bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Chronic Urinary Retention over Serum Prostate-Specific Antigen and Its Role in Histopathological Diagnosis
Authors: Verma Sahil , Sarpal Rajeev , Agarwal Shikhar , Kim Mammen Jacob 
Published: May 2024

Background:
Prostate-specific antigen (PSA) rises in all types of retentions and also in carcinoma prostate. The raised levels of PSA levels due to urinary retention may raise a false suspicion of carcinoma prostate in these patients. Unlike chronic urinary retention (CUR), the effect of acute urinary retention (AUR) on serum PSA levels had been studied in detail as evident from the past literature.

Objectives:
The objectives of the study were first to estimate and interpret serum PSA levels in adult males with CUR due to prostatic pathology, second to assess the need of taking prostatic biopsy based on the studied PSA trends, and finally to assess the prostatic histopathology in cases of persistently high PSA levels after 6 weeks.

Materials and Methods:
This was an observational follow-up study including 41 patients diagnosed with CUR due to prostatic etiology, matching the inclusion and exclusion criteria. On presentation, serum PSA levels were recorded. Retention was relieved by either per urethral catheterization or suprapubic catheterization. PSA levels were recorded after 24 hours, 1 week, 3 weeks, and 6 weeks and PSA trends were noted. Prostatic biopsy was advised for only those subjects in whom PSA did not attain the baseline value of 4 ng/mL within 6 weeks. The histopathological report of the biopsy was followed in each patient for studying its association with PSA trends.

Results:
Mean PSA at the time of presentation was 17.92 ng/mL. PSA trends showed that in the majority of the patients “Suspected benign group” (80.49%, n = 33), PSA returned to <4 ng/mL within 6 weeks of catheterization. Six patients, the “Borderline group” (14.63%), showed a downtrend in their PSA trends but could not attain baseline value. PSA trends in only two patients, the “Suspected malignant group” (4.87%), showed a comparative constant or an uptrend. All patients in the “Suspected benign group” and a majority of the “Borderline group” patients (83.33%) had a histopathologically confirmed benign prostatic pathology. Out of the two highly suspected malignant cases, only one patient (50%) had carcinoma prostate on final histopathology.

Conclusion:
PSA rises mainly in carcinoma prostate, but it falsely rises in all urinary retentions. The relationship between AUR and PSA had been studied in detail as evident from the past literature but needs to be established in patients with CUR. A period of 4 to 6 weeks can be safely employed for waiting for PSA to fall back to normal in CUR. A biopsy is required only for patients in which PSA is constantly high to rule out carcinoma prostate.
Anesthesia Concerns and Management in Case of Severe Hemophilia A
Authors: Jamgade Deepali , Kantha Manasa , Agrawal Sanjay , Chattopadhyay Debarati , Nath Uttam K. 
Published: May 2024

Abstract
Hemophilia is a genetic disease presenting with increased chances of perioperative bleeding. Preoperative recognition, assessment of risk, and careful titration of factor VIII transfusion are important for anesthesia management and decrease of morbidity. Here we present a case of severe hemophilia with an open wound of the knee scheduled for flap rotation and cover.
Use of Students’ Learning Outcomes as a Tool for Changing Teaching Content and Methodology
Authors: Naeem Syed Shariq , Roy Vandana 
Published: May 2024

Objectives:
Assessment of student's learning outcomes in alignment with the teaching goals can be a tool for modification of curriculum and teaching methods. This study was conducted to evaluate the impact of a pharmacology curriculum on students’ learning outcomes and the use of their assessment as a tool for making curriculum changes.

Materials and methods:
An assessment of the students’ (exiting 2014) knowledge and skills at the end of their fifth semester training in pharmacology was carried out using a questionnaire that was developed to accommodate testing of all areas which are underlined in the Medical Council of India's goals and objectives of teaching pharmacology to MBBS undergraduates at the time of designing of the study. Areas where lesser than 50% students scored well were identified for educational interventions with the next two batches of students (2015, batch B and 2016, batch C), who were then subjected to the same assessment.

