bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Addition of Sodium Bicarbonate to Dexamethasone and Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Orthopedic Procedures
Authors: Kour Loveleen , Sharma Gourav , Tantray Saima Hassan 
Published: August 2021

Background:
Peripheral nerve blocks have taken over as the principle technique for upper limb surgeries. A number of adjuvants have been tried individually, but very few studies have investigated the cumulative effect of two or more adjuvants given together along with local anesthetic.

Aim:
This study aimed to evaluate the effect of addition of sodium bicarbonate to dexamethasone and ropivacaine in supraclavicular brachial plexus block.

Settings and Design:
This was a prospective, randomized, double-blind study that comprised 90 American Society of Anaesthesiologist (ASA) 1 and 2 patients posted upper limb orthopedic procedures.

Materials and Methods:
Ninety ASA 1 and 2 patients were selected and divided into three groups of 30 each: Group R received 30 mL of 0.75% ropivacaine plus 4 mL normal saline; Group RD 30 mL of 0.75% ropivacaine, 2 mL normal saline and 2 mL of dexamethasone were given; Group RB 30 mL of 0.75% ropivacaine plus 2 mL of dexamethasone and 2 mL of sodium bicarbonate. Onset and duration of sensory and motor block and postoperative pain scores were studied in each group.

Statistical Analysis:
Student's independent t-test was employed for comparing the continuous variables and Chi-square test for the categorical variables. Kruskal–Wallis test was used for postoperative pain score data.

Results:
Addition of sodium bicarbonate to dexamethasone and ropivacaine quickens onset and prolongs duration of sensory and motor block.

Conclusion:
Sodium bicarbonate produces a synergistic and potentiating effect with dexamethasone as adjuvant in supraclavicular brachial plexus block.
Comparison of Ultrasound-Guided Direct versus Ultrasound-Guided Dart Technique of Radial Artery Cannulation
Authors: Varnitha M. S. , Kumar Ajay , Gupta Priyanka , Yadav Vikas , Agarwal Ankit , Darbari Anshuman 
Published: August 2021

Background:
Three different types of cannulation method for radial artery are Direct technique, Seldinger technique, and modified Seldinger technique (Dart). Their comparative efficacy has been studied using palpatory method but not with ultrasound guidance.

Aims:
We compared the efficacy of ultrasound-guided Direct and ultrasound-guided Dart technique of arterial cannulation.

Settings and Design:
One hundred and sixty patients posted for elective surgeries were included in prospective randomized control, single-blind study in a tertiary care center.

Materials and Methods:
The study comprised of two groups: Direct method (n = 80) and Dart method (n = 80), which were compared for the rate of successful cannulation within 5 min. The secondary objectives were time for successful cannulation, number of attempts, and rate of complications (hematoma, posterior wall puncture, and needle reinsertion) between two groups.

Statistical Analysis:
The group comparison for continuously distributed data was compared using the independent sample t-test. The Chi-square test was used for the group comparison of categorical data. Binary logistic regression was conducted to ascertain significant predictors for successful cannulation in 5 min.

Results:
Cannulation success rate was similar in both Direct (57.5%) and Dart (55%) groups. There was no significant difference in time for successful cannulation, number of attempts, number of needle redirection, and posterior wall puncture. However, the incidence of hematoma (Direct 22.5% [18]; Dart 8% [10]) was significant. There was better success rate of cannulation (n = 90) in patients with normal pulse and bigger radial artery lumen.

Conclusion:
There was no significant difference between Dart and Direct technique with the use of ultrasound guidance.
Examination of Spinal Canal Anatomy with MRI Measurements in Lomber Disc Herniation Patients
Authors: Kaydu Ayhan , Andan İbrahim , Deniz Muhammed Akif , Bilge Hüseyin , Başol Ömer 
Published: August 2021

Background and Aim:
The aim of this study is to investigate the magnetic resonance imaging (MRI) of patients with lumbar disc herniation (LDH) to identify the challenges associated with neuraxial anesthesia.

