bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of prophylactic antiemetic therapy with palonosetron and dexamethasone as single-agents or in combination in adult patients undergoing laparoscopic surgery
Authors: Sadhoo Neha , Prakash Jay , Kumar Vishwanath , Kharwar Ramesh Kumar , Ahmad Sabih , Sethi Bijaya Kumar 
Published: March 2023

Background:
The incidence of postoperative nausea and vomiting (PONV) is quite high after laparoscopic surgeries. This study endeavors to compare the efficacy of the combination of palonosetron and dexamethasone with that of either drug alone in the prevention of PONV in patients undergoing laparoscopic surgeries.

Methods:
This randomized, parallel-group trial was done on ninety adults of American Society of Anesthesiologists Grade I and II patients aged 18–60 years undergoing laparoscopic surgeries under general anesthesia. The patients were randomly divided into three groups of thirty patients each. Group P (n = 30) received palonosetron 0.075 mg intravenously (iv), Group D (n = 30) received dexamethasone 8 mg iv and Group P + D (n = 30) received palonosetron 0.075 mg and dexamethasone 8 mg iv. The primary outcome was incidence of PONV in 24 h, and the secondary outcome was a number of rescue antiemetics required. To compare the proportions in the groups, unpaired t-test, Mann–Whitney U-test, Chi-square test, or Fisher's exact test was applied.

Results:
We found that the overall incidence of PONV was 46.7% in Group P, 50% in Group D, and 43.3% in Group P + D during the first 24 h. Rescue antiemetic was required in 27% of the patients in Group P and Group D compared to 23% of the patients in Group P + D and twice in 3% of the patients in Group P, 7% of the patients in Group D, and none in Group P + D which were not significant.

Conclusions:
The combination therapy of palonosetron plus dexamethasone did not significantly reduce the incidence of PONV when compared with either drug alone.
The Study of Obstructive Sleep Apnea Among the Patients of Systemic Hypertension - An Original Research Article
Authors: Anand K. N. N. , Kumar Prasanna P. , Kulkarni Ashwin , Krishnamurthy Vishwanath , Kumar Anil 
Published: March 2023

Background:
Obstructive sleep apnea (OSA) is a long-term sleep disorder that presents with partial or complete obstruction of the upper airway during sleep. It is one of the secondary causes and independent risk factors of hypertension (HTN). The study aimed to study and compare characteristics between patients with and without OSA among hypertensives.

Materials and Methods:
A total of 76 patients with systemic HTN attending a tertiary care hospital from January 2019 to September 2019 were included in the study. Clinical and demographic data were collected and recorded. For the patients with Epworth Sleepiness Scale score >10, limited polysomnography was done. Patients were diagnosed with and without OSA. Characteristics of all the patients were compared.

Results:
The mean age of the study participants was 59 years, 51.3% were females, 48.7% were males, and 63.8% had OSA. The average neck and waist circumference were significantly greater in patients with OSA than without (P = 0.004 and P = 0.001, respectively). The average spontaneous bacterial peritonitis among patients with OSA and without differed significantly (P = 0.023). The average random blood sugar among patients with OSA was significantly higher (P < 0.001). The average total cholesterol and triglycerides levels were significantly higher in OSA patients (P < 0.002 and P < 0.001, respectively). Although statistically insignificant, average high-density lipoprotein and low-density lipoprotein were higher in OSA patients (P > 0.05). The presence of resistant HTN was significantly associated with OSA (P < 0.05).

Conclusion:
There is a significant association of OSA among patients with HTN. In addition, OSA was also linked with a higher frequency of other comorbidities such as diabetes mellitus and dyslipidemia. Hence, patients with HTN should be screened for undiagnosed OSA, especially if HTN is not responding to multiple drugs adequately.
A Formula for Estimating the Mesiodistal Width of Permanent Mandibular Central Incisors
Authors: Jadhav Vikrant , Tiwari Meenakshi , Seegavadi Vasudevan , Kamble Ranjit , Daigavane Pallavi 
Published: March 2023

Introduction:
A chieving acceptable occlusal contact during orthodontic treatment is very important. Tooth size ratios play a major role in the prediction of treatment outcomes.

Aim:
The aim of this study is to determine the mesiodistal width of missing mandibular central incisor.

