bluuebunny/crossref_metadata_2025 huggingface dataset:
A rapid method for DNA Isolation from blood, dried blood spots and rapid diagnosis test
Authors: Sharma Supriya , Sen Aparajita , Ahmed Naseem , Swarnkar Deendayal , Singh Himmat
Published: December 2023

Background & objectives:

Malaria is a parasitic disease spread by Plasmodium parasite. Microscopy, lateral flow devices such as the Rapid Diagnostic Test (RDT), molecular methods such as Polymerase Chain Reaction (PCR), isothermal methods such as Loop-mediated isothermal amplification (LAMP), and other diagnostic methods are available for malaria. On the other hand, the accuracy of molecular diagnosis is dependent on genomic DNA isolation. A quick method for isolating and subjectively determining the presence of genomic DNA from blood, dried blood spot (DBS), and rapid diagnostic test (RDT), was identified.

Methods:

We have developed a protocol for isolating DNA from blood, DBS, and RDTs using the HUDSON Buffer (TCEP and EDTA). Isolated genomic DNA was seen with SYBR Safe DNA stain (1X) under a UV transilluminator without running in 0.8 percent gel electrophoresis or using a spectrophotometer.

Results:

The technique for DNA isolation was accurate for the presence of malaria parasite genomic DNA from positive samples confirmed by microscopy with a sensitivity of 76% and specificity of 78.67% and RDT with a sensitivity of 88% and specificity of 66%. The requirements were minimal, and the process took 30 minutes for a hundred sample processing.

Interpretation & conclusion:

Finding a fast and reliable method of separating nucleic acids from many samples is crucial. This approach extracts intact genomic DNA in under ten minutes, making it ideal for large-scale investigations.
Evaluation of the knockdown resistance locus (kdr) in Anopheles stephensi (Diptera: Culicidae) in southeastern Iran
Authors: Hajibeygi Ramtin , Hejripour Seyed Zia , Taghavi Nader , Shahali Hamzeh , Zarei Saeed , Nouri Majid , Mirahmadi Hadi , Tabatabaie Seyed Mahdi , Solgi Rahmat , Darvishi Mohammad
Published: December 2023

Background & objectives:

The resistance to insecticide among Anopheles stephensi population due to insecticide selection pressure has been previously reported from Iran. The current study was performed to evaluate the susceptibility of different insecticide reagents against An. stephensi by bioassay and molecular methods in Saravan County, a malaria-endemic area in southeastern Iran.

Methods:

An. stephensi mosquitoes were collected from different larval habitats in Saravan City, southeastern Iran in 2022. At first, the susceptibility of collected samples for DDT, permethrin, and deltamethrin were evaluated by bioassay test. The collected mosquitoes were then evaluated for the presence of different kdr mutations.

Results:

Insecticide susceptibility tests were conducted on the field population of An. stephensi from Saravan, revealing its potential resistance to pyrethroids and DDT. Of the 150 An. stephensi samples, 4 % carried the kdr L1014F mutation as heterozygous and the rest of them were homozygous L1014 wild type.

Interpretation & conclusion:

The current study revealed the presence of L1014F mutation for the first time in Iran. So, further monitoring of kdr mutations in the VGSC gene and resistance phenotypes should be performed.
Prevalence of preoperative anxiety and depression in patients undergoing major oncologic surgeries: An analytical cross-sectional study
Authors: Opneja Sonali , Sureshan Roopesh , Abraham Jisha , Balasubramanian Satheesan , Malodan Riyas , John Mayan
Published: December 2023

Background:

Depression and anxiety experienced before major cancer surgeries have been associated with postoperative morbidity and mortality.

Objectives:

This study aimed to estimate the prevalence of preoperative anxiety and depression in patients undergoing major oncosurgeries.

Materials and Methods:

This was a cross-sectional analytical study conducted between June 2021 and June 2022 at Malabar Cancer Center in Thalassery, Kerala, in South India. We enrolled patients aged 18–65 years undergoing major oncosurgeries with American Society of Anesthesiologists (ASA) Physical Status Grades I and II. Patients were administered a questionnaire (in the local language, Malayalam) by the anesthesiologist on their first preoperative visit after the preanesthetic checkup. The questionnaire was in two parts: part 1 consisted of the demographic data, and part 2 comprised the Patient Health Questionnaire-4 (PHQ-4) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). On the PHQ-4, a score of ≥3 for the first two questions was the cutoff for anxiety, and a score of ≥3 for the last two questions was the cutoff for depression. APAIS is a six-item questionnaire; a score of ≥11 on the anxiety scale was considered positive for anxiety, and a score of >5 was considered to indicate the need for more information.

Results:

We enrolled 200 patients; 136 (68%) were women, and the median age overall was 52 (interquartile range [IQR], 42–60). Patients enrolled were planned for surgeries for head-and-neck cancers (n = 55, 27.5%), laparotomies or therapeutic laparoscopies (n = 70, 35%), breast cancers (n = 67, 33.5%), and bone and soft tissue surgeries (n = 8, 4%). Anxiety was noted in 49 (24.5%) patients by PHQ-4 and 23 (11.5%) patients by APAIS; depression was detected in 31 (15.5%). The presence of depression significantly contributed to anxiety. Patients who screened positive for depression had 79.6 times higher odds of screening positive for anxiety, as compared to those who screened negative for depression.

