bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 158: Comparison of different screening tools for predicting osteoporosis in community dwelling post-menopausal women
Authors: Singhal Vaibhav , Kakaji Manisha , Awasthi Ashish , Gupta Sushil Kumar
Published: August 2024

Background: Dual-energy X-ray absorptiometry (DEXA) is gold standard in diagnosing osteoporosis. However, screening all postmenopausal women (PMW) for osteoporosis is not feasible in clinical practice. Questionaire based screening tools have still not been validated in Indian settings.

Aims and Objectives: This cross-sectional study aimed to assess the performance of various osteoporosis-screening tools (OSTA, ORAI, SCORE, ABONE, BW, OSIRIS) in prediction of osteoporosis in PMW.

Results: We enrolled 190 healthy middle-class community dwelling postmenopausal women (mean age 61.09 ± 6.5 years, range 50-86 years). The mean age of menopause was at 46.21 ± 4.9 years. Mean BMI was 27.92 ± 4.72 kg/m2. Self reported fracture was present in 26.8% patients. BMD parameters showed osteoporosis in 63 (38.7%); osteopenia in 54 (33.1%) and normal in 46 patients (28.2%). Vitamin D deficiency (serum 25OHD <20 ng/ml) was present in majority (48.7%) of subjects. Clinically applicable screening tool for osteoporosis status were ABONE (AUC: 0.628) followed by the ORAI (AUC: 0.608, specificity 41%, Sensitivity- 97%).

Conclusions: ABONE and ORAI clinical risk instruments demonstrate high sensitivity for predicting osteopororosis in PMW. These can help us identify individuals at high risk for osteoporosis and prioritize them for DEXA scanning.
Abstract 6: Maternal efficacy, safety, and pregnancy outcomes with degludec versus detemir in the treatment of pregnant women with type 1 diabetes: An international, multicentre, randomised trial
Authors: Balaji Kamaleswari , Mathiesen1,2 E R , Corcoy3 R , Dunne4 F , Ekelund5 M , Feig6 D S , Hod7 M , Jia5 T , Kalyanam8 B , Kar8 S , Kautzky-Willer9 A , Damm1,2 P ,   behalf of the EXPECT study group
Published: August 2024

JOURNAL/ijeam/04.03/02223308-202203001-00018/inline-graphic1/v/2022-10-03T190107Z/r/image-tiff

Background and Aims: To compare the efficacy and safety of insulin degludec (degludec) versus insulin detemir (detemir) in pregnant women with type 1 diabetes (T1D).

Materials and Methods: EXPECT was an open-label, randomised trial of women aged ≥18 years with T1D and previously treated with insulin, who were at 8-13 weeks’ gestation or planned to become pregnant within 52 weeks. Women were randomised to degludec once daily or detemir 1- 2 times daily, both with insulin aspart 2-4 times daily. The primary analysis aimed to demonstrate the non-inferiority (margin of 0.4%) of degludec to detemir with respect to the last planned glycated haemoglobin (HbA1c) measurement prior to delivery (>16 weeks’ gestation) using ANCOVA. Secondary endpoints were maternal efficacy, safety, and pregnancy outcomes.

Results: In total, 225 women (degludec: 111; detemir: 114) were randomised including 144 who were, and 81 who planned to become pregnant. Mean (±SD) HbA1c at treatment baseline was 6.8% (±0.7%) and 6.7% (±0.8%) with degludec and detemir, respectively. Over the trial, 188 women (degludec: 92; detemir: 96) with singleton pregnancies were included and there were 171 live-born infants (degludec: 86; detemir: 85), with no perinatal deaths (between ≥20 week's gestation and and <1 week after delivery). Estimated mean HbA1c prior to delivery was 6.23% with degludec and 6.34% with detemir (estimated treatment difference: −0.11% [−0.31; 0.08]95% CI, confirming non-inferiority). See Table for supportive maternal safety and pregnancy outcomes.

Conclusion: In pregnant women with T1D, degludec was non-inferior to detemir with respect to HbA1c prior to delivery. Hypoglycaemia rates and pregnancy outcomes were comparable between insulins.
Abstract 11: Should all subjects with Type 2 diabetes mellitus receive magnesium supplementation
Authors: Talwar Vipan , Talwar Gourav
Published: August 2024

Background: Deficiency of Mg may increase the incidence of diabetes mellitus and occurrence of diabetic complications.

Aim: To evaluate an association between serum magnesium level, glycaemic status and diabetic complications in T2DM subjects in Punjab.

Methods: Participants were 650 T2DM subjects who underwent clinical evaluation, relevant investigations including serum Mg levels. Hypomagnesemia was a Mg level below 1.8 mg/dL.

Results: Mean age of the participants was 51.2 years, mean duration of diabetes 9.5 years and 53.6% were males. The mean HbA1c was 9.13 ±2.4%. 51.3% of the participants had hypomagnesemia. Hypomagnesemia was significantly associated with retinopathy, microalbuminuria, neuropathy and HbA1c but not with hypertension, BMI, CAD, Age, Sex and duration of diabetes.

