bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of oat bran fiber on physicochemical properties and acceptance of enriched rabbit meat burgers
Authors: Silva Heloísa Lara , Pires Paula Gabriela da Silva , Lima André Luis Ferreira , Cristofolini Aline Chiarelli , Peres Netto Diego , Miotto Marília , Hauptli Lucélia , Moraes Priscila de Oliveira
Published: February 2024

Burger is a practical source of animal protein for consumers, sold both raw (ready-to-cook) and cooked (ready-to-eat), and can be an alternative to stimulate the consumption of rabbit meat, which is a source of healthy animal protein. This study evaluated the effects of different levels of oat bran addition on physicochemical properties and sensory acceptance of rabbit meat burgers. Burgers were formulated with 0, 5, 10, and 15% oat bran plus garlic and salt, then manually processed and analyzed for composition, technological parameters (pH, cooking loss, shrinkage percentage, water holding, texture, and color), and sensorial acceptance. The higher the levels of inclusion of oat bran, the lower the burger moisture (p < 0.0001). Burgers with 15% oat bran presented higher content of lipids and carbohydrates, thus higher caloric value (p < 0.0001). The loss of water during cooking was greater in the burger without the inclusion of oat bran (p < 0.05). No significant difference was found for color and aroma attributes. Overall acceptability was higher for burgers with 5% oat bran. Rabbit meat burgers containing oat bran may represent a viable alternative to improving their sensory and technological profiles and overall consumer acceptance.
Computational implementation of alternative method for determining the loss of prestressing by deformation of the anchorage in post-tensioning
Authors: Fraga Iuri Fazolin , Sartorti Artur Lenz , Mascarenhas Fernando Júnior Resende , Almeida João Paulo Boff , Moraes Matheus Henrique Morato de , Christoforo André Luis
Published: February 2024

Due to its advantages, Prestressed Concrete has been used as a structural element in many buildings worldwide. In order to overcome large spans, limiting the formation of cracks, its application can be visualized, for example, in bridges, viaducts, and building slabs. These structures are executed by stretching steel cables with a subsequent release, introducing compressive stresses in the concrete. However, during this process, stress losses occur in the active reinforcement, requiring forecast by the designers. Quantifying these losses in certain cases is a long and iterative process. The present work aimed to present the computational implementation of an alternative method for determining the loss due to deformation of the anchorage in post-traction. In order to prove its effectiveness, this method was contrasted with two conventional methodologies established in the literature. To this end, two models of beams of the same cross-section were simulated, however, with different spans and cable paths. Both proposed simulations aimed to cover all possible situations for the development of prestressing stress along with the tensioned cables. The alternative method showed minor differences in all measurements compared to the conventional methods, proving its effectiveness. Furthermore, the computational tool, entitled vProt, proved to be reliable in the two proposed simulations, allowing its use in the elaboration and verification of structural projects.
Ecological soap production using green chemistry principles
Authors: Cavalheiro Nadine , Stadler João Paulo , Giusti Edneia Durli , Chendynski Leticia Thaís , Gomes Sandra  Inês Adams Angnes
Published: February 2024

The reuse of fatty materials for soap production is considered a viable alternative to minimize environmental problems such as the eutrophication of lakes and rivers and to reduce the high costs of effluent treatment and domestic water supply. This research presents protocols for ecological soap production from the determination of the saponification index (SI) using the principles of Green Chemistry. The chemical greenness of the produced soap was assessed using mass and holistic metrics. The SI measurement ensured a final product without residues, aligning with the principles of Green Chemistry: principle 1 (waste prevention) with a Factor E of 0 and an Atomic Economy of 100%. Additionally, the Green Matrix and Green Star analyses demonstrated a more sustainable experimental approach for bar soap production, with 45% higher greenness compared to traditional soap and 95% greenness for ash soap. The changes in the saponification process by the principles of green chemistry allowed ecological soap production without residues, an innocuous product to health and the environment. The methodology proposed in this research can contribute to minimizing an environmental problem related to the incorrect disposal of non-biodegradable oil.
Low-Temperature Atmospheric Pressure Plasma Jets and their Applications in the Surface Activation of some Polymeric Substrates for Advanced Electronic Packaging
Authors: Hsu Shan Yao , Tseng Chuan Ming , Hsieh Jang Hsing
Published: February 2024

The present study applied low-temperature atmospheric plasma (LTAPP) jets to modify polymer substrates used in chip packaging. These substrates include bismaleimide triazine (BT), polyimide (PI) and PTFE materials. All these materials play important roles in modern semiconductor packaging. During the study, focuses were aimed the effects of reactive species (mainly OH and atomic oxygen) generated by atmospheric plasma jets on surface energy, water contact angle (WCA) and surface composition of these three substrates. In order to better understand and apply LTAPP jets, another focus will be on the understanding of the relationship among (1) the generation and distribution of various reactive species, (2) parameters for generating LTAPP jet, and (3) plasma characteristics. The plasma activation mechanism of these substrates was also discussed. In addition to plasma generation using AC high-voltage supplies, plasma characterization using optical emission spectroscopy (i.e., analysis of electron density, electron temperature, plasma temperature, and reactive species), XPS and water WCA analysis were used to understand surface activation mechanisms. In sum, Ar and Ar-O2 plasma jets can be used to modify the surfaces of these three substrates, although the latter relies on the generation of O radicals, while the former relies on OH radicals more. According to the results obtained by XPS analysis, the formation of C-O and C=O bond after plasma treatment is the main reason for surface activation in this study.
Fabrication of Paper-Based Silver Nanoparticle (AgNP) Sensors for Smartphone-Based Colorimetric Detection of Cu (II) in Water
Authors: Gomeceria Mich Adrian D. , Miranda Ma. Lorena Isabel C. , Lopez Edgar Clyde R. , Perez Jem Valerie D.
Published: February 2024

