bluuebunny/crossref_metadata_2025 huggingface dataset:
Two-balloon epistaxis catheter to ensure vaginal patency in a complex case of vaginoplasty for vaginal agenesis: a case report
Authors: Costantini Chiara , Fati Federica , Pani Elisa , Beretta Fabio , Bisoffi Silvia , Mazzero Giosuè , Negri Elisa , Revetria Clara , Sadri Hamid R. , Ciardini Enrico
Published: November 2023

Congenital vaginal atresia is a rare anomaly of the female genital tract. Many vaginoplasty procedures have been described, but the postoperative risk of vaginal stenosis remains a challenge. We report a case of isolated distal vaginal agenesis in a patient with neurological impairment where the use of an “alternative” dilator was needed. An 11-year-old girl with Down syndrome was admitted to the Emergency Department complaining of pelvic pain. The clinical evaluation showed a hard and painful pelvic mass associated with an imperforate hymen. Abdominal ultrasound and pelvic MRI were suggestive for hematometrocolpos and absence of the lower third segment of the vagina. Vaginoscopy confirmed the diagnosis of congenital vaginal agenesis. The patient then underwent a laparoscopic-assisted vaginoplasty. Considering the difficult management of the postoperative period, an epistaxis catheter was used as a vaginal stent and dilator. The use of an epistaxis catheter to provide adequate vaginal patency after vaginoplasty can be an alternative solution especially in those cases where calibrations with dilators are difficult or not tolerated.
Nephrologists' Perspectives of the Potential Utilization of Home Hemodialysis in Saudi Arabia
Authors: Al Sahlawi Muthana A. , Dahlan Randah A.
Published: November 2023

Home hemodialysis (HD) is an attractive renal replacement modality that has been shown to provide several benefits to the patient and health-care system. However, home HD programs have not been well-established in Saudi Arabia. We aimed to explore the perspectives of adult nephrology consultants in Saudi Arabia about the potential utilization of home HD via a survey-based cross-sectional study. The survey was distributed via email to all adult nephrology consultants practicing in Saudi Arabia and registered in the Saudi Society of Nephrology and Transplantation. Out of 236 invited consultants, 151 (64%) participated in the study. Half of the participants defined home HD as a trained patient who can independently perform his/her HD sessions at home. Eighty-one (54%) consultants have never managed a patient on home HD during their nephrology training period. More than 70% of participants believed that home HD provides advantages over in-center HD, and that its utilization in Saudi Arabia would be feasible. Although 40% of participants worked in centers with no accredited nephrology training program, most of the remaining participants believed that the local training program did not provide enough teaching about home HD to trainees. Patients' refusal, the nephrologists' lack of motivation and experience, a lack of administrative support, and the lack of infrastructure and nursing support were identified by most participants as the major barriers to the utilization of home HD in Saudi Arabia. Addressing these barriers would be the first step to facilitate initiatives aiming to establish home HD programs in this country.
Clinical Response to Intestine-targeted Steroid Therapy in Biopsy-proven Immunoglobulin A Nephropathy
Authors: Lingaraj Umesh , Mallapur Sashikanth , Viswanathan Akila , Vankalakunti Mahesha
Published: November 2023

Primary immunoglobulin A (IgA) nephropathy is associated with a dysfunctional mucosal immune system, leading to renal deposition of IgA and injury. Fifty patients with biopsy-proven IgA nephropathy were included. All patients were initiated on renin-angiotensin-aldosterone system (RAAS) inhibitors, polyunsaturated fatty acids, and a controlled release formulation (CRF) of budesonide. All drugs were started together, as isolated RAAS inhibitors will not prevent the immunological damage caused by the ongoing deposition of IgA. Depending on the histology (mesangial hypercellularity, endocapillary proliferation, segmental glomerulosclerosis, tubular atrophy/interstitial fibrosis, and crescents score), the patients received 9 mg or 12 mg of budesonide. All patients were followed up every 4 weeks to monitor renal function, 24-h urinary protein, and adverse effects. Our primary outcome was a mean change in the estimated glomerular filtration rate (eGFR) and 24-h urinary protein from the baseline to the end of 6 months. The percentage of decline in mean 24-h protein at 6 months from the baseline was 33%. The mean decrease in serum creatinine from the baseline was 0.73 mg/dL. The mean gain in eGFR from the baseline was an increase of 9 mL/min/1.73 m2. Of 50 patients, 11 (22%) achieved complete remission, 20 (40%) achieved partial remission, and 16 (32%) were non-responders. Three patients (6%) were lost to follow-up. The early initiation of CRF budesonide with optimized supportive care led to reductions in proteinuria and improvements in eGFR at 6 months in patients with IgA nephropathy. Early lesions with minimal chronicity showed an excellent response to budesonide.
Recurrent Urinary Tract Infections in Renal Transplant Recipients: Risk Factors and Outcomes in Low-resource Settings
Authors: Jamil Sana , Zafar Mirza Naqi , Siddiqui Sulleha , Ayub Salma , Rizvi Adeeb-ul-Hassan
Published: November 2023

