bluuebunny/crossref_metadata_2025 huggingface dataset:
Teledermatology: Case Selection and Consultation “Technology is Best when it Brings Patient–Physician Together.”
Authors: Kanthraj Garehatty Rudrappa
Published: May 2023

Teledermatology consultation (TC) is an effective, safe, and fast medium to reach one who is difficult to reach. The scope of TC is triage, diagnosis, counseling, and follow-up care. Feasibility studies for diagnosis and follow-up care by TC are analyzed. Teledermatology has been extensively evaluated in terms of diagnostic accuracy with respect to teledermatology tools, clinical outcomes, patient and provider satisfaction, and costs. Follow-up care by TC in cutaneous, esthetic surgeries and lasers is documented and widely used. We review and analyze the commonalities and differences between diagnosis and follow-up care using TC. There is a need to define case selection for TC. A dermatologist has to select an appropriate case and define the purpose for TC. A case with characteristic morphology and distribution of diagnosis is performed by TC. Follow-up care is provided by TC for cases with longer duration with remission and exacerbation. Interpretation of multiple patch test readings is performed by TC. Initial in-person examination is followed by TC to provide follow-up care. Various clinical situations and technical factors TC should not be offered are analyzed. A dermatologist should be aware of these clinical situations and technical factors and offer TC. Store-and-forward teledermatology and mobile messenger apps (e.g., WhatsApp) are commonly used to perform capture, transfer, and store clinical images. A dermatologist should realize providing follow-up care is one of the most important scopes of TC. Patient and physician satisfaction is best achieved for follow-up care. Further studies are needed in this area.
Comparative Clinical Assessment of Updosing of Bilastine and Combination of Levocetirizine and Hydroxyzine in Chronic Spontaneous Urticaria
Authors: Shah Bela , Mistry Deval , Jangid Neha , Shah Shikha , Kamat Shruti , Dhoot Dhiraj , Deshmukh Gaurav
Published: May 2023

Background:

Second-generation antihistamines (SGAHs) are first-line drugs in management of chronic spontaneous urticaria (CSU). However, almost 50% of the patients do not respond to standard dose of SGAH. Various guidelines recommend either updosing of SGAH or combination of different antihistamines in such patients. However, the studies comparing these treatment regimens are limited.

Materials and Methods:

In this comparative study, CSU patients were randomized to receive standard dose of either bilastine or levocetirizine for 2 weeks. After 2 weeks of treatment, nonresponders received a double dose of bilastine while hydroxyzine 25 mg once daily was added in the levocetirizine group. Patients were primarily evaluated for improvement in CSU, quality of life (QOL), and somnolence.

Results:

At the end of 2 weeks, 23/39 and 17/36 achieved well-controlled urticaria, and at the end of 4 weeks, 9/16 and 5/19 patients achieved well-controlled urticaria in the bilastine and levocetirizine groups, respectively. Only one patient in the bilastine group was symptom free and none in levocetirizine at the end of 4 weeks. At week 2, there was no statistical difference in Urticaria Activity Score over 7 days (UAS7) improvement between both the groups, however, at week 4, there was a statistical difference (P < 0.05). Somnolence was significantly lower in the bilastine group (P < 0.05). Bilastine was statistically significant (P < 0.05) in the improvement of QOL by CU-Q2oL as compared to levocetirizine. No major adverse events were reported during study period, however, bilastine was associated with significantly lower Adverse events (AEs) compared to levocetirizine (P < 0.05).

Conclusion:

Updosing of bilastine improves CSU symptoms without compromising safety as compared to combination of levocetirizine and hydroxyzine.
Comparison of In-Person Versus Teledermatology Consultation in the Development of a New Score: Analysis of Tinea Corporis Score from Baseline up to Two Follow-Up Visits
Authors: Andrea Rosario , Samiksha Shankar Shetty , Ashwini Padubidri Kombettu , Chethana Santhebachalli Gurumurthy , Kanthraj Garehatty Rudrappa
Published: May 2023

Background:

Conventionally, dermatophytoses demand at least 6 weeks of treatment. However, frequent follow-up can be a burden for elderly, working population, and COVID-19 pandemic. Teledermatology consultation may reduce follow-up visits.

Objective:

To propose a new score that provides a periodic clinical audit and minimizes in-person follow-up visits for patient convenience.

Materials and Methods:

A comparative study between teledermatology and in-person (face-to-face) consultation was conducted in the outpatient department of dermatology JSS Hospital, Mysuru, India from December 2018 to July 2019. The tinea corporis (TC) score constitutes three components: (a) area involvement, (b) erythema intensity, and (c) border visibility. Area involvement by teledermatology consultation was calculated by point counting method of Bahmer. TC score is calculated as the product of area involved and the sum of the erythema intensity and border visibility. These patients were followed up on a weekly basis for a month and values of the proposed score derived from the two methods of consultation were compared. Statistical data collected were tabulated and assessed by the SPSS software version 20 (IBM Corporation, Chicago, USA).

