bluuebunny/crossref_metadata_2025 huggingface dataset:
Makrofungi Diversity In The Sesaot Aik Nyet Forest Area, Buwun True Village, West Lombok, West Nusa Tenggara
Authors: Liza Fitriani  , Cantika Agustina  , Huru’in  , Erlin Apriani  , Firman Ali Rahman  , Meilinda Pahriana Sulastri  , Mai Rizali
Published: January 2025

This research aims to map and identify the types of macrofungi that exist in the Sesaot forest, understand the ecological role played by macrofungi in maintaining the balance of the forest ecosystem, and provide recommendations on sustainable forest management practices. The activity method can be referred to as "Macrofungi Field Survey" . This method involves direct observation in the field to search for, identify and record various types of macrofungi in the environment. The diversity of macrofungi in the Sesaot forest area, Aik Nyet Hamlet, Buwun Sejati Village, West Lombok, West Nusa Tenggara shows significant variation and represents the high richness of the ecosystem in the region. Studies carried out in this area identified various species of macrofungi distributed in a variety of forest habitats, from damp forest floors to dead tree trunks. Macrofungi are an important part of the biodiversity in forest ecosystems. Macrofungi diversity includes many species with various forms ranging from size, color and ecological function. Macrofungi also have a big role, namely as decomposers which help decompose organic matter, develop nutrients into the soil, and establish symbiotic relationships with other plants through microbes.
Two-Wheel Tractor Performance Test With Variations Of Soil Trilling Patterns In Rice Land, East Lombok
Authors: Riza Hamkary Salam  , Muhammad Yul Fikry  , Mai Rizali
Published: January 2025

The purpose of this experiment was to determine the effect of variations in soil cultivation patterns on the performance of two-wheeled tractor plows in rice fields. The research experiment was conducted in Kotaraja Village, Sikur District, East Lombok Regency. The type of soil at the location is clay textured with an area of 0.09 Hg. The research was carried out in January 2022. The method used in this study was an experimental method with a Completely Randomized Design (CRD) which was repeated three times. The experimental activities were carried out by comparing variations in soil cultivation patterns (a. Edge cultivation pattern, b. Middle cultivation pattern and c. Close alternating cultivation pattern) on rice fields so that different effects were obtained from each soil cultivation pattern. The research parameters observed were fuel requirements, work speed, and soil cultivation efficiency. Based on the results and discussions, several conclusions can be put forward, namely that the land cultivation pattern has an effect but is not significant on speed, fuel consumption, theoretical field capacity, effective field capacity and field efficiency. In addition, the edge pattern has a high working speed of 1.27 m/s and a processing time of 0.16 hours and more efficient fuel consumption compared to other patterns, namely 2.25 L/hour. The field efficiency value of the three soil processing patterns is relatively low, ranging from 34.30% to 52.04%. Therefore, in this study, it is recommended to use the edge pattern as an effective and efficient method in soil processing.
Analysis of Seagrass Nutritional Content of Enhalus acoroides (L.F.) Royle at Jelok Kete Beach, Jerowaru District, East Lombok, Indonesia
Authors: Muhammad Zulpadli  , Firman Ali Rahman  , Ervina Titi Jayanti
Published: January 2025

Enhalus acoroides (L.F) Royle seagrass is one type of seagrass that has an important ecological role in maintaining the balance of coastal ecosystems. However, research on the nutritional content of seagrass is still very limited, especially in the East Lombok region. This study aims to analyze the nutritional content of Enhalus acoroides (L.F) Royle seagrass fruit growing on Jelok Kete Beach, Batu Nampar, Jerowaru District, East Lombok. This study uses a descriptive quantitative approach. The method used includes sampling seagrass fruits at the research site and analyzing the laboratory to determine the nutritional content such as ash content, water content, carbohydrates, proteins, fats, and vitamins. The results showed that  the fruit of Enhalus acoroides (L.F) Royle has a nutritional content of 11% water content, 50% ash content, 7.87% protein, 10% fat, 21.2% carbohydrates, 7.74% vitamin c, and 2.67% chlorophyll-a levels.
The Impact of the Russia-Ukraine War on EU Energy Security
Authors: Shoukat Waqas , Mustafa Zainab , Ul Muneer Munib , Shahzadi Amna
Published: January 2025

The Russia-Ukraine war has greatly affected the energy security of the European Union (EU), setting a new paradigm for the region to address its policies and strategies on energy issues. The EU had traditionally relied on Russian energy imports, while the current disruptions in the supplies of natural gas, oil, and coal brought unprecedented challenges to the region, which is now making it adopt urgent diversification. Simultaneously, the war has intensified diplomatic and economic cooperation with alternative suppliers of energy--Norway, the United States, and North African countries--in an effort to reduce dependence on Russian resources. Along these lines, it has put some very bold policy in place to promote energy efficiency and reduce consumption in relation to building an increase level of resilience towards future shock from supply disruptions. Geo politics arising from the war also places under sharp focus the argument for a unitary EU energy policy by strengthening an integral relationship of mutual accord between the different member countries. As a result, it is placing the EU under an energizing challenging landscape, balancing short-term needs with long-term goals in relation to sustainability. Short term, the war impacts increased the energy prices in all the European households and industries, which can further contribute to socio-economic issues including inflation and perhaps slowdown economies
A novel design silicone oil removal cannula
Authors: Fevzi Akkan  , Dincer Dinc
Published: January 2025

