bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Crime Scene Analysis
Authors: Ahmed Saquib , Khan Mohd. Faheem , Singh Bhupinder , Singh Nituja , Sharma Bhumika
Published: February 2025

Conventional approaches often find it challenging to adapt to the growing complexity and data volume in crime scene analysis. The advent of artificial intelligence technologies, such as machine learning, computer vision, and natural language processing, is transforming the processing of evidence by improving efficiency, precision, and scalability. AI algorithms can swiftly analyse extensive datasets, uncovering patterns and relationships that may be overlooked by human investigators. For example, AI-driven tools enable the rapid examination of digital evidence and DNA samples, significantly alleviating backlogs in forensic laboratories. This chapter also explores the application of AI in reconstructing crime scenes through sophisticated 3D modelling techniques, which offer investigators a detailed perspective of events and enhance courtroom presentations. Additionally, the chapter addresses ethical issues related to the use of AI in forensic science, including privacy concerns, algorithmic bias, and the importance of human oversight.
Exploring Artificial Intelligence (AI) in Forensic Pathology and Autopsy Analysis
Authors: Malviya Rishabha , Jain Ashima , Lal Sahil , Arora Manmeet Kaur , Kumar Santosh
Published: February 2025

Forensic medicine has long relied on conventional autopsy techniques both to establish a cause of death and criminal investigation. Nevertheless, the arrival of artificial intelligence (AI) has brought a new era, transforming the autopsy workflow. The integration of AI in the autopsy setting exemplifies a paradigm shift with novel technologies providing a new paradigm for investigative approaches. Among these, VIRTOPSY as an advanced imaging technique is gaining prominence, complementing traditional autopsies and further refining forensic examinations. Based on the review of recent advancements, practical uses, and future prospects, this review provides a comprehensive picture of the implication of AI in contemporary forensic medicine. It highlights the AI potential to enhance investigative precision, to increase the reliability of forensic evidence, and to aid efforts at social good.
Pattern Recognition in Fingerprint and DNA Analysis
Authors: Nair Megha M. , Likitha S.
Published: February 2025

In forensic science, DNA and fingerprint analysis are crucial methods that are frequently used to identify people and solve criminal cases. DNA analysis matches biological samples from crime scenes with suspects or identifies victims by using the distinct genetic code present in each person's cells. Forensic scientists can examine even minute amounts of DNA using methods like mitochondrial DNA analysis, short tandem repeat (STR) profiling, and polymerase chain reaction (PCR) amplification, which yields highly accurate human identification. Analyzing fingerprints also depends on the distinct patterns of ridges, whorls, and loops seen on human fingertips. Automated fingerprint identification systems (AFIS) have advanced in recent years and enhanced the speed and accuracy of matching fingerprints across large databases. In forensic investigations, DNA and fingerprint analysis work well together as complementary methods. Fingerprints are direct proof of physical touch, whereas DNA provides a genetic blueprint.
Performance of AI-Powered Forensic Facial Recognition
Authors: Chandra Saurabh
Published: February 2025

Facial recognition technology (FRT) is one of the transformational new tools to forensic science that greatly aid in law enforcement to identify suspects and solve the crimes. You have to be aware of this very important enhancement of facial recognition technologies. It also relates to the legality and ethical issues involved with the use of this technology in forensic settings. FRT raises significant concerns regarding privacy rights and civil liberties, and its impact on these rights is critically analysed, highlighting the importance of establishing a balance between individual freedoms and the effective use of these powerful tools by law enforcement. Connecting cutting-edge technology with proscribed legal bounds that the technology must abide by, this chapter strives to promote recognition of how forensic science can utilize facial recognition technology for the betterment of society while protecting fundamental liberties.
A Study of HR's Role in Managing the Shift to AI-Enhanced Knowledge Management Systems
Authors: Baisakhi D. , Sandhu Shilpa , Tiwari Richa , Tripathi Manisha , Patrick Harold A. , Reddy Divya A. , Kour Manjit
Published: February 2025

The rapid advancement of Artificial Intelligence (AI) in organisational training is revolutionizing learning and development. This research paper delves into the essential role of Human Resources (HR) in managing change during the shift to AI-enhanced learning systems. Utilizing a review method, this study examines the strategies HR departments employ to facilitate this transition. The research underscores the crucial role of clear communication, continuous training, and active employee participation in the change process. It highlights HR's responsibility in fostering a culture of adaptability and resilience, along with the importance of strategic planning and stakeholder engagement. Additionally, the study identifies common barriers to successful implementation, such as resistance to change and the necessity for HR professionals to develop AI competencies. This paper contributes valuable knowledge on best practices and potential challenges, offering guidance on how HR can effectively manage change amidst technological advancements.
Digitally Enhanced World of Realities
Authors: Oyedokun Tunde Toyese
Published: February 2025

The digital age has seen an unparalleled evolution in technology, particularly with immersive technologies like augmented reality (AR), virtual reality (VR), and mixed reality (MR), leading us toward a metaverse-defined future. This chapter explores their transformative impact on various industries as we stand on the brink of a convergence between digital and physical realms. Tracing the historical trajectory and pivotal milestones of AR and VR development, it examines their current state and convergence with domains like AI and IoT. Examining their applications across sectors such as healthcare, education, and retail, the chapter unveils innovative business models emerging within the metaverse. From redefining consumer behavior in e-commerce to revolutionizing traditional learning methods, immersive technologies are reshaping industries and necessitate understanding for individuals, businesses, and policymakers navigating this transformative landscape.
Supporting the wounded: Parents of adolescents recovering from substance use disorder
Authors: Mathibela Faith , Masombuka Jan
Published: February 2025