Detection of heavy metals in water has long been a key area of study due to the adverse health effects these substances may bring. Multiple methods of detecting heavy metals have already been established. Though these methods are highly selective and can detect heavy metals in trace amounts, they commonly require specialized equipment. Thus, producing an inexpensive, reliable, and convenient sensor that could be used for point-of-need applications is of great interest. This study focuses on fabricating paper-based silver nanoparticle (AgNP) sensors for the smartphone-based colorimetric detection of Cu2+ ions in water. Polymer-decorated AgNPs functionalized by chitosan, glutaraldehyde, and polyethyleneimine were used as the main sensing mechanism for the paper-based sensors. Various fabrication methods were tested, and the optimal fabrication method was through the rectangular soak method with a total of 5 coatings as it produced the most uniform sensors. The calibration curve was studied over concentrations from 0.5 mM to 50 mM of Cu2+ across multiple parameters. It was found that there was a linear correlation between the Euclidean distance measured in reference to the blank filter paper against the concentration of copper in the analyte. The calibration curve exhibited a dynamic linear range between 2 mM to 28 mM of Cu2+ with R2 = 0.99789. The LOD and LOQ were reported at 94.9438 ppm and 316.4793 ppm, respectively. Lastly, selectivity studies were also performed to determine the sensor’s response to other metal ions. It was found that the response of the sensor to Cu2+ was significantly different from those elicited by Ni2+, Cd+, Mn2+, Ca2+, Mg2+, Sn2+, K+, Cr3+, Al3+, Ba2+, Na+, Zn2+, Fe3+, and Fe2+. The study demonstrated its strong potential as rapid on-site detection method for Cu (II) in industrial wastewater.
Alarming signs of localized and generalized lymphadenopathy referred to two pediatric tertiary centers
Authors: Elalfy Omar , Adly Amira , Elghamry Islam
Published: February 2024

Background

Lymphadenopathy (LN) affects as many as 90% of young children. A common cause of cervical LN is viral agents. The second most common cause is bacterial infections. While cancer is the most feared cause of generalized LN [2].

Objectives

To define the etiology of localized versus generalized LN in children and adolescents in two tertiary centers (Ain Shams and Sultan Qaboos University Hospitals).Define the alarming signs for possible malignancy.

Methods

All children 2–16 years of both sexes presented to the two centers during the period 2018–2022, we divided them into patients with single lymph node enlargement and those with multiple LNs. Also with viral infection,either EBV or cytomegalovirus (CMV), and those with oncological diagnosis such as lymphoma and leukemia.

Results

Six hundred twenty-four children, 62% males aged 2–16 years (median, 6.5 years) over a period of 4 years,and acute both bacterial and granulomatous-related LNs were excluded (n=236). Meanwhile, 388 were enrolled from two centers, Ain Shams Children’s hospital (90%) and Sultan Qaboos (10%). In Ain Shams, 40% were referred to the general pediatrics clinic (n=155), only 1.9% were malignant, while of those referred to the pediatric oncology clinic(n=233), 42 (mostly 18%) were malignant, either leukemia (n=21) or lymphoma (four Hodgkin and seven NHL), and 10 were IMLN. Viral infection was the commonest; two-thirds were EBV and one third were CMV infection. Affected children with leukemia or NHL were commonly younger than 5 years.Boys were affected more with either EB or CMV often (two-thirds). No difference in the frequency of high temperature and sore throat between examined children in both viruses, but stomachaches, eyelid swelling, and skin rash were more common in CMV, while the frequency of LN and hepatosplenomegaly was not different. Alarming signs for risk for leukemia were associated with fever for more than 2 weeks. Purpura, bone aches and LNs. Generalized, nonregressive, firm and nontender, and splenomegaly were more at risk for noninfectious. Delay in diagnosis was 9–56 days comparable in both localized and generalized LN(mean, 17±3.1 days).

Conclusion

EBV was the commonest viral cause of LN in young children. Alarming signs for more serious illness were bone aches, splenomegaly, and purpura.
How to adjust therapy for elderly AML patients in developing countries?
Authors: Shaaban Yasmine , Alghandour Reham , Hamed Manar , Atef Manal , Elbogdady Mohamed , Ebrahim Mohamed A , Sakr Doaa H
Published: February 2024

Background

Acute myeloid leukemia (AML) with advancing age represents a therapeutic challenge. The tools used for comprehensive geriatric assessment (CGA) in elderly AML are not uniform.

Methods

This is a retrospective study that included 226 elderly AML patients (≥60 years), identified from the electronic database and followed till the end of 2021. Comorbidities were assessed using Charlson Comorbidity Index (CCI), Cumulative Illness Rating Scale-Geriatric (CIRS-G), Hematopoietic cell transplantation-specific comorbidity index (HCT-CI) scores, and Chia-Jen Liu and colleagues simplified proposed models. The primary outcome was 30 days mortality. The secondary outcomes were the achievement of complete remission.

