bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awake videolaryngoscopic orotracheal intubation in patients with laryngeal tumour using the C-MAC D-Blade
Authors: Selvam Selwin R. , Jindal Swati , Anand Lakesh K. , Dawar Manpreet Singh , Dass Arjun 
Published: August 2022

ABSTRACT

Background and Aims:
This study assessed the applicability of C-MAC videolaryngoscope (VL) D-blade for awake intubation in patients with laryngeal tumour. The primary study objective was to determine the rate of successful intubation in the first attempt. The other parameters recorded were number of attempts required for intubation, duration of different stages of intubation, haemodynamics, ease of intubation and patient comfort on visual analogue scale (VAS) postoperatively.

Methods:
Thirty patients were studied. Patients were sedated with dexmedetomidine and fentanyl as a slow bolus (over 20 min) and Ramsay sedation score was assessed. Topicalisation of the oropharynx, tonsillar pillars and base of the tongue was done with lignocaine 10% spray. Four ml of 4% lignocaine using MADgic atomiser was used for anaesthetising the glottis and the tracheal lumen.

Results:
Successful intubation was achieved in 86.6% patients in first attempt and 13.3% in two attempts. Total time for all intubations was less than 30 seconds. Fremantle score was F-1-C-MAC D-blade (easy intubation with full view) in 60% patients, while 23.3% had F-2-C-MAC D-blade (full view and either required more than one attempt or a modified technique), 13.3% had P-1-C-MAC D-blade (partial view with easy intubation) and 3.3% had P-2-C-MAC D-blade (partial view and required more than one attempt or a modified technique). The VAS score for anaesthesiologist’s ease and for patient’s experience was 85.83 ± 7.20 and 86.66 ± 14.46, respectively.

Conclusion:
C-MAC VL D-blade-assisted awake intubation is an effective and safe method to manage the airway of patients with laryngeal tumour once adequate topicalisation is ensured before the procedure.
Optimal positioning of right internal jugular venous catheter: A randomised study comparing modified Peres’ height formula and distance between insertion point and right third intercostal space
Authors: Chopra Swati , Luthra Neeru , Kathuria Suneet , Saggar Kavita , Gupta Shikha , Singh Tanveer 
Published: August 2022

ABSTRACT

Background and Aims:
The position of the tip of the central venous catheter (CVC) is important to minimise complications. The aim of our study was to compare modified Peres’ height formula and landmark method using distance between puncture site and right third intercostal space (PS-RTICS) and to develop a reliable formula for correct positioning of tip of the CVC.

Methods:
This prospective, randomised study was conducted on 400 patients of either gender, of age 18 years and older, scheduled to undergo right internal jugular venous cannulation. Depending on the technique used for deciding the length of CVC to be inserted, the patients were randomly allocated into two groups: Group A, using modified Peres’ height formula, that is, height of patient (cm)/10-2 and Group B, using distance between PS-RTICS and subtracting one from it, that is (PS-RTICS)-1. The carina was taken as the landmark for optimum insertion of CVC, which was confirmed on postprocedure chest X-ray. Data so obtained were tabulated and analysed. P<.05 was considered statistically significant for correlation and regression coefficients.

Results:
In group A, the mean length of catheter inserted was 15.18 ± 0.73 cm and the catheter tip was found to be 2.41 ± 0.85 cm distal to carina (P =0.001). Over-insertion was found in 98.45% patients in group A. In group B, the mean length of catheter inserted was 14.12 ± 0.85 cm and the catheter tip was found to be 0.20 ± 1.18 cm distal to carina.

Conclusion:
Though both landmark and modified Peres’ height formula has low accuracy, landmark technique is superior in predicting correct depth of right internal jugular venous cannulation catheter.
Prevalence of Thrombophilia in Indian Patients with Deep Venous Thrombosis – An 8-Year Single-Center Study
Authors: Agrawal Vivek , Deshpande Sanjeev Kumar , Biswas Brijesh , Thupakula Suresh Reddy , Anand Vembu 
Published: August 2022

Background:
Thrombophilia is a recognized risk factor for deep venous thrombosis (DVT) and its recurrence. Routine thrombophilia testing is controversial because of low yield and high cost. However, screening for thrombophilia helps in deciding the duration of anticoagulant treatment. The aim of this study is to determine the prevalence of thrombophilia in DVT patients in India.

