bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Relationship between Death Perspectives of Doctors Working in the Emergency Department and Termination of Resuscitation
Authors: Simsek Salih Denis , Karakus Ali , Polat Mustafa , Zortuk Okkes , Iflazoglu Anil , Bayar Pınar Yücel
Published: November 2024

Introduction:

Criteria for terminating resuscitations have been identified in the literature such as no VF/VT rhythm during cardiopulmonary resuscitation (CPR). People’s perception of death varies depending on social, geographical, cultural, and educational factors. The Death Perception Scale (DPS) was developed to measure these variations. This study aims to evaluate the relationship between individuals’ perspectives on death, the CPR process they apply in the emergency room, and the factors that affect it.

Materials and Methods:

The study was conducted on physicians working in emergency departments in Hatay province. The participating physicians completed a 39-question test, which included multiple-choice and DPS questions, to record their demographic data, education, and the situations they consider when terminating CPR. The data were collected digitally. IBM SPSS 27 and GraphPad Prism were used for data analysis.

Results:

79 physicians participated in the study, the mean age of these physicians was 27.53 ± 3.61, and 45.6% were female. The average tenure as a physician was 2.81 years, while the average duration of work in the emergency department was 2.25 years. No statistically significant relationship was found between the change in the duration of working in the emergency department and the change in the medical profession and DPS among the physicians included in the study. No relationship was found between the degree of the physician (general practitioner, resident, and specialist) and the CPR termination times of the patients.

Conclusions:

Analyzing individual characteristics with objective values while managing a terminally ill patient will enhance perceptual integrity.
A Study of Fire Safety Knowledge among Health-care Professionals in a Tertiary Care Teaching Hospital
Authors: Soman Suresh , Rupakumar Lakkhumi C. , Suresh Nirupama C. , Naik Aakash , Guduru Abhiram Archith
Published: November 2024

Background:

According to media sources, from August 2020 to April 2022, 122 people died in 29 major hospital fires across India. Several fire incidents in hospitals have lately been recorded around the country, notably at the AIIMS in New Delhi, the LNJP Hospital in Delhi, the Gandhi Hospital in Hyderabad, the ESIC Kamgar Hospital in Mumbai, and many others.

Methodology:

A cross-sectional study was conducted in an 1800-bed tertiary care teaching hospital using a standardized validated questionnaire to assess fire safety knowledge among health-care professionals.

Results:

The result indicates that 1% of health-care professionals had excellent knowledge level, 82% had average to good knowledge of fire safety, whereas only 17% had poor to below-average knowledge. The study outcome shows that there is no significant difference concerning sociodemographic variables with knowledge level, such as “gender” and “profession,” whereas “age” and “first training period” showed some significant change in knowledge level regarding fire safety among health-care workers.

Conclusion:

Health-care professionals have average-good knowledge of fire safety, which can be upgraded to better levels through classes and hands-on training by conducting regular mock drills.
Accessibility Requirements in Academic Buildings for Teaching Hospitals: A Cross-sectional Study
Authors: Khan Seema , Bhardwaj Nitin Dutt , Srivastava Pradeep , Suhaib Mahwish , Jain Anmol , Pal Meenu
Published: November 2024

Introduction:

Equal and nondiscriminatory access in the built environment enables persons with disabilities to move and interact freely without encountering any hindrances or barriers. As per the University Grants Commission, India, all universities and colleges must provide 3% reservation to disabled students. Ensuring equal access to education is crucial, especially for individuals with disabilities. People with disabilities suffer from poor access to academic and cultural facilities that an institution offers; hence, the purpose of this study is to analyze the accessibility compliance of academic buildings in terms of the design and infrastructure with the existing standards.

Materials and Methods:

The observational study was conducted in the Central Library, New Teaching Block, and Convention Centre at a Tertiary Care Government Teaching Hospital in North India, for 2 months. An observational checklist was used for data collection, which was made using Harmonized Guidelines and Standards for Universal Accessibility in India, 2021, and Accessibility Guidelines and Standards for Higher Education Institutions and Universities, Government of India.

Results:

The overall compliance of the Central Library, New Teaching Block, and Convention Centre was 49%, 42%, and 39%, respectively. In the Central Library, of 21 parameters, 12 parameters showed compliance ≥50% and 10 parameters scored ≥50% in the New Teaching Block. In the Convention Centre, 19 parameters were observed, of which eight parameters scored ≥50%.

Conclusion:

The data indicate the development of more accessible facilities for people with disabilities on the university premises. Implementing better infrastructure and technology shall create more inclusive and equitable educational environments.
Management of Biomedical Waste: An Overview of a Tertiary Care Teaching Hospital in India
Authors: Suhaib Mahwish , Srivastava Pradeep , Bhardwaj Nitin Dutt , Ali Junaid , Singh Vishika , Sharma Deepu , Khan Seema
Published: November 2024

Introduction:

Waste is an inevitable result of health-care services that may pose a health risk. Health-care waste comprises of general, infectious, and chemical/radioactive waste. Preventing the spread of infection to health-care personnel, patients, attendants, and the community at large is the ultimate objective of biomedical waste management (BMWM).

Materials and Methods:

It was a descriptive study which explored available resources, considering physical facilities, equipment, and human resources. All the personnel engaged in the management of BMW were included with focus on their training and vaccination status. The workflow process for BMWM was documented. In addition, the quantities of Yellow, Red, Blue, and White Waste generated were recorded. BMW generated per bed per day was calculated for each category and also overall waste collected was calculated.

