bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retropupillary iris-claw lens
Authors: Singh Rahul , Ramraika Divya , Kapadia Seemee , Agrawal Saket , Ramraika Moon 
Published: May 2024

Aim:
To evaluate the preoperative and intraoperative indications, postoperative complications, incidence of secondary glaucoma, and visual outcome in patient who underwent iris-claw implantation during cataract surgery and effect of vitrectomy on postoperative intraocular pressure (IOP).

Material and Methods:
A retrospective study was conducted from January 2016 to February 2020. One hundred eighty-seven eyes of 187 patients who underwent iris-claw lens implantation, with minimum 1 month follow-up, were included in the study. Analysis of records was done for preoperative, intraoperative findings and was recorded and postoperative best corrected visual acuity (BCVA) and IOP were noted in each follow-up.

Results:
Mean preoperative BCVA of 187 eyes was 1.78 logMAR (SD 0.68), which increased to 0.61 ± 0.50, 0.36 ± 0.26, 0.21 ± 0.16 logMAR at postoperative day 1, day 7, and 1 month, respectively. Most common indications included phacodonesis (17.65%), small dilating and nondilating pupil (11.22%), zonular dialysis (6.41%), and pseudoexfoliation in (4.81%). Few patients (6.94%) had preexisting corneal pathologies which lend up in intraoperative complications that lead to iris-claw implantation. Mean IOP in vitrectomized eye after 1 month was 15.53 (SD 2.16) mm Hg and those of nonvitrectomized was 16 (SD 1.90) mm Hg. Posterior capsular rent and whole capsular bag loss were the most common intraoperative indications. Incidence of secondary glaucoma was 2.13%. Irregular pupil was the most common anterior segment finding at 1 month postoperatively.

Conclusion:
Retropupillary iris-claw implantation is one of the safe and least complicated methods of managing intraoperative complications which gives good visual acuity and prevent patient from the trauma of multiple surgeries.
Patient-reported Outcomes of SARS-CoV-2 Positive Adult Orthopedic Trauma Patients Treated During the Ongoing Pandemic
Authors: Bajaj Vineet , Khan Yasim , Kashyap Abhishek , Ram Devajee Bharat , Arora Saurabh , Arora Sumit , Kumar Vinod , Maini Lalit 
Published: May 2024

Background:
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has become a matter of concern all over the world. It has resulted in delay in surgery or, at times, preference for nonoperative treatment for SARS-CoV-2 positive orthopedically injured adult patients which may adversely affect the clinical outcomes. In this study, we report the outcomes of orthopedic adult trauma patients who tested positive for SARS-CoV-2 at admission.

Methods:
We retrospectively reviewed the prospectively collected data from the period between April 1, 2020 and December 31, 2020. We reviewed 521 out of total 2435 patients presenting in the casualty that required orthopedic trauma surgery. Thirty-eight out of total 521 patients, that tested positive for SARS-CoV-2, were followed-up using telecommunication for final outcome of fracture treatment. A telecommunication patient satisfaction score after injury (TPSSI) was used to evaluate the patient satisfaction.

Results:
The mean age was 37.94 years (range: 18–72 years). They were followed-up for mean duration of 8.18 months (range: 6–13 months). Out of total 38, 23 underwent orthopedic trauma surgeries and rest 15 were managed nonoperatively. There was a mean delay in surgery of 5 weeks (range: 3–12 weeks). Five patients lost their lives and seven others had nonunion. The median TPSSI score was three.

Conclusions:
Nonoperative and delayed surgical management of adult orthopedic trauma patients, who tested positive for SARS-CoV-2 at admission, result adversely in activities of daily living and return to original occupation and, thus, have poor patient satisfaction.
Assessment and Comparison of the Mental Health Status of Patients Seeking Psychiatry Facilities in Pre-lockdown and Post-lockdown Period During COVID-19 Pandemic
Authors: Sharma Devesh , Garg Sunny , Sharma Anchal , Sharma Dinesh Dutt , Sharma Nidhi , Gupta Simran , Sharma Shivam 
Published: May 2024

Background:
The servicing and framework for mental health care accessible to population have been affected during the unprecedented times of coronavirus disease (COVID-19) pandemic. The new and almost exclusive method to maintain a therapeutic alliance with these patients has been the recently evolving telepsychiatry services.

