bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deciphering the Role of Autophagy in Heart Failure
Authors: Ajoolabady Amir , Tuomilehto Jaakko , Lip Gregory Y. H. , Klionsky Daniel J. , Ren Jun 
Published: July 2021

Abstract
Heart failure (HF) refers to a progressive pathological condition when cardiac muscles fail to pump adequate blood supply (cardiac output) to meet the metabolic demand of the body. Among various cellular and molecular mechanisms identified for the onset and progression of HF, autophagy dysregulation is increasingly getting recognized. Autophagy is a natural cellular process that is observed in almost all eukaryotic cells. Autophagy removes damaged/long-lived organelles, protein aggregates, and unwanted cellular compomemts via forming autophagosomes then fusing with lysosomes. Although mild-to-moderate induction of autophagy is deemed cytoprotective and adaptive, excessive or unchecked induction of autophagy can be detrimental and maladaptive. Both adaptive and maladaptive autophagy play a vital role in the pathophysiology of HF. In the current review, we provide an overview of autophagy regulation in HF and possible strategies targeting autophagy for the management of HF.
Endoscopic Orbital Transposition for Inverted Papilloma in an Unusually Large Supra Orbital Ethmoidal Cell
Authors: Felix Vinod , Vivek Mariappan , Narendrakumar Veerasigamani 
Published: July 2021

Abstract
The management of inverted papilloma involving frontal sinus and supraorbital ethmoidal cells is still challenging even for the well-trained rhinologists. These cases sometimes require an external approach, but now with the technique of endoscopic orbital transposition many such cases are handled effectively endonasally. Here in our case report, we are describing an unusually large supraorbital ethmoidal cell, which has pneumatized all the way above the orbit, from the frontal sinus to the anterior clinoid process and hence with the optic nerve lying inside this cell. We will be describing how we still could tackle this endoscopically with the modified endoscopic Lothrop and orbital transposition.
A Case of Cystic Hygroma in Adults and Its Management
Authors: Jayabal Pandiaraja 
Published: July 2021

Abstract
Cystic hygroma is a congenital abnormality due to lymphoid sequestration in the sac. Incidence of cystic hygroma in adult is rarely report. It is most commonly present in posterior triangle as cystic mass. Even in adult patient, any cystic lesion present in posterior triangle cystic hygroma should be considered one of the differential diagnoses. Here, we present a rare occurrence of cystic hygroma in adult male patient present as cystic lesion. This case is reported for its adult presentation and discusses the management for cystic hygroma.
Hijab Pin
Authors: Shakrawal Neha , Choudhury Bikram , Soni Kapil , Kaushal Darwin , Goyal Amit 
Published: July 2021

Abstract
Foreign-body aspiration is a serious and deadly event which can lead to major complications. This is more common in children and if not promptly managed, can lead to significant complications. We here report a rare case of hijab pin inhalation into the trachea which migrated to the carina in a 3-year-old child which was successfully removed by rigid bronchoscopy.
Is There an Association between the Anteroinferior Cerebellar Artery Vascular Loop and Asymmetrical Sensorineural Hearing Loss?
Authors: Bhatia Abhijeet , Phukan Pranjal , Sharma Barun , Polley Goutam 
Published: July 2021

Abstract

Background:
Asymmetrical sensorineural hearing loss is usually idiopathic. Vascular loops are commonly implicated in compression disorders involving lower cranial nerves, which can be relieved on surgical decompression. However, the cause–effect relationship between vestibulocochlear symptoms and vascular loops is still controversial.

Objective:
The objective of this study is to look for an association between the presence of anteroinferior cerebellar artery (AICA) loops and asymmetrical sensorineural hearing loss of unknown etiology.

Methods:
Twenty-four patients with complaints of asymmetrical hearing loss of no discernible cause underwent a magnetic resonance imaging of the brain between August 2015 and August 2017. The AICA loops were graded using two classifications, namely Chavda classification and a grading system proposed by Adam Gorrie et al. (second classification). The vascular loops were correlated with the presence of hearing loss, tinnitus, and vertigo.

Results:
Hearing loss did not correlate significantly with the vascular loops on grading with either Chavda or the second classification. The presence of tinnitus or vertigo too did not correlate significantly with the grading of vascular loops. The caliber of AICA too did not correlate significantly with hearing loss.