Results:

The hospital’s comprehensive waste management plan encompasses seven defined routes, ensuring coverage of the entire facility. The BMW produced during a month range from 32,201 to 44,390 kg with a total of 465,392 kg/year. The mean BMW generated was 38,782.67 kg and the average BMW generated per day was 1271.25 kg. BMW generated per bed per day came out to be 0.33 kg.

Conclusion:

Every employee involved in the management of BMW was vaccinated for Hepatitis B and Tetanus toxoid. Sixty-eight percent of the workforce involved in BMWM underwent regular BMW refresher training. The remaining 32% received BMW training at the commencement of their roles but did not undergo refresher training. Regularly refresher training sessions on BMWM should be conducted, maintaining accurate and up-to-date records.
A Study on E-waste Generation and Disposal in a Tertiary Care Government Teaching Hospital, Lucknow
Authors: Dubey Umesh Dhar , Srivastava Pradeep , Bhardwaj Nitin Dutt , Chodankar Sairaj , Jaiswal Garima , Jain Anmol
Published: November 2024

Background:

KGMU is a 4000 bedded super-specialty hospital with 69 specialities. The hospital generated huge amount of E-waste due to large volume of medical equipment, IT appliances and electrical fittings. Currently there is no set disposal method defined for the disposal. The objective of the study is estimation of e-waste generation and develop a method of disposal as per laid down guidelines by the government.

Aim and Objective:

Aim of the study was to estimate amount of e -waste generated and disposal methods used by Hospital to discard these waste.

Materials and Methods:

Study was conducted at tertiary hospital of Lucknow and the data was compiled from the available records of last one year in the Engineering department of the hospital. The study was retrospective and observational. Currently e-waste generated is handed over to Engineering department, which conducts annual or bi annual auction as per requirement.

Result:

E-waste generated in last financial year at KGMU was around 8 tonnes which was disposed by open auction method to the highest bidder. A SOP has been developed incorporating all the government regulations and directions. Salient features are • The SOP defined various categories of e-waste like medical equipment, IT equipment and other electrical and electronic equipment. • New Purchases- All e-equipment’s to be purchases with buy back policy. • For existing Equipment’s- 6 monthly condemnation board to be constituted and items listed to be auctioned based on H1 to the registered vendors only.

Conclusion:

E-waste is an environmental threat and hence disposal in all hospitals should be done as per various guidelines.
Estimating Morphological Nose Features for Craniofacial Reconstruction: A Retrospective Study
Authors: Sak Nazan Guner , Babacan Serdar , Işıklar Sefa , Kafa İlker Mustafa , Gökalp Gökhan
Published: November 2024

Background:

Craniofacial reconstruction is one of the techniques used in forensic sciences to rebuild the probable antemortem face of unknown human skulls. Considering the soft‐tissue thickness, the skull is covered with clay or similar material. After covering, facial features such as lips, ears, eyes, and nose should be added. The nose has considerable diversity. This variety makes it have substantial importance for facial recognition. Aims and Objectives: The current study aimed to determine the morphology of the nose of the Anatolian population and develop regression formulas to estimate the nose shape using the measurements of the skull.

Materials and Methods:

The current study was conducted on three‐dimensional computed tomography cranial images. The images belonging to 50 adult patients (25 males, 25 females) were taken from the Radiology Department of Bursa Uludag University Medical Faculty Hospital. Eighteen parameters on bony structure and twenty-four parameters on soft tissue were measured using ImageJ software. SPSS 22.0 was performed for statistical analyses.

Results:

The regression formulas were developed to estimate the nose morphology belonging to the skull using the correlated parameters between the bony structure of the skull and soft tissue.

Conclusion:

Accurate nasal shape prediction means increasing the identification of the unknown skull. We believe that the regression formulas, developed with this idea could be helpful in craniofacial reconstruction.
Comparative evaluation of fracture resistance of wide and flared endodontically treated teeth with new techniques of postplacement – An in vitro study
Authors: Priyanka Banavathu , Parvathaneni Krishna Prasad , Raju T. B. V. G. , Seshadri Abitha , Dondapati Gowtam Dev
Published: November 2024

Aim:

This study aims to compare and evaluate the fracture resistance of endodontically treated maxillary anterior teeth restored using new postplacement techniques.

Methodology:

Forty-five single-rooted maxillary anterior teeth (n = 15) were selected and decoronated at the cementoenamel junction. The working length was determined using a 15K file. Biomechanical preparation was done up to size 70 and the teeth were obturated. After 1 week, the root-filling material, gutta-percha, was removed, and postspace was prepared using a size 3 and 4 peeso reamer. The samples were divided into three groups (n = 15). Group I: Coltene Tenax fiber Post-reinforced with composite (anatomical post). Group II: Coltene Tenax fiber postreinforced with a leno-woven polyethylene; Ribbond fibers. Group III: Coltene Tenax fiber Post-luted with a dual cure cement. After postcementation, core buildup was done. Fracture resistance was measured using a universal testing machine.

Results:

Statistical analysis was done using one-way analysis of variance and Tukey’s post hoc tests. A statistically significant difference was seen in the mean maximum load (N) between the groups. Group I showed the highest mean maximum load (N), followed by Group II and Group III. A significant P value (P = 0.025) was noted.

