bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing the Combined Effects of Axial Loads and Bending Moments on Unequal-Angle Steel Members
Authors: Hsu Wei Ting , Chung Shu Ti
Published: August 2024

Angle steel is commonly used in inclined bracing components such as transmission towers. Due to its inherent section characteristics, unequal angle steel undergoes angular rotation when subjected to eccentric axial pressure, resulting in a change in the direction of action along the X and Y axes. In comparison to equal angle steel, the analysis of unequal angle steel is more complex. In design, particular attention should be given to whether the angle steel section is compact or noncompact, with a significant emphasis on the impact of the width-to-thickness ratio on strength. In study analyzed nine different angle steel sections, revealing that two of them exhibit a phenomenon known as control point transfer. This is especially prone to occur with shorter lengths of angle steel components, leading to Leg Local Buckling. In contrast, longer components are more susceptible to Lateral-Torsional Buckling. Summarizing the research findings, it is recommended to exercise caution when using non-compact section angle steel in design, and a preference for compact sections is advised to ensure the safety of the structure. Furthermore, it is advised to pay attention to the parameter βw in the AISC unequal angle steel calculation formula and adhere to relevant specifications to enhance the accuracy and reliability of structural design.
Systemic Mastocytosis Successfully Managed using Cytosorb® During Cardiopulmonary Bypass for Aortic Valve Replacement
Authors: Gross Adrien , Colombier Sébastien , Arlettaz Lionel , Delay Dominique
Published: August 2024

We describe the case of a 72-year-old male with a history of systemic mastocytosis scheduled for on-pump aortic valve replacement for severe aortic insufficiency. Anesthesia and peri-operative management included avoidance of histamine-releasing drugs, methylprednisolone and clemastin prophylaxis. Furthermore, a CytoSorb® cartridge has been added to the bypass circuit and hemoadsorption was performed throughout the entire cardiopulmonary bypass (CPB) duration. CytoSorb® is a hemoadsorption device designed to remove various cytokines and drugs from the blood. The use of CytoSorb® during CPB in our case was not associated with adverse events, and the patient did not present any allergic or anaphylactic reaction.
Maintaining a Bloodless Field for HeartMate 3 Placement: Splicing an RVAD Outflow Cannula into the CPB Venous Reservoir for Complete LV Emptying
Authors: Walker Justin W. , Roberts S. Michael
Published: August 2024

Over the previous 20 years, the use of extracorporeal membranous oxygenation (ECMO) as a bridge to durable left ventricular assist device (dLVAD) increased significantly. Additionally, emerging literature has demonstrated a protective effect of biventricular decompression while on ECMO, with one such strategy including a temporary LVAD and right ventricular assist device (RVAD). The complexity of these operations is increased by the frequency of re-sternotomies, which result in adhesions and difficult access to traditional cannulation sites. In this case report, we present a patient presenting for a re-sternotomy for dLVAD on biventricular support in whom the RVAD outflow cannula was spliced into the cardiopulmonary bypass venous reservoir by the cardiac anesthesiologist. This innovative cannulation strategy allowed for continuation of RVAD flows to prevent thrombosis and active venting of the pulmonary artery to facilitate a bloodless surgical field.
The Shared Airway: Tracheal Mass Excision
Authors: Shringarpure Amruta , Saba Surendhar , Umbarkar Sanjeeta , Sarkar Manjula
Published: August 2024

We report a case of successful airway management of a 26-year-old male patient who was posted for tracheal mass excision. The main challenge in such a case is to formulate a plan to provide maximum surgical access to the trachea for mass excision through an intraoral approach while ensuring adequate oxygenation and airway management. The patient presented with acute respiratory distress in the emergency ward. On computed tomography (CT), the patient was diagnosed with a polypoidal tracheal tumor occluding more than 90% of the tracheal lumen and 5.8 cm away from the carina. The case was successfully managed using a peripheral bypass for airway management. After the removal of the tumor, a tracheostomy tube was placed through the tracheotomy hole used for tumor excision. The whole process was uneventful.
Outcomes of Surgical Treatment of Diaphyseal Fractures of Long Bones in Children and Adolescents through Open Reduction and Intramedullary K-Wire Fixation at Yopougon Teaching Hospital, Abidjan (Côte d’Ivoire)
Authors: Thomas Helen Audrey , Bationo Elysée Yves , Mieret Jean Claude , Yaokreh Jean Baptiste , Koffi N’goran Eric , Odéhouri-Koudou Thierry Hervé , Kouamé Bertin Dibi , Ouattara Ossénou
Published: August 2024

Background:

Nowadays, elastic stable intramedullary nailing is a well-accepted method for treating paediatric diaphyseal fractures, but it requires fluoroscopy that is lacking in our practice. For this reason, we have systematically performed open reduction and intramedullary Kirschner-wire fixation (ORIKF). The objective of this study was to assess ORIKF-related functional and radiological outcomes for the treatment of paediatric long bone fractures in the context of limited resources.

Patients and Methods:

From January 2010 to October 2019, 70 children (71 fractures) with an average age of 10.6 years sustaining closed displaced long bone diaphyseal fractures have been treated by ORIKF without fluoroscopy at Yopougon Teaching Hospital. They had their medical records reviewed retrospectively. Fractures were located in femur (n = 42), tibia (n = 11), humerus (n = 6) and forearm (n = 12). Pre-operative time, length of hospital stays, bone union time, nail removal time and complications were recorded. Functional and radiological outcomes were assessed according to Flynn’s criteria for lower limb and the Price’s criteria for upper limb.