Background: The increase of adolescent substance use disorders (SUDs) around the world has a lot of negative effects on the parents and frequently degrades their quality of life. Substance use disorder is a critical issue recognised as a chronic, complex health and social condition. Parents of adolescents recovering from SUD may suffer significantly as a result of the wide range of negative emotions that come with having adolescents recovering from SUD. From the extant literature, there is little evidence of the strategies used to address the support needs of parents who carry the burden of adolescent SUD care.Aim: The authors focused on exploring the support needs of parents living with adolescents recovering from SUD.Setting: The study was conducted in Tshwane, where they struggling with adolescent SUD issues, making it challenging to foster stable communities and social cohesion. Data were collected at the three in-patient treatment centres.Methods: Qualitative reseach was used to understand the phenomenon using ecological systems theory. The researchers conducted face to face interviews with parents, employing semi-structured method through purposive sampling.Results: The findings highlighted the following themes: The findings highlighted the following them: experiences of parenting an adolescent recovering from SUD, the support needed for parents and the desired services to help them cope.Conclusion: Parents expressed feeling overwhelmed and struggling to cope with adolescents recovering from SUD.Contribution: The study benefits the social work profession in the field of substance dependency by finding ways to support parents of adolescents recovering from SUD.
Gauteng mental healthcare providers’ understanding of cultural and religious illnesses
Authors: Mathapo-Thobakgale Ellen M. , Mulaudzi Fhumulani , Ngunyulu Roinah N.
Published: February 2025

Background: Cultural and religious illnesses such as spirit possessions are health conditions that are not easily understood by healthcare providers in mental healthcare service institutions. Mental health care providers’ understanding is guided by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) that seems to not recognise cultural and religious illnesses as a disorder that needs distinct care. The study explored mental healthcare providers’ understanding of cultural and religious illnesses that could assist spirit-possessed persons to receive proper management and early referrals to traditional health practitioners and faith healers who are expects in cultural and religious illnesses.Methods: Hermeneutic phenomenology explored 12 mental healthcare providers’ understanding of cultural and religious illnesses. In-depth individual interviews were conducted with 12 mental healthcare providers who were selected through a purposive sampling technique. Data were collected from two mental healthcare institutions in the Gauteng province of South Africa that provide mental healthcare services. Data analysis followed Heidegger’s and Gadamer’s philosophies and Van Manen’s six steps.Results: The findings revealed that mental healthcare providers understood cultural and religious illnesses as mental illness that is unclassified, a calling for a person to become a traditional health practitioner, a demonic spirit and/or witchcraft. The term ‘unclassified disorder’ denotes that there are no specific criteria that could be used to classify an illness.Conclusion: Understanding of cultural and religious illnesses could assist mental healthcare providers that ill-nesses that do not respond to psychiatric treatment can be referred to traditional health practitioners with expert cultural and religious assessment.Contribution: The study could assist MHCPs to acknowledge and take culture and religion into account when providing care to person with cultural and religious illness. Considering the culture and religion of the spir-it-possessed person could be an attempt to move towards a holistic understanding of health needs that highlight the continuous connections between mind, body, and soul.
Factors associated with non-adherence to antiretroviral therapy among adolescents in Oshikoto Region, Namibia
Authors: Ashipala Daniel O. , Shuukwanyama Tukwatha A. , Nghikevali Abraham V.
Published: February 2025

Background: In Namibia, the Omuthiya Antiretroviral Therapy (ART) Clinic has indicated that nine older adolescents (15–19 years) out of 125 adolescents active on ART have defaulted and become lost to care. This represents an 89% retention rate among older adolescents compared to a 97% retention rate for the adult population in the same facility. There is a lack of information on the extent of ART adherence among older adolescents, particularly in terms of viral suppression rates. This study aims to measure the level of adherence to ART treatment among adolescents enrolled at the Omuthiya ART Clinic in the Oshikoto Region, Namibia.Methods: From November to December 2020, a cross-sectional study was conducted among 100 adolescents living with HIV (ALHIV) at the Omuthiya ART Clinic. Data were collected through structured questionnaires and analysed using descriptive statistics and logistic regression.Results: The study found that 24% of adolescent patients on ART treated at the Omuthiya ART Clinic are non-adherent to treatment. A significant association found was between education level and adherence (p = 0.008), alcohol use and adherence (p = 0.022) and memory aids use and adherence (p  0.001).Conclusion: Adolescents’ adherence to ART at the Omuthiya ART Clinic is influenced by educational level, alcohol use, and memory aid use. Further research is needed to explore other potential factors influencing adherence.Contribution: These findings may be used to develop ongoing strategies and targeted interventions that prioritise a patient-centred care approach, recognising the autonomy of adolescents. In addition, they highlight the importance of a supportive family environment in managing HIV and improving ART adherence.
Community service rehabilitation therapists’ perspectives of cross-disciplinary supervision
Authors: Sibiya Zinzile N. , Ross Andrew J.
Published: February 2025

