bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral Healthcare Knowledge, Attitude, and Practice (KAP) of Primary School Students in Rural Areas Using Digital Technologies
Authors: Siripipatthanakul Supaprawat , Siripipattanakul Sutithep
Published: December 2024

This study uniquely employs digital technologies to investigate the relationship between oral care knowledge, attitude, and practice among school students in rural areas of Thailand. The research utilized an online questionnaire survey and convenience sampling to gather data from 438 respondents, parents of primary school students in Thailand. Descriptive data was tested using SPSS version 29, and the research hypotheses were tested using Structural Equation Modelling (PLS-SEM; ADANCO 2.3.3). The results suggest that educators and strategic planners should prioritize digital oral care knowledge to enhance oral healthcare practices and foster positive student attitudes. To ensure sustainable development in student oral care practices, it is recommended that schools, classes, parents, hospitals, dental professionals, and digital technology information be improved to enhance student knowledge and attitude. Qualitative investigations such as interviews and focus group discussions are recommended for further exploration.
Auditor’s Perception on the Level of Usage and Importance of Fraud Detection and Prevention through Software-Based Methods: Evidence from Sri Lanka
Authors: Fernando I. , Manawadu I.
Published: December 2024

The increasing number of fraudsters and the challenges of fraud recognition and mitigation have made it crucial for businesses to adopt modern fraud identification and prevention systems. Traditional methods are no longer sufficient, and modern fraudulent actions require sophisticated tactics for prevention and detection. Organisations must now employ software-based fraud detection and avoidance procedures to detect and prevent fraud in real time. This study aims to determine the usage and significance of software-based fraud prevention and identification approaches from the perspectives of auditors in Sri Lanka, a developing country during an economic crisis. Further, this study investigates the challenges faced by Sri Lankan businesses in integrating Information Technology (IT) in this area. A quantitative research approach was used, and primary data was gathered using a self-administered questionnaire. The study's sample included 104 internal and external auditors. Major findings from this study include that software-based fraud prevention techniques like firewalls, password protection, and virus scanning are the most popular and highly effective, while sophisticated techniques like genetic algorithms, K nearest neighbours, and random forests have the opposite effect. The study reveals that Sri Lankan businesses face challenges in fraud detection and prevention due to lack of knowledge, training, and evolving fraud patterns. The findings also reveal significant differences in perceptions between male and female auditors regarding the usage and importance of fraud prevention and detection tools, as well as specific challenges associated with their implementation. The findings aim to promote software-based methods among policymakers and practitioners to overcome implementation challenges.
Future Relevance of Innovative Information Technology in External Auditing and the Gap Between the Expertise in Sri Lanka
Authors: Hashen M. , Ajward R.
Published: December 2024

This study addresses a critical empirical gap by investigating the perceptions of external auditors in Sri Lanka regarding their current expertise and the future relevance such expertise in terms of innovative information technology (IT) in external auditing. The research also assesses whether discrepancies exist between auditors’ current IT capabilities and the expected expertise of emerging IT technologies. Additionally, it explores how specific auditor characteristics influence IT competence and perceptions of future relevance. A structured questionnaire was administered to a sample of 200 external auditors from both Big Four and non-Big Four firms, and the data were analyzed using descriptive and inferential statistical techniques. The findings indicate that while auditors acknowledge the growing importance of IT, a significant gap persists between their existing expertise and the skills required to adopt future IT tools effectively. This gap is most pronounced for advanced technologies such as machine learning, process mining, and robotic process automation. On the other hand, regression analysis highlights that work experience and hierarchical position of external auditors significantly influence IT knowledge and perceptions of relevance. Conversely, demographic factors such as age, gender, education, and firm size did not show a significant impact. The study underscores the need for targeted professional development, particularly for senior auditors, to bridge the technological gap. The results suggest that regulatory and educational bodies should implement strategic initiatives to ensure external auditors are equipped to meet the evolving demands of the audit profession in a rapidly changing technological landscape.
Left ventricular ejection time: its relation to left ventricular systolic function and functional capacity in cardiomyopathic patients
Authors: El Shahawy Eman S. , Hassan Asmaa A.
Published: December 2024

Background and aim

Left ventricular ejection time (LVET) was used to evaluate left ventricular function. Transthoracic echocardiogram was done, and parameters of LV systolic function by utilizing tissue Doppler imaging and two-dimensional strain were obtained. Moreover, the New York Heart Association (NYHA) functional class and 6 min walk test (6MWT) was investigated intending to detect the LVET value in the detection of LV systolic dysfunction in patients with dilated cardiomyopathy (DCM) and its relation to a functional capacity to assess the clinical severity of systolic heart failure.

Patients and methods

The enrolled 131 cases (101 myopathic patients and 30 case as a control). All cases do complete transthoracic echocardiogram to assess LV dimensions, volumes, and systolic function. Parameters of LV systolic function were compared in both groups. LVET was calculated, compared, and correlated with LV systolic function, NYHA class, and 6MWT.

Results

The LV volumes of patients with DCM were significantly elevated (P<0.001), while their LV systolic function was significantly reduced. Additionally, the cardiomyopathic group revealed a significant reduction in LVET in comparison to the control group (P=0.002). Moreover, the LVET correlates significantly with parameters of LV systolic function [LVEF by M-mode (r=0.01), LVEF by two-dimensional (r=0.17), left ventricular global longitudinal strain (r=0.09), left ventricular systolic velocity (r=0.20)]. Furthermore, LVET connected to NYHA functional class and 6MWT (r=−0.06, P<0.0001, r=0.04, P=0.01, respectively).