Aim and Objectives:
The main aim of the study was to assess and compare the mental health status of patients seeking available psychiatry facilities in pre-lockdown and post-lockdown period during COVID-19 pandemic.

Methodology:
This was a retrospective cross-sectional study that was conducted in a tertiary care hospital in a hilly region of North India. The registered data was analyzed between January 1, 2020 to March 21, 2020 to gather the information of patients about sociodemographic profile and clinical diagnosis on the basis of International Classification of Diseases-10. The retrieved data constituted 499 new consecutive patients during this period. Then in the post-lockdown phase after the resumption of OPD services in the institute (May 3, 2020), the data collection was initiated to collect a similar sample size of new consecutive patients (501). These data were collected over 151 days (May 3, 2020 to September 30, 2020).

Results:
A total number of 1000 patients were analyzed. Majority of the patients were male (66%) and within 19 to 60 years of age (85–90%). The average number of patients (3.31) seen per day was less and the average age of the patients (39.17 years, standard deviation = 14.37) was significantly higher in the post-lockdown phase. The most common diagnostic group consisted of neurotic/stress-related/somatoform disorders. As compared to the pre-lockdown period, a significantly (P < 0.001) lower number of patients diagnosed with substance use disorders and a significantly (P < 0.001) higher number of patients diagnosed with psychotic disorders along with anxiety disorders availed the available psychiatry services in the period of COVID-19 pandemic.

Conclusion:
Sudden cessation of the psychiatry services further precipitated the deterioration of mental health of the patients. There is an urgent demand for services to adapt to changing scenarios with emphasis on practical approaches to help the mentally ill people especially in geographically difficult hilly areas.
Effect of acute exercise on Cardiovascular and Serum cortisol reactivity to mental stress in offspring of hypertensives
Authors: Nigade Pooja Sardar , Varshney VP , Bedi Mona 
Published: May 2024

Introduction:
The purpose of our study was to evaluate the effect of acute exercise on HR, BP and serum cortisol levels in offspring of hypertensives. This could serve as a preventive measure to habituate the high risk population group right at the early age.

Material and Methods:
The study was a double blind single centered randomized controlled prospective study conducted in the Department of Physiology & Biochemistry, Maulana Azad Medical College and associated hospitals, New Delhi over a period of 1 year. 30 subjects were recruited for the study. They were labelled as:- Group 1–the subjects were rested for 10 minutes after which the measurement of BP, HR and Serum cortisol was done. This resting value was labeled as R-1. The subjects were then exposed to mental arithmetic test (MAT) for 5 minutes. Thereafter their BP, HR and Serum Cortisol were measured again and labeled as T-1. Group 2–Same subjects were similarly rested for 10 minutes after which the measurement of BP, HR and S. cortisol was done. This resting value was labeled as R-2. This was followed by 20 minutes of Bicycle ergometry exercise. The subjects were then exposed to MAT for 5 minutes. Thereafter their BP, HR and Serum cortisol were measured again and labeled as T-2. We then compared (T2–R2) known as

Cardio-Adrenal Reactivity (CAR)
with exercise vs CAR without exercise (T1-R1). 2ml of blood sample was withdrawn for estimation S. cortisol. Paired t-test was applied for comparison (p value <0.05–significant).

Results:
The CAR was more in Group 1 compared to Group 2, difference being statistically significant.

Conclusion:
Study showed statistically significant change between with and without exercise groups. Acute exercise can reduce the adrenocortical reactivity to stress, a preventive tool for development of future hypertension.
Correlation between Levels of Vitamin D and Disease Severity and Outcome in COVID 19 Patients at a Tertiary Hospital in North India
Authors: Ghosh Tamoghna , Krishnan Rahul , Chowdhury Souradeep , Kumar Arvind , Baitha Upendra , Sharma Shweta , Wig Naveet 
Published: May 2024

Introduction:
COVID-19 disease is more prevalent and severe in people who are more likely to be deficient in vitamin D, people with obesity and diabetes mellitus, and people who live in higher latitudes.

Materials and methods:
The study was an ambispective, analytical, observational study conducted at a tertiary care teaching hospital in New Delhi, India. The study population consisted of adults with a confirmed diagnosis of COVID-19.

