bluuebunny/crossref_metadata_2025 huggingface dataset:
No Barrier
Authors: Guttikonda Jai , Sanchit A. , Krishnamoorthy A. , Chaudhary Krish , Likitha B. , Prabakaran N.
Published: January 2024

In a digital realm, language diversity remains a significant hurdle to effective global communication, impacting approximately 60% of internet users worldwide. The aim is to promote inclusive conversation and overcome the language barrier in the online world where people from various backgrounds work together. The chapter revolves an NMT model, a transformer-based architecture for translation which facilitates real time translations and contextually aware along with a fine-tuned front end chat room specifically crafted for the users by providing multiple well-known languages with smooth translation so that communication remains fluid and accurate which can significantly improve the online community. Introduced digital twin technologies into this which is a concept that digitally mirrors real world and process this digital twin analysis focuses on user side preferences, inputs, and contextual meanings. The outcome of the study holds the promise of forever changing the structure of digital communication between multiple languages which will turn in an evolving online world.
Synergies of Digital Twin Technology and AI
Authors: Rathod Seema Babusing , Ponnusamy Sivaram , Mahajan Rupali A.
Published: January 2024

This chapter explores the dynamic intersection of digital twin technology and artificial intelligence (AI) within the strategic landscape of forward-thinking businesses. As organizations increasingly embrace the potential synergy between these technologies, the chapter delves into their collaborative implementations, aiming to enhance operational efficiency and foster innovation. The study investigates the transformative impact of digital twin technology and AI on business processes, shedding light on emerging trends and future prospects. Through a comprehensive analysis of case studies and industry applications, this research aims to provide insights into the evolving landscape of technologically driven businesses poised for future success.
Assessment of the mixed timber combination effect of finger-jointed timber species using flexural and tensile strength
Authors: Muthumala C. K. , De Silva Sudhira , Alwis P. L. A. G. , Arunakumara K. K. I. U.
Published: January 2024

Off-cut wood is one of the wastes dumped by sawmills, and inadequate length of sawn timber materials fail to fully utilize the wood supply. Finger joint, a method that connects two small pieces of timber, is identified as a sound technique to minimize wastage. Different timber species should be bonded at the finger joint production process for making finger-jointed mixed boards. When mixing the different timber species, timber pieces should be matched based on the mechanical strength. This study was, therefore, conducted to find the strength properties of mixed finger-jointed timber species of wood, namely, Grandis (Eucalyptus grandis), Jack (Aartocarpus heterophyllus), Kumbuk (Terminalia arjuna) and Pine (Pinus caribaea), commonly used in Sri Lanka in the manufacture of furniture. The tests were carried out on timber samples with 19 mm finger lengths made of two sections bonded with an adhesive containing polyvinyl acetate (PVAc). The tensile strength and variation of the flexural strength of the finger length of the samples were studied. BS 373: 1957 was the standard used for the flexural tests. A Universal Testing Machine (UTM 100 PC) was used for the mechanical tests. Timber combination categories are not significantly different for the MOR tests. Pine-Pine vs. Pine-Grandis combination category is significantly different for Bending tests. According to overall results, timber combination categories are significantly different for the tensile tests except for Pine and Kumbuk combinations. The findings of this study will directly benefit the finger joint manufacturers in Sri Lanka.
Antiviral and Anti-Inflammatory Therapeutic Effect of RAGE-Ig Protein against Multiple SARS-CoV-2 Variants of Concern Demonstrated in K18-hACE2 Mouse and Syrian Golden Hamster Models
Authors: Dhanushkodi Nisha Rajeswari , Prakash Swayam , Quadiri Afshana , Zayou Latifa , Srivastava Ruchi , Shaik Amin Mohammed , Suzer Berfin , Ibraim Izabela Coimbra , Landucci Gary , Tifrea Delia F , Singer Mahmoud , Jamal Leila , Edwards Robert A , Vahed Hawa , Brown Lawrence , BenMohamed Lbachir
Published: January 2024

SARS-CoV-2 variants of concern (VOCs) continue to evolve and reemerge with chronic inflammatory long COVID sequelae, necessitating the development of anti-inflammatory therapeutic molecules. Therapeutic effects of the receptor for advanced glycation end products (RAGE) were reported in many inflammatory diseases. However, a therapeutic effect of RAGE in COVID-19 has not been reported. In the present study, we investigated whether and how the RAGE-Ig fusion protein would have an antiviral and anti-inflammatory therapeutic effect in the COVID-19 system. The protective therapeutic effect of RAGE-Ig was determined in vivo in K18-hACE2 transgenic mice and Syrian golden hamsters infected with six VOCs of SARS-CoV-2. The underlying antiviral mechanism of RAGE-Ig was determined in vitro in SARS-CoV-2–infected human lung epithelial cells (BEAS-2B). Following treatment of K18-hACE2 mice and hamsters infected with various SARS-CoV-2 VOCs with RAGE-Ig, we demonstrated (1) significant dose-dependent protection (i.e., greater survival, less weight loss, lower virus replication in the lungs); (2) a reduction of inflammatory macrophages (F4/80+/Ly6C+) and neutrophils (CD11b+/Ly6G+) infiltrating the infected lungs; (3) a RAGE-Ig dose-dependent increase in the expression of type I IFNs (IFN-α and IFN-β) and type III IFN (IFNλ2) and a decrease in the inflammatory cytokines (IL-6 and IL-8) in SARS-CoV-2–infected human lung epithelial cells; and (4) a dose-dependent decrease in the expression of CD64 (FcgR1) on monocytes and lung epithelial cells from symptomatic COVID-19 patients. Our preclinical findings revealed type I and III IFN-mediated antiviral and anti-inflammatory therapeutic effects of RAGE-Ig protein against COVID-19 caused by multiple SARS-CoV-2 VOCs.
Arterial thoracic outlet syndrome in an adolescent
Authors: Kothari Shyam S. , Champaneri Bhavik , Panchal Nirav
Published: January 2024

