bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustainability in Building and Construction: LCA of 21 Mural Paints
Authors: Ciacci Luca , Vassura Ivano , Catalano Fabrizio , Simoncelli Alice , Moretti Fabrizio , Passarini Fabrizio
Published: May 2022

Sustainability and environmental impact assessment are essential to orient new generation of materials for building and construction. In this study, life cycle assessment was applied to a set of 21 mural paints produced by a paint factory in Italy. Data collection covered upstream processes (i.e., raw materials extraction and supply), the core process (i.e., paint manufacture and packaging) and downstream processes (i.e., transport to retailers). Material and energy inputs and outputs for the main components employed in paint manufacturing (e.g., antifoaming agents, dispersants, coalescing agents, additives, biocides and similar) were gathered from primary and secondary data sources. Life cycle impact assessment results were estimated for global warming potential (on average, 1.03 ± 0.60 kg CO2/kg paint), photochemical oxidation (0.60 ± 0.46 g C2H4/kg paint), abiotic depletion (1.94 ± 1.58 g Sb/kg paint), acidification (6.80 ± 6.64 g SO2/kg paint), and eutrophication (1.96 ± 1.47 g PO4/kg paint). Overall, upstream processes are responsible for the greatest environmental impact (on average, more than 70% for global warming potential), with titanium rutile from sulfates being the most impacting raw material. The results informed decision makers and provided a basis for achieving improvement and greener production strategies in paint manufacturing.
Tuberculous meningitis and miliary tuberculosis in Iran
Authors: Mortazavi-Moghaddam Sayyed Gholamreza , Pagheh Abdol Sattar , Ahmadpour Ehsan , Barac Alacsandra , Ebrahimzadeh Azadeh
Published: May 2022

In recent years, the number of cases of extrapulmonary tuberculosis in Iran has increased. The goal of this study was to determine the epidemiological status, clinical symptoms, diagnostic methods, and treatment strategies of extrapulmonary tuberculosis in Iran, with a focus on tuberculosis meningitis and miliary tuberculosis. Between January 1, 2000 and June 1, 2021, 1 651 cases of tuberculosis meningitis and miliary tuberculosis were discovered in Iran. The prevalence of tuberculosis meningitis was higher in Sistan and Baluchestan, South Khorasan, and Mazandaran compared with other provinces. The most prevalent symptoms of tuberculous meningitis were fever, anorexia, headache, neck stiffness, loss of consciousness, and vomiting. The most commonly used procedures for diagnosing tuberculous meningitis were polymerase chain reaction and cerebrospinal fluid culture. The most prevalent clinical symptoms of miliary tuberculosis were fever, lethargy, weariness, and anorexia. In 70% of chest radiographs, a miliary pattern was visible. Bone marrow biopsy was used to diagnose miliary tuberculosis in 80% of patients, while bronchoalveolar lavage was used in 20% of cases. The conventional 6-month treatment approach for tuberculous meningitis and miliary tuberculosis was used for all of the participants in the investigations. Given the high prevalence of extrapulmonary tuberculosis patients in Iran and the devastating consequences of the disease, the researchers recommend that further study be done to prevent extrapulmonary tuberculosis in the general population.
Outcome of patients with severe COVID-19 pneumonia treated with high-dose corticosteroid pulse therapy
Authors: Karakoc Hanife Nur , Aksoy Aysun , Aydin Merve , Ozcan Safiye Nur , Zengin Gulcin , Yasar Hacer Aksit
Published: May 2022

Objective:

To assess the effectiveness of high-dose corticosteroid pulse therapy and evaluate possible factors associated with 28-day mortality in hospitalised patients with severe COVID-19 pneumonia.

Methods:

We conducted a single-centre retrospective cohort study on hospitalised patients with clinical, epidemiological, and/or radiologically confirmed and suspected COVID-19 at Bitlis Tatvan State Hospital in Turkey between December 1, 2020 and June 1, 2021. All data of the study participants were recorded, and all patients received intravenous high-dose corticosteroid pulse therapy. The Ordinal Scale for Clinical Improvement (OSCI), Charlson Comorbidity Index and Total Severity Score were calculated. Univariate and multivariate Cox regression models were performed to evaluate the clinical and laboratory parameters that may affect the 28-day mortality.

Results:

A total of 126 patients were included in the analysis. The 28-day mortality rate of the patients was 22.2%. Laboratory and clinical improvement were observed in 77.8% (98/126) of patients after high-dose corticosteroid pulse therapy. There was a statistically significant difference between the survivors and non-survivors in terms of age, platelet count, neutrophil/lymphocyte ratio, and OSCI, Charlson Comorbidity Index, and Total Severity Score (P<0.001). Multivariate Cox regression analysis revealed that age [HR 1.047 (95% CI 1.01-1.08)], use of prophylactic anticoagulation [HR 0.838 (95% CI 0.79-0.89)], and bacterial co-infection [HR 3.966 (95% CI 1.40-11.21)] were significant determinants of mortality. Early C-reactive protein (CRP) response, decreased oxygen requirement, and improving respiratory rate/OSCI scores after administration of high-dose corticosteroid pulse therapy could contribute to clinical improvement.

