bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental study on effect of interventions on practices of hand washing among primary school teachers in Kware, Sokoto, Nigeria
Authors: Raji Taibat A. , Awosan Kehinde J. , Edzu Yunusa Usman , Tahir Yusuf
Published: December 2022

With the emergence of corona virus disease in 2019, handwashing has gotten more attention (COVID-19). It is the most efficient preventative measure against infectious infections. Especially in primary schools, when youngsters spend time close together and may be less concerned with personal hygiene. Through health education regarding hygiene, teachers play a crucial role in ensuring the students’ health at school. Therefore, the focus of this interventional research is the hand washing practices of elementary school instructors. This study investigated the impact of health education and hands-on demonstrations on the handwashing practices of primary school teachers in Kware town, LGA, Sokoto State. The design of the study was non-randomized and quasi-experimental. Using a semi-structured self-administered questionnaire, data were obtained. Fifty-five people were enlisted in the study and participated in the pre-experimental phase, whereas 50 participants participated in the post-experimental phase. The data was analyzed using version 23 of SPSS. Initial instructor expertise was quite limited, particularly at the school entry and during after-school activities. The intervention produced a statistically significant improvement in knowledge from 40.0% to 96.0% and 54.5% to 94.0%, respectively. For other timings, the increase in handwashing habit was minimal. Teachers of elementary schools lacked awareness about handwashing in important areas of daily school life. The health education intervention and practical demonstration resulted in a high level of knowledge and practice. It is essential for the success of infectious disease prevention in schools that teachers participate in training sessions for health education programs.
Effect of health education on knowledge and practices of infectious disease prevention among primary school teachers in Kware, Sokoto, Nigeria
Authors: Raji Taibat A. , Edzu Yunusa Usman , Awosan Kehinde J. , Tahir Yusuf
Published: December 2022

Infectious Disease (ID) knowledge and prevention practices are key elements that ensure the students' health and well-being while in school. The students' health faces many challenges, even more so in the developing world, especially in school premises where pupils live in close proximity. Teachers are the role model of the pupils while in school, therefore, they may play a central role in ensuring the pupils’ health. This research assessed the knowledge and practices of teachers and the effect of Health Education (HE) intervention on ID prevention in schools. A nonrandomized, quasi-experimental study was conducted, using the consecutive sampling method. Data were collected using a structured self-administered questionnaire. Fifty-five participants were enrolled at the start, but only 50 participants completed the study. Data were analyzed using IBM SPSS version 23. The majority demonstrated poor knowledge before the intervention and, after the intervention, there was a knowledge gain from 14.5% to 98%. The practices of ID prevention in schools were poor due to other influences, such as the availability of facilities to put knowledge into practice. The primary school teachers had poor knowledge and practices on ID prevention in schools. The HE intervention yielded a statistically significant knowledge gain. Knowledge alone, however, is not enough for adequate practices, as most schools lack the facilities to foster ID prevention practices. The study suggested that the training of teachers on HE should be upheld. However, ID prevention practices can only be sustained by a commitment from the school management, and from the government through the provision of infrastructure.
Autoinflammatory diseases: what’s behind them and what’s new. A review
Authors: Maalouly Michele , Saade Serena , Kurban Mazen
Published: December 2022

Autoinflammatory diseases are characterized by bouts of systemic or localized inflammation in the absence of an infection. While some autoinflammatory diseases are caused by a single gene mutation, others have been shown to be multifactorial, involving a large array of genes coupled with environmental factors. Previous studies briefly elucidated the molecular mechanisms behind the many autoinflammatory diseases, focusing on the dysregulation of IL-1β or IL-18, NF-κB activation, and IFN secretion. In this review, we precisely highlight the autoinflammatory disease-specific signalosomes, and we aim to provide a scaffold of the link between the various affected pathways.
Screening of endophytic bacteria from potato tubers and their antagonistic activity against soil-borne potato pathogens
Authors: Shirazi Kowsar , Ketabchi Saghar , Kargar Mohammad
Published: December 2022

In order to appraise the bacterial endophyte communities that help resist disease in potato tuber, the separation, the population density, biodiversity and the antagonistic activity of endophytic bacteria, from the tuber peel of potato cultivars (Fontan90, Agria, Sante’a and Jeli89), were examined in the Fars province in Iran. In this study, the bacterial endophyte Colony Forming Units (CFU) were counted based on the most suitable dilution in petri dishes and expressed per g of wet weight of tuber tissue. The presence of bacteria was found mostly in the outer layer. A wide variety of endophyte species biodiversity was in Agria cultivar. To estimate the antagonistic effect of potato associated endophytic bacteria, 115 bacterial isolates were evaluated by dual culture method against main soil-borne potato pathogens Fusarium oxysporum, Rhizoctonia solani, Verticillium dahliae, Streptomyces scabies and Ralstonia solanacearum. Endophyte strains were identified based on physiological, morphological and chemical characteristics and the 16S rRNA gene sequence analysis. The highest degree of the inhibitory activity in all layers of potato cultivars was related to Bacillus subtilis, Bacillus mojavensis and Klebsiella variicola. Antagonistic activity of endophytic bacteria against the pathogens was significantly higher (p<0.01) in the examined strains from the outermost layer of tuber peel and decreased progressively toward the center of the tuber. In this research, Klebsiella variicola was reported as endophyte bacteria in the four commercial potato cultivars mentioned above, for the first time.
The effectiveness of short-term dynamic/interpersonal group therapy on perfectionism; assessment of anxiety, depression and interpersonal problems
Authors: Babaei Shirzad , Dehghani Mahmood , Lavasani Fahimeh Fathali , Ashouri Ahmad , Mohamadi Leila
Published: December 2022

Introduction: Perfectionism is acknowledged as a core vulnerability and a perpetuating factor in several psychopathologies. The purpose of the present study was to investigate the effectiveness of short-term dynamic/interpersonal group therapy on perfectionism and perfectionism-related distress such as anxiety, depression, and interpersonal problems.

