bluuebunny/crossref_metadata_2025 huggingface dataset:
Pyloric atresia and epidermolysis bullosa: A fatal association
Authors: Kundu Soham , Mahapatra Alapan , Halder Dhrubajyoti , Halder Pankaj Kumar
Published: March 2024

Pyloric atresia (PA) contributes less than 1% of all gastrointestinal atresias with an incidence of 1 in 100,000 newborns. It is often associated with epidermolysis bullosa (EB) or aplasia cutis congenita. This association is believed to be lethal because of the increased risk of developing septicemia, electrolyte imbalance, and protein loss. Here, we attempt to highlight the fatal complications of PA with EB in a 10-day-old female baby and reevaluate the representative features that an astute clinician needs to be aware of.
Caregivers’ knowledge, perception, and management of childhood pneumonia: A study in tribal district of India
Authors: Kulkarni Prashant , Mahajan Uma , Kurane Anjali
Published: March 2024

Introduction:

Childhood pneumonia, if identified early, is readily treatable through low-cost antibiotics. The study aimed to understand the family caregivers’ knowledge and care-seeking behavior for the management of childhood pneumonia. The study was cross-sectional, with mixed methods assessing knowledge, perceptions, and practices of caregivers of under-five children on pneumonia using a vignette.

Methodology:

Systematic random sampling was used to select the participants. Of 107, more than half of the respondents were 18–25 years old.

Results:

Less than one-fourth were illiterate. Cough, flu, and stomach distention were the commonly reported symptoms. Food ingestion was reported as a main perceived cause; private doctors and traditional healers were the most reported source of help-seeking. Friend/family were reported as leading sources of information. Health education is to be imparted using local knowledge regarding childhood pneumonia. Traditional healers and private practitioners sensitize in early management and referral of childhood pneumonia cases.

Conclusions:

Information, education and communication messages need to be prepared in the local languages. Strengthening the public health sector is suggested.
Standard Snodgrass urethroplasty versus Snodgrass with glans augmentation urethroplasty for distal hypospadias: A comparative study
Authors: Tanger Ramesh , Prajapati Sahaj , Gupta Pradeep , Gupta Rahul , Rengan Vinayak , Varma Aseesh
Published: March 2024

Introduction:

Hypospadias is one of the most common congenital anomalies of the male genitourinary system. The Snodgrass urethroplasty is the most common worldwide accepted procedure for distal hypospadias. Various modifications have been made to reduce common complications, such as urethra-cutaneous fistula and meatal stenosis. In this study, we compare the results of hypospadias repair using the standard Snodgrass urethroplasty technique and Snodgrass urethroplasty with glans augmentation.

Materials and Methods:

This is a single institution series from January 2020 to January 2023. One hundred patients with distal hypospadias were included in the study. Out of these, 50 patients underwent the standard Snodgrass repair (Group 1), whereas another 50 patients underwent the Snodgrass urethroplasty with glans augmentation technique (Group 2).

Results:

The average follow-up period was 8 months. Four patients in Group 1 developed a fistula, and three had meatal stenosis (two were managed by meatal dilatations, and one with severe meatal stenosis was managed by meatotomy). In comparison, none of the patients in Group 2 developed a fistula, and only one developed meatal stenosis, which was managed by meatal dilatation. Partial skin necrosis was noted in three patients in Group 1 and two patients in Group 2. The final cosmetic appearance was acceptable.

Conclusions:

Snodgrass urethroplasty with glans augmentation is an effective procedure with a low complication rate and good cosmetic results.
Yoga practices and sattvic ahar in the management of overweight and obesity: Four case studies
Authors: Rajbhoj Pratibha Hemant , Pathak Satish Dattatray , Bhogal Ranjeet Singh , Pandey Santosh
Published: March 2024

The advent of the twenty-first century has evidenced a significant change in our lifestyles, leading to a sedentary way of living resulting in an imbalanced food consumption and output in the form of energy expenditure. Furthermore, modern individuals have developed new habits of consuming unethical, unhealthy, and incompatible food combinations to cater to their taste preferences and to indulge in addictive eating patterns. Media advertisements further promote such food consumption, diverting attention away from nutritious traditional food habits. A case study was conducted on four individuals belonging to the obesity classes I, II, and III. The study intervention consisted of a yoga regimen and sattvic ahar for 7 days. In the study, body weight, blood pressure, bioelectrical impedance, body mass index (BMI), muscle mass, and body fat percentage were measured. Data were collected twice: at the beginning and the end of the study. Postintervention results showed a remarkable reduction in average body weight, BMI, and fat percentage compared with the baseline results. In addition, the average bioelectrical impedance and muscle mass of these four subjects increased notably. Based on the findings of this study, it can be concluded that a regular practice of yoga and adherence to a sattvic diet may prove effective in weight management. Future research should explore the long-term effects of this practice and sattvic ahar on weight management, as well as, their possible implications for overall health and wellbeing. Additionally, further research should include different demographic groups to validate the effectiveness of the intervention comprising yoga and a sattvic diet.
“Seven-Plus-One Model”: A Move Toward Dengue Free Community
Authors: Kumar Santosh , Mishra Rakhi , Singh Dharnidhar
Published: March 2024

