bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing the Sensitivity of Palm Print Sign and Prayer Sign in Prediction of Difficult Intubation in Diabetic Patients
Authors: Singh Harjot , Dwivedi Deepak , Tandon Urvashi , Bhatnagar Vidhu , Jinjil Kavitha , Tara Swayam 
Published: December 2022

Background and Aim:
Palm print and prayer signs are manifestations of “limited joint mobility” syndrome caused by long-standing Type I and Type II diabetes mellitus. This study aims at finding out, which of the two signs is more sensitive for the prediction of difficult intubation in type II diabetes mellitus patients. The secondary objective is to correlate the above two signs with the Cormack–Lehane View during direct laryngoscopy and also to determine whether the duration of Type II diabetes mellitus correlates with difficult intubation in isolation.

Materials and Methods:
A prospective observational study was carried out in a tertiary care hospital. One hundred and fifty patients suffering from Type II diabetes mellitus, undergoing elective general anesthesia with endotracheal intubation, were enrolled in the study. The correlation between Palm print and Prayer sign with Cormack and Lehane grades was studied using the Chi-square test, continuity correction, and Fisher's exact test. The diagnostic efficacy of intubation difficulty for both the signs was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio.

Results:
The palm print sign was found to be a better indicator of difficult intubation in type II diabetes mellitus patients (P < 0.01). The duration of Type II diabetes mellitus was found to be associated well with difficult intubation (P = 0.007).

Conclusion:
Palm print sign is the single most important test for predicting difficult intubation in Type II diabetes mellitus patients. Duration of Type II diabetes mellitus itself correlates well with difficult intubation.
Role of Aminoglycosides in Management of Ventilator-Associated Pneumonia Caused by Klebsiella Pneumoniae
Authors: Kataria Shaveta , Rajni Ekadashi , Thandi Priyanka , Kumar Mohit , Kulhari Garima 
Published: December 2022

Background and Aim:
Ventilator-associated pneumonia (VAP) is considered as a sub-category of healthcare-associated infections and is associated with high morbidity and mortality. Acinetobacter baumannii complex and Klebsiella pneumoniae (K. pneumoniae) are known to be the most important causes. During the last few decades, polymyxins have represented the most commonly used antimicrobial options against multidrug resistant K. pneumoniae. However, in some cases, aminoglycosides were also found to be effective.

Materials and Methods:
This retrospective observational study was conducted in a tertiary care hospital in Jaipur from June' 2020 to June' 2021. All endotracheal (ET) aspirate samples from the clinically suspected cases of VAP received in microbiology laboratory were processed using the standard procedures and relevant medical records were reviewed. VITEK 2 automated system was used for the bacterial identification and antimicrobial susceptibility testing.

Results:
Out of 705 ET aspirate samples received during the study period, 467 were found culture positive. Majority 304 (98.1%) were Gram-negative isolates, while only 6 (1.9%) were Gram-positive. 156;51.3% isolates belonged to A. baumannii complex, followed by K. pneumoniae (73;24.0%). Antimicrobial susceptibility profile of 73 K. pneumoniae isolates to aminoglycosides was noted. Out of 73 isolates, 42 were found to be resistant to both gentamicin and amikacin, 12 isolates were sensitive to both, while 19 isolates showed variable susceptibility.

Conclusion:

K. pneumoniae is an important causative agent of VAP. While polymyxins have an important role in the management of such cases, aminoglycosides need to be given a careful consideration. They can constitute an effective polymyxin sparing regimen, especially for carbapenem-resistant isolates.
Addressing the Need to Develop Critical Thinking Skills in the New Competency-Based Medical Education Post Graduate Curriculum in Pathology
Authors: Kelkar Anjali J , Bhandary Shital , Chacko Thomas V 
Published: December 2022

Background and Aim:
Ability to integrate and apply knowledge to clinical practice is recognized as a core competency under the new CBME curriculum and assessment of critical thinking skills is an essential component. Script Concordance Test (SCT) is recognised as an appropriate assessment tool for measuring critical thinking. Since in India, SCTs for testing critical thinking in the Postgraduate curriculum in Pathology, have not been developed, we worked on developing such test in the setting of a busy referral hospital attached to Medical College in Western India.

