bluuebunny/crossref_metadata_2025 huggingface dataset:
Type and antibiotic susceptibility of bacteria cultured in paediatric acute appendicitis
Authors: Brits Elizabeth , Kruger Estie , Fivaz Karlize , Oosthuizen Koot , Joubert Mariska , Van Pletzen Petro-Mari , Roux Ronelle , Fourie Tahlita , Van Aswegen Trewhella , Sempa Joseph B. , Le Grange Susanna
Published: February 2025

Background: Studying the microbial profile and their antibiotic resistance in paediatric appendicitis is essential for tracking susceptibility, guiding treatment choices and ensuring effectiveness. Understanding variations in therapies can improve outcomes and reduce complications. Despite its importance, limited research has been conducted in South Africa on microbial profiles and antibiotic resistance in paediatric appendicitis.Objectives: To identify bacteria cultured from pus specimens obtained from paediatric patients with acute appendicitis and determine their antibiotic susceptibility.Method: This was a prospective case series of children aged 13 years and younger, who had appendectomies for acute appendicitis. Data were collected via REDCap and analysed using R software. Pus swabs were obtained for microscopy, culture and sensitivity of organisms isolated.Results: The study comprised 20 patients, of whom 12 (60%) were male. Most cases (n = 17; 85%) were complicated appendicitis. Escherichia coli was the most prevalent bacterial species isolated, accounting for 60% of cases, while no bacterial growth was observed in 30% of cases. All the isolates (100%) were susceptible to cefepime, gentamicin, amikacin, ertapenem, imipenem and meropenem, while high sensitivity rates of 92.9% were found for ciprofloxacin, ceftazidime and piperacillin-tazobactam. Short-term complications (predominantly surgical site infections) were present in 6 patients (30%).Conclusion: Escherichia coli was the most common bacterium in paediatric acute appendicitis, with all isolates sensitive to ciprofloxacin.Contribution: Regional monitoring and research are useful to adapt protocols and combat increasing antibiotic resistance.
Serum Soluble Endocan Might Be a Predictor of Preterm Labor
Authors: Sachan Rekha , Shahi Anamika , Sachan Pushplata , Shyam Radhey , Patel Munna Lal , Ali Wahid
Published: February 2025

Background:

Preterm birth is defined as birth before 37 weeks of gestation. It occurs in 10% of all deliveries worldwide and is a major contributor to perinatal mortality and morbidity. The study aimed to evaluate the role of serum-soluble Endocan levels in the prediction and prognostication of preterm labor.

Materials and Methods:

This was a prospective observational study carried out for 1 year in the Department of Obstetrics and Gynaecology, in collaboration with Pathology. Preterm labor was defined as per ACOG guidelines. After informed consent and ethical clearance from the institutional ethics committee, a total of 130 pregnant women with established preterm labor were recruited, and finally, 124 women were enrolled and further divided according to their gestation age, extreme preterm (n = 1), very preterm (n = 22), moderately preterm (n = 32), late preterm (n = 39), and term (n = 30) pregnancy. Serum endocan level was measured using the ELISA technique using a human ESM1 ELISA kit as per manufacturer protocol.

Results:

94.4% of women were not registered while 52.4% were urban and 41.9% were primigravida, 88.7% had body mass index (BMI) in the normal range. The mean serum endocan level was maximum in women who delivered moderate preterm babies (866.64 ± 43.42 pg/ml). followed by (730.68 ± 107.05 pg/ml) who delivered very preterm and almost equal to late preterm (659.21 ± 68.17 pg/ml) and term delivery (662.50 ± 38.30 pg/ml). The mean serum endocan level was higher (839.52 ± 81.16 pg/ml) in women who delivered within 24 h.

Conclusion:

Serum endocan might be a good prognostic marker in preterm labor; adequate antenatal care is required to prevent preterm labor.
Association between improved erectile function and dietary patterns: a systematic review and meta-analysis
Authors: Yang Bin , Wei Chao , Zhang Yu-Cong , Ma De-Lin , Bai Jian , Liu Zhuo , Liu Xia-Ming , Liu Ji-Hong , Yuan Xiao-Yi , Yao Wei-Min
Published: February 2025

Erectile dysfunction (ED) is prevalent among men, but its relationship with dietary habits is uncertain. The aim of our study was to assess whether dietary patterns enhance erectile function by reviewing the literature published before August 1, 2022, via PubMed, Web of Science, and EMBASE databases. The data compiled included author details; publication dates, countries, treatments, patient numbers, ages, follow-ups, and clinical trial outcomes, such as ED cases, odds ratios (ORs), confidence intervals (CIs), and International Index of Erectile Function-5 (IIEF-5) scores with means and standard deviations. An analysis of 14 studies with 27 389 participants revealed that plant-based diets (OR = 0.71, 95% CI: 0.66–0.75; P < 0.00001), low-fat diets (OR = 0.27, 95% CI: 0.13–0.53; P = 0.0002), and alternative diets such as intermittent fasting and organic diets (OR = 0.54, 95% CI: 0.36–0.80; P = 0.002) significantly reduced ED risk. High-protein low-fat diets (hazard ratio [HR] = 1.38, 95% CI: 1.12–1.64; P < 0.00001) and high-carb low-fat diets (HR = 0.79, 95% CI: 0.55–1.04; P < 0.00001) improved IIEF-5 scores. Combined diet and exercise interventions decreased the likelihood of ED (OR = 0.49, 95% CI: 0.28–0.85; P = 0.01) and increased the IIEF-5 score (OR = 3.40, 95% CI: 1.69–5.11; P < 0.0001). Diets abundant in fruits and vegetables (OR = 0.97, 95% CI: 0.96–0.98; P < 0.00001) and nuts (OR = 0.54, 95% CI: 0.37–0.80; P = 0.002) were also correlated with lower ED risk. Our meta-analysis underscores a strong dietary-ED association, suggesting that low-fat/Mediterranean diets rich in produce and nuts could benefit ED management.
Risk factors of scrub typhus infection in children and adults in Kerala, south India
Authors: Renu Govindarajan , Jaganathasamy Nagaraj , Ranganathan Krishnamoorthi , Kumari Krishna , Kumar Ashwani , Paulraj Philip Samuel
Published: February 2025

Objective:

To identify the risk factors for acquiring scrub typhus infection among all age group.

