bluuebunny/crossref_metadata_2025 huggingface dataset:
L’art du récit-cadre chez Dumas
Authors: Callet-Bianco Anne-Marie
Published: July 2024

Cette contribution s’intéresse au traitement du récit-cadre dans les romans et nouvelles de Dumas. Même si ce type de début n’est pas le plus répandu dans son abondante production, sa relative fréquence justifie une analyse. Reprenant un type d’incipit classique, Dumas en fait un usage extrêmement personnel et original. Mélangeant réalité et fiction, il bouscule volontiers le cloisonnement des genres ; il s’en sert aussi pour s’approprier un texte écrit en collaboration ; cette appropriation passe souvent par l’écriture de soi qu’on retrouve dans tous ces débuts, et qui composent un portrait de l’auteur sous forme de puzzle. Avec Dumas, le récit-cadre cesse d’être une simple utilité pour devenir une marque de style.
Ambiguity and confusion around the celebration of the Mawlid.
Authors: Berriah Mehdi
Published: July 2024

As the supposed date of the birth of Prophet Muḥammad approaches, the debate within the Muslim community about the legality or permissibility of celebrating the birth of the Prophet (Mawlid) of Islam opens up each year: condemnable bidʿa (innovation) to some since neither the Prophet nor his Companions celebrated it during their lifetime ; Bidʿa ḥasana (good innovation) for others who see this event as an opportunity to show respect and love for the Prophet by recalling traditions (sunan) and certain episodes of his life. In addition to the Sunna, both sides of this contemporary debate draw on medieval authors who discussed the issue of celebrating al-mawlid al-nabawī in their time. Among these scholars, Ibn Taymiyya (d. 728/1328), one of the most divisive and influential medieval theologians in contemporary Islamic thought, seems to be a particular case. Indeed, his writings are cited by both supporters and opponents of the Mawlid to give more weight to their speeches. The use of the same source to support antagonistic positions ultimately leads to confusion as to the real position of Ibn Taymiyya on the issue, as he is sometimes presented as a supporter of the Mawlid while elsewhere as a fierce opponent. The aim of this article is twofold. The first is to analyse the reception of Ibn Taymiyya’s words on the subject and how they are used and integrated into the discourse of contemporary religious actors involved in the debate on the Mawlid. The second aim is to use the comparison of sources to clarify Ibn Taymiyya’s stance on the Mawlid, a topic that is unquestionably relevant in ongoing debates within the Muslim religious community.
Les chiites et la célébration du gamou au Sénégal
Authors: Diop Macoumba
Published: July 2024

À partir des années 2000, les chiites du Sénégal participent à la célébration de la naissance du Prophète. Bien qu’ils s’inscrivent dans la tradition des confréries soufies pour célébrer le Mawlid, appelé gamou au Sénégal les chiites considèrent que cette fête doit être célébrée sous une autre forme. La première partie de cet article rappelle les éléments qui font du gamou un évènement majeur dans la vie religieuse, sociale et même politique du Sénégal. On montrera ensuite comment la célébration de cette fête par les chiites sénégalais témoigne à la fois d’une volonté de se rapprocher des confréries soufies, notamment dans une opposition commune aux critiques des wahhabites, et d’une volonté de distinction vis-à-vis de l’environnement religieux sunnite.
In-Vitro Proliferation and Enrichment of CD34+ Autologous Haematopoietic Stem Cells, Obtained from Patients with End-Stage Left Ventricular Failure
Authors: Athauda arachchi P. M. , Kuruppu A. I.
Published: July 2024

With a rising global prevalence of end-stage heart failure and a limited availability of cardiac transplantation programmes or left ventricular assist devices in many parts of the world, there is a renewed interest in potential alternative treatment options.Along with other groups, we have previously demonstrated the beneficial effect of intracoronary autologous bone marrow derived peripheral haemopoietic stem cell transplantation, to improve myocardial contractility in end-stage heart failure.We now assess the ability of these cells to expand in numbers in-vitro, to achieve enrichment of stem cell counts, using standard cell culture methods and flow- cytometric analysis.We demonstrate that with in-vitro culturing (within 3 passages post-harvest), the CD34+ stem cell fraction increases in standard culture media, across multiple samples. However, optimal culture conditions to achieve near pure stem cell populations with rapid cell proliferation, still needs to be defined.
Legal Framework of Plastic Packaging and Labelling in Sri Lanka: A Comparative Analysis
Authors: Balachandra B. A. K. S. , Abeysekara T. B.
Published: July 2024

Plastic packaging plays a pivotal role in delivering quality products to consumers but poses significant waste management challenges once discarded. Landfilling, the primary method for solid waste disposal in Sri Lanka, exacerbates plastic pollution due to poor waste separation, leading to environmental contamination and health hazards. Mismanaged plastic packaging waste also threatens key industries like tourism, fisheries, and agriculture, endangering the country's economy and biodiversity. This research utilized secondary data to examine plastic packaging waste regulations, incorporating expert strategies such as the circular economy and extended producer responsibility. An extensive literature review, including German and EU directives, identified effective waste management practices, while primary data on food packaging was collected through observation to propose improved labelling regulations for Sri Lanka. The findings recommend mandatory labelling by manufacturers to inform consumers about the recyclability and quantity of plastic packaging, promoting awareness and sustainable consumption. Additionally, implementing eco-labelling and legislation for plastic packaging in Sri Lanka will enhance waste separation, recycling, and recovery, reducing plastic pollution and mismanaged waste.
The Impact of Digital Financial Inclusion on Banking Sector Stability: Evidence from Developing Countries
Authors: Fernando J. M. R. , Disanayaka K.
Published: July 2024

