bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful closure of the open abdomen utilizing novel technique of dynamic closure system with biologic xenograft
Authors: Puckett Yana , Caballero Beatrice , McReynolds Shirley , Richmond Robyn E. , Ronaghan Catherine A.
Published: May 2024

PURPOSE:

The objective of this study was to demonstrate an alternative option for definitive fascial closure and accelerated wound healing of catastrophic open abdominal wounds utilizing a novel technique combining a mechanical closure system with biologic xenograft.

MATERIALS AND METHODS:

All patients who underwent abdominal closure with a dynamic wound closure system with biologic xenograft were analyzed between 2016 and 2017. ABRA® dynamic wound closure system was placed and adjusted daily until fascial closure was achieved. ACeLL® urinary porcine bladder matrix was placed in midline of wound once fascial closure was achieved. Information was abstracted on patient demographics and extent of open abdomen (OA) and postoperative outcomes.

RESULTS:

Fifty patients underwent novel closure of the OA with mean age of 48.3 years with males comprising 72%. The average body mass index was 35.0. Majority (62%) of OAs were secondary to abdominal sepsis. The average myofascial gap prior to closure of abdomen was 19.0 cm, incision length 28.9 cm, and visceral extrusion 7.7 cm. Prior to installation, the abdomen on average had 3.6 laparotomies and was open for 8.6 days. Primary myofascial closure was achieved in 49/50 (98%) patients; 3/50 (8.3%) developed a hernia. Surgical site infection (SSI) occurred in 4/50 (8%).

CONCLUSION:

We present a novel technique to achieve primary myofascial closure rate in critically ill patients with OA associated with low hernia rate and SSI.
A case report of a combined laparoscopic-open approach to a bladder inguinal hernia and mesh herniorrhaphy
Authors: Pillay Yagan , Naidoo Vimal
Published: May 2024

An inguinoscrotal hernia of the urinary bladder is a rare surgical entity with an incidence of 0.5%–4%, in the literature. Its surgical management may vary given the paucity of information in the published literature. Most herniorrhaphy attempts have been open with some sporadic attempts at a laparoscopic preperitoneal repair. We present a unique combined approach involving a laparoscopic and open-mesh herniorrhaphy. The surgical outcomes are generally good, even in the presence of bladder complications such as necrosis or perforation. One of the advantages of the combined approach is the ability to confirm the pelvic bladder position posthernial reduction without the need for a voiding cystourethrogram. It also allows the surgeon to exclude any bladder injury which may have occurred during bladder reduction.
Chemical abdominal wall release using botulinum toxin A
Authors: Hoffmann Henry , Nowakowski Debora , Kirchhoff Philipp
Published: May 2024

Introduction:

Botulinum Toxin A (BTA) has gained increasing interest in hernia surgery, especially when dealing with complex ventral hernias. The goal of using BTA is the preoperative reduction of the transverse hernia diameter achieving a higher primary fascial closure rate, avoiding a potential additional component separation. However, high evidence data are sparse and the treatment protocols of BTA and patient selection are heterogenic. In this article, we review the most recent literature; discuss indications for BTA, the ideal patient selection, and available BTA protocols. Also, we provide our own data and discuss the potential future role of BTA in treating complex ventral hernias.

Materials and Methods:

We reviewed the available literature and analyzed our own data from patients with complex ventral hernias undergoing preoperative BTA application retrospectively. We present our BTA protocol and measured abdominal wall muscle and hernia parameters before BTA application and before surgery using CT scans.

Results:

In total 22 patients with a median diameter of the incisional hernias of 11.75 cm (IQR 10.9–13.4) were included in our study. BTA administration was performed 4 weeks prior to surgery. In CT scans a significant reduction of the thickness and an elongation of the lateral abdominal wall muscle compartment were seen in all patients. Also, the transverse hernia diameter decreased in all cases from median 11.8 cm (IQR 10.9–13.4) pre-BTA to 9.1 cm (IQR 7.6–10.2) presurgery. Primary fascial closure was achieved in all cases with additional component separation in three cases.

Conclusion:

BTA administration in the lateral abdominal wall muscle compartment is a helpful tool to simplify surgery of complex ventral hernias. It has a visible effect on the muscle parameters in the CT scans and subsequently may increase the rate of primary fascial closure. Further multicenter studies are necessary to gain data with higher evidence.
Endoscopic anterior component separation
Authors: Jørgensen Lars N. , Jensen Kristian Kiim
Published: May 2024

The repair of large incisional hernia is challenging and has evolved at a high pace in recent decades, since Ramirez described the open anterior component separation, dividing the external oblique aponeurosis. Endoscopic anterior component separation is a minimally invasive approach to this technique, which also serves as an adjunct to open repair of large incisional hernia. Popularized by Michael Rosen's group in 2007, this technique has become one of the many important tools every abdominal wall surgeon should master. In the current paper, we review the technique, from preoperative considerations and patient placement to specific technical details, and discuss pitfalls and potential limitations.
The open perforator sparing anterior component separation
Authors: Mughal Maleeha , Ross Daniel , Ross David
Published: May 2024

