bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of class 1 human leukocyte antigen allele subtypes in Egyptian patients with idiopathic uveitis
Authors: Bahgat Dina M.R. , Gad Alaa A. , Kosmass Walid R. , Fadel Mariam R. , Abdelraouf Fatma H. 
Published: August 2024

Bacground
Idiopathic uveitis is the most common uveitis type and is viewed as an inconclusive diagnosis for patients as well as physicians. Human leukocyte antigen (HLA) typing helps in understanding the pathogenesis of several diseases. Limited knowledge is known regarding the association of HLA with idiopathic uveitis.

Aim
This was a cross-sectional observational case–control study evaluating HLA-A and HLA-B allelic and phenotypic frequencies in patients with idiopathic uveitis.

Patients and methods
HLA-A and HLA-B molecular typing by PCR-sequence-specific oligonucleotide probes and LIRAS interpretation software was performed for 60 patients with idiopathic uveitis and 60 controls recruited from Kasr Al-Ainy Hospitals, Cairo University.

Results
Anterior uveitis pattern was the most common (55%), followed by pan-uveitis (35%) and posterior uveitis (10%). Overall, 40% of patients had bilateral uveitis, whereas 60% had unilateral uveitis. A total of 23 HLA-A and 43 HLA-B variant alleles were detected. HLA-A*09 and HLA-A*10 allele and phenotype frequencies were significantly higher in the patient group (P=0.023 and 0.034, and P=0.013 and 0.029, respectively). HLA-B*07 allele and phenotype frequencies were significantly higher in the control group (P=0.007 and 0.006, respectively). HLA-B*27 and HLA-B*05 were detected in 8.3 and 26.7%, respectively, with no significant difference.

Conclusion

HLA-A*09 and HLA-A*10 alleles were statistically significantly higher in patients with idiopathic uveitis. HLA-B*07 might be a protective allele against disease development. Larger cohort needs to be tested to validate these findings. Routine HLA typing and proper follow-up for primarily diagnosed idiopathic uveitis is recommended as it might reveal secondary causes for uveitis, especially in patients with positive HLA-B*27 and HLA-B*05.
Procrastinating necessary evolution awaiting a calamity: The journey post the morcellation saga
Authors: Trivedi Soumil Prakash , Trivedi Prakash Harikant , Trivedi Aditi Soumil , Kar Kaustav , Kar Malvika Tiwari 
Published: August 2024

Abstract
This review article highlights the need for the timely adoption of various containment devices for tissue retrieval of large specimens, especially myomas and large uteri, irrespective of the minimally invasive surgical route or modality used for debulking, principally focusing on morcellation. This article aims to share the feasibility and safety profile of laparoscopic contained power morcellation and also to provide a basic comparative overview of various other tissue retrieval techniques currently employed. The authors share their technical experience of nearly 3000 cases of laparoscopic contained in-bag morcellation of fibroids or large uteri, which required debulking for retrieval and also the possible limitations. The authors found this technique viable, safe, and effective in reducing potential hazards of uncontained morcellation such as parasitic fibroids, leiomyomatosis peritonei and also reducing possible up-staging of cancers, but believe there is a pivotal role of preoperative diagnostic differentiation of any malignant conditions, which may be lacking in some cancers such as leiomyosarcoma. In conclusion, the authors urge to make this necessary evolution in tissue retrieval techniques rather than procrastinating for other multiple calamities to strike again.
Learning curves in robotic surgery: A retrospective analysis
Authors: Padte Kedar , Padte Jayashri , Pawar Uddhav , Gadkar Jyoti , Patil Shailaja 
Published: August 2024

Abstract

Purpose:
The purpose of this study was to outline the surgical outcomes associated with learning curves before and after achieving proficiency in the first 150 robot-assisted hysterectomies in an individual surgeon.

