bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiproliferative potential of Plinia edulis leaves
Authors: Ishikawa Tati , Yamaguchi Lydia Fumiko , Barros Silvia Berlanga de Moraes , Rodas Andrea Cecilia Dorión , Higa Olga Zazuco , Ruiz Ana Lúcia Tasca Gois , Varanda Eliana Aparecida , Kato Edna Tomiko Myiake
Published: September 2024

Plinia edulis, popularly known as ‘cambucá’, is used in Brazilian folk medicine to treat several conditions. The aim of this study was to evaluate the mutagenicity and cytotoxicity of cambucá leaf extract, as well as its antioxidant activity. The ‘Ames’ test and Orac assay were used to evaluate the mutagenicity and antioxidant activity, respectively, and the phytochemical analysis of the ethanol leaf extract (LE) was performed by chromatographic and spectrometric methods. The in vitro cytotoxicity was tested on CHO (Chinese Hamster Ovary) cells and on nine human tumor cell lines. Phytochemical analysis of LE has revealed the presence of triterpenes and flavonoids. The LE did not show mutagenicity at the concentration of 20 mg plate-1 and exhibited high antioxidant activity, with Orac value of 3948 µmol TE g-1. The LE and its fractions (ethyl acetate; methanol) showed antiproliferative activity against cancer cell lines and proliferative activity in normal cells. The ethyl acetate fraction was the most active extract, presenting antiproliferative activity against strains of breast cancer, prostate cancer, colon cancer, lung cancer, melanoma and leukemia (GI50 0.01-8.57 µg mL-1), being more effective than the reference drug (doxorubicin) against human breast adenocarcinoma MCF-7 cell line. These results suggest P. edulis as a potential adjuvant in cancer therapy and chemoprevention.
The G Protein–Coupled Receptor GPR56 Is an Inhibitory Checkpoint for NK Cell Migration
Authors: Palacios Daniel , Majhi Rakesh Kumar , Szabo Edina K , Clement Dennis , Lachota Mieszko , Netskar Herman , Penna Leena , Krokeide Silje Z , Vincenti Marianna , Kveberg Lise , Malmberg Karl-Johan
Published: September 2024

G protein–coupled receptors (GPCRs) represent the largest family of surface receptors and are responsible for key physiological functions, including cell growth, neurotransmission, hormone release, and cell migration. The GPCR 56 (GPR56), encoded by ADGRG1, is an adhesion GPCR found on diverse cell types, including neural progenitor cells, melanoma cells, and lymphocytes, such as effector memory T cells, γδ T cells, and NK cells. Using RNA-sequencing and high-resolution flow cytometry, we found that GPR56 mRNA and protein expression increased with NK cell differentiation, reaching its peak in adaptive NK cells. Small interfering RNA silencing of GPR56 led to increased spontaneous and chemokine-induced migration, suggesting that GPR56 functions as an upstream checkpoint for migration of highly differentiated NK cells. Increased NK cell migration could also be induced by agonistic stimulation of GPR56 leading to rapid internalization and deactivation of the receptor. Mechanistically, GPR56 ligation and downregulation were associated with transcriptional coactivator with PDZ-binding motif translocation to the nucleus and increased actin polymerization. Together, these data provide insights into the role of GPR56 in the migratory behavior of human NK cell subsets and may open possibilities to improve NK cell infiltration into cancer tissues by releasing a migratory checkpoint.
Context factors for implementation of clinical recommendations for chronic musculoskeletal pain
Authors: Ernstzen Dawn V. , Louw Quinette A.
Published: September 2024

Background: Implementing evidence-informed clinical practice recommendations is important for managing chronic musculoskeletal pain (CMSP) to address the multidimensional impact of the condition. Successful implementation of recommendations requires understanding the multiple context factors that influence CMSP management in different settings.Aim: This study aims to explore contextual factors that could influence the implementation of evidence-informed clinical practice recommendations for the primary health care of adults with CMSP.Setting: The study focused on the primary health care (PHC) sector in Cape Town, South Africa.Methods: A qualitative descriptive study was conducted. A multidisciplinary panel of 13 local health care professionals participated in focused group discussions. The participants considered multimodal clinical recommendations derived from published clinical practice guidelines. In four focus group discussions (three or four members per group), the panel generated and documented context factors that would influence implementing the recommendations in practice. Inductive content analysis was performed to identify categories and themes.Results: The five contextual themes generated indicated health care system organisation, human resource requirements, provider practice patterns, patient empowerment and integration into policy as imperative for the successful implementation of recommendations.Conclusion: There are diverse context factors that could influence the implementation of clinical recommendations for managing CMSP in PHC settings. Identifying these factors as barriers or facilitators is beneficial for developing effective knowledge translation strategies.Contribution: The study findings indicate that an integrated systems approach supported by health care policy and multisectoral collaboration is needed to successfully implement clinical recommendations to address the impact of CMSP.
An Evaluation of Mental Health Knowledge and Stigma in Medical College Students in Rural Western Maharashtra
Authors: Waghjale Shatakshi Ramesh , Arya Ashish Baldev , Ubhale Ashish Suresh
Published: September 2024

Background:

As per the World Health Organization, stigma is a major barrier to get professional psychological help. Various studies have pointed to the need for shifting focus to enhance the knowledge of doctors and medical students in whom mental health issues are very common and can eventually lead to unfavorable outcomes for the students as well as the whole society.