Results:

There were 150 TC cases. Analysis of 77 patients who completed the first follow-up visit by in-person and teledermatology consultation showed that the tinea corporis score (TCS) decreased from 171.25, 157.94 from baseline to 97.4, 98.61, respectively (P = 0.001). Analysis of 30 patients who completed the second follow-up visits showed a reduction in TCS from 138.2, 152.7 to 68.2, 71.7, respectively (P = 0.001). The Pearson score obtained by the two methods in each visit (0.990, 0.969, and 0.971) resulted in a positive correlation.

Conclusion:

TC score may be recommended for both in-person and teledermatology consultation. The ease of calculation, objective assessment, and application of TC score in teledermatology consultation are the advantages.
Pathogenesis of Androgenetic Alopecia
Authors: Kidangazhiathmana Ajithkumar , Santhosh Parvathy
Published: May 2023

The pathogenesis of androgenetic alopecia (AGA) is a complex interplay of genetic, hormonal, and environmental factors. In scalp follicles of susceptible individuals, androgens promote miniaturization of hair and shorten hair growth in the anagen stage, ultimately leading to AGA. The major circulating androgen, testosterone, is converted to the more potent androgen dihydrotestosterone by the enzyme 5α-reductase (5αR). Androgen receptors (ARs) and 5αR are significantly more in balding scalp hair follicles than those from nonbalding follicles. Genetic predisposition plays a crucial role in AGA. Various genetic loci including AR gene and the ectodysplasin A2 receptor (EDA2R) (AR/EDA2R locus in Xq11-q12) have been strongly implicated. The basic pathology of AGA is progressive miniaturization of the terminal hair follicles and eventual conversion of terminal hair to vellus hair. The duration of the anagen phase diminishes progressively with each cycle, while the length of telogen phase remains constant or may be prolonged. This eventually results in a reduction of the anagen to telogen ratio. With each successive shortening of hair cycle, the length of each hair shaft is reduced, and it becomes too short for the growing hair to attain even the minimum length required to reach the skin surface, resulting in an empty follicular pore. Hair follicle miniaturization leads to conversion of terminal hairs into secondary vellus hairs. Although many mechanisms have been proposed, the actual mechanism of hair miniaturization has not yet been fully elucidated. This article attempts to collate the existing information regarding the pathogenesis of AGA.
Pharmacovigilance of Severe Cutaneous Adverse Drug Reactions
Authors: Saini Kriteeka , Sutaria Amita , Shah Bela
Published: May 2023

Background:

Severe cutaneous adverse drug reactions (SCARs) are idiosyncratic reactions comprising 2% of all drug-induced skin reactions. These include Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, and acute generalized exanthematous pustulosis. These dermatologic emergencies lead to increased morbidity, mortality, and economic burden and may be a cause of litigation.

Objectives:

The aim was to study the clinicoepidemiological profile of SCARs and establish causal association.

Materials and Methods:

Patients presenting with SCARs over a period of 2 years were included in this observational, cohort, hospital-based study conducted in a tertiary care center in western India. The patterns of drug reactions were analyzed, and the drug causality was established.

Results:

A total of 62 patients were included in this study. SJS was the most common pattern of drug reaction observed. Aromatic anticonvulsants (phenytoin and carbamazepine), antimicrobials (co-trimoxazole and amoxicillin), and nonsteroidal anti-inflammatory drugs were the most common drugs implicated. Drug reactions in people living with HIV/AIDS on antiretroviral therapy were noteworthy.

Conclusion:

SCARs represent the most challenging dermatoses in terms of survival, sequelae, and quality of life. Prompt withdrawal of the offending drug and strict pharmacovigilance can improve the prognosis of SCARs. There is a need for exploration of newer genetic associations which may be the only tool to predict these severe reactions.
“Clarity with Granularity:” A Case Report of Malignant Granular Cell Tumor
Authors: Somashekhar Sachin , Kanathur Shilpa , Ramesh Heera , Shishira L
Published: May 2023

Granular cell tumor (GCT) is an uncommon mostly benign neoplasm named after Abrikossoff. This mesenchymal neoplasm supposedly arises from the Schwann cells. Most commonly presents as asymptomatic swelling in the gastrointestinal tract and skin. Histologically in the dermis polyhedral cells with round vesicular nucleus with eosinophilic cytoplasm is seen. Here, we present a case of a malignant GCT in a 45-year-old male over the upper back which on biopsy revealed neuron-specific enolase-positive tumor cells and the patient was treated with S-plasty with wide excision, there was no recurrence till 1 year.
Ulcerations in Chronic Plaque Psoriasis: A Diagnostic Clue for Acute Methotrexate Toxicity
Authors: Bhakthavatsalam Anitha , Shivanna Ragunatha
Published: May 2023

