bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of penetration depth of chitosan, zinc oxide, and silica-doped titanium novel nanoparticle irrigant solutions – A confocal laser scanning microscopic in vitro study
Authors: Bademela Sree Laksmi , Raju T. B. V. G. , Parvathaneni Krishna Prasad , Seshadri Abitha , Varma Nadimpalli Mahendra , Dondapati Gowtam Dev
Published: September 2024

Aim:

The aim of this study was to evaluate the penetration depth of three different irrigant solutions incorporated with nanoparticles (NPs) using a confocal laser scanning microscope.

Methods:

Forty-two single-rooted teeth were used. Access cavities were prepared, and working length was determined. The samples were split into three groups at random (n = 14). Group 1 – chitosan NPs, Group 2 – zinc oxide NPs, and Group 3 – silica-doped titanium NPs. Each group was further divided into subgroup A with activation and subgroup B without activation. Each tooth received final irrigants for 1 min. Each sample is sectioned at 3 mm from the apex. A confocal laser scanning microscope was used to observe the irrigant penetration.

Results:

The results showed that there was a significant difference in the penetration depth in Group 2A and Group 3A.

Conclusion:

Activation with PATS Vario increases the penetration when compared to conventional syringe, and zinc oxide NP solution showed increased penetration when compared with other groups.
Indian Endodontic Society: Position statement on the management of separated instruments during root canal treatment
Authors: Vasudevan Aishwarya , Miglani Sanjay , Hegde Vivek , Gopikrishna Velayutham
Published: September 2024

This position statement on the management of separated instruments, endorsed by the Indian Endodontic Society, aims to provide a brief perspective on the challenges faced during shaping of the complex root canal system, and how the inadvertent separation of a broken instrument must be dealt with. The need for referral of such cases to specialist endodontists who are trained to use advanced instrument retrieval systems with the aid of the dental operating microscope is also highlighted.
Knowledge and awareness of pulp vitality tests among dental interns and postgraduates: A multicenter cross-sectional study
Authors: Saikiran Kanamarlapudi Venkata , Gurunathan Deepa , Elicherla Sainath Reddy , Rahul Shaik , Nuvvula Sailavanya , Nuvvula Sivakumar
Published: September 2024

Aim:

The aim of this study was to assess knowledge and awareness on pulp vitality tests among dental interns and postgraduate (PG) students.

Methods:

Using a standardized approach and employing focus group discussions, a 13-item questionnaire was developed. The questionnaires were shared with dental interns and PGs of various dental colleges through WhatsApp and their registered e-mail addresses as a Google Form link. Data from all the individuals were collected to assess and compare the knowledge among dental interns and PG students.

Results:

During 4 weeks, 358 of the total 428 responses were received. The final analysis was carried out using 340 responses (145 PG [42.6%] and 195 intern [57.4%] responses), of which 18 were excluded due to repeated responses. More than half of the participants needed more knowledge about pulp vitality testing.

Conclusion:

Dental PG students had better knowledge and awareness than interns, but implementing this in practice was relatively negligible. Knowing the importance of comprehending pulp vitality tests may aid students in reducing the possibility of damaging the healthy structure of the teeth.
Correlation between root canal anatomy of mandibular incisors and premolars in Western Uttar Pradesh population of India - A cross sectional study
Authors: Mishra Preeti , Nikhil Vineeta , Jha Padmanabh , Raj Shalya , Ravinder Rohit , Sahu Sonal
Published: September 2024

Aim:

This study aimed to evaluate the correlation between the presence of two canals in mandibular incisors and multiple canals in mandibular premolars in the Western Uttar Pradesh population of India using cone-beam computed tomography (CBCT).

Methods:

CBCT scans with 0.125-mm voxel size and 50 mm × 50 mm field of view of 800 patients were evaluated for the parameters; a number of canals, root canal configurations (according to Vertucci’s classification), unilateral/bilateral occurrences, and correlation between presence of two canal configuration in mandibular incisors and multiple canals (>1 canal) in mandibular premolars. The data obtained were subjected to statistical analysis using the SPSS statistical program version 22.0 using the Chi-square test. The significance level was set as 5%.

Results:

According to the current analysis, the prevalence of mandibular incisors with one canal was 68.1% and two canals were 31.9% whereas in mandibular premolars prevalence of one canal was 71.5%, two canals were 27.2%, and three canals were 1.3%. The incidence of Vertucci type I canal configuration (68.1% mandibular incisors and 71.5% mandibular premolars) was more prevalent than the other types. The incidence of C-shaped canals was 2.6%. The prevalence of bilateral occurrence of the same canal configuration was 16.6%. A positive correlation was found between the presence of two canals in mandibular incisors with multiple canals in mandibular premolars (20.4%).

Conclusion:

The root canal morphology of mandibular premolar teeth of the Western Uttar Pradesh Indian population is complex. Two canals in mandibular incisors are frequently associated with multiple canals in mandibular premolars.
Comparative evaluation of fracture resistance and push-out bond strength of glass fiber post with composite core and single-unit post and core system luted with two different resin cements: An in vitro study
Authors: Garg Ishika , Kumar Pragya , Taneja Sonali
Published: September 2024

Aim:

The aim of the study was to compare the fracture resistance and push-out bond strength of glass fiber post (GFP) with composite core and single unit post and core system luted with two different resin cements.

