bluuebunny/crossref_metadata_2025 huggingface dataset:
Partial Atrioventricular Septal Defect Associated With Wolff-Parkinson-White Syndrome
Authors: Mammen Anand , Tewari Prabhat , Horo Pallavi , Pande Shantanu
Published: March 2023

Wolff-Parkinson-White syndrome (WPW) is rarely seen in association with atrioventricular septal defect. Although paroxysm's of palpitation due to supraventricular tachycardia can occur in these patients, rare, fatal, ventricular dysrhythmias can also occur. Herein, we report the case of a 20-year-old male patient with partial atrioventricular septal defect and WPW syndrome for intracardiac repair, developing intraoperative Torsades de pointes and postoperative cardiac arrest, adding to the difficulty in overall patient management.
Comparison of postoperative delirium within 24 hours between ketamine and propofol infusion during cardiopulmonary bypass machine
Authors: Siripoonyothai Sutira , Sindhvananda Wacharin
Published: March 2023

Background:

Postoperative delirium (POD) is a common complication in cardiac surgery especially in elderly population which can lead to a delay of weaning from ventilator and extubation. Cardiopulmonary bypass (CPB)-induced inflammation is related to POD. Anti-inflammatory effect of anesthetic agent might attenuate POD.

Aims:

The present study was primarily aimed to compare within-24-h POD between ketamine-based anesthesia and propofol-based anesthesia during CPB. The secondary objective was to identify risk factors associated with within-24-h POD.

Setting and Design:

Our study was a randomized controlled trial in patients undergoing cardiac surgery with CPB. Enrolling patients were aged >65 years, and able to comprehensive communication. Exclusion criteria were aortic surgery, cognitive disorders, cerebrovascular and carotid disease, and positive result of preoperative CAM-ICU.

Materials and Methods:

Patients were randomly assigned to group Ketamine infusion of 1 mg/kg/h and group Propofol infusion of 1.5-6 mg/kg/h during CPB. POD was evaluated by validated Thai version CAM-ICU at 8-24 hour after ICU arrival.

Statistics:

Chi-square, Fisher exact and t-test tests, univariate analysis and multivariate logistic regression were utilized. Results: Total 82 patients entered this study and 64 patients remained after exclusion (Group Ketamine = 32 and Group Propofol = 32). Within-24-h POD were 31.25% and 56.25% (P = 0.04) and mean arterial pressure (MAP) were 71.45 and 65.53 mmHg (P = 0.01) respectively in Ketamine and Propofol group. Postoperative leukocytosis was a significant risk to POD (adjusted OR 124.5).

Conclusion:

With limitations of the study, prevention of 24-h POD in general by ketamine was inconclusive. In comparison with propofol, ketamine leaded to less events of 24-h POD and kept higher MAP. Severity of postoperative inflammation was a significant prediction of 24-h POD.
Preoperative mitral annulus size – Can we get it right?
Authors: Panicker Varghese T. , Sreekantan Renjith , Lokanath Nagananda
Published: March 2023

Objective:

We looked for a correlation between the surgically measured mitral valve size and the cardiac dimensions (left ventricle internal diameter, left atrial size, aorta size, and body surface area) measured by preoperative and intraoperative echocardiography. We also assessed to see if we could predict the mitral prosthesis size based on the correlation data obtained.

Methods:

The hospital records of 180 patients who underwent mitral valve replacement (MVR) with TTK Chitra valve between January 2008 and December 2012 at our hospital, were studied. The correlation between surgically measured mitral annulus size to left ventricular internal diameter systolic (LVIDS) and diastolic (LVIDD), left atrial size (linear measurement), and aorta size on echocardiography and body surface area was calculated using Pearson correlation coefficient. Mean LVIDS was calculated for each valve prosthesis size separately and the correlation was studied.

Results:

The correlation between mitral valve prosthesis size and left ventricular internal diameter (systolic) showed a Pearson coefficient of 3.3 with significance at the level 0.01. Mitral valve size and left atrial size showed a correlation coefficient of 2.7 with significance at the level 0.01. The correlation coefficient for mitral valve size with left ventricular internal diameter diastolic, aorta and body surface area were 2.5, 1.9, and 1.8, respectively. There was a gradual increase in the mean LVIDS with increase in the prosthetic valve size. Box plot and scatter plot showed linear correlation between valve size and mean LVIDS.
Collateral Circulation − “Hand of God:” Salvaging the Transplant Kidney!
Authors: Ramalingam Ramprasad , Patro Kiran Chandra , Ramakrishnan S. , Rangarajan Dilip
Published: March 2023

The physiological adaptation capability of any living being is necessary for survival. Vascular collaterals are proven to be maintaining organ perfusion in various situations such as ischemic heart disease, cerebrovascular disease, and peripheral vascular diseases. We are presenting here a postrenal transplant case with renal graft perfused by collaterals because of the complete occlusion of right common iliac artery. This was diagnosed while the patient presenting with right lower limb claudication pain. He required femoro-femoral graft to perfuse the right lower limb. The importance of pretransplant iliac vessels imaging and Doppler studies is emphasized.
Spectrum of Infections in Renal Transplant Recipients, Factors Affecting Long Term Patient and Graft Outcomes Over 10 Years Including COVID Pandemic Periods
Authors: Mahapatra Himansu Sekhar , Gautam Abhisek , Kaur Nirmaljit , Pursnani Lalit , Muthukumar B. , Singh Amandeep , Patil Sanket Kishore , Prabhakaran Manoj
Published: March 2023

Introduction:

Multiple factors including infections affect graft and patient outcomes in Renal Allograft Recipients. Survival data from tropical countries is scarce, especially during the COVID 19 pandemic.

