bluuebunny/crossref_metadata_2025 huggingface dataset:
Socio-economic & demographic determinants of hypertension & knowledge, practices & risk behaviour of tribals in India
Authors: Laxmaiah A. , Meshram I.I. , Arlappa N. , Balakrishna N. , Rao K. Mallikharjuna , Reddy Ch Gal , Ravindranath M. , Kumar Sharad , Kumar Hari , Brahmam G.N.V.
Published: December 2024

Background & objectives:

An increase in prevalence of hypertension has been observed in all ethnic groups in India. The objective of the present study was to estimate prevalence and determinants of hypertension among tribals and their awareness, treatment practices and risk behaviours in nine States of India.

Methods:

A community based cross-sectional study adopting multistage random sampling procedure was carried out. About 120 Integrated Tribal Development Authority villages were selected randomly from each State. From each village, 40 households were covered randomly. All men and women ≥ 20 yr of age in the selected households were included for various investigations.

Results:

A total of 21141 men and 26260 women participated in the study. The prevalence of hypertension after age adjustment was 27.1 and 26.4 per cent among men and women, respectively. It was higher in the States of Odisha (50-54.4%) and Kerala (36.7-45%) and lowest in Gujarat (7-11.5%). The risk of hypertension was 6-8 times higher in elderly people and 2-3 times in 35-59 yr compared with 20-34 yr. Only <10 per cent of men and women were known hypertensives and more than half on treatment (55-68%). Men with general and abdominal obesity were at 1.69 (CI: 1.43-2.01) and 2.42 (CI: 2.01-2.91) times higher risk of hypertension, respectively, while it was 2.03 (CI=1.77-2.33) and 2.35 (CI 2.12-2.60) times higher in women. Those using tobacco and consuming alcohol were at a higher risk of hypertension compared with the non users.

Interpretation & conclusions:

The study revealed high prevalence of hypertension among tribals in India. Age, literacy, physical activity, consumption of tobacco, alcohol and obesity were significantly associated with hypertension. Awareness and knowledge about hypertension and health seeking behaviour were low. Appropriate intervention strategies need to be adopted to increase awareness and treatment practices of hypertension among tribals.
Herbal medicine & healthcare practices among Nicobarese of Nancowry group of Islands - an indigenous tribe of Andaman & Nicobar Islands
Authors: Chander M. Punnam , Kartick C. , Vijayachari P.
Published: December 2024

Background & objectives:

Tribal people often depend on herbal medicines and the traditional knowledge practitioners (TKPs) serve as their healthcare service providers. This study was an attempt to document the use of medicinal plants by the Nicobarese of Nancowry group of Islands.

Methods:

Field survey was conducted in all the five inhabited Islands of the Nancowry group of Islands. All the TKPs were interviewed with a questionnaire-guided ethnomedicinal survey protocol. Voucher specimens of all the cited plants (botanic species) were collected and a Community Biodiversity Register of Nicobarese of Nancowry was prepared.

Results:

A total of 77 TKPs were identified, who together were using 132 medicinal plant species belonging to 113 genera and 62 families. The TKPs were treating a total of 43 ailments. Seven endemic and three rare plant species were recorded. The most common plant part used was leaves. Remedies were usually prepared using water as the excipient. Routes for administration of medicinal plant preparations were oral, topical and others. The information collected from the TKPs were collated in the form of Community Biodiversity Registers.

Interpretation & conclusions:

The present survey shows that the medicinal plants play a pivotal role in the healthcare of the Nicobarese tribe of Nancowry group of Islands. Efforts to document the medicinal plant species and the formulations used by them are necessary to prevent the loss of this precious knowledge.
International open trial of uniform multidrug therapy regimen for leprosy patients
Authors: Manickam Ponnaiah , Mehendale Sanjay M. , Nagaraju Bathyala , Katoch Kiran , Jamesh Abdul , Kutaiyan Ramalingam , Jianping Shen , Mugudalabetta Shivakumar , Jadhav Vitthal , Rajkumar Prabu , Padma Jayasree , Kaliaperumal Kanagasabai , Pannikar Vijayakumar , Krishnamurthy Padabettu , Gupte Mohan D.
Published: December 2024

Background & objectives:

Uniform therapy for all leprosy patients will simplify leprosy treatment. In this context, we evaluated six-month multidrug therapy (MDT) currently recommended for multibacillary (MB) patients as uniform MDT (U-MDT) in a single-arm open trial under programme conditions. Primary objective was to determine efficacy to prevent five-year cumulative five per cent relapse. Secondary objectives were to assess acceptability, safety and compliance.

Methods:

Newly detected, treatment-naive leprosy patients were enrolled in India (six sites) and P. R. China (two sites). Primary outcome was clinically confirmed relapse of occurrence of one or more new skin patches consistent with leprosy, without evidence of reactions post-treatment. Event rates per 100 person years as well as five-year cumulative risk of relapse, were calculated.

Results:

A total of 2091 paucibacillary (PB) and 1298 MB leprosy patients were recruited from the 3437 patients screened. Among PB, two relapsed (rate=0.023; risk=0.11%), eight had suspected adverse drug reactions (ADRs) (rate=0.79) and rate of new lesions due toreactions was 0.24 (n=23). Rates of neuritis, type 1 and type 2 reactions were 0.39 (n=37), 0.54 (n=51) and 0.03 (n=3), respectively. Among MB, four relapsed (rate=0.07; risk=0.37%) and 16 had suspected ADR (rate=2.64). Rate of new lesions due to reactions among MB was 1.34 (n=76) and rates of neuritis, type 1 and type 2 reactions were 1.37 (n=78), 2.01 (n=114) and 0.49 (n=28), respectively. Compliance to U-MDT was 99 per cent. Skin pigmentation due to clofazimine was of short duration and acceptable.

