bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Observational Study of Respiratory Dysfunction in Parkinson’s Disease at a Tertiary Care Hospital in Delhi
Authors: Ali Alfarid Shahid , Garg Jyoti , Anand Kuljeet Singh , Suri Amit , Gulati Kartika 
Published: June 2023

Abstract

Objectives:
The purpose of this study is to evaluate the impact of Parkinson’s disease (PD) on respiratory function using spirometry. In addition, the study aims to investigate the relationship between the severity of PD and any impairments in a respiratory capacity as measured by forced vital capacity (FVC%).

Methods:
This case–control study (40 cases of PD vs. 40 healthy controls) was conducted from July 1, 2021, to October 31, 2022, in a tertiary care hospital of New Delhi. Clinical symptoms and severity (Movement Disorder Society Unified Parkinson’s Disease Rating Scale [MDS-UPDRS] part-III score and Modified H and Y Scale) of the patients of PD were noted. A pulmonary function test (by spirometry) was performed and parameters such as forced expiratory volume in 1 s (FEV1), FVC, FEV1/FVC, and peak expiratory flow rate (PEFR) were noted. Mann–Whitney U-test (for two groups) and Chi-square test were used for the comparison of variables. Spearman rank correlation coefficient was used for the correlation of FVC (% predicted) with MDS-UPDRS part-III score and Modified H and Y stage.

Results:
Compared to controls, cases had significantly lower FVC% (70.5 vs. 88, P < 0.01), significantly lower FEV1% (68 vs. 83.5, P < 0.01), comparable FEV1/FVC (% predicted) (97 vs. 96, P = 0.805) and significantly lower PEFR (% predicted) (80.5 vs. 92, P < 0.01). The pattern of lung involvement was restrictive, normal, and obstructive in 72.50%, 20%, and 7.50% of cases, respectively. FVC (% predicted) showed a significant negative correlation with MDS-UPDRS part-III score (r = −0.895, P < 0.01) and with Modified H and Y Scale (r = −0.792, P < 0.01).

Conclusion:
Patients with PD had significantly more deranged respiratory dysfunction and there was significantly higher respiratory dysfunction with increasing severity of PD. A proper screening of lung functions may allow an early detection of respiratory dysfunction, thereby helping to initiate an early pulmonary rehabilitation to prevent respiratory complications.
Shelf life estimation of Saraswata ghrita – A preliminary evaluation
Authors: Badal Robin , Kaushik Shreshtha , Yadav Pramod , Prajapati Pradeep Kumar 
Published: June 2023

BACKGROUND:

Saraswata ghrita (SG), a multicomponent ayurvedic formulation is well-known for its cognitive properties. Although it is a very effective classical formulation, there is no appropriate data available on its stability study till date. The shelf life of certain Ayurvedic medications is specified in official Gazette, Government of India. However, it is necessary to revalidate the shelf life of each formulation following parameters prevalent in concerned scenario. Hence, an attempt has been made to determine the shelf life of SG through accelerated stability study.

OBJECTIVES:
The objective is to evaluate shelf life of SG.

MATERIALS AND METHODS:
SG was manufactured in a pharmaceutical laboratory, All India Institute of Ayurveda, New Delhi following classical reference. The samples were subjected to an accelerated stability study maintaining temperature and humidity 40°C ± 2°C and 75 ± 5% respectively. Relevant analytical parameters were performed at an interval of 0, 1, 3, and 6 months to check the degradation levels in the formulation.

RESULTS:
Insignificant changes were observed in physicochemical constants and chromatographic assay at different stages of analysis. The product was free from microbial contamination and heavy metals were within the prescribed limits. On extrapolation of the observations, the shelf life of SG is found to be 1 year and 5 months.

CONCLUSION:
The shelf life of SG corresponds to the classical standards for oleaginous preparations. However, it is less than the specifications set in the official gazette, Govt. of India. This decreased shelf life may be due to milk and salt component present in its composition which possibly speeds up the process of degradation, shortening its shelf life.
A cross-sectional study on quality of life and stress among medical students and interns in Central Karnataka
Authors: Sindhu B. M. , Kumar Prianka Shashi , Kumbar Abhinandan S. , Rashmi B. M. 
Published: June 2023

INTRODUCTION:
Studies have shown the lower quality of life (QoL) and higher levels of stress among students of health-care courses compared to others. The present study was done to assess the QoL and perceived stress levels among medical students and interns and the correlation between them. Symptoms experienced in the case of stress and coping strategies for stress were also studied.

