bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract No.: ABS1979: Effects of dexmedetomidine versus fentanyl combined with target controlled infusion of propofol for laproscopic surgery under general anaesthesia
Authors: Panchal Harsh
Published: September 2024

Background & Aims:

1.The primary objective of the present study wasto compare anaesthetic efficacy of dexmedetomidine versus fentanyl in terms of : Perioperative hemodynamics, Propofol consumption, Requirment of Rescue analgesia and also to compare postoperative analgesia and sedation between the two while the secondary objective was to assess any undesirable side effects if any 2.

Methods:

The present study was a prospective, randomized, double blind study conducted on 60 patients of American Society of Anesthesiologists ASA I&II aged between 20-60 years undergoing elective laproscopic surgeries. Patients were divided in two groups. GroupD received Dexmedetomidine 1mcg/kg loading dose over 10 min, followed by 0.5 µg/kg/hr continous infusion &GroupF received fentanyl 2 µg/kg bolus followed by 0.5 µg/kg/hr by continous infusion. Target controlled infusion (TCI) Propofol infusion was given to achieve target site concentration of 3-4 µg/kg in both groups. Heart rate (HR), mean arterial pressure (MAP),systolic pressure, diastolic pressure, percentage saturation of oxygen (Spo2), bispectral index monitoring (BIS) were recorded at induction,intubation, at pneumoperitoneum, 5 min, 15 min, 30 min, 45 min, 60 min, 120 min, 180 min & at extubation.Adverse haemodynamic events were noted.

Results:

Group D showed significant fall in HR, BP whereas it remained constantly high in Group F. Total mean requirement of propofol, in Group D patients was found to be 57.99% lower than GroupF. Requirement of rescue analgesia in form of opioid was significantly less in Group D 18% as compared to 30% in Group F. Post-operative analgesia requirement was earlier in group F. Sedation scores were higher in group D at all time points. Patients had bradycardia and hypotension in Group D. Postoperative nausea vomiting (PONV) was 3 times lower in Group D.

Conclusion:

Dexmedetomidine is better adjuvant compared to fentanyl when combined with target-controlled infusion of propofol. Iteffectively blunts various stress responses during surgery and maintains hemodynamic stability,reducespropofol requirements, provides better analgesia with few side effects.
Abstract No. : ABS2056: To compare time and intraoperative haemodynamic changes of spinal anaesthesia with general anaesthesia for laparoscopic cholecystectomy
Authors: Azmin Ameena
Published: September 2024

Background &Aims:

Laparoscopic cholecystectomy (LC) is conventionally performed under general anaesthesia (GA). As with any day care procedure, LC requires an anaesthetic technique which provides rapid recovery and fewer side effects. Neuraxial techniques resulted in decreased morbidity and mortality. Theaimofthestudywasto comparethe time and haemodynamic changes of spinal with GA.

Methods:

Following approval by the institutional ethical committee, registering in CTRI (CTRI/2021/04/032586 ) and after taking patient consent ,a controlled ,prospective, randomised trial of 70 patients with symptomatic gallstone disease and American Society of Anesthesiologists status I or II were operated for LC under spinal (n=35) or GA (n=35)between the academic years 2020 and 2021. Statistical analysis was done using SPSS version 25.0. Time taken for both groups were compared. Haemodynamic parameters were recorded to find theincidence of hypotension and bradycardia.

Results:

All the procedures were completed by the allocated method of anaesthesia and there were no conversions from spinal to GA. The incidences of hypotension(p=0.742) and bradycardia (P=0.163) were 17% and 11.4% in SA group and 14% and 2.8% in GA group respectively and no significant difference were observed. The total time taken in SA group was significantly less than in GA group; 38.9 ï‚±9.64 versus 46.7ï‚±9.487 respectively (P=0.0011).

Conclusion:

LC done under spinal anaesthesia is safe and less time consuming. Spinal anaesthesia can berecommended as the technique of choice for LC in developing countries where time and cost can be saved.
Abstract No.: ABS2070: Comparative evaluation of intubating Laryngeal Mask Airway (Fastrach) and Blockbuster Laryngeal Mask Airway for blind tracheal intubation in general surgical operations
Authors: Singh Arshdeep
Published: September 2024

Background & Aims:

Supraglottic devices fill a niche between the facemask and tracheal tube. The aim of this study was to compare the insertion characteristics (ease of insertion), insertion time, number of attempts, haemodynamic changes and complications (if any)following blind tracheal intubation.

Methods:

The comparative study was conducted by dividing 70 patients of age 18-60 years, ASA grade I and II into two groups of 35 patients each who were scheduled for general surgical operations. Group F underwent blind tracheal intubation usingFastrach LMA whereas Group B underwent blind tracheal intubation using Blockbuster LMA. The two groups were thencompared for the efficacy and overall success rate of blind tracheal intubation in patients undergoing surgeries under general anaesthesia.

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Results:

Both devices were inserted in first attempt only. The first time successful ETT insertion following Blockbuster LMA was in 33/35 patients (94.29%) as compared to 26/35 patients (74.29%) of FT LMA. The mean time taken by Group B was13.57Â±3.48 seconds as compared to 18.82Â±5.09 seconds of Group F. The complications (sore throat, dysphagia, dysphonia) were significant for Group F as compared to Group B. The haemodynamic parameters were insignificant for both the groups.