Method: This study is a quasi-experimental study applying clinical trial method and contains pre-test, post-test, follow-up periods and control group. The study population included students and the sample consisted of 30 people with extreme perfectionism, who were assigned in two groups of 15 people, experimental and waiting list groups using randomized block design. Research instruments included TMPS, PSPS, PCI, BDI-II, BAI and IIP-32 scales. In order to analyze the collected data, mixed analysis of variance and Repeated Measures Analysis of Variance were used in SPSS software version 22.

Findings: The results show that the intervention in the experimental group compared to the waiting list group caused a clinically and statistically significant decrease in the mean scores. This result is observable and evident in all levels of perfectionism and psychological distress (anxiety, depression and interpersonal problems), except for the subscale of non-display of imperfection from the PSPS scale. These results were preserved through the follow-up periods.

Discussion: These results show that short-term dynamic/interpersonal group therapy is effective in treating most of the components of perfectionism, and concerning its effectiveness; it reduced psychological distress and showed that the components pertaining to perfectionism are factors of vulnerability in this regard.
Comparison of Haemoglobin Estimation of Blood Donors by Specific Gravity Method, HemoCue Method and Automated Haematology Cell Analyzer
Authors: Choudhari Nikhil , Das Subhashish , Kumar Ravi
Published: December 2022

Introduction:

Pre-donation haemoglobin (Hb) screening is among the foremost test done on blood donors to determine whether an individual is fit to donate with the intention of preventing inadvertent donation from an anaemic donor. The aim of the study was to compare the efficacy of the three common Hb estimation methods, namely, copper sulphate (CuSO4) method, HemoCue photometer and automated cell counter in reporting the Hb levels of blood donors.

Materials and Methods:

CuSo4 specific gravity method, HemoCue and automated cell analyzer (Sysmex XN-550) were used to determine the Hb levels in blood samples of 500 donors. Descriptive statistics were used to analyse the demographic details of the donor. Kappa statistics were used to determine the level of agreement between the three methods of Hb estimation.

Results:

HemoCue was found to be more sensitive (86.21%), whereas CuSo4 (97.88%) was found to be more specific. Kappa agreement was good between CuSo4 and Sysmex XN-550 (0.703), whereas it was moderate between HemoCue and Sysmex XN-550 (0.458).

Conclusions:

The CuSO4 method is still viable for Hb estimation among blood donors. Thus, it can be utilised as the primary screening method; however, follow-up testing with HemoCue or automated cell analyzer can be done to minimise unnecessary deferrals and false acceptance.
Evaluation of Periodontal Status Amongst the Diabetic Patients Visiting Private Dental Clinic in Ahmedabad Using CPITN
Authors: Patel Eshita Dasharathbhai , Parikh Hiral Akshat , Shah Riddhi , Mandaliya Devarsh , Vishwkarama Sagar , Nayak Saurabh
Published: December 2022

Introduction:

To determine the periodontal status and treatment needs using CPITN in a group of adult diabetic patients attending OPD in a private dental clinic in Ahmedabad.

Materials and Methods:

One hundred and two diabetic patients were screened by a single examiner according to the WHO criteria using a mouth mirror and CPITN probe. The patients were selected from the routine OPD after obtaining verbal consent for the same, and about 76 patients were included in the study, which was carried out for 9 months.

Results:

Results showed that the highest number of patients had code 3. The majority of sextants had code 2 and 3. Amongst all, 42 patients had a TN score of 2 and 33 had TN score of 3. 56–65 age groups had the worst periodontal status among all groups and required the highest periodontal treatment.

Conclusion:

The periodontal health of our diabetic patients reinforces the need to establish a comprehensive oral health promotion programme for diabetic patients with a multidisciplinary approach.
A Head-to-Head Randomised Controlled Trial of Aripiprazole Versus Quetiapine as Augmenting Agents in Treatment-Resistant Depression
Authors: Kulkarni Alok V
Published: December 2022

Introduction:

Almost 30%–50% of the patients with major depressive disorder can be categorised as treatment-resistant depression (TRD). The use of augmenting agents such as aripiprazole (ARI) and quetiapine (QP) to the existing antidepressant (AD) therapy could be a suitable alternative for treating TRD. The superiority of anyone over others is not established in short-term studies. Hence, the present study was performed to compare the safety and efficacy of ARI and QP for the treatment of TRD.

Materials and Methods:

In the present study, a total of 50 patients with TRD who showed insufficient response to at least two ADs for 12 weeks were enrolled. The participants were assigned randomly in a double-blind trial to receive ARI (10 mg/day; n = 25) or QP (300 mg/day; n = 25) in addition to their standard AD therapy for 12 weeks. Montgomery–Åsberg Depression Rating Scale (MADRS) and the Clinical Global Impressions (CGI) scale were used to measure treatment efficacy. The safety was evaluated by recording treatment-caused adverse effects (AEF).

