventive maintenance has been performed by Kaluthara district BME unit. But in the aspect of corrective maintenance, they expressed the highest performance. Other two districts evidence showed an average performance. It is recommended to instruct BME unit Kaluthara district to start preventive maintenance. It is recommended to use their professional judgment and experience in establishing their own maintenance strategies.
SWASTHA: Revolutionizing Medical Supply Management in Sri Lankan Healthcare
Authors: Attanayake H. , Rambukwelle I. W. Y. K. C.
Published: May 2024

No abstract available
IRF7 Exacerbates Candida albicans Infection by Compromising CD209-Mediated Phagocytosis and Autophagy-Mediated Killing in Macrophages
Authors: Qing Furong , Sui Lina , He Wenji , Chen Yayun , Xu Li , He Liangmei , Xiao Qiuxiang , Guo Tianfu , Liu Zhiping
Published: May 2024

IFN regulatory factor 7 (IRF7) exerts anti-infective effects by promoting the production of IFNs in various bacterial and viral infections, but its role in highly morbid and fatal Candida albicans infections is unknown. We unexpectedly found that Irf7 gene expression levels were significantly upregulated in tissues or cells after C. albicans infection in humans and mice and that IRF7 actually exacerbates C. albicans infection in mice independent of its classical function in inducing IFNs production. Compared to controls, Irf7−/− mice showed stronger phagocytosis of fungus, upregulation of C-type lectin receptor CD209 expression, and enhanced P53–AMPK–mTOR–mediated autophagic signaling in macrophages after C. albicans infection. The administration of the CD209-neutralizing Ab significantly hindered the phagocytosis of Irf7−/− mouse macrophages, whereas the inhibition of p53 or autophagy impaired the killing function of these macrophages. Thus, IRF7 exacerbates C. albicans infection by compromising the phagocytosis and killing capacity of macrophages via regulating CD209 expression and p53–AMPK–mTOR–mediated autophagy, respectively. This finding reveals a novel function of IRF7 independent of its canonical IFNs production and its unexpected role in enhancing fungal infections, thus providing more specific and effective targets for antifungal therapy.
Risk factors for diabetic retinopathy: a case-control study
Authors: Nathani Pratiksha , Kharat Pratik R. , Wadde Satish
Published: May 2024

Purpose

To emphasize the severity of the issue, it is crucial to recognize that diabetic retinopathy (DR) is not only the biggest contributor to blindness in India, but it is also becoming increasingly prevalent with each passing day. This study offers information from a matched case-control study conducted in an Indian tertiary care hospital on several risk factors for DR. The objective of the investigation is to identify the primary diabetes mellitus (DM) risk factors and the amount by which they influence diabetes pathogenesis.

Methods

The outpatient and inpatient departments participated in a matched research study. Diabetics with DR were included among the patients, while diabetics without DR were included in the controls. Before performing structured interviews, a total of 252 people (126 cases and 126 controls) were recruited and matched for age (±2 years) and sex.

Results

The average age in the DR and non-DR categories was 63.7 9.5 years and 63.3 10.4 years, respectively. Smoke (OR=1.92, P=0.02), alcoholism (OR=2.62, P=0.03), a poor diet (OR=2.72, P=0.0008), nonadherence to dietary advice (OR=4.41, P=0.0001), other microvascular disorders (OR=3.79, P=0.0001), dyslipidaemia (OR=1.85, P=0.0), and hypertension (OR=5.91, P=0.0001). Drug abnormalities (adjusted odds ratio (AOR)=7.89, P=0.0001) and hypertension (AOR=1.16, P=0.0001) were indicated as risk factors for the development of DR in multivariate regression research.

Conclusion

According to our findings, DM with inconsistent anti-diabetic drug use and hypertension are more likely to acquire DR. Modifiable risk factors for DR include insulin, physical inactivity, dyslipidemia, alcoholism, and smoking. With the increasing frequency of DR educating DM about lifestyle changes that may minimize their risk of developing DR is more critical than ever.
Monocular elevation deficit management
Authors: Gaballah Karim , Shawky Dalal
Published: May 2024

Aim

The aim of the study is to study cases of monocular elevation deficit (MED), and find an appropriate procedure to follow in management.

