bluuebunny/crossref_metadata_2025 huggingface dataset:
Takayasu arteritis coexisting with scalp necrosis, alopecia, and sterile osteomyelitis
Authors: Arora Rajnish , Tayal Mohit , Rao Neeraj , Singh Monica , Walia Rohit
Published: May 2022

A twelve-year-old girl with classical features of Takayasu arteritis presented with scalp ulceration and osteomyelitis. Her computed tomography (CT) of the head revealed an extensive ulcerated lesion over the left high parietal region with lytic destruction of the outer and inner tables of the skull. Because of full-thickness calvarial bone involvement, chronic osteomyelitis, and ulcerated scalp lesion, she underwent debridement of involved bone along with the margin of normal skin. During surgery, underlying dura was found to be not involved, and a transposition flap was done for reconstruction. Histopathology did not reveal any evidence of bacterial infection or granulomas. Sterile osteomyelitis of the skull associated with alopecia and scalp necrosis has not been reported with typical Takayasu disease. Family physicians should be vigilant to keep this as a differential diagnosis in nonhealing osteomyelitis, not responding to antibiotics, or showing any evidence of infection.
Prevalence of metabolic syndrome in chronic obstructive pulmonary disease and its correlation with severity of disease
Authors: Sahoo Kshiroda C. , Subhankar Saswat , Mohanta Paresh C. , Jagaty Suman K. , Dutta Pravati , Pothal Sudarsan
Published: May 2022

Introduction:

The understanding of chronic obstructive pulmonary disease (COPD) has changed considerably over the past decade. The metabolic syndrome (MS) represents a cluster of risk factors that increases the risk for developing various noncommunicable diseases. In COPD, it is associated with worsening respiratory symptoms, increasing lung function impairment, pulmonary hypertension, and increasing hospitalizations

Aims:

To determine the prevalence of MS in patients with COPD and correlate it with disease severity

Methodology:

The present study was a cross-sectional observational study. Patients confirmed by spirometry to have COPD were included in the study. All demographic data and anthropometric, radiological, and laboratory parameters were recorded. The definition stated by modified NCEP ATP III criteria proposed by the AHA/NHLB (2005) was followed to identify patients with MS. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 20 for Windows

Results:

A total of 76 patients were included in the study. MS was recorded in 42.1% of COPD cases. The average number of exacerbations and hospitalizations due to COPD in MS cases (1.38 ± 1.95 and 0.97 ± 1.51) were more than the patients without MS (1.27 ± 1.30 and 0.68 ± 0.96). The majority of patients with MS exhibited grade 3 dyspnea based on modified medical research council grading (MMRC). MS was commonest in patients with GOLD stage III disease. High serum triglyceride level was observed in an increasing trend (25%, 30%, 35.5%, and 75%) in GOLD stages I, II, III, and IV, respectively

Conclusion:

Patients with MS present with more severe disease and frequent exacerbations. All COPD patients should be screened for MS at the primary level.
Anti-SARS-CoV-2 antibodies among vaccinated healthcare workers
Authors: Mishra Sanjeeb Kumar , Pradhan Subrat Kumar , Pati Sanghamitra , Panda Bimal Krushna , Bhattacharya Debdutta , Sahu Sumanta Kumar , Kshatri Jaya Singh
Published: May 2022

Background:

Since the novel SARS-CoV-2 has been detected and the ensuing pandemic, the search for a cure or prevention has been the only target of the medical fraternity. As the second wave racked havoc, vaccines seemed to be the only viable option to stop this global surge. World Health Organization (WHO) and subsequently the Government of India have issued emergency use authorization to two vaccines. Our study aims to estimate the prevalence of the anti-SARS-CoV-2 antibodies and identify predictors of antibody titers in vaccinated healthcare workers in VIMSAR, Burla.

Methods:

This is a part of the ongoing, repeated cross-sectional study. Participants were enrolled well above the sample size (322) to increase precision. Two rounds of the survey were conducted and are being reported. Serum IgG antibodies against spike protein of SARS-CoV-2 were estimated using Elecsys® anti-SARS-CoV-2S is an immunoassay by ECLIA-based Cobas e411 analyzer. Univariate and multivariate regression were used in statistical analysis.

Results:

Our results show that 95.1% and 99.5% of the vaccinated individuals have developed antispike protein antibodies after the first and second doses, respectively. Previous COVID-19 infection was significantly correlated with antibody production, and age was negatively correlated. No difference was reported for sex, occupation, and diabetes.

Conclusion:

Our interim analysis report is coherent with the available literature and research regarding the high efficacy of the COVID-19 vaccine as far as seroconversion is concerned.
Oral nifedipine and parenteral isoxsuprine in arresting preterm labor
Authors: Ray Namrata , Kshirsagar Nitin
Published: May 2022

Objective:

To compare the efficacy of oral nifedipine and parenteral isoxsuprine in arresting preterm labor. Considering the paucity of studies comparing these two agents, a comparative analysis is obligatory.

Materials and methods:

Eighty antenatal women in the gestational age range of 28–37 weeks, with regular uterine contractions, cervical dilatation ≤3 cm, and <50% cervical effacement, admitted with complaints of preterm labor pain were randomized to receive either 40 mg isoxsuprine or 20 mg nifedipine. Efficacy of the drugs was measured in terms of arrest of preterm labor, prolongation of pregnancy, and the days gained by infant before birth.

