bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of intrathecal and intravenous dexamethasone on complications associated with intrathecal morphine after cesarean section
Authors: Kiasari Alieh Zamani , Aghaei Nahid , Aezzi Goli , Alipour Abbas , Ghavibonyeh Khadijeh 
Published: February 2024

BACKGROUND:Pain and nausea and vomiting are of serious complications following the use of opiates after surgery, especially cesarean section. Control of postoperative complications is one of the necessities of quality promotion of health-care system. Medications with few side effects such as corticosteroids including dexamethasone can be an appropriate option. In addition, the route of administration can have a significant effect on the effectiveness of the drug. The aim of the present study was to compare the effects of intrathecal with intravenous dexamethasone in reducing the complications associated with intrathecal morphine after cesarean section.MATERIALS AND METHODS:The study was a double-blind randomized controlled clinical trial and determined the effect of intrathecal and intravenous dexamethasone on the incidence and severity of complications of intrathecal morphine after cesarean section on 120 patients and its relationship with serious complications after surgery. Descriptive and analytical statistics were used to examine the characteristics of the case and control groups, and STATA SPSS software was used to compare the two groups.RESULTS:There was no significant association between the two groups in terms of baseline characteristics. Pain score in the intrathecal injection group was lower than the intravenous injection group, with a statistically significant difference (P= 0.02). In addition, there was a significant association regarding to the incidence of nausea, vomiting, and itching between intrathecal and intravenous injection groups (P= 0.008).CONCLUSION:Dexamethasone was effective to reduce opiate complications after cesarean section. Establishing a suitable association between dexamethasone half-life, efficacy, type of use, and time of use can result the best outcomes and promote patients' satisfaction in cesarean section.
Physical Fitness in Children with Thalassemia Major Measured With 6-min Walk Test
Authors: Karthiga T. , Imtiaz G. Yasmeen , Hariharan S. 
Published: February 2024

Background:
Thalassemia major is a common type of genetic disorder found in improvement in the medical field, the life expectancy of these children was also increased so there arises a need to promote the quality of life of such patients. A lot of studies concentrate on various aspects of the life of thalassemia major, but no study was done to assess the physical fitness of such children which is quite important to regularize their exercise sessions.

Objectives:
The objective of this study was to find out the physical fitness of children with thalassemia patients.

Materials and Methods:
Nonexperimental study designed with 20 individuals diagnosed with thalassemia in major age groups between 7 and 18 both boys and girls. The outcome measure used in this study was 6-min walk test (6 MWT).

Results:
The mean distance covered in 6 min was 351.3 m on average. There was increase in heart rate and blood pressure after completion of the test, whereas oxygen saturation was found to drop post-6 MWT among these patients.

Conclusion:
Thalassemia major patients are found with this physical fitness when assessed with 6 MWT.
Enhancing healthcare access and malaria management via mobile clinics and phone call services in Nuh district of Haryana, India
Authors: Rahi Manju , Nazmeen Aarifa , Kumar Sanjeev , Yadav Chander Prakash , Kumar Gaurav , Mittal Peeyush , Joy Sam , Sharma Sachin , Baharia Rajendra Kumar , Bhati Gaurav , Goel Pawan , Sharma Amit 
Published: February 2024

Background & objectives:
Malaria remains a complex challenge in India due to its diverse epidemiology, multi-ethnic population, and multiplicity of malaria vectors. While progress has been made in reducing malaria nationally, persistent pockets hinder elimination efforts. These challenges include hidden reservoirs, inadequate healthcare, suboptimal surveillance, non-compliance, and subclinical infections. Shortage of grassroot level and primary care health staff, transportation issues and general inaccessibility and unavailability of healthcare services are additional challenges.

Methods:
Mobile healthcare vans have been tried and found useful in enhancing healthcare availability in several health conditions in different settings. Nuh district in Haryana, India is a malaria endemic region; it is indeed one of the districts included by India’s NITI Aayog in the Aspirational Districts Programme, a government initiative that focuses on rapidly transforming and developing the most underdeveloped districts in country. With an aim to improve the healthcare seeking behavior of malaria-endemic community of selected villages of Nuh district, we carried out a study using interventions in two villages of the district, that had mobile malaria clinics and toll-free telephone services in enhancing healthcare access.

