bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitreous substitutes and tamponades – A review of types, applications, and future directions
Authors: Shettigar Manoj P , Dave Vivek Pravin , Chou Hung-Da , Fung Adrian , Iguban Eleonore , March de Ribot Francesc , Zabala Camille , Hsieh Yi-Ting , Lalwani Geeta
Published: July 2024

Vitreous substitutes and tamponades occupy the vitreous cavity following vitrectomy in the management of various conditions such as retinal detachment, macular hole, and diabetic retinopathy. Such replacements can be for the short term (gases such as sulfur hexafluoride (SF6) and perfluoropropane (C3F8) or long term (such as silicone oils). Certain substitutes such as perfluorocarbon liquids are used only transiently during surgery as “a third hand” or rarely till a few days post surgery. Hydrogels and hyaluronan derivatives are among the newer vitreous substitutes that are showing promise for the future, albeit still under investigation. still being investigated for use as vitreous substitutes. These materials have properties similar to the natural vitreous and may offer advantages such as improved biocompatibility and biodegradability. Although vitreous substitutes are valuable tools in treating vitreoretinal conditions, they carry risks and potential complications such as cataract formation, glaucoma, and inflammation. The current communication extensively reviews the available literature on vitreous tamponades. It details the composition and properties of various vitreous substitutes and tamponades available for the clinician, highlighting the techniques of usage, indications, and limitations.
Electroretinographic changes in the inner and outer retinal layers before and after intravenous chemotherapy for retinoblastoma
Authors: Kannan Kiruthika , Jethva Dishank , Parameswarappa Deepika C , Kaliki Swathi , Raval Vishal
Published: July 2024

Purpose:

To study the inner and outer retinal functions using a full-field electroretinogram (ERG) before and after intravenous chemotherapy (IVC) in children with retinoblastoma (RB).

Methods:

Of the 11 eyes, seven had RB and four were normal. All children were examined under anesthesia using a handheld ERG machine with a standard protocol – light-adapted single-flash ERG (fERG), photopic single-flash 3.0- and 30-Hz flickers, and photopic negative response (PhNR) amplitudes at 72 ms (P72). The amplitudes and peak times were compared before and after IVC.

Results:

Post-chemotherapy tumor regressed in all seven eyes. Of the seven eyes, the fERG peak time (a-wave) was delayed in two eyes (29%), whereas the b-wave was delayed in six eyes (86%). The fERG amplitude height for a- and b-waves decreased in five eyes (71%) and six eyes (86%), respectively. In addition, photopic flicker 30-Hz b-wave peak time delayed in five eyes (71%), whereas the b-wave amplitude height decreased in six eyes (86%). Simultaneously, the P72 amplitude height decreased in six eyes (86%), whereas the P-ratio increased in all seven eyes (100%). In comparison, the ERG responses improved in three of the four contralateral normal eyes. Overall, the cone function improved in two eyes (29%), whereas cone bipolar cell and retinal ganglion cell (RGC) function improved in one eye (14%) each.

Conclusion:

Comparison of light-adapted ERG changes before and after IVC showed reduced amplitudes and delayed peak times for both a and b waveforms, as well as reduced PhNR amplitude attributable to bipolar and RGC injury.
Comparison of intraocular lens power prediction by American Society of Cataract and Refractive Surgery formulas and Barrett True-K TK in eyes with prior laser refractive surgery
Authors: Shetty Naren , Sathe Priyanka , Aishwarya  , Francis Mathew , Shetty Rohit
Published: July 2024

Purpose:

To evaluate the prediction accuracy of various intraocular lens (IOL) power calculation formulas on American Society of Cataract and Refractive Surgery (ASCRS) calculator and Barrett True-K total keratometry (TK) in eyes with previous laser refractive surgery for myopia.

Methods:

This retrospective study included eyes with history of myopic laser refractive surgery, which have undergone clear or cataractous lens extraction by phacoemulsification followed by IOL implantation. Those who underwent uneventful crystalline lens extraction were included. Eyes with any complication of refractive surgery or those with eventful lens extraction procedure and those who were lost to follow-up were excluded. Formulas compared were Wang–Koch–Maloney, Shammas, Haigis-L, Barrett True-K no-history formula, ASCRS average power, ASCRS maximum power on the ASCRS post-refractive calculator and the IOLMaster 700 Barrett True-K TK. Prediction error was calculated as the difference between the implanted IOL power and the predicted power by various formulae available on ASCRS online calculator.

Results:

Forty post-myopic laser-refractive surgery eyes of 26 patients were included. Friedman’s test revealed that Shammas formula, Barrett True-K, and ASCRS maximum power were significantly different from all other formulas (P < 0.00001 for each). Median absolute error (MedAE) was the least for Shammas and Barrett True-K TK formulas (0.28 [0.14, 0.36] and 0.28 [0.21, 0.39], respectively) and the highest for Wang–Koch–Maloney (1.29 [0.97, 1.61]). Shammas formula had the least variance (0.14), while Wang–Koch–Maloney formula had the maximum variance (2.66).