Methods:

Sixty-four mandibular premolars were chosen as the sample for the study. Sample preparation was done, and specimens were randomly divided into two groups (n = 32) each according to the type of post used: Group I – RelyX GFP, Group II – Edelweiss post and core. They were further subdivided in two subgroups based on luting cements: subgroup A: RelyX U200 Adhesive Resin cement and subgroup B: SoloCem resin cement. Fracture resistance was measured in half of the prepared specimens by subjecting a load of 1 mm/min. The load was subjected along the long axis of the tooth at an angle of 45° until failure occurred using the universal testing machine. Half of the samples were divided into three horizontal thirds, i.e., coronal, middle, and apical, and push-out bond strength was evaluated at a rate of 0.5 mm/min. The scores were subjected to statistical analysis using independent t-test and SPSS Version 22.0.

Results:

Group I showed nonsignificantly better fracture resistance than Group II irrespective of type of luting agent used. Subgroup B showed nonsignificantly higher fracture resistance than subgroup A irrespective of the post used. Subgroup B was nonsignificant better push-out bond strength than Subgroup A (P < 0.05). Push-out bond strength of Group II was significantly better than Group I irrespective of the luting agent.

Conclusion:

Fiber post showed nonsignificantly better fracture resistance than Edelweiss post and core system. SoloCem showed nonsignificantly better fracture resistance and push-out bond strength with Edelweiss than RelyX U200.
A quantitative comparison of apically extruded debris during root canal preparation using NiTi full-sequence rotary and single-file rotary systems: An in vitro study
Authors: Goel Pallavi , Vikram R. , Anithakumari R. , Adarsha M. S. , Sudhanva M. E.
Published: September 2024

Aim:

The purpose of this study was to compare quantitatively the apically extruded debris during root canal preparation using NiTi full-sequence rotary and single-file rotary systems.

Methods:

Sixty extracted mandibular premolar teeth with single canals and similar lengths were used and divided into four groups. Groups A and B are NiTi full-sequence rotary systems and Groups C and D are single-file rotary systems. In Group A, the canals were prepared using V-Taper 2H file (up to 25/0.06), Group B: TruNatomy file (up to 26/0.04), Group C: OneShape file (25/0.06), and Group D: OneCurve file (25/0.04). The initial weight of each Eppendorf tube to be used was calculated using an analytical balance before instrumentation. After instrumentation, the tubes were then stored for 15 days in an incubator at 37°C. The Eppendorf tubes were weighed again to determine their final weight which contained the extruded debris. The data were statistically analyzed using a one-way ANOVA test and Tukey’s post hoc test.

Results:

The OneCurve single-file system resulted in statistically significant less debris extrusion than the OneShape single-file system, TruNatomy multifile system, and V-Taper 2H multifile system (P < 0.001). Among the full-sequence rotary file systems, the TruNatomy rotary file system produced statistically significantly less debris extrusion than the V-Taper 2H rotary file system (P = 0.01).

Conclusion:

All the instrumentation systems caused apical extrusion of debris. OneCurve system showed least debris extrusion, followed by OneShape, TruNatomy, and V-Taper 2H systems. Thus, single-file rotary instruments performed better with the less extrusion of debris when compared to multifile rotary systems.
A novel ultra-performance liquid chromatography detection method development and validation for paclitaxel and its major metabolite in human plasma
Authors: Kumar Vikas , Vardhan Gyan , Sehrawat Amit , Handu Shailendra , Dhamija Puneet
Published: September 2024

BACKGROUND:

Paclitaxel is a promising anticancer drug for patients with ovarian, breast, lung, gastrointestinal, genitourinary, prostate, and head-and-neck cancers. Paclitaxel follows nonlinear pharmacokinetics. The major metabolite of paclitaxel is 6-alpha-hydroxy paclitaxel, mediated by CYP2C8, while metabolism to two of its minor metabolites, 3’-p-hydroxypaclitaxel and 6a, 3’- p-dihydroxypaclitaxel, is catalyzed by CYP3A4. Therapeutic drug monitoring of paclitaxel could be a promising approach to improve the efficacy and safety of paclitaxel correct personalized doses and improve the overall benefit–risk ratio. A novel and highly sensitive chromatographic method for the detection of paclitaxel and its metabolite has been proposed that allows quantification in human plasma with 100% accuracy in terms of recovery without significant intraday or interday variations.

MATERIALS AND METHODS:

The present study was planned following bioanalytical method validation guidance according to the U.S. Food and Drug Administration requirements. The validation of the analytical procedure was performed as per ICH Q2(R1) guidelines. It was done to assure the reliability of the results obtained for various parameters such as linearity, accuracy, precision, limit of detection (LOD), limit of quantification, robustness, stability, and system suitability.

RESULTS:

The specificity of the method was established by ensuring no interference with peak obtained from paclitaxel and 6-alpha-hydroxy paclitaxel. LOD was found to be 0.05 and 0.033 while the limit of quantitation was 0.14 and 0.099 for paclitaxel and 6-alpha-hydroxy paclitaxel, respectively. Median (±interquartile range) accuracy for paclitaxel and 6-alpha-hydroxy paclitaxel was found to be 102.73 (±13.581) and 100.87 (±7.573), respectively.

