bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Tear Film after Phacoemulsification and Manual Small Incision Cataract Surgery in Tertiary Care Hospital: A Prospective Study
Authors: Shirwadkar Shruti , Shinde Chhaya , Waghmare Rahul , Ganvir Amol , Yadav Abhilasha , Joshi Sanyukta , Apte Monisha
Published: December 2024

Background:

An adequate and consistent layer of tears on the surface of the eye is essential to keep your eyes healthy, comfortable, and well. Consequences of dry eyes range from subtle but constant eye irritation to significant inflammation and even scarring of the front surface of the eye. This study was to evaluate the changes in the tear film. The aim of this study was to compare subjectively and objectively the course of surgically induced tear film changes in terms of dryness of eyes induced surgically after phacoemulsification and manual small incision cataract surgery (SICS) in tertiary care hospital.

Materials and Methods:

One hundred eyes of 100 patients were chosen for a prospective study. Those patients were included who had unilateral or bilateral cataracts without dry eye symptoms. By simple randomization, any abnormality in the tear film in pre- and postphacoemulsification and manual SICS was studied. Patients were tested for different parameters such as tear meniscus height (TMH), tear film breakup time, Schirmer test 1, and Rose Bengal staining. Eyes were tested 1 day before and 1 day, 1 month, and 3 months after surgery. Moreover, they were analyzed for possible causative factors. The association between categorical variables was analyzed using the Chi-square test. The paired t-test was used to compare the mean of quantitative variables. Preexisting ocular disease, surgery, trauma, and systemic diseases were ruled out.

Results:

There was no significant difference between the two groups at the end of 3 months. Fifty-three males and 47 females between the age group of 50 and 70 years were studied prospectively for changes in tear film after cataract surgery for 2 years from January 2015 to December 2016, i.e., 24 months. Group 1 consisted of manual SICS and Group 2 consisted of phacoemulsification surgery. Among 50 patients in Group 1, there were 23 (46%) females and 27 (54%) males, and among 50 patients in Group 2, 24 (48%) females and 26 (52%) males. TMH was evaluated by image software of the slit lamp. The difference between the two gender groups was insignificant (P = 1.000).

Conclusion:

As any kind of incision over the cornea or ocular surface be it clear corneal or incision over the sclera like in SICS causes disturbance in the ocular surface; it causes tear film changes postoperatively. It is observed that there are definitely tear film changes seen after the surgery as microscopic ocular surface damage during any kind of incision of cataract surgery seems to be one of the causative factors causing discomfort and dry eye. But the changes at the end of three months were tear film changes have no significant difference with reference to the kind of surgery performed.
Beyond Doubt: An Ultrasonic Gaze into Cyclodialysis Cleft
Authors: Sagarika Snehi , Nidhi Mamtani , Rajesh Pattebahadur , Kanishk Singh
Published: December 2024

A 40-year-old male presented with decreased vision postblunt trauma. The affected eye vision was a perception of light with a 10-mmHg intraocular pressure. Further examination revealed a deep anterior chamber, iridodonesis, ectropion uveae, and a cataractous lens obscuring posterior details. The gonioscopy revealed a 180° angle recession and a doubtful cyclodialysis cleft nasally. The diagnosis was confirmed by an ultrasonography B-scan revealing suprachoroidal fluid with shallow choroidal detachment. This case highlights how this simple modality can be used to diagnose cyclodialysis cleft, particularly in hazy media and when anterior segment imaging is not available.
Short-term Indian Experience with Micropulse Transscleral Cyclophotocoagulation Using Revised Micropulse Probe in Advanced Glaucoma
Authors: Salu M. , Ariga Murali , Roopesh K. Jeyasudha , Nivean Pratheebadevi
Published: December 2024

Introduction:

Micropulse transscleral laser therapy, commonly referred to as micropulse transscleral cyclophotocoagulation (MP-TSCPC), is a safe and effective treatment for glaucoma.

Objective:

To evaluate the mean intraocular pressure (IOP)-lowering effect of micropulse diode laser cyclophotocoagulation performed using a revised micropulse probe and to observe any adverse events.

Materials and Methods:

A single-center retrospective study included 34 patients diagnosed with advanced glaucoma who underwent micropulse transscleral cyclophotocoagulation using a revised micropulse P3 probe. Data were collected from the electronic medical records of patients. Data noted at baseline-demographics, best-corrected visual acuity, IOP, prior glaucoma surgeries, and the number of anti-glaucoma medications. The procedure was performed by a single surgeon with standard laser settings. The eye was patched with topical moxifloxacin 0.5% combined with dexamethasone 0.1%. Anti-glaucoma medications were continued postoperatively. Postoperative data-IOP and the number of anti-glaucoma medications at postoperative 1 week and 3 months were noted.

Results:

Statistical analysis was performed using Minitab 19. Mean IOP (in mmHg) at baseline was 31.64 ± 6.97, and 22.20 ± 8.57 and 21.82 ± 7.56 at postoperative 1 week and 3 months, respectively, (P < 0.001). The mean number of antiglaucoma medications at baseline was 3.5 ± 0.74 and at 1 week after MP-TSCPC was 2.97 ± 0.79 and at 3rd month was 2.97 ± 0.83 (P < 0.001).

