bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Morphology on the Permeability of CO2 Across PSF/FCTF-1 Mixed Matrix Membranes
Authors: Abdulabbas Ali A. , J. Mohammed Thamer , Al-Hattab Tahseen A.
Published: April 2023

This reaserch examines different analytical models based on the ideal case membrane structure that can use to evaluate gas penetration into mixed-matrix membranes (MMMs) loaded with non-partial fillers. Many models predicted CO2 permeance over PSF/FCTF-1(MMMs) and were compared to experimental results. The models were compared using standard criteria for validating models, such as the difference in penetrant permeability between the two phases ( and the absolute average relative error percentage. A comparison of those models was carried out based on the widely used model validation criteria, including a convenient measure of penetrant permeability difference between the two phases and absolute average relative error percent. Based on the typical values of morphological characteristics, it was determined that the following models fitted the data in the best order: Lewis‐Nielsen model< Pal model<Higuchi< Bruggeman model< Chiew and Gland < Maxwell model having AARE% values of 6.79, 8.45, 8.53, 10.23, 13.10, and 14.33, respectively. A scanning electron microscopy (SEM) examination of the cross-sectional image confirmed that the fillers were really ellipsoids scattered inside the matrix. The Maxwell-Wagner-Sillar model and the Lewis-Nielsen model were then used to evaluate the prolate effect, and the optimization curves of maximum packing () and shape factor (n) produced the least deviations. The AAR% variation was determined to be in the order of 0.01n 0.3, indicating the significance of the shape factor parameter in determining the accurate CO2 permeance. Key words: polysulfone, Mixed matrix membrane, the permeability of CO2, theoretical models
Reducing Medication Errors: Rethinking Prescribing Drugs in Standardized Units over Quantities of Ingredients
Authors: Karunananda Asoka S. , Madushani Jeewandarage S.
Published: April 2023

The prescribers need to memorize the dose and strength of thousands of drugs often with similar sounding names but differing actions, by their weight (strengths), which could lead to significant errors in medication. When prescribing, instead of using amounts in milligrams, a “standard unit” - a universal standard adult dose unit- concept can be employed to minimize such instances of erroneous recollection of dosages. Prescribers would not essentially need to know the composition and actual amount of active pharmaceutical ingredients in prescribed drugs if such a standardized unit prescribing system could be adopted. They could simply resort to prescribing the required number of units of medication instead. The standard adult dose of any drug could be referred to as one adult unit regardless of the amounts by weight. Only drug manufacturers and research scientists would need to know the actual strengths of the medications in milligrams of what would be referred to as a standard adult unit. Implementation of the unit system, along with the incorporation of electronic prescribing, could allow for simple data entry, and easier corrections for lean body weight/BMI, renal function, age, pregnancy, etc., leading to improvements in patient safety and optimal dosage achieved, eliminating difficult calculations. Moreover, a parallel paediatric unit could also be developed. The conceptual study to arouse an interest cannot address all issues and details relating to actual implementations.
Post-acute COVID-19 Syndrome and Predicting Factors: A Narrative Review
Authors: Kaushalya Lakshani , Bowatte Gayan , Welikannage Kosala , Yasaratne Duminda
Published: April 2023

Accumulating evidence indicates a high prevalence rate of persistent symptoms leading to post-acute COVID-19 syndrome. It has been identified as a multi-organ disease with a wide range of prolonged symptoms that may be reflective of underlying respiratory, cardiovascular, neuropsychiatric, gastrointestinal, dermatological, renal, and endocrine disorders. The most frequent symptoms of post-acute COVID-19 include fatigue, dyspnea, anosmia, ageusia, and cough. Additionally, female gender, older age, pre-existing comorbidities, and initial COVID-19 severity, especially those requiring intensive care unit treatments and mechanical ventilation seem to relate to developing persistent symptoms. Studies also suggest that biological factors such as higher viral load, reactivation of the Epstein-Barr Virus, presence of certain autoantibodies, alterations in the gut microbiome, and other factors such as ambient air pollution, not being vaccinated, and reinfection with COVID-19 increase one’s susceptibility to developing lasting symptoms. This narrative review presents an overview of the current understanding of the postacute symptoms and sequelae, and their potential predicting factors. In addition, this highlights the need for further research to be conducted to improve understanding of the pathophysiological aspects of the post-acute COVID-19 syndrome and develop effective therapies.
A Mini Review on Association between Physical Activity and Academic Performance among University Students
Authors: Wijayasinghe Hashini M. , Nishshanka Pradeepa S. , Liyanage Esther
Published: April 2023

Academic Performance (AP) in higher education is a significant factor. It is very important to evaluate the factors that influence AP. In this review, we aimed to summarize the results from published articles in recent years about the correlation between Physical Activity (PA) and AP among university students. This review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted using the PubMed, Google Scholar, and PEDro databases. After applying inclusion and exclusion criteria and final screening, 11 studies were selected to include in the review. Physical Activity was measured by self-administered questionnaires in most studies, and AP was graded mostly using Grade Point Average (GPA). Few studies that were identified in this review revealed that PA had a positive influence on AP. Findings from studies have shown that PA has a positive correlation with AP. There is also evidence that PA is reduced among university students due to various factors. Hence, more longitudinal and interventional studies are needed to assess this relationship and to encourage involvement in PA among university students.
MHC Class I Ligands of Rhesus Macaque Killer Cell Ig-like Receptors
Authors: Anderson Jennifer L , Sandstrom Kjell , Smith Willow R , Wetzel Molly , Klenchin Vadim A , Evans David T
Published: April 2023

