bluuebunny/crossref_metadata_2025 huggingface dataset:
Ligasure™ Hemorrhoidectomy versus Conventional Hemorrhoidectomy: Comparison in Outcome
Authors: Alhamdany Arkan , Wahhab Rawa’a A. Sattar A. , Lateef Nawras Falah
Published: January 2022

BACKGROUND: Hemorrhoids are a common problem faced in the surgical practice that cause a variety of symptoms ranging from bleeding per rectum to prolapsed, non-reducible and painful anal masses. Therefore, hemorrhoidectomy is one of most frequently performed surgical procedures worldwide.

AIM: In this study, we will compare between the conventional surgical method and between LigaSure™ hemorrhoidectomy.

PATIENTS AND METHODS: All 120 patients underwent hemorrhoidectomy by conventional and LigaSure™ method between September 2015 and September 2018 in Al-Kafeel hospital in Karbala city in Iraq. All cases underwent surgery by the three authors under regional anesthesia or general anesthesia by anesthetic team. A thorough history taking and physical examination were done and an informed consent has been taken from each patient before the surgery. Conventional hemorrhoidectomy was done for 50 patients randomly selected. The operation was done in the open method (Milligan Morgan’s). LigaSure™ hemorrhoidectomy was done for 70 patients randomly selected as well. Quantification of intra-operative bleeding was done by counting the number of gauzes. Patients were evaluated 5 days and a month and 3 months after the operation for complications and improvement of symptoms. The data were analyzed using Statistical Package for Social Sciences version 22.0.

RESULTS: There were significant differences regarding the operation time, number of gauzes soaked with blood, hospital stay, pain score, post-operative bleeding, wound infection, residual mass, fecal incontinence and anal stenosis in favor of the LigaSure™ method. There was no significant difference regarding urine retention and post-operative discharge between the two methods.

CONCLUSION: LigaSure™ hemorrhoidectomy can be a good alternative to conventional methods to reduce pain and make a more rapid recovery after hemorrhoidal surgery.
Brief Cognitive Behavioral Therapy for Patients with Comorbid Depression and Type 2 Diabetes in an Urban Primary Care Facility: Randomized Controlled Trial
Authors: Mansour Nadine , Labib Nargis , Khalil Mohamed , Esmat Shereen
Published: January 2022

Background: The relation between depression and diabetes is bidirectional and both can lead to morbidity and mortality. Despite the success of Cognitive Behavioral Therapy (CBT) in managing psychiatric comorbidities, research on its use in the treatment of comorbid diabetes and depression is limited and with varying results. The aim of the study is to assess the efficacy of CBT on depressed patients with type 2 diabetes.
Methods: This randomized controlled trial was conducted at an urban primary healthcare center in Egypt from February 2019 to March 2020 and included 80 participants. Key inclusion criteria were uncontrolled type 2 diabetes (T2D) (HbA1c >7.5%) and depression symptoms diagnosed by Beck’s Depression Index. Participants were assessed for all battery of instruments. Subsequently, participants were randomized to control and treatment groups. The treatment group received four CBT sessions. Both groups received a thirty-minute structured diabetes education and their usual diabetes treatment. Three months later, all participants were reassessed for depression and diabetes compliance and all labs were performed post intervention. Both the primary (the difference in HbA1c pre-post intervention) and secondary outcomes (the change in depressive symptoms assessed) were analyzed using ANCOVA.
 Results: Both groups were matching at baseline. Post intervention, the CBT group revealed a significant reduction in depressive symptoms while adjusting for Beck Depression Index (BDI) pre-intervention [F (1, 74) = 7.074, p = 0.010]. Moreover, HBA1c was improved significantly when controlling for pre-intervention BDI scores and BMI [F (1,73) = 4.27, p = 0.042] compared to the control group.
Conclusions: The CBT program was both inexpensive and easily accessible. It could fit very well in primary care settings. The results indicated CBT intervention was effective in improving diabetes control and depression. However, a larger-scale study to test its effect on a larger scale population and its long-term impact is recommended.
Contribution to the microscopic identification of Zingiber officinale
Authors: Gavrilova Anna , Gavrilov Genadi , Trifonova Dora
Published: January 2022

Zingiber officinale Roscoe has a very long history of use throughout the world, both as a spice and as a medicinal plant. During the last two years in the midst of a global pandemic of SARS-CoV-2 the use of various herbal products with ginger rhizome as active ingredient increased because of its numerous health beneficial properties. A detailed characteristic of the crude powdered drug is presented by microscopic photographs for the first time. Although the structure of ginger rhizome is relatively simple and well-studied, the presented results in combination with the detailed analysis of the literature provide additional insight to the pharmacopoeial guidelines for the identification of ginger powder.
Les écoles et leur réputation
Authors: Jadot Évelyne , Theys Coralie , Verhoeven Marie
Published: January 2022