Conclusion:

MP-TSCPC using the revised micropulse probe is effective in lowering IOP, has an acceptable safety profile and tolerability, and can be considered for patients with advanced glaucoma.
Anemic Retinopathy with Subhyaloid Hemorrhage: Sinking the Boat with Laser
Authors: Rewatkar Kaustubh , Shenoy Pratik , Pirdankar Onkar H. , Nene Amit S. , Badole Pushpanjali , Shah Smitesh , Kamble Gaurav
Published: December 2024

We report the case of a 37-year-old female diagnosed with subhyaloid hemorrhage (SHH) in her left eye due to anemia. She underwent Nd:YAG laser posterior hyaloidotomy for the SHH with its subsequent resolution over 1 month. Her best-corrected visual acuity improved from 20/1200 at presentation to 20/30 at 1-month follow-up. Postresolution, there were pigmentary changes at the macula which remained stable over a 9-month follow-up period.
Photo Snippet on Complications following Pterygium Surgery
Authors: Christy Josephine S. , Nair Megha
Published: December 2024

Pterygium is a wing-shaped fibrovascular growth that occurs due to conjunctival degeneration. Although early pterygia can be conservatively managed with lubricants, progressive or symptomatic ones need surgical excision. Various methods include the bare sclera technique, conjunctival autograft transplantation with sutures or fibrin glue, and amniotic membrane grafting. This article depicts the various possible complications that can occur following pterygium surgery with clinical images.
Surgical Innovations in Vitreo-Retinal Surgery
Authors: Sharma Sumant Vinayak , Narayanan Raja
Published: December 2024

Vitreo-retinal surgery has enabled the treatment of multiple posterior segment pathologies, which till few decades back were considered untreatable. With continuing innovation, modern retinal surgery is becoming more efficient and safer, while simultaneously making forays into newer paradigms. In this review article, we look at recent innovations that are changing the practice patterns among surgeons. Surgical innovations in instrumentation, visualisation and automation are discussed. The introduction of ultrasound energy in vitrectomy, termed as hypersonic vitrectomy, promises freedom from complications of current guillotine-based cutters. In terms of new avenues of visualisation, heads up 3-Dimensional (HUD) viewing systems, intraoperative OCT(i-OCT) and endoscopic vitrectomy permit better ergonomics, real time cross-sectional imaging and visualisation in opaque media respectively. Automation of surgical steps via robotic surgery heralds a new era in surgical safety.
Multimodal Imaging in a Case of Stargardt’s Disease
Authors: Bhattacharya Shruti , Chawla Khushboo , Gupta Priyadarshi , Thakar Meenakshi
Published: December 2024

Stargardt Disease is the most common macular dystrophy, and multimodal image can be used for diagnosis and monitoring of the disease.
Retinal Nerve Fiber Layer and Macular Ganglion Cell Layer Thickness in Subjects Suffering from Diabetes Mellitus: An Observational Study
Authors: Gharat Anujja , Potdar Nayana Anil , Tabani Salma Mohd Iqbal , Fakhri Burhanuddin Kaidjoher , Rathod Darshana B. , Choksi Twinkle
Published: December 2024

Purpose:

The purpose of this study was to investigate the relationship of retinal nerve fiber layer (RNFL) and ganglion cell–inner plexiform layer (GCIPL) thickness in between normal healthy eyes and those affected by diabetes mellitus (DM) and also associate it with the extent of the disease.

Materials and Methods:

This hospital-based observational case-control study was conducted at a major tertiary health care center to investigate the relationship of RNFL and GCIPL thickness using spectral-domain optical coherence tomography (SD-OCT). A total of 124 eyes were studied out of which 62 belonged to diabetic subjects and 62 were normal homogenous controls. Among the diabetics, 30 eyes had mild-to-moderate diabetic retinopathy (DR) and 32 eyes had no DR.

Results:

The peripapillary RNFL thickness was significantly thinner in the eyes of patients with DR compared to controls. Furthermore, it was significantly thinner when compared to the eyes of diabetic subjects with no DR. No significant statistical difference was observed when comparing RNFL thickness in diabetic subject’s eyes without DR and controls. Significant GCIPL thinning was noted in eyes with DR compared to control eyes. Furthermore, it was significantly thinner when compared to the eyes of diabetic subjects without DR. No statistical difference was observed when comparing GCIPL thickness in diabetic subjects’ eyes without DR and controls. No significant correlation was obtained of glycated hemoglobin with either RNFL or GCIPL thickness in the diabetic patients’ group. A multiple linear regression model showed DR status and duration of diabetes as the best explanatory variables for GCIPL loss in diabetic eyes.

Conclusion:

The results show that both processes, the visible diabetic microvascular changes and neurodegeneration as studied clinically by SD-OCT, are late complications of DM and are closely linked. Thus, a complex neurovascular interaction occurring simultaneously is an early event in the pathogenesis of DR.
Leber’s Congenital Amaurosis and its Complications – A Very Rare Presentation
Authors: Das Sujit , Singh Sakshi , Agarwal Aastha , Misra Ram Monohar
Published: December 2024

Leber’s congenital amaurosis is one of the most severe forms of retinal dystrophies responsible for congenital blindness. It accounts for 10%–18% of congenital blindness cases. It is characterized by at least three findings: severe and early visual impairment, sluggish or near-absent pupillary responses, and severely subnormal or nondetectable electroretinogram. Some patients exhibit solely retinal blindness and show evidence of multisystemic involvement. Here, in this article, we are presenting a case of complicated Leber’s congenital amaurosis with cataract and primary hyperplastic primary vitreous along with neurodevelopmental delay.
Effect of axial elongation on anterior scleral thickness in myopia
Authors: Yan Hui , Li Jie , Wang Cheng , Mei Cai-Qiu
Published: December 2024

Objective:

This study aimed to investigate the effect of axial elongation on anterior scleral thickness (AST) in myopia.