Subjects and Methods:

In this ambispective study, records of KTRs between 2011 to 2019 and prospective follow up of subsequent transplants up till 2021 was done. Infection rate, etiology, and patient and graft outcomes were studied with appropriate investigations. Univariate and multivariate analysis was done to assess the predictors of patient and graft outcomes.

Results:

A total of 249 patients were studied, of which 218 episodes of infection occurred in 129 patients (49.79%). Bacterial infections were the most common (40.50%), followed by viral (35.20%), mycobacterial (11%), and fungal (8.10%). Of all infections, 52.3% of cases occurred within the 1st 6 months. Infections led to patient mortality in 14.7% of cases. Infections were significantly associated with graft rejection and chronic graft dysfunction. Donor age, cytomegalovirus (CMV) infection, and graft rejection were independent predictors of chronic graft dysfunction. Recipient age and graft rejection were independent predictors of graft loss. Graft survival was 88.53%, 73.75%, and 44.90% at the end of 1, 3, and 5 years, respectively, with average 18% of total graft losses occurring during the pre-COVID era as compared to 39% in COVID period.

Conclusion:

Invasive fungal infections and tuberculosis are more common in late transplant period. Recipient and donor age, graft rejection, CMV infection, and COVID pandemic period affected graft and patient outcomes. COVID pandemic period led to a disproportionately higher occurrence of graft loss.
An Interesting Case of Posttransplant Obstructive Uropathy Managed with a Novel Surgical Approach
Authors: Philip Alphons , Anand Abhay , Sahadevan Sajeesh , Karunakaran Ravikumar
Published: March 2023

Obstructive uropathy of the graft kidney is a common complication. However, graft ureteric obstruction due to inguinal herniation of transplant ureter is a rare complication. The management of such cases is challenging. This is a case report of a patient who presented with obstructive uropathy and acute kidney injury postrenal transplant due to inguinal herniation of the transplant ureter. Laparoscopic repair was done successfully and renal function returned to baseline.
Coexistent De novo Membranous and Collapsing Glomerulopathies in the Allograft: Unusual Alloimmune Injury
Authors: Pooniya Vishal , Rao Namrata S. , Chandra Abhilash , Malhotra Kiran Preet , Srivastava Alok
Published: March 2023

We describe a kidney transplant recipient who presented 7 months after transplantation with nephrotic proteinuria and graft dysfunction, which on biopsy revealed two concomitant lesions: de novo membranous and collapsing glomerulopathies. While the index episode responded favorably to plasmapheresis and rituximab, repeat evaluation 4 months later showed an evolution of acute antibody-mediated rejection, along with the remnant pathologies.
Antihypertensive Drug Usage and Target Blood Pressure Attainment in Postrenal Transplant: A Prospective Study in Indian Population
Authors: Choudhury Shouvik , Chatterjee Suparna , Chaudhury Arpita Ray
Published: March 2023

Introduction:

The etiology of hypertension in post renal transplant patients is multifold and effective control of blood pressure (BP) contributes towards proper graft functioning and reduces risk of cardiovascular diseases. This prospective observational study was undertaken to evaluate the prevalence of antihypertensive drug use, the prescribing pattern and trends of blood pressure control in a cohort of post renal transplant patients from eastern India.

Materials and Methods:

Patients who had undergone renal transplant in this public hospital were enrolled as per eligibility criteria. All enrolled patients were on antihypertensive from at least 3months prior to transplant and were followed upto one year post-transplant. Antihypertensive drug (AHD) and immunosuppressant intake, BP recordings and occurrence of major adverse cardiac events (MACE), if any were noted at each visit.

Results:

56 patients were enrolled with a mean age of 33.04 ± 9.96 years, 87.5% were male. 75% were hypertensive at discharge (2-3 weeks post-transplant). Percentage of patients on AHD at 3, 6, 9 and 12 months post-transplant were 83.9%, 82.1%, 75% and 71.4% respectively. Amlodipine was the most common prescribed AHD. Target BP control (≤130/80 mm of Hg) was achieved in 62.5% patients at 1year post-transplant. There were no major adverse cardiac events (MACE) during the study period.

Conclusion:

In our study comprising of a relatively young cohort of transplant patients from India, hypertension control was well achieved in majority of the subjects and no MACE were noted. Amlodipine was the most commonly used AHD either as monotherapy or in combination with beta-blocker. Long term follow up of this cohort shall provide further insights into the trends of such control.
Therapeutic Challenges of Tacrolimus Dose Requirement and Trough Level in an Indian Pediatric Renal Transplant Recipient with Extensive Metabolizer (Cytochrome P450 3A5*1)
Authors: Bag Sananda , Pradhan Subal Kumar
Published: March 2023