Conclusion:

Coltene Tenax fiber postreinforced with composite (anatomical post) showed the highest fracture resistance in endodontically treated maxillary anteriors.
Clinical efficacy of platelet-rich fibrin, injectable platelet-rich fibrin, and advanced platelet-rich fibrin in regenerative endodontics: A case series
Authors: Pandey Jayati , Nagpal Rashmeet , Sinha Dakshita Joy , Gupta Aditya
Published: November 2024

Background:

This series investigates the efficacy of regenerative endodontic therapy (RET) using various platelet-rich fibrin (PRF) formulations in treating apical periodontitis and necrotic pulp in immature permanent teeth.

Aim:

This study aims to evaluate the effectiveness of different PRF formulations in RET.

Materials and Methods:

Three cases involving patients aged 15–16 with immature teeth and necrotic pulp were treated with RET using PRF, injectable PRF, and advanced PRF. The procedure included inducing bleeding with a Hedstrom file, applying PRF variants, and sealing with mineral trioxide aggregate and composite resin. Patients were followed up at 1, 3, 6, 12 and 18 months.

Results:

Radiographic evidence showed apical closure, root maturation, and healing of periapical tissues in all cases. However, pulp sensibility tests were negative.

Conclusion:

RET using PRF variants promotes root development and apical healing in immature teeth. Further research with larger sample sizes is needed to understand these therapies’ potential and limitations.
Root caries: Prevalence, risk indicators, and clinical characteristics – A cross-sectional study
Authors: Shetty Jyothi , Hegde Mithra N. , D’Souza Neevan
Published: November 2024

Objectives:

The objectives of this study were to determine the prevalence of root caries (RC) in South Coastal population of India, to identify the risk indicators associated with it and to describe some clinical characteristics of RC lesions.

Materials and Methods:

A cross-sectional study was conducted with a sample size of 1062 subjects to assess the prevalence of RC. Each subject underwent an oral examination, performed by a single-calibrated examiner. Questionnaires were used to collect the data on oral hygiene habits, diet, smoking, alcohol habits, systemic conditions, and education level. Univariate and multivariable regression analyses were performed to identify the risk indicators associated with RC.

Results:

The prevalence of RC was found to be 7.5%, with a mean RC Index of 17.66%. The results of multiple logistic regression showed that age (≥40 years), systemic conditions, and exposed root surfaces were statistically significantly associated with RC (P < 0.05).

Conclusion:

RC is prevalent not only in the older age group but also the younger adults in this cohort. This study suggests an association between RC and the variables age (≥40 years), exposed root surfaces and systemic conditions.
Effect of glutathione on bond strength of composite resin to enamel following extracoronal bleaching
Authors: Devika Nair , Charanya Chandrasekaran , Athira K , Vandana James , Balagopal Sundaresan
Published: November 2024

Background:

Bleaching is a conservative treatment option to deliver esthetic smile makeover for discoloured tooth. Various concentration of bleaching agents can influence the bonding of the restoration to the tooth.

Aims and Objectives:

The aim of the study was to determine the effect of glutathione on bond strength of composite resin to enamel following extra coronal bleaching at two different time intervals.

Materials and Methods:

Forty molars were randomly assigned into four groups of ten each. Group A: Bleaching followed by immediate composite build up and no antioxidant application. Group B: bleaching followed by application of 20% Glutathione and immediate composite built-up was done. Group C: Bleaching followed by composite restoration after one week. Group D: Bleaching followed by application of 20% Glutathione before composite build up after one week. Shear bond strength was tested using a universal testing machine and fracture analysis was done using scanning electron microscope (SEM). Data were analyzed by one-way ANOVA and Post Hoc test with 95% level of significance (p<0.05).

Results:

Group D, which was treated with glutathione and restored after one week, revealed the highest shear bond strength compared to group B which was immediately restored following treatment with glutathione.

Conclusion:

Addition of 20% Glutathione as an antioxidant increased the shear bond strength of composite resin to enamel following extra-coronal bleaching using 40% hydrogen peroxide.
Comparative clinical evaluation of correct anatomic contour and tight contact in Class II direct composite restoration using two newer contact forming instruments
Authors: Patel Jaimini , Shah Nimisha C. , Dedania Meetkumar , Choudhary Deebah , Bharti Nidhi , Jain Aishwarya
Published: November 2024

Aim:

The aim of the study was to compare and evaluate proximal contact tightness and contours using two newer contact-forming systems in Class II composite restorations.

Materials and Methods:

After institutional ethical approval and Clinical Trials Registry-India registration, patients were chosen according to the inclusion-exclusion criteria with informed consent. A total of 60 patients were randomly assigned to two groups. Group A: LM Arte contact former (n = 30) and Group B: The design village (TDV) contact former (n = 30). Quadrant isolation was performed after the complete elimination of dental caries, preceded by the insertion of a matrix band and retainer with the proper wedging system. The LM Arte with the appropriate tip was selected for Group A, whereas the TDV contact former was selected for Group B based on the cavity size. Following the conversion of Class II cavities to Class I, nanohybrid resin composite restoration was done by cuspal layering. It was followed by finishing and polishing. E. B. Hencock criteria were used to evaluate gingival index, pocket depth, interproximal calculus, overhangs, food impaction, and contact integrity in both groups at baseline, 6 months, and 1 year.

