bluuebunny/crossref_metadata_2025 huggingface dataset:
Leishmania parasite arginine deprivation response pathway influences the host macrophage lysosomal arginine sensing machinery
Authors: Madan Evanka , Ganguly Nirmal , Puri Madhu , Pawar Harsh , Selvapandiyan Angamuthu , Muthuswami Rohini , Zilberstein Dan , Madhubala Rentala
Published: November 2024

The outcome of infection is greatly influenced by extensive interaction between the metabolic networks of the host and the pathogen. The intracellular protozoan parasite Leishmania donovani causes competition between the host and the parasite for arginine. L. donovani transports arginine via a high-affinity transporter LdAAP3, encoded by two genes LdAAP3.1 and LdAAP3.2. Earlier reports show that upon arginine starvation, cultured Leishmania parasites promptly activate an Arginine Deprivation Response (ADR) pathway, resulting in the stoichiometric up-regulation of LdAAP3.2 mRNA, protein and activity. Lysosomes, on the other hand, employ a specific sensor and an arginine-activated amino acid transporter, solute carrier family 38 member 9 (SLC38A9), which monitors intra-lysosome arginine sufficiency and subsequently up-regulates cellular mTOR kinase activity. The present study investigates the interaction between Leishmania and macrophage-lysosome arginine sensing machinery. We demonstrate that infection with L. donovani activates SLC38A9 arginine sensing in the human monocyte like-macrophage cell line (THP-1) under physiological concentrations of arginine (0.1 mM). However, THP-1 cells infected with LdAAP3.2 null mutants grown in 0.1 mM arginine exhibited reduced expression of SLC38A9 and mTOR. These results indicate that inside the host macrophage, Leishmania overcome low arginine levels by up regulating the transport of arginine via LdAAP3 and SLC38A9 signalling. Furthermore, while LdAAP3.2 null mutants were impaired in their ability to develop inside THP- 1 macrophage, their infectivity and intracellular growth were restored in SLC38A9 silenced macrophages. This study provides the first identification of regulatory role of SLC38A9 in the expression and function of LdAAP3.
High antioxidant capacity may alter the severity and treatment of hypoxic-ischemic encephalopathy in newborns
Authors: Özalkaya Elif , Topçuoğlu Sevilay , Tüten Abdülhamit , Karatepe Hande , Karatekin Güner
Published: November 2024

Background: We compared prooxidant and antioxidant capacity in newborns with mild, moderate, and severe hypoxic-ischemic encephalopathy with a control group. Methods: Twenty-eight newborns were included in the perinatal asphyxia group and 32 healthy newborns were included in the control group. Newborns in the perinatal asphyxia group were divided into two groups as mild hypoxic-ischemic encephalopathy (n=12) and moderate+severe hypoxic-ischemic encephalopathy (n=16) groups according to the Sarnat Classification. Basal venous blood samples were taken from the newborns in the mild hypoxic-ischemic encephalopathy (n=12), moderate+severe hypoxic-ischemic encephalopathy (n=16) and the control group (n=32) at the postnatal 1st hour, and the level of total oxidative stress and total antioxidant capacity were studied. Oxidative stress index was calculated as the percent ratio of total oxidative stress to antioxidant capacity in all newborns. Results: Total antioxidant capacity level was significantly higher in the mild hypoxic-ischemic encephalopathy group (n=12) compared to the control group (n=32) (p=0.04). No statistically significant difference was found between the mild hypoxic-ischemic encephalopathy, moderate+severe hypoxic-ischemic encephalopathy and control groups in terms of total oxidative stress and oxidative stress index Conclusion: High antioxidant capacity predicted the diagnosis of mild hypoxic-ischemic encephalopathy. There is a need for studies showing a cut-off value for antioxidant capacity as a biomarker in the diagnosis of HIE. Maternally given antioxidant therapy can be neuroprotective in newborns with hypoxic-ischemic encephalopathy where there is a clinical picture of mild hypoxic-ischemic encephalopathy in newborns with a high antioxidant capacity. Further studies are needed to evaluate whether maternal antioxidants are neuroprotective in newborns.
Characteristics associated with social anxiety in adults with developmental stuttering: A review
Authors: Bauerly Kim
Published: November 2024

People who stutter are at a greater risk for developing symptoms of social anxiety, with up to 22-60% of adults who stutter meeting the criteria for a clinical diagnosis. Negative attitudes and feelings about speaking and stuttering are reported to emerge as early as the preschool years and are suspected to be due to exposure to negative listener reactions, stereotyping and social isolation. Repeated negative experiences lead to feelings of fear, embarrassment and loss of control during speaking which over time, leads to the development of more severe difficulties with speaking and an overall apprehension to speak as they perceive themselves as an incompetent communicator. The present review aims to summarize risk factors, particularly temperament and environmental factors, that are reported to play a role in the emergence and maintenance of social anxiety in people who stutter. Another aim of this review is to summarize the features of social anxiety reported in adults who stutter, some of which, are similar to high socially anxious fluent speakers (e.g., avoidant strategies) while others are specific to stuttering (e.g., muscle tension). The clinical implications of these findings and recommendations for future research are also discussed.
AROMATHERAPY PROTOCOL FOR OLFACTORY RESTORATION
Authors: Wolffenbüttel Adrian
Published: November 2024

