bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Pictorial and Textual Health Warning Labels on Sugar-sweetened Beverages Effect Consumer Consumption: An Exploratory, Cross-sectional Study
Authors: Vedha V. P. K. , Mohanty Vikrant R. , Balappanavar Aswini Y. , Kapoor Shivam , Gupta Vaibhav
Published: December 2023

Background:

Sugar is considered to be the arch criminal of dental caries, and sugar sweetened beverages (SSBs) are a common source of dietary sugar. It is an established fact that tobacco warning labels efficiently inform customers about the harmful effects of tobacco and enable individuals to reduce consumption. Lessons learnt from tobacco warning labels can be applied to developing and implementing warning labels for SSBs.

Aim:

To develop pictorial and textual health warning labels for SSBs and assess effectiveness among the study population regarding oral health risks and their readiness to change their consumption pattern.

Methodology:

An exploratory cross-sectional study was conducted among 200 patients visiting a Public Dental Hospital in New Delhi. Pictorial and textual warnings for SSBs were developed and assessed for the comprehension and credibility, persuasiveness, and impact of the warning labels by a specially designed questionnaire.

Results:

More than 80% of the study population found both the warning labels to be easy to understand, believable, and truthful. Pictorial warning labels had very high impact that 96% of the study population was ready to reduce their consumption and more appreciably 29% of the respondents were ready to quit SSB consumption. Similarly, 95% of the study population were ready to reduce their consumption on seeing the textual warning labels (P = 0.12) with 27.5% reporting to completely give up the consumption.

Conclusion:

Textual and pictorial warnings have desired deterrent impact on the SSB consumers who tend to consume SSBs habitually. It can help us in achieving the sustainable development goals.
Development and Validation of an Instrument to Assess Oral Health Literacy among Adults-seeking Dental Care in Pune, India
Authors: Dargad Priti , Hegde-Shetiya Sahana , Jadhav Sudhir Laxman
Published: December 2023

Context:

Oral health literacy (OHL) has emerged as an important dimension of oral health care with the potential to have multiple applications in a health-care setting. Most of the tools that measure were developed out of India.

Aim:

Since OHL is a contextually sensitive construct, this study developed and validated a tool to measure OHL among adults in India.

Material and Methods:

A questionnaire covering all three domains of OHL was framed in two languages using the “dual development approach.” After content validation, the 20-item questionnaire was subjected to test-retest, pretest, and pilot test. It was then administered to 200 adults in a dental college and five private clinics. Socio-demographics, Decayed, Missing, Filled Permanent Teeth (DMFT) and Oral Hygiene Index– Simplified (OHI-S) were recorded to establish the construct and predictor validity of the tool.

Results:

The results showed that the overall reliability of the questionnaire was high, with Cronbach’s alpha of 0.81. The mean OHL score was 15.4, with a minimum score of 2 and a maximum of 20. A statistically significant correlation was found between socioeconomic status and OHL as an indicator of convergent validity (r = 0.62). The discriminant validity of the questionnaire was assessed by comparing OHL levels with education levels using the Kruskal–Wallis test, and statistically significant results were derived. Significant associations (P < 0.001) between DMFT and OHL; and OHI-S and OHL were found with an adjusted odds ratio of 3.01 and 4.78, respectively, establishing its predictive validity.

Conclusions:

Hence the validity and reliability of this tool were established through this research, opening avenues for further research.
Knowledge and Attitude of Students and Teachers who Smoke Toward the Electric Chanting Cigarette Lighter in Colleges of Pimpri-Chinchwad – A Cross-sectional Study
Authors: Bomble Nikhil , Shetiya Sahana Hegde , Agarwal Deepti
Published: December 2023

Introduction:

The mandatory pictorial warnings on cigarette packets were not properly understood and thus were not very effective. Hence, there was a felt need for a strategy which could bring an implicit change in the attitude and practice of tobacco users. Electric chanting lighter chants a death phrase when users light up, to deter smokers from smoking, which is patented by the Cancer Patient Aid Association, Mumbai, India. However, as the attitude toward it was unknown, this study was conducted.

Objective:

The objective of the study is to assess knowledge and attitude of smoking college students and teachers toward the electric chanting lighter.

Materials and Methods:

A questionnaire study was conducted among the students and teachers of arts, science, and commerce colleges in Pune. A total of 100 (25 teachers and 75 students) participants were part of the study, which was conducted in 2014. Every participant was asked to listen to the lighter live and then immediately a self-administered questionnaire was provided to them to answer.

Results:

It was seen that, albeit 100% of the staff and 95% of the students were aware of the fact that smoking causes cancer, neither of the groups were even remotely aware of the existence of a chanting lighter. Eighty percent of the staff and 70% of the students believed that the chanting lighter would be accepted by the society. Meanwhile, 80% of the staff and 66% of the students agreed that the chanting lighter will play an essential role to help give up the habit of tobacco use in the long run.