Methods:

A case-control study was carried out from June to December 2019 in collaboration with the Department of Health Services, Kerala. 136 Of serologically confirmed scrub typhus reported during 2018 were included and 270 age and sex-matched healthy controls were selected randomly from different locations in the same area where the cases were reported. The risk factors identified were compared between cases and controls, using univariate and multivariable logistic regression analysis to identify the risk factors for scrub typhus infection.

Results:

Some key factors like house type with individuals residing in houses with concrete roofs are associated with a higher risk of scrub typhus infection compared to tiled roofs (aOR 0.14, 95% CI 0.36-0.56, P=0.005). Housewives exhibit a significantly higher risk (aOR 3.97, 95% CI 2.15-8.94, P=0.038) of scrub typhus infection. Environmental factors, including the presence of rats (aOR 3.48, 95% CI 1.19-6.53, P=0.023), the presence of domestic animals (aOR 2.98, 95% CI 1.67-5.19, P<0.001), wet agricultural fields around the house (aOR 3.64, 95% CI 1.50-6.54, P<0.001), and hygiene practices like not changing clothes after work (aOR 2.64, 95% CI 1.37-4.68, P=0.024), and disposing of the wastes in their own yard (aOR 4.79, 95% CI 3.78-9.55, P=0.043) are identified as significant high-risk factors for scrub typhus infection.

Conclusions:

These findings will be very useful to create awareness among the public and to undertake a detailed control strategy for scrub typhus.
Trends of Candida species causing bloodstream infections in South-Eastern Asia: A systematic review and meta-analysis
Authors: Yamin Dina , Wakil Abubakar Muhammad , Goni Mohammed Dauda , Irekeola Ahmad Adebayo , Hajissa Khalid
Published: February 2025

A reliable estimation of Candida bloodstream infection prevalence is increasingly important to track changes in Candida species distribution and define burden of ongoing candidemia. A systematic review and meta-analysis were conducted to estimate candidemia prevalence and identify patterns of Candida species in South-eastern Asia. Systematic electronic-databases literature search was performed on published studies recorded candidemia prevalence in South-Eastern Asia. Using meta-analysis of proportions, the overall pooled prevalences of candidemia by Candida (C.) albicans, C. tropicalis, C. parapsilosis and C. glabrata were calculated as 28.4% (95% CI 24.9-31.8), 29.2% (95% CI 24.7-33.7), 19.1% (95% CI 14.8-23.4) and 14.0% (95% CI 10.4-17.5), respectively. Based on publication year and country, subgroup analyses were conducted on Candida species to determine heterogeneity source. The findings may not precisely reflect true candidemia prevalence in different countries. Therefore, it highlights continuous need to conduct prevalence studies, assess and monitor growing burden, control effect of potential risk factors and implement regional surveillance programs to prevent further rise.
In vitro evaluation of a novel endodontic irrigant and its efficacy on smear layer removal
Authors: Selvakumar B Gladson , Abinaya R , Swathika B , Ganesan S , Elavarasu Prem Kumar , Vinodhini V , Kannan K Bharathi , Arockiam Selva
Published: February 2025

Aim:

The study’s objective was to evaluate the efficacy of simvastatin (SMV) solution in different concentrations as an endodontic irrigant for eliminating the smear layer from intraradicular dentin, utilizing a scanning electron microscope (SEM).

Methods:

In this experimental study, smear layer removal efficacy was evaluated by collecting freshly extracted 50 single-rooted teeth. Teeth were decoronated, and biomechanical preparation was done according to the step-back technique. Roots were then randomly divided into five groups: Group 1: SMV of 1 μM/L concentration, Group 2: SMV of 5 μM/L concentration, Group 3: SMV of 10 μM/L concentration, Group 4: 17% ethylenediaminetetraacetic acid (positive control), Group 5: 0.9% normal Saline (negative control). After irrigation with respective irrigating solutions, all canals were dried and sectioned into two halves and observed under a scanning electron microscope at the apical third level, and the images were scored according to the criteria.

Results:

The study’s findings indicate that SMV at a concentration of 10 µM/L demonstrated superior efficacy in removing the smear layer compared to the other experimental groups, with the exception of the positive control group. Statistical analysis using Chi-square and sample t-test revealed a significant difference among the experimental groups (P < 0.0001).

Conclusion:

The results of this in vitro study have shown that SMV can be used as an effective endodontic irrigant based on its smear layer removal potential.
Effect of gypsum accelerators on properties of mineral trioxide aggregate
Authors: Gopinath Sarath , Karthikeyan Kittappa , Kavitha Sanjeev , Mahalaxmi Sekar
Published: February 2025

Aim:

Comparative evaluation of the pH, compressive strength, setting time, and cytotoxicity of mineral trioxide aggregate (MTA) with and without the incorporation of four different accelerators.