L’école citoyenne est un dispositif institutionnel visant le développement des compétences citoyennes des élèves à partir d’un processus à la fois collectif et cadré de construction et de régulation démocratique des règles et de la « loi » de l’école ; plus largement, le dispositif repose sur l’idéal d’une participation active des élèves dans la construction du « vivre ensemble » à l’école. Ce chapitre explore les conditions organisationnelles et professionnelles de la mise en place d’un projet d’école citoyenne dans trois établissements secondaires situés dans des segments disqualifiés du système éducatif de la Communauté française de Belgique soit en raison des filières qu’ils organisent (qualifiantes et/ou spécialisées), soit en raison de leur situation dans un environnement géographique défavorisé. Il envisage le projet d’école citoyenne comme un instrument de requalification de l’image de ces établissements sur fond d’une identité catégorielle plutôt négativement connotée. Se penchant sur les usages différenciés de l’étiquette ou du « label école citoyenne » développés par les établissements concernés, ce chapitre montre que le projet d’école citoyenne peut servir à redorer l’image de l’établissement et son positionnement à l’intérieur d’un segment, mais qu’il participe aussi, de manière plus large, à une revalorisation de l’ensemble du segment « disqualifié » et de son public.
Les écoles et leur réputation
Authors: van Zanten Agnès , Olivier Alice
Published: January 2022

Les journées portes ouvertes se présentent – et sont conseillées par les prescripteurs scolaires et familiaux – comme des occasions pour les futurs étudiants de découvrir les offres de formation de différents types d’établissements d’enseignement supérieur, de s’informer sur l’organisation des études, leur coût ou leurs débouchés professionnels ou de demander des conseils concernant les procédures d’admission ou les attentes du corps professoral. Ces différentes dimensions sont de toute évidence présentes dans l’esprit des organisateurs, des animateurs et des visiteurs de ces journées. Néanmoins, les journées portes ouvertes sont aussi le lieu où prend place un processus plus subtil, parfois explicite, mais souvent implicite, d’« appariement statutaire » (status matching) (Podolny, 1993) des établissements et des futurs usagers, qui est aussi à l’œuvre, sous d’autres modalités, dans d’autres dispositifs institutionnels ou marchands de type semi-personnel ou impersonnel (Callon et al. 2007 ; Karpik, 2007 ; van Zanten et Legavre, 2014). Ce processus prend forme à travers différentes activités (visite des locaux, production/réception de discours institutionnels et professionnels, échanges individuels entre les enseignants ou les élèves de l’établissement et les visiteurs, etc.) au travers desquelles se construisent des rapports d’équivalence et de connivence entre les représentants des établissements et les visiteurs. Ces rapports vont à leur tour influer sur les procédures de choix, de classement, d’arbitrage et de sélection de part et d’autre.
Du ministère du Temps libre aux politiques temporelles localisées
Authors: Gwiazdzinski Luc
Published: January 2022

Absentes du débat public national, les politiques temporelles s’expérimentent essentiellement à l’échelle locale, nous explique Luc Gwiazdzinski , à travers les « bureaux du temps », les « conseils de la nuit », les nouveaux horaires d’ouverture des services publics et des transports le dimanche, entre « midi et deux », etc.
Ou comment incarner l’identité culturelle de l’Europe
Authors: Martin Laurent
Published: January 2022

Dans le troisième volet de sa trilogie, Laurent Martin montre que c’est le Conseil de l’Europe qui a permis de développer des actions en faveur du patrimoine à l’échelle communautaire, dont l’une des finalités est d’incarner l’identité culturelle de l’Europe.
Le tiers-lieu, berceau des communs ou couteau suisse des communes ?
Authors: Idelon Arnaud
Published: January 2022

Dans une analyse documentée, Arnaud Idelon , à la fois théoricien et praticien de ces espaces qui suscitent confusion, fantasmes et projections, met en garde contre les programmes descendants qui les éloigneraient de leur identité originelle faite d’hybridation, de culture et d’expérimentation.
Pour un processus de politique culturelle « poreux »
Authors: Ciancio Giuliana , Sanchez Benjamin
Published: January 2022

Tout à la fois chercheuse et curatrice de projets de coopération européenne, Giuliana Ciancio aborde les mécanismes de la fabrique de la politique culturelle de l’UE en pointant des avancées certaines, malgré des moyens encore faibles, et un souffle réformateur encore à venir.
Et si la culture changeait d’échelle et jouait la sobriété ?
Authors: Delotte François
Published: January 2022

La course à l’événementialisation et au super-équipement qui a marqué le secteur culturel n’est plus tenable dans le contexte actuel de dérèglement climatique. Pour plus de sobriété, il faut désormais interroger la taille des manifestations, la durée des tournées, et mieux adapter les offres artistiques aux territoires, explique François Delotte .
Peut-on attribuer un sens aux alcoolisations ? À propos de l’éclairage apporté par un atelier d’écriture et trois cas cliniques
Authors: Bonnefous Aurélien
Published: January 2022

Les patients aux prises avec l’alcool évoquent parfois les ivresses et la façon dont ils se mettent en scène dans ces moments-là. Il est notable que certaines de ces scènes soient rejouées très régulièrement. De cette répétition, nous avons pu repérer des éléments connus de la problématique alcoolique qui font écho à certains écrits que les patients ont réalisés lors de l’atelier d’écriture que nous proposons. Éléments concernant leur rapport au temps, aux autres et au monde. En suivant ce cheminement, nous en sommes venus à repérer dans ces « lieux communs », ce qu’il pouvait en être de chaque patient, de sa position de sujet et de sa problématique. C’est ce que nous allons présenter au travers de cet article.
L’indicible dans la problématique addictive et ses implications dans la psychothérapie
Authors: Marchin Élodie , Marty François
Published: January 2022