The loss or decrease of smell and taste can be caused by several factors, such as psychotropic medications, chronic rhinitis and sinusitis, neurological pathologies, cancer treatments, postinfectious and posttraumatic olfactory loss, older people, car accident, fire, cigarette smoke, psychological trauma, and other causes. Currently the greatest demand is due to the sequelae of Covid-19, that is the loss of smell. This aromatherapy protocol to restore the sense of smell was developed based on research data and references of the performance of essential oils (EO). EO are lipophilic substances extracted from plant species; they are mainly constituted by terpenic structures which are therapeutic bioactives. The objective of the methodology is to re-sensitize the neural route that allows the identification of aroma and taste. Following this, we recommend the use of EO to restore the health of the respiratory system, immune system, mental and emotional system. It can be observed that the olfactory and gustatory perception improve after one month this protocol is applied. There are researchers though, showing that the average time is 3 months, and it may extend above 8 months. This treatment methodology is based on neural plasticity of the olfactory system, non-invasive and safe procedure, that should thus be considered a simple addition to existing smell treatment methods.
Multidisciplinary Approach to a Complicated Renal Angiomyolipoma: A Case Report Review
Authors: Kawalit Issa
Published: November 2024

Angiomyolipoma (AML) is a benign kidney tumor composed of fat tissue, smooth muscle cells, and significant neovascularization, which can lead to spontaneous hemorrhage, causing hematuria and/or retroperitoneal hematoma with back pain. While nephrectomy can be a first-line treatment, embolization is an effective, less invasive alternative. We present a 41-year-old male admitted with left flank pain. Initial ultrasound revealed a heterogeneous hyperechoic mass in the right kidney, and subsequent CT showed a right renal AML with an arterial aneurysm and perirenal fat hematoma. Despite initial hemodynamic stability, a drop in hemoglobin levels necessitated urgent intervention. Interventional radiology performed endovascular embolization with microparticles and coils, resulting in successful devascularization. This case report discusses the clinical presentation, diagnostic workup, treatment strategy, and successful outcome of this complex case.
Distribution of VDR Gene Polymorphisms in Northern Eurasia Populations
Authors: Kozlov Andrey
Published: November 2024

Maintaining bone health involves a complex balance of factors, including the intake and absorption of minerals such as calcium and phosphorus. These processes are influenced by the presence of vitamin D and its receptor (VDR). The VDR gene is essential for regulating these processes, and variations in the gene can impact bone density and susceptibility to diseases.
Healthcare Leadership: Leading for Creativity, Innovation, and Performance by Changing Organizational Culture in Healthcare
Authors: Paul Jijo
Published: November 2024

Leadership is one of the critical factors for organizational creativity, innovation, and performance. Organizational culture is a significant strategic element that stimulates creativity, innovation, and performance to strengthen the organization and compete. This study aims to investigate and understand the leading role of leadership in creativity, innovation, and organizational performance to foster team performance. Since workplace culture and employee attitudes are vital predictors of organizational innovation and performance, looking deep into leadership roles improves organizational performance by enhancing work culture in healthcare. Innovation sessions provide great opportunities to redesign solutions and encourage divergent thinking in teams, and these innovations dramatically depend on the leaders and the team's psychological safety. Innovative ideas from the teams should be rewarded, and the teams should be encouraged to work flexibly to bring creative ideas forward for further innovations. Organizational performance reports should address goal policies and management limitations; a balanced scorecard method could help leaders balance various pressing parameters. An easy way to diagnose organizational culture is by conducting an institutional survey, which reflects the inner mind of the organization and workplace culture. An organizational culture begins with excellent mission and vision statements guiding leaders to values and objectives. Timeline setup for goals supports the leaders in managing and achieving goals on time, and regular monitoring is suggested to track progress. Demarcating and applying metrics to milestones support progress tracking, and the goal reports identify the organization's vision for growth and expansion. Excellent leaders are desired to promote organizational creativity and innovation to improve organizational performance by enhancing work culture in healthcare.
The Role of Regional Anesthesia in Neonatal Care: A Review
Authors: E. Balverde , Laurent F. Terra , Halty F. Cristiani
Published: November 2024

Effective pain management in neonates is critical, as inadequate treatment can result in both immediate complications and long-term cognitive and behavioral issues. Neonates, particularly preterm infants, have heightened sensitivity to pain, which necessitates the use of specialized pain management techniques. Regional anesthesia (RA) offers significant benefits in this patient population, including reducing the need for opioids and their associated risks, minimizing the stress response, and improving postoperative outcomes. Despite its proven efficacy in pediatric and adult populations, there is limited published evidence regarding RA's use in neonates. This article reviews the fundamental science, clinical applications, and safety considerations of regional anesthesia in neonates, focusing on four modalities: neuraxial blocks, peripheral nerve blocks, fascial plane blocks, and analgesic catheters. While RA has been shown to provide superior pain control and reduce opioid consumption, safety is paramount, especially considering the unique physiological characteristics of neonates.
Long-term cryopreserved umbilical cord derived mesenchymal stem cells: A study on their safety
Authors: Baba Kyoko , Sugimoto Yoshika , Moriyama Kazuno , Kumazawa Kenichi , Sugimoto Takayuki , Yamazaki Yasuharu , Takeda Akira
Published: November 2024