Conclusions: Our findings suggest that Mg deficiency is common in subjects with T2DM in Punjab. Intracellular Mg regulates glucokinase, KATP channels and L-type Ca channels in pancreatic b-cells. Insulin receptor autophosphorylation is also dependent on intracellular Mg concentration. Hypomagnesemia in T2DM leads to reduced pancreatic b-cell activity and increases insulin resistance thereby resulting in poor glycaemic control and increased risk of complications. Dietary Mg supplementation for all patients with T2DM can be a simple and cost effective strategy to improve glucose metabolism and insulin sensitivity and prevent long term complications.
Role of dithiothreitol in the resolution of pretransfusion immunohematology testing in patients receiving the anti-CD38 monoclonal antibody daratumumab for the treatment of multiple myeloma
Authors: Yadav Anshika , Agarwal Pankaj , Gupta Gajendra Nath
Published: August 2024

INTRODUCTION:

Daratumumab (Darzalex; Janssen-Cilag Pty Ltd), an anti-CD38 monoclonal antibody (MoAb), has demonstrated high efficacy in treating relapsed and refractory multiple myeloma (MM). It stands as the pioneering anti-CD38 MoAb approved by the US FDA (2015) and TGA Australia (2017). While targeting CD38 on myeloma cells, daratumumab poses a challenge in pretransfusion testing by inducing panreactivity in indirect antiglobulin tests (IATs) due to CD38 expression on red cells. This study investigates the role of dithiothreitol (DTT) in resolving pretransfusion immunohematology testing in patients treated with daratumumab for MM.

MATERIALS AND METHODS:

Pretransfusion samples from three hematological patients diagnosed with MM and receiving anti-CD38 drugs necessitating red cell transfusion were subjected to immunohematology serological testing. Clinicians provided patient information, including gender, age, transfusion history, and time between anti-CD38 MoAb infusion and sample collection. Tests included ABO/RhD typing, IAT, both polyspecific and monospecific direct antiglobulin test (DAT), antibody (Ab) screening, Ab identification, eluate preparation, and red cell crossmatch. Control tests were conducted by incubating patient samples at 37°C for 1 h.

RESULTS:

ABO/RhD typing remained unaffected, yet all samples exhibited panreactivity in IATs. Two samples showed positive DAT results but negative eluates. Treatment of reagent red blood cells (RBCs) with 0.2 M DTT effectively mitigated interference by anti-CD38 monoclonal antibodies, resulting in compatible red cell crossmatches. Notably, incubation of patient samples at 37°C for 1 h yielded identical results.

CONCLUSION:

Pretreatment of erythrocytes with DTT deactivated the CD38 antigen, eliminating reactivity with patient serum treated with daratumumab. DTT treatment of reagent RBCs emerges as an efficient and accessible strategy to counteract interference from anti-CD38 drugs in pretransfusion tests.
Role of therapeutic plasma exchange in dengue-related microangiopathy
Authors: Sahni Aarushi , Wadhera Sarthak , Lamba Divjot Singh , Hans Rekha , Jain Arihant , Malhotra Pankaj , Sharma Ratti Ram
Published: August 2024

Thrombotic microangiopathies (TMAs) are a group of disorders characterized by microangiopathic hemolytic anemia and thrombocytopenia, leading to ischemic tissue injury. We, hereby, describe an interesting case of TMA secondary to dengue along with dengue encephalitis. Dengue-related TMA is rarely described. Treatment was initiated with standard-volume (1.5 plasma volume) therapeutic plasma exchange (TPE) by centrifugation method on a multifunctional cell separator (Spectra Optia, Terumo BCT, USA) within a few hours of admission based on high PLASMIC score, which led to improvement in hemolytic parameters and kidney injury. This case highlights the role of early diagnosis and early initiation of TPE is key in the management of dengue-related TMAs.
A rare case of ABO grouping discrepancy due to probable blood group switching which presented as lost antigens detectable only with indigenous reagents in less sensitive platforms compared to highly sensitive automated platforms using non indigenous reagents
Authors: Hadhiya Thahir , Shiffi Fazal , Fathima V. J.
Published: August 2024

Blood group switching in the form of loss or diminished expression of RBC antigens has been reported in malignancies and infections. Blood group antigens are present on the red cell surface. ABO blood group system is the most clinically significant system. Some cases can present as grouping discrepancy. Here we present a rare case of ABO grouping discrepancy due to probable blood group switching which presented as lost antigens detectable only with indigenous reagents in less sensitive platforms compared to highly sensitive automated platforms using non indigenous reagents. 66 year old female whose historic blood group was A Rh D positive with history of uneventful transfusion of 2 units of A Rh D positive packed red cell one and half years back now presented with mycoplasma pneumonia and acute pulmonary edema. On routine complete blood count testing her hemoglobin was 3.6 gm%, request send to blood bank for pretransfusion testing. Testing performed via conventional tube technique and ABO blood group discrepancy was noted with forward grouping turned to be A Rh D positive (positive reaction with anti A1 lectin) and on reverse grouping 3+ reactions was observed in both A and B cell giving a picture of O blood group. Blood grouping was performed in different platforms including fully automated, semi automated and manual using commercially available antisera and human plasma as a source of anti A, anti B antibodies for forward grouping. The antisera used in automated platforms are non indigenous and that for manual are indigenous. Discrepancy was noted (Forward A and Reverse O) in CTT with commercially available antisera and human plasma as reagents for forward grouping .The same discrepancy was noted with CAT in neutral card with commercially available antisera for manual grouping. But when grouping performed with Column Agglutination Technology using matrix grouping gel card the discrepancy was resolved reporting the blood group as O. For further confirmation we repeated the blood grouping in another fully automated platform, SPRCA Technology (Immucore NEOIRIS) and in that also no discrepancy noted giving a picture of O group. This patient probably had undergone a blood group switching from A to O by losing some but not all A epitopes and started anti A antibody production. Some A epitopes which were not lost had been picked up by the commercially available antisera intended for manual grouping. These antisera are indigenous in origin. Also when human plasma was used as source of antibodies the A epitopes which were not lost were detected. But when grouping was done with non-indigenous antisera in both manual and automatic platform the A epitopes were not detected. This case points towards the relevance of incorporating indigenous antisera in automated platforms.
The role of blood donation on wheels in the blood collection chain operational logistics during the first wave of coronavirus disease 2019 pandemic
Authors: Sachdev Suchet , Prinja Nippun , Kumari Sangeeta , Singh Lakhvinder , Lamba Divjot Singh , Dhawan Hari Krishan , Sharma Ratti Ram
Published: August 2024