Methods:

10% CaCl2, 3% Na2SO4, 2% NaCl, and 3% K2SO4 solutions were replaced instead of MTA liquid and mixed with MTA powder (Group B, C, D, and E) and were evaluated for setting time, pH, compressive strength, and cell viability using Gilmore needle, digital pH meter, universal testing machine, and 3-(4,5-dimethylthiazol–2–yl) 2,5-diphenyltetrazolium bromide assay, respectively, and compared with that of MTA (Group A).

Results:

Group A (control) showed significantly less initial and final setting time. Groups D and E showed a significant decrease in the setting time compared to Groups B and C. Significantly no difference was observed in the pH values, immediately and 3 h after mixing in all groups. The mean compressive strength was greater for Group E followed by the control Groups D, C, and B. About 10% CaCl2 group showed a significant reduction in the compressive strength. Both fresh and set groups showed no significant difference in the cell viability at varying concentrations.

Conclusion:

Considering its application, as root-end filling and setting time of MTA incorporated with 3% K2SO4 and 2% NaCl have satisfied the requirements as compared to 10% CaCl2 and 3% Na2SO4.
Comparative evaluation of side-vented needle, air sonic, and ultrasonic irrigation techniques on sodium hypochlorite penetration into tubules of dentin in root canal: An in vitro study
Authors: Meena Anjali , Sharma Nidhi , Sinha Dakshita Joy , Singh Sarita , Dhawan Anu , Verma Neha
Published: February 2025

Aim:

This study aimed to assess the effectiveness of several irrigation techniques, including side-vented needles, air-sonic, and ultrasonic methods, in penetrating the dentinal tubules of root canals with sodium hypochlorite (NaOCl).

Methods:

“Seventy-five fully developed, permanent premolars on the lower jaw with a single root canal were assigned by simple randomization by chit picking method to three groups: Group A – irrigation with 30-gauge side-vented needles, Group B – air sonic irrigation, and Group C – passive ultrasonic irrigation done with NaOCl, positive control group and negative control group. After 72 h of submerging the root canals in crystal violet, the bleaching impact of NaOCl will be measured under a stereomicroscope.

Results:

Data were analyzed using the Kruskal–Wallis test. One-way analysis of variance test was used to study the differences in NaOCl penetration using conventional needle irrigation and sonic and ultrasonic irrigation in coronal, middle, and apical third. The level of significance and confidence of the interval were set at 5% (P < 0.05) and 95%, respectively. In the coronal section, maximum penetration depth was seen in the conventional needle group and least in the sonic group (P < 0.05). In the middle section and apical sections, the maximum penetration depths were seen in the sonic group which was statistically significantly different from the other two groups.

Conclusion:

“Irrigation methods impact the depth to which NaOCl penetrates dentinal tubules in root canals. The penetration of NaOCl into root canal dentinal tubules can be enhanced using the sonic irrigation approach in the apical third.
Effect of the addition of nanoparticles on setting time and solubility of mineral trioxide aggregate: A systematic review and meta-analysis
Authors: Humnabad Vamshi , Hindlekar Ajit , Mittal Priya , Jadhav Ganesh Ranganath , Shinde Siddharth , Arora Suraj , Patil Rutuja
Published: February 2025

Aim:

This systematic review and meta-analysis aims to assess and compare the solubility and setting time of mineral trioxide aggregate (MTA) by the addition of nanoparticles.

Methods:

This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The online databases used for searches were PubMed, Directory of Open Access Journals, and Google Scholar. In this review, in vitro studies conducted till May 2024 in the English language were incorporated. The inclusion criteria were entrenched using the PICOS strategy.

a. P (Population): The use of extracted teeth, cylinders, or tubes containing experimental materials

b. I (Intervention): Studies including MTA with the addition of nanoparticles such as silica, silver, titanium, etc.

c. C (Comparison): Studies including comparison MTA with and without nanoparticles

d. O (Outcome): Physical properties, solubility, and setting time of the MTA

e. S (Study Design): in vitro or laboratory studies.

In vitro studies without a valid comparison group or addition of materials other than nanoparticles in MTA or nonavailability of full texts or studies with outcomes not included in the inclusion criteria were excluded from the analysis. The risk of bias assessment used the QUIN tool. The statistical heterogeneity was assessed using χ² and I² values. A random-effects model was used for meta-analysis. RevMan software (5.4 version) was used for meta-analysis.

Results:

After the application of the inclusion and exclusion criteria, seven studies were included in the final analysis. The addition of nanoparticles significantly reduced the setting time (Pooled Odds ratios for setting time and solubility were 2.17 [−14.03, 9.70]) and 1.41 (−0.26, 3.09), respectively. Among the included studies, 5 showed a low risk of bias and 2 showed a medium risk. Information about sample size calculation, sampling technique, randomization, and blinding was not mentioned in any of the included studies.

Conclusion:

The addition of nanoparticles increased the solubility and shortened the setting time.
Biofabrication of periostracum, the outer covering of seashells, mediated silver nano particles as a promising irrigant with antibiofilm efficacy
Authors: Valan Annie Sylvea , Krithikadatta Jogikalmat , Doble Mukesh , Lakshmipathy Muthukrishnan
Published: February 2025

Aim:

The aim of the present study is to assess the antibiofilm and antibacterial efficacy of periostracum as an irrigant with and without silver nanoparticles (AgNPs).