Conclusion:

Almost one in four patients undergoing major oncosurgeries experience preoperative anxiety, and one in six have depression. Patients have a substantial requirement for information concerning anesthesia and surgical procedures, which, if unmet, contributes to anxiety and/or depression. Preoperative counseling and providing more information to patients could reduce anxiety or depression. Other causative personal, familial, social, or economic factors should also be assessed and managed (Clinical Trials Registry of India number: CTRI/2021/07/034568).
The prevalence and correlates of comorbidities among patients with cancer attending a tertiary care cancer center in South India: An analytical cross-sectional study
Authors: Sebastian Divya , Joseph Jaison , Mathews Elezebeth
Published: December 2023

Background:

Comorbidities in patients with cancer can affect treatment, and should, therefore, be prioritized and managed.

Objectives:

Our primary aim was to assess the prevalence of comorbidities among patients with cancer. The secondary objective was to identify the association of comorbidities with various sociodemographic and clinical variables.

Materials and Methods:

This was a cross-sectional study conducted between December 2019 and March 2020 among patients with cancer, seeking treatment at Malabar Cancer Center, in Kannur District of northern Kerala in South India. Semi-structured interviews were conducted, and comorbidities were assessed using the Charlson Comorbidity Index. The anthropometric measurements were recorded using a standardized instrument and protocol.

Results:

We enrolled 242 patients in this study. There were 148 (61.2%) female patients; 106 (43.8%) were aged between 41 and 50 years. Cancers of the head-and-neck and breast accounted for the majority of cases (23.1% each, n = 56), followed by the digestive system (18.6%, n = 45) and female reproductive system (11.2%, n = 27). The most common primary cancers in the head-and-neck, digestive, and female reproductive systems were oral, colorectal, and cervical, respectively. The prevalence of comorbidities among patients with cancer was 70.2% (n = 170). Common comorbidities were hypertension (n = 82; 33.9%), arthritis (n = 57; 23.6%), and diabetes (n = 53; 21.6%). After controlling for potential confounders, the factors noted to be independently associated with the presence of comorbidities were advanced age, family history of comorbidity, normal weight or underweight, and cancer treatment for more than 6 months' duration.

Conclusions:

The high prevalence of comorbidities among patients with cancer suggests the need for an integrated system of care and management as the comorbidities affect the overall management of cancer treatment and care.
TAFRO Syndrome Mimicking Solid Cancer and Successfully Treated by Tocilizumab: A Case and Literature Review
Authors: Fu Pei-An , Wu Chia-Chi , Hsu Ya-Ting
Published: December 2023

TAFRO syndrome, or now formally termed idiopathic multicentric Castleman disease (iMCD) with thrombocytopenia, anasarca, fever, renal insufficiency or reticulin fibrosis, and organomegaly (iMCD-TAFRO), describes a unique subtype of iMCD. Hypersecretion of pro-inflammatory cytokines, such as interleukin-6, plays a critical role in this disease. Several anti-inflammatory medications are used for treatment, such as tocilizumab, siltuximab, and rituximab, and they have demonstrated efficacy in some cases; however, the disease remains incurable. Here, we report a 56-year-old woman who presented with ileus and progressive ascites formation. She received several operations for suspected secondary peritonitis, but thrombocytopenia, lymphadenopathy, and anasarca progressed. It took 1 year to reach the diagnosis of iMCD-TAFRO, and tocilizumab was given soon after the diagnosis. After tocilizumab treatment, her symptoms improved dramatically. Due to the heterogeneous clinical manifestations of iMCD-TAFRO, awareness of iMCD-TAFRO and a multidisciplinary team approach are required for a timely and accurate diagnosis of iMCD-TAFRO.
A retrospective analysis of the 5-year trends of antimicrobial resistance in gram-negative bacterial isolates from an intensive care unit at a tertiary care hospital
Authors: Raj Nikhil , Agarwal Jyotsna , Singh Vikramjeet , Nath Soumya Sankar , Das Anupam , Sen Manodeep
Published: December 2023

Background:

Intensive care units (ICUs) in developing countries constitute a high risk for patients acquiring infection by multidrug-resistant organisms (MDROs). The rise in antimicrobial resistance (AMR) threatens the effective prevention and treatment of an increasing range of infections. The present study analyzed the local trends of AMR in Gram-negative isolates of ICU patients from a tertiary care facility in North India.

Methods:

This retrospective study was conducted over 5 years (January 2018–December 2022). All bacterial isolates from patients admitted to ICU during the study period were included in the study, and their AMR pattern was analyzed. In addition, sensitivity trends of different antimicrobials against the common Gram-negative bacteria were analyzed, and AMR trends were analyzed over the study period.

Results:

Klebsiella spp. was the most common isolate in samples received from ICU. A rise of carbapenem-resistant microorganisms was observed over the study period. Escherichia
coli and Klebsiella spp. showed around 10% and a 17% decrease in susceptibility to carbapenems, respectively. In contrast, a marked 29% decrease in sensitivity to carbapenems was observed in Acinetobacter spp.

