bluuebunny/crossref_metadata_2025 huggingface dataset:
A case series of patients with ophthalmic manifestations of monkeypox in Spain
Authors: Bryan Sofía , Fernández-Jiménez Marina , Fente Luis Celestino Franco , Ruiz-Moreno José M.
Published: April 2024

Monkeypox virus (MPXV) is a zoonotic orthopox DNA virus presently causing a global outbreak. The mucosae are affected in 41% of the cases; the nasal and eye regions are the least affected (1%). The most frequent eye infection is conjunctivitis with severe cases of corneal affection leading to permanent visual sequelae. We describe two cases of patients presenting facial edema, erythema, and vesiculo-pustular lesions with confirmed positive MPXV DNA polymerase chain reaction (PCR). Preseptal cellulitis and MPXV infection were diagnosed and treated with antibiotics and tecovirimat. A third patient was admitted to the hospital with pain and redness of the right eye and vesiculo-pustular skin lesions. On ophthalmological examination, he was diagnosed with a corneal ulcer and a creamy white infiltrate and was treated with systemic tecovirimat and ciprofloxacin eye drops. Healthcare professionals should be familiar with ocular manifestations of MPXV infection and consult ophthalmologists to reduce the risk of potentially vision-threatening complications.
Hemophilus influenzae-associated scleritis – A case report with a review of the literature
Authors: Babu Kalpana , Raksha V , Murthy Krishna R
Published: April 2024

We report a challenging clinical course of Hemophilus influenzae (H. influenzae) scleritis with a review of the literature. A 62‐year‐old lady with a history of progressing necrotizing scleritis over 7 months, negative for infection on scleral explorations, was given pulse doses of intravenous cyclophosphamide after she failed conventional immunomodulation. After two doses, she developed a tiny area of pus pointing, which was explored and subjected to microbiology. Though cultures were negative, PCR showed H. influenzae. She received intravenous ceftriaxone [2 g/day for 5 days], oral clarithromycin [500 mg twice daily for 14 days] and hourly fortified piperacillin, tazobactam and ceftazidime eyedrops. In addition, she received subconjunctival injections of ceftazidime. At 4 months follow‐up, the scleritis had resolved completely. At 1 year follow‐up, there was no recurrence of scleritis. H. influenzae is a rare cause of infectious scleritis. This case highlights the diagnostic challenge and the clinical course in such a case.
An asymptomatic case of intracorneal graphite particles following pencil injury since 30 years
Authors: Swain Samabesh
Published: April 2024

Reports of graphite pencil lead injuries to the eye are rare. Although graphite is considered to remain inert in the eye, it has been known to cause severe inflammation and damage to ocular structures. We report a case of a 35-year-old lady with intracorneal graphite foreign bodies following a graphite pencil injury in childhood.
A unique case of VKH in HIV patient
Authors: Ramesh Arpitha , Minija C K , Dubey Nidhi
Published: April 2024

A 49-year-female with known human immunodeficiency virus on highly active antiretroviral therapy presented with diminution of vision and mild pain in both eyes of 2 weeks duration, preceded by alopecia, headache, and tinnitus. Her best corrected visual acuity was 6/60 in both eyes, with anterior segment inflammation and multiple pockets of neurosensory detachments in the fundus bilaterally. Systemic workup done to rule out other causes of uveitis was negative. A diagnosis of complete Vogt–Koyanagi–Harada syndrome was made and treated with systemic corticosteroids, which resolved upon treatment, with improvement in visual acuity to 6/9P.
Multimodal imaging and genetic analysis in a rare case of autosomal recessive bestrophinopathy in India
Authors: Sen Ahana , Thounaojam Sanatombi , Majumdar Bristi , Kala Urvashi , Bhattacharyya Sampurna , Chowdhury Ruchira , Pradhan Amrita , Chattree Surabhi , Saurabh Kumar , Roy Rupak
Published: April 2024

We report a rare case of autosomal recessive bestrophinopathy (ARB) in India, where multimodal imaging and genetic analysis were done. Optical coherence tomography revealed a thickened Verhoeff’s membrane in both eyes and genetic analysis revealed a homozygous missense mutation in exon 4. To the best of our knowledge, this is the first case of ARB in India where genetic analysis has been done.
Incidence of thromboembolic events in non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
Authors: Yang Miaomiao , Cao Hongxin , Wang Congcong , Yu Caiyan , Sun Ping
Published: April 2024

The incidence of thromboembolic events (TEs) in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs) has rarely been reported. The MEDLINE, EMBASE, and the Cochrane Library databases were searched. The primary outcome was the incidence of TEs, and the secondary outcome was the relationship between TEs and overall survival (OS) following ICI therapy. A subgroup analysis of TE incidents was performed according to the TE type and combination regimens. The I2 statistic was used to determine the heterogeneity, and funnel plots and Egger’s test were used to assess publication bias. A total of 16,602 patients with NSCLC in 63 experimental arms were included in the analysis. The rate of TEs ranged from 0.1% to 13.8%, and the pooled overall incidence of all-grade TEs was 3% (95% confidence interval [CI], 2%–4%). The pooled rate of high-grade TEs was 1% (95% CI, 1%–2%). The venous and arterial TE rates were 3% (95% CI, 2%–4%) and 1% (95% CI, 1%–2%), respectively. Patients who received immunotherapy + chemoradiotherapy had the highest incidence of TEs (7%). The TE pooled rate was higher in patients treated with combined ICIs than in those treated with mono ICIs (4% vs. 2%). The OS was lower in patients with TEs than in those without TEs (hazard ratio, 1.4; 95% CI, 1.02%–1.92%). The incidence of TEs in NSCLC patients treated with ICIs was reasonable. Nonetheless, clinicians must be aware of potential thrombotic complications and treat them promptly.
Local therapy combined with anti-PD-1 immunotherapy for advanced lung adenocarcinoma: A case report
Authors: Wu Na , Yang Xiaoxin , Zhai Yan , Lu Wei
Published: April 2024