L’indicible correspond à un creux dans la trame des représentations psychiques. Il est ce qui ne peut se dire parce qu’il est irreprésentable. Il contribue à la constitution de la trouvaille de l’addiction. Parce que la personne ne peut saisir ce qui la fait souffrir, elle va tenter de trouver dans les produits psychoactifs une solution. Le processus même de l’addiction renforce ensuite cet effacement de la vie psychique. Considérant l’addiction comme un langage potentiel, la psychothérapie ouvre un espace où une pensée propre pourra se déployer. Cette approche utilise la dynamique transféro-contre-transférentielle pour rechercher les traces d’une vie psychique ensevelie et leur donner un droit de cité. Elle implique la parole du thérapeute pour ouvrir la voie à celle du patient. Le parcours de soin, qui ne manque pas d’embûches, vise une distanciation d’avec ce fonctionnement addictif prothétique afin, avant tout, de permettre au sujet de se « trouver-créer », si l’on peut dire, en tant que sujet.
Impacts relationnels et conjugaux vécus par les conjointes de joueurs pathologiques : comparaisons des perceptions des joueurs et de leurs conjointes
Authors: Bourget Marie-Noëlle , Ferland Francine , Blanchette-Martin Nadine , Tremblay Joël , Kairouz Sylvia , Nadeau Louise , Savard Annie-Claude , L’Espérance Nadia , Dufour Magali
Published: January 2022

Le trouble lié au jeu d’argent (TJA) a d’importantes répercussions dans la vie de l’individu qui en souffre, mais aussi dans celle des membres de son entourage, dont spécifiquement au niveau conjugal. En raison de leur nature complexe, les impacts vécus par les conjoints ont été le plus souvent explorés à partir d’observations cliniques tenant compte uniquement du point de vue du joueur pathologique (JP) ou uniquement du point de vue du conjoint. Des études tentant de dresser des parallèles entre les perceptions du JP et celles de son conjoint font toutefois souvent état de divergences importantes entre les perceptions des deux membres du couple. L’objectif de la présente étude était de documenter, sur le plan qualitatif, les divergences et les convergences de perceptions entre des JP et leurs conjoints quant aux impacts relationnels/conjugaux subis par ces dernières en raison du TJA. Le discours de JP (n = 22) et de leurs conjoints.es (n = 22) a été analysé. Les résultats ont révélé de nombreuses divergences entre les perceptions des deux groupes, notamment sur la nature des impacts identifiés, l’importance qui leur a été accordée, et la manière de décrire ces impacts. Les limites de l’étude et de nouvelles avenues de recherche sont aussi discutées.
Mediating Effect of Cognitive Function on the Relationship Between Geriatric Oral Health and Quality of Life Among Korean Seniors
Authors: Chang Eun Jee , Woo Hyun-Jae , Jeong Kyu-Hyoung
Published: January 2022

Objectives: Previous studies have found that the oral health of seniors can affect their physical nutrition and quality of life (QoL). Additionally, poor oral health can lead to the development of dementia, which is associated with decreased cognitive function. This study aimed to examine the impact of geriatric oral health (GOH) on the QoL of Korean seniors and the mediating effects of cognitive function.Methods: We used data from the seventh Korean Longitudinal Study of Aging conducted in 2018. In total, 4049 seniors were included in our study. We analyzed the impact of GOH on QoL according to 5 mediating domains of cognitive function and control variables. To examine each path of mediating effects, bootstrapping with 5000 iterations was performed with 95% confidence intervals.Results: Our findings revealed that good GOH had a positive effect on the QoL of seniors. Also, better GOH corresponded to a higher degree of cognitive function within all 5 domains: orientation, memory registration, attention/calculation, memory recall, and language and visuospatial ability. In addition, 3 domains of the 5 domains (attention/calculation, memory recall, and language and visuospatial ability) had significant mediating effects on the relationship between GOH and QoL.Conclusions: This study suggests that adequate management of GOH is crucial for promoting a better QoL and a high degree of cognitive function among seniors. To prevent cognitive impairment, such as dementia, future studies should take a more targeted approach by examining data according to each cognitive domain and various socio-demographic factors.
Vulnerabilidad sociocultural en contextos de crianza: retos teóricos y propuesta analítica
Authors: Grau Rebollo Jorge , Piella Vila Anna , González Echevarría Aurora , Valdés Gázquez María
Published: January 2022

La naturaleza multidimensional de la vulnerabilidad sociocultural, unida al carácter sectorial de la mayoría de los estudios realizados hasta el momento, dificulta enormemente una aproximación verdaderamente comprehensiva a los contextos de crianza vulnerable, en buena medida debido a la carencia de una delimitación analítica precisa que articule los diversos tipos y niveles de vulnerabilidad que convergen en dicho ámbito.
En este artículo nos proponemos identificar los principales retos de carácter teórico y metodológico a los que nos enfrentamos en la investigación antropológica sobre este fenómeno. Para ello comenzamos por ofrecer un panorama de las aproximaciones al estudio de la vulnerabilidad en Antropología y otras Ciencias Sociales del que se deducen tales retos. A partir de esta revisión bibliográfica, de los resultados del proyecto anterior del grupo de investigación y de los trabajos etnográficos en curso, hacemos una propuesta analítica que constituye un marco genérico pensado para que futuras investigaciones etnográficas puedan aproximarse de forma más integrada al campo, facilitando una identificación más adecuada de riesgos, recursos de afrontamiento y líneas efectivas de ayuda a población vulnerable.
Etnografía de una ausencia. Los sentidos de la fotografía familiar en la transmisión de la memoria traumática
Authors: Moreno Andrés Jorge
Published: January 2022