Conclusion:

It can be concluded that, the chanting lighter can be promoted as one of the first verbal warning aid to be used for smoking cessation. It is clearly reflected through this study that this lighter can bring about a change in the attitude of smokers.
Influence of Mother’s Oral Health Knowledge and Attitude on Primary Teeth among 1–6-year-old Children Attending Pediatric Hospital in Nellore District: A Cross-sectional Study
Authors: Desu Ravali Durga , Kumar R. V. S. Krishna , Gomasani Srinivasulu , Reddy V. Prathyusha , Prasanth Punamalli Symon
Published: December 2023

Introduction:

Oral health in children plays an important role as it lays down the foundation for healthy permanent teeth. In children, primary teeth play an important role in eating, speech, and facial appearance and also as a perfect space maintainer for permanent teeth. Mother is the first teacher of the child and she is the one who will take care of the child, so knowledge regarding the importance of primary teeth is necessary.

Aim:

The present study aimed to assess the knowledge of mothers with children aged 1–6 years on primary teeth and their importance.

Materials and Methods:

A cross-sectional study was conducted among the mothers of children between 1 and 6 years attending a pediatric hospital in Nellore for 3 months. A prevalidated closed-ended questionnaire consisting of 15 questions on the knowledge and attitude of mothers on primary teeth and the importance of visiting a dentist for regular dental checkup was given, and the responses were collected on the same day.

Results:

A total of 211 mothers participated in the study and filled the questionnaire, of which 65.4% are of the view that it is important to save an infected primary tooth, and among them, 60.2% agreed for treatment. About 41.7% responded that they visited a pediatrician when pain occurs and 51.7% believed that having too much sweets is the reason for tooth decay.

Conclusion:

This study concluded that the mothers of preschool children had partial knowledge of primary teeth and there is a need to improve the knowledge of the importance of primary teeth and regular dental checkup.
Prevalence of Early Childhood Caries and Its Association with Feeding Habits among 3–5 Year Old Preschool Children: A Cross-sectional Study in Chennai City, India
Authors: Mahapatra Shilpa , Chaly Preetha Elizabeth , Mohapatra Smruti Chandan
Published: December 2023

Background:

Early childhood caries (ECC) is a form of dental caries affecting infants, toddlers, and preschoolers.

Aim:

The study was carried out to determine the prevalence of ECC and its association with feeding habits among the preschool children aged 3–5 year old in Chennai city.

Materials and Methods:

A cross-sectional study was conducted among 342 randomly selected mother-child dyads in Chennai city. The mothers were asked to complete a self-administered questionnaire comprising of their demographic data and child’s feeding habits. The presence of decay was assessed by a single trained examiner using the criteria described by the World Health Organization (2013). Data obtained were analyzed using Chi-square test. The significance level was set at P ≤ 0.05.

Results:

The overall ECC experience among the study subjects was 53.8%. Among the children who started bottle feeding at the age of 1–2 years, 72.9% belonged to the high caries group. The practice of nocturnal bottle feeding was observed in 39.6% children in the high caries group. Moreover, 56.2% in the high caries group were fed cow’s milk. ECC was higher among children who consumed snacks 1–3 times a day.

Conclusion:

Duration and frequency of bottle feeding, nocturnal feeding practice, feeding with cow’s milk, and frequent consumption of snacks, were significantly associated with ECC experience among the children. Data obtained may serve as a baseline for planning and evaluation of community development and oral health promotion programs.
Assessing the Prevalence of Traumatic Dental Injuries and its Impact on Self-esteem among Schoolchildren in a Village in Gurugram
Authors: Kundu Priyanka , Tandon Shourya , Chand Sachin , Jaggi Amrita
Published: December 2023

Background:

Pitiful smile and oral health have always been bounded up to poor social relationships and permanent impairment that causes harm to the ability to learn and grow which may lead toward decreased self-esteem.

Aim:

This study was conducted to assess the prevalence of traumatic dental injuries (TDIs) and its impact on self-esteem among schoolchildren in a village of Gurugram.

Materials and Methods:

This cross-sectional epidemiological study was conducted among 10–17-year-old schoolchildren to assess the prevalence and impact of TDIs. Convenience sampling was used and 240 schoolchildren constituted the sample size. TDIs were recorded using Ellis classification, and self-esteem was recorded using Rosenberg’s Self-Esteem Scale. For statistical analysis, Chi-square test and t-test were used. The odds ratio was utilized to assess and compare the self-esteem according to high and low esteem among individuals with or without dental trauma.

Results:

Results of the present study showed that out of total 240 children, 54.2% were males and 45.8% were females. The overall prevalence of trauma was found to be 28.3%. Ellis class I was the most common type of injury in schoolchildren (70%). The most frequently traumatized teeth were maxillary incisors, among which maxillary central incisor was the most affected (60.4%). The difference between low and high self-esteem among individuals with or without dental trauma low esteem, high esteem was not statistically significant (P > 0.05).

Conclusion:

By improving oral health in schools may contribute considerably to the self-esteem of individuals in positive direction and help them in becoming a socially competent adult.
Implementation of Digitization in Dentistry from the Year 2011 to 2021: A Bibliometric Analysis
Authors: Gavali Neelam , Chandak Alaka , Waghmare Pramod , Jamkhande Amol , Nisa Shams UL , Shah Priyanka
Published: December 2023

Introduction:

Digitalization has revolutionized dentistry in the last decade. Current application in digitization has increased which includes use of various systems such as cone-beam computed tomography for implant purpose, temporomandibular joint disease diagnosis, utilization of computer-aided design–computer-aided manufacturing system (CAD-CAM system) for prosthodontics. The usage of digital dentistry is made right from diagnosis to treatment planning which reduces the time consumption & human efforts to a great extent & increases accuracy for treatment planning. Therefore, this review focuses on analysis of implementation of digitization in dentistry from 2011 to 2021.

