bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular response analyzer and posterior segment optical coherence tomography findings in refractive surgery candidates
Authors: Samir Ghada , Elmassry Ahmed A.K. , Bayoumi Nader , Osman Ehab M. 
Published: December 2022

Aim
The aim of the study was to report on the ocular response analyzer and posterior segment optical coherence tomography findings in refractive surgery candidates.

Patients and methods
The study was conducted on 100 eyes of 50 (37 females) patients seeking refractive surgery at a private eye center in Alexandria, Egypt. Following detailed history taking, all study participants were subjected to a thorough ophthalmic examination including assessment of uncorrected and best-corrected visual acuity, manifest and cycloplegic refraction, slit-lamp examination, measurement of intraocular pressure (IOP) using Goldmann applanation tonometry, and fundus examination using a high plus auxiliary lens. Optical coherence tomography and corneal biomechanical properties were then studied using the Reichert ocular response analyzer.

Results
The mean±SD age of the study patients was 25.27±4.9 years and of contact lens wear (24% of study patients) was 2.5±0.9 years. The mean±SD of the manifest refractive error was −5.6±5.2 D sphere and −1.6±1.2 D cylinder and of the best-corrected visual acuity was 0.9±0.2. The mean±SD of the IOPg, IOPcc, corneal hysteresis and cornea resistance factor were 14.9±3.8, 16.5±3.4, 9.3±1.9, and 9.4±2 mmHg, of the Peripapillary Retinal Nerve Fibre Layer (pRNFL) thickness were 68.9±20.5 μ nasal, 113.3±20.7 μ superior, 77.7±16 μ temporal, and 119.3±21.5 μ inferior and of the central macula thickness was 270.8±22.9 μ.

Conclusions
The corneal biomechanical properties and the macular nerve fiber layer thickness are not correlated with the refractive error of the eye, whereas the peripapillary nerve fiber layer thickness correlates with the refractive error and the visual acuity. Screening of the corneal biomechanical properties and the nerve fiber layers is recommended for refractive surgery candidates.
To Evaluate the Effect of Increasing Maternal Age on Maternal and Neonatal Outcomes in Pregnancies at Advanced Maternal Age
Authors: Juneja Sunil Kumar , Tandon Pooja , Kaur Gagandeep 
Published: December 2022

Abstract

Introduction:
Late pregnancies have been a sensitive issue in the society and medical field for many years. The reason for this development could be the increasing use of reproductive techniques, women empowerment and late conceptions. The increased level of education in women, having more responsibilities at work, giving priority to their professional career could be leading to delay in conception and childbearing. Many studies have investigated the effect of advanced maternal age on fetal outcome suggesting higher risk of poor neonatal outcome. Recent studies have debated these outcomes.[1
-
4]

Aims and Objectives:
To evaluate the effect of increasing maternal age on maternal and neonatal outcomes in pregnancies at advanced maternal age.

Material and Methods:
The study was conducted on 843 women above the age of 35 years who delivered at Dayanand Medical College and Hospital during 2015-2020. Patients were categorized into 2 groups, Group A comprised of pregnant women aged 35-40 years; group B included pregnant women aged >40 years. Various other parameters including parity, gestation at delivery, whether the pregnancies were spontaneous or conceived through ART (assisted reproductive techniques) and other associated co-morbid conditions were noted. The obstetrical, gynecological, medical, surgical, fetal and neonatal complications were studied in both the groups and the data was analyzed with release 9.4 (SAS Institute Inc, Cary, NC).

Results:
Out of 843 patients in our study, 81.4% (n=687) belonged to the age group of 35- 40 years. 18.5% (n=156) belonged to the age group of > 40 years. Patients more than 40 years underwent ART for conception more often as compared to group A. Co-morbid medical conditions including chronic hypertension, thyroid diseases, auto immune disorders and obstetric complications such as abortions, oligohydramnios, GDM, placenta previa, PPH was significantly more common in patients with group B. Cesarean delivery rate was significantly more in group B as compared to group A. Neonatal outcome in terms of NICU admissions and preterm birth at less than 35 weeks gestation was seen more frequently in group B as compared to Group A.

