bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of COVID-19 on Social Stigma and Vice Versa: Implications and Potential Responses from a Mental Health Perspective
Authors: Christy Jayakumar , Nikketha Bala Shanthi , Manikappa Sanjeev Kumar , Sadh Kamaldeep , Dinakaran Damodharan 
Published: June 2023

Abstract
This manuscript reports the impact of Coronavirus Disease 2019 on social stigma; verbatims demonstrating this impact on society and the potential responses or measures that can be taken as individuals and mental health professionals to combat stigma.
A Comparative Study of Supportive Group Therapy and Individual Psychotherapy in Admitted COVID-19 Patients at a Tertiary Health-Care Center: The Effective Feasible Double-Blinded, Randomized Controlled Trial
Authors: Tejaswini Miskin , Ramachandra V. , Sinha Deoraj , Mane Astik 
Published: June 2023

Abstract

Background:
Earlier pieces of evidence suggest that any pandemic has an impact on the mental health of general population, so is with COVID-19. The mental health of patients during such situations needs special attention and warrants proper care and support. We hypotheses that psychological interventions have an effective outcome in overcoming this.

Methods:
Consenting inpatient adults (n = 55) infected with COVID-19 were randomly allocated into two groups. The participants were assessed using a semi-structured sociodemographic detail, medical history pro forma, NEWS score, and Depression, Anxiety, and Stress Scale-21. In the 1st week of admission, group therapy (n = 26) and individual therapy (n = 29) sessions were delivered at an interval of 3–4 days.

Results:
On follow-up after a week, on comparing the groups, it was found that there was a significant difference in the mean ranks of depression and anxiety in COVID-19 patients who underwent group therapy and supportive individual therapy (P = 0.02, P = 0.03) versus (P = 0.001, P = 0.001), whereas the mean rank of stress in patients with group therapy (P = 0.33) revealed no significant difference compared to supportive individual therapy (P = 0.002).

Conclusion:
Our study found that group therapy was as effective as supportive individual therapy on the outcome measures of depression and anxiety in COVID-19 patients. However, in these difficult times, with shortage of health-care workers, this finding strengthens the benefits of group therapy for achieving psychological well-being in COVID-19 patients.
Employing a Structured Framework to Deal with Problem Learners: Role of Medical Teachers
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh 
Published: June 2023

Abstract
The field of medicine is quite complex, which makes it extremely difficult for students to accomplish the learning outcomes at an identical pace. The medical teachers often have to deal with the students, who either lag on the cognitive aspect or have problems related to their attitude or behavior. These students are broadly referred as “problem learners” and it becomes extremely important for the teachers to give due attention to their needs. Under ideal circumstances, it is always an encouraging practice to have a structured framework within a medical college, which will not only help the teachers in the identification of the problem learners, but also aid in the planning and assessing the impact of the intervention specific to a student. In conclusion, the presence of a problem learner in the field of medicine cannot be denied. However, the important thing will be to identify them at the earliest and give due consideration to teacher and system-related attributes. The entire process should be driven by the teachers, and they should offer them support and help the learners to overcome their issues.
Lemierre syndrome complicated by bronchopleural fistula
Authors: Kodaka N , Nakano C , Oshio T , Matsuse H 
Published: June 2023

ABSTRACT
We present a 19-year-old woman, a case of Lemierre syndrome, who presented with fever, sore throat, and left shoulder pain. Imaging revealed a thrombus in the right internal jugular vein, multiple nodular shadows below both pleura with some cavitations, right lung necrotizing pneumonia, pyothorax, abscess in the infraspinatus muscle, and multiloculated fluid collections in the left hip joint. After inserting a chest tube and administering urokinase for the pyothorax, a bronchopleural fistula was suspected. The fistula was identified based on clinical symptoms and computed tomography scan findings. If a bronchopleural fistula is present, thoracic lavage should not be performed as it may cause complications such as contralateral pneumonia due to reflux.
Relationship between Serum IgE Level and Childhood Nephrotic Syndrome with Atypical Presentation
Authors: Chowdhury Munmun , Chowdhury Pranab K. , Maruf-Ul Quader Mohammed , Chowdhury Muhammad Jabed Bin Amin , Choudhury Zabeen , Biswas Susmita 
Published: June 2023

Background:
Patients with nephrotic syndrome (NS) have altered serum immunoglobulin E (IgE) levels during relapse and remission, while presentation may be typical or atypical.

