Global research on Obsessive Compulsive Disorder and related disorders: A scientometric assessment of global research during 2002-2021.

OBJECTIVES: to examine the global publication output on Obsessive Compulsive Disorder (OCD) during the last 20 years using bibliometric methods. METHODS: The quantitative and qualitative analysis of global publications was performed for all the publications in Scopus database by using "OCD, Obsessive Compulsive Disorder, other related disorders" as keyword in "Title" tag. RESULTS: 10,365 publications on OCD and related disorders were indexed in Scopus international database in the last 20 years and these publications were cited 241,962 times, averaging 23.34 citations per paper (CPP). About 24.91% share of global publication output received funding support and registered a CPP of 36.57. Among various countries, authors from USA, U.K., and Germany contributed the largest number of publications (3585, 965, and 836 publications), and publications arising from Netherlands (36.79 and 1.58), U.K. (32.65 and 1.40), and USA (32.43 and 1.39) registered the highest CPP and relative citation index (RCI). The organizations that produced the highest number of publications were Harvard Medical School, USA (487 papers), Massachusetts General Hospital, USA (454 papers), and King's College London, U.K. (297 papers). The authors who published highest number of papers were E.A. Storch (254 papers), D. Mataix-Cols (178 papers), and D.J. Stein (178 papers). The authors whose publications had highest CPP and RCI were B.D. Greenberg (USA) (73.76 and 3.16), and S.A. Rasmussen (USA) (63.36 and 2.71). CONCLUSIONS: This study reveals that majority of the research on OCD and related disorders is from the developed countries and compared to disorders like schizophrenia, OCD has received less research attention.

Multisystem inflammatory syndrome with persistent neutropenia in neonate exposed to SARS-CoV-2 virus: A case report and review of literature.

BACKGROUND: Multisystem inflammatory syndrome in Children (MIS-C) is a postinfectious immune mediated hyperinflammatory state seen in children and adolescent below 21 year of age and develop after 4-6 weeks of severe acute respiratory syndrome coronavirus -2 (SARS-CoV-2) infection, however, it is rare in neonates. We report an extremely rare and first of its kind case of MIS-C in a neonate with persistent neutropenia. CASE DESCRIPTION: A 19-day old boy presented with complaints of fever and loose stools for 1 day and developed rash after admission. Baby was investigated for sepsis and commenced on IV antibiotics empirically. In view of persistent fever, diarrhoea, rash and absence of obvious microbial etiology of inflammation, with elevated inflammatory marker and an epidemiologic link to SARS-CoV-2 infection, the diagnosis of MIS-C-was made. Intravenous immunoglobulin (IVIg) was administered and defervescence occurred within 24 hours. He also developed neutropenia during course of illness which persisted on follow up. CONCLUSION: MIS-C in neonates is uncommon and fever with elevated inflammatory markers during COVID-19 pandemic should alert the pediatrician to the possibility of MIS-C. Neutropenia may be associated with MIS-C in neonates and warrants prolonged follow up.

A scientometric study of publications on delirium from 2001 to 2020.

AIM: This study aims to evaluate the publications on delirium by using bibliometric analysis. METHODOLOGY: The Scopus database was evaluated for publications on delirium, during the period of 2001-20. The search results were analyzed for the origin of country, origin of institution, authorship, collaborations, type of article, source of funding, and number of citations. RESULTS: The searches of Scopus database yielded 22,941 publications, originating from 139 countries. Compared to the decade of 2001-2010, the number of publications on delirium doubled in the decade of 2011-2020. The majority of the papers were research articles (58.26%), and the papers were cited for mean number of 20.53 times. Only a small proportion of the papers were based on funding (13.14%). Maximum number of papers emerged from United States of America. In terms of institutional affiliations, among the authors from top 20 institutes, 15 were from United States, 2 from Netherlands and 1 each from Canada, Germany and United Kingdom. In terms of authors, the research productivity of the top 20 most productive authors varied from 172 to 612 publications with 12 authors belonging to United States, 2 from Italy and 1 each from Canada, Greece, India, Ireland, Netherland and the United Kingdom. The maximum number of papers were published in Journal of the American Geriatric Society and based on the number of citations the New England Journal of Medicine was the most impactful journal. CONCLUSION: Over the years number of publications on delirium have increased, majority of the publications have emerged from United States.