Interpretation & conclusions:

We observed low relapse, minimal ADR and other adverse clinical events. Clofazimine-related pigmentation was acceptable. Evidence supports introduction of U-MDT in national leprosy programmes. [CTRI No: 2012/ 05/ 002696]
Observation on frequency & clinico-pathological significance of various cytogenetic risk groups in multiple myeloma
Authors: Kadam Amare Pratibha S. , Jain Hemani , Nikalje Shraddha , Sengar Manju , Menon Hari , Inamdar Nitin , Subramanian P. G. , Gujral Sumeet , Shet Tanuja , Epari Sridhar , Nair Reena
Published: December 2024

Background & objectives:

Multiple myeloma (MM) is a plasma cell malignancy characterized by cytogenetic heterogeneity. In comparison with conventional karyotyping, fluorescence in situ hybridization (FISH) can efficiently detect various genetic changes in non-cycling plasma cells in 50-90 per cent of MM cases. The present study was undertaken in MM patients to evaluate the frequency and clinico-pathological significance of various cytogenetic abnormalities in the Indian population.

Methods:

Interphase FISH was applied on purified plasma cells of 475 patients with MM using specific probes. Interphase FISH for 1q gain/1q amplification was performed on a separate group of 250 newly diagnosed MM patients.

Results:

Low frequency of Δ13 [-13/del(13q)] (32%) and t(11;14) (5%) was observed in our 475 patients probably due to ethnic diversity. Clustering of Δ13, del(17) (p13.1) and IgH translocations in non-hyperdiploidy confirmed prognostic significance of ploidy in MM. t(4;14) and del(17) (p13.1) were high-risk groups due to correlation with high serum β2-microglobulin, increased plasma cells and advanced disease. Hyperdiploidy and t(14;16) were associated with higher age group. In a separate group of 250 patients, 1q amplification [amp(1q)] in combination with Δ13 and/or del(17p) with t(4;14) revealed association with adverse clinico-laboratory features, which confirmed progressive role of amp(1q) with adverse prognostic impact. Amp(1q) was clustered at 1q21 and 1q25 loci.

Interpretation & conclusions:

Based on our findings, it appears that comprehensive analysis of various cytogenetic aberrations by interphase FISH is a powerful strategy being adapted for risk stratification of MM.
Computational prediction of immunodominant antigenic regions & potential protective epitopes for dengue vaccination
Authors: Muthusamy Karthikeyan , Gopinath Krishnasamy , Nandhini Dharmalingam
Published: December 2024

Background & objectives:

Epitope-based vaccines (EVs) are specific, safe and easy to produce. However, vaccine failure has been frequently reported due to variation within epitopic regions. Therefore, development of vaccines based on conserved epitopes may prevent such vaccine failure. This study was undertaken to identify highly conserved antigenic regions in the four dengue serotypes to produce an epitope-based dengue vaccine.

Methods:

Polyprotein sequences of all four dengue serotypes were collected and aligned using MAFFT multiple sequence alignment plugin with Geneious Pro v6.1. Consensus sequences of the polyproteins for all four dengue serotypes were designed and screened against experimentally proven epitopes to predict potential antigenic regions that are conserved among all four dengue serotypes.

Results:

The antigenic region VDRGWGNGCGLFGKG was 100 per cent conserved in the consensus polyprotein sequences of all four dengue serotypes. Fifteen experimentally proven epitopes were identical to the immunodominant antigenic region.

Interpretation & conclusions:

Computationally predicted antigenic regions may be considered for use in the development of EVs for protection against dengue virus. Such vaccines would be expected to provide protection against dengue infections caused by all dengue serotypes because these would contain antigenic regions highly conserved across those serotypes. Therefore, the immunodominant antigenic region (VDRGWGNGCGLFGKG) and 15 potential epitopes may be considered for use in dengue vaccines.
Prevention of phosphine-induced cytotoxicity by nutrients in HepG2 cells
Authors: Rashedinia Marzieh , Jamshidzadeh Akram , Mehrabadi Abbas Rezaiean , Niknahad Hossein
Published: December 2024

Background & objectives:

Phosphides used as an insecticide and rodenticide, produce phosphine (PH3) which causes accidental and intentional poisoning cases and deaths. There is no specific treatment or antidote available for PH3 poisoning. It is suggested that PH3-induced toxicity is associated with adenosine triphosphate (ATP) depletion; therefore, in this study the effect of some nutrients was evaluated on PH3 cytotoxicity in a cell culture model.

Methods:

PH3 was generated from reaction of zinc phosphide (10 mM) with water in the closed culture medium of HepG2 cells, and cytotoxicity was measured after one and three hours of incubation. ATP, glutathione (GSH) and lipid peroxidation were also assessed at one or three hours post-incubation. ATP suppliers including dihydroxyacetone, glyceraldehyde and fructose were added to the culture medium 10 min before PH3 generation to prevent or reduce phosphine-induced cytotoxicity.