Methods:

The periostracum was extracted and mixed with silver nitrate solution (at 1:1 ratio). The periostracum was characterized using Fourier-transform infrared spectroscopy, and the antibiofilm efficacy of the irrigant against Enterococcus Faecalis was determined using the crystal violet assay. Confocal laser scanning microscope (CLSM) was used to determine the number of viable and dead bacterial cells after the treatment of sixty extracted mandibular central incisors that were colonized with a biofilm of E. faecalis. The results were compared with standard irrigants that are currently in use.

Results:

Sodium hypochlorite (NaOCl) had the highest antibiofilm efficacy and could inhibit the E. Faecalis biofilm by 93.15%. A higher concentration of periostracum showed 50% inhibition at 0.08–0.09 mg/ml, while periostracum-mediated AgN) irrigant demonstrated 50% inhibition at 0.01–0.02 mg/ml in a concentration-dependent manner. The root samples treated with NaOCl, when studied under CLSM, showed 95% dead cells. This was comparable to the root samples treated with 1 mg/ml of the periostracum-mediated AgNp irrigant, which showed 85% dead cells, while with periostracum alone, 23% viable cells and 77% dead cells were observed.

Conclusion:

Periostracum alone, as well as mediated silver nanoparticles, has a significant anti-biofilm and antimicrobial activity, which could be attributed to their synergistic effect.
Geographic and Hospital Variations in the Use of Red Blood Cells and Tranexamic Acid among Total hip and Total Knee Arthroplasty
Authors: Hsu Ling-I , Chen Jen-Wei , Hou Sheng-Mou
Published: February 2025

Background:

Hemorrhage is a consideration when performing joint replacement surgeries. The utilization of hemostatic agents, such as tranexamic acid (TXA), has proven effective in reducing blood loss.

Objectives:

We aimed to investigate the trends in red blood cell (RBC) transfusion and TXA usage in unilateral total hip or knee arthroplasty (THA, TKA) and to explore variations among geographic regions and hospital levels.

Materials and Methods:

We obtained data from the National Health Insurance database for patients who underwent THA or TKA 2017–2021. The analysis included the utilization of RBCs and TXA based on hospital levels and geographic regions. The relative risk (RR) associated with these factors was estimated using logistic regression.

Results:

A total of 42,832 and 122,373 cases of THA and TKA were included. The RBC transfusion rates continued to decrease, while TXA usage showed a consistent rise for both surgeries. In 2021, the transfusion rates for THA and TKA were 43.7% and 26.6%, respectively, with TXA utilization rates of 61.8% and 73.5%, respectively. Medical centers exhibited lower transfusion rates (hip: 33.0%, knee: 20.1%) compared to nonmedical centers (hip: 54.4%, knee: 33.5%). Compared to medical centers, nonmedical centers had a higher RR of RBC transfusion for hip: 1.55 (95% confidence interval: 1.50–1.60) and knee: 1.56 (1.52–1.60). After adjusting for institutional surgical volume, the association remained, though much attenuated (THA: RR = 1.07, 1.02–1.11; TKA: 1.27, 1.23–1.31). Regarding geographic differences, RBC transfusion rates for THA and TKA in the Southern and Kao-Ping regions were lower than in other regions.

Conclusions:

These findings identified areas for improvement in peri-operative transfusion practice in joint arthroplasties. To further mitigate the demand for transfusions, priority should be accorded to nonmedical centers, emphasizing the promotion of patient blood management, including the appropriate use of TXA.
Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
Authors: Yang Wei-Hsiang , Lu Yung-Chang , Chang Ting-Kuo , Liu Chung-Ting
Published: February 2025

Background:

Acromioclavicular (AC) separation is a prevalent shoulder girdle injury, accounting for 50% of all sports-related shoulder injuries. Surgery is recommended for Rockwood Types IV-VI injuries. In such cases, AC joint congruity and coracoclavicular ligament complex integrity are prerequisites for robust scar tissue healing.

Objectives:

This study aimed to describe our indirect reduction procedure using a minimally invasive, closed-loop, double endobutton (Tightrope) technique for Type V AC separation and evaluate short-term outcomes and complications.

Materials and Methods:

A total of 51 patients with Rockwood Type V AC separation underwent surgery using the Tightrope technique between January 2017 and December 2021. Clinical and radiological outcomes were assessed using the Constant–Murley score with documentation of complications.

Results:

Patients were divided into three groups based on the amount of reduction: Good reduction (16, 31.4%), partial reduction loss (25, 49%) and complete reduction loss (10, 19.6%). Notably, no statistically significant differences were observed between the first two groups. However, the complete reduction loss group demonstrated significantly lower Constant–Murley scores.

Conclusions:

The Tightrope technique is a promising approach for Rockwood Type V AC separation, yielding favorable clinical outcomes; however, radiographic findings may not be satisfactory. While partial reduction loss had minimal impact, complete loss was associated with inferior results. Therefore, precise tightrope placement and avoidance of coracoid tip positioning are crucial for optimal outcomes.
Comminuted Inferior Pole Fracture of the Patella Treated with Cerclage-wire-augmented Separate Vertical Wiring: A Case Series Report
Authors: Tsai Yi-Yen , Chen Chiu-Ming , Tsai Yao-Tung , Lin Kun-Yi , Yang Jui-Jung
Published: February 2025

