bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rasch development and validation of the “Medellín Dry Eye Inventory” (ME·Dry), an instrument to measure multidimensional quality of life compromise in patients with dry eye disease
Authors: Balparda Kepa , Herrera-Chalarca Tatiana , Cardozo-Dávila Ximena , Pacheco Maria A , Godin Fernando , Nicholls-Molina María A 
Published: April 2023

Purpose:
Dry eye disease (DED) is a common condition that affects the quality of life. There is a great need for better-developed scales that comply with Rasch model requirements.

Methods:
Prospective study including patients with DED. A series of focus groups were performed to determine the best items to be included. A Rasch modeling methodology was used to validate the Medellín Dry Eye Inventory (ME·Dry). After iterative analysis and scale modification, a final version of the scale was attained which complied with the Rasch analysis expectations. Correlation between the different subscales of the ME·Dry and the Ocular Surface Disease Index (OSDI) was evaluated through Spearman correlation.

Results:
A total of 166 patients with DED were included. Rasch modeling demonstrated an excellent behavior for the ME·Dry, including four subscales: Symptoms, Triggers, Activity Limitation, and Emotional Compromise. Infit and Outfit parameters were all between 0.50 and 1.50, with excellent category utilization. Person and item separation and reliability were excellent for all subscales. There was a need for a category collapsing for the Emotional Compromise subscale. There was a strong correlation between the different subscales of the ME·Dry except for the Emotional Compromise subscale, which seems to be independent.

Conclusion:
The ME·Dry is a reliable scale, complying with the Rasch model expectations, that allows for a reliable measurement of quality of life compromise in patients with DED. Emotional compromise secondary to DED does not seem to correlate with disease severity as assessed by the other quality-of-life subscales.
Dry eye parameters measured with an ocular surface analyzer in eyes after vitrectomy for vitreomacular interface disorders
Authors: Nawrocka Zofia A , Dulczewska-Cichecka Karolina , Nawrocka Zofia , Nawrocki Jerzy 
Published: April 2023

Purpose:
Dry eye disease (DED) might be caused by multiple ocular surgical interventions. The aim of the study was to estimate the extent of DED in patients undergoing core vitrectomy for vitreoretinal interface disorders.

Methods:
In this prospective observational study, we included patients with 12 months of follow-up after vitrectomy. The following data were collected as controls: age, sex, best-corrected visual acuity before and after surgery, and phakic status. In OSA (ocular surface analysis), the following parameters were evaluated: NIBUT (non-invasive tear break-up time), sltDear (thickness of the lipid layer), Meibomian gland (MGD) loss, and the height of tear meniscus. Shapiro–Wilk test, Wilcoxon rank-sum test, and Mann–Whitney U tests were used for statistical analysis.

Results:
We evaluated 48 eyes of 24 patients (10 men, 14 women; 64.63 ± 14.10 years) 1 year after vitrectomy. From the analyzed ocular surface parameters, NIBUT was significantly lower in operated versus non-operated eyes (P = 0.048). The higher the level of difference in MGD loss between both eyes, the higher the level of difference in NIBUT between both eyes (rs = 0.47, P = 0.032).

Conclusion:
NIBUT levels were still decreased 12 months after vitrectomy. Patients with more pronounced MGD loss or decreased NIBUT levels in the fellow eye were more likely to experience such disorders. The tear meniscus height was lower in patients undergoing surgery for retinal detachment than in those with vitreoretinal disorders. This might allow the suggestion to include artificial tears in pre- and post-operative care in vitrectomized eyes.
Assessing clinical and molecular outcomes of prophylactic thermal pulsation therapy on ocular surface health following refractive surgery
Authors: Shetty Rohit , Khamar Pooja , Nair Archana Padmanabhan , Pandian Packiya Raj , Vaidya Tanuja Arun , Trivedi Divya , Sethu Swaminathan , Roy Subhasita , Mahajan Sanjay , Shirodkar Sailie 
Published: April 2023

Purpose:
To study ocular surface signs, symptoms, and tear film composition following prophylactic thermal pulsation therapy (TPT) prior to refractive surgery, and to compare these outcomes with those who underwent TPT after refractive surgery.