Materials and Methods:
This was a retrospective, prospective, observational study done from April 2012 to April 2020. Thrombophilia screening was done in DVT patients who were <40 years, with unprovoked DVT, or with recurrent DVT. Homocysteine, antithrombin III, protein C and S, factor V Leiden, and lupus anticoagulant (LAC) were assessed. Follow-up was done to assess post thrombotic syndrome (PTS), pulmonary embolism (PE), and recurrence of DVT.

Results:
One hundred and sixty-six patients selected for thrombophilia out of which 163 were males. Patients were ranging age from 35 to 70 years. 82 (49.4%) patients had abnormal thrombophilia. 66 had one abnormal factor, while 16 had more than one. A total of 102 abnormal factors found in 82 cases, of which 41 had hyperhomocysteinemia, 20 protein S deficiency, 12 protein C deficiency, 15 factor V Leiden mutations, 8 antithrombin III deficiency, and 6 LAC. 10.2% of patients developed PTS, 16.3% recurrence, 2% PE, and 0.3% mortality.

Conclusion:
DVT patients are at a substantial risk of recurrence. Although laboratory evaluation of thrombophilia is costly but it is essential for monitoring therapy in certain sets of patients. Identification of thrombophilic condition is worth and affects the overall standard clinical management. In our study we found prevalence of thrombophilia in about 50% of DVT patients who are <40 years, with unprovoked DVT or with recurrent DVT. Out of which hyperhomocysteinemia is most common. But more studies including RCTs are required for further clarifications.
Learning curve in performing palatoplasty
Authors: Menon P. Varun , Radhakrishnan Vasant , Narayanan P. V. , Adenwalla H. S. 
Published: August 2022

Objectives:
The aim of the study was to assess the influence of the experience of the surgeon on the occurrence of fistulas and breakdowns following palatoplasty.

Materials and Methods:
A retrospective review on the outcomes of palatoplasty done by a young surgeon in his initial 3 years of operating cleft palate was done. Cleft palate repair was performed using the Pinto's modification of Wardill–Kilner palatoplasty, Veau-Wardill-Kilner V-Y Pushback in both the techniques radical levator muscle dissection was carried out. Data were collected for age, sex, date of birth, syndrome, cleft palate type, type of repair, cleft width, length of soft palate, quality and quantity of muscle, fistula occurrence, and location of fistula.

Results:
Retrospective analysis was done on the outcomes of palatoplasty performed by a young surgeon in his initial 3 years at Charles pinto center for cleft lip palate and craniofacial on 220 cleft palate children which included all variants and dimensions of cleft palates. Postoperatively, the incidence of palatal fistulas occurred in 12 patients, three patients had bifid uvula, however, out of 12 patients who had fistulas only four needed fistula closure and one required a uvula re-repair; the rest healed well.

Conclusion:
We believe there is a learning curve in performing cleft palate repair. Our technique and principles followed in palatoplasty appear to have a low or zero fistula rate even in the initial period of learning. Furthermore, effective mentorship and guidance help in reducing errors and providing a better outcome.
IndiCleft – A web-based standardized research tool and resource for cleft anomalies
Authors: Kharbanda O. P. , Grover Ashoo , Dawar Savita , Aggarwal Karoon , Sharma S. C. , Singhal Maneesh , Chauhan Shashank , Singh Harpreet , Kabra Madhulika , Gupta Neeraja , Scaria Vinod , Rajkhowa MriduPobon , Garg Arti , Monga Nitika , Singh Ravinder , Dhaliwal R. S. 
Published: August 2022

Introduction:
In India, approximately 35,000 new cleft patients are born every year. Many patients receive suboptimum, improper, little, or no treatment. The cumulative burden of cleft care is up to 1 million cases. The spectrum of problems is varied, the caseload is enormous, and the logistics of treatment delivery are complicated. The Indian Council of Medical Research (ICMR) task force project was launched in 2012 to evaluate the status of cleft care in India and develop strategies to provide comprehensive cleft care through a dynamic multidisciplinary and multidimensional tool. ICMR task force project (2012–14) was conducted in Delhi, and the National Capital Region reported that at least 50% of studied cases had complex and multiple treatment needs. The needs identified were related to surgical, orthodontic, dental, ENT and Speech, rehabilitation of mutilated dentition, and various psychological disturbances among patients with Cleft anomalies.

