bluuebunny/crossref_metadata_2025 huggingface dataset:
The world-wide spread of carbapenem-resistant Enterobacterales
Authors: TAMBIC ANDRASEVIC Arjana , ANTAL ANTUNOVIC Ivana
Published: June 2021

Introduction. Gram-negative bacilli belonging to the order Enterobacterales are normal inhabitants of the human gut, which also are the most common causative agents of both nosocomial and community-acquired infections in patients of all ages.  Although not even a century has passed since Fleming's discovery of penicillin, the scientists have been alarmed by the fact that the "last resort antibiotics" viz. carbapenems have been compromised.

Material and methods. The analysis of fifty-two articles and documents regarding this topic was performed.

Results. The main mechanism of resistance to carbapenems in Enterobacterales is the production of carbapenemases, being enzymes that destroy all or almost all β-lactam antibiotics including carbapenems. According to Ambler’s classification β-lactamases can be distributed into four classes (A, B, C, and D) being based on primary amino acid sequence homology.  The most important carbapenemases produced by Enterobacterales belong to class A (KPC), class B (metallo-β-lactamases NDM, VIM, IMP) and class D (OXA-48-like). Unlike other mechanisms of resistance, carbapenemase production is easily spread via plasmids making carbapenemase-producing Enterobacterales (CPE) a global challenge for healthcare providers.

Conclusions. CPE is not readily detected in the laboratory but the ability to detect carbapenemase production in Enterobacterales has very important infection control implications and therefore is essential for local infection control programs and national and international surveillance systems. Furthermore, local epidemiology of multidrug-resistant organisms has a major influence on the development of national clinical guidelines for antimicrobial use.
Storms, Variability, and Multiple Equilibria on Hot Jupiters
Authors: Cho James Y-K. , Skinner Jack W. , Thrastarson Heidar Th.
Published: June 2021

Observations of hot-Jupiter atmospheres show large variations in the location of the “hot spot” and the amplitude of spectral features. Atmospheric flow simulations using the commonly employed forcing and initialization have generally produced a large, monolithic patch of nearly stationary hot area located eastward of the substellar point at high altitude. Here we perform high-resolution (T682) pseudospectral simulations that accurately capture small-scale eddies and waves inherent in hot-Jupiter atmospheres due to ageostrophy. The atmospheres contain a large number of intense storms over a wide range of scales, including the planetary scale. The latter sized storms dictate the large-scale spatial distribution and temporal variability of hot, as well as cold, regions over the planet. In addition, they exhibit quasi-periodic life cycles within multiple equilibrium states—all identifiable in the disk-integrated time series of the temperature flux.
Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea: 2020 Revised Edition
Authors: Jung Hye-Kyung , Kang Seung Joo , Lee Yong Chan , Yang Hyo-Joon , Park Seon-Young , Shin Cheol Min , Kim Sung Eun , Lim Hyun Chul , Kim Jie-Hyun , Nam Su Youn , Shin Woon Geon , Park Jae Myung , Choi Il Ju , Kim Jae Gyu , Choi Miyoung ,   Korean College of Helicobacter and Upper Gastrointesinal Research
Published: June 2021

Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence.
Guidelines for Safe Drug Use
Authors: Kim Su Hyun , Jung Hye-Kyung , Shin Ein-Soon , Lee Jin Seo , Ryu Yon Ju , Hong Kyoung Sup , Bang Soo Mee , Chang Yoon-Seok , Kim Chan Kyu , Lee Byung Wan , Hong Seung-Jae , Kim Chang Oh ,   Clinical Practice Guidelines Committee of the Korean Association of Internal Medicine
Published: June 2021

Background/Aims: In Korea, medications are available by prescription from a physician, or can be purchased over-the-counter (OTC) without a prescription. Education regarding both prescribed and OTC drugs is important to minimize side effects and avoid drug abuse. The risk of side effects due to polypharmacy is increasing due to the growing number of elderly patients with comorbidities.Methods: There are various clinical guidelines for physicians, but it is difficult for patients and their caregivers to find published guidelines regarding drug use. In this regard, experts from nine subspecialties of internal medicine, geriatric medicine, and guideline development methodology formed a working group to develop guidelines for safe drug use under the Clinical Practice Guidelines Committee of the Korean Association of Internal Medicine.Results: The main contents of this guideline are 1) safe and effective drug administration, 2) the proper use of analgesics (acetaminophen and nonsteroidal anti-inflammatory drugs), 3) the proper use of tranquilizers and sleeping pills to prevent drug abuse, 4) points to be aware of when taking multiple medications.Conclusions: The guidelines were developed for patients and their caregivers to understand the general principles and precautions for drug use, including commonly used painkillers, mood stabilizers, sleeping pills, and polypharmacy. These guidelines could also be used as educational materials for physicians, nurses, and healthcare workers to educate patients and their caregivers.
L’intégration des services sociaux pour les groupes vulnérables : un enjeu d’ordre public
Authors: Richardson Dominic , Thévenon Olivier
Published: June 2021

Les populations vulnérables connaissent souvent des besoins complexes qui exigent de multiples interventions. Pour aider ces populations de façon effective, et de façon efficace du point de vue de l’État, beaucoup de pays visent à réaliser une meilleure intégration des services sociaux. Ce chapitre examine les enjeux liés à une telle intégration.
La haine dans le bébé
Authors: Le Nestour Annick
Published: June 2021