Results

226 patients were included, the median age was 67 years, and 86.2% of patients had ECOG greater than or equal to 2 performance status at diagnosis. 82 patients received intensive induction treatment, 85 patients received reduced-intensity treatment, and 59 patients were unfit for therapy. 30-Day mortality was reported in 49.1% of included patients. With multivariate analysis; ECOG-PS (3-4), high CIRS-G or HCT-CI scoring system (≥3), and intermediate-high Chia-Jen Liu score were considered as prognostic factors for early mortality in elderly AML patients. Complete remission (CR) was achieved in 38.3% and 4.7% of the patients who received intensive induction and low-intensity therapy, respectively.

Conclusion

Geriatric and comorbidity assessment tools can be used to predict early mortality in elderly AML. Higher scores and poor PS are predictors for early death rather than a prediction of response to treatment.
Use of Anakinra in a Case of Severe Dengue with Refractory Secondary Hemophagocytic Lymphohistiocytosis
Authors: Chaudhuri Kaustabh , Chatterjee Anumita Biswanath , Pal Priyankar
Published: February 2024

Background:

Hemophagocytic lymphohistiocytosis (HLH) is a severe life-threatening systemic inflammatory syndrome which may be secondary to infections. It is a potential complication of severe dengue. We report a child with severe dengue with worsening clinical course due to secondary HLH. The refractory course responded to intravenous anakinra (an interleukin-1 blocker) as an add-on therapy.

Clinical Description:

An 11-year-old girl with dengue presented on the 7th day, with progressively worsening clinical condition, having developed multi-organ dysfunction syndrome.

Management and Outcome:

She required mechanical ventilation, hemodialysis, and extracorporeal hemoadsorption therapy. In view of secondary HLH, intravenous immunoglobulin and methylprednisolone were administered, but there was clinical worsening. Hence, anakinra was initiated and improvement was noted in the next 48 hours. The child was finally extubated on day 17 of illness and could be discharged.

Conclusion:

Secondary HLH should be considered early in severe dengue cases with cytopenias, hyperferritinemia, and multi-organ dysfunction and immunotherapy should be initiated without delay. Anakinra is a promising, efficient, therapeutic choice and may have a beneficial role and better prognosis if started early in rapidly worsening HLH.
Bee Sting-induced Nephrotic Syndrome in a Child: A Case Report with Review of Literature
Authors: Bargujar Payal , Meena Kuldeep , Meena Kailash , Meena Jeetam Singh , Meena Shiv Lal
Published: February 2024

Background:

Nephrotic syndrome (NS) is common in children, and it is usually idiopathic. Bee sting-induced NS in children is rarely reported.

Clinical Description:

A 9-year-old female child presented with a complaint of generalized edema for 2 days which started to develop 4 days after being stung on the dorsum of her right foot by a bee. She had pedal edema, facial puffiness, and abdominal distension.

Management and Outcome:

Laboratory investigations showed proteinuria, low serum protein, elevated serum cholesterol, serum triglycerides, and immunoglobulin E levels. A diagnosis of NS secondary to bee sting was made. The patient was treated with supportive measures for edema. There was a significant clinical and biochemical improvement by 10 days.

Conclusion:

This case reiterates the association between allergen exposure and NS, which is hardly reported in children. Such a phenomenon may be transient with requirement of only supportive therapy for symptom relief.
Full transforaminal endoscopic discectomy versus microlumbar discectomy for lumbar disc herniation: 2-year results
Authors: Sharma Manoj , Chhawra Sanjay , Jain Raman , Singh Gaganpreet
Published: February 2024

Objective:

Microlumbar discectomy (MLD) has been a gold standard surgical treatment of lumbar disc herniation (LDH); we have compared its results with full transforaminal endoscopic discectomy (FTED), which is a recent trend performed under local anesthesia. FTED and MLD are currently prevalent techniques for the surgical treatment of LDH.

Materials and Methods:

Patients were randomly assigned to the FTED or MLD groups in this single center study if they had clinical LDH with low back ache with radiculopathy confirmed with magnetic resonance imaging findings. The Oswestry disability index score was the primary outcome. 36-Item Short-Form Health Survey, Macnab, and visual analog scales for back pain and leg pain were used as secondary outcomes.

Results:

Over a follow-up of 2 years, both primary and secondary outcomes differed significantly according to the location of the discs; FTED was very successful in foraminal and extraforaminal herniated discs with many other benefits whereas MLD was better in central discs.

Conclusion:

FTED is superior in cosmesis, returning to work in 2 weeks, less surgical trauma, minimal bleeding, infection, hospital stay, and surgical scar compared with MLD. FTED was found to be less effective for median disc herniation, whereas MLD did not appear to be the best alternative for foraminal/extraforaminal disc herniation.
Effect of collagen cross-linking agents on the depth of penetration of bioceramic sealer and release of hydroxyproline: An in vitro study
Authors: Reddy K. Hanisha , Swetha Bollineni , Priya B. Devi , Mohan T Murali , Malini Duvvuri Lakshmi , Sravya M. Sai
Published: February 2024

Context:

During endodontic treatment, sealers seal off dentinal tubules and prevent microbial attack. Bioceramic sealers have excellent bioactivity, but its high alkalinity is found to have detrimental effects on radicular collagen. Collagen cross linkers have the ability to chemically modify collagen and can prevent the detrimental effects of the sealer.