Methods:

The convenience sampling method was used to select 122 patients without ocular or systemic diseases affecting ametropia in Ya’an People’s Hospital between March 2020 and January 2022. According to the diopter and axial length (AL), the patients were divided into an emmetropia group (32 cases), a low-to-moderate myopia group (40 cases), and a high myopia group (40 cases). Relevant data were collected and analyzed.

Results:

The AST of the four diameter lines was highest at the scleral process and measured. The results, in descending order, were as follows: temporal side (716.45 ± 65.55 μm), lower side (692.32 ± 74.76 μm), nasal side (671.54 ± 61.76 μm), and superior side (550.76 ± 51.34 μm). There was a correlation between the AL and the average AST of the four diameter lines. The correlations, from highest to lowest, were as follows: the mean AST of the nasal side (r = −0.455, P < 0.001), the mean AST of the upper side (r = −0.431, P < 0.001), the mean AST of the lower side (r = −0.402, P < 0.001) and the mean AST of the temporal side (r = −0.363, P < 0.001). Age was associated with the average AST of the upper, nasal, and temporal sides. The correlations, from highest to lowest, were as follows: the average AST of the upper side (r = 0.545, P < 0.001), the average AST of the temporal side (r = 0.422, P < 0.001), and the average AST of the nasal side (r = 0.411, P < 0.001). There were significant differences in AST among the three groups at 0, 1, 2, 3, 4, 5, and 6 mm from the scleral bulge (P < 0.05). AST was positively correlated with age and negatively correlated with AL (R
2
= 0.432, F = 231.73, P < 0.05).

Conclusion:

The thickness of the sclera changed with the AL and measurement position. AST was negatively correlated with the AL and positively correlated with age. Compared with emmetropia and low-to-moderate myopia, the anterior sclera in cases of high myopia was thinner. Myopia affects not only the thickness of the posterior sclera but also the AST.
A Single-Center Review of Cases to Understand the Indian Polyvalent Antivenom Use in Hump-Nosed Pit Viper Bites in South India
Authors: Abraham Siju V. , Paul Sarah , Paul Martin V. , Davis Clint , Rafi Aboobacker Mohamed , Suseel Appu , Mathew Deo , Kassyap C. K. , Chathappan Rajeev Punchalil
Published: December 2024

Introduction:

India, with nearly 60 venomous snake species, has just one commercially available antivenom, the Indian polyvalent antivenom (IPAV). The hump-nosed pit viper (Hypnale
hypnale), an indigenous venomous snake, causes considerable morbidity and at time mortality for which we have no commercially available antivenom. However, most clinicians rely purely on the clinical syndromes and end up using the available IPAV for H. hypnale envenomation.

Methods:

Between April 2017 and December 2022, we reviewed 41 cases of H. hypnale envenomation, comparing clinical and laboratory profiles of patients who received IPAV with those who did not.

Results:

Local signs of envenomation were seen in 39 (95.12%) cases, with the most common being edema or swelling at the bite site. Eight (19.5%) patients developed coagulopathy, and two developed renal failure during their hospital stay. Among the 39 envenomated individuals, 13 received polyvalent snake antivenom. Over half of those receiving antivenom had hypersensitivity reactions. Patients who received antisnake venom (ASV) had increased intensive care unit stay, duration of hospitalization, and hospital expenses as compared to patients who did not. There was one death among the patients who received antivenom.

Conclusion:

H. hypnale viper envenomation is associated with local and systemic signs of envenomation, with coagulopathy being a common complication. Administering the current polyvalent antivenom to victims of H. hypnale bites did not reduce the morbidities or prevent mortality; instead, it exposes them to additional risks associated with ASV administration.
A study of acute transfusion reactions at a tertiary care center: a retrospective analysis
Authors: Dey Damayanti R. , Dhote Shweta W. , Lad Subhangi Y. , Gupta Sonal S.
Published: December 2024

Background:

Blood transfusion refers to the therapeutic use of blood products, and while often lifesaving, it carries a variety of potential complications. Ensuring access to safe and sufficient blood is a critical component of healthcare, leading to the development of hemovigilance. Hemovigilance is essential for improving patient safety by learning from errors and implementing system-wide changes to prevent their recurrence. A comprehensive assessment of adverse events is the primary goal of hemovigilance.

Aim:

To assess the frequency and types of acute transfusion reactions (ATRs).

Objectives:

(1) To examine the types of ATRs related to the specific blood components transfused. (2) To analyze ATRs based on different clinical parameters.

Materials and Methods:

A retrospective analysis was conducted over 3 years, evaluating all transfusion reactions reported to the Department of Immunohematology and Blood Transfusion at Mahatma Gandhi Mission College and Hospital, Navi Mumbai. Reactions were assessed according to the institution’s established protocol. Statistical analysis was performed using IBM Statistical Package for the Social Sciences version 20, with significance at P < 0.05.