Background: In recent years, mesenchymal stem cells have gained attention in the field of regenerative medicine. While mesenchymal stem cells derived from adipose tissue and bone marrow are well-studied, obtaining sufficient tissue from neonates or infants poses significant challenges. Umbilical cord-derived mesenchymal stem cells are a promising alternative source, as they can be harvested non-invasively and in large quantities with minimal ethical concerns. This study aims to evaluate the safety of long-term cryopreserved umbilical cord-derived mesenchymal stem cells and explore their potential for clinical applications in regenerative medicine. Methods: Umbilical cord-derived mesenchymal stem cells were cryopreserved for periods ranging from 4 years and 5 months to 5 years and 9 months. After thawing, the following assessments were performed: Morphological changes: Cell morphology was observed under a light microscope before and after cryopreservation. Multipotency evaluation: Osteogenic and adipogenic differentiation potentials were assessed to confirm MSC characteristics. Chromosomal stability: G-band staining and Spectral Karyotyping were used to identify numerical and structural chromosomal abnormalities. Tumorigenic potential: Real-time PCR was conducted to measure the expression of telomerase reverse transcriptase, a tumorigenic marker. Results: No significant morphological differences were observed before and after cryopreservation. Both osteogenic and adipogenic differentiation potentials were maintained, confirming the multipotency of the cells. Chromosomal abnormalities were found in 4 out of 168 cells using G-banding, but no abnormalities were detected with Spectral Karyotyping. Telomerase reverse transcriptase gene expression was low, indicating a low risk of tumorigenicity. Conclusion: Long-term cryopreserved umbilical cord-derived mesenchymal stem cells maintain their safety in terms of morphology and function, showing promise as autologous graft material for regenerative medicine. However, further safety evaluations, particularly concerning chromosomal abnormalities, are essential before clinical application.
The US COVID-19 Provider Relief Fund - Adventures and Lessons Learned in Healthcare Financing during a Global Pandemic
Authors: Parente Stephen , Grossbach Anna
Published: November 2024

The 2020 Provider Relief Fund, established by the U.S. Department of Health and Human Services, provided critical financial support to healthcare providers during the COVID-19 pandemic. This fund helped to stabilize the U.S. health economy by offsetting lost revenue and increased costs incurred by healthcare organizations. By ensuring continued operational funding, the relief measures allowed providers to maintain essential services despite the pandemic's disruptions. This financial aid was vital in preventing further strain on the U.S. healthcare infrastructure during an unprecedented global crisis. This paper is an interview with Stephen T. Parente, the health policy architect of the initial $100 Billion COVID Provider Relief Fund.
Exploring experiences and changes in daily and social activities among individuals with spinal cord injury during the COVID-19 pandemic: A longitudinal study
Authors: Simpson Ethan , Singh Gurkaran , Mamman Rinni , Miller William , Borisoff Jaimie , Derakhshan Pegah , Mortenson W. Ben
Published: November 2024

Objectives: To explore experiences and changes in daily and social activities among individuals living with spinal cord injuries over the first 9 months of the COVID-19 pandemic. Materials and methods: In this longitudinal qualitative study, data were collected by conducting semi-structured interviews with participants at four time points (June 2020, July 2020, August 2020, January 2021). Data were analyzed longitudinally using a recurrent cross-sectional approach. Results: The 22 participants had a mean age of 54 years, 13 were male. We identified three main themes: 1) ‘Dealing with the emotional impact of pandemic-related restrictions’ explored feelings of frustration, sources of anxiety, and the importance of adopting a positive mindset; 2) ‘Changing daily routines’ described aspects of normal routines that changed and ways of adapting to those changes; and 3) ‘Revisiting social engagement’ conveyed the struggles caused by a lack of social engagement and coping strategies to overcome them. Conclusion: This study explicates the changes experienced by the SCI community during various points of the COVID-19 pandemic. Participants discussed feelings of frustration, anxiety, and gratitude. They described changes, challenges, and strategies used when navigating life during the pandemic. These findings can facilitate future research to address the challenges faced by this population.
Navigating the Pandemic: Exploring Perspectives of Individuals with Spinal Cord Injury on COVID-19 Resources
Authors: Derakhshan Pegah , Miller William , Simpson Ethan , Scales Tyrone , Chishtie Farrukh , McBride Christopher , Borisoff Jaimie , Schmidt Julia , Mortenson W. Ben
Published: November 2024