A statistical approach to secure health care services from DDoS attacks during COVID-19 pandemic.

Over the course of this year, more than a billion people have been afflicted by the COVID-19 outbreak. As long as individuals maintain their social distance, they should all be secure at this period. Because of this, there has been a rise in the usage of different online technologies, but at the same time, there has also been a rise in the likelihood of different cyber-attacks. A DDoS assault, the most prevalent and deadly of them all, impairs an online resource for its users. Thus, in this paper, we have proposed a filtering approach that can work efficiently in the COVID-19 scenario and detect the DDoS attack. We base our proposed approach on statistical methods like packet score and entropy variation for the identification of DDoS attack traffic. We have implemented our proposed approach on Omnet++ and for testing its efficiency we have checked it with different test cases. Our proposed approach detects the DDoS attack traffic with 96% accuracy and can also clearly have differentiated the DDoS attack traffic from the flash crowd.

COVID-19 and suicidal behavior: A bibliometric assessment.

The paper examines the global research output on suicidal behavior during the COVID-19 pandemic. The Scopus database was used to identify the publications on suicidal behavior during the COVID-19 pandemic from the beginning of the pandemic to up to 17th May 2021. The 686 publications emerging from 78 countries were found on the topic. These publications received 7970 citations, with an average of 11.62 citations per paper. About one-sixth (16.33%) of the total publications were funded, and these publications averaged 17.24 citations per paper. The publications from the top 10 most productive countries accounted for 92.71% of all publications. The highest number of publications emerged from United States, United Kingdom, and India. However, the relative citation index was highest for publications arising from France, Bangladesh, and Germany. The total number of organizations and authors involved in these publications were 286 and 290, respectively. The top 20 most productive organizations and authors contributed to 35.13% and 17.64% of publications and 79.15% and 58.61% global citations share, respectively. The maximum number of papers were published in the Asian Journal of Psychiatry, followed by Psychiatry Research and Lancet Psychiatry. This study suggests that suicidal behavior has received considerable attention during the ongoing COIVD-19 pandemic.

Schizophrenia research in India: A scientometric assessmentof India's publications during 1990-2019.

The present study examined India's publications (2803) on schizophrenia, using various bibliometric indicators during 1990-2019. The study focuses on the number of publications, and citations received by the papers on schizophrenia, published by authors affiliated to Indian institutes by using Scopus data base. Additionally, an attempt was made to evaluate the performance of India's leading organizations and authors, and inter-collaborative linkages between them. Scopus database include publications of Indian Journal of Psychiatry and Indian Journal of Psychological Medicine from 2009 and 2011. Accordingly, the publications in these journals were included after these years. Analysis of the publications showed that India is globally ranked at 13th position in number of publications on schizophrenia with 2.04 % global share, depicting 14.21 % annual growth, with 22.8 % of publications having international collaboration. Publications from India published during the period of 1990-2019, registered a citation impact per paper (CPP) of 13.3. National Institute of Mental Health and Neurosciences, Bangalore (671 papers), Post Graduate Institute of Medical Education and Research, Chandigarh (271 papers) and Central Instittue of Psychiatry, Ranchi (136 papers) were the most productive institutes. However, the most impactful organizations in terms of citation per paper (CPP) and relative citation index (RCI), Indian Institute of Science, Bangalore (77.27 CPP and 5.78 RCI), Schizophrenia Research Foundation, Chennai (31.16 CPP and 2.55 RCI) and Banaras Hindu University, Varanasi (29.21 CPP and 2.18 RCI) were at the top. In terms of Individual authors, G. Venkatasubramanian (180 papers), and B.N. Gangadhar (162 papers) were the most productive authors and R.Thara (31.87 CPP and 2.38 RCI), B.K. Thelma (24.0 CPP and 1.8 RCI), M.S. Keshavan (23.91 CPP and 1.79 RCI) were the most impactful authors, among the top 15 authors. The journals which reported comparatively higher productivity for Indian publications included Indian Journal of Psychiatry (242 papers), followed by Asian Journal of Psychiatry (214 papers) and Indian Journal of Psychological Medicine (103 papers). In terms of most impactful Indian publications, these were published in The Lancet (97.7), Progress in Neuro Psychopharmacology & Biological Psychiatry (50) and Schizophrenia Bulletin (44.67).