Results:

Phosphine caused about 30 and 66 per cent cell death at one and three hours of incubation, respectively. ATP content of the cells was depleted to 14.7 per cent of control at one hour of incubation. ATP suppliers were able to prevent cytotoxicity and ATP depletion induced by PH3. Dihydroxyacetone, α-ketoglutarate, fructose and mannitol restored the ATP content of the cells from 14.7 per cent to about 40, 34, 32 and 30 per cent, respectively. Lipid peroxidation and GSH depletion were not significantly induced by zinc phosphide in this study.

Interpretation & conclusions:

The results supported the hypothesis that phosphine-induced cytotoxicity was due to decrease of ATP levels. ATP suppliers could prevent its toxicity by generating ATP through glycolysis. α-keto compounds such as dihydroxyacetone and α-ketoglutarate may bind to phosphine and restore mitochondrial respiration.
Risk factors associated with fluoroquinolone-resistant enterococcal urinary tract infections in a tertiary care university hospital in north India
Authors: Banerjee Tuhina , Anupurba Shampa
Published: December 2024

Background & objectives:

Fluoroquinolone resistance in both Gram-positive and Gram-negative bacteria has increased with the widespread use of fluoroquinolones. Fluoroquinolone resistance in Gram-negative bacilli has been widely studied, though staphylococci and enterococci are also notably resistant. Enterococci being the second most common cause of healthcare-associated urinary tract infections (UTIs) fluoroquinolones are often the drug of choice. This study was undertaken to assess the risk factors associated with fluoroquinolone-resistant enterococcal UTI in a tertiary level health facility in north India.

Methods:

A total of 365 patients with UTI caused by enterococci were studied over a period of two years. Patients with ciprofloxacin-resistant and susceptible UTI were considered as cases and controls, respectively. Resistance profile of the isolates against common antibiotics was studied by minimum inhibitory concentration (MIC) determination. Mechanisms for fluoroquinolone resistance was studied by efflux pump inhibitor activity and multiplex PCR targeting the qnr genes.

Results:

A total of 204 (55.89%) cases and 161 (44.1%) controls were identified. The fluoroquinolone-resistant isolates were significantly resistant to ampicillin, high strength aminoglycosides and vancomycin. The majority (78%) of the resistant isolates showed efflux pump activity. Treatment in indoor locations, presence of urinary catheters and pregnancy along with recent exposure to antibiotics especially fluoroquinolones, third generation cephalosporins and piperacillin-tazobactam were identified as independent risk factors.

Interpretation & conclusions:

Our results showed that fluoroquinolone resistance in enterococcal UTI was largely associated with indoor usage of antibiotics and use of indwelling devices. Knowledge of risk factors is important to curb this emergence of resistance.
Characterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital
Authors: Vancini-Campanharo Cássia Regina , Vancini Rodrigo Luiz , de Lira Claudio Andre Barbosa , Andrade Marília dos Santos , Lopes Maria Carolina Barbosa Teixeira , Okuno Meiry Fernanda Pinto , Batista Ruth Ester Assayag , Atallah Álvaro Nagib , de Góis Aécio Flávio Teixeira
Published: December 2024

Background & objectives:

Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality.

Methods:

This prospective study was conducted at Emergency Department of São Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3±17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality.

Results:

Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation.

Interpretation & conclusions:

The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.
Transplant-associated Thrombotic Microangiopathy: An Enigma Treated with Eculizumab
Authors: Ravitej S. , Khan Mohammed Fahad , Augustine Rohan , Siddini Vishwanath , Vankalakunti Mahesha , Ballal H. Sudarshan
Published: December 2024

ABSTRACT

Transplant-associated thrombotic microangiopathy (TA-TMA) is characterized by high mortality and morbidity, often presenting with TMA and renal dysfunction. The condition can be challenging to diagnose due to overlapping symptoms with other HSCT complications. Here, we discuss the medical history of a young patient with acute myeloid leukemia who underwent hematopoietic stem cell transplantation (HSCT). The patient’s posttransplant course was complicated by several issues, including liver graft-versus-host disease, neutropenic sepsis, and suspected calcineurin inhibitor toxicity, which led to the discontinuation of tacrolimus. This case of TA-TMA post-HSCT shows the complexity of this condition. The interventions, including plasmapheresis, dialysis, and eculizumab, were pivotal in stabilizing her condition. The renal biopsy which was done once her active disease settles confirmed the clinical suspicion. It is encouraging to see that she no longer requires dialysis, and her hematological parameters have normalized.
Synaptic roles of cyclin-dependent kinase 5 & its implications in epilepsy
Authors: Dixit Aparna Banerjee , Banerjee Jyotirmoy , Tripathi Manjari , Sarkar Chitra , Chandra P. Sarat
Published: December 2024

There is an urgent need to understand the molecular mechanisms underlying epilepsy to find novel prognostic/diagnostic biomarkers to prevent epilepsy patients at risk. Cyclin-dependent kinase 5 (CDK5) is involved in multiple neuronal functions and plays a crucial role in maintaining homeostatic synaptic plasticity by regulating intracellular signalling cascades at synapses. CDK5 deregulation is shown to be associated with various neurodegenerative diseases such as Alzheimer's disease. The association between chronic loss of CDK5 and seizures has been reported in animal models of epilepsy. Genetic expression of CDK5 at transcriptome level has been shown to be abnormal in intractable epilepsy. In this review various possible mechanisms by which deregulated CDK5 may alter synaptic transmission and possibly lead to epileptogenesis have been discussed. Further, CDK5 has been proposed as a potential biomarker as well as a pharmacological target for developing treatments for epilepsy.
Ocular distribution of antioxidant enzyme paraoxonase & its alteration in cataractous lens & diabetic retina
Authors: Bharathidevi Subramaniam Rajesh , Babu Kannadasan Anand , Jain Nishit , Muthukumaran Sivashanmugam , Umashankar Vetrivel , Biswas J. , Angayarkanni Narayanasamy
Published: December 2024