This study investigates a novel surgical technique, cerclage-wire-augmented separate vertical wiring, for treating comminuted inferior pole patellar fractures. Traditional methods, such as tension band wiring, face challenges in avoiding postoperative immobilization, and muscle weakness. This retrospective analysis evaluates five patients (three men and two women) with AO/OTA 34A1 fractures using the novel surgical technique. Results indicate successful bony union in all cases, with an initial mean gap of 1.78 cm and mean fragment size of 0.28. The technique demonstrates rigid stability and allows for early rehabilitation, achieving a full range of motion. Although one case exhibited postbony union patella alta, patients attained a mean Bostman score of 26.2. The study suggests promising outcomes, advocating for further research with larger patient cohorts to validate this innovative approach.
Mechanistic Insights on Skin ageing and Dermatologic Interventions to Slow Ageing Process
Authors: Sriram Rajashree , Gopal V
Published: February 2025

The skin which is a robust predictor of age-related diseases, undergoes morphological and physiological alterations, because of synergistic effects of Intrinsic or Chronological (Age-dependent decline of cell function) and Extrinsic (environmental insults) ageing factors. Ageing is a preordained process that can be determined as the collection of various deleterious changes in cells and tissues. Skin that ages as a consequence of the combination effect of intrinsic and extrinsic factors is characterized by coarseness, wrinkling, hyperpigmentation, telangiectasia, burns and skin sagging. Despite the structural and pathophysiological differences, both types of ageing share several molecular similarities, with the emergence of reactive oxygen species and matrix metalloproteinases induction reflecting as the key aspects of skin ageing. This review elucidates the skin ageing mechanism with a focus on the management of dermatologic ageing that includes treatment strategies and trends in the use of invasive procedures, and energy-based devices which are aimed at addressing skin ageing phenotypes.
Effectiveness, Tolerability and Safety of Topical Clobetasol with Oral Hydroxychloroquine versus Topical Clobetasol with NBUVB Phototherapy in Unstable Vitiligo: Investigator Blind, Randomized Controlled Trial
Authors: Tarafdar Dhiman , Sen Indrayudh , Koley Sankha , Ray Biswarup , Sarkar Pinaki , Sil Amrita , Ghosh Arghyaprasun , Das Nilay K.
Published: February 2025

Background:

Vitiligo is an acquired multifactorial depigmentation disorder with dreadful social stigma without any gold standard treatment option. Treatment of unstable vitiligo is, furthermore limited. Hydroxychloroquine has shown promise in a few case reports.

Objectives:

The effectiveness, tolerability and safety of narrow-band ultraviolet B (NBUVB)-plus topical clobetasol (group A) versus oral hydroxychloroquine-plus topical clobetasol (0.05%) (group B) were evaluated.

Methods:

Single-centre, investigator-blind, randomised, active-controlled, parallel-group phase IV trial (CTRI/2019/07/020345) was conducted on unstable vitiligo of either sex. Patients were randomised into two groups (1:1 allocation ratio), and allocation concealment was ensured by the sequentially numbered, sealed, opaque envelope technique. The assessing physician was unaware regarding treatment allocation. Outcome measures were the vitiligo area scoring index (VASI), vitiligo disease activity score (VIDA) and dermatology life quality index (DLQI). The economic burden of therapy was calculated in terms of travel costs and loss of time for availing of the therapy. Routine haematological and biochemical tests and treatment-emergent adverse events were monitored for safety. The calculated sample size was 82 (5% alpha-error, 80% power, 61.1% and 30% percentage improvement in study groups, 10% drop-out).

Results:

Intention-to-treat analysis showed significant improvement in VASI (Friedman’s analysis of variance, P < 0.01) in group A (1048.00 ± 1450.10 reduced to 933.43 ± 1387.79) and group B (415.00 ± 458.47 reduced to 283.85 ± 386.61) at the end-of-treatment visit (24th week). Improvement was noted from 12 weeks onwards in group A and eight weeks onwards in group B (post-hoc Dunn’s test, P < 0.001). Within group comparison showed significantly more improvement in group B than group A from eight weeks onwards (P < 0.05, analysis of covariance test with baseline VASI as covariate). A similar result was obtained with VIDA. DLQI significantly improved only in group B. The monthly cost of travel and loss of time were significantly less (Mann-Whitney’s test, P < 0.5) in group B than group A. No adverse events were noted in either group.

Conclusion:

Both NBUVB and hydroxychloroquine combined with topical clobetasol are safe and effective agents in the treatment of vitiligo, though the improvement is more and faster with hydroxychloroquine. With hydroxychloroquine, there is no infrastructural requirement, less travel cost and less loss of working hours as opposed to NBUVB, which needs infrastructural set-up.
Bone Health in Young Adults with Type 1 Diabetes Mellitus in South India
Authors: Bhandarkar Akhila , Bhavani Nisha , Pavithran Praveen V. , Kumar Harish
Published: February 2025

Introduction:

Patients with type 1 diabetes mellitus (T1DM) have a higher lifetime fracture risk. The rising obesity incidence in T1DM is causing hybrid diabetes. There is scarce data of bone health and body composition in T1DM from India. This South Indian study compared bone health and body composition of patients with T1DM to healthy age- and sex-matched controls.

Methods:

Fifty-one adults with T1DM and 52 healthy controls were enrolled and underwent dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD) and body composition. Bone turnover markers—C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N pro-peptide (P1NP), parathormone (PTH) and 25 hydroxy-vitamin D levels were measured in patients.

