bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 Vaccines - A Narrative Review
Authors: Deka Saurav , Iram Farah , Hariharan Niveditha
Published: November 2021

Since the pandemic started, various clinical trials have been going on to develop COVID vaccines. Vaccines which have passed the clinical trials include live attenuated vaccines, inactivated vaccines, protein subunit vaccines, virus like particles vaccines, viral vector vaccines, and nucleic acid vaccines. There are several vaccines in phase III and IV trials, and more than ten vaccines have been approved or authorized. Most of these vaccines are efficacious and safe. However, there are various pros and cons of these vaccines. This review explains how these vaccines have been developed, their mechanism of action, advantages, and disadvantages of these vaccines, along with costing and post vaccination challenges.

Keywords: Covid-19 vaccines, efficacy, safety, post-vaccination challenges.
Functional Lipids as Nutraceuticals: A Review
Authors: Bhat Sneha S.
Published: November 2021

Stephen L. Defelice, founder and chairman of the Foundation of Innovation Medicine, created the term "Nutraceuticals" in 1989 as a combination of the words "nutrition" and "pharmaceutical." Nutraceuticals are food-derived products that are claimed to give additional health advantages in addition to the fundamental nutritional content present in meals. Their kinds may be more significant than their quantity in terms of health and disease. The aim of this review is to provide a summary of the research on the role of functional lipids namely: Omega -6 fatty acid, Omega -3 fatty acid, Conjugated linoleic acid, Medium chain triglycerides and Phytosterols as nutraceuticals in human health. Functional lipids have been related to the prevention and treatment of a variety of ailments, according to new study. With the use of supplementary and dietary forms of functional lipids, scientific data has demonstrated positive improvements in patients and favorable benefits in healthy people.

Keywords: Nutraceuticals, Functional lipids, Conjugated linoleic acid, Medium chain triglycerides, Omega -6 fatty acid, Omega -3 fatty acid, Phytosterols,
Effectiveness of Buteyko Breathing Technique versus Nadi Shuddhi Pranayama to Improve Pulmonary Function in Subjects with Bronchial Asthma
Authors: Swathi G , Kumar T Sunil , Raghunadh N
Published: November 2021

Background: Asthma is a chronic life-threatening disease as the airways in the lungs often swollen or inflamed, which makes the airways very sensitive. So, the exposure to the environment in day-to-day life triggers asthma. Asthma can affect at any age group. This study mainly focuses on comparing the effects of Buteyko breathing technique and Pranayama on improving Pulmonary Function in subjects with Bronchial Asthma.
Method: Total of 79subjects selected, out of those 66 subjects were included after obtaining the consent document. Subjects are divided into two groups by lottery method, in which 6 subjects dropped. So, the study was completed with 60 subjects. Both groups performed intervention for 1 hour a day 5 days week for 4 weeks. The outcomes of the study were FEV1, FVC & FEV1/FVC ratio.
Results: Paired t test was used to assess statically significance between pre and post test scores with in the groups, independent t test was used to access statistical significance of post-test mean score between the groups, statistical analysis of the data revealed that Buteyko Breathing technique group has more difference when compare to Pranayama group.
Conclusion: The results had shown that both Group-A (Buteyko Breathing Group) and Group-B (Pranayama Group) has improved significantly on pre and post-test values within the groups but when compared between the groups statistical significance is noted in Group-A. So, this study concludes that Group-A showed significant improvement on Pulmonary Function in subjects with Bronchial Asthma.

Keywords: Buteyko Breathing technique, Nadishuddhi Pranayama, FEV1/FVC, Bronchial Asthma.
Evaluating the Correlation between Periodontal Status of Teeth Adjacent and Contralateral to Implant with Peri-Implantitis - A Retrospective Study
Authors: Kour Navneet , Wani Nadia Irshad , Sharma Parul
Published: November 2021

Background: Previous history of periodontitis associated with smoking and poor oral hygiene are considered as one the risk factor for peri-implantitis which in-turn leads to implant failure. Periodontitis is regarded as the most prevalent infectious diseases with around 75% of adults being affected. A similarity between the pathogenesis of periodontitis and peri-implantitis is as a result of intra-oral translocation of periodontal pathogen from teeth showing periodontitis to the peri-implant niche.
Aim: The main aim of the study is to evaluate the prevalence of peri-implantitis in patients suffering from periodontitis.
Material and Methodology: A retrospective study was conducted in the department of periodontology on 30 patients suffering from periodontitis and with dental implant insertions. In all the patients, periodontal and bone conditions were evaluated. Probing depth, gingival recession, clinical attachment levels, and radiographic bone loss was calculated around the implants, adjacent teeth and contra- lateral teeth to evaluate correlation between periodontitis and implant failures.
Results: On evaluation of results with 30 patients, periodontal depth, clinical attachment levels, and gingival recession showed statistically significant around implants when compared with the periodontal parameters around the adjacent teeth and contra-lateral teeth. Non significant results were obtained when radiographic bone loss was evaluated.
Conclusion: Within the limitations of the study, it was concluded that dental implant therapy is strongly affected by the periodontal health and health of adjacent teeth plays an important role in determining the failure or success of the implant while contra-lateral teeth have no or minimal relationship between periodontitis and implant failure.