Definition of MHC class I ligands of rhesus macaque killer cell Ig-like receptors (KIRs) is fundamental to NK cell biology in this species as an animal model for infectious diseases, reproductive biology, and transplantation. To provide a more complete foundation for studying NK cell responses, rhesus macaque KIRs representing common allotypes of lineage II KIR genes were tested for interactions with MHC class I molecules representing diverse Macaca mulatta (Mamu)-A, -B, -E, -F, -I, and -AG alleles. KIR–MHC class I interactions were identified by coincubating reporter cell lines bearing chimeric KIR-CD3ζ receptors with target cells expressing individual MHC class I molecules and were corroborated by staining with KIR IgG-Fc fusion proteins. Ligands for 12 KIRs of previously unknown specificity were identified that fell into three general categories: interactions with multiple Mamu-Bw4 molecules, interactions with Mamu-A–related molecules, including allotypes of Mamu-AG and the hybrid Mamu-B*045:03 molecule, or interactions with Mamu-A1*012:01. Whereas most KIRs found to interact with Mamu-Bw4 are inhibitory, most of the KIRs that interact with Mamu-AG are activating. The KIRs that recognize Mamu-A1*012:01 belong to a phylogenetically distinct group of macaque KIRs with a 3-aa deletion in the D0 domain that is also present in human KIR3DL1/S1 and KIR3DL2. This study more than doubles the number of rhesus macaque KIRs with defined MHC class I ligands and identifies interactions with Mamu-AG, -B*045, and -A1*012. These findings support overlapping, but nonredundant, patterns of ligand recognition that reflect extensive functional diversification of these receptors.
A Single Nasal Dose Vaccination with a Brucella abortus Mutant Potently Protects against Pulmonary Infection
Authors: Wang Hongbin , Clapp Beata , Hoffman Carol , Yang Xinghong , Pascual David W
Published: April 2023

The Brucella abortus double-mutant (ΔznuA ΔnorD Brucella abortus-lacZ [znBAZ]) was assessed for its protective efficacy after vaccination with a single nasal dose. Superior protection was achieved in znBAZ-vaccinated mice against pulmonary, wild-type B. abortus 2308 challenge when compared with conventional livestock Brucella abortus vaccines, the smooth S19 (smooth B. abortus strain 19 vaccine) and rough RB51 (rough mutant vaccine strain of B. abortus) strains. Nasal znBAZ vaccination reduced splenic and lung colonization by wild-type brucellae by >3–4 logs. In contrast, S19 reduced lung colonization by only 32-fold, and RB51 failed to reduce colonization. One profound attribute of znBAZ vaccination was the >3-fold increase in pulmonary CD8+ T cells when compared with other vaccinated groups. S19 vaccination increased only CD4+ T cells. All vaccines induced IFN-γ and TNF-α production by CD4+ T cells, but only znBAZ vaccination enhanced the recruitment of polyfunctional CD8+ T cells, by >100-fold. IL-17 by both CD4+ and CD8+ T cells was also induced by subsequent znBAZ vaccination. These results demonstrate that, in addition to achieving protective immunity by CD4+ T cells, CD8+ T cells, specifically resident memory T cells, also confer protection against brucellosis. The protection obtained by znBAZ vaccination was attributed to IFN-γ–producing CD8+ T cells, because depletion of CD8+ T cells throughout vaccination and challenge phases abrogated protection. The stimulation of only CD4+ T cells by RB51- and S19-vaccinated mice proved insufficient in protecting against pulmonary B. abortus 2308 challenge. Thus, nasal znBAZ vaccination offers an alternative means to elicit protection against brucellosis.
COVID-19 lockdown
Authors: Akhouri Deoshree , Madiha Maria , Ahmed Jameel
Published: April 2023

Background:

The coronavirus pandemic has affected more than 14 million people in the world. Adults are somehow able to manage their stress created by the most fearful disease. However, it is the children and adolescents who are most affected by COVID-19 lockdown.

Aim:

This study aimed to assess the effect of COVID-19 lockdown on adolescent's psychosocial factors.

Materials and Methods:

Using the Google Form link, a questionnaire was developed and an online survey was conducted. This online questionnaire consisted of 40 items assessing personal, social, academic, and family domains related to adolescents.

Results:

A total of 223 responses were obtained. The results indicate that 6.5% of adolescents experience extreme level of anxiousness, 29.8% become little irritable and angry, affecting their personal/emotional domain. About 12.6% of the adolescents are uncomfortable with social distancing and 48.4% of them greatly miss their friends; 38.1% miss their school and 28.8% are unable to clear their doubts through online teaching. Mathematics was the most uncomfortable subject for them to deal with 49.8%. About 79% of adolescents suffer mildly from family distress, 43.3% (extremely) are eagerly waiting for the lockdown to end.

Conclusion:

Among all four domains, the family domain was the most affected due to COVID-19 lockdown, followed by social, academic, and personal domains.
Prevalence of medical comorbidity in early onset versus late-onset depression in Vindhya region
Authors: Singh Rajesh , Ahuja Sunil K. , Singh Amrendra , Shakya Makhan , Pathak Umesh , Rure Daisy
Published: April 2023

Background:

Late-onset depression differs significantly from early-onset depression according to clinical features, physical comorbidities, cognitive impairment, and cerebrovascular abnormalities, which suggest that these might have differing etiopathological pathways toward the depressive phenotype.

