bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study of Post COVID-19 Psychiatric Disorders in a Tertiary Care Hospital of Central India
Authors: Mudgal Varchasvi , Rastogi Pali , Jain Priyash , Kaur Partik 
Published: June 2023

Background and Aim:
COVID-19, one of the deadliest pandemics, has taken a toll on physical and mental health alike. It has been noticed that there is a rise in psychiatric comorbidities in COVID-19 recovered cases. Various disorders such as posttraumatic stress disorder, anxiety, depression, and sleep disorders have been reported in COVID-19 survivors. The current study aims to estimate the prevalence of psychiatric disorders and their associated correlation in patients with a history of COVID-19.

Materials and Methods:
The study population comprised the patients referred to the psychiatry outpatient department (OPD) from the post-COVID-19 OPD over 3 months. Patients were assessed using a semi-structured pro forma, sociodemographic profile, treatment facility (institutional or home quarantined), duration of stay at the treatment facility, and medical and psychiatric diagnoses were recorded and analyzed using descriptive statistics.

Results:
One hundred and sixty patients were included and assessed of which 66.25% were male and 33.75% were female. The mean age was 38.8 years. The referral rate was found to be 15.9%. The most common psychiatric disorder was sleep disorder (25%), followed by Reaction to severe stress and adjustment disorder (16.25%), depression (11.25%), and anxiety disorder (10%).

Conclusion:
We would like to emphasize on vigilant approach and constant supervision of these patients so that an early diagnosis could be made and an add-on the burden to the mental health care system could be reduced. For this to be achieved screening of such patients should be increased.
Assessing Diabetic Macular Edema through Spectral Domain Optical Coherence Tomography: An Analysis of Foveal Thickness, External Limiting Membrane, and Ellipsoid Zone Integrity
Authors: Gayatri Dasari , Rao V. V. L. Narasimha , Chavali Satyavara Prasad 
Published: June 2023

Background and Aim:This study emphasizes using external limiting membrane (ELM) and EZ ellipsoid zone (EZ), disruption as imaging biomarkers in fovea-involved diabetic macular edema (DME).Materials and Methods:This is a retrospective study conducted in the Department of Ophthalmology, Gitam Institute of Medical Sciences and Research, from June 2021 to May 2022. Spectral-domain optical coherence tomography (SD-OCT) images of 17 patients with fovea-involved DME were analyzed in this retrospective pilot study. Neither disruption of ELM nor EZ was graded 0, only disruption of ELM was graded as 1, and disruptions of both ELM and EZ were graded 2.Results:Twenty-five eyes (SD-OCT pictures) of 17 patients, nine men and eight women, with a mean age of 54.23 years (35–77 years), were included in the study. Eleven (44%) eyes had mild nonproliferative diabetic retinopathy (NDPR) with clinically significant macular edema (CSME). Seven (28%) eyes had moderate nonproliferative diabetic retinopathy (NPDR) with CSME, and 7 (28%) eyes had severe NPDR with CSME. Cystoid pattern of macular edema was present in 15 (60%) eyes; 3 (12%) eyes had cystoid pattern with vitreomacular traction (VMT), 1 (4%) eye had cystoid pattern with serous retinal detachment (RD), 5 (20%) eyes had diffuse macular edema, and 1 (4%) eye had diffuse CSME with VMT. Ten (40%) eyes had grade 0 ELM and EZ disruption with a foveal thickness of 245–310 μ (mean – 269.2), 3 (12%) eyes had grade 1 with foveal thickness varying from 263 to 348 μ (mean 301.3) and 12 (48%) eyes had grade 2 with a macular thickness of 315–651 μ (mean 467.8).Conclusion:A statistically significant association exists between foveal thickness and disruption of the ELM and EZ. Grade 0 had a foveal thickness ranging from 240 to 260 μ, grade 1 from 260 to 340 μ, and grade 2 from 340-≤650 μ.
Jigsaw: A Step toward Co-Operative Learning among Medical and Nursing Students
Authors: Kumar C. S. Vinod , Kalasuramath Suneeta , Reddy S. Jayandra , Reddy R. Sriman Narayan 
Published: June 2023

Background and Aim:
To shift the paradigm from passive tutor driven tutorials to more responsible active learning by the students, a co operative teaching learning method could be a good alternative. The Jigsaw approach, a model of co operative learning, focuses on learning in groups with fellow learner co operation and reassures team work. Thus, this study was aimed at assessing the effectiveness of jigsaw strategy in comparison to tutorials in enhancing cognitive skills among the medical students in microbiology.

