bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness of cataract and glaucoma in two rural districts of Telangana, India
Authors: Marmamula Srinivas , Boopalan Dharani , Khanna Rohit C , Hassija Neha , Keeffe Jill 
Published: February 2022

Purpose:
To determine the level of awareness of cataract and glaucoma and identify the determinants of awareness in two rural districts of Telangana, India.

Methods:
A population-based cross-sectional study was conducted using the rapid assessment of visual impairment (RAVI) methodology in Khammam and Warangal districts. A validated questionnaire was administered to participants aged 40 years and above to assess the level of awareness of cataract and glaucoma.

Results:
The awareness questionnaire was administered to 3273 participants of whom 1433 (43.8%) were men, 1985 (60.6%) of them had no education, and 1645 (50.3%) were from Khammam district. In total, 2539/3273 (77.6%; 95% confidence intervals (CI): 76.1– 79.0%) participants reported awareness of cataract. Awareness of cataract was higher in Khammam compared to that in Warangal (84.4% versus 70.6%; P < 0.01). Only 41/3273 (1.25%, 95% CI: 0.90–1.69%) participants were aware of glaucoma. Awareness of glaucoma was also higher in Khammam (1.88% versus 0.61%; P < 0.01). Younger age groups, men, any level of education, and residing in Khammam were factors associated with awareness of cataract. Only having any level of education and residing in Khammam were associated with awareness of glaucoma.

Conclusion:
Awareness of cataract was high, but awareness of glaucoma was very poor. There is a need to spread awareness about these potentially blinding conditions. Moving forward, this can be a critical step in developing a preventive eye care strategy to achieve universal eye health in India.
Three Indian Siblings Affected with Progressive Myoclonic Epilepsy due to Unverricht–Lundborg Disease
Authors: Srivastava Kavita , Thakor Bina Mahendrasinh , Roy Shuvendu , Rajadhyaksha Surekha , Datar Chaitanya 
Published: February 2022

Background:
Progressive myoclonus epilepsy (PME) is a group of heterogeneous genetic disorders characterized by action myoclonus, epileptic seizures, and progressive neurologic deterioration with onset of symptoms in adolescence and adulthood. Unverricht–Lundborg disease (ULD) is the most common type of PME in high-income countries; however, it is under-reported from India due to challenges in clinical recognition and establishment of diagnosis due to lack of availability of genetic studies.

Clinical Description:
We herewith report three siblings (two girls and a boy) born out of a third-degree consanguineous marriage, with onset of “difficult-to-treat” seizures since early adolescence, with concurrent action myoclonus and ataxia. All three had a waxing and waning course. Electroencephalography exhibited generalized spike-wave and polyspike-wave discharges with photosensitivity while neuroimaging was normal.

Management and Outcome:
The possibility of PME was considered in view of the clinical phenotype and strong family history. Following detailed elicitation of history, focused physical examination, and rational investigative work-up specific molecular genetic testing were planned for ULD. This showed homozygous expansion of dodecamer (set of 12 nucleotides) repeat in the cystatin B gene in all the three affected siblings. The parents were heterozygous carriers. Genetic counseling was undertaken and anticonvulsant drugs (ACDs) modified accordingly. The definitive diagnosis helped in accurate prognostication and management to improve the quality of life of all three siblings.

Conclusion:
Clinicians should consider a specific epilepsy syndrome in patients with onset of symptoms in adolescence. ULD is a type of PME with a relatively better course of illness. Establishing the diagnosis has implications on the extent of investigative workup, choice of ACD, and prognosis.
Implications of CYP21A2 Gene Duplications in Carrier Screening and Prenatal Diagnosis of Congenital Adrenal Hyperplasia due to 21 Hydroxylase Deficiency
Authors: Dubey Sudhisha , Saxena Renu , Puri Ratna Dua , Verma Ishwar Chander 
Published: February 2022

Background:
Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder that presents as salt wasting or simple virilization (SV). It is due to biallelic mutations in the CYP21A2 gene that encodes the 21-hydroxylase enzyme. This gene is susceptible to deletions and duplications due to the presence of a homologous pseudogene and its location in the RCCX module. This complicates the interpretation of molecular analysis of the CYP21A2 gene.