Results:

A significant decrease in MADRS score was observed with ARI groups than in the QP group ([FIGURE DASH]7.5; [FIGURE DASH]4.6, P < 0.001). The CGI scores in the ARI group also exhibit significant improvement compared with the QP group. There was a non-significant change in CGI score recorded in both groups. The AEF was observed in 11% of patients with more incidences in the QP groups. The incidences of AEFs resulting in discontinuation of therapy were found low in both groups (ARI: 1.6%; QP: 3.2%).

Conclusion:

The findings of this study conclude that TRD patients can be more benefitted by ARI augmentation therapy than QP.
Zirconia Monolithic Veneers
Authors: Shetty Rajesh , Pinge Siddharth Shrirang , Shetty Sanath , Banga Parmeet , Zahid Mohammed
Published: December 2022

Ceramics have greatly evolved since they came into the eye of the dental community. Currently, there is a demand for a highly aesthetic as well as strong restoration and high translucent zirconia fits that criteria pretty well. This has significantly increased the applicability of zirconia as a restorative material in aesthetically demanding cases. Veneers have an innate disadvantage of lack of strength, decreased fracture resistance and chipping. Using these highly translucent zirconia veneers will help overcome these disadvantages. Therefore, the objective of the case series was to test the effectiveness of adhesively bonded highly translucent zirconia veneers using resin cement. This type of veneers provides satisfactory aesthetic outcomes and decreases the risk of fracturing during the trial and clinical use. However, further studies with long-term follow-ups are needed.
DRD2 Gene-141C Insertion/Deletion Polymorphism Among Schizophrenia Patients
Authors: Maritska Ziske , Fitri Fitri , Prananjaya Bintang Arroyantri , Mulya Liansari Raden Ayu , Parisa Nita , Saleh Hasani Mgs Irsan
Published: December 2022

Introduction:

Schizophrenia remains one of the most common mental health disorders, affecting people worldwide. Its causes comprise environmental risk factors to genetic risk factors. One of the candidate genes for schizophrenia is the dopamine D2 receptor (DRD2) gene. There are several single-nucleotide polymorphisms found in the gene, with-141 C insertion/deletion polymorphism as one of the most commonly investigated polymorphisms. This study is the first to investigate the DRD2 gene-141 C insertion/deletion polymorphism among schizophrenia patients in Palembang, Indonesia.

Materials and Methods:

Eighty schizophrenia patients from the only national reference mental hospital in the South Sumatra area, Ernaldi Bahar Mental Hospital, participated in this cross-sectional study. DRD2 gene-141C insertion/deletion polymorphism (DD, DI and II) was detected using restriction fragment length polymorphism analysis.

Results:

The-141 C insertion or DD genotype was less frequent (n = 4; 5%) compared to the II genotype (n = 25; 31.25%) and-141 C deletion or DI (n = 51; 63.75%) as the most frequent genotype found.

Conclusion:

This study is one of the few studies in the Indonesian population investigating the DRD2 gene-141 C insertion/deletion polymorphism. With a small sample size in consideration, our findings suggest that this polymorphism is prevalent in the Indonesian population.
A Comparative Study to Analyze the Effect of Gabapentin with Amitriptyline Versus Pregabalin with Amitriptyline in Neuropathic Pain in Cancer Patients Undergoing Palliative Care
Authors: Lamba Nipun , Pareek Anukriti , Dhal Shikha , Goyal Sumit , Makkar Ruchika , Sarna Sudha
Published: December 2022

Introduction:

Antiepileptics and antidepressant medications are known for managing neuropathic pain. We aim to compare the effects of pregabalin with low-dose amitriptyline and gabapentin with low-dose amitriptyline in managing neuropathic pain in cancer patients undergoing palliative care.

Materials and Methods:

We conducted our study on 160 cancer patients who were having neuropathic pain and were undergoing palliative care treatment in our institute. It was a hospital-based, randomized, tertiary cancer center-based observational study. After taking approval from the institutional ethics committee and taking written informed consent from patients, the patients were divided into two groups and the effect of medicines on incidence of neuropathic pain was observed; the incidence of burning sensation and the incidence of adverse effects of medications were also analyzed. Statistical analysis was done using paired t-test and SPSS version 20 software.

Results:

The onset of relief in pain was earlier in the pregabalin group as compared to the gabapentin group. There was more reduction in a burning sensation in the pregabalin group as compared to the gabapentin group. The incidence of headaches was the same in both groups. Nausea and vomiting were more in the pregabalin group but the overall difference in adverse effects was not statistically significant (P > 0.05)

Conclusions:

In the management of neuropathic pain in cancer patients who are undergoing palliative care, a combination of pregabalin with amitriptyline was found to be more effective in pain relief than gabapentin with amitriptyline.
Histomorphological Analysis of Gestational Trophoblastic Disease Spectrum with Clinicopathological Correlation at a Teaching Hospital
Authors: Soumya B. M. , Rajalakshmi D. , Kulkarni Sriharsha , Devi Rajkumari Jayshree , Kulkarni Vardendra G
Published: December 2022

Introduction:

Clinically, all trophoblastic lesions are frequently combined under a broad spectrum of gestational trophoblastic diseases (GTDs) without the use of specific pathological terms. However, studies now demonstrate that various forms of GTDs demonstrate differences in etiology, histogenesis, morphology, and clinical behavior. Thus, the need for diagnostic histopathology of these lesions to distinguish gestational trophoblastic neoplasms from nonneoplastic lesions and molar pregnancies and also for early anticipation for early anticipation, risk category stratification, prognostication, management, and prediction of persistent GTD. Our study aimed to study the histomorphological patterns of various types of GTD with light microscopy and the pattern of occurrence of GTDs in relation to age, parity, and gestation.

