bluuebunny/crossref_metadata_2025 huggingface dataset:
Bacteriological Profile and Antibiotic Susceptibility Pattern of Pathogens Isolated in Ventilator-associated Pneumonia – A Single-center Study
Authors: Vaidhyswaran Ramya , Pawar Jyoti Amol , Karnam Ravishekhar , Chowdhary Abhay
Published: December 2023

Background:

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in people receiving mechanical ventilation. VAP developed during the first 4 days of mechanical ventilation is early-onset, usually less severe, mostly caused by antibiotic-sensitive bacteria, and has a better prognosis. On the other hand, late-onset VAP develops five or more days after the initiation of mechanical ventilation, is caused by multidrug-resistant pathogens, and is usually associated with increased morbidity and mortality. VAP may be caused by a wide spectrum of bacterial pathogens that may be polymicrobial and are rarely due to viral or fungal pathogens in immunocompetent hosts.

Methods:

Data were collected retrospectively from case files of the medical records department corresponding to the identified clinical isolates. The study included a total of 143 ventilated patients of both sexes who were admitted to intensive care units (ICUs) and fulfilled the criteria of VAP as well as non-VAP.

Results:

A total of 102 patients suffered from VAP. The number of ventilator days was calculated to be 2940 days. With the estimated VAP cases to be 102, the VAP rate was calculated to be 34.69/1000 ventilator days. The commonly isolated organisms were Acinetobacter species, Pseudomonas aeruginosa, and Klebsiella pneumoniae, which showed proportions of 39.5%, 28.1%, and 15.3%, respectively.

Conclusion:

Our study highlights the organism distribution, antibiotic susceptibility patterns, and the VAP incidence rate in our center. These findings, if replicated across centers, can potentially inform the management of VAP.
Simple-Virilizing Congenital Adrenal Hyperplasia – A Rare Case Report
Authors: Sharma Niketa , Lohiya Sham B.
Published: December 2023

Simple-virilizing congenital adrenal hyperplasia (SV-CAH) is an inherited condition which transmission is autosomal recessive due to complete or partial enzyme deficiency which leads to defective cortisol synthesis. It involves five enzyme-linked steps. Insufficiency of any enzyme leads to different types of CAH. It can be classified into classic and nonclassic. Classic has two subtypes – salt wasting and simple-virilizing type. This case report of a 3½-year-old boy showing an increase in growth of genitals and increase in pigmentation of the skin. A probable diagnosis of virilizing CAH or precocious puberty was made. On laboratory investigation, there was a decrease in the level of cortisol and grossly raised level of 17-hydroxyprogesterone. This condition was diagnosed with SV-CAH after confirmation with laboratory parameters. The patient was managed accordingly. The aim of the treatment was to correct the level of cortisol and maintain balance of electrolytes. Hence, the patient was treated with hydrocortisone and fludrocortisone and discharged with advice to continue the same treatment.
Human Teeth: The Valiant Survivors
Authors: Saraf Bharti , Gupta Shekhar , Patel Shraddha Aditya , Bedia Aarti S. , Bedia Sumit , Chaudhary Meenal , Khan Samar , Gawande Madhuri Nitin
Published: December 2023

Background:

Fire accidents are an important cause of mortality and morbidity worldwide which includes automobile accidents, bomb explosions, electric accidents, etc., Soft tissues are easily destroyed and conventional identification becomes impossible. In such cases, forensic odontology has been an important medicolegal investigation in humans during fire accidents as the teeth can withstand high temperatures. Unlike soft tissues, teeth have a higher degree of resistance to temperature, could potentially provide valuable information, and allowing personal identification.

Aim:

The aim of the study was to investigate the macroscopic and stereomicroscopic findings of the teeth exposed to various temperature ranges from 80°C to 90°C, 250°C–350°C, 750°C–850°C, and 900°C–1000°C.

Materials and Methods:

Tooth extracted for orthodontic or periodontal purposes was placed in a furnace and heated at a rate of 20°C/min and the effects at the predetermined temperatures range of 80°C–90°C, 250°C–350°C, 750°C–850°C, and 900°C–1000°C were examined macroscopically and then observed microscopically using stereomicroscope.

Results:

Teeth can resist high temperatures and their change in color from lesser to high temperature was seen. The evident colour changes were ranging from light yellow to yellowish–brown, greyish–brown, bluish–grey, and chalky–white.

Conclusion:

Teeth can be a reliable source of identification in fire accidents if no other means of identification is available.
Self-evaluation of Ethical Competence in Senior Physiotherapy Practitioners – An Observational Study
Authors: Ronghe Rashmi , Chandani Anjali , Khairkar Prajakta
Published: December 2023

Background:

The core aspect of a health-care professional’s expertise is their ethical competence. It is considered part of expertise.

Methodology:

A descriptive-qualitative study was conducted in the setting of private physiotherapy centers through a convenient sampling for 18 months. Over 170 physical therapists with more tha10 years of clinical experience participated in the study. Participants were given a printed form Self-modified Physiotherapist’s Ethical Competence Evaluation Tool, and results were prepared accordingly.

Results:

Out of 170 physiotherapists, majority of the therapists are ethically aware, though there is a small percentage of therapists who are not scoring well and need further education or further uplift in ethical practices and official ethical education in all ethical aspects.

