bluuebunny/crossref_metadata_2025 huggingface dataset:
The Development of Products From Budi Brown-Rice Flour to Promote Gluten-Free Brownies in Budi Subdistrict, Yala Province, Thailand
Authors: Lekhawichit Sutida , Phaiboonvessawat Wiroj , Tansom Ubol , Pangsuban Sasithorn , Yamirudeng Kurosiyah
Published: October 2024

This research to development of products from Budi brown rice flour to promote gluten-free brownies in Budi Subdistrict, Yala Province. The study combines a mixed-method approach combined with (PAR).The quantitative research utilized questionnaires, with the study population comprising consumers interested in or purchasing the product. The sample group included consumers interested in or purchasing the product. It was found that the development of the product's form to suit the target group, the quality of the product, and the characteristics of the product such as color, aroma, taste, texture, and packaging should be appropriately aligned with the product. The qualitative research involved in-depth interviews using a structured interview guide with key informants. The research findings suggest that participation in strengthening the enterprise allows community organizations to play a role and represent their network in expanding distribution channels. The development process:1) Innovation development, 2) Utilizing online media or processes, 3) Creating differentiation and recyclable
Impact of Social Media on the Development of Religious Tourism Industry
Authors: Talukder Mohammad Badruddoza , Das Iva Rani , Afchar Mohammad Nurul
Published: October 2024

This chapter investigates the impact of social media on religious tourism, exploring its role in destination marketing, visitor experiences, and community engagement. A comprehensive literature review was conducted to examine the influence of social media on religious tourism development. Academic databases were searched using relevant keywords, and findings were structured around key themes. Social media enhances accessibility, information sharing, and community engagement in religious tourism but presents challenges regarding authenticity and privacy. Case studies illustrate successful social media strategies employed by stakeholders. Insights from this chapter inform stakeholders on leveraging social media to promote religious heritage and sustainable tourism practices, fostering visitor experiences and interfaith dialogue. This chapter offers a holistic understanding of social media's impact on religious tourism, combining theoretical insights with practical examples to guide industry stakeholders.
Tourism Industry Amidst COVID-19 With Special Reference to National Capital Region of India
Authors: Verma Rama , Singh Kuldeep , Gantait Arnab , Chaini Susanta Ranjan
Published: October 2024

Travel and Tourism is one of the leisure and service-based industries that survive to facilitate people around the globe; at the same time, it is a loaf of bread for millions. The outbreak of the Novel Coronavirus devastated the industry for a period of time. In view of the severe impact, the study focuses on the strategy for the revival and survival of the industry and its industry professionals. The area is particularly in the Delhi NCR region of India. The major objective of the study is to showcase and measure the outcome of the impact in the selected area, the strategies implemented so far, and the plans to inculcate ways to overcome any such occurrence in the near future. Also, to analyze the impact of this region on the entire world, The study uses a quantitative method to analyze it with the help of the One-way ANNOVA technique. Probable suggestions provide a survival platform for the industry in times of crisis.
Alarm Functions of PD-1+ Brain-Resident Memory T Cells
Authors: Musial Shawn C , Kleist Sierra A , Degefu Hanna N , Ford Myles A , Chen Tiffany , Isaacs Jordan F , Boussiotis Vassiliki A , Skorput Alexander G J , Rosato Pamela C
Published: October 2024

Resident memory T cells (TRM cells) have been described in barrier tissues as having a “sensing and alarm” function where, upon sensing cognate Ag, they alarm the surrounding tissue and orchestrate local recruitment and activation of immune cells. In the immunologically unique and tightly restricted CNS, it remains unclear whether and how brain TRM cells, which express the inhibitory receptor programmed cell death protein 1 (PD-1), alarm the surrounding tissue during Ag re-encounter. Using mouse models, we reveal that TRM cells are sufficient to drive the rapid remodeling of the brain immune landscape through activation of microglia, dendritic cells, NK cells, and B cells, expansion of regulatory T cells, and recruitment of macrophages and monocytic dendritic cells. Moreover, we report that although PD-1 restrained granzyme B upregulation in brain TRM cells reactivated via viral peptide, we observed no apparent effect on cytotoxicity in vivo, or downstream alarm responses within 48 h of TRM reactivation. We conclude that TRM cells are sufficient to trigger rapid immune activation and recruitment in the CNS and may have an unappreciated role in driving neuroinflammation.
Dermatosurgical rounds: shark island pedicle flap for skin defect of the alar crease area after basal cell carcinoma removal
Authors: Tchernev Georgi , Kordeva Simona
Published: October 2024

A 67-year-old female presented to the Dermatology Department with a tumor formation located on the left lateral side wall of the nose, measuring 1,5/1,2 cm in size, which had been slowly growing over the past few years. The tumor exhibited a shiny, pink-colored surface with a dome-shaped appearance, irregular borders, and superficial telangiectasias, raising clinical suspicion for basal cell carcinoma. Additionally, there was no reported history of skin cancer in any family member or painful sunburns during childhood. The patient was recommended surgical excision under local anesthesia for the suspected lesion.
Drug <>
Authors: Ancona Leonardo
Published: October 2024