Objective:
To evaluate serum IgE level in childhood NS with the atypical and typical presentation.

Materials and Methods:
A total of 66 children with NS aged between 1 and 12 years were enrolled in this cross-sectional study. Among them, 33 children were with atypical presentations, and an equal number of children were with the typical presentations. Serum IgE level was measured in all cases.

Result:
The mean age of patients was 5.9 ± 3.1 years with a male-to-female ratio of 1.4:1. The mean serum IgE level was 1063.2 ± 1042.6 IU/mL in NS atypical presentation and 1099.8 ± 842.1 IU/mL in NS typical presentation, both of which were higher than the normal range for age but statistically not significant (P = 0.877).

Conclusion:
Elevated level of serum IgE is a feature of childhood NS with atypical and typical presentations.
Comparison of the effects of remifentanil and dexmedetomidine in patients under general anesthesia for rhinoplasty
Authors: Ersoy Zeynep , Uslu Ahmed , Gökdemir Begüm Nemika , Çekmen Nedim , Jafarov Sabuhi 
Published: June 2023

Objective
We aim to compare the effects of remifentanil and dexmedetomidine administered under general anesthesia in patients undergoing rhinoplasty. The primary outcomes were hemodynamics, postoperative pain, and recovery; the secondary outcomes were PONV, shivering, and patient and surgeon satisfaction.

Methods
In this randomized controlled, double-blind trial, 62 patients 18–65 years of age and ASA I-II class who underwent rhinoplasty under elective conditions were accepted to the study and divided into two groups. Group R (n = 31) received 0.25 μg/kg/min intravenously infusion during the operation without a loading dose. Group D (n = 31) was initiated with a bolus of 1 μg/kg over 10 min before induction of anesthesia and then received 0.5 μg/kg/h intravenously infusion during the operation. The patient’s pain level was assessed at 5 min, 30 min, and 12 h after surgery. Intraoperative hemodynamics, vital parameters, PONV, shivering, and patient and surgical satisfaction were evaluated.

Results
Remifentanil and dexmedetomidine had similar effects on hemodynamics and additional analgesic requirements. No postoperative complications, including PONV, occurred in either group. Recovery from anesthesia was faster, and pain scores were lower in the dexmedetomidine group. While patient satisfaction was similar, surgeon satisfaction was higher in the remifentanil group.

Conclusion
We think dexmedetomidine can be used safely and effectively as an adjuvant during general anesthesia for nasal surgery.
Ultrasound-guided popliteal sciatic nerve block using bupivacaine alone or combined with magnesium sulfate for diabetic foot surgeries
Authors: Abd El-Aziz Rehab Abd El-Raof , Morsy Ahmed R. , Abdelmaksoud Mervat M. , Abdelhamid Mariam S. 
Published: June 2023

Background
This prospective study examined the influence of adding magnesium sulfate to bupivacaine in popliteal sciatic nerve block in diabetic foot surgeries.

Patients and methods
Patients were divided into two equal groups: patients in B group received 28 ml of 0.25% bupivacaine plus 2-ml normal saline, and patients in BM group received 28 ml of 0.25% bupivacaine plus 2-ml magnesium sulfate 10%. The primary end point was postoperative analgesic duration assessment. Secondary aims were to assess the sensory and motor block regarding the onset and the duration and assessment of analgesic requirements postoperatively.

Results
In B group, the range of analgesic duration was between 450 and 690 min, with a mean of 585.90±78.96 min, whereas in BM group, it ranged from 720 to 1080 min, with a mean of 870.0±100.6 min. A statistically significant higher prolongation in the duration of analgesia was found in the BM group than the B group.