Results and conclusion:
Eighty eight patients diagnosed with COVID-19 between February and July 2021 were enrolled, with mean (SD) age being 40(2) years and there were 55 (62.5%) males. The most common co-morbidities were hypertension, diabetes mellitus, and chronic obstructive pulmonary disease (COPD) and the most common symptoms were fever, cough, and myalgia. Twelve (13.6%) patients had severe disease. Seven (7.9%) patients died. Sixty one (69.3%) patients had vitamin D levels <30 ng/mL and had severe disease, more symptoms, and increased oxygen requirement, but did not affect laboratory parameters and mortality.
Osmotic Demyelination Syndrome Presenting as Extrapontine Myelinolysis with or without Central Pontine Myelinolysis
Authors: Gupta Saurabh , Gupta Shikha , Shroti Akhilesh 
Published: May 2024

Background and objective:
Osmotic demyelination syndrome (ODS) refers to a spectrum of clinicoradiologic syndrome which occurs due to pontine and extrapontine involvement due to myelinolysis. It is well described in association with rapid correction of hyponatremia and in alcoholics. In this case series, we have reviewed clinical presentation, neuroimaging features, and clinical outcomes of five patients diagnosed with ODS.

Methods:
The hospital medical records of all patients diagnosed with ODS between September 2018 and May 2020 at our hospital were analyzed retrospectively. Patients’ relevant clinical details and laboratory findings were recorded and magnetic resonance imaging (MRI brain) was reviewed. Those cases having imaging or clinical picture not clearly consistent with diagnosis were excluded.

Results:
Patients included in the study were 49 to 69 years old. All patients were treated as a case of hyponatremic encephalopathy in local hospitals. All patients had initial improvement followed by neurologic deterioration for which they were referred to our hospital. Possible etiologies of hyponatremia were recurrent vomiting and diuretic induced in two patients each and alcohol induced in one patient. Three out of five patients showed isolated extrapontine involvement on MRI. All patients showed improvement on dopaminergic drugs, whereas one patient had residual pseudobulbar symptoms which improved on follow-up.

Conclusion:
This series represents cases with clinical, etiopathogenic and radiologic spectrum of the ODS. ODS is a potentially treatable condition and rewarding results can be obtained by prompt diagnosis and management of associated secondary complications.
COVID-19 and Underlying Comorbidities
Authors: Lamba Manvi , Khurana Vatsala , Lamba Ginni , Goswami Binita 
Published: May 2024

Context:
The world witnessed the emergence of a new disease, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is now a global pandemic. Studies have shown that people with pre-existing conditions are more vulnerable to the virus compared to people with no comorbidities.

Aims:
The present study has been conducted to evaluate the prevalence of comorbidities among patients with COVID-19 admitted to a district hospital in Sonipat, Haryana.

Materials and methods:
An epidemiologic, questionnaire-based cross-sectional study was conducted on consecutive patients with COVID-19 admitted to a civil hospital in Sonipat, Haryana between May 13, 2020 to November 13, 2020 over a period of 6 months.

Statistical analysis:
The data were analyzed using SPSS version 20.0 (IBM Corp., Armonk, New York, USA).

Results:
The results show that men (65.4%) were affected more than women with maximum prevalence in the age group of 21 to 30 years (28.8%). Only 10.7% of the volunteers showed no signs of any chronic ailment in contrast to 89.3% volunteers who were already suffering from some underlying health condition. The data also revealed that people suffering from type 2 diabetes (40.9%) and hypertension (33.5%) are more susceptible to develop SARS-CoV-2. About 55.9% of the participants were asymptomatic at presentation.

Conclusion:
People with chronic conditions were more susceptible to COVID-19, may be due to an increased inflammation leading to weakening of the immune system. As prevention is better than cure, so by following basic principles of sanitization, social distancing, and use of proper face masks, people with comorbidities can protect themselves from the virus.
A Study on Perception of Stress Among First-Year Medical Undergraduates During Covid-19 Pandemic
Authors: Khullar Shilpa , Das Suman , Rizvi S Aijaz Abbas , Sinha Praveena , Abidi Syed Sibte Akbar , Baisla Rahul 
Published: May 2024

Background:
Medical students have been reported to suffer from a higher degree of perceived stress compared to the age-matched population doing other courses. Stress caused by the ongoing coronavirus disease (COVID-19) pandemic, lockdown, and the consequent shift of teaching methods to digital format has further compounded the stress associated with pursuing the medical curriculum.

Aims and Objectives:
Our study aimed to assess perceived stress among first-year MBBS students during COVID-19 induced lockdown using a self-administered Perceived Stress Scale (PSS-10) questionnaire.