Background: In South Africa, graduate rehabilitation therapists undertake a compulsory community service (CS) year in public healthcare facilities, often entering this role without sufficient competency to work independently. They rely on supervision and support, which may come from senior therapists of different disciplines. This study, conducted in KwaZulu-Natal (KZN) province, explores the experiences of rehabilitation therapists regarding cross-disciplinary supervision and support during their CS year.Methods: A qualitative, descriptive, and exploratory design was employed. Virtual semi-structured interviews were conducted with seven purposively sampled participants from five KZN districts. Data were audio recorded, transcribed verbatim, and analysed thematically.Results: The findings revealed four themes and ten sub-themes, highlighting the challenges and benefits of cross-disciplinary supervision, dissatisfaction with existing support structures, and recommendations for improvement. The CS therapists, as junior staff, often lacked the experience and authority to deliver optimal patient care within resource-constrained settings.Conclusion: While discipline-specific supervision remains the preferred approach, cross-disciplinary supervision contributed positively to professional development, broadening therapists’ understanding of other rehabilitation disciplines. However, the limited availability of accessible, discipline-specific supervisors remains a significant concern. Given their frequent isolation and minimal experience, CS therapists require consistent, discipline-specific support to meet service demands.Contribution: This study emphasises need to address the experiences of CS therapists, who face high patient loads and limited support, in public health sector planning. Incorporating their insights can enhance their ability to deliver essential services, ensuring better outcomes for the populations served by the public health system.
Benefit of Gastro™ Laryngeal Mask Airway® during Total Intravenous Anesthesia for Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Study
Authors: Archana K. N. , Subramanian Akaash , Kumar P. Harish , Kumararadhya Girish Bandigowdanahalli , Nandeesh H. P. , Shivakumar K. G.
Published: February 2025

Context:

Deep level of sedation required during endoscopic retrograde cholangiopancreatography (ERCP) can cause hypoxia in part due to an unsecured airway. This study aims to study the benefits of using the laryngeal mask airway (LMA) Gastro to secure the airway in ERCP.

Aims:

To determine the benefit of Gastro LMA for securing airway for ERCP procedure, by recording the incidence of intraprocedural adverse cardiorespiratory events – hypoxia, hypotension, bradycardia, and arrhythmias.

Settings and Design:

A prospective randomized controlled study was conducted at a tertiary hospital with the American Society of Anesthesiologists (ASA) Grade I to III patients undergoing ERCP procedure in the endoscopy suite.

Subjects and Methods:

Eighty patients between 18 and 70 years of age fulfilling the inclusion criteria undergoing ERCP were selected for this prospective, randomized controlled study, after obtaining institutional ethical committee approval. Patients were allocated to either LMA Gastro group (G) or to control group (C). Standard anesthesia protocols were followed, and cardiorespiratory parameters were recorded at regular intervals during the course of the procedure.

Statistical Analysis Used:

Comparisons were made using t-tests and Chi-square tests, with significance set at P < 0.05.

Results:

Our study demonstrated that the LMA Gastro group maintained significantly greater oxygen saturation, with nil hypoxic events occurring in this group. Comparatively, the control group experienced four episodes of hypoxia. The LMA Gastro group also demonstrated statistically significant increases in mean blood pressure, while mean heart rates were lower. However, these did not translate to any clinically significant differences, and the incidence of hypotension and bradycardia events were comparable between the groups. The total amount of propofol required to maintain desired sedation levels was found to be comparable between the groups. No postoperative hemodynamic or respiratory adverse events were recorded, and incidence of sore throat was found to be statistically insignificant.

Conclusions:

The LMA Gastro offers excellent control of the patient airway during TIVA for ERCP, providing superior maintenance of oxygen saturation. It also allows for the initiation of positive pressure ventilation when required. The hemodynamic profile including incidence of hypotension and arrhythmias, while providing sedation with the LMA Gastro in situ is not clinically significant in comparison to sedation with native unsecured airway. It can be easily inserted by an anesthetist, and it offers the same level of efficacy and safety even in ASA class III patients. These characteristics make it an attractive primary airway technique in ERCP.
Retrospective study of root canal configuration of permanent mandibular incisors among Indian subpopulation using cone-beam computed tomography
Authors: Doshi Purva , Oswal Piyush , Srinidhi S. R. , Bhujbal Mayuresh , Malu Krutika
Published: February 2025

Aim:

The aim of this study was to evaluate and determine the root canal configuration in mandibular incisors among the Indian subpopulation using cone-beam computed tomography (CBCT).

Methods:

A cross-sectional retrospective study was performed on 872 CBCT images of mandibular permanent incisors (central and lateral) of Indian subpopulation who visited the radiology department at a dental college between 2014 and 2023. The teeth were investigated for the number of roots and canals and canal configuration types according to Vertucci’s classification. The CBCT images were interpreted, and the data were analyzed statistically.