Results:

Isoxsuprine showed increased lowering of systolic blood pressure (SBP), diastolic blood pressure (DBP), and slightly higher maternal pulse rate, but higher fetal pulse rate post-administration in comparison to nifedipine (P < 0.05). Isoxsuprine was significantly associated with more side effects. Pregnancy was more prolonged in the nifedipine group (25 days) than in the isoxsuprine group (19 days) (P < 0.05). The birth weight of neonates in group B was more than that of neonates in group A (P < 0.05). At 5 min after birth, none of the neonates in group B had an Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) abnormal score <7, compared to neonates in group A. Majority of neonates in group A showed tachycardia and respiratory distress syndrome (RDS) (17.5% and 12.5%, respectively), compared to group B (12.5% and 7.5%, respectively). The overall success rate was better in group B (86.8%) compared to group A (80%).

Conclusion:

Nifedipine was slightly more effective in arresting preterm labor with fewer side effects, compared to isoxsuprine.
An epidemiological study on factors influencing gaming disorder
Authors: Wani Rabbanie Tariq , Rashid Imrose , Chowdri IqraNisar , Qazi Tanzeela Bashir
Published: May 2022

Background:

Gaming disorders have increased over time due to easy availability of online gaming. The aim of this study is to determine the factors influencing the gaming disorders

Methods:

An online questionnaire was circulated on gaming platforms for the assessment as per IGD-20 and DSM-5 criteria

Results:

A significant correlation was found between duration of play and gaming disorders (r = 0.131, P < 0.05). The scores were concurrent as per IGD-20 and DSM-5 criteria

Conclusion:

Undiagnosed gaming disorder among gamers needs to be addressed. Duration of playing of games also needs to be checked to reduce the prevalence of gaming disorders.
Psychological and stigma profiles of HIV patients in a North-Central city of Nigeria
Authors: Ahmed Abdullahi , Osinubi Medinat O. , Fasiku Mojirola M. , Uthman Muhammed M.B. , Soyannwo Tolulope , Jimoh Saheed O. , Olubodun Tope
Published: May 2022

Background:

The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of infirmity and disease. Researchers and clinicians have mainly focused on health outcomes that are physically or laboratory measured. These, however, do not reflect how the affected individual feels and functions in daily life. This study assessed the psychological and stigma profiles of patients attending HIV clinics in a North-central State of Nigeria.

Methods:

The study design was descriptive cross-sectional. A total of 384 HIV-positive patients who were systematically recruited at 5 public service delivery sites in Ilorin, Kwara State, North-central Nigeria participated in the study. Data was analyzed using SPSS software version 20.0. Level of significance was pre-determined at P value < 0.05 at a confidence level of 95%.

Results:

Fifty-nine percent of respondents reported being anxious about their condition and 25.5% felt depressed. Eighty-six percent received adherence counselling and 82.3% received psychological care from support groups. In the psychological domain, majority (74.5%) of the respondents had high health-related quality of life (HRQoL). There was a statistically significant association between employment status and psychological domain of HRQoL. As regards stigma, majority experienced high stereotype stigma (73.7%) and 67.2% experienced high stigma as pertains disclosure.

Conclusion:

Health workers should promote psychological support of HIV patients, for example, in form of support groups and adherence counseling. Efforts by government and corporate bodies should be geared towards employment empowerment of PLWHA which may help improve quality of life.
The circadian preference to operate electively among surgeons
Authors: Arab Khalid , Mortada Hatan , Alarki Subhi M. K. Zino , Alyousef Loujain A. , Alharthi Sawsan A. , Alnowaiser Maha W.
Published: May 2022

Background:

The circadian rhythm is unique to each individual. The time of the day when an individual is most productive is determined by several factors associated with circadian rhythm. Some evidence suggests that late-night surgeries are associated with a better prognosis and a lower rate of complications than those performed at other times of the day. However, the impact of surgeons’ preferred operating time on patients remains unclear

Objective:

The present study is the first to examine at what time of the day surgeons prefer to operate

Methods:

This cross-sectional, questionnaire-based study involved 15 items designed to interrogate surgeons’ preferred time of day to operate. The questionnaire was distributed electronically to the consultants of different surgical specialties after explaining the purpose of the study and obtaining their consent to participate

Results:

A total of 226 surgeons participated in this study, of which 192 (85%) were men. Most (25.2%) consultants were general surgeons. The weekly workload for most (66.4%) surgeons was 41–60 h. The surgeons indicated their preference to operate in the early (11.9%) or late morning (71.2%), early (15.0%) and late (1.3%) afternoon, and evening (0.4%). The key determinant of their preference was the availability of hospital resources (36.3%). Men and women tended to prefer operating in the early morning and afternoon and late afternoon, respectively

Conclusions:

In the present study, most surgeons preferred to operate between 8 am and 12 noon (late morning), and their preference was determined by the availability of hospital resources.
Student’s perception of utility and application of skills taught during the foundation course at a medical college in central Uttar Pradesh, India
Authors: Gangwar Vibha , Singh Manish Kumar , Lumbani Amrita
Published: May 2022

Context:

“Foundation course” is an orientation program for MBBS students at time of entry into medical college.

