bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Inhaler Technique and Asthma Control Among Children in a Low-Resource Setting
Authors: Prasad Harit , Ghosh Sohini , Das Sai Chandan , Manasa R. V. 
Published: October 2022

Background:
Inhalation has become the preferred route of drug administration compared to oral medication in managing Asthma due to its direct delivery to the airways, thus producing a faster onset of action and fewer systemic side effects at lower doses than would be required for other routes of administration.

Aims and Objectives:
This study aimed to evaluate the inhaler technique among children with asthma and its association with the level of asthma control and to identify factors associated with improper use of inhaler devices.

Materials and Methods:
This is a prospective cross-sectional study conducted at the Department of Pediatrics at B. P Koirala Institute of Health Science, university teaching Hospital in Nepal. The children with asthma were asked to use their inhaler device as usual and inhalational technique was assessed using inhaler device assessment tool and control of asthma level was assessed using the Childhood Asthma Control Test score.

Results:
One hundred and three asthmatic children of the age range of 4–11 years were enrolled in the study. The mean age of surveyed children was 6.3 ± 2.2 years and over half of the participants were boys (68.9%). Around 60% had moderate asthma. Among them, 50% had symptoms for <3 years; only 50% of children with asthma demonstrated good technique of inhaler medication. Forty-five percent of them showed optimal asthma control. Near about a quarter of the participants showed mistakes in one step and about a fifth of the children showed mistakes at more than one step. Almost 30% of children with asthma have not obtained inhaler technique education. Factors associated with poor inhaler technique and poor asthma control were younger age and irregular follow-ups. The most common errors in the proper use of inhalers were not shaking the inhaler before use (30%) and wrong breathing techniques (30%).

Conclusions:
Improper inhaler technique is common among children with asthma. Children with asthma should have their inhaler technique routinely checked, during visits and should be given detailed education on proper inhalation techniques. Health education programs on asthma control are recommended in countries like Nepal to improve proper asthma inhaler device use and treatment outcomes in children with asthma.
Re-inventing the straight incision with a single central suture in manual small-incision cataract surgery to minimize surgically induced astigmatism
Authors: Rathi Manisha , Dahiya Monika , Dabas Ruchi , Rustagi Inder Mohan , Sachdeva Sumit , Dhania Sweety 
Published: October 2022

Purpose:
To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10-0 polyamide suture and to document any suture-related complaints and complications.

Methods:
A retrospective, hospital-based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ≥ grade 4, “with the rule” astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10-0 nylon suture. Patients with “against the rule” astigmatism, keratoconus, pre-existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded.

Results:
The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture-related complications.

Conclusion:
SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10-0 polyamide suture, as compared to a straight incision without a suture.
Evaluation of cautery in manual small-incision cataract surgery
Authors: Bahl Vishwa Jyoti , Malik Krishan Pal Singh , Guliani Braham Prakash 
Published: October 2022

Purpose:
Manual small-incision cataract surgery (MSICS) has a major role in tackling cataract blindness in our country. Cauterization of sclera is one of the important steps performed in MSICS to have bloodless field during surgery. Only few studies have addressed the effect of cautery on post-operative astigmatism. The present study is designed to evaluate the effect of cautery on surgically induced astigmatism in Indian patients.

Methods:
The study was designed as a prospective randomized trial conducted in a tertiary health care institution over a period of 2 years. A total of 150 eyes were randomized into two groups. The study group (Group 1, n = 75) underwent MSICS with cauterization using wetfield bipolar cautery with 4 amperes power. In the control group (Group 2, n = 75), no cauterization was performed. Surgically induced astigmatism was calculated using Naesers polar value method and compared between these two groups up to 60 days post-operatively.

Results:
Data from 150 eyes were available for evaluation. The net post-operative astigmatic value was 1.01 ± 0.21, 1.04 ± 0.19, and 1.03 ± 0.22 D on the 1st, 7th, and 30th post-operative days, respectively, showing a stable trend in patients undergoing cauterization. In Group 2, the net post-operative astigmatic values observed were 0.47 ± 0.11 D, 0.54 ± 0.10, and 0.54 ± 0.09 D on the 1st, 7th, and 30th post-operative days, respectively. The mean value of surgically induced astigmatism at 2 months post-operatively with and without cautery was 0.60 ± 0.20 D at 90° and 0.47 ± 0.10 D at 90°. The difference was not statistically significant (P = 0.08).

Conclusion:
The results of this study show that the use of cautery in MSICS is not associated with a higher surgically induced post-operative astigmatism. The magnitude of surgically induced astigmatism decreases with time.
Safety and efficacy of manual small-incision cataract surgery in patients with brunescent and black cataracts and other ocular comorbidities
Authors: Gajraj Manju , Mohan Amit 
Published: October 2022

Purpose:
To determine the safety and efficacy of manual small-incision cataract surgery (MSICS) for brunescent and black cataracts in patients with other ocular comorbidities.