Conclusions:

CRP response, needed oxygen and OSCI scores can be used as prognostic factors to select patients who will benefit from high-dose corticosteroid pulse therapy.
Impact of COVID Pandemic on Psychological Health and Academics of Undergraduate Students
Authors: Pokale Aarati B. , Godbole Aditya A. , Deshmukh Rupeshkumar
Published: May 2022

Introduction:

Novel coronavirus disease (COVID-19) first caused an outbreak in Wuhan, China in December 2019. After its spread in India, lockdown was initiated which forced students to continue their education through online learning platforms.

Aim:

The aim of the study was to assess the impact of the pandemic on psychological health and academics of undergraduate students in India.

Settings and Design:

Online survey conducted among undergraduate students.

Materials and Methods:

Cross-sectional study was conducted using three validated scales to assess fear, anxiety and depression (Numeric Rating Scale, Hamilton Anxiety Scale A, and Zung Self-Rating depression Scale).

Statistical Analysis:

Data were analyzed using the SPSS software version 25.0. The Chi-square test was used for the comparison of variables with demographic characteristics and regression analysis was done to calculate anxiety and depression scores.

Results:

Online survey was filled by 721 undergraduate students from across India. Moderate scores of fear, anxiety, and depression were reported to be 43.3%, 23.4%, and 76.4%, respectively. A total of 82.5% of respondents reported that the pandemic had affected their studies with disturbed routine, loss of concentration, and eye strain being the major causes.

Conclusions:

Mental health of students should be assessed and psychological guidance should be provided during the pandemic. Online teaching curriculum should consider all the stressors faced by students and planned accordingly.
Psychiatric Morbidities in Inpatients of COVID-19 in Dedicated COVID Hospitals
Authors: Joshi Rashmi , Chavhan Smita S. , Dhikale Prasad T. , Adsul Balkrishna , Kumbhar Maharudra , Gokhale Chinmay N. , Ingale Aniket R. , Pawar Pradnya
Published: May 2022

Objectives:

We aimed to assess (a) the prevalence of psychiatric illness in inpatients of COVID-19 and (b) different types of psychiatric morbidities.

Materials and Methods:

This hospital-based cross-sectional study was done in a dedicated COVID hospital after an Institutional Ethics Committee approval. It was a cross-sectional observational study of all patients admitted from December 2020 to May 2020 after ethical committee clearance. A total of 1535 patients were referred, and 1452 (8.2%) were diagnosed with psychiatric illnesses by using clinical interview and diagnostic questionnaire based on Diagnostic and Statistical Manual for Mental Disorders Fifth Edition criteria.

Results:

Out of the 17,676 patients admitted during this period, 1,452 (8.2%) patients were diagnosed with psychiatric illness, out of them 1,233 (6.9%) had new onset psychiatric illness. The age (mean±SD) of the patients was 59.75±16.46 years. The majority [959 (66.1%)] of the patients were males and 493 (33.9%) were females. Psychopharmacotherapy and psychological interventions were done to help patients through this crisis. Duration of stay (mean±SD) was 16.86±10.4 days and 636 (43.8%) patients had comorbidities.

Conclusion:

The prevalence of psychiatric illness was 8.2% in inpatients of COVID-19. Common psychiatric morbidities in COVID-19 inpatients are depression, anxiety disorders, adjustment disorders, and delirium.
Fine-needle diathermy for corneal vascularisation
Authors: Ravichandran Swetha , Natarajan Radhika
Published: May 2022

Background:

Corneal angiogenesis occurs as a sequel to an insult and it brings with it cells that mediate immunity as well as repair and aids in flushing toxins out. These vessels are formed in haste and leak lipid and cells, ultimately resulting in loss of transparency, lipid keratopathy and immunogenicity. So, they may need treatment prior to an optical keratoplasty.

Purpose:

To demonstrate the procedure of Fine Needle Diathermy (FND) to treat corneal neovascularization, its indications and contraindications.

Synopsis:

FND uses coagulating current from a monopolar cautery unit to occlude the afferent and efferent blood vessels. FND works best at the stage of mature vessel formation. The needle is placed across a tuft of vessels or parallel to a single large vessel, being mindful of the depth and direction. FND is avoided in necrotic tissue where the blood vessel is needed for healing process. Occlusion of the vessel in these situations may result in tissue melt.

Highlights:

Corneal neovascularization follows the stages of latent phase, active neovascularization, mature vessel formation and then regression. The treatment modality depends on the stage of angiogenesis. FND works best for neovascularization due to infectious keratitis. Keratoplasty is best performed 3 to 4 months later when regression of corneal vascularization occurs.

Video Link:

https://youtu.be/2RK6d_a2Gdc
Endoilluminator-aided cataract surgery in eyes with corneal opacity – A modified surgical approach
Authors: Parameshwarappa Deepika C , Nanda Satabdi , N Kavya , Matada Roopashri , Murthy Gowri J , R Murthy Praveen
Published: May 2022

Background:

Cataract and corneal blindness continue to be leading causes of reversible blindness in India. These can co-exist in a multitude of pathologies such as trauma, healed keratitis (old herpetic scar), chronic degenerative changes such as labrador keratopathy, bullous keratopathy, corneal dystrophies etc. Phacoemulsification in such eyes is rewarding to the patient in terms of minimal intervention, less risk of complications owing to reduced open sky time (as in case of combined keratoplasty), and better predictable visual outcomes. Approach to such eyes with poor visualisation is highly challenging.

Purpose:

We illustrate a modified surgical technique of chandelier illumination through pars plana for cataract surgery in eyes with corneal opacity of varying grades.