Aims:

To study the MBBS student’s perception of relevance and level of confidence in application of skills acquired in foundation course and its predictors.

Settings and Design:

A cross sectional study was done among second year MBBS students at a medical college in central Uttar Pradesh, India.

Methods and Material:

Data was collected online using a Google form over 1 month. About 97 (out of 200) students participated in the study. Final analysis was done for 94 responses.

Statistical Analysis Used:

Chi Square test for proportions.

Results:

Overall 83% students found foundation course to be relevant. Sessions on professional development & ethics (94.6%), biomedical waste management (94.6%), social responsibility of doctors (91.5%), communication skill (93.6%), role and responsibilities of Indian Medical Graduate (93.6%), universal precautions (91.5%), immunisation (91.5%) and assessing E –resource (90.4%) were rated as most relevant. Computer skills and sports/extra-curricular activities were perceived as non-relevant by 29% and 16% students respectively. Overall 61% students were confident about application of knowledge/skills acquired in the foundation course. A significant difference was observed for gender and medium of education with regards to level of confidence in application of certain skills/knowledge.

Conclusions:

Foundation course was perceived as relevant by most students. However, level of confidence with regards to application of skills/knowledge was found to be variable with significant difference for some variables.
HIV care policy in India
Authors: Koni Kiranmayi , Chaudhuri Sirshendu , Tarugu Jayanthi , Udayasree Kodakinti , Hema Kurugundla
Published: May 2022

Social protection schemes are available in India to mitigate the various challenges faced by people living with human immunodeficiency virus (PLWH) infection. The availability of the schemes should be uniform across the country and based on the rights of these people. We reviewed the schemes available in the high PLWH-burdened states of the country for the year 2019. We identified 83 social protection schemes for the PLWH in 13 representative states from different zones of India. The number of schemes was as low as two in the states of Mizoram and Telangana and 12 schemes in Rajasthan. Most of the schemes belong to the ‘health’ category (n = 26, 31.3%), nutrition (n = 14, 16.9%), financial aid (n = 12, 14.5%), insurance (n = 11, 13.5%), employment generation (n = 3, 3.6%), housing (n = 3, 3.6%), and legal support (n = 5, 6.0%). While health-related schemes are present in all the states, the distribution of the other social schemes varies widely across the states. The schemes commonly address the social safety of the children affected by human immunodeficiency virus (HIV), nutritional supplementation, direct financial assistance or subsidized services, and employment generation but vary considerably regarding the type and the number of services. We strongly recommend for evidence-based policy decision to provide uniform social schemes for PLWH.
Delayed liver toxicity and delayed gastroenteritis
Authors: Tiewsoh Iadarilang , Bhattacharya Prasanta K. , Barman Bhupen , Barman Himesh , Rapthap Kamwamangika , Sangla Lima , Lynrah Kyrshanlang G
Published: May 2022

Introduction:

Mushroom poisoning occurs from consumption of the wild variants of mushroom containing varied forms of toxins. Among those toxins, amatoxin containing mushrooms are known for the significant morbidity and mortality from hepatic toxicity and delayed gastroenteritis. Although not a very common cause of poisoning, it is prevalent in the north-eastern region of India, especially during the rainy summer seasons when the wild variants are found abundantly and often confused with the edible variants.

Aims and Objectives:

To study the clinical and biochemical profiles and short term outcomes of patients with mushroom poisoning admitted to a tertiary care hospital.

Materials and Methods:

We analyzed the data of patients with mushroom poisoning admitted to a tertiary care institute in north-eastern India between January 2015 to December 2020 to study their clinical and biochemical profiles, and short-term outcomes. Their clinical features, biochemical parameters, management, and in-hospital outcomes were noted. All data was recorded in Microsoft MS Excel and analyses done using SPSS version 22.

Results:

Of the 44 patients with mushroom poisoning, 23 (52%) were male and 21 (47%) were female, with a mean age of 20.13 years. Seventeen patients (38%) had delayed liver failure and delayed gastroenteritis, 19 patients (43%) had acute gastroenteritis syndrome, 5 patients (11%) had cholinergic symptoms, one patient (2%) each had acute kidney injury and a disulfiram-type reaction with headache. The mean hospital stay of the patients was 5 days. In-hospital mortality occurred in 10 (58%) patients with delayed liver failure and none of the patients with the other complications died.

Conclusion:

This study revealed a high prevalence of mushroom poisoning that caused delayed liver toxicity and delayed gastroenteritis, probably amatoxin-induced, which is fatal, thus accounting for high mortality and poor outcomes in these patients.
Utility of inquest and medico-legal autopsy in community deaths at tertiary care hospital of India
Authors: Parmar Pragnesh B. , Rathod Gunvanti B. , Bansal Prerna , Yadukul S , Bansal Anupam Kumar
Published: May 2022

Background:

In India, inquest is carried out by police or magistrate depending upon the type of death and medico-legal autopsy is carried out by doctor. In some cases, inquest is sufficient to make out necessary information related to death and medico-legal autopsy can be avoided in such death, but medico-legal autopsy has its own value.