Conclusion:

In post-myopic laser refractive surgery eyes, Shammas formula and Barrett True-K TK no-history formula on ASCRS calculator are more accurate in predicting IOL powers.
Optical coherence tomography characteristics and prognostic predictors of acute macular neuroretinopathy following SARS-CoV-2 infection
Authors: Huang Ying , Sun Zuhua , Li Yingzi , Huang Shenghai , Zhou Rong , Yang Chun , Lin Bing
Published: July 2024

Purpose:

To analyze the characteristics of optical coherence tomography in acute macular neuroretinopathy (AMN) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and discuss the prognostic predictors.

Methods:

Patients with AMN following SARS-CoV-2 infection were divided into two groups according to the presence or absence of hyperreflective outer nuclear layer (ONL) lesion involving the fovea.

Results:

The first visit included 14 eyes in the fovea-involved group and 20 eyes in the no fovea-involved group. Ellipsoid zone (EZ) hyporeflection and interdigitation zone (IZ) interruption were detected in all eyes. Other common manifestations were myoid zone (MZ) hyperreflection (76.5%), ONL hyperreflection (73.5%), outer plexiform layer (OPL) thickening (64.7%), and EZ interruption (50%). The follow-up period was 48.4 ± 55.3 days. At the last visit, 12 eyes were in the fovea-involved group and 13 eyes in the no fovea-involved group. IZ interruption was detected in all eyes. Other common manifestations were EZ hyporeflection (92.0%), ONL atrophy (40.0%), OPL thickening (36.0%), OPL linear (32.0%), and MZ hyperreflection (32%). The improvement of visual acuity (VA) was -0.5 ± 0.5 and -0.2 ± 0.4 in the fovea-involved group and the no fovea-involved group, respectively, with a statistically significant difference between them (P = 0.045). Initial VA, initial cotton wool spot, initial ONL cyst, final ONL cyst, and final OPL linear were associated with final VA (P = 0.000, P = 0.029, P = 0.044, P = 0.049, P = 0.049, respectively).

Conclusions:

In the early stage of AMN following SARS-CoV-2 infection, IZ interruption and EZ hyporeflection were the most common manifestations, and pathology of IZ was more serious than that of EZ. Subsequently, OPL and ONL atrophied, and ONL atrophied faster. Regardless of whether hyperreflective ONL involved the fovea, VA improved, with a more noticeable improvement found in the fovea-involved group. The presence of initial ONL cyst and initial cotton wool spot, rapid atrophy of OPL, and poorer initial VA indicating poorer VA outcome.
Outcomes of keratoplasty in a cohort of Pythium insidiosum keratitis cases at a tertiary eye care center in India
Authors: Acharya Manisha , Singh Aastha , Nidhi Vatsala , Tiwari Anil , Gandhi Arpan , Chaudhari Isha
Published: July 2024

Purpose:

To assess outcomes of keratoplasty performed in patients diagnosed with keratitis caused by Pythium insidiosum (PI).

Design:

Retrospective review.

Methods:

Preoperative, intra operative and post operative data of patients diagnosed with PI keratitis and who underwent keratoplasty for their condition from January 2020 to December 2021 were collected from the central patient database of a tertiary eye care hospital in India. The data were analyzed for anatomic success, elimination of infection, graft survival, incidence of repeat keratoplasty, final visual acuity and varied complications.

Results:

In total, 16 eyes underwent penetrating keratoplasty for PI keratitis during the study period. Mean time to keratoplasty from onset of symptoms was 31.3 days and mean graft size was 10.4 mm. Nine out of the 16 cases had recurrence of infection following surgery, seven of which required a repeat keratoplasty for elimination of infection. Mean graft size for repeat keratoplasty performed in recurrent cases was 11.7 mm. Globe was successfully salvaged in 14 out of 16 patients (87.5 %). Three grafts remained clear at 6-month follow up while 11 grafts failed. Mean improvement in uncorrected visual acuity from 2.32 to 2.04 logMAR was observed at last follow up. Endo-exudates, graft infiltration, graft dehiscence, secondary glaucoma and retinal detachment were the various complications noted after keratoplasty.

Conclusion:

PI keratitis is a tenacious and potentially blinding condition. Keratoplasty remains the choice of treatment in this condition, however recurrence of disease and graft failure are common. Large sized grafts, meticulous per-operative removal of infection, adjuvant cryotherapy, and intraoperative and post operative use of antibiotics can help in improving outcome of keratoplasty in these patients.
Tear meniscus particle analysis with anterior segment optical coherence tomography in keratoconus
Authors: Seyyar Sevim Ayca , Büyükbayram Şaban , Soysal Gizem Gürbostan , Ayla Serhat , Doğan Levent , Tokuç Ecem Önder , Mercanlı Murat , Mete Alper
Published: July 2024

Purpose:

To perform tear meniscus particle analysis using anterior segment spectral domain-optical coherence tomography (SD-OCT) and ImageJ software in keratoconus patients.

Methods:

A total of 76 participants (76 eyes) were included in the study. A comprehensive analysis of tear meniscus parameters, including tear meniscus height (TMH), tear meniscus depth (TMD), tear meniscus turbidity (TMT), and percentage of area occupied by particles (PAOP) within the meniscus, was performed in kerataconus patients and healthy controls.