BACKGROUND AND OBJECTIVES:

The blood collection agencies (BCAs) employ two major logistical modes of conduct for outdoor blood collection. First, the collection agency walks to the donor’s preferred location for routine blood donation drives. Second, the drive is conducted using a heavy-duty vehicle having all the facilities for blood donation in it – Blood Donation on Wheels – hereinafter referred to as mobile blood drive (MBD). The study aimed to review the role of MBDs during the coronavirus disease 2019 (COVID-19) pandemic.

MATERIALS AND METHODS:

This was a retrospective analysis of data concerning the blood collection at the outdoor blood donation drives such as the number of drives, blood donations in voluntary (total outdoor), routine blood drive (RBD), and MBDs during the COVID-19 pandemic with respect to referent data.

RESULTS:

There was a trend in the increase in MBDs (43.3% in 2020 vs. 35.6% in 2019), with odds of 1.38 (confidence interval [CI]: 0.99–1.9), P = 0.05, during the pandemic. There was a statistically significant increase in contribution in terms of blood donations from MBDs (25.8% in 2020 vs. 19.5% in 2019), with odds of 1.43 (CI: 1.4–1.5), P < 0.05, during the pandemic. There was a statistically significant reduction in the rates of vasovagal reactions in blood donors donating blood at voluntary blood drives, RBD, and MBDs during the pandemic, in comparison with the referent data.

CONCLUSION:

The blood donation on wheels compliments the public outreach efforts of the BCAs, both in terms of the organization of the outdoor blood donation drives and the blood donations obtained thereof.
A Comparative Study between Conventional Diaphragmatic Breathing Exercise and Virtual Reality-based Diaphragmatic Breathing Exercise on Quality of Life in Chronic Obstructive Pulmonary Disease Patients: A Randomized Control Trial
Authors: Shirodkar Sridhar , Deo Medha
Published: August 2024

Background and Aim:

Breathing exercise is an exercise intended to promote effective and healthy breathing and breathing control. Virtual reality (VR) is defined as a computer-generated simulation, such as a set of images and sounds that represent a real place or situation that can be interacted within a seemingly real or physical way by a person using special electronic equipment. Breathing exercises with VR have shown benefits over conventional diaphragmatic breathing exercises in normal individuals in many new studies. We propose the use of a novel VR-based approach as a respiratory biofeedback to improve breathing patterns in chronic obstructive pulmonary disease (COPD) patients, decrease their work of breathing, and improve breathing control.

Materials and Methods:

In a randomized controlled study involving 72 COPD patients divided into two groups of 36 in each, the control and experimental groups performed a short 5 min breathing exercise for 6 consecutive days. In experimental group patients performed breathing exercise with VR goggles while in controls they performed without VR goggles.

Results:

Both the control and experimental groups showed improved changes in vitals and better quality of life, but not statistically as significant when compared to each other.

Conclusion:

Future studies need to address the long-term effects and stability of the results with a larger sample size, compare the approach with the existing treatments, and make the required smaller changes to the program for better outcomes.
Comparison of Two Automated Urine Analyzers (URiSCAN Super + YD Diagnostics and Sysmex UC-3500–UF-5000 Urine Chemistry Analyzer) with Routine Microscopy
Authors: Aden Durre , Khambra Poonam , Ranga Sunil , Alvi Yasir
Published: August 2024

Background and Aim:

Urinalysis is one of the most commonly performed screening tests in the clinical laboratory to diagnose and monitor various urological as well as systemic conditions. Newly developed automated urine analyzers are expected to routinely screen urine in less time compared to conventional routine microscopy and provide clinicians with prompt clinical information with a lower false-negative rate. The study aimed to evaluate the diagnostic performance of the two automated urine analyzers, URiSCAN Super + YD Diagnostics and Sysmex UC-3500–UF-5000 urine analyzer and compare them with microscopy.

Materials and Methods:

This was a prospective study performed on 124 randomly selected samples of patients coming to the clinical pathology laboratory at a tertiary care hospital for 3 months between March 1, 2022 and May 30, 2022. Each sample was taken for both automated analyzer testing and microscopic evaluation. The results of urine examination consisting of cells, formed elements, and microorganisms were compared between both the automated urine analyzers and microscopy, and the degree of concordance was calculated utilizing Cohen’s kappa (κ) analysis to see the concordance between all three values. The statistical analyses were performed using SPSS version 25, developed by IBM Co, and P < 0.05 was considered statistically significant.

