bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological spectrum of lumps and bumps on the hand: A 5-year retrospective study
Authors: Konkay Kaumudi , Neelima Poola , Sindhura Nugala , Chaganti Padmavathi Devi 
Published: May 2023

Background:
Diverse lesions ranging from infective, inflammatory to neoplastic can occur in the hand. Almost all lesions that occur elsewhere in the body can affect the hand as well.

Methods:
This was a hospital-based retrospective study of 5 years done between January 2016 and December 2020. We enumerated the clinical and histopathological spectrum of lesions of the hand. The details were collected from the patient requisition forms and pathology records.

Results:
Of the 80 cases seen during the study period, 25 (31.3%) were non-neoplastic and 55 (68.8%) were neoplastic; male: female ratio was 0.95:1. The most frequent lesions identified were ganglion cysts (n = 13), followed by giant cell tumour (GCT) of tendon sheath (n = 11). Common non-neoplastic lesions included were ganglion cyst (n = 13), pyogenic granuloma (n = 3); epidermoid cyst, fungal granuloma, pigmented seborrhoeic keratosis (n = 2 each) and cutaneous horn, molluscum contagiosum and granulomatous inflammation. Amongst neoplastic lesions, mesenchymal lesions were 49 (89.1%) and epithelial lesions were 6 (10.9%); they were GCT of tendon sheath 11 (22.4%) lipomas and nerve sheath tumours 9 (18.36%) cases each, arteriovenous malformations/haemangiomas 5 (10.2%), fibromas 2 (4.08%) and one (2.04%) case each of myolipoma, fibrolipoma, benign fibrous histiocytoma, calcifying aponeurotic fibroma and benign spindle cell tumour, palmar fibromatosis. Malignant mesenchymal neoplasms included synovial sarcoma (n = 3), epithelioid sarcoma, malignant peripheral nerve sheath tumour and high-grade spindle cell sarcoma (n = 1 each). Amongst epithelial, benign lesions were 2, malignant lesions were 4, of which 3 were squamous cell carcinoma and one was melanoma and the two benign lesions were skin adnexal tumours, of which one was a case of eccrine poroma and the other was pilomatrixoma.

Conclusions:
In patients presenting with lumps and bumps on the hand, common non-neoplastic lesions included ganglion cyst and pyogenic granuloma. Amongst neoplastic lesions, mesenchymal lesions and epithelial lesions were most commonly seen.
Adaptation of case report guidelines on published case reports in the Indian Medical Journals from 2020 to 2021: A cross-sectional study
Authors: Anushree D. , Muraraiah Sushma 
Published: May 2023

Background:
Case reports are detailed reports of a patient’s specific medical problem and its clinical management. They serve as the initial evidence for the generation of hypothesis for any novel disease. However, incomplete reporting results in false inferences.

Methods:
The objective of this study was to assess the adherence of case reports published in Indian Medical Journals (IMJs) to Case Report (CARE) 2016 guidelines, to assess the extent of endorsement of these guidelines by the selected IMJs and its impact on the completeness of reporting (COR) score. The journals published by the Associations of 12 Indian medical specialities, namely, Indian Journal of Dermatology, Venerology and Leprology, Indian Journal of Anaesthesia, Indian Journal of Ophthalmology, Indian Journal of Orthopaedics, Indian Journal of Otorhinolaryngology and head and neck surgery, Indian Paediatrics, Indian Journal of Pharmacology, Indian Journal of Psychiatry, Indian Journal of Surgery, Journal of Association of Physicians India, Journal of Obstetrics and Gynaecology and Lung India between 2020 and 2021 were accessed for completeness as per CARE guidelines. The effect of CARE endorsement on the COR was determined.

Results:
None of the 590 case reports met all the CARE guidelines.: Major areas of reporting deficiencies were title, timeline, patient perspective and informed consent. No association between COR and the impact factor of the journal.

Conclusions:
The quality of case reporting with respect to CARE 2016 checklist is not satisfactory. The endorsement of the CARE checklist in the journal must be made mandatory to generate high-quality case reports.
Microalbuminuria in hypertension and its relationship to target organ damage: A cross-sectional observational study in a tertiary hospital in Eastern India
Authors: Bhowmick Diptak , Chakraborty Sisir , Ali M. D. Hamid , Ghosh Kaushik , Acharyya Amitava , Karmakar Partha Sarathi , Banerjee Swati 
Published: May 2023

Background:
Microalbuminuria (MA) is an independent risk factor in association with fatal cardiovascular and cerebrovascular outcomes among patients with hypertension (HTN).