Results:

TMT was significantly higher in the keratoconus group, while PAOP was significantly lower (P < 0.05). However, TMH and TMD did not show significant differences between the two groups (P > 0.05). There was a negative correlation observed between TMT and PAOP. In binary logistic regression analysis, TMT and Schirmer score were found to be the most influential factors in predicting keratoconus (odds ratio [OR] = 0.995, P = 0.039 and OR = 1.143, P = 0.021, respectively).

Conclusion:

This study revealed novel findings on analysis of the tear film in keratoconus patients, with higher TMT and lower POAP levels in the keratoconus group compared to the healthy control group.
To compare horizontal strabismus deviation as assessed from photographs with that in the strabismus clinic using the prism bar
Authors: Bose Aparna , Amitava Abadan Khan , Gupta Yogesh , Sharma Nikita , Raza Syed Aisha , Masood Anam , Singh Ramprakash , Meena Gangasagar
Published: July 2024

Purpose:

To compare the deviation in cases of horizontal strabismus as assessed from photographs with the measurements as obtained in the strabismus clinic.

Methods:

After obtaining informed consent, we recruited subjects with manifest horizontal strabismus. We took a frontal flash photograph from a distance of 50 cm using smart-phone-based cameras with the flash light vertically aligned with the lens. After projecting the photograph on a laptop and using a vernier caliper, we measured the horizontal corneal diameter of the non-strabismic eye and the decentration of reflex in the strabismic eye taking limbus as the reference point. We converted these values to degrees by using a conversion factor of 7.5°/mm and further to prism diopters (PD) by the standard mathematical formula 100*tanθ.

Results:

We included 74 subjects aged between 5 and 40 years with manifest horizontal deviation from 20 to 85 PD. We found a statistically significant correlation of 82.6% (P value < 0.001) between the clinic and photographic measurements. Agreement analysis suggested that the photographic measurements measured on average 7 PD less (95% confidence interval: 4.6 to 9.2) than clinical measurements along all values of misalignment, although the difference between the two methods decreased as the quantum of deviation increased. Linear regression revealed an r2 of 68% and provided a predictive equation to derive clinic equivalent measurements from photographic estimates.

Conclusion:

We believe our simple method provides robust evidence that a photographic estimation can provide the basic information of the size of the deviation to plan possible surgeries, especially in situations of a tele-consultation. This is an easy approach to both understand and master and should form the armamentarium of most orthopticians and strabismologists.
Excess of high-caffeinated energy drinks causing ventricular arrhythmias
Authors: Walia Rohit , Kaur Sirat
Published: July 2024

ABSTRACT

A young male patient had palpitations after consumption of few high caffeinated energy drinks which he took after his office hours to relieve fatigue. He immediately seeked medical help. Electrocardiogram showed multiple runs of non-sustained ventricular tachycardia and ventricular bigeminy and trigeminy. Echocardiography was normal. The patient was admitted to intensive care unit and treated with anti-arrhythmic drugs to which the arrhythmias responded and subsided. Cardiac magnetic resonance imaging of heart did not reveal any structural heart abnormality and treadmill stress test was negative ruling out significant coronary artery disease. High caffeinated energy drinks can produce serious ventricular arrhythmias if taken beyond safe doses. These ventricular arrhythmias are known to be causative factor for sudden cardiac arrest and therefore a caution & regulation is needed in widespread unrestricted used of these drinks.
Effect of protein supplements on cardiovascular health and exercise performance of young adult males
Authors: Khandelwal Ekta , Chawali Krishna Dutt , Bhavya S
Published: July 2024

ABSTRACT

Introduction:

The modern fitness culture, propelled by celebrity influence and media exposure, has led to widespread acceptance and consumption of protein supplements, particularly among young adult males aspiring for an ideal physique. Despite the surge in usage, limited research has explored the impact of these supplements on cardiovascular health and exercise performance. This study aims to bridge this gap by clinically examining the cardiovascular system using heart rate variability (HRV) and comparing outcomes between those using protein supplements and a control group.

Methodology:

This study was conducted at the Department of Physiology, AIIMS Raipur. The cross-sectional study involved 60 young adult males aged 18–25 years. Participants were divided into two groups: group I (n = 30), comprising individuals using commercially available protein supplements for a minimum of three months, and group II (n = 30) as age-matched controls. Cardiovascular assessments, including HRV analysis, were performed at rest and after the Harvard step test. Pre-exercise and post-exercise parameters were statistically analyzed, and participants in the test group provided information on supplement labels.

Results:

Participants in both groups exhibited comparable pre-exercise cardiovascular parameters. However, post-exercise results did not reveal significant variations in systolic blood pressure, diastolic blood pressure, mean blood pressure, low frequency/high frequency (LF/HF) ratio, Standard deviation of the successive differences between adjacent NNs (SDNN), and standard deviation of successive differences (SDSD) between the test and control groups. The average exercise duration for the control group was longer than that of the test group. Amino acid profiles and nutritional content varied among 13 different protein supplement brands.

Conclusion:

The study found no statistically significant positive influence of protein supplements on cardiovascular health or exercise performance in young adult males.
Evaluation of case based simulation teaching to improve the Family Medicine residents urgent care management skills at a teaching hospital
Authors: Bhombal Swaleha T. , Babar Shazia , Qureshi Asra , Zaki Samar , Jabeem Ismat , Farid Rubia
Published: July 2024

ABSTRACT

Context:

Simulation based teaching is effective strategy to allow trainees to acquire skills, develop clinical judgment and to become competent in order to manage the patients in a safe environment. The Case-based simulation improves the assessment and management skills of the trainees to prepare them as a competent physician.

