bluuebunny/crossref_metadata_2025 huggingface dataset:
Employing Escape Rooms in Medical Education to Deliver Engaging and Immersive Learning: Brief Review
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh , Tiwade Yugeshwari
Published: April 2024

ABSTRACT

The conventional mode of medical education is delivered using didactic lectures, wherein teachers disseminate the desired information to a large number of students in a structured manner. The purpose of the current review is to explore the scope and need of escape rooms in medical education and identify the potential considerations to be acknowledged while designing an escape room in a medical college for training undergraduate medical students. Escape rooms in principle refer to the learning environments that are interactive and immersive, in the sense that students who are part of these rooms are posed with a puzzle or a challenge or a task that must be solved by them within a defined period of timeframe to eventually escape from the room, which is the ultimate goal of such sessions. The success of escape rooms is determined depending by the way it has been designed, in terms of their ability to engage the involved participants and promote collaboration. In conclusion, the employment of escape rooms in medical education is an innovative teaching–learning method to overcome the limitations of conventional strategies. Acknowledging the merits of escape rooms in the development of critical thinking and teamwork skills, it is the need of the hour that every medical institution must explore the possibility and introduce it within their settings to ensure experiential and long-term learning among medical students.
Bioactive Biosilicate Cements in Pediatric Dentistry – A Review of the Latest Materials
Authors: Acharya Sonu , Raghunath N , Mallikarjun Rachappa M , Nalawade Triveni , Gurunathan Deepa , Godhi Brinda S.
Published: April 2024

ABSTRACT

Pediatric dentistry plays a critical role in ensuring the oral health and well-being of children and adolescents. The quest for effective dental materials that are safe, biocompatible, and capable of promoting natural remineralization has led to the emergence of biosilicate cements as a promising advancement in this field. Biosilicate cements are bioactive materials composed of amorphous silica, calcium oxide, phosphorus pentoxide, and other trace elements. The bioactivity of biosilicate cements allows them to interact with living tissues, promoting remineralization and stimulating the formation of hydroxyapatite, a vital component of teeth and bones. Their ability to release essential ions, such as calcium, phosphate, and fluoride, supports the natural healing processes, aiding in the preservation of pulp vitality and reducing the risk of secondary caries. Biosilicate cements offer versatility in pediatric dentistry, finding application indirect pulp capping, indirect pulp capping, and small-sized restorations. Their rapid setting time proves advantageous when treating young patients with limited cooperation. Furthermore, the continuous release of fluoride contributes to caries prevention and enhances the long-term oral health of children. While the advantages of biosilicate cements in pediatric dentistry are promising, this manuscript also discusses the limitations and challenges associated with their use. Some biosilicate cements may have different handling characteristics compared to traditional materials, necessitating adaptations in clinical techniques. In addition, long-term clinical data on the performance of these materials in pediatric patients are still limited, requiring further research to establish their efficacy and longevity. This manuscript explores the potential of biosilicate cements in pediatric dentistry.
Comparison of Different Modes of Oral Health Education in Visually Impaired Children
Authors: Santhoshi Kayithi , Ansari Khaja R. , Mekala Sirisha , Kala Tejaswi , Madala Manasa V. , Onteru Pradeep
Published: April 2024

ABSTRACT

To compare the effectiveness of various modes of oral health education in visually impaired children. A total of 100 students aged 8–15 years were included. The children were divided randomly into four groups. Children in Group I received oral hygiene instructions through Braille pamphlets. In Group II, children received instructions through nonvisual desktop access (NVDA). For children in Group III, both Braille and NVDA were used to deliver the instructions. Children included in Group IV served as controls, who did not receive any information in any form for the study period. After oral examination to record plaque and OHI-S scores, a questionnaire was given to the children to assess their knowledge scores. The same questionnaire was repeated after 1 month to reassess the knowledge score in different groups. Chi-square test, Wilcoxon test, and post hoc analysis tests were used. The mean plaque scores among the control group children at the follow-up were significantly higher (2.5 ± 0.64) than any other group. Similarly, the control group had higher mean oral hygiene simplified scores (1.75 ± 1.32) than the Braille (1.12 ± 0.65), NVDA (0.85 ± 1.38), and Braille + NVDA (0.2 ± 0.64) groups at follow-up. With regards to the mean total knowledge score, the control group scored the least (2.16 ± 1.46), while the Braille, NVDA, and Braille + NVDA groups scored 3.16 ± 1.43, 4.52 ± 1.12, and 6.36 ± 0.52, respectively. Combination of Braille and NVDA was found to be effective in educating and motivating visually impaired children regarding maintenance of oral hygiene.
Evaluation of Lingual Foramen in the South Indian Population Using Cone-Beam Computed Tomography: A Prospective Cross-Sectional Study
Authors: DevaThambi T. Jones Raja , Aswath Nalini
Published: April 2024

ABSTRACT

Background:

Surgical procedures in the anterior mandibular region require a profound understanding of the complex anatomical structures to ensure patient safety. The lingual foramen (LF) and its intra-osseous canal are pivotal structures, supplying vascular and neural support to the mental region. The prevalence of LF is widely recognized, with variations among populations.

Methods:

The study involved 650 adult participants. Data were collected using high-resolution cone-beam computed tomography (CBCT), and statistical analysis was conducted, establishing inter-rater agreement.

Results:

The population had a varied age distribution, with males comprising 53.23% and females comprising 46.77%. The median lingual canal was found in the Supra and Infra spinosum (65.38%). Most participants had lateral lingual canals (60.92%). The most prevalent lingual foramina was 4 (30.62%). The study found no significant associations between gender and LF diameter, distribution in different travel directions, or LF locations. However, males had a slightly larger diameter.

