bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disseminated cutaneous leishmaniasis due to Leishmania (Leishmania) amazonensis in human immunodeficiency virus (HIV)-infected patients
Authors: Araujo Camila F , Oliveira Iara B N , Silveira Murilo B , Ribeiro-Dias Fátima 
Published: June 2021

Rationale:
Co-infection of human immunodeficiency virus (HIV) and Leishmania spp. has impact on clinical and therapeutic outcomes of leishmaniases. Most studies do not present the identification of Leishmania species causing American tegumentary leishmaniasis in co-infections. In the Americas, Leishmania (L.) Viannia (V.) braziliensis and L. (V.) guyanensis have been identified.

Patient concerns:
In this study, two cases of American tegumentary leishmaniasis in patients infected with HIV are described. Patients presented several lesions with rapid dissemination and mucosal involvement.

Diagnosis:
Disseminated cutaneous leishmaniasis caused by L. amazonensis was identified by molecular test.

Interventions:
The patients were treated with conventional therapies for HIV infection and American tegumentary leishmaniasis.

Outcomes:
In co-infection, the clinical manifestations are atypical and the treatment response can be impaired.

Lessons:
These cases show that HIV infection impacts L. amazonensis infection and point to the relevance of identifying Leishmania species, which can lead to a better patient management.
Antimicrobial Stewardship – Implementation and Improvements in Antibiotic-Prescribing Practices in a Dental School
Authors: Telang Lahari Ajay , Nerali Jayashri Tamanna , Kalyan Chakravarthy Pishipati Vinayak , Siddiqui Fawaz Shamim , Telang Ajay 
Published: June 2021

Background and Aim:
Antimicrobial stewardship (AMS) is a coordinated systematic approach aimed at educating prescribers to follow evidence-based prescription practice to reduce misuse of antimicrobials and thus antimicrobial resistance (AMR). We aimed to improve the standards of antimicrobial prescribing in a dental school by implementing AMS.

Materials and Methods:
A retrospective (first) clinical audit of antibiotic prescriptions (n = 200) over a 6 months' period was analyzed for the following parameters: type of antibiotic, clinical condition, compliance to national guidelines, and errors in prescriptions. In response to the results of this audit, an educational intervention workshop was conducted for clinical faculty. A validated self-administered questionnaire on perception and practice of antimicrobial prescribing was given to participants (n = 31) before and after the workshop and t-test was used to compare the mean scores of responses. Prospective clinical audits were conducted 6 months (second) and 1 year (third) after the workshop assessing the same parameters. A Strengths, Weaknesses, Opportunities, and Threats analysis of the AMS program was also done.

Results:
The total number of prescriptions issued was 943 in the first audit, which reduced to 552 in the second audit and further to 435 in the third audit. The most commonly prescribed antibiotic was a combination of amoxicillin and metronidazole. The percentage of prescriptions in accordance with national guidelines improved from 19% during the first audit to 54% and 79% in the subsequent audits. The percentage of erroneous prescriptions was 23% in the first audit, which reduced to 12% in the second audit and 9% in the third audit. The pre- and posttest mean values of the questionnaire when compared suggested that there is a need for uniformity in prescribing antimicrobials.

Conclusions:
Clinical audits with educational workshops on appropriate use of antibiotics have a positive impact on conforming with prescription guidelines. This will encourage the rational prescription of antibiotics based on clinical needs of patients, thus contributing to the fight against AMR.
Impact of CoronaVirus Disease-19 Lockdown on Physical Activity and Energy Expenditure among Middle Adolescence - A Cross-Sectional E-Survey
Authors: Rathod Vandana Jivatsinh 
Published: June 2021

Background and Aim:
Coronavirus disease-19 (COVID-19) is a pandemic disease spreading throughout the world. Lockdown declared by the Indian government to control the spread of this disease leads to change an entire lifestyle of the population. Individual's lives are greater affected due to lockdown which leads to a reduction in their physical activity (PA). It might increase the chance of infection by reducing immunity. How much PA is reduced during this lockdown period among middle adolescence is not known. This study attempts to find out PA level and energy expenditure (EE) among middle adolescence during the lockdown.

Materials and Methods:
One hundred and twenty-three volunteered students participated in an open e-survey. The survey was carried out by the International PA questionnaire-short form through social networking sites during the COVID-19 lockdown period through the Google Forms link. PA and EE have been measured.