Materials and Methods:

A cross-sectional study on MBBS UG students from a private medical college was conducted. Three scales, Mental Health Knowledge (MAK) Schedule, Stigma Scale of Seeking Help (SSOSH) Scale, and Stigma Scale for Receiving Psychological Help (SSRPH), were used.

Results:

Total 515 responses were received, out of which 47% were male and 53% were female. Overall, on the SSRPH and SSOSH Scale, the mean score was 6.02 and 29.67, whereas standard deviation (SD) 2.75 and 2.69 respectively, which showed that stigma was moderate among students. The MAK Scale showed that students have a high level of knowledge, with a mean score of 44.31 and SD 8.49. Furthermore, there is a negative correlation between MAK and SSRPH and SSOSH, as suggested by Pearson’s coefficient −0.25 and −0.41, respectively.

Conclusion:

The students showed moderate degrees of stigma, and they displayed a high level of knowledge in regard to mental health. The results likewise found that there is a negative correlation between the stigma and the degree of knowledge in regard to mental health. It shows up from this that raising information about mental health could possibly reduce stigma and encourage students in medical colleges to look for therapy when they need it.
Comparison between Combination of Proximal Adductor Canal Block and Infiltration between Popliteal Artery and Capsule of Knee (iPACK) with Large-Volume Distal Adductor Canal Block in Facilitating Early Mobilization after Total Knee Replacement: A Randomized, Single-Blind Study
Authors: Pryambodho Pryambodho , Kwan Lawrence , Tantri Aida Rosita , Lubis Andri Maruli Tua
Published: September 2024

Background:

Adductor canal block (ACB) and infiltration between popliteal artery and capsule of knee (iPACK) are popular block methods for analgesia after total knee replacement (TKR), covering both the anterior and posterior knee. This study aimed to compare the performance of the combination of ACB and iPACK with large-volume distal ACB in facilitating early mobilization after TKR.

Patients and Methods:

This study was a single-blind, randomized, controlled trial of 30 subjects who underwent TKR. Subjects were randomly assigned to either Group A (the large-volume distal ACB) or Group B (the combination of proximal ACB and iPACK). Outcome variables included postoperative time up and go (TUG) test, numeric rating scale (NRS), postoperative morphine consumption, block-performing time, time to first opioid rescue analgesia, and side effects.

Results:

This study found that the block-performing time was significantly shorter in Group A compared to Group B (230.67 vs. 509.67, P < 0.001). The mean postoperative TUG test (67 vs. 64, P = 0.78), NRS at all-time points, and postoperative morphine consumption (3 vs. 3 mg, P = 0.85) did not differ significantly. No block-related side effects were found in either group.

Conclusion:

Large-volume distal ACB is not superior to the combination of proximal ACB and iPACK in facilitating early mobilization after TKR. Block-performing time of distal ACB was shorter compared to the combination of proximal ACB and iPACK.
Intubation Learning Curve with the HugeMed Video Laryngoscope among Anesthesiology Postgraduate Students: An Observational Study
Authors: Naithani Udita , Khatri Siddharth , Jain Shweta , Sethi Surendra Kumar , Choudhary Santosh , Sharma Chandra Prakash
Published: September 2024

Background:

Video laryngoscopy (VL) facilitates intubation by providing an indirect view of the glottis. To determine VL intubation success, establishing its learning curve is important. This study aimed to evaluate the learning curve of VL intubation in anesthetized patients, performed by anesthesiology postgraduate (PG) students.

Materials and Methods:

Thirty-six anesthesiology PGs with a direct laryngoscopic (DL) intubation experience of >1 year, but new to VL, participated in this study. Each PG performed five VL intubations in anesthetized patients having normal airways (total 180 VL intubations). The primary outcome variable was intubation time, and the secondary outcome measures were first attempt success rate and difficulties encountered.

Results:

Mean intubation time decreased significantly from the first VL experience [57.81 s (95% CI 52.09–63.54)] to the fifth VL experience [24.14 s (95% CI 22.28–25.99)], P < 0.001. The first attempt success rate showed a significant increase from 83.3% (n = 30) in the first, 97.2% (n = 35) in the second, and 100% (n = 36) in the next three VL experiences (P < 0.001). The incidence of difficulty in laryngoscopy and endotracheal tube (ETT) insertion progressively decreased in successive VL experiences, and by the fifth VL experience, none of them faced any difficulty (P < 0.001).

Conclusion:

The learning curve of VL intubation showed a significant reduction in intubation time and improvement in the first attempt success rate over successive experiences, emphasizing the need for prior training even if the user is familiar with the process of DL intubation.
Successful Anesthesia Management in Landau–Kleffner Syndrome Undergoing Laparoscopic Surgery: A Case Report
Authors: Uslu Ahmed , Çekmen Nedim
Published: September 2024