Results:

The average follow-up time was 21 months. The results were excellent for 58 cases (81.7%), good for 8 (11.3%) and poor for 5 (7%). The average time to surgery was 10.8 days. The average in-patient stay was 11.1 days. Bone union duration was 12.3 weeks on average. The average time for nail removal was 8.1 months. According to Moroz’s system, minor complications occurred in 33 cases (46.5%); major complications were observed in four cases (5.6%) and they consisted of two cases of osteomyelitis (2.8%), 1 case (1.4%) of compartment syndrome and delayed union, respectively. Complications associated with bone recovery were reported in 10 patients (14.3%).

Conclusion:

Despite the open reduction of the fractures, the results were satisfactory in 9 out of 10 patients with few major complications in a context of limited resources.
A Comparative Study on the Effect of Different Management Options on Body Mass Index in Overweight Polycystic Ovarian Syndrome Patients at a Tertiary Care Hospital
Authors: Krishna U. R. Namrutha , Nazrin T. M. Safhana , Biju Abin , Joseph Merrin
Published: August 2024

Introduction:

According to the data from the World Health Organization, polycystic ovarian syndrome (PCOS) may affect as many as 116 million women worldwide (3.4%). The main objective of the study was to determine the effectiveness of treatment on the body mass index (BMI) of overweight PCOS patients.

Materials and Methods:

This prospective, observational study was conducted from December 2022 to February 2023 and 252 PCOS patients were included in the study.

Results:

A detailed analysis of the risk factors in the study population concluded that a family history of the PCOS, lack of exercise, regular consumption of fast food, broiler chicken, high sugar, soft drinks, and packed foods had contributed to the lifestyle syndrome, where each showed a P = 0.0001.

Conclusion:

The comparative analysis of the treatment effectiveness in terms of BMI among three treatment strategies—(1) medication, (2) lifestyle, and (3) medication along with lifestyle established the conclusion that the treatment with lifestyle alone and lifestyle along with medication together showed similar extend in weight reduction in overweight PCOS patients after performing post hoc statistical analysis. However, a greater proportion of people who experienced weight reduction falls under lifestyle + exercise.
A Prospective, Randomized, Comparative Study between Dexmedetomidine and Buprenorphine as an Adjuvant to Ropivacaine in Ultrasound-guided Supraclavicular Brachial Plexus Block for Upper Limb Orthopaedic Surgeries
Authors: Sangeetha C. , Kumar Malathi Anil , Bathalapalli Aparna , Kumar K Bharath , Malashree G , Heggeri Vijayakumar M
Published: August 2024

Introduction:

Supraclavicular approaches serve as a common method for administering regional anesthesia in upper limb procedures. In improving the impact with a length of pain relief, medical professionals frequently include additional substances such as dexmedetomidine, buprenorphine, dexamethasone, clonidine, sodium bicarbonate, and tramadol alongside local anesthetics. The intent of this study was to evaluate its impact of incorporating buprenorphine and dexmedetomidine into ropivacaine 0.5%.

Materials and Methods:

The trial of 90 patients between the ages of 18 and 60, who were identified as American Society of Anesthesiologists Grade 1 and 2, and scheduled upper limb surgery using the supraclavicular approach, were included. They were assigned into distinct groups, each of the groups consisting of thirty individuals. Group R was administered anesthesia consisting of 25 ml of ropivacaine 0.5% along with 1 ml of saline. Group B was administered anesthetics containing ropivacaine 0.5% and buprenorphine, which was diluted in saline. Group D was administered a solution containing ropivacaine 0.5% and dexmedetomidine, which was diluted in saline.

Results:

Group D had an earlier sensory blockade onset (8.25 min) compared to Group B (9.64 min) and Group R (12.89 min). Group D demonstrated a notably quicker motor blockade onset (9.21 min) in contrast to Group B (12.07 min) and Group R (15.03 min). In contrast with the other groups, Group D exhibited a more longer time frame of both sensory and motor blockades and also an extended period of anesthesia after the surgery.

Conclusion:

Dexmedetomidine was a more effective adjuvant over buprenorphine in the brachial plexus blocks. This resulted in significantly lower postoperative pain scores at 407.67 min and 612.32 min for the plain ropivacaine and buprenorphine groups, respectively.
To Evaluate the Impact of Pneumoperitoneum on Oropharyngeal Seal Pressure of Proseal™ LMA and Baska™ mask in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Authors: Balakrishnan N. , Kumar Rakesh , Kumar Mritunjay , Kamal Manoj , Mohammed Sadik , Mishra Akash , Bhatia Pradeep
Published: August 2024

Background:

Newer supraglottic airway devices (SGADs) are becoming more and more popular as a means of maintaining the airway during laparoscopic procedures. The present study’s aim was to compare the impact of pneumoperitoneum on the oropharyngeal seal pressure (OPSP) of Proseal™ laryngeal mask airway (PLMA) and Baska™ Mask (BM) in patients undergoing laparoscopic cholecystectomy.

Methods:

We enrolled 60 American Society of Anesthesiologists physical Status I and II patients and randomised to either the PLMA group or the BM group. After induction of anaesthesia using a standardised protocol, one of the SGADs was inserted. The primary outcome was the effect of pneumoperitoneum on the OPSP of the two devices. The secondary outcomes were the time required for insertion of the airway devices, OPSP, fibre-optic view of the vocal cord, ease of insertion and any laryngopharyngeal morbidity.