Materials and Methods:
A cross sectional study was carried out at microbiology department for 50 consenting MBBS students of professional year II and 50 consenting B.Sc nursing students of 2nd years. Students were randomly divided into two batches: Aand B of 25 students each. They were prepared for either a jigsaw (Experimental) or tutorial (Control) a week prior on predecided topics. The same groups were crossed over for another topic. Students’ performance was assessed by pretest, posttest, academic achievement level, and retention test by prevalidated multiple choice questionnaires. The student perception on TL methods was evaluated by using learning experience questionnaires.

Results:
Posttest scores of both groups were found to be significant at the level of P < 0.05. Among medical students, mean of posttest scores in the jigsaw is more than tutorial (12.4 v/s 9.7, crossover 13.3 v/s 11.2) and in nursing students (11.7 v/s 8.2, crossover 11.6 v/s 9.9). Mean retention tests scores and absolute achievement level were high in jigsaw groups. The students preferred jigsaw over the tutorial.

Conclusion:
Jigsaw strategy is a robust instructional tool, well perceived by the students to enhance cognitive skills as inferred by the results and can be tailored to the needs of varied topics across different disciplines.
Prevalence of Hyperglycemia on Admission and its Effect on Short-Term Cardiovascular Outcomes of Non-ST Elevation Myocardial Infarction: A Retrospective Study from a Tertiary Care Center in South India
Authors: Mandal Amit , Iyyadurai Ramya , Ninan K. Fibi , Gunasekaran Karthik 
Published: June 2023

Background and Aim:
Hyperglycemia has a significant negative impact on the morbidity and mortality of patients presenting with acute myocardial infarction. This retrospective study was conducted to determine the short-term clinical outcomes (inhospital mortality, cardiogenic shock, acute heart failure, stroke, fatal arrhythmia, and length of stay) of patients with non-ST-elevation myocardial infarction (NSTEMI) patients and to compare the outcomes in NSTEMI patients with and without hyperglycemia on admission. We also wanted to identify the clinical profile and assess the mortality rates in patients with NSTEMI.

Materials and Methods:
This retrospective study was conducted over 7 years (April 1, 2014–July 31, 2021). The data were extracted from the inpatient medical records and it was analyzed. All adult patients requiring admission in a single medical unit with a diagnosis of NSTEMI were included in the study. Descriptive statistics were obtained for all variables and entered in MS Excel and analyzed with SPSS (SPSS for Windows, version 16.0, Chicago, IL, USA) in the study, and appropriate statistical tests like P value were employed to ascertain the significance. Factors that were significant in univariate analysis were tested by multivariate regression analysis to identify those that independently predicted poor outcomes.

Results:
Our study cohort consisted of 260 patients, 144 (55.4%) patients had hyperglycemia on admission (admission blood sugar >200 mg/dl), and 116 (44.6%) had normoglycemia. In our cohort, 166 (63.8%) were male. The most common comorbidity was diabetes mellitus 195 (75%) and 134 (68.7%) diabetic patients had hyperglycemia at presentation. The most common clinical outcome was acute heart failure in 225 (86.5%), followed by cardiogenic shock in 110 (42.3%) patients. Fifteen (5.8%) patients had acute cerebrovascular accident during the hospital stay and 39 (15%) had developed fatal arrhythmias. The mean ± standard deviation duration of hospital stay was of 7.09 ± 5.396 days. The mortality in this cohort was 67 (25.8%). The presence of hyperglycemia on admission was not found to have an effect on mortality (odds ratio [OR]: 0.61, 95% confidence interval [CI]: 0.34–1.10, P = 0.102); however, the presence of hyperglycemia on admission was an independent predictor of cardiogenic shock (OR: 2.18, 95% CI: 1.069–4.483, P = 0.032), acute heart failure (OR: 3.52, 95% CI: 1.44–8.59, P = 0.006), and acute cerebrovascular accident (OR: 13.76, 95% CI: 1.67–112.0, P = 0.015).