Patients and methods

This prospective study included 21 patients presenting with MED, complete ocular examination including ocular motility examination in all directions, forced duction test (FDT) were performed, then cases having hypotropia in the affected eye in primary position were operated, and the choice of operation was depending on the result of FDT.

Results

The total number of cases was 21 patients, 18 patients had hypotropia in primary position accompanied by pseudoptosis, and three cases had no hypotropia. Sixteen cases of hypotropia had positive FDT, inferior rectus muscle recession by hang back procedure was performed in them, while in two cases of hypotropia with negative test, Knapp’s muscle transposition was performed. All operated cases had postoperative good ocular alignment and spontaneous regaining of normal lid position except two cases. Cases with no hypotropia were not operated and only followed up.

Conclusion

MED or double elevator palsy, can present with hypotropia and pseudoptosis, so requiring management, or presenting with normal eyes in primary position, requiring follow up. The choice of surgical procedure depended on results of FDT.
Outcomes of different surgical procedures for optic disc pit: a meta-analysis
Authors: Khaqan Hussain A. , Naz Raheela , Rehman Hafiz A. ur , Hassan Laraib , Akram Nabeel , Farooqui Hafiz M. , Fauzan Ahmad , Khan Asad M.
Published: May 2024

Objective

To assess the surgical outcomes of pars plana vitrectomy (PPV) in conjunction with various adjuvant procedures for optic disc pit maculopathy (ODPM).

Methods

We conducted a literature search to identify clinical studies and case series of surgically treated OPM patients. (1) greater than two patients, (2) surgical treatment and (3) reporting of pre and postoperative visual acuity data were inclusion criteria. We excluded review articles and studies unavailable in the English language. One-way analysis of variance, Pearson’s chi-squared test and straightforward linear regression were used to analyze the results.

Results

A total of 838 studies were initially identified as potentially relevant studies. After removing duplicates and screening titles and abstracts, the eligibility of 86 full-text articles was evaluated. There were 50 studies included in the meta-analysis. We identified the following commonly reported techniques: juxtapapillary laser alone, PPV alone or with juxtapapillary laser (PPV/JPL), internal limiting membrane peeling (PPV/ILMP), both ILMP and JPL (PPV/ILMP/JPL), inner retinal fenestration (PPV/IRF), autologous platelet concentrate (PPV/APC), macular buckling alone or with PPV, PPV with ocriplasmin (PPV/OCR) and PPV with autologous scleral flap. All groups showed an improvement in best-corrected visual acuity compared with baseline, with no significant differences between groups. The average OPM resolution rate for all groups was 70% (range: 56–100%), and the average resolution duration was 9.1 months. Central macular thickness was diminished in the PPV, PPV/JPL, and PPV/ILMP groups, but there were no significant differences between groups. There was no effect on the outcomes. Analyses of linear regression revealed significant correlations between preoperative best-corrected visual acuity and the aforementioned outcome measures. The rate of complete anatomic success and visual improvement following PPV is ∼85%. Anatomic and visual success rates for PPV alone are 89% and 100%, respectively, according to subgroup analysis. Gas tamponade, laser and ILMP during vitrectomy are less promising, whereas PPV with ILM flap stuffing may yield better results than cases without it.

Conclusion

We did not find a significant difference in functional outcomes between the various surgical procedures used to treat OPM. Based on the available evidence, PPV is effective for ODPM, while gas tamponade, laser and ILMP should be used with caution. This study is limited by its reliance on retrospective studies and publication bias towards positive outcomes.
Dexmedetomidine addition to local anesthetic mixture for peribulbar anesthesia in strabismus surgery
Authors: Gabr Ahmed F. , Badry Badry M. , Rabea Mohammed H.
Published: May 2024

Aim

To evaluate the effect of the addition of dexmedetomidine to the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries.

Methods

A randomized controlled study included 58 patients who were divided into two groups, group І: included 29 patients who received peribulbar block by a mixture of local anesthetics only, and group II: included 29 patients who received peribulbar block by a mixture of local anesthetics with dexmedetomidine. All cases underwent preoperative full ophthalmic examination. The onset and duration of sensory block, onset and duration of motor block, hemodynamic parameters, sedation level, and duration of analgesia were assessed.