Materials and Methods:
A total of 108 first-year MBBS students in the 18–25 years age group of both sexes were administered a 10-item questionnaire: PSS-10 during 2 months from June-July 2021and depending on their scores of PSS were divided into three groups Group A, B, and C signifying mild, moderate, and severe stress perceived by them, respectively. The continuous variables are presented as mean ± standard deviation and the categorical variables as proportions. Analysis of Variance (ANOVA) was used to compare the data between continuous variables in the three groups.

Result:
There was a statistically significant difference in the PSS scores between the three groups when a comparison was done (P < 0.05). A larger segment of the first-year medical students undergoing medical curriculum during the COVID-19 pandemic were found to be moderately (63%) to severely (4%) stressed.

Conclusion:
Our study suggested that the stress induced by the pandemic in addition to the stressors associated with undertaking medical courses creates a highly stressful environment for the medical students predisposing them to significant psychological morbidity.
Psychological Impact of Covid-19 Pandemic on Healthcare Workers Posted in the Obstetric Unit
Authors: Chadha Shikha , Prasad Sonal , Tyagi Dinesh , Ansari Aaliya , Kahar Govind R 
Published: May 2024

Objective:
This study was done to determine the prevalence and predictors of depression, anxiety, and stress among doctors in COVID MCH unit in Delhi.

Method:
A cross-sectional study was conducted in India among 356 doctors to evaluate the mental health of doctors working in COVID-infected maternity wards over a period of 6 months using a predesigned, semistructured Depression, Anxiety, and Stress Scale (DASS-21) questionnaire which was developed on Google Forms. The predictors to stress, anxiety, and depression were subject to univariate logistic regression.

Result:
Out of the total 356 participants, 38.76% felt stressed, 56.46% were anxious, while 43.25% felt depressed. The mean DASS-21 score for stress, anxiety, and depression was 7.46, 4.12, and 4.29, respectively. Female gender was found to be a significant predictor of stress, anxiety, and depression. Staying with parents/children was a significant predictor for stress and living alone was found to be a significant predictor of depression. Fear of infecting their family members was the main concern among those tested positive.

Conclusion:
The present study has shown a significant psychological impact arising from this pandemic. Early screening targeting the medical workforce and the implementation of psychological interventions is essential for maintaining the functionality of the healthcare system.
Pharmacovigilance Activities in Maulana Azad Medical College and Associated Hospitals
Authors: Roy Vandana , Tayal Vandana , Haque Ijasul , Ahmad Jamshed , Verma Kavita , Singh Virendra 
Published: May 2024

Introduction:
Pharmacovigilance plays an important role in patient safety and rationalizing the use of medicines. It helps in identifying the frequency of adverse drug reactions (ADRs), their causes, and the associated risk factors. Pharmacovigilance activities are facilitated through adverse drug reactions monitoring centers (AMCs) in most of the institutions.

Aim:
The objective of this paper is to provide an overview to the health care professionals regarding ADRs reported from the associated hospitals of Maulana Azad Medical College (MAMC) and the pharmacovigilance activities undertaken.

Observations:
Maulana Azad Medical College, Department of Pharmacology was recognized as an AMC in 2014 under the Pharmacovigilance Program of India (PvPI). The AMC established a way for reporting ADRs both by spontaneously and through active monitoring of ADRs from different wards. The causality assessment of all ADR reports collected is done. The program was informed by a college pharmacovigilance committee, emails, and by putting posters in the hospital nursing stations. Fourteen training workshops for doctors and pharmacists and two training workshops exclusively for nurses have been conducted so far on pharmacovigilance. In 2017, a program to sensitize doctors working in the Delhi government hospital was started. A total of 854 healthcare workers have been sensitized. The center has reported a total of 2572 ADRs to the National Coordination Centre (NCC) at Indian Pharmacopoeia Commission until December 2021. ADRs reported were highest in the age group of 20 to 59 years. Most of the reports were from the department of T.B. and Chest (n = 589, 23.8%). The most common class of medicines implicated in causing ADRs was antimicrobials (n = 1100, 44%). Among the ADRs reported, the majority were mild (n = 1451, 81.1%) with 346 (18.8%) reported as serious.