Hernia surgery, and intra-abdominal surgery in general, have been accompanied by an increased risk of complications, largely due to a combination of operative complexity and obesity. Advances in care following major abdominal trauma, infections and complex abdominal procedures has led to the advent of several techniques that can allow dependable closure of these wider, more difficult defects. Anterior component separation (ACS) is a well-established technique used to achieve fascial closure in complex abdominal wall reconstruction (AWR). Wound related complications in the traditional ACS procedure have been reported to occur in 24%-50% of cases. In a quest to reduce complications and improve wound healing rates, methods have evolved in order to limit the anatomical injury caused by lateral elevation of flaps in the conventional techniques. These techniques involve preservation of the abdominal wall perforators. Thus ensuring appropriate perfusion of the overlying skin flaps. Perforator-sparing techniques have become increasingly important as they reflect greater understanding of how pre-operative planning can aid reduction of surgical risk, wound infection and improve wound healing in patients with complex abdominal wall hernias.
Progressive pneumoperitoneum
Authors: Allaeys Mathias , van Ramshorst Gabrielle H. , Berrevoet Frederik
Published: May 2024

Progressive pneumoperitoneum (PPP) is a technique in which the abdomen is artificially and gradually insufflated over a period of time. The technique was first applied in hernia repair in the 1940s and is now regarded as a useful adjunct in the treatment of complex or giant hernias and those associated with “loss of domain” (LOD). With gradual insufflation, the abdomen becomes progressively distended, promoting soft tissue elongation and preparing it for the post-repair surplus volume of the herniated content. PPP also helps with preoperative pulmonary stabilization and preparation, and it induces pneumatic lysis of intestinal adhesions. In contrast to the longevity of the technique, the heterogeneity in indications and technical variations is remarkable. Indications vary greatly in literature, being either based on clinical judgment or different volumetric cut-off values. Neither is there any consensus on which gas should be used, what volume should be injected, in what frequency, and for how long the pneumoperitoneum should be maintained. There is a clear need for an international consensus concerning LOD hernias and how they are defined. As setting up randomized controlled trials on PPP is not feasible, further research should rely on high-quality observational studies. For reviews and meta-analysis to have any meaningful conclusions, these studies should follow, and adhere to, clear guidelines on the manner of reporting. However, PPP remains a very powerful adjunct in the treatment of large and complex hernias with LOD and has proven its value over time.
Assessment of glaucoma severity and deterioration by using Spaeth/Richman contrast sensitivity (SPARCS) and its correlation with retinal nerve fiber layer thickness and perimetry
Authors: Jinna Shihail , Bhatnagar Kavita R , Jaisingh Kirti , Shakrawal Jyoti , Meena Seema , Agarwal Nikhil
Published: May 2024

Purpose:

To assess the severity of glaucoma and its worsening using Spaeth/Richman contrast sensitivity (SPARCS). To evaluate its correlation with retinal nerve fiber layer thickness (RNFL) and perimetry.

Methods:

In this prospective observational study, 90 eyes of primary open-angle glaucoma were categorized into mild, moderate, and severe glaucoma (30 each). All eyes were subjected to contrast sensitivity measurements by using the Pelli-Robson (PR) chart and SPARCS, Humphrey automated perimetry, and optical coherence tomography (OCT) RNFL, along with routine ophthalmological evaluation at baseline. Contrast sensitivity was repeated at 1, 3, and 6 months. Other investigations were repeated at 6 months. The correlation between contrast sensitivity and other parameters was analyzed at baseline and 6 months.

Results:

Total SPARCS showed a significant positive correlation with visual field index, pattern standard deviation, mean deviation, OCT RNFL, and a negative correlation with best corrected visual acuity. Central SPARCS and PR scores exhibited strong positive correlations. Both total and quadrantic SPARCS significantly reduced from mild to moderate to severe glaucoma. The quadrant-wise SPARCS also correlated well with opposite-side RNFL thickness. At 6 months, SPARCS showed a significant reduction along with RNFL measurements preceding any significant changes in visual field parameters.

Conclusion:

This study establishes SPARCS as a reliable and reproducible tool in assessing the deterioration of visual function in glaucoma patients even before significant perimetric changes. The specific relationship of quadrantic SPARCS with opposite-side RNFL is a novel yet expected finding. The findings advocate integrating SPARCS into routine glaucoma assessment for timely detection of any worsening and prompt intervention, improving the visual outcomes in these patients.
A compressive assessment of patient satisfaction with ophthalmology with ophthalmology clinic services: A study at a tertiary care academic institution amidst and after the COVID-19 pandemic
Authors: Asodariya Ronak , Bhatnagar Kavita R , Tandon Manjari , Jaisingh Kirti , Shakrawal Jyoti , Meena Seema , Pandey Latika
Published: May 2024

Purpose:

The study aims to systematically assess patient satisfaction concerning eye care services provided during and after the coronavirus disease 2019 (COVID-19) pandemic at a tertiary care academic institution. This work seeks to analyze the various dimensions influencing the holistic measure of overall patient contentment.

Methods:

A cohort of 2485 patients seeking physical consultation for ocular conditions at a tertiary care academic institution between April 2020 and December 2022 were recruited in a cross-sectional study. They were divided into two groups, viz. during the COVID period and post-COVID period. The primary focus was on evaluating overall satisfaction, measured through a validated patient satisfaction questionnaire (PSQ-18).

