bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Necrotizing Encephalopathy as a Complication of Chikungunya Infection
Authors: Holla V V , Gohel Abhishek B , Kartik N , Netravathi M
Published: April 2021

Background:

Acute necrotizing encephalopathy (ANE) is a rapidly progressive encephalopathy seen commonly in children triggered by various prodromal viral infections, most common being influenza virus and Human herpes virus-6.

Objective:

We report two rare cases of ANE preceded by Chikungunya infection.

Cases:

A 13-year old girl presented with a three-day history of headache, fever, seizures, and altered sensorium. Another 42-year old man presented with two days history of fever and altered sensorium. Both were suspected to have viral encephalitis. Evaluation revealed serum positivity for Chikungunya virus. In both cases, diagnosis was clinched by characteristic bilateral symmetrical thalamic lesions with central necrosis and hemorrhage along with lesions in cerebral white matter, brainstem, and cerebellum.

Conclusions:

ANE is reported to have high morbidity and mortality. To the best of our knowledge, this is the first report of ANE post-Chikungunya infection. Apart from being rare etiologically, the patients had excellent response to steroids.
Neuroimaging Patterns in Patients with COVID-19-Associated Neurological Complications
Authors: Garg Ravindra K , Paliwal Vimal K , Malhotra Hardeep S , Sharma Praveen K
Published: April 2021

Background:

A variety of neuroimaging abnormalities in COVID-19 have been described.

Objectives:

In this article, we reviewed the varied neuroimaging patterns in patients with COVID-19-associated neurological complications.

Methods:

We searched PubMed, Google Scholar, Scopus and preprint databases (medRxiv and bioRxiv). The search terms we used were “COVID -19 and encephalitis, encephalopathy, neuroimaging or neuroradiology” and “SARS-CoV-2 and encephalitis, encephalopathy, neuroimaging or neuroradiology”.

Results:

Neuroimaging abnormalities are common in old age and patients with comorbidities. Neuroimaging abnormalities are largely vascular in origin. COVID-19-associated coagulopathy results in large vessel occlusion and cerebral venous thrombosis. COVID-19-associated intracerebral hemorrhage resembles anticoagulant associated intracerebral hemorrhage. On neuroimaging, hypoxic-ischemic damage along with hyperimmune reaction against the SARS-COV-2 virus manifests as small vessel disease. Small vessel disease appears as diffuse leukoencephalopathy and widespread microbleeds, and subcortical white matter hyperintensities. Occasionally, gray matter hyperintensity, similar to those observed seen in autoimmune encephalitis, has been noted. In many cases, white matter lesions similar to that in acute disseminated encephalomyelitis have been described. Acute disseminated encephalomyelitis in COVID-19 seems to be a parainfectious event and autoimmune in origin. Many cases of acute necrotizing encephalitis resulting in extensive damage to thalamus and brain stem have been described; cytokine storm has been considered a pathogenic mechanism behind this. None of the neuroimaging abnormalities can provide a clue to the possible pathogenic mechanism.

Conclusions:

Periventricular white-matter MR hyperintensity, microbleeds, arterial and venous infarcts, and hemorrhages are apparently distinctive neuroimaging abnormalities in patients with COVID-19.
Nonconvulsive Status Epilepticus in Metabolic Encephalopathy in Indonesia Referral Hospital
Authors: Octaviana Fitri , Bestari Andriani P , Loho Anastasia M , Indrawati Luh A , Wiratman Winnugroho , Kurniawan Mohammad , Sugiarto Adhrie , Budikayanti Astri
Published: April 2021

Background:

Nonconvulsive status epilepticus (NCSE) is often underdiagnosed in patients with metabolic encephalopathy (ME). The diagnosis of ME should be made specifically to recognize the underlying etiology. Delay in seizure identification and making a diagnosis of NCSE contributed to the poor outcome.

Objective:

This study aimed to find the incidence and outcome of NCSE in patients with ME.

Methods and Material:

This was an observational prospective cross-sectional study in patients with ME in emergency and critical care units in Cipto Mangunkusumo General Hospital. The diagnosis of NCSE was based on EEG using Salzburg Criteria for Nonconvulsive Status Epilepticus (SCNC). The outcome was assessed within 30 days after the NCSE diagnosis has been made.

Results:

A total of 50 patients with ME were involved in this study. NCSE was confirmed in 32 subjects (64%). The most common etiology of ME was sepsis (58%). The mortality rate in the NCSE and non-NCSE group was 40.6% vs 44.4%. Multiple aetiologies were risk factors to poor outcome in the NCSE group.

Conclusions:

The incidence of NCSE among patients with ME at our hospital was high. Despite the anti-epileptic treatment of the NCSE group, the underlying cause of ME is still the main factor that affected the outcome. Therefore, aggressive treatment of anti-epileptic drug (AED) should be very carefully considered knowing the possible side-effect that might worsen the outcome of patients with ME.
Primary Angiitis of Central Nervous System-Tumor-Like Mass Lesions
Authors: Murthy Jagarlapudi M K , Challa Sundaram , Parida Subhendu , Murthy Tenneti V R K , Paspala Syed Ameer Basha
Published: April 2021