Recurrent urinary tract infections (UTIs) after kidney transplantation are a common problem adversely affecting graft outcomes. This retrospective study aimed to report the frequency and risk factors of recurrent UTI and their impact on graft and patient outcomes in kidney transplant recipients at the Sindh Institute of Urology and Transplantation, Karachi, Pakistan, in January-December 2015. Five-year graft and patient survival rates were compared among different groups using Kaplan-Meier analysis. Of the 251 recipients, 67 developed one episode of UTI. Of these 67, 29 had 76 episodes of recurrent UTI. Out of the 76 episodes of recurrent UTI, Escherichia coli was the most common pathogen in 32 cases. Organisms causing recurrent UTI showed resistance to carbapenem in 19 cases versus 2 in the non-recurrent UTI group (P = 0.006). The estimated glomerular filtration rate at 1 year was 57.8 ± 16.23 mL/min/1.73 m2 in the recurrent UTI group vs. 61.9 ± 15.7 mL/min/1.73 m2 in the non-recurrent UTI group (P = 0.001). Graft survival in the recurrent UTI group at 5 years was significantly lower (76%) than in the non-recurrent UTI (95%) and no UTI groups (93%) (log-rank P = 0.006), with no significant effect on patient survival in these groups (P = 0.429). The presence of double-J stent (P = 0.036) and cytomegalovirus infections (P = 0.013) independently predicted recurrent UTI. Recurrent UTIs are common in low-resource settings and adversely affect graft outcomes. Appropriate prophylaxis and treatment are important to reduce recurrent UTI to improve graft outcomes.
Chronic Kidney Disease and Its Clinical Correlates in a Rural Community in Southwestern Nigeria
Authors: Oni Opeyemi O. , Akinwusi Patience O. , Owolabi James I. , Odeyemi Abiona O. , Israel Gbenga M. , Ala Oluwabukola , Akande Joel O. , Durodola Adewumi , Israel Oluwaseyi K. , Ajibola Idowu , Aremu Ayodele O.
Published: November 2023

Chronic kidney disease (CKD) is a burgeoning problem globally, and more than a billion adults were affected as of 2016, with 1.2 million people dying from renal failure in 2017. To arrest the seemingly relentless progression of CKD to renal failure, there is a need to detect CKD early in the community. A community-based study was carried out to look at the prevalence and risk factors of CKD. Anthropometric and other clinical variables were measured. Blood samples were taken for determining creatinine, uric acid, urea, and lipids. CKD was defined as an estimated glomerular filtration rate of ≤60 mL/min/1.73 m2. Electrocardiograms and renal ultrasound scans were performed. In total, 201 people were recruited. Those with CKD had a male:female ratio of 1:3.9 and were older. The prevalence of autosomal-dominant polycystic kidney disease and CKD was 531.9 persons/100,000 population and 46.3%, respectively. Systolic blood pressure, pulse pressure, total cholesterol, triglycerides, high-density lipoprotein (HDL), uric acid, QTc interval, and electrocardiographic left ventricular hypertrophy were higher in those with CKD. Age, female sex, and HDL were independently associated with CKD. There was a steep rise in CKD at the community level. Increased awareness of CKD and prompt interventions are therefore imperative.
Detailed Nephro-urological Management of a Case of Medullary Sponge Kidney with Distal Renal Tubular Acidosis and Obstructive Uropathy
Authors: El-Reshaid Kamel , Al-Terki Abdullatif , Al-Bader Shaikha
Published: November 2023

Medullary sponge kidney (MSK) is a rare renal malformation characterized by precalyceal tubular ectasia of the renal collecting ducts that clinically manifests as recurrent renal stones, distal renal tubular acidosis (dRTA), osteoporosis, and nephrocalcinosis. In this case report, we present the case of a woman with a severe form of MSK associated with dRTA. She had extensive nephrocalcinosis and obstructive uropathy caused by a large upper ureteric stone in the left kidney. The stone was disintegrated by flexible ureteroscopic laser lithotripsy. Her initial biochemical derangements were identified and corrected with a Polycitra-K solution and hydrochlorothiazide, leading to reduced stone load and osteopenia 1 year later.
Intensity and Density of Stressful Life Events in First Suicide Attempters with Psychiatric Morbidity and Comorbidity: A Case–Control Study
Authors: Kulkarni Ranganath R. , Rao K. Nagaraja , Begum Shamshad
Published: November 2023

Background:

Stressful life events (LEs) have been pivotal to suicidal behavior in vulnerable individuals, although its quantum and clustering have remained unclear. This study aimed to estimate and compare the quantum and clustering of LEs across three time periods, three suicide intentionality–lethality categories, and three diagnostic groups in survivors of first suicide attempt (SoFSA).

Materials and Methods:

One hundred SoFSA were compared to 100 age- and sex-matched controls for LEs across psychiatric and/or personality comorbidity. Presumptive Stressful LE Scale, Risk-Rescue Rating Scale, Hamilton Depression- and Anxiety-Rating Scales, and structured and semi-structured clinical interviews were administered for comprehensive mental health evaluation.

Results:

SoFSA with age ≥30 years, male gender, schooling <10 years, middle-lower socioeconomic class, married, extended/joint family living, family history of psychiatric disorders/suicide, and concomitant depression–anxiety exhibit significantly higher undesirable, ambiguous, and total LEs across time periods. One-way analysis of variance with post hoc analysis revealed SoFSA who attempted medically serious suicide suffered higher undesirable (F[2,97] = 4.43; P = 0.014) and total (F[2,97] = 3.39; P = 0.038) LEs during recent 6 months compared to medically nonlethal group. SoFSA diagnosed with comorbid psychiatric and personality disorders experienced higher undesirable, ambiguous, and total LEs across all time periods (P < 0.0001), compared to either disorder alone. Desirable LE did not significantly differ across all time periods and diagnostic categories, but ambiguous LE was the only significant finding among SoFSA with personality disorders.

