bluuebunny/crossref_metadata_2025 huggingface dataset:
This Somewhere, this Anywhere - this Liverpool
Authors: Kay Mark
Published: April 2024

The cleavages and dichotomies of Brexit are evermore numerous. In an attempt to better understand the Leave and Remain vote, this article returns to one of the oldest divides - the rural-urban dichotomy with a focus on the urban and considers the role of belonging, ontological security and the sense of place in what was once Britain’s second city of Empire - Liverpool.1 Making use of quantitative data collected through questionnaires as part of my doctoral research, the importance of place identity and place attachment in the 2016 referendum will be considered in the context of Liverpool. The city is open to the world but with its resonant locale, it remains a ‘Somewhere’ place.
First assessment of changes in dust sources in the black forest during the Holocene: case study at Wildseemoor
Authors: Steiner Martin , Rambeau Claire , Marx Samuel K. , May Jan­‑Hendrik , Vogel Hendrik , Preusser Frank
Published: April 2024

A 600 cm peat sequence was extracted from the ombrotrophic peat bog Wildseemoor in the northern Black Forest, covering the last ca. 10,000 years thus allowing for identification of potential changes in dust input during the Holocene. Such information is critical to the understanding of past environmental change at the local to supra-regional scale and helps with interpreting, in particular, fire history and its links to both climate change and anthropogenic impacts. Dust composition change was investigated using X-ray fluorescence core scanning (XRF-CS) to establish bulk chemical composition of lithogenic input to the peatland, using element signatures, and in particular the ratios of Ca/Ti and Ti/Zr. Two main different sources of dust could be differentiated, a local and a distal (long-distance) dust source, which show variations through time. Distal dust input is elevated during the early Holocene (ca. 8,800 - 8,300 cal BP), as well as around 5,000 cal BP, 3,000 cal BP, 2,300 cal BP and the last ca. 200 years. Distal dust might originate from remobilized loess deposits in the Upper Rhine Graben or, periodically, more distant sources such as the Sahara or the Massif Central. Local dust input roughly correlates to peaks in charcoal influx after ca. 3,850 cal BP, potentially recording phases of increased anthropogenic influence in the surroundings of Wildseemoor. Additional research in nearby bogs (from the Black Forest and the Vosges), as well as more precise geochemical fingerprinting of the different dust sources, is needed to explore the regional extent and significance of Holocene environmental changes recorded at Wildseemoor.
Alemania y el triángulo del litio: entre la diplomacia comercial y la difusión normativa
Authors: León González Jaime , Aguirre Juan Carlos
Published: April 2024

La relación entre política exterior, diplomacia comercial y difusión normativa ha concitado poco interés académico desde la Teoría de las Relaciones Internacionales. En específico, la forma en que las normas internacionales que emanan de países del norte global y se intentan aplicar en naciones del Sur Global ha sido poco estudiada por los especialistas. En este sentido, esta investigación explora las características del ciclo de vida de la norma a nivel internacional y cómo estas pueden tener distintos efectos en los territorios en donde se intentan localizar. Con el objetivo de demostrar esto, estudiamos tres casos de estudio vinculados con el triángulo del litio (Argentina, Chile y Bolivia) y las inversiones alemanas relacionadas al mineral. Alemania ha impulsado nacional e internacionalmente la necesidad de generar una transición energética sobre la base del desarrollo de la electromovilidad, impulsando su diplomacia comercial. No obstante, en el camino, se ha encontrado con ciertas resistencias locales. Al mismo tiempo, los esfuerzos del Estado alemán han generado paradojas respecto de la promoción de la transición energética y la protección del medio ambiente y los derechos humanos en aquellos territorios desde donde se explota el litio.
A greener past? An assessment of South African environmental historiography
Authors: Steyn Phia
Published: April 2024

Die doel met hierdie artikel is om 'n oorsig te verskaf van die bestaande literatuur oor Suid-Afrikaanse omgewingsgeskiedenis. Die opkoms van omgewingsgeskiedenis as 'n identifiseerbare sub-dissipline in historiografie kan wereldwyd toegeskryf word aan die belangstelling in die natuurlike omgewing wat deur die omgewingskrisis en gepaardgaande omgewingsrevolusie in die 1960s gegenereer is. In teenstelling met hierdie algemene tendens het omgewingsgeskiedenis in Suid-Afrika aanvanklik in die loop van die tagtigerjare ontwikkel vanuit die revisionistiese historiografie se belangstelling in pre-koloniale swart gemeenskappe. Sedertdien het die fokus en omvang daarvan uitgebrei tot so 'n mate dat omgewingshistorici daarop kan begin aandring dat omgewingsgeskiedenis as 'n volwaardige sub-dissipline binne die Suid-Afrikaanse historiografie erken moet word.
Long-term outcome of pulmonary involvement in patients with coronavirus disease 2019: The role of high-resolution computed tomography and functional status – A prospective single-center observational study
Authors: Imtiaz Sadia , Batubara Enas M , Abuelgasim Mohammed H , Alabad Mahdi M , Alyousef Lujain Mahmoud , Alqahtani Nayef H , Sabbagh Alaa Y , Alharbi Fawaz A , Ibrahim Ahmed S
Published: April 2024

BACKGROUND:

Since its first outbreak, coronavirus disease 2019 (COVID-19) has led to a great deal of published literature highlighting the short-term determinants of morbidity and mortality. Recently, several studies have reported radiological and functional sequelae from 3 months to 1 year among hospitalized COVID-19 survivors; however, long-term (more than 1 year) respiratory consequences in this population remain to be evaluated.