Dengue is a wide spectrum of diseases creating menace in the community. This vector-born disease alone has a significant impact on global public health and the economy. Resources need to be mobilized to tackle the situation. The present article focused on the novice concept of “Seven-Plus-One models” as an approach to dengue prevention with vector management through community participation. A multidisciplinary approach along with exemplifying effective methods of inspectorial coordination and community participation is much required. The implementation of the Seven-Plus-One model has a positive impact on reducing dengue cases, indicating acceptance and effectiveness of the concept among the public. Dengue morbidity rate can be reduced through early detection and mobilizing the community for active participation in dengue prevention and control.
Effect of Yoga of Adaptive Yogasana Practice on the Flexibility and Psychomotor Variables in Intellectually Disabled Subjects
Authors: Sriharisukesh Naduvanthody , Pailoor Subramanya , Sudharshanan Sukanya , Chathambally Riya
Published: March 2024

Intellectual disability (ID) is a public health challenge affecting communities worldwide. ID is characterized by impaired physical and cognitive functioning and less engaged in physical activities. The objective of this study was to assess the impact of adaptive yoga practices on cognitive and motor abilities in the subjects with ID. Sixty-six subjects with mild and moderate IDs were purposively selected and randomly divided into experimental and control groups, with 33 subjects in each group. One month of adaptive yoga module was provided to the experimental group. To assess the impact of the yoga intervention, Functional Reach Test (FRT), Wall Toss Test (WTT), Finger Tapping Test (FTT), Sit–Reach Test (SRT), and Six Letter Cancellation Test (SLCT) were administered. The experimental group showed a statistically significant improvement with P < 0.05 across all the parameters, whereas the control group could not observe a significant improvement. Based on the results, this study concludes that “one month of adaptive yoga module” delivered impact and helped to improve the dynamic balance, eye–hand coordination, neuro-motor function, spinal flexibility, and selective attention in ID-afflicted subjects.
Agrawal and Shah Modified Cast Index – A Novel Index Assessing Prevalence of Dental Caries and Treatment Needs of the Adult Indian Population
Authors: Agrawal Vineet , Shah Nimisha
Published: March 2024

Background:

Agrawal and Shah modified CAST (Caries Assessment Spectrum and Treatment) is the novel index prepared specifically for the Indian population for the complete evaluation of the spectrum/range of dental caries described hierarchically.

Objective:

To assess the prevalence of dental caries and treatment needs in an adult Indian population using Agrawal and Shah modified CAST index.

Materials and Methods:

A cross-sectional transverse study was performed on 2000 adult patients in the age range of 19–70 years. All the adult patients were scored for caries presence by Agrawal and Shah modified CAST codes on a structured proforma. SPSS version 20 was used to analyze the data.

Results:

The prevalence of dental caries calculated using Agrawal and Shah modified CAST index was 85.6%. 5.2% (104) adults had sound dentition, 4.1% (82) adults had restorations, 2.1% (42) adults had non-cavitated lesions, 13.7% (274) adults had the presence of caries in the enamel, 19% (380) adults had the presence of caries in dentine, and pulpal involvement was observed in 27.7% (554) adults. 10.3% (206) adults had presented with a root surface and cervical caries. 13.6% (272) adults had lost at least one tooth due to caries, and 3% (60) adults had lost teeth due to any other reason except dental caries. 1.3% (26) adult patients do not show any caries-related diagnosis but were having predisposing conditions.

Conclusion:

Agrawal and Shah modified CAST index proved to be simple, useful, and appropriate in assessing dental caries prevalence in the Indian population along with the treatment needs of the Indian population.
Prevalence and Determinants of Low Birth Weight among the Newborns in Dadra and Nagar Haveli: A Community-based Study
Authors: Jangid Sunil , Chauhan Pooja , Mehta Vaibhav , Patel Mitali , Mahyavanshi Darshan , Das Vatte Katte
Published: March 2024

Background:

The world is not on track to meet the World Health Assembly (WHA) global target on Low Birth Weight (LBW). To estimate the prevalence and to identify the associated determinants of LBW among the newborns.

Material and Methods:

We conducted a cross-sectional study among the 364 mothers registered under the all government health facilities of Dadra & Nagar Haveli (DNH) during November 2021 to January 2022.

Results:

The prevalence of LBW was found to be 39%. On uni-variable logistic regression, live in relationship, caste, weight of mother, Body Mass Index (BMI), weight gain <5 kg in 2nd and 3rd trimester, high-risk pregnancy, complication present in previous pregnancy and preterm delivery, while on multi-variable logistic regression, weight gain <5 kg in 2nd and 3rd trimester (AOR 2, 95% CI 1.007-4.2) and having high-risk pregnancy (AOR 2, 95% CI 1.1-3.0) were found to be the significant predictors of LBW among the newborns.

Conclusions:

We conclude from the study that the prevalence of low birth weight among the newborn was high. There is a need to address maternal and child health issues like low birth weight, malnutrition and high-risk pregnancy under the RMNCAH+N program through various effective interventions. Future research should evaluate the feasibility of collaborative activities between RMNCAH+N program and the UNICEF in India.
Outbreak of toxic anterior segment syndrome following vitreoretinal surgery – A retrospective analysis
Authors: Kannan Naresh B , Sivadarshan M , Sarkar Avik Dey , Vallinayagam MuthuKrishnan , Ramaswamy Kim
Published: March 2024

Background:

Toxic anterior segment syndrome (TASS) is an uncommon complication of vitreoretinal surgery and is characterized by severe anterior chamber reaction, hypopyon, and limbus-to-limbus corneal edema.

