bluuebunny/crossref_metadata_2025 huggingface dataset:
Behçet’s disease and COVID-19, retrospective analysis
Authors: Elmohsen Mai Nasser Abd , Abouaggour Amr Khaled Mohamed , Youssef Maha Mohamed , Aboulfotouh Mohammad Refaat
Published: August 2024

Purpose

This study aimed to investigate the impact of the COVID-19 pandemic and its consequences on the clinical condition of patients with Behçet’s uveitis and compare this with the pre-pandemic state.

Patients and methods

This retrospective observational study included patients with Behçet’s uveitis who had adequate follow-up before the pandemic (three visits before March 2020) and during the pandemic (two visits between March 2020 and September 2021). We compared uveitis activity, complication rates, and treatment changes during the pandemic with their preCOVID data. Patients who met the inclusion criteria were contacted by phone to confirm previous COVID-19 exposure and vaccination status.

Results

The study included 59 eyes of 30 patients with Behçet’s uveitis. There was a statistically significant difference between the preCOVID and COVID eras with respect to visual acuity, with median values changed from 1.033 to 1.3 (P=0.003). There was an increase in secondary glaucoma (16.9% to 30.5%, P=0.039), with a corresponding increase in antiglaucoma topical eye drops (20.3–35.6%) (P=0.012). The use of subtenon injections and systemic steroids decreased during the COVID-19 pandemic, but the difference was not statistically significant (P=0.687 and P=0.481, respectively). However, the average steroid dose and the number of subtenon injections per patient showed a statistically significant decrease during the pandemic (20 and 26.7 mg per day, respectively) compared to the preCOVID era (0 and 1 injection per patient) (P=0.007 and 0.027, respectively).

Conclusion

The COVID-19 pandemic did not result in increased uveitis activity, but a decrease in follow-up frequency led to more complications, mainly secondary glaucoma.
Challenges and difficulties in diagnosis of normal-tension glaucoma
Authors: Metwally Islam M. , Bahgat Mostafa M. , El-Shahed Ahmed F.
Published: August 2024

Aim

The aim of this study is to clinically investigate the challenges and pitfalls of normal-tension glaucoma (NTG) diagnostic methods by ophthalmic clinical and investigative examinations.

Setting

This study was conducted at Al-Agouza Police Authority Hospital and Badr University Hospital.

Methods

A cross-sectional comparative study between the diagnosis of normal nonglaucoma patients and NTG. It included 40 normal nonglaucoma patients’ eyes as controls and 40 NTG patients’ eyes who met inclusion criteria. They were assessed by a complete ophthalmic exam., visual field (VF), and optical coherence tomography (OCT) variables between January 2022 and September 2022.

Results

The median age of the control group was 38 years old, while that of glaucomatous patients was 41 years old. The mean intraocular pressure (IOP) for the normal group was 15.53 mmHg (±1.935), while that for the glaucomatous group was 16.85 mmHg (±1.703). The intraocular pressure was considerably higher in the NTG group compared with the control (P = 0.0017).

The mean deviation (MD) in dB of VF loss was considerably higher in the NTG group compared with the control (P = 0.0001). Also, the mean standard deviation (MSD) was considerably varied between the two groups (P < 0.0001).

The average Retinal Nerve Fiber Layer (RNFL) in the NTG group, with a mean of 72.3

JOURNAL/jeos/04.03/01735167-202316030-00002/inline-graphic1/v/2023-09-27T140929Z/r/image-jpeg

(±10.239) was significantly lower than in the control group with a mean of 102.025

JOURNAL/jeos/04.03/01735167-202316030-00002/inline-graphic2/v/2023-09-27T140929Z/r/image-jpeg

(±7.454), P = 0.0001.

Optic Disc Parameters: The Cup Area (mm2) was significantly wider in the NTG group with a mean of 1.62 (±0.476) than in the control with a mean of 1.297 (±0.44), P = 0.0024. Also, the Rim Area was significantly smaller in the NTG group with a mean of 0.614 (±0.342) than in the control with a mean of 1.135 (±0.319), P = 0.0024. The Cup/disc ratio was significantly larger in the NTG group than in the control group (P < 0.0001).

The average Ganglion cell complex (GCC) was considerably thinner in the NTG patients in comparison to the controls (P = 0.0001).

Conclusion

The effects of NTG on VF and optic nerve seems to be more intensive. More focal notches and disc hemorrhage were noted in NTG. In the NTG group, the Cup Area was potentially wider, the rim area was significantly thinner, and the Cup/disc ratio was significantly larger.
Evaluation of corneal topography and higher order aberrations of the fellow eye in unilateral keratoconus
Authors: El Morsy Mahmoud Mohamed Attia , El Dein Galal Mohamed Ezz , Ghanem Assad Ahmed Ibrahiem , Omar Ismail Ahmed Naguib , Elhiny Rasha Safwat
Published: August 2024

Purpose

To assess parameters of corneal topography and higher order aberrations (HOAs) data in the apparently normal contralateral eyes of unilateral keratoconus (KC) cases in comparison with normal eyes of healthy individuals.

Patients and methods

This observational case-control study included 70 eyes divided into two equal groups; group A was the fellow eyes of unilateral keratoconus patients and group B included the normal control eyes. They were examined by Schimpflug camera to extract the study parameters (keratometry indices, the inferior-superior(I-S) difference at 4 mm, posterior elevation (PE), front and back difference, thickness progression index, corneal pachymetry, multimetric D index (D index), topometric indices and Zernike analysis).