Arterial thoracic outlet syndrome (aTOS) is rarely diagnosed in children. A 15-year-old boy with recent-onset claudication was found to have aTOS on investigation. Bony abnormality other than the cervical rib might also cause aTOS. Enhanced awareness of aTOS as a cause of vascular symptoms in children is warranted.
Spectrum and outcome of the use of noninvasive ventilation in a pediatric cardiac intensive care unit: A single-center experience
Authors: Das Shubhadeep , Desai Minal , Das Debasis , Dutta Nilanjan , Gajpal Shivani , Sharma Manish
Published: January 2024

Background and Aims:

The pediatric cardiac intensive care unit (PCICU) frequently uses noninvasive ventilation (NIV). There are several reasons for its use, including prophylactic use right after the patient has been extubated. It is also used when patients are experiencing acute respiratory failure due to either cardiac or noncardiac reasons but are still able to maintain their airways. The objective of this study was to understand the spectrum of use of NIV following congenital cardiac surgery and analyze the outcome.

Methods and Results:

A retrospective observational study was conducted in a 14-bed PCICU, reviewing data from August 2019 to August 2022. Among 1750 congenital cardiac surgeries, 523 patients (29.9%) received NIV. The median age of the population was 2.5 months. Factors such as higher Risk-Adjusted Classification for Congenital Heart Surgery-1 category, longer intraoperative cardiopulmonary bypass time, and aortic cross-clamp time were associated with increased NIV use. Preoperative ventilator needs, infections, genetic syndromes, diaphragmatic paralysis, high vasoactive inotrope score (VIS) in the first 24 h, neonatal age, and weight <5 kg were independently associated with increased NIV need. The NIV group had a longer intensive care unit (ICU) stay compared to non-NIV patients. The success rate of NIV was 84%, with 440 successful cases and 83 failures. The mortality rate in the success and failure groups was not significantly different (5.27% vs. 6.0%).

Conclusions:

NIV is widely used in PCICU, but it is associated with longer ICU stays. It proves beneficial after congenital cardiac surgery, especially for patients with specific risk factors. However, NIV may not directly impact mortality rates, suggesting that other factors contribute to patient survival.
In silico prediction, molecular modeling, and dynamics studies on the targeted next-generation sequencing identified genes underlying congenital heart disease in Down syndrome patients
Authors: Carlus Fiona Hannah , Sujatha L. Balasubramaniam , Kumar Anbazhagan Ganesh , Loganathan Lakshmanan , Muthusamy Karthikeyan , Carlus Silas Justin
Published: January 2024

Background:

Individuals with Down syndrome (DS) have a 40%–60% chance of being born with congenital heart disease (CHD). This indicates that CHD in individuals with DS is not solely caused by trisomy 21, and there may be other genetic factors contributing to the development of CHD in these children. A study has identified variants in the specific genes that contribute to the pathogenesis of CHD in children with DS, isolated DS, and the CHD group. Computational studies on these identified variants, which, together with trisomy 21, determine the risk for CHD in DS cases, were limited. Here, we aimed to identify the impact of the identified variants that contribute to the pathogenesis of CHD in children with DS through in silico prediction, molecular modeling, and dynamics studies.

Methodology and Results:

The target single-nucleotide polymorphisms included in the study were examined for pathogenicity, residue conservation, and protein structural changes. The structural predictions were done using I-TASSER, Robetta, SWISS-MODEL, and Phyre2 tools. Further, the predicted models were validated through the PROCHECK server and molecular dynamics simulation using GROMACS software. The conservation analysis conducted on the identified variant highlights its significance in relation to the genetic disorders. Furthermore, a dynamics simulation study revealed the impact of the variant on protein structural stability (≤3 Å), providing valuable insights into its pathogenicity. We have also observed that the structure of the centrosomal protein of 290 kDa gene is relatively unstable, which may be attributed to its exclusive inclusion of helices within its secondary structural components.

Conclusions:

This computational study explores, for the first time, the association between genes and CHD-DS, evaluating the identified specific frameshift variants. The observed pathogenic mutations in CHD-DS patients require further experimental validation and may contribute to the development of prospective drug design research. The insights gained from the structural and functional implications of these variants could potentially serve as a cornerstone in the development of effective treatments for this debilitating condition.
Left sided Scimitar syndrome
Authors: Pandey Sabyasachi , Bharath Adaligere Paraswanath , Mohata Aditya P. , Barthur Ashita , Subramanian Anand P. , Jayranganath Mahimarangaiah
Published: January 2024

The images depict a rare case of Scimitar syndrome involving the left lower pulmonary vein.
Toxicological Studies and Antibacterial Efficacy of Sorghum bicolor Fermented Liquor Extracts of Bambusa tuldoides cv. ventricosa Leaf against Salmonella typhi
Authors: Gabriel Ajobiewe Ruth Adefolakemi Oluwahenyinmi , Okotie Blessing O. , Gabriel Mosope Blessing , Fowora Memunat A. , Cyril Olutayo Christian Mojisola , Ojo Stephen Kayode S.
Published: January 2024

Background:

Bamboo leaf extracted with steep liquor from fermented cereal grains has been used as an ethnomedicine for the treatment of severe typhoid fever in Africa without the proper documentation of its efficacy and side effects.