CONCLUSION:

This novel method of simultaneous detection of paclitaxel and its major metabolite 6-alpha-hydroxy paclitaxel demonstrated significant resolution and was sensitive enough for its quantification in human plasma.
Efficacy, safety, and cost-effectiveness of biosimilars of bevacizumab in näive patients with diabetic macular edema
Authors: Virani Shalini , Bhatiwal Akshay , Rewri Parveen
Published: September 2024

OBJECTIVES:

Anti-vascular endothelial growth factor (VEGF) therapy restores retinal architecture and enhances vision in diabetic macular edema (DME). Bevacizumab is an off-label anti-VEGF drug that effectively treats DME. The safety and efficacy of bevacizumab biosimilars, which are more affordable than the original medication, still need to be established. This study aimed to assess the cost-effectiveness, efficacy, and safety of biosimilars for treating patients with naïve DME across various price ranges that are accessible in the Indian market.

MATERIALS AND METHODS:

Two biosimilars, BevaciRelTM (Reliance Life Sciences Pvt. Ltd.) and ZyBev (Cadila Healthcare Limited), were compared to their original, Avastin (Roche Products [India] Pvt. Ltd.), in a randomized, control study. Three end-notes were used to assess safety and efficacy: persistence, improvement, and adverse events. Cost-effective analysis was carried out using a decision-tree analysis model.

RESULTS:

This study included 69 (59%) men and 54 (41%) women with naïve DME. The cohort had an average log MAR visual acuity of 0.87 ± 0.22, and the central retinal thickness at baseline on OCT was 398.5 ± 37.61 μm. The visual acuity showed a similar improvement, and there was a decrease in central retinal thickness as observed on OCT across the groups. The incremental cost-effectiveness ratio was 10.8.

CONCLUSIONS:

The biosimilars of bevacizumab are safe and efficacious in treating DME in a cost-effective manner.
Topiramate induced bilateral angle closure with anterior uveitis – A masquerade in a migraine patient
Authors: Srivastava Rajat M. , Agarwal Ruchi , Agarwal Neha , Agrawal Siddharth
Published: September 2024

Topiramate (TPM), a sulphonamide derivative, is a commonly used medication by physicians and psychiatrists. Topiramate-induced angle closure glaucoma (ACG) and TPM-induced myopic shift are reported ocular adverse reactions of this drug. We report here a case of TPM-induced ciliochoroidal effusion presenting as bilateral acute angle closure with anterior uveitis and myopic shift in a patient with migraine. The acute and often bilateral severe visual deterioration in patients on TPM therapy cannot only be disturbing to the patient but can also be a challenge to the attending ophthalmologist to manage. We highlight the confusing presentation leading to the initial misdiagnosis of bilateral ACG and challenges in the management of this potentially sight-threatening condition.
To evaluate the effects of the application of 0.03% tacrolimus ointment in patients of vernal keratoconjunctivitis at a tertiary care hospital
Authors: Waghmare Ajay V. , Awargaonkar Amarnath V. , Kuril Surajkumar S. , Nandedkar Varsha
Published: September 2024

Context:

The aim of this study was to evaluate the effect of the application of 0.03% tacrolimus eye ointment in treating patients diagnosed with vernal keratoconjunctivitis (VKC) specifically within a tertiary care hospital setting.

Materials and Methods:

From October 2019 to October 2021, a prospective observational study took place at the department of ophthalmology in a tertiary care center. The study involved 42 consecutive VKC cases that had not seen relief with antihistaminics, mast cell stabilizers, or topical steroids. When steroid is applied in VKC patient it leads to various complications. So, in steroid refractory VKC tacrolimus application is used. Treatment involved applying topical 0.03% tacrolimus ointment was an effective and safe treatment. The study assessed changes in symptoms and signs posttreatment and monitored potential complications at 1, 4, 7, 10, and 14 weeks into the treatment during follow-up sessions.

Results:

The mean age of the patients was 10.7 ± 3.3 years. Following the administration of 0.03% tacrolimus, all signs and symptoms such as itching, foreign body sensation, tearing, photophobia, papillae, conjunctival hyperemia, limbal edema, Horner-Trantas dots, as well as keratitis (superficial punctate keratitis) showed significant improvement (P < 0.001).

Conclusion:

The application of 0.03% tacrolimus has been found effective in reducing the symptoms and signs of VKC, particularly in cases refractory to steroids, with very few cases reporting minimal side effects. This study emphasizes the crucial role of tacrolimus in preventing the severe visual complications often linked to this disease.
Retrospective review of clinical outcomes of fornix reservoir restoration surgery for conjunctivochalasis with cryopreserved amniotic membrane
Authors: Quiceno Jose Ivan
Published: September 2024

Background:

Conjunctivochalasis (CCh) is characterized by loose, redundant conjunctival folds that result in tear film instability. For cases that are refractory to conventional therapies, surgical treatment may be used to address the underlying pathophysiology.

Aims:

The aim of this study was to assess the clinical outcome of fornix reservoir restoration surgery with cryopreserved amniotic membrane (AM) in patients with symptomatic CCh.

Setting and Design:

This was an observational, retrospective, single-site study.

Materials and Methods:

Retrospective review of eyes with CCh that underwent fornix deepening reconstruction with conjunctival recession and AM transplantation with at least 3 months of follow-up. Outcome measures, which were assessed at 2 ± 1 weeks postoperatively and at the last follow-up visit, included CCh severity, symptoms, tear break-up time (TBUT), corneal and conjunctival fluorescein staining, subconjunctival hemorrhage, and delayed tear clearance.