Aim:

This research was aimed to assess the effect of collagen cross-linking agents on the integrity of radicular collagen matrix and depth of penetration of sealer.

Materials and Methods:

Mandibular premolars (n = 48) were taken. Teeth were decoronated; canals were prepared till ProTaper size F2 and were irrigated with 5 mL of 2.5% NaOCl, followed by 3 mL of 17% ethylenediaminetetraacetic acid between instrumentation and finally rinsed with saline following which teeth were divided into three groups based on the surface treatments: Group 1: 6.5% proanthocyanin (PA), Group 2: chlorhexidine (CHX), and Group 3: saline. Teeth were obturated using gutta-percha and bioceramic sealer and stored in artificial saliva. Hydroxyproline (HYP) release was assessed after 14 and 21 days using spectrophotometer. Sealer penetration was assessed using the scanning electron microscope.

Statistical Analysis:

Wilcoxon signed-rank test and Kruskal–Wallis test for release of HYP and paired t-test and ANOVA for sealer penetration were performed.

Results:

Significantly lower release of HYP was seen in proanthocyanin-treated group. Sealer penetration was better for both the proanthocyanin- and CHX-treated groups when compared to saline.

Conclusion:

Surface treatment with collagen cross-linkers caused a decrease in the amount of HYP released, indicating lesser degradation of collagen. Sealer penetration was better due to the removal of smear layer following the surface treatments.
Revolutionizing endodontics: Advancements in nickel–titanium instrument surfaces
Authors: Agrawal Paridhi Rajesh , Chandak Manoj , Nikhade Pradnya Prashant , Patel Aditya Satyawansingh , Bhopatkar Jay Kailas
Published: February 2024

Nickel–titanium (NiTi) instruments have become the backbone of endodontics due to their exceptional properties, superelasticity, and shape memory. However, challenges such as unexpected breakage, poor cutting efficiency, and corrosion have prompted researchers to explore innovative surface modifications to enhance their performance. This comprehensive review discusses the latest advancements in NiTi metallurgy and their impact on rotary NiTi file systems. Various surface treatment techniques, including ion implantation, cryogenic treatment (CT), thermal nitridation, electropolishing, and physical or chemical vapor deposition, have been investigated to minimize defects, boost surface hardness, and improve cyclic fatigue resistance. Ion implantation has shown promise by increasing wear resistance and cutting efficiency through nitrogen ion incorporation. Thermal nitridation has successfully formed titanium nitride (TiN) coatings, resulting in improved corrosion resistance and cutting efficiency. CT has demonstrated increased cutting efficiency and overall strength by creating a martensite transformation and finer carbide particles. Electropolishing has yielded mixed results, providing smoother surfaces but varying impacts on fatigue resistance. Physical or chemical vapor deposition has proven effective in forming TiN coatings, enhancing hardness and wear resistance. Furthermore, the concept of surface functionalization with silver ions for antibacterial properties has been explored. These advancements present an exciting future for endodontic procedures, offering the potential for enhanced NiTi instruments with improved performance, durability, and patient outcomes.
Comparative evaluation of the marginal fit of computer-aided design-computer aided manufacturing fabricated crowns from direct and indirect digital impression – A systematic review
Authors: Seshan R. Rakkesh , Karthikeyan Hari Raghavendar , Rajan R. Mathan , Rajakumaran Arasappan , Varadan Preethi , Gopal Rajeswari
Published: February 2024

The accuracy of the digital impression method is responsible for fabricating crowns with adequate marginal fit which in turn determines the postendodontic prognosis. This systematic review was undertaken to identify the influence of the two digital impression techniques in producing full coverage crowns with better marginal fit. This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A detailed search was done in electronic databases (PubMed, EBSCOhost, LILACS, Cochrane) along with hand searches of reference articles. In vivo crossover studies comparing the marginal fit of the computer-aided design-computer-aided manufacturing (CAD-CAM) fabricated crowns from direct and indirect digital impressions published from inception till July 2023 were included in this review. The quality assessment of the included articles was done based on a modified Cochrane collaboration tool for crossover studies. A total of 280 articles were identified, after duplicate removal, title and abstract screening, and full-text evaluation, 7 articles were included in this systematic review. The overall quality of evidence is moderate. The CAD-CAM crowns fabricated from direct digital impressions exhibited a better marginal fit than those crowns fabricated by indirect digital impressions. The overall quality of evidence is moderate. Further clinical studies has to be conducted for evaluating the latest technologies towards achieving the misfit of zero.
Active case finding of tuberculosis among nomads and semi-nomads in Puducherry
Authors: Ramalingam Sivapragasam , Senthil Rajini , Dhasaram Premnath , Bajwin Faustina
Published: February 2024

ABSTRACT

Context:

Tuberculosis (TB), is a global epidemic and communicable disease that accounts for increased global mortality and morbidity. India is also marching towards the elimination of tuberculosis by 2025 with this background we conducted this study.

Aims:

To identify the undiagnosed TB cases in nomadic and semi-nomadic populations of Puducherry.

Settings and Design:

A community-based cross-sectional study was done among nomads and semi-nomads in Puducherry for four months between May 2022 to September 2022 after getting the Institute’s ethical committee approval.