The research explores the transformative impact of Digital Financial Inclusion on banking sector stability in developing countries, where advanced technologies reshape financial services. With a focus on FinTech, E-wallets, and digital transactions, the study addresses a critical gap in the existing literature by examining the impact of digital Financial Inclusion indicators, such as ATMs and mobile money accounts, on developing countries banking stability. This study contributes valuable knowledge to policymakers and financial professionals in a rapidly evolving digital era. Employing data from 36 developing nations and covering the period of 2011 to 2017, the research establishes a link between digital Financial Inclusion and enhanced banking stability. Z-score is used to measure financial stability, and ATMs and mobile money accounts are used to measure digital financial inclusion, covering the outreach and usage metrics. Macroeconomic variables like gross domestic product and inflation are included to capture broader economic influences on banking stability. A panel regression was used to analyse the data. The study found that digital Financial Inclusion proxies significantly impact the banking sector's stability. The attention for enhancing digital financial services in improving and maintaining the banking sector stability is reconfirmed from this study based on a larger data set of developing countries.
Psychosocial Correlates of Emotional Eating Among Healthcare Professionals in a Tertiary Care Centre in Mysuru
Authors: Basheer Sayana , Kulkarni Praveen , Pragadesh R. , Vanmathi A
Published: July 2024

Introduction:

People’s food preferences and eating habits are heavily influenced by their psychological health. Emotional eating (EE) is not a distinct eating disorder, but rather a subtype within a range of different eating behaviors that are affected by habits, stress, emotions, and personal eating attitudes. Stress and eating are frequently unhealthy companions for those in the medical field. This study proposes to determine the prevalence and psychosocial correlates with EE among health-care professionals.

Materials and Methods:

A cross-sectional study was done among 320 health-care professionals at JSS Hospital, Mysore, over 6 months using a convenient sampling technique. A pretested, semistructured self-administered questionnaire was used to collect information regarding sociodemographic characteristics, perceived stress (Perceived Stress Scale), EE (Emotional Eaters Questionnaire), and eating and lifestyle habits of participants. Statistical tests such as Chi-square tests and Spearman’s correlation test were used.

Results:

Among 320 health-care professionals, 82.8% were emotional eaters. Among emotional eaters, 28.8%, 42.5%, and 11.5% were low, emotional, and very emotional eaters, respectively. Among the study subjects, 77.19% had moderate stress and 13.12% had severe stress. There was a statistically significant association between age, perceived stress, and fried food intake with EE.

Conclusion:

The findings raise concerns over the high prevalence of EE among health-care professionals, calling for close attention from policymakers to address this new health challenge. Enhancing dietary habits, body weight status, exercise, and perceived stress levels could be potential targets for interventions.
Pediatric Leukonychia Totalis: A Case Report and Review of Literature
Authors: Lin Yi Yang , Wee Lynette Wei Yi
Published: July 2024

Leukonychia totalis, a rare condition characterized by complete whitening of the nails, presents an intriguing diagnostic challenge, particularly when it occurs in pediatric patients without an established family history. We discuss a case of an 8-year-old boy with leukonychia totalis, involving all fingernails but sparing his toenails, in the absence of familial predisposition. This report aims to discuss the etiopathogenesis, differential diagnosis, and diagnostic approach in pediatric leukonychia totalis.
Comparative Evaluation of 0.2% Chlorhexidine and Oxygenated Mouthwash as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients - A Clinico-microbiological Study
Authors: Banerjee Aditya , Martande Santosh , Swathi P. V. , Gopalakrishnan Dharmarajan , Mangal Kashish , Kulloli Anita , Shetty Sharath , Thakur Shambhavi , Suryawanshi Krishna
Published: July 2024

ABSTRACT

Background and Objective:

Oxygen therapy has been proven to be beneficial in the treatment and healing of chronic wounds. Oxygenated mouthwash could help in the management of oral infections like periodontal disease by reducing the levels of reactive oxygen species. The current study was designed to evaluate the effectiveness of Blue M, an oxygenated mouthwash as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP).

Materials and Methods:

Forty-two CP patients were randomly divided into 3 groups (Group A – only SRP, Group B – SRP with oxygenated blue®m mouthwash, and Group C-SRP with 0.2% chlorhexidine [CHX] mouthwash). Clinical parameters-plaque index, gingival index, probing pocket depth, and relative attachment level were evaluated at baseline, 1 month, and 3 months while microbial analysis was carried out, using chairside N-benzoyl-DL-arginine-2-naphthylamide Assay for detection of either presence or absence of Treponema denticola, Porphyromonas gingivalis, and/or Tannerella forsythia at baseline and 3 months.

Results:

All groups showed a significant reduction in clinical and microbiologic parameters from baseline to 3 months (P < 0.05). Intergroup analysis showed Group B and Group C to be significantly better than Group A (P < 0.05) while Group B showed similar results when compared to Group C (P > 0.05).