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Conclusion:

Although both supraglottic devices are feasible for blind tracheal intubation, Blockbuster LMA is a better option as it provides higher first pass success rate with less complications like sore throat, dysphagia and dysphonia.
Abstract No. : ABS2330 : Comparison of three different sedative regimens for gastrointestinal endoscopic procedures
Authors: Mahesh Parameshwaran
Published: September 2024

Background &Aims:

Gastrointestinal (GI) endoscopic procedures are relatively invasive and unpleasant and need high level of patient co-operation. Aim of our study was to compare three different sedative regimens using propofol, dexmedetomidine and fentanyl-midazolam combination for safer sedation in GI endoscopic procedures.

Methods:

The patients who satisfied the inclusion criteria were randomly allocated into three groups of 30 each. Group P patients received propofol 1mg/kg i.v followed by 0.5mg/kg/hr infusion. Group- D received dexmedetomidine1µg/kg i.v. infusion over 10min followed by 0.5µg/kg/hr infusion. Group- FM received fentanyl 1µg/kg and midazolam 20 µg/kg i.v. followed by fentanyl 0.5µg/kg/hr infusion. The endoscopic procedure was started when the patient attained a level of conscious sedation [score of 2-4 on the Observer Assessment of Alertness/Sedation Scale(OAA/S scale)].The patient’s and endoscopist level of satisfaction was assessed using the 10 - point visual analogue scale

Results:

Demographic data and the duration of the procedure between the three groups were similar and statistically insignificant. The heart rate, mean arterial pressure and oxygen saturation were lower in Group-D and were statistically significant. The onset of sedation was earlier with Group-P. The time to recovery, requirement of additional fentanyl, incidence of gagging, patient and surgeon’s satisfaction scores and maximum OAA/S score were similar in Groups D and P and better than Group-MF.

Conclusion:

I We conclude that dexmedetomidine provides an overall better experience for the patient, endoscopist and anaesthesiologist than propofol and midazolam-fentanyl combination.
Abstract No. : ABS2796: Comparative evaluation of transaortic coeliac plexus rhizolysis with bilateral splanchnic nerve radio frequency ablation in patients of upper gastro-intestinal malignancies with intractable pain : A prospective interventional study.
Authors: Litin Yasum
Published: September 2024

Background and Aims:

This study aimed for a comparative evaluation of transaortic coeliac plexus rhizolysis with bilateral splanchnic nerve radio frequency ablation for decrease in visual analogue scale(VAS) score and oral morphine requirements, in patients having upper gastrointestinal (GI) malignancies with intractable pain.

Methods:

Patients were randomly allocated in two group of 30 eackGroup 1 received bilateral splanchnic nerve radio-frequency ablation(SRF group) and group 2 had trans-aortic coeliac plexus rhizolysis (CPR group). Study was conducted over a period of 18 months. Following data were collected:VAS score, oral morphine requirement , adverse effects, and improvement in the quality of life.

Results:

Total of 33 patients (17 in SRF and 16 in CPR group) completed full 6 months follow-up Other patients were followed up until their demise. At the end of 6 months VAS score was reduced to 2.13±1.48 (cm) and 3.28±1.4 (cm) in SRF and CPR groups respectively and mean morphine consumption was 13.4 ± 15.3 mg/day and 26.11 ± 23.5 mg/day in SRF group and CPR group respectively..

Conclusion:

In upper GI cancer patients with severe intractable abdominal pain, interventional approach along with pharmacological management provides better analgesic efficacy . Both the techniques (bilateral splanchnic nerve RFA and trans-aortic coeliac plexus rhizolysis) were effective for the relief of severe intractable abdominal pain in upper GI malignancies.
Abstract No.: ABS2881: Comparison of cardiac indices using two different concentrations of adrenaline wicks during endoscopic trans-sphenoidal pituitary surgery: a prospective randomised observational study
Authors: Gautam Archana
Published: September 2024

Background & Aims:

Trans-nasal trans-sphenoidal approach is preferred for surgical excision of pituitary tumours. Adrenaline is a generally usedvasoconstrictor for instillation or infiltration to decrease bleeding and improve the operative field quality. We aimed to compare the cardiac indices (Flotrac guided) and hemodynamic parameters while using two different doses of adrenaline for instillation

Methods:

60 ASA I/II patients, aged 18-65 years, undergoing transsphenoidal surgery for pituitary tumours were enrolled and allocatedto two groups. Group 1 received 1:200,000 concentration and Group 2 receiving 1:100,000 concentration of adrenalinetopically using cotton strips for 10-15 minutes. Cardiac indices and haemodynamic parameters were noted at baseline, every 5 minutes for first hour followed by every 10 minutes till the end of the procedure. Blood loss, quality of thefield and any adverse events were noted

Results:

Significant reductions in cardiac indices (CO, CI) were noted in Group 2 at 60 and 70 minutes of the procedure compared to Group 1. There was no difference in haemodynamic parameters (HR, SBP, DBP, MAP, SPO2,) between the 1:100,000 and 1:200,000 adrenaline groups. However, hypertension and tachycardia were higher following instillation of 1:100,000 adrenaline concentration when compared with the baseline (p<0.005)

Conclusion:

1:200,000 concentrations of adrenaline for nasal decongestion was associated with lowered cardiac indices compared to1:100,000 concentration. Field quality and usage of rescue drugs were comparable in both the study groups

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Abstract No. : ABS0646: Efficacy of combined epidural general anaesthesia in laparoscopic cholecystectomies - a prospective randomised study
Authors: HN Nethra
Published: September 2024

Background &Aims:

Pnuemoperitonium in laparoscopy is associated with cardiorespiratory changes. Combination of epidural with general anaesthesia might offer benefits of haemodynamic control and peri-operative analgesia. We aimed to study the efficacy of combinedepidural-general anaesthesia(CEGA) over general anaesthesia in laparoscopic cholecystectomies.

