Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence and determinants of Alcohol use in a remote rural area in South India: A community-based cross-sectional study

Introduction: Alcohol use is a major public health problem in India. We sought to study the use of alcohol and its risk factors in a rural area in South India. Methods: This study was conducted in 20 villages surrounding a Rural Health Training Centre, located in South India. The study was done from March 2018 to October 2018 with the help of Medical Interns and Medical Social Workers using a pretested questionnaire. Results: In a total population of 14,925, 11,995 individuals are in the age group of 15 years and above, among whom 1,005 were reported to be using alcohol. The prevalence of alcohol among 15 years and above is 8.4% (7.9–8.9) and the overall prevalence in the total population is 7% (6.3–7.1). Prevalence of alcohol use among males and females are 16% and 1%, respectively. The alcohol use is higher among those who prefer open defecation (adjusted Odds Ratio (aOR) 1.2 (1.0–1.4)), Kutcha house (aOR 1.7 (1.4–2.2)) or semi-pucca house (aOR 1.3 (1.121.6)), lower caste (Most Backward Castes (MBC) aOR 1.7 (1.2–2.2), Scheduled Castes (SC) aOR 2.1 (1.6–2.9)), male gender (aOR 41 (29–59)), Married 5.0 (3.7–6.8), or Separated 2.6 (1.5–4.4) and Diabetes 1.6 (1.1–2.3). Conclusion: Alcohol use in a remote rural area is high among socially deprived communities who live in kutcha and semi-pucca houses and belong to a lower caste. This needs serious public health interventions to improve their socioeconomic status.
Outcome of care in an apex tertiary care referral institute of North India – A study of 90,000 patients

Introduction: Outcome of care is an important measure of quality in health care and also provides input for healthcare planning. It is an indicator which can be used for comparing performance of various hospital/Institute. Aims: Study intended to analyze the morbidity and mortality pattern among admitted patients with respect to selected hospital indices. Study Settings: All India Institute of Medical Sciences (AIIMS), New Delhi. Subjects and Methods: A cross-sectional retrospective study was conducted in 93,223 patients admitted at AIIMS, New Delhi. Information provided in Management Information System (MIS) was used for analysing morbidity as per International Statistical Classification of Diseases (ICD)-10. Results: Diseases related to the genitourinary system (14.25%) and neoplasms (14.18%) were the most common cause of admissions. Overall, predominance of adult age group (61.6%) followed by geriatric age group (20.5%) was observed. Male predominance was observed in diseases related to mental, behavioural, and neurodevelopmental disorders (89.2%). Overall, median length of stay was calculated to be 4 days (mean LOS-7 days), maximum for diseases related to mental, behavioural, and neurodevelopmental disorders (median 13 days). Gross and net death rate for admitted patients was calculated to be 4.3% and 3%, respectively, with maximum rate for diseases related to respiratory system (22.7% and 17%). Conclusions: Analysis of morbidity and mortality in high volume tertiary care centers and segregation of the patients according to their ailment and disease behaviour helps in establishing priorities in healthcare delivery system and thus allocating limited resources accordingly.
Retrospective Analysis of Oral and Maxillofacial Biopsies: An Institutional Study

Aim: To determine the preponderance and the distribution of pathological lesions in oral and maxillofacial region reported in and around the Madurai city. Study Design: Retrospective study on the oral and maxillofacial biopsies taken during 11 years period from 2007 to 2018 in a CSI Dental College, Madurai, Tamilnadu. A total of 1000 cases were analyzed and 904 were selected. The parameters recorded were age, sex, area, and the histopathological report obtained. Descriptive statistics was used for analysis. Result: The most common soft tissue lesion was traumatic fibroma (16.1%) and the prevalent hard tissue lesion was periapical cyst (12.7%). The more common oral malignant tumour observed was squamous cell carcinoma (7.3%) and benign tumor was ameloblastoma (5.3%). The frequently affected sites were mandible (36.1%) and buccal mucosa (19.8%). There was more predilection among male than females. The frequency of lesion is common in age group of 31-60 years. A considerable similarity was observed between age, type of lesion and its location. Conclusions: This study evaluated chronic periapical lesions were the most common hard tissue lesions and fibromas in soft tissue category. The idea of this histopathological study concludes on the requirement for biopsy to rule out type of the lesion and its severity to start up the earlier management.
Clinical and laboratory findings of COVID-19