Aim:

This study embarks on the evaluation of the toxicity and pharmacological safety profile of fermented Sorghum bicolor liquor extract of Bambusa tuldoides cv. ventricosa leaf as an ethnomedicine against Salmonella typhi infection.

Settings and Design:

Reconstituted concentrates of various fermented extracts were used for the minimum inhibitory concentration (MIC) assay. Acute toxicity assay comprised two phases. The bioassay constitutes a total of 25 albino mice randomly distributed into 5 test groups.

Materials and Methods:

Steep liquor from fermented S. bicolor seeds served as the extracting solvent for the leaf of B. tuldoides using Soxhlet apparatus. The determination of both the sensitivity test and MIC assay used different levels. Extracts were orally administered for acute toxicity and dosage determination studies. Extracts were administered at concentrations 25, 50, and 100 mg/mL per day for the bioassays. Application of one-way analysis of variance was used for the determination of the statistical significance of the variations at 0.05 and 0.01 levels.

Results and Conclusions:

The average zones of inhibition were between 15.00 ± 2.34 and 20.00 ± 4.64 mm, and MIC was 12.5 mg/mL for the growth of S. typhi. The extract administered was found to be safe up to 5000 mg/kg body weight dosage. The agglutination result showed a concentration-dependent effectiveness of fermented liquor extract against S. typhi. Therefore, the bamboo leaf extract is efficient for the treatment of S. typhi infection.
Ayurvedic Management of Abnormal Uterine Bleeding in Uterine Fibroid
Authors: Rajoria Kshipra , Singh Sarvesh Kumar
Published: January 2024

Abnormal uterine bleeding (AUB) is the most common gynecological problem and is often accompanied with uterine fibroid. Very limited options are available in biomedicine for the AUB. In this reported case, AUB associated with stasis dermatitis was managed on the line of treatment of Vataja Yonivyapada with satisfactory results. This is a case of AUB in uterine fibroid associated with stasis dermatitis in the left lower limb of a 39-year-old female. Gokshuradi Guggulu 750 mg, Shatavari Churna - 2 g, Gairika - 500 mg, and Mukta Shukti Pishti - 500 mg were given twice a day for 18 months, Pushyanuga Churna - 2 g, Chandraprabha Vati - 250 mg, and Arsha Kuthara Rasa 250 mg twice a day for 8 months, and Gokshura churna - 2 g twice a day for 14 months were given to her as oral medication. Jatyadi taila was applied locally twice a day on affected area for 17 months. Four sets of Anuvasana Basti (medicated oil enema), one set of Raktamokshana (therapeutic bloodletting) with Alabu, and three sets of Raktamokshana with Shringa were also adopted in 14 months of treatment duration. After 14 months of treatment, the size of the bulky uterus was reduced from 108 mm × 76 mm × 70 mm in May 2018 to 102 mm × 64 mm × 55 mm in May 2019 and from 7.0 to 6.6 mm in endometrium thickness. The fibroid was resolved, and abnormal bleeding was arrested. This case demonstrates that Ayurveda oral medication and Panchakarma based on the management of Vataja Yonivyapada may be useful in AUB associated with stasis dermatitis.
Phytochemistry and Pharmacology of Selected Species of Smilax L. (Smilacaceae) in India
Authors: Uthaman Neethu , Thomas Valukattil Ponnachan , Thomas Binoy Thundiathu
Published: January 2024

Background:

Medicinal plants have been used in traditional medical practices since prehistoric times. It is popularly known that roots, rhizomes, and leaves of some Smilax species are widely used for treating various diseases such as toothache, muscular pain, urinary diseases, and jaundice.

Methodology:

This review aims to document the information regarding major phytochemicals and pharmacological activity of selected Smilax species in India. Details of different species of Smilax species in India were collected from online databases such as https://wcsp.science.kew.org/(2022), https://powo.science.kew.org (2022), and https://www.ipni.org (2022). All the available information related to phytochemistry and pharmacological activities was collected from electronic databases such as Academic Journals, Springer, PubMed, Google Scholar, ScienceDirect, MEDLINE, Scopus, Web of Science, and other primary and secondary sources.

Results:

Literature survey revealed that members of the genus Smilax possess large quantities of steroids and phenolic compounds and possess various bioactive properties such as antibacterial, antifungal, antioxidant, and analgesic activities.

Conclusion:

This review concludes that more research on the genus Smilax is required to identify and evaluate the presence of potential bioactive constituents, and further investigations may be led to the development of new drugs.
A Randomized Study of b3 Agonists versus Anticholinergics Administration in Patients with Multiple Sclerosis and Lower Urinary Tract Dysfunction
Authors: Stamatakos Panagiotis Velissarios , Mari Victoria , Moschotzopoulos Dimitrios , Stathouros Georgios , Ntoumas Konstantinos
Published: January 2024

Introduction and Objective:

Multiple sclerosis (MS) is the most frequent autoimmune demyelinating disease of the central nervous system usually affecting lower urinary tract function. In the present study, we compare the efficacy and safety of either a b3 agonist (mirabegron) or anticholinergics in treating MS patients with lower urinary tract dysfunction (LUTD) and assess the LUTD symptom improvement.