Materials and Methods:
The study sample consisted of study casts of 300 participants in the age range of 18–30 years. Samples having a full complement of teeth with Angle's Class I molar and canine relationships, good intercuspation, normal overjet and overbite, and minimal crowding and spacing. Tooth dimensions were measured using a digital Vernier caliper. The data calculated were used for measuring schedule variance (SV) formula.

Results:
Based on the achieved data, SV formula is derived.

Conclusion:
For achieving esthetic profile, it is essential to calculate the correct mesiodistal width of the teeth. Ideal tooth proportions play an important role in achieving good occlusion at the end of orthodontic treatment.
Current Practice of Otolaryngologists during COVID-19 Pandemic
Authors: Saldanha Marina , Goutham MK , Kamath P Shrinath D , Aroor Rajeshwary , Manojan Sourabh 
Published: March 2023

Objectives:
The aim of the study was to determine current methods implemented by the otorhinolaryngologists in their outpatient practice, their mental wellbeing and recommend safe clinical practice based on current literature.

Materials and Methods:
Qualitative questionnaire study was conducted on otorhinolaryngologists working in various setups. The questionnaire had four parts including demographics, current ENT practice and precautions, mental wellbeing based on Coronavirus Anxiety Scale, and the COVID infection status.

Results:
Stress related to COVID did not affect the practice hours and consultation duration (P = 0.94). Nearly, 96% of the participants diligently followed hand hygiene and 87.4% stressed on the need of screening the patients before consultation. Although none of the participants had dysfunctional anxiety (score >9) on coronavirus anxiety scale, participants who had elders at home showed increased stress levels during the pandemic (P = 0.027). Participants with comorbidities did not show any elevated stress levels (P = 0.06). Endoscopic procedures (71.65%) and digital palpation of the oral cavity (42.3%) were the most stressful outpatient department procedures experienced by the participants. Although prophylactic medications were taken by 56.8% of participants, there was no association observed between comorbidities and prophylaxis (P = 0.57).

Conclusion:
The study highlights that otorhinolaryngologists are taking adequate precautions during the pandemic and the risk factors for anxiety were less due to a better understanding of coronavirus infection.
Antioxidant Status and Oxidative Stress in Hypothyroidism
Authors: Sankha Simlai , Kumar Yadav Manoj , Madhuri Agnihotri A. , Kumar Mohapatra Tapan 
Published: March 2023

Objectives:
Oxidative stress (SOX) in overt hypothyroidism (OHT) has been reported with unclear outcomes. Furthermore, the studies assessing SOX in subclinical hypothyroidism (SHT) were limited. Our present study was taken up to establish oxidative/antioxidative status in hypothyroids patients.

Design and Material and Methods:
One hundred and seventy-six patients with hypothyroidism diagnosed as OHT (n = 176) or SHT (n = 176) were included along with 176 healthy euthyroid controls. Serum lipid profile, malondialdehyde of plasma (MDA), protein carbonyls (PCO), glutathione reduced (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT), and antioxidant enzyme ratio SOD-to-(GPx + CAT) were projected.

Results:
Compared with euthyroid controls, hypothyroid patients had dyslipidemia, notably higher MDA concentrations and PCO, significantly reduced GSH, SOD, SOD/(GPx + CAT) ratio and a noteworthy increase in GPx activity. Although CAT activity in hypothyroids was unchanged when compared to euthyroid controls. In OHT patients, the SOX was markedly more when compared to SHT patients. MDA had a positively associated with excess TSH in the OHT group. fT3 and fT4 showed positive and negative correlation, respectively, with TC, whereas TSH showed a positive correlation with low-density lipoprotein cholesterol in the OHT group. PCO was seen to have positive relations with TSH and MDA in hypothyroids.

Conclusions:
We found increased peroxidation of lipid, carbonylation of protein, and diminished antioxidant defense system in hypothyroids. Higher points of SOX were seen in OHT patients than SHT patients. SOX was related to change in hormone condition related to hypothyroidism.
Predictive Accuracy of Neutrophil-to-Lymphocyte Ratio on Severity and Outcomes in COVID-19 Patients
Authors: D'Souza's Nikhil Victor , Haroon H. , Acharya Vishak , Unnikrishnan Bhaskaran , Mithra Prasanna , Mascarenhas Chrystle , Dhillon Navjot Singh , Tom Alex 
Published: March 2023

Background/Aims:
Neutrophil-to-lymphocyte ratio (NLR) is a proven marker in coronavirus disease 2019 (COVID-19) severity and mortality. However, the utility of a sequential NLR 2 (on day 5) in comparison to baseline NLR in predicting clinical outcomes and severity remains largely unexplored.