Objectives:

This study aims to analyze the scientific literature on digitization in dentistry by examining the origin of manuscripts, study types, and levels of evidence.

Materials and Methods:

The study retrieved data from journals indexed in Scopus. Subsequently, a descriptive analysis was conducted on bibliographic data, collaboration network, and keyword co-occurrence. The articles were then classified based on their field of interest, main research question, study type, and level of evidence.

Results:

The study has identified 203 original papers on digital dentistry, published in 112 journals, and co-authored by 1436 individuals affiliated with 89 institutions from 45 countries. While the majority (81.4%) of these papers were from a single country, we observed high collaboration among institutions from the United States, Britain, and Brazil. The primary focus of these papers was on the potential uses of digital technology in dentistry. Regarding study type, most articles were systematic reviews, cross-sectional studies, and original research papers.

Conclusion:

Integrating digital technology in dentistry has brought numerous benefits, including a more organized and streamlined approach to medical records and thorough investigation and treatment planning within a shorter timeframe. Furthermore, digital technology enables the accurate detection of even the minutest details, minimizing errors and eliminating human bias. The use of three-dimensional imaging techniques allows for the precise determination of objects’ geometrical characteristics and spatial orientation, resulting in the accurate placement of implants and prosthetics.

Clinical Relevance:

Digitization in dentistry has opened a whole new world for practitioners to focus on the patient satisfaction approach. Digital platforms can help optimize diagnosis and consulting and provide an excellent base for treatment planning.
Finite Element Stress Analysis after Simulated Canal Preparation Using Two Different Methods: An In vitro Study
Authors: Sasidhar P. C. , Govula Kiranmayi , Anumula Lavanya , Maddineni Kowmudi
Published: December 2023

Background:

The success of root canal treatment and the amount of surviving dentin tissue around the root canals determine the prognosis of root canal-treated teeth. Stainless steel or nickel–titanium (NiTi) file can prepare the root canal biomechanically. The widespread use of NiTi equipment has improved the predictability of the crucial phase of root canal treatment.

Aim and Objective:

This study aimed to evaluate and compare the stresses generated by rotary and reciprocatory files in straight and curved canals.

Methodology:

Computer-assisted design models of mandibular premolars with straight and curved root canals and rotary and reciprocatory files were made per the detailed drawings. After preprocessing, node-to-node connections were made, boundary connections were defined and subjected to stress application, which was analyzed using finite element analysis.

Results:

The maximum von Mises stress under a vertical load of 12.5 N that appeared in the curved canal with rotary motion was 40.287 Mpa. Reciprocatory action produces fewer stresses than rotary motion. The maximum von Mises stresses under a vertical load of 12.5 N appeared in straight root with reciprocatory movement (18.697 Mpa). The peak of von Mises stresses under a vertical load of 12.5 N appeared in curved roots with reciprocatory motion was 27.524 Mpa. The results might be attributed to the salient design of the rotary instrument and its continuous motion during the simulated canal preparation, which reduces the compacting forces of the obturating material.

Conclusion:

Within the study’s limitations, it can be stated that the rotary group had higher stress distribution in both straight and curved canals than the reciprocatory group in dynamic analysis. On static analysis, the rotary group has shown a lower amount of stress when compared to the reciprocating group in both straight and curved canals. There was no significant difference between the two analyses.
Association of Serum Leptin Levels in Patients with Chronic Periodontitis and Cardiovascular Diseases
Authors: Indraganti Bhavya , Samatha Yalamanchili Pallavi , Chivukula Satya Kishore , Surapaneni Hemchand , Chandra Challa Bharath , Atluri Rohith
Published: December 2023

Background:

In recent years, clinical studies have shown an association between leptin and periodontal disease. The present study aimed to estimate and compare the serum leptin levels in chronic periodontitis patients with cardiovascular diseases.

Materials and Methods:

A total of 30 subjects were included in the study and are divided into three groups, i.e. Group 1: ten healthy subjects, Group 2: ten subjects with chronic periodontitis, and Group 3: ten subjects with periodontitis and cardiovascular disease. Two millimeters of the venous blood sample was collected from the antecubital fossa of all the sixty subjects under aseptic conditions. Serum was obtained from the blood by centrifuging at 2500 rpm for 10 min. Now, this collected serum is used to estimate leptin using a leptin enzyme-linked immunosorbent assay (ELISA) kit (Clementia biotech). Leptin levels were assessed in an ELISA reader. Statistical analysis was conducted using SPSS software version 24.

Results:

A significant correlation was observed with serum leptin levels and clinical parameters in the chronic periodontitis + cardiovascular disease group, i.e. plaque index (r = −0.96, P = 0.0003*), gingival index (r = −0.89; P = 0.0005*), probing depth (r = −0.82; P = 0.003*), and clinical attachment level (r = −0.84; P = 0.001*) * is Statistically Significant.