Methods:
We retrospectively analyzed the outcomes of patients who underwent robotic hysterectomy between February 2021 and August 2023. All perioperative details of each procedure were meticulously recorded by qualified personnel using standardized case report forms. The collected data included various parameters, namely, age, body mass index (BMI), obstetric and medical histories, and operative characteristics.

Results:
The mean patient age at the time of surgery was 49.8 years, and the mean BMI was 28.5. The mean total operative time was 98.6 min, the mean total docking time (DT) was 13.3 min, and the mean console time (CT) was 33.5 min. The mean estimated blood loss was 66.1 mL and the mean specimen weight was 281.1 g. Most patients were discharged 2.62 days after surgery. The analysis of patients by the learning curve showed that the operation, DT, and CT were significantly longer in patients treated before the surgeon achieved proficiency versus those treated after.

Conclusion:
Robot-assisted hysterectomies performed in the later phases of the surgeon’s learning curve showed significant decreases in operative, DT, and CT. Surgical proficiency, as measured by operative time, was attained in 50–60 cases.
An unusual case of neuroendocrine tumor
Authors: Raj Mala , Dalal Sharayu Parth , Palaniappan Rajashree 
Published: August 2024

Abstract

Introduction:
Neuroendocrine tumour is defined as tumour arising in specialised cells called neuroendocrine cells who show traits of nerve cells and hormone producing cells. These slow growing tumours are more common in adult female than in males or children and often present with vague symptoms. This report highlights unusual case of NET diagnosed incidentally intraoperatively.

Clinical Case:
A 46 yrs. old P2L2, menstruating women was referred with complaints of mild lower abdomen pain for 3 months. Since patient was symptomatic and USG inconclusive, MRI pelvis was done which revealed a well marginated thin-walled lesion in left paracentral presacral area suggestive of Para-ovarian or Haemorrhagic cyst. Patient posted for laparoscopy in view of adnexal cyst and intraoperative findings revealed normal uterus, bilateral tubes, and ovaries with no evidence of para-ovarian cyst. On examining lateral pelvic wall, a paracentral mass lateral to left uterosacral ligament was noted, excised, and retrieved in toto. Histopathology and immunohistochemical analysis suggestive of well differentiated Neuroendocrine tumour of WHO GRADE 2. Primary was noted in anterolateral wall of mid-rectum and colonoscopic biopsy confirmed the diagnosis followed by which low anterior resection of rectum was performed. Patient was followed for postoperative recovery and discharged.

Conclusion:
According to literature there is often a delay of average 52 months before patient reaches its correct diagnosis. High index of suspicion remains a key to clench diagnosis in such cases.
Factors Determining Risk of Contralateral Lower Limb Amputations in Unilateral Dysvascular Transfemoral and Transtibial Amputees
Authors: Muthusamy Ambikaveni , Thirunavukkarasu P. , Rajakumar A. , Chitrarasu K. , Kamakshi R. M. , Premalatha K. , Guna A. 
Published: August 2024

Abstract

Background:
This study deals with the factors influencing contralateral lower limb amputations among unilateral dysvascular transfemoral and transtibial amputees.

Aim:
(1) Early identification of risk factors responsible for amputations in contralateral lower limb. (2) To determine the preventive measures of the concerned risk factors. (3) The aim of this study was to determine the risk factors associated with, contralateral amputation in patients with chronic limb threatening ischaemia (CLTI).

Study Design:
Cross-sectional study, 45 patients with unilateral transfemoral and transtibial amputees due to diabetes and peripheral arterial disease (PAD) were recruited for this study.

Materials and Methods:
Analysis of risk factors by ankle-brachial index (ABI), Claudication Pain Scale.

Results:
Unilateral transfemoral and transtibial amputees due to diabetic foot syndrome and PAD are at 2–4 times increased risk for contralateral lower-limb amputations.