METHODOLOGY:
All students and interns in a medical college in Central Karnataka were interviewed. WHOQoL-BREF scale and Perceived Stress Scale-10 were used to assess the QoL and perceived stress levels, respectively.

RESULTS:
A total of 94 students participated. Psychological domain and environment domain scores (52.3 and 59.02, respectively) were lower. A significant negative correlation was observed between all the domains of QoL and stress scores. More than half of the students (60.6%) were under moderate stress.

CONCLUSION:
Efforts should be made to improve the QoL and reduce stress levels among medical students and interns. Various better-coping methods for stress should be taught to them.
Postoperative Pregnancy Outcomes Following Laparoscopic Surgical Management in Women with Stage III/IV Endometriosis: A Single-Center Follow-Up Study
Authors: Fujii Maya , Koshiba Akemi , Ito Fumitake , Kusuki Izumi , Kitawaki Jo , Mori Taisuke 
Published: June 2023

Objectives:
The effects of laparoscopic surgical management in women with stage III/IV endometriosis remain controversial. The standard extent of resection for stage III/IV endometriosis with deep endometriosis to treat endometriosis-associated infertility is debatable. This study aimed to assess the postoperative pregnancy outcomes following a routine surgical intervention for stage III/IV endometriosis patients.

Materials and Methods:
Patients with stage III/IV endometriosis who underwent conservative laparoscopic surgery at our hospital between January 2010 and December 2018 were retrospectively analyzed. Statistical analyses were performed to determine the correlations between endometriosis features and postoperative pregnancy outcomes.

Results:
Of 256 patients enrolled, 94 wished to conceive. Exclusion criteria: ≥40 years, adenomyosis, partners with infertility issues. Finally, 71 women were included. The overall postoperative pregnancy rate was 76.1% (n = 54): 49 and five from non-assisted reproductive technology (ART) and ART, respectively. The postoperative pregnancy rate in patients diagnosed with infertility presurgery (40/71) was 70.0% (n = 28): 24 (non-ART) and four (ART). The endometriosis fertility index (EFI) score was higher in the pregnant than in the nonpregnant group (P = 0.03). The EFI score and surgical score of EFI were higher in the non-ART than in the ART group (P = 0.04; P = 0.02); in the infertile group, they were higher in the pregnant than in the nonpregnant group (P = 0.018; P = 0.027).

Conclusion:
Our postoperative pregnancy rate after conservative laparoscopic surgery for patients with stage III/IV endometriosis compared favorably with previous reports. EFI was a significant predictor of postoperative pregnancy. Our surgical approach to maintain a high surgical score of EFI might help treat endometriosis-associated infertility.
Predicting postoperative pain by using preoperative pain threshold in response to electrical stimulus in women undergoing gynaecological cancer surgery - Single-arm, prospective, observational study
Authors: Bakshi Sumitra G. , Kadam Sonal , Shylasree T. S. 
Published: June 2023

Background and Aims:
Individual variability leading to different pain experiences makes pain prediction challenging. This study aimed to evaluate whether preoperative electrical pain threshold testing is predictive of postoperative pain.

Methods:
Following ethics committee approval and registration of the trial, 40 consenting patients undergoing open laparotomy (interval debulking surgery) for ovarian cancer were included in the study. Electrical stimulus (maximum of 256 μA) was used preoperatively to determine the current perception threshold (CPT) and pain equivalent current (PEC). A numerical rating scale (NRS; 0–10, with 0 indicating no pain and 10 indicating severe pain) was used to assess pain. All patients received intravenous paracetamol in accordance to body weight, diclofenac (1 mg/kg, maximum 50 mg), and tramadol (1 mg/kg, maximum 50 mg) eight hourly for 24 hours. The preoperative PEC was compared with worst pain score (PS) at movement at the end of 24 hours. PEC was also compared with average PS at rest, at movement, and with opioid requirement (24 hours).