Results:

The study encompassed a total of 2485 participants, with 1242 individuals in the cohort during the COVID period and 1243 in the post-COVID phase. Within the COVID period subgroup, the mean age of male and female patients was 39.46 ± 19.31 and 39.58 ± 19.07 years, respectively. In the post-COVID subgroup, the mean age of male and female patients was 45.26 ± 19.38 and 45.36 ± 19.22 years, respectively. Examining the COVID subgroup, the highest satisfaction scores were observed in the domain of time spent with the doctor (3.3453 ± 0.59), followed by financial aspects (3.0816 ± 0.47), interpersonal manner (3.0589 ± 0.37), and accessibility and convenience (3.0585 ± 0.37). Notably, technical quality received the lowest satisfaction score (2.4763 ± 0.42). A statistically significant difference (P < 0.0001) was noted in the PSQ-18 scores between the two groups. In the post-COVID subgroup, patients expressed higher satisfaction with the technical quality of treatment, irrespective of the mode of management. However, financial satisfaction was better in the COVID group.

Conclusion:

Our study using the PSQ-18 questionnaire highlights significant variations in patient satisfaction with ophthalmology clinic services during and after the COVID era. Notably, time spent with the doctor scored the highest, emphasizing its positive impact. However, addressing concerns related to technical quality is crucial for overall improvement.
Effect of anterior segment structure on vault and position after implantable collamer lens implantation
Authors: Wang Qin , Chen Xiao , Li Li , Zhou Lin , Gao Yang , Shen Li , Peng Shaomin , Zhou Qizhi
Published: May 2024

Purpose:

To evaluate the effect of anterior-segment structure on vault and position after implantable collamer lens (ICL) implantation using ultrasound biomicroscopy.

Methods:

The retrospective case-control study included insufficient vault eyes (<250 µm), ideal vault eyes (250–750 µm), and excessive vault eyes (>750 µm). The preoperative biometric parameters of the anterior-segment structure and basic data between the three groups were analyzed using one-way analysis of variance.

Results:

There were significant differences (P< 0.05) between the three groups in maximum ciliary body thickness (CBTmax), iris-zonule distance (IZD), and trabecular-ciliary angle (TCA). The vault gradually decreased as CBTmaxdecreased and TCA increased. In the pairwise comparison, the CBTmaxcomparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P= 0.024, 95% CI: −0.17–0.017 µm); the TCA comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P= 0.005, 95% CI: 1.78°–12.15°); The IZD comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P= 0.037, 95% CI: 0.0027–0.1119 µm). The analysis of 284 ICL haptics locations showed that there were 16.67%, 32.69%, and 70.83% haptics located in the ciliary sulcus in three groups, respectively.

Conclusion:

The vault and ICL haptics position are related to anterior-segment structure. A thinner and posteriorly positioned ciliary body would increase the risk of low vault and fewer ICL haptics located in the ciliary sulcus after ICL implantation. This provides guidance for the selection of the ICL size and placement position before surgery.
Histopathological findings of anterior lens capsule in pediatric cataract
Authors: Özer Ferhad , İnanç İrem , Kızıltunç Pınar B , Atilla Hüban , Can Belgin
Published: May 2024

Purpose:

To investigate the histopathological findings of the anterior lens capsule in pediatric patients who had surgery for cataracts.

Methods:

This study is a prospective interventional study. Anterior capsule tissue samples that were obtained by the anterior capsulotomy method during phacoemulsification surgery were fixed and examined under a transmission electron microscope.

Results:

Twenty-two eyes of 19 patients who were diagnosed with congenital and juvenile cataracts were included in this study. Five patients had associated systemic diseases, including hydrocephalus, cerebral palsy, prematurity, juvenile myelomonocytic leukemia, and Down’s syndrome. Electron microscopic evaluation demonstrated single-layered epithelium under the capsule, degenerated organelles with round-oval and prismatic-oval nuclei, and degenerated mitochondria and heterochromatin-rich nuclei. In the case with cerebral palsy, collagen fibrils of the connective tissue and fibroblast-like cells were observed replacing the epithelium that should be underneath the capsule in both eyes, and there was a disorganized distribution of collagen fibrils and vacuole structures in the cytoplasm of fibroblast-like cells.

Conclusion:

Similar histopathological findings were found in pediatric cataracts with or without systemic disease except in one cerebral palsy case. The absence of lens epithelium may have been a result of degeneration in this patient, and this can be attributed to the presence of systemic inflammation and gliosis in cerebral palsy. The absence of lens epithelium can play a role in the development of dense subcapsular fibrosis and cataract formation.
Air bubble guide for adequacy of ophthalmic viscosurgical device during phacoemulsification
Authors: Nath Manas , Odayappan Annamalai , Tripathy Koushik , Nachiappan Sivagami
Published: May 2024