Methods:
Patients with mild-to-moderate evaporative dry eye disease (DED) and/or meibomian gland dysfunction (MGD) undergoing refractive surgery were included. Group 1 patients received TPT (LipiFlow) prior to laser-assisted in situ keratomileusis (LASIK; n = 32, 64 eyes), and Group 2 patients received TPT three months after LASIK (n = 27, 52 eyes). Ocular Surface Disease Index (OSDI) score, Schirmer’s test (ST1, ST2), Tear Breakup Time (TBUT), meibography, and tear fluid were obtained preoperatively and at three months postoperatively in Groups 1 and 2. Additional postoperative evaluation was performed three months after TPT in Group 2. Tear soluble factor profile was measured by multiplex enzyme-linked immunosorbent assay (ELISA) using flow cytometry.

Results:
Postoperative OSDI score was significantly lower and TBUT was significantly higher when compared with matched preoperative values of Group 1 participants. On the other hand, the postoperative OSDI score was significantly higher and TBUT significantly lower when compared with matched preoperative values of Group 2 participants. TPT significantly reduced the postoperative elevation in OSDI and significantly reduced the postoperative reduction in TBUT in Group 2 participants. Tear Matrix metalloproteinase-9/ Tissue inhibitor matrix metalloproteinase 1 (MMP-9/TIMP1) ratio was significantly higher, postoperatively, when compared with matched preoperative levels in Group 2. However, MMP9/TIMP1 ratio remained unaltered in Group 1 participants.

Conclusion:
TPT prior to refractive surgery improved postsurgical ocular surface signs and symptoms and reduced tear inflammatory factors, thereby suggesting the plausibility of reduced post-refractive surgery DED in patients.
Nexus of ocular motility and dry eye
Authors: Gorimanipalli Bhavya , Muthu Sumitha , Shetty Rohit , Ranade Reshma Raghunath , Khamar Pooja 
Published: April 2023

Purpose:
To evaluate the effectiveness of vision therapy (VT) in patients with chronic presumed refractory dry eye disease (DED) and concurrent nonstrabismic binocular vision anomalies (NSBVAs). To propose an algorithmic approach to manage patients with refractory DED.

Methods:
Thirty-two patients with chronic (>1 year) presumed refractory DED and NSBVA were prospectively evaluated. The baseline dry eye evaluation and comprehensive orthoptic evaluation were done. VT was administered by a trained orthoptist for 2 weeks. The binocular vision (BV) parameters and percentage subjective improvement were assessed after the VT.

Results:
On evaluation, 12 patients (37.5%) had both DED and NSBVA, and 20 patients (62.5%) had only NSBVA. Twenty-nine patients (90.62%) showed significant improvement in BV parameters following VT. Binocular near point of accommodation (median, range) improved from 17 (8–40) to 12 (5–26) mm (P value < 0.0001), and near point of convergence (median, range) improved from 6 (3–33) to 6 (5–14) (P value 0.004) with VT. Thirty-one patients (96.87%) reported symptomatic improvement after VT, and 62.5% of these showed more than 50% improvement in symptoms.

Conclusion:
The present study confirms the beneficial role of VT in the treatment of patients with DED with concurrent NSBVA. It is essential to diagnose and treat NSBVA in patients with DED to ensure complete relief of symptoms and patient satisfaction. As there is a significant overlap between symptoms of dry eye disease and that of NSBVA, a complete orthoptic evaluation is recommended in all patients presenting with refractory dry eye disease related symptoms.
Somatoform Disorders and Expressed Emotions in the Family: Results from a Cross-Sectional Observational Study to Evaluate a Novel Relationship
Authors: Gupta Manushree , Saluja Jasdeep , Dhiman Rupam , Singh Shagun , Kumar Kuldip 
Published: April 2023

Abstract

Background:
Expressed emotions (EEs) in the family affect the presentation and course of psychiatric disorders. Somatoform disorders with their psychosocial origins may be caused or perpetuated by family dynamics like EEs.

Aims:
The study aimed to assess the prevalence, type, and levels of EEs in the families of patients with somatoform disorders.