Methods:
An observational study was conducted among 100 randomly selected hypertensive patients January 2013 to January 2014 to observe the proportion of MA among hypertensive patients and the proportion of presence of various target organ damages (TODs) in them.

Results:
The frequency of MA was 36% among participants. The frequency in males was slightly more than females (38.2% vs. 33.3%). The frequency of MA increased linearly with the duration and severity of HTN. It was more commonly found in smokers than in non-smokers. Diastolic dysfunction (42%) and Grade 2 hypertensive retinopathy (60.7%) were associated with MA. TOD was frequently observed in MA-positive patients.

Conclusions:
The proportion of patients with MA was in increasing trend with increasing age of hypertensive participants and duration of history of HTN. Hypertensive retinopathy, regional wall motion abnormality and neurological deficit emerged to be sensitive surrogate markers for MA in patients with HTN.
Reduction in postoperative sore throat by preoperative nebulization with dexmedetomidine, ketamine or saline: A prospective, randomized-controlled trial
Authors: Ittoop Amanta L. , Gupta Priyanka , Jain Gaurav , Tyagi Nidhi , Eda Jhansi , Shajahan Shafiq 
Published: May 2023

Background and Aims:
Postoperative sore throat (POST) is a minor but distressing complication following general anesthesia. The current literature on the effect of preoperative nebulization with dexmedetomidine, or ketamine on POST is, however, sparse. So, we compared the effect of preoperative nebulization with these drugs on POST.

Material and Methods:
One hundred and thirty-two American Society of Anaesthesiology (ASA) grade I-II patients undergoing elective laparoscopic surgeries under general anesthesia were randomized into three equal groups: D, K, or C to receive dexmedetomidine, ketamine, or saline as preoperative nebulization, respectively. The primary objective was to compare the incidence and severity of POST, as inferred from the patient interviews at 2, 6, 12, 24-h postoperatively.

Results:
Group D had a significantly lower incidence (29.5%) and severity (12: mild; 1: moderate) of POST compared to group K (54.5% [21: mild; 3: moderate]) and group C (56.8% [19: mild; 6: moderate]), at 2-h postoperatively. The same trend was observed at 6-h postoperatively (group D: 22.7% [9: mild; 1: moderate]); group K: (40.9% [17: mild; 1: moderate]); group C (50% [17: mild; 5: moderate]). The mean arterial pressure was significantly lower in group D at 15 min intraoperatively (84.09 mmHg, P = 0.018) and immediate postoperatively (97.60 mmHg, P = 0.034). The postoperative sedation, nausea, and vomiting was not statistically significant.

Conclusion:
Preoperative nebulization with dexmedetomidine is effective in the reduction of the incidence and severity of early POST.
Ropivacaine pharmacokinetics in the arterial and venous pools after ultrasound-guided continuous thoracic paravertebral nerve block
Authors: Matsota Paraskevi , Karalis Vangelis , Saranteas Theodosios , Kiospe Fay , Markantonis Sophia Liberty 
Published: May 2023

Abstract

Background and Aims:
Although thoracic paravertebral blockade (TPVB) is employed in thoracic surgery to ensure satisfactory postoperative analgesia, large doses of anesthetics are required and manifestations of local anesthetic systemic toxicity (LAST) may appear. Currently, there are limited data on the pharmacokinetics of ropivacaine after continuous TPVB. The aim of this prospective study was to investigate ropivacaine kinetics, in the arterial and venous pools, after continuous TPVB and assess the risk of LAST.

Material and Methods:
Immediately after induction of general anesthesia, an ultrasound-guided continuous TPVB at T5 or T6 or T7 thoracic level was performed in 18 adult patients subjected to open thoracotomy. A 25-ml single bolus injection of ropivacaine 0.5% was administered through thoracic paravertebral catheter, followed by a 14 ml/h continuous infusion of ropivacaine 0.2% starting at the end of surgery. Quantification of total ropivacaine concentrations was performed using a validated high-performance liquid chromatography method. Population pharmacokinetic models were developed separately for arterial and venous ropivacaine data.