Conclusion:

The inception of integrated stewardship measures has shown a rising trend in susceptibility and is the need of the hour to prevent the spread of MDROs. Surveillance studies help us understand the impact of AMR in hospitals and help plan prevention programs.
A prospective observational study to correlate lung ultrasound with clinical severity and prognosis score in patients with primary pulmonary pathology on invasive ventilatory support
Authors: Basu Sulagna , Verma Rishiraj Narayan , Joshi Aditya , Dwivedi Deepak , Mateen Mohammad Abdul , Bhatia Jagdeep Singh
Published: December 2023

Background:

Lung ultrasound (LUS) is a known imaging modality employed for monitoring patients in an intensive care unit. This study evaluates, LUS in assessing disease severity and prognosis, by correlating its score with the three commonly used clinical severity scoring systems (CSSS), namely, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE) II score, and simplified acute physiology score (SAPS) II.

Methods:

This single-center prospective observational study included 54 adult patients of primary lung disease-induced acute respiratory distress syndrome (ARDS), on invasive ventilation. The primary objective was to correlate LUS score with SOFA score. Secondary objectives were to correlate LUS score with APACHE II and SAPS II scores. LUS score was also correlated with the estimated mortality derived from the above-mentioned scores. A subgroup analysis on COVID-19-positive cases was also carried out. All scores were calculated on the initiation of mechanical ventilation, daily for 7 days or mortality, whichever was earlier.

Results:

A significant positive correlation (P < 0.001) was found between LUS and all three severity scores, as well as their corresponding estimated mortality percentages, for all days of the study period, in both non-COVID-19 ARDS patients and in COVID-19 patients. The merit of all four scores in differentiating between the survivor and mortality group for the duration of study also showed significant (P < 0.05) to very significant (P < 0.001) results.

Conclusion:

Point-of-care LUS in conjunction with CSSS is a reliable tool for assessing the severity and progression of primary lung disease.
Clinical utility of i-gel® and BlockBuster™ supraglottic devices for airway management in postburn injury contracture neck patients under general anesthesia: A randomized controlled trial
Authors: Tripathi Manish Kumar , Tiwari Tanmay , Naithani Bhavya , Upadhyaya Divya Narain , Singh Prem Raj , Tripathi Ila
Published: December 2023

Background:

Post burn injury contracture (PBC) neck patients pose a unique challenge for the anesthesiologists. The use of supraglottic device (SGDs) for managing such patients is being increasingly used. We compared i-gel® and LMA BlockBuster™ in PBC adult patients under general anesthesia (GA).

Methods:

The study included 63 subjects with mild/moderate PBC neck of either sex with American Society of Anesthesiologists Physical Status I and II under GA. Patients with intraoral pathology, mouth opening <2.5 cm, and severe contracture were excluded. Patients were randomly assigned to i-gel® (I) and BlockBuster™ (B) groups. The primary objective of the study was the time for successful insertion. First attempt success rate, oropharyngeal leak pressures (OLP), and complications were also assessed.

Results:

Mean insertion time was significantly less in Group I as compared to Group B (17.35 ± 1.43 vs. 21.32 ± 1.10 s; P < 0.001), OLP in Group B was significantly higher as compared to Group I (34.03 ± 1.33 vs. 25.23 ± 3.04 cm of H2O; P < 0.001). Group I was found to be statistically easier to insert as compared to Group B (P = 0.011) with reduced requirement of airway maneuvering to insert the device (P = 0.017). Groups were similar in terms of complications.

Conclusion:

SGDs are attractive option for airway management in mild/moderate degree of PBC neck. i-gel® having shorter insertion time with easier insertion can be favorable at times of emergency while use of LMA BlockBuster™ can be preferred to reduce the risk of aspiration owing to higher OLP.
Comparative histomorphologic study of basement membrane side staining and additional epithelial side staining of the anterior lens capsule with Trypan Blue
Authors: Srinija Kommana , Bhat Subrahmanya K , Prasad Kishan H L
Published: December 2023

Purpose:

To compare the histomorphologic changes on the anterior lens capsule by both epithelial and basement membrane side staining to those of only basement membrane side staining of the anterior lens capsule with Trypan Blue (TB).

Methods:

A cross-sectional study was done on 72 samples from patients who underwent cataract surgery between April 2021 and September 2022. After capsulorhexis of the TB-stained capsule, it was made into two halves externally and one half labeled as controls (sample A). The other half was immediately stained further with TB on the epithelial side and was taken as cases (sample B). Samples were analyzed for lens epithelial cells and basement membrane changes.

Results:

The loss of intactness of lens epithelial cells, partial or complete detachment of lens epithelial cells, degeneration of lens epithelial cells, and basement edema were significantly higher in cases compared to controls, whereas intactness of the basement membrane did not show any statistical significance between the two groups. There was a statistically significant decrease in cell density in cases compared to controls.