Background: Silicone oil, which is one of the most commonly used endotamponades in vitreoretinal surgery, is removed after a certain period of time in most cases. In this study, we present our results with a unique cannula that provides effective and safe silicone oil removal.
Aims and Objectives: To assess the aids and success of silicone oil removal with a novel 23-gauge cannula for the patients who underwent pars plana vitrectomy and silicone oil injection before.
Materials and Methods: 72 eyes of 64 patients who operated by the same surgeon (FA) between May 2017 and May 2019 were involved in the study. The primary indications were proliferative diabetic retinopathy in 46 (63.9%) eyes and retinal detachment in 26 (36.1%) eyes. Phacoemulsification and intraocular lens implantation (23 eyes), membrane peeling (23 eyes), internal limiting membrane peeling (5 eyes), and argon laser endo-photocoagulation (37 eyes) performed in the same session. Furthermore, perfluorocarbon remnants aspirated in 9 eyes and 17 eyes needed suturing. Descriptive statistical analyses achieved by SPSS 10.5 statistical software.
Results: The mean follow-up time was 11.7 + 2.5 months (between 3 and 23 months), and the mean age was 61.4 + 8.52 years (between 44 and 69 years). 1000 centistokes (cSt) silicone oil was removed from 61 (84.7%) eyes, and 5000 cSt silicone oil was removed from 11 (15.3%) eyes. The mean removal time was 2.04 + 0.1 min for 1000 cSt silicone oil and 5.11 + 0.3 min for 5000 cSt silicone oil. 4 re-detachment and 3 vitreous hemorrhage observed in follow-up period. Post-operative silicone oil remnants were not detected in any patient.
Conclusion: The unique 23-gauge cannula provides silicone oil removal without any conjunctival cut-down and sclerotomy enlargement. Thus, it reduces the duration of surgery and post-operative recovery period.
Study on breakthrough infection and effectiveness of COVID-19 vaccination among COVID-19 patients visited ayush triage center attached to McGann district teaching hospital, Sims-Shvaimoga, Karnataka, India: A longitudinal and retrospective study
Authors: Anupama Kavalibasappla  , Kanchana Nagendra  , Prashanth Hebballi Lingaraj  , Raghavendraswamy Koppad  , Mageppa Mandi  , Darshitha Rajanna  , Shashi Kiran Guttinadu Mallikarjunappa
Published: January 2025

Background: Novel coronavirus (COVID-19) first came to China in December 2019 and had become a public health emergency. There was a sudden rise of COVID-19 cases and its deaths.
Aims and Objectives: This study intends to study the estimation of breakthrough infection among COVID-19 patients and to estimate the vaccination effectiveness among COVID-19 patients concerning the severity of the disease.
Materials and Methods: This study was conducted in Mc Gann teaching hospital. The patients who were attending the Ayush Triage were included in the study. The sample size of 200 was estimated and the study was conducted for July 5–August 4, 2021, (1 month). A retrospective study design was planned and ethical board clearance was taken before starting the study. Patients were interviewed by telephone. The basic information such as contact number was collected by secondary data available in the triage center. Later details about Vaccination status and outcome of the disease were collected through telephonic interviews.
Results: Among 200 COVID-19 patients, 28.5% of the patients had taken vaccination. The breakthrough (COVID-19 patients who had taken both doses) infection rate was 10.5% among the people who had been diagnosed with the COVID-19 infection. Most breakthrough infections were mild. The majority of the 163 (81.50%) did not know the source of infection. The majority of the patients 143 (71.50%) were not vaccinated. After the COVID-19 infection, only around 12 (6%) patients were not recovered completely, that is, they had a history of death or hospitalization, and the remaining 188 (94%) patients were completely recovered.
Conclusion: Overall, one in every tenth individual after complete vaccination against COVID-19 infection had contracted the infection. Most of the breakthrough infections were mild and many of the subjects did not know the source of the infection.
Transcranial Doppler in hypoxic-ischemic encephalopathy babies as a prognostic marker in the short-term outcome
Authors: Arya Jayendra , Sakshi Jain  , Shashikant Patidar  , Sardar Vikram Singh Bais
Published: January 2025

Background: Birth asphyxia is a lack of blood flow or gas exchange to or from the fetus in the period immediately before, during, or after the birth process. Birth asphyxia can result in profound systemic and neurologic sequelae due to decreased blood flow and/or oxygen to the developing fetus or infant. Birth asphyxia is one of the most common causes of neonatal mortality and morbidity globally.
Aims and Objectives: The aims of this study were to assess the importance of cranial Doppler as investigation tool for the early prognostic marker of babies with hypoxic-ischemic encephalopathy (HIE) in short term.
Materials and Methods: This prospective study was carried out in a tertiary care teaching hospital. The present study includes 50 newborns, out of which 30 newborns admitted with birth asphyxia were considered as a case, while 20 healthy term newborns were taken as control. Transcranial Doppler of middle cerebral artery (MCA) was done on day 1 of life. They were followed up at discharge for neuromotor outcome by Hammersmith Neonatal neurological examination (HNNE). The outcome was correlated with, Doppler findings of MCA. P<0.05 was taken significant.
Results: Abnormality detected by transcranial Doppler within 24 h of life in neonates with birth asphyxia was significantly associated with poor neuromotor outcome when compared to healthy term neonates. HNNE score in HIE babies was lesser than healthy term neonates on discharge.
Conclusion: Cranial Doppler within 24 h of birth in term HIE babies has very high sensitivity in predicting short-term outcome in babies with HIE, such as Low HNNE score.
Assessment of cognitive impairment in hypertensive individuals attending a tertiary health-care center in metropolitan city: An analytical study
Authors: Nikhil Gode  , Amol Kinge  , Shri Karan Jain  , Prashant Patil  , Harish Wankhede  , Dipti Nimje
Published: January 2025

