bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing skeleton-based human motion recognition with Lie algebra and memristor-augmented LSTM and CNN
Authors: Fan Zhencheng , Yan Zheng , Cao Yuting , Yang Yin , Wen Shiping
Published: May 2024

Lately, as a subset of human-centric studies, vision-oriented human action recognition has emerged as a pivotal research area, given its broad applicability in fields like healthcare, video surveillance, autonomous driving, sports, and education. This brief applies Lie algebra and standard bone length data to represent human skeleton data. A multi-layer long short-term memory (LSTM) recurrent neural network and convolutional neural network (CNN) are applied for human motion recognition. Finally, the trained network weights are converted into the crossbar-based memristor circuit, which can accelerate the network inference, reduce energy consumption, and obtain an excellent computing performance.
Éléments de réflexion issus de notre travail sur l’activité des enseignants des écoles primaires en Tunisie
Authors: Hadj Amor Habib
Published: May 2024

Dans cet article, nous rendons compte de la problématique saisie dans la thèse de doctorat réalisée en cotutelle entre l’Université de Lyon 2 et l’Université de Tunis. Il s’agit de faire le point sur l’activité des enseignants des écoles primaires en Tunisie qui est au carrefour de trois facteurs que l’on considère à la fois complémentaires et interdépendants : la formation, l’ordinaire des pratiques et la relation avec l’inspection. L’intérêt témoigné à ces facteurs montre qu’on ne peut pas analyser l’activité enseignante comme un mécanisme abstrait totalement indépendant de la formation initiale, des pratiques mises en œuvre et de la relation avec la hiérarchie de proximité (l’inspection).
Inserção social dos Grupos Escolares de Campinas segundo os Anuários do Ensino do Estado de São Paulo (1907-1920)
Authors: Ramos Géssica Priscila
Published: May 2024

Este artigo aborda a inserção social dos primeiros Grupos Escolares de Campinas, tendo como ênfase o alcance, os espaços e o perfil de atendimento destes até 1920. É um estudo qualitativo de ênfase documental, com foco nos dados estatísticos dos Anuários do Ensino do Estado de São Paulo (1907 a 1920). Observou-se que esses Grupos atuaram de forma singela no atendimento da demanda por formação primária, considerando-se a reduzida cobertura, os altos índices de reprovação e a baixa conclusão do curso. Todavia, mesmo que os resultados sejam irrisórios quanto à democratização do ensino primário local, a inserção de crianças de diferentes gêneros, raças, idades e nacionalidade em seus espaços é emblemática e reveladora sobre o importante campo de disputa que se abriu por dentro deles.
“Castigou corporalmente, sendo possível ouvir os gritos”
Authors: Ripe Fernando , Alves Marcelo Marin , Serralheiro Laryssa Celestino
Published: May 2024

O artigo apresenta um processo criminal envolvendo menores em uma instituição escolar privada da cidade de Lajeado, no estado do Rio Grande do Sul, do ano de 1911. Ao trazermos à tona uma queixa-crime do início do século XX, buscamos compreender as possíveis representações jurídicas sobre o universo infantil vítima de abusos e de violências – simbólicas e físicas. Para tanto, opera-se com os conceitos foucaultianos de acontecimento, violência e punição, bem como com a micro-história da violência, subsidiada por horizontes metodológicos advindos respectivamente dos estudos de Ginzburg e Fausto, com a intenção de identificar, em um caso de agressão infantil, a maneira como a educação foi estruturada e dirigida em uma instituição privada de cunho confessional e os seus desdobramentos na área jurídica.
Progress on TTFields combined with other therapies for glioblastoma treatment
Authors: Cao Yong , Wu Haibin , Tang Bin , Li Meihua , Wan Yilv , Duan Jian , Xu Jiang
Published: May 2024

Glioma is the most common primary malignant tumor in the skull, and the current treatment remains a combination of surgery, radiotherapy (RT), and chemotherapy. Radiation therapy plays an important role in the treatment of glioma, and currently, surgical resection under molecular pathology guidance plus postoperative radiation therapy and chemotherapy is the standard treatment protocol for primary glioma, but its widespread use is limited by its radiotoxicity. Meanwhile, with the increasing development of new technologies in the medical field of tumor treatment electric fields, there has been some improvement in the treatment and prognosis of glioma. TTFields are a noninvasive anti-cancer modality consisting of low-intensity (1–3 V/cm), medium-frequency (100–300 kHz), alternating current electric fields delivered through an array of skin sensors to provide optimal coverage of the tumor site. TTFields target cancer cells through multiple mechanisms of action, including inhibition of proliferation, migration, and invasion, disruption of DNA repair and angiogenesis, antitumor effects, induction of apoptosis, and immunogenic cell death. TTFields alone have good efficacy against tumors, and with the gradual development of technologies such as immune and targeted therapies, TTFields are now more frequently studied in combination with chemotherapy, RT, immunotherapy, and immunotherapy. At present, the treatment methods of glioma include surgery, chemotherapy, RT, immunotherapy and targeted therapy. This article will summarize the research progress of TTFields combined with other therapies to provide a reference for the treatment of glioblastoma.
Brain metastases treated with CyberKnife and TomoTherapy
Authors: Zhu Li , Li Ying , Kong Xiangyu , Mu Anna , Zhang Ye , Chen Liping , Li Xia
Published: May 2024