Conclusion:

Around 70%–80% scored well, and a very small percentage needs an update in ethical education. The ethically effective practices provided by physiotherapists represent physiotherapists’ self-worth in these situations. A number of strategies can be applied to enhance the development of ethical competence, including moral contemplation, ethics groups, multidisciplinary ethics committees, ethics counseling, and ethics resources (such as online).
Rehabilitation of Edentulous Patient with Customized Functional Palatal Contours
Authors: Beri Arushi , Pisulkar Sweta Kale , Bansod Akansha Vilas , Godbole Surekha , Shrivastava Akshay
Published: December 2023

To restore the stomatognathic system of the patient with an edentulous span of 12–13 years who presents flabby tissue in the maxillary tuberosity region, severe resorption in the mandible along with reduced masticatory efficiency, and speech impairments in his old dentures. Complete denture rehabilitation helps patients cope with the significant psychological and social consequences of tooth loss. In today’s image-conscious culture, dentures help sufferers reconnect with the world and re-establishes normal form, function, and esthetics. The most common complaints about prostheses are chewing, as well as poor esthetics and phonetics. Prosthetic rehabilitation for denture wearers should include more than just replacing missing teeth. The ultimate goals should be phonetics, esthetics, and oral function restoration. This article describes a simple, low-cost, practical, and beneficial procedure for the rehabilitation of people with complete dentures who have speech impairment, bone resorption, and flabby tissue. A 71-year-old male patient who is a teacher by profession and has a 30-year habit of chewing kharra paid a visit to the Department of Prosthetic Dentistry at Sharad Pawar Dental College and Hospital in Sawangi, Wardha. He was dissatisfied with his previous dentures because they did not provide adequate chewing quality, pronunciation, or esthetics. After compiling his dental history, it was discovered that he had previously worn dentures for 12 years and had missing teeth due to periodontal disease for 12–13 years. The case report affirms a simple and unique technique for the fabrication of dental prostheses. Palatograms are common, but the technique described in the case report is simple to implement. We achieved both form and function by resolving the issues of residual ridge resorption in the mandibular arch and flabby tissue in the maxillary arch. To summarize, deviations from natural speech immediately following complete denture rehabilitation are completely normal, and a pretreatment speech diagnosis is required for a more accurate comparison. Accustoming the patient to such instantaneous speech deviations must improve his adaptability. Palatograms are useful in identifying these deviations and confirming corrected palatal contours. Simple and low-cost, it is ideal for patients with total dentures and speech disorders.
Implications of Intrauterine Contraceptive Device on Cervical Health: A Cross-Sectional Study
Authors: Gowardhan Vidula Prashant , Karmarkar Pragati J. , Dongre Trupti
Published: December 2023

Background:

Amongst long acting, reversible contraceptives, Intrauterine contraceptive devices (IUCDs) are popularly used. While IUCDs are generally safe and effective, they can sometimes cause cytopathological changes in the cervix and endometrium. The most common cytopathological changes associated with IUCDs include inflammatory response in the endometrium and cervix, which can lead to the formation of granulomas and other inflammatory lesions, squamous metaplasia and endometrial hyperplasia. IUCDs can sometimes cause atypia in the glandular cells of the cervix, which may indicate a precancerous or cancerous condition.

Aims and Objectives:

This study was aimed at cytopathologic changes seen in cervicovaginal smears in IUCD users.

Material and Methods:

This descriptive, cross-sectional study was conducted in a tertiary care hospital over a period of 1 year.

Results:

In this study, maximum number of IUCD users belonged to age group 21 to 30 years and parity wise maximum number of patients were in P-2 group (65.78%). As duration of Cu-T increased, incidence of infection was found to be increased. The most frequent chief presenting complaint was excessive discharge per vaginum (49.13%). In our study specific causes of cervical infection in UCD users were reported as trichomanias 0.8% and candida species 12.07% respectively. We observed that most of the cases initially thought to be LSIL were later attributed to reactive changes specific to IUCD use. Prevalence of LSIL 5.26% and HSIL 0.87% have been reported.

Conclusion:

These cytopathological changes don’t occur in all the IUCD users and most of changes that do occur are benign and do not require treatment. However, women who use IUCDs should undergo regular cervical cancer screening to detect any abnormal changes that may require further investigation or treatment.
Benefits and Risks of Animal-assisted Interventions in Pediatric Health Care: A Mini Review
Authors: Vashe Asha , Bernhardt Liegelin Kavitha , Bernhardt Grisilda Vidya , Bhat Sujatha
Published: December 2023

Animal-assisted therapy (AAT) is a form of therapeutic approach aimed at faster achievement of therapeutic goals, through the use of certain animals. It is generally used as an adjunct or alternative therapy in people receiving other treatments for their health conditions. In recent decades, significant number of studies, to evaluate the effect of AAT on physical, psychological, social, and academic well-being of pediatric population have been completed, and most of these studies have proved AAT to be beneficial. This study aims to review the literature on AAT for children and to obtain a clearer understanding of the evidence supporting this interventional practice, and the possible risks involved.
Oral Manifestations and Considerations for Dental Care in Patients with Liver Diseases
Authors: Sonar Prasanna Ravindra , Panchbhai Aarati S.
Published: December 2023