Methods and Material:

After obtaining written consent/assent, a pretested semi structured questionnaire was used to record the data. The questionnaire consists of three parts that include, sociodemographic details and history specific to tuberculosis based on operational definitions such as presumptive TB and physical examination. Those participants fulfilling the criteria for presumptive TB was provided a Falcon tube for spot sample. The participants were explained the procedure to collect the sputum and its quality was verified by the principal investigator before sending it to the laboratory.

Statistical analysis used:

Data was analysed with Statistical Package for Social Science (SPSS Inc, Chicago, Illinois, USA) software version 16.0 and Microsoft Excel 2016. Frequencies and percentages were estimated for categorical data.

Results:

Our study showed 6.25% was the proportion of presumptive TB cases in our study population. In the presumptive TB cases 60% belonged to age >45yrs 80% belonged to the male gender and all of them belonged to lower socioeconomic status. The macro-environment findings of those presumptive TB cases were 80% belonged Kutcha houses, with poor ventilation and overcrowding present. Their co-morbidity status indicates 60% were diabetics and 20% were hypertensive. Their predominant findings were 80% reported Cough and 20% fever, significant weight loss. No contact history of TB was found. When these presumptive TB cases underwent microbiological examination, none were sputum positive.

Conclusions:

This study showed ACF helped to identify presumptive TB in an effective way and needs large-scale screening to identify sputum-positive cases.
Case report: Contraceptive implant migration
Authors: Alotaibi Sahar M. , Al-Otaibi Mohammed L.
Published: February 2024

ABSTRACT

Subdermal contraceptive implants are one of the effective and reversible methods of contraception available today. Implanon is a Saudi FDA-approved contraceptive that is commonly used by the Saudi population. Along with their hormonal side effects such as mood changes and acne, subdermal contraceptive implants can also lead to more life-threatening, albeit rare, mishaps, such as the deeper migration of them into the axillary and thoracic structures. Only a few cases exist in the literature regarding these rare complications. In this case report, we describe the case of a 31-year-old woman presenting with ulnar neuropathy due to deep proximal migration 3 years after the insertion of an Implanon. The foreign body was removed using intraoperative image-enhancing fluoroscopy, with neurological symptoms being resolved as a result.
Micronutrient status in patients with diabetic foot ulcers: A cross-sectional study in Saudi Arabia
Authors: Ababneh Mutasem , Al Ayed Mousab Y. , Robert Asirvatham A. , Amer Maysa , Al Rashidi Raeed A. , Al Mansour Faisal , Al Saeed Abdulghani , Al Dawish Mohamed A.
Published: February 2024

ABSTRACT

Background:

Patients with diabetes are at risk for developing diabetic foot ulcers (DFUs). It is recognized that type 2 diabetes (T2D) is distinguished by the loss of vitally important micronutrients because of the metabolic nature of this disease and its associated complexities.

Objective:

This study was performed to determine the level of micronutrients in patients with DFUs in Saudi Arabia. From February to May 2022, this descriptive study was conducted, adopting the cross-sectional design and a group of 88 patients with T2D.

Materials and Methods:

Applying the convenience sampling method, this study was conducted at a tertiary hospital in Riyadh, Saudi Arabia. Data collection was conducted through a standard questionnaire, and details regarding the demographic variables and micronutrient deficiency were collected.

Results:

Among the nutritional deficiencies identified, the one with the highest frequency was vitamin D, observed in 43.2% of the patient population; after vitamin D, in order of descent, were low ferritin levels (29.5%), B12 (13.6%), and the folic acid deficiency (12.5%). Folic acid showed a statistically significant difference among patients with cardiovascular disease (CVD) (P = 0.041). Moreover, vitamin B12 showed a significant association among patients who have charcot foot (P = 019) and previous amputation (P = 0.029).

Conclusion:

Vitamin B12 deficiency is significantly associated with patients who had an amputation; having charcot foot and folic acid revealed a vital relationship among patients with DFUs having CVD. Comprehensive research is a pressing need to enable deeper awareness of micronutrient deficiencies in patients with diabetes.
The frequency of unintended pregnancy-associated factors among Iranian women in the poor part of the capital, Tehran
Authors: Zendehdel Mozhgan , Jahanfar Shayesteh
Published: February 2024

ABSTRACT

Background and Objectives:

Unintended pregnancy is considered one of the critical indicators of community health as being a risk factor in unsanitary abortions, miscarriage, and insufficient prenatal care. This study aimed to determine the frequency of unintended pregnancy and the related factors in married women.

Materials and Methods:

The study was conducted on 1013 married women aged 15–49 who were referred to health centers in the South of Tehran. To analyze the data, single and multiple logistic regressions were used.

Results:

About 50% of participants had already experienced at least one unintended pregnancy. Analysis showed the following predictive factors for unintended pregnancy: being within the age range of 26 to 40 (AOR, 95% CI = 1.91; 1.25–2.90), being over 40 years of age (AOR, 95% CI = 1.96; 1.04–3.71), spouse education level of high-school or lower (AOR, 95% CI = 1.64; 1.11–2.42), first marriage age range of 21 to 30 years (AOR, 95% CI = 0.64; 0.47–0.88), use of the DMPA method as contraception (AOR, 95% CI = 3.42; 1.16–10.06), history of tubectomy (AOR, 95% CI = 4.45; 1.99–10) and history of vasectomy (AOR, 95% CI = 4.61; 1.18–17.98).