Results:

The demographic parameters were comparable between the study groups. The insertion time was 18.034 ± 7.73 and 18.7 ± 6.96 s for the PLMA group and BM group, respectively (P = 0.7255). The OPSP in each group was not significantly impacted by pneumoperitoneum, although it remained the same throughout the procedure. Compared to the PLMA group, OPSP was higher in the BM group at all three time intervals (5 min after the insertion of the device [T1], 10 min after pneumoperitoneum [T2] and 5 min after the revoking of pneumoperitoneum [T3]).

Conclusion:

Pneumoperitoneum had no effect on OPSP in either group. Significantly higher OPSP was noted in the BM group (both before and following pneumoperitoneum) compared to the PLMA group.
Venous Malformation in Upper Airway - Anaesthetic Challenges and Management
Authors: Sankarlal Nirmal Kumar , Kaliannan Senthil Kumar , Eliyas NoorMohamed Mohamed , Sherfudeen Khaja Mohideen
Published: August 2024

We present a patient with a venous malformation involving the upper airway, who developed airway obstruction immediately after extubation, requiring reintubation and tracheostomy. Our reflection on the management of this case highlights several important learning points. These include: (i) the importance of clear communication between different medical specialties to promote shared situation awareness, (ii) limitations in training anaesthesiologists beyond standard difficult airway management algorithms and (iii) the implications of the skillset mix of doctors responding to airway emergencies.
High-flow Nasal Oxygen in a Physiologically Difficult Airway for Awake Craniotomy: Optimising the Highs and Lows
Authors: Thakur Nimisha , Rebello Joslita , Monteiro Joseph Nascimento , Desai Ketan
Published: August 2024

Respiratory failure is a major risk factor for perioperative pulmonary complications, requiring mechanical ventilation following general anaesthesia. Awake craniotomy avoids physiological derangements related to general anaesthesia, while facilitating continuous neurological monitoring of eloquent areas. High-flow nasal oxygen (HFNO) provides effective oxygenation with CPAP of 3–4 cmH2O, along with providing a favourable interface for communication. We present a 53-year-old female with carcinoma breast having brain and lung metastases with malignant pleural effusion and superimposed pulmonary infection, posted for parietal lobe metastasis excision. Due to her pulmonary comorbidities with an oxygen saturation of 88%, she was posted for an awake craniotomy. HFNO was used to maintain her oxygenation intraoperatively. In this patient, HFNO effectively improved the patient’s oxygenation, comfort and compliance without compromising her involvement in neurological testing.
Awake Look-assisted Intubation in a Patient with Antiretroviral Therapy-induced Neck Lipodystrophy Posted for Liposuction Surgery
Authors: Vaswani Geeta , Parikh Devangi , Patil Shruti
Published: August 2024

Highly active antiretroviral therapy (HAART)-induced lipodystrophy refers to a serious metabolic syndrome in human immunodeficiency virus-infected patients, characterised by the development of dyslipidaemia, insulin resistance, glucose intolerance and abnormal redistribution of body fat (peripheral lipoatrophy and lipohypertrophy). Lipohypertrophy refers to abnormal fat accumulation occurring commonly in the intra-abdominal compartment, breast, dorsocervical area (buffalo hump) or under the skin (lipomas). We report a case of HAART-induced lipodystrophy with a massive accumulation of adipose tissue in the dorsocervical region posted for liposuction.
Lingual Thyroid: Concerns for the Anaesthesiologist
Authors: Paul Bitty , Rajasree O. , Sreelekshmi P. R.
Published: August 2024

The lingual thyroid gland is rare, and it occurs due to failure of the thyroid gland to descend to its normal cervical location during embryogenesis. It can be associated with an increase in levels of thyroid-stimulating hormone. Lingual thyroid can be challenging to the anaesthesiologist as it poses difficulties while securing the airway. The lingual thyroid gland may present with dysphagia, dysphonia, upper airway obstruction or haemorrhage. Oropharyngeal mass can cause difficult intubation and failure to ventilate. Preoperative airway evaluation and indirect laryngoscopy will indicate the need for fibreoptic bronchoscopy-guided intubation. We report the case of a 50-year-old female with a lingual thyroid gland for breast surgery under general anaesthesia.
Grief and bereavement support amidst palliative care in the paediatric intensive care unit
Authors: Charan Gopal Singh , Kalia Raman , Kumar Atul , Sharma Karuna
Published: August 2024

In paediatric intensive care units (PICUs), advanced medical care meets deeply emotional human experiences. This review examines grief and bereavement support in PICUs, emphasising its significance in extending palliative care beyond end-of-life scenarios. A comprehensive literature search of PubMed and Google Scholar from 2014 to 2023 yielded 50 relevant studies. The findings illustrate the unique challenges in PICUs, such as children’s limited communication abilities, parental distress and emotional burden on healthcare providers. Our review revealed the multifaceted nature of grief in PICUs, including anticipatory and complicated grief, and its profound impact on families and siblings of PICU patients. We identified diverse emotional, psychological, cultural and spiritual support needs that underscored the importance of continuous bereavement care and access to resources. Current support practices, including counselling, support groups, memorial services and interdisciplinary teamwork, are explored. Challenges such as resource limitations, healthcare providers’ emotional toll and communication barriers are discussed. The study also highlights emerging trends such as digital tools, innovative therapies and policy changes to enhance holistic, family-centred care in PICUs.
Valproate-induced leucocytoclastic vasculitis: A rare case report
Authors: Bollapally Naveen Goud , Kumar Rahul , Batra Tanvi , Kakar Atul
Published: August 2024