Results:

During the study period, 22,188 blood component units were issued, of which 38 (0.174%) resulted in an ATR. Febrile non-hemolytic transfusion reactions (FNHTR) accounted for 31 cases (81.58%), allergic transfusion reactions for six cases (15.79%), and one case (2.63%) involved an immunologic hemolytic transfusion reaction caused by alloantibodies. Among the reported ATRs, 37 (97.36%) were associated with packed red cells (PRC), while 1 (2.64%) occurred with fresh frozen plasma (FFP).

Conclusion:

FNHTR was the most common ATR, followed by allergic reactions. These findings highlight the importance of continuous monitoring and strict adherence to standard protocols in blood transfusion practices to enhance patient safety.
Vitamin D and HbA1c levels in newly diagnosed type 2 diabetes mellitus
Authors: Kiran Baligumba Ramu , Kumar Venoor Shreyas , Preeti Giri Premkumar , Kumar Venoor Ajith , Vikas Bheemappa Raja
Published: December 2024

Background:

This study examined the correlation between 25-hydroxyvitamin D [25(OH)D] and glycated hemoglobin (HbA1c) levels in male and female patients diagnosed with type 2 diabetes mellitus (T2DM).

Design:

Hospital-based cross-sectional study.

Materials and Methods:

This study was conducted in the Department of General Medicine at Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, with the Institutional Ethics Committee approval. Each participant admitted to the hospital as an inpatient or outpatient underwent a thorough medical history review, physical examination, and relevant diagnostic tests. Vital signs, including pulse rate and blood pressure, were recorded as part of the general examination. Additionally, detailed assessments and investigations evaluated participants for potential vitamin D deficiency.

Results:

The mean age of participants was 59.46 ± 11.06 years, with an observed trend of increasing vitamin D deficiency with age. No significant association was found between gender and HbA1c or vitamin D levels. The average HbA1c level was 9.75% ± 2.05, while the mean vitamin D level was 23.44 ng/mL ± 8.26. A negative correlation was identified between serum vitamin D and HbA1c levels, with a correlation coefficient of −0.53 and a P value of <0.01.

Conclusion:

The study confirmed an association between vitamin D deficiency and elevated HbA1c levels in T2DM patients, with variations observed between male and female subjects.
Freeze-all cycles for normal responders: Is this way forward?
Authors: Sharma Satish , Mhatre Shalaka , Jadhav Ashwini , Lad Nikita
Published: December 2024

Background:

The freeze-all approach has gained traction in in vitro fertilization (IVF) practices, and this study explores its benefits for normal responders.

Aims and Objectives:

The study evaluates whether the freeze-all strategy is advantageous in normal responders, irrespective of ovarian response.

Materials and Methods:

A retrospective study was conducted at a private IVF center, analyzing 225 oocyte retrieval cases and 170 frozen embryo transfers performed between January 2023 and February 2024. All patients underwent controlled ovarian stimulation using a gonadotropin-releasing hormone antagonist regimen, with the freeze-all policy applied. Fresh embryo transfers were postponed, and all embryos were cryopreserved. Frozen–thawed embryo transfers (FET) were performed in subsequent cycles.

Results:

The implantation rate for cleavage-stage FETs was 13.79%, whereas for blastocyst-stage transfers, it was 31.61%. The clinical pregnancy rate was 43.75% for cleavage-stage and 47.40% for blastocyst-stage FETs.

Conclusion:

The freeze-all approach can enhance IVF outcomes. However, an individualized treatment plan is essential for optimizing results, as there are currently no noninvasive clinical methods to determine, which patients would benefit most from a freeze-all strategy.
A large submucosal pedunculated fundal fibroid presenting as a vaginal mass: a rare case report
Authors: Dasila Priyank Singh , Shah Maitri , Thamke Pratima
Published: December 2024

This study reports the clinical outcomes of a 47-year-old female, para 1, living 1, abortion 1, with a previous lower segment cesarean section, who presented with a history of vaginal spotting and weight loss over 6 months. Both ultrasonography and magnetic resonance imaging indicated a mass originating from the lower uterus and cervix, likely of neoplastic origin. Upon vaginal and speculum examination, a soft, round cystic mass was detected, filling the vaginal cavity, making cervical evaluation impossible. However, histopathology and fluid cytology confirmed the mass as benign. An exploratory laparotomy revealed a large submucosal pedunculated fibroid originating from the fundus and extending into the vaginal cavity. The fibroid was removed, and a hysterectomy was performed. This case highlights a rare presentation of a submucosal fibroid as a vaginal mass. It underscores the importance for gynecologists to recognize this complication to avoid delays in diagnosis and prevent unnecessary morbidity and mortality.
A study on the expression of Her2/neu in malignant epithelial ovarian tumors
Authors: Bhardwaj Amit Kumar , Bhaskar Vanita , Nayak Rashmi , Chandrakar Anubhav , Bombeshwar Vikas , Kailashiya Vikas
Published: December 2024

Background:

Ovarian cancer poses a considerable challenge in surgical treatment, often requiring careful and complex approaches. A review of the literature highlights a wide range of Her2/neu overexpression or amplifications in ovarian tumors, with reported rates between 8% and 66%. This variability may be associated with chemotherapy resistance and poor treatment outcomes, thereby playing a significant role in prognosis.

