bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total laparoscopic hysterectomy – Learning curve and its impact on surgical outcome of 773 case series from a single center
Authors: Tantia Aruna , Chatterjee Sunipa , Khanna Shashi 
Published: August 2024

Abstract

Study Objective:
The objective of this study was to assess the learning curve of total laparoscopic hysterectomy (TLH) and its impact on surgical outcome of 773 consecutive cases between two decades.

Design:
This was a retrospective observational comparative study of 773 consecutive cases of TLH.

Setting:
This study was conducted at ILS Hospital, Kolkata, India, a private tertiary referral center for endoscopic surgery.

Patients:
Total 773 women with benign pelvic pathologies from 2000 to 2019 having similar demographic characteristics irrespective of uterus size and previous surgery were included while patients with malignancy and second-degree uterus prolapse were excluded.

Interventions:
TLH by ipsilateral technique.

Materials and Methods:
The study period was divided into two decades with 386 and 387 surgeries of TLH in the first and second decades, respectively, maintaining homogeneity within the periods. The CUmulative SUMmation (CUSUM) technique was used to construct a learning curve of operative time where learning point.

Results:
Learning Point was found at the 118th surgery. Overall complications decreased from 4.39% to 1.33% (P = 0.0096) between two decades, and major and minor complications decreased from 3.36% to 0.52% (P = 0.0042) and from 1.03% to 0.78% (P = 0.1416), respectively. No major vessel injury occurred. Five ureter injuries occurred in the first decade and none in the second decade. In-spite of significant increase in uterus size and double the number of Lower Uterine Caesarian Section (LUCS) in 2nd decade (P<0.00001), bladder injuries occurred in 1st decade & 2nd decade was 7 (1.81%) and 1 (0.26%) respectively (P=0.033). Total 56 conversions (7.56%) occurred: the first decade was 27 (6.97%) and the second decade 29 (7.51%) (P = 0.7814).

Conclusion:
Laparoscopic hysterectomy can be safely done by ipsilateral technique with low complication if one achieves a learning curve under supervised training. In our study, gained experience helped us to decrease major bladder, bowel, and ureteric injuries drastically by 90.91% in spite of increased complexity of cases in the second decade.
Unveiling the evolution of endoscopy
Authors: Tandulwadkar Sunita 
Published: August 2024

Abstract
Endoscopy, also known as minimally invasive surgery (MIS), has dramatically transformed surgical practice since its inception in the early 20th century. Initially met with skepticism, it has now become fundamental in various surgical fields. This evolution is marked by significant milestones, including the pioneering work of Georg Kelling and Jacobaeus in the early 1900s, the technical innovations of Raoul Palmer and Kurt Semm from the 1960s to the 1980s, and the advent of video laparoscopy in the late 20th century. These advancements have facilitated the transition from diagnostic to surgical laparoscopy, improving safety, efficacy, and patient outcomes. Modern laparoscopy, enriched by high-definition imaging and robotics, allows for complex procedures with enhanced precision. Robotic-assisted surgery, introduced in 1994, has further expanded the capabilities of minimally invasive techniques, offering 3D visualization and improved dexterity. The continuous evolution in this field is driven by technological advancements and a commitment to improving surgical outcomes. This article explores the historical milestones, current practices, and future challenges of endoscopy, highlighting its revolutionary impact on medicine. As the field progresses, innovations such as artificial intelligence and augmented reality are poised to shape the future of laparoscopy, making it safer, more cost-effective, and accessible. The ongoing evolution of endoscopy underscores the relentless pursuit of excellence in surgical care and the enduring impact of human ingenuity and technological progress.
Laparoscopic pectopexy: As a safe and effective new approach for repair of pelvic organ prolapse
Authors: Saini Sushila , Gupta Seema 
Published: August 2024

Abstract

Objective:
The objective is to assess the feasibility, safety, and effectiveness of laparoscopic pectopexy for repair of pelvic organ prolapse (POP).

Design:
This was a prospective study.