Tumor-like mass lesion is a rare subtype of primary angiitis of the central nervous system (ML-PACNS). This report describes six patients of histologically verified ML-PACNS. The mean age was 44.5 years (range 25–68) and four were males. Presenting symptoms headache (5), focal neurologic deficits (5), and seizures (4). On magnetic resonance imaging (MRI) the lesion was unifocal in two and multifocal in four patients. Consistent radiological findings were mass lesions with heterointense internal morphology with areas of diffusion restriction (DWI), and variable post-contrast enhancement. Pathologically vasculitis was classified as: Granulomatous in one, necrotizing in two and lymphocytic in three. There were two deaths. In conclusion patients with ML-PACNS are likely to be younger and more likely to present with seizures. MRI lesions with hetrointense internal morphology with areas of DWI was a consistent finding and may be a clue for the diagnosis of ML-PACNS.
Acute Acalculous Cholecystitis in a Multiple Sclerosis Patient Treated with Natalizumab
Authors: Lambea-Gil Álvaro , Fumanal-Idocin Luis , Sebastián-Torres Berta , Saldaña-Inda Ignacio , Huici-Polo Patxi , Alarcia-José-Ramón-Ramón Ara-Callizo Raquel
Published: April 2021

Natalizumab is a disease-modifying drug that has proved greatly effective and well-tolerated in highly-active Multiple Sclerosis (MS). However, it may increase the risk for opportunistic infections, such as viral ones. We describe a 37-year-old woman treated with Natalizumab for Relapsing-Remitting Multiple Sclerosis (RR-MS) who presented to our clinic with malaise, arthromyalgias, rash, and fever. She later developed diarrhea and severe abdominal pain. A diagnosis of parvovirus B19 (B19V) infection and acute acalculous cholecystitis (AAC) was eventually made. To our knowledge, this is the first reported case of AAC possibly related to Natalizumab therapy and B19V infection.
An Unusual Case of Muscle Twitching
Authors: Tomar Laxmikant Ramkumarsingh , Shah Dhrumil Jatinbhai , Ranjan Rajeev , Rohatgi Anshu , Agrawal C S
Published: April 2021

A 50-year-old male, presented with a two-months history of ascending paresthesias, with continuous twitchings over the body, associated with insomnia. His electromyography (EMG) revealed neuromyotonia and was diagnosed as a case of peripheral nerve hyperexcitability (PNH) syndrome due to Leucin-rich glioma-inactivated 1 (LGI1) antibody. He showed significant improvement with intravenous immunoglobulin and carbamazepine.
Ultrasound-Guided Erector Spinae Plane Block for Perioperative Analgesia in Cervical and Thoracic Spine Surgeries — A Case Series
Authors: Goyal Amit , Kalgudi Pramod , Sriganesh Kamath
Published: April 2021

Erector spinae plane (ESP) block is a recently introduced regional technique for pain management. However, its usefulness for perioperative analgesia in cervical and thoracic spine surgeries is underutilized. In this case series, we reviewed the case records of seven patients who received ultrasound-guided ESP block for perioperative analgesia for cervical and thoracic spine surgeries during a two-month period. We evaluated the performance of the ESP block with regards to intraoperative nociception and hemodynamics, postoperative pain, and need of rescue analgesia in these patients. The median age of our patients was 28 years (range 5–74 years) and the duration of surgery was 300 minutes (range 240–540 minutes). The surgical pleth index, a marker of intraoperative nociception, was below the threshold of 50 at most time-points during the surgery. Similarly, intraoperative hemodynamic parameters (HR and BP) were stable throughout the surgery. Postoperative pain control was good during the initial 48 after surgery with median NRS score of 2 at rest and 4 with movement. The ESP block results in good intraoperative and postoperative analgesia and also provides hemodynamic stability and opioid-sparing effect for cervical and thoracic spine surgeries.
A Systematic Review and Meta-analysis of Prevalence of Epilepsy, Dementia, Headache, and Parkinson Disease in India
Authors: Dhiman Vikas , Menon Geetha R , Kaur Supreet , Mishra Amar , John Denny , Vishnu Mendu Vardhan Rao , Tiwari Rajnarayan R , Dhaliwal upinder Singh
Published: April 2021

Background:

There are wide variations reported in the prevalence rates of common neurological disorders in India leading to huge treatment gap. There is no comprehensive systematic review reporting prevalence of common neurological conditions affecting Indians which is essential for developing and aligning health services to meet patient care.

Objectives:

The aim of this study was to perform a systematic review and meta-analysis of prevalence of epilepsy, dementia, headache, and Parkinson's disease (PD) in India from 1980 to 2019.

Methods and Materials:

We performed a bibliographic systematic search in PubMed and Google Scholar along with manual search for peer-reviewed cross-sectional studies and community-based surveys reporting prevalence of epilepsy, dementia, headache, and PD in India from January 1980 to July 2019. Meta-analysis was performed adopting a random-effects model using “Metafor” package in R.

Results:

The systematic review and meta-analysis included 50 studies [epilepsy (n = 22), dementia (n = 19), headache (n = 6), and PD (n = 3)] including a total of 179,1541 participants of which 5,890 were diagnosed with epilepsy, 1,843 with dementia, 914 with headache, and 121 were diagnosed with PD. The pooled prevalence of epilepsy was 4.7 per 1,000 population (95% CI: 3.8–5.6) with high heterogeneity (P < 0.01, I2 = 98%). The prevalence of dementia was found to be 33.7 per 1,000 population (95% CI: 19.4–49.8) (P = 0, I2 = 100%). The pooled prevalence of headache and PD were found to be 438.8 per 1,000 population (95% CI: 287.6–602.3) (P < 0.0001, I2 = 97.99%), and 0.8 per 1,000 population (95%CI: 0.4–1.3) (P < 0.01, I2 = 95%), respectively.