The most important organ and second- largest organ is the liver. The liver performs a wide range of tasks for maintaining health and homeostasis and also breaks down a variety of drugs. In addition, the liver is where a number of clotting components are synthesized. Several disorders, including hepatitis, jaundice, cirrhosis, hepatocellular cancer, and liver failure, can have an impact on the liver. Different liver illnesses might have a negative impact on oral health as well. The current paper provides a brief summary of oral symptoms and dental care issues in liver disease patients. It focuses on issues with infections, hemorrhagic episodes, and therapy using medications frequently used in dental surgery.
The Conundrum of Identity or Prerogative of Choice
Authors: Joshi Yatishkumar S , Vagha Sunita , Venugopal Adith , Mishra Gaurav Vedprakash
Published: December 2023

A dentist, often known as a dental surgeon, is a medical professional who specializes in Dentistry, a specialty of medicine that deals with diagnosing, preventing, and treating illnesses and ailments of the mouth. It can be frustrating to come across debates like “Are dentists actual doctors?” or similar themes that have been accumulating for decades. There have been instances where dentists have lobbied to be entitled to use titles such as “Doctor,” and despite their triumph, many have chosen not to do so. Dentists are sometimes described as a combination of a doctor, artist, scientist, engineer, and businessman, and they are free to apply their skills in whatever way they deem fit. With a diverse set of talents and ample opportunities, the dentist has many job options. Therefore, why limit yourself to being a one thing, when you can do so much more?
Exploring the barriers and expectations towards health care services among parents/caretakers of people with intellectual disability in Kuantan, Malaysia: A qualitative study
Authors: Mohd Farah Natashah , Said Abdul Hadi , Ahmad Mas Suryalis , Ridzwan Ain Nuha , Muhammad Amira Izwani , Mat Naji Ahmad Syahir
Published: December 2023

Abstract

Backgrounds:

People with intellectual disabilities (PWID) are often characterized by challenges in learning and difficulties in performing daily activities. These difficulties can have an impact not only on the individuals themselves but also on the people around them, especially their parents, caregivers, and healthcare workers. Therefore, establishing a positive relationship between parents or caregivers and individuals with disabilities is crucial as a key factor in promoting positive healthcare experiences and outcomes.

Aim:

This study aims to explore the barriers and perceptions toward healthcare services among parents or caretakers of people with intellectual disability, including the challenges and their expectations toward healthcare services.

Materials and Methods:

This was a qualitative study using purposive sampling. Thirty participants were contacted at the initial stage and invited to participate in the study. Semi-structured in-depth interviews were done among parents and caretakers of PWID who attended Special Care Dentistry and Paediatric Dentistry clinics in Sultan Ahmad Shah Medical Centre, Kuantan, Pahang. Topic guides were generated from literature review and expert opinions, followed by pilot interviews to refine them. However, after the interviews were done for the first 13 participants, we have reached data saturation, and no new themes emerged. The interviews were recorded, verbatim transcribed, and analyzed using Braun and Clarke’s guidelines for thematic analysis.

Results:

The satisfaction of parents or caretakers toward healthcare services for PWID and positive experiences in receiving healthcare services were noted. However, the results revealed several barrier themes in seeking healthcare services: lack of availability of parking, longer waiting time, appointment time, crowded environment, limited information on the availability of the services, and longer travel duration. Furthermore, expectation themes emerged from this study: continuous follow-up, accessibility to healthcare services, and staff attitude.
Exploring the Efficacy of ZB-06 Vaginal Biofilm as a Novel Treatment for Recurrent Bacterial Vaginosis
Authors: Zubair Rooja , Mughal Sanila , Rathi Sushma , Ejaz Roshanay
Published: December 2023

The purpose of this research was to investigate the efficacy of ZB-06 vaginal biofilm as a novel treatment for recurrent bacterial vaginosis (BV). BV is a prevalent vaginal infection that primarily affects women of reproductive age and is linked to adverse health outcomes. Biofilm production allows bacteria to cling to the vaginal epithelium, making antibiotics harder to penetrate and treat the illness efficiently. ZB-06 is a vaginal biofilm inhibitor that may dissolve the biofilm generated by the bacteria causing BV, enhancing antibiotic therapy efficacy and lowering the risk of recurrence. The current literature on BV, biofilm formation, and the possible function of ZB-06 as a therapy option for recurrent BV is reviewed in this article. More research is needed to determine ZB-06’s safety and efficacy.
Effect of Strengthening Exercises on Sleep Quality among Females Suffering from Polycystic Ovarian Syndrome: A Randomized Controlled Trial
Authors: Bashir Shafiya , Goyal Kanu , Goyal Manu , Vaish Hina
Published: December 2023

Background:

Sleep problems also occur in women with polycystic ovarian syndrome (PCOS) of normal weight. Furthermore, PCOS and sleep disturbances are linked with worsening of cardiometabolic health in the long term.

Objective:

The study aimed to determine the effect of strengthening exercises on sleep quality among females suffering from PCOS.

Materials and Methods:

Twenty-four female participants aged 20–45 years suffering from PCOS from at least 1 year with body mass index of 18.5–29.9 kg/m2 and Pittsburgh Sleep Quality Index (PSQI) score ≥5 were randomized into experimental (n = 12) and control (n = 12) groups; allocation (1:1). The participants were blinded. Experimental group received strengthening exercises thrice per week for 4 weeks, and no intervention was given in control group. Sleep quality was assessed using PSQI.