Drug-induced vasculitis is essentially a small-vessel vasculitis. Histopathological changes in this condition are characterised by neutrophilic leucocytoclasia of the small vessels. To label it leucocytoclastic vasculitis, one must exclude other types of vasculitis where autoimmune workup comes into play. Antiepileptics, although rare, are also known to have such a presentation. We present a case of a 35-year-old male, a known case of hypertension and seizure disorder (on regular treatment), with a recent history of generalised tonic–clonic seizures, leading to a change in his antiepileptics. This was followed by extensive rash development, predominantly on his lower limbs, which was diagnosed as leucocytoclastic vasculitis, with sodium valproate (VPA) being the aetiology for the same. The offending drug was removed, and after treatment with steroids, the patient’s condition significantly improved.
Evaluation of polymerase chain reaction and adenosine deaminase levels for rapid diagnosis of clinically suspected tuberculous pleural effusion
Authors: Shashidhara K. C. , Reddy Rajashekar , Vijayakumar Savitha , Joseph Jerin Abraham , Meghana B. S.
Published: August 2024

Background:

Tuberculosis (TB) often leads to pleural effusion, particularly prevalent in developing nations such as India. There has been a global rise in TB cases. Although lymphocytic predominant fluid is commonly associated with tubercular pleural effusion, it is essential to note that not all lymphocytic predominant fluids indicate TB. The diagnosis of pleural TB has benefited significantly from the use of biochemical markers. Conventional bacteriological methods are not very useful in diagnosing tubercular effusion and rarely identify Mycobacterium tuberculosis in pleural fluid. Owing to diagnostic difficulties, newer investigations, such as TB polymerase chain reaction (TB-PCR), adenosine deaminase (ADA) and culture, are amongst the most recent techniques currently used due to the challenges associated with diagnosis.

Aims:

This study aimed to measure the sensitivity and specificity of TB-PCR and compare them with those of ADA and TB cultures for suspected TB pleural effusion.

Methods:

This study included 50 patients diagnosed with pleural effusion who underwent pleural fluid analysis. Patients exhibiting exudative effusion with lymphocyte predominance also underwent a pleural biopsy. Pleural fluid ADA levels were also measured, and TB-PCR tests were conducted.

Results:

Eighteen patients were confirmed to have TB by biopsy. ADA was both sensitive and specific at 67% and 62.5%, respectively. However, PCR showed a sensitivity of 16.6% and a specificity of 100%.

Conclusion:

This study found a statistically significant association (P < 0.05) between ADA levels and distinguishing pleural effusion, which is tubercular in origin, from non-tubercular effusion. Therefore, the pleural ADA estimate appears to have the potential to be a reliable test for diagnosing TB pleural effusion. It has sufficient sensitivity and specificity while being cost-effective and easily executable compared to pleural biopsy. Our study also compared the sensitivity of PCR with pleural biopsy and discovered that PCR was more specific and less sensitive.
Association between Iron deficiency and hypothyroxinemia in first-trimester pregnant women: A study from a tertiary care hospital
Authors: Vijayakumar Savitha , Madhu B , Sree M. Mounika , Mahadevaiah Mahesh , Basavanagowdappa H
Published: August 2024

Background:

Iron deficiency (ID) is a common nutritional concern worldwide. Hypothyroidism during pregnancy also has harmful effects on both mother and child, such as post-partum hemorrhage, pre-eclampsia, low-birth weight, pre-term labour and abruptio placenta. Few articles have shown an association between ID and hypothyroidism.

Aims:

To evaluate the association between hypothyroidism, hypotriiodothyroninemia and ID in pregnant women.

Materials and Methods:

This cross-sectional study was conducted between January 2017 and June 2019 at JSS Hospital, a Tertiary Care Teaching and Research Hospital attached to JSS Medical College in Mysuru City, South India. Five hundred consecutive pregnant women aged 18–45 years in the first trimester of pregnancy were recruited. A venous blood sample of approximately 5 mL was drawn and sent for analysis of haemoglobin, thyroid-stimulating hormone (TSH), T3, T4, anti-thyroid peroxidase (TPO) antibodies and serum ferritin. T3, T4, TSH, anti-TPO antibody and serum ferritin levels were measured by chemiluminescence for all pregnant women. Correlation and linear regression analyses were performed to determine the association between ID and T3, T4 and TSH levels.

Results:

Out of 500 women, nine were excluded because of pre-analytical errors; hence, there were 491 pregnant women in the first trimester. Mean values of T3, T4, TSH and ferritin in the study were 1.45 ± 0.72, 9.29 ± 2.53, 2.37 ± 3.17 and 31.54 ± 30.28. There was a positive correlation between serum ferritin and T4 levels, with a correlation coefficient of 0.135. The scatter plot also showed a linear relationship between serum ferritin and T4 levels. There was no significant correlation between serum ferritin, T3 and TSH levels. Linear regression analysis also showed an association between ferritin and T4 levels, with a significance of 0.003. Linear regression analysis was insignificant for TSH, T3 and serum ferritin levels.