This study aimed to compare the safety and efficacy of CyberKnife (CK) versus TomoTherapy for the treatment of brain metastases (BMs). Three cases of BM treated at our hospital – two with CK and one with TomoTherapy – were compared and analyzed. Both treatments showed good therapeutic effects, but CK was more effective. No radiation-related adverse reactions were observed in the three patients. It is concluded that both CK and TomoTherapy can effectively control target lesions by allowing a higher dose in a single treatment while minimizing damage to surrounding normal brain tissue. This can reduce the total number of treatments needed, improve the prognosis of patients, and save medical resources.
Associations of O6-methylguanine-DNA methyltransferase promoter methylation status with age and 1p/19q codeletion status in isocitrate dehydrogenase mutation gliomas based on an Asian cohort
Authors: Wang Xu , Han Mingzhi
Published: May 2024

The expression of the DNA repair protein O6-methylguanine-DNA methyltransferase (MGMT) can lead to tumor cell resistance to alkylating agents. Glioblastomas with isocitrate dehydrogenase mutation (IDHmut) were reported to have significantly higher MGMT promoter methylation, which predicted improved outcomes after temozolomide treatment. However, the MGMT methylation status in IDHmut glioma remains controversial. To further explore the associations of MGMT promoter methylation status with other molecular features in IDHmut gliomas, in this work, we analyzed the relationship of MGMT promoter methylation status with 1p/19q codeletion status and age in IDHmut gliomas based on a large Asian (Chinese) cohort. We found that there was no significant difference in MGMT methylation status in IDHmut 1p/19q-codeleted oligodendrogliomas compared to IDHmut astrocytomas, in either primary or recurrent cases. Moreover, the MGMT methylation status was not associated with age. The difference compared to previous research which indicated the MGMT methylation status differed significantly among IDHmut glioma might be caused by differences between populations, indicating that routine assessment of MGMT methylation status in oligodendrogliomas may still be necessary.
WHO grade III diffuse astrocytic glioma in a 35-year-old male
Authors: Du Rong , Liu Huandong , Yi Guoqing , Cheng Huilin , Liang Ping
Published: May 2024

Gliomas are tumors that originate from glial cells and the most common neoplasms in the central nervous system. The World Health Organization (WHO) has classified glioma into four grades, I to IV, with multidisciplinary therapies required for the management of high-grade gliomas (grades III and IV). Molecular pathology has become increasingly critical in guiding the treatment and predicting the prognosis of patients with gliomas. A 35-year-old man diagnosed with WHO grade III diffuse astrocytic glioma initially underwent surgical resection, followed by immunohistochemical and molecular diagnosis. The patient was administered adjuvant radiotherapy and chemotherapy based on the molecular characteristics of the tumor. Long term follow-up showed a relatively satisfactory therapeutic response. Molecular classification may help guide decisions on the comprehensive treatment of patients with WHO grade III diffuse astrocytic glioma. This study was approved by the Ethics Committee of Zhongda Hospital of Southeast University, China (approval No. 20211015001, approval date: October 15, 2021).
Current status of clinical application of immunotherapy in the treatment of glioma
Authors: Chen Qiuzi , Ren Peng , Huang Guohao , Zhang Zuoxin , Hugnot Jean-Philippe , Lv Shengqing
Published: May 2024

Glioma is a common type of brain tumor. Current treatment for glioma includes surgical resection, radiotherapy, chemotherapy, and tumor-treating fields. The application of immunotherapy to treat glioma is still far from satisfactory in the clinic. Here, we review the mechanisms of immunotherapy for glioma (including immune checkpoint inhibitor, chimeric antigen receptor-T-cell, tumor vaccine, and oncolytic virus) and the results of completed clinical trials, and will discuss the current status of immunotherapy and possible future directions.
Research progress in the treatment of glioblastoma by an oncolytic virus
Authors: Shao Xiangxiang , Ni Wei , Xu Xiaobin , Luo Yuanyuan
Published: May 2024

Glioblastoma is the most common malignant tumor in the adult primary central nervous system. It has a strong proliferative ability, high recurrence rate, and high malignant degree. Despite standard radiotherapy combined with temozolomide chemotherapy, the prognosis was poor, with a 5-year survival of <10%. Therefore, more effective treatments need to be explored. Oncolytic viruses (OVs) have attracted the attention of researchers because of their unique targeting, safety, and antitumor effects. OV therapy has achieved remarkable efficacy in the treatment of many kinds of malignant tumors, and it has also made great progress in the treatment of glioblastoma. This article reviews the recent clinical research progress of OVs in the treatment of glioblastoma.
Patterns and Determinants of Primary Tooth Extraction in Children: A Study in an Indian Tertiary Care Dental Setting
Authors: Singh Shamsher , Singh Vikram , Sharma Swati , Patel Chirag , Shahi Ajoy Kumar , Mehta Vanisha , Manek Pranav V
Published: May 2024

ABSTRACT

Introduction:

Preservation of primary teeth is essential for optimal oral health in children; however, there is limited research on primary tooth extraction patterns in India. This study aimed to investigate the reasons for and patterns of primary tooth extraction in children in an Indian tertiary care dental setting.

Methodology:

This retrospective cross-sectional study analyzed dental records of children aged up to 14 years who underwent tooth extraction under local anesthesia from January to December 2023. Demographic data, reasons for extraction, and tooth types extracted were collected and analyzed using descriptive statistics and the Chi-square test.

