bluuebunny/crossref_metadata_2025_split huggingface dataset:
A gender wise correlation analysis between glycated hemoglobin level and estimated glomerular filtration rate among type 2 diabetes patients
Authors: Leena Chalissery Ouseph , Ajith Thekkuttuparambil Ananthanarayanan , Vijayasimha Mulavagili , Sah Ashok Kumar 
Published: July 2021

Background: Studies found inconsistent relationship between glycated hemoglobin (HbA1C) and estimated glomerular filtration rate (eGFR) in diabetes. Hence, population based studies are warranted. This study was aimed to find out the prevalence of good glycemic control and correlation of HbA1c level with eGFR in male and female type 2 diabetes patients. Methods: A cross sectional study was designed among type 2 diabetes patients. Medical records of patients’ in the inclusion criteria were abstracted for demographic characteristics, HbA1c and serum creatinine level. Patients were grouped into male and female and further sub grouped as with or without good glycemic control (HbA1c ≤ 7%). Data were statistically analyzed.Results: A total of 465 diabetes patients (186 males and 279 females) were included. Among the total, more female patients were in good glycemic (p=0.0008) control. Gender wise comparison showed that HbA1c level was statistically significant between male and female patients in age groups below 60 years (p<0.05). HbA1c level, at >7%, showed an inverse correlation with eGFR in both male (r=- 0.3208, p=0.0008) and female patients (r =-0.3680, p<0.0001). For every 1% rise in HbA1c, eGFR declined by 10 ml/min/1.73 m2 in males and 13 ml/min/1.73 m2 in females.Conclusions: More female patients were in good glycemic control. HbA1c level above 7% showed an inverse correlation with eGFR in both male and female patients. For every 1% rise in HbA1c, the eGFR declined by 10 ml/min/1.73 m2 in male and 13 ml/min/1.73 m2 in female patients.
A comparison of high thoracic epidural anaesthesia versus conventional intravenous opioids in pediatric patients undergoing corrective open heart surgery for ventricular septal defect
Authors: Singh Kshetrimayum Sandeep Kumar , Sharma Vipul K. , Shouche Sachin , Sasidharan Shibu , Dhillon Harpreet 
Published: July 2021

Background: We compared high thoracic epidural anaesthesia with a combination of morphine and bupivacaine versus IV fentanyl as an alternative for perioperative pain management.Methods: Group-E: Injection Morphine 75-100 mcg/kg and Injection 0.25 % Bupivacaine 0.5 ml/kg was given via epidural catheter at insertion, Injection 0.25% Bupivacaine 0.5 ml/kg just before skin incision, and continuous infusion of Injection 0.125% Bupivacaine at 0.2 ml/kg/hr intra-operatively. Post-operative 0.1 ml/kg/hr infusion. Group F- intravenous fentanyl 2-3 mcg/Kg IV bolus given just before skin incision, followed by 1-2 mcg/Kg/hr IV fentanyl started after weaning from cardiopulmonary bypass.Results: The mean ScvO2 was comparable between the two groups during induction period but became higher in group E during bypass and post bypass period intraoperatively, and the difference in rise in ScvO2 is statistically significant with a p<0.05. The mean rSo2- C was comparable between the two groups in the first postoperative hour but group F shows higher rSo2-C postoperatively which was statistically significant. The postoperative pain was significantly lower in group E in the postoperative period (except for 4,5,6 and 40 and 48th hour).Conclusions: HTEA to paediatric patients prior to sternotomy for cardiac surgeries resulted in a much better control of haemodynamic parameters. Produces better central venous and regional tissue oxygenation during bypass and post bypass intraoperatively as compared to the patients that received only intravenous fentanyl. There was lower amount of postoperative bleeding in the HTEA group with significant reduction in requirement of post-operative ventilation and time to extubation after surgery, better post-operative pain control and overall outcome.
Hypoglycemia due to insulin autoimmune syndrome (Hirata’s disease): a rare cause of hypoglycaemia
Authors: Patel Het V. , Kumar Sunil , Moradiya Kalpesh , Shah Vidhi 
Published: July 2021