Conclusion:

Blue M mouthwash showed better improvement as compared to SRP alone while it showed similar improvements in clinical as well as microbiologic parameters when compared with CHX. It can be concluded that Blue M mouthwash could well be a futuristic prospect as an alternative to chemical agents like CHX in the treatment of CP.
Drug-induced Pruritus to Escitalopram
Authors: Meenakshi R. , Selvaraj Nitya
Published: July 2024

ABSTRACT

Drug-induced pruritus is a dermatological adverse event that is usually underreported. The negative impacts of the unpleasant itching sensation largely affect the quality of life and adherence to the treatment. Here, we report a case of drug-induced pruritus to escitalopram – the most widely used medication in the treatment of depression and anti-anxiety in India; hence, it is pertinent to be familiar with such rare adverse drug reactions which may assist in early detection and better quality of care to the patient.
A Study Evaluating the Aspects of Stroke-specific Quality of Life and Severity in Hypertensive Stroke Patients
Authors: Sridhar Tejashree , Varghese Leena Elizabeth , Hasharudeen Ayisha , Saxena Anushka , Hiremath Jayasheela S. , Nyamagoud Sanatkumar B. , Swamy Agadi Hiremath Viswanatha , Bhadri Gururaj N.
Published: July 2024

ABSTRACT

Background:

A wide range of cognitive and physical effects occur depending on the location and extent of brain damage caused by the stroke. These effects vary widely in terms of severity. There is a strong correlation between quality of life (QoL) scores and the traditional functional outcome measures. The objective is to evaluate stroke patients’ QoL and severity. A total of 196 hypertensive stroke patients across all age groups are included in this prospective observational study.

Methods:

Stroke-specific QoL Scale (SS-QoL) questionnaires were self-administered, to assess health-related QoL among stroke patients. The severity level was determined using the modified Barthel index (MBI) and Modified Ranking Scales (mRS). Suitable Statistical methods (Pearson Chi-square and Pearson correlation) were applied to analyze the outcomes.

Results:

A total of 156 hypertensive stroke patients were assessed for SS-Qol and MBI. We observed that patients with hemorrhagic stroke (5.8%) showed excellent QoL (200–249 range) in comparison with that of ischemic stroke patients (4.4%) and correlation between the domains was significant at P < 0.05 level. Majority of 61 (39.1%) patients showed severe dependence and 1% of patients were independent. mRS was assessed on 196 hypertensive stroke patients, our results showed that the majority of 51 (27%) had severe disability followed by 49 (25%) patients who were completely bedridden, and about 40 (20.4%) deaths were encountered.

Conclusion:

From our study, we conclude that on using SS-QoL scales assessing SS-QoL the results showed that patients who suffered from a stroke were severely affected physically and mentally decreasing the normal lifespan of a patient and causing death.
Antimicrobial Stewardship Program Implementation among Hospitals in Iloilo Province, Philippines – A Pilot Study
Authors: Dueñas Edric Ancel P. , Islahudin Farida
Published: July 2024

ABSTRACT

Context:

Antimicrobial resistance (AMR) presents a global health crisis, demanding urgent attention. The Philippines has responded with an action plan, including Antimicrobial Stewardship Programs (ASPs), to combat AMR. However, challenges persist in implementing effective ASPs.

Aims:

This study aims to evaluate the implementation of ASP in Iloilo Province, Philippines.

Settings and Designs:

The study was a cross-sectional study performed in hospitals (n = 14) within the Iloilo Province, Philippines. Incomplete questionnaires were excluded.

Subjects and Methods:

The research employed the World Health Organization ASP toolkit to assess ASP implementation levels in these hospitals.

Statistical Analysis Used:

Implementation was measured using an overall score and individual scores for 6 core elements of ASP. Scores were presented as mean and standard deviations.

Results:

A total of 10 hospitals responded. All 10 (100%) hospitals had implemented the ASP, although the overall implementation score was an average of 31.9 (7.9) (total possible score of 45). However, there were still gaps in the implementation of all 6 core elements: Leadership Commitment (8.1 [1.2], total possible score 11), accountability and responsibility (6.3 [0.8], total possible score 8), antimicrobial stewardship action (9.8 [3.3], total possible score 14), training and education (1.2 [0.8], total possible score 2), monitor and surveillance (2.7 [1.2], total possible score 4), and reporting and feedback (3.8 [2.3], total possible score 6).

Conclusions:

There is still a need to improve ASP implementation among hospitals in Iloilo Province and possibly nationally in the Philippines. National strategies to address potential barriers that may aid in improving the use of antimicrobials are urgently required.
The Increasing Demand for Skilled Professionals in the Field of Pharmacovigilance
Authors: Sunil V. , Mohit K. , Akondi Butchi Raju
Published: July 2024

ABSTRACT

The pharmaceutical sector is experiencing rapid advancements in drug discovery, strict regulations, and a commitment to patient safety. This has led to an increased demand for skilled pharmacovigilance experts who can ensure the safety and effectiveness of medicinal products. Several factors contribute to this demand. The expanding pharmaceutical landscape leads to the need for thorough investigation of the safety profile of new medications and treatments. The increasing volume of pharmaceutical products also requires close monitoring for safety and efficacy. Strict regulatory requirements from global agencies further emphasize the need for a robust pharmacovigilance system. The industry’s focus on patient safety drives the demand for professionals who can effectively manage and analyze safety data. The rise of biologics and biosimilars presents additional challenges in monitoring and assessing safety profiles, creating a need for specialized expertise. Furthermore, the globalization of clinical trials and technological advancements, such as artificial intelligence (AI) and machine learning (ML), require experts who can integrate these tools into pharmacovigilance methods. There are certain skill sets that are crucial for pharmacovigilance professionals. These include regulatory knowledge, data analysis and interpretation, case processing, signal detection and risk management, medical and scientific expertise, communication skills, and technological proficiency. There are various career opportunities in pharmacovigilance, including pharmacovigilance officer, pharmacovigilance scientist, medical reviewer, pharmacovigilance team lead/manager, regulatory affairs specialist, and consultant and trainer. Future trends in the field include the convergence of AI and ML, the use of real-world evidence for postmarketing surveillance and drug safety monitoring, collaboration, and outsourcing for PV projects, and the need to tailor pharmacovigilance approaches to personalized medicine. In conclusion, the pharmaceutical industry’s evolution and commitment to patient safety have created a growing need for skilled professionals in pharmacovigilance. Investments in the development and education of these professionals are essential for the advancement of drug safety and public health.
Comparing the Efficacy of Probiotic Nutraceuticals and Probiotic Food (Curd) in Combination with Antidepressants for Depression
Authors: Sanmith T. D. , Chourasiya Jitendra , Patel Nishant
Published: July 2024

