bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Cardiac Emergencies: When to Worry and When to Reassure
Authors: Igwe Chukwuemeka , Iyengar Tara , McQueen Alisa , Nater Melissa
Published: April 2023

Cardiac symptoms are a frequent reason for pediatric patients to present to the emergency department. As stressful as these visits can be for both parents and inexperienced providers, many of these symptoms may have a benign explanation, and recognition of red flags are of the utmost importance to provide optimal care. In this article, we present four clinical scenarios that have a cardiac etiology and are common to the pediatric emergency department. In addition to highlighting differential diagnoses, we discuss important red flags, key signs, and findings on physical examination that should not be missed. A brief review of important workup and management is also discussed. Lastly, we review common electrocardiogram pearls and pitfalls important for the ordering provider to recognize. In this article, we hope to provide guidance on when to provide reassurance and when to refer to a pediatric cardiologist for evaluation.

[
Pediatr Ann
. 2023;52(4):e128–e134.]
Pediatric Respiratory Emergencies—Recognition, Approach, and Management
Authors: Rahim Nasiha , Uraizee Aisha , Rao Anil , Finkel Leah
Published: April 2023

This article reviews the current trends and management of respiratory emergencies in children. Respiratory emergencies are a common report in pediatrics and often require prompt recognition and intervention. It is important to differentiate upper from lower respiratory disease processes because the management is often different. With the advent of many vaccinations, the concern for certain diseases has changed with variations in the prevalence of other organisms. This article discusses detection and management of many respiratory emergencies.

[
Pediatr Ann
. 2023;52(4):e146–e152.]
The Latest National Asthma Education and Prevention Program Guidelines: A Review for the Busy Pediatrician
Authors: Ni Jeffrey , Chowdhury Naema , Giles B. Louise
Published: April 2023

Asthma is one of the most common chronic diseases affecting the pediatric population. The diagnosis and management of asthma is constantly evolving, and recently the National Heart, Lung, and Blood Institute published an updated guideline regarding various aspects of pediatric asthma. In this report, we review and summarize these guidelines and compare them with the Global Initiative for Asthma guidelines.

[
Pediatr Ann
. 2023;52(4):e153–e158.]
A combined intuitionistic fuzzy closeness coefficient and a double normalization-based WISP method to solve the gerontechnology selection problem for aging persons and people with disability
Authors: Hezam Ibrahim M. , Rani Pratibha , Mishra Arunodaya Raj , Alshamrani Ahmad M.
Published: April 2023

This study aims to introduce a decision-making framework for prioritizing gerontechnologies (GTs) for aging persons and people with disability under an intuitionistic fuzzy set (IFS) context. First, the intuitionistic fuzzy (IF)-divergence measure and its properties are developed to obtain the criteria weight. Second, a new exponential function-based score function and its properties for the IFS are introduced to order the different IFSs. Third, an IF-relative closeness coefficient (RCC)-based method is proposed to determine the criteria weights. Fourth, the double normalization (DN) procedure-based weighted integrated sum product (WISP) approach is introduced under the IFSs. To demonstrate the applicability and usefulness of the proposed IF-RCC-DN-WISP model, a case study that involves ranking the different GTs for aging persons and people with disability is conducted from an IF perspective. The results of the developed model show that mobility is the most appropriate gerontechnology for aging persons and people with disability. A comparison with different models is also performed to prove the superiority of the obtained results. The comparative study shows how the developed model outperforms the other extant models, as it can offer more sensible outcomes. Therefore, it is more suitable and efficient for expressing uncertain information when treating practical decision-making problems.
Revisiting Rentierism through the Lens of Algerian Gas
Authors: Mañé-Estrada Aurèlia , Albinyana Roger
Published: April 2023

This paper aims at critically reviewing the concept of rentierism and the Rentier State coined after the oil shocks of the 1970s. It explains that it is the result of a relationship, which properly institutionalized through the market generates a mineral rent. This allows us to argue that the oil price fulfils a systemic role. Finally, this paper assesses the case of Algeria by examining its positioning in the hydrocarbon global value chains, with the aim to draw the conclusions that the future of Algeria as a gas rentier economy is quite unclear, but in the case of a major restructuring of the international gas trade, it could lead to its petrolization.
Modeling the Specific Heat Capacity of Chemical Elements Superalloys of Gas Turbines
Authors: Badamshin Ildar Kh.
Published: April 2023

One of the thermophysical characteristics of metals and alloys is the specific heat capacity. It is measured, as a rule, experimentally, which determines the high cost and labor intensity of this approach. A model has been developed for calculating the specific heat capacity of chemical elements and their compounds. The calculation results are in satisfactory agreement with the experimental data of other authors (reference data). The simulation results are used to calculate the thermal state of gas turbine parts. It can also be used in alloy design.
Mathematical Modeling of FSW for AA5056 Alloy
Authors: Uporov Pavel A. , Ozhegov Mikhail A. , Rylkov Evgenii N.
Published: April 2023