Results:
We found that Sangel village had higher literacy rates (60.6%) as compared to 39.4% in Naushera. Similarly, the unemployment rate was higher for Naushera. It the mobile malaria clinic was deployed from December 2019 to July 2020 and a total of 269 phone calls were received from both the villages. A similar number of rapid tests and microscopy smears were examined and all were negative for malaria. The febrile patients were referred to the nearest healthcare facility.

Interpretation & conclusion:
The study shows that the community is open to using these healthcare interventions. These initiatives of mobile malaria clinics and toll-free telephone services can bridge healthcare gaps, especially in malaria-endemic regions, aligning with India’s malaria elimination and equitable healthcare access goals.
Study of Various Modalities of Management of Lower One-third Leg Defects in a Tertiary Care Hospital
Authors: Gantayat Rajesh , Routray Satyabrata 
Published: February 2024

Background:
Lower extremity reconstruction is essential to plastic surgery and focuses on treating wounds and defects secondary to trauma, cancer, or chronic disease processes. Anatomical features of the lower third of the leg like subcutaneous bone surrounded by tendons with no muscles and vessels in isolated compartments with little intercommunication between them make the coverage of the wounds in the region a challenging problem.

Aim:
to study the various modalities of surgical management of lower 1/3rd leg defects. The study also aims to study the defect size and region in planning various flaps possible in the reconstruction ladder.

Methods:
The study was conducted from September 2014 to June 2017 on patients admitted to the Department of Burns, Plastic & Reconstructive Surgery and referred patients from the Department of General Surgery & Orthopaedic Surgery, S C B Medical College & Hospital, Cuttack. The Study includes all lower 3rd Leg defect varieties for different surgical treatment modalities.

Results:
Various reconstructive methods were used to cover the lower 1/3rdleg defects; the maximum was the free muscle transfer in 9 cases. The following typical flap used was the reverse sural flap.

Conclusion:
The goal in lower limb reconstruction involves needing a stable skeleton, allowing weight-bearing status, with adequate soft tissue coverage to nourish and protect the underlying bone. What one would use for reconstruction depends upon the surgeon’s familiarity and comfort levels with the technique as much as the various circumstances.
Low Platelet Count Analysis as a Prognostic Indicator in Pregnancy-induced Hypertension
Authors: Ashraf Nazima , Khanyari Insha Jan , Saldanha Cimona Lyn , Geelani Sajad , Parvez Tabassum , Shera Faiz Altaf 
Published: February 2024

Introduction:
Hypertension is one of the serious complications of pregnancy which virtually affects all maternal organs such as the liver, kidney, brain, and placenta. Changes in the hemostatic system are observed in normal and hypertensive patients. The frequency and intensity of maternal thrombocytopenia vary and are dependent on the intensity of the disease process and duration of pregnancy-induced hypertension (PIH) syndrome. In general, the lower the platelet counts, the higher the maternal and fetal morbidity and mortality.

Aims and Objectives:
The aims and objectives of the study were to study the platelet counts in cases of PIH, compare the values with normotensive pregnant participants, and study the association between thrombocytopenia and fetomaternal outcome.

Materials and Methods:
A total of 226 patients were included in the study and were evaluated for their platelet count and fetomaternal outcome. The patients were divided into two groups, with each group comprising 113 patients, namely, Group I which included controls and Group II which included patients with PIH (subgroups: gestational hypertension, preeclampsia, and eclampsia). Platelet counts in all groups were charted, compared, and correlated with various maternal parameters such as age, gravidity, severity of hypertension, gestational age of termination, maternal complications, and hospital stay. Fetal parameters studied were intrauterine growth restriction, stillbirth, neonatal intensive care unit care, and intrauterine fetal demise.

Results:
Our study found that the mean platelet count decreases with the severity of gestational hypertension. Thus, the highest platelet count was seen in the control group (D), i.e., 1.67 lakh/mm3 and the lowest platelet count was seen in the eclamptic group, (C) i.e., 0.75 lakh/mm3. Pregnancies complicated by thrombocytopenia were terminated at an earlier gestation (35–37 weeks). Maternal complications such as postpartum hemorrhage (56.5%) and stitch line ooze (27.5%) were found to occur more in the thrombocytopenic group. The association between birth weight and thrombocytopenia was statistically significant in our study.