Conclusions:
The presence of hyperglycemia on admission is an independent predictor of short-term outcomes such as cardiogenic shock, acute heart failure, and acute cerebrovascular accident; however, it does not have an effect on inhospital mortality. NSTEMI is associated with significant mortality.
A Randomized Control Trial to Compare the Efficacy of Dexmedetomidine and Labetalol for Induced Hypotensive Anesthesia in Ear, Nose, and Throat Surgeries
Authors: Chacko Robin Sajan , Priyadharsini K. Soundarya , Arif Mohamed , Prasad T. Krishna 
Published: June 2023

Background and Aim:
Induced hypotension is advantageous in certain types of procedures like endoscopic surgeries in which it establishes a clear surgical field and simultaneously reduces surgical blood loss. The quest for an ideal hypotensive agent still continues in this modern era where many classes of antihypertensive drugs are being studied to provide a predictable and safe reduction in blood pressure with least side effect profile. In this study, we aimed to assess the efficacy of dexmedetomidine and labetalol in providing hypotensive anesthesia in patients undergoing ear, nose, and throat surgeries.

Materials and Methods:
This was a prospective, double-blinded, randomized controlled study. Fifty-eight individuals undergoing ear, nose, and throat surgeries were randomly divided into two groups (Groups A and B). Group A received an intravenous infusion of 0.25 mg/kg of labetalol as a bolus over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 30 mg/h till the end of surgery. Group B received a loading dose of 1 μg/kg of dexmedetomidine intravenously over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 0.4 μg/kg/h till the end of surgery. In both the groups, diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate, and oxy-hemoglobin saturation (SpO2) were recorded. These study variables were recorded before the administration of the study drug, immediately after the administration of the bolus dose of study drug, at the time of induction of anesthesia, immediately after intubation, and then at regular intervals until the end of the surgery. In addition to the abovementioned study, variables blood loss, recovery time, and surgeon satisfaction were also recorded.

Results:
The heart rate was significantly lower in Group B when compared to Group A at various time intervals. There was no significant difference between the two groups in terms of DBP, SBP, MAP, and SpO2. The blood loss was lesser and the surgeon satisfaction was better in Group B when compared to Group A. The difference in blood loss and surgeon satisfaction was statistically significant between the two groups. However, the recovery time was faster in Group A and the difference was statistically significant.

Conclusions:
Patients in both the groups showed a reduction in blood pressure, but dexmedetomidine was associated with greater reduction in heart rate, lesser blood loss, and more surgeon satisfaction, whereas labetalol was associated with faster recovery from anesthesia.
Is Metabolic Syndrome a Fellow Traveler with Abnormal Uterine Bleeding in Women of Reproductive Age? A Case–Control Study
Authors: Balakrishnan Grrishma , Tyagi Manasvi , Uppinakudru Gurunandan , Thalanjeri Padmini , Kaveri Vismaya , Balasubramaniyam Kalpana , Ali Syed Irfan 
Published: June 2023

Background and Aim:
Abnormal uterine bleeding (AUB) has a major social, psychological, and economic impact on women aged 18–45 years, in the most productive stage of their life. This study was done to assess the impact of menstrual and obstetric patterns, cardiometabolic risk factors, and metabolic syndrome on women of reproductive age with AUB.

Materials and Methods:
Our hospital-based case–control study had 61 participants, of which 31 were cases and 30 were age-matched controls. They were compared on their age, age of menarche and marriage, number and type of deliveries, contraceptives used, cardiometabolic risk factors like body mass index, waist-hip ratio, waist-height ratio, fasting blood sugar (FBS), total cholesterol (TC), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), and having metabolic syndrome.

Results:
The majority of the cases were 36–45 years of age. The mean age of marriage was significantly less but the parity was more ≥2 in cases when compared to controls. FBS, TC, triglycerides, LDL, and HDL in cases were significantly more than controls. A 33.3% of cases had metabolic syndrome. Women with metabolic syndrome were 15 times more likely to develop AUB, as compared to normal women.

