bluuebunny/crossref_metadata_2025 huggingface dataset:
Ochrobactrum anthropi: a rare case of endocarditis
Authors: Salvotti Francesca , Rossoni Gilda , Pilia Maria Chiara , Carleo Pietro , Kofler Veronika , Carmignani Cristina , Marin Maria Grazia , Bonfante Fabrizio Paolo , Zagni Irene
Published: October 2024

Ochrobactrum anthropi is an aerobic Gram-negative bacillus, formerly known as “Achromobacter group Vd”. It is increasingly recognized as a potentially problematic, opportunistic, and nosocomial pathogen. Most cases of human diseases due to O. anthropi are associated with central venous catheter line infection; few case reports about infective endocarditis, pancreatic abscess, puncture wound osteochondritis, endophthalmitis, urinary tract infection, meningitis, pelvic abscess, and osteomyelitis are present in the literature. Among the previously stated infections it can cause, infective endocarditis is very rare; only four cases have been described in the literature. Here, we report the case of an immunocompromised man who developed native valve endocarditis with septic cerebral embolization due to O. anthropi.
Acknowledgement to reviewers
Authors: Office Editorial
Published: October 2024

N/A
Acknowledgement to reviewers
Authors: Office Editorial
Published: October 2024

No abstract availbale.
Crossing the frontier from oral to written translanguaging for epistemic access in natural science
Authors: Abdulatief Soraya , Guzula Xolisa
Published: October 2024

Background: South Africa’s Language-in-Education Policy (LiEP) provides for bi/multilingual education, but schools are only supported to choose monolingual English language policies from Grade 4 and ignore the learners’ home language or languages as resources for learning. Many teachers translanguage orally, using the learners’ home language and English to make learning more meaningful but seldom extend this to written translanguaging.Objectives: Research was conducted to document the process and effects of a teacher development project, translanguaging-for-learning (L4L) which supported teachers in developing translanguaging pedagogies to improve learner access to the curriculum and to develop academic bi-literacy.Method: This article focuses on the development of one senior phase (Grades 7–9) natural science teacher who participated in the L4L project. Data were collected following an ethnographic approach in workshops and classrooms through observation, interviews, photos, videos, and learners’ workbooks.Results: The research illustrates how with workshop engagement, mentoring support and the provision of multilingual dictionaries, a teacher’s bi/multilingual languaging skills were legitimised and mobilised to engage learners in knowledge construction, both orally and in writing. Classroom interaction shifted from being teacher-led to being more learner-centred and bilingual, providing opportunities for biliteracy, and identity affirmation.Conclusion: The findings illustrate improved learning opportunities through planned, systematic translanguaging pedagogies.Contribution: The research suggests a model for bi/multilingual education and teacher development that recognises African languages as important resources for learning to further linguistic equity, access, and social justice.
Rural Hospital Focus - Debating Points
Authors: Couper Ian , Spring Robyn , Reid Steve
Published: October 2024

No abstract available.
The Hand Patient: Dupuytren's Contracture
Authors: Mennen U.
Published: October 2024

No abstract available.
Hypertension guideline implementation and blood pressure control in Matlosana, South Africa
Authors: Ditlhabolo Keolebile I. , Lion-Cachet Carien , Variava Ebrahim
Published: October 2024

Background: High systolic blood pressure remains a leading modifiable risk factor for cardiovascular diseases worldwide and in South Africa (SA). Information about the extent of guideline implementation and blood pressure (BP) control is lacking in Matlosana Sub-district, North West province, SA. The study aimed to assess the implementation of the South African Hypertension Practice Guideline (SAHPG) and BP control in adults attending primary care facilities in Matlosana.Methods: Cross-sectional study was conducted, using 523 randomly sampled medical records. Data collected included demographic information, recorded BP readings, anthropometry, screening for target organ damage (TOD), hypertension complications, comorbidities, lifestyle advice and drug therapy.Results: According to the reviewed records the mean age of the participants was 56.77 years with a standard deviation of 12.4 years and 376 (71.9%) records belonged to females. Blood pressure control was documented in 229 (43.8%) of the medical records, with better control recorded in a group with comorbid human immunodeficiency virus (HIV) than in groups with other comorbidities.Conclusion: The study found poor documentation of the SAHPG recommendations among patients with hypertension. According to the patient records BP control was suboptimal, the most common documented comorbid illness was HIV, and screening for TOD was generally poorly documented.Contribution: Programmes that audit and improve the quality of hypertension guideline implementation and BP control in primary care require ongoing support and research.
Community-based infant hearing screening: Outcomes of a rural pilot programme
Authors: Kgare Khomotjo S. , Joubert Karin
Published: October 2024