Conclusions

In individuals having DCM, LVET is a simple and valuable measure to diagnose LV systolic dysfunction as well as it has potential implications for assessing the clinical severity of heart failure.
Community-acquired Burkholderia cepacia: A Case of Encysted Pleural Effusion in an Immunocompetent Patient
Authors: Gupta Chhavi , Sharma Shiwangi , Das Shukla
Published: December 2024

Burkholderia cepacia commonly causes lung infection in patients with cystic fibrosis and chronic granulomatous disease, rarely found in immunocompetent patients. Here, we describe a case report of community-acquired B. cepacia in an immunocompetent patient. A 63-year-old male presented with complaints of dry cough, fever, and shortness of breath. Imaging revealed right encysted pleural effusion. 10 ml thick purulent fluid was aspirated, and B. cepacia was isolated in pyogenic cultures. The patient was treated with sulfamethoxazole–trimethoprim. Gradually, the patient improved clinically, and imaging showed complete resolution after 8 weeks of antimicrobial therapy.
Intestinal Tuberculosis Complicated by Autoimmune Hemolytic Anemia: A Rare Case Report and Treatment Outcome
Authors: Khan Ulma , Pandit Sanjay , Aravindhan Manikkodi Ravi , Dharra Gaurav , Aggarwal Rupal
Published: December 2024

Intestinal tuberculosis (TB) presenting with autoimmune hemolytic anemia (AIHA) is a rare clinical entity that poses diagnostic and therapeutic challenges. We present the case of a 26-year-old female with symptoms of malaise, fever, and gastrointestinal disturbances, diagnosed with intestinal TB complicated by warm-type AIHA. Despite initial difficulties in diagnosis, treatment with antitubercular therapy led to a significant improvement in symptoms and resolution of hemolysis. This case highlights the importance of considering TB as an underlying cause of AIHA, particularly in endemic regions, and underscores the effectiveness of timely intervention with appropriate therapy.
A Retrospective Cohort Study of Mucormycosis Infection in Patients with Previous History of COVID-19 in a Tertiary Care Hospital
Authors: Chakraborty Arkaprava , Ghafur Abdul , Ambika R. S. , Rayappa C.
Published: December 2024

Background:

Mucormycosis is an angioinvasive fungal infection mostly affecting patients with uncontrolled diabetes and immunocompromised status. It belongs to the order Mucorales, class Zygomycetes. It is one of the major causes of morbidity and mortality among invasive fungal infections. India witnessed an epidemic of mucormycosis during COVID-19 period.

Objective:

This study analyses the demography, risk factors, clinical features, and adverse effects of treatment in patients with mucormycosis admitted to our hospital during the pandemic.

Materials and Methods:

It is a retrospective cohort study carried out in a tertiary care hospital from May 2021 to November 2021. The cases of mucormycosis were identified based on either single positive test for fungal stain, fungal culture, or histopathology.

Results:

A total of 22 patients were included in this study. The mean age of the patients was 55.79 years (range 26–86), with 90.90% being males. Majority (68.18%) were diabetics. Of these, seven patients had diabetes for more than 10 years. All patients were previously diagnosed with COVID-19 before admitting to hospital and 66.67% received steroids previously. Magnetic resonance imaging showed sinus involvement in all patients (100%), soft tissue (90.90%), and orbital involvement (72.72%). Aseptate hyphae were seen in fungal stain (54.54%), histopathology (59.10%), and Rhizopus grown in fungal culture (31.81%) of the cases. A combination of surgical debridement and medical treatment with antifungal therapy was given.

Conclusions:

Mucormycosis is a life-threatening disease for post-COVID-19 patients with high rate of morbidity as well as mortality. Uncontrolled diabetes and previous use of steroids were additional risk factors for the development of mucormycosis among post-COVID patients.
Clinical Profile of Blood Culture-proven Typhoid and Paratyphoid Fever in Hospitalized Patients from a Tertiary Care Hospital in South India
Authors: Kandikuppa Ravi Teja , Gopalakrishnan Ram , Ramasubramanian Venkatasubramanian , Krishna Vidya , Nambi Panchatcharam Senthur , Sethuraman Nandini
Published: December 2024

Introduction:

Enteric fever is an important cause of community-acquired sub-acute febrile illness, particularly in India. Over the years, improved availability of blood cultures has helped increase the number of cases diagnosed and receive appropriate treatment.

Materials and Methods:

A retrospective observational study on the clinical profile of hospitalized blood culture-proven enteric fever patients from October 2018 to March 2023 was done.

Results:

Of 125 patients, 68 (54.4%) had an infection with Salmonella typhi, and 57 patients (45.6%) with Salmonella paratyphi A. 69 (55.2%) had fever for 1–3-week duration. Among the 55 children, 32 (58.1%) had infection with S. paratyphi A and 23 (41.81%) with S. typhi. There were no life-threatening complications such as intestinal hemorrhage, perforation, or death. Seventy-seven (61.6%) of patients received ceftriaxone and azithromycin combination antibiotic therapy. Fluoroquinolone resistance was present in all the isolates (100%). Sixteen patients (12.8%) received inappropriate antibiotics before admission. Absolute eosinopenia (0%–1%) was seen in 102 (81.6%). The overall mean time to defervescence (TTD) in the study was 3.7 ± 1.3 days. The TTD was 0.7 days longer in patients presenting with fever for <7 days compared with patients with a fever of 1–3-week duration, with a statistically significant P = 0.012.