Conclusion:
Thrombocytopenia associated with PIH is a reliable prognostic indicator for the severity of hypertension as well as the associated maternal and fetal morbidity.
Comparison of a single-dose vectored thermal pulsation procedure with 5-day course of daily oral azithromycin for meibomian gland dysfunction
Authors: Kodavoor Shreesha Kumar , Jayashri M. , Patekar Komal Bhimrao , Ramamurthy Shreyas , Sachdev Gitansha 
Published: February 2024

AbstractPURPOSE:This study aims at comparing the efficacy of a single-dose vectored thermal pulsation (VTP) procedure versus 5 days once daily oral azithromycin in patients with meibomian gland disease (MGD) by measuring the symptomatology and ocular surface parameters.MATERIALS AND METHODS:The study was conducted as a prospective, nonrandomized, comparative study over a period of 17 months at a tertiary care center. In this study, 60 patients with MGD were enrolled after they gave their informed consent according to the inclusion–exclusion criteria and were divided into two groups, 30 each in the azithromycin group and the VTP, i.e., the LipiFlow group. One group was treated with oral azithromycin for 5 days and the other group was given LipiFlow treatment. Postprocedure, follow-up was done for 2 weeks, 3 months, and 6 months.RESULTS:A statistically significant difference was noted in the score Standard Patient Evaluation of Eye Dryness questionnaire after 3 months of treatment in both the azithromycin and LipiFlow group (P< 0.0001), and the LipiFlow group showed sustained improvement at 6-month follow-up as score improved to 8.83 ± 2.32, whereas it deteriorated in azithromycin group to 13.77 ± 1.65. Pretreatment Ocular Surface Disease Index score (P= 0.126) and posttreatment (P< 0.0001) showed significant differences in both groups. The LipiFlow group showed an improved score of 25.65 ± 6.11 after 6 months of treatment, whereas it deteriorated to 34.79 ± 4.98 in the azithromycin group. Pretreatment, tear film break-up time (P= 0.28) and 6 months posttreatment score (P< 0.0001) showed significant differences in both groups, but in the LipiFlow group, it improved to 15.30 ± 1.76 after 6 months, whereas in the azithromycin group, it was 10.07 ± 1.60. The pretreatment MG score was 4.10 ± 0.99 and 4.23 ± 1.07 (P= 0.62) in the azithromycin and LipiFlow group, respectively. After 2 weeks, 3 months, and 6 months, the MG score was 24.20 ± 3.38, 21.67 ± 3.46, and 15.83 ± 2.41, respectively, in azithromycin group. In the LipiFlow group, the score was 13 ± 1.88, 14.27 ± 2.07, and 14.37 ± 1.85 at 2 weeks, 3 months, and 6 months, respectively, suggestive of improvement in all visits.CONCLUSION:Both oral azithromycin and LipiFlow treatment are effective in patients with MGD. The effect of LipiFlow treatment lasted longer as compared to azithromycin. The efficacy of azithromycin in resolving the symptoms of MGD was greater compared to LipiFlow in the initial 2 weeks of treatment. However, the effect deteriorated in the subsequent follow-up at 3 months and 6 months.
Knowledge, attitude, and practice about red eye among the general population visiting a tertiary care hospital in rural setting, Tamil Nadu, India
Authors: Arunachalam Muthusundari , Devadas Bravian Samvict , Saravanakumar P. , Premnath Gnaneswaran , Bravian Shinisha Paul 
Published: February 2024

Abstract

BACKGROUND:
Red eye is a common symptom in patients visiting the ophthalmology outpatient department (OPD). However, not all with red eye are due to infection and some can be threatening to visual loss. This study aimed to explore the knowledge, attitude, and practice (KAP) among the general public regarding red eye attending a tertiary care hospital, Tamil Nadu.

METHODS:
A cross-sectional study was conducted after approval by the institutional ethics review board among 500 patients >18 years attending general OPD excluding ophthalmology in tertiary hospital and research institute, Tamil Nadu, from January 2022 to April 2022. After informed consent, a semi-structured questionnaire with details of KAP on red eye was used and analyzed with descriptive statistics and Chi-square test using SPSS version 16.