Results:
Based on the learning outcomes, 15 areas were identified for educational interventions with batch 2015. Improvement in learning outcomes of students was observed in 10, ranging from 10% to 15% in batch 2015, whereas in batch 2016, an improvement of 20% was observed in three questions and >10% was observed in six questions. Overall improvement in the intervention questions was 60% (+9 questions) in batch 2015 and 80% (+12 questions) in batch 2016 when compared with preintervention batch 2014. The preintervention batch 2014 scored better overall than the intervention batches 2015 and 2016.

Conclusions:
Changing teaching content and method, based on assessment of students’ learning outcomes alone, may not translate into an improvement in students’ learning outcomes. Teachers must look for other factors that can impact students’ learning.
Perspective of Medical and Dental Students and Teachers Toward Online Teaching in Pharmacology During Covid-19 Pandemic
Authors: Kumar Sahil , Tayal Vandana , Akhtar Razi , Chawla Shalini , Roy Vandana 
Published: May 2024

Introduction:
In the light of the disruption caused by the coronavirus pandemic on medical education systems worldwide, several institutions switched to online mode of teaching-learning. Therefore, this study was planned to evaluate the perception, difficulties faced, and preference of second year medical/dental students and their teachers toward the online learning and live-streamed lectures during the COVID-19 pandemic.

Methods:
This was a cross-sectional, questionnaire based observational study. Data were collected by administering pretested, self-administered, online circulated, structured questionnaire via Google Forms. Descriptive statistics were used to summarize the study results.

Results:
In this study, 198 and 77 responses were obtained from MBBS and BDS students, respectively, and 14 responses from their teachers. Most students agreed that it was a good idea to conduct online teaching during lockdown. Majority of the students were able to adapt even without previous experience. “GoToWebinar” and “Cisco Webex” were reported as good online teaching platforms. Smart phones or tablets were most commonly used to attend classes. Major challenges reported were related to lack of skills, interest, attention, time management, resources (including internet connectivity), and poor communication among others. The students felt that the optimum duration of lectures should be 30 to 45 minutes. Majority of students and teachers alike felt that online teaching is a good option to be adopted for repeat classes or to gain extra knowledge in the future. Overall rating of online teaching (out of 10) was reported as good by both students (MBBS students mean score: 7.49 ± 1.57) and teachers (mean score: 7 ± 1.58).

Conclusions:
The situation arising out of the pandemic gave rise to a situation where online resources had to be used for teaching. The shift of medical education to online platforms presented a spectrum of issues for educators and students alike. It would be worth considering addressing these issues, so as to strengthen electronic learning processes in the institute.
Perception of Medical Faculty and Students About Online Teaching During the Covid-19 Pandemic in a Tertiary Care Teaching Institute
Authors: Maheshwari Nidhi , Kalra Bhupinder Singh , Roy Vandana 
Published: May 2024

Background:
Classroom teaching has been found to be the most common modality used for teaching. The unusual situation of the coronavirus disease 2019 (COVID-19) pandemic led to the shutdown of all educational institutions across the country. To limit the spread of the coronavirus, classroom teaching had to be abandoned and online teaching was sought for to continue the learning process. The study was conducted with the aim of assessing the perception of faculty as well as undergraduate medical students toward online teaching and learning methodology.

Methods:
A cross-sectional observational study using two separate pretested, structured questionnaires for faculty and students was conducted. The questionnaire had a total of 45 questions for collecting data on demographic information, awareness, perception and knowledge toward online teaching, perception about establishing connect between teachers and students through online portal, and operational and technical aspects. These questionnaires were mailed to faculty and students using Google forms (Google Survey platform).