Conclusions:

The findings could be used for appropriate policy measures and targeted treatments for addressing these conditions.
Neural substrates of psychiatric symptoms in patients with Huntington’s Disease
Authors: Kamble Nitish , Saini Jitender , George Lija , Ratna Nikhil , Bhattacharya Amitabh , Yadav Ravi , Jain Sanjeev , Pal Pramod Kumar
Published: April 2021

INTRODUCTION:

Numerous studies in Huntington’s disease (HD) have shown striatum as the major site of neuronal loss, but recently the presence of neurodegeneration in other regions of the brain is gaining attention. In our study, we used voxel-based morphometry and diffusion tensor imaging to identify other areas in the brain that are involved in the disease.

METHODS:

The present study is a prospective study conducted in the Departments of Neurology, Psychiatry, and Neuroimaging and Interventional Radiology (NIIR), NIMHANS, Bengaluru. The study included 20 genetically confirmed HD patients and 20 healthy controls. Magnetic resonance imaging was performed on a 3-Tesla Philips Achieva scanner with a 32-channel head coil with the acquisition of whole-brain T1-weighted and DTI.

RESULTS:

The patients (41.25 ± 10.04 years) and controls (38.27 ± 11.29 years) were age-matched (P = 0.38), and the mean age at the onset of the symptoms of the disease was 37.53 ± 10.11 years, and the expanded CAG repeat allele was 45.95 ± 7.27 (range 40–73) repeats. All patients had psychiatric symptoms at presentation such as anger outbursts, irritability, abusive behavior, apathy, low mood, crying spells, delusions, lack of initiation, and obsessive–compulsive disorder. Compared with controls, HD patients had significant atrophy of bilateral caudate nuclei, right globus pallidus, left culmen, right precuneus, hypothalamus, and right superior temporal gyrus. Fractional anisotropy was increased in bilateral cerebral white matter and thalamus with the reduction in mean diffusivity.

CONCLUSIONS:

In addition to atrophy of caudate, atrophy was also observed in globus pallidus, thalamus, hypothalamus and right superior temporal gyrus. This may explain the neuropsychiatric and cognitive symptoms observed in these patients.
Theory of Fighting the Epidemic with Traditional Chinese Medicine Qigong (气功) Therapy
Authors: Zhao Dan
Published: April 2021

Qigong (气功) therapy is an active self-paced exercise therapy and it has a long history in traditional Chinese medicine (TCM). As early as the mention of it in the Huang Di Nei Jing (《黄帝内经》 Huangdi's Internal Classic), there is a record of using qigong therapy to prevent and treat pestilence. This thesis discusses the idea and methods of qigong therapy in TCM, such as daoyin (导引), expiration and inspiration, and meditation. These methods purpose to have the functions of strengthening and consolidating the primordial qi, improving health conditions, and resisting pestilent qi. Therefore, the core idea of fighting the epidemic with qigong therapy is to enhance the healthy qi, and to prevent the intrusion of pestilent qi into the human body. It embodies the TCM thought of “when there is sufficient healthy qi inside the body, the evil cannot invade the body.”
Application of Traditional Chinese Medicine in Treating COVID-19
Authors: Liu Meng-Cheng , Gao Hong-Yun
Published: April 2021

Traditional Chinese medicine (TCM) has been applied to the treatment of the novel coronavirus (COVID-19). In the epidemic, COVID-19 patients were treated through integrated TCM and Western medicine. The effect was remarkable, especially in the treatment of mild COVID-19 cases. This paper introduces several TCM treatments to COVID-19, put forward by both domestic and foreign scholars.
Reticulocyte haemoglobin as a diagnostic marker and its response towards oral iron therapy in paediatric iron deficiency anaemia
Authors: Behera Bodhisatwa , Subhadarshini Sarmistha , Satapathy Jagat Shreya , Mohanty Niranjan , Mishra Debi Prasad , Mantri Santwana , Purohit Prasanta , Patro Manoj Kumar
Published: April 2021

Background:

Iron deficiency anaemia (IDA) in the paediatric age group is prevalent in developing countries like India, especially in the lower socio-economic strata. Early detection and management will prevent the associated morbidity and mortality. Reticulocyte haemoglobin (Ret-Hb) is an indirect assessment of Hb content of reticulocytes by automated haematology analysers.

Aims:

The present study was aimed to evaluate the diagnostic efficacy of Ret-Hb in paediatric IDA and its prognostic efficacy by detecting early response to oral iron supplementation.

Materials and Methods:

This was an institutional prospective, cross-sectional study. Eighty-two cases of microcytic hypochromic anaemia, in the age group of 1–14 years negative for haemoglobinopathy by high-performance liquid chromatography, constituted the study group. Ret-Hb and serum ferritin (SF) values were correlated with other haematological parameters on day 0 and day 3 after oral iron supplementation and results obtained were statistically correlated.

Results:

The mean values of Hb, mean corpuscular volume, mean corpuscular Hb, red cell distribution width-CV (RDW-CV), Ret-Hb and SF were found to be 8.32 ± 1.99 g/dL, 63.44 ± 7.01 fL, 19.25 ± 3.21 pg, 19.16 ± 2.87%, 20.36 ± 3.41 pg and 8.99 ± 1.85 mcg/dL respectively. The Ret-Hb and SF levels were found to be linearly positively correlated with all parameters except RDW-CV which was negatively correlated; a stronger association was noted with the former. After oral supplementation on Day 3, only Ret-Hb showed statistically significant change, i.e., 20.36 ± 3.41 pg to 21.35 ± 3.61 pg (P < 0.001).