This paper presents a Computational Fluid Dynamics (CFD) model for friction spot stir welding applied to two plates made of AA5056 alloy. Welding was carried out at several speeds of rotation of the tool, while the temperature was observed from the surface of the upper plate using thermocouple. Using this temperature, the mathematical model was adjusted. Since the model is based on the CFD method, in this case the plate material was specified as a very viscous fluid, the dynamic viscosity of which depends on temperature and strain rates. Welding was carried out at several speeds of rotation of the tool, with its own model created for each speed. As a result, the temperature and dynamic viscosity distributions in the welding zone were obtained.
Fabrication and Utilization of High Loft Mats Based on Recycling Egyptian Pulled Wool and Flax Fibers Waste for Thermal Insulation Applications
Authors: Nassef Mohamed G.A. , El Basyoni Ahmed M. , Badr Alaa A. , Alnahrawy Ashraf , Hassanin Ahmed H.
Published: April 2023

Heating and cooling activities of buildings consume a considerable amount of energy used in building envelopes and are responsible for almost 16 % of CO2 emissions in the air. This problem has been confronted with a recent worldwide trend by introducing eco-friendly buildings with net zero emissions. Currently used thermal insulators in building envelopes are usually made from synthetic polymers which are difficult to recycle or dispose of. This paper presents a novel bio-composite mats using Egyptian pulled wool fiber waste and flax fibers waste as an alternative to commercial polystyrene foam. High loft nonwoven mats with different blends of wool and flax are fabricated and characterized to utilize a composite structure with satisfactory thermal and physical properties. Thermal conductivity test, ignition test, and compression and recovery test are applied to the developed specimens. The results proved the competitiveness and suitability of the proposed composites to be used as building interior insulators when compared to polystyrene and other similar composite materials from literature.
Characterization of Eco-Friendly Lightweight Aggregate Concretes Incorporating Industrial Wastes
Authors: Sadrolodabaee Payam , Di Rienzo Gianmarco , Farina Ilenia , Salzano Cinzia , Singh Narinder , Colangelo Francesco
Published: April 2023

Towards the sustainable development goals in the built environment, the use of waste and recycled sources has been attaining great interest among researchers and policy-makers, especially in concrete as the most used construction material. Excess use of natural aggregates, as one of the main components of concrete, causes the depletion of natural resources and the associated environmental problems, thus, the use of artificial and recycled aggregates is of great importance. In this regard, the production of lightweight artificial aggregates from industrial and hazardous wastes may be a promising solution that not only mitigates the depletion of natural resources but also stabilize those kinds of wastes. This study aimed to investigate the production of concrete with recycled aggregates from industrial wastes, mainly municipal solid waste incineration fly ash (MSWI-FA). To this end, different kinds of mix designs to manufacture the aggregates were developed based on MSWI-FA, ground granulated blast furnace slag (GGBFS), marble sludge (MS), and cement. The concrete samples containing different artificial aggregates, as well as recycled polyethylene terephthalate (PET) in the sand form, were produced and the properties, including compressive strength and thermal insulation, were evaluated. The obtained results of the lightweight concrete demonstrated enhanced thermal property (up to 30%), but at least 30% lower resistance with respect to the normal concrete produced from the natural aggregate.
Density and Strength Performance of Cellular Concrete Blended with Bentonite Clay and Polypropylene Fiber
Authors: Baker Mousa Bani , Abendeh Raed , Alshorman Batool
Published: April 2023

Cellular concrete (known as foamed concrete) is a lightweight building material with low densities ranging from 900 kg/m3 to 1900 kg/m3, which can have potential applications in civil engineering practices. However, it is very weak in withstanding tensile loads which leads to cracks during shrinkage in the drying stage. Therefore, six different groups of cellular concrete are prepared for a possible application in grouting underneath the foundations to achieve a minimum compressive strength of 2000 psi (13.79 MPa) as per ASTM C476, and for soil nail grout with a minimum compressive strength of 3000 psi (20.86 MPa) as per ASTM C109 at 28 days. Furthermore, these mixtures are undergoing laboratory testing for pushout (using steel cylinders with varied diamters and thickneses) and pullout tests as the subsequent part of this project. All groups contain 0.34 water-to-cement ratio, same size and amounts of sands and superplasticizer (SP). The first group included four control mixes without bentonite and polypropylene fiber (PPF) additives with varied foam content (C1-F1,F2,F3,F4). The remaining groups consist of 17 different mixes blended with either one or both additives. The content effect of foam agent, bentonite clay, and PPF as additives on the density and compressive and flexural strengths of cellular concrete are investigated in this study. The results revealed that the introduction of bentonite and/or PPF in cellular concrete mixtures increased the density and strength. The results revealed that low dry densities (less than 1900 kg/m3) of blended cellular concrete mixtures can reach high compressive strength of 24.37 MPa with 4.74 MPa flexural strength that make them feasible for geotechnical and structural engineering applications.
Cryptococcal meningitis with suspected concomitant neurosyphilis in an immunocompetent individual: A diagnostic dilemma
Authors: Ranatunga Krishna , Jayasinghe Ranjith P
Published: April 2023

No abstract available.
Experiences of migrant mothers attending vaccination services at primary healthcare facilities
Authors: Acheampong Stephan , Lowane Mygirl P. , Fernandes Lucy
Published: April 2023