Conclusion:

This study sheds newer insights that quantitative estimation (intensity and density) of LEs has a potential role in suicide-risk evaluation, with clustering of total or undesirable LE (>3 within 1 year or >10 lifetimes) and ambiguous LE (≥1 within 1 year or > 3 lifetimes) posing risk for psychiatric morbidity and medically serious suicidal behavior (especially, if lifetime total LE > 10). SoFSA with comorbid psychiatric and personality disorders experience higher intensity and density of LEs than either disorder alone, across all time periods.
Organic Brain Disorders Manifesting as Psychiatric Symptoms
Authors: Patel Beejal M. , Ghosh Sanjukta S , Vora Vaishal N. , Lakdawala Bhaveshkumar M.
Published: November 2023

Organic brain disorders (OBD) may present with multiple psychiatric symptoms which may mimic as primary psychiatric disorder. We present three cases such as astrocytoma, cerebellar cyst, and hypothalamic hamartoma presented to our psychiatric outpatient department with psychotic, manic, and headache symptoms with no physical neurological signs and symptoms. Treatment resistance and relapse motivated us for seeking neuroimaging that subsequently revealed space occupying lesions. Some patients with neurologically silent OBD may present with psychiatric symptoms only. Therefore, we should consider of neuroimaging in patients with a change in mental status regardless of a lack of neurological symptoms.
Online Support Group: Ways to Care for the Caregivers during the Pandemic
Authors: Maritska Ziske , Nudhar Latifah , Prananjaya Bintang Arroyantri , Liansari Raden Ayu Mulya , Parisa Nita , Suryani Puji Rizki , Hartanti Miranti Dwi , Fathia Rizka , Triyoga Muhammad Adam , Ramadhan Mohammad Hilal Atthariq , Anggraini Friska , Salim Jesica Putri , Putri Safa Nabila
Published: November 2023

The current world situation has put many at risk of having mental health issues, with the caregivers of mental disorders patients no exception. The pandemic has limited their access to the support they need in providing care for people with mental illnesses. Thus, a group of lecturers and students from the faculty of medicine at Universitas Sriwijaya assist families/caregivers of people with mental disorders during the pandemic through an online platform. The team screened for potential families/caregivers of mental disorder patients who went to Ernaldi Bahar Mental Hospital in Palembang, Indonesia. Twenty-four families of mental disorder patients consented to join the WhatsApp group with the doctors, who took a turn sharing varied topics weekly for 4 months (June–September 2021) through the WhatsApp messaging platform. Families found it helpful to join the group because they could interact and ask questions directly to doctors who are experts in their field, signifying that this activity is beneficial for families of people with mental disorders to increase resilience during the pandemic.
Anxiety and Depression in Parents of Children and Adolescents with Intellectual Disability
Authors: Sharma Rachit , Singh Harpreet , Chatterjee Kaushik , Bhat Pookala Shivaram , Srivastava Kalpana , Saini Rajiv Kumar
Published: November 2023

Background:

Parents of the children and adolescents with intellectual disability (ID) are prone to psychological distress than as compared to parents of normally developing children and adolescents. Various biopsychosocial factors affect the perception and manifestation of this stress and influences difference in quality and severity in psychological outcomes. When a couple faces stress of caregiving as a unit, it is worthwhile to know and assess distribution pattern amongst the primary care giver and the other parent.

Aim:

The aim of the study is to evaluate the proportional distribution of depression and anxiety in primary care giver and the other parent in parents of children and adolescents with ID.

Materials and Methods:

Using a Cross-sectional observational study design, 99 parents (99 fathers and 98 mothers) of 99 children and adolescents (up to 18 yrs of age) with Intellectual Disability were assessed for Depressive and Anxiety symptoms using Hospital Anxiety and Depression Scale (HADS). Comparison of proportional distribution of psychiatric morbidity among fathers and mothers (primary care giver) was done using 2 independent sample proportion tests.

Results:

The mothers were found to be the primary care givers. 35.4% of fathers and 66.3% of mothers had significant depressive symptoms. 57.6% of fathers and 91.8% of mothers had significant anxiety symptoms. In 33 couples, fathers did not report anxiety or depressive symptoms but corresponding 27 mothers reported significant anxiety or depressive symptoms or both. In rest of the couples in whom fathers reported anxiety and/or depressive symptoms, the corresponding mothers also reported. In six couples where mothers did not report anxiety or depression, the fathers also did not report any anxiety or depressive symptoms.

Conclusion:

Depressive and Anxiety symptoms are very prevalent in parents of children with ID. Their proportion is significantly high in primary care giver (mother) as comparedto corresponding other parent (father). There is unequal distribution of anxiety and depression in these parents with a skew towards mother.
Endodontic Microsurgery for a Mandibular First Molar With a Large Lateral Canal in Mesial Root: A Case Report
Authors: Sun Jinghua , Zhang Chen , Hou Benxiang
Published: November 2023

Introduction: The lateral canal that occurs in the mesial root of the mandibular first molar is relatively rare. Herein we reported a rare case about a large lateral canal located in the middle of the mesial root of mandibular molar. Case report: A 38-year-old woman presented with symptomatic apical periodontitis and J-shaped bone defect similar to vertical root fracture on the mesial root of tooth #30. Endodontic microsurgery was chosen to make a clear diagnosis and treatment. The procedure was carried out with apicoectomy, root-end and lateral canal preparation, and retrograde filling. At the 1-year follow-up, clinical examination and the radiograph showed complete healing. Discussion: The untreated mesiobuccal root canal with large lateral canal was found to be the cause of the J-shaped bone defect.
Analysis of Salivary Levels of IL-8 and IL-34 in Periodontitis Patients: An Analytical Cross-Sectional Study
Authors: Abood Farah R. , Aldhaher Zainab A.
Published: November 2023