Although the most common cause of recurrent hypoglycaemia is diabetes mellitus as patient is on antidiabetic medications which can be prevented by modification of antidiabetic doses, nutrition therapy and lifestyle modifications. Some endogenous hyperinsulinemic conditions like insulinoma, functional beta cell disorders and insulin autoimmune syndromes, hormonal deficiencies can cause serious and sometimes life threatening hypoglycaemia. So further laboratory evaluation like plasma/serum glucose levels, c-peptide levels, insulin levels, insulin antibodies and imaging studies are needed to evaluate unexplained hypoglycaemia. Here we report a case of insulin autoimmune syndrome in a 67 year old Indian male who had presented to us with multiple episodes of spontaneous hypoglycaemia. On further workup, the patient was found to have endogenous hyperinsulinemic hypoglycemia. As the patient’s abdominal imaging revealed no apparent cause of EHH, on further evaluation he came positive for insulin antibodies. Patient was diagnosed as IAS and he was given frequent small meals and complex carbohydrate diet and he had improved symptomatically. The incidence of IAS is most common in Japan and very few cases have been reported from India, so it should be kept in differential diagnosis of recurrent hypoglycaemia.
Music listening practices of college-going students and their impact on hearing
Authors: H. Gayathri , Paul Christina Mary P. 
Published: July 2021

<p class="abstract"><strong>Background:</strong> A billion youngsters are at risk of recreational noise-induced hearing loss. Motivated by WHO’s campaign ‘Make listening safe’, the objective of this study was to estimate the prevalence of the habit of listening to music at high volumes using Personal Listening Devices (PLDs) among college students and to analyze their audiometric findings.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional study was performed between December 2019 and May 2020 on college-going students with a habit of listening to music using PLDs. PTA was performed on the eligible study subjects. A modified LHQ was given to the selected candidates to answer. </p><p class="abstract"><strong>Results:</strong> The study population comprised 62 boys (24.5%) and 191 girls (75.5%) of the age of 17-24 years. 77.1% of the participants listened to music through PLD, at a scale of &gt;5 on 10 (median PLD volume-7). 26.1% of students listened to music for more than 14 hours a week using their headphones or earphones. Fifteen students (5.93%) had evidence of a 4 kHz dip on PTA out of which 9 patients (3.56%) had bilateral and 6 patients (2.37%) had unilateral involvement.</p><p class="abstract"><strong>Conclusions:</strong> Though many students had some awareness regarding safe volume levels while listening to music, not many were aware of daily sound allowance (DSA). Health education to the target population along with the addition of an in-built app in all PLDs for monitoring device volume and DSA may reduce the impact of music on hearing.</p>
Round window versus conventional bony cochleostomy technique in pediatric cochlear implantation; A Randomized controlled double blinded trial.
Authors: Shishodia Shama , Saurav Dipu 
Published: July 2021

<p><strong>Background:</strong> Objective of the study was to investigate the outcomes of cochlear implantation when done via two different techniques namely, the round window or the bony cochleostomy.</p><p><strong>Methods:</strong> A single-center, double-blinded randomized controlled trial including forty prelingual, bilateral severe to profoundly deaf children less than six years from the year 2014 to 2016 in a tertiary referral center in India were randomly allocated to round window and bony cochleostomy group. Our primary outcome measures were intraoperative neural response telemetry levels, behavioral threshold (t) and comfortable (c) loudness levels. The secondary subjective outcomes were measured via the category of auditory performance (CAP) and the meaningful auditory integration scale (MAIS) score. The cases were followed up for 9 months.</p><p><strong>Results:</strong> Intra-operative, electrically evoked compound action potentials (ECAP) showed comparable mean thresholds for both the techniques except intermediate electrodes (p~0.04) showed lower values for the round window. Similarly, a lower threshold (p~0.03) and comfortable mean current levels (p~0.03) were noticed for the round window group at 6 months post-implantation. Secondary speech perception outcome scores measured via category of auditory performance (CAP) and MAIS score were comparable. </p><p><strong>Conclusions:</strong> The round window insertion technique has physiological benefit as compared to the bony cochleostomy as evidenced by better stimulation levels in the intermediate electrodes and lower mean threshold and comfortable levels in the round window with more beneficial peri-modiolar position of electrode arrays. However, comparable speech perception outcomes revealed no clinical benefit in the cochlear implant performance depending on the technique of electrode insertion. </p>
Impact of hydration on vocal loading using phonetogram measures
Authors: Ghosh Sujan , Chatterjee Indranil , Kundu Piyali , Pani Susmi , Kumar Suman , Mandal Joyanta Chandra 
Published: July 2021

