bluuebunny/crossref_metadata_2025 huggingface dataset:
Endolift® the “lunch-time” laser lifting for the lower eyelids
Authors: Dell’Avanzato Roberto
Published: December 2022

Lasers and others energy-based devices have reached very high levels of results. Although the area of the lower eyelids is one of the most difficult to treat without surgery, Endolift® represents one of the safest and effective techniques that we can offer. Endolift® procedure was performed with a 200 microns second-generation bare fiber connected to an Italian 1470nm semiconductor laser to treat the lower eyelids of a 43-year-old patient with wrinkles and skin laxity. No anesthesia was required. The fiber was easily inserted through the skin, without any incisions, directly between the orbicularis oculi muscle and the septum. The total laser energy delivered was 80 J for each side. Post-procedure the patient immediately resumed her daily activities. Snap Back test was performed before (T0) and 6 months (T1) after the procedure; Fitzpatrick “wrinkle score” and “degree of elastosis” were assessed at T0 and T1; investigator Global Aesthetic Improvement scale (iGAIS), external investigator Global Aesthetic Improvement scale (eiGAIS) and participant Global Aesthetic Improvement scale (pGAIS) were also recorded at T1. The treatment has been completed with a session of a vascular 532nm diode laser for treating the fine telangiectasias, immediately before the Endolift® procedure. The lower eyelids have benefited from the possibility that the Endolift® has to remodel and retract the tissues, activate the collagen production, and stimulate the neo-angiogenesis. Results are evaluated at T1, when the skin laxity is reduced and superficial wrinkles are smoothed, resulting in an overall compacting of the skin which is visible and continues to progress over the following months. The only adverse events recorded were redness for 3 hours and a light swelling for 2 days. Snap Back test at T0 was severe and negative at T1; at T0 wrinkle score” was II and Fitzpatrick “degree of elastosis” was 7-9 but at T1 Fitzpatrick “wrinkle score” was I and Fitzpatrick “degree of elastosis” was 1-3; iGAIS, eiGAIS and pGAIS at T1 were all +3. Endolift® can currently be considered one of the leading non-surgical treatments for the laxity of lower eyelids.
Book review on the Mr Oswal's autobiography Globe Trotting and 62 Years of ENT
Authors: Ohshiro Toshio
Published: December 2022

As Vasant Oswal's professional colleague and friend, it gives me immense pleasure to review Vasant's biography, published and launched in Edinburgh in the U.K. in May 2022 at the Annual British Medical Association conference.

I met Vasant at the annual meeting of the Form (Preparatory Committee) of the World Federation of Societies in Laser Medicine and Surgery (WFSLMS). I was elected Secretary-General and Vasant, Honorary Treasurer. Subsequently, our encounters went on for many years at the various international laser medical, dental, and veterinary conferences in different parts of the world. [...]
The clinical significance of serum complement component 1q tumor necrosis factor-related protein 3 and complement component 1q tumor necrosis factor-related protein 9 levels in patients with rheumatoid arthritis
Authors: Li Xin , Wang Yuan , Jia Xiaoxia , Ke Jing , Zhang Baoyu , Wang Yan
Published: December 2022

Objective:

The objective of this study was to assess the expression of serum complement component 1q tumor necrosis factor-related protein 3 (CTRP3) and CTRP9 in rheumatoid arthritis (RA) patients, and further explore their correlation with disease activity and the predictive value of RA.

Methods:

RA group (n = 60) and healthy group (n = 60) were enrolled in Beijing Luhe Hospital, Capital Medical University. We collected the clinical data, including the basic information, laboratory parameters as well as the Disease Activity Score using 28 joint counts (DAS28) scores, and measured the expression of serum CTRP3 and CTRP9 in two groups by enzyme-linked immunosorbent assay. To analyze the correlation between serum CTRP3 and CTRP9 and RA. We explored the predictive value of the serum CTRP3 and CTRP9 for RA.

Results:

Compared to the healthy group, the expression of serum CTRP3 and CTRP9 was higher in the RA group (P < 0.05). Except rheumatoid factor (serum CTRP9: r = −0.310, P = 0.018), and immunoglobulin (serum CTRP9: r = 0.338, P = 0.010), platelet, erythrocyte sedimentation rate, C-reactive protein, DAS28, anti-cyclic citrullinated peptide antibody, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, etc., of RA patients were not related to the levels of serum CTRP3 and CTRP9. The best cutoff value of serum CTRP3 and CTRP9 was 31.66 and 34.39 ng/ml, respectively. In terms of sensitivity, negative predictive value, and accuracy, compared with single detection of serum CTRP3 or CTRP9, combined detection has more predictive value for RA.

Conclusion:

CTRP3 and CTRP9 may become two candidate biomarkers for RA. The serum CTRP3 and CTRP9 may have certain predictive values for RA.
A case of fatal liver failure due to chronic environmental exposure of copper in a child
Authors: Sutaria Utpal , Modi Rohan , Solanki Aarti , Patel Nehal
Published: December 2022

Chronic liver damage followed by copper toxicity is very rare in pediatric population. This case report describes a 9-year-old child with acute liver failure as the presentation of copper toxicity due to chronic environmental exposure as a part of an occupational hazard. If not intervened in the early stage, the outcome is always lethal. Therefore, it is recommended to rule out heavy metal toxicity like copper as a cause of liver damage for any case of acute or chronic liver failure after ruling out the common infectious and inflammatory causes.
Compliance rate of anti-rabies vaccination in patients presenting with an animal bite
Authors: Pal Rathijit , Vegiraju Vaishnavi , Hazra Darpanarayan , Nekkanti Ankita Chowdary , Abhilash Kundavaram Paul Prabhakar
Published: December 2022

Introduction:

To prevent rabies in animal bite victims, complete postexposure prophylaxis (PEP) with an anti-rabies vaccination (ARV) is essential. This study was done to determine the compliance rate of ARV in patients with animal bites who presented to the emergency department (ED) during the COVID-19 pandemic.