Statistical Methods:

The data were analyzed using the Chi-Square test with SPSS (Statistical Package for Social Sciences) software version 18.0, IBM.

Results:

A statistically significant reduction in gingival index score was observed in both groups 6 months and 1 year after the procedure. However, the values revealed in terms of gingival index (P < 0.05) and (P > 0.05) for pocket depth, interproximal calculus, overhangs, food impaction, and contact integrity in both groups for 6 months (P > 0.05) and (P > 0.05) after the procedure.

Conclusion:

Both the LM Arte and TDV contact-forming systems are effective in establishing perfect proximal contacts and contours. However, the LM Arte contact-forming system edges out the TDV contact-forming system.
Comparative evaluation of removal of oil-based calcium hydroxide intracanal medicaments with two calcium chelators: An in vitro cone-beam computed tomography volumetric analysis
Authors: Bajaj Hemal , Nair Rashmi , Ganorkar Onkar , Dole Sudhir , Parakh Shrikant , Singh Neha Dhananjay
Published: November 2024

Background:

Intracanal medicament (ICM) eliminates remaining bacteria and their toxins that were not removed by chemomechanical preparation during endodontic treatment.

Aim:

The aim of this study was to compare and evaluate the removal of ozonated oil-based, silicone oil-based, and distilled water-based ICM with two calcium chelators, i.e., 0.2% chitosan and 17% ethylenediaminetetraacetic acid (EDTA).

Materials and Methods:

A total of 54 mandibular permanent premolars were included and randomly allocated into 3 groups after cleaning and shaping along with thorough irrigation. Group 1 - ozonized calcium hydroxide group; Group 2 - Metapex group; Group 3 - Ca(OH)2 with distilled water group. Using an irrigant for removal, the teeth in each group were distributed at random to two subgroups – (A) 0.2% chitosan solution; (B) 17% EDTA solution. All the samples were ultrasonically agitated and the volume remaining in each tooth after retrieval was estimated using additional cone-beam computed tomography scans. The result was analyzed using one-way analysis of variance, following post hoc Tukey test.

Results:

The mean percentage of ozonized Ca(OH)2, aqueous calcium hydroxide, and Metapex removed by 0.2% chitosan had greater values in comparison to 17% EDTA. When eliminating aqueous-based calcium hydroxide, both chelators showed similar effectiveness (P > 0.05). In contrast, 0.2% chitosan outperformed 17% EDTA in retrieving oil-based Ca(OH)2 (P < 0.05).

Conclusion:

The aqueous-based form of Ca(OH)2 was removed more easily compared to the oil-based form. A combination of 0.2% chitosan and ultrasonics proved to be more effective than 17% EDTA in eliminating oil-based calcium hydroxide.
Postoperative pain in patients following endodontic treatment by XP-endo Shaper files: A systematic review and meta-analysis
Authors: Dedhia Henal Nilesh , Hegde Vibha R. , Bhayani Maitri B. , Hegde Sanitra R.
Published: November 2024

Context:

Postoperative pain occurs in 25%–60% of patients following endodontic treatment. It can significantly impact a patient’s quality of life and requires timely management or, preferably, prevention.

Aims:

The present systematic review was conducted aiming to analyze randomized controlled trials that compared postoperative pain in patients whose canals were shaped by XPS versus other endodontic file systems.

Materials and Methods:

A systematic search was performed using key terms “postoperative pain” AND “XP-endo Shaper” across multiple databases to identify relevant randomized controlled trials. Details concerning the study design, endodontic preparation, XP-endo Shaper-related factors, and pain assessment were recorded. The risk of bias was calculated using the RevMan 5.3 software. Meta-analysis done using the random effects model which was represented using forest plots.

Results:

Six studies evaluating a total of n = 290 samples of XP-endo Shaper file and other file systems each, respectively, were included in the final review and meta-analysis. The standard mean difference ranged from 0.8 to 2.88 with a mean of 1.04 (0.80–2.88) favoring other file systems. This signifies that the postoperative pain is on average 1.04 times more by other file systems as compared to XP-endo Shapers file although the difference was statistically nonsignificant (P > 0.05).

Conclusions:

XP-endo Shaper has proven to be a relatively more efficient file system that effectively cleans and shapes the root canals, including those with difficult anatomy.
Influence of apical patency in endodontic treatment outcome – A systematic review of clinical studies
Authors: Kuzhanchinathan Manigandan , Dhakshinamurthi Balaji , Rajendran Mathan Rajan , Kalaiselvam Rajeswari
Published: November 2024

Objective:

The aim of this systematic review was to evaluate the influence of maintaining apical patency (AP) in endodontic treatment outcome.

Methodology:

An electronic database search was performed in PubMed, Cochrane Library, LIVIVO, LILACS, and EBSCO host from inception till July 2024. The data from the included articles were extracted and the quality was assessed using the Cochrane Collaboration tool and ROBINS-I tool.

Results:

Five articles were included for the qualitative synthesis, and all the included articles were determined to have a low risk of bias. Maintaining the AP resulted in two-fold increase in the healing outcome with long-term follow-up.

Conclusion:

It can be concluded from this systematic review that maintaining AP is likely to enhance the endodontic treatment outcome. However, more long-term clinical studies are required to further evaluate the possible influence of AP.