L’auteur s’intéresse à l’intrication des pulsions d’amour et de haine chez le bébé qu’il illustre par des observations cliniques, montrant que l’environnement joue un rôle prépondérant.
La haine : une passion actuelle. Questions à l’anthropologie clinique
Authors: Douville Olivier , Le Fourn Jean-Yves , Lauru Didier
Published: June 2021

Olivier Douville, Jean-Yves Le Fourn et Didier Lauru s’accordent sur cela que la haine est une notion-clé en psychanalyse qui doit être envisagée autrement que comme l’envers de l’amour. Une haine primordiale est au service de l’autoconservation d’un moi idéal, et « purifié » hostile à toute intrusion par l’étranger et l’altérité. Cette définition, qui éclaire les racines inconscientes de la haine, permet également de théoriser les solutions sociales qui incitent à conserver cet idéal d’une pureté cruelle. L’apport de la psychanalyse à l’anthropologie serait bien de situer les irruptions et les variations de cette passion dans le rapport du sujet à ses croyances et à ses allégeances et dans ses volontés de faire Un avec un groupe, un idéal, une cause. Observant la sensibilité et l’appétence des adolescents vivant en des temps de tourments et de violence extrême pour les affiliations valorisant la haine, et alertés en ceci que cette haine est une passion froide (à l’inverse de la jalousie), les auteurs élaborent des hypothèses sur les liens ente haine, honte et « mélancolisation du lien social ».
Arthur Rimbaud et sa « Mother ». Fragments de discours de haine
Authors: Le Fourn Jean-Yves
Published: June 2021

Rimbaud, le poète, le « voyant », fut tout au long de sa vie, de l’enfance à l’âge adulte, en passant par son adolescence, accompagné par la Haine. Haine envers ses origines, Haine de l’injustice, Haine dans ses relations personnelles, la haine fut le vrai compagnon de sa vie. La haine lui a été « utile », tant dans sa vie de poète, que d’homme. Elle fut son « sentiment de lucidité », mais aussi sa « saison en enfer » permanente.
Haine à l’école, Jordan a l’seum
Authors: Faure-Fillastre Odile , Chevallier Marc
Published: June 2021

Présentation du parcours, à l’école primaire, de Jordan qui a le seum/la haine. Il accédera très difficilement aux apprentissages en raison de difficultés majeures relationnelles et d’adaptation aux modalités de scolarité, malgré les aides et accompagnements divers mis en place à différentes étapes par les équipes pédagogiques puis médico-sociales. L’évolution de l’école, pour faire face à des comportements violents d’élèves, a produit de nombreuses réformes qui visent l’égalité des chances mais peinent à y parvenir.
L’hainamoration à l’adolescence
Authors: Lauru Didier
Published: June 2021

La haine est un affect essentiel que nous rencontrons fréquemment dans la clinique avec les adolescents. Ce peut être la haine de soi, comme la haine de l’autre, ce qui donne des situations cliniques très variées souvent au travers de passages à l’acte. L’hainamoration est un fait clinique qui consiste en une coexistence de la haine et de l’amour chez le même sujet. La thérapie analytique est une approche intéressante pour aider les adolescents à penser leur violence et les origines de leur haine.
L’errance de Fabien : mélancolisation de la haine et culture populaire
Authors: Sylla Arnaud
Published: June 2021

Si l’adolescent, en tant que construction sociale, n’est pas attendu pour ce qu’il est en devenir mais pour ce qu’il produit comme angoisses projectives du corps social, comment dès lors le sujet pris dans ce processus peut-il attraper des signifiants nouveaux pour se démarquer et se singulariser ? Le récit clinique de la rencontre d’un adolescent en marge de lien social nous permettra d’interroger la place des objets de culture dans un processus adolescent en impasse. La haine et le trauma y figurent comme éléments structurels des mangas de type Shonen , lesquels serviront de trame dans le cheminement thérapeutique. La culture sera envisagée au service d’une restauration du lien social en soutenant un processus d’individuation et donc une capacité à se séparer en sécurité.
La haine comme résultante d’un manque de reconnaissance
Authors: Collin Philippe
Published: June 2021

La haine renvoie à un sentiment violent de rejet et de volonté de nuire à l’autre. Dans l’exercice de mon métier de travailleur social, j’ai rarement été confronté à des situations de haine dans lesquelles j’ai pu me sentir agressé. Les personnes prises dans cet état exprimaient un fort ressentiment qui parfois n’arrivait pas à définir son objet. C’était le cas d’adolescents lorsque j’intervenais sur des dispositifs de protection de l’enfance. Être confronté à ces situations est difficile pour les professionnels. C’est pourquoi, lorsque j’ai pris des responsabilités de direction d’établissement d’accueil pour des adolescents, j’ai favorisé la mise en place d’une culture institutionnelle permettant l’élaboration d’une pensée et l’engagement des professionnels. Pour sortir de ces situations de haine, les prestations de soin et d’éducatif doivent intégrer une dimension de reconnaissance de la personne en difficulté.
Être soignant dans une unité de double prise en charge somato-psychiatrique au sein d’un service de médecine de l’adolescent
Authors: Gilormini Graziella , Bensoussan Anne-Laure , Laurent Élodie , Vincent Magali , Zanini Than , Celton Marie-Thérèse , Marbot Caroline , Lovic Blanca , Tres Aurélie , Beunas Jean-Marie , Breugnot Catherine
Published: June 2021