Conclusion:

Staining the epithelial side of the capsular bag with TB is more detrimental to lens epithelial cells and paves the way for a further study of staining the capsular bag before intra-ocular lens implantation to reduce the incidence of posterior capsule opacification.
Endothelium sparing – Air-assisted wedge resection for the treatment of pellucid marginal degeneration
Authors: Michael Tsatsos , Ioannis Giachos , Ferdinardo Martini , Ioannis Athanasiadis
Published: December 2023

To describe the surgical technique of performing a wedge resection of a 1 mm area of inferior corneal stroma using stromal air injection assisted separation sparring the endothelium in a patient with bilateral Pellucid Marginal Degeneration. 68-year-old male Caucasian advanced, non progressive. A 30G needle on a 1 ml air-filled syringe injects air into the stromal lamellae with the bevel up, leading to stromal emphysema. An MVR blade is used to incise the marked area until clear corneal tissue is seen. The incised areas are separated with a lamellar dissector, and the crescentic area is excised. The lips of the wound are approximated with 10-0 Prolene sutures. This surgical approach leads to adequate management of the Pellucid Marginal Degeneration without injury to the endothelium, ensuring reduced antigenic input and maintenance of the architectural integrity of the eye.
Clinical profile, demographic distribution, and management of Posner–Schlossman syndrome: An electronic medical record-driven data analytics from an eye care network in India
Authors: Warjri Gazella B , Das Anthony V , Senthil Sirisha
Published: December 2023

Purpose:

To describe the clinical profile, demographics, and management of Posner–Schlossman syndrome (PSS) in patients presenting to a multitier ophthalmology hospital network in India.

Methods:

This cross-sectional hospital-based study included 3,082,727 new patients presenting between August 2010 and December 2021. Patients with a clinical diagnosis of PSS in at least one eye were included as cases. The data were collected using an electronic medical record system.

Results:

Overall, 130 eyes of 126 (0.004%) patients were diagnosed with PSS. The majority of the patients were male (81.75%) and had unilateral (96.83%) affliction. The most common age group at presentation was during the fourth decade of life, with 46 (36.5%) patients. The overall prevalence was higher in patients from a higher socioeconomic status (0.005%) presenting from the metropolitan geography (0.008%) and in professionals (0.014%). A significant number of patients (108; 83.08%) had a raised intraocular pressure of >30 mm of Hg. The majority of the eyes had mild or no visual impairment (better than 20/70) in 99 (76.15%) eyes. Keratic precipitates were found in 59 (45.38%) eyes, anterior chamber cells in 43 (33.08%) eyes, and iris atrophy in seven (5.38%) eyes. The majority of eyes (127; 97.69%) had open angles on gonioscopy. The average duration of use of topical steroids was 1.70 ± 0.76 months, and the average duration of use of topical antiglaucoma medications (AGMs) was 1.66 ± 0.81 months, with 35 eyes (26.92%) requiring continued AGMs. Among the surgical interventions, trabeculectomy was performed in nine (6.92%) eyes and cataract surgery in five (3.85%) eyes.

Conclusion:

PSS more commonly affects males presenting during the fourth decade of life from higher socioeconomic status and is predominantly unilateral. The majority of the eyes have mild or no visual impairment, open angles, and require surgical intervention in a tenth of the eyes.
Choroidal thickness in thyroid eye disease and its correlation with disease activity
Authors: Muralidhar Alankrita , Singh Shalini , Das Sima , Mondal Kheyali , Kumar Brajesh , Agarwal Manisha , Majumdar Atanu
Published: December 2023

Context:

This study adds to the existing body of literature on the role of optical coherence tomography (OCT) parameters in active thyroid eye disease (TED) among the Indian population.

Purpose:

Comparison of choroidal vascularity index (CVI) and subfoveal choroidal thickness (SFCT) in active and inactive TED.

Settings and Design:

An observational, cross-sectional analytical study conducted at a tertiary eye care hospital in North India that included patients with active and inactive TED.

Methods:

Demographic details and clinical evaluation were performed for all TED patients. SFCT was determined with OCT by using the Cirrus linear measurement tool. CVI was calculated using Image J software. The SFCT and CVI measurements were compared between both groups.

Statistical Analysis Used:

Comparison between active and inactive TED groups was done using Mann–Whitney U test for non-parametric data and Student t test for parametric data. Multivariate regression analysis was performed with SFCT and CVI as dependent variables.

Results:

Sixty-two eyes of 31 patients were included. Thirteen eyes had active TED, and 49 eyes had inactive TED. SFCT was significantly lower in eyes with higher clinical activity score (CAS) and older age. No significant difference was found in CVI between active and inactive TED eyes.

Conclusion:

SFCT was lower in eyes with higher CAS and older age. Our findings differ from previous studies, which showed a positive correlation between SFCT and CAS. There was no significant difference in CVI between active and inactive TED eyes.
A Case of Hidradenitis Suppurativa with Plaque Morphea: Association or Chance?
Authors: Sharmeen Ayesha , Adil Mohammad , Amin Syed S , Rehman Suhailur
Published: December 2023

Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the apocrine glands characterized clinically by recurrent nodules, abscesses, and discharging sinuses which heal with a bridge or rope-like scars in the axilla, groin, and perineum. HS is seen to be associated with several other autoimmune and pilosebaceous structural disorders. We present the case of a 50-year-old obese female, known case of HS for 3 years who developed hyperpigmented indurated plaques over the breasts for the past 1 year. Histopathology from the plaques showed thickened and homogenized collagen bundles. A diagnosis of plaque morphea was made based on the clinical and histopathological findings. There are few case reports of HS associated with connective tissue diseases (CTDs) such as systemic lupus erythematosus, Sjogren’s syndrome, and systemic vasculitis. We discuss the shared pathogenesis of HS and CTDs which may have led to morphea developing in our patient.
Screening for Allergic Contact Dermatitis Based on Pattern of Patch Test Results: A Retrospective Study
Authors: Alshamrani Hussein M. , Alhothali Omar S. , Alyemani Rawan M. , Basendwh Mohammad A.
Published: December 2023

Background:

Contact allergies are associated with morbidity worldwide.