Results:
The median values of CPT and PEC were 12.51 (45 [10.1–14 .6]) μA and 94.75 (174 [48.8–94.7]) μA, respectively. A moderate correlation was observed between PEC and worst PS (P = 0.01, r = −0.402), with patients having PEC less than 60 μA being associated with moderate-to-severe PS. There was no correlation between PEC and average PS at rest (P = 0.16, r = 0.225), at movement (P = 0.46, r = 0.119), and the postoperative opioid consumption in the first 24 hours (P = 0.50, r = −0.110).

Conclusion:
There is a moderate association between preoperative pain threshold in response to electrical stimulus and worst PS in the postoperative period following interval debulking surgery for ovarian cancer.
Comparative preoperative sonological assessment of gastric contents in patients with chronic kidney disease versus those with normal renal function - A prospective observational study
Authors: Sharma Sadhvi , Raman Padmalatha , Deo Alka S. 
Published: June 2023

Background and Aims:
Though the role of fasting preoperative gastric ultrasound has been validated in different patient populations, namely, obese, pregnant and diabetics, it has not been explored in patients with chronic kidney disease (CKD). This prospective, observational study compared the fasting sonological assessment of gastric contents in patients with CKD versus those with normal renal function scheduled for elective surgery.

Methods:
After ethical approval and trial registration were obtained, preoperative gastric ultrasound was done in 115 CKD patients and 115 with normal renal function. Qualitative and quantitative assessment of residual gastric volume was done. Also, the patients were administered the Porto Alegre Dyspeptic Symptoms Questionnaire (PADYQ) to evaluate gastroparesis objectively. The researcher was not blinded to the patient groups. Data analyses were done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 22.0).

Results:
Gastric volumes exceeding 1.5 ml/kg or particulate or solid contents were found in 57 patients with CKD and 36 patients with normal renal function (P = 0.004). The PADYQ scores were 6.54 ± 8.49 for CKD and 2.15 ± 5.71 for normal renal function (P < 0.0001) groups. CKD patients had a higher age (P < 0.001), lower body mass index (P = 0.005) and higher incidence of diabetes mellitus (P < 0.001). There were no incidents of gastric aspiration.

Conclusion:
Renal dysfunction contributes to delayed gastric emptying. PADYQ can also help identify those at high risk of gastroparesis. Combining the questionnaire and preoperative gastric ultrasound must be considered in these patients to ensure optimum safety.
Efficacy and safety of supraclavicular versus infraclavicular approach for subclavian vein catheterisation: An updated systematic review and meta-analysis of randomised controlled trials
Authors: Imai Eriya , Watanabe Jun , Okano Hiromu , Yokozuka Motoi 
Published: June 2023

Background and Aims:
Subclavian vein catheterisation (SVC) is more effective than internal jugular or femoral catheterisation and is linked to a lesser incidence of infection and patient discomfort. Whether the supraclavicular (SC) or infraclavicular (IC) approach is more effective for SVC is unclear in the previous systematic review. This updated review is designed to search the efficacy and safety of both approaches adopting the Grading of Recommendations Assessment, Development and Evaluation approach.

Methods:
In May 2022, we explored the databases of Embase, MEDLINE, CENTRAL, ClinicalTrials.gov and WHO-ICTRP for randomised controlled trials to compare the two approaches.

Results:
Seventeen trials (2482 cases) were included. In the primary outcomes, the SC approach likely reduces the failure proportion (relative risk [RR], 0.63; 95% confidence interval [CI], 0.47–0.86; I
2 = 5%) and the incidence of malposition (RR, 0.23; 95% CI, 0.13–0.39; I
2 = 0%) with moderate evidence and may slightly reduce the incidence of arterial puncture and pneumothorax (RR, 0.59; 95% CI, 0.29–1.22; I
2 = 0%) with low evidence. In the secondary outcomes, the SC approach may decrease the access time and may increase the first-attempt success proportion.