Cet article est le fruit d’un travail de réflexion d’une équipe de soignants, d’infirmiers et d’aides-soignants, travaillant au sein d’une unité singulière de double prise en charge en médecine de l’adolescent, dans un établissement de la Fondation Santé des Étudiants de France. Du fait du cadre particulier de leur exercice, de la population adolescente accueillie, les soignants ont développé une identité professionnelle spécifique à laquelle ils se proposent de réfléchir.
Numérique et innovations pédagogiques en sciences de gestion : résultats de recherches
Authors: Chevalier Françoise , Fournier Christophe
Published: June 2021

Cet éditorial est une introduction au dossier spécial « Numérique et innovations pédagogiques en sciences de gestion : résultats de recherches ». Outre le fait de présenter les 3 articles retenus suis au processus scientifique, les rédacteurs en chef invités font le point sur l’innovation pédagogique notamment numérique, aux enjeux majeurs et stratégiques pour nos institutions, et ce, indépendamment de la crise sanitaire actuelle. Cet éditorial s’articule autour de trois points. Le premier rappelle la difficulté de mener des recherches dans le domaine des innovations pédagogiques numériques, tant le domaine est foisonnant et ses contours mouvants. Le deuxième est consacré à la variété des innovations pédagogiques numériques mises en œuvre et soulève l’épineuse question des modes d’évaluation de ces innovations. Enfin, le troisième point introduit les articles présentés dans ce dossier qui, chacun dans un domaine (marketing/vente, comptabilité/contrôle et ressources humaines), relate les résultats de recherche sur la mise en œuvre d’innovations pédagogiques faisant appel au numérique.
Le modèle d’ « organizing » de Weick : un cadre pertinent pour l’analyse de l’enseignement à distance
Authors: Marsal Christine
Published: June 2021

Les exigences de l’économie de la connaissance, l’élévation régulière des qualifications requises pour exercer tel ou tel métier, nécessitent la mise en place de dispositifs de formation tout au long de la vie. Les dispositifs d’enseignement à distance tels que MOOC 1 , SPOC 2 , enseignements hybrides font l’objet d’une attention soutenue tant de la part des managers que des professionnels de l’éducation. Ces dispositifs s’inscrivent dans un environnement variable, ambigu dans lequel le statut de connaissance pertinente évolue régulièrement. De fait, les enseignements à distance peuvent être source de désordre, d’ambiguïté et d’équivocité. L’utilisation du cadre théorique de Weick (1995,2001) concerne précisément l’équivocité de l’environnement. Dans ce contexte, nous cherchons à mieux connaître la systémique actions/interactions dans le cadre de deux dispositifs d’enseignement en comptabilité. Les résultats indiquent que le processus de création de sens se construit essentiellement sur les actions proposées. La phase d’équivocité semble être plus « longue » dans les enseignements à distance. Les étudiants à distance consultent moins les ressources du cours, interagissent moins entre eux, et obtiennent de moins bons résultats académiques.
Technique et méthode chez Aristote
Authors: Stephanou Henri
Published: June 2021

La distinction qu’Aristote propose de la connaissance pratique et de la connaissance théorique semble laisser le statut de la technique problématique : présentée comme une étape vers la science en Métaphysique A 1, la technique est rapprochée de la prudence en Éthique à Nicomaque VI 1, en ce qu’elles relèvent toutes deux de la même « raison délibérative ». Cette indétermination semble légitimer la critique célèbre adressée par Kant à la distinction aristotélicienne, ainsi que la conclusion radicale qu’il en tire de rapatrier l’ensemble de la technique et des maximes de la prudence dans le domaine de la connaissance théorique. Le commentaire aristotélicien lui-même reste divisé sur cette question. Dans cet article, nous souhaitons proposer une interprétation nouvelle de la place qu’assigne Aristote à la technique dans le domaine du savoir, et notamment de son autonomie vis-à-vis des sciences théoriques. Cette interprétation se fonde sur l’analyse par Aristote de la délibération pratique comme d’une forme de recherche (ζήτησις), qui s’oppose fondamentalement à l’ἐπιστήμη comme savoir constitué et achevé dans sa présentation déductive. La technique apparaît alors comme le savoir positif qui permet de guider la délibération, et qui a donc trait aux méthodes. L’intérêt de cette lecture est de suggérer l’existence d’un lien profond entre la technique et la logique de l’ Organon , qui pointe vers notre concept moderne de « procédure », dont le rôle est central dans la théorie moderne de la calculabilité et en informatique.
Les pères meurtriers, ces hommes criminels. La construction médiatique des masculinités infanticides dans les journaux télévisés (1985-2018)
Authors: Dubec Sophie
Published: June 2021

