bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral blood eosinophil count as a biomarker of exacerbation in stable chronic obstructive pulmonary disease outpatients: a prospective observational study
Authors: Safwat Tarek , El-Sheikh Mohammed , El-Sayed Amira Ali , Abd-Elsattar Dalia 
Published: July 2023

Abstract

Background
Peripheral blood eosinophil count is liable to many factors and has variability over time. There are few studies on the association between the rise of blood eosinophils and the exacerbation incidence in stable chronic obstructive pulmonary disease (COPD) patients. The association between the rise of blood eosinophils and the rate of exacerbation in stable COPD patients is controversial.

Objective
To study the relationship between the count of eosinophils in the peripheral blood and the incidence of COPD exacerbation in stable patients.

Patients and methods
This prospective inquiry was done on 46 patients diagnosed as suffering from stable COPD ‘on the report of the global initiative for chronic obstructive lung disease (GOLD) guidelines’ attending Ain Shams University hospital outpatient clinic.

Results
Forty-six stable COPD patients were classified into two groups (groups A and B) based on their median eosinophilic count of ‘250 cell/μl.’ Patients with high eosinophil count ‘group A’ (>250 cell/μl) had a significantly higher incidence of exacerbations (P=0.003), with a relative risk ratio of 2.77, as well as a higher number of exacerbations per patient (two exacerbations/patient) versus one exacerbation/three patients (P<0.001), and a shorter period to the first exacerbation (17 vs. 31 days) (P=0.024), compared with those with low eosinophil count ‘group B (≤250 cell/μl)’ during the study period. On the contrary, there was no significant difference between them in the incidence of pneumonia in relation to inhaled corticosteroid use.

Conclusion
The count of eosinophils in the peripheral blood is a reliable exacerbation biomarker in stable COPD patients.
Analgesia and sedation strategy for mechanically ventilated patients in the respiratory ICU
Authors: El Embaby Dalia A E S , Azab Mai S , Shalaby Heba M 
Published: July 2023

Abstract

Background
Mechanical ventilation is typically required for ICU patients as part of their care. This recommends the use of analgesia and sedation in a balanced strategy to alter patients’ comfort and assist synchronization with mechanical ventilation while avoiding the downsides of excessive sedation.

Objective
The aim of the study was to compare between deep sedation and light sedation, analgesia, and no sedation strategies and their effects on the length of mechanical ventilation, and their effects on patients’ prognosis.

Patients and methods
This cohort prospective pilot study was conducted at the medical respiratory ICU at Ain Shams University Hospital in Cairo, Egypt, on 54 patients separated into four groups according to the type of sedation and analgesia suited for each patient’s severity condition.

Results
In this study, 54 mechanically ventilated patients in respiratory ICU were recruited. The patients were divided into group 1: no sedation or analgesia, group 2: analgesia only, group 3: light sedation, and group 4: deep sedation. There was a significant difference in Acute Physiology and Chronic Health Evaluation score and severity%, although the Acute Physiology and Chronic Health Evaluation score and severity % were the highest in group 1 (25.53, 55.11%) and group 4 (23.40, 47.68%), but the prognosis was poorer in group 4 and was affected by deep sedation (100% death rate) than that in group 1 (60.0%). The average infusion rate of fentanyl and the total dose were significantly different between groups, the highest being in the deep sedation group. ICU length of stay was nonsignificant between groups but it was lower in group 4 (median: 9 days) than other groups. The average rate of dormicum infusion in the deep sedation group was 5 µg, while there was no daily vacation period; so, it can be explained that higher doses of sedation and analgesia in group 4 affected their prognosis to be poorer than other groups. Delirium occurred in 80% of group 4 patients, but only in 6.7% of subgroups, indicating a highly significant difference. Complications either metabolic, cardiac, or hematologic in the postextubation period were higher in group 4 (60%), than in group 1 (47.7%), group 2 (40%), and group 3 (15%).