Synopsis:

Five patients with dense cataract and small pupils, associated with corneal opacity (leucomatous and macular grade) are described. Closed chamber phacoemulsification with intraocular lens with or without pupil expanders was performed assisted by 23 or 25 gauge pars plana chandelier illumination introduced in the vitreous cavity through a sclerotomy wound made prior to phacoemulsification in the inferotemporal quadrant.

Highlights:

Chandelier illumination aids in reducing the light scatter that occurs due to corneal opacity. Ease of visualisation of lens structures and of performing cataract surgery was noticed. One case was combined with penetrating keratoplasty with reduced open sky time. This assisted technique has advantages such as enhancing visualisation intraoperatively and allowing working in closed chamber. Its self-retaining nature aids bimanual manipulation. No complications were encountered. The video highlights the utility, advantages and practicality of chandelier retroillumination in patients with corneal opacities of varying degree undergoing phacoemulsification.

Video Link:

https://youtu.be/I3z6QG-_wD8
Complications of corneal collagen cross-linking
Authors: Agarwal Richa , Jain Parul , Arora Ritu
Published: May 2022

Corneal collagen cross-linking (CXL) is an effective treatment for arresting progression in patients with keratoconus. CXL was approved by United States Food and Drug Administration for the treatment of progressive keratoconus in 2016. It is a relatively safe procedure with a low complication rate. As this approach becomes more popular, it is paramount to be familiar with the potential complications associated with the procedure and its management. This article aims to report and review the complications of CXL for the treatment of keratoconus and post-LASIK ectasia.
Agreement between the biometric measurements used to calculate the size of the implantable collamer lenses measured with four different technologies
Authors: Calvo-Sanz Jorge A , Poyales Francisco , Zhou Ying , Arias-Puente Alfonso , Garzón Nuria
Published: May 2022

Purpose:

To evaluate the agreement between the biometric measurements used to calculate the size of the implantable collamer lenses (ICL) with different technologies: swept-source optical coherence tomography, spectral domain optical coherence tomography, and Scheimpflug tomography.

Methods:

This retrospective observational study included subjects undergoing refractive surgery with posterior chamber phakic IOL implantation to correct their myopia. The anterior chamber depth (ACD) and the horizontal white to white (WTW) or the angle to angle (ATA) distance were measured with the following four devices: the IOLMaster 700 biometer (Carl Zeiss Meditec, Jena, Germany), based on swept-source optical coherence tomography; the Cirrus and Visante optical coherence tomographs (Carl Zeiss Meditec) based on low-coherence interferometry; and the Pentacam rotating Scheimpflug camera (Oculus, Wetzlar, Germany).

Results:

In the horizontal corneal diameter measurements, there were statistically significant differences between Pentacam–IOLMaster 700 pair (P < 0.001) and Pentacam–Visante pair (P < 0.001). WTW from CIRRUS showed the lowest correlation when paired with Pentacam and IOLMaster 700 (R
2 = 0.452 and 0.385 for Visante and R
2 = 0.494 and 0.426 for Cirrus). Regarding the linear correlation of the ACD measurements, all pairs of devices were statistically significant and all of them showed a very good correlation index.

Conclusion:

There is a good agreement between the different devices under evaluation for ACD measurements. As for WTW, the values measured with the different devices showed large discrepancies with low correlation levels, especially when comparing the tomographs with the other devices under evaluation.
Redrawing vitreoretinal surgical training program in the COVID-19 era: Experiences of a tertiary care institute in North India
Authors: Singh Ramandeep , Arora Atul , Tigari Basavaraj , Singh Simar Rajan , Dogra Mohit , Katoch Deeksha , Bansal Reema , Gupta Vishali
Published: May 2022

Purpose:

The COVID-19 pandemic has brought medical and surgical training to a standstill across the medical sub-specialties. Closure of outpatient services and postponement of elective surgical procedures have dried up opportunities for training vitreoretinal trainees across the country. This “loss” has adversely impacted trainees’ morale and mental health, leading to feelings of uncertainty and anxiety. Therefore, there is an urgent need to redraw the surgical training program. We aimed to describe a systematic stepwise approach to vitreoretinal surgical training.

Methods:

We introduced a three-pronged approach to vitreoretinal surgical training comprising learn from home, wet lab and simulator training, and hands-on transfer of surgical skills in the operating room in our institute.

Results:

Encouraging results were obtained as evaluated by feedback from the trainees about the usefulness of this three-pronged approach in developing surgical skills and building their confidence.

Conclusion:

The disruption caused by the COVID-19 global pandemic should be used as an opportunity to evolve and reformulate surgical training programs to produce competent vitreoretinal surgeons of the future.
Update on diagnosis and management of refractory corneal infections
Authors: Agarwal Shweta , Khan Tanveer A , Vanathi Murugesan , Srinivasan Bhaskar , Iyer Geetha , Tandon Radhika
Published: May 2022

Infectious keratitis is a medical emergency resulting in significant visual morbidity. Indiscriminate use of antimicrobials leading to the emergence of resistant or refractory microorganisms has further worsened the prognosis. Coexisting ocular surface diseases, delay in diagnosis due to inadequate microbiological sample, a slow-growing/virulent organism, or systemic immunosuppressive state all contribute to the refractory response of the ulcer. With improved understanding of these varied ocular and systemic factors contributing to the refractory nature of the microbes, role of biofilm formation and recent research on improving the bioavailability of drugs along with the development of alternative therapies have helped provide the required multidimensional approach to effectively diagnose and manage cases of refractory corneal ulcers and prevent corneal perforations or further dissemination of disease. In this review, we explore the current literature and future directions of the diagnosis and treatment of refractory keratitis.
Toxic non-inflammatory fungal keratitis
Authors: Subudhi Praveen , Patro Sweta , Pattanayak Sabyasachi , Agarwal Prateek , Sitaram Silla , Subudhi B N R
Published: May 2022

Purpose:

To report a new entity called “toxic non-inflammatory fungal keratitis.”