Materials and Methods:

A retrospective record-based study was carried out at RVRS Medical College, Bhilwara, Rajasthan, regarding the correlation of inquest and medico-legal autopsy findings in community deaths which were brought dead to hospital in the year 2020

Results:

A total of 467 cases of community deaths were brought dead for medico-legal autopsy in the year 2020. As per inquest, 7.28% died due to hanging, 3.85% died due to burns, 3.43% died due to electrocution, 16.27% died due to poisoning, and the same was established via medico-legal autopsy without any difference from inquest report. After inquest, in 3% of cases, the cause of death remained undetermined, while after the medico-legal autopsy, it was only 0.86%. The manner of death was undetermined in 3% of cases after inquest, while after the medico-legal autopsy, only in 0.86% of cases

Conclusion:

We recommend proper training of the investigating officers who conduct inquest to overcome the discrepancies observed between the investigating officer and the doctor in ascertaining the cause of death and manner of death in all unnatural deaths in India. If well-trained person will conduct in depth inquest, then medico-legal autopsies can be avoided in certain types of death.
Herd immunity in COVID-19
Authors: Raina Sunil Kumar , Kumar Raman
Published: May 2022

Despite the evolving science on Covid-19 pointing to the contrary, the concept of Herd immunity continues to influence decision making in this pandemic. This paper attempts to evolve an understanding of the concept of herd immunity and its relevance in context of pandemics in general and Covid-19 in particular.
Human papillomavirus bowel colonization in inflammatory bowel disease
Authors: Mosli Mahmoud H. , Albeshri Marwan , Alsanea Mohammad N , AlAmeel Turki , Alabsi Haneen , Alsahafi Majid , Saadah Omar , Qari Yousef
Published: May 2022

Background and Aims:

Although much of the research on the plausible environmental triggers for inflammatory bowel disease (IBD) has focused on bacterial pathogens, the relationship between bowel colonization with human papillomavirus (HPV) and IBD has not been previously explored. In this study, we aimed to investigate the association between HPV ileocolonic colonization and IBD.

Patients and Methods:

We performed a cross-sectional study involving consecutive patients with established IBD who were referred for endoscopic evaluation. During endoscopy, mucosal biopsies were obtained from the most inflamed colonic or ileal segments in cases and from the rectosigmoid region for controls. A hybrid capture assay was used to detect tissue HPV. The prevalence of HPV colonization was determined for cases and controls and was compared using Fisher’s exact test.

Results:

A total of 201 patients, including 104 patients with IBD and 97 non-IBD controls, were prospectively included. Females comprised 55.5% of the study participants (58% vs. 55.2% for controls, P = 0.94). Fifty-seven (54.8%) patients had ulcerative colitis, and 45 (43.2%) had Crohn’s disease. The mean age was 43.2 +-18.2 years. Endoscopically active disease was documented in 56 cases (56%). HPV colonization was detected in four (4.1% subjects in controls vs. none in the cases, P = 0.05).

Conclusions:

There was no evidence of HPV ileocolonic colonization in this cohort of patients with IBD, regardless of disease activity. HPV colonization does not appear to be linked to IBD diagnosis or disease severity.
Cognizance towards implementation and adherence of Cigarette and other Tobacco Products Act (COTPA) directives - A descriptive cross-sectional study among security guards in Goa
Authors: Gaunkar Ridhima , Sanjeevan Vinita , Gadiyar Akshatha , Kamath Vinayak , Rajput Soni , Kamat Amita K.
Published: May 2022

Objective:

The use of tobacco has proven to be one of the leading cause of preventable premature deaths and diseases across the globe. The World Health Organization (WHO) claims that tobacco consumption alone kills more people annually as compared to Acquired Immunodeficiency Syndrome (AIDS), alcohol, and other addictions (drugs, etc.) put together. Although the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law to curb the tobacco epidemic, the effectiveness of its implementation remains disputed. The current study aims to examine the role of the security guards in the implementation of the COTPA by assessing their awareness

Method:

A cross-sectional questionnaire-based study was conducted among 258 security guards in Goa to ascertain the knowledge regarding the tobacco legislation in the country. A self-administered 20-item close-ended questionnaire was used to collect information regarding the demographic variables, tobacco use, and knowledge regarding COTPA. Data analysis was done using SPSS version 22.0

Results:

The mean age of the study participants was 29.93 ± 6.93 years. Overall, 68.6% of the study participants were aware of any tobacco control law in India. It was observed that 71% of the subjects had adequate knowledge of the COTPA. The participants with higher secondary educational levels had significantly higher knowledge scores

Conclusion:

The overall awareness of the security guard was good but there is a need to provide in-depth knowledge on certain key aspects of the COTPA. Efforts should be made to train the security personnel to increase their awareness of the act.
A Retrospective analysis of the profile of trauma victims presenting to an emergency department in South India
Authors: Kundavaram Paul Prabhakar Abhilash , Jindal Anmol , Hazra Darpanarayan , Biju Albin , Raju Feema , Samarpit C. C.
Published: May 2022

Background:

Trauma is a leading cause of morbidity and mortality in both developed and developing countries.

Methodology:

This retrospective observational study was done in the Emergency Department (ED) of a tertiary care trauma center in Southern India in 2018 (January to December).

