bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Ahmed glaucoma valve surgery performed by glaucoma fellows – A large retrospective study from Eastern India
Authors: Roy Avik K , Khan Sardar M , Rao Aparna 
Published: March 2024

Purpose:
Teaching and training of glaucoma fellows on the technique of Ahmed glaucoma valve (AGV) implantation surgery is very important. The purpose of this study was to describe the clinical outcomes and complications of AGV surgery performed by glaucoma fellows of a tertiary eye center from eastern India.

Methods:
This was a retrospective study based on electronic medical records. Thirty-five eyes operated with AGV by five glaucoma fellows from January 2016 to November 2020 were included. Best-corrected visual acuity, intraocular pressure (IOP), and number of antiglaucoma medications (AGMs) were the study outcome measures.

Results:
The mean (±standard deviation) age of the patients was 40.5 (±19.7) years. The follow-up period was 24.37 (±13.01) months. Both complete success (IOP <21 mmHg without additional AGM) and qualified success (IOP <21 mmHg with an additional AGM) were achieved in eight eyes each (22.8%). Failure of the surgery was noted in 19 eyes (54.3%) as there was a need for repeat surgery for IOP control in 12 eyes and a persistent IOP spike (IOP >21 mmHg with AGM beyond 3 months) in seven eyes. Despite a high rate of failure of the primary surgery, with the consultants’ intervention, there was statistically significant improvement in vision and IOP in all patients (P < 0.01) at the last follow-up.

Conclusion:
AGV implantation is a challenging surgical skill to be acquired by the glaucoma fellows.
Comparative study of the three-dimensional perception of videos recorded on a “Do it yourself” three-dimensional recording assembly versus the conventional recording system
Authors: Aravind MJ , Sampangi Raju , Sud Rouli , Sheikh Rubina , Kaur Harpreet , Hemalatha BC , Khanduja Sumeet 
Published: March 2024

Purpose:
To develop an indigenous “Do it yourself” (DIY) three-dimensional (3D) ophthalmic surgery recording system and validate the perception of stereopsis using it.

Methods:
A cross-sectional survey of practicing ophthalmologists with post-postgraduation experience of at least 5 years for perception of stereopsis for three different surgeries was performed; cataract, retinal detachment, and intravitreal drug injection were recorded on DIY assembly, viewed on VRBOX and using laptop videos and pseudo 3 d videos as control.

Results:
The laptop videos and 3D VR Box videos received higher ratings for stereopsis than the pseudo 3D videos. The parameters that received significantly higher ratings on the 3D VR Box viewing were instrument’s position relative to the ocular surface in cataract surgery, anterior chamber depth during capsular staining, ophthalmic visco-surgical device injection, capsulorhexis, phaco tunnel depth, movement of nuclear fragments in the anterior chamber, and intra-ocular lens tilt in the capsular bag during cataract surgery (P < 0.05). In scleral buckling surgery, the parameters that were significantly rated higher on VR Box were globe contour, separation of the scleral plane from muscle, and explant plane (P < 0.05). Furthermore, the depth of the needle in the vitreous cavity while administering intravitreal drug injection was also rated significantly higher on VR Box (P < 0.05). However, the ratings for the depth of corneal incision, depth of scleral incision, overall color, and overall quality were not different statistically when compared between laptop and VR Box viewing.

Conclusion:
DIY 3D recording assembly offers a superior means of appreciating depth at various stages of cataract surgery, scleral buckling, and intravitreal drug injection when compared to laptop viewing and can serve as an effective tool for skill transfer.
Safety evaluation of 5-hydroxytryptophan and S-(2-aminoethyl)isothiouronium bromide hydrobromide on rodent lungs
Authors: Thokchom Suresh Kumar , Indracanti Namita , Khanna Anoushka , Indraganti Prem Kumar 
Published: March 2024

OBJECTIVES:
During the past few decades, various compounds have been researched for their potential as radioprotectants, and many of them were found to be safe and effective in several preclinical models. However, many of these compounds were found to have serious adverse effects when evaluated in clinical settings, thereby making them unsuitable for human applications. 5-hydroxytryptophan (5-HTP) and S-(2-aminoethyl) isothiouronium bromide hydrobromide (AET) act in a synergistic fashion to promote radioprotection. The present study primarily emphasizes the safety of fixed dose of 5-HTP + AET in the lungs of C57BL/6 mice, a well-known model used in drug safety studies.

