bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-microbial efficacy of Vanilla planifolia leaf extract against common oral micro-biomes
Authors: Kamath Ajith K. , Nasim Iffat , Muralidharan NP , Kothuri Ravalika N.
Published: April 2023

Introduction:

Over the past century, several antibiotics have been discovered and used to treat various microbial diseases. However, over the past few decades, with the emergence of anti-microbial resistant strains of microbiomes, it has become increasingly necessary to discover and develop alternative anti-microbial agents. Herbal formulations have shown promising results in the past decade. However, many herbal formulations remain unexplored. The present study aims to explore the anti-microbial properties of a newly preparedVanilla planifoliaextract.

Methodology:

Vanilla planifolialeaves were collected, shade-dried, and then powdered. The powdered leaves ofVanilla planifolia(100 gm) were extracted by the cold percolation method with 300 ml ethanol at room temperature for 72 hours. The extracts were then tested for its constituent anti-microbial activity by the agar well method and disk diffusion method against different commonly found oral micro-biomes. The zones of inhibition were noted and measured, and the results were derived. Statistical analysis was performed using the Student t-test (P <_ 0.001). Based on the statistical analysis, conclusions were drawn.

Results:

The ethanolic extracts ofVanilla planifoliaon the agar plates showed considerable anti-microbial activity in both the test methods againstStaphylococcus aureus, Streptococcus mutans, and Enterococcus. However, no effect was found againstCandida albicans. There was no significant difference in the results obtained by the two test methods (P >_ 0.001).

Conclusions:

This experimental study presents a medicinal plant, an orchid Vanilla planifolia, which demonstrates the presence of essential anti-microbial agents in it, making it a potent, potential dental biomaterial with a positive and benefitting effect on the oral micro-environment.
A rare osteolytic lesion in the mandible
Authors: Singh Priyanka , Arora Manpreet , Dave Aparna , Rai Radhika
Published: April 2023

Odontogenic myxofibroma is a benign tumour that is rarely encountered in any bone other than jaws. It accounts for only 3–11% of all odontogenic tumours. The pathogenesis of these tumours is still controversial and may arise from myxomatous degeneration or fibrous stroma or from the mesenchymal portion of the tooth germ. Clinically, they are slow-growing and can cause gradual expansion of the cortical plates, loosening, displacement of teeth, and rarely root resorption. Biologically, the tumour is locally aggressive with a high recurrence rate, which warrants extensive surgical treatment. Here, we present a case of central odontogenic myxofibroma in a 45-year-old female resulting in the extensive involvement of the mandible within a month.
Myofibroblasts as important diagnostic and prognostic indicators of oral squamous cell carcinoma
Authors: Gandhi Piyush , Kaur Manmeet , Punia Ramandeep Singh , Halappa Thippeswamy Shamenahalli , Singh Harkanwal Preet
Published: April 2023

Background:

Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, with multifactorial etiopathogenesis. Data from the past literature suggest that myofibroblasts (MFs) can also contribute significantly to the pathogenesis of the disease. Hence, the present study was undertaken for assessing the expression of MF in well-differentiated OSCC (WDOSCC), moderately differentiated OSCC (MDOSCC), poorly differentiated OSCC (PDOSCC) and healthy controls by immunohistochemistry using alpha-smooth muscle actin (α-SMA) antibody.

Methodology:

Forty cases each of WDOSCC, MDOSCC, PDOSCC and healthy controls were included. 4-μm thick sections from each tissue sample were stained with routine hematoxylin and eosin as well as immunohistochemically using α-SMA. Among different grades of OSCC, expression of MFs was compared. All the results were subjected to statistical analysis.

Results:

While comparing the expression of MFs in between different grades of OSCC, nonsignificant results were obtained. While comparing the expression of MF in between OSCC cases and normal controls, significant results were obtained.

Conclusion:

MFs are one of the vital pathogenetic components in OSCC cases in predicting their invasive behaviors. We advocate the use of MFs as a stromal marker for visualizing invasion and progression in OSCC patients.
Efficacy of Csaba stain to demonstrate mature and immature mast cells in oral inflammatory lesions
Authors: Lakshminarayana Surendra , Sowmya SV , Rao Roopa S.
Published: April 2023

Background:

Mast cells (MCs) are immune cells of the myeloid lineage and are present in connective tissues throughout the body. Mastocytosis regulates many physiologic processes and affects the pathogenesis of allergic conditions, anaphylactic reactions, autoimmune disorders and leukemias. Toluidine blue is commonly employed as a special stain for MCs that uniformly imparts blue color to both immature and mature cells. Csaba stain that distinguishes mature from immature MCs has not been widely explored. However, its use in differentiating mature and immature cells has not been reported in the literature. The identification of mature and immature MCs may provide a major clue for the diagnosis of any unrecognized systemic pathologies.

Objectives:

Materials and Methods:

Fifty sections of inflammatory lesions were subjected to Csaba stain, toluidine blue and Leishman's stains each for studying MCs. The staining efficacy of the three stains was compared for parameters such as homogeneity, specificity, staining intensity, granular staining property and differentiation between mature and immature cells.

Results:

The Csaba, toluidine blue and Leishman's stains showed statistically insignificant P = 0.50, 0.95, 0.29, 0.48 for homogeneity, specificity, staining intensity and granular staining property respectively, but Csaba stain showed statistically significant P = 0.0001* in differentiating mature from immature cells.