Pediatric patients need a higher dose of tacrolimus for posttransplant immunosuppression due to its high clearance. In addition, genetic polymorphism in cytochrome P450 (CYP) 3A5 enzyme (CYP3A5*1/*3) is an important determinant for its serum concentration. Substantial data exist about the requirement of higher doses of tacrolimus in patients with the CYP3A5*1 genotype (extensive metabolizer). Ketoconazole, an inhibitor of CYP, leads to the reduction of the tacrolimus dose while maintaining therapeutic levels in transplant recipients. However, very few studies have mentioned coadministration of ketoconazole and tacrolimus in pediatric renal transplant recipients. Herein, we present a case of a 10-year-old boy with end-stage renal disease due to posterior urethral valves who underwent a living-related kidney transplant. We also emphasize the importance of CYP3A5 genotype evaluation in deciding the course of the treatment and maintaining therapeutic levels of tacrolimus in pediatric transplant recipients.
Chylous Ascites Following Laparoscopic Donor Nephrectomy: Report of a Case and a Brief Overview
Authors: Sheela Chithra Sugathan , Thomas Renu , Yadav Manish Kumar , Sasidharan K.
Published: March 2023

Postoperative chylous ascites is a well-known complication of retroperitoneal lymph node dissection for testicular malignancies. This complication is now being reported increasingly with laparoscopic nephrectomies as well. A 33-year-old woman with no comorbidities underwent laparoscopic left donor nephrectomy. She had an uneventful postoperative recovery and was discharged on the 5th postoperative day. She reported on the 11th postoperative day with abdominal distension. Clinical examination revealed free fluid in the peritoneal cavity, and she was evaluated further. Imaging revealed mild ascites, which was aspirated, yielding milky fluid. Biochemical analysis of the fluid revealed triglycerides and chylomicrons, consistent with chyle. She was admitted, and an intra-abdominal drain placed under ultrasound guidance. Subsequently, she underwent lymphangiography and embolization. Her drain output came down, and she remained asymptomatic following drain removal. There was no further chylous leak on subsequent follow-up. Chylous ascites following laparoscopic nephrectomy is more common on the left side. Chylous leaks have been attributed to incomplete sealing of lymphatics with energy devices. Precise surgical technique of division of lymphatics between clips can prevent this complication. Most small leaks settle with a conservative care. Those that do not settle require open ligation. Percutaneous lymphatic embolization is an effective minimally invasive modality in managing such patients.
Knowledge and Attitude of Health-Care Professionals toward Organ Donation in Bahrain
Authors: Shah Shamik H. , Sridharan Kannan , Alalwan Adel A. , Alshehabi Khadija M. , Alsitri Fadhel , Alaradi Ali H. , El-Agroudy Amgad El-Baz
Published: March 2023

Background and Aim:

The present study was carried out to assess the awareness, knowledge, and attitude of health-care professionals (HCPs) toward organ donation in the Kingdom of Bahrain.

Materials and Methods:

In a cross-sectional study, 376 HCPs including physicians (n = 223), nurses (n = 101), and other HCPs (n = 52) were asked to fill out a validated questionnaire about their demographics, knowledge, and attitude toward organ and tissue donation and transplantation.

Results:

About two-thirds of the physicians (57.84%), nursing staff (38.6%), and other HCPs (54.4%) knew that Islamic laws allow organ donation (P = 0.005). Most of the physicians (99.1%) and nurses (95%) knew that brain-dead persons are eligible for organ donation, whereas only 91.2% of the other HCPs thought so. The majority of the HCPs supported organ donation during their life (96.2%); physicians (96.9%), nurses (88.1%), and other HCPs (82.3%). It was found that only 9.4% of the participants had registered as organ donors. Among HCPs, only about 50% thought that everyone should be automatically registered as an organ donor, whereas around 25% donated blood/tissue in their life. Three hundred and thirty-two participants (88.3%) reported a positive attitude toward living kidney donation and 71.8% expressed their agreement to donate organs after their death.

Conclusions:

HCPs had a good attitude toward organ transplantation, although less than half of them had knowledge of transplantation rules and its theoretical basis and financial issues. Additional awareness and education of HCP are needed in all areas of the organ donation process in the Kingdom of Bahrain.
Assessment of the functional efficacy of various light-curing units of different manufacturers
Authors: Wazir Nikhel Dev , Choudhary Deebah , Rathore Hemanee
Published: March 2023

Background:

Light plays an important role in polymerizing a light-cured resin-based composite as a hard restorative material. The present study was conducted to assess the functional efficacy of various light-curing units (LCUs) available to us.

Materials and Methods:

The present study was conducted in the Department of Endodontics on 60 different LCUs of different manufacturers. Parameters such as type of light-curing unit, the curing protocol, and frequency of bulb replacement were also recorded.

Results:

Out of 60 LCUs, 26 were quartz–tungsten–halogen (QTH) and 34 were light-emitting diodes (LEDs). The mean intensity of QTH was 486.3 W/cm2 and of LED was 612.1 W/cm2. The difference was significant (P < 0.05). Nineteen QTH and 22 LEDs were satisfactory, while 7 QTH and 12 LEDs were unsatisfactory. The difference was nonsignificant (P > 0.05).

Conclusion:

The authors found that maximum satisfactory results were seen with QTH type as compared to LED type.
An assessment of knowledge of dentists about third-molar extractions
Authors: Yesodharan Venu , Priya S. , Mathew Sujo
Published: March 2023

Background:

Third-molar extractions, commonly known as wisdom teeth extractions, are routine procedures performed by dentists. However, the potential for complications arising from these extractions can have a significant impact on patient outcomes. It is essential for dentists to have a comprehensive understanding of the procedure and its associated risks.

Aim:

This study aimed to assess the knowledge of dentists in India regarding third-molar extractions and to identify any gaps in their knowledge.