Results:

Among the 261 subjects studied, there were 132 males and 129 females. Dental caries was the leading cause of extraction (42.6%), followed by mobility (20.8%) and over-retention (17.3%). Maxillary teeth were extracted more frequently than mandibular teeth, with central incisors being the most commonly extracted.

Conclusion:

This study highlights the prevalence of dental caries as the primary reason for primary tooth extraction in Indian children. Gender-specific differences were observed in extraction reasons, and maxillary teeth were more frequently extracted than mandibular teeth. These findings emphasize the importance of targeted preventive strategies to address dental caries and promote optimal oral health in children in India.
Exploring the use of Virtual Surgical Planning (VSP) in Maxillofacial Reconstructions
Authors: Guruprasad Yadavalli , Laskar Shyamalendu , Patadiya Mohammed Mohsin Moosabhai , Gowdar Inderjit Murugendrappa , Parihar Anuj Singh , Singh Karandeep , Makkad Ramanpal Singh
Published: May 2024

ABSTRACT

Background:

Virtual surgical planning (VSG), also known as computer-assisted reconstruction, has started to become the norm for more complex patients in many centers in recent times.

Aim:

This study was conducted to evaluate the VSG in maxillofacial reconstruction surgery.

Methods and Materials:

This study included 20 patients who underwent surgery for maxillofacial reconstruction. The study participants were divided into two main categories: Category 1: Conventional surgical planning (CSG). Category 2: VSG. The surgical planning in both categories, including the evaluation of volume of defect, length, width, and height of graft, to be placed.

Results:

The gap between defect to be reconstructed and graft placed was greater in CSG as compared to VSG. The distance of graft from actual location was lesser in VSG as compared to CSG. The findings were significant statistically. Frequency of success was 93.21% and 97.47%, respectively. The frequency of success was greater in VSG as compared to CSG.

Conclusion:

Virtual surgical planning is more effective in maxillofacial reconstruction surgery.
Assessment of Discomfort and Analgesic Usage Following Pediatric Dental Procedures in India: A Cross-Sectional Study
Authors: Singh Vikram , Singh Shamsher , Sharma Swati , Diwanji Amish , Diana Wahengbam , Patel Chhaya , Manek Pranav V
Published: May 2024

ABSTRACT

Introduction:

Pain management in pediatric dentistry is crucial for ensuring positive treatment outcomes and reducing patient suffering. This study aimed to evaluate postoperative discomfort and analgesic usage among pediatric dental patients undergoing various procedures in India.

Methodology:

A cross-sectional study was conducted at a tertiary care dental hospital in India from June 2023 to December 2023. A total of 150 pediatric patients aged 2–18 years who underwent different dental procedures were included. Data on postoperative discomfort and analgesic usage were collected immediately following the procedure and during follow-up phone calls.

Results:

Significant differences were found in immediate postoperative discomfort following pulpotomy (P = 0.03). Patients receiving primary stainless steel crowns (SSCs) alone or in combination with pulpotomy were significantly more likely to report discomfort (P < 0.001 and P < 0.05, respectively). No significant associations were observed between discomfort and sealants, preventive resin restorations, 1- or 2-surface restorations, or extractions. Over-the-counter analgesic usage was prevalent, particularly following SSC placement.

Conclusion:

This study highlights the variability in postoperative discomfort among pediatric dental patients undergoing different procedures in India. Tailored pain management strategies based on specific procedures are essential to minimize discomfort and improve patient outcomes in pediatric dentistry.
Cone-Beam Computed Tomography (CBCT) Study on Gender Difference and Root Canal Morphology in Mandibular Premolars
Authors: Paul Sukriti , Gupta Ankita , Ingole Ranu S. , Ingole Yogesh S. , Vaidya Seema B. , Manek Pranav V. , Arya Sugandha
Published: May 2024

ABSTRACT

Introduction:

The study examined mandibular premolars’ root and canal distribution across genders and sides.

Materials and Methods:

Cone-beam computed tomography (CBCT) imaging of mandibular premolars was performed using SINORA ORTHOPHOS XG 3D, with specific parameters set.

Results:

Cone-beam computed tomography (CBCT) imaging of 100 participants revealed mostly single-rooted premolars, with slight variations, notably among females. Mandibular first premolars predominantly had single canals and roots, with a higher occurrence of two canals in females. Statistical analysis showed no significant gender- or side-based differences in root distribution. The findings underscore gender-specific variations in premolar morphology, highlighting the importance of tailored treatment planning, especially for the left side.

Conclusion:

While CBCT proves valuable, further research is needed to optimize its utility in endodontic decision-making.
Effect of Different Surface Treatments on the Bonding Strength of Three Different Post Biomaterials to a Resin-Based Luting Agent
Authors: Kumar Madhurendra , Barui Asish K. , Rajapur Anand , Shahi Harendra , Kaur Harman , Singla Kunal , Pradhan Sujit
Published: May 2024

ABSTRACT

Aim:

The aim of this study was to evaluate how different post-surface treatments affect the ability of luting cement to bond three different dental post materials to a resinous surface.

Materials and Methods:

The study analyzed a total of 108 posts categorized into three main groups: stainless steel, cast, and fiber posts. Next, the core group was divided into four subgroups (n = 9) according to the type of surface treatment applied: no surface treatment (NS), silanization (SZ), sandblasting (SB), and sandblasting plus silanization (SBSZ).