Methods:
This was a hospital-based retrospective observational study.

Results:
Higher mortality (19.9% vs. 48%) and a more severe disease (14.8% vs. 21%) were observed with elevated NLR 1 and NLR 2, respectively. NLR 2 at a cutoff of 9.88 was a better predictor of mortality, when compared to NLR 1 at 5.67, and NLR 2 has a strong correlation with mortality rates in COVID-19.

Conclusion:
Our study demonstrated that NLR 1 and NLR 2 were more reliable predictors of mortality than disease severity; in comparison, NLR 2 is a more accurate predictor of mortality than NLR 1. The study unravels the potential role of a sequential NLR 2, to have a better correlation in predicting the clinical severity and outcomes. The potential role of NLR 2 in assessing the interim progression of the disease and thereby initiating specific interventions at critical junctures to influence the outcome is unveiled and merits exploration in detail by larger studies.
Health-Related Quality of Life Among Medical Students
Authors: Thomas Joel , Nair Dhanushree , John Preetha , Beeran Rishtha , Simon Praisil 
Published: March 2023

Introduction:
Medical education appears to perpetuate stress through its intense academic workload, working with patients and grading systems. Various studies show that the stressful life of medical students can attribute to development of various ailments and deterioration of quality of life. The World Health Organization has defined quality of life as “individuals' perception of their position in life in the context of the culture and value systems in which they live and their relation to their goals, expectations, standards and concerns.

Aim:
To determine the health related quality of life of medical students and assess their mental status.

Material and Methods:
A descriptive cross sectional study was conducted among the undergraduate students of Jawaharlal Nehru Medical College. A total of 235 students from 2nd year MBBS and Final year part 1 MBBS participated in the survey. The study was conducted after obtaining written consent from the participants and permission from the Head of the Department to conduct the study.

Results:
The students who participated ranged from the age group of 17 years to 24 years, maximum being 21 years (30%), 164 of them were females. Sixty two percent of the students belonged to 2nd year. According to Beck's Depression Inventory, 23%(53) evaluated to have mild mood disturbances. Overall scores for all 8 domains ranged between 78.2 and 60.2. The maximum score was obtained in the Physical Function domain and the minimum score was obtained in the Role Limitation Due to Emotional Problems domain.

Conclusions:
The study shows that the quality of life, health related as perceived by the participants is low. Various factors may be associated with this, including time constraints for social activities, heavy workload and limited contact with family and friends. Deteriorated quality of life may affect the attainment of knowledge by the students, their performances as well as their future competencies as a clinician.
Effects of Electric Arc Welding and Laser Welding Under Argon Gas Shield on the Tensile Strength of Ni-Cr Alloys
Authors: Shetty Sneha Harish , Sushma R. , Sanyal Pronob 
Published: March 2023

Purpose:
Whether electric arc welded and laser-welded Ni-Cr alloys can resist tensile stresses in the oral environment is unknown.

Materials and Methods:
Sixty Ni-Cr bars (0.8 mm × 60 mm) with a circular cross-section were cut in half and welded using laser welding and electric arc welding. Fifteen bars from both the group were immersed in artificial saliva at pH 7 and pH 2 at room temperature for 60 days and remaining 15 samples were used as control. After the stress corrosion simulation, the tensile strength was determined using universal testing machine.

Results:
On comparison between the electric arc welded and laser welded samples, the laser welded samples showed a significant decrease in the tensile strength after simulation in artificial saliva (P = 0.05). Oral condition simulation did not affect the tensile strength of electric arc welded samples (P < 0.001).

Conclusion:
Oral simulation decreased the tensile strength of laser welded Ni-Cr bars.
Dexmedetomidine for Attenuation of Sympathomimetic Response to Laryngoscopy and Tracheal Intubation in Neurosurgical Patients
Authors: Sen Bitan , Sen Jayashree 
Published: March 2023

Background:
Stress responses caused by noxious stimuli during laryngoscopy and tracheal intubation can incite harmful effects, especially in neurosurgical patients. Among various drug regimens and techniques tried for obtunding such consequences, dexmedetomidine, an α-2 receptor agonist mediating its action through α-2A receptors located in locus coeruleus, inhibits noradrenaline release thus decreases such sympathetic activity.