MATERIALS AND METHODS:
Post-administration of the combination of HTP+AET at specific time points, blood and bronchoalveolar lavage fluid (BALF) were collected for the analysis of inflammatory and oxidative stress markers of the lungs. Thereafter, the mice were sacrificed and the lungs were dissected out, weighed, and fixed in formalin for histopathological studies.

RESULTS:
The inflammatory biomarkers: tumor necrosis factor-alpha and interleukin-10 and oxidative stress biomarkers: 8-isoprostane and 8-hydroxy-2′-deoxyguanosine were found to have normal levels in blood and BALF in both control and treatment groups, which was further supported by normal histological findings. In addition, other endpoints such as food and water intake were found to be within normal limits.

CONCLUSION:
The present safety study reflects that the combination has no adverse effects on the lungs of the experimental mouse. Further, evaluation in higher mammals including nonhuman primates is essential prior to validation of the safety of the combination in humans.
The effective dose of remimazolam in adult gastroscopy
Authors: Zhang Rongyan , Zhao Gang , Yan Zhangjun , Xuan Hongmei , Chen Yan 
Published: March 2024

OBJECTIVES:
The objectives of this study were to explore the median effective dose (ED50) and the dose required for successful anesthesia in 95% of the patients (ED95) of remimazolam for intravenous anesthesia in adult outpatients undergoing gastroscopy.

METHODS:
This pilot study was conducted in patients scheduled to undergo painless gastroscopy at the authors’ hospital between March 15, 2022 and March 25, 2022. The ED of remimazolam was determined using the modified Dixon sequential method, using an initial induction dose of 0.2 mg/kg. With successful or failed anesthesia, the remimazolam dose was decreased or increased by 0.05 mg/kg for the next patient, respectively.

RESULTS:
Twenty-two patients (43.6 ± 10.5 years of age) were enrolled. During gastroscopy, the remimazolam induction dose was 19.93 ± 2.96 mg (0.2–0.45 mg/kg). Eighteen patients could complete anesthesia with remimazolam alone, and four patients needed propofol to complete anesthesia. The induction time after the injection of remimazolam was 20.8 ± 8.4 s, the gastroscopy time was 5.1 ± 1.3 min, and the anesthesia recovery time was 17.5 ± 5.6 min. The ED50 and the ED95 of remimazolam were 0.362 mg/kg (95% confidence interval [CI]: 0.313–0.455 mg/kg) and 0.464 mg/kg (95% CI: 0.403–2.242 mg/kg), respectively. The vital signs of all patients remained within the predefined acceptable limits. No patients required antagonist rescue.

CONCLUSION:
The ED50 and ED95 of remimazolam for adult gastroscopy were 0.362 mg/kg and 0.464 mg/kg, respectively. Additional anesthetics might be required during gastroscopy in some patients.

TRIAL REGISTRATION:
The trial was registered. The number is ChiCTR2200057446.
Real-world safety and effectiveness of Pistacia lentiscus (mastic gum) in patients with diabetic gastroparesis: 24-week interim analysis postintervention
Authors: Kant Ravi , Singh Ajaypal , Raina Rohit , Dhingra Vandana , Bairwa Mukesh , Kanwar Varsha 
Published: March 2024

INTRODUCTION:
Gastrointestinal neuropathies are frequently found in diabetic patients.

AIM:
The aim of this study was to find out the safety, adverse reactions, and long-term effectiveness of Pistacia lentiscus plant extract (mastic gum) in diabetic gastroparesis (DG) with respect to sustainable improvement in gastroparesis symptoms (Gastrointestinal Cardinal Symptom Index [GCSI] score) by observational follow-up study of a single-centric double-blind noninferiority randomized control trial.

MATERIALS AND METHODS:
Thirty-eight individuals were recruited and equally randomized in two study groups based on GCSI score and TC99 radionuclide gastric emptying scintigraphy (GES), i.e. the mastic gum group and the levosulpiride group. After 24 weeks, the GCSI score was recalculated in both the groups, and patients were evaluated for the safety, adverse reactions, and long-term effectiveness of mastic gum and the standard drug levosulpiride.