Conclusions:

Sending appropriate blood cultures, avoidance of inappropriate empiric antibiotic therapy, using combination antibiotic therapy, and a vaccine that protects against both S. typhi and paratyphi serotypes are some of the essential steps in reducing the burden of enteric fever.
Full-mouth Implant-supported Rehabilitation Using the Additive Manufacturing Technology
Authors: Garg Nisha , Phukela Sumit Singh
Published: December 2024

This case report details the patient’s rehabilitation using fixed partial dentures for the maxilla and the mandible that are supported by implants. In the mandibular arch, six implants were effectively inserted, and there were no difficulties during the healing process. In the meantime, a fixed dental prosthesis was used to restore the maxillary arch when taking esthetics and functionality into account. The direct metal laser sintered (DMLS) porcelain-veneered prosthesis used to restore the mandibular arch was found to be clinically, physiologically, and mechanically stable. The patient was happy with the prosthesis’ appearance and functional capabilities. In the current report, DMLS restorations were utilized due to their advantages of accurate restoration and mediocre accuracy.
Clinical and laboratory profile and its outcome in scrub typhus-positive acute febrile illness cases in the Pediatric Department of BRD Medical College, Gorakhpur
Authors: Chaudhary Anamika , Sharma Bhoopendra , Pandey Ashok Kumar , Singh Priyanka
Published: December 2024

Background:

A common cause of acute febrile illness in India is scrub typhus, a zoonosis caused by Orientia tsutsugamushi. It is a reemerging cause of acute undifferentiated fever in India and around the world. It was previously thought to be a seasonal disease occurring mainly in rural areas, but cases are now frequently detected in urban areas outside the monsoon season. This study determined the prevalence of scrub typhus and investigated the clinical and laboratory characteristics of scrub typhus-positive AFI cases and their outcomes.

Material and Methods:

The hospital based cross-sectional study included rapid tests for malaria parasites, scrub typhus immunoglobulin M (IgM) (enzyme-linked immunosorbent assay), typhoid IgM, and dengue IgM. Patients underwent the required investigations, such as cerebrospinal fluid examination.

Results:

Seventy-two (37.1%) of the 194 AFI patients were scrub typhus positive. The male-to-female ratio was 0.8:1. The most common symptom among the 72 scrub typhus-positive AFI patients was loose stools (61.1%), followed by vomiting (59.7%), abdominal pain (52.8%), headache (30.6%), swelling (13.9%), cramps (13.9%), and rash (11.1%). About 69.7% of rural land is scrub typhus positive. Fifty-four (75.0%) patients had thrombocytopenia, whereas hyperbilirubinemia was noted in 7 (9.7%) cases. Impaired renal function was noted in 9 (12.5%) cases. Hypocalcemia was reported in 25 (36.7%) patients, hyponatremia in 40 (55.6%) cases, and hypokalemia in 2 (2.8%) cases.

Conclusion:

Scrub typhus is common, accounting for a third of AFI cases. It is more common in rural and female-dominated areas. A child admitted with AFI with hepatosplenomegaly, lymphadenopathy, and anemia with thrombocytopenia must be evaluated for scrub typhus.
A Survey and Comparison the Amount of Important Pollutants in the Exhaust of Light Gasoline Vehicles Referring to the Technical Inspection Centers in Urban Areas: A Case Study in Iran
Authors: Khodabakhshi Abbas , Alijanvand Moluk Hadi , Mohammadi-Moghadam Fazel , Mutauligalleh kolaie Abdullah , Ebrahimi Soghra
Published: December 2024

Aims:

Traffic congestion and the increase in the number of vehicles lead to an increase in vehicle emissions, consequently causing, a decrease in ambient air quality. The objective of this study is to investigate and compare the concentrations of exhaust gases, namely carbon dioxide (CO2), carbon monoxide (CO), hydrocarbon (HC), and oxygen (O2), emitted by cars tested at the Technical Inspection Centers in Shahrekord and Rasht.

Methods:

In this cross-sectional study, primary data from 82,316 cars examined at the technical centers in Shahrekord and Rasht were collected and subjected to statistical analysis. The car frequencies considered were 1000 and above. Overall, 16 types of Iranian and foreign cars were assessed, with 51,919 cars from Rasht and 30,397 cars from Shahrekord. The statistical analysis employed a six-way multivariate analysis of variance.

Results:

The proportion of carbureted cars that were rejected exceeded that of injection cars, while the percentage of cars rejected due to CO2 emissions was lower than that of authorized cars (P < 0.05). Furthermore, the likelihood of these associations occurring in Shahrekord city was higher than in Rasht city, with a chance ratio and confidence interval (CI) of 95. The odds ratios (ORs) (95% CI) were 1.936 (1.829–2.050) and 3.036 (2.924–3.151), respectively. Moreover, the rejection rates were higher (P < 0.05) for cars manufactured in Iran compared to foreign-made cars, private vehicles compared to public vehicles, and cars with CO pollution compared to licensed cars. The likelihood of these associations transpiring in Shahrekord city, in comparison to Rasht city, were as follows: OR (95% CI) of 0.793 (0.755–0.834), 0.667 (0.743–0.598), and 0.018 (0.016–0.020), respectively. The audit analysis, which involved a linear combination of O2, CO, CO2, HC, and vehicle age, successfully differentiated between cars in Shahrekord and Rasht, yielding a correct prediction rate of 81.3% (Wilks’ Lambda statistic = 0.687, Eigen value = 0.455, Canonical correlation value = 0.60 with a P < 0.0001).