Methods:

A prospective, randomised, double blind study was conducted on 90 surgical in-patients after obtaining ethical and informed consent from the institution and participants respectively.In Group GE-(n=45), Lumbar epidural analgesia with ropivacaine with GA ;In Group G, only GA was administered. Propofol ,vecuronium, fentanyl, paracetamol, isofluranewereused in both the groups. Along with minimum mandatory monitoringfor study purpose, heart rate(HR), mean arterial Pressure(MAP), end-tidal carbon-dioxide (ETCO2), peripheral oxygen saturation ( SpO2) ,visualanaloguescale score, Ramsay sedation score , requirement of propofol, muscle relaxants and analgesics were studied with recovery and pain in 12 hours post operatively.Statistical analysis was carried out with SPSS version 20. Student’s t test, Chi-square test were used for comparison.

Results:

Statistical value of p<0.05 was considered significant. We noted significantly lesser readingsin group GE than inGroup G i.e (p<0.001) in MAP, SBP, DBP muscle relaxants, propofol and Fentanyl (p<0.001) . Early recovery and lesser pain scores were noted in group GE than Group G.

Conclusion:

CEGAtechnique has the benefit of better control of haemodynamics .It reduces requirements of analgesics and anaesthetic drugs and has faster recovery with less post-operative pain in laparoscopic cholecystectomies.
Abstract No. : ABS2957: Efficacy of continuous magnesium infusion in prevention of post- operative atrial Fibrillation in patients undergoing off-Pump Coronary Artery Bypass Graft Surgery
Authors: George Robin
Published: September 2024

Background & Aims:

Postoperative atrial fibrillation (POAF) occurs in 30-50% of patients after coronary artery bypass surgery (CABG). Serum hypomagnesemia is common after cardiac surgeries.The primary objective was to evaluate whether magnesium infusion could reduce the incidence of postoperative atrial fibrillation (POAF) after off pump CABG.

Methods:

This prospective, singe centre, randomised controlled study was conducted among 100 patients who underwent off-pump

CABG. The participants were classified into two groups: Group (M); study group in which magnesium infusion was started for three days after an initial bolus dose when the patient was received in intensive care unit (ICU) and Group (C); control group was managed with usual care. The target in Group M was to attain a serum magnesium level of 1.5 to 2 mmol/L. Theincidence of POAF was observed in both the groups. A p value < 0.05 was taken as statistically significant.

Results:

The incidence of POAF was significantly higher in control group (20%) when compared to the study group (2%)(p=0.008). There were no significant changes in vasoactive inotropic scores, length of ICU stay, additional pharmacotherapy and cardioversion needed between both the groups.

Conclusion:

The study established that continuous magnesium infusion was effective in preventing POAF in patients undergoing off-pump CABGs.
Abstract No. : ABS3025: To study the safety and efficacy of preoperative oral carbohydrate loading in type 2 Diabetics undergoing elective off pump coronary artery bypass grafting.
Authors: Ram R Sree
Published: September 2024

Background & Aims:

The aim was to study the safety and efficacy of oral carbohydrate loading in type 2 diabetics undergoing off-pump coronary artery bypass grafting (CABG).The primary objective was to evaluate the residual gastric volume and secondary objectives included evaluating insulin resistance and inotrope requirement.

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Methods:

This prospective, unicentric, non-blinded randomised controlled study was conducted on 40 American Society of Anesthesiologists grade III & IV subjects. The study population was randomly allocated into Control Group in which patients were given 800 ml of clear fluids on the night before surgery and 400 ml of clear fluids 2 hours before on the day of surgery and Study group in which patients were given carbohydrate drink (50 gm of two carbohydrate sachets mixed with 800 ml of water) night before surgeryand 50 gm of one carbohydrate sachet mixed with 400 ml of water 2 h before surgery.

Results:

Both the groups had comparable residual gastric volumes. The Carboload group had higher blood sugar levels in the preoperative and intraoperative periods. Blood sugar control was better in the Carboload group during the postoperativeperiod, and the mean total insulin requirement and lactate levels for the Carboload group were less than the clear fluid group.Patient wellbeing was significantly higher in the Carboload group. No episodes of regurgitation or aspiration were recordedin either group.

Conclusion:

In patients with type 2 diabetes, consuming a Carboload drink two hours before surgery was safe and didnot increase the risk of pulmonary aspiration. Although there was a slight increase in their preoperative blood glucose levels, the postoperative glucose levels were easier to control and required a lesser amount of insulin to achieve normoglycemia.Moreover, we found a remarkable improvement in the patient’s well being as the carbohydrate consumed group experiencedless thirst, and hunger. Patients with Type 2 diabetes may benefit from the physiologic benefits of this beverage, justas do patients without diabetes in enhanced recovery after surgery (ERAS) protocols. RBS levels during the perioperative period (mg/dl)
Abstract No.: ABS3115: Effect of sevoflurane vs desflurane on blood glucose level in patients undergoing intracranial neurosurgery: A randomised control study
Authors: Kaushal Ashutosh
Published: September 2024

Background & Aims:

Patients undergoing neurosurgery are prone to neurological damage due to the anaerobic metabolism of blood glucose. In this study we aimed to to compare the effect of sevoflurane and desflurane on blood glucose levels in patients undergoing intracranial surgery.