Cet article étudie la construction des masculinités au sein des JT sur l’infanticide (1985-2018). La première partie met en lumière la construction genrée asymétrique des parents meurtriers. Les femmes (associées à la sphère privée, aux émotions et à la souffrance psychologique) sont représentées comme des mères et les pères (rattachés à la sphère publique, à la rationalité et à la violence) comme des hommes. La seconde partie s’intéresse à la performance du genre dans les affaires Romand (1993), Godard (1999) et Dupont de Ligonnès (2011). Elle met en évidence les sanctions qu’entraîne la non performance de normes masculines, la possibilité de construire le masculin en l’absence d’un protagoniste ainsi que l’entrée progressive des hommes dans une culture de l’intimité.
Le renouvellement de l’antiféminisme dans la manosphère : idéalisation de la tradition et individualisme masculiniste
Authors: Morin Céline
Published: June 2021

La consolidation sur Internet d’une « manosphère », où convergent les défenseurs de la « cause masculine », témoigne du recalibrage des politiques masculinistes en fonction des avancées féministes. Les participants y critiquent les mouvements d’émancipation féminine des années 1960 et dénoncent les dérives néolibérales engagées à compter des années 1980, tout en idéalisant une certaine vision de la société française d’immédiate après-guerre. Le champ sentimental et sexuel apparaît aujourd’hui comme le principal point de crispation des mouvements masculinistes en ligne. Partant d’une cartographie de la manosphère, cet article explore l’hybridation stratégique entre la défense d’une domination traditionnelle du masculin sur le féminin et l’inscription dans l’individualisme contemporain, avec une récupération adroite des outils et techniques féministes de conscientisation.
Le rôle controversé de la radio dans les « événements sénégalo-mauritaniens » de 1989
Authors: Niang Bocar
Published: June 2021

En avril 1989, une crise diplomatique et humanitaire de grande ampleur éclate entre le Sénégal et la Mauritanie. Elle provoque alors de meurtriers affrontements intercommunautaires et des déplacements massifs de populations de part et d’autre de la frontière entre les deux pays. Le rôle joué par les médias en général, la radio en particulier, dans le surgissement et l’amplification des violences, constitue une des grandes variables de cette crise diplomatique aux relents identitaires et politiques très ancrés dans l’histoire précoloniale, coloniale et post-indépendance des deux voisins. L’instrumentalisation de la radio par les pouvoirs en place n’a-t-elle pas exacerbé les nombreux différends opposant mauritaniens et sénégalais au point d’aboutir à un passif humanitaire non encore soldé à ce jour ? Au-delà de cette problématique, se dévoilent surtout à travers cette crise des enjeux politiques et historiques en rapport avec la question de la viabilité et la solidité des projets d’État-nation mis en place au moment des indépendances.
Mettre Les Couilles sur la Table . À l’écoute d’un podcast sur les masculinités
Authors: Tuaillon Victoire , Allouch Annabelle , Muller Caroline
Published: June 2021

Victoire Tuaillon est la créatrice du podcast Les couilles sur la table disponible sur Binge Audio. Depuis près de deux ans, la journaliste invite universitaires et activistes à partager leurs réflexions sur les masculinités contemporaines, si bien que le podcast compte aujourd’hui (février 2021) près de soixante-dix épisodes, véritable radiographie thématique des questionnements autour du viol, de la paternité, du couple, de la violence ou encore des logiques d’entre-soi masculin. En 2019, elle a publié le livre Les Couilles sur la table (édité par Binge Audio), qui a reçu le Prix de l’essai féministe du magazine Causette. Pour Le Temps des médias , nous sommes revenues avec Victoire Tuaillon sur son parcours, ses choix journalistiques, la place des masculinités dans le champ médiatique, que ce soit du côté des producteurs de contenu ou des contenus eux-mêmes.
Telephone Triage Simulation Activity for Prelicensure Nursing Students
Authors: Ehly Erin , Fitzwater Julie
Published: June 2021

Background:

To meet the demands of a complex health care environment, nursing students need education that includes telephone triage in outpatient settings. Developing telephone triage communication skills requires the use of a different set of senses than in-person assessments. The purpose of this pilot study was to measure the effect of a telephone triage classroom simulation on prelicensure nursing students' knowledge and skills.

Method:

A simulation was developed to learn outpatient telephone triage protocols focused on lower respiratory illness. Students documented the encounter, gave a report to the provider, and completed the Simulation Effectiveness Tool-Modified.

Results:

Eighty-eight percent of students strongly agreed that learning about telephone triage and outpatient nursing was useful. Student perceptions of learning pathophysiology and teaching patients about illness scored lowest. Most students had inaccurate documentation of patient encounters.

Conclusion:

Identified areas for curricular improvement included accurate documentation, pathophysiology, and patient teaching opportunities in outpatient telephone triage.

[
J Nurs Educ
. 2021;60(6):352–355.]

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Developing Mental Health–Related Simulation Activities for an Australian Undergraduate Nursing Curriculum
Authors: McGough Shirley , Heslop Karen
Published: June 2021

Background:

Although simulation-based learning experiences have been widely used in nursing curricula to develop confidence, knowledge, and skills, the use of mental health–related simulation in undergraduate nursing education is sparse.