The COVID-19 pandemic severely impacted vulnerable populations, such as individuals with spinal cord injury (SCI). Concerns within this group have escalated regarding access to essential services, including caregiver support, equipment maintenance, and medical care during the pandemic. In response, multiple COVID-19 online resources tailored for individuals with SCI were developed and provided. This study aimed to investigate the perspectives of individuals with SCI (n=12) on available COVID-19 online resources and to examine the perceived usability, clarity, and applicability of the resources. In this qualitative description study, we used an online survey and semi-structured interviews to collect data. Survey results indicated that 70% of participants found the resources useful, 65% found them easy to navigate, and 60% were likely to use the information provided, with specific feedback revealing generally positive responses for prevention infographics and text-based mental health resources, mixed feedback for mental health and physical activity videos, and varied responses for caregiver resources. Based on the data from qualitative interviews, three main themes emerged, namely “Quality of information”, “Presentation” and “Delivery of Resources”. Findings highlight the need for more specific, realistic, and actionable information tailored to the SCI community, emphasizing the importance of detailed, visually appealing, and regularly updated resources to effectively support individuals with SCI during health crises.
Insights on detecting clinically significant prostate cancer in PI- RADS v2.1 scores of 4 and 5
Authors: Gharib Mohammad
Published: November 2024

Background: Previous studies have identified various predictors for clinically significant prostate cancer in biopsy-naïve patients. Aims: To identify clinical variables associated with clinically significant prostate cancer diagnosis using systematic biopsy combined with cognitive targeted biopsy. Methods: This retrospective study analyzed data from 76 biopsy- naïve men who underwent systematic biopsy combined with cognitive targeted biopsy due to Prostate Imaging Reporting and Data System (PI- RADS) 4 or 5 lesions detected on prebiopsy prostate multiparametric magnetic resonance imaging between March 2020 and September 2022. Binary logistic regression was used to identify independent predictors of clinically significant prostate cancer, with odds ratio and 95% confidence intervals. Results: The overall detection rate for clinically significant prostate cancer was 44.7%. In univariable analyses, prostate-specific antigen density ≥0.16 ng/ml 2 (odds ratio 57.6 [95% confidence intervals 7.13-464.77]), PI- RADS 5 (odds ratio 10.41 [95% confidence intervals 3.47-31.2]), peripheral zone lesions (odds ratio 3.85 [95% confidence intervals 1.32-11.24]), and biopsy density ≥ 0.26 core/ml (odds ratio 2.95 [95% confidence intervals 1.09-8.01]) were significantly associated with clinically significant prostate cancer (p<0.05) and were entered to multivariable analysis. Considering p<0.2 for selecting variables for multivariable analysis, a single lesion (odds ratio 2.09 [95% confidence intervals 0.81-5.34]) and transition zone lesions (odds ratio 0.45 [95% confidence intervals 0.17-1.14) were also included. According to Multivariable analysis results, prostate-specific antigen density ≥0.16 ng/ml 2 (odds ratio 49.88 [95% confidence intervals 4.96-501.47]) and PI-RADS 5 (odds ratio 19.89 [95% confidence intervals 3.36-117.55]) were significant independent predictors of clinically significant prostate cancer, while peripheral zone lesions (odds ratio 0.97 [95% confidence intervals 0.09-10.05]), biopsy density ≥0.26 core/ml (odds ratio 3.44 [95% confidence intervals 0.46-25.68]), a single lesion (odds ratio 3.34 [95% confidence intervals 0.72-15.5]), and transition zone lesions (odds ratio 1.18 [95% confidence intervals 0.15-8.88]) were not. Conclusions: The clinical implementation of PI-RADS version 2.1 combined with systematic biopsy combined with cognitive targeted biopsy yielded an acceptable overall detection rate for clinically significant prostate cancer. Moreover, PI-RADS 5 and prostate-specific antigen density ≥0.16 ng/ml 2 were significant predictors of positive systematic biopsy combined with cognitive targeted biopsy results.
Essentials of Esthetic Dentistry: Principles, Practice and Progress
Authors: Shronika Dr. , Jain Dr. Gaurav , Misra Prof. (Dr.) Pradyumna
Published: November 2024

Essentials of Esthetic Dentistry-Principles, Practice and Progress is an essential resource for dental professionals and students seeking to deepen their knowledge and refine their skills in the art and science of aesthetic dentistry. This meticulously crafted guide offers a thorough exploration of both the foundational principles and the latest advancements in the field.

The book provides a detailed overview of aesthetic principles, including smile design, tooth morphology, and colour theory. It addresses both the science behind aesthetic procedures and the artistry required to achieve naturallooking results. Comprehensive chapters on various aesthetic techniques, such as tooth whitening, veneers, bonding, and step-by-step protocols and practical tips are included to aid in the execution of these procedures.

The book delves into the latest materials and technologies used in aesthetic dentistry, providing guidance on material selection and application. It includes discussions on composite resins, ceramics, and other innovations that influence aesthetic outcomes. Effective communication with patients is crucial in aesthetic dentistry. This guide explores strategies for discussing treatment options, setting realistic expectations, and achieving patient satisfaction.

The text is grounded in evidence-based research, offering a critical review of current literature and best practices. This ensures that the techniques and recommendations presented are both scientifically sound and clinically relevant.

High-quality photographs, diagrams, and illustrations complement the text, making complex concepts more accessible and enhancing understanding of procedural details. Featuring insights from leading experts in the field, the book offers diverse perspectives and up-to-date information on emerging trends and techniques.