Conclusions:
Risk of anticipated contralateral limb amputation is high based on ABI and Claudication Pain Scale. All patients, but particularly those at increased risk, should undergo close surveillance and counselling to help prevent subsequent amputations in their contralateral lower extremity.
Footwear Modification in Patients with Peripheral Neuropathy by Use of Three-dimensional Force Plate
Authors: Saha Swati , Kumar Sanyal , Kumar Anjani , Pandey Sanjay Kumar 
Published: August 2024

Abstract

Background:
Peripheral neuropathy is the most common chronic complication of both type 1 and type 2 diabetes, with an estimated lifetime prevalence exceeding 50%. Loss of cutaneous sensory information from the foot sole is reported to be a critical factor contributing to walking instability, poor balance and falls, in people with diabetic peripheral neuropathy (DPN). Although there is a very little evidence in the literature on the effectiveness of microcellular rubber insoles, they may offer a new rehabilitative approach, which promotes self-management by the user, to improve balance and walking, and reduce the risk of falling, in adults with diabetes and this study aims to find out the effectiveness of microcellular rubber insoles in peripheral neuropathy.

Materials and Methods:
This was a prospective observational study. A total of 30 patients with DPN, fulfilling the inclusion criteria, were selected for the study. All of the participants were clinically tested for the presence of neuropathy and evaluated by the force platform, after which they were advised to wear micro cellular rubber insole footwear (which was made in institutional set up as per patient’s foot size) for a period of 4 weeks. At the end of the stipulated period, the participants were again evaluated on the same parameters in the force platform.

Results:
After 4 weeks of intervention, there was a significant improvement in the postural stability as evidenced by a decrease in the mean of anterior–posterior sway (7.1225 ± 0.7102/5.7972 ± 0.6901) (P < 0.0001). Mean mediolateral sway also shows an improvement (4.9570 ± 0.5106/3.9639 ± 0.5749) (P < 0.0001). Similarly, improvements shown in mean sway area (368.4048 ± 58.9558/313.8788 ± 57.5957) (P = 0.0040) and sway velocity (23.2842 ± 2.1151/21.8840 ± 1.8419) (P < 0.0001). The step length, however, did not show any statistically significant improvement (0.6474 ± 0.0524/0.6333 ± 0.0597) (P = 0.2820). There was a significant reduction in the vertical component of the ground reaction force post-use of the insole (737.4333 ± 73.1577/659.3667 ± 82.7937) (P < 0.0001) with a reduction of 13% mean value.

Conclusion:
This study demonstrates that neuropathy deteriorates postural balance and gait; the present evidence provides insight indicating that footwear interventions do significantly alter static balance performance in the neuropathy population. Footwear interventions seem to have the capacity to alter underlying strategies controlling static and dynamic movement patterns through a combination of mechanical and sensorimotor mechanisms, for which in-depth investigation of neurophysiologic responses to footwear interventions is necessary to help confirm any sensorimotor adaptations.
A Comparative Study of the Efficacy of Ultrasound Therapy against Intra-articular Corticosteroid Injection in Adhesive Capsulitis: A Randomised Open-label Study
Authors: Sannyashi Puja 
Published: August 2024

Abstract

Introduction:
Adhesive capsulitis is idiopathic, progressive, painful, and restricted active and passive shoulder range of motion in patients with normal radiographs. Adhesive capsulitis can be effectively treated by ultrasound therapy, exercise, and intra-articular steroids.

Objective:
To see the efficacy of ultrasound therapy and intraarticular corticosteroid injection in adhesive capsulitis. And compare the efficacy of ultrasound therapy and intra-articular corticosteroid injection.

Materials and Methods: Study Design:
A comparative study.

Setting:
Tertiary care center. Time period:from October 2019 to September 2020.

Participants:
80 patients who attended the Physical Medicine and Rehabilitation department during the study period, met the inclusion criteria.

Intervention:
Patients were randomly assigned to the intra-articular corticosteroid injection (Group A) and ultrasound therapy treatment (Group B).

Main Outcome Measures:
Parameters such as the Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI) and range of motion with goniometry. The examination was performed at the 1st visit (0 week) and then 4th, 8th and 12th weeks.