Results:
The best model was one-compartment disposition with an additional pre-absorption compartment corresponding to thoracic paravertebral space. Gender had a significant effect on clearance, with females displaying lower elimination than males. Some patients had ropivacaine concentrations above the toxic threshold, but none displayed evidence of LAST. Continuous thoracic paravertebral nerve blocks provided adequate postoperative analgesia.

Conclusion:
Ropivacaine doses at the upper end of clinical use (800 mg/d) did not inflict the manifestations of LAST and provided adequate postoperative pain control. Pharmacokinetic models were developed, and the effect of gender was identified.
The effects of subtenon and intravenous dexmedetomidine on patients undergoing cataract surgery: A comparative randomized controlled double-blind study
Authors: Saad Ashraf Magdy Eskandr , Abd-Allah Elmorsy Osama , Abd-Elmaseeh Sadik Sadik 
Published: May 2023

Abstract

Background and Aims:
This prospective randomized study designed to evaluate the efficacy of dexmedetomidine either added to LA mixture or administered IV during subtenon block for cataract surgery.

Material and Methods:
75 patients, undergoing cataract surgery with subtenon anesthesia, were assigned randomly into three equal groups, Group I received subtenon bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml) + saline 0.9% (0.5 ml) and IV infusion of normal saline. Group II received subtenon bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml) + 0.5 μg/kg dexmedetomidine (0.5 μl) and IV infusion of normal saline. Group III received subtenon bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml) + saline 0.9% (0.5 ml) and IV infusion of 0.5 mg/kg dexmedetomidine over 10 min. before subtenon block. We recorded onset and duration of sensory and motor block, pain during subtenon injection, intraoperative hemodynamics, intraocular pressure, sedation and postoperative pain score.

Results:
There was a significant decrease in the onset of action and an increase in the duration of sensory block in Group II. Pain during subtenon injection was significantly less in group III. Sedation Score was higher in Group III, while heart rate showed a significant reduction in the same group. The VAS was significantly decreased in group II. After the end of surgery, the intraocular pressure was significantly decreased in Groups II and III.

Conclusion:
Subtenon dexmedetomidine shortens onset time, prolongs sensory block durations and significantly decreases the postoperative pain score with hemodynamic stability, while, IV dexmedetomidine substantially reduces pain during subtenon block and produces intra-operative sedation.
Assessment of potential predictors affecting preoperative anxiety in Indian children- A prospective observational study
Authors: Mathew Preethy J. , Gopinath Arun M. , Gupta Aakriti , Yaddanapudi Sandhya , Panda Nidhi B. , Kohli Adarsh 
Published: May 2023

Background and Aims:
Preoperative anxiety is a common problem among children undergoing surgery. The aim of the study was to assess the incidence and identify various predictors of preoperative anxiety in Indian children.

Material and Methods:
A prospective, observational study was conducted on 60 children of the American Society of Anesthesiologists Physical status 1/2, aged 2–6 years and scheduled for elective surgery under general anesthesia in a tertiary care teaching hospital. Preoperative parental anxiety was assessed using the State-Trait Anxiety Inventory questionnaire. The children’s anxiety was assessed in the preoperative room, at the time of parental separation, and at the induction of anesthesia using modified Yale Preoperative Anxiety Scale (mYPAS) scoring by an anesthesiologist and a psychologist. Sedative premedication was employed prior to parental separation. Logistic regression analysis was carried out to identify the possible predictors of anxiety.

Results:
The incidence of high preoperative anxiety among the studied children was 76% in the preoperative room, 93% during parental separation, and 96% during anesthetic induction. Among the nine possible predictors identified on univariate regression, the presence of siblings was found to be a significant independent predictor on multivariate regression analysis (P = 0.04). The inter-rater agreement was excellent for the assessment of preoperative anxiety using mYPAS by the anesthesiologist and psychologist (weighted Kappa, k = 0.79).

Conclusion:
The incidence of preoperative anxiety in Indian children in the age group of 2–6 years is very high. The preop anxiety escalates progressively at parental separation and induction of anesthesia despite sedative premedication. The presence of siblings is a significant predictor of preoperative anxiety.
Clinical evaluation of preoperative three -item questionnaire and pain experienced on infiltration of local anesthetics to predict severity of acute pain after caesarean section
Authors: Gupta Divya , Kerai Sukhyanti , Saxena Kirti N. , Gaur Saurabh 
Published: May 2023

Background and Aims:
Several studies have attempted to identify patients at risk of developing severe pain after caesarean section (CS) by utilizing preoperative experimental pain application and clinical tests. The three-item questionnaire and reported pain intensity on infiltration of local anesthetic (LA) on the back of patient just before administration of spinal anesthesia, are two simple tests previously shown to be promising. We aimed to study utility of these two tools in Indian patients undergoing CS and find their correlation with postoperative pain and analgesic consumption.