Conclusion:
The SC approach for SVC should be selected after considering the clinician’s expertise.
Comparing two techniques of performing an epidural catheter-assisted epidural blood patch using a 20 ml syringe versus a 5 ml syringe and its effect on clotting time, the strength of clot retraction and haemolysis – A prospective in vitro study (EC-EBP study)
Authors: Mariappan Ramamani , Kumar Snehil , Raju Krishnaprabhu , Daniel Dolly , Nair Sukesh Chandran , Subramani Sathya 
Published: June 2023

Background and Aims:
Epidural blood patch (EBP) is performed by injecting autologous blood into the epidural space using a Tuohy needle. Certain clinical scenarios mandate an epidural catheter (EC)-assisted EBP. Collecting blood in a 20-ml versus 5-ml syringe appears to influence the quality of the clot. This in vitro study compared the techniques of performing the EC-assisted EBP using 20-ml versus 5-ml syringe on clotting time (CT), clot retraction (CR) and haemolysis.

Methods:
This in vitro study was performed in a haematology laboratory. Five consented adult healthy male volunteers donated blood. In the 5-ml syringe technique, blood was injected through an EC, and as it flowed out of the tip, it was collected at the beginning and the end of 1 min. With the 20-ml technique, blood was collected at the beginning and end of the first, second and third minute. The samples were tested for CT, CR and haemolysis by measuring the plasma-free haemoglobin (PFHb).

Results:
Five injections were made using a 5-ml syringe, and another five with a 20-ml syringe. Injection time was shorter in the 5-ml technique (80.80 ± 5.89 vs. 272 ± 28.4 s, P < 0.0001). With the 20-ml technique, CT progressively increased (>15 min), whereas, with the 5-ml syringe, the CT was normal. Both techniques caused mild, insignificant haemolysis (PFHb >0.005 g/dl), without affecting the quality of CR.

Conclusion:
EC-assisted EBP using a 5-ml syringe technique shortens the injection time and deposits fresh blood quickly without affecting CT and CR.
Impact of inverted internal limiting membrane-flap technique on functional outcome and structural restoration of small and medium size macular holes
Authors: Singh Deependra Vikram , Reddy Raja Rami , Sharma Ajay , Gaur Sandhya , Sharma Yog Raj 
Published: June 2023

Purpose:
To evaluate the impact of the inverted internal limiting membrane (ILM)-flap technique on the visual outcome and anatomical recovery for small (<250 μ), medium (<400 μ), and large (>400 μ) macular holes (MHs).

Methods:
Retrospective study included consecutive idiopathic MH cases operated on using the inverted ILM-flap technique. Clinical data were retrieved from electronic medical records (EMRs), surgical videos, and optical coherence tomography (OCT) machines. Eyes with axial length >25 mm, coexisting macular diseases, and follow-up <6 weeks were excluded. Data included the presence or absence of ILM flap and restoration of External Limiting Membrane (ELM), Ellipsoid Zone (EZ) lines. Mean visual improvement and structural recovery were compared between eyes showing ILM flap and those showing no flap in three MH size groups.

Results:
Forty eyes of 38 patients with a mean age of 62.7 ± 10.1 years and a mean MH diameter of 348 ± 152 μm were included. The mean follow-up was 527 ± 478 days with anatomical closure observed in all eyes. Mean best-corrected visual acuity (BCVA) improved significantly from 0.87 ± 0.38 to 0.35 ± 0.26. ILM flap was visible in 29 (72.5%) all MHs, 7 (53.8%) small MHs (n = 13), 8 (61.5%) medium MHs (n = 13), and 14 (100%) large MHs (n = 14). The mean BCVA change was 0.47 ± 0.34, 0.53 ± 0.48, and 0.56 ± 0.20 in large, medium, and small MHs, respectively, and the difference between eyes showing ILM flap versus no flap in each MH size group was not statistically significant (P > 0.05). However, for medium MHs, it was higher in the ILM flap (0.66 ± 0.52) group compared to the no flap (0.32 ± 0.37) group. One eye with small MH developed significant gliosis resulting in reduced BCVA. ELM was restored in all eyes with small and medium MHs.

Conclusion:
We observed that the ILM flap did not adversely affect anatomical and visual outcomes for MHs <400 μm. Restoration of ELM suggests minimal interference in structural recovery by an ILM flap.
Qualitative ultrasound biomicroscopy in glaucoma
Authors: Mansoori Tarannum 
Published: June 2023

Background:
UBM is a high-resolution ultrasound technique which allows non-invasive, in vivo imaging of the anterior segment and iridocorneal angle.