Materials and Methods:

The present study was conducted in the department of pathology, from January 2020 to April 2022. All GTDs confirmed by histopathological examination by hematoxylin- and eosin-stained slides were included.

Results:

The spectrum of GTDs found in this study was seventy cases of hydatidiform mole (92.10%), three cases of exaggerated placental site (EPS) reaction (3.94%), and two cases of choriocarcinoma (2.63%) and one case (1.31%) of placental site trophoblastic tumor (PSTT). The most common presenting symptom was vaginal bleeding (93.42%).

Conclusion:

Hydatidiform mole forms the most common type of GTD with an incidence of complete moles more than partial moles. Histomorphological examination and analysis are helpful for confirmatory diagnosis. The most common clinical presentation of GTD was vaginal bleeding followed by amenorrhea. Emphasis on detailed descriptive morphological assessment can help in the histological distinction of benign lesions such as EPS reaction and placental site nodule and avert such cases from being erroneously diagnosed as neoplastic. The Ki-67 proliferation index helped in distinguishing the EPS reaction from neoplastic lesions such as PSTT which requires surgical intervention and chemotherapy.
A Comparative Evaluation of Antimicrobial Efficacy of Novel Surfactant-Based Endodontic Irrigant Regimen's on Enterococcus faecalis
Authors: Ravinanthanan Manikandan , Hegde Mithra N. , Shetty Veena , Kumari Suchetha , Al Qahtani Fahd Nasser
Published: December 2022

Introduction:

Irrigants play an important role in the eradication of microorganisms in the complex root canal system. Sodium hypochlorite (NaOCl), chlorhexidine (CHX), and iodine potassium iodide (IKI) have certain limitations despite their routine clinical use. Surfactant irrigants with antimicrobial properties can be a milestone in endodontics to overcome the drawbacks of conventional irrigants. The aim of this study was to evaluate the antimicrobial efficacy of surfactants in comparison with routine endodontic irrigants on Enterococcus faecalis.

Materials and Methods:

Primary irrigants NaOCl, CHX, IKI were prepared at concentrations of 5%, 2.5%, 2%, and 1%; while mixture of tetracycline acid and detergent (MTAD) (100%) served as control group. Surfactants such as cetrimide (CTR) and sodium dodecyl sulfate (SDS) were prepared at concentrations of 0.5%, 1%, and 2%. The direct contact assay was used to evaluate the antimicrobial efficacy after 5 min. Statistical analysis was performed using one-way ANOVA and Mann–Whitney U-test.

Results:

In the primary group, only 5% CHX was significant over MTAD (P < 0.05). In the surfactant group, all concentrations of CTR and SDS (except 0.5%) were significant (P < 0.05) in killing E. faecalis over MTAD. Two percent CHX in combination with 0.5% CTR and 1% SDS had an effective kill percentage over 2% CHX and MTAD alone.

Conclusion:

Surfactant irrigant regimens can be used as adjuncts with CHX to overcome its clinical limitations and potentiate its substantivity, thereby enhancing clinical success in endodontics.
Osteocalcin and Runx2 Expression in Anterior Maxillary Reconstructions Using Bone Xenografts Associated to Bone Marrow Aspirate Concentrate
Authors: Hergemöller Daniel Fernando , Pelegrine André Antonio , Pasquali Paulo José , Scavone de Macedo Luis Guilherme , Teixeira Marcelo Lucchesi , Moy Peter Karyen , Aloise Antonio Carlos
Published: December 2022

Background:

It is known that a large number of mediators involved in osteogenesis can influence bone development and repair; however, whether these mediators could be used as markers of bone maturity has yet to be determined.

Aim:

To evaluate the expression of osteocalcin (OC) and Runt-related transcription factor 2 (Runx2) in bone biopsies obtained during the reconstruction of atrophic anterior maxillae using particulate bone xenografts with or without association of autogenous bone marrow aspirate concentrate (BMAC).

Materials and Methods:

Ten patients were distributed into two groups (n = 5), according to the type of grafting material used: Control group (CG), particulate bone xenograft alone, and test group (TG), particulate bone xenograft combined with BMAC. A bone specimen was removed from the graft area 4 months after grafting, before implant placement. The specimens were processed and submitted to immunohistochemical analysis for detection of OC and Runx2. Histomorphometry was used to ascertain the percentage of stained areas in both groups. The Wilcoxon Mann–Whitney U-Test was used in the statistical analysis (P < 0.05).

Results:

The immunohistochemical analysis revealed a significantly higher OC expression in the TG than in the CG, namely 27.40 ± 1.34% and 11.40 ± 2.70%, respectively (P < 0.05), and a significantly higher Runx2 expression in the TG than in the CG, namely 2.80 ± 0.84% and 0.40 ± 0.55%, respectively (P < 0.05).