Results

In comparing the study data between Groups A and B, we demonstrated that ISV, IVA, and CKI had no difference between the two groups. But other topometric parameters showed statistically significant differences between the two groups. Assessment of corneal aberrations revealed that the RMS HOA, vertical coma, and spherical aberrations were associated with significant increases in the apparently normal eyes of unilateral KC cases in comparison with healthy individual eyes (P<0.001).

Conclusion

Fellow eyes of unilateral KC cases seem not to be totally normal. And so, it is recommended to regularly examine these eyes at close intervals to catch up any abnormality and to avoid KC progression.
Courses of uveal manifestations following surgical treatment of patients with ulcerative colitis in adults: Observation study
Authors: Al-Naimy Mohammed A. , Habeeb Tamer A.A.M. , Deiaeldin Yasmine A.
Published: August 2024

Purpose

This study aimed to investigate the course of uveal manifestations in a cohort of patients who underwent surgery for ulcerative colitis (UC), highlighting the diverse spectrum of associated eye disorders and alerting clinicians of their significance.

Patients and methods

A retrospective observational study was conducted on 40 UC patients with ocular manifestations who underwent one-stage laparoscopic restorative proctocolectomy according to the European Crohn’s and Colitis Organization (ECCO) guidelines. Ophthalmic examinations were performed preoperatively and postoperatively during the 6-month follow-up period. Anterior uveitis attacks were graded based on the presence of cells or flares, vitreous haze indicates intermediate uveitis while posterior uveitis was indicated by retinitis or choroiditis, or both. Recurrence was a Standardization of Uveitis Nomenclature (SUN) grading system score greater than or equal to 2+ for anterior chamber cells or vitreous haze.

Results

Postoperatively, uveitis regression was observed in ∼60% of the patients, 25% showed a stationary course, and 15% exhibited progression. After surgery, more patients had lower Standardization of Uveitis Nomenclature grades for anterior chamber cells, flares, and vitreous haze than at baseline.

Conclusion

Ulcerative colitis can manifest with various ophthalmic manifestations ranging from nonspecific to severe, affecting visual prognosis or remaining asymptomatic. In our study most patients who underwent colonic surgery got benefits in the form of not only decreasing the severity of disease activity but also a decrease in the recurrence rate postsurgical.
Role of epithelial mapping in the differentiation between early keratoconus and high regular astigmatism using spectral-domain optical coherence tomography
Authors: Abdelfadeel Sameh M. , Khalil Noha M. , Khazbak Lobna M. , Sidky Mohamed Karim
Published: August 2024

Pur6pose

To detect epithelial thickness-based diagnostic variables to detect early keratoconus (KC) and differentiate cases of early KC from high regular astigmatism, especially if abnormal topographic changes are present.

Patients and methods

A total of 84 eyes with high regular astigmatism on Scheimpflug imaging were evaluated by anterior segment optical coherence tomography (AS-OCT). Imaging of the cornea as well as pachymetry and epithelial thickness mapping was done using AS-OCT via a special lens mounted to a tomographic device. The same was done using Scheimpflug imaging (CSO Sirius device). Thickness of the corneal epithelium was automatically mapped using a computer algorithm. Calculations of the following diagnostic factors were recorded: minimum, superior–inferior, minimum–maximum, root-mean-square variation, root-mean-square pattern deviation, and thickness of the zonal epithelium.

Results

This study analyzed 84 eyes divided into two groups: group A (n=56 eyes) had high regular astigmatism and group B (n=28 eyes) with early KC. The mean spherical refraction, cylindrical refraction, and central corneal thickness (Scheimpflug imaging) for group A were −1.16±1.02 D, −3.67±0.67, and 542.88±29.64 μm, respectively. In group A, the mean central corneal thickness and central epithelial thickness was 538.84±29.67 and 52.34±1.69 μm, respectively. The mean spherical refraction, cylindrical refraction, central corneal, and epithelial thickness mean for group B were −1.75±0.87, −4.02±0.69 D, 505.36±28.48, and 49.93±0.9 μm, respectively. A significant correlation between central epithelial thickness with anterior elevation was noted in group B (P=0.048).

Conclusion

AS-OCT epithelial mapping may prove to be a useful diagnostic tool for determining early development of KC.
Hospital-based study of causative organisms and clinical picture of orbital cellulitis secondary to sinusitis
Authors: Shokier Gihan M. , Rabiea Sara A. , Soliman Mahmoud M. , EL Batawi Ahmed M. , Ahmed Rana , Bahgat Nermeen M.
Published: August 2024

Objectives

The aim of this study was to assess the behavior of orbital cellulitis secondary to sinusitis and the detection of the causative organisms in patients presenting to Cairo University Hospitals.

Patients and methods

This was a cohort study in which 43 cases diagnosed with orbital cellulitis secondary to sinusitis were admitted to hospital and were enrolled in the study. All patients underwent thorough ophthalmological examinations, ENT consultations, and systemic assessments. Coronal and axial computed tomography scans of orbit, paranasal sinuses, and brain were done for all patients. Some patients had specimen sent for culture and sensitivity from the drained pus either from sinuses or lid abscesses.