Aim:

The aim of the study was to identify comorbid physical disorders with late-onset depression.

Methods:

The present cross-sectional study was conducted in inpatients of the Department of Psychiatry during a period of 18 months. A study consisted of 60 patients of first depressive episode diagnosed using International Classification of Diseases-10 criteria, segregated 2 different groups of Early onset depression (between 40 and 65 years) and late-onset depression (LOD) (>65 years) with 30 patients each.

Results:

In LOD group, predominant comorbidities were hypertension 56.6%, cerebrovascular disease 36.6%, diabetes 33.3%, cardiovascular disease 23.3%, and anaemia 23.3%, followed by respiratory illnesses, arthritis, benign prostatic hyperplasia and cirrhosis. While, in early-onset depression group, common comorbidities were hypertension (13.3%), anemia (10%), arthritis (10%), and diabetes (6.6%).

Conclusions:

Hypertension cerebrovascular disease, diabetes, and cardiovascular disease were the predominant comorbidities in late-onset as well as early onset depression.
A study of dementia in old age homes
Authors: Saldanha Daniel , Mani R. N. , Mujawar Swaleha , Chaudhury Suprakash
Published: April 2023

Background:

By 2040, dementia is projected to rise exponentially by 300% in India. Studies addressing the need for psychiatric care in the community being few and those focusing in old age homes even fewer, a study was undertaken to study the prevalence of dementia and the association with sociodemographic factors and psychiatric morbidity.

Materials and Methods:

A total of 558 elderly aged 60 years and above, residing in old age homes in Pune were studied. 179 inmates were included based on the inclusion and exclusion criteria. Those who scored a predetermined cut-off score on the screening tool were included to undergo a detailed physical and neurological examination, cognitive profile using subtests from the cognitive test (community screening instrument for Dementia of 10/66 group).

Results:

Mean age of the sample was 75.02 years majority (39.7%) was in the 60–70 years group. Males 25.7% versus females 74.3%. The sample consisted of the following socioeconomic groups: 40.2% middle, 26.3% low middle, 24% high middle, 8.4% high income, and 1.1% in low income. 60.3% widow/widower category, 36.3% never married, 4.5% had family history of dementia. Mean scores of mini mental state examination in the overall sample was 26.02 compared to 18.02 in those cut-off point of 23. The prevalence of dementia in the sample was 22.9%. There was the high prevalence of psychiatric symptoms and psychiatric morbidity in the dementia group than the rest. Frontal lobe dysfunction and impairment of orientation with increasing severity of dementia were observed.

Conclusions:

Sociodemographic factors, which were considered protective against the prevalence of dementia, identified were less restriction in physical activity and having fish in the diet regularly.
Psychiatric morbidity in absentees in industry
Authors: Reddy Indla Ramasubba , Singh Aakanksha B. , Reddy Indla Vishal
Published: April 2023

Background:

Absenteeism refers to a worker's unscheduled absence from the workplace. Around the world, a large share of mental disorders can be attributed to work productivity losses. Despite industries working on improvement in employees' wages, better work environment and improved health care to improve their mental health. Absenteeism continues to be a global burden.

Aim:

The aim of the study was to explore the factors influencing absenteeism.

Materials and Methods:

A sample size of 100 workers was selected and standardized, and reliable research tools were employed. Factors influencing absenteeism such as the sociodemographic factors, personality traits, psychiatric morbidity, family typology, and interactions were studied using relevant scales, i.e., Eysenck's Personality Inventory and Family Typology by Batti and Channabasavanna.

Results:

Study found that absentees were more emotionally stable, whereas regulars were found to be emotionally unstable. Factors were found to be associated with absenteeism such as low income, 11–20 years of service, low mean neuroticism score, chronic physical disease, high psychiatric morbidity among the workers, egoistic and anomic family typology. This study reveals that a significantly higher proportion of absentees had a low pay scale. Paradoxically, a high proportion of absenteeism had a longer duration service, indicating that the low pay scales could have resulted from disciplinary actions against absentees, like loss of increments, etc.

Conclusion:

Psychosis, alcoholism, and chronic physical illnesses are among the illnesses which contribute to absenteeism.
Prevalence and risk factors associated with Internet gaming disorder
Authors: Singh Yujal Man , Prakash Jyoti , Chatterjee Kaushik , Khadka Bharat , Shah Ayushma , Chauhan Vinay Singh
Published: April 2023

Background:

Internet gaming disorder (IGD) is an entity of clinical attention prominent among schoolgoing students. The reported nature and extent of Internet gaming varies widely, as does the extent of its effects.

Aim:

This study aimed to assess the prevalence of IGD and factors associated with it.

Methods:

After institution ethics approval, individual assent, and parental consent, a cross-sectional study was conducted among 142 students of a school in western Maharashtra. A specially designed sociodemographic pro forma and IGD Scale were administered to the students. Data thus generated were statistically analyzed and compared with published literature.

Results:

The prevalence of IGD was 10.6% among 13–19-year-old students. It was significantly higher among male students (15.3%) than female students (3.5%). Multivariate logistic regression found IGD to be significantly associated with male gender and lower age at first gameplay.

