bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of sensory posterior articular nerves of the knee (SPANK) block versus infiltration between the popliteal artery and the capsule of the knee (IPACK) block when added to adductor canal block for pain control and knee rehabilitation after total knee arthroplasty---A prospective randomised trial
Authors: Padhy Shibani , Patki Abhiruchi Yeshwant , Kar Akhya Kumar , Durga Padmaja , Sireesha L 
Published: November 2021

Background and Aims:Adductor canal block (ACB), though an effective procedure for postoperative analgesia in total knee arthroplasty (TKA), does not provide analgesia to the posterior articular aspect of the knee joint. Infiltration between the popliteal artery and the capsule of the knee (IPACK block) and sensory posterior articular nerves of the knee (SPANK block) are two single injection techniques that have been shown to provide effective analgesia in posterior knee pain. This study aims to compare the effect of IPACK block and SPANK block when combined with ACB for analgesia and postoperative rehabilitation in TKA.Methods:A total of 82 patients were randomised into two groups: (1) ACB combined with IPACK, (2) ACB combined with SPANK block. The primary outcome was the pain scores from 6 h to 48 h after surgery and the duration of postoperative analgesia. The secondary outcome measures were 24 h opioid consumption, ambulation parameters like mobilisation ability, quadriceps muscle strength and patient satisfaction score at discharge.Results:Numerical rating scale (NRS) scores at rest and on movement, duration of analgesia, total opioid consumption, and patient satisfaction were significantly better (P< 0.05%) in the IPACK group than in the SPANK block. There were no significant differences in the knee rehabilitation parameters between the blocks.Conclusion:ACB with IPACK block offers better analgesia, less opioid consumption and better patient satisfaction with comparable knee rehabilitation parameters in the immediate postoperative period after TKA compared to ACB with SPANK block.
Length of the middle finger of hand as a simple and reliable predictor of optimal size of uncuffed endotracheal tube in paediatric patients: An observational study
Authors: Saikia Priyam , Thottan Rohan S. 
Published: November 2021

Background and Aims:A recent study suggested middle finger length-based formula as a better predictive guide compared with age-based formula for selecting uncuffed endotracheal tubes (ETTs) in children. But that study did not meet sample size requirement. Thus, we primarily aimed to determine the accuracy of formula using length of the middle finger to determine the internal diameter of the uncuffed ETT and to compare its accuracy with the Cole’s formula. As a secondary objective, we desired to compare its accuracy with some commonly used length and weight-based formulae.Methods:This prospective observational study included children aged up to 12 years posted for elective surgery under general anaesthesia. The length of the middle finger on the palmar aspect of the hand was measured in the preoperative period and the characteristics of the airway used were noted. A predefined criterion of optimal size of the uncuffed ETT was used.Results:A total of 139 patients were included in the final analysis. It was observed that the formula based on middle finger length can predict the optimal size of uncuffed ETT within an error of 0.5 mm in more than 90% instances and its predictive performance is better than Cole’s formula. As a secondary outcome, we also observed that its accuracy is better than other formulae under evaluation.Conclusion:Formula based on middle finger length can be used as a predictor of optimal size of uncuffed ETT in paediatric patients and it is a better predictor than Cole`s formula.
Simulation with a colour indicator to help reduce contamination during airway management in COVID-19 times: An experience from a tertiary centre in India
Authors: George Leah R. , George Smitha E. , Dhawan Ira , Babu Malavika , Sahajanandan Raj , Joselyn Anita S. 
Published: November 2021

Background and Aims:The coronavirus disease 2019 (COVID-19) pandemic has initiated modified protocols for aerosol-generating procedures. A simulation study using dye was conducted to highlight contamination at intubation and extubation and to encourage adherence to the new COVID-19 protocol among anaesthesia personnel in our institution.Methods:A video demonstrating the new COVID-19 protocols was circulated in the Department of Anaesthesiology a week prior to the study. Thirty teams, each comprising an anaesthesia resident and a staff technician, were enroled. Each team was asked to demonstrate the steps of preparation, intubation and extubation on a mannequin in a COVID-19 scenario. Checklists were used to assess points of contamination and adherence to the protocols. Following debriefing, a repeat simulation was conducted. The use of a dye highlighted the points of contamination. The study subjects provided feedback on the usefulness of the session and practical difficulties encountered in adapting to the new protocols.Results:The average contamination scores decreased by 3.4 (95% confidence interval (CI): 2.4–4.4,P< 0.001) in the post-debrief session. Adherence to the steps of the modified protocol improved by a score of 2.7 (CI: 3.6–1.83) among anaesthesiologists and by 4.3 (CI: 5.3–3.3) among technicians. Further, 93% felt that the use of the colour indicator reinforced awareness of the possible points of contamination.Conclusion:Simulation with a low-fidelity mannequin by using colour indicator for secretions is an effective teaching tool to reduce health hazards during airway management in COVID-19 times.
Serum Paroxonase 1 level may be an Indicator and Predictor of the Severity of Androgenetic Alopecia
Authors: Tantawy Maha , Khabir Ahmed Abdel , Mahsoub Nancy , Zohdy Marwa 
Published: November 2021

Background:
Androgenetic alopecia (AGA) is a common stressful form of hair loss caused by androgen excess, genetic factors, and exposure to oxidative stress (OS) with the formation of reactive oxygen species (ROS). Paraoxonase 1 (PON1) is an enzyme synthesized in the liver bound to high-density lipoproteins to prevent lipid peroxidation.

Aim:
The aim of our work is to estimate serum PON1 level in patients with AGA and correlate its levels with disease severity which may help in determining if there is a role of ROS in pathogenesis of AGA.

Subjects and Methods:
This study was carried out as a case and control on 40 patients with AGA (diagnosed by typical clinical and dermoscopic finding) versus 40 control subjects. Blood samples were taken from all subjects to assess serum PON1enzyme using enzyme-linked immunosorbent assay kits.

Results:
There was a significant decrease in serum PON1 concentration level in AGA patients in comparison to controls, in addition, there was a significant decrease correlated with AGA severity (P < 0,001). The study proved that PON1 is considered highly sensitive and specific for AGA cases and a good predictive factor of AGA in healthy subjects.

Conclusion:
This is the first study done to reveal that the level of PON1 significantly decreased in AGA patients, which may give additional proof that OS has role in the pathogenesis of AGA and hence may help in the management of AGA by adding antioxidants in treatment.
A Clinico-trichological Study of Female Androgenetic Alopecia
Authors: Verma Isha , Madke Bhushan , Singh Adarsh Lata , Choudhary Sanjiv 
Published: November 2021

Background:
Female Androgenetic Alopecia (FAGA) is one of the most common cause of diffuse scalp hair loss in women. FAGA is insidious in onset, gradually progressive, non scarring alopecia. Trichoscopy is a newly developed non invasive, objective, bed side analytical method of hair imaging based on video dermoscopy of scalp. The objective of this study is to study the clinical features of female androgenetic alopecia, to study the trichoscopic features in patients of female androgenetic alopecia and to correlate the trichoscopic features according to clinical grade of female androgenetic alopecia.

Methods:
Study enrolled 50 females with FAGA and 50 normal females. FAGA cases were divided into subgroups according to sinclair scale. Laboratory investigations including hemoglobin level, triiodothyronine (T3), thyroxine (T4) thyroid stimulating hormone (TSH) and serum ferritin level were carried out in both cases and controls. After clinical diagnosis, trichoscopic examination was done and categorised using Diagnostic Criteria set by Rakowska A. et al and trichoscopic findings were coorelated with clinical grades.

Results:
>4 yellow dots in frontal area, >2:1 ratio of single hair units (frontal: occiput) & >3:1 ratio of hair with perifollicular discoloration (frontal: occiput) are mainly seen in late stages of FAGA i.e. grade 4 & 5 and >1.5:1 ratio of vellus hairs (frontal :occiput) in early stages i.e. grade 2 & 3 while lower mean hair thickness in frontal area & > 10% thin hairs in frontal area are seen in all stages of FAGA Conclusion: Trichoscopy not only confirms the diagnosis by assessing the trichoscopic features of FAGA but also coorelates them with clinical severity. And as the age increases, grade of clinical severity increases. Not necessarily hemoglobin, thyroid and serum ferritin levels will be dearranged in FAGA cases.

Limitation:
The study is done on few number of patients. Further studies needs to be done to validate results.
Hair Loss in Children
Authors: Shetty Varsha M. , Shanmukhappa Asha Gowrappala , Nataraj H. V. , Aradhya Sacchidanand Sarvajnamurthy 
Published: November 2021

Background:
Scalp hair loss in children is one of the common complaints encountered in dermatological practice. Accurate diagnosis of hair loss in children is of major significance as it can have severe psychological implications given the cosmetic importance of hair.

Aims:
This study aims to study the different causes and clinical presentations of scalp hair loss in children.

Materials and Methods:
This was a hospital-based descriptive study that enrolled a total of 170 children with scalp hair loss. A detailed history, scalp, and hair examination were done. Bedside investigations such as KOH mount, hair shaft microscopy, and hair pull tests were conducted. Scalp biopsy and dermoscopy were done wherever necessary to confirm the diagnosis.

Results:
Majority of the children with scalp hair loss were school going and adolescents accounting for 62.4% of cases; 52.4% of patients were male and 47.6% were female. Asymptomatic hair loss was the most common presenting complaint contributing to 71.2% of cases. Patchy pattern of scalp hair loss formed a majority (86.5%) compared to diffuse pattern (13.5%). Around 89.4% of scalp hair loss were of acquired type and remaining 10.6% were of congenital type. Neonatal occipital alopecia (38.9%) was the most common cause of congenital hair loss. However, in the acquired group, 90.1% had nonscarring and 9.9% had scarring alopecia. In the nonscarring group, tinea capitis, alopecia areata, and telogen effluvium accounted for 47.4%, 37.9%, and 8.8% of cases, respectively.

Conclusion:
Childhood alopecia is different from adult alopecia in terms of causes and the pattern of presentation. There is a scarcity of literature on childhood alopecia from India, hence, this study can serve as a useful guide in understanding the different causes and its presentation in our population. In addition, this study signifies the importance of simple diagnostic tests such as KOH and hair shaft microscopy in the diagnosis of common hair loss conditions in children.
Evaluation of the effect of Jaftex herbal mouthwash on the growth of Candida albicans and Candida tropicalis
Authors: Amin Mansour , Babadi Fatemeh , Baghipour Najme , Sadeghi-Nejad Batool 
Published: November 2021

Background:
Increased resistance of Candida albicans to standard antifungal agents has caused special attention to medicinal plants. The aim of this study was to evaluate the effect of Jaftex mouthwash on the growth of C. albicans and Candida tropicalis.

Methods and Material:
In this in vitro study, standard strains of C. albicans and C. tropicalis were used. Jaftex mouthwash was prepared with the active ingredient (10g/100cc) of aqueous extract of oak fruit hull (Jaft), Zataria multiflora, and Satureja bachtiarica. The mouthwash was diluted in half, 8 different concentrations were obtained. 10 μl volume of each dilution was poured on discs mounted linearly on the culture medium inoculated with the target fungus. After 24 h, due to the slow growth rate of these fungi, the Petri dishes were incubated at 37°C and the mean minimum inhibitory concentration (MIC) was determined for each fungus. The modified E. test method was used to measure the MIC of Jaftex mouthwash for the two fungi. The experiment was repeated three times for each fungus and the mean value was measured.

Results:
The mean value of MIC for C. albicans and C. tropicalis was 0.0625 (mg/mL) and 0.0833 (mg/mL), respectively. Candida albicans appeared to be more sensitive to Jaftex, but no statistically significant difference was observed.

Conclusion:
Jaftex mouthwash inhibits the growth of C. albicans and C. tropicalis. The use of this mouthwash is recommended for treatment of oral candidiasis.
Effect of yoga on pulse rate and blood pressure among women
Authors: Kaleeswari G. , Kalyani C. Vasantha , Jayarani J. S. , Rohilla Kusum K. 
Published: November 2021

Objectives:
Change in the past few decades in human life style, nowadays international health organizations, i.e., World Health Organization are also focusing on prevention along with treatment aspect of chronic illness. Researches focus that women of age group 30–45 years are at increased risk for hypertension and heart disease due to increased weight. Yoga is an effective method to control our physiological variables like blood pressure (BP), pulse, etc. The main aim of this study was to identify the effects of yoga on physiological variables.

Methods:
The study was an experimental study with two group, pretest and posttest control group, design, which was conducted on 40 female participants. Pranayama and meditation for a period of 6 weeks was done by these women.

Results:
Yoga therapy significantly reduced the BP (0.000*) and pulse rate (0.000*) of women, which was also statistically proved.

Conclusions:
Yoga therapy can be an effective method to control BP and pulse rate of patients with chronic diseases.
TG/HDL Ratio
Authors: Chauhan Ajay , Singhal Ayushi , Goyal Parul 
Published: November 2021

Background:
The spectrum of Diabetes Mellitus and various complications associated with it have been regarded as major global health challenges. Raised TG/HDL has been regarded as one of the valid markers for Insulin resistance. It leads to increased risk of CVD by causing Insulin resistance and also by its own effect on the vessel wall. Detection of raised TG/HDL ratio and early intervention before the patients develop clinical disease can help in mitigation of future consequences of CVD.

Aims:
The aim of our study was to compare TG/HDL ratio between prediabetics and controls and further to look for any correlation between the TG/HDL ratio value with HOMA-IR and Carotid Intima Media Thickness (CIMT) in prediabetics.

Settings and Designs:
A cross sectional study

Methods and Material:
Study was done at ABVIMS and Dr RML Hospital, New Delhi. 60 prediabetics and 60 age, sex, BMI matched controls were employed. In both cases and controls fasting and postprandial blood glucose, glycated Hemoglobin (HbA1C) and fasting Insulin levels were measured. HOMA-IR values in both the groups were calculated using fasting glucose and Insulin levels. Serum lipid profile was obtained and TG/HDL ratio was analysed in two groups. Values obtained were compared between the two groups. CIMT was only measured in cases using B mode ultrasonography.

Statistical Analysis and Results:
Median (IQR) of fasting plasma Insulin (µIU/ml) in cases was 11.3 (10.175-13.505) versus that in controls being 5.73 (4.3-7.1). HOMA-IR (IQR) values in cases and controls were 3.12 (2.73 - 3.595) and 1.21 (0.918 – 1.505) respectively. Median (IQR) for TG/HDL ratio was 3.26 (2.712 – 4) for cases and 2.05 (1.755- 2.502) for controls. However no correlation was observed between either the mean CIMT (mm) or HOMA-IR with TG/HDL ratio.

Conclusions:
Diabetes Mellitus and its various complications are of a great burden to society. Diagnosing the risk factors early before the onset of these manifestations can help us in combating these major issues. One of the risk factors among them is raised TG/HDL ratio. Early detection of elevated TG/HDL in prediabetics may serve in early detection of atherosclerotic complications and help physicians in framing primary preventive strategies for tackling ASCVD in patients with prediabetes and full-blown Diabetes.
High-resolution chest computed tomography findings of coronavirus disease 2019 (COVID-19) – A retrospective single center study of 152 patients
Authors: Kaur Navdeep , Sahoo Soumya S. , Chhabra Harvinder S. , Kaur Amandeep , Singh Navdeep , Garg Shivane 
Published: November 2021

Introduction:
Coronavirus disease 2019 (COVID-19) pandemic has engulfed the world, within a short span of time crippling many health systems. The disease in its ever-evolving course is exhibiting a myriad of symptoms and imaging manifestations. This retrospective study was conducted to generate evidence from the chest computed tomography (CT) findings of patients with COVID-19 pneumonia to aid in the diagnosis and disease management.

Methods:
This retrospective study included all patients with reverse transcriptase polymerase chain reaction confirmed COVID-19 disease who underwent chest CT between 1st June to 31st December 2020 at a tertiary care institute of North India. Anonymized data of 152 COVID-19 positive patients was used for the evaluation of the clinical profile and imaging findings.

Results:
The common presenting clinical symptoms were fever, cough, myalgia and sore throat. The most frequent CT imaging feature consisted of ground-glass opacities (GGOs), consolidation and crazy paving distributed bilaterally, peripherally in subpleural location with a predilection for the posterior parts of lungs. Reverse halo sign was observed in 12 patients and halo sign in 3 patients. Dilated pulmonary vessels with mild bronchiolectasis were observed in the involved lung parenchyma. Less common findings included pleural effusion, mediastinal lymphadenopathy, and pericardial effusion. The mean CT severity score gradually increased with increasing age.

Conclusion:
The predominant imaging finding of COVID-19 pneumonia was peripheral GGO’s distributed bilaterally in peripheral subpleural region and having predilection for the posterior parts of the lungs which gradually evolve into organizing pneumonia patterns. Although COVID-19 shares imaging findings with other viral pneumonias, however in the context of the current pandemic, we must keep COVID-19 a differential diagnosis, in all patients with fever and respiratory symptoms.
Dietary behaviour and anthropometric parameters across the spectrum of pregnant and lactating mother, infant, young children, adolescent girls and reproductive age group females
Authors: Yadav Surbhi , Ahmad Shamshad , Chaudhary Neha , Kumar Mahendra , Gahlot Anju 
Published: November 2021

Introduction:
The Kol is an ancient tribal community, who resides in the backward Bundelkhand and Baghelkhand regions bordering UP and MP. Reports claim the high level of exploitation and marginalisation of them by feudal landed landlords. Due to the dearth of studies on Kol community their plight hasn’t been addressed effectively so far. Thus, this study was undertaken to assess the dietary behaviour and anthropometric parameters across the spectrum of Maternal, Lactating, Infant, Young Children, Adolescent girls, and reproductive-age women (MIYC-AR) of Kol Community.

Methodology:
It was a descriptive observational cross-sectional study, conducted over a period of 6 months; in hard to reach area of Manikpur block, Mangawa, in Chitrakoot district. Pregnant, lactating mothers, infant, young children, adolescent and reproductive age females who were found eligible, were included in the study. A total of 180 participants (30 from each group) were recruited by non-probability purposive sampling. A structured questionnaire was used to collect information regarding Iron folic acid and calcium intake, frequency of major meals and snacks, feeding history of infant and young child. Weight, height, head circumference and mid upper arm circumference were noted and the participants were classified accordingly. Statistical analysis was done using STATA version 13 software.

Results:
Only 36% and 30% of the pregnant and lactating mother, respectively, consumed IFA and calcium. The mean diet diversity score was inadequate for all the groups. Maximum among adolescents (70%) and half of the reproductive age group female (50%) were underweight. More than half of the infants (57%) were found to be malnourished on MUAC measurement, while the similar proportion among young children were found to be normal (p < 0.001). Half of the young children had timely initiation of complimentary feeding. But, none among young children received Vitamin A syrup.

Conclusion:
Significant higher prevalence of malnutrition was found among infants, adolescents, and reproductive age group females. Strengthening the public distribution system and rigorous supplementary nutrition services through ICDS are the priority intervention needed to address the poor nutritional status of tribe.
Out-of-pocket expenditure and its predictors for illness of under-five children
Authors: Mohanty Parimala , Satpathy Sudhir Kumar , Patnaik Sibabratta , Patnaik Lipilekha 
Published: November 2021

Introduction
Out-of-pocket (OOP) expenditure influences the access to the healthcare of the marginalized and vulnerable population including under-five children (U5C). The aim of the study is to estimate the OOP expenditure and its predictors in Bhubaneswar, a region of eastern India.

Methods:
A cross-sectional study was conducted using a semi-structured interview schedule in 20 urban slums of Bhubaneswar. The survey was carried out by using the National Sample Survey Office (NSSO) health consumption schedule 25.0 in which mothers of U5C with illness (n = 530) were interviewed. For data analysis, the nonparametric Wilcoxon rank-sum test and Kruskal–Wallis test were used as tests of significance.

Results:
The study revealed that the mean OOP expenditure for outpatient department (OPD) care was

JOURNAL/jfmpc/04.03/01697686-202110100-00058/math_58MM1/v/2022-10-03T183005Z/r/image-tiff

375.9 (

JOURNAL/jfmpc/04.03/01697686-202110100-00058/math_58MM2/v/2022-10-03T183005Z/r/image-tiff

219.48). The mean approximated expenditure was

JOURNAL/jfmpc/04.03/01697686-202110100-00058/math_58MM3/v/2022-10-03T183005Z/r/image-tiff

1669.8 (

JOURNAL/jfmpc/04.03/01697686-202110100-00058/math_58MM4/v/2022-10-03T183005Z/r/image-tiff

1131.9) for inpatient department (IPD) care. In OPD care, doctors’ fee and medicine cost constituted 65.01% and 50.46% of OOP expenditure, respectively. In IPD care, medicine cost and doctors’ fee contributed to 36.62% and 30.54% of OOP expenditure, respectively. The major significant predictors that contributed to increased OOP were gender and delay in approaching the source of treatment in OPD, whereas in IPD no such predictors were observed.

Conclusions:
This study prominently sheds light on the issue of accessibility and affordability of health services without a comprehensive health insurance scheme for U5C illness among the vulnerable urban slum dwellers to achieve universal health coverage.