Results:

During the study period of 1 year, the ED attended 74,466 patients which included 7675 (10.3%) trauma patients. The mean age was 35.3 (SD: 18.5) years with three-fourth (76.6%) being males. Pediatric/adolescents (age ≤18 years) and geriatric age groups (age ≥60 years) comprised 16.7% and 11.8% cases, respectively. Road traffic accidents (RTA) (66%) were the predominant mode of injury followed by falls (fall from height: 8.6% and fall on level ground: 7.8%). Among the RTAs, the majority were two-wheelers related (73.8%), followed by pedestrian injuries (9.4%) and four-wheelers injuries (7.2%). Bivariate and multivariate logistic regression analysis showed pedestrian injuries, low Glasgow Coma Scale (GCS), and hypotension at arrival as independent predictors of hospital mortality. The in-hospital mortality rate was 0.7%. A quarter (24%; n = 1841) of the patient’s population was solely managed by the ED team and discharged stable, while 2179 (28.4%) victims required hospital admission.

Conclusion:

Trauma is a major cause of mortality especially among the breadwinners of families in India with almost half being due to two-wheeler accidents. Efficient ED professionals and a multispecialty team of trauma surgeons, neurosurgeons, and orthopedics handle the major load of acute trauma. Pedestrian injuries, low GCS, and hypotension at arrival are independent predictors of in-hospital mortality.
Small contracted bladders posing bigger problems
Authors: Panwar Vikas Kumar , Tosh Jyoti Mohan , Mittal Ankur , Narain Tushar Aditya , Mandal Arup Kumar , Talwar Harkirat Singh
Published: May 2022

The purpose of this study was to assess various etiologies, diagnosis and management. This rare entity is a neglected condition which should always be under clinical suspicion by broad speciality of practitioners for early treatment. Retrospective data collected from 2018 to 2021 in the All India Institute of Medical Sciences Rishikesh was used. All patients diagnosed with the small contracted bladder in the given period were included. The primary outcome of the study was to find out the common causes, early tests used for diagnosis and management done in the patients of small contracted bladder attending this tertiary care centre. Between 2018 and 2021, a total of 12 patients were diagnosed to have small capacity bladder (SCB). The most common symptom was frequency (75%). On cystoscopy, 33.33% (n = 4) had less than 50 ml and 66.66% (n = 8) had 50-100 ml bladder capacity respectively. 37.5% (n = 3) were diagnosed by urine AFB culture, 62.5% (n = 5) were diagnosed by urine for PCR, 62.5% (n = 5) were diagnosed by radiological investigations. Eight patients (66.66%) underwent surgical treatment in cases diagnosed as tuberculosis like augmentation cystoplasty and supra-trigonal cystectomy. Other rare causes found were eosinophilic cystitis, radiation induced contracture and BCG induced contracture. Small capacity bladder is an unusual condition, with still dilemma on the definition of small capacity and only few literature mentioning the causes, diagnosis and treatment. Even though tuberculosis is a common cause of SCB, still rare causes should always be kept in mind for relieving patient symptoms at the earliest.
Effect of COVID-19 pandemic on home delivery of contraceptives by community health workers in India
Authors: Bharati Bhavna , Sahu Kirti Sundar
Published: May 2022

The World Health Organization (WHO) declared COVID-19 a global health emergency in January 2020, leading to a nationwide lockdown in India. It has been an experience from other outbreaks that governments cannot maintain the essential health services and guarantee health services. Due to COVID-19-related case management, all health schemes, including FP services, have been disrupted globally regarding availability, accessibility, appropriateness of service delivery, adequacy, and continuity of care. The impact of the pandemic on FP services listed includes disruptions in supply chain management, enhanced gender inequity, communication barriers, fear of going outside and buying contraceptives, discontinuity of ASHA capacity building, increased time spent with all family members, reverse migration of workers, and increased need of contraceptive commodities. Evidence shows the consequence of non-supply of logistics, social distancing, inadequate human resources, and inability to access services might result in 26 million couples in unmet need for contraception, resulting in 2.4 million unintended pregnancies and 1.45 million abortions, which may lead to unsafe abortions. Potential solutions to these problems include telephonic service delivery, maintaining a record, using video communication and other technological solutions using a smartphone, combining routine immunization with FP services, and installing self-dispensing machines for contraceptives at accessible places. The limitation of this work is that this is wholly experienced-based work and not based on primary findings from the field level data. These findings highlight the importance of reproductive health needs during the pandemic and guide policymakers.
Neurofibromatosis 1
Authors: Sethi Neha K. , Chadha Charu , Goyal Sumit , Kaur Manpreet
Published: May 2022

Neurofibromatosis type 1 (NF1) or Von Recklinghausen disease comes under a group of multisystem hereditary syndromes called phakomatoses. It presents with skin, ophthalmic, bony, and systemic manifestations. We present a photographically well-documented case series of NF in a family (n = 3). Skin manifestations were present in all the patients. The ophthalmic manifestations were Lisch nodules (100% of eyes), subcutaneous neurofibroma of eyelids (33% of eyes), mechanical ptosis (33% of eyes), and mechanical ectropion (16.5% of eyes). We report the rare occurrence of multiple solitary neurofibromas causing mechanical ptosis and mechanical ectropion.
Urinary tract infection and Diabetes Mellitus—Etio-clinical profile and antibiogram
Authors: Jagadeesan Subramani , Tripathi Brijendra K. , Patel Pranav , Muthathal Subramanian
Published: May 2022