Background: Cognitive impairment is a physiological consequence of ageing. Mostly, after 65 years of age, impairment in the memory and dexterity is common. The various factors for such decline are yet under evaluation. The “Montreal Cognitive Assessment Scale” scoring system is been used in this study. This scale is based on seven domains of cognition. It is developed to improve the chances of early detection of cognitive impairment and it claims to diagnose dementia more efficiently compared to the standard MMSE scale.
Aims and Objectives: The present study was conducted to compare the cognition status in hypertensive and normotensive individuals of similar age groups.
Materials and Methods: The study participants were the selected patients attending the hypertension (HTN) OPD in Seth GS Medical college and KEM HOSPITAL Parel, Mumbai and among the staff working. Patients with age 30–40 years and blood pressure (BP) <140/90 mm Hg supine position without taking any anti-hypertensive medication. After selection of study subjects, the cognition status was assessed in both groups using the MoCA instrument. The BP was measured in supine posture, after interval of 10 min between each measurement, with the help of Sphygmomanometer. Unpaired “t”-test was applied to test the significance of difference of mean values of MoCA scale.
Results: We observed that among hypertensive subjects, comparatively lower MoCA score (mean value: 25.97) was reported. Thirteen (28.88%) study subjects had low MoCA score, whereas 32 (71.11%) hypertensive study subjects had normal MoCA score.
Conclusion: Thus, if the HTN is of a longer duration, it may show the poor cognitive performance. However, more such studies are required to know the exact mechanism and to know the critical level of BP which can cause cognitive impairment in long standing cases.
A comparative study of cytomorphological features of primary and metastatic hepatic lesions - A tertiary care hospital experience
Authors: Sujitha R  , Mohamed Hamza A  , Kandibanda Sai Sri Ram Rao  , Vashista Sai Kumar G
Published: January 2025

Background: Ultrasonography (USG)-guided fine-needle aspiration cytology (FNAC) of the liver is a primary diagnostic procedure for primary and metastatic hepatic lesions. It is a minimally invasive and accurate technique and renders timely diagnosis for further management.
Aims and Objectives: The purpose of the study was to evaluate the cytomorphological features of primary and metastatic hepatic lesions.
Materials and Methods: This retrospective study was conducted in the Department of Pathology of a tertiary care hospital over a period of 2 years. 50 cases of clinically suspicious cases for hepatic malignancy were radiologically confirmed by USG and were subjected to FNAC under USG guidance with simultaneous cell block preparation in 35 cases. Relevant biochemical and serological data were retrieved from laboratory investigation archives.
Results: The study was conducted on 50 cases of hepatic lesion. Majority of cases were male patients. All liver lesions were diagnosed on USG scan. Out of 50 cases diagnosed cytomorphologically, 8 cases (16%) were diagnosed as hepatocellular carcinoma. Among metastatic lesions, more prevalent lesions were adenocarcinoma 20 (40%). The rest of metastatic deposits included poorly differentiated carcinoma 12 (24%), mucinous carcinoma 4 (8%), malignant lymphoma 3 (6%), neuroendocrine tumor 2 (4%), and malignant melanoma 1 (2%). Primary site for metastatic lesions was diagnosed in 22 cases (52.4%) and unknown in 20 cases (47.6%).
Conclusion: FNAC is a quick, feasible, and reliable procedure which enables the interpretation of cytological features of malignant hepatic masses.
A rare case of meningioma with extracalvarial extension: A Case report
Authors: Jolly Sinha  , Vivek Kumar Kankane  , Avdhesh Shukla  , Avinash Sharma
Published: January 2025

Meningioma is a common primary tumor of the central nervous system. Here, we describe a case of meningioma en plaque with intracranial mass with osteolysis with extracalvarial extension. The patient was a 54 years male who presented to us with a rapidly growing mass in the left frontal region. On magnetic resonance imaging brain, the mass was avid heterogeneously enhancing extra-axial lesion in the left frontal lobe with surrounding cerebrospinal fluid cleft with an erosion of overlying frontal calvaria on the left side with an extracranial component. Simpson’s grade 1 excision was carried out. Histopathology showed a meningothelial meningioma with low tumor cell proliferation but with infiltration into the bone and angioinvasion. The patient was taken for radiotherapy. The patient recovered well in the post-operative period.
Takotsubo cardiomyopathy complicating acute on chronic pancreatitis: A case report
Authors: Swaminathan Rajan  , Sivasankar Amarapathi  , Somasekar Durairaj
Published: January 2025

Acute or chronic pancreatitis as a trigger of Takotsubo cardiomyopathy (TCM) has been infrequently described in the literature. Misdiagnosis of this phenomenon can often occur due to overlap in symptomology, particularly in those outside of the usual. A 50-year-old man with a history of alcohol abuse presented with epigastric and chest pain. Electrocardiography showed ischemic changes, and laboratory workup revealed elevated lipase, amylase, and troponin. He was diagnosed with acute pancreatitis and managed presumptively as acute coronary syndrome, class 4 angina. Patient had no signs of chronic liver disease, his pulmomary system was stable. He was a known case of left upper limb thrombosis and had portal venous thrombosis and was on tablet Rivaraxoban 10 mg. Subsequent coronary angiography was negative for obstructive coronary artery disease, and left ventriculography demonstrated basal hyperkinesis and apical akinesis, characteristic of TCM. TCM is a rare complication of acute pancreatitis. Increased awareness of this phenomenon is required to prevent delays in diagnosis and avoid unnecessary interventions and complications.
Maternal dietary habit influences fetal life
Authors: Ruby Dhar  , Arun Kumar  , Subhradip Karmakar
Published: January 2025