Evidence Acquisition:

A multi-center, single-blinded, comparative study was designed, including MS patients with LUTD. Patients were administered either mirabegron or anticholinergics in combination with standard MS treatment. All cases underwent clinical examination and completed urination diaries and validated questionnaires (Neurogenic Bladder Symptom Score and MS International Quality of Life). Furthermore, urine test analysis, as well as abdominal ultrasound imaging examination, was performed. Data on several clinical and imaging parameters were collected between the two groups at the first visit and after 3 months of treatment.

Evidence Synthesis:

A total of 61 patients with LUTD participated in the survey. An improvement regarding LUTD was noted in all patients. However, no statistical difference was recorded between the mirabegron and the anticholinergic group. Medical treatment was well tolerated, and no patient discontinued medication due to side effects.

Conclusions:

Both mirabegron and anticholinergic therapy can be administered for LUTD in MS patients. In terms of drug efficacy, no statistical difference was noted between the two cohorts at 3 months.
Therapeutic Options in Metastatic Renal Cancer
Authors: Bellos Themistoklis Ch. , Manolitsis Ioannis S. , Katsimperis Stamatios N. , Kyriazis Ioannis P. , Angelopoulos Panagiotis A. , Neofitou Panagiotis N. , Kapsalos-Dedes Sotirios G. , Deligiannis Panagiotis K. , Tzelves Lazaros I. , Kostakopoulos Nikolaos A. , Lazarou Lazaros C. , Markopoulos Titos P. , Berdempes Marinos V. , Kiriakidis Alexandros A. , Livadas Konstantinos E. , Mitsogiannis Iraklis C. , Varkarakis Ioannis M. , Papatsoris Athanasios G. , Skolarikos Andreas A. , Deliveliotis Charalampos N.
Published: January 2024

Background:

Renal cancer is the 3rd most common cancer of the urinary tract. It peaks at the age of 64 years and appears more common in men than women.

Methods:

The purpose of this study is to review the potential therapeutic options in metastatic renal cancer. A thorough MEDLINE/PubMed nonsystematic literature review was conducted from 1990 to May of 2023. The terms used for the search were “metastatic” AND “renal cancer” OR “renal cell carcinoma” AND “therapy” OR “treatment” AND “metastasectomy” AND “immunotherapy”.

Results:

Metastasectomy is advantageous when the metastatic foci are completely excised. When there is no clinical suspicion of any remaining metastatic disease, there is no need for further systemic therapy. Patients at intermediate risk may initiate neoadjuvant systemic therapy with immune-oncology (IO) and IO or tyrosine kinase inhibitor and IO; once the tumor regresses, metastasectomy is performed.

Conclusion:

In conclusion, there are many modalities for metastatic renal cancer treatment which depend on the prognostic factors of the disease itself.
A Rare Case of Complete Urethral Duplication and Short Review of the Literature
Authors: Joshi Prashant B. , Babu Sreelakshmi Suresh , Prabhu Shailee , Kunte Maithili , Mishra Baleshwar , Thanki Meet
Published: January 2024

Duplication of the urethra is a rare congenital anomaly, predominantly seen in males. Due to the rarity of the condition, there is no fixed consensus regarding the management of these patients. We report the case of a 4-year-old male child who presented with phimosis and balanoposthitis, with the occasional double stream of urine and was incidentally found to have duplication of the urethra. Cystoscopy revealed the duplication to be Effman Type II A-1. No surgical intervention was done for the duplication as the patient was asymptomatic. Our aim is to report this rare case and to enhance the knowledge by reviewing the already existing scanty literature of this rare condition.
Transient Ischemic Attack Following Foam Sclerotherapy for Chronic Venous Ulcer with No Cardiac Defect - A Rare Case Scenario
Authors: Egappan A R Satthish , Prathap K
Published: January 2024

Chronic venous insufficiency (CVI) constitutes one of the main causes for lower limb ulceration. Foam sclerotherapy forms an important part of CVI treatment. It is used to treat truncal incompetence, perforating veins, and primary and secondary varicosities as well as reticular and spider veins. It is used either alone or in addition to the endovenous ablative techniques. Although usually done as an office procedure, it can cause serious complications which include allergic reaction, deep-vein thrombus formation, superficial vein thrombosis, and ulceration if extravasated into the subcutaneous plane and rarely can cause various neurological manifestations such as transient visual loss, migraine, transient ischemic attack, speech disturbances, and stroke. Neurological complications amount to only 0.90% among all the complications according to a systematic review by Tharsi Saravananthan et al. The neurological complications are usually transient and generally occur due to patent foramen ovale (PFO). There are very few case reports mentioned in the literature where the neurological symptoms occur without any evidence of cardiac defects. Herein, we report a case where foam sclerotherapy was given for chronic venous ulcer, and the patient developed speech disturbance in the immediate postprocedure period which resolved on its own. His preoperative echocardiography was normal without any structural heart defects. This is one of the few cases to be reported in the literature where sclerotherapy-induced neurological complication has occurred without any evidence of PFO.
Bovine Pericardial Tube as a Conduit for Left Renal Vein Transposition in Treatment of Nutcracker Syndrome
Authors: Shah Kesha , Saini Devi Prasad , Sain Ram Swaroop , Yadav Rajkumar
Published: January 2024

