bluuebunny/crossref_metadata_2025 huggingface dataset:
AB0 blood groups and oncological and functional outcomes in bladder cancer patients treated with radical cystectomy
Authors: Tafuri Alessandro , Panunzio Andrea , Soldano Antonio , Mazzucato Giovanni , Ornaghi Paola Irene , Di Filippo Giacomo , Gozzo Alessandra , De Maria Nicola , Cianflone Francesco , Shakir Aliasger , Tian Zhe , Brunelli Matteo , Porcaro Antonio Benito , Pagliarulo Vincenzo , Artibani Walter , Karakiewicz Pierre I. , Antonelli Alessandro , Cerruto Maria Angela
Published: December 2022

Objectives: We investigated AB0 blood groups prevalence according to preoperative and pathological tumor characteristics, and their association with oncological outcomes, and renal function decline in a contemporary large cohort of bladder cancer (BCa) patients, who underwent radical cystectomy (RC) at a tertiary referral center. Materials and Methods: We retrospectively evaluated data of patients with histologically confirmed and clinically non metastatic BCa, who underwent RC between 2014 and 2021 at our Institution. Kaplan-Meier (KM) plots and Cox regression (CR) models tested the relationship between AB0 blood groups and local recurrence-, metastasis-, cancer specific mortality-, and overall mortality-free survival. Logistic regression (LR) models tested the association between AB0 blood groups and renal function decline, defined as an estimated Glomerular Filtration Rate (eGFR) < 60 mL/min, at post-operative day 1, discharge and 6- months of follow-up. Results: Of 301 included patients, 128 (42.5%) had group A, 126 (41.9%) had group 0, 28 (9.3%) had group B, and 19 (6.3%) had group AB. Patients with group 0 developed higher rates of muscle- invasive BCa (p = 0.028) with high-grade features (p = 0.005) at last bladder resection, and less frequently received preoperative immunotherapy with Bacillus of Calmette-Guerin (p = 0.044), than their non-0 counterparts. Additionally, these patients harbored more advanced pathologic tumor stage at RC (p = 0.024). KM plots showed no differences among all tested cancer control outcomes between AB0 blood groups (p > 0.05 in all cases). Patients with group AB presented the lowest median eGFR at each time point. In multivariable LR analyses addressing renal function decline, group AB was independently associated with eGFR< 60 mL/min at discharge (Odds Ratio: 4.28, p = 0.047). Conclusions: Among AB0 blood groups, patients with group 0 exhibited the most aggressive tumor profile. However, no differences were recorded in recurrence or survival rates. Group AB independently predicted renal function decline at discharge.
Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones?
Authors: Ibrahim Ahmed , Elatreisy Adel , Khogeer Abdulghani , Ahmadi Abdulsalam , Mishra Shashikant , Faisal Mahmoud , Sabnis Ravindra , Aube-Peterkin Melanie , Carrier Serge , Ganpule Arvind , Desai Mahesh
Published: December 2022

Objective: To quantify the predictors for the ancillary treatments after extracorporeal shock wave lithotripsy (SWL) for renal and upper ureteral stones. Materials and methods: From January 2014 to January 2017, patients undergoing SWL using an electromagnetic lithotripter machine (Compact Delta; Dornier MedTech GmbH, Wessling, Germany) for renal and upper ureteral stones ≤ 20 mm were retrospectively reviewed. All patients underwent CT urography prior to SWL. The cohort was subdivided into three groups according to stone attenuation values in Hounsfield Units (HU). Group I; HU < 500 (n = 20), group II; HU 500-1000 (n = 51) and group III; HU ≥ 1000 (n = 180). The parameters included for multivariate analysis were stone size, location, multiplicity, stone attenuation value, number of shocks and stone clearance rate by 3 months. The ancillary treatments were ureteroscopy (URS), ureteral stenting and hospital readmission for pain or fever. Results: A total of 251 patients were included in the study. The overall SWL success rate was 92.4%. Mean stone size was 10.9 ± 2.1, 11.6 ± 3 and 11.4 ± 3.6 mm and mean stone attenuation values were 364 ± 125, 811 ± 154 and 1285 ± 171 HU for groups I, II and III respectively. The stone clearance rates by 3 months were 96%, 92% and 88.4% for groups I, II and III respectively. On subgroup analysis, group III required ancillary treatments in 70% of patients whereas group I, II, did not require any ancillary treatments. On multivariate analysis, stone multiplicity, stone location (lower calyceal stones) and HU were independent significant predictors for the need for ancillary treatments after SWL (p values < 0.05). Conclusions: Patients with stone attenuation value (HU) > 1000, multiple stones and/or lower calyceal stones have higher risk to necessitate ancillary treatments after SWL. These patients would likely benefit from upfront endoscopic lithotripsy for treating symptomatic renal or upper ureteral stones.
The choice of therapeutic agent in female overactive bladder patients in real-world practice
Authors: Masuda Hiroshi , Mikami Kosuke , Otsuka Kotaro , Hou Kyokusin , Suyama Takahito , Araki Kazuhiro , Kojima Satoko , Naya Yukio
Published: December 2022