The pandemic of coronavirus disease-19 started in Wuhan City of China in December 2019 and quickly spread all over the world, infecting almost two million people. The clinical presentation of the disease is mild/moderate in 80% of cases; however, it leads to a critical clinical presentation by 20%, which is severe or very severe disease requires intensive care. The mortality is high, especially in cases with advanced age, comorbidities, and pneumonia-related acute respiratory distress syndrome and respiratory failure, while children are often with subclinical manifestations. The most common clinical findings are fever, cough, fatigue, and shortness of breath. The incubation period ranges from 2 to 14 days. The most common laboratory findings are lymphocytopenia and thrombocytopenia. Elevated D-dimer, ferritin, troponin I, lactate dehydrogenase and interleukin-6, and hypoxia (O2 saturation ≤90%) were identified as “poor prognostic factors” associated with severe disease and mortality. The monitoring of such parameters was reported to be beneficial for determining patients with risk and potentially high mortality.
Health-related quality of life of chronic obstructive pulmonary disease patients: A hospital-based study

Background: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by the presence of persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities owing to significant exposure to noxious particles or gases. Restricted activities of daily living as a result of reduced pulmonary function or dyspnea, impair quality of life in such patients. Methods: A cross-sectional study was conducted in a tertiary care hospital of Lucknow with 250 COPD patients to assess their health-related quality of life (HRQOL) using the St. Georges Respiratory Questionnaire (SGRQ). Study participants were selected using a systematic random sampling method. Results: HRQOL of participants was significantly impaired. Employment status and airflow limitation severity of study participants had a statistically significant negative correlation whereas, duration since diagnosis of disease was seen to have a statistically significant positive correlation with SGRQ scores. Conclusion: COPD deteriorated the quality of life of patients. The activity score was the most affected. Urban residents had a comparatively poor HRQOL.
Surgical coverage of cataract in a rural area of north India: A cross-sectional study

Background: India has the highest number of blind people globally, unoperated cataract being the most common cause of blindness and low vision. Although safe and effective cataract surgical techniques are available, the cataract burden continues to increase annually, due to the backlog of patients to be operated upon, and a growing number of cataract cases due to increased life expectancy. Aim: To assess cataract surgical coverage (CSC) in a rural area of north India. Methods: A population-based cross-sectional study of CSC among adults (40 years and above) was carried out in two villages of a block in north India using a predesigned questionnaire, visual acuity assessment, and distant direct ophthalmoscopy. Based on the data obtained, CSC (VA <6/60) for both “persons” as well as “eyes” was calculated. Results: Overall, CSC (persons) of 43.20% was observed, 29.31% coverage among persons with unilateral cataract and 50.45% among persons with bilateral cataract while CSC (eyes) was found to be 37.14%, being significantly higher (43.56%) among females compared to males (28.21%) (P = 0.012). Around 50% of cataract surgeries were performed in private facilities, 41.35% in government facilities, and rest 8.65% in eye camps. Nearly 90.38% were implanted intraocular lens and 9.62% were non-intraocular lens surgeries. Conclusions: Surgical needs for cataract are currently not being met effectively. Reasons for inadequate cataract surgical services need to be sought and addressed to improve the uptake of existing services. Further, reasons for underutilization of government hospitals for cataract surgeries need to be examined.
Effectiveness of mouth self-examination for screening of oral premalignant/malignant diseases in tribal population of Dehradun district