Diet and nutrition have a tremendous influence on health and disease. Dietary constituents can affect health and have been known to supplement with essential nutrients, minerals, and calories for physiological homeostasis. However, diet can also affect gene expression through epigenetic reprogramming or by altering the level of micronutrients. While a nutrigenomics study has delineated this causal link, a recent study published in EMBO Molecular Medicine by Grant et al. went a step further to establish that maternal intake of dietary fibers can alter the fetal gut microbiome, influencing the diversity of the intestinal bacterial flora, thereby affecting the gut-brain axis. Although the relationship between diet and fertility in males and females has been reported, the effect on postnatal life is not well documented. In this study by Grant et al. at the (Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg), the authors reported that selected feeding of fiber-free diets to pregnant mice alters the gut microbiome composition of their neonate pups depriving them of protective and beneficial commensal, Akkermansia muciniphila, a mucin-foraging bacterium. Further, these animals exhibited heightened immune activity by enriching defense response pathways and IL-22 expression. Therefore, the protective role of A. muciniphila is associated with its protection against chronic inflammation through TLR4 signaling. The author’s study has far-reaching conclusions on improving human health outcomes by the rational choice of food, drugs, and lifestyle to prevent gut dysbiosis and colonization of the right microbiome.
To study dexmedetomidine’s effect on intraocular pressure after succinylcholine and endotracheal intubation
Authors: Surya Gowthami Katika  , Sri Harsha Merugu  , Jaya Chandra Tentu  , Rama Krishna Prasad Katuri
Published: January 2025

Background: One of the most important preconditions for any anesthetic operation is perioperative hemodynamic stability during laryngoscopy and intubation, which has been the subject of extensive research and documentation. Numerous approaches have been proposed to protect the patient from the sympathetic reaction, intraocular pressure (IOP) response, and catecholamine response during laryngoscopy and intubation.
Aims and Objectives: To study the efficacy of two doses of intravenous dexmedetomidine premedication given as a single bolus dose over 10 min, 0.4 μg/kg and 0.6 μg/kg, 10 min before induction in preventing the rise of intraocular pressure following succinylcholine administration and endotracheal intubation.
Materials and Methods: A retrospective randomized study was conducted. Ethical committee permission and signed informed consent were obtained from 60 eligible patients before the trial began.
Results: Premedication with either 0.4 mcg/kg I.V. or 0.6 mcg/kg I.V. of dexmedetomidine diluted in normal saline at a 2 mcg/mL concentration administered over 10 min before induction resulted in significant obtundation of the rise in IOP associated with succinylcholine administration and intubation. Sympathetic response to laryngoscopy and intubation was also significantly diminished. The dose of 0.4 mcg/kg I.V. produced the best hemodynamic stability.
Conclusion: Therefore, from the above research it can be concluded that, before succinylcholine delivery and intubation, dexmedetomidine 0.4 mcg/kg I.V. can be used as a premedication in situations where an increase in IOP could be hazardous.
Does triple negative breast cancer subtype carry poorer prognosis as compared to non-triple negative breast cancer lesion - A study from a tertiary hospital
Authors: Srijan Basu  , Mintu Mohan Nandi  , Ranjit Kumar Haldar  , Amit Kumar Das
Published: January 2025

Background: The breast cancer (BC), in spite of tremendous advances has continue to remain an enigma. The major change in understanding of BC has taken place after understanding of molecular biology.
Aims and Objectives: The objectives are as follows:(1) To categorize the incidence of triple negative BC (TNBC) in hospital based data. (2) To study the prognostic outcomes of TNBC.
Materials and Methods: The study was an observational prospective for the period of 18th months, from February 2014 to August 2015, where total 146 cases were selected. The data regarding age, sex, tumor size, stage, grade, nodal status, Nottingham prognostic index (NPI), morphology was noted. All patients underwent immunohistochemistry (IHC) study, maintaining higher quality assurance in the same IHC laboratory.
Results: Our study revealed that out of 146 patients, 71 patients are TNBC. The mean age of presentation was 54.06 years in TNBC group. About 69.0% patients presented with Grade III tumor and 74.6% patient presented with NPI ≥5.4 among TNBC. However, 56% patients presented with NPI ≥5.4 among NON TNBC. Most of the morphological variant was IDC (95.8%), 85.9% patients presented with only lymph nodes metastasis among TNBC.
Conclusion: The study is tremendously significant from Indian perspective. It proofs that TNBC had the point of diagnosis, seems to be more aggressive. It suggests that Indian BC is likely to be younger at presentation as compared to its Western counterpart.
Efficacy of landmark based blind transverse abdominis plane block for post-operative pain relief in inguinal hernia
Authors: Swetha Purohit  , Chandrashekarappa Kavi  , Sudharani Halli
Published: January 2025