Background & objectives:

The enzyme paraoxonase (PON), an antioxidant enzyme that has both arylesterase and thiolactonase activity, is well studied in cardiovascular diseases. Although a few studies have shown altered PON activity in ocular diseases such as age-related macular degeneration and diabetic retinopathy, but the tissue-wise expression of PON in its three gene forms has not been studied. This study was conducted to see the ocular distribution of PON for any altered expression in ocular pathologies such as in cataract and diabetes mellitus.

Methods:

Immunohistochemistry (IHC) of the ocular tissues was done for localizing all three forms of the PON in the human donor eyeballs. The PON arylesterase (PON-AREase) and thiolactonase (PON-HCTLase) activities were determined by spectrophotometry in kinetic mode, and the mRNA expression of the PON genes (PON1-3) was determined by reverse transcription-polymerase chain reaction.

Results:

IHC showed the presence of both PON1 and 2 in all the ocular tissues and PON3 was seen only in retina. The mRNA expression analysis showed that PON2 and PON3 were present in all the tissues, whereas PON1 was seen only in ciliary and retina. Both the PON-AREase and PON-HCTLase activities were detected in all ocular tissues and was in the order of lens>retina>choroid>ciliary body>iris. The expression and activity were studied in cataractous lens and in diabetic retina of the donor eyes. A significant decrease in PON-AREase activity was seen in cataractous lens (P<0.05) but not in diabetic retina, and there was an increase in PON- HCTLase activity (P<0.05) only in diabetic retina. Bioinformatic studies and in vitro experiments indicated that advanced glycation end products (AGE) such as carboxymethyl -lysine might decrease the PON- AREase activity of the PON.

Interpretation & conclusions:

Distribution of PON enzyme and its activity in ocular tissues is reported here. The study revealed maximal PON activity in lens and retina, which are prone to higher oxidative stress. Differential activities of PON were observed in the lens and retinal tissues from cataractous and diabetic patients, respectively.
National sample survey to assess the new case disease burden of leprosy in India
Authors: Katoch Kiran , Aggarwal Abha , Yadav Virendra Singh , Pandey Arvind
Published: December 2024

A national sample survey of leprosy was undertaken in partnership with Indian Council of Medical Research (ICMR) institutions, National Leprosy Eradication Programme (NLEP), Panchayati Raj members, and treated leprosy patients to detect new cases of leprosy in India. The objectives of the survey were to estimate the new leprosy case load; record both Grade 1 and Grade 2 disabilities in the new cases; and to assess the magnitude of stigma and discrimination prevalent in the society. A cluster based, cross-sectional survey involving all States was used for the door-to-door survey using inverse sampling methodology. Rural and urban clusters were sampled separately. The population screened for detecting 28 new cases in rural and 30 in urban clusters was enumerated, recorded and analyzed. Data capture and analysis in different schedules were the main tools used. For quality control three tiers of experts were utilized for the confirmation of cases and disabilities. Self-stigma was assessed in more than half of the total new patients detected with disabilities by the approved questionnaire. A different questionnaire was used to assess the stigma in the community. A population of 14,725,525 (10,302,443 rural; 4,423,082 urban) was screened and 2161 new cases - 1300 paucibacillary (PB) and 861 multibacillary (MB) were detected. New case estimates for leprosy was 330,346 (95% Confidence limits, 287,445-380,851). Disabilities observed in these cases were 2.05/100,000 population and 13.9 per cent (302/2161) in new cases. Self-stigma in patients with disabilities was reduced, and the patients were well accepted by the spouse, neighbour, at workplace and in social functions.
Interplay of cytokines in preterm birth
Authors: Pandey Monika , Chauhan Mradula , Awasthi Shally
Published: December 2024

Preterm infants (i.e., born before <37 wk of gestation) are at increased risk of morbidity and mortality and long-term disabilities. Global prevalence of preterm birth (PTB) varies from 5 to 18 per cent. There are multiple aetiological causes and factors associated with PTB. Intrapartum infections are conventionally associated with PTB. However, maternal genotype modulates response to these infections. This review highlights the association of cytokine gene polymorphisms and their levels with PTB. Varying PTB rates across the different ethnic groups may be as a result of genetically mediated varying cytokines response to infections. Studies on genetic variations in tumour necrosis factor-alpha, interleukin-1 alpha (IL-1α), IL-1β, IL-6, IL-10 and toll-like receptor-4 genes and their association with PTB, have been reviewed. No single polymorphism of the studied genes was found to be associated with PTB. However, increased maternal levels of IL-1β and IL-6 and low levels of IL-10 have been found to be associated with PTB.
Female genital tuberculosis
Authors: Sharma Jai Bhagwan , Sharma Eshani , Sharma Sangeeta , Dharmendra Sona
Published: December 2024