OBJECTIVE:

To assess the long-term radiological and pulmonary function outcomes of patients with COVID-19 2 years after resolution of the initial infection.

METHODS:

Hospitalized COVID-19 patients with moderate to severe disease who survived acute illness were included in this prospective and partially retrospective study. Clinical assessment, laboratory tests, high-resolution computed tomography scans, and pulmonary function tests (PFTs) were performed at baseline, followed by radiological and lung function assessments at 6 and 24 months.

RESULTS:

Among 106 enrolled participants (mean age 62 ± 13.5 years; males: 61), 44 (41.5%) and 27 (25.4%) underwent radiological assessment at 6 and 24 months, respectively. Overall, 22.6% (24) of patients had residual radiological abnormalities. Overt fibrosis was observed in 12.2% of patients. Computed tomography disease severity and extent diminished significantly at 6 (13 ± 6, P < 0.001) and 24 months (11 ± 6, P < 0.001) from baseline. PFTs were performed in 65 (61.3%), 22 (20.7%), and 34 (32%) patients at baseline, 6 and 24 months, respectively. Impaired diffusion capacity (median diffusion capacity for carbon monoxide: 60%, interquartile range [IQR]: 51–80), restrictive lung defect (mean total lung capacity: 73.4% ± 18% predicted), and reduced exercise tolerance (median 6-min walk distance: 360 m, IQR: 210–400) were the predominant features at baseline. With the exception of exercise tolerance, a statistically significant improvement was observed in lung function parameters at the extended follow-up (2 years).

CONCLUSIONS:

Hospitalized COVID-19 survivors are at increased risk of developing long-term pulmonary complications, including lung fibrosis. A protocol-based approach to the management of post-COVID-19 patients is mandatory to improve future outcomes.
Continuous positive airway pressure combined with small-tidal-volume ventilation on arterial oxygenation and pulmonary shunt during one-lung ventilation in patients undergoing video-assisted thoracoscopic lobectomy: A randomized, controlled study
Authors: Yang Yudie , Jia Dong , Cheng Lu , Jia Ke , Wang Ji
Published: April 2024

BACKGROUND:

One-lung ventilation (OLV) is frequently applied during video-assisted thoracoscopic surgery (VATS) airway management to collapse and isolate the nondependent lung (NL). OLV can give rise to hypoxemia as a result of the pulmonary shunting produced. Our study aimed to assess the influence of continuous positive airway pressure (CPAP) combined with small-tidal-volume ventilation on improving arterial oxygenation and decreasing pulmonary shunt rate (QS/QT) without compromising surgical field exposure during OLV.

METHODS:

Forty-eight patients undergoing scheduled VATS lobectomy were enrolled in this research and allocated into three groups at random: C group (conventional ventilation, no NL ventilation intervention was performed), LP group (NL was ventilated with lower CPAP [2 cmH2O] and a 40–60 mL tidal volume [TV]), and HP group (NL was ventilated with higher CPAP [5 cmH2O] and a 60–80 mL TV). Record the blood gas analysis data and calculate the QS/QT at the following time: at the beginning of the OLV (T0), 30 min after OLV (T1), and 60 min after OLV (T2). Surgeons blinded to ventilation techniques were invited to evaluate the surgical fields.

RESULTS:

The demography data of the three groups were consistent with the surgical data. At T1, PaO2 in the HP group was substantially higher compared to the C group (P < 0.05), while there was no significant difference in the LP group (P > 0.05). At T1-T2, PaCO2 in the LP and HP groups was significantly less than that in the C group (P < 0.05). At T1, the QS/QT values of groups C, LP, and HP were 29.54 ± 6.89%, 22.66 ± 2.08%, and 19.64 ± 5.76%, respectively, and the QS/QT values in the LP and HP groups markedly reduced (P < 0.01). The surgical field’s evaluation by the surgeon among the three groups was not notable (P > 0.05).

CONCLUSION:

CPAP combined with small-tidal-volume ventilation effectively improved arterial oxygenation and reduced QS/QT and PaCO2 without compromising surgical field exposure during OLV. Among them, 5 cmH2O CPAP + 60–80 ml TV ventilation had a better effect on improving oxygenation.
Role of impulse oscillometry together with diffusing capacity of the lungs for carbon monoxide and high-resolution computed tomography for the chest in early diagnosis of interstitial lung disease in patients with connective tissue diseases
Authors: Hiekal Abdel HMS , Dayem Aya MMA , Gomaa Ashraf A , Mohamed Mohamed R , Ali Wafaa R , Hendawy Mahmoud M
Published: April 2024

Background

Connective tissue diseases (CTDs) are systemic autoimmune disorders characterized by repeated lung involvement. Interstitial lung disease (ILD) can arise from nearly any CTD, imposing a significant burden on patients and strongly affecting their prognosis. Addressing the gaps in early diagnosis, monitoring, and treatment of these patients requires a comprehensive and multidisciplinary approach for optimal management.

Aim

To find the best modality for early diagnosis of ILD in patients with connective tissue disorders through the use of diffusing capacity of the lungs for carbon monoxide (DLCO), impulse oscillometry (IOS) and high-resolution computed tomography (HRCT) chest.

Patients and methods

This study was cross-sectional, analytical, and observational was conducted on 60 patients who were diagnosed with CTD, during the period from March 2022 to March 2023, who were admitted to Chest and Rheumatology Department or outpatient clinics visitors, to Ain Shams University Hospitals.

