bluuebunny/crossref_metadata_2025 huggingface dataset:
Chitosan biomaterials
Authors: Gayen Khooshbu , Pabale Sagar , Shirolkar Supreet , Sarkar Subir , Roychowdhury Somen
Published: May 2024

In the quest for discovering ideal dental materials, biomaterials or those derived from biological sources play a special role because of their varied usages and inherent biocompatibility. Chitosan has been a rather recent material derived primarily from exoskeletons of life that forms mainly anthropods and fungi, etc. Evolving technology and understanding has made it possible for us to employ more biomaterials that are easy to adapt for uses in humans with less side effects and more therapeutic effects. With increasing applications that chitosan has found in medicine, exploring the dental applications of chitosan needs to be started with more vigor as well. Chitosan owing to its properties of being antimicrobial, biocompatible, biodegradable, osteoconduction, etc., either de novo or on being modified can be a real blessing in disguise for dentistry and find application in therapies from preventive to regenerative dentistry in various of its specialties.
Role of presurgical nasoalveolar molding in the repair of unilateral cleft lip
Authors: Dutta Subhrangshu , Mandal Kartik Chandra , Majumder Saheli , Roy Sourav , Neilasano L , Halder Pankaj Kumar
Published: May 2024

Aim:

A study aims to reappraise the merits of nasoalveolar molding before the repair of unilateral cleft lip.

Materials and Methods:

A prospective study was conducted with 20 cases of the unilateral complete cleft lip for 3 years. We counseled the parents, offered them to choose the surgical procedure with/without preoperative nasoalveolar molding (NAM), and obtained consent from them. The nasolabial closure was done either after aligning the cleft segments with NAM or without preoperative NAM. The patients were followed up for 1 year and assessed. Both groups are then compared with normal healthy individuals of the same age group.

Results:

Depending on preoperative NAM, the patients were divided into Groups A (without NAM) and B (with NAM). All the facial proportions and angles (except oral commissural width: facial width and nasal tip angle) of Group B are much closer to the values of normal age-controlled individuals. However, a significant difference existed between the Group A values and normal individuals. Group B showed better nasal symmetry and restoration of normal proportions. The quality of scar produced was significantly superior in Group B when compared to Group A. Body weight change was also significantly different in the two groups. Group B seemed to catch the 15th percentile while Group A stayed at the 3rd percentile in the postoperative period.

Conclusion:

Presurgical NAM helps to restore the normal facial proportions and produces a healthier scar. Furthermore, the bodyweight of patients seems to improve as the NAM plate acts as a feeding plate.
Antibiotic prescription pattern among dentists in Imphal city of North East India
Authors: Thoudam Bebika Devi , Santosh H N , Bose Aditi , Singh Moirangthem Niteshore
Published: May 2024

Background:

Antibiotics are a subject of intensive abuse due to overprescription and also administration for inappropriate reasons. In India, some studies have reported the use and abuse of antibiotic therapy and their consequential impact on antibiotic resistance. However, there has been no study yet on the use of antibiotics among dentists in North East India.

Objective:

To determine the rationale and prescription pattern of antibiotics among dentists of Imphal city in North East India.

Materials and Methods:

A self-administered questionnaire was used. The questionnaire consisted of demographic data and comprised questions related to the use of antibiotics for various dental procedures and in certain clinical situations.

Results:

The results of this survey indicate that there is wide spectrum of antibiotics prescribed by dentists in Imphal city. Amoxicillin was clearly the choice of antibiotic among dentists. Although the dentists handpicked antibiotics based on its efficacy and side effects, at certain places these drugs were overtly used. Majority of the respondents thought that antibiotic sensitivity tests would help them choose the right antibiotic.

Conclusion:

The prescription pattern for antibiotics was inconsistent and at times inappropriate. A standard guideline needs to be formulated according to the population for prescribing antibiotics; because when used judiciously antibiotics are lifesaving.
Recent advancements in materials in pediatric restorative dentistry
Authors: Hambire Chaitali , Hambire Umesh
Published: May 2024

The most common infectious disease affecting the children worldwide is dental caries. It affects children of all races, castes, and creeds. Refined diet and improper oral hygiene increase the risk of caries in children. Meticulous clinical examination and diagnosis of dental caries are an integral part of a comprehensive treatment plan. The factors to be considered include the developmental status of the dentition, caries-risk assessment, the patient's oral hygiene, anticipated parental compliance and likelihood of timely recall, and the child's ability to cooperate for treatment. Restorative science is undergoing great revolutions that are leading the humanity toward a new era of dentistry.
Cerebral palsy
Authors: Nirmala SVSG , Degala Saikrishna , Nuvvula Sivakumar
Published: May 2024