Landau–Kleffner syndrome (LKS), also known as acquired epileptic aphasia, is a childhood disease associated with acquired aphasia and epileptiform abnormalities on the electroencephalographic. We report the uneventful anesthesia management of a 17-year-old female patient with LKS syndrome. Her vital signs and laboratory results were normal, and plasma levels of valproic acid (73.6 µg/mL) were within therapeutic limits. She had mild micrognathia, short thyromental distance, and normal neck movements and mouth opening. An intravenous induction was performed with 100 mg lidocaine, 100 µg fentanyl, 200 mg propofol, and 60 mg rocuronium intravenously. After preoxygenation with 80% O2 for 3 min, she was intubated without complications with a number 7.5 mm endotracheal tube connected to a ventilator. Anesthesia maintenance was provided with 2.2% sevoflurane and 50% oxygen–50% air mixture, 0.01–0.05 μg/kg/min infusion of remifentanil. The target partial pressure of carbon dioxide was 30–35 mm Hg. Care was taken to ensure that intra-abdominal pressure did not exceed 14 mm Hg. Spontaneous breathing returned in 5 min after discontinuation of sevoflurane. She was extubated after following commands and transferred to the post-anesthesia care unit. It is unknown whether general anesthesia has a short- or long-term effect on patients with LKS. Since epileptic seizures are essential in patients with LKS, the correct selection of anesthetic agents is significant. In addition, hypoxemia, hypercarbia, hypocapnia, high positive end-expiratory pressure, and acidosis should all be avoided as they may trigger seizure activity.
Modified Ultrafiltration Technique in Valvular Heart Surgery: A Case Series
Authors: Kharmayani Made Ryan , Soenarto Ratna Farida , Alatas Anas , Putra Muhammad Arza
Published: September 2024

Application of cardiopulmonary bypass (CPB) in cardiac surgery may cause systemic inflammatory reactions, possibly causing clinical sequelae and multiple organ failures such as systolic or diastolic dysfunction, regional or global left ventricle or right ventricle low contractility, and the function of vascular tone. The use of drugs (i.e., corticosteroids) and the ultrafiltration method during the CPB application has been known to prevent or minimize the complication of CPB in cardiac surgery. One of the non-pharmacological approaches to minimize those inflammatory responses is the modified ultrafiltration (MUF) technique. Theoretically, this is due to ultrafiltration which may reduce the interstitial fluid and inflammatory mediator. MUF can be used to counteract inflammatory responses in pediatric cardiac surgery. This ultrafiltration method became a recommended procedure in minimally invasive surgery and conventional open-heart surgery. However, studies about effectiveness in adults are limited. In this case series, the MUF technique was used in three patients who underwent valvular heart surgery with a CPB machine. Following the application of the CPB, the MUF technique is performed for 10 min at a speed of no more than 10% full flow. Hemodynamic measurements and interleukin-6 (IL-6) levels were taken during surgery and 24 h post-CPB. At 24 h post-CPB, the vasoactive inotropic score and duration of mechanical support use were less than 20 and 18–24 h, respectively, and the IL-6 level ranged from 7.22 to 14.22 pg/mL. The cardiac index increased, ranging from 2.43 to 3.47 L/min/m2, and pulmonary vascular resistance decreased, ranging from 78 to 146 dyne s/cm5.
Predictors of Renal Replacement Therapy in Cardiac Surgery-Associated Acute Kidney Injury Patients: A Single-Centered, Retrospective Study
Authors: Adriane Prieta , Ardiyan Ardiyan , Dewi Ni Luh Kusuma , Andria Krisna
Published: September 2024

Background:

Studies have reported that cardiac surgery-associated acute kidney injury (CSA-AKI) patients requiring dialysis or renal replacement therapy (RRT) have a higher risk of in-hospital mortality. This study aimed to investigate the predictors contributing to postoperative RRT.

Materials and Methods:

This retrospective observational study was conducted at a single cardiovascular center. Patients who underwent cardiac surgery complicated with CSA-AKI in the intensive care unit (ICU) from January 2020 to December 2022 were included. They were categorized into two groups: those who required RRT (group A, n = 302) and those who did not (group B, n = 811). Bivariable and multivariable analyzes were conducted to compare the risk with odds ratio (OR) for in-hospital mortality between those groups.

Results:

We analyzed 1113 patients (29.4%) in the final analysis. The in-hospital mortality rate was 31.8% vs. 4.2% (OR = 10.6, P < 0.001). Variables that significantly predicted postoperative RRT requirements in CSA-AKI patients included female sex (P = 0.038), coronary artery bypass graft (P = 0.001), multiple valves surgery (P = 0.032), diabetes (P = 0.01), renal disease (P = 0.005), postoperative serum creatinine >3.0 mg/dL (P < 0.001), mechanical ventilation use of ≥48 h (P < 0.001), ICU length of stay of >5 days (P < 0.001), use of more than two inotropes and vasoactive agents, (P < 0.001), and postoperative intra-aortic balloon pump (IABP) (P < 0.001).

Conclusion:

CSA-AKI patients who require dialysis are associated with a higher mortality. Predictors of postoperative RRT included female sex, certain types of surgery, diabetes, postoperative serum creatinine >3.0 mg/dL, mechanical ventilation use of ≥48 h, ICU length of stay of >5 days, use of more than two inotropes and vasoactive agents, and postoperative IABP.
Anesthesia Management of a Patient with Idiopathic Thrombocytopenic Purpura Undergoing Laparoscopic Esophageal Hiatal Hernia Surgery: A Case Report
Authors: Seri Zoukou Marie France Dominique , Uslu Ahmed , Çekmen Nedim
Published: September 2024