Results

A total of 43 cases were involved in this study. The mean age was 23.93±19.38 years. Seven patients had systemic medical disorders. Six patients were diabetic. All patients received antimicrobial treatment, with seven (16.2%) patients needing addition of antifungal treatment and seven (16.2%) patients needing addition of steroids. A total of 20 (46.5%) patients needed surgical intervention. From these patients who had a specimen sent for culture and sensitivity, five (11.6%) had bacterial infections, seven (16.3%) had fungal infections, and eight (18.6%) showed no growth. A total of 39 (90.7%) patients responded clinically to treatment and four patients had recurrence within 6 months.

Conclusion

Bacterial infection was the commonest cause of orbital cellulitis secondary to sinusitis in the current study. Diabetes mellitus was a predisposing factor to fungal infection, which had a poor prognosis, in which visual acuity reached no light perception.
Comparative study of diathermy assisted probing and intubation versus standard probing and intubation in congenital nasolacrimal duct obstruction
Authors: Elessawy Kareem B. , Gawdat Tamer I. , Ibrahim Mohamed A. H. , Elbaky Sameh H. A.
Published: August 2024

Purpose

To compare the efficacy of diathermy-assisted probing and intubation to standard probing and intubation in children more than 2 years.

Methods

A prospective comparative randomized clinical study conducted from April 2019 to April 2020. Follow-up visits at 1 week, 1, 3, and 6-month. This study included 160 eyes of 104 children with congenital nasolacrimal duct obstruction. Children were divided into two groups; group I included 80 eyes of 50 children who underwent probing with a metal probe followed by intubation, and group II included 80 eyes of 54 children who underwent probing, diathermy, followed by intubation to assess the efficiency and success rate of endodiathermy probe followed by intubation in children.

Results

After 1 week and 1 month, both techniques were comparable as regards the MUNK score (P value = 0.11 for each). However, after 3 and 6 months, there was a statistically significant difference between both groups regarding the MUNK score (P-value=0.01 for each). Fluorescein disappearance test (FDT) results with a success rate were higher in group II than in group I (90% vs. 77.5%, P value = 0.03*). We removed 5 tubes early in group I and 3 tubes early in group II due to early tube extrusion or chess wiring.

Conclusions

The newly introduced diathermy-assisted probing and intubation could be considered as an alternative method to treat congenital nasolacrimal duct obstruction. The success rate is higher when compared with the standard method of intubation.
Evaluation of the role of optical coherence tomography angiography in monitoring treatment response in patients with neovascular age-;1;related macular degeneration
Authors: Makled Hebatalla S. , Sahban Ahmad A. , Khattab Ayman M. , Nossair Ashraf A.
Published: August 2024

Aim

The aim was to assess the role of optical coherence tomography angiography (OCTA) in the diagnosis, assessment of activity, and monitoring the treatment response of choroidal neovascularization secondary to age-related macular degeneration (AMD).

Methods

Prospective, interventional case series of eyes that were diagnosed with active neovascular AMD. Spectral-domain optical coherence tomography (SD-OCT) and OCTA were done at baseline after intravitreal antivascular endothelial growth factor (anti-VEGF) treatment to determine OCTA sensitivity in the detection of activity in relation to SD-OCT findings and its specificity following intervention.

Results

Twenty-five eyes were included, of which 20 eyes were imaged successfully by OCTA. The diagnostic sensitivity of OCTA in those eyes was found to be 75%, and its sensitivity in the assessment of neovascular activity was 80 and 60%, before and after anti-VEGF therapy, respectively, whereas its specificity after anti-VEGFs therapy was 100%.

Conclusion

Although SD-OCT continues to be the gold-standard for noninvasively diagnosing and tracking neovascular AMD treatment response, OCTA may offer a noninvasive option that can support treatment selection throughout follow-up and guide efficient therapeutic approaches.

Author contributions:

All authors contributed to the construction of idea and question of the research with complete assessment and managements of all the study group. Hebatalla S. Makled: Assessment of the patients with follow-up, doing OCTA for the patients with interpretation, data collection and analysis, and manuscript writing and revision. Ahmad Almabrook Sahban: recruitment of patients with consent acquisition, doing OCTA for the patients, treatment with follow-up of the patients, collection and analysis of data, and manuscript writing. Ayman M Khattab: Patients assessment, decision making and follow-up of patients treatment, OCTA interpretation, collection and analysis of data, and manuscript writing and revision. Ashraf Ahmed Nossair: Patients assessment with follow-up, OCTA interpretation, data collection and analysis, and manuscript writing and revision.
Comparative evaluation of physical properties of resin and calcium silicate-based root canal sealers
Authors: Khullar Lochan , Purayil Tina Puthen , Ginjupalli Kishore , Pentapati Kalyana Chakravarthy , Muliya Vidya-Saraswathi , Shenoy Neetha Goverdhan
Published: August 2024

Aim:

The aim of this study was to evaluate the flow, solubility, and pH of AH Plus sealer, Bio-C Sealer, and Cerafill RCS.

Methods:

The selected sealer materials were mixed according to instructions of the manufacturers under aseptic conditions. For flow and solubility, the recommendations of ISO 6876/2012 and ANSI/ADA 2000 standards were followed (n = 10). Additionally, pH changes during the setting of selected sealers (n = 10) were measured at regular intervals of time using a digital pH meter. Data were statistically analyzed using Kruskal–Wallis ANOVA test with post hoc Dunn’s test.