Background: Migration to South Africa is currently dominated by women and children, for socio-economic and refugee reasons or to utilise the healthcare system for various services. Migrants and refugees are at risk of vaccine-preventable diseases, and many of their children have an incomplete or unknown immunisation status.Aim: This study aimed to explore the experiences of migrant mothers in utilising child immunisation services in primary healthcare facilities.Setting: Ten primary healthcare facilities that were providing immunisation services, located in the Buffalo City Metropolitan Municipality, Eastern Cape province, South Africa.Methods: A qualitative research design, making use of in-depth interviews (IDIs) from 18 purposefully selected migrant women, was used for data collection. Thematic content analysis was used to analyse the recorded data of the experiences of study participants in their access to immunisation services.Results: From the IDIs, four themes were identified: difficulty in communicating with the healthcare workers because of language barriers, access challenges, interpersonal barriers and interpersonal relationships were identified in this study, which influenced the utilisation of immunisation services by migrant mothers.Conclusion: The findings of this study support and reinforce the duty of the South African government and healthcare facilities to work together to improve migrant women’s access to immunisation services.Contribution: A positive relationship between healthcare workers and migrant mothers while accessing immunisation services should contribute to reducing child mortality in South Africa and achieving Sustainable Development Goal 3 by the year 2030.
Seroprevalence and associated risk factors of bovine neosporosis in the Khomas region of Namibia
Authors: Samkange Alaster , Chitanga Simbarashe , Tjipura-Zaire Georgina N. , Mutjavikua Vimanuka G. , Smith Jan W. , Neves Luis , Matjila Tshepo
Published: April 2023

Neospora caninum is a coccidian parasite that occurs worldwide and is one of the most important causes of abortion, especially in cattle. However, no studies have been performed in Namibia to determine the N. caninum status in livestock. Therefore, this study aimed to determine the seroprevalence of N. caninum in cattle and the associated risk factors in the Khomas region of Namibia. A total of 736 sera were collected from cows in 32 farming establishments. These comprised 698 beef and 38 dairy cattle sera and were tested using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Questionnaires were concurrently administered to determine possible risk factors associated with N. caninum seropositivity. A total of 42 sera were positive (all beef), giving an animal-level seroprevalence rate of 5.7%. Eight of the 32 establishments had at least one positive animal, giving a herd-level seroprevalence of 25%. There was no significant association between seropositivity and the presence of dogs, jackals, history of abortions, farm size, number of cattle or average annual rainfall. The establishments with moderate to high numbers of Feliformia were 9.8 times more likely to be seropositive to N. caninum than those with none to low levels of the former (p = 0.0245). The authors concluded that the seroprevalence level of N. caninum in the Khomas region was relatively low compared with other parts of the world and that the role of Feliformia in the epidemiology of bovine neosporosis needed to be further investigated.Contribution: Serological evidence of bovine neosporosis and the associated risk factors are reported in Namibia for the first time. This study contributes to the scientific body of knowledge on N. caninum in Africa, which is currently limited.
Clozapine use at a specialised psychiatric hospital in Johannesburg
Authors: Ord Katherine L. , Marais Belinda
Published: April 2023

Background: Clozapine is the gold standard medication for treatment-resistant psychosis, with robust evidence supporting its efficacy in multiple symptom domains. However, clozapine’s side effect profile contributes to its underutilisation and discontinuation.Aim: This study aimed to explore the magnitude of clozapine use and describe factors that impact on its effective use among in-patients.Setting: Tara Hospital, a specialised psychiatric hospital in Johannesburg.Methods: This was a retrospective, cross-sectional file review of clozapine-treated patients admitted over the 2-year study period. Data variables included: demographics, clinical information, discharge prescription, clozapine-related side effects and details of clozapine discontinuation, where applicable.Results: A cohort of 33.2% of patients from Tara’s biological wards received a trial of clozapine. Participants experienced anti-cholinergic clozapine-related side effects that included weight gain (79.5%), tachycardia (35.2%) and constipation (35.2%). Clozapine was discontinued in 13.7% of participants, and no life-threatening side effects or deaths occurred. Significantly more use of flupenthixol decanoate (64.3% vs. 30.7%; p = 0.0322) and anticholinergics (35.7% vs. 11.4%; p = 0.0474) occurred in the clozapine-discontinued group. Polypharmacy rates were high for psychiatric and non-psychiatric medications.Conclusion: One-third of patients received clozapine trials, most of whom continued at discharge. Although side effects occurred frequently, life-threatening side effects did not. Clozapine monitoring protocols, side effect rating scales, pre-emptive management of side effects, lifestyle interventions and clinician education may improve outcomes of clozapine use. The use of plasma clozapine levels may be beneficial.Contribution: This study expands our limited knowledge regarding current clozapine prescribing trends in South Africa.
Hell: Educationally in post-secular societies
Authors: Firth Walter
Published: April 2023