Perioperative management of patients with immune thrombocytopenic purpura (ITP) has significant challenges for anesthesiologists. Perioperative bleeding due to thrombocytopenia in patients with ITP can be an essential challenge and is the most significant risk to anesthetists. Laparoscopic surgery can also be an additional challenge in such patients because of the risk of pneumoperitoneum that can lead to hemodynamic instability and bleeding deterioration. We present a 77-year-old successful anesthesia management of a female patient with ITP who underwent elective laparoscopic esophageal hiatal hernia surgery. A multidisciplinary team approach and comprehensive perioperative assessment and treatment are critical to ensure successful perioperative management of patients with ITP. We also aim to suggest that intravenous immunoglobulins therapy is not always mandatory in perioperative management of patients with ITP.
Preventive Effect of Ultraviolet Photofunctionalization on Peri-implant Biofilm Formation: An In vivo Randomized Study
Authors: Goel Akanksha , Swami Vinit , Patil Amol Somaji , Swami Vasanthi Vinit
Published: September 2024

Background:

Peri-implant biofilm formation due to local bacterial colonization is one of the important factors for the instability of temporary anchorage devices (TADs).

Aim:

The aim of this study was to quantify and compare the colonization of Streptococcus sanguinis on ultraviolet (UV) treated and untreated titanium TADs.

Materials and Methods:

This prospective, in vivo study included 20 subjects requiring orthodontic treatment with first premolar extraction, followed by retraction of the anterior teeth with absolute anchorage using TADs. TADs were placed interdentally, in the keratinized tissue between the upper second premolar and the first molar on the buccal side, at the mucogingival junction. It was a split-mouth study where one side of TAD was UV-treated for 15 min, and the other side was kept untreated as a control. TADs were removed after 6 months for S. sanguinis quantification on both sides and were compared for biofilm reduction.

Statistical Analysis:

Statistical software was used to perform unpaired t-tests for the individual samples as well as for comparing total UV-treated and untreated samples. P <0.05 was considered significant.

Results:

The mean bacterial count (per ml) was found to be 2.2 × 106 copy numbers and 8.9 × 106 copy numbers in the UV group and untreated group, respectively. The total count of bacteria was found to be less in the UV-treated group compared to the untreated group.

Conclusions:

The study concludes that UV photofunctionalization results in a significant reduction of S. sanguinis colony on TADs with reduced chances of failure due to inflammation.
Atypical Presentation and Surgical Management of Ectopic Mandibular Third Molar in Subcondylar Region: A Rare Case Report
Authors: Khandelwal Pulkit , Saluja Harish , Shah Seemit , Dadhich Anuj
Published: September 2024

Ectopic teeth arise from developmental abnormalities and can be supernumerary, deciduous, or permanent teeth. They can cause orofacial pain, swelling, and infection. There is a major paucity in literature about ectopic mandibular third molar (EMTM) and its causes, symptoms, and treatment. We present an unusual case of EMTM in the mandibular subcondylar region and its surgical management. A 58-year-old female reported with complain of pain and swelling in the right preauricular region. On radiographic assessment, the right mandibular third molar was ectopically present in the subcondylar region and associated with a small dentigerous cyst. Complete removal of cystic lining and extraction of EMTM was done under general anesthesia using a retromandibular approach. After surgery, there was a complete resolution of symptoms within 1 month with uneventful healing and no postoperative complications.
Technique for Spacer Adaptation and Custom Tray Fabrication in Impression Making for Fixed Prosthodontics
Authors: Nanda Aditi , Koli Dheeraj Kumar , Kaur Harsimran
Published: September 2024

The objective is to minimize the inaccuracies in two-step impressions by homogenizing the polymerization shrinkage of elastomeric impression material in fixed prosthesis fabrication. The objective is accomplished by the technique of spacer adaptation and custom tray fabrication for two-step impressions. The technique makes the use of two vacuum-adapted spacers, selected based on the viscosity of elastomeric impression, and a vacuum-adapted custom tray. The procedure of using the specially fabricated custom tray for impression making is also presented. Consistent thickness of the two different viscosities of impression material is maintained due to vacuum adaptation of the spacers. This homogenizes the polymerization shrinkage of the elastomeric material in different regions of impression, as uniform space is occupied by the material in the space created by the spacer. The procedure of vacuum adaption of the tray material also limits the dimensional change of the tray. The technique minimizes the inaccuracies of impression by homogenizing the polymerization shrinkage of the elastomeric impression, thus promising a well-fitting prosthesis.
A Single-Step Root Coverage Procedure Using Modified Bridge Flap Technique and De-epithelialized Gingival Unit Graft: A Prospective Clinical Study
Authors: Katti Neelima , Mohanty Devapratim , Srivani Peri , Siddiqui Humaira , Raj Subash Chandra , Baral Debajani
Published: September 2024

Background:

The mucogingival conditions associated with the recession defects at the mandibular anterior region, not only make plaque control difficult to be performed by the patient but also pose a problem in passively advancing the tissues at the recipient site. This surgical technique is used to treat multiple recession defects in the mandibular anterior region.

Materials and Methods:

Twenty-five sites in 17 subjects (11 women and 6 men) underwent modified bridge flap and de-epithelized gingival unit graft (d-GUG) as a single-step treatment modality to cover the denuded root surface, as well as increase the width of keratinized gingiva in recession type 1 gingival recession defects in the mandibular anterior region.

Results:

Nearly 60% of sites in our study showed complete root coverage, with a mean root coverage percentage of 88.08%. Furthermore, keratinized tissue width, keratinized tissue thickness as well as vestibular depth showed statistically significant increases as compared to baseline levels.

