bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Coronary Syndrome (ACS) during Corona Virus Disease-19 (COVID-19) Pandemic
Authors: Baruah Dibya K. , Darimireddi Anuradha , Telikicherla Ravikanth , Allamsetty Suresh 
Published: October 2021

Aim:
To analyze the impact of corona virus disease-19 (COVID-19) pandemic and various containment measures taken for the pandemic control on hospital admissions of acute coronary syndrome (ACS).

Materials and Methods:
This study is a single-center, comparative study conducted at a tertiary care center situated in the southern part of India. The study period was from March 1, 2020 till May 31, 2020, including the first lockdown period in India. All patients admitted with a diagnosis of ACS to our hospital during the study period were included in the study (study group). This group was compared with the patients admitted with ACS into our hospital during the corresponding period of the previous year (control group). Patients with ST-elevation myocardial infarction (STEMI) were compared with the control group for clinical profile, treatment, hospital course, outcome, and incidence rate ratio (IRR) of admissions.

Results:
There was a significant reduction of mean daily admissions of ACS cases in the study group with IRR of 0.702; 95% confidence interval (CI), 0.719–1.02; P < 0.001. The reduction rate of ACS cases was 29.74% (study period, n = 215; control period, n = 306), and it was mostly related to a decline in the number of non-ST-elevation myocardial infarction (NSTEMI) and unstable angina. No significant reduction of patients with STEMI was observed between the groups. However, patients with STEMI had more left ventricular (LV) dysfunction, LV thrombus, and a significantly higher incidence of mitral regurgitation (13.3% vs. 8.8%, P < 0.05). The impact of the COVID-19 outbreak on the patients with ACS revealed a parallel reduction of hospital admissions with an increasing number of COVID-19 cases in the community.

Conclusion:
The COVID-19 pandemic and concomitant social restrictions resulted in a significant decline in hospital admissions due to ACS in this tertiary care center, but without any effect on the number of admissions with STEMI. A parallel reduction of hospital admissions for ACS cases with a rising number of COVID-19 cases in the community was also observed in this study.
Comparison of block characteristics of intrathecal isobaric levobupivacaine versus isobaric ropivacaine for infra-umbilical surgeries in school-age children: A prospective randomised double-blind study
Authors: Bhati Kanta , Kuraning Kiran , Dhawan Sonali , Jawaid Irum , Khilji Yunus 
Published: October 2021

Background and Aims:Levobupivacaine and ropivacaine are effective local anaesthetic drugs used in regional anaesthesia with low cardio-neurotoxicity profile than bupivacaine, but comparative studies are limited in children. So, we compared these two drugs intrathecally to study their efficacy and safety in school-age children.Methods:This study was carried out in 60 American Society of Anesthesiologists class I, II and III patients aged 6–12 years, of either sex undergoing infra-umbilical surgeries. After institutional ethical committee approval and written informed consent, the patients were randomly divided into two groups. Group A received isobaric levobupivacaine (0.5%, 0.3-0.4 mg/kg), whereas group B received isobaric ropivacaine (0.5%, 0.5 mg/kg) intrathecally. Fentanyl (0.2 μg/kg) was used as an adjuvant in both the groups. Onset, peak and duration of sensory and motor blockade, duration of post-operative analgesia, time for micturition, perioperative haemodynamic parameters and complications were compared.Results:Onset and peak of sensory and motor block were earlier in group A. Significantly longer duration of sensory and motor block was achieved in group A (251 ± 41 min, 201 ± 40 min) compared to group B (211 ± 21 min, 102 ± 16 min) (P< 0.001). The time to first rescue analgesic was also significantly prolonged in group A (270 ± 39 min) compared to group B (233 ± 18 min) (P< 0.001). Time to micturition was much early in group B (157 ± 27 min) compared to group A (225 ± 31 min) (P< 0.001).Conclusion:Intrathecal isobaric levobupivacaine and ropivacaine with fentanyl produces effective surgical anaesthesia and postoperative analgesia without any adverse effects. Early regression of sensorimotor blockade makes ropivacaine better in comparison to levobupivacaine for short infra-umbilical surgeries in children.
Tracheal intubation with King Vision video laryngoscope in patients with cervical spine instability—Comparison of straight versus curved reinforced endotracheal tubes
Authors: Patel Nisha , Desai Devyani J. 
Published: October 2021