Conclusion:

The findings of this study offer a practical approach to address the complexities arising from the emission of polluting gases, contributing to the global warming phenomenon.
Risk Factors in Periodontitis
Authors: Ravindran Arjun Machingal , Chandran Nanditha , Stephenraj Sindhuja , Indrajith D. , Krishna Rahul , Rasha
Published: December 2024

Periodontitis is a chronic inflammatory condition initiated by dental plaque that progressively damages the structures supporting teeth. It involves complex interactions between bacterial pathogens, the host’s immune responses, and environmental factors such as smoking. Conventionally, periodontitis was attributed to poor oral hygiene, but recent decades have revealed that specific bacterial infections and individual susceptibility play crucial roles. This has shifted the focus toward identifying at-risk individuals and modifiable risk factors. The pathogenesis of periodontitis centers on the dental biofilm, which harbors Gram-negative anaerobic bacteria like Porphyromonas gingivalis. These bacteria trigger immune responses, leading to inflammation and tissue destruction. The disease progresses through acute episodes of tissue damage followed by remission periods. Diabetes mellitus significantly correlates with periodontitis, with evidence suggesting that treating periodontal disease can improve glycemic control in diabetic patients. Smoking is a major environmental risk factor, increasing the prevalence of periodontal pathogens and exacerbating disease outcomes. In addition, periodontitis is linked to myocardial infarction, endothelial dysfunction, peripheral artery disease (PAD), stroke, and heart failure through shared risk factors and inflammatory pathways. Periodontal treatment shows promise in mitigating systemic conditions such as endothelial dysfunction and PAD, although more research is needed to establish definitive links and therapeutic benefits. The ongoing investigation into these associations underscores the importance of periodontal health in overall well-being.
Descriptive study of patient outcome and satisfaction with telemedicine and physical consultation during and after the COVID-19 pandemic
Authors: Asodariya Ronak , Bhatnagar Kavita R , Jaisingh Kirti , Tandon Manjari , Pandey Latika , Agrawal Nikhil , Misra Sanjeev
Published: December 2024

Purpose:

This study was conducted to assess patients’ outcome and satisfaction with the eye care received with telemedicine and physical consultation at a tertiary care hospital during and after the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

A descriptive study was carried out on 6052 patients who consulted for eye illness at a tertiary care hospital between April 2020 and December 2022. An outcome scoring system was developed and validated for the assessment of patient outcome after providing treatment on telemedicine consultation and physical consultation. Outcome scores for various symptoms were compared pretreatment and posttreatment. Telehealth Usability Questionnaire (TUQ) was used through an online survey to assess patients’ satisfaction with teleophthalmology services during the COVID-19 pandemic. An 18-item Patient Satisfaction Questionnaire (PSQ-18) was used to assess the same with physical consultation.

Results:

A total of 6052 patients were included in the study. Physical consultation group had 2485 patients (41.06%) and the telemedicine group had 3567 patients (58.93%). Male patients constituted 63.11% and females were 36.89%. There was a significant improvement in outcome scores for pain and redness in both physical and telemedicine consultation groups (P < 0.0001). All subgroups of TUQ had significantly high scores (including usefulness, ease of use and learnability, interface quality, interaction quality, and satisfaction and future use), except one subgroup (reliability). Uneducated patients were significantly more satisfied with telemedicine compared to educated patients (P = 0.044).

Conclusion:

Majority of patients expressed satisfaction with teleophthalmology services. The recent pandemic paved the way for the future integration of telemedicine in ophthalmology, especially if virtual eye examinations attain a higher level of reliability.
Comparative evaluation of localized genotoxicity between the field of focus and scatter following exposure to cone beam computed tomography using buccal mucosal micronuclei assay: A cross-sectional study
Authors: Sreeenivas Rajeswari , Nadil Algi , Thomas Priya , Baby Giju George , Mathew Deepu George , Latti Pooja , George Jiss
Published: December 2024

