bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacognostical and physicochemical profile of Abhayadi Gutika
Authors: Patil Sunny C. , Baghel Arjun S. , Kamble Shubhangi B. , Rudrappa Harisha C. , Shukla Vinay J. , Mehta Mehul D.
Published: August 2023

Introduction:

Quality standardization and maintenance of these standards is the need of the hour in this era which is showing growing demand for traditional medicines. Although Abhayadi Gutika (AG) is an important formulation in Ayurvedic pharmacopeia, it lacks scientific documentation.

Aims:

The aim was to study organoleptic, microscopic, physicochemical, phytochemical, nutraceutical, and high-performance thin-layer chromatography (HPTLC) profile of AG.

Materials and Methods:

AG was prepared and subjected to pharmacognostical analysis in which organoleptic and microscopic characteristics were identified. This was followed by analytical study comprising physicochemical, phytochemical, neutraceutical parameters, acid-neutralizing capacity, and HPTLC profile.

Results:

Pharmacognostical microscopic evaluation revealed the presence of starch grains, acicular crystals, group of fibers, sclereids, stone cells, and epicarp cells. Quantitative physicochemical analysis revealed loss on drying value as 6.37% w/w, ash value as 2.16% w/w, water-soluble extractive value as 44.37% w/w, alcohol-soluble extractive value as 37.91% w/w, and pH value as 6.5. Phytochemical analysis showed the presence of flavonoids, saponins, and tannins in the finished product. In nutraceutical evaluation, functionalities such as total proteins (4.82%), total fats (0.5%), total carbohydrates (70.48%), total sugars (48%), and crude fibers (2.5%) were observed. Acid-neutralizing capacity for AG was found to be 1.3 meq/gm. HPTLC fingerprinting exhibited five peaks (Rf values: 0.18, 0.28, 0.72, 0.81, 0.84) at 254 nm, seven peaks (Rf values: 0.09, 0.22, 0.25, 0.28, 0.53, 0.58, 0.64) at 366 nm and two peaks (Rf values: 0.64, 0.72) at 540 nm on densitogram.

Conclusion:

Preliminary profiling of AG exhibited striking pharmacognostical as well as analytical characteristics. In nutraceutical analysis, functionalities like proteins, fats, carbohydrates, sugars and crude fibers were observed. Acid-neutralizing capacity which is a measure of efficacy of medicines prescribed for hyperacidity (antacids) was found to be 1.3 meq/gm for AG which supports its therapeutic efficacy in the disease conditions like Vidagdhajirna.
Therapeutic aspects of Kashtartava (dysmenorrhea) in Ayurveda
Authors: Goel Monika , Singh Rohit , Bidhoodi Unnati
Published: August 2023

Kashtartava (painful menstruation or dysmenorrhea) is one of the common gynecological disorders observed among women. It has been described as a symptom of various diseases such as Kukshishoola, Vatala yoni, Udavartini yonivyapada, etc. in Ayurvedic classics. It is characterized by a condition in which Artava (menstrual fluid) is shedded with great difficulty and pain. Acharya Charaka has specifically mentioned that none of the gynecological disorders can arise without the involvement of vitiated Vata dosha (a type of body humor). The pain produced in dysmenorrhea is due to vitiation of Vata dosha only or in combination with other Doshas, which is the result of Vatavriddhi (elevation in the Vata level) due to Apanavayu (type of Vata), margavarodha (obstruction of channel), etc. It has been reported that around 90% of adolescent females and above 50% of menstruating women worldwide reported suffering from it, with 10–20% of them describing their suffering as severe and distressing. Owing to these facts, various classical texts of Ayurveda have been reviewed and literature search was performed using the keywords “Kashtartava, Dysmenorrhea, Menstrual pain, Menstruation, Yoni vyapada (vaginal disorder)” in various online databases in order to collect the data regarding the same. It has been revealed that Dhatukshaya (depletion of body tissues), Kopa (aggravation of Doshas), and Margavarodha (obstruction of channel) are the three prime conditions which lead to the vitiation of Vata dosha resulting in dysmenorrhea. It can be managed with various Ayurvedic preparations such as Phala ghrita, Jeerakadi modak, Maharasnadi kwath, etc. Panchkarma (five therapeutic biodetoxification procedures) such as Shatavaryadi anuvasana basti and Baladi anuvasana basti is also proved to be beneficial along with Pathya ahara and Vihara (wholesome regulated diet and lifestyle).
Total Anomalous Pulmonary Venous Connection with Persistent Left Superior Vena Cava: A Retrospective Surgical Series
Authors: Mishra Amit , Parmar Tarun , Patel Herin , Parmar Divyakant , Jain Imelda , Patel Jigar , Pandya Himani , Sharma Rajesh
Published: August 2023

Introduction:

Total anomalous pulmonary venous connection (TAPVC) is a common cyanotic congenital heart disease seen in developing countries at tertiary referral centers. Association with persistent left superior vena cava (LSVC) without innominate vein (H-connection) is an extremely rare condition which makes the surgical correction extremely challenging.

Materials and Methods:

This was a retrospective case record review of 18 patients with TAPVC in the presence of LSVC without innominate vein (without H-connection) at our institution from January 2007 to February 2021. We detail our experience of our modified surgical technique for this complex anatomy using various modifications for each type of TAPVC with LSVC in the absence of innominate vein.