Results

The onset of sensory and motor block was shortened (P =0.021 and <0.001, respectively) and their duration was prolonged (P <0.001) and the duration of postoperative analgesia was significantly longer in the dexmedetomidine group (P <0.001). Dexmedetomidine group achieved higher sedation scores and lower intra and early postoperative pain scores (P 0.001 and <0.001, respectively) with higher levels of patient and surgeon satisfaction.

Conclusion

The addition of dexmedetomidine with the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries accelerates the onset of anesthesia and akinesia of the globe and prolongs their duration. It extends the time to the first analgesic request and enhances the satisfaction of both patients and surgeons.
Effects of intracameral dexamethasone injection versus topical steroids post phacoemulsification operation
Authors: Ghonim Alaa I. A. , Elgharieb Mervat E. , Gab-Alla Amr A.-F. , Moawad Ehab M.
Published: May 2024

Introduction

Cataract surgery is one of the most commonly performed surgeries worldwide, with nearly 20 million cases annually. Ophthalmologists usually use a prophylactic perioperative regimen consisting of topical corticosteroids and nonsteroidal anti-inflammatory drugs to reduce the risk of inflammation. However, patient compliance and other problems concerning administration with elderly patients self-administering medication drops can vary widely and a wide proportion of them fail to comply with a long-term regimen.

Aim

Evaluation of intracameral dexamethasone injection efficacy and safety versus topical anti-inflammatory eyedrop regimens for postphacoemulsification inflammation for better postoperative management of cataract patients.

Methodology

A prospective randomized clinical trial. Participants were divided into two groups in group A, dexamethasone sodium-phosphate (0.4 mg/0.1 mL) was injected intracamerally at the end of phacoemulsification surgeries without topical steroids postoperatively. Group B: took the routine postoperative anti-inflammatory steroidal and nonsteroidal eye drop regimen.

Results

Included the corneal thickness that showed no discernible change between postoperative numbers in both groups. Nevertheless, there was a statistically significant increase in CCT postoperatively in both groups. The intraocular pressure decreased significantly after 1 month of phacoemulsification operation in both groups simultaneously. Postoperative cell density and hexagonality were significantly lower in both groups compared with preoperative values. There was also no significant difference between both groups regarding the anterior chamber cells’ index. Moreover, the Dexamethasone-injected group showed better compliance on the postoperative visits regarding their prescriptions taken after the operation compared with the Prednisone acetate eye drops group.

Conclusions

Better results regarding the severity of the endothelial damage with the use of a single intraoperative injection post phacoemulsification compared with the group who did not get injected but took postoperative prednisone acetate eye drops. The obligatory single intraoperative injection of dexamethasone has handled the poor compliance of some patients’ post phacoemulsification.
Comparison of Red Blood Cell Parameters as Metabolic Indicator in Stunted and Nonstunted Children
Authors: Nisa Khairun , Islami Suryadi , Listiyaningsih Erlin , Arisandi Rizki , Nurhaniefah Azmi Adha
Published: May 2024

Introduction: Stunting occurs as a result of chronic malnutrition, which triggers changes in metabolic function, which are usually characterized by impaired blood profiles in stunted children. This study aims to compare the red blood cell (RBC) Parameters in stunted and nonstunted children. Methods: This study used laboratory observational analytic methods with a cross-sectional approach. The study included a total of 74 participants aged 6–10 years. Primary data was collected by collecting sociodemographic data from the subjects, measuring anthropometric variables, and taking blood samples to analyze the erythrocyte index based on the hematological parameters of RBCs, including hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). Data analysis was performed using the one-way ANOVA test for erythrocytes, HGB, HCT, and Kruskal–Wallis for MCV, MCH, and MCHC at 95% confidence level. Result: The participants consisted of 33 males and 41 females. Based on the World Health Organization classification of anthropometric measurements, it was found that 46 children were normal, 18 were classified as stunting, and the remaining 10 were severe stunting. Conclusion: RBC parameter analysis based on hematological parameters found that in the male group, there were significantly lower RBC counts, HGB, HCT, MCH, and MCHC in stunting and severe stunting children compared to the nonstunted or normal children, whereas in the female group, the significant lower result found in the parameter of RBC counts, HGB, HCT, and MCV.
Formulation and Proximate Analysis of Makhana-Enriched Laddoos
Authors: Ekal Vanthi , Kumbamoorthy Silambuselvi
Published: May 2024