Background and Aims:King Vision video laryngoscope is commonly used to facilitate intubation in corrective surgery for cervical spine instability patients due to less manipulation. Curved and straight reinforced tracheal tubes are regularly used in this surgery as neck of the patient is likely to be flexed. We aimed to compare intubation characteristics between the curved and straight reinforced tubes through King Vision video laryngoscope in patients to be operated for cervical spine instability with the primary objective being intubation time.Methods:Sixty patients undergoing cervical spine surgery were enroled in this prospective randomised comparative clinical study. All were intubated after applying manual in-line stabilisation of the neck, using either curved (group C) or straight (group S) reinforced endotracheal tubes through King Vision video laryngoscope. The intubation time, number of attempts, incidence of tube impingement with arytenoids/aryepiglottic folds, optimisation manoeuvres required and complications were observed. Unpaired ‘t’ test and Chi-square test were used to analyse the data using MedCalc software, version 12.5.Results:Time taken for intubation was shorter with curved compared to straight reinforced tube (16.24 ± 3.09 vs. 29.08 ± 5.48 seconds,P< 0.0001) The first attempt success rate was higher using curved than straight reinforced tube (93.3% vs. 70%,P= 0.02). Incidences of impingement with arytenoids/aryepiglottic folds and optimisation manoeuvres required more with the straight reinforced tube.Conclusion:The intubation was fast and with higher first attempt success rate with curved than with straight reinforced tube through King Vision videolaryngoscope when used in patients with cervical spine instability.
Intermediate outcomes of therapeutic penetrating keratoplasty for severe microbial keratitis using glycerol-preserved donor corneas during the COVID-19 pandemic
Authors: Roy Aravind , Kamra Dhruv , Murthy Somasheila I , Mohamed Ashik , Chaurasia Sunita , Fernandes Merle , Das Sujata , Sharma Savitri 
Published: October 2021

Purpose:
To report the intermediate outcomes of therapeutic penetrating keratoplasty (TPK) performed for severe microbial keratitis using glycerol-preserved corneas during the Corona virus diseases of 2019 (COVID-19).

Methods:
Retrospective non-comparative case series from April to August 2020 in a network of tertiary eye care centers. Glycerol-preserved tissues were used for therapeutic keratoplasty (TPK). We reviewed the demographics, microbiology, surgical outcomes such as wound integrity, recurrence, graft melt, epithelialization, and complications.

Results:
A total of 49 eyes that underwent TPK with glycerol-preserved corneal tissues were analyzed. The primary indication was severe microbial keratitis in 47 eyes. The majority was a fungal infection in 33 eyes (67.3%). The mean age was 53.8 ± 12.2 years, with male predominance (3:1). The corneas were stored for an average of 85.5 ± 53 days prior to transplant. The median donor age was 65 years. The grafts were tectonically stable in 32/36 eyes (88.9%) at 1 month and 20/24 eyes (83.3%) at 3 months. The graft melt was noted in three eyes at 1 and 3 months. The recurrence of the infection was noted in four eyes and all were of fungal etiology. The graft epithelialization was delayed with a mean duration of 48.9 ± 25 days after surgery. Post-TPK, raised intra-ocular pressure (>21 mm Hg) was noted in 51.2% at 1 week, 17.4% at 1 month, and 11.8% at 3 months.

Conclusion:
Glycerol preservation is a reliable alternative with good therapeutic outcomes in the short and interim postoperative period. Delayed epithelialization and secondary glaucoma were the commonest postoperative complications.
Changing patterns of posterior segment trauma during the COVID-19 pandemic: A regional analysis from the Bodhya Eye Consortium
Authors: Parchand Swapnil , Shenoy Pratik , Muralidhar Alankrita , Kohli Gaurav , Gangwe Anil , Agrawal Deepanshu , Varshney Abhishek , Mittal Ruchi , Saha Indranil , Madharia Aishwarya , Singh Shalini , Sen Alok , Trehan Hemant , Agarwal Manisha 
Published: October 2021

Purpose:
To assess changes in the presentation patterns of posterior segment trauma during the COVID-19 pandemic from six tertiary eye care institutes of North and Central India.

Methods:
A multicenter, hospital-based, retrospective comparative analysis of patients presenting with posterior segment trauma was done during the COVID-19 (Group A) (March 25, 2020 - September 30, 2020) period and the pre-COVID-19 (Group B) (March 25, 2019 - September 30, 2019) period.