Purpose:

To investigate the patterns of sensitization to contact allergens in a local population.

Methods:

A retrospective study investigated patch test reactivity among patients with a clinical diagnosis of contact dermatitis referred to the dermatology clinic at King Fahad Armed Forces Hospital, Jeddah, between January 2021 and January 2023. Pregnant women, immunosuppressed patients, and those receiving immunosuppressive therapy were excluded. Only 92 of 101 referred patients underwent patch testing after fulfilling requirements. The patch test was performed using a Thin-layer Rapid-Use Epicutaneous patch test containing 35 contact allergenic elements and one control (total = 36).

Results:

Among 92 patients, 35 (38%) were males, and 57 (62%) were females. Of these, 62 (67.4%) patients had a positive patch test and reacted to one or more allergens. The most common sensitizing allergens were p-phenylenediamine (PPD), gold sodium thiosulfate, and disperse blue 106, with equal positive reactions in 16 (25.8%) patients, followed by nickel sulfate in 13 (21%), p-tert-butylphenol formaldehyde resin in eight (13%), fragrance mix in 7 (10.8%), and epoxy resin in six (9.2%) patients. No significant sex differences were found among patients with contact dermatitis where notable patch test allergen reactivity was observed.

Conclusion:

Patch test reactivity to PPD, gold sodium thiosulfate, and disperse blue 106 was high. The pattern of contact allergy observed here highlights the need for large-scale investigations to identify local allergens for contact allergy and formulate policies for avoiding exposure.
Variations of the Ala-Tragal Plane to Occlusal Plane in Three Different Skeletal Jaw Relations in Dentate Subjects Using Digital Cephalometric Analysis an In vivo Study
Authors: Mohammad Fahad , Shetty Rajesh , Chadha Reema , Shetty Mallika S. , Shetty Naresh , Moureen Ayisha
Published: December 2023

ABSTRACT

Context:

Orientation of the occlusal plane (OP) is one of the most important factors that help us in the development of occlusion. Developing an occlusion that is compatible with the functional movements of the stomatognathic system is one of the key factors in determining the prognosis of a completely edentulous patient.

Aim:

The aim of this study was to assess the variations of the ala-tragal (AT) plane to OP in three different skeletal jaw relations in dentate subjects using digital cephalometric analysis.

Settings and Design:

A total of 60 subjects (20 belonging to each, Class I, Class II, and Class III skeletal jaw relations) were selected for this study among the patients and students.

Methodology:

The subjects were classified into one of the three skeletal jaw relations based on selection criteria.

Statistical Analysis Used:

The value obtained was subjected to statistical analysis using analysis of variance test and post
hoc test of Bonferroni.

Results:

Study indicates that in Class I and Class III skeletal jaw relations, a line drawn from the lower border of ala of the nose to the inferior position of the tragus was found to be relatively parallel to the OP and, in Class II skeletal jaw relation, a line drawn from the lower border of ala of nose to middle border of tragus was found to be relatively parallel to the OP.

Conclusions:

AT line may be used as a posterior plane of reference when it is combined with other methods for determining the OP.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY

Definitive relative parallelism of occlusal plane to ala-tragal plane is accurate when obtained digitally than mere visual perception. Occlusion plays a key role in any fixed prosthesis or single tooth restorations including post and core as well as maintaining the periodontal health and thereby maintaining harmony in the stomatognathic system.
Creeping Attachment-aided Root Coverage with Free Gingival Graft in the Esthetic Zone
Authors: Arun Ramya , Sevugan Rajkumar
Published: December 2023

ABSTRACT

Free gingival grafts (FGGs) are considered to be one of the most predictable procedures for increasing keratinized tissue width (KTW) in spite of shortcomings such as color mismatch and second surgical site morbidity. As the primary purpose of FGG is to increase KTW, root coverage is not deemed to be its tangible objective. Yet, it may be achieved on narrow recessions, especially by a distinct healing process known as creeping attachment (CA). The present case report aims at establishing the efficacy of FGG in gingival augmentation and CA after 6 months in the mandibular anterior region.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY

The presence or absence of keratinized tissue plays an important role in controlling the inflammatory process, especially in patients with malocclusion or in patients who are undergoing orthodontic, prosthetic, or restorative treatment where oral hygiene maintenance is difficult. Free gingival graft is one among the procedures, which aims at increasing the width of keratinized tissue, and sometimes, root coverage can be achieved with the help of a phenomenon known as creeping attachment, especially in the mandibular anterior region.
Clinical Evaluation of Class I Posterior Restorations Restored with Smart Dentin Replacement Flowable Bulk-fill Composite Material in Bulk-fill and Incremental Technique – One-year Randomized Clinical Trial
Authors: Mungara Niharika , Sannapureddy Swapna , Suneelkumar Chinni , Anumula Lavanya , Nelapati Haritha , Govula Kiranmayi
Published: December 2023

ABSTRACT

Aim and Objective:

The aim and objective of this in vivo study are to evaluate the clinical performance of smart dentin replacement (SDR) flowable bulk-fill composite in class I restorations with incremental technique and bulk-fill technique.

