bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fresh Human Myopic Lenticule Intrastromal Implantation for Keratoconus Using SMILE Surgery in a Long-term Follow-up Study: Ultrastructural Analysis by Transmission Electron Microscopy
Authors: Semiz Faruk , Lokaj Anita Syla , Tanriverdi Gamze , Caliskan Gulser , Hima-Musa Njomza , Semiz Ceren Ece 
Published: August 2022

PURPOSE:
To investigate new intrastromal histological structures that develop after myopic human lenticular implantation in keratoconus with femtosecond laser–assisted small incision lenticule extraction (SMILE) surgery using transmission electron microscopy.

METHODS:
Sixty eyes with advanced keratoconus indicated for corneal transplantation were included in this study. Fresh myopic lenticular implants were placed in all eyes through SMILE surgery. Lenticular implants were extracted from patients with myopic refractive errors of the cornea, untreated keratoconus, and treated keratoconus following 1, 2, and 3 years of surgery. These five lenticular samples were examined under the electron microscope and compared.

RESULTS:
Disorganized and thinned collagen fibers were observed in the stroma with degenerative stromal cells (telocyte-like cells and keratocytes) in the keratoconic cornea. Apoptotic bodies and cell debris were easily observed near the disorganized fibers. In contrast, the myopic refractive error of the control and treatment groups demonstrated well-organized parallel lamellar structures. Healthy keratocytes and telocyte-like cells were observed in samples obtained 1, 2, and 3 years after lenticular implantation. Thus, telocyte-like cells may be activated by appropriate stimuli, such as stem cells, and be involved in stromal regeneration.

CONCLUSIONS:
Fresh myopic intrastromal lenticular implantation is a safe, economical, and reliable technique that leads to increased corneal thickness, improved visual acuity, and the regeneration of healthy keratocytes and telocyte-like cells that are involved in stromal regeneration.

[
J Refract Surg
. 2022;38(8):520–528.]
ADAPTACIÓN DE ESPACIOS COMUNES EN EDIFICIOS PLURIFAMILIARES DURANTE PANDEMIAS
Authors: Galiana Agulló Mercedes , Climent Mondéjar Mª José , González Ponce Eloísa , Rosa Roca Nuria , Carazo Díaz Carmen 
Published: August 2022

El confinamiento vivido por la COVID-19 ha puesto de manifiesto las carencias de muchas viviendas, relacionadas con la ausencia de espacios exteriores que palian los efectos negativos del mismo, mayoritariamente en aquellas situadas en edificios plurifamiliares. El objetivo de esta investigación ha sido lanzar una propuesta de adaptación de los espacios comunes al aire libre disponibles en estos edificios, para darles un uso privativo durante pandemias y mejorar la calidad de vida de sus habitantes. Se ha estudiado para ello el porcentaje de población afectada en el caso de la Región de Murcia, España, así como las características de las edificaciones que habitan. Se han establecido los criterios a tener en cuenta en el diseño y materialización de los nuevos espacios exteriores y se han recopilado y complementado las medidas sanitarias aplicables para el uso y disfrute de estos y el resto de espacios comunes. Ello ha permitido lanzar un propuesta de adaptación viable y económica, aplicable tanto a la zona geográfica en estudio como al resto del territorio nacional y países de similares características urbanas y arquitectónicas.
Palabras clave: edificios plurifamiliares, adaptación de espacios exteriores, higienización de espacios comunes, COVID-19.
Spare the Rod and Spoil the Child? Child Disciplining Practices Adopted by Mothers in Urban Maharashtra, India
Authors: Nair Sreeni V. , Yadav Arun Kumar , Mukherjee Reema 
Published: August 2022

Background:
Very little is known about child disciplining practices adopted by parents in India. Few studies carried out in India have shown a high prevalence of violent disciplining practices.

Aims:
We carried out this study to assess the nature and severity of violent disciplinary practices (VDPs) adopted by mothers in urban Maharashtra and identify possible social and demographic factors associated with them.

Materials and Methods:
This descriptive cross-sectional study was carried out in a hospital attached to a medical college in Western Maharashtra, India. One hundred mothers were included in our study, and written informed consent was taken from all participants. The UNICEF/WHO Child Discipline Module questionnaire was used as the data collection tool. Ethical clearance was also obtained from the Institutional Ethical Committee before the conduct of the research.