Phacoemulsification in hard cataracts is a challenge. The use of dispersive ophthalmic viscosurgical devices (OVDs) to protect the endothelium is a routine step in such scenarios. However, as OVD is transparent, it is difficult to spot within the anterior chamber. Therefore, surgeons may not be aware when the OVD coating of the endothelium disappears during surgery. Consequently, there may be too frequent OVD injections, resulting in a waste of resources. On the contrary, the surgeon may fail to inject OVD at an appropriate time, leading to greater endothelial damage. We propose a novel technique of using an air bubble as a guide that helps in identifying the time when OVD disappears from the anterior chamber, thereby suggesting the surgeon to reinject before proceeding further.
Ultrasound-Guided Hydrodistention with Corticosteroid Instillation in Glenohumeral Joint for Relief in Frozen Shoulder: A Case Series
Authors: Gulati Smita , Singh Aparna , Sharma Kush
Published: May 2024

The frozen shoulder (FS) also known as adhesive capsulitis is one of the most common causes of shoulder pain and disability. It is marked by pain and limitation of movement resulting in progressive deterioration of quality of life. Although a few patients with an FS recover without any intervention, the majority of patients have persistent pain with or without movement restriction. Ultrasound (USG)-guided hydrodistension of the shoulder joint is an upcoming mode of treatment for FS which can theoretically lead to pain relief, functional improvement, and a better quality of life, especially if combined with the anti-inflammatory effects of intra-articular corticosteroids. Here, we are presenting our experience with USG-guided hydrodistention of the shoulder joint along with intra-articular corticosteroid in cases of FS both in terms of objective indices of shoulder functionality and subjective outcomes of pain. Eight patients who presented to the outpatient department of pain medicine in our hospital having FS (stage 2/3) were selected. Outcome measures included pain score, Shoulder Pain and Disability Index (SPADI) and Shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Visual Analogue Scale, and range of movement. Data were collected at baseline, as well as at 6 weeks, 12 weeks, and 6 months. We performed hydrodistension with 30 ml of volume constituted by adding lignocaine and triamcinolone acetate to normal saline immediately, followed by physiotherapy of the shoulder joint and cryotherapy. We found promising results with all our patients both in the short term as well as long term with both SPADI and QuickDASH scores as well as the range of motion of the shoulder joint improving significantly in all eight patients at 6 weeks and 12 weeks. This improvement notably persisted in all the patients when reassessed at 6 months indicating a long-term benefit of the intervention.
Research on clinical aspects of bipolar disorder: A review of Indian studies
Authors: Narula Sharon , Pal Arghya , Reddy MS , Mahajan Sudhir L.
Published: May 2024

Background:

Bipolar disorder is one of the severe mental disorders that are associated with significant morbidity of the patients. Despite advancements in our understanding about the disorder, it remains a challenging proposition to treat bipolar disorder, largely since the prophylactic treatment of the disorder requires assessment of complex clinical algorithms. The revisions of the classificatory systems have also changed the conceptualization of the disorder. In this background, we conducted a review of the Indian studies conducted on the clinical aspects of bipolar disorder.

Methods:

A narrative review was conducted with focus on the literature published from India. The databases searched included PubMed, Scopus, and Google Scholar, and articles published over the last 15 years by Indian authors were included for this review.

Results:

In our review, we could access a substantial volume of research published from India. We could identify studies that catered to most of the relevant themes in bipolar disorder including epidemiology, etiology, comorbidities, stigma, disability, clinical course, cognitive profile, pathways to care, and recovery.

Conclusion:

The research trajectory was in line with the research conducted elsewhere in the world. However, certain dissimilarities in terms of focus could also be observed. The possible reason behind this deviation could be the difference in clinical need and unique challenges faced in the management and rehabilitation of patients in bipolar disorder in Indian scenario.
How severe are ocular surface abnormalities 3 months following cataract surgery? An observational study
Authors: Undrakonda Vivekanand , Koyi Amulya , Kamireddy Krishnapriya , Lobo Sarita
Published: May 2024

Aim:

The aim of this study was to detect the pattern of ocular surface changes seen 3 months after undergoing phacoemulsification or manual small-incision cataract surgery (SICS) and match them with age-matched normal individuals.

Materials and Methods:

A prospective observational study was conducted in the ophthalmology outpatient department (OPD) in a tertiary care center. Consecutive patients coming to OPD were grouped into three study groups – Group 1 included 25 patients who had undergone manual SICS, Group 2 included patients who had undergone clear corneal phacoemulsification surgery, and Group 3 included age-matched controls. Patients with ocular and systemic diseases were excluded. All the patients underwent Schirmer’s test, tear film breakup time, ocular surface staining, and ocular surface disease index score. One-way analysis of variance test was used for the comparison of data, and P = 0.05 or less was considered to indicate a significant difference.

Results:

Significant dry eye changes after 3 months of cataract surgery were present in SICS and Phacoemulsification groups as compared to age-matched normals (p-value < 0.05), but there was no significant difference between SICS and PHACOEMULSIFICATION surgery groups in the incidence of dry eye incidence.

Conclusion:

Dry eye symptoms are significant following cataract surgery irrespective of the type of surgery either SICS or phacoemulsification.
Pupil cycle time and its significance in patients with diabetic retinopathy
Authors: Kalita Prasenjit , Gogoi Ankita , Bhuyan Jyoti , Boro Manjit
Published: May 2024

Context:

Prolonged pupil cycle time (PCT) is a complication of type II diabetes and becomes more protracted as the disease progresses. PCT can be used as a quick and accurate clinical test to determine how much autonomic neuropathy is influencing a diabetic patient’s pupil.