Lung adenocarcinoma (LUAD) encompasses all lung epithelial cancers except small-cell lung cancer. Although programmed cell death protein 1 (PD-1) inhibitors, such as pembrolizumab, and other Food and Drug Administration-approved immune checkpoint inhibitors, offer new hope for LUAD treatment, LUAD’s overall efficacy remains limited. Thus, the combination of immunotherapy with other therapeutic approaches has gained widespread attention. Local therapy is an optimal method for treating many advanced unresectable lung cancers. Herein, we present a case of a patient with multiple metastases from LUAD, who attained complete response for more than 3 years until present through local therapy combined with a PD-1 inhibitor.
Analysis of the retraction papers in oncology field from Chinese scholars from 2013 to 2022
Authors: Yang Wenyan , Sun Na , Song Hongwei
Published: April 2024

Objective:

To analyze the characteristics of retracted oncology papers from Chinese scholars and the reasons for retraction.

Methods:

Data on retracted oncology papers from Chinese scholars published from 2013 to 2022 were retrieved from the Retraction Watch database. The retraction number and annual distribution, article types, reasons for retraction, retraction time delay, publishers, and journal characteristics of the retracted papers were analyzed.

Results:

A total of 2695 oncology papers from Chinese scholars published from 2013 to 2022 had been retracted. The majority of these papers were published from 2017 to 2020. In terms of article type, 2538 of the retracted papers were research articles, accounting for 94.17% of the total number of retracted papers. The main reasons for retraction were data, result, and image problems, duplicate publication, paper mills, author- and third-party-related reasons, plagiarism, false reviews, and method errors. The retraction time delay for the retracted papers ranged from 0 to 3582 days (median, 826 days). The retractions mainly occurred within the first 4 years after publication. A total of 77 publishers were involved in the retracted papers. In terms of journal distribution, 394 journals were involved in the retracted papers, of which 368 (93.40%) were included in the SCI database. There were 243 journals with an impact factor of <5 (66.03%).

Conclusion:

In the field of oncology, the annual distribution of retracted papers from Chinese scholars exhibited first an increasing and subsequently a decreasing trend, reaching a peak in 2019, indicating an improvement in the status of retraction after 2021. The main type of the retracted papers was research article, and the main reason for retraction was academic misconduct. The retractions were mainly concentrated in several major publishers and periodicals in Europe and the United States. Most of the journals had low-impact factors.
Efficacy of radioactive 125I seed implantation in treating inoperable or refused operation head and neck cancers
Authors: Zhang Yuwei , Liang Yansong , Liu Zezhou , Zhang Hongtao , Gao Zhen , Wang Juan
Published: April 2024

Purpose:

This study aims to observe the curative effect of radioactive 125I seed implantation in treating inoperable or refused operation head and neck cancer.

Methods:

Data from 132 patients with head and neck malignant tumors underwent computed tomography-guided radioactive 125I seed implantation from April 2004 to August 2020 were analyzed retrospectively. The Kaplan-Meier method was used to calculate the local control and survival rates. The logarithmic rank test and the Cox proportional risk model were used for univariate and multivariate analysis, respectively.

Results:

A total of 132 patients were enrolled. All tumors were confirmed to be malignant through pathological analysis. Herein, we revealed that the seeds were implanted at the primary tumor site (23 cases, representing 17.4%), recurrent (9 cases, representing 6.8%), or metastatic lymph nodes (100 cases, representing 75.8%). Three months after the operation, 96 patients were evaluated as effective, whereas 36 patients were considered ineffective. The median local control time was 16 months; the local rates at 6, 12, 18, and 24 months were observed to be 75%, 47%, 35%, and 22%, respectively. The study reports a median survival period (OS) of 15 months. Additionally, the survival rates at 6, 12, 18, and 24 months were 61%, 42%, 31%, and 27%, respectively. Regarding side effects, skin or mucosal toxicity occurred in 14 patients. Grade I skin toxicity occurred in seven cases (5.3%), grade IV skin toxicity in one case (0.8%), grade I mucosal ulcer in four cases (3.0%), and grade I dry mouth in four cases (3.0%). The multivariate analysis showed that short-term efficacy and tumor site were independent prognostic factors (P < 0.001, 0.006, respectively). Additionally, the multivariate analysis showed that the independent OS influencing factors included D90, the longest tumor diameter, and short-term efficacy (P = 0.017, 0.001, <0.001).