Conclusion:
Vascular loops do not appear to be associated with asymmetrical hearing loss and other cochleovestibular symptoms.
Impact of Adenoidectomy/Adenotonsillectomy on Hearing Threshold and Middle Ear Pressure
Authors: Somayaji K. S. , Fathima A. , Saimanohar S. 
Published: July 2021

Abstract

Introduction:
Enlarged adenoids may cause obstruction of the nasopharynx and blockage of the Eustachian tube and thereby preventing ventilation of the middle ear – mastoid system. It can also act as a reservoir for bacteria causing frequent middle ear infections. This study was done to assess the middle ear pressure (MEP) and hearing threshold before and after adenoidectomy or adenotonsillectomy.

Materials and Methods:
Fifty-four children aged between 4 and 12 years undergoing adenoidectomy or adenotonsillectomy were included in the study. Pure tone audiometry (PTA) and impedance audiometry were done preoperatively and postoperatively twice, on the 2nd day and at 6th week to assess the changes in hearing threshold and MEP. Statistical analysis was done using paired t-test and Chi-square test to determine the changes in hearing threshold and MEP. P < 0.05 was found to be statistically significant.

Results:
Of the 54 patients (108 ears) studied, 26 ears (24%) showed air–fluid level and 19 ears (17.6%) had dull-retracted tympanic membrane. The mean preoperative PTA value was 15.95 ± 8.19 dB. The mean preoperative MEP value was −63.69 ± 88.9 mm H2O. Postoperatively on 2nd postday, both the values were higher and at 6th week, there was an improvement as compared to preoperative and immediate postoperative values. At 6th week postoperatively, it was also observed that 52 children had tympanogram as type A, confirming the improvement in MEP. All these changes were statistically significant (P < 0.005).

Conclusion:
Adenoidectomy or adenotonsillectomy alone does improve the Eustachian tube function, especially in otitis media with effusion. Myringotomy with grommet insertion may not be necessary in all the cases.
Closure of Irradiated Tracheocutaneous Fistula with Pectoralis Major Muscle Flap and Split Skin Graft
Authors: Taliat George , Gogi Abhijit , Mohan Kumaraswamy 
Published: July 2021

Abstract
Tracheocutaneous fistula in an irradiated neck is often difficult to manage. Simple closure often leads to dehiscence and recurrence. We present a patient with supraglottic carcinoma, postradiotherapy, who presented with a persistent trachea-cutaneous fistula. We excised the fistula along with surrounding indurated tissue and covered the defect adequately with skin graft for tracheal lining and pectoralis muscle flap as a muscle cover. Fistula was closed and wound healed well. There was no recurrence of fistula as evidenced with indirect laryngoscopy. Pectoralis major flap is a well-vascularized flap that can be used to cover defects in anterior lower neck. Simple skin graft with a cover of muscle flap was enough to give adequate tracheal lining.
Middle Ear Surgery and Taste Dysfunction
Authors: Patil Basavaraj , Rajguru Renu , Raghavan Dilip , Singh Inderdeep , Naga Rahul 
Published: July 2021

Abstract

Introduction:
Middle ear surgery involves handling of chorda tympani nerve. Patients after middle ear surgery may complain of taste disturbance and lingual numbness. Clinical testing of taste is not a test which is routinely performed in ENT Clinics. Consequently, the prevalence of postoperative taste dysfunction remains largely unknown.

Aim:
The aim of this study is to determine taste function in patients before and after middle ear surgery with a clinically suitable test and to find out the factors which determine the extent of taste dysfunction.

Setting:
The study design involves tertiary care hospital.

Materials and Methods:
This was a prospective observational study conducted from October 2017 to October 2019 in the ENT department of a tertiary care hospital. Hundred patients undergoing middle ear surgery fulfilling the inclusion criteria were considered as the study population. All patients underwent assessment of taste thrice: the day before the operation, seventh postoperative day and at 3 weeks after surgery by administering three kinds of taste testing solutions for testing sour, sweet, and salty taste in varying concentrations. Scoring was done and tabulated followed by statistical analysis.

Results:
Nineteen (19.0%) participants had taste disturbance after undergoing middle ear surgery. The factors which influenced whether injury to the chorda tympani causes tastes dysfunction included the age of the patient, extent of the injury, type of middle ear disease, and the type of surgery done.