Materials and Methods:

This was a prospective observational study done on patients presenting to the ED with a history of animal bites over 1 year (May 2020–June 2021). Categorical variables were presented as percentages, and quantitative variables were summarized using mean and standard deviation (SD).

Results:

A total of 122 animal bite (World Health Organization [WHO] Category II and III) victims presented to the ED during the study. The mean age of the cohort was 38.12 (SD: 16.4) years with a male (n = 67: 54.9%) preponderance. Based on the physiological stability, a majority were triaged as priority III (n = 119; 97.5%). Most patients presented with dog bites (n = 88; 72.1%), followed by cat (n = 14; 11.5%) and rat bites (n = 13; 10.7%). Two-thirds were unprovoked (n = 82; 67.2%) and were caused by stray animals (n = 62; 50.8%). More than half (n = 65; 53.3%) of the bites were WHO Category III bites. All Category II and III patients had received the first dose of ARV at our center and category III patients received immunoglobulin local injection as well. Noncompliance to ARV was seen in almost a quarter (n = 32; 26.2%) of patients of which forgotten dates (n = 11; 34.4%) were the most common cause. There was no significant statistical variable to determine the cause of noncompliance.

Conclusion:

Unprovoked bites by stray dogs were the cause of a majority of the animal bites. Compliance with PEP remains low at two-thirds of the total. The most common cause of noncompliance to ARV was due to forgotten dates.

The following core competencies are addressed in this article:

Medical knowledge, Systems-based practice, Practice-based learning and improvement.
Evaluation of the Consequences of Menopause on Women with Respect to Salivary Flow Rate, Gustatory Function, and pH
Authors: Agrawal Anshu , Chaudhary Minal S , Hande Alka Harish
Published: December 2022

Context:

Saliva is considered a predictive gateway to the body. Alterations in salivary secretion can be assessed quantitatively and/or qualitatively. Thus, estimation of salivary components may give insight to the general health of an individual and be considered the mirror of the body's health. The health needs of women vary mainly due to hormonal fluctuations occurring throughout the woman's life. Hence, the “menstruation cycle and menopause” may affect the metabolism of periodontal tissue including swollen salivary glands, bright red swollen gums, or bleeding gums or might cause alterations in the flow rate of saliva, its pH, as well as taste function. Due to menopause, there are unique hormonal changes in women and they are more receptive to salivary alterations, such as sensitivity to hot and cold food, altered taste, burning sensation, and reduced flow rate of saliva that lead to xerostomia and atrophic gingivitis also.

Aim:

This research project is designed for the evaluation of “salivary flow rate,” gustatory perception, and “pH” of resting saliva in premenopausal, menopausal, and postmenopausal women.

Subjects and Methods:

The evaluation of salivary flow rate, gustatory perception, and salivary pH was carried out in a total of 105 women, each 35 from, the premenopausal, menopausal, and postmenopausal categories.

Results:

The present study observed significant alterations of reduced salivary flow rate, reduced sweet intensity, and pH in postmenopausal women than the menstruating women.

Conclusion:

Menopause is followed by a variety of alterations, few of which occur in the mouth. The use of salivary flow rate, gustatory perception, and pH is helpful to identify the risks linked with menopause.
Immune Thrombocytopenic Purpura in an Elderly Male
Authors: Mahadeviah Mahesh , Shinde Nikhil Ramdas , Shivanagappa Mamatha , Mahesh Madhumitha
Published: December 2022

Idiopathic Thrombocytopenic Purpura (ITP) is an acquired disorder in which there is immune mediated destruction of platelets and also inhibition of platelet release from the megakaryocytes.[1] The features are by mucocutaneous bleeding and a low platelet count with an otherwise normal peripheral blood cells and smear. ITP is a heterogeneous disease with varying severity and clinical course. It is mainly a disorder of children. In adults the peak prevalence is between 20-50 years.[2] The clinical features in adults are different from those seen in children. ITP in persons above 60 years is being increasingly recognized in literature. ITP in elderly differs in its presentation, course and severity compared to its manifestations in younger adults. The response to treatment is different and the presence of co-morbid conditions such as diabetes, hypertension and ischemic heart disease needs to be kept in mind in the management algorithm.[3] A case of ITP in elderly is presented herewith with a brief review of literature.
Diagnostic Utility of Imprint Cytology for Assessment of Breast Lumps
Authors: Vinod K. , Aroul Tirou , Vaithi K. Anand Raj
Published: December 2022

Background:

Breast lesions are a commonly encountered complaint in the surgical outpatient department. Although majority of these lesions are benign, breast carcinoma is the second most common malignancy in women. Fine-needle aspiration cytology (FNAC) is a well-established preoperative diagnostic measure, whereas histopathological examination (HPE) forms the gold standard for the postoperative diagnosis. Imprint cytology (IC) is a rapid, inexpensive intraoperative diagnostic method under investigation. This study attempted to compare IC with FNAC and HPE for the diagnosis of breast lesions.

