bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral administration of baicalein-enriched fraction during pre- and post-ischemic stroke alleviated cognitive impairments in rat models
Authors: Othman Farah Amna , Nik Salleh Nik Nur Hakimah , Tan Suat Cheng
Published: January 2024

In recent years, numerous studies have discovered the potential of natural compounds extracted from medicinal plants as a promising alternative treatment for ischemic stroke (IS). Oroxylum indicum is among the plants that has been widely proven to contain a beneficial flavonoid compound known as baicalein. However, the therapeutic potential of this compound for IS disease has yet to be demonstrated. In this study, a baicalein-enriched fraction (BEF) was harvested from the leaves of O. indicum and tested on neural stem cells (NSCs) to determine its effects on the cell viability and gene expression prior to an in vivo animal study. NSCs were chosen because they are the primitive brain cells that play important roles in neurogenesis after IS injury. It was found that NSCs treated with BEF at concentration of 3.125 µg/mL for 48 hours showed a significant higher cell proliferation rate. Moreover, these cells expressed high NSC markers (Nestin and SOX2) and genes responsible for antioxidant (SOD2) and angiogenesis (ANGPT1) mechanisms, indicating that the BEF treatment could enhance the progenitor brain cells viability and the expression of cytokines that are beneficial to reduce oxidative stress and reinstate blood flow in an ischemic brain. Subsequently, the in vivo therapeutic effects of BEF for IS disease was tested by administering 50 mg/kg b.wt of BEF to male Sprague Dawley (SD) rats via oral gavage before and after induction of IS. Assessments of neurological impairments were performed using a modified neurological severity score (mNSS) and the quantification of the total infarct volume was evaluated as the endpoint of this study. Results showed that an oral administration of BEF improved the behavioral scoring for motor functions (forelimb flexion and forelimb twisting), contralateral sensory functions (paw-whiskers test), motor coordination, balance functions (beam balance test) and reflex functions (pinna, corneal, startle and tail reflex) within 24–72 h; alternatively, the non-treated rats showed continuously lower scores for all the tests throughout the study, indicating that the BEF-treated rats exhibited a faster recovery rate as compared to the non-treated rats. Such improvements were observed up to two weeks. In addition, histological assessment also revealed a reduction of infarct volume in the BEF-treated rats as compared to the control rats. In summary, the present study demonstrated the potential of BEF extracted from the O. indicum as a supplement to improve preclinical IS models.
Exploring  the Awareness of Mammographic Screening for Breast Cancer and Identifying Barriers to Refrain from Screening:  Mini Review of the Literature
Authors: Walpola Thishuli , Weerakoon Bimali
Published: January 2024

One of the most important factors to be addressed regarding breast cancer (BC) mortality and morbidity is the identification of BC at a late stage due to a lack of awareness of early detection methods of BC. Mammography can be emphasized as a foremost vital facet in the early detection of breast cancer as a screening tool. A mini review of the literature was performed to explore the concepts of awareness of screening mammography for breast cancer under three main aspects. There, the knowledge, attitude, and practice of women in mammographic screening were focused meanwhile identifying the common barriers for women to refrain from undergoing mammographic screening for breast cancer. The studies included various categories of participants especially subcategorized under their personal history or demographic characteristics. Therefore, the correlation of these factors with their awareness level has also been focused. Further, the barriers to screening mammography encountered by women were included. Therefore, this mini-review highlights the different levels of awareness of mammographic screening among females and the common reasons for avoiding screening. It concludes the benefit of bringing the knowledge of females to a considerably positive juncture by utilizing escalating awareness programs, hence minimizing the common causes of refraining from screening mammography.
Stability of Aspartate Transaminase in Blood Specimens Subjected to Various Storage Temperatures and Times Prior to Centrifugation
Authors: Abewickrama Dishani , Amali Madhu , Wijesekara Udaya , Bandara Samantha , Samaranayake Shyamalee
Published: January 2024

Aspartate Transaminase (AST) is an enzyme used to diagnose medical problems and found in erythrocytes other than in the heart, liver, skeletal muscles, kidney, and brain. Prolonged serum-clot contact time and the fluctuation in storage temperature are possible reasons for the changes in chemical constituents in serum. The objective of this experimental study was to determine the effect of the storage time (three and six hours) before centrifugation and the storage temperature (4℃ and 28℃) on the stability of AST in blood. Methods: The study sample consisted of fifty-three healthy adult volunteers. Five milliliters of blood samples were collected from each subject and then aliquoted into five Eppendorf tubes. One of the aliquots was centrifuged within 30 minutes of collection, and the AST assay was done to obtain the control (baseline) value. Two of the remaining aliquots were stored at 4℃ while the other two aliquots were stored at room temperature for three hours and six hours, respectively prior to centrifugation. The difference between the baseline AST values and paired values of samples at different times of storage and temperatures was analyzed using the non-parametric Wilcoxon signed-rank test. Results: Significant differences were found in AST level compared to the baseline value when samples were stored at room temperature for three hours (p=0.027) and six hours at room temperature (p=0.011). Conclusions: AST in blood was unstable for at least three hours at room temperature (28℃). At 4℃, AST was stable for up to six hours, and blood samples can be stored at 4℃ for up to six hours for analysis of AST.
Comparative Analysis of Green and Brown Morphotypes of Kappaphycus alvarezii Doty (Doty): Morphology, Total Phenol Content, Antioxidant Activity and Antimicrobial Activity
Authors: Rajapaksha G. D. S. P. , Gunathilake P. M. P. C. , Nirooparaj B. , Vidanarachchi J. K. , Jayawardana B. C. , De Croose M. D. S. T. , Wijesekara I. , Bandaranayake P. C. G.
Published: January 2024