Conclusion:
Our study concludes that the decision to delay childbearing should be discouraged owing to increased maternal and fetal morbidity associated with advanced maternal age, the risks being higher with increasing maternal age.
Role of Efflux Pumps in Reduced Susceptibility to Tigecycline among Clinical Isolates of Acinetobacter baumannii
Authors: Mahapatra Ashoka , Pati Amresh , Gupta Kavita 
Published: December 2022

Abstract

Background:

Acinetobacter baumannii (A. baumannii) is a very well-known emerging pathogen and has become a major burden on healthcare system especially in intensive care units (ICUs). Tigecycline is the last resort drug for treatment of multidrug-resistant A. baumannii infections. However, non-susceptibility to this drug is a rising problem. Resistance to tigecycline is mediated by Resistance-nodulation-cell division (RND) efflux pumps.

Objective:
This study was done to detect efflux pump genes (adeABC) and regulator genes (adeS,adeR) responsible for tigecycline resistance among the clinical isolates of A. baumannii.

Materials and Methods:
A total of 150 OXA-51 confirmed clinical isolates were subjected for tigecycline susceptibility test by broth microdilution (BMD) method. All isolates irrespective of their MIC were subjected to conventional PCR for detection of efflux genes (adeABC) and regulator genes (adeRS).

Results:
Prevalence of tigecycline resistance was found to be 14 (9.33%) by the reference broth microdilution method (BMD). Overall prevalence of efflux genes was highest for adeB (69%) and lowest for adeR (29%). Combination of genes especially three, four or five were found more prevalent among resistant isolates with higher minimum inhibitory concentration (MIC).

Conclusion:
Combination of efflux genes confer higher MIC and can be a major contributor for resistance to tigecycline.
A Retrospective Observational Study to Compare the Outcome of Various Treatment Modalities of Idiopathic Avascular Necrosis of Hip
Authors: Bakshi Amandeep Singh , Singh Mandeep , Kaur Gurleen , Singh Jaspreet , Kaur Harsimrat 
Published: December 2022

Abstract

Background:
Avascular necrosis (AVN) of hip of the femoral head is increasingly seen in young age, disabling them in their productive years of life. Available treatment options need to be evaluated.

Aim:
The aim was to compare the outcome of various treatments at different stages of AVN hip.

Materials and Methods:
A retrospective observational study was done in patients with idiopathic AVN hip, who had undergone different treatment modalities. The data of the included patients at different time intervals were compared. All patients were graded with the help of Harris Hip Score (HHS), and their outcome was evaluated.

Results:
The age distribution of patients showed that nearly 80% of them were below the age of 50 years. The patients were presenting more often in Ficat and Arlet stage 4 compared to earlier stages. The patients in stage 1 were treated by core decompression alone, which produced good-to-excellent results in 4 of 7 (57.1%) patients. Patients in stage 2 and 3 were treated by core decompression with fibular bone grafting and had good-to-excellent results in 6 of 8 (75%) patients. In stage 4 of disease, cemented total hip replacement (THR) was done, and it produced good-to-excellent results in 13 of 15 (86.6%) patients.

Conclusion:
In the early stage of disease, core decompression with and without bone grafting produced satisfactory results. In an advanced stage of AVN, THR is an excellent treatment option.
An Unusual Presentation of Ludwig’s Angina with Empyema Thoracis and External Carotid Artery Pseudoaneurysm
Authors: Meena Satya Prakash , Rodha Mahaveer Singh , Garg Pawan Kumar , Patel Surendra 
Published: December 2022

Abstract
Ludwig’s angina is a rapidly spreading soft-tissue infection and commonly occurs following odontogenic infection. A 30-year-old male presented to the emergency department, 7 days after the extraction of molar teeth with a sudden onset of mandibular swelling. He was diagnosed with Ludwig’s angina with empyema thoracis and external carotid artery (ECA) pseudoaneurysm. He was successfully managed with video-assisted thoracoscopic surgery-guided drainage and endovascular embolization of ECA pseudoaneurysm. We share our experience of challenges faced during the management of unusual presentation of complicated Ludwig’s angina.
Air flow limitation in smokers – A cause of concern
Authors: Kumar Naresh , Chawla Gopal , Kansal Amrit Pal , Deokar Kunal , Niwas Ram , Abrol Nupur , Asfahan Shahir , Garg Sakshi , Keena Monika 
Published: December 2022

ABSTRACT

Introduction:
In India smoking is a common habit prevalent in both urban and rural areas irrespective of mode of smoking i.e., cigarettes, bidis, pipes, cigar, hookah etc., Spirometry can be helpful to determine effects of smoking on pulmonary functions. We aimed to study the effect of smoking on the pulmonary function tests.

