bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modulation of mucin secretion using combined polyethylene glycol–propylene glycol topical formulation in a hyperosmotic stress-based explant model
Authors: Panigrahi Trailokyanath , James Edwin , Khamar Pooja , Gorimapalli Bhavya , D’Souza Sharon 
Published: April 2023

Purpose:
Ocular surface discomfort and dry eye disease are caused by a dysfunctional tear film. The efficacy of lubricating eye drops on the human eye is known, but the compositions may show differential effects on rescuing the tear film. Mucins form a critical layer of the tear film, a reduction of which may be causative for ocular surface conditions. Therefore, it is essential to develop relevant human-derived models to test mucin production.

Methods:
Human corneoscleral rims were obtained from a healthy donor (n = 8) post-corneal keratoplasty and cultured in DMEM/F12 media. Hyperosmolar stress mimicking dry eye disease was induced by exposing the corneoscleral rim tissues to +200 mOsml NaCl-containing media. The corneoscleral rims were treated with polyethylene glycol–propylene glycol (PEG–PG)-based topical formulation. Gene expression analysis was performed for NFAT5, MUC5AC, and MUC16. Secreted mucins were measured by enzyme-linked immunosorbent assay (ELISA) (Elabscience, Houston, TX, USA) for MUC5AC and MUC16.

Results:
The corneoscleral rims responded to hyperosmolar stress by upregulating NFAT5, a marker for increased osmolarity, as observed in the case of dry eye disease. The expression of MUC5AC and MUC16 was reduced upon an increase in hyperosmotic stress. The corneoscleral rim tissues showed induction of MUC5AC and MUC16 expression upon treatment with PEG–PG topical formulation but did not show significant changes in the presence of hyperosmolar treatments.

Conclusion:
Our findings showed that PEG–PG-based topical formulation slightly alleviated hyperosmolar stress-induced decrease in MUC5AC and MUC16 gene expression that is encountered in DED.
Study of dry eye syndrome: Focus on causative factors, treatment modalities, quality of life, and preservatives used in eye drops
Authors: Raval Pratham M , Patel Harsh H , Purohit Dipali M , Raval Reema M , Sood Shikha V 
Published: April 2023

Purpose:
Dry eye syndrome (DES) is a global issue occurring due to tear deficiency or excessive tear evaporation. It is associated with a variety of symptoms causing ocular discomfort. The purpose of the study was to evaluate causative factors, treatment modalities, quality of life, and preservatives used in eye drops.

Methods:
This prospective, follow-up study was conducted in the ophthalmology outpatient department of a tertiary care teaching hospital. Patients older than 18 years of age of either sex diagnosed with DES and willing to give written informed consent were included. The patients were subjected to the Ocular surface disease index Questionnaire (OSDI Questionnaire) twice; at the time of the first visit and at 15 days follow-up.

Results:
A male preponderance was observed with a 1.86:1 male-to-female ratio. The mean age of the study population was 29.15 ± 10.07 years. The most common presenting complaints were symptoms related to dryness of the eyes followed by refractive error. Exposure to TV/computer screen for more than 6 hours is the most common causative factor. There was a statistically significant improvement in overall quality of life (QoL) in patients of DES on treatment. However, no significant difference was seen in the improvement of quality of life in comparison with different preservatives used in prescribed eye drops for the treatment of DES.

Conclusion:
DES can adversely affect the quality of life of patients. Prompt treatment of this condition can significantly improve the patient’s QoL. Physicians should be encouraged to perform quality of life evaluations for patients with DES to guide them in treatment with more individual-specific treatment options.
Early Retention in Services as a Predictor of Tobacco Cessation: A Medical Record-based Longitudinal Tele-Follow-Up Study at a Tertiary Care Center in Eastern India
Authors: Basu Aniruddha , Rina Kumari , Guin Aparajita , Haokip Hoineiting Rebecca 
Published: April 2023

Abstract

Introduction:
The aim was to evaluate the outcome of tobacco cessation services. The primary objective was to find the association of early retention in services with tobacco cessation outcomes. Secondarily, it tried to find other sociodemographic, clinical, and treatment-related predictors of tobacco cessation.