Context:

A complex dysregulation of glucose homeostasis, Diabetes Mellitus (DM) is an iceberg disease with an ever-rising global (8.5%, 2018) and national prevalence (7.3% - ICMR-INDIAB study, 2017) amidst adults. Besides the micro and macrovascular complications, in virtue of diverse mechanisms that downplay the immune system culminating in an array of infections especially UTIs are commoner in routine diabetic clinics. The spectrum of UTI ranges from asymptomatic bacteriuria (ASB) to serious complications such as emphysematous pyelonephritis, renal abscesses that are encountered frequently among Diabetics than the general population. The risk stratification and varying modalities of presentation of UTIs in diabetics in contrast with non-diabetics are being studied.

Methods and Material:

A prospective comparative cross-sectional study was conducted in 250 adult consenting participants with equal diabetics and non-diabetics with culture-proven UTI, at the Department of Internal Medicine in a tertiary care hospital of National Capital Territory (NCT) of India, after fulfilling appropriate criteria. Alongside socio-demographic details and vitals parameters, glycaemic status assessment and relevant investigations were done in either group.

Results:

Mean age of the participants was 52.18 ± 9.06 with age and gender being reasonably distributed in both the groups. Fever (P <0.01), dysuria (P <0.01), urgency (P <0.01) and urinary frequency (P <0.01) found frequently among non-diabetics wherein vomiting (P <0.01) and incontinence (P <0.01) relatively commoner among diabetics. E. coli, Klebsiella sp., were the most common organisms in both groups with Proteus sp., and Pseudomonas sp., higher among diabetics. Severe infection and Pyelonephritis were frequent (AOR 2.64, 95% CI- 2.01-3.27, P <0.05) among diabetics. Antimicrobial sensitivity patterns were not significantly different among both groups.

Conclusions:

Primary care physicians are to be acquinted with the possibility that UTI in diabetics could exhibit relatively lesser symptoms or more severe forms of UTI at presentation and less favorable outcomes. Further validation from a larger cohort of diabetics is warranted in terms of symptomatology, diagnostic approach, and sensitivity patterns.
Assessment of e-aushadhi program (drug inventory e-health initiative in Rajasthan) using benefit evaluation framework
Authors: Mantri Neha , Joshi Nitin K. , Bhardwaj Pankaj , Manda Balwant , Joshi Vibha , Singh Kuldeep , Passi Rakesh
Published: May 2022

Background:

E-aushadhi is a drug supply chain management initiative of the Rajasthan government. This study is conducted to assess this e-health program as evidence is lacking in this context

Methods:

A mix-method study was conducted. Primary data were recorded from key stakeholders using qualitative interviews. Secondary data were collected from internet-based searches, reports, documents, and available literature. Findings were contextualized into the Benefit-Evaluation framework using six dimensions

Results:

E-aushadhi provides a systematic approach for sourcing, storing, and re-distribution of essential medicine through its three-tier structure. Its user-friendly dashboard entails accurate entries, customizable reports, and easy tracking. It has reduced workload and improved information management with timely drug supply while allowing monitoring with key performance indicators

Conclusions:

E-aushadhi has been successful in improving beneficiary access at public health facilities and may act as a backbone architecture for various digital interventions in the National Digital Health Mission that supports the universal health coverage.
Atypical presentation of maxillary osteomyelitis in an immunocompromised patient
Authors: Divyambika CV , Warrier S Aravind , Preethi Ramesh
Published: May 2022

Maxillary osteomyelitis is a relatively rare presentation. This condition is more often associated with underlying immunocompromised systemic conditions. Thorough clinical examination coupled with meticulous investigative protocol is needed to prevent the dreaded complications associated with the disease. With the emergence of new antibiotics and the use of advanced imaging modalities, the management of such patients has been better over the recent years. Oral physicians play a major role by providing primary care in the early diagnosis of such lesions, especially in immunocompromised patients, thereby improving the patient’s quality of life. The present report highlights an atypical presentation of maxillary osteomyelitis in a newly diagnosed diabetic patient, with the importance of appropriate diagnostic workup, and prompt institution of treatment resulting in complete recovery.
Challenges and Road Map towards Starting a New COVID Hospital
Authors: Duggal Shalini D. , Gupta Shweta , Vats Sumit , Goyal Ashish
Published: May 2022

Background and Aim:

With advent of the Coronavirus Disease 2019 (covid-19) pandemic, need for a dedicated government hospital was felt. Following directions after a cabinet decision, a dedicated Covid hospital was made functional within a month in Central district of Delhi. This manuscript briefs the journey and challenges experienced during this mission.

Method:

As per decision of the state health ministry, bed allocation was planned along with provision for diagnosis, treatment and prevention of Covid -19. Various trainings were simultaneously conducted, licences were obtained and manpower and material were arranged starting with procurement to service provision and waste management.