Aim:
The aim of this study was to develop and test web-based application to create a system for national data of patients with cleft anomalies and digitize the patient records in a standardized preagreed format.

Methods and Results:
Corresponding to contemporary digital technologies and evolutionary improvements in data collection, web-based data collection instrument, including text, photographs, X-rays, and audio files, was considered the most appropriate. The experts from varied domains in consultation with ICMR and National Informatics Centre evolved a web-based data collection instrument which is named the “IndiCleft tool.” The tool has been tested and used over the years and is presently being upgraded to dynamic version for a national data and patient care registry.

Conclusion:
The present article describes the process of the development of a “dynamic” web-based data collection instrument. The IndiCleft tool is the national resource on cleft data in India.
Feasibility, safety and oncological outcomes of minimally invasive oesophagectomy following neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma – Experience from a tertiary care centre
Authors: Surendran Suraj , Midha Geet , Paul Negine , Yacob Myla , Abraham Vijay , Mathew Manu , Sasidharan Balu Krishna , Gunasingam Rajesh Isiah , Pavamani Simon Pradeep , Irodi Aparna , Mani Thenmozhi , Samarasam Inian 
Published: August 2022

Background:
Neoadjuvant chemoradiotherapy (nCRT) has improved the resectability and survival of operable oesophageal squamous cell carcinoma (OSCC). We aimed to study if nCRT for OSCC makes minimally invasive oesophagectomy (MIO) technically more challenging and if the peri-operative and oncological outcomes are acceptable for MIO following nCRT.

Materials and Methods:
A retrospective review of patients with OSCC (cT1-2N1-2, cT3-4aN0-2) treated with nCRT and MIO between 2013 and 2019 was performed. The operative details including the technical difficulty in tumour dissection and lymphadenectomy, the post-operative complications and oncological outcomes were studied.

Results:
Seventy-five patients (male:female - 50:25; mean [range] age - 55.49 ± 8.43 [22–72] years; stage II - 34.7%; stage III - 37.3%; stage IVA - 28.0%) were enrolled. The concurrent chemotherapy course was completed by 25.3% of patients and the most common reason limiting the completion of chemotherapy was neutropaenia (66.0%). A thoraco-laparoscopic (n = 60) or hybrid (n = 15) McKeown's oesophagectomy with a two-field lymphadenectomy was performed. The increased surgical difficulty was reported in 41 (54.7%) patients, particularly for mid-thoracic tumours and tumours exhibiting incomplete response. The 30-day overall and major complication rate was 48.0% and 20.0%, respectively, and there was no mortality. The rate of R0 resection, pathological complete response and median lymph nodal yield were 93.3%, 48% and 8 (range: 1–25), respectively. The mean overall survival (OS) was 62.2 months (95% confidence interval [CI]: 52.6–71.8) and recurrence-free survival (RFS) was 53.5 months (95% CI: 43.5–63.5). The 1-, 2- and 3-year OS and RFS were 89.5%, 78.8% and 64.4% and 71.1%, 61.3% and 56.6%, respectively.

Conclusion:
Minimally invasive McKeown's oesophagectomy is feasible and safe in patients with OSCC receiving nCRT. The radiation component of nCRT increases the degree of operative difficulty, especially in relation to the supracarinal dissection and lymphadenectomy. However, this drawback did not adversely affect the short-term surgical or the long-term oncological outcomes.
Four-year outcomes for endoscopic sleeve gastroplasty from a single centre in India
Authors: Bhandari Mahak , Kosta Susmit , Reddy Manoj , Mathur Winni , Neto Manoel Galvao , Bhandari Mohit 
Published: August 2022

Background:
Bariatric endoscopy has emerged for non-surgical treatment of obesity, providing a treatment option for weight loss and associated comorbidities. Outcomes of endoscopic sleeve gastroplasty (ESG) of 12 months have been published by our team and there is a need for longer follow-up period understanding the effects of ESG techniques.