Conclusion:

Thus, the modified bridge flap technique using d-GUG within the limitations of our study design, showed promising results in terms of recession coverage as well as management of the difficult mucogingival conditions at the mandibular anterior region.
Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor) as a Rare Entity on Upper Lip: A Case Report and Review
Authors: Shetty Lakshmi , Raut Shreya Jeetendra , Camblay Gauri , Brahma Tirtha Raj
Published: September 2024

Masson’s tumor is a benign intravascular lesion of proliferating endothelial cells that accounts for 2% of vascular and subcutaneous lesions. It manifests clinically as a bluish swelling, resembling a mucocele or hemangioma. Intravascular papillary endothelial hyperplasia (IPEH) was coined by Clearkin and Enzinger in 1976 to describe reactive vascular expansion, following traumatic vascular stasis mimicking angiosarcoma. Clinically, this condition manifests as a bluish enlargement resembling a mucocele or hemangioma. We reported a rare case of IPEH located on the upper lip in an 18-year-old female. A diagnosis of IPEH was reported based on the histopathological findings of papillary proliferating endothelial cells with engorged red blood cells. There was no evidence of recurrence after 6 months of follow-up.
Benign Fibrous Histiocytoma of Gingiva: A Rare Case Report
Authors: Sangala Bhavani Nagendra , Jawdekar Ashwin , Choudhari Sheetal S. , Tank Urvashi R. , Buva Kirti Balkrishna , Deshpande Sneha Masne
Published: September 2024

Fibrous histiocytoma is a benign soft-tissue neoplasm that commonly involves the dermis. It is rare in the oral cavity. This lesion creates a diagnostic dilemma due to its nonspecific clinical appearance and microscopic similarities with other benign fibrous tissue lesions. Microscopically, it shows the proliferation of both spindle-shaped fibroblasts and histiocytes. Surgical excision is the treatment of choice with a good prognosis. The purpose of this paper is to report a rare case of gingival benign fibrous histiocytoma occurring in an 11-year-old female patient. The diagnosis of this lesion is based on combined clinical, histopathological, and immunohistochemical features.
Variations in Root Canal Morphology of Mandibular Incisors in a North Indian SubPopulation: A Retrospective Cone-Beam Computed Tomography Analysis
Authors: Kaur Brar Prabhleen , Rajdeep Brar , Ruchi Vashisht , Nishant Mehta , Richa Shrivastava , Rigzin Tamchos
Published: September 2024

Background:

There is a high failure rate of endodontic treatment in the mandibular incisors due to insufficient knowledge of the morphology.

Aim:

The aim of this study was to analyze the root canal morphology in mandibular incisor teeth in the North Indian subpopulation to improve the outcome of endodontic treatment.

Setting and Design:

A cross-sectional study was conducted at the OPD of a tertiary care institute.

Materials and Methods:

A total of 200 mandibular central incisors and 200 mandibular lateral incisors were selected from available cone-beam computed tomography examinations of 100 patients aged 18–79 years. They were evaluated for root canal system configuration and symmetry between right and left elements in the same individual.

Statistical Analysis:

Chi-square/Fisher’s exact test was used to find the association between different study variables.

Results:

For mandibular central incisors, type I Vertucci classification was present in 69% of cases, type II in 3.5%, type III in 18.5%, type IV in 2%, and type V in 7% of cases. For mandibular lateral incisors, type I was present in 70.5% of cases, type II in 4% of cases, type III in 19.5%, type IV in 2%, and type V in 4% of cases. There was no evidence of types VI, VII, and VIII. Symmetry of root canal morphology between left and right teeth was observed in 90% of central incisors and 93% of lateral incisors.

Conclusion:

Type I Vertucci configuration was the most prevalent; however, the prevalence of other configurations is also evident. Therefore, endodontists should explore the morphology of these teeth carefully while performing root canal treatments.
Etiology, Diagnosis, and Treatment Strategy of Dental Therapy-related Subcutaneous Emphysema
Authors: Sun Jinghua , Zhang Luyang , Zhang Chen , Hou Benxiang
Published: September 2024

Subcutaneous emphysema (SE) is defined as localized tissue swelling caused by gas entering subcutaneous tissue through a tissue gap. Although SE is usually a nonfatal and self-limiting disease, in severe cases, the gas may spread to the neck, mediastinum, and chest, leading to mediastinal emphysema and other serious complications. This article aims to explore the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, and treatment strategy of SE related to dental therapy, to provide some reference for dentists.
Evaluation of Dental Implant Stability in Narrow Alveolar Ridges Utilizing Osseodensification Technique Versus Screw Expansion: A Randomized Single Blinded Clinical Trial
Authors: Tofan Nawfal Hasan , Hussaini Ali H Abbas
Published: September 2024

Introduction:We aimed to compare the implant stability quotient (ISQ) values of endosteal dental implants (DIs) inserted into narrow alveolar ridges via osseodensification (OD) versus manual screw expansion (SE).Methods:Nineteen patients were randomized into two groups. The patients ranged in age from 21 to 59 years, with 46 implant osteotomy sites and 41 DIs. Twenty DIs were installed using OD drilling (OD group), and 21 DIs were inserted using manual screw expander drills (SE group). Primary stability was measured at the surgery time, and secondary stability was measured at the 24th week using the Osstell ISQ device. A probability value < 0.05 was considered to be statistically significant.Results:No statistical difference was observed between the mean values of primary stability of the OD (ISQ: 67.06 ± 4.41) and SE (ISQ: 67.76 ± 4.79) groups (P = 0.518). No statistical difference was noted between the mean values of secondary implant stability of the OD (ISQ: 68.53 ± 6.70) and SE (68 ± 5.68) groups (P = 0.780).Conclusion:The OD technique is comparable with the manual SE counterpart in terms of primary and secondary stability.
Intracranial multiple glioblastomas resembling metastases: A case report
Authors: Dong Qiufeng , Hu Peizhen , Huo Junli , Yang Shuangwu , Zou Peng , Zhang Xiang , Zhen Haining
Published: September 2024