Materials and Methods:
The MRI images in the supine position of 203 patients admitted to hospital with complaints of lower back pain were studied. Medial sagittal slices of the lumbar spine were imaged from L1 to S1. LDH is classified as either bulging, extrusion, or protrusion.

Results:
For this study, 83 males and 120 females with a mean age of 43.18 ± 14.68 years were recruited. The highest herniation level was observed at L4–L5 in 145 (71.4%) patients: 76 instances of disc bulging (37.4%), 56 instances of extrusion (27.6%), and 13 instances of protrusion (6.4%). The longest distance between the skin and spinal cord was 60.06 ± 1.61 mm at L5–S1; the longest distance at width of the epidural space was 6.09 ± 1.95 mm at L3–L4. According to the disc herniation groups, no significant differences were found between the skin-to-dura distance, width of the epidural space, and depth of skin level to spinous process (P > 0.05). Moreover, the anterior dura to cord distances was significantly different from normal patients (P < 0.05). Indeed, there was a statistically weak and negative correlation between both the length and age of the lumbar spinal canal (P < 0.05, r = −0.295).

Conclusions:
Lumbar disc pathologies can cause anatomical derangements in the spinal canal, which may cause neurologic deficits by neuraxial blockade.
A Comparative Study in Airway Novices Using King Vision Videolaryngoscope and Conventional Macintosh Direct Laryngoscope for Endotracheal Intubation
Authors: Pujari Vinayak Seenappa , Thiyagarajan Balaji , Annamalai Alagu , Bevinaguddaiah Yatish , Manjunath A. C. , Parate Leena Harshad 
Published: August 2021

Background and Objectives:
Tracheal intubation using laryngoscopy is a fundamental skill, for an anesthesiologist. However, teaching this skill is difficult since Macintosh direct laryngoscope (DL) allows only one individual to view the larynx during the procedure. Hence, this study aimed to determine whether King Vision® videolaryngoscope (KVL) provides any advantage over direct laryngoscopy in teaching this skill to airway novices.

Materials and Methods:
In this prospective randomized crossover study, Ethical Committee clearance was obtained from the institutional review board (MSRMC/EC/2017) and the study was registered with Clinical Trial Registry. After informed consent, 53 medical students were allotted to perform laryngoscopy and endotracheal intubation on a manikin by using either KVL or Macintosh DL. The participants first performed laryngoscopy with either KVL or Macintosh DL following a brief instruction and then crossed over to the second arm of the study to perform laryngoscopy using the other scope. The primary outcome measure was the time for successful endotracheal intubation. The secondary outcome measures were incidence of esophageal intubation (EI), excess application of pressure on maxillary teeth excess maxillary pressure, and success rate.

Results:
Mean time for endotracheal intubation was significantly faster using KVL than in DL (44.64 vs. 87.72 s; P < 0.001). No significant difference was found in the incidence of esophageal intubation 15.1% in KVL group versus 24.5% in DL group (P = 0.223). In the KVL group, 81.1% did not apply pressure on maxillary teeth versus 26.4% in the DL group (P < 0.001). The success rate of intubation was 100% in the KVL group versus 86.8% in the DL group (P = 0.006).

Conclusion:
The KVL is a more effective tool to teach endotracheal intubation in comparison to Macintosh laryngoscope in airway novice medical students. Clinical trial registry India registration number: CTRI/2017/11/010491.
Clinical Features and Outcome of Stroke with COVID-19. COVID-19 Stroke Study Group (CSSG), India
Authors: Bhatia Rohit , Padma Srivastava M. V. , Sylaja P. N. , Komakula Snigdha , Upadhyay Ashish , Pardasani Vibhor , Iype Thomas , Parthasarathy Rajsrinivas , Reddy Rajshekhar , Kushwaha Suman , Roy Jayanta , Satish P , Trikha Anjan , Wig Naveet , Dhar Lalit , Vibha Deepti , Vishnu Venugopalan Y. , Pandit Awadh Kishore , Gupta Anu , Elavarasi A , Agarwal Ayush , Gupta Vipul , Singh Rakesh K. , Oza Harsh , Halani Hiral , Ramachandran Dileep , George Githin B. , Panicker Praveen , Suresh MK , Kumaravelu S , Khurana Dheeraj , Rajendran Srijithesh P. , Pamidimukkala Vijaya , Gupta Salil , Pandian Jeyaraj D. , Chowdhury Debashish , Rai Nirendra K. , Sharma Arvind , Nambiar Vivek K. 
Published: August 2021

Background and Purpose:
Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19.