Materials and Methods:
A total of 324 women of POP-Q Stage ≥II who underwent laparoscopic pectopexy between January 2017 and January 2023 at Jaipur Doorbeen Hospital, Jaipur, India were included in this study. All patients underwent laparoscopic mesh fixation to bilateral pectineal ligament with Moschcowitz repair with pelvic floor repair.

Results:
Among 324 patients, the mean age was 48.29 ± 14.82 years and the mean body mass index was 24.10 ± 3.19 kg/m2 . Out of 324 cases, 24.07% of Stage II, 71.30% of Stage III, and 4.63% of Stage IV. Maximum cases were under Stage III (71.30%). Follow up was done after 1 week, 3 weeks, 6 weeks, 3 months, 6 months, and 1 year. At 1 year of follow up out of 324 cases, 66 patients lost to follow up. Out of the remaining 258 patients, only 9 (3.4%) patients show recurrence of prolapse. Out of nine cases, four cases show Stage I cystocele, three cases show Stage II apical prolapse and two cases show Stage 1 rectocele. Results are promising, with 96.51% all over success rate.

Conclusion:
The laparoscopic pectopexy is a good alternative to the laparoscopic sacrocolpopexy. It is equally effective and shows no de novo stress urinary incontinence, defecation disorders, backache, or neuralgia in the long term follow up.
The learning experiences of senior residents in laparoscopic gynecological surgeries: A quality study
Authors: Agarwal Mukta , Sinha Shivangni , Kumar Pragya , Bhushan Devendu 
Published: August 2024

Abstract

Background:
Laparoscopic operations have increased in acceptance over the years owing to their established advantages over conventional open procedures, ranging from superior diagnostic to therapeutic outcomes. Significant advances in surgical training, equipment development, imaging, and surgical procedures have made laparoscopic surgery safe and feasible in a variety of medical specialties.

Materials and Methods:
We aimed to qualitatively evaluate the learning experiences of senior residents in laparoscopic gynecological surgeries. The study is a qualitative descriptive study conducted in a tertiary care institution. It included senior residents undergoing training in laparoscopic gynecological surgery. Their learning experiences were qualitatively evaluated at the end of their 3-year residency. Six residents responded to questionnaires.

Results:
The experience of learning a new system from its beginning motivated residents to push themselves against all difficulties, work as a team, and pumped them with confidence when their mentors held back in encouragement and support. There is a requirement for an upgraded infrastructure to sustain consistent and skilled training that would aid in encouraging training experience at hospitals across the country. Patient management, strenuous surgeries, and complications affect residents’ physical and psychological well-being, making them vulnerable. The system must also collaborate with residents and doctors at work to create a positive environment not only for patients but also for their residents.

Conclusion:
Improving the residents’ learning experiences through effective uniform training and a healthier working environment will result in better patient care outcomes and system performance.
Higher Discharge GCS Score is Associated with Both Survival and Long-term Functional Recovery in Patients with Clinically Defined Diffuse Axonal Injury
Authors: Sajan Jane Elizabeth , Ramanathan Saraswathi , Selvi Bernice Thamarai , Manikandan S. K. , Thomas Raji , Joseph Mathew 
Published: August 2024

Abstract

Background:
Diffuse axonal injury (DAI) refers to widespread axonal damage due to traumatic brain injury. There are very few studies that have specifically looked at outcomes in patients with DAI, where the injury is not associated with accompanying focal lesions (such as haematomas and other mass lesions) or ischaemic brain injury. In this study, we assessed factors that predict mortality and long-term functional outcome of patients with DAI who underwent treatment and rehabilitation in a tertiary care hospital in South India.

Methodology:
Long-term outcome and neuropsychiatric sequelae were assessed in 160 patients with DAI, who underwent rehabilitation and were on regular follow-up for a median duration of 5 years (interquartile range = 3–6). Cox proportional hazards and logistic regression models were used to determine factors associated with mortality and functional outcome (Glasgow Outcome Scale-Extended [GOSE], Mayo-Portland Adaptability Inventory [MPAI] and Neuropsychiatric Inventory [NPI]).