Introduction: The aim of this study was to determine the salivary levels of interleukin-8 (IL-8) and interleukin-34 (IL-34) among patients with periodontitis and healthy individuals. Methods: Thirty participants with periodontitis and 30 healthy individuals were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine salivary levels of IL-8 and IL-34, blindly. Statistical analysis was carried out by unequal variances t-test (Welch’s t-test) and the Pearson correlation coefficient using R software. Result: Statistically significant differences were found between participants with periodontitis and healthy subjects regarding salivary levels of IL-8 (P = 0.012) and IL-34 (P < 0.001). There was a non-significant (P > 0.05) correlation between salivary levels of IL-8 and IL-34 and periodontal parameters, including plaque index, bleeding on probing, probing pocket depth, and clinical attachment loss. Conclusion: Within the limitations of this study, the salivary levels of IL-8 and IL-34 were higher among participants with periodontitis in comparison with healthy subjects. In the periodontitis group, salivary levels of IL-8 and IL-34 were not correlated with clinical indicators of periodontitis.
The Applicability of Interprofessional Education for Collaborative People-centered Practice and Care to Health Plans and Workforce Issues: A Thematic Global Case Review
Authors: Gilbert John H. V. , Girard Marie-Andree , Grymonpre Ruby E. , Mahler Cornelia , Maxwell Barbara
Published: November 2023

Background:

This article focuses on a growing, global recognition of the importance of the field of interprofessional education for person-centered collaborative practice (IPECP) expressed through high-level policy and accreditation decisions/actions taking place in 5 countries. Policy decisions are used to motivate strategies related to IPECP that align with national health plans, and workforce issues.

Methods:

Using a collective of representative stories from around the globe, a grouping of case studies were developed to illustrate different approaches and challenges to IPECP implementation.

Results:

Institutions from countries of various income levels face many similar challenges in the execution, delivery, and sustainability of IPECP. All programs face issues of financing, of preparing faculty, of developing and organizing curricula, and of bridging between campus and community.

Discussion:

Policies are being developed that promote a global approach to the inclusion of IPECP in the accreditation and regulation of postsecondary institutions and health service organizations, in keeping with WHO National Health Workforce Accounts. Policies developed promote and demonstrate the benefits of IPECP through remote emergency learning methods. The policies also build national systems for IPECP as an integral part of continuing professional development and lifelong learning. The organization of interprofessional research programs and the increasing publication of their results of such programs will lead to a clearer understanding of the efficacy of the field of IPECP. To ensure sustainability, stakeholders and policymakers should continue to foster policies that facilitate IPECP.
Mystery in the Air: A Case Report of Emphysematous Pyelonephritis Presenting as Subcutaneous Emphysema and Septic Pulmonary Embolism
Authors: Hande Madhav , Khan Mohammed Fahad , Shivashankar K
Published: November 2023

ABSTRACT

We report a patient with uncontrolled type 2 diabetes mellitus who was found to have subcutaneous emphysema on examination. Left-sided emphysematous pyelonephritis (EPN) due to Escherichia coli was identified as the cause of this finding. Further evaluation revealed that she had septic emboli in the lungs, which was also likely to be due to EPN. This case report highlights the possibility that EPN may present as a subcutaneous emphysema. This also reports the occurrence of septic embolism in EPN.
Antimicrobial Activity of Simarouba glauca Leaf Extracts Against Oral Pathogens − An In Vitro Study
Authors: Rudraswamy Sushma , Hombarvali Jai Shankar Puttabuddi , Kenganora Mruthunjaya , Doggalli Nagabhushana , Godhi Brinda Suhas , Srinivas Sowmya
Published: November 2023

Introduction: Oral diseases caused by biofilm continue to be a public health concern worldwide. The interesting task is to “battle” against oral biofilms, chiefly due to their propensity to persist even after mechanical removal. Mechanical oral hygiene measures, along with professional maintenance and usage of fluorides, are conservative practices to prevent oral biofilm. Adjunct to mechanical plaque control method, antimicrobial mouth wash is suggested. Although chlorhexidine is a gold standard antiplaque agent, its potential drawbacks on long-term use necessitates the development of a novel, alternate strategy that can inhibit oral biofilm. Materials and Methods:
Simarouba glauca (SG) leaf extracts were prepared by maceration and Soxhlet methods. Zone of inhibition (ZOI) and Minimum inhibitory concentration (MIC) were conducted against Streptococcus mutans, Lactobacilli acidophilus, Staphylococcus aureus, Escherichia coli, and Prophyromonas gingivalis to determine the antimicrobial activity of leaf extracts of SG using agar well diffusion and broth dilution method. Results: ZOI was exhibited by ethanol extract (ESG) on S. mutans (25 ± 0.03 mm) and L. acidophilus (23 ± 0.07 mm) at 1 mg/mL while ZOI was exhibited by aqueous extract (ASG) on E. coli (14 ± 0.00 mm) and S. aureus (15 ± 0.01 mm) at 1.5 mg/mL. Both ESG and ASG did not show activity on P. gingivalis. MIC was obtained at 0.625 mg/mL for S. mutans, 0.312 mg/mL for L. acidophilus, 1.25 mg/mL for S. aureus, 0.625 mg/mL for E. coli, and P. gingivalis did not show inhibitory effect. Conclusion: The in vitro studies on antimicrobial activity showed antimicrobial activity of SG plant extract on oral microorganisms. This could be because of secondary metabolites like flavonoids, phenolics, etc.
Extracellular microRNA-223-5p Levels in Plasma, Saliva, and Gingival Crevicular Fluid in Periodontal Disease as a Potential Diagnostic Marker − A Case–Control Analysis
Authors: Bandi Dhathri Priya , Sudhakar Uma , Parthasarathy Harinath , Rajamani Snophia Rani , Krishnaswamy Balasubramanian
Published: November 2023