About drug addiction and drugs in general, the scientific and lay literature is flooding nowadays; it is constantly discussed, all aspects of it are discussed, all aspects are discussed, all aspects are proposed, all aspects are disposed of, all aspects are opposed; and one has the impression that in every way the same things are repeated.
The experience of the sexual body in addicts
Authors: Callieri Bruno
Published: October 2024

Not available.
The problem of the handicapped between marginalisation and integration: sociological reflections on the subject
Authors: Burgalassi Silvano
Published: October 2024

It is not difficult to note that in tandem with the refinement of collective awareness and consciousness, phenomena typical of our age, albeit one steeped in contradictions, the problem of the handicapped is gradually being re-proposed to public opinion from an exclusively biological-individual setting to a conspicuous opening up to the sphere of the social and public sphere.
Research on the inclusion of the handicapped in schools in Italy
Authors: Scarpellini Costante
Published: October 2024

Not available.
A Narrative Review on Broken Heart Syndrome: A Guide for Clinicians to Understand Takotsubo Cardiomyopathy
Authors: Woods Edward , Chandrasekhar Sanjay , Rizwan Affan , Munye Mohamed , Newman Noah , Bennett Josiah , McLean Patrick , Montelaro Brett , Khawaja Muzamil , Krittanawong Chayakrit
Published: October 2024

Takotsubo cardiomyopathy (TCM) is a transient and reversible cardiomyopathy which exhibits regional wall motion abnormalities in the absence of obstructive coronary artery disease. While TCM is a rare condition (incidence <1%), its diagnosis has increased since its initial description in 1990. While many cases may follow an acute physical or emotional stressor, pathophysiology is likely multifactorial including factors such as catecholamine surges and microvascular dysfunction. On initial presentation, TCM often mimics acute coronary syndrome but may be differentiated with coronary angiography. Additional laboratory testing and imaging including transthoracic echocardiography may help with diagnosis and identification of complications such as left ventricular (LV) outflow obstruction and LV thrombus. Treatment is supportive, although medications such as angiotensin-converting enzyme inhibitors and beta-blockers have shown some benefit in improving long-term outcomes. Acute complications may include arrhythmia, LV or systemic thrombus, and cardiogenic shock, but most patients do well and experience rapid recovery. TCM continues to be an active area of research as there is still much to be learned regarding its pathogenesis, diagnosis, and treatment. This review analyzes the latest research to provide insight into the presentation, pathophysiology, diagnosis, and management of TCM.
A Study of Serum Ferritin and Thyroid-Stimulating Hormone Levels in Male Patients with Androgenetic Alopecia
Authors: Prasad Pallakshi , Sinha Preema , Beniwal Nagendra Singh , Sahu Rajesh
Published: October 2024

Background:

Androgenetic alopecia (AGA) is a multifactorial disorder expressed by several genes and various environmental factors apart from nutritional and endocrinological factors. Although association of iron deficiency (ID) as well as thyroid disorder has been evaluated in females, this is still an untouched topic as far as male pattern hair loss (MPHL) is concerned. This study tries to establish if any association of MPHL with ID and thyroid dysfunction.

Materials and Methods:

This case–control study comprised 30 consecutive cases of MPHL and equal numbers of age-matched healthy controls attending dermatology outdoor department at a tertiary care hospital. Cases as well as controls were evaluated and screened for the levels of serum ferritin (SF) and thyroid-stimulating hormone (TSH). Value of SF (8–388 ng/mL) and TSH (0.358–3.7 uIU/mL) was used as standardized reference.

Results:

In cases of AGA, SF level varied from 6.00 to 212.09 ng/mL (mean - 88.30 ng/mL). Whereas controls showed SF levels ranging between 23.67 and 185.05 ng/mL (mean 78.69 ng/mL). The range of TSH level in the case group was 0.379–5.078 uIU/L (mean 2.25 uIU/L), respectively, whereas control group showed serum TSH levels ranging between 0.30 and 4.30 uIU/L (mean - 1.78 uIU/L). Statistically considering two samples of equal variance P (2-tailed) for SF level was found to be 0.424, whereas 0.085 in case of TSH level depicting insignificant association. Spearman’s correlations (P = 0.244) between alopecia grade and SF level were found to be statistically insignificant (P = 0.193). Similarly, the P value calculated for the alopecia grade and serum TSH was 0.784, making the correlation between alopecia and serum TSH as insignificant.

Conclusion:

The study found no statistically significant difference in the SF level and TSH level of the cases as compared to controls.
A Cross-sectional Observational Study to Correlate the Trichoscopic Findings of Female Pattern Hair Loss with the Disease Severity and Underlying Histopathological Changes
Authors: Singh Shreya , Makhecha Meena B. , Rambhia Kinjal Deepak
Published: October 2024

Background:

The increasing prevalence of female pattern hair loss (FPHL) is an alarming concern. Trichoscopy is an important bedside diagnostic tool for the diagnosis of FPHL, but there are very few studies correlating it with disease severity or histopathological findings which would provide a better insight to the treating clinician. Hence, we decided to take up this study.

Aim:

This study aimed to study the trichoscopic findings of FPHL and correlate their relationship with disease severity and histopathological finding in our tertiary care hospital.