Results:

Stainless steel posts exhibited the lowest bond strength, whereas fiber posts demonstrated the highest shear bond strength. When it comes to surface treatments, dental post-surfaces treated with sandblasting have been found to exhibit the highest bond strength, outperforming other methods.

Conclusion:

Comparing all methods of surface modification, sandblasting with 50 um Al2O3 particles demonstrated the strongest connection.
Effect of Fixed Orthodontic Appliances on Oral Microbial Changes and Dental Caries Risk in Children: A 6-Month Prospective Study
Authors: Chandra Subhash , Jha Awanindra K. , Asiri Saeed N. , Naik Atri , Sharma Swati , Nair Arvind , Manek Pranav V.
Published: May 2024

ABSTRACT

Introduction:

Orthodontic treatment can alter the oral environment, leading to plaque accumulation and changes in microbial colonization. This study aimed to assess microbiological changes in 10 to 16-year-old children undergoing fixed orthodontic treatment.

Methodology:

The study included children aged 10–16 years, with one group wearing fixed orthodontic appliances and a control group without brackets. Data on salivary pH, buffer capacity, Streptococcus mutans, and Lactobacillus spp were collected at baseline and after 6 months. Logistic regression models evaluated associations between orthodontic treatment and elevated bacterial levels, adjusting for age, gender, pH, and buffer capacity.

Results:

Wearing fixed orthodontic appliances was significantly associated with elevated Streptococcus mutans (aOR: 6.62, 95% CI: 1.91–21.88) and Lactobacillus spp (aOR: 9.49, 95% CI: 2.57–35.07). Gender showed a significant association with Lactobacillus spp levels (aOR: 0.28, 95% CI: 0.09–0.87).

Conclusion:

Fixed orthodontic appliances significantly impact oral microbial changes, underscoring the need for proper oral hygiene during orthodontic treatment to reduce dental caries risk.
Knowledge and Awareness Regarding Facemasks among Medical Professionals in a COVID-Dedicated Hospital – A Cross-sectional Study
Authors: Aggarwal Sulakshna , Bains Lovenish , Mishra Anurag , Dabas Aashima , Goel Madhav , Afsar Aiman Perween
Published: May 2024

Background:

Severe acute respiratory syndrome coronavirus 2 is a severe respiratory infection that spreads through infected droplets. Facemasks have been mandated by the World Health Organization and Centers for Disease Control as the cornerstone for preventing the spread of infection among healthcare workers. However, despite the ubiquitous use of masks, many healthcare professionals are unaware of their properties and proper use. Therefore, the study aims to assess the awareness, practices followed, and problems faced in the use of facemasks among medical professionals in a coronavirus disease (COVID)-dedicated hospital.

Methodology:

An e-questionnaire-based survey was conducted among medical professionals working in a tertiary care (COVID-dedicated) hospital in North India. The questionnaire tested for the knowledge and awareness on properties of facemasks, problems faced on regular or prolonged use, and removal, storage, and disposal practices among professionals.

Results:

The survey was sent to 368 medical professionals with a response rate of 45.65%. About 43.3% of the participants were aware of the properties of the N95 facemask, and 26% of the health professionals checked for the proper fit of the mask after putting it on. Discomfort and sweat issues were the most common problems reported by 84% and 69.33% of participants, respectively. About 86% of the participants had the knowledge of appropriate removal of the mask, but only one-third were aware of the proper mask disposal practices.

Conclusion:

Knowledge about the properties of facemasks, their use, and disposal practices among the North Indian healthcare professionals was found to be significantly lower than in western countries; however, the awareness increased with experience in the participants studied (P < 0.001). As it is the young medical force at the forefront to tackle the menace, regular training and accurate information on facemask usage must be disseminated via institutional training programs to prevent the risk of infection and equip the frontline workers to share this knowledge with the community further.
Impact of COVID-19 Pandemic on the Care of Non-COVID Pediatric Patients
Authors: Kaur Sahi Puneet , Meena Priyanka , Pallavi  , Mandal Anirban , Dabas Aashima
Published: May 2024

Background:

Coronavirus disease 2019 (COVID-19) pandemic-related refocusing of healthcare along with needs for social distancing, complete or partial lockdowns, and burgeoning economic crisis has created immense barriers to the access of healthcare services by the non-COVID patients.

Aim:

We aimed to assess the perspectives of Indian healthcare workers taking care of pediatric patients on the barriers to healthcare delivery to pediatric non-COVID illnesses.

Methods:

Indian healthcare workers, working in both public and private sectors, taking care of pediatric patients were surveyed using a predesigned pretested online questionnaire over a period of 1 month (May 2020). The impact on healthcare delivery was graded using a Likert scale.

Results:

Of the total of 356 responses obtained, 75.3% reported a significant negative impact of the COVID-19 pandemic on delivery of healthcare to non-COVID pediatric patients. Respondents of government and COVID hospitals reported a significantly worse impact than private (P = 0.0002) and non-COVID hospitals (P = 0.01), respectively. Significant decline in number of non-COVID patients attending outpatient department (86.2%), admitted in wards (71.6%), number of routine (81.7%) and emergency surgeries (60.5%), number of diagnostic procedures (61.2%), and scheduled therapies (50.2%) was reported by the surveyed healthcare workers. Most important factors for disrupted healthcare delivery were restricted travel (78.3%) and fear of contracting COVID-19 (68.8%). Telemedicine (67.4%) was the commonest alternate strategy deployed for continuing care of patients.