Results:
A total of 405 patients were diagnosed with posterior segment trauma (Group A: 206, Group B: 199). The time interval between onset of trauma and presentation was higher in Group A (16.59 ± 29.87 days) as compared to Group B (9.41 ± 19.19 days) (P = 0.004). A majority of patients in Group A had a history of prior consultation before presentation (P = 0.049). In Group A, 120 (58.2%) patients sustained ocular trauma at home as compared to 80 (40.2%) patients in Group B (P < 0.0001). Patients presenting with light perception were significantly more in Group A (43.7%) as compared to Group B (30.2%) (P = 0.004). In Group B, 37.6% patients had presenting visual acuity of counting finger or better as compared to 27.6% patients in Group A (P = 0.07). Patients in Group A had a significantly higher proportion of post-traumatic endophthalmitis with delayed presentation (P = 0.011) and retinal detachment (P = 0.041). Patients undergoing surgery for foreign-body removal were significantly fewer in Group A (P = 0.05).

Conclusion:
Although the number of patients presenting with posterior segment trauma was comparable in Groups A and B, a greater number of patients sustained home injuries during the COVID-19 pandemic. A majority of these patients had delayed presentation with poor presenting visual acuity and a higher tendency of retinal detachment.
Role of pre-operative percutaneous embolization in orbital alveolar soft part sarcoma – An experience from a tertiary eye-care center
Authors: Koka Kirthi , Singh Parinita , Nisar Sonam Poonam , Alam Md. Shahid , Backiavathy Varsha , Scott Julius Xavier , Krishnakumar Subramanian , Mukherjee Bipasha 
Published: October 2021

Purpose:
To describe the clinic-radiological, pathological profile, and management outcomes of primary alveolar soft-part sarcoma (ASPS) of the orbit.

Methods:
A retrospective analysis of all histopathologically proven cases of orbital ASPS that presented between May 2016 and September 2019 was done. Data collected included demographics, clinical features, imaging characteristics, metastatic workup, management, and follow-up.

Results:
Five patients, of which four were males, presented to us during the study period. The mean age of presentation was 12.6 years (range 3–22 years). The most common presenting features were abaxial proptosis (n = 4) and diminished vision (n = 4). Imaging showed a well-defined orbital mass in all patients with internal flow voids in three. Preoperative percutaneous embolization with cyanoacrylate glue was done in these three patients owing to high vascularity. Four patients underwent complete tumor excision. One patient underwent exenteration. Histopathology showed polygonal tumor cells arranged in a pseudo-alveolar pattern and Periodic Acid-Schiff (PAS) positive crystals in the cytoplasm in all patients. One patient had systemic metastasis at presentation and developed a local recurrence after 3 months. No recurrence or metastasis was noted in the remaining four patients at a mean final follow-up of 11.2 months (range 5–15 months).

Conclusion:
ASPS is a rare orbital neoplasm that poses a diagnostic and therapeutic challenge. Imaging might show a soft-tissue tumor with high vascularity. Multidisciplinary management with interventional radiologists for preoperative embolization of vascular lesions helps minimize intraoperative bleeding and aids in complete tumor resection. A localized orbital disease carries a better prognosis.
Comparison of the effect of fluoride gel and two toothpastes with different materials on remineralization of initial carious lesions in primary teeth
Authors: Meshki Razieh , Basir Leila , Rahbar Nadereh , Kazempour Maryam 
Published: October 2021

Introduction:
Various types of toothpastes are claimed to be able to improve initial enamel caries. This study compared the effect of fluoride gel and two toothpastes on remineralization of initial caries lesions in primary teeth.

Materials and Methods:
A total of sixty-four sound extracted primary canine were immersed in demineralizing solution at 37°C for 96 h to produce artificial caries in vitro. Enamel pieces (3 × 3 × 5 mm) were prepared from each tooth and mounted in self cure acrylic blocks. The specimens were randomly assigned to four groups (n = 16) based on treatment agent (fluoride gel, Chitodent toothpaste, ReminPro toothpaste, no treatment as control) and underwent a pH cycling model for 10 days. Vickers microhardness (VH) was measured before and after treatment. Data was analyzed using analysis of variance and paired t-test by SPSS 18 (P < 0.05).

Results:
No significant difference was found in VH between groups at baseline (fluoride group: 265.9 ± 44.8, Chitodent group: 282.6 ± 34.6, ReminPro group: 266.5 ± 26.6, control: 272.7 ± 32.5; P = 0.516). Microhardness significantly increased after exposure to ReminPro toothpaste (VH change: 24.1%, P < 0.001) and fluoride gel (VH change: 10.9%, P = 0.046), but no significant changes were observed in Chitodent (VH change: 2.8%, P = 0.635) and control (VH change: - 2.2%, P = 0.181) groups.