Whether you are a seasoned practitioner seeking to enhance your aesthetic practice or a student eager to gain a solid foundation, Essentials of Esthetic Dentistry-Principles, Practice and Progress is an invaluable addition to your professional library. With its blend of theoretical knowledge, practical guidance, and expert insights, this guide is designed to elevate your practice and achieve outstanding aesthetic results for your patients.
Practical Experiments in Optometry: A Comprehensive Approach
Authors: Sharma Ms Komal
Published: November 2024

Thorough explanation of more than fifty crucial optometry experiments intended for hands-on learning, including step-by-step instructions with thorough diagrams and clinical photos.
Comprehensive descriptions of optical concepts and their medical uses.
Particular attention to maintenance, calibration, and equipment handling procedures.
Each experiment's clinical pearls and troubleshooting advice.
Normative data and quick reference charts for interpreting results.
Documentation methods and quality control guidelines.
For every chapter, there are practice tasks and self-evaluation questions.
Access to digital resources featuring crucial procedure videos.
Written in an easy-to-read style for students and working optometrists.
Discusses the most recent developments in optometric instrument technology.
During procedures, special attention is paid to patient engagement and communication.
Includes clinical examples and real-world case scenarios.
Essential Guide of Anaesthesia - For Anaesthesia Technicians and Residents (Set of 2 Volumes)
Authors: Jain Dr. Amit Kumar , Tripathi Dr. Sonali , Singh Dr. Puja
Published: November 2024

Volume 1

Anaesthesia is more than just a subject—it's a blend of science, skill, and empathy. In these pages, we've woven together the essential elements of cognitive understanding, practical knowledge, and emotional intelligence to provide a holistic learning experience through "Essential Guide of Anaesthesia - For Anaesthesia Technicians and Residents". Explore the foundational pillars of anaesthesia technology in this comprehensive guide designed for technicians and residents. Delve into essential topics including pharmacology, perioperative care, anatomy and physiology, instrumentation, and the rich history of anaesthesia. Each chapter is meticulously crafted to provide clear explanations, practical insights, and visual aids, ensuring a thorough understanding of critical concepts. Whether you're preparing for exams or advancing your career, this book serves as your definitive resource in mastering the fundamentals and complexities of anaesthesia practice.

Volume 2

The book “Essential Guide of Anaesthesia-For Anaesthesia Technicians and Residents (Volume-2)” is divided into chapters that systematically address topics such as Anaesthetic Pharmacology, Perioperative monitoring and management, Postoperative Care, Anesthesia Instruments and Special attention has been paid to key concepts like patient safety, anesthesia pharmacology, and the practical aspects oaf anaesthesia concepts to bridge the gap between theoretical knowledge and clinical application.

The most special thing about this book which makes it different from others is that a full coloured atlas has been included in it, which is providing vivid illustrations that enhance understanding and retention.. In writing this book, we have drawn on our collective experiences in the field, hoping to pass on practical insights that will aid in the decision-making process of anaesthesia practice.

We hope this guide will not only enhance your understanding but also inspire you to pursue deeper knowledge and mastery in the fascinating world of anaesthesia.
Pregnancy dating: Determining gestational age through fetal kidney length-what do we observe?
Authors: Kalliyil Fathimathul Jusna , Narayanan Sai Krishna , Rajan Ambika Prema , Nair Lakshmi Rajappan , Shenoy Heera Trivikrama , Ramakrishnan  , Tajunnisa M
Published: November 2024

Accurate gestational age is crucial for obstetric care, pregnancy management, and preterm labor decisions. Ultrasound, based on fetal biometric parameters, is a reliable method for this purpose. This study aims to estimate gestational age in the third trimester using ultrasonographic methods, focusing on fetal kidney length. Gestational age is estimated in the third trimester by measuring fetal kidney length and comparing it with gestational age derived from other biometric parameters (bi-parietal diameter, head circumference, abdominal circumference, and femur length) and the last menstrual period (LMP).

A nine-month prospective study was conducted Kozhikode, Kerala, from September 2016 to May 2017. The study involved 200 women in their third trimester of pregnancy, utilizing third-trimester ultrasound to measure and document kidney length along with other biometric parameters (BPD, HC, AC, and FL). Subsequently, the collected data was reviewed and analyzed.

: The study revealed a strong positive correlation between fetal kidney lengths (FKL) measured in millimeters and gestational age in weeks during the third trimester. The correlation was significant, with a Pearson's correlation coefficient of 0.87 (p < 0.001). Additionally, FKL exhibited positive correlations with other variables, including abdominal circumference (r = 0.832), head circumference (r = 0.845), bi-parietal diameter (r = 0.838), and femur length (r = 0.837). These findings demonstrated a strong Pearson’s correlation (r= 0.87-0.96, P <0.05) for all the biometric parameters including FKL.