Conclusion:

Radioactive 125I seed implantation is a safe and effective salvage therapy for patients with inoperable or refused operation head and neck cancer.
Endovascular Management of Middle Meningeal Artery Post-traumatic Pseudoaneurysm with Adjacent Intracerebral Haematoma
Authors: Preethi Yasam , Anantaram Gudipati , Panigrahi Manas , Chandrashekhar Y. B. V. K.
Published: April 2024

ABSTRACT

Traumatic pseudoaneurysm of middle meningeal artery (MMA) occurs mostly in association with temporal bone fractures following head trauma. Hence, timely, the management of such pseudoaneurysm is extremely of crucial importance for improving prognosis. The article reports the case of a patient who met with a motor vehicle accident and was found to have a large intracerebral haematoma in the left temporal lobe on the initial non-contrast computed tomography scan of the brain, which on evaluation with magnetic resonance imaging, was found to be a pseudo-aneurysm of the middle meningeal artery, successfully embolised with the liquid, non-adhesive embolic agent Onyx. This pseudoaneurysm was successfully embolised with the liquid, non-adhesive embolic agent Onyx.
Cavernous Carotid Aneurysm Presenting as Direct Carotid-Cavernous Fistula with Contralateral Ocular Symptoms: A Rare Case Report
Authors: Sharma Amit Kumar , Yadav Vivek , Shankar K. B.
Published: April 2024

ABSTRACT

Carotid-cavernous fistula (CCF) resulting from intracavernous carotid artery aneurysms is uncommon. However, if rupture does occur, it can lead to a CCF, which causes sudden onset of unilateral ophthalmoplegia. In this report, we present a case of a ruptured giant intracavernous carotid artery aneurysm leading to a direct CCF with contralateral ocular features. The aim is to discuss the distinctiveness of this case and the most challenging aspects of identifying similar cases. A woman in her sixties developed a sudden direct CCF, resulting in proptosis in the opposite eye. Magnetic resonance angiography revealed that the left cavernous sinus (CS) and superior ophthalmic vein were dilated, whereas the right side was unaffected. However, digital subtraction angiography (DSA) revealed a large aneurysm in the right cavernous internal carotid artery (ICA) and a direct connection between the right ICA and CS, with venous drainage exclusively occurring in the opposite direction via the intercavernous sinus. To address the issue, the aneurysm and fistula underwent Coil and Onyx embolisation, successfully closing the fistula and leading to a regression in the orbital symptom. This presents a unique scenario of an unexpected unilateral CCF with contralateral symptoms in a direct CCF, which demands immediate attention. It is crucial to remain alert for CCF and verify the diagnosis through DSA when dealing with such patients to avoid severe outcomes. Prompt identification and intervention can enhance the patient’s chances of a positive outcome.
Bipolar Cautery in Aneurysms: Effective but Underutilised Technique
Authors: Janu Vikas , Sharma Raghavendra Kumar , Agrawal Mohit , Jha Ashutosh , Ruparelia Jigish , Bhaskar Suryanarayanan , Jha Deepak Kumar
Published: April 2024

ABSTRACT

Background:

Bipolar cautery for aneurysms is an effective technique, described in the literature about 50 years back by Yasargil, however, there is an inadequacy of articles highlighting the technique.

Materials and Methods:

Operative videos of aneurysm surgeries were analysed to select the videos/photographs which can help readers to understand the technical nuances of using bipolar cautery during aneurysm surgeries. Cautery was used after the completion of sharp dissection around the neck and demarcation of proximal and distal vessels in non-giant aneurysms. Cautery setting was kept around 10%–20% of the maximum. Blunt tip forceps were used with continuous irrigation. A shaft instead of the tip of the cautery was used.

Results:

Bipolar cautery resulted in the shrinkage of the wall of the aneurysm. It had a similar effect on the neck, fundus or transition zone between the neck and fundus. It helped in controlling the bleeding from the fundus even during intraoperative rupture of the aneurysms. Even the flimsy wall of the fundus shrunk, which prevented their rupture during dissection. It was very useful to make giant aneurysm fundus shrink to a smaller size providing space for dissection. The wide neck could be modified to a desirable shape for easier clip applications.

Conclusion:

Fear of intraoperative rupture by cautery appears misconceived. It causes shrinkage of the wall of the aneurysm, can stop bleeding from the fundus and can change the shape of the neck fundus, which helps clipping the aneurysms easily.
Psychosis Following a Cerebellar Stroke Revealing a Vertebral Artery Dissection
Authors: Mnaili Mohamed Amine
Published: April 2024

ABSTRACT

The cerebellum plays a role not only in the control of balance and intentional voluntary movement but also plays an important role in the control of cognitive and emotional processes. We report a 62-year-old man who developed persistent persecutory delusions, hallucinations, cognitive impairment and flattened affect following a left bilateral cerebellar stroke. This is the second case reported of psychosis secondary to cerebellar vascular infarction due to vertebral dissection. Based on the distribution of the patient’s lesions, we suggest that his corresponding symptoms are a result of a disruption to cerebellar pathways. There is no consensus on the preferred pharmacological treatment of psychotic symptoms secondary to cerebellar lesions.
Ischaemic Stroke in Pregnancy: Case Report and Review of Literature
Authors: Mnaili Mohamed Amine
Published: April 2024

ABSTRACT

Stroke continues to be one of the main causes of death in developed countries and the incidence in pregnancy appears to be increasing. Our case describes a 34-year-old woman presenting in her third trimester with a sudden onset of slurred speech, right hemiparesis, facial nerve central palsy, psychomotor agitation and pain in the right lower limb related to ischaemic stroke in the left middle cerebral artery. The aim of our case report is to know the current recommendations for the investigation and management of acute stroke and how they apply to pregnancy, to understand the secondary prevention of stroke and the safety of these strategies in pregnancy and to recognise the importance of multidisciplinary input in the management of pregnancy and delivery in women with stroke.
Rare Cause of Basal Ganglionic Haematoma: Rete Anomaly of Middle Cerebral Artery
Authors: Seelam Pulla Reddy , Panigrahi Manas , Gudipati Ananta Ram
Published: April 2024