Conclusion:

The OC and Runx2 expression levels were higher when BMAC was associated with the bone xenograft than when it was not.
Rotary versus Manual Instrumentation for Root Canal Preparation in Primary Teeth
Authors: Faghihian Reyhaneh , Amini Kiana , Tahririan Dana
Published: December 2022

Objectives:

The aim of this systematic review was to assess the scientific evidence on the effect of rotary versus manual instrumentation for root canal preparation in primary teeth.

Materials and Methods:

Search terms were selected based on Medical Subject Headings (MeSH) and non-MeSH terms. Electronic database search of English published literature was performed in March 2020 within the following databases: Scopus, Cochrane, PubMed, and Embase. The risk of bias of selected studies was assessed by means of Cochrane collaboration tool. The heterogeneity level among the included studies was measured by I
2 index. For statistical analysis of instrumentation time, standard mean difference (SMD) of continuous data was analyzed with 95% confidence intervals (95% CIs) using the fixed-effects model. A random-effects model was used for analysis of odds ratio (OR) to assess the probability of optimal fill, underfill, and overfill obturations. Forest plots were applied to show the results and to estimate the effectiveness of rotary instrumentation.

Results:

Seven articles were selected for this review. The SMD in rotary techniques was 1.79 min less than manual techniques (95% CI: −2.56–−1.03 min) and had a significant P = 0.001. The OR of optimum quality was calculated to be 3.53 (95% CI: 1.79–6.97) in the rotary technique at P = 0.254.

Conclusions:

Within the limitations of this review, it can be asserted that rotary files decrease the instrumentation time and increase the rates of optimally filled canals in primary teeth. However, these files do not decrease the risk of underfilling and overfilling compared to manual files.
Association of internet addiction with anxiety, stress and quality of life among undergraduate students
Authors: Periasamy Panneerselvam , Suganthi Vajiravelu , Gunasekaran Sasikala , Narenkumar Jayaraman , Ramachandran Vasudevan , Kannabiran Ajitha
Published: December 2022

Background:

This study examined undergraduate MBBS and nursing students' quality of life with internet addiction and the association of anxiety and stress.

Aim:

We aimed to partially replicate the participant's online activities, changes in behaviour by internet addiction, quality of life when internet access was not possible and frequency of internet use.

Materials and Methods:

A cross-sectional study was applied in included university involving 400 MBBS and nursing students. World Health Organization Quality of Life-BREF Questionnaire (WHOQOL-BREF) scale for assessment of the personal quality of life. Scores of internet addiction test, Beck Anxiety Inventory and WHOQOL-BREF were compared by using the Mann–Whitney test or Kruskal–Wallis test.

Results:

The main findings revealed various risk factors associated with internet addictions, such as psychological distress, anxiety, mood disorders, suicidality, aggression, stress and sleep problems. Most of the intervention studies used an invariant behavioural therapy approach, although other interventions appeared effective in reducing addiction symptoms.

Conclusion:

Based on the students' addiction finding of an association between quality of life with internet addiction and anxiety and stress problems across combination with high prevalence rates amongst adolescents and university students, the individuals will use these tools. The implication of these findings is further discussed, and research is needed to develop and implement prevention strategies and treatment offers.
Comparative Evaluation of Hydroxyapatite Fluoride and Casein Phosphopeptide Amorphous Calcium Phosphate Fluoride as Remineralizing Agents in Primary Teeth Using pH Cycling and Single-Sectioning Technique
Authors: Nair Malvika Chandrashekharan , Patil Raju Umaji , Bahutule Samhita Ramchandra
Published: December 2022

Background:

Hydroxyapatite and casein phosphopeptide-amorphous calcium phosphate are known to remineralize subsurface carious lesions.

Aim:

The aim of this study was to evaluate the effect of topical application of hydroxyapatite fluoride (HF) and caseinphosphopeptide-amorphous calcium phosphate fluoride paste (CPP-ACPF) in bringing about remineralization changes in artificially induced carious lesions of primary teeth using pH cycling and single-sectioning technique.

Materials and Methods:

Seventy extracted deciduous teeth were divided into two groups: Group A: HF (Remin Pro) n = 35 and Group B: CPP-ACPF (Tooth Mousse Plus®) n = 35. The samples were immersed in demineralizing solution for 96 h followed by pH cycling for 10 days which included cycles of demineralization and remineralization of their respective groups.

Results:

Intergroup comparison of the change in the mean value after demineralization and remineralization showed statistically highly significant difference as the change in Group A HF was 213.52 ± 113.17 (standard deviation [SD]) as compared to that in Group B (CPP-ACPF) 76 ± 57.22 (SD).

Conclusion:

HF was found to be better when compared to CPP-ACPF for tooth remineralization.
Reasons for Patients Opting Out from Root Canal Treatment and Preferring Extraction in a Prospective Study
Authors: Singh Abhinav Kumar
Published: December 2022

Background:

Unfortunately, endodontic care has a bad reputation. To effectively address the problem, it is vital to identify the elements that cause patients' discomfort and so prevent them from participating in RCT.

Aim and Objectives:

The goal of this study is to assess the factors that lead people from southern India to forego root canal treatment (RCT) in favor of tooth extraction.

Methodology:

500 patients who sought therapy for irreversible pulpitis at the department of conservative dentistry and endodontics and ultimately opted for extraction were analyzed. Patients were contacted, and their completed surveys were gathered. To conduct statistical analysis, the recorded explanations were put into SPSS (Statistical Package for the Social Sciences). Frequency distribution tests were performed on the data.