Results:

Out of a total of 872 incisor teeth, it was found that out of male subjects, 472 (99.8%) had one root, and 1 (0.2%) had two roots, and out of 400 incisor teeth of female subjects, 396 (99.0%) had one root, and 4 (1.0%) had two roots. It was found that of 436 right-sided incisors, majority, i.e., 187 (42.9%) were of type 1, 112 (25.7%) were of type 2, 86 (19.7%) were of type 3, 43 (9.9%) were of type 4, 6 (1.4%) were of type 5, and 2 (0.4%) were of type 6. Out of 436 left-sided incisors, the majority, i.e., 179 (41.0%) were of type 1, 110 (25.2%) were of type 2, 105 (24.1%) were of type 3, 38 (8.7%) were of type 4, 2 (0.4%) were of type 5, and 2 (0.4%) were of type 6. The distribution of Vertucci’s classification did not differ significantly between the group of right-sided teeth and the group of left-sided teeth in the study group (P > 0.05). While the distribution of the number of roots differs significantly across various age groups of subjects studied in the study group along with the total of 436 right-sided incisors, 433 had one root, and 3 had two roots. Out of 436 left-sided incisors, 434 (99.5%) had one root, and 2 (0.5%) had two roots. The distribution of the number of roots did not differ significantly between the group of right-sided teeth and the group of left-sided teeth in the study group.

Conclusion:

Mandibular central and lateral incisors showed no statistical difference between males and females in terms of the number of canals and canal configurations. The distribution of the number of roots differs significantly across various age groups. The distribution of the number of roots did not differ significantly between the group of right-sided teeth and the group of left-sided teeth in the study group. CBCT is the ideal method for critically analyzing the root canal system. Therefore, comprehensive interpretation of radiographs in determining the extension of access preparation and the use of dental microscopy to enhance visibility can help clinicians locate and negotiate extra canals.
Effect of continuous rotary and reciprocating motions on cyclic fatigue resistance of two different nickel–titanium endodontic files: An in vitro study
Authors: Nagpal Rashmeet , Sinha Dakshita Joy , Rathi Ruchi , Gupta Aditya , Puri Nikhil , Paul Rahul
Published: February 2025

Aim:

The objectives of this study were to evaluate and compare the cyclic fatigue resistance (CFR) of TruNatomy (TRN) and WaveOne Gold (WOG) nickel–titanium files subjected to continuous rotary and reciprocating motions.

Methods:

Forty files were divided into two groups which were further divided into two subgroups where Group 1A and Group 2A consisted of 10 samples having size 26, 4% taper TRN files and 25, 7% taper WOG files, respectively, with each file subjected to rotary motion, whereas Group 1B and Group 2B consisted of 10 samples having size 26, 4% taper TRN files and 25, 7% taper WOG files, respectively, with each file subjected to reciprocation motion. All files were tested for cyclic fatigue in the customized model made of stainless steel having an angle of curvature of 60° and a radius of curvature of 3 mm.

Results:

Highest resistance to cyclic fatigue was obtained from WOG files subjected to reciprocating motion followed by TRN files subjected to reciprocating motion and TRN files subjected to rotary motion. Least resistance to cyclic fatigue was obtained from WOG files subjected to rotary motion.

Conclusion:

Using files in reciprocating motion enhances their CFR and TRN files showed more resistance to cyclic fatigue than WOG files in continuous rotation motion.
Comparative evaluation of compressive strength and morphological interface of carbonated hydroxyapatite with other pulp capping materials: An in vitro analysis
Authors: Priyadharshini S. Swathi , Ragavendran Chinnasamy , Sherwood I. Anand , Jeyapalan Ramanaramya
Published: February 2025

Aim:

The aim of this study was to evaluate and compare the compressive strength of carbonated hydroxyapatite (CHA) to other pulp capping materials and to assess the morphological interface of CHA when immediately restored with final restorative material.

Methods:

CHA was synthesized and subsequently subjected to characterization. To evaluate compressive strength, samples were prepared in stainless steel molds and then divided into two groups for testing: immediate and after 24 h of incubation. They were subsequently subjected to compressive strength testing using an INSTRON universal testing machine. Statistical analysis was conducted using IBM SPSS software. Samples were prepared and divided into three groups to assess the bond interface between pulp capping materials and restorative materials using scanning electron microscopy (SEM).

Results:

ApaCal ART exhibited the highest compressive strength immediately after setting and after 24 h, followed by mineral trioxide aggregate (MTA), with CHA showing the lowest strength. SEM examination revealed consistent interpenetration between the pulp capping materials and adhesive system for all groups. CHA and MTA showed an interdiffusion zone at the junction, while the ApaCal group displayed voids at the interface.

Conclusion:

In conclusion, although CHA may not match the compressive strength of other materials, its reliable bonding characteristics make it a promising candidate for clinical applications in pulp capping procedures.
Prediction of Loss of Reduction in Unstable Colles’ Fractures following Supplementary Percutaneous K-wire Pinning
Authors: Hsueh Cheng-Yang , Ma Ching-Hou , Tu Yuan-Kun , Jou I-Ming , Wu Chin-Hsien
Published: February 2025

Background:

Colles’ fractures are one of the most common types of injury treated by an orthopedic surgeon. With a rapid increase in elderly populations, supplementary percutaneous K-wire pinning may not be able to maintain fracture reduction for those higher-demand elderly. Taiwan National Health Insurance is considering to enroll the locking plate systems into a benefit package.