Aims:

The aim of the study was to compare the PCT of type II diabetes patients with that of the healthy control group and analyze the impact of several factors, including age, sex, duration of diabetes, and grade of diabetic retinopathy on PCT.

Settings and Design:

The study was conducted from August 2022 to August 2023. One hundred people were arbitrarily selected, 50 of whom had diabetes and 50 healthy controls.

Subjects and Methods:

To start rhythmic cycles of contraction and relaxation, a narrow, horizontally aligned beam of fixed proportions was focused on the inferior area of the pupil. The cycle period was then monitored in milliseconds using a handheld stopwatch. The mean PCT of diabetics was compared with nondiabetics and its correlation with different variables such as age, sex, diabetes duration, and grade of retinopathy was done.

Results:

Fifty diabetic patients (28 females and 22 males) aged 42–74 years and 50 controls (32 females and 18 males) aged 44–70 were included in the study. The mean PCT of the diabetics was 1130 ± 186 ms, whereas it was 940 ± 132 ms in the controls; thus, the mean PCT was longer in the diabetics. It was also found that the mean PCT increased with increasing grades of retinopathy. A positive correlation was also noted between mean PCT and duration of diabetes.

Conclusions:

PCT is a fast, simple, and reliable clinical test of optic nerve function. Being objective and quantifiable for each eye separately is a huge benefit. The PCT measurements might be used in the clinical evaluation of an autonomic nervous system. It is a simple, inexpensive yet quick, and effective tool to assess pupillary autonomic neuropathy in the diabetics.
Typical cytomegalovirus retinitis in non-human immunodeficiency virus partially immunosuppressed patients: A case series
Authors: Singh Alok Pratap , Pandharipande Archit Sunil , Ojha Anubha , Yadav Sanjeev , Behera Manas R. , Sharma Kumudini
Published: May 2024

Purpose:

The purpose of the study was to analyze the occurrence of severe, typical cytomegalovirus (CMV) retinitis (CMVR) in human immunodeficiency virus (HIV) negative, partially immunosuppressed patients, emphasizing inconsistency in the clinical presentation of CMVR and to evaluate the role of combined anti-CMV therapy in the management of such patients.

Materials and Methods:

This study was a retrospective, observational, noncomparative case series. We examined and treated consecutive HIV-negative adult patients of CMVR. Blood-based polymerase chain reaction analysis of the CMV genome was done pre- and posttreatment. Details of underlying systemic conditions were collected. Patients were treated with simultaneous administration of intravitreal and intravenous (IV) anti-CMV therapy. Follow-up was for 1 year. All outcomes were determined retrospectively.

Results:

A total of 6 eyes of 4 consecutive patients were diagnosed with CMVR in HIV-negative patients. Patients were only partially immunosuppressed but revealed typical severe fulminant CMVR. Patients received a total of 2 intravitreal ganciclovir injections, and IV ganciclovir/oral valganciclovir was given. All patients achieved complete healing within the treatment period.

Conclusion:

As opposed to the general perception, typical, fulminant, severe CMVR may occur in patients with limited immune dysfunction. Our report underlines this inconsistency in the clinical presentation of CMVR in partially immunosuppressed patients. The immune status of the patients seems a significant factor in determining the clinical phenotypes of CMVR. Combined intravitreal and IV ganciclovir/oral valganciclovir therapy was successful in treating this group of CMVR patients.
Clinical study of ocular manifestations in patients with newly diagnosed and relapsed hematolymphoid malignancies at a tertiary care hospital
Authors: Honniganur Deepthi Rameshbabu , Pradeep Thanuja Gopal , Devadas Santhosh Kumar
Published: May 2024

Objectives:

To estimate the proportion of ocular manifestations in new and relapsed cases of various hematolymphoid malignancies and to determine an association between these ocular manifestations and the hematological parameters of the patients.

Materials and Methods:

The study was conducted in the department of ophthalmology in association with medical oncology. All patients with newly diagnosed or presenting with a relapse of hematolymphoid malignancies underwent a complete ocular evaluation.

Results:

A total of 63 patients were included in this study. The mean age of the patients was 34.71 ± 19.80 years. Acute myeloid leukemia and B-ALL accounted for 73% of the cases. At the time of examination, 47.61% of patients (n = 30) were newly diagnosed and 52.38% (n = 33) had relapsed. Acute leukemias had more probability of having ocular manifestations than chronic leukemias (P = 0.01). Subconjunctival hemorrhage was found to be the most common anterior segment finding (n = 10, 15.87%; P = 0.05). The most common posterior segment finding seen in both the right and left eyes was dot blot hemorrhages (n = 20). Those patients who had hemoglobin counts <6.5 mg/dl had the most ophthalmic manifestations (n = 20); of which Roth spots were seen the most (n = 6; P = 0.04). And those who had platelet counts <50,000 cells/cumm presented with Roth spots (n = 6, P = 0.05) followed by subretinal hemorrhages (n = 5, P = 0.05) and preretinal hemorrhages (n = 5, P = 0.05).