Results:

The mean age of patients with T1DM was 27 years, the median duration of illness was 15 years and the median glycated haemoglobin (HbA1c) was 8%. BMD at the lumbar spine and hip were similar among patients and healthy controls. Patients with T1DM had decreased levels of CTX compared to controls (cases 0.347 (0.233–0.463) ng/mL, controls 0.440 (0.320–0.684) ng/mL, P = 0.005), whereas both had similar levels of P1NP. One-third of patients with T1DM were obese. Patients with T1DM with disease duration more than 10 years showed higher abdomen fat% (<10 years 20.4% [14–39.5], 10–20 years 37.2% [30.1–41.9], >20 years 41.5% [36.4–42.7] P = 0.013) and trunk fat% (<10 years 22.6% [14.8–37.2], 10–20 years 36.7% [30.1–40.5], >20 years 37.6% [33.55–40.5]).

Conclusion:

Young adults with T1DM have normal BMD and low bone resorption markers compared to healthy controls, whereas truncal obesity increases with a longer duration of illness. This may indicate a change in T1DM bone health and body composition characters, probably due to better glycaemic management.
Trabecular Bone Score in Asian-Indian Post-menopausal Women Across the Spectrum of Hyperglycaemia: Insights from a Cross-Sectional Study
Authors: Aggarwal Tanushi , Shah Ravi , Pal Rimesh , Rastogi Ashu , Singla Veenu , Bhadada Sanjay K.
Published: February 2025

Introduction:

Type 2 diabetes mellitus (T2DM) increases the risk of fragility fractures, despite the fact that areal bone mineral density (aBMD) is either increased or normal compared to healthy non-diabetic subjects. Hence, the trabecular bone score (TBS) is under investigation in this patient cohort as an alternative metric for the assessment of bone health. The present study aimed to determine TBS in post-menopausal women diagnosed with T2DM and in non-diabetic individuals.

Methods:

This cross-sectional study enrolled 101 individuals with T2DM and 101 individuals without overt T2DM (43 individuals with pre-diabetes and 58 normoglycaemic individuals). Participants underwent a comprehensive history and physical examination, biochemical investigations, and a dual-energy X-ray absorptiometry (DXA) scan with TBS measurement.

Results:

Post-menopausal women with T2DM did not exhibit any significant difference in aBMD levels in comparison to those with pre-diabetes or normoglycaemic individuals. Although there was no statistically significant difference in aBMD among the three groups, the mean TBS value was significantly lower in the T2DM group when compared to both comparison groups (P < 0.001). Additionally, glycated haemoglobin (HbA1c) and the duration of diabetes demonstrated a significant negative correlation with TBS.

Conclusion:

TBS may serve as a valuable tool for assessing bone health in individuals with T2DM, particularly when aBMD does not accurately predict the risk of fragility fractures. Both glycaemic control and the duration of diabetes significantly impact TBS values. In individuals with T2DM, incorporating TBS measurements alongside aBMD assessments could offer a more comprehensive evaluation of their bone health.
An Early Decline of Cognitive Functions in Healthy Individuals with Family History of Diabetes in South India: A Comparative Analysis with Diabetics and Healthy Control
Authors: Rout Suchismita , Radhakrishnan Aiswaryah
Published: February 2025

Background: There is mounting evidence prediabetes significantly elevates the likelihood of developing diabetes-related cognitive impairment before it manifests in the diabetic stage. A considerable number of individuals with a family history of diabetes remain unaware of their diabetes status; hence, the identification of these individuals is imperative, as regular screening and rigorous monitoring may prevent or delay their progression to type 2 diabetes. Aim and Objective: The aim of the study was to measure and compare the cognitive tasks among diabetic subjects and healthy subjects with a positive family history of diabetes who do not fulfill the clinical criteria of diabetes but are identified as being at “risk” of developing diabetes. Methods: To investigate the study’s objective, a cross-sectional, comparative study was conducted among subjects who attended the hospital between November 2021 and January 2023. Subjects were divided into three groups: type 2 diabetes mellitus, subjects with family history (FHD+), and healthy controls (HCs); after obtaining an informed consent form, visual cognitive tasks were performed using the PsyToolkit platform. Results: Compared to HC, subjects with a family history of diabetes performed poorly in all visual cognitive parameters. The mean attention and processing time was longer for FHD+ (151 ± 54. 4 vs. 130 ± 63.7 ms, P = 0.001) than compared to the HC group. The visual search time (VST) was significantly delayed in the FHD+ group (high-risk) (2655 ± 549 ms) compared to HC (1619 ± 331 ms, P = 0.001). The findings revealed that elevated levels of HbA1c (β = 102.37, P = 0.057) and low-density lipoprotein (β = −0.042, P = 0.021) were linked to delayed cognitive metrics. Conclusion: Unexpectedly, subjects with a family history of diabetes, the “high-risk” group, exhibited remarkable delays in the Corsi span and VST, similar trends as observed in diabetics. This novel result emphasizes the need to do evaluations of visual cognitive abilities in their clinical practice to detect early changes in cognitive functions during the prediabetic stage before they progress to diabetes.
Impact of vitamin D in acute ischemic stroke: A randomized clinical trial in rural central India
Authors: Manuja Nishtha , Kumar Sunil , Acharya Sourya , Mohale Sandip , Daiya Varun , Sood Anshul , Khandelwal Shreya , Hamdulay Khadija , Padwal Akshay , Kakde Prajakta
Published: February 2025