Results:
Among identified 147 potential survey participants, 123 responded. Total PA during COVID–19 lockdown period was 6262.21 metabolic equivalent task-min/week. While EE during COVID–19 lockdown period was 6009.28 cal/week.

Conclusions:
A significant reduction in self-report PA and EE levels was observed among middle adolescent students during the COVID–19 lockdown period.
Suicidal Thoughts, Suicidal Attempts, and Nonsuicidal Self-Injury among Undergraduate Health Professionals
Authors: Patel Vishal Kanaiyalal , Bhatt Renish Bhuperndrabhai , Raja Hitarth Himanshu , Kumar Parveen , Tiwari Deepak Sachidanand , Vasavada Disha Alkeshbhai 
Published: June 2021

Background and Aim:
Nonsuicidal selfinjury (NSSI) was observed in both males and females, with higher rate among females. NSSI could increase the risk of future suicide attempts. Adolescence is considered as stressful period because of identity crisis, physical growth, coupled with set of decision regarding future profession and personality traits. The study is aimed to find suicidal thoughts, suicidal attempts, extent of the NSSI and its impact on the undergraduate health professionals.

Materials and Methods:
A cross-sectional study was carried out among medical, dental, and physiotherapy undergraduate college students of Jamnagar, Gujarat. A total of 1850 students were approached, out of them 1050 medical, 500 dental and 300 were physiotherapy students. Participants were requested to fill the pro forma containing following parts: (1) Demographic details, (2) Inventory of Statements about Self-injury, (3) Impact of Non-Suicidal Self-Injury Scale.

Results:
A total of 1408 students completed the pro forma. Overall 13.99% prevalence rate of NSSI was reported. Female participants had higher prevalence of self-harming behavior than male participants (χ2 = 24.226, P < 0.001). NSSI was related to suicidal thoughts and suicidal attempts with (χ2 = 263.050, P < 0.001) and (χ2 = 197.777, P < 0.001), respectively. A negative correlation was observed with age of onset of NSSI behaviors with and numbers of NSSI behavior (r = −0.317, P < 0.001).

Conclusions:
Participants engaged in different NSSI behaviors for affect regulation, interpersonal boundaries, sensation seeking, self-punishment, revenge, and self-care. High prevalence of NSSI among young health professionals needs independent clinical attention. There is a need of crisis interventions for the management of self-harming behaviors and to prevent future fetal suicidal attempts.
Determinants of Depression and its Associated Coping Mechanisms among College Students Confined during COVID-19 Lockdown
Authors: Garg Sunny , Chauhan Alka , Singh Sanjeet , Bansal Kirti 
Published: June 2021

Background and Aim:
During COVID-19 pandemic lockdown, mental health of students was highly pregnable to the loss of social connectedness, disarray of normal pattern of activities as well as academic issues. Adopted coping mechanisms may have played a significant role in surmounting the challenges related to the pandemic. The main aim of the survey is to evaluate the prevalence of depression, its determinants, and association with coping mechanisms among college students during COVID-19 lockdown.

Materials and Methods:
College students were invited during lockdown to participate in a nationwide cross-sectional e-survey using Snowball sampling technique (dated October 6–30, 2020). A total sample size of 920 was calculated. A self-administered questionnaire regarding sociodemographic characteristics, COVID-19-related experiences along with two scales (Patient Health Questionnaire-9 [PHQ-9] and Carver Brief-Coping Orientation to the Problem Experienced-28) for assessment of depression, and adopted coping mechanisms was applied to participants. Chi-square test, independent “t-” test, Pearson's correlation, and hierarchical multiple regression analysis were used to investigate the determinants of depression and its association with coping mechanisms in college students.

Results:
On analysis of 884 participants, it was revealed that 402 (45.5%) participants have depressive symptoms ranging from moderate to severe level. The mean score of PHQ-9 was 9.82 ± 6.61. Nearly 85% of the students were lagging behind in studies. Around 5%–10% of the students initiated/increased the consumption of substances. The main determinants of depression in this study were the age group of 21–24 years, thought of lagging behind in studies, and family members/friends/relatives diagnosed with COVID-19. Adaptive coping mechanisms (emotional support, religion, and humor) were significantly associated with lower depressive symptoms and maladaptive coping mechanisms (self-distraction, denial, behavioral disengagement, and venting) were significantly associated with higher depressive symptoms among students.