Methods:
The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected.

Results:
The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0–2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality.

Conclusions:
CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.
Use and Adherence to Oral Anticoagulants in a Tertiary Care Hospital
Authors: Pradhyumna M , Faruqui Atiya Rehman , Joshi Sunil S 
Published: August 2021

Background:
In patients at risk of thromboembolism, oral anticoagulants (OAC) are effective, but there are limited data from India on OAC use and adherence. This study in a tertiary care hospital aims to record the pattern of prescription of OAC and medication adherence over 6 months.

Materials and Methods:
Medications prescribed were recorded, and a follow-up at 3 and 6 months was done to record outcomes and adherence to medication. Modified Morisky medication adherence scale (MMAS-8) was used and compliance to monthly International Normalized Ratio (INR) monitoring was recorded.

Results:
Of the 140 patients included, mean age was 55.32 (±18.04 years), and 84 (60.0%) were males. Indications for OAC were deep vein thrombosis 64 (45.7%) and atrial fibrillation 42 (30.0%). After initial injectable anticoagulants, majority of patients were shifted to Vitamin K antagonists. Most common OAC was nicoumarol 73 (52.1%), followed by warfarin 43 (30.2%), dabigatran 12 (9.2%), and apixaban 12 (9.2%). Over 6 months, 12 patients were lost to follow-up and 16 (11.4%) deaths were recorded. Monthly INR was done by 23 patients till the 3rd month but only by five patients between 3rd and 6th month. By the 3rd month, 19 (86.3%) and between 3rd and 6th month 4 (13.7%) patients were nonadherent. At 6th month, 78 (86.6%) had a MMAS-8 score of 8 (high adherence). The presence of a caretaker in 37 (41.2%) emerged as the most important factor contributing to adherence.

Conclusion:
Early identification of patient-specific barriers for INR monitoring and adherence to medications should be sought in patients with thromboembolism.
Premedication with intravenous midazolam for neonatal endotracheal intubation
Authors: Badiee Zohreh , Zandi Hamed , Armanian Amirmohammad , Sadeghnia Alireza , Barekatain Behzad 
Published: August 2021

Background:
Pain during the neonatal period has been associated with immediate and long-term adverse effects. One of the most frequent painful procedures that neonates face in neonatal intensive care unit is the endotracheal intubation. Midazolam has been a candidate for premedication before neonatal intubation. Our aim was to evaluate the effects of midazolam as the premedication on endotracheal intubation of premature infants during surfactant administration.

Materials and Methods:
In a double-blind clinical trial, 80 preterm infants were undertaken for tracheal intubation following the use of atropine associated to either midazolam or placebo. Patient's vital signs and general conditions were constantly monitored, and pain was assessed using premature infant pain profile (PIPP) score.

Results:
The mean ± standard deviation for postnatal age was 95.38 ± 50.04 and 111.63 ± 49.4 min in control and midazolam groups, respectively. The patients in the midazolam group had significantly better outcomes across several intubation outcome measures such as duration of endotracheal intubation (23.5 ± 6.7 vs. 18.8 ± 4.8 s, P = 0.001), oxygen saturation level (88.05% ±13.7 vs. 95.1 ± 1.8%, P = 0.002), intubation failure (34.2% vs. 2.5%, P = 0.0001), awake and resistance during intubation (95% vs. 20%, P = 0.0001), and excellent patient condition during intubation (0% vs. 82.5%, P = 0.0001). In addition, PIPP score was significantly lower in the midazolam group (5.2 ± 2.06 vs. 12.9 ± 2.9, P = 0.0001).