Methods:

All consenting patients of either gender 18-65 years belonging to American Society of Anesthesiologists (ASA) physical status I & II scheduled for intracranial surgery under sevoflurane or desflurane maintenance anaesthesia were included. Patients suffering from diabetes, thyroid dysfunction, renal or hepatic disease, on steroids, beta-adrenergic blocking agents, insulin or oral hypoglycaemic agents, pregnant or lactating patients, chronic alcoholic patients, and non-consenting patients were excluded from the study. The enrolled patients were randomised in the sevoflurane and desflurane groups. The periodic glucose level was measured hourly after induction until completion of surgery using the glucose oxidase peroxidase method.

Results:

A total of 70 patients was included in the study. Both sevoflurane and desflurane when used as maintenance anaesthetics cause changes in blood sugar levels. Sevoflurane causes a gradual increase in blood sugar intraoperatively whereas desflurane causes an initial rise in blood sugar followed by a decline in blood sugar level in euglycemic patients. There was a significant difference in the trend of blood sugar (mg/dL) over time between the two groups (p =<0.001).

Conclusion:

The changes in blood sugar level by both agents were statistically significant but clinically insignificant as the values remained within clinically normal range and there were no episodes of hypo or hyperglycaemia.
Abstract No. : ABS3541: A comparative study to confirm the endotracheal tube placement using ultrasonography and standard auscultation method inchildren
Authors: Sinha Neha
Published: September 2024

Background & Aims:

In paediatric patients, due to shorter trachea, suboptimal positioning of endotracheal tube (ETT) is seen in 20-50% of patients triggering grave complications. We compared standard auscultation and ultrasound-guided lung sliding to confirmposition of ETT in children.

Methods:

75 paediatric patients between 2-8 years of age, American Society of Anesthesiologists (ASA) I and II scheduled for surgery under general anaesthesia with endotracheal intubation were studied. Position of ETT was confirmed by chest auscultation for the breath sounds bilaterally and by ultrasound on same sites for lung-sliding sign. The data obtained were compared to findings on waveform capnography. Study outcomes included position of the ETT; tracheal or oesophageal, accuracy and time taken till confirmingthe diagnosis.

Results:

Compared to waveform capnography findings, ultrasound revealed sensitivity of 100% and specificity of 41.7% while that for standard auscultation were 72.86% and 100% respectively. The mean time taken for confirmation of ETT position by auscultation was 32.38±6.2s and was significantly lower (p=0.001s) than the ultrasonography time of 136.8±7s. However, ultrasonography findings were 90.7% accurate which was significantly higher than 74.7% accuracy of auscultation.

JOURNAL/ijana/04.03/01762628-202203001-00039/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Conclusion:

Confirmation of ETT position using ultrasonography or waveform capnography is essential because of high false results using standard auscultation alone. Ultrasound-guided lung sliding method is a simple and accurate method used for detectingtube malposition.
Abstract No. : ABS3624: Comparison of monitored anaesthesia care using dexmedetomidine with spinal anaesthesia using ropivacaine in day care varicose vein surgery
Authors: NannamSpandana
Published: September 2024

Background &Aims:

The purpose of this study was to compare the safety and efficacy of monitored anaesthesia care(MAC)using dexmedetomidine with spinal anaesthesia(SA) using ropivacaine in day care varicose vein surgery in terms of patient satisfaction and postoperative ambulatory and discharge time.

Methods:

64 patients who underwent varicose vein surgery were randomly divided into two groups.GROUP I MAC(n=32) GROUP II SA(n=32).In the MAC group, a loading dose of 1µg/kg dexmedetomidine was administered followed by 0.6µg/kg/min maintainance infusion which was then titrated according to sedation. Fentanyl was given as rescue anagesia. In the SA group ,SAwas given with 10mg of 0.5 % ropivacaine by a median/paramedian approach in L3/L4 interspace with 25G Quincke spinal needle. Patient’s satisfaction to anaesthesia and post operative ambulatory time and discharge time were recorded.

Results:

Significantly higher verbal numerical rating scale for patient’s satisfaction to anaesthesia’ was observed in patients of Group I as compared to Group II. Ambulatory time was significantly earlier in Group I as compared to Group II .Range of ambulatory time in Group I was 2 to 5 hours while that in Group II was 4 to 6:30 hours . Group I patients were discharged earlier than Group II though significant differences were not found.

Conclusion:

Monitored anaesthesia care using dexmedetomidine with fentanyl as rescue analgesia isa better alternative for day care varicose vein surgery due to its association with better patient satisfaction and early ambulatory time and early discharge compared to spinal anaesthesia using ropivacaine.
CAUSES OF BLINDNESS AMONG CHILDREN IN BLIND HOME OF NORTH BIHAR - AN ANALYSIS FOR BURDEN REDUCTION
Authors: Elango Haarish , Nisha Lucy , Shahnawaz Asif , Jha Alka
Published: September 2024

Purpose:

To assess causes of Blindness/ Severe Visual Impairment/ Moderate Visual Impairment among Children living in Blind home of North Bihar.

Methods:

Study was conducted during 2020-21 at a Blind home of North Bihar. 60 SVI/BL children were included. History of blindness was taken, ophthalmological Examination with Torch light and Slit Lamp Examination followed by Fundus exam was done. The anatomical sites and etiology for SVI/BL were recorded using the WHO-Prevention of Blindness reporting form.