Methods:

Twenty-nine vitreoretinal surgeries were performed, of which 14 developed TASS in the early postoperative period. The operative records were reviewed retrospectively.

Results:

The median age of patients was 49.07 ± 16.75 years and 14.28% of them were female. Also, 71.42% were operated in the left eye and 42.8% were pseudophakic. Recurrent retinal detachment, secondary scleral-fixating intraocular lens (SFIOL), and silicone oil removal (SOR) were the most common procedures. Severe anterior chamber reaction was seen in 14 patients, circumcorneal congestion in eight, corneal edema in 11 (78.6%), hypopyon in 13 (92.8%), and severe fibrin membrane in two patients.

Conclusion:

We describe the largest series of TASS following uneventful vitreoretinal surgery. Balanced salt solution was the instigating agent in this series. A prompt and thorough investigation is critical in obviating recurrences.
Hospital corneal retrieval program: A long way to go
Authors: Jain Anu , Sen Snigdha , Upadhyay Prerna , Dwivedi Nishi , Singh Lokesh K , Agrawal Renu , Kumar Sarvesh
Published: March 2024

Purpose:

The Hospital Corneal Retrieval Program (HCRP) aims to counsel and encourage the family of a critically ill or deceased person in the hospital for eye donation. Adequately sensitized health-care workers (HCWs) may play a pivotal role in boosting HCRP.

Study Design:

Multicentric, cross-sectional, descriptive study.

Methods:

Study participants included all HCWs of three medical colleges, including one with eye bank and corneal transplant services. A pretested, structured questionnaire was used to record the awareness, knowledge, and attitude about eye donation among HCWs. The expected outcome was to seek differences in awareness, if any, among medical and paramedical workers of medical colleges with (group A) or without (group B) eye bank and corneal transplant facilities.

Results:

Of the 4060 study participants, 2100 HCWs were in group A and the rest (1960) were in group B. For eight out of 13 questions assessing awareness and perception, a statistically insignificant difference in responses was observed between the two groups. Regarding questions related to attitude, although the majority of HCWs in both groups were comfortable talking about eye donation, they did feel that counseling relatives of a terminally ill patient about eye donation was insensitive. Less than half of HCWs showed a willingness to donate eyes, and about half of the participants wanted to acquire more knowledge about eye donation.

Conclusion:

Awareness regarding eye donation among HCWs was mostly found to be at dismal levels, irrespective of whether they worked in an institute with or without eye bank and corneal transplant services. This warrants an accelerated effort at sensitizing HCWs as a strengthening measure for HCRP.
Quality and applicability of cadaveric donor eyes for molecular biology research: An Indian experience
Authors: Kulshrestha Prerna , Sharma Sarmeela , Vishwakarma Sushma , Ali Mohammed J , Dave Tarjani V , Kaur Inderjeet
Published: March 2024

Purpose:

Human ocular tissue banking plays an important part in the advancement of translational research for identifying the molecular processes involved in disease etiology and pathogenesis. Timely obtaining a good-quality ocular tissue from a cadaveric donor is exceedingly difficult, especially in remote areas, with a variable transportation time (within 12–24 h), raising concerns about RNA quality and its subsequent applications. Therefore, we assessed the utility of retinal tissues from cadaver donor and enucleated eyes based on the RNA quality and gene expression by real-time polymerase chain reaction (PCR).

Settings and Design:

Prospective study.

Methods:

Retina tissues were separated from the donor/enucleated eyes received in the eye bank within 24 h of death (n = 15) and within an hour from OR (n = 3), respectively, and stored immediately at -80 degree. RNA was isolated using trizol, and the quantity and quality were assessed using Qubit and agarose gel electrophoresis, respectively. QPCR was performed for measuring the expression of different retinal-specific genes. The cellular viability of the retina was assessed by establishing explant primary cell cultures.

Statistical Analysis:

The data were calculated as an average of normalised Ct values ± standard error of the mean.

Results:

RNA obtained from cadaveric tissues despite being partially degraded showed a uniform strong gene expression of several retinal-specific genes such as PAX6, RHO, TUBB3, CRX, and ALDH1L1. The primary cultures established from cadaveric tissues showed viable cells.

Conclusion:

The cadaver donor tissues collected within 24 hours of death can be effectively utilized for gene expression profiling.
Acanthamoeba keratitis – A review
Authors: Raghavan Anita , Rammohan Ram
Published: March 2024

This is a comprehensive review after a thorough literature search in PubMed-indexed journals, incorporating current information on the pathophysiology, clinical features, diagnosis, medical and surgical therapy, as well as outcomes of Acanthamoeba keratitis (AK). AK is a significant cause of ocular morbidity, and early diagnosis with timely institution of appropriate therapy is the key to obtaining good outcomes. The varied presentations result in frequent misdiagnosis, and co-infections can increase the morbidity of the disease. The first line of therapy continues to be biguanides and diamidines, with surgery as a last resort.
An Analysis of the clinical and investigative profile of uveitis in the elderly: First case series from India
Authors: Magesan Kowsigan , Ahmed Arshee , George Amala E , Ganesh Sudha K , Biswas Jyotirmay , Dutta Majumder Parthopratim
Published: March 2024

Purpose:

To evaluate the spectrum of uveitis occurring after 60 years of age in elderly patients who presented to a tertiary care eye center in India.