Introduction: X-rays, a crucial diagnostic tool, are known for their cytotoxic and mutagenic effects, capable of inducing gene mutations and chromosomal aberrations. Despite this, the risks, especially from dental X-ray machines, are often overlooked. Digital X-ray imaging, particularly cone-beam computed tomography (CBCT), is now common in dental practice due to its reduced radiation dose, high accuracy, and rapid scanning. However, no radiation dose is entirely safe, and biological effects accumulate over time. A significant drawback of CBCT is its emission of scattered X-rays. Biomonitoring studies, such as the micronucleus (MN) assay on buccal mucosal cells, are essential for evaluating genotoxic risk from diagnostic radiation. To evaluate and compare the genotoxic and cytotoxic damage in exfoliated cells, using the buccal cytome assay following exposure to x-ray radiation during partial CBCT exposure between the field of direct and scatter radiation. Materials and methods: To establish the genotoxic and cytotoxic impacts of CBCT radiation on the mucosa and its effects on the basal cell layer of the epithelium, the research enlisted 35 subjects aged 18 to 60 years. Before and after CBCT exposure, samples of exfoliated oral mucosa were stained with Feulgen. Nuclear anomalies were then graded using image analysis software, and 500 intact exfoliated epithelial cells were checked for micronuclei and other nuclear anomalies according to 1992 criteria set by Tolbert et al. Result: The results showed that cytotoxic anomalies, such as karyorrhexis and karyolysis, were significant with a P-value of <0.01, while all other anomalies, including micronuclei, were not significant. However, between post exposure and scattered radiation, all cytotoxic and genotoxic anomalies were insignificant. Conclusion: CBCT induces significant cytotoxic effects in oral mucosa cells, such as increased pyknosis, karyolysis, and karyorrhexis, but does not cause significant genotoxic damage. Scattered radiation also contributes to cytotoxic effects, though to a lesser extent than direct exposure. The radiation dose from CBCT, at lower levels, affects both the exposure site and the contralateral buccal mucosa equally, indicating that higher doses could potentially lead to greater cellular damage. Considering the established link between cytotoxicity and carcinogenesis, it is imperative to use CBCT with careful deliberation, ensuring adherence to the ALARA (As Low As Reasonably Achievable) principle to effectively mitigate potential risks.
Evaluation of Correlation between C-reactive Protein (CRP) Levels in Synovial Lavage Fluid and Clinical Staging of Temporomandibular Joint Internal Derangement Disorders by Diagnostic Arthroscopy: A Prospective Study
Authors: Singhal Mayank , Goyal Manoj , Gupta D.S. , Bhardwaj Saurabh
Published: December 2024

Introduction: Pain in the temporomandibular joint (TMJ) is thecommonsymptom in the patients with TMD. Unfortunately, the factors mediating pain are not sufficiently known to permitspecific treatment. Therefore the knowledge about themediators and their specific effects on local inflammation and pain is very important. Material and Methods: seventy-two patients with the TMJ disorder based on the results of clinical and radiographic examination were examined and included in the study. Samples of lavage fluid were obtained prior to arthrocentesis by washing the joint with saline. Samples were assayed for CRP levels using Nycocard test (solid phase sandwich format immunometric assay), and concentrations were measured. Subjective pain was assessed by patients using a visual analog scale. Bone changes in the condyle were assessed by radiographs, and synovitis was assessed based on arthroscopic findings. Results: CRP was present in significantly higher concentrations in the synovial fluid of the TMJ, and the CRP levels were in significant correlation with clinical parameters as well as the arthroscopic findings in the patients. CRP levels (as per nycocard test) were 4.50 in patients suffering from Internal Derangement type II (SD ± 1.04) whereas in subjects with Internal Derangement type III it was 9.64 (SD ± 3.08), t-value 1.01. Conclusion: The CRP level in the TMJ synovial fluid significantly reflects the intensity of pain, or synovitis and the detection of high concentrations of the same is a possible marker of degradation in the TMJ.
Comparative Evaluation of Occlusion with and Without Finishing and Detailing Post Orthodontic Treatment Using T-Scan: A Prospective Follow-Up Study
Authors: Chattopadhyay Anwesha , Pradhan Tejashri , Acharya Aditya
Published: December 2024

Introduction: The phases of orthodontic treatment include Initial Leveling and aligning, space closure, finishing detailing, settling, and retention. The phase of finishing and detailing in orthodontic treatment has a crucial role in refining the occlusion and ensuring long-term stability. However, the effectiveness of orthodontic treatment is not solely assessed by the alignment of teeth and jaws but also by achieving stable occlusion posttreatment. Hence, the study aims to evaluate postorthodontic occlusion in patients who meet the set criteria of finishing and detailing compared to those who have not, using a digital occlusal analyzer. Materials and methods: The posttreatment records of 42 patients who had undergone debonding after fixed mechanotherapy were evaluated for categorizing the patients based on the inclusion criteria into Groups A and B. The occlusal parameters of the patients were evaluated at time intervals—T1 (30 min after debonding), T2 (3 months after debonding), and T3 (6 months after debonding). The occlusal parameters evaluated were—force distribution in the right and left sides and anterior–posterior force %. Results: In a comparative evaluation between Groups A and B, it was seen that occlusion time, force distribution between the right and left sides, and the anteroposterior force distribution in the anterior and the posterior aspect were higher in Group B as compared to A. Conclusion: The results of our study indicated that in patients who had met the goals of finishing and detailing, the occlusal parameters showed near-ideal values as compared to the patients who had not met the goals of finishing and detailing. Digital analysis obtained using T-Scan is essential during the process of finishing and detailing to obtain a stable and well-balanced occlusion by the end of the orthodontic treatment.
Cherubism and Central Giant-Cell Granuloma: A Diagnostic Predicament
Authors: Chakravarthi P. Srinivas , Selvan Preetha , Sanjana Lingampalli , Praveena Ruttala Sai , Badam Venkat Ramana Reddy , Ranganathan K.
Published: December 2024