<p><strong>Background:</strong> Vocal loading is a phenomenon that affects the vocal folds and voice parameters. Prolonged vocal loading may cause vocal fatigue. Hydration is one of the easiest precautions to reduce the effect of vocal loading. Voice range profile is an analysis of a participant’s vocal intensity and fundamental frequency ranges. Speech range profile is a graphical display of frequency intensity interactions occurring during functional speech activity. Phonetogram software can analyse VRP and SRP.</p><p><strong>Methods:</strong> Total sixty normophonic participants (thirty male and thirty female) were included in this study. Phonetogram, version 4.40 by Tiger DRS, software used to measure the voice range profile and speech range profile. For VRP, participants were asked to produce vowel /a/ and a passage reading task was given for SRP measurement.</p><p><strong>Results:</strong> All sample recording were done at pre vocal loading task, VLT and after hydration. Parameter that were used to measure the effects were Fo-range, semitone, max-F, min-F, SPL range, max-I, min-I, area (dB). Result showed that after VLT all other parameters like Fo-range, semitone, max-F, min-F, SPL range, max-I, min-I, area (dB) in VRP and SRP were reduced except min-F VRP in male, min-I VRP and min-I SRP in both male and female participants. After hydration all other parameters were improved except max-F VRP and min-F VRP in female, max-I VRP, min-F VRP and area VRP.</p><p><strong>Conclusions:</strong> This study concluded that vocal loading has negative impact on vocal fold tissue and mass. </p>
Isolated 6th cranial nerve palsy: a rare manifestation of tuberculosis
Authors: Kantharia Shehnaz , Kantharia Rajesh A. , Reddy P. Pradeepkran 
Published: July 2021

<p>Tuberculosis (TB) is a contagious infection that is usually caused by <em>Mycobacterium tuberculosis</em> bacteria. It usually affects the lungs and also spreads to the brain and spine. In the central nervous system, the neurological manifestations are numerous and varied and usually occur in two major forms, tuberculous meningitis and tuberculoma. Tuberculoma are well defined, granulomatous, space occupying lesions, which can occur anywhere in the central nervous system. Usually, brainstem tuberculoma can cause sixth and seventh cranial nerve affections along with motor and sensory symptoms, which are usually unilateral. Isolated abducens nerve palsy could be attributed to lesions of the nerve along their extra axial course and cause diplopia. Here we are presenting a case report of an 18-year-old boy with isolated sixth nerve palsy due to tuberculosis. The diagnosis of tuberculosis was achieved using interventional radiology for the purpose of biopsy. Using an image guided technique, we could avoid an open surgical procedure. </p>
Clinical and forensic aspect’s of the cocaine body packer in senegal
Authors: Bigot C. , Ngongang F.O. , Nseme E. , Soumah M. , Sando Z. 
Published: July 2021

This study aims to describe the clinical and forensic features of the cocaine body packer in Senegal.This research work is a retrospective and descriptive study. It was conducted based on 19 suspect cases attended for medical care at the Hospital of tambacounda. Suspects were exclusively male subjects, aged 24 to 33 years and Nigerian citizens. All of them were asymptomatic. Pelvic touch was positive in 42.1% of cases. Abdominal radiography pointed out that all the suspects presented with damage (100%). The average number of drug pellets carried per person was 43+/- 20 units. Body drug packing is a reality in Senegal. Narcotic drug policies should invest in capacity building by financing effective diagnostic tools.
Study of patients with Pseudoexfoliation syndrome undergoing cataract surgery
Authors: Srinivasan G , R Deepa 
Published: July 2021