Conclusion:

The study found a statistically significant increase in serum leptin levels in the Group III compared to Groups II and I which suggest an increase in inflammatory state increases the serum levels of leptin.
A Curious Case of Eroded Citations and the Current Status of Top 50 Cited Articles by Indian Periodontists: A Bibliometric Analysis
Authors: Baghele Om Nemichand , Nagime Shital Chandraprakash , Ugale Gauri Mahesh , Bhandari Vishnudas Dwarkadas , Vamdama Kharidi Laxman
Published: December 2023

Context:

The bibliometric studies on topmost articles on many subjects are available and fascinating, but there is no research available analyzing the fate of top-cited articles. The citation to an article is a dynamic process which is dependent on a multitude of factors and may indicate the direction of research.

Aims:

The aim of this study was to analyze using bibliometric approach the current status of the top 50 cited articles by Indian periodontists based on the PubMed database published in 2014.

Settings and Design:

The study was conducted at the Departments of Periodontology at Dental Council of India recognized Maharashtra Institute of Dental Sciences & Research, Latur. It is a comparative follow-up bibliometric citation analysis of publications by Indian Periodontists.

Subjects and Methods:

All the 50 top-cited articles were individually searched on PubMed and Google Scholar databases for their availability and citations. The citations received by these articles till November 25, 2022, by 11.00 a.m. Indian Standard Time were subjected to detailed analyses.

Statistical Analysis Used:

Descriptive statistics using mean, median, range, percentages, and proportions were used for analysis.

Results:

Total citations to the 50 articles were increased from 597 (2012) to 932 (2022) with an overall increase of 6.7 citations/article. Seventeen (34%) articles showed a decrease in citations as compared to 2012 numbers; a decline of 99 citations with an average of 5.8 citations/article. One article showed no change, and the rest 32 (64%) noted an increase by 434, averaging 13.6 citations/article. The topmost 2012 article was relegated to the 10th spot in 2022 while it remained at the 6th spot in Google Scholar citations. In 2022, the topmost article received 57 PubMed and 466 Google Scholar citations.

Conclusions:

A top-cited or classic article may not remain at that position through its lifecycle, but goes on receiving citations. There are instances of “erosion in citations” as well which needs to be recognized and awareness among researchers is necessary. There is a need to identify the current top 50 classic articles and compare them with these to understand the focus on current research topics.
Comparative Evaluation of Fracture Resistance in Endodontically Treated Teeth Using Epoxy Resin-based Sealer and Bioceramic Sealer: An In vitro Study
Authors: Gadekar Apeksha Dhanraj , Jadhav Aniket , Sharma Anupam , Patil Ruchira , Shinde Mrunal , Ingale Vinaya
Published: December 2023

Background:

The aim of this study was to compare the fracture resistance of endodontically treated teeth using epoxy resin-based sealer and bioceramic sealer.

Materials and Methods:

Twenty-eight single-rooted, single-canal mandibular premolars extracted for orthodontic purposes were used in this in vitro study. The teeth were decoronated using a wheel diamond bur to a standard length of 14 mm under water lubrication. The canals were irrigated between successive filings. All teeth were instrumented (biomechanical preparation) by ProTaper rotary files up to F2. These teeth were then divided into two groups based on the type of root canal sealer used. Gutta-percha was used for all the samples: Group I: Bio-C root canal sealer and Group II: AH Plus root canal sealer. The teeth were embedded in acrylic resin blocks, and fracture force was measured using a universal testing machine. Independent sample t-test/unpaired t-test was performed to assess significant differences between the two groups. This comparison showed statistically significant differences between the two groups (P < 0.05).

Results:

Group I, i.e., Bio-C (bioceramic based) sealer, showed higher resistance to fracture than Group II, i.e., AH Plus (resin based) sealer.

Conclusion:

Based on this in vitro study, the Bio-C sealer was more effective as compared to the resin-based AH Plus sealer.
High-grade B-cell Lymphoma Initially Presenting with Dysphagia, Upper Gastrointestinal Bleeding, and Adrenal Invasion
Authors: Gamal Ahmed Y. , AlOtaibi Yazzan , Alqahtani Nasser T. , Alsultan Qasem A. , Alakeel Fadi
Published: December 2023

Gastric high-grade B-cell lymphoma (HGBL) with adrenal gland invasion is a rare clinical entity with few cases reported in the literature. Patients usually present with nonspecific symptoms that lead to delays in the diagnosis, initiation of treatment, and prognosis. In this report, we present a case of a middle-aged woman in her 60s who presented with shortness of breath, dysphagia, early satiety, and melena. Further investigations confirmed the presence of an ulcerated gastric mass with invasion to the left adrenal gland, and histopathological and molecular studies of the gastric mass confirmed the diagnosis of B-Cell Lymphoma with MYC and BCL-6 rearrangements, a rare aggressive lymphoma subtype known as HGBL. Consequently, she was started on R-CHOP-21 chemotherapy protocol with good outcomes and resolution of the mass on repeat imaging; the current report aimed to emphasize the importance of recognizing unusual presentations of HGBL, especially gastric HGBL, which will help in early recognition, treatment, and prognosis.
Attitude of Previous Blood Donors toward Blood Donation during COVID-19
Authors: Alahwal Hatem M. , Nour Yasmin Mohamed Abbas , Khan Shahida A. , Barefah Ahmed S , Bahashwan Salem M. , Radhwi Osman O. , Alzahrani Atheer Mousa Saeed , Tash Rawan Azizullah Marouf , Bajunaid Weam M , Alkhaldi Afaf Bader Radi , Almohammadi Abdullah T.
Published: December 2023

BACKGROUND:

Access of blood donors to blood banks among several other factors affected rates of blood donation in many blood banks during COVID-19. Shortage of blood supply occurred to variable degrees in many countries, including Saudi Arabia. Rather than approaching new donors to donate during the time of crisis, past donors constitute a pool of potential donors that may be approached during these times. The objective of this study was to evaluate the attitude of donors who donated before the pandemic toward donating during the pandemic and to identify any specific donor characteristics that may affect their attitude.