Background: Community-based universal newborn hearing screening (UNHS) has not been fully realised in South Africa despite the availability of contextually relevant early hearing detection and intervention guidelines. Research has confirmed the feasibility of implementing UNHS programmes in urban contexts; however, limited information exists for rural contexts.Objectives: The aim of the study was to describe the outcomes in terms of coverage rate, referral rate and follow-up rate of a 1-year UNHS pilot programme implemented at three primary health care (PHC) clinics in the Limpopo province.Method: A descriptive retrospective review of 2 302 audiological records of infants who underwent NHS between July 2014 to June 2015 was conducted.Results: The mean age at first-stage screen was 112 days (16 weeks). The coverage rate was 87% for the infants screened at 3- and 10- days clinic visits and 27% for infants screened at the 6-week immunisation visit. The first-stage referral rate was 33.9% and 8.3% for the overall second stage referral for diagnostic audiology services. The follow-up rate for rescreens at the clinical level was 77%, while for initial diagnostic assessments, it was 26%.Conclusion: Although not all benchmarks were met within the first year of implementation, the high coverage- and low referral rates, especially in the last 6 months, are the first steps in improving the outcomes of the screening programme.Contribution: The findings confirm the feasibility of implementing community-based UNHS programmes in rural areas in South Africa. Regular monitoring and evaluation contribute to the success of screening programmes.
The role of Ondofolo to maintain religious harmony: A study in a Christian perspective
Authors: Warwer Fredrik
Published: October 2024

Local wisdom refers to the cultural heritage of a community, which is derived from its cultural origins and includes a wide range of values, rituals and traditions. Ondofolo is the current paramount chief of the Sentani community in Papua province, a position that remains in effect at the moment. The local community holds Ondofolo’s leadership in high esteem and places substantial trust in it. The research aims to investigate the function of Ondofolo within religious congregations using a qualitative phenomenological design approach. Data were gathered via participatory observations, interviews with Ondofolo, leaders of prayer rooms and Islamic boarding schools and a review of literature and research conducted in the indigenous area of Sentani. The local knowledge of Sentani ‘Ondofolo’ plays a crucial role in fostering the religious community by embodying the fundamental qualities of leadership, peace, love and brotherhood found in the Bible. The preservation of wisdom in all its manifestations is imperative, as it represents an irreplaceable cultural legacy.Intradisciplinary and/or interdisciplinary implications: This study applies the interdisciplinary characteristics of contextual theology to Ondofolo’s leadership of the religious congregation in Papua, drawing on Christian wisdom. The findings positively impact the formation of religious communities in Sentani, Papua. They also present a viable leadership model specific to the local context and can be used as an option for guiding the faithful community in Indonesia.
Workup of residual incontinence after artificial urinary sphincter placement
Authors: Tzeng Michael , Lang Jacob , Wang Shu , Anand Diya , Davuluri Meenakshi
Published: October 2024

Artificial urinary sphincter (AUS) is the gold standard for treatment of male stress urinary incontinence. Despite high success rates, some men continue to experience incontinence after AUS placement. The workup of residual incontinence is based on its potential etiologies, including improper use, underlying physiologic bladder dysfunction, mechanical failure such as device malfunction or system leak, technical failure such as poor sizing of the cuff or balloon, tissue atrophy, or cuff erosion. Here, we offer a framework to evaluate these potential causes.
Infection of the artificial urinary sphincter: Prevention, diagnosis, and management
Authors: Loh-Doyle Jeffrey C. , Markarian Emily , Simhan Jay
Published: October 2024

Male stress urinary incontinence, often following treatment for prostate conditions or genitourinary malignancies, can profoundly affect quality of life. The artificial urinary sphincter (AUS) stands as a cornerstone therapy for moderate to severe cases, boasting high patient satisfaction and efficacy. Despite these merits, the AUS, like any mechanical device, has its vulnerabilities—including the potential for infection. Infections are comparatively less documented than mechanical failures or erosions but present a serious clinical challenge. This review aims to delve into the lesser-known territory of AUS infections, examining the intricate pathophysiology, pinpointing risk factors, and appraising both literature and rich anecdotal evidence to outline best practices for identification, prevention, and intervention. By the review’s conclusion, readers will be equipped with comprehensive insights into managing AUS infections, ultimately enhancing patient outcomes within this clinical context.
Artificial urinary sphincter erosion: Risk factors, recognition, and surgical management
Authors: Saltman Anna J. , Kasabwala Khushabu Dinesh
Published: October 2024

The artificial urinary sphincter (AUS) is the gold standard for the treatment of men with moderate-to-severe stress urinary incontinence. However, despite excellent functional outcomes, the AUS is associated with a 26% reintervention rate, with 8.7% explanted due to cuff erosion. Cuff erosion is associated with significant morbidity, including infection, urinary obstruction, irritative lower urinary tract symptoms, and possible urethral stricture development. In this literature review, AUS erosion risk factors, their clinical presentation, as well as best practices in surgical and postoperative management of explantation were investigated.
Penile implant infection: Risk factors, prevention, and management
Authors: Alkassis Marwan , Lee Adrianna , Iwuala Rosemary , Kocjancic Ervin
Published: October 2024

Penile implants are indicated for the treatment of erectile dysfunction (ED) in patients who have failed medical treatment. They consist in either a malleable device or an inflatable device. Inflatable penile implants were first introduced in 1973 and have become a reliable mainstay in the treatment of ED. They are associated with a high rate of patients’ reported satisfaction; however, they can be subject to multiple complications, such as bleeding, infections, and mechanical failure. The incidence of penile implant infection varies between 1% and 3% and is associated with patient-related and surgery-related factors. Based on these risk factors, multiple strategies have been adopted by the urology community to reduce the infection rate. While some strategies such as smoking cessation 4 weeks before surgery and alcohol-based skin preparation are well established and accepted strategies, other strategies need more evaluation. Penile implant infection can have devastating consequences such as severe pain, mechanical failure, and sepsis. Management of penile implant infection depends on the severity of the infection and consists in conservative management and explantation with early or delayed replacement.
Historical perspective on the artificial urinary sphincter
Authors: Smith Loren J. , Bose Sanchita M.
Published: October 2024