Statistical Analysis:
Contingencies tables were made to find out factors associated with discipline behavior. Bivariate logistic regression was done, and factors found statistically significant were taken into multivariable logistic regression.

Results:
Seventy-one percent of mothers used VDP against their children. The older age of a child's mother and father and female gender significantly increased the child's risk of facing VDP.

Conclusion:
There is a need to sensitize parents on the ill effects of VDP on the physical and mental health of children.
Ossicular Chain Reconstruction in Austin-Kartush Type A and B Defects using Titanium Prosthesis
Authors: Malhotra Tarun , Nadiger Sujay , Thakur Vaidehi , Kamal Deep 
Published: August 2022

Introduction:
Ossicular chain reconstruction (OCR) augments the hearing mechanism in various ossicular pathologies. Titanium allograft with superior properties was evaluated in the study.

Materials and Methods:
To assess the audiological and anatomical outcomes following titanium OCR, a retrospective review was performed for 47 cases who underwent OCR from January 2015 to December 2018 at a tertiary care center. The ossiculoplasty was carried out in a single stage tympanoplasty. The partial ossicular replacement prostheses (PORP) and total ossicular replacement prostheses (TORP) were used in 28 and 19 patients, respectively, with a follow up for 12 months. The pre and postoperative air conduction pure tone averages and air bone gaps(ABG) were analyzed. The operative success was defined as a postoperative ABG of ≤20 dB. Fisher's test, analysis of variance (ANOVA), and t test were used depending on data compared.

Results:
Postoperatively, the mean ABG was 15.4 ± 2.8 dB; about 80. 85% of cases achieved operative success. ABG values showed significant improvement compared with preoperative values (P = 0.001, t test). Successful OCR was achieved 85.7% of PORP and 73.6% TORP cases.

Discussion:
The mean postoperative ABG was 13.75 ± 5.4 dB for the PORP group and 17.84 ± 2.5 dB for the TORP group. No variation in audiological outcomes was observed when comparing PORPs to TORPs. There was no significant difference in postoperative ABG on comparison of different etiologies (P = 0.508, ANOVA), procedures undertaken (P = 0.226, ANOVA), and primary/ revision surgery (P = 0.172, t test). The extrusion and displacement rates were 2% each. These findings highlight that Titanium OCR gives stable hearing gains with low extrusion rates.
COVID-19 Breakthrough Infections amongst ChAdOx1 nCoV-19 (Covishield) Vaccinated Health-Care Workers and Its Clinical Manifestations
Authors: Kamal Deep , Thakur Vaidehi , Chauhan Anurag S 
Published: August 2022

Introduction:
Second wave of the COVID -19 pandemic had a significant impact on India with large number of populations getting affected by it. Pan -India COVID -19 vaccination was started on 16 January 2021. All the hospital Health Care Workers (HCWs) started receiving Covishield vaccine. By March 2021, all the HCWs received 02 dosages of the vaccine. It was the time when the second wave of COVID-19 started in India. This study was conducted to investigate the occurrence and severity of breakthrough COVID -19 infection (BCI) amongst fully vaccinated HCWs.

Materials and Methods:
This prospective observational study was conducted at a single multispecialty COVID-19 dedicated hospital on fully vaccinated HCWs who developed BCI. A total of 981 HCWs were enrolled and observed them for six months from March -September 2021 for occurrence of BCI. The outcome measures included percentage of fully vaccinated HCWs developing BCI. The BCI according to various demographic variables was studied. Clinical profile, duration between last dose of vaccine and BCI and requirement of mechanical ventilation were analysed.

Results:
Out of 981 fully vaccinated HCWs, 97 developed BCI. Amongst one -fifth of them were asymptomatic. Fever and cough were the prominent symptoms. Two HCWs developed COVID -19 pneumonia. None required oxygen supplementation or mechanical ventilation. There was no death observed amongst these COVID -19 infected HCWs.