Conclusion
Light sedation and analgesia strategies with daily sedation interruption would have a better survival outcome and cause fewer issues in patients, who were on mechanical ventilation than a heavy sedation approach.
Effect of physiotherapy and its frequency on the outcome of COVID-19 patients regarding acute care setting at isolation unit of Ain Shams University
Authors: El-Bably Mona M , Galal Ahmed M M , Rafat Riham Hazem , El Rehem Samia M Abd 
Published: July 2023

Abstract

Background
Severe acute respiratory syndrome coronavirus 2 is a new strain of coronavirus that started in 2019 and causes a pandemic disease called coronavirus disease 2019 (COVID-19). The present report result was 80% of cases are asymptomatic or mild; 15% of cases are severe; and 5% are critical needing ICU and mechanical ventilation. Physiotherapy (PT) provides airway clearance techniques and improves physical fitness.

Aim
The aim of this study is to assess the effect of PT and the frequency of PT session on the outcome of patients with COVID-19 infection at an isolation unit of Ain Shams University.

Patients and methods
This is randomized controlled clinical trial that was applied on 264 confirmed adult patients with COVID-19, who were admitted to isolation units at Ain Shams University Hospitals over 6 months since March 2021 with 134 females and 130 males in the age range from 31 to 82 years. The breathing method was room air, oxygen mask and nasal cannula, HFNC, and ventilated patients (both invasive and noninvasive). The patients were divided randomly into two groups: one group received two sessions of PT per day and the other group received one session of PT per day.

Results
The patients were divided clinically into mild, moderate, severe, and severe-critical patients. In mild cases, the range of incentive spirometer (ml) after one daily PT became 2300–2800 ml, and for twice daily PT it became 2300–3300 ml with highly statistical difference (P=0.005) before and after one or two PT sessions. Regarding 6-min walking test (m) the range became 420–740 m for one PT session per day and 420–880 m for two PT sessions per day with significant statistical difference (P=0.010). In moderate cases, the SPO2 (%) became 88–98% after one daily PT session and 90–98% after twice daily PT sessions with significant statistical differences between the one and two PT (P=0.032) sessions. Regarding the incentive spirometer (ml) at the moderate group, after one daily PT session it became 1200–2500 ml and for twice daily PT it became 1500–2500 ml with significant statistical differences between one and two PT sessions (P=0.032).

Conclusion
Patients with mild and moderate COVID-19 infection had significant improvement in SPO2 (oxygen saturation), dyspnea scale, and incentive spirometer after receiving two daily sessions of PT compared with patients who received one daily PT session. There was no difference in both groups for severe and severe-critical cases.
SARS-CoV-2 Antibody Response Following COVID-19 Vaccination, a Longitudinal Study
Authors: Chavhan Smita Santosh , Dhikale Prasad Tukaram , Adsul Balkrishna B. , Gokhale Chinmay N. , Ingale Aniket R. , Pawar Pradnya N. , Jadhav Nilam 
Published: July 2023

Background:
The objective was studying the antibody response following immunization with COVID-19 vaccines.

Material and Methods:
It was a longitudinal study of healthcare workers (HCWs). Two groups were taken, Group 1 had taken first dose of the COVID-19 vaccine, at least 3 weeks have passed. Group 2 had taken two doses of COVID-19 vaccine and at least 2 weeks have passed. A quantitative test for antibodies to SARS-CoV-2 spike protein was done. Follow-up of both groups was done after 3 months of collection of the first sample.

Results:
The antibody titre of the 57 HCWs in Group 1, decreased significantly 125 days after the first dose [median = 2,013 U/ml] as compared to the titre 30 days after the first dose of Covishield vaccine[median = 9,965.26 U/ml]. The median interval between two doses of vaccine was 34 days. In Group 2, the antibody titre of the 60 HCWs in Group 2, decreased significantly 114 days after second dose[median = 1,411 U/ml] as compared to the titre 19.5 days after second dose of Covishield vaccine [median = 2,377.5]. There was no significant difference in the antibody titre in follow-up samples of HCWs with and without side effects.