Conclusion:

Csaba stain is more effective in differentiating mature from immature MCs compared to the other special stains.
Primary diffuse large B-cell lymphoma of the nasal bone and palate
Authors: Abeles Elisabeth B. , Umrau Kavita , Gray Mingyang L , Boahene Kofi D
Published: April 2023

Primary bone lymphomas account for 3-5% of extranodal non-Hodgkin lymphomas in adults and are typically present in the axial skeleton and weight-bearing bones. We present a unique case of primary bone diffuse large B-cell lymphoma (DLBCL) of the nasal bone and palate. We discuss the pathologic and radiologic findings and review the current literature and clinical management to highlight how this unusual clinical entity should be considered in differential diagnoses of head and neck bone masses.
Apoptotic and mitotic indices in oral epithelial dysplasia and squamous cell carcinoma
Authors: Suhasini PD , Mulki Shaila , Supriya H
Published: April 2023

Background:

Assessment of apoptotic cells and mitotic figures using light microscopy is an easy and viable alternative to assess tumour behaviour.

Aims:

To evaluate apoptotic index (AI), mitotic index (MI) and apoptotic to mitotic index ratio (AI: MI) in different grades of oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC) in haematoxylin and eosin-stained (H&E) sections.

Settings and Design:

The study included 45 cases each of OED and OSCC cases which were further subgrouped into groups of 15 each based on their grades. AI, MI and AI/MI were assessed and compared with 15 cases of normal mucosa.

Methods and Material:

Apoptotic cells and mitotic figures were counted using a binocular light microscope equipped with an oculometer grid (20 × 20 squares) on the eyepiece. Cells were counted in 15 grid fields under oil immersion lenses (×100) in a stepladder fashion. AI/MI ratio was calculated.

Statistical Analysis:

The results obtained were statistically analysed using Analysis of variance and Tukey Honestly Significant Difference tests with SPSS 20 software at a 0.05 significance level.

Results:

AI increased with increasing grades of dysplasia and decreased with increasing grades of OSCC. MI increased with increasing grades of OED and OSCC. AI/MI increased with increasing grades of OED but decreased with increasing grades of OSCC.

Conclusion:

In the light of the current observations, AI, MI and AI: MI can be considered as valuable parameters to assess the biological behaviour of OED and OSCC.
Intraoral malignant glomus tumor
Authors: Chandran Satheesh , Elangovan Arun , Vijayakumar Saranya , Kumar K. Sai Sarath
Published: April 2023

Glomus tumors are uncommon, benign solitary tumors derived from the glomus apparatus. We report here a case of a malignant glomus tumor in an 8-year-old child presenting as a multilocular ill-defined radiolucency of the mandible. The lesion microscopically showed sheets of round basophilic cells with high nuclear-cytoplasmic ratio, indistinct cell boundaries, nuclear hyperchromatism and nuclear pleomorphism. Immunohistochemically, the tumor was positive for vimentin and smooth muscle actin.
Preoperative platelet-lymphocyte ratio and neutrophil-lymphocyte ratio as predictors of occult lymph node metastasis detected using Desmoglein 3 and Cytokeratin in Indian population
Authors: Urs Aadithya B , Augustine Jeyaseelan , Khurana Nita , Uniyal Akanksha , Passey J C , Meher Ravi
Published: April 2023

Aim:

This study aims to assess whether preoperative platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) can predict occult metastasis in oral squamous cell carcinoma (OSCC).

Materials and Methods:

Thirty-five OSCC cases were analyzed for clinicopathological and hematological data. Cases without metastasis (pN0) were checked for micrometastasis immunohistochemically using Desmoglein 3 (DSG3) and Cytokeratin (CK). Mean PLR and NLR were compared and analyzed between the study groups.

Results:

Metastatic deposits were detected in 9 out of 26 pN0 cases (34.6%) accounting for 11 out of 62 (17%) lymph nodes subjected to immunohistochemistry. The mean PLR was higher in OSCC cases with or without occult metastasis in comparison to controls (P < 0.001). No significant difference was found in the mean PLR and NLR between OSCC cases with and without occult metastasis. Furthermore, we found DSG3+ sinus histiocytes within the lymph nodes in majority of cases which is least reported in literature.

Conclusion:

A significant percentage of cases showed occult metastasis in this study which led to upstaging of tumor. Although PLR was elevated in OSCC cases, it did not have a positive correlation with the presence of occult metastasis but was able to successfully distinguish OSCC patients from healthy individuals.
Prevalence of oral lichen planus in patients with hypothyroidism versus non-hypothyroidism – A case control study of 1000 cases
Authors: Maddheshiya Nisha , Shivakumar GC , Misra Neeta , Rastogi Varun , Kumar Shailesh
Published: April 2023

Background:

The oral cavity is a unique environment where systemic maladies may be amplified by the oral mucosa. Oral diseases are usually local, but may also be the sign of systemic disease. Oral lesions are mostly one of the first indications of a systemic problem. Lichen planus (LP) is an inflammatory disease that involves the skin and mucous membrane. It is one of the most common oral diseases that manifest itself in the oral cavity. The exact cause of oral lichen planus (OLP) is unknown, but the immunologic system plays a leading role in the pathogenesis. It is well documented that OLP represents a cell-mediated immune response.

Materials and Methods:

The study population was drawn from the patients attending the outpatient Department of General Medicine and Department of Oral Medicine and Radiology with a total of 1000 subjects, out of which 500 subjects were clinically diagnosed with hypothyroidism and 500 subjects were without the history of hypothyroidism. The data collected was compiled and analysed to obtain the result. A Chi-square test was used to compare the categorical variables and the analysis was carried out on SPSS 16.0 version.