Method:

This project aimed to develop a simulation activity that incorporated the National Safety and Quality Health Service standards in acute mental health for undergraduate nursing students to prepare them for their clinical practicum in mental health. Clinical confidence was evaluated using the Mental Health Clinical Confidence scale.

Results:

Mental health clinical confidence increased in students following the activity.

Conclusion:

The findings show simulation activities that build on existing knowledge improve student confidence in providing care for people with mental health conditions. This article reports on the development and implementation of a mental health–related simulation-based learning experience in an undergraduate nursing program and builds on the existing knowledge of simulation-based learning in health care education.

[
J Nurs Educ
. 2021;60(6):356–361.]

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Compliance of spectacle wear among school children
Authors: Gajiwala Uday R , Patel Rajesh Umedbhai , Sudhan Anand , Sil Asim , Jain Elesh , Jhala Laxmi , Mahendra Manish , Bezankiwar Vijayalaxmi
Published: June 2021

Purpose:

In India, school eye screening is an important component of the National Programme for the Control of Blindness providing spectacles free of cost to children from primary section. The primary aim of this study was to know the compliance of wearing spectacles provided during school screening program and to find out reasons for noncompliance. The secondary aim of this study was to get information regarding the types of modifications required in the school eye screening program to improve the compliance level.

Methods:

It was a cross-sectional follow-up study involving school children of age group 10–16 years, class 5–9 from different parts of the country. Public or private schools were randomly selected based on their distance from the base hospitals/partner organizations. Data were collected by standard format directly from the students after informed written consent from school principal or class teacher.

Results:

The utilization of spectacles was found to be only 29.8% (n = 289) within 2 years of receiving the spectacles. Thirty-five percent (n = 108) students were using spectacles with less than 0.75 D. Appearance of the frame was a deciding factor. It was observed that the frames provided by the DBCS were especially not liked by the children. Twenty-five percent (n = 79) children were found to be wearing adult frames.

Conclusion:

Less than a third of the students were compliant with their spectacle prescription in this study. To improve the compliance, children should not be prescribed spectacles for nonsignificant refractive errors, should be given choices for frames and quality of work being conducted under school screening program needs a review.
Macular associations of tilted disc syndrome
Authors: Kumar Vinod , Surve Abhidnya , Kumawat Devesh , Azad Shorya , Vohra Rajpal , Venkatesh Pradeep
Published: June 2021

Purpose:

The aim of this study was to describe macular changes associated with tilted disc syndrome (TDS) using multimodality imaging.

Methods:

This is a retrospective observational study of the consecutive TDS cases which were studied for macular changes using color fundus photographs and optical coherence tomography (OCT). Fundus autofluorescence, fundus fluorescein angiography, and OCT angiography were performed wherever required.

Results:

Twenty consecutive TDS cases (36 eyes) were included. OCT showed inferior depression of all layers in specific scans and macular pathologies seen included lamellar macular hole, full-thickness macular hole, retinal pigment epithelial detachment, acute and resolved subretinal fluid, central serous chorioretinopathy, and choroidal neovascular membrane. Macular involvement was seen in 13 eyes (36.11%) while in the remaining 23 eyes, outer retinal changes were seen on OCT in 9 eyes and normal retinal layers in 14 eyes (38.89%).

Conclusion:

Various macular pathologies associated with TDS are described using multimodality imaging. These provide understanding of changes which can occur with TDS. It also highlights the need for recognition, differentiation from similar confusing entities, and the necessity to follow-up of these cases carefully to detect the macular changes earlier.
Resident-performed immediate sequential bilateral cataract surgery during the COVID-19 pandemic
Authors: Chen Tiffany A , Chen Stephanie P , Ahmad Tessnim R , Pasricha Neel D , Parikh Neeti , Ramanathan Saras
Published: June 2021

Purpose:

To assess visual outcomes and patient satisfaction for senior resident-performed immediate sequential bilateral cataract surgery (ISBCS) versus delayed sequential bilateral cataract surgery (DSBCS) during the COVID-19 pandemic, when minimizing healthcare-related exposures for patients and providers are paramount.

Methods:

This was a pilot retrospective cohort study of all ISBCS and DSBCS patients who underwent senior resident-performed cataract surgery from May to September 2020 at a single academic institution. Outcome measures were final corrected distance visual acuity (CDVA), final manifest refraction (MRx), intraoperative and postoperative complications rates, total number of visits, and patient satisfaction assessed postoperatively by telephone questionnaire.

Results:

Twenty-two eyes of 14 patients and 56 eyes of 28 patients underwent senior resident-performed ISBCS and DSBCS, respectively. Final CDVA was 20/25 or better in 21 (95%) ISBCS and 51 (91%) DSBCS eyes (P = 0.670). Deviation of final MRx from target refraction was within 0.50 D in 17 (77%) ISBCS and 47 (84%) DSBCS eyes (P = 0.522). There was no significant difference in intraoperative (P = 1.000) or postoperative (P = 1.000) complications. ISBCS patients averaged 3.5 fewer visits than DSBCS patients (5.9 vs 9.5, P < 0.001). All ISBCS and 20 DSBCS patients (87%) reported they were “very satisfied” or “satisfied” with their experience (P = 0.701). Five of six senior residents responded that they preferred performing ISBCS over DSBCS.