Results:

Out of 18 patients of TAPVC with LSVC, 17 patients survived and are being followed up regularly. There was one mortality (5.5%) in a 5-month-old infant with double-outlet right ventricle with ventricular septal defect with severe pulmonary arterial hypertension with infracardiac TAPVC who died in intensive care unit on the 5th postoperative day.

Conclusion:

In our experience, the modified surgical technique for treating this complex variant of TAPVC is especially useful for favorable long-term outcomes with minimal incidence of recurrent pulmonary venous obstruction.
A Simple and Innovative Repair of an Incidentally Discovered Sinus of Valsalva Aneurysm during Aortic Valve Replacement
Authors: Kumar Sarvesh , Tewarson Vivek , Hakim Mohammad Zeeshan , Kumar Bhupendra , Rahul Kumar , Kumar Shobhit , Singh Sushil Kumar
Published: August 2023

The sinus of Valsalva aneurysm is a rare pathological lesion found in around 0.09% of the population. Surgical management is usually indicated for large aneurysms causing hemodynamic compromise or aneurysms that enlarge progressively. Surgical approaches for unruptured aneurysms include patch or primary closure. The article describes our technique for closing the small sinus of a Valsalva aneurysm discovered incidentally during surgery for aortic valve replacement. Interrupted pledgeted sutures placed for fixing the mechanical prosthetic aortic valve (St Judes Medical TM) were passed through the aortic valve annulus and the superior edge of the aneurysm sac, resulting in transverse primary closure of the aneurysm opening in the aortic root.
Adult Congenital Heart Disease: Surgical Correction of Total Anomalous Pulmonary Venous Connection with Severe Pulmonary Hypertension at 16 Years of Age - Perspective of Anaesthetic Management
Authors: Das Sambhunath , Srivastava Sarvesh , Talwar Sachin
Published: August 2023

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease with an incidence of 1%–3% of all congenital heart disease patients. The pulmonary veins returning oxygenated blood from the lungs are draining into the right side (right atrium or great veins), causing systemic hypoxia and cyanosis. TAPVC patients are mostly present at an early stage and need surgical correction to sustain life and prevent complications. However, some subsets of patients with TAPVC in whom the mixing of blood is happening may progress into adult life and have associated pulmonary arterial hypertension (PAH) and right ventricular (RV) dysfunction. We report a case of a young adult lady who presented to our hospital at 16 years of age with TAPVC along with severe PAH and RV dysfunction. During the perioperative period, the patient was successfully managed with pulmonary vasodilators and inotropic support. The objective of the case report was to describe the management strategy followed in the successful treatment of the patient. Due to congestive heart failure, low cardiac output status, and other factors, these individuals will also experience comorbidities such as PAH, RV dysfunction, and organ dysfunction. Patients require care in an environment that has experience handling a variety of problems and a PAH crisis. PAH can be controlled with the aid of pulmonary vasodilators such as sildenafil, bosentan, milrinone, NTG, and inhaled nitric oxide. Mechanical hyperventilation to lower pulmonary vascular resistance will also aid in treatment. When combined with intraoperative transesophageal echocardiography monitoring, the balanced anesthetic method can be used to successfully manage the majority of cases.
Parents’ perception about children screen time and myopia during covid-19 pandemic
Authors: Shetty Aksha , Naik Nehal , Usgaonkar Ugam P. S.
Published: August 2023

Purpose:

To understand parents’ perception of children’s screen time and myopia during the COVID-19 pandemic.

Methods:

In this e-survey, 413 parents were included. It was designed on the “Google Forms website and distributed through the social media platform.” The information was collected regarding parent perception of children’s screen use and time spent on digital devices during and after the post-COVID-19 pandemic and knowledge about myopia. The statistical analysis was carried out using SPSS.

Results:

In this study, 56 children were myopic according to parental responses. The majority of the parents reported their child is spending more time watching television (73%) and using smartphones (79%) which included playing video/online games (75%) and participating in e-learning (75%). 60% of parents agree that prolonged screen time is harmful to children’s eye health. It was seen that children were spending >4 hrs/day using electronic devices which is 48% since the pandemic began, up from 20% before the pandemic with aPvalue of <0.05. Overall, 75% of parents believed myopia to be a very/somewhat serious problem for their children. 61% of parents correctly answered that glasses are not the only option for myopia.

Conclusion:

Parents, as well as children, had increased screen time as compared to the pre-pandemic situation in activities like watching TV, and using a smartphone which included playing online games and e-learning. Children’s screen time had doubled compared to pre-pandemic in almost all age groups. Parents should further be educated on how to control their children’s screen time. Parents had adequate knowledge about myopia and risk factors but further awareness about it is required.
Efficacy of topical immunotherapy in the management of Ocular Surface Squamous Neoplasia (OSSN)– A retrospective analysis
Authors: Thulaseedharan Sinumol S. , Raghavan Ajithkumar V , Sankar Ashwati , Sujatha N , Vaikkakara Sudha , Krishna T Devu
Published: August 2023

Purpose:

To evaluate the efficacy of topical immunotherapy with Interferon α 2b [INF- α 2b] drops with a concentration of 3 million international units per millilitre (3 MIU/ml), in the treatment of noninvasive Ocular Surface Squamous Neoplasia (OSSN).