Results:

The Wilcoxon signed-rank test showed significant improvements (P < 0.05) in sleep quality, sleep latency, sleep efficiency, sleep disturbances, and global score with strengthening exercises. Mann–Whitney U-test revealed significant improvements (P < 0.05) in use of medication (P = 0.016) and global score (P = 0.045).

Conclusion:

Four weeks of strengthening exercises has significant benefits in improving the sleep quality among females with PCOS.
Correlation of Female Genital Tuberculosis and Infertility: A Comprehensive Systematic Review, Meta-analysis, and Female Genital Tuberculosis Infertility Pathway Analysis
Authors: Vijay Anushri , Tiwari Neha , Sharma Amita , Pandey Geeta
Published: December 2023

Female genital tuberculosis (FGTB) is a significant health concern that can lead to infertility in women. FGTB is a common form of tuberculosis that affects the female reproductive organs. In India, around 27.5 million individuals are facing infertility issues due to female factors, and FGTB might be one of the leading causes. A systematic review and proportion meta-analysis of six studies was conducted using MedCalc 20.116 to examine the association between FGTB and infertility. The studies were identified through an electronic search of PubMed, MEDLINE, Elsevier, and the Cochrane Library from 2010 to 2023. The results showed that FGTB is significantly associated with infertility, with a prevalence of approximately 34.86%. These findings underscore the need for effective interventions to improve reproductive health in women with FGTB. Based on pathway analysis, we conclude that more clinical trials should be conducted to explore the potential utilization of interferon gamma and nuclear receptors as therapeutic drug targets and biomarkers for the prevention of FGTB. The findings of this review will contribute to raising awareness, facilitating accurate diagnosis, and improving the management of FGTB-related infertility.
Role of Alternate Therapies to Improve the Quality of Life in Menopausal Women: A Systematic Review
Authors: Aarshageetha P , Janci P. R. Rani , Tharani N. Devi
Published: December 2023

Middle aged women in majority undergoing menopausal symptoms are unaware of the physiological changes happening in their body, necessary lifestyle changes and alternate therapies to overcome the symptoms. All major electronic sources of relevant information were systematically searched and collected data were pooled under specific subheadings. From the reviewed papers, the awareness on symptoms and related complications of menopause in the middle aged women were consolidated. Studies helped to identify alternative therapies replacing or in parallel with the Hormone Replacement Therapy to overcome the menopausal symptoms. Reduced oestrogen and progesterone level causes physiological, psychological, and genitourinary symptoms. Prolonged consequences cause libido, osteoporosis, and cardio vascular diseases. Hypo-estrogenic status is well managed with alternative therapies including dietary intervention, acupuncture, aromatherapy, exercise, and yoga. Dietary interventions involving foods like Fennel, Soy, Black Cohash, St. John Wort, Red Clover and Date Pollen were found to be managing vasomotor symptoms and sexual dysfunction. Non-Hormonal and Non-Pharmacological impact behind acupuncture treatment was well accepted. Various studies proved inhaling and massaging with Lavender, Neroli oil, Fennel, Rose, and Geranium essential oils balance cortisol hormone and reduce stress and anxiety. Impact of yoga therapy on neurohormonal pathways reduce both psychological and physiological symptoms. Reviews summarizes various symptoms and complications during menopausal transition and alternate ways of better management with dietary intervention, yoga, exercise, aromatherapy, and acupuncture to improve the quality of menopausal women’s life.
Comparison of Human Epididymis Protein 4, Cancer Antigen 125, and Ultrasound Prediction Model in Differentiating Benign from Malignant Adnexal Masses
Authors: Bahadur Anupama , Bhattacharya Namrata , Mundhra Rajlaxmi , Khoiwal Kavita , Chawla Latika , Singh Rajni , Naithani Manisha , Kishore Sanjeev
Published: December 2023

Background:

This study aimed to compare the diagnostic performance of carcinogenic antigen (CA) 125, (HE)-4 (Human epididymis protein 4), and ultrasound (International Ovarian Tumor Analysis [IOTA]) Simple Rules individually and to derive a composite score in the differentiating ovarian cancer from benign ovarian mass.

Subjects and Methods:

Consecutive patients (n = 100) with pelvic mass admitted during February 2018–August 2019 were included prospectively. Patients with either known case of epithelial ovarian cancer (EOC) or metastatic EOC were excluded. The primary outcome was to assess the sensitivity and specificity of CA-125, HE-4, and IOTA Simple Rules in predicting benign from malignant mass independently, while secondary outcome was derivation of a new model incorporating these variables using multivariate logistic regression analysis to predict benign from malignant lesions. Receiver operator curve (ROC) was drawn to redefine the best-performing cutoff values and difference between area under the ROC (AUROC) were compared by DeLong’s method.

Results:

Out of 100 cases of adnexal mass selected, the sensitivity and specificity of CA-125 were 73.8% and 77.6%, HE-4 were 90.5% and 87.9%, and IOTA Simple Rules were 92.9% and 81.0%. CA-125, HE-4, and IOTA Simple Rules were independently associated with the likelihood of malignancy/borderline (P < 0.001). The area under the curve for the “composite score” (AUC = 0.93) was the highest and was significantly better than that of CA-125 (AUC = 0.786) (P = 0.004 using DeLong’s test) and comparable with HE-4 (AUROC = 0.90; P = 0.128 using DeLong’s Test).