Materials and Methods

Fifty patients with at least two class 1 cavities in the age group of 18–40 years were recruited. In all cavities, Xeno Vplus self-etch adhesive was applied. In one of the cavities, SDR was placed in bulk increments up to 4 mm as needed to fill the cavity 2-mm short of the occlusal surface. The occlusal part was placed with SureFil nanohybrid composite, and the other cavity was placed by incremental technique. The restorations were evaluated using FDI criteria.

Results:

Data were subjected to statistical analysis and analyzed using Chi-square test. After 1 year, all restorations received clinically excellent and clinically good scorings for each criterion.

Conclusion:

There is no statistically significant difference between the bulk-fill technique and the incremental technique using SDR after 1-year follow-up.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY

The smart dentin replacement bulk-fill resin composites demonstrated good clinical durability as equal as conventional composites. It provides an advantage of less clinical time for placement in deep posterior cavities.
Evaluation of Efficacy of 4% Ocimum sanctum Gel in the Management of Chronic Periodontitis
Authors: Thomas Raison , Arya Kanchan , Shah Rucha , Pooja N
Published: December 2023

ABSTRACT

Aim:

The present experimental study was performed with the aim of assessing the efficacy of Ocimum sanctum (OS) gel as an adjunct to scaling and root planing (SRP) in the management of chronic periodontitis.

Materials and Methods:

Minimum inhibitory concentrations and minimum bactericidal concentration of OS on Porphyromonas gingivalis, Prevotella intermedia (Pi), Fusobacteria nucleatum, and Aggregatibacter actinomycetemcomitans was carried out as a pilot study. Further, a total of 60 patients (mean age of 34.5 ± 8.3 years) were enrolled in this study (n = 30 in each group). In the control group (A), Phase I periodontal therapy was performed, whereas in the test group (B), 4% OS gel was inserted into the pockets at baseline after the same. The clinical parameters recorded included plaque index (PI), sulcus bleeding index, probing depth, and clinical attachment level were recorded at baseline and after 45 days.

Results:

The results obtained by in vivo assessment following the placement of 4% OS gel demonstrated that the mean PI score at baseline was 2.29 ± 0.21, which was reduced to 0.97 ± 0.293 at the 45th day (P = 0.001) for Group A, whereas it was 2.18 ± 0.22, which was reduced to 1.46 ± 0.29 at the 45th day (P = 0.001) for Group B. The mean Modified Sulcular Bleeding Index score at baseline was 3.56 ± 0.77, which was reduced to 1.55 ± 0.62 at the 45th day after local drug delivery of OS gel for Group A, whereas it was 3.08 ± 0.69, which was reduced to 1.45 ± 0.51 at the 45th day (P < 0.001). The difference between Group A and Group B was statistically not significant (P > 0.05). The mean probing depth at baseline was 8.07 ± 1.60, which was reduced to 4.83 ± 1.38 for Group A (P < 0.001), whereas it was 7.50 ± 1.63 at baseline and 5.68 ± 1.29 at the 45th day for Group B (P < 0.001). The mean clinical attachment level at baseline was 4.26 ± 1.02, which was reduced to 2.78 ± 0.84 for Group A at the 45th day (P < 0.001), whereas it was 4.05 ± 1.08 at baseline and 3.27 ± 0.97at the 45th day for Group B (P < 0.001). The difference between Group A and Group B was statistically highly significant (P < 0.01).

Conclusions:

The subgingival delivery of 4% OS gel can be used as an adjunct to SRP for superior clinical outcomes in chronic periodontitis cases as compared to SRP alone.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY

This study emphasizes the anti-inflammatory role of Ocimum sanctum in nonsurgical management of periodontal infection which need to be tackled before any other procedures of orthodontics, prosthetic or restorative dentistry.
Application of Real-time Submental Ultrasonography to Assess Swallowing
Authors: Liao Li-Jen , Tung Yung-Hsin , Lin Yu-Hsuan , Hsu Wan-Lun
Published: December 2023

Background:

Speech and swallowing dysfunction are common problems in head-and-neck cancer (HNC) survivors. Ultrasound (US) is a good method to assess suprahyoid muscles and hyoid bone movement, and it can provide valuable information on swallowing. The aims of this study were to measure the biometry of the supraglottic muscles and hyoid bone movement during swallowing and elucidate the application of real-time US for assessing swallowing dysfunction.

Methods:

We collected data from HNC and thyroid cancer patients with dysphagia symptoms and healthy controls without a history of cancer or dysphagia symptoms for comparison. Real-time submental US was used to check the anterior belly of the digastric muscle, geniohyoid (GH) muscles, and hyoid bone movement during swallowing. Logistic regression analysis was used to explore significant US predictors of dysphagia. Based on the regression coefficients of independent variables, we established the nomogram prediction model for dysphagia.

Results:

There were significant differences in GH size at contraction, GH size increase percentage, GH length at rest, GH length increase percentage, anterior displacement of the hyoid bone and superior displacement of the hyoid bone between the cancer survivors with dysphagia and volunteers without dysphagia. In multivariate logistic analysis, after adjusting for sex and age, the proportion of GH length contraction <22% (odds ratio [OR]: 6.8 95% confidence interval [CI]: 1.1–42.6) and hyoid bone superior displacement <3.3 mm (OR: 10.7, 1.8–64.1) were associated with a higher risk of dysphagia (P < 0.05).