The study aimed at
1. Piloting the development of script concordance test to test critical thinking ability and clinical reasoning skills in haematology. 2. Experience sharing of the process of development and validation of the test to enable others to replicate for other topics in pathology.

Materials and Methods:
After obtaining Ethical clearance, SCT for the topic Coagulation was constructed by following the guidelines from AMEE Guide 75. The experts' reactions and their satisfaction about the test were obtained. Pilot testing was done with post graduate students after informed consent. The students' reactions and satisfaction were obtained after taking the test. The analysis was performed using the excel workbook available from a web link maintained by the SCT creators. Item analysis and group comparison was also done.

Results:
Analysis performed with 22 vignettes having 66 items revealed a statistically significant difference between the scores of the experts and the students. Internal consistency reliability (Cronbach's α) was 0.86 whereas Effect size (Cohen's d) was 1.9 with 34% overlap in the items and superiority probability of 91%. Item analysis classified 23 items as “Bad”, 11 items as “Fair” and 32 items as “Good” based on the “item-total correlation” statistic. Re-analysis after removing the bad items, increased Cronbach's α to 0.91 and Cohen's d to 3.9; whereas overlap decreased to 5% and probability of superiority reached 100%.

Conclusion:
Development of a reliable and valid SCT for coagulation was a complex but rewarding process. The analysis of the test required inputs from the statistical experts. Using AMEE Guide 75 and our in-detail description of the process of development, optimisation and validation of script concordance test will enable faculty in many specialities to develop and include it for use in their respective fields.
Using Qualitative Research for Curricular Redesign of Communication Skills Training in a Dental School
Authors: Sriranga Jyotsna , Chacko Thomas V. 
Published: December 2022

Background and Aim:
Poor patient-health care provider (HCP) communication skills are a major contributor for noncompliance, lack of trust and sometimes even violence against the HCPs. The students are expected to pick up communication competency through observation and self-learning. In this context, there is a need to bring in the implicit curriculum to the ambit of the explicit curriculum. Here, the focus was on “listening” to the stakeholder's voice to establish the need for explicit communication skills training and justify its importance to professional practice.

Materials and Methods:
A socioconstructivist world-view and qualitative research methodology was adopted. The method of data collection was interviews and focus group discussions. The dean, teaching faculty, students, and patients were interviewed until data saturation. The data were transcribed and a team of 3 coders coded the data manually using inductive methods.

Results:
This study identified the gaps in the existing curricular framework for teaching communication skills. Six major themes emerged from the research. The research process served as a tool to leverage on the gaps identified and build a customized communication skills training program for students.

Conclusion:
The process of qualitative research involves the extensive interviews and discussions with stakeholders to better understand the underlying issues. It initiates dialogs and helps to co-construct solutions to the educational problems. Such self-discovered solutions for change in curriculum that emerges from key stakeholders from within the institution, they are more likely to be accepted, adopted and “institutionalised”.
A Retrospective Analysis of Moderate and Severe COVID-19 Pneumonia with Special Reference to the Use of Adjuvant Tocilizumab
Authors: Raval Pratik , Panakkal Benny Jose , Joshi Dinesh , Natrajan Karthik , Shukla Anand , Dubey Gajendra , Sahoo Sibasis , Bajpai Subhendu 
Published: December 2022

Background and Aim:
Coronavirus disease 2019 (COVID-19) pneumonia is associated with a hyper-inflammatory syndrome which may cause life-threatening acute respiratory distress syndrome. The aim of this study was to evaluate the safety and efficacy of an anti-inflammatory agent, tocilizumab (TCZ), a monoclonal antibody that targets the interleukin 6 receptor.

Materials and Methods:
We included 53 patients admitted between April and July 2020 with COVID-19 pneumonia who received TCZ. Patients received one intravenous infusion of TCZ, dosed at 8 mg/kg, up to a maximum dose of 800 mg. All patients were evaluated with clinical, laboratory, and radiological parameters.

Results:
Out of 53 patients 28 (52.8%) had severe disease and 25 (47.2%) had the moderate disease. The mean age was 55 years. The most common presenting symptom was fever (73%; n = 39). C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), d-dimer, and ferritin levels were elevated at baseline. After TCZ administration CRP, ferritin and NLR levels reduced significantly whereas d-dimer levels did not fall. Pulmonary fibrosis may be observed later in the course of the disease. All the mortality occurred in patients who had severe disease on presentation. There was no difference in outcomes according to gender, diabetic status, and presence of preexisting cardiac disease.