Objective: The reasons why anticholinergic drugs or β3 adrenergic agonists are selected as treatments for overactive bladder (OAB) are unclear. The aim of this study was to investigate the background data of female OAB patients that were prescribed anticholinergic drugs or β3 adrenergic agonists in a real-world setting. Materials and methods: Between January 2013 and December 2014, 75 patients who had been diagnosed with OAB were included in this study. Administered medications, age, the persistence on treatment rate at one-year, medical history, pretreatment total Overactive Bladder Symptom Score (OABSS), pretreatment score for each OABSS factor, body mass index (BMI), and various comorbidities were evaluated retrospectively. Since there were many types of anticholinergic drugs and few patients, we grouped the patients into those that were prescribed anticholinergic drugs (group A) and those that were prescribed β3 adrenergic agonists (group B). Results: 75 patients (29 in group A and 46 in group B) were included in this study. There were no significant differences in age, BMI, obesity, medical history, pretreatment total OABSS, or pretreatment score for each OABSS factor. There was a significant difference in the post-voiding residual urine volume (PVR) between the groups (group A: 22 ml, group B: 9 ml; p = 0.0252). The 1-year persistence on treatment rate was 28% in both groups. Conclusions: There were no significant differences in clinical characteristics of patients who were prescribed anticholinergics and β3 adrenergic agonists for OAB treatment, but a marginal difference of PVR value before treatment. The 1-year persistence rates of anticholinergic drugs and β3 adrenergic agonists were considered to be almost equivalent.
The effectiveness of flashlamp-pumped pulsed dye laser in conjunction with topical imiquimod treatment for rosacea
Authors: Chang Chen-Jen , Hsiao Yen-Chang , Aviña Ana Elena , Chiang Yu-Fan
Published: December 2022

Rosacea is a chronic dermatosis with no cure. Our goal was to evaluate if the combination of flashlamp-pumped Pulsed Dye Laser (PDL) treatment with topical imiquimod could improve therapeutic outcomes. Fourty patients diagnosed with rosacea and aged between 16 and 53 years were assigned for three different types of treatment: i) PDL-only, ii) imiquimod-only, and iii) PDL + imiquimod. The PDL test sites received a single treatment with the VBeam laser (λ = 595 nm; spot size = 7 mm; tp = 1500 msec) at a dosage of 10 J/cm2 with cryogen spurt duration (30 msec) and the delay time (20 msec). For the test sites of PDL + imiquimod and imiquimod-only, the patients applied imiquimod topically to the test sites once a day for 1 month. Patients were followed-up at 1, 3, and 6 months. The primary efficacy was measured with a DermoSpectrometer. Patients were also monitored for adverse effects. Pair-wise analysis showed statistically significant differences between the blanching responses for the PDL + imiquimod and PDL-only and imiquimod-only treatments (p<0.005). Transient hyperpigmentation was noted in 5% (n=2) and 20% (n=8) of patients in the PDL + imiquimod and PDL-only treatment, respectively. Hyperpigmentation resolved spontaneously within 6 months. Permanent hypopigmentation or scarring was not observed. Superior blanching responses were obtained when using PDL + imiquimod than PDL-only or imiquimod-only treatment for rosacea. A larger number of patients are required to support the results of this study.
Comprehensive approach to correct involutional-dystrophic skin changes in women
Authors: Tsepkolenko Volodymyr , Tsepkolenko Hanna
Published: December 2022

Skin aging is one of the most urgent problems that is not being studied today. The study involved 107 women with signs of age-related changes in the skin of the face aged 25 to 60 years. They were treated according to our autor’s technology neofibrolifting - autologous fibroblasts transplantation into the pretreated with platelet-rich plasma skin and ablative fractional photothermolysis procedure. The developed neofibrolifting technology allows reconstructing authentic skin structure, improving its appearance and immunity.
Risk factors matter: case report of Y. pseudotuberculosis in obese patient
Authors: Scoppapietra Lara , Amarù Giuseppina , Crocillà Cristina , Finotti Mara , Salafia Marika , Canevaro Alessandra , Granero Valentino
Published: December 2022

Yersinia pseudotuberculosis is a Gram-negative bacillus that can occasionally cause zoonosis. Infections of this bacterium typically present as self-limiting ileitis, often accompanied by diarrhea, but, especially in the case of immunocompromised patients, can also lead to serious secondary complications which, if not treated properly, can progress with a poor prognosis. Here, we present a case of successfully treated bacteremia due to Y. pseudotuberculosis in a multipathological obese patient. The diagnosis was possible through blood culture, and this highlights the importance of the search for unconventional pathogens, especially in certain categories of patients whose risk factors are strongly indicative and suggestive.
Autoinflammatory keratinization diseases
Authors: Akiyama Masashi
Published: December 2022

As predisposing factors and pathogenic mechanisms of inflammatory keratinization disorders of the skin have become increasingly elucidated in recent years, a number of inflammatory keratinization disorders are now known to have the excessive activation of innate immunity as their pathogenesis. Autoinflammation-associated pathogeneses have been clarified in patients with generalized pustular psoriasis (GPP), pityriasis rubra pilaris (PRP) type V, and familial keratosis lichenoides chronica (KLC). Thus, based on these findings, in 2017, we proposed the clinical entity “autoinflammatory keratinization disease (AiKD),” which comprehensively includes inflammatory keratinization disorders with pathogenic mechanisms related to autoinflammation (the excessive activation of innate immunity). In 2017, GPP and associated diseases, PRP type V, and familial KLC came to be considered as AiKDs. In addition to these diseases, hidradenitis suppurative, porokeratosis, keratosis linearis with ichthyosis congenita and sclerosing keratoderma syndrome, and AiKDs with hepatitis and autism have been newly recognized as AiKDs. The concept of AiKD may contribute to the selection of novel treatment methods. For example, recognizing hidradenitis suppurativa precisely as an AiKD has resulted in the application of adalimumab, an anti-tumor necrosis factor alpha antibody, as a treatment. The concept of AiKD is thought to be useful toward our accurate understanding of the pathogeneses of inflammatory keratinization disorders and our choice of appropriate treatment methods. As the pathogenic mechanisms of inflammatory keratinization disorders are further elucidated, it is presumed that the number of keratinization diseases whose pathogeneses are associated with autoinflammation will increase and that the number of diseases recognized as AiKDs will grow more and more.
Mini review
Authors: Duan Honglian , Kohls Wesley , Ilagan Roxanne , Geng Xiaokun , Ding Yuchuan
Published: December 2022