Clinical Description:
During preconception counseling and subsequent workup of a couple, the wife (who had been diagnosed with simple virilizing CAH at the age of 14 years, based on clinical and metabolic profile) was identified with c.373C >T variant on one and a deletion on the other allele of CYP21A2. Her asymptomatic husband harbored a novel c. 939+5G>A variant in intron 7 of CYP21A2. Prenatal diagnosis by Sanger sequencing revealed the presence of both maternal (c.373C>T) and paternal (c. 939+5G>A) variants in the fetus, indicative of SV form. After genetic counseling, the parents decided to continue with the pregnancy.

Management and Outcome:
A baby boy was born who underwent investigations according to the standard protocol. However, a diagnosis of CAH could not be established conclusively. The molecular diagnosis of both baby and parents was revisited. It was found that the baby harbored a duplication of CYP21A2 (inherited from his father) along with a novel variant. The duplication neutralized the paternal variant, and thus the baby was not affected, but a carrier.

Conclusion:
Evaluation of duplication in parents is crucial before prenatal testing, as duplications have important bearing on the carrier status.
Conn's Syndrome
Authors: Sivadas Suchitra , Bhavani Nisha , Bhaskaran Praveena , Panicker Jayakumar Chandrasekhara , Viswanath Naveen 
Published: February 2022

Background:
Acute flaccid paralysis is a medical emergency. Hypokalemia secondary to an aldosterone-secreting adrenal adenoma or Conn's syndrome is a rare cause of hypokalemic paralysis. There are very few case reports from the pediatric population of the same.

Clinical Description:
We report the case of a 17-year-old girl, previously asymptomatic, who presented with sudden-onset, progressive weakness of all four limbs. There was no history of altered sensorium, cranial nerve involvement, or abdominal complaints. On examination, she was found to be hypertensive. Preliminary investigations revealed severe hypokalemia and metabolic alkalosis. There was no history suggestive of gastrointestinal potassium losses. Hence, a possibility of renal losses was considered and she was found to have kaliuresis.

Management and Outcome:
In view of hypokalemia, with hypertension with increased renal potassium loss, a possibility of hyperaldosteronism was considered. Plasma aldosterone concentration was elevated with levels of 20.3 ng/dl (normal <15 ng/dl). The direct renin concentration was <0.5 μIU/l (normal 5–14 μIU/l). This confirmed a diagnosis of primary hyperaldosteronism. Contrast-enhanced CT of the abdomen showed an adrenal adenoma. She electively underwent a laparoscopic adrenalectomy after her motor power improved with potassium replacement. Currently, she remains normotensive, asymptomatic, and off medications.

Conclusion:
The case highlights that Conn's syndrome though rare is an important cause that a high index of suspicion is necessary in young hypertensive patients to make an early diagnosis of this potentially treatable condition.
Diagnostic utility of chest computerized tomography in the diagnosis of recurrence among sputum scarce and sputum negative previously treated pulmonary tuberculosis suspects
Authors: Bharath BG , Ray Animesh , Jorwal Pankaj , Vyas Surabhi , Soneja Manish , Biswas Ashutosh , Sinha Sanjeev , Khan Maroof A 
Published: February 2022

Objective:
The objective was to study the sensitivity, specificity, and diagnostic accuracy of various computed tomography (CT) chest findings in diagnosing recurrence among pulmonary tuberculosis (PTB) suspects.

Materials and Methods:
A prospective observational study was conducted in a tertiary care hospital in New Delhi. A total of 130 suspects with a past history of treatment for PTB, who presented with any of the symptoms suggestive of recurrence were included. Sputum-positive, HIV-positive patients, pregnant females, and patients aged <18 years were excluded. Patients underwent CT chest followed by bronchoalveolar lavage (BAL).

Results:
A total of 62 patients were there in the final analysis. The median age of the patients with recurrent PTB was 27.5 years. Cough was the universal symptom in all these patients (>90%). Hemoptysis was the predominant symptom among patients with chronic pulmonary aspergillosis (66.6%). Necrotic mediastinal lymph nodes had good diagnostic accuracy of 88.71% with area under the curve of 0.806, P < 0.001 in diagnosing recurrent TB. BAL GeneXpert and mycobacteria growth indicator tube had good sensitivity (83.33% and 84.62%, respectively), specificity (100% for both), and excellent diagnostic accuracy (95.16% and 96.36%, respectively) for diagnosing recurrence in sputum negative and sputum scarce patient, (P < 0.001) when compared with composite reference standard. For culture-positive cases, BAL GeneXpert MTB/RIF had 100% sensitivity and 97.73% specificity in diagnosing recurrent PTB patients.