Urinary incontinence imposes significant social and psychological distress. The artificial urinary sphincter (AUS) is the most effective device presently available for treating severe stress urinary incontinence (SUI). The principal reason for AUS placement worldwide is to correct postprostatectomy urinary incontinence in males. The concept of an implantable prosthetic device to address SUI dates back to the 1940s. The history of AUS development is marked by trial and error in an era of more permissible latitude for experimentation. Numerous technological innovations, modifications, setbacks, and lucky happenstance paved the path for the emergence of the current Boston Scientific American Medical Systems (AMS) AUS 800 device we use today. This review article emerges from a systematic examination of archival repositories, scholarly databases, primary source materials, and subsequent qualitative assessments, with the aim of delving into the techno-historical evolution of the AUS.
Extracorporeal robotic-assisted anastomotic urethroplasty in a case of complex traumatic bulbar urethral stricture
Authors: Priyadarshi Shivam
Published: October 2024

Robotic-assisted surgery is usually done intracorporeally by placing the robotic arms through the preplaced ports. There have been publications of microsurgery done with the assistance of robotic systems by extracorporeal route. We are presenting here a case of extracorporeal robotic assisted anastomotic urethroplasty in a case of complex traumatic bulbar urethral stricture by air docking of the robotic arms of the Davinci XI system. To our knowledge, this is the first case of urethral stricture done by this technique.
The future of male stress urinary incontinence surgery
Authors: Gonzalez-Jauregui Rebeca , Nigro Noah N. , Doersch Karen , Bhalla Rohan G. , Flynn Brian J.
Published: October 2024

Male stress urinary incontinence (SUI) is a life-altering condition. It occurs more commonly secondary to prostate surgery, pelvic trauma, radiation, or neurological disorders. Men with SUI are at an increased risk of anxiety and depression, occupational limitations, weight gain, impaired libido, and social isolation. Both operative and non-operative management options exist. Surgical options must continue to become safer, faster, more successful, and less invasive to meet the population’s demands. We conducted a literature review utilizing a Population, Intervention, Comparison, Outcomes, and Study framework. Studies included focused on adult male patients undergoing surgical intervention for SUI with a particular focus on pre and postoperative outcomes, complications, and follow-up data. We excluded non-human studies in languages other than English, conference abstracts, commentaries, and editorials. We broke surgical management options into endoscopic treatment (urethral bulking agents), passive devices, and active devices. Passive devices, such as AdVance, Virtue, ARGUS, Adjustable Trans-obturator Male System, Readjustment Mechanical External, and ProACT (Adjustable Continence Therapy), are broken into adjustable and non-adjustable suburethral devices giving the urethra additional support. Active devices, including the AMS 800 artificial urinary sphincter (AUS), Conti® AUS systems, ARTUS, and VICTO, allow patients to control their urinary stream while treating varying degrees of incontinence. While passive devices provide minimally invasive options with respectable outcomes, active devices remain the gold standard in managing male SUI. Emerging technologies excite the future of male SUI by promising reduced morbidity and simplicity of the medical device. Shared decision-making, patient-specific considerations, and appropriate postoperative monitoring remain critical to optimizing outcomes and patient satisfaction.
Patient-reported subjective outcome after electromotive drug administration for Peyronie’s disease
Authors: Herroelen Siemen , Brits Tim , De Win Gunter
Published: October 2024

Introduction:

Peyronie’s disease (PD) is a condition with subjective (pain, burden) and objective (curvature) symptoms.

Objective:

The study aims to analyze the efficacy of electromotive drug administration (EMDA) on PD, with a focus on subjective complaints such as pain and burden via patient-reported subjective outcomes.

Materials and Methods:

A total of 32 patients, in either the acute or chronic phase, were treated with EMDA in an uncontrolled retrospective cohort study. About 23 patients (72%) agreed to participate in a post-treatment questionnaire allowing us to evaluate the burden of PD and the effect of EMDA on objective and subjective symptomatology.

Results:

Patients report a high psychological burden, sexual difficulties, and other subjective symptoms like pain. Among patients in the acute and chronic phases, 75% and 60%, respectively, reported that the pain reduced to a noticeable extent, and 50% and 28%, respectively, reported a positive effect on curvature. Up to 68.8% (acute) and 42.9% (chronic) said they would choose EMDA again, and up to 62.5% (acute) and 57.1% (chronic) would recommend it to friends or family.

Conclusion:

The high patient satisfaction rates and positive effects on subjective symptoms show that EMDA can be used for the treatment of PD. Furthermore, data are needed to support this.
Relationship Between Dental Anxiety, Dental Utilization, and Oral Health-Related Quality of Life: A Systematic Review
Authors: Ab Malek Azizi , Mohd Radzi Nawwal Alwani , Che Musa Muhd Firdaus , Luai Amirul Faiz
Published: October 2024

Aim:

No comprehensive synthesis of dental anxiety (DA), dental utilization (DU), oral health-related quality of life (OHRQoL), and their relationships have been examined despite various systematic investigations being done on their prevalence and interventions individually. Therefore, this review aims to systematically review the status and relationship between DA, DU, and OHRQoL among adult groups.