The impact of stroke, currently the second leading cause of death worldwide, continues to worsen, and even those that survive can have persistent neurological deficits. A potentially significant implication may be due to hyperglycemia, found in one-third of all acute ischemic stroke (AIS) patients. However, prior studies reported conflicting information about the impact of hyperglycemia on poststroke prognosis, likely due to different measurements of stress-induced hyperglycemia. The glucose-to-glycated hemoglobin ratio is an index of stress-induced hyperglycemia after AIS that better quantifies acute changes in blood glucose, as opposed to absolute variations in glucose levels. Moderate blood glucose reductions might counteract the negative effects of hyperglycemia and glycemic control medications can also play a role in neuroprotection. The liver is the main organ that functions to maintain energy and glucose metabolism and the effects of AIS can reach far peripheral organs, including the liver. In this review, we highlighted the mechanism responsible for acute poststroke hyperglycemia, a hepatic inflammatory pathway that results in hepatic gluconeogenesis and reduced hepatic insulin sensitivity. Hepatitis cascades lead to hepatic gluconeogenesis, and targeted therapy with antihyperglycemic drugs has the potential to improve stroke prognosis and recovery.
The Seventh Annual Academic International Medicine Virtual Congress and Scientific Forum, June 9–12, 2022
Authors: Firstenberg Michael S. , De Wulf Annelies , Narayan Mayur , Clark Taryn , Miller Andrew , Stawicki Stanislaw P.
Published: December 2022

As the COVID-19 pandemic continued to fade, first glimpses of “post-pandemic normal” began to emerge in the late 2021 and early 2022. This new hope came with a positive new momentum – an opportunity to transform and reinvent. Yet given a high degree of uncertainty extending well into 2022, the American College of Academic International Medicine made a strategic decision in the late 2021 to move forward with Virtual 7th Annual Congress and Scientific Forum (AIM 2022). The theme of this year's meeting was “Building a Stronger Future” and reflected the early post-pandemic optimism. Primary organization of the meeting was facilitated by the Sarasota Memorial Health Care System, Sarasota, Florida, with substantial contributions provided by Northwell Health, Long Island, New York. The Scientific Forum once again took place virtually, enabling participants from around the globe to present their research. A summary of these efforts and outcomes is provided in this article.

The following core competencies are addressed in this article:

Interpersonal and communication skills, Professionalism, Practice-based learning and improvement, Systems based practice.
Esophageal melanosis due to mishri usage
Authors: Girish Muppa Indrakeela , Dahale Amol Sonyabapu , Banerjee Debabrata , Bhate Prasad , Karad Abhijeet
Published: December 2022

Esophageal melanosis (EM) is a rare disease of the upper digestive system. We present a case series of two patients with EM who presented with dysphagia and had the habit of mishri consumption. Endoscopy showed black-pigmented spots involving the upper and mid esophagus. EM due to mishri consumption was a rare presentation as there were no cases reported till date.

The following core competencies are addressed in this article:

Patient care, Practice-based learning and improvement, Medical knowledge.
The Efficacy of Music Therapy in Lowering Intraoperative Sedative Requirement and Recall of Intraoperative Processes by Patients Under Spinal Anesthesia
Authors: Chandak Aruna , Sharma Monika , Chandak V. C. , Ninave S.
Published: December 2022

Background:

This music therapy was found to be a potent and efficient means of strategy for the treatment of illness in all the health aspects. It modifies the normal body's flight and fight response to stress during surgeries. It is a unique approach for relieving patients, making them stress-free without any means of side effects.

Methods:

This prospective comparative observational study includes a total of 50 cases, randomly assigned in 2 sets of 25 each in age (20–60 years), lower abdomen, urinary complaints related to surgeries, etc. under spinal blockade. These patients were assigned randomly to Group M (music group) and Group C (nonmusic group). Midazolam was given for sedation in both the groups with the aim to achieve Observer's Assessment Sedation/Alertness Score (OAS)-3 or less and to calculate and compare midazolam (total dose) requirement. After giving spinal to the patient and achieving desired levels, the patients were given headphones and the music was set up n music group patients. Basic vitals and requirements (total sedative) during surgery were recorded and then compared between the two groups. The ability of the patient to recall intraoperative events after surgery was also calculated by 6-point questionnaire, and for assessing pain severity, the visual analog scale score method was used.