A Lightweight and Robust Secure Key Establishment Protocol for Internet of Medical Things in COVID-19 Patients Care.

Due to the outbreak of COVID-19, the Internet of Medical Things (IoMT) has enabled the doctors to remotely diagnose the patients, control the medical equipment, and monitor the quarantined patients through their digital devices. Security is a major concern in IoMT because the Internet of Things (IoT) nodes exchange sensitive information between virtual medical facilities over the vulnerable wireless medium. Hence, the virtual facilities must be protected from adversarial threats through secure sessions. This article proposes a lightweight and physically secure mutual authentication and secret key establishment protocol that uses physical unclonable functions (PUFs) to enable the network devices to verify the doctor's legitimacy (user) and sensor node before establishing a session key. PUF also protects the sensor nodes deployed in an unattended and hostile environment from tampering, cloning, and side-channel attacks. The proposed protocol exhibits all the necessary security properties required to protect the IoMT networks, like authentication, confidentiality, integrity, and anonymity. The formal AVISPA and informal security analysis demonstrate its robustness against attacks like impersonation, replay, a man in the middle, etc. The proposed protocol also consumes fewer resources to operate and is safe from physical attacks, making it more suitable for IoT-enabled medical network applications.

Research on bipolar disorder from India: A bibliometric analysis of papers published during 2000-19.

The paper examines 1037 publications on bipolar disorder (BD) during the years 2000-19 from India, as listed in the Scopus database. India's publications constituted 2.27 % share of global output (45,624 publications) in the study period of 20 years. India does not figure in the top 10 countries in terms of research output on BD. The number of publications on BD from India increased from 13 in 2000 to 107 in 2019, registering 14.44 % annual average growth, higher than world's growth of 6.02 %. India's 10-year cumulative publications increased from 264 during 2000-09 to 773 during 2010-19, registering 192.8 % absolute growth, much higher than world cumulative growth of 63.27 %. India's publications on BD averaged citation impact per paper of 14.24, which decreased from 25.38 to 10.43 from 2000-09 to 2010-19. Maximum numbers of papers from India on BD were published by researchers from National Institute of Mental Health and Neurosciences, Bangalore (222 papers),Post Graduate Institute of Medical Education and Research, Chandigarh(118 papers), and AII India Institute of Medical Sciences, New Delhi (79 papers). Lady Harding Medical College, New Delhi (36.20 and 2.54), Schizophrenia Research Foundation, Chennai (27.45 and 1.93), and King George's Medical University, Lucknow (25.21 and 1.77) were the most significant organizations in terms of citation per paper and relative citation index. Maximum number of papers were published in Indian Journal of Psychiatry (101 papers), followed by Asian Journal of Psychiatry (88 papers) and Indian Journal of Psychology Medicine (34 papers).

Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic.