An elderly male patient, a known case of psoriasis vulgaris, presented with ulcerations in preexisting psoriatic lesions. The patient had fever with chills and severe pain and burning sensations in the lesions. There was a history of intramuscular methotrexate (Mtx) injection 15 mg followed by oral Mtx 7.5 mg once daily from next day for 5 days. Laboratory investigations revealed severe pancytopenia and abnormal renal and liver function tests. A diagnosis of acute Mtx toxicity was made and started treatment with intravenous leucovorin and subcutaneous granulocyte colony-stimulating factor (filgrastim) for 4 days. The patient responded to the treatment with improvement in skin lesions and laboratory parameters. The present case underlines the importance of patient counseling regarding the dosage schedule of the drugs and their adverse effects. The ulceration of preexisting lesions helps in early diagnosis, evaluation, and initiation of specific therapy.
Dynamic Immune Status of Pregnancy and Dermatological Diseases
Authors: Parthasarathy Navya , Janagond Ajit B , Inamadar Arun C , Lingaiah Anusha , Gangadhar Meghana , Arsiwala Nazneen Zulfikar , George Rintu Merin , Ratan Vartika
Published: May 2023

Dynamic changes of immune system in the various stages of pregnancy affect the course of various diseases afflicting the mother alongside determining how pregnancy affects these diseases. To understand this, a thorough knowledge on how the immune system differs in pregnancy is essential. The complex interplay between the maternal and fetal immune systems via placenta in order to maintain the pregnancy leads to waxing and waning of immune responses in both mother and fetus. This dynamic nature of immune responses can heavily influence the manifestations and severity of several dermatological diseases, whether infectious or noninfectious. Here, we discuss the effect of altered immunity of gestation on a few important dermatological diseases such as psoriasis, systemic lupus erythematosus, syphilis, varicella, leprosy, and TORCH infections and vice versa.
Hidradenitis Suppurativa
Authors: Preda-Naumescu Ana , Sowell Josiah , Ahmed Hana N. , Mayo Tiffany T. , Yusuf Nabiha
Published: May 2023

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that poses a significant diagnostic, as well as therapeutic, challenge for clinicians. The purpose of this review is to explore current treatment guidelines, as well as the newer, investigative immunotherapies, used in the management of HS. Through a detailed, albeit nonexhaustive, literature review, the most-recently published management guidelines and clinical trials concerning HS therapy were identified and their implication in current and future disease management was explored. An understanding of available treatment options, and what lies on the horizon, is important as researchers and clinicians work toward better understanding this unique disease.
Granuloma Faciale from Dermatoscopic Perspective
Authors: Tandel Jinal Jainendra , Nair Pragya Ashok
Published: May 2023

Granuloma faciale (GF) is a rare and benign skin disease of unknown etiology, characterized by chronic leukocytoclastic vasculitis. It is usually diagnosed on the basis of clinical features and histopathology. Dermoscopy is a noninvasive method for the diagnosis of various skin conditions in clinical practice. GF needs to be differentiated from various dermatoses involving the face particularly presenting with the papular morphology. Here, we present the case of a 61-year-old male patient with facial lesions, diagnosed with GF on a dermoscopic and histopathologic basis.
Hair Transplantation
Authors: Razmi T Muhammed , Subburaj Kiruthika
Published: May 2023

Hair transplantation is a safe and effective treatment option in patients with male and female pattern hair loss. Alopecia leads to a lack of self-confidence and social withdrawal in young patients when compared to their peers with good hair density. Patient selection, counseling, and planning the procedure have equal importance as that of the hair transplantation surgery itself. Follicular unit transplantation (FUT) and follicular unit extraction (FUE) are the two commonly used techniques of hair restoration. In FUT, a strip of tissue is excised from the occipital donor area resulting in a linear scar. Whereas in FUE, the scarring can be avoided as small individual follicular units are harvested and transplanted in the recipient area. FUE is emerging as a most opted hair restoration procedure in patients with patterned hair loss. This review elaborates on the procedure of FUE in brief and gives a detailed step-by-step guide for performing the procedure.
Dermoscopic Aid in Diagnosing Vulval Intraepithelial Neoplasia
Authors: Rao K M Sudhakar , Koti Varsha R
Published: May 2023

Vulval intraepithelial neoplasia (VIN) is a premalignant disease which has the propensity to progress to vulval squamous cell carcinoma. Usual type of VIN is commonly seen in young female patients associated with human papillomavirus (HPV) infection. In this case report, a 50-year-old postmenopausal woman presents with an asymptomatic lesion over vulva since 5 years. Dermoscopic evaluation of the lesion showed the presence of finger-like, knob–like, and mosaic patterns with glomerular and dotted vessels as vascular pattern. The histopathological examination showed the presence of cells with atypical vesicular nuclei in basal and parabasal layer of epidermis and koilocytes. The diagnosis of usual type of VIN induced by HPV was made in a postmenopausal woman, which is a rare entity.
Multiple Itchy Nodules over the Scalp – Clinicopathological Challenge
Authors: Dhanta Aditi , Taneja Gargi , Hazarika Neirita , Anthony Michael Leonald
Published: May 2023

Angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular proliferation with histologically distinct endothelial cells and a mixed inflammatory infiltrate composed of mainly lymphocytes and eosinophils unknown. It commonly affects middle-aged adults and characterized by flesh/plum-colored pruritic nodules and papules. In our case, it has to be differentiated from other appendageal tumors such as cylindroma, spiradenoma because of similar site involvement. The histopathological examination is a fundamental tool to achieve a correct diagnosis.
Dermatological Manifestations among Doctors Using Personal Protective Equipment in Coronavirus Disease 19 Pandemic
Authors: Deoghare Shreya , Pol Devayani , Kothari Rohit , Kumar Ajay , Deora Mahendra Singh
Published: May 2023

Background:

Coronavirus disease 19 (COVID-19) pandemic is a recent outbreak of a viral infection caused by severe acute respiratory syndrome coronavirus 2. Increase in the use of personal protective equipment (PPE) among doctors has resulted in increase in adverse effects such as contact dermatitis, urticaria, acne, and infections.