Cherubism and central giant cell granuloma (CGCG) present a diagnostic puzzle. Both are uncommon, benign jaw lesions harboring giant cells. Their overlapping features make them difficult to distinguish and require correlation of clinical presentation, radiographic findings, and histopathological features for a definitive diagnosis.
Study of Neem Fiber Composite Toothbrush – Latest Approach for the Prevention of Oral Disease
Authors: Raja Thandavamoorthy , Thirumalaivasan N. , Shivalingam Chitra
Published: December 2024

Introduction: Using a toothbrush made from natural neem wood has several benefits, including reducing the risk of gum disease, reducing inflammation in the gums, decreasing the buildup of plaque, and whitening the teeth. Materials and Methods: Since this is the case, neem twigs fiber toothbrushes and neem leaf powder was proven effective in awarding against tooth decay and oral disease. In this present work, a fiber extracted from neem twigs is impregnated in neem leaf powder influenced ploy lactic acid and identified their functional groups, crystalline effect, and morphological analysis. Results: Results reveal the FTIR analysis confirms a sharp peak at 1737 cm−1 indicating the C═O vibrations and from the XRD analysis it was confirmed more amorphous region of 82% which is used to improve the bonding strength of fiber with other bonding agents. Conclusion: Based on the results and requirements the neem fiber toothbrush was developed to improve the teeth quality and reduce the oral disease for human health.
Papillon-Lefevre syndrome: Case series
Authors: Patel Vasumati I. , Thakkar Karan R. , Gupta Shalini S. , Pujara Meghna J.
Published: December 2024

Papillon-Lefevre syndrome (PLS) is an exceptional autosomal recessive disorder characterized by palmoplantar keratinization and premature loss of deciduous and permanent teeth. The palmoplantar keratoderma commonly has its onset between the ages of 1 and 4 years with severe periodontitis initiating at 3 or 4 years old. Parental consanguinity has been demonstrated in 20% to 40% of the cases. Management and preservation of teeth in such patients is a challenge to periodontists. Genetic studies have shown that mutation in the major gene locus of chromosome 11q14.1–q14.3 with the loss of function of the Cathepsin-C (CTSC) gene is responsible for PLS. An early diagnosis of the syndrome can help preserve the teeth through early institution of treatment, using a multidisciplinary approach. We hereby present four cases having all the characteristic features of the syndrome.
A case of dermatofibrosarcoma protuberance with myoid differentiation – A rare occurrence
Authors: Shetty Nisha , Sharma Swati , Kudva Adarsh
Published: December 2024

Dermatofibrosarcoma protuberans (DFSP) of the head and neck is a rare, locally infiltrative, low-grade sarcoma that typically involves the dermis and surrounding structures occurring in middle-aged adults. The common clinical presentation consists of a slowly enlarging, indurated plaque, usually asymptomatic, found on the trunk. In this case report, we present a case of a 37-year-old male patient with facial swelling which was diagnosed as classic DFSP along with myoid differentiation, which is a rare occurrence. Here, we have discussed the clinicopathologic features and histogenesis that can aid in the diagnosis and treatment of this condition.
Malignant fibrous histiocytoma of the mandible: A rare case report with diagnostic challenge and treatment approach
Authors: Sharma Preethi N. , Chaudhary Minal S. , Hande Alka H. , Patil Swati K.
Published: December 2024

Malignant fibrous histiocytoma (MFH), now termed undifferentiated pleomorphic sarcoma (UPS), is a high-grade tumour, mostly affecting the extremities and retroperitoneum. It is a rare entity in the mandible. After a literature search in the PubMed database, only 15 cases have been reported, indicating how uncommon it is in the mandible. In this instance, we document an unusual occurrence of MFH, affecting the mandible in a 37-year-old male patient. Histopathology of the biopsy specimen along with the strong positivity to immunohistochemical markers such as Vimentin and CD68 confirmed the diagnosis of MFH. It is a rare entity presenting diagnostic and therapeutic challenges requiring a multidisciplinary approach for optimal management and treatment.
Association between alcohol consumption and sleep difficulty in a nationwide Korean survey
Authors: Hwang In Cheol , Park Yujin , Ahn Hong Yup , Kim Kwan Jung , Park So-Jung
Published: December 2024

Background:

The data on the association between alcohol intake and sleep quality in a community-based setting are lacking. This study examined overall sleep difficulty according to alcohol habits among Korean adults.

Materials and Methods:

We analyzed data from 4937 adults who responded to questions about sleep difficulty and drinking habits from the 2019 Korea National Health and Nutrition Examination Survey. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for substantial sleep difficulty based on the frequency or amount of alcohol consumption in total and age- and sex-stratified subgroup analyses.

Results:

Approximately 8.5% of the study population had substantial sleep difficulty. Individuals who drank <1 per week (frequency) or 1–2 cups per time (amount) had the lowest prevalence of substantial sleep difficulty, even compared with nondrinkers. Among drinkers, the association between alcohol use and sleep difficulty was significant in a dose-dependent manner (P for trend: 0.003 in frequency and < 0.001 in amount). Subgroup analysis revealed that significant linear relationships were robust for adults aged <50 years ([ORs] 1.20 [95% CIs 1.03–1.40] for frequency and 1.25 [1.10–1.42] for amount) and females (1.26 [1.10–1.44] for amount).