Conclusions:

Training and distribution of free contraceptive methods would be much more effective and less expensive than paying for costly illegal induction of abortion and unwarranted complications due to abortion.

Implications:

Vulnerable women who are referred to health centers to receive health services should be trained in contraceptive methods and be informed of the probability of unintended pregnancy with each contraceptive method and the consequences of self-induced abortion.
Antenatal factors and risk of postpartum hyperglycemia in women with gestational diabetes mellitus: A central India prospective cohort study
Authors: Bagde Nilajkumar , Bagde Madhuri , Shanbhag Vijayalakshmi , Trigunait Pragati , Sheikh Nagma , Agrawal Sarita
Published: February 2024

ABSTRACT

Introduction:

Global prevalence of gestational diabetes mellitus (GDM) ranges from <1% to 28%. Risk of postpartum diabetes (PPDM) is 7 times higher in women with GDM. We aimed to identify antenatal risk factors associated with postpartum hyperglycemia so that these women may be subjected to targeted screening in a low resource setting.

Methods:

Screening for GDM was done with a 75gram GTT using IADPSG criteria in women between 28-29 weeks and post-partum screening for hyperglycemia was done using 75 gm 2hour OGTT.

Results:

Mixed effect linear regression model to assess PPDM as outcome against age, pre pregnancy weight, baby weight at birth, HbA1C and postpartum BMI as predictors was significant at overall level (p=0.00). HbA1C (p =0.00) and pre pregnancy weight (p=0.001) were significant at individual level. Same model for postpartum prediabetes was significant at overall level and assumed significance for pre pregnancy weight (p=0.00), baby birth weight (p= 0.001), postpartum BMI (p=0.00) and HbA1C (p= 0.05) at individual level. The same model for postpartum abnormal sugars (PPDM or prediabetes) was significant at overall level (p = 0.00).

Conclusion:

Women with GDM represent a vulnerable population that is likely to develop a chronic metabolic disease at a young age exposing them to morbidity associated with unrecognized untreated hyperglycemia. Easily detectable clinical and biochemical antenatal risk factors may help identify women eligible for targeted screening for early diagnosis and treatment as well as use of preventive interventions against type2 diabetes after GDM
Exploring pH levels and environmental impacts on handwash products in Riyadh, Saudi Arabia: A cross-sectional study
Authors: Alsalhi Abdulaziz , Alzamil Lama , Alekrish Khalid , Alhaqbani Renad , AlKanaan Renad , Al-Mohaimeed Amal M. , Almohawis Nada , Alsalhi Hamad , Al-salhy Abdulmalik , Alsalhi Abdullah , Mitwalli Hadeel
Published: February 2024

ABSTRACT

Background:

The human skin, with a pH of 4 to 6, serves as a barrier against external pathogens. Alkaline handwash products (HWPs) can compromise this barrier and are widely used following the Coronavirus disease-2019 (COVID-19) pandemic. This study aims to determine the pH of a sample of HWPs in Riyadh, Saudi Arabia, and assess the effect of environmental factors on their pH.

Methods:

This is a cross-sectional, descriptive, observational study carried out in Riyadh, Saudi Arabia. The study involved a convenience sample of 33 liquid soaps, soap bars, and synthetic detergents (Syndets) from various brands. The pH of the handwash products was measured using laboratory-validated techniques. Data analysis was conducted using RStudio 2022 software.

Results:

Of the HWPs, 16 (48.5%) had a highly alkaline pH (≥10), while 14 (42.4%) had an acidic pH (4.0-6.9). Most liquid soaps were acidic (84.6%), with a mean pH of 5.9, whereas soap bars had a mean pH of 10.3. Syndets had a mean pH of 6.0.

Conclusions:

On average, liquid soaps and syndets offered a more physiological pH than soap bars. Liquid soaps were more affordable than synthetic detergents, making them a better value option among the three types of HWPs. Environmental factors such as exposure to hot weather did not have a significant impact on HWPs.
Glycemic Control in the era of bariatric surgery: A systematic review and meta-analysis of published studies on the Saudi-Arabian population
Authors: Alzahrani Ahmed Atiah S. , Alsoliman Muath Abdulaziz S. , Alattiah Thamer Mohammad A. , Almohussein Nasser Saleh N.
Published: February 2024

ABSTRACT

We aim in our systematic review and meta-analysis to summarize and evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (RYGB) as two types of bariatric surgery in reducing the body mass index (BMI) and controlling the glycemic state in obese, diabetic patients. Our systematic review and meta-analysis (MA) were carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for randomized studies. We searched PubMed, Web of Science, Scopus, and Cochrane library for included studies. We chose randomized controlled trials (RCTs) assessing the efficacy of LSG and RYGB in controlling the glycemic state in obese patients; then we used Review Manager software to pool the outcomes of our MA. Three RCTs were included in our meta-analysis. The outcomes evaluated were BMI and HbA1C. As for the BMI, the results were significant and favor LSG and RYGB post-operatively as follows: mean difference (MD) 0.30; confidence interval (CI) 0.07–0.54; P value 0.010. Also, the results were significant regarding HbA1C as follows: MD 0.30; CI 0.07–0.54; P value 0.010. Bariatric surgeries, especially LSG and RYGB, improve the glycemic state and reduce BMI in obese diabetic patients.
Perception of women on safety and efficacy of contraceptives: A comparative study
Authors: Bhat Anagha , Jain Muskan , Manjunath GN
Published: February 2024

ABSTRACT

Background:

Contraceptive information and services are fundamental to the health and human rights of all individuals. Low contraceptive use is a major challenge faced in India. To determine whether a lack of awareness of contraceptive methods was a factor, we assessed the perception of women on contraceptive methods, their safety and efficacy and further determined whether their demographic background played any role in their perception.