To analyze the visual outcome in patients with pseudoexfoliation and to know the surgical parameters to cogitate in patients with pseudoexfoliation syndrome. An Observational study which was conducted in the Ophthalmology department in a tertiary care hospital in a rural area from June 2019 to December 2019. A total of 52 eyes of 52 patients aged 40 years and above, of either sex, clinically diagnosed with senile cataract and associated with pseudoexfoliation were enrolled in the study. After assessing best corrected visual acuity (BCVA), a detailed anterior and posterior segment examination was performed along with lacrimal sac syringing, manual keratometry, contact A-scan biometry and intraocular lens (IOL) power was calculated. All patients underwent manual small incision cataract surgery under peribulbar anaesthesia and intraocular lens was implanted. Intraoperative complications were noted during the surgery and was reported .Best corrected visual acuity was recorded on day 1, at 1week and at 1 month of follow up. Out of 52eyes of 52 patients, 29 were females (55.76%) and 38 eyes (73.07%) exhibited bilateral involvement. Distribution of the PXF material in various ocular structures was observed and majority of them (36.53%) had PXF material equally in iris, pupillary margin and lens. Based on the morphology of cataract associated with psudoexfoliation, nuclear cataract was the most commonly observed in 16 eyes (30.76%) and 42 eyes (80.76%) had moderate pupillary dilatation. The intraoperative difficulties observed during cataract surgery was poor pupillary dilatation which was managed by controlled sphincterotomy during the surgery in 3 eyes (5.76%), Iridiodialysis, rhexis extension, zonular dialysis each in 1 eye and posterior capsular rent in 2 eyes. Around 92.30% of the total study population achieved post-operative BCVA of 6/12 or better at 1month of follow up. Decreased visual acuity was noted in 2 (3.84%) eyes due to persistent corneal edema, one eye (1.92%) had posterior capsular opacification and one eye (1.92%) had cystoid macular edema. This study concludes that with careful preoperative assessment and necessary intraoperative precautions, good visual outcome can be achieved in patients with cataract with pseudoexfoliation.
Travoprost versus latanoprost or timolol in primary open angle glaucoma- Efficacy and safety profile
Authors: Prasad Mukta , Ranjan Abhishek , K Sugyani Satapathy 
Published: July 2021

Glaucoma is progressive optical neuropathy which is challenging to treat despite advances in medical and interventional mode of treatments. Primary open angle glaucoma(POAG) is generally associated with diabetes mellitus and hypertension. Any ocular topical pharmacological agent which is to be used in POAG to maintain intraocular pressure have to be very efficacious with good safety profile. We conducted a study comparing travoprost with latanoprost and timolol as single therapeutic agent having favorable outcome.Seventy five patients were included in the study for a period of two years. After ethical clearance, patients were randomly allocated to three groups of treatment arm having 25 patients in each group. IOP was noted at 8 A.M, 10 A.M, 4 P.M on two eligibility visits for the same eye. Data collected included demographic data, blood pressure, visual acuity, ocular hyperaemia, Slit lamp finding, IOP & fundus examination. Travoprost treated patients had minimum IOP significantly lower at all visits than those using timolol (p&#60;0.0001) and latanoprost (p&#60;0.004). Also, Travoprost treated patient had maximum IOP records significantly lower at all visits than those using timolol (p&#60;0.0001) and those using latanoprost (p&#60;0.02). No significant difference was found between travoprost and latanoprost treated patients (p&#60;0.25) while patients treated with timolol had on average a higher IOP variance (p&#60;0.004) suggesting a lower peak control during the day. TRAVOPROST 0.004% once daily or in combination with other agents is the most effective and safest topical agents for patients of primary open angle glaucoma with the best safety profile.
Glaucoma characteristics evaluation in myopia – A clinical study
Authors: Rosita J Helen , J Gnanaselvan , S Amudhavadivu , Kurian Mullasseril Anna 
Published: July 2021

Glaucoma is the leading cause of irreversible blindness, one of the risk factor recognised being high myopia. Intra ocular pressure may be normal in myopic patients, with optic nerve head glaucoma characteristics. Eye ball elongation and optic nerve head tilting may be present in patients with high myopia that will represent field defects mimicking glaucoma. Treating patients with myopia having suspected aspects of glaucoma may be a challenge but even more challenging is the diagnosis of glaucoma in myopic patients.: To evaluate the association of glaucoma features with myopia. To create the awareness regarding the long term follow up.: Patients in the age group of 15 to 45 years who had attended our institution over a period of one year who fulfilled the inclusion and exclusion criteria were subjected for this study. Fifty four patients who were diagnosed to have moderate or high degree myopia were selected for this analytical study. They were subjected to vision, ocular examination, tonometry and results obtained were analysed.: In our study moderate myopes constituted 55.5% and high myopes were 44.5%. The mean Intra ocular pressure and the mean corrected Intra ocular pressure in high myopes were observed to be higher than in moderate myopia. It was observed that higher prevalence of glaucoma was observed in high myopes.: There is a clinically as well as statistically significant difference between mean Intra ocular pressure and mean corrected Intra ocular pressure. So mean corrected Intra ocular pressure should be measured .From our study, there is a clear indication that there is increased prevalence of glaucoma in high myopes.
Diffuse infiltrating retinoblastoma: A diagnostic conundrum
Authors: Bhattacharjee Harsha , Mehta Aditi , Das Dipankar , Bhattacharjee Kasturi , Barman Manabjyoti , Kuri Ganesh Chandra , Deka Hemlata , Deori Nilutparna , Venkatraman Vatsalya , Deka Apurba 
Published: July 2021