Conclusion:

Several challenges exist to maintain the continuity of healthcare services to pediatric non-COVID patients especially in those with chronic diseases, poor financial background, and follow-up in COVID government hospitals. Use of telemedicine, strategic preplanning, strengthening peripheral healthcare, and optimal resource reallocation may help reduce the broader health impact of the COVID-19 pandemic.
Use of Online Learning in Medical Education Delivery
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2024

In the current era, information technology has found its scope and application across all the streams and the same applies to the field of medical education and health care industry. The emergence of the coronavirus disease-2019 pandemic has significantly affected the delivery of the medical curriculum. The adoption of online learning in medical institutions has neutralized the issue of accessibility and has enabled the teachers to continue the process of facilitation of learning. Regardless of the multiple merits that can be attributed to online learning, it has its inherent limitations and thus has to be supplemented by the conventional teaching-learning. Considering the multiple competencies that a medical student should acquire and the complexity of the medicine stream, the best approach will be to use online learning as an approach to supplement learning. It will be ideal to continue online learning till conventional learning becomes a feasible option, and then integrate the best aspects of online learning with face-to-face learning to simultaneously meet the varied needs of medical students. In conclusion, online learning has its own pro and cons, and the best approach is to use the technology for ensuring effective learning among medical students. This will essentially require adequate faculty development along with the necessary support from the administration and the technical team.
A Giant Angiolipoma
Authors: Aggarwal Vaibhav , Kumari Suneha , Kataria Kamal , Goyal Ankur
Published: May 2024

Angiolipomas are uncommon benign vascular adipocytic mesenchymal tumors and generally present as painful subcutaneous nodules in the extremities and trunk. Chest wall is a rare site for angiolipoma. We describe a case of a giant retromammary angiolipoma that presented clinically as an apparent large breast lump. This tumor was surgically excised after preoperative angioembolization. Latter was carried out to reduce intraoperative bleeding and facilitate the excision. We recommend keeping benign tumors such as angiolipomas in differential when dealing with apparent breast/chest wall lumps. We also advocate preoperative angioembolization in select cases while excising large angiolipomas to decrease perioperative blood loss.
How Do Residency Match Applicants Fight Battle Against COVID-19 Storm?
Authors: Aggarwal Vaibhav
Published: May 2024

Every year thousands of domestic and international medical graduates apply for a residency spot in the United States. This communication is an effort to qualitatively measure and describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on the United States residency match application process. This communication tries to perceive a medical graduate who faces the challenges of being a health worker and an examinee at the same time. It is meant for international United States Medical Licensing Examination (USMLE) aspirants to apprise them of the changes that have taken place in the USMLE examinations as a result of the COVID-19 pandemic and advise on how to overcome the difficulties.
Effect of Lateral Positioning on Oxygen Levels in an Obese, Critically Hypoxic COVID-19 Patient
Authors: Saseedharan Sanjith , Patil Shalaka , Kene Gauri , Yadav Ashish , Bagade Rujuta
Published: May 2024

COVID-19 is an infectious disease caused by SARS-CoV-2 virus. COVID-19 patients can develop a severe disease that can lead to hypoxic respiratory failure and acute respiratory distress syndrome (ARDS), which requires mechanical ventilation, prone ventilation, and salvage therapy like extracorporeal membrane oxygenation. The COVID lung is a hypoxic lung with myriad of reasons of hypoxia including poor ventilation perfusion mismatch and atelectasis. We present a case report of a morbidly obese individual managed with lateral positioning as a salvage for deteriorating PaO2/FiO2 ratio. We also demonstrated that the improvement of oxygenation was due to the recruitment of previously nonventilated lung areas as demonstrated by electrical impedance tomography (EIT). Our patient was morbidly obese and there was a dearth of man power to perform the prone position on this patient. Moreover, the sheer weight of this patient prevented us from trying the prone position. Hence, this patient was placed in a cycle of left lateral, right lateral, and supine position for 120 minutes each for the subsequent 24 hours. Significant improvement in oxygenation and ventilation was noticed in the EIT and SpO2 measurements. The EIT reading indicated ventilation redistribution to previously collapsed areas of the lung and this change persisted even when the patient was turned supine due the application of positive end expiratory pressure (PEEP) to maintain positive expiratory transpulmonary pressure. These results provide evidence of effectiveness of a lateral positioning in the improvement of oxygenation in COVID-19 ARDS.
A Study on Prevalence of Depression Among Health Care Workers of a Tertiary Care Center in Northern India During Covid-19 Pandemic
Authors: Gupta Vikesh , Singh Sukhjit , Kumar Vineet , Kanwar Pankaj
Published: May 2024

Background:

COVID-19 pandemic has given rise to a diverse set of problems related to mental health, employment, economic wellbeing, access to education, inflation, transportation, and vaccination in addition to physical health consequences. Health care workers (HCWs), being in forefront of providing care to COVID-19 patients, are a special vulnerable population suffering from COVID-19-related mental health problems.