Materials and Methods:

Data collection spanned 6 months, from 1 July to 31 December 2023, involving eight databases. Only cross-sectional (CS) studies with adult participants aged 15–64 years, conducted globally, published in English, and available as full-text articles by December 31, 2023, were included. Two reviewers screened the titles and abstracts and assessed the full-text articles. All studies were CS. The risk of bias was evaluated using the Joanna Briggs Institute’s Critical Appraisal Checklist for Analytical CS studies. The quality of evidence for each measured factor was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology.

Results:

The initial search yielded 3333 studies. The 22 final studies included 13 high-quality studies with over 80% and nine fair studies with 50% and 79% scored. None of the studies scored below 50%. A negative link between DA and DU was identified in 15 of 16 studies with 35,846 participants aged 22.19–50.21 years. Six studies on DA, DU, and OHRQoL included 22,845 participants aged 15–55 years, mostly in their late and mid-fifties. Four of six verified Berggren and Meynert’s (1984) vicious cycle theory’s high association between DA, DU, and OHRQoL.

Conclusions:

A 22-study review reveals a strong association between DA, DU, and OHRQoL. Most moderate to high-quality studies emphasized a negative correlation between DA and DU, which affected OHRQoL. PROSPERO registration number CRD42023455219.
Scenario Modeling for Dentistry in Malaysia: Utilization, Privatization, and Specialization
Authors: Che Musa Muhd Firdaus , Morgan Jennifer , Harper Paul , Bernabé Eduardo , Gallagher Jennifer E.
Published: October 2024

Aim:

To study to model future clinical dental workforce scenarios in Malaysia, in relation to population need–demand, to inform future change.

Materials and Methods:

A system dynamics (SD) model was developed in Vensim-software to model the need/demand and supply for dental care across public–private sectors over 3 decades (2010–2040). This model included two sub-models relating to “need/demand” and “supply,” drawing on national evidence from two previous studies (student career surveys and interviews of key stakeholders nationally), together with relevant available data. This SD model provided the baseline model (S1) for Malaysia and four-distinctive-scenarios (S2–5), involving enhancing generalists–specialists across public–private sectors. An additional scenario (S6) was run to optimize workforce utilization, informed by career expectations of emerging graduates drawing on earlier scenarios (S2–5).

Results:

Modeling future five-scenarios highlighted the gap in dental workforce nationally across both sectors could range from a surplus of a total of 3739 dentists and 817 therapists in the baseline scenario to a total shortfall of 1249 dentists and surplus of 817 therapists by the year 2040, influenced by dentist working patterns, specialization, and privatization. Increasing the potential for specialist training and permitting emerging graduates’ to working part-time, while optimizing public sector primary care, and responding to the career expectations of emerging graduates, has the potential to absorb potential oversupply, and, thus, utilize the entire clinician dental workforce in Malaysia in the medium term.

Conclusion:

The findings of this model demonstrate the short-term requirement to expand the Malaysian dental workforce to meet dental needs of the population, highlighting that continued production at the current rate will result in oversupply, unless action is taken to maximize primary care, enhance specialization, and embrace flexible working to meet career expectations of graduates.
Emerging Patterns, Collaboration, and Impact of Scientific Production on Hyaluronic Acid in Dentistry: A Bibliometric Analysis
Authors: Quinteros-Quispe Carla , Jimenez-Obregón Fiorella , Tinedo-López Pedro Luis , Espinoza-Carhuancho Fran , Pacheco-Mendoza Josmel , Mayta-Tovalino Frank
Published: October 2024

Aim:

This observational, descriptive, retrospective presentation aimed to analyze the emerging patterns, collaboration, and impact of scientific production on hyaluronic acid (HA) in dentistry.

Materials and Methods:

A bibliometric analysis of research indexed in Scopus from January 2018 to May 2024 was performed. Emerging patterns, collaboration, impact, Bradford’s law, and Lotka’s law were applied. In addition, thematic maps were designed to visualize the connections between authors and countries.

Results:

A total of 767 documents from 176 diverse sources were analyzed, identifying 3437 authors. Articles were the most common type of document. The author of the highest scientific output was Sculean Anton of the University of Bern, Switzerland. Most of the articles were published in first-quartile journals, with Clinical Oral Investigation and Journal of Thermal Analysis and Calorimetry having the highest number of publications. The University of Bern in Switzerland was the institution with the highest research output.

Conclusion:

This study provides a comprehensive overview of the academic production of HA in dentistry. The results highlight the importance of international collaboration and the concentration of scientific production in certain institutions and journals. These findings may be useful to researchers and institutions seeking to understand and navigate the field of HA in dentistry.
Comparative Antimicrobial Efficacy of Garlic and Guava Extracts on Oral Pathogens Using a Time Kill Assay: An In Vitro Study
Authors: Rashik Kader Mohideen Mohamed , Potluri Leela Ravishankar , Varatharajan Kalaivani , Raja Sindhujaa , Dolly Sheryl , Geddam Soury
Published: October 2024

Background:

Periodontal disease is characterized by inflammation mediated by the host and related microbes, which leads to the loss of periodontal attachment and tooth loss. Due to an increase in bacterial resistance to antibiotics, there is a shift toward use of herbal medicines.