Conclusions:
This survey revealed multiple determinants of depression, mainly including academic worries among college students. The college staff should provide a well-structured pedagogical framework to encourage them and alleviate the unpleasant psychological effects of pandemic on students.
A Multicentric, Prospective and Retrospective Analysis of Stevens–Johnson Syndrome, Toxic Epidermal Necrolysis and Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis Overlap
Authors: Bhat Ramesh Marne , Jayaraman Jyothi , Suresha Navyashree , Dandekeri Sukumar , D'souza Myfanwy Joanne 
Published: June 2021

Background:
Stevens Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) represent adverse drug reactions characterized by generalized rash, blisters, epidermal detachment, mucosal and systemic involvement presenting as dermatological emergencies. Drugs are the most common culprits implicated in the pathogenesis of SJS /TEN. The primary step in the management of SJS/TEN is identification and stopping the offending drug.

Materials and methods:
This was a multi-centric retrospective as well as prospective observational study conducted in 7 tertiary care hospitals including Father Muller Medical College Hospital, Mangalore, India. A detailed evaluation of the hospital in patient record for 10 years retrospective from September 2015 and all new cases of SJS/TEN as well as SJS-TEN overlap presenting to these centres for 1 year prospective was performed. Detailed history was taken and clinical examination was recorded and different modalities of treatment was noted and compared.

Results:
A total of 152 patients with clinical diagnosis of SJS, TEN and SJS-TEN overlap were analysed. Males were more commonly affected than females and history of drug intake was present in 118 patients (77.6%). The most common drugs which caused SJS/ TEN in our study were antibiotics in 40 patients (26.3%) followed by anti epileptics in 35 patients (23%) and nevirapine in 10 patients (6.5%). In our study the most common finding on cutaneous examination was maculopapular rash (19.3%).

Conclusion:
SJS and TEN form part of a spectrum of severe cutaneous drug reactions that can lead to high morbidity which can be reduced by early withdrawal of the offending drug and timely intervention. Individuals with known drug allergies need to be educated and drug allergy card has to be carried.
Relationship between peripapillary vessel density and visual function based on Garway-Heath sectorization in open-angle glaucoma
Authors: Kwon Jeong Min , Park Keunheung , Kim Sangyoon , Shin Jonghoon 
Published: June 2021

Purpose:
To investigate the relationship between peripapillary vessel density (pVD) and visual field sensitivity (VFS) and between peripapillary retinal nerve fiber layer thickness (pRNFLT) and VFS, based on Garway-Heath sectorization in open-angle glaucoma patients.

Methods:
Sixty-six eyes of healthy subjects and 84 eyes of glaucoma subjects were included. All subjects underwent several eye examinations, including standard automated perimetry and optical coherence tomography angiography. Sectoral structure-function relationships based on the Garway-Heath sectorization were compared among normal subjects, the ‘mild glaucoma,’ and ‘moderate-to-severe glaucoma’ group. Multivariate analyses were performed for each sector to determine the factors related to VFS. The diagnostic abilities of vessel density parameters and RNFLT were evaluated by calculating the area under the receiver operating characteristic curves (AUROC).

Results:
The correlation between pVD-VFS and pRNFLT-VFS was statistically significant in the glaucoma group independent of the VFS sector. In the glaucoma group, VFS in the temportal sector was statistically related in a multivariate model to pVD, pRNFLT and age (R2 = 0.721; P = 0.007, < 0.001, .15, respectively). We found pRNFLT and age were significantly associated with VFS in glaucoma. The AUROC values of pVD in the inferotemporal sector of the total, mild, and moderate-to-severe glaucoma (0.843, 0.714, and 0.972, respectively) were comparable to pRNFLT in this sector (0.833, 0.718, 0.948, respectively).

Conclusion:
Since the relationship between pVD and VFS in the papillomacular area was significant, measuring pVD and RNFLT in the corresponding area will be valuable in expanding our pathophysiologic knowledge of the paracentral field defects in glaucoma.
Profile of complications in pterygium surgery - A retrospective analysis
Authors: Kodavoor Shreesha K , V Preethi , Dandapani Ramamurthy 
Published: June 2021

Purpose:
Analysis of complication profile after pterygium excision, in primary and recurrent pterygia.