RESULTS:
In the extended study, mean GCSI score changes at 24 weeks were statistically significant (P < 0.001) (t-test) between the two groups. In the mastic gum arm, the change in mean GCSI score at 24 weeks was statistically nonsignificant mean ± (standard deviation [SD]) 16.7± (3.81) compared to the GCSI score at 2-month postintervention mean (SD) 16.35± (2.27) (intragroup P = 0.89) (repeated measures ANOVA). It strongly indicates that mastic gum provided a sustainable improvement in DG symptoms in comparison to levosulpiride, with excellent subjective well-being postintervention, without any obvious significant adverse effects.

CONCLUSION:
Six-month (24-week) interim analysis of patients suggests that mastic gum gives a sustainable improvement in DG symptoms without any obvious adverse effects as compared to levosulpiride.
Amelioration by Withania somnifera of neurobehavioural and immunological markers in time dependent sensitization induced post traumatic stress disorder in rats
Authors: Rehman Sana , Faizan Mohammad , Ali Nafaa Hasan , Gulati Kavita , Ray Arunabha 
Published: March 2024

AIMS AND OBJECTIVES:
Posttraumatic stress disorder (PTSD) is a complex neuropsychiatric pathophysiology with an unmet need for safe, effective, and sustainable therapeutic modalities. Thus, the present study evaluated the effects of Withania
somnifera (WS, Ashwagandha) on an experimental model of PTSD in rats.

MATERIALS AND METHODS:
Wistar rats (200–250 g) were used and time-dependent sensitization (TDS) was used as the experimental model of PTSD. Standardized WS root extract (100 and 300 mg/kg, p.o. for 15 days) was administered with TDS and their effects were observed on neurobehavioral (anxiety) and brain cytokines, corticosterone, and oxidative stress markers.

RESULTS:
Exposure to TDS resulted in anxiogenic behavior in the elevated plus maze (EPM) test, i.e., reductions in open arm entries and open arm time, as compared to the control group. Pretreatment with WS extract (100 and 300 mg/kg × 14 days) attenuated the TDS-induced anxiogenic activity in a dose-related manner, and these WS effects were comparable to those seen after the comparator drug fluoxetine (10 mg/kg). Assay of brain homogenates showed that TDS also resulted in elevations in brain interleukin-6 and reduction in corticosterone levels in both the hippocampus and prefrontal cortex (PFC), which were reversed after WS pretreatments. Further, WS pretreatment also reversed the TDS-induced changes in brain oxidative stress markers, namely elevated malondialdehyde and reduced glutathione levels in both the hippocampus and PFC.

CONCLUSION:
These results suggest that WS could have potential as a therapeutic agent for treating PTSD by attenuating anxiogenesis, neuroimmune axis activation, and oxidative stress.
Topical antibiotics in the prevention of port-site infection after elective day care laparoscopic cholecystectomy
Authors: Sharma Nipun , Kaman Lileswar , Khare Siddhant , Dahiya Divya , Gupta Ashish , Thakur Uttam Kumar , Sethi Sameer 
Published: March 2024

BACKGROUND:
Wound-related infections and complications are rare after day care laparoscopic cholecystectomy (LC). They can have a significant adverse impact on the postoperative course after an uneventful elective LC. The use of topical antibiotics over the port site may prevent such complications.

MATERIALS AND METHODS:
This trial was conducted from January 2018 to June 2019. Two hundred and fifty patients who met the inclusion and exclusion criteria were included in the study. They were randomized into the topical antibiotic group (Group A, n = 125) and control group (Group B, n = 125). All patients underwent four-port LC. Mupirocin 2% topical antibiotic ointment was applied to all four-port sites in Group A, whereas no topical antibiotic was used in Group B. One dose of prophylactic systemic antibiotics was given to all patients in both groups.

RESULTS:
The mean age was 43.22 ± 12.7 years in Group A and 43.44 ± 12.5 years in Group B. The comorbidities and the other variables were comparable between the two groups. The port-site infection (PSI) was observed in one patient in Group A and three patients in Group B, which was statistically nonsignificant (P = 0.622). The mean time of detection of infection was 4.75 ± 1.7 days. All the infections were superficial surgical site infections. Microbiological swabs culture of the infected wounds yielded no growth of bacteria.