The diagnosis and treatment of gliomas have traditionally been both a research hotspot and a challenge in clinical medicine. Intracranial multiple gliomas are rare, and their diagnosis and treatment are often more difficult than those of solitary gliomas. In this article, we report our experience with the diagnosis and treatment of a case of intracranial multiple glioblastomas that closely resembled metastatic tumors in terms of neuroimaging and anatomy. This case may provide a useful reference and insight into the clinical management of this type of disease.
A Cross-Sectional Study for the Assessment of Fractional Exhaled Nitric Oxide in Children with Atopic Dermatitis and Reactive Airway Disease in Comparison to Healthy Controls
Authors: Ganguly Mimi , Ghosh Aniruddha , Dhar Sandipan , Roy Indrani , Kundu Ritabrata
Published: September 2024

Introduction:

Nitric oxide (NO) is an important biological mediator of inflammation which is exhaled after being produced in the lungs. Fractional exhaled NO (FENO) is a new tool which measures the amount of NO exhaled.

Aims and Objective:

The objective of our study was to find the correlation between the FENO levels between atopic dermatitis and asthma patients in comparison to healthy controls and hence identify steroid responsiveness.

Methodology:

Our study was a cross-sectional observational study performed in a tertiary care hospital involving 150 children (>5–<18 years) who were either attending the outpatient departments or were admitted as inpatients. Relevant history and physical findings were noted and severity scorings were done in the preformed pro forma. Their FENO levels were then recorded and compared.

Results:

The level of FENO was higher in both bronchial asthma and atopic dermatitis patients as compared to controls. The level of FENO was higher in treatment-naïve patients as compared to treated cases. There was also a strong positive correlation between the levels of FENO and disease severity in both the groups.

Conclusion:

FENO is a relatively new tool and as such still requires standardization and acceptance in the medical field. It can be a very useful tool in not only identifying these atopic diseases, but it can also act as a prognostic marker as well as a marker for patient compliance. There being a gap in literature related to FENO, hopefully our study will provide some insight to its usefulness.
Smegma Pearl in Toddlers: A Case Series
Authors: Rout Arpita Nibedita , Sirka Chandra Sekhar , Nayak Surajit
Published: September 2024

Smegma pearl (or smegmoma) is a benign condition encountered in young boys. It can be a cause for parental concern. The condition is usually self-limiting and asymptomatic. There are very few cases reported in the literature, although this condition is not rare. We report the condition in three toddlers who presented with yellowish-white papulonodular lesions on the glans and preputial region along with partial adhesions of the undersurface of the prepuce to the glans. This report aims at creating awareness about this condition, to avoid unnecessary diagnostic workups and apprehensions.
Unveiling Squamous Papilloma Resembling Verruca Vulgaris in a Case of Nevus Sebaceous: A Diagnostic Challenge
Authors: Behera Debasmita , Begum Farheen , Raj Chinmoy , Choubey Shini
Published: September 2024

This case report details the unusual presentation of a 6-year-old male child who had an asymptomatic, well-defined, brown raised lesion over the vertex area of the scalp since birth. His parents noticed a new growth with finger-like projections over existing old lesions for 1 year. With an initial diagnosis of growth of verruca over nevus sebaceous (NS), a sample for histopathology study was sent which revealed findings consistent with squamous papilloma occurring on NS. This is reported to emphasize that any growth over NS should be confirmed histopathologically due to the rarity of this association and to reduce the possibility of its malignant potential. The article emphasizes how crucial histological analysis is to clarifying mistaken cutaneous lesions and refining an accurate diagnosis.
Epidermolysis Bullosa Simplex – Dowling-Meara Type: A Case Report in a 10-year-old Boy
Authors: Zachariah Linza P. , Ambooken Betsy , Rao Raghavendra , Asokan Neelakandhan
Published: September 2024

Epidermolysis bullosa simplex – Dowling-Meara type (EBS-DM) is characterized by the presence of bullae and vesicles with arcuate borders in a herpetiform manner at the trauma-prone areas of the body since birth. Here we report the clinical course of EBS-DM in a 10-year-old boy. We confirmed the diagnosis by antigen mapping which showed clumping of keratin 14 with decreased staining in few areas.
Clinical Spectrum of Atopic Dermatitis in Pediatric Age Group from a Tertiary Care Center in India: A Cross-sectional Study
Authors: Mendiratta Vibhu , Verma Damini , Himadri
Published: September 2024

Introduction:

Atopic dermatitis (AD) is a chronic, inflammatory, relapsing skin disorder with early age of onset in infancy and early childhood. A gradual increase in the prevalence of AD has been observed recently, especially in low-income countries like ours.

Objective:

We aimed to study the epidemiology and clinical profile of AD among pediatric age group in a tertiary care hospital in North India.