Materials and Methods:

This study included 65 patients with breast lesions. In each case, a diagnosis was established by preoperative FNAC, an intraoperative IC, and their sensitivity and specificity were compared to the diagnosis by HPE which was considered the gold standard for the diagnosis.

Results:

Sensitivity of IC for diagnosing malignant lesions was 91.6% and specificity was 100%. Similarly, for FNAC, the sensitivity for diagnosing malignant lesions was 91.6% and specificity was 100%.

Conclusion:

Intraoperative IC is a good diagnostic modality comparable to FNAC in the diagnosis of breast lesions and a reliable adjunct to HPE.
Transforming the Face of Life with a Customized Ocular Prosthesis Made using Digital Photographic Sheet
Authors: Hoskalle Maithilee Vikram , Bhasin Abhilasha Sunny , Mistry Gaurang S , Kini Ashwini Y.
Published: December 2022

Anophthalmic eye has a physical, social, and psychological influence on the affected person. It is quite challenging to restore the normal look of the patient for bringing him to normality in society. An Indian female presented with the chief complaint of an ocular defect due to enucleation for choroidal melanoma, leading to an unpleasant facial appearance. Bearing in mind her psychological and economical status, a customized ocular prosthesis using a digital photographic film for the iris was planned, fabricated, inserted into the ocular defect, and was followed to assess improvement in quality of life. This case report describes the fabrication of an ocular prosthesis using a digital photographic sheet having multiple images of the iris of the patient's normal eye with slight variation in shade and size. Artistic skills, extra time needed in painting the iris, and errors happening due to incorrect sizing of the iris are avoided. The technique is advantageous for a setup where modern equipment is unavailable and a patient's economical status restricts the use of an expensive approach.
Delayed Diagnosis of Ankylosing Spondylitis
Authors: Dhaniwala Nareshkumar Satyanarayan , Prasad Shivangee , Dhaniwala Mukund Naresh , Salwan Ankur
Published: December 2022

Ankylosing spondylitis (AS) is a chronic inflammatory condition affecting the axial skeleton, enthesis, and peripheral joints and is included in a group of disorders termed spondyloarthropathy. Its diagnosis is based on clinical and radiological features. This article reports an atypical case of AS in a 24-year-old female presenting with bilateral hip arthritis without any back symptoms. The report discusses the causes of delayed diagnosis and the relevance of thorough clinical examination.
Evaluation of Completeness of Hematology Requisition Forms Leading Preanalytical Errors in Laboratory of a Tertiary Care Teaching Hospital
Authors: Duraiswami Ramanan , Gaiki Varun Vijay
Published: December 2022

Background:

Laboratory services provide crucial information for the optimal management of patients in a hospital setting. A crucial step in the preanalytical phase of sample testing is the correct filling up of the laboratory requisition form (LRF).

Objectives:

this study as planned to identify the possible parameters for pre analytical errors.

Methodology:

We analyzed the LRF submitted to the Hematology Section of Central Laboratory of a tertiary care teaching hospital from Hyderabad to assess the degree of completeness of the submitted LRF as a cause of preanalytical error in the laboratory workflow. Randomly selected laboratory forms submitted along with specimens to the Central Hematology Laboratory of a tertiary hospital over a period of 1 month for their completeness, as laid down in standard operating procedures. Collected data were entered in an Microsoft Excel Worksheet and analyzed by SPSS version 23. Only the patient's name, identification number, gender, type of sample, and examination requested were correctly filled.

Results:

Patient contact details were available only in 0.82% of LRFs. The diagnosis and clinical history were correctly filled in only 39.62% and 0.27% LRFs, respectively. There was a significant lack of information regarding the doctor requesting the investigation (doctor's name written in 8.47% of forms and doctor's contact telephone number written in 0.27% of forms evaluated). It was also found that the present format of the LRF was inadequate for providing the necessary details of the samples received.

Conclusion:

The existing LRF needs to be re-designed to enable the clinicians to provide more clinical details and patient-related details. Clinicians need to be sensitized regarding the necessity of submitting correctly filled LRFs. The use of system generated online requisition forms can also be done, where forms cannot be submitted unless complete.
Approaching Medical Humanities with an Interactive Tool
Authors: Bansal Monika , Goyal Manoj , Bajpai Anurag
Published: December 2022

Introduction and Background:

The focus of medical education should not only be the cognitive aspects but also be the qualities and values that make us human. Researchers suggest that the required attitudes and values can be inculcated by exposing the students to medical humanities, which will be helpful in making them not only competent but also ethical and humane doctors. “Theatre of the Oppressed (TO),” which was devised by Augusto Boal, has been used as a tool in medical humanities with positive outcomes.

Aim:

A study was conceptualized with the aim of sensitizing the students with medical humanities with “Theatre of the Oppressed” and to evaluate the workshop by students' perceptions and reflections.

Materials and Methods:

A workshop of 7 days, 5 days online and 2 days physical, was conducted for 30 students, in which they participated in TO games and activities, which are based on theoretical framework of Paulo Freire's “Pedagogy of the Oppressed” TO.

Results:

Students participated very enthusiastically in the workshop. The feedback and reflections of students reveal that they felt more empathetic toward patients and underprivileged, developed mutual trust between their class mates, listened more during the workshop, and developed better understanding on their bodies and emotions.