Female genital tuberculosis (FGTB) is caused by Mycobacterium tuberculosis (rarely Mycobacterium bovis and/or atypical mycobacteria) being usually secondary to TB of the lungs or other organs with infection reaching through haematogenous, lymphatic route or direct spread from abdominal TB. In FGTB, fallopian tubes are affected in 90 per cent women, whereas uterine endometrium is affected in 70 per cent and ovaries in about 25 per cent women. It causes menstrual dysfunction and infertility through the damage of genital organs. Some cases may be asymptomatic. Diagnosis is often made from proper history taking, meticulous clinical examination and judicious use of investigations, especially endometrial aspirate (or biopsy) and endoscopy. Treatment is through multi-drug antitubercular treatment for adequate time period (rifampicin, isoniazid, pyrazinamide, ethambutol daily for 60 days followed by rifampicin, isoniazid, ethambutol daily for 120 days). Treatment is given for 18-24 months using the second-line drugs for drug-resistant (DR) cases. With the advent of increased access to rapid diagnostics and newer drugs, the management protocol is moving towards achieving universal drug sensitivity testing and treatment with injection-free regimens containing newer drugs, especially for new and previously treated DR cases.
A Century-Old Threat: Disseminated Tuberculosis in a Healthy Host – Case Report
Authors: Kumarasamy Poongodi Santhana , Ponnuthurai Bala , Swamidoss Stanley James Benjamin , Mohamed Mohamed Arafath
Published: December 2024

Disseminated tuberculosis (dTB) is usually rare in immunocompetent individuals. We report a case of dTB presented with constitutional symptoms and extensive lymphadenopathy with bilateral lung parenchymal airspace opacities. Histopathological and molecular methods confirmed the etiological agent – Mycobacterium tuberculosis. She was started on first-line antitubercular treatment and she had significant clinical recovery.
Multimodality Imaging Approach in Infective Endocarditis: When Less is More
Authors: Di Salvo Giovanni , Muhammad Saleem , Galzerano Domenico , Mansour Al Jufan
Published: December 2024

The latest ESC guidelines advocate for a multimodality imaging approach in diagnosing infective endocarditis, incorporating echocardiography, computed tomography (CT), magnetic resonance imaging, positron emission tomography/CT, and single-photon emission CT/CT to enhance diagnostic accuracy. This case study examines the limitations of this approach in a patient with suspected prosthetic valve endocarditis, suggesting that while multimodality imaging is valuable, a clinically oriented strategy may be more effective in certain situations.
Comparative Study of Fluence Distribution and Point Dose Using Arc-check and Delta4 Phantoms
Authors: Singh Sandeep , Bhushan Manindra , Singh Benoy Kumar , Kumar Anuj , Dipesh  , Singh Abhay Kumar , Gairola Munish , Vikram
Published: December 2024

The study aims to assess the fluence distribution and point dosage between two phantoms for patient-specific quality assurance on the Tomotherapy system. This was a retrospective study conducted on 15 patients who had radiation using the Helical Tomotherapy Machine (Radixact, Accuray Inc.). We used two phantoms to quantify the fluence produced by the treatment planning system (TPS) and recorded from the machine. The ArcCHECK (Sun-Nuclear) has 1386 diodes placed in a cylindrical configuration. The minimal resolution for this was 7 mm. The second was Delta4, supplied by ScandiDos. It has 1069 diode detectors arrayed in a crossed orthogonal configuration with a minimum resolution of 5 mm. All patient plans were transferred to these phantoms to validate the accuracy of treatment plan delivery. We used SunCHECK and ScandiDos Delta4 software to compare the fluence produced by the TPS with the fluence measured by the equipment. In ArcCHECK, we used an external ionization chamber, cc13 (IBA dosimetry), whereas in Delta4,we employed a central diode detector to quantify point dosage. The mean and standard deviation of the gamma pass percentage with ArcCHECK were 98.3 ± 0.8%, with an average point dose deviation of ± 0.94%. The mean and standard deviation of the gamma pass percentage using Delta4 was 99.1 ± 1.6%, while the average point dose deviation was ± 0.60%, both of which were well within the 3% tolerance employing the two phantoms.
Study of Molecular Interactions, Optical, and Structural Properties through the Green Synthesis of Selenium Oxide Nanoparticles from Hibiscus sabdarriffal: Biocompatibility for Biophysics
Authors: Bahari Ali , Esmail Saad I. , Alattar Ashraf M.
Published: December 2024

Background:

Recently, the green synthesis process has been utilized to manufacture a large quantity of metal nanocrystallites due to its low cost and the availability of numerous natural resources and the find the activity of bacteria and viruses that in the body of humans.

Aims and Objectives:

In this study, nanocrystallites of selenium oxide were produced utilizing Hibiscus sabdariffa. Researchers have analyzed the antibacterial properties and nanostructure characteristics of selenium oxide nanocrystallites using various techniques methods, such as imaging microscopy, scanning electron microscopy, ultraviolet‒visible spectroscopy (UV‒VIS), transmission electron microscopy, atomic force microscopy, and X-ray diffraction (XRD) spectroscopy.

Results:

According to the results, the films are discovered to have a nanocrystalline structure in a cubic spinel configuration. The crystallites are semispherical in shape and are both uniform and easily distributed. The XRD data were recorded on card number 22-1314, and the 2 θ (hkl) value was 38.351 (311). The UV‒VIS spectrum of the material exhibited a plasmon resonance peak at 272 nm, confirming the presence here of selenium oxide. This study also investigated the response of four distinct strains of pathogenic bacteria to biosynthesized selenium oxide nanoparticles (NPs). The data indicate that the biosynthesized selenium oxide NPs were highly effective against Klebsiella spp. and had the lowest effectiveness against Staphylococcus
aureus, Staphylococcus epidermidis, and Escherichia coli.