Results:

We have found that intraoperatively, midazolam requirement (total) was found to be very low in the patients who listened music (P < 0.01), the OAS score was better in the music group, and the systolic and diastolic blood pressure and pulse rate may be comparable in both the groups. Conversations between doctors/nurses, OT staff during surgery, and monitors sound, instruments, etc., were more significantly recalled by a group of people who do not listen to music intraoperatively.

Conclusion:

Our study concluded that the use of intraoperative music in patients under spinal anesthesia can be demanding therapy by reducing patient's requirement of medication, needed for sedating them and relieving pain. This helps in creating an effective, safe method for patient's overall satisfaction.
Study of Expression of Epithelial Cadherin in Benign and Malignant Epithelial Lesions of Uterine Cervix
Authors: Gupta Pooja , Agarwal Pooja , Kumar Lalit , Prakash Shikha , Yadav Poonam
Published: December 2022

Context:

Epithelial cadherin (E-cadherin) is inversely proportional to the histologic grade of squamous cell carcinoma (SCC) of the cervix and is reduced with the increasing grade of cervical intraepithelial neoplasia, with downregulation upon transition to cervical intraepithelial neoplasia and further to invasive cancer.

Aims:

The aim of the study was to study the expression of E-cadherin in benign and malignant epithelial cervical lesions and to compare the results statistically.

Settings and Design:

The cross-sectional study was hospital based conducted in the department of pathology from January 2018 to March 2019.

Methods:

The study was carried out on sixty biopsy specimen of cervix (33 malignant, 4 premalignant, and 23 benign lesions). Two sections were taken; one for hematoxylin and eosin and other for E-cadherin immunohistochemical staining.

Statistical Analysis Used:

Statistical analysis was done using Chi-square test and Fisher's exact test.

Results:

In well-differentiated SCC, the majority cases (40%) revealed membranous staining while in moderately differentiated SCC and poorly differentiated SCC, the most common staining pattern was membranous and cytoplasmic (70% and 45.4%, respectively). In adenocarcinoma, 66.6% of cases had membranous pattern of staining, whereas two cases (33.3%) were negative. In High-grade Squamous Intraepithelial Lesion (HSIL), 75% of cases had membranous staining. Pure membranous pattern of staining of E-cadherin showed a progressive decline with a loss of differentiation while pure cytoplasmic revealed a reverse pattern.

Conclusions:

We concluded that, in malignant lesions, there is a loss of membranous E-cadherin pattern as compared to benign lesions. Furthermore, there is a progressive decline in pure membranous staining of E-cadherin with increase in shift to cytoplasmic staining as differentiation decreases.
An Innovative Device for Finding Submerged Cover Screws of Dental Implants
Authors: Chandhok Jasmeet , Chandhok Deepika , Niswade Grishmi
Published: December 2022

This article describes the use of an electronic instrument to detect the presence of cover screws of dental implants submerged inside the mucous membrane during the second-stage surgical procedure for placement of gingival former. The instrument detects the presence of a metallic object at a certain distance from it and makes the clinical procedure of giving a precise incision without unnecessary trauma to the periodontal tissues.

Clinical Implication:

This device is of use when detecting the exact position of implant cover screw during the second-stage implant surgery. This makes the clinical procedure easy and saves the tissues from unnecessary trauma.
Comparative Evaluation of Bacterial Growth Following Removal of Peripheral Intravenous Cannula Inserted in an Emergency Room and in Aseptic Condition
Authors: Natarajan Srivalli , Vathare Pradeep , Asnani Usha , Vaidya Sushrut , Baviskar Padmakar , Balkawade Ruchita
Published: December 2022

Context:

Approximately 60% of hospital inpatients annually undergo peripheral intravenous cannulation to receive therapeutic intravenous (IV) medication. About 6.2% of hospital-acquired bacteremia may be directly attributable to peripheral IV cannulation. The setting in which the PICs are inserted may influence the microbial flora around the site of insertion.

Aims:

The study aims to evaluate and compare the incidence of bacterial growth and assess the local complications like cellulitis and phlebitis following removal of PIC inserted in an emergency room and in aseptic condition.

Settings and Design:

This was a prospective randomized double-blind Study.

Materials and Methods:

A total of 50 subjects (Group A n = 25 and Group B n = 25) were randomly divided and evaluated for the incidence of bacterial growth and assessing the cellulitis and phlebitis. Group A underwent removal of PIC inserted in aseptic condition after 72–96 h and Group B underwent removal of PIC inserted in the emergency room after 72–96 h.

Statistical Analysis Used:

Unpaired t-test and Chi-square test were used for statistical analysis.

Results:

No (0%) subjects had bacterial growth in Group A and 2 (8%) subjects in Group B had bacterial growth, but the difference was not found to be statistically significant (P = 0.149). On comparison, cellulitis and phlebitis were absent in both the groups.

Conclusions:

The incidence of bacterial growth and the local complications like cellulitis and phlebitis following removal of PIC inserted in the emergency room and in aseptic condition was nominal. However, strict aseptic precautions should always be followed while inserting a foreign object into the circulatory system.
Knowledge, Attitude, and Practices among Front-Line Health-Care Workers in a COVID Hospital
Authors: Tomar Priya , Chauhan Naveen
Published: December 2022

Background and Objectives:

COVID-19 pandemic has currently attacked the health-care system of the whole world. Prevention and collaboration are the key to its management. Our study aims to assess the knowledge, attitude, and practices (KAP) among front-line health-care workers (HCWs) of a COVID dedicated hospital regarding the infection.