ABSTRACT

A 52-year-old female without co-morbidities presented to us with a history of sudden onset of severe headache and vomiting followed by drowsiness. Computed tomography brain plain was done which showed left capsuloganglionic bleed with intraventricular haemorrhage. In view of normal blood pressure and no co-morbidities, we suspected a vascular pathology and hence planned for digital subtraction angiogram (DSA). DSA showed rete anomaly of the middle cerebral artery (MCA) with aneurysm arising from the one of the anterior branches. The patient was taken up for surgery and left pterional craniotomy and evacuation of haematoma with clipping of aneurysm was done. Rete anomaly of MCA is an extremely rare entity with the incidence of 0.11%. It is web-like anomaly of MCA that does not coalesce to form a prominent, large single branch from the plexiform vessels in the foetal stage. The most common form of presentation is haemorrhagic stroke. The scan mimics a hypertensive basal ganglionic haematoma. Any non-hypertensive patient with a basal ganglionic haematoma needs an angiogram to look for other causes. In cases with rete anomaly with aneurysm, clipping is advocated over endovascular procedures as it is difficult to negotiate through these tiny vessels.
The effect of emotional freedom techniques (EFT) on anxiety and caregiver burden of family caregivers of patients with heart failure: A quasi-experimental study
Authors: Marzban Arash , Akbari Mohammad , Moradi Mohsen , Fanian Nasrin
Published: April 2024

BACKGROUND:

Family members are at the forefront of providing care to patients with chronic illnesses, such as heart failure (HF). Since patient caregiving can affect the mental and physical health of family caregivers, the implementation and training of new psychological interventions by nurses are considered important and necessary for family caregivers. Therefore, the aim of this study was to evaluate the effect of emotional freedom techniques (EFTs) on anxiety and caregiver burden of family caregivers of patients with HF.

MATERIALS AND METHODS:

This study was a quasi-experimental study, in which 91 family caregivers participated. The family caregivers were assigned into two groups of intervention (n = 46) and control (n = 45). Data were collected using a demographic information form, Zung Self-Rating Anxiety Scale (SAS), and Caregiver Burden Inventory (CBI) developed by Novak and Guest. The intervention group underwent EFT training within six sessions, while the control group received no training. Descriptive statistics (mean, standard deviation, and absolute and relative frequency) and inferential statistical tests such as Chi-square, Fisher’s exact, and independent t-tests were run, and the data were analyzed by Statistical Package for the Social Sciences (SPSS) version 23 software.

RESULTS:

The findings showed that the intervention group had a significant improvement in reducing anxiety (P > 0.001). In addition, EFT significantly reduced caregiver burden among family caregivers of HF patients (P > 0.001).

CONCLUSION:

EFT could significantly reduce anxiety and caregiver burden in family caregivers of patients with HF in our study. Therefore, nurses working in clinical settings are recommended to learn and use EFT to reduce the anxiety and caregiver burden of patients’ family caregivers.
The effect of extra virgin olive oil (EVOO) on fat mass and fat-free mass for breastfeeding mothers (0-24 months) in Makassar City, Indonesia
Authors: Abidin Sri W. , Citrakesumasari Citrakesumasari , Bahar Burhanuddin , Jafar Nurhaedar , Hidayanti Healthy , Hadju Veni
Published: April 2024

BACKGROUND:

Extra Virgin Olive Oil (EVOO) is a fat source classified as monounsaturated fatty acid. Previous studies have shown that 47.5% of breastfeeding mothers have less fat intake when compared to the Adequacy of Nutrition Rate (RDA). EVOO consumption can improve the composition of breast milk. However, no research has been found regarding the body composition of breastfeeding mothers after consuming EVOO. This study aims to determine the effect of EVOO on the body composition of breastfeeding mothers 0-24 months.

MATERIALS AND METHODS:

The study was conducted at the Sudiang Raya and Tamalanrea Health Centers in Makassar City with a randomized clinical trial design from January to February 2023. The sample was breastfeeding mothers 0-24 months divided into the intervention group (EVOO and Nutrition Education, n = 17) and the control (Nutrition Education, n = 17). Instruments with Bioelectrical Impedence Analysis tools. Data analysis using t-test.

RESULTS:

The sample is breastfeeding mothers aged between ≤19 and >35 years. The results of the analysis showed that the average pre-post test, % fat mass (FM) P = 0.426 and % fat free mass (FFM) P = 0.508 (P > 0.05), meant that there was no significant difference. Between the two groups there was no significant difference at the end of the study, %FM P = 0.469 and %FFM P = 0.529 (P > 0.05).

CONCLUSIONS:

In the intervention group that was given EVOO, it was possible to maintain%FM and%FFM in the normal percentage range, while in the control group, there was a decrease from the normal to less/low range.
Antimicrobial effect of indocyanine green-mediated photodynamic therapy in patients with periodontal disease: A systematic review
Authors: AlSarhan Mohammed A
Published: April 2024

Aim:

This systematic review assessed the antimicrobial effect of indocyanine green-mediated photodynamic therapy (ICG-PDT) in patients with periodontal disease.