Conclusion:

The sensitivity and specificity of HE-4 and IOTA Simple Rules for predicting malignant ovarian tumor was better than those of CA-125. The diagnostic performance of “composite score” was comparable to those of either HE-4 or IOTA Simple Rules and significantly better than CA-125.
Gross Appearance of Fine Needle Aspiration Smears: Can Adequacy of the Sample be Assessed and Correlated with their Microscopic Cytological Yield
Authors: Ramraje Sushma , Deb Prabal , Hiwale Buddheshwar N. , Deb Bishakha
Published: December 2023

Background:

Fine needle aspiration cytology (FNAC) is a simple procedure that is widely accepted as a first-line investigation. It should ideally be performed near the patient with microscopic assessment for evaluation of adequacy of aspirate. Since this is not always possible, a worthwhile substitute is to assess the gross appearance of the material obtained. This study was aimed to determine the value of this alternative rapid, bed-side approach.

Method:

This study was carried out in a tertiary care hospital for a duration of 1 year, where 50 cases undergoing FNAC in the out-patient department (OPD) were included. Unstained smears of commonly encountered lesions were photographed and assessed by three independent observers, who graded them into four grades, viz. Grade 1: unlikely to contain diagnostic material. Grade 2: possibly contains diagnostic material. Grade 3: probably contains diagnostic material. Grade 4: material suggesting a specific diagnosis. Results were subsequently compared with the microscopic findings of stained smears.

Results:

Distribution of the 50 cases between grades 1, 2, 3, and 4 were 5, 6, 17, and 22, respectively.

Conclusion:

Gross appearances of FNA smears are helpful in predicting the adequacy of the sample and sometimes the final microscopic diagnosis. The cellularity of a sample can be gauged by inspection and sometimes a likely diagnosis can be made. Some lesions show typical gross appearance easily detected by the experienced eye so a likely diagnosis can be predicted prior to microscopic examination. However, near-patient microscopic assessment of FNA specimens for rapid onsite evaluation, if available, should be the preferred mode.
Young Adults’ Knowledge and Perceptions of Permanent Noise-Induced Tinnitus and its Influence on Behavioural Intentions
Authors: Runciman Lucy , Johnson Christine
Published: December 2023

Objective: Young adults’ music-listening behaviours may put them at risk of developing permanent hearing loss and tinnitus. This study aimed to assess knowledge of permanent tinnitus and whether this knowledge may influence listening behaviours to a greater degree than knowledge of hearing loss. Materials and Methods: A two-group (between subjects), randomised post-test only, single-factor experimental design was used to determine the effects of health message focus (permanent tinnitus vs. permanent hearing loss) on the main outcome measure of protective behavioural intention. The sample included 109 male and 287 female adults, aged 18 to 25 years, living in the United Kingdom. The young adults’ existing knowledge of either permanent hearing loss or permanent tinnitus was measured, and after exposure to a health message, their perceptions and resultant behavioural intentions were assessed and compared. The pooled data were used to test a proposed model of factors influencing hearing protective behavioural intention using path analysis. Results: Whilst 83% knew about the link with hearing loss, only 75% knew that loud music may cause permanent tinnitus. The participants viewed tinnitus as closer temporally than hearing loss, perceived themselves as equally susceptible to both, but perceived hearing loss as more severe. There was no significant difference in behavioural intention between the groups. Conclusion: Perceived susceptibility and severity have a positive effect on behavioural intentions. In light of these results, recommendations for future noise-damage prevention campaigns are made.
Effects of Comprehensive Noise Reduction Management Combined with Reality Therapy on Anxiety and Depression in Hospitalised Patients with Breast Cancer
Authors: Dong Jie , Guo Juan
Published: December 2023

Objective: This study was conducted to explore the effects of comprehensive noise reduction management combined with reality therapy on anxiety and depression in hospitalised patients with breast cancer. Methods: The medical records of 166 inpatients with breast cancer in Tongji Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology from March 2020 to March 2022 were retrospectively analysed. According to different intervention methods, these patients were divided into group A (n = 58, receiving conventional intervention), group B (n = 55, receiving conventional intervention combined with reality therapy) and group C (n = 53, receiving conventional intervention combined with comprehensive noise reduction management and reality therapy intervention). Patients’ anxiety and depression, quality of life and satisfaction degree in the three groups were compared. Results: Before the intervention, the scores of the Hospital Anxiety and Depression Scale (HADS) and Short-From-36 Health Survey (SF-36) scale did not significantly differ amongst the three groups (P > 0.05). After the intervention, we observed a difference in the pairwise comparison of HADS scores amongst the three groups, in which group C had the lowest score and group A had the highest HADS score (P < 0.001). We also noted a difference in the pairwise comparison of SF-36 scores amongst the three groups, in which group C had the highest SF-36 score and group A had the lowest SF-36 score (P < 0.001). The pairwise comparison of satisfaction revealed a difference amongst the three groups, in which group C had the highest satisfaction (92.45%, 94.34% and 94.34%), and group A had the lowest satisfaction (74.14%, 74.14% and 75.86%; P < 0.05). Conclusion: Comprehensive noise reduction management combined with reality therapy can effectively relieve the negative emotions of inpatients with breast cancer, as well as improve their survival state of patients. It is suggested that it be included in the clinical intervention system for breast cancer.
The modified NUTRIC score as a predictor of 28-day mortality in patients with sepsis
Authors: Moubarez Doaa Atef
Published: December 2023

Background

Malnutrition is prevalent among severely ill individuals hospitalized in ICUs (intensive care units). In order to determine the potential for nutritional consequences in ICU patients, the score of ‘modified nutrition risk in the critically ill’ (mNUTRIC) is applied. This research aimed to determine whether the mNUTRIC score could be employed in septic patients for predicting 28-day death.