Discussion:
BCI occurred in 9.88% fully vaccinated HCWs. They were primarily minor and did not lead to severe disease. Overall, Covishield prevented severe infection in HCWs, leading to decreased ICU admission and deaths.
Profile of Acute Coronary Syndromes in Serving Personnel Presenting to a Field Cardiology Center Without Cath Lab Facilities
Authors: Jayachandra A , Datta Rajat , Swamy Ajay , Issar Neel Kanth , Sarkar Saikat , Aggarwal Vivek 
Published: August 2022

Introduction:
Acute coronary syndrome (ACS) is common in serving personnel and requires prompt diagnosis and treatment. This retrospective study was done to see the profile of ACS in serving personnel presenting to a tertiary hospital without cardiac catheterization laboratory (CCL) facilities.

Methods:
ACS was diagnosed based on an electrocardiogram (ECG), clinical features, and cardiac biomarkers. History of comorbidities, risk factors, and preceding exertion was taken. Immediate medical management was done as per the standard guidelines, and follow-up angiography was done at a dependent cardiology center with CCL.

Results:
A total of 75 personnel reported with ACS. The mean age of personnel was 42.01 ± 8.59 years. Acute ST-elevation myocardial infarction (STEMI) was noted in 48% (36/75) of the patients, 32% (24/75) had non-STEMI, and 20% (15/75) had unstable angina (UA). Low ejection fraction was more common in patients with STEMI (P ≤ 0.001). History of preceding exertion was noted in 55 personnel. Eighteen patients with STEMI were thrombolysed. Angiographically significant lesions were noted only in 30.6% (23/75) individuals with ACS.

Conclusion:
ACS is common in deployed serving personnel. The most common precipitators were immediate preceding exertion and smoking. Morbidity and mortality due to ACS can be decreased by digital transmission of ECG, prehospital thrombolysis, graded physical exertion, and counseling about a healthy diet.
Clinical Profile and Spectrum of Duodenal Biopsy and other Investigational Abnormalities in NUD Patients
Authors: Singh Sarvinder , Bansal Naresh , Mamidi Sreenivasu , Singh Pradeep Kumar , Sharma P. K. , Jain Rahul , Brar K. S. 
Published: August 2022

Aim of Study:
The study was done to find out the prevalence of rapid urease test (RUT) positivity, IgA-tTG, and spectrum of duodenal abnormalities in nonulcer dyspepsia (NUD) patients.

Methods:
This descriptive observational study was carried out in the gastroenterology center in GOI research institute from August 2020 to March 2021. Initially, 200 dyspepsia patients were selected. Fifty patients were excluded due to various reasons. Finally, 150 patients who met the Rome 4 criteria for NUD/functional dyspepsia were recruited. The inclusion criteria were patients above 18 years of age, dyspepsia for ≥ Six months, and no evidence of underlying malignancy, pan gastritis, previous gastric ulcers, and pancreatitis. The patients underwent RUT, upper gastrointestinal endoscopy, duodenal biopsy, and serum IgA-tTG antibody.

Results:
The mean age was 46.3 years ± 14.12 years, of which 49.3% were female and 50.70% were male. The prevalence of epigastric pain syndrome (EPS) was found in 37.3%, postprandial distress syndrome (PDS) in 30.7%, and both EPS + PDS in 32%. Thirty-eight percent of the NUD patients were positive on RUT suggesting Helicobacter pylori infection. 88.7% of the NUD patients were IgA-tTG antibody negative and 11.3% serologically positive. The duodenal biopsy was normal in 48% of the patients, 21.3% had mild inflammation/duodenitis, 8% had chronic duodenitis, and 22.7% had various grades of celiac disease (CeD) (as per Marsh grading). These 22.7% showing evidence of CeD on histopathological examination showed Marsh Grade 1 in 12.7%, Grade 2 in 2%, Grade 3A in 6.7%, and Grade 3B in 1.3%. Only 17.6% of biopsy positive had IgA-tTG antibody positivity, but only 4% of the total cases were positive for both biopsy and IgA-tTG antibody (P = 0.05). Eosinophilic infiltration in the duodenum was common in NUD patients. It was observed that 17.33% (26/150) of the NUD patients had duodenal eosinophilia. Duodenal eosinophilia association with various other Gastrointestinal disorders, It was observed that 33.33%(19/57) of the H. pylori patients had duodenal eosinophilia with p<0.001. It was also observed that 7.52% (7/93) of others, such as normal individuals, chronic duodenitis, and mild inflammation/duodenitis, had duodenal eosinophilia.