Materials and Methods:

Four electronic databases that is, MEDLINE, MEDLINE-In-Process, EMBASE, and Cochrane Library were systematically searched from their inception until December 22, 2022. Randomized controlled trials (RCTs) reporting the antimicrobial effect of ICG-PDT in patients with periodontal disease and published in English were included. The Cochrane risk of bias tool was used to assess the quality of the included RCTs. Two independent reviewers performed all the steps involved in a systematic review (primary and secondary screening, data extraction, and quality assessment). As the data extracted was not suitable for meta-analysis, the evidence was synthesized qualitatively.

Results:

Overall, seven RCTs from seven publications were included. All included studies had PDT, laser, or photothermal with ICG as the test group while the control group included low-level laser therapy, root surface debridement, and scaling and root planning. The bacterial species assessed across the included studies included Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Fusobacterium nucleatum, and Treponema denticola. With subtle exceptions, ICG-PDT in combination with root surface debridement and scaling and root planning significantly reduced the growth of periodontal pathogens from baseline.

Conclusion:

Based on the evidence from the limited studies, ICG-PDT seems to exhibit potent antimicrobial activity against an array of periodontal pathogens in patients with periodontal disease.
Bibliometric analysis of scientific production on botulinum toxin and dentistry: Collaboration, impact, and trends
Authors: Portocarrero-Reyes Alfredo , Javier-Felipe Carlos , Espinoza-Carhuancho Fran , Mayta-Tovalino Frank
Published: April 2024

Aim:

To conduct a detailed examination of the scientific literature on the topic of botulinum toxin in relation to dentistry, using bibliometric analysis methods.

Materials and Methods:

This study employed a retrospective and descriptive design with a bibliometric approach. The research focused on the intersection of botulinum toxin and dentistry, analyzing articles published from 2018 to 2023. This search was conducted on September 21, 2023. These articles were then organized and analyzed through metadata analysis. The selection criteria were defined based on the PICO question. Inclusion criteria encompassed research articles related to botulinum toxin and dentistry, published between 2018 and 2023, available in Scopus, and containing the specified keywords. Exclusion criteria were set to omit review articles, editorials, letters to the editor, commentaries, articles not written in English, articles that had not undergone peer review, and those whose full text was not accessible. This approach allowed for an objective measurement of variables using SciVal from Scopus, ensuring the reliability and validity of the study findings. The progressive increase in scientific production on botulinum toxin and dentistry over the last five years was thus effectively captured and analyzed.

Results:

From 2018 to 2023, the scientific production on botulinum toxin and dentistry was higher in Q2 and Q1. 2019 was the only year where there were a higher number of publications in Q1, since in the other years the publications were mostly in Q2. The scientific journal with the highest average of publications on this topic was the British Journal of Oral and Maxillofacial Surgery. Most of the publications were from Peking University, China, and the Universidade de Sao Paulo. The most prolific author was Paulo César Rodrigues Conti, and the countries with the most publications on botulinum toxin and dentistry were the United States and Brazil.

Conclusions:

During the last five years, the scientific production on botulinum toxin and dentistry has progressively increased, with most of the publications being in the Q2 and Q1 quartiles. The United States was the country with the highest number of publications. The author, Paulo César Rodrigues Conti, was the researcher with the highest average manuscripts.
Evaluating the Impact of Various Treatment Modalities on the Chewing Efficiency of Anterior Disc Displacements of Temporomandibular Joint Disorder Cases: A Comparative Study
Authors: Abdel-Gawwad Esmail Ahmed , Atito Ehap , Osman Mohammed , Emam Abdel-Naser M , Baraka Yasser , Abdullah Abdel Aziz Baiomy , Helal Mohamed Ahmed
Published: April 2024

Abstract

Aim:

Internal disc displacement of the temporomandibular joint (TMJ) is identified by an anomaly between the condylar-disc assembly, which, in many cases, may lead to discomfort and malfunction of the chewing function. The study’s objective was to assess the effects of four distinct treatment approaches on temporomandibular disorder cases with anterior disc displacements focusing on their chewing efficiency.

Materials and Methods:

One hundred participants suffering from reducible TMJ disc displacement were selected for enrollment in the study. Subjects were divided equally into four groups: group I patients were treated with behavioral therapy; group II patients were treated with low-level laser therapy (LLLT); group III patients were treated with anterior repositioning splints; and group IV patients were treated with flat plane splints. Chewing efficiency was assessed utilizing the fractional sieving method and a synthetic food substitute was created using silicon impression material. The statistical analysis encompassed comparisons of chewing efficiency between groups and between baseline and posttreatment within each group, employing analysis of variance (ANOVA) and paired t tests, respectively.

Results:

Using the paired t test, a significant difference in chewing efficiency values as expressed by the median particle size was observed between the baseline and 6-month values in all groups (P < 0.05), except for group I where no significant change was noted over the 6 months (P > 0.05). The one-way ANOVA test revealed a statistically significant difference among groups following therapies (P ˂ 0.05). The post hoc Tukey test was employed for pairwise comparisons and revealed statistically significant variances in the main values of chewing efficiency among all groups at a 95% confidence level (P ˂ 0.05).

Conclusion:

The study’s results suggest that occlusal splints and LLLT are more effective in improving chewing efficiency than behavioral interventions.
Dental caries as a health risk for visual acuity in relation to salivary transforming growth factor beta-1 among students aged 8–10 years: A cross-sectional study
Authors: Ajeel Noor Adil , Diab Ban Sahib
Published: April 2024

Abstract

Background:

Dental caries and an impairment in visual acuity (VA) may both be caused by a variety of risk factors. Various conditions of the eye can appear as a consequence of overall inflammation and active dental caries.