Results:

Twenty percentage of patients in the study reported that they did not want to undergo RCT because they believed it would be ineffective, while 15% cited the high cost of RCT and a crown as a deterrent. Twenty-five percentage of respondents said they needed pain relief immediately but were unconcerned about tooth loss.

Conclusion:

Patient misconceptions about the efficacy of RCTs were a major factor in their decision to forego participation in these studies in favor of extraction.
Health Consequences of Uninsured Adults
Authors: Patil Vinit Shashikant , Sidhulal K , Vaghela Nilima , Belgaumi Uzma , Rafeeque P A , Siraj M M
Published: December 2022

The health consequences of uninsurance are real, vary in magnitude in a clinically consistent manner. Health services research conducted over the past 25 years makes a compelling case that having health insurance or using more medical care would improve the health of the uninsured. Uninsured adults have less access to recommended care, receive poorer quality of care, and experience worse health outcomes than insured adults do. Uninsured adults forego preventive care and seek health care at more advanced stages of disease. Society then bears these costs through lower productivity, increased rates of communicable diseases, and higher insurance premiums. Some mortality studies imply that a 4%–5% reduction in the uninsured's mortality is a lower bound; other studies suggest that the reductions could be as high as 20%–25%. The potential health benefits of expanding insurance coverage for these adults may provide a strong rationale for reform. In its review study, we have highlighted the health consequences of uninsurance among adults.
Knowledge, materials, methods, and attitudes employed during endodontic treatment by dentists to evaluate and improve the quality of practice of endodontic treatment
Authors: Sasidharan Rahul
Published: December 2022

Background:

This procedure, known as root canal treatment, is widely used in modern dental care. Modern endodontics frequently includes the introduction of many modern devices, materials, and methods, and yet it is one of the fastest-expanding fields in everyday clinical practice. Root canal fillings, coronal restorations, and the dentist's own knowledge, attitude, and expertise all have a role in the success of endodontic therapy, which is why it is important to maintain these high standards.

Aim and Objectives:

This study's objectives were similar to those of the aforementioned audit to collect data on the various approaches, specific and regular strategies, materials, and attitudes utilized by both general dental specialists and endodontists during root trench treatment, to analyze these choices in depth, and to disseminate endodontic treatment standards to evaluate the state of current practice and make adjustments as necessary.

Methodology:

The materials and techniques used by general dentists during root canal treatment were the subjects of a survey. Before the research itself could begin, a questionnaire had to be created and tested in advance.

Results:

The current study's findings provide light on the mindsets, strategies, supplies, and procedures used by dentists during root canal treatment. In the field of health-care evaluation, the survey questionnaire is a frequent tool. In this investigation, data were acquired by interviewing dentists in person and writing down their responses, a method that ultimately helped eliminate bias.

Conclusion:

Using the tried-and-true method of positioning the apical stop 1 mm from the radiographic apex, most dentists today continue to do so. The trend toward doing root canal treatment in a single office visit applies to all patient types. As a remarkable characteristic, both types of responders made very little use of rubber dams for isolation purposes during endodontic treatment.
A study to evaluate the preferences of dentists for the materials chosen to restore endodontically treated teeth and the influence of both clinical experience and level of specialization on the dentist's choice of posts
Authors: Talkal Arun Kumar , Prajapati Ushma Hardik , Shashank S. N. , Swamy Mahesh C. , Patil H. G. , Reddy Mahesh Kumar
Published: December 2022

Background:

In endodontics, dentist's choice for using posts/materials relevant to posts used to restore endodontic-treated teeth is influenced by clinical experience, whether concerning the length of practice time and level of specialization.

Objective:

Traditional restorative approaches are being modified as newer materials become available and patient preferences shift. The purpose of the study was to see if dentists' preferences for using posts and other materials associated to post used to restore endodontically treated teeth are influenced by practical experience, whether measured by the length of clinical practice time or level of specialty.

Methodology:

A cross-sectional study was conducted with dentists (n = 100) working in Karnataka utilizing a questionnaire. Data on sociodemographics, clinical experience, postgraduate training, and postendodontic restoration characteristics (posts/types of cement and rubber dam application) were obtained. The samples only included general and specialist dentists. A descriptive analysis was performed on the data. The Chi-square test and Fisher's exact test investigated the relationships.

Results:

The most chosen materials were metal posts (60%) and resin cement (70%). There was a statistically significant association between clinical practice duration and postuse type (P = 0.017). In addition, there was a highly significant relationship (P = 0.001) between clinical practice time, level of specialty, and the use of rubber dams.

Conclusions:

Dentists favored metal posts for post endodontic restorations, while resin-based cement was the preferred luting cement for the posts' cementation. Additional training and more clinical practice time were factors in several dental postselection decisions.
A neoteric platelet concentrate – Titanium-prepared platelet-rich fibrin
Authors: Jhawar Bhumika , Kujur Shirish , Gupta Vineeta , Chanreiphy Hungyo , Kumari Pragya
Published: December 2022

Titanium-prepared platelet-rich fibrin (TPRF) is the future of modern regenerative dentistry that has a wider application not only in the periodontic field and implant dentistry but also in oral surgery, endodontics, tissue engineering, and other medical fields including orthopedic and plastic surgery. It accelerates wound-healing properties along with its antibacterial and antihemorrhagic are beneficial for patients which attract more clinicians to adopt this technology. To discover the biological properties of TPRF and its broader applications in the area of periodontic and implant dentistry, TPRF is increasingly being investigated. Positive growth and improved healing results and less patient pain have been seen in current studies.
Relationship between prognostic nutritional index and neutrophil lymphocyte ratio with overall survival in patients with metastatic colorectal cancer receiving regorafenib
Authors: Erdogan Bulent , Ozcan Erkan , Gokmen Ivo , Gokyer Ali , Kucukarda Ahmet , Kostek Osman , Hacıoglu Muhammet Bekir , Uzunoglu Sernaz , Cicin Irfan
Published: December 2022

Aim:

In this study, we aimed to analyze the effect of prognostic nutritional index and neutrophile lymphocyte ratio on the overall survival (OS) in patients treated with regorafenib.