Materials and Methods:
This study was conducted on 300 subjects including 150 smokers and 150 non-smokers aged between 25 and 60 years attending a tertiary health care center in northern part of our country. Quantification of tobacco smoking was performed by calculating smoking index. All the study subjects underwent spirometry.

Results:
All the spirometric variables (FVC, FEV1, PEFR, FEF 25-75%) were lower in smokers as compared to non-smokers and this difference was statistically significant. 76% of the smokers had obstructive, 10.7% had normal, 6.7% had restrictive, and 6.7% had mixed pattern on spirometry. 65.3% of the non-smokers had normal, 28.7% had obstructive and 6% had restrictive pattern on spirometry.

Conclusion:
Almost all the pulmonary function parameters were significantly reduced in smokers compared to non-smokers and obstructive impairment was common amongst smokers. As early quitting is associated with improved survival, it is important that these asymptomatic smokers are identified early and helped to quit. Primary care physicians being the first point of contact, can play a major role.
Prevalence of using folk medicine and/or natural products in the treatment of hypertension problems compared with medicinal drugs in KSA
Authors: Aldahhasi Ghadeer Abdullah , Alzaidi Raghad Sami , Althobaity Wejdan Fawaz , Alahmad Sarah Mohammad , Abo El-Enin Hadel A. 
Published: December 2022

ABSTRACT

Introduction:
Hypertension (HT), the silent killer, is highly prevalent in KSA due to several reasons. Some patients used to take non-pharmacological treatment for HT management.

Aim:
This study focuses on the prevalence of using folk medicine and/or herbal drugs in HT treatment in Saudi Arabia.

Methods:
Online questionnaires will be used as a study tool among the population in different regions of Saudi Arabia, keeping in mind all ethical aspects. A sample size of 240 will be taken. Univariate and multivariable regression data analyses were used to identify factors affecting the study. To make comparisons of the proportion, chi-squared tests will be used.

Results:
By using online questionnaires conducted on 229 participants as a study tool among the population in different regions of Saudi Arabia, we found that only 30% of the participants tried treating their high blood pressure elevation using alternative or complementary medicine, and 42.2% and 32.5% using herbal therapy and Hyjama, respectively. They consider that using Allium sativum and Hibiscus sabdariffa has a great effect which is 44.1% and 32.9%, respectively, and only 10.5% from them consider that THM is not useful. The selected alternative or complementary medicine beneficial knowledge was from the Qur’an and the Sunnah of the Prophet. Additionally, social media helps in sharing the user/practitioner beliefs, attitudes, and experiences about THM.

Conclusion:
From the previous study, we concluded that age and gender have a significant effect on health beliefs and behaviors which are associated with the use of herbal or alternative medicine in HT treatment.
Health care utilization and out-of-pocket expenditure of type 2 diabetic patients: A study in primary care in Bhubaneswar, India
Authors: Pati Sandipana , Swain Subhashisa , van den Akker Marjan , Schellevis François G. , Pati Sanghamitra , Burgers Jako S. 
Published: December 2022

ABSTRACT

Background:
Globally, noncommunicable diseases (NCD) demand a higher healthcare expenditure. Among NCDs, diabetes mellitus is often associated with multiple, co-existing chronic conditions. In low- and middle-income countries where most of the healthcare expenditure is borne out of pocket, diabetes management may pose a significant financial stress.