Objective:

We aimed to study the expression of Her2/neu in malignant epithelial ovarian tumors using immunohistochemistry.

Materials and Methods:

This descriptive, observational (cross-sectional) study was conducted in the Department of Pathology at Pt. Jawaharlal Nehru Memorial Medical College, Raipur, Chhattisgarh, India, from August 2022 to December 2023, over 18 months. Seventy cases of malignant epithelial ovarian tumors were included. The immunohistochemical analysis assessed the expression pattern of the Her2/neu protein in these tumors.

Results:

Among the 70 cases, the majority were serous carcinomas (n = 47, 67.2%), with low-grade serous carcinoma (n = 24, 34.3%) being slightly more common than high-grade serous carcinoma (n = 23, 32.9%). Fourteen cases (20%) were mucinous cystadenocarcinomas, and nine (12.9%) were endometrioid carcinomas. The mean age of the study population was 52.58 ± 2.80 years, with the highest proportion of cases (n = 25, 35.7%) observed in the perimenopausal age group (40–50 years). Her2/neu positivity was observed in 15 cases (21.4%) of the 70 malignant epithelial ovarian tumors.

Conclusion:

Her2/neu protein overexpression was found in 21.4% (n = 15) of cases. No statistically significant association was observed between Her2/neu overexpression and the histological subtype or the age of the patients.
Nanotechnology in cancer: advancements in treatment and detection—a review
Authors: Parthasarathi Abhirami K. , Karabsanawar Someshwar S. , Acharya Prajnashree
Published: December 2024

Cancer, characterized by the rapid growth of abnormal cells capable of invading surrounding tissues and metastasis, is a leading cause of mortality worldwide. Conventional treatments such as chemotherapy and immunotherapy often encounter challenges such as limited specificity, drug resistance, and significant side effects. Nanotechnology offers promising advancements in both cancer treatment and diagnosis. Nanoparticles (NPs) represent a breakthrough in cancer treatment because they target tumors precisely, improve drug delivery, and enhance imaging techniques. These nanoscale materials have the potential to reduce side effects and overcome drug resistance, thus boosting the therapeutic effectiveness. Additionally, NPs play a critical role in early cancer detection and metastasis imaging. This review examines how nanotechnology enhances cancer cell eradication, supports immunotherapy, and advances drug delivery systems. Ongoing research in nanoparticle production and multifunctional nano-platforms highlights the potential of nanomedicine to transform cancer therapy, paving the way for personalized and highly effective treatment approaches.
Clinical case series on presentations of krait bite envenomation
Authors: Yakub Shireen Faruque , Ghodke Babita , Puvvadu Lakshmi Monika , Nirmal Apoorva , Patil Ravi
Published: December 2024

Neurotoxicity is the most peculiar feature of krait envenomation. A patient presenting to the emergency room with complaints of snakebite followed by acute neuromuscular weakness and progressive respiratory involvement should ring a bell for neurotoxic snakebite. The progression of symptoms, muscle involvement and weakness, respiratory worsening, and recuperating post administration of antivenom and acetylcholinesterase inhibitors can vary widely. Delays in diagnosis and administration of treatment are linked to increased mortality rates. In this report, we present cases of krait envenomation, highlighting differences in their management based on each patient’s presentation. All three cases were confirmed krait bites—in two cases, the bystanders had killed and brought the snake to the emergency room, where it was identified as a krait on arrival. Meanwhile, in the third case—based on symptoms, treatment was initiated, and krait was identified a couple of hours later.
Paecilomyces keratitis: a case report
Authors: Choudhury Debapriya Das , Ubale Milind , Baranwal Rimjhim , Nanoty Vaibhavi , Patel Mayuri
Published: December 2024

Ocular trauma involving vegetative matter is the most common cause of keratitis in ophthalmic practice in India, with many cases resulting in fungal keratitis or corneal ulceration. Here, we present a case of fungal keratitis due to Paecilomyces lilacinus that was successfully managed with oral and topical antifungal therapy, avoiding surgical intervention. The patient, a female, presented with a corneal abscess, conjunctival congestion, and persistent pain in her right eye after sustaining an ocular injury from vegetative matter. Based on the clinical signs, a provisional diagnosis of fungal keratitis was made, and treatment with 5% natamycin eye drops was initiated. Potassium hydroxide mount findings indicated fungal hyphae, leading to the addition of oral voriconazole due to suspected deuteromycosis. Fungal culture confirmed the presence of P. lilacinus. Gradually, the patient improved with antifungal therapy over a month without surgical intervention.
Hymenolepis nana: a case report of an intestinal helminthic infection from Northern India
Authors: Singh Sangeeta , Sen Manodeep , Raj Nikhil , Singh Riddhi , Agarwal Jyotsna
Published: December 2024