Diffuse infiltrating retinoblastoma (DIR) is characterized by absence of intraocular mass, lack of calcification. It may mimic inflammatory uveitis or exudative retinopathy. An eight-years-old boy presented with progressive loss of vision in left eye. Clinical evaluation revealed neovascular glaucoma with a yellow–gray fundal glow, exudative retinal detachment, subretinal exudation and telangiectatic vessels. The presentation was consistent with exudative retinopathy (Coat’s disease) but for the presence of a family history of retinoblastoma in the younger sibling. Despite the absence of an intraocular mass or calcification on multimodal imaging, the enucleation was done on the basis of clinical suspicion of retinoblastoma. Histopathology confirmed a diagnosis of DIR.: DIR can pose a diagnostic challenge due to its non-characteristic clinical and imaging features and atypical presentation. A high index of suspicion along with a positive family history was key to diagnosis in our case; histopathology was confirmatory.
Hypercalcemia of malignancy in metastatic adenocarcinoma of left lower eyelid - A report of a rare case
Authors: BM Divya , Shylashree  , Mani Muthukumar 
Published: July 2021

Adenocarcinoma of eyelid is a rare disease with an incidence of 1 to 5.5% and is considered to be the most common eyelid malignancy following basal cell and squamous cell carcinoma. The symptoms usually present as swelling, thickening, change in appearance of the eyelid skin and ulceration. Various treatment modalities include surgery, radiation or chemotherapy relying upon the stage of tumor at the time of presentation. However, metastasis of adenocarcinoma of the eyelid to other organs is quite rare. We are presenting a case of a 35 year old male who initially presented with complaints of watering in the left eye and in due course, was diagnosed with adenocarcinoma of eyelid which was being treated and eventually progressed to lung and skeletal tissues. This gentleman also had severe Hypercalcemia which was secondary to paraneoplastic syndrome.
An unusual presentation of well-differentiated squamous cell carcinoma of left upper eyelid: Case report
Authors: Bhattacharjee Rajneel , Deka Baby , Shree Namrata 
Published: July 2021

Squamous cell carcinoma is mainly an invasive epithelial malignancy having keratinocyte differentiation. They are relatively rare and usually slow growing skin cancer. Well-differentiated squamous cell carcinoma closely resembles normal epithelial cell. We report a case of a sixty-five-year-old female who presented to the ophthalmology outpatient department with the chief complaint of a rapidly growing mass on her left upper eyelid for 6 months interfering with her vision. Physical examination revealed a firm mass of size 3.5 cm x 3 cm x 2.5 cm. RT-PCR for COVID-19 was done and found negative. Routine blood investigations, blood sugar levels, viral serology, chest X-ray were done. Excision and biopsy with wide margins at the base were performed under local anesthesia. Histopathological examination of the specimen showed well differentiated squamous cell carcinoma. The patient responded satisfactorily. Early diagnosis and treatment reduce the morbidity and mortality of the patient.
STUDENT-CENTERED APPROACH FOR BEFITTINGLY TEACHING SCIENCE CONCEPTS AT ELEMENTARY LEVEL
Authors: Atta Malik Amer , Jamil Asif , Hafeez Abdul , Salah-Ud-Din Bushra , Bibi Sadia 
Published: July 2021

Purpose of the study: The main purpose of the study is to find out the “use of student-centred approach of teaching science on the performance of students performance at elementary level”.
Methodology: Quasi-experimental research was used in this study. Pre-test and post-test were used to collect the data and analyses were done through SPSS. Three classes; grades 6th, 7th, and 8th were chosen as a sample of the study.
Main Findings: Findings of the research study revealed that the students belonging to lower grade levels responded more positively to the student-centred methods as compared to the students belonging to higher grade levels.
Applications of this study: This study is applicable in the elementary level of education in Khyber Pakhtunkhwa. Policymakers and government officials can take guidance to improve the situations of elementary schools.
Novelty/Originality of this study: This study was originated to determine the effectiveness of a Student-centered learning slant, especially for teaching science at the elementary level. It was also attempted to know whether or not the effectiveness of the Student-centered approach alters at different grade levels of students.