Introduction: Periodontal disease is distinguished by an aberrant host response to oral pathogens, leading to soft and hard tooth-supporting tissue inflammation. MicroRNAs are minute, single-stranded, highly dynamic biomolecules that control gene expression and regulate protein synthesis and functioning. Periodontal pathogenesis is associated with microRNA dysregulation. Accordingly, the proposed study will evaluate the extracellular circulating microRNA-223-5p in the plasma, saliva, and gingival crevicular fluid (GCF) of patients with periodontal disease. Materials and Methods: The research population comprised of 50 healthy individuals and 50 periodontitis patients. The clinical parameters of each participant were documented. Under sterile conditions, blood, saliva, and GCF were collected and stored at −80 °C. MicroRNA was isolated using microRNA extraction kits in accordance with the manufacturer’s instructions, and the expression pattern of mir-223-5p in body fluids was analyzed using real-time polymerase chain reaction. Results: Expression of circulating extracellular microRNA-223-5p is elevated (P = 0.05) in plasma, saliva, and GCF by a fold of 2.511, 8.072, and 10.46, respectively. The clinical parameters, clinical attachment loss, and probing pocket depth correlated significantly and positively with an increase in miR-223-5p expression (P = 0.05). According to a ROC analysis, MicroRNA-223-5p may be a viable biomarker for periodontal disease, with a diagnostic accuracy of 84.50%. Conclusion: In conclusion, extracellular microRNA-223-5p detected in plasma, saliva, and GCF can be a reliable biomarker for periodontal disease. GCF is a potential body fluid for the analysis of microRNA-223 in relation to periodontal disease considering its expression is significantly higher in comparison to that of plasma and saliva. Due to their exceptional stability in body fluids, extracellular microRNAs can be employed as periodontal disease detectors, forecasting variables of treatment, and for the tailored modalities of treatment.
Gray Value Evaluation of Mandibular Bone in the Adult and Elderly: Pilot Study for Osteoporosis Screening
Authors: Saraswati Inka , Lorenza Cindy , Kiswanjaya Bramma , Syahraini Syurri I.
Published: November 2023

Introduction: Postmenopausal women are more at risk of osteoporosis than men of the same age. Osteoporosis is often undetected due to lack of symptoms. The aim of the study was to explore the potential of gray value (GV) in clinical panoramic radiographs as a screening method for osteoporosis. Cross-sectional comparative study using secondary data. GV of mandible in panoramic radiographs between male and female of several age groups were compared. X-ray parameters were considered. Materials and Methods: A total of 294 panoramic radiographs were obtained from regular clinical activity regardless of mA (3.3–8 mA), and divided into sexes and ages 31 to 45, 46 to 60, and 61 to 75 years old. A subset of 60 panoramic radiographs obtained by a narrow range of mA (5.7–6.4 mA) were randomly selected and then divided into sexes and ages 32 to 53 and 54 to 75 years old. Average GV was recorded. Average GV between age groups (divided by sexes) was evaluated by one-way analysis of variance (ANOVA) for groups with unrestricted mA, and unpaired t-test for restricted mA. Results: Average GV without mA restriction were not significantly different between age groups in men (P = 0.883) and women (P = 0.617). If mA is restricted, average GV was significantly different between age groups in women (P = 0.007) but were not significantly different between age groups in men (P = 0.386). Conclusion: GV obtained from panoramic radiographs may have potential in detecting osteoporosis if x-ray parameters are kept in narrow range. It would not have the same screening potential if the range of x-ray parameters are too wide.
Status of the Indian biopharmaceutical industry and way forward to be a dominant global player
Authors: Ghosh Prasanta Kumar
Published: November 2023

The government promotes biotechnology in India, with the Department of Biotechnology (DBT) taking the leadership role, whereas some other departments also join in the endeavor. Modern biotechnology is no more new to India. Several therapeutic and diagnostic products are manufactured in the country from the primary stage. The emphasis is on the manufacture of patent-expired products more cost-effectively. The Indian biopharmaceutical market was approximately INR 32261 crores (US$ 4.032 billion) during 2021–2022 and approximately 1.14% of the global market. The manufacture of biopharmaceuticals needs sophisticated equipment and specialized skills. India has acquired skills in recombinant deoxyribonucleic acid (rDNA) technologies, developed capacities in genetically modifying Escherichia coli, Saccharomyces cerevisiae, Pichia pastoris, Hansenula polymorpha, and Chinese hamster ovary (CHO) cells lines, and has expertise in the multiplication of viruses in different animal and human cell lines. India produces many therapeutic and diagnostic recombinant proteins, including several therapeutic monoclonal antibodies. The more advanced areas of biopharmaceutical technology, such as mRNA-based cell therapies, including in-vitro modified somatic cell-based treatment and chimeric antigen receptor (CAR) T-cell therapy, are evolving. Genome editing technologies involving the manipulation of germ line cells are in the research and development (R&D) stage. Xenotransplantation technologies and the development of humanized transgenic animals are yet to start. Appropriate artificial intelligence programs may be included in the Indian biopharmaceutical industry to speed up the development of novel biopharmaceuticals. There are shortages of leaders adequately trained in biopharmaceutical skills in manufacturing, and the industry has constraints of abundant infrastructure and finance for deployment in R&D. India is committed to fulfilling a social objective by providing many essential medicines, including biopharmaceuticals at affordable prices through the Pradhan Mantri Bhartiya Janaushadhi Pariyojana.
Short-term functional outcome of distal femur fracture treated with locking compression plate
Authors: Timbadiya Viral H , Parmar Haresh P , Machhi Rajnikant I , Aepa Shailesh A
Published: November 2023