Methodology:
The outcome would be evaluated through a retrospective–prospective design. The retrospective design was recorded based, while the prospective design was done telephonically by calling the patients and enquiring about their status after at least 6 months since their first visit. Patients with “No tobacco usage in last 1 month” were considered “abstinent.” Those who “reduced their usage in last 1 month” by about 50% were considered to have “reduced” usage, whereas others who “continued their usage in same previous manner” were considered “same” user.

Results:
Out of 356 patients registered between June 1, 2021 and February 28, 2022, 81 (22.75%) could not be contacted, 221 (62.08%) had “reduced usage” after a tele-follow-up of at least 6 months, 50 (14.04%) patients have retained similar amount of usage and 4 patients expired. Of the 221 who reduced usage, 53 were abstinent (14.48%). “Initial retention in services” that is a single physical follow-up was significantly associated with “reduced usage” (P = 0.003) in the tele-follow-up with a median duration of 13 months. With regard to “abstinence,” none could stand the test of significance after correction in the logistic model except “types of tobacco usage” which predicted a statistically significant effect with an odds ratio of 3.15 (P = 0.01).

Conclusion:
This study reveals important information regarding “type of tobacco” as a predictor of abstinence and “initial physical retention” as a predictor of “reduction in tobacco usage.” Such studies need further clarification in future, more robust face-to-face studies with biochemical verification.
Psychosocial Correlates of Recovery Capital in Alcohol and Opioid-Dependent Patients: A Cross-sectional Comparative Study
Authors: Kaur Apinderjit , Lal Rakesh , Sen Mahadev Singh , Sarkar Siddharth 
Published: April 2023

Abstract

Introduction:
All the resources that catalyze this recovery are known as recovery capital. This study aims at finding out the correlates which help increase the recovery capital of an individual and the extent to which it can affect them.

Methodology:
Along with sociodemographic and clinical variables, we assessed recovery capital (Assessment of Recovery Capital [ARC] Scale), religiosity (Duke University Religion Index), spirituality (Daily Spiritual Experience Scale), Coping (Coping Strategies Inventory-short form), social support (Social Support Questionnaire), subjective happiness (Subjective Happiness Scale) of patients diagnosed with Alcohol dependence syndrome (ADS group), and Opioid dependence syndrome (ODS group) who were currently not having withdrawal symptoms.

Results:
A total of 111 individuals were screened, of which 49 in the ODS group and 30 in the ADS group met the selection criteria. The majority of the individuals in both groups were married, belonged to urban areas, practiced Hinduism, and lived in nuclear families. There was a significant difference between the educational status, the religion practiced, the age of onset of dependence, the severity of dependence, and the duration of abstinence between the ADS and ODS groups. Better social support (P = 0.029), higher emotion-focused coping (P < 0.001), and higher engagement (P = 0.001) in ADS, while the pattern of disengagement (P = 0.003) was found higher in the ODS group. Other correlates were comparable in both groups. Recovery (ARC) has a moderate correlation with social support in both groups (ODS-rho = 0.424, P = 0.002 and ADS rho = 0.695, P < 0.001). Furthermore, in the ADS group, a moderate correlation was seen between emotion-focused engagement, problem-focused engagement, and coping skills. While in ODS individuals, a weak correlation of recovery capital was observed with organizational religious activity and emotion-focused engagement, emotion-focused disengagement coping skills.

Discussion and Conclusions:
The results of our study reveal that social support emerged as the important factor common in both groups, which suggests that it should be the key area of psychosocial interventions in both disorders. A focus on enhancing coping styles and increasing other lifestyle factors can help sustain this path for longer.
A Cross-Sectional Questionnaire-Based Study to Assess Anxiety among Healthcare Professionals in India during COVID-19 Pandemic
Authors: Arushi  , Agarwal Mudit , Patel Lajjaben , Agrawal Samprati , Kaur Snimarjot , Dhingra Lovedeep Singh , Boparai Gurasis Singh , Sarkar Siddharth , Ranjan Piyush , Khakha Deepika , Sharan Pratap 
Published: April 2023

Abstract

Background and Aims:
Coronavirus has resulted in unique challenges to the healthcare professionals. The pandemic has affected the mental health of healthcare professionals, which may impact their ability to provide care to patients. We aimed to assess anxiety among healthcare professionals, and its relation to selected parameters.