Registration:

The protocol of this review was registered in the PROSPERO database with registration number: CRD42022374966.
Vital pulp therapy: A bibliometric analysis of the 100 most-cited articles from 1966 to 2022
Authors: Pandey Pratima , Nawal Ruchika Roongta , Talwar Sangeeta , Yadav Sudha
Published: November 2024

Introduction:

Vital pulp therapy (VPT) aims to preserve dental pulp after injury and has gained significant popularity due to advancements in materials and understanding of pulp biology. While bibliometric analyses are common in various fields, none have been conducted specifically for the 100 most-cited articles on VPT.

Materials and Methods:

This bibliometric study analyzed the 100 most-cited VPT papers using data from Web of Science (WoS-CC), Scopus, and Google Scholar. Articles were manually reviewed to extract key bibliometric data, including titles, citation counts, citation density, authorship, country of origin, publication year, journal, study design, and VPT type.

Results:

The articles collectively received 19,782 citations, with the oldest from 1966 and the most recent from 2019, having 803 and 104 citations, respectively. Key journals included the Journal of Endodontics, International Endodontic Journal, and Dental Materials. Review articles were the predominant study design, followed by clinical, laboratory, and basic research studies. Eight of the top 20 articles focused on the properties of mineral trioxide aggregate (MTA). Torabinejad and Parirokh were notable contributors before 2010, while Duncan, Bjørndal, and Simon were prominent after 2010. VPT research has increased significantly post-2010, with a notable shift in focus from early studies on calcium hydroxide to more recent studies on MTA’s biocompatibility and its use as a pulp capping agent.

Conclusion:

This analysis provides a comprehensive list of the top 100 cited VPT articles, offering valuable insights for researchers, students, and clinicians. The study highlights key trends and influential contributions in the field of VPT research.
Phase transformation and metallurgical characterization of heat-treated nickel–titanium rotary instruments using differential scanning calorimetry, X-ray diffraction, and energy dispersive spectrometry
Authors: Hamid Tahira , Kumar Ajay , Malik Azhar , Anjum Shamim , Zahoor Nayeem
Published: November 2024

Objective:

The present study aimed to evaluate the phase transformation behavior and elemental analysis of thermomechanical-treated nickel–titanium (NiTi) rotary instruments, TruNatomy (Dentsply Sirona), HyFlex CM (coltene, Whaledent), and Neoendo Flex (Orikam healthcare India), using differential scanning calorimetry (DSC), X-ray diffraction (XRD), and energy dispersive X-ray spectrometry.

Materials and Methods:

A total of 18 NiTi rotary instruments, TruNatomy, Hyflex CM, Neoendo Flex, taper. 04, size 25 (except TruNatomy, size 26) were selected and were divided into three groups (n = 6). Three NiTi files from each group were investigated for the DSC test (n = 3). The two segments of each sample were cut carefully by slow-speed water-cooling carborundum disc at 3 mm from the tip and then 4 mm from the previous section. The mass of the samples was measured on the electronic balance and samples that weighed 10–15 mg were loaded into a 40 µL aluminum crucible. The samples are then subjected first to a heating cycle from 0°C to 100°C and subsequently a cooling cycle from 100°C to 0°C in the differential scanning calorimeter (Mettler-Toledo, NIT Srinagar) at a rate of 10°C min−1. XRD (Make. Rigaku Japan, smart lab 3kW, NIT Srinagar.) was performed to verify the DSC results. The remaining two samples from each group (n = 2) were subjected to XRD analysis. The sample preparation for XRD analyses was done precisely with slow speed water cooled carborundum disc and samples were sectioned into three segments. Each segment was 5 mm long and grounded to obtain a uniform smooth plane. The data obtained from DSC and XRD were subjected to origin 8.5 software and graphs were obtained that depict the transformation temperature and phase composition, respectively. Alloy distribution and trace elements of the NiTi rotary instruments were done using energy dispersive spectrometry microanalysis.

Results:

The DSC results showed that the TruNatomy, Hyflex CM, and Neo Endo instruments had an Austenite finish (Af) temperature exceeding 37°C. The XRD graphs show the different intensity peaks that correspond to the various phases of NiTi rotary instruments. The TruNatomy is predominantly Austenite, Hyflex CM exists mainly in R-phase with a variable amount of austenite and martensite, while Neoendo flex endo mostly contains austenite phase. The elemental analysis revealed that all three file systems show Nickel and Titanium within their bulk structure in an equiatomic ratio.

Conclusion:

This study concluded that TruNatomy is predominantly martensite with a variable amount of austenite phase. There are differences in thermal transition temperature between the files.
Successful Transcatheter Closure of an Iatrogenic Axillary Arteriovenous Fistula in a Young Girl: A Delayed Complication of Intervention in a Resource-limited Setup
Authors: Islam Nurul , Saha Siddhartha , Parida Ashok Kumar
Published: November 2024