Conclusion:

We confirmed that GH muscle and hyoid bone movement are important for normal swallowing function. US is a good method to assess the suprahyoid muscles and hyoid bone movement, which could provide valuable information on swallowing.
Hepatic Sarcoidosis: Lesson Based on a Case Report
Authors: Farina Renato , Clemenza Mariangela , Borzì Santo Riccardo , Basile Antonio
Published: December 2023

Sarcoidosis is a multisystemic disease of unknown etiology that can involve lungs, abdominal organs, and lymph nodes. The incidence of sarcoidosis is highest between the ages of 20 and 40 years, and it affects both sexes equally. The most frequent localization is in the lungs, and about half of the affected patients are generally asymptomatic but can involve in small percentages of various other parts such as the biliary tract, pancreas, stomach, and urinary tract. Hepatic and splenic localization is infrequent, and lesions are often mistaken for metastases due to their morphologic similarity. The histological lesion of sarcoidosis is a noncaseous granuloma always associated with high levels of angiotensin-converting enzyme, hypercalcemia, hypercalciuria, and, in a significant percentage of cases (35%–40%), liver enzyme alteration. The pathological evolution of granulomas is fibrosis, and the most severe cases of hepatic sarcoidosis can develop into cirrhosis or portal hypertension. Imaging is essential for lesion localization and is represented by ultrasound, computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT. The differential diagnosis is very difficult and is almost always histological. We describe a case of hepatic sarcoidosis in an asymptomatic patient with elevated liver enzymes.
A systemic review on Ayurvedic and modern pharmacology of Strychnos potatorum Linn. to determine its therapeutic potential
Authors: Sharma Neeru , Yadav Yadevendra , Sharma Khem Chand
Published: December 2023

A large variety of medicinal plants have been documented in Ayurveda. Some of them are extinct or near to extinct. Seeds of Strychnos potatorum Linn. (SPLs) are known as Kataka. It is used for medicinal as well as a clarifying agent for water and self-generated alcohol. However, in the Ayurvedic compendium, very few formulations are written. Its two synonyms viz., Chakshushya (improve eyesight) and Nirmali (remove redness and other discoloration, also a clarifying agent for muddy water) is based on its therapeutic uses in ophthalmological disorders in the form of Anjana (collyrium). It has several bioactive compounds chiefly indole, alkaloids besides iridoid, glycosides, terpenoids, Polysaccharide, polyphenols, and flavonoids. Various in vitro experiments show that it has more therapeutic values than documented in the classical text. None of the study proves that it has toxic or harmful effects on the body. In this paper, a summarized compilation of traditional therapeutic and preclinical and clinical studies showed promising results for their application in a variety of disorders.Various classical books are reviewed with word Kataka, Anjana, Chakshusya, and Nirmali to describe the pharmacological action of Kataka in Ayurvedic compendium. Word-by-word searching methodology was adopted in texts review and some online research paper is also included. Psychopharmacological and pharmacological researches reveal that SPLs has Anti-inflammatory, Analgesic, Antimicrobial, Anti-allergic, Anti-diabetic, Hepatoprotective, and Mucoprotective properties.
Reported ADRs of efavirenz-based antiretroviral drugs among outpatients attending sexually transmitted infections clinic in a tertiary health facility in Northern Nigeria
Authors: Tukur Umar Muhammad , Isah Balarabe Adamu
Published: December 2023

BACKGROUND:

Adverse drug reactions (ADRs) constitute a major public health challenge and account for 8.4% of hospital admissions and are poorly reported. Highly active antiretroviral therapy (HAART) has revolutionized treatment approach to HIV-AIDs patients. Efavirenz plays a critical role in the treatment of HIV as part of HAART first-line regimen. It has a narrow therapeutic window with a significant between subjects’ variability. The type of regimen used in the management of HIV-positive patients determines the nature, time, and duration of ADRs. The incidence of these adverse effects could be as high as 50% in some cases and may warrant the discontinuation of the drug-based regimen which reverses the success recorded with grave consequences.

METHODOLOGY:

It was a cross-sectional descriptive study. Both antiretroviral-naïve and experienced participants were enrolled in the study selected by convenience from patients attending the sexually transmitted infections clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto. All were 18 years and above diagnosed with HIV. The Naranjo algorithm was used to determine the causality of the ADRs. The data were generated through a semistructured validated questionnaire and analyzed using Statistical Package for the Social Sciences IBM* version 25, IBM Corp., Armonk, NY, USA, 2017 (SPSS version 25).

RESULTS:

Up to 51.3%of all the participants had an episode at least one adverse drug event and majority were female (70.7%). Sleep disturbances and dizziness were the most cited adverse events 67.6%. No severe reactions were reported.