¿Cómo se mueven las fotografías familiares dentro del espacio doméstico? ¿Qué ocurre cuando esas imágenes pertenecen a las víctimas del franquismo? El artículo examina los usos intergeneracionales que sufren esas imágenes y que permiten analizar la transmisión de la memoria familiar en un contexto traumático. Esto se realiza a partir del estudio de un caso paradigmático: el de la familia de Emilio Silva, fundador de la Asociación para la Recuperación de la Memoria Histórica. Será precisamente una fotografía familiar escondida en la rendija de la pared la que impulse a Emilio a reconstruir la historia de su abuelo, algo que fortuitamente desencadenará con el inicio del movimiento memorialista en España.
Redistribución ritual en una expresión festiva popular. La fiesta de verdiales de los montes de Málaga
Authors: Llorente Marín Francisco Manuel , Zurita Márquez Evelina
Published: January 2022

Este artículo aborda una investigación realizada sobre la Fiesta de Verdiales, una expresión festiva popular localizada en el espacio ecológico-cultural de los Montes de Málaga. Acometemos esta indagación desde el análisis o descomposición de la doble dimensión de la acción humana, en cuanto instrumental y expresiva, inspirada en las tesis sobre teoría de la comunicación de la Escuela de Palo Alto. Los sujetos sociales no sólo se enfrentan al mundo para sobrevivir. La interpretación de las culturas nos muestra el gozoso esfuerzo en que se alzan por encima de sí mismos, a través de formas de expresión que transfiguran lo que su realidad es. En la Fiesta, como comunicación y expresión de la comunidad, es decir de lo común, se construyen formas de relación social que van a contrapelo de lógicas hegemónicas individualistas, de la rentabilidad y el consumo. La Fiesta es una plataforma que invita a imaginar la Realidad hecha añicos.
La spiritualité dans l’approche holistique à la Nature-territoire : un processus d’auto-écoformation
Authors: Boelen Virginie
Published: January 2022

Cet article présente les éléments théoriques d’un modèle éducationnel ayant pour but de recréer une relation saine entre l’être humain et son milieu de vie naturel. Campé dans le paradigme transdisciplinaire et en concordance avec l’épistémologie du savoir autochtone, il s’agit d’un modèle holistique transformationnel émancipateur qui prend appui sur une relation écoformatrice à la Nature et au territoire. Ce modèle mobilise toutes les dimensions de l’apprenant, dont cette dimension ontologique de son humanité souvent incomprise et mise de côté en éducation qu’est la spiritualité. Nous en clarifierons le sens et la dimension écologique ainsi que les apports en éducation. Il s’agit de favoriser chez l’apprenant le déploiement d’une agentivité autant épistémique qu’écocitoyenne pour un vivre-ensemble écologique et un réenchantement du monde. Nous traiterons enfin de la pertinence d’un tel modèle éducationnel au sein de notre société post-moderne.
Formation of Calprotectin-Derived Peptides in the Airways of Children with Cystic Fibrosis
Authors: Edwards Teagan S , Dickerhof Nina , Magon Nicholas J , Paton Louise N , Sly Peter D , Kettle Anthony J
Published: January 2022

Calprotectin is released by activated neutrophils along with myeloperoxidase (MPO) and proteases. It plays numerous roles in inflammation and infection, and is used as an inflammatory biomarker. However, calprotectin is readily oxidized by MPO-derived hypohalous acids to form covalent dimers of its S100A8 and S100A9 subunits. The dimers are susceptible to degradation by proteases. We show that detection of human calprotectin by ELISA declines markedly because of its oxidation by hypochlorous acid and subsequent degradation. Also, proteolysis liberates specific peptides from oxidized calprotectin that is present at inflammatory sites. We identified six calprotectin-derived peptides by mass spectrometry and detected them in the bronchoalveolar lavage fluid of children with cystic fibrosis (CF). We assessed the peptides as biomarkers of neutrophilic inflammation and infection. The content of the calprotectin peptide ILVI was related to calprotectin (r = 0.72, p = 0.01, n = 10). Four of the peptides were correlated with the concentration of MPO (r > 0.7, p ≤ 0.01, n = 21), while three were higher (p < 0.05) in neutrophil elastase–positive (n = 14) than –negative samples (n = 7). Also, five of the peptides were higher (p < 0.05) in the bronchoalveolar lavage fluid from children with CF with infections (n = 21) than from non-CF children without infections (n = 6). The specific peptides liberated from calprotectin will signal uncontrolled activity of proteases and MPO during inflammation. They may prove useful in tracking inflammation in respiratory diseases dominated by neutrophils, including coronavirus disease 2019.
Upper Triassic to Lower Jurassic stratigraphy along the northeastern margin of the Sverdrup Basin, Axel Heiberg and Ellesmere islands, Nunavut: new data from measured sections
Authors: Midwinter D , Hadlari T , Dewing K
Published: January 2022