Results

The sensitivity of DLCO, HRCT, and IOS in detecting interstitial affection in CTD patients was 90, 81.5, and 72.2%, respectively.

There is high statistical significance between DLCO and both CT chest and IOS in detecting ILD in CTD patients.

There is a highly significant correlation between DLCO with Spirometric parameters (forced vital capacity, forced expiratory volume 1 s) and between DLCO with IOS parameters (actual ×5).

Conclusion

ILD should always be considered in patients with CTD. Diagnosis of CTD-ILD is challenging so early diagnosis of ILD using DLCO, HRCT chest or by using IOS is important as it could affect therapy plans.
Outcome of Acinetobacter baumannii Ventilator Associated Pneumonia in Upper Egypt: does the resistance profile play a role?
Authors: Abdel-Rahim Mona H , Abd–ElNasser Randa A , Hassnein Khaled M , Mahmoud Manal A , Elkhawaga Amal A
Published: April 2024

Background

Ventilator-associated pneumonia (VAP) due to drug resistant Acinetobacter baumannii (A. baumannii) is a challenging nosocomial problem associated with increased morbidity and risk of mortality.

Objective

This study aimed to investigate plasmid mediated quinolone resistance genes (PMQR) as a mechanism of resistance transmission, risk factors and outcome of A. baumannii VAP.

Methods

This prospective cohort study included 100 VAP patients between October 2020 and December 2022. Microbiological confirmation of A. baumannii. was done and PMQR genes were exposed by polymerase chain reaction (PCR). Pneumonia severity index (PSI), risk factors for developing drug resistant A. baumannii VAP, and the outcome were studied.

Results

The proportions of drug sensitive (DS), multidrug (MDR), extensive drug (XDR), and pan drug (PDR) resistant A. baumannii were 14%, 35%, 50%, and 1%, respectively. Majority of PSI classes IV and V showed XDR (66%) and PDR (100%) isolates. Detection of qnrA, qepA and aac(6′)-Ib-cr genes was predominant in PSI classes IV and V. The in-hospital mortality for MDR, XDR, and PDR was 22.7%, 70.5%, and 2.3%, respectively. ICU duration, prior use of carbapenems and use more than 2 antibiotics prior to VAP were risk factors for developing MDR A. baumannii while septic shock, multilobar chest radiography (CXR) infiltration and PSI class were predictors of in-hospital mortality.

Conclusions

VAP caused by MDR, XDR and PDR isolates of A. baumannii which harbors qnrA, qepA and aac(6’)-Ib-cr PMQR genes showed higher PSI classes and increased in-hospital mortality. The number of PMQR genes in A. baumannii isolates, ICU days, use of more than 2 antibiotics, and use of carbapenem prior to VAP, were independent risk factors for the development of drug resistant A. baumannii VAP.
Volume support ventilation versus pressure support ventilation as a weaning mode of mechanically ventilated patients with chronic obstructive pulmonary disease
Authors: Ghanem Maha K , Makhlouf Hoda A , Taghyan Alaa M , Hassan Ali A
Published: April 2024

Background

A dual controlled ventilatory mode called volume support ventilation (VSV) is anew mode, which is intended to speed up weaning and encourage spontaneous breathing. The purpose of the study was to compare the effectiveness of pressure support ventilation (PSV) and VSV in weaning patients with chronic obstructive pulmonary disease (COPD) who are mechanically ventilated.

Patients and methods

Fifty COPD patients admitted to the respiratory ICU were enrolled. Patients were assigned randomly to either PSV or VSV as a weaning mode. Patients were checked on at intervals of 30, 60 min, and 24 h. Results of weaning and hospital outcomes were recorded.

Results

Compared with PSV, VSV showed significant shorter weaning duration (12.76 ± 8.02 vs. 18.56 ± 5.97 h, P=0.04). Moreover, there was a higher successful extubation rate of 80% for VSV group compared with 76% for PSV, with the same complications and death rate between the two groups.

Conclusion

When compared to PSV mode, VSV mode was a safer, more dependable strategy that may be used responsibly for weaning trials in COPD patients. It also has the potential to shorten ICU stays and weaning times.
MMP-7, RANKL mRNA expression in the gingival tissue correlates with periodontitis: An in vivo study
Authors: Khuda Fazle , Baharin Badiah , Anuar Nur N. M. , Jayusman Putri A. , Nasruddin Shaqinah N.
Published: April 2024

Introduction

MMP-7 supports the immune response and can have both beneficial and destructive effects. As part of the innate host defense, MMP-7 is connected to the mucosal antimicrobial defense. Even though research on other Matrix metalloproteinase (MMPs) is well-established, understanding MMP-7 expression is required to establish an improved diagnostic strategy. This research investigates the mRNA expression of MMP-7 and RANKL by RT-qPCR assay.

Methods and material

Twelve male Sprague Dawley rats were allocated into three groups, no treatment, experimental (7 and 14 days). Periodontitis is induced by sterile wire insertion (0.2 mm) and Enterococcus faecalis inoculation within the gingival sulcus situated between the maxillary right 1st and 2nd molar tooth regions. Following euthanasia, tissue samples from the maxillary gingiva and maxillary jaw were extracted for quantitative real-time PCR assay and histopathological assessment.