Materials and Methods:

A hospital-based cross-sectional study was conducted over 1 year in the department of dermatology and sexually transmitted diseases in a tertiary care center in India. All children diagnosed with AD, aged 0–18 years, were recruited, and their clinical and demographic data were recorded.

Results:

In the 62 children having AD, the mean age was 7.7 ± 6.3 years. Majority of children belonged to the age group of 1–5 years. The mean age of onset of AD was 2.3 ± 2.2 years. A personal history of atopy was present in 53.2% of children, whereas 48.3% of children had a family history of atopy. Acute AD was the most common clinical type that was noted in 43.5%. Hyperlinearity of palms, keratosis pilaris, pityriasis alba, and periorbital darkening were found in 59.6%, 33.8%, 24.1%, and 29% of children, respectively.

Conclusion:

The prevalence of AD is low in developing countries like India, but it is slowly rising due to rapidly evolving urbanization and environmental changes. Disease manifestation is usually mild to moderate in Indian patients; hence, vigilant eyes and high clinical suspicion are required for accurate diagnosis and efficient management of AD in Indian settings.
Pili Torti: A Clue to Life-threatening Illness – A Rare Case Report
Authors: Patel Nikita M. , Narang Sanya K. , Chauhan Jatin D. , Shah Hiral A.
Published: September 2024

Menkes kinky hair disease (MKHD) is a rare inherent error of copper metabolism presenting during early infancy with multi-system involvement. It is associated with high morbidity and mortality in early childhood. Characteristic hair changes mirror internal metabolic alterations. Here, we report a case of 13-month-old male child who presented with peculiar changes of skin and hair along with convulsion and high-grade fever. Dermatoscopy and hair mount examination showing pili torti with pigmentary dilution pointed toward the diagnosis of MKHD, which was further enforced with blood investigations showing low copper and ceruloplasmin levels. Cutaneous findings play a crucial role in early diagnosis, thereby reducing morbidity with timely treatment.
Scabies and Nodules in Children: An Intriguing Entity
Authors: Palaniappan Vijayasankar , Karthikeyan Kaliaperumal
Published: September 2024

Nodular scabies (NS) is a relatively common variant of classical scabies whose pathogenesis is unclear. It is clinically characterized by pruritic, firm nodules most commonly involving the genitalia followed by axilla and groin region. A clinical diagnosis of NS is often straightforward. NS may persist despite the administration of antiscabicidal drugs such as permethrin and ivermectin. Topical and intralesional corticosteroids form the mainstay of treatment. Postscabietic nodule is a complication that primarily occurs in patients with previous history of scabies that had been successfully treated.
Nonodontogenic Causes of Toothache: A Case Series and Narrative Review
Authors: Chawla Jitendra , Dey Samarjit , Chamala Vamshidhar , Gupta Sunit Kumar
Published: September 2024

Chronic orofacial pain is a complex and frequently misdiagnosed condition that significantly impacts individuals’ well-being. Accurately diagnosing orofacial pain can be challenging due to the overlap between headaches and orofacial regions. Patients who complain of tooth pain may actually be experiencing pain unrelated to dental issues. It is crucial for clinicians to accurately pinpoint the source and location of the pain to devise effective treatment plans. Nonodontogenic facial pain can stem from various causes such as musculoskeletal, neuropathic, or neurovascular issues. In addition, toothaches can result from conditions originating from other areas like systemic disorders related to the heart, nose, throat, or sinuses. Referred pain phenomena are acknowledged in the literature but are poorly understood, presenting significant treatment challenges. This is worrisome because such patients are more prone to developing chronic pain conditions, and invasive treatments may exacerbate their suffering and overall health. In the current review paper, three cases are detailed: one of myofascial pain, the second of trigeminal neuralgia, and the third of posttraumatic trigeminal neuropathy. In all three cases, dentists were the initial point of consultation as the pain was perceived in the teeth, resulting in unnecessary dental interventions. There remains a lack of knowledge regarding nonodontogenic toothache among clinicians. Increasing awareness of nonodontogenic toothache can help avoid unnecessary interventions and improve overall pain relief for patients.
Anthropometric Study of Nasal Indices among the Akan People in the Assin Districts of Central Region, Ghana
Authors: Kyei Gordon , Egbenya Daniel Lawer , Brown Ato Ampomah , Aidoo Eric
Published: September 2024

Introduction:

Nasal index (NI) may establish racial and ethnic identity and serves as a useful tool in forensic medicine and reconstructive surgery. Previous studies on nasal indices in many races and ethnicities serve as baseline and reference points for forensic and surgical purposes in those populations. However, there is scanty or no data on NI in Ghana including the Akan ethnicity. The study was conducted to provide baseline data on NI among the Akan people in the Assin Districts of the central region of Ghana.

Materials and Methods:

Four hundred adults between the ages of 20 and 58 years were used. Nasal height (NH) and nasal width (NW) were measured using Vernier caliper. NI computation and statistical analyses such as z-test and Pearson correlation were performed.

Results:

Mean NI of 91.32 ± 8.66 and 89.39 ± 10.16 were recorded in males and females, respectively, indicating that the predominant nose type in the study population is platyrrhine. There was a strong positive correlation between NH and NW, but there was no sexual dimorphism in NI among the Akan population.