Statistical Analysis Used:

Wilcoxon signed–rank test and Fisher’s exact test were used for statistical analysis.

Results:

Ten eyes (76.9%) presented with Grade 3 CCh, and 3 eyes (23.1%) presented with Grade 2 CCh along with ocular irritation (100%), epiphora (84.6%), dryness (76.9%), ocular pain (38.5%), and photophobia (23.1%). Following surgical intervention, CCh severity significantly improved to Grade 0 in all eyes. This was accompanied by a significant improvement in corneal staining, symptoms, and resolution of conjunctival staining/subconjunctival hemorrhage.

Conclusion:

Surgical treatment using the reservoir restoration procedure addresses the pathophysiology of CCh as demonstrated by improved symptoms, TBUT, and corneal and conjunctival staining.
Rare association of lens coloboma and retinitis pigmentosa in Marfan syndrome
Authors: Godbole Anushri , Rewatkar Kaustubh , Nene Amit S. , Pirdankar Onkar H. , Shenoy Pratik , Badole Pushpanjali , Shah Smitesh
Published: September 2024

A 17-year-old female, a known case of Marfan syndrome, presented with complaints of diminution of vision in both the eyes for 10 years. Clinical examination revealed that the presence of lens coloboma with advanced retinitis pigmentosa (RP) in the right eye and left eye showed cataractous changes along with persistent hyperplastic primary vitreous (PHPV) on ultrasonography B scan. This report describes the rare association of RP, lens coloboma, and PHPV in Marfan syndrome.
Sinus surprise: The rare encounter of frontal mucocele with optic nerve compression
Authors: Parande Madhuri , Raghavendra R. , Sneha R. , Soundarya D.
Published: September 2024

Mucoceles are epithelial-lined cavities filled with sterile mucus that develop due to the obstruction of a sinus ostium. Frontal mucocele is one of the most common among mucoceles. Most of them present with ophthalmic manifestations. Here, we present such a case with ocular symptoms. Despite the absence of thyroid-related symptoms or significant medical history, her examination revealed left eye proptosis, limited ocular motility, optic disc edema, and significant visual loss due to optic nerve compression. Further investigations, including orbital computed tomography, confirmed a frontal mucocele extending into the left orbit. Following endoscopic sinus surgery with mucocele excision, the patient experienced significant improvement in vision, resolution of optic disc edema, and proptosis. This case underscores the importance of considering mucoceles in the differential diagnosis of orbital pathologies. It also highlights the efficacy of endoscopic management in achieving favorable outcomes and emphasizes the significance of interdisciplinary collaboration in optimizing patient care.
Children’s Hospital of Philadelphia score to predict Type 1 retinopathy of prematurity in a resource-limited country
Authors: Sahu Sandip Kumar , Parija Sucheta , Som Tapas Kumar , Mohanty Pankaj Kumar , Panigrahi Sahadeb , Moharana Bruttendu
Published: September 2024

Background:

Retinopathy of prematurity (ROP) leads to permanent vision loss unless treated timely. National screening guidelines for ROP are sensitive but lack specificity. The Children’s Hospital of Philadelphia ROP (CHOP ROP) model is highly specific for detecting severe ROP.

Aim:

The aim of the study was to evaluate the diagnostic performance of the CHOP ROP model in an Indian setting.

Setting:

In this prospective observational study, preterm neonates admitted to the neonatal intensive care unit were included.

Materials and Methods:

The screening was done as per the conventional screening guidelines. The CHOP ROP algorithm was applied to all neonates undergoing ROP screening, and the risk score was calculated from 2nd week onward.

Statistics:

The sensitivity, specificity, and Pearson coefficient of the CHOP algorithm in detecting Type 1 ROP were calculated.

Results:

Keeping the alarm level at 0.014, 143 (87.2%) babies fall into the low-risk group and 21 (12.8%) in the high-risk group. The sensitivity and specificity of the CHOP algorithm in detecting Type 1 ROP were 33% and 88%, respectively. Keeping the alarm level at 0.001, 118 (72%) babies were categorized as high risk, including 8 Type 1 ROP.

Conclusion:

The CHOP ROP model is unsuitable as an adjunct to the conventional screening guidelines to reduce the screening burden. This may be because the original nomogram was developed based on the screening criteria of Western countries. In India, where larger and older preterm babies tend to develop ROP, the nomogram may need to be updated.
Comparative evaluation of modified diurnal tension curve with water drinking test among glaucoma suspects at University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
Authors: Mohammed Safinatu W. , Adio Adedayo O. , Ejimadu Chibuike S. S. , Nathaniel Godswill Inye
Published: September 2024

Objective:

The objective of the study was to assess the correlation of intraocular pressure (IOP) peaks and fluctuation obtained using a modified diurnal tension curve (mDTC) and water drinking test (WDT) and to investigate the relevance of routine use of WDT in glaucoma suspects at University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State Nigeria.

Materials and Methods:

Glaucoma suspects were enrolled in this prospective comparative study. A total of 138 participants were recruited. All participants were subjected to two hourly IOP checks for 8 h (mDTC starting from 8:00 am). The WDT was done the following day, starting at 8:00 am. There was a 2-h water fast before the commencement of the WDT and IOP was measured every 15 min for 1 h after ingestion of 1 L of water.