Methods:
Medical records of patients with hard cataracts (grade 4 nuclear opalescence and above) with other ocular comorbidities such as spheroidal degeneration of the cornea (SDC), pseudoexfoliation (PXF), non-dilating pupil, and high myopia who underwent MSICS were retrieved retrospectively. Intraoperative and postoperative complications were noted. Preoperative and postoperative visual outcome comparisons were performed using paired t-tests. Statistical significance was set at P < 0.05.

Results:
A total of 124 cataract patients with brunescent or black cataracts and other ocular comorbidities underwent surgery during the study period. They ranged in age from 56 to 89 years (mean: 68.9 + 11.9 years), with 55.66% (n = 69) of the patients being female and 44.35% (n = 55) male. Of the 124 cases, 45.16% (n = 56) had SDC, 31.45% (n = 39) had PXF, 14.51% (n = 18) had non-dilating pupils, and 8.87% (n = 11) had high myopia. Preoperatively all patients had visual acuity <6/60. At 1 month postoperatively 77.4% of patients achieved good vision >6/18, 16.9% had a borderline vision (6/18–6/60), and 5.6% had a poor vision (<6/60). No serious complications were observed. One patient had posterior capsular rent in a case of high myopia, and two cases had zonular dialysis for pseudoexfoliation.

Conclusion:
MSICS with intraocular lens implantation is safe and effective in eyes with brunescent/black cataracts if associated with SDC, PXF, high myopia, and non-dilating pupils and provides good visual outcomes with minimal complications.
Comparative study of anatomical and functional recovery of eye along with patient satisfaction score after small-incision cataract surgery and phacoemulsification cataract surgery
Authors: Dole Kuldeep , Baheti Neha , Deshpande Rahul , Kulkarni Sucheta , Shetty Rakesh , Deshpande Madan 
Published: October 2022

Purpose:
Functional recovery after cataract surgery depends on the anatomical recovery of the eye. This study compared the improvement in visual function parameters after uniocular manual small-incision cataract surgery (MSICS) and phacoemulsification cataract surgery.

Methods:
This study included 310 patients divided randomly into two groups: 155 who received MSICS (MSICS group) and 155 who underwent phacoemulsification (phaco group) for cataract treatment. Outcome measures assessed included vertical and horizontal keratometry reading. The mean corneal astigmatism tear function measured using Schirmer 1 test results were recorded preoperatively, and on postoperative day 1, day 7, and day 30. Optical coherence tomography (OCT) was done to record the average central macular thickness (μm) on day 7 and day 30.

Results:
The mean corneal astigmatism and anterior chamber inflammation were more in the MSICS group than in the phaco group immediately postoperatively. However, no statistically significant difference was found between the groups with respect to corneal sensation, mean corneal astigmatism, tear film function, and visual outcomes on postoperative day 30. Uncorrected visual acuity was better in the phacoemulsification group than in the manual SICS group on postoperative day 1, day 7, and day 30 (P < 0.001).

Conclusion:
Both phacoemulsification cataract surgery and manual small-incision sutureless cataract surgery (MSICS) are safe and effective for visual rehabilitation. Phacoemulsification is the preferred technique where resources are available with the advantages of less mean corneal astigmatism, less anterior chamber inflammation, and better uncorrected visual acuity (UCVA) in the immediate postoperative period.
Modified small-incision cataract surgery for combined extraction – A comparative study of two techniques
Authors: Khan Lubna , Verma Sonam 
Published: October 2022

Purpose:
To explore straight incision technique in terms of efficacy for intraocular pressure (IOP) lowering by small-incision cataract surgery (SICS) trab versus modified “frown” incision with triangular scleral flap technique.

Methods:
This study was done at a tertiary health center. It included 44 eyes diagnosed with cataract and coexisting primary glaucoma that underwent SICS with trabeculectomy using modified “frown” incision with triangular scleral flap technique and straight incision in group A (n = 22) and B (n = 22), respectively. Postoperative evaluation was done at first postoperative day, then at the end of first week, third week, and 6 weeks; at the end of third month and finally at the end of sixth months. Data were entered and analyzed via Microsoft Excel sheet and SPSS software using Mann–Whitney U test for averages and Chi-square test for categorical values.

Results:
Mean preoperative IOP in groups A and B were 38.6 and 29.1 mm Hg respectively, by applanation tonometry. After 6-month follow-up, mean of difference in IOP (preoperative – postoperative) for group A was 20.8 ± 8.3 mm Hg and that for group B was 17.2 ± 13.5 mm Hg.