Keywords: Implant, Oral Health, Peri-Implantitis, Periodontitis, Translocation.
Hospitals’ and Nurses’ Preparedness to COVID-19 Pandemic
Authors: Al Awamleh Rana AbdelFattah
Published: November 2021

Background: Human corona virus disease (COVID-19) is a contagious disease that has been suggested to have a negative impact on both health care system and health care providers, and this was mainly attributed to the rapid and unexpected spread of this pandemic.
Purpose: This study was conducted to assess the level of preparedness of Jordanian nurses and hospitals to COVID-19 pandemic.
Method: cross-sectional, descriptive design was used. Data were collected through electronic survey questionnaires from 306 nurses from seven Jordanian hospitals. A modified version of tool developed by Elhadi and colleagues (2020) was used to collect data regarding the preparedness of nurses and hospitals to COVID-19 pandemic.
Results: The majority of nurses (84.3%) have participated in care provision for clients with COVID-19. Findings of this study revealed that male, older, more experienced nurses scored significantly higher on nurses’ preparedness scale. About 60% of nurse participants perceived their hospitals to be well-prepared to COVID-19 pandemic.
Conclusion: The level of preparedness among nurse was found to be good, but not optimal. Greater emphasis should be placed on younger and less experienced nurses. Urgent actions should be taken to enhance the health institutes’ preparedness, particularly in terms of infection control domain.

Keywords: COVID-19, Preparedness, Nurses, Hospitals, Pandemic.
Development and Evaluation of Evidence Based Patient Education Booklet in Hindi Language for Prevention of Shoulder Pain in Paraplegia
Authors: Verma Taniya , Kataria Chitra
Published: November 2021

Background: Shoulder pain is one of the most frequent complaints of Paraplegia with a prevalence reported to range from 50% to 60%.It has been attributed to the increase in upper extremity (UE) weight bearing following lower extremity paralysis.
Purpose of the study: To develop and Evaluate an Evidence Based Patient Education Booklet in Hindi Language for Prevention of Shoulder Pain in Paraplegia along with pictorial presentation.
Design: A methodological study
Method: It consist of 4 steps. 1) Literature review and informal interview of 2 doctors, 7 physiotherapists, 5 occupational therapists and 10 patients were used to determine the domains of the education booklet. 2) Development of content of the evidence based patient education booklet according to domains found in step 1 and develop a rough draft of booklet in Hindi Language. 3) Evaluation of the evidence based booklet by expert panel using SAM and to modify the booklet to produce the final booklet draft. 4) Pilot study on patients to take their views regarding the booklet developed.
Results: The domains found in step 1 were: Education about pain, Education about the treatment options, Ergonomics modifications, Positioning, Wheel chair selection and transfer techniques, Exercises, General precautions. The content was developed in step 2. In step 3 the SAM score is- 88.13% and final booklet was produced after modification. In step 4 the patient rated the booklet easy to read and understand with an overall rating of 9/10
Conclusion: The developed patient education booklet came out to be easy to read and understand and of superior quality according to Suitability assessment of material questionnaire and hence should be made a part of patient education.

Keywords: Patient education booklet, Shoulder pain in paraplegia, Suitability assessment of material questionnaire, booklet in Hindi language, Pain prevention and management, Health education material
A Comparative Analysis of Cost and Affordability between Veterinary and Human Pharmaceutical Drugs in India
Authors: M.R Prashanthy. , S Shreelakshmi. , D Prabu.
Published: November 2021

To analyze the comparison of cost and affordability between veterinary and human drugs in India. A comparative study was conducted in two regions of Chennai based on a simple random sampling technique. Both Veterinary and human drugs were collected from private veterinary and Human drug pharmacies. Price and availability data of veterinary medicines and human medicines were collected from private sector retail pharmacies. As per the data analysis, descriptive statistics are used. The comparison of various antibiotic, anti-helminthic, anti-inflammatory, anti-fungal, anti-histamine, anti-tick drug prices used in humans and Animals. The variation of a single unit Amoxicillin drug for veterinary costs Rs.30 whereas in Humans, the same drug costs to Rs.18.6.Cephalexin, ciprofloxacin, Sulfamethoxazole, tetracycline, clindamycin drugs showed a higher cost range in veterinary than in human drugs which had a difference of Rs.9 on average. Doxycycline, Chlorpheniramine, aspirin, Clotrimazole were the only veterinary drug cheaper than their similar human combination. The veterinary drugs are too expensive and we must take certain steps to avoid those high prices. Drug Regulation policies must be implemented for a veterinary drug similar to a human drug.