Background: Pain after open hernia surgery can be moderate-to-severe and is known to be associated with prolonged hospital stay and delayed return to normal daily activities.
Aims and Objectives: We aimed to investigate the effect of a blind landmark-based approach of transversus abdominis plane (TAP) block on patients undergoing elective inguinal hernia repair surgery under spinal anesthesia.
Materials and Methods: This was a prospective, randomized, controlled, and clinical trial consisting of 60 patients scheduled for inguinal hernia repair under spinal anesthesia. Patients in Group-1 received TAP block by landmark based blind technique, whereas those in Group-2 did not receive TAP block. Pain assessments were scored for all patients at rest and movement at 2, 4, 6, 12, and 24 h after surgery using visual analog scale.
Results: The pain scores in the post-operative period, during rest and movement, were significantly lower in patients that received TAP block. Significant number of cases reported nausea and vomiting or headache in Group-2 due to increase requirement of analgesics for pain relief during first the 24 h of post-operative period.
Conclusion: Landmark-based blind TAP block may be an effective way of providing analgesia in patients undergoing elective open inguinal hernia repair under spinal anesthesia.
A cross-sectional comparative study of anxiety and depression among doctors working in covid care centres during the first and second waves of COVID-19 pandemic in Chennai, Tamil Nadu
Authors: Rajaraman Nivetha  , Balaji Arumugam  , Annamalai Radhakrishnan  , Vikram Ashokkumar  , Arunagirinathan Keerthana
Published: January 2025

Background: Doctors are at significant risk of developing psychological morbidity during the coronavirus diseases 2019 (COVID-19) Pandemic due to the shortage of resources and changing medical protocols. The fear, stigma, prejudice, and marginalization toward COVID-19 added with the physical discomfort of using personal protective equipment kits leads to mental exhaustion among doctors.
Aims and Objectives: The aim of the study was to estimate and compare the prevalence and level of anxiety and depression along with its risk factors among doctors working in COVID Care centers during the COVID-19 pandemic’s First and Second wave.
Materials and Methods: A cross-sectional study among 200 doctors working in the COVID care centers using mailed questionnaires was conducted. A convenient sampling method was used to include the study participants. Collected data were entered in an MS Excel spreadsheet and analyzed using SPSS version 21.0.
Results: During the first wave of the COVID-19 pandemic, the observed prevalence of the symptoms of depression and anxiety respectively among doctors was 42% and 56% whereas it increased to 83% and 82%, respectively, during the second wave.
Conclusion: The present study highlighted the high prevalence of anxiety and depression among doctors. As the COVID-19 pandemic continues to sweep the world, the global doctors’ community have to be sensitized to the prevalence of psychological disorders and a necessary appropriate psychological support strategy needs to be developed.
A study on the prevalence of retinopathy in newly diagnosed Type 2 diabetes mellitus in a tertiary care center of Tamil Nadu
Authors: Prakash G  , Kumar Raja M  , Kalaisezhian N  , Yoganandh T  , Vasanthakumar JA  , Nivedhapriya P
Published: January 2025

Background: Type 2 diabetes mellitus (Type 2 DM) is one of the leading risk factors for cardiovascular diseases. Although the awareness of the need for screening and treatment for Type-2 DM is widely prevalent, the awareness of complications arising out of it is not widespread. This article highlights the occurrence of diabetic retinopathy (DR) among newly detected diabetic patients.
Aims and Objectives: The aim of the study was to study the prevalence of DR in patients who are diagnosed as having Type 2 diabetes mellitus for the first time.
Materials and Methods: The present study involved 501 newly diagnosed Type 2 DM patients. Their history was recorded and the investigations done included haemoglobin (Hb), glycated Hb percent (HbA1c), fasting blood sugar, and post-prandial blood sugar. These patients underwent fundus examination through direct ophthalmoscope and slitlamp examination.
Results: Out of the 501 patients in the study, 59.5% (298) had good knowledge about diabetes, but only 3.8% knew about retinopathy. A total of 71.5% of patients did not have periodic eye examination; the most common barrier identified was lack of awareness about the necessity for this (58.5%), 5.6% among the total population had an eye disease. Mild non-proliferative DR (NPDR) was found among 10 females and it was observed in eight males. Moderate NPDR was identified in three males and two females and while no severe cases were reported among the men, two were noted among the women.
Conclusion: The study highlights the prevalence of retinopathy in newly diagnosed Type 2 DM population in tertiary care center hospital in Salem district. The study also highlights the importance of detection of Type 2 DM before the occurrence of complications which arise due to diabetes and screening for microvascular complications is necessary at the time of diagnosis of DM and periodically.
Guillain-Barre syndrome in SARS CoV-2: Case series of uncommon neurological complication from tertiary care center, Bengaluru, South India
Authors: Mamatha Tittamegalapalya Ramalingaiah  , Latha Venakataramanappa  , Sumedha Swamy  , Virender Singh  , Vinutha Bagalur Srinivas Murthy
Published: January 2025

Coronavirus disease is an infectious disease caused by severe acute respiratory syndrome-coronavirus 2 virus. It predominantly affects respiratory system causing fever, cough, and breathlessness. But it can also affect central nervous system and peripheral nervous system. It is important that physicians keep a high index of suspicion for patients with neurologic symptoms following a recent or during COVID-19 infection. The low rate of initial diagnosis is alarming, as few of the percentage of patients with Guillain-Barre syndrome will develop respiratory muscle weakness requiring invasive ventilation. The ability to recognize the disease process could lead to life saving management. Furthermore, the initiation of therapy such as plasma exchange or intravenous immunoglobulin leads to an accelerated recovery time.
Heat and moisture exchanger filter as a substitute for T-piece device - A novel approach
Authors: Balaji Vaithialingam  , Arun BG
Published: January 2025