Conclusions:

IGD affects a tenth of our schoolgoing population with a male preponderance. Lower age at first gameplay had an adverse association.
Trichotillomania in childhood
Authors: Patkar Prajakta , Patil Anand A. , Singh Ichpreet , Priyambada Richa , Chaudhury Suprakash
Published: April 2023

Trichotillomania is a psychodermatological disorder characterized by an uncontrollable urge to pull one's own hair. It is often associated with depression and obsessive–compulsive disorder. We report five cases, a young male and four females, who presented with an increased desire to pluck out their hair, leading to large patches of baldness. Despite distinct forms of presentations and different comorbidities, the management more or less remained the same.
Counseling patients with COVID-19
Authors: Santre Manjeet , Panse Smita , Wadgaonkar Gaurav , Haritha S.
Published: April 2023

COVID-19 pandemic is generating considerable stress in the population. Uncertain prognosis, looming severe shortages of resources for testing and treatment, imposition of unfamiliar public health measures (infringing on personal freedoms), large and growing financial losses, and conflicting messages from authorities are few of the major stressors due to COVID-19. The effect due to COVID varies from individual to individual. Healthcare providers are more vulnerable as there is increased risk of exposure to coronavirus, concern about infecting and caring for loved ones, shortages of personal protective equipment, and longer working hours. Yashwantrao Chavan Memorial Hospital started functioning as Dedicated COVID-19 hospital since April 2020. Psychiatric services were also active and were delivered by means of telepsychiatry outpatient services, consultation-liaison psychiatry for COVID-19 patients, group counseling, supportive counseling, and psychosocial counseling center for relatives. Our experience is briefly described
Dangers of mRNA vaccines
Authors: Ali Tahoora , Mujawar Swaleha , Sowmya A. V. , Saldanha Daniel , Chaudhury Suprakash
Published: April 2023

“Necessity is the mother of invention:” An adage was brought to life with the emergence of the mRNA vaccine against the backdrop of the foreboding and mercurial COVID-19 pandemic. Considering a negligible adverse-effect profile and a break-neck manufacturing speed, it shone bright as the ideal vaccine candidate. However, “all that glitters is not gold,” as was evidenced by the significant reactogenicity, a host of multi-systemic side-effects, that are being reported by the vaccine recipients; which is palpably resulting in a shift of emotions for the vaccine, accounting for vaccine hesitancy. Anaphylaxis, antibody-dependent enhancements, and deaths, comprise the most serious side-effects, albeit occurring in sparing numbers. Storage and transportation require fastidious temperatures, rendering it substantially inaccessible to a country like India. The biggest jolt, however, was the unfolding of the biases in reporting vaccine efficacy, as only the attractively high numbers of the relatively equivocal relative risk reduction were reported while keeping at bay the meager numbers of the more forthright absolute risk reduction. Notwithstanding the fallacies, the mRNA vaccine still promises hope; and with the right precautions and finesse, can be potentiated, as “a watched pot never boils.”
Intracranial space-occupying lesion masked by alcohol dependence syndrome
Authors: Gupta Nishtha , Samudra Madhura , Davis Supriya , Javadekar Archana
Published: April 2023

A lot of comorbidities exist in patients with dependence on alcohol, psychoactive, or other substances. Many times, their comorbidities go undiagnosed or neglected due to the stigma prevalent with dependence. A 22-year-old person with alcohol dependence who was detected to have a parietal lobe space-occupying lesion which proved to be a tuberculoma is reported.
Suicidal behavior in schizophrenia
Authors: Davis Supriya , Patil Jaideep , Aziz Sadaf , Chaudhury Suprakash , Saldanha Daniel
Published: April 2023

Suicide/parasuicide is seen at a greater rate in schizophrenia than in the general population, yet the psychological basis of this risk is poorly understood. It is estimated that 10% of patients suffering from schizophrenia attempt suicide. The major risk factors implicated are male gender, chronic illness with multiple relapses, family history of suicide, past suicidal and impulsive behavior, negative attitude toward treatment, and concurrent substance use. Treatment must target the identified risk factors for prevention of suicide in these patients. Here, we discuss three cases with self-inflicted cuts over the anterior aspect of the neck and wrists. They were diagnosed to have paranoid schizophrenia and were treated with antipsychotics, on which they showed improvement.
Neuropsychiatric involvement in systemic lupus erythematosus
Authors: Gupta Nishtha , Arya Aakansha , Ali Tahoora , Chaudhari Bhushan
Published: April 2023

Patients with systemic lupus erythematous that suffers from one or more of several neuropsychiatric symptoms represent a subcategory termed “neuropsychiatric systemic lupus erythematosus” (NPSLE). Different environmental factors, such as infection, stress, and ischemia, mediated by inflammatory cytokines, may damage the blood–brain barrier, further contributing to neuropsychiatric symptoms. Antiribosomal-P antibodies are specifically related to psychosis in NPSLE. Three patients of systemic lupus erythematosus who developed features of psychosis are presented and the condition is briefly discussed.
An updated list of mosquito species in Armenia and Transcaucasian region responsible for Dirofilaria transmission: A review
Authors: Shcherbakov Oleg V , Aghayan Sargis A , Gevorgyan Hasmik Sh , Burlak Vladimir A , Fedorova Valentina S , Artemov Gleb N
Published: April 2023