METHODS:

All blood donors who donated during 2019 identified and systematically sampled. The selected donor sample was approached through phone calls and text messages from January 1, 2019, to December 31, 2019. Donors were asked to fill up a self-administered web-based survey that contained 30 questions about donor characteristics, variables related to COVID-19 infection and vaccine, and attitude toward blood donation.

RESULTS:

A total of 258 previous donors provided consent and completed the survey. The donor pool was male-dominated, and most donors were aware of their blood group. A significant difference in attitude was observed regarding blood donation and concern about COVID19 between college-educated and lesser educated individuals on certain aspects. Health-care workers displayed more awareness toward the donation and hospital policies.

CONCLUSION:

The academic level was associated with a positive attitude toward blood donation and COVID-19 infection, more awareness of the critical role of blood donation during the pandemic but also more concern about COVID-19 infection. Health-care workers are more aware about the entire condition. Thus, it is deemed essential that blood banks and hospitals design ways to educate and encourage the donors toward blood donation during the pandemic.
Splenic Sequestration and Infarction upon Exposure to High Altitude in Adult Patients with Sickle Cell Anemia
Authors: Alkhaldy Husain , Alsalman Mortadah , Almuhaini Mariyyah , Alshehri Renad , Almusaad Samar , Al-Qahtani Wejdan , Samih Tamer A. , Makkawi Mohammed
Published: December 2023

Adult patients with sickle cell disease usually have atrophied spleens due to autosplenectomy, and only rarely have complications related to the spleen, such as splenic sequestration and infarctions. However, some sickle cell haplotypes/genotypes are associated with persistent spleen until adulthood and thus are at risk of splenic complications. In this case report, upon or shortly after arrival at high altitude, three patients with sickle cell anemia were presented with acute splenic sequestration and splenic infarction. This major complication can be the presenting feature of an otherwise benign course of sickle cell anemia. A national travel recommendation is merited to advise patients with sickle cell anemia before traveling to high altitudes, especially those with Arab-Indian haplotype.
Analysis of Thrombophilia Test Ordering Practices at King Fahad Hospital of the University
Authors: Aldawood Fatimah Adel
Published: December 2023

BACKGROUND:

Thrombophilia tests are widely performed but often in a nonjustified and inappropriate manner as patients are not properly selected, or test timing is not considered. This study aims to assess the current practice of thrombophilia testing at our institution by determining the indications and the testing characteristics to start an initiative toward the reduction of inappropriate testing.

METHODOLOGY:

This is a retrospective study of patients who have undergone thrombophilia testing at King Fahad Hospital of the University from January 1, 2019, to December 31, 2020. The data were collected from electronic medical records.

RESULTS:

A total of 545 patients were included (the median age was 38, 76.4% were females). Of the ordered analyzed, 36.59% were for inappropriate indications. Tests were done in the acute phase of thrombosis in 55.21% of patients. However, 18.89% of patients had thrombophilia tests requested during anticoagulants therapy. Positive results were found in 32.66% of patients and were confirmed in 52.24% of patients. The positive diagnostic yield of thrombophilia testing at our institution was only 14.6%. Of the screened tests that required confirmation for definitive diagnosis, 52.23% was obtained.

CONCLUSION:

This study highlights the improper practice of thrombophilia testing, which calls for initiatives toward reduction in test request by means of educational intervention, posttest guidance by the laboratory, or restraining ordering to the highly specialized clinicians.
First Observation of Hemoglobin Ypsilanti in Saudi Arabia: A High Oxygen Affinity Hemoglobin Presenting with Extreme Erythrocytosis
Authors: Alkhaldy Husain , Algarni Abdullah , Bakheet Omayma , Qahtani Afaf , Alasiri Lama , Makkawi Mohammed
Published: December 2023

High oxygen affinity hemoglobin (HOAH) variants are rare hemoglobinopathies sometimes associated with congenital erythrocytosis. Patients with HOAH are usually asymptomatic and are incidentally discovered when unexplained erythrocytosis is observed in the complete blood count. Here, we report the first patient with hemoglobin (Hb) Ypsilanti from high-altitude Southern Saudi Arabia, who presented with chronic extreme erythrocytosis (polycythemia) with an Hb concentration of 23 g/dL and hematocrit of 70%. The patient lacked any finding suggestive of secondary erythrocytosis, and the evaluation for acquired polycythemia vera was negative. Hb protein analysis and genetic testing confirmed the presence of a high-affinity Hb variant. Living at high altitude contributed to the presentation of extreme erythrocytosis. Besides highlighting important clinical and diagnostic characteristics, this case illustrates two important diagnostics caveats: high-affinity Hb can be misdiagnosed as another more common qualitative hemoglobinopathy such as Hb S or Hb D carrier state, and it can interfere with HbA1C analysis.
D-dimer and Ferritin Levels in Prediction of COVID-19 Severity
Authors: Alqirbi Hujaz Ismail Abdulrazzaq , Salih Wafaa Hazim , Mahdi Batool Mutar
Published: December 2023

BACKGROUND:

The most common cause of upper respiratory tract infection is coronavirus, which has a crown appearance due to the existence of spikes on its envelope. D-dimer levels in the plasma have been considered a prognostic factor for COVID-19 patients.