Objectives:

To identify the prevalence of common dermatosis developing in doctors using PPE. To compare if dermatosis is more common in doctors working in COVID-19 dedicated setup. To assess if the development of dermatosis use was related to the duration of PPE use.

Materials and Methods:

A cross-sectional type of observational study was conducted. A questionnaire was circulated on social media to the doctors. The response was collected in Microsoft Excel and analyzed.

Results:

Two hundred and sixty-nine (71.35%) doctors reported the development of dermatosis due to personal protective equipment (PPE) use. Eczema of the face (30%) and acne (26.25%) were the commonly reported dermatosis in our study. The development of dermatosis was significantly related to the duration of PPE use. Our study revealed a high prevalence of dermatosis among doctors using PPE, which was related to the duration of work.

Conclusion:

Hence, there is a need to make the doctors aware about such dermatosis, suggest prevention measures, provide them with effective dermatological treatment, and establish guidelines for prevention for occupational skin disorders at a national level.
A Clinicopathological Study of Primary Cutaneous Amyloidosis in Tertiary Care Center, Hubballi
Authors: Thejaswi Sanjay Ramachandra , Rao Shendre Mohan Eshwar , Kudligi Chandramohan , Tophakhane Raghavendra
Published: May 2023

Background:

Cutaneous amyloidosis has a varied clinical presentations. Clinically, it is difficult to distinguish different subtypes of PCA.

Objectives:

This study was been taken up to correlate clinicohistological profile of all three forms of primary cutaneous amyloidosis (PCA) and to study various factors affecting the disease.

Materials and Methods:

A total number of 85 patients of PCA attending Skin and STD in tertiary care center in Hubballi were included in the study. A detailed history was taken, complete general physical, systemic, and cutaneous examination was done, and details of skin lesions were noted. Patient was subjected to skin biopsy from the affected area. Clinicohistological findings so obtained were analyzed, and results were correlated.

Results:

Out of 85 cases, 36 (42.35%) were macular amyloidosis (MA), 43 (50.58%) lichen amyloidosis (LA), and 6 (7.05%) were biphasic amyloidosis (BA). Majority of the patients were in the age group of 21–50, with a male: female ratio of 1:1.3. History of scrubbing while taking bath was given by 90.58%. Housewives were the most frequently involved group (38.82%). In MA, most frequently involved sites were upper back (58.33%) and extensor aspect of arm (55.55%). In LA, majority had involvement of the pretibial area (86.04%). The dermal changes seen in MA and LA were almost the same, while the epidermal changes were less frequent in MA.

Conclusions:

In the present study, most of the patients of macular and LA had clinical and histopathological correlation. There is not much difference in the demographic profile and histopathological characteristics between LA and MA. The findings confirm that the two forms of primary localized cutaneous amyloidosis are closely related variants of one disease. Histological examination will help in confirming the diagnosis.
Acute Undifferentiated Fever Presenting as Multi-Organ Dysfunction
Authors: Sharma Sanjana , Gupta Monica , Lehl Sarabmeet Singh , Singla Nidhi
Published: May 2023

Introduction:

Acute undifferentiated fever (AUF) in India is highly prevalent in the monsoon and postmonsoon periods. AUF may trigger potentially fatal illnesses with acute-onset complications; therefore, this study was carried out to recognize the common forms of organ dysfunction in tropical vector-borne diseases which present as AUF.

Materials and Methods:

A 20-month prospective study was conducted to estimate the incidence of multi-organ dysfunction syndrome (MODS) among the common causes of AUF. The association of mortality with MODS patterns was also determined. All nonparametric variables were compared using Chi-square and Kruskal–Wallis. Bivariate as well as multivariate logistic regression analyses were performed to find the predictors of mortality/poor outcome.

Results:

Scrub typhus had the highest incidence of MODS and highest mortality with simultaneous hepatic and renal involvement in 35.8%, followed by hepatic involvement with acute respiratory distress syndrome (ARDS) in 33.9% and hepatic involvement with shock in 32%. Patients of MODS with acute kidney injury (AKI), shock, or sepsis had higher mortality rates.