Letter to Editor
A cross-sectional study on the role of hematological and inflammatory biomarkers as predictor of mortality at the time of admission among COVID-19 patients
Authors: Sanjay Kumar Totade  , Chanchlesh Daheria  , Rajesh Kumar Morya  , Bhagwan Singh Yadav  , Amit Varma  , Neelam Toppo
Published: January 2025

Background: Whole world experienced COVID-19 pandemic with more than 155 million cases and >3.4 million deaths. Vasculitis and immune system activation plays a critical role in pathogenesis, especially in severely ill and non-survivors COVID-19 patients.
Aims and Objectives: The aim of the study was to establish the role of hematological indices and inflammatory biomarker as predictors of mortality among non-survivor and survivor COVID-19 cases at the time of admission.
Materials and Methods: The cross-sectional study was conducted at a dedicated COVID-19 referral hospital from July 2020 to August 2020, among 300 real time-polymerase chain reaction confirmed COVID-19 cases. Demographic, clinical, comorbidity, laboratory investigation, and outcome data were collected from patient’s medical record. Outcome variables – discharged (survived) or death (non-survived) were considered for comparison of various hematological indices and inflammatory biomarkers. Data are represented as median, IQR (Q1-Q3) and difference between median and proportions were calculated by Mann–Whitney U-test and χ² test. A predictive power of laboratory parameters between survivors and non-survivors was evaluated using receiver operant curve (ROC) analysis and area under the ROC curve (AUC).
Results: The median age of non-survivors was significantly higher than survivors. Hypertension was significantly associated with non-survivors. Hematological parameters such as total leukocyte count, absolute neutrophil count, Neutrophil: Lymphocyte ratio were significantly increased with lymphocytopenia (P=0.001), and Inflammatory biomarkers such as C-reactive protein (CRP), lactate dehydrogenase, D-dimer, ferritin, procalcitonin, and NT-Pro BNP, all were significantly increased in non-survivors patients (P=0.001). CRP and neutrophil lymphocyte ratio (NLR) showed “Good” predictive value for mortality with cutoff value of 74.0 mg/l (AUC=0.841, Sensitivity=80.4%, Specificity=73.0%) and 5.65 (AUC=0.805, Sensitivity=76.1%, Specificity=73.0%), respectively. Pro-BNP showed “Fair” predictive value for mortality with cutoff value of 330.5 pg/ml (AUC=0.726, Sensitivity=73.9%, Specificity=58.2%).
Conclusion: We suggest that CRP, NLR, and Pro-BNP can be used as a screening tool to predict mortality in COVID-19 patients for timely intervention to save valuable life, especially when sensitivity toward severity of COVID-19 among medical health professionals and general public is on decline.
Comparison between transdermal buprenorphine and intravenous paracetamol for post-operative analgesia after major plastic reconstructive surgery under general anesthesia – A randomized double-blind controlled trial
Authors: Arghya Maity  , Rajasree Biswas  , Suchismita Mallick  , Sujata Ghosh  , Sarbari Swaika
Published: January 2025

Background: Adequate pain management is an essential entity in reconstructive surgery to prevent adverse physiological and psychological outcome. Transdermal buprenorphine has been mostly studied in chronic pain and cancer related pain but hardly studies in acute pain are available.
Aims and Objectives: The aims of this study were to compare post-operative pain relief achieved by transdermal buprenorphine and IV paracetamol in terms of safety and efficacy. Sedation and adverse effects were also studied.
Materials and Methods: This is a prospective, parallel group, double-blind, and randomized trial. After ethics, clearance and consent from 46 patients undergoing major reconstructive surgery were allotted into Group B, (n=23) who received transdermal buprenorphine and Group P (n=23) who received m IV paracetamol 6 hourly. IV Paracetamol was taken as active control. Standard institutional protocol for general anesthesia was followed. Visual analog scale (VAS) score was measured postoperatively for 48 h. Diclofenac sodium was the rescue analgesic. Sedation was assessed by Ramsay Sedation score.
Results: Transdermal buprenorphine patch (TDB) gave superior pain relief in comparison to intravenous paracetamol 48 h postoperatively, P≤0.0.5 pin VAS score. The total amount of rescue analgesic required was high in Group P than Group B (P=0.034). Hemodynamic stability was better maintained with TDB with minimal sedation and side effect.
Conclusion: TDB (20 μg/h; 20 mg) can be safely used for post-operative analgesia with greater efficacy and minimal side effects when compared to intravenous paracetamol.
Thoracic segmental spinal anaesthesia for laparoscopic cholecystectomy in a case of birt-hogg-dube syndrome
Authors: Tushar Kanti Ghosh  , Purbasha Roy
Published: January 2025