Conclusion:

ID anaemia (IDA) is associated with hypothyroxinemia in pregnant women. Further extensive studies are needed to evaluate the causal association between hypothyroidism and IDA. Iron therapy might improve thyroid parameters in patients with subclinical hypothyroidism and ID without thyroxine, which requires further research.
Isolation and characterization of human periodontal ligament stem cells under the terms of use in clinical application: A pilot study
Authors: Behfarnia Parichehr , Fazlalizadeh Sheida , Nasr-Esfahani Mohammad Hossein , Ejeian Fatemeh , Mogharehabed Ahmad
Published: August 2024

Background:

The aim of the present study is to determine the possibility of isolation and characterization of the human periodontal ligament stem cells (hPDLSCs) using limited harvested periodontal ligament (PDL) tissue of only one patient’s wisdom teeth (2–4 teeth) under the more compatible terms of use in clinical application without using the fetal bovine serum (FBS).

Materials and Methods:

In this pilot study, hPDLSCs were isolated from the impacted third molar, and tissue was scraped from the roots of the impacted third molar of 10 volunteers to enzymatically digest using collagenase. The cells were sub-cultured. The samples of the first seven patients and half of the eighth patient’s sample were cultured in alpha modified of Eagle’s medium (α-MEM) (−FBS) medium and the other part of the eighth patient’s sample was cultured with prior medium supplemented with +FBS 15% as a control of the cultivation protocol. While for the past two patients (9th and 10th the α-MEM medium was supplemented with L-Glutamine, anti/anti 2X, and 20% knock-out serum replacement (KSR). Two more nutritious supplements (N2 and B27) were added to the medium of the tenth sample. Flow-cytometric analysis for the mesenchymal stem cell surface markers CD105, CD45, CD90, and CD73 was performed. Subsequent polymerase chain reaction was undertaken on three samples cultured with two growth media.

Results:

Cultivation failed in some of the samples because of the lack of cell adhesion to the culturing dish bottom (floating cells), but it was successful for the 9th and 10th patients, which were cultured in the α-MEM serum supplemented with KSR 20%. Flow cytometry analysis was positive for CD105, CD90, and CD73 and negative for CD45. The PDL stem cells (PDLSCs) expressed CD105, CD45, and CD90 but were poor for CD73.

Conclusion:

According to the limited number of sample tests in this study, isolation and characterization of PDLSCs from collected PDL tissue of one patient’s wisdom teeth (2–4) may be possible by the proper setup in synthetic FBS-free serum.
Perceptions of mandibular asymmetry among orthodontists, oral and maxillofacial surgeons, and laypersons
Authors: Tayyebi Kamyar , Arab Sepideh , Razmara Farnoosh , Geramy Allahyar , Kharazifard Mohammad Javad , Kamali Elaheh
Published: August 2024

Background:

Facial asymmetry is one reason orthodontic patients seek treatment. This study assessed the effect of mandibular asymmetry on facial esthetics and treatment needs perceived by laypersons, orthodontists, and maxillofacial surgeons.

Materials and Method:

In this descriptive cross-sectional study, the frontal image of a model was captured and symmetrized from the facial midline using Adobe Photoshop software. The mandible was rotated 0°–8° with 1° intervals. Images were presented to 41 laypersons, 39 orthodontists, and 29 surgeons using an online questionnaire. The observers rated each image’s esthetics with a 0–100 Visual Analog Scale and determined their treatment need by choosing one of the following three choices: No need for treatment, needs treatment, acceptable, but better to be treated. Analysis of variance for repeated measurements model. The regression method, Kruskal–Wallis analysis, was used for statistical analysis and the level of significance was set as P < 0.05.

Results:

The images with 0° and 1° rotation received the highest esthetic rates among all three groups, while the images with 8° rotation were the least attractive ones. Furthermore, the image esthetic ratings significantly affected their treatment need. Mandibular asymmetry diagnosis threshold was 1° for orthodontists, and 3° for both laypersons and surgeons. The treatment need threshold was 5°, 6°, and 7° for surgeons, orthodontists, and laypersons, respectively.

Conclusion:

The esthetics of images decreased when mandibular asymmetry increased. Treatment need was also related to increased asymmetry. Orthodontists were the most sensitive group in diagnosis, while surgeons were the most sensitive ones when it came to treatment.
The impact of obesity on the outcome of periodontal disease treatment: Systematic review and meta-analysis
Authors: Paranhos Klenise , Oliveira Simone , Bonato Rafael , Niknami Neda , Vinayak Shalin , Loomer Peter
Published: August 2024

Background:

Obesity and periodontitis are two commonly occurring disorders that affect a considerable amount of the world’s population. Several studies have mentioned that there may be a link between the two. The purpose of this systematic review was to determine whether there was a difference in response to nonsurgical periodontal therapies (NSPTs) between obese and nonobese individuals.

Materials and Methods:

An online search was assembled with a combination of Medical Subject Headings terms and free-text words of the literature published up to December 2020, to identify interventional studies limited to an adult human population. Titles, abstracts, and finally full texts were scrutinized for possible inclusion by two independent investigators. Reduction in periodontal pocket depth was the primary parameter used to assess the outcome of NSPT.

Results:

The primary search yielded 639 significant titles and abstracts. After filtering, data extraction, and quality assessment, 34 full-text studies were selected. All studies matching inclusion criteria, suggest a positive association between obesity and periodontal disease.