Conclusion:

Alcohol consumption is associated with increased sleep difficulties, especially in younger adults and women, underscoring the need for targeted interventions and in-depth research on the effects of alcohol on sleep.
Psoriasis and malignancy, is there a link? Data from the Malaysian Psoriasis Registry
Authors: Mashor Mazliha , Chan Gin Peng , Robinson Suganthy , Tang Min Moon
Published: December 2024

Background:

The risk of malignancy in psoriasis patients may be attributed to the chronic inflammatory course of the disease, the associated comorbidities and the treatment modalities employed. However, the association between psoriasis and malignancy has not been explored among Asians in depth. Our aim is to determine the frequency of malignancy and to identify the risk factors associated with malignancy among psoriasis patients in Malaysia.

Materials and Methods:

A retrospective cross-sectional study utilising the database of the Malaysian Psoriasis Registry was conducted. All psoriasis patients registered from 1 January 2007 to 31 December 2018 who were diagnosed with malignancy during their lifetime were included.

Results:

There were 123 (0.57%) psoriasis patients who reported a malignancy from a total of 21,735 patients. The male-to-female ratio was 1:1.41. The rate of malignancy was highest among inverse psoriasis (4.81%) patients followed by localised pustular psoriasis (1.79%), guttate psoriasis (0.81%), plaque psoriasis (0.57%) and erythrodermic psoriasis (0.26%). The ethnic Chinese had the highest rate of malignancy (32.5%) followed by Malays (31.7%) and Indians (14.6%). The top five cancers reported among our psoriasis patients were breast cancer, haematological cancers, colorectal cancer, female genital cancers and brain cancers. Only 1 paediatric patient (16 years old) had malignancy which was a brain tumour.

Conclusions:

The frequency of malignancy was 0.57% among psoriasis patients in our registry. Being older than 40 years and female were significantly associated with malignancy in psoriasis patients. The rate of malignancy was highest among inverse psoriasis patients.
Prevalence of dry eye disease in rheumatoid arthritis patients and its correlation with duration of rheumatoid arthritis
Authors: Gandhi Priyanshi Ashishbhai , Samar Arun Kumar , Kathuria Nitish , Mishra Avinash , Chhabra Harbeer Singh
Published: December 2024

Background:

Dry eye is a condition of the tear film and ocular surface that causes discomfort, visual disturbance, and tear film instability. The subjective symptoms in dry eye disease (DED) are often nonspecific. More or less common are conjunctival redness and damage to the ocular surface with punctate epithelial erosions. Rheumatoid arthritis (RA) is a systemic autoimmune disease with approximately 25% of patients having ocular manifestations.

Methodology:

A prospective observational study was carried out in the ophthalmology outpatient department of a tertiary care center. There were 200 RA patients enrolled. Dry eye workup was done using various tests and the Ocular Surface Disease Index questionnaire. RA patients were divided on the basis of duration of illness into two groups. The results of dry eye tests were compared between these two groups.

Results:

Out of 200 RA patients, 89% were females. The overall prevalence of dry eye was 52.5% according to Schirmer’s test without anesthesia. There were 112 patients who were suffering from RA for <5 years and another group of 88 patients who were suffering for ≥5 years. Schirmer’s test and corneal fluorescein staining suggested that the patients with longer duration of RA are more prone to DED.

Conclusion:

The prevalence of dry eyes in patients with RA is high. Chronic ocular surface changes were observed with the longer duration of RA disease activity which affects the quality of life in such patients.
Development and Validation of a Filipino Version of Obstetric Quality of Recovery-10
Authors: Carandang Rafael Jacob T. , Pablo Ma. Carmela B. , Bonus Guada Marie M. , Quintin Ma. Patricia Mae J. , Guo Nan , Sultan Pervez
Published: December 2024

ABSTRACT

Background:

The Obstetric Quality of Recovery-10 (ObsQoR-10) is a patient-reported outcome measure that provides a holistic assessment on the quality of in-hospital postpartum functional recovery. Validated across several countries in various languages, it has shown great potential for widespread global acceptance in both clinical practice and research. We aimed to develop a Filipino version of the ObsQoR-10 and to evaluate its validity, reliability, and feasibility.

Methods:

One hundred women who had elective cesarean delivery (CD) completed the ObsQoR-10-Filipino and EuroQol five-dimensional 3 L Filipino version questionnaires (including a Global Health Visual Analog Scale [GHVAS]) 24 h after delivery. Twenty-five women completed the ObsQoR-10-Filipino survey again 25 h after delivery. Validity was assessed by evaluation of convergent validity, discriminant validity, and hypothesis testing. Reliability was assessed by evaluating internal consistency, split-half reliability, and test–retest reliability; and (iv) floor and ceiling effects.

Results:

The ObsQoR-10-Filipino scores showed good and moderate correlation to the EQ-5D-3 L scores (r = −0.636; 95% confidence interval [CI]: −0.740–−0.503, P < 0.001) and to the GHVAS scores (r = 0.387; 95% CI: 0.207–0.543, P < 0.001), respectively. ObsQoR-10-Filipino discriminated well between good (GHVAS score ≥ 70, 68.4 ± 12.9) and poor recovery (GHVAS score < 70, 55.1 + 12.9). Internal consistency was acceptable (Cronbach’s α =0.76), and split-half reliability was very good (Spearman–Brown Prophesy Reliability Estimate = 0.87). Test–retest reliability was excellent (intraclass correlation coefficient = 0.973; 95% CI: 0.873–0.976). No floor or ceiling effects were observed. The recruitment rate and completion rate were 92% and 91%, respectively. No correlation was observed between the ObsQoR-10-Filipino scores and factors such as maternal age, gestational age, blood loss, and American Society of Anesthesiologists classification.