Results:

According to WHO criteria,60% were blind,10% had SVI, 6% had moderate visual impairment and 24% had no visual impairment. Among 60 blind children most common sites of SVI/BL were whole globe-18 and cornea-12, followed by uvea- 5, retinal disorders- 4, lens- 3, optic nerve-2 and others (amblyopia- 1).

Conclusion:

Study shows 24% of paediatric blindness is avoidable. With availability of proper healthcare facilities, trend is changing from corneal causes to whole globe abnormalities but still a lot of effort in form of timely neonatal eye care facilities, paediatric surgical services and proper refraction strategies are required.
A CASE REPORT ON NEUROFIBROMATOSIS TYPE 1 IN CHILDREN
Authors: Kumar Amrendra , Anjula  , Bharti Paramveer , Poonam  , Ambastha Anita , Bhaskar Gyan
Published: September 2024

Neurofibromatosis1 is an autosomal dominant neurocutaneous disorder occurs due to mutation of NF1 gene on chromosome 172. It affects 1 in 3000 births.There is no sex or racial predilection. It is a multiorgan disease affecting nervous system ,skin and bones. Most cases with NF1 develop hyperpigmented cutaneous macule (café au lait macules),skinfold freckling,lisch nodules and dermal neurofibroma1

Here, we present a case of 4 year old boys with NF1. He was seen by many ophthalmologist outside and was diagnosed with congenital ptosis and reffered to our institute for ptosis management. Ptosis and deterioration of vision is an uncommon presentation.He presented with multiple cutaneous macules,plexiform neurofibroma, ptosis and sphenoid wing dysplasia on imaging. Here, we present a cse report on neurofibrmatosis(NF1) in a four year old child presenting in this mode.

The diagnosis of NF1 was made according to the diagnostic criteria laid by National Institute of Health Consensus Development Conference1.
PTERYGIUM WITH CYST - CASE REPORT AND LITERATURE REVIEW
Authors: Anjula  , Amrendra  , Parambir  , Poonam  , Ambasta Anita , Bhaskar Gyan
Published: September 2024

Background: Pterygium is a degenerative condition which presents as a fleshy growth on the nasal side of bulbar conjunctiva.1It is a triangular or wing-shaped conjunctiva encroachment on the cornea which may be atrophic, stationary or progressive1. It can cause conjunctival redness, lacrimation, itching/ grittiness and visual impairment resulting from induced astigmatism, glare, decreased contrast sensitivity. It can rarely undergo neoplastic changes,calcification or cystic degeneration rarely.5
Intraoral Lipoma
Authors: Dhinoja Karthik Nileshkumar
Published: September 2024

Lipomas, benign tumours of mature fat cells, typically appear in the head-and-neck region, with rare occurrences in the mouth. This case involves an unusually large intraoral lipoma exceeding 1.8 cm. Lipomas, usually painless, may go unnoticed for an extended period. Recognition of atypical presentations is crucial for accurate diagnosis and management. A surgical procedure under local anaesthesia removed a 1.8 cm × 1.7 cm × 1.3 cm gingival growth. Using a 15 No, an incision was made on the BP blade to preserve the attached gingiva. Coe-Pak dressing safeguarded the treated area, ensuring optimal recovery. The soft-tissue section’s histopathological examination revealed an encapsulated lesion with mature adipocytes arranged in lobules, separated by fibrous connective tissue. Adipocytes displayed polygonal shapes with clear cytoplasm, eccentrically placed nuclei and compressed membranes. Deeper observations included dilated blood capillaries, extravasated red blood cells, muscle fibres and minimal inflammatory cells. Lobules of mucous salivary acini were also identified as intraoral lipomas, rare but detected during dental check-ups. They usually lack pain, which causes delayed treatment. Patients focus on aesthetics or mild discomfort. Clinicians must use modern diagnostics to identify and conservatively manage intraoral lipomas. Ongoing trials explore non-surgical treatments, potentially shaping future standards of care.
Awareness and Education of Medical Students toward Artificial Intelligence and Radiology
Authors: Sachdev Rohan , Garg Kriti , Srivastava Akash
Published: September 2024

Context:

Artificial intelligence (AI) is focused on understanding the essence of human intelligence and developing smart artifacts that can perform the tasks that intelligence is said to entail when performed by humans.

Aims:

The aim of the study was to understand medical students views, understanding and level of confidence in working on AI and explore if AI influences their career intentions with specific regard to radiology.

Settings and Design:

401 medical students of two medical colleges were included.

Subjects and Methods:

Four and one medical students of two medical colleges were included to complete an anonymous electronic survey consisting of Likert and dichotomous questions.

Statistical Analysis Used:

Statistical analysis was performed with simple descriptive statistics in frequency and percentages.

Results:

In this study, 89.11% was the response rate of participants and majority (30.9%) of medical students strongly agreed about the awareness of AI. Nearly 36.3% of the medical students disagreed that they were less likely to consider a career in radiology due to AI. Around 29% of medical students strongly agreed for the scope of integration of AI in medical education of India.

Conclusions:

Medical students recognize the significance of AI and are eager to get involved. AI medical college curriculum should be broadened and upgraded. Students must be provided with practical use cases and drawbacks of AI so that they may not feel discouraged from pursuing radiology.
Effect of Different Manufacturing Techniques on Color in Zirconia-Based All Ceramics
Authors: Uğur Mehmet , Kavut Idris
Published: September 2024

Aim:

The aim of this in vitro study was to investigate the effect of different veneering techniques on the color, translucency, of zirconia-based systems.