CONCLUSION:
The PSI after LC is very less. The use of topical antibiotics to prevent PSIs after LC could not be established.
A study on patients who have undergone prosthodontic procedures using digital impressions and traditional impressions to evaluate their comfort levels and preferences
Authors: Sinha Manish , Agarwal Manisha , Shah Sanket S. , Goyal Varun , Patel Deven , Patel Rahulkumar Ratilal 
Published: March 2024

ABSTRACT

Background:
Prosthodontic procedures involving dental impressions play a critical role in restorative dentistry. The advent of digital impression technologies offers an alternative to traditional methods, potentially influencing patient experiences. This study systematically explores and compares patient experiences with digital impressions and traditional impressions, aiming to provide insights into comfort levels, overall satisfaction, and preferences.

Materials and Methods:
Participants: A sample of 500 individuals who underwent prosthodontic procedures (250 with digital impressions and 250 with traditional impressions). Data collection: A structured questionnaire addressing demographic information, comfort levels during the procedure, overall satisfaction, and preferences for impression methods.

Results:
The digital impressions group demonstrated higher overall satisfaction scores than the traditional impressions group (P < 0.001). Preference for impressions: a majority of patients expressed a preference for digital impressions (78%) over traditional impressions (22%) (P = 0.002).

Conclusion:
This study indicates that patients undergoing digital impressions in prosthodontic procedures reported higher comfort levels, greater overall satisfaction, and a preference for digital impressions. The findings emphasize the potential benefits of incorporating digital technologies into prosthodontic practice to enhance patient-centered care.
Analysis of the quality of information provided by “Dr. YouTube™” on premature ejaculation
Authors: Singh Swarndeep , Neupane Bastabika , Dhungel Omkar , Sharma Pawan 
Published: March 2024

Background:
YouTube™ is an important online resource to access health-related online information by the public worldwide. However, the quality of information available on it has not been adequately characterized.

Aim:
To assess the quality and reliability of information available on the treatment of premature ejaculation (PME) on YouTube™ in the Hindi and English language videos.

Materials and Methods:
A total of 151 (Hindi: 109, English: 42) YouTube videos were selected for assessment. The quality was evaluated using structured tools: Patient Education Materials Assessment Tool (PEMAT); and a 5-point modified DISCERN questionnaire (Range: 1-serious shortcomings; 5-minimal shortcomings). PEMAT assesses the understandability and actionability of video as separate percentages.

Results:
Three most common treatments suggested for PME were Kegel exercise (22.5%), start–stop technique (21.9%), and antidepressant medications (20.5%). Antidepressant medications, stop-squeeze techniques, and psychotherapy were more frequently suggested in English videos, whereas ayurvedic or herbal medicines were more frequently suggested in Hindi videos. About two-thirds of videos presented information in an easy-to-understand and actionable manner (PEMAT scores ≥70%). Only 6% of videos had a DISCERN score of ≥4, indicating good overall quality of information presented in them.

Conclusion:
People likely to encounter poor-quality information when seeking information for PME treatment on YouTube. A large number of videos suggested ineffective or unproven treatment strategies for PME. Healthcare professionals need to be mindful of this while counselling patients, and guide them regarding useful and reliable sources of health information available online.
Socio-demographic correlates of autism spectrum disorder: A study in Odisha
Authors: Nayak Asmita , Khuntia Rooplekha 
Published: March 2024

Background:
There is very little data available on socio-demographic factors associated with the early detection of autism spectrum disorder (ASD).

Aim:
This study sought to investigate the socio-demographic correlates of ASD.

Materials and Methods:
A cross-sectional study of 201 first-time reported cases of ASD using a semi-structured socio-demographic datasheet was conducted to understand the socio-demographic correlates. The Statistical Package for the Social Sciences (SPSS) software (version 26) was used to calculate frequencies, percentages, and Chi-square values.

Results:
Descriptive analysis revealed an upward trend in the number of reported cases among both genders. Most cases were five years old or above, from middle socioeconomic background, with parents who had studied above matriculation, and lived in an urban area. Chi-square test results revealed a significant relationship between the number of first-time reported cases of ASD and that of parental education, socioeconomic status (SES), and living conditions.