Methods:
A cross-sectional study was conducted in 17 urban primary healthcare facilities of Bhubaneswar to assess the healthcare utilization and out-of-pocket expenditure among type 2 diabetes patients attending these facilities. Healthcare utilization was determined by the number of visits to healthcare facilities in the last 6 months, and out-of-pocket expenditure was assessed by outpatient consultation fees, medicines, travels to health care facilities, and diagnostic tests. Total out-of-pocket expenditure was defined as the sum of these costs.

Results:
The median number of visits in 6 months for diabetes patients with any comorbidity was 4 and 5 for diabetes patients with more than 4 comorbidities. Among the comorbid conditions, depression, stroke, auditory impairment, and acid peptic disease were associated with higher healthcare utilization. The total out-of-pocket expense was 2.3 times higher among diabetes patients with any comorbid condition compared to patients with diabetes only. The total median expenditure was higher for diabetes patients having stroke, heart diseases, kidney diseases, and cancer compared with other comorbid conditions. The association of comorbidity in diabetes patients with health care utilization and out-of-pocket expenditure is statistically significant after adjustment for sociodemographic characteristics and diabetes duration.

Conclusion:
Considerable expenditure is incurred by diabetes patients attending primary healthcare facilities for the management of diabetes and other chronic conditions. This is a significant burden for diabetes patients below the poverty line and with limited or no insurance cover. There is a need to increase the coverage of insurance schemes to address the chronic conditions management expenditure of outpatients.
Changing trends in Covid-19 publication in India by bibliometrics analysis
Authors: Kulkarni Chaitanya Ajay , Wadhokar Om Chandrakant , Naqvi Waqar Mohsin 
Published: December 2022

ABSTRACT

Objective:
The purpose of this research is to compare over the developing trend in Covid-19 research publications between 2020 and 2021 in India, overall in respect of age groups, health conditions, funding support, institutions, and research design.

Background:
Covid-19 is a contagious disease caused by severe acute respiratory syndrome coronavirus (SARS-CoV), first cited in Wuhan, China in December 2019. And has affected the entire world rapidly and still ongoing. The symptoms are fever, cough, weakness, and breathlessness; the infected individual develops pneumonia that sometimes leads to respiratory failure. The older population with co-morbidities is at higher risk.

Methodology:
This is a cross-sectional study done by Scopus, Web of Science, and Pubmed Indexed journals, with the Covid-19, SARS-CoV, Pandemic, Coronavirus, India, and Outburst as keywords. Yearly publication data were extracted through ‘Bibliometrix R studio’ and relative percentage was computed and linear or exponential regressions examined the yearly growth in the proportion to research publications on Covid-19.
Palestinian analysis of COVID-19 vaccine compliance and reported death by vaccination type
Authors: Maraqa Beesan , Alkarajeh Mohammad , Almahareeq Marwa , Al-Shakhra Kamal , Al-Kalia Mai 
Published: December 2022

ABSTRACT

Background:
This study aims to compare mortality and adherence to the second dose between different types of vaccines administered in Palestine.

Methods and Participants:
A retrospective cohort study of individuals vaccinated against COVID-19 from February 14, 2021 through January 2022. Data were retrieved from the Palestinian Ministry of Health database and included identity number, date of birth, vaccination date, vaccine type, and mortality.

Results:
The study included 16,726 individuals who were vaccinated and later diagnosed with COVID-19. The mean age was 42.1 years, and females comprised 48.5% (8,112) of the population. Only 62.7% of individuals adhered to receiving the second dose of a vaccine, and the average duration of effectiveness of all vaccines was 126 days after completing the double dose. Seventy-five COVID-related deaths were recorded among vaccinated individuals who were significantly older ages.

Conclusion:
Our study design demonstrated the disparity in vaccine uptake and adherence due to delay in vaccination and dependence on COVAX and other countries for the donated vaccines. It highlights the importance of a global approach and higher-income countries assisting lower-income countries in securing vaccine.
Self-reported stress among senior dental students during complete denture procedures
Authors: Elagra Marwa El. , Rayyan Mohammad R. , Bin Razin Khaled I , Alanazi Abdulhadi A , Aldossary Mohammed F , Alqahtani Alanoud M , Alhomoud Shatha A , Almutair Abdulmohsen M 
Published: December 2022

ABSTRACT

Aims:
Stress is a common problem that can have a considerable impact on student performance and subsequently the quality of treatment given to the patients. This study aimed to investigate the levels and reasons of stress among senior dental students when they perform different complete denture clinical procedures.