Background: Mouth self-examination (MSE) is shown as a speedy, economical, and effortless method of oral cancer detection. As previous studies were conducted in population with high literacy, the current survey was performed to explore the usefulness of MSE for finding the oral cancerous precancerous lesions in indigenous low literate population of Dehradun district. Materials and Methods: It is a cross-sectional survey which was done on the Buksa tribal communities in Dehradun district, India. Out of seven tehsils in the district, two were randomly selected, from which two villages were selected. Individuals belonging to Buksa tribe above the age of 18 years were gathered in commonplace. A total of 539 people who gave their consent were enrolled for study. Using a questionnaire, information regarding sociodemographic details, history of risk factors, and practice of MSE was obtained by interview method, followed by recording oral findings by a single expert. Later, performance of MSE was taught to the participants and they were asked to record the same. Descriptive analysis and Chi-square test were applied wherever applicable and significance level was kept at below 0.05. Results: It was observed that out of 539 participants, 220 (40.8%) practiced MSE and 319 (59.2%) have never practiced MSE. Further analysis showed that a total of 39% males and 42.7% females had MSE habits and this difference was not statistically significant (P > 0.05). In totality, the prevalence of oral lesions identified by health worker was 213 (39.5%), whereas MSE showed only prevalence rate of 69 (12.8%). MSE had low sensitivity (24.6%), whereas high specificity (87.4%) for all the lesions and most sensitive in detecting ulcers (72.7%), and highest specificity in identifying red lesions (99.2%). Conclusion: Even though the sensitivity of MSE for detecting oral premalignant/malignant lesions was low, specificity was very high. Frequent efforts to educate and encourage public on MSE may enhance efficacy and compliance.
Molecular Insight into Odontogenesis in Hyperglycemic Environment: A Systematic Review

Diabetes mellitus is an endocrinal disorder affecting worldwide and the disease incidence is rising alarmingly high. The effects of diabetes on tooth development are explored by limited studies and their molecular insights are very rarely studied. This systematic review is aimed to provide the best scientific literature source on the molecular insights into odontogenesis in hyperglycemic environment caused by diabetes mellitus or by maternal diabetes on the offspring. The literature search was conducted on the databases, namely PubMed, PubMed Central, Cochrane, and Scopus. The original studies exploring the alterations in the molecular pathways of odontogenesis in diabetes mellitus were selected. Data were extracted, chosen, and evaluated by two independent researchers. At the end of thorough data search, four articles were eligible for the review. Three articles brought out the molecular pathways involved in the offspring of gestational diabetes through animal models. Fourth article was an in vitro study, which treated the stem cells in hyperglycemic environment and drafted the molecular pathway. The altered molecular pathways in dental epithelial stem cells (DESCs), dental papilla cells (DPCs), and stem cells from apical papilla were studied and empowered with statistical analysis. Thus with this systematic review, we conclude that apurinic/apyrimidinic endonuclease1 downregulation causing deoxyribonucleic acid hypermethylation and Oct4, Nanog gene silencing, activation of toll-like receptor-4/nuclear factor kappa B (TLR4/NF-κB) pathway are involved in suppressing cell proliferation and accelerated apoptosis in DESCs in high glucose environment. DPCs are suppressed from odonto differentiation by activation of TLR4 signaling and resulting inhibition of SMAD1/5/9 phosphorylation in diabetic condition. NF-κB pathway activation causes decreased cell proliferation and enhanced differentiation in apical papilla stem cells in hyperglycemia. Further studies targeting various stages of odontogenesis can reveal more molecular insight.
Solvent denaturation

Solvent denaturation is developed along thermodynamic lines rather than from multiple‐binding theory. Almost all the relations derivable from site‐binding theory have their counterparts in the thermodynamic formulation showing that the details of binding models may be sufficient but are not necessary for the general description of solvent denaturation. Equations are derived for the effect of denaturant concentration on stability at constant temperature and on tm. It is recommended that the thermodynamic treatment be used instead of binding models unless stoichiometric interactions are demonstrable experimentally.
Análisis de crecimiento, área foliar especí­fica y concentración de nitrógeno en hojas de pasto "mulato" (Brachiaria hí­brido, cv.)