Keywords: Veterinary Drugs, Human Drugs, Price, Affordability.
Prevalence of Dental Caries among Children of Aged 6-12 Years in Tamilnadu - A Systematic Review
Authors: P Suganya. , M Rajmohan. , V. V Bharathwaj.
Published: November 2021

Background: Dental caries is a serious public health problem in developed as well as developing nations, with high prevalence among children around the world. This systematic review of literature was undertaken to document the prevalence of dental caries.
Aims and Objectives: This study aims to evaluate the prevalence of dental caries among children of aged 6-12 years in Tamilnadu by conducting a systematic review.
Materials and Method: Studies evaluating the prevalence of dental caries among children of aged 6-12 years in the Tamilnadu were investigated. An extensive literature search was done in the following databases: Prospero, Grey literature, Science Direct, Cochrane library, Wiley online library, Lilacs and PubMed. The articles were retrieved from each database based on the MeSH representation. A modified version of the Newcastle-Ottawa Scale for cross-sectional studies was used for assessment of the quality of the studies. A systematic literature search yielded 1034 publications from the various databases searched. According to the Preferred Reporting Items for systematic Reviews and Meta-Analyses and based on the inclusion and exclusion criteria, the final number of included studies was fifteen.
Results: Among the included studies, five studies were carried out in the Chennai district. Erode district was found to have the highest prevalence of dental caries at 89.3%.
Conclusion: This review has reported a high prevalence of dental caries in Tamilnadu. None of the states reported prevalence below 30%. The government should identify dental caries as a national priority which requires significant attention.

Keywords: Dental caries, Prevalence, Tamilnadu, Newcastle-Ottawa Scale.
Effectiveness of Respiratory Proprioceptive Neuromuscular Facilitation Techniques on Pulmonary Functions in Patients with Spinal Cord Injury - A Pilot Study
Authors: Thorat Komal Dattatray
Published: November 2021

Background: Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion which is a life threatening condition that carries a high risk of morbidity and mortality. The Incidence of SCI varies from 9.2 to 56.1 per million. In the Indian setup, Approx. 20,000 new cases of SCI are added every year. Spinal cord injury (SCI) patients are at increased risk of chronic respiratory symptoms as Respiratory muscle paralysis both restricts maximum inflation of the lungs and impair the ability to cough. Patients with tetraplegia have decreased chest wall and lung compliance, rib cage stiffness with paradoxical chest wall movements.
Material and method: A Pilot study was carried out on 04 Traumatic Spinal cord injury patients. The purpose of the study was To find out effectiveness of respiratory PNF on pulmonary functions (FVC & FEV1) & Chest Expansion in patients with spinal cord injury. The pulmonary Functions (FVC & FEV1) and chest expansion was measured by using Spirometer (PFT machine) and inch tape. The data was analyzed using standard statistical software.
Result: In this study After 4 weeks of Intervention there was Significant Improvement in Pulmonary Functions ( Pre Mean of FEV1 & FVC 0.99 L & 1.03L and Post Mean of FEV1 & FVC was 1.25 L & 1.35L respectively) and Chest Expansion (Pre Mean was 1.15 cm and Post Mean was 1.62 cm at Xiphoid Process Level).
Conclusion: This Study concluded that Respiratory PNF increases Pulmonary Functions and chest expansion in Patients with Spinal Cord Injury after 4 weeks of Intervention.

Keywords: Spinal Cord Injury, Forced Expiratory Volume (FEV1), Forced vital Capacity, Peak expiratory flow rate, Respiratory Proprioceptive Neuromuscular Facilitation Technique.
Short Term Effects of Rhythmic Auditory Stimulation with Body Weight Supported Treadmill Training on Gait and Balance in Individuals with Incomplete Spinal Cord Injury
Authors: Singhal Kanika , Kataria Chitra
Published: November 2021

Background: Rhythmic auditory stimulation and body weight supported treadmill training both are standardized gait rehabilitation techniques. However there is limited literature evaluating the effect of rhythmic auditory stimulation and its combination with gait training in spinal cord injury. Aim of this study is to determine the short term effectiveness of rhythmic auditory stimulation with body weight supported treadmill training on gait and balance in individuals with incomplete Spinal Cord Injury.
Method: A randomized control study design. 8 subjects with incomplete spinal cord injury who met the inclusion criteria were randomly allocated into two groups: Experimental and Control. Subjects in experimental group were given body weight supported treadmill training with rhythmic auditory stimulation. Subjects in Control Group were given Body weight supported treadmill training alone. Both the groups received conventional rehabilitation as well. Both groups received training for 30 minutes, five times a week for two weeks (10 sessions).
Outcome Measures: Gait parameters i.e. cadence, velocity, step length were measured using the Biodex Gait Trainer 2TM, level of walking performance measured using Walking Index for Spinal Cord Injury II, and balance was evaluated using Prokin 252NTM , Berg Balance Scale, and Activity specific Balance Confidence scale.
Results: No significant improvement was found on gait parameters i.e. cadence, velocity, step length which were measured using the Gait Trainer, level of walking performance measured using WISCI II, and balance which was evaluated using Prokin 252NTM , Berg Balance Scale, and Activity specific Balance Confidence scale.
Conclusion: Rhythmic auditory stimulation didn’t have any positive effect on gait training in incomplete spinal cord injured patients. Further studies are warranted to explore the entrainment effects of rhythmic auditory stimulation in spinal cord injured individuals on gait rehabilitation.