Methods:

A questionnaire was distributed to 200 dentists, containing 20 multiple-choice questions related to third-molar extractions, including indications for extraction, surgical techniques, and potential complications.

Results:

The results showed that dentists had a good overall knowledge of third-molar extractions.

Conclusions:

There were areas where dentists exhibited gaps in their knowledge highlighting the need for ongoing education and training.
Antimicrobial Effects of Green and Roasted Beans of Coffee Robusta and Coffee Arabica on Streptococcus mutans – An in vitro Comparative Study
Authors: Gupta SA , Potdar GV , Jain KD , Jethwa KP , Thakkar VP , Ram SM , Pachpute Samir Ramkrishna
Published: March 2023

Introduction:

In India, coffee is the third most common beverage consumed after water and tea. Through this study, we have analyzed the antimicrobial properties of coffee extracts by determining their zone of inhibition on blood agar plates in comparison to chlorhexidine which was used as the control.

Aim:

The study aims at determining the antimicrobial effects of extracts of green and roasted beans of Robusta and Arabica coffee (in
vitro).

Methodology:

The samples were collected from local markets of Coorg and Navi Mumbai. Streptococcus
mutans were cultured on blood agar, which was then inoculated with these samples. Antimicrobial properties were determined using the agar well diffusion method. The results were compared with gold standard solution, i.e., 0.2% chlorhexidine solution.

Results:

The coffee bean extract of Green
Robusta showed a more inhibitory effect on S. mutans when compared to Roasted
Arabica and Chlorhexidine. The diameter of the zone of inhibition around the extracts of Green
Robusta was 22 mm, 22.5 mm, 23.5 mm, and 24 mm of 2 g, 4 g, 10 g, and 20 g, respectively, and that of Roasted
Arabica was 11 mm, 12 mm, 13.5 mm, 15 mm of 2 g, 4 g, 10 g, and 20 g, respectively.

Conclusion:

According to this methodology, Green
Robusta has more inhibitory effects than chlorhexidine. Thus in future after more in vivo and in vitro studies, coffee may be used in dental aids such as mouthwashes, dentifrices, dental floss, and chewing gum for its antimicrobial effect.
Remineralizing Effect of Commercially Available Two Herbal Dentifrices on human Teeth-An in vitro Evaluation
Authors: Gomathi MS , Prasad SV , Iyer K , Jegadeson M , Indrapriyadhrshini K , Shrienitha DN
Published: March 2023

Background:

Dental caries is most prevalent oral infections worldwide, characterized by a progressive demineralization that affects the mineralized dental tissues. Although the decline of dental caries prevalence can be attributed to the widespread use of dentifrices that contain fluoride, there is a need for an advanced alternative fluoride remineralizing dentifrice preferably, herbal-based dentifrices.

Aim:

To investigate and compare the remineralization effect of demineralized human enamel using two herbal toothpastes via in vitro method.

Materials and Methods:

An in vitro study was conducted on 40 extracted natural teeth. Crowns and roots were sectioned at cementoenamel junction, and crowns were further sectioned to buccal and lingual halves. All the teeth samples were examined for baseline hardness level by Vickers hardness tester. Samples were kept for demineralization continuously for 48 h and postdemineralization hardness values were also evaluated. Samples randomly divided and allocated into two groups for remineralization procedure. Group A -Dabur Red (N = 20) and Group B - Patanjali Dant Kanti (N = 20). Remineralization using two dentifrice slurries was performed for 10 days and postremineralization hardness estimated. Data were collected and analyzed using Student’s unpaired t-test and analysis of variance (ANOVA). Intergroup analysis was done using Student’s t-test and intragroup analysis at baseline, demineralization and remineralization was done using ANOVA.

Results:

A highly significant difference in the Vickers hardness was observed between the two groups with Group A showing increased mean hardness levels in comparison to Group B (P < 0.001) and there was a significant change in hardness observed from baseline, demineralization, and remineralization of both Dabur Red (Group A) and Patanjali (Group B).

Conclusions:

Both the herbal toothpastes showed better remineralization potential but still Dabur Red showed highest remineralization when compared to Patanjali Dant Kanti. The role of herbal dentifrices as a remineralizing agent appears to be as effective as conventional toothpastes.
Knowledge, Attitude, and Oral Hygiene Practices among Law Students in Davangere City: A Cross-sectional Study
Authors: Babitha GA , Holla KS , Patel B , Prashant GM , Prakash S
Published: March 2023

Aim:

The aim of this study was to assess dental health awareness and oral hygiene practice among law students of R L Law College, Davangere, Karnataka.

Materials and Methods:

A questionnaire containing 30 questions, regarding basic knowledge, attitude, and practice was distributed among 150 Law students of R L Law college of Davangere, Karnataka, India. The data obtained were tabulated in Microsoft Excel and statistically analyzed in the Statistical Package for the Social Sciences (IBM Corporation) software.

Results:

In the present study, only 39.4% of the participants were aware of routine dental check-ups. 8.5% of the participants visited the dental clinic twice a year and 57% of the participants had never visited a dental clinic. 37.3% of the participants were aware of oral hygiene aids. 62% of the participants used a tongue cleaner routinely and 55.5% brushed their teeth using only horizontal brushing technique. 48.6% were aware that consuming tobacco causes cancer. Only 9.2% consumed tobacco in various forms. 49% of the participants felt that all dental procedures were painful and expressed fear. 81% of the students were unaware of dental fluorosis. 65.5% of the participants agreed that dental health education is important and 21.8% thought that it might be important. Inferential statistics using the Pearson Chi-square test showed that there was a statistically significant correlation between the responses and the Year of law degree the participant was pursuing.