Conclusion:

The findings provide valuable insights into LF variations based on anatomical locations, and there were no statistically significant differences in measurements across different age groups. This knowledge contributes to the evolving field of oral and maxillofacial surgery, ensuring better patient outcomes.
Anticancer Effects of Ethanolic Extracts of Macaranga Peltata Leaves on Human Oral Squamous Carcinoma Cell Lines: An In Vitro Study
Authors: Nizar Amjitha , Ravindran Rathy , Palani Jayanthi , Nripan T. , Asha S. D. , Pynadath Meera K.
Published: April 2024

ABSTRACT

Cancer is a disease resulting from the disruption of cell cycle regulation, leading to the abnormal and unchecked proliferation of cells. Medicinal plants are rich in various bioactive phytochemicals or nutritional compounds. The aim is to determine the cytotoxic and genotoxic effects of ethanolic extracts of Macaranga peltata leaves on human oral cancer cell lines. The study setting was centre for Research on Molecular and Applied Sciences, Azeezia College of Dental Sciences and Research. The study design is a Comparative In Vitro study. Shade dried leaves of Macaranga peltata were subjected to Soxhlet extraction, and ethanolic extract was prepared. In vitro cytotoxic effects on human oral cancer cell lines were evaluated by (3-(4,5-dimethyl thiazole-2yl)-2,5–diphenyl tetrazolium bromide) MTT assay, and genotoxic effect was evaluated by comet assay. Untreated cell lines were used as control, and 5-fluorouracil was used as positive control. All experiments were performed in triplicates, and results were represented as Mean+/- SE. One-way ANOVA and Dunnet test were performed to analyze data. ***P < 0.001 compared with the control group. The ethanolic extract of Macaranga peltata exhibited cytotoxicity against oral cancer cells (LC50: 40.193089 μg/ml). There was a concentration-dependent increase in cell death, and at 100 μg/ml, the extract was most effective, causing 50% inhibition of viability. The comet assay showed significant genotoxic effects compared with 5-fluorouracil and untreated oral cancer cell lines. The ethanolic extract of Macaranga peltata leaves was subjected to MTT assay and comet using KB cell lines. The study concludes that the extract gave promising result for the anticancer activity on the KB cell lines producing cytotoxicity and genotoxicity.
The GC-MS Analysis of Kabasura Kudineer: A Vital Siddha Drug in COVID-19 Therapy
Authors: Sudhan Aparna , Prabhu K , Jones Sumathi , Balakrishnan Deepalakkshmi , Muttevi Hayagreva Kumar , Kalaivannan J
Published: April 2024

ABSTRACT

Introduction:

This study focuses on the gas chromatography-mass spectrometry (GC-MS) analysis of Kabasura Kudineer, a Siddha formulation renowned for its properties against cold and exclusively utilized during the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

The medication was obtained from a reputable Siddha vendor in Chennai, India, and subsequently extracted and subjected to GC-MS analysis.

Results:

The GC-MS profiling revealed the presence of several molecules, including benzoic acid, eugenol, alpha-ylangeneol, trans-2,4-dimethylthiane, S, S-dioxide, humulene, methyl 4,7,10,13-hexadecatetraenoate, 17-octadecynoic acid, 1-hexadecyn-3-ol, 3,7,11,15-tetramethyl, sulfurous acid, butyl heptadecyl ester, chloroacetic acid, tetradecyl ester, n-propyl cinnamate, oleyl alcohol, trifluoroacetate, 1-heptatriacotanol, and fenretinide. These compounds exhibit expansive medicinal roles.

Conclusion:

Kabasura Kudineer emerges as a highly effective remedy for cold-related ailments, particularly owing to the presence of bioactive compounds such as eugenol and humulene. These constituents play pivotal roles in antimicrobial and anti-inflammatory activities. Further investigations into the individual medicinal efficacy of each identified molecule are warranted to substantiate the therapeutic potential of Kabasura Kudineer, providing valuable insights for future applications.
Canal-Centering and Apical Transportation Ability of Similar Cross-Section NiTi Instruments Working with Different Kinematics—Micro-CT-based In Vitro Analysis
Authors: Shareef Mohammed S. , Reddy Smitha , Habeeb Aisha , Singh Thakur Veerandar , Firdaus Tamanna , Bhattacharjee Priyendu
Published: April 2024

ABSTRACT

Objective:

Evaluating the canal-centering and apical transportation ability of endodontic file systems working with different kinematics but of similar cross section.

Materials and Methods:

Sixty human maxillary first molar mesiobuccal (MB) roots were assigned to three experimental groups based on instrumentation techniques: Reciproc Blue (RB), Mtwo (M2), and OneShape (OS). Pre- and post-instrumentation micro-computed tomographic analysis was performed. Centering ability and apical transportation were analyzed at 3 mm, 6 mm, and 9 mm short of the apex. Statistical analysis was conducted using Mann–Whitney U test and Kruskal–Wallis test.

Results:

OS showed better canal-centering ability than RB and M2 at 3 mm, 6 mm, and 9 mm. No significant difference among the tested groups was observed during the assessment of apical transportation (P < 0.05).