Kappaphycus alvarezii Doty (Doty), commonly known as elkhorn sea moss, is a popular seaweed cultivated globally. It is a well-known source of carrageenan, which is a thickening agent used in food and other industries. Even though different morphotypes of K. alvarezii are reported globally, it has been cultivated and marketed as a single genotype. However, such information is important, especially to produce high-value products such as nutraceuticals. Therefore, this study aimed to evaluate differences in microscopic structure, antimicrobial and antioxidant properties, and total phenolic contents of green and brown morphotypes of K. alvarezii cultivated in Jaffna, Sri Lanka. Except for the colour, there was no significant difference in macroscopic parameters. There was no significant difference observed in cross-sections under the light microscope. Antimicrobial properties of ethanol, methanol and water extracts were evaluated by disc diffusion assay against, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Antioxidant properties and total phenolic contents were determined using 1, 1- diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assay and Folin–Ciocalteau method, respectively. Interestingly, the antibacterial activity, antioxidant properties and total phenolic content of K. alvarezii depend on the morphotype. The green morphotype was rich in total phenolic compounds along with high antibacterial and antioxidant properties. Staphylococcus aureus was the most susceptible bacteria to antimicrobial agents of K. alvarezii and both ethanol and methanol extractions were efficient without significant differences between them in all the assays. The current data suggests better performance of the green morphotype of K. alvarezii as a natural source of antibacterial and antioxidant compounds.
Engineering Strategies to Modulate the Gut Microbiome and Immune System
Authors: Han Kai , Xu Jin , Xie Fang , Crowther Julia , Moon James J
Published: January 2024

The gut microbiota, predominantly residing in the colon, is a complex ecosystem with a pivotal role in the host immune system. Dysbiosis of the gut microbiota has been associated with various diseases, and there is an urgent need to develop new therapeutics that target the microbiome and restore immune functions. This Brief Review discusses emerging therapeutic strategies that focus on oral delivery systems for modulating the gut microbiome. These strategies include genetic engineering of probiotics, probiotic-biomaterial hybrids, dietary fibers, and oral delivery systems for microbial metabolites, antimicrobial peptides, RNA, and antibiotics. Engineered oral formulations have demonstrated promising outcomes in reshaping the gut microbiome and influencing immune responses in preclinical studies. By leveraging these approaches, the interplay between the gut microbiota and the immune system can be harnessed for the development of novel therapeutics against cancer, autoimmune disorders, and allergies.
Microengineered In Vitro Assays for Screening and Sorting Manufactured Therapeutic T Cells
Authors: Muhuri Abir K , Alapan Yunus , Camargo Camila P , Thomas Susan N
Published: January 2024

Adoptively transferred T cells constitute a major class of current and emergent cellular immunotherapies for the treatment of disease, including but not limited to cancer. Although key advancements in molecular recognition, genetic engineering, and manufacturing have dramatically enhanced their translational potential, therapeutic potency remains limited by poor homing and infiltration of transferred cells within target host tissues. In vitro microengineered homing assays with precise control over micromechanical and biological cues can address these shortcomings by enabling interrogation, screening, sorting, and optimization of therapeutic T cells based on their homing capacity. In this article, the working principles, application, and integration of microengineered homing assays for the mechanistic study of biophysical and biomolecular cues relevant to homing of therapeutic T cells are reviewed. The potential for these platforms to enable scalable enrichment and screening of next-generation manufactured T cell therapies for cancer is also discussed.
The role of clinical and laboratory finding in the differential diagnosis of hantavirus and leptospirosis infections
Authors: Şahin Ahmet Melih , Çetin Sinan , Şenel İlknur , Erdem-Çakır Tuğçegül , Aydın Emsal , Yetkin Meltem Arzu
Published: January 2024

Background & objectives:

Hantavirus and leptospirosis infections are zoonotic diseases with similar clinical and laboratory findings. The aim of this study is to identify the distinguishing features of these two diseases, for which a definitive diagnosis can take a long time.

Methods:

Between September 2021 and June 2023, a total of 45 patients who were admitted to our hospital and were diagnosed with hemorrhagic fever with renal syndrome (HFRS) or leptospirosis were retrospectively evaluated. Patients were compared in terms of demographic data, clinical, and laboratory parameters. The role of these variables in predicting HFRS or leptospirosis was investigated. The two diseases were compared with regard to outcomes. Receiver operating characteristics were employed for the calculation of cut-off values, sensitivity, specificity, and positive and negative predictive values for parameters showing significant differences. A statistical significance level of p<0.05 was considered.

Results:

Fifteen patients diagnosed with HFRS and thirty patients diagnosed with leptospirosis were included in the study. In both groups, hospital admissions were observed with non-specific and similar symptoms. There was no statistically significant difference observed between the two groups in terms of length of hospital stay, blood product transfusion, requirement for hemodialysis, intensive care unit admission, the rate of return to normal renal function and mortality. Elevated ferritin levels were statistically significant in favor of HFRS, while lymphopenia, elevated bilirubin, CRP, and ESR were statistically significant in favor of leptospirosis.