Conclusion:

In the present study, law students have satisfactory knowledge about good oral hygiene practices and oral health care. However, the knowledge acquired must be transferred into daily practice. This can be achieved by a change in their attitude toward oral hygiene maintenance. The inclusion of oral health-oriented education programs in their curriculum would improve their knowledge along with behavior, and they would be a good model to the community. This study will help us in devising an outline for the oral hygiene education of Law students of our country based on their current attitude, knowledge, and oral hygiene practice.
Assessment of Knowledge and Practice Behaviors about Minimally Invasive Surgical Technique in Periodontics among Dental Students, Dental Practitioners, and Academicians: An Online Questionnaire-Based Study
Authors: Gupta V , Mishra S , Dahiya S , Gupta DK , Gazala MP , Kujur SK
Published: March 2023

Background:

The concept on minimally invasive surgical technique (MIST) is rapidly evolving in the field of medicine and Dentistry. MIST in periodontics is beneficial in enhancing clinical performance and in terms of patient-related factors also.

Aims:

The aim of this study was to assess the knowledge and practice behaviors about MIST in periodontics among dental students, dental practitioners, and academicians.

Materials and Methods:

An online questionnaire was prepared as Google Form and was distributed to respondents to assess their knowledge and practice behaviors about MIST.

Statistical Analysis Used:

A descriptive analysis comprising counts and the percentage was performed for all the variables. Categorical variables were compared among the different groups using the Chi-square test.

Results:

The study revealed that most of the respondents had adequate knowledge of MIST but only 46% of them had performed MIST procedures in daily clinical practice.

Conclusions:

There is sufficient knowledge about MIST and its implications in periodontics among dental students and professionals. However, there is a need to emphasize the clinical applications and more training to enhance skills and practice about MIST.
Association of Sugary Food Consumption, Self-Perception of Dental Health Status, and Dental Health Awareness with Dental Caries and Gingivitis among Rural School Children Aged 12 Years – An Analytical Cross-Sectional Study in Nellore District, Andhra Pradesh, India, 2020
Authors: Vuyyuru CR , Ponnaiah M , Rangari RN
Published: March 2023

Background and Objectives:

Data on the prevalence of dental caries and gingivitis among Indian rural children are scarce. Hence, we estimated the prevalence of dental caries, gingivitis, and associated factors among the rural school children aged 12 years of Nellore district, Andhra Pradesh.

Methods:

We conducted this analytical cross-sectional study, with 1513 children by following two-stage cluster sampling. We collected data on dental caries and gingivitis using the WHO dentition status and community periodontal index modified, respectively, and associated factors by direct interviews using standardized semi-structured interview guide. We estimated the prevalence of dental caries and gingivitis and 95% confidence interval (CI); we calculated prevalence ratios (PRs) and its 95% CI by comparing factors among those with and without caries and gingivitis; we computed adjusted PRs using the generalized linear regression model.

Results:

Overall prevalence of dental caries and gingivitis was 61% (95% CI: 58–63) and 68% (95% CI: 65–70), respectively. Sugary food consumption (PR 1.56, 95% CI 1.33–1.82), fair and poor perception of the current dental health status (PR 1.31 95% CI 1.19–145 and PR 1.59 95% CI 1.45–1.73, respectively), and no dental health awareness (PR 0.85 95% CI 0.75–0.95) were associated with caries. Fair and poor perception of current dental health status (PR 1.16 95% CI 1.07–1.26 and PR 1.27 95% CI 1.17–1.38, respectively) was associated with gingivitis.

Conclusion:

We observed a high prevalence of dental caries and gingivitis among the study participants. Sugary food consumption, dental health awareness, and perception of current dental health status are associated with dental caries and gingivitis.
Simple limbal epithelial transplantation
Authors: Singh Vivek , Kusumesh Rakhi , Sinha Bibhuti Prassan , Anand Abhishek , Ambasta Anita
Published: March 2023

Purpose:

To evaluate the efficacy of auto simple limbal epithelial transplantation (SLET) and alloSLET in patients with different causes of limbal stem cell deficiency (LSCD).

Study Type:

Single-center prospective interventional study.

Materials and Methods:

Patients visiting tertiary referral hospital between April 2019 and March 2020 satisfying the criteria for labeling LSCD, also inclusion and exclusion criteria were enrolled.

Results:

Thirty-one eyes of 31 patients (20 men, 11 women) underwent SLET surgery (15 autoSLET, 16 alloSLET). The most common etiology in patients undergone SLET was chemical injury (11, 35.5%) followed by Stevens–Johnson syndrome/Toxic Epidermal Necrolysis (SJS/TEN) (9, 29.0%). SJS/TEN was the most common cause of bilateral LSCD. Combined successful outcome of autoSLET and alloSLET was 64.5%.