Surgical practice during the coronavirus disease 2019 (COVID-19) pandemic has changed significantly, without supporting data. With increasing experience, a dichotomy of practice is emerging, challenging existing consensus guidelines. One such practice is elective tracheostomy. Here, we share our initial experience of head and neck cancer surgery in a COVID-19 tertiary care centre, emphasizing the evolved protocol of perioperative care when compared to pre-COVID-19 times. This was a prospective study of 21 patients with head and neck cancers undergoing surgery during the COVID-19 pandemic, compared to 193 historical controls. Changes in anaesthesia, surgery, and operating room practices were evaluated. A strict protocol was followed. One patient tested positive for COVID-19 preoperatively. There was a significant increase in pre-induction tracheostomies (28.6% vs 6.7%, P=0.005), median hospital stay (10 vs 7 days, P=0.001), and postponements of surgery (57.1% vs 27.5%, P=0.01), along with a significant decrease in flap reconstructions (33.3% vs 59.6%, P=0.03). There was no mortality and no difference in postoperative morbidity. No healthcare personnel became symptomatic for COVID-19 during this period. Tracheostomy is safe during the COVID-19 pandemic and rates have increased. Despite increased rescheduling of surgeries and longer hospital stays, definitive cancer care surgery has not been deferred and maximum patient and healthcare worker safety has been ensured.

Rhabdomyosarcoma of the cervix in teenagers - Is fertility preservation a feasible option?

Embryonal rhabdomyosarcoma (RMS) of the cervix is a rare entity, encountered mainly in the first two decades of life. The literature consists mainly of case reports and few small case series, and no standard treatment guidelines are available. As this is a disease of adolescence, fertility preservation in well selected cases is of paramount importance. We report 3 cases of cervical RMS, in adolescents highlighting the clinical presentation, diagnosis and management.

Quality of life outcomes one year after replacement of the temporomandibular joint using a modified SF36 questionnaire.

The aim of this study was to assess the quality of life (QoL) of patients who had total replacement of the temporomandibular joint (TMJ) using a modified short form 36 (SF36) questionnaire, which is validated for use in this context. A total of 36 patients (32 female, 4 male, mean (range) age at the time of operation 44.5 (19-74) years) who had TMJ replacements between 2013 and 2016 were evaluated. Each completed a questionnaire preoperatively and at one year postoperatively. Postoperatively there were significant reductions in scores for pain and anxiety, and improvements in mood, diet, and the ability to chew. There were no significant differences between the preoperative and postoperative scores in terms of speech or recreation, although most reported an overall improvement in general well-being. Our results suggest that TMJ replacement is associated with a better QoL in terms of pain and function, and that the modified questionnaire is suitable for the appraisal of outcomes after this type of operation.

Profound approach to check legitimacy of an old technique used to gauge palatal rugae.

AIMS: The present study aimed at assessing two fixed points of reference from where the mesial and distal point of all rugae can be measured so that the exact movement of particular rugae in any direction can be evaluated and assessing the changes in the palatal rugae after orthodontic treatment. METHODS: A longitudinal study conducted among a sample of 20 (8 male and 12 female) adult patients. Pre- and post-orthodontic treatment casts of patients were obtained from the Department of Orthodontics College of Dentistry Jazan University. Antero-posterior linear distances (Technique I) between medial and lateral points of primary, secondary and tertiary rugae were measured. Also, the transverse linear distance (Technique II) between medial and lateral points of right and left rugae were measured. Technique III involved marking two fixed points and using these two points a third point is located on the medial or lateral end of rugae of right and left side in pre and post-treatment orthodontic casts. The independent sample t-test was employed to compare gender. Difference between the pre- and post-treatment mean values were checked by the paired t-test. RESULTS: Technique III successfully showed the statistically significant difference (P ≤ 0.05, 95% CI) in the overall pre and post-treatment values on the patients' cast (N = 20) which was not observed with a technique I and technique II. CONCLUSION: The triangle created by the three reference points in the technique III was able to identify the changes in the palatine rugae more precisely than the technique I and Technique II.

Analysis of outcomes after revision replacement of failed total temporomandibular joint prostheses.