Purpose:
This video is compilation of short video clips and images which gives description on identification of angle closure due to pupillary block, peripheral anterior synechiae, iris bombe, plateau iris, supra ciliary effusion, and malignant glaucoma. It also shows video demonstrating partially and fully patent iridotomy and features of trabeculectomy bleb.

Synopsis:
This video summarizes importance of UBM application in angle closure glaucoma to understand its pathophysiology by showing the relationship between the peripheral iris, trabecular meshwork and ciliary processes.

Highlights:
UBM provides two-dimensional, grayscale images of the angle structures and allows identification of non-pupillary block mechanism in angle closure glaucoma, which can be recorded for qualitative and quantitative analyses.

Video Link:
https://youtu.be/prsmGnR8jYc

Key words: Angle closure glaucoma, pupillary block, UBM
Validation of three weight gain-based algorithms as a screening tool to detect retinopathy of prematurity: A multicenter study
Authors: Raffa Lina , Alamri Aliaa , Alosaimi Amal , Alessa Sarah , Alharbi Suzan , Ahmedhussain Huda , Almarzouki Hashem , AlQurashi Mansour 
Published: June 2023

Purpose:
Screening guidelines for retinopathy of prematurity (ROP) are updated frequently to help clinicians identify infants at risk of type 1 ROP. This study aims to evaluate the accuracy of three different predictive algorithms—WINROP, ROPScore, and CO-ROP—in detecting ROP in preterm infants in a developing country.

Methods:
This retrospective study was conducted on 386 preterm infants from two centers between 2015 and 2021. Neonates with gestational age ≤30 weeks and/or birth weight ≤1500 g who underwent ROP screening were included.

Results:
One hundred twenty-three neonates (31.9%) developed ROP. The sensitivity to identify type 1 ROP was as follows: WINROP, 100%; ROPScore, 100%; and CO-ROP, 92.3%. The specificity was 28% for WINROP, 1.4% for ROPScore, and 19.3% for CO-ROP. CO-ROP missed two neonates with type 1 ROP. WINROP provided the best performance for type 1 ROP with an area under the curve score at 0.61.

Conclusion:
The sensitivity was at 100% for WINROP and ROPScore for type 1 ROP; however, specificity was quite low for both algorithms. Highly specific algorithms tailored to our population may serve as a useful adjunctive tool to detect preterm infants at risk of sight-threatening ROP.
Comparative analysis of visual outcomes following small-incision lenticule extraction with or without cyclotorsion compensation in eyes with high astigmatism: Contralateral eye study
Authors: Sachdev Gitansha S , Patekar Komal B , Ramamurthy Shreyas 
Published: June 2023

Purpose:
To compare the visual outcomes in patients undergoing small-incision lenticule extraction (SMILE) for correction of myopic astigmatism (≥−1.50 D) with or without manual cyclotorsion compensation.

Methods:
A prospective, double-blinded, randomized, contralateral study was conducted in the refractive services of a tertiary eye care center. Eligible patients with bilateral high myopic astigmatism (≥1.5 D) and intraoperative cyclotorsion (≥5°) undergoing SMILE between June 2018 and May 2019 were included. Cyclotorsion compensation was performed using triple centration method before femtosecond laser delivery. Uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) measurement, manifest refraction, slit-lamp biomicroscopy, and corneal tomography were performed preoperatively and at 1 and 3 months’ postoperative visit. Astigmatic outcomes were analyzed using Alpins criteria.

Results:
A total of 30 patients (60 eyes) were included in this study. The patients underwent bilateral SMILE surgery, with manual cyclotorsion compensation in one eye (CC group, n = 30 eyes) and no cyclotorsion compensation in the other eye (NCC group, n = 30 eyes). Preoperative astigmatism and intraoperative cyclotorsion were −2.0 D and 7.03° ± 1.06° (CC) and −1.75 D and 7.24° ± 0.98° (NCC) (P = 0.472 and 0.240, respectively). No significant differences were noted in mean refractive spherical equivalent (MRSE), UDVA, CDVA, and refractive error between the two groups at 3 months’ postoperative visit. Astigmatic outcomes measured using Alpins criteria demonstrated no significant difference between the two cohorts.

Conclusion:
The cyclotorsion compensation technique provided no additional advantage in terms of astigmatic outcomes or postoperative visual quality, in eyes with high preoperative astigmatism and intraoperative cyclotorsion.