Conclusion:

The systems evaluated safely prepared curved MB canals with minimal canal transportation. OS showed superior canal-centering ability compared to the other two groups.
A Pharmacy-Based Cross-Sectional Study to Assess the Antibiotic Prescription Pattern by Medical and Dental Practitioners in Saudi Arabia
Authors: Almutairi Waleed , Alrasheed Ali S. , Alaglan Yasir K. , Aleyeoni Saleh , Almogbel Abdulmajeed
Published: April 2024

ABSTRACT

Introduction:

The misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have emphasized the need to reduce and limit the precipitation. In this study we aimed to identify the prevalence, type, dose, and duration of antibiotics prescribed by general medical and dental practitioners in Saudi Arabia.

Materials and Methods:

This cross-sectional study was performed from April 2020 to December 2020. A total of 45,100 antibiotic prescriptions were collected from different governmental and private pharmacies and screened to be included in this study. Data extraction from all prescriptions followed a standardized form that included the following information: Doctor specialty, type of antibiotic, duration, and dose of antibiotic.

Results:

A total of 38,175 antibiotic prescriptions prescribed by licensed doctors practicing in governmental or private hospitals were included in this study. Thirty-five thousand one hundred and seventy-eight (92%) outpatient antibiotics were prescribed by medical practitioners, and 2997 (8%) antibiotics were prescribed by dentists. The most commonly prescribed antibiotic was Augmentin (60%), followed by metronidazole and amoxicillin (35%). The most common dose and duration prescribed by dentists for Augmentin was 625 mg, 3 times per day for 5 days, whereas that of metronidazole was 500 mg, 3 times per day for 7 days. Prescribed dose and duration of amoxicillin was 500 mg, 3 times per day for 7 days.

Conclusions:

This study helps in understanding healthcare practitioners’ patterns and adds to the knowledge on how to deal with odontogenic infections. Further national studies are recommended to include more regions in Saudi Arabia and to illustrate the misuse of outpatient antibiotics.
Sodium Alginate Chitosan Crosslinked Hydrogel Amoxycillin Absorption Properties
Authors: Kannan Madhumita , Kalpana R. , Kumar Vinay
Published: April 2024

ABSTRACT

Wound healing refers to the replacement of destroyed or damaged tissue of a living organism by newly produced tissue, and the time taken is known as wound regeneration time. Wound care is a major challenging biomedical field due to the delayed healing process or delayed wound regeneration time. The factors responsible for delayed wound healing are poor oxygen flow, less exposure to moisture, diseases such as diabetes and cancer, etc., Wound dressings that are formulated from biopolymers such as chitosan, chitin, and cellulose have properties such as biocompatibility (compatible with living systems and does not cause any immunological rejection), biodegradable, nontoxic with minimal side effects, anti-microbial, anti-inflammatory properties. Chitosan is obtained from scales of fish and shrimp. It contains highly reactive amine groups and sodium alginate, which is a polysaccharide produced from seaweed and bacteria and is biocompatible with living systems and biodegradable polysaccharides. This study is based on the development of sodium alginate crosslinked hydrogel and testing the properties of hydrogel with amoxycillin drug and water release property of the drug.
Polyethylene Glycol Cross-Linked Hydrogel for Drug Absorption Properties
Authors: Durairaj VTA , Kalpana R , Kumar Vinay
Published: April 2024

ABSTRACT

Three-dimensional polymeric networks called hydrogels have drawn a lot of interest in a variety of biomedical applications because of their distinctive qualities, like high water content and biocompatibility. Hydrogels can be strengthened mechanically and become more stable via cross-linking. In this study, we described the synthesis and characterization of a cross-linked hydrogel made of polyethylene glycol (PEG) capable of absorbing drug. The hydrogel was created by using a polymerization procedure to cross-link PEG chains. In order to allay this worry, we added particular functional groups to the hydrogel matrix that had a strong affinity for glutaraldehyde. These functional groups made it easier for excess glutaraldehyde to be absorbed and sequestered inside the hydrogel, lowering its cytotoxic potential. After incubation with the hydrogel, the residual glutaraldehyde concentration in solution was measured in order to assess the glutaraldehyde absorption potential.
Daily Use Water Bottles as a Hub for Microbial Population: A Comparative Study of PET vs. Stainless Steel Water Bottles and Outcome of Washing Strategy Intervention
Authors: Hariharan Ashvikka Vijayalakshmi , Sankar Manimuthu Mani
Published: April 2024

ABSTRACT

Water bottles for everyday usage are a typical addition to people’s life and offer a practical way to stay hydrated. Even though safe and clean water is preferred for consumption, the water bottle or container used to drink water was never considered to be cleaned. Here, we examined the adhering microbial populations in water bottles composed of stainless steel (SS) and polyethylene terephthalate (PET). A total of 30 water bottles—15 PET and 15 SS—were gathered from different users. To identify and quantify the adhering microbial populations, microbial swabs from the inside surface of the bottles were collected and later cultivated on certain growth media. Overall the microbial load of PET is significantly higher than the SS water bottles of 68.8 + 19.1 cfu/ml and 35.4 + 8 cfu/ml respectively at initial sampling (P = 0.0027). We also evaluated the efficiency of various cleaning procedures in eliminating adherent bacteria populations. The cleaning strategy significantly reduced the microbial load (P<0.0001). The mean load observed was 11.2 + 2.3 cfu/ml post-wash. This comparison study offers important new information about the adherent microbial populations found in SS and PET water bottles used every day, in the end. This finding emphasizes the necessity of routine cleaning and upkeep of these bottles to reduce the possibility of microbial contamination and the accompanying health risks.
Phytochemical Analysis of Silver Nanoparticles of Psidium guajava Leaf Extract and Evaluation for Its Antibacterial Property
Authors: Raghupathy Sanjana , Sivalingam Azhagu Madhavan , Brahma Neha , Alex Arockia
Published: April 2024