Conclusion:
The presence of mediastinal necrotic lymph node is the most accurate CT finding that can differentiate recurrent TB from post-TB sequelae. No other single chest CT scan finding had reliable diagnostic accuracy in comparison to microbiological tools in diagnosing recurrence among sputum negative or scarce previously treated PTB suspects.
Asthma phenotype: Clinical, physiological, and biochemical profiles of North Indian patients
Authors: Vennilavan R Naveen , Spalgais Sonam , Kumar Raj 
Published: February 2022

Background and Objectives:
Asthma is a common, chronic and heterogeneous disease with various phenotypes. The clinical phenotypes has aided in revealing the genetic heterogeneity, provide education, life style advice and novel biological treatments. The few common factors associated with phenotypes are smoking, rhinitis and obesity. The present study was thus planned to analyse and correlate the clinical, physiological, biochemical and serological parameters of asthma and to study the phenotypic characteristics in different asthmatic.

Methods:
This was a prospective observational study of 120 patients with 30 each in BA-rhinitis, BA, BA-obesity and BA smoker phenotypes. All the enrolled patients were assessed by SGRQ, Mini-AQLQ, GINA with ACE, chest X ray, Spirometry, SPT against common aero-allergens, FENO, hsCRP, vitamin-D, IgE, and Interleukins (IL) including IL-5, IL-6, IL-8, IL-13, IL-17 and IL-33. The mentioned profiles of each phenotype correlated and characterized among different phenotypes.

Results:
The majority of patients 78(65%) were female with mean BMI of 24.07±4.73kg/m2. Majority of the patient in BA and BA-rhinitis phenotype are in mild severity and young compared to majority in BA-obesity and BA-smoker are moderate to severe severity with older. (p<0.001) The SPT and FENO level were highest among BA-rhinitis phenotype with significant difference among phenotypes. (p<0.001) Similarly the most of inflammatory markers were significantly different in various phenotypes. The FEV1 showed correlation with most of parameters with statistically significant correlation with IL-5, IL-8 and FENO.

Conclusion:
The majority of parameters were significantly different among various phenotypes. We advise to phenotypic classification of asthma whenever possible for better management and quality of life.
Spatial analysis of chronic obstructive pulmonary disease and its risk factors in an urban area of Trivandrum, Kerala, India
Authors: Surendran Sethulekshmi , Mohan Ananth , Valamparampil Mathew Joseph , Nair Sanjeev , Balakrishnan Sreekanth Karthikeyan , Laila Achu Asokan , Reghunath Rajesh , Jose Chinu , Rajeevan Amjith , Vasudevakaimal Prasannakumar , Surendrannair Anish Tekkumkara , Nujum Zinia Thajudeen , Varghese Sara , Mohan Alladi 
Published: February 2022

Background:
Chronic obstructive pulmonary disease (COPD) is the second leading cause of death in India. The objective of this study was to map COPD cases and its risk factors and to determine the association between them using geographic information system (GIS) in a semi-urban area of Trivandrum, South India.

Materials and Methods:
This community-based cross-sectional, descriptive study (n = 494) was conducted in a subcenter area of a primary health center. Location was mapped and COPD population screener questionnaire was administered to all the study subjects enrolled by census method. Lifetime firewood exposure (person-hours) and tobacco smoking were enquired and distance from road was mapped using portable differential global positioning system. The association with COPD was assessed by kriging and hotspot analysis using ArcGIS software.

Results:
The prevalence of COPD (6.5%) was comparable to national prevalence estimates. Spatial maps showed COPD case clustering in areas with higher firewood exposure, greater smoking exposure, and in households with closer proximity to local roads. A particular high-risk cluster was obtained which had a significant association with all the risk factors.

Conclusion:
GIS technology is useful in identification of spatial clustering of COPD cases and its environmental risk factors, making it an important tool for targeted interventions for COPD.
Lower respiratory tract sampling in COVID-19 acute respiratory distress syndrome: A focus on microbiology, cellular morphology, cytology, and management impact
Authors: Bansal Sameer , Kalpakam Hariprasad , Kumar Ashwin , Varsha Amogha , Thorbole Anmol , Mehta Ravindra M. 
Published: February 2022

Background:
Lower respiratory tract (LRT) sampling through bronchoscopy has been done sparingly in COVID-19 acute respiratory distress syndrome (ARDS) due to the high aerosol risk for the health-care workers (HCWs). Valuable information can be gained by a detailed evaluation of bronchoscopic LRT samples.