Cerebral palsy is one of the most severely handicapping conditions affecting irregular gait childhood. This condition manifests itself as a number of neuromuscular dysfunctions and involves muscle weakness, stiffness, paralysis, poor balance irregular gait, and uncoordinated or involuntary movement. These children may have higher risk of caries due to their inability to maintain good oral hygiene, intake of soft and cariogenic food, increased prevalence of enamel hypoplasic defects on the teeth. Periodontal diseases occur with great frequency, as they are unable to brush and floss adequately, they may also be on phenytoin to control seizure activity which is a cause of some degree of gingival hyperplasia. Malocclusion occurs twice, bruxism is commonly seen in athetoid type, and due to the nature of disorder, these children are more susceptible to trauma, especially of the maxillary anteriors. They have excessive drooling and difficulty in swallowing. Spastic children present with spastic tongue thrust, Class II DIV 2 malocclusion with unilateral crossbite. Athetoid patients presents with mouth breathing and anterior open bite. Many patients prefer to be treated in the wheel chair, which may be tipped back into the dentist's lap, head should be stabilized throughout the procedure, use physical restraints for control of failing extremities, mouth props, and finger splints can be used for control of involuntary jaw movements, avoid abrupt movements, lights and noises to minimize startle reflex reactions. Local anesthetic can be used with care, rubber dam can be used to protect the working area from hyper active tongue movements, and gauge shield should be used during extraction to avoid aspiration. Premedication can be used to reduce hypertonicity, involuntary movement, and anxiety; general anesthesia can be used as a last resort. This article discusses about etiology, clinical features along with management of children with cerebral palsy.
Laser versus surgical
Authors: Samal Santoshni , Mahakur Manoranjan , Kumar Mukesh , Ray Prayas
Published: May 2024

The mucocele is the accumulation of mucous from salivary glands and its ducts into subepithelial tissue. It is the most common, painless, and harmless oral lesions. Etiology could be trauma, lip habits or unknown. Diagnosis is made mainly on the basis of history and clinical examination. Along with conventional surgical treatment now, we have lasers also for excision of mucocele lesions. We reported a case series of mucocele treated with conventional treatment as well as laser.
Barriers and Facilitators to Yoga for Obesity, Diabetes, and Hypertension: A Qualitative Systematic Review Protocol
Authors: Chattopadhyay Kaushik , Biswas Isha , Wang Haiquan
Published: May 2024

The global burden of obesity, diabetes, and hypertension is high and increasing. Several systematic reviews suggest yoga, an ancient mind–body discipline from the Indian subcontinent, is safe and can be beneficial for preventing and managing obesity, diabetes, and hypertension. Several qualitative studies have been conducted to explore barriers and facilitators to yoga practice among people at high risk of or with obesity, diabetes, or hypertension and providers who delivered yoga to these people. However, no systematic review on this topic has been conducted to date, and this systematic review will aim to synthesize such barriers and facilitators to yoga practice. We will follow the JBI guideline on systematic reviews of qualitative evidence. For published studies, we will search the following electronic databases from inception dates: MEDLINE, EMBASE, CINAHL Plus, APA PsycInfo, AMED, and Web of Science. For gray literature, we will search EthOS and ProQuest Dissertations and Theses. Screening of studies, methodological quality assessment, and data extraction will be performed independently by two reviewers. Any disagreements between reviewers will be resolved through discussion or by involving a third reviewer. Initially, a narrative synthesis will be conducted. Study findings from the included studies will be pooled using the meta-aggregation approach, where possible.

Systematic Review Registration Number:

PROSPERO (CRD42020220640).
Impact of Yoga Intervention in Lower Limb Amputees following Trauma in Relation to Behavior and Quality of Life: A Randomized Controlled Trial
Authors: Mir Nida , Sen Mahadev Singh , Mani Kalaivani , Sagar Rajesh , Arulselvi S. , Kumar Subodh , Gupta Amit , Sagar Sushma
Published: May 2024

Background:

Yoga is an emerging intervention causing improvement in physical, mental, and spiritual well-being. Its role in improving outcomes in patients with amputation was investigated.

Methodology:

Patients with traumatic lower limb amputation (n = 50) were enrolled and randomized to the Yoga group (n = 26) against control (n = 24). Sociodemographic details, quality of life (QOL) (World Health Organization QOL-BREF), Depression anxiety stress scale (DASS), Rosenberg self-esteem scale, and amputee body image score were applied at baseline, 6,–18 weeks of amputation.

Results:

Sociodemographic and clinical variables were comparable between groups. At 18 weeks, the Yoga group had better QOL (P = 0.005) than the control group. Symptoms of depression (0.02) and anxiety (<0.001) reduced, and self-image (P = 0.015) improved significantly at 6 weeks, while stress (P = 0.003) reduced at 18 weeks in the yoga group. Despite comparable body image scores, the prosthesis usage (hours/day) was more (P = 0.005) in the Yoga (6.9 ± 3.2) group against the control (12 ± 2.7).

Conclusion:

Yoga improves QOL and self-esteem and reduces depression, anxiety, and stress symptoms in patients with traumatic amputation.
Yoga Intervention Improves the Metabolic Parameters and Quality of Life among Infertile Women with Polycystic Ovary Syndrome in Indian Population
Authors: Patil Anushree Devashish , Pathak Satish Dattatray , Kokate Pratibha , Bhogal Ranjit Singh , Badave Akshata Sudesh , Varadha Mangalam , Joshi Beena Nitin , Tandon Deepti , Begum Shahina , Surve Suchitra Vishwambar , Dalvi Prachi Datta
Published: May 2024

Background:

The heterogenic manifestations of polycystic ovarian syndrome have led to various treatment approaches that include improving hormonal imbalance, weight management, and improving quality of life (QoL). Yoga therapy being a versatile treatment approach benefits physical and mental well-being and can be recommended to women with polycystic ovary syndrome (PCOS).