Objectives:

This retrospective study assessed the radiographic outcome and to determine predictive factors for loss of reduction of unstable Colles’ fractures following supplementary percutaneous K-wire pinning, and our study may provide some evidence when regulating suitable populations indicated for locking plate systems.

Materials and Methods:

From December 2015 to December 2018, 59 patients with unstable Colles’ fractures were treated with percutaneous K-wire pinning and immobilized with plasters or external fixators. There were 37 women and 22 men, with a mean age of 56.4 (range, 18–84) years. Patient factors, pre- and postreduction radiographic parameters, and follow-up radiographic parameters were recorded. During 3 months of follow-up, patients were classified into a “loss of reduction” group or a “maintained reduction” group according to the criteria of “loss of reduction.”

Results:

At the end of the 3-month follow-up, there were 18 patients (31%) whose Colles’ fractures were united as loss of reduction. Prereduction radial height, radial inclination, ulnar variance, dorsal tilting, and the presence of radial comminution do not predict the loss of reduction of unstable Colles’ fractures. The presence of dorsal comminution (odds ratio [OR], 26.26; 95% confidence interval [CI], 2.35–293.70; P = 0.008) was the most important risk factor for loss of reduction, followed by female gender (OR, 3.55; 95% CI, 0.54–23.20; P = 0.186) and advanced age (OR, 1.08; 95% CI, 1.01–1.16; P = 0.024).

Conclusions:

Our study suggests that a more rigid fixation modality than simply percutaneous K-wire pinning might be considered when we treat an elderly female with a dorsally comminuted unstable Colles’ fracture. However, a long-term follow-up of functional outcomes is still required for a more thorough understanding of this issue.
Evaluation of the Antibacterial Activity of Ethanol Versus Hydroalcoholic Extract of Mangifera indica Linn Leaves in Different Concentrations Against Streptococcus Mutans - An in vitro Study
Authors: Lilly B.K. , Prashant G.M. , Sushanth V.H. , Imranulla Mohamed , Allamaprabhu C.R. , Vivek H.P.
Published: February 2025

Aim:

To evaluate the antibacterial activity of ethanolic extracts and hydroalcoholic extracts of Mangifera indica Linn (mango) plant leaves on Streptococcus Mutans in comparison with the positive control (chlorhexidine 0.12%) and negative control (alcohol 96%).

Settings and Design:

Ethanolic and hydroalcoholic extracts of Mangifera indica Linn leaves were obtained by following the extraction procedure. A disc diffusion test was carried out for each group on Streptococcus Mutans.

Materials and Methods:

In brain heart infusion agar, Mangifera indica ethanol extract (MEE) and Mangifera indica hydroalcoholic extract (MHE) at 100% and 25% were applied to S. mutans cultures in comparison to the positive (chlorhexidine 0.12%) and negative (alcohol 96%) control groups. For every study group, cultures were produced using the Kirby-Bauer diffusion method, and incubating the cultures at 37°C for 24 hours.

Statistical Analysis Used:

The data were analysed using two-way ANOVA followed by a post hoc test.

Result:

It was found that the MHE 100% and 25% had a higher antibacterial activity of 27.8 ± 1.7 mm and 21.8 ± 1.0mm at 75 mg/ml, respectively compared to other groups. Extracts were found to have statistically significant (P ≤ 0.05) antimicrobial activity against Streptococcus Mutans.

Conclusion:

All the six groups used in the present study showed antibacterial efficacy and were effective against Streptococcus Mutans. Chlorhexidine continues to remain the gold standard. In comparison with control groups and extracts, MHE 100% showed a maximum zone of inhibition (27.8 ± 1.7 mm at 75 mg/ml) followed by other groups with statistically significant differences. Hence the herbal alternatives proved to be an effective and safe alternative and can be used as conventional modes of treatment.
Intraoperative Identification of Parathyroid Tissue Using the Ratio of Aspartate Transaminase to Lactate Dehydrogenase
Authors: Bhat Ganesh , Sooraj Rizhin , Mishra Anand K. , Ramakant Pooja , Rahalkar Ashwinee , Rana Chanchal , Ali Wahid , Singh Kul R.
Published: February 2025

Introduction:

Inadvertent devascularisation or removal of parathyroid glands (PT) during thyroidectomy necessitates their autotransplantation after Frozen section (FS). FS is time-consuming, tedious and expensive, disrupts the pathology department and is not universally available. This study aimed to determine the ratio of aspartate aminotransferase to lactate dehydrogenase (AST/LDH) of PT extracts to differentiate it from fat, thyroid, and lymph node (LN).

Methods:

This prospective study was conducted on all patients planned for any thyroid or parathyroid surgery. Intra-operatively, a 2.5 × 2.5 × 2.5 mm3 of the devascularised or inadvertently removed PT was excised, minced in 2 mL normal saline and the supernatant fluid was sent to the standard lab for AST/LDH estimation. The minced tissue was sent for histopathological examination for confirmation. Thyroid, LN and fat samples were taken as controls and analysed similarly. Parathyroid adenoma (PTA) was analysed separately.

Results:

The mean AST/LDH ratios of PT (0.311 ± 0.176) were significantly higher than that of thyroid, fat and LN. A cut-off of ≥0.165 for PT had a sensitivity and specificity of 83.8% and 83.1% against thyroid tissue, 83.8% and 74% against fat, and 83.8% and 100% against LN. AST/LDH ratio of PTA was found to be 0.318.