Results:
A total of 47 teaching faculty and 386 students responded to the questionnaires. More than 70% faculty availed the training and guidance provided for online teaching. The move to switch over to online mode of teaching during lockdown was appreciated by majority (95%) of respondents. The faculty members made use of online polls, surveys, and educational videos for making online lectures interesting. In addition, online assessments (72%) and use of an interactive software (70%) were found worthy and useful. Majority of (80%) students missed direct and in person contact with instructor. Majority of the students (60%) felt isolated and alone during online teaching sessions. One-third of the students believed that instructors were able to generate interest in the topic and 63% of students were satisfied with the explanations delivered with regard to queries during online lectures. The major disadvantages that surfaced were limited options for two-way communication (55%), technical glitches (70%), social isolation (63%), eye strain, and other health-related issues (62%). Internet connectivity emerged as the biggest limitation by faculty members.

Conclusion:
Overall, the respondents were of the opinion that online teaching was a useful modality during COVID-19 and can be used as a complementary aid to regular teaching in. Adequate infrastructure and uninterrupted internet connectivity is vital for smooth conduct of online teaching.
False Positive Reaction to Vdrl Test with Prozone Phenomenon in a Case of Lepromatous Leprosy
Authors: Chawla Rohit , Thakur Preeti , Mohan Kochhar Atul , Singla Sumeet 
Published: May 2024

Abstract
The venereal disease research laboratory (VDRL) test, a nontreponemal test for syphilis, may under a certain set of conditions give false positive results in patients who are not infected with Treponema pallidum. A false positive reaction is defined as a positive reaction to nontreponemal tests, and a negative reaction to treponemal tests, in the serum of a patient who has no history or clinical evidence of syphilis or other treponematosis. A prozone phenomenon in nontreponemal tests is seen largely with secondary syphilis due to high-titer samples that show nonreactive results unless the specimens are diluted. We report here perhaps the first case of lepromatous leprosy, which had a false positive reaction to the VDRL test with the prozone phenomenon. The case initially presented to the outpatient clinic with complaints of epistaxis with nasal stuffiness. The finding of septal perforation on nasal endoscopy is what led to the initial suspicion of syphilis and the subsequent syphilis workup. It was only when the false positive reaction to VDRL test with the prozone phenomenon was noted that the search for other causes was made, which eventually lead to the diagnosis of lepromatous leprosy.
Quality of Life of Health Care Professionals During Covid-19 Pandemic in India
Authors: Kaur Banipreet , Aggarwal Yash , Bhatnagar Nidhi , Singla Sumeet 
Published: May 2024

Introduction:
Nature of disease, poor working conditions, prolonged work duration, stigma, and discrimination in the community have worsened the well-being of health care professionals in COVID-19. This survey is conducted to understand the quality of life and its key determinants among health care workers (HCWs) during the COVID-19 pandemic in a low middle-income country like India.

Methodology:
A cross-sectional study using a Google form-based online questionnaire survey was planned at two COVID dedicated centers of New Delhi. A convenience sample of 300 HCWs involved in patient care at the study sites was studied using an SF-36 questionnaire for quality of life assessment and a self-made questionnaire (risk exposure assessment).

Results:
In the study, 61.0% were males and 40.72% were females across all specialties. The majority (77%) were single and 81.4% were from the age group of 20 to 30 years. 84% of the study subjects belonged to clinical specialties. Nearly 56% of study subjects reported being not satisfactory or uncomfortable in the personal protective equipment (PPE). Shortage of PPE was reported by 10% of study subjects. The majority (82.35%) of study subjects were satisfied with the quality of PPE. Satisfaction of the study subjects was less than satisfactory among food provided, accommodation, and transport facilities. Social isolation (70.5%) and lockdown restraints (57.6%) were reported by the majority of study subjects. The median score for the domain of general vitality was 55, for the emotional domain was 33, and for social was 62. The domains of quality of life were not significantly affected by place of work, discipline, age, sex, and type of work.

Conclusion:
The overall well-being of HCWs was affected during the pandemic mostly across mental, social, and general vitality domains. Social isolation was a key concern reported by the majority of HCWs.
Should planning of cervical pedicle screws be race specific? Computed tomography–based morphometric analysis
Authors: Agarwal Ashish , Agarwal Anant , Kumar Ashutosh 
Published: May 2024

Introduction:
The neurovascular surgical structures are protected by quantitative understanding of cervical pedicle morphology and aiding in better surgical outcome. Aim of the study is to do morphometric analysis of subaxial cervical pedicle by noncomputerized computed tomography (CT) scans.