Methods:

A retrospective case record-based study of patients with noninvasive OSSN, who were treated with INF- α 2b drops (3 MIU/ml) during the period from January 2016 to January 2020 at a tertiary care centre in South India. The demographic details, clinical findings, slit lamp photographs, investigations, histopathological records, clinical course, mean duration of clinical and cytological resolution, any evidence of intolerance to treatment, failure to treatment, and recurrences were analysed.

Results:

Fourteen eyes of 12 patients were studied. The majority of patients were male (83%) and aged more than 50 years (83%). 64.28% of cases became disease free clinically and histopathologically in 3 months. 21.4% of cases showed partial resolution.

Conclusion:

Topical immunotherapy is an effective mode of treatment for noninvasive OSSN. The 3 MIU/mL dose of topical IFN-α2b drops helped in faster resolution. No recurrences were reported. No severe surface toxicity or intolerance was observed.
Herpes simplex virus-1 associated third cranial nerve palsy in pediatric age group
Authors: Mishra Suchismita , Mehra Lipika , Panigrahi Pradeep Kumar , Sahoo Lulup Kumar
Published: August 2023

A 4-year-old female patient presented with drooping of the right upper eyelid of 10 days duration. There was a history of low grade fever 15 days ago which subsided with the use of oral paracetamol. Abnormal head posture with mild upper lid ptosis was noted on right side. Right pupil was fixed and mid-dilated. She was diagnosed with right-sided third cranial nerve palsy. Serum and cerebrospinal fluid samples were positive for IgM antibodies to herpes simplex virus-1. The patient was treated with systemic steroids and anti-virals. The patient responded well to treatment, and there was complete resolution of ocular signs 45 days after presentation.
Bilateral giant dacryocele in a case of Tessier cleft-3
Authors: Agrawal Sahil , Modaboyina Sujeeth , Gupta Saloni , Das Deepsekhar
Published: August 2023

Tessier cleft-3 represents diverse clinical presentations, from simple notch in nasolabial groove to bilateral forms with cranial extensions. We report a 10-year-old child with facial features of Tessier cleft-3 and associated epiphora due to an abnormally dilated nasolacrimal duct on imaging. No previous associations of giant dacryocoeles have ever been reported.
Blind spot in ultrasound central corneal thickness measurement – Central corneal thickness of apex versus central corneal thickness of vertex
Authors: Ramesh Prasanna Venkatesh , Parthasarathi Sathyan , Ashok Abhinay , John Rajesh Kumar
Published: August 2023

Aims:

This study aimed to compare central corneal thickness (CCT) using ultrasound pachymetry (USP) (CCT apex) and specular microscopy (CCT vertex) and also to find out the intra-reading variability from the two instruments.

Settings and Design:

A prospective, observational study was conducted in a tertiary eye care center in southern India.

Materials and Methods:

This study was conducted on 12 patients (24 eyes, 96 data set eyes, 768 data points in total) aged 20–50, in non-pathological corneas. Eight CCT measurements by specular microscopy and eight measurements by USP were taken by two different experienced observers on day 1, followed by repeating the same on day 2.

Statistical Analysis:

The readings were averaged and compared by paired t-test. SPSS software was used for statistical analysis. Variability between the eight readings produced by the same instrument was calculated and coefficient of variation was plotted. Inter-examiner variability and intra-examiner variability of the two modalities were studied, and it was considered statistically significant if P < 0.05.

Results:

The mean CCT by USP was 522.71 µm and the mean CCT by specular microscopy was 519.43 µm. The coefficient of variation of the eight readings varied significantly between the machines. On an average, the coefficient of variation was 0.4% compared to 0.8% in specular microscopy and USP, respectively.

Conclusion:

The intra-reading variability of ultrasound CCT is twice as that compared to specular microscopy. The clinical relevance of this spread is relevant and important in modern-day practice. Hence, it is better advisable that CCT readings from both the modalities, not be used interchangeably.
Evaluation of tacrolimus and cyclosporine in the treatment of vernal keratoconjunctivitis in children
Authors: Suresha A. R , Shashidhar Gaargi , Prabhudeva H
Published: August 2023

Aims:

To compare the efficacy and safety of 0.03% tacrolimus eye ointment with 2% cyclosporine eye drops in the treatment of vernal keratoconjunctivitis.

Settings and Design:

Comparative, Hospital-based, Prospective, Randomized, Clinical study.

Methods and Material:

About 56 children diagnosed with Vernal keratoconjunctivitis (VKC) were enrolled in the study. All the subjects underwent a comprehensive ophthalmic evaluation. Total subjective symptom scoring (TSSS) and Total objective sign scoring (TOSS) were done for each patient based on their history and clinical examination. They were divided into two groups. One group was treated with 0.03% tacrolimus ointment bd and the other with 2% cyclosporine eye drops tid. Both groups were also put on carboxymethylcellulose eye drops four times a day. Steroids were never used during the study. The patients were followed up at intervals of two weeks, four weeks, and eight weeks. At each follow-up, the TSSS and TOSS were done for each patient. Patients were also questioned about any adverse effects encountered by them during the treatment. A comparison was done between both groups based on the above scoring.