Results:

The flow of Bio-C Sealer was significantly higher than Cerafill RCS (P < 0.05). Among the sealers, Bio-C Sealer exhibited the highest solubility, whereas AH Plus exhibited the least solubility. Calcium silicate-based sealers showed higher pH than resin-based sealer.

Conclusion:

The results of the present study indicate that resin-based sealer and calcium silicate-based sealers have acceptable flow, whereas calcium silicate sealers exhibited high solubility and an alkaline pH.
A qualitative and quantitative evaluation of smear layer removal efficacy of three different chelating agents using scanning electron microscopy and inductively coupled plasma mass spectrometry
Authors: Singh Gyanendra Pratap , Attavar Shruthi H. , Kavuri Sivaji
Published: August 2024

Aim:

The main goal of the present experimental research was to analyze the smear layer removal efficacy of chelating agents and correlate with the amount of calcium released from the radicular dentin with the canal space.

Methods:

Forty single-rooted teeth were exposed to standardized root canal instrumentation technique with copious amount of irrigation with 2.5% sodium hypochlorite solution between each instrumentation, following which the specimens were randomly allocated into four groups: Group I: 17% ethylenediaminetetraacetic acid (EDTA), Group II: 0.2% Chitosan, Group III: Qmix™, and Group IV: Control group with no final irrigation. After the irrigation protocol, the specimens were subjected to the scanning electron microscopy (SEM) evaluation to determine the smear layer removal efficacy and induced plasma mass spectrophotometric analysis was done to quantify the amount of calcium ions content in the irrigating solution. The data were statistically analyzed using Kruskal–Wallis and Dunnett’s tests for smear layer removal analysis. Quantitative data were interpreted by the analysis of variance and Tukey’s-Karmer test for the spectroscopic data analysis.

Results:

The result of the SEM analysis showed that there was no significant difference among the smear layer removal efficacy between the experimental groups with P > 0.05. The quantitative spectrophotometric data showed that the highest calcium ions release was from the 17% EDTA group followed by 0.2% chitosan and lesser from the Qmix™ group.

Conclusion:

Within the limitation of this in vitro experimental research, all the three experimental groups showed a better smear layer removal efficacy. EDTA showed the greater amount of mineral release compared to Qmix™ and chitosan group.
Total laparoscopic hysterectomy – Learning curve and its impact on surgical outcome of 773 case series from a single center
Authors: Tantia Aruna , Chatterjee Sunipa , Khanna Shashi
Published: August 2024

Study Objective:

The objective of this study was to assess the learning curve of total laparoscopic hysterectomy (TLH) and its impact on surgical outcome of 773 consecutive cases between two decades.

Design:

This was a retrospective observational comparative study of 773 consecutive cases of TLH.

Setting:

This study was conducted at ILS Hospital, Kolkata, India, a private tertiary referral center for endoscopic surgery.

Patients:

Total 773 women with benign pelvic pathologies from 2000 to 2019 having similar demographic characteristics irrespective of uterus size and previous surgery were included while patients with malignancy and second-degree uterus prolapse were excluded.

Interventions:

TLH by ipsilateral technique.

Materials and Methods:

The study period was divided into two decades with 386 and 387 surgeries of TLH in the first and second decades, respectively, maintaining homogeneity within the periods. The CUmulative SUMmation (CUSUM) technique was used to construct a learning curve of operative time where learning point.

Results:

Learning Point was found at the 118th surgery. Overall complications decreased from 4.39% to 1.33% (P = 0.0096) between two decades, and major and minor complications decreased from 3.36% to 0.52% (P = 0.0042) and from 1.03% to 0.78% (P = 0.1416), respectively. No major vessel injury occurred. Five ureter injuries occurred in the first decade and none in the second decade. In-spite of significant increase in uterus size and double the number of Lower Uterine Caesarian Section (LUCS) in 2nd decade (P<0.00001), bladder injuries occurred in 1st decade & 2nd decade was 7 (1.81%) and 1 (0.26%) respectively (P=0.033). Total 56 conversions (7.56%) occurred: the first decade was 27 (6.97%) and the second decade 29 (7.51%) (P = 0.7814).

Conclusion:

Laparoscopic hysterectomy can be safely done by ipsilateral technique with low complication if one achieves a learning curve under supervised training. In our study, gained experience helped us to decrease major bladder, bowel, and ureteric injuries drastically by 90.91% in spite of increased complexity of cases in the second decade.
Unveiling the evolution of endoscopy
Authors: Tandulwadkar Sunita
Published: August 2024

