bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morphometric measurements of patella in population of South Bengal with literature review
Authors: Biswas Soumali , Pal Anwesa , Biswas Ananya , Datta Indra , Kundu Rajib 
Published: May 2024

Abstract

Background:
Morphometric analysis of patella is important for implant surgeries, medicolegal point of view. Success of total knee replacement depends on proper dimensions of the implant. Measurement varies with race and ethnicity. Several studies have been done all over India regarding measurements of patella, but there is a scarcity of data on South Bengal population.

Objective:
Measurement of different parameters of patella: Thickness, height, width of articular and non- articular surfaces and correlation between them in dry bones among South Bengal population.

Materials and Methods:
One hundred right and 100 left dry patellae of unknown age and sex were collected from bone libraries of different medical colleges of Kolkata as well as from Prafulla Chandra Sen Government Medical College and Hospital, Arambagh. Measurements were taken by Vernier calipers, and data analysis was done using SPSS version 16. We also classified patella according to Koyuncu’s classification.

Results:
We got mean and standard deviation values of height, width, thickness, width of medial and lateral articular facets, height of articular and nonarticular surface, height of articular/total height, and ratio of width of medial and lateral articular facets for right and left patellae. The measurement of medial articular facet of right and left sides of patella was 20.58 ± 2.051 and 19.98 ± 2.177, respectively. The P value of this was 0.046 which was statistically significant. We also correlated height and width with other parameters. We followed Koyuncu’s classification in present study and found minimum number of type C patella 4(2%), 19 (09.5%) samples of type A, and maximum number of type B 117(88.5%).

Conclusion:
These morphometric data of patella will be helpful from medicolegal point of view as well as reconstructive surgery of knee joint.
Prevalence of psychological distress and perceived stress among nursing staff in a tertiary care center, Bengaluru
Authors: Shruthi M. N. , Veena V , Seeri Jayashree S. 
Published: May 2024

Background:
Nurses among the health care providers play a vital role in the success of the health care system. Their continuous hours of working and the existing lacunae in regard to their mental health in the current study setting, this study was conducted to elicit if the nurses are posed to any such mental health risks and perceive any stress?

Objectives:

Materials and Methods:
This is a cross-sectional study conducted among all the nursing staffs at our tertiary care centre for 2 months. A predesigned and pretested semi-structured self-administered questionnaire including general health questionnaire (GHQ)-12 and perceived stress scale (PSS)-10 were used to collect the data and to asses psychological distress and perceived stress considering the cut-off scores of a minimum of 12 and 19, respectively. Data were entered into Microsoft Excel 2010 and analyzed using the SPSS software version 20.0, Armonk, NY, USA: IBM Corp.

Results:
The mean age of the participants was 24.4 ± 3.7 years. Mean GHQ-12 score was 11. As per the scores, the cutoff of at least 12 was found in 35% of the respondents indicating the prevalence of psychological distress among 35.0% and as per the screening tool PSS-10 used, majority of the study subjects (93.0%) perceived moderate level of stress with a median score of 19.

Conclusion:
Nearly one-third of the nursing personnel were under psychological distress and almost the entire nursing faculty perceived moderate level of stress.
Prevalence and profile of functional constipation among children aged 1–12 years at a tertiary care center
Authors: Musali Sumanth Reddy , Damireddy Archana Reddy 
Published: May 2024

Background:
Constipation not only bothers children but also their parents. Even then, it remains neglected and leads to delayed medical care. It leads to physical as well as psychological morbidity. It affects the quality of life of children. Lack of timely medical care compounds the problem. The child may lose his/her self-esteem. About 1%–3% of children may develop impaction of the feces and may lead to soiling with fecal matter.

Objective:
The objective was to study the prevalence and clinicopsychological profile of functional constipation (FC) among children aged 1–12 years.

Materials and Methods:
This was a hospital-based cross-sectional study carried out among 156 children aged 1–12 years attending the tertiary care center for 1 year. During the study, 911 children aged 1–12 years attended the hospital. We applied Rome IV criteria for the diagnosis of FC. Using these criteria, 156 children were found to have FC, and all of them were included in the present study.