Method:

A cross-sectional study to assess the prevalence of depression among HCWs working in different specialties of a tertiary care health center of Northern India was done. A self-designed performa containing sociodemographic details along with the “Zung self-rating depression scale” was used to obtain the prevalence of depression among HCWs.

Result:

Among 192 participants, 14.58% had signs of depression, out of which 11.96% had mild, 1.56% had moderate, and 1.04% had signs of severe depression.

Conclusion:

The depression among HCWs has increased after the onset of the COVID-19 pandemic.
Effect of Chronic Urinary Retention over Serum Prostate-Specific Antigen and Its Role in Histopathological Diagnosis
Authors: Verma Sahil , Sarpal Rajeev , Agarwal Shikhar , Kim Mammen Jacob
Published: May 2024

Background:

Prostate-specific antigen (PSA) rises in all types of retentions and also in carcinoma prostate. The raised levels of PSA levels due to urinary retention may raise a false suspicion of carcinoma prostate in these patients. Unlike chronic urinary retention (CUR), the effect of acute urinary retention (AUR) on serum PSA levels had been studied in detail as evident from the past literature.

Objectives:

The objectives of the study were first to estimate and interpret serum PSA levels in adult males with CUR due to prostatic pathology, second to assess the need of taking prostatic biopsy based on the studied PSA trends, and finally to assess the prostatic histopathology in cases of persistently high PSA levels after 6 weeks.

Materials and Methods:

This was an observational follow-up study including 41 patients diagnosed with CUR due to prostatic etiology, matching the inclusion and exclusion criteria. On presentation, serum PSA levels were recorded. Retention was relieved by either per urethral catheterization or suprapubic catheterization. PSA levels were recorded after 24 hours, 1 week, 3 weeks, and 6 weeks and PSA trends were noted. Prostatic biopsy was advised for only those subjects in whom PSA did not attain the baseline value of 4 ng/mL within 6 weeks. The histopathological report of the biopsy was followed in each patient for studying its association with PSA trends.

Results:

Mean PSA at the time of presentation was 17.92 ng/mL. PSA trends showed that in the majority of the patients “Suspected benign group” (80.49%, n = 33), PSA returned to <4 ng/mL within 6 weeks of catheterization. Six patients, the “Borderline group” (14.63%), showed a downtrend in their PSA trends but could not attain baseline value. PSA trends in only two patients, the “Suspected malignant group” (4.87%), showed a comparative constant or an uptrend. All patients in the “Suspected benign group” and a majority of the “Borderline group” patients (83.33%) had a histopathologically confirmed benign prostatic pathology. Out of the two highly suspected malignant cases, only one patient (50%) had carcinoma prostate on final histopathology.

Conclusion:

PSA rises mainly in carcinoma prostate, but it falsely rises in all urinary retentions. The relationship between AUR and PSA had been studied in detail as evident from the past literature but needs to be established in patients with CUR. A period of 4 to 6 weeks can be safely employed for waiting for PSA to fall back to normal in CUR. A biopsy is required only for patients in which PSA is constantly high to rule out carcinoma prostate.
Anesthesia Concerns and Management in Case of Severe Hemophilia A
Authors: Jamgade Deepali , Kantha Manasa , Agrawal Sanjay , Chattopadhyay Debarati , Nath Uttam K.
Published: May 2024

Hemophilia is a genetic disease presenting with increased chances of perioperative bleeding. Preoperative recognition, assessment of risk, and careful titration of factor VIII transfusion are important for anesthesia management and decrease of morbidity. Here we present a case of severe hemophilia with an open wound of the knee scheduled for flap rotation and cover.
Use of Students’ Learning Outcomes as a Tool for Changing Teaching Content and Methodology
Authors: Naeem Syed Shariq , Roy Vandana
Published: May 2024

Objectives:

Assessment of student's learning outcomes in alignment with the teaching goals can be a tool for modification of curriculum and teaching methods. This study was conducted to evaluate the impact of a pharmacology curriculum on students’ learning outcomes and the use of their assessment as a tool for making curriculum changes.

Materials and methods:

An assessment of the students’ (exiting 2014) knowledge and skills at the end of their fifth semester training in pharmacology was carried out using a questionnaire that was developed to accommodate testing of all areas which are underlined in the Medical Council of India's goals and objectives of teaching pharmacology to MBBS undergraduates at the time of designing of the study. Areas where lesser than 50% students scored well were identified for educational interventions with the next two batches of students (2015, batch B and 2016, batch C), who were then subjected to the same assessment.

Results:

Based on the learning outcomes, 15 areas were identified for educational interventions with batch 2015. Improvement in learning outcomes of students was observed in 10, ranging from 10% to 15% in batch 2015, whereas in batch 2016, an improvement of 20% was observed in three questions and >10% was observed in six questions. Overall improvement in the intervention questions was 60% (+9 questions) in batch 2015 and 80% (+12 questions) in batch 2016 when compared with preintervention batch 2014. The preintervention batch 2014 scored better overall than the intervention batches 2015 and 2016.