Endoscopy, also known as minimally invasive surgery (MIS), has dramatically transformed surgical practice since its inception in the early 20th century. Initially met with skepticism, it has now become fundamental in various surgical fields. This evolution is marked by significant milestones, including the pioneering work of Georg Kelling and Jacobaeus in the early 1900s, the technical innovations of Raoul Palmer and Kurt Semm from the 1960s to the 1980s, and the advent of video laparoscopy in the late 20th century. These advancements have facilitated the transition from diagnostic to surgical laparoscopy, improving safety, efficacy, and patient outcomes. Modern laparoscopy, enriched by high-definition imaging and robotics, allows for complex procedures with enhanced precision. Robotic-assisted surgery, introduced in 1994, has further expanded the capabilities of minimally invasive techniques, offering 3D visualization and improved dexterity. The continuous evolution in this field is driven by technological advancements and a commitment to improving surgical outcomes. This article explores the historical milestones, current practices, and future challenges of endoscopy, highlighting its revolutionary impact on medicine. As the field progresses, innovations such as artificial intelligence and augmented reality are poised to shape the future of laparoscopy, making it safer, more cost-effective, and accessible. The ongoing evolution of endoscopy underscores the relentless pursuit of excellence in surgical care and the enduring impact of human ingenuity and technological progress.
Laparoscopic pectopexy: As a safe and effective new approach for repair of pelvic organ prolapse
Authors: Saini Sushila , Gupta Seema
Published: August 2024

Objective:

The objective is to assess the feasibility, safety, and effectiveness of laparoscopic pectopexy for repair of pelvic organ prolapse (POP).

Design:

This was a prospective study.

Materials and Methods:

A total of 324 women of POP-Q Stage ≥II who underwent laparoscopic pectopexy between January 2017 and January 2023 at Jaipur Doorbeen Hospital, Jaipur, India were included in this study. All patients underwent laparoscopic mesh fixation to bilateral pectineal ligament with Moschcowitz repair with pelvic floor repair.

Results:

Among 324 patients, the mean age was 48.29 ± 14.82 years and the mean body mass index was 24.10 ± 3.19 kg/m2 . Out of 324 cases, 24.07% of Stage II, 71.30% of Stage III, and 4.63% of Stage IV. Maximum cases were under Stage III (71.30%). Follow up was done after 1 week, 3 weeks, 6 weeks, 3 months, 6 months, and 1 year. At 1 year of follow up out of 324 cases, 66 patients lost to follow up. Out of the remaining 258 patients, only 9 (3.4%) patients show recurrence of prolapse. Out of nine cases, four cases show Stage I cystocele, three cases show Stage II apical prolapse and two cases show Stage 1 rectocele. Results are promising, with 96.51% all over success rate.

Conclusion:

The laparoscopic pectopexy is a good alternative to the laparoscopic sacrocolpopexy. It is equally effective and shows no de novo stress urinary incontinence, defecation disorders, backache, or neuralgia in the long term follow up.
The learning experiences of senior residents in laparoscopic gynecological surgeries: A quality study
Authors: Agarwal Mukta , Sinha Shivangni , Kumar Pragya , Bhushan Devendu
Published: August 2024

Background:

Laparoscopic operations have increased in acceptance over the years owing to their established advantages over conventional open procedures, ranging from superior diagnostic to therapeutic outcomes. Significant advances in surgical training, equipment development, imaging, and surgical procedures have made laparoscopic surgery safe and feasible in a variety of medical specialties.

Materials and Methods:

We aimed to qualitatively evaluate the learning experiences of senior residents in laparoscopic gynecological surgeries. The study is a qualitative descriptive study conducted in a tertiary care institution. It included senior residents undergoing training in laparoscopic gynecological surgery. Their learning experiences were qualitatively evaluated at the end of their 3-year residency. Six residents responded to questionnaires.

Results:

The experience of learning a new system from its beginning motivated residents to push themselves against all difficulties, work as a team, and pumped them with confidence when their mentors held back in encouragement and support. There is a requirement for an upgraded infrastructure to sustain consistent and skilled training that would aid in encouraging training experience at hospitals across the country. Patient management, strenuous surgeries, and complications affect residents’ physical and psychological well-being, making them vulnerable. The system must also collaborate with residents and doctors at work to create a positive environment not only for patients but also for their residents.

Conclusion:

Improving the residents’ learning experiences through effective uniform training and a healthier working environment will result in better patient care outcomes and system performance.
Higher Discharge GCS Score is Associated with Both Survival and Long-term Functional Recovery in Patients with Clinically Defined Diffuse Axonal Injury
Authors: Sajan Jane Elizabeth , Ramanathan Saraswathi , Selvi Bernice Thamarai , Manikandan S. K. , Thomas Raji , Joseph Mathew
Published: August 2024

Background:

Diffuse axonal injury (DAI) refers to widespread axonal damage due to traumatic brain injury. There are very few studies that have specifically looked at outcomes in patients with DAI, where the injury is not associated with accompanying focal lesions (such as haematomas and other mass lesions) or ischaemic brain injury. In this study, we assessed factors that predict mortality and long-term functional outcome of patients with DAI who underwent treatment and rehabilitation in a tertiary care hospital in South India.

Methodology:

Long-term outcome and neuropsychiatric sequelae were assessed in 160 patients with DAI, who underwent rehabilitation and were on regular follow-up for a median duration of 5 years (interquartile range = 3–6). Cox proportional hazards and logistic regression models were used to determine factors associated with mortality and functional outcome (Glasgow Outcome Scale-Extended [GOSE], Mayo-Portland Adaptability Inventory [MPAI] and Neuropsychiatric Inventory [NPI]).