Results:
The prevalence of FC among the children was 17.1%. It was more in the toddler group (43.6%) with a slight female preponderance (51.3%). It was more in urban resident children (69.2%) and children belonging to the low socioeconomic group (33.3%). Painful defecation was the most common presenting complaint (81.4%). Most of the children passed Bristol Type II stool <three times a week. Majority of children were taking low-fiber diet, had poor physical activity, and aversion to school.

Conclusion:
The prevalence FC among children was high at 17.1%. Low-fiber diet, poor physical activity, and aversion to school were common in children with FC.
Distance learning environment
Authors: Giri Kiran R. , Palandurkar Kamlesh M. , Giri Reena , Agrawal Uditkumar , Agrawal Shikha 
Published: May 2024

Background:
Amid the COVID-19 period and lockdowns, medical education has witnessed major changes. Shifting from face-to-face offline education to online education in such an important branch of education dealing with human lives and serving mankind is really very challenging. In this distance learning process, student satisfaction is important and prediction of their satisfaction and other important parameters will help in improving the online system of medical education.

Objective:
To evaluate students' perception about distance learning education based on different domains given in the Distance learning Education Environment survey scale.

Materials and Methods:
A cross-sectional study was conducted among first-year and final-year MBBS students of the Institute of Medical Sciences, BHU. The total number of students who participated in the study was 123. The Distance Education Learning Environments Survey (DELES) scale which was validated for higher education by Scott L was used. The domain represents instructor support (D1), student interaction and collaboration (D2), personal relevance (D3), authentic learning (D4), active learning (D5), student autonomy (D6), and student satisfaction in distance learning process (D7).

Results:
The mean and standard deviation for each domain of the DELES were calculated. For instructor support, the mean was 25.9 for first-year students and 21.3 for final-year students. For the domain of authentic learning, the mean score was low, i.e. 15.7, for the first year and 13.3 for the final year. In the learning domain for the question about students satisfaction, the mean score was 19.8 for first-year students and 17.9 for final-year students.

Conclusion:
The finding of this study indicated that the majority of students were satisfied with instructor's support and personal relevance of the online learning classes, but were unsatisfied with opportunities of student interaction and group discussion, which is essential in medical education.
The effects and outcomes of different maternal positions on the second stage of labor
Authors: Jyoti R , Sharma Mudita , Pareek Shatrughan 
Published: May 2024

Introduction:
Maternal and child health is an important public health issue, especially in developing countries like India. Maternal and child health services help to determine maternal and neonatal morbidity and mortality in a country. The second stage of labor is the most stressful part of childbirth process and the proper maternal position during this period is paramount for women's safe vaginal birth. Midwives play a pivotal role in managing maternal positions during the second stage of labor. However, there is limited evidence to support an ideal maternal position during the second stage of labor.

Methodology:
All studies that explored the effects of positioning during the second stage of labor were retrieved. Only four major databases, Google Scholar, ResearchGate, PubMed, and Shodhganga, were searched. The keywords used for search included the second stage of labor, maternal position, upright position, left lateral position, squatting position, and maternal outcomes. The search criteria included studies published from 2008 to 2021. Out of 154 research articles, only 14 studies were included for the review process.

Results:
The positions such as maternal upright, lateral position, squatting position, and sitting position are beneficial for the maternal and neonatal outcome. The mean length of the second stage of labor was shorter in squatting primiparas and multiparas than in semirecumbent women, whereas lithotomy and supine positions during labor are associated with poor maternal and fetal outcomes.

Conclusion:
The selected positions during the second stage of labor have shown positive outcomes for the pregnant and her child. The findings should be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.
Assessment of knowledge and preventive practices towards COVID-19 among tribals living in tea gardens of Eastern India
Authors: Samanta Sampriti , Biswas Daliya , Sarkar Payel , Bandyopadhyay Alapan 
Published: May 2024

Introduction:
The government of India has launched large-scale health education and vaccination campaigns to combat pandemic COVID-19. However, their effects on changing behavior and practices of the very vulnerable tribal communities remain largely unexplored.