Conclusion:

Ret-Hb was found to be a reliable parameter not only in diagnosing IDA in children but also in detecting early response to oral iron supplementation.
A perspective on diabetes-related hypogonadism
Authors: Tripathi Shikhar , Elakiya M. , Mishra Alka , Sherrif Dhastagir Sultan
Published: April 2021

Testosterone deficiency leads to hypogonadism, which has shown a direct correlation with Type 2 diabetes mellitus. Hypogonadotropic hypogonadism is the major classification of hypogonadism, based on origin, which is related with diabetes. It also shows it's co-effect on other systems and has complications related to cardiovascular risks, subcutaneous and visceral fat, etc., Our article also talks about the effects of testosterone replacement therapy on indices such as insulin resistance, metabolic syndrome, etc., Statin therapy can have detrimental effects on testosterone levels, hence, this review talks about such effects and the possible ways to manage them.
Struggle Turning Back to Professional Nursing Practice in Iran
Authors: Mohammadi Nooredin , Seyedfatemi Naiemeh , Nikbakht-Nasrabadi Alireza , Mahmoudi Mokhtar
Published: April 2021

Background:

Current nursing shortage is becoming more complicated because of turnover intention among nurses. Most of the inactive nurses in Iran after a long time for various rations Returned To Professional Nursing Practice (RTPNP). Because the RTPNP program does not exist in Iran to prepare inactive nurses returning to practice, this study aimed to explore the strategies that contribute to preparing nurses for RTPNP.

Materials and Methods:

The present study was a part of the findings of a larger grounded theory study that lasted about 9 months from April 2019 to December 2019. The data were collected through semi-structured interviews with participants after signing an informed consent form. The average interview duration was 40 minutes. The study participants were selected through purposeful sampling from both public and private hospitals affiliated to Iran University of Medical Sciences. Participants included eight nurses, two education supervisors, two matrons, and two head nurses. Interviews were verbatim transcribed and analyzed using a constant comparative analysis method.

Results:

Struggle turning back to PNP was the main category that emerged from four categories of “seeking learning resources,” “return to practice support,” “getting used to a practice,” and “building a new family life” from the data analysis process.

Conclusions:

Returners struggle to get prepared for providing PNP to clients if there is no definite process of RTPNP. Organizational support and RTPNP programs are efficient strategies and could help these returners get prepared for PNP.
Caregiving Strategies in Families of Children with Congenital Heart Disease
Authors: Dalir Zahra , Manzari Zahra-Sadat , Kareshki Hossein , Heydari Abbas
Published: April 2021

Background:

The families of children with Congenital Heart Disease (CHD) experience challenges in taking care of their child, which may affect the whole family. Therefore, the families need to manage and organize the caregiving process for the child. In order to help families provide optimized and quality care for their child, it is important to understand how they manage caregiving challenges. This study was conducted with the aim to explore the strategies used by families for managing family caregiving for their child.

Materials and Methods:

This qualitative study was conducted on families of children with CHD referred to hospitals in Mashhad, Iran. The participants were selected using a purposive sampling method. The data were collected from among 40 eligible participants using in-depth and semi-structured interviews from November 2017 to December 2018. Conventional content analysis was used for data analysis and MAXQDA software for managing the coding process.

Results:

According to the results, effort to manage caregiving emerged as the main theme, which included the 4 categories of “monitoring the child's health conditions,” “organizing family life,” “optimizing family life,” and “establishing interaction.”

Conclusions:

The families used various strategies to manage caregiving including monitoring of the child's health conditions, organization, and optimization of family life, and effective interaction based on their knowledge, experiences, beliefs, and available sources. The results of the present study can help healthcare professionals and nurses to develop family-centered empowerment programs in order to promote families' abilities to manage family caregiving for a child with CHD.
An Analytical Cross-sectional Study to Compare Pulmonary Function and Respiratory Morbidity-Related Quality of Life between Construction Workers with Age-and Gender-Matched Controls
Authors: Chittaluru Praveen K. , Korra Raj K. , Asuri Vinay K. , Annakula Pratyusha , GMM Reddy
Published: April 2021

Context:

Respiratory morbidity among construction workers is one of the most neglected occupational diseases, in spite of the high risk.

Aims:

The aim of this study is to compare the respiratory symptoms, pulmonary function, and respiratory morbidity-related quality of life between people working in construction sites and the age- and gender-matched controls.

Settings and Design:

It is an analytical cross-sectional study.

Methods and Material:

People working in the construction sites (mason/daily laborer) for at least 5 years and control group working in other occupations were included. People other than mason/daily laborer and people with a past history of COPD/bronchial asthma before joining the construction industry were excluded.

Statistical Analysis Used:

Pulmonary function test was done and St. George respiratory questionnaire was used to the quality of life. Unpaired t-test and Chi-square test/Fisher's exact test were used to compare numeric outcomes and categorical outcomes respectively.

Results:

We have included 120 construction workers and 120 age- and gender-matched controls. The Forced Vital Capacity (FVC) (mean difference [MD] 0.20, 95% CI 0.025–0.381, P value 0.025), FEV1 (MD 0.21, 95% CI 0.061–0.364, P value 0.006), and FEV1\FVC% predicted (MD 5.01, 95% CI 1.11–8.92, P value 0.012) were significantly lower among the construction workers. The overall SGRQ score was also significantly higher among the construction workers indicating poor overall respiratory morbidity-related quality of life (MD 12.69, 95% CI 10.59–14.80, P value <0.001).