Conclusion:
Overall, TCZ administration is safe and effective in improving clinical and laboratory parameters with a possible reduction in the need for ventilatory care and duration of intensive care unit stay, particularly in patients with moderate severe acute respiratory syndrome coronavirus- 2 disease. However, our results should be considered preliminary and should be interpreted with caution as they stem from an uncontrolled series.
Prevalence and Predictors of Cyberchondria and Depression Amid COVID-19 Pandemic in Adult Population of Uttar Pradesh, India
Authors: Srivastava Saumya P. , Tiwari Surya Kant , Negi Monika 
Published: December 2022

Background and Aim:
COVID-19 pandemic and related measures of containment such as lockdown led to heavy reliance on Internet for education and leisure activities. This study aimed to assess the prevalence and predictors of cyberchondria and depression amid COVID-19 pandemic among adult population of Uttar Pradesh, India.

Materials and Methods:
A web-based study was conducted among 236 adult participants of Uttar Pradesh during August–November 2021. Standardized tools including Cyberchondria Severity Scale-short version (CSS-SV) and Patient Health Questionnaire-9 were used for eliciting details about cyberchondria and depression.

Results:
The study highlighted that the cyberchondria cluster comprised 45.3% of participants. Subscale score distribution of CSS-SV was found to be the highest (7.53 ± 2.98) for excessiveness and the lowest (6.40 ± 2.93) for compulsion subscale. Furthermore, majority (56.4%) of the participants had depression in various severities. Multivariate logistic regression analysis predicted factors such as female gender, health-care worker, and duration of watching TV and smartphone usage to be influencing cyberchondria. Strong influence of duration spent (>6 h/day) in watching TV, etc., was found on depression.

Conclusion:
Cyberchondria and its association with depression are indeed growing health concerns; efforts should be directed toward controlled Internet usage, which involves adhering to credible sources for authentic health-related information.
Comparison of Nutrition Risk Screening 2002 and Subjective Global Assessment for Predicting Postoperative Complications Among Patients Undergoing Elective Abdominal Surgery
Authors: Raghuraman Hemamalini , Kavyashree M. , Balakrishnan Gurushankari , Elamurugan T. P. , Shankar Gomathi , Nanda Nivedita , Thulasingam Mahalakshmy , Kate Vikram 
Published: December 2022

Introduction:
Malnutrition leads to poor outcomes in surgical patients, leading to negative impact during the postoperative period. Nutrition Risk Screening (NRS) 2002 and Subjective Global Assessment (SGA) are novel tools to assess nutrition risk which have the potential to predict the postoperative complications in surgical patients.

Aim:
This study was carried out to determine the efficiency of the NRS 2002 and SGA in predicting postoperative complications.

Materials and Methods:
A prospective cohort study was conducted to assess the nutritional risk of patients aged 18 years and above who underwent elective abdominal surgery. NRS 2002 and SGA were used for nutritional screening. Univariate analysis was carried out to determine the relative risk (RR) of complications for each variable. Receiver operating characteristic (ROC) and area under curve (AUC) were plotted for NRS 2002 and SGA to identify the score for the former and grade for the latter that predicted complications postoperatively. The correlation of malnutrition with surgical outcomes was performed to determine their association.

Results:
A total of 320 patients were included in the study. Among the patients who underwent elective abdominal surgeries, 39.4% of the total number developed postoperative complications. The most prevalent were Grade 2 complications, which accounted for 69.1% of all such events. Postoperative complications were recorded in 75.5% of the patients identified as at risk by NRS 2002, with a RR of 5.3 (95% confidence interval [CI]: 3.7–7.6; P < 0.001). Complications were found among 68.3% of those who were malnourished by SGA, with a RR of 4.2 (95% CI: 3.0–6.0; P < 0.001). The ROC curve for NRS 2002 to determine the complications had an AUC of 0.80. A score of 3 was the optimal cutoff of NRS 2002 for predicting complications with a maximum sensitivity of 93.6%. Similarly, the ROC curve for SGA grades to determine complications had an AUC of 0.79. Grade B was the best cutoff, with a sensitivity of 77.0%.