Results:

Out of the 138 glaucoma suspects recruited for the study, 57 were male and 81 females, with a mean age of 37.8 ± 11.7 years. The mean peak IOP measured during mDTC (19.0 ± 3.5 mmHg) was statistically different from that measured during WDT (20.9 ± 4.4 mmHg; P < 0.001). The mean IOP fluctuation measured during the mDTC (5.6 ± 1.9 mmHg) was also statistically different from that measured by WDT (6.9 ± 2.7 mmHg) (P < 0.001). The peak IOP measured during mDTC showed a strong correlation with peak IOP during WDT (r = 0.840); however, there was moderate agreement between the two peaks (k = 0.408). The IOP peaks of mDTC and WDT showed excellent strength of association (Cronbach’s alpha = 0.901) and poor strength of association for the fluctuation in IOP (Cronbach’s alpha = 0.556).

Conclusion:

The WDT can provide an easier, nonexpensive, and less time-consuming method of peak IOP determination, which will aid in the timely management of glaucoma patients.
Scleral lens surface crazing in an eye with giant papillary conjunctivitis and keratoconus: Outcome of lens surface polishing
Authors: Sadhu Soumen , Iqbal Asif , Srinivasan Bhaskar , Padmanabhan Prema
Published: September 2024

We present a case of scleral lens surface crazing in a patient with keratoconus (KC) and chronic giant papillary conjunctivitis (GPC). A 45-year-old Asian male with known keratoconus (KC) and allergic eye disease in both eyes, who is an experienced scleral lens user, presented with a 3-month history of lens intolerance in the right eye. On examination, the right eye scleral lens showed extensive lens surface crazing with poor surface wettability. The upper tarsal conjunctiva showed conjunctival hypertrophy – active GPC. After allergy treatment and symptomatic improvement, the scleral lens was refitted after intensive cleaning and polishing with aluminum oxide. The lens surface showed significant improvement and good fitting characteristics, and the patient resumed lens wear. At 6 months of follow-up, the patient was asymptomatic, and the ocular condition was stable.
Beyond human perception: Revolutionizing ophthalmology with artificial intelligence and deep learning
Authors: Jabeen Asma
Published: September 2024

The purpose of the study was to provide a comprehensive overview of the transformative applications of artificial intelligence (AI) in ophthalmology, with a focus on its impact on screening, diagnosis, and treatment planning. A comprehensive literature search was conducted to identify relevant studies on the applications of AI in ophthalmology. PubMed, Embase, and Scopus were searched using appropriate keywords, with inclusion criteria focusing on studies related to image analysis, diagnostic algorithms, predictive models, and treatment planning. Limited to English-language articles, both original research and review articles were considered, while studies emphasizing nonophthalmic applications of AI or lacking sufficient detail were excluded. AI algorithms, powered by deep learning models, have demonstrated remarkable accuracy in the automated screening and detection of various ocular diseases. The potential implications of AI include revolutionizing screening programs for early identification of individuals at risk, facilitating timely interventions, and improving patient outcomes. The integration of AI with teleophthalmology and remote monitoring systems has the potential to alleviate the burden on health-care systems, particularly in underserved areas. The applications of AI in ophthalmology hold significant potential for transforming the field by enhancing diagnostic accuracy, optimizing treatment strategies, and increasing access to eye care. However, successful implementation requires addressing challenges such as diverse and representative datasets, ensuring interpretability and explainability of AI models, and addressing ethical considerations related to patient privacy and data security. Collaborative efforts between ophthalmologists, data scientists, and regulatory bodies are deemed crucial to fully leverage the potential of AI in ophthalmology.
A study on knowledge, awareness, and practices about eye donation in medical students
Authors: Darade Nikhil Nivritti , Joshi Rajesh S , Gurudasani Bhavishya Tulsidas , Hussaine Murtuza , Karampuri Samiksha , Rathod Aditi
Published: September 2024

Aim:

The aim of the study was to assess knowledge, awareness, and practices about eye donation in medical students of medical colleges.

Setting:

Tertiary Care Centre.

Design:

This study involves a cross-sectional study.

Materials and Methods:

A cross-sectional study at a tertiary care center in Western Vidarbha from August 2023 to October 2023, among medical students. Approval from the institutional ethical committee was taken. A total of 538 students participated in the study. After taking consent, data were collected in self-reported questionnaire consisting of questions about the knowledge and awareness of eye donation, the source of their information, willingness for donation, and respective reasons for willingness and nonwillingness. Data were analyzed.

Results:

Majority of students belonged to the age group between 21 and 30 years. Most were undergraduates, followed by interns and post-graduates. Five hundred and twenty-nine had heard about eye donation mainly through medical personnel. The majority of students believed that eye donation means giving sight to the blind. Most knew the nearest point of contact for eye donation. The answer given by most to the question “What is removed for transplantation?,” was cornea. The most common response to questions about a site for the removal of eyes was the hospital. The majority knew that no monetary benefits were given for donations. Those willing to pledge their eyes wanted to do so to help the blind, and those not willing said objection by family as the main reason among others.