AIM OF THE STUDY:

The aim of the study is to demonstrate the role of COVID-19 on coagulation parameters D-dimer and ferritin with their association with COVID-19 severity and disease progression in a single-center study.

PATIENTS AND METHODS:

This study included 200 COVID-19 patients in a private single center from January 01, 2021, to January 01, 2022, in Baghdad-Iraq. D-dimer and ferritin were analyzed in those patients and evaluated their association with the need for oxygen therapy and intensive care unit (ICU) admission.

RESULTS:

Two hundred COVID-19 patients met the criteria for inclusion in this research. The total mean age of all patients was 60.1 ± 11.6 years and the sex distribution was 130 (65%) males and 70 (35%) females. Regarding D-dimer and ferritin, there were significantly higher values in patients in respiratory care units (4748 ± 7.2) (215.7 ± 4.2) (P = 0.0001) in comparison with another group who did not need oxygen or ICU admission (345 ± 3.6) (98.4 ± 1.7), respectively.

CONCLUSIONS:

High levels of D-dimer and ferritin may be used as tools to predict unfavorable clinical outcomes of the disease and poor prognosis.
Unique Approach: A Case Report on Modified Conventional FPD Design for Replacing Periodontally Compromised Lower Arteriors
Authors: Jana Anjan , Mukhopadhyay Santanu
Published: December 2023

This paper offers a novel method for restoring lower anterior teeth with impaired periodontal tissues. For dental health, appearance, and communication, these teeth are crucial. In this article, three instances involving impaired periodontal conditions are presented. Before beginning any restorative treatments, a thorough assessment of periodontal problems is required. We used modified fixed partial dentures (FPD) with stable canines serving as abutments. The limitations of conventional methods are overcome by this method. The efficacy of this strategy in three different situations is demonstrated. When conventional methods are ineffective, this strategy provides potential answers to reclaim stability, beauty, and functionality. Overall, it emphasizes creative methods for improving patient care.
Prevalence and Characteristics of Supernumerary Teeth in Pediatric Patients: A Retrospective Study
Authors: Goswami Suchetana
Published: December 2023

Background:

Supernumerary teeth are a dental anomaly that can impact oral health, yet their prevalence and characteristics in pediatric populations remain underexplored. This retrospective study aimed to investigate the occurrence and attributes of supernumerary teeth in children aged 4–14 years.

Methods:

Medical records including panoramic radiographs of 3127 pediatric patients were reviewed. Data included patient demographics and supernumerary tooth characteristics (number, location, eruption status, morphology, primary/permanent, sagittal position, and orientation) and were subjected to statistical analysis using Fisher’s exact and Chi-square tests (P < 0.05).

Results:

Among the 3127 patients, 87 (2.8%) showed supernumerary teeth, with a male predominance (56.3%). Supernumeraries were most common in the mixed dentition (58.6%), followed by permanent dentition (26.5%) and primary dentition (14.9%). The majority had a single supernumerary tooth (83.9%), resulting in a total of 101 supernumeraries. Conical supernumeraries were the most common (65.3%), followed by tuberculate (20.8%) and supplemental (13.9%) types. Palatal placement was predominant (78.2%), whereas 18.8% were on the alveolar arch, and 3% were labial. Most were normally oriented (78.2%), with 13.9% inverted and 7.9% angular. Eruption status indicated that 63.4% were erupted, whereas the rest were impacted.

Conclusion:

This retrospective study revealed a 2.8% prevalence of supernumerary teeth among pediatric patients, with a male predominance.
The effect of different pressures of pneumoperitoneum on the optic nerve sheath diameter – A prospective study
Authors: Ponduru Supraja , Nanda Ananya , Pakhare Vandana Patilbuwa , Gopinath Ramchandran , Sangineni Kalyani Suryadhanalakshmi , Priyanka R. Devi Sai
Published: December 2023

Background and Aims:

Increased intra-abdominal pressure (IAP) and carbon dioxide gas during pneumoperitoneum leads to various systemic changes involving cardiovascular, respiratory, and cerebral physiology. In our study, we aimed to investigate the effect of standard (13–15 mmHg) and low (6–8 mmHg) pressure pneumoperitoneum on optic nerve sheath diameter (ONSD) using ultrasound, which is a reflection of intracranial pressure (ICP). Patient hemodynamics, surgery duration and surgeons’ comfort, and ease of performing surgery at low-pressure pneumoperitoneum were studied as secondary objectives.