Conclusion:
Capacity of IOP reduction of both techniques was found to be comparable and did not show much difference up to the end of 6 months. Mastering technique of group A (modified “frown” incision with triangular scleral flap technique) requires more expertise; the simpler straight incision technique provided in group B may be effectively used by the novice and current era Ophthalmologists to combat glaucoma coexistant with cataract.
Role of single-ring oval disposable wound protecting device in preventing surgical site infection in laparoscopic colorectal resections
Authors: Kurumboor Prakash , Chacko Sidharth , Vipin I. S. , Prakash Rohan , Pal Ashna S. 
Published: October 2022

Context:
Surgical site infections (SSI) continue to be a major cause of morbidity, mortality, prolonged hospital stays and a major reason of financial burden to health-care providers and patients after major abdominal surgeries. Along with infection control practices and care bundles, additional use of devices which protect the wound from contamination is believed to decrease the burden of SSI.

Aims:
This study aims to assess the benefit of single-ring disposable wound protector in preventing SSI, overall complications, hospitals stay and morbidity data in laparoscopic colorectal resection.

Settings and Design:
The study design involves case–control study, retrospective.

Subjects and Methods:
A case–control study comparing single ring oval wound protector versus conventional wound protectors retrospectively between August 2019 and December 2021. The ease of use of the device, rate of SSI, overall complications, hospitals stay and morbidity data were analysed.

Statistical Analysis Used:
The statistical analysis was performed by IBM SPSS Statistics 20 version. All Categorical Variables will be described as frequency and percentage. Continuous variables will be described as mean ± standard deviation. Continuous variables were analysed using t-test and categorical parameters using Fisher’s exact test.

Results:
Of the 110 patients studied, wound Protecting devices were used in 58 patients Wound Protector Group (WPG group) and 62 patients did not use such devices (no WPG). The groups were comparable in demographic features, risk features, systemic illness, type of surgeries undertaken and the specimen extraction wound used. There was a significant decrease in the incidence of SSI (1.7% vs. 16% P ≤ 0.008) and the hospital stay (P ≤ 0.03) when WPG was used compared to the group in which it was not used.

Conclusions:
Apart from the use of infection control practices and care bundles, the use of oval-shaped single-ring wound protector is likely to reduce SSI.
Laparoscopic management of symptomatic urachus remnants in adults: A retrospective study
Authors: Bawahab Mohammed A. 
Published: October 2022

Aim:
To report our experience in the laparoscopic management of symptomatic urachal remnants (URs) in adults.

Patients and Methods:
A retrospective study included all patients who underwent laparoscopic excision of URs during the period January 2015–January 2020. The following data were retrieved from the files of the patients: demographic data, clinical presentations, intra-operative findings, the procedure performed, operative details, intraoperative or post-operative complications and follow-up period mentioned in the files for those patients.

Results:
The study included 10 patients (four males and six females) with a mean age of 27.8 ± 11.0 years. URs were discovered preoperatively in all patients except one patient who was diagnosed intraoperatively. URs were associated with other pathologies in four patients (40%) that required two simultaneous surgical procedures. Eight patients (80%) presented with simple umbilical discharge and were diagnosed easily by ultrasonography. All patients were managed successfully with laparoscopic excision and umbilical sparing technique. Excision of the dome of the bladder was done on the selective approach to one patient. No patients showed early post-operative complications. Only one patient had stitch sinus 6 months postoperatively due to a concomitant hernia repair rather than due to the excision of the URs.

Conclusions:
Laparoscopic excision of symptomatic urachus is a feasible procedure even when the excision of the bladder is required. It could be performed successfully with other pathologies. It is associated with a low incidence of complications. Laparoscopy allows good visualisation and complete excision that leads to almost no recurrence rate.
Comparison of pulmonary computed tomography scan findings and clinical symptoms of COVID-19 in three outbreak peaks in Isfahan, Iran
Authors: Soufi Ghazaleh Jamalipour , Hekmatnia Ali , Zarei Andrew Parviz , Hekmatnia Farzaneh , Shafieyoon Shamim 
Published: October 2022

Background:
The aim of the present study was to investigate and compare the relationship between the anatomical distribution of pulmonary lesions in computed tomography scan of patients with COVID-19.

Materials and Methods:
This is a cross-sectional study that was performed in 2020–2021 in Isfahan on 300 patients infected with COVID-19 pneumonia. We collected data on the age, gender, and comorbidities of patients. In addition, we gathered data on the clinical manifestations of the patients from their medical records.