Materials and Methods:

Ninety females attending the dermatology outpatient department who were clinically diagnosed with FPHL were included in the study after informed consent and clearance from the institutional ethics committee. This was followed by a detailed history, clinical examination, and trichoscopic assessment. A trichoscopy-guided biopsy was performed from two sites. After the data collection, the statistical software used was IBM SPSS version 21.0 and Microsoft Office Excel 2007. P < 0.05 was accepted as indicative of statistical significance.

Results:

Anisotrichosis, increased interfollicular distance, and decreased hairs per follicular unit were universal. Brown peripilar sign had a positive association with inflammation (P < 0.0005) and white peripilar sign with duration of disease and fibrosis whereas dartboard sign had a significant association with inflammation as well as fibrosis.

Conclusion:

Trichoscopy helps in diagnosing the condition, assessing the severity, and monitoring the response to treatment. A knowledge about the features underlying specific trichoscopic signs such as inflammation and fibrosis would help the clinician decide the line of management.
Graham-Little-Piccardi-Lassueur Syndrome with Mucosal Involvement: A Rare Case
Authors: Polra Rutoo Vipulkumar , Tandel Jinal Jainendrabhai , Nair Pragya Ashok
Published: October 2024

Graham-Little-Piccardi-Lassueur syndrome (GLPLS) is a type of lichen planopilaris. It mainly affects females aged 40–60 years. It is characterized by the triad of patchy cicatricial alopecia of the scalp, noncicatricial alopecia of the axilla and groin and a follicular spinous papule on the body, scalp, or both. The diagnosis is based on clinicopathological correlation. Different modalities of treatment are available with unsatisfactory responses, so early diagnosis is necessary to prevent progression and scarring alopecia. A case of GLPLS with classical features on clinical, dermoscopic, and histopathological examination is presented in a 73-year-old female.
Ostial left main disease tackled with a percutaneous coronary intervention using a second-generation drug-eluting stent: A case report
Authors: Natarajan Deepak
Published: October 2024

The hospital emergency admitted a middle-aged male who had previously undergone stenting in the left anterior descending (LAD) and right coronary arteries due to severe central chest pain radiating to both arms. A two-dimensional color Doppler echocardiogram showed septal hypokinesia, and coronary angiography showed a 70% ostial left main (LM) stenosis. The LAD coronary artery had a patent stent, but the mid-right coronary artery had a totally occluded stent. The chest pain increased during coronary angiography, and the patient consented to percutaneous coronary intervention (PCI) with a second-generation drug-eluting stent. The patient was discharged in a stable condition. The evolution and the current approach of PCI compared to coronary artery bypass grafting surgery for LM coronary disease based on randomized trials are discussed.
Microwave ablation after VATS in patients with multiple pulmonary nodules
Authors: Cui Xiangyu , Zhao Jinglan , Lu Ruizhen , Sui Yingzhong , Shao Changqing , Zhang Zhixue , Chen Jun
Published: October 2024

Background:

The management of residual nodules after video-assisted thoracoscopic surgery (VATS) for multiple pulmonary nodules (MPNs) is challenging. Microwave ablation (MWA), which is highly repeatable and minimally invasive, has garnered widespread attention in the treatment of MPNs.

Methods:

Ninety-one patients with MPNs who underwent VATS for resection of high-risk nodules followed by MWA for residual nodules were examined. Clinical efficacy and complications were assessed. The primary end points were MWA success rate and complete ablation rate. Secondary end points were local progression-free survival (LPFS), overall survival (OS), and complications.

Results:

MWA was successfully completed in all patients. Mean tumor diameter, ablation time, and ablation output power were 0.81 cm, 3.4 minutes, and 39 W, respectively. LPFS was 100% at 3, 6, 12, and 24 months, respectively. OS was 100% at 12 and 24 months, respectively. No intraoperative or postoperative deaths occurred. Complications with MWA were infrequent. Pneumothorax was most common, occurring in 31 patients (34.07%); among these, seven (7.69%) required closed thoracic drainage. Pleural effusion occurred in six patients (6.59%), hydropneumothorax in five (5.49%), and pneumonia in three (3.30%). The pain level after MWA was moderate-to-severe in 29 patients (31.87%).

Conclusion:

MWA is safe and feasible for treating residual nodules in patients with MPNs who have undergone VATS. The incidence of complications was low, and most complications were mild.
Senile patient, no medical history: Hexdrive ingestion during implant placement
Authors: Srivastava Nikhil , Swaroop Chouduri Sai , Shetty Akshay , Bagga Vivek , Rishi Diljith , Kakkar Pragati
Published: October 2024

While rare, the ingestion of foreign bodies is a potential occurrence in dentistry, particularly during routine implant procedures if adequate precautions are not taken. Such incidents can lead to severe complications, including intestinal perforation. Confirmation of the presence or absence of a foreign body is crucial and is typically achieved through radiographs, enabling accurate diagnosis and subsequent treatment. The key to preventing such instances lies in obtaining a proper case history and ensuring the correct positioning of the patient. In general, instruments entering the gastrointestinal tract often pass without symptoms, and surgical intervention is rarely necessary. However, when indicated, a surgical approach may be required for instrument removal. Therefore, a precise diagnosis is essential to avoid unnecessary surgical interventions. This article aims to highlight a case involving the accidental ingestion of a hexdrive by a senile patient.
Efficacy of oral alprazolam in the management of perioperative anxiety in dental implant surgeries: A randomized controlled study
Authors: Ahmed Fazeel , Shetty Akshay D. , Krishnakumari Aparna Melethu , Ahmed Nida , Imran Mohammed , Chandrashekhar V
Published: October 2024

Objectives:

Surgical anxiety has emerged as a major limitation of implant surgery impeding its emergence as a leading choice of rehabilitation. It also triggers a series of physiological, emotional, and cognitive responses which adversely affects treatment outcomes and postoperative management. Hence, this study was designed specifically to address anxiety in patients undergoing dental implant surgeries.