Result:

Concerted efforts resulted in initiation of clinical and diagnostic services within one month of initiation of teamwork. Government supported in all the licencing requirements and material management. The hospital became functional during the first wave; and by the start of second wave, 20-bedded fully equipped Intensive Care Unit (ICU) was ready with pressure swing adsorber (PSA) oxygen generator in premises.

Conclusion:

A well-coordinated action in the right direction with administrative support can help in achieving difficult targets. Opening a new hospital amidst lockdown and resource constraints in an emergency situation was a rewarding achievement.
Unicystic ameloblastoma of mural variant crossing the midline
Authors: James Leena , Shafath Adil , Nagaraj Tejavathi , Biswas Arundhati
Published: May 2022

Unicystic ameloblastoma (UCA) refers to cystic lesions that show gross features of a jaw cyst but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Even though the lesion is not as aggressive as the solid ameloblastoma, an accurate histopathologic diagnosis is essential for the treatment and prognosis. This case report illustrates a case of UCA of mural variant in the anterior region of the mandible crossing the midline, which is usually an unusual site of occurrence.
Comparative and clinical evaluation between piezoelectric and conventional rotary techniques for mandibular impacted third molar extraction
Authors: Sharma Amit Kumar , Gupta Akshat , Pabari Hemang P. , Pathak Sanchaynee K. , Odedra Nilesh H. , Beniwal Jyoti , Arora Karandeep Singh
Published: May 2022

Purpose:

The aim of this study was to evaluate and compare the operative and postoperative outcomes of the mandibular impacted third molar removal using piezoelectric technique and conventional rotary bur technique.

Settings:

The study was conducted in the department of oral and maxillofacial surgery between January 1, 2019, and January 1, 2020.

Materials and Methods:

Thirty patients, with an age of 18–40 years, with asymptomatic bilateral impacted mandibular third molars, were selected for the study and randomly surgical extraction was done either using piezoelectric or the conventional rotary bur technique on each site. The intraoperative time taken, postoperative pain, swelling, and trismus were assessed over a follow-up period of 7 days postoperatively.

Results:

Study and control groups were compared using paired t-test. There was statistical significance in reduction of pain and swelling in the study group where the duration of surgery was increased in the study group.

Conclusion:

Even if piezoelectric technique takes more time but can be used safely as another technique to conventional surgical method with surgical bur and handpiece for removal of impacted mandibular third molars.
Review of current vaccine development platform to prevent coronavirus disease
Authors: Arif Khushboo , Malhotra Shitanshu , Mohammad Shadab , Fatima Somi , Farooqui Sana , Saleem Mohammad
Published: May 2022

On January 30, 2020, the World Health Organization (WHO) declared a severe respiratory disorder syndrome which originated in Wuhan city as a global public health emergency, and the pandemic declaration by the WHO was made on March 11, 2020. Persons infected with SARS-CoV-2 are frequently asymptomatic, yet they have high respiratory viral loads, and they are major purveyors of viral spread. These factors have led to the current explosion of COVID-19 hospitalizations and deaths. Vaccines could play an important role by preventing severe diseases and increasing population immunity and reducing the ongoing health crisis. There is wealth of information for the review available since it is a current topic of interest. Initially, Google Scholar was utilized to take an initial sample of what types of articles are available. We searched other databases such as PubMed, EMBASE, and COCHRANE LIBRARY for research articles published up to March 2021, with no language restrictions. We found seven peer-reviewed publications available on the efficacy of SARS-CoV-2 vaccines: AZD1222 (AstraZeneca/University of Oxford), a ChAdOx1-based vaccine with a reported efficacy of 70.4% and two mRNA-based vaccines: BNT162b2 (Pfizer/BioNTech) with a reported efficacy of 95% and mRNA-1273 (Moderna/NIAID) with a reported efficacy of 94.1%. Internet was used as a source because of its limitless networking of resources. Sources used from the internet were written by professionals in their fields and published on reliable sites, in referred publications, or on professional organization sites. The cited references were within the last 2 years.
A child with refractory orbital cellulitis after water pipe smoking
Authors: AlQahtani Dhabiah S. , Alsaif Mohammed A. , AlSulaiman Naif , Alsuhaibani Adel H.
Published: May 2022

Orbital cellulitis in children rarely occurs secondary to smoking water pipe. A 3-year-old girl who presented with fever, eyelid swelling, pain, and proptosis of the left eye for 4 days after water pipe consumption. The patient was given the usual course of antibiotics for a few days along with subperiosteal abscess drainage however no improvement was noticed for a week. Cultures were positive for methicillin-resistant Staphylococcus aureus and pseudomonas aeruginosa. Intravenous dexamethasone was co-administered in three courses for 3 weeks, during which residual symptoms was slowly resolving. In conclusion, attempt of dexamethasone in children can shorten hospital stay and augment full recovery.
Study on Quality Markers and Action Mechanisms of Inulae Flos on Anti-Hepatitis Through Network Pharmacology and High-Performance Liquid Chromatography Fingerprints
Authors: Lin Li , Su Lian-Lin , Li Huan-Huan , Mao Chun-Qin , Ji De , Xie Hui , Lu Tu-Lin
Published: May 2022

Objective:

The objective of the study is to combine network pharmacology with high-performance liquid chromatography (HPLC) to screen for quality markers (Q-markers) of Inulae Flos and predict mechanism on anti-hepatitis.