Conclusions:

Pulmonary function and respiratory function-related quality of life are considerably poor among people working in the construction industry.
A Comparative Study on the Health Problems and Substance Abuse among the Tobacco Farmers and Non-Tobacco Farmers in Hassan District, Karnataka
Authors: Muniswamy Sundar , Maliakel Steffi F
Published: April 2021

Background and Aims:

India ranks third in the worldwide tobacco production (2017), and it is increasing every year. Hassan is an important tobacco growing district in Karnataka with over 12,000 growers. These growers are exposed to health risks during cultivation of tobacco, pesticide exposure, long duration of work, mental stress, and nicotine toxicity – Green Tobacco Sickness (GTS) due to direct handling of green tobacco leaves.

Objectives:

To determine the prevalence of health problems associated with tobacco farming. To determine the extent of substance abuse in tobacco farmers as compared to non-tobacco farmers.

Methodology: Study design:

Cross-sectional study.

Duration:

3 months.

Sampling technique:

30 × 7 Cluster sampling technique. House-to-house survey was conducted in 30 tobacco growing villages of Hassan. Seven tobacco growers and seven non-growers were interviewed in each village. Alcohol use disorder identification test (AUDIT) & Fagerstrom nicotine dependence (FND) scale was used to assess the extent of substance abuse.

Results:

Symptoms of GTS like nausea, dizziness, poor appetite, insomnia were reported more in tobacco growers (p < 0.01). On FND assessment, 63% had moderate to high dependence. On AUDIT assessment, 55.07% growers who had drinking habit had hazardous drinking behavior. Logit function model was used to assess parameter estimate (OR) on substance abuse.

Conclusion:

Lack of knowledge regarding health effects of tobacco farming, lack of use of PPE, dust and smoke exposure during curing, intense physical and mental stress maybe some reasons for health problems in tobacco growers.
Continuous Adductor Canal Block for the Management of Below-Knee Postamputation Stump Pain in a Diabetic Patient
Authors: Basak Samir , Poddar Krishna
Published: April 2021

Limb amputation surgery is one of the oldest surgical procedures. Below-knee amputation (BKA) surgery is indicated for advanced critical limb ischemia, diabetic foot sepsis, and major trauma. The majority of unplanned readmission after lower limb amputation surgery occurs mainly due to persistent postamputation stump pain. One of the important causes of postamputation stump pain is stump site infection. A higher rate of infection is seen in diabetic patients. Postamputation stump pain management is challenging due to the presence of mixed nociceptive and neuropathic pain component. Various modalities of treatment to control the stump pain are published in different articles. However, no single technique or drug is found superior to others. Here, we report a case of severe postamputation stump pain after BKA surgery in a diabetic patient with stump site infection. The pain was successfully managed by continuous infusion of analgesics via the adductor canal perineural catheter. After the stoppage of the infusion, the patient did not report any phantom limb pain syndrome during the 6-month follow-up.
The Effectiveness of Low-Level Laser Therapy on Controlling Pain and Discomfort during Separator Placement before Fixation of Orthodontic Appliances
Authors: Muctar Sahar Abdelatif , Marouf Ali Abdelrahman , Awooda Elhadi Mohieldin
Published: April 2021

Background:

Pain and discomfort are the most common sequel of orthodontic treatment both before and after separator placement. The aim of this study was to evaluate the effectiveness of low-level laser therapy (LLLT) on pain and discomfort control during separator placement before orthodontic fixed appliance placement.

Materials and Methods:

A single-blind, split-mouth clinical trial with a sample size of six patients (12 half mouths as cases where three positions on the buccal side of each tooth lased by the power of 1 Watt diode laser before orthodontic separator placement, while the other 12 teeth acted as control where separators were placed without laser application. Assessment of pain and discomfort was done by visual analog scale. The results of pain intensity and discomfort between the study group (EG) and the control group (CG) were compared by t-test and ANOVA, and the level of significance was set at a level at P ≤ 0.05.

Results:

The majority of the laser group experienced pain during chewing (85.70%) and most of them change their food habits (66.70%). In most of the lased cases (70%), pain intensity increased after 72 h, while among the control cases; it increased after 24 h (83.40%). There was a statistically significant difference in pain degree among the laser group at different time intervals (P = 0.05), while on the control group, statistically significant difference was found at baseline immediately after placement of orthodontic separator (P = 0.05). The majority of the patients' followed the instructions and did not take any medication to decrease pain intensity (66.70%).

Conclusion:

LLLT was effective in decreasing pain and discomfort during elastic separator placement for orthodontic patients with fixed appliances.
Mobile Applications for Chronic Pain Management
Authors: Gupta Bhavna , Ahluwalia Pallavi
Published: April 2021

Background:

There has been considerable interest in mobile and tablet technology in the field of health care. This interest has brought the area of mobile health apps, described as providing health care and health-related services through communications devices, into-sharp focus. This study aimed to assess the status of contemporary apps targeted at chronic pain assessment and management with a particular focus on patient-centered approach, criterion for pain assessment, medication assessment, targeted system, and pain management/guidance.

Methodology:

We searched for pain apps specific for chronic pain on the App Store for iOS devices and Google Play for Android devices. Each app store was searched using terms related to “pain,” “chronic pain,” “pain scale,” and “pain management.” Various parameters such as the name of the app, availability in operating systems (iOS or Android), download cost, creation dates, date of latest update, language, type of pathology, user rating, number of downloads, reviews, type of target population, the objective of the app and target population were explored. To explore the downloaded apps, an Excel® tool was designed for data extraction.