Methods:
One hundred and six adult patients with somatoform disorders (F45; ICD-10) and their family member were recruited for the study. Patients with any comorbid medical or psychiatric disorder and substance use disorders (except tobacco dependence) or subjects living alone were excluded from the study. The study participants were assessed for somatoform disorders and EEs using a sociodemographic proforma, Mini-International Neuropsychiatric Interview structured interview, Patient Health Questionnaire-15 (PHQ-15), Family Emotional Involvement and Criticism Scale, and perceived criticism measure (PCM). Final analysis was done using statistical tests including Chi-square test, Fisher’s exact test, Student’s t-test, Pearson’s correlation coefficient, and univariate and multiple regression analysis. P ≤ 0.05 was considered to denote statistical significance.

Results:
The most common somatoform disorder in the sample was somatization disorder (33%) followed by persistent somatoform pain disorder (18.87%) and undifferentiated somatoform disorder (15.09%). Age (P = 0.007), married status (c2 = 6.752, P = 0.034), and a diagnosis of hypochondriacal disorder and somatization disorder (c2 = 14.613, P = 0.023) were significantly associated with perceived criticism (P < 0.05), while emotional overinvolvement (EOI) was high in subjects with somatoform autonomic dysfunction disorder (21.75) (P < 0.05). Significant positive correlation was seen between PCM and PHQ15 (severity measure) scores (r = 0.209; P = 0.032).

Conclusions:
Moderate level of EEs were found in the families of patients with somatoform disorders with the association being significant for criticism in hypochondriacal and somatization disorders and for EOI in somatoform autonomic dysfunction disorders. The hypothesis needs further study with follow-up and stronger statistical models to establish causation.
Eye Tracking as a Tool for Assessing Social Cognition: A Case-Control Study Comparing Patients with Psychosis and Healthy Controls
Authors: Tom Ashlyn , Narnoli Shubham , Verma Rohit 
Published: April 2023

Abstract

Background:
Eye movement dysfunction is a common abnormality in Schizophrenia and other psychotic disorders. Various eye movement paradigms can be used to measure predefined parameters using eye trackers. The current study intends to understand the eye movement characteristics in individuals suffering from psychosis using newer eye-tracking instruments with better precision.

Methodology:
In this study, we included 29 individuals meeting the diagnostic criteria for schizophrenia spectrum and other psychotic disorders based on the clinical assessment as per Diagnostic and Statistical Manual of Mental Disorders, 5th Edition along with 29 age- and gender-matched healthy controls and measured various eye tracking parameters using a Tobii Pro Spectrum. We compared the eye-tracking parameters between both groups.

Results:
There were significant differences between the groups in the free-viewing task. The average duration of fixations was higher, whereas the number of fixations and total amplitude of saccades was found to be reduced in the patient group. The peak velocity of the first saccade was also seen to be reduced in the patient group. However, there were no abnormalities in the anti-saccade, predictive saccade, memory saccade, and smooth pursuit tasks. Eye movement parameters were also found to be significantly correlated with the cognitive task measurements.

Conclusion:
These findings confirm the presence of eye movement abnormalities in psychosis spectrum disorders and their role in cognitive deficits in psychosis. Altered free viewing may be linked to deficits in social cognition found in patients with schizophrenia.
Hemolacria as a Rare Presentation of Dissociative Disorder
Authors: Sachdeva Diksha , Shah Ruchita , Singla Himanshu 
Published: April 2023

Abstract
Hemolacria is a rare manifestation of dissociative disorder. Aim of index report was to present clinical findings in a 13-year old female and explore the socio-cultural meaning associated with this phenomenon. Eclectic psychotherapeutic approach was implemented to address the symptoms. To conclude, physical symptoms presenting in dissociative disorder may be conceptualized in socio-cultural context.
Assessment of Suitability of Indian Disability Evaluation Scale (IDEAS) to Assess Disability among Persons with Alcohol use Disorders
Authors: Singh Shalini , Modak Tamonud , Sarkar Siddharth , Balhara Yatan Pal Singh 
Published: April 2023

Abstract

Background:
Alcohol use disorders (AUD) contribute substantially to the global disease and disability burden. The Indian Disability Evaluation and Assessment Scale (IDEAS) has seldom been used to measure disability in those with AUDs.