Materials and Methods:

An online questionnaire based study was conducted. Participants were doctors and nursing staff working in a medical college. KAPs were assessed using a 26-item questionnaire with questions pertaining to knowledge (n = 13), attitude (n = 6), and practice (n = 7). Individual scores were generated and stratified as good (>10)/moderate (7–10)/poor knowledge (<7), positive (≥4)/negative (<4), attitude and good (≥4)/poor (<4) practice scores. Percentages of correct and incorrect responses were calculated for each question. Predictors of good overall scores were identified.

Results:

Response rate was 75%. Participants were interns (n = 45, 28.7%), junior residents (n = 7, 4.5%), postgraduate students (n = 58, 36.9%), clinicians (n = 9, 5.7%), and nursing staff (n = 38, 24%). Mean age was 26.13 ± 3.27 years. 8 (5%), 98 (62%), and 51 (32.5%) participants acquired good, moderate, and poor scores, respectively. Seventy-seven (49%) participants had positive attitude scores. Majority (n = 149, 94.9%) participants had good practice scores. Older age of HCWs was found significantly associated with better knowledge (adjusted odds ratio [aOR] = 3.81, 95% confidence interval [CI] = 1.29–11.22, P = 0.015). Similarly, HCWs who had personal experience of work in COVID area had more positive attitude than those who did not (aOR = 2.58, 95% CI = 1.23–5.42, P = 0.013). Good practices were evenly distributed among all subgroups.

Interpretation and Conclusions:

Repeated training sessions for correct dissemination of knowledge are essential in the fight against this novel pandemic. Collective efforts should be made regarding management.
An in vitro Digital Comparative Evaluation of the Accuracy and Dimensional Stability of Vinyl Polyether Silicone Impression Material with the Conventionally Used Elastomeric Materials Scanned Using a Blue Light Scanner
Authors: Ahuja Bhavna Mahesh , Sanyal Pronob Kumar , Guru Rakshith , Kore Abhijeet
Published: December 2022

Background:

The development of material science has allowed integrating qualities of polyether (PE) and Vinyl Polysiloxane (VPS) into a newer material Vinyl polyether silicone (VPES). There is limited literature available on this combination material. The aim was to evaluate and compare the accuracy and dimensional change of elastomeric impression materials with a three-dimensional (3D) approach.

Materials and Methodology:

Impressions were made of standard tooth model and custom trays using the three monophase impression materials, i.e., Group A–Vinyl polysiloxane (VPS), Group B-Polyether (PE), and Group C-Vinyl Polyether silicone (VPES). All the impressions were digitized and compared on eight predetermined points using a 3D compare software by the superimposition of computer-aided design files of impressions onto that of Standard tooth model. Three-dimensional comparison is repeated after storage of impressions for 1 week to re-evaluate the dimensional stability of the impression materials.

Results:

The average measurement of mean discrepancies of all the 8 points obtained on day 1 for VPS, PE, and VPES were 75.758 μm, 139.52 μm, and 49.24 μm, respectively, which helps in the determination of accuracy and after interval of 1 week 91.27 μm, 157.25 μm, and 89.76 μm, respectively, which helps to deduce that the linear dimensional change values for Group A, Group B, and Group C were 15.52 μm, 17.73 μm, and 40.52 μm, respectively.

Conclusions:

Average dimensional accuracy was highest of VPES followed by VPS and PE. Whereas VPS impression material shows the highest dimensional stability after prolonged storage of 1 week, followed by PE and then VPES impression material.
Critical Appraisal of Curriculum Content for Undergraduate Academic Curricula Under Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University) as Against Principles of Curriculum Design
Authors: Mishra Gaurav Vedprakash , Dhok Archana , Srivastava Tripti , Singh Rohan Kumar , Patwa Prerna Anup
Published: December 2022

Background:

A judicious mix of all three domains makes the curriculum better suited to the needs of the learner. At the same time, the curricula can be considered for their compliance with certain qualities such as the degree at which the curriculum addresses the cognitive domain, psychomotor domain as well as affective domains. Moreover, the design of the curricula should be such that they should be standardized for all interested learners taking into mind their different mental and psychological makeup. On this front, principles of curriculum design were given by The Curriculum Centre and are considered as standard of reference for this present study.

Materials and Methods:

Rapid review of literature with reference to curriculum of Intensive Care Technology, Biomedical Sciences, Clinical psychology, and Physician Assistant under faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University) in the academic year 2020–2021 for purpose of their “Typing” with principles of curriculum design was done.

Results:

The academic curricula included in the present study were found to adhere to the principles of richness of knowledge, curriculum designed with memory of the learner in mind, curriculum designed for novices and not experts. However, they were found to be not in consonance with the principles of domain specificity, coherence, cumulation, and academic challenge.