Conclusion:

After the study, we concluded that awareness about eye donation was good in the students, while knowledge regarding eye donation varied among the students. Willingness to donate showed mixed responses.
An Innovative Technique to Prevent Air Leaks from Cervical Esophagostomy during Face Mask Ventilation
Authors: Shah Shreya , Goel Prabudh , Sharma Kanika , Singh Teg Rabab , Khanna Puneet , Subramaniam Rajeshwari , Jain Vishesh , Dhua Anjan Kumar , Yadav Devendra Kumar , Bajpai Minu , Agarwala Sandeep
Published: September 2024

ABSTRACT

During face mask ventilation, invariably, some air enters the esophagus rather than the airways; this results in gastric insufflation while the esophagus is intact or loss of tidal volume in patients with a cervical esophagostomy (Cx-esophagostomy).

Objective:

The objective of the study was to report the indigenous use of an electrocardiography (ECG) electrode in successfully occluding the Cx-esophagostomy to prevent inadvertent loss of tidal volume.

Materials and Methods:

Twenty-nine observations were recorded on 27 patients (mean age: 10.9 months; male:female = 2.6:1). The oral cavity, pharynx, and Cx-esophagostomy were cleared of saliva. Peristomal area was cleaned with dry gauze and dried with alcohol. Latex-free, 50 mm, ECG electrode was pasted symmetrically over the Cx-esophagostomy. The efficacy of the electrode was assessed using a five-point algorithm: (i) collapse of reservoir bag, (ii) chest expansion, (iii) ballooning of electrode, (iv) cotton-wisp test, and (v) change in compliance with manual compression of the electrode. Subgroup analysis was conducted for laterality and health of Cx-esophagostomy.

Results:

Study cohort: Cx-esophagostomy was located on the left in 58.26% (n = 17/29) patients. The health of Cx-esophagostomies was graded from I to IV (n = 9, 16, 3, and 1, respectively). The collapse of the reservoir bag and chest rise indicated successful ventilation. Ballooning of the electrode with each breath was observed in 79% (23/29) patients. Partial separation of the electrode from the skin (exaggerated with each breath) was observed in 10.3% (3/29) patients (Group I: n = 1, Group III: n = 1, and Group IV: n = 1). This was related to poor local preparation or pooling of saliva (n = 1; Group I: resolved with procedural re-application of a fresh electrode) and underlying skin condition (n = 2; Groups III and IV: resolved only temporarily with re-application). The cotton-wisp test was positive in two additional patients (1 each in Groups II and III) and was related to the pooling of saliva. No change in compliance was observed with manual compression of the electrode. No difference in success was observed between left and right Cx-esophagostomies. Overall success with this technique was 82.8% with a potential for 100% in those with peristomal health graded I–III.

Conclusions:

The ECG electrode is a technically simple, cost-effective, and widely available device, instrumental in addressing the problem of air leak through Cx-esophagostomy during face mask ventilation before intubation.
Demystifying Fetus-in-fetu: A Systematic Review of Its Clinical and Pathological Attributes
Authors: Palo Seetu , Mangla Mishu , Gabbeta Spandana , Motwani Rohini
Published: September 2024

ABSTRACT

Background:

Fetus-in-fetu (FIF) is an exceedingly rare condition, characterized by a fetal-like or fetiform mass with a calcified vertebral axis surrounded by other organs or limbs. This systematic review was conducted to comprehensively analyze the clinicopathological attributes, management strategies, and prognosis of FIF to consolidate existing knowledge on FIF.

Methodology:

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was performed across various electronic databases, using the keywords “fetus-in-fetu,” “fetus-ex-fetus,” “homunculus,” or “fetiform teratoma” to look for published articles until December 2023. Data extraction and analysis were carried out for cases meeting the defined criteria for FIF diagnosis, that is “presence of both/either the vertebral column and/or long bones of extremities” and “absence of immature elements.”

Results:

A total of 249 case reports/case series comprising 241 single FIF cases and 33 multiple FIF cases were included for analysis. The majority of single FIF cases presented within the 1st year of life, with a slight male predominance. Retroperitoneal location was most common, and imaging modalities played a crucial role in preoperative diagnosis. Complete surgical removal of the mass with detailed histopathological examination is the cornerstone of treatment for FIF, with favorable outcomes in the majority of cases. Both mature and immature teratoma can rarely be found in association with FIF.

Conclusion:

This comprehensive systematic review enhances understanding of FIF, emphasizing the importance of accurate diagnosis by diligent histopathological examination, appropriate management, and vigilant postoperative monitoring for favorable outcomes.
A Rare Case of Ebstein’s Anomaly with Biventricular Noncompaction
Authors: Sathyamurthy Immaneni , Sridhar Anuradha , Subramanian Sasikala , Lakhani Zeeshan Sakina A.
Published: September 2024

Ebstein’s anomaly is a rare cyanotic congenital heart disease, which can present with right heart failure when associated with septal defects and/or right ventricular outflow tract obstruction. Left ventricular failure is extremely rare, and we report one such case due to the coexistence of biventricular noncompaction.
Challenges faced by dentists during provision of oral health care in children and adolescents with special health-care needs: A scoping review
Authors: Tuli Shivya , Goswami Mousumi , Saxena Aditya , Bhatara Supriya , Saxena Bhawna , Gogoi Rimpi
Published: September 2024

Introduction/Background:

Oral health care for children with special health-care needs (CSHCN) is often overlooked despite a substantial global population with disabilities or special needs. This scoping review delves into the challenges dentists face in delivering oral health care to CSHCN.

Methodology:

The scoping review was conducted as per the guidelines of PRISMA-ScR with a search strategy based on the population, intervention, comparison, and outcome (PICO) framework of the research question. The databases searched were PUBMED, Google Scholar, and EBSCOhost. Articles published within 20 years and in the English language were included in the study.