Materials and Methods:

Specimens were randomly divided into three groups (n = 12): layering (L), pressing (P), and computed aided design (CAD)-on (CO). Group L was veneered with nano-fluorapatite veneering ceramic. Group P was heat pressed with fluorapatite glass-ceramic ingots. Group CO the veneering ceramics were designed with and milled from lithium disilicate glass-ceramic blocks in CAD/computed aided manufacturing unit. Color parameters (L* a* b*) were measured with a spectrophotometer and color difference (ΔE), and translucency parameter (TP) properties were calculated. The results were analyzed with one-way ANOVA (P < 0.05).

Results:

There were significant differences between the ΔE of the groups (P < 0.05). The highest value was observed in the L group (ΔE = 4.17 ± 0.98); the lowest value was observed in the P group (ΔE = 2.08 ± 0.54). There were significant differences between the TP values of the groups (P < 0.05).

Conclusion:

Optical properties of the zirconia-based systems are greatly affected by the fabrication techniques.
Impact of Social Media on the Knowledge Regarding Oral Health Practices and COVID-19 Preventive Measures among Children
Authors: Vudata Usha Kiran , Vanga Narsimha Rao V. , Pandranki Jayalakshmi
Published: September 2024

Background:

There has been a concerning escalation in oral health problems worldwide. More than half of Indian children are affected by dental diseases. Although several oral health education programs are being implemented at national and regional levels, the goal of optimal oral health seems elusive. During the recent COVID-19 outbreak and the ensuing global lockdown, social media played a key role in disseminating crucial information about the novel coronavirus, leading to appropriate protocols being followed by a vast majority of the population, resulting in the containment of the pandemic.

Aim:

The aim of this study was to evaluate knowledge among children about oral hygiene practices and compare them with knowledge regarding COVID-19 preventive measures in view of the role played by social media.

Subjects and Methods:

An online questionnaire survey was conducted among children aged 10–15 years.

Results:

A total of 177 children responded to the questionnaire. The results showed that all the participants (100%) followed the correct method of wearing a mask during the COVID-19 pandemic, as advised by social media. More than half of the children (61%) had knowledge about the handwash protocol. Contrarily, only 33% of children brushed their teeth twice a day, 51% of children brushed for 2–3 min, 68% of children had a snacking habit, and only 7.3% of children were aware of the process to be followed in the event of tooth avulsion due to dentofacial trauma.

Conclusion:

Children are sensitized to information regarding COVID-19 safety measures and therefore followed them better than oral hygiene practices.
Assessment of Quality of Life for Oral Cancer Patients Receiving Chemotherapy Treatment at a Government Tertiary Care Center
Authors: Sharma Kopal , Neemawat Kanu , Sharma Amit
Published: September 2024

Objectives:

Quality of life (QOL) is a valuable prognostic indicator of survival in cancer patients. It further aids the health-care professionals to cater to patient needs. This study aimed to estimate longitudinally the changes in the QOL of oral cancer patients in early and late stages and receiving chemotherapy treatment.

Materials and Methods:

This was a prospective observational study conducted with 400 oral cancer patients receiving chemotherapy treatment at a government tertiary care cancer hospital in Jaipur city. QOL for each patient was measured before treatment, after 6 months, and 1 year posttreatment using the instrument Functional Assessment of Cancer Therapy-Head and Neck version 4. Statistical analysis was conducted with IBM Statistical Package for the Social Sciences for Windows version 17.0 software (IBM Corp., Armonk, NY, USA). For all the analyses, P < 0.05 was considered statistically significant.

Results:

A statistically significant difference in the mean score for physical (P < 0.0001), social (P < 0.0001), and functional (P = 0.001) well-being was recorded for early- and late-stage cancer patients at baseline. Only emotional (0.03) and social (0.04) well-being showed a significant improvement for late-stage cancer patients in contrast to early-stage patients where all QOL subscores improved longitudinally.

Conclusion:

Early-stage disease is associated with better QOL. Chemotherapy treatment could improve only emotional and social well-being parameters in late-stage disease patients. QOL studies can be fruitful clinical endpoint and should be inculcated in the framework of various tertiary care centers.
The Perceptions of II MBBS Students toward Flipped Classroom as an Active Method of Learning
Authors: Vaddatti Tejeswini , Chaitra. B , Renuka I. V. , Potti Ramya
Published: September 2024

Introduction:

With the advent of competency-based medical education, self-directed learning and student-centric approach have been emphasized. The flipped classroom (FC) is a learning design which encourages active involvement of students. Hence, this study was conducted to assess the effectiveness and perceptions of FC among II MBBS students.

Materials and Methods:

This was an interventional study done on II MBBS students. The study material on a topic was provided to all participants 1 week before interaction and assessment sessions. The perception of students was assessed by a standard validated questionnaire with Likert scale and open-ended questions. The knowledge gained was assessed by a total of 10 multiple-choice questions, 5 each from topics covered by FC and traditional method and scores analyses by unpaired t-test among high and low achievers and between two methods.

Results:

A total of 103 students were included in the study. In this study majority of students felt that flipped classroom was more engaging, motivating and increased communication. This method was also flexible they could go through the course according to their own pace and helped in improving learning. The overall rating of FC was 60.83%. The mean scores in topics delivered by FC (2.05 ± 1.17) were higher than that of traditional didactic lecture (1.46 ± 1.02) and P = 0.0001 was statistically significant and also among high achievers (P = 0.0001).