Arteriovenous fistula (AVF) is a well-known complication in the adult population following cardiac interventions. Data on the pediatric age group are lacking. Furthermore, there are no guidelines for the management of the pediatric population. We present a case of successful endovascular device closure of iatrogenic axillary AVF in a limited resource setup. A 9-year-old girl had palliative ductal stenting through the left axillary artery for complex congenital cyanotic heart disease 6 months back. She presented with an iatrogenic axillary AVF. We planned to close the defect in catheterization laboratory. After successful device deployment, there was a complete occlusion of the arterial system. To maintain arterial patency stenting was performed subsequently. Successful device closure of complicated axillary AVF in the pediatric population can be achieved even in a recourse-limited setup.
Spectrum of Renal Tumors Other Than Renal Cell Carcinoma with Emphasis on Cytomorphological, Immunohistochemical, and Cytogenetic Study
Authors: Alashetty Soumya , Dharmalingam Priya , Ramamurthy Sindhu , Kavitha Bidadi Lingappa , Shanthala Siddappa , Ali Rajasab Subhan
Published: November 2024

Background:

The role of fine needle aspiration cytology (FNAC) in the diagnosis of renal malignancies is established and has been getting more precise and important over a period of time. Knowledge of the pathology of uncommon renal neoplasms along with radiological and clinical correlations often aids in correct diagnosis.

Aims:

The present study aims to describe the cytomorphological and immunohistochemical findings in the varied spectrum of renal tumors, other than renal cell carcinomas (RCC).

Materials and Methods:

Data of 238 cases of ultrasound-guided renal FNAC performed in our tertiary cancer institute over 4 years were collected from the department registry. All nondiagnostic cases and cases diagnosed as RCC were excluded from the study, so 57 cases of renal tumors were reviewed along with the cell blocks and ancillary studies.

Results:

Out of the 57 cases, 35 cases were primary renal neoplasms, which included renal oncocytoma (3.5%), angiomyolipoma (3.5%), rhabdoid tumor (1.8%), Wilms tumor (28.0%), Ewing sarcoma (3.5%), urothelial carcinoma (8.8%), and small round cell tumor unclassified (12.3%). Twenty two cases were metastatic tumors, which included hematolymphoid neoplasm (14%) and metastatic carcinomas (24.6%) from various other primary carcinomas.

Conclusion:

Our study shows that renal FNAC is safe and fairly accurate in diagnosing a wide spectrum of renal tumors and has high diagnostic accuracy, when performed along with cell block and immunohistochemistry. Awareness of the pathology of uncommon renal tumors along with relevant clinical history and radiological findings may aid in identifying the type of tumor for further appropriate management.
Application of the Sydney System for Classification and Reporting Lymph Node Cytopathology to Assess the Risk of Malignancy and its Diagnostic Accuracy
Authors: Das Sudipta , Das Aseema , Das Bandita
Published: November 2024

Background:

Fine-needle aspiration cytology (FNAC) of the lymph nodes is the first-line evaluation of lymphadenopathy of unknown etiology. For better diagnostic clarity and proper communication to clinicians, the Sydney System was proposed in 2020 for the performance, classification, and reporting of lymph node cytopathology. The present study was conducted to analyze the diagnostic performance and risk of malignancy (ROM) associated with each of the diagnostic categories of the proposed Sydney System.

Materials and Methods:

This retrospective study was conducted over 2 years. All patients with lymphadenopathy undergoing FNAC during the study period for which subsequent histopathological examination (HPE) reports or clinical follow-up data were available were included in the study. The original diagnoses were reviewed, and each case was assessed according to the first diagnostic level of the Sydney System classification. The diagnostic accuracy and ROM were correlated with FNAC diagnoses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of lymph node FNAC were calculated using SPSS version 20.0.

Results:

A total of 456 out of 753 cases were selected in the study as they had subsequent histopathological correlation and/or clinical follow-up data. The majority were females n = 294 (64.4%). The most common lymph node was the cervical group (n = 274, 60%).

On Statistical Analysis:

sensitivity 82.8%, specificity 97.5%, PPV 95.3%, NPV 90.1%, and diagnostic accuracy 92%.

Conclusion:

The sydney system, which introduces a uniform categorization, may increase the lymph node FNAC diagnostic accuracy.
Ventriculopleural Shunt Following Failed Ventriculoperitoneal Shunt in Children: Two Case Reports
Authors: Narayan Vinitha , Narayanan Vidhya , Reddy Ashwini , Sethuraman Raghuraman M. , Baskaran Nivedita
Published: November 2024

Abstract

There have been no reports of ventriculopleural (VPL) shunt in children younger than four years of age in the last 24 years. The pleural space is an alternative to the peritoneum for shunting cerebrospinal fluid (CSF) in cases where the latter cannot be used due to infection or other complications. Though there have been case series published reporting the use of VPL shunts, the anesthetic management has not been described in detail. We describe the management of two pediatric patients aged three and six years old who successfully underwent VPL shunt after failure of ventriculoperitoneal (VP) shunt.
A Retrospective Study of Pediatric Posterior Fossa Tumors: Was the Outcome Different in Patients Undergoing Elective versus Emergency Surgery?
Authors: Kumar Ashutosh , Singh Suyash , Datta Aanchal , Bhaisora Kamlesh Singh , Sardhara Jayesh , Dikshit Priyadarshi , Maurya Ved Prakash , Verma Pawan Kumar , Das Kuntal Kanti , Mehrotra Anant , Srivastava Arun Kumar , Jaiswal Awadhesh K. , Kumar Raj , Behari Sanjay
Published: November 2024

Abstract

Background:

Pediatric posterior fossa tumors (pPFTs) may present acutely with features of increased intracranial pressure that need urgent intervention or with stable symptoms requiring elective management. In this article, we have analyzed the outcomes of pPFTs managed under three arms: (1) emergency tumor resection (A), (2) elective tumor resection (B), and (3) pre-resection cerebrospinal spinal fluid (CSF) diversion followed by elective tumor resection (C).