Results:

The study revealed an increased prevalence of OLP in hypothyroidism. Cases clearly had a predilection of 2.37 times more tendency to develop OLP as compared to the control.

Conclusion:

To conclude, it seems that OLP was more prevalent in hypothyroid individuals, especially in females in the third and fourth decades of life.
Identification of genetic instability in peripheral blood lymphocyte of oral squamous cell carcinoma patients assess by comet assay
Authors: Dekate Kamlesh , Barpande Suresh , Tupkari Jagdish , Thakur Mansee , Swain Niharika
Published: April 2023

Context:

Studies established that human cancer is principally a genetic disease; it arises as accumulation of a set of genetic changes. In the pathogenesis of cancer, genetic instability is the sequential event to a carcinogenic stimulus resulting in various genomic changes including DNA damage.

Aims:

To assess genetic instability, as susceptibility to DNA damage, we used single-cell gel electrophoresis (comet assay) to study double strand breaks in associated with the risk of oral squamous cell carcinoma (OSCC).

Materials and Methods:

We used comet assay to measure double strand break in individual peripheral blood lymphocytes from 50 individuals with OSCC and 30 healthy control subjects. All personal information was gathered from subjects including tobacco history. DNA damage was visualized as comet assay and quantified by movement of damaged strands as length of tail.

Results:

Study results of OSCC patients were observed in relation to clinical staging and histological grading of carcinoma. On the basis of clinical observation, cases were grouped in to Stage I, Stage II, Stage III and Stage IV. No stage I cases were in study sample. The mean DNA damage migration length was observed 4.600 ± 0.4613 μm in stage II, whereas in Stage III and Stage IV, it was observed to be 4.961 ± 0.5620 μm and 4.883 ± 0.410 μm, respectively. The DNA damage length in histological grades of squamous cell carcinoma patients in Grade I was 4.6437 ± 0.3061 μm and Grade II was 5.3533 ± 0.3831 μm. In comparison with control group and squamous cell carcinoma group, it was observed in the range of 0.02–0.36 μm and varied from 4.04 to 5.84 μm range, respectively. Thus, the results were statistically significant with the histological grading of OSCC.

Statistical Analysis:

Unpaired' test and “ANOVA” test are used for statistics.

Statistical Analysis:

Unpaired' test and “ANOVA” test are used for statistics.

Conclusion:

The amount of DNA strand breaks in peripheral lymphocytes are measured by comet assay which is associated with relative risk of OSCC.
An unusual case report of basal cell ameloblastoma and a detailed review of literature
Authors: Buva Kirti , Deshmukh Ajinkya , Kavle Pratibha , Gupta Anish
Published: April 2023

Ameloblastoma is an odontogenic tumour derived from the remnants of odontogenic epithelium. Ameloblastoma shows versatile clinical and histological variants. Basal cell ameloblastoma is a rare variant among all histopathological variants of ameloblastoma. We present a case of a 25-year-old male patient with painless swelling on the lower left side of the face for 1 year, which had gradually increased in size and histologically showed features of basal cell ameloblastoma. The aim of the present paper is to understand this rare variant of ameloblastoma and review the literature.
Glucose transporter 1 expression in ameloblastoma and odontogenic keratocyst – A comparative immunohistochemical study
Authors: Pragallapati Sindhuri , Manyam Ravikanth
Published: April 2023

Introduction:

Facilitative glucose transporters (GLUTs), which mediate glucose transport across the cell membrane, differ in their tissue distribution and affinity for glucose. GLUT1 is ubiquitously present and help in the basal uptake of glucose into the cells. Its expression is known to be elevated in conditions that induce hypoxia and by growth factors. GLUT1 is known to be increased in many malignant tumors to meet the metabolic requirements, but its role in odontogenic tumors is not known.

Objective:

The objective of this study is to evaluate and compare the immunohistochemical expression of GLUT1 in ameloblastoma (AM) and odontogenic keratocyst (OKC).

Materials and Methodology:

Thirty cases each of AM and OKCs were immunohistochemically stained using anti-GLUT1 antibody according to the standard protocol. Qualitative assessment of GLUT1 expression was done under the categories of distribution, intensity and localization of staining. Quantitative assessment was done using Image J software. The results were tabulated and statistically analyzed.

Results:

GLUT1 positivity was observed in 25 (83.3%) cases of OKC and 26 (86.7%) of AM cases. The majority of cells in the suprabasal layer of OKC showed positivity, whereas the equal distribution of staining was observed in the central and peripheral cells of AM.

Conclusion:

GLUT1 expression in these tumors is suggestive of an increased glucose uptake and probably increased utilization of energy, which may be correlated with their aggressive behavior.
Microstructural analysis of accessory canals in the furcation area of the mandibular first molar using micro-computed tomography
Authors: Suzuki Megumi , Kasahara Norio , Matsunaga Satoru , Yamada Masashi , Abe Shinichi , Furusawa Masahiro
Published: April 2023

Introduction:

Accessory canals in the furcation area (ACF) can be seen to provide routes of communication joining the dental pulp and periodontal tissue and be considered a cause of endodontic-periodontal disease. However, many points remain unknown concerning the three-dimensional morphology of ACFs as well as their locations and incidences in different types of teeth. The aim of this study was to examine the three-dimensional structure of ACFs using ultra-high-resolution micro-computed tomography (micro-CT), and their incidence on the basis of the existing classification system.