Results:

There was progressive reduction which was statistically significant (P < 0.05) in the TSSS and TOSS in both the groups throughout treatment. Reduction in TSSS The only adverse effect reported by a few patients was a burning sensation that was not severe enough to discontinue treatment.

Conclusions:

Both tacrolimus 0.03% eye ointment and cyclosporine 2% eye drops are effective in the treatment of VKC without any significant severe side effects. Tacrolimus eye ointment was more effective than cyclosporine drops.
Normative Reference Values for Functional, Lateral, and Oblique Direction Reach Tests in Saudi Children Aged Six to 15 Years Old and Psychometric Properties of the Oblique Direction Reach Test
Authors: Tedla JS , Sangadala DR , Gular K , Reddy RS , Alshahrani MS , Ahmad I , Abohashrh M
Published: August 2023

Aims:

To establish normative values for functional, lateral, and Oblique Direction Reach Tests (ODRT) and to assess the validity and reliability of the ODRT in Saudi children of age 6–15 years.

Methods:

Three hundred Saudi children of age 6–15 years children were recruited by using snowball sampling. Children were measured for distance reached in forward, lateral, and oblique direction on a graph paper, which was mounted on a wall/cardboard.

Results:

The Mean ± SD for forward, lateral and oblique direction reach was 25.63 ± 6.95, 18.91 ± 5.66, 22.08 ± 5.98 cm respectively. The Intraclass Correlation Coefficient values of intra and inter-rater reliability of ODRT shown to be 0.94 and 0.91, respectively. Concurrent validity of ODRT with forward and lateral reach test is 0.87 and 0.84, respectively.

Conclusion:

We established the normal values for functional, lateral, and ODRT in 6–15 years of Saudi children. We found that ODRT is a valid and reliable for measuring limits of stability in oblique direction.
Mismatch Repair Protein Expressions in Cohort of Colorectal Carcinoma Patients in Lagos
Authors: Badmos KB , Adebayo LA , Osinowo AO , Lawal AO , Habeebu MY , Rotimi O , Abdulkareem FB
Published: August 2023

Background:

Colorectal carcinoma (CRC) is a major cause of morbidity and mortality worldwide. Microsatellite instability pathway is important in the pathogenesis of CRC. Immunohistochemistry expression of mismatch repair (MMR) proteins serves as surrogate marker for MMR gene mutation.

Aims:

This study aimed to determine MSI status of a cohort of CRC cases using immunohistochemistry.

Materials and Method:

Surgical pathology blocks of resected colonic carcinoma (CC) between 2011 and 2015 were extracted from our departmental archives and The Specialist Laboratories in Lagos. Immunohistochemical expression profile of 4 MMR proteins was assessed in the representative blocks and this was correlated with the demographic and pathological characteristics.

Results:

There were 19 males and 16 females with CC, mean age of 51.6 years, and 40% of them were below 50 years of age. Twenty (57.1%) out of the 35 CC cases seen were mismatch repair proficient (pMMR) while the remaining 15 (42.9%) were mismatch repair deficient (dMMR). Seven dMMR cases were seen equally on the right and left colonic tumors respectively. Five (71.4%) out of the 7 mucinous tumors in this study were dMMR, right sided with 3 of them in patients who were below 50 years of age.

Conclusion:

The frequency of mismatch repair deficiency in CC among Nigerians is high, and presence of right-sided mucinous colon cancer in patients below 50 years is highly suggestive of dMMR status. Mutation studies of larger patient samples to determine the percentage with germline mutation will further our knowledge, and influence therapeutic options for CC.
Parent Participation in Early Intervention/Early Childhood Hearing Impairment Program
Authors: Sevinç Ş , Şenkal ÖA
Published: August 2023

Background:

It is a well-known fact that the parents play a key role in the early intervention program for their deaf and hard of hearing children.

Aims:

This study aims to focus on issues related to the need for a collaborative, supportive and parent centred early intervention programs and (re)habilitation process for the children with hearing aids or cochlear implants for sustainable health. This study was a retrospective case control study.

Subject and Methods:

Sixty parents (30 parent educated and 30 non- parent educated) were completed a Profile Questionnaire and a Family Awareness and Knowledge Questionnaire. The first questionnaire was designed to obtain the information related with the demographics of the family and their deaf or hard of hearing children. The latter was used to evaluate the knowledge of parents about their hearing handicapped children. All statistical analyses were performed with IBM SPSS Statistics, Version 22.0 software (Armonk, NY: IBM Corp).

Results:

The parent awareness and knowledge of children with cochlear implants differed from those of control group who do not receive any family counselling, but not in clinically significant ways.