Methods

Four hundred ten individuals hospitalized in the ICU with sepsis were involved in this prospective observational research. To evaluate nutritional status upon hospitalization to the ICU, the mNUTRIC score was applied. Demographic and clinical characteristics were used to determine the mNUTRIC score.

Results

Four hundred ten individuals with sepsis participated in this investigation. The 56.6% of cases were shown to be at elevated risk of malnutrition (mNUTRIC ≥ 5 points), whereas 43.4% showed a lower risk (mNUTRIC < 5 points). During 28 days of being hospitalized in the ICU, 225 patients (54.9%) died. The mortality rate increased significantly in the group with an mNUTRIC score of greater than or equal to 5 compared with the group with an mNUTRIC score of less than 5 (P < 0.001). Multivariate analysis revealed a link between the mNUTRIC score and 28-day mortality (OR = 1.715, 95% CI = 1.549–1.898). The AUC (area under the curve) for mNUTRIC’s prediction of 28-day mortality was 0.866 (specificity 79.5% and sensitivity 80.9%) with the best cut-off value of 5.

Conclusion

When evaluating the likelihood of death within 28 days in patients with sepsis, the mNUTRIC score performed well as an independent predictor.
The incidence of aspiration pneumonia in acute ischemic stroke patients in relation to early insertion of nasogastric tube feeding
Authors: Hamdy Mohamad M. , Abdelshahid Amir I. , Mahrous Atef A.
Published: December 2023

Background

Stroke is the acute onset of cerebral ischemia. Dysphagia with difficult swallowing is one of the common complications during the course of acute stroke, its incidence varies between 29–67%. Pneumonia is the second most common cause of death during the acute phase of stroke, with up to 20% mortality rate. In patient with risk of dysphagia or deficient oral intake, enteral feeding will be recommended.

Objective

Study the effect of early insertion of nasogastric tube for feeding on incidence of aspiration pneumonia in acute ischemic stroke patients with abnormal water swallow test.

Methods

The study was carried out in Alexandria Main University Hospital on 40 patients with acute ischemic stroke. Patients with abnormal water swallow test were classified into two groups: Group A: Insertion of nasogastric tube on admission after diagnosis. Group B: Giving intravenous fluids, minerals and traces for the first 48 h then inserting nasogastric tube on the third day.

Results

By comparing the patients in both groups, there was no statistical significant difference between them as regards; age, gender, comorbidities, and APACHE II score on admission. There was a statistical significant difference between both groups regarding fever, CRP level, WBCs, hypoxic index and the length of hospital stay.

Conclusion

Inserting Nasogastric tube insertion on admission in acute stroke patients may increase the incidence of aspiration pneumonia than being non-oral for 48 h before insertion on the third day as it affects the duration of ICU and hospital stay.
Comparative study between ultrasound-guided transversus abdominis plane block and spinal morphine for pain relief after an elective cesarean section
Authors: Mahmoud Wael A.M. , El Khayat Hala M.H. , Omar Mohamed M. , Ahmed Islam M.
Published: December 2023

Background

Severe acute pain occurs in more than 10% of patients within the first 36 h after a cesarean section and can significantly impact women’s satisfaction. The aim of this study was to compare the transversus abdominis plane (TAP) block for postoperative pain relief following cesarean section operations with the most famous analgesia (intrathecal morphine) used for a cesarean section regarding its efficacy and complications.

Patients and methods

This interventional double-blinded randomized controlled study was carried out on 60 cases, who underwent an elective cesarean delivery. They were randomized into two groups; patients were divided into two equal groups. Group M received intrathecal 150 μg morphine in a 0.5 ml volume, mixed with 10 mg of hyperbaric bupivacaine 0.5% in a 2 ml volume (total volume 2.5 ml). Group B received intrathecal 10 mg hyperbaric bupivacaine 0.5% 2 ml volume+0.5 saline (total volume 3 ml) and at the end of surgery the patient received bilateral TAP block with a 20 ml volume of 0.25% bupivacaine on each side.

Results

Postoperative heart rate, respiratory rate, oxygen saturation, mean arterial blood pressure, and intraoperative Bromage score were insignificantly different at all-time measurements between both groups. Visual analog score and postoperative Bromage score at 2, 3, and 4 h were higher in group B than group M (P<0.001). Time of rescue analgesia was significantly prolonged in group M than group B (P<0.001). Total paracetamol and morphine doses were significantly lower in group M than group B (P<0.001).