Conclusion:

SLET is a simple, useful surgery to restore LSC and it does not require any specialized center and can be done in a center with limited resources.
A prospective study to evaluate the functional and clinical outcome of anterior cruciate ligament reconstruction with standard hamstring autograft
Authors: Parvez Mohsin , Kumar Raman , Kumar Manish , Subhash Abhijeet , Kumar Santosh , Kumar Rajeev
Published: March 2023

Background:

The anterior cruciate ligament (ACL) is the primary stabilizer of the knee and prevents the knee against anterior translation. It is also important in counteracting rotational and valgus stress. The arthroscopically aided approach has the advantages of smaller skin and capsular incisions, improved viewing of the intercondylar notch for placement of the tunnel and attachment sites, less postoperative pain, fewer adhesions, earlier motion, and easier rehabilitation. The advantages with semitendinosus grafts are the availability of a greater sectional area and the unaffected integrity of the extensor mechanism. Moreover, the tensile strength of quadrupled hamstring is found to be even better than a normal ACL. The rate of complications such as extension loss, anterior knee pain, and surgical site infections was also lower than in other procedures such as in BPTB grafts. Cortical suspension devices have the necessary biomechanical properties with regard to ultimate failure strength, displacement, and stiffness for the initial fixation of soft tissue in the femoral tunnel for ACL reconstruction. The aperture fixation methods such as the interference screws allow for early firm fixation and heal with a tight bone–tendon interface.

Objective:

A prospective study to evaluate the functional and clinical outcome of ACL reconstruction with standard hamstring autograft.

Materials and Methods:

The study results included 30 patients admitted with clinical and radiological deficiency of ACL from September 2019 to March 2021 using endobutton and bioabsorbable interference screw in terms of range of motion, postoperative knee stability, subjective knee functions, and prospective assessment of functional outcome using Tegner Lysholm knee scoring system.

Results:

Sports injuries were the most common mode of injury (n = 17, 56.7%). The mean size of graft used was 8.2 ± 0.39 mm. Postoperatively at 2-year follow-up, 30 cases (100%) had 0 grade pivot-shift test, 0 grade Lachman test, and anterior drawer test. The mean postoperative Lysholm score improved from preoperative score of 62.83 ± 5.2–91.0 ± 5.54. The overall satisfactory result (excellent + good) at 6-month follow-up was (excellent – 30 and good – 70) 100%. Out of this, 27 (90%) patients had returned to preinjury level of activity in 1 year. In this study, one patient had superficial infection and two patients had knee pain.

Conclusion:

Arthroscopy-assisted ACL reconstruction using hamstring tendon autograft provides a stable knee, reduces postoperative morbidity, and enables early rehabilitation.
A study to identify leadership style of nurse managers and influence of leadership style on patient safety culture, organizational citizenship behavior, and job satisfaction so as to suggest an evidence based feed forward for preparing guidelines for training of nurse managers working in a superspecialty tertiary health care teaching institute in Northern India
Authors: Harsvardhan Rajesh , Singh Dimpi , Patnaik S. K. , Khatun Shabana
Published: March 2023

Introduction:

The safety of patients in health-care systems has long been a concern, but despite many positive changes in practice, health systems, and regulations, the desired level of safety remains unachieved. The competency of health-care leaders to create positive work environments and manage constant change is essential to the success of teams and organizations. The need for great leadership in health care has always been imperative; however, throughout the industry's recent transformation, it has been vital. Faced with enormous amounts of change, today's leaders must be capable of serving their teams while adapting to the evolving landscape and leading us into the future.

Aim:

The aim of this study was to identify the leadership style of nurse managers and ascertain the influence of leadership style on patient safety culture, organizational citizenship behavior, and job satisfaction so as to suggest an evidence-based feed forward for preparing guidelines for training of nurse managers working in a superspecialty tertiary health-care teaching institute in Northern India.

Objectives:

The objectives of this study were as follows – (1) to identify the leadership style of nurse managers based on full-range leadership model using the prevalidated tool, (2) to ascertain the influence of leadership style on patient safety culture using the prevalidated tool, (3) to assess the influence of leadership style on organizational citizenship behavior and job satisfaction using the prevalidated tool, and (4) to suggest an evidence-based feed forward for preparing guidelines for training of nurse managers working in a superspecialty health-care teaching institute in India using analysis of data thus obtained.

Methodology:

This was an analytical study.

Results:

(1) In the study, it was thus found that as transformational and transactional leadership behavior increases, patient safety culture, organizational citizenship behavior, and job satisfaction also increase; (2) on the other hand, patient safety culture, organizational citizenship behavior, and job satisfaction decrease as laissez-faire leadership behavior increases.

Conclusion:

Staff nurse under the leadership of their managers provides exemplary care and shares professional knowledge as well as provides direction and support to practice best patient care through policy development.
Mucormycosis and COVID-19 coinfection in kidney transplant recipient
Authors: Singh Prit Pal , Krishna Amresh , Kumar Abhijeet , Kumar Om
Published: March 2023

In the current pandemic of COVID-19, kidney transplant recipients with COVID-19 are at an additional risk of contracting mucormycosis and other infections. Rarely, coinfection of COVID-19 and mucormycosis in kidney transplant recipient may occur, which poses challenges in the management. Mucormycosis is caused by a fungus of Mucorales family. Delayed identification and management are associated with a higher mortality. High index of suspicion is needed for timely interventions. We report a case of COVID-19 coinfection with mucormycosis in a kidney transplant recipient. Timely treatment with antifungal drugs like liposomal amphotericin B with surgical debridement helped cure the patient and prevent damage to the brain.
A case of flunarizine-induced movement disorder
Authors: Alam Anwar , Kumar Baidyanath , Azad Zeyaur Rahman , Rajalakshmi C.
Published: March 2023