Results

Results showed that at 7 days, there was significant upregulation of MMP-7, which was downregulated in 14 days, as well as migration of the junctional epithelium, attachment loss, inflammatory cells, and fibroblasts, as observed by histological analysis.

Conclusions

Thus, the study suggests that MMP-7 is associated with the progression of periodontitis.
Hepatoprotective effect of jojoba oil against lead-induced toxicity in rats
Authors: El-Saeed Rasha A. , El-Khawaga Omali Y.
Published: April 2024

Background

Previous investigations showed that jojoba oil exhibited a protective effect against hepatotoxicity caused by different toxicants, however, to the best of our knowledge, no prior research has been done to determine the effectiveness of jojoba oil in protecting against lead toxicity.

Objective

This study assessed the hepatoprotective properties of jojoba oil against lead toxicity in rats.

Materials and methods

The study included four groups, each consisting of six Sprague Dawley male rats, and orally administered jojoba oil (JO group), lead acetate (LA group), and lead acetate plus jojoba oil (protective group)

Results and conclusion

The results showed that lead acetate-induced hepatotoxic effects were revealed by increased serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase activities with hepatic histomorphological changes. There was a significant increase in serum total cholesterol, triglycerides, and low-density lipoprotein-cholesterol, while levels of high-density lipoprotein-cholesterol significantly declined compared to normal rats. Additionally, lead acetate triggered oxidative damage of hepatocytes, evidenced by a significant increase of malondialdehyde levels and a decrease of reduced glutathione levels and activities of superoxide dismutase and glutathione S-transferase. Administration of lead was associated with a change in the distribution of cells over different cell cycle phases, characterized by a marked increase in the sub G1 cell population and a significant decrease in the G0/G1 cell population. Supplementation of jojoba oil with lead acetate relieved the toxic impacts of lead acetate with an enhancement of the liver enzyme activities, antioxidant status, lipid profile parameters, and histopathological alterations. In conclusion, jojoba oil might be an effective natural product that offers a promising preventive action towards lead-induced liver damage in rats.
Autoantibodies in epileptic patients indicate the autoimmune epilepsy
Authors: Naser Hajer N. , Ali Naael H. , Derraj Maysoon K.
Published: April 2024

Background

Epilepsy is a multifaceted neurological condition marked by recurring seizures. Delving into the functions of VGKC (voltage-gated potassium channels), AMPA GluR3 (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor subunit 3), GAD65 (glutamate decarboxylase 65), and LGI1 (leucine-rich glioma-inactivated 1) in epilepsy yields significant perspectives into the fundamental immunological mechanisms of this disorder.

Objective

The study target was to assess the clinical significance of neural autoantibody biomarkers in patients with epilepsy and determine the types of autoimmune epilepsy.

Materials and methods

A case–control study that comprised 50 epilepsy patients (33 males and 17 females) and 40 controls (21 males and 19 females), the patients and controls attending Basrah Teaching Hospital between November 2022 and March 2023, Basrah City, Southern Iraq. The control age ranged from 2 to 62 years and patients’ age 2–68 years were considered the control group in this study. The VGKC, AMPA GluR3, GAD65, and LGI1 were measured using the sandwich ELISA technique.

Results and conclusion

There is no statistically significant difference between the patients and control group for VGKC, GAD65, and LGI1 (P=0.460, P=0.061, and P=0.440, respectively), while there is a statistically significant difference between the patients and the control group for AMPA GluR3 (P=0.012). GAD65 appeared an elevation in epilepsy patients but was not statistically significant. This upregulation may contribute to the hyperexcitability observed in the epileptic brain and potentially play a role in seizure generation and propagation.
Silica nanoparticles improve growth, chemical bioactive, and antioxidant enzyme activity of Dianthus caryophyllus L., plant
Authors: El-Sayed Iman M. , Soliman Dina M.
Published: April 2024

Background

Nanotechnology has provided innovative use of various materials with unique properties. These substances may react positively in plants, and the induction of bioactive compounds and antioxidant activity is particularly remarkable. Ornamental plant production is a positive economic activity of great interest, especially Carnation (Dianthus caryophyllus L.). This plant is more attractive for its various colors, but the flower quality and its longevity can diminish very fast. Thus, examining methods capable of improving flower quality and vase life is crucial. Additionally, carnation can be used to treat coronary and nervous disorders. Carnation contains compounds that calm the nervous system and minimize swelling and inflammation.

Objective

This research aimed to evaluate the effect of silica nanoparticles (SiO2 NPs) on the growth, bioactive chemical analysis, enzyme activity, and antioxidant accumulation.

Material and methods

The different rates of SiO2 NPs (0, 150, and 300 ppm) were used in two ways: foliar spray and soil drench; it was applied 3 times. The first application was after 3 weeks of transplanting and repeated with 21-day intervals.

Results and conclusion

The results showed that foliar application of SiO2 NPs increased all morphological and flowering traits compared with drench and the control, higher levels of photosynthetic pigments and anthocyanin, greater total phenols, total sugars, and total free amino acids were obtained from plants treated with foliar spray 300 ppm followed than 150 ppm. In addition, the greatest levels of enzyme activity were recorded with plants treated with foliar spray of SiO2 NPs at a rate of 300 ppm, as well as improved anatomical structure of the stem and stomata properties compared with the drench method and control. Similarly, SiO2 NPs application method is more critical than their concentration. Therefore, it is recommended that foliar spraying of SiO2 NPs at 300 ppm can enhance plant growth, flowering, bioactive compounds, enzyme activity, and anatomical structure of the stem of carnation plants while adding SiO2 NPs drench at a rate of 150 ppm had rather acceptable findings.
Production of vitamin B12 via microbial strains isolated from marine and food sources in Egypt
Authors: Abdel-Baki Rania M. M. , Khalafalla Galal M. , Barakat Olfat S. , Ahmed Marwa N.
Published: April 2024

Background

Vitamin B12 is a very important water-soluble vitamin, which was first isolated from the liver as an anti-pernicious anemia factor. The sole source of vitamin B12 is the animal-based food. It has a complicated structure and requires expensive multi-steps to be synthesized chemically. Intriguingly, vitamin B12 can be produced through microbial fermentation by microorganisms in a cheap and more effective manner.