Methods:
This online questionnaire-based study recruited Indian healthcare workers through convenience sampling. Anxiety was measured using the Generalized Anxiety Disorder 7 scale. The reasons of emotional distress were also ascertained.

Results:
The sample comprised of 677 healthcare professionals including resident doctors, consultants, interns, nursing personnel, and others. Moderate/severe anxiety was present in 24.4% of the respondents. Moderate/severe anxiety was more likely to occur among those who had a friend or family member affected by COVID-19 (odds ratio [OR] 2.74, 95% confidence intervals [CI] 1.61–4.69), or who themselves had a psychiatric disorder in the past (OR 2.44, 95% CI 1.36–4.38). Those who reported long working hours and inadequate sleep, fear of being infected by the virus, concerns about transmitting the virus to a family member, mob violence against doctors, and shortage of personal protective equipment had significantly higher odds of moderate/severe anxiety.

Conclusion:
A considerable proportion of healthcare professionals suffering from anxiety suggests the need for addressing their mental health concerns.
COVID-19 and Women’s Mental Health during a Pandemic – A Scoping Review
Authors: Das Nileswar , Kathiresan Preethy , Shakya Pooja , Sarkar Siddharth 
Published: April 2023

Abstract
The novel coronavirus disease (COVID-19) has infected more than 10 million people globally, and it caused more than 500 thousand deaths. Researchers have highlighted the need for early detection and intervention for psychological ill effect of the pandemic on various population subgroups. Women may be more vulnerable in such a crisis phase. This review addresses the mental health needs of women and the kind of interventions needed to cater to their various psychological issues. All existing literature was searched using PubMed, Google Scholar, and Medline databases for articles published on mental health aspects of women during COVID-19 pandemic. Only English language articles published till June 15, 2020, were considered for the review. Data were extracted by the authors from the selected articles, and the findings were synthesized in a narrative format. From the available literature, following themes were identified for further discussion: sexual health and contraception, pregnancy, lactation, domestic abuse, female healthcare workers, women with pre-existing mental illness, women with substance use disorders, homeless women, refugees, and professional sex workers. Studies have reported a higher burden of mental health issues in females than male counterparts and an increase in domestic violence and crises for those at-risk (such as refugees and women with pre-existing illnesses). Women mental health is compromised in many aspects due to COVID-19 pandemic. Findings stress upon the increased need for early detection and prompt intervention for women in the community to alleviate the long-term psychological consequences of this pandemic.
Person-Centered Medicine and Psychiatry – Emerging Perspectives
Authors: Kallivayalil Roy Abraham , Enara Arun 
Published: April 2023

Abstract
Person-centered medicine is dedicated to the promotion of health as a state of physical, mental, socio-cultural and spiritual wellbeing as well as to the reduction of disease, and founded on mutual respect for the dignity and responsibility of each individual person. The concept of person centered care has evolved over the years and the main focus has been on moving further away from biological reductionism that has plagued western medicine. In the recent years, a critical evaluation of the current practices in psychiatry and the emerging lived experience research has helped garner momentum to the narratives around person centered care. In times of psycho-social adversity, and especially when health resources are inadequate, Person Centered Medicine offers a ray of hope. The article will look into some of the emerging perspectives in person centered care.
Evaluation of Peripheral Arterial Disease Using Noncontrast Magnetic Resonance Angiography
Authors: Gulhane Ämol Vijay , Mandapal T , Murali Belman , Burli Pradeep , Gupta P C 
Published: April 2023

Introduction:
Peripheral arterial disease is common in older age group. PAD is evaluated using Doppler, contrast CT and MR angiography. Many PAD patients have comorbidities like diabetes, hypertension and renal dysfunction. CT and MR contrast administration is considered risky in patients with impaired renal function. CT contrast agents are nephrotoxic. Gadolinium-based MRI contrast are associated with nephrogenic systemic fibrosis in patients with severe renal dysfunction.