Conclusion:

Screening to detect ocular manifestations is of importance in hematolymphoid malignancy, especially in newly detected and relapsed cases. A complete ocular examination is recommended in these patients, as most patients are asymptomatic and ocular manifestation could be an early sign of worsening of the disease. Among the various blood parameters, low hemoglobin and platelet counts are definite indicators of the presence of intraretinal bleeding manifestations.
The burden of non-communicable diseases: A scoping review focus on the context of India
Authors: Ramesh Swathi , Kosalram Kalpana
Published: May 2024

The mortality rate of non-communicable diseases (NCDs) contributes more in low-income and middle-income countries, also among individuals with lower socioeconomic status in high-income countries, making NCDs a big hurdle to minimizing global and national health disparities. Among 55 million fatalities worldwide in 2019, NCDs accounted for about 41 million (71%) deaths. The purpose of this scoping review was to comprehend the available literature on the burden of NCDs in India. This review included the studies that have been published between the period of 2009–2020. For this review, 18 full-text articles have been selected. A preliminary search was done to obtain articles from the search engines such as PubMed, Google Scholar, web of science, and Scopus. Our scoping review was focused on five major NCDs which are cardiovascular, hypertension, diabetes, cancer, and stroke. In 2019, around 17.9 million individuals died from cardiovascular disease (CVD), which is accounting for 32% of all deaths. As compared to Chandigarh and Jharkhand (0.12 million and 0.96 million, respectively) Tamil Nadu and Maharashtra (4.8 million and 9.2 million, respectively) have a higher percentage of the population affected by diabetes. In India, stroke is the fifth-significant cause of disability and the fourth-leading cause of fatality, which is accounting for 3.5 percent of all disabilities. India should construct a higher-level coordinating framework and devise an overarching policy or strategy tailored to NCDs. To limit risk factor exposure, it is necessary to emphasize health promotion and preventive actions.
Prevalence of acute low back pain with risk of long-term disability and its correlates among medical students: A cross-sectional study
Authors: Shekhar Saket , Rao Rajath , Nirala Santosh Kumar , Naik Bijaya Nanda , Singh Chandramani , Pandey Sanjay
Published: May 2024

BACKGROUND:

Low back pain (LBP) is responsible for the highest number of years lived with disability globally. There is a paucity of data regarding the same among medical students. So, this study was planned to estimate the prevalence of acute LBP having a high propensity to develop into chronic one as well as to determine associated correlates among medical students.

MATERIALS AND METHODS:

This cross-sectional study was conducted among 300 medical students at a tertiary hospital using an Acute Low Back Pain Screening Questionnaire (ALBPSQ) to identify individuals with LBP and having a high risk of developing a long-term disability. ALBPSQ is a 21-question-based biopsychosocial screening instrument for identifying patients at risk of chronicity. ALBPSQ scores have been found to be significantly associated with pain and functional disability. Descriptive statistics, bivariate analysis, and multiple binary logistic regression have been performed through SPSS-22 software.

RESULTS:

The prevalence of LBP having the propensity to develop into a long-term disability was found to be 14.3% (95% CI: 10.6–18.8). In bivariate analysis, higher age, no exercise, higher screen time, mental stress, studying in bed, abnormal posture, alcohol intake, tobacco use, positive family history, greater screen time per day, and more time spent in a sitting posture are significant with LBP. Stress ((adjusted odds ratio) AOR: 4.37, 95% CI: 1.79–10.68)), abnormally bent standing posture (AOR: 3.6, 95% CI: 1.3–10.6), and positive family of LBP (AOR: 3.6, 95% CI: 1.3–10.1) were found to be independent predictors of LBP among medical students.

CONCLUSION:

Among medical students, every 15 out of 100 have a low back problem with chances of long-term disability. These students require early intervention to avoid long-term disability. Abnormal stooping posture, psychological stress, and positive family history of low pain might independently lead to LBP.
Nursing students and faculty perception of academic incivility: A descriptive qualitative study
Authors: Ehsani Maryam , Farzi Sedigheh , Farzi Fatemeh , Babaei Sima , Heidari Zeinab , Mohammadi Fatemeh
Published: May 2024

BACKGROUND:

Incivility is one of the significant challenges that affect nursing education. Uncivil behaviors have a significant upward trend compared to the past in nursing education. This study was conducted to explore academic incivility from the perspective of nursing students and faculty.

MATERIALS AND METHODS:

This study was conducted in 2021 using a descriptive qualitative method. Fifteen baccalaureate nursing students and six faculty were selected using purposeful sampling method. Data was collected through in-depth semi-structured interviews, and a qualitative content analysis was applied for data analysis.

RESULTS:

Data analysis revealed four categories, namely, ineffective teaching–learning, inapposite/unreasonable requests, behaviors disrupting mutually respectful environment, and academic dishonesty, and 14 subcategories.