Conclusions
Magnesium sulfate when added to bupivacaine produced prolongation of analgesic duration postoperatively with decreased analgesic requirements without significant complications.
Intraoperative electromyographic monitoring in children using a novel pediatric sensor
Authors: Kalsotra Sidhant , Rice-Weimer Julie , Tobias Joseph D. 
Published: June 2023

ABSTRACT

Background:
Train-of-four (TOF) monitoring is essential in optimizing perioperative outcomes as a means to assess the depth of neuromuscular blockade and confirm recovery following the administration of neuromuscular blocking agents (NMBAs). Quantitative TOF monitoring has been limited in infants and children primarily due to lack of effective equipment. The current study evaluates a novel electromyography (EMG)-based TOF monitor with a recently developed pediatric-sized self-adhesive sensor in infants and children.

Methods:
Consented pediatric patients undergoing inpatient surgery requiring the administration of NMBAs were enrolled. The EMG electrode was placed along the ulnar nerve on the volar aspect of the distal forearm. The muscle action potentials from the adductor pollicis muscle were recorded throughout surgery at 20-second intervals. Data from the monitor’s built-in memory card were later retrieved and analyzed.

Results:
The final study cohort included 51 patients who ranged in age from 0.2 to 7.9 years and in weight from 4.2 to 36.0 kilograms. Thirty patients weighed less than 15 kgs. Supramaximal stimulus current intensity (mA) at a pulse width of 200 μsec was 30 mA in 8%; 40 mA in 29%; 50 mA in 16%; and 60 mA in 20% of the patients. Supramaximal stimulus current intensity (mA) at a pulse width of 300 μsec was 50 mA in 4%; 60 mA in 24%. The muscle action potential baseline amplitude was 8.7 ± 3.3 mV and recovered to 7.2 ± 3.7 mV after antagonism of neuromuscular blockade. The average baseline TOF ratio was 100 ± 3% and recovered to 98 ± 7% after antagonism of neuromuscular blockade. No technical issues were noted with application of the sensor or subsequent use of the monitor.

Conclusion:
Neuromuscular monitoring can be performed intraoperatively in pediatric patients who are less than 8 years of age using a novel commercially available EMG-based monitor with a recently developed pediatric sensor. The novel sensor allows use of an EMG-based monitor in infants and children in whom acceleromyography or subjective (visual) observation of the TOF response may not be feasible. Automatic detection of neuromuscular stimulating parameters (supramaximal current intensity level, baseline amplitude of the muscle action potential) was feasible in pediatric patients of all sizes including those weighing less than 15 kilograms or when there was limited access to the extremity being monitored.
The P value - and its historical underpinnings – pro and con
Authors: Grech Victor , Eldawlatly Adelazeem A. 
Published: June 2023

ABSTRACT
The derivation and interpretation of P values derived from inferential testing remain somewhat vague and ambiguous in the minds of some researchers/editors/reviewers/readers. The British polymath Fisher famously averred: “the value for which P = 0.05, or 1 in 20, is 1.96 or nearly 2; it is convenient to take this point as a limit in judging whether a deviation is to be considered significant or not. Deviations exceeding twice the standard deviation are thus formally regarded as significant.” This sometimes leads to an almost reductio ad absurdum mindset with an automatic discardment of studies with results where P > 0.05. It must be remembered that results may be negatively impacted by myriad factors that may be out of the researcher/s control, such as small sample sizes, small effects, bias, and random error. This paper briefly reviews the historical events leading to the acceptance of P ≤ 0.05 for statistical significance, the rationale behind the null hypothesis (H0), the meaning of P (and the potential for Type 1 and 2 Errors), α, β, the possibility of using non-0.05 cut-offs when studies are “trending toward statistical significance,” and the importance of including confidence intervals (CIs) in results. P values are vital but must be tempered by judicial consideration of CI and study design. P is a probability spectrum and not simply a binary significant/non-significant statistical metric.

MeSH:
95% confidence interval, biostatistics, P value
Preoperative ultrasound evaluation of gastric contents in children one hour after ingestion of clear liquid: An observational study
Authors: Valencia Alejandra , Trujillo Alexander , Arango Fernando 
Published: June 2023

ABSTRACT

Background:
Gastric ultrasound is an effective, non-invasive method to assess the nature and volume of gastric content in the pediatric population. Recently, the UK, European, and French Pediatric Anesthesia Societies recommend fast for clear fluids in children for 1 h. However, studies showing that 1 h of fasting is safe in the pediatric population are still scarce. This study aims to verify by ultrasound evaluation if 1 h of fasting for clear liquids is sufficient to have an empty stomach before anesthetic induction.