Conclusions:

Some of the variability in cochlear implantation outcomes that have protracted periods of development is related to family environment. Because the family environment can be modified and enhanced by therapy or counselling, these preliminary findings hold promise for future work in helping families for sustainability in health.
Schooling and Nigerian Children with Asthma
Authors: Kuti BP
Published: August 2023

Epidemiologic studies have reported increasing prevalence of childhood asthma in Nigeria and other developing countries where there are parallel increases in school enrolments. Children with asthma face lots of challenges in school which can affect their academic performance and quality of life. This narrative review highlights the challenges and the risks of schooling encountered by Nigerian children with asthma and the prospects of utilizing the School Health Programme (SHP) to overcome these challenges. An electronic search of relevant published articles from 2000 to 2020 was carried out using appropriate search engines for the following words: “schooling”, “childhood asthma”, “school health programme”, “school environment,” “health instructions”, “school health services” and “asthma care in schools”. The challenges and risks the school age asthmatics encounter in school include discrimination and victimization, exposure to triggers on the road and in the school environment, poor and non-existence asthma care services in schools, suboptimal knowledge of teachers and caregivers about childhood asthma hence poor asthma-related instructions and increased school absenteeism. The prospects of SHP as a tool to overcome these challenges are highlighted. These include the roles expected to be played by all stakeholders – the government and education authorities need to revise and more effectively implement the school health policy. The roles of asthma care professionals include the need to “adopt” schools to ensure optimal asthma care for the school population and the all-important enlightenment of teachers, school health workers, parents/caregivers and school children for overall improved asthma care delivery in Nigerian schools.
Comparison of Orthodontic Treatment Need among Professionals and Parents in Dammam, Saudi Arabia
Authors: Al-Khalifa KS , AlDabbus HR , Almadih AI , Alaqeeli HM , Almarshoud AA , Muhana MH , Alzaidani SD , Nassar EA
Published: August 2023

Aims:

This study aimed to assess parents' awareness and attitude regarding their children's malocclusion compared with professional assessments and to measure the prevalence of malocclusion among children in Dammam, Saudi Arabia.

Methods:

The study population consisted of 377 randomly selected children (aged 8–12 years) from five schools in Dammam, Saudi Arabia. A questionnaire was used to assess parents' awareness using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and knowledge about preventive orthodontics. A clinical examination was performed by two calibrated examiners to measure the prevalence of malocclusion using both the AC and dental health component (DHC) of IOTN.

Results:

The most common Angle's molar relationship was Class I (78.2%), followed by Class II (17.5%) and Class III (4.2%). The DHC (score 3–5), which indicated the need for orthodontic treatment, was 55.4%. There was a significant difference (P < 0.05) between AC from examiners and parents, whereby the parents tended to underestimate their children's malocclusion by a factor of 1.45. Surprisingly, many parents (67.4%) lacked knowledge about preventive orthodontics.

Conclusions:

Class I malocclusion was most prevalent among children in the area of Dammam. A moderate percentage (55.4%) of the study subjects required treatment based on the DHC. Based on the lack of knowledge about preventive orthodontics in the majority of parents in our study, it is recommended that oral health-promoting programs be implemented to improve the awareness of malocclusion in the region.
The Measurement of Different Diaper Parameters for the Evaluation of Postcircumcision Bleeding and Their Significance for the İnfant's Health
Authors: Akman M
Published: August 2023

Background:

Evaluation of circumcision bleeding cannot depend on the visual change in the diaper. Diapers have different product features and absorbency capacities. The apparent changes in the diapers may vary according to their absorbent capacity and may not be in parallel with the amount of bleeding. Before significant visual difference occurs, the patient's hemodynamics may be impaired.

Aim:

Aim of the study is to evaluate better circumcision bleeding.

Patients and Methods:

Patients were divided into groups according to 12 different brand diapers of the same size, containing super-absorbent material. The study started by 15/01/2022, and finished by end of 01/03/2022. Diapers with concealed brands were soaked with blood with equal hematocrit value in 100 ml with increments of 5 ml. 252 images were obtained by taking 21 images of each diaper with the same method. The diapers were evaluated colorimetrically, and numerical values were obtained showing the color differences in red, green, and blue and saturation and lightness. Working groups were formed according to 12 different brands of diapers of the same size, containing super-absorbent material. Standard statistical tests were performed using obtained values.

Result:

Dry diapers had different weights, volumes, and specific gravities; the diapers with the lowest unit weight were ranked ninth in terms of volume; the diapers with the highest specific gravity were ranked third in terms of thinness. There were significant differences in the blood on the diaper, and significant differences between some groups (p < 0.005); on the other hand, there was not any difference between some other groups (p > 0.05). There was a significant relationship in terms of Analysis of Variance (ANOVA) (P < 0.05 and P < 0.01). Visual graphic examination showed that linear but non-parallel color changes occurred. As the blood load increased, the visual and statistical differences between the diapers became more pronounced, and the curves diverged.

Conclusion:

Visual evaluation of the color change of the diapers may not give accurate results for bleeding follow-up. If necessary to use diapers after circumcision, it is more appropriate to prefer those with low absorbency capacity. Using fabric or cotton products in cases with bleeding risk may be recommended. If bleeding is suspected, hemogram control is the most appropriate option. Diaper manufacturers should warn consumers of the risk. In conclusion, we should be on the safe side for mortality and morbidity.
Are The Perfusion İndex and Pleth Variability Index Title an Early İndicator of Brachial Plexus Block?
Authors: Koca E , Öterkus M
Published: August 2023

Background:

Studies on the evaluation of the Perfusion Index (PI) and the Pleth Variability Index (PVI) and the success of PI and PVI block in patients undergoing brachial plexus are limited and quite inadequate.