Results:

Majority of the 160 patients included in this study were young males (92%) who presented with severe head injury (Glasgow Coma Scale [GCS] score of 5.6 ± 2.1). At the time of follow-up, 94 (58.75%) patients were alive, while 66 (41.25%) were dead. Patients who were alive at the time of follow-up were significantly younger, had higher GCS score and lower Rotterdam computed tomography (CT) grade at presentation compared to those who died. Compromised airway requiring tracheostomy (χ
2 = 21.3; P < 0.001) and abnormal pupil reactivity (χ2 = 30.2, P < 0.001) were significantly associated with mortality. GCS score at discharge was the single most important determinant of mortality (hazard ratio = 0.802, P < 0.001). Among those who were alive, majority (73.4%) had good functional recovery (GOSE score 8). GCS scores (at admission and that at discharge) and Rotterdam CT score independently and significantly predicted MPAI, NPI and caregiver distress scores. Among them, GCS score at discharge was the strongest predictor. In-hospital improvement in GCS correlated with GOSE but not with MPAI and NPI.

Conclusion:

Higher GCS scores at discharge were strongly associated with both survival and functional recovery in patients with DAI.
Teletherapy as an Alternate Model for Therapeutic Interventions for Children with Neurodevelopmental Disabilities in a Low-resource Setting in Jharkhand, India
Authors: Rangwala Shabnam
Published: August 2024

Background:

This project was a collaboration between a community-based organization in rural India and a professional organization providing training and teletherapy support. The objective was to address the human resource gaps in rural areas for delivering therapeutic interventions to children with neurodevelopmental disabilities (NDD) in low-resource settings.

Objective:

To empower health workers in rural areas with the skills necessary to provide need-based therapeutic interventi ons to children with developmental disabilities through training and teletherapy.

Methods:

The project began with an initial training phase consisting of 10 online training sessions. This was followed by five additional need-based online training sessions over a 9-month period. Thirty-one children with NDD (15 girls and 16 boys) were enrolled and tracked using the Canadian Occupational Performance Measure (COPM). A total of 750 need-based therapy interventions, including physiotherapy, occupational therapy, and speech therapy, were provided by professional therapists via teletherapy.

Results:

The children showed significant improvement in the functional goals set from baseline to midline and end line. A one-way repeated-measures ANOVA test revealed a significant positive impact of teletherapy on the functional goals planned for the sample (P < 0.5).

Conclusion:

Teletherapy demonstrated a positive impact on achieving functional goals for children with NDD in rural Jharkhand. It is recommended as an effective model to address human resource gaps and provide family-centered therapeutic support in low-resource rural areas.
A cross-sectional study on domestic violence among infertile women in western Iran
Authors: Jenabi Ensiyeh , Khazaei Salman , Gholami Amir Hossein , Abdoli Sara
Published: August 2024

Background:

To date, no study has examined domestic violence among infertile women in western Iran.

Aims:

This study aims to investigate the prevalence of domestic violence among infertile women in the region.

Materials and Methods:

A cross-sectional study was carried out at the infertility clinic in Hamadan. A total of 200 eligible infertile women, with a mean age of 31.48 ± 4.57 years, were recruited for the study. The Domestic Violence Questionnaire (DVQ) was administered to all participants. Data analysis was performed using Stata Statistical Software (version 17), with a significance level set at P ≤ 0.05.

Results:

This study included 200 infertile women with an average age of 31.48 ± 4.57 years. The mean duration of infertility was 1.9 ± 0.76 years. Regarding education, approximately 66% of the women and 69% of their spouses had completed high school or attained a diploma. Female-related causes accounted for 72.5% of infertility cases. Among the participants, 59.4% reported experiencing domestic violence. Emotional violence scored the highest percentage (67.5%), while sexual violence had the lowest percentage (43.63%). Statistical analysis revealed significant associations between age, spouse’s education level, frequency of sexual intercourse, and the level of violence experienced by women.

Conclusion:

The findings of this study reveal that 59.4% of women experienced various forms of domestic violence. Moreover, significant associations were observed between domestic violence and factors such as age, spouse’s education level, and frequency of sexual intercourse.
Disulfiram-induced psychosis still an important clinical entity: A case series
Authors: Mandula Santosh K. , Mukherjee Diptadhi , Chakravarty Pranjal J. , Bhattacharya Sourabh
Published: August 2024

Disulfiram, an FDA-approved medication for treating alcohol dependence syndrome (ADS), is often used surreptitiously, resulting in severe adverse drug reactions such as disulfiram-induced psychosis (DIP). DIP presents diagnostic challenges, despite being perceived as common; however, there is limited literature available on DIP in India. We describe four cases with a history of psychosis in the background of disulfiram exposure. Our four male patients, aged 30–46 years old, had a history of ADS ranging from 7 to 16 years. They developed DIP after 5–15 days of exposure to disulfiram in doses ranging from 500 to 750 mg. In all cases, disulfiram was administered surreptitiously based on advice from non-experts. Predominant symptomatology included delusion, followed by perceptual disturbances. Naranjo adverse drug reaction probability scale was applied to establish disulfiram as the probable cause of psychosis in all cases. All patients responded to disulfiram discontinuation and a brief period of low-dose antipsychotic therapy within 7 days. The probability of DIP should be explored in a case of ADS presenting with an acute psychotic episode. Disulfiram, though an effective agent, should be used cautiously in selected cases at the recommended dose. Awareness building among family members may prevent and aid in the early detection of DIP.
Psycholegal issues in marital conflict
Authors: Reddy Vrushali Dillikar , Arya Saroj
Published: August 2024

Background:

Marital conflict and disputes involve many issues to be settled between the couples like finance, health, assets, children, postdivorce securities, etc. The traumatic experiences of separation affect their mental health and the future of their children. Not being conscious of their legal rights and court procedures leads to long court litigation, causing distress and trauma to the couples.