Interpretation & conclusion:

The use of laboratory findings and clinical symptoms can aid in the challenging task of accurately diagnosing and using appropriate treatment for these two diseases.
Single jar for collecting and rearing mosquito life stages: An innovative prototype
Authors: Kachhwaha Neetu
Published: January 2024

Background & objectives:

Mosquitoes vectors are the key threat that spread viruses, bacteria, nematodes, protozoans, and other infections responsible for the transmission of serious public health ailments including dengue, yellow fever, malaria, and chikungunya.

Methods:

To rear and cultivate mosquitoes at multiple stages of development (egg, larva, pupa, and adult) to be employed in various biomedical research, an innovative tool mosquito larva adult 2-in-1 rearing jar was designed and developed. The eggs/larvae or adults collected from the field or laboratory cultures can be released into the lower larvae or upper adult-rearing chamber so that they can find a suitable breeding place to oviposit or metamorphose into wrigglers and tumblers attaining the adult stage. Aedes, Anopheles, and Culex are three significant genera (Diptera: Culicidae) that were reared in experiments using this jar (Method I) in contrast to other conventional instruments available (Method II).

Results:

Results of one-way ANOVA showed that the prototype was compatible and competitive for rearing, as the data was non-significant when compared in both groups. However, throughout the trials, it was discovered that the prototype had a greater record of mean percentage of adult emergence (98.33), which supports the novelty of the instrument.

Interpretation & conclusion:

This unique device eliminates the need for multiple tools, causes minimum bodily damage to stages during handling, can be used in both the lab and the field, is inexpensive, lightweight, portable, and requires single manpower to operate.
Investigation of in vitro and in vivo therapeutic activity of Tarantula cubensis extract (Theranekron®) on Leishmania major
Authors: Akyol Elif , Polat Zübeyda Akın
Published: January 2024

Background & objectives:

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by several species of the protozoan parasite Leishmania. The need for new anti-leishmanial drugs for the treatment of CL is complicated by factors such as high cost, toxicity, potential for resistance and limited long-term use of existing anti-leishmanial drugs. The aim of this study was to investigate the therapeutic effect of Tarantula cubensis alcoholic extract (TCE), which has been shown to have wound-healing, anti-inflammatory, regenerative, resolving and epithelialising effects, on Leishmania major promastigotes in vitro and in vivo in an experimental mouse model of CL.

Methods:

The effect of TCE on L. major promastigotes in vitro was investigated after determining non-cytotoxic concentrations of TCE using the XTT method. To establish a CL model, L. major amastigotes were injected into the paws of BALB/c mice. Lesion size and histopathological evaluation were used to assess the effect of treatment.

Results:

TCE was found to be effective against L. major promastigotes at 24 h and 48 h at concentrations 250 μg/ mL, 125 μg/mL and 62.5 μg/mL (P<0.05). TCE was found to be more effective than meglumine antimonate in treating CL in the experimentally induced CL model in BALB/c mice.

Interpretation & conclusion:

The results suggest that TCE holds promising potential as a therapeutic agent for the treatment of CL. However, further extensive investigations are required to substantiate and expand our understanding in this area.
Design and Manufacture of Computer-controlled Wear Device for Biomedical Material: A Different Ambient pH Experimental Application
Authors: Yilmaz Efe Cetin , Polat Murat
Published: January 2024

Background:

The wear resistance of biomaterials determined in experimental studies will have a major impact on material selection in clinical applications. Because the experimental determination of optimum material behavior will provide a more comfortable treatment process in clinical terms.

Methods:

In this study, a computer-controlled device with rotating parts that can determine the abrasion resistance of biomaterials placed in the human mouth has been design and manufacture in the experimental study. The periodic wear behavior of biomaterials placed in the human mouth was determined by the experiments carried out on this device. Test specimen was stored in the distill water for 7 days before the wear test procedures. Then, the composite test specimen was subjected to 15N wear force, 10.000 rotating wear cycle, 37°C ambient temperature, 2 Hz wear frequency immersed drinking water (about pH = 7.7), and citric acid solution (about pH = 3.2). Al2O3 balls were used as antagonist materials in every wear test procedure (d = 6 mm). Composite test specimen’s microhardness values were determined with Vickers hardness method before wear test procedures.

Results:

With the data obtained in this study, it was observed that the composite biomaterial had more wear volume scar loss in the acidic environment.

Conclusion:

In addition, it was observed in the microstructure analyses that the designed device affected the wear area, thus it was proved that the device remained in the optimum region throughout the wear test procedures.
A Case Report of Co-occurrence of Hemoglobinopathy EE and Glucose-6-phosphate Dehydrogenase A+ Variant
Authors: Basumatary Noymi , Baruah Dipankar , Sarma Paresh Kumar , Sarmah Jatin
Published: January 2024