Materials and Methods:

Active ingredient library of Inulae Flos is structured using databases and the literature. “Compound-target-pathway” network on anti-hepatitis and protein–protein interaction (PPI) network are constructed using network pharmacology. Next, chromatographic fingerprints of Inulae Flos in 7 origins are obtained through HPLC, and chemometric analysis is implemented to identify chemical markers, which is combined with network pharmacology to identify Q-markers and detect content.

Results:

1,6-O, O-Diacetylbritannilactone, Ivangustin, and Inulanolide A are key ingredients of Inulae Flos to interact with 82 potential targets related to anti-hepatitis. Furthermore, signal transducer and activator of transcription 3, tumor necrosis factor, interleukin-6, and transcription factor AP-1 are the core targets in the PPI network. Chromatographic fingerprints of the Inulae Flos define 20 common peaks and identify 8 peaks using reference substances. Through partial least square discriminant analysis, 7 compounds including caffeic acid, chlorogenic acid, and 1,6-O, O-Diacetylbritannilactone were main chemical markers for variability. 1,6-O, O-Diacetylbritannilactone is both a key ingredient and exclusive chemical marker. Therefore, 1,6-O, O-diacetylbritannilactone is a Q-marker of Inulae Flos, and the average content is 1.82 mg/g.

Conclusion:

1,6-O, O-diacetylbritannilactone is determined to be a Q-marker of Inulae Flos.
Cloud-Edge Orchestration for Smart Cities: A Review of Kubernetes-based Orchestration Architectures
Authors: Böhm Sebastian , Wirtz Guido
Published: May 2022

Edge computing offers computational resources near data-generating devices to enable low-latency access. Especially for smart city contexts, edge computing becomes inevitable for providing real-time services, like air quality monitoring systems. Kubernetes, a popular container orchestration platform, is often used to efficiently manage containerized applications in smart cities. Although it misses essential requirements of edge computing, like network-related metrics for scheduling decisions, it is still considered. This paper analyzes custom cloud-edge architectures implemented with Kubernetes. Specifically, we analyze how essential requirements of edge orchestration in smart cities are solved. Also, shortcomings are identified in these architectures based on the fundamental requirements of edge orchestration. We conduct a literature review to obtain the general requirements of edge computing and edge orchestration for our analysis. We map these requirements to the capabilities of Kubernetes-based cloud-edge architectures to assess their level of achievement. Issues like using network-related metrics and the missing topology-awareness of networks are partially solved. However, requirements like real-time resource utilization, fault-tolerance, and the placement of container registries are in the early stages. We conclude that Kubernetes is an eligible candidate for cloudedge orchestration. When the formerly mentioned issues are solved, Kubernetes can successfully contribute latency-critical, large-scale, and multi-tenant application deployments for smart cities.
Функтор $p$-выпуклости для $L_p(X)$-пространств
Authors: Volosova Nina Vladimirovna
Published: May 2022

Описывается конструкция, превращающая произвольную $L_p(X)$-норму на нормированном пространстве $E$ в $p$-выпуклую. Применение этой конструкции к проективной тензорной норме позволяет получить явную формулу для максимальной $p$-выпуклой $L_p(X)$-нормы на $E$.
Библиография: 9 названий.
SAE Fuel Consumption Test Procedure (Engineering Method)
Authors:   Truck and Bus Aerodynamics and Fuel Economy Committee
Published: May 2022

This document describes a fuel-consumption test procedure that utilizes industry accepted data collection and statistical analysis methods to determine the difference in fuel consumption between vehicles with a gross vehicle weight of more than 10000 pounds. This test procedure can be used for an evaluation of two or more different vehicles but is not to be used to evaluate a component change. Although on-road testing is allowed, track testing is the preferred method because it has the greatest opportunity to minimize weather and traffic influences on the variability of the results. All tests shall be conducted in accordance with the weather constraints described within this procedure and shall be supported by collected data and analysis. This document provides information that may be used in concert with SAE Recommended Practices SAE J1264, SAE J1252, SAE J1321, and SAE J2966, as well as additional current and future aerodynamic and vehicle performance SAE standards.
Student Friendly Teaching and Learning Environment: Experiences from Technical Vocational Educational Training Schools in Nepal
Authors: Subedi Ramila , Shrestha Milan
Published: May 2022

The learner friendly atmosphere in the school has been fore grounded by the state while it is equally emphasized by the Technical Vocational Educational Training (TVET) schools in Nepalese context. Thus, this paper aims to exploring the opportunities and challenges the school leaders, teachers, students and parents have been experiencing while creating student- friendly teaching learning atmosphere in TVET schools. In this study, we employed the narrative inquiry and the data were collected by in-depth interview from the participants. Through the collected narratives, it was discovered that, although student- friendly environment in teaching learning has been gaining significant popularity, creating such environment comes up with many challenges like: ambiguous role of facilitators, infrastructural constraints and attitudinal rigidity of individuals towards student- centered teaching learning. However, student-friendly teaching learning environment was recounted to have been constructive in stimulating confidence, creativity, criticality, social spirit and self-reliance among students.