Conclusions:

The utilization of selenium oxide nanocrystals as antibacterial agents has yielded diverse outcomes, demonstrating their remarkable efficacy in combatting Klebsiella spp.
Analysis of Planning Risk Volume for Heart during Radiotherapy Delivery with Breath-Hold Technique for Carcinoma of Left Breast
Authors: Jain Radhika , Kamal Rose , Semwal Manoj K. , Thaper Deepak , Kanwar Shefali , Saxena Tripti
Published: December 2024

Purpose:

The purpose of the study was to analyze and estimate planning risk volume (PRV) margin for heart in deep inspiration breath hold (DIBH)-based left breast radiotherapy.

Materials and Methods:

Fifty left-sided cancer breast cases treated with volumetric modulated arc radiotherapy were included in this retrospective study. Treatment plans were created using the Eclipse treatment planning system from Varian Medical System. The treatment was delivered on TrueBeam linear accelerator (Varian). Onboard cone-beam computed tomography (CBCT) images were generated and image registration between the planning computed tomography images and the CBCT images was performed before treatment delivery. The registration provided the shifts (errors) values in 6° of freedom, namely three translational and three rotational. From the shift values, the systematic and random errors were estimated which were used to estimate PRV margin for the heart after incorporating the rotational errors with the translational errors.

Results:

The systematic error values after incorporating rotational errors with translational errors were 0.13 cm (lateral) and 0.11 cm (cranio caudal [CC] and anterioposterior each), and the random error values were 0.16 cm (lateral) and 0.13 cm (CC and anterioposterior each). Based on these values, the PRV margins for the heart in all three directions were 0.24 cm (lateral), 0.20 cm (CC), and 0.19 cm (anterioposterior).

Conclusion:

As per our institutional practice, the 2 mm value for PRV margin for the heart in all the three directions would suffice for appropriate sparing of the heart during DIBH-based radiation therapy.
Angioarchitecture and Endovascular Therapy of Infantile Dural Arteriovenous Fistulas
Authors: Liang Shikai , Lv Xianli
Published: December 2024

Infantile dural arteriovenous fistula (IDAVF) is a rare complex dural arteriovenous fistulas. This study is to provide a comprehensive understanding of the angioarchitecture of arteriovenous shunts in IDAVFs and planning endovascular treatment. Five cases of IDAVF and a literature review were analyzed to characterize the shunt patterns of IDAVFs in terms of anatomic relations to the arterial feeder, sinuses, and cortical veins. Treatment characteristics and outcomes were evaluated. A total of 37 cases of IDAVF were identified, including 32 cases from the 15 literature studies and five cases from our center. The patients’ age is 11 weeks to 27 years, with an average of 6 ± 7.8 years. Fourteen patients were female, and 23 patients were male. IDAVFs were characterized by multiple high-flow fistulas fed by arterial feeders from six vessels converging to enlarged dural sinuses, most of which were torcular, transverse-sigmoid, or superior sagittal sinuses (94.6%). In 31 cases treated endovascularly, only 9 (29%) IDAVFs resulted in complete occlusion. Clinical outcomes were reported in 28 cases treated endovascularly with a 64.3% of morbidity (mRS ≥ 2) and mortality. There were no differences in complete occlusion rate (25% vs 33.3%, P > 0.999) and death rate (21.4% vs 21.4%, P > 0.999) between transarterial and transvenous approaches. IDAVFs were characterized by multiple high-flow fistulas fed by arterial feeders from six vessels converging to enlarged dural sinuses, most of which were torcular, transverse-sigmoid, or superior sagittal sinuses. Considering these multiple suppliers and high-flow shunts, transarterial or transvenous embolization is still insufficient and unsatisfactory.
Numerical analysis of a FE/SAV scheme for a Caginalp phase field model with mechanical effects in stereolithography
Authors: Jin Xingguang , Lam Kei Fong , Ye Changqing
Published: December 2024

In this work, we propose a phase field model based on a Caginalp system with mechanical effects to study the underlying physical and chemical processes behind stereolithography, which is an additive manufacturing (3D printing) technique that builds objects in a layer-by-layer fashion by using an ultraviolet laser to solidify liquid polymer resins. Existence of weak solutions is established by demonstrating the convergence of a numerical scheme based on a first order scalar auxiliary variable temporal discretization and a finite element spatial discretization. We further establish uniqueness and regularity of solutions, as well as optimal error estimates for the Caginalp system that are supported by numerical simulations. We also present some qualitative two-dimensional simulations of the stereolithography processes captured by the model.
Factors associated with hospitalisation among diabetes patients in Western Kenya
Authors: Tessy Achieno , Awandu Shehu Shagari , Ochung' Antony , Mudibo Evans O. , Ayodo George
Published: December 2024