Material and Methods:
A total of 150 parturients undergoing elective CS were enrolled. Preoperatively patients were asked to rate their level of anxiety, anticipated postoperative pain and analgesic need after surgery (three-item questionnaire). The pain intensity reported by patient upon LA injection for spinal anesthesia were recorded. In the postoperative period, pain intensity at rest, evoked pain and need for rescue analgesics were recorded. The correlation between three item questionnaire and pain on LA infiltration to postoperative pain were evaluated. To see relationship between the predictor variables to outcome, a multiple regression analysis was performed.

Results:
The predictors variables and postoperative pain were found to have mild correlation (r = 0.124 to 0.239). The predictor variables were significantly correlated with postoperative pain at rest but their association was not significant to evoked pain intensity. Multiple regression analysis showed that change in the predictors explains only 7-8% variance in postoperative pain outcomes.

Conclusion:
The three -item questionnaire and pain intensity reported upon LA infiltration for spinal anesthesia have mild correlation to postoperative pain in Indian parturients undergoing CS. As these variables predicts only 8% variance in pain experienced after CS, further studies are required for accurate prediction and targeted treatment of post CS pain.
Surveillance of central line associated bloodstream infection (CLABSI) – comparison of current (CDC/NHSN) and modified criteria: A prospective study
Authors: Rai Durgesh , Kumar Pravin , Gupta Poonam , Verma Pardeep K. 
Published: May 2023

Abstract

Background and Aims:
There is a huge load of central line–associated bloodstream infection (CLABSI) being reported in developing countries, with increased mortality and healthcare costs. Effective surveillance is a must to reduce the incidence of CLABSI. The current criteria (Centre for Disease Control and Prevention/National Healthcare Safety Network [CDC/NHSN]) for CLABSI surveillance have their own shortcomings. For diagnosing CLABSI, current CDC/NHSN CLABSI surveillance criteria are laborious and time consuming with low predictive power. Hence, modified criteria have been postulated, which are simple and implementable at resource-constrained setups. The primary objective was to compare modified criteria with CDC criteria. The secondary objective was to determine the prevalence of CRBSI.

Material and Methods:
A total of 98 patients with central line in situ or having the central venous line removed ≤24 hrs prior to the date of the event were enrolled. Paired blood cultures were obtained and results were analyzed using differential time to positivity.

Results:
The incidence of CLBSI was 8.16% and the device utilization rate was 11.6%. The negative predictive value of both the surveillance criteria was found to be excellent and comparable (96.2% for modified criteria and 97.1% for CDC criteria), therefore both can be used for screening purposes. AUC for current CDC/NHSN criteria was better than modified criteria (0.76 versus 0.66, P < 0.0001), suggesting it to be a better criterion for surveillance of CLABSI.

Conclusion:
Modified criteria were not superior to CDC/NHSN criteria for surveillance. Thus, there is a scope of improving the modified criteria for the purpose of surveillance. CLBSI load was higher; CLABSI bundle for prevention is thus highly recommended.
The analgesic efficacy of ultrasound-guided transversus abdominis plane block vs. local anesthetic infiltration technique in major gynecologic surgery: A randomized controlled trial
Authors: Ismail Samina , Mistry Akbar A. , Siddiqui Ali S. , Aziz Aliya , Zuberi Nadeem F. 
Published: May 2023

Abstract

Background and Aim:
Transversus abdominis plane (TAP) block and local anesthetic infiltration (LAI) technique are used as part of the multimodal analgesic regimen after abdominal surgery. Postoperative opioid consumption and analgesic efficacy was compared using TAP and LAI techniques in patients undergoing gynecologic surgery in a randomized, controlled clinical trial.

Material and Methods:
Total of 135 patients scheduled for major gynecological surgeries were allocated into three groups: group T received bilateral TAP block with bupivacaine 0.25%; group I received LAI with 0.25% bupivacaine with epinephrine 5 μ/mL in the peritoneum and abdominal wall, and group C was control group. Anesthesia and postoperative analgesia were standardized. Outcome measures were cumulative and rescue tramadol consumption, numerical rating score (NRS) for pain and side effects in post-anesthesia care unit (PACU) at 4, 8, 12 hours postoperatively.