Materials and Methods:

Ninety-six Japanese mandibular first molars were grouped according to age, with those extracted from individuals <20 years old at the time of extraction classed as “junior” and those from individuals ≥20 years old at the time of extraction as “senior.” Regions of interest were designated for vertical and horizontal observations. Collected specimens were scanned in micro-CT, and three-dimensional reconstruction and morphological analyses were carried out. The morphological classification of ACFs of Yoshida et al. was followed. After classification, the prevalence of teeth with ACFs and the total numbers and percentages of ACFs in each type were calculated. Mann–Whitney U-tests were used for the statistical analysis of numbers of ACFs, with values of P < 0.05 regarded as significant.

Results:

Ninety-five molars showed at least one accessory canal. Accessory canals were present in 98.0% of junior and 100% of senior individuals. Types 3 and 6 were the most commonly found in the furcation area. Junior showed significantly more accessory canals per tooth than senior (P < 0.05).

Conclusions:

ACFs were present in the vast majority of specimens of both junior and senior teeth. This result suggested that clinically, affecting endodontic-periodontal disease as well as the presence of ACFs may impact reinfection after infected root canal treatment.
Assessment of debris extrusion on using step-wise irrigant activation versus conventional activation in different access designs: An ex-vivo study
Authors: Teja Kavalipurapu Venkata , Taduri Vivek , Harsha Tummala Sri , Bindu Vinukonda Hima
Published: April 2023

Introduction:

A successful endodontic therapy mainly depends on the effective chemomechanical debridement. The present study assessed the effect of different activation modes on debris extrusion in different access cavity designs.

Materials and Methods:

Freshly extracted 168 maxillary premolars were collected. They were allocated into two groups (n = 84) (Group I: Traditional Endodontic Access (TEA) and Group II: Contracted Endodontic Access (CEA)). These groups were further subgrouped (n = 28) based on the activation protocol used (Subgroup A, D: Manual irrigation with no activation, Subgroup B, E: Conventional activation (CA), and Subgroup C, F: Step-wise irrigant activation). Each tooth specimen was inserted into Eppendorf for debris collection. The canals were instrumented using HyFlex CM rotary files to 0.04 taper. The irrigation was specific to the experimental subgroups, which was done by a single operator. Following the experimental irrigation, the collected debris was weighted using an analytical balance. The collected data were statistically analyzed.

Results:

Statistical significant debris extrusion was seen with TEA (P < 0.05). Among the subgroups, step-wise irrigant activation technique showed significant (P < 0.05) debris extrusion.

Conclusion:

CEA showed less debris extrusion when the CA technique was used for irrigation.
Single-visit regenerative endodontic procedure of necrotic immature lower permanent molar with acute apical abscess
Authors: Alsharqawi Nujud Saleh , Austah Obadah N.
Published: April 2023

Regenerative endodontic procedures (REPs) of immature teeth with necrotic pulp and apical pathosis focus on passive chemomechanical debridement and usually require multiple visits to enhance the antibacterial effect by placing intracanal medications. However, different case reports showed a favorable clinical and radiographic outcome in single-visit REPs of necrotic immature teeth with symptomatic apical periodontitis or chronic apical abscess. To the best of our knowledge, there are no published reports of single-visit REPs on cases with acute apical abscess. Therefore, this case report aimed to present a successful REP performed in a single visit for immature lower molar with necrotic pulp and acute apical abscess. A 9-year-old female patient referred for the management of the lower right molar (#46), with the chief complaint of localized moderate pain with cold drinks in the lower right molar for 1 week. The extraoral clinical examination revealed no significant findings. Intraorally, tooth #46 revealed a deep occlusal caries, with normal response to palpation, mild pain on percussion, and moderate pain to the cold test. The radiographic examination showed deep occlusal caries approaching the pulp, and periapical radiolucency related to the distal root. It was diagnosed as symptomatic irreversible pulpitis with symptomatic apical periodontitis. After accessing the pulp chamber, the radicular pulp on the mesial root was vital, while necrotic in the distal root. Therefore, vital pulp therapy was done for the mesial root, and REPs initiated for the distal root with intracanal medicament placement. However, the patient failed to show up in the scheduled visit to complete the treatment. The father refused to bring her as she was asymptomatic, and he was afraid of the COVID-19 pandemic situation. One month later, she presented to the clinic with pain and facial swelling in the lower right area of her face. Clinical examination revealed extra- and intraoral swelling related to tooth #46 (i.e., acute apical abscess) with severe pain on palpation and percussion. The patient’s parents insist to finish the treatment or extract the tooth on the same visit. Hence, a single-visit REP was done. After 20 months, clinical and radiographic examinations showed that the tooth became asymptomatic, responded to sensibility tests, and the periapical pathosis healed. It was concluded that regenerative endodontic treatment can be done in single visit in cases with acute apical abscess. It should be considered in cases of poor complaint, difficulty in accessing dental care, or pandemic curfew.
Evaluation of the effect of diode laser activation on push-out bond strength of different intraorifice barriers in endodontically treated teeth. An in-vitro study
Authors: Halkai Rahul S , Begum Raeesunisa , Halkai Kiran R. , Zakaullah Syed , Indi Shreeshail , Thimwala Aadil Mahammad , Almohareb Rahaf , Algahtani Fahda Nabeel
Published: April 2023

Introduction:

The placement of intraorifice barriers should facilitate proper adhesion; however, it is still a challenge with existing intraorifice barrier materials. Thus, this study aims to evaluate the push-out bond strength of Glass Ionomer Cement (GIC), Tetric-N-Flow, and Biodentine as intraorifice barriers with and without diode laser activation.