Hemoglobinopathies and glucose-6-phosphate dehydrogenase (G6PD) deficiency are two genetic disorders prevalent in malaria-endemic regions. There are conflicting reports on the co-occurrence of G6PD deficiency and hemoglobinopathies. The present study was conducted to explore the co-occurrence (if any) of the two disorders among ethnic populations of Proto-Australoid and Mongoloid origin races. Out of 2310 subjects screened, only one case was detected with both disorders. The case described here is an asymptomatic female of 52 years detected with both hemoglobinopathy EE (HbEE) and G6PD A+ variant. Lower levels of hemoglobin (Hb) %, mean corpuscular hemoglobin (MCH), MCH concentration, platelets, and white blood cell count, and high red cell distribution width and fetal Hb% were recorded. Family screening revealed both daughters as HbAE and normal G6PD. The husband had HbAA and normal G6PD. Out of six siblings of the case subject, two were detected as HbEE and four as HbAE; G6PD was normal.
Antioxidant Phenolics of Justicia adhatoda L. and Cordia dichotoma Frost. Promote Thrombolytic Activity through Binding to a Serine Protease, Tissue Plasminogen Activator Protein
Authors: Paul Annika Maria , Nag Anish
Published: January 2024

Background:

The tissue plasminogen activator (tPA) protein dissolutes fibrin clots and prevents the disease like thrombosis. The current study aimed to study the tPA-promoting activity of bioactive molecules of Justicia adhatoda L (JA) and Cordia dichotoma Frost (CD).

Methods:

The phytochemical characterization of methanolic and aqueous extracts of JA and CD stems was performed through qualitative analysis, Fourier-transform infrared spectroscopy (FTIR), and biochemical tests (total phenolic and total flavonoid content [TPC and TFC]). The bioactivity of the extracts was studied through total antioxidant capacity (TAC) and ferric-reducing antioxidant potential (FRAP) assays. Finally, forty phytocompounds from JA and CD were identified from the literature, and in silico molecular docking study was performed to target tPA protein (PDB id 1A5H, Chain A, X-ray diffraction, resolution 2.90 Å).

Results:

Various phytochemical classes were identified from extracts, through qualitative and FTIR analysis. TPC and TFC were estimated from the JA and CD extracts within the range of 9.34–28.67 mg gallic acid equivalent/100 g of extract weight (EW) and 2.48–16.17 mg quercetin equivalent/100 g of EW, respectively. The aqueous extract of CD showed the highest TAC of 14.90 ascorbic acid equivalent (AAE)/100 g of EW, and the methanolic extract of JA had the highest FRAP activity of 27.77 mg AAE/100 g EW. The molecular docking study showed that apigenin 6,8-di-glucopyranoside had the highest binding potential toward the tPA (−9.380 kcal/mol).

Conclusion:

It can be concluded that antioxidant phytochemicals of JA and CD could promote the tPA activity, thereby promoting thrombolytic activity.
Calcium Sulfate Alone or Associated with Chorion Membrane in Deep Narrow Periodontal Defect? A Clinical and Radiographic Study
Authors: Sharda Anjusha , Ikbal SK Aziz , Verma Neelu , Gupta Sanjay , Siddiqui Zeba Rahman
Published: January 2024

Background:

Soft-tissue intervention over bony defects may impede periodontal regeneration, the sole purpose of periodontal therapy. Human chorion membrane (CM) enhances guided tissue regeneration (GTR) and restores lost tissue. Consequently, calcium sulfate may represent a promising class of bone graft substitutes that helps in significant attachment gain without GTR membrane in deep narrow defects. Hence, this study was conducted to evaluate the efficacy of calcium sulfate graft in periodontal regeneration and to weigh the rationale of using CM for GTR in deep narrow defects.

Methods:

Thirteen patients with bilateral deep narrow defects clinically and radiographically (26 sites, ≥7 mm pocket depth [PD]) were selected and randomly allocated to Group I (open flap debridement and calcium sulfate placement) and Group II (open flap debridement and calcium sulfate with CM placement). Clinical parameters such as PD, clinical attachment level, and radiographical intrabony defect were recorded at baseline and 6 months postsurgery.

Results:

Significant attachment gain was found in both groups with nonsignificant intergroup differences.

Conclusion:

Calcium sulfate with or without CM is able to restore deep narrow bony defects efficiently. Deep narrow defects itself able to prevent soft-tissue collapse and ascertain excellent periodontal regeneration.
Toxoplasmosis as an Uncommon Finding in Biliary Brush Cytology: Case Series Exploration
Authors: Sheereen Shazima , Manva Mohnish Zulfikar , Attar Abdul Hakeem , Sheereen Shamama , Patil Namrata N. , Khan Sabiha Mokashi
Published: January 2024

Background:

The protozoan Toxoplasma gondii is the parasite that causes toxoplasmosis. In immunocompetent hosts, it typically has no symptoms. A common source of the infection is undercooked meat. It can also be transmitted through contact with cat excrement. The parasite can be transmitted to the fetus during pregnancy. Immunocompromised patients may experience symptoms in the brain, lymph nodes, heart, liver, eye, and inner ear. Molecular methods, histology, or serology are typically used to diagnose toxoplasma. These were the few instances of toxoplasmosis identified in biliary brush smears that we know of as per research literature.

Methods:

A 4-year study was carried out by the Saraswati Dhanwantari Dental College and Hospital, Post Graduate Research Institute, Parbhani, India, between March 1, 2019, and March 1, 2023. A study has located five cases of cytological slides related to toxoplasmosis in the biliary brush over time.