Conclusion:

The undergraduate course curricula of academic course curricula launched under the Faculty of Allied Health Sciences included in the present study have been critically appraised on the basis of their adherence with the principles of curriculum design as proposed by The Curriculum Centre.
Adenomatoid Odontogenic Tumor
Authors: Samuel Soumi , Thomas Biju , Pillai Saurabh , Kumar Harish , Abraham Abel , Deepak Deeyah Miriam
Published: December 2022

The adenomatoid odontogenic tumor (AOT) is a hamartomatous benign neoplasia of odontogenic origin. It appears to be, mostly prevalent in young female patients, mostly during the second decade of life. The maxillary region is most affected when compared to the mandible. Its presentation is slow-growing, asymptomatic, and quiet but not quite a lesion. It is related to canines which are unerupted. Here, we report a case of the AOT in the left maxillary region of a female patient aged 13 years. We approached with a surgical enucleation resulting in an excellent outcome.
Utility of Uterine artery Doppler indices for prediction of Preeclampsia
Authors: Patwa Prerna Anup , Mishra Gaurav Vedprakash , Dhande Rajasbala Pradeep , Singh Rohan Kumar , Singh Sonal
Published: December 2022

Background:

Hypertensive disorders complicating pregnancy are common. Preeclampsia and eclampsia are major causes of maternal morbidity and mortality, particularly in developing countries. With prompt recognition of symptoms and early diagnosis of preeclampsia can lead to improved maternal and neonatal outcomes. Although, numerous tests have been proposed for the prediction of preeclampsia, their results have been inconsistent. So, we focused our research to study the uterine artery doppler for predicting preeclampsia in high-risk women.

Methodology:

We conducted a search on Google Scholar and PubMed based on Medical Subject Heading terms preeclampsia and uterine artery Doppler ultrasound. The articles between 2016 and 2020 which were in English were taken into consideration. We performed a qualitative interpretation as an approach for extracting the data.

Results:

Majority of the studies showed raised pulsatility index as a good predictor of preeclampsia, although it was closely followed by uterine artery notching which is in the early diastolic period.

Conclusion:

The findings of our research suggest that uterine artery Doppler indices and early diastolic notch can be used as a tool for the prediction of preeclampsia with high confidence.
A Study to Assess the Reliability of Structured Viva Examination over Traditional Viva Examination among 2nd-Year Pharmacology Students
Authors: Ahsan Marya , Mallick Ayaz Khurram
Published: December 2022

Introduction:

Although viva voce provides the examiner an opportunity to probe and assess the reasoning and higher-order thinking abilities of the student, it is marred by inconsistency, subjectivity, and biases. These issues can be addressed by increasing the objectivity and standardization of the viva examination. Hence, this study was done to explore the perception and opinion regarding structured viva examination and to compare and correlate the marks of structured viva with theory examinations among 2nd-year medical students.

Materials and Methods:

An educational study was carried out on 150 students after obtaining institutional ethical committee and informed consent, out of which 42 students had dropped. The students were subjected to a theory examination of 30 marks following which they were divided into two groups. One group was assessed by traditional viva examination, whereas the other group was assessed by structured viva. The perception of the students and faculty was recorded using a five-point Likert scale. The marks obtained in the viva examination were correlated with the theory examination using Pearson coefficient. The significance of the mean was compared using Student's t-test. P < 0.05 was considered statistically significant.

Results:

A moderate positive correlation (r = 0.442; P = 0.001) was seen between marks scored in structured viva and theory examination. The overall response of the students and examiners was favorable toward a structured examination.

Conclusion:

Structured viva examination may be considered more reliable and fairer in comparison to a traditional viva examination. Hence, it may be preferred over the traditional viva examination.
Cartridge-Based Nucleic Acid Amplification Test
Authors: Wagh Pankaj , Rajpurohit Rakesh , Ali Saood , Adwani Sameer , Kadukar Juhi , Aurangabadkar Gaurang
Published: December 2022

Introduction:

Tuberculosis (TB) of the lung is an infectious disease caused by Mycobacterium tuberculosis, which is an aerobic, acid-fast, Gram-positive bacillus. India has the world's highest number of TB cases, accounting for one-fourth of all TB cases. For efficient treatment of pulmonary TB, microbiological diagnosis is the mainstay. Acid-fast bacillus (AFB) smear-negative patients could account for 31% of new cases. After multiple negative induced-sputum smear tests, we conducted this study to observe whether cartridge-based nucleic acid amplification test (CBNAAT) provides an additional and early diagnostic yield for undiagnosed cases of pulmonary TB.

Objectives and Goals:

The purpose of this study was to observe if CBNAAT could be used to diagnose pulmonary TB early in patients who had TB clinically and radiologically but negative for sputum direct smear.

Materials and Methods:

At our institute, 82 patients were involved in an observational study for assessing the utility of CBNAAT in the early confirmation of TB in individuals who had an X-ray chest that is indicative of PTB, but a negative sputum smear for AFB. Our hospital's department of respiratory medicine was the site of the current clinical study.

Results:

The patients were mostly between the ages of 31 and 40 years, with a male majority. Cough was the most common symptom in 72 (88%) patients. In 30 patients, the sputum CBNAAT test was positive (36.5%). All 82 instances were given a bronchoalveolar lavage (BAL). In 46 (56%) patients, BAL CBNAAT was positive. In 12 (15%) cases, bronchial brushings tested positive for AFB on smear examination. Caseating epithelioid granuloma was seen in 4 (14%) patients after a transbronchial lung biopsy.

Conclusion:

In individuals with strong indication of pulmonary TB, sputum CBNAAT and BAL CBNAAT provide a higher bacteriological confirmation of diagnosis.
Health Problems and Challenges for Optimal Health-Care Delivery in Humla District, Nepal
Authors: Rokaya Dinesh , Rokaya Nabin , Patel Jot Narayan , Sah Alok , Yadav Ranjit Kumar , Suttagul Kanokwan
Published: December 2022

Background:

Humla is one of the remote districts located in the north-west of Nepal and located at an altitude between 1500 and 7300 meters. Poor health-care services, less health-care professional, seasonal outbreak of diseases, food deficit in winter, and traditional beliefs in the curative service have caused health-care problems, hindrance, and challenges in the proper health-care delivery in Humla.