Methods:

Retrospective study of patients who visited a tertiary eye care institute between January 2010 and July 2020.

Result:

Eighty-seven patients developed uveitis after 60 years, with only 44.8% having sufficient follow-up documentation and were included in the final analysis. The median age of these patients was 64 (IQR: 62–70) years, and 69% of them were male. Among the identifiable causes of uveitis, infectious uveitis (36%) was the most common and noninfectious uveitis was noted in 23% of patients. The most common subtype of uveitis was anterior uveitis (52%), followed by intermediate uveitis (32%), panuveitis (11%), and posterior uveitis (7%). Tuberculosis (28%) was the most common cause in our cohort, followed by HLA B27 (10%), sarcoid (8%), and Vogt-Koyanagi-Harada disease (5%). In 41% of patients, a definitive diagnosis of uveitis could not be achieved, and the anterior uveitis group had the highest number of undifferentiated uveitis cases. There were no undifferentiated cases of uveitis in the posterior and panuveitis category. The median follow-up period of these patients was 52 (15–91) months and 66% of eyes had recurrence. A statistically significant improvement in vision was seen in anterior uveitis and panuveitis groups, whereas the median visual acuity of the intermediate uveitis group remained stable throughout the follow-up period.

Conclusion:

Uveitis in the elderly can have a higher recurrence rate; however, the lack of follow-up in these groups of patients is a major challenge.
Chandelier-assisted scleral buckle surgery – contact versus non-contact wide-angle viewing system (CAB-CNV): A retrospective, multicenter, clinical study
Authors: Kelkar Aditya S , Nagpal Manish , Mondal Sukanya , Mehrotra Navneet , Jain Harsh , Sharma Akansha , Camus Erwin , Sathaye Vaidehi
Published: March 2024

Purpose:

To investigate and compare the anatomic and functional outcomes of chandelier-assisted scleral buckling (CASB) surgery using contact versus non-contact lens-based wide-angle viewing systems (WAVSs) in rhegmatogenous retinal detachment (RRD) patients.

Methods:

This was a retrospective, multicenter study evaluating the anatomic (reattachment rate) and visual acuity (VA) outcomes at 6 months post-CASB for primary RRD.

Results:

Forty-seven RRD patients underwent CASB with a non-contact WAVS (Group C1) and 90 with a contact lens WAVS (Group C2). Preoperative parameters including myopia, macula-off RRD, posterior vitreous detachment, number of retinal breaks, and retinal dialysis as the etiology of RRD did not differ significantly between the two groups. The outcomes of retinal attachment (85.11% of C1 patients and 76.67% of C2 patients, P = 0.34) and final visual outcome (VA ≥6/12: C1 = 61.7%; C2 = 46.67%, P = 0.13) were also comparable. Furthermore, no significant difference in postoperative complications such as cataracts, glaucoma, infection, buckle exposure, and buckle failure was observed. Finally, both groups were comparable in terms of re-detachment rates (10.64% in C1 and 23.33% in C2, P = 0.11).

Conclusion:

The two WAVS approaches used in CASB surgery have comparable surgical and functional outcomes and postoperative complications. The operating surgeon can freely choose between these viewing platforms during the contemporary scleral bucking (SB) surgery without impacting the outcome.
Management of a pediatric mandibular symphysis fracture with a custom acrylic cap splint
Authors: Chaudhary Ayeshwarya Rajendra , Sampat Saumil Chetan , Roy Malvika Suresh , Afonso Macnol
Published: March 2024

Traumatic dentoalveolar injuries in pediatric patients are a common occurrence. Treatment strategies for managing mandibular fractures in pediatric patients are dissimilar to that of adult patients. The dynamic nature of bone, developing tooth buds, parent’s levels of apprehension, and the patient’s level of cooperation are some of the factors which dictate the treatment of choice. Treatment rendered should aim at the stabilization of fractured segments with minimum invasiveness. The purpose of this case report is to describe the management of mandibular symphysis fracture in a 1-year-old boy using an acrylic splint which is stabilized with circummandibular wiring.
Tooth mobility index
Authors: Melath Anil , Raveendran Arjun Machingal , Kelotte Deepith , Jaison Desmin , Dharshika V.
Published: March 2024

The presence of tooth mobility is frequently observed as a typical consequence and potential exacerbating factor for periodontal disease. The successful handling of this issue significantly impacts the results of periodontal therapy. To ensure the effective clinical management of tooth mobility, it is imperative to possess a precisely evaluating tooth mobility indices. This article aims at different indices that are done and evaluates their respective constraints.
A clinical study on cognitive dysfunction in depressed patients
Authors: Kishore Karnik , Medhi Deepanjali
Published: March 2024

Background:

Major depression is a commonly occuring, seriously impairing, and often recurrent mental disorder. Depression and cognitive impairement have enormous implications for public health. Cognitive symptoms represent one of the core features of depression and have an impact on many functional outcomes. Different cognitive domains such as attention and concentration, psychomotor speed, executive functioning, and memory have been found to be implicated.