Aim:

Evaluation of case based simulation teaching to improve the Family Medicine residents urgent care management skills at a teaching hospital.

Setting and Design:

An Interventional study (Pre and post design) was conducted on the residents of the Family Medicine department of the Aga Khan University hospital Karachi.

Methodology:

After getting their consent, pre intervention Objectively structured clinical examination (OSCE) was conducted at the Center for Innovation in medical education, AKUH. The scenarios were based on urgent care problems presenting in the Family Medicine setting. It was followed by the case based simulation teaching intervention by the facilitators and debriefing. The post intervention OSCE was conducted in order to assess the resident’s performance. Statistical Analysis: The data was analyzed in Stata version15 software in two stages; descriptive and inferential. In descriptive analysis frequency and proportion were calculated for categorical variables. Median and inter quartile range were reported for continuous variable. Paired T-tests were applied to compare the pre and post test results.

Results:

The resident’s scores significantly improved after case based simulation in majority of the post intervention OSCE stations proving the effectiveness of the intervention.

Conclusion:

Case based simulation is an effective teaching strategy for the learning process of the Family Medicine residents regarding the urgent care management skills. It is advised to use this strategy in the teaching and learning process of other Family medicine residency programs.
Anemia and its association with glycemia and transaminitis in patients with type 2 diabetes mellitus: A cross-sectional pilot study
Authors: Agarwal Harsh , Kapoor Gautam , Sethi Prayas , Ghosh Tamoghna , Pandey Shivam , Sehgal Tushar , Meena Ved P. , Ranjan Piyush , Vikram Naval K.
Published: July 2024

ABSTRACT

Background and Aims:

Anemia impairs glucose homeostasis, affects glycemic control, and predisposes to complications in diabetics. It correlates with oxidative stress and increases the risk of developing microvascular and macrovascular complications. However, it is an underrecognized comorbidity in diabetics. This study was conducted to assess the prevalence of anemia in diabetic patients and compare the metabolic profiles of anemic and non-anemic diabetics.

Methods:

This is a cross-sectional study, conducted among type 2 diabetes (T2DM) patients, at the outpatient clinic. Patients with chronic kidney disease (CKD), known hematological disorders, and chronic inflammatory disorders were excluded.

Results:

Of the 97 patients, 37 (38.14%) were found to be anemic (hemoglobin (Hb): male <13 g/dl, female <12 g/dl). The mean values of fasting blood sugar (FBS) in low and normal mean corpuscular volume (MCV) patients were 265.9 ± 43.7 mg/dl and 157.2 ± 7.2 mg/dl, respectively (P = 0.0026), and those of postprandial blood sugar (PPBS) were 370.3 ± 58.4 mg/dl and 226.3 ± 10.1 mg/dl, respectively (P = 0.0015). It was found that 6 (22.2%) of 27 patients with raised alanine aminotransferase (ALT) had anemia against 27 (45.8%) of 59 patients with normal ALT (P = 0.03). The mean Hb levels in patients with raised and normal ALT were 13.31 ± 2.3 gm% and 12.2 ± 2.0 gm% (P = 0.03), respectively.

Conclusions:

Blood sugar may have a direct relationship with MCV in T2DM patients. Hb tends to relate to hepatic enzymes likely due to altered dietary patterns in anemics. Further larger studies on the effect of iron supplementation and dietary habits on glycemic control and hepatic steatosis are warranted.
Epidemiological study of health profile and quality of life of postmenopausal women in the urban field practice area of a teaching medical institute in a metropolitan city
Authors: Singh Khushboo , Rawat Shalini , Dhutraj Pooja , Gokhe Seema S Bansode
Published: July 2024

ABSTRACT

Background:

Menopause is one of the most significant phases in the life of a woman which brings about various physiological changes called postmenopausal syndrome. A health programme catering to the needs of postmenopausal women is lacking in our health system.

Methodology:

A cross-sectional study was conducted in an urban health and training centre. Sample size of 171 was taken by simple random sampling. Women of age more than or equal to 45 and having 12 months of amenorrhea were enrolled in the study after obtaining their consent.

Results:

The mean age of menopause was found to be 45.31 years. In the vasomotor domain, the most common postmenopausal symptom was hot flushes (47.95%) followed by sweating (25.73%) while in the psychological domain it was seen that the most common symptom was feeling depressed down or blue (37.43%) followed by being dissatisfied with personal life, feeling anxious or nervous (36.26%) and being impatient with other people and feelings of wanting to be alone (34.50%). In physical domain, the most common symptom was ache in muscles and joints (92.98%) followed by low backache (86.55%), feeling tired or worn out (84.80%), decrease in physical strength (83.63%) and aches in the back of neck or head (81.87%). The other domain was the sexual domain in which the most common symptom was a change in sexual desire (93.57%) followed by avoiding intimacy (92.98%).