Methods:

Eyes manifesting infective keratitis with a history of prior administration of topical steroids were included in the study. The details pertaining to the type of injury, duration of injury, and primary treatment for corneal trauma were meticulously documented. The corneal tissues were scraped from the patients and were analyzed for fungal filaments by using a 10% KOH mount under a compound microscope. Moreover, these scraped materials were plated on blood agar and Sabouraud dextrose agar plates.

Results:

The corneal ulcers displayed a disproportionately reduced intensity of pain and improved visual acuity. Further, 10% KOH revealed profuse fungal filaments with few inflammatory cells in all the patients. The anterior chamber cells and flare were either reduced or entirely absent. There was no evidence of lid edema and surrounding corneal edema in any of the patients. The mean healing period was 28.8 days (standard deviation (SD): 10.05). The KOH mount revealed the presence of confluent fungal hyphae with a few inflammatory cell infiltrates. The Aspergillus species and Fusarium species were found in 47% and 40% of the cases, respectively.

Conclusion:

Toxic non-inflammatory fungal keratitis following steroid therapy needs to be considered in fungal ulcers with disproportionately less pain and good visual acuity. The fungal ulcers with altered clinical signs of classical inflammation need to be assessed for topical steroid misuse.
Profile of ocular conditions from school eye screening in Southern India
Authors: Chandrasekar Ambika , Rangavittal Subhiksha , Krishnamurthy Saara , Narayanan Anuradha
Published: May 2022

Purpose:

To profile the presentation of ocular conditions among school children aged 6 to 17 years from the south Indian state of Tamil Nadu.

Methods:

The study was conducted as part of a school eye health program in Kanchipuram district, Tamil Nadu that aimed to address the refractive needs of children (6–17 years) between July 2016 and June 2019. The study followed a three-phase protocol, which included visual acuity test, modified clinical test, color vision test, binocular vision assessment, objective and subjective refraction, dispensing spectacles, posterior segment evaluation using direct ophthalmoscopy, and referral to the base hospital. The demographics, clinical details, and ocular conditions (classified under 16 categories) were analyzed. Profiling and association of ocular conditions among different locations, types of schools, class grades, and gender were presented.

Results:

Data of 2,45,565 children were analyzed from 1,047 schools, of which 4,816 (1.96%) children were identified with ocular conditions other than refractive errors. The common reasons for referral were high myopia 901 (0.37%), strabismus 819 (0.33%), and amblyopia 691 (0.28%). Retinal problems (odds ratio [OR]: 1.65, 95% confidence interval [CI]: 1.22–2.22, P = 0.001) and strabismus (OR: 1.41, 95% CI: 1.21–1.65, P < 0.001) were the conditions prevalent in the rural location. Cataract and related conditions (OR: 5.73, 95% CI: 4.10–8.01, P < 0.001) and retinal problems (OR: 4.76, 95% CI: 3.37–6.72, P < 0.001) were common in children studying in public schools. Of the 16 categories, 13 conditions were seen among primary school children. Vernal keratoconjunctivitis (OR: 3.64 95% CI: 2.12–6.23 P < 0.001) was common among males.

Conclusion:

The study profiled ocular conditions among school children. Most ocular conditions warrant prolonged care and specialty eye care services. Ensuring the availability of such services and follow-up after school eye screening would safeguard the visual development of these children.
Bilateral blindness in a young male of rhino-orbital-cerebral mucormycosis: A case report
Authors: Kaur Rajwinder , Sehgal Akriti , Khan Balbir , Budhiraja Grace , Roychoudhury Arnav Kr , Kaur Manjot
Published: May 2022

The storm of COVID-19-associated mucormycosis (CAM) has not yet settled, and it has proven itself a disfiguring and potentially life-threatening disease, complicating the course of COVID-19 infection. Mucormycosis is a rare but devastating fungal infection caused by filamentous fungi of the family Mucoraceae. We report a rare case of a 37-year-old diabetic male with bilateral rhino-orbital-cerebral mucormycosis (ROCM) where it leads to bilateral central retinal artery occlusion (CRAO) as manifestation of the disease. Bilateral CRAO secondary to ROCM is extremely rare. A strong suspicion of CAM in uncontrolled diabetics can result in early diagnosis and management.
Neuromyelitis optica spectrum disorder post-COVID-19 infection: A rare case report from Northeast India
Authors: Das Dipankar , Bhattacharjee Harsha , Rehman Obaidur , Deori Nilutparna , Magdalene Damaris , Bharali Gayatri , Mishra Sakshi , Godani Kanika
Published: May 2022

Multiple sclerosis and neuromyelitis optica spectrum disorder may be seen in the acute setting of coronavirus disease 2019 (COVID-19) infection or even post-recovery. Such patients may present with optic neuropathy along with weakness in the back and lower limbs. Ascending paralysis can present with respiratory distress in acute COVID-19 infection and may even prove to be fatal. We report a unique case of a 16-year-old female with past history of COVID-19 infection having optic neuropathy, and radioimaging showing demyelinating plaques in the central nervous system with spinal cord edema. Serology showed positivity for rheumatoid arthritis, and the patient was managed with steroids and rituximab.
Severe scrub typhus infection in infancy with multiple organ dysfunction
Authors: Ghosh Sanchari , Roychowdhoury Satyabrata , Giri Prabhas Prasun , Basu Ankika , Sarkar Mihir
Published: May 2022

Background:

Scrub typhus is relatively less common among infants but found to have a mentionable association with multiple organ dysfunction and turbulent course. The aim of this study was to delineate the clinicolaboratory profile of infantile scrub typhus, complication, course of illness, and responsiveness to therapy.