Many countries around the world, including Australia, have secularism expressed in their identity. However, as these secular nations (as they understand themselves) shift into post-secular societies, it raises questions around the place and content of religious education and instruction in secular settings: particularly in regard to the shadow side of theological views, such as on the matter of hell. Acknowledging the valuable contribution religious education offers by providing a space for children to question and search for meaning, how or indeed should hell be taught to children in public (secular) schools?Intradisciplinary and/or interdisciplinary implications: In the context of the secular and/or non-religious public reflex in society, there is a tension on the place of religious thought in secular educational settings. As scrutiny increases of what, and how, religious material is shared and taught, especially to children, the role and place of hell in this space must be reviewed. This study provides a basis for Practical Theology in post-secular societies, utilising the Australian context, to do so.
Cry in the sky
Authors: Saini Rajiv Kumar , V. K. Raju M. S. , Chail Amit
Published: April 2023

Drone operations have added a new chapter to modern warfare. They may not guarantee immediate territorial gains but can significantly influence ideological and political alignment of the adversary at a cost which is much lower than conventional war. However, drone operators, which include remote pilots, intelligence coordinators, and other support staff, may face important psychological issues which may affect their mental health and operational efficiency. We conducted a nonsystematic narrative review of the articles dealing with the issue and found that drone operators and support staff have higher chances of suffering from emotional disengagement, Post Traumatic Stress Syndrome (PTSD), emotional exhaustion, and burnout. The scope of the article does not cover the psychological effect on the targeted populations or political and ethical issues dealing with drone warfare.
Analysis of change in knowledge, attitude, and practices about COVID-19 following and awareness session in rural population of Western India
Authors: Shah Saurabh N. , Shah Drashti , Desai Nimisha , Shah Sandip H. , Bhowmick Shreyasee
Published: April 2023

Background:

Beginning of the pandemic showed our limitations in our understanding of the spread of the dreaded coronavirus-19 that had sprung from China and spread through thick and thin across the world. The measures to contain the spread of virus in the absence of specific treatment protocol had everyone grope for the solutions in a very short time frame. One such is the knowledge, attitude, and practice in the rural setup.

Aim:

The aim of the study is to measure the change in knowledge, attitude, and practices (KAP) regarding COVID-19 following an awareness session in rural population.

Materials and Methods:

A cross-section interventional study was carried out in January 2021. An interactive awareness session was conducted with the help of audiovisual aids following MOHFW guidelines for COVID-19, and the change in KAP about COVID-19 was measured by pre- and posttest standardized questionnaire.

Results:

Of all the participants, statistically significant change in knowledge was seen from 43% to 52%. The villagers were educated about preventive steps and a positive change was measured in the practice of changing masks regularly (84%–100%), maintaining social distancing (44%–64%), frequent handwashing (52%–64%). No change was seen in wearing of masks (92%) and negative change was seen in avoiding handshakes (32%–28%). The preventive practices regarding COVID-19 pandemic changed significantly from 50% to 58%. Our study measured positive attitude change toward getting vaccinated from 64% to 72%.

Conclusion:

A single, short awareness session led to significant change in KAP about COVID-19 in rural population.
Efficacy of psychological intervention in patients with post-COVID-19 anxiety
Authors: Priyamvada Richa , Ranjan Rupesh , Chaudhury Suprakash
Published: April 2023

Background:

Individuals who suffered from COVID-19 remain stressed and worried about anxiety issues for significant changes in daily living activities, causing strong emotional distress.

Aim:

The aim of this study was to assess the efficacy of psychological intervention in patients with post-COVID-19 anxiety.

Materials and Methods:

Thirty patients recovered from COVID-19 were selected for the study of age group 20–45 years of both the sexes. Initially, sociodemographic data sheet was filled, and after that, Mental Health Inventory (MHI) was administered. The patients who scored less on MHI were taken for the study, and psychoeducation, relaxation exercises, and activity scheduling were given to them. The goal of intervention was to prepare the patients to learn, interpret, and react to physical and psychological symptoms related after recovering from COVID-19 infection. The intervention was done for 30 min twice a week for 1 month, after that again postassessment was done to see the efficacy of psychological intervention.

Results:

Result reveals a significant improvement in mental health-related issues after psychological intervention as assessed by the MHI.

Conclusion:

Psychological intervention resulted in significant improvement of post-COVID-19 anxiety and related mental health issues.
Sociodemographic and clinical profile of cannabis-induced psychosis
Authors: Padhi Debasish , Shukla Priyanka , Chaudhury Suprakash
Published: April 2023

Background:

Cannabis is the most widely used drug in the world. An association between cannabis use and mental illness, in particular psychotic illness, was recognized since long. Various cultures have traditionally used cannabis for different purposes, and continuous increasing use of cannabis is promoting psychosis also.

Aim:

The present study has tried to identify the differences in profile between the two groups and thus proposing possible variables underlying cannabis and psychosis.

Materials and Methods:

This cross-sectional descriptive hospital-based study included 50 consecutive cannabis-using patients with psychosis and equal number of age-matched patients with schizophrenia but no cannabis intake. Permission was taken from the institutional ethics committee. All subjects gave written informed consent. Detailed history regarding psychotic symptoms and different parameters of cannabis use were collected from the key informant as well as the patients in the ward. Both the groups' psychotic symptoms were assessed using scale for assessment of the positive symptoms.