Conclusion:
The antibody titre decreases after 13 to 17 weeks post the second dose of Covishield vaccination. The decision of the Government of India to increase the interval between two doses of Covishield is justified. Low antibody titre can be the reason for breakthrough infections. The antibody titre was not related to side effects post-vaccination.
Prevalence and Risk Factors of Iron Deficiency Anemia among the Tribal Residential Adolescent School Students of Odisha: A Cross-Sectional Study
Authors: Sahoo Jyotiranjan , Mohanty Smaraki , Gupta Sandhya , Panigrahi Sandeep K. , Mohanty Sambedana , Prasad Deepa , Epari Venkatarao 
Published: July 2023

Background:
Globally, anemia is one of the biggest public health challenges. The highest prevalence of anemia is seen among adolescents. Tribal communities are especially at a disadvantage, with several studies documenting a high prevalence of anemia among tribal adolescents. We investigated the prevalence of anemia and its associated risk factors among the tribal residential adolescent school students in Odisha.

Material and Methods:
In a cross-sectional survey, the prevalence of anemia was estimated by spectrophotometry among adolescents of residential schools in three predominantly tribal districts of Odisha. The severity of anemia was defined as per the World Health Organization classification for adolescents.

Results:
The mean age of 953 subjects was 13.07 ± 1.48 years. The prevalence of anemia was found to be 37.3%. As per the World Health Organization classification, 19.9% had mild anemia, 16.3% had moderate, and 1% had severe anemia. Consumption of Iron Folic Acid (IFA) was associated with the level of hemoglobin at a statistically significant level.

Conclusion:
We found that the prevalence of anemia was lower than in similar studies conducted in other parts of the country. Despite poor coverage of beneficiaries with iron and folic acid at the national level, our study showed better compliance and was associated with a significantly higher level of hemoglobin among those who consumed IFA.
Impact of Educational Intervention in Reducing the Weight of School Bags in Selected School Children
Authors: Meenakshi  , Saini Sushma K. , Bharti Bhavneet , Gopinathan Nirmal R. , Kavita  
Published: July 2023

Background:
To assess the effectiveness of educational intervention to reduce the weight of school bags.

Material and Methods:
The study design was one group pre- and posttest experimental Research design.

Place and Duration of Study:
Government Senior Secondary School Dhanas, Chandigarh, and Shri Guru Harkrishan Model Senior Secondary School Sector-38D, Chandigarh (A private school) between July and November 2018. Names of the schools can be avoided. Total 760 students from selected sections nursery to 10th class of school were enrolled in the study. At baseline and end line weight of children, school bags and its content were weighed using weighing scale. Length of bag strap, breath of bag, torso of children, and their shoulders size were measured by measuring tape. Bag carrying style, posture, etc., were observed by observation checklist. Interviewed children (5th to 10th class) were using Nordic musculoskeletal questionnaire for musculoskeletal system assessment. Educational intervention was provided to the children for one month to reduce weight of school bag by teaching in assembly and displaying the charts in school. (Use of softbound thin textbooks, breaking thin books in 2–3 thin softbound books, use lightweight bag, pencil box, lunch box, and water bottles. Pack bag as per timetable.)

Result:
The result revealed that heavy school bags were carrying 69.7% children from government school and 80.2% from private school. Children carrying heavy bags reported musculoskeletal problems 5 times higher than their counterparts. After intervention, there was significant reduction in the weight of school bags (P < 0.001 as per paired t-test). Provide the weight of the bags before and after intervention in addition to the P value.

Conclusion:
Children carrying heavy bags were suffering from musculoskeletal problems. Intervention helped in reducing the weight of school bag.
Self-medication Practices of the Rural Community People: A Cross-Sectional Study
Authors: Thenmozhi B , Sharmil S Hepsibah 
Published: July 2023

Background:
Self-medication is the practice of taking medicines without a physician’s advice, and it has become more common in developing nations. The root cause could be anything from a shortage of physicians to financial factors. However, most people are not aware of the ill effects and drug reactions brought on by self-medication. This research aimed to find out the prevalence, frequency, common complaints, primary sources, and regular medicines utilized for self-medication, which are the goal of this study.

Materials and Methods:
A cross-sectional study was conducted among the rural community people in Keezhur, Chengalpattu District, Tamil Nadu, India. A group of 253 participants were selected using a random sampling technique. A self-structured questionnaire was used to collect the data. The gathered information was coded and examined.