A linear relationship exists between fetal kidney length (FKL) and gestational age, allowing FKL to serve as an effective parameter for estimating gestational age during the third trimester. Given its positive correlation with other fetal biometric parameters such as bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), incorporating FKL alongside these measurements enhances the accuracy of gestational dating in the third trimester. This combination of parameters improves the prediction of gestational age during this stage of pregnancy.
A 5-years cross-sectional study of risk-factors feto-maternal outcomes in placenta accreta spectrum at single tertiary care centre in South India
Authors: Metgud Shridevi Chidanand , Prabhu Gauri Abhishek , Renuka Prasad Murigendrappa
Published: November 2024

: PAS is an abnormal placental trophoblastic invasion into the myometrium, serosa and surrounding structures causing severe maternal morbidity and mortality due to massive obstetric hemorrhage (MOH). The incidence of PAS is on the rise due to increasing rate of Cesarean Section (CS) worldwide.

: This study aimed to assess the risk factors associated with Placenta accreta spectrum (PAS) and to compare the feto-maternal outcomes in elective and emergency delivery in PAS.

This is a 5 years single centre cross-sectional study from 1st January 2018 to 31st December 2022. All diagnosed cases of PAS beyond 28 weeks of gestation were included. A total of 38 cases of PAS were studied. Chi-square test and T-test were used to compare the categorical variables with p value 0f <0.05 as statistically significant.

The incidence of PAS was 1.85/1000 deliveries. Advanced maternal age, previous CS, placenta previa in current pregnancy were major risk factors. MOH was the commonest complication. The blood loss, increased operative time and need for blood transfusions was mainly dependent on the placental location. Prematurity and low birth weight were the most important perinatal outcomes.

Adequate blood and blood products prior to surgery is important as even in expert hands blood loss can be massive. Early referral and specialized regional team to manage PAS at tertiary care are needed. Future studies should emphasize on easy and early detection of PAS.
Randomized comparative study between ferric carboxymaltose and iron sucrose for correction of anemia in antenatal women
Authors: Kollur Ashwini Mallikarjun , Sunita T H  , Hegde Sanchita , Gaddi Mahalakshmi Someshwar
Published: November 2024

Anemia during pregnancy is a significant global health concern. This study aims to evaluate the efficacy and safety of Ferric Carboxymaltose (FCM) compared to Iron Sucrose (ISC) in treating mild to moderate iron deficiency anemia (IDA) in pregnant women.

A randomized prospective control study was conducted with antenatal women suffering from mild to moderate anemia at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital from December 2018 to November 2019. Participants were randomly assigned to either Group A (FCM) or Group B (ISC).

A total of 128 women were randomized, with 64 in each group. The mean increase in hemoglobin was significantly higher in the FCM group (1.34 g/dl) compared to the ISC group (0.98 g/dl) (p < 0.001). FCM required fewer administrations, improving patient compliance. Both treatments were well-tolerated, with minor local reactions observed.

FCM offers a more effective, convenient, and well-tolerated treatment option for IDA in pregnancy compared to ISC.
Menstrual challenges in puberty: Investigating menorrhagia in adolescent girls
Authors: Radhakrishnan Akshaya , Sharma Nidhi , Archunan Priya Aarthy
Published: November 2024

Menorrhagia, defined as excessive or prolonged menstrual bleeding, poses a significant challenge during this developmental stage, potentially impacting the health and well-being of adolescent girls. Despite its prevalence, comprehensive studies on menorrhagia in this specific demographic are scarce. This study aims to address this gap by investigating the underlying causes and treatment outcomes of puberty menorrhagia.

A six-month observational study involving 50 adolescent girls presenting with menorrhagia was conducted at the Department of Obstetrics and Gynecology in a tertiary care center. The study utilized consecutive enumerative sampling and included a thorough investigation of participants, collecting data on demographic profiles, symptom severity, anemia levels, diagnoses, therapy requirements, and responses to conservative management. Baseline investigations encompassed a range of tests, including pregnancy exclusion, complete blood count, coagulation profile, and hormonal assays.

The study cohort of 50 participants revealed varying characteristics: 24% were under 14 years, 34% were between 14-16 years, and 42% were aged 17-19 years. BMI distribution showed 14% below 18.5, 76% between 18.5 and 25, and 10% exceeding 25. Symptom duration included 20% reporting less than 6 months, 34% between 6-12 months, and 46% over 12 months. Etiology analysis indicated 60% with ovulatory dysfunction. Hemoglobin level analysis illustrated the prevalence and severity of anemia. Diverse treatments, including hormonal and non-hormonal interventions, were administered.

This study provides insights into the causes of puberty menorrhagia, emphasizing the need for a holistic treatment. Future research should delve deeper into identified associations and clinical variants to enhance our understanding and guide effective interventions. Management should be directed to the cause.
Comparative study on maternal and fetal outcomes in emergency versus elective caesarean section
Authors: Sangwan Aditi , Sunitha C , Goel Suyash , Dumeer Deepika Gulati , Singh K C , Sangwan Shivani
Published: November 2024

: The progressive increase in the incidence of caesarean section during the last few decades has been constant worldwide, increasing; at the same time, the indications, many of them unnecessary, resulting in indiscriminate practice, becoming the most frequent surgical intervention performed in health institutions, both private and public. Caesarean section is preferred as an emergency or elective procedure depending on the maternal and fetal conditions. It has been seen that risk of surgical complications is greater with emergency as compared with elective caesarean section.

: Present study is a retrospective study, designed to evaluate maternal and fetal outcomes in elective versus emergency caesarean sections performed at our hospital from January 2023 to December 2023.