Objective

This study aims to isolate and characterize microorganisms that have the capability to produce vitamin B12. In addition, the current work aims to optimize the vitamin B12 production conditions by isolating strains using suitable waste materials to obtain a high vitamin B12 yield.

Materials and methods

Different bacterial and yeast isolates were isolated from marine and food samples using the pour-plate technique. These isolates were screened for vitamin B12 production using a specific growth medium that lacked vitamin B12 and a test indicator bacterium. The content of vitamin B12 was estimated using spectrophotometer measurement and high-performance liquid chromatography (HPLC). The isolates that showed high vitamin B12 productivity were identified using MALDI-TOF technique. The identified strains were implemented for the optimization of vitamin B12 production to reveal the most proper and optimum conditions for the production. Response surface methodology (RSM) was employed to enhance the production of vitamin B12 in a flask scale. Agro-industrial wastes such as molasses were used for vitamin B12 production using the most optimum conditions as determined by RSM.

Results and conclusion

Eighty-seven actinomycetes, bacterial, and yeast isolates were screened for vitamin B12 production. Out of these isolates, 15 showed high vitamin B12 productivity. We found that bacilli and yeast isolates were the most productive among the tested cocci and actinomycetes isolates. The highly productive Bacillus and yeast isolates were identified using the MALDI-TOF analysis. The isolates were identified as Candida pelliculosa, Geotrichum candidum, Bacillus subtilis and Bacillus sp. One strain of Candida pelliculosa (coded BYI), three strains of Geotrichum candidum (coded as MZYC, MZYD, and MZYG) were selected for studying the effect of sugar type and inoculum size on the yield of vitamin B12 production. Strain MZYD was selected for the statistical modelling using RSM to optimize seven factors for the vitamin B12 production. These factors included temperature, fermentation time, salt concentration, pH, sugar concentration, inoculum size, and aeration. Five factors i.e., temperature, pH, sugar concentration, and inoculum size were shown to significantly improve the vitamin B12 production. A maximum yield of 64.21 μg/100 ml was obtained using the optimized RSM conditions. These optimized conditions were used to produce vitamin B12 using molasses as a raw material for the microbial growth.
Congenital Insensitivity to Pain: A Fatal Entity
Authors: Biswas Debojit , Thander Paramita , Pati Moumita , Halder Pankaj
Published: April 2024

Congenital insensitivity to pain (CIP), also known as congenital analgesia, is an autosomal recessive, extraordinarily rare condition, in which a patient cannot feel pain in any part of his or her body. These patients may experience hyperthermia due to anhidrosis and sustain multiple fatal injuries because they are unable to feel pain at all. All these contribute to the early demise of the patient at a young age. Herein, we attempt to highlight the potentially catastrophic effects of CIP in a 4-year-old girl and reevaluate the representative features that a prudent physician should be aware of.
Components and Process of Performance Appraisal of Teaching Faculty
Authors: Shrivastava Saurabh RamBihariLal , Prihatiningsih Titi Savitri
Published: April 2024

In the field of medical and health professions education, performance appraisal has been regarded as one of the crucial aspects to improve the effectiveness and efficiency. Performance appraisal has to be a systematic and well-thought plan, wherein even inputs from the faculty members have been taken for the overall improvement of the existing or novel system. We must remember that performance appraisal is a formal management system that serves the purpose of evaluating the performance of a faculty member or any employee in a wide range of domains in an organization. In conclusion, performance appraisal should not be looked upon as a method to find shortcomings, rather as an opportunity to have a constructive dialog with the faculty to bring about improvement in their performance.
Unveiling Complexity: A Case Study of Evans Syndrome Secondary to Atypical Pneumonia
Authors: Sawant Rucha , Acharya Sourya , Kumar Sunil , Chaudhari Pranav
Published: April 2024

Evans syndrome (ES) is a combined presentation of immune thrombocytopenia along with autoimmune hemolytic anemia with a positive direct antihuman globulin test. Approximately half of the cases of ES may be secondary to diverse causes, including infections, systemic autoimmune, transplantation, and lymphoproliferative syndromes. We discuss a 53-year-old male who came with complaints of low-grade fever, breathlessness, and cough and was found to have low hemoglobin levels and reduced platelet count. His Coomb’s test was positive, and his chest X-ray suggested pneumonia. The serum nucleic acid amplification test was positive for mycoplasma. A diagnosis of atypical pneumonia with ES was confirmed.
Profile of Multisystem Inflammatory Syndrome in Children (MIS-C) in Infants in North India during the Second Wave of SARS-CoV-2 Pandemic
Authors: Kumar Ashna , Maheshwari Anu , Mahajan Akanksha , Mahto Deonath , Sehgal Suchitra , Basu Srikanta
Published: April 2024

Background:

Multisystem inflammatory syndrome in children (MIS-C) secondary to severe acute respiratory syndrome coronavirus-2 has affected not only older children, adolescents, and adults but also infants, more so during the second wave of the global pandemic.