Birt-Hogg-Dube syndrome is an extremely rare genetic disorder featuring multiple lung cyst or bulla which lead to recurrent spontaneous pneumothorax. Laparoscopic cholecystectomy poses a significant challenge in such cases from anesthetic point of view. Thoracic segmental spinal anesthesia (TSS) is a relatively new and beneficial alternative to general anesthesia to avoid post-operative complications. In this report, we used thoracic segmental spinal successfully in a known case of Birt-Hogg-Dube syndrome to avoid post-operative pneumothorax and discussed the technique and anatomical and physiological consequences. We can conclude that thoracic segmental spinal anesthesia can be used safely and successfully in laparoscopic cholecystectomy specially in cases where general anesthesia is better avoided as in Birt-Hogg-Dube syndrome.
The tunnel versus medial versus lateral approach in laparoscopic right hemicolectomy in colon cancer: A retrospective study
Authors: Leesa Misra  , Mahesh Kumar Sethi  , Manash Ranjan Sahoo  , Preeti Kumari Gond  , Kallol Kumar Das Poddar
Published: January 2025

Background: Laparoscopic right hemicolectomy for the right-side colon cancer is well-established and proven to be better than the open approach in terms of post-operative and overall hospital stay. Laparoscopic right hemicolectomy can be done by lateral to medial approach (LA), medial to lateral approach (MA), or tunnel/IRETA approach (TA). No previous study has been conducted to compare the clinical outcomes of all three approaches and the superiority of one approach over the other is still debatable.
Aims and Objectives: This retrospective study was conducted to compare all three approaches and to find the ideal one to practice.
Materials and Methods: This is a retrospective cohort study carried out to analyze 86 patients who were admitted to the department of General Surgery from March 2015 to December 2021 with a diagnosis of the right-side colon cancer and underwent laparoscopic right hemicolectomy with either of these three approaches. A total of 29 patients had operated with lateral to medial approach (LA), 29 patients with medial approach (MA), and 28 with tunnel (TA) approach. The patient’s baseline demographics, perioperative parameters, and post-operative outcomes were compared.
Results: Intraoperative blood loss was significantly lower in the medial to lateral approach and tunnel approach. Duration of surgery was less in the medial to lateral approach as compared to the other two approaches and was statistically significant. R0 resection, lymph node dissection, intraoperative and post-operative complications, morbidity, mortality, and conversion to open were similar in all three groups.
Conclusion: Laparoscopic medial to lateral to medial to lateral approach is feasible and safe and should be preferred approaches in laparoscopic right hemicolectomy.
Assessment of neutrophil and platelet-to-lymphocyte ratio as inflammatory markers in type 2 diabetes mellitus patients
Authors: Jyotindra Kumar Sahu  , Rajeeb Kalita  , Rajeev Gandham  , Ravikanth Medikonda
Published: January 2025

Background: Diabetes mellitus (DM), metabolic disease, and its prevalence are increasing in India. DM causes micro- and macrovascular complications. Inflammation is one of the contributing factor in the pathophysiology of DM.
Aims and Objectives: This study aimed to evaluate neutrophil and platelet-to-lymphocyte ratio (PLR) in T2DM patients.
Materials and Methods: This study was carried out in Biochemistry Department, Lt. B.R.K.M Government Medical College, Chhattisgarh, India. In this study, 150 type 2 DM patients were considered as cases and 150 normal subjects were considered as controls. Baseline data was collected from subjects. All subjects underwent physical and clinical examination. Fasting and post prandial venous blood samples were collected. FBS, PPBS, renal profile (urea, creatinine and uric acid) were estimated in serum sample. EDTA samples were used for complete blood count (CBC). Neutrophil-to-lymphocyte ratio (NLR) and PLR ratio were calculated from CBC values. HbA1c was estimated using whole blood sample. Blood pressure and BMI were recorded.
Results: In this study, mean age of 61.2±4.0 years, systolic blood pressure 136.2±14.4 mmHg, diastolic blood pressure 100.1±12.5 mmHg, BMI 28.1±2.6 (kg/m2), FBS 180.7±22.3 mg/dL, PPBS 289.3±33.2 mg/dL, HbA1c 8.1±0.7%, serum urea 39.1±8.3 mg/dL, creatinine 1.1±0.2 mg/dL, uric acid 7.1±2.0 mg/dL, lymphocytes 18.3±3.0%, NLR 8.1±3.1, and PLR 20.3±7.1 were significantly increased in cases than controls.
Conclusion: Elevated ratios of NLR and PLR may serve as markers of inflammation in T2DM. These are inexpensive and helpful to assess the inflammatory status in T2DM.
Antimicrobial resistance - are future prescribers aware? A study among undergraduate medical students in Kumaon region
Authors: Mohd Maroof  , Mohd Najmul Aqib Khan  , Zafar Masood Ansari  , Sadhana Awasthi  , Preeti  , Rupali Gupta  , Kartik Krishan Atri
Published: January 2025

Background: According to the WHO, antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness, and death and is a global issue and measures to halt this is the need of the hour.
Aims and Objectives: This study aims at identifying awareness as well as knowledge, attitude, perception, and practice regarding AMR and antibiotic use among medical undergraduate students, so to get insight and take appropriate actions to enhance their knowledge that will help in reducing AMR as they are the future prescribers.
Materials and Methods: A descriptive cross-sectional study was conducted among 483 undergraduate medical students enrolled in government medical college, Haldwani. A pretested, semi structured questionnaire was designed to collect data from participants through Google forms regarding sociodemographic profile, and behavior of the participants regarding antibiotic use which comprises: Attitude, perceptions, and practice.
Results: Majority of study participants have heard about AMR before (97%) of which most of them got information about antibiotic resistance by web/internet (35%). Majority of study participants were aware (>90%) of phenomenon of antibiotic resistance, 98.9% of them were correctly able to identify Amoxicillin and Penicillin as antibiotics, most of them had correct knowledge about role of antibiotics. Majority (83.6%) of participants take antibiotic only after the prescription of doctor, 78.9% of them reported use of antibiotics in the last year.
Conclusion: A fair good amount of awareness, knowledge, attitude, perception, and practice regarding AMR and its use was found among study participants. Still, there is scope of improvement in it that can be addressed through giving more emphasis on this in undergraduate teaching curriculum.
Observational study of changes in dominant ovarian follicle with and without administration of clomiphene citrate in primary infertility cases among eastern Indian women
Authors: Susmita Ghosh  , Kausiki Ray Sarkar  , Oyndrila Sengupta  , Subhajit Halder
Published: January 2025