Materials and Methods:

Human-extracted single-rooted 60 mandibular premolars were decoronated to standardize 13 mm root length. Root canal was instrumented with rotary ProTaper universal system till F4 and alternatively irrigated with 5 ml of 2.5% sodium hypochlorite and normal saline, followed by obturation using gutta-percha and AH-plus sealer. About 3.5 mm of gutta-percha was removed from the orifice using peso reamer. Horizontal tooth sections of 3.5 mm in length were obtained from the coronal third of each sample and were randomly divided into three groups (n = 20 each) for intraorifice barrier materials. Group 1: GIC; group 2: Tetric-N-Flow and group 3:Biodentine. Each group was further subdivided into two subgroups A and B (n = 10 each) with and without diode laser. After 7 days, the specimens were mounted in acrylic molds and push-out bond strength was evaluated under universal testing machine. Data analysis was done using One way-analysis of variance and post hoc Tuckey comparison tests (P ≤ 0.05).

Results:

Laser activation in each group showed greater push-out bond strength; however, Biodentine with laser (group 3A) exhibited higher bond strength compared to all groups (P ≤ 0.05).

Conclusion:

Biodentine with laser activation before placement of the coronal barrier of endodontic treated tooth increases the quality of bond strength.
Interdisciplinary approach for diagnosis and management of the tooth with type III palatogingival groove
Authors: Baranwal Harakh Chand , Yadav Jyoti
Published: April 2023

Palatogingival grooves (PGGs) are developmental anomalies well known for causing endodontic and periodontal diseases to the teeth that have no evidence of caries or trauma. It is a rare developmental defect that frequently exhibits the palatal aspect of maxillary anterior teeth. The aim of this case report is to diagnose PGG using cone-beam computed tomography (CBCT) and manage it with an interdisciplinary approach by endodontic and periodontic intervention. A 20-year-old healthy female patient came with a chief complaint of foul smell and discharge of pus from the gum region. During clinical examination, a sinus opening and deep periodontal pocket were noticed with respect to the maxillary left lateral incisor. The tooth showed mild tenderness to percussion and a negative response to thermal and electric pulp testing. The intraoral periapical radiograph showed a vertical radiolucent line with periapical radiolucency, giving suspicion of PGG, which was confirmed by CBCT investigation. The diagnosis of pulp necrosis with chronic periapical abscess was made. After root canal treatment, surgical intervention was done and sealed the groove with Biodentine. This case report shows the successful outcome of a tooth associated with PGG after a 9-month follow-up. The tooth associated with this anomaly can be correctly diagnosed and planned with CBCT, and successfully treated using an interdisciplinary approach with a bioactive restorative material.
High-Flow Nasal Cannula Treatment in Patients with COVID-19 Acute Hypoxemic Respiratory Failure
Authors: Alshahrani Mohammed S , Alshaqaq Hassan M. , Alhumaid Jehan , Binammar Ammar A. , AlSalem Khalid H , Alghamdi Abdulazez , Abdulhady Ahmed , Yehia Moamen , AlSulaibikh Amal , Al Jumaan Mohammed , Albuli Waleed H , Ibrahim Talal , Yousef Abdullah A. , Almubarak Yousef , Alhazzani Waleed
Published: April 2023

Background:

Early use of high-flow nasal cannula (HFNC) decreases the need for endotracheal intubation (EI) in different respiratory failure causes. While HFNC is used in coronavirus disease 2019 (COVID-19)-related acute hypoxemic respiratory failure (AHRF) under weak recommendations, its efficacy remains to be investigated.

Objectives:

The primary objective was to examine HFNC efficacy in preventing EI among COVID-19 patients with AHRF. Secondary objectives were to determine predictors of HFNC success/failure, mortality rate, and length of hospital and intensive care unit (ICU) stay.

Patients and Methods:

This is a prospective cohort study conducted at a single tertiary care centre in Saudi Arabia from April to August 2020. Adult patients admitted to the ICU with AHRF secondary to COVID-19 pneumonia and managed with HFNC were included. We excluded patients who were intubated or managed with non-invasive ventilation before HFNC.

Results:

Forty-four patients received HFNC for a median duration of 3 days (interquartile range, 1–5 days). The mean age was 57 ± 14 years, and 86% were men. HFNC failure and EI occurred in 29 (66%) patients. Patients in whom HNFC treatment failed had a higher risk of death (52% versus 0%; P = 0.001). After adjusting for confounding factors, a high SOFA score and a low ROX index were significantly associated with HFNC failure (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.04–1.93; P = 0.025; and HR, 0.61; 95% CI, 0.42–0.88; P = 0.008, respectively).

Conclusions:

One-third of hypoxemic COVID-19 patients who received HFNC did not require intubation. High SOFA score and low ROX index were associated with HFNC failure.
Childhood Atopic Dermatitis
Authors: Aldosari Batal M. , Shadid Asem M. , Alekrish Khalid A. , Alreshidi Ibrahim G. , Alturki Abdulaziz Yousef , Sulaiman Mohammed A. Al , Sheikh Afaf Al
Published: April 2023

Background:

Atopic dermatitis (AD) negatively affects the quality of life (QoL). However, few studies from Saudi Arabia have assessed the effect AD has on the QoL of pediatric patients.