Conclusion:

The study documents the experience of exposing the students to TO as an interactive tool to address medical humanities. The feedback of students reflects that TO workshop was successful in bringing deep insights on the role of human values in medicine and they want to participate in more of TO workshops in future.
Granulomatosis with Polyangiitis Affecting Nervous System
Authors: Ramanandi Vivek , Ashish Kakkad , Desai Anjan
Published: December 2022

Central nervous system involvement in granulomatosis with polyangiitis is quite rare condition. Involvement of multiple systems makes the management of condition difficult. Role of physiotherapy for such a rare condition is unexplored. In this case report, the disease and its medical and physiotherapy management are discussed in brief.
Dentinal Hypersensitivity
Authors: John Deepa Sara , Shenoy Nina , Bhandary Rahul
Published: December 2022

The increase in lifespan and decrease in the prevalence of edentulism have increased the overall risk of tooth wear. This in turn has caused dentinal hypersensitivity (DHS) to be one of the most frequently encountered oral health problems. DHS, commonly referred to as the “common cold” of dentistry, is associated with pain due to exposure of dentine following loss of the enamel. The discomfort caused due to DHS is highly subjective and can lead to deterioration of their quality of life. The most crucial but often neglected phase of the management of DHS is the elimination of its etiology. Identifying the etiology enables the clinician to include prevention in the treatment plan. There is a wide range of treatment modalities ranging from those that can be self-administered by the patient at home or those that can be applied by clinicians in a dental clinic. However, one of the main limitations is that there is no universally accepted, gold-standard treatment for DHS, which gives a long-term pain relief. Different agents have been suggested with varying degrees of efficacy when studied scientifically. An electronic literature search was conducted through PubMed, and dental associations of different countries' website and full-text articles in the English language were selected. This article concisely reviews the prevalence and distribution, etiological factors, and the management of DHS.
Sonoelastographic Characterization of Parotid and Submandibular Lesions Our Initial Experience
Authors: Manoj Megha , Phatak Suresh V. , Harshith Gowda K. B. , Ghanta Prashanthi , Jain Soumya , Gupta Rishabh
Published: December 2022

Context:

Sonoelastography is an emerging noninvasive imaging modality used for the assessment of soft tissue lesions. Parotid and submandibular glands are relatively superficial structures which can be easily assessed and examined to characterize the lesions.

Aim:

The aim of the present study is to evaluate the sonoelastographic features of various benign and malignant parotid and submandibular gland lesions, and correlate their findings with pathology.

Materials and Methods:

In a prospective observational study conducted in Acharya Vinoba Bhave Rural Hospital of JNMC College, Sawangi, Wardha, 24 patients who presented with salivary gland lesions were evaluated with sonoelastography during 2 years.

Results:

The most common age group in this study was 51–60 years, followed by 31–40 years. Benign lesions were more common than malignant ones. Higher values of strain ratio were seen in cases of malignant tumours correlating well with score of 3 and 4 on elastography.

Conclusions:

Sonoelastography is a recent advance in ultrasound for the evaluation of salivary gland lesions showing good correlation with pathology so it can be employed routinely in presurgical evaluation.
Autoimmune Disorders with Special Reference to Coronavirus Disease-2019
Authors: Gurajala Swathi
Published: December 2022

The COVID-19 outbreak by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, was reported in late December 2019 in Wuhan, China, and has gradually evolved into a pandemic. The number of cases is increasing enormously, so is our knowledge of possible signs and symptoms, clinical manifestations, diagnosis, and management. Few cases develop complications due to excessive cytokine release and uncontrolled immune activation. Several researchers believe that the extensive organ, tissue, and cellular damage done by the virus can be due to antigenic mimicry with the human tissues and the production of autoantibodies. Recent reports of SARS-CoV-2 preceding antiphospholipid antibody syndrome, Miller Fisher syndrome, Guillain–Barré syndrome, Kawasaki syndrome, etc., provide definite examples of this virus's capability to cause the immune system dysregulation. With the rush to mass immunization against the disease, several types of vaccine candidates are in clinical trials, and the risk of developing autoimmune reactions should be considered due to host and pathogen interactions. Hence, in this review, we aim to summarize the various immune dysregulation autoimmune syndromes concerning the SARS-CoV-2 infection published to date.
To Assess the Knowledge and Skill Regarding Oral Rehydration Solution Preparation among the Mother Having Under Five Children
Authors: Deshmukh Mayuri , Kalode Shivali , Jaiswal Anushka , Chiddarwar Vaishnavee , Nidhishree R.
Published: December 2022

Background:

Oral rehydration solution (ORS) is the most significant development in the management of acute diarrheal disease in children.

Aims and Objectives:

The aim of the study was to assess the knowledge and skill regarding ORS preparation among the mothers having under five children.

Methodology:

The cross-sectional study was done among 100 mothers of under five children from rural areas of Selsura, Wardha district.

Results:

The results showed that 15% of the mothers had the knowledge of taking a clean glass of water, 76% of the mothers knew to add a spoonful of sugar and to add a pinch of salt, 21% knew to stir it till all dissolves, 18% mothers tasted the solution, and 2% replaced the caps of salt and sugar bottle.
Lesions in the Parotidomasseteric Domain
Authors: Natarajan Srivalli , Oswal Yash , Gandevivala Adil , Baviskar Padmakar Sudhakar , Vaishampayan Sagar , Vaidya Sushrut , Deshpande Gaurav , Sidana Sunil
Published: December 2022

Context:

Swellings in parotidomasseteric region are one of the most intriguing and challenging lesions in the head and neck. Diverse array of diagnosis, striking clinical similarities between different pathologies and anatomical complexity of this region make parotidomasseteric lesions unique.