ABSTRACT

Nonessential heavy metals are toxic to human health. In this study, mercury, a hazardous metal, was detected by colorimetric analysis using Murraya koenigii. The eco-friendliness of this method was also emphasized. UV spectrum is a broad peak observed at 200–250 nm in P. guajava leaf extracts. The UV spectrum of green synthesized P. guajava exhibited an absorption band of 418 nm, which confirms the nanoparticle synthesis. FTIR analysis of the vibrational peak around 3307 cm−1 is assigned to ν(O–H) stretching that could possibly emanate from carbohydrates or phenolics. The peaks found around 2917 and 2849 cm−1 are ascribed to the –C-H stretch of the alkyl group, and the peak around 1625 cm−1 is due to the enolic β-diketones or -C = O stretch of carboxylic acids, while the corresponding -C-O stretch is observed around 1375 and 1029 cm−1. The assignment of peaks is similar. It is clear from the SEM image that the constituent parts were non-uniform sphere-shaped, agglomerated, and of an average size of 30.9 nm. XRD analysis was utilized to determine the structural characteristics and crystalline nature of P. guajava. The observed intensity peaks at 32.35°, 36.69°, 39.24°, 44.76°, 59.42°, and 67.35° represent the 2θ values for P. guajava in the diffraction pattern, aligning with the values in the standard database. The synthesized AgNPs tested antibacterial properties against various strains of microorganisms, including Escherichia coli, 25 μg/mL 6.02 ± 0.17 and 100 μg/mL 7.3 ± 0.05, Staphylococcus aureus, 25 μg/mL 05.02 ± 0.07 and 100 μg/mL 11.3 ± 1.12, Streptococcus mutans, 25 μg/mL 04.02 ± 0.19 and 100 μg/mL 11.1 ± 0.11, Enterococcus faecalis, 25 µg/mL 0.8.05 ± 0.11 and 100 µg/mL 11.7 ± 0.02. The short novelty of Psidium guajava (guava) lies in its potential relevance to human health, as it has been found to possess bioactive compounds with various medicinal properties, such as antimicrobial, antioxidant, and anti-inflammatory activities, making it a promising natural resource for therapeutic applications.
Pharmacological Effect of In Vitro Antioxidant Property and Green Synthesis of Silver Nanoparticles (AgNPs) Utilizing Murraya koenigii Antibacterial Application
Authors: Vinyagamoorthy Sneha , Sivalingam Azhagu Madhavan , Alex Arockia , Brahma Neha
Published: April 2024

ABSTRACT

Background:

Nonessential heavy metals pose a significant threat to human health due to their toxicity. Mercury, in particular, is identified as a hazardous metal. The study aims to detect mercury using colorimetric analysis with Murraya koenigii, emphasizing the eco-friendliness of the method.

Aims and Objectives:

The primary objective is to detect mercury using a colorimetric analysis method employing Murraya koenigii. Additionally, the study aims to investigate the eco-friendliness of this detection method.

Materials and Methods:

Colorimetric analysis was conducted using Murraya koenigii to detect mercury. Ultraviolet-visible (UV-vis) spectroscopy was employed to detect the formation of silver nanoparticles (AgNPs), with a characteristic surface plasmon resonance (SPR) band observed. X-ray diffraction (XRD) data analysis was performed to determine the crystalline nature and size of AgNPs. Scanning electron microscopy (SEM) was utilized to visualize the morphology of AgNPs. Fourier transform infrared (FTIR) spectroscopy was employed to identify functional groups involved in reducing silver ions. Antibacterial properties of synthesized AgNPs were tested against various microorganisms, including Escherichia coli, Staphylococcus aureus, Streptococcus mutans, and Enterococcus faecalis.

Results:

Mercury was successfully detected using colorimetric analysis with Murraya koenigii. Formation of AgNPs was confirmed by UV-vis spectroscopy, with a characteristic SPR band at 418 nm. AgNPs were found to be crystalline with an average size of 5.20 nm, as determined by XRD analysis. SEM images revealed spherical and polycrystalline AgNPs. FTIR spectra indicated the involvement of the -OH group of compounds in the extract in reducing silver ions. Synthesized AgNPs exhibited antibacterial properties against various microorganisms.

Conclusion:

A sustainable and eco-friendly method for synthesizing AgNPs using Murraya koenigii extract was successfully developed. This method not only detected mercury but also demonstrated antibacterial properties against various microorganisms. The study underscores the health implications of nonessential heavy metals, emphasizing the importance of eco-friendly detection and mitigation methods.
Sesuvium Portulacastrum Potentiates Anticancer Activity by Facilitating the Expression of IRS-1/AKT Signalling: An In vitro Study
Authors: Mukundh S Tarun , Veeraraghavan Vishnu Priya , Panneerselvam Swetha , Jayaraman Selvaraj
Published: April 2024