Aim and Objective:
To evaluate the effect of a single preoperative dose of dexmedetomidine 1 μg/kg slow infusion on hemodynamic responses to laryngoscopy and tracheal intubation.

Materials and Methods:
Sixty patients randomized into two groups of 30 each of age range 20–60 years, the American Society of Anesthesiologists physical Status I and II posted for planned neurosurgical procedures, to receive dexmedetomidine (Group D): 1 μg/kg diluted with 0.9% saline to a total volume of 20 mL, control Group (C): 20 ml 0.9% normal saline, both infused intravenously over 10 min, 3 min before induction. Changes in heart rate (HR), systolic, diastolic, mean arterial pressure (MAP), and any side effect associated with the drug during the study of 20 min of intubation, were observed and statistically analyzed.

Results:
Insignificant difference (P > 0.05) in demographic criteria. In comparison to the baseline (BL) value, during laryngoscopy, a fall in mean HR by 12.1% in dexmedetomidine group and a rise of 28.39% in control group, reduction in mean systolic blood pressure value 11.40% in dexmedetomidine group, a rise by 19.50% in control group (P < 0.05), a fall in mean diastolic blood pressure by 11.19% in dexmedetomidine, in control group a rise of 16.97%, the difference is statistically significant (P < 0.0001), rise in the mean MAP value in the control group to 18.12% above the BL value but in Group D, it was reduced by 11.29% (P < 0.05).

Conclusion:
Infusion of dexmedetomidine, in attenuation of hemodynamic response to laryngoscopy and tracheal intubation, is a safe and effective protective method.
Correlation of Temporal Bone Fracture on Computed Tomography Scan with Hearing Loss in Posttraumatic Patients
Authors: Singh Rohan Kumar , Mishra Gaurav Vedprakash , Patwa Prerna Anup , Dhande Rajasbala Pradeep , Gowda K. B. , Singh Sonal , Goyal Aditi V. , Bele Akanksha 
Published: March 2023

Introduction:
Temporal bone fractures in adults are invariably due to motor vehicle accidents or road traffic accidents. Hearing loss is a common complaint following temporal bone fractures, but attention to it is frequently overlooked as there may be other life-threatening complications associated with it that may require immediate attention of the caregiver. Immediate detection of temporal bone fracture and its complications helps in providing early and effective treatment.

Aim:
The main objective of our study is to observe various types of fractures on multidetector computed tomography (CT), difference between various types, and classification of fractures of temporal bone with correlation between types of fracture and clinical hearing loss.

Methods:
Two-year (2019–2021) prospective study of head injured patients with temporal bone fracture presented to the Department of Radio-diagnosis (AVBRH, DMIMS, Wardha) with complaints of hearing loss was subjected for study. Temporal bone fracture patients satisfying inclusion and exclusion criteria having hearing loss were evaluated audiologically after a gap of 3 months following the initial injury once the patient was stable. Age and gender distribution, cause of injury, radiological findings, and clinical presentations were analyzed. Data were entered into Microsoft Excel data sheet and were analyzed using SPSS 22 version software.

Results:
Out of 173 patients having hearing loss with temporal bone fracture, majority of the patients were male (84.97%) and were between 20 and 39 years (46.24%) with a mean age of 41 years. The major cause of injury was motor vehicle accidents (84.39%). The right side was involved (49.1%) more than the left side (46.0%). Longitudinal type fracture was most frequent (64.74%). Otic capsule involvement was present in 9.25%. Conductive hearing loss was more common in otic capsule sparing and sensorineural hearing loss was more common in otic capsule-involved fractures. Otic capsule sparing was more common in (95.54%) longitudinal type of fracture. Otic capsule violation was more common in (26.09%) transverse type of fracture.