Aim:

The present study aims to assess dental caries and salivary status by measuring the transforming growth factor beta-1 (TGF-β1) and flow rate between visually impaired students compared with students with normal vision.

Materials and Methods:

Research was performed employing a cross-sectional comparative study design conducted among representative 653 students aged 8–10 years at primary schools in Al-Diwaniyah governorate using the Snellen E chart for measuring VA status. Partitioning the students according to the degree of VA into normal students with normal VA of 6/9 or better and students with visual impairment of 6/12 or worse was done. Sub-sample of 180 students was recruited randomly from both groups, age and gender-matched participants for salivary analysis, and dental caries assessment measured by decay, missed, filled index, according to the World Health Organization in 2013

Results:

Out of 653 students, only 70 students suffer from a decrease in VA. Dental caries was more prevalent in those who had a decrease in VA compared with normal groups. For primary teeth decay, missed, filled teeth index (DMFT/dmft), the result was not significant but highly significant for DMFT/dmft. A significant decrease in salivary flow rate and increased salivary TGF-β1 level among visually impaired students was found.

Conclusions:

According to the current research, the study population that has impaired VA, dental health status has greatly deteriorated.
Application of Binary Logistic Regression in Biological Studies
Authors: Banerjee Debashmita , Kumar Roshan , Tripathi Srishti , Murry Benrithung
Published: April 2024

Binary logistic regression (BLR) is a statistical method that utilizes one or more independent variables to make predictions about the outcome of a categorical dependent variable. The examples in this article demonstrate the utilization of biological data in statistical software such as SPSS and Excel to illustrate BLR. The primary objective of this essay is to provide readers with a comprehensive understanding of binomial logistic regression. This presentation examines the appropriate circumstances for utilizing this specific regression technique and provides guidance on assessing the adequacy of the regression model.
Correlation of oxygenation indices in invasive mechanical ventilated adult patients
Authors: Jain Ravi , Jain Ashish , Jain Srishti , Jain Rohit , Panwar Puneet , Goyal Manish , Jain Anand Kumar , Meena Munesh , Gupta Priyamvada , Manghwani Hetal , Gupta Divyansh
Published: April 2024

Background:

Mechanical ventilation is essential for managing acute respiratory failure, but traditional methods of assessing oxygenation, like the PaO2/FiO2 ratio, pose challenges due to invasiveness and cost.

Objective:

This single-centre prospective observational study aimed to assess the potential of the non-invasive Oxygen Saturation Index (OSI), utilising SpO2 measurements, to diagnose hypoxemia in mechanically ventilated adults. The study sought to establish correlations between OSI, oxygenation index (OI), PaO2/FiO2 ratio and SpO2/FiO2 ratio.

Methods:

From August 2022 to July 2023, data was collected from 1055 mechanically ventilated intensive care unit patients. Statistical analysis included correlation tests, receiver operating curve (ROC) analysis and cut-off value determination for hypoxemia diagnosis.

Results:

We found that the P/F ratio had a statistically significant negative correlation with OI (correlation coefficient -0.832, P value: 0.000 in hypoxemic group and correlation coefficient -0.888, P value: 0.000 in the non-hypoxemic group), and OSI (correlation coefficient -0.746, P value: 0.000 in hypoxemic group and correlation coefficient -0.629, P value: 0.000 in non-hypoxemic group) and has a positive correlation with P/F ratio (correlation coefficient 0.92, P value: 0.000 in hypoxemic group and correlation coefficient -0.67, P value: 0.000 in non-hypoxemic group). OI and OSI had a statistically significant correlation (correlation coefficient 0.955, P value: 0.000 in hypoxemic group and correlation coefficient 0.815, P value: 0.000 in non-hypoxemic group). on ROC analysis P/F ratio was the most accurate in predicting hypoxia followed by OI and OSI. with a cut-off value, of OI being 7.07, and that for OSI being 3.90, at an 80% sensitivity level to diagnose hypoxemia.

Conclusion:

OSI can serve as a dependable surrogate for OI, simplifying ARDS severity assessment. The P/F ratio is the most accurate predictor of hypoxia. Further research, especially in larger multicentre studies, is needed to validate these findings and explore the long-term clinical implications of using OSI for oxygenation monitoring in mechanically ventilated patients.
Effect of Low Vision Devices on Visual Acuity and Visual Function of Students of Schools for the Blind in Southeast Nigeria
Authors: Okeke C.J. , Achigbu E.O. , Ogborogu E.U. , Onyia O.E.
Published: April 2024

Aim: To determine the effect of low vision aids (LVA) on the visual acuity and visual function of students of schools for the blind in South East Nigeria. Settings and design: This was a cross-sectional, interventional study conducted in three schools for the blind in Southeast, Nigeria. Methods: All students who consented and met the eligibility criteria from these schools were enlisted for the study. Each participant underwent visual acuity assessment and a thorough eye examination, which included tests involving low vision aids. Participants who had improvement in their vision were provided with low vision aids and reassessed four months later. In addition, changes in functional vision were assessed using the LV Prasad Functional Vision Questionnaire. Results: Ninety-two students made up of 52 (57.0%) men and 40 (43.0%) women were examined. The mean age was 18.4 ± 6.4 years. Eighty-eight (95.7%) students had visual acuity <3/60 in the better eye before refraction. Eleven (12%) students had improvement in visual acuity to ≥6/60 in the better eye with refraction. Thirteen (14.1%) students had improvement by at least one grade of the WHO visual acuity categories with the use of low vision aids and 10 (76.9%) of these were able to read N10 or better. The improvement in functional vision was statistically significant (P < 0.001). Conclusion: Low Vision Aids are important in the rehabilitation of students with residual vision.
Short-term Visual Outcome Following Anterior Chamber Intraocular Lens Implantation—The Experience of a Rural Teaching Hospital
Authors: Obasuyi Osamudiamen C. , Tagar Blessing O. , Ewoigbe Juliet O. , Tabowei Philip , Ofuadarho Oghenevwaire J. , Eguaojie Irene E. , Ovienria Wilson A. , Eigbedion Tessy Eronmwon , Enock Malachi E. , Momoh Nanaishat , Fuh Ukamaka C. , Alikah Anita A.
Published: April 2024