Aim:

The aim of the study is to compare the antimicrobial effect of aqueous garlic extract (AGE) and ethanolic guava extract (EGuE) on Tanerella forsythia and Porphyromonas gingivalis using the time kill assay

Materials and Methods:

AGE and EGuE are prepared. Ciprofloxacin was taken as the control. The MIC was performed for garlic, guava extract, and ciprofloxacin. P. gingivalis and T. forsythia were cultured, and the time kill assay was performed at 0 h, 5 min, 30 min, 1 h, and 2 h. Colonies were counted after 48–72 h for growth.

Results:

The minimal inhibitory concentration (MIC) results indicated that both EGuE and AGE exhibited superior antibacterial activity compared to ciprofloxacin, suggesting their potential as alternative or complementary antimicrobial agents. In a time kill assay, EGuE demonstrated a significant reduction in colony forming units (CFUs) at 30 min, 1 h, and 2 h, outperforming AGE and ciprofloxacin. Intragroup comparisons revealed that EGuE significantly reduced CFUs at 0 h and 5 min, while AGE showed no notable reduction over time.

Conclusion:

Overall, the study demonstrates the antimicrobial efficacy of EGuE and AGE against T. forsythia and P. gingivalis at higher concentrations. Hence, these extracts may serve as alternative antimicrobial agents against periodontal pathogens.
Comparison of the Adhesive Remnant Index and Shear Bond Strength of Different Metal Bracket Bases on Artificially Aged Human Teeth: An In vitro Study
Authors: Cervantes-Ganoza Luis , Castro-Ramirez Leonor , Aroste-Andía Rosa , Huamani-Echaccaya José , Ladera-Castañeda Marysela , Cayo-Rojas César
Published: October 2024

Abstract

Aim:

Bond failure can compromise the clinical efficacy and duration of orthodontic treatment. A decemented bracket can lengthen the course of treatment by about 0.6 months. This study aimed to compare the adhesive remnant index (ARI) and shear bond strength of different metal bracket bases on artificially aged human teeth.

Materials and Methods:

In this experimental in vitro, prospective, cross-sectional study, thirty-six human premolars were cemented with three types of metal bracket base designs: Group 1 had a laser-structured base, Group 2 had a mesh base, and Group 3 had a base with retention grooves. All groups were bonded with Transbond XT light-curing resin. Shear strength testing was performed, and the ARI was evaluated. The parametric one-factor analysis of variance test and Tukey’s post hoc test were used for the comparison of shear bond strength, and the effect size was also evaluated with eta squared. In addition, the Kruskal–Wallis test was used to compare the ARI of the three groups on an ordinal scale. All statistics were set at a significance of P < 0.05.

Results:

The ARI scores did not exhibit any statistically significant differences (P = 0.163). Nevertheless, the three groups exhibited statistically significant differences in shear bond strength, with an effect size of 69% (P < 0.001). The mesh base bracket had the lowest average (9.9 ± 2.6 MPa) (P < 0.001), while the laser-structured base bracket had the greatest average (19.1 ± 3.0 MPa) (P = 0.006).

Conclusion:

The variation in shear bond strength was influenced by 69% due to the type of the metal bracket base used. Laser-structured and mesh-based brackets had the highest and lowest shear strength, respectively. All bases left a similar ARI on the tooth enamel.
The Parental Concern and Acceptance of Silver Diamine Fluoride Treatment in Preschool Children: A Cross Sectional Study
Authors: Ladparkdy Souphavady , Asvanund Yuwadee , Prapansilp Woranun , Srimaneekarn Natchalee
Published: October 2024

Abstract

Aim:

Silver diamine fluoride (SDF) is a minimally invasive treatment with proven efficacy for managing early childhood caries. However, the dark staining associated with SDF treatment remains a major concern that affects parental acceptance. This study examines the level of parental acceptance of SDF treatment for preschool children in Laos and explores associated factors such as parental anxiety, previous dental experience, and demographic data.

Materials and Methods:

A cross-sectional survey was conducted with 324 parents of children aged 2–5 years enrolled in preschools in Vientiane Capital, Laos. Participants provided demographic information, details on their children’s dental history, and their own dental anxiety levels. Following a video demonstration of the effectiveness and application of SDF, parents completed a survey assessing their acceptance of and concerns about SDF using a 5-point Likert scale. Parental dental anxiety was measured with the modified dental anxiety scale. Data were analyzed using chi-square tests, independent t tests, and multiple logistic regression (P ≤ 0.05).

Results:

Eighty percent of the parents accepted SDF treatment for their children. Those highly concerned about SDF staining were significantly less likely to accept it as a treatment option (P < 0.01). Increased acceptance correlated with reduced concern about staining (95% confidence interval = 15.57–1095.88). Additionally, 84.9% of parents reported some level of dental anxiety, with older parents showing higher acceptance of SDF.