Subjects and Methods:

This retrospective observational study was undertaken in two tertiary care pediatric teaching centers in eastern India among infants with diagnosis of scrub typhus. Clinical features, especially pattern of organ dysfunction, laboratory findings with emphasis on hyperferritinemia, and treatment schedules with responsiveness to therapy, were analyzed retrospectively.

Results:

A total of 272 cases of scrub typhus had been admitted during the study period. Among them, 17 kids (6.25%) were infants. All of them presented with lethargy and poor feeding as a common complaint along with seizures and respiratory distress. Seven out of 17 (41%) were identified early. Fifteen (88%) were critically ill and required pediatric intensive care unit admission, out of which 13 (76.4%) patients were put on ventilator support. Thirteen (76.4%) of them developed hyperferritinemia with multi-organ dysfunction syndrome (MODS) and required additional immunotherapy. Sixteen of them recovered completely without any sequelae. Severe complications such as acute respiratory distress syndrome and MODS were significantly high (P = 0.001 and 0.004, respectively) and hospital stay was longer (P-0.04) in infants in comparison to older children.

Conclusion:

We conclude that infantile scrub typhus, though not very common, should be considered an important differential in infants presenting with an acute febrile illness with hyperferritinemia and MODS. Infants with scrub typhus can have a more stormy disease course compared to their older counterparts.
Overlap of severe dengue with multisystem inflammatory syndrome in children due to SARS-CoV-2 infection
Authors: Chaitanya Krishna , Avani Duggirala , Keerty Ramya , Srinidhi T
Published: May 2022

India is currently facing a double burden of severe dengue and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Co-infection/complication due to these viruses can result in severe morbidity. We present five cases of severe dengue with multisystem inflammatory syndrome in children (MIS-C) due to SARS-CoV-2 infection in children. All children presented with shock with variable degrees of plasma leakage. They were treated initially as severe dengue cases; however, due to refractory symptoms such as persistent fever and inotropic requirement, an alternate diagnosis was suspected and established. They were successfully managed according to the World Health Organization Dengue Shock Syndrome and MIS-C Guidelines with intravenous (IV) fluids, methylprednisolone, aspirin, and IV immunoglobulin. Severe dengue in endemic regions overlapping with MIS-C makes it difficult to diagnose which needs early recognition and appropriate management.
A randomized trial to compare thenar eminence dimensions-based method with body weight method to determine I-gel size in pediatric patients
Authors: Engineer Smita R. , Sivashankari B. , Sreekanth Balagopal K. T.
Published: May 2022

Background:

In pediatric daycare surgery, I gel has been used safely and effectively in anesthetized children. I-gel size is determined routinely by the manufacture's recommended weight-based method. The dimension of thenar eminence can help in determining I-gel size. The aim of this study was to compare the weight-based method and thenar eminence dimension method in the selection of I gel.

Subjects and Methods:

The prospective, randomized, single-blind study included 80 patients of the age group 6 months to 12 years, the American Society of Anesthesiologists class I, II, and III of either gender who were undergoing surgery under general anesthesia. Group 1– (n = 40) recommended weight-based method and group 2 – (n = 40) thenar eminence-based method. Parameters observed were proper placement, adequate ventilation, leak fraction (LF), and number of attempts.

Results:

Proper placement and adequate ventilation were comparable between two groups. LF is statistically higher in group 1 compared to group 2 (P = 0.003). The mean insertion time was 17 s in each group. The number of attempts, hemodynamic parameters, and ease of insertion were all comparable between two groups.

Conclusions:

Thenar eminence dimension can be the better method for the recommended weight-based method, especially in the emergency situations when the weight cannot be determined.
Effect of severe acute respiratory syndrome coronavirus 2 antibodies on outcomes of dengue infected children
Authors: Kolla Sravani , Balleda Lokeswari , Thimmapuram Chandra Sekhara Reddy
Published: May 2022

Background:

Dengue virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) share similar antigenic properties. In some studies, it has been shown that immunological memory/antibodies to dengue virus in endemic countries reduces the severity and spread of COVID-19. It is not known whether SARS-CoV-2 antibodies reduce or augment the severity of dengue viral infections. This study aims to evaluate the effects of SARS-CoV-2 antibodies on the outcomes of dengue infection in children.

Subjects and Methods:

This was a retrospective observational study conducted at the pediatric emergency and intensive care units and wards of a tertiary care teaching hospital in Andhra Pradesh, India, between August and November 2021.

Results:

About 400 children with dengue infection were admitted to our hospital, of which 96 children also had SARS-CoV-2 antibody titers estimated. In 50 (52.08%) of these 96 children, SARS-CoV-2 antibodies (IgG and/or IgM) were positive. In these 96 children, clinical severity and outcomes of dengue infection were compared between the two groups, i.e., with and without SARS-CoV-2 antibody positivity.