Aim:

This study aimed at assessing the cognitive domains affected and severity of cognitive dysfunction in first-episode patients of the unipolar depressive episode without psychosis and to assess the correlation of association of severity of cognitive deficit with severity of depression.

Materials and Methods:

A total of 40 patients with depression diagnosed according to International Classification of Diseases Research Diagnostic Criteria and 40 healthy controls were included. PGI Battery of Brain Dysfunction, Frontal Assessement Battery, and Hamilton Depression Rating scale (HAM–D) were adminstered, and analysis was done using Chi-square test, unpaired t-test, and Pearson’s correlation.

Results:

The study revealed significant differences in the dysfunction scores between the study and control populations. In the study group, more than 80% of patients had cognitive dysfunction and a positive correlation was found between dysfunction and HAM–D scores.

Conclusion:

Depression is associated with significant disturbance in cognitive functioning, and the cognitive dysfunction increases with an increase in the severity of depression.
Clinical Utility of Diaphragmatic Ultrasound in Chronic Obstructive Pulmonary Disease Patients Undergoing Rehabilitation
Authors: Arora Shweta , Kumar Rohit , Kaushik Rajnish , Ish Pranav , Mahendran A. J. , Madan Manu , Gupta Neeraj Kumar , Gupta Nitesh
Published: March 2024

Background:

Pulmonary rehabilitation (PR) is a well-recognized intervention in the management of individuals with chronic obstructive pulmonary disease (COPD) that is designed to improve patients’ physical and psychosocial conditions. The primary aim of the study was to determine the effect of PR on ultrasonography (USG) assessment of diaphragmatic excursion.

Materials and Methods:

The current study is a prospective, interventional study in COPD (Group D) patients. All subjects underwent 8 weeks of supervised PR. The baseline assessment with USG diaphragmatic excursion, quadriceps femoris (QF) thickness, biceps brachii (BB) thickness, mid-thigh circumference, mid-arm circumference, modified Medical Research Council score, 6-min walk distance, COPD assessment test score, and after 8 weeks of supervised rehabilitation same parameters observed.

Results:

About 25.71% of the study population was in the age group range of 45–55 years, 51.43% between 56 and 65 years and 22.86% within 66–75 years of the age group. Out of 35 patients, 15 (42.86%) were females and the rest 20 (57.14%) were males. A significant increase was found in the diaphragmatic excursion (cm) from (P < 0.0001), mid-arm circumference (cm) (P < 0.0001), BB thickness (cm) (P < 0.0001) (upper limb strength and endurance training), and mid-thigh circumference (cm) (P < 0.0001) along with QF thickness (cm) (P < 0.0001) (lower limb strength and endurance training).

Conclusion:

An 8-week physical and PR program in COPD patients can lead to an improved USG diaphragmatic excursion.
A Rare Case of Fungal Synovitis Presenting as Pigmented Villonodular Synovitis
Authors: Iqbal Banyameen , Agarwal Mallika , Kambale Tushar Jalindar , Choudhury Nilanjana Dhar
Published: March 2024

Synovitis is a disorder that develops when the synovial tissue or joint lining becomes inflamed. The term pigmented villonodular synovitis (PVNS) refers to a form of tenosynovial giant cell neoplasm affecting the tendon and joint soft-tissue lining. We describe the rare case of a 37-year-old male presenting with complaints of swelling in the left knee following trauma. Patients have a limited range of motion. There is a previous history of an accident 1 year back for which he was operated. Recent magnetic resonance imaging (MRI) revealed anterior cruciate ligament and posterior cruciate ligament avulsion fracture. The clinical diagnosis and radiologic findings were in favor of PVNS. Histopathological examination revealed the presence of fungus. It was further confirmed by fungal culture, for which the patient was given antifungals and was further followed up in the orthopedics outpatient clinic. Thus, we diagnosed fungal synovitis in a patient who came with clinical presentation and MRI findings suggestive of PVNS.
Incidence and Management of Post-dural Puncture Headache among Parturients: A Retrospective Analysis
Authors: Nair Sobha S. , Puthenveettil Nitu
Published: March 2024

Background:

Postdural puncture headache (PDPH) is a known complication following spinal and epidural anesthesia.

Study Design:

This is a retrospective study to assess the incidence, risk factors, severity, and management of PDPH.

Materials:

The data were extracted from the medical records. All parturients who gave birth under spinal anesthesia or epidural analgesia were included. Maternal demographics, the size of the needle, the position of the parturient, and the day of onset of the headache were noted. Categorical variables were expressed using frequency and percentage and numerical variables as mean and standard deviation. One-way analysis of variance test was used for cross-comparison between groups.

Results:

A total of 35 patients developed PDPH. It was managed conservatively in 65.71%, with Sphenopalatine ganglion block (SPGB) in 28.57% and by epidural blood patch (EBP) in 5.72%. The mean age was 28.6 years and body mass index was 27.2. 25G spinal needle was used in 54.3% and 23G in 28.6%. At 30 minute, pain score was <4 in SPGB and EBP. At 2 hours, pain score was <4 in all patients. The difference in the drop in pain score was statistically significant with a P value of < .002 at all time points. On cross-comparison, conservative management with SPGB and blood patch was statistically significant.