Materials and Methods:

This study included 54 partially edentulous patients requiring single-implant rehabilitation. The patients were randomly assigned to the test group (Alprazolam group) and control group (Placebo group). Twenty-seven patients (test group) received Alprazolam 0.5 mg as a preemptive anxiolytic and 27 patients (control group) received a multivitamin tablet as placebo 1 h before implant surgery. Heart rate, blood pressure and respiratory rate of patients were measured to access the activation of sympathetic nervous system.

Results:

Oral administration of Alprazolam 1 h before the procedure showed significant reduction in preoperative anxiety in patients undergoing surgical placement of dental implants.

Conclusion:

Anxiolytic effect of Alprazolam mediated by binding to the alpha 1 subunit of GABA A receptor enhances the inhibitory effect on the nervous system. Preoperative administration of alprazolam 0.5 mg h prior, conceivably be standardized for management of surgical anxiety.
Pregnancy-induced Hypertension: What Are the Associated Factors in Rural Areas? A Study from Rural Dehradun, Uttarakhand
Authors: Dhinwa Manisha , Aggarwal Pradeep , Singh Mahendra , Bahurupi Yogesh Arvind , Sharma Nandita
Published: October 2024

Background:

Pregnancy-induced hypertension (PIH) is a major significant cause of adverse pregnancy outcomes – mortality and morbidities in both mother and foetus.

Aims:

The present study aims to determine the prevalence of PIH and its associated factors among pregnant women attending antenatal care in rural field areas of a tertiary care hospital in Uttarakhand.

Patients and Methods:

A cross-sectional study was conducted on pregnant women-seeking antenatal services from January 2020 to October 2020 at three sub-centres (Raiwala, Pratit Nagar and Haripur Kala) of the Primary Health Centre (Raiwala) after giving informed consent. A sample size of 113 was calculated and included in our study. A pre-tested structured schedule was used to interview the study participants after a pilot test. Blood pressure was determined using an average of three measurements, and some clinical and laboratory findings were reviewed from medical records; these were mainly the mother-child protection card. Data were presented as frequency, percentage frequencies and the results are presented with the table. Fisher’s exact statistics were calculated for the association with pregnancy-induced hypertension, and logistic regression was performed to identify independent predictors. P <0.05% was considered statistically significant.

Results:

The prevalence of PIH among total study participants in Dehradun District, Uttarakhand, was 6.2% (95% confidence interval [CI], 1.8%–10.6%). The majority of respondents were noted in ≤ 30 years of age group (91.15%), followed by > 30 years of age group (8.84%). In univariate regression, factors such as age, pre-term birth, abortion, pedal oedema, blurred vision, proteinuria, present history of gestational diabetes mellitus, present history of diabetes, present history of other morbidities, past history of diabetes, past history of other morbidities, i.e. surgeries, otitis media, obesity and thyroid, family history of hypertension and family history of diabetes were associated with pregnancy-induced hypertension. In multivariate logistic regression, maternal age (adjusted odds ratio AOR = 18.29, 95 CI% =2.3–141.4, P = 0.005*), pre-term birth (AOR = 61.7, 95% CI = 3.5–1071.3, P = 0.005*), (proteinuria AOR = 8, CI = 0.80–79.6, P = 0.006*), gestational diabetes (AOR = 19.9, CI = 2.9–133.06, P = 0.002*), history of other morbidities (AOR = 13.4, 95% CI; 1.7–106.5, P = 0.014*) and family history of diabetes (AOR; 8.7, 95% CI = 1.7–43.3, P = 0.008*) were found as the predictor factors for developing PIH.

Conclusions:

Early detection and treatment of pregnancy-induced hypertension and risk factors in pregnant women by healthcare professionals and policy-makers at the community level should be strengthened.
The Effect of Magnesium Sulfate plus Ketorolac versus Morphine plus Ketorolac on Pain Relief in Patients with Renal Colic: A Double-blind Randomized Clinical Trial
Authors: Mardani Hosseinali , Isfahani Mehdi Nasr , Abootalebi Alireza
Published: October 2024

Background:

It seems that magnesium sulfate (MgSO4) can be useful in reducing acute pain caused by stone passing through the ureter by reducing ureteral smooth muscle contractions.

Aim:

This study aimed to evaluate the effect of MgSO4 plus ketorolac versus morphine plus ketorolac on pain relief in renal colic.

Methods:

The present double-blind randomized clinical trial was performed on 70 patients with renal colic divided into two groups. Patients in the first group received 30 mg intravenous ketorolac plus 5 mg intravenous morphine while patients in the second group received 30 mg/kg MgSO4 plus 30 mg intravenous ketorolac. Then, patients’ hemodynamic parameters and pain scores were evaluated before and 20, 40, and 60 min after the intervention.