Materials and Methods:

Reproductive-aged women from both rural and urban backgrounds of Bangalore and Tumkur, Karnataka, were individually questioned in a community setting using both Google Forms and personal interviews from September 2022 to December 2022. The questions consisted of limited demographic information and specific questions related to the knowledge and beliefs of women on the efficacy and safety of contraceptive methods and assessed situational awareness.

Results:

Although awareness was more amongst urban women (99.1%) compared with rural women (79%), the practice was significantly higher amongst rural women (63.2%) compared with urban women (36.7%). Perception showed variations with respect to age, education, religion and parity. A major religion-wise disparity was observed. With regard to safety, oral contraceptive pills (60.9%) and condoms (51.8%) were unanimously perceived to be the most and least harmful to health. The most commonly perceived short-term complications were found to be body changes, and mood swings, tiredness and infertility with no data to support the claim were the most commonly chosen long-term complication.

Conclusion:

From the study, we concluded that more educated women were not immune to misinformation. The efficacy rates of different methods were highly underestimated with methods with higher failure rates perceived to be more effective. Results demonstrate that women are ill-informed about the long-term complications of various methods.
Clinico-epidemiological profile and outcome of snakebite patients presented to a teaching institute – A descriptive retrospective review
Authors: Kumar S. Mohan , Shreekrishna H. K. , Singi Yatiraj
Published: February 2024

ABSTRACT

Introduction:

Snakebites are a significant cause of morbidity and mortality in India despite availability of anti-snake venom and the absence of a large number of highly venomous snakes. This may be attributed to treatment seeking behaviour of the population. The study aims to find out common clinical features, outcome, and delay in arrival time to the hospital in snakebite cases.

Materials and Methods:

This is a cross-sectional retrospective record-based study among the patients presented with a history of snakebites to the Basaveshwara Medical College Hospital and Research Centre, Chitradurga, conducted from 1 January 2019 to 31 January 2021.

Results:

Out of the 96 patients, the majority of snakebite victims were male and of an age group of 21–30 years. The most common site for snakebite was the lower limb, and about 57.2% of patients had visible fang marks. Among snake species identified, the most common was krait bites, followed by cobra bites. Neurotoxic envenomation manifestation and severe presentation were found in almost half (53.1%) of the cases. Almost half of the patients took 1–4 hours to arrive at the health facility. Surprisingly, only 35% cases arrived to the health care facility within an hour of snakebite. Most of the patients (82%) recovered with the treatment with very minimal fatality/mortality.

Conclusion and Recommendations:

Although half of the patients presented with severe forms, only 35% of the patients arrived within an hour to the health care facility. This indicates the need for an information dissemination system to avoid severe disease as well as to prevent mortality.
Blood lead levels in pregnant women and their newborn infants at an Indian teaching hospital
Authors: Sahu Mahesh C. , Yogeshbhai Mehta R. , Oza Hina , Upadhyay Kuldip , Chanania Kabita , Pati Sanghamitra
Published: February 2024

ABSTRACT

Background and Aim:

With the growth of the world’s economy and industrialization, lead (Pb) contamination in the environment has become a major issue on a global scale. Lead is typically linked to unfavorable pregnancy outcomes such as stillbirth, low birth weight preterm, and spontaneous abortion. In this study, we evaluated the blood lead levels of pregnant women and their birth outcomes attending an Indian tertiary care teaching hospital, those who were not exposed to any lead-associated industry or shops.

Methods:

A descriptive study was undertaken to evaluate blood lead estimation in pregnant women and umbilical blood lead levels in a community hospital. Blood samples from 104 mothers during the 1st trimester, 90 mothers during 3rd trimester, and from the umbilical cord were collected. Self-administered questionnaires were used to collect information on demographics, medical history, and concerns linked to pregnancy. Following acid digestion, the levels of lead in whole blood were determined by an atomic absorption spectrometer. The DNA damage in high blood lead-concentrated pregnant women was evaluated by comet assay methods.

Results:

Among 194 blood samples of pregnant women, 31 (15.98%) samples revealed ≥5 μg/dL blood lead levels. High lead concentration (≥5 µg/dL) in 1st trimester pregnant women, end of 3rd trimester and cord blood were detected 20.19%, 11.11% and 1.11% respectively. The mean blood lead levels in 1st trimester, 3rd trimester, and cord blood were 3.88 ± 3.19, 2.66 ± 1.82, and 1.53 ± 1.06 mg/dL, respectively. The blood lead concentrations were significantly higher in the 1st trimester of pregnancy than in the 3rd trimester of pregnancy (P < 0.0017). A positive correlation between maternal and infant blood lead levels was revealed (P < 0.0001). When the comet assay was used to assess the genotoxic consequences of elevated blood lead levels during pregnancy, higher amounts of DNA damage were found in the samples (P < 0.01).