Objective:

To determine the psychological impact of AD on pediatric Saudi patients using the Children’s Dermatology Life Quality Index (CDLQI).

Methods:

This cross-sectional was conducted across five tertiary hospitals located across five cities of Saudi Arabia from December 2018 to December 2019. The study included all Saudi patients aged 5–16 years who were diagnosed with AD for at least 6 months prior to visiting the dermatology clinic of the included hospitals. The quality of life in children with AD was assessed using the Arabic version of the CDLQI.

Results:

A total of 476 patients were included, of which 67.4% were boys. AD had a very large and extremely large effect on the QoL in 17.4% and 11.3% of the patients, respectively; the QoL of only 5.7% of the patients was not impacted due to AD. The average CDLQI score was not significantly different between males and females (9.7 vs. 9.1, respectively; P = 0.4255). Domains related to symptoms and emotions were affected to a greater extent compared with the remaining domains, while the school domain was the least affected. The correlation between age and CDLQI (r = 0.04, P = 0.52) and between the duration of the disease and CDLQI (r = 0.062, P = 0.18) was not significant.

Conclusions:

This study found that AD affects the QoL of a significant proportion of the Saudi pediatric patients, thereby highlighting the need to consider QoL as a measure of treatment success.
Cyberchondria and its Association with Smartphone Addiction and Electronic Health Literacy among a Saudi Population
Authors: El-Zayat Ayat , Namnkani Sundus Amin , Alshareef Nouf Abdullah , Mustfa Mashaer Mohammed , Eminaga Nuran Shukri , Algarni Ghadah Ahmed
Published: April 2023

Background:

Cyberchondria is a recent phenomenon characterized by the excessive/frequent searching of the internet for health-related information (HRI) that results in concerns/anxiety over health and wellness. Studies have shown an increase in the prevalence of cyberchondria and that it is associated with smartphone addiction and eHealth literacy, but few such studies are available from Saudi Arabia.

Methods:

This cross-sectional study included adult Saudis living in Jeddah, Saudi Arabia, and was conducted between May 1 and June 30, 2022. A four-section questionnaire was distributed using Google Forms, and included the Cyberchondria Severity Scale (CSS), Smartphone Addiction Scale-Short Version (SAS), and Electronic Health Literacy scale (eHEALS). The scales were translated into Arabic using the forward–backward technique, and then evaluated for content validity, face validity, and reliability.

Results:

The reliability of the translated versions was satisfactory: CSS Cronbach’s alpha = 0.882; SAS = 0.887; eHEALS = 0.903. A total of 518 participants were inlcuded, of which the majority were female (64.1%). The prevalence of cyberchondria was 2.1% (95% CI: 1.1–3.8), 83.4% (79.9–86.5), and 14.5% (11.6–17.8) for low, moderate, and high grades, respectively. Two-thirds of the participants (66.6%) had smartphone addiction, while three-fourths (72.6%) had a high level of eHealth literacy. There were significant correlations between cyberchondria and smartphone addiction (r = 0.395, CI = 0.316/0.475, P = 0.0001) and high eHealth literacy (r = 0.265, CI = 0.182/0.349, P = 0.0001).

Conclusion:

The study revealed a high prevalence of cyberchondria in a Saudi population, and this was associated with smartphone addiction and high eHealth literacy.
Plateletcrit is a Useful Marker in the Quality of Life Assessment of Patients with Rheumatoid Arthritis: A Cross-Sectional Study from Erbil, Iraq
Authors: Aref Sheelan Faroz , Jalal Aryan Mohamadfatih , Mawlood Zhala Kakamin , Al-Nimer Marwan Salih
Published: April 2023

Background:

In patients with rheumatoid arthritis (RA), hematological indices and ratios have been reported to be related to the severity of illness, and thus could potentially be useful determinants of quality of life (QoL).

Objective:

To evaluate the association between hematological indices or ratios, which serve as biomarkers of disease activity, and the QoL of RA patients.

Materials and Methods:

This study was carried out in the Rizgary Teaching Hospital in the Kurdistan region of Iraq between December 01, 2021, and March 31, 2022. All female patients with a confirmed diagnosis of RA and aged ≥18 years were included. Data relating to the disease activity score (DAS-28), biochemical measurements of the profile, and hematological indices and ratios were assessed. The QoL of each patient was assessed using the Quality of Life-Rheumatoid Arthritis II (QoL-RA II) and the World Health Organization-Quality of Life (WHOQOL-BREF) scales.

Results:

A total of 81 participants were included, with a median disease duration of 9 years. The median values of the hematological indices were as follows: mean corpuscular volume, 80 fL; platelet count 282 × 103/mm3; mean platelet volume, 9.7 fL; neutrophil-to-lymphocyte ratio, 2.76; and platelet-to-lymphocyte ratio, 170.5. In six of the eight domains of the QoL-RA II scale, the median score was ≤5, indicating poor QoL. The transformed scores of WHOQOL-BREF domains were <50. Multivariate regression analysis showed significant inverse correlations between plateletcrit and the health domains. The area under the curve of the physical, psychological, and environmental domains was <0.5 at a cutoff value of plateletcrit of 0.25.