Results:

There is no significant difference between both the groups with respect to age. Cannabis-using patients with psychosis showed high symptomatology in the areas of pressure of speech, distractible speech, and clanging. On the other hand, patients with schizophrenia but no cannabis intake showed high symptomatology in the areas of derailment, incoherence, illogicality, and global rating of positive formal thought disorder.

Conclusion:

Continuous heavy use of cannabis can induce a psychotic disorder distinct from acute schizophrenia. Cannabis-induced psychosis has distinct demographic, premorbid, and clinical features.
Impact of COVID-19 on obsessive–compulsive disorder
Authors: Sowmya A. V. , Singh Pratishtha , Samudra Madhura , Javadekar Archana , Saldanha Daniel
Published: April 2023

A public health emergency of international concern, novel coronavirus disease (COVID-19), began in Wuhan, China, in December 2019. Since then, it has been caused a pandemic along with serious mental health problems. No other disorder is more vulnerable to the current situation than obsessive–compulsive disorder (OCD). Our case series focuses on the effects of COVID-19 on OCD along with its various manifestations. Most of our patients had exacerbated symptoms during the current situation, but there were also new onset OCD cases triggered by a variety of stressors.
Erotomania
Authors: Sowmya A. V. , Gupta Nishtha , Dhamija Sana , Samudra Madhura , Chaudhury Suprakash , Saldanha Daniel
Published: April 2023

Erotomania is an unusual psychotic disorder exemplified by an individual's delusions of another person being infatuated with them. The condition is usually, but not exclusively, observed in females who are shy, dependent, and sexually inexperienced. The object of the delusion is usually beyond reach, being of much higher social or financial status, already married or disinterested. We present a case series of three patients suffering from this uncommon disorder.
Psychogenic vomiting
Authors: Pooja V. , Gupta Nishtha , Khan Aslam , Chaudhury Suprakash , Saldanha Daniel
Published: April 2023

Psychogenic vomiting is a syndrome in of recurrent vomiting without any organic pathology. It must be differentiated from cyclical vomiting syndrome, functional vomiting, and chronic idiopathic nausea. It occurs as a result of an emotional or psychic disturbance. This condition is highly disabling, increasingly recognized, and under-researched. In India, the number of patients reporting to the psychiatric outpatient department with eating disorders is comparatively very less. We describe how two patients with diagnostic dilemmas who were treated successfully after psychiatric intervention.
Stigma associated with COVID-19
Authors: Davis Supriya , Samudra Madhura , Dhamija Sana , Chaudhury Suprakash , Saldanha Daniel
Published: April 2023

A number of incurable, deadly, and disfiguring diseases are associated with stigma which worsens the quality of life of the sufferer. Unfortunately, at the beginning of the COVID-19 pandemic, the disease was associated with severe stigma and extreme prejudice. Stigma of COVID-19 and its adverse effects are briefly discussed and solutions suggested.
Impact of COVID-19 pandemic on healthcare workers
Authors: Gupta Nishtha , Dhamija Sana , Patil Jaideep , Chaudhari Bhushan
Published: April 2023

The COVID-19 pandemic is a healthcare crisis that has led to unprecedented impact on healthcare services. At the heart of the unparalleled crisis, doctors face several challenges in treating patients with COVID-19. The psychological burden and overall wellness of healthcare workers (HCWs) have received heightened awareness, with research continuing to show high rates of burnout, psychological stress, and suicide. Detrimental effects include high rates of infection and death, excessive financial hardships, stress related to known and particularly unknown information, and fear of uncertainty regarding continued impact. Some researchers focused specifically on COVID-19's impact on HCW sleep. Anxiety and stress were significantly increased, leading to negative impacts on both self-efficacy and sleep. Stress is an important factor in drug use. Efforts should be made to explore the factors that are associated with psychological distress, which may lead to symptoms of anxiety, depression, or provoke suicidal ideation, and efforts should be made to control the factors that are modifiable. There needs to be more awareness among doctors and further long-term studies focusing on their mental health as adverse mental health conditions will further affect them as the disease advances.
Transient global amnesia following deliberate self-harm by hanging
Authors: Prakash Jyoti , Ali Tahoora , Chaudhury Suprakash , Srivastava Kalpana
Published: April 2023

A 25-year-old female was hospitalized subsequent to an attempt to hang herself. She was unconscious for a few minutes but responded to initial resuscitative measures. Relevant investigations, including X-ray neck, computed tomography scan brain, and electroencephalogram were normal. Physical examination was consistent with attempted hanging. On mental status examination, speech was relevant. Mood was euthymic. Attention was arousable, but concentration was impaired. Orientation to time and recent memory were impaired. Remote memory, insight, and judgment were unimpaired. Serial Mental Status Examination (MSE) revealed improvement in concentration and orientation. Due to sudden onset memory loss of <24 h in duration without other signs of cognitive impairment or concomitant focal neurological symptoms, she was diagnosed as a case of transient global amnesia. The pathophysiology of the condition is briefly reviewed.
Correlates of depression, anxiety, self-esteem, and suicidal ideas in COVID-associated mucormycosis patients and the effects of treatment
Authors: Ahuja Amod , Samudra Madhura , Prasad Shashi Prabha , Chaudhury Suprakash , Bora Shivangi , Singh Varsha , Dhore Nilay
Published: April 2023

Aim:

The aim was to study the correlates of depression, anxiety, self-esteem, and suicidal ideas in patients of COVID-associated mucormycosis (CAM) and effects of treatment.