Background and Aim:

Depression is a widespread mental health condition with a significant global impact. Recent research has explored the gut–brain axis, emphasizing the role of microbiota in neurotransmitter production. This study aims to explore the effectiveness of two complementary probiotic interventions: probiotic-rich curd and probiotic capsules, used in combination with the antidepressant escitalopram over 4 weeks. The primary objectives include assessing their impact on reducing the severity of depression, comparing their effectiveness, and discussing the clinical implications of findings.

Materials and Methods:

We conducted a 4-week prospective observational study at the Department of Psychiatry, MGM Medical College, and the associated Mental Hospital in Indore. Ninety individuals aged 18–60, diagnosed with depression (International Classification of Diseases-10) and assessed using the Hamilton Depression Rating Scale, participated. Subjects were divided into three groups: escitalopram 10 mg (n = 30), escitalopram 10 mg + 120 mL curd (n = 30), and escitalopram 10 mg + probiotic capsule (n = 30). Assessments were conducted on days 0, 14, and 28 using the Hamilton Depression Rating Scale.

Results:

All treatment groups exhibited a significant reduction in mean Hamilton Depression Rating Scale scores over the study duration (P < 0.001). Notably, the probiotic group showed a slightly greater reduction in scores between day 0 and day 28 compared to the curd and escitalopram-only groups.

Conclusion:

The study demonstrates the potential for slightly better outcomes with probiotic interventions alongside the antidepressant escitalopram over 4 weeks. Beyond symptom relief, this approach may offer lower side effects, potentially enhancing patient adherence. Future research should investigate long-term effects and specific probiotic strains in a larger, diverse population.
Suicide among Indian Medical Students and Professionals: A 3-year Exploratory Study Using Online Google Database (2020–2022)
Authors: Chadha Gunjan , Yadav Jagriti , Khushboo  , Singh Priti , Jangid Purushottam , Gupta Rajiv
Published: July 2024

Background and Aims:

Medical students and professionals are particularly susceptible to psychological distress due to various factors especially after COVID 19 pandemic. However, there is currently no robust reporting system for suicides among medical professionals in India. We aimed to explore the characteristics of suicide deaths among medical students and professionals in India over three years (2020–2022).

Materials and Methods:

We conducted a two-level retrospective analysis of online news report on suicide deaths among medical students and professionals from January 2020 to December 2022.

Results:

A total of 118 fatal suicides among MBBS students, postgraduates and working medical professionals were reported. More than 50 percent of the reported suicides were before the age of 30 years. The most common method used was hanging (49%) and the presence of mental illness (12%) was the commonest predictor of suicide among medical students and professionals.

Conclusion:

There is pressing need for a national suicide reporting system for medical students and professionals to formulate a stringent policy on suicide prevention for medical community.
Vancomycin-resistant Enterococcus faecium: A Sinister Cause of Necrotizing Pneumonia in Post-COVID-19 Patient
Authors: Gupta Chhavi , Sharma Shiwangi , Agarwal Meenakshi
Published: July 2024

Post-COVID-19 necrotizing pneumonia has been rarely reported. We report of case of a 55-year-old male with underlying comorbidities of diabetes and hypertension and a history of severe COVID-19 illness managed with mechanical ventilation. A few days after recovery, he developed bilateral pneumothorax and empyema with lung collapse and multiple patchy air opacities. Pus discharge from both intercostal tubes grewEnterococcus faeciumresistant to vancomycin and sensitive to linezolid. The patient was successfully treated with linezolid and showed complete recovery.
Application of Machine Learning Algorithms for Carpal Tunnel Syndrome
Authors: Yener Yıldız , Darol Elif Sarıca , Uzun Süleyman , Alemdar Murat , Çolak Tuncay
Published: July 2024

Introduction:

Median nerve entrapment is commonly related to alterations in the anatomy of the surrounding tissues in the carpal tunnel. Carpal tunnel syndrome (CTS) is the most prevalent form of peripheral entrapment neuropathy. Machine learning (ML) is utilized in a variety of fields. After conferring with a physician, ML enables doctors to conduct the necessary examinations and make an early diagnosis. Methods based on artificial intelligence have the potential to be utilized in clinical practice as a supplementary instrument for accurate evaluation of median nerve entrapment. Despite the rise in ML-based medical research, median nerve entrapment has received less attention. The purpose of this study was to evaluate the performance of classification approaches with ML algorithms in CTS patients utilizing electromyography test data from patients exhibiting varied CTS symptoms and indications.