Results:
We noted a significant decline in symptoms such as fever and sputum production in the second and third peak in comparison to the first peak (P < 0.05). Moreover, cough and muscular pain were higher in the second and third peaks compared to the first peak (P < 0.05). Cough was the most common clinical manifestation related to the peripheral distribution of the involvements, bilateral lung disease, and right lower lobe (RLL) involvements in the first peak. In the second COVID-19 peak, fever and cough were the most common clinical findings, respectively, that were mostly associated with peripheral distribution and left lower lobe involvement.

Conclusion:
Cough was the most common clinical manifestation related to the peripheral distribution of the involvements, bilateral lung disease, and RLL involvements in the first peak. In the second COVID-19 peak, fever and cough were the most common clinical findings.
Sociodemographic and Clinical Factors Associated with Treatment Outcomes for Drug-resistant Tuberculosis
Authors: de Oliveira Jeronymo Neves Ana Carolina , Gomes dos Santos Ana Paula , de Medeiros Regielle Luiza , de Oliveira Jeronymo Ana Júlia , Coelho Neves Guilherme , de Almeida Isabela Neves , Carvalho de Queiroz Mello Fernanda , Lineu Kritski Afrânio 
Published: October 2022

ABSTRACT.
Drug-resistant tuberculosis (DR-TB) continues to be a serious public health problem. The objective of this study was to evaluate the sociodemographic, radiological, clinical, and outcome characteristics and assess the determinants of unfavorable outcomes in DR-TB. The descriptive-analytical study was carried out in a reference outpatient clinic in Rio de Janeiro, Brazil, among DR-TB cases that received treatment between February 2016 and October 2020, using descriptive statistics, χ2 test, and logistic regression multivariate. Of the 148 cases, 12.2% were resistant to rifampicin, 12.2% were resistant to isoniazid, 18.2% were polyresistant, 56.1% multidrug resistant, and 1.3% were extensively drug resistant. Most of the patients were men, aged up to 44 years, with brown or black skin, having up to 8 years of schooling, unemployed or working in the informal economy, and of low income. Presenting with acquired resistance or positive sputum smear microscopy in the diagnosis, taking more than four drugs, and being unemployed were associated with unfavorable outcomes. Having no income or acquired resistance doubled the chances of unfavorable outcomes. There was a high proportion of unfavorable outcomes, thereby highlighting the need to concentrate efforts on planning and executing public policies that include the severity of DR-TB and its risk factors.
Factores de riesgo psicosocial que afectan al desempeño laboral en el área administrativa del Instituto Tecnológico Bolivariano de Guayaquil
Authors: CAMPOVERDE CORONEL TATIANA CECIBEL , Muñoz Loor Karina 
Published: October 2022

En todas las empresas están presentes los factores de riesgo psicosociales que afectan al desarrollo del trabajo, la salud física y social de los colaboradores de dicha empresa. Por lo cual se propone un plan de prevención de riesgos psicosociales en el desempeño laboral, de los trabajadores en el área administrativa del Instituto Tecnológico Bolivariano de Guayaquil. Por lo cual tiene un estudio descriptivo porque se quiere analizar características y rasgos importantes basado en los factores de riesgo psicosocial y como estos influyen en el desempeño laboral. Tiene un enfoque cuantitativo su técnica es la encuesta en la cual se aplica a los 30 trabajadores del instituto siendo este número de pobladores y muestra. Para poder analizar la presencia de riesgos psicosociales se utiliza el cuestionario ISTAS 21 en el cual se miden seis dimensiones psicosociales como: exigencias psicológicas, trabajo activo, inseguridad, apoyo social doble presencia y compensación en la cual se califica al instituto con tres opciones: bajo, medio y alto. Se detecta que de las 6 dimensiones de factores de riesgo solo 3 están en un riesgo alto, teniendo como resultado que el Instituto está en un nivel medio por consiguiente se da unas recomendaciones para todo su personal administrativo.
The Technique Homotopy Perturbation Method Operated on Laplace Equation
Authors: Samajdar S. , Khandakar M. H. , Purkait A. , Das S. , Sen Banashree 
Published: October 2022

In this study, we introduce a technique acknowledged as the Homotopy Perturbation Method (HPM) for obtaining the particular solution of two-dimensional Laplace’s Equation with conditions like Dirichlet, Neumann and the use of different boundary prerequisites to exhibit this method’s potential and reliability. The steady-state condition, which depends on temperature, converts Laplace’s equation into a greater dimension and deforms the equal into a Partial Diﬀerential Equation (PDE). Here we additionally tried to discover a comparative measurement in terms of literature survey [1] between the results bought by means of the HPM approach and the same result for the identical equation introduced in any other technique eventually referred to as the Variable Separation Method (VSM). The consequences exhibit that HPM has excessive eﬃciency and eﬀectiveness in fixing Laplace’s equation. Also dealing without delay with the trouble has a wide variety of benefits and furnished the approximate solution which converges very unexpectedly to a correct answer.