Materials and Methods:

A cross-sectional, analytical study was performed in a tertiary care center in Western Maharashtra. By purposive sampling, 34 patients of CAM were included in the study with their informed consent and after obtaining ethical clearance. A self-made questionnaire to include demographic and clinical details was filled. Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (RSES), and Suicidal Ideation Attributes Scale (SIDAS) were applied after initial diagnosis. The HADS, RSES, and SIDAS were reapplied after their operative treatment.

Results:

A significant reduction in anxiety and depression scores postoperatively was seen. No significant difference was found in self-esteem or suicidal ideas postoperatively in the study population. However, patients who underwent orbital exenteration showed a significant reduction in level of self-esteem with anxiety and depression postoperatively. No specific correlation was found between the computed tomography score, family history, intensive care unit admission, or orbital exenteration with anxiety, depression, self-esteem, and suicidal ideas.

Conclusion:

Levels of anxiety and depression in patients of CAM reduced significantly after treatment, but self-esteem worsened in males more than females owing to disfigurement. There is a need of psychological counseling in patients of mucormycosis undergoing a debilitating surgery both pre- and postoperatively for a better outcome and recovery.
Psychogenic nonepileptic seizures
Authors: Gupta Nishtha , Davis Supriya , Dhamija Sana , Javadekar Archana , Saldanha Daniel
Published: April 2023

Manifestation of abnormal excessive synchronous cortical activity, which is what defines epileptic seizures, is typically absent in seizures with psychological etiology, a heterogeneous set of factors that have been identified. Distinguishing psychogenic nonepileptic seizures (PNES) from epileptic seizures may be difficult at the bedside. We report a case series of PNES which presented with diagnostic dilemma. Diagnostic delay of years with PNES is common. The exact choice of treatment is often difficult and should be based on individual differences in the underlying factors. Outcome can be measured in terms of seizure occurrence (frequency, severity), but other measures might be of greater importance for the patient. Prognosis is varied but studies consistently report that 1/3rd to 1/4th of these cases become chronic.
First report on larvicidal potential of zinc sulfide aqua nanoparticles against Aedes aegypti (Linnaeus)
Authors: Sandhu Komalpreet Kaur , Vashishat Nisha , Sidhu Anjali
Published: April 2023

Background & objectives:

Mosquitoes are considered to be the deadliest arthropod-vectors, which cause millions of human deaths globally. Presently, nanotechnology in the field of insect pest management is being explored. The current study deals with the synthesis of zinc sulfide nanoparticles (ZnS NPs) in aqueous medium and their larvicidal efficacy against Ae. aegypti.

Methods:

Aqueous zinc sulfide nanoparticles were synthesized by mixing equal quantities of zinc acetate and zinc sulfide solutions by using sonochemical irradiation method. The synthesized NPs were characterized by Transmission Electron Microscopy (TEM). Larvicidal activity was performed according to WHO protocol and toxicity values were calculated by log-probit technique using POLO software. The morphological alterations between treated and control larvae were observed and compared.

Results:

TEM studies revealed the average particle size of synthesized nanoparticles to be 19.65 ± 1.08 nm with distorted spherical shape. The mosquito-larvicidal efficacy of ZnS NPs against Ae. aegypti showed maximum lethal effects with the LC50 and LC90 values of 4.49 and 15.58 ppm respectively. The morphological analysis of the mosquito larvae treated with ZnS NPs revealed shrunken and darkened body.

Interpretation & conclusion:

This study suggests that synthesized zinc sulfide aqua nanoparticles have good potential larvicidal properties making them best candidate for Aedes aegypti control.
Scrub typus fulminating as liver failure: A rare report
Authors: Jagadeesan Subramani , Patel Pranav , Kushwaha Pushpendra , Patidar Nehal
Published: April 2023

Scrub typhus is almost an endemic tropical mite-borne, zoonotic illness often cognate with the bacterium Orientia tsutsugamushi. After a typical incubation period of a fortnight, non-specific symptoms including fever, headache, and a specific skin ‘eschar’ is customary. If untreated after a symptomatic week, scrub typus may precipitate end-organ involvements spiraling into vivid complications. Nevertheless, crub typhus tends to display mild transaminitis, frank liver failure is hardly common in clinical practice. An instance of scrub typus triggering fulminant hepatic failure (FHF) in a middle-aged female is being reported here.
Aqueous deficiency dry eye in post conjunctivitis cicatrization - Effect of deep thermal punctal cautery
Authors: Agarwal Manokamna , Srinivasan Bhaskar , Agarwal Shweta , Pandey Sunita , Kumar Shobha P S , Sadhu Soumen , Saranya S , Iyer Geetha
Published: April 2023

Purpose:

To evaluate the effect of deep thermal punctal cautery in eyes with post-conjunctivitis cicatrization.