Conclusions:

This study concludes that majority of students perceived FC as an effective strategy for learning and test scores of students were higher with FC than with traditional lecture and also in high achievers compared to low achievers.
The flare up of immune-mediated inflammatory dermatoses during COVID-19 pandemic—a cross sectional study in a tertiary care hospital
Authors: Mohanasundari P.S. , Kumar Mani S. , Anandan V. , Sowmiya R. , Rajee Saranya
Published: September 2024

Background and aim

COVID-19 disease raises many critical issues in dermatology and dermatological care. Addressing these issues is necessary, yet also challenging, because there are only a few direct data available. We attempted a study to provide a better understanding regarding the impact of COVID-19 pandemic on the course and management of chronic immune-mediated inflammatory skin disease during COVID-19 pandemic.

Methods

A Questionnaire based study was conducted on patients with chronic immune-mediated inflammatory skin diseases started on immunosuppressant therapy before COVID period and questioned regarding the treatment taken for skin disease, follow up, COVID-19 infection and vaccination status, flare up of skin disease, management of the disease flare up. The data collected are tabulated and analyzed in epi-info software/MS excel.

Result

Among 500 patients, 462 (92.4%) discontinued the treatment which was mainly due to their inability to reach the hospital (99.5%) and remaining 0.5% were afraid of taking immune suppressants during pandemic. 385 (83.3%) of 462 patients who discontinued the drug had disease flare up. 75 (15%) out of 500 patients turned COVID–19 positive. 50 (66.6%) out of 75 COVID-19 (+) patients developed disease flare up. 293 (58.6%) out of 500 patients were vaccinated, among which 12 patients (4%) had flare up.

Conclusion

COVID-19 infection as well as vaccination has both direct and indirect influence in disease progression/flare up of preexisting inflammatory dermatoses. Knowledge regarding the course and management of chronic inflammatory skin conditions during this pandemic helps in providing better quality of life.
Inflammatory biomarkers and clinical adverse effects associated with Isotretinoin treatment: A prospective study
Authors: Nofal Ahmad Abdel-Gawad , Hussein Ghada H. , Ahmed Noha , Ibrahim Al shimaa M.
Published: September 2024

Background

Isotretinoin is considered now one of the most important drugs in the treatment of different dermatological diseases. However, different body systems can be affected during the treatment due to isotretinoin induced apoptosis.

Objectives

To evaluate the clinical adverse effects and laboratory changes associated with isotretinoin used in the treatment of different dermatological diseases.

Methods

73 patients on isotretinoin treatment fulfilled a questionnaire about side effects associated with isotretinoin. Complete blood count (CBC), fasting lipid profile, liver enzymes, and the inflammatory markers Monocytes/HDL ratio (MHR), Neutrophil/lymphocyte (NLR), and Platelets/lymphocyte ratios (PLR) were assessed before treatment and monthly during the treatment period.

Results

The commonest adverse effects were related to dryness of skin and mucus membrane. 32.9% complained of myalgia and 12.3% arthralgia. Headache was reported in 13.7%, mood alteration in 11%, and insomnia in 12.3%. 24.5% of studied females reported menstrual irregularities. There were no statistically significant changes in CBC. TG, cholesterol, AST, ALT, and MHR significantly increased while HDL, NLR and PLR ratios significantly decreased after isotretinoin treatment. Conclusion: isotretinoin affects different body systems by side effects that are reversible in most instances; however, some of them are serious and need regular monitoring especially in high- risk patients.
Current Trends in Metabolic Evaluation of Patients with Urinary Tract Lithiasis
Authors: Zarkadas Anastasios , Bozios Dimitrios , Konstantinopoulos Vassileios , Tsiakoulias Eleftherios , Safioleas Konstantinos , Filios Athanasios , Rodinos Evaggelos , Mitiliniou Despoina , Kallinikas Georgios , Filios Panagiots , Vlassopoulos Gerasimos , Gerzelis Ioannis , Kozyrakis Diomidis
Published: September 2024

Urolithiasis is one of the most frequent disorders of the urinary tract with a high prevalence among the general population. The etiology is multifactorial and is related primarily with, race, age, gender, occupation, hygienic-dietetic issues, lifestyle factors, geographic and climatic aspects, hereditariness, and metabolic changes. Therefore, for prevention of the disease, the metabolic causes responsible for stone formation should be addressed before and particularly after treatment. Key point for the metabolic evaluation is to perform stone analysis and to classify patients into low- and high-risk group. In low-risk patients, basic metabolic evaluation is proposed comprising basic urine and blood tests. Spot urinalysis should include red cells, white blood cells, nitrite, urine pH, urine microscopy, and culture if indicated. Basic blood testing includes blood cell count, creatinine, uric acid, ionized calcium, sodium, potassium, and C-reactive protein if indicated. In high-risk stone formers, apart from the basic workup, analysis of two 24-h urine samples should be examined for evaluation of the total urine volume as well as the concentration of creatinine, calcium, phosphate, oxalate, urea nitrogen, uric acid, citrate, magnesium, sodium, and if indicated of cystine. Further examination should be based on the composition of stone. The follow-up of stone formers is still matter of debate, but most experts agree that the follow-up should be individualized according to stones composition, the underlying metabolic cause, and the treatment that has been offered.
How Valuable is Uroflowmetry in Children with Enuresis Nocturna?
Authors: Çakıroğlu Basri , Gözüküçük Ali , Cesur Ilknur Banlı
Published: September 2024

Objective:

Enuresis nocturna is an important social and psychological problem in children. Uroflowmetry (UF) is a noninvasive urodynamic test that is performed in daily clinical practice to evaluate urinary function. In UF evaluation, urine amount, urination time, latency time, maximum urine flow rate access time, maximum urine flow rate, and mean urine flow rate are evaluated. The objective of the study was to evaluate the UF results of children with primary nocturnal enuresis (PNE).