Methods:
LRT samples were obtained by bedside bronchoscopy severe COVID-19 ARDS patients on mechanical ventilation. Microbiological, cellular, and cytological studies including LRT COVID-19 reverse transcription-polymerase chain reaction were analyzed.

Results:
A total of 100 samples were collected from 63 patients, 53 were males (84%). Forty-three patients (68%) had at least 1 comorbidity. 55% of cases had a secondary bacterial infection, commonly with multidrug-resistant organisms (94.5%). The most common organisms were Klebsiella
pneumoniae and Acinetobacter
baumannii in 56.3% and 14.5% of cases, respectively. Fungal superinfection was observed in 9 patients (14.3%). Bronchoscopy helped confirm COVID-19 diagnosis in 1 patient and helped rule out COVID-19 in 3 patients. The median bronchoalveolar lavage fluid (BALF) white blood cell (WBC) count was 953 (inter quartile range; 400–2717), with mean neutrophil count 85.2% (±13.9) and mean lymphocyte count 14.8% (±13.9). Repeat sampling done in some patients showed a progressive increase in the total WBC count in BALF, an increase in neutrophil percentage, and a higher chance of isolating an organism on the culture. Rate of superinfection increased with a longer duration of illness. Bronchoscopic LRT sampling contributed significantly to modifying antibiotic coverage and discontinuing steroids in 37% of cases.

Conclusions:
Our study provides a detailed analysis of bronchoscopic LRT sampling in critically ill COVID-19 patients, augmenting disease understanding and contributing to clinical management.
Awareness of forensic odontology among general dental practitioners in Mumbai
Authors: Mistry Rishabh G. , Pereira Treville , Shetty Subraj , Gotmare Swati , Anjali A. K. , Vidhale Rutuja 
Published: February 2022

Introduction:
Forensic odontology is the application of dental knowledge in human identification. It has major implications in criminal investigation, and human remains identification.

Objective:
The aim of this study is to introspect the attitude and knowledge of forensic odontology among general dental practitioners (GDPs) in Mumbai.

Materials and Methods:
A cross-sectional study was conducted in a sample size of 225 GDPs of Mumbai with the help of an online questionnaire comprising 11 questions.

Results:
GDPs were found to have a lack of exposure and poor knowledge regarding the subject of forensic odontology. Only 13.3% of dentists have had a formal training in the subject. About 29.3% are unaware that they can testify in the court and support the investigation.

Conclusion:
The lack of awareness and knowledge among dentists will hinder the criminal investigation. Hence, awareness should be created among young dentists and more courses should be available in the field.
KEMAMPUAN BAHAN AKTIF EKSTRAK AEGLE MARMELOS DALAM PENGENDALIAN DENGUE HEMORRHAGIC FEVER
Authors: Prayogo Damar , Astuti Dumilah 
Published: February 2022

Penyakit Demam Berdarah Dengue (DBD) merupakan penyakit yang ditularkan oleh nyamuk Aedes aegypti. Penggunaan insektisida yang berasal dari tumbuhan mojo (Aegle marmelos L.) mengandung senyawa tanin, saponin, alkaloid, flavonoid, terpenoid, dan steroid, yang berfungsi sebagai larvasida. Penelitian ini bertujuan untuk mengetahui kemampuan ekstrak daun mojo (Aegle marmelos L.) dalam mengendalikan nyamuk Aedes aegypti dengan metode elektrik dengan menggunakan 2 konsentrasi yaitu 60% dan 70%. Berdasarkan hasil penelitian diketahui kematian nyamuk rata-rata pada konsentrasi 60% ekstrak daun mojo (Aegle marmelos L.) sebesar 16%, dari 30 ekor sampel nyamuk, pada 240 menit waktu pengamatan, dan konsentrasi 70% ekstrak daun mojo (Aegle marmelos L.) sebesar 18%, dari 30 ekor sampel nyamuk, pada 240 menit waktu pengamatan. Memenuhi Lethal Consentration 50 (LC50) dimana nyamuk Aedes aegypti yang mati rata-rata mencapai 16 ekor (53%) dan 18 ekor (56%), sedangkan pada kontrol tidak terdapat nyamuk yang mati. Kesimpulan yang di peroleh dalam penelitian ini yaitu Pada konsetrasi 60 % dan 70 % ekstrak daun mojo (Aegle marmelos L.) mampu pada 240 menit dengan 240 menit waktu pengamatan, dimana rata-rata kematian nyamuk Aedes aegypti sebanyak 16 ekor (53%) dan 17 ekor (56%) dan telah mencapai LC50.
The role of nurses in the application of bedsores in palliative care
Authors: Andriulevičienė Lina 
Published: February 2022