BACKGROUND
Diabetes patients routinely visit hospitals and often get admitted for periods. However, drivers of routine hospital visits and admissions (here defined as hospitalisation) are poorly understood to inform improved management of diabetes at the household level. This study determined factors associated with hospitalisation among diabetes patients in Busia County, Kenya.
METHODOLOGY
The study adopted a hospital-based cross-sectional study design and employed systematic sampling to select 155 participants from diabetes patients seeking healthcare services at Busia County Referral Hospital. Data was collected in March 2023, six months retrospectively using a structured questionnaire. Bivariate and adjusted multivariable logistic regressions were used to assess factors associated with hospitalisation.
RESULTS
More than one-half (n = 89, 57.4%) of the participants were females. Over 85% of the participants enrolled were aged 40 years and above (40-59 years [n = 66, 42.6%]; 60+ years [n = 67, 43.2%]). Approximately 53% of respondents reported at least one hospital admission within six months, whereas 47% had routine visits. Participants aged at least 60 years old had higher odds of hospital admission and routine clinic visits; 16.07 (Adjusted Odds Ratio [AOR] = 16.07, 95% CI = 4.47 – 57.72, p-value <0.001) and 7.30 (AOR = 7.30, 95% CI = 2.35 – 22.62, p-value <0.010), respectively. Diabetes patients who reported to be taking alcohol had a higher proportion of hospital admissions, p-value = 0.004. Diabetes patients with concurrent HIV had more routine hospital visits compared to their counterparts without HIV (AOR =2.74, 95% CI = 1.03-7.25, p-value <0.001).
CONCLUSIONS
The study shows that old age, employment status, alcohol consumption, and comorbid HIV were associated with hospitalisation. These findings underscore the urgency of targeted interventions to address the socioeconomic disparities and strengthen diabetes management policies in Kenya. Further studies targeting; behavioral status, host diabetes, and comorbidity conditions will be important to inform improved management of diabetes at the household level to reduce hospitalisation.
Patterns and distribution of malocclusion among ghanaian orthodontic population.
Authors: G.K Amoah , R.D Pobee , M Newman-Nartey , T.A Ndanu , G.T Mayari Yabang
Published: December 2024

BACKGROUND: Knowledge about the distribution patterns of the malocclusions in a population helps orthodontic practitioners plan orthodontic services and preventive programs.AIM: To determine the distribution patterns of malocclusions in the Ghanaian orthodontic population.MATERIALS AND METHODS: Across-sectional study involving 70 orthodontic patients aged between 9 and 18 years was conducted at the University of Ghana Dental School. The participants were selected using consecutive sampling and recruited after they had signed a written consent or assent. The participants’ facial profiles and lower anterior facial heights (LAFH) were determined. The incisor, canine, and molar relationships and open bite were assessed. Descriptive statistics were used to summarize the findings and finally presented in tables. The significance level was p<0.05.RESULTS: 51% of the participants had orthognathic profiles. The incisor, canine, and molar relation more frequent were Class II div 1 for the incisors (40%) and Class I for canines and molars (47% and 88%, respectively). Only 11.4% of participants had an open bite.CONCLUSIONS: Among the participants with orthognathic profiles, Angle’s class I molar and canine relationship were most frequent, and class II division 1 for the incisal relationship was more prevalent. Open bites were not frequent among these patients.
Patients’ acceptance of shade selected in the fabrication of pfm crowns: spectrophotometric method compared with the visual method.
Authors: Adebayo Gbenga Emmanuel , M.D Ajayi , O.S Gbadebo
Published: December 2024

BACKGROUND: Aesthetic factors are increasingly important in the fabrication of dental prostheses. Ultimately, dental restoration must accurately reproduce the tooth shade that matches the neighboring teeth to satisfy the patient’s aesthetic demand.Objective: To compare the effectiveness of conventional visual and digital spectrophotometric methods of shade selection for porcelainfused-to-metal crown restoration with respect to patients’acceptability of the outcome product.MATERIALS AND METHODS: Twenty-six teeth were included in the study. Three calibrated examiners performed the visual shade selection, while the primary investigator performed the spectrophotometric shade selection. The shade of the fabricated PFM crowns for each method was subjectively rated by the patient and objectively rated by measuring the CIEL*a*b* colour difference. Data were analysed using IBM SPSS version 23 (p <0.05).RESULTS: There was a poor agreement with the shades selected using conventional and spectrophotometric methods. Inter-examiner and intra-device reliability for both methods were 0.11 and 0.39, respectively. The shades of PFM crowns from the spectrophotometric method were more acceptable to participants than the visual method. (p value=0.002).CONCLUSION: The patient’s acceptance of the shade of the porcelain-fused-to-metal crown was higher in the spectrophotometric shade selection method. The difference in the total colour of the PFM crown from the conventional visual and spectrophotometric methodwas not statistically significant.
Marginal adaptation and post-operative sensitivity in non-carious cervical lesions using a universal adhesive in a Nigerian population
Authors: OMOSEBI Temitope Olabisi , C.I Adegbulugbe , A.O Awotile , L.L Enone , G.E Adebayo
Published: December 2024

BACKGROUND: Problems such as microleakage and post-operative sensitivity may arise in the composite restoration of non-carious cervical lesions (NCCLs). This study assessed marginal adaptation and post-operative sensitivity in restored non-carious cervical lesions using a universal adhesive with different application techniques.MATERIALS AND METHODS: An interventional study included sixty teeth that met the selection criteria. Total-etch and selective-etch were the two application techniques used. Marginal adaptation and post-operative sensitivity were evaluated immediately post-op as a baseline, then at 3, 6, and 12 months using FDI Criteria. Data collected was analyzed using SPSS with statistical significance at p≤ 0.05.RESULTS: The majority of participants belonged to the 41-50 years age group. The NCCLs were present more in the maxillary teeth at 43(71.7%). Regarding marginal adaptation, out of the 60 restorations, seven restorations showed small marginal fractures at the 12- month period in both techniques. Restorations in the selective-etch technique group had 100% scores of 1 (no hypersensitivity) in postoperative sensitivity throughout the evaluation periods, whereas there was a score of 2 for minor hypersensitivity of restoration in the totaletch technique.CONCLUSION: The assessment of marginal adaptation and post-operative sensitivity in restored teeth with NCCLs using a universal adhesive with selective etch and total-etch techniques showed good clinical performance over a one-year evaluation.
Experimental evaluation of effect of Drakshasava on memory and learning of Wistar rats
Authors: Dawane Jayshree , Panpaliya Gaurav , Raorane Riya
Published: December 2024