Results:

The review included 20 studies and highlighted several significant barriers encountered by dentists when providing oral health care for CSHCN. They included inadequate training among dentists in managing special needs patients, the time-intensive nature of oral procedures for this population, and the unpredictable behaviors exhibited by CSHCN during dental visits.

Conclusion:

The findings underscore the crucial need to address the challenges dentists face in delivering oral health care to CSHCN.
Comparison of intranasal ketamine with intranasal midazolam and dexmedetomidine combination in pediatric dental patients for procedural sedation: A crossover study
Authors: Dubey Bibhav , Singh Neerja , Kumar Santosh
Published: September 2024

Background:

The main goal of the pediatric dentist is to address and reduce children’s fear and anxiety during the dental treatment, especially when conventional behavior-guiding strategies fail. In such cases, the use of pharmacological agents becomes an essential factor to consider.

Objective:

The objective of the study was to compare the efficacy, safety, and acceptability of intranasal ketamine (INK) with the combination of intranasal midazolam and dexmedetomidine (INMzD) in pediatric dental patients for the procedural sedation.

Patients and Methods:

Forty-seven children aged 3–9 years who required dental procedures such as extractions, pulpectomy, and restorations were randomly distributed into two groups using the envelope drawing method. Group INK received 7 mg/kg INK, whereas Group INMzD received a combination of midazolam spray (0.3 mg/kg) and atomized dexmedetomidine (3 μg/kg).

Results:

INK showed faster onset, faster recovery, and shorter discharge time than INMzD. Both groups had acceptable physiological parameters and no postoperative complications. INK was more accepted by the patients than INMzD.

Conclusions:

In terms of efficacy, safety, and acceptability, INK outperformed the combination of INMzD for the procedural sedation.
Evaluation of oral complications in children undergoing chemotherapy: An observational study
Authors: Ambati P , Galhotra Virat , Jondhale Sunil Natha , Dolker Tundup , Ravi Mugilan , Rathod Parth
Published: September 2024

Background:

Chemotherapy, a cornerstone treatment for childhood cancers, can negatively impact oral health. This study aimed to evaluate the prevalence and evolution of oral complications in these patients.

Materials and Methods:

A prospective observational study enrolled 44 children diagnosed with malignancy undergoing chemotherapy at a tertiary care institute in central India. Oral examinations were performed at baseline, with follow-ups at 3–6 and 9–12 months. Data collected included demographics, medical history, oral hygiene practices, and oral lesions. Blood counts and World Health Organization grading for mucositis were used. Descriptive statistics and appropriate statistical tests analyzed the data (P ≤ 0.05).

Results:

Acute lymphoblastic leukemia (ALL) was the most prevalent malignancy. Children reported various oral complaints such as ulcers, bleeding gums, and difficulty eating. Mucositis prevalence significantly decreased over follow-up visits (baseline: 56.8% and second follow-up: 13.3%). Gingival inflammation was present, though mean scores decreased over time. Oral hygiene scores varied without significant changes. Caries experience scores increased from baseline to follow-up.

Conclusion:

This study identified a high prevalence of ALL and diverse oral complications in children undergoing chemotherapy. While mucositis severity lessened over time, other issues such as caries persisted. These findings highlight the critical need for preventive oral care strategies to safeguard this vulnerable population’s oral health.
Effectiveness of EndoActivator, PATS Vario system, and XP-endo Finisher files on smear layer removal under scanning electron microscope: A comparative study
Authors: Patel Rishabh , Shinde Gaurav , Bondarde Prashant , Vishwakarma Aruna , Bhandare Madhuri , Pharne Vaibhavi
Published: September 2024

Context:

The smear layer may harbor many bacteria; hence, alternative methods are used to disrupt and remove biofilm.

Aim:

The aim of the study was to compare the effectiveness of EndoActivator, PATS Vario System, and XP-endo Finisher files on smear layer removal using a scanning electron microscope.

Subjects and Methods:

Sixty single-rooted extracted premolars with Vertucci Type 1 configuration were decoronated and divided into four groups. The groups were instrumented with the rotary ProTaper file system. All specimens were flushed with 1 ml of 3% sodium hypochlorite. Group 1 was irrigated with a conventional needle and syringe. In Group 2, the irrigant was activated with an EndoActivator. In Group 3, the irrigant was activated with PATS Vario system, and in Group 4, XP-endo Finisher files were used after biomechanical preparation to remove debris and smear layer. All specimens were finally rinsed with 3 ml of 3% sodium hypochlorite. The teeth underwent longitudinal splitting and grooving in the coronal, middle, and apical thirds, and then, the samples were taken for scanning electron microscopy to evaluate the amount of smear layer removal in each third.

Results:

The middle and coronal thirds Showed that almost similar efficacy to remove smear layer in both Group II and Group III. At the apical third, Group III showed comparatively better results than Group I, II, and IV, respectively.

Conclusion:

Equal amount of smear layer was seen with EndoActivator and PATS Vario system when used as sonic irrigation devices.
Spatial and angular alterations in the dental arch after premature loss of primary molars: Immediate and 9-month computed tomography evaluation
Authors: Kundra Ruchika , Sharma Deepak , Kaur Ravneet , Monga Suneet , Duvedi Shuchi
Published: September 2024

Background:

Contemporary imaging methods and quickly advancing technologies have increased the number of diagnostic tools available in medicine and orthodontics. The current study aimed to determine three-dimensional (3D) space changes that occurred after the extraction of either the maxillary or mandibular primary molars during the mixed dentition period.