Results:

The degree of concordance of red blood cell (RBC), white blood cell (WBC), and epithelial cells (ECs) was good between the two automated analyzers, URiSCAN Super + YD Diagnostics and Sysmex UC-3500–UF-5000 urine analyzer and microscopy with P < 0.05. The concordance between the Sysmex UC-3500–UF-5000 urine analyzer and manual microscopy was better than between manual microscopy and URiSCAN Super + YD Diagnostics. There was no concordance between any of these methods for either crystals, cast, bacteria, and fungi with P > 0.05.

Conclusion:

The results from the automated analyzers for RBCs, WBCs, and ECs were similar to the result of manual microscopy, and the analyzers can be relied on for testing and can help in reducing turnaround time of routine urine examination. However, bacteria, fungi, dysmorphic red cells, casts, and crystals need to be analyzed by microscopic examination before giving a final diagnosis.
Cross-cultural Adaptation, Translation, and Validation of Gujarati Version of Neck Disability Index in Patients with Chronic Neck Pain
Authors: Vaidya Shlesha , Vaid Shreya
Published: August 2024

Background and Aim:

Specific to the population of Gujarat state, a need arises to have neck disability index (NDI) in the regional Gujarati language. The aim of present study is to translate NDI in Gujarati language and assess its validity for use in patient care.

Materials and Methods:

A total of 100 patients suffering from chronic neck pain and aged between 18 and 65 years participated in the study. In phase I, translation and cross-cultural adaptation of the original English version of NDI was performed according to the published guidelines. In phase II, all the patients were asked to complete a questionnaire booklet consisting of Gujarati version of NDI (NDI-G), Neck Pain and Disability (NPAD), and Beck’s depression inventory scales. The psychometric testing included evaluation of factor structure by exploratory factor analysis, reliability by test–retest reliability and internal consistency, agreement by Bland–Altman plots and value of measurement error (standard error of measurement and minimal detectable change), construct validity by assessing hypotheses of NDI-G correlations with the Gujarati version of Neck Pain and Disability (NPAD-G) and Gujarati version of BDI (BDI-G). A panel of 15 expert members assessed the content validity of NDI-G on a 7-point Likert scale for content equivalence, content relevance, and content representativeness. Test–retest reliability for the NDI-G was examined in 50 patients, twice with an interval of 48 h.

Results:

In phase I, the cross-cultural adaptation process of the NDI-G was successful, and less difficulty was experienced in achieving an acceptable translation. In phase II, the NDI-G showed strong psychometric properties. The translated version of the scale showed high internal consistency (Cronbach α = 0.82) and excellent test–retest reliability (Intra-class correlation coefficient = 0.982). Face and content validity of the NDI-G was well established with no floor and ceiling effects observed. In construct validity, convergent validity was confirmed by a high correlation of NDI-G with NPAD-G (r = 0.941, P < 0.01).

Conclusion:

The NDI-G was successfully translated into Gujarati, showing good psychometric properties. Its use is recommended for clinical and research purposes.
A Rare Case of Intraconal Orbital Schwannoma
Authors: Ravindra Savithri , Hegde Raghuraj , Meghana B.
Published: August 2024

Schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannoma is relatively rare, accounting for only 1% of all orbital neoplasms. Intraconal orbital schwannoma (within the muscle cone) is rarer still. We present a case of 68-year-old male with painless, slow-growing mass with protrusion of the right eye. The mass was excised after lateral orbitotomy and tissue diagnosis was made on histopathological examination.
High Prevalence of Additional Cardiovascular Risk Factors in Eastern-Indian Young Adults with Type 2 Diabetes Mellitus
Authors: Barure Ramdas , Shanthaiah Dhananjaya Melkunte , Atluri Sridevi , Channabasappa Shivaprasad , Kolla Gautam , Reddy S. L. Sagar , Sarathi Vijaya
Published: August 2024

Background and Aims:

The American Diabetes Association recommends statin therapy for young type 2 diabetes mellitus (T2DM) adults only if one additional cardiovascular (CV) risk factor coexists. The data regarding CV risk factors in young Indian T2DM adults is limited. Hence, we assessed the prevalence of CV risk factors in young adults with T2DM from eastern India.

Methods:

In this cross-sectional study, diabetic medical health check records of eastern-Indian T2DM patients performed between March 2018 and March 2019 were retrospectively reviewed and the relevant data of T2DM patients (n = 3564) including CV risk factors [serum LDL-cholesterol of ≥100 mg/dL, hypertension (>140/90 mmHg), smoking, chronic kidney disease (eGFR of <60 ml/min), microalbumin to creatinine ratio of ≥30 mg/mg, and obesity/overweight (body mass index ≥23 kg/m2)] were analysed.

Results:

There were 3280 T2DM patients from eastern India and 679 (20.7%) were ≤40 years of age. Overweight/obesity (74.3%) and serum LDL-cholesterol of ≥100 mg/dL (69.2%) were the two most common additional CV risk factors. At least one additional CV risk factor was present in 576 (95.36%) patients, whereas at least two additional CV risk factors were present in 409 (67.7%) patients. At least one non-obesity/overweight CV risk factor was present in 472 (78.1%) patients.

Conclusions:

The study demonstrates a high prevalence of additional CV risk factors in young eastern-Indian adults with T2DM. Hence, there is a need for an intensive approach to managing the CV risk factors in young Indian adults with T2DM.
Obesity, Lipid Profile and Cytokines in Spondyloarthritis
Authors: Slouma Maroua , Lahmer Wided , Kharrat Lobna , Ali Khaoula Ben , Tezeghdenti Aymen , Metoui Leila , Dhahri Rim , Ghazouani Ezzedine , Gharsallah Imen , Louzir Bassem
Published: August 2024

Context:

Chronic rheumatic diseases seem to be associated with a higher risk of developing cardiovascular diseases. The link between cytokines and lipid profile in spondyloarthritis is not well elucidated.