Purpose: To report the indications, frequency and short-term visual outcome of anterior chamber intraocular lens implantation (ACIOL) in a rural tertiary hospital; as well as to describe the reasons for poor visual outcome following ACIOL implantation. Methods: This was a retrospective descriptive study of all patients aged at least 18 years who underwent cataract extraction and implantation of ACIOL between January 2004 and May 2023. Information retrieved from the case records included preoperative visual acuity, indication for ACIOL implantation, first-day postoperative visual acuity, and 6 weeks postoperative visual acuity. Results: A total of 133 eyes of 126 patients were reviewed in this study. The mean age was 60.9 years, with a male-to-female ratio of 1.7:1. The most common indication for ACIOL use was a posterior capsular rent (70.7%). The first-day postoperative visual acuity was 6/18 or better in 7 (5.3%) patients, and by the sixth postoperative week, this proportion had increased to 28.6% (38 patients). The most common complication on the first day post-op was striate keratopathy (72.9%), while the most common at 6 weeks was pseudophakic bullous keratopathy (21.1%). Conclusion: Although complications were noted with the use of ACIOLs, improvement in visual acuity was observed at 6 weeks. ACIOLs may still be relevant in settings where automated vitrectomy equipment is not readily available, but the availability of expertize is required for its implantation and the complication profile of ACIOLs must always be taken into consideration.
Atypical antipsychotic-induced neuroleptic malignant syndrome
Authors: Prajapati Nishant Babubhai , Gupta Sapna D. , Sood Shikha V. , Malhotra Supriya Deepak
Published: April 2024

The rare neuroleptic malignant syndrome (NMS) is associated with early mortality of >30%. Better supportive care has reduced mortality to <10%. Atypical antipsychotics such as clozapine and risperidone are associated with an atypical but potentially lethal, NMS. A 22-year-old male developed NMS after being treated with clozapine and risperidone for aggression associated with mental retardation for about 8 years. For the past 1 year, the dose of clozapine was 200 mg/day and the dose of risperidone was 8 mg/day. The patient presented with symptoms of hyperthermia, perspiration, neck rigidity, and tonic posturing of all four limbs with tongue bite and frothing from the mouth. On examination, the patient’s Glasgow coma Scale was E3V1M4. He was intubated and given antibiotics, antiepileptic, tablet bromocriptine 2.5 mg (1-1-1-1), and other supportive treatment. The patient showed improvement in 10 days. Knowledge of diagnostic features, risk factors, treatment modalities, and differential diagnosis of NMS is essential. Early diagnosis and prompt treatment can reduce mortality and morbidity significantly.
Team and leadership training in medical students
Authors: Palanisamy Priyadharsini Raman , Ramasamy Akilesh
Published: April 2024

The effectiveness of health care depends on core knowledge and competencies such as professional approach, team building, and leadership skills. A qualified doctor has to be a member of the health-care team and a leader of the health-care team at times. The ability to adapt as a team member and lead the team are two different roles to which medical students should be exposed at the beginning of the course. Medical students are subjected to a foundation course in their 1st year, which includes various topics such as ethics, professionalism, and team and leadership skills. However, these students are young adults directly entering medical college from school, and specific topics can be sensitized in a gamified/activity-oriented mode to improve learning. This review focuses on these gamified/activity-oriented methods to teach team and leadership skills to students straight from school.
Propofol-based Anesthesia versus Volatile Anesthesia on Brain Relaxation in Neurosurgery: A Meta-analysis of Randomized Controlled Trials
Authors: Jonathan Jeremy , Wijaya Khema Metta , Johansyah Theodorus Kevin Putra , Sari Felicia Puspita , Satrio Kenny , Jobul Ivan Christianto
Published: April 2024

Background:

The main objectives of neuroanesthesia are maintaining the stability of cerebral blood flow, intracranial pressure (ICP), and hemodynamics. Both intravenous and volatile anesthetics are frequently used in neuroanesthesia, yet the superior agent is still an ongoing debate. This study aimed to compare propofol-based versus volatile anesthesia on brain relaxation in patients undergoing neurosurgery.

Subjects and Methods:

PubMed, Cochrane, EMBASE, and ProQuest were searched using suitable keywords. Randomized controlled trials comparing propofol-based and volatile anesthesia for neurosurgery were included. The primary outcome was the brain relaxation score. Secondary outcomes were cerebral hemodynamics, intraoperative hemodynamics, recovery profiles, and postoperative complications. A meta-analysis was done to analyze the outcomes.