Nutcracker syndrome (NCS) is caused by compression of the left renal vein (LRV) between the aorta and the superior mesenteric artery. This results in left renal venous hypertension and the subsequent development of venous varicosities of the renal pelvis, ureter, and gonadal vein, also called renal vein entrapment syndrome. Its treatment includes open surgical technique as well as minimally invasive technique, namely laparoscopic and endovascular techniques. Here, we report the case of a young male diagnosed with NCS treated with LRV transposition using bovine pericardium as conduit interposing between inferior vena cava and LRV.
Prescription Patterns of Analgesics for Oral Conditions in India - Analysis of Large Medical Audit Data of Outpatients in India’s Private Healthcare Sector
Authors: Sayeed Saif , Mathur Manu Raj , Mishra Vijay Kumar , Nagrath Deepti , Watt Richard G.
Published: January 2024

Background:

Analgesic use needs to be regulated due to its adverse effects. This study aimed to analyse the change in prescription rates and patterns of the analgesics prescribed for various oral conditions and to analyse their trends across different age groups and gender to promote rational prescription of drugs and eventually influence regulatory policies.

Methods:

Secondary analysis was conducted on medical audit data collected from the private health sector in India. The prescription rate per 1000 persons per year was calculated from May 2013 to April 2016 using the mean projected population (PP) of India. Cross-tabulations were conducted to analyse the prescription rate and their changes across different age groups, gender and oral conditions.

Findings:

The mean analgesic prescription rate was highest among the 20-40 age group, and the highest increase was noted in ‘non-steroidal anti-inflammatory drug (NSAID) combinations’ (3.56 per 1000 persons per year) from May 2013 to April 2016. The ‘NSAID combinations’ group was also the most prescribed medication across all the oral conditions, with ‘diseases of hard tissues’ having the highest prescription rate (41.4 and 45.6 per 1000 persons per year, respectively, for 2013–14 and 2015–16).

Interpretation:

The results indicate an overall increase in the analgesic prescription rate, especially ‘NSAID combinations’ for each dental disease and age group, a finding that is hard to explain. Due to the lack of prescription guidelines in India, it is difficult to assess whether these analgesics were prescribed rationally or not.
Effect of Novel Biomodification Strategies on Bonding to Pulp Chamber Dentin – An In Vitro Study
Authors: Radhakrishnan Saranya , Devadiga Darshana
Published: January 2024

Context:

Adhesion to dentin remains a tough challenge due to its heterogeneous composition, complex histologic structure and high tubular content, warranting the need to investigate methods to improve the bond strength of the commonly used access restorative materials to pulp chamber dentin.

Aims:

To evaluate the effect of dentin biomodification using 6.5% grape seed extract and a 980 nm diode LASER on the shear bond strength of resin-based bonded restoration to pulp chamber dentin.

Methods and Materials:

Access cavities were prepared in 42 extracted human maxillary premolars, which were then sectioned in a buccolingual direction. The samples were serially immersed in 5.25% NaOCl for 40 minutes and 17% EDTA for 3 minutes and allocated into three groups: the control group, the group pre-treated with 6.5% grape seed extract (GSE) and the group pre-treated with a 980 nm diode light amplification by stimulated emission of radiation (LASER). All the samples were restored with resin composites and subjected to shear bond strength testing using a universal testing machine.

Statistical Analysis Used:

Statistical analysis was done using SPSS version 23 software.

Results:

The mean shear bond strength was highest in the group pre-treated with GSE, followed by that pre-treated with diode LASER and finally in the control group.

Conclusions:

Dentin biomodification using both chemical and physical agents such as grape seed extract and diode LASER was shown to improve the shear bond strength of resin composite endodontic access restorations to the pulp chamber dentin.
Clinical Usability of Vasundhara’s Transit for Gutta-Percha (V Transit GP) - A Questionnaire-Based Survey
Authors: Vijayaraghavan Siddheswaran , Menon Krutika , Dhanyakumar N. M. , Shivanna Vasundhara
Published: January 2024

Context:

The lack of a suitable armamentarium to aid in the disinfection and handling of gutta-percha (GP) cones during obturation has been a common challenge amongst dentists.

Aims:

This study assessed the clinical usability of ‘Vasundhara’s (V) Transit GP’ through a questionnaire-based survey.

Settings and Design:

This questionnaire-based study was conducted in Davanagere, Karnataka, in February 2021 for 4 months.

Methods and Material:

The design was 3D printed using a heat-resistant polypropylene material and named ‘Vasundhara’s Transit for Gutta Percha (V Transit GP)’. Eighteen postgraduate students participated in the study. Fourteen cases were done by each student, seven without and seven with the use of ‘V Transit GP’. The GP cones, before obturation, were transferred to their respective canal slots containing 5.25% sodium hypochlorite for one minute and then transferred to their respective distilled water slots. The cones were dried with sterile gauze and taken for obturation. At the end of the procedure, a questionnaire was handed out, the responses were recorded, and the results were tabulated and analysed using Statistical Package for the Social Sciences (SPSS) version 22.0 software.

Results:

The results showed that without the use of ‘V Transit GP’, 84.2% of the dentists felt that the disinfection and handling of GP cones were difficult, whereas with the use of ‘V Transit GP’, 94.2% of the participants found it to be extremely easy.

Conclusions:

‘V Transit GP’ proved to be an extremely efficient and user-friendly equipment for easy handling and disinfection of GP cones during obturation.
Effect of Various Preparation Designs on Pull-Out Bond Strength of Endocrown
Authors: Thangarasu Naveen , Venkatesh K. Vijay
Published: January 2024

Background:

The endocrown is described as monobloc ceramic component. The pull-out bond strength acts as a real-life scenario of failure that occurs in endocrown. The different preparation designs have been included to assess the type of preparation that resists the least failure.