Objectives:

This study aims to provide information on the health problems and describes the difficulties and challenges to the health-care system in Humla district.

Materials and Methods:

A retrospective cross-sectional survey was conducted at the District Hospital Humla regarding medical treatment and disease prevalent from June 2017 to April 2018. Microsoft and SPSS version 18 were used to analyze the data.

Results:

It showed that the majority of the patients visiting at hospital show gastritis (30%), followed by pelvic inflammatory disease (20%), chronic obstructive pulmonary disease (12%), trauma (from landslide injury and fall injury) (8%), and alcoholic liver disease (10%). In addition, 35% of Humli people follow the traditional belief of witch doctor, 15% do home remedy, and 50% of people go to see a medical doctor and do modern treatment.

Conclusions:

Humli people face several difficulties in the health care, such as less number of hospitals, less number of doctors and health-care personals, few specialists, and less medical equipment. Among medical problems, gastritis and pelvic inflammatory disease were the most common medical problems in Humla.
Need for Artificial Intelligence in Pharmaceutical Industry and its Limitations
Authors: Pareek Varun , Sharma Lokendra , Kumar Sushil , Sharma Vishal
Published: December 2022

Artificial intelligence (AI) is often being touted as the means to bring about the fourth industrial revolution and its role in almost all sectors of our society is almost certain. This brings about an urgent need for evaluating the benefits and limitations of AI and machine learning (ML) across various sectors. Pharmaceutical industry has pioneered in embracing the use of AI in all its core areas but the success as of now seems very limited. The major advantage of AI is that it reduces the time that is needed for drug development, and in turn, it reduces the costs that are associated with drug development, enhances the returns on investment, and may even cause a decrease in cost for the end user along with improved drug safety. Hence, in this article, we will review the scope and limitations of AI in the pharmaceutical industry along with the brief review of how AI/ML can impact geriatric health care.
Ocular Morbidities among the Geriatric Persons, Attending the Ophthalmology Outpatient Department of a Tertiary Care Hospital in Eastern Odisha
Authors: Mohanty Smaraki , Mohanty Saumendu , Mohanty Minakshi , Behera Tapas Ranjan
Published: December 2022

Background:

According to the census of 2011, 13% of the Indian population was 60 years of age or older. As the geriatric population is the most vulnerable part of society, they are prone to all type of diseases including eye problems which are preventable or correctable but requires constant medical, financial, and social support. This study will find the magnitude of various ocular morbidities and their relationship with sociodemographic factors among geriatrics.

Objective:

1. To find the magnitude of ocular morbidities among the elderly. 2. To study the relationship of different sociodemographic factors with ocular morbidities. 3. To estimate the average time spent for getting ophthalmic care at the outpatient department (OPD).

Subjects and Methods:

It was a hospital-based cross-sectional study conducted in the Ophthalmology OPD of Sriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, from January to December 2016. A total of 1320 geriatric persons were enrolled during this period. Ethical clearance was obtained.

Results:

Out of the 1320 geriatric patients, 58.86% were in the age group of 60–69 years, 35.22% in 70–79 years, and 5.9% ≥80 years with a mean age of 67.7 ± 6.7 years. Males accounted for 70.98% and females for 29.02%. Different ocular morbidities detected are cataract (59.2%), refractive error (18%), ocular injury (5.9%), diabetic retinopathy (3.9%), glaucoma and chronic dacryocystitis (3%), and foreign body in the eye (2%). The total waiting time in the ophthalmology OPD to get ophthalmic care was 7.8 ± 3.2 min. The total consultation time in the OPD was 75.59 ± 27.15 min.

Conclusion:

The most common cause of visual impairment/blindness in the geriatric age group are cataract and refractive errors which are treated/corrected free of cost at any government health facility under the National Programme for Control of Blindness. People should be aware of the causes, prevention modalities, and treatment of the causes of blindness.
The Aging Larynx
Authors: Devadas Deepa , More Raghunath Shahaji , Sahni Chetan , Gupta Mayank , Nayak Amit Kumar , Mishra Anand
Published: December 2022

There has been a striking increase in the geriatric population worldwide over the last few decades. As the aging process continues to alter functioning of all body systems, the human voice is also significantly affected. The senile voice is characterized by its changes in pitch, hoarseness, tremulousness, and breathiness with reduced harmonics and intensity. Such phonatory changes in the elderly may hinder effective communication, thus bringing down their confidence levels and impairing their quality of life. These characteristic features that distinguish the senile voice from younger speakers are accompanied by age-related changes in the organ of phonation, the larynx. The summative morphological and structural changes occurring in the elderly larynx have been referred to as “Presbylarynx.” The present review article is an attempt by the authors to explore the various anatomical age-related changes occurring in the larynx that may be responsible for altered vocal function in the elderly. An improved understanding of the anatomical basis of the aged voice can give further directions into the management of vocal disorders and improved speech performance in the elderly.
Patterns and Outcomes of Empirical Antimicrobial Use in Elderly Outpatients
Authors: Ojha Bisweswar , Singh Amit , Chakrabarti Sankha Shubhra , Kaur Upinder
Published: December 2022

Introduction:

Despite the rampant use of antimicrobials in health-care settings, the safety and clinical outcome data of antimicrobials are scarce in the elderly population. The main aim of this study is to assess the prescription pattern, therapeutic gains, and adverse reactions resulting out of antimicrobial use in elderly outpatients.