Conclusion:

The incidence of PDPH was 0.8%. We can continue with the 23G and 25G Whitacre needles due to the incidence of PDPH being lower. The use of SPGB and EBP is effective in management of severe PDPH.
Anesthetic Challenges in Severe Pulmonary Stenosis Posted for Caesarean Delivery
Authors: Nimmagadda Rajaratnakumar , Athmakuri Krishna S. , Vinjamuri Saketh , Chakravarthy Kousalya
Published: March 2024

Isolated Pulmonary stenosis (PS) accounts for 10–12% of adult congenital heart diseases. The effect of PS on pregnancy depends on the severity of the stenosis. There are limited data available in the literature to guide the anesthetic management of pregnant patients with severe PS. We report the successful anesthetic management of a pregnant woman presenting with severe pulmonary re-stenosis 10 years after open pulmonary valvotomy, posted for caesarean section.
Radiological Study of Synovial Chondromatosis of the Temporomandibular Joint
Authors: Budakoti Akansha , Choudhary Anuridhi , Bhandari Akanksha , Samlok Japnit Kaur
Published: March 2024

Temporomandibular joint disorders (TMDs) are usually accompanied by changes in the bone structure of the TMJ brought on by degenerative processes. Osteophytes, erosion, flattening, subchondral sclerosis, pseudocysts, TMJ remodeling, articular cartilage abrasion, bone degradation, and synovial inflammation are among the characteristics of degenerative joint disease. Synovial chondromatosis (SC) is one of the degenerative joint conditions, which is defined by the growth of cartilaginous nodules, which are typically loose in the joint space of the synovial membrane. Its appearance in the TMJ, however, is more uncommon than in other large joints such as the knee and hip and is accompanied by preauricular pain, swelling, and restricted mouth opening. However, we recently encountered cases of degenerative joint disorder, i.e., of SC of TMJ, which showed the typical histopathological findings along with the typical imaging findings on Panoramic radiography (PAN) TMJ and cone-beam computed tomography images.
A Comparative Study to Observe the Effects of Online Lectures and Flipped Classroom-Assisted Sessions among First-Phase MBBS Students during the COVID-19 Pandemic
Authors: Chaudhuri Arunima
Published: March 2024

Background:

The past decade has encouraged learner-centered approaches which expect students to take greater responsibility for their learning and support each other’s progress. The flipped classroom (FC) is a teaching–learning tool that uses learner-centeredness. The present comparative study was conducted to observe the effects of online lectures and FC-assisted sessions among first-phase MBBS students during the COVID-19 pandemic.

Materials and Methods:

The present study was conducted after taking institutional ethical clearance and informed consent of the participants. Two hundred first MBBS students participated and were divided into two Groups A and B. Ten topics of neurophysiology were taught to both groups using either FC-assisted self-directed learning (SDL) sessions or online lecture classes. A cross-over of groups was done to prevent any bias. Pretest and posttest scores of all topics were assessed using multiple-choice questions (MCQs) and feedback was taken. Program evaluation was done.

Results:

There was no significant difference in performance in pretest MCQ examinations between the two groups. Students of both Groups A and B performed significantly better in posttest MCQ examinations as compared to pretest MCQ examinations. However, the posttest results of the FC group were better. Faculty and students provided positive views in support of the sessions. Students were highly satisfied with the program.

Conclusions:

FC needs to be introduced in medical schools early, to help young medical students to develop SDL skills which will enhance their ability to become lifelong learners and improve the quality of patient care in long run.
Expected Additional Protection Rate against Omicron COVID-19 Infection and Death for the Fifth Dose of COVID-19 Vaccine: An Appraisal from an Endemic Area in Indochina
Authors: untipantip Rujittika Mungmunp , Wiwanitkit Viroj
Published: March 2024

Objective:

COVID-19 is still a global emergency with no effective treatment. Vaccination is the greatest option for disaster management. COVID-19 vaccination is now universally acknowledged as an effective primary COVID-19 preventive strategy. In the case of the introduction of a new strain, as well as the likely loss of public immunity following routine mass vaccination, some scientists are recommending a fifth dosage vaccine. Because the efficacy of the fifth vaccine dose is unknown, any investigation into its efficacy is intriguing.

Materials and Methods:

To evaluate an additional protection rate against omicron COVID-19 infection and death resulting from a fifth dose of COVID-19 vaccine, the authors of this study used a clinical model technique.

Results:

According to simulations, the fifth immunization dose can still enhance immunity and provide additional protection against omicron COVID-19 infection. Despite this, the fifth immunisation dose can still enhance immunity while providing no additional protection against omicron COVID-19 mortality.

Conclusions:

There is no additional benefit in terms of avoiding omicron COVID-19 death because just four vaccination doses are required to protect against mortality.
A Comparison of Efficacy of Autologous Platelet-rich Plasma and Conventional Sutures in Anchoring Split Skin Graft on Wounds
Authors: Gupta Urbee , Bellad Anilkumar P. , Powar Rajesh S. , Sultanpur Chetan V.
Published: March 2024

Context:

Split thickness skin grafting (STSG) restores cutaneous cover over wounds thus protecting the underlying surface from contamination, fluid loss and stimulates healing. Autologous platelet rich plasma (PRP) provides a large number of platelets and high concentration of growth factors which promote overall uptake of STSG.