Conclusion:

The ObsQoR-10-Filipino is a valid, reliable, and feasible tool for assessing inatient postpartum recovery in Filipino-speaking women undergoing elective CD.
A Case Report of Intraoperative Awareness under General Endotracheal Anesthesia during Decompressive Laminectomy T3–T4
Authors: Molina Jan Marteen Diaz
Published: December 2024

ABSTRACT

Intraoperative awareness during general anesthesia remains a significant concern. This report presents a rare case of a 40-year-old male patient, experiencing intraoperative awareness during an elective decompressive laminectomy T3–T4 for spinal cord compression secondary to an epidural abscess. Despite no comorbidities and being classified as American Society of Anesthesiologists II, the patient postoperatively reported recalling intraoperative events. Notably, intraoperative findings revealed malfunctioning of the anesthesia machine’s bellows and a vaporizer installation issue. This mishap suggests equipment failure as the potential cause of reduced anesthetic delivery. Using the Brice protocol, the patient’s claims were confirmed as he recalled specific discussions during the operation, though he reported no pain. The team acknowledged and apologized for the awareness incident, assuring patient safety. Awareness, although rare, can be distressing and might result from anesthesia underdosing, equipment failure, or anesthetic application errors. Anesthesiologists must remain vigilant, ensuring equipment functionality, considering increased anesthetic doses when safe, and promptly addressing patient claims of intraoperative awareness. Proper communication, documentation, and patient follow-up are crucial in managing these cases effectively.
A Case Report on the Obstetric Anesthesia Management of a Patient with Gorham–Stout Disease for Elective Cesarean Section
Authors: Noble Sher William Labordo , Odi Alexandra Nina
Published: December 2024

ABSTRACT

Gorham–Stout disease (GSD) is a rare bone condition characterized by osteolysis, angiomatosis, and lymphangiomatosis. This paper presents a case, in which a 38-year-old pregnant female with GSD underwent cesarean delivery due to a low-lying placenta. Her medical history, which included a previous surgical intervention for an intraoral mass attributed to GSD and a course of radiotherapy, suggested potential difficulties in both securing the airway and instituting neuraxial anesthesia, as well as potential complications, including perioperative bleeding. In this case, tailored anesthetic management strategies and interdisciplinary collaboration helped achieve optimal outcomes for the mother and successful delivery of a healthy baby. In particular, combined spinal and epidural anesthesia avoided the need for GA, and provided a rapid onset and titratable anesthesia with minimal systemic effects. Furthermore, vigilant monitoring of hemodynamic parameters was also paramount in mitigating the risks associated with both GSD and pregnancy itself.
Efficiency of Packed Red Cell Utilization and Establishment of Effective Maximum Surgical Blood Order Schedule in Elective Coronary Artery Bypass Graft Surgery in a Specialized Tertiary Care Center
Authors: Rayos Del Sol Joanna Marie Dalisay
Published: December 2024

ABSTRACT

Background:

Implementation of blood conservation protocol may increase the efficiency of blood utilization and optimize the maximum surgical blood ordering schedule (MSBOS) in our institution. The primary objectives of this study are to evaluate the efficient utilization of a fixed blood request of 4 units of packed red blood cells (PRBCs) and to establish an effective MSBOS on primary isolated elective coronary artery bypass graft (CABG).

Methodology:

This was a retrospective, analytical, observational, cohort type of study conducted through chart review of CABG patients from January 2018 to December 2019. Indices used to evaluate blood utilization efficiency were crossmatch to transfusion (C/T) ratio, transfusion probability (T%), and transfusion index (TI). MSBOS was computed based on the data gathered.

Results:

A total of 77 patients were included in this study. Blood transfusion based on C/T ratio was associated with body surface area <1.75 m2 (P = 0.006) and involvement of distal grafts >3 vessels (P = 0.042). Overall, C/T ratio was 2.44, T% was 70.1%, and TI was 1.69. Unutilized blood was measured at 59%. The computed MSBOS for elective CABG was at 2 units (2.53).

Conclusion:

There is efficient PRBC utilization in primary elective CABG when the blood indices were used. Evidence-based MSBOS is established and the previous 4 units PRBC can be reduced to 2 units to promote C/T ratio <2 as evidence of an optimal blood utilization.
Multiple Fractures with Bony Deformities: An Unusual Clinical Presentation of Distal Renal Tubular Acidosis
Authors: Karthika I. K. , Kavati Hemanth , Satapathy Amit Kumar
Published: December 2024

Renal tubular acidosis (RTA) is characterized by hyperchloremic metabolic acidosis resulting from defective urinary acidification. Though rickets with bony deformity is a common manifestation in proximal RTA, it is rarely seen in children with distal RTA. We are reporting three cases of distal RTA who presented with multiple fractures of bones and had radiological evidence of rickets. All three children had normal anion gap metabolic acidosis with hypercalciuria. Ultrasound revealed medullary nephrocalcinosis in all three children. All of them had shown improvement following bicarbonate therapy and potassium supplements. Early diagnosis not only helps prevent complications like fractures but also ensures optimal growth and development.