Materials and Methods:

In this prospective double-blind randomized study, 75 patients of the American Society of Anesthesiologists physical status grades I and II, of both genders undergoing elective laparoscopic surgery, were allocated into two groups – S (standard IAP 13–15 mmHg) and L (low IAP 6–8 mmHg). ONSD acquired at different time points: before induction of anesthesia (T1), 5 min after intubation (T2), 5 min after the creation of pneumoperitoneum (T3), 5 min before desufflation (T4), and 5 min before extubation (T5). ONSD of 5 mm is taken as the cutoff value to correlate raised ICP. Continuous variables were analyzed by the Student’s t-test, and categorical data were assessed by the Chi-square test.

Results:

There was a significant increase in ONSD with insufflation in both the groups; however, T3 is higher than the cutoff value (>5 mm) in Group S. The ONSD values at T1 (baseline) and at T2 (after intubation) were comparable between the groups, with P = 0.1855 and P = 0.8988, respectively. With pneumoperitoneum, the increase in ONSD (T3) is significantly higher in Group S than in Group L with P = 0.0022, attributing to the high IAP in Group S.

Conclusion:

Laparoscopic surgery with low-pressure pneumoperitoneum can be a safe approach, particularly in individuals at risk of raised ICP.
An association between gastric contents and gastric volume with gender and comorbidities: An observational study
Authors: Sojitra Rashesh , Patkar Charushila , Mahadik Shripad , Phalgune Deepak Sadashiv
Published: December 2023

Background and Aims:

The data regarding fasting gastric contents and gastric volume in patients with comorbidity are lacking. The present study was conducted to determine an association between gender and comorbidities with gastric contents and gastric volume determined by ultrasonography in 8 h fasting patients. It was hypothesized that there is no association between gastric contents and gastric volume with gender and comorbidities.

Materials and Methods:

The present cross-sectional observational study was conducted in patients aged between 18 and 60 years posted for elective surgery. The patients were advised to overnight fast for a minimum of 8 h. Preoperative bedside ultrasonography was done in the right lateral decubitus position. According to the appearance on the ultrasound, the contents were identified as either empty, clear liquids, or solids. Antral cross-section area was measured and gastric volume was estimated. Statistical Package for Social Sciences for Windows, version 22, was used for analysis. Comparison of the distribution of categorical variables was done using the Chi-square test/Fisher’s exact test. Comparison of parametric and nonparametric continuous variables was done using unpaired t-test and Kruskal–Wallis test, respectively.

Results:

The mean gastric volume among males and females was 64.8 mL and 64.2 mL, respectively (P = 0.896). The median gastric volume and the median gastric volume in mL/kg were significantly higher in patients who had chronic kidney disease (4.53 mL/kg and 125.5 mL) as compared to other comorbidities such as diabetes mellitus (1.88 mL/kg and 52.3 mL), hypertension (2.05 mL/kg and 53.9 mL), hypothyroidism (1.69 mL/kg and 48.9 mL), and obesity (2.18 mL/kg and 65.6 mL). The percentage of patients who had no gastric content was significantly higher in males as compared to females. There was no statistically significant difference in the type of gastric contents and comorbidities.

Conclusions:

There was an association between gastric volume and comorbidities, but there was no association between gastric contents and comorbidities. There was an association between gastric contents and gender, but there was an association between gastric volume and gender.
Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries
Authors: Qureshi Sana , Mathur Veena , Singh Maina , Garg Deepak Kumar , Kumar Pradeep , Jonwal Kuldeep
Published: December 2023

Background and Aims:

Brachial plexus block is a widely used approach for upper limb surgeries as an alternative to general anesthesia to achieve ideal operating conditions by providing adequate muscle relaxation and maintaining intraoperative hemodynamic stability. Ultrasound-guided supraclavicular brachial plexus block provides intraoperative anesthesia and postoperative analgesia. It reduces many complications such as intravascular injection pneumothorax. Levobupivacaine is preferable over bupivacaine due to its lower cardiotoxicity, prolonged sensory block, and shorter duration of motor block.

Materials and Methods:

A prospective, hospital-based, double-blinded, randomized, controlled, comparative study was planned on 80 adult patients of either sex belonging to the American Society of Anesthesiologists Class 1 and 2 undergoing upper limb orthopedic surgeries. Group L – 24 mL levobupivacaine 0.375% (90 mg) + NS (1 mL) (total volume 25 mL) and Group LN – 24 mL levobupivacaine 0.375% (90 mg) +5 mg nalbuphine diluted with NS to 1 mL volume (total volume 25 mL). Duration of analgesia, onset, and duration of sensory block and motor block, hemodynamic changes, and total doses of rescue analgesia in 24 h were noted in both groups.

Results:

The duration of analgesia was significantly longer in Group LN (749.80 ± 9.70 min) as compared to Group L (641.20 ± 12.71 min) (P < 0.001). Onset of sensory block in Group LN (11.15 ± 0.83 min) is faster than in Group L is (13.30 ± 0.52 min) (P < 0.001). Onset of motor block in Group LN (13.68 ± 0.73 min) is faster than in Group L (16.33 ± 0.89 min) (P < 0.001). Hemodynamic parameters were comparable in both groups. There was no significant difference in adverse effects and complications.