Conclusion:
Patients with NRS 2002 scores higher than or equal to 3 and SGA Grades B and above had a higher incidence of postoperative complications in patients undergoing elective abdominal surgeries. Hence, NRS 2002 and SGA are reliable nutrition risk assessment tools for predicting postoperative outcomes.
RITUAL MATTAMPUNG: MENALAR GAP DI KALANGAN MASYARAKAT SOPPENG RIAJA DI BARRU SULAWESI SELATAN
Authors: Nasruddin  
Published: December 2022

The mattampung ritual is a practice of beliefs and traditions carried out by the Bugis in order to remember the spirits of the deceased by reciting prayers or verses of the Qur'an in order to gain salvation and get the right place by the side of Allah. The purpose of this study is to reveal an understanding of the ritual of mattampung among the people. This type of research is qualitative usingnormative theological proximity which is then supported by an interview with a local scholar. The results of this study revealed that the rituals of mattampung can be studied based on legal sources. The first source of law based on naqly's postulates is the Qur'an and hadith. While the second source of law is the aqly postulate which is the source of law based on reason. later, developed by the scholars of ushul fiqhi on the basis of ijtihad. The difference in people's understanding of the death ritual in Soppeng Riaja District, Barru Regency, is because on the one hand that the ritual is an Islamic culture by relying on two postulates, namely the naqli postulate (al-Qur'an and Hadith) and also the aqli (reason consideration) postulate which is used by ushul fiqhi scholars as one of the sources of Islamic law, namely al- Urf' (the establishment of laws based on customs and traditions carried out by the local people).
Association of IL-β1, PGj2 Among Patient with First Episode Psychosis (Case-control study)
Authors: Mahdi Al Har Sumeiya 
Published: December 2022

Background: A first episode of psychosis is the primary point in time a person experiences a psychotic period. it is frequently very confusing. frightening and distressing, particularly for the reason that it is an unusual experience. unluckily, there are moreover many negative misconceptions and stereotypes linked with psychosis that can additional to one’s distress. Aim of the study Investigate the association between some inflammatory biomarkers with first episode psychosis (FEP) and to find out the correlation with different socio demographic profile
Methods: A case-control study was involve patients with first episode psychosis and healthy control. peripheral Blood samples collected from 44 cases they were attending AL-Hakeem General hospital, Psychiatric Department, in the period between January, 2019 to may, 2019. the cases included females and males, and the age was 18-70 years. Control: 44 healthy controls who had no history or clinical evidence of fist episode psychosis or any other disease.
Results: revealed that increase in the level of Interlaken β1, and decrease PGJ-2 among FEP patients (1591.8±108.6, and 3.82±0.36) respectively in comparison to control were mean (554.8±54.8, and 9.94±0.67).
Conclusion: The inflammatory response is an immune system that allow the individual to cope with various menacing advise, but in long-lasting conditions and pathological, the continuous of this stimulate could develop into harmful. The regulation of the all development involves endogenous counter-balancing mechanisms that control special effects of deleterious pro inflammatory mediators. information showing a misbalance in some pro inflammatory/anti inflammatory in blood of person with FES.
Evaluation Of Knee Meniscal Tear Frequency In Symptomatic Patients Setting MRI As Gold Standard
Authors: Javed Sana 
Published: December 2022

Background: Physical activities like sports gymnastics games, cycling, brisk walking, and running has always been a fun and important activities for people’s health and especially when it became their occupation. Due to increased unhealthy eating disorders in people, they have developed an unhealthy weight which is causing them to be weakened and causing pain especially at joints. For the diagnosis conventional radiography was never helpful because it is not for soft tissues whereas MRI is been using in muscoskeletal as modality of choice.
Methods: total 600 patients were included in this prospective study with acute knee pain held at Lahore. 1.5 T MRI is used to rule out meniscal tears. Duration was of one year. Scans were reported by 2 expert radiologists and spss version 25.0 is used for frequency analysis. Asymptomatic patients were excluded from this study.
Results: Knee meniscal tear frequency was ruled out in symptomatic patients including acute knee pain. Frequency was determined from 600 patients by determining male and female in them. Positive meniscal tear findings were discriminated by negative meniscal tear findings. Men has high ratio of meniscal tears because of many factors as compared to women.
Conclusion: Jumping, supports, running and high intensity physical activities can be the cause of meniscal tear. Early evaluation of tear is necessary for the treatment of symptoms such as acute knee pain etc. Magnetic resonance imaging is non- invasive useful muscoskeletal imaging modality which can detect the tear even at very small grade such as grade 1.
Awareness Of Thalassemia In Male And Female Students
Authors: Qayyum Rimsha 
Published: December 2022