Conclusions:

Parents were highly receptive of the SDF treatment for their children’s primary dentition. Parents who were older tended to be less concerned about the staining, and those who had a high level of dental anxiety were more likely to accept SDF treatment.
Tracheal Stent Placement In A Difficult Airway In A Patient With Central Airway Obstruction With Anterior Mediastinal Mass –A Case Report
Authors: Sharma Juhi , Sarkar Satyaki , Mohan Anant , Garg Rakesh
Published: October 2024

Central airway obstruction due to benign and malignant aetiologies can result in life-threatening airway emergencies. Tracheal stenting is one of the definitive approaches for symptomatic relief in inoperable case scenarios. We report a case of papillary thyroid carcinoma with an anterior mediastinal mass presenting with dyspnoea and stridor for emergency tracheal stent placement. Awake stent placement using a video laryngoscope was performed after adequate airway topicalisation, followed by fibreoptic bronchoscope (FOB)-guided negotiation. Although rigid bronchoscopy is the gold standard, it often requires general anaesthesia, which could predispose to complete airway collapse in this patient.
Interesting Life Journey of a Type 1 Diabetes Individual from the Era of Injectable Insulins to the Hybrid Closed-Loop Insulin Pump
Authors: Damle Varun Anil , Amutha Anandakumar , Lovelena Munnavar , Mohan Viswanathan
Published: October 2024

Continuous subcutaneous insulin infusion (CSII) pump has shown good outcomes in individuals with diabetes. An individual with type 1 diabetes (T1D) was diagnosed in 1996 at the age of 14 years with GAD-positive and absent C Peptide reserves confirming the diagnosis. Initially, the individual was started with the conventional treatment for T1D consisting of multiple insulin injections per day, however, with this treatment, there was a wide fluctuation in the blood sugar levels with frequent hyperglycemic and hypoglycemic episodes, and could not achieve strict HbA1c control. In 2019, the treatment was switched to a 620G CSII pump, the fluctuations in blood sugar levels were reduced, but still, there were occasional hyperglycemic and hypoglycemic episodes failing to achieve the target HbA1c control. In 2022, again the treatment was changed to the latest 780G CSII pump termed the artificial pancreas which helped the person with T1D to achieve strict blood sugar level control and excellent ‘Time in Range’ with no hyperglycemic and hypoglycemic episodes and a better quality of life.
Improving Medication Adherence in Geriatric T2DM Patients: A Factorial Randomized Controlled Trial
Authors: Samajdar Shambo Samrat , Tripathi Rohan , Mukherjee Shatavisa , Biswas Kaushik , Joshi Shashank R. , Sarkar Sougata , Tripathi Santanu K. , Saboo Bharat
Published: October 2024

Background:

The complexity of managing type 2 diabetes (T2D) in the elderly is compounded by the need to balance over-prescription, under-prescription, and appropriate prescription. Managing hyperglycemia and its complications, along with geriatric syndromes such as cognitive impairment and falls, often leads to use of an increased number of medications. Quality improvement measures, while aimed at better management, can inadvertently contribute to the burden of polypharmacy. Addressing medication non-adherence is crucial, as it is a significant contributor to poor clinical outcomes, increased hospitalizations, and healthcare costs.

Objectives:

This study thus aimed to evaluate the effectiveness of interventions to improve medication adherence among elderly patients with T2D. It assessed the impact of a medication adherence device, clinical pharmacological intervention, and their combination compared to standard of care (SOC) alone on adherence rates, adverse drug reactions (ADRs), and glycemic control.

Materials and Methods:

This pilot study was a factorial randomized controlled trial. A total of 120 elderly T2D patients with a medication adherence rate of less than 80% over the past year were randomized into four groups: (1) medication adherence device + SOC, (2) clinical pharmacological intervention + SOC, (3) combined intervention + SOC, and (4) SOC alone. The primary outcome was medication adherence, assessed through pill counting. ADRs were evaluated using the Naranjo ADR causality assessment scale, and glycemic control was monitored through HbA1c levels. Statistical analyses included chi-square tests and ANOVA, with significance set at P < 0.05.

Results:

Interim analysis showed the highest adherence rate in the combined intervention group (82.1%), followed by the clinical pharmacological intervention + SOC group (75.3%), the medication adherence device + SOC group (73.1%), and the SOC alone group (70.0%). The combined intervention group also recorded the lowest ADR rate (6.6%). Regarding glycemic control, 81% of the combined intervention group achieved an HbA1c level of less than 7%, compared to 80% in the clinical pharmacological intervention + SOC group, 78% in the medication adherence device + SOC group, and 69% in the SOC alone group. Differences in glycemic control were not statistically significant (P = 0.950).