Background:

Common modes of trauma for distal femur fractures are falls, sports injuries, and road traffic accidents, especially in older patients. Locking plates are a commonly used surgical intervention for these fractures, as they provide stability and promote fracture healing, allowing patients to regain function and early mobility. Compared with traditional compression plates, locking plates provide better construct and more excellent stability than screws locked and provide fixed angled construct.

Aims and Objectives:

To analyze the short-term outcome of distal femur fractures regarding pain relief, range of motion (ROM) at the knee joint, and radiological outcome after treatment with a locking compression plate.

Materials and Methods:

This prospective study involves 20 cases of fractures of the distal femur aged 18–80 years. All patients underwent open reduction and internal fixation using a locking plate. Functional and radiological outcomes were assessed using nominal effective exchange rate’s (NEER) scoring system as patients were followed up for 6 months. NEER’s scoring system evaluation includes pain, motion, walking capacity, work capacity, anatomy, and radiological assessment.

Results:

Radiological union was seen at the mean time of 18 weeks. On the final follow-up at 6 months, we noted ROM of more than 110° in 5 patients, 90°–100° in 11 patients, and 60°–90° in 4 patients. According to the NEER’s scoring system, patients with excellent results were 11 and satisfactory results were 6, whereas two patients went in failure in our study.

Conclusion:

Locking plate is an excellent option for treating the distal femoral fractures of both the articular and extra-articular types. Locking plates show an excellent outcome regarding fracture healing and patient satisfaction. However, potential complications such as infection, implant failure, malunion, and nonunion should be carefully considered and monitored.
Impact of trace elements and risk factor for glaucoma pathogenesis
Authors: Choudhari Jyoti K , Chaterjee Tanushree
Published: November 2023

Glaucoma is a multifunctional disease with several trace elements associated with its pathophysiology. This review aimed to provide readers with a sound and scientific understanding of the risk factors related to the pathogenicity of the disease. This review covers the aspects of investigating trace element risk factors associated with glaucomatous pathogenesis from a fundamental biomechanical point of view. A study of a significant amount of literature suggests that several trace element elements are associated with intraocular pressure (IOP), trabecular meshwork, and optical nerve oxidative stress changes in complex eye diseases. Traces such as selenium, chromium, manganese, magnesium, iron, cobalt, copper, and zinc elements are significantly associated with primary open-angle glaucoma (POAG). Other risk factors, such as trace elements, modulate opposing aqueous humor production and outflow dynamics, extracellular matrix structure and function, and neurotransmitter release. The current evidence and human expertise help us understand that our diet contains numerous factors that may influence optically dynamic parameters, such as IOP and drug outcome effectiveness.
Morphology of the occipital condyle and its surgical implications: Computed tomographic study
Authors: Ominde Beryl S , Ikubor Joyce E , Iju Wilson Josiah , Igbigbi Patrick S
Published: November 2023

Background:

Considering the morphology of the bilateral occipital condyles is fundamental during surgical procedures of the craniovertebral junction region due to their proximity to critical neurovascular structures. This study elucidates the variant shapes of the occipital condyle in a Nigerian Tertiary Hospital.

Materials and Methods:

The configuration of 672 occipital condyles was retrospectively evaluated on cranial computed tomographic images of Nigerian adults (137 females and 199 males). After the study protocol was approved, these were accessed in the imaging database of the Radiology Department in a referral center. Data analysis was implemented by Statistical Package for Social Sciences version 23.0 and summarized in percentages. Gender, age group, and side comparisons were assessed using the chi-square test with significance at P < 0.05.

Results:

The oval shape (434, 64.6%) was the most common, followed by the kidney shape (166, 24.7%), while the round shape was rare (4, 0.6%). The shapes showed significant gender differences (P = 0.038) but were not associated with side or age (P > 0.05).

Conclusion:

The study highlights the different occipital condyle conformations in the population studied, emphasizing the need for radiological evaluation before surgical procedures of the posterior cranial fossa and the upper vertebral column.
Carbapenemase detection methods for carbapenem-resistant Enterobacterales: Which to choose?
Authors: Dobhal Shipra , Sen Manodeep , Agarwal Jyotsna , Das Anupam , Chandra Abhilash , Srivastava Alok , Nath Soumya S
Published: November 2023

Background:

Carbapenems are among the last resorts in managing multidrug-resistant bacterial infections. The rise in resistance to carbapenems is a significant concern, and the production of carbapenemases that inactivate the drug is the most typical mode of resistance developed by the bacteria. Carbapenemase-producing bacteria are associated with higher morbidity and spread faster than noncarbapenemase-producing bacteria. Detection of carbapenemases is essential for epidemiological surveillance and in choosing the most efficient antimicrobial in managing the patient.

Materials and Methods:

We processed urine samples received in our laboratory over 6 months. Samples with carbapenem-resistant Enterobacterales were further processed for carbapenemase detection using the modified carbapenem inactivation method (mCIM), combined disc diffusion test (CDDT), Epsilometer test (E test), and modified Hodge test (MHT). The results were analyzed.