Settings and Design:
A questionnaire was designed and distributed electronically among senior dental students of 19 universities in Saudi Arabia.

Materials and Methods:
The students were asked to score the levels of stress during five complete denture clinical steps on a scale from zero to ten and report factors contributing to it.

Statistical Analysis Used:
Descriptive statistics and inferential statistics were carried out by One-way ANOVA and independent t-test to compare stress scores between different procedures.

Results:
A total of 419 responses were collected, 195 (46.5%) males and 224 (53.5%) females. One-Way ANOVA revealed statistically significant difference in the mean stress scores between the five procedures (P < 0.001). The highest mean stress score was for border molding and final impression procedure (4.06 ± 2.664) and jaw relation (4.20 ± 2.690). Moreover, the Stress scores were significantly higher among females when compared to males in all procedures (P < 0.05) except the placement of final denture (P > 0.05).

Conclusion:
Border molding, final impression, and jaw relation records cause more stress for dental students than the other complete denture procedures. Difficulty of these two procedures was the most common reported stress provoking factors.
Maternal mortality and predictors of adverse outcome in patients with heart disease in pregnancy
Authors: Sharma Nalini , Khan Dina A. , Das Rituparna , Jethani Roma , Panda Subrat 
Published: December 2022

ABSTRACT

Introduction:
Heart disease in pregnancy possesses a great haemodynamic challenge and is a known risk for increased maternal morbidity and mortality. The functional status of the patient is one of the most significant parameters which can impact the feto-maternal outcome. Many predictors have been studied and compiled in various scoring systems time and again. The most updated and validated is the modified WHO classification, according to which the presence of pulmonary artery hypertension (PAH) and severe ventricular dysfunction (ejection fraction <30%) mandates the patient to be under class IV, which along with another important risk factor, i.e., New York heart association (NYHA) class, is revaluated under the present study. The objective of this study is to examine three of the most important predictors of adverse outcomes, i.e., functional status (NYHA class), PAH, and left ventricular ejection fraction (LVEF) in patients with heart disease in pregnancy.

Methods:
It’s a prospective study from January 2016 to August 2017 wherein pregnant patients with heart disease were divided on the basis of NYHA class, PAH, and LVEF, and the feto-maternal outcome was recorded and evaluated in terms of maternal mortality, fetal demise, the occurrence of major cardiac complication, and risk of preterm delivery.

Results:
A total of three out of 29 (10.34%) maternal deaths were attributed to a cardiac cause. 5.45% of patients with heart disease had maternal mortality, which is in contrast to the 1.12% maternal mortality rate in general at our centre. Three out of 17 (17.64%) patients in NYHA classes 3 and 4 ended in maternal deaths, while there were no mortalities in classes 1 and 2. Intrauterine fetal demise (23.52%), risk of preterm delivery (relative risk = 0.4688; 95% CI: 0.2320 to 0.9470) was significantly higher in patients belonging to NYHA classes 3 and 4 as compared to those in classes 1 and 2. All of the ten (100%) patients who developed cardiac complications belonged to classes 3 and 4. The percentage of abortions (20.00%), intra uterine fetal demise (IUFD) (40.00%), and cardiac complication (80%) in patients with LVEF <44% were significantly more than in patients with better ejection fraction. Pulmonary artery systolic pressure (PASP) ≥ is associated with higher maternal mortality, a greater number of abortions and IUFD (22.62%), cardiac complication (22.72%), and increased risk of preterm birth (0.5769; 95% CI: 0.2801 to 1.188), but these associations are not found to be significant.

Conclusion:
NYHA class was found to be a very strong predictor followed by left ventricular ejection fraction for poor outcome. Maternal mortality in asymptomatic patients or patients with mild symptoms (NYHA classes 1 and 2) is comparable to that found in the general population. However, pulmonary artery systolic pressure is not found to be significantly associated with worse outcomes in our study.