Conclusion:

AUF presents with multiple overlapping manifestations which are difficult to discern clinically into specific etiologies, especially once MODS sets in. However, we observed statistically higher odds of the patient having scrub typhus as the cause of AUF when simultaneous hepatitis, AKI, ARDS, and shock were present.
Nanopolyphenols
Authors: Rathod Priyanka , Yadav Raman P.
Published: May 2023

Recently nanopolyphenols are gaining widespread interest in the drug discovery domain. Nanonization of polyphenols has greatly affected the therapeutic index owing to improvement in pharmacokinetic and biopharmaceutical obstacles linked with the use of natural polyphenols. They have been looking at an emerging paradigm for an array of disease symptoms. In this article, we have explored the therapeutic potential of nanopolyphenols in oxidative stress-induced diseases such as neurodegeneration, cancer, obesity, and diabetes. This article will present the current state of the art of various nanopolyphenols targeting oxidative stress-induced diseases. The advanced fabrication strategies presented for polyphenols including nanocrystal, mesoporous silica nanoparticles, nanoparticles, nanoliposome, gold nanoparticle, and nanosuspension are discussed. The information presented in light of recent in vitro, in vivo, and clinical evidence for nanoformulation and delivery of polyphenols may show a new dimension to future research in the realm of herbal therapy for oxidative stress-induced diseases. Significant information on the molecular mechanisms underlying linkages of oxidative stress with neurodegenerative diseases, cancer, obesity, and diabetes is discussed. Valuable information on dietary polyphenols in these diseases and their clinical data is presented. Based on different experimental evidence, the review findings support phenomenal therapeutic strategies for nanopolyphenolic fabrication with extended benefits and a condensed time frame. The status of clinical trials conducted on nanopolyphenols is presented. Although clinical trials conducted on nanopolyphenols for mentioned diseases are few, we have tried to present as much available clinical data in this article.
Study of prevalence and operative results of fracture shaft femur in adults
Authors: Shah Poojan V. , Tank Parag M. , Patel Nimish B. , Italiya Keval S.
Published: May 2023

Background:

Being the principal weight bearing of the lower limb, fractures related to the femur pose a threat to humans and affect the overall quality of life. Conservative management is no longer preferred, and stable internal fixation is the modality of treatment these days.

Aims and Objectives:

The aim of this article is to study the operative outcomes of fixation of fracture shaft femur in terms of union, stability, functional outcomes, and complications.

Materials and Methods:

This study is a retrospective study of 35 patients with proximal, mid-shaft, and extra-articular distal shaft femur fractures admitted to Smt. SCL Municipal Hospital for 3 years from May 2019 to May 2022.

Results:

The results showed improvement in all the functional and radiological outcomes. More than 70% of the patients achieved greater than 125° of knee flexion. The radiological union of fractures was 4.4 months in our study. According to Neer’s score, 33 patients scored excellent to satisfactory.

Conclusion:

Internal fixation of fractures in the femoral shaft is an absolute must and has gained widespread acceptance as implants and technology have improved. The rationale for internal fixation is that it restores anatomical alignment and allows early mobilization of the patient and limb.
Comparison conventional endoscopic myringoplasty with fibrin glue supplemented endoscopic myringoplasty
Authors: Devendiran Rajendiran , Mohanbabu Nagabooshanam , Ravikumar Venugopal
Published: May 2023

Introduction:

The fibrin tissue glues have been used in many surgeries to reinforce surgical sutures and tissue adhesion. Myringoplasty is the commonly done ear surgery for the perforations of the tympanic membrane, where no suturing is done between remnant membrane and graft.

Aim:

The aim of the study is to compare the results and effectiveness of this biological fibrin tissue glue in myringoplasty surgeries as a supplementary procedure to conventional endoscopic myringoplasty (CEM) surgeries.

Materials and Methods:

Seventy patients with chronic suppurative otitis media with tympanic membrane perforation without ossicular and mastoid involvement have been chosen. One group of 35 patients underwent CEM surgeries. In another group of 35 patients, biological fibrin tissue glue, TISSEEL, has been used as supplementary to the CEM surgeries, and the graft uptake rate and hearing improvement were evaluated and compared postoperatively.

Results:

The graft success rate at 3 months postoperatively was 91.42% in both the groups, that is, 32/35, and these values were not statistically significantly different (P = 1.00). There was a highly statistically significant hearing outcome before and after the surgery in both the CEM and the fibrin tissue glue supplemented endoscopic myringoplasty groups. However, there was no statistically significant change in hearing outcomes between the two groups.

Conclusion:

In our study, we have got more or less similar results compared with the results of the studies on routine CEM cases. But the high-cost nature of the commercially available fibrin tissue glue makes it difficult to recommend for use in all routine endoscopy myringoplasty cases.
Open safety pin in the pediatric airway
Authors: Swain Santosh K. , Choudhury Jasashree , Dubey Debasmita
Published: May 2023

Background:

Aspiration of an open safety pin in the airway is an extremely rare and critical condition that needs immediate and safe removal of the foreign body (FB). An open safety pin in the airway of the pediatric patient requires urgent recognition. Imaging will confirm the exact site of the open safety pin in the airway. Rigid bronchoscopy with optical forceps or grasping forceps is an ideal tool for the removal of the open safety pin from the airway.

Objective:

This study aims to evaluate the clinical details, management, and outcome of pediatric patients with an inhaled open safety pin in the laryngotracheal airway.

Materials and Methods:

This is a retrospective descriptive study done between November 2016 and December 2021. There were six children with inhaled open safety pins in the laryngotracheal airway. The diagnosis was done through proper history taking, clinical examination, and the X-ray of the neck and chest of the children. All children underwent rigid bronchoscopy with optical forceps to remove the open safety pin.