Materials and Methods:

Our study includes message and demographic information derived from the electromyography results of 315 individuals. In classification procedures, the logistic regression, support vector machine (SVM), K-nearest neighbor, and naïve Bayes algorithms from ML techniques were utilized.

Results:

As a result of the classification, performance values for accuracy, precision, sensitivity, specificity, and F1-score were obtained. As a result of our research, the SVM algorithm achieved a 96% success rate.

Conclusion:

ML algorithms are an emerging method of analysis. The diagnosis and treatment of diseases are gradually gained by clinicians through observation and experience. Therefore, categorization systems can aid in the accurate and timely diagnosis of median nerve entrapment by clinicians.
A Radioanatomical Evaluation of the Plantaris Tendon with Magnetic Resonance Imaging Method and a Review of the Literature in the Light of Our Findings
Authors: Çankal Fatih , Altıntaş Hilal Melis , Patat Dilara , Kaya Mustafa
Published: July 2024

Introduction:

Variations of the plantaris muscle and tendon are common. Ultrasonography and magnetic resonance imaging (MRI) are radiological methods for evaluating the plantaris tendon. This study aimed to perform a radioanatomical evaluation of the plantar tendon using MRI and to compare our findings with the literature data.

Materials and Methods:

The presence of the plantaris tendon in 155 ankle magnetic resonance studies of 139 patients, its diameter, its course, the localization of the calcaneal attachment of the tendon, and its relationship with the Achilles tendon were evaluated. Student’s t-test was used for those with normal distribution in numerical data, and the Mann–Whitney U test was used for those who did not. Pearson Chi-square test was used in the evaluation of categorical data, depending on the assumptions. P <0.05 was considered statistically significant.

Results:

A total of 139 patients, 89 (67.74%) females, and 50 (32.26%) males were included in the study. In 115 (74.2%) of 142 cases in which the plantaris tendon was imaged, the plantaris tendon was inserted into the calcaneus separately from the Achilles tendon and was joining the Achilles tendon at various levels in 27 cases (17.41%). In 27 cases where the plantaris tendon joined with the Achilles tendon, the distance from the junction point to the calcaneal insertion was 15 ± 9.90 cm.

Conclusion:

Our study is one of the limited number of studies in the literature to examine the thickness and termination levels of the plantaris tendon. We believe that our measurements will contribute to future radioanatomical meta-analyses.
Morphology and Morphometry of the Anterior Clinoid Process in a Select South African Population
Authors: Magcaba Nomthandazo , Olojede Samuel Oluwaseun , Lawal Sodiq Kolawole , Rennie Carmen , Azu Onyemaechi Okpara , Naidu Edwin Coleridge
Published: July 2024

Background:

Clinoid space is revealed when the anterior clinoid process (ACP) is removed, and it makes anterior vertical segment of the internal carotid artery (ICA) visible. Also, the presence of Carotico-clinoid foramen (CCF) makes the ICA from the cavernous sinus emerges through it and endangers the artery during anterior clinoidectomy which necessitates understanding the variable dimensions of ACP.

Aim and Objectives:

This study intended to investigate the morphology and morphometry of the ACP and to document the prevalence of the CCF in a select group of the South African population.

Materials and Methods:

The study was carried out on a total of 32 open crania (n=64 ACP) obtained from the University of KwaZulu-Natal, Nelson Mandela School of Medicine, Discipline of Clinical Anatomy using digital vernier caliper to measure the dimensions of the ACP.

Results:

The mean length, basal width, and thickness of the ACP on the right were10.18±1.34mm, 10.27±0.73mm, and 5.81±0.80mm and the left side was 10.89±0.94mm, 11.63±0.90mm, and 4.78±0.64mm respectively. The left ACP was significantly longer, wider, and thinner than the right ACP. Type I (short and broad) ACP was the most prevalent type, occurring in 53.13% of the studied population. Out of the 32 skulls studied, the CCF was observed in 6 (18.75%) cases. Five out of the six skulls (83.33%) had a bilateral complete CCF, and 1 (16.67%) had a unilaterally incomplete CCF.

Conclusion:

The ACP in our setting differs from other populations in terms of type, dimensions, and prevalence of the CCF and these should be considered when interpreting skull base radiographs and planning anterior clinoidectomy.
Topographic Radioanatomical Analysis of the Singular Canal: Computed Tomography Study
Authors: Demir Berin Tuğtağ , Köksal Ali , Çankal Fatih
Published: July 2024

Purpose:

The singular canal (SC) is where the singular nerve, a branch of the inferior vestibular nerve, which carries afferent information from the posterior semicircular canal (PSCC), passes and is important in the surgical approach of the presigmoid retrolabyrinthine. This study was carried out to evaluate the visibility of the SC on standard computed tomography (CT) images, its distance to the surrounding structures, and to investigate the variations of its anatomy and its relationship with the meatus acusticus internus.

Materials and Methods:

The study was carried out retrospectively using images of 194 temporal bones on temporal bone CT scans of 44 men and 53 women aged 18–65. In the study, various measurements were made, especially the presence of the SC, its length, its angle with the internal acoustic canal (IAC), and the distance between the internal acoustic pore (IAP) and the singular foramen. In addition, the presence of the high jugular bulb and PSCC dehiscence images were investigated.