Conclusion:
A prominent finding of this study was parents’ lack of awareness regarding their child’s condition. Measures for awareness and early detection have been recommended.
Severity of Exacerbation in Pneumococcal Vaccinated versus Unvaccinated Patients with Exacerbation of Chronic Obstructive Pulmonary Disease: A Post hoc Analysis of Presentation Status of the Subjects of HOPE Chronic Obstructive Pulmonary Disease Study
Authors: Venkitakrishnan Rajesh , Vijay Anand , Ramachandran Divya , Cleetus Melcy , Nirmal Aparna Soman , John Susan 
Published: March 2024

Background:
Acute exacerbations occur with varying frequency and severity and impact the natural course of chronic obstructive pulmonary disease (COPD) patients. Pneumococcal vaccination has been shown to decrease the incidence of community-acquired pneumonia and exacerbation rate in COPD patients. There is a paucity of data on the influence of pneumococcal conjugate vaccination on the severity of COPD exacerbations.

Objectives:
The objectives of this study were to evaluate the severity of exacerbation in pneumococcal vaccinated (vaccinated with 13-valent conjugate vaccine) versus unvaccinated COPD subjects hospitalized with acute exacerbation.

Materials and Methods:
This was a post hoc analysis of the severity of exacerbation in the subjects of HOPE COPD study. This involved the collection of clinical, radiological, and laboratory data of 120 COPD patients who were hospitalized with an acute exacerbation, 60 of whom had prior pneumococcal vaccination and 60 were unvaccinated. Data of COPD patients at the time of presentation with acute exacerbation were analyzed. Comparison was made between severity parameters such as presence of fever, leukocytosis, respiratory failure, multilobar consolidation, hypotension needing inotropic support, and presence of sepsis between pneumococcal vaccinated and unvaccinated subjects.

Results:
The occurrence of multilobar consolidation was substantially less in the vaccinated group (60% vs. 6.7%; P = 0.0001). The incidence of fever, leukocytosis, and elevated C-reactive protein was significantly higher in the unvaccinated group. Need for intensive care unit care was higher in the unvaccinated group (58.3% vs. 30% with P = 0.019). The occurrence of new-onset respiratory failure was similar in both the groups although type 2 failure with respiratory acidosis was more in the unvaccinated group. Patients in the unvaccinated group had a higher incidence of sepsis and need for inotropic support as well as assisted ventilation.

Conclusions:
Prior immunization with 13-valent pneumococcal conjugate vaccine ameliorates the severity of exacerbation in COPD patients needing hospitalization. Pneumococcal vaccination may be recommended for all patients with COPD who are at risk of hospitalization with acute exacerbation.
The Use of Neuraminidase Inhibitors in Teenagers May Not Increase the Risk of Neuropsychiatric Adverse Events: A Nationwide Population-based Retrospective Study
Authors: Chang Chao-Feng , Chung Chi-Hsiang , Lin Hsuan-Hwai , Chiu Chun-Hsiang , Chien Wu-Chien , Chen Tien-Yu 
Published: March 2024

Background:
Pandemic influenza virus is a public health issue, and the neuraminidase inhibitors (NIs) “Oseltamivir” and “Zanamivir” are effective treatments. While teenagers use NIs, there are concerns regarding neuropsychiatric adverse events (NPAEs).

Aim:
We aimed to use the Taiwan National Health Insurance Research Database to identify the correlation between NPAEs and NIs use in teenagers aged 13–19 years.

Methods:
The final population between 2000 and 2015 included in this study was 3698 individuals, with 2287 individuals having received “Oseltamivir” and “Zanamivir” (study cohort group) and 9148 individuals not receiving “Oseltamivir” and “Zanamivir” (comparison cohort group). We initially used a multivariate Cox regression analysis during the tracking period to determine the cumulative incidence of NPAEs.

Results:
Our findings revealed no significant increase in the likelihood of developing NPAEs in the study group. The Kaplan–Meier survival curve demonstrated that individuals who received “Oseltamivir” and “Zanamivir” were not associated with statistically significantly increased NPAEs compared with controls (log-rank test, P = 0.724).

Conclusion:
No more risk in comparison of the normal population in our study, and the safety of “Oseltamivir” and “Zanamivir” is established treatments for influenza.