Aim:
This report emphasises on weight loss pattern in follow-up time points and monitors the post-procedure improvement in comorbidities with minimum 4-year follow-up of patients undergoing ESG at a single academic centre in India.

Subjects and Methods:
This was a prospective cohort study. All procedures were performed by the same surgeon. Patients with a body mass index of >30 kg/m2 (or >27 with comorbidities) underwent ESG for treatment of obesity. Patients were systematically followed yearly after their procedure. Data collected on the primary outcome and secondary outcomes were analysed and presented.

Results:
612 patients (69.3% female) with a mean age of 40.70 ± 12.66 years and mean body mass index of 34.30 ± 5.05 kg/m2 underwent ESG. Out of 612 patients, follow-up rates for a 1-2-3 and 4 years were 93.1%, 90.2%, 81.7% and 81.9%, respectively. The mean percentage total body weight loss was 18.19% (95% confidence interval [CI]: 17.72–18.57) and %EWL was 49.30% (95% CI: 48.91–49.68) with 90% of participants-maintaining a percentage of total weight loss of ≥5% and 70% of patients maintaining an EWL of ≥25% at 4 years, respectively. Resolution/improvement of comorbidities was 51.2% cases of T2DM, 65.8% cases of hypertension, 73.6% cases of dyslipidaemia and 89.9% remission were in obstructive sleep apnoea. No patient required an emergency intervention, and there was no mortality or significant morbidity.

Conclusions:
This study shows acceptable results with ESG at 4 years in our unit. Regular monitoring by a multidisciplinary nurtures weight loss, resolution or improvement of comorbidities and improvement of quality of life with low perioperative complications. There is a need for more reports with this approach to determine the amount and duration of weight loss outcome and medical intervention.
Nursing students' experiences with blackboard
Authors: Alkarani Ahmed Saleh 
Published: August 2022

Abstract

Background:
The coronavirus disease 2019 pandemic has overwhelmed the nursing workforce through tremendous pressure worldwide. Therefore, the Ministry of Education in many countries had transferred the education system to virtual learning. Thus, blackboard is currently the main tool for delivering education and enabling the interactions between teachers and students.

Aims:
The aim of this study is to explore nursing students' challenges in using Blackboard, and to explore the advantages and disadvantages of using blackboard among nursing students.

Settings and Design:
This study used a descriptive qualitative study design. The study collected eleven nursing students.

Subjects and Methods:
In-depth individual semi-structured interviews were used.

Statistical Analysis:
The data were analyzed using thematic analysis.

Results:
The results identified four themes: high student satisfaction in using backboard; the positive impact of using Blackboard; learning obstacles through using blackboard; and students' desire for in-class education instead of the blackboard platform.

Conclusion:
Blackboard, through its current characteristics and features, makes education easy and available to all students. However, students do not prefer blackboard in practical nursing subjects.
Association between demographic, academic, and behavioral characteristics with physical activity levels among international students in China during COVID-19 pandemic
Authors: Nivyimana Willy , Mbasani Rogious , Yollande Djivoh Sènan , Daan Zhou , Bayumvire Claudette , Wang Manyu 
Published: August 2022

Abstract

Background:
International students face multiple challenges due to cultural distance, cultural shock, social support, stress and anxiety, language barriers, and classroom transition. Moreover, the outbreak of COVID-19 complicated the living situation for international students. Physical activity (PA) can be a coping strategy in overcoming health challenges as it is known to have health benefits, improve socialization and integration skills.

Aim:
The study aimed to determine PA levels of international students in China during COVID-19 and analyze the associated characteristics.

Setting and Design:
A cross-sectional study was conducted among international students in China.

Subjects and Methods:
An online questionnaire that included demographic, academic, and behavioral characteristics together with International Physical Activity Questionnaire Short Form tool was used to collect the data.

Statistical Analysis:
Descriptive statistics, Chi-square test, and Mann–Whitney U test were employed to analyze the data.