Hymenolepis nana (H. nana), known as the dwarf tapeworm, is an intestinal helminth. This report highlights a case of H. nana infection in a young female from Northern India who presented with abdominal pain and achieved a favorable outcome following antiparasitic treatment. An 18-year-old female from a rural community in Kothara village, Baharaich, Uttar Pradesh, India, was diagnosed with H. nana infection. She exhibited mild iron deficiency anemia and granulocytosis but remained largely asymptomatic despite a moderate infection burden. While H. nana infections are often asymptomatic, prompt treatment is essential. Without intervention, the infection can spread within isolated rural populations. Therefore, incorporating H. nana screening into routine evaluations for intestinal parasites and treating even asymptomatic cases is vital to prevent further transmission.
Identification of risk for work-related musculoskeletal disorders in jewelry die makers using rapid entire body assessment – A cross-sectional study
Authors: Raut Harshika , Sawant Nikita Vishnu , Karajgi Asmita
Published: December 2024

CONTEXT:

Ergonomics means laws of work. The jewelry die makers are mold makers with the job demand of attaining sustained static posture with inconsistent time duration and repetitive work. Thus, they are more prone to develop musculoskeletal disorders. Rapid entire body assessment (REBA) is a widely used tool for ergonomic assessment of workplace postures. This study used the REBA scale to evaluate postures and identify potential ergonomic risks associated with postures and movements. Analysis of work posture will help to identify areas for improvement in the work environment.

AIMS:

The aim of the study was to assess the risk of developing work-related musculoskeletal disorders in jewelry die makers.

SETTINGS AND DESIGN:

This was a descriptive, cross-sectional study conducted at Chinchani village, Palghar district.

SUBJECTS AND METHODS:

Two hundred and nine adult males between the age group of 18 and 60 years who had completed a training period of 6 months and working as jewelry die makers in a home-based setting were included, and their working postures were assessed using the REBA scale. Jewelry die makers already diagnosed with musculoskeletal or neurological conditions or part-time workers and those using computers for their jobs were excluded from the study. Demographic data and additional work-related information were collected using a self-made questionnaire by interview method. Two subject experts validated the self-made questionnaire before its application.

STATISTICAL ANALYSIS USED:

The components of the self-made questionnaire, such as work posture, total hours of sustaining work posture, number of breaks during work hours, and areas of discomfort while sustaining work posture, were analyzed. Detailed neck, trunk and leg analysis, arm and wrist analysis were interpreted using the scoring method of the REBA Employee Assessment Worksheet.

RESULTS:

According to the REBA score, 163 of 209 participants fall under medium-risk work posture, 38 fall under high-risk work posture, but unexpectedly, 53% reported no discomfort, which indicates that many of them are unaware of their faulty work posture. Only 8 participants indicate low-risk work posture.

CONCLUSIONS:

The study concludes that few jewelry die makers are at high risk and require immediate medical attention and intervention, whereas the majority are at medium risk. This suggests the necessity of investigation and action for a change in work posture when assessed using the REBA scale. A rare number of participants are at low risk.
Periodontal microsurgery: Achieving unprecedented levels of precision – A narrative review
Authors: Leslie C. Cynthia , Vijayarangan Anitha , Elumalai Agila
Published: December 2024

Magnification in periodontics can transform clinical notions of surgical periodontal treatment. With the introduction of contemporary technological advancements, like microsurgery, periodontology has experienced exponential growth. Microsurgery is linked to better visual perception, ergonomic advantages, lower patient complications, faster healing, and increased patient acceptability in periodontal therapy. When minimally invasive surgical procedures are paired with periodontal microsurgery, a clinician’s accuracy in manipulating tissues is enhanced, providing the most predictable outcome. This review aims to highlight the advantages of periodontal microsurgery, including improved diagnostic ability, treatment quality, and patient outcomes. It also addresses the role of microsurgery in periodontal plastic surgery, which involves the use of microsurgical instruments and techniques for microsurgical knot tying. The review concludes that microsurgery provides substantial benefits over conventional surgery, enhancing patient acceptability and outcomes.
Various prosthodontic options for malpositioned implants in the anterior region: A narrative review
Authors: Sanketh Archana K , Shrutika  , Kalavathy N. , Shetty Mitha , Kumar Roshan , Anuradha V
Published: December 2024

Dental implants are now widely used in a wide range of clinical settings because of the growing research in the field of dental implantology. Dental implant placement is becoming more and more prevalent, which might lead to complications. One common issue is placing a dental implant improperly. The restorative dentist, laboratory technician, and the patient have an enormous challenge when it comes to prosthetically unfavorable implant rehabilitation.

Aim:

The purpose of this narrative review is to discuss classic prosthodontic challenges faced by clinicians for anterior implant restorations when the alterations/improvement of the surgical site is not an option and requests for rehabilitation of the existing situation.

Methods:

Researchers conducted a search of 13 studies using databases from the Cochrane Library, EBSCO, EMBASE, PubMed, and Web of Science. It gathered articles published from January 2000 to December 2023 with comprising terms such as “Angulated Abutment, Angulated Screw access, UCLA abutment, Cross-pin screw-retained implant prosthesis, Gingival ceramic collar.”

Results:

A total of 13 articles were collected and used to formulate this review. It describes different scenarios for correction of esthetic complications of malpositioned anterior implant region with a focus on prosthesis design and material selection. Other aspects such as advantages, disadvantages, and complications of different prosthetic options are also considered.

Discussion:

Even in cases where the implants are misaligned or malpositioned, labially located screw access of anterior implant restoration can be nonsurgically managed at the abutment level; material basis and prosthesis type (fixed or removable) may contribute to both esthetic and functional restorations.