Results:
Majority of the 160 patients included in this study were young males (92%) who presented with severe head injury (Glasgow Coma Scale [GCS] score of 5.6 ± 2.1). At the time of follow-up, 94 (58.75%) patients were alive, while 66 (41.25%) were dead. Patients who were alive at the time of follow-up were significantly younger, had higher GCS score and lower Rotterdam computed tomography (CT) grade at presentation compared to those who died. Compromised airway requiring tracheostomy (χ
2 = 21.3; P < 0.001) and abnormal pupil reactivity (χ2 = 30.2, P < 0.001) were significantly associated with mortality. GCS score at discharge was the single most important determinant of mortality (hazard ratio = 0.802, P < 0.001). Among those who were alive, majority (73.4%) had good functional recovery (GOSE score 8). GCS scores (at admission and that at discharge) and Rotterdam CT score independently and significantly predicted MPAI, NPI and caregiver distress scores. Among them, GCS score at discharge was the strongest predictor. In-hospital improvement in GCS correlated with GOSE but not with MPAI and NPI.

Conclusion:
Higher GCS scores at discharge were strongly associated with both survival and functional recovery in patients with DAI.
Teletherapy as an Alternate Model for Therapeutic Interventions for Children with Neurodevelopmental Disabilities in a Low-resource Setting in Jharkhand, India
Authors: Rangwala Shabnam 
Published: August 2024

Abstract

Background:
This project was a collaboration between a community-based organization in rural India and a professional organization providing training and teletherapy support. The objective was to address the human resource gaps in rural areas for delivering therapeutic interventions to children with neurodevelopmental disabilities (NDD) in low-resource settings.

Objective:
To empower health workers in rural areas with the skills necessary to provide need-based therapeutic interventi ons to children with developmental disabilities through training and teletherapy.

Methods:
The project began with an initial training phase consisting of 10 online training sessions. This was followed by five additional need-based online training sessions over a 9-month period. Thirty-one children with NDD (15 girls and 16 boys) were enrolled and tracked using the Canadian Occupational Performance Measure (COPM). A total of 750 need-based therapy interventions, including physiotherapy, occupational therapy, and speech therapy, were provided by professional therapists via teletherapy.

Results:
The children showed significant improvement in the functional goals set from baseline to midline and end line. A one-way repeated-measures ANOVA test revealed a significant positive impact of teletherapy on the functional goals planned for the sample (P < 0.5).

Conclusion:
Teletherapy demonstrated a positive impact on achieving functional goals for children with NDD in rural Jharkhand. It is recommended as an effective model to address human resource gaps and provide family-centered therapeutic support in low-resource rural areas.
A cross-sectional study on domestic violence among infertile women in western Iran
Authors: Jenabi Ensiyeh , Khazaei Salman , Gholami Amir Hossein , Abdoli Sara 
Published: August 2024

Background:
To date, no study has examined domestic violence among infertile women in western Iran.

Aims:
This study aims to investigate the prevalence of domestic violence among infertile women in the region.

Materials and Methods:
A cross-sectional study was carried out at the infertility clinic in Hamadan. A total of 200 eligible infertile women, with a mean age of 31.48 ± 4.57 years, were recruited for the study. The Domestic Violence Questionnaire (DVQ) was administered to all participants. Data analysis was performed using Stata Statistical Software (version 17), with a significance level set at P ≤ 0.05.

Results:
This study included 200 infertile women with an average age of 31.48 ± 4.57 years. The mean duration of infertility was 1.9 ± 0.76 years. Regarding education, approximately 66% of the women and 69% of their spouses had completed high school or attained a diploma. Female-related causes accounted for 72.5% of infertility cases. Among the participants, 59.4% reported experiencing domestic violence. Emotional violence scored the highest percentage (67.5%), while sexual violence had the lowest percentage (43.63%). Statistical analysis revealed significant associations between age, spouse’s education level, frequency of sexual intercourse, and the level of violence experienced by women.