Conclusions:

The study indicates that combined interventions including medication adherence devices along with SOC significantly improve medication adherence and reduce ADRs in elderly T2D patients. Future research should focus on diverse populations and long-term sustainability of these interventions.
Cardiorenal Benefit of Tirzepatide in Type 1 Diabetes: A Case Report
Authors: Ahmed Khalid , Koubeh Sakina , Ahmed Aisha , Hussain Suleiman
Published: October 2024

Patients with type 1 diabetes (T1D) who are obese are at risk of cardiovascular disease, renal diseases, and other complications. Unfortunately, there is currently no cure for T1D, necessitating individuals with this condition to rely on lifelong insulin therapy. Tirzepatide, a dual-acting glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 agonist, has recently been approved for treating type 2 diabetes. We report the case of a 38-year-old male who presented with T1D, stage 2 chronic kidney disease, obesity, and other comorbidities. He was prescribed tirzepatide 2.5 mg initially, followed by titration up to 5 mg. A significant reduction in blood glucose levels, weight, and microalbumin levels was observed. Additionally, the systolic blood pressure level was also seen to improve. These results highlight new indications of tirzepatide in managing T1D and obesity. However, further studies are warranted to explore its efficacy and safety in patients with T1D.
Clinical Utility of Serial Monitoring of C-Peptide in Diagnostic Dilemmas of Young-Onset Diabetes: A Case-Based Discussion
Authors: Gangadhara Praveen , Mohan Anjana Ranjit , Unnikrishnan Ranjit , Mohan Viswanathan
Published: October 2024

Diabetes in the young has been traditionally defined as onset of diabetes below 35 years of age. In this age bracket, a variety of distinct types of diabetes might occur which poses a unique challenge in the diagnosis and management. Phenotypic features such as age of onset, presence of obesity and family history have traditionally been used in differentiating the various types of diabetes. With the increasing prevalence of obesity and T2DM in youth, these features have become less reliable in classifying diabetes in this age group. Along with detailed patient history and physical examination, biochemical parameters such as C-peptide and presence or absence of pancreatic autoantibodies (along with imaging studies for pancreatic pathology and genetic testing for monogenic forms of diabetes) are assuming greater importance in appropriate diagnosis and understanding the types of diabetes. C-peptide test which is a proxy for pancreatic beta cell function plays an important role in classifying type / subtypes of diabetes. When used appropriately it also helps in personalized approach to treatment and practice of Precision Diabetes.
Comparative Effects of Different Focus Methods on Muscular Activation During Single-Leg-Squat Exercise
Authors: Atalay ES , Soylu Ç , Kılınç B , Şahan TY , Türker D , Demir P , Yıldırım NÜ
Published: October 2024

Background:

Single-leg squats are frequently featured in training and rehabilitation programs. The use of focus during exercise changes the state of concentration during exercise. This causes changes in muscular activity. No study has been found comparing focusing methods’ effectiveness during single-leg squat movement.

Aim:

This study aims to compare the changes in lower extremity muscular activations in cases of external focus, internal focus, and absence of focus.

Methods:

The muscular activities (Gluteus Medius, Vastus Lateralis, Vastus Medialis, Rectus Femoris, Biceps Femoris, and Semitendinosus) of the healthy participants included in the study were measured with the surface electromyography (EMG) device. External focus, internal focus and without-focus positions were used.

Results:

Seventeen recreationally active participants were included in this study. The muscular activities of the participants, which occurred in three different situations, were measured with the surface electromyography (EMG) device. While the quadriceps were more active in the descent phase, the hamstring muscle group was more active in the ascent phase. The external focus provided more muscular activation than the other two focal conditions.

Conclusion:

According to the results of this study, the use of focus during single-leg squat training and rehabilitation may change the muscular response obtained.
Comparison of the Effects of Microfracture, Soft Callus Implantation, and Matrix-Supported Chondrocyte Implantation in an Experimental Osteochondral Defect Model in Rats
Authors: Özkan ÖC , Kurdal DP , Yılmaz B , Tutcu HK , Somuncu ÖS , Yücel IA , Savaşır E , Midi A
Published: October 2024

Background:

The treatment of cartilage defects remains challenging due to the avascular nature of cartilage.

Aim:

This study investigates the therapeutic effect of soft callus in osteochondral defects and explores the ability of multipotent and pluripotent cells within the callus to form fibrous or hyaline cartilage in the defective area.

Methods:

Twenty-one rats were divided into three equal groups: Group 1 received only microfracture (MF), group 2 received microfracture with autologous chondrocyte implantation (MF+ACI), and group 3 received microfracture with soft callus implantation (MF+SCI). All rats underwent diaphyseal fracture in their left tibias, which was stabilized with a Kirshner wire. One week later, osteochondral defects were created in the right knees of all rats. For group 1, microfracture alone was applied to initiate healing in the defects. In group 2, heterologous chondrocytes, previously harvested from the lateral condyle of a rat’s left femur and cultivated in a laboratory environment, were implanted into the microfracture site. In group 3, soft callus tissue obtained from the left tibial fracture was compressed and implanted into the defective area. All groups were sacrificed at the 6th week, and the healing status of the osteochondral defect areas was histopathologically evaluated.

Results:

Macroscopic examination at the end of the study revealed comparable ICRS-1 scores for MF+ACI (group 2) (11.28 ± 1.25) and MF+SCI (group 3) (11.14 ± 0.37), while MF alone (group 1) (4.28 ± 1.25) showed significantly lower results. Microscopic examination yielded similar outcomes. Regarding histological scores, ICRS-2 scores for MF (group 1) (35.30 ± 1.13), MF+ACI (group 2) (47.09 ± 1.63), and MF+SCI (group 3) (43.97 ± 1.49) were statistically significantly lower.