Materials and Methods:
From 50 volunteers, a total of 500 cervical pedicles were evaluated using axial and sagittal CT scan. Five parameters such as outer pedicle width (OPW), inner pedicle width (IPW), pedicle height (PH), pedicle transverse angle (PTA) and pedicle axis length (PAL) were analyzed.

Result:
OPW, IPW, PH, and PAL show increase in values from C3 to C7, while PTA shows a decrease in value from C3 to C7.

Conclusion:
The cervical pedicle dimension of our study population was smaller than other studies carried out on Asian and European population. Hence, the planning for pedicle screw fixation should be race specific.
Translational Research in Health Care
Authors: Singaram Muthu , Muraleedhran VR , Sivaprakasam Mohanasankar 
Published: May 2024

Background and Objective:
The translational research objective is to produce meaningful and applicable results that directly benefit the community. The objective of translational research is to move from traditional research discoveries rapidly and efficiently into practice. Translational research encourages and promotes multidisciplinary collaboration among clinicians, researchers, industry, policy makers, and other related stakeholders. It further incorporates the needs of the general public with communities being engaged to determine their requirements for health invention. It identifies and supports medical and health practices. Translational research is frequently classified by which stage of restatement (from beginning exploration to societal operation and impact) it falls into. Translational research is the process of turning compliances in the laboratory, clinic, and community into interventions that apply to the health of individualities, public from diagnostics, and to medical procedures as well as behavioral changes.

Methods:
This study adopted a qualitative research methodology based on Hill et al. consensual qualitative research (CQR) to build multiple case studies to acquire the information. We ion.opted to apply a modified method of CQR[9] based on multiple case studies. This is an emerging methodological approach in research.

Results:
Based on the 24 semi-structured interviews, these interviews were directly with researchers who carry out the research. Twenty-four voluntary researchers participated in the research and these semi-structured interviews were made into 24 case studies to be analyzed. Each case study was built based on the questions on methods of research. These were used to identify and build the tools for practicing translational research.

Conclusion:
There is a huge untapped potential for India in the area of translational research.
Comparison of Efficacy of Erector Spinae Plane Block with Paravertebral Block for Postoperative Analgesia in Patients Undergoing Breast Cancer Surgery
Authors: Singh Arjun , Agrawal Nidhi , Baruah Udismita , Sandill Surabhi 
Published: May 2024

Background:
Patients undergoing modified radical mastectomy (MRM) experience acute pain. Inadequate acute postoperative pain control may lead to anxiety, hemodynamic imbalance and development of chronic pain syndrome. Hence analgesia is extremely important for favourable outcome. This study was undertaken to compare the efficacy of ultrasound guided thoracic paravertebral block (TPVB) versus ultrasound guided thoracic erector spinae plane block (ESPB) with clonidine as an adjuvant to local anaesthetic for post-operative analgesia in modified radical mastectomy.

Method:
This prospective randomized interventional comparative trial, involving 60 patients were undergoing modified radical mastectomy for breast cancer surgery, was conducted in a tertiary care teaching hospital over 18 months. Sixty patients undergoing MRM for breast cancer under general anaesthesia were enrolled. The patients were randomly allocated into one of the two groups. Group E received ultrasound guided erector spinae block and Group P received Paravertebral block at the level of 4th thoracic vertebra (T4). Both the groups were given 21 mL of 0.5% ropivacaine and 1 μg/kg of clonidine diluted in 1 mL of saline (making total volume of up to 22 mL). Primary outcome measure was to compare duration of analgesia, that is from the time of block administration till the time to first rescue analgesia demanded by the patients. Secondary outcome measures were mean visual analogue scale (VAS) score at rest as well as during abduction of ipsilateral arm at various time points, total intraoperative fentanyl and tramadol requirement up to 24 hours postoperatively; postoperative nausea and vomiting; patients satisfaction at the end of 24 hours postoperatively.