Objective:

The objective of this study was to study the effect of structured yoga intervention on anthropometric, metabolic, hormonal, biochemical, ovarian morphology, and infertility-related QoL parameters among infertile women with PCOS.

Settings and Design:

A prospective, controlled before and after study was conducted at a Multidisciplinary PCOS Clinic in Mumbai, Maharashtra, India.

Methodology:

Infertile women with PCOS (26 participants in each group which includes intervention and control arm) seeking treatment for infertility at the Multidisciplinary PCOS Clinic at National Institute for Research in Reproductive and Child Health. The intervention group received 90 min of structured yoga intervention for 3 months.

Statistical Analysis:

The median change in parameters between baseline and after 12 weeks of intervention was analyzed using IBM SPSS software, version 26 to perform descriptive analyses and Wilcoxon test to analyze pre- and postintervention parameters in the intervention and control group.

Results:

There was a significant difference in the weight, basal metabolic rate, postglucose insulin, anti-Müllerian hormone, cholesterol, high-density lipoprotein, low-density lipoprotein, serum glutamic pyruvic transaminase, ultrasound parameters such as stromal thickness, follicle number per ovary, and QoL in infertility domain in the intervention group compared to the control group. Within 1 year of initiation of the study, 13 participants became pregnant in the yoga intervention group as compared to 7 participants in the control group.

Conclusion:

The metabolic comorbidities of PCOS have adverse effects on the QoL and pregnancy outcome among infertile women with PCOS. This pilot study demonstrated that a 12-week yoga intervention brought overall improvement in anthropometric, hormonal, biochemical, ovarian morphology, and infertility-related QoL parameters compared to the control group. Integration of yoga in infertility management will help to improve the QoL and to optimize prepregnancy metabolic parameters among infertile women with PCOS.
Clinicopathological features and evaluation of microsatellite stability of colorectal carcinoma with cribriform comedo pattern
Authors: Günler Tuğba , Karabağli Pinar , Tiyek Hicret , Keskin Özge , Körez Muslu K.
Published: May 2024

Background:

Cribriform comedo-type adenocarcinoma (CCA) was a colon cancer subtype defined in the 2009 World Health Organization (WHO) classification. In the 2018 classification, it was a colon cancer subtype included in the adenocarcinoma, Not otherwise specified (NOS) group. A few studies have reported that colon cancers with a cribriform pattern have worse overall survival, and most of them are microsatellite stable (MSS). In this study, we evaluated CCAs based on their clinicopathologic features and microsatellite stability. We aimed to answer whether these tumors could be defined as a distinct morphologic subtype with prognostic significance.

Materials and Methods:

Pathology reports and specimens from 449 patients with colorectal adenocarcinoma (CRA) were re-evaluated. All subtypes were determined. To evaluate MSS status, the CCA cases were immunohistochemically stained with anti-MLH1, MSH2, MSH6, and PMS2 antibodies.

Results:

CCA was present in 40.5% of cases. These cases were found to have higher rates of lymph node metastasis, lymphovascular-perineural invasion, metastasis, and advanced stage (P < 0.05). Also, 2.7% of CCA cases were microsatellite instable (MSI). However, no statistically significant result was found regarding overall survival and progression-free survival of CCA cases with MSI.

Conclusion:

According to the findings, CRAs with comedo cribriform patterns are tumors with more aggressive features. It can be said that these tumors have a specific molecular feature related to MSS. Because this feature is important for planning adjuvant chemotherapy, it may be useful to identify cases, particularly with a cribriform comedo pattern >90%. However, because no significant difference in survival rates was found, CCAs may not need to be defined as distinct subtypes.
A Prospective Randomized Clinical Study to Assess and Compare the Efficacy of Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block for Postoperative Analgesia in Patients Undergoing Abdominal Hysterectomy Under General Anaesthesia
Authors: Khare Arvind , Thada Beena , Parasrampuria Mudrika , Jonwal Kuldeep , Rathore Mukut
Published: May 2024

Background and Aims:

Multimodal analgesia regimens for optimizing the postoperative pain following abdominal surgeries are a crucial component of enhanced recovery after surgery (ERAS), as it reduces postoperative opioid consumption along with their adverse effects. We compared the analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block (QLB) versus posterior transversus abdominis plane block (TAPB) with respect to duration of analgesia, modified Defense and Veterans Pain Rating Scale (DVPRS) scores for pain, activity, sleep, stress, and mood, respectively, the total amount of rescue analgesic consumption, hemodynamics parameters and side effects, in patients undergoing total abdominal hysterectomy under general anesthesia.

Materials and Methods:

In this study, which was prospective, randomized, and double-blind, 60 patients of the American Society of Anesthesiologists Physical Status I and II, aged 18–65 years, undergoing abdominal hysterectomy, were randomized into two groups. Group QLB (n = 30) and Group TAPB (n = 30) received bilateral QLB and TAPB with 40 ml of 0.375% ropivacaine, respectively. The data were compared using standard qualitative and quantitative tests.