Aims:

This article aims to provide a detailed description of various pathologies associated, the diagnostic challenges posed, and the respective management strategies.

Settings and Design:

The study design involves retrospective observational.

Subjects and Methods:

Sixteen rare cases of various parotidomasseteric pathologies were reviewed to delineate clinical presentation and characteristic features in diagnostic investigations and subsequent treatment strategies.

Statistical Analysis Used:

Not applicable.

Results:

The analysis showed that lesions in the parotidomasseteric region can be categorized into specific entities with distinct but often overlapping clinical features. Given the location and anatomy of the parotidomasseteric region, these lesions can often remain indolent Investigations are fruitful to some extent in determining the expanse of these lesions, however, remain inconclusive in diagnosing the origin and their true nature.

Conclusions:

The authors conclude that a systematic approach to the diagnosis of a parotidomasseteric lesion is of utmost importance because the differential diagnosis is prodigious. These lesions can be considered very deceptive, demanding surgical intervention and their excision. With the exception of surgical exploration, physical examination remains the most indispensable tool. Hence, a better classification system which determines the treatment required for a particular parotidomasseteric lesion and which correlates the clinical findings with the preoperative investigations will be more beneficial for the operating surgeon.
Steroids in the Management of Superior Orbital Fissure Syndrome
Authors: Baviskar Padmakar Sudhakar , Natarajan Srivalli , Vathare Pradeep Pandurang , Rao Chinmay Vasant , Balkawade Ruchita Arun , Shah Saloni Bharat , Goyal Prachi Manoj
Published: December 2022

Superior orbital fissure syndrome (SOFS) presents as complex impaired function of multiple cranial nerves with unique signs and symptoms. Traumatic etiology is seen in cases of trauma to the deep orbit with associated craniofacial fractures. Being a rare presentation to the oral and maxillofacial surgeon, a sound knowledge of this condition renders an effective diagnosis and prompt initiation of treatment necessary. Current literature evidence on management of this entity is low but highly debated. The authors present a case report of traumatic SOFS of an otherwise systemically healthy patient with detailed diagnostic evaluation and a close follow-up. A combination therapy of high then low-dose corticosteroids was initiated for the patient who demonstrated a rapid as well as complete recovery in 12 weeks. The authors conclude that steroid therapy for management has significantly reduced recovery time and should be considered over observational line of management.
Extraorally Proliferating Verrucous Carcinoma of Buccal Mucosa Mimicking Squamous Cell Carcinoma
Authors: Akhil S , Krishna Prasad R. S. , Girish K. L. , Harinee T. , Mridula R. G.
Published: December 2022

Verrucous carcinoma (VC) (Ackerman's tumor/Snuff dipper's cancer) is a variant of oral squamous cell carcinoma (SCC) with minimum aggressive potential. The most common sites of involvement in the head-and-neck regions are oral cavity and larynx. VC of the oral cavity is a different clinicopathologic tumor distinguished from the usual SCC because of its local invasiveness, nonmetastasizing behavior, and special clinical appearance, but long-standing cases have shown transformation into SCC. An accurate pathological diagnosis is difficult because of an inadequate tumor sample for the study, and more importantly, a close collaboration is needed between a clinician and a pathologist to achieve the correct diagnosis. In this article, we discuss a case of 42-year-old male with VC of the left buccal mucosa which was proliferating extraorally.
Geriatric Syndromes
Authors: Pandey Vandna , Kurien Nancy , Mohan Remiya
Published: December 2022

Aging is a natural phenomenon that is irrevocable. The older adult population is increasing rapidly in India, projected to increase from 6% to nearly 20% in 2050. Clinical conditions found among the elderly that do not fit into discrete disease categories and result from accumulated impairments in multiple systems are called geriatric syndromes. The authors have done a literature search of research papers from indexed and nonindexed journals e databases, Google Scholar, PubMed, and Scopus, Science Direct, Research Gate, and Cochrane. The search terms included were geriatric population, geriatric syndrome, geriatric care, elderly health problem, and comprehensive approach. The management of geriatric syndromes is a challenge to modern geriatric clinical practice. The comprehensive assessment of older adults using standardized tools must be carried out in any healthcare facility to ensure that their needs are met through care and treatment. Evidence-based standards of practice need to be implemented to provide nursing care for dealing with the therapeutic challenges of various geriatric syndromes.
Morbidity Pattern and Health-Seeking Behavior among the Elderly Residing in Slums of Eastern Odisha
Authors: Patnaik Asmita , Mohanty Smaraki , Pradhan Srabani , Behera Tapas Ranjan
Published: December 2022

Introduction:

Of the total population, elderly people comprised of 8.14% in India where in India or globally. Main challenges faced by the elderly in our country are feminization, ruralisation, migration, and an increasing number of 80-plus adults. This sudden change of environment or being left stranded alone unattended or being dependent on children for their necessities is a major cause of mental illnesses.

Objectives:

To study the socio-demographic profile, find out the different morbidities and assess the health-seeking behaviour of the study subjects.