End-stage disease of the temporomandibular joint (TMJ) can be managed successfully with alloplastic total replacements, but these can fail because of allergy, infection, wear, fracture, and heterotopic development of bone. We prospectively reviewed the outcome data of all patients who required revision of previously placed replacement joints between 2004 and 2016. Data included pain and diet scores using 100mm visual analogue scales (VAS), and interincisal distance recorded before, and at six weeks, six months and 12 months after operation. The reasons for failure and the number of previous procedures were also noted. Twenty patients (26 joints) had revisions. The reasons included infection (n=9), reankylosis (n=5), wear of the existing prosthesis (n=2), fracture of the prosthesis (n=2), foreign body reaction (n=1), and allergy to the prosthesis (n=1). The mean (range) age of the patients was 53.3 (47-68) years, and 15 were female and five male. Preoperatively, the mean (SD) pain score was 73.1 (22.4), mouth opening was 20.9 (10.2) mm, and diet score 41.7 (23.6). At 12-month follow up, all the measurements had improved significantly (p≤0.05), with the pain score improving to a mean (SD) of 18.4 (25.2), mouth opening to 32.2 (9.3) mm, and diet score to 89.4 (18.5). Revision replacements done by an experienced team result in considerably improved outcomes with limited complications, but the improvements in function and pain are not as marked as they are after primary replacement.

Preliminary clinical assessment and non- toxicity evaluation of an ayurvedic formulation BGR-34 in NIDDM.

In view of the overall health impact of NIDDM, inventers understand the necessity of improving glycemic control in adults with type 2 diabetes. BGR-34 provides an effective treatment option for adults with type 2 diabetes who have been inadequately controlled on lifestyle with or without other oral hypoglycemic agents (OHGAs) such as metformin, sulfonylurea, or a glitazones. BGR-34 is an appropriate option to consider for addition to a managed care drug formulary. Treatment with BGR-34 produced clinically relevant and statistically significant reductions in all three key measures of glucose control studied -FPG, PPBG and HbA1c- when compared with placebo. BGR-34, showed the promising result with respect to glycemic parameters in NIDDM patient with a significant reduction in fasting blood sugar by 34.3%, postprandial blood sugar 35.5% & glycosylated haemoglobin by 20.31% as compared to placebo group showing a reduction by 13.2%, 10.9% & 10.87% respectively. The trial has also been registered to CTRI, India. This study has been registered in the clinical trial registry-India.

Hemophagocytic lymphohistiocytosis presenting with acute liver failure and central nervous system involvement in early infancy.

Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal and likely underdiagnosed disease characterized by unregulated histiocyte proliferation, hypercytokinemia and hemophagocytosis, causing life-threatening tissue damage and organ failure. We report a case of a 56-day-old infant presenting with fever, acute liver failure, and neurological manifestations as presenting features that succumbed to rapidly progressive HLH. Our objective is to emphasize the importance of early diagnosis by high suspicion in varied initial presentation of HLH so that life-saving therapy may be instituted in time.

Early Detection of Right Ventricular Dysfunction in Chronic Obstructive Pulmonary Disease by Echocardiography.

OBJECTIVE: This study is designed to investigate the effects of pulmonary arterial hypertension on RV systolic and diastolic functions in cases of COPD and to correlate RV systolic and diastolic functions with pulmonary arterial pressure. MATERIALS AND METHODS: 100 patients admitted in various medical wards of tertiary care Hospital and a primary care hospital with stable chronic obstructive pulmonary disease persons with age and sex-matched. 35 age and sex matched person without any associated and known disease were taken as control subjects. Selection of cases has been made on basis of detailed history, thorough clinical examination, electrocardiography, chest x-ray, pulmonary function tests. OBSERVATION: RV Systolic function (RVEF and RVWT) are significantly abnormal in patients of stable compensated COPD and they are significantly correlated with PAP(p< 0.002). RV diastolic function i.e., E/A ratio and PFR are altered in 60%(n-60) of patients of COPD studied against control subjects and significantly correlated with PAP(p< 0.002). CONCLUSION: Echocardiography is a non invasive method to detect changes of right ventricular dysfunctions in early stages with very good significant sensitivity and specificity.