Methodology:
Patients between 11 months and 16 years of age scheduled for elective outpatient surgery were included. A qualitative and quantitative ultrasound evaluation was performed by calculating the cross-sectional area (CSA) of the gastric antrum, 1 h after ingesting a volume of 3 mL/kg of a non-carbonated sports drink, before anesthetic induction.

Results:
Fifty patients were included. The average CSA measured by ultrasound was 2.85 ± 1.64 cm2 with an average calculated total volume of 12.9 ± 11.06 mL. All patients had an empty stomach criterion (calculated volume ≤1.5 mL/kg) during the ultrasound evaluation, with an average of 0.40 ± 0.23 mL/kg. With the qualitative assessment of gastric volume, 19 patients (38%) were classified as grade 0, 31 patients (62%) as grade 1, and none as grade 2.

Conclusion:
One hour of fasting after ingestion of 3 mL/kg of a non-carbonated sports drink is sufficient to meet ultrasound criteria for an empty stomach in a pediatric population undergoing elective outpatient surgery.
Artificial intelligence in medicine and research – the good, the bad, and the ugly
Authors: Grech Victor , Cuschieri Sarah , Eldawlatly Abdelazeem A. 
Published: June 2023

ABSTRACT
Artificial intelligence (AI) broadly refers to machines that simulate intelligent human behavior, and research into this field is exponential and worldwide, with global players such as Microsoft battling with Google for supremacy and market share. This paper reviews the “good” aspects of AI in medicine for individuals who embrace the 4P model of medicine (Predictive, Preventive, Personalized, and Participatory) to medical assistants in diagnostics, surgery, and research. The “bad” aspects relate to the potential for errors, culpability, ethics, data loss and data breaches, and so on. The “ugly” aspects are deliberate personal malfeasances and outright scientific misconduct including the ease of plagiarism and fabrication, with particular reference to the novel ChatGPT as well as AI software that can also fabricate graphs and images. The issues pertaining to the potential dangers of creating rogue, super-intelligent AI systems that lead to a technological singularity and the ensuing perceived existential threat to mankind by leading AI researchers are also briefly discussed.
Analgesic efficacy of bupivacaine with or without magnesium adjunct in bilateral ilioinguinal and iliohypogastric nerve blocks following cesarean section under subarachnoid block: A randomized controlled trial
Authors: Ojo Abayomi Kolawole , Olajumoke Tokunbo Olumide , Kolawole Israel Kayode , Adetoye Adedapo Omowonuola , Elegbe Eniola Olanrewaju 
Published: June 2023

ABSTRACT

Background:
Pain relief is a basic aspect of anesthesia care. Optimal post-cesarean section analgesia should minimize postoperative complications, facilitate infant care, and prevent postoperative morbidity. Bilateral ilioinguinal–iliohypogastric (IIIH) nerve block has been considered as a part of the multimodal approach. This study was designed to explore the efficacy of adding magnesium sulfate as an adjunct to bupivacaine to provide analgesia following cesarean delivery, using bilateral IIIH nerve block.

Materials And Methods:
Seventy-two parturients who were scheduled for elective cesarean section were randomized into two groups of 36 patients each. Group MB patients were given bilateral IIIH nerve block with 250 mg of magnesium sulfate and 95 mg of 0.25% plain bupivacaine. Group B patients were given bilateral IIIH nerve block with 0.9% normal saline and 95 mg of 0.25% plain bupivacaine. Postoperative visual analog scale (VAS) pain scores at post-anesthesia care unit (PACU), 2, 4, 6, 12, and 24 h, both at rest and with activity were measured. Rescue doses of opioid (intravenous [IV] tramadol 50 mg) at each time point of assessment, total tramadol consumption, time to patients’ first request for rescue analgesic agent, and patients’ satisfaction score were recorded.

Results:
The demographic and social parameters of patients in both the groups were comparable. The mean postoperative VAS pain score in group MB was significantly lesser both at rest and with movement than in group B at 12 and 24 h after surgery (P < 0.05). Total postoperative tramadol consumed over 24 h was significantly lesser in the magnesium group than in the control group (125.55 ± 20.76 vs. 160.24 ± 25.82 mg), with a P value of 0.026. The time to patient’s first analgesic request was significantly prolonged in group MB compared to group B (505.2 ± 41.4 vs. 372.6 ± 88.8 min, respectively), with a P value of 0.040. However, patients in both groups expressed good satisfaction scores.