Materials and Methods:

We retrospectively reviewed our database from July 2012 to March 2020 for pediatric patients (age ≤16 years) with PFTs. The patients were classified into three groups based on the timing and type of intervention. Their result was assessed as the primary (postoperative complications) and secondary outcomes (post-resection CSF diversion, CSF diversion failure, residual tumor, and survival). A P value < 0.05 was considered significant (SPSS version 22.0, IBM, New York).

Results:

A total of 154 patients (M:F = 2.42:1) were included with a mean age of 8.1 (SD ± 4.2)-years (range 1–16). Group B (n = 72/46.8%) had a significantly higher number of patients as compared to the group A (n = 40/26%) and group C (n = 42/27.3%) (χ2 test, P value = 0.02). The primary outcomes were comparable between group A and group B. A higher incidence of preoperative external ventricular drain insertion and post-resection CSF diversion failure was noted in group A as compared to group B (P value < 0.01). Group C had a significantly higher proportion of patients with residual tumor (n = 19/48.7%) as compared to group A (n = 11/29.7%, P value = 0.09) and group B (n = 20/ 29.4%,P value < 0.05). The post-resection CSF diversion failure rate was significantly higher in group C than in the other two groups (P value < 0.05).

Conclusion:

The pre-resection CSF diversion subgroup had a poorer outcome as compared to elective and emergency tumor resection. The outcomes of elective and emergency resection of pPFTs were comparable, except for the higher risk of shunt failure in the emergency cohort.
Long Lead of a Bobble-Head Doll Syndrome
Authors: Venkataramana Neelam Krishnan , Venkat Bharggavi Neelam
Published: November 2024

Abstract

Bobble-head doll syndrome is a rare and interesting childhood movement disorder, which often presents with involuntary, repetitive, stereotyped head movements, though other presentations such as neuroendocrine disturbances, visual and gait disturbances, and memory and psychiatric disturbances are also described. Imaging reveals hydrocephalus. If the cause can be identified and resolved using surgery, it is one of the treatable movement disorders of childhood.
Optical coherence tomography characteristics in hydroxychloroquine retinopathy and the correlations with visual deterioration in Taiwanese
Authors: He Shao-Kai , Lai Tso-Ting , Hsieh Yi-Ting
Published: November 2024

PURPOSE:

This study aimed to investigate optical coherence tomography (OCT) characteristics in hydroxychloroquine (HCQ) retinopathy and their correlation with visual acuity among Taiwanese patients.

MATERIALS AND METHODS:

We retrospectively recruited patients undergoing long-term HCQ treatment who had received examinations of best-corrected visual acuity and OCT scans. We observed disruptions in the ellipsoid zone (EZ) and retinal pigment epithelium (RPE) across different retinal regions. Principal component analysis (PCA) was employed to identify the most significant factors associated with visual deterioration.

RESULTS:

Among the 120 eyes included in the study, HCQ retinopathy was present in 42 eyes (35.0%). In patients with mild-to-moderate retinopathy, the pericentral pattern was predominant (75.0%), whereas no parafoveal pattern was observed. Serial examinations revealed that lesions typically progressed from pericentral to parafoveal and foveal regions. EZ disruption was observed in all affected cases, most frequently at the pericentral region (100%), followed by the perifoveal (87.4%), parafoveal (72.1%), and foveal (43.2%) regions. RPE disruption was noted in 59.5% of cases, with the highest prevalence at the pericentral (53.2%) and perifoveal (52.3%) regions, followed by the parafoveal (33.3%) and foveal (28.8%) regions. PCA identified RPE disruption at the fovea and parafoveal regions as the most strongly correlated factors for visual deterioration.

CONCLUSIONS:

In Taiwanese patients, HCQ retinopathy predominantly manifests with pericentral lesions, while isolated parafoveal lesions are rare as an initial presentation. RPE disruption, rather than EZ disruption, appears to be the primary determinant for visual deterioration in this population.
Optic disc and peripapillary tumors
Authors: Shettigar Manoj , Raval Vishal , Reddy P. Vijay Anand , Kaliki Swathi
Published: November 2024

This review covers the tumors either originating or seen close to the optic disc in the peripapillary area. Most of the optic disc tumors are diagnosed on clinical examination. In a few atypical cases, ancillary imaging, such as optical coherence tomography, fluorescein angiography, and ultrasonography, may be required to demonstrate characteristic features. The majority of these tumors have systemic associations, and hence, a multidisciplinary approach involving ocular oncologists, neurophysicians, radiation oncologists, and medical oncologists is the need of the hour. The treatment of optic disc tumor is challenging due to its proximity to critical areas such as optic nerve and macula, which could be a limiting step when compared to conventional treatments such as laser photocoagulation and surgical excision.
Evaluating the role of serum cystatin C as a circulating biomarker of diabetic retinopathy from a rural Indian population
Authors: Raghu Keerthana , Surya R. Janani , Mishra Chitaranjan , Singh Karan , Mohanty Nabatika , Sahoo Jitendra Kumar , Sahoo Shiva Prasad , Singh Ashok Kumar , Raman Rajiv
Published: November 2024

PURPOSE:

This study aimed to evaluate serum cystatin C as a potential biomarker for diabetic retinopathy (DR) in a rural Indian population, addressing the urgent need for effective screening tools amidst rising diabetes prevalence.