Aim:

The aim of the article is to find out the level of psycholegal awareness among couples in conflict, approaching forums like police and courts, and to find the difference between the two groups.

Materials and Methods:

A sample of 30 couples each from court and noncourt forums was taken. The demographic details were taken and a psycholegal checklist was administered. It is a cross-sectional study and exploratory research design was applied.

Results:

There was a significant difference in legal awareness of couples opting for redressal in the court and those opting for counseling in noncourt resolution centers.

Conclusion:

The results indicate that a lack of legal awareness among the couples in the two groups may be leading to lengthy litigation.
Anxiety, depression, and perceived stress among loco pilots of Indian Railways
Authors: Shekhawat Bharat Singh , Yadav Sandhya , Dhaka Vikas
Published: August 2024

Background:

The job of loco pilots of Indian Railways is very demanding as they are responsible for operating locomotives and ensuring the safe and timely transportation of people and goods across the vast and diverse landscape of the country. So, they are prone to various mental health issues.

Aim:

To study anxiety, depression, and perceived stress among loco pilots of Indian Railways and to study their correlation with various work-related factors.

Materials and Methods:

This cross-sectional study included 53 loco pilots recruited by convenience sampling from three railway stations under the Kota Division of Indian Railways. Prior permission from the Institutional Ethical Committee was taken. After obtaining informed consent, loco pilots were evaluated on Hamilton scales for Anxiety and Depression and Perceived stress scale 10.

Results:

The mean age of participants was 32.01 ± 6.15 years. They were working for an average of 61.01 ± 19.12 hours per week. The majority of them were assistant loco pilots and were operating goods trains. 26.41%, 20.76%, and 13.20% had mild, moderate, and severe anxiety, respectively. Likewise, 30.19% and 5.66% had mild and moderate depression, respectively. Also, 33.97%, 50.94%, and 15.09% of loco pilots had low, moderate, and high perceived stress, respectively. Age, working hours, and years of work experience did not correlate significantly with anxiety and depression scores. A significant positive correlation of perceived stress score was found with average working hours per week (P = 0.012).

Conclusion:

The magnitude of psychiatric problems among loco pilots was found to be significant and hence needed to be addressed. Also, further exploration of factors contributing to these mental health issues is required.
Assessment of depression, anxiety, stress, and insomnia among government school teachers in the rural catchment areas of Nandyal district: A cross-sectional study
Authors: Kalam Bandubai Muhammad , Omkaram Sindhuja , Murthy P. S. , Chaudhury Suprakash
Published: August 2024

Background:

Among the most demanding careers that many Indians choose is teaching. Teachers are under a lot of stress because of all the extra responsibilities and duties they have from the school, education boards, and institutions. This can be a fertile ground for psychological problems among teachers.

Aim:

To assess depression, anxiety, stress, and sleep disturbances among school teachers and to find out their correlates.

Materials and Methods:

A cross-sectional observational study was planned in 100 teachers working in the government schools of the rural catchment of Nandyal district, Andhra Pradesh. Teachers were assessed through a semistructured proforma containing sociodemographic information, information about job-related factors, and DASS 21 to assess depression, anxiety, and stress and Insomnia Severity Index to assess sleep disturbances.

Results:

The overall prevalence of depression, anxiety, and stress symptoms among teachers was found to be 28%, 61%, and 24%, respectively, and sleep disturbances were 38%. Depression was found to be independently associated with marital status (married > single, P < 0.001), position at workplace (secondary grade > primary grade, P < 0.001), mode of transport (public transport > personal, P = 0.001), source of income (single > family, P = 0.013), higher level of income (P < 0.001), stress (P < 0.001), and anxiety (P < 0.001). Anxiety was associated with migration for the job (P < 0.001), stress (P < 0.001), and depression (P < 0.001), while insomnia was associated with the type of family (nuclear > joint, P = 0.015), source of income (single > family, P = 0.039), no interaction with a colleague (P = 0.007), being dissatisfied with job (P = 0.002), and stress (P = 0.005).

Conclusion:

The significantly moderate proportion of depression, anxiety, stress, and insomnia among government schoolteachers is suggestive of the need for the necessary psychological aid and counseling for such teachers. Therefore, appropriate methods must be introduced to address the concerns of teachers, thereby reducing anxiety and stress among them.
Clinico-epidemiological Profile of Primary Hyperhidrosis in Indian Patients: Single-center Experience
Authors: Rajput Gopalsing Rameshsing , Jandhyala Sridhar , Kansal Vishal , Hemdani Ruchi , Chatterjee Manas
Published: August 2024

Background:

Primary hyperhidrosis (PHH) is characterized by excessive sweating which is focal, bilaterally symmetrical, idiopathic with age of onset before 25 years of age. The QoL derangement comparable to chronic disorder like psoriasis. There exist a scarce data about prevalence, facto associated with PHH and its correlations with hyperhidrosis disease severity score (HDSS) and dermatology life quality index (DLQI) in Indian population. This study aimed to bridge this gap.