Canine dirofilariasis is a world-wide distributed mosquito-borne helminthiasis that has a potential zoonotic impact. This disease is a serious problem in Southern Caucasus region, including Armenia. Average extensity of Dirofilaria infection in canids in Armenia is 26.9%. At present, 77 mosquito species (Diptera: Culicidae) are presumed to have a role in the transmission of dirofilariasis. 80 species of Culicidae family mosquitoes are registered in Southern Caucasus Region, and 31 of them are described in Armenia. The following species of Culicidae can serve as vectors of Dirofilaria spp. in Armenia: Aedes vexans, Ae. caspius, Ae. albopictus, Ae. geniculatus, Culex pipiens, Cx. theileri, Cx. modestus, Anopheles maculipennis s.s., An. claviger, An. hyrcanus, An. superpictus, Coquillettidia richardi, Culiseta annulata and Uranotaenia unguiculta. We see a risk of transmission in active foci of dirofilariasis, as well as for human infection in Armenia. Comprehensive research should be conducted on detection of microfilariae in the target mosquito species and in target localities.
Morphological and molecular evidence of sandfly (Diptera: Psychodidae: Phlebotomine) and its relevance to recent cases of leishmaniasis from Jammu region of North India
Authors: Sofi Omer Mohi U Din , Godara R , Katoch R , Yadav A
Published: April 2023

Present study was conducted to carry out morphological and molecular confirmation of sandflies collected at the Department of Parasitology, Faculty of Veterinary and Animal Sciences, R.S. Pura, Jammu, India. Larva was maggot like with large head, thorax and abdomen with typical black head, 12 abdominal segments and last abdominal segment carried two pairs of caudal bristles with matchstick hairs on each segment. The adult fly possessed head, abdomen and thorax. Head consisted of pair of long, hairy and beaded antenna, proboscis and one pair of prominent black eyes. Thorax possessed a pair of wings and three pairs of legs, wings were hairy and pointed with 2nd longitudinal vein branched twice. The abdominal segments were covered with small hairs and last abdominal segment was having a pair of anal recti. These identification characteristics confirmed the fly under study as Phlebotomus argentipes that confirms its occurance in this region. Molecular characterization of identified flies was carried out on positive morophological flies. Confirmation of Phlebotomus species was ascertained by amplifying the 18S ribosomal RNA gene sequence using PCR. Clear amplification was observed for Phlebotomus argentipes (538 bp). After sequencing/genotyping, Phlebotomus argentipes (OP646634) isolate of present study was clustering in same clade with Phlebotomus argentipes sequences obtained from GeneBank from other locations across globe, irrespective of their geographical location, thus providing the molecular evidence of this species present in Jammu region of North India.
Exploring Outcomes in Formal Physical Therapy Mentorship Programs
Authors: Becker Emily S. , Grant Michael , Witte Maria M. , Deveikis Lauren T. , Traisman Rachel K.
Published: April 2023

Purpose:

While formal mentorship is a valued development tool, there is limited information regarding these programs within physical therapy. This study aims to identify factors that influence mentorship program outcomes, including increasing mentee confidence and perception of improved clinical outcomes.

Materials and Methods:

Eighty-five physical therapists participated in a 38-question online survey regarding their employer’s mentorship program within the first 5 years of practice. Responses regarding the mentorship program’s structure, quality of mentorship experiences, and frequency of best practice behaviors demonstrated by the mentor were collected using five-point Likert-type scales for agreement and frequency. Associations between mentorship practices and mentorship outcomes were analyzed via Chi-square and Cramer’s V likelihood ratios.

Results:

All indicators related to mentorship best practices showed strong associations with the intended outcomes for formal mentorship programs of increased mentee confidence and improved perception of clinical outcomes. These associations ranged from χ
2(36) = 153.202, P = <0.001, V = 0.667 to χ
2(36) = 186.946, P = <0.001, V = 0.805. The same three variables of creating safe learning environments, being invested in the mentee’s growth, and preparing for the session had the strongest associations with these mentorship program outcomes ranging from χ
2(36) = 171.378, P = <0.001, V = 0.778 to χ
2(36) = 186.946, P = <0.001, V = 0.805.

Conclusions:

Though the results demonstrated that mentees reported overall positive experiences, formal mentorship programs should find additional ways to incorporate mentorship best practices. Creating a safe learning environment, investing in a mentee’s growth, and preparing for mentorship sessions, in particular, bolster mentorship program outcomes of increasing mentees’ confidence and perception of improved overall clinical outcomes.
Continuous Glucose Monitoring-Assisted Insulin Dose Titration in the Indian Outpatient Setting
Authors: Ganti Sri Ramya , Gurazada Kalyan Chakravarthy
Published: April 2023

Context:

Monitoring blood glucose levels is an important aspect in the overall management of an individual with diabetes mellitus. Continuous glucose monitoring (CGM) system is an effective tool that enables physicians to do so by way of regular automated checks of sensor glucose (SG).

Aims:

In this article, we discuss in detail on how CGM technology works, practical aspects of its application and how CGM data are interpreted. We describe the different glucose sensors available in India and suggest when and whom to use them. We also evaluate the effectiveness of CGM-assisted titration of insulin dose in our hyperglycemic patients and discuss the results.

Settings and Design:

This is a single-center retrospective observational study of insulin-treated patients with diabetes attending the endocrinology outpatient department, who opted for a CGM-assisted insulin dose titration.