Keywords: Rhythmic Auditory Stimulation (RAS), Body Weight Supported Treadmill Training (BWSTT), Metronome, Incomplete spinal cord injury, Biodex Gait Trainer 2.0, Prokin 252N
Financial Autonomy as an Aid to Rural Development: A Study of Isoko North Local Government Area of Delta State
Authors: O.N. Egware , O.F. Akporien , S. Otuya
Published: November 2021

Lack of financial autonomy and undue interference by state governments have been identified as some of the impediments to effective administration of local governments in Nigeria. To this end, this study was carried out to examine the effect of financial autonomy on rural development using Isoko North Local Government Area as a case study. The study adopted a survey research design; hence, data were collected through the use of questionnaires administered to the management and staff of selected departments in Isoko North Local Government Council. The findings of the study indicate that financial autonomy will contribute positively to rural development and service delivery in the area of study, and recommends that local governments should be made financially autonomous to promote rural development and enhance better service delivery.
Voltage and Frequency Control for Hybrid Stand-Alone Power Systems For Isolated Communities
Authors: A.D. Adebayo , A. Christian
Published: November 2021

This paper proposes a control and overall coordination of a hybrid stand-alone power system. The system may comprise a wind turbine, fuel cell, electrolyzer, battery storage, diesel generator and a set of loads. The overall control planning of the hybrid system is based on a two-level structure. The top-level is the energy management and power regulation system. Depending on wind and load conditions, this system generates reference dynamic operating points to low-level individual sub-systems. The energy management and power regulation system also controls the load scheduling operation during unfavourable wind conditions with inadequate energy storage in order to avoid a system black-out. Based on the reference dynamic operating points of the individual sub-systems, the local controllers control the wind turbine, fuel cell, electrolyzer and battery storage units. The proposed control system is implemented in MATLAB Simpower software and tested for various wind and load conditions. Results are presented and elucidated.
Regional Health Disparities in the Aftermath of Health System Reforms in Turkey
Authors: UGUR Zeynep , TİRGİL Abdullah
Published: November 2021

Starting in 2003, Turkey introduced major health system reforms through the Health Transformation Program (HTP). The HTP aimed to address inequities in health care services across Turkey. This study explores whether regional disparities in several health care indicators persist ten years after the HTP. For this purpose, we use administrative records and individual-level data from the only regionally representative survey, Life Satisfaction Survey, undertaken by the Turkish Statistical Institute in 2013. First, the disadvantaged North-East, Middle-East, and South-East Anatolia regions experienced the most substantial increases in all health inputs and the odds of receiving the non-contributory Green Card insurance was also higher in these regions. Yet, there is still substantial disparity across regions in many health care access and satisfaction indicators. Especially, the disadvantaged regions still have lower utilization, lower satisfaction with healthcare, and lower subjective health scores in 2013 even after accounting for a wide range of control variables. While the HTP enabled the provision of a generous insurance benefits package, there is still room for progress in regional distribution of other major indicators such as subjective assessment of health, healthcare utilization, and satisfaction with health services. To further reduce health inequities across regions, the quality aspect of healthcare provision needs to be prioritized.
Capillary hemangioma on the tip of the tongue
Authors:   Department of Oral Medicine and Radiology, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation (Deemed to be University), Salem, Tamilnadu, India., R Karthik , PT Ravikumar ,   Department of Oral Medicine and Radiology, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation (Deemed to be University), Salem, Tamilnadu, India., fenn Saramma Mathew ,   Department of Oral Medicine and Radiology, Vinayaka Missions Sankarachariyar Dental College, Vinayaka Missions Research Foundation (Deemed to be University), Salem, Tamilnadu, India.
Published: November 2021

Hamangioma is a benign, local malformation of blood vessels and grow along with the same rate as the adjacent tissues, they do not invade underlying structures but may involute over a period of time resulting in fine telangiectasia or scarring. Haemangioma can occur anywhere in the body and also in the oral cavity. In tongue they may get ruptured and result in spontaneous bleeding [1].
An update on neurological outcome in Covid-19 crisis
Authors:   Consultant Neurologist, Department of Clinical Neurology, GNRC Hospitals, Guwahati, India, Mathur Manik , Das Rupjyoti ,   Head of Department & Senior Consultant, Department of Clinical Neurology, GNRC Hospitals, Guwahati, India
Published: November 2021

Recent pandemic surge of Covid-19 has made it necessary to further understand a detailed neurological association with the virus in-relation to sub-clinical picture. Additionally, in the presence of a sweeping corona virus wave throughout the globe, pre-liminary studies have indicated a strong association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in addition to neuropsychiatric and neurological illness. Following a trivial research (clinical and paraclinical data), five major scenarios have been observed, namely, encephalopathies with no distinct MRI or CSF abnormalities, inflammatory CNS syndrome (including para-or-post-infections) with/out isolated myelitis, ischaemic strokes associated with pro-thrombotic state, peripheral neurological disorders such as Guillain-Barre syndrome and other miscellaneous neurological disorders. Therefore, an early recognition and understanding in the backdrop of neuropathology associated with COVID-19 is essential. Where hypercoagulability is a newfangled conduit in further complicating the pathogenesis to unreasonable levels. Here, a brief discussion on present neurology associated outcomes in COVID-19 scenario.
Papillary carcinoma arising from thyroglossal duct cyst with cervical lymph node metastasis
Authors:   Associated Professor, Department of Otolaryngology, Head and Neck Surgery, Kerman University of Medical Sciences, Kerman, Iran, Eslami Hadi , Zahraei Seyed Ali Hossein ,   Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, Saberi Mandana ,   Resident of ENT, Department of Otolaryngology, Head and Neck Surgery, Kerman University of Medical Sciences, Kerman, Iran
Published: November 2021