Methods:

This retrospective study consisted of patients who underwent deep thermal punctal cautery for post-conjunctivitis dry eye (PCDE). The diagnosis was based on a history suggestive of viral conjunctivitis in past followed by the onset of present clinical features of aqueous deficiency dry eye (ATD). All patients underwent a rheumatological evaluation to rule out underlying systemic collagen vascular disease as a cause for dry eye. The extent of cicatricial changes was noted. Best-corrected visual acuity (BCVA), Schirmer’s test, and fluorescein staining score (FSS; total score of 9) were analyzed pre- and post-cautery.

Results:

Out of 65 patients (117 eyes), 42 were males. The mean age at presentation was 25.769 ± 12.03 years. Thirteen patients presented with unilateral dry eye. Pre-cautery BCVA (logarithm of the minimum angle of resolution [logMAR]) and Schirmer’s test (mm) improved from 0.5251 ± 0.662 to 0.372 ± 0.595 (P value = 0.000, 95% confidence interval [CI]: 0.09–0.22), and 1.952 ± 2.763 to 4.929 ± 4.338 (P value = 0.000, 95% CI: -3.79–-2.17); post-cautery, respectively. The pre-cautery FSS of 5.9 ± 2.82 reduced to 1.58 ± 2.38 (P value = 0.000, 95% CI: 3.46–5.17) post-cautery. The mean follow-up was 11.22 ± 13.32 months. No progression in cicatricial changes was noted in any eye during the follow-up. Re-canalization rate was 10.64%, and repeat cautery was performed with successful closure of puncta.

Conclusion:

Symptoms and clinical signs of ATD in PCDE patients improve with punctal cautery.
Efficacy and safety of topical 2% rebamipide ophthalmic suspension in dry eye disease at tertiary care centre
Authors: Jain Kalpna , Jaju Meenu , Yadav Dinesh
Published: April 2023

Purpose:

To evaluate the effect and side effects of topical 2% rebamipide ophthalmic suspension in dry eye disease.

Method:

This prospective randomized case control study included total 80 patients (40 cases and 40 controls) of dry eye. Symptoms were graded according to OSDI scoring system and specific tests for dry eye included Tear film breakup time (TBUT), Schirmer’s test, Fluorescein corneal staining (FCS), Rose Bengal staining) were performed. Case group received 2% rebamipide ophthalmic suspension four times daily and control group given carboxymethylcellulose 0.5% four times daily. The follow ups had done at two, six and twelve weeks.

Results:

The maximum numbers of patients were between 45-60 years. Patient with mild moderate and severe OSDI Score shows marked improvement. Mild TBUT score showed improvement but statistically not significant (P value-0.34). In moderate and severe TBUT Score statistically significant improvement (P value- 0.0001, 0.0001). In all grade FCS shows statistically significant improvement with p value-0.0001, 0.0001, and 0.028 respectively. Schirmer’s test score in all cases had shown improvement but statistically not significant and P value were 0.09, 0.07, and 0.07 respectively. In mild, moderate and severe Rose Bengal staining statistically significant improvement (P value -0.027, 0.0001, and 0.04) .The only side effect was dysgeusia (10% patients).

Conclusion:

Rebamipide 2% ophthalmic suspension showed significant improvement in symptoms and signs of dry eye. It able to modify epithelial cell function, improve tear stability, and suppress inflammation suggests that it may be a first drug of choice for severe dry eye disease.
Impact of salivary stimulation on tear film function in dry eye subjects
Authors: Sah Anup Kumar , Aparna S , Ashwini D L
Published: April 2023

Purpose:

Dry eye is a common condition affecting people worldwide. It causes ocular discomfort by reducing the quality of vision and impacts daily activities. To overcome such ocular discomfort, artificial tears are used but it is difficult to use artificial tears every time to protect eyes from dryness. There is a need to explore other treatment options, which can be used during work hours. The aim was to study the effect of salivary stimulation on tear film functions among dry eye subjects.

Methods:

Thirty-three subjects were enrolled in this prospective experimental study. Tear film function tests such as tear break up time (TBUT), tear meniscus height (TMH), and Schirmer’s I and II tests were conducted. For dry eye subjects, salivation was induced by giving a tamarind candy (a soft slightly sour tamarind pulp mixed with sugar) for 5 min. Tear film function tests were carried out within a few seconds (2 to 3 s) after finishing the candy and then after 30 and 60 min of the induction of salivation. The pre- and post-tear film function measurements were recorded and analyzed.

Results:

TBUT, TMH, and Schirmer’s II tests showed statistically significant (P < 0.05) increase immediately and after 30 min of stimulation of salivation for all tests in both eyes. However, the difference was insignificant after 60 min of stimulation of salivation. Schirmer’s I showed statistically significant changes in the left eye, but not in the right eye immediately after stimulation of salivation (P = 0.025).

Conclusion:

The quantity as well as the quality of tear film improved after the stimulation of salivation among dry eye subjects.
A case–control study of the ocular surface and tear film parameters in gestational diabetes mellitus
Authors: Singh Chaithanya B , Savur Sheetal A
Published: April 2023

Purpose:

Gestational diabetes mellitus (GDM) is fairly common in India. There is an interplay of various factors like androgens, sex hormone-binding globulin (SHBG), estrogen, and progesterone on the tear film in pregnancy. Diabetes mellitus in itself affects the lacrimal function unit (LFU) and ocular surface. This study was therefore performed to assess the effect of the various factors on the tear film function and ocular surface in GDM using different diagnostic tests.