Materials and Methods:

All sequentially admitted infants hospitalized during 6 months who fulfilled the World Health Organization criteria for MIS-C or American Heart Association 2017 criteria for Kawasaki disease (KD) (and positive coronavirus disease-2019 [COVID-19] serology) were included in the present study.

Results:

A total of 19 infants were studied. Thirteen (68.3%) had evidence of recent COVID-19 infection. The median age of presentation was 2 months (interquartile range 25–75th, 0.5–3). The most common presenting symptoms were fever (68.4%), gastrointestinal complaints (63.1%), and edema (36.8%). Other predominant signs were shock (78.9%), myocarditis (52.6%), and neurological complaints (26.3%). Incomplete KD was present in 21% of patients. Elevated C-reactive protein, ferritin, D-Dimer, N-terminal prohormone of brain natriuretic peptide, and reduced fibrinogen were markers of severe illness. All subjects received intravenous immunoglobulin (IVIG) (100%), 31.5% received a second dose of IVIG, and 63.1% received pulse intravenous methylprednisolone. A total of 5 (26.3%) died as a result of the disease process.

Conclusion:

The spectrum of MIS-C in infants can be varied and is different from older children. A high index of suspicion is therefore needed in infants who present with critical illness and do not respond appropriately to conventional antibiotics and supportive care. The addition of IVIG and corticosteroids to the treatment regimen leads to a favorable outcome.
Serum Ferritin as a Prognostic Marker in COVID-19
Authors: Nongtdu Balary , Ruram Alice Abraham , Tiewsoh Iadarilang , Sundaram Shanthosh Priyan , Boruah Polina
Published: April 2024

Background and Objectives:

This study was conducted during the peak of COVID-19 disease with the objective to find the association of serum ferritin and COVID-19 disease severity, to evaluate the utility of serum ferritin as a prognostic marker in COVID-19, and to determine a cutoff value for serum ferritin as a prognostic marker for COVID-19.

Materials and Methods:

A retrospective study was conducted by the department of biochemistry, in collaboration with the department of medicine in a tertiary care center among 103 patients who were admitted with COVID-19 infection after fulfilling the eligibility criteria. Patients were grouped according to the disease severity and also on the outcome during hospitalization.

Results:

The serum ferritin level was found to be significantly higher in the severe and critical groups when compared to the mild and moderate groups. However, the difference was not significant between mild and moderate and also between severe and critical groups. The serum ferritin level was also significantly higher in those who did not survive when compared to those who survived. A cutoff value of 635.25 ng/ml was found to have 76% sensitivity and 90.5% specificity to identify patients with severe COVID-19 disease. A cutoff value of 760.65 ng/ml was able to predict mortality with 73.3% sensitivity and 84.1% specificity.

Conclusion:

Estimating serum ferritin levels in all COVID-19 patients can be beneficial in predicting the progress of the disease and hence aid in the selection of appropriate management.
Antibiotic Resistance Pattern of Pseudomonas aeruginosa-associated Pneumonia over a Period of 6 Years at a Teaching Hospital in Northern India
Authors: Kar Mitra , Dubey Akanksha , Fatima Nida , Sahu Chinmoy
Published: April 2024

Background:

Pseudomonas aeruginosa is a major cause of multidrug resistant (MDR) nosocomial pathogen isolated from clinical samples of patients admitted to the intensive care unit. Treating the ever-increasing antimicrobial resistance in P. aeruginosa isolates has turned into a challenge.

Materials and Methods:

All data were extracted from the hospital information system on P. aeruginosa pneumonia from July 2017 to July 2022. All isolates were identified by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry and routine biochemicals. A comparison between the consequences of antibiotic susceptibility testing, demographics, and risk factors between the patients with community-acquired and nosocomial-acquired pneumonia due to either P. aeruginosa or multidrug-resistant P. aeruginosa was performed.

Results:

In this study, 576 (576/19224, 2.99%) patients developed P. aeruginosa pneumonia over 6 years. There were 114 (19.79%) cases of community-acquired pneumonia and 462 (80.21%) cases of nosocomially acquired pneumonia in this study. P. aeruginosa showed high resistance to cefoperazone-sulbactam and imipenem, which was statistically significant in cases of patients suffering from nosocomially acquired pneumonia compared to community-acquired pneumonia. High susceptibility to colistin was statistically significant in cases of community-acquired pneumonia compared to nosocomially acquired pneumonia. A total of 182 (182/576, 31.59%) deaths occurred among cases of P. aeruginosa pneumonia.

Conclusion:

This study explains the emergence of resistance among the P. aeruginosa isolates causing community-acquired pneumonia or nosocomially acquired pneumonia over 6 years.
Cough-induced Reflex Epilepsy – A Mystery yet Unfolded
Authors: Sahoo Haramohan , Chandra Krishna
Published: April 2024

Stimulus-induced epilepsy is termed reflex epilepsy. It is an uncommon entity. It can be induced due to exposure to stimuli such as flashes of light, music, hot water, or while eating, running, brushing teeth, or micturating. In reflex epilepsy, the patient can have any kind of seizure semiology. Treatment of these entities in many cases is difficult. Counseling of the patient and antiepileptic drugs are the mainstay of treatment. We present here a case of reflex epilepsy who developed it every time he had a prolonged cough.
Sociodemographic profile and pattern of congenital heart disease in referred children at tertiary cardiac centre – An observational study
Authors: Harikesh Hridaya , Sudha Reddy V. R. , Anand Shivaraja , Shankar Gautam
Published: April 2024

Background:

Sparse data are available regarding congenital heart disease (CHD) from southern India. This study was designed to document the sociodemographic factors, clinical profile and pattern of CHD at a referral centre.