Results:

The SC was detected in 85.1% of the analyzed images. The mean canal length was 3.93 ± 1.22 mm, the angle between the SC and the IAC was 22.68° ±3.60°, and the distance between the SC and the IAP was 7.70 ± 0.83 mm. While no difference was found between the sides, it was determined that the length and diameter of the SC did not differ according to gender.

Conclusion:

Detailed morphometric analysis of the SC and a thorough understanding of its relationship with the IAC, vestibulum, and PSCC will help to accurately define the posterior and lateral borders of the dissection for this region.
Important Morphometric Values and Anatomical Ratios Obtained from Cervical Magnetic Resonance Imaging Images and their Differences from the Literature in Terms of Evaluation of Myelopathy
Authors: Bakirci Sinan , Senturk Senem
Published: July 2024

Objective:

A Torg ratio of 0.80 or less is considered positive support for the diagnosis of cervical spinal canal stenosis. In our study, it was aimed to determine the morphometric values of the spinal cord, spinal canal, and vertebral body, to calculate the subarachnoid distance, and to examine the differences in Torg ratio according to cervical vertebra levels and between genders in young adult individuals belonging to our community.

Materials and Methods:

The study was performed on magnetic resonance imaging (MRI) images (28–35 years, 50 men and 50 women, retrospectively).

Results:

The Torg ratio was found to be <0.80 in 194 of 350 measurements made at 7 levels (55.4%) in men and in 83 of 350 measurements in women (23.7%). The Torg ratio value was found to be higher in women than men at C3–T1 levels (P < 0.01). There is a positive and highly significant relationship between the Torg ratio and “canal-cord distance” (P < 0.01). Spinal canal diameter was found to be <14 mm in 235 vertebrae (67.1%) in men and 282 vertebrae (80.6%) in women. In addition, it was found below 12 mm in 12.6% of men and 16% of women.

Conclusion:

In our study, the Torg ratio was found below 0.80 in a significant part of our cases. Therefore, it would be appropriate to revise the Torg ratio separately for different populations in MRI measurements. It is clear that there is a need for planning epidemiological studies consisting of control–patient groups in the future, especially for many societies.
Comparative evaluation of the accuracy of six different apex locators in working length determination of molars using intraoral periapical radiographs: An in vivo study
Authors: Sayed Abrar , Dighole Santoshi , Lobo Wendy Maria Vianney , Sapkale Kishor , Ramugade Manoj M , Baker David C.
Published: July 2024

Context:

One of the crucial steps in endodontic treatment is determining the working length (WL). There are various methods for performing this procedure, one of which is an electronic apex locator (EAL) measurement.

Aims:

The aim of this study was to determine the accuracy of six EALs, i.e.. Root ZX, Root ZX Mini, Propex PiXi, Innvopex-1, Woodpex III, and Raypex 6 for WL estimation in the mandibular first molars.

Material and Method:

The study included 180 root canals with symptomatic irreversible pulpitis, divided into six groups using different apex locators. WL determination was compared with intraoral periapical radiographs. Results were categorized as accurate, short, or long. The data were statistically analyzed.

Results:

ROOT ZX had an accuracy of 96.7%, Root ZX Mini had an accuracy of 93.3%, PiXi had an accuracy of 90.0%, Innvopex-1 had an accuracy of 90.0%, Woodpex III had an accuracy of 86.7%, and Raypex 6 had an accuracy of 83.4%, respectively. There was a statistically nonsignificant difference between groups (P < 0.05).

Conclusion:

Newly developed apex locators, such as the Innvopex-1, have shown accuracy comparable to well-established EALs like the Root ZX. This highlights the importance of conducting more extensive, large-scale research to confirm and validate their effectiveness.
Comparative evaluations of shear bond strength of mineral trioxide aggregate, Biodentine, and calcium-enriched mixture to bulk-fill flowable composite using three different adhesive systems: An in vitro study
Authors: Fatima Asmat , İftekhar Huma , Alam Sharique , Tewari Rajendra Kumar , Andrabi Mukhtar Un Nisar
Published: July 2024

Objective:

The objective of the study was to assess the shear bond strength of bulk-fill flowable composite resin smart dentin replacement plus when bonded to mineral trioxide aggregate (MTA)-angelus, biodentine, and calcium-enriched mixture (CEM) at two different aging periods (15 min and 72 h) using three distinct adhesive systems. In addition, the study identified the specific modes of failure (adhesive, cohesive, or mixed) using a stereomicroscope and scanning electron microscope.

Materials and Methods:

One hundred and twenty-six cylindrical acrylic blocks used in the study were sorted into three groups based on the bioactive substance used to fill the 3-mm diameter and 3-mm high hole in the center of each block. The groups were MTA, Biodentine, and CEM. The specimens were then divided into subgroups based on the aging interval (15 min and 72 h) of the bioactive material and the adhesive system used (two-step total-etch, two-step self-etch [SE], and one-step SE) while bonding to the restorative bulk-fill flowable composite. The shear bond strength values were measured with a universal testing machine, and the data were analyzed using two-way and one-way analysis of variance, followed by a post hoc test. The specimens were assessed under stereomicroscope and scanning electron microscope to characterize the mode of bond failure (cohesive, adhesive, or mixed).