Flunarizine is a calcium channel antagonist widely used for the treatment of migraine. This can cause side effects like movement disorders with longstanding use in the elderly, especially females. This is the case report of a 56-year-old female, taking flunarizine for 6 months, who presented with a movement disorder.
A study on post intervention impact assessment of antibiotic prescribing practices in the neurosurgery ICU, under antimicrobial stewardship program
Authors: Mishra Richa , Omar Arushi , Verma Harshit , Harsvardhan Rajesh
Published: March 2023

Introduction:

Antimicrobial Stewardship is a coordinated program that ensures the optimal selection, dose, and duration of an antimicrobial therapy that leads to the best clinical outcome for the treatment or prevention of an infection.

Objectives:

Objectives of the study are, (1) to describe antibiotic stewardship program implementation by critically evaluating antibiotic prescribing practices; (2) to design an appropriate intervention for subsequent implementation; and (3) to discern the impact of intervention.

Methodology:

An interventional and cross-sectional study was carried out for 19 months in a neurosurgery intensive care unit (ICU) of a tertiary-care hospital, consisting of three phases: baseline, intervention, and postintervention. First phase involved the evaluation of antibiotic utilization and prescribing practices and appropriateness for the same without provision of any recommendations. In second phase, a 3-component intervention was introduced, i.e. active ICU rounds, postprescription review with feedback and teaching programs. Third phase involved evaluation of antibiotic utilization and prescribing practices and appropriateness for the same with provision of recommendations. The study tool was an antibiotic prescription chart (pre and post-intervention phase) and postprescription review and feedback form (only postintervention phase) that was used for data collection. The primary outcome of the study was days of therapy (DOT) per 1000 In-patient days (PD) for antimicrobials. Data analysis was done by SPSS 23.

Results:

Overall decrease in the DOT per 1000 In-patient days from baseline to postintervention phase was 17.8% (P = 0.35). The reduction in cost of antibiotic usage per patient day from preintervention phase to postintervention phase was INR 78.1.

Conclusion:

Antibiotic stewardship ward rounds and dedicated prescription chart can achieve reduction in antibiotic consumption.
Titanium Alloy, Sheet, Strip, and Plate 6Al - 6V - 2Sn Annealed
Authors:   AMS G Titanium and Refractory Metals Committee
Published: March 2023

This specification covers a titanium alloy in the form of sheet, strip, and plate up through 4.000 inches (101.60 mm), inclusive (see 8.5).
Steel Strip 0.68 - 0.80C (SAE 1074)
Authors:   AMS E Carbon and Low Alloy Steels Committee
Published: March 2023

This specification covers a carbon steel in the form of strip.
Steel, Corrosion-Resistant, Bars, Wire, Forgings, Rings, and Extrusions 13Cr - 8.0Ni - 2.2Mo - 1.1Al Vacuum Induction Plus Consumable Electrode Melted Solution Heat Treated, Precipitation Hardened (H1000)
Authors:   AMS F Corrosion and Heat Resistant Alloys Committee
Published: March 2023

This specification covers a corrosion-resistant steel product 12 inches (305 mm) and under in nominal diameter, thickness, or for hexagons, least distance between parallel sides in the solution and precipitation heat treated (H1000) condition.
Alternative (Ecological) Method for Measuring Electronic Product Immunity to External Electromagnetic Fields
Authors:   AE-4 Electromagnetic Compatibility (EMC) Committee
Published: March 2023

This method is used to define the immunity of electric and electronic apparatus and equipment (products) to radiated electromagnetic (EM) energy.

This method is based on injecting the calibrated radio frequency currents (voltages) into external conductors and/or internal circuits of the product under test, measuring the strength of the EM field generated by this product and evaluating its immunity to the external EM field on the basis of the data obtained.

The method can be utilized only when it is physically possible to connect the injector to the conductors and/or circuits mentioned before.

The method allows:

Evaluating immunity of the product under test to external EM fields of the strength equal to a normalized one;

Calculating the level of external EM field strength at which the given (including maximum permissible) induced currents or voltages are generated in the equipment under test, or solving the “opposite” task;

Finding potentially “weak” points of the product design (housing, shield, etc.), through which EM energy can enter inside the product.

The method capabilities mentioned above define the sphere of its application:

Measurements of electronic product immunity to external EM fields at different conditions (polygons, laboratories, in-situ) as an alternative to direct test methods;

Operating instruments for a designer working out the product of a given immunity to external EM fields.

This method can’t be directly applied to evaluate the immunity of the equipment under test to the pulse electromagnetic fields. But it can be used to get the initial data necessary to solve this task.
Atuação de odontopediatras brasileiros com relação a pacientes com má oclusão
Authors:   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Bauermann Kelli Zeferino Correia , Silva Paula Patrícia Cotrin da ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Santin Gabriela Cristina ,   Universidade Estadual de Maringá - UEM, Maringá, PR, Brasil., Pinzan-Vercelino Célia Regina Maio ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Valarelli Fabricio Pinelli ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Freitas Karina Maria Salvatore de ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil.
Published: March 2023