Aim:

In our study, we aimed to compare PI and PVI between the interscalen block and infraclavicular block and evaluate its use as an early marker in block success.

Patients and Methods:

Single-center prospective randomized controlled trials. Preoperative unit, operating room. Patients over 18 years of age who have had upper extremity surgery. Brachial plexus block (interscalene, infraclavicular). Demographic data, Hemodynamic parameters, Perfusion index and Pleth Variability Index. 40 patients, including ASA1-2, 20 patients over the age of 18, who were planned for upper extremity surgery, in the interscalen group, and 20 in the supraclavicular group, were included in the study. Demographic data of the patients were recorded by measuring PI and PVI values at baseline before the block and at the 1st, 5th, 10th, 15th, and 20th minutes after the block, both simultaneously.

Results:

62.5% (n = 25) of the patients included in the study were female. The mean age of the patients was detected as 52.63 ± 16.472, the mean BMI as 26.57 ± 4.423, and the mean entry hemoglobin level as 13.71 ± 1.87 g/dL. The hemodynamic data of the groups were similar across the time periods. The increase in PI increased significantly after 1 minute in both groups. The PVI was similar between the groups at all measurement times.

Conclusion:

In our study, we observed an increase in PI from the 1st minute compared to the non-blocked arm in successful block applications. We consider the early indicator of PI in the evaluation of block success. In our study, we did not observe a significant change in the arm that was blocked and the arm that was not treated with PVI.
A Rare Complication of Pica
Authors: Ekinci F , Yildizdas D , Horoz OO , Kilic S , Gokay N
Published: August 2023

Tracheobronchial foreign body aspiration (FBA), a common pediatric presentation to emergency departments, is still a public healthcare problem affecting children all over the world. There are several types of foreign bodies reported from different parts of the world, including both organic or nonorganic substances. Pica, another interesting clinical entity, is characterized by persistent eating of nonnutritive substances, which is inappropriate for the maturation stage of the individual. A 3-year-old pediatric patient was admitted to our emergency department with a 3-day history of coughing and new onset respiratory distress. A chest X-ray was performed and it showed a suspicious radiopaque foreign body in the localization of left bronchi. Urgent rigid bronchoscopy was performed. The foreign body in the left main bronchi was, surprisingly, a 0.5–1 cm diameter, irregularly shaped stone particle. The laboratory evaluations and patient history revealed the diagnosis of severe iron deficiency anemia and accompanying pica. Stone aspiration, as an FBA, is a rare but potentially life-threatening complication of pica. Iron deficiency anemia accompanied by pica should be diagnosed and treated in the early stage of the disease because of their complications. According to our knowledge and literature search, this is the first case of stone aspiration as a complication of severe iron deficiency anemia and pica.
Adolescents' Usage and Attitude Toward Contact Lenses
Authors: AlSaqr AM , Al-Zahrani HA , Alghamdi SK
Published: August 2023

Aims:

The aim of this study was to explore adolescents' (11–20 years) usage of, beliefs in, attitudes toward, and barriers to contact lens use in Riyadh, Saudi Arabia.

Method:

The study recruited 1252 healthy participants from 20 highly populated schools. The schools were selected at random from middle and high schools in Riyadh. A self-administered contact lens questionnaire was used directed towards glasses usage and contact lens knowledge, usage, attitudes, and barriers.

Result:

A total of 726 of the 1252 participants had refractive errors, and 47% of those wore glasses. The proportion of non-compliance was 24%. One of the main reasons of non-compliance was cosmetic appearance (26%). Fewer than 10% were offered contact lenses for refractive error correction. One hundred and fifty-nine participants used contact lenses, and most obtained them without proper professional consultation. About 90% of contact lens-wearing participants did not sleep with the lenses and about 50% had no complications wearing them.

Conclusion:

The percentage of contact lens users was relatively low. A substantial number of older adolescents and females were found to wear contact lenses, although without proper professional consultation. Knowledge of and attitudes toward contact lenses among adolescents were in acceptable levels. These results gave indications that contact lens usage in adolescents can be achievable and valuable for refractive error correction, especially for those who are non-compliant with glasses.
Allergic Rhinitis
Authors: Tukur AR , Mahmud A , Jibril YN , Jalo RI , Salisu Abubakar Danjuma
Published: August 2023

Background:

Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction involving nasal mucosa characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness, and eyes itching. Tympanometry is a simple, rapid, and objective test that can be easily carried out. The use of tympanometry in clinical setting can improve detection of middle ear effusion and other middle ear abnormalities. AR has been found to be one of the predisposing factors to developing Otitis Media with Effusion (OME) in children.

Patients and Methods:

A case–control study was used to determine the prevalence of OME among children with AR as cases and those without allergy as controls. The study participants were children aged 4–12 years with clinical diagnosis of AR attending ENT clinics of Aminu Kano Teaching Hospital, whereas controls were children age 4–12 years without history of AR, ear diseases, or other respiratory system related ailments attending general outpatient clinics in Aminu Kano Teaching Hospital. An interviewer-administered score for AR (SFAR) questionnaire was filled out for all the participants, those with score of 6 and above were selected as cases. The two groups had complete ENT examination and tympanometry done, findings were recorded, and analyzed using SPSS version 21.