Results:
At the end of the study, a statistically significant improvement was obtained in all clinical parameters: VAS (P < 0.001), SPADI (P < 0.001) and goniometry (P < 0.001) in both Group A (the intra-articular corticosteroid injection) and Group B (ultrasound therapy treatment). While in combination with therapeutic exercises, the greatest pain improvement was seen in the local corticosteroid injection group, the ultrasound therapy group also showed significant and comparable improvement.

Conclusions:
Both intra-articular corticosteroid injection and ultrasound therapy were effective in adhesive capsulitis treatment. Thus, ultrasound therapy can be an alternative treatment for adhesive capsulitis, particularly in patients who do not accept injections.
Depression, anxiety, and stress among private shopkeepers after COVID-19 pandemic: A cross-sectional study from Mohali, India
Authors: Goyal Ekram , Malhotra Nidhi , Kumar Ajay , Puria Alka , Chaudhury Suprakash , Saldanha Daniel 
Published: August 2024

Background:
The COVID-19 pandemic affected almost all sections of society. The economy of the country collapsed and it affected the economic situation of the common man. Private shopkeepers also suffered as they could not open their shops. The current study was an effort to assess the psychological status of these people.

Aim:
To assess depression, anxiety, and stress levels among private shopkeepers in Mohali after the COVID-19 pandemic who were previously mentally healthy.

Materials and Methods:
This observational, cross-sectional study was conducted on 500 consenting private shopkeepers from 10 different topographically scattered markets of Mohali. Written informed consent was obtained. Ethical clearance was sorted by the institutional ethics committee. Sociodemographic data were recorded on sociodemographic proforma. Depression Anxiety Stress Scale -21 (DASS-21) was employed to assess depression, anxiety, and stress. The data obtained was statistically analyzed.

Results:
A total of 34.2% of shopkeepers had depression, 31.4% had anxiety, and 44.80% had stress. Out of which street vendors had more depression (6.60%), anxiety (6.80%), and stress (7.40%) compared to other shopkeepers. Depression (36.07%), anxiety (32.61%), and stress (46.87%) were comparatively more among shopkeepers who had incurred financial loss compared to those who had received gain. Shopkeepers who had their shops closed were suffering from depression (35.42%), anxiety (33.26%), and stress (46.65%) comparatively more than individuals who had their shops open. A total of 59.75%, 51.57%, and 72.96% of shopkeepers whose products expired during the pandemic were suffering from depression, anxiety, and stress respectively.

Conclusion:
Depression, anxiety, and stress are high in private shopkeepers after the pandemic. Mental health services should be more accessible, affordable, and available during a pandemic and its aftermath. The economy of the country should be strengthened after the pandemic keeping in interest the economic needs of the common man.
Assessment of depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during COVID-19 crisis
Authors: Soumya A V , Dhamija Sana , Davis Supriya , Samudra Madhura , Pooja V , Gupta Nishtha , Khan Aslam , Chaudhari Bhushan , Chaudhury Suprakash , Saldanha Daniel 
Published: August 2024

Background:
During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems.

Aim:
To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis.

Materials and Methods:
Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor–Davidson resilience scale short form (CD RISC) for assessing resilience.

Results:
A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers.

Conclusion:
During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance.
Prevalence of psychiatric comorbidities and cognitive dysfunction among chronic kidney disease patients in a general hospital
Authors: Singh Hartwinder , Nath Shubranshu , Singh Ranveer 
Published: August 2024