O objetivo foi analisar o perfil de odontopediatras brasileiros sobre pacientes com má oclusão para avaliar as preferências da prática ortodôntica em crianças. Um questionário on-line foi aplicado. As perguntas foram sobre quais más oclusões eles tratam, quais aparelhos utilizam, e quando encaminham ao ortodontista. Vinte odontopediatras responderam, com idade média 36,70 anos, especialistas há 10,75 anos. As principais más oclusões tratadas são mordidas cruzada posterior (60%) e anterior (55%), mordida aberta anterior (55%), perda precoce de dentes decíduos (50%), Classe II (25%), Classe III (25%) e apinhamento (20%); 25% não faz ortodontia em seus pacientes, sempre encaminha ao ortodontista.
Autopercepção de saúde mental dos estudantes de medicina de Maringá-PR durante a pandemia da Covid-19
Authors:   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Fernandes Jhonatan Guilherme , Santos Jaquelini Fernanda Gomes dos ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Godinho Jacqueline ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Shima Vivian Taciany Bonassoli ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil.
Published: March 2023

Com a pandemia da Covid-19, estudantes tiveram sua rotina modificada pela interrupção das atividades acadêmicas. O trabalho avaliou a autopercepção de saúde mental dos estudantes de medicina da cidade de Maringá-PR durante a pandemia da Covid-19, dentro do contexto de isolamento social. Dessa forma, realizou-se um estudo quantitativo e qualitativo utilizando um questionário aplicado on-line. Observou-se que 79,6% dos participantes perceberam que os sintomas de ansiedade, depressão e estresse apareceram com maior frequência; 71,4% sentiram necessidade de apoio psicológico profissional; 71,4% não sentiram necessidade de utilizar ou aumentar ouso de drogas lícitas, enquanto 51% necessitou usar medicamentos para os sintomas.
Avaliação da gordura corporal em gatos por meio de tomografia computadorizada e escore de condição corporal
Authors:   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Gonçalves Milena Dias , Leite Julia Hirasaki ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Dalgalho Nayara Maira ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Romani Isaac ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Grande Paula Adriana ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil.
Published: March 2023

A obesidade representa um importante desafio na rotina clínica de animais de companhia e devido às consequências que esta condição pode gerar, objetivou-se por meio deste trabalho avaliar a composição corporal de felinos castrados através da tomografia computadorizada, relacionando a deposição de gordura com seu peso e escore corporal. Para a realização deste, foram realizados 16 gatos adultos e castrados, os quais após serem submetidos ao exame, tiveram suas análises submetidos a uma avaliação. Não foram verificadas diferenças estatísticas para os dados avaliados, porém, constatou- se que a tomografia constitui uma importante ferramenta na avaliação corpórea de felinos domésticos.
Avaliação da mortalidade por sepse por Staphylococcus aureus em ambiente hospitalar
Authors:   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Marta Matheus de Lima , Rodrigues Vanusa Messiano ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Teston Ana Paula Margioto ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Araújo Daniela Cristina de  Medeiros ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Chierrito Danielly ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil.
Published: March 2023

A sepse é uma das principais preocupações no ambiente hospitalar por estar associada à alta taxa de mortalidade. Neste contexto, foi desenvolvido um estudo descritivo, quantitativo, por meio do levantamento de dados secundários obtidos no Departamento de Informática do Sistema Único de Saúde (DATASUS) nos anos anteriores e posteriores a pandemia da doença infecciosa causada pelo coronavírus SARS-CoV-2 (Covid-19). Com os dados obtidos, foi possível identificar uma redução no número de óbitos relacionados à sepse por Staphylococcus aureus durante a pandemia, o que pode estar relacionado ao grande número de internações causadas pelo vírus SARS-CoV-2 nesse período.
Avaliação do conhecimento dos cirurgiões-dentistas sobre as desordens potencialmente malignas
Authors:   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Girotto Eduarda , Queiroz Polyane Mazucatto ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Moreschi Ana Regina Casaroto ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil.
Published: March 2023

O câncer bucal no Brasil é considerado um problema de saúde pública. Apesar da cavidade oral ser rotineriamente examinada pelos cirurgiões-dentistas, as desordens potencialmente malignas (DPMs) comumente passam despercebidas. O presente trabalho avaliou o conhecimento de cirurgiões-dentistas de Maringá-PR sobre o reconhecimento das DPMs quanto suas características clínicas, fatores de risco, conduta a ser adotada e tratamento. 49 profissionais responderam a um questionário pelo Google Forms. Foram 80% dos participantes que apontaram dificuldades para identificação das características clínicas e conduta a ser adotada para as DPMs, admitindo possuírem conhecimento limitado sobre o assunto.
Bongestabs e o projeto da Unilivre: notas de um desfrute espacial
Authors:   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Avanci Renan Augusto , Daminelli Talita Caroline ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Scabora Debora de Oliveira ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil., Marion Silvia Letícia Henrique  de Carvalho ,   Centro Universitário Ingá – Uningá, Maringá, PR, Brasil.
Published: March 2023

Em contraponto com as definições da arquitetura do espetáculo, nesta pesquisa entendida pelas características formais que definem as obras icônicas, os edifícios monumentos e as propostas de construções megaestruturais, o estudo se apoia no conceito de ‘desfrute espacial’, vinculado às pesquisas de Douglas Aguiar. O objetivo é explorar questões de movimento, percurso e espacialidade no projeto para a Universidade Livre do Meio Ambiente – Unilivre. Considera-se que este edifício ao propor uma circulação peculiar, configura-se em uma arquitetura mais espacial, que espetacular.