Results:

The study showed that the type of adhesive system and the time of bonding affected the shear bond strength of bulk-fill composite to the pulp capping agents (P < 0.05). For MTA, the highest bond strength was observed with two-step SE group at 15 min (18.16 ± 2.97 MPa) (P < 0.05). CEM exhibited the highest bond strength with two-step SE group at 72 h intervals (8.77 ± 1.76) (P < 0.05). The highest bond strength for biodentine group was observed with total-etch group (8.54 ± 1.35 Mpa) and two-step SE (8.19 ± 1.94 Mpa) bonded at 72 h interval (P < 0.05). The majority of the samples in the MTA group (29/42) and CEM group (20/42) showed a cohesive fracture, whereas Biodentine group (22/42) had an adhesive fracture in most of its samples.

Conclusion:

MTA demonstrated the highest bond strength with two-step SE group at 15 min, and CEM exhibited the highest bond strength with two-step SE groups at 72 h interval. For biodentine group, the type of adhesive used did not impact the bond strength values.
Cone-beam computed tomographic analysis of canal convolution in mesial root of mandibular second molars and a proposed new classification
Authors: Desai Kavina S. , Arora Ankit V. , Kapoor Sonali V. , Shah Purnil B. , Rathore Yashrajsingh R.
Published: July 2024

Aim:

The aim is to evaluate the anatomical characteristics of mesiolingual and mesiobuccal canals in mandibular second molars particularly in terms of its exit direction, distance of confluence from the minor constriction, and the angle of confluence.

Materials and Methods:

The cone-beam computed tomography images of hundred mandibular second molars were analyzed. Endodontically treated teeth and those with anatomical variations such as C-shaped canal configuration were excluded from this study. The distance of the confluence from the minor constriction, angle of confluence, and the exit direction of the mesiobuccal and the mesiolingual canals were assessed. Data were analyzed using an independent t-test.

Results:

The course of the mesiobuccal and mesiolingual canals beyond the confluence was towards the center of the root. The average angle of confluence was 32.75°–35.28°. The average distance of confluence from the minor constriction was 2.19 to 2.68 mm. The mesiolingual canal was straighter whereas the mesiobuccal canal had a tortuous course. Considering the results of the present study, a new classification has been proposed for the root canal morphology of the mesial root of mandibular second molars.

Conclusion:

The variation in the morphology of mandibular second molars highlights that the mesiolingual canal presented a mild curvature through and beyond the confluence when compared to the mesiobuccal canal which exhibited a tortuous course through the confluence.
Enriched advanced platelet-rich fibrin plus gold nanoparticles against Enterococcus faecalis for its potential use in revascularization for necrotic immature permanent teeth
Authors: Saud Sophia , Narayana Indiresha H.
Published: July 2024

Background:

Regenerative endodontic procedures allow reinforcement of root canal wall and continuation of root development, opening new therapeutic possibilities. The root canal system of infected teeth is colonized by a variety of microorganisms, which hinder the regenerative process, leading to treatment failure if not adequately addressed, thereby requiring careful attention to microbial control.

Aim and Objective:

The aim of the study was to assess the antimicrobial activity of advanced platelet-rich fibrin (A-PRF) and gold nanoparticles (AuNps) against Enterococcus faecalis.

Materials and Methods:

Intravenous blood (5–6 ml) was drawn from four healthy individuals, and A-PRF was prepared through centrifugation at 1500 revolutions per minute (rpm) for 14 min. A-PRF was doped with 3 µl of AuNps and centrifuged at 1000 rpm for 1 min. Antimicrobial activity was assessed using disk diffusion; inhibition zones were measured. For minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), A-PRF + AuNps were added to the microbial broth at varying concentrations to determine growth inhibition and microbial death.

Results:

Disk diffusion assays revealed significant antibacterial effects against E. faecalis. Norfloxacin displayed the highest mean zone of inhibition (20.33 ± 1.53 mm), followed by the Test group (A-PRF + AuNPs) (19.33 ± 0.58 mm). Multiple comparisons indicated significant differences (P < 0.001). MIC of A-PRF + AuNPs against E. faecalis was 0.031 mg/ml, with MBC at 0.015 mg/ml.

Conclusion:

The addition of AuNPs to A-PRF offers the potential for sustained growth factor release while maintaining the sterility of the canal, leading to successful revitalization and regeneration. The combined use of A-PRF + AuNps shows promise for enhancing revascularization in necrotic immature permanent teeth.
Comparative evaluation of antimicrobial efficacy of chitosan nanoparticles and calcium hydroxide against endodontic biofilm of Enterococcus faecalis: An in vitro study
Authors: Pandey Aparna , Bhushan Jagat , Joshi Rajesh Kumar , Uppal Amandeep Singh , Angrup Archana , Kansal Shubhangi
Published: July 2024

Aim:

The aim of the study was to assess and evaluate the antimicrobial effectiveness of chitosan nanoparticles (CSNPs) with calcium hydroxide in the elimination of Enterococcus faecalis.

Materials and Methods:

Using the broth microdilution method, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of calcium hydroxide and CSNPs were measured. The antibiofilm effect of calcium hydroxide and CSNPs against E. faecalis biofilm was qualitatively analyzed using a crystal violet assay. A 7-day-old biofilms of E. faecalis grown on dentine discs were assigned to the following three groups (n = 11 dentine discs), normal saline (group I), calcium hydroxide (group II), and CSNPs (group III). Quantification of live and dead cells using confocal microscopy was done to evaluate the antibiofilm efficacy of the medicaments included in the study.