Results:

The study looked at five cases, all of which experienced fatigue or weakness as their most common symptom. Abdominal pain was present in three of the cases. All five cases showed an enlarged common bile duct (CBD) and intrahepatic bile radicles on the ultrasound abdomen. Contrast-enhanced computed tomography shows dilated CBD and common hepatic duct. The endoscopic retrograde cholangiopancreatography-guided biliary brushing Papanicolaou (PAP) smear cytology showed the presence of numerous tachyzoite forms of toxoplasma in an inflammatory background, and the biliary brush cytology diagnosis was confirmed to be toxoplasmosis in all five cases.

Conclusion:

One of the main causes of biliary strictures is parasites. In all biliary cytology samples that tested negative for malignant cells, other potential diseases or infestations must be checked out.
Transcription Factor 7-like 2 Gene Polymorphism and Type 2 Diabetes Mellitus: A Meta-analysis
Authors: Stephen Sharon Benita , Devaraj Danis Vijay , Sivasubramanian Jayanthi , Antony Bibin Savio , Subbaraj Gowtham Kumar
Published: January 2024

The meta-analysis aimed to investigate transcription factor 7-like 2 (TCF7 L2) (rs12255372 and rs7903146) gene polymorphisms and its association with type 2 diabetes mellitus (T2DM) in a Caucasian and Asian population. The studies included in this article were obtained using online databases. We searched databases such as Scopus, Web of Science, Embase, and PubMed for case–control articles related to TCF7 L2 polymorphisms and T2DM. To determine TCF7 L2 polymorphisms are significantly associated with T2DM, Metagenyo was used to calculate the odds ratio and 95% confidence interval. A total of 15 articles were included in this meta-analysis. TCF7 L2 rs12255372 and rs7903146 gene polymorphisms were strongly related to susceptibility to T2DM in the general population, as shown by the results of a meta-analysis. Subgroup analysis showed that both Asians and Caucasians showed a statistically significant result. This meta-analysis findings supported that TCF7 L2 rs12255372 and rs7903146 gene polymorphisms to determine susceptibility with type 2 diabetes. According to the findings of this study, people with TCF7 L2 gene polymorphisms rs12255372 for allelic, recessive, dominant, and over-dominant models have been connected to T2DM; however, rs7903146 for allelic, recessive, dominant, and over-dominant models have not been associated to the disease.
Study on association of nuclear factor kappa B gene polymorphism with bacterial load in pulmonary tuberculosis
Authors: Baliarsingh Pallavi , Sahu Pratima Kumari , Mohanty Paresh Nath , Rattan Roma , Mohapatro Monalisa
Published: January 2024

Objectives: Pulmonary tuberculosis (PTB) is a leading infectious disease and a major public health concern. Out of susceptible genes, nuclear factor kappa B (NF-κB) gene influences inflammation and hence the progression of the disease. A single nucleotide polymorphism of functional NF-κB1 promoter −94 ins/del ATTG (rs28362491) has a regulatory effect on the NF-κB1 gene. The aim of our study was to ascertain the bacterial load and to find the association with NF-κB gene polymorphism. Methodology: One hundred two diagnosed and microbiologically confirmed cases of PTB patients between 18 and 69 years of age and 102 healthy age, sex, and socioeconomic status–matched volunteers were taken as controls. Sputum from cases and blood samples from cases and controls were collected. Bacterial load estimation was done from the sputum sample. Genomic deoxyribonucleic acid (DNA) was extracted for NF-κB gene. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) were performed. Results: The genotypic frequency of ins/del was found to be 54.9% in PTB patients which was more than that of the other genotype frequencies in the case group and also from the control genotype frequencies, although it was found to be insignificant (P value = 0.098). On analysis of bacterial load with NF-κB gene polymorphism, a significant association was found more particularly for ins/del versus del/del. Conclusion: The bacterial load showed significant variation among the del/del genotype, ins/del genotype, and ins/ins genotype which was statistically significant. The del/del genotype exhibited the highest bacterial load in and greater statistical significance was found between ins/del and del/del genotypes. This implies the association between NF-κB gene polymorphism and bacterial load.
Assessment of patient satisfaction level with orthodontic treatment in private orthodontic practice: A questionnaire survey
Authors: Chaudhary Nabin Kumar , Chaulagain Tekendra , Thakur Bishow Prakash , Chaudhary Suvin
Published: January 2024

Context:

Patient satisfaction gives important insight into the patient's expectations and perceptions of the quality of service. There have not been many studies done in Nepal on the evaluation of orthodontic treatment satisfaction after it has been completed.

Aims:

The goal of this study was to analyze patient satisfaction after orthodontic treatment was completed.

Settings and Design:

In Private Dental Clinics in Kathmandu, Nepal, 115 patients who had finished their orthodontic treatment within a year of the research's inception were the subjects of this descriptive cross-sectional study.

Materials and Methods:

The patient was called over the phone for a follow-up examination. At the time of follow-up, the data was collected from them by a self-administered questionnaire.

Statistical Analysis Used:

The degree of satisfaction was measured using descriptive statistics, such as frequencies, percentages, and the Likert 5-point scale. The Mann–Whitney U-test was used to compare the levels of satisfaction between males and females, as well as across age groups (15–25 years) and those beyond 25 years after orthodontic treatment had finished.