Conclusion:

A thorough esthetic analysis of both hard and soft tissues, as well as precise treatment planning, may be required to achieve an optimal outcome during treatment. However, in certain cases, surgical corrections rather than prosthetic modifications would be required to improve results, which may pose a limitation.
Intraoral salivary duct cyst – A rare case report with review of literature
Authors: Pantham Hemalatha , Kumar N. Govind Raj , Kumar A. Sudarshan , Sowmya M. , Srikanth Damera
Published: December 2024

Rationale:

Salivary duct cysts, while uncommon, pose significant diagnostic challenges due to their clinical and histopathological similarities with other oral cystic lesions. This case report details an uncommon instance of a salivary duct cyst presenting on the hard palate in an elder patient, highlighting the importance of distinguishing it from more common lesions like mucoceles.

Patient Concerns:

An 87-year-old male noticed a small, painless nodular growth on the hard palate, which was associated with bleeding at a later stage.

Diagnosis and Investigations:

Upon presentation, the patient had nodular growth on the hard palate. Initially, the growth was clinically mistaken for a mucocele. To obtain a definitive diagnosis, an excisional biopsy was performed. Histological analysis of the excised tissue confirmed the growth of a salivary duct cyst.

Interventions:

The primary therapeutic intervention was the surgical excision of the cyst. It was fully excised without complications. No changes in therapeutic intervention were necessary postsurgery, and the patient’s recovery was monitored.

Lessons:

This case report highlights the significance of accurately distinguishing between salivary ductal cysts and mucoceles due to their unique treatment approaches and potential outcomes. Salivary duct cysts, although uncommon, should be considered when diagnosing cystic lesions of the oral cavity, particularly in elderly patients. Surgical excision with histopathological analysis is essential for proper diagnosis and management. Recognizing the potential for malignancy in the cysts of salivary ducts emphasizes the importance of careful monitoring and appropriate clinical intervention.
An atypical case of retinal pigment epithelium tear with remodeling and visual preservation
Authors: Ong Charles Jit Teng , Cheung Chui Ming Gemmy
Published: December 2024

This report describes a patient with polypoidal choroidal vasculopathy (PCV) with fovea-involving retinal pigment epithelium (RPE) tear that showed tissue remodeling with a good visual outcome. Imaging over the patient’s clinical course from 2019 was reviewed. A 74-year-old female presented with left submacular hemorrhage and a large multi-lobular pigment epithelial detachment. Left eye vision was 6/19 at the presentation. Indocyanine green angiography (ICGA) revealed underlying PCV. One month after initiation of intravitreal aflibercept (IVA, Bayer), she developed fresh subretinal hemorrhage. An RPE tear of 1 disc area in size, centered over the fovea was diagnosed. The torn RPE edge was scrolled up temporal to the fovea on spectral-domain optical coherence tomography (SD-OCT), with hypertransmission into the choroid observed over the area of RPE loss. Left eye vision after the RPE tear was 6/15. Over the next 2 months, the subretinal hemorrhage resolved following further IVA. At month 3, fundus autofluorescence (FAF) demonstrated hypo-autofluorescence while fundus fluorescein angiography (FFA) and ICGA showed a window defect corresponding to the area of RPE tear. On SD-OCT, there was a faint hyper-reflective layer where one might expect the RPE layer to be. Serial SD-OCT scans over 5 years revealed increasing prominence of the hyperreflective layer between the ellipsoid zone and Bruch’s membrane. FAF remained hypo-autofluorescent. At the last review, the patient retained 6/9 vision. We report a case of fovea-involving RPE tear documented with multimodal imaging with good visual outcome, which is atypical. Serial OCT suggests tissue remodeling may explain the functional preservation.
Schauder's fixed point theorem and Pontryagin maximum principle
Authors: Avakov Evgeny Rachievich , Magaril-Il'yaev Georgii Georgievich
Published: December 2024

We prove the Pontryagin maximum principle for a general optimal control problem.
The main ingredient of the proof is the abstract lemma on an inverse function,
which is proved via the Schauder fixed-point theorem.
Under this approach, the proof of the Pontryagin maximum principle
is quite short and transparent.
Residually linear abstract groupoids
Authors: Draoui Khalid , Choulli Hanan , Mouanis Hakima
Published: December 2024

We introduce the notion of residually linear groupoids. We characterize this class in analogy with the group-theoretic setting.
Various properties are proved and a relationship with residual finiteness is investigated.
From a categorical point of view, our approach extends some well-known results in the theory of discrete groups, due mainly to Mal'cev and Menal. Finally, as an application, we show that the character groupoid of the Hopf algebroid of representative functions of a transitive groupoid is always residually linear.
Enhancing Roll Reduction in Road Vehicles on Uneven Surfaces through
the Fusion of Proportional Control and Reinforcement Learning
Authors: Marotta Raffaele , Strano Salvatore , Terzo Mario , Tordela Ciro
Published: December 2024