Conclusion:
Age of menarche did not influence but lower age of marriage and increased number of pregnancies had a profound effect on the occurrence of AUB. Metabolic syndrome is significantly associated and could be a potential fellow traveler in women with AUB.
Post-Anaesthetic Herpetic Lesion following Extraction - A Case Report
Authors: Balasubramaniyan Nathiya , Sakthi S. , Bhagat M. James Antony , Durairaj D. , Ganesan Suresh Kumar 
Published: June 2023

Abstract

Rationale:
In Indian subcontinent, every adult may have suffered from chicken pox during their early childhood and harbour the virus, which eventually becomes inactive over years. These latent organisms can undergo sudden activation when triggered by injection of local anaesthesia in the oral cavity. Probably, some symptoms develop along the distribution of the nerve.

Patient Concerns:
Here, we present a case report of a 55-year-old male patient who reported to us with post-anaesthetic herpetic lesion involving the face unilaterally and also a lesion present in the intraoral cavity not crossing the midline.

Diagnosis:
The patient was diagnosed as post-anaesthetic herpetic lesion.

Treatment:
Symptomatic medical management was given.

Outcomes:
On two month follow-up, the lesion was completely resolved and replaced by healthy tissue.

Take-Away Lesson:
Medical history should also include a question about past experience with chicken pox before proceeding with extraction.
Outcomes of Open Rhinoplasty for Unilateral Cleft Patients using Photogrammetric Analysis - An Evaluative Study
Authors: Elkashty Sherif Mohamed , Taalab Ahmed Abdelaziz , AboShaban Mohammed Saad 
Published: June 2023

Abstract

Introduction:
Secondary cleft rhinoplasty is a challenge due to the complex anatomy of the nose, with structural deformity and difficulty in surgical management. This study aimed to evaluate the effect of an anatomical-based approach on enhancing tip and alar symmetry in secondary unilateral cleft rhinoplasty using photogrammetric evaluation.

Methods:
The study was conducted on 57 adult patients seeking rhinoplasty after primary repair of congenital unilateral cleft lip deformity. All patients were operated upon using an external open rhinoplasty approach using an anatomical-based surgical technique. The cases were periodically followed up at three, six, 12 and 18 months for both aesthetic and functional outcomes with photogrammetric analysis of facial profile using the software Mirror Suite programme to compare before and after the surgical procedure.

Results:
The photogrammetric analysis showed a significant improvement of facial angles (P = 0.05). The nasofrontal angle changed from a median of 146° to 132.5°, nasolabial angle of 73° to 95°, nasofacial angle of 21.5° to 32° and nasomental angle of 105° to 130°. The rotation angle of the nasal tip showed a significant cephalic rotation with a mean increase of the tip elongation of 1.8 cm achieved per lateralised millimetre.

Discussion:
Secondary rhinoplasty in unilateral cleft deformities needs accurate evaluation of the anatomical and pathological abnormalities. Open approach is preferred with using costal cartilage graft allowing adequate columellar lengthening, maxillary enhancement and alar repositioning which leads to optimise the definition, projection and cephalic rotation with better stabilisation and symmetry of the nasal tip.
A study of the effect of some musical compositions on glucagon-like peptide 1, insulin, leptin, and body weight of crowded adult albino rats
Authors: Al-Etreby Mohamed Z. , Khalil Ali A. , Abd-Elrhman Ahmed Abd-Elhamid 
Published: June 2023

Background and Aim
Music therapy is an established health profession where music is used to address cognitive, emotional, social, and physical needs of individuals. Stress is a reaction of an organism to stimulus that changes psychophysiological equilibrium with harmful consequences, by affecting the concentration of hormones related to homeostasis.
The current study aimed to assess the possible effect of enhancing the quality of environment to alleviate stressful environmental conditions.