Methods:

Case–control study includes 49 subjects after calculating the sample size. Cases of newly diagnosed GDM in their second or third trimester of pregnancy without any ocular or systemic comorbidities. The following standard tests were performed, namely, ocular surface disease index (OSDI) scoring, Schirmer’s test, tear film breakup time (TBUT), and ocular surface staining (SICCA).

Results:

The two study groups did not differ significantly in terms of age, gestational age, and presenting symptoms. None of the patients had diabetic retinopathy, and the ocular surface was unaffected in both groups. There was a significant difference in the Schirmer’s II test (P = 0.01) between the groups, while Schirmer’s I (P = 0.06) and TBUT (P = 0.07) were not significant.

Conclusion:

Our study suggests that GDM patients can potentially suffer from DES despite the lack of symptoms and may be the basis for conducting larger studies to justify routine screening of GDM for DES in order to improve the quality of life of pregnant women.
Safety and efficacy of topical diquafosol for the treatment of dry eye disease: An updated meta-analysis of randomized controlled trials
Authors: Liu Shuang , Yang Guang , Li Qingnan , Tang Shaohua
Published: April 2023

Dry eye disease (DED) is a common multi-factorial disease that is characterized by tear film instability. Diquafosol tetrasodium (DQS), an ophthalmic solution, has been shown to be beneficial in the treatment of DED. The goal of this study was to provide an update on the safety and efficacy of topical 3% DQS in treating DED patients. A thorough search for all the published randomized controlled trials (RCTs) up to March 31, 2022 in CENTRAL, PubMed, Scopus, and Google Scholar databases was performed. Data were reported as standardized mean difference (SMD) with 95% confidence interval (CI). Modified Jadad scale was used for sensitivity analysis. Funnel plot and Egger’s regression test assessed the publication bias. Fourteen RCTs evaluating the safety and efficacy of topical 3% DQS treatment in DED patients were included. Eight included RCTs reported data on the DED after cataract surgery. Overall findings suggest that 3% DQS treatment in DED patients was associated with significantly better improvement at 4 weeks in tear breakup time, Schirmer test, fluorescein staining scores, and Rose Bengal staining score as compared to patients treated with others eye drops including artificial tears or 01% sodium hyaluronate. However, no significant difference in ocular surface disease index was observed. Our findings suggest that 3% DQS treatment is safer and had a superior efficacy compared to artificial tears or sodium hyaluronate for treating DED in general and DED after cataract surgery.
Lid wiper epitheliopathy in symptomatic and asymptomatic dry eye subjects
Authors: Kamath Vandana , Arvind Anitha , Bhuvana K
Published: April 2023

Purpose:

Lid wiper epithliopathy (LWE) was stuided in symptomatic and asymptomatic dry eye subjects. This is the first such study to be conducted in the Indian population. LWE is a clinical condition associated with vital staining in the lower and upper eyelids on increased friction of the lid margin over to the cornea. Our aim was to study LWE in symptomatic and asymptomatic (control) dry eye subjects.

Methods:

Out of 96 subjects screened, 60 subjects were enrolled in the study and were divided into two groups, symptomatic and asymptomatic dry eye subjects, based on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and the Ocular Surface Disease Index (OSDI) scores. The subjects were examined to rule out clinical dry eye findings and assessed for LWE with two different dyes (fluorescein and lissamine green). Descriptive analysis was done and Chi-square test was used for statistical analysis.

Results:

A total of 60 subjects were enrolled in a study with a mean age of 21.33 ± 1.88 years, out of which the majority of LWE patients (99.8%) was seen in the symptomatic group than the asymptomatic group (73.3%); the difference was statistically significant (p = 0.00) and also clinically significant. LWE was found to be significantly higher in symptomatic dry eye subjects (99.8%) compared to asymptomatic dry eye subjects (73.3%). LWE severity was also found to be more (56.6% of grade 3) among symptomatic dry eye subjects compared to asymptomatic subjects (40% of grade 2).

Conclusion:

It is important to assess the lid wiper region (LWR) and treat LWE in routine clinical practice.
Autologous serum eye drops in dry eye disease: Preferred practice pattern guidelines
Authors: Vazirani Jayesh , Sridhar Uma , Gokhale Nikhil , Doddigarla Venkateswara Rao , Sharma Savitri , Basu Sayan
Published: April 2023

Autologous serum eye drops provide lubrication and promote epithelial healing. They have been successfully used in the management of ocular surface disorders such as dry eye disease, persistent epithelial defects and neurotrophic keratopathy for many decades. A great deal of variation in the methods of preparation of autologous serum eye drops, the end concentration and the duration of use exists in published literature. In this review, simplified recommendations for preparation, transport, storage and use of autologous serum are described. Evidence for the use of this modality in aqueous deficient dry eye disease is summarized, along with expertise-based rationale.