Thyroglossal duct cyst carcinoma is uncommon. Its prevalence is less than one percent. Papillary carcinoma is the most common pathologic finding of the thyroglossal duct cyst carcinoma. Metastasis of the cervical lymph node is less common. Its prevalence is less than 8%. A 38-year-old woman presented with a complaint of painless mass in the midline of the neck. Ultrasonography of the neck revealed a solid cystic mass, measuring 5.5 × 2.5 cm in the submental area. Ultrasonography of the neck additionally revealed suspicion lymph node at bilateral level Ib. A preoperative Computed Tomography (CT) showed a 4 cm size MIX heterogeneous lesion in the anterior left-sided hyoid bone. The patient underwent sistrunk surgery, which was the result of the patient’s frozen section papillary carcinoma arising from the thyroglossal duct cyst. The patient had local metastasis to the neck, so she underwent total thyroidectomy and central N-D surgery and bilateral modified radical N-D. Diagnosis of thyroglossal duct cyst carcinoma before surgery is unusual. The definitive diagnosis is often after surgery and is based on the patient’s histopathological findings. The best surgical procedure is sistrunk. But if the patient has local metastasis to the neck, total thyroidectomy and modified radical N-D are performed.
Openness to discuss cancer: Not only a matter of medical communication
Authors:   Faculté de Medecine, Université catholique de Louvain, Avenue Emmanuel Mounier 50, B-1200 Woluwé-Saint-Lambert, Belgium, USERN, Naviaux Anne-Frédérique , Janne Pascal ,   Faculté de Psychologie, Université catholique de Louvain, Place Cardinal Mercier 10, 1348 Ottignies-Louvain-la-Neuve, Belgium, USERN., Bradish Alan ,   University College, (HONS°) Belfield, Dublin 4, www.near.ie, RCN 20205453, Gourdin Maximilien ,   Université catholique de Louvain, Département d’Anesthésiologie, CHU UCL Namur, Yvoir, Belgium, USERN
Published: November 2021

Though many studies have been made - sometimes even blaming - to optimize the communication between doctor-patient-caregiver in oncology, very little work is focused on the intra-familial aspects of the communication [1-5]. Clinical experience shows us how much communication between cancer patients and their loved ones can also be impacted by cancer: We will refer to this phenomenon as “Communicative Cancer”. In fact, as soon as the communication of the diagnosis is made, perverse effects can quickly occur due to at least two mechanisms: the defense mechanisms of the patient and his entourage and the significant deterioration of communication between the patient and his loved ones [6,7].
Multidrug-resistant klebsiella pneumoniae-induced sepsis with multiple abscesses: A case report
Authors:   State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, China, Xiong Ye , Huang Jianrong ,   State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, China
Published: November 2021

Klebsiella pneumoniae, a Gram-negative bacillus which exists widely in nature, is generally colonized in the human intestine and oral cavity and does not cause disease [1]. However, the emergence and global expansion of hypervirulent and multidrug-resistant clones of K. pneumoniae have been increasingly reported in community-acquired and nosocomial infections. Management of antimicrobial resistance in multi-drug-resistant-K. pneumoniae (MDR-KP) is a major challenge for clinicians [2]. The optimal treatment option for MDR-KP infections is still not well established, which brings huge challenges to clinical treatment [2].
RBD in pure autonomic failure
Authors:   DM Resident Neurology, Calcutta National Medical College & Hospital, Kolkata-700014, West Bengal, India, Ahmad Paul Shabeer , Patra Chandrakanta ,   DM Resident Neurology, Calcutta National Medical College & Hospital, Kolkata-700014, West Bengal, India, Prasad Mondal Gouranga ,   Professor and Head Neurology (DM Neurology), Calcutta National Medical College & Hospital, Kolkata-700014, West Bengal, India, Bhattacharyya Ramesh ,   Professor, Neurology, DM Neurology, Calcutta National Medical College & Hospital, Kolkata-700014, West Bengal, India, Ghosh Kartik Chandra ,   Professor, Neurology, DM Neurology, Calcutta National Medical College & Hospital, Kolkata-700014, West Bengal, India, Das Sarbajit ,   Professor, Neurology, DM Neurology, Calcutta National Medical College & Hospital, Kolkata-700014, West Bengal, India
Published: November 2021

Pure autonomic failure is considered to be a degenerative condition of the autonomic nervous resulting from accumulation of alpha-synuclein in autonomic ganglia [1,2]. Lack of CNS involvement distinguishes this disorder from other synucleopathies with CNS involvement like MSA, DLB and PD. However, long term follow-up of PAF patients has shown that some of these cases convert to one of these disorders most commonly MSA [3]. Also, recent data, albeit limited in nature has shown the association of REM sleep disorder in PAF patients challenging the previous notion that PAF is a disease restricted to autonomic nervous system. This data has led to the discovery of a clinical syndrome with a position in the middle of the spectrum of these disorders with PAF at one end of the spectrum and MSA, DLB and PD at the other end. We hereby present a case report of one such patient with PAF associated with RBD but without any other CNS manifestations.
A giant juvenile fibroadenoma in a 12-year-old girl: Case report and brief literature review
Authors:   Department of Surgical Oncology, UZ-Leuven, Leuven, Belgium, Bardisi Ekhlas S , Smeets Ann ,   Department of Surgical Oncology, UZ-Leuven, Leuven, Belgium, Floris Giuseppe ,   Department of Pathology, UZ-Leuven, Leuven, Belgium, Ongeval Chantal Van ,   Department of Radiology, UZ-Leuven, Leuven, Belgium, Keupers Machteld ,   Department of Radiology, UZ-Leuven, Leuven, Belgium, Nevelsteen Ines ,   Department of Surgical Oncology, UZ-Leuven, Leuven, Belgium
Published: November 2021