This research addresses the pivotal role of active anti-roll bars in mitigating
vehicle body roll during cornering, thereby enhancing overall stability,
maneuverability, and comfort. The proposed approach integrates two distinct
control methodologies—a straightforward error proportional controller and a
reinforcement learning (RL)-based controller. Each front and rear active
anti-roll bar applies a roll-reducing torque computed by the proportional
controller during cornering. However, this torque alone proves insufficient in
effectively damping roll oscillations induced by road irregularities. The
RL-based controller leverages observations encompassing inertial measurement
unit data (roll rate, pitch rate, and vertical acceleration), and wheel vertical
displacements and employs the roll as a reward signal. This controller
calculates two additional corrective torques. These torques are seamlessly
incorporated by both front and rear anti-roll bars alongside the proportional
controller, effectively minimizing cornering oscillations. The results
demonstrate the efficacy of the solution in significantly reducing vehicle roll,
even in challenging road conditions. This novel hybrid control strategy combines
the simplicity of proportional feedback with the adaptability of RL, offering a
robust anti-roll system that excels in both cornering dynamics and rough terrain
scenarios. In the test maneuver, the proportional controller showed an RMSE,
NRMSE, and MAE of 0.1626, 1.3966, and 0.9169 deg, respectively. In contrast, the
hybrid controller showed 0.0935, 1.1525, and 0.6710 deg, respectively. The
results denote a decrease in RMSE, NRMSE, and MAE of roll over null reference
between hybrid and purely proportional controller by 42.79%, 17.60%, and 27.64%,
respectively. The presented findings underscore the potential of this integrated
approach for advancing vehicle comfort, stability, and safety across diverse
driving conditions.
Steel Bars, 1.0Cr - 0.20Mo - 0.45Se (0.39 - 0.48C) (4142H Modified), Die-Drawn, 130 ksi (896 MPa) Yield Strength, Free Machining
Authors:   AMS E Carbon and Low Alloy Steels Committee
Published: December 2024

This specification covers a free-machining, low-alloy steel in the form of round bars 3.50 inches (88.9 mm) and under in nominal diameter produced by a die-drawing process.
Steel Bars, Forgings, Tubing, and Forging Stock, 1.0Cr - 3.25Ni - 0.40Mo (0.17 - 0.22C), Electroslag Remelted or Consumable Electrode Vacuum Remelted, Premium Aircraft Quality
Authors:   AMS E Carbon and Low Alloy Steels Committee
Published: December 2024

This specification covers a premium aircraft-quality, low-alloy steel in the form of bars, forgings, mechanical tubing, and forging stock.
Hands-On Data Gathering
Authors: Mejía de la Pava Claudia , Manessi Silvia
Published: December 2024

Data collection is a fundamental aspect of linguistic and sociolinguistic research methodologies, and while many scholars may choose to gather their own data, others tend to rely solely on data that are readily available. There are various different methods of elicitation, including conducting interviews, questionnaires or leading focus groups to gather data, either as the main source of information or to complement existing material, which will most likely enhance both the quality of the research as well enriching the researcher’s personal experience. This paper aims to elucidate the experience gained by two researchers who implemented different data-collection methodologies during their research projects, to gather suitable data and conduct their analysis of the English language – one written the other oral – in two diverse, yet specialized, settings. They introduce their subjects of study and the communities in which the studies took place in order to help the reader get acquainted with the context, and then proceed to describe the processes they carried out. Their aim is to offer a retrospective on the decisions made, the evolution of their data-gathering approaches to determine the suitability of the focal methodologies, and the results.The aim of the paper is to contribute to the literature and applied linguistics research fields by disseminating empirical information on the collection of data within different communities of practice, so that it might be used, as a brief guide, to encourage and assist fellow researchers should they decide to embark in their own data collection projects.
Die Informationsverhältnisrekonstruktion und ihr Vergleich in der Figurenkonstruktion als Ausgangspunkt und Zugangsmöglichkeit zum Wissen des Modell-Retextualisierers in der historischen Perspektive
Authors: Obreza Kajetana
Published: December 2024

The following article emphasizes the possibility of using cognitive literary approaches in a historical context with the aim of following the process of the construction of a literary character. In doing so, it derives from the specific literary transmission of Old German texts and their corresponding Old French source texts. These literary transmissions are not tied to modern translation theoretical frameworks. This peculiarity is manifested in a large gap in content, which nevertheless maintains similarities between the transmitted and original texts. The focus of the research is placed on literary characters who are carriers of both similarities and differences in transmission for a new recipient. Theoretically, they are understood as mental models that arise in the interaction between the reader and the text. Mental models as final products remain inaccessible for research, since each recipient creates their own unique mental model in interaction with the text, and this remains inaccessible not only in the absence of a historical recipient, but also through empirical analysis in the present. However, this does not prevent the study of the text, which presents instructions for the construction of mental models. The method is based on the comparative reconstruction of a relationship between two information sources of the same literary character. This informational relation, however, has become a paradigm for the analysis of the construction of these two literary characters in a cultural transfer. Their comparison also enables the changes that occurred during retextualization of literary characters to be tracked in and for the new socio-historical context. For this analysis, the model from Fotis Jannidis’ Figur und Person (2004) is presented, which describes the construction of a literary character on four levels: from its creation and the first information given through characterization, motivation and all the way to identification. The comparative tracking of the constructions of two literary characters with the aforementioned model on four levels enables the process of construction of differences, and thus the changed instructions for the construction of the mental model to be tracked and the knowledge of the mental retextualizer to be accessed.