Conclusion:
Magnesium sulfate as an adjunct to bupivacaine in bilateral IIIH nerve block reduced VAS pain scores, total tramadol consumption, and prolonged post-cesarean section analgesia.
An unexpected intraoperative airway obstruction due to betadine solution
Authors: Mallikarjuna Swathi , Agarwal Ankit , Kadian Sakshi , Thenmozhi Kuppi Srinivasan 
Published: June 2023

ABSTRACT
Intraoperative airway obstruction is a nightmare for anesthesiologists, especially in head and neck surgeries. Due to the proximity of airway and surgical area, it will be difficult for anesthesiologists for the airway access. There are many causes of intraoperative airway obstruction. To the best of our literature search, there is no case report of airway obstruction due to betadine solution. Here we present a case of airway obstruction due to endotracheal tube blockade by the use of betadine solution in the surgery of cervical region in a child posted for posterior C1-C2 fusion in prone position on skull pins.
Ultrasound-guided seldinger technique-assisted submental intubation for panfacial trauma—walking off the beaten path
Authors: Bihani Pooja , Paliwal Naveen , Jaju Rishabh , Chattopadhyay Chandrashekhar , Chhabra Abhas 
Published: June 2023

ABSTRACT

Introduction:
After introduction of ultrasound, there is paradigm shift towards under vision performance of procedures in anaesthesia. Blind puncture and dissection of submental space may lead to vascular injury and injury to salivary glands. We describe the ultrasound guided Seldinger technique assisted submental intubation for panfacial trauma.

Methodology:
Modified ultrasound guided Seldinger technique for submental intubation in 10 patients, who were posted for open reduction and fixation of panfacial fractures. Total procedural time, peri-procedural complications such as bleeding, dislodgment of tube, desaturation and postoperative complications such as injury to sublingual glands/submandibular glands, hematoma, cheloid or hypertrophic scar formation or skin site infection were noted.

Results:
The mean time to perform submental intubation was 8.9 ± 0.94 minutes (range, 8-11 minutes). Only one patient had minor bleeding during procedure which was stopped after local application of pressure. All patients had a clean scar with no formation of cheloid or hypertrophic scar in the postoperative follow up.

Conclusion:
Ultrasound assisted submental intubation increases safety of the procedure in patients presenting with maxilla-facial trauma.
Neuraxial anesthesia in Lutembacher’s syndrome? Yes, we can!
Authors: Turki Sonali , Arya Abhishek , Kajal Kamal , Gourav Krishna P. 
Published: June 2023

ABSTRACT
Lutembacher’s syndrome is a rare congenital cardiac syndrome comprising of a combination of an atrial septal defect complicated by congenital or acquired mitral stenosis. The applied physiology of the patient depends upon the severity and the interactions of the lesions. They pose certain difficulties to the administration of both general or neuraxial anesthesia. A preference of one form of anesthesia over the other should be based on the understanding of the physiology of the patient. There should not be an orthodox avoidance of neuraxial anesthesia in complex cardiac pathologies as general anesthesia can be associated with certain complications of its own. Here, we report our successful experience of neuraxial anesthesia being administered in a patient with Lutembacher’s syndrome.
2022 in review: a look at key developments in opt-out collective redress in the UK
Authors: Rigby Lucy , Edwards Sofie , Stellardi Anna , McEwen Hannah 
Published: June 2023

2022 was a record year for opt-out collective redress in the UK. The highest number of new collective proceedings claims were filed to date, and a record six claims were granted certification.
While some actions were certified by the Competition Appeal Tribunal without challenge from the defendants, other proceedings were appealed to the Court of Appeal. All of this scrutiny saw both the judiciary – and the parties before it – test the boundaries of the certification stage; ultimately providing important guidance for the young regime.
This article tracks the key developments in 2022 and analyses their impact on the collective proceedings regime under section 47B of the Competition Act 1998, before looking ahead to potential trends in 2023 and beyond.