Objectives:
To assess the validity of IDEAS to quantify disability among persons with AUDs by measuring the level of agreement between IDEAS and World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0).

Materials and Methods:
A cross-sectional measurement of disability and quality of life (QoL) measures was carried out among those seeking treatment for AUDs. Correlational analyses and Bland–Altman plot analysis were done to measure the level of agreement between IDEAS and WHODAS2.0.

Results:
The scores on the WHODAS and IDEAS show statistically significant positive correlation (Rho: 0.435, P = 0.0001) indicating convergent validity. There was a significant level of agreement of disability scores using both tools. The IDEAS score had significant negative correlation with the brief version (WHOQoL BREF-Hindi) measures (Rho: –0.301, P = 0.003) indicating divergent validity. Those with greater severity of AUD had higher IDEAS scores (b = 1.9, P = 0.046).

Conclusions:
IDEAS scores correlate with disability scores measured with WHODAS 2.0 and QoL assessment using WHOQOL-BREF Hindi in those with AUDs. This instrument can be used to quantify disability and provide socioeconomic compensations to these individuals.
Effect of Age of Gravida on Post-Cesarean Section Pain: An Observational Study
Authors: Kasim Mohammad , Malviya Deepak , Nath Soumya Sankar , Misra Shilpi , Kumar Suraj , Parashar Samiksha , Singh Neetu 
Published: April 2023

Objective:
Preoperative identification of women at greater risk of post-cesarean pain might allow more intensive analgesic interventions. This study aimed to assess the effect of age of a parturient on post-cesarean section (CS) pain.

Methods:
100 pregnant females were enrolled and divided into 4 groups: group A (age 18–24 years), group B (25–30 years), group C (31–35 years), and group D (≥36 years). Patient-controlled epidural analgesia was started postoperatively in all patients. Pain on a 0- to 10-point visual analog scale (VAS), a number of attempts tried for patient-activated dose delivery of ropivacaine, and successful delivery of patient-activated dose of ropivacaine were recorded for 72 hours. Breastfeeding was initiated as early as possible. The effect of breastfeeding on post-CS pain was observed for 72 hours in terms of increase, decrease, or no change in VAS scores with breastfeeding.

Results:
The peak VAS scores over 72 hours were 4.10 ± 0.60, 4.00 ± 0.67, 3.75 ± 0.45, and 3.42 ± 0.67, respectively, in groups A, B, C, and D, showing a significant declining trend (P = 0.007). The mean VAS scores decreased from 4.08 to 1.69 (group A, P < 0.0001), from 4.00 to 1.64 (group B, P < 0.0001), from 3.67 to 1.25 (group C, P < 0.0001), and from 3.33 to 1.50 (group D, P < 0.0001) over 72 hours. A statistically significant decline in patient-activated rescue drug delivery attempts, the number of times the rescue analgesic was delivered, and 24-h cumulative ropivacaine dose requirement was seen.

Conclusions:
In this study, it was found that post-cesarean pain decreases significantly with increasing age, as evidenced by reduced pain scores, reduced attempts at rescue drug delivery, and reduced rescue analgesic requirements.
A Randomised Comparative Study to Compare the Prophylactic use of Phenylephrine and Norepinephrine in Caesarean Delivery under Spinal Anaesthesia
Authors: Ali CV Soabir , Bajaj Jeetendra Kumar 
Published: April 2023

Background:
To compare the efficacy and safety of prophylactic intravenous infusions of phenylephrine (0.1 mg/kg/min) and norepinephrine (NE) (0.05 mg/kg/min) for the management of maternal hypotension under spinal anesthesia for cesarean delivery.

Methods:
A prospective randomized comparative interventional study was conducted on 100 pregnant patients who underwent elective/emergency cesarean section under the sub-arachnoid block. The study patients were randomly allocated into two equal groups comprising of Group P (n = 50): who received phenylephrine 0.1 mg/kg/min infusion prophylactically and Group N (n = 50): who received norepinephrine 0.05 mg/kg/min infusion prophylactically. The data of outcome measures were compared among the two groups by SPSS ver 21.0.