In palliative care, the role of the nurse is very important in the prevention of bedsores, as only by providing qualified care and early prevention can bedsores be prevented and thus improve the patient's quality of life in the last years of life. The role of nurses in the prevention of bedsores is mainly reflected in the use of bedding prevention and treatment mattresses and functional beds. Less than three-quarters of nurses often use biophysical agents, various bandages, auxiliary surfaces, heel guards, stationary lifts, flip-flops, transfer boards / stretchers / belts, and other positioning devices in palliative care. According to the recommendations of the EPUAP, almost half of nurses say that the most effective means of preventing bedsores in palliative care is flipping. Nurses perform many professional and effective actions, functions that improve the patient's health and well-being in the treatment of bedsores. Also, in the prevention of patients' bedsores and palliative care, nurses perform their work responsibly, reliably, and are able to empathize with patients.
The aim. To elucidate the role of nurses in the application of bedsores in palliative care.
Research methods: after analyzing the scientific literature, from 2021. A quantitative survey and an anonymous survey were conducted in November-December. The research data were analyzed by MS Office Excel 2016 data processing program. The research was conducted in accordance with ethical principles.
Results of the study: 64 nurses (women) participated in the study. The productive role of nurse in the prevention of bedsores is reflected in the use of EPUAP guidelines in the prevention of patient bedsores.
Conclusions: The study found that 94 percent. (n = 60) the role of nurses in the prevention of bedsores is reflected in the most common use of bedsores for the prevention and treatment of bedsores, 91%. (n = 58) - uses functional beds. On average, 67 percent. (n = 43) nurses often use biophysical agents, various bandages, auxiliary surfaces, heel guards, stationary lifts, flip-flops, transfer boards / boards / stretchers / belts and other positioning devices, with the least use of implants - 39%. (n = 25). According to the EPUAP, 46 percent. (n = 29) The most effective measures for nurses in the prevention of bedsores in palliative care are reversal, and 17%. (n = 11) - when more employees work, 11 percent. (n = 7) - patient hygiene and dry maintenance, 8 percent. (n = 5) - bed rest mattresses and functional beds.
Correction of mature skin with the help of decorative cosmetics
Authors: Jankauskaitė Gerda , Gierasimovič Zita 
Published: February 2022

Beauty products are used to visually conceal visible aging of skin. The appropriate selection of makeup techniques and decorative cosmetics for mature age women help correct their features and conceal skin problems.
Aim. The article deals with the effect of cosmetic products on mature face skin.
Material and methods. In 2021, as many as 16 publications on the subject under discussion that appeared during the past decade, were analysed. Between 2012 and 2021, articles were published in the databases of the journals Skin Research and Technology, Psychology, Journal of Pharmaceutics, Dermatology, Cosmetics, Journal of Consumer Behaviour. All publications are in the English language, the texts are complete and easily accessible. The selected publications describe the skin aging process, the composition of beauty products, nanotechnology products and the application of cosmetic products to prevent the process of premature skin aging. Recommendations for mature skin care are provided.
Results. In the 21st century, cosmetics is widely used and is in great demand in the world market. Annually the demand increases by approximately 4.5 percent. Cosmetic products and make-up make mature face skin look more attractive. Attractive faces are perceived as much younger, the face contour is preserved, skin is firm, the size of the eyes and the area around them, and lip distraction remain unchanged. Cosmetic surgical procedures enhancing the appearance of face skin can improve psychological health of the patients; there is no evidence about how these changes effect a positive attitude of other individuals to their changed appearance, the status of an individual and his/her social wellbeing.
Conclusions. 1. Most often scientific literature is concerned with the effect of make-up on the psychological aspect – an individual’s attractiveness. 2. Beauty products and make-up techniques chosen for mature skin change the face in three directions: they change the contours of the face, skin homogeneity, contrast of the face and the size of facial features. 3. Innovative, biologically active cosmetic products have an external and therapeutic benefit to the appearance of face skin, are not only friendly to human skin and health but also are environmentally friendly.