Results:

The mean age of the cases was 6.8 ± 2.1 years, whereas it was 7.5 ± 2.6 years for the controls. The mean difference was 0.7 and was not statistically significant (t = 2.35, df = 258, P value = 0.20). Type B tympanogram suggesting OME was found in 7.3% of subjects and in 2.8% of controls. Type C tympanogram suggesting negative middle ear pressure was found in 15.5% of subjects and in 4.6% of controls. Type A tympanogram suggesting normal middle ear pressure was found in 75% of subjects and in 90% of controls. Acoustic reflex was found to be absent in 29.6% of subjects and in 15.4% of controls and this found to be statistically significant (χ2 = 7.77, df = 1, P value = 0.001). The difference between type A, B, and C tympanograms of subjects and that of controls was found to be statistically significant (Type A χ2 = 14.62, df = 4, P value = 0.01, Type B χ2 = 14.06, df = 4, P value = 0.01, Type C χ2 = 17.01, df = 6, P value = 0.01). Type B tympanogram was used as an indicator to suggest OME for the purpose of this study.

Conclusion:

Participants with AR were found to have more abnormalities of tympanometric parameters and higher prevalence of type B tympanogram suggesting OME than controls.
Measurement of Dental Implant Stability by Two Different Techniques
Authors: Koçak-Büyükdere A , Kayabay G
Published: August 2023

Objectives:

To measure dental implant stability by two noninvasive methods which are vibration characteristics of the periodontium Periotest® and resonance frequency analysis Osstell. The objective of this comparative study was to assess the correlation of these 2 techniques in clinic. Materials and Methods: Implant stability of 54 clinically stable unloaded implants in 10 males and females (mean age: 52.05 ± 8.42) was measured in triplicate by Osstell and Periotest®. The measurements were taken first in the same day of the surgery and the second was 4 weeks later. Statistical analysis was performed with SPSS 22.0 (P < 0.05). Results: The mean values were 75.90 ± 5.13 ISQ for the resonance frequency analysis and − 4.31 ± 1.43 PTVs for Periotest. There was no significant difference in first and the second measurements accordance with gender. However, a significant difference was shown in ratio of percentage change for both PTV and ISQ values in female patients. There was a positive strong correlation between mean percentage changes of PTV and ISQ values (P = 0.811, P = 0.001). The only significant difference between ISQ values and implant length was observed at 4 weeks (P = 0.037).

Conclusions:

Although Periotest® values appear to be more susceptible to clinical conditions, both measuring techniques are applicable in the assessment of implant stability.
Evaluation of the Mode of Failure of Abutments Supporting Implant-Supported Fixed Partial Dentures Via Different Retention Techniques
Authors: Alqahtani F , AlHomidhi M
Published: August 2023

Objective:

The objective was to in-vitro evaluate the mode of failure of abutments supporting fixed partial dentures (FPDs) via different retention techniques.

Materials and Methods:

Thirty-six implants with diameter and length of 4.5 and 13 mm, respectively, were used to prepare 18 samples of FPDs. Based on the variations on abutment's design, the FPDs were divided into three groups: Group A is cement-based retention; Group B is screw-based retention; and Group C is multiunit screw-based retention. Using a chewing simulator, cyclic loads of 1,250,000 load cycles with the load of 70N were applied on all samples to simulate 5 years of human functional chewing. The samples were loaded until failure using an electromechanical test machine. Sample-size estimation was done and fracture-load values were recorded as means and corresponding standard deviations; and group comparisons were done using one-way analysis of variance and Tukey's post hoc tests. A P value below 0.01 was nominated as an indicator of statistical significance.

Results:

In total, 36 samples (12 implant-abutment connections per group) were assessed. Abutment bending was observed in 6 (50%), 6 (50%) and 6 (50%) samples in groups A, B and C, respectively. De-attachment of the FPD form the abutment occurred in 5 (41.7%) and 5 (41.7%) samples in groups A and C, respectively. Screw fracture and fracture of FPD at the connector side occurred in 1 (8.3%) and 1 (8.3%) sample in groups A and C, correspondingly. Failure of the FPD was more often encountered in groups A (100%) and C (100%), compared to group B (50%).

Conclusion:

All abutments underwent failures under cyclic loading with abutment bending being the most common failure mode. Cement- and multi-screw-supported abutments fail more often than screw-supported abutments.
Emotional Intelligence and Perceived Stress among Female Dental Students at King Khalid University, Saudi Arabia
Authors: Zakirulla M , Mustafa MM , Fageeh SN , Alghothimi AA , Kaleem SM , Kota MZ
Published: August 2023

Objective:

To assess the emotional intelligence and identify the perceived sources of stress among female dental students and interns at King Khalid University College of Dentistry (KKUCOD), to investigate whether specific stressors were related to the year of study and gender, and to evaluate the relationship between emotional intelligence (EI) and perceived stress (PS).