Materials and Methods:

Metastatic colorectal cancer (CRC) patients who treated with regorafenib between 2016 and 2020 in a single center were evaluated retrospectively. ROC analysis was used for neutrophile lymphocyte ratio (NLR’s) and prognostic nutritional index (PNI’s) optimum cut-off value. The relationship between OS with PNI and NLR was investigated.

Results:

Fifty-two patient’s data were analyzed. The median age was 57 years, 22 (41.5%) of the patients were female. The optimal cut-off value of PNI for OS was 45.7 according to ROC curve analysis. The median NLR value was accepted as 2.7. Median OS was 8.3 months. Patients who have high PNI value than 45.7 had longer OS (12.09 months vs. 6.31 months hazard ratio [HR]: 0.37 95% confidence interval [CI]: 0.19–0.73 P = 0.003) and there was a tendency for longer OS with low NLR value then median (12.05 months vs. 6.14 months HR: 0.54 95% CI: 0.29–1.23 P = 0.057). Primary tumor resected patients had longer OS than nonresected patients (12.05 months vs. 6.30 months HR: 0.34 95% CI: 0.17–0.66 P = 0.001). In multivariate analysis, high PNI value more than 45.7 (HR: 0.40 95% CI: 0.18–0.88 P = 0.02) and resection of the primary tumor (HR: 0.40 95% CI: 0.21–0.80 P = 0.01) were the only independent factors for longer OS.

Conclusion:

Metastatic CRC patients with high pretreatment PNI and primary tumor resected are more likely to have longer OS with regorafenib. PNI is more reliable index than NLR to predict OS in metastatic CRC patients treated with regorafenib.
Mucormycosis, COVID-19 Pandemic and the Lessons Learnt
Authors: Varghese Anila , Upadhyay Anita , Daniel Roy A. , Sharma Twinkle , Mohan M. Shyam , Susindran Balaji , Singh Priyanka , Lahariya Chandrakant
Published: December 2022

Mucormycosis emerged as a major public health challenge during the second wave of the COVID-19 pandemic in India in mid-2021. The disease, colloquially known as the Black fungus, was declared epidemic by the government. This review describes the epidemiological pattern and the determinants of mucormycosis. The review also proposes evidence based public health strategies for the prevention and control of mucormycosis. The rationale use of steroids in clinical management, formulation of evidence-based standard treatment guidelines and adherence to those guidelines by physicians, the strengthening of primary healthcare services to facilitate early care; compliance with infection prevention and control measures at all the health facilities; and early diagnosis and case management are the key strategies to prevent future emergence of mucormycosis. The article concludes that it is not enough that we tackle a health challenge at hand, in crisis mode. It is equally important that we derive learnings and take measures prevent any future. Effective control of mucormycosis and prevention of future outbreaks of disease is possible through coordinated actions of health policy makers, public health experts and clinicians. The entire episode is also a reminder for strengthening India's health systems at all levels – primary, secondary and tertiary – as well as in both public and private sector.
Incidence of and modifiable risk factors for inadequate epidural analgesia in pediatric patients aged up to 8 years
Authors: Pangthipampai Pawinee , Sutthibenjakul Karuna
Published: December 2022

Background and Aims:

Postoperative pain in pediatric patients is one of most inadequately treated conditions. This study aimed to investigate the incidence of and modifiable risk factors for inadequate epidural analgesia in pediatric patients aged up to 8 years at Siriraj Hospital—Thailand’s largest national tertiary referral center.

Material and Methods:

This retrospective study included pediatric patients aged 0–8 years who underwent surgery with epidural catheter during January 2015 to January 2020. Patients with missing data were excluded. Records from both the ward staff and the acute pain service were reviewed. All relevant data were extracted until the epidural catheters were removed.

Results:

One hundred and fifty pediatric patients were included. The median age was 29 months and the range varied from 12 days to 98 months on the day of surgery, and 86 (57.3%) were male. The incidence of inadequate epidural analgesia was 32%. Most patients (95.8%) had an unacceptably high pain score within 4 hours after arriving at the ward. Univariate analysis revealed direct epidural placement, the length in epidural space less than 5 cm, and postoperative leakage to be substantially higher in the inadequate pain epidural analgesia group. When those factors were included in multivariate analysis, only length in epidural space less than 5 cm was identified as an independent risk factor.