Materials and methods
A total of 45 adult male albino rats were chosen for this study. They were divided into five groups as follows: group 1, uncrowded control rats; group 2, rats exposed to crowding; group 3, rats exposed to crowding and listening to instrumental music; group 4, rats exposed to crowding and listening to soft songs; and group 5, rats exposed to crowding and listening to rallying songs. After 90 days, all rat groups were anesthetized, and a blood sample was collected for measurement of glucagon-like peptide 1 level, insulin level, and leptin level for these groups.

Results
Music had no significant (P<0.05) effect on water and food consumption, but it had a significant (P<0.01) effect on body weight in music listening groups in comparison with the control crowded group. Music listening can significantly (P<0.01) increase the level of glucagon-like peptide 1 and leptin but significantly (P<0.01) decrease the level of insulin in comparison with the control uncrowded group.

Conclusions
Music may alleviate stressful situations and improve the quality of life.
Comparative study between manipulation under anesthesia combined with local steroid injection versus local steroid injection alone in resistant cases of coccydynia
Authors: Elsadek Amer A.M. 
Published: June 2023

Background and aim
Coccydynia is pain around and in the coccyx; it is not a diagnosis, but it is symptom. Typically, the affected patients suffer from pain while sitting and particularly when rising from sitting. The current study aims to compare the manipulation under anesthesia combined with local steroid injection versus local steroid injection alone in resistant cases of coccydynia.

Patients and methods
The present study included 20 patients with coccydynia of different etiologies that unresponsive to medical treatment for more than 3 months. Those patients were classified into two groups: the first group included 10 patents that received a local injection alone. The other 10 patients of the second group had local steroid injection followed by immediate mobilization under anesthesia. The degree of improvement was recorded in every outpatient visit (1 week following the procedure, 1 month later, 3 months later, and after 6 months).

Results
The obtained results were evaluated according to visual analog scale (VAS) score and ODI. Patients in the first group had 5025+ improved at least two grades on the VAS score two (20%) of them had relapsed and their complaint recurred after 2 months. Another three (30%) patients had recurrence of the original complain after 4 months, that is, 50% of the cases had recurrence. Patients in the second group had improvement of more than four grades in the VAS score with no recorded recurrence, however two of them felt some discomfort for about 2 days after the manipulation that improved spontaneously.

Conclusion
Manipulation under anesthesia combined with local steroid injection is more superior to local injection alone in management of resistant coccydynia.
Oral versus intravenous omeprazole in management of bleeding peptic ulcer: a randomized controlled trial
Authors: Abdelmohsen Ahmed S. , Ahmed Zeinab N. , Hasanain Ahmad F. , Abozaid Mohamed A.A. , Hassan Waleed A. 
Published: June 2023

Background
Upper gastrointestinal bleeding (UGIB) is a common gastrointestinal emergency with significant morbidity and mortality. Intravenous (IV) route administration of proton pump inhibitors is more commonly used for prevention of bleeding; however, it is more expensive and invasive than the oral route. We, herein, compared between oral and IV omeprazole in patients with high-risk UGIB regarding outcome.

Patients and methods
Patients with high risk for rebleeding peptic ulcers were included. All patients initially received IV omeprazole, and then esophagogastroduodenoscopy with hemostatic procedure was done. Thereafter, the patients were allocated to group A, who received oral omeprazole, and group B, who received IV omeprazole. The patients were followed up for 2 weeks for signs of rebleeding. Reendoscopy, angioembolization, or surgery was provided when needed (NCT04170270).

Results
The study included 189 patients (96 in group A and 93 in group B). Frequency of rebleeding was higher among patients in group B (40%) compared with those in group A (30%) (P: 0.1). Reendoscopy was more frequently required for patients in group B (16.1%) than those in group A (3.1%) (P<0.001). Surgery was mandatory for three (3.2%) patients in group B, whereas angioembolization was used nearly equally in both groups (31.3% in group A vs. 29% in group B). Admission to ICU was more frequently needed (P: 0.02) and the length of hospital stays was longer (P: 0.003) for patients of group B. Regarding UGIB-related deaths, three (3.1%) patients from each group died.

Conclusion
Oral omeprazole is not inferior to IV omeprazole as adjuvant therapy to control peptic ulcer bleeding and to reduce the frequency of rebleeding.