CONCLUSION:

To reduce incivility, closer attention needs to be paid to the admission of faculty as well as training them to use effective communication techniques and interactive teaching methods. In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore, clear and precise rules and regulations concerning incivility incidence should be developed and implemented in the universities.
Requirements for promoting help-seeking behaviors in family caregivers of cancer patients: A qualitative study
Authors: Hamedani Behzad , Alavi Mousa , Taleghani Fariba , Fereidooni Moghadam Malek
Published: May 2024

BACKGROUND:

Caring for a family member with cancer is a challenging issue for families. Family caregivers often need the help of supportive resources to solve problems in their care role. A deep understanding of the requirements of caregivers to seek help is an effective step toward their ability to use supportive resources. This study aimed to identify and describe the requirements for promoting help-seeking behaviors in Iranian family caregivers of cancer patients.

MATERIALS AND METHODS:

This qualitative study was conducted through in-depth semi-structured interviews with 28 participants selected using purposeful sampling method from 2019 to 2021. An interview guide with general questions about seeking help was used to maintain coherence in data collection. The interviews continued until data saturation. All interviews were recorded, transcribed and analyzed through qualitative content analysis.

RESULTS:

The requirements of promoting help-seeking behaviors in family caregivers were grouped into four main categories: (1) improving social paths toward seeking help, (2) spiritual-psychological-cognitive empowerment toward seeking help, (3) strengthening the motivations behind seeking help, and (4) modifying the perception of cultural barriers to seeking help.

CONCLUSION:

According to the results of this study, it is expected that by identifying the requirements of caregivers for seeking help and by health stakeholders designing comprehensive programs to address these needs, caregivers will be empowered to use supportive resources and provide a better care role.
Facilitators of improving the function of nongovernmental organizations (NGOs) in Iran's health system
Authors: Rajabi Mohanna , Ebrahimi Parvin , Aryankhesal Aidin
Published: May 2024

BACKGROUND:

Iranian health nongovernmental organizations (NGOs) could play a variety of roles at many levels of Iran's health system, but their participation in the health sector is far from ideal. Therefore, this study was conducted to identify practical solutions for increasing the role and function of NGOs in the Iranian health system.

MATERIALS AND METHODS:

This qualitative study was conducted between 2020 and 2021 in Tehran, Iran. The data for this study were gathered through 32 in-depth semi-structured interviews with 11 managers from the Ministry of Health as well as from Iran and Tehran universities of medical sciences and 21 Chief executive officers and directors of health NGOs. Data were analyzed by the content analysis approach using the MAXQDA 10 software.

RESULTS:

The facilitators for expanding the function and roles of NGOs in Iran's health system are classified into two groups of legal and structural mechanisms. “The existence of mandatory laws,” “government support for NGOs,” “the formulation of standard strategic planning and goals,” “the establishment of a database and a network of NGOs,” and “the establishment of independent organizational units as the connectors and coordinators of NGOs' affairs in the public sector” are the critical facilitators for the improvement of NGOs' roles in Iran's health system.

CONCLUSION:

According to the findings of this study, only limited measures and efforts have been made to improve NGOs' roles and participation in the Iranian health system; at the same time, NGOs' participation in the health sector is far from ideal. Iranian health NGOs are at the beginning of this route, and they would inevitably require various legislative and structural mechanisms to succeed.
The effectiveness of digital storytelling in teaching medical information searching
Authors: Nouri Mohsen , Shahmoradi Leila , Mohammadi Aeen , Soleimani Hojat O. , Mojtahedzadeh Rita
Published: May 2024

BACKGROUND:

Novel technologies development has created a new path for education. Digital storytelling (DST) is one of the educational approaches used in universities and scientific centers. We aimed to investigate the effect of DST on Scientific Information Search (SIS) and Information Seeking Anxiety (ISA) in students.

MATERIALS AND METHODS:

This mixed-method study utilized the pre-test-post-test method containing test and control groups. We used the simple random sampling method (available) and used the formula to determine the sample size. Forty-two people participated in the study. A researcher-made questionnaire was used to collect SIS data and standard questionnaire for ISA data. The teaching approaches were accomplished using DST and the conventional methods in test and control groups, respectively. Using SPSS v. 22, we did paired-sample T-test and independent sample T-test to compare the mean score in before and after intervention in each group. Also Analysis of Covariancetest was used for considering post-test result as dependent variable, groups as independent variables and pre-test score as covariate.

RESULTS:

The results showed significant changes in mean score between the post-test and pre-test of both questionnaire in both groups. Also, in the post-test, compared to the control group, the experimental group obtained higher scores forSIS, which was statistically significant, and obtained lower scores forISA, but it was not statistically significant.

CONCLUSIONS:

It can be concluded that the DST method has a positive impact on learning and reducingISAcompared to the conventional ones, and students' interest and participation in learning have increased using DST method.
Elucidating experiences of faculty members in applying effective teaching strategies in the online class during the COVID-9: A qualitative study
Authors: Rezaei Habibolah , Ramezani Ghobad , Koohestani Hamid Reza , Zazoly Atefeh Zabihi , Taghavinia Mansoureh , Shirazi Mohammad Khabaz , Ostovarfar Maral , Baghcheghi Nayereh , Keshavarzi Mohammad Hasan
Published: May 2024

BACKGROUND:

Despite the restrictions on providing medical courses online in medical universities, all instructors were required to provide training on virtual platforms. This study aimed to explain faculty members' experiences applying effective strategies in online class teaching.