Conclusion:

It was found that the domain, most severely affecting quality of life was sexual followed by physical and psychological domain. Awareness should be created regarding the psychosocial, physical, nutritional and sexual needs of postmenopausal women.
Effect of mindfulness-based intervention on perceived stress among breast cancer patients undergoing chemotherapy
Authors: Naskar Soumi , Dixit Sanjukta , Varadharasu Sivasankari , Pattnaik Jigyansa I. , Singh Reena
Published: July 2024

ABSTRACT

Introduction:

Breast cancer is the second most prevalent disease among women in India and one of the most dangerous and lethal. Chemotherapy-treated breast cancer patients may have perceived stress, which is defined as emotions of mental or physical exhaustion that make them feel angry or anxious. Mindfulness-based intervention (MBI) gives some ideas in line with the conventional mindfulness technique.

Purposes:

(i) To assess the effect of MBI on perceived stress among breast cancer patients undergoing chemotherapy. (ii) To determine the association between perceived stress with selected demographic variables among breast cancer patients undergoing chemotherapy.

Methods:

The current quantitative pre- and postexperimental study was carried out in two oncology departments of selected cancer hospitals, Bhubaneswar. A total number of 40 breast cancer patients of perceived stress receiving chemotherapy and data were gathered by using a self-structured socio-demographic proforma and a structured Perceived Stress Scale 10. The experimental group received MBI, and a posttest was conducted on the 17th day on both the groups after 10 days of the termination of intervention. This MBI was provided to breast cancer patients for five sessions over five days continuously, each session for 45 min with mindfulness breathing exercises, progressive muscle relaxation techniques, practising meditation, and guided imagery technique.

Results:

The study findings illustrated that reduction of perceived stress among female breast cancer patients undergoing chemotherapy with (t = 2.2463) (P = 0.0306) at the P < 0.05; furthermore, there is one socio-demographic variable which had association with perceived stress that is history of psychiatric illness (χ2 = 14.1176) (P = 0.0009) and others had no association with perceived stress.

Conclusion:

MBI was an effective therapy for reducing the perceived stress of breast cancer patients undergoing chemotherapy.
Clinico-radiological and pulmonary function assessment of post-COVID-19 patients with respiratory symptoms
Authors: Behera Nilakantha , Patra Jeetendra Kumar , Dash Bijay Kumar , Pattnaik Manoranjan , Sahu Deepak , Rambhoopal Reddy Bayyaram
Published: July 2024

ABSTRACT

Background:

Respiratory symptoms may persist for several weeks following the initial coronavirus disease 2019 (COVID-19) infection. The aims and objectives were to assess the clinical symptoms, pulmonary functions, and radiological changes and to assess the cardio-vascular complications in post-COVID-19 patients.

Methods:

This observational study was conducted in the Department of Pulmonary Medicine in collaboration with the Department of Cardiology, SCBMCH, Cuttack, from March 2021 to August 2022 on 75 post-COVID-19 patients with respiratory symptoms from 4 weeks to 2 years after treatment for COVID-19 infection. Post-COVID patients having previous respiratory diseases were excluded from the study.

Results:

Among 75 patients, the most common age group was 18–30 years with a male-to-female ratio of 2.5:1. Based on O2 requirement, patients were divided into the mild symptomatic group and moderate to severe pneumonia group. The most common respiratory symptom was dyspnea, followed by cough with expectoration. Bilateral crepitations were found in 17% of cases. C-reactive protein (CRP) and D-dimer were increased in 38.6% and 32% of patients, respectively. 42.6% had abnormal chest X-ray, and the most common abnormal finding was reticular thickening. In spirometry, the restrictive pattern and mixed pattern were the predominant types documented in 49.3% and 13.3% of cases, respectively, which were significant in the moderate–severe group. Diffusion capacity of the lungs for carbon monoxide (DLCO) was performed in only 19 patients (mild group 13 and moderate–severe group 6). Twelve (63.2%) patients had abnormal DLCO. P- values were significant for RV (0.0482) and RV/TLC (0.0394). High-resolution computed tomography (HRCT) of the thorax was abnormal in 55.7% with the most common abnormalities as inter- and intra-lobular septal thickening. The left ventricular ejection fraction was preserved in all patients, with right atrium and right ventricle enlargement in 2.6% and pulmonary hypertension in 4.0% of participants.

Conclusion:

All post-COVID-19 patients having respiratory symptoms after recovery from acute COVID-19 may be referred by family care physicians to a dedicated post-COVID center for further evaluation, management, and early rehabilitation to decrease the morbidity in recovered patients. Persistent increased blood parameters like TLC, N/L ratio, RBS, CRP, and D-dimer seen in recovered post-COVID-19 patients. The long-term impact of CT findings on respiratory symptoms, pulmonary functions, and quality of life is unknown. Cardiovascular abnormalities in post-COVID-19 patients are infrequent.
Emerging role of vitamin D deficiency as a risk factor for retinal venous occlusions and need for public health measures for its prevention
Authors: Sahu Pramod Kumar , Gautam Priyanka , Das Gopal Krushna , Gogoi Priyanka , Beri Nitika , Bhatia Rahul
Published: July 2024

ABSTRACT

Purpose:

To estimate levels of serum vitamin D in patients of retinal vein occlusion (RVO) and compare with age- and sex-matched controls.