Conclusion:
Premedication with midazolam in newborns before intubation, can hold promising effects that manifests as better overall outcomes, less complications, better vital signs, more comfortable situation, and lesser pain for these patients.
Trends of human brucellosis in Central Iran (2010–2018)
Authors: Khalilian Mohammad-Sadegh , Ramazanpour Javad , Hosseini Sayed Mohsen , Narrei Sina , Zeinalian Mehrdad 
Published: August 2021

Background:
Brucellosis is one of the most common infectious diseases worldwide which is caused by direct contact with affected animals or their products. It puts a huge impact on the economy, society, and the environment. Iran is the fourth endemic country for brucellosis in the world. It has been described a new epidemiological feature of the disease and its trends in Isfahan province, as one of the endemic areas of brucellosis in Central Iran.

Materials and Methods:
This is a cross-sectional, population-based study. Data collection was performed using epidemiological questionnaires through Epi-2006 software from the private and public sectors in 22 districts of Isfahan province over 9 years (2010–2018). The results were obtained by the description statistics using the SPSS Statistics software version 20 (SPSS Inc., Chicago, IL, USA).

Results:
Altogether, 5751 new brucellosis patients were recorded over 9 years. About 70% of these cases were male. The majority of cases had occurred in the age group of 21–30 years. The average incidence of brucellosis over the 9 years was 14.1 cases/100,000 population including 8.8 in the urban versus 45.2 cases in the rural areas. During the 9-year study period, the incidence of brucellosis was increased between 2010 and 2014. From 2014 to 2017, the trend has been decreasing, but in the last year of the study, the trend has been increasing again. Seasonally, the incidence rate was variable between the lowest from October to January and the highest from June to July.

Conclusion:
According to the fluctuation of incidence trend of brucellosis during the 9-year study period in Central Iran, it seems some policy changes regarding to the control and prevention of brucellosis have a role, changes that should be fixed and corrected.
Translation and linguistic validation of the Persian version of the International consultation on Incontinence Questionnaire Vaginal Symptoms
Authors: Pourmomeny Abbas Ali , Foolad Farnaz , Sedighmehr Njmeh , Zargham Mahtab , Sharifiaghdas Farzaneh 
Published: August 2021

Background:
There is no validated measurement tool to assess vaginal symptoms (VS), sexual matter (SS), and quality of life (QOL) among Persian-speaking women. This study aimed at translating and assessing the validity and reliability of the Persian version of the International Consultation on Incontinence Questionnaire for Vaginal Symptoms (PICIQ-VS).

Materials and Methods:
In this cross-sectional study, after obtaining permission from the International Consultation on Incontinence Questionnaire (ICIQ) Advisory Board, the English version of ICIQ-VS was translated into Persian per a standard translate and back translate process, and the validity and reliability were studied. Two hundred women with and without pelvic organ prolapse were asked to complete the PICIQ-VS (mean age: 52.1, range: 22–84 years). A panel of 10 experts evaluated the content and face validity of the questionnaire. Cronbach's alpha examined the internal consistency reliability of the measure. To evaluate the test–retest reliability, we redistributed the questionnaire among 30 patients 2 weeks after their initial visit using intra-class correlation coefficient (ICC).

Results:
Content and face validity of the questionnaire was confirmed after some light modification (content validity ratio ranged from 0.69 to 1.00, and content validity index ranged from 0.79 to 1.00). PICIQ-VS showed an acceptable internal consistency and stability reliability (VS: α = 0.64, ICC = 0.84; SM: α = 0.69, ICC = 0.88; and total scale: α = 0.72, ICC = 0.91, respectively). Significant differences were observed between the asymptomatic and symptomatic groups for VS and the total score (P < 0.05).

Conclusion:
In the light of the results, interestingly, PICIQ-VS could be utilized as a valid and reliable tool to assess the VS among Persian-speaking women, both in research and clinical practice.
Could Our Species Usefully Become Social Psychiatry's 21st Century Scientific Concern?
Authors: Becker Robert E. 
Published: August 2021

General Purpose:
To identify evolved human social traits that undermine effective interventions against social, environmental, and other threats to health, wellbeing, and survival of individuals and our species.