Materials and Methods:

The present study was a longitudinal split-mouth study with a study group and a control group. The sample consisted of 20 children aged between 6 and 9 years. Clinical examination, radiological analysis, and 3D digital images of the plaster casts were used sequentially to gather all the data. The dental cast measurements recorded were arch width, arch length, hemi-perimeter, dental space at the extraction site, and angulation of the first permanent molar. The children were recalled for follow-up after 9 months, and all dental cast measurements were repeated using nondestructive 3D computed tomography software. For repeated measurements, the test applied was a paired t-test, and for independent samples, the test was a Student’s t-test.

Results:

A significant decrease in arch width (P = 0.001), arch length (P < 0.001), hemi-perimeter (P < 0.001), D-space (P < 0.001), and E-space (P = 0.001) was observed following extraction. A significant increase in angulation measurements was observed (P = 0.001).

Conclusion:

The study revealed a comparative reduction in mandibular arch width, a reduction in arch length in both the maxilla and the mandible, a reduced hemi-perimeter of dental arches, loss of dental extraction space, and a change in angulation of the erupted first permanent molars following premature loss of the primary molar.
Chemerin 15 peptide reduces neuroinflammation via the ChemR23 receptor after ischemia-reperfusion injury
Authors: Huang Yan , Li Shuang , Yang Yuhan , Li Kunyi , Wen Lan , Li Jinglun
Published: September 2024

Microglia-mediated neuroinflammation plays a crucial role in ischemic stroke; consequently, understanding its regulation could facilitate the development of therapies for ischemic stroke. Chemerin 15, a 15-amino acid peptide derived from chemerin, exerts powerful anti-inflammatory effects through ChemR23, modulates macrophage polarization, and diminishes inflammatory cytokine expression in peripheral inflammation models. However, its effects on microglia and stroke remain unclear. In this study, we used an in vitro oxygen/ glucose deprivation BV2 cell model and a mouse model of ischemia-reperfusion injury to investigate the role of chemerin 15 in stroke and the underlying mechanisms. We co-cultured BV2 microglial cells with HT-22 hippocampal neurons and observed that chemerin 15 reduced apoptosis in HT-22 cells. Furthermore, we found that chemerin 15 binds to the ChemR23 receptor on the cell surface, inducing its internalization. This process regulated the activity of adenosine 5’-monophosphate-activated protein kinase and inhibited its downstream target nuclear factor kappa B. These effects could be reversed by treatment with α-NETA, a ChemR23 inhibitor. In mice with ischemia-reperfusion injury, chemerin 15 modulated microglial polarization, reduced infarct volume and neuronal apoptosis, and facilitated cognitive and neurological function recovery. Our findings suggest that chemerin 15 suppresses the microglia-mediated inflammatory response, decreases neuronal apoptosis, and enhances long-term neurological function recovery by inducing ChemR23 internalization and regulating the adenosine 5’-monophosphate-activated protein kinase/nuclear factor kappa B signaling pathway.
Crosstalk among canonical Wnt and Hippo pathway members in skeletal muscle and at the neuromuscular junction
Authors: Hashemolhosseini Said , Gessler Lea
Published: September 2024

Skeletal muscles are essential for locomotion, posture, and metabolic regulation. To understand physiological processes, exercise adaptation, and muscle-related disorders, it is critical to understand the molecular pathways that underlie skeletal muscle function. The process of muscle contraction, orchestrated by a complex interplay of molecular events, is at the core of skeletal muscle function. Muscle contraction is initiated by an action potential and neuromuscular transmission requiring a neuromuscular junction. Within muscle fibers, calcium ions play a critical role in mediating the interaction between actin and myosin filaments that generate force. Regulation of calcium release from the sarcoplasmic reticulum plays a key role in excitation-contraction coupling. The development and growth of skeletal muscle are regulated by a network of molecular pathways collectively known as myogenesis. Myogenic regulators coordinate the differentiation of myoblasts into mature muscle fibers. Signaling pathways regulate muscle protein synthesis and hypertrophy in response to mechanical stimuli and nutrient availability. Several muscle–related diseases, including congenital myasthenic disorders, sarcopenia, muscular dystrophies, and metabolic myopathies, are underpinned by dysregulated molecular pathways in skeletal muscle. Therapeutic interventions aimed at preserving muscle mass and function, enhancing regeneration, and improving metabolic health hold promise by targeting specific molecular pathways. Other molecular signaling pathways in skeletal muscle include the canonical Wnt signaling pathway, a critical regulator of myogenesis, muscle regeneration, and metabolic function, and the Hippo signaling pathway. In recent years, more details have been uncovered about the role of these two pathways during myogenesis and in developing and adult skeletal muscle fibers, and at the neuromuscular junction. In fact, research in the last few years now suggests that these two signaling pathways are interconnected and that they jointly control physiological and pathophysiological processes in muscle fibers. In this review, we will summarize and discuss the data on these two pathways, focusing on their concerted action next to their contribution to skeletal muscle biology. However, an in-depth discussion of the non-canonical Wnt pathway, the fibro/adipogenic precursors, or the mechanosensory aspects of these pathways is not the focus of this review.