Materials and Methods:

A community-based cross-sectional study was conducted in the field practice area of urban health and training center using the simple random sampling method.

Results:

The mean age of study subjects was 67.58 ± 6.53 years. Majority of participants, i.e., 308 (73.0%) were young old. 207 (49.1%) were illiterate, 272 (64.5%) unemployed 272 (64.5%) and 224 (53.1%) were living with their children, i.e., 224 (53.1%). Inappropriate health-seeking behavior was significantly associated with under-weight (P < 0.001) which accounted for 2/3rd of participants. Severe depression was observed among 59.5% participants. Females showed a higher proportion of myalgia (5.7%), whereas males showed preponderance of upper respiratory tract diseases (19.2%). The prevalence of inappropriate health-seeking behavior was higher in females (65.1%). The proportion of the elderly with poor health-seeking behavior was found to be 50.4%.

Conclusion:

Morbidity among the elderly is very high and health-seeking behavior is very poor. Hence, strong efforts are needed to provide them holistic care. Hence, this study was conducted to threw some light on health status of the elderly, their morbidity pattern and health-seeking behavior. It will help the policy-makers to prepare the intervention strategies at the community level.
Quality of Life among Malnourished Elderly Population in Rural Puducherry, South India
Authors: Sivapushani Aruljothi , Mathiyalagen Prakash , Dhasaram Premnath , Sivadamien Thirunavukarasu
Published: December 2022

Context:

Health of the elderly will be an important issue in defining the health status of a population in coming years. There is a paucity of information with regard to quality of life (QOL) among malnourished elderly.

Aims:

To assess the QOL among malnourished elderly in a rural field practice areas of tertiary care hospital, Puducherry, and to find the sociodemographic factors associated with QOL among malnourished elderly population.

Settings and Design:

A community-based cross-sectional study in the rural field areas of Government Medical College of Puducherry.

Subjects and Methods:

After obtaining ethical approval, the study was conducted among 225 malnourished elderly (>60 years) from April to June 2019 using multistage random sampling technique. Sociodemographic data were obtained using a semistructured questionnaire. Malnutrition was screened using Mini Nutritional Assessment Short Form and QOL was assessed using World Health Organization QOL-BREF questionnaire.

Results:

The mean and standard deviation of the study participants' age was 69.89 + 6.3 years. 57.8% of them were female, 81.3% were unemployed, and 73.3% were dependent on their old age pension for their livelihood. QOL of malnourished elderly was poor in all the domains when compared to those without malnourished and this is found to be statistically significant. In binomial logistic regression analysis, the presence of comorbidity (adjusted odds ratio [AOR]: 2.4 and 95% confidence interval: 1.3–4.4), unemployed (AOR: 4.8; 1.4–15.9), and living without family (AOR: 0.2; 0.06–0.7) revealed the statistically significant association with low QOL score among malnourished elderly.

Conclusions:

The mean score of QOL among malnourished elderly was below average in all four domains in which psychosocial domain was badly affected.
The Management of Complex Perforation in a Maxillary Central Incisor
Authors: Kumar Palmoor Santosh , Karthikeyan Kittappa , Mahalaxmi Sekar
Published: December 2022

Root perforations severely affect the prognosis of the teeth. This case report presents the successful management of a complex perforation with mineral trioxide aggregate (MTA) and fiber post. MTA was used to seal the perforation site since it is regarded as one of the ideal materials for perforation repair. Following retreatment and perforation repair, the root canal was rehabilitated using fiber post and composite resin. The elimination of the clinical signs and symptoms is the primary goal of successful treatment. One-year follow-up showed healthy periodontium with no clinical signs and symptoms.
Ecological Momentary Assessment for Awake Bruxism Diagnosis and Treatment
Authors: de Oliveira Sarah Barros , da Fonte Tatiana Prosini , Berden Maria Emília Servín , Conti Paulo César Rodrigues , Cunha Carolina Ortigosa
Published: December 2022

Context:

Awake bruxism (AB) is a common oral behavior that can cause damage to the stomatognathic system. Ecological momentary assessment (EMA) is a method which collects information about the patient in their natural environment, with several alerts throughout the day.

Aims:

The aim of the present study was to evaluate the effectiveness of EMA in the diagnosis and treatment of AB, psychosocial aspects in individuals diagnosed with AB and to compare self-report of AB with the diagnosis of AB through the EMA.

Subjects and Methods:

The research was performed on an online questionnaire in two stages. The initial sample was composed by volunteers from 18 to 50 years-old, randomly recruited through social media, without restriction of sex and occupation.

Settings and Design:

The first stage involved answering an online questionnaire for the initial diagnosis of AB, and in the second stage, participants underwent EMA for 15 days and answered online questionnaires about perceived stress and anxiety.

Statistical Analysis:

Statistical analysis consisted of qualitative and quantitative descriptive statistics with parametric and nonparametric tests, with a significance level of 5%.

Results:

Results showed a significant moderate and positive correlation between the level of AB "tight muscles without teeth contact" and the level of anxiety.