Conclusion:
The findings of this study reveal that 59.4% of women experienced various forms of domestic violence. Moreover, significant associations were observed between domestic violence and factors such as age, spouse’s education level, and frequency of sexual intercourse.
Psycholegal issues in marital conflict
Authors: Reddy Vrushali Dillikar , Arya Saroj 
Published: August 2024

Background:
Marital conflict and disputes involve many issues to be settled between the couples like finance, health, assets, children, postdivorce securities, etc. The traumatic experiences of separation affect their mental health and the future of their children. Not being conscious of their legal rights and court procedures leads to long court litigation, causing distress and trauma to the couples.

Aim:
The aim of the article is to find out the level of psycholegal awareness among couples in conflict, approaching forums like police and courts, and to find the difference between the two groups.

Materials and Methods:
A sample of 30 couples each from court and noncourt forums was taken. The demographic details were taken and a psycholegal checklist was administered. It is a cross-sectional study and exploratory research design was applied.

Results:
There was a significant difference in legal awareness of couples opting for redressal in the court and those opting for counseling in noncourt resolution centers.

Conclusion:
The results indicate that a lack of legal awareness among the couples in the two groups may be leading to lengthy litigation.
Anxiety, depression, and perceived stress among loco pilots of Indian Railways
Authors: Shekhawat Bharat Singh , Yadav Sandhya , Dhaka Vikas 
Published: August 2024

Background:
The job of loco pilots of Indian Railways is very demanding as they are responsible for operating locomotives and ensuring the safe and timely transportation of people and goods across the vast and diverse landscape of the country. So, they are prone to various mental health issues.

Aim:
To study anxiety, depression, and perceived stress among loco pilots of Indian Railways and to study their correlation with various work-related factors.

Materials and Methods:
This cross-sectional study included 53 loco pilots recruited by convenience sampling from three railway stations under the Kota Division of Indian Railways. Prior permission from the Institutional Ethical Committee was taken. After obtaining informed consent, loco pilots were evaluated on Hamilton scales for Anxiety and Depression and Perceived stress scale 10.

Results:
The mean age of participants was 32.01 ± 6.15 years. They were working for an average of 61.01 ± 19.12 hours per week. The majority of them were assistant loco pilots and were operating goods trains. 26.41%, 20.76%, and 13.20% had mild, moderate, and severe anxiety, respectively. Likewise, 30.19% and 5.66% had mild and moderate depression, respectively. Also, 33.97%, 50.94%, and 15.09% of loco pilots had low, moderate, and high perceived stress, respectively. Age, working hours, and years of work experience did not correlate significantly with anxiety and depression scores. A significant positive correlation of perceived stress score was found with average working hours per week (P = 0.012).

Conclusion:
The magnitude of psychiatric problems among loco pilots was found to be significant and hence needed to be addressed. Also, further exploration of factors contributing to these mental health issues is required.
Assessment of depression, anxiety, stress, and insomnia among government school teachers in the rural catchment areas of Nandyal district: A cross-sectional study
Authors: Kalam Bandubai Muhammad , Omkaram Sindhuja , Murthy P. S. , Chaudhury Suprakash 
Published: August 2024

Background:
Among the most demanding careers that many Indians choose is teaching. Teachers are under a lot of stress because of all the extra responsibilities and duties they have from the school, education boards, and institutions. This can be a fertile ground for psychological problems among teachers.

Aim:
To assess depression, anxiety, stress, and sleep disturbances among school teachers and to find out their correlates.

Materials and Methods:
A cross-sectional observational study was planned in 100 teachers working in the government schools of the rural catchment of Nandyal district, Andhra Pradesh. Teachers were assessed through a semistructured proforma containing sociodemographic information, information about job-related factors, and DASS 21 to assess depression, anxiety, and stress and Insomnia Severity Index to assess sleep disturbances.

Results:
The overall prevalence of depression, anxiety, and stress symptoms among teachers was found to be 28%, 61%, and 24%, respectively, and sleep disturbances were 38%. Depression was found to be independently associated with marital status (married > single, P < 0.001), position at workplace (secondary grade > primary grade, P < 0.001), mode of transport (public transport > personal, P = 0.001), source of income (single > family, P = 0.013), higher level of income (P < 0.001), stress (P < 0.001), and anxiety (P < 0.001). Anxiety was associated with migration for the job (P < 0.001), stress (P < 0.001), and depression (P < 0.001), while insomnia was associated with the type of family (nuclear > joint, P = 0.015), source of income (single > family, P = 0.039), no interaction with a colleague (P = 0.007), being dissatisfied with job (P = 0.002), and stress (P = 0.005).