Conclusion:

Although a possible correlation exists between periodontitis and obesity, as with other oral-systemic disease implications, some controversy exists. While some studies have reported a distinct correlation between periodontitis and obesity, other papers have suggested only moderate or no association between the two conditions at all. These results advise of a difference between response to NSPT amid obese and nonobese individuals. However, with few quality studies and variable reported findings, there is limited evidence of any significant difference in clinical practice. However, it can be a positive warning that obesity is a risk factor toward the outcome of periodontal disease treatment.
Effect of conventionally fabricated and three-dimensional printed provisional restorations on hard and soft peri-implant tissues in the mandibular posterior region: A randomized controlled clinical trial
Authors: Kaushik Smriti , Rathee Manu , Jain Prachi , Malik Sanju , Agarkar Vipul , Alam Maqbul
Published: August 2024

Background

The purpose of this study was to conduct a randomized controlled clinical trial to compare and evaluate the effect of provisional restorations fabricated by two techniques, namely, conventional and three-dimensional (3D) printing processes on the peri-implant hard and soft tissues over early nonfunctional loaded implants in the mandibular posterior region.

Materials and Methods:

A randomized controlled clinical trial was conducted across 24 subjects broadly divided into two groups with 12 dental implants each, i.e., GpIC with conventionally fabricated provisional restoration and GpIID with 3D printed fabricated provisional restoration. The prosthetic phase was carried out at 2 weeks, and subjects were evaluated at baseline (at the time of prosthesis placement), 2 months, and 4 months for peri-implant marginal bone level, mucosal suppuration, sulcular probing depth, and modified sulcular bleeding index. Patient satisfaction was assessed using 5-item questionnaires at 4 months. The intragroup comparison for all the data was done using Wilcoxon signed-rank test. The intergroup comparison for all the data was done using Mann–Whitney U-test. The comparison of frequency of responses between GpIC and GpIID was done using Chi-square test. P < 0.05 was considered to be statistically significant.

Results:

Nonsignificant difference was observed in all the hard and soft tissue parameters between the groups at baseline, 2 months, and 4 months (P > 0.05). Improvement in bleeding on probing was found to be greater around dental implants restored with 3D printed provisional restoration than dental implants restored with conventionally fabricated provisional restoration from baseline to 4 months of follow-up, and the difference in finding was statistically significant (P < 0.05). There was a statistically nonsignificant difference seen for the frequencies between the groups (P > 0.05) for all questions related to patient satisfaction.

Conclusion:

The effect of conventionally fabricated and 3D printed provisional restorations on peri-implant hard and soft tissues was comparable to each other on an early nonfunctionally loaded implant in the mandibular posterior region.
Effects of probiotic yogurt, casein phosphopeptide-amorphous calcium phosphate, and xylitol chewing gums on the salivary count of Streptococcus mutans: A single-blinded randomized controlled clinical trial
Authors: Dehghani Tafti Samira , Parisay Iman , Mehrabkhani Maryam , Sabbagh Sedigheh , Seddigh Sadaf , Ghazvini Kiarash , Daghestani Naeemeh
Published: August 2024

Background:

Dental caries is a preventable multifactorial disease, with Streptococcus mutans being suggested to be its primary pathogen. Our study aim was to compare the effects of three different low-cost and easy-to-use regimens with that of the gold standard (chlorhexidine [CHX] mouthwash) on the count of salivary S. mutans in dental students over 30 days.

Materials and Methods:

In this single-blinded parallel randomized controlled clinical trial, a total of 120 dental students were included and randomly allocated into four intervention groups: (1) CHX mouthwash (control(, (2) probiotic yogurt, (3) casein phosphopeptide-amorphous calcium phosphate chewing gum, and (4) xylitol chewing gum. Salivary S. mutans counts were evaluated at baseline, 15 days, and 30 days after initiation of the study and compared at different times and among different groups using the repeated measures analysis of variance design analysis and least significant difference test with SPSS software version 20. The level of significance was determined to be 0.05.

Results:

The microorganism count variable at baseline, first, and second follow-ups was significantly different for all groups except the probiotic yogurt group (P = 0.340). S. mutans count was significantly different when comparing the first follow-up and baseline values in the CHX and xylitol gum groups (P = 0.027, P = 0.037). When comparing the second follow-up with baseline values, a significant difference was observed in the xylitol gum group (P = 0.003).

Conclusion:

Xylitol chewing gum seems to be a viable alternative to the gold standard (CHX mouthwash) in reducing the salivary count of S. mutans.
Efficacy of topical curcuma longa in the healing of extraction sockets: A split-mouth clinical trial
Authors: Pandya Kalpa , Abbinayah Devee , Selvakumar Deepshika , Jayakumar Naveen
Published: August 2024

Background:

The healing process after dental extraction is influenced by various factors, and finding effective strategies for promoting wound healing and reducing postoperative discomfort remains a challenge. This study aimed to evaluate the effectiveness of topical Curcuma longa gel in reducing pain and promoting wound healing after dental extraction, with the secondary objective of assessing the occurrence of dry sockets. The study was a split-mouth randomized controlled trial conducted at the oral and maxillofacial surgery department over 3 months.

Materials and Methods:

This split-mouth randomized controlled trial consisted of a total of 21 patients undergoing bilateral extractions. One extraction socket was randomly assigned to the test group, where Curcuma. longa gel was applied, while the contralateral socket served as the control group, receiving a placebo. Pain and wound healing were evaluated using standardized scales on the 3rd and 7th days postextraction. Descriptive statistics, paired t-tests, and unpaired t-tests were performed using the SPSS software version 19. The statistical significance was fixed at P ≤ 0.05.

Results:

The test group showed significantly higher mean healing scores on the 3rd and 7th days compared to the control group. On the 7th day, the test group had significantly lower mean pain scores than the control group. No cases of dry sockets were observed in either group.