Conclusions:

As a treatment, EMA can be effective; however, this will depend also on the patient's commitment.
Functional Rehabilitation of a Patient with Generalized Stage IV Periodontitis
Authors: Ganguly Rajashree , Choudhury Ishan R. , Rajan Kritika
Published: December 2022

When inflammatory changes around the tooth reach the periodontal ligament and alveolar bone, it is known as periodontitis, which ultimately leads to tooth loss. Generalized Stage IV periodontitis is characterized by the rapid destruction of periodontal ligament and alveolar bone. It is characterized by pathologic migration of teeth and tooth loss, producing esthetic and functional problems for the patient. For restoration of the lost tooth, implant-supported rehabilitation is one of the most successful treatment options, for a fixed prosthesis. In postsurgical prosthodontic rehabilitation, hybrid prosthesis offers a number of advantages including reducing the impact force of dynamic occlusal loads, being less expensive to fabricate, and highly esthetic restorations. The purpose of this clinical report is to present the clinical experience and 1-year follow-up of treating a middle-aged patient suffering from generalized Stage IV periodontitis by means of the implant-supported hybrid prosthesis.
Comparative Evaluation on Clinical Efficacy of Active Oxygen Toothpaste with Herbal Toothpaste in Supragingival Plaque Reduction among Gingivitis Patients
Authors: Murugesan Dharshana , Elanchezhiyan S. , Daniel G. Rajkumar , Vennila K. , Priyadharshini E. Gayathri , Udhayaa A. S.
Published: December 2022

Context:

Gingivitis is a soft-tissue inflammation of the gingiva. It is initiated in the oral cavity by the accumulation of plaque. Among the various plaque control methods, dentifrices play a major role to reduce the microbial load in gingivitis patients. Herbal dentifrice reduces plaque levels and gingival inflammation. In a revolutionary process on dentifrice, BlueM (BM) International has recently introduced the BM dentifrice. Its mechanism of action is to reduce inflammation by controlled delivery of reactive oxygen species to injury sites.

Aims:

The aim of this study was to compare the clinical efficacy of two commercially available toothpaste, BM, and Dabur Red (DR) in gingivitis patients.

Settings and Design:

To compare the anti-plaque and anti-gingivitis efficacy of two commercially available toothpaste by measuring gingival, plaque, and bleeding indices in gingivitis patients.

Subjects and Methods:

A total of 45 patients with chronic gingivitis were included in the study. After oral prophylaxis, they were divided into three groups: Group A, Group B, and Group C who received BM toothpaste, DR toothpaste, and placebo toothpaste, respectively. The clinical parameters were recorded at baseline, 1st, 2nd, and 3rd weeks.

Statistical Analysis Used:

Data on the gingival index (GI) and plaque index (PI) and bleeding index (BI) were statistically analyzed by the mean and standard deviation between the groups using analysis of variance with Statistical Package for the Social Sciences software (SPSS version 20.0) with a 95% confidence level (P < 0.05).

Results:

The three groups showed significant reduction (P < 0.05) in PI, GI, and BI from baseline. The BM has more significant mean PI and BI than DR.

Conclusions:

This study demonstrated that active oxygen toothpaste has comparable anti-plaque and anti-gingivitis efficacies with herbal toothpaste (DR).
Point-of-care Ultrasound Helps Differentiate the Causes of Unilateral Lower Limb Swelling with Rapid Progression
Authors: Huang Chun-Yen , Sun Jen-Tang , Wu Cheng-Yi , Lien Wan-Ching
Published: December 2022

Unilateral lower limb swelling is a common complaint among emergency department (ED) patients. However, an isolated intramuscular hematoma is an uncommon cause of lower limb swelling. We present a case of left thigh swelling after a traffic accident in which an intramuscular hematoma was diagnosed using point-of-care ultrasound. A literature review was also conducted.
Similar Mullerian Cysts in an Identical Twin
Authors: Pahlavan Fattaneh , Taghi Dizaj Ahmad Vosough
Published: December 2022

Several genital anomalies have been reported in the identical twins which have a tremendous effect on reproductive status. No previous studies have reported the Mullerian duct cyst in identical twin brothers. We describe a rare case of Mullerian cyst in a male identical twin with infertility. A 43-year-old man presented with 2 years of infertility. In the spermogram analysis, sperm count leaded to azoospermia detection. Transrectal ultrasonography (TRUS) examination was done. An echo-free structure in the mid part of prostate suggested a Mullerian cyst which had caused ejaculatory duct obstruction. The other twin, who dealt with infertility as well, was referred for TRUS. A Mullerian cyst was detected. Ultimately, testicular sperm extraction and percutaneous epididymal sperm aspiration procedures were recommended. Imaging with variety ranges of modality can help to identify Mullerian cyst. Further researches for detecting the genetic factor causes of this anomaly should be considered.
Usage of Point-of-care Ultrasonography for Rapid Diagnosis of Acute Renal Infarction
Authors: Lai Yi-Hsin , Chuang Cheng-Hsun , Ho Sai-Wai , Chen Chia-Ching
Published: December 2022

Acute renal infarction is a rare form of vascular emergency. Although major risk factors of renal infarction are due to cardio-embolic events such as atrial fibrillation, valvular or ischemic heart disease, renal artery thrombosis/dissection, and coagulopathy, the prevalence of idiopathic acute renal infarction can be as high as 59%. Two cases that contributed to this emergency are presented. The history, physical examination, and clinical imaging findings for clinical assessment are briefly described. Point-of-Care Ultrasonography (POCUS) was used to exclude other etiology and identify the pathological changes. The role of POCUS in rapid rule in acute renal infarction has been emphasized in clinical settings.
Comparing Two- and Three-Dimensional Antral Follicle Count in Patients with Endometriosis
Authors: Oliveira Rodrigues Andréia Regina De , de Sá Renato Augusto , Velarde Guillermo Coca , Valle Marcello Pereira , Nóbrega Beatrice Nuto , Roque Matheus , Júnior Edward Araujo
Published: December 2022

Background:

The purpose of the study was to compare three-dimensional (3D) ultrasound semiautomatic antral follicle count (AFC) with two-dimensional (2D) ultrasound real-time AFC to evaluate patients with deep endometriosis and/or endometrioma submitted to ovarian stimulation (OS).