Introduction: Stroke is associated with several known risk factors, such as diabetes, raised blood pressure, high cholesterol levels, atrial fibrillation, and smoking. However, there are many instances in which these risk factors cannot be identified. In recent times, significant attention has been placed on vitamin D (vit D) deficiency as a particular risk factor. Various investigations have identified a link between low vit D levels and an increased incidence of strokes. This study aims to evaluate the role of vit D in assessing the prognosis of acute ischemic stroke (AIS) patients at a rural tertiary care teaching hospital. Methods: In this randomized control trial, 137 patients with AIS admitted to the medical intensive care unit/medicine wards were enrolled from June 2004 to September 2004. A consecutive sample of vit D levels was collected from patients with confirmed ischemic stroke, as determined by computed tomography scan or magnetic resonance imaging upon admission. Patients were divided into two groups: those with normal serum vit D levels and those with vit D-deficiency. Furthermore, the deficient group was supplemented with vit D. All three groups were compared after 3 months using the modified Rankin score (m-RS). Results: The study population was divided into three groups: group A had AIS patients with vit D deficiency who were supplemented with vit D; group B included AIS patients with vit D deficiency who were given a placebo; and group C comprised AIS patients with normal vit D levels who were given conventional stroke treatment. Groups A and B exhibited higher National Institutes of Health Stroke Scale (NIHSS) score with mean values of 25.5 and 27, respectively, while group C had a lower NIHSS with a mean of 17. On further follow-up at 3 months, the m-RS of groups C and A were 2 and that of group B was 3. Conclusions: Our findings suggest that the severity of stroke is greater in the vit D-deficient group, as evidenced by their higher NIHSS scores. Additionally, our results indicate that vit D supplementation may have a significant impact on recovery outcomes post-stroke. Patients who received vit D supplementation had significantly lower m-RS, suggesting improved functional recovery.
Nursing Students’ and Faculty Perspectives: Challenges and Insights into Digital Classes during Pandemic − Qualitative Study
Authors: Kanagaraj Puvaneswari , Subramanian Umavalli , Christhumary Preetha Carolin , Sakthivel Rajathi , Kanagaraj Anbueswari , Jacob Jessy , Yesuwilson Albin Joseph
Published: February 2025

Introduction: The pedagogical transition from traditional to distance learning is a challenge for nursing education during the pandemic in India, since the faculty and students were not exposed to the virtual classes. Methods: Qualitative research examined faculty and students’ perspectives on the challenges and insights into digital classes during the pandemic. Convenient sampling was employed to gather qualitative data from the diploma, undergraduate, or postgraduate program students who had experienced digital classes during the pandemic. Six focus group interviews were done with a total of 32 nursing students and 14 faculty after obtaining consent, each session lasting between 1.5 and 2 h. The data were analyzed using thematic analysis, following Braun and Clarke’s (2012) six-phase analytical process. Results: The major themes created through students’ perspectives were (1) closing the educational divide: bridging the gap with E-technology, (2) exposed to different approaches of teaching–learning, (3) challenges and technological glitches in the digital classroom, (4) expression of dissatisfaction, (5) struggling with self-motivation, and (6) environmental influences. The major themes created through faculty perspectives were (1) escalating workload: navigating increased demands, (2) enhanced technology proficiency: gaining improved access, (3) discipline concerns, (4) improved methods of teaching, (5) lack of clinical learning, and (6) need for a special platform. Subthemes were also reported, along with the major themes. Conclusion: This study concluded that digital classes were very convenient and beneficial during the pandemic. Both groups of respondents stressed the challenges that need to be focused on to fill the gap in the future.
Hybrid Deep Learning Model Integrating Long Short-Term Memory Networks and Convolutional Neural Nets for Predicting Anesthesia Outcomes in Surgical Procedures
Authors: Nithiyasree P. , Subramani Kavitha , Sathiya V. , Maheswari M. , Vinmathi M.S. , Balaji S.
Published: February 2025

Anesthesiologists administer three types of medications during surgery to modulate anesthesia. These are analgesics to block pain, hypnotics to induce and sustain unconsciousness, and muscle relaxants to prevent muscle responses. Modern anesthesiologists use equipment to track unconsciousness in real-time by attaching monitors to the patient’s brow, which displays signals obtained from electroencephalogram activity, enabling determination of the patient’s level of awareness. The amount of anesthetic injected is influenced by the patient’s preoperative physical state, intraoperative vital signs, and postoperative recovery period. This necessitates quick thinking and specialized knowledge from anesthesiologists to safeguard patient vital signs throughout surgery. Given the unique intraoperative conditions and indicators of each patient, a practical system is proposed to forecast the degree of consciousness under anesthesia. As a result, the suggested method offers a reliable way to anticipate the patient’s level of awareness while under anesthesia. The ensemble deep learning techniques using convolutional neural network and long short-term memory achieved a 94% accuracy.
The role of virtual training workshops based on the ISO 10015 standard in increasing the health and safety students’ knowledge
Authors: Khosravi Zeinab , Mish Mast Mohammadreza , Davoodi Fereshteh , Hosseini Gousheh Seyed Nouredin , Khajehnasiri Farahnaz , Azmoon Mohammad Hossein , Ahangarzadeh Milad , Eshaghzadeh Maliheh , Sahlabadi Ali Salehi , Askari Ali , Poursadeghiyan Mohsen
Published: February 2025

BACKGROUND:

A basic level of knowledge is obtained through training courses; which leads students to achieve the desired level of preparation of professional knowledge and skills. The purpose of the present study, Evaluating the role of educational workshops organized by scientific-research associations in increasing the level of knowledge and examining its impact on the performance and information of professional health engineering students of Ardabil University of Medical Sciences.

MATERIAL AND METHODS:

This study was semi-experimental with a pre-test-post-test design for the implementation of an educational process, which was conducted by census sampling method in 2021. The research tool was the implementation of educational evaluation models through the implementation of ISO 10015 clauses. The ISO 10015 educational standard includes the step-by-step process of needs assessment, design and planning, implementation, and evaluation of effectiveness. Data analysis was done through SPSS V.22.