Aims:
The aim of our study was to evaluate the usefulness of non contrast enhanced MR angiography in imaging of peripheral arteries in patients with impaired renal function.

Materials and Method:
This prospective study was done using ECG-triggered 2D TOF MR Angiograpgy on 1.5 Tesla MR unit in PAD patients having renal dysfunction. We studied various arterial segments of lower limb for the degree of narrowing on MRA and compared the findings in all patients with duplex scan and in some patients with DSA. We determined accuracy, sensitivity, specificity, PPV and NPV of MRA compared to duplex scan for assessment of arterial luminal narrowing.

Results:
Our study results have demonstrated that in patients with high grade blockage (>50% diameter reduction or arterial occlusion) NC MRA had almost 100 % accuracy, sensitivity, specificity, PPV and NPV when compared to duplex scan in iliac, femoro-popliteal and tibioperoneal segment. In patients with low grade blockage (<50% diameter reduction) NC MRA had low sensitivity with high specificity and NPV.

Conclusion:
ECG-triggered non contrast-enhanced MR angiography (NCMRA) is safe and highly accurate in PAD patients having renal dysfunction.
Carotid Body Tumor Presentation, Management, and Outcome an Institutional Experience – 12-Year Experience
Authors: Prabhu B Venkatesh , Duraichi B Vella , Sritharan N , Jeyachander K , Ilayakumar P , Kumar S Prathap , Babu R Ranjith , Ramya M , Sujith P Jan 
Published: April 2023

Objective:
This study aimed to analyze the presentation and treatment modalities of carotid body tumor (CBT) and evaluate the outcomes and complications of surgical treatment of CBT.

Methodology:
Twenty-seven CBT patients treated surgically from January 2012 to August 2022 were included in the study. Patient presentation, diagnostic modalities, surgical and radiological interventions, outcomes, and complications were analyzed.

Results:
(1) A total of 27 patients were studied, with an age ranging from 13 to 65 years (median age - 45 years), in which male preponderance was found (male: female = 2.5:1), (2) Local swelling was the most common symptom (n = 27), with other symptoms being hoarseness of voice, dysphagia, and ear/neck pain, (3) Left laterality was found in 76.2% of patients, whereas 17.3% of them were right sided with 6.5% of bilateral cases, (4) 15 patients (55.5%) out of the 27 total patients, were classified in Shamblin’s type II, 8 patients (29.6%) in Shamblin’s type I, and the remaining 4 patients (14.8%) as Shamblin’s type III CBTs, (5) Thirteen (48.1%) patients underwent preoperative angioembolization. All (100%) patients underwent complete excision (6) Operative site hematoma was the most common postoperative complication encountered. All patients are asymptomatic with the minimum of 6-month follow-up.

Conclusion:
Careful preoperative evaluation, which included appropriate modality for diagnosis, preoperative angioembolization for large tumors, meticulous dissection, and good postoperative care, resulted in complete excision of all the tumors and with less complications postoperatively. Shamblin III had a high risk of postoperative neurovascular complications. Therefore, early detection and prompt surgical resection of CBTs will decrease surgical morbidity.
Evaluation of Non-Modifiable Factors Associated with Post-Dural Puncture Headache Following Subarachnoid Block Utilising 26 G Quincke Spinal Needle: Prospective, Observational Study
Authors: Negi Chander Mohan , Bhandari Shyam , Kumar Ravinder , Rana Shelly , Sharma Radhika , Kaushal Nishita 
Published: April 2023

Background and Aims:
Post-dural puncture headache (PDPH) is one of the complications of the subarachnoid block (SAB), and the incidence of PDPH is influenced by various factors related to either patients or the type of spinal needle used. This study observed the incidence and severity of PDPH in relation to non-modifiable factors in the patients scheduled for surgeries under SAB.

Methods:
The study enrolled 302 obstetric and non-obstetric patients, aged 20–60 years, American Society of Anesthesiologists (ASA) I/II having body mass index (BMI) 18.5–29.9 kg.m-2 scheduled for surgeries under SAB utilizing 26 G Quincke spinal needle. Primary outcome was the incidence of PDPH in obstetric and non-obstetric patients. The secondary outcomes included onset, severity of PDPH, and association of age, BMI, and gender to PDPH.