Conclusion:

AST/LDH ratio can be a simple, reliable, less labour-intensive method of identification of PT and can be a replacement for FS. The high specificity to differentiate an LN is clinically relevant in central compartment lymph node dissections with a higher probability of inadvertent removal or devascularisation of PT.
Endocrinology and Supernatural Beliefs; A Review
Authors: Khare Jaideep , Pendharkar Preeti S. , Kalra Sanjay , Jindal Sushil
Published: February 2025

Medical Science is ever-evolving, advancing and progressing for better understanding and management of diseases. However, despite these advancements and progression, even today we can find superstition, non-scientific thinking and supernatural beliefs influencing the way people think and behave to manage their diseases. Supernatural beliefs are beliefs in things that do not and cannot exist to the best of scientific knowledge, but which appear real to believers. Supernatural beliefs involve the acceptance of phenomena that transcend scientific understanding and can affect health behaviour and understanding. Endocrinology is the branch of science that deals with endocrine glands and hormones, which regulate mood, growth, development, metabolism and the way our organs work to maintain internal homeostasis. Supernatural beliefs may have an impact on endocrine health. So, in this review, we will discuss supernatural beliefs and endocrine health.
Unraveling BURnout Determinants among ENdocrinologists in Indian conText (UNBURDEN-IT)
Authors: Bhat Sowrabha , Mondal Sunetra , Nagendra Lakshmi , Bhattacharya Saptarshi , Boro Hiya , Dutta Deep , Kalra Sanjay , Bhadada Sanjay K. , Sahay Rakesh K. , Kumar Hari KVS
Published: February 2025

Introduction:

Burnout is a growing concern among healthcare providers, with varying prevalence by specialty. While reports suggest that up to half of endocrinologists experience burnout, few systematic studies exist to identify the factors responsible.

Methods:

We conducted an electronic survey of practicing endocrinologists across India. The survey included demographic information and a modified 10-item Mini-Z questionnaire.

Results:

The prevalence of self-reported professional burnout was 12.1% (n = 41) among 339 endocrinologists (236 males, 103 females) with a mean age of 42.5 years. About 25.4% reported a joyful workplace, 34.5% reported a highly supportive work environment, and 79.6% experienced a high work pace and documentation-related stress. Burnout was associated with younger age, fewer years in practice, increased working days, smoking, and lack of exercise (P < 0.03 for all). On logistic regression, smoking (OR: 8.18, 95%CI 1.97 – 33.9, P = 0.004) was positively associated with burnout, while daily exercise (OR: 0.3, 95%CI 0.11 – 0.78, P = 0.01) was negatively associated. Male endocrinologists (80.9%, P < 0.03) and those affiliated with academic institutions (86.5%, P < 0.03) expressed greater job satisfaction. Mini-Z scores positively correlated with age and years of practice (Pearson’s rho = 0.21, P < 0.001) and negatively correlated with daily working hours (Pearson’s rho = −0.15, P < 0.003) and days worked per week (Pearson’s rho = −0.18, P < 0.003).

Conclusion:

Professional burnout was lower among Indian endocrinologists compared to global data. The risk was higher among professionals early in their careers. Embracing a healthy lifestyle including exercise and refraining from smoking are effective coping strategies.
Role of Anabolic Anti-Osteoporosis Therapy in Diabetes Subjects
Authors: Durgia Harsh , Palui Rajan , Sahoo Jayaprakash , Kamalanathan Sadishkumar , Naik Dukhabandhu
Published: February 2025

Diabetes mellitus (DM) is a metabolic disorder that leads to the destruction of various tissues including bones. The pathogenesis of osteoporosis (OP) varies in DM due to many specific factors. DM increases the risk of fracture as well as post-fracture mortality. It is because of this fact that OP treatment should not be neglected in patients with DM. OP therapy comprises anabolic as well as anti-resorptive agents. Primary OP as observed in post-menopausal women is associated with high bone turnover, whereas OP in DM is a disease of low bone turnover. Therefore, anabolic agents seem to be quite promising in cases of OP in DM. Although the anti-fracture efficacy of these drugs is proven beyond any doubt in the general population without DM, evidence in persons with DM is limited. Among the anabolic agents, teriparatide has the most evidence in favor of its efficacy and safety in persons with DM. Studies evaluating other anabolic agents such as abaloparatide and romosozumab in diabetic osteopathy are scarce in the literature. Future studies specifically in both type 1 and type 2 DM populations are needed to evaluate the effects of osteoanabolic agents.
The Role of Statins in Managing Chronic Kidney Disease: A Comprehensive Review
Authors: Toshniwal Saket Satyasham , Avinash Parepalli , Loya Anand , Toshniwal Tejas , Kumar Sunil , Acharya Sourya
Published: February 2025