Results:

Within 60 min of administration, systolic blood pressure was significantly reduced in the morphine plus ketorolac group (P < 0.001) while there was no significant change in the MgSO4 plus ketorolac group in this regard (P = 0.576). In addition, the patients’ mean pain scores were not significantly different between the two groups in any of the studied times (P > 0.05).

Conclusion:

Given that the addition of MgSO4 to ketorolac, as compared with the addition of morphine (as a drug) to ketorolac, has been associated with fewer complications and greater stability of hemodynamic parameters, it can be stated that the use of MgSO4 as an adjunct can be a good choice for further pain relief in patients with contraindications for drug administrations.
Ficus carica Puree Exerts a Higher Antioxidative Profile in Hypoxic Lungs after Intermittently Inducing Hypoxia in Sprague–Dawley Rats
Authors: Fitri Ayu Tiara , Meliala Andreanyta , Widyawati Dwi , Narwidina Paramita , Siswanto Siswanto , Sumarno Yogi Tri
Published: October 2024

Background:

The body produces more hypoxia-inducible factor and reactive oxygen species in response to hypoxic situations because they cause unbalanced oxygen levels. Ficus carica provides numerous benefits because of its high antioxidant and mineral content. Nevertheless, the mechanism by which F. carica consumption confers this protective benefit remains incompletely understood.

Aim:

This study aimed to evaluate how F. carica puree (FCP) can affect the antioxidant enzyme activity and malondialdehyde (MDA) levels in the lung by mitigating the effects of intermittent hypoxia (IH).

Methods:

Thirty Sprague–Dawley rats were divided into five groups: negative control (NC), untreated; positive control (PC), treated with aquadest; FCP1; FCP2; and FCP3, which received FCP at doses of 1.25, 2.5, and 5 mL/200 g body weight. The treatment was administered for 4 weeks before inducing IH (10% O2 and 90% N2) into all groups (except NC) for 4 h for 7 days. Furthermore, hemoglobin (Hb) level, lung MDA level, and lung superoxide dismutase (SOD) enzyme activity were assessed.

Results:

The Hb level did not exhibit a significant increase under IH conditions. Conversely, the PC group exhibited the least activity of lung antioxidant enzymes and the highest lung MDA levels. In addition, the FCP intervention group exhibited lower MDA levels than the PC group and ameliorated relative lung weight loss.

Conclusion:

All FCP intervention groups showed lower MDA levels and higher SOD levels compared to the PC group, suggesting that FCP could mitigate the effects of hypoxia in rat lungs.
Diagnosis of Autism in Children Based on their Gait Pattern and Movement Signs Using the Kinect Sensor
Authors: Yazdi Shabnam Akhoondi , Janghorbani Amin , Maleki Ali
Published: October 2024

Background:

Autism spectrum disorders are a type of developmental disorder that primarily disrupt social interactions and communications. Autism has no treatment, but early diagnosis of it is crucial to reduce these effects. The incidence of autism is represented in repetitive patterns of children’s motion. When walking, these children tighten their muscles and cannot control and maintain their body position. Autism is not only a mental health disorder but also a movement disorder.

Method:

This study aims to identify autistic children based on data recorded from their gait patterns using a Kinect sensor. The database used in this study comprises walking information, such as joint positions and angles between joints, of 50 autistic and 50 healthy children. Two groups of features were extracted from the Kinect data in this study. The first one was statistical features of joints’ position and angles between joints. The second group was the features based on medical knowledge about autistic children’s behaviors. Then, extracted features were evaluated through statistical tests, and optimal features were selected. Finally, these selected features were classified by naïve Bayes, support vector machine, k-nearest neighbors, and ensemble classifier.

Results:

The highest classification accuracy for medical knowledge-based features was 87% with 86% sensitivity and 88% specificity using an ensemble classifier; for statistical features, 84% of accuracy was obtained with 86% sensitivity and 82% specificity using naïve Bayes.

Conclusion:

The dimension of the resulted feature vector based on autistic children’s medical knowledge was 16, with an accuracy of 87%, showing the superiority of these features compared to 42 statistical features.
Evaluation of the Activity of Vogt–Koyanagi–Harada Disease; A Comparison of Indocyanine Green Angiography Scoring, Enhanced Depth Imaging Optical Coherence Tomography, and Choroidal Vascularity Index
Authors: Fadakar Kaveh , Rezaii Keivan , Niktinat Hanieh , Roohipourmoallai Ramak , Mahmoudi Tahereh , Tuli Sonal , Ahmadi Amin , Pour Elias Kalili , Pahlaviani Fatemeh Golsoorat , Mahdizad Zahra , Davoudi Samaneh , Zarei Mohammad , Ebrahimiadib Nazanin
Published: October 2024

Purpose:

To investigate the correlation between choroidal biomarkers using enhanced depth imaging optical coherence tomography (EDI-OCT) and indocyanine green angiography (ICGA) scoring for monitoring the activity of Vogt–Koyanagi–Harada (VKH).