Conclusions:

The present study provides preliminary evidence that outcome and severity of dengue infection in children are not affected by the SARS-CoV-2 antibody positivity.
Surgical Management of Retrosternal (Intrathoracic) Goitre
Authors: Vijayan K. N. , Safwan Mohamad , Akash S.
Published: May 2022

The neck is 'a space with no bottom' as described by Lahey and Swinton. Large multinodular goitre in the neck enlarges and descends to the chest for variable extent. Such goitre is called plunging or secondary retrosternal goitre. Rarely, these can be primary intrathoracic goitre from ectopic thyroid tissue. Large retrosternal goitre produces pressure symptoms and may become toxic or malignant. Thyroidectomy is the treatment of choice for retro-sternal goitre which carries great challenge for the surgeons. Here, our objectives to present (1) characteristic features of primary and secondary intrathoracic goitre. (2) Basic evaluation and concise pre-operative assessment for thyroidectomy and (3) surgical steps of the procedure emphasising on safety for a large intrathoracic goitre. Most of the cases of retrosternal goitre can be removed safely via a cervical approach.
Filarial Dance in Epididymis
Authors: Kumar Rohan , Pillai Biju S.
Published: May 2022

Lymphatic filariasis is caused by the worms Wuchereria bancrofti, Brugia malayi, and Brugia timori. The most common clinical presentation is hydrocele, with lymphedema and elephantiasis occurring less commonly. Among various imaging modalities, sonography is most commonly used for diagnosis and assessing treatment response. We report a case of a boy with painless swelling and low-grade fever in whom real-time ultrasonography depicted the presence of filarial dance sign in right epididymis.
Predictive Factors Associated with Negative Appendectomy among Clinically Diagnosed Acute Appendicitis
Authors: Pattillath Raheef Pazhaya , Kumar Rajan
Published: May 2022

Introduction:

The diagnosis of acute appendicitis is predominantly based on the typical history and examination findings. However, with clinical evaluation alone, the chances of negative appendectomy (NA) are more common. This article was to study the predictive factors associated with NA among clinically diagnosed acute appendicitis.

Materials and Methods:

This is an observational study of 327 patients who underwent appendectomy with clinically diagnosed acute appendicitis at a tertiary care teaching hospital. Clinical presentation, laboratory, radiological findings and final histology were documented for the outcome analysis.

Results:

Acute appendicitis was more common in the reproductive ages. Alvarado score <4 tended towards NA, while a score more than 7 favoured appendicitis in the final histopathology. Anorexia and nausea also had a significant association with a positive diagnosis, and hence, did an elevated total leucocyte count and ultrasonographic diagnosis. Serum C-reactive protein, however, did not concur with the final diagnosis. Out of 327 patients, 297 diagnoses were confirmed histologically.

Conclusion:

NA rate was 9.17% in this study. Anorexia, nausea, elevated total leucocyte count and US diagnosis correlated well with a positive final diagnosis. Proper clinical and laboratory evaluation, combined with quality ultrasound imaging may reduce the incidence of NA. Thorough pre-operative assessment will avoid the complications of unnecessary surgery and save resources.
Total Laparoscopic Left Hemicolectomy with Preservation of Inferior Mesenteric Artery and Vein Combined with Natural Orifice Specimen Extraction
Authors: Ma Xiaolong , Guan Xu , Chen Hai Peng , Zhao Zhi Xun , Yang Ming
Published: May 2022

Introduction:

For left side colon cancer surgery, the roots of the inferior mesenteric artery and vein (IMA/IMV) are generally cut to perform the D3 lymph node dissection. In these cases, the extended resection of the colon would be required owing to the poor blood supply of the colon. In order to reduce the risk of distal bowel ischaemia and anastomosis leakage and preserve more normal sigmoid colon function, we aimed to introduce an innovative method to preserve the IMA/IMV and present its efficacy and safety.

Materials and Methods:

From January to February in 2019, two advanced colonic splenic flexure cancer (CSFC) patients received total laparoscopic left hemicolectomy with preservation of IMA/IMV combined with natural orifice specimen extraction surgery. The surgery followed the D3 lymph node dissection principle.

Results:

Two patients underwent a total laparoscopic surgery and no cases were converted to open or laparoscopic-assisted surgery. The mean time of operation was 148 min and mean blood loss was 50 ml. The harvested lymph nodes were 17 and 39 respective and the length of normal bowel both proximal and distal to the tumor more than 10 cm. The mean time of post-operative hospitalisation was 6 days. There were no cases of intra-or post-operative morbidity, or of bleeding owing to vessel injury.

Conclusion:

It is an efficient and safe technique to treat CSFC in a setting of surgeons experienced in laparoscopic colorectal surgery.
Incidence of Acute Kidney Injury in Patients Undergoing Off-Pump and On-Pump Coronary Artery Bypass Grafting
Authors: Prasad Yadav S. Krishna , Pradeep K. K.
Published: May 2022

Introduction:

The present study was undertaken to assess the incidence of acute kidney injury (AKI) after coronary artery bypass grafting (CABG) and to compare the incidence of AKI in off-pump and on-pump CABG and to compare the pre-operative and post-operative glomerular filtration rate.

Materials and Methods:

A cross-sectional hospital-based comparative study was done on 98 patients who underwent CABG from August 2017 to August 2018. Non-randomised sampling technique was used and independent sample t-test and Chi-square analysis were done for testing independence of attributes. Significance level was taken to be P < 0.05, and the tests are two-tailed.