Two stratigraphic sections were measured through Late Triassic - Early Jurassic aged strata in the Blue Mountains map area (NTS 340-B/11) on Ellesmere Island and the Depot Point map area (NTS 049-G/7) on Axel Heiberg Island. These sections are subdivided in terms
of established member and formation names based on previous mapping along the north-eastern margin of the Sverdrup Basin. The lowermost strata in the Heiberg Formation, the Romulus Member (510-575 m thick), is a coarsening-upward succession of mudstone to fine-grained sandstone from a prodelta to
delta plain environment. The overlying Fosheim Member (317-425 m) is a coal-bearing and sandstone-rich interval from a mixed alluvial-marine environment, such as a delta plain. It is overlain by the Remus Member (100-112 m); a sandstone-rich unit representative of shallow marine deposits. The
Heiberg Formation at Depot Point is of similar thickness (1009 m) to the Blue Mountains (1035 m) and may represent a marginally more distal basinal setting with a thinner Fosheim Member but a slightly thicker Romulus and Remus members.
Catheter-directed thrombolysis in a COVID-19 patient complicated with pulmonary embolism
Authors: Kocas Betul Balaban , Kilickesmez Kadriye
Published: January 2022

Since December 2019, the novel coronavirus (COVID-19) outbreak has become an important public health problem and one of the most common causes of morbidity and mortality worldwide. COVID-19 is highly associated with thromboembolic events, like deep venous thrombosis and pulmonary embolism (PE). Catheter-directed thrombolysis (CDT) provides effective reperfusion for the treatment of PE. We report a patient who was presented with intermediate-risk PE and had a saccular aneurysm of the anterior cerebral artery. The patient was suffered from recent COVID-19 infection and ischemic stroke. As the patient had high bleeding risk for full-dose systemic thrombolytic therapy, CDT was the preferred method for reperfusion. Finally, the patient was discharged from the hospital uneventfully 4 days later. In the setting of high bleeding risk, CDT seems to be an effective and safe approach in patients with intermediate-risk PE.
Scrub typhus manifesting as electrocardiographic disturbance
Authors: Gupta Samiksha , Jesrani Gautam , Gaba Saurabh , Gupta Monica
Published: January 2022

Scrub typhus (ST) has wide organ system involvement, but cardiac involvement is paramount in this spectrum due to early hemodynamic compromise. Various forms of cardiac involvement have been described in the literature, but we are describing rare electrocardiographic changes in the ST infection. A young male presented in our emergency department with complaints of restlessness and vomiting of 2 days’ duration. The patient was having stable vitals on presentation, but his electrocardiogram (ECG) demonstrated second-degree atrioventricular block type 1 (also known Mobitz 1) and Osborn wave in the precordial leads. Further, he was having thrombocytopenia and eventually diagnosed with ST. For this, appropriate antibiotic treatment was given, which led to considerable symptomatic improvement and reversal of the ECG changes.
The end-of-life care in the emergency department setting with respect to the Middle East countries and comparison with the Western countries
Authors: Qureshi Alamgir Ahmed , Mohammad Jassim , Mohammed Elkandow Ali Elhaj , Hanumanthappa Jagannath , Ariboyina Ashok Kumar , Türkmen Süha
Published: January 2022

Patients who are affected with severe chronic illness or in need for end-of-life care ((EOLC), they are mainly treated in the emergency departments (EDs) to provide the utmost amount of care for their condition. The major aspects which impact the accessibility of care in the ED include the clinical, social, and economic factors in different regions of countries. In recent years as the EOLC has been provided, it has been observed that patients experiencing EOL and dealing with a dying process do not always achieve the experience what resonates with a good death. The main cause of concern for these patients is the problem that in the ED they do not have access to palliative care options, mainly the ones who are suffering from noncancer ailments. These patients are provided palliative care at a very later stage in the ED when they could have been provided with palliative management at home in an earlier manner. EOLC plays a very critical role in ensuring that terminally ill patients are given a proper and adequate amount of care. The present article aims to highlight the EOLC in the ED in the Middle-Eastern regions. We aim to present a broader view that has impacted the current situation of EOLC in the Middle East regions and demonstrate a description of the EOLC in an ED setting between the Middle Eastern regions and western culture focusing on the following five important factors: Situation acceptance in the ED, cultural compatibility of bioethics, treatment perspective, skills among clinical providers and physician's attitude. In this literature review, we present the evidence associated with the EOLC in the ED setting with respect to the Middle East countries and bring out their differences in the religious, clinical, social, ethical, and economic aspects in comparison with the Western countries. We also tried to determine the differences between the two regions in terms of the principle of explaining the fatal diagnosis or poor prognosis, family relations, and do-not-resuscitate decision. This comparative analysis will help to bring out the gaps in the quality of care in the ED in the Middle East countries and promote the development of well-assessed policies and strategies to improve EOLC. The findings of this study and the future interventions that can be implemented to improve the structure and design of the EOLC that will act as a guiding force to execute evidence-based quality improvement program.
Individual-Level Active Aging Index and Quality of Life of Older People
Authors: Tajvar Maryam , Yaseri Mehdi , Mahmoudi Roya , Zaidi Asghar
Published: January 2022

Background:

Iran is one of the fastest ageing countries in the world. The model of Active Ageing (AA) could be a strategy contributing in addressing the problem of population ageing in Iran. This study measured the status of AA in Iran and examined its associations with the health-related quality of life of older people.