Materials and Methods:

Total of 150 female undergraduates from 5th and 6th years and dental interns were invited to complete a questionnaire using face-to-face interview. Data on EI was collected using a scale developed by Schutte et al. while a modified version of the Dental Environment Stress (DES) was applied to assess the stress perceived by dental students.

Results:

120 students agreed to join the study with a response rate of 84%. Mean EI score for the sample was 120 (SD = 11.56), and the mean PS score was 70.37 (SD = 16.19). One-way ANOVA revealed a significant difference between different age groups and the educational, environmental score (P < 0.05). Correlational analysis showed that the PS scale and its factors correlated positively with each other (P < 0.01) and directly with the total EI score (P > 0.01); except for the living accommodation factor, negative correlations with overall EI score were significant.

Conclusion:

The present study showed that female interns and undergraduate students in clinical years of study at College of Dentistry reported higher EI and PS. The educational environmental score was found to be significantly different among different age groups. In contrary to most published literature, a direct association between EI and PS scores was found, except for the living accommodation factor. This might be attributed to the fact that the study was conducted 1 month prior to final exams. Living accommodation, personal factors, educational environment, academic work and clinical factors were identified as significant predictors of PS.
Review of Anterior Submuscular Transposition of Ulnar Nerve for Cubital Tunnel Syndrome
Authors: Ergen E , Ertem K , Karakaplan M , Kavak H , Aslantürk O
Published: August 2023

Objective:

In this study, we report the results of patients who underwent ulnar nerve submuscular anterior transposition surgery due to cubital tunnel syndrome.

Methods:

Data of 46 patients who underwent anterior submuscular transposition surgery due to cubital tunnel syndrome between January 2010 and December 2014 were retrospectively reviewed. Twenty-seven patients with preoperative and postoperative complete medical records available and who had completed at least 24 months follow-up were included in the study.

Results:

According to preoperative McGovan staging system, 1 patient was classified as stage 1, 8 were stage 2A, 3 were stage 2B, and 15 were stage 3. The mean follow-up time was 61.4 (35–88) months. The mean DASH score of the patients was calculated as 19 (0–81.81). Mayo elbow performance score was excellent in 13 patients, good in 7, fair in 6, and poor in 1.

Conclusion:

Anterior submuscular transposition of ulnar nerve had resolved symptoms 89% of our patients. The technique is a successful method with a low recurrence and complication rate.
A Rare Case of Raoultella Planticola Peritonitis in a Chronic Ambulatory Peritoneal Dialysis Patient and Review of the Literature
Authors: Yilmaz U , Kizilates F
Published: August 2023

Peritonitis is a common and serious complication of peritoneal dialysis and often primary factor of change over to hemodialysis treatment. Raoultella planticola is known as as environmental bacterium and rarely causes infections in humans. We present a case of peritoneal dialysis related peritonitis due to Raoultella planticola and review the clinical manifestations and treatment options of this microorganism. As far as we know, this is the third case of Raoultella planticola peritonitis in the literature.
Non-Invasive Ductal Carcinoma within Malignant Phyllodes Tumor of the Breast
Authors: Erdogan O , Parlakgumus A , Turan U , Toyran T , Irkorucu O
Published: August 2023

Phyllodes tumors are uncommon breast neoplasms that constitute of 1-2% of breast malignancies. The tumor can mimic fibroadenoma clinically, radiologically and histologically. Ductal carcinoma in-situ in the epithelial component of phyllodes tumor is very rare. When ductal carcinoma in-situ is detected within the specimen, the management of treatment changes completely. We report a rare case of low grade ductal carcinoma in-situ arising in a malignant phyllodes tumor in a 55-year-old female patient.
Resistance Training Exercises for Obese and Non-Obese Individuals Living in High-Altitude Regions Utilizing Biochemical Markers—A Controlled Trial
Authors: Ahmad I , Zaman GS , Silvian SP , Alshaharani MS , Ahmad I , Mansuri N , Fayazuddin S
Published: August 2023

Background:

High-altitude disease prevalence varies according to types of exposure and the effects of hypoxic and hypobaric environments, with the result that people at high altitudes present many different physiological responses.

Aims:

The research aims to analyze the effects of resistance training (RT) exercises at high altitudes on obese subjects and to explain the determinants that make obese people more susceptible to various chronic illnesses such as diabetes mellitus, hypertension, asthma, etc.,

Methods:

This study recruited 225 subjects living in the high-altitude region of Aseer, Saudi Arabia, and divided them into three groups. The first two groups consisted of obese people, out of which one group received RT and one did not. The third group consisted of average-weight individuals, according to their BMI, who received RT. Biochemical parameters were checked for all three groups before commencing with the RT and at the 4th and 8th week to measure the effects of the exercise.

Results:

Mean and standard deviations of the demographic variables: age was 34.2 ± 8.9 years, weight was 69.3 ± 8.5 kg, and height was 1.6 ± 0.06 meters. RT had a significant effect on the total levels of cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, adiponectin, interleukin-6, and testosterone. Post-hoc comparisons using the Fisher's Least Significant Difference test indicated that the mean scores between the groups differed significantly.

Conclusion:

Our findings show that RT would be a useful and practical substitute to improve the health status of obese patients. It helps to decrease body fat and to improve lipid profiles and hormonal control.