A study was done of the morphological behavior, specific leaf area (SLA) and leaf nitrogen concentration (LNC) of "mulato" grass (Brachiaria ruziziensis x B. brizantha) at different phenological stages (PS). Plant morphology (PM), growth rate (GR), height (H), SLA, and LNC were measured at seven-day intervals during a 21-week experimental period. Data were analyzed using the SAS GLM procedure in a completely randomized experimental design, with four replications and a regression analysis for each variable. PM varied significantly (P<0.05) in the different PS's. The highest leaf biomass was reached on d 102 after germination (5.7 +- 1.059 g DM plant-1). The highest GR was recorded at about wk 16 (2.44 +- 0.474 g DM plant-1 day-1). LNC attained the highest level at wk 4 (6.98%) and then declined until wk 21 (0.683%). LNC was positively correlated to SLA (R2=0.86971, P<0.001), and negatively correlated to plant height (R2=0.90231, P<0.001). Results suggest that as SLA increases, so does LNC, though it decreases as the plant matures. Plant height is negatively correlated to LNC.
Knowledge, attitude, and perception of Indian population toward coronavirus disease (COVID-19)

Background: Coronavirus disease (COVID-19) has spread very fast worldwide as a pandemic causing unprecedented morbidity and mortality. Most countries in the world have undergone emergency lockdown in an attempt to flatten the curve and reduce the load on healthcare systems. Objective: This study was done to assess the knowledge, attitude, and perception toward the disease among the home-bound Indian population during the lockdown. Methodology: This was a questionnaire-based descriptive cross-sectional study conducted online. Compilation and assessment of the online data in the form of responses were done as for descriptive studies. Results: Among the 320 participants of the study, the awareness about the epidemiological features, including the signs and symptoms of the disease, was very good (more than 99% in some aspects). The attitude toward the measures for prevention of disease at home and outside was also very good (more than 97%) in some aspects, with a scope of improvement in a few others. Only one-third had the knowledge of online (e-consultation) services floated by governments and hospitals for medical advice. Ten percent had the potential to misuse drugs as prophylaxis. Most of the participants perceived that they had no predictable idea about the shape of disease epidemiology in the near future and only hoped for things to get better. Conclusion: This study reflects that aggressive awareness drives have played an important role in the dissemination of knowledge and the development of informed positive attitude toward COVID-19. Few gaps in knowledge and practices related to disease epidemiology, safe practices, mobile app for tracking and the availability of e-resources for medical advice, still remain. These should be addressed more aggressively, to strengthen the efforts to overcome this unprecedented crisis.
Comparative Evaluation of Antimicrobial Efficacy of Toothpastes Containing Probiotic and Neem as Primary Ingredient on Salivary Streptococcus mutans in Melmaruvathur Population: An In Vivo Study

Aim: This in vivo study was designed to compare the antimicrobial effect of toothpastes containing probiotics and neem on Streptococcus mutans in 18–30-year-old patients in Melmaruvathur population. Materials and Methods: The study consisted of 60 patients who were randomly divided into two groups of 30 each. Group I received probiotic-based toothpaste (PerioBiotic), whereas Group II received neem-based toothpaste (Babool) as a preventive measure protocols to control the incidence and prevalence of dental caries. Study Design Protocols: Participants were instructed to use the dentifrice selected for the study, two times a day for 60 days. Tests were performed on the saliva samples at the beginning of the study, 0 day, 15th day, 30th day, and 60th day following the use of toothpaste. The Statistical Package for the Social Sciences (SPSS-25) software, version, and Chi-square and one-way analysis of variance were used for data analysis. Results: The toothpastes containing neem and probiotics as primary ingredients were efficient in reducing the number of bacterial count when comparing the baseline data with the 60 days data in both the groups as a therapeutic regimen. Intragroup values showed reduction in the number of bacterial count in both the groups in a gradual manner, whereas the intergroup values between the toothpaste showed no statistically significant difference in the bacterial count, and both toothpastes were efficient in reducing the bacterial count. Conclusion: This study reveals the influence of probiotics and neem on salivary S. mutans levels. The results revealed that neem-based and probiotic-based toothpaste, which were tested in this study, showed comparable antibacterial activity against the S. mutans. The neem-based toothpaste showed promising and good antimicrobial activity and reduced the level of bacterial count, which can be attributed to the presence of secondary metabolites, such as flavonoids, alkaloids, lectins, and polyphenols, as its active components. The effect of each component against the S. mutans needs to be quantified in further studies, and within the limitation of this short study, it can be considered as a better choice than commercially available toothpaste, which predominantly has chemicals as active ingredients, which in turn can compromise the safety aspects in the patients when used for controlling the dental caries for a longer duration.
High-resolution computed tomography (HRCT) in pediatric and adult patients with unsafe chronic suppurative otitis media (CSOM) and its surgical correlation