Conclusion:
The prevalence of H. pylori and IgA-tTG antibodies in NUD patients was 38% and 11.3%, respectively. The spectrum of duodenum biopsy abnormalities in NUD patients included mild inflammation/duodenitis, chronic duodenitis, and CeD. 22.7% of the NUD patients had various degrees of CeD morphology on D2 biopsy, and only 17.6% of these biopsy-positive patients were positive for IgA-tTG. Only 4% of the total NUD patients were positive for both biopsy and IgA-tTG antibody labeled as CeD. There is a significant association between H. pylori and duodenal eosinophilia.
Association between vitiligo and risk of suicide and suicidal ideation
Authors: Phan Kevin , Shumack Stephen , Gupta Monisha 
Published: August 2022

Abstract

Background:
Vitiligo is an autoimmune skin disorder characterized by patches of depigmentation due to loss of melanocytes. Vitiligo is associated with significant psychosocial burden, with prior studies showing links with psychiatric comorbidities such as depression. Few studies have evaluated the relationship between vitiligo and suicidal ideation and suicide attempts. We aimed to investigate the underlying prevalence and risk of suicidal ideation or suicide attempts among patients with vitiligo.

Materials and Methods:
A systematic search of PubMed, MEDLINE, Embase, and the Cochrane Library was conducted. Cross‐sectional, case–control or cohort studies that assessed the prevalence of suicidal ideation or suicide attempts among patients with vitiligo were included. DerSimonian and Laird random‐effects models were utilized to calculate the pooled prevalence and odds ratios.

Results:
From systematic review, we identified seven studies included for analysis. A total of 12,043 vitiligo cases were compared with 87,053,333 controls. The pooled proportion of suicidal ideation in vitiligo was 15.2% compared to 2.0% in the control group (P < 0.001). The proportion of suicide attempts/suicides was also higher for vitiligo compared to controls (3.2% vs. 2.1%, P < 0.001). Moderate‐to‐high heterogeneity was observed between the studies.

Conclusion:
Our data further provide evidence of the significant impact vitiligo has on self-esteem and psychological burden. Patients with vitiligo were significantly more likely to have suicidal ideation. Clinicians should actively evaluate patients with vitiligo for signs/symptoms of suicidal ideation and provide appropriate referrals to manage their psychiatric symptoms accordingly.
Clinico-dermatoscopic study of facial melanosis at a tertiary care hospital
Authors: Patel Dhruv R. , Tandel Jinal J. , Polra Rutoo V. , Ganjiwale Jaishree , Nair Pragya A. 
Published: August 2022

Abstract

Introduction:
Facial pigmentary disorders are a group of heterogeneous disorders with clinical features of hyper- or hypopigmentation. They cause a great degree of psychosocial impact on patients’ quality of life due to their easy visibility.

Aims and objectives:
To find out different clinical and dermatoscopic patterns in facial melanosis.

Materials and methods:
Patients with hyperpigmentation or hypopigmentation over the face attending the skin OPD were recruited after taking their written consent in vernacular language. A detailed history was taken to collect demographic data. Clinical examination and dermatoscopy were done in all patients. Relevant investigations and biopsy were carried out as and when required. The descriptive statistics has been used to describe the quantitative data. Qualitative data were presented as frequency and percentage for clinical and dermatoscopic patterns.

Results:
The study included 180 patients having 20 different facial melanoses. Maximum number of patients (99; 55%) belonged to the age group of 19 to 40 years with female:male ratio of 1.72:1. The most common precipitating factor was sunlight in 66 (36.7%) patients followed by seasonal variation in 27 (15%) cases. Cheek was the most common site involved in 101 (56.1%) cases. Melasma was reported as the most common dermatosis including epidermal melasma 40 (22.2%), dermal melasma 26 (14.4%), and mixed melasma 4 (2.2%) cases followed by postinflammatory pigmentation (18; 10%), acanthosis nigricans (13; 7.2%), and vitiligo (11; 6.1%). In dermatoscopy, the most common pattern seen was reticuloglobular pattern in 68 (37.3%) cases, followed by black-brown globules in 47 (25.6%) cases.