MATERIALS AND METHODS:

This study has been done with a qualitative approach and using the method of conventional content analysis. Participants included 14 faculty members working at the Shiraz University of Medical Sciences. Semistructured interviews were used to collect data. Faculty members who had experience in conducting online classes were purposefully selected. Graneheim and Lundman's (2004) approach was used to analyze interview data.

RESULTS:

Two main categories were obtained from the data analysis: interpersonal communication and supportive behavior. The category of interpersonal communications comprises the subcategories of emotional expression and flexibility. The category of supportive behavior includes the subcategories of educational design, learner encouragement, diversity in evaluation, collaborative learning, and prompt feedback.

CONCLUSION:

Our findings confirmed that an appropriate teaching strategy leads to better attention to class and deep learning in learners. The cause is that in online classes, the student's attention is more minor than in daily classes due to its virtual nature. Appropriate educational strategies will motivate learners, interest them, and improve teacher interaction. These strategies increase students' participation in educational activities.
Attitude and perceptions of the faculty toward use of LMS in a tertiary medical college: An interventional study
Authors: Palve Suchitra S. , Palve Sachin B.
Published: May 2024

BACKGROUND:

E-learning has become a new technique of instructional strategy during the current instructional era where we are surrounded with the uncertainty of pandemic outbreak and unrest in the educational system.

AIM AND OBJECTIVES:

To analyze and modulate the attitude and perception of the faculty towards the use of the Learning Management System for teaching and learning.

MATERIALS AND METHODS:

This descriptive cross-sectional study was conducted among 112 faculty members of Symbiosis Medical College for Women Pune. An elaborated research tool was designed to measure the attitudes and perception of the faculty members toward the use of the learning management system in teaching. The research tool was administered before and after the LMS sensitization workshop to all the participants. Workshop was planned to sensitize faculty regarding MOODLE (E-learning platform)

RESULTS:

Statically, significant change in the mindset of the faculty members was found after sensitization workshop regarding incorporating LMS as an instructional method. Statistically, significant variations were found in the attitude toward using LMS based on gender variation, (0.021, F = 5341), experience (0.033, F = 0.189), and discipline (0.052, F = 0.233). Based on the themes derived from responses faculty felt that training and sensitization will help them to use LMS more effectively.

CONCLUSION:

Use of blended learning strategies are need of an hour, there are lot of problems which can be faced by the faculty members while incorporating use of LMS in their routine teaching process. Training sessions for implementing any e-learning platform should be done on priority basis to increase its use more effectively.
Prevalence, diagnosis and treatment of Helicobacter pylori infection in Nigeria
Authors: Smith Stella I. , Ajayi Abraham , Jolaiya Tolulope F. , Essiet Utibeima
Published: May 2024

Helicobacter pyloriinfection remains a major health concern around the world as untreated infection can lead to gastric cancer. The burden ofH. pyloriinfection in Nigeria is high (87.7%) with the northern part of the country having a higher prevalence compared to other regions of the country. Methods comprising invasive and non-invasive approach are widely used around the country for the diagnosis ofH. pyloriinfection. However, data on use of culture which gives the advantage of antimicrobial susceptibility testing is limited. Treatment and management ofH. pyloriin Nigeria is becoming difficult as the rate of resistance to antibiotics is on the rise. This review highlights key findings on the incidence, diagnosis and treatment ofH. pyloriinfection in Nigeria.
Rectal xanthomatous polyp within the context of a normal serum lipid Profile: A case report
Authors: Rahman Adam Tolulope , Asaolu Olutoyin Iretiola , Ezenkwa Uchenna Simon
Published: May 2024

A xanthoma is a localized mass-forming collection of lipid-bearing cells (foamy histiocytes). They are uncommon in the gastrointestinal tract and reports among Nigerians are rarer. We present here a case of a 50-year-old hypertensive man, who had screening colonoscopy on account of positive fecal immunochemical test during a general health checkup. His clinical history and examination findings were unremarkable. He had marginally elevated plasma glucose values, but normal lipid profile. Findings at colonoscopy were a rectal polyp and erythematous patches in the transverse colon. The histology revealed lamina propria collections of foamy histiocytes, negative for periodic acid Schiff.
Soghin clinical practice guidelines for hepatocellular carcinoma
Authors: Ndububa Dennis Amojuaji , Abdulkareem Fatimah Biade , Mustapha Shettima Kagu , Ekwunife Christopher N , Omuemu Casimir Erhunmwun
Published: May 2024

HCC accounts for over 90% of primary liver cancers and 7% of all cancers from all sites worldwide. In Nigeria, HCC develops at a younger age compared to the developed world and co-exists with liver cirrhosis in about 80% of cases. The prognosis is dismal because the majority of HCC patients present with advanced disease, when only symptomatic treatment could be given. These Clinical Practice Guidelines contains extensive review of relevant data and provide practitioners in this resource-limited setting with the necessary information that would help detect liver cancer at early stages, when there is a possibility of cure, as well as assist in selecting patients, whose survival may be significantly prolonged, for treatment.