Results:

A total of 32.3% of Enterobacterales uropathogens showed resistance to imipenem/meropenem. The commonest isolate was Escherichia coli, followed by Klebsiella pneumoniae. Maximum positivity was detected by mCIM (89.2%) followed by CDDT (86.5%), E test (77.1%), and MHT (54%).

Conclusion:

In this study, we compared four phenotypic methods of carbapenemase detection and compared their diagnostic accuracy. These included CDDT, E test, MHT, and mCIM. Maximum positivity was detected by mCIM followed by CDDT and E test.
Impact of curriculum implementation support program workshop on faculty of a Medical College in Panipat district, Haryana, India
Authors: Singh Gurjeet , Singh Raksha
Published: November 2023

Background:

Medical education has changed significantly in the last decades. There is a need for a medical education workshop, that is, Curriculum Implementation Support Program (CISP) at every medical college for every faculty to sensitize medical teachers toward the new curriculum. India’s Medical Council (MCI) introduced competency-based medical education (CBME) in 2019. Further, it has been made mandatory the CISP training of the medical faculty. The CISP workshop provides academic support to faculty members for a smooth transition from the existing curriculum to the CBME curriculum. The study aimed to evaluate the impact of the CISP workshop on the participating faculty.

Materials and Methods:

Twenty-nine medical teachers from preclinical, paraclinical, medical and allied, and surgical and allied departments attended the workshop. The CISP-II workshop was a 2-day workshop mandated by the National Medical Commission (NMC). A prevalidated test comprising various components of CBME was administered to all participants before and after the workshop, and the test was then evaluated for gain in knowledge. At the end of each workshop day, all participants were provided a feedback form to fill out to assess different workshop sessions. At the end of the workshop, a focused group discussion (FGD) was conducted, and all participants’ reflections were obtained.

Results:

Significant increases in the knowledge (P < 0.01) of the participants were observed through pre- and posttest analyses. All participants thought that workshop comprised interactive lectures as well as practical training. Approximately 90% of participants (n = 26) felt the seminar was informative, beneficial, interactive, and punctual; 76% of participants (n = 22) suggested that to avoid the repetition of the same concepts in several sessions, the duration of the session shall not be more than 60 min. Fifty-five percentage (n = 16) of participants felt it was challenging to implement the CBME curriculum. All the participants felt CISP training must be provided to all faculty members to implement the CBME curriculum effectively.

Conclusion:

Faculty members with CISP training can better implement the new curriculum with better knowledge and perception of CBME. Given this, MCI should increase the frequency of CISP workshops and include tutors and demonstrators as participants.
A functional realization of the Gelfand-Tsetlin base
Authors: Artamonov Dmitrii Vyacheslavovich
Published: November 2023

A realization of a finite dimensional irreducible representation of the Lie algebra $\mathfrak{gl}_n$ in the space of functions on the group $\mathrm{GL}_n$ is considered.
It is proved that functions corresponding to Gelfand-Tsetlin diagrams are linear combinations of some new functions of hypergeometric type which are closely related to $A$-hypergeometric functions. These new functions are solution of a system of partial differential equations which
follows from the Gelfand-Kapranov-Zelevinsky by an "antisymmetrization". The coefficients in the constructed linear combination are hypergeometric constants, that is, they are values of some hypergeometric functions when instead of all arguments ones are substituted.
Bibliography: 16 titles.
New approaches to $\mathfrak{gl}_N$ weight system
Authors: Yang Zhuoke
Published: November 2023

The present paper has been motivated by an aspiration for understanding the weight system corresponding to the Lie algebra $\mathfrak{gl}_N$. The straightforward approach to computing the values of a Lie algebra weight system on a general chord diagram amounts to elaborating calculations in the non-commutative universal enveloping algebra, in spite of the fact that the result belongs to the
centre of the latter. The first approach is based on M. Kazarian's proposal to define an invariant of permutations taking values in the centre of the universal enveloping algebra of $\mathfrak{gl}_N$. The restriction of this invariant to involutions without fixed points (such an involution determines a chord diagram) coincides with the value of the $\mathfrak{gl}_N$ weight system on this chord diagram. We describe the recursion allowing one to compute the $\mathfrak{gl}_N$ invariant of permutations and demonstrate how it works in a number of examples. The second approach is based on the Harish-Chandra isomorphism for the Lie algebras $\mathfrak{gl}_N$. This isomorphism identifies the centre of the universal enveloping algebra $\mathfrak{gl}_N$ with the ring $\Lambda^*(N)$ of shifted symmetric polynomials in $N$ variables. The Harish-Chandra projection can be applied separately for each monomial in the defining polynomial of the weight system; as a result, the main body of computations can be done in a commutative algebra, rather than non-commutative one.
Bibliography: 18 titles.
Непрерывные дроби и проблема классификации
эллиптических полей над квадратичными полями констант
Authors: Fedorov Gleb Vladimirovich
Published: November 2023