Methods:

A quantitative cross-sectional survey of a random sample of 623 people aged 55 + years resident in Tehran was conducted. In total, 590 people responded. The AA was measured using the Active Ageing Index (AAI) questionnaire and the health-related quality of life was measured using SF-36 questionnaire. Associations between the domains and the overall AAI scores with the quality of life were examined by MANCOVA analysis in four models using the STATA software.

Results:

The score of overall AAI was calculated at 26.8 (men 33.9 vs. women 20.6) out of 100. We found a stronger association of the AAI with the physical component than the mental component of the SF-36. Generally the 1st (employment) and the 2nd (participation in society) domains of the AAI showed little or no association with SF-36, but there was an association between the 3rd domain (enabling environment for active ageing) and the SF-36 and a particularly strong associations with the 4th domain (independent, healthy and secure living capacity).

Conclusions:

Iranian elderly, particularly women, are experiencing relatively inactive life, which negatively influence on their health-related quality of life. To improve the AAI status in Iran, some aspects including “enabling environment” and “independent, healthy and secure living capacity” need special attention.
Safety of Intraparenchymal Injection of Allogenic Placenta Mesenchymal Stem Cells Derived Exosome in Patients Undergoing Decompressive Craniectomy Following Malignant Middle Cerebral Artery Infarct, A Pilot Randomized Clinical Trial
Authors: Dehghani Leila , Khojasteh Arash , Soleimani Masoud , Oraee-Yazdani Saeed , Keshel Saeed Heidari , Saadatnia Mohammad , Saboori Masih , Zali Alireza , Hashemi Seyed Mahmoud , Soleimani Reyhane
Published: January 2022

Background:

Malignant middle cerebral artery infarct (mMCAI) largely contributes to high mortality and physical disability among adults. Surviving individuals may not have proper outcomes and suffer from severe lasting disabilities. Utilization of stem cells and paracrine factor for regenerative purposes is considered as a potential strategy for patients with neurological deficits. While preclinical stroke studies have shown that mesenchymal stem cells (MSCs) reduce post-treatment neurological deficits and prevent disability and also promote recovery, few randomized clinical trials (RCT) have assessed exosome therapy in humans.

Methods:

In this RCT, we assessed the safety of intraparenchymal injection placenta MSC-derived Exosome in mMCAI patients with average age of 62 years between January, 2019, till September, 2020. The study was done in a single-center as an open-label RCT, with a 3-months follow-up. Primary outcomes assessed the safety and also disability indexes were followed.

Results:

Five mMCAI patients were included with mean NIHSS: 17.6 ± 5.02. The mean MRS was 3.25 ± 0.95 in three patients. No serious adverse events were observed. Hematoma or local reaction as excessive edema were not seen at the site of injection.

Conclusions:

Intraparenchymal implantation of MSC-EXO showed no post-interventional adverse effects in five ischemic stroke patients. It is proposed Local injection Exosome treatment following mMCAI can be safe and in future, it would be applied as a supportive, restorative and preventive treatment in patients who suffer from acute ischemic stroke and post ischemic disability.
Pharmacomechanical Catheter-Directed Thrombolysis
Authors: Aashish Arumugam , Ganesh Balasubramaniyan Amirtha , Karthikeyan Selvaraj , Giridharan Srinivasan
Published: January 2022

Venous thromboembolism comprising pulmonary embolism and deep-vein thrombosis (DVT) is a major health problem with DVT accounting for two-third of them. Lower extremity DVTs account for 25%–50% of them and have long-term chronic venous complications which are termed as postthrombotic syndrome. The armamentarium in DVT management includes systemic anticoagulation, mechanical thrombectomy, and catheter-directed thrombolysis (CDT). Despite the benefits of therapy, CDT has its own limitations. Pharmacomechanical CDT (PMCDT) is an emerging percutaneous therapy which improves the treatment efficacy and reduces the incidence of long-term complications. Here, we present a series of three cases where PMCDT was used in acute to subacute DVT with poor response to anticoagulation therapy.
A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
Authors: Goyal Vipin Kumar , Gupta Priyamvada , Baj Birbal , Garg Vishnu Kumar
Published: January 2022

Background and Aims:

Intraoperative fluid management is important in renal transplant recipients with end-stage renal disease. Conventionally, central venous pressure (CVP) has been used to guide perioperative fluid administration but with high incidence of poor graft outcome. There is a requirement of reliable parameter to guide the fluid therapy in these patients so as to minimize the perioperative complications and improve the outcome. Hence, this study was conducted.

Material and Methods:

This prospective study included 75 patients of chronic kidney disease undergoing renal transplantation. Patients were divided into two groups. Group A (control group): Intraoperative fluids were guided by CVP; Group B: Intraoperative fluids were guided by pulse pressure variation (PPV). Primary outcome measure of this study was incidence of delayed graft functioning, i.e., need of hemodialysis within 7 days of renal transplant. Secondary outcome measures were incidence of perioperative hypotension, post-transplant pulmonary edema, tissue edema, and lactic acidosis.