MATERIALS AND METHODS:

A cross-sectional study recruited 112 patients with diabetes mellitus from Sambalpur, Odisha, India, categorized into groups with and without DR. Serum cystatin C levels were measured alongside clinical and demographic parameters, using established diagnostic methods.

RESULTS:

Patients with DR exhibited significantly higher serum cystatin C levels compared to those without DR (mean: 0.99 ± 0.50 mg/L vs. 0.80 ± 0.36 mg/L, P = 0.027). Adjusted analysis showed a notable association between higher cystatin C tertiles and DR (adjusted odd’s ratio: 7.65, 95% confidence interval: 1.49–39.08, P = 0.01), highlighting its potential as an independent predictor.

CONCLUSION:

Elevated serum cystatin C levels were strongly associated with the presence of DR, suggesting its utility as a biomarker for early identification and risk stratification in diabetic patients. Integration of cystatin C measurement into routine clinical practice may enhance DR screening and management strategies, offering potential benefits in reducing vision loss and improving patient outcomes. This study underscores the need for further longitudinal research to validate these findings and elucidate the temporal relationship between cystatin C levels and DR progression.
Odziv na intervju z dr. Kozmo Ahačičem: Kaj pomeni ljubezen do slovenščine?
Authors: Kranjc Simona
Published: November 2024

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A Bibliometric Analysis of STEM Education for Undergraduate Level Based on CiteSpace Software
Authors: Zeng Zhaofeng , Tho Siew Wei , Gao Zhengfang , Adenan Nur Hamiza , Ng Sue Ting
Published: November 2024

This study aims to review the STEM education intervention on the undergraduate level by applying CiteSpace software, an innovative tool for bibliometric analysis and visualization. The Web of Science (WOS) database was used and covers the period from January 2008 to August 2023. Based on keyword search, seven clusters with the largest research volume in the past 15 years were identified and analysed with relevant literature. The results revealed that the trending topics of STEM education research included racial and gender differences in STEM education, reform of STEM education assessment and motivation methods for undergraduates, strategies to improve STEM academic performance, and the impact of STEM education on undergraduate employment. Furthermore, a cluster analysis of keywords and references was conducted to explore the connections between the clustered themes and the core theme of STEM. The timeline visualization diagram was used to examine the duration and evolution of each research theme in STEM education, which provided useful information for identifying the direction of STEM research. Finally, through the citation burst analysis, the top 15 most cited references were determined, and the STEM research hotspots were discussed in relation to their literature, which were consistent with the STEM research hotspots derived from the high-frequency themes and node literature. The findings of this study offer important insights into the development trend of STEM education and provide an evidence base and reference for future research and development of STEM education particularly at the undergraduate level.
The Influence of Dynamic Representations in Mobile Applications on Students’ Learning Achievements in Solving Multiple Integrals
Authors: Milenković Aleksandar , Takači Đurđica , Božić Radoslav
Published: November 2024

In this paper, we describe the influence of the implementation of methodology for teaching and learning multiple integrals based on the constructivist approach and the interconnectedness of multiple representations (with an emphasis on dynamic representations) for different mathematical objects using GeoGebra’s applications Graphing Calculator and 3D Calculator. The empirical research was conducted at the University of Kragujevac, Serbia, with two groups (the experimental and the control groups) of second-year students. During the learning process of the experimental group, students created digital materials to visualize the domain of the integration for the concrete tasks, to set the integration bounds, to recognize in which situation they needed to introduce the switch of variables, and all that to solve double or triple integral problems. Students in the control group, on the other hand, didn't use technology of any kind, including the programs Graphing Calculator and 3D Calculator. The findings of the empirical study showed that students' use of these tools to create digital materials improved their academic achievement and their practical and theoretical knowledge of multiple integrals.
Nurturing Argumentation Skills to Solve Complex Problems through Structured Scaffolding-Guided Inquiry (SSGI)
Authors: Nasir Muhammad , Kusumadani Annur Indra
Published: November 2024

This study aims to develop a structured scaffolding-guided inquiry (SSGI) learning model that is oriented toward nurturing argumentation skills to solve complex problems. Test the effectiveness of the SSGI model in improving students' argumentation skills to solve complex problems. This research is development research that refers to Dick and Carey. Test the effectiveness of the SSGI learning model in a quasi-experimental pre-test and post-test group design. Argumentation skills to solve complex problems data were collected using an essay test. The research sample used Physics Education students in the 4th semester (N = 30). The significance of the difference in pre-test and post-test scores was analyzed using the t-test. The impact of the SSGI is analyzed using effect size. The result of this study indicates that the SSGI enhances students' argumentation skills to solve complex problems. The increase in students' argumentation skills to solve complex problems was 7% in the high category, 57% in the medium category, and 36% in the low category. The effect size coefficient of the SSGI is 0.78 in the medium category. The SSGI syntax that contributes the most to growing argumentation skills to solve complex problems is the reasoning syntax. Then the next sequence is syntax exploration, closure, and orientation.