Materials and Methods:
A cross-sectional study was conducted to obtain COVID-19 knowledge and practice data from 390 households of 10 representative tea gardens of Darjeeling district, chose by cluster random sampling. Heads of each household were interviewed using a questionnaire containing 19 knowledge-related questions and 9 practice-related questions, marked on a 3-point Likert scale. A multivariable linear regression model was fitted to ascertain any association between sociodemographic parameters and participants' knowledge with COVID appropriate behavioral practice.

Results:
Most households were led by men and had a per capita monthly income of >INR 3000. The mean age of the respondents was 52.15 ± 10.14 years, with most being employed and having secondary-level education and above. The mean knowledge score was 30.16 ± 2.97, and practice score was 5.68 ± 1.54. The most common source of knowledge was from government and health-care campaigns. While most of the participants followed COVID-appropriate behaviors such as wearing masks and getting vaccine, hand hygiene (33.82%) and social distancing practices (32.05%) were found to be poor. Employment (P = 0.005) and knowledge about COVID-19 (P = 0.016) were significantly associated with a higher practice score.

Conclusions:
Among the tribal people assessed, good knowledge about COVID-19 was observed, owing to government efforts. However, while some COVID-appropriate behavior was widely adopted, hand hygiene, and social distancing were not.
Acute kidney injury
Authors: Singh Krishan , Yadav Arun Kumar , Aggarwal Rashmi , Alam Aftab 
Published: May 2024

Background:
Coronavirus disease-2019 (COVID-19) has protean clinical presentation, influencing almost every organ. The number of COVID-19 patients with acute kidney injury (AKI) is expanding, and the incidence of kidney injury in COVID-19 patients with severe disease is higher than in patients with mild disease.

Objectives:
The objective of the study is to find out the association of AKI with COVID-19 deaths.

Methods:
A case–control study was designed with a total of 172 patients. This included 92 death cases and 80 discharged cases in a dedicated COVID-19 hospital, critical care and fully intensive care unit equipped, in the peak of the second wave of COVID pandemic. Various biochemical parameters and inflammatory markers were studied to find out the mortality indicators in these severe COVID-19 cases.

Results:
Significantly elevated AKI markers such as urea (mean 58.5 vs. 37.1, P < 0.05), uric acid (mean 5.67 vs. 4.18, P < 0.05), and blood urea nitrogen (mean 26.9 vs. 17.3, P < 0.05) were detected in the death group compared to discharge group. This was accompanied by significantly elevated markers of inflammation such as total leukocyte count (TLC) (mean 16082 vs. 12100, P < 0.05), interleukin (IL-6) (mean 194.9 vs. 58.7, P < 0.05), C-reactive protein (mean 28.45 vs. 9.73, P < 0.05), and ferritin (mean 761.4 vs. 608.2, P < 0.05) in the death group.

Conclusion:
Significant AKI was noticed in the death group and AKI was further positively correlated with inflammatory markers C-reactive protein, ferritin, IL-6, d-dimer, and TLC levels.
Seroprevalence of syphilis in human immunodeficiency virus patients with special reference to diagnostic utility of rapid plasma reagin test
Authors: Lakshminarayan Divya , Vodapalli Akshay Kumar , Kolla Sri Harsha , Nakka Annie Ratnam 
Published: May 2024

Background:
Syphilis is a sexually transmitted infection caused by Treponema pallidum. High prevalence of syphilis was observed among human immunodeficiency virus (HIV)-positive patients. Atypical serological responses such as high antibody titers leading to frequent false-negative reactions have been reported with nonspecific treponemal tests. Simultaneous infection of syphilis and HIV in pregnant women increases the risk of HIV transmission from mother-to-child.

Aim:
The aim of the study was to assess the seroprevalence of syphilis in HIV patients including pregnant women and to know the efficiency of serological tests in detecting syphilis among HIV patients.