Results:

Total amount of fluid before reperfusion was significantly greater in the control group (P = 0.005). However, the total amount of fluid required at the end of surgery was comparable. Delayed graft functioning was seen only in CVP group, although it was not statistically significant. The postoperative tissue edema was more in CVP group (P = 0.03). The postoperative nausea and vomiting, pulmonary edema, and mechanical ventilation were more in CVP group but not statistically significant. Increase in lactate value was more in CVP group.

Conclusion:

Perioperative fluid guidance by PPV is better than central venous pressure in renal transplant patients.
A study to evaluate ocular changes in patients undergoing spine surgery in the prone position
Authors: Kaur Kiranpreet , Khanduri Neetu , Sachdeva Sumit , Singh Roop , Bhardwaj Mamta , Bala Manju
Published: January 2022

Background and Aims:

AA present prospective study was conducted to evaluate ocular changes occurring in patients undergoing spine surgery in the prone position.

Material and Methods:

A total of 44 patients of either sex, belonging to American society of Anaesthesiology I and II (aged 18-60 years) scheduled for elective spine surgery in prone position were enrolled in the study. Baseline IOP and MAP measurement were taken prior to induction. After induction of anaesthesia patients were intubated using flexo-metallic tube of appropriate size. IOP and MAP were recorded after induction of anaesthesia, following completion of surgery and immediately after turning the patient supine and 30 min following extubation. Blood loss and duration of surgery was also noted. The OPP was derived using the formula (OPP = MAP-IOP). Ophthalmic examination was also performed using direct and indirect ophthalmoscopy on the day prior to surgery and on first post-operative day to rule out anterior ischemic optic neuropathy (AION), posterior ischemic optic neuropathy (PION), and retinal ischemia.

Results:

Mean IOP significantly increased (18.91 ± 3.56 mm Hg) (P < 0.001) at the end of surgery as compared to baseline value 12.85 ± 3.07 mm Hg. As a result mean OPP significantly reduced (75.12 ± 16.45) (P = 0.0018) at the end of the procedure.

Conclusion:

In patient’s undergoing spine surgery in the prone position, careful patient positioning with no extrinsic pressure on the eyes, minimal surgical time and blood loss, and prevention of intraoperative hypotension, should be ensured to prevent the IOP rise and a reduction in OPP which can further prevent post-operative visual disturbance.
Comparison of lidocaine–dexmedetomidine and lidocaine–saline on the characteristics of the modified forearm bier block: A clinical trial
Authors: Ghaderi Kamal , Rahmani Khaled , Rahmanpanah Nasser , Shami Shoaleh , Zahedi Farhad , Nasseri Karim
Published: January 2022

Background and Aims:

Forearm Modified Bier Block (FMBB) reduces local anesthetic systemic toxicity risks compared to the traditional method. This study was designed and implemented to compare the effects of lidocaine–dexmedetomidine (LD) and lidocaine–saline (LS) on the characteristics of the MFBB in distal forearm and hand surgery.

Material and Methods:

In this randomized double-blind trial, which was conducted after obtaining institutional ethical committee approval, 60 patients were enrolled and randomly divided into two groups. In both groups, the analgesic base of the block was 20 mL lidocaine 0.5% that was supplemented by 1 μg/kg dexmedetomidine in the LD group or 1 mL of 0.9% saline in the LS group. Patients were evaluated for the onset and duration of sensory block, time of the first request for postoperative analgesic, and analgesic request frequency during the first 24 h after surgery.

Results:

Sensory block onset in the LD group (7.1 ± 1.4 min) compared to the LS group (8.4 ± 1.4) was faster (P = 0.008). Duration of the sensory block in LD group (49.7 ± 7.2 min) was longer than LS group (33.3 ± 2.6) (P < 0.001). Compared to LS group, time of the first request for postoperative analgesic in LD group was later (P = 0.6), and had lesser analgesic requests during the first 24 h after surgery (P < 0.001).

Conclusion:

Based on our study’s finding, adding dexmedetomidine to lidocaine in the MFBB increases the duration of sensory block.
A study on oral mucosal changes among tobacco users
Authors: Ramasamy Jeyaseelan , Sivapathasundharam B
Published: January 2022

Introduction:

Oral malignancies account for about 4% in males and 2% in females among all malignant tumors. Tobacco use in the oral cavity can cause potentially malignant disorders such as oral submucous fibrosis (OSMF), leukoplakia and oral squamous cell carcinoma (OSCC). Factors such as lifestyle changes, habits and limited access to health care increase cancer development and morbidity.

Aim and objectives:

This study aimed at studying and correlating the oral mucosal changes among the tobacco users with the different forms of tobacco used.

Materials and Methods:

Four thousand and five hundred individuals were examined and patients with habits were categorized as Group A: only chewing, Group B: only smoking and Group C: smoking and chewing. A preformed case sheet with a detailed recording of the patient's habits was used for each individual. The suspected oral lesions were examined with care and a biopsy was taken (if needed) with patient consent. The collected data were compiled and statistical analysis was done.