Aims:

We aimed to assess the relationship between cytokines and obesity, lipid profile and atherogenic indexes in spondyloarthritis.

Methods and Material:

We conducted a cross-sectional study including 45 patients with axial radiographic spondyloarthritis. For each patient, we measured the following pro-inflammatory cytokines: interleukin (IL-) 1, IL-8, IL-6, IL-17, IL-23 and tumor necrosis factor a (TNFa), and anti-inflammatory cytokines: IL-10. We also measured total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLc) and low-density lipoprotein cholesterol (LDLc). We calculated the following ratios: TC/HDLc, TG/HDLc, LDLc/HDLc and Log[TG/HDLc].

Statistical Analysis Used:

SPSS.

Results:

The mean age was 46 ± 11.9 years. IL-8 levels were increased in obese patients (P = 0.003). IL-8 and IL-22 levels were significantly higher in patients with abdominal obesity (P = 0.024 and P = 0.042, respectively). IL-6 levels were lower in patients with hypercholesterolemia (P = 0.009). IL-1 levels correlated to TG (r = 0.413; P = 0.005). IL-1 and IL-6 were correlated to TG/HDLc (IL-1: r = 0.484, P = 0.001; IL-6; r = 0.700, P = 0.012) and Log[TG/HDLc] (IL-1: r = 0.354; P = 0.012; IL-6: r = 0.309, P = 0.041). IL-10 level was correlated to TC/HDLc (r = 0.333, P = 0.027) and LDLc/HDLc (r = 0.342, P = 0.023).

Conclusions:

IL-8 and IL-22 were higher in patients with abdominal obesity, highlighting the contribution of the adipocytes to the secretion of pro-inflammatory cytokines. The correlation between cytokines and atherogenic indexes suggests the role of these cytokines in the occurrence of cardiovascular diseases in spondyloarthritis.
Vitrectomy for cases of diabetic retinopathy
Authors: Shaikh Nawazish , Kumar Vinod , Ramachandran Aiswarya , Venkatesh Ramesh , Tekchandani Uday , Tyagi Mudit , Jayadev Chaitra , Dogra Mohit , Chawla Rohan
Published: August 2024

Microvascular complications of diabetic retinopathy (DR) may require surgical intervention in the form of vitrectomy. Since its inception, diabetic vitrectomy has evolved with introduction of better instruments, newer techniques, and smaller port sizes. Common indications for diabetic vitrectomy include nonresolving vitreous hemorrhage, tractional retinal detachment, epiretinal membrane, progression of fibrovascular membranes despite laser therapy, recalcitrant diabetic macular edema, and neovascular glaucoma. Preoperative systemic stabilization is essential prior to planning surgery. Surgical techniques commonly used in diabetic vitrectomy are segmentation, delamination, and rarely en-bloc dissection. Modification in surgical techniques such as chandelier-assisted bimanual dissection and pharmacological adjuvants improve surgical outcomes in these patients. Prognosis in these patients could be improved with early intervention. Studies evaluating the outcome of vitrectomy in patients with early proliferative DR are required to understand the appropriate time of intervention in patients. Treatment aimed at arresting the progression of DR and gene therapy are avenues that need further evaluation. The following review will focus on covering the epidemiology of DR, indications of vitrectomy, preoperative considerations, surgical procedures of diabetic vitrectomy, methods of membrane dissection, pharmacological adjuvants to vitrectomy, outcomes of diabetic vitrectomy, and future directions of diabetic vitrectomy.
Low-cost do-it-yourself (DIY) kit for glaucoma procedures
Authors: Pegu Indira , Venkatesh Rengaraj , Upadhyaya Swati
Published: August 2024

Surgical skill training in ophthalmology is pivotal for ensuring optimal and safe patient outcomes. Access to traditional training resources such as cadaveric or animal eyes, as well as modern alternatives such as silicone eyeballs and simulators, remains limited, especially in resource-constrained settings. We present a series of innovative and low-cost do-it-yourself (DIY) models for glaucoma training using readily available hospital waste materials. These models allow ophthalmic assistants, fellows, and junior consultants to practice various procedures before transitioning to live patients, thereby enhancing surgical proficiency and minimizing the financial burden on both trainees and training institutions. We were able to practice procedures such as tonometry, central corneal thickness measurement, laser suture lysis, laser iridotomy, anterior chamber decompression, bleb needling, trabeculectomy flap construction, and suturing. By providing a practical and easy training solution, these models have the potential to boost confidence among glaucoma trainees and thus address the growing demand for skilled glaucoma surgeons.
Coronary artery morphometrics in Indians – An optical coherence tomography perspective
Authors: Modi Ranjan , Modi Sunil
Published: August 2024

BACKGROUND:

The diameter of the coronary artery is an important predictor of prognosis and long-term outcome after percutaneous coronary interventions. There are very limited data available about coronary artery dimensions in an Indian population.

AIMS:

The aim is to study the normal dimensions of the coronary artery segments in Indians without coronary artery disease using optical coherence tomography and to compare the dimensions in Indians with Western.

METHODS:

Two hundred patients who have undergone coronary angiography with an entirely normal coronary angiogram were included in our study.