Results:
A significant difference was seen in the incidence of bradycardia between groups P and N (20% vs 4%, P value = 0.028). The blood pressure was significantly higher in Group N (systolic-120.5 vs 104 mm of Hg, P = 0.026; diastolic-66 vs 61 mm of Hg, P = 0.019). Group N patients had no complications whereas Group P patients experienced nausea (8%) and vomiting (4%), P = 0.027. Neonatal outcomes in terms of Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score and umbilical arterial/venous blood gases were similar among the two groups (P > 0.05).

Conclusion:
In conclusion, the study results show that NE is better in maintaining the hemodynamic parameters (BP and HR) during spinal anesthesia for cesarean delivery with minimal side effects. It can be suggested that NE may be advantageous in pregnancies especially those complicated with pregnancy-induced hypertension.
Maternal Oxygenation and Neonatal Outcome in Pregnant Women with COVID-19: A Case Series of 20 Patients
Authors: Yamaguchi Takumi , Fujii Tomoaki , Hirate Hiroyuki , Ota Yusuke 
Published: April 2023

Purpose:
Management of delivery in pregnant women with coronavirus disease 2019 (COVID-19) is mainly based on extrapolated evidence or expert opinion. This study aimed to assess the clinical manifestations and maternal and perinatal outcomes of COVID-19 during pregnancy.

Methods:
We retrospectively reviewed the cases of 20 pregnant women infected with the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Their demographic data and clinical characteristics, including symptoms, laboratory examination, and imaging findings, were evaluated. We also assessed the delivery method and timing and clinical courses of mothers, including oxygenation and treatment for COVID-19, as well as neonatal outcomes.

Results:
The most common symptoms were fever (65%) followed by cough (45%). Seven cases (35%) of preterm birth were observed. Eight patients (40%) required oxygen administration during pregnancy. Among them, two patients (10%) required a high-flow nasal cannula, and one patient (5%) required venovenous extracorporeal membrane oxygenation (VV-ECMO). No maternal death was observed; however, one instance of severe neonatal asphyxia and one intrauterine fetal death were observed.

Conclusion:
Although most pregnant women with COVID-19 were discharged without any major complications, some cases became severe. Therefore, the timing and method of delivery should be considered for each case to control maternal and infant respiratory conditions.
Comparison of Two Different Doses of Magnesium Sulfate as an Adjuvant to Intrathecal Bupivacaine in Patients with Pre-Eclampsia Undergoing Elective Cesarean Section: A Prospective Double-Blind Randomized Study
Authors: Tuteja Swapnil , Gupta Apoorva , Choudhary Savita , Panwar Roshni , Zala Rajeshwar , Bhokan Ravina 
Published: April 2023

Background:
Intrathecal magnesium sulfate is now emerging as a safe and effective adjuvant for spinal anesthesia (SA). The aim of the present study was to compare the efficacy of two doses of intrathecal magnesium in parturients with pre-eclampsia.

Methods:
This prospective randomized double-blind study was conducted on 105 parturients undergoing elective cesarean section (CS) who were randomized into three groups of 35 each: Group C, M50, and M75. Group M50 and group M75 received 50 mg of 50% (0.1 ml) and 75 mg of 50% (0.15 ml) magnesium sulfate, respectively. All of the groups received 10 mg of 0.5% heavy bupivacaine with normal saline accordingly to make a total volume of 2.2 ml. The sensory and motor block characteristics, visual analogue scale (VAS) score, post-operative analgesic requirements, hemodynamic parameters, and adverse effects were compared.

Results:
The sensory and motor block characteristics were significantly delayed in group M75 compared to group M50 and the control group (P < 0.05). VAS scores were significantly high in the control group up to 6 h as compared to group M50 and group M75 (P < 0.05). The time to first rescue analgesia was significantly extended in group M75 (222.86 ± 12.502 min) as compared to group M50 (221.14 ± 13.671 min) and the control group (127.43 ± 11.464 min) (
P
< 0.05)

Conclusion:
Intrathecal magnesium sulfate at doses of 50 mg and 75 mg in pre-eclamptic parturients undergoing elective CS results in prolonged duration of analgesia, decreased VAS scores and also delays the first rescue analgesic requirement with a favorable adverse effect profile in terms of decreased incidence of nausea and shivering.