Conclusions:

Changing teaching content and method, based on assessment of students’ learning outcomes alone, may not translate into an improvement in students’ learning outcomes. Teachers must look for other factors that can impact students’ learning.
Kienbock’s Disease with Volar Intercalated Segment Instability
Authors: Arora Sumit , Sankaran Ajeesh , Dhal Anil
Published: May 2024

The etiology of avascular necrosis of the lunate (Kienbock disease) remains unclear despite long clinical experience. Very rarely, it may be associated with carpal instability. We describe a case of 45-year-old female who had Kienbock disease with associated volar intercalated segment instability, detailing how the radiographic features can often cause a dilemma in the staging and management of this enigmatic problem.
Perspective of Medical and Dental Students and Teachers Toward Online Teaching in Pharmacology During Covid-19 Pandemic
Authors: Kumar Sahil , Tayal Vandana , Akhtar Razi , Chawla Shalini , Roy Vandana
Published: May 2024

Introduction:

In the light of the disruption caused by the coronavirus pandemic on medical education systems worldwide, several institutions switched to online mode of teaching-learning. Therefore, this study was planned to evaluate the perception, difficulties faced, and preference of second year medical/dental students and their teachers toward the online learning and live-streamed lectures during the COVID-19 pandemic.

Methods:

This was a cross-sectional, questionnaire based observational study. Data were collected by administering pretested, self-administered, online circulated, structured questionnaire via Google Forms. Descriptive statistics were used to summarize the study results.

Results:

In this study, 198 and 77 responses were obtained from MBBS and BDS students, respectively, and 14 responses from their teachers. Most students agreed that it was a good idea to conduct online teaching during lockdown. Majority of the students were able to adapt even without previous experience. “GoToWebinar” and “Cisco Webex” were reported as good online teaching platforms. Smart phones or tablets were most commonly used to attend classes. Major challenges reported were related to lack of skills, interest, attention, time management, resources (including internet connectivity), and poor communication among others. The students felt that the optimum duration of lectures should be 30 to 45 minutes. Majority of students and teachers alike felt that online teaching is a good option to be adopted for repeat classes or to gain extra knowledge in the future. Overall rating of online teaching (out of 10) was reported as good by both students (MBBS students mean score: 7.49 ± 1.57) and teachers (mean score: 7 ± 1.58).

Conclusions:

The situation arising out of the pandemic gave rise to a situation where online resources had to be used for teaching. The shift of medical education to online platforms presented a spectrum of issues for educators and students alike. It would be worth considering addressing these issues, so as to strengthen electronic learning processes in the institute.
Perception of Medical Faculty and Students About Online Teaching During the Covid-19 Pandemic in a Tertiary Care Teaching Institute
Authors: Maheshwari Nidhi , Kalra Bhupinder Singh , Roy Vandana
Published: May 2024

Background:

Classroom teaching has been found to be the most common modality used for teaching. The unusual situation of the coronavirus disease 2019 (COVID-19) pandemic led to the shutdown of all educational institutions across the country. To limit the spread of the coronavirus, classroom teaching had to be abandoned and online teaching was sought for to continue the learning process. The study was conducted with the aim of assessing the perception of faculty as well as undergraduate medical students toward online teaching and learning methodology.

Methods:

A cross-sectional observational study using two separate pretested, structured questionnaires for faculty and students was conducted. The questionnaire had a total of 45 questions for collecting data on demographic information, awareness, perception and knowledge toward online teaching, perception about establishing connect between teachers and students through online portal, and operational and technical aspects. These questionnaires were mailed to faculty and students using Google forms (Google Survey platform).

Results:

A total of 47 teaching faculty and 386 students responded to the questionnaires. More than 70% faculty availed the training and guidance provided for online teaching. The move to switch over to online mode of teaching during lockdown was appreciated by majority (95%) of respondents. The faculty members made use of online polls, surveys, and educational videos for making online lectures interesting. In addition, online assessments (72%) and use of an interactive software (70%) were found worthy and useful. Majority of (80%) students missed direct and in person contact with instructor. Majority of the students (60%) felt isolated and alone during online teaching sessions. One-third of the students believed that instructors were able to generate interest in the topic and 63% of students were satisfied with the explanations delivered with regard to queries during online lectures. The major disadvantages that surfaced were limited options for two-way communication (55%), technical glitches (70%), social isolation (63%), eye strain, and other health-related issues (62%). Internet connectivity emerged as the biggest limitation by faculty members.

Conclusion:

Overall, the respondents were of the opinion that online teaching was a useful modality during COVID-19 and can be used as a complementary aid to regular teaching in. Adequate infrastructure and uninterrupted internet connectivity is vital for smooth conduct of online teaching.
Kikuchi Disease
Authors: Garg Ankur , Choudhary Prashant , Chandra Mithilesh , Singh Devendra Kumar
Published: May 2024

Kikuchi–Fujimoto disease, also known as “histiocytic necrotizing lymphadenitis,” is a rare, benign disease that commonly affects young females. Patient usually presents with swollen lymph nodes in neck (cervical lymphadenopathy), fever, night sweats, weight loss, nausea, and vomiting. Due to the similar symptomatology, the disease is often confused with tuberculosis and lymphomas. The exact cause remains unknown with no evidence of inheritance. The diagnosis is confirmed by histopathologic examination of lymph node biopsy, which reveals necrosis (that varies considerably from one case to another), histiocytes (contains phagocytosed debris), crescentic nuclei, karyorrhexis, and plasmacytoid monocytes. The disease is self-remitting within 1 to 4 months. However, nonsteroidal anti-inflammatory drugs (NSAIDs), oral corticosteroids, and hydroxychloroquine may be used for symptomatic relief.
Moebius Syndrome
Authors: Ramraika Divya , Kumar Pradeep , Chowdhury Bithi
Published: May 2024