Results:

MIC of calcium hydroxide and CSNPs against E. faecalis was observed at 2.5 mg/mL and 0.31 mg/mL, respectively. MBC of calcium hydroxide and CSNPs was observed at 2.5 mg/mL and 0.31 mg/mL, respectively. Using Crystal Violet (CV) assay, calcium hydroxide and CSNPs showed biofilm inhibition at concentrations of 2.5 mg/mL and 0.625 mg/mL, respectively. Confocal laser scanning microscopy analysis found that both calcium hydroxide and CSNPs showed a significant decrease in viable cells at their MBC values compared to the control group’s normal saline. CSNPs showed a significantly lower percentage of live cells than calcium hydroxide (P < 0.05).

Conclusion:

The study results reveal that the antimicrobial efficacy of CSNPs is better than calcium hydroxide and normal saline against E. faecalis biofilm.
Comparative evaluation of remaining dentin thickness using single file, two file, and multiple rotary file system – An in vitro CBCT study
Authors: Chandar Chikine Yashas , Veeraiyan Mounika , Kumar Yata Prashanth , Reddy Nithesh Kumar , Thomas Delphia , Sreeja Dundigalla
Published: July 2024

Context:

Endodontic success hinges on a multifactorial interplay, with meticulous canal shaping, proper disinfection, and three-dimensional obturation being paramount. Among these factors, the amount of dentin remaining after instrumentation directly influences the biomechanical resilience and longevity of the tooth.

Aims:

This study aims to evaluate the impact of various rotary instrumentation systems, including single-file, two-file, and multiple-file configurations, on the remaining dentin thickness (RDT) following canal preparation.

Settings and Design:

This was an in vitro study, original research article.

Materials and Methods:

Sixty mandibular premolar human extracted teeth were decoronated at the cementoenamel junction with a diamond disc. Samples were randomly assigned to three groups using a simple random sampling technique (n = 60). Group I – Single-file system (One Curve, MicroMega) (n = 20), Group II – Two-file systems (2Shape, MicroMega) (n = 20), and Group III – Multiple-file system (Hero Gold, MicroMega) (n = 20). Preoperative cone-beam computed tomography (CBCT) scans were obtained after the sample was mounted on a modeling wax sheet. The biomechanical preparation of canals followed the manufacturer’s protocols for every system. Postoperative CBCT scans were obtained. Pre- and postoperative scans were compared at standardized depths (4 mm, 7 mm, and 11 mm) within the canals (coronal, middle, and apical thirds), allowing for a comprehensive assessment of RDT throughout the canal.

Statistical Analysis and Results:

According to one-way ANOVA, the highest mean was seen in Group I, followed by Group II and Group III. Hence, a statistically significant difference was found between all the groups. Post hoc Tukey’s test was done for intergroup comparison.

Conclusions:

A single-file system preserved more dentin with less aggressive cutting compared to two-file and multiple-file systems.
Comparative evaluation of incorporation of ferrule in premolars endocrown designs to check any alterations in their fracture resistance: A pilot study
Authors: Pal Progyna Paramita , Mazumdar Dibyendu , Bera Swarupananda , Kar Suman , Sahay Dristi , Chowdhuri Kuntal
Published: July 2024

Introduction:

Endocrown preparation of endodontically treated teeth as final restoration has been extensively studied for different teeth. Bindl et al. questioned the application of endocrowns for premolars due to the pulp chamber space’s smaller dimensions, which diminish bonding surface area. The addition of ferrule into the endocrown preparations of premolars has not been extensively studied.

Aims and Study Design:

Comparative evaluation of incorporation of the ferrule in premolars endocrown designs to check any alterations in their fracture resistance.

Materials and Methods:

The sample consisted of 40 maxillary first premolars without cracks or caries, extracted for orthodontic or periodontal purposes. The teeth were individually mounted with cold-cure acrylic resin. Group A: Composite endocrown without ferrule and Group B: Composite endocrown with ferrule. An endocrown former was prepared with elastomeric polyvinyl siloxane material (GC Exaclear). Endocrowns were then prepared with dual-cure core build-up composite-Core-x flow (Dentsply Maillefer, Switzerland) using the endocrown former so that morphologically, they all were almost identical. Endocrowns are cemented by dual-cure resin cement following manufacturer instructions. The fracture resistance of endocrowns with and without ferrule was evaluated and compared.

Results and Observations:

The data were tabulated in Microsoft Excel and analyzed with SPSS version 24 software. The variables were presented with mean, standard deviation, and independent t-test. The P ≤ 0.05 is considered statistically significant. Group B (with ferrule) showed higher fracture resistance (622.06 N) than Group A (537.59 N) (without ferrule). Independent t-test showed that the difference was statistically significant (P = 0.008).

Conclusion:

Comparing the failure load findings, it could be concluded that ferrule-containing endocrown needed greater loads than ordinary endocrown restorations for failure.
Ischaemia with no obstructive coronary arteries: a review with focus on the Asian population
Authors: Soh Rodney Yu-Hang , Low Ting-Ting , Sia Ching-Hui , Kong William Kok-Fai , Yeo Tiong-Cheng , Loh Poay-Huan , Poh Kian-Keong
Published: July 2024

Ischaemia with no obstructive coronary arteries (INOCA) has been a diagnostic and therapeutic challenge for decades. Several studies have demonstrated that INOCA is associated with an increased risk of death, adverse cardiovascular events, poor quality of life and high healthcare cost. Although there is increasing recognition of this entity in the Western population, in the Asian population, INOCA remains elusive and its prevalence uncertain. Despite its prognostic significance, diagnosis of INOCA is often delayed. In this review, we identified the multiple barriers to its diagnosis and management, and proposed strategies to overcome them.