Results:

Out of the six children, four were boys and two were girls. Out of the six cases, four were in the proximal part of the airway and two were seen in the distal airway. The most common clinical presentation was coughing. In this study, open safety pins of the pediatric airway were removed successfully under general anesthesia with the help of a rigid bronchoscope.

Conclusion:

Open safety pin is rarely found in the laryngotracheal airway. Open safety pin may cause a life-threatening complication. During the removal of the open safety pin, the surgeon should maintain maximum care to not injure the surrounding structures by the sharp end of the open safety pin.
Histopathological study of salivary gland tumors
Authors: Pande Pankaj R. , Pandav Amitkumar B. , Bhosale Vijay R.
Published: May 2023

Introduction:

Salivary gland tumors (SGTs) are relatively uncommon and show a wide variety of morphological heterogeneities. The incidence of SGTs is said to be affected by geographical and racial factors. Histopathological diagnosis plays a major role in the diagnosis of these neoplasms.

Objectives:

This study investigated the incidence of SGTs and histopathological features of various SGTs, aimed at knowing the epidemiological pattern of these tumors and comparing the results of our study with other studies of SGTs in the literature.

Materials and Methods:

A retrospective study was conducted on SGTs at the Pathology Department of the Government Medical College and Hospital for a period of 5 years. Clinical and demographic data were documented and analyzed concerning histopathologic type.

Results:

A total of 86 SGTs were identified, 65.12% of which were classified as benign and 34.88% as malignant. Most tumors occurred in the parotid gland (59.14%). Pleomorphic adenoma (PA) was the most common tumor (56.98%), followed by mucoepidermoid carcinoma (MEC) (17.44%). The tumors occurred more often in men (51.16%) than in women (48.84%).

Conclusion:

SGTs exhibit broad morphological heterogeneity and these tumors are rare. The parotid gland is the most common location, and PA is the most frequent benign tumor. MEC followed by adenoid cystic carcinoma is the most common malignancy of the salivary gland.
Efficacy of B-Lynch compression suture for control of intractable hemorrhage during cesarean section
Authors: Bagade Priya Manohar
Published: May 2023

Background:

Primary postpartum hemorrhage (PPH) due to atonicity during lower segment cesarean section is commonly seen in obstetric practice. Usually, it responds to uterotonics but at times it may lead to life-threatening complications. B-Lynch brace suture is a fertility-preserving alternative surgical technique used in patients with primary atonic PPH not responding to uterotonics. This study was conducted to find out the efficacy of B-Lynch sutures in the surgical management of atonic PPH and prevention of obstetric hysterectomy in the same patients.

Materials and Methods:

The study included 34 patients with primary atonic PPH during cesarean section refractory to oxytocics and managed with B-Lynch brace sutures. It was a cross-sectional observational study conducted over 1 year at a tertiary hospital. The amount of blood loss, any additional surgical procedure required, and associated complications were studied in these patients.

Results:

Fertility could be preserved in 100% of the patients undergoing B-Lynch sutures for primary atonic PPH, following the failure of the medical line of management. No major complications including uterine wall necrosis or pyometra were observed in any of these patients.

Conclusion:

B-Lynch suture is a safe, effective, simple, life-saving, and fertility-preserving surgical technique in the treatment of primary PPH that requires lesser expertise. So it can easily be used before major interventions such as uterine devascularization or obstetric hysterectomy.
Effect of stretching exercises on menstrual pain among adolescent girls
Authors: Talekar Vaishali Chandrakant , Singh Maharaj , Kamble Kalpana , Mane Dhiraj Kumar
Published: May 2023

Background:

Pain is an unpleasant, intense feeling. During menstruation, contraction of the uterus to expel the built-up lining. Prostaglandin hormone is responsible for the muscle contraction in the uterus, which causes press against the blood vessels around it. It leads to a cut-off oxygen supply to muscle tissue, which triggers pain. One of the treatments for primary dysmenorrhoea is regular exercise and relaxation techniques. Stretching exercises help to relieve pain by reducing stress, improving flexibility, and strengthening the muscle. This study aims to find out the effect of stretching exercises on menstrual pain among adolescent girls.

Materials and Methods:

A cross-sectional evaluative study was conducted among the adolescent girls of Selected schools in Navi Mumbai, India from October 2021 to February 2022 to analyze the relationship between stretching exercises and menstrual pain among adolescent girls. A numerical pain scale and a modified women’s health questionnaire were used to collect data from 100 adolescent girls. The non-probability purposive sampling technique was used to select adolescent girls.

Statistical Analysis:

SPSS 24.0, software was used to tabulate and analyze the data.

Results:

This study result shows that a maximum of girls from age of 15–17 years (48%). A total of 82% of girls experienced menstrual pain. After doing stretching exercises, girls reduced their total pretest mean score from 2.65 to 1.99 post-test mean score. Posttest menstrual symptoms were reduced than the pretest menstrual symptoms after 8 weeks of intervention, so it was proven that stretching exercises helped in reducing menstrual pain and coping with problems.(‘p-value was <0.0001.