Conclusion:
ReminPro toothpaste might be effective in remineralizing initial carious lesions of primary teeth.
Clinical, CT scan, and laboratory changes of abscess patients with odontogenic origin admitted to Shiraz acute surgical care center, Iran
Authors: Aliabadi Ehsan , Farshad Mohammad Mahdi , Kheirkhah Masoomeh , Jafari Seyed Hamed 
Published: October 2021

Introduction:
Rapid diagnosis of maxillofacial abscess with the odontogenic origin is effective in the treatment of patients. This study aimed to check the clinical evaluation, head, and neck computed tomography (CT) scan, and microbial sensitivity of hospitalized patients diagnosed with maxillofacial abscess admitted to the Maxillofacial Surgery Ward Shaheed Rajaie Surgical Acute Care Center of Shiraz, Iran from 2019-2021.

Method:
A cross-sectional study was conducted. The sample included patients diagnosed with the abscess of odontogenic origin. Data collection tools included personal profile registration form, chief complainant and clinical evaluation, laboratory test results, pus culture, antibiogram results, and head and neck CT scan changes form. Data was reported with descriptive statistics by SPSS-16 software.

Results:
The majority of patients were male; infection duration was 10 days; maximum mouth opening size was less than 20 mm in more than half of patients.The scan revealed 41.8% abscess, 36.4% cellulite, and 21.8% mixed abscess and cellulitis. There was 29.1% involvement of salivary glands. The majority of abscesses were unifocal involved in the submandibular space, and the least involvement was in peri mandibular space and carotid sheath. The most common organism causing was staphylococcal abscess coagulase-negative.

Conclusion:
In patients with maxillofacial abscess requiring hospitalization, the most common clinical features were trismus, toxic appearance, and dysphagia, and the most common source of abscess in scanning patients with mandibular molars was the most involved submandibular space and pterygomandibular space. Vancomycin, cotrimoxazole, and cefazolin had the greatest effect in the treatment of odontogenic infections in terms of antibiogram results and microbial culture.
A study on patterns, indications, and complications of an enteric stoma
Authors: Pandiaraja Jayabal , Chakkarapani Rajesh , Arumugam Shalini 
Published: October 2021

Introduction:
Stoma could be a surgically created opening within the abdominal wall. The main purpose of the stoma is to divert the excreta off from the distal intestinal loops to relieve an obstruction or protect anastomosis. The indications for stoma creation are intestinal obstruction due to benign or malignant tumors, perforation peritonitis, inflammatory bowel disease, colorectal malignancies, and anorectal malformations.

Aim of the study:
The study aimed to identify the patterns, indications, and complications that occur following the creation of enteric stomas.

Materials and Methods:
It is a prospective observational study conducted from May 2012 to October 2015 on a hundred patients, who were admitted in the department of general surgery, surgical gastroenterology, and pediatric surgery, Government Stanley Medical College and Hospital. The sampling method followed here is the non-probability convenience sampling technique. The data is collected from all the patients who come under the inclusion criteria.

Results:
Of 100 patients, the majority of the patients belonged to 26–35 years and 46–55 years (n = 25). Based on the study, loop colostomy is more common with age less than one year and loop ileostomy is more common in 26–55 years. The foremost common indication of an enteric stoma is a gastrointestinal malignancy (25%) followed by abdominal trauma (22%). In our study, an ileostomy (80%) is the most common type of stoma created followed by colostomy. Within the ileostomy, loop ileostomy is the more common (60%) followed by end ileostomy (20%). Among the complications related to an enteric stoma, skin excoriation (54.4%) is most common followed by surgical site infections (8.5%).