Results:
Self-medication was common in 60.5% of people, and 46.6% of them frequently utilize analgesics. The most frequent condition for which people used self-medication was headache (30.4%). The practice was significantly correlated with the younger age group and the level of education.

Conclusion:
Self-medication is harmful to one’s health and is widespread in the research group’s region. To reduce the practice of self-medication, general people should get sufficient health education.
Management of scorpion bite through Ayurveda: A case report
Authors: Deepthi M. K. , Deepak A. S. 
Published: July 2023

Abstract:

Agadatantra, the branch of toxicology in Ayurveda, refers to various methods of eliminating toxins from the body that arises from animate, inanimate, and artificial poisons. Scorpion stings are a serious health concern in rural areas. In Agadatantra, the symptoms of scorpion sting are explained under Vrischika visha (~scorpion venom poisoning). The main characteristics of scorpion venom poisoning are Vahnivat dahanam (~burning sensation like fire), Kshipram urdhvarohanam (~quick spreading in an upward direction), Danshe ruja tishthati (~pain remains at bite site), Sadyah ati ruk (~instant severe pain), Danshashyavata (~brownish discoloration of bite site), and Dansha toda (~ pricking type of pain at bite site). This is a case report of a 24-year-old male, who had an episode of Vrischika damsha (~scorpion bite) and presented to the outpatient department with complaints of severe edema, pain and redness, and itching. The first line of management for scorpion stings is typically symptomatic including strong analgesics, which can be systemic (opiates or paracetamol) or localized (such as a cold compress). Antivenom is the specific treatment for scorpion envenomation that is used in conjunction with supportive measures. In Ayurveda classics, Hinguadi gulika is one of the formulations mentioned in Vrischikavisha prakarana, which has been referred to as the most potent Lepana (~anointment) for scorpion venom poisoning. In comparison to existing conventional treatment modalities, Hinguadi gulika lepana is a very simple and very cost-effective procedure. Hinguadi gulika was given in combination with Kulakadi kashaya which is widely practiced in all Visha (~poison) conditions. In the present case, Hinguadi gulika and Kulakadi kashayam have shown assuring results in the management of acute scorpion envenomation.
Ayurvedic modalities in the management of Koshta-Shakhashrita kamala (~hemolytic jaundice): A case report
Authors: Varsakiya Jitendrakumar Nathabhai , Goyal Mandip , Kathad Divyarani , Kumari Ritu 
Published: July 2023

Abstract:
Hemolytic jaundice, also known as prehepatic jaundice, is hyperbilirubinemia when the total bilirubin level exceeds 3.0 mg/dL. A 27-year-old male patient with features of jaundice, including yellowish discoloration of the eyes, weakness, fatigue, difficulty in breathing, decreased appetite, irritability, and reddish-yellow discoloration of urine, was managed with Mridu virechana (~mild therapeutic purgation) and Ayurvedic medications, namely. Gomutra haritaki (5 g) with Navayasa loha (500 mg) twice daily. Complete blood count and liver function tests were considered for the diagnostic changes in the clinical features and biomarkers, namely, hemoglobin, total red blood cells, total bilirubin, and indirect bilirubin were considered criteria for the assessment of the outcome of the therapeutic intervention. The total duration of treatment was one month, and follow-up was done for six weeks. No complications or recurrences were noticed during the period. This case report illustrates the utility of Ayurvedic modalities in managing hemolytic jaundice.
Rhino orbital cerebral mucormycosis in settings of COVID-19 infection: A case series of thirteen patients
Authors: Verma Rajesh , Chakraborty Rajarshi , Keerthiraj D. B. , Pal Uma S 
Published: July 2023