Results:

The degree of satisfaction of patients was excellent regarding the behavior of the orthodontist. In terms of patient satisfaction, there was no discernible difference between patients of either gender. The degree of satisfaction with the orthodontist's behavior varied significantly across patients in the age groups of 15–25 years and those above 25 years.

Conclusion:

The level of patient satisfaction following the completion of orthodontic treatment will aid in service improvement, planning, and organization, leading to high-quality care.
Periodontal ligament stem cell colony-forming units of fluorosed and nonfluorosed teeth: An in vitro study
Authors: Aditya Vangara , Vandana Kharidhi Laxman
Published: January 2024

Introduction:

The continued quest for extracting possible differences in the colony forming units (CFUs) of periodontal ligament stem cells (PDLSCs) between fluorosed and nonfluorosed, led to the current original project to evaluate if any such difference exists.

Materials and Methods:

For this study, the soft tissues adhering to eight healthy fluorosed and seven nonfluorosed extracted teeth were scraped using a curette.

Results:

The results of this study demonstrate similar CFUs by both fluorosed and nonfluorosed PDLSCs (P = 0.97), but nonfluorosed PDLSCs showed higher CFUs. Moreover, this is the first study where CFUs on PDSLCs were compared between fluorosed and nonfluorosed groups.

Conclusion:

This would influence the regeneration or renewal capacity of PDLSCs following treatment or on the physiologic basis, respectively. This is the first study of its kind; therefore, further studies are in progress on age-related changes in PDLSCs to evaluate the potential markers and various tissue-forming abilities.
Retention systems in extraoral prosthesis
Authors: Pai Anjali Gopinath
Published: January 2024

Prosthodontist plays a very important part in the reconstruction of extraoral defects. Prosthetic rehabilitation of huge maxillofacial defects will be a crucial process for a prosthodontist. The rehabilitation depends on multiple factors such as size, site, etiology, extension of the defect, age of the patient, patient's comfort, patient's satisfaction, and treatment cost. The experience, skill, and knowledge of both a surgeon and a prosthodontist help to decide the foremost mode of retention possible for the rehabilitation of maxillofacial prosthesis. Achieving adequate retention for maxillofacial prosthesis is a great challenge. Various conventional methods are there for retention of maxillofacial prosthesis but treatment modalities became advanced with the rise of osseointegrated implants. Periodic evaluation of prosthesis must be carried to determine the retention, stability, function as well as esthetics of the extraoral prosthesis which enhances the well-being and satisfaction of patients. In this review, we collected the articles from PubMed as well as Scopus-indexed journals and limited to research articles published from 1976 to 2020.
The impact of moderate versus deep neuromuscular blockade on the recovery characteristics following laparoscopic sleeve gastrectomy: A randomized double blind clinical trial
Authors: Alotaibi Narjes , Althaqafi Mahmoud , Alharbi Abdullah , Thallaj Ahmed , Ahmad Abdulaziz , Aldohayan Abdullah , Bamehriz Fahad , Eldawlatly Abdelazeem
Published: January 2024

Background:

Anesthesia with deep neuromuscular block for laparoscopic surgery may result in less postoperative pain with lower intra-abdominal pressure. However, the results in the existing literature are controversial. This study aimed to evaluate the effect of deep versus moderate neuromuscular block (NMB) on the postoperative recovery characteristics after laparoscopic sleeve gastrectomy (LSG) for weight loss surgery.

Methods:

This is parallel-group, randomized clinical trial. The study was conducted at a tertiary care center. Patients undergoing LSG were included. Patients were randomly assigned to either deep (post-tetanic count 1–2) or moderate (train-of-four 1–2) NMB group. The primary outcomes were numeric rating scale scores of the postoperative pain at rest and postoperative shoulder pain. The secondary outcomes were the length of hospital stay (LOS) and postoperative complications. The statistics were performed using StatsDirect statistical software (Version 2.7.9).

Results:

Two groups were identified: Group D (deep NMB), 29 patients, and Group M (moderate NMB), 28 patients. The BMI mean values for groups D and M were 44 and 45 kg/m2 respectively (P > 0.05). The mean durations of surgery for were 46.7 min and 44.1 min for groups M and D, respectively (P > 0.05). The mean train-of-four (TOF) counts were 0.3 and 0 for groups M and D, respectively (P < 0.05). The mean times from giving reversal agent to tracheal extubation (minutes) were 6.5 and 6.58 min for groups M and D, respectively (P > 0.05). In the recovery room, the means of pain scores were 3 and 4 for groups M and D, respectively (P > 0.05). Upon admission to the surgical ward, the median values of the pain score were non-significant (P > 0.05) (95% CI: 0.4–0.7). The opioid consumption in the recovery room was non-significant between both groups (P > 0.05) (95% CI: 0.3–0.6). Postoperative shoulder pain was non-significant between both groups (P > 0.05) (95% CI: 0.4–0.7). The median values of surgeon opinion of both groups were non-significant (P > 0.05). Regarding the LOS, the mean values of groups D and M were 1.20 and 1.21 days, respectively (P > 0.05).