Conclusion:

Defects treated with soft callus implantation demonstrated comparable outcomes to the widely used and gold-standard autologous chondrocyte implantation. When compared to microfracture alone, better macroscopic and microscopic results were achieved with soft callus implantation.
Comparison of the Analgesic Effect of Erector Spinae Plane Block Versus Caudal Epidural Block Following Unilateral Pediatric Inguinal Hernia Surgery: A Prospective, Randomized Study
Authors: Kart K , Gencer M , İtal İ
Published: October 2024

Background:

Caudal epidural block (CEB) has long been used as a standard method for pain control in pediatric surgery. Erector spinae plane block (ESPB) is a newer technique that has attracted attention for its potential to provide analgesia in children.

Aim:

The aim of this study was to compare and evaluate the effectiveness of ESPB and caudal block on postoperative pain in pediatric patients who underwent unilateral inguinal hernia surgery.

Methods:

This prospective, randomized trial was conducted with a total of 60 pediatric patients, aged 1–8 years, in the ASA I–II group. The patients were randomly divided into two groups as Group CEB (n = 30), and Group ESPB (n = 30). In the caudal block group, 0.25% bupivacaine 0.5 ml/kg (max 20 ml) was administered in the caudal space, while in the ESPB block group, the block was performed with 0.5 ml/kg 0.25% (max 20 ml) bupivacaine at the L1 vertebral level. Face, legs, activity, cry, and consolability (FLACC) scores were recorded postoperatively at 1, 2, 4, 6, 12, and 24th hours. The first analgesic requirements and time for rescue analgesia were also recorded.

Results:

While no significant difference was noticed between the two groups’ FLACC scores at the zeroth hour, first hour, second hour, fourth hour, and sixth hour (i.e. postoperatively [P > 0.05]), the FLACC scores of 12th hour in the ESPB group were significantly lower than the caudal block group (P < 0.05). There was also no significant difference in intraoperative additional analgesia requirements between the groups (P > 0.05). The time to first postoperative analgesia in the ESPB group was higher than that in the caudal block group (P < 0.05).

Conclusion:

The ESPB provided superior postoperative analgesia to the CEB in pediatric patients undergoing inguinal hernia surgery, and ESPB can be used as a relatively safer postoperative multimodal analgesia approach as an alternative to CEB.
Exploring Myrrh Oil as a Natural Antimicrobial Agent Against Oral Pathogens: An In Vitro Research
Authors: Koppolu P , Khan HF , AlQasem SM , AlShaban RAA , AlAjmi HK , Afroz M , Swapna LA
Published: October 2024

Background:

While contemporary pharmaceuticals play a critical role in managing oral infections, there remain persistent concerns regarding their chemical composition and potential adverse effects. This apprehension has led to an increased focus on exploring natural alternatives, particularly herbal substances, for their potential therapeutic benefits in oral health.

Aim:

This study aimed to examine the antibacterial properties of myrrh oil against common oral bacteria, including Candida, Escherichia coli, Klebsiella, and Staphylococcus aureus, and to assess its suitability as a natural alternative in oral healthcare.

Methods:

Oral swabs were obtained from 50 individuals from various socioeconomic backgrounds. The isolated organisms were cultivated on different types of media and identified using established microbiological methods. Bacterial growth inhibition was evaluated by culturing subsequent cultures on Muller-Hinton agar with myrrh oil. This agar medium was selected for its suitability in evaluating myrrh oil’s suppressive impact on oral bacteria proliferation.

Results:

Candida demonstrated abundant proliferation on the control media but showed a reduction in colony-forming units when treated with myrrh oil. E. coli, Klebsiella, and Staphylococcus aureus exhibited decreased growth and suppressed colony formation when exposed to myrrh oil.

Conclusion:

These findings indicate that myrrh oil can prevent the growth of oral bacteria, making it a promising natural antibacterial agent for managing oral health. Additional investigations are needed to examine the safety, ideal dosage, and clinical feasibility of this treatment.
Neurological manifestation and complications of coronavirus disease 2019: MRI findings
Authors: Elsayed Alaa Hamdy , Khdrah Rania S.A. , Elbahnasy Wafik S. , Abd Al Haleem Kareem M.
Published: October 2024

Background

Coronavirus disease 2019 (COVID-19) is an infectious disease that commonly manifests in forms that are systemic and/or respiratory. Although less common, some individuals also manifest mild symptoms of gastrointestinal tract or cardiovascular system. We aimed to assess the MRI findings in patients suffering from neurological manifestations after COVID-19.

Aim

We aimed to assess the MRI findings in patients suffering from neurological manifestations after COVID-19.

Patients and methods

This study was conducted on 60 patients with clinical criteria of both sexes, with clinical criteria of neurological manifestations after COVID-19 infection. Patients were subdivided in to two groups according to computed tomography (CT) severity index (moderate n=33 and severe n=27), ICU admission (negative n=4 and positive n=56) and white matter changes (negative n=20 and positive n=40). All patients were subjected to radiological assessment by CT scan of the chest and MRI examinations of the brain.

Results

There was statistically significant higher mean O2 saturation among cases with moderate CT severity index than cases with severe CT index and higher mean D-dimer among cases admitted to ICU than cases not admitted. There was a statistically significant higher frequency of bilateral lobar involvement, CONSOL among cases with severe than moderate CT severity index, and higher frequency of reticulation among cases admitted to ICU than cases not admitted.

Conclusion

There may be a link between the neurological development symptoms and a poor prognosis in COVID-19 individuals.