Conclusions:

In RA patients, hematological indices and ratios could serve as a QoL assessment tool, particularly plateletcrit, as higher plateletcrit (≥0.25) were found to negatively impact the physical health, psychological, and environmental domains.
Health Economic Analysis of Pharmacist-Led Annual Wellness Visits
Authors: Mallouh Mohammad Abu , Briggs Alyse , Hawkins Stefanie , Heffern Cassie
Published: April 2023

Objective To quantify the financial and clinical implications of pharmacists completing Medicare Annual Wellness Visits (AWV). Design Retrospective, observational, population-based health economic analysis utilizing electronic medical record data.
Setting A single family-practice clinic within a Missouri-based not-for-profit community health system. Patients/Participants Medicare patients in their second year of coverage who had not been seen for an AWV within the previous 12 months. Intervention
Patients attended a subsequent AWV conducted by a licensed ambulatory care pharmacist between July 1 and December 31, 2021. The pharmacist completed all necessary visit requirements and helped facilitate completion of preventive screenings. Main Outcome Measures Primary
outcomes measured were financial implications of pharmacists completing AWVs. The primary objective was to quantify the direct and indirect financial benefits for a health system incorporating pharmacist-led AWVs. Direct revenue was calculated based on the number of visits completed multiplied
by the reimbursement rate paid to the health care system by the Centers for Medicare & Medicaid Services (CMS). Indirect revenue was estimated based on the number and type of interventions completed by the patient. The secondary outcome measured was the clinical impact of pharmacist-led
AWVs through quantifying preventive care service needs and completion of these services. Alongside these measures, the number of medication discrepancies and drug interactions were also measured and cost avoidance estimated. Annual cost in salary of a pharmacist was considered, but additional
cost of overhead was beyond the scope of the study. Results Thirty-nine AWVs were completed. Two hundred six recommended screenings, labs, and immunizations were identified, of which 24% were completed. The pharmacists were also able to identify 205 medication issues. These
visits generated $4,593.42 in direct revenue. Recommended preventive care generated $2,161.71 in indirect revenue. Conclusion Pharmacist-led AWVs are financially beneficial to the health care system and increases the number of completed AWVs while avoiding
demand for additional physician time.
Ambulatory Care Pharmacists' Perception of Telehealth Services in the Wake of the COVID-19 Pandemic: Identifying Barriers and Best Practices for the Older Patient and Beyond
Authors: Hiskey Olivia , McKeirnan Kimberly , Frazier Cheyenne
Published: April 2023

Background Telehealth practice in the ambulatory care pharmacy setting has seen extensive expansion because of the COVID-19 pandemic. Historically, evaluations of pharmacy-driven telehealth services have shown positive patient outcomes and high patient satisfaction, but little
was known about pharmacist provider satisfaction. Additionally, barriers to telehealth practice have been highlighted with the widespread expansion of telehealth. With the push to continue high rates of telehealth use postpandemic, evaluation of current ambulatory care pharmacist telehealth
practices is needed. Objective This study aimed to evaluate ambulatory care pharmacists' perception of the telehealth services they provide, including barriers patients experience, solutions to address these barriers, and perceptions of the quality of care provided through
telehealth. Methods Ambulatory care pharmacists in Washington State were recruited to participate in a 16-item key informant interview. The Technology Acceptance Model was the theoretical framework applied to the interview questions and used to evaluate common themes emerging
from the interviews. Results Common themes from the interviews included positive and negative attributes to telehealth care, pharmacist preferences for a video telehealth platform, technology access and use barriers for patients accessing telehealth, technology support
from the provider’s organization as an avenue to address these barriers, and patient-specific characteristics allowing high-quality health care through telehealth. Conclusion Using these described common ideals, ambulatory care pharmacist telehealth best practices
can be developed, including a personalized approach to this care. As we emerge from the COVID-19 pandemic, actively addressing common barriers as well as successfully identifying appropriate telehealth candidates will be essential in providing high-quality virtual care.
Numerical Investigations of the Dust Deposition Behavior at Light
Commercial Vehicles
Authors: Yigci Ibrahim , Strohbücker Veith , Schatz Markus
Published: April 2023

Dry dust testing of vehicles on unpaved dust roads plays a crucial role in the
development process of automotive manufacturers. One of the central aspects of
the test procedure is ensuring the functionality of locking systems in the case
of dust ingress and keeping the dust below a certain concentration level inside
the vehicle. Another aspect is the customer comfort because of dust deposited on
the surface of the car body. This also poses a safety risk to customers when the
dust settles on safety-critical parts such as windshields and obstructs the
driver’s view. Dust deposition on sensors is also safety critical and is
becoming more important because of the increasing amount of sensors for
autonomous driving. Nowadays, dust tests are conducted experimentally at dust
proving grounds. To gain early insights and avoid costly physical testing,
numerical simulations are considered a promising approach.

Simulations of vehicle contamination by dry dust have been studied in the past.
However, they lack detailed tire resuspension models, and none of the
publications focus on the dust deposition at the vehicle in detail, such as door
gaps and locks. Moreover, the emphasis of many authors is the environmental
impact of vehicles resulting from non-exhaust emissions, such as tire and road
wear, brake wear, and dust emissions.