Results:

The duration of pain relief was longer in Group QLB compared to Group TAPB (981.83 ± 138.62 min vs. 637 ± 127.02 min, P < 0.0001). The DVPRS score for pain, activity, sleep, stress, and mood, respectively, were significantly lower in Group QLB (P < 0.05). The total rescue analgesic consumption was significantly lesser in Group QLB (103.33 ± 18.26 mg) compared to Group TAPB (150.00 ± 50.85 mg) (P < 0.0001). No significant hemodynamic changes or side effects were observed (P > 0.05).

Conclusion:

Bilateral QLB significantly prolonged the duration of analgesia with reduced rescue analgesic requirement compared with bilateral TAPB in patients undergoing total abdominal hysterectomy.
COVID-19 and rhino-orbital mucormycosis – A case report
Authors: Singh Dilbag , Kaur Harveen , Kajal N.C.
Published: May 2024

There is a constant rise in cases of rhino-orbital mucormycosis in people with coronavirus disease 2019 (COVID-19). Generally, mucormycosis develops in immunosuppression or debilitating diseases. In cases having head and neck involvement, the mold enters the respiratory tract with further involvement of nose and sinuses and there is consecutive progression into orbital and intracranial structures. Diabetes mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. The clinical examination and direct smears are helpful for early diagnosis of the disease and timely intervention. For the better prevention and management of such opportunistic infections in COVID-19 patients, it is prudent to establish prophylactic treatment protocols along with rational use of corticosteroids. We here report a case of rhino-orbital mucormycosis infection caused by Rhizopus oryzae in a COVID-19 patient with DM.
Story of a Cisternography
Authors: Chakraborty Debabrata , Bhaumik Sanjay , Pramanick Gobinda , Biswas Devarati
Published: May 2024

A 53-year-old lady with no known comorbidity had undergone cisternography for persistent rhinorrhea. Rhinorrhea resolved, and the report was normal. However, a week later, she complained of low back pain, followed by progressive quadriparesis and sphincter dysfunction. A detailed imaging revealed evidence of leptomeningitis around the brain stem, intradural cervical and dorsal collection with nodular enhancement, and clumping of cauda equina roots. Cerebrospinal fluid (CSF) showed pleocytosis with increased protein and hypoglycorrhachia. CSF cell count was 6000 (all lymphocytes), CSF proteins were 1138 mg%, and CSF glucose was 30 mg% (corresponding blood glucose level of 110 mg%). We did not get any systemic clue about the illness except progressive weight loss. Our team concluded either it is directly a deadly sequel of the dye-related complication of cisternography or activation of a chronic infection in the spine. We treated her with antitubercular drugs and steroids along with physiotherapy. We kept in mind the chronicity of the illness and endemicity of tuberculosis. She responded well and was mobilizable with minimal support. Hence, we continued the same regimen, keeping in mind the responsiveness of the patient to the same. We report this case to realize the possibility of this type of complication even with advanced dye and modern techniques of cisternography. Our case also underscores the requirement of prior imaging (magnetic resonance imaging of the spine) before undertaking such a procedure (cisternography). Last but not the least, sometimes we also need to make decisions based on our clinical knowledge as neurological investigations may be inconclusive in many circumstances.
A Curious Case of Classic Biphasic Pulmonary Blastoma
Authors: Vinay V. , Saini Jitendra Kumar , Dinesh Kanna M. N. , Srivastava Alpana
Published: May 2024

Classic biphasic pulmonary blastoma is an uncommon and highly aggressive primary pulmonary malignancy characteristically arising from fetal lung tissues comprising biphasic histology that is made up of both epithelial and mesenchymal components. We present this rare case in which a young adult presented with chest pain for 3 months and dyspnea for 1 month. Contrast-enhanced computed tomography of the thorax revealed a right-sided homogeneous mass. The diagnosis was confirmed by transthoracic biopsy and histopathological examination. Surgical excision remains the treatment of choice. Recurrence usually occurs within 12 months of surgery, with 5-year survival rates <20%. We report this rare malignancy with a special focus on improving the management of this malignancy.
The Moral-Ethical Dilemma of Climate Crisis
Authors: Raina Sunil Kumar , Kumar Raman
Published: May 2024

What generally we know as natural hazards floods, droughts, and heat waves are not solely the products of nature's wrath against humans. These situations have an enormous impact on society because of inherent vulnerability. A neutral evaluation of this context is required by the people, societies, nation states and the ecosystems (physical and academic); turning a blind eye to it puts it at risk of harm to all. The shallow efforts and mere talk about helping poor nations transition to greener energy, the narrative being built around climate change, is purely an attempt to deflect from the fact that the global western powerhouses have continued to contribute the most to the climate crisis.
An Unusual Mode of Facial Thermal Burn Injury by an Oxygen Mask Caught Fire While Smoking in a Patient With COPD: A Case Report
Authors: Singh Anshu , Pandey Sandhya , Kumar Ravi , Kumar Manish , Kumar Vijay
Published: May 2024

Introduction:

Unusual mode burns are not uncommon. In developing countries like India where bidi (local cigarette; made from tobacco and plant leaves without filter), smoking is very common and is a common cause of chronic obstructive pulmonary disease (COPD). Individuals who are suffering from COPD are usually addicted to smoking. Smoking in hospitals due to improper checking of belongings is considered poor safety measures and negligence of the hospital community and lack of knowledge and awareness among the general public.

Methods:

The patient course in the hospital after the facial burn injury through oxygen face mask was studied.