This comprehensive review examines the multifaceted role of statins in managing chronic kidney disease (CKD), highlighting their impact beyond traditional lipid-lowering functions. CKD poses a significant global health challenge due to its association with elevated cardiovascular risks. Statins, known primarily for lowering cholesterol, have been explored for their potential benefits in both cardiovascular and renal aspects of CKD. This review discusses statins’ mechanisms of action, including lipid-lowering effects, anti-inflammatory properties, and potential reno-protective mechanisms. By evaluating evidence from clinical studies, it addresses the impact of statins on cardiovascular outcomes, atherosclerosis reduction, and renal function, specifically in terms of proteinuria and glomerular filtration rate. Addressing safety concerns, it also delves into common side effects, monitoring strategies, and considerations for CKD patients. Challenges and controversies surrounding statin therapy, such as individual variability, applicability across CKD stages, and long-term effects, are thoroughly examined. The implications for clinical practice underscore the need for a personalized approach, while the conclusion emphasizes the evolving role of statins as crucial components in the comprehensive management of CKD, highlighting potential benefits and challenges in this complex landscape.
Systematic review of branched-chain amino acid supplementation high in leucine on interleukin-6
Authors: Wulandari Yohannessa , Sunardi Diana
Published: February 2025

Background: Inflammation-induced muscle catabolism and atrophy are well-documented phenomena often associated with elevated interleukin-6 (IL-6) levels. Branched-chain amino acids (BCAA), especially leucine, play essential roles in suppressing IL-6 expression and secretion through the mammalian target of rapamycin (mTOR) signaling pathway, and their administration is known to enhance muscle recovery. Aims: This review explores the impact of branched-chain amino acid supplementation on inflammation, explicitly focusing on interleukin-6 levels. Methods: The literature search was conducted across the Embase, Cochrane, PubMed, and Scopus databases using search terms such as ((((BCAA administration) OR (branched-chain amino acid administration)) OR (leucine administration)) AND (interleukin 6)) OR (IL 6). The articles published between 2013 and 2023 were selected. The quality of the included studies was assessed using the Oxford Centre for Evidence-Based Medicine and the Jadad Scale. Results: Thirteen studies involving 770 subjects were included in the analysis. Results revealed variability in the effects of BCAA on IL-6 levels. Some studies reported significant impacts, while others did not. Notably, post-exercise IL-6 levels increased in most cases, and BCAA supplementation was suggested to attenuate this response potentially with variation of dosage, intervention forms, and duration. Conclusion: BCAA supplementation toward IL-6 levels is still ambiguous, yet potential benefits were suggested. Future investigations are needed to refine our understanding of the complex interplay between BCAA and IL-6 and for near-future clinical recommendations.
Role of Multiple Cervical Biopsies on Colposcopy for the Detection of Premalignant and Malignant Lesions of the Cervix
Authors: Kaur Guneet , Shivani  , Zutshi Vijay , Yadav Amit Kumar
Published: February 2025

Introduction:

Cervical cancer screening is done by various methods like pap smear testing, visual inspection with acetic acid (VIA) and visual inspection with lugol’s iodine (VILI), and HPV DNA testing. All screen-positive women are subjected to colposcopy, and colposcopic-directed biopsy is taken from the abnormal area, and sent for histopathology, which is the gold standard for diagnosing premalignant and malignant lesions cervix. Colposcopy has some limitations because it is a subjective test, and its accuracy relies on the physician’s experience and performance to a great extent. To improve the detection of cervical intraepithelial neoplasia (CIN)2+ lesions various studies have suggested taking multiple cervical biopsies from colposcopy-positive as well as negative areas.

Objective:

To study the role of four quadrant cervical biopsy on colposcopy to detect premalignant and malignant lesions of the cervix.

Materials and Methods:

This cross-sectional study was carried out on 100 women after obtaining ethics committee approval. Women in the age group of 21–65 years with any of the screening tests positive and with abnormal colposcopic findings were subjected to four quadrants cervical biopsy, directed biopsy from colposcopically abnormal quadrant and nondirected biopsy from colposcopically normal quadrant along with endocervical curettage (ECC).

Results:

The mean age was 41.27 years and most women had an age <20 years at the time of first sexual contact. About 95% of women had parity ≥3. On nondirected biopsy, 33.6% of premalignant lesions and 1% of malignant lesions were picked up, while 37.8% of lesions were benign on directed biopsy. Twelve percent additional CIN lesions were picked up by nondirected biopsy which could have been missed by directed biopsy. ECC in our study could pick up 2% of CIN lesions when Transformation Zone (TZ) was type 1, while 10% of CIN lesions were picked up in TZ type 2/3. The sensitivity, specificity, positive predictive value, and negative predictive value of colposcopy in predicting premalignant and malignant lesions of the cervix using the Modified Reid Colposcopic Index were 51.7%, 46.8%, 47.6%, and 50.9% respectively.