Conclusion:
Our study shows stoma creation is higher in the adult and old age group, mostly done as an emergency procedure compared to an elective procedure. So, better preoperative planning in both emergency and elective settings can reduce the number of stoma and its related complications. The duration of hospital stay is higher in stoma patients. So, the reduction in stoma creation leads to a reduction in complication, duration of hospital stays and indirectly reduces expenditure related to it. In our study, most of the stoma is created for obstruction in malignancy and perforation in trauma patients. From our study, we can observe early diagnosis of intestinal malignancy with a well-planned elective procedure or bride procedure like colonic stenting in malignant obstruction can reduce the number of stoma creation. Skin excoriation is the most complication followed by surgical site infections. These complications can be reduced by better postoperative stoma care and early reversal of stoma.
Pregnancy outcomes and vertical transmission capability of SARS-CoV-2 infection among asymptomatic females
Authors: Kumari Kalpana , Yadav Ramakant , Mittra Sangh , Kumar Arushi , Bajpai Prashant K. , Srivastava Dhiraj K. , Kumar Raj 
Published: October 2021

Background:
The COVID-19 pandemic is still spreading throughout the world along with its strange and frightening mutations, and the World Health Organization (WHO) has declared it as a global pandemic.

Objective:
The present investigation aims to evaluate the effect of SARS-CoV-2 infection on mother and newborn outcomes and the vertical transmission potential of this virus.

Study Design:
This was a cross-sectional study conducted at a tertiary care dedicated COVID-19 hospital. A total of 40 pregnant females (RT-PCR positive for SARS-CoV-2) and their 41 neonates (including stillbirths and a twin delivery) were included in the present study.

Results:
All the mothers in the study were SARS-CoV-2 positive on the RT-PCR test, but none had any COVID-19 symptoms (pneumonia-like fever, cough, fatigue, sore throat, shortness of breath, and diarrhea). Out of 41 newborns, 38 (92.7%) were healthy, one (2.4%) was a stillbirth, and two newborns (4.9%) could not be revived. All the 41 (100.0%) neonates, including stillborn and preterm were negative for the SARS-CoV-2 RT-PCR test. Twenty-Six neonates (63.4%) were delivered by caesarean section, whereas 15 cases (36.6%) had a normal vaginal delivery.

Conclusion:
The present study showed no suggestion of vertical transmission of SARS-CoV-2 in pregnant females. Therefore, the placenta might function as a barrier to the SARS-CoV-2 virus. Also, there were no complications come upon during the delivery of any neonate in the present study.
Utilization of antenatal care services in a remote, tribal and hilly district of Himachal Pradesh
Authors: Purohit Neha 
Published: October 2021

Background:
A traditional African phrase, 'A pregnant woman has one foot in the grave' expresses the immense health risks associated with pregnancy and childbirth. Antenatal care (ANC) is considered an important determinant to alleviate mortalities and morbidities associated with maternal health.

Objectives:
The study aimed to identify the utilization pattern of ANC services by pregnant women in a remote, tribal, and hilly district of Himachal Pradesh and to understand their healthcare needs during antenatal period.

Methods:
A community based descriptive, cross-sectional study was carried out in 41 far-flung villages of Lahaul and Spiti district in Himachal Pradesh, India, using a mixed-method approach of data collection. Purposive sampling was done to select 103 females who had experienced delivery in the past 2 years and were residents of Lahaul for minimum of 3 years. The participants were interviewed using a semi-structured questionnaire and the data were analysed by SPSS-20.

Results:
The study revealed high utilization of ANC services by indigenous women, but it was accompanied by physical, psychological, and financial hardships. The triple challenge of inadequacy of quality antenatal services, transport facilities, and unfavourable weather conditions compelled women to leave their communities in Lahaul and relocate to adjoining districts during the maternity period.

Conclusion:
Pregnancy is still a stressful event that disrupts the link between families and communities in such underserved areas. The study recommends the establishment of programs that promote availability of quality ANC services within the rural and remote communities.
Oral appliances for obstructive sleep apnea
Authors: Belkhode Vikram , Godbole Surekha , Nimonkar Sharayu , Parhad Sameer , Nimonkar Pranali 
Published: October 2021

Background:
As per the current epidemiological studies, the prevalence of obstructive sleep apnea (OSA) among the adult population is very high. Oral appliances (OAs) have emerged as the most recommended alternative treatment option for mild to moderate OSA.

Objective:
The objective of this article is to propose or develop a new design of OA named “customized maxillary oral appliance (CMOA),” for managing moderate OSA syndrome.

Methods:
The design proposed in this article is first of its kind that is fabricated on the maxillary arch. CMOA is developed by combining the principles of the three most popular OAs used in OSA, namely, soft palate lifters, tongue retaining devices, and mandibular advancement devices.

Conclusions:
Given the potential impact of OSA on general and mental health and the side effects of existing appliances, there is a need for a new remedy to be introduced in the field of sleep medicine. This novel design can provide a new therapeutic option for patients with moderate OSA.