Aims:

The aim of this study was to assess the immediate, subsequent adhesion and final take of STSG with application of PRP over recipient site.

Methods and Material:

1 year Randomised Control Trial where 80 wounds of various aetiologies were randomised into intervention group (n=40) which received PRP before placing STSG on recipient site and control group (n=40) in which the graft was fixed in place with sutures alone. Immediate graft adhesion and subsequent graft uptake were compared between the two groups and statistical analysis was done with: SPSS Version 20.

Results:

Irrespective of aetiology, and size, among a total of 80 wounds 87.5% grafts had adhered by 1st minute of application in the intervention group compared to nil in control group (p< 0.0001). Graft uptake was assessed on first three consecutive dressings. There was significantly better graft uptake in intervention group compared to control group [third dressing uptake (98.29%, 93%, p< 0.0001) respectively].Difference in seroma and haematoma formation were also compared between the two groups and found to be not significant. (p>0.05) Conclusions: Application of topical PRP facilitates STSG uptake. It decreases operative time by decreasing mobility of graft over the wound bed. Thus, use of PRP improves outcome of split thickness skin graft in wounds of various aetiologies and we recommend use of the same at recipient site of STSG.

CTRI/2021/06/034401
Twist in Tale: A Story of Strangulated Paraduodenal Hernias
Authors: Majumdar Namrata , Halder Pankaj Kumar , Das Dipratim , Das Atithi Ranjan , Das Shalini , Bhattacharya Dipro
Published: March 2024

The term “paraduodenal hernia (PDH)” refers to a herniation of the entire/partial small bowel into a sac derived from folds of peritoneum and fossae normally found at the terminal or 4th portion of the duodenum. It is rare, having variable presentation, and the severity of symptoms/signs is directly proportional to the degree of obstruction. We present three cases of paraduodenal hernias presenting in emergency with signs of with acute intestinal obstruction. Here we attempt to re-evaluate the representative features of PDHs, and to highlight the perioperative complications and management strategies that surgeons need to be aware of.
A Lake on Lower Lip
Authors: Gupta Kunal , Khan Arshiya , Jangid Shivani , Madke Bhushan
Published: March 2024

A localized vascular dilatation frequently involving sun-exposed skin is the source of the common vascular tumor known as the venous lake of the lip. Venous lakes are sometimes known as phlebectasias or senile hemangiomas. Deterioration of the connective tissue in the vascular adventitia and dermis plays a pivotal role in the development of the lesion. In older adults, they are frequently placed over the lower lip. It is seen as a smooth-surfaced, round or oval, soft, dark blue-to-dark purple nodule with sharply defined edges. Venous lakes can exhibit cosmetic damage or bleaching following local trauma, despite the fact that they are typically asymptomatic and of varying size.
Molecular Docking of Combretastatin Derivatives to Combat Human Cancer Cells
Authors: Chitnis Kshitij , Tuteja Jasdev Singh , Patidar Priti
Published: March 2024

Cancer is defined as the group of diseases which involve abnormal cell growth or controlled growth of abnormal cells that are present in any part of the body. The causative agents of cancer are chemical, environmental, viral, and mutagenic, which lead to the mutation of genes into oncogenes, which provoke or demean regulatory biochemicals, resulting in accelerated cellular growth. Combretastatin was selected as the candidate because it is a water-soluble prodrug which is quickly converted into combretastatin A4, a cancer-fighting substance. It has longer circulation, better drug targeting, increased efficiency, and fewer side effects. The research was carried out to find a potential drug that could inhibit the action of cancer in humans. In the experiment, 21 derivatives of combretastatin were subjected to molecular docking for analyzing the binding interactions of the derivative with the active site using the Protein Data Bank: 3DK9 through Molegro Virtual Docker 6.0. The docking showed that the (E)-1-(2,6-dimethoxypyridin-4-yl)-3-(1H-indol-3-yl)-2-methylprop-2-en-1-one was the most potent, had a Mol Dock score of-194.925 and gave interactions with Asp331, Gly31, and Thr57. Thus, this research can be further extended further to have more potent drugs.
Analyse and Predict the Detection of the Cyber - Attack Process by Using a Machine-Learning Approach
Authors: Singh Charanjeet , Singh Ravinjit , Shivaputra  , Tiwari Mohit , Hazela Bramah
Published: March 2024

Crimes committed online rank among the most critical global concerns. Daily, they cause country and citizen economies to suffer massive financial losses. With the proliferation of cyber-attacks, cybercrime has also been on the rise. To effectively combat cybercrime, it is essential to identify its perpetrators and understand their methods. Identifying and preventing cyber-attacks are difficult tasks. To combat these concerns, however, new research has produced safety models and forecast tools grounded on artificial intelligence. Numerous methods for predicting criminal behaviour are available in the literature. While they may not be perfect, they may help in cybercrime and cyber-attack tactic prediction. To find out whether an attack happened and, if so, who was responsible, one way to look at this problem is by using real-world data. There is data about the crime, the perpetrator's demographics, the amount of property damaged, and the entry points for the assault. Potentially, by submitting applications to forensics teams, victims of cyber-attacks may get information. This study uses ML methods to analyse cyber-crime consuming two patterns and to forecast how the specified characteristics will furnish to the detection of the cyber-attack methodology and perpetrator. Based on the comparison of eight distinct machine-learning methods, one can say that their accuracy was quite comparable. The Support Vector Machine (SVM) Linear outperformed all other cyber-attack tactics in terms of accuracy. The initial model gave us a decent notion of the assaults that the victims would face. The most successful technique for detecting malevolent actors was logistic regression, according to the success rate. To anticipate who the perpetrator and victim would be, the second model compared their traits.  A person’s chances of being a victim of a cyber-attack decrease as their income and level of education rise. The proposed idea is expected to be used by departments dealing with cybercrime. Cyber-attack identification will also be made easier, and the fight against them will be more efficient.
Credit Card Deception Recognition Using Random Forest Machine Learning Algorithm
Authors: Jaiswal Ishita , Bharadwaj Anupama , Kumari Kirti , Agarwal Nidhi
Published: March 2024