Methods:

Patients who were not in the acute phase of VKH were recruited. Simultaneous EDI-OCT and ICGA were captured in seven patients only at baseline, in six patients at the 3-month follow-up, and in two patients at both the 6- and 9-month follow-ups. Subfoveal choroidal thickness (SFCT), subfoveal choroidal area (SFCA), and choroidal vascular index (CVI) were measured on EDI-OCT using FIJI software and a denoising system. ICGA scoring was performed.

Results:

Fifteen subjects with the median of 4-month follow-up were recruited. Forty-eight pairs of EDI-OCT and ICGA were investigated. In univariate analysis, ICGA scores were positively associated with SFCT, and SFCA, but negatively with CVI. The strength of correlation between ICGA scores and SFCT was strong (correlation coefficient: 0.91). In multivariate analysis, only SFCT remained significant (B: 2.4, 95% confidence interval: 1.9–3.0; P < 0.001).

Conclusions:

SFCT can be an acceptable representative of the subclinical inflammatory activity of VKH. As an alternative to ICGA, SFCT functions better than SFCA and CVI.
Deep Learning Algorithm for Keratoconus Detection from Tomographic Maps and Corneal Biomechanics: A Diagnostic Study
Authors: Quanchareonsap Wiyada , Kasetsuwan Ngamjit , Reinprayoon Usanee , Piyacomn Yonrawee , Wungcharoen Thitima , Jermjutitham Monthira
Published: October 2024

Purpose:

To develop an artificial intelligence (AI) approach for differentiating between normal cornea, subclinical, and keratoconus (KC) using tomographic maps from Pentacam (Oculus) and corneal biomechanics from Corvis ST (Oculus).

Methods:

A total of 1,668 tomographic (769 patients) and 611 biomechanical (307 patients) images from the Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital were included. The sample size was divided into the Pentacam and combined Pentacam-Corvis groups. Different convolutional neural network approaches were used to enhance the KC and subclinical KC detection performance.

Results:

AI model 1, which obtained refractive maps from Pentacam, achieved an area under the receiver operating characteristic curve (AUC) of 0.938 and accuracy of 0.947 (sensitivity, 90.8% and specificity, 96.9%). AI model 2, which added dynamic corneal response and the Vinciguerra screening report from Corvis ST to AI Model 1, achieved an AUC of 0.985 and accuracy of 0.956 (sensitivity, 93.0% and specificity, 94.3%). AI model 3, which added the corneal biomechanical index to AI Model 2, reached an AUC of 0.991 and accuracy of 0.956 (sensitivity, 93.0% and specificity, 94.3%).

Conclusions:

Our study showed that AI models using either anterior corneal curvature alone or combined with corneal biomechanics could help classify normal and keratoconic corneas, which would make diagnosis more accurate and would be helpful in decision-making for the treatment.
Correlation between Orbital Computed Tomography Scan Measurements and Clinical Enophthalmos in Acute Isolated Orbital Floor Fractures
Authors: Rajabi Mohammad Taher , Samadi Melika , Ghods Sepide , Rafizadeh Seyed Mohsen
Published: October 2024

Purpose:

To analyze the correlation between orbital computed tomography (CT) scan measurements including the fracture area (FA), the fracture location, the soft-tissue herniation volume (HV), the fractured orbital volume ratio (OVR) to the normal orbit, and the clinical enophthalmos in acute isolated orbital floor fractures.

Methods:

We enrolled 100 patients with acute isolated unilateral orbital floor fractures from May 2017 to January 2021. Based on the CT scan findings, we measured the FA, HV, OVR, and fracture site. We assessed enophthalmos using both clinical (CE) and radiographic (RE) measurements. Additionally, we investigated the correlation between CE and the measured parameters, along with the relationship between the pattern of diplopia and the fracture site.

Results:

We identified enophthalmos in 81% and diplopia in 78% of the patients with an acute blowout orbital floor fracture. CE was moderately correlated with the FA (R
2 = 0.4341, P < 0.001). CE was weakly correlated with the HV (R
2 = 0.2861, P = 0.04). Anterior fractures caused diplopia in both vertical gazes, but posterior fractures were mostly associated with diplopia in the up gaze. OVR was strongly associated with RE (R
2 = 0.663, P < 0.0001) and moderately associated with CE (R
2 = 0.4378, P < 0.0001). The univariate regression analysis also showed that OVR could significantly predict CE and RE.

Conclusions:

OVR surpasses other CT scan measurements such as FA and HV in the prediction of clinical enophthalmos. Thus, OVR could be utilized to estimate clinical enophthalmos at the time of presentation, especially when the acute clinical setting prohibits the proper clinical evaluation.
How Safe is Nd:YAG Laser Capsulotomy in Patients with Uveitis? Outcomes of a Long-Term Study
Authors: Rajpoot Mukesh , Nehra Harshraj , Sharma Vinod , Bhargava Rahul , Pandey Kanakambari , Mehta Bhavya , Kalra Gautam , Reddy P.L. Sireesha
Published: October 2024

Purpose:

To study the outcomes and complications of Nd: YAG laser capsulotomy in patients with uveitis.

Methods:

This study retrospectively evaluated outcomes of Nd: YAG laser capsulotomy in 260 eyes of 260 patients with uveitis. The main indications for performing capsulotomy were a visually significant posterior capsule opacification (PCO) and inability to visualize the posterior segment. The presence of 5 or <5 cells per high-power field in the anterior chamber for a minimum period of 3 months was a prerequisite for capsulotomy.