Statistical method used:
Quantitative variables were compared using Independent t-test/Mann-Whitney Test (when the data sets were not normally distributed). Qualitative variables were compared using Chi-Square test /Fisher’s exact test. A p value of <0.05 was considered statistically significant.

Results:
Duration of analgesi, that is, time of first rescue analgesia from the administration of the block was comparable between the two study groups. The mean (SD) duration of analgesia in group E was 22.78 (3.31) hours and in group P was 22.88 (3.34) hours (P = 0.914). Both the groups were comparable in terms of fentanyl requirement and total 24 hours tramadol requirement Other parameters like postoperative nausea vomiting, effect on hemodynamic and overall patient satisfaction were also comparable between the two groups.

Conclusions:
Both ultrasound guided ESPB and TPVB are equally efficacious in providing postoperative analgesia in patients undergoing modified radical mastectomy.
Assessment of Periodontal Status in the Patients with Chronic Obstructive Pulmonary Disease (COPD)
Authors: Shree Shanta , Khan Rehbar , Pathak Vivek , Pandey Anuj Kumar , Verma Ajay Kumar , Singh Devendra Kumar 
Published: May 2024

Background:
Oral infections, especially periodontal diseases, may affect the course and pathogenesis of a number of systemic diseases including respiratory diseases. The current study aimed to determine the periodontal status in the patients with chronic obstructive pulmonary disease (COPD).

Materials and Methods:
The study consisted of 65 COPD patients (case) and 65 healthy individuals (non-COPD). Individuals in the case group were well-functioning, ambulatory patients having COPD as determined by their history, clinical examination, and spirometry. Periodontal status was evaluated by the indices, namely, simplified oral hygiene index (OHI-S), plaque index (PI), gingival index (GI), pocket probing depth (PPD), and clinical attachment level (CAL) in both the groups.

Results:
In the studied population, the mean (± standard deviation, SD) age was higher in COPD group (50.3 ± 11.4) compared to the control group (41.9±8.1; P < 0.0001). In the COPD group, average smoking index was 369.3 ± 167.2, while in control group, it was 323.88 ± 132.8 (P = 0.889). Our data show that individuals in the COPD group had significantly higher OHI-S, PI, GI, PPD, and CAL (P < 0.0001) compared with the control group. The mean score of OHI-S, PI, GI, PPD, and CAL was higher in moderate and severe COPD patients compared to mild COPD patients; however, this difference was not statistically significant.

Conclusion:
The patients with COPD showed poor oral hygiene and a higher prevalence of periodontal disease. Prevention and treatment of periodontal disease could be included in the planned intervention campaigns designed to help patients with COPD.
The clinical, sociodemographic, and pharmacotherapeutic characteristics influencing quality of life in patients with epilepsy
Authors: Qanoongo Faheem Nazir , Faheem Mehreen , Raina Adnan Firdous , Shah Parvaiz 
Published: May 2024

Background:
It is becoming widely understood that evaluating a patient’s quality of life (QOL) is crucial to managing their epilepsy. The study aimed to explore the impact of sociodemographic, clinical, and pharmacotherapy factors on QOL in patients with epilepsy.

Methods:
This was a cross-sectional study conducted over 2 years at the outpatient and inpatient Department of Medicine (Neurology Division) of SMHS Hospital, affiliated with Government Medical College, Srinagar. The patients with epilepsy with a definite diagnosis of epilepsy as per the International League Against Epilepsy (ILAE) guidelines were included.

Results:
Patients on polytherapy had significantly lower scores for overall QOL, energy/fatigue, medication effects, social functioning, and overall score. Patients on monotherapy scored significantly lower for the said domains, including the seizure worry domain, compared to those patients with epilepsy who were antiepileptic drugs (AEDs) naive.

Conclusion:
Individuals who were receiving monotherapy had greater QOL scores than those who were receiving traditional AEDs and had focal epilepsy. Furthermore, in patient with epilepsy, all QOL domains were significantly predicted by increased seizure frequency and the presence of adverse drug reactions (ADRs).