Methods:

A cross-sectional observational study was done by direct interview method and review of medical records of 414 participants using internally validated, pre-defined proforma.

Results:

More than half of the cases (54.6%) referred were within 1 year of age. Wasting was present in 45%. Most of the cases belonged to middle and lower socio-economic status group (79%) and were referred by paediatricians (70%); 48% had travelled more than 500 km to avail cardiac services. Predominant symptoms of referral were respiratory distress (61.8%), feeding difficulties (50%), cyanosis (43.7%) and palpitation (24.9%). Major abnormalities detected were ventricular septal defect (31.2%) and tetralogy of Fallot (21.7%).

Conclusions:

This study highlights the need of prioritising and planning for the implementation of affordable and accessible cardiac infrastructure to people from rural areas with low socio-economic background.
Platelet indices and plasma gelsolin in patients presenting with acute stroke
Authors: Kailash J , Mohan Reenaa , Sindhuri R. , Kumar Prem , Badrinath A. K.
Published: April 2024

Background:

Cerebrovascular diseases are the most common and devastating disorders. Early diagnosis using biochemical tests plays a significant role.

Methods:

This hospital-based analytical cross-sectional study conducted over 18 months using a pre-designed structured questionnaire. Patients (n = 82) presenting with aute stroke belonged to age group of 30-85 years were included in the study. Patients with an old stroke, transient ischaemic attacks and those on antiplatelet and statin therapy were excluded. We studied the correlation between serum platelet indices and plasma gelsolin (GSN) levels in patients presenting with acute stroke.

Results:

Among the study participants 59.8% were males; 31.7% were 56–65 years of age. Ischaemic stroke was evident in 78.5% of the study participants; the others had haemorrhagic stroke. There was a weak negative correlation between platelets and GSN levels, which was not statistically significant. There was no correlation between platelet count and platelet distribution width (DW) and severity of the stroke, and a weak correlation was observed between mean platelet volume (MPV) and severity of stroke (r = 0.142, P = 0.21).

Conclusions:

MPV and pGSN can be used as an indicator to determine the severity and prognosis of the patient.
Assessment of Long-Term Success and Survival Rates of Different Types of Intracanal Medicaments
Authors: Ron Akshata , Jena Debkant , Dwivedi Vartul , Sharma Durgesh Kumar , Late Laxmikant , Jethlia Ankur , Makkad Ramanpal Singh
Published: April 2024

ABSTRACT

Background:

Antimicrobial endodontic intracanal medicaments play a vital role along with biomechanical preparation in the elimination of bacteria present in the pulp area to achieve success in endodontic therapy.

Aim:

The present research was conducted with the objective of evaluating and comparing intracanal medicaments regarding antibacterial properties against Enterococcus faecalis.

Materials and Methods:

One hundred and twenty healthy human premolars of the mandible were used. All premolar crowns were removed, keeping the standardized length of the root as 15 mm. Category 1 received triple antibiotic paste (TAP) (n = 30), Category 2 received double antibiotic paste (DAP) (n = 30), Category 3 received augmentin (n = 30), and Category 4 received calcium hydroxide (n = 30). Hygienic paper points were placed in each root canal, then they were moved to a tube containing 1 mL of brain-heart infusion medium and left there for bacteriological testing. Colony-forming units (CFUs) of E. faecalis were then observed and counted after the plates had been incubated overnight at a temperature of 37°C.

Results:

During intracategory comparisons, there was a significant reduction in colonies of E. feacilis in each category (P ≤ 0.001). When there were intercategory comparisons, there was a maximum reduction in CFU in specimens of Category 1 (TAP) followed by Category 3 (Augmentin) and Category 2 (DAP).

Conclusion:

Intracanal medicaments like TAP, DAP, and augmentin are effective against root canal E. faecalis.
A Survey on Awareness Regarding Certain Common Craniofacial Deformities and its Treatment Approach Among Gujarat Population
Authors: Bhavsar Priyal Sanjay , Kubavat Ajay Kantilal , Patel Khyati Viral , Patel Riddhi , Patel Anuj , Sejani Vishwa
Published: April 2024

ABSTRACT

The leading intent of the present questionnaire is to assess the ratio of the concerned population as well as the treatment approach of craniofacial deformities among Gujarat citizenry. The theme of Google Form was used for 100 partakers to record responses via sending the questionnaire in English and Gujarati languages through WhatsApp and Emails. From the 100 respondents which are from laymen of Gujarat, 62.25% of inhabitants are acquainted with craniofacial syndromes, 15% of residents have craniofacial deformities as their family history, 51.66% of denizens have some idea for the treatment approach of craniofacial malformations. A good number of Gujarat laymen have some clear concept for craniofacial syndromes.
Evaluation of Conventional and Novel Risk Factors in Young and Aged Patients, Undergoing Coronary Artery Bypass Grafting
Authors: Chakrabarty Ushnish , Yadav Surendra S. , Datta Swarnendu
Published: April 2024

ABSTRACT

Aim:

The aim of this study was to find out the relationship of conventional and/or novel cardiovascular risk factors with coronary artery disease severity in terms of SYNTAX scores in young (≤45 years) and aged (>45 years) patients.