Results:

On the 4th postburn day, the patient’s condition improved, he was able to breathe, talk, and swallow well following management.

Conclusion:

Facial burn injury is the most commonly associated with inhalational injury. The proper early management of inhalational injury by intubation and mechanical ventilation results in the improvement of hypoxia or hypercapnia along with steroid administration to reduce proinflammatory cytokines and reduce further cellular injury. Use good quality tubing of nasal prong for oxygen supply at home in COPD patient is recommented.
Pulmonary Functions Assessment in Post-COVID-19 Pneumonia Cases by Spirometry
Authors: Patil Shital , Patil Rajesh , Gondhali Gajanan
Published: May 2024

Background:

Although lung is the primary target organ involvement in coronavirus disease-19 (COVID-19), post-COVID lung pathology and its impact on lung functions are still uncertain.

Materials and Methods:

Prospective multicentric study conducted during May 2020 to June 2021, to find pulmonary function assessment in post-COVID-19 recovered pneumonia cases irrespective of their symptoms, included 600 cases in symptomatic and asymptomatic group and subjected to inclusion and exclusion criteria. All cases were subjected to Spirometry analysis. Statistical analysis was done by using Chi-test.

Results:

In Spirometry assessment of post-COVID-19 pneumonia cases at 12 weeks' postdischarge from hospital, abnormal lung function in 77.5% post-COVID-19 pneumonia cases; restrictive pattern was predominant type and documented in 43.33% cases, normal lung functions were documented in 22.5% cases. In age and gender assessment in normal and abnormal lung functions assessment, statistically significant association in males 90/150 versus females 45/315 (P < 0.00001); and in the age of population in study cases as below 50 years 110/300 versus above 50 years 25/165 (P < 0.0001). Computed tomography severity score has shown a negative impact on lung function after recovery at 12 weeks' postdischarge; cases with score <8, 8–15, and >15 documented normal and abnormal lung functions as in 36/54, 60/80, and 39/331 respectively of total 600 study cases (P < 0.00001). The duration of illness has associated negative impact on lung function; <7 days, 8–15 days and >15 days of onset of symptoms documented normal and abnormal lung functions in 108/132, 22/168 and 5/165 cases respectively (P < 0.00001). Low oxygen saturation at entry point has a negative impact on overall outcome on lung function; cases with oxygen saturation < 75%, 75%–90%, and >90% observed as normal and abnormal lung functions in 92/18, 35/135 and 6/314 cases, respectively (P < 0.00001). Timing of biphasic positive airway pressure/noninvasive ventilation (BIPAP/NIV) has a significant association in attaining normal lung functions after post COVID19 pneumonia recovery; cases received BIPAP/NIV at entry point <1 day, 3–7 days and after 7 days of hospitalization were documented normal and abnormal lung functions in 30/150, 40/35 and 5/50 cases, respectively (P < 0.00001).

Conclusions:

Pulmonary functions abnormality in post-COVID-19 pneumonia cases has been documented and should be assessed cautiously to have successful treatment outcome. Restrictive lung disease is the predominant lung function impairment in post-COVID 19 recovered lung pneumonia cases. Age above 50 years, male gender, diabetes, High CT severity, longer duration of illness, proper timing of initiation of BIPAP/NIV therapy, has documented significant impact on post-COVID lung functions at 12 weeks assessment.
Remote Patient Monitoring
Authors: Gupta Anannya
Published: May 2024

Concerns about the unsatisfactory condition of chronic disease management prompted the design and development of a telemonitoring home system based on user input. Patients, caring for themselves through self-care and monitoring, can control and prevent chronic disorders, restructuring the treatment process into a constant cooperative interaction between patients and health-care professionals. The primary major goal of this study is to highlight future research directions in remote health care and patient monitoring for chronic illnesses treatment and management, as well as to provide an overview of the current state of remote patient monitoring (RPM), its contemporary constraints, and possible future prospects that will aid to resolve those contemporary constraints. The methodology of this review is that an independent literature search was conducted on Medline, PubMed, and Google Scholar for the below-mentioned keywords, and studies published till April 2022 that had used any type of RPM intervention were screened for inclusion in the review. The conclusion of this review is that continuous RPM may increase patient adherence to medication and other guideline-recommended therapy strategies that have been linked to a reduction in clinical mortality and better prognosis. However, a number of technological, medical legal and economic barriers must be overcome before they may be widely used.
Correlation of Subjective and Objective Assessment of Hypernasality in Children with Repaired Cleft Lip and Palate
Authors: Girish K. S. , Pushpavathi M.
Published: May 2024

Introduction:

Correlational studies between subjective and objective evaluations in the area of cleft lip and palate might provide evidence on the reliability and validity of subjective evaluations. This will, in turn, help in deciding to use subjective evaluations in remote areas. Such correlational studies are scanty in Indian languages.

Aims:

The present study aimed at correlating the perceptual rating of hypernasality with its instrumental measure in Kannada speaking children with repaired cleft lip and palate (RCLP) across different stimuli. The study also discusses various aspects that affect nasality (the type of speech stimuli and age of first palatal surgery) which helps in better understanding of RCLP cases and their characteristics.

Settings and Design:

This study was based on correlational research designs.