Results:

The mean age of patients was 52.8 ± 11.3 (range, 38–75 years). The incidence of PCO in the study was 22.4%. The mean follow-up was 21.5 ± 11.3 months postcapsulotomy. The mean best-corrected visual acuity (BCVA) improved in 161 (62%) eyes after capsulotomy. The BCVA remained stable in 50 (19.3%) eyes due to preexisting ocular pathology involving the macular area. There was worsening of BCVA in 49 (18.8%) eyes. The main causes of worsening of BCVA were sustained intraocular pressure (IOP) elevation (n = 13%), cystoid macular edema (CME) (n = 8.5%), and retinal detachment (RD) (n = 2.7%), respectively. Ninety-one percent (n = 20) of patients with CME had exaggerated postlaser inflammation and recurrent uveitis. The presence of posterior vitreous detachment (PVD) and higher laser energy levels were significant risk factors for RD.

Conclusions:

Nd: YAG laser capsulotomy in patients with uveitis may be associated with complications. Inflammation and IOP should be well controlled before initiating laser capsulotomy. Capsulotomy should be performed with caution in patients with preexisting PVD.
Short-Term Outcomes of a Modified Safer Surgery Trabeculectomy Technique
Authors: Konuganti Prakriti Yagnam , Rajamani Muralidhar , Chaya Craig John , Ramamurthy Chitra
Published: October 2024

Purpose:

To determine the short-term outcomes of a modified Moorfields Safer Surgery System technique of trabeculectomy.

Methods:

This is a prospective interventional study. Trabeculectomy was performed according to the author’s modification of Moorfields Safer Surgery System. This method allows titrating the opening pressure of trabeculectomy by varying the side cuts, varying the ostium size, and adjusting the tightness of the sutures. Forty-four eyes of 43 patients were included. Main outcome measures include postoperative intraocular pressure (IOP), incidence of intra and postoperative complications, and success up to 6 months after surgery.

Results:

The mean preoperative and postoperative IOP at 6 months were 20.97 ± 7.93 mmHg and 12.69 ± 4.76 mmHg, respectively (n = 44). 70.5% of the patients had absolute success at 6 months, and the overall success was 88.6%. None of the patients had hypotony and there were no intraoperative complications noted. Forty-two out of 44 eyes (95.5%) had diffuse formed blebs without leak on the 1st postoperative day. The most common postoperative complication (13.6%) was a conjunctival leak that was detected on fluorescein staining. In all these patients, the anterior chamber was deep, and the bleb well formed. These leaks were resolved with conservative measures. Many of these leaks would have been missed if not intentionally looked for. Excluding this complication, we had a complication rate of 9.1%.

Conclusion:

The authors’ modification of the Moorfields Safer Surgery System technique may allow the surgeon to optimize aqueous flow through trabeculectomy while mitigating complications.
Topical Insulin for Neurotrophic-Related Epithelial Defects: Where do We Stand? A Systematic Review
Authors: Wouters Colette , Saelens Isabelle , Delbeke Heleen
Published: October 2024

Purpose:

To review the existing literature to evaluate the utility of insulin eye drops as a treatment for neurotrophic-related epithelial defects.

Methods:

A comprehensive literature search of Medline, Embase, and Web of Science and additional manual searches were conducted using relevant keywords. All articles published from January 2005 to January 2024 were examined. Studies on the use of topical insulin drops in neurotrophic epithelial defects were included.

Results:

A total of 16 articles were found relevant to be discussed in the review. All included patients had neurotrophic-related epithelial defects ranging from 3.8 mm2 to 144 mm2. After treatment with topical insulin, most of the epithelial defects showed a complete epithelialization. Various concentrations and types of insulin were used. The studies also varied in the type of vehicle used in the preparation of insulin drops. Two randomized controlled trials demonstrated that topical insulin drops were more effective than conventional treatment with artificial tears or autologous serum. All included studies, except for two, reported the absence of local or systemic side effects.

Conclusions:

Topical insulin is a promising and effective (adjuvant) treatment for neurotrophic keratopathy. It facilitates the healing of neurotrophic epithelial defects and offers many advantages over the current treatment options; insulin is widely available and it is relatively inexpensive. Topical insulin drops do not affect systemic blood glucose levels and are well tolerated. However, further investigation is needed.
Identification of Learning Styles of Undergraduate Physiotherapy Male and Female Students
Authors: Rani Jyoti , Jagga Vinay
Published: October 2024

Abstract

Background:

The concept of learning styles pertains to the different ways in which individuals organize and interpret information. Numerous factors influence an individual’s learning style.

Objective:

The purpose of this study was to investigate the most popular learning styles of male and female physiotherapy students.

Materials and Methods:

A total of 181 participants were selected via a stratified random sampling method based on specific inclusion criteria. Of these, 71 were male and 110 were females. The VARK learning style questionnaire was employed to assess their learning styles, and the data were analyzed using statistical variables such as mean and percentage.

Results:

The results indicated that 91.5% of male participants preferred bimodal learning styles, with the most popular learning style among them being kinesthetic, chosen by 53.8%. Among female participants, 83.6% preferred unimodal learning styles, while 7.27% preferred bimodal learning styles. Their most favored learning style was also kinesthetic, chosen by 61.38% of female participants.