INTRODUCTION: The credit card deception poses a global threat, resulting in significant monetary losses and identity theft. Detecting fraudulent     transactions promptly is crucial for mitigating these losses. Machine learning algorithms, specifically the random forest algorithm, show promise in addressing this issue.
OBJECTIVES: This research paper presents a comprehensive study of numerous machine learning algorithms for credit card deception recognition, focusing on the random forest algorithm.
METHODS: To tackle the increasing fraud challenges and the need for more effective detection systems, we develop an advanced credit card deception detection system utilizing machine learning algorithms. We evaluate our system's performance using precision, recall, & F1-score metrics. Additionally, we provide various insights into the key features for fraud detection, empowering financial institutions to enhance their detection systems.  The paper follows a structured approach.
RESULTS: We review existing work on credit card fraud detection, detail the dataset and pre-processing steps, present the random forest algorithm and its application to fraud detection, compare its performance against other algorithms, discuss fraud detection challenges, and propose effective solutions.
CONCLUSION: Finally, we conclude the research paper and suggest potential areas for future research. Our experiments demonstrate that the random forest algorithm surpasses other machine learning algorithms in accuracy, precision, recall, & F1-score. Moreover, the system effectively addresses challenges like imbalanced data and high-dimensional feature spaces. Our findings offer valuable insights into the most relevant features for fraud detection empowering financial organizations to improve their fraud detection capabilities.
Enhancing Diabetes Prediction with Data Preprocessing and various Machine Learning Algorithms
Authors: Saranya Gudluri , Pande Sagar Dhanraj
Published: March 2024

Diabetes mellitus, usually called diabetes, is a serious public health issue that is spreading like an epidemic around the world. It is a condition that results in elevated glucose levels in the blood. India is often referred to as the 'Diabetes Capital of the World', due to the country's 17% share of the global diabetes population. It is estimated that 77 million Indians over the age of 18 have diabetes (i.e., everyone in eleven) and there are also an estimated 25 million pre-diabetics. One of the solutions to control diabetes growth is to detect it at an early stage which can lead to improved treatment. So, in this project, we are using a few machine learning algorithms like SVM, Decision Tree Classifier, Random Forest, KNN, Linear regression, Logistic regression, Naive Bayes to effectively predict the diabetes. Pima Indians Diabetes Database has been used in this project. According to the experimental findings, Random Forest produced an accuracy of 91.10% which is higher among the different algorithms used.
Diabetic Retinopathy Eye Disease Detection Using Machine Learning
Authors: Dahiya Ruby , Agarwal Nidhi , Singh Sangeeta , Verma Deepanshu , Gupta Shivam
Published: March 2024

INTRODUCTION: Diabetic retinopathy is the name given to diabetes problems that harm the eyes. Its root cause is damage to the blood capillaries in the tissue that is light-sensitive in the rear of the eye. Over time, having excessive blood sugar may cause to the tiny blood capillaries that nourish the retina to become blocked, severing the retina's blood circulation. As a result, the eye tries to develop new blood arteries.
OBJECTIVES: The objective of this research is to analyse and compare various algorithms based on their performance and efficiency in predicting Diabetic Retinopathy.
METHODS: To achieve this, an experimental model was developed to predict Diabetic Retinopathy at early stage.
RESULTS: The results provide valuable insights into the effectiveness and scalability of these algorithms. The findings of this study contribute to the understanding of various algorithm selection and its impact on the overall performance of models.
CONCLUSION: The findings of this study contribute to the understanding of multiple algorithm selection and its impact on the overall performance of models’ accuracy. By applying these algorithms, we can predict disease at early stage such that it can be cured efficiently before it goes worse.
On Gibbs measures and topological solitons of exterior equivariant wave maps
Authors: Bringmann Bjoern
Published: March 2024

We consider

k

-equivariant wave maps from the exterior spatial domain

\mathbb{R}^{3} \setminus B(0,1)

into the target

\mathbb{S}^{3}

. This model has infinitely many topological solitons

Q_{n,k}

, which are indexed by their topological degree

n\in \mathbb{Z}

. For each

n\in \mathbb{Z}

and

k\geq 1

, we prove the existence and invariance of a Gibbs measure supported on the homotopy class of

Q_{n,k}

. As a corollary, we obtain that soliton resolution fails for random initial data. Since soliton resolution is known for initial data in the energy space, this reveals a sharp contrast between deterministic and probabilistic perspectives.