RESULTS:
Among the 500 participants, one-third were >60 years, 58%-females. Only 15.6% had awareness on red eye, 12.6% were aware of serious side effects while <10% knew the complication of red eye such as visual loss can follow if left untreated. Among those aware, 63% reported infection as the most common cause, followed by injury and allergy. Source of awareness was from past experience in the majority of the patients, followed by mass media and doctors. Only 12.4% had a positive attitude while 14.2% had good practice of seeking medical attention. Harmful practices such as instilling breast milk and instilling over-counter drops were highly prevalent. The major determinants of awareness were younger age, literacy, and health education given by health personnel (P < 0.05).

CONCLUSION:
Awareness about red eye, attitude, and practice among the general population in rural settings in Tamil Nadu are still poor. The need of the hour is for health education on red eye and management to prevent morbidity and loss of vision in the community at all levels of health care.
Manifestations of coronavirus infection disease-19 in anterior eye segment: An up-to-date review
Authors: Marzoog Basheer Abdullah 
Published: February 2024

AbstractCoronavirus infection disease-19 (COVID-19) is a worldwide catastrophic emergency that first appeared in late 2019, in Wuhan, China. COVID-19 is a multitropism disease that first affects lung tissue. However, extrapulmonary manifestations have been suspected from the first COVID-19 cases. The ocular signs and symptoms were from the early changes that occur during the course of the disease. Changes in the anterior eye segment have a relatively higher incidence than the posterior eye segment. Of which, conjunctivitis, COVID-19 pharyngioceratoconjuctivitis, iridocyclitis, corneal punctate epitheliopathy, and pathomorphological changes in the physio-anatomy of the anterior eye segment. The potential pathogenesis includes direct penetration of the virus into the eye (conjunctiva, lumbus, and cornea) or due to a systemic pathway through viremia, as well as due to autoimmune antibodies against the ocular structure (immune privilege). The presence of ocular manifestations of the external anterior fibrous layer suggests a mild course of the disease.
Pseudophakic reverse pupillary block after implantation of a single-piece foldable intraocular lens in the capsular bag: Case report and literature review
Authors: Abushanab Mokhtar Mohamed , Solyman Omar , Sakr Ahmed Abd El Samee , Serhan Hashem Abu 
Published: February 2024

Abstract
Reverse pupillary block with intraocular pressure (IOP) elevation after cataract surgery with in-the-bag implantation of intraocular lens (IOL) is considered a very rare complication. We report the case of a 47-year-old female patient with bilateral high axial myopia and posterior staphyloma presented with left acute loss of vision and eye pain, headache, and vomiting 2 weeks after uneventful presenile cataract surgery with single-piece IOL implantation in the capsular bag 1 month and 2 weeks in the right and left eyes, respectively. Gonioscopy showed extremely wide angle in all quadrants compared to the other eye with Spaeth classification of E 60c + 2 (14). Ultrasound biomicroscopy of the left eye showed epithelial corneal edema, 4.56 mm-deep anterior chamber, abnormal iris configuration with posterior concavity, and angle opening ranging between 60° and 74°, with unremarkable posterior chamber IOL and ciliary body. We managed the patient with topical antiglaucoma medications and laser peripheral iridotomy. IOP returned to normal levels. The patient was followed for 12 consecutive months. Elevated IOP from the reverse pupillary block is a rare postoperative complication of cataract surgery. It was initially described in association with the ciliary sulcus implanted IOL. Elevated IOP from the reverse pupillary block was then reported associated with scleral sutured IOLs and Yamane technique, and most recently with in-the-bag implanted 3-piece-IOL. Herein, we report the first case of pseudophakic reverse pupillary block in association with in-the-bag implanted single-piece foldable acrylic IOL.
Quality of life improvement in dry eye patients after intense pulsed light therapy compared to punctal plugs
Authors: Elbakary Molham A. , Shalaby Osama E. , Allam Waleed A. , Alagorie Ahmed R. , Shafik Heba M. 
Published: February 2024

Abstract

PURPOSE:
The purpose of the study was to evaluate the quality of life (QOL) improvement in evaporative dry eye patients after treatment with intense pulsed light (IPL) therapy compared to punctal plug insertion.