This paper introduces a novel method for simulating the production of dust
resulting from vehicles driving on a dry and dusty, unpaved road, as well as the
subsequent deposition mechanisms that occur within door gaps and locks. To
achieve this, both a basic, generic vehicle model and a more complex, detailed
model of a Volkswagen (VW) Caddy are used in the context of a multiphase
computational fluid dynamics (CFD) simulation with Lagrangian particles.
Brain Tumor Classification using the Probabilistic-Deformable Fuzzy system and RideNN
Authors: G. Srishailam
Published: April 2023

In the medical field, brain tumor classification is a very significant treatment process. The manual segmentation and classification of brain tumors is a tedious and time-consuming process. Hence, automatic classification and segmentation methods are very important. This paper presents brain tumor classification using a Probabilistic-deformable fuzzy system (PDFS) with RideNN. The overall procedure of the proposed approach involves four steps, such as pre- processing, segmentation, feature extraction, and classification. Initially, the input image is subjected to pre-processing. Then, the brain tumor segmentation is done using a new model called the Probabilistic-Deformable Fuzzy system. It is developed by combining a deformable model and a fuzzy system. Then the result is combined using probability-based fusion. After the segmentation, feature extraction is carried out by extracting texture-based features such as Local Gradient Pattern (LGP) and tetrolet transform. Finally, the classification is performed based on the features extracted using RideNN which employs Rider optimization Algorithm (ROA) for training the Neural network (NN). The performance of the brain tumor classification is based on PDFS-RideNN and evaluated based on sensitivity, specificity, and accuracy. The proposed PDFS-RideNN method achieves a maximal sensitivity of 93.18%, a maximal specificity of 98.67%, and a maximal accuracy of 98.25%.
A COMPARATIVE STUDY ON PRECISION METROLOGY SYSTEMS FOR ADDITIVE MANUFACTURING
Authors: SAĞBAŞ Binnur , POYRAZ Özgür , DURAKBASA Numan
Published: April 2023

This paper presents a comparative study on precision metrology systems such as Coordinate Measuring Machine (CMM), 3-Dimensional Scanning (3DS) and Computed Tomography (CT) for polymer additive manufacturing. A special test sample was designed and manufactured by Fused Deposition Modeling (FDM) and Selective Laser Sintering (SLS) AM systems. The manufactured parts were then measured by three different precision metrology systems and the results were compared in terms of different measurement and AM methods. Uncertainty analyses were conducted based on the results of CMM measurements. The benchmark highlighted the difference between part characteristics manufactured by FDM and SLS, where FDM part represented higher surface roughness and more deviation to the nominal design. Furthermore, expanded uncertainties computed for the FDM manufactured part were almost three times of the uncertainties computed for the SLS manufactured part. It was also demonstrated that one of the major contributors to the expanded uncertainty occurred because of rougher surface of FDM manufactured part. Similar tendency of part to nominal deviations were observable in all metrology systems including CMM, CT and 3DS. Findings of the study revealed the need of standardized measurement for inspection and control of AM parts.
Meme Kanserinde PD-1/PD-L1 Hedefli Tedaviler
Authors: ÖZEN EROĞLU Güneş , YAYLIM İlhan , GEZER Uğur , KURUCA Serap
Published: April 2023

Meme kanseri, kadınlarda en yaygın görülen kanserlerden biridir ve
dünyadaki en yüksek insidansa sahip kanser türüdür. Meme kanseri

gelişiminde cinsiyet, yaş, östrojen düzeyi, aile öyküsü, gen mutasyon-
ları ve sağlıksız yaşam tarzı gibi çok sayıda risk faktörü bulunmaktadır.

Mevcut tedavi seçenekleri cerrahi, radyoterapi, hormonal tedaviler,
kemoterapi ve hedefe yönelik tedavilerdir. Hedefe yönelik tedavilerin
içinde immünoterapi son yıllarda oldukça yaygın bir tedavi stratejisi
olarak karşımıza çıkmaktadır.

Meme kanseri immün sistemden bağımsız bir kanser olduğu düşün-
cesinin aksine, artık meme kanserinin immün temelli bir kanser türü

olduğu bilinmektedir. Bu kapsamda diğer kanser türlerinde olduğu

gibi, meme kanserinde de immünoterapinin hedeflediği moleküller-
den programlanmış hücre ölümü-1 (PD-1) ve programlanmış hücre

ölümü ligandı-1 (PD-L1) ile yapılan çok sayıda çalışma bulunmakta-
dır. PD-1 ve PD-L1 hedefli tedaviler günümüzde meme kanseri tedavi-
sinde uygulanmaktadır. Meme kanseri alt tipleri olarak ele alındığında;

farklı alt tipler arasında heterojen bir dağılım olmakla birlikte tümör

hücrelerinde artmış PD-L1 ekspresyonu gözlenmektedir. Ayrıca, PD-
L1 ekspresyonu, genç yaş, ileri evre, tümör infiltre eden lenfositlerin

(TIL’ler) varlığı ve agresif moleküler alt tipler ile pozitif korelasyon gös-
termektedir. Şimdilik sadece üçlü negatif meme kanserinin (TNMK)

tedavisinde yer alan immünoterapi, yapılacak daha fazla araştırma so-
nucunda, diğer meme kanseri alt tiplerinde de kombinasyon ya da tek

tedavi olarak yer alabilecektir.
Meme kanseri tedavisinde, PD-1 ve PD-L1 düzenlemesinin ayrıntılı
mekanizmasını anlamak; tedavilere direncin üstesinden gelinmesi ve

daha iyi klinik sonuçlara ulaşılması açısından büyük önem taşımak-
tadır.

Bu derlemede meme kanserinde PD-1 ve PD-L1 hedefli tedavilerin
incelenmesi hedeflenmiştir.