Methods:
Retrospective analysis of all the patients who had undergone pterygium excision in a tertiary center in South India from 2010 to 2018 was analyzed. A total of 2356 eyes in 2028 patients were included in the study. Patients who had undergone conjunctival autografting for primary pterygium, conjunctival limbal autografting for recurrent pterygium, vertical split conjunctival autografting for double head pterygium were included in the study. In all the surgical procedures fibrin glue was used for fixation of the autograft. The follow-up period ranged from 6 months to 75 months, with an average of 17 months. Patients with less than 6 months of follow-up were excluded from the study.

Results:
The following postoperative complications were noted, Sub-conjunctival hemorrhage in 912 eyes (38.7%), edema of the graft in 522 cases (22.15%), graft loss in 22 cases (0.93%), graft retraction in 692 cases (29.37%) and sliding of the graft was seen in 9 cases (0.38%). Granuloma was seen in 4 cases (0.16%) at the host site and 5 cases (0.21%) at the donor site. Recurrence was seen in 34 patients (1.44%). Other severe complications like corneal melt were seen in only 1 case (0.04%) who was operated on for recurrent pterygium. In comparison between primary and recurrent pterygia; subconjunctival hemorrhage, edema of the graft, graft loss, and recurrence was significantly (P < 0.05%) higher in recurrent pterygia.

Conclusion:
Various complications can occur post pterygium surgery as listed above. Selecting a proper procedure for a particular type of pterygium with a proper graft fixation technique will improve the outcome with minimal complications.
Incidence and risk factors for retinal detachment following laser-assisted in-situ keratomileusis
Authors: Srinivasan Ramyaa , Jain Smriti , Jaisankar Durgasri , Raman Rajiv 
Published: June 2021

Purpose:
The aim of this work was to study the incidence and potential risk factors for development of retinal detachment (RD) after laser-assisted in situ keratomileusis (LASIK) surgery over a long-term follow-up.

Methods:
This was a retrospective interventional case series. A total of 694 eyes of 352 patients were included who had undergone LASIK surgery at a tertiary eye care institute between January 2005 and September 2015 who had a minimum follow-up of 5 years after the surgery were included. Kaplan–Meier analysis and Cox proportion regression model was used to estimate the potential risk factors and cumulative risk for the development of RD.

Results:
Out of the total patients, 5 eyes developed RD after a mean follow-up of 7 years. The cumulative risk of RD after 1 year was 0.4%, after 2 years was 0.5% and after 7 years was 0.7%. Increased risk of RD was not associated with age at LASIK surgery, gender, laterality, and spherical equivalent (P > 0.05). A significantly increased risk for the development of RD was observed in eyes that were given prior prophylactic laser photocoagulation for peripheral lesions in multivariate cox proportional regression analysis with a hazard ratio (HR) of 9.33 (CI- 1.554-56.094; P = 0.015).

Conclusion:
We emphasize the need for a regular follow-up after the LASIK procedure to ensure timely treatment of any new retinal lesions.
Tribal Odisha Eye Disease Study (TOES) Report # 9. Eye diseases and retinal disorders in an adult and elderly tribal community in Odisha, India - A community hospital-based study
Authors: Padhy Srikanta Kumar , Akkulugari Vidhyadhar , Kandagori Meenaketan , Padhi Tapas Ranjan , Rathi Varsha M , Das Taraprasad 
Published: June 2021

Purpose:
To measure the proportion of people with major ophthalmic and retinal disorders in the tribal and non-tribal people presenting to a community eye hospital in an Indian state with a sizeable tribal population.

Methods:
Hospital-based cross-sectional retrospective study of all new adult patients, examined between September 2015 and June 2020. A tribal was defined as per the Indian ethnic classification. Blindness and visual impairment were defined as per the WHO standards. Diabetes and hypertension were defined as per Indian standards. The proportion of common ophthalmic and retinal disorders between the tribal and non-tribal community were compared.

Results:
This cohort consisted of 76,166 people (45.8%; n = 34,869, tribal); 39.4% (n = 29,989; non-tribal 23.6% and tribal 15.8%) people had ophthalmic disorders. In the examined people 2.3% were blind (higher in tribal community 4.7% versus 0.8%; P < 0.001) and 8.4% had moderate-to-severe visual impairment (higher in tribal community 14.4% versus 4.4%; P < 0.001). Refractive error (64.4%; higher in non-tribal community, 77.3% versus 44.6%, P < 0.001) and operable cataract (23.9%; higher in tribal community, 40.9% versus 11.8%, P < 0.001) were the principal ophthalmic disorders. Retinal disorders were higher in non-tribal people (5.9% vs. 2.9%; P < 0.001), but the tribal group had higher proportion of retinitis pigmentosa (20% vs. 6.4%; P < 0.001) and lower proportion of diabetic retinopathy (8% vs. 40.7%; P < 0.001).