Conclusions

TAP block is a good alternative technique to intrathecal morphine in reducing postcesarean section pain, with less postoperative nausea and vomiting and pruritus compared with intrathecal morphine (ITM).
Using teledentistry as a tool for management of dental services: A systematic review
Authors: Alsalman Wesam Talal
Published: December 2023

Introduction:

Unlike telemedicine, which is relatively well established in the literature and practice, implementation of teledentistry and its limitations are underexplored, and more well-designed research is needed to investigate them.

Aims:

The aim of the present study was to evaluate and identify the scopes, challenges, and opportunities for the use of teledentistry based on high-quality literature.

Materials and Methods:

As a qualitative systematic review with thematic analysis, the present study included English cross-sectional, prospective, and retrospective studies about the use of teledentistry for the prevention and treatment of dental patients. A quality appraisal methodology was used to evaluate the included studies which were found from online databases, namely, Medline through PubMed, Scopus, Web of Knowledge, and Cochrane databases, from 2017 to 2022.

Results and Discussion:

Five studies were included and presented with fair-to-good quality of evidence. Furthermore, there was overall agreement about the effectiveness of the use of teledentistry and the great opportunities it provides for the improvement of dental services. Several scopes were identified, including education, consultation, and examination. However, challenges such as technical difficulties and accuracy of examination of certain conditions were also identified and was advised to integrate the topic of teledentistry in dental school and health-care management courses.

Conclusion:

Teledentistry was found not to be a substitute for the establishment of a dental home but a complementary aspect of dental service management. In addition, better-quality, well-designed comparative studies, especially those related to scopes, economic aspects, telecommunication means, legislation, licensing, and official dental reporting are needed.
Assessment of crown dimensions of primary teeth in a selected sample of Indian children - An odontometric study
Authors: Kavyashree G. , Babu K. L. Girish
Published: December 2023

Introduction:

The size and shape of the tooth are important sources of information for anthropology, forensic odontology, and clinical dentistry. Different populations, and even individuals within the same population, may have variations in the odontometric characteristics of their teeth, which limits the applicability of the data across groups.

Aim:

To establish the normal odontometric data of primary teeth and examine the sexual dimorphism and its usefulness as a tool to identify the sex among young children.

Materials and Methods:

This cross-sectional study involved 150 children aged 3–5 years. The parents of the selected children were informed about the procedure protocol of the study and their written consent was obtained. The negative replica of the maxillary and mandibular teeth was obtained and dental casts were prepared. The mesiodistal, buccolingual, and crown height dimensions of each tooth were measured with a digital Vernier caliper. Two independent examiners measured each tooth’s dimensions three times, and the mean was analyzed.

Results and Discussion:

There was no significant difference between the teeth in the right and left quadrants. Males had larger odontometric dimensions than females. The sex of children based on odontometrics of primary teeth crowns could be determined with an accuracy of 98%, 72%, and 86% using mesiodistal, buccolingual, and crown height dimensions, respectively.

Conclusions:

There was a clear sexual dimorphism of the primary teeth. The odontometrics can be used as a low-cost and alternative tool for sex identification among children.
Assessment knowledge of dental erosion, signs and symptoms, and causes among adult in Saudi Arabia: A cross-sectional survey
Authors: Binaljadm Tahani Mohammed , Aljuaid Areej Owaid , Rummani Ghassan Mahmood , Almaghrabi Haneen Abdullah , Halabi Somayah Abdulrahman , Deeban Yahya Ahmed M. , Alqahtani Abdullah Saad
Published: December 2023

Introduction:

Dental erosion results from the chemical effect of nonbacteria origin. The causes of dental erosion could be from the intrinsic or extrinsic origin. Dental erosion is a silent disease as symptoms and signs occur gradually.

Aims:

To assess the knowledge of adults in Saudi Arabia about the causes, signs, symptoms, and factors that increase the possibility of getting dental erosion.

Materials and Methods:

A cross-sectional study was conducted using an online-based self-administrated questionnaire. The sampling was convenient with a snowball effect. It was divided into four sections; demographic data, signs, and symptoms, causes, and factors that increase acidic effect.

Results and Discussion:

A total of 765 respondents completed the online survey. Looking at dental erosion signs and symptoms, 57% identified chipping of the incisal edge of the teeth, and 47.6% increased teeth translucency. Asking the participants about causes of dental erosion 59% identified soft drinks and citrus fruit, followed by 44% putting lemon near the teeth for a long time. Eighty-three percent of the participants recorded visiting the dentist when noticing signs or symptoms of dental erosion. The responses highlighted dental students had higher level of knowledge compared to other.