ABSTRACT

Sesuvium portulacastrum, a coastal medicinal plant with traditional uses has shown promising biological activities including anti-inflammatory, antioxidant and antimicrobial properties. However, the mechanisms of action active ingredients of this plant have not been studied. Aim of the current study is to investigate the anticancer activity of Sesuvium portulacastrum using in vitro and in silico analysis. The in vitro assays included NO radical scavenging activity, total phenolic and flavonoid content determination. The data were analysed by one-way-ANOVA and p<0.05 was considered as statistically significant. The phytochemical analysis showed the presence of tannins, steroids, terpenoids and phenols. Antioxidant activity of S. portulacastrum showed the dose dependent effect of nitric oxide radical scavenging activity. In silico analysis showed a better binding affinity with IR, IRS1 and Akt molecules which demonstrated the action of bioactive compound of S. portulacastrum against IRS-1/AKT signalling pathway.
Elucidating the Role of Pelargonidin-3-O-Glucoside on C1QL3, CYBB, and CYTIP Involved in Glucose Metabolism: An In Silico Approach
Authors: Krishna Aravind , Renu Kaviyarasi
Published: April 2024

ABSTRACT

Aim:

The metabolism of glucose is carefully regulated by several chemical elements and plays a critical part in preserving cellular energy balance. Our study investigates possible connections between the essential proteins CYTIP, C1QL3, and CYBB, which are involved in the metabolism of glucose, and pelargonidin, a naturally occurring plant chemical. The underlying mechanisms of pelargonidin’s anti-diabetic effects are still unknown.

Materials and Methods:

We examine the binding affinities and possible binding sites between pelargonidin and C1QL3/CYBB AND CYTIP using molecular docking simulations. The results demonstrate favorable docking scores and potential binding sites, suggesting the formation of stable complexes between pelargonidin and the target proteins.

Results:

This finding means that pelargonidin may modulate the function of C1QL3 and CYBB, CYTIP consequently influencing glucose metabolism.

Conclusion:

This study provides a foundation for future experimental investigations to validate the predicted interactions and explore the mechanisms through which pelargonidin affects glucose metabolism. Understanding these molecular interactions could lead to the development of new therapeutic strategies for glucose metabolism and its related disorders.
Retrospective Case Study on the Evaluation of Inflammatory Markers, Macrophage Inhibitory Protein-1α and Interferon-γ in Sleep Deprivation Condition
Authors: Visallini T.S. , Parameswari R.P.
Published: April 2024

ABSTRACT

Background and Aim:

Sleep is an important physiological process that is necessary for the normal functioning of the body. Sleep greatly affects all aspects of our body, including the immune pathways or immune response system of our body, which plays a determinant role in the development and progression of chronic inflammatory diseases. In this study, we worked to find the relation between sleep deprivation and levels of pro-inflammatory markers macrophage inflammatory protein 1-alpha (MIP-1α) and interferon gamma (IFN-γ). To find the relation between sleep deprivation and levels of pro-inflammatory markers MIP-1α and IFN-γ.

Objective:

To find the relation between sleep deprivation and levels of pro-inflammatory markers MIP-1α and IFN-γ.

Materials and Methods:

The study was conducted with 40 individuals as participants, of which 20 were sleep-deprived (SD), and 20 had adequate amounts of sleep. The sleep duration details of the individuals were obtained by questionnaire. Blood was withdrawn from all the subjects after due consent from them. Plasma was separated and was used to evaluate their MIP-1α levels and IFN-γ levels.

Results:

The MIP-1α levels and levels of IFN-γ were found to be significantly elevated in the SD individuals than that of individuals who had adequate sleep.

Conclusion:

Sleep loss and sleep deprivation are associated with altered expressions of key regulatory factors and upregulation of pro-inflammatory cytokines production. Thus, sleep deprivation can be considered to be one of the major contributors to the development and progression of various chronic inflammatory diseases.
Microneedling with PRP for Acne Scars: A New Tool in Dermatologist Arsenal - A Scoping Review
Authors: Meghe Soham R. , Madke Bhushan , Singh Adarshlata , Kashikar Yash , Rusia Kaveri
Published: April 2024

ABSTRACT

Acne scars can greatly impact patient quality of life. While treatment options have included mi- croneedling, the recent addition of platelet-rich plasma (PRP) to this regimen has led to an increased popularity of combination treatment. Here, we aimed to review the efficacy of microneedling and PRP therapies and review the literature on combination treatment for acne scars.
Awareness of Side Effects of Corticosteroids among Users and Nonusers in Saudi Arabia
Authors: Al-Jabr Khalid H. , Alhumaidan Lama Saleh , Alghamdi Abdullrahman A. , Almutairi Meshari Sanad L. , Alsubaihi Abdulrahman Abdullah , Alrasheedi Sami M. , Alkhdairi Ahmad , Alzweihary Ali M , Alrasheedi Majed Swailem , Alrasheedi Khaled Ali Mohammed , Alrashdi Mousa Nasser
Published: April 2024

ABSTRACT

Background:

Corticosteroids are anti-inflammatory medications that are used to reduce inflammation and inhibit the immune system in a variety of disorders, including allergies, asthma, systemic lupus erythematous, eczema, inflammatory bowel disease, and swollen joints or muscles. The goal of this study was to assess the level of awareness and sources of information about the side effects of corticosteroids among the general population in Saudi Arabia.

Methods:

This observational cross-sectional study was conducted in Saudi Arabia using an electronic questionnaire. A non-probability convenience sampling technique was used. Statistical Package for the Social Sciences (SPSS) was used for data analysis.

Results:

The study included 755 participants from Saudi Arabia (67.3% females and 32.7% males). Around 26.8% reported using corticosteroids, and 73.9% were aware of the side effects of glucocorticoids. Among steroid users (202 participants), the most common conditions were allergies (36.1%), asthma or chronic obstructive pulmonary disease (COPD) (21.8%), and skin diseases (27.7%). The majority of respondents (57.9%) used steroids for less than 2 weeks, and topical application (52.5%) was the most common form. Only 30.7% received information about side effects at the time of prescription. The most reported side effects were truncal obesity, moon face, skin thinning, bruising, and slower wound healing.