Conclusion:

Topical Curcuma longa gel demonstrated positive effects in promoting wound healing and reducing pain after dental extraction. Clinicians should consider the use of Curcuma longa gel as a post-extraction medicament, particularly in cases involving multiple or traumatic extractions.
Effect of local administration of injectable platelet-rich fibrin on root resorption during orthodontic tooth movement in dogs
Authors: Sedaghati Golnoosh , Feizbakhsh Masood , Esnaashari Nasim , Razavi Seyed Mohammad
Published: August 2024

Background:

This study aimed to assess the effect of local administration of injectable platelet-rich fibrin (i-PRF) on root resorption during orthodontic tooth movement in dogs.

Materials and Methods:

This animal study was conducted on 4 adult male mongrel dogs. The right and left maxillary first premolars of the dogs were extracted, and a Nickel-Titanium closed coil spring was used to connect the canine to the second premolar with 150 g load. Next, 0.5 cc of i-PRF was injected in one quadrant of the maxilla around the second premolar into the periodontal ligament. The other quadrant of the maxilla served as the control group and received saline injection. Injections were performed at 1, 21, and 42 days, and the dogs were sacrificed after 63 days. Histological sections were prepared and cementum resorption, secondary cementum formation, and number of cementoblasts and cementoclasts were compared between the two groups by the Friedman test, Wilcoxon test, and Mann–Whitney test (α = 0.05).

Results:

The mean percentage of cementum resorption (17.75% ± 5.56%) and secondary cementum formation (14.50% ± 6.65%), and the mean number of cementoblasts (10.25 ± 2.36) and cementoclasts (9.75 ± 4.71) were insignificantly higher in the i-PRF group than the corresponding values (13.75% ± 4.34%, 8.50% ± 2.88%, 7.75 ± 1.25, and 6.50 ± 3.10, respectively) in the control group (P > 0.05).

Conclusion:

Administration of i-PRF insignificantly increased the percentage of cementum resorption, secondary cementum formation, number of cementoblasts, and number of cementoclasts.
Effect of local injection of injectable platelet-rich fibrin on bone remodeling during orthodontic tooth movement in dogs
Authors: Tabibi Atefeh , Feizbakhsh Masood , Esnaashari Nasim , Razavi Seyed Mohammad
Published: August 2024

Background:

This study aimed to assess the effect of local injection of injectable platelet-rich fibrin (i-PRF) on bone remodeling during orthodontic tooth movement in dogs.

Materials and Methods:

In this animal study, the maxillary first premolars of four adult male mixed-breed dogs were bilaterally extracted, and a nickel–titanium closed coil spring with 150 g force was placed between the canine and second premolar teeth. One quadrant of the maxilla was randomly selected as the test quadrant, and 0.5 cc i-PRF was injected into the periodontal ligament (PDL) around the second premolar at 1, 21, and 42 days. The other quadrant served as the control group and received saline injections. The dogs were sacrificed after 63 days, histological sections were prepared, and changes in bone remodeling were assessed by comparing the percentage of osteogenesis and number of osteoblasts and osteoclasts between the two groups by the Wilcoxon and Mann–Whitney U-tests (a = 0.05).

Results:

The percentage of osteogenesis (16.0% ± 4.96% in i-PRF and 13.5% ± 4.43% in the control), the percentage of newly formed lamellar bone (10.25% ± 2.87% in i-PRF and 8.75% ± 2.36% in the control), the percentage of woven bone (5.75% ± 2.21% in i-PRF and 4.75% ± 2.36% in the control), the number of osteoblasts (15.0 ± 3.46 in i-PRF and 11.75 ± 2.36 in the control), and the number of osteoclasts (11.25 ± 4.34 in i-PRF and 6.25 ± 2.62 in the control) were not significantly different between the two groups (P > 0.05).

Conclusion:

PDL injection of i-PRF around the second premolars of dogs under orthodontic force had no significant effect on bone remodeling.
Evaluation of Patch Test Results in Paediatric Patients in a Tertiary Dermatology clinic
Authors: Kazan Didem , Odyakmaz-Demirsoy Evren , Eloglu Hatice , Kiran Rebiay
Published: August 2024

Background and Objectives:

Allergic contact dermatitis is common in childhood as well as in adulthood. Children could be affected by numerous allergens. Allergen sources could change by region. In this study, we aimed to identify the most common allergens that cause contact sensitivity in paediatric patients in our region to make a standardized patch test series and define the ways of exposure to these allergens.

Materials and Methods:

Between June 2013 and January 2021, a total of 61 patients' European baseline series patch test results were evaluated.

Results:

Among 61 patients, 36 (%59) were female and 25 (%41) were male. The mean age was 10.4 years. Positivity with at least one allergen was present in 39 (64%) cases. The most common allergens with positive reactions were balsam of Peru (BOP) in 11 (18%) patients, nickel in eight (13.1%) patients, and fragrance mix-1 in seven (11.4%) patients. No statically significant difference was found between patch test results and gender (P = 0.109), atopy (P = 0.774), atopic dermatitis (P = 0.662), hobby (P = 0.377) and side of lesions (P = 0.826). However, there was a significant relationship between the duration of complaints and patch test results (P = 0.007).