Aim:

To evaluate the effect of three different types of preparation designs on the pull-out bond strength (PBS) of computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic endocrowns.

Methods and Materials:

Thirty extracted mandibular first molars were used for this study. Root canal treatment was done. Samples were divided into three groups of 10 samples each. Group A consists of traditional endocrown preparation with a butt joint preparation. The group B consists of a modified preparation with 50-60 degree inward slope. The group C consists of preparation with a 50-60 degree outward slope. Endocrowns were fabricated using CAD/CAM lithium disilicate glass-ceramics. The endocrowns were adhesively bonded to the respective preparations. Pull-out bond strength was calculated using the universal testing machine at a crosshead speed of 1 mm/min.

Statistical Analysis:

The results were statistically evaluated by one-way ANOVA and Tukey’s post hoc analysis.

Results:

Group B had higher pull-out bond strength compared to the other two types of preparation designs and showed a statistically significant value with a mean significant difference at 0.05 level (P < 0.05).

Conclusion:

The 50-60 degree inward bevel in endocrown preparation increased the pull-out bond strength in lithium disilicate endocrowns.
Mucormycosis in COVID-19 Patients – A Case Series from a Dental College in South India
Authors: Sevagaperumal Annapoorani , Winnifred A. Christy , Thambi T. Jones R. Deva
Published: January 2024

Introduction:

Incidence of mucormycosis has increased recently due to rapid spread of coronavirus disease 2019 (COVID-19), which is a hyper-ferritemic state paving a way for easy growth of mucor species. COVID-19 infection results in an immunocompromised state due to the steroid therapy administered to patients and the infection itself. The presence of co-morbidities makes patients more susceptible to acquire mucor infection. Mucormycosis spreads rapidly, associated with aggressive angioinvasion, leading to ischemic necrosis of surrounding tissues. Due to its rapid spread and angioinvasion, mucormycosis is associated with increased mortality and morbidity.

Treatment Planning:

Early diagnosis and proper treatment planning are crucial to prevent further spread of infection, where dentists play an important role.

Discussion:

This case series is mainly focused on patients reported to the oral medicine department with complaints of discomfort or mobility of teeth in the maxillary region while explaining the role of dentists in diagnosing and treating the disease.
Evaluation of Efficacy of Artificial Intelligence in Orthopantomogram in Detecting and Classifying Radiolucent Lesions
Authors: Singar Sheetal , Parihar Ajay , Reddy Prashanthi
Published: January 2024

Aim and Objective:

The objective of our study was to build a convolutional neural network (CNN) model and detection and classification of benign and malignant radiolucent lesions in orthopantomogram (OPG) by implementing CNN.

Method:

Two basic CNN models were implemented on Anaconda with Python 3 on 64-bit, CNN-I for detection of radiolucency and CNN-II for classification of radiolucency into benign and malignant lesions. One hundred fifty eight OPG with radiolucency and 115 OPG without radiolucency was used for training and validation of CNN models. Data augmentation was performed for the training and validation dataset. The evaluation of the performance of both CNN by new data consisting (60 OPG images) 30 benign and 30 malignant lesions.

Statistical Analysis:

Performed using SPSS (Statistical package for social science) 20.0 version. The descriptive statistics was performed. The Cohen kappa correlation coefficient was used for assessment of reliability of the diagnostic methods. P < .05 was considered statistically significant. Determination of sensitivity, specificity, positive and negative predictive value was also performed.

Result:

CNN-I showing sensitivity for detection of the benign lesion is 76.6% and sensitivity for the malignant lesion is 63.3% with overall sensitivity is 70%. CNN-II showing sensitivity for classification of the benign lesion is 70% and for classification of the malignant lesion is 63.3% with overall classification sensitivity is 66.6%. The kappa correlation coefficient value for diagnosis made by CNN-II is 0.333 and P < .05.

Conclusion:

Both CNN showed statistically significant and satisfactory results in detecting and classifying radiolucency in OPG.
Adherence and Effectiveness of HBV Vaccination among Healthcare Workers in Egypt
Authors: Elshaer Mohammed , Elsayed Eman , El-Gilany Abdel-Hady , El-Mashad Noha , Mansour Mostafa
Published: January 2024

Context:

Healthcare workers (HCWs) face a potential risk of acquiring different bloodborne pathogens, by occupational exposure to contaminated blood and body fluids. Hepatitis B vaccine is a safe, effective method of conferring long-term protection against HBV infection.

Aims:

The study aimed to assess the adherence and effectiveness of HBV vaccination among HCWs at Gastrointestinal Surgical Center, Mansoura University, Egypt.

Settings and Design:

A prospective descriptive study was carried out between June 2019 and December 2019 at Gastrointestinal Surgical Center, Mansoura University, Egypt.

Methods and Material:

All HCWs with anti-HBs levels below 10 mIU/mL were advised to receive 3 doses of recombinant HBV vaccine, at 0, 1, and 6 months. The anti-HBs levels were checked 3 months after the third dose of the HBV vaccine.

Statistical Analysis Used:

Data was analyzed using the Statistical Package of Social Science (SPSS) program for windows (version 16).