Conclusion:

This study highlights the importance of promoting awareness and knowledge regarding the side effects of corticosteroids in Saudi Arabia. While overall awareness levels were relatively satisfactory, specific side effects require further attention in educational efforts.
Evaluation of Interstitial Fibrosis and Tubular Atrophy (IFTA) in Renal Allograft Biopsies:- Comparison of Visual Analysis with Morphometric Quantification and its Correlation with Renal Function
Authors: Paliwal Gourang , Kritya Mangesh , Prakash Sudeep , Kashif Ahmed Waheed , Sahu Rajesh
Published: April 2024

ABSTRACT

Introduction:

With the increase in number of allografts being performed, the frequency of chronic allograft nephropathy (CAN) has also increased. It is characterized clinically by a progressive decline in glomerular filtration rate, and histologically, by a progressive interstitial fibrosis (IF) and tubular atrophy (TA) which can even be seen in recipients with good allograft function.

Objectives:

To compare visual analysis with morphometric quantification of interstitial fibrosis and tubular atrophy (IFTA) in renal allograft biopsies and its correlation with renal function.

Materials and Methods:

A total of 29 renal allograft biopsies were evaluated for fibrosis and tubular atrophy by light microscopy by visual method on Masson’s trichrome-stained and PAS-stained sections, respectively, as well as by computer-assisted morphometry. IFTA was graded as per Banff working classification of renal allograft pathology, which includes a four-point estimate of the prevalence of IF (ci score) and for tubular atrophy (ct score). The estimation of IF and TA by the two methods was correlated with the renal function state; the serum creatinine level.

Result:

The percentage of IFTA showed statistically significant correlation between manual and morphometric methods (P < 0.001). Each of the method was correlated with serum creatinine level. IF showed a good correlation with serum creatinine by both the methods; however, no correlation could be established between TA and serum creatinine by either method.

Conclusion:

When calculating scoring IFTA as per Banff criteria, by either the visual method or the morphometric method, there was a significant correlation between the two methods. However when expressed only as a percentage of total area, the visual method was associated with slight overestimation of both the parameters.
Carbapenem Resistant Acinetobacter baumannii: Current Status of Problem in a Tertiary Care Hospital, Jaipur
Authors: Rajni Ekadashi , Kataria Shaveta , Garg Vishnu , Jorwal Ayushi , Bacchani Daisy , Sharma Richa
Published: April 2024

ABSTRACT

Background:

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a serious global health challenge. It is increasingly associated with nosocomial infections and outbreaks in healthcare facilities. This study was conducted in a tertiary care teaching hospital in Jaipur to quantitate the burden of CRAB in our setup, examine the clinico-epidemiological profile of patients infected with this bug, and determine their antibiotic susceptibility pattern.

Methods:

Clinical specimens collected from patients admitted in various wards and ICUs were processed. Bacterial identification and susceptibility testing were done using standard laboratory techniques and VITEK 2 automated system. Only one isolate per patient was included for study purposes. The data on the sociodemographic and epidemiological profile was collected and analyzed statistically.

Results:

A total of 4897 clinical samples were received in the department of microbiology during the study period, out of which 1517 exhibited significant growth, sample positivity rate being 31%. Acinetobacter baumannii was the third most common gram-negative isolate (228/1067; 21.3%). Out of the total 228 A. baumannii isolates, 221 (97%) were carbapenem resistant. The maximum number of CRAB isolates were obtained from endotracheal secretions (103), followed by blood (59). All patients were critically ill and needed intensive care. The antibiotic susceptibility testing of these clinical isolates revealed a high level of resistance (99%) against ceftazidime, meropenem, and imipenem with the least resistance against colistin (2%) and tigecycline (9%).

Conclusions:

CRAB is an important global pathogen contributing to increased morbidity and mortality in hospitalized patients. Viable treatment options that may be used with success against bugs include minocycline, tigecycline, and polymyxins.
Prevalence of Thrombotic Microangiopathy Among Patients With Snake Bite-Induced Hemotoxic Clinical Syndrome in the Hills of Himachal Pradesh, India
Authors: Ihsan Haseeb , Raina Sujeet , Raina Rashmi K. , Sharma Rajesh
Published: April 2024

ABSTRACT

Objective:

Snakebite envenomation-related thrombotic microangiopathy (TMA) is observed in a subset of patients with venom-induced consumption coagulopathy (VICC). The study was planned to determine the prevalence of TMA among patients with hemotoxic envenomation admitted to a medical college hospital in Himachal Pradesh, India.

Methods:

This was a hospital-based open cohort observational study conducted on patients diagnosed with hemotoxic envenomation. The study period was of 1 year and patients were recruited using a nonprobability sampling method. Hemotoxic envenomation was defined as prolonged bedside 20-min whole blood clotting time (20 WBCT) following a history of snake bites. TMA was defined as the triad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI).

Results:

A total of 56 patients (32 females and 24 males) were included in the study. The prevalence of TMA was (7/56) 12.5%. Out of the seven patients with TMA, four (57.1%) patients improved without renal replacement therapy and three (42.9%) patients took referrals for getting nephrology services outside the state and hence were lost in follow-up. AKI was developed in 17 (30%) patients.