Conclusions:
Patients undergoing middle ear surgery may exhibit taste dysfunction. However, in the majority of the cases, this goes unnoticed by the patient and is transitory. The sense of taste has a great capacity to compensate after partial dysfunction. However, preoperative information to the patients regarding the existence of potential taste disturbance, and that it is transitory usually, but is untreatable if persistent, may prevent any medicolegal problems later.
Long-term study of topographic changes following pulsed accelerated corneal collagen cross-linking in progressive keratoconus
Authors: Gaafar Ahmed M. , Azzam Sarah A. , Salah El-Din Yehia M. , Sherif Ahmed M. 
Published: July 2021

Purpose
To evaluate long-term stability following pulsed accelerated cross-linking (CXL) in patients with progressive keratoconus by studying the changes in corneal topography.

Patients and methods
A retrospective study was conducted on patients with progressive grades 1–3 keratoconus who underwent epithelium-off pulsed-light accelerated corneal CXL (30 mW/cm2 for 8 min) using the KXL system (Avedro Inc.). Follow-up period was 12–36 months. Topographic changes including maximum keratometry (Kmax), minimum keratometry (Kmin), topographic cylinder, central corneal thickness, and thinnest point (TP) were recorded and analyzed.

Results
A total of 72 eyes of 38 patients were included. The 12-month results showed significant reduction in Kmin (P=0.038), central corneal thickness (P<0.001), and TP (P<0.001). At 24 and 36 months, there were no significant changes in corneal topography, except for reduction in TP (P=0.024 and 0.002, respectively).

Conclusion
Pulsed accelerated CXL is an effective long-term method of arresting keratoconus progression.
Effect of coronavirus disease 2019 pandemic on ophthalmology practice in Kasr Al Ainy Hospital, Cairo University
Authors: Eissa Mohamed G. , Salah Shaymaa H. , Abdelbaki Ahmed 
Published: July 2021

Purpose
To discuss the effect of coronavirus disease 2019 (COVID-19) pandemic on ophthalmology practice and share our experience to ensure a continual ophthalmology service to the patients at Cairo University Hospital.

Patients and methods
This is a retrospective study. Administrative measures taken to address challenges in different ophthalmology care settings during this pandemic are discussed. These include infection control measures, logistics, and manpower strategies. The effect of these measures on the number of ocular surgeries performed are analyzed in comparison with the same period of the last year. The records of all patients who underwent ocular surgeries between mid-March and mid-July 2020 at Kasr Al Ainy Hospital are compared with the records of patients who had ocular surgeries in the same time frame in 2019.

Results
The total number of elective surgical cases in the period of COVID-19 lockdown (2020) was 392 in comparison with 2470 during the same period last year. The decrease was statistically significant (P=0.0035). Intravitreal injection for macular edema was the most common indication of elective surgeries during the lockdown. The total number of emergency cases operated in the period of COVID-19 lockdown was 733 in comparison with 959 during the same period last year. The difference was not statistically significant (P=0.40). Repair of globe rupture was the most common indication of emergency surgeries.

Conclusion
Our protocol was able to provide sight-saving measures needed in many patients during this outbreak. With COVID-19 is expected to continue for a long time, we need to revise our protocols to improve the service presented to the patients especially those with nonurgent conditions, while maintaining the safety of both patients and health care workers.
Comparing the knowledge and awareness of cervical and breast cancer among medical and nonmedical students of a private institution in South India
Authors: Sajan Achsah Susan , Eldhose Sara Rose , Kandasamy Krishnaveni , Ramanathan Sambathkumar 
Published: July 2021

Context:
Cervical and breast cancer is the most leading cause of death among women globally. Cervical and breast cancer can be cured if detected early.

Aims:
The aim of the study was to compare the knowledge and awareness of cervical and breast cancer among medical and nonmedical students of a private institution in South India.

Settings and Design:
A cross-sectional study was done on 600 female students of a private institution comprising both medical and nonmedical for a period of 6 months.

Subjects and Methods:
A study was done to assess the awareness and knowledge on cervical and breast cancer by using a standardized questionnaire.

Statistical Analysis Used:
The data were statistically analyzed with Mann–Whitney test by using GraphPad prism.

Results:
Out of the 600 female students, there were each of 300 female students in medical and nonmedical. Majority of the student population was seen in 17–19 years: 143 (47.6%) in medical and 206 (68.6%) in nonmedical. A total of 235 (78.3%) medical students have heard of cervical cancer and its screening (164 [54.6%]). Many nonmedical students have never heard of cervical cancer (248 [82.6%]) and its screening (283 [94.3%]). Nearly 61% of the medical students and 1.1% nonmedical have heard of Pap smear. Both medical students (276 [92%]) and nonmedical students (179 [53.2%]) were aware of the breast cancer but have less awareness about the age of occurrence. Awareness on breast self-examination was poor among medical (137 [45.6%]) and nonmedical (19 [5.6%]) students. The P < 0.0001 (<0.05) showed a statistically significant difference between the medical and nonmedical students.