Conclusion:
The significantly moderate proportion of depression, anxiety, stress, and insomnia among government schoolteachers is suggestive of the need for the necessary psychological aid and counseling for such teachers. Therefore, appropriate methods must be introduced to address the concerns of teachers, thereby reducing anxiety and stress among them.
Clinico-epidemiological Profile of Primary Hyperhidrosis in Indian Patients: Single-center Experience
Authors: Rajput Gopalsing Rameshsing , Jandhyala Sridhar , Kansal Vishal , Hemdani Ruchi , Chatterjee Manas 
Published: August 2024

Abstract

Background:
Primary hyperhidrosis (PHH) is characterized by excessive sweating which is focal, bilaterally symmetrical, idiopathic with age of onset before 25 years of age. The QoL derangement comparable to chronic disorder like psoriasis. There exist a scarce data about prevalence, facto associated with PHH and its correlations with hyperhidrosis disease severity score (HDSS) and dermatology life quality index (DLQI) in Indian population. This study aimed to bridge this gap.

Aim and Objectives:
The aim of this study is to understand the features associated with PHH and to describe distribution of known etiologic factors of hyperhidrosis in individuals visiting the Dermatology OPD. Also this study assess the impact of excessive sweating on the QOL.

Material and Methods:
The study design is prospective observational study in patients visiting Dermatology OPD at tertiary care hospital. The study was questionnaire based and for appropriate case multispecialty referral and necessary investigation to rule out secondary cause was done. The study period was of total 18 months from Dec 2016 to May 2018. Data collected was analyzed by SPSS V 23.

Results:
In our study the male predominated with M: F ratio of 1.4 :1. Total 42,365 patients visited to dermatology OPD in this time frame and prevalence was found to be 2.6%. The mean age at presentation in our study was 24.5 years, with mean age of onset being 15.33 years (90% before third decade). Family history was present in 52.6% patients. Most common site affected was palmoplantar (43.8%) followed by palmar (36.3%). DLQI score was more in students as compared to salaried individuals or housewife similarly the palmoplantar HH patients has more DLQI score as compared to other site affected patients. Similar finding was applicable for HDSS scale.

Conclusion:
The PHH is underreported entity with prevalences of approx. 2.6% in our study. The impact on QOL is very profound and it is positively correlated with HDSS. There is felt need to carry targeted data collection for PHH.
Audit on Effectiveness of the Dental Information System Utilisation by Dental Post-graduates and Academicians at the Department of Restorative Dentistry
Authors: Palaniappan P. L. Ranganayakidevi S. , Seong Lim Ghee 
Published: August 2024

Abstract

Introduction:
A Dental Information System (DEISY) is a web-based application that facilitates data collection, retrieval of the history of patients and exchange of information on treatments performed for similar cases. Patient information and record keeping are essential for record management and follow-up for treatments conducted. A digital management system will improve the effectiveness and efficacy of the entire process.

Aims:
The aim of the study was to study the effectiveness of the DEISY system among dental post-graduates and the dental academicians of the restorative department.

Methodology:
Participants were required to fill out the questionnaire through the Google Form. Information gathered includes the clinician’s usage of DEISY, their experience, expectations and recommendations to improve the existing system for a more effective way of managing the patient’s healthcare records. The data were collected, and descriptive analysis was performed.

Results:
A total of 40 questionnaires were sent to the participants. About 70.4% of them responded that they will key in the patients, 29.6% of them will sometimes key in and about 7.4% of them will not key in these records at all. In line with this, approximately 66.7% responded that they will key in the outcome of the treatment on their own for each patient, whereas 7.4% do not key in the outcome of the treatment to the DEISY system.

Conclusion:
All participants realise the importance of the DEISY system but fail to utilise it due to technical difficulties. Without a doubt, utilising such system will provide more advantages than disadvantages.