Objective:-Objective of this look at is to access the awareness stage of Thalassaemia in University college students. Method: Study design was chosen to be crosssectional prospective. Sample size for this study was taken as 64. . A wellstructured:data collecting form or questionnaire was created, analysedand filled out during the interview.The data was summarized using descriptive statistics. Results The total 64 cases of all age groups were enrolled in this study. The are 64 cases of all age group are involved in this study in which there are 21 male (32.8%) and 43 females (67.2%). In this survey out of 64 persons 53 persons know about thalassemia. 5 people know about thalassemia gene. 40 persons know that thalassemia is inherited from parents. 53 persons know that thalassemia is blood related disease. 45 persons know severe anaemia is the clinical presentation of thalassemia. 25 persons know about the permanent treatment of thalassemia. 37 persons know that thalassemia is treated by bone marrowtransplantation.However, the study findings revealed that education status had a substantial impact.
Conclusion:- Females have more awareness about thalassemia then man.
Frequency Of Splenomegaly In Patients With Abdominal Ultrasound
Authors: Saleem Sumbal 
Published: December 2022

Aims and objectives: To find out the frequency of splenomegaly in patients with abdominal ultrasound Methods: This prospective cross-sectional study was conducted at the Radiology Department of City Care Hospital in Gujranwala. A total of 65 participants with pain in the left upper quadrant were included in the study. Patients ranged in age from 21 to 75 years old, with 37 men and 28 females. Statistical analysis was then performed using SPSS. In individuals with left upper quadrant pain, the frequency of splenomegaly is calculated. Results: Out of 65 patients who presented with splenomegaly, positive cases for splenomegaly reported were 26 and negative cases were 39
Conclusion: For detecting splenomegaly, sonography is a good modality with numerous advantages. It is nonionizing radiation free, relatively inexpensive, widely available, and simple to use, with a high diagnostic effectiveness. Patients who have complained of abdominal pain have been concluded.
Inhibition of hepatic energy metabolizing enzymes in murine model exposed to diisononyl phthalate
Authors: Kehinde Samuel , Ore Ayokanmi , Olayinka Ebenezer , Olajide Abosede 
Published: December 2022

Background and objectives: Diisononyl phthalate (DINP) is a class of phthalates and phthalates are known to be metabolism disrupting chemicals (MDCs). Numerous MDCs, to which humans are exposed, have an effect on every aspect of energy transduction. They affect the liver by impairing insulin secretion in pancreatic cells and altering the liver’s insulin-dependent glucose metabolism.
Methods: For this study, eighteen male albino rats weighing 200±20g were randomly assigned to three groups (of six rats each) and followed for a 14-days period. The groups were: group A or control which was given Tween-80 orally, group B or DINP1 group which was given 20 mg/kg b.wt. DINP, and Group C or DINP2 group which received 200 mg/kg b.wt. DINP. The rats were then sacrificed, their livers were removed, and the glycolytic and oxidative phosphorylation enzyme activities were evaluated.
Results: Activities of the glycolytic, tricarboxylic acid cycle and electron transport chain enzymes under investigation were significantly down-regulated with severity observed in decreased activities of hepatic oxidative phosphorylation enzymes when compared with control (P<0.05). Hepatic tissue sections of 20 and 200mg/kg DiNP group revealed distorted cytoarchitecture of hepatocytes ranging from histocellular disarrangement to vaocular changes suggestive of loss of liver integrity or fibrosis.
Conclusions: Finally, DINP exposure impairs hepatic energy transduction enzymes as evident in down-regulation of the various enzymes of energy metabolism under investigation and this may invariably be a good tool for the diagnosis of hepatic energy impairment as seen in some disease conditions.