Conclusion:

Menstrual pain was a common problem among adolescent girls in schools of Navi Mumbai, Maharashtra, India. Dysmenorrhea adversely affects school attendance in adolescents. Regular daily exercises were can help to reduce menstrual pain among adolescent girls.
Nonlinear fractal interpolation functions on the Koch curve
Authors: Ri Song-Il , Drakopoulos Vasileios , Nam Song-Min , Kim Kyong-Mi
Published: May 2023

Nonlinear fractal interpolation functions defined on the Koch curve by replacing the usual Banach contractions used to define (linear) fractal interpolation functions with Rakotch contractions are considered. This allows to take care of the nonlinear term in the associated Read–Bajraktarević operator, respectively, the underlying iterated function system. Moreover, we present an extremely explicit example to demonstrate the effectiveness of the obtained results.
Symmetries of simple $A\mathbb{T}$-algebras
Authors: Zhang Yuanhang
Published: May 2023

Let

A

be a unital simple

A\mathbb{T}

-algebra of real rank zero. Given an order two automorphism

h: K_1(A)\to K_1(A)

, we show that there is an order two automorphism

\alpha

:

A\to A

such that

\alpha_{*0}=\mathrm {id}

,

\alpha_{*1}=h

and the action of

\mathbb{Z}_2

generated by

\alpha

has the tracial Rokhlin property. Consequently,

C^*(A,\mathbb{Z}_2,\alpha)

is a simple unital AH-algebra with no dimension growth, and with tracial rank zero. Thus our main result can be considered as the

\mathbb{Z}_2

-action analogue of the Lin-Osaka theorem. As a consequence, a positive answer to a lifting problem of Blackadar is also given for certain split case.
Fast NVH Prediction for E-Motor Noise and Validation
Authors: Packer James , Zhang Henry , Riviere Nicolas , Movahed Ehsan , Michon Melanie , Chen Keyu , Hartwig Marcus , Amoozegar Shahram
Published: May 2023

Fast NVH analysis from the start of the motor design is important to speed up product development by avoiding major NVH issues later. In this paper, different methods for electric motor noise and vibration predictions are proposed for different stages in the design process. The results are compared to previous experimental validation [1]. The first method combines electromagnetic finite element analysis to calculate the forces, with analytical models for the stator vibration and acoustic response [2]. This requires minimal structural design data, and can be carried out rapidly, allowing the exploration of many design possibilities in the early design stage, and is implemented in Ansys Motor-CAD. This is compared with the full structural finite element analysis (FEA) [1]. It is shown that the fast analytical NVH process provides a good prediction for the motor noise level early in the design process. The structural FEA approach provides additional information about the structural response at a later stage to refine the design. The use of frequency response functions (FRF) derived from the structural FEA are demonstrated, allowing the rapid calculation of noise results from the electromagnetic forces.
Active Vibration Control of Motor Driven Power Steering in Electric Vehicle
Authors: An Kanghyun , Baek Jiseon , Lee Sang Kwon , Jang Daewon , Shin Soohyun
Published: May 2023

This study presents a novel active vibration control (AVC) system on motor driven power steering (MDPS) to reduce interior noise reduction caused by operating the MDPS in an electric vehicle.

MDPS is electronic power steering (EPS). The MDPS attached to the rack gear of power steering system is called R-MDPS. Operating of the R-MDPS generates a structural vibration of R-MDPS, and the vibration is transmitted to car body through mounts of car subframe. The vibrating body of car becomes a monopole and dipole sources of vibroacoustic noise generated inside car. This vibracoustic noise is a structure borne noise and makes passenger annoyance. To reduce interior noise inside a car directly, active noise control (ANC) has been used as active method and is a useful method for active cancellation of the low frequency noises less than 400Hz. However, in this study, because the frequency range of interior noise due to operation of R-MDPS is higher than 400Hz, the AVC system is employed and is applied to active cancellation of the vibration transmitted to car body through the subframe mounts. For application of AVC to test car, the control force is required and the actuator for generation of control force should be install on the mounts. For application of AVC to test car, the control force is required and the actuator for generation of control force should be inserted in the mount between subframe and R-MDPS. It requires an extra rework of test car. In this study to study the feasibility for the application of AVC system to R-MDPS, the test jig, which composes of R-MDPS and subframe of test car, is made and is set up in the laboratory. All study on AVC is performed in the laboratory. The proposed method is successfully applied to the active cancellation of vibration at target point of subframe. The developed method is going to be applied to the AVC of real test vehicle.
Rationale and Process for Developing an SAE Damping Test Method
Authors: Saha Pranab , Anderson Codi
Published: May 2023

The paper discusses the process of developing an SAE damping measurement test method that is suitable for testing bars that are not made of steel or are difficult to measure with the traditional Oberst bar method. The method is based on measuring mechanical impedance (force over velocity) of a vibrating bar. The bar is excited at the center using a shaker and hence it is also called a CenterPoint method. The paper discusses the round robin tests that have been conducted so far and discusses the test results that will help develop the standard. The paper discusses the variability of the round robin test results within a laboratory, between laboratories, as well as the coefficient of variation for these measurements. The paper also discusses various parameters that should be carefully monitored in this study, that otherwise could affect the precision of the test procedure.
New Approach for Road Induced Noise Prediction in Battery Electric Vehicles
Authors: Shaik Mohammad Asif Basha , M Iyyappan , MR Vikram
Published: May 2023