Subjects and Methods:

Monitoring was done using the Freestyle libre pro™ CGM system and insulin doses were titrated on regular follow-ups every 3–4 days for a total of 2 weeks. Patients who had an average SG level of more than 250 mg/dl on day 1 of monitoring, and had CGM data for a minimum of 12 days were included (n = 73). Data were analyzed using CGM-specific glucometrics including average SG and estimated A1c (eA1c) reduction, and changes in the percentage time in range (TIR), time below range (TBR), and time above range (TAR).

Statistical Analysis Used:

Not applicable.

Results:

When compared to day 1, the last day (D12–14) of CGM-assisted insulin dose titration showed: 1. An average SG reduction of 164.1 mg/dl (321.34 mg/dl → 157.24 mg/dl). 2. An eA1c reduction of 4.98% (12.08% → 7.1%). 3. An average TIR improvement of 51.21% (3.8% → 55.01%). 4. An average TAR reduction of 62.06% (96.12% → 34.06%). 5. An average increase in TBR from 0% to 10.21%. Target TIR >70% was achieved by 31/73 patients on D12-14, compared to 0/73 on day 1. Target TAR <25% was achieved by 43/73 patients on D12-14, compared to 0/73 on day 1. Target TBR <5% was not achieved by 21/73 patients on D12-14 when compared to 0/73 on day 1.

Conclusions:

CGM is a novel, easy-to-use, useful technology easily available in India for all patients with diabetes. We have demonstrated that quick and effective glycemic reduction is possible with CGM-assisted insulin dose titration within a short period of 2 weeks.
Comparative Study of Positive Predictive Value of Diagnostic Single Versus Dual Median Branch Block for Radiofrequency Neurotomy in Lumbar Facet Joint Syndrome
Authors: Bhandari Baibhav , Ray Subrata , Goswami Subrata
Published: April 2023

Background:

Almost 60%–85% of people suffer from low back pain once in their lifetime. Due to a large number of pain generators, many a times lower back pain pose as enigma. Many clinical trials have shown validity of median branch block (MBB) in the management of chronic low back pain arising from facet joint pathology. Single blocks result in 27%–63% false positives, whereas double controlled blocks significantly decrease the false positives and increases the sensitivity to 54% and specificity to 88%. The aim of our study was to determine positive predictive value of diagnostic single and dual MBB for radiofrequency (RF) neurotomy in patients with facet joint arthropathy in Indian population.

Subjects and Methods:

Thirty patients allocated into two groups (n = 15), Group S - Single diagnostic MBB and Group D - Dual diagnostic MBB. Numerical Rating Score (NRS) and Roland Morris Disability Questionnaire (RMDQ) were recorded in all patients in both the groups at multiple times. Pre and postprocedure NRS and RMDQ score in both the groups were statistically compared.

Results:

NRS in Group D was lower as compared to Group S 1 month after neurotomy (P = 0.034). RMDQ in Group D 1 month after RF neurotomy was lower as compared to Group S (P = 0.045). The positive predictive value in Group S with single MBB is 66.6%, whereas the positive predictive value in Group D with dual MBB is 86.6% at the end of 1 month post-RF ablation.

Conclusions:

Single MBB injection for diagnosis of facet joint syndrome yields many false positives results and the positive predictive value for the same is lower as compared to Dual MBB.
Medical Cannabis in Chronic Pain Management – Where Are We Now?
Authors: Haider Shamim , Liew Wan Jane
Published: April 2023

Chronic pain is a debilitating condition that afflicts a significant number of people throughout the world. The mechanisms of chronic pain remain to be fully understood, and treatment for chronic pain has remained a challenge for pain practitioners. Cannabis and cannabis-based medicine (CBM) have emerged over the last two decades as potential treatment options for an array of medical issues, of which chronic pain is one of them. Clinical trials thus far seem to suggest that medical cannabis may have some clinical effect in reducing pain severity in chronic noncancer pain as an adjunct to standard treatment, but inherent weaknesses in the available evidence mean that the verdict for medical cannabis has yet to be set in stone. The issue of medical cannabis is further complicated by the connection of cannabis with neuropsychiatric side effects and substance misuse. Much work needs to be done by both clinicians and government bodies to translate the benefits of medical cannabis in the laboratory into positive patient outcomes at the bedside in a safe manner.
An Observational Study on Clinical Profile and Management of Transatlantic Intersociety Consensus II C and D Aortoiliac and Femoropopliteal Occlusive Diseases: Role of Hybrid Procedures in Hybrid Operation Theater
Authors: Biswas Brijesh , Prakash Marasandra S , Singh Bhanu Pratap , Agrawal Vivek , Anand Vembu
Published: April 2023

Objective:

Peripheral arterial disease is a powerful predictor of the loss of limb and even loss of life. Endovascular treatment (ET) and hybrid procedures are gradually replacing open procedures. The purpose of this study is to evaluate the management outcome of transatlantic intersociety consensus (TASC) C and D aortoiliac (AI) and femoropopliteal (FP) disease by various methods.

Materials and Methods:

Prospective observational study was done at Army Hospital (Research and Referral) Delhi Cantt from June 2015 to January 2017. Patients with TASC C and D AI and FP lesions were included. Patients were treated with either open, endovascular or hybrid technique and followed at 1, 3, and 6 months.