Conclusion:
A system for reporting ADRs on campus has been established. The pattern of ADRs reported to this ADR monitoring center is comparable to the national and global data. Hospital-based ADR monitoring and reporting programs are very crucial to identify and quantify the risks associated with the use of medicines. The pharmacovigilance program at MAMC is a commitment and a small step towards patient safety.
Tracking Annual Antimicrobial Resistance at a Tertiary Care Hospital amidst Raging COVID-19 Pandemic
Authors: Saxena Sonal , Aggarwal Prabhav 
Published: May 2024

Background:Timely preparation and presentation of the annual cumulative antibiogram play an important role in the dissemination of an updated susceptibility pattern to clinicians and thus aid in the appropriate choice of antimicrobials for empirical therapy while minimizing adverse effects and resistance. The study aimed to present and analyze the annual AMR data that may be helpful in designing antibiotic policy.Methods:All clinical specimens routinely submitted to the Department of Microbiology from January to December 2021 for bacteriological culture and antimicrobial susceptibility testing (AST) were included. AST was performed for pathogenic isolates by disc diffusion/agar dilution/broth microdilution methods/VITEK® 2 compact system. All data were entered and analyzed using WHONET 2020 software.Results:A total of 46,629 routine specimens were processed, yielding 5792 non-repeat bacterial isolates. Relatively fewer specimens were received during the first few months when the hospital catered exclusively to COVID-19 patients. The most common bacterial isolates wereEscherichiacoli(30%),Staphylococcus aureus(21%),Klebsiella sp. (18%),Pseudomonas sp. (10%),Acinetobacter sp.(8%) andEnterococcus sp.(5%). Analysis showed low susceptibility to 3rd generation cephalosporins, fluroquinolones, and cotrimoxazole among Gram negative bacteria. Less than 50% Acinetobacter sp. were carbapenem susceptible. We report high rate of methicillin resistance inS. aureus(74%). Overall susceptibility was much lower in specimens from ICU followed by in-patients and out-patients.Conclusion:Antimicrobial resistance is rapidly assuming the proportions of a pandemic, with several authors calling it “invisible” pandemic. As is evident from the present study, low susceptibilities to all but a few last-resort drugs are leaving few choices for treatment. This mandates effective preparation, distribution, and presentation of annual antibiograms, which will help in formulating hospital antibiotic policy.
Acute Influence of Moderate Exercise on Smoking Urge, Mood, and Physical Withdrawal Symptoms
Authors: Singh Saurabh Kumar , Jain Preeti 
Published: May 2024

Background and Objectives:
The potential role of exercise as an aid to conventional smoking-cessation measures is being increasingly suggested. The present study was conducted with the aim of assessing and comparing the influence of short-duration, moderate-intensity exercise on the urge to smoke, and mood and physical withdrawal symptoms among male smokers following an overnight temporary abstinence from smoking with those who smoked ad-libitum.

Methods:
Thirty male smokers between 18 and 45 years, who smoked >10 cigarettes/day for >1 year were recruited and randomized into two different groups (n = 15 in each group). The abstinent group included smokers who had at least 10 hours of overnight temporary abstinence from smoking on test day. The non-abstinent group included smokers who smoked ad libitum without having any temporary abstinence from smoking on test day. Nicotine dependence, smoking-urge, and withdrawal symptoms were assessed using the Fagerström test for nicotine dependence (FTND), brief questionnaire on smoking-urge (QSU-Brief), and the mood and physical symptom scale (MPSS), respectively. All subjects in both groups performed moderate-intensity exercise on a friction-type bicycle-ergometer at a fixed frictional force of 2 kg for 5 minutes at 40-60% of heart-rate reserve. QSU-Brief and MPSS were assessed pre-exercise and post-exercise (immediately, 5 and 10 minutes after stoppage of exercise).

Results:
QSU-brief and MPSS scores were comparable in both groups at all time points (P > 0.05). There was a significant decline (P < 0.001) in QSU-brief and MPSS scores immediately following exercise in both groups, which persisted after 5 (P < 0.001) and 10 minutes post-exercise (P < 0.01).

Interpretation and Conclusions:
Our results indicate that a single session of short-duration, moderate-intensity exercise effectively alleviated the smoking urge and negative effects of nicotine withdrawal symptoms in both study groups and led to an overall improvement in their mood. The results further indicated that these beneficial roles of exercise persisted even after a 10 minutes of stoppage of physical activity. We recommend the incorporation of a brief session of moderate exercise as a smoking cessation aid to provide additive relief from cigarette cravings and nicotine withdrawal symptoms in smokers attempting to quit.