Results:

A total of 442 healthcare providers were included. Most of them completed the 3 doses of the vaccine (81.7%), 10.2% refused the vaccine, while 0.9% and 7.2% received 1 and 2 doses, respectively. Odds of vaccination were the highest (88.1%, 273/310) among nurses (OR, 4.7; 95% CI, 2.6–5.2; P ≤ 0.001). The overall anti-HBs positivity of 97% (350/361) was observed. The main reasons for not being vaccinated included the fear of vaccine side effects 25/81 (30.9%) and lack of trust in the vaccine effectiveness 18/81 (22.2%).

Conclusions:

The outcome of the present study emphasizes the need to apply alternative and innovative measures to build a positive attitude toward the HBV vaccine among HCWs.
Dealers in Black Gold
Authors: Thattil Anissa Mary Thomas , Gnanaselvam Nancy A. , Rajitha K , Goud B. Ramakrishna
Published: January 2024

Background and Objectives:

Fecal sludge management (FSM) is an unorganised sector, which is wrought with occupational health hazards for fecal sludge operators (FSOs). This study was conducted to identify the knowledge, attitude, and practices regarding FSM among FSOs.

Study Setting and Design:

This cross-sectional study was conducted in a rural area of Anekal Taluk, Bengaluru Urban District, Karnataka and in Hosur, Krishnagiri District, Tamil Nadu.

Methods and Materials:

Snowball method of sampling was employed and, 60 participants were interviewed using an interviewer administered semi-structured questionnaire.

Statistical Analysis:

The data has been described using measures of central tendency, frequencies, and percentages.

Results:

All 60 participants were males with a mean age of 33.7 ± 7.9 years. Majority practised Hindu religion (98.3%) and 95.0% belonged to the scheduled castes; only 3.3% were illiterate. According to modified SLI, 45.0% belonged to high standard of living. The common occupational hazards reported were injuries, social stigma, and alcoholism. Although 91.7% felt that personal protective equipment (PPE) would protect against health hazards, 65.0% felt that it hampered work. Most (86.7%) felt that FSM was attached to social stigma. None reported the use of the full set of required PPE. All participants reported washing their hands and feet with only water at the end of each operation.

Conclusion:

The knowledge and practices followed by the FSOs were found to be inadequate in this study. Health awareness generation and provision of PPE must be employed to ensure sustained behaviour change.
Healthcare Workers Exposure to Ionizing Radiation
Authors: Bolbol Sarah A. , Zaitoun Mona F. , Abou El-Magd Sahar A. , Mohammed Noha A.
Published: January 2024

Background:

Ionizing radiation is well known to cause oxidative stress which is responsible for various health hazards. Controlling healthcare workers' exposure and raising attention toward continuous monitoring is the first step for improving both the health of healthcare workers and the quality of patient care, thus decreasing both human and economic costs.

Objectives:

To assess oxidative stress by measuring the level of lipid peroxidation, antioxidants, and measure complete blood count (CBC) among healthcare workers exposed to ionizing radiation.

Methods:

A cross-sectional study conducted at the diagnostic radiology department on 31 healthcare workers exposed to ionizing radiation and a non-exposed group of 31 healthcare workers from outpatient clinics. Malondialdehyde (MDA), superoxide dismutase (SOD), and CBC were measured among both groups.

Results:

MDA was significantly higher among the exposed group, while the level of SOD was significantly lower. Red blood cells and hemoglobin were significantly lower among the exposed group. The most significant predictor of oxidative stress was the duration of work.

Conclusion:

Ionizing radiation exposure induce oxidative stress which has an important role in radiation-related health effects. Anemia was the most common hematological health hazards among the exposed group.
Assessment of Squalor in Migrant Colonies of Thiruvalla Province of Kerala, India using Rapid Survey Technique
Authors: Cherian Koshy M. , Samuel Johnson Abel K. , Chacko Avira , Babu Bichu P. , Joseph Marina Rajan , David Alice , Varghese Sangeetha M.
Published: January 2024

Background:

Domestic squalor refers to households that are extremely cluttered, in a filthy condition, and where the accumulation of items such as personal possessions, rubbish, excrement and decomposing food creates an environment that jeopardizes the health and wellbeing of the occupant(s). In India, an estimated 258 million are migrants. They are more likely to live in squalor due to inferior socio-economic status and no permanent residence. This poses a threat to the health of the migrants and the neighbors.

Objective:

To assess the squalor and morbidity pattern among the migrants of Migrant colonies in Thiruvalla using Rapid survey technique.

Methodology:

The state of squalor in migrant colonies was assessed by Lot Quality Assurance Sampling Methodology using the Environment Cleanliness and Clutter Scale (ECCS). The sample size for each lot/colony was '14' dwellings according to LQAS table. The details were collected from 14 inhabitants of different dwellings of the same colony. The inhabitants were selected randomly and were excluded if he belonged to the same dwelling. Fifteen colonies were randomly selected to achieve the sample size of 210 (15*14). The study was done in Tiruvalla municipality.

Results and Conclusion:

Only two colonies (n = 15) were squalor free. Majority of the dwellings (n = 210) were having an ECCS score between 13 and 15. Common ailments affecting migrants include Common cold, Skin disorders, and dental caries and gastritis. Squalor was found in most of the migrant colonies as they are living in inhuman conditions.
Clinical Epidemiology and Predictors of Outcome in Chlorpyrifos Poisoning in Farming and Allied Agricultural Workers in East Godavari, Andhra Pradesh
Authors: Acharya Anand , Panda Abinash
Published: January 2024

Background:

Chlorpyrifos is the ninth most consumed pesticide for agricultural purposes in India. It is a chlorinated organophosphate that also causes poisoning in non-target species such as humans. There is a scarcity of published literature on chlorpyrifos intoxication in the Indian scenario.