Materials and Methods:
The present study was a hospital-based cross-sectional study conducted among 500 HIV-reactive patients, including 100 HIV-reactive pregnant women attending the Outpatient Department of Dermatology, Venereology and Leprosy in a tertiary care center were enrolled in the study and were tested for the presence of syphilis using rapid plasma reagin (RPR) and T. pallidum hemagglutination assay (TPHA).

Results:
Among 500 samples, 58 (11.65%) were positive for syphilis. The most common age group was 30–39 years. Both RPR and TPHA were reactive in 25% of cases, TPHA reactive in 60.2% of cases, and only RPR reactive in 14.7% of cases. Seropositivity among pregnant women was 7%. The sensitivity and specificity of RPR test was 29.3% and 97.7%, respectively, in comparison with TPHA. Positive and negative predictive values of the same were found to be 62.9% and 91.3%, respectively, compared to TPHA.

Conclusion:
In all symptomatic and asymptomatic cases of syphilis, both RPR and TPHA should be performed for laboratory diagnosis of syphilis. It is advocated that all patients with newly diagnosed HIV should be suggested for syphilis serology and vice versa.
Determinants of out-of-pocket health care expenditures and financial coping strategies among beneficiaries of a state-run health insurance scheme in South India
Authors: John Anugraha , Avirneni Hari Teja , Swaminathan Sinthu Sarathamani , Abhina Sivakumar 
Published: May 2024

Background:
The household spending for health care in terms of out-of-pocket expenditures (OOPEs) in India remains one of the highest in the world at around 55% of current health expenditures and 48% of total health expenditures. Hence, it becomes extremely important to explore the determinants, i.e., the factors leading to OOPE.

Objectives:
To explore the determinants of OOPE and the financial strategies undertaken by the households to cope up with OOPE.

Methodology:
A longitudinal study was conducted among chronic kidney disease (CKD) patients who availed care at a Tamil Nadu Chief Ministers Comprehensive Health Insurance Scheme empanelled health care facility. They recorded their OOPE over a period of 6 months in the hand-book provided to them. An interview schedule was administered at the end of 6 months, to explore the determinants of OOPE and coping strategies.

Results:
Among the sociodemographic characteristics, age and gender had an impact on OOPE. Females had higher OOPE (INR 10,100) when compared to that of males (INR 9360) and with increased age of more than 60 years, there was a dip in OOPE (<60-INR 11,072; >60-INR 10,100). The duration of current treatment has been another important determinant, whereas borrowings were the most predominant financial strategy to cope up with OOPE.

Conclusion:
Despite having the health insurance coverage sponsored by government, CKD patients had OOPE pertaining to the various aspects such as age, gender, comorbidities, and number of members in the household utilizing the scheme and the coverage amount under the scheme.
Role of deferred retinal laser following intravitreal injection of bevacizumab in treatment of severe retinopathy of prematurity
Authors: Bhat Vishalakshi , Patil Shankargouda H. 
Published: May 2024

PURPOSE:
The purpose is to determine the advantages and role of supplemental deferred retinal laser treatment following intravitreal bevacizumab (IVB) monotherapy in cases of severe retinopathy of prematurity (ROP) requiring treatment.

MATERIALS AND METHODS:
This is a retrospective study involving preterm infants diagnosed with treatment requiring ROP, treated initially with bevacizumab monotherapy who subsequently received deferred laser treatment during the study period from April 2019 to March 2021. Deferred laser treatment was done when recurrence of ROP or plus disease was noted or nonprogression of retinal vasculature was noted on two consecutive examinations over 2 weeks. The main outcomes measured were the ability of the treatment to prevent ROP progression or recurrence and anatomic outcome at the last follow-up visit.

RESULTS:
Twenty-three eyes of 14 neonates were treated with a deferred laser treatment following the initial intravitreal injection of Bevacizumab. The mean postmenstrual age at which IVB was given was 34+6 ± 1+3 weeks. The mean duration between IVB and retinal laser was 5+3 ± 3+4 weeks. The mean weight at the time of injection was 1317.8 ± 231.8 g. The mean weight of the infants at the time of the laser was 2050 ± 813.9 g. None of the eyes developed recurrence or adverse anatomical outcomes following laser till the last available follow-up.