Conclusion:

The study demonstrated that TMA is not an uncommon entity. Investigation protocol for TMA should be included in all patients with VICC.
Ultrasound-Guided Thoracolumbar Interfascial Plane Block with and Without Dexamethasone: A Comparative Study in Patients Undergoing Lumbar Spine Surgeries
Authors: Tarigonda Sumanth , Papireddy Sujatha M. , Senthamarai Shrieaswari , Voleti Vishnuvardhan , Srinivasa Manohar
Published: April 2024

ABSTRACT

Background:

Thoracolumbar interfascial plane (TLIP) block is a novel regional anesthetic technique that can provide effective postoperative analgesia in patients undergoing lumbar spine surgeries. This block targets the dorsal rami of thoracolumbar nerves as they pass through the paraspinal muscles. Multilevel spine surgeries are often prolonged, requiring extended duration of postoperative analgesia.

Objective:

To compare the duration and quality of postoperative analgesia of TLIP block when given with and without dexamethasone as an additive to bupivacaine.

Methodology:

This was a prospective, double-blinded randomized study done on 20 patients undergoing two- or three-level lumbar spine surgeries. Ten patients in group C received 20 ml of 0.25% bupivacaine alone, whereas 10 patients in Group D received 8 mg dexamethasone along with 20 ml of bupivacaine for TLIP block before skin incision. Time for first analgesic request and pain scores using Wong–Baker Faces Pain Rating Scale were measured postoperatively.

Results:

The mean duration of sensory block was longer in group D when compared to group C (502.00 ± 95.13 vs. 383.5 ± 54.53 min with a P value of 0.001). The amount of rescue analgesic requirement was also higher in group C compared to group D.

Conclusion:

Dexamethasone, as an additive to bupivacaine, prolongs the duration and improves the quality of TLIP block for lumbar spine surgeries.
Predictors of Mortality in Acute Bacterial Meningitis in Outborn Neonates with Late Onset Sepsis
Authors: Meshram Rajkumar M. , Dudhbhate Satish A.
Published: April 2024

ABSTRACT

Introduction:

Neonatal bacterial meningitis (NBM) is the most devastating complication of late-onset sepsis with incidence ranging from 12.5% to 61.11% with a mortality rate of 16-45.5% and disability rate of 25-50%.

Objectives:

To estimate the clinical and laboratory predictors of mortality in outborn neonates with NBM.

Methods:

A prospective observational study was carried out on 150 outborn neonates with late-onset sepsis and with clinically diagnosed meningitis; and CSF biochemical abnormalities with or without CSF culture positivity at a tertiary care teaching hospital in central India over a period of 2 years. Data on demographic, maternal, neonatal, and socio-cultural factors were recorded and analyzed using a univariate and multiple regression model.

Results:

Distance travelled more than 150 km (OR 1.01, CI 1.0-1.02, P = 0.04), transport duration >3 hrs (OR 4.58, CI 2.07-10.11, P < 0.0001), premature rupture of membrane >24 hours (OR 9.68, CI 2.14-43.70, P < 0.0001), transaminitis (SGPT >40IU/L) (OR 0.93, CI 0.88-0.97, P < 0.003), CSF turbidity (OR 16.70, CI 4.45-62.70, P < 0.0001), raised CSF protein (OR 8.81, CI 1.45-53.34, P = 0.018), and low CSF sugar (OR 20.48, CI 4.18-100.26, P < 0.0001) were independent predictors of mortality in neonatal meningitis on multivariate analysis.

Conclusion:

Anticipation, early recognition, and prompt treatment of maternal, neonatal, socio-cultural, and laboratory risk factors are important to reduce the mortality of devastating complication of late-onset sepsis.
Histopathologic Spectrum and Clinicopathologic Concordance of Pediatric Skin Biopsies: 18-Year Experience in a Tertiary Hospital in Southeast Nigeria
Authors: Ndukwe Chinedu O. , Eziagu Uchechukwu B. , Eni Anthony O. , Nnamani Christian S. , Alexander Amuche K.
Published: April 2024

ABSTRACT

Background:

Many studies have evaluated the spectrum of pediatric skin disorders in outpatient, inpatient, and emergency settings in different regions of Nigeria. However, literature analyzing histopathological data of dermatologic diseases in children undergoing biopsy or excision of skin lesions in Nigeria is lacking. The present study was aimed at determining the spectrum, frequency, and clinicopathologic diagnostic concordance of pediatric dermatopathological lesions at a tertiary care hospital in southeast Nigeria.

Materials and Methods:

This is a retrospective cross-sectional study undertaken at the department of Histopathology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All pediatric (up to 18 years old) skin biopsies received at the department of Histopathology, NAUTH, Nnewi over an 18-year period from January 2004 to December 2021 were included in the study. Relevant clinical and demographic data had been collected from the request forms. For ease of analysis and comparison with other skin studies, the skin lesions were classified according to the International Classification of Diseases, Tenth revision (ICD-10) (2019), for disorders of the skin and subcutaneous tissue.

Results:

Pediatric skin biopsies constituted 20.2% of all the skin biopsies received at our laboratory during the study period, with a male to female ratio of 1:1. The initial clinical diagnosis was concordant with histopathologic diagnosis in 88 out of 189 cases (46.6%). Forty-nine percent of biopsies/excisions were performed in the head and neck area. The most common diagnostic categories, in decreasing order of size, were neoplasms, disorders of skin appendages, papulosquamous disorders, and infections. Only about a quarter of neoplasms were malignant.