Conclusion:

The addition of nalbuphine to levobupivacaine provides a longer duration of analgesia as compared to levobupivacaine alone.
Effectiveness of norepinephrine versus phenylephrine intravenous boluses for the treatment of hypotension in elective lower-segment cesarean section under spinal anesthesia: A randomized controlled, double-blind study
Authors: Jain Neena , Chatterjee Bidisha , Patodi Veena , Kumar Pradeep , Garg Deepak Kumar
Published: December 2023

Background and Aim:

Hypotension following spinal anesthesia is a common adverse effect during caesarean sections, with potentially harmful consequences for both the mother and the fetus. While phenylephrine is the current first-line treatment for maternal spinal hypotension during obstetric anesthesia, norepinephrine has been proposed as a possible alternative due to its weaker b-agonist-mediated positive chronotropic action. However, there is a lack of comparative data on the safety and efficacy of these two drugs in obstetric anesthesia. This study aimed to compare the number of bolus doses of phenylephrine and norepinephrine required to treat hypotension after spinal anesthesia in lower segment caesarean sections, as well as to evaluate maternal and fetal outcomes in both groups, including complications.

Materials and Method:

A prospective double-blinded randomized controlled trial was conducted, The study included 60 term parturients between the ages of 18 and 40, who had singleton pregnancy and were categorized as American Society of Anaesthesiologists (ASA) physical class II, and who were scheduled for elective caesarean section under spinal anesthesia. the parturients were randomized into two groups: Group N and Group P. Group P patients received an intravenous dose of phenylephrine 100 µg, while Group N patients received an intravenous dose of 8 µg whenever the systolic arterial pressure dropped below 20% of the baseline.primary objective was number of intravenous drugs required to treat spinal hypotension, secondary objective were incidence of maternal and foetal Complications. The data was collected on a form and entered into Excel. Statistical analysis was done using Epi Info 7.2.1.0 for Windows. The Kolmogorov-Smirnov test was used to check normality. Mean and standard deviation or median and range were used to present numerical data, while frequency and percentage were used for categorical data. T-tests compared quantitative variables, and Chi-square tests compared categorical data. Two-tailed tests were used, and a P-value of <0.05 was considered significant.

Result:

The patient’s demographic profile was comparable in both groups.T he number of bolus doses of study drug required to treat spinal hypotension was significantly lower in Group N versus P (1.50 ± 0.57 vs. 2.13 ± 0.73, p =0.001)Incidence of bradycardia was more in group P, but not statistically significant. Other maternal complications like bradycardia, hypertension, nausea, vomiting, shivering were comparable in both groups.

Conclusions:

According to our study, Intermittent boluses of norepinephrine were effective in the management of spinal-induced hypotension during caesarean section. Norepinephrine boluses can thus be considered as an alternative to phenylephrine boluses.
Prospective comparative analysis of intraoperative and postoperative anesthetic and analgesic effect of ultrasound-guided pectoral with serratus anterior plane block versus thoracic paravertebral versus erector spinae blocks in breast oncosurgeries
Authors: Kangle Sameer , Dudhedia Ujjwalraj , Pradhan Amol Shashikumar , Nair Abhijit Sukumaran
Published: December 2023

Aims and Objectives:

Different regional anesthetic techniques have been described and are frequently used in breast cancer surgeries to provide efficient pain management and reduce the use of opioids. This study’s main goal was to use pain scores to compare the postoperative analgesic effectiveness of pectoral nerve (PECS 1) block with serratus anterior plane (SAP) block, thoracic paravertebral (TPV) block, and erector spinae plane (ESP) block. Comparing the needs for intraoperative analgesia and postoperative anesthesia was one of the secondary goals.

Methods:

After institutional ethical committee approval and after prospectively registering this trial with the Clinical Trials Registry of India, 25 patients were randomized and enrolled in each group (Group 1 – PECS 1 and SAP block, Group 2 – TPV group, and Group 3 – ESP group). Standard general anesthesia was administered to all the patients and the blocks, as per randomization were performed before anesthesia induction.

Results:

The demographic characteristics, intraoperative opioid and sevoflurane consumption, and requirement of rescue analgesia were comparable between the three groups. Pain scores at 0 and 6 h were significantly less in the TPV group when compared to the ESP group and PECS 1 with the SAP group (P= 0.005 andP= 0.006, respectively). Pain scores at 12 and 24 h were comparable between three groups.

Conclusion:

TPV block provides significantly better pain scores at 0 and 6 h, with comparable pain scores at 12 and 24 h, compared to PECS 1 with SAP block and ESP block with comparable adverse events.
Congenital anomalies of lens shape
Authors: Bhate Manjushree , Motwani Divya , Murthy Somasheila I. , Fernandes Merle
Published: December 2023

The crystalline lens is an important structure in the eye that starts to develop as early as the 22nd day of gestation, with further differentiation that continues after the induction. Congenital anomalies of the lens may involve the size, shape, and position of the lens. They may sometimes be associated with anterior segment dysgenesis or persistence of the tunica vasculosa lentis and hyperplastic vitreous and hyaloid system. Manifestations of anomalies of the lens shape are usually seen in early or late childhood however may sometimes be delayed into adulthood based on the level of visual impairment or the presence or absence of any syndromic associations. While lens coloboma has more often been reported in isolation, the more commonly implicated genes include the PAX6 gene, lenticonus in particular anterior is often part of Alport