Makhana (Euryale ferox) has nutraceutical benefits and abundant nutrients with a reserve of essential amino acids and antioxidants. The inclusion of nutraceutical-rich foods as dietary management helps to improve the quality of life and sustain good health. The aim of this study is to develop makhana-enriched laddoos and to analyze their proximate principles, glycemic index (GI), and glycemic load (GL) levels. Two varieties of makahana laddoos were developed using two different cereals—wheat and barnyard millet to make them more acceptable. Following a 9-point hedonic organoleptic evaluation, the developed makhana laddoos were analyzed using AOAC methods for proximate principles and GI estimation. GL was calculated using the formula. The proximate analysis results of the millet makhana laddoo showed carbohydrates 33.4%, fat 14.58%, and fiber 4.32% with a low level of GI (40.0) and GL (6.01). In contrast, the wheat makhana laddoo contained 78.9% carbohydrates, fat 12.98%, and fiber 6.54%, with a low level of GI 39.9 and a medium level of GL (14.06). The protein content for millet makhana and wheat makhana laddoos was found to be 2.41% and 2.54%, respectively. Shelf life analysis showed that millet makhana laddoos can be stored upto 15 days and wheat makhana laddoos for one month. The GI and GL were comparatively lower in millet makhana laddoo than in wheat makhana laddoo, making it more recommendable as a healthy snack and a dietary alternative for various therapeutic conditions.
Suspected Hypovitaminosis in Patients with Cases of Sepsis and Septic Shock Undergoing Abdominal Surgery
Authors: Puspita Eka Ari , Veterini Anna Surgean , Kusuma Edward
Published: May 2024

Background: The effectiveness of vitamin C in sepsis and critical illnesses has not been conclusively demonstrated. Given the significant incidence of sepsis and septic shock in patients undergoing abdominal surgery, it is imperative to gather evidence on vitamin C levels in these patients. This study compared vitamin C levels between patients undergoing abdominal surgery with and without septic shock. Methods: This analytical observational study with a cross-sectional approach involved patients undergoing abdominal surgery for sepsis and septic shock who were being treated at General Hospital “X” in East Java from March to May 2023. Blood samples were collected from the patients preoperatively. Statistical analysis was performed using the independent t-test and the Mann–Whitney U test. Results: The 40 participants included 21 (52.5%) with sepsis and 19 (47.5%) with septic shock. The sepsis group comprised 17 (80.96%) males and 4 (19.04%) females, whereas the septic shock group included 13 (68.42%) males and 6 (31.58%) females. Most patients with sepsis had perforation of abdominal organs, accounting for 19 (90.48%) cases. In the septic shock group, perforation of the abdominal organs was observed in 11 (57.89%) patients, whereas abscesses were noted in 8 (42.11%) patients. The mean vitamin C level (µmol/L) in sepsis was 4.19 ± 3.34; in septic shock, it was 5.02 ± 3.18 (P = 0.427). Conclusions: In this study, hypovitaminosis suspicion did not demonstrate statistically significant differences between the sepsis and septic shock groups.
A Case Series of Imaging Nuances of Persistent Craniopharyngeal Canal – Connecting the Pharynx to Brain!
Authors: Bajpai Amit , Chidanandaswamy Naveen , Hosur Bharat , Kurimilla Akshay , Dixit Nikhil , Sahdev Ravinder
Published: May 2024

Persistent craniopharyngeal canal (PCPC) is a rare congenital anomaly arising from the incomplete closure of the craniopharyngeal canal during embryological development. Imaging plays a crucial role in identifying and understanding the anatomical characteristics and guiding appropriate management strategies. We present a series of four cases of PCPC with varied and unexpected clinical presentations along with details of imaging nuances and management implications, emphasizing the importance of radiodiagnosis in guiding appropriate management strategies. From incidental diagnosis in an asymptomatic adult to a symptomatic syndromic child, the PCPC has a wide clinico-radiological spectrum of presentation as well as management challenges.