Methods:

A prospective case-control study of 54 patients of RVO and 54 age- and sex-matched attendants of patients presenting to a tertiary care hospital in Delhi was performed. Patients on vitamin D supplementations and RVO due to infective or immunological causes or patients of glaucoma were excluded. Serum vitamin D levels of all the study participants along with relevant blood investigations with history and examination were documented. Vitamin D deficiency was defined as <20 ng/ml

Results:

The mean serum vitamin D levels seen in RVO patients and the control group were 14.19 ± 5.23 ng/ml and 19.42 ± 10.27 ng/ml, respectively (P value = 0.001) with an odds ratio of 10.558 (CI = 2.34–47.50), indicating vitamin D deficiency to be strongly correlated with RVO. Maximum patients of RVO (46.3%) were seen during the winter season. The study noted hypertension [odds ratio 20.22 (CI = 5.812–70.347)], dyslipidemia, and anemia [odds ratio 4.107 (CI = 0.62–26.90)] to be the risk factors for RVO as previously proved in the literature. Smoking, diabetes, alcohol intake, and body mass index did not emerge as risk factors for RVO.

Conclusion:

Vitamin D deficiency is associated with RVO; hence, estimation of serum vitamin D levels should be advised as a part of routine investigations while looking for the cause of RVOs. Public health measures like food fortification with vitamin D micronutrients and public awareness towards increased sunlight exposure in the community are simple, inexpensive measures that can decrease the burden of sight-threatening disease of RVO in the community.
How safe is Autheem therapy for young Saudi infants? A question worth asking
Authors: Bin Alamir Abdulrahman Ahmed , AlShammari Alanoud M. , Almutairi Maram M. , Aldhafiri Hamad J. , Alnasser Yossef
Published: July 2024

ABSTRACT

Background:

In Saudi Arabia, a traditional therapy for a folk labeled problem known as “Autheem –

JOURNAL/jfmpc/04.03/01697686-202413080-00056/inline-graphic1/v/2024-08-14T134557Z/r/image-tiff

” is often offered to infants. The procedure involves manipulating an infant’s soft palate to alleviate pain associated with infant colic and poor feeding. However, concerns remain about this procedure’s impact on infant health and its potential to transmit infections. This study focused on perceptions that Saudi mothers hold about Autheem therapy.

Methods:

A descriptive, cross-sectional, community-based study was conducted via an online platform to reach Saudi mothers in the Riyadh region of Saudi Arabia.

Results:

Five hundred and thirty-six Saudi mothers participated; half were older than 30 years of age. Despite a high rate of college degree attainment, the majority of mothers relied on their elders as a source of information (88.4%). Autheem was viewed to be a stand-alone disease by 86.5% of respondents; 71.4% believed it could not be treated with modern medicine. Most infants were under six months of age when they received Autheem therapy (72%). Roughly 13% of mothers found that their infant had a fever after the therapy; we found an association between Autheem therapy and viral illnesses. About 13% of mothers altered their child’s vaccination schedule after Autheem therapy.

Conclusion:

Older mothers have more positive attitudes towards and stronger beliefs in Autheem therapy than younger mothers. The therapy’s strong association with viral illnesses and its negative impact on vaccination schedules are major public health concerns.
Pattern of occupational lung disease among industrial workers attending a medical college of Eastern India
Authors: Chaudhuri Susmita , Jaison Merin K. , Chattopadhyay Biswadip , Paul Kalyan Kumar , Sengupta Trina
Published: July 2024

ABSTRACT

Background:

Occupational lung diseases (OLDs) contribute a significant proportion to the global burden of pulmonary morbidities but are grossly misdiagnosed due to the relative lack of attribution given to occupational exposures. Obstructive lung diseases are known to be associated with long-lasting disability and loss of earning capacity (LOEC) among workers in industrial setups, thus reducing nationwide productivity.

Objective:

In this context, the study aimed to find out the pattern of OLD and factors associated with the severity of it among patients in a tertiary care hospital.

Materials and Methods:

The study was a record-based secondary data analysis conducted in the Medical Records Department of a Medical College in Kolkata. A computerized database of patients attending Special Medical Board (SMB) examinations from the Department of Medical Records was utilized for data collection. A data abstraction format was constructed to collect information on pulmonary morbidity, occupational exposure, and sociodemographic and behavioral variables. Extracted data were analyzed in Microsoft Excel and Statistical Package for Social Sciences (SPSS) software

Results:

After a review of records, it was shown that 62.3% (66 out of 106 people) of the study subjects had an obstructive type of OLD, the most common being Jute Byssinosis. A negative correlation (Spearman’s ρ = -0.136) was found between pulmonary function (FEV1/FVC) and LOEC (%) in the study subjects. In the multivariable logistic regression, exposure to organic dust was found to be significantly associated with worsened lung function {adjusted-Odd’s Ratio (95% Confidence Interval) =3.11 (1.1–8.8), P value = 0.03}.

Conclusion:

OLD is an understated health issue, especially in an industrial diaspora of developing countries, like India. Healthcare facilities should utilize their resources properly for the advancement of medical surveillance in industries where organic dust is produced. Health education of the stakeholders regarding the consequences of OLDs and the benefits of preventive primary approaches will go a long way in alleviating the burden of disease.
Rapid and non-invasive diagnosis of hyperkalemia in patients with systolic myocardial failure using a model based on machine learning algorithms
Authors: Torshizi Hamid M. , Khorgami Mohammad R. , Omidi Negar , Khalaj Fattaneh , Ahmadi Mohsen
Published: July 2024

ABSTRACT

Background:

Hyperkalemia is a potentially life-threatening electrolyte disturbance that if not diagnosed on time may lead to devastating conditions and sudden cardiac death. Blood sampling for potassium level checks is time-consuming and can delay the treatment of severe hyperkalemia on time. So, we propose a non-invasive method for correct and rapid hyperkalemia detection.