Methods:

This was a retrospective cohort study assessing all women with documented diagnosis of deep endometriosis who underwent OS for assisted reproduction treatment. The primary outcome was the difference between AFC by semiautomatic 3D follicle count using 3D volume datasets and 2D ultrasound count with the number of oocytes retrieved at the end of the cycle. The 3D ultrasound AFC was obtained using sonography-based automated volume count (SonoAVC), and the 2D ultrasound AFC data was collected from the electronic medical record.

Results:

Total of 36 women had deep endometriosis documented by magnetic resonance imaging, laparoscopy, or ultrasonography and 3D ovarian volume datasets stored from their first exam. The differences between the 2D and 3D AFC and the number of oocytes retrieved at the end of the stimulation were compared, showing no significant statistical difference between both methods (P = 0.59). Correlations were similar using both methods when compared to the number of oocytes retrieved (2D [r = 0.83, confidence interval (CI) = 0.68–0.9, P < 0.001]); (3D [r = 0.81, CI = 0.46–0.83, P < 0.001]).

Conclusion:

3D semiautomatic AFC can be used to access the ovarian reserve in patients with endometriosis.
Shear Wave Elastography for Assessment of Testicular Stiffness in Patients with Varicocele
Authors: Yüzkan Sabahattin , Çilengir Atilla Hikmet
Published: December 2022

Background:

The purpose of this study was to use ultrasonography and shear wave elastography (SWE) to assess stiffness and volume of testes in adult patients with varicocele, to compare the results with those of normal contralateral testes of the same patients and healthy testes of control subjects.

Methods:

In this IRB-approved prospective comparative study, 58 patients with varicocele (116 testes) and 58 control patients (116 testes) were enrolled. A total of 66 testes with varicocele were added to group A, their 50 healthful contralateral testes were added to Group B, and 116 healthy control testes were added to Group C. Analysis of variance (one way ANOVA) test was used to compare groups and Student's t-test was used for their binary comparisons. The correlation between the testicular stiffness and volume was studied using Pearson's correlation test.

Results:

There was not a significant difference in the mean SWE values between three groups and also, between two-group comparisons (P < 0.05). In the mean testicular volumes, a significant difference was observed between Groups A and C (P = 0.028). Conversely, there was not a significant difference between Groups A and B (P = 0.907) or Groups B and C (P = 0.094). A meaningful correlation between testicular stiffness and volume was not detected for each group.

Conclusion:

A significant correlation was not determined between SWE values and varicocele, and also between SWE values and testicular volume. We advise that more studies with larger populations of patients are required to verify the effectiveness of SWE in predicting testicular parenchymal damage.
Vitamin D Status and Sociodemographic Profile of Pregnant Nigerian Igbo Women
Authors: Adinma Joseph I. B.-D. , Ahaneku Joseph E. , Adinma Echendu D. , Ugboaja Joseph O. , Egeonu Richard O. , Adinma-Obiajulu Nneoma D. , Edet Mark M
Published: December 2022

Background:

Vitamin D deficiency (VDD) in pregnancy is of major public health concern because of the effect it may have on maternal and fetal outcomes. Some of these effects include gestational diabetes mellitus, preeclampsia, infections, increased rate of cesarean sections, fetal growth restrictions, and poor fetal and infant bone mineralization.

Aims:

The aim of this article is to determine the serum vitamin D levels of pregnant women and the influence of some sociodemographic factors on vitamin D status.

Subjects and Methods:

This prospective, cross-sectional study, involving 256 consecutive parturient Igbo women, was carried out at two locations in Anambra State of southeastern Nigeria. Ethical approval and appropriate participatory consent were elicited and obtained from the participants. Blood samples were taken from the women during labor. Serum obtained from each maternal blood sample was labeled, stored in a refrigerator at -80°C, and ultimately assayed for 25-hydroxyvitamin D3 using high performance liquid chromatography. A proforma eliciting the biosocial characteristics was also completed for each of the pregnant woman. Data analysis was performed using SPSS version 23. Serum vitamin D level of ≥32 ng/mL was reported as normal, whereas that of <32 ng/mL was reported as deficiency. Comparison of variables was carried out using the χ2 test and Student’s t-test with P-value less than 0.05 at 95% confidence interval, which was considered to be significant.

Results:

In this study, VDD occurred in 36 (14.1%) women. VDD occurred significantly higher among multiparous women (para 1–4), P = 0.011. All 36 (100%) women with VDD occurred at term gestational age (37–42 weeks). VDD was more prevalent in dark complexion compared with others. Women with indoor work location had higher prevalence of VDD than those of outdoor, and all the women with VDD were of urban domicile.

Conclusion:

VDD is low in this study and is significantly influenced by parity, gestational age, complexion, location of work place, and place of domicile. It is recommended that pre- and early pregnancy administration of vitamin D supplements be individualized on the basis of certain biosocial factors: multiparity, term gestational age, dark complexion, indoor work location, and urban domicile.