Conclusions:
Melasma was reported as the most common cause of facial melanosis. The most common dermatoscopic pattern was the reticuloglobular pattern. The study is useful in understanding the different clinical and dermatoscopic patterns of facial melanosis, thereby help the physician to effectively manage the conditions and reduce the need of biopsy.

Limitation:
Histopathological correlation was not done.
Tamoxifen-induced lichen planus pigmentosus − case report
Authors: Chaudhary Azra Ferheen , Goel Shitij , Arora Tunika 
Published: August 2022

Abstract
Lichen planus pigmentosus is characterized by slaty-gray pigmentation, predominantly on sun-exposed sites. It is considered to be a type IV hypersensitivity reaction to unknown antigen with lichenoid inflammation which may lead to melanin incontinence and superficial dermal pigmentation. This report presents a rare case of lichen planus pigmentosus caused due to tamoxifen intake.
Newer indications of tranexamic acid in dermatology beyond melasma
Authors: Arora Astha , Bhalla Mala 
Published: August 2022

Abstract
Tranexamic acid (TXA) is an antifibrinolytic agent approved for use to control bleeding during surgery and after trauma. It has been used in dermatology as a therapeutic and prophylactic agent in angioedema since 1970s but its recently discovered role in melasma has made it the current molecule of interest. At present TXA is being widely researched for multiple indications in view of its role in reducing melanogenesis and angiogenesis in skin. Various case reports and clinical trials have been published over the last few years describing its role in postinflammatory hyperpigmentation, dermal melanosis, rosacea, telangiectasia, and even as an antiaging agent. We present this review here summarizing the various publications for the aforementioned indications.
“I Believe in Science and in All Vaccines
Authors: Nascimento Marcelo de Maio , Nunes Allysson Nathan Galvão , Juchem Luciano 
Published: August 2022

Introduction:
To investigate the intention of older Brazilian adults to receive the COVID-19 vaccine, to find out their perception of the older adults' fragility to the virus, and to know their opinion on the progress of the national immunization plan against COVID-19.

Methods:
An exploratory qualitative study was carried out through semi-structured telephone calls with 32 participants (aged 60–89), between February and March 2021. Data were analyzed thematically, emerging three major themes.

Results:
Most participants expressed concern about the vulnerability of their immune system to the coronavirus, and dissatisfaction with the organization of the national immunization plan. Strong criticism was leveled at the leadership of the President of the Republic due to his resistance to vaccination and encouraging the use of hydroxychloroquine.

Conclusion:
The vast majority of respondents reported an intention to receive the vaccine. The short time for the production of vaccines generated distrust with its effectiveness. All expressed dissatisfaction with the organization of the national immunization plan, and agreed that after the pandemic, their lives and the world will no longer be as before.
A Theory-based Educational Intervention to Promote Behavior Change and Physical Activity Participation in Middle-aged Women
Authors: Joveini Hamid , Malaijerdi Zeinab , Sharifi Nader , Borghabani Rohollah , Hashemian Masoumeh 
Published: August 2022

Introduction:
Promoting physical activity (PA) behavior by education can help people to create and maintain an active lifestyle until old age. This study aimed to design and evaluate a theory-based educational intervention to promote behavior change and PA in middle-aged women.

Methods:
This randomized controlled trial was conducted on 73 middle-aged women in Jovein, Iran, from January to November 2018. A researcher-made questionnaire based on the volition phase constructs of the Health Action Process Approach (HAPA) model was used. Randomly, one health base and one health house were assigned to the intervention group and one health base and one health house were assigned to the control group, and the participants were randomly selected from these centers. Both the groups completed the questionnaires before, immediately after, and 3 months after the educational intervention. The educational intervention was held in three 60-min sessions among three groups of approximately 17 participants. PA maintenance was measured 6 months after the intervention.

Results:
Immediately and 3 months after the intervention, the mean scores of all the volition phase constructs significantly increased in the intervention group compared to the control group (P < 0.05). Three and 6 months after the intervention, the number of people who had at least 150 min of moderate PA per week was significantly higher in the intervention group compared to the control group (P < 0.05).

Conclusion:
The educational intervention based on the volition phase constructs of the HAPA increased PA intention and facilitated the transition from an inactive lifestyle to an active lifestyle among middle-aged women.