Conclusions:

There was no significant difference between moderate and deep NMB techniques in terms of duration of the surgical procedure, postoperative pain, shoulder pain, and length of hospital stay. Further studies on a larger sample size are required to investigate the long-term recovery characteristics of patients with obesity undergoing LSG.
Postoperative pain: What can we do?
Authors: Gregório Mariana de Brito , Fonseca João Pedro Pires , Adrião Maria Madalena Oliveira , Cavaco Elisabete Oliveira Valente
Published: January 2024

Chronic postoperative pain (CPOP) is a potentially devastating consequence of a surgical procedure. It leads to increased medical costs, painful, and stress experience to the patients. After a surgical decompression performed in a patient with a non-traumatic compartment syndrome, a muscle biopsy confirmed McArdle disease, and after surgery, severe pain of neuropathic characteristics developed in the arm decompressed. Advanced techniques up to neuromedullary stimulation failed to improve the clinical status, after which repeated treatment with capsaicin patch ameliorated the patient's condition. This case report illustrates the need for a high index of suspicion for metabolic diseases in patients who present compartment syndrome without prior history of trauma and also the challenges in treating neuropathic pain after surgery.
The diagnostic accuracy of preoperative perfusion index as a predictor of postspinal anesthesia hypotension in parturients undergoing cesarean delivery: A prospective non-blinded observational study
Authors: Kesavankutty Manu P. , Panda Chinmaya , Karim Habib M. R. , Singha Subrata , Agrawal Sarita
Published: January 2024

Background and Objectives:

Spinal anesthesia is the technique of choice for elective cesarean section with a prominent side effect of postspinal anesthesia hypotension (PSH). This needs an early prediction to avoid feto-maternal complication. This study aimed to assess the diagnostic accuracy of perfusion index (PI) and inferior vena cava collapsibility index (IVCCI) in the prediction of PSH.

Material and Methods:

Thirty parturients of American Society of Anesthesiologists Physical Status (ASA-PS) 1 and two undergoing cesarean delivery participated in the study. IVCCI, PI, baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and heart rate (HR) were noted in the preoperative period. The fall of MBP by 20% from baseline or below 65 mm Hg was considered PSH. After spinal anesthesia, SBP, DBP, MBP, and HR were noted again for diagnosing PSH.

Results:

It did not show any statistical difference when comparing the PI between the PSH and non-PSH groups in both the PSH definition groups. IVCCI was significantly higher when PSH was considered MBP <65 mm Hg (P = 0.01). However, IVCCI was found to be statistically insignificant if PSH was considered a 20% reduction in baseline MBP. The correlation matrix between IVCCI and PI showed Pearson's r-value of 0.525, indicating a substantial relationship between the two (P = 0.003). Multivariate logistic regression analysis had shown that neither IVCCI nor PI was a good predictor of PSH in parturients for both definition groups for PSH.

Conclusion:

Although there is a modest correlation between PI and IVCCI, both cannot be used to predict postspinal hypotension in parturients undergoing elective lower-segment cesarean section (LSCS).
Preoperative gastric point-of-care ultrasound in nonelective surgical procedures in pediatric-aged patients
Authors: Ghimire Anuranjan , Moharir Alok , Yamaguchi Yoshikazu , Tram Nguyen K. , Tobias Joseph D.
Published: January 2024

Background:

Airway management for nonelective surgical procedures in the setting of trauma, pain, and opioid use can be complicated by the potential for aspiration due to delayed gastric emptying. Point-of-care ultrasound (POCUS) remains a useful tool for evaluating gastric content and volume in various clinical settings. The authors evaluated gastric volume and content in children scheduled for urgent and semi-urgent procedures to assess their aspiration risk.

Methods:

After obtaining consent, gastric POCUS was performed in the preoperative holding area for pediatric patients scheduled for both elective and nonelective surgery. Qualitative and quantitative measurements of the gastric antrum were taken, and the risk of gastric aspiration was calculated. Additional data collected included patient demographics, the type of surgery, nil per os (NPO) status at the time of surgery, NPO status at the time of injury, and administration of opioids.

Results:

The study cohort included 100 patients ranging in age from 3 to 17 years old (mean age 9.2 years). Out of these 100 patients, gastric scanning was successfully conducted in 98 patients. Sixteen of fifty-nine nonelective patients (27%) had received opioids for pain control prior to surgery. Among the 34 patients who had suffered an acute injury, 7 (21%) had been NPO for <8 hours at the time of the injury. Ninety-nine out of hundred patients had been NPO for at least 6 hours at the time of the gastric ultrasound. Based on our gastric ultrasound findings, all patients who were appropriately NPO had either Grade 0 or Grade 1 risk for aspiration, indicating a low risk of aspiration.

Conclusions:

The preliminary data show that when patients presenting for nonelective surgery are appropriately NPO, they may have a low risk of aspiration. This information may help guide the choice of anesthetic induction technique, particularly when concerns exist about the safety of a rapid sequence induction. It allows for a more stable and controlled induction of anesthesia.
Incidence of complications associated with deep brain stimulation surgery in patients with Parkinson's disease: An 8-year retrospective study
Authors: Eiamcharoenwit Jatuporn , Akavipat Phuping
Published: January 2024

Background:

Various complications occur in patients undergoing deep brain stimulation (DBS) surgery. The objective of this study was to determine the incidence of complications in patients with Parkinson's disease who underwent DBS surgery and identify the risk factors, especially anesthetic factors.

Methods:

A retrospective cohort study was performed between May 2015 and December 2022. Based on a review of medical charts, patients aged 18 years or older who underwent DBS surgery at a tertiary neurological center in Thailand were recruited. Univariate analysis using the Chi-square test or Fisher's exact test was performed to compare patients with and without complications. Multivariate logistic regression analysis was performed to identify the predictive factors for complications.