Results:
The total incidence of PDPH was 5.6%, eight (7%) patients in obstetric and nine (4.8%) patients in non-obstetric group (P = 0.597). The onset of PDPH was comparable in obstetric 17.25 ± 3.69 and non-obstetric patients 18.0 ± 6.02 h (P = 0.663). None of the patient had severe PDPH. The BMI of the patients was not associated with the incidence of PDPH. The female patients among non-obstetric group had higher incidence of PDPH (P = 0.0002). The six patients having PDPH in non-obstetric group belonged to age-group of 31–40 yrs as compared to two above 40 years (P = 0.0173).

Conclusion:
Obstetric population had comparable incidence of PDPH to non-obstetric population. In the subgroup analysis of non-obstetric patients, the higher incidence of PDPH was observed in the female and younger patients.
Evaluation of High Flow Nasal Oxygenation as a Technique for Preoxygenation in Full Term Pregnant Women
Authors: Ajeetha P.G , Kachru Nisha , Saraswat Namita 
Published: April 2023

Background and Aims:
Obstetric airway guidelines recommend preoxygenation before the induction of general anesthesia to achieve an end tidal oxygen concentration of ≥90%. Recently, high flow nasal oxygenation (HFNO) has been evaluated as a technique for delivering a high concentration of oxygen using high flow rates to patients. We evaluated the use of HFNO as a technique for preoxygenation in full-term pregnant women.

Methods:
A cross-sectional observational study was conducted on 100 term pregnant women. They underwent preoxygenation using HFNO for 4 minutes (30 L/min for 30 secs followed by 50 L/min for 210 secs) and end tidal oxygen concentration (ETO2) was measured at the end of preoxygenation. The primary outcome was the percentage of women who achieved an expired oxygen concentration of ≥90% for the first expired breath. The secondary outcome was the acceptability and comfort of HFNO as compared to facemask preoxygenation using a 4-point Likert scale.

Results:
The percentage of women who achieved expired oxygen concentration of ≥90% after 4 minutes of HFNO preoxygenation was 32% [95% confidence interval (CI):22.7-41.3%] with the mean end tidal oxygen (SD) being 86.67 (3.4). 71% [mean (SD): 2.94 (0.92)] found nasal cannula and 56% [mean (SD): 2.67 (1.21)] found facemask comfortable and acceptable for preoxygenation (P value, 0.05).

Conclusion:
Although HFNO is a comfortable technique, when used for preoxygenation for 4 minutes, it did not achieve an acceptable level of preoxygenation (ETO2 ≥90% in 95% of individuals). Therefore, it is an inadequate technique for preoxygenation in term pregnant women.
Walking Epidural in Labor Analgesia: A Comparative Study of Ropivacaine with Fentanyl and Without Fentanyl
Authors: Thacker Avni , Kheskani Divya , Panchal Divyesh , Chhanwal Heena 
Published: April 2023

Background:
Labor pain and child birth entail a number of physiological consequences that may lead to deleterious effects on the mother and fetus. Implication of a neuraxial technique is being appreciated in labor. Fetal prognosis and maternal consent and its satisfaction are key to labor analgesia.

Method:
The primary objectives were to determine the visual analog scale (VAS), total duration of labor analgesia, patient-controlled analgesia demand, sensory and motor block, and hemodynamics. The secondary objectives were to determine obstetrics parameters such as maternal satisfaction, cervical dilation, membrane, APGAR score, and complications such as hypotension, bradycardia, and vomiting. A randomized prospective comparative, interventional study including 50 parturients was conducted, where they were divided into two equal groups of 25 each, and epidural analgesia was given by 0.2% ropivacaine with 2 mcg/ml fentanyl and 0.2% ropivacaine without fentanyl.

Observation and Results:
Analgesia was more in the RF group compared to the R group. The maternal satisfaction was more in the RF group than in the R group. Clinical hemodyamics, VAS score, Bromage score, and APGAR score were appreciable in the RF group as compared to the R group.

Conclusion:
We concluded that 0.2% ropivacine with fentanyl gives more analgesia and maternal satisfaction than ropivacine alone.