In general, in-cabin booming noise is low frequency (20 Hz∼300 Hz) phenomenon which excites the cabin structure mainly due to excitations from the powertrain, exhaust system, road loads, etc. When a vehicle drives over road seams or a bumpy surface, low-frequency drumming noise is generated, causing driver discomfort. The generation of drumming noise is due to road irregularities, transferred and amplified through the vibration characteristics of the suspension, body frame, and body panels, as well as the acoustic characteristics of the vehicle interior. It is therefore difficult to take measures to get rid of drumming, after the basic vehicle construction has been finalized. The regular practice in vehicle development is finite element method (FEM) to obtain acoustical transfer functions of the body, and multi body simulation to get suspension load characteristics. The full vehicle simulation needs more time for analysis and extracting data. So traditional computational aided engineering (CAE) will not support development timeline. Market has become very dynamic, benchmark changes very often, so getting complete data is difficult for very accurate analysis in ‘early to market’ project timeline. Most of the automotive companies are using computational tools for predicting road noise in simulation phase. But with the help of method, we developed can predict road noise at early design stage itself. It is a novel hybrid tool which can give strong directional results in comparatively lesser time.

This user-friendly hybrid tool is developed for predicting and improving road noise at early stage with limited data, especially for new age battery electric vehicle. The inputs used during the initial stage of the program are vibration data of benchmark vehicle at body attachment points, targets, or simulation data (DPDS, NTF), etc. By the proposed methodology, overall trend of road noise can be predicted. In addition to that critical paths can be identified by using transfer path analysis. Once the project/program matures, we can use physically measured data (DPDS & NTF) of the trimmed body and perform the robust root cause analysis to identify the critical paths. Based upon the analysis, modifications to be made on actual body structure for effective drumming reduction. Hence new hybrid approach is proposed, which consists of mathematical model and design philosophy for better in cabin noise. It is worth to note that there are some limitations in the tool and results from the calculations such as granularity of benchmark test data availability, accurate trimmed body level test or simulation data.
Data-Driven Modeling of Linear and Nonlinear Dynamic Systems for Noise and Vibration Applications
Authors: Gudetti Jacinth Philemon , Mostafavi Yazdi Seyed Jamaleddin , Baqersad Javad , Peters Diane , Ghamari Mohammad
Published: May 2023

Data-driven modeling can help improve understanding of the governing equations for systems that are challenging to model. In the current work, the Sparse Identification of Nonlinear Dynamical systems (SINDy) is used to predict the dynamic behavior of dynamic problems for NVH applications. To show the merit of the approach, the paper demonstrates how the equations of motions for linear and nonlinear multi-degree of freedom systems can be obtained. First, the SINDy method is utilized to capture the dynamic behavior of linear systems. Second, the accuracy of the SINDy algorithm is investigated with nonlinear dynamic systems. SINDy can output differential equations that correspond to the data. This method can be used to find equations for dynamical systems that have not yet been discovered or to study current systems to compare with our current understanding of the dynamical system. With this amount of flexibility, SINDy can be used for NVH applications to help analyze vibration-related datasets as the study shows that SINDy results are consistent with ODE solutions. This study demonstrates how SINDy can accurately replicate mature known dynamical system models to highlight its potential to extract equations for more complex systems whose dynamic equations are challenging or impossible to obtain.
Simulation Based Ventilated Seat Performance Correlation with Respect to Airflow and Noise
Authors: Nomani Mustafa , Kandekar Ambadas , Joshi Rahul , Dimble Nilesh , Titave Uttam , Duppati Darshan Virupakshaia , Jain Ayush
Published: May 2023

Nowadays, a higher amount of time is being spent inside the vehicles on account of varied reasons like traffic, longer distances being travelled and leisure rides. As a result, better comfort and convenience features are added to make the driver and passenger feel at ease. Thermal comfort and acoustic isolation are the primary parameters looked at by both the customers and the original equipment manufacturers. Seats are one of the primary touch points inside the vehicle. Perspiration caused at the contact patch areas between the seats and passengers leads to high thermal discomfort. A ventilated seat, with or without an air-conditioning system, is one such attribute offered to improve passenger thermal comfort. Ventilation becomes even more essential for front-row seats, as these are more likely to be exposed to external solar loading through the front windshield. This luxury feature of seat ventilation is now being adopted as a standard to improve the passenger's thermal comfort experience inside the vehicle.

Standard component level evaluation of ventilated seats involve airflow and noise measurements to determine its performance. A simulation based performance prediction of these parameters would provide quick and more insightful results. Current work utilizes a transient based solver – Lattice Boltzmann Method – to correlate the performance parameters for ventilated seats. The performance parameters include seat-level airflow delivery and velocity, along with passenger ear level noise prediction. The simulation results correlates well with the test, which can be used for deployment for providing design and performance related counter-measure.