Objective:

The objective of the study was to find out the clinical epidemiology and factors influencing the outcome of chlorpyrifos poisoning in the farming and allied agricultural workers.

Methodology:

The patient record-based cross-sectional study was carried out on 40 confirmed cases of chlorpyrifos poisoning in a tertiary care teaching hospital in East Godavari district, a predominantly agrarian region in the state of Andhra Pradesh. Clinic-demographic profile, aspects of poisoning, outcome in terms of recovery, death, ventilator support were obtained. Mortality or requirement of ventilator support was classified as a bad outcome. Carlsons’ Co-morbidity Index, Poison Severity Score, and Glasgow Coma Scale score at the time of admission were assessed objectively. The strength of association between the predictor variables and the outcome was represented using the odds ratio. Statistical analysis was performed using Graph Pad Prism 8.0 trial version.

Results:

Chlorpyrifos poisoning constituted about 10% of pesticide poisoning and 25% of such cases had a poor outcome. The mean age was 44.73 ± 10.76 years, the majority being farmers. Younger age (<40 years), early reporting to hospital, Carlsons’ Co-morbidity Index of less than 8, Glasgow Coma Scale score of more than 12, and Poison severity score of less than 2 were significantly associated with favorable outcome (P < 0.005). During admission, 60% of cases had a plasma pseudocholinesterase level of less than 1000 U/L. Lower plasma pseudocholinesterase was associated with a poor outcome (OR 9.62 CI 4.05-22.84).

Conclusions:

Farmers and allied agricultural workers are susceptible to chlorpyrifos intoxication. Along with clinical and laboratory parameters, Carlsons’ Co-morbidity Index, Glasgow Coma Scale score, and Poison severity score at the time of admission are seen as reliable predictors of outcome.
Geographical Information System–Aided Noise Pollution Mapping of Urban Puducherry, South India
Authors: Devasia James T. , Thulasingam Mahalakshmy , Lakshminarayanan Subitha , Naik Bijaya N. , Shanmugavelu Sabesan , Raju Hari K. , Premarajan KC
Published: January 2024

Context:

Noise pollution and its influence on environmental and quality of human life are a major concern and hot topic of scientific research in the twenty-first century.

Aims:

Spatial analysis of noise pollution in urban Puducherry, South India.

Settings and Design:

Cross-sectional study conducted in 36 locations of urban Puducherry.

Methods and Material:

Noise measurements were taken using a calibrated NOR 132 digital sound level meter using the prescribed parameters set by the Central Pollution Control Board. Geo coordinates were taken using Garmin Oregon 550 GPS. Noise measurements were classified according to the Bureau of Indian Standards for town planning into five zones.

Statistical Analysis Used:

Noise pollution map of urban Puducherry for three time points of the day was generated using ArcGIS Desktop v10.3 with Geo-statistical module and Inverse Distance method.

Results:

Seventeen percent of the sites are high noise sources (80–90 dB), two thirds (65%) of the study sites fall into concentrated average noise zones (70–80 dB), and less than one fifth (18%) of the study sites are in relatively quiet zones across different measurement time slots.

Conclusions:

Long-term strategy for noise control should be incorporated in the development of new townships and other infrastructures in accordance with the noise control norms. Implications for future research include monitoring noise pollution levels in rural areas and health effects of noise pollution in bystanders and drivers.
Work-related Musculoskeletal Disorders and Quality of Life Among Staff Nurses in a Tertiary Care Hospital of Bangalore
Authors: Chandralekha Kona , Joseph Merlyn , Joseph Bobby
Published: January 2024

Background:

Work-related musculoskeletal disorder (WMSD) is a collective and descriptive term used for the symptoms caused or aggravated by work. Significant WMSDs can affect the productivity and Quality of Life (QOL) of nurses. This study was undertaken to estimate the prevalence of WMSDs, identify their risk factors, and find the association, if any. This study also assessed the quality of life of nurses and its association with WMSDs.

Methods:

This cross-sectional study was conducted among 207 staff nurses at a tertiary care hospital in Bangalore for a period of 7 months (June-2018 to Dec-2018). The nurses were stratified based on their parent department into three broad categories – Medical, Surgical, and Operation Theatre. Stratified random sampling was followed to obtain the required number of nurses from each stratum. Data was collected using a pre-tested semi-structured questionnaire, Nordic Musculoskeletal Questionnaire (NMQ), clinical examination tests, and WHOQOL-BREF.

Results:

The annual prevalence of WMSDs among the study subjects using NMQ was 168 (81.2%). The prevalence of WMSDs based on clinical examination tests was 67 (32.4%). Repetitive movements at work (OR 9.3, 95% CI 3.4-25.7), working in abnormal postures for prolonged periods (OR 4.7, 95% CI 1.7-12.9), and working even when sick (OR 5.3, 95% CI 2.0-14.1) were the risk factors for WMSDs (P < 0.05). No significant association was found between reported WMSDs (according to NMQ) and QOL.

Conclusion:

Our study found that the prevalence of WMSDs was high among the staff nurses and it did not affect their QOL significantly. Workshops and training sessions on ergonomics should be regularly conducted at the workplace to prevent WMSDs.