Conclusion:

Our study has documented the importance of histopathology as a gold standard in the diagnosis and management of skin lesions. Improved training of primary care physicians and closer cooperation between pediatricians, dermatologists, and pediatric surgeons will increase the chances of accurate diagnosis.
Mothball (Naphthalene) Poisoning in Adults: A Case Series
Authors: Chand Subhash , Rao Pallavi , Raina Sujeet
Published: April 2024

ABSTRACT

We describe a series of six patients with naphthalene ball intentional poisoning in adult patients. A 41-year-old male developed methemoglobinemia, intravascular hemolysis, and hemoglobinuria. The patient was managed by intravenous methylene blue, ascorbic acid, N-acetylcysteine, and packed red blood cell transfusion. Rest of the patients had mild symptoms and were managed symptomatically. All the patients had a favorable outcome. The relationship between features of the toxidrome and serum levels of methemoglobin is analyzed. The supportive role of gastric lavage and methylene blue is being discussed.
Neurological Involvement in Dengue: An Autopsy Study
Authors: Bhatia Ravjot Singh , Bhatia Jasvinder Kaur
Published: April 2024

ABSTRACT

Dengue is a mosquito-borne disease that is a public health concern and outbreaks have increased in India. The virus produces fever, hemorrhagic fever, and shock syndrome. Dengue may cause encephalopathy. Few autopsies in individuals with neurological complaints have been documented. Our paper reports on an adult with dengue and neurological symptoms with postmortem findings. Thirty-six-year-old presented with a 2-day fever. He was febrile with a normal systemic exam. By evening, he was stuporous. His platelet count was moderately decreased to about 80,000/cumm. His serum and cerebrospinal fluid (CSF) were positive for dengue non-structural (NS) 1 antigen (Ag). He deteriorated and succumbed on day 4. An autopsy was performed to determine the cause of death. On examination, the brain was edematous with frontoparietal, internal capsule, and brain stem hemorrhages. Microscopy showed vascular congestion, edema, multiple hemorrhages, and liquefactive necrosis. In India, diagnostic testing is limited. This patient’s platelet count was not too low, but postmortem findings of brain hemorrhages highlight the necessity of recognizing its uncommon manifestations.
Demographics, Clinical Presentation, and Surgical Procedures Performed for the Persistent Vitellointestinal Duct During Infancy: A Systematic Literature Review of the Past Fifty Years from 1971 to 2021
Authors: Ghritlaharey Rajendra K.
Published: April 2024

ABSTRACT

The persistent vitellointestinal duct is the rarest of all vitelline duct anomalies. This systematic literature review was undertaken to investigate and review the demographics, clinical presentation, surgical procedure performed, and outcome of infants who were operated upon for the persistent vitellointestinal duct. Infants with incomplete desired details, and children/cases operated upon for the above-mentioned anomaly after infancy were excluded. Published literature/manuscripts were retrieved for the previous fifty years from 1971 to December 2021, and the manuscripts were retrieved through an online database search. This review is presented in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A total of n = 280 infants who were operated upon for the patent vitelline duct were recruited for the systematic review. More than three-fourths (n = 217, 77.5%) of infants were boys. Ninety percent of infants were under the age of 3 months, and 72% were neonates/newborn babies. Discharges through the umbilicus (n = 148; 52.85%), and prolapse of the bowel through the umbilicus (n = 117; 41.78%) were the chief complaints in the above-mentioned infants. Operative procedures were performed (n = 280) in the following order of frequency: (1) resection of the persistent vitellointestinal duct, small adjacent segment of ileum, and ileo-ileal anastomosis (n = 121, 43.21%); (2) resection of the persistent vitellointestinal duct, wedge resection of ileum, and ileal repair (n = 88; 31.42%); and (3) other surgical procedures (n = 11, 3.92%). Operative details were not clear/not available/not provided for n = 60 (21.42%) of the infants. Peri-umbilical incisions were more frequently employed for surgical therapy. This review revealed postoperative death in n = 17 (6.07%) infants. The persistent vitellointestinal duct must be surgically resected at the earliest, preferably during the neonatal period.
Transition from Morphocytochemical Diagnosis to Immunophenotypic Diagnosis of Acute Leukemia: A Flow Cytometry Experience from Southern Odisha
Authors: Patnaik Chaitali , Purohit Prasanta , Behera Samira K. , Pradhan Swayamprabha
Published: April 2024

ABSTRACT

Background:

In today’s generation of targeted therapy, traditional reporting of acute leukemia by morphology using the FAB system of classification has limited uses due to a lack of standardization and use in risk stratification. Immunophenotyping by flow cytometry has gained popularity due to its influence on the treatment and prognosis of the disease. The present study evaluates the judicious application of flow cytometry as an adjunct to morphocytochemical assessment in all newly diagnosed cases of acute leukemia in Southern Odisha.

Materials and Methods:

A total of 61 cases were subjected to complete blood count analysis, peripheral smear examination, bone marrow study, cytochemistry, and those suspected of leukemia underwent flow cytometry analysis using BD FACS CANTO II as per manufacturer’s instructions.

Results:

Out of 61 cases of acute leukemia diagnosed, 35 were acute lymphoblastic leukemia, and 24 were acute myeloid leukemia. There was 96.7% correlation between diagnosis by cytomorphology and flow cytometry. Seven cases showed aberrant expression of various antigens. Two cases of acute leukemia on cytomorphology were diagnosed as hematogones and the other as reactive lymphocytosis on flow cytometry.

Conclusion:

Although morphologic FAB diagnosis is still widely used to classify acute leukemia, flow cytometry has more specificity and should be used as an adjunct to morphology. Along with subclassification of leukemia, flow cytometry can also detect the possibility of an associated genetic abnormality.