Juvenile fibroadenoma is the most common breast mass in adolescents accounting for 0.5–4% of all cases of fibroadenomas. Giant fibroadenomas are rare variants and represent only 0.5% of all fibroadenomas, usually occurring in girls between the ages of 10 and 18. They are characterized by massive and rapid enlargement of a rubbery, mobile, and non-tender mass and defined as being larger than 5 cm or weighing more than 500 g. The aetiology is not well understood and is believed to be an increased sensitivity to normal oestrogen level. We present a 12-year-old Asian girl treated at the age of 8 for idiopathic precocious puberty, without known family history of breast masses or cancers, who developed spontaneous giant fibro-adenoma measuring 15cm X 17 cm. The patient was further evaluated via ultrasonography showing a sole large lesion of 15 X 17 cm in the left breast. Surgical excision with conservation of the developing breast parenchyma and nipple-areolar complex under general anaesthesia was performed. Histopathological findings after the surgical excision were suggestive of juvenile fibroadenoma. The patient has a normal breast development throughout 4 years follow-up. The rapid growth of a breast mass in such young patients can be of great concern causing a considerable impact on these patients’ psychological and emotional condition. One of the most important concerns is the impact on potential future mammary gland development. Therefore, it is crucial to promptly rule out malignant processes or phyllodes tumors and educate young patients and their families on treatment options that fit their concerns. In addition, the final cosmetic result is essential after the surgical excision; although the primary cause of asymmetrical breast enlargement is a benign mass, early surgical excision is efficient concerning the best possible cosmetic outcome. Keywords: Breast mass; juvenile fibroadenoma; giant fibroadenoma.
The effect of using instrumental music on the pain and anxiety levels of patients with impacted third molar surgery
Authors:   Assistant Professor, Department of Oral and Maxillofacial Surgery, Assistant professor of OMFS Department, Dentistry School, Mazandaran University of Medical Sciences, Sari, Ira, Moadabi Amirhossein , Kazemi Mahsa ,   Dentist, Shiraz, Iran, Moosazadeh Mahmood ,   Assistant Professor, Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran, Zamanzade Maryam ,   Assistant Professor, Department of Oral and Maxillofacial Pathology, Dentistry School, Mazandaran University of Medical Sciences, Sari, Iran, Ghasemi Shohreh ,   DDS, Msc of Oral Surgery, Adjunct Assistant professor of OMFS Department of Augusta University, GA, USA, Akbari Sara ,   Fifth year of Dentistry in Mazandaran University of Medical sciences, Sari, Iran
Published: November 2021

Background: Anxiety and fear about dentistry are a global problem that affects a large number of people around the world. Music, as a soothing method, can be used as a relaxing treatment to relieve anxiety and discomfort pain of the patient. Purpose: This analysis aimed to check the instrumental music therapy effect on anxiety and pain levels in patients undergoing surgical treatment of an impacted third molar. Materials and methods: In this investigation, 88 patients who were contender for third molar extraction were isolated into the mediation and control groups. In the mediation bunch, delicate instrumental music was played from the time the patients went into the working room until the finish of the medical procedure when the patient left the room. Patients’ pain and nervousness levels were estimated by the Visual Analog Scale (VAS). Results: The consequences of this investigation showed that there were no measurably critical difference in depression, pain, preoperative anxiety, and postoperative uneasiness in the control and intervention group (P>0.05); however, preoperative anxiety was basically more noteworthy than postoperative anxiety in the two group (p=0.001). Conclusion: As per the outcomes, it sems to be that utilizing music doesn’t lead to measurably significant difference in the nervousness level in patients going through third molar medical procedure. However, it is suggested that different analysts direct further examinations with larger sample sizes just as choosing the music dependent on the people’s preferences. Keywords: Pain; anxiety; music.
Unilateral seminal vesicle agenesis in patient presenting with epididymo-orchitis
Authors:   Meherbai Tata Memorial Hospital, Dhadkedi, Jamshedpur, Jharkhan 831001, India, Khalkho Varsha Mary
Published: November 2021

Seminal vesicle anomalies are rare. It includes agenesis, hypoplasia, duplication, fusion and cyst. Agenesis of seminal vesicle is usually associated with anomalies of ipsilateral kidney and can be the cause of infertility in male [1]. We report a case with seminal vesicle agenesis with ipsilateral renal hypoplasia.
Reduced access to care among older American adults during CoVID-19 pandemic: Results from a prospective cohort study
Authors:   Research Group, The World Bank, Washington DC, USA, Das Ashis Kumar , Mishra Devi Kalyan ,   Department of Community Medicine, Hitech Medical College, Rourkela, India, Gopalan Saji Saraswathy ,   Human Development Department, The World Bank, Washington DC, USA
Published: November 2021