Conclusion:

This early experience suggests that senior resident-performed ISBCS is as safe and effective as DSBCS, with the added benefit of averaging fewer in-person visits. Residency programs should consider offering senior resident-performed ISBCS to select patients during the COVID-19 pandemic.
A novel device to visualize Descemet membrane during donor preparation for Descemet membrane endothelial keratoplasty
Authors: Fogla Rajesh
Published: June 2021

The aim of this study was to describe a novel device for improved visualization of descemet membrane (DM) during donor preparation for descemet membrane endothelial keratoplasty (DMEK). Comparative analysis was performed using this device (group 1) versus conventional technique (group 2) between an experienced and a trainee surgeon. A total of 20 eyes were analyzed in each group. Average time for DM peeling by experienced surgeon was 238.8 + 17.2 s in group 1 and 382.8 + 36.3 s in group 2 (P < 0.0001), and for trainee surgeon it was 519 + 30.8 s and 686.8 + 31.9 s (P < 0.0001). Retro-illumination made it easier to identify the peripheral cut edge of DM and abnormal adhesions to the underlying stroma during peeling. In group 2, DM tear occurred in 2/10 eyes with an experienced surgeon and 4/10 eyes with a trainee surgeon. Our novel device with retro-illumination allows DM peeling for donor preparation in DMEK to be performed safely with reduced risk of tissue damage.
Training Indian ophthalmologists in phacoemulsification surgery: Nine-year results of a unique two-week multicentric training program
Authors: Farooqui Javed Hussain , Mathur Umang , Pahwa Rashmi Rani , Singh Aditi , Vasavada Vaishali , Chaudhary Reena M ,   Phaco Development Program Working Group
Published: June 2021

Purpose:

To assess the outcome of 2 weeks phacoemulsification training program that is a unique collaboration between premier ophthalmic training institutes of India and Alcon Inc. initiated 10 years ago.

Methods:

Cataract surgeons eager to adopt phacoemulsification surgery as the primary treatment modality were enrolled in an intensive 2 weeks training program across seven premier ophthalmic institutes in India. These surgeons performed supervised phacoemulsification surgery under the guidance of expert faculty. Simultaneously didactic lectures, postoperative video discussions, and wet laboratory training were conducted. To assess improvement in the surgical skills each surgery was scored using the International Council of Ophthalmology-Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR). Phaco Development Specialist supported these surgeons for minimum duration of 1 year and maximum of 9 years and 2 months. In this multicentric study, surgical data of the participants enrolled between June 2010 to August 2018 was retrospectively analyzed.

Results:

Nine hundred 89 ophthalmologists across 27 Indian states and 4 Union Territories were trained between June 2010 and August 2018. The mean age of participants was 40.6 (+ 8.2 years) and 64.8% were males. After completing their training they performed 1,022,508 phacoemulsification surgeries in 9 years and 2 months. At follow-up, 92.11% and 88.77% of the surgeons were performing phacoemulsification at the end of 1 year and final follow-up, respectively.

Conclusion:

This program highlights how partnership model between industry and ophthalmologists can go hand in hand for training and skill development of doctors contributing to much-needed improvement in patient care across societies.
Preferred practice pattern and observed outcome of deep anterior lamellar keratoplasty – A survey of Indian corneal surgeons
Authors: Fogla Rajesh , Sahay Pranita , Sharma Namrata
Published: June 2021

Purpose:

This study aimed to assess the preferred surgical technique and outcome of deep anterior lamellar keratoplasty (DALK) among corneal surgeons in India.

Methods:

An online questionnaire-based cross-sectional survey was conducted among members of the Cornea Society of India (CSI) with experience of performing >10 DALK procedure. The responses pertaining to their surgical experience, preferred technique, complications, and outcome of DALK were collected and analyzed.

Results:

A total of 156 responses were received. In total, 35.9% of participants reported annual keratoplasty of >50, and DALK constituted >25% surgeries for 25% of participants. Ectatic corneal disorder was reported as the most common indication for DALK by 71.6% of the respondents. Big-bubble (BB) DALK (WA-1.82) was the most preferred technique, along with suction trephine (50%) for partial trephination and bottom port cannula (45.5%) for BB formation. On statistical analysis, no difference was observed in the surgeon reported success rate of BB formation with or without anterior lamellar keratectomy (ALK) (Χ2 (1,156) = 3.1498, P = 0.08) or paracentesis (Χ2 (1,156) = 0.2737, P = 0.60) before stromal air injection, and method of stromal air injection (Χ2 (1,156) = 4.7325, P = 0.09). Conversion to penetrating keratoplasty was reported by 16% of participants in >25% cases, while 66.7% reported in <10% cases. Cataract and double anterior chamber were the most common complications. 50% of participants suggested that >20 procedures are required to overcome the learning curve.