Subjects and Methods:

Twenty-three Kannada speaking children with RCLP served as participants. Speech samples (vowels, oral words, nasal words, oral sentences, nasal sentences, and oronasal sentences) of children with RCLP were recorded using a sound level meter and were perceptually evaluated using Henningsson's rating scale by three experienced speech-language pathologists. Furthermore, nasalance values were objectively obtained using a nasometer.

Statistical Analysis:

This study was statistically analyzed using the Shapiro–Wilk test of normality and Spearman's correlation.

Results:

The results revealed a high positive correlation (0.78) between the subjective and objective assessment. The different degrees of perceptually rated hypernasality were in a positive correlation with nasometry scores of vowels (0.766), words (0.785), and sentences (0.819).

Conclusions:

A good correlation was obtained between the subjective and objective measurement of nasality indicating the high utility of perceptual evaluation in remote areas.
Spontaneous Regression of Traumatic Lumbar Disc Herniation: A Case Report and Literature Review
Authors: Chang Chia-Yuan
Published: May 2024

Traumatic intervertebral disc herniation is more common in the cervical spine than in the lumbar spine. Traumatic lumbar disc herniation (LDH) had the same symptoms as degenerative LDH including low-back pain and nerve root radiculopathy. Many reports are showing that herniated discs can regress spontaneously, therefore, improving neurologic symptoms. The exact mechanism of spontaneous herniated disc regression remains unclear. Traumatic LDH treatment principle should be the same as degenerative LDH. We report a case of traumatic LDH with spontaneous regression and discuss the possible mechanisms of spontaneous lumbar herniation disc regression.
Raised Bilirubin: An Independent Indicator for Perforated or Gangrenous Appendicitis
Authors: Pattnaik Manas Ranjan , Ghose Saurov , Basra Sharanjit Singh , Kumar Brajesh , Panigrahi Mohit Mohan , Ramakrishnan DM
Published: May 2024

Introduction:

Acute Appendicitis is still one of the most common surgical emergencies that most general surgeons encounter in their practice. Diagnosis of acute appendicitis is made in almost 80% of cases, clinically and is helped by some laboratory tests. Certain clinical scoring systems such as Alvarado Score and MANTRELS Score have been developed to aid in diagnosis. A delay in diagnosis or delayed presentation leads to perforation and localized or generalized peritonitis leading to increased mortality. Furthermore, the presence of appendicolith has been found to be correlated with complicated appendicitis. Increased bilirubin level (>1.0) has been indicated as marker for predicting appendiceal perforation in various studies.

Objective:

This study aimed to evaluate whether a raised bilirubin level has an independent predictive value for complicated appendix.

Methods:

This was a prospective observational study conducted at Command Hospital, Lucknow, and was further continued at Military Hospital Jaipur and Military Hospital, Jammu, from January 2021 to December 2023. A total of 169 patients were included in the study. After clinical examination, laboratory tests were sent for routine investigations to include total leukocyte count and liver function test. Subsequently, they underwent appendicectomy and intraoperative findings were noted. Data were further analyzed to know the correlation of raised bilirubin with various parameters such as presentation, MANTRELS scoring, presence or absence of appendicolith, intraoperative findings, and pathological findings.

Results:

In our study, in acute presentation of appendicitis, serum bilirubin was raised (>1 mg/dL) in 94 patients. However, in chronic presentation, it was raised only two patients. This difference was statistically significant with P < 0.001. MANTRELS scoring was compared with bilirubin level and it was found that the patients with higher score had raised bilirubin level with a mean of 7.98 and median was 8. Patients with normal bilirubin level had mean MANTRELS score of 7.01 and median of 7. This difference was significant. Gangrenous appendix, burst or perforated appendix with intraperitoneal pus was found in 39 patients. Out of 39 patients, 38 patients had raised bilirubin level which was statistically significant P < 0.001. In our study, 23 patients had appendicolith, out of which 21 patients had raised bilirubin level which was statistically significant. Thirty-seven patients out of a total of 38 patients with perforated or gangrenous appendix on histopathological examination had raised bilirubin level while only one patient had normal bilirubin level which was statistically significant.

Conclusion:

A high index of suspicion should be kept for complicated appendicitis in a patient with acute appendicitis with raised bilirubin.
Burden of Significant Anxiety and Stress Symptoms in Persons with Visual Impairment in a Nigerian Hospital
Authors: Okeke Suhanyah , Onu Justus Uchenna , Asimadu Ifeoma Nwabuogo , Onyebueke Godwin C.
Published: May 2024

Background:

Visual impairment (VI) presents a unique situation for adaptation with diverse socio-cultural and psychological consequences. However, the treatment of patients with visual impairment (PVI) in Nigeria is yet to embrace the biopsychosocial model thereby leaving huge unmet mental health needs.

Aims:

The aim of the study was to determine the burden of anxiety disorders and stress symptoms in PVI and highlight its relationship with vision-related health status.

Subjects and Methods:

This was a cross-sectional study involving 400 PVI using standard criteria. Screening for anxiety disorders and stress symptoms was done using the 21-item Depression, Anxiety and Stress Scale (DASS). Diagnosis of anxiety disorders was confirmed using relevant modules of the Mini-International Neuropsychiatric Inventory (MINI). The vision-targeted health status was measured using the 25-Item Visual Function Questionnaire (WHO-NEI-VFQ-25). Multivariate linear regression model was used to determine the potential predictors of general health and vision sub-scales of quality of life.