Observations:

Two hundred and fifty-four numbers of apps were identified after excluding duplicates. Forty-seven apps were included in the study that had a rating of above 4 in Google play store for further analysis. Eight out of 47 apps only did extensive pain assessment, and pain rating score was available in 14 apps. Most of the apps targeted exercise as a primary modality of management, and provided knowledge about the disease process. Few apps were based on the patients' hospital-based management and very few apps targeted yoga, integrative therapy, and trigger point as the primary modalities of management. 75% of apps targeted general pain, and only 25% were specific to an organ system. Majority of the apps were neither designed nor edited by licensed health-care providers, and there was little direct involvement by health-care professionals.

Conclusion:

The use of mobile devices can offer many advantages and opportunities for enhancing medical care. At present, due to the lack of evidence supporting their use, caution should be taken in the use of smartphones apps. These applications should also be assessed and regularly analyzed, and integrated with pain assessment and pain management and incorporate various integrative therapies based on available recommendations.
Molecular docking studies and ADME-Tox prediction of phytocompounds from Merremia peltata as a potential anti-alopecia treatment
Authors: Abdurrahman Syawal , Ruslin Ruslin , Hasanah Aliya Nur , Mustarichie Resmi
Published: April 2021

Alopecia is a condition in which some or all of the hair from the scalp is lost. One recent preventative measure is the inhibition of the enzyme 5-α-reductase. Inhibition of the enzyme 5-α-reductase converts circulating testosterone to its more potent metabolite, dihydrotestosterone. Ethnobotically, Merremia peltata is used as a baldness medicine by utilising compounds contained within the leaves. This research aimed to test activity of 18 known compounds contained within M. peltata) as anti-alopecia. Activity was based on their interaction with the androgen receptor (PDB code 4K7a) using molecular docking and ADME-Tox prediction. The stages of research performed were: preparation of androgen protein structure databases; preparation and optimization of three-dimensional structures of compounds using ChemDraw 8.0; molecular docking to the androgen receptor protein using Autodock 1.5.6.; and ADME-Tox prediction using the pkCSM tool. The following test compounds had strong bond energies (ΔG): compound 16 (olean-12-en-3beta-ol, cinnamate)-7.71 kcal/mol, compound 17 (alpha-amyrine)-6.34 kcal/mol, and Finasteride-6.03 kcal/mol. Interestingly, the ΔG of compound 16 (olean-12-en-3beta-ol, cinnamate) is better than of minoxidil (-4.8 kcal/mol) and also to gold-standard treatment compound, finasteride. ADME-Tox prediction for compound 16 showed favorable results in several metrics such as skin permeability, absorption, and distribution. Compound 16 (olean-12-en-3beta-ol, cinnamate) is therefore a potential androgen receptor antagonist and may be beneficial in the treatment of alopecia.
Protective effect of purple corn silk extract against ultraviolet-B-induced cell damage in human keratinocyte cells
Authors: Poorahong Watcharaporn , Innalak Sukanda , Ungsurungsie Malyn , Watanapokasin Ramida
Published: April 2021

Ultraviolet-B (UVB) could lead to inflammation and cell death induction. Purple corn silk (PCS), part of female flower of corn has multiple pharmacological properties. This investigation focused on determining the preventive effects of PCS extract on human keratinocyte HaCaT cell damage induced by UVB irradiation. Cells were irradiated with 25 mJ/cm2 UVB after pre-treated with PCS extract for 1 h. Then, the cells were then placed in culture medium followed by subsequent experiments. Cell survival was determined by MTT assay. The immunofluorescence, DCFH-DA, JC-1, and Hoeshst33342 staining assays were used to determine γ-H2AX, intracellular reactive oxygen species (ROS), membrane potential of mitochondria, and nuclear condensation, respectively. Western blot analysis was used to investigate the proteins expression. The statistically significant comparison was calculated by analysis of variance at P < 0.05. The fluorescence and protein band intensity were quantified by Image J densitometer. The results indicated cell survival was increased upon PCS extract pretreatment followed by UVB exposure. PCS extract decreased γ-H2AX expression, intracellular ROS overproduction, and nuclear condensation in cells induced by UVB. Furthermore, The PCS extract pretreatment attenuated apoptosis response through stabilized mitochondrial membrane potential, decreased apoptosis mediator proteins including Bax, Bak, cleaved-caspases, and cleaved-PARP, and increased Bcl-2 and Bcl-xL expression comparing to the UVB-treated control. This finding demonstrated that the PCS extract can reduce the deleterious effects from UVB exposure through decreased intracellular ROS, DNA damage, and apoptosis induction on HaCaT cells.
Enhanced cytotoxic effects of Clinacanthus nutans and doxorubicin in combination toward breast cancer cell lines
Authors: Widjaja Sry Suryani , Rusdiana  , Ichwan M.
Published: April 2021

Breast cancer is one of the most common cancers with a relatively high mortality rate. Despite the advancement of its medical treatments, many patients are still seeking complementary alternative medicines, namely Clinacanthus nutans which is found mainly in South-East Asian countries. We aim to find the antioxidant properties and cytotoxic activity of the plant extract toward breast cancer cell lines Michigan Cancer Foundation-7 (MCF7) and T47D individually and in combination with doxorubicin. Extractions of C. nutans with ethanol, n-hexane, and ethyl acetate were done using rotatory vacuum evaporators with the reflux method. Screening of biochemical properties was conducted. Antioxidant activity was measured toward α, α-diphenyl-β-picrylhydrazyl (DPPH) with IC50 scores were shown to be highest in ethyl acetate extract. Cytotoxic effects of all three extracts were shown to be low in both MCF7 and T47D cells. However, combinations of 125 μg/ml n-hexane extract of C. nutans, and 0.1 μg/ml doxorubicin in T47D cancer cells showed further proliferation reduction compared to the single administration. The results suggested possible synergisms of the treatment combination.
Egg white-induced inflammation models
Authors: Barung Elisabeth Natalia , Dumanauw Jovie Mien , Duri Meilany Feronika , Kalonio Donald Emilio
Published: April 2021