RESULTS:

Results show there is a significant difference in the analyzed parameters before and after the courses, including the change in attitude, students’ understanding of the ease and usefulness of the courses, and their overall satisfaction (P value <0.005).

CONCLUSION:

The establishment and implementation of the ISO 10015 educational management, and the increase of scientific workshops and webinars in the field of safety, health, crisis, and disasters can have an effect on the learning process and skills, and the satisfaction with the education quality.
Interaction of the Investigator with the Bodies of Intelligence Gathering and Forensic Activities
Authors: Baigelenova Ainur K. , Tuzelbayev Yergali O. , Baimoldina Svetlana M. , Kolesnikov Yuriy Y. , Tuzelbayev Nurgali O.
Published: February 2025

Background:

Without high-quality, effective interaction of the preliminary investigation bodies and the bodies of inquiry, forensic authorities, it is impossible to examine the case and collect evidence on it fully and comprehensively. Establishing all the facts in the case and the truth is quite difficult for investigators and other participants in the investigation of crimes.

Aims and Objectives:

The aim of the study is to analyze the characteristics of the investigator’s engagement with the entities involved in operational investigative and forensic activities.

Materials and Methods:

The primary approach employed in investigating this matter is modeling, making it a deliberate and organized endeavor for professional growth and the acquisition of specialized skills that enable the effective examination of the investigator’s interaction with intelligence gathering and forensic entities.

Results:

The model focuses on a thorough initial examination of how the investigator collaborates with intelligence and forensic entities, leading to the development and study of scientifically grounded suggestions for updating the criminal law of Kazakhstan and improving its implementation practices.

Conclusion:

The study holds practical significance in terms of the potential applications of the findings in the following areas: (1) enhancing the methods of interaction between investigators and intelligence gathering and forensic entities; (2) incorporating the research outcomes into the curriculum for the “Interaction of Law Enforcement Agencies” course; and (3) enhancing the professional qualifications of officials in the Republic of Kazakhstan.
Craniofacial Reconstruction of a 4000-year-old Human Skull
Authors: Tu Lyu , Shiwei Li , Caixia Li , Xingtao Wei , Jiaxin Zhang , Ran Xu , Zhixin Bai , Yuan Ji , Dong Zhao
Published: February 2025

Craniofacial reconstruction (CFR) is a traditional technology used in forensic science and archaeology. CFR recovers the craniofacial appearance to approximate the appearance of missing persons or ancient humans. To reconstruct the craniofacial appearance of a 4000-year-old skull of a person who lived during the Longshan period of Chinese history, we performed CFR using a protective method. The skull was scanned and three dimensionally printed. Subsequently, morphological measurements were carried out. Traditional steps, such as sculpturing of the facial soft tissues, and facial features, and the creation of a cast skull model, were still essential for the complete outcome. Three-dimensional scanning and printing progressed the CFR to the digital stage, which avoided probable breaks during the traditional procedures and improved precision and efficacy. Although CFR is a scientific method with anatomical and anthropometry bases, it still requires expert experience in sculpture, history, and photography.
A Forensic Approach in the Determination of Sequence of Strokes using Fluorescence Spectrometry
Authors: Khare Vartika , Singla Anu , Gupta Pawan
Published: February 2025

Background:

Fluorescence Microscope is a promising analytical method for the examination of the sequence of strokes of writing inks of different colours, brands, and models in a questioned document.

Aims and Objectives:

In the present article, an attempt has been made to categorize the writing inks of different brands and colours on the basis of their fluorescence.

Materials and Methods:

A total of 36 writing inks were used to make the different intersections on a standard A4 sheet which were then analyzed under the excitation filters of the Fluorescence Microscope.

Results:

The results indicated that the different inks can be characterized optically based on the luminescent components of the ink present in crossed lined intersections.

Conclusions:

Fluorescence Microscopy is a relatively simple, fast, inexpensive, and non-destructive technology that can be used in conjunction with other, more complex, and expensive technologies to identify the sequence of line crossing. It can provide a novel way of analysis based on the assessment of microelement analysis and the characteristics of diverse ink handwriting samples.
Clinical and Radiographic Evaluation of Different Techniques for Impacted Canine Exposure
Authors: Kohli Arshdeep S. , Goyal Jashan D. , Jamatia Kahamnuk , Kaur Guramrit P. , Syed Afroz K. , Anoosha M. , Tiwari Rahul
Published: February 2025

ABSTRACT

Introduction:

Impacted canines pose a significant challenge in orthodontic treatment, often requiring surgical exposure and orthodontic traction to achieve proper alignment. Various techniques, including open and closed methods, are employed, each having distinct advantages and complications. This study aims to compare these techniques using clinical and radiographic evaluations to determine their effectiveness in canine exposure and alignment.

Methods:

A prospective analysis was conducted on 50 patients with impacted canines. Two techniques, the closed flap and open window, were compared across key parameters, including treatment duration, patient discomfort, and periodontal health. Postoperative radiographs were evaluated for root resorption, and success was measured by the time taken for the canine’s eruption and alignment.

Results:

The closed technique showed a statistically significant reduction in treatment duration (P < 0.05) compared to the open method. However, there was no significant difference in periodontal health outcomes. Radiographic analysis indicated no substantial difference in root resorption between the two techniques.

Conclusion:

The closed technique is more efficient in reducing treatment time, with comparable outcomes in terms of periodontal health and root resorption. It may be considered the preferred method for impacted canine exposure.