Drakshasava is a traditional herbal preparation used in Ayurveda as a general tonic to treat various ailments. It primarily consists of draksha (grapes), along with multiple other herbal ingredients. During the manufacturing of the asava the alcohol is generated. There are claims about enhancement of the effect of Drakshasava by this self-generated alcohol. Present study was undertaken with the objective to evaluate the effects of Drakshasava, an Ayurvedic fermented formulation, on memory and learning in Wistar rats. Thirty-two Wistar rats were allocated into four groups: a control group, Drakshasava-LD & HD and standard drug treated. The Drakshasava-treated group received 2 ml/kg and 4ml/kg body weight and Piracetam was given to standard drug group orally for 21 days. Behavioral assessments were conducted using the Elevated Plus Maze and Morris Water Maze (MWM) to evaluate spatial learning, memory retention, and recall abilities. Rats treated with Drakshasava showed significant improvement in the EPM, Drakshasava-treated rats demonstrated improved retention and recall, evidenced by prolonged step-through latency. In the MWM test, no significant reduction in escape latency and time spent in the target quadrant compared to the control groups, indicating no effect on spatial learning and memory. Drakshasava enhances cognitive function moderately in Wistar rats, as evidenced by improved performance in behavioral tests. These findings support the potential use of Drakshasava as an antianxiety agent but not as a cognitive enhancer.
Ethanol root extract of Uvaria chamae down-regulates Ki-67 in cadmium chloride-induced prostate pre-malignancy in Wistar rats
Authors: Edem Donatus Gabriel , Sakpa Christopher Lucky , Ezeuko Vitalis Chukwuma
Published: December 2024

Prostate malignancy is one of the most diagnosed malignancies in men worldwide and a major health problem to men in both developed and developing world. Currently, several medicinal plants have been reported to possess anti-malignant property, hence we decided to investigate this property in Uvaria chamae (UC) on Ki-67 which is a prognostic factor in prostate malignancy. Emphasis was also placed on oxidative stress markers. A total of sixty (60) Wistar rats were used for this investigation and were randomly divided into ten (10) groups of six (6) animals each. Group 1 served as control and received distilled water alone, group 2-6 were induced with pre-malignancy using 3mg/kg of cadmium chloride (Cdcl2) for twenty-eight (28) days. Group 3-6 were subsequently treated with 150mg/kg of casodex, 2500mg/kg, 1500mg/kg and 1000mg/kg of UC root extract respectively, after the initial induction of pre-malignancy. Group 7-10 received 150mg/kg of casodex, 2500mg/kg, 1500mg/kg and 1000mg/kg Uvaria chamae root extract alone, respectively. After sacrifice, prostate tissues were removed for immunohistochemical assay of Ki-67 and oxidative stress studies. Results obtained from this study showed ki-67 up-regulation in prostate tissues induced with pre-malignancy, similarly a significant down-regulation of Ki-67 marker was observed in prostate tissues of Uvaria chamae treated groups after pre-malignancy. Ki-67 marker remained low in Uvaria chamae alone treated group. Furthermore, ethanol root extract of U. chamae down-regulated tissue level of MDA but up-regulated tissue levels of SOD, CAT and GPx in Cdcl2-induced prostate pre-malignancy. The results established that, U. chamae root exhibit strong anti-cancer property in prostate pre-malignancy.
Gas chromatography-mass spectrometry analysis, druggability and in-silico dermatopharmacokinetics screening of Mitracarpus scaber extract.
Authors: Attah Friday , Abalaka Moses E. , Abdulsalami Halimat , Builders Philip F.
Published: December 2024

Medicinal plants are an important source of natural compounds used in the development of drugs to treat infectious diseases. The plant Mitracarpus scaber has traditionally been used to treat various ailments, including skin disorders. In this study, GC-MS (gas chromatography-mass spectrometry) analysis was used to identify eighteen bioactive components in the methanolic extract of Mitracarpus scaber whole plants. To assess the druggability and skin pharmacokinetics of these phytocompounds, in silico screening was performed using online programs such as Swiss ADME, pkCSM, ADMETLab 2.0, and StopTox. The druggability assessment of the identified compounds met the requirements of Lipinski's Rule of Five, which is a set of standards used to estimate the likelihood of good oral drug absorption. The pharmacokinetic factors such as skin sensitization, acute inhalation toxicity, acute dermal toxicity, skin irritation and corrosion, skin permeability, Ames toxicity, carcinogenicity, eye corrosion, eye irritation, and oral acute toxicity were screened. Results indicated that the plant may be safe for therapeutic use since they do not exhibit acute oral toxicity and Ames toxicity and also had less acute dermal toxicity and acute inhalation toxicity. However, direct eye contact with the compounds should be avoided due to its potential to cause eye corrosion and eye irritation. Therefore, this in-silico screening method should be encouraged for the preclinical study of medicinal plants to avoid costly mistakes in the course of drug discovery and development