Results:

The prevalence (95% confidence interval [CI]) of anxiety disorders and significant stress symptoms were 29.5% (25.1%–34.2%) and 34.5% (29.9%–39.4%), respectively. Vision-related quality of life scores in the domains of general health, general vision, ocular pain and mental health were significantly lower in participants with anxiety disorders when compared with those without (P < 0.05).

Conclusion:

The findings of this study support the thinking that the presence of significant anxiety and stress symptoms lower the quality of life of the visually impaired. This has implications for clinical practice in the areas of routine screening for psychiatric morbidities and integration of psychosocial care into ophthalmic care.
Correlation Between Foot Length and Height in a Cohort of 1677 Nigerian School Children
Authors: Bafor Anirejuoritse , Chibuzom Chukwuemeka Ndubuisi , Mbanuzuru Ahoma Victor
Published: May 2024

Background:

Dimensions of body parts have been used to estimate height in different populations using correlation equations. Among these, foot length has been found to be a reliable predictor of height in adult and pediatric populations.

Aims:

This study was designed to derive correlation equations for estimating height from foot length among a cohort of Nigerian school-age children.

Subjects and Methods:

Foot length, weight, and height measurements were obtained from healthy primary-school students of Nigerian descent aged 5–13 years in Benin City, Nigeria.

Results:

In total, 1677 subjects consisting of 778 boys and 899 girls were included in this study. The mean height for boys and girls was 134 ± 11 cm and 135 ± 13.5 cm, respectively, while the mean foot length was 21.9 ± 2 cm in boys and 21.9 ± 2.1 cm in girls. A significant correlation was observed between the length of both feet in boys and girls. No significant gender differences were observed in the foot length. A significant correlation was observed between height and the average foot length in boys and girls (P < 0.0001 for both sexes). We derived linear regression equations to determine the height from foot length for boys (height [cm]) = (4.6238 × average foot length [cm]) + 32.843 and girls (height [cm]) = (4.9276 × average foot length [cm]) + 27.373. Wilcoxon matched-pairs signed rank test determined that there was no statistically significant difference between the actual and predicted height based on the regression equations in both sexes.

Conclusion:

Our findings show that foot length can be used to estimate the height of school-aged Nigerian children. This finding is valuable in forensic medicine and in the estimation of height when actual height measurement is not possible.
External Cephalic Version
Authors: Bako Babagana , Geidam Ado Danazumi , Zaifada Zanna Usman , Musa Fadimatu Yusuf
Published: May 2024

Background:

External cephalic version (ECV) is the first-line treatment in the management of uncomplicated breech presentation at term.

Objectives:

The aim of this study was to determine the success rate, factors associated with success, and obstetric outcome of ECV for breech presentation at term.

Materials and Methods:

This was a longitudinal interventional study of patients with breech presentation at term who underwent ECV at the University of Maiduguri Teaching Hospital from January 1, 2017 to December 31, 2018. Data analysis was performed using IBM SPSS version 25.0 and a statistically significant association was determined using chi-square or Fisher exact test for categorical data as appropriate. Multinomial logistic regression was computed to find factors independently associated with ECV success. A value of P was set at <0.05.

Result:

The success rate of ECV was 78.5% (62/79). There were no differences in the mean age, parity, and gestational age at ECV between the successful and the unsuccessful groups with P = 0.19, 0.79, and 0.36, respectively. Multinomial logistic regression analysis showed that parous women, women who did not complain of pain during the procedure, women who weighed 80 kg or less, and women with an estimated fetal weight of <3.5 kg were significantly associated with successful ECV. There was an increased risk of postterm pregnancy and induction of labor among women with successful ECV. There were no maternal or fetal complications associated with the procedure.

Conclusion:

ECV is safe and associated with a high success rate. It should be offered routinely to all eligible women with breech at term.
Childhood Bullous Pemphigoid with Atypical Immunopathology: A Case Series
Authors: Li Jennifer C. , Gabriel Rio Mae Timon , Garcia Ma. Desiree Hannah C. , Omangayon Ma. Fatima Lourdes , Mendoza Clarisse G. , Umali-Adasa Gisella E.
Published: May 2024

Bullous pemphigoid (BP) is a rare autoimmune blistering disorder primarily affecting older adults, with limited occurrences in children. BP in children typically manifests as large, tense blisters on the skin, often on flexural areas. It also more often affects the oromucosal areas and the face in children than in adults. Diagnosis involves histopathological examination revealing eosinophilic spongiosis or subepidermal split, immunofluorescence tests highlighting immunoglobulin G (IgG) and C3 depositions, and immunological assays detecting BP180 and BP230 IgG autoantibodies. This report presents two cases of childhood BP (CBP) with atypical immunopathological findings. Clinically, the two cases had generalized plaques and bullae, including the face. The first case exhibited the characteristic linear deposits of IgG and C3 on the basement membrane through direct immunofluorescence (DIF) and revealed negative anti-BP180 antibodies on enzyme-linked immunosorbent assay (ELISA). In contrast, the second case showed negative DIF results, despite clinical suspicion, but had positive anti-BP180 IgG antibodies on ELISA. It is, therefore, crucial to consider the complete clinical presentation of the patient, in conjunction with the histological findings and immunopathologic assessments to diagnose CBP.
A Case of Psoriasis and Pemphigus Foliaceous in a 55-year-old Filipino
Authors: Ollet Anikka Mae Crystal E. , Garcia Ma. Desiree Hannah C. , Mendoza Clarisse G.
Published: May 2024