Background: Reduced access to routine care can lead to higher morbidity and mortality among older adults. We assessed the extent of reduced access to care among older American adults during the COVID-19 pandemic, identified predictors and reasons for reduced access. Materials and methods: Using publicly available data from the COVID-19 module (interim release) of the Health and Retirement Study, we undertook descriptive analyses of older adults stratified by socio-demographic characteristics. Associations between reduced access to care and predictors were estimated using a multivariable logistic regression model. Results: 30.2% of respondents delayed or avoided care during the pandemic. Reduced access was more likely to be reported by respondents that were female, younger, educated, not receiving social security benefits, with limitations in daily activities and three preexisting conditions. In terms of the reasons, the majority of the respondents (45.9%) reported that their visit was either cancelled or rescheduled by the provider; 13.9% thought they could wait, 10.9% could not get an appointment, 9.1% found it unaffordable, and 7.4% were afraid to visit the provider. Respondents reported of reduced access to doctor’s visits, surgery, prescription filling, and dental care. Conclusions: We suggest urgent attention on improving access to care for older adults during the pandemic. For nonemergency conditions and routine care that can be delivered virtually, telehealth services can be strengthened. Additionally, health messaging can reemphasize that neglecting medical care might lead to increased morbidity and mortality among older adults from preexisting illnesses. Keywords: Older adults; Access to care; COVID-19; Health and retirement study
Pure muscle tenosynovial giant cell tumor mimicks a metastasis in patient with melanoma
Authors:   Radiology Unit, Department of Radiology, Pugliese-Ciaccio Hospital, Catanzaro, Italy, Arcuri Pier Paolo , Commisso Angela ,   Radiology Unit, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy., John Marta ,   Radiology Unit, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy., Cascini Giuseppe Lucio ,   Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy., Laganà Domenico ,   Radiology Unit, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy.
Published: November 2021

Tenosynovial Giant Cell Tumor (TGCT) is a rare benign synovial tumor arising from the tendon sheath, bursae, synovium or adjacent soft tissue. TGCT typical occurs in intra-articular site but can be rarely extra- articular. A 50-years-old woman already affected by malignant melanoma was submitted to PET/CT scan for routine diagnostic examinations during follow up; an intense FDG focal uptake corresponding to peritrochanteric medial part of right iliopsoas muscle was detected. Corresponding MRI images demonstrated a lesion with well-defined margins, slightly hyperintense in T1, low to intermediate signal intensity in T2 weighted scans, no significant restriction in DWI, and intense enhancement in T1 after intravenous contrast medium administration. There wasn’t evidence of extra-lesional spread. MRI findings oriented for benign lesion, but according to intermediate signal intensity in T2, intense enhancement in T1 after intravenous contrast medium, the presence of intense FDG uptake as well as history of aggressive malignancy, a local excision was done; then the final diagnosis of TGCT has been proven. Our case shows TGCT lesions may reproduce malignant appearance on FDG-PET, while MRI may be useful tool to properly manage affected patients. Keywords: Tenosynovial giant cell tumor; Melanoma metastasis; Diffusion-MRI; FDG-PET/CT.
Current best practice recommendations for safe dental Practice in the COVID-19 era
Authors:   School of Pharmaceutical Sciences and Health Products, University of Camerino, Italy.
Published: November 2021

Methods: The researchers conducted a thorough review of the American Dental associations (ADA), Advisory Taskforce on Dental Practice Recovery, CDC (Centers for disease controls & Prevention, USA) guidelines for providing dental care during Covid-19 pandemic to protect the dental personal, OSHA’s (Occupational safety and health administration, US Government agency) supplemental interim guidelines for dental workers and employers related to control and prevention of Covid-19 & the UK’s National Health Services (NHS) proposed guidelines for standard operating procedures for urgent dental care during covid-19 pandemic. Results: Systematically laid down and concisely presented infection control, administrative and engineering control guidelines from top international organizations. Step by step guidelines beginning from pre-appointment screening, in office registration process, chairside protocols to staff protection protocols are presented. Special focus on aerosol/droplet/fomite generating procedures and prevention of infection through judicious use of PPE’s and other novel disinfection techniques including administrative and engineering controls. Conclusion: Covid-19 pandemic is a unique and once in a generation crisis for the practice of dentistry globally. Most dental professionals are limiting themselves to emergency treatments as per local guidelines. There is an urgent need to ensure state of the art and scientifically authentic guidelines are presented to the dental community to alleviate their anxiety so that they can begin to practice dentistry without the uncertainty and fear that Covid-19 has brought upon the dental fraternity. Keywords: COVID-19; dental practice; CDC guidelines; viruses.
Primary oral tuberculosis in an immunocompetent patient
Authors:   Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, Mahdia 5100, Tunisia., Chelli Jihene , Mabrouk Asma Ben ,   Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, Mahdia 5100, Tunisia., Mrabet Houcem Elomma ,   Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, Mahdia 5100, Tunisia., Masmoudi Mohamed ,   Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia 5100, Tunisia., Hasnaoui Mehdi ,   Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia 5100, Tunisia., Ammari Fatma Larbi ,   Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, Mahdia 5100, Tunisia.
Published: November 2021