Results:

A total of 110 (36 AI and 74 FP) patients were included. 96.3% were smokers. Seventeen were TASC C and 93 were TASC D lesions. Fourteen out of 17 TASC C lesions could be managed by endovascular, two by hybrid and only one required open reconstruction. Whereas 58 out of 93 TASC D lesions needed to be opened, 15 were endovascular, and the rest 20 cases were managed by hybrid procedures. One had an iliac artery rupture managed with bypass graft. We have seven mortalities two within 30 days and five from 30 days to 1-year primary and secondary patency for ET was 72.4% and 80%, for open surgery was 76.2% and 93% and for hybrid procedure was 60% and 77.7%.

Conclusions:

Hybrid therapy simplifies and allows the one-step treatment with complex peripheral multifocal steno-obstructive vascular disease with high technical success rate and excellent long-term patency in few patients.
A Study of Arterial Supply to Carotid Body Tumor and Its Prospective Implication in Clinical Practice
Authors: Singh Devender , Praveena Madavan , Aryala Shalini
Published: April 2023

Introduction and Objectives:

Arterial supply to carotid body tumor is primarily from ascending pharyngeal artery (APA), a branch of the external carotid artery, and with infrequent feeders from other branches of the latter described in the literature. The present study attempted in describing other sources of arterial supply to carotid body tumor and its implication in clinical practice.

Materials and Methods:

This study was retrospective to start with turning a prospective midway for 5 years from July 2017 to July 2022. The data of all the 12 patients, in whom seven males and five females with a mean average of 45 years, were analyzed, There were seven males and five females with the mean age of 45 years; the average size of the tumor documented was 5 cm. All the patients underwent computed tomography angiography for confirming the diagnosis. Three-dimensional volume-rendered images from the rotational angiogram were analyzed for assessing the arterial supply. All patients underwent surgical excision without embolization.

Results:

In all 12 patients, APA was found primarily the main source of blood supply. Four patients, in addition, had occipital artery and superior thyroid in one. Two patients were identified to have glomic artery arising from the bulb of the common carotid artery supplying the tumor. The thyrocervical trunk was also supplying the tumor in a patient. Anomalous branches from the internal carotid artery were found to be the sole source of arterial supply to the tumor in a patient.

Conclusion:

Surgical excision of carotid body tumors still continues to be a challenge due to multiple arterial feeders leading to hypervascularity. A detailed knowledge of arterial supply helps in proper planning and reducing perioperative bleeding. The glomic artery, and in rare cases, the internal carotid artery, also contribute as a feeder to the tumor. These unusual arterial feeders give an important warning before routine embolization to avoid cerebrovascular events.
Is Revascularization the Only Mode of Treatment for Diabetic Foot Ulcer?
Authors: Joshi Parth Devdatt , Desai Sanjay C , Ramswamy Chandrashekar Anagavalli , Pandya Radhika Himanshu , Vinaykumar
Published: April 2023

Introduction and Objective:

Diabetic foot infection is a common cause for hospital admissions among diabetics in India. This could be attributed to sociocultural practices, such as walking barefoot, inequitable access to diabetes care, poor education, and poor socioeconomic conditions. The purpose of this study is to highlight the role of diabetic footwear in care of diabetic foot.

Materials and Methods:

The observational study included 170 patients, presenting with diabetic foot ulcers, studied over a period of 19 months. The patients were categorised in those suffering from neuropathic ulcers and neuroischemic ulcers using biothesiometery and Ankle Brachial Pressure Index. Diabetic foot wears were prescribed based on plantar pressure measurement. The mode of management was noted and need for incidence on follow up was recorded.

Results:

Our study population predominantly consisted of elderly males with a mean age of 63.2 years and 71.7 % males. Out of 170 patients presenting with diabetic foot ulcer, neuroischemic ulcers were diagnosed in 35 patients, and the rest 135 patients were diagnosed to have neuropathic ulcers. (Graph 1) NIU was observed more common among male patients with 25 males out of 35 patients [71.4 %], similarly NPU were more common in males [72.8 %]. Among the 35 patients who were diagnosed to have neuroischemic ulcers, all required diabetic foot wear, however 10 patients required revascularization procedure, 2 patients required Prostaglandin therapy infusion and 1 patient required stem cell implantation. The group of patients who were diagnosed to have neuropathic ulcers, required only diabetic foot wear and medical therapy which involved antibiotics, antiplatelets, vasodilators and Prostaglandin infusion. Amputation was required in 8 (23%) out of 35 patients suffering from NIU and in 12 (9%) out of 135 patients suffering from NPU.

Conclusion:

ABI, bioethesiometry and plantar pressure measurement play an important role in planning management and need of diabetic foot wear. Majority of the patients may have neuropathic involvement with recurrence rate and need of amputation significantly reduced by use of diabetic foot wear.
Endovascular Treatment of Superficial Femoral Artery Ostial Occlusions and Outcomes of Unexpected Postprocedural Deep Femoral Artery Occlusion
Authors: Igus Behlul , Firat Ali
Published: April 2023

Introduction:

This study aimed to demonstrate different revascularization approaches to superficial femoral artery (SFA) ostial occlusion and to evaluate the outcomes of unexpected deep femoral artery (DFA) occlusion encountered during the endovascular treatment (EVT).

Materials and Methods:

This retrospective study included 56 patients diagnosed with ostial SFA occlusion between March 2014 and December 2019.