METHODS:
A prospective comparative interventional study included 30 patients with moderate-to-severe evaporative dry eye. Patients’ QOL affection before and after treatment was assessed by the Ocular Surface Disease Index (OSDI) questionnaire. Fifteen patients were treated with IPL therapy (Group 1). The other 15 patients were treated with silicone punctal plug insertion (Group 2).

RESULTS:
Improvement of patients’ QOL was noticed in all patients of Group 1, with significant improvement of OSDI score from a mean value of 56.9 to 22.9 (P = 0.001). Improvement was noticed in 80% of Group 2 patients (mean OSDI score pretreatment: 53.8 and posttreatment: 31.7, P = 0.017). The tear breakup time (TBUT) in Group 1 significantly improved from a mean of 3.2 s to 5.9 s (P = 0.001), whereas it showed no significant changes in Group 2 (mean TBUT pretreatment: 3.6 s and posttreatment: 3.9 s, P = 0.654). Complications occurred in 13.3% in Group 2, including punctal granuloma and proximal canalicular obstruction. No adverse effects were recorded in Group 1.

CONCLUSION:
IPL therapy had better results with more improvement of patients’ QOL compared to punctal plugs. It also showed a better safety profile with no reported complications.
Nummular keratitis: A rare manifestation of brimonidine allergy
Authors: Al Asmi Maitha , Al Busaidi Aisha 
Published: February 2024

Abstract
A 32-year-old male, with juvenile open-angle glaucoma on chronic antiglaucoma therapy and recently introduced brimonidine eye drops to the treatment regimen, developed bilateral follicular conjunctivitis with subepithelial infiltrates (SEIs) initially resembling common infectious keratoconjunctivitis entities. The persistent nature of the conjunctivitis, the lack of positive conjunctival cultures, the absence of systemic symptoms, the full resolution of the condition upon discontinuation of antiglaucoma drops, and the commencement of topical steroids, along with the reappearance of SEIs upon reintroducing brimonidine; suggested an immune-mediated drug reaction secondary to a Benzalkonium chloride (BAK) preserved brimonidine tartrate 0.2% formulation. The interval between the initiation of brimonidine and the onset of the drug reaction was 13 months and shortened to 1 week upon re-exposure to the drug. The condition fully resolved without further sequelae off brimonidine. Brimonidine is notoriously known for causing ocular allergic reactions, the most common being follicular conjunctivitis, but very few reports exist describing its adverse effects on the cornea. This case highlights that brimonidine may directly or indirectly induce an immune reaction affecting the cornea in the form of SEIs. Brimonidine is, thus, capable of mimicking more commonly recognized infectious disease entities causing keratoconjunctivitis. This is the second report of a similar manifestation linked to its use.
Normal diameter of the optic nerve using magnetic resonance imaging: A retrospective Nigerian study
Authors: Ominde Beryl S. , Abadom Gloria E. , Ikubor Joyce E. , Achapu Lawrence C. , Enakpoya Princess O. , Igbigbi Patrick S. 
Published: February 2024

Abstract:

PURPOSE:
The variations in the diameter of the optic nerve (ON) are important clinically in the diagnosis of conditions associated with the ON such as raised intracranial pressure, meningioma, optic neuritis, and Grave’s orbitopathy. This study determined the normal diameters of the ON in adult Nigerians seen in a Hospital in Delta State.

METHODS:
Axial T1-weighted brain magnetic resonance imaging images of 150 patients (75 males and 75 females) aged ≥20 years were retrieved from the hospital’s radiological database and retrospectively used to evaluate the diameter of the ON on axial and coronal sections. The data were analyzed and summarized using descriptive statistics. The mean diameters were compared based on gender, side, and age groups and correlated with age using inferential statistics. The significance level was considered at 5%.

RESULTS:
The diameter of the ON measured 0.45 ± 0.07 cm on the coronal section, besides 0.50 ± 0.07 cm, and 0.46 ± 0.06 cm at 0.3 cm and 0.8 cm from the posterior pole of the globe, respectively, on the axial slices. The diameters were significantly larger in males than in females (P < 0.05) and were symmetrical. However, they lacked significant association with age (P > 0.05). The three diameters measured had a significant positive correlation with each other (P < 0.05).

CONCLUSION:
The study provides a normal range of ON diameter in the study center to aid in the diagnosis of raised intracranial pressure and pathologies involving the nerve and its sheath.