RESULTS:

This study showed the diameter of vessels in males and females when taken together, the left main was larger in size, followed by the proximal left anterior descending, proximal right coronary artery, and proximal left circumflex, respectively. When the vessel diameter was indexed to body surface area (BSA), there was no statistical difference between males and females (P > 0.05). The computed value of proximal coronary artery diameter unadjusted for individual BSA, when compared to Caucasians, showed that Caucasians have larger coronary artery dimensions than Indians. However, when the proximal vessel diameter was indexed to BSA, there was no statistically significant difference between Indians and Caucasians (P > 0.05).

CONCLUSIONS:

We found that coronary artery size when indexed to BSA is not statistically different in Indian males and females and compared to Caucasians. However, with a smaller body habitus, Indians have smaller coronary arteries.
Double trouble: Synchronous T-cell lymphoma and colonic adenocarcinoma
Authors: Muvva Swetha , Nagarajan Priyathersini , Arun Arthi , Shanmugam Sri Gayathri
Published: August 2024

Background:

Synchronous tumors consisting of colorectal adenocarcinoma and lymphoma are infrequent and pose a tricky situation to the clinicians for the management.

Observations:

We present a case of a 67-year-old male ex-alcoholic who presented with loss of appetite, weight loss for 3 weeks, high fever, abdominal pain for 2 days, and difficulty in passing stool for 1 month. Upon examination and further investigations, a diagnosis of stage 4 peripheral T-cell lymphoma, moderately differentiated sigmoid colon adenocarcinoma with liver metastasis, and SIADH-tumor associated was made. In light of the case’s metastatic disease, the tumor board opted to proceed with stenting for the sigmoid colon mass and chemotherapy for the peripheral T-cell lymphoma.

Conclusion:

It is certain that with the development of regular screening programs and extensive evaluation across the country, early identification and diagnosis can lead to efficient treatment plans and can improve the prognosis significantly.
Pediatric recurrent fibromatosis managed by hydroxyurea monotherapy
Authors: Tiwari Charu , Borkar Nitinkumar
Published: August 2024

Fibromatosis is a rare and locally invasive soft tissue lesion with propensity for local recurrence after surgical excision. Recently, many drugs have been explored with curative intent instead of surgical excision. We present a case of pediatric recurrent fibromatosis which was managed by hydroxyurea monotherapy.
Metabolic complications of childhood obesity
Authors: Munusamy Jeyaraj , Yadav Jaivinder , Kumar Rakesh , Bhalla Anil , Dayal Devi
Published: August 2024

Context:

Childhood obesity is a global health problem. A percentage of 2.3 of Indian boys and 2.5 of Indian girls are obese. Childhood obesity is associated with many morbidities like diabetes mellitus, coronary artery disease, musculoskeletal problems, and increased mortality.

Aims:

The aim of this study is to estimate burden of metabolic complications of obesity in child and parents of obese children and compare it with normal-weight children.

Settings and Design:

The study was done at a tertiary health center in northern India. It was a cross-sectional study.

Methods and Material:

We enrolled 60 obese children and age- and sex-matched 26 controls, based on Indian Academy of Pediatrics (IAP)2015 body mass index (BMI) charts. Anthropometric parameters and metabolic complications in family were compared between cases and controls. Clinical markers of metabolic derangements and laboratory metabolic profile were assessed for obese children.

Statistical Analysis Used:

Descriptive statistics was used to describe frequencies. Chi-square test and Mann–Whitney test and Spearman correlation were used for comparison.

Results:

The prevalence of obesity and obesity-related complications was high in families of obese children. Ten percent of obese children had impaired fasting glucose and 30% had Haemoglobin A1c (HbA1c) in prediabetes category. Forty percent of obese children had dyslipidemia, 45% had transaminitis, and 46.7 were vitamin D deficient. A percentage of 41.7 of obese children had fatty liver on ultrasound.

Conclusions:

The family health and child weight are linked through home environment and genetics. The metabolic complications of obesity prediabetes, dyslipidemia, fatty liver, and lower vitamin D level are common in childhood obesity. Regular screening and interventions of metabolic complications are essential for saving child's future health.
Cienciometric Analysis of Scientific Production on Hydatidosis/Echinococcosis in Latin America
Authors: Roman Luz Angela , Tapia-Sequeiros Gustavo , Galeas-Torre Maryorie Katteryne , Roman-Lazarte Victor
Published: August 2024

Introduction:

Hydatidosis/cystic echinococcosis (CE) is considered a neglected disease due to its preventive nature and impact on low-income populations. In Latin America, there is a high incidence, and in the high Andean regions, it is considered an endemic disease. The objective of this study was to quantify and analyze the scientific production of hydatidosis/echinococcosis through a bibliometric analysis in Latin America up to 2022.

Methods:

A bibliometric analysis study was conducted based on the scientific production of CE in the SCOPUS database until 2022 in Latin American countries. Information was collected through a systematic search. Frequencies and percentages were used to summarize the variables captured in the final database.

Results:

Scientific production showed growth over the years, with Argentina, Uruguay, and Chile having the highest production. In addition, there has been a trending use of the term “neglected disease” since 2018. The most cited articles were primarily narrative reviews, book chapters, and original articles in that order. Only 27% of the studies were funded by an institution in Latin America.