Conclusion:

Increasing public awareness of dental erosion is important, as only a third of all participants were able to identify three or more dental erosion signs and symptoms, and 10% identified 5 out of 8 dental erosion causes. Participants with dental backgrounds showed the highest percentage of identifying dental erosion causes and, signs and symptoms, however, it is still low. Therefore, improving dental erosion learning outcomes should be improved in our colleges.
Indian Green Hydrogen Framework: An Assessment
Authors: Pandey Isha , Kumari Sandhya
Published: December 2023

INTRODUCTION: India, with its diverse energy needs, is at a crucial point, looking to adopt greener energy options for sustainable future; wherein green hydrogen is emerging as a key player, fitting well with India's renewable energy goals.
OBJECTIVES: In this backdrop, this research paper dives into the world of green hydrogen, India's renewable energy regime, and the latest green hydrogen initiatives. The paper highlights how green hydrogen works hand-in-hand with India's broader renewable energy plans, including private public partnerships. The paper also looks at the overview, challenges and future prospects of the green hydrogen framework of India.
METHODS: The methodology used in this paper is based on comprehensive analysis of legal documents, statutes and case law, focusing on a systematic examination of judicial decisions and legal principles.
RESULTS: The research concludes that green hydrogen holds significant promise for India's energy future, effectively complementing its renewable energy strategies and offering viable solutions to climate change challenges, thereby supporting the achievement of Sustainable Development Goal 7.
CONCLUSION: In conclusion, the research paper ends on a hopeful note, suggesting that green hydrogen could be a vital tool in addressing climate change and play a significant role in India's renewable energy regime, aiding in the achievement of SDG7.
On von Neumann equivalence and group approximation properties
Authors: Ishan Ishan
Published: December 2023

The notion of von Neumann equivalence (vNE), which encapsulates both measure equivalence and

W^*

-equivalence, was introduced recently by Ishan, Peterson, and Ruth (2019).
They have shown that many analytic properties, such as amenability, property (T), the Haagerup property, and proper proximality are preserved under von Neumann equivalence. In this article, we expand on the list of properties that are stable under von Neumann equivalence, and prove that weak amenability, weak Haagerup property, and the approximation property (AP) are von Neumann equivalence invariants. In particular, we get that AP is stable under measure equivalence. Furthermore, our techniques give an alternate proof for vNE-invariance of the Haagerup property.
The holonomy inverse problem
Authors: Cekić Mihajlo , Lefeuvre Thibault
Published: December 2023

Let

(M,g)

be a smooth Anosov Riemannian manifold and

\mathcal{C}^\sharp

the set of its primitive closed geodesics. Given a Hermitian vector bundle

\mathcal{E}

equipped with a unitary connection

\nabla^{\mathcal{E}}

, we define

\mathcal{T}^\sharp(\mathcal{E}, \nabla^{\mathcal{E}})

as the sequence of traces of holonomies of

\nabla^{\mathcal{E}}

along elements of

\mathcal{C}^\sharp

. This descends to a homomorphism on the additive moduli space

\mathbb{A}

of connections up to gauge

\mathcal{T}^\sharp: (\mathbb{A}, \oplus) \to \ell^\infty(\mathcal{C}^\sharp)

, which we call the
primitive trace map
. It is the restriction of the well-known
Wilson loop
operator to primitive closed geodesics.

The main theorem of this paper shows that the primitive trace map

\mathcal{T}^\sharp

is locally injective near generic points of

\mathbb{A}

when

\dim(M) \geq 3

. We obtain global results in some particular cases: flat bundles, direct sums of line bundles, and general bundles in negative curvature under a spectral assumption which is satisfied in particular for connections with small curvature. As a consequence of the main theorem, we also derive a spectral rigidity result for the connection Laplacian.

The proofs are based on two new ingredients: a Livšic-type theorem in hyperbolic dynamical systems showing that the cohomology class of a unitary cocycle is determined by its trace along closed primitive orbits, and a theorem relating the local geometry of

\mathbb{A}

to the Pollicott–Ruelle resonance near zero of a certain natural transport operator.
Cnoty samic w De natura animalium Eliana
Authors: Kostuch Lucyna
Published: December 2023

The Virtues of the Female in Aelian’s De natura animalium

In De natura animalium, Aelian describes the animal world in a manner that succumbs to the tendency to anthropomorphize that is rooted in the human mind – a phenomenon currently widely discussed in ethological and cognitive research. The author observes a female animal seeing in her the features of a woman. However, Aelian’s understanding is not superficial. At the same time, he tries to penetrate the perceptual environment of the male of a particular species and look at the female through his eyes. In some cases, the male animal analyzes the behaviour of a female, e.g., his female owner. In Aelian’s work, natural observations overlap with the author’s moral reflections (personal and as a product of his era) creating a set of virtues that could be assigned to the female sex. In the approach proposed by Aelian, these virtues are not always stereotypical, because apart from female virtues that are obvious in ancient culture, there are also less obvious ones: physical strength and courage, independence, speed in action, activity, as well as beauty that is a product of splendour. In De natura animalium, the traditional catalogue positive features attributed to the female sex seen through the prism of natural observations is modified.
Wielkopolskie „entuzjastki” – Bibianna Moraczewska i Emilia Sczaniecka. Życie złożone w służbie Ojczyzny – świadomy wybór czy zrządzenie losu?
Authors: Wyder Grażyna
Published: December 2023

Wielkopolskie Enthusiasts – Bibianna Moraczewska and Emilia Sczaniecka: Life in the Service of the Homeland – Conscious Choice or Fate?

Women of Greater Poland in the nineteenth century – outstanding Polish women: Bibianna Moraczewska (1811–1887) and Emilia Sczaniecka (1804–1896) – can be considered the first Polish suffragettes. They devoted their entire lives to national, social, and political activities. They actively participated in Polish national uprisings. They took part in the independence movement’s underground activities. They were known and respected in wide social circles, often actively collaborating in social and national projects. They treated their activities as a duty towards the enslaved homeland.