Conclusion:
This study suggests that image analysis of high-resolution CT can be used in fracture of temporal bone either to detect the hearing loss or to know the type and classify the fracture or to find the correlation between the types of fracture and clinical hearing loss.
Violence Against Doctors
Authors: Thapar Rekha , Hegde Kausthubh , Bhat Nishantha , Kumar Nithin , Unnikrishnan Bhaskaran , Mithra Prasanna , Holla Ramesh , Bhagawan Darshan 
Published: March 2023

Background:
Commercialization of medical care and lack of mutual trust between doctors and patients have led to a rise in acts of violence against health-care workers.

Materials and Methods:
In this facility-based cross-sectional study, 71 doctors and 71 patient caretakers were assessed about their perceptions of violence among doctors. Ethics committee approval was obtained before the commencement of the study. The study participants were interviewed using a semi-structured questionnaire. An independent t-test was applied to study the difference in the mean perception scores between doctors and patient caretakers and P < 0.05 was considered to be statistically significant.

Results:
A majority (n = 49, 69%) of the doctors in our study had personally faced aggression or violence at their workplace. More than half of the doctors who faced violence/aggression were postgraduates (n = 29, 59.2%). Patient caretakers were responsible for violence/aggression in the majority of the cases. The long waiting period in hospitals was the main reason perceived by the doctors (n = 45, 63.3%) and patient caretakers (n = 54, 76.1%) for the aggression/violence. Doctors strongly felt that the media played an important role in the rising violence against doctors by portraying them negatively (P < 0.05).

Conclusion:
Workplace violence against doctors is very prevalent in our setting and junior doctors are more at risk. Violence against doctors is overlooked outside of the health-care community and does not receive the due global attention it deserves.
An Observational Study of Metabolic Syndrome in Patients with Chronic Obstructive Pulmonary Disease
Authors: Ali Saood , Wagh Pankaj , Aurangabadkar Gaurang , Jadhav Ulhas , Adwani Sameer , Kadukar Juhi 
Published: March 2023

Introduction:
This observational study was done to study the patients having metabolic syndrome with chronic obstructive pulmonary disease (COPD).

Methodology:
A cross-sectional observational study was done which included all the patients having COPD by convenience sampling presented at the Respiratory Medicine Department in Acharya Vinoba Bhave Rural Hospital, a tertiary hospital in Sawangi (Meghe), Wardha, India, from November 2021 to January 2022. The patients having metabolic syndrome as per definition were studied, and appropriate statistical tests were applied.

Observation and Results:
A total of 124 patients were studied in total out of which 40 patients had metabolic syndrome. Out of 124 patients studied, 70 were females and 54 were males. Almost half of the patients were above 70 years of age and above. Out of 40 patients having metabolic syndrome, 18 were females and 22 were males.

Conclusion:
The study concluded that metabolic syndrome was present in a significant population of COPD; hence, with appropriate interventions, the morbidity and mortality of COPD may be reduced by reducing the occurrence of metabolic syndrome.
Online Teaching–Learning Assessment Practices
Authors: Gotarkar Shashank , Rawekar Alka , Taksande Avinash , More Akash 
Published: March 2023

Introduction:
Various modalities had been adopted by educational institutes, after declaration of pandemic of COVID-19 by the World Health Organization. Students of higher education cannot be prevented for their right to education due to this severe pandemic and its fallout thereat. All the educators across the Globe started with some or other modality of online learning to keep the pace of teaching–learning activities including examination. School of allied health sciences also tried various modes of teaching. To evaluate this, an online survey was conducted to find out the usefulness and effectivity of this modality.

Materials and Methods:
The study was cross-sectional which was conducted among students of the School of Allied Health Sciences, DMIMS, Wardha, during April–May 2021. The undergraduate and postgraduate students from first and second graduation years were randomly selected and all 200 students were approached through WhatsApp group after Institutional Ethics Committee approval. The responses received, were collated and analyzed in the form of descriptive statistics.

Results:
Out of 200 students, 186 had responded to survey questionnaire with response rate of 93%. For communication regarding time table, examination schedule, or interactions or participation, the mean percentage for accepting was 66.9%. However, their satisfaction with online mode was 40.89% only. Perception of helpfulness related to learning or flexibility was about 52%.

Conclusions:
Although some of the students had good perception for online teaching–learning assessment modalities, some of them did not agree for it and they wanted face-to-face teaching. This may be attributed to Internet connectivity issue or residing at rural places where specified bandwidth was not available.