CONCLUSIONS:
In our small number of subjects, blinding complications of ROP were prevented by using a deferred laser treatment protocol following initial bevacizumab therapy in treatment requiring ROP. It is better suited in cases where compliance for long-term follow-up after bevacizumab therapy cannot be ensured.
Human immune deficiency virus conundrum
Authors: Kochar Anju , Farooq Shaheen 
Published: May 2024

BACKGROUND:
Human immune deficiency virus (HIV) causes a wide spectrum of diseases worldwide and has the capability to affect every organ system in the body. Ocular manifestations have been reported in up to 70% of individuals infected with HIV and the ocular manifestations reflect systemic disease and maybe the first sign of disseminated infection.

PURPOSE:
To study the pattern of ocular manifestations related to HIV in seropositive patients with the objective of identifying its spectrum in highly active antiretroviral therapy (HAART) era and to emphasize on the role of ophthalmologists in fighting the battle against HIV.

MATERIALS AND METHODS:
A cross sectional study was undertaken on 300 HIV positive patients. Data were collected, tabulated and analyzed using MSTAT software. Chi-square test was applied and P < 0.05 was considered significant.

RESULTS:
Ocular lesions were observed in 50.33% of patients. Conjunctival microvasculopathy being the most common finding seen in 27 (9%) patients, followed by retinal microvasculopathy and trichomegaly in 20 (6.66%) patients each. Herpes zoster ophthalmicus and cytomegalovirus retinitis were observed in four (1.33%) and three (1%) patients respectively. In the study 78.33% patients were on ART.

CONCLUSION:
HAART has reduced serious ocular opportunistic infections and ocular malignancies, but HAART mediated visually disabling immune recovery uveitis has emerged as a clinical challenge for ophthalmologists. Improved communication between the two broad specialties of HIV medicine and ophthalmology will definitely go a long way in the battle against this dreadful disease.
Maximal levator resection versus Gore-Tex® sling for congenital blepharoptosis with poor levator function
Authors: Dawood Ahmed Said , Hassan Omar Abdelghany , El Sayed Mohamed Othman 
Published: May 2024

BACKGROUND:
Treating congenital blepharoptosis is often mandatory to clear the visual access and avoid amblyopia; however, when the levator function is poor, achieving a satisfactory long-term outcome is challenging. This study aimed to compare the outcomes of maximal levator resection (MLR) with those of frontalis suspension (FS) using Gore-Tex ®, in the treatment of congenital blepharoptosis with poor levator function.

PATIENTS AND METHODS:
The study included 102 eyelids of 66 patients of mean age 4.3 ± 1.6 standard deviation (SD) years, randomly divided into two groups (51 eyes each). Group A: FS using Gore-Tex ®, Group B: MLR. Postoperative outcomes were evaluated at 1, 6 and 12 months. Patients' ophthalmic examination including margin-reflex distance (MRD1) before and after surgery and postoperative complications were recorded.

RESULTS:
At the end of the follow-up, the mean MRD1 increased from 0.3 ± 0.7 SD mm in Group A, 0.4 ± 0.8 SD mm in Group B preoperatively, to 2.7 ± 0.5 SD mm and 2.9 ± 0.7 SD mm, respectively (P < 0.001 in both groups). Results of Group B were significantly higher than Group A (P = 0.047). Success was achieved in 77 eyelids (75.4%), distributed as follows: 36 eyelids (70.6%) in Group A, and 41 eyelids (80.1%) in Group B. The total recurrence rate was 6.9% (seven eyes), while other complications were recorded in 23 eyes (22.5%).

CONCLUSION:
MLR, compared to FS with Gore-Tex® sling, can be a more efficient surgical option to correct congenital blepharoptosis with poor levator excursion. Prominent postoperative lagophthalmos warrants close ocular surface observation in early follow-up weeks.