Conclusion:

BB DALK is the most commonly practiced DALK technique, and its success is independent of ALK and paracentesis being performed prior to air injection and method of air injection (cannula/needle).
Application of two-part glue technique in epithelial ingrowth after laser in situ keratomileusis flap dislocation
Authors: Lee Peng-Hsuan , Huang Yi-Hsun
Published: June 2021

A 59-year-old woman who underwent uneventful laser in situ keratomileusis surgery 16 years ago presented with traumatic flap dislocation complicated by an epithelial ingrowth in the right eye. The epithelial ingrowth was managed with re-lifting the flap, mechanical debridement, soaking with 70.0% alcohol, and irrigation. The flap was repositioned and secured with a two-part glue technique. Serial anterior segment-optical coherence tomography demonstrated a well-attached flap with no gap or haze in the flap-stromal interface. Three weeks postoperatively, the patient returned to emmetropia and the uncorrected distance visual acuity improved to 20/20. Twelve months postoperatively, the patient’s visual acuity remained 20/20, and there was no evidence of recurrent epithelial ingrowth.
A rare case of persistent large cystic breast tumor mimicking as malignant cystic breast cancer
Authors: Teh Mei-Sze , Teoh Li-Ying , See Mee-Hoong
Published: June 2021

Breast cyst, especially galactocele is usually benign. Needle aspiration or surgical removal are both diagnostic and therapeutic. Mastectomy is not necessary even if the whole breast is affected, but surgeons need to be vigilant. We describe a rare case of persistent and large breast cyst.
Remdesivir – Current evidence & perspective in management of COVID-19 infection
Authors: Bajpai Jyoti , Kant Surya , Pradhan Akshyaya , Verma Ajay K.
Published: June 2021

Coronavirus infection or COVID 19 was first reported in December 2019 in Wuhan, China, and has rapidly spread to more than 200 countries. The pandemic has also taken a toll of over 2.2 million. But the elusive search for an effective antidote is still on. Pending multiple and robust randomized controlled studies, some drugs are being used globally based on in-vitro studies, in -vivo evidence, observational studies, and small nonrandomized studies. Remdesivir is a nucleotide analog. It inhibits viral RNA-dependent RNA polymerase enzyme. Several studies have hitherto demonstrated the promising in-vitro and in-vivo antiviral activities of the molecule against severe acute respiratory syndrome coronavirus (SARS-CoV-1) and the Middle East respiratory syndrome coronavirus (MERS-CoV) strains. It has now exhibited potential in vitro activity against SARS-CoV-2 strains too. Based on pivotal studies, remdesivir is now being used to treat moderate to severe patients through emergency use authorizations and other access programs around the world. This review aims to summarize the evidence and clinical trials of remdesivir as a potential therapeutic option for COVID-19.
Translation, validation and cross-cultural adaptation of the geriatric depression scale (GDS-30) for utilization amongst speakers of Malayalam; the regional language of the South Indian State of Kerala
Authors: Thomas Ann Mary , Cherian Vinu , Antony Ashok
Published: June 2021

Background:

The Geriatric Depression Scale (GDS-30) is a popular instrument that has been ratified and is being used around the world as a screening tool for over three decades. However, a validated version of the scale is not available for use among speakers of Malayalam. In this paper, we elaborate on the procedure involved in the translation and validation of the GDS-30 from the official English version into Malayalam, the hurdles encountered in the process, and how they were overcome.

Methods:

The steps recommended by the World Health Organization (WHO) were applied for the translation of the original questionnaire. This involved initial forward translation of the English questionnaire, discussion by an expert panel, back-translation, pre-testing, and pilot testing of the final version. The Malayalam translation thus obtained was administered to 100 elderly persons in the community. These individuals were then examined by a qualified doctor, who had received the necessary training from a consultant psychiatrist in the diagnosis of depressive disorders. This doctor evaluated the study subjects clinically using theInternational Classification of Diseases-tenth revision (ICD-10) criteria for the diagnosis of depression, which is considered as the gold standard. Sensitivity, specificity, Cronbach'salpha, and split-half reliability were calculated to determine validity.

Results:

The translated scale yielded a sensitivity of 87.20%, a specificity of 73.80%, an area under the Receiving Operator Curve (ROC) of 0.814, Cronbach's α of 0.920, and split-half reliability of 0.897, thereby proving to be a valid screening tool.

Conclusion:

The Malayalam translation of the GDS-30 is a valid instrument to screen for depression in an elderly Malayalam-speaking population.
Prevalence of depression amongst the Elderly population in old age homes of Mangalore city
Authors: Kumar Saurabh , Joseph Sharon , Abraham Athul
Published: June 2021

Context:

Depression is a silent killer. The people living in the old age homes (OAHs) appear to be overtly neglected by the community and depression is easily overlooked in such individuals especially in elderly people with comorbidities. Its early detection and treatment are imperative to improve quality of life.

Aim:

To find the prevalence of depression and the socio-demographic factors associated with depression among the elderly of OAHs.

Materials and Methods:

A Cross-sectional study in geriatric population of OAHs around Mangalore city was conducted over a duration of 5 months. About 142 elderly above the age of 60 years participated in the study. The study tools used were Geriatric Depression Scale-15 (GDS-15), Activities of Daily Living Scale (Katz index) and socio-demographic questionnaire.

Statistical Analysis Used:

The results were expressed in percentages and proportions. Univariate logistic regression analysis was done to find out the associated sociodemographic factors. Means and standard deviation of the GDS-15 and KATZ index scores were calculated and correlation was assessed between both the scores.

Results:

The overall prevalence of depression was 47.8% by using the GDS. The GDS score and Katz score were found to have a significant negative correlation. (r = -0.245 P = 0.003). Less social interaction amongst the peers was found to be associated with depression.