ABSTRACT
Rhino orbital cerebral mucormycosis (ROCM) is an important infectious disease encountered in large numbers in this recent post-COVID-19 era. An alteration in the defense immune system during COVID-19 illness; in the presence of uncontrolled hyperglycemia has led to the new epidemic of ROCM, especially in developing nations such as India. This case series of thirteen patients illustrates the various clinical presentations, laboratory parameters, imaging features and outcomes of patients with ROCM admitted to a tertiary care hospital in Northern India. In our case series, a total of 13 newly diagnosed cases of rhino-orbital-cerebral mucormycosis were studied. A history of COVID-19 illness was observed in seven cases (53.8%) with a mean duration of mucormycosis after 25 ± 3.6 days, the use of steroids during COVID-19 illness was seen in 5 cases (38.5%), and oxygen therapy was given in 4 cases (30.8%). A comorbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with a mean duration of 16.69 months, with an important finding of seven cases (53.85%) having new-onset diabetes; hypertension was present in three cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all 13 cases (100%), including maxillary and ethmoidal sinuses, with frontal involvement in 12 cases (92.3%), sphenoidal involvement in 11 cases (84.6%), symmetric involvement in 9 cases (69.2%), mastoiditis in four cases (30.8%), maxillary space involvement in four cases (30.8%), and palatal involvement in one case (7.7%). On statistical analysis, there was a significant association of new-onset diabetes, optic neuropathy and high C reactive protein with blindness (P-value < 0.05) in our study. However, there were no statistically significant association for the involvement of nervous system in our study. Multispecialty approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in six cases (46.2%) with exenteration done in seven patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all cases. There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at the initial state of diagnosis for better outcomes. The need for sustained proper glycemic control during the COVID-19 era along with judicious use of steroids and public awareness of early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemics to a substantial rate. New-onset diabetes mellitus, optic neuropathy and high C reactive protein (>50 mg/L) showed statistically significant association with blindness. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.
Alveolar ridge preservation: A review of concepts and controversies
Authors: Quisiguiña Salem Cinthya , Ruiz Delgado Emilio , Crespo Reinoso Pablo A. , Robalino James Jerez 
Published: July 2023

ABSTRACT
The loss of thickness and height of the alveolar process after tooth extraction is a significant impediment to implant placement, which limits the aesthetic results of many restorative treatments. Alveolar ridge preservation can reduce bone resorption. Knowing how beneficial this procedure is can help clinicians decide if it is worth doing. The purpose of this article is to present a contemporary review of the different approaches to preserving the dimensions of the alveolar ridge. We analyze the alveolar healing process, atraumatic extraction techniques, graft materials, and controversies.
CT-based retrospective cohort study for the evaluation of mandibular condylar dimensions – A pilot study
Authors: Kolte Vrinda Sunil , Shenoi Ramakrishna S. , Dhok Avinash 
Published: July 2023

ABSTRACT

Background:
The temporomandibular joint (TMJ) is a unique structure of the body where the mandible, one of the important facial bones, articulates with the temporal part of the skull bone. Obtaining morphometric dimensions for mandibular condyle is important for performing an accurate pre/postoperative assessment, planning temporomandibular and orthognathic surgeries, and applications in forensic sciences in context to the Indian population, which is presently based on dimensions of Caucasian population from available literature. Several investigators noticed the variation in the craniofacial morphology in different ethnic groups and vary according to age and sex. This study aims to provide the normal dimensions of the mandibular condyle in the Indian population, which would be providing racially specific values for diagnosis, treatment planning of surgeries involving condylar processes such as rigid internal fixation of TMJ region, congenital deformities, and customizing TMJ prosthesis concerning these measurements.

Aim of the Study:
To measure the change in dimensions of mandibular condyle according to age and sex using computed topographic scan imaging.

Objectives of the Study:
1. To measure the dimensions of mandibular condyle. 2. To evaluate any age-related changes in dimensions. of mandibular condyle (intercohort comparison). 3. To evaluate any sex-related changes in dimensions of mandibular condyle (intercohort comparison).

Materials and Methods:
A retrospective analytical cohort study.

Inclusion Criteria:
Indian adult males and females aged between 20 and 50 years who underwent facial computed tomography (CT) for any reason (e.g., head injury).

Exclusion Criteria:
Patients with congenital or acquired dentofacial deformities involving TMJ.

Data Collection:
By assessing the morphometric dimensions of condyle of mandible using CT scan images.

Result/Conclusion:
Mean condylar dimensions for each age/sex cohort are established; however, no significant change as per age and sex in condylar dimensions in the Indian population is noted.