Methods:
To identify destructive individual and group social behaviors, the author surveyed 21st century interpretations of behavioral issues raised in primatologists studies of chimpanzees and bonobos. Drawing from a wide range of physical and social sciences, he then selected specific issues regarding health, wellbeing, and survival for study in humans. To test functionality, concepts were challenged for implications. To explore practicality, applications were identified and models for possible clinical and policy use were developed.

Results:
Analyses identified specific impediments to effective human responses to threatening or otherwise challenging circumstances and their implications. Using two models for psychiatric interventions, the author explored potentials for intervention against the involved dysfunctional behavioral traits.

Conclusions:
An evolutionary biological phylogenetic focus clarifies why humans experience dysfunctional traits as a result of evolution. This provides a broader, important grounding for further psychiatric research and development of interventions.
Beliefs Related to COVID-19 Infection
Authors: Sahoo Swapnajeet , Pattnaik Jigyansa Ipsita , Padhy Susanta Kumar , Mehra Aseem , Panigrahi Mahima , Nehra Ritu , Grover Sandeep 
Published: August 2021

Aim:
To evaluate the prevalence of specific beliefs held by people with respect to SARS-2-CoV (COVID-19) infection.

Study Design:
Web-based cross-sectional survey by using nonprobability snow-balling sampling technique.

Methodology:
The survey-specific questionnaire designed based on the review of literature on the prevailing myths/beliefs was circulated by an online cross-sectional survey through the SurveyMonkey® platform using the WhatsApp®, both individually and through the WhatsApp groups, by using a nonprobability snow-balling sampling technique.

Results:
1695 people participated in the survey, of which 1636 responses were found to be complete and were analyzed. The mean age of the participants was 34.55 years, and two-thirds of the participants were males (n = 1092). About one-third of the participants were educated up to graduation (32.1%), and about one-fifth were healthcare workers. Incorrect beliefs related to various preventive aspects, modes of spread of infection, and treatments were present in a significant proportion of people, with a wide variation for specific issues. When the number of participants with at least one incorrect belief related to any of the aspects of COVID-19 infection was evaluated, except for four participants, all the participants reported at least one incorrect belief. Male and female participants differed significantly in few beliefs.

Conclusions:
This survey highlights a widespread prevalence of myths/misconceptions in society regarding various aspects of COVID-19 infection, which warrants more focus on awareness programs.
52 Years of Lassa Fever Outbreaks in Nigeria, 1969–2020: An Epidemiologic Analysis of the Temporal and Spatial Trends
Authors: Agbonlahor Dennis E. , Akpede George O. , Happi Christian T. , Tomori Oyewale 
Published: August 2021

ABSTRACT.
The year 2020 made 52 years since the first report of Lassa fever (LF) outbreaks from Nigeria, but what progress has been made in its control? We sought to answer this through an epidemiologic analysis of the temporal and spatial trends of the outbreaks from 1969 to 2020. The analysis showed an overall strengthening of the outbreaks, hallmarked by the change from irregular to regular annual and from limited local to nationwide outbreaks, while there was a sharp contrast between the upward trend in case numbers and downward trend in case fatality. Pending the availability of effective vaccines, greater effort is required to reverse the upward trend in case numbers and sustain the downward trend in case fatality. We discuss the factors associated with the observed trends as well as the prerequisites for further improvements.
Rol del farmaceutico comunitario en la identificacion De factores de riesgo cardiovascular en la menopausia
Authors: Guerrero Claudia E. , Ruggieri María E , Scerbo Matías Pernochi , Rencoret María Mercedes 
Published: August 2021

En la actualidad, la esperanza de vida se ha incrementado en todo el mundo hasta la octava década. (Lobo RA, 2018; Ahuja M, 2016)
Las enfermedades cardiovasculares (ECV) siguen siendo la principal causa de muerte en muchos países en vías de desarrollo, pero también en países desarrollados. (Bolaños Chavez, BD; 2021) y representa una de las principales causas de mortalidad en mujeres postmenopáusicas. (Arteaga Urzúa E; 2016).