Primary tuberculosis of the tongue is very rare. The chronic ulceration is commonly misdiagnosed as a cancerous lesion. We report the case of a 44 years old immunocompetent woman who presented with a lingual chronic painful ulceration. The biopsy of the lesion showed a granulomatous inflammation, with caseous necrosis in the center. The ulceration healed after a 6 month tuberculosis treatment. Keywords: Tuberculosis; oral; immunocompetence; ulcer.
Cowden syndrome and Lhermitte - Duclos disease: A case report and review of the literature
Authors:   Division of Neurosurgery, Ng Teng Fong General Hospital, Singapore., Goh Chun Peng , Wu Bingcheng ,   Department of Pathology, National University Hospital, Singapore., Feng Ting Ting ,   Division of Neurosurgery, Ng Teng Fong General Hospital, Singapore., Chou Ning ,   Division of Neurosurgery, National University Hospital, Singapore.
Published: November 2021

Cowden syndrome (CS) is a rare, autosomal dominant, multisystem disease related to the mutation of Phosphatase and tensin homolog (PTEN) tumour suppressor gene. It is characterized by the occurrence of multiple hamartomas, mucocutaneous lesions, and is associated with a high risk of malignancies. Lhermitte–Duclos Disease (LDD), or dysplastic cerebellar gangliocytoma, is a rare hamartomatous lesion of the cerebellar cortex with a unique “Tiger Stripe” appearance on Magnetic Resonance Imaging (MRI). Since 1991, LDD has been considered pathognomonic and part of CS. In addition, as almost all adult onset LDD cases were associated with PTEN gene mutations, LDD and CS are both included in PTEN Harmartoma Tumour Syndrome (PHTS). In this article, we report a 48-year-old female patient, who presented with a right cerebellar lesion resulting in hydrocephalus. The histology of the cerebellar lesion confirmed the diagnosis of LDD, and her clinical history is highly suggestive of CS. Due to the high incidence of multisystemic malignancies and other disease, it is important for clinicians to be aware of the association between LDD and CS. Affected patients should be evaluated carefully and screened for cancers accordingly, so as to allow early diagnosis and treatment.
An overview of breastfeeding and how to support breastfeeding
Authors:   Department of Pathology, Baylor Scott & White Medical Center, Temple, TX 76508, USA, Kalyanasundaram Sridhar , Dhemre Priyanka ,   Department Obstetrics & Gynecology, Burjeel Medical City, Abu Dhabi, UAE, Dhemre Ashish ,   Department of Neonatology, Danat Al Emarat Hospital for Women & Children, Abu Dhabi, UAE, Narayanan Vidya Kanamkote ,   Consultant Paediatrician, Mediclinic Parkview Hospital, Dubai, UAE
Published: November 2021

There is absolutely no doubt that breastfeeding is the best nutrition for the baby. In this article, we discuss why breastfeeding is important. With appropriate preparation and support, the majority of mothers can successfully breastfeed their babies. We discuss some important facts about breastmilk composition as well as some practical aspects that would need attention to ensure the mother is supported adequately to ensure a successful breastfeeding experience. Keywords: Breastfeeding; breastfeeding support; lactogenesis; problems during breastfeeding.
Deep vein thrombosis and our treatment applications: 12-year results
Authors:   Atatürk University, Medical Faculty, Department of Cardiovascular Surgery, Erzurum-Turkey., F Borulu , B Erkut ,   Atatürk University, Medical Faculty, Department of Cardiovascular Surgery, Erzurum-Turkey.
Published: November 2021

Introduction: Deep vein thrombosis is an important health problem that is frequently encountered in the general population and especially in surgical clinics and has a negative impact on quality of life. In this study, treatment options and results of patients with deep vein thrombosis who have been hospitalized for 12 years in Atatürk University and Erzurum Regional Hospital were examined and discussed. Methods: In our clinic, 412 cases of deep vein thrombosis (211 female, 201 male) were hospitalized between 2009 and 2021. The mean age of the patients was 49 ± 19 years. While medical treatment with heparin was given to all 412 patients; thrombolytic therapy, surgical embolectomy (vascular and pulmoner), and pharmaco-mechanical thrombectomy were applied to some of these patients. Results: Deep vein thrombosis was more common in the lower extremity (n=322, 78.2%). All patients had at least one of the complaints of pain, swelling and redness. All cases were diagnosed by color Doppler ultrasonography. Medically, standard and low molecular weight heparin therapy was given to all patients after hospitalization. Thrombolytic therapy was applied to 66 (16,1%) of the cases, pulmonary embolectomy to 8 (1,9%), surgical thrombectomy to 10 (2,4%) and pharmacomechanical thrombectomy to 44 (10,7%) patients. In addition to these 120 patients (29.1%), a vena cava filter was placed for prophylactic purposes. Conclusions: In patients diagnosed with deep vein thrombosis and hospitalized, the diagnosis should be supported by Doppler ultrasound in addition to clinical diagnosis after an etiology investigation. Early diagnosis, rapid and effective treatment methods are important for the subsequent quality of life of patients. In addition to low molecular weight heparins being the first choice agents, standard heparin administration still needs to be applied in some clinical pictures. In addition, we believe that pharmacomechanical thrombectomy can be applied in appropriate acute cases. Keywords: Deep vein thrombosis; anticoagulant treatment; heparin therapy; low-molecular-weight heparin; mechanical thrombectomy.