Conclusions:
Through the findings of our study, we analyzed that the knowledge and awareness of cervical and breast cancer among medical students was better than that of the nonmedical students.
Mimosa pudica
Authors: Khan Firoz Naem , Zaidi Kamal Uddin , Tenguria Rajesh Kumar , Thawani Vijay 
Published: July 2021

Introduction:
Arsenic contamination in soil and its environmental effects have been studied for its global impact around the globe.

Materials and Methods:
This study evaluated the role of five plant species collected from arsenic-contaminated sites in in vitro phytoremediation of arsenic and its correlation with rhizobacteria under hydroponic conditions using high-performance liquid chromatography -ICP.

Results:

Mimosa pudica showed the ability to uptake arsenic with/ without Rhizobium.

Conclusion:
It is concluded that rhizosphere microbiota helps plants to increase arsenic uptake and may be utilized as an efficient biological alternative in phytoremediation.
Causes of Mortality and Morbidity among Neonates Admitted to the Neonatal Intensive Care Unit in Ladakh, India
Authors: Murtaza Mohd , Ali Md. Niamat , Khan Ishfaq Shafi , Zargar Mahrukh Hameed 
Published: July 2021

Background:
The first month of life is the most important and hazardous as neonates are prone to a number of infections and obstacles. This hospital-based prospective study was conducted for two years from June 1, 2017, to May 31, 2019, in the neonatal intensive care unit (NICU) of District Hospital, Kargil-Ladakh.

Aims and Objective:
The aim of this study is to analyze the causes of morbidity and mortality among neonates in the tribal population of Ladakh region. The final diagnosis of the patients was made mainly on clinical grounds by pediatricians with the help of available necessary laboratory investigations.

Results:
During the period of 2 years, a total of 686 neonates were admitted to the NICU of district hospital Kargil. Out of the 686 neonates, 57.1% were male and 42.8% female with a ratio of 1.34:1. Of the admitted neonates, 68.8% were inborn and 31.1% were outborn babies. Of them, 628 (91.5%) neonates were discharged, two left against medical advice, four were referred to a specialty hospital in Kashmir valley, and 52 (7.5%) died. Of the 52 expired neonates, 27 (51.9%) were male and 25 (48%) were female. Thirty-seven were inborn and delivered at a district hospital, while 15 were born outside the district hospital. The major causes of morbidity among neonates in NICU were preterm with low birth weight (36.5%), neonatal sepsis (19.2%), meconium aspiration syndrome (19.2%), birth asphyxia (13.4%), and intrauterine growth restriction (5.7%).

Conclusion:
We found prematurity, neonatal sepsis, meconium aspiration syndrome, and asphyxia to be the common causes of mortality in neonates. Most of these problems can be prevented by improving the quality of the concerned health units, improved maternal care, timely intervention, and timely referral to tertiary care hospitals in high-risk situations.
Sickle Cell Crisis as a Cause of Death over the Past 10 Years in Vidarbha Region
Authors: Singh Shikha , Patil Bharat , Gangane Nitin M. 
Published: July 2021

Background:
Sickle cell disease is a heritable disorder having an autosomal recessive inheritance. The disease arises as a consequence of a single base mutation in the sixth codon of the β-globin gene, which leads to an interchange of valine for glutamic acid.

Aim:
The aim of this study is to provide an insight to physicians about sickle cell disease being a cause of sudden demise, so that future unexpected deaths due to complications can be avoided.

Materials and Methods:
This study is a retrospective study conducted over a period of ten years from January 2010 to December 2019. The data was collected from the hospital information system of our institute. A total of 18 cases were collected over a period of ten years. The respective case related findings along with past history were reviewed.

Results:
Out of 18 cases, 11 cases were males and 7 were females. The youngest person was a nine-year old male and oldest was a 65-year-old male. Four cases were known patients of sickle cell disease, while in the remaining cases no history of sickle cell disease was available.