We report a case of a 13-year-old female who presented in the medical emergency with seizures and was referred to the ophthalmology department for fundus examination. On examination, she was found to have bilateral asymmetric VIth and VIIth nerve palsy, bilateral horizontal gaze paresis (right > left), tongue atrophy, mask-like face, normal intelligence, prominent lower lip, and history of treated club foot. She was diagnosed to have Moebius syndrome based on the above findings. She also had some atypical features such as head tilt, significant refractive error, anisometric amblyopia, and horizontal nystagmus. Her computed tomography scan of the head revealed neurocysticercosis.
False Positive Reaction to Vdrl Test with Prozone Phenomenon in a Case of Lepromatous Leprosy
Authors: Chawla Rohit , Thakur Preeti , Mohan Kochhar Atul , Singla Sumeet
Published: May 2024

The venereal disease research laboratory (VDRL) test, a nontreponemal test for syphilis, may under a certain set of conditions give false positive results in patients who are not infected with Treponema pallidum. A false positive reaction is defined as a positive reaction to nontreponemal tests, and a negative reaction to treponemal tests, in the serum of a patient who has no history or clinical evidence of syphilis or other treponematosis. A prozone phenomenon in nontreponemal tests is seen largely with secondary syphilis due to high-titer samples that show nonreactive results unless the specimens are diluted. We report here perhaps the first case of lepromatous leprosy, which had a false positive reaction to the VDRL test with the prozone phenomenon. The case initially presented to the outpatient clinic with complaints of epistaxis with nasal stuffiness. The finding of septal perforation on nasal endoscopy is what led to the initial suspicion of syphilis and the subsequent syphilis workup. It was only when the false positive reaction to VDRL test with the prozone phenomenon was noted that the search for other causes was made, which eventually lead to the diagnosis of lepromatous leprosy.
Quality of Life of Health Care Professionals During Covid-19 Pandemic in India
Authors: Kaur Banipreet , Aggarwal Yash , Bhatnagar Nidhi , Singla Sumeet
Published: May 2024

Introduction:

Nature of disease, poor working conditions, prolonged work duration, stigma, and discrimination in the community have worsened the well-being of health care professionals in COVID-19. This survey is conducted to understand the quality of life and its key determinants among health care workers (HCWs) during the COVID-19 pandemic in a low middle-income country like India.

Methodology:

A cross-sectional study using a Google form-based online questionnaire survey was planned at two COVID dedicated centers of New Delhi. A convenience sample of 300 HCWs involved in patient care at the study sites was studied using an SF-36 questionnaire for quality of life assessment and a self-made questionnaire (risk exposure assessment).

Results:

In the study, 61.0% were males and 40.72% were females across all specialties. The majority (77%) were single and 81.4% were from the age group of 20 to 30 years. 84% of the study subjects belonged to clinical specialties. Nearly 56% of study subjects reported being not satisfactory or uncomfortable in the personal protective equipment (PPE). Shortage of PPE was reported by 10% of study subjects. The majority (82.35%) of study subjects were satisfied with the quality of PPE. Satisfaction of the study subjects was less than satisfactory among food provided, accommodation, and transport facilities. Social isolation (70.5%) and lockdown restraints (57.6%) were reported by the majority of study subjects. The median score for the domain of general vitality was 55, for the emotional domain was 33, and for social was 62. The domains of quality of life were not significantly affected by place of work, discipline, age, sex, and type of work.

Conclusion:

The overall well-being of HCWs was affected during the pandemic mostly across mental, social, and general vitality domains. Social isolation was a key concern reported by the majority of HCWs.
Pseudoaneurysm of Mitral-Aortic Intervalvular Fibrosa – A Case Report
Authors: Praveen C.H. , Chhotu Shaikh Mohammed Husain , Roy Arindam , Desai Neelam Bipinchandra
Published: May 2024

Pseudoaneurysm of mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare, well-known entity with few cases reported in the literature. We here present a case report of repair of large P-MAIVF that was successfully managed. Postoperatively patient had an uneventful course and patient was asymptomatic at 3rd month follow-up. The cause of P-MAIVF could be an atheromatous ulcer at interleaflet trigone with severely calcified aortic valve as in our case. Even if the imaging and diagnostic modalities are inconclusive, a strong suspicion should be made preoperatively in the presence of abovementioned combination for better preparedness to improve the outcome of surgery.
Tubercular osteomyelitis as scalp swelling and alopecia areata
Authors: Bhatia Anjali , Verma Pushpendra , Singh Ashok K.
Published: May 2024

Tuberculosis (TB) is a well-known endemic disease in developing countries. It continues to be one of the major causes of death and disability in such countries. However, extrapulmonary TB is less common than pulmonary TB. Skeletal TB constitutes about 1% of all tubercular cases. Tubercular osteomyelitis of skull is a rare entity. The most common sites affected are the frontal and parietal bones with destruction of both the inner and outer table. We hereby report a young male presenting to us with scalp swelling in the left frontal region with loss of hair in surrounding areas and in left temporal region. NCCT head was suggestive of osteolytic lesion in frontal bone on left side with accompanying periosteal reaction, consistent with osteomyelitis. In Gene Xpert of pus drained from the swelling, Mycobacterium tuberculosis was detected. Patient was started on Antituberculous treatment, and subsequently improved.