Aim and Objectives:

The aim of this study is to understand the features associated with PHH and to describe distribution of known etiologic factors of hyperhidrosis in individuals visiting the Dermatology OPD. Also this study assess the impact of excessive sweating on the QOL.

Material and Methods:

The study design is prospective observational study in patients visiting Dermatology OPD at tertiary care hospital. The study was questionnaire based and for appropriate case multispecialty referral and necessary investigation to rule out secondary cause was done. The study period was of total 18 months from Dec 2016 to May 2018. Data collected was analyzed by SPSS V 23.

Results:

In our study the male predominated with M: F ratio of 1.4 :1. Total 42,365 patients visited to dermatology OPD in this time frame and prevalence was found to be 2.6%. The mean age at presentation in our study was 24.5 years, with mean age of onset being 15.33 years (90% before third decade). Family history was present in 52.6% patients. Most common site affected was palmoplantar (43.8%) followed by palmar (36.3%). DLQI score was more in students as compared to salaried individuals or housewife similarly the palmoplantar HH patients has more DLQI score as compared to other site affected patients. Similar finding was applicable for HDSS scale.

Conclusion:

The PHH is underreported entity with prevalences of approx. 2.6% in our study. The impact on QOL is very profound and it is positively correlated with HDSS. There is felt need to carry targeted data collection for PHH.
Audit on Effectiveness of the Dental Information System Utilisation by Dental Post-graduates and Academicians at the Department of Restorative Dentistry
Authors: Palaniappan P. L. Ranganayakidevi S. , Seong Lim Ghee
Published: August 2024

Introduction:

A Dental Information System (DEISY) is a web-based application that facilitates data collection, retrieval of the history of patients and exchange of information on treatments performed for similar cases. Patient information and record keeping are essential for record management and follow-up for treatments conducted. A digital management system will improve the effectiveness and efficacy of the entire process.

Aims:

The aim of the study was to study the effectiveness of the DEISY system among dental post-graduates and the dental academicians of the restorative department.

Methodology:

Participants were required to fill out the questionnaire through the Google Form. Information gathered includes the clinician’s usage of DEISY, their experience, expectations and recommendations to improve the existing system for a more effective way of managing the patient’s healthcare records. The data were collected, and descriptive analysis was performed.

Results:

A total of 40 questionnaires were sent to the participants. About 70.4% of them responded that they will key in the patients, 29.6% of them will sometimes key in and about 7.4% of them will not key in these records at all. In line with this, approximately 66.7% responded that they will key in the outcome of the treatment on their own for each patient, whereas 7.4% do not key in the outcome of the treatment to the DEISY system.

Conclusion:

All participants realise the importance of the DEISY system but fail to utilise it due to technical difficulties. Without a doubt, utilising such system will provide more advantages than disadvantages.
Distribution of Intraocular Pressure in Indigenous Black Africans and Related Risk Factors: A Population-Based Study in Southwest Nigeria
Authors: Sarimiye Tarela F. , Olawoye Olusola , Bekibele Charles , Ashaye Adeyinka
Published: August 2024

Background: Elevated intraocular pressure (IOP) is a major risk factor for glaucoma and is presently the only modifiable risk factor. Even in a healthy population, IOP distribution varies among different racial groups. Objective: To determine the distribution of IOP and factors affecting it, among an indigenous African population in Southwest Nigeria. Methods: A population-based descriptive cross-sectional survey with an analytical component was performed. The study was conducted among participants 16 years and older who were residents of Akinyele Local Government Area of Oyo State and were all black Africans. A multi-stage sampling with probability proportional to size was used to identify the study population. All participants were examined at the local health center in their community, assessing the visual acuity, Goldmann applanation tonometry, central corneal thickness, anterior segment, fundoscopy, weight, height, and blood pressure. Results: A total of 1810 respondents completed the study; male patients accounted for 41.55%. Mean age was 49.43 ± 15.57 years. The mean IOP was 15.91 ± 4.74 mmHg. There was a significant association between elevated IOP and the male gender. Intraocular pressure also had a significant positive correlation with increasing age, systolic blood pressure, and central cornea thickness. There was no significant relationship between IOP and self-reported diabetes mellitus. Conclusion: The mean IOP and distribution in this study were a bit different from that observed in studies in different geographical locations but similar to studies in West Africa. It may be advisable to employ a geographical approach to normal IOP interpretation.
Medical management of vitiligo: a narrative review
Authors: Sinha Surabhi , Agrawal Diksha
Published: August 2024

Vitiligo is a chronic cutaneous disease presenting with asymptomatic depigmented macular lesions without any signs of inflammation. Since time immemorial, treatment has been sought for this disorder due to the substantial stigma associated with it, more so in patients with skin of color. Vitiligo can be divided into two major clinical types − segmental vitiligo (SV) and non-segmental vitiligo (NSV). The pathophysiological basis for the loss of functional melanocytes resulting in vitiligo includes genetic predisposition, autoimmune mechanisms, and oxidative stress, among others. Thus, combination therapies targeting the autoimmune nature of disease, activation of melanocytes, and reduction of oxidative stress often yield a successful treatment response. There are very few FDA-approved options for vitiligo, and certain recently introduced modalities may modify the way vitiligo is conventionally treated. This review summarizes the conventional as well as the newer medical treatment options for different clinical types of vitiligo.