Patients were divided into two groups:

the percutaneous transluminal balloon angioplasty (PTA) group, which included 32 patients treated with PTA, and the stent group, which included 24 patients treated with stents. The preferred access site was the contralateral femoral approach, and in 20 patients, access was performed with the popliteal artery (n: 13), pedal arteries (n: 4), and retrograde occluded SFA (n: 3).

Results:

Technical success was 100%. In the PTA group and stent group, primary patencies were 81%, 75%; 62%, 66%; and 56%, 58% and secondary patencies were 92%, 90%; 64%, 63%; and 50%, 54% at 6, 12, and 24 months, respectively, with no significant differences determined between the groups (P = 0.943 and P = 0.640 by log-rank). DFA occlusion occurred in 8 patients during the EVT. Rutherford score was a statistically significant decrease in both the groups (Wilcoxon signed-rank test, P = 0.010).

Conclusion:

Even in challenging SFA ostial lesions, using several different approaches has high success rates in EVT. This study showed no significant difference in PTA and stenting patency rates. Accidentally, DFA occlusion may be encountered, in which case revascularization of the SFA is the priority, even if the procedure ends with occluded DFA. A patent SFA and good distal flow will be sufficient for foot perfusion in DFA’s occluded patients.
An Alternative Route for Petroclival Tumors: Without Mastoidectomy and Superior Petrosal Sinus Ligation: A Cadaveric Study
Authors: Özbek Muhammet Arif , Başak Ahmet Tulgar
Published: April 2023

Objective:

Retrosigmoid approach and presigmoid approach and its derivatives including retrolabyrinthine, translabyrinthine, and transpetrosal approaches have long been used for reaching posterior and middle cranial fossa. In neurosurgery perspective, many types of tumors arise extradurally and surgical resection of these tumors is still challenging. We aimed to describe a modified way to approach posterior and middle fossa to contribute to the surgical management of petroclival tumors with posterior extension.

Methods:

Modified sigmoid approaches were performed bilaterally in 5 fresh adult cadaver heads.

Results:

In this approach, it was possible to reach the middle and posterior fossa with a single craniotomy. Temporal dura matter was dissected from the temporal bone with extradural gentle dissection. In addition, sigmoid sinus and superior petrosal sinus (SPS) were dissected off from the petrous bone meticulously. Subsequently, the posterolateral superior arcuate petrosectomy was performed with high-speed surgical drill extradurally by protecting the semicircular canal, labyrinthine channel, and cochlea. Dura matter was elevated for 1.5 cm with retractor above the mastoid bone. Dura was opened from an alternative area of Trautmann’s triangle. After having exposed and opened the dura, posterior fossa was reached at the level of 7.−8. cranial nerves.

Conclusion:

We described an alternative route which seems to be a feasible way to reach posterior and middle fossa without mastoidectomy and SPS ligation. Notably, this technique can be applicable to petroclival tumor surgery after more anatomic studies with cadaveric specimens.
The mediating role of perceived stress in the relationship between neuroticism and death anxiety among women in Isfahan during the coronavirus pandemic
Authors: Joneghani Neda Amani , Sajjaian Ilnaz
Published: April 2023

BACKGROUND:

The aim of this study was to evaluate the structural modeling of the mediating role of perceived stress in the relationship between neuroticism and death anxiety among 25–50-year-old women during coronavirus infection.

MATERIALS AND METHODS:

The present correlational study was conducted with the presence of 130 people (women) using the available sampling method in Isfahan. The Perceived Stress Scale, BFI Five Factor Scale and Death Anxiety Scale were used to measure the research variables. Data analysis was performed using structural equation modeling, and also SPSS version 23 and Smart PLS3 statistical.

RESULT:

Findings show that the indirect coefficient of neuroticism on death anxiety mediated by perceived stress in the model was significant (P < 0.05) although the mediation rate was partial. Also, in modeling structural equations, the direct effect of perceived stress on death anxiety (0.195), neuroticism on perceived stress (0.305), neuroticism on death anxiety (0.407) were achieved significantly (05/0p).

CONCLUSIONS:

Based on the results of the study, it can be concluded that with increase of neuroticism, death anxiety increases in women and with the entry of perceived stress in this regard and increasing this variable in women, the effect of neuroticism on death anxiety increases. Paying attention to this mechanism can be useful in formulating effective preventive and therapeutic interventions for women to reduce the effects of neuroticism and death anxiety.
VACTERL Association in Kano, North-West Nigeria
Authors: Ahmadu Ibrahim , Abubakar Muhammad Shakur , Asani Mustafa O. , Aliyu Ibrahim
Published: April 2023

VACTERL association is a term used to describe the simultaneous occurrence of at least 3 of the following congenital malformations: vertebral anomalies, anal atresia, cardiac malformation, tracheo-oesophageal fistula, renal dysplasia, and limb abnormalities. Most cases occur sporadically with an estimated incidence rate of 1 in 10,000 – 40,000 births. We report the case of an 11-month-old infant that presented with a complaint of recurrent cough and difficulty in breathing since 1 month of life. There is also the history of delayed motor developmental milestones. Physical examination and investigations revealed the presence of VACTERL association (bilateral talipes equinovarus deformity, multiple cardiac shunt lesions, and malformation of the 5th lumbar vertebrae with dural ectasia and lumbosacral scoliosis). She has been on oral diuretics and is currently on follow-up in pediatric cardiology, orthopedic, and neurosurgery clinics. This case report highlights the presence of a rare case of the VACTERL association in Kano, North-West Nigeria.