Background: Changing environment and social factors with advancement of science bestowed the human population with both curse and boon. Increasing number of primary infertility is one of the many challenges which is encountered among 3.59% of Indian women population in reproductive age group. Use of clomiphene citrate (CC) is one of the commonly practiced way to find out a ray of hope.
Aims and Objectives: The aim of the study was to measure the changes of morphometric parameters of dominant ovarian follicles and their numbers and compare the same before and after administration of CC was the aim of the present study.
Materials and Methods: This interventional and cohort study performed on 50 women coming to the infertility clinic at Institute of Post Graduate Medical Education and Research, Kolkata, with primary infertility of reproductive age group. Informed consent was taken from all. Transvaginal ultrasonography was utilized to measure the parameters related with dominant follicles. Comparison among them with respect to number, size, and time to rupture both before and after ovulation induction with CC was made.
Results: Statistically significant increase in number and average size of dominant follicle is seen from 1.08 to 2 and 12.26 to 15.31 mm following CC in the third cycle. In polycystic ovarian disease, cases also ovulation has increased significantly.
Conclusion: Transvaginal ultrasonography proves to be regarded as a gold standard procedure to measure and monitor the ovarian follicle status. Undoubtedly CC can be regarded as an easy and dependable solution toward treatment of primary infertility.
Observational study on histopathology of male anterior urethral stricture: Toward better understanding of stricture pathophysiology
Authors: Kashinath V Thakare  , Tappa Mahammad Mustaq Rasool  , Abhiram Kucherlapati  , Ifrah Ahmad Qazi  , Veda Murthy Reddy Pogula  , Mude Sai Priyanka
Published: January 2025

Background: Stricture urethra is generally limited to anterior urethra. At present, there are only a few studies which focus exclusively on the histopathology of stricture urethra disease.
Aims and Objectives: The aims of this study were to assess the urethral stricture pathology specimens for determining the severity of chronic inflammation and characteristics of stricture, demographics, and patient-reported outcome measures in patients with inflammatory and non-inflammatory strictures.
Materials and Methods: This was a prospective and observational study done on 60 male patients of anterior urethral stricture disease who underwent excision biopsy of stricture during urethroplasty. Pre-operative urinary symptoms assessment was done with a questionnaire provided to all patients and data maintained to assess patient-reported outcomes in inflammatory and non-inflammatory stricture urethra. Cohorts comprising strictures with no inflammation, mild, and moderate to severe inflammation were developed and stricture, the patient characteristics were compared.
Results: In a total of 60 histopathological stricture specimens, there was no inflammation in 40%, mild and moderate inflammation was in 28% and 3.3%, respectively. Lichen sclerosis-related strictures had moderate to severe inflammation and most of the strictures were in bulbar urethra (51.6%). Patients with BXO changes showed more inflammation. In patients with inflammatory strictures, hesitancy, straining, and stream were statistically more compared to non-inflammatory strictures. Idiopathic is the most predominant etiology for stricture which showed no inflammation.
Conclusion: Histopathological analysis of urethral stricture showed significant tissue heterogeneity in clinically similar strictures. Chronic inflammation was commonly found in stricture specimens indicating active antigen presentation for underlying pathology and patients with inflammatory strictures reported worse health outcomes.
A case series on isolated maxillary sinus involvement in mucormycosis
Authors: Praveen Kumar J  , Sengottuvelu P  , Semmanaselvan K  , Pavithra JR
Published: January 2025

Mucormycosis is a potentially fatal fungal infection that can affect various parts of the body, including the sinuses. Isolated maxillary sinus involvement usually indicates an early diagnosis of Mucormycosis. The aim of the study was to present a case series on the clinical presentation and management outcomes in patients with isolated maxillary sinus involvement in Mucormycosis to emphasize on the early diagnosis and management of the condition. A retrospective study of 10 patients who presented to the RGGGH ENT department with isolated maxillary sinus involvement in Mucormycosis that was confirmed by diagnostic nasal endoscopy, CT scan and fungal KOH swab and who were managed by endoscopic sinus surgery. In our study, out of 10 cases, two patients had unilateral symptoms and eight patients had bilateral symptoms. Most common presentation was nasal obstruction, nasal discharge, and facial pain. Complete disease clearance was achieved in all cases by endoscopic sinus surgery with debridement. Diabetes was the most common underlying comorbidity, present in all 10 patients. All patients were treated with a combination of antifungal therapy and surgical debridement. All patients showed improvement on followup, with no recurrence or mortality reported during the follow-up period. Mucormycosis with isolated maxillary sinus involvement is a timely presentation of mucormycosis but potentially life-threatening due to the nature of the disease to spread rapidly. Prompt diagnosis and management are crucial for improving outcomes in these patients. A combination of antifungal therapy and surgical debridement appears to be an effective treatment approach in these patients.