Materials and Methods:

The UF findings of healthy and visualized children without any urinary symptoms and who were prospectively admitted to the urology and pediatric surgery outpatient clinic with the complaint of PNE were compared. Information and UF results of PNE and healthy children included in the study were recorded. In this research, we compared the clinical characteristics and features of bladder assessment: UF, postvoid residuals, and bladder wall thickness between boys and girls with PNE and the clinical characteristics and bladder assessment between children with primary and secondary PNE.

Results:

A total of 183 children, comprised 103 potty-trained children with PNE and 80 potty-trained healthy children were included in the study. There were 60 children in the PNE group and 62 children in the control group. There was no statistically significant difference between the groups in terms of age. When the UF findings of both groups were compared, it was found that only maximum flow was higher in the children with PNE. In other parameters, there was no difference between the two groups. The Qmax in the group with PNE and the control group was found to be 20.48 ± 6.57 ml/s and 17.22 ± 6.17 ml/s, respectively (P = 0.001).

Conclusions:

The present study reveals that there is no difference between patients with enuresis nocturna and healthy individuals in terms of UF. Therefore, UF is not recommended for use in differential PNE diagnosis.
Efficacy of cryoneurolysis in the management of chronic non-cancer pain: A systematic review and meta-analysis
Authors: Goyal Sonal , Kumar Ajit , Sharma Ravi Shankar , Goyal Divakar , Singh Girish Kumar
Published: September 2024

Background and Aims:

Cryoneurolysis, a neuroablative technique, is used in the event of failure of conservative treatment in chronic pain conditions. To date, no systematic review has been published to demonstrate its effectiveness in managing chronic non-cancer pain. Therefore, this review was done to ascertain the efficacy of cryoneurolysis and describe its role in chronic non-cancer pain management.

Methods:

We searched PubMed, Cochrane, Embase, Scopus, and Google Scholar databases for articles published between January 2011 and September 2021. Two independent reviewers extracted the data from the included studies. Assessment of risk of bias of included randomised controlled trials (RCTs) was done using RevMan 5.4.1 software and Newcastle-Ottawa scale was used for non-randomised studies.

Results:

Ten studies enroling a total of 425 patients were included in the qualitative analysis. Eight studies were assessed quantitatively. RCTs were found only for cervicogenic headache and knee osteoarthritis management. The rest of the included studies were prospective non-controlled and retrospective studies. A significant pain reduction was seen at seven-day [Standardised Mean Difference (SMD) 1.77 (1.07, 2.46)], P < 0.00001, I2 = 79%), one-month (SMD 3.26 [2.60, 3.92], P < 0.00001, I2 = 45%), three-month (SMD 2.58 [1.46, 3.70], P < 0.00001, I2 = 93%), six-month (SMD 2.38 [0.97, 3.79], P = 0.001, I2 = 86%) follow-ups. Improved disability and no serious complications were noted.

Conclusion:

Cryoneurolysis appeared to be effective in pain alleviation in refractory painful conditions for up to six months. It is safe and well-tolerated with an excellent safety profile but the quality of evidence is limited by substantial heterogeneity between trials. Therefore, more comparative clinical trials on a larger sample size are needed to provide more concrete evidence.
Pap smear changes and cervical inflammation in women with infertility in correlation to clinical and microbiological findings
Authors: Bose Arshiya , Acharya Mousumi , Panigrahi Kumudini , Pradhan Prita , Dash Kanakalata
Published: September 2024

Introduction:

One of the prime causes of infertility is reproductive tract infections as they can produce marked cervical inflammation. These can be seen in Pap smears at various stages as cervical health plays an imperative role in blocking ascending infections. This study assesses infections and related changes in Pap smears from women with infertility and its association with clinical and microbiological findings.

Materials and Methods:

A prospective observational study was done for 3.5 years. Pap smears of women with infertility were taken, and those showing significant inflammation (>50%) were studied. Relevant history and “per-speculum” findings were noted. Pap smear changes, infections or intraepithelial changes, and lactobacilli were studied. High vaginal swab culture was done, and follow-up conception data were correlated.

Results:

Almost 50% of women with inflammatory smears showed the presence of an infection; of which the most common was candidiasis followed by bacterial vaginosis. Out of the 12 women whose culture reports were available, 11 showed growth (90%). Most women showed depleted lactobacilli. On follow-up, the conception rate despite assisted reproductive technology was significantly lower in women with Pap smear changes (P = 0.0002).

Conclusion:

These observations show a strong and significant association between inflammatory Pap smears, infections in the reproductive tract, depleted lactobacilli, and conception. It is advisable that a Pap smear should be done in all cases of infertility to look for infections and inflammation, and a follow-up with high vaginal swab culture should be done in cases where inflammation is detected in a Pap smear.

The following core competencies are addressed in this article:

Patient care and procedural skills, Medical knowledge, Practice-based learning and improvement.