Conclusion:

The study identified that both male and female physiotherapy students mostly preferred the kinesthetic learning styles, thereby indicating a similarity in learning styles between them. These findings could be useful for educators in the field of physiotherapy by helping them design learning materials that cater to the most popular learning styles of their students.
An Assessment of Distraction Plating in the Management of Intra-Articular Comminuted Distal End Radius Fractures in the Elderly
Authors: Panat Rohan , Singh Kunal , Vibhute Dinesh , Panat Mangesh
Published: October 2024

Background:

Distal radius fractures are one of the most common injuries, representing one-sixth of all fractures seen and treated in the emergency department. Distal radial fractures with extensive comminution involving the metaphyseal–diaphyseal junction present a major treatment dilemma, especially when it has an intra-articular involvement. This study evaluates the surgical and functional outcomes of intra-articular comminuted fracture of distal end radius treated with dorsal distraction plating.

Materials and Methods:

A prospective randomized controlled observational study was done with a sample size of 50 patients over a period of 3 years, each of whom was diagnosed to have an intra-articular fracture of distal end radius (AO classification type C). All patients were treated by distraction plating (radio-metacarpal). Minimum follow-up after treatment of upto 6 months was ensured, and a final assessment of the functional outcome was then decided.

Results:

The study showed that average union time was 8.65 ± 0.93 weeks, and average implant removal was done at 8.75 ± 0.85 weeks. All patients achieved full ROM at the wrist, maintaining articular congruity post-implant removal. In our study, we found two (6.67%) patients with superficial infections and two (6.67%) patients with complex regional pain syndrome. No patients were reported with the tendon (extensor pollicis longus) irritation, neuropraxia, stiffness of the wrist and inter-phalangeal joints, nonunion/malunion, or implant failure.

Conclusion:

The final results were evaluated and compared after making observations for age, sex, mode of trauma, dominancy of the affected hand, time interval between injury and admission, duration of hospital stay, duration of surgery, time to fracture union, and complications. The final outcome was measured by DASH SCORE. All patients had excellent or good results treated with distraction plating; six (20.00%) patients out of 30 studies were found to have excellent results, whereas the remaining 24 (80.00%) patients had good results.
Current perspectives on vestibular insights into spatial cognition: A narrative review
Authors: Roy Barnana , Thomas Annie
Published: October 2024

Conventionally, the focus on vestibular information has centered on basic functions such as adjusting eye movements, controlling posture, and gaze stabilization. However, there has been a noteworthy transformation in recent years as researchers seek to unravel the mysterious relationship between the vestibular system and spatial cognition. This narrative review endeavors, to provide a thorough analysis of current perspectives by delving into a vast body of research in this domain. The principal aim is to critically assess existing studies, offering nuanced insights into the complex interplay between the vestibular system and spatial abilities. For this the electronic database such as PubMed, EMBASE, CINAHL, and Google Scholar was searched for available literature from 2014 onward based on inclusion and exclusion criteria. After reviewing the literature by different authors, a brief review was conceptualized from the same. This article thoroughly explores brain regions related to vestibular function and their connections to spatial orientation and clinical implications. It identifies research gaps and proposes future avenues to deepen our understanding of the vestibular system’s role in spatial cognition, aiming for a holistic perspective. The intricate link between the vestibular system and spatial memory processing is a significant area in neuroscience, with vestibular exercises holding potential for personalized interventions, emphasizing the need to address research gaps for optimal cognitive well-being.
Physiotherapy student’s perception of facilitators and barriers to their academic performance: An exploratory study
Authors: Panhale Vrushali P. , Nair Shruti Prabhakaran , Doshi Aashvi
Published: October 2024

INTRODUCTION:

Academic performance is defined as the extent to which student accomplishes their educational goals as a result of exposure to learning. Identifying the facilitators and barriers influencing the performance of physiotherapy (PT) students will help in enhancing the learning experience of the learners.

MATERIALS AND METHODS:

A convenient sample of 1118 under-graduate PT students were recruited from PT colleges of a state health-science university. A semi-structured questionnaire consisting of four domains, namely institution, faculty, family/environment, and personal factors was developed after a thorough literature search and focused group discussion. The final validated questionnaire was administered to the participants. Descriptive statistics were summarized as frequencies and percentages.

RESULTS:

Out of 1800 students approached, 1118 participated in the study showing a response rate of 62.11%. The mean age of the participants was 20.87 ± 1.35 years. 83.81% (n = 937) participants were females and 16.19% (n = 181) were males. The most commonly reported facilitators were provision of study leaves for examinations (n = 1101, 98.48%), self-determination to become a skilled practitioner (n = 1100, 98.39%), good clinical exposure (n = 1098, 98.21%), availability of experienced faculty members (n = 1095, 97.94%), and positive atmosphere at home (n = 1089, 97.41%). Whereas personal/family health problems (n = 987, 88.28%), peer pressure (n = 944, 84.44%), exam-related anxiety (n = 891, 79.70%), and social commitments in family (n = 881, 78.80%) were the commonly reported barriers of academic performance.

CONCLUSION:

Our research concludes that PT students’ perceptions of their academic performance are multifaceted and influenced by both personal and environmental factors inclusive of support from academic institution and their family.