Materials and Methods:

The final number of patients included in the study was 132 and divided into 2 groups: Group A was young patients with age less than 45 years, and in group B, the age was more than 45 years. The SYNTAX score was determined for each case based on the preoperative coronary angiogram using the Online SYNTAX score calculator version 2.11.

Results:

It was seen that 33% of patients in group A had high SYNTAX scores, as compared to only 8% in group B. This definitely shows that the younger population has more COMPLEX coronary artery lesions than the elderly.

Conclusion:

YOUNG patients have significantly higher levels of homocysteine as compared to the elderly. Serum homocysteine correlates with SYNTAX scores in YOUNG patients, with a sensitivity of 83.33%, specificity 91.67%, and diagnostic accuracy 86.67%. Percentage of Low HDL in YOUNG is significantly higher than in the elderly.
Assessment of Unmet Needs of Family Planning in Extended Postpartum Period in Women of Urban Slum of Maharashtra
Authors: Pande Bhanupriya Shivshankar , Patel Aashutosh Ramakant , Patel Shraddha , Gaikwad Sayali Raju , Pande Shivshankar J
Published: April 2024

Context:

Unmet need for family planning (FP) refers to the gap between the intentions to use FP methods and actual use. This poses a challenge to the FP program.

Aims:

The aim of this study was to find out the extent of unmet needs, associated sociodemographic factors, and possible reasons for unmet needs among women during the extended postpartum period (EPP).

Settings and Design:

This was a cross-sectional analytical study in a slum community of Nagpur coming under a preview of urban primary health center.

Subjects and Methods:

The listing of females who are in EPP was made. Two hundred seventy women were selected by systematic random sampling for a period of 7 months in an urban slum using pretested semi-structured questionnaire.

Statistical Analysis Used:

Descriptive statistics was used for summarization of the data. Statistical association was determined using the Chi-square test.

Results:

In the present study, the extent of unmet needs during EPP was 145 (39.189%), 110 (75.862%) for spacing the birth, and 35 (24.137%) for limiting the birth. Unmet need was significantly associated with socioeconomic status and number of living children. The main reason for the unmet need for FP was fear of side effects. (n = 127, 87.56%).

Conclusions:

The extended period of postpartum is an opportunity to provide FP services by adding more components on counseling and alleviating fear among women.
Knowledge, attitude, and practices of areca nut and betel quid chewing among the adult population – A questionnaire-based cross-sectional study
Authors: Gupta Juhi , Jain Vipul
Published: April 2024

Background:

The use of areca nut also known as supari or chaali is an age-old tradition and very popular in people living in South Asian countries. However, in general, people know very little about its ill effects.

Aims:

This study aimed to examine knowledge, attitudes, and practices regarding the health risks associated with chewing areca nuts and betel quid among the adult population and to evaluate the knowledge about its possible role as a contributing factor in oral cancer among the adult population.

Materials and Methods:

The unicentric cross-sectional survey was conducted on 1644 adult subjects belonging to the adult population of Aligarh and nearby places between March 2021 and December 2021. We analyzed the data using the Statistical Package for the Social Sciences (SPSS) software version 22.

Results:

The overall average age of the participants was 39.32 ± 14.18. The male-to-female ratio was 2:1. Among the study subjects, 54% were betel nut or betel quid chewers. Only 30.8% knew that areca nut may cause oral cancer and with low knowledge related to its systematic effect.

Conclusion:

Areca nut is a known carcinogenic agent and carries the risk of cancer even if it is used alone. However, information about the systemic ill effect especially its carcinogenic effect is very low among the general population.
Students’ perception toward traditional versus interactive lectures in preclinical operative dentistry course: A comparative cross-sectional study
Authors: Ahmed Marwa Abdalrhman , Sulaiman Aliaa Omer , Zain Israa Mohamed , Aljack Kamal Mubark , Awooda Elhadi Mohieldin
Published: April 2024

Background:

A lecture is one of the most common methods of teaching in higher education. The lecture is generally divided into interactive and traditional.

Objectives:

This study aimed to assess and compare senior and junior preclinical dental students’ perceptions of interactive lectures versus traditional lectures during the preclinical operative course.

Materials and Methods:

This was a descriptive, comparative cross-sectional study among 100 undergraduate students from Igraa College, Sudan. Students from 2 class years were involved; the first one was batch 2 (semester 6) and the second group was batch 3 (semester 5). Fourteen preclinical operative dentistry lectures were delivered to both classes (7 lectures were interactive and 7 were traditional) during the full-time course. At the end of the course, a self-administered questionnaire included questions about students’ demographic data and their perceptions toward traditional and interactive lectures. A comparison between different nonparametric data was done by Chi-square test with the level of significance set at P < 0.05.

Results:

The response rate was 77%, where male students were 26 (33.8%) and female students were 51 (66.2%). There was no statistically significant difference between sex and class year in terms of the student’s preference for the types of lecture. Female students 42 (54.5%) and male students 24 (31.2%) agreed that interactive lectures increase focus on the material more than traditional lectures. The majority of students from both class years agreed that interactive lectures help them in leadership skills 58 (75.4%) and improving their communication between professors and students 65 (84.4%).

Conclusions:

interactive teaching has been greatly accepted by students who were accustomed to traditional teaching with differences in the preference of either type of lecture.