Results:

The study included 46 patients. The most common complication during DBS electrode placement was hypertension (30/46, 65.2%), and 19 patients (41.3%) who developed hypertension did not receive antihypertensive treatment. The most common complication during battery placement was clinical hypotension (14/46, 30.4%). The most common postoperative complication was delirium (6/46, 13.0%). In the multivariate analysis, no significant independent risk factors for overall complications after DBS surgery were identified.

Conclusions:

Hypertension during DBS electrode insertion was the most common perioperative complication. Hemodynamic instability is preventable and manageable, and vigilant and prompt treatment should be provided during DBS surgery.
Comparison of nebulized ropivacaine (0.75%) with nebulized dexmedetomidine on the hemodynamic response on intubation in patients undergoing surgery under general anesthesia: A comparative randomized double-blind placebo-controlled study
Authors: Saxena Puja , Gill Ravneet Kaur , Saroa Richa , Sidhu Bharti , Alen John , Sood Parul
Published: January 2024

Background:

Laryngoscopy and tracheal intubation lead to sympathetic stimulation resulting in hemodynamic fluctuations. We compared local anesthetic ropivacaine 0.75% with alpha agonist dexmedetomidine through ultrasonic nebulization for direct local action of the drug in the airway.

Methods:

In our randomized study, 180 patients were prospectively assigned to three groups of 60 each: group R (0.75%), group D (1 microgram/kg), and group C (control). The primary objective was to determine whether nebulized ropivacaine or nebulized dexmedetomidine can cause a reduction in stress response to laryngoscopy and intubation. The secondary objectives were to compare the hemodynamic parameters at extubation, cough response at extubation, and postoperative sore throat.

Results:

A total of 165 patients were analyzed. Demographically, all the groups were similar. Group R and group D were found to significantly attenuate the heart rate (HR) at intubation and extubation when compared to group C (P < 0.05). A significant reduction in mean arterial pressure (MAP) was seen (P < 0.05; group D: 90 ± 18.4 mmHg, group C: 99.5 ± 15.9 mmHg, group R: 92.4 ± 16.1 mmHg). There was a significant reduction in cough response in both groups in comparison with group C at 0 minutes (P value; group C vs group D: <.0001; group C vs group R:.01) and 5 minutes (P value; group C vs group D: <.0001; group C vs group R: <.0001).

Conclusion:

Preinduction topical use of ropivacaine or dexmedetomidine, through the nebulization route, effectively attenuated the pressor responses when compared to placebo.
An audit on surgery cancellation in a teaching hospital
Authors: Tayeb Baraa
Published: January 2024

Background:

Operative procedure cancellations are a dilemma for the healthcare system as well as for the patients. It causes increased workload and cost to our system. For patients, it has major financial, psychological as well as medical consequences. We aim to self-identify the causes of cancellations for efficient operation room management.

Methods:

We performed a retrospective chart review in a tertiary academic medical center for the last 66 months of operative records. Subsequently, we performed thematic coding to categorize causes into distinct categories.

Results:

Our records showed 5153 cancellations which represent (7.3%) of the total booked procedures. Of these cancellations 91% were ordered before the day of surgery, compared to 9% for same-day cancellations. Cancellations were 58% female patients and 40% male patients. The number one reason for cancellations for both same-day and prior cancellations is the unavailability of the surgical consultant.

Conclusion:

Surgical procedure cancellations profile is unique among our settings and has changed over time. Over the last 5 years, the number one reason is unavailability of the surgical consultant. Efforts should be made to identify and correct the underlying reasons to improve patient outcomes in our evolving healthcare system.
Pulmonary edema: A complication of post-complete ingrown toenail excision. A case report
Authors: Aljonaieh Khalid Ibrahim , Aldakhil Sadal
Published: January 2024

A sympathetic crashing pulmonary edema (SCAPE) is an emergency medical situation necessitating early recognition and treatment. We present a case of a 15-years old male who underwent a toenail excision of his left big toe and who developed SCAPE postoperatively. The low incidence of SCAPE intraoperatively makes it challenging for anesthesiologists to diagnose it. It occurs unexpectedly and precipitously, and it may increase the risks of morbidity and mortality if it is not treated promptly. Our aim is to raise awareness of how to abruptly manage such cases.
Cannabinoids in anesthesia and chronic pain: Where do we stand?
Authors: Pandey Khushboo , Hoda Wasimul
Published: January 2024

Cannabis derivatives have been conventionally employed globally for their curative and restorative properties for various ailments. However, its recreational use and consequent legal restrictions have substantially cramped its scientific research. An emerging interest regarding the profound therapeutic potential of cannabinoids has been observed among clinicians. Despite a rich cultural background, high-quality research on cannabinoids is lacking in the Indian scenario. This review readdresses the challenges on this front and brings an insight into the current status of cannabinoids and their utility in scientific exploration. Cannabinoids have a significant medicinal value in various clinical disorders. Its use so far has been based on scarce resources and corroborations, as evidence-based substantiation is limited. Through this review article, we emphasize the remarkable role enacted by cannabinoids in the treatment of various clinical disorders and an utterly significant need to formulate stringent research methodologies to promote its systematic investigation.