The egg white was used to induce rat paw inflammation, with inadequate references to explain its mechanism. It's contained protein was identified as an allergen was suspected to trigger an inflammatory reaction. This research was aimed to evaluate the use of egg white as an inflammatory inductor in inflammation animal models through edema profile and histological change. Male Wistar rats were divided into three groups, which were given λ-carrageenan, fresh takes of the hen's egg white, and sterile saline solution. Edema was induced by subcutaneous injection of 0.1 ml of λ-carrageenan (1%), egg white, and sterile saline solution as the control in the hind paw of rats. Paw volume was measured before and then at 1, 2, 3, 4, 5, 6, and 24 h after the inductor injection. Paw tissue was taken for evaluation of rats’ paw histological change. The data were analyzed by one-way ANOVA followed by LSD test. The results of the study showed that the egg white could induce rat paw inflammation. Edema formation began in the 1st h and reached the peaks in the 2nd h after the subcutaneous injection of egg white. A number of leukocyte cells were also found in the inflamed paw tissues. Egg white was potential as an edema inductor for animal models of inflammation for the evaluation of new drugs or natural product with anti-inflammation activity.
Structure-based virtual screening of bioactive compounds from Indonesian medical plants against severe acute respiratory syndrome coronavirus-2
Authors: Gani Maria Apriliani , Nurhan Ahmad Dzulfikri , Maulana Saipul , Siswodihardjo Siswandono , Shinta Dewi Wara , Khotib Junaidi
Published: April 2021

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a virus that causes the infectious disease coronavirus disease-2019. Currently, there is no effective drug for the prevention and treatment of this virus. This study aimed to identify secondary metabolites that potentially inhibit the key proteins of SARS-CoV-2. This was an in silico molecular docking study of several secondary metabolites of Indonesian herbal plant compounds and other metabolites with antiviral testing history. Virtual screening using AutoDock Vina of 216 Lipinski rule-compliant plant metabolites was performed on 3C-like protease (3CLpro), RNA-dependent RNA polymerase (RdRp), and spike glycoprotein. Ligand preparation was performed using JChem and Schrödinger's software, and virtual protein elucidation was performed using AutoDockTools version 1.5.6. Virtual screening identified several RdRp, spike, and 3CLpro inhibitors. Justicidin D had binding affinities of −8.7, −8.1, and −7.6 kcal mol−1 on RdRp, 3CLpro, and spike, respectively. 10-methoxycamptothecin had binding affinities of −8.5 and −8.2 kcal mol−1 on RdRp and spike, respectively. Inoxanthone had binding affinities of −8.3 and −8.1 kcal mol−1 on RdRp and spike, respectively, while binding affinities of caribine were −9.0 and −7.5 mol−1 on 3CLpro and spike, respectively. Secondary metabolites of compounds from several plants were identified as potential agents for SARS-CoV-2 therapy.
Periosteal Ganglion Cyst Masquerading as Pes Anserine Bursitis
Authors: Dharmshaktu Ganesh Singh , Pangtey Tanuja
Published: April 2021

Periosteal ganglion cysts result from mucoid degeneration and cyst formation from periosteal tissue and are uncommon clinical entities. Long-standing periosteal ganglion cyst may present ith pain and pressure effect on underlying bone. Periosteal ganglion cysts at location near important bursa, in rare instances, may mimic bursitis and be misdiagnosed or treated inappropriately. Magnetic resonance imaging provides extensive details and delineation and is crucial for diagnosing these lesions. We report a case of 30-year-old female diagnosed and treated for pes anserine bursitis for months before radiological, and biopsy revealed a periosteal ganglion cyst spanning knee joint on medial aspect. Surgical excision as done to relieve the symptoms and there as no recurrence of the lesion noted in the follo-up.
Empirical analysis of extreme weather conditions and aviation safety in Nigeria
Authors: Akanni C.O. , Hassan A.M. , Osuji T.C.
Published: April 2021

The frequency of delay, diversion and outright cancellation occasioned by poor weather has affected the Nigerian aviation industry and serious safety implication.This study therefore examines the influence of weather conditions on aviation safety in Nigeria. Secondary data basically from Nigeria Meteorological Agency such as information on thunderstorm, fog occurrence and rainfall from 2004 to 2013 and data obtained from Federal Airport Authority of Nigeria on air accident induced by extreme weather within the same period were analysed using Multiple Regression Analysis. Results show that low visibility as a result of fog occurrence causes four (4) air traffic accidents more than other weather conditions and that Lagos experienced two (2) air accidents more than other airports during the period under study.  So also the value of R2 shows a value of 77.8% which implies that there is variation in the dependent variable (Airport Operation) which can be predicted by independent variables (Weather conditions). The F-statistic value of 62.892 is also found to be statistically significant at 5% (p<0.05) which shows that weather condition has significant influence on aviation safety. Baseline studies on flight operation, government intervention in aviation industry, maintenance culture were recommended.Keywords: Fog, Thunderstorm, Rainfall, Safety, Accident
Predictors of Time to First Line Antiretroviral Treatment Failure among Adult Patients Living with HIV in Public Health Facilities of Arba Minch Town, Southern Ethiopia
Authors: Oumer Enderis Bilcha , Hussen Hebo Sultan , Kote Debir Mesfin , Boti Sidamo Negussie , Shegaze Shimber Mulugeta
Published: April 2021