Conclusions:

The prevalence of depression in this study population was moderately high. Spending time with other residents was protective and functionally able people were less likely to have depression.
Role of radiology in RT-PCR negative COVID-19 pneumonia
Authors: Sureka Binit , Garg Pawan Kumar , Saxena Suvinay , Garg Mahendra Kumar , Misra Sanjeev
Published: June 2021

Currently, RT-PCR is the gold standard for diagnosing SARS-CoV-2 infection. However, due to the time-consuming laboratory tests and the low positivity rate of RT-PCR, it cannot be an ideal screening tool for infected population. In this review article, we have reviewed studies related to RT-PCR and CT chest and we would like to give our recommendations. Depending upon the patient's clinical symptoms and radiology imaging typical of viral pneumonia compatible with COVID-19 infection, clinicians need to consider isolation of these patients early even if the RT-PCR test is negative.
Burnout and its correlates in Saudi family medicine residents
Authors: Al-Ghamdi Malak Aziz , Nahar Shamsun , Siddiqui Aesha Farheen , Al-Saleem Safar Abadi
Published: June 2021

Background:

Burnout is a workplace phenomenon and is high among healthcare workers, particularly physicians. It brings in significant negative impact on patient care and physicians. Considerable number of studies have highlighted burnout issues on residents of other specialties; however, scarcity of data exist on burnout among family medicine residents.

Objectives:

This study aimed to measure the prevalence of burnout, and its predictors amongst family medicine residents in Aseer region, Saudi Arabia.

Methodology:

This cross-sectional study was conducted among 133 family medicine residents using a custom-designed and validated Self administered questionnaire. The Maslach Burnout Inventory Human Services Survey (MBI-HSS) was used to measure the three dimensions of burnout: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA).

Results:

The overall prevalence of burnout was 84.2%. In terms of three dimensions of burnout, 29.3% of respondents scored high for EE burnout, 19.5% for DP and 79.7% for PA. High burnout in all three dimensions was found to be strongly associated with a number of variables under study. Male gender (aOR = 3.41, 95% CI 1.1-11.10; P = 0.042), married residents (aOR = 3.32, 95% CI 1.1-10.48) and use of anti-anxiety drugs (aOR = 3.75,95% CI = 2.0-21.26) were identified as predictors of high emotional exhaustion. A work schedule of more than 8 hours per day (aOR = 3.79, 95% CI 1.12-10.87) and young age (aOR = 2.6, 95% CI 1.12-10.87) were identified predictors for high depersonalisation and low personal accomplishment, respectively.

Conclusions:

Prevalence of burnout in this study exhibits that it is a common problem in family medicine residents. There is a need for a nationwide longitudinal study targeting the family medicine residents to study the effects of burnout on physician well-being and patient care.
A correlation study to assess the knowledge and attitude regarding postpartum intrauterine contraceptive device (PPIUCD) among women admitted in antenatal and postnatal wards
Authors: Ghildiyal Deepika
Published: June 2021

Introduction:

India is the second most populous country in the world. Intrauterine contraceptive device (IUCD) is a very effective, reversible, and economical family planning method. In India, the acceptance rate of IUCD is very low, only 3% of the women in the reproductive age group are using IUCD.

Aims:

The study was conducted to assess the knowledge and attitude regarding the postpartum intrauterine contraceptive device (PPIUCD) among women.

Materials and Methods:

A descriptive approach with a non-experimental research design was used for the study. The subjects were 180 women selected by the non-probability convenience sampling technique. The study was conducted among the women admitted in antenatal and postnatal wards at Doon Medical College Female Hospital, Dehradun, Uttarakhand.

Results:

The study showed that 54.44% (98) of the women have average knowledge about PPIUCD, 21.11% (38) have poor knowledge, 23.33% (42) did not know, and only 1.11% (2) was having good knowledge about it. The study revealed that favorable and unfavorable attitudes toward PPIUCD of women were 43.33% and 56.67%, respectively. The present study communicated that there was no correlation (−0.113) between knowledge and attitude toward PPIUCD among women. The finding suggested that women had average knowledge and unfavorable attitude toward the PPIUCDs. The χ2 value showed that demographic variables such as age, family income, and education status were having an association with the level of knowledge regarding the PPIUCD. No association was found between attitude and selected demographic variables.

Conclusion:

Findings stress the need for teaching programs, which in turn may enhance the knowledge and attitude of women regarding the PPIUCD. It will also helpful in improving the health status of women. It may reduce maternal morbidity and mortality.
Ichthyosis uteri with carcinoma cervix
Authors: Ilyas Abeer M. , Maheswari Ujwala
Published: June 2021

Ichthyosis uteri is a rare condition in which the entire surface of the endometrium undergoes metaplasia and is replaced by stratified squamous epithelium. This change is the endometrial response to iatrogenically introduced caustic substances and a variety of inflammatory conditions of the endometrium. We describe herein microinvasive squamous cell carcinoma of the uterine cervix with extensive ichthyosis uteri-like changes in the adjacent endometrium. The possible origin of these complex findings and the neoplastic potential of ichthyosis uteri is also discussed.