Pemphigus foliaceous is a rare autoimmune blistering disease, while psoriasis is a common immune-mediated inflammatory skin disease. The coexistence of psoriasis and pemphigus foliaceous has rarely been reported. We report a case of a 55-year-old Filipino female with an 8-year history of chronic plaque-type psoriasis biopsy-proven. After 5 years, she developed generalized flaccid bullae and crusted erosions over the face, trunk, and extremities, with no mucous membrane involvement. Skin punch biopsy, direct immunofluorescence, and enzyme-linked immunosorbent assay were consistent with pemphigus foliaceous. The combination of topical corticosteroids and oral methotrexate was selected as the therapeutic approach, leading to a notable improvement in the patient’s condition. This case report underscores the significance of identifying the simultaneous presence of psoriasis alongside autoimmune blistering diseases like pemphigus foliaceous. Examining predisposing and triggering factors, performing re-biopsy, and further work-up as the disease evolves may yield more profound insights. Nonetheless, effectively managing this condition poses a significant challenge.
A review of the physicochemical properties of severe acute respiratory syndrome coronavirus 2 and its effect on coronavirus disease-2019 manifestation
Authors: Joseph Adejoke Adijat , Odimayo Michael Simidele , Akinbodewa Ayodeji Akinwunmi , Ogbaini-Emovon Ephraim , Gbala Michael Olumide
Published: May 2024

The coronavirus disease-2019 (COVID-19) has been declared a global pandemic by the World Health Organization due to its spread to more than 90% of nations of the world with significant consequences on their health, social structure, and economy. The causative agent, severe acute respiratory syndrome coronavirus 2, is a highly contagious virus of the coronaviridae family that is known to survive on many surfaces for days at various temperatures. It is acid stable at a high titer (1.2 × 103 PFU) for up to an hour and inactivated when exposed to temperatures 33°C and above for up to 30 min. Chemical agents such as ethanol, diethyl ether, chlorine, per-acetic acid, and chloroform likewise inactivate it as well as exposure to ultraviolet (UV) rays at 254 nm. Emerging evidence indicate that while modes of transmission of the disease are the same across the globe, incidence rates, clinical manifestation, severity, and outcome of COVID-19 in tropical Africa differ from other continent. Patients in Africa have presented with less severe symptoms, higher rates of recovery, and lower case-fatality rates. There are suggestions that higher environmental temperature and humidity in African countries, immune status, dietary pattern, and sociocultural practices of the people may have contributed to this. This review of literature sought to investigate the probable influence of these factors on the impact of COVID-19 in Africa with recommendations to mitigate its spread and impact on morbidity and mortality.
Relations of plasma homocysteine to left ventricular geometry and functions
Authors: Agbogu-Ike Obiageli Uzoamaka , Maiha Bilkisu Bello , Okonkwo Lilian Okwubenata , Aliyu Mohammed , Oyati Albert Imhoagene
Published: May 2024

Background:

Hyperhomocysteinemia is a risk factor for heart failure commonly in females. The study aimed at determining Hcy's association with left ventricular (LV) remodeling.

Materials and Methods:

A cross-sectional study evaluating the relationship of plasma Hcy to echocardiographic LV structure and function in 65 apparently healthy Nigerians (Mean age 41.87 ± 12.90 years, 52.2% females) without cardiovascular disease.

Results:

The mean Hcy level was 10.76 ± 2.69 μmol/L with no significant (P = 0.89) sex difference and 50.8% of the subjects had Hcy levels within the fourth quartile (hcy: 10.3–17.5 μmol/L). Plasma Hcy showed no significant (P > 0.05) relationship to LV mass (LVM), wall thickness (WT), relative WT, systolic/tissue-Doppler-derived diastolic function, and left atrial dimension in both sexes. Hyperhomocysteinemia (hcy >10.3 μmol/L) was significantly (P < 0.007) correlated to LVM indexed to height2.7 in all subjects but showed no such association in the unadjusted and adjusted binary logistic regression models. The odd of hyperhomocysteinemic patients having thicker LVM trended more toward females (odds ratio: 1.44, 95% confidence interval, 0.59–3.50) than males.

Conclusion:

Plasma hyperhomocysteinemia found in healthy Nigerian-Africans shows no relationship to LV remodeling, echocardiographic LV structural and functional parameters.
The rodent ulcer
Authors: Yahya Husain
Published: May 2024

A rodent ulcer refers to the slowly growing, ulcerated, locally invasive basal-cell carcinoma (BCC) which is the most common cutaneous malignancy in Caucasians but is rare in people with dark skin. We report two morphologically different presentations of nodular BCC in Nigerian patients. The first was a large, slowly growing ulcer on the right side of the face which had been present for many years, with the diagnosis not being made despite visits to various health centers, whereas the second was a much smaller ulcerated nodule on the right alar nasi and dorsum of the nose. We highlight the need for vigilance to make the correct diagnosis early and institute appropriate treatment.