BACKGROUND: Antiretroviral therapy is a proven medication given for Human Immunodeficiency Virus positive individuals. However, first-line antiretroviral treatment failure becomes a public health issue and early detection of treatment failure is crucial for timely actions. Therefore, this study aimed to identify the predictors of time to first-line antiretroviral treatment failure among adult patients living with HIV in public health facilities of Arba Minch Town.METHODS: Institution-based retrospective cohort study was employed among 396 adult patients that were selected using simple random sampling. The data on relevant variables were extracted from patient medical cards. Bi-variable and multi-variable Cox proportional hazard regression analyses were used to identify predictors.RESULTS: The median survival time was 21 months. Substance use (AHR=2.94, 95% CI=1.62 to 5.32), disclosure status (AHR=1.98, 95% CI=1.03 to 3.79), time since HIV diagnosis (AHR=2.19 95% CI=1.01 to 4.79), WHO clinical stage (AHR=2.02, 95% CI=1.02 to 4.00), opportunistic infection (AHR=2.27, 95% CI=1.23 to 4.19), nutritional status (AHR=3.78, 95% CI=1.99 to 7.17), functional status (AHR=2.71 95% CI=1.33 to 5.51), CD4 count (AHR=1.99, 95% CI=1.05 to 3.75), and adherence level (AHR=1.99, 95% CI=1.05 to 3.76) were independent predictors of time to first line ART treatment failure.CONCLUSION: History of substance use, lack of disclosure status, time since HIV diagnosis, advanced WHO clinical staging, low CD4 counts, opportunistic infection, functional status, poor adherence to ART and under-nutrition affect the time to first-line treatment failure among adult patients living with HIV. Therefore, preventive interventions, and information and counseling focusing on high risk groups of HIV infected adult are very important.
Prevalence and Risk Factors of High Blood Pressure among Adults in Banyuwangi Coastal Communities, Indonesia
Authors: Erni Astutik  , Septa Indra Puspikawati  , Desak Made Sintha Kurnia Dewi  , Ayik Mirayanti Mandagi  , Susy Katikana Sebayang
Published: April 2021

BACKGROUND: Hypertension is a disease that still a problem in the world. Hypertension is a risk factor for heart disease and stroke mortality. Economic development and an emphasis on coastal tourism may have an impact on public health conditions, such as hypertension. This study aimed to determine risk factors related to hypertension among adults in coastal communities in Indonesia.METHODS: This was a cross-sectional study of 123 respondents between the age of 18-59 years old selected by cluster sampling. This study was conducted among coastal communities in Banyuwangi District, East Java, Indonesia. Data was analyzed using multivariate logistic regression.RESULTS: Our study showed that the prevalence of systolic and diastolic hypertension among residents of coastal communities were as high as 33.33% and 31.71%, respectively. Increasing age was associated with systolic and diastolic hypertension (ORsystolic=1.11; 95% CI=1.03-1.19, p=0.01 and ORdiastolic=1.07; 95% CI=1.01-1.15, p=0.03) after controlling other variables. Respondents with the poorest and richer socio economic status had higher odds of having systolic and diastolic hypertension compared to respondents with the richest socio-economic status (ORsystolic-poorest =12.78; 95% CI=1.61-101.54, p=0.02; ORsystolicricher=10.74; 95% CI =1.55-74.37, p=0.02 and ORdiastolicpoorest= 10.36; 95% CI= 1.40-76.74, p=0.02;ORdiastolic-richer=6.45;95% CI=1.01-41.43, p=0.05) after controlling other variables.CONCLUSION: Being of older age and of the lower in socioeconomic status are significantly associated with increasing risk for systolic and diastolic hypertension in these coastal communities. More studies need to be done in these and other coastal village to help design appropriate health promotion and counseling strategies for coastal community.
Evaluation of Antibacterial Activity of Pine Tar on Periodontal Pathogenic Bacteria: An In Vitro Study
Authors: Eman Ali Alqahtani  , Mohamed Fadul. A. Elagib  , Rawan Hamad Al-Yami  , Alanoud Saeed Abu Hatlah  , Amel I. Faragalla
Published: April 2021

BACKGROUND: Periodontal pathogens play an important role in etiology and pathogenesis of periodontitis. Microbiological examination of sub gingival plaque is used at the present time in etiological research as well as in clinical treatment of periodontitis to select the appropriate antibiotic agent if indicated. Pine tar has been used for the treatment of various skin diseases. So the study was done to evaluate the effect of Pine Tar oil on bacteria isolated from periodontitis patients.METHODS: Plaque samples from volunteer patients were collected using sterile paper points. Robertson's Cooked Meat (RCM) medium was used for the transportation and cultivation of aerobic, microaerophilic, and anaerobic microorganisms.RESULTS: The result suggests the use of Pine tar oil for topical application in periodontal diseases. Disc diffusion analysis was sufficient enough to illustrate that 75 μl tar oil solution produced growth inhibition of microbial strains.CONCLUSION: Pine tar oil has become one of the important areas of research both in pharmaceutical and periodontal research, hence in vivo studies has to be carried out with various form of pine tar.