Results:

Seventeen studies (2135 patients) were included. Propofol-based group had lower ICP values (mean difference [MD]: −5.13 mmHg; 95% confidence interval [CI]: −6.95 to − 3.32; P < 0.00001); however, brain relaxation was similar within both groups. Intraoperative hemodynamics parameters were similar, aside from higher hypertension incidence in the propofol-based group. Remifentanil usage was higher with propofol-based anesthesia (MD: 1.08 μg; 95% CI: 0.72–1.44; P < 0.00001). Recovery profiles and postoperative complications were similar, with the exception of lower postoperative nausea and vomiting (PONV) incidence with propofol-based anesthesia (odds ratio = 0.59; 95% CI: 0.43–0.79; P = 0.0005).

Conclusions:

Propofol-based and volatile anesthesia provides comparable adequate brain relaxation in patients undergoing neurosurgery, although ICP was lower with propofol-based anesthesia. Propofol-based anesthesia significantly promoted the incidence of hypertension and reduced PONV. Other adverse events with both regimens were comparable.
Surgical outcomes of pediatric glaucoma in Indian eyes
Authors: Menon Meena Gopinath , Thulasidas Mithun , Singh Aditi
Published: April 2024

Purpose:

To evaluate the surgical outcomes of pediatric glaucoma in a cohort of Indian population.

Materials and Methods:

We conducted a single-center retrospective study including pediatric glaucoma patients who had undergone surgery between January 2012 and January 2022. The surgeries performed were trabeculectomy with mitomycin-C or Ologen, combined trabeculectomy with trabeculotomy (CTT), Ahmed glaucoma valve (AGV) implantation, and diode laser transscleral cyclophotocoagulation. Success was defined as complete if intraocular pressure (IOP) was between 6 and 21 mmHg in children who were examined on slit lamp, or between 6 and 18 mmHg in patients examined under general anesthesia, in the absence of any glaucoma medication and as qualified, with glaucoma medication at the last follow-up. Outcome measures included IOP at the last follow-up, number of glaucoma medications, any complications, and additional surgeries.

Results:

Seventy-eight eyes of 68 children were included. The most common glaucoma types were primary congenital glaucoma (30.8%), followed by posttraumatic glaucoma (17.9%) and postvitreoretinal surgery glaucoma (16.7%). The mean IOP reduced from 34.17 ± 9.35 mmHg preoperatively to 21.38 ± 9.61 mmHg at the last follow-up (P < 0.001). The number of glaucoma medications reduced from 2.55 ± 1.10 preoperatively to 1.76 ± 1.26 at the last follow-up (P < 0.001). Success was achieved in 62.8% of eyes and the mean survival time was 3.62 years. Among all procedures, AGV implantation had a longer survival time (mean 4.86 years).

Conclusion:

Pediatric glaucoma management remains a challenge. Majority of the cases remain refractory in spite of multiple surgical interventions. AGV and CTT could be offered as primary surgery in cases of pediatric glaucoma with hazy cornea where goniotomy may not be an option.
An Atypical Etiology for Granulomatous Mediastinal Lymphadenopathy in an Immunocompetent Adult Male
Authors: Deepak T. H. , Joseph Ananthu , Santhakumar S. , Venugopal J.
Published: April 2024

Nontuberculous mycobacteria (NTM) are widely distributed microorganisms that have the potential to cause severe illness in humans, especially those with compromised immune systems. In adults, the disease mainly manifests as chronic pulmonary disease. Few case reports are available on lymphadenopathy caused by nontubercular mycobacterium in children, primarily affecting the cervical lymph nodes. However, it is exceptionally rare for an immunocompetent adult to develop mediastinal lymphadenopathy due to NTM infection. We present a case of posttubercular fibrocavitary lung disease with mediastinal adenopathy in an immunocompetent male. The initial clinical suspicion was the reactivation of tuberculosis. However, the cultures from the mediastinal node aspirate obtained by Endo Bronchial Ultra Sound guided Trans Bronchial Needle Aspiration (EBUS-TBNA) and the bronchoalveolar lavage showed growth of nontubercular mycobacterium. Our literature search only revealed a case report discussing mediastinal lymphadenopathy associated with NTM in an immunocompetent individual.
Destination on the Horizon: The Prolonged Journey to Attain Pharmacists' Provider Status
Authors: Davitian Leigh
Published: April 2024

This article explores the historical milestones and the significant challenges encountered by organizations dedicated to advocating for the recognition of pharmacists as providers under Medicare, a mission that has spanned decades. Moreover, the article seeks to highlight the latest efforts that offer a promising path toward rectifying this long-standing oversight within the pharmacy community.
Przestępstwo szpiegostwa po nowemu, czyli w świetle nowelizacji Kodeksu karnego z 17 sierpnia 2023 roku
Authors: Burczaniuk Piotr
Published: April 2024

The study analysed the scope of changes in the criminalisation of the crime of espionage in Poland that took place with the amendment to the Criminal Code of 17 August 2023, as well as the systemic changes introduced by it in eight other laws, including the competency laws of all Polish special services. The amendments were introduced to increase the powers to combat this type of crime. The primary objective of the analysis was an attempt to answer the question of whether the scope of the changes introduced corresponds to the demands made by legal doctrine as well as practitioners involved in combating espionage in Poland, consequently adjusting the legal state to the current geopolitical situation, mainly related to aggressive non-military actions described in the doctrines of war. The analysis of the introduced changes was shown against the background of the legislative process of the indicated law, and especially the discussion that took place within its framework, without which a proper understanding of the changes would not be possible.