Results:
One thousand and hundred and twenty international students were recruited into the study. 71.3% of the participants were engaged in low, 15% in moderate and 13.8% in high PA. PA of international students was associated with gender, body mass index, marital status, continent of origin, student residence, study language, time spent in China and alcohol consumption P< 0.01; academic level P< 0.05. However, there was no significant association of PA with age and smoking status P< 0.05.

Conclusion:
This study indicates a lower level of PA among international students in China. International education management may consider the promotion of PA as a good intervention to the health of international students during COVID-19.
Active surveillance of adverse events following the first dose of COVID-19 vaccination - Oxford-AstraZeneca (Covishield) vaccine
Authors: Varghese Sangeetha Merrin , John Grace Mary , George Geomcy , Jacob Linda , Paul Mammen , Sachu Arun , Johnson Abel K Samuel , Chandy George Mateethra 
Published: August 2022

Abstract

Background:
COVID-19 vaccines have been the most rapidly developed vaccines in history and consequently, fears of its safety and efficacy intrigue the minds of the common man.

Aims:
This study was intended to determine the adverse events following COVID-19 vaccination and thereby reduce vaccine hesitancy in the people.

Methods and Materials:
An active vaccine safety surveillance study was carried out on health-care workers of a tertiary care center in Central Kerala using a prestructured interview schedule documenting a description of adverse events following immunization (AEFI), time of occurrence, management and outcome of AEFI, knowledge about AEFIs, and fear of COVID-19 vaccination. A telephonic survey was carried out on 475 randomly selected COVID vaccine beneficiaries.

Results:
Overall, 86% of the participants reported at least one postvaccination symptom. Fever (51.8%), injection-site pain (46.9%), headache (29.3%), myalgia (28.4%), and fatigue/tiredness (25.1%) were the most common symptoms. None of the symptoms were severe/serious to warrant hospital admission. Side effects were more common in females (P = 0.003) and reactogenicity of the COVID-19 vaccine decreased with advancing age (P = 0.001). The vaccine did not have any difference in side effects among those who had previous COVID-19 infection.

Conclusion:
This study shows that COVID vaccines are safe in the Indian population and the side effects are similar to any other vaccine. It may help to dispel any fear and misinformation regarding COVID-19 vaccination and thus maximize the benefit of the nationwide immunization program.
The preferences and practices regarding refractive surgeries among Saudi Ophthalmology Society members
Authors: AlGhamdi Abdullhamid S , AlGethami Rahma A , Almalki Nada Ahmad , Al-Amri Abdulrahman Mohammed , Al-Barry Ma'an 
Published: August 2022

Abstract

Background:
Refractive errors are the leading cause of visual impairments in the Kingdom of Saudi Arabia (KSA). Laser refractive eye surgeries are getting huge popularity for correcting these visual impairments in KSA and other gulf countries.

Aims:
The study assessed the preferences and practices regarding refractive surgeries The preferences and practices regarding refractive surgeries among Saudi ophthalmology society members.

Setting and Design:
A cross-sectional study was conducted using an online questionnaire among the Saudi Ophthalmology Society members.

Methods and Materials:
The questionnaire was pilot tested and had 28 items that included sociodemographic details and practices related to refractive eye surgery of participating ophthalmologists.

Statistical Analysis:
The collected data was analyzed using Pearson's Chi-square test to determine the relationship between categorical variables.

Results:
Excimer laser platform EX500 (Alcon) was the most commonly used refractive surgery system. There were region-wise differences observed in the type of refractive surgery system where surgeons from Central KSA used AMARIS 1050 RS (SCHWIND) (83.4%) and AMARIS 500 (SCHWIND) (68.4%) comparatively more than other regions (P < 0.05). The majority of the eye surgeons (84.4%) used Pentacam comprehensive eye scanner preoperative screening, and corneal topography was the most commonly used preoperative examination method. Only 9.1% of the surgeons had refractive eye surgery on 75%–100% of their patients, and the most commonly preferred refractive eye surgery (RES) by the surgeons in our study was photorefractive keratectomy.

Conclusion:
The findings showed that refractive eye surgery trends are changing, and surgeons are shifting to more reliable techniques with fewer postsurgical complications.