Conclusion:

In this descriptive study, there was a significant amount of lead transferred from mother to baby through the placenta. All mothers were not exposed to lead-associated industry and most were housewives. This article may be viewed as an eye-opener for understanding the blood lead concentration during pregnancy to avoid abnormal birth outcomes. To minimize exposure to environmental lead, all possible measures should be undertaken.
Comparison of triglyceride/glucose index and related parameters with Indian Diabetes Risk Score assessment in non-diabetic individuals visiting primary healthcare centre—A community-based cross-sectional study
Authors: Ramalingam Sivapragasam , Kar Amlan Kumar , Senthil Rajini
Published: February 2024

ABSTRACT

Context:

Diabetes mellitus is a chronic metabolic disorder and has reached epidemic proportions in developing countries like India.

Aims:

Our study aimed to identify relationship between triglyceride glucose (TyG) index and related parameters with Indian diabetes risk score in non-diabetic individuals.

Settings and Design:

An analytical cross-sectional study was conducted in community at a primary healthcare centre attached to a medical college for six months from April 2022 to October 2022 after getting approval from institute ethical committee.

Methods and Material:

We conducted a cross-sectional study at a primary healthcare centre attached to the medical college for six months duration with a sample size of 107, aged ≥18 years, which included apparently healthy individuals not diagnosed with any type of diabetes. Indian diabetes risk score (IDRS) scale was calculated along with anthropometric measurements and biochemical laboratory investigations like fasting triglyceride and fasting blood glucose.

Results:

Our study population included 53.3% male and 46.7% female; the mean age of male was 29.70 ± 12.26 and female was 34.28 ± 11.91. The mean TyG index for male and female was 8.48 ± 0.45 and 8.39 ± 0.52, respectively. 52.3% of our study population belonged to high-risk category, and 47.7% belonged to moderate-risk category. We also found positive correlation between TyG index and its related parameters and IDRS score. In linear regression between IDRS and TyG index, we found positive correlation, and in logistic regression showed for every 1 unit rise in age, there was 1.28 times increase in IDRS score (P < 0.001). TyG-WHtR was superior to other TyG-related parameters in identifying high IDRS score (P < 0.001).

Conclusions:

TyG index and its related parameters can be used as a predictor in identifying diabetes mellitus along with IDRS score assessment in low-cost clinical settings like primary healthcare centre.
Successful Management of a Polytrauma with Open Complex Pelvic Fracture
Authors: Rajeev P. B. , Jyothiprasanth M. , Savio Albin , Valsan Shery , Jithin C. R.
Published: February 2024

Pelvic fractures frequently result from powerful external forces and carry a high risk of concurrent injuries. In these patients, fatalities are often caused by associated injuries. Pelvic fractures cause substantial morbidity and can lead to long-term impairment in physical functioning, as well as difficulties with daily activities and negative psychological health. Surgical intervention is necessary for treating unstable pelvic fractures, which may involve isolated posterior or combined posterior and anterior fixation utilizing screws and plates to restore anatomical alignment and promote natural healing. A 19-year-old female road traffic accident victim in hemorrhagic shock was hemodynamically stabilized and investigated for associated injuries. She was diagnosed with bilateral sacroiliac joint dislocations, bilateral superior and inferior pubic rami fractures and crescent fracture of the right iliac wing, Grade III liver injury, Grade III splenic infarction and hemoperitoneum, lung contusion, and bilateral hemothorax with multiple rib fractures, fracture of the transverse process of L4 and L5 vertebrae. A secondary survey revealed a right sciatic nerve injury, admitted to intensive care and managed by a multidisciplinary approach. Abdomen and thorax injuries were managed conservatively, and meanwhile, the pelvic fracture was stabilized by a damage control protocol, and definitive surgical intervention includes iliac crest wound debridement and pelvic ring open reduction and internal fixation by the Modified Stoppa approach. Abdomen and chest injuries were managed conservatively. Monthly regular follow-up was the first 6 months, was able to walk and sit comfortably at the end of 4 months, and was able to resume her normal routine work and job at 6 months without any pain and limitation of movements. It is essential to promptly identify and assess the injuries and implement appropriate perioperative management by a multidisciplinary team. Temporary stabilization of fracture followed by the management of associated injuries and delayed definite fixation yields the best result in polytrauma patients with pelvic fracture.
A Case Report on Complex Sacral Fracture Treated by Spinopelvic Fixation
Authors: Anand S. Vijaya , Krishnakumar R.
Published: February 2024

Unstable sacral fractures are mostly associated with spinopelvic instability. This type of fracture occurs following a fall from height or a high-energy mechanism. Roy–Camille’s classification system helps in identifying and treating those fractures. Lumbopelvic fixation or spinopelvic fixation is an option to be considered for treating these unstable fractures. The principle of treating these fractures is to maintain the sacropelvic stability. A 54-year-old male patient presented with a history of falling from a tree from a height of 9–11 feet on his back. On further examination, he was having severe tenderness over the sacral region and dorsal spine region. His power was normal on both lower limbs, with numbness over the base of the scrotum with intact sensation distally. Deep tendon reflexes and plantar reflexes were normal. Radiographs show fracture over D12 (AO A5 – stable incomplete burst fracture) and the sacrum. Computerized tomography and magnetic resonance imaging were taken to decode the sacral fracture and to assess the neurology and posterior ligament integrity. His sacral fracture was classified by Roy–Camille type 3, U-shaped fracture, and Denis type 2 fracture.