Теория периодичности функциональных непрерывных дробей имеет глубокие приложения к проблеме поиска и построения фундаментальных единиц и $S$-единиц, к проблеме описания точек конечного порядка на эллиптических кривых и проблеме кручения в якобианах гиперэллиптических кривых. Кроме того, изучение функциональных непрерывных дробей имеет интерес с точки зрения арифметических приложений, в том числе к решению норменных уравнений или функциональных уравнений
типа Пелля.
В этой статье для всех квадратичных числовых полей $K$ приведено описание свободных от квадратов многочленов $f(x) \in K[x]$
степени 4 таких, что $\sqrt{f}$ имеет периодическое разложение в непрерывную дробь в поле формальных степенных рядов $K((x))$, а эллиптическое поле $L=K(x)(\sqrt{f})$ обладает фундаментальной $S$-единицей степени $m$, $2 \leqslant m \leqslant 12$, $m \ne 11$, где множество $S$ состоит из двух сопряженных нормирований определенных на поле $L$ и связанных с униформизующей $x$ поля $K(x)$.
Библиография: 28 названий.
Интегрирование модифицированного уравнения Кортевега-де Фриза-Лиувилля в классе периодических бесконечнозонных функций
Authors: Khasanov Aknazar Bekdurdievich , Hudayerov Ulugbek Obilmalikovich
Published: November 2023

В данной работе метод обратной спектральной задачи применяется для интегрирования нелинейного модифицированного уравнения Кортевега-де Фриза-Лиувилля
(мКдФ-Л) в классе периодических бесконечнозонных функций. Доказана разрешимость задачи Коши для бесконечной системы дифференциальных уравнений Дубровина в классе шесть раз непрерывно дифференцируемых периодических бесконечнозонных функций. Показано, что сумма равномерно сходящегося функционального ряда построенного с помощью решения системы уравнений Дубровина и формулы первого следа, удовлетворяет уравнению мКдФ-Л. Кроме того, доказано, что если начальная функция является действительной $\pi$-периодической аналитической функцией, то решение задачи Коши для уравнения мКдФ-Л тоже является вещественной аналитической функцией по переменной $x$; а если число $\pi/2$ является периодом (антипериодом) начальной функции, то число $\pi/2$ также является периодом (антипериодом) по переменной $x$ решения задачи Коши для уравнения мКдФ-Л.
Библиография: 41 название.
FTMPST: Fault-Tolerant Multiparty Session Types
Authors: Peters Kirstin , Nestmann Uwe , Wagner Christoph
Published: November 2023

Multiparty session types are designed to abstractly capture the structure of
communication protocols and verify behavioural properties. One important such
property is progress, i.e., the absence of deadlock. Distributed algorithms
often resemble multiparty communication protocols. But proving their
properties, in particular termination that is closely related to progress, can
be elaborate. Since distributed algorithms are often designed to cope with
faults, a first step towards using session types to verify distributed
algorithms is to integrate fault-tolerance. We extend multiparty session types
to cope with system failures such as unreliable communication and process
crashes. Moreover, we augment the semantics of processes by failure patterns
that can be used to represent system requirements (as, e.g., failure
detectors). To illustrate our approach we analyse a variant of the well-known
rotating coordinator algorithm by Chandra and Toueg.
Fine-Grained Complexity of Regular Path Queries
Authors: Casel Katrin , Schmid Markus L.
Published: November 2023

A regular path query (RPQ) is a regular expression q that returns all node
pairs (u, v) from a graph database that are connected by an arbitrary path
labelled with a word from L(q). The obvious algorithmic approach to
RPQ-evaluation (called PG-approach), i.e., constructing the product graph
between an NFA for q and the graph database, is appealing due to its simplicity
and also leads to efficient algorithms. However, it is unclear whether the
PG-approach is optimal. We address this question by thoroughly investigating
which upper complexity bounds can be achieved by the PG-approach, and we
complement these with conditional lower bounds (in the sense of the
fine-grained complexity framework). A special focus is put on enumeration and
delay bounds, as well as the data complexity perspective. A main insight is
that we can achieve optimal (or near optimal) algorithms with the PG-approach,
but the delay for enumeration is rather high (linear in the database). We
explore three successful approaches towards enumeration with sub-linear delay:
super-linear preprocessing, approximations of the solution sets, and restricted
classes of RPQs.
Assessment of Correlation of Serum Lipid Profile and Urinary Protein Creatinine Ratio with Occurrence of Gestational Hypertension in Pregnant Mothers in a Tertiary Care Hospital, Kolkata
Authors: Talukdar Dr. Sumit , De Prof. Dr.Jayanta , Saha3 Dr. Ananya , De Dr. Angshuman
Published: November 2023

After 18 months study from 1st April, 2021 to 30th September, 2022 on the pregnant mothers in a tertiary care hospital, i.e., in R.G. Kar Medical College & Hospital, Kolkata, we have observed that there is significant rise of Urinary Protein Creatinine ratio in spot urine sample of Gestational hypertensive women in comparison to normotensive pregnant women. We may opine that, measurement of Spot Urinary Protein Creatinine Ratio as well as Serum Triglyceride, Total Cholesterol, different components of Cholesterol and calculation of their ratios may be used as precautionary steps, to take the necessary actions to prevent the complications of Gestational hypertension, i.e., graver grades of Pregnancy Induced Hypertension (PIH), namely, Preeclampsia and Eclampsia.
Variation in Acacia senegal Seed size and Germination Collected from Different Regions of Rajasthan
Authors: Bohra N.K. , Soni Anuj , Manda Manita , Rawalram
Published: November 2023

Acacia senegal is common in Rajasthan and its seeds are used in Panchkutta vegetable. It is good for fencing and also on bunds fencing. Seeds from different locations were collected and their seed size and other parameters were studied. Its germination in laboratory with different treatments as well as with different concentrations of Growth regulators was studied. Results shows that seed size varies with different locations even in same districts also. However there is no correlation with germination behavior. Phenological study and reproductive biology of seeds need to be studied in details.