: Out of total 2573 deliveries conducted, 1496 were normal deliveries, 116 were instrumental and 961 were caesarean deliveries, 446 were emergency and 515 were elective caesarean section. In our study overall operative complications were 114(11.8%) which was mainly contributed to emergency group.

: The elective caesarean section shows less maternal and perinatal complications as compared to emergency caesarean sections.
Overcoming challenges into miraculous motherhood: successful pregnancy outcomes in patients with SLE: A case series
Authors: Mathesan Manju , Ethirajan Shanthi
Published: November 2024

Systemic lupus erythematosus is a multisystem autoimmune disorder associated with multiple positive antibodies. Reproductive age group women have been found to develop SLE more commonly so than males, and pregnancy is associated with an increased rate of flare ups. The rate of pregnancy loss has decreased from 43% to 17% in recent years due to optimization of treatment and management during pre-pregnancy period. Recent studies have reported that both maternal and foetal outcome are favourable if SLE has been quiescent for at least 6 months prior to pregnancy. The effects of SLE over pregnancy and impact of pregnancy over SLE patients can be managed by optimization of pre-pregnancy treatment and management in antenatal period and follow-up. A multi-disciplinary team approach by an obstetrician, medical specialist and paediatrician for a successful management. Management of SLE to be continued in post-partum period and risk of flares and thrombotic events can be avoided by optimization of treatment in post-partum period till 6 weeks after delivery. Comprehensive maternal and new-born care has improved survival and quality of life outcomes in pregnant patients with SLE. Here, we present a series of three cases of SLE in pregnancy that had successful obstetric outcomes with an interdisciplinary management plan.
Assessing AI chatbots efficacy in ophthalmic triage and referrals: A comparative study
Authors: Jain Piyush , Panda Sarita , Mishra Ankita , Priyadarshini Deepika , Bhoi Radhakanta
Published: November 2024

To evaluate the efficacy of AI chatbots (OpenAI ChatGPT GPT-3.5, Google Bard, and WebMD) compared to human ophthalmology trainees in triage and referrals for common ophthalmic conditions.

A single-center study was conducted at MKCG Medical College, Berhampur, Odisha, involving six ophthalmology trainees. The performance of AI chatbots was assessed based on diagnostic accuracy and triage categorization. Key performance indicators included the accuracy of the top three suggested diagnoses and concordance in recommendations for investigations and referrals.

Physician respondents identified the correct diagnosis among the top three suggestions in 95% of cases. Google Bard achieved 90% accuracy, ChatGPT 85%, and WebMD 20%. High concordance was observed between physician and AI recommendations for investigations and referrals.

AI chatbots demonstrate promising potential in supporting triage and referral decisions for ophthalmic conditions. While human expertise remains crucial, AI tools can augment diagnostic accuracy, improve efficiency, and enhance patient care. Future research should focus on refining AI algorithms, integrating clinical data, and exploring real-world implementation strategies.
A deep dive into penetrating ocular trauma: Insights from a South Indian tertiary eye care center
Authors: Sharat Soumya , Deepak Jayaram
Published: November 2024

Penetrating ocular trauma is a significant cause of visual impairment and blindness worldwide. In India, with its vast and diverse population, understanding the epidemiology and patterns of Penetrating ocular trauma is crucial for effective prevention and management. This study aims to investigate the prevalence, characteristics, and outcomes of penetrating ocular trauma in the South Indian population. By analyzing data from a tertiary eye care center in South India, this research seeks to contribute to the existing knowledge base and inform evidence-based interventions to reduce the burden of penetrating ocular trauma in this region.

To analyze the clinical profile, management, and outcomes of penetrating ocular trauma cases at a tertiary eye care center in South India.

A retrospective review of medical records from January 2024 to June 2024 was conducted. Data collected included demographic details, mode of injury, clinical presentations, management approaches, and visual outcomes.

Out of 150 cases, 120 were male (80%) and 30 female (20%). The majority of cases occurred in the 20-40 age group (60%). Common causes included workplace accidents (45%), domestic injuries (30%), and road traffic accidents (15%). Initial visual acuity varied from no light perception to >6/18. Surgical intervention was required in 90% of cases. Post-operative follow-up indicated that 60% achieved a visual acuity of 6/60 or better, while 20% had no light perception.

Penetrating ocular trauma predominantly affects young males in South India, with workplace injuries being a major cause. Early surgical intervention improves visual outcomes. Public awareness and safety measures could reduce the incidence of such injuries.
The effect of low level laser therapy and piezocision in canine retraction: A prospective randomized split-mouth study
Authors: Kamboj Ashish , Chopra SS , Kochar Gagandeep , Angrish Paras , Joseph Allen , Bansal Amit , Kumar Dharmendra
Published: November 2024

This study evaluated and compared the duration for retraction of maxillary canines in subjects who underwent piezocision and low-level laser therapy.