CONCLUSION:

The efavirenz-based combination regimen remained responsive among the HIV patients.
Upper gastrointestinal bleeding due to chronic use of paracetamol in a geriatric patient
Authors: Pandya Tejas Rajendrakuamr , Gupta Sapna D. , Rana Devang A. , Malhotra Supriya Deepak
Published: December 2023

Nonsteroidal anti-inflammatory drugs(NSAIDs) are a class of drugs commonly used for pain relief and reduction of inflammation.While they are generally considered safe and effective, they are also associated with gastrointestinal (GI) adverse events.The risk of these complications are increased in individuals with certain risk factors, such as older age (>65 years), a history of complicated peptic ulcers. The type and dose of NSAIDs used can also affect the relative risk of GI complications.Here we report a case of upper gastrointestinal bleeding in a patient taking paracetamol for tree months. Although mortality rates associated with GI complications from NSAIDs use have decreased. Therefore, individuals taking NSAIDs should be aware of the potential risks and take precautions to minimize their likelihood of experiencing these adverse events. Paracetamol is a commonly used pain reliever and an antipyretic. It is available over-the-counter and by prescription. It is generally considered safe when taken as directed.
A questionnaire-based survey on resident doctors regarding knowledge, attitude, and practice of oxygen therapy at a tertiary care teaching hospital
Authors: Mathai Jeenu M. , Chandaliya K. C. , Deshmukh J. B. , Parsode R. B.
Published: December 2023

INTRODUCTION:

Oxygen is listed as a core item on the World Health Organization model of essential medicines. Poor knowledge of using oxygen therapy in critical situations could deteriorate patient’s condition and outcome.

AIM AND OBJECTIVES:

The aim is to assess the knowledge, attitude, and practice (KAP) of oxygen therapy among resident doctors in a tertiary care teaching hospital.

METHODOLOGY:

A cross-sectional prevalidated, questionnaire-based study was employed after ethics committee approval. The sample size was calculated using Epi Info version 7, and simple random sampling was done. Data collected were analyzed using the Statistical Package for the Social Sciences trial version 25.

RESULTS:

Out of 96 residents, 59.4% of residents were from clinical and 40.6% were from nonclinical departments. Nonclinical residents (94.8%) had better knowledge than clinical residents (91.2%). More than three-fourth of residents showed a good attitude toward the practice of humidification to prevent dryness and maintain the prescribed SpO2 range for severe lung disease patients. Majority of the residents had good practice in administering oxygen therapy. About 47.9% of residents read oxygen therapy guidelines, and only 13.5% attended training on oxygen therapy.

CONCLUSION:

In this study, majority of the residents had good KAP of oxygen therapy. Formal training of resident doctors on oxygen therapy was poor. Any gap in KAP of oxygen therapy can affect patient’s safety. Extensive educational and training programs on oxygen therapy should be encouraged to raise awareness among health-care providers.
Is it a coloboma or not? A new definition for isolated lens coloboma: focal zonular dysgenesis
Authors: Larivoir Nicole B. , Marinho Paula M. , Teixeira Ivan C. , De Figueiredo Gabriel B. , Fernandes Rodrigo A. B. , Freitas Lincoln L.
Published: December 2023

Purpose:

Ocular coloboma is defined as a congenital malformation caused by defective closure of the fetal fissure, resulting in a notch in any structure. However, the entity known as “isolated lens coloboma” does not seem to have a similar etiological basis with other ocular colobomas. This congenital malformation can induce an important decrease of the visual acuity, and facectomy has an increased risk for intraoperative and postoperative complications. Better surgical planning could be achieved with an accurate definition of the diagnosis and pathophysiology of this lens abnormality, as the extent and mechanism of zonular disease will have a significant impact on the selection of the modality of intervention.

Methods:

Nine eyes of seven patients, who were diagnosed with “isolated lens coloboma” and underwent phacoemulsification and implant of intraocular lens (IOL), were studied (retrospective case series). The surgeries were performed by four different surgeons, according to their preferred technique, in the last 5 years.

Results:

There were no intraoperative complications. Two (22.22%) eyes presented postoperative complications, one of which was the IOL decentralization.

Conclusion:

Considering the ocular morphogenesis and the definition of coloboma, the ideal denomination for the congenital malformation traditionally known as isolated lens coloboma would be “focal zonular dysgenesis.” The best surgical approach, contemplating the pathophysiology, in addition to the cases described and review of literature, is discussed.
Coats disease in a female child in Colombia: A surgical success
Authors: Pérez Sara Margarita , Martínez Camilo Eduardo , Cárdenas Valentina , González María Camila
Published: December 2023

This article aims to report the case of a female child with Coats disease stage 5 who underwent posterior vitrectomy plus perfluorocarbon liquid injection, internal drainage, endolaser, and cryotherapy. Follow-up of the patient showed that although visual recovery was not able to achieve due to its severity, and anatomical preservation of the eye with an appropriate surgical approach was guaranteed.
Insights into COVID-19 in age-related macular degeneration
Authors: de Almeida Torres Rogil Jose
Published: December 2023

Studies have shown that age-related macular degeneration (AMD) patients present a poor prognosis in coronavirus disease 2019 (COVID-19). These diseases have completely different etiologies and clinical courses. COVID-19 is a systemic, fast-evolving, and lethal infectious disease. AMD, in turn, is a chronic disease triggered by oxidative stress and is considered the main cause of irreversible blindness in old age. Both COVID-19 and AMD have in common the participation of immunological and inflammatory components arising from the imbalance of the redox state, responsible for the most severe phases of these diseases. Therefore, this study aims to present the triggering pathways of these diseases, as well as analyze the possible molecular mechanisms that increase the severity of COVID-19 in patients with AMD.