Methods:

The cardiac signal of patients referred to the Pediatrics Emergency room of Shahid Rejaee Hospital was measured by a 12-lead Philips electrocardiogram (ECG) device. Immediately, the blood samples of the patients were sent to the laboratory for potassium serum level determination. We defined 16 features for each cardiac signal at lead 2 and extracted them automatically using the algorithm developed. With the help of the principal component analysis (PCA) algorithm, the dimension reduction operation was performed. The algorithms of decision tree (DT), random forest (RF), logistic regression, and support vector machine (SVM) were used to classify serum potassium levels. Finally, we used the receiver operation characteristic (ROC) curve to display the results

Results:

In the period of 5 months, 126 patients with a serum level above 4.5 (hyperkalemia) and 152 patients with a serum potassium level below 4.5 (normal potassium) were included in the study. Classification with the help of a RF algorithm has the best result. Accuracy, Precision, Recall, F1, and area under the curve (AUC) of this algorithm are 0.71, 0.87, 0.53, 0.66, and 0.69, respectively

Conclusions:

A lead2-based RF classification model may help clinicians to rapidly detect severe dyskalemias as a non-invasive method and prevent life-threatening cardiac conditions due to hyperkalemia.
Prognostic Nutritional Index (PNI) and Systemic Immune-Inflammatory Index (SII) as markers of severity among patients having COVID-19 infection
Authors: Reddy Rithika Manjunatha , Suthana Sana , Karthikeyan Aditya , Kulkarni Ashwin , Aslam Shaikh Mohammed , Suhail K Mohammed
Published: July 2024

ABSTRACT

Background:

Prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) are two novel markers that have emerged as potential candidates as an early indication of the severity of the disease in coronavirus disease 2019 (COVID-19) patients.

Objective:

The objective of the study is to assess the utility of the prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) as markers of severity among patients with COVID-19 infection.

Methods:

This is a retrospective study conducted in a tertiary care centre in South India. A total of 80 patients diagnosed with COVID-19 were included in the study. The patients were divided into mild, moderate, and severe groups based on the clinical parameters as per Indian Council of Medical Research guidelines. Lab values taken at admission were obtained from patient records, using which the PNI and SII were calculated using standard formulae. These markers were correlated with the severity of the COVID-19 illness.

Results:

PNI and SII were significantly elevated in the patients with severe COVID-19 illness as compared with mild COVID-19 illness. The mean PNI among subjects with mild COVID-19 and severe COVID-19 being 46.62 ± 6.51 and 34.09 ± 5.81, respectively. The mean SII among subjects with mild COVID-19 was 9,52,287.2 ± 1,42,113, and among subjects with severe COVID-19 was 15,39,461 ± 8,04,285. The cut-off value for PNI and SII for predicting severity of COVID-19 illness was 35.93 and 5,82,400, respectively. The sensitivity for PNI was 87.5, and the SII was 95.

Conclusion:

The present study showed a significant correlation between the SII and PNI as markers used to determine the severity of COVID-19. Based on these findings, it can be effectively used independently of other markers to predict critical illness among COVID-19 patients.
Alterations in hematologic, coagulation, and inflammatory markers based on fever status in hospitalized COVID-19 patients: A retrospective study
Authors: Chatterjee Bijoya , Modi Nikunj , Desai Khushi , Murugan Yogesh , Trivedi Ami
Published: July 2024

ABSTRACT

Background:

Laboratory markers like lymphopenia, thrombocytopenia, elevated D-dimer, and C-reactive protein (CRP) predict worse outcomes in coronavirus disease 2019 (COVID-19). However, a comprehensive analysis of hematologic and coagulation parameter alterations based on fever status is lacking.

Methods:

This retrospective study analyzed 300 COVID-19 patients hospitalized from March to December 2020. Demographic, clinical, and laboratory data were extracted from electronic medical records. Patients were stratified into fever (n = 200) and no fever (n = 100) groups. Hematologic, coagulation, and inflammatory markers were compared between groups using appropriate statistical tests. Multivariate regression identified independent predictors of fever.

Results:

Fever was associated with leukocytosis, neutrophilia, lymphopenia, thrombocytopenia, elevated CRP, D-dimer, procalcitonin, interleukin-6, neutrophil to lymphocyte ratio (NLR), and ferritin compared to no fever (all P < 0.05). D-dimer (r = 0.42), CRP (r = 0.52), NLR (r = 0.48), and interleukin-6 (r = 0.46) demonstrated the strongest correlation with fever (P < 0.001). High D-dimer >1000 ng/mL (adjusted odds ratio 2.7), CRP >100 mg/L (3.1), lymphopenia <1.0 × 109/L (2.8), NLR >4 (2.9), and thrombocytopenia <150 × 109/L (2.7) were significant independent predictors of fever status (P < 0.005). These parameters had moderate sensitivity (40–60%) and high specificity (74–88%) for discriminating febrile patients with AUC of 0.85.