Results:

88.6% of the patients who underwent CABG had preserved renal function (PRF), irrespective of the type of CABG. 8.6% of the patients AKI I, 2.2% had AKI II and none had AKI III or AKI IV. Overall, the incidence of AKI in off-pump was lower than the incidence in on-pump.

Conclusions:

AKI is more in patients who underwent CABG using on-pump technique. Ninety per cent of the patients PRF postoperatively. The severity of AKI depends on the baseline renal function.
Documentation in Surgical Practice
Authors: Jain Sanjay Kumar
Published: May 2022

Documentation and record keeping are the important aspects of health-care practice, and peri-operative practice is no exception to this rule. Recording every activity or intervention that a patient receives is a legal. The clarity of information is essential. Hence, the surgeon has to record appropriate information in the appropriate and meaningful language in a timely manner maintaining confidentiality. Thus, record keeping is a 'part of the professional duty'. In this article, the essential parts of surgical case recording are highlighted.
Comparative Study of Raja Isteri Pengiran Anak Saleha Appendicitis Scoring System and Alvarado Scoring System for Clinical Diagnosis of Acute Appendicitis
Authors: Lal Nishant , Pillai Aiswarya R , Khan Shafy Ali , Varghese Liju
Published: May 2022

Introduction:

Acute appendicitis is essentially a clinical diagnosis, and there are many places in India where confirmation based on radiological imaging is not available immediately. In such scenarios, clinical scoring system comes handy.

Materials and Methods:

This paper is based on a study to compare the sensitivity and specificity of Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) Scoring System and Alvarado Scoring System in the clinical diagnosis of acute appendicitis. There is very little literature about RIPASA Scoring System.

Results:

The Alvarado Scoring System showed that 6%–12.5% of patients had total score of 5–6 (possible), 31%–64.6% had total score of 7–8 (probable) and 11%–22.9% had total score of 9–10 (very probable). Forty-two patients had a total score of ≥7, which is the cut-off score to be considered for confirming appendicitis. RIPASA Scoring System showed that 43%–89.6% of patients had cut-off score >7.5 (suggestive of appendicitis) and only 5%–10.4% of patients had score <7.5 (other causes).

Conclusions:

RIPASA Scoring System was more sensitive and specific than Alvarado Scoring System in the clinical diagnosis of acute appendicitis.
Incidence of Level 2B Node Involvement in Carcinoma of Oral Tongue
Authors: Balagopal P. G. , George Ciju K. , Singh Rajesh , George Nebu Abraham
Published: May 2022

Background:

Head-and-neck cancer is the most common site of malignancy among males in India, and tongue is the second most common subsite. The single most important prognostic factor in tongue cancer is node involvement. During neck dissection, the lymph nodes at different levels of the neck are removed along with nodes at level 2B. However, the surgical dissection at level 2B is associated with the traction of spinal accessory nerve, resulting in shoulder weakness and atrophy of trapezius and sternocleidomastoid muscles significantly affecting the quality of life of the patient.

Aim:

A prospective study to analyse whether you need to address level 2B in all cases of squamous cell carcinoma (SCC) of oral tongue.

Settings and Design:

A prospective study was conducted to assess level 2B node involvement in SCC of oral tongue at Regional Cancer Centre, Trivandrum.

Materials and Methods:

A total of 236 patients of oral tongue SCC were operated during the year 2015–2018. The data were collected with the help of a questionnaire. All the patients underwent upfront surgery. The patients who received radiotherapy and chemotherapy before surgery were not included in the study. The patients who underwent previous surgery in the neck and oral cavity were also excluded. Only patients with cancerous lesions in the anterior tongue were included in the study.

Results:

Seven patients had level 2B node involvement on histopathology (2.97%). None of the patients in Stage 1 or 2 had level 2B involvement, while all level 2B involved cases were from Stages 3 and 4 with node involvement.

Conclusion:

Routine clearance of level 2B can be avoided in Stages 1 and 2 of oral tongue cancers.
Abdominal Cocoon
Authors: Prasad G. Raghavendra , Subbarao J. V. , Naureen Mahera , Danda Gayatri Reddy
Published: May 2022

Introduction:

There are varied causes for abdominal cocoon. This study aims to present the varied causes of abdominal cocoon and definite pre operative indicator if any.

Materials and Methods:

A retrospective analysis of 38 cases of abdominal cocoon formed the cohort. An attempt was made to compare with the published cases of abdominal cocoon.

Results:

Giant cystic meconium peritonitis and para duodenal hernias were the most common non tubercular acute abdomen in children. Tubercular cocoon, cerebrospinal fluid CSF pseudocyst, ruptured ovarian cyst and idiopathic nonspecific sclerosing peritonitis were other causes. Imaging analysis showed clustering of bowel loops and well defined sac were the most reliable predictors. A comprehensive review of 38 cases of abdominal cocoon showed clustering of the bowel loops as the most reliable preoperative indicator of abdominal cocoon.