Background and Aim: Atticoantral, alias unsafe type of CSOM affects the posterosuperior part of the middle ear cleft and is frequently coupled with complications and bony erosions. This study aimed to correlate the high-resolution computed tomography (HRCT) temporal bone and intraoperative findings in the patients with the unsafe type of CSOM. Methods: This prospective study included 50 patients (28 males: 22 females; mean age 24 ± 14 years) who presented with clinically suspected unsafe CSOM. All patients underwent HRCT of the temporal bone and subsequent surgical procedure. The intraoperative and histopathological findings were compared with HRCT findings. Descriptive statistics, sensitivity, specificity, and positive and negative predictive value for HRCT were calculated. Student's t-test and Chi-square test were performed. Results: Out of 50 patients, left, right, and bilateral ear involvement were seen in 42% (21/50), 38% (19/50), and 20% (10/50) patients, respectively. Ear discharge was the most common symptom (100%) followed by earache (66%), vertigo (16%), and tinnitus (14%), respectively. Cholesteatoma was reported in 82% (49/60) of ears on HRCT while histopathological and intraoperative evaluation confirmed the diagnosis in 40 out of 49 ears. In 18% (11/60) ears, the cholesteatoma was not diagnosed on HRCT evaluation; however, the intraoperative and histopathological assessment revealed cholesteatoma in six patients while the rest had granulation tissue. For detection of ossicular erosions, tegmen erosions, erosions of facial nerve canal, erosions of sigmoid sinus plate, and erosions of lateral/posterior semicircular canals; HRCT had high sensitivity (86.44%–100%) and specificity (93.33%–100%). Conclusion: HRCT has a superb correlation with intraoperative findings and is a valuable tool for preoperative assessment of temporal bone pathologies.
Outcome of Endovascular-Treated Subarachnoid Bleeding Triggering Pulmonary and Cardiac Takotsubo

With interest we read the article by Nonaka et al. about 10 female patients undergoing endovascular treatment for aneurysmal subarachnoid bleeding being complicated by neurogenic pulmonary edema (NPE) and simultaneously Takotsubo syndrome (TTS). [1] In six patients, the Hunt‐Hess classification (HHC) was IV‐V and in the remaining patients II‐III. [1] In all patients, embolization was successful without procedure‐associated complications. [1] The outcome on the modified Rankin scale was 0 (n = 4), 1 (n = 2), 3 (n = 1), and 5 (n = 3). [1] We have the following comments and concerns.
Identification of Prognostic Factors in Surgically Treated Patients with Acute Epidural Hematoma

Context: Only few comprehensive studies have investigated acute epidural hematoma (AEDH), and a low incidence of the lesion has been observed in comparison with other types of traumatic brain injuries such as subdural hematoma, traumatic subarachnoid hemorrhage, and contusion. Aim: This study aims to identify the prognostic factors of surgically treated AEDH. Settings and Design: The medical records of 58 consecutive patients with surgically treated AEDH between September 2011 and 2018 were retrospectively reviewed. Subjects and Methods: All patients were diagnosed with AEDHs using 5-mm-slice computed tomography (CT). Information regarding the following demographic and clinical characteristics was collected: age, sex, antithrombotic drug use, mechanisms of injury, time from onset to operation, neurological examination, vital signs, blood examination, and CT findings. Statistical Analysis Used: We analyzed prognostic factors in patients with AEDH using univariate and multivariate regression analyses. Results: Univariate and multivariate regression analyses revealed that age (P < 0.01) and the Glasgow Coma Scale (GCS; P < 0.01) were independent predictive factors for good prognosis. In addition, receiver operating characteristics (ROC) analysis showed that an age of <55 years and a GCS score of >12 were optimal cutoff values for predicting good prognoses, with the areas under the ROC curve of 0.827 and 0.810, respectively. Conclusions: Age and GCS are useful predictors of prognosis in patients with surgically treated AEDH. These findings are appropriate prognostic indicators for urgent surgery performed to treat AEDH and intended to help clinicians make a prompt diagnosis.