Conclusion:

The incidence of inadequate epidural analgesia in this pediatric study was 32%. Multivariate analysis showed length of catheter in epidural space less than 5 cm to be the only factor independently associated with inadequate epidural analgesia.
Comparative evaluation of three methods of endotracheal tube cuff inflation for adequacy of seal
Authors: Satya Prakash M.V.S. , Aravind C , Mohan V.K.
Published: December 2022

Background and Aims:

Intubation with cuffed endotracheal tube (ETT) is common in operation rooms, critical care, and emergency rooms. The pressure exerted by the cuff on the tracheal mucosa can lead to a reduction in blood flow to the tracheal wall and result in mucosal ischemia. There are many methods for ETT cuff inflation. Aim of the study was to compare the cuff pressures and volumes between the three methods of ETT cuff inflation.

Material and Methods:

One hundred and twenty patients were randomized into three groups: Group SG (stethescope guided), group AL (audible leak), and group P (palpation). In group SG, the cuff was inflated by auscultating with the bell of the stethoscope over the thyroid cartilage for leak around cuff. In group AL, the cuff was inflated by listening for an audible leak around the cuff with observer’s ear 5 cm away from the mouth of the patient. In group P, the cuff was inflated by palpating for a leak over the cricoid and trachea. The adequacy of the cuff seal was compared between the groups by assessing the volumes of additional air needed to stop the leak around the cuff as confirmed by supraglottic capnometry.

Results:

The initial volumes needed to inflate the cuff were significantly more in the stethoscope (SG) and hearing (AL) groups than in the palpation (P) group (SG = 5.1 ± 1.4 ml, AL = 4.6 ± 1.6 ml, P = 3.1 ± 0.9 ml; SG and AL vs. P, P < 0.001). Additional cuff volumes required to achieve zero leak around cuff by supraglottic capnometry were 0.85 ± 1 ml in group SG, 1.3 ± 1.1 ml in group AL, and 2.237 ± 0.8 ml in group P (SG vs. P and AL vs. P; P < 0.001).

Conclusion:

Out of the auscultation-guided, audible leak-guided, and palpation-guided methods of ETT cuff inflation, the auscultation-guided and audible leak-guided methods achieve significantly better tracheal seal than the palpation-guided method.
Comparison of double lumen tube insertion using the McGrath MAC versus direct laryngoscopy in adult patients with a limited glottis view: A prospective interventional study
Authors: Bakshi Sumitra G. , Panigrahi Amit R. , Bhawalkar Pranay , Divatia Jigeeshu V.
Published: December 2022

Background and Aims:

Passage of double-lumen tubes (DLT) can be challenging in patients with limited glottis view. This study aims to determine the usefulness of McGrath® MAC videolaryngoscope (VL) in cases with limited glottis view on direct laryngoscopy with Macintosh blade.

Material and Methods:

After study approval and registration of trial, consent was sought from all adult patients planned for elective DLT insertion for lung isolation during the course of general anesthesia. Patients not consenting, less than 18 years, with anticipated difficult mask ventilation or need for rapid sequence induction were excluded. Following routine anesthetic induction, laryngoscopy was attempted by an experienced anesthesiologist using Macintosh scope. If the view obtained was Cormack and Lehane (CL) view IIB and above or the attempt at intubation using DLT failed despite a CL I/IIA view, the patient was included in the trial. The laryngoscope was removed and after ensuring adequate oxygenation and depth of anesthesia, intubation was attempted using McGrath® MAC VL. The percentage of glottis opening (POGO) score was noted for both the scopes.

Results:

DLT insertion was attempted in 76 patients in the study period. Eight patients were included in the trial on account of limited glottis view/failure with Macintosh scope. Insertion of DLT with McGrath MAC was tried only in six patients, in two patients, the VL was not available for use. The mean (standard deviation) POGO score with Macintosh scope was 9 (±20), which significantly improved with the use of VL to 71 (±24), P = 0.01.

Conclusion:

McGrath MAC is helpful in inserting DLT in patients with limited glottis view with Macintosh scope.
Effect of two barrier devices on the time taken and ease of intubation of a paediatric intubation manikin - A randomised cross-over simulation study
Authors: Kamabathula Sailaja , Nath Gita
Published: December 2022

Background and Aims:

During the present COVID-19 pandemic, several inventions have been employed to protect personnel involved in intubation from inhalational exposure to the virus. In this study, we compared the effect of two barrier devices, Intubation Box versus Plastic Drape, on the time taken and difficulty in intubating a pediatric manikin.

Material and Methods:

Nineteen experienced anesthesiologists performed six different intubations: without barrier, with intubation box, with plastic drape; with and without a bougie, using the Latin Square Design for randomizing order of intubations. The time taken for intubation (TTI) was compared using Student’s t test, and nonparametric values were analyzed using Chi-square test with Yates correction.

Results:

Both barrier devices increased the TTI from 14.8 (3.5) s to 19.8 (6.8) s with intubation box (P = 0.068) and 19.3 (8.9) s with plastic drape (P = 0.099). Use of bougie significantly prolonged TTI to 25.8 (6.7) s without barrier (P = 0.000), 32.5 (13.3) with intubation box (P = 0.000), and 29.8 (7.3) s with plastic drape (P = 0.000). The number of attempts was not different (P = 0.411), and the visibility was slightly impaired with both barriers (P = 0.047). The ease of intubation, even without the bougie, was significantly different compared to default, with P values of 0.009 and 0.042 for intubation box and plastic drape, respectively. The highest significance was with intubation box with bougie with a P value of 0.00017.

Conclusion:

Both the intubation box and plastic drape increased the time taken as well as difficulty in intubation. The extra protection afforded should be balanced against risks of hypoxia in the patient.