: The study sample consisted of 12 adult patients in a prospective randomized split-mouth study design, requiring therapeutic extraction of bilateral maxillary first premolar and bilateral canine distalization. The subjects were evaluated for 4 months or till the time taken for the maxillary canine to achieve positive contact with the maxillary second premolars bilaterally. Intervention in the form of low-level laser therapy was carried out on one side using a diode laser vis-a viz piezocision on the other side. This was followed by a comparative evaluation of canine retraction due to both the interventions on their respective sides.

The LLLT group showed 1.105 times the canine retraction in 4 months as compared to the group subjected to piezocision and the findings are statistically significant (P Value = 0.09) using paired t test . The canine showed a mean distal movement of 3.14mm and 2.84 mm in LLLT and piezocision group respectively.

The rate of tooth movement is slightly higher in teeth exposed to LLLT. From the results, we can also infer that there is a constant decline in the rate of tooth movement throughout the duration of the study. With no need for incision and a lesser chance of damage to hard and soft tissue, LLLT appears to be a comparatively attractive option for acceleratory orthodontics.
Perceptions of Indian dental students about online training on preclinical orthodontics during the COVID pandemic: A qualitative study
Authors: Ghanti Poorvi , Badavannavar Anand , Jirge Vasanti Lagali , Jatti Roopa , Karvekar Shruti
Published: November 2024

The objective of the study was to determine students’ perceptions about online training in preclinical orthodontics during the COVID lockdown.

After obtaining ethical approval this phenomenological descriptive qualitative study was conducted for sixty minutes on two different days. It reported students’ experiences during the pandemic through focus group discussions. These were recorded on audio and video platforms. The researchers then transcribed and analyzed the recordings and codified the answers into categories to determine the emerging topics until a saturation point was reached.

The core emerging themes were (1) Angst and apprehensions (2) Perception about the learning experience (3) Challenges encountered.

Even though online learning has been a useful tool for delivering didactic (theoretical) concepts, we attempted to teach preclinical orthodontics to students of final year BDS. Students reported being skeptical and worried at first, but they soon were able to overcome the initial apprehensions and perform well.
ASSESSING THE CONTRIBUTION OF THE THARI PROGRAMME IN PROTECTING CHILDREN AGAINST VIOLENCE AND ENHANCING SCHOOL SAFETY
Authors: Reyneke Roelf
Published: November 2024

This study examines the Thari pilot programme, developed by the Adopt-a-School Foundation as a potential solution to address school violence and children’s psychosocial health in South Africa. Employing an exploratory sequential mixed methods research design (QUAL-quan), the study evaluates the effectiveness of the Thari programme in providing essential psychosocial support services to children. The primary objective of the programme is to foster safe and violence-free learning environments that are academically effective, gender-sensitive, inclusive, and conducive to the health and well-being of all education stakeholders. The paper explores the psychosocial interventions employed by the Thari programme and assesses their contributions in creating secure and violence-free learning environments. The study findings offer support for the utilisation of psychosocial interventions in schools, as evidence suggests that these interventions positively impact school safety.
EXPERIENCES AND SUPPORT NEEDS OF FAMILIES RAISING ADOLESCENTS WITH PROFOUND INTELLECTUAL AND MULTIPLE DISABILITIES DURING THE TRANSITION TO ADULTHOOD
Authors: Luitwieler Nicole , Luijkx Jorien , Van der Schans Cees P. , Van der Putten Annette A. J. , Waninge Aly
Published: November 2024

There is a lack of knowledge about families raising adolescents with profound intellectual and multiple disabilities (PIMD) during the transition to adulthood. This study explores the experiences and support needs of these families throughout this transition. A qualitative design was used, consisting of semi-structured interviews with mothers (N = 10) of children aged 10 to 23 with PIMD. The interviews were analyzed via a coding scheme based on a theoretical framework for family quality of life (FQOL) and stages of adolescence. Positive and negative experiences and distinct support needs were examined in the FQOL domains and stages of adolescence. These families have a unique need for information on development and participation opportunities for children with PIMD, and how to support them. Other needs and experiences expressed, such as dealing with hormonal changes and with being transferred from paediatric to adult care services, were consistent with other families with support needs. The obtained knowledge can be used to improve support for families with an adolescent child with PIMD. In addition, future research in this area is recommended and should be grounded in a family-centred, strengths-based, longitudinal approach.
Cultivating creative minds: Integrating imagination and innovation in primary school piano instruction
Authors: Wu Si , Yoshioka Yumi , Wen Zaihua
Published: November 2024

This study aims to show how creativity and imagination can be integrated into primary school instruction to foster creative musical minds. A mixed method was employed, examining the impact of various pedagogical practices, instructor experience, and cultural differences on students’ creative music-making abilities, focusing on improvisation and composition. Participants included primary school students, piano teachers, and parents from diverse Chinese ethnic backgrounds. The study found that innovative approaches emphasizing creative and experiential learning significantly enhanced students’ ability to structure and optimize music, compared to conventional methods. The cultural context and the teacher’s expertise were also identified as critical factors in fostering students’ creative musical development. Integrating creativity into music education is essential for primary school students. A learning environment that encourages experimentation, self-expression, and discovery plays a vital role in developing students’ creative potential. Music educators should consider adopting teaching methods that prioritize creativity and imagination tailored to the cultural context and the teacher’s expertise to better cultivate creative musical talents in young learners.