Background:Chronic kidney disease (CKD) presents a profound clinical challenge, not only affecting physical health but also significantly impacting mental well-being. The complex interplay between CKD and psychiatric morbidities remains understudied.Aim:To address the existing gap by investigating the prevalence and patterns of psychiatric morbidity and cognitive dysfunction among CKD patients.Materials and Methods:This study adopted a cross-sectional and hospital-based study design. It included 72 patients diagnosed with CKD who fulfilled the inclusion and exclusion criteria. Structured clinical interviews, validated assessment tools (GHQ-12, HAD-S, AUDIT, Addenbrooke’s Cognitive Examination-III), and a proforma gathered data on socio-demographic factors, illness severity, treatment history, and psychiatric history.Results:70.1% of participants exhibited psychological distress, indicating a high prevalence of psychiatric morbidity. Anxiety disorders were prevalent, affecting 58.1% of participants, while depression affected 32.3% (12.9% mild, 20.8% moderate, 4.8% severe). Cognitive impairment varied with CKD severity, with Stage 3 showing better scores than Stage 4, and hemodialysis patients exhibiting the most significant decline.Conclusion:This study underscores the substantial burden of psychiatric morbidity and cognitive dysfunction in CKD patients within a general hospital setting. Early identification and integrated interventions in mental health care are crucial for improving CKD patient outcomes and well-being.
Compassion fatigue, secondary traumatic stress, and coping strategies of mental health professionals
Authors: Kumar Kavya , Ponnuchamy Lingam , Anand Nitin , Ganjekar Sundarnag , Majhi Gobinda , Prakash Priya 
Published: August 2024

Background:
The prevalence of compassion fatigue (CF) and secondary traumatic stress (STS) has been studied with a predominant focus on medical care professionals, indicating a significant presence of STS and CF among them. The present study has identified a dearth in the representation of mental healthcare professionals (MHPs), grouped by psychiatrists, clinical psychologists, psychiatry nurses, and psychiatric social workers within the Indian context.

Aim:
To assess the degree of CF and STS and the subsequent coping mechanisms adopted by MHPs.

Materials and Methods:
This study followed a cross-sectional research design. There were 75 participants selected using purposive sampling and administered scales that measured CF, STS, and coping strategies adopted by the participants.

Results:
There is a strong presence of CF in MHPs along with problem-focused coping as the preliminary approach to STS. Participants with average or higher scores in STS had higher intrusion scores. Higher STS scores tend to have avoidant coping styles in comparison to the larger sample. Female participants indicated higher levels of CF and STS than their male counterparts.

Conclusion:
The study emphasizes on the immediate requirement to address and manage CF levels among the MHPs and focus on the factors that continue to aggravate STS.
Peripartum Cardiomyopathy: An Analysis of Clinical Profiles and Outcomes from a Tertiary Care Center in Northern India
Authors: Mumtaz Aqdas , Kela Dheeraj , Rai Sangeeta , Agrawal Vikas 
Published: August 2024

Objective:
The present study was conducted to evaluate the clinical profile, and risk factors of peripartum cardiomyopathy (PPCM) and its association with maternal and fetal outcomes from a tertiary care center in Northern India.

Methods:
An observational cohort study was conducted on 19 pregnant females showing features of heart failure in the last month of pregnancy or 5 months postpartum. We analyzed the clinical profiles and outcomes in these women with PPCM.

Results:
The mean age of presentation was 27.9 years with a mean gestational age of 34.9 weeks. 68.4% were primigravida. The most commonly associated comorbidities were anemia and preeclampsia/eclampsia. Breathlessness was present in all women with maximum presenting with class IV breathlessness. The mean baseline ejection fraction (EF) was 34%. A significant change (P < 0.05) was observed in various echo parameters (left ventricular [LV] end diastolic volume; LV end systolic volume; LV strain; EF; right ventricular systolic excursion velocity; left atrial diameter) from baseline to 3 months. Maternal and fetal deaths occurred in 5.2% and 31.5% of subjects, respectively. Cardiogenic shock and significantly reduced EF were associated with adverse fetal and maternal outcomes.

Conclusion:
The majority of the study participants were young primigravidas with preeclampsia and anemia being strongly associated risk factors. PPCM with poor LVEF and shock is associated with adverse fetal and maternal outcomes. Larger studies with a higher number of patients are needed to study PPCM in detail in the Indian subset.