Conclusions:

In addition to biopsies from colposcopy-positive areas, biopsies should be taken from colposcopy-negative quadrants of the cervix in women with abnormal screening tests. ECC should be performed when the TZ type is 2/3.
Recurrent Vulvovaginal Infections: Etiology, Management Strategies, and Challenges in Prevention
Authors: Kumar Rajiv , Yadav Garima
Published: February 2025

Recurrent vulvovaginal infections, including bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and Chlamydia trachomatis infections, are common yet persistent health issues affecting many women. Characterized by symptoms such as itching, discharge, and discomfort, these infections can significantly impair quality of life. Understanding their causes, management, and recurrence factors is essential for effective treatment. BV is primarily caused by a dysbiosis of vaginal flora and biofilm formation, with Gardnerella vaginalis commonly implicated in recurrences. Incomplete treatment, biofilm resistance, and antimicrobial resistance are key factors. Extended regimens with metronidazole or boric acid are options for recurrent BV management. For VVC, Candida albicans and nonalbicans species contribute to recurrences, often requiring extended antifungal regimens. In recurrent vulvovaginal candidiasis, genetic and immunological factors also play roles. Management includes induction and maintenance treatments with fluconazole or topical antifungals, especially in pregnancy. In C. trachomatis infections, treatment focuses on symptom relief, preventing complications, and minimizing reinfection risks, with doxycycline or azithromycin as first-line options. Reinfection from untreated partners is a common recurrence cause. Partner therapy and follow-up testing are crucial across all infections to ensure complete resolution and prevent recurrences. A literature search was conducted in PubMed to identify articles addressing recurrent vulvovaginal infections.
Endometrial Actinomycosis in a Patient with Uterine Leiomyoma and Abnormal Uterine Bleeding in the Absence of an Intrauterine Contraceptive Device: A Rare Case Report
Authors: Kumar Dinesh , Yadav Garima , Aggarwal Divya , Singh Pratibha
Published: February 2025

Abnormal uterine bleeding (AUB) can occur due to various reasons in females according to their age and most prevalent risk factors. Among them, uterine fibroids are the most common cause of AUB in perimenopausal females. Endometrial actinomycosis is seen sometimes in females with Intrauterine contraceptive devices, but isolated endometrial actinomycosis is very rare, and as per our knowledge, only four cases are reported; among them, two cases are of ovarian actinomycosis, one endometrial actinomycosis in virgin female and one in a postmenopausal female. This case was interesting, as our patient who was perimenopausal and immunocompetent presented with AUB and was diagnosed to have endometrial actinomycosis along with a large leiomyoma.
The reasons for the decrease in learning motivation of medical students in South Iran
Authors: Kojouri Javad , Charkhandaz Maryam , Hojat Mohsen
Published: February 2025

BACKGROUND:

Numerous studies have shown that the motivation of medical students has decreased. If we know what factors decrease motivation, we can predict and reinforce learning behaviors in medical students. This study aimed to explore and explain the reasons for the decrease in the motivation of medical students at Jahrom University of Medical Sciences, Iran.

MATERIALS AND METHODS:

A qualitative design based on the conventional content analysis approach was used. This study was conducted at Jahrom University of Medical Sciences in 2019–2021. Data were drawn from 24 semi-structured interviews with 52 medical students in the third year to seventh year. Purposeful sampling was performed. The average interview time was (53.42 ± 22.18) minutes. The 12 individual interviews and five focus group discussions (40 participants) were immediately verbatim and analyzed by the Colaizzi method by Max-Q (2014) data software.

RESULTS:

The mean age was (22/30 ± 2/16). The mean grade was (13.34 ± 1.28). After conducting 24 semi-structural interviews, 180 in vivo codes, 17 primary codes, six sub-categories, and two main categories were obtained. Two main categories consist of the Cultural and Socio-Economic Capital Damaged and Unmotivated Educational System.

CONCLUSION:

Paying attention to the educational culture of the university and the economic, social, and cultural conditions of the society is necessary to improve students’ lack of motivation.
Evaluation of educational environment using the short-version Postgraduate Hospital Educational Environment Measure (PHEEM): A multicenter study
Authors: Shavoun Amin Hoseini , Mirzazadeh Azim , Kashani Homa , Raeeskarami Seyed Reza , Gandomkar Roghayeh
Published: February 2025

BACKGROUND:

The quality of the educational environment (EE) influences residents’ achievement of learning outcomes and their professional development. The purpose of this study was to evaluate the EE using the short-version Postgraduate Hospital Educational Environment Measure (PHEEM) and compare residents’ perceptions in total and subscale PHEEM according to their age, sex, residency year, and specialty.

MATERIALS AND METHODS:

This multicenter cross-sectional study was conducted at 12 teaching hospitals affiliated with the Tehran University of Medical Sciences. We recruited residents from 24 specialties and from the first to third/fourth residency years. Data were collected using the short-version PHEEM, which consists of 12 items with three subscales: senior doctor support and teaching skills (4), conditions of working and time to learn (4), and lack of harassment (4). The association between scores in total and each subscale with sex, residency year, and specialty was assessed.

RESULTS:

In total, 538 residents from 24 specialties completed the questionnaire. Most participants were from internal medicine (n = 72, 13.4%). A total of 347 (64.5%) participants were females. The total PHEEM score was 20.60 (standard deviation (SD) 5.44) out of 48, with occupational medicine residents giving the highest scores and forensic medicine residents the lowest. The mean scores for the dimensions of senior doctor support and teaching skills were 7.55 (SD 2.87), for conditions of working and time to learn 6.08 (SD 3.94), and 6.95 (SD 3.22) for lack of harassment. There was no significant difference in total PHEEM scores for males and females. However, significant differences were found in subscales by sex. There were no statistically significant differences in residents’ perceptions of the EE (total and subscales) according to their residency years, but there were significant differences between the specialties (P < 0.001).

CONCLUSIONS:

The EE of the residency training program during COVID-19 was perceived to have plenty of problems that need immediate attention and follow-up.