Subjects and Methods:

This was a prospective observational study conducted for 7 months from June 2019 to December 2019 in elderly patients visiting the geriatric outpatient department of a tertiary hospital of North India. Primary outcomes included clinical improvement as well as the incidence and type of adverse drug reactions (ADRs) observed with antimicrobial use.

Results:

Of 110 participants recruited, 107 were assessed for clinical outcomes. The common indications of antimicrobial use were lower respiratory tract infection (48.6%), urinary tract infection (18.7%), and worm infestations (14%). Macrolides (57%) and beta-lactams (43%) were the commonly prescribed individual antimicrobials. Outcome-wise, clinical improvement was seen in 91.3%, 88.5%, and 14.3% of patients receiving beta-lactams, macrolides, and antiprotozoals, respectively. ADRs occurred in 17.7% of participants and gastrointestinal disturbance was the commonly reported ADR. Beta-lactams and macrolides were responsible for the majority of ADRs, in 19.6% and 13.1% of participants, respectively. No association of antimicrobial-associated clinical responses or ADRs was observed with demographics and underlying comorbidities.

Conclusions:

Elderly patients with respiratory tract infections showed improvement with empirical extended-spectrum beta-lactams and azithromycin therapy. The response was suboptimal to empirically selected antiprotozoal therapy. Elderly patients are at increased risk of ADRs. Close to one out of every five elderly prescribed beta-lactams may develop ADR to the antimicrobial agent. Larger clinical studies are required to predict the risk factors of ADRs and poor responsiveness to antimicrobials.
Clinical Profile and Etiological Spectrum of Acute Symptomatic Seizures in the Elderly Populace
Authors: Verma Archana , Kumar Alok , Sachan Divyata
Published: December 2022

Aim:

The current study aimed to analyze the etiology and the clinical spectrum of acute symptomatic seizures (ASS) and the predictors of in-hospital mortality in the elderly population.

Materials and Methods:

We evaluated 94 elderly (≥60 years of age) hospitalized patients with ASS for clinical profile, etiologies, and predictors of in-hospital mortality.

Results:

Mean age of onset of ASS was 67.63 ± 11.48 years. The main seizure type was focal seizure in 62 (59.7%) cases, followed by tonic-clonic seizures in 30 (31.9%) cases. The most common aetiologies in ASS were stroke in 61.7%, followed by infective cause in 30.9% of cases. In-hospital mortality in the ASS in the elderly was 21 (22.3%) in our series, and stroke was the most common cause of mortality.

Conclusion:

Stroke was the most common etiology of ASS in the elderly and was also related to mortality. It is necessary for us to analyze the causes of ASS in the elderly, to reduce in hospital mortality.
Chronic Musculoskeletal Pain in Older People
Authors: Jain Gunja , Singhal Sunny , Goyal Laxmi Kant , Agarwal Ankita , Mathur Ajay
Published: December 2022

Musculoskeletal pain is a common and debilitating symptom in older adults. However, its importance is often underestimated. In this review article, we discuss its proper evaluation and management. Pain evaluation includes detailed history taking, physical examination, imaging, and laboratory investigations. Management of musculoskeletal pain requires a multidomain approach including nonpharmacological, pharmacological, and surgical modalities. A step-wise approach recommended by the World Health Organization can be used for pain management. Common musculoskeletal conditions causing pain are osteoarthritis, low-back pain, gout, pseudogout, rheumatoid arthritis, polymyalgia rheumatica, and fibromyalgia.
A Comparative Evaluation of Shear Bond Strength of Direct Composite Laminates using Different Surface Treatments
Authors: Gupta Jyoti , Agarwal Abhinav , Lahori Manesh
Published: December 2022

Background:

In dentistry re-establishing, a lost dental esthetic appearance is one of the most important topics. Advances in modern dental materials provide patients with a choice of natural-looking laminates as esthetic restorations.

Aim:

This study aims to evaluate and compare shear bond strength of direct composite laminate veneer using different surface treatments.

Setting and Design:

A total of 60 permanent maxillary central incisors were selected for the study. The extracted teeth were thoroughly cleaned and stored in 3% hydrogen peroxide at room temperature for 24 h and then stored in normal saline.

Materials and Methods:

The facial surfaces of the teeth were prepared to accommodate laminates of equal thickness and were randomly divided into four groups which were allocated to receive different surface treatments. Group A and B included total-etch adhesive system with etching time 15 s and 60 s, respectively, Group C included a self-etch adhesive system with two components and Group D included self-etch adhesive system with single component. After these surface treatments, direct composite laminate veneers were placed on the teeth samples. Later, thermocycling process was carried and final testing was done using universal testing machine.

Statistical Analysis:

Results were compared with 1-way ANOVA and post hoc Tukey HSD test.

Results:

The mean shear bond strength was found to be highest for the total-etch method with 60s etching time followed by etching for 15s and the lowest was found to be of self-etch adhesive comprising of a single component.

Conclusions:

The study concluded that the mean shear bond strength of direct composite laminate veneers using total-etch adhesive system with 60 s etching time was found to be significantly higher compared to other surface treatment methods used in the study.