Conclusion:

The responsible allergen in paediatric patients may vary especially by region, thus this could be challenging for diagnosis. Therefore, each region should create its own specific standardized paediatric patch tests.
Caffeine in Skincare
Authors: Elias Marcus L. , Israeli Alexa F. , Madan Raman
Published: August 2024

Caffeine is ubiquitous in our society—not only in the drinks consumed but also increasingly in dermatologic topicals. Given that coffee and caffeine are increasingly used for the production of many dermatologic anti-cancer topicals, sunscreens, and cosmetics, it is of imperative importance to review the basic science and clinical evidence for such claims. In this concise review, we outline the current evidence.
Effect of Intralesional Sodium Stibogluconate Alone Versus Combinations with Topical Trichloroacetic Acid 50% or Fractional Carbon Dioxide Laser on Cutaneous Leishmaniasis
Authors: Ali Shaimaa M. , Ali Moshira M. , Kamel Abeer M.
Published: August 2024

Background:

Cutaneous leishmaniasis (CL) is a vector-borne protozoal disease. Antimonial drugs remain the first-line treatment for CL despite the widespread drug resistance and high incidence of side effects. The present study aimed to compare the efficacy and safety of traditional intralesional sodium stibogluconate (SSG) alone and its combinations with trichloroacetic acid (TCA) 50% and fractional carbon dioxide (CO2) laser for the treatment of CL.

Materials and Methods:

An interventional study was carried out on 25 CL patients. In each patient, three lesions were assigned to treatment either by SSG alone (GI), SSG plus TCA 50% (GII), or SSG plus fractional CO2 laser (GIII). The overall clinical improvement and changes in the sizes of lesions and scars were assessed and compared among the three groups.

Results:

GIII patients had significantly lower treatment sessions as compared to GI patients (3.6 ± 1.29 versus 4.04 ± 2.11, P = 0.042). Moreover, GII and GIII patients had significantly shorter healing times when compared with GI (3.63 ± 1.35 and 3.46 ± 1.25, respectively, versus 4.0 ± 2.15 weeks, P = 0.019). Also, it was shown that GIII patients had significantly lower scar scores (1.40 ± 1.52) when compared with GI (3.00 ± 0.0) and GII (2.80 ± 1.10), P = 0.017.

Conclusions:

Intralesional SSG with TCA 50% is more effective than SSG alone and is comparable to SSG and fractional CO2 combination in the treatment of CL with better safety profile and patient satisfaction.
Reactive Cutaneous Capillary Endothelial Proliferation Caused by Camrelizumab
Authors: Hui-Mei Pang , Guang-Ming Huang , Xiao-Ling Qin , Hong-Liang Zhang , Si-Jun Wei
Published: August 2024

To investigate the regularity and characteristics of adverse drug reaction (ADR) of reactive cutaneous capillary endothelial proliferation caused by Camrelizumab, so as to provide reference for clinical rational use of drugs. Searching for case reports of Camrelizumab-induced reactive cutaneous capillary endothelial proliferation (RCCEP) in databases such as China Biology Medicine disc, VIP Database, CNKI, Wanfang Medical, PubMed, Wiley online library, Embase with “Carritzumab/Ericab,” “SHR-1210,” “Reactive cutaneous capillary endothelial proliferation,” “Reactive capillary hemangiomas,” and “Capillary proliferation” as search terms. The retrieval time is from the establishment of the database to February 2022. After eliminating clinical trials and incomplete literature, information of patients included in the literature was analyzed, which included gender, age, reason for medication, usage and dosage, time of ADR, concomitant medication, clinical manifestations, intervention measures, outcomes of patients, etc. A total of 11 articles involving 16 patients were included, including 11 males and five females, with an average age of 60.5 years. Reasons for medication included nine cases of non-small cell lung cancer (NSCLC), four cases of liver cancer, one case of small cell lung cancer (SCLC), one case of synovial sarcoma, and one case of Hodgkin lymphoma. Thirteen patients recorded in detail that the dosage of Camrelizumab was 200 mg, and the frequency of medication was q2w~q4w. Eight patients were treated with Camrelizumab alone, and eight patients were treated with combined medication. RCCEP occurred in nine patients after the first medication, and in seven patients after two-four cycles of medication, the average medication cycle was two cycles, and the average occurrence time was 12.5 days after the last medication. The main clinical manifestations were that several different sizes of growths such as red nevus-like, pearl-like, and mulberry-like growths appear on the head, face, neck, torso, limbs, and other parts of the body, all of which were grade 1-2. The RCCEP of all patients was controlled after treatment. During the treatment, 11 patients were stable and five patients were local remission. RCCEP is caused by Camrelizumabis a special skin immune response, which will not cause life-threatening to patients. However, clinicians and pharmacists should be familiar with the characteristics and regularities of the adverse reaction, to do a good job in medication monitoring and management, as for ensuring the safety of patients with medication.
Uveitis Occurring in a Patient with Psoriasis during Adalimumab Therapy
Authors: Zheng Qiaoli , Zhu Yingjie , Cheng Hao , Zhu Kejian
Published: August 2024

Here we report a case of a 34-year-old patient with psoriasis who developed uveitis induced by adalimumab. After receiving two subcutaneous injections of adalimumab, the patient suffered from a sudden onset of ocular pain and blurred vision in her left eye, which was diagnosed with acute anterior uveitis. Adalimumab therapy was discontinued and the patient was hospitalised for the treatment of acute anterior uveitis with systemic corticosteroids. This paradoxical adverse event was alleviated after timely interventions and went into remission during a 6-month follow-up period. To the best of our knowledge, this is the first case of uveitis occurring in patients with psoriasis under adalimumab treatment. It indicates that paradoxical uveitis, although rare, is one of the adverse events of adalimumab therapy. Early recognition and prompt intervention would lead to a good outcome.