Conclusions:

Though there are varied causes for abdominal cocoon, clustering of bowel loops and well defined sac were the most reliable predictors.
Adaptive Mangrove Ecosystem Rehabilitation Plan based on Coastal Typology and Ecological Dynamics Approach
Authors: Rahadian Aswin , Kusmana Cecep , Setiawan Yudi , Prasetyo Lilik Budi
Published: May 2022

Mangrove rehabilitation has implications for important ecological, social and economic values for coastal communities. The mangroves ecosystem Karawang Regency is still under pressure due to the management and utilization that does not pay attention to the sustainability aspect. The rehabilitation plan to mangrove management must be adapted to the nature and characteristics of the habitat. This study aims to formulate technical considerations for the direction of a rehabilitation plan based on an ecological approach and the dynamics of the mangrove ecosystem. The methods used in this study were geospatial approach that integrated with field quanitative and qualitative data. The results show that the total of mangrove potential area in Karawang Regency was 19,139.53 ha, consisting of 421.95 ha (2.2%) of vegetated area and 18,717.58 ha (97.8%) of unvegetated area. We integrate mangrove typology, mangrove stand density, physical parameters, and land use as the basis for determining the direction of rehabilitation planning. In the estuarine deltaic mangrove typology, we aim at protecting with natural regeneration. In infringe areas, we recommend constructing natural coastal structures before planting. On the backward for intensive planting. Furthermore, mangroves with low density, medium density, and high density are recommended for planting, species enrichment, and protecting respectively, and on the pond with implementing the mixed mangrove-aquaculture system to bridge between rehabilitation effort and economic needs of coastal communities.
Nicotiana tabacum var. Virginia Bio Oil-based Pyrolisis Extraction Have Prominence Antimicrobial Potential Compared to Ethanol Heat Reflux Extraction (EHRE)
Authors: Pramono Andri Pramesyanti , Amru Basra Ahmad , Rahmani Halimah Anggi , Fernanda Sheila Azelya , Nugraha Yudhi , Ramadhan Muhammad Yusuf Arya , Harahap Andre Fahriz Perdana , Fauzantoro Ahmad , Irsyad Nasihin Saud , Bahar Meiskha , Puspita Oktania Sandra , Zulfa Fajriati , Yati Kori , Jufri Mahdi , Gozan Misri
Published: May 2022

Tobacco leaf contains antibacterial secondary metabolite compounds, such as phenol, alkaloids, and essential oils. This study compares the potential antibacterial effects of Indonesian tobacco leaf extracted using the heat reflux method (producing an extract) and pyrolysis method (providing a bio-oil). The tobacco leaf extract was challenged against Staphylococcus aureus ATCC 25923, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853. The bio-oil from the pyrolysis method showed inhibitory Kirby Bauer zones higher than those of the extract from heat reflux method, with the maximum results in the pyrolysis method indicating zones of 6.35 mm (S. aureus), 5.90 mm (E. faecalis), 3.97 mm (E. coli), and 5.025 mm (P. aeruginosa). Further study analyzed the effectiveness of the disc and well diffusion antibacterial test methods for measuring the antibacterial effect of bio-oils against Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853. The bio-oil used in the well diffusion test method showed the most significant antibacterial effectiveness. It showed the biggest inhibition zone, with a maximum of 11.65 mm and 8.90 mm for E. coli and P. aeruginosa. Our results showed Nicotiana tabacum var. Virginia Bio Oil from Ponorogo (Indonesia) is a strong potential antimicrobial, especially using well diffusion test.
The use of implicit single-step linear block method on third order ordinary differential equations by interpolation and collocation procedure
Authors: Althemai J.M. , Sabo J. , Mutah Yaska
Published: May 2022

This research showed the use of implicit single-step linear block method on third order ordinary differential equations by interpolation and collocation procedure. The block method is found using power series as a basic function through interpolation and collocation. The properties of the block method were considered. The outcome achieves on the application of new block method on selected tested modeled third order linear problems was found to give better approximation than the current methods in literature.
Isolation and identification of aflatoxin producing fungi from different foodstuffs at Shuwarin Market, Jigawa State, Nigeria
Authors: Kutama A.S. , Adamu Muhammad , Sani Mahadi Danjuma , Mai – Abba A.
Published: May 2022

Aflatoxin is a word derived from Aspergillus spp toxin which is naturally occurring mycotoxins that is produced by Aspergillus flavus and Aspergillus parasiticus species of fungi. The aim of this study was to isolate and identify aflatoxin producing fungi from four different grains (maize, rice, cowpea, and groundnut). During the research, four (4) different grain samples were obtained from Shuwarin market (Kiyawa L.G.A), Jigawa state. The samples were analyzed for microbial examination through serial dilution, inoculation, incubation, subculture and microscopy. Six (6), fungal species were isolated which included Aspergillus flavus, Rhizopus sp, Penicillium sp, Fusarium sp, Cladosporium sp and Aspergillus niger, where A. niger has the highest number of isolates (16; 40%), Rhizopus sp with 12 (30%) isolates, and A. flavus having 8 isolates (20%), Penicillium sp, 2 (5%), Cladosporium sp has and Fusarium sp has 1(2.5%) having 1 (2.5%), each, having the lowest number of isolate. Furthermore, the samples were also used to detect the presence of aflatoxin using thin layer chromatography technique (TLC). The contamination levels found ranged from the relative factor value (Rf) for maize, the Rf 0.94 registering the highest level of aflatoxin content and groundnut with Rf value of 0.08 registering the lowest level of aflatoxin content. This is due to improper harvesting, handling, processing, storage, and poor hygiene of the farmers and vendors. Therefore, the farmers and vendors have to be trained and enlightened on the method of harvesting, storage, handling, processing, transportation and selling of cereals and legumes so as to reduce the risk of causing health problems to the consumers.