Discussion and Conclusion:

This study provides a baseline data on NI anthropometry of the Akan people of the Assin Districts and will be a reference point for nasal anthropometry for clinical practice, rhinoplasty, and forensic science.
Morphometric Investigation of Nasal Structure with Nasal Septum Deviation in Young Adults and Correlation with 2:4 Digit Ratio
Authors: Desdicioglu Kadir , Oguz Buket , Tutuk Vahide
Published: September 2024

Aim:

The nose, both anatomically and esthetically, is a central feature of the human face. This study aims to morphometrically investigate the nasal structure with septal deviation in young adults and examine its correlation with 2:4 digit ratio.

Materials and Methods:

The study was conducted on 194 volunteers (female: 100 and male: 94), aged 18–25 years, studying at Yıldırım Beyazıt University Faculty of Medicine, Ankara. Volunteers with nasal septum deviation were included in the study. Initially, participants’ height and weight measurements were taken, followed by morphometric measurements of the nasal and hand regions by the same researcher. Body mass index (BMI) was also calculated. Subsequently, the volunteers were divided into eight age groups for age and four for BMI. The data were analyzed using the Student’s t-test for normally distributed continuous variables and the Mann–Whitney U-test for ordinal or nonnormally distributed continuous variables. P < 0.05 was considered statistically significant.

Results:

Initially, the averages and standard deviations of parametric data taken from the nose and hand according to gender, age, and BMI were calculated. Then, the nasal and hand parameters were statistically evaluated according to gender, age, and BMI. The correlation between nasal parameters and the 2:4 digit ratio was also examined. The evaluation revealed statistically significant differences and correlation relationships between the parameters (P < 0.05).

Conclusion:

The data obtained from our study will assist clinicians involved in evaluating nasal development, determining gender in forensic medicine, diagnosing and treating pathologies related to the nose, describing anatomical points in surgical procedures applied to this region, and planning these surgical procedures.
Aberrant Origin of Left Vertebral Artery – Multidetector Computed Tomography Study
Authors: Sharma Vinay , Babu C. S. Ramesh , Gupta O. P.
Published: September 2024

Background:

The vertebral arteries originating from respective subclavian arteries are the major source of oxygenated blood to posterior cerebral circulation and supply the upper spinal cord, brain stem, cerebellum, and occipital lobes of the cerebrum. Paucity of radiological studies prompted us to undertake this study which aims to analyze the variations in origin of left vertebral artery (LVA).

Materials and Methods:

This is a retrospective cross-sectional study of contrast-enhanced computed tomography chest scans of 710 subjects retrieved from the archives of a single imaging center.

Observations and Discussion:

Normal origin of LVA from the left subclavian artery (LSA) in the root of the neck was noted in 90.56% and variant origin in 9.44% of cases. Four-branched aortic arch (AA) with direct AA origin of LVA was observed in 6.76% of cases. An atypical three-branched pattern with LVA origin between the bovine trunk (common trunk of brachiocephalic trunk [BCT] and left common carotid artery [LCCA]) and LSA was seen in 0.84% of cases. Common origin of both LVA and LSA from a vertebro-subclavian trunk (VST) is found in 0.98% of cases. LVA as the last branch of arch distal to LSA and LVA of arch origin associated with aberrant right subclavian artery were noted in 0.14% of cases each. A rare but important observation is the presence of two common trunks (bovine trunk (BCT + LCCA) and VST (LVA + LSA) in an atypical two-branched fashion found in 0.56%.

Conclusion:

Critical knowledge of variations of the origin of LVA is clinically relevant as such variations are more prone to vascular pathologies. Variations of the LVA are thought to alter cerebral hemodynamics and can produce cerebral dysfunction. Preprocedural knowledge of such variations aids in the successful accomplishment of catheterization of LVA and avoids complications during neuroradiological interventions and surgical procedures.
Investigate the Relationship Between the Presence of JCV DNA and the Immunohistochemical Expression of CK2 0, CK7, and CDX2 in Colorectal Cancer
Authors: Hassoon Hind Jaber , Muhsin Jasim Mohammed
Published: September 2024

Background:

Globally, colorectal cancer (CRC) is the most common malignancy and has a high fatality rate. Early childhood the John Cunningham virus or JC virus (JCV) infection persists throughout life and has been linked through multiple routes to colorectal cancer. The expression of cytokeratins 7 (CK7), 20 (CK20), and CDX2 have been investigated in a variety of primary and metastatic carcinomas, and their patterns of expression may be used to determine the site of origin of metastatic carcinomas.

Objectives:

The aim is to assess the relationship between JCV DNA and tumor markers (CK7, CK20, and CDX2) in patients with colorectal cancer, this study was carried out.

Materials and Methods:

Ninety CRCs (45 of which were squamous cell carcinomas and 45 of which were adenocarcinomas) had their paraffin sections randomly chosen, extracted, and immunostained for CK7, CK20, CDX2, and for the detection of JCV DNA by real-time (PCR).

Results:

JCV DNA was detected in 22 (24.4%) of AD-CRC and 24 (26.7%) of SCC-CRC (P = 0.004). The presence of JCV was significantly correlated with tumor stages (P = 0.04) and age categories (P = 0.05). Moreover, JCV presence was significantly correlated with all studied tumor markers (P < 0.05).

Conclusion:

JCV might play a role in the development of colorectal cancer, and CDX2, which is highly specific and sensitive as markers of colorectal origin should be helpful in the detection of intestinal adenocarcinomas.