Conclusion:
The health-seeking behavior of the tribal community in India is low. A tribal person in India apparently visits the hospital when vision is grossly affected. It calls for greater advocacy, increased access to healthcare, and a larger population-based study.
First horizontal and first vertical derivatives from high resolution aeromagnetic data over the Gongola basin upper Benue trough Northeastern Nigeria
Authors: Hayatudeen Musa , Rasaq Bello , Onaolapo Raheem I , Abe Ayoola Olumide 
Published: June 2021

High-resolution aeromagnetic data investigation was carried out over the Gongola basin upper Benue trough northeastern Nigeria. Total intensity magnetic map were processed to get the residual map, reduction to equator, polynomial fitting, radially average power spectrum (RAPS) were done, subsequently the first horizontal and first vertical derivatives of the data was carried out in order to identify linear structures (faults and fractures). The outcomes from both the horizontal and vertical derivatives give contact locations that are continuous, thin and show major structures in the NE-SW direction both in the maps and in the rose diagrams. The study focused on delineation of geological structures such as rock contacts; rock boundaries, fractures and faulted zones from the maps, they are principally important in mineral resources studies because many of these resources are located along fracture zones. Linear structures perceived in this kind of studies are also reliable indicators for geologic structures. The result of this work is also significant in identifying areas to be avoided when constructing bridges, dams as well as siting nuclear power plants and delineation of potential risk areas of natural hazard.
Keywords: Aeromagnetic Data, first Horizontal Derivative, first Vertical Derivatives, Gongola Basin, Linear Features.
Analysis of a 4-span continuous plate in one direction using Matlab programming
Authors: Adah E. I. , Ubi S. E , Idagu F. O. , Ubi P. A. 
Published: June 2021

The present study presents a computer approach based on polynomial shape functions application for analysis of continuous plate in one direction using Matlab. A 4-span continuous plate in the x-direction comprises of boundary conditions SSSC, SCSC, SCSC and SCSS single panels’ plate was analyzed. It was assumed that, the external edges were simply supported while the internal edges of each panel were clamped. The bending moments of the clamped edges were calculated for each panel using appropriate boundary conditions which formed the fixed end moments (FEMs). Stiffness method was used based on beam analogy to analyze the continuous plate. Matlab codes were applied to develop a computer program for this analysis. To validate the results of this present study, the values of the moments obtained were compared with those of earlier studies using manual method. The percentage difference for fixed end moments were all 0.00% and that of support moments had the maximum value of 0.016%. Thus, it was concluded that the present study program based on Matlab is adequate and a faster approach for a 4-span continuous plate in one direction analysis.
Keywords: Matlab Programming, Continuous Plate, Polynomial Shape Functions, Beam Analogy, Fixed Edge Moment.
Pectinolytic activity of aspergillus niger and Aspergillus flavus grown on grapefruit (citrus Parasidis) peel in solid state fermentation
Authors: Adedayo M. R. , Mohammed M. T , Ajiboye A. E. , Abdulmumini S. A 
Published: June 2021

The present study was aimed at studying pectinolytic activity of resident fungi isolated from decomposing grapefruit (Citrus parasidis) peels in solid state fermentation. Grape fruit peel was subjected to natural fermentation and the fermenting fungi were isolated, characterized and identified using standard microbiological methods. The isolated fungi were in turn used for fermentation to determine their pectinolytic activity through solid state fermentation technique. Culture parameters such as incubation period, temperature, moisture content and addition of salts supplements were optimized during the research for five days. The identified fungi were Aspergillus Niger and Aspergillus flavus. The peak of pectinolytic activity was at day three of fermentation when the highest pectinase activity of 13.32 μmol/mg/min was recorded for A. Niger and 11.32 μmol/mg/min for A. flavus. Optimum temperature and pH for pectinase activity by A. Niger and A. flavus was at 40 0C and pH 7.5 and 7.7 respectively. The use of salt supplemented substrate did not alter enzyme activity. In conclusion, the isolated fungi could be promising organisms for pectinolytic enzyme production on grape peel as substrate.
Keywords: Grapefruit, Pectinolytic Activity, Fungi, Fermentation, Aspergillus