Results:

Among the three groups OSMF, chewer's mucositis, smoker's palate and OSCC were more compared to other lesions.

Conclusion:

OSCC, OSMF and chewer's mucositis were seen more among A and C Group individuals. Smoker's palate was more in Group B. All the lesions showed a strong correlation with increased usage of tobacco. Lesions were more among males compared to females as there were no females with smoking habits in the study. A future study with larger sample size and equal gender distribution in different population among various locations is to be carried out to get accurate details about the lesions associated with tobacco habits and to correlate between the types, frequency and duration of the habit with the tobacco usage.
Twitter for microblogging in oral health care, research, and academics
Authors: Chowdhry Aman , Kapoor Priyanka
Published: January 2022

Current times have seen growing use of social medial tools, including microblogging sites like Twitter as an efficient method to disseminate information related to health amongst patients, students as well as health care workers. This article explores the role of this short, effective messaging platform in oral health care, teaching, research and learning. The concepts of “tweeting the meeting” and aggregation of conversations via “hashtags” is advocated for academic conferences, which will extend the conference reach to give the users better access to the instructors and enhance the related outcomes. Tweeting and retweeting the required research content may increase the academic footprint of the conducted research and researchers. In addition, it has served an immense role in the current COVID-19 pandemic by the regular circulation of information to the public and helped governments in policymaking and showcasing the areas of public concern. However, it still has a huge potential yet to be explored, with collective efforts towards strengthening the aspects of authenticity and standardization of the shared content.
COVID-19 and oral implications
Authors: Boyapati Ramanarayana , Dhulipalla Ravindranath , Kolaparthy Lakshmi Kanth , Bodduru Ruparani
Published: January 2022

The emerging (COVID-19) pandemic is a global health disaster, caused by infection with severe acute respiratory syndrome coronavirus-2. The disease spreads at an alarming rate all over the world and presents a range of disease manifestations including asymptomatic, mild, moderate and severe symptoms irrespective of age groups. Most patients with severe symptoms exhibit underlying comorbidities such as diabetes, hypertension and obesity. Alternatively, there is an existing evidence for an association between oral health and nonoral systemic diseases. Since the oral cavity is a significant pool for many respiratory pathogens, patients with oral infections are more likely to develop pneumonia as a complication. Therefore, we emphasize that the oral hygiene status has a great impact on the recession and progression of oropharyngeal and respiratory diseases.
Herpes zoster of orofacial region
Authors: Dosi Tanvi R , Chawla Ashmita Kaur , Barkalle Gauri , Phulambrikar Tushar
Published: January 2022

Herpes zoster (HZ) is a viral disease which is primarily caused by the nerve tissue, but its treatment necessitates a multidisciplinary approach. Varicella zoster virus (VZV) is a DNA virus that causes both primary and recurrent infection. HZ, also known as shingles, is a unique condition induced by VZV reactivation. Neuropathic pain, headache, malaise and sleep disruption are all prodromal symptoms in such cases. HZ generates a pruritic, localized and vesicular rash that is usually unilateral. Individuals who are immunocompromised as a result of disease or receiving any treatment are also at increased risk, regardless of their age. HZ and its sequelae set a major strain on patient's caregivers, health-care system and business. Despite recent advances, prevention and treatment of HZ, consequences remain a therapeutic challenge. This is a case report of HZ infection in a 56-year-old female patient who was managed with comprehensive medical treatment.
Velscope guided oral cancer screening
Authors: Vibhute Nupura Aniket , Jagtap Sunil Vitthalrao , Patil Sujata Vijaysinh
Published: January 2022

Context:

Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope.

Aims:

Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder.

Settings and Design:

A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India.

Materials and Methods:

Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed.

Statistical Analysis Used:

Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome.

Results:

The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity.

Conclusions:

The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.
Questionnaire-based survey regarding the opinion of general pathologists on the need for oral pathology services
Authors: Salian Varsha , Natarajan Srikant
Published: January 2022

Context:

Oral and maxillofacial pathology (OMFP) is a subspecialization having a masters course in India. Due to lesser number of oral pathologists in the country, the biopsy material from the head and neck is catered to by the general pathologist.

Aim:

This survey was conducted to acquire responses from general pathologists and gathering knowledge on their perspective of oral pathology.

Methods:

Pathologists at various medical institutions and at laboratories all over Karnataka were requested to answer a questionnaire comprising 13 questions pertaining to the need and scope of oral pathology.

Results:

In total, 37 (57%) general pathologists completed the questionnaire, of whom 97% (36) were aware of the specialty and 30 (81%) perceived a need for it. Eleven (30%) of them referred oral biopsy specimens to oral pathologists. The most common sources of diagnostic difficulty were identified as odontogenic tumors and cysts. Twenty-six (70%) pathologists felt the need for a short-term posting for their postgraduates in oral pathology, while 28 (76%) of them expressed their opinion about considering an oral pathologist as a part of their team when diagnosing complex head and neck pathologies. Twelve (71%) of them mentioned that they sometimes found that head and neck lesions took longer time to diagnose.

Conclusion:

Although the utilization of OMFP specialists’ services in the state is quite low, general pathologists strongly feel the need for OMFP training as head and neck specimens form a considerable proportion of biopsies received by them.