Conclusions:

Marked alterations in hematologic, coagulation, and inflammatory markers occur in COVID-19 based on fever. Routine laboratory parameters can facilitate diagnosis and risk stratification.
Assessment of water, sanitation and hand hygiene practices in rural households of Tamil Nadu: A cross-sectional study
Authors: Fazeela A , Borkar Rajnish S. , Mer Hetal T.
Published: July 2024

ABSTRACT

Context:

Water is a basic human right essential to all for sustainable development. Sanitation is one of the determinants of quality of life and the human development index. Drinking unsafe water impairs health through illnesses such as diarrhoea, and untreated excreta contaminates ground waters and surface waters used for drinking, bathing and household purposes.

Aims:

To assess the existing facilities and practices related to drinking water, sanitation, and hygiene among household members in the rural population of Tamil Nadu and to assess whether accessibility and availability of safe drinking water and adequate sanitation under sustainable development goal 6 is being achieved in the rural population of Tamil Nadu.

Methodology:

This community-based cross-sectional study was carried out among 200 households in the rural field practice area of the Medical College and Hospital, Thiruvallur district, Tamil Nadu. The participants were interviewed using a predesigned semi-structured questionnaire on their existing water, sanitation, and hand washing facilities and practices

Results:

Our study observed that 71.5% of households had piped water supply into their dwellings, 82% were using sanitary latrines and 28% had closed drainage for draining wastewater. Twenty-eight percent were using soap and water for hand-washing before food, and 82.5% were doing hand-washing with soap after using the toilet. In our study, the association between sanitary practices and education, occupation and socioeconomic status was statistically significant

Conclusions:

Our study emphasized the need for strengthening health education and behaviour change communication regarding sanitation and hand hygiene practices.
Quality of sleep among hypertensive patients attending a rural health training centre
Authors: Venkatesh Aishwarya , Varadarajan Suresh
Published: July 2024

ABSTRACT

Introduction:

Sleep is a vital biological, reparative, and restorative phenomenon, and poor sleep has a serious detrimental effect on health. Poor sleep quality is a serious problem as it adversely affects a person’s ability to function physically and socially, as well as their potential for profession and quality of life. The degree of hypertension directly affects sleep quality, and poor sleep can exacerbate hypertensive symptoms. This study assesses hypertension patients’ sleep quality in a rural health training centre in Chennai.

Objectives:

1. To study the prevalence of poor sleep quality among hypertensive patients. 2. To determine the association between selected socio-demographic factors and sleep quality among these patients.

Materials and Methods:

Hypertensives attending the outpatient department of a rural health and training centre were selected in a systematic manner and administered a semi-structured interview schedule and the Pittsburgh Sleep Quality Index (PSQI) questionnaire followed by a basic clinical examination. Using the PSQI, they were categorised as having either poor or good sleep quality and the association between selected socio-demographic factors and sleep quality was assessed.

Results:

Out of the 179 study participants, there were almost equal numbers of male and female participants. The mean age of participants was 57.80 years (standard deviation (SD) = 9.8 yrs.). Among the study participants, 44.13% had completed secondary level of school as an education qualification and 6.70% were illiterate. By the modified BG Prasad classification 2022, most of the study participants (34.08%) came under the class II socioeconomic classification. A large proportion (78.8%) of study participants had poor sleep quality. The difference in sleep quality was observed with respect to gender, socio-economic class, alcohol consumption and body mass index (BMI).

Conclusion:

This observational study shows that individuals with hypertension suffer significantly from poor sleep. A poor quality of sleep was reported by 78.77% of the patients in this study. Statistically significant factors that influenced sleep quality were gender, alcohol consumption and BMI.
Prevalence of diabetes distress and its correlates among adults with type 2 diabetes mellitus in a primary health center of Bihar − A cross-sectional study
Authors: Naik Bijaya N. , Rao Rajath , Verma Manisha , Nirala Santosh K. , Pandey Sanjay , Gera Mounica , Ramalingam Anuvarshini
Published: July 2024

ABSTRACT

Context:

Diabetes is a chronic disease associated with many complications. Approximately 20% of people living with diabetes suffer from some form of depression. “Diabetes distress” (DD) is used to describe the significant negative psychological reactions related to emotional burdens and worries specific to an individual’s experience to manage severe, complicated chronic disease such as diabetes.

Aim:

To determine the proportion having DD and to identify the sociodemographic and morbidity related factors associated with the presence of DD among adults with Type2DM who are being treated at PHC Naubatpur, Bihar.

Material and Methods:

This facility based cross-sectional analytical study was done over 3 months among 260 Type2DM patients attending PHC Naubatpur. Sociodemographic details and morbidity related details were collected followed by PAID questionnaire to assess DD

Results:

Around 60% of the participants were of age ≤60 years. Majority (63.8%) of the participants were having diabetes from past 1-10years. One-fourth (24.6%) of them were having score of ≥40, therefore having DD. Alcohol consumption and presence of diabetes complications in the participants were found to be independent predictors of DD.

Conclusion:

This study showed a high (24.6%) prevalence of DD. It is essential to identify high-risk patients with different mental health needs. Healthcare providers should focus on reducing DD and devise ways to increase self-care practices and coping skills.