Results:
Tramadol consumption, need for rescue analgesia, and NRS for pain between three groups at 4, 8, and 12 hours postoperatively had no statistically significant difference (P < 0.05). In PACU, median tramadol consumption used for rescue analgesia between group T (15 (15–30)) and group C (30 (15–45)) (P = 0.035), and between group T (15 (15-30)) and group I (30 (15-52)) was statistically significant (P = 0.034). In PACU, the percentage of patients having NRS >4 on movement in group C (72%) compared to group T (46.5%) and group I (46.5%) was significant (P = 0.034). No statistically significant difference was observed in the incidence of side effects among study groups (P > 0.05).

Conclusion:
Except for the immediate postoperative period, neither TAP block nor LAI had added benefit to the multimodal analgesia regimen in patients undergoing gynecological surgeries.
Pattern and Predictors of Internet Addiction among Secondary School Adolescents in Enugu, Nigeria
Authors: Odinka JI , Chinawa AT , Nduagubam OC , Ossai EN , Odinka PC , Ugwunna NC , Chinawa JM 
Published: May 2023

ABSTRACT

Background:
Internet addiction has negative effects on adolescents. These range from psychological and social impediments to school absenteeism.

Aim:
To ascertain the pattern of Internet addiction and the factors that predict Internet addiction among secondary school adolescents in southeast Nigeria.

Subjects and Methods:
This was a cross-sectional study that involved 796 secondary school adolescents drawn from six secondary schools in Enugu, Nigeria. The data were analyzed using IBM Statistical Package for Social Sciences (SPSS) software.

Results:
The highest proportion of the respondents (36.3%) had a moderate level of Internet addiction, while the least proportion (2.1%) had severe dependence on the Internet. Adolescents who were less than 15 years of age have 1.1 odds of having Internet addiction when compared to those who were 20 years and above (AOR = 1.1; 95% CI: 0.4–2.8). The respondents who were of the low socioeconomic class were 1.2 times more likely to have Internet addiction when compared with those in the high socioeconomic class (AOR = 1.2; 95% CI: 0.9–1.7). About 20.1% of adolescents were always depressed when they are not using the Internet, while 16.3% of adolescents who were addicted to the Internet developed insomnia.

Conclusion:
There is a rising prevalence of Internet addiction among secondary school adolescents. Younger adolescents tend to be more addicted to the Internet than their older counterparts. A small number of them had severe Internet addiction. A subpopulation of adolescents who were addicted to the Internet presents with depression and sleep disorders.
The Impact of Meteorological Factors on the Spread of COVID-19
Authors: Topaloglu MS , Sogut O , Az A , Ergenc H , Akdemir T , Dogan Y 
Published: May 2023

ABSTRACT

Background:
Clinical studies suggest that warmer climates slow the spread of viral infections. In addition, exposure to cold weakens human immunity.

Aim:
This study describes the relationship between meteorological indicators, the number of cases, and mortality in patients with confirmed coronavirus disease 2019 (COVID-19).

Patients and Methods:
This was a retrospective observational study. Adult patients who presented to the emergency department with confirmed COVID-19 were included in the study. Meteorological data [mean temperature, minimum (min) temperature, maximum (max) temperature, relative humidity, and wind speed] for the city of Istanbul were collected from the Istanbul Meteorology 1st Regional Directorate.

Results:
The study population consisted of 169,058 patients. The highest number of patients were admitted in December (n = 21,610) and the highest number of deaths (n = 46) occurred in November. In a correlation analysis, a statistically significant, negative correlation was found between the number of COVID-19 patients and mean temperature (rho = −0.734, P < 0.001), max temperature (rho = −0.696, P < 0.001) or min temperature (rho = −0.748, P < 0.001). Besides, the total number of patients correlated significantly and positively with the mean relative humidity (rho = 0.399 and P = 0.012). The correlation analysis also showed a significant negative relationship between the mean, maximum, and min temperatures and the number of deaths and mortality.

Conclusion:
Our results indicate an increased number of COVID-19 cases during the 39-week study period when the mean, max, and min temperatures were consistently low and the mean relative humidity was consistently high.