Conclusion:

Scientific production in Latin America regarding CE is on the rise, especially in countries with high incidence rates. Furthermore, these countries demonstrate a significant network of international collaboration.
Delayed Presentation of Malrotation after Infancy: A Systematic Review Based on Clinical Presentations, Associated Anomalies, Diagnosis, and Management
Authors: Sharma Charu , Borkar Nitinkumar Bhajandas , Ashwin C. , Sinha Chandrasen
Published: August 2024

ABSTRACT

Need and Purpose of Review:

Approximately 75% of patients with classic malrotation and midgut volvulus present in neonatal age-group; another 15% may present up to one year. In these, the diagnosis is made because of typical presentation. However, there are many cases in which malrotation has been detected after infancy. In-spite of the variable case reports and studies in literature, there is no specific data on the incidence of malrotation after infancy, its presentation and management guidelines. With this systematic review, we aim to coalesce these findings from various individual case reports and studies.

Methods Used for Collecting and Analysing Data:

This systematic review was performed as per the PRISMA (preferred reporting items for systematic review and meta-analyses) guidelines. The authors conducted thorough searches in databases like PubMed/MEDLINE, SCOPUS, Google Scholar and Web of Science for relevant articles. Studies were reviewed for clinical presentation and outcome for malrotation diagnosed beyond infancy.

Main Conclusions:

Clinical presentation of malrotation after infancy can be acute as well as chronic; acute presentation being common under 2 years of age and chronic symptoms present as age increases. Sudden onset of abdominal pain and bilious vomiting are commonest acute symptoms and intermittent episodes of recurring vague abdominal pain associated with vomiting and diarrhoea are the commonest chronic symptoms. The diagnostic modalities vary from UGI Contrast series to USG with colour Doppler and CECT scan. Management is operative open as well as laparoscopic Ladd’s procedure is being favoured.

Key Messages

Presentation of malrotation beyond infancy is infact more than that reported in literature. Timely and appropriate diagnosis of malrotation is essential to avoid gangrene and subsequent gut loss and morbidity.
Nongenetic Risk Factors of Severe Hypospadias: A Case–Control Study
Authors: Indriasari Vita , Diposarosa Rizki , Syukriani Yoni Fuadah , Rachmadi Dedi
Published: August 2024

ABSTRACT

Background:

Various risk factors were contributed to hypospadias and may be varied by region and hypospadias severity. The study aims to analyze the nongenetic risk factors associated with severe hypospadias in a provincial referral hospital in West Java, Indonesia.

Methods:

A case–control study was conducted in hypospadias patients and boys with normal penis treated in our institution during 6-month period. Risk factors of hypospadias were compared between severe and mild hypospadias and the control group and analyzed with Chi-square/Fisher exact test and multivariate logistic regression analysis (P < 0.05 = significant).

Results:

We studied 84 subjects consist of 46 hypospadias patients (severe: 30 and mild: 16) and 38 control groups. Maternal workplace, primipara, age >35 years old, overweight, the absence of nausea, hypertension, bleeding, alcohol, cigarette smoking, medication, and vegetarian during pregnancy, as well as prematurity, were not significantly different between groups. The use of hormonal contraception and low birth weight infants were significantly higher in severe hypospadias (P = 0.033; P = 0.023; respectively). Multivariate logistic regression analysis showed that hormonal contraception, primipara, and age >35 years old were the risk factors of severe hypospadias (P = 0.008; P = 0.003, P = 0.049, respectively).

Conclusions:

Hormonal contraception, primipara, and maternal age >35 years old are among the nongenetic risk factors of severe hypospadias in West Java.
Predictors of Feeding Tube Placement in Infants with Congenital Diaphragmatic Hernia: A Systematic Review and Meta-analysis of Cohort Studies
Authors: Evila Yodya , Ekaputra Anthony , Widjanarko Nicolas Daniel , Ang Jessica Felicia
Published: August 2024

ABSTRACT

The early stages of life pose feeding challenges for infants with Congenital Diaphragmatic Hernia (CDH), necessitating feeding tube placement to prevent growth failure. Predicting the factors prompting this intervention has yielded inconclusive findings in prior research. Thus, this review explored prenatal, perinatal, and postnatal variables associated with feeding tube placement in CDH. Retrospective cohort or case-control reporting outcomes linked to prenatal, antenatal or postnatal predictors of feeding tube placement were included, following PRISMA 2020 guidelines. Reports, case series, conference abstracts, book sections, commentary, reviews, and editorials were excluded. Database searches were conducted in August 2023 encompassed Cochrane, MEDLINE, ProQuest, Wiley, and Google Scholar. Quality assessment using the Newcastle-Ottawa Scale and Review Manager 5.4 performed meta-analysis. Within eight studies, four exhibited a low risk of bias and the other was categorized as moderate. Analysis revealed significant effects for liver herniation (OR = 3.24, 95%CI 1.64-6.39, P = 0.0007), size of herniated defects classified as C or D (OR = 7.12, 95%CI 3.46-14.65, P < 0.00001), Extracorporeal Membrane Oxygenation treatment (ECMO) (OR = 6.05, 95%CI 4.51-8.12, P < 0.00001), and patch repair (OR = 5.07, 95%CI 3.89-6.62, P < 0.00001). ECMO treatment and patch repair surgery are robust predictors of feeding tube placement in CDH infants. Although liver herniation and size of herniated defect also showed associations, further studies are needed to address heterogeneity concerns. The review was registered in PROSPERO with the number CRD42023480109. No funding was received.
Epignathus with Cervical Lymphangioma
Authors: Lal Rohit , Thakur Vinit Kumar
Published: August 2024

ABSTRACT

The occurrence of teratoma is 1 in 4,000 live births. Head-and-neck region teratoma (epignathus) is rare. These patients present with facial disfigurement, respiratory problems, and difficulty in feeding. It warrants early excision to avoid any morbidity or mortality due to airway obstruction. We describe the management of a patient with pedunculated epignathus with cervical lymphangioma.
Inflammatory Myofibroblastic Tumor Masquerading as Congenital Pelvic-ureteric Junction Obstruction
Authors: Kumar Pallav , Zameer Mohammed Moinuddin , Chandrashekar Vinay , Rao Sanjay
Published: August 2024

ABSTRACT

Inflammatory myofibroblastic tumor (IMT) is a very rare tumor with still rare occurrence in the genitourinary system, presenting as a pelvic-ureteric junction (PUJ) obstruction (PUJO). We report a case of IMT at the PUJ mimicking congenital PUJO and review the relevant literature.
Dear Laparoscopic Surgeons: Caution with the Use of Glutaraldehyde!!!
Authors: Phugat Shivani , Choudhury Prativa , Jain Vishesh , Dhua Anjan Kumar , Yadav Devendra Kumar , Bhattacharjee Hemanga Kumar , Anand Sachit , Singh Harpreet , Agarwala Sandeep , Goel Prabudh
Published: August 2024

ABSTRACT

Background:

The occupational hazards of glutaraldehyde are well known; the possibility of harm to the patients has been highlighted in the form of isolated reports only.

Objective:

To synthesize evidence for contact mucosal injury or injury due to intraperitoneal instillation of glutaraldehyde following its use during laparoendoscopy.

Materials and Methods:

The current review is Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant. PubMed, PubMed Central, and Google Scholar were interrogated for animal and human studies upon the harmful effects of glutaraldehyde during laparoscopy and proctosigmoido-colonoscopy.

Results:

Thirty-five studies substratified into animal experiments (n = 2), glutaraldehyde-induced colitis (G-iC) postendoscopy (n = 30), and laparoscopy (n = 3) were included. Rats suffered mucosal injury following colonic injection of glutaraldehyde which was time- and concentration-dependent quantum and developed bloody diarrhoea. Omental and renal injury was observed due to glutaraldehyde instillation during simulation of intra-peritoneal insufflation in rats; the serum leucocytes, CRP and creatinine were also elevated. G-iC following colonoscopy was related to contact mucosal injury due to failure (human or machinery) to rinse the chemical off the instrument surface or as a case of mistaken identity (glutaraldehyde was mistaken for saline or another reagent). The incubation period was <24 h in 90% of patients; clinical presentation was related to the initiation of intense inflammation. Intraperitoneal instillation during laparoscopy also leads to intense inflammation. One patient was asymptomatic, the second required laparotomy and peritoneal irrigation for 48 h, while the third case underwent multiple laparotomies for enteric cutaneous and enteroenteric fistulae, adhesions, and multiple intra-abdominal abscesses. Hydronephrosis consequent to retroperitoneal fibrosis has been reported.

Conclusions:

The use of glutaraldehyde in the patient care facilities should be discontinued; when unavoidable, the standard processes of disinfection and rinsing must be stringently followed.
Physicochemical and Biological Properties of Pulp Capping Agents: A Systematic Review of In Vitro Studies
Authors: Priyadharshini S. Swathi , Ragavendran Chinnasamy , Unnikrishnan Manu , Sherwood I. Anand , Amaechi Bennett T.
Published: August 2024

Aim:

The primary aim was to evaluate the physicochemical and biological characteristics of pulp capping materials.

Materials and Methods:

The systematic review report adhered to the latest Preferred Reporting Items for Systematic Reviews and Meta-Analysis statements, and the protocol was pre-registered (CRD42023471030) in the PROSPERO database before its commencement. To retrieve relevant literature, electronic searches were conducted using the Medline and Google Scholar databases from January 2000, up to August 2023. The records obtained through our electronic search were managed using a specialized web application for systematic review screening, and data were extracted using a standardized form. The evaluation of potential bias within the studies employed the modified Consolidated Standards of Reporting Trials (CONSORT) checklist specifically designed for reporting in vitro dental material research.

Results:

The results revealed that out of 255 identified records, 16 studies were included. An analysis based on the modified CONSORT checklist identified a moderate risk of bias in the included studies, with compliance scores ranging from 50% to 70%. Studies scoring below 50% were omitted from the discussion because of a higher risk of bias.

Conclusion:

This study concludes that the physicochemical properties of resin-incorporated materials are better than those of calcium silicate cement (CSCs). However, the biological properties of CSCs are superior to those of resin-incorporated materials.
Role of Robotics in Transforming Orthodontic Practice – A Narrative Review
Authors: Ahuja Dhruv , Jose Nidhin Philip , Shetty Prajwal
Published: August 2024

The dental specialty of orthodontics is moving toward a modern era of dental medicine assisted by robots. The advent of artificial intelligence in the field of technology has led to the emergence of robotics which has remarkably changed the orthodontic scenario in today’s world. The latest technology of robotics has various applications in the field of orthodontics to facilitate better treatment outcomes. From the management and diagnosis of treatment for orthodontic patients to helping orthodontists in patient care, robots have played a vital role. The blooming augmented reality with the latest concept of nanotechnology has paved the way for the production of robots and nanorobots, covering the broader areas of medical science. However, modern robot technology has not been introduced completely to orthodontic research; hence, this review highlights the application of robots and the futuristic aspects of artificial intelligence in orthodontics.