Conclusions:
Sickle cell crisis is an important reason of sudden unexplained deaths and this study highlights the role of autopsy in such cases.
Prevalence of Anaemia and Compliance to Weekly Iron-Folic acid Supplementation Programme amongst Adolescents in Selected Schools of Urban Puducherry, India
Authors: Wangaskar Sneha Anil , Sahu Swaroop Kumar , Majella Marie Gilbert , Rajaa Sathish 
Published: July 2021

Context:
Adolescents constitutes 21% of total Indian population. Iron deficiency anaemia has remained as a major nutritional problem amongst adolescents. To overcome this problem, Government of India started weekly iron-folic acid supplementation (WIFS) in 2012.

Aims:
Amongst adolescents in selected schools of urban Puducherry, to determine the prevalence of anaemia, proportion of those compliant to WIFS and to assess the sociodemographic and clinical factors associated with anaemia and compliance to WIFS.

Subjects and Methods:
A cross-sectional analytical study was conducted amongst school-going adolescents (10–18 years) in selected schools of Urban Puducherry. Data were collected using semi-structured, self-administered and pretested questionnaire. Haemoglobin estimation was done using a digital haemoglobinometer. Details regarding intake of iron and albendazole tablets were recorded. The anaemia status was evaluated as per World Health Organization guidelines.

Results:
The prevalence of anaemia was found to be 62.7% (95% confidence interval [CI]: 58.2–67.0). Proportion having mild, moderate and severe anaemia were 27.3%, 32.5% and 2.8% respectively. The proportion of adolescents compliant to WIFS was 67.7%. Late adolescents were significantly more associated with anaemia (adjusted prevalence ratio [aPR]: 1.7 95% CI: 1.0–3.0) as compared to early adolescents. Males were more compliant to iron-folic acid (IFA) tablets (aPR 1.4 95% CI: 1.0–1.8).

Conclusions:
More than half of adolescents were anaemic. This study emphasises on the fact that stricter supervision by teachers will result in better compliance to WIFS program. Strategies to improve WIFS compliance, imparting knowledge regarding IFA intake and involvement of school teachers will help to tackle anaemia amongst adolescents.
Comparative evaluation of centrifuged liquid-based cytology method over conventional brush cytology in normal oral mucosa
Authors: Arunachalam M. , Gunasekaran Nandhini , Rajkumar K. , Thayalan Dinesh Kumar , Dinakaran J. , Bharanidharan R. 
Published: July 2021

Introduction:
Liquid-based cytology (LBC) is a new monolayer slide preparation method introduced to overcome the limitations of conventional Papanicolaou (PAP) smears which is used in cancer screening. The study was aimed to compare the efficacy of modified technique, centrifuged LBC (CLBC) with that of conventional brush cytology in normal oral mucosa.

Materials and Methods:
Two smears were obtained from 100 cases of normal mucosa using a cytobrush. One smear was spread on to the slide by conventional technique, and the other smear was prepared by CLBC. Regular PAP staining was done for both the smears. Both the smears were evaluated for cellularity, cell distribution, cellular overlapping, cell elongation, and cellular background and were graded using the grading criteria. Mann–Whitney U-test was used, and P ≤ 0.05 was considered statistically significant.

Results:
The mean score of the criterias was found to be more desirable in CLBC than conventional technique, but there was no statistical significance found.

Conclusions:
LBC offers a significant advantage over conventional smear preparation in most of the criteria to advocate its use for routine diagnostic and mass screening procedures.
Automorphisms and opposition in spherical buildings of exceptional type, I
Authors: Parkinson James , Van Maldeghem Hendrik 
Published: July 2021

AbstractTo each automorphism of a spherical building, there is a naturally associated opposition diagram, which encodes the types of the simplices of the building that are mapped onto opposite simplices. If no chamber (that is, no maximal simplex) of the building is mapped onto an opposite chamber, then the automorphism is called domestic. In this paper, we give the complete classification of domestic automorphisms of split spherical buildings of types
$\mathsf {E}_6$
,
$\mathsf {F}_4$
, and
$\mathsf {G}_2$
. Moreover, for all split spherical buildings of exceptional type, we classify (i) the domestic homologies, (ii) the opposition diagrams arising from elements of the standard unipotent subgroup of the Chevalley group, and (iii) the automorphisms with opposition diagrams with at most two distinguished orbits encircled. Our results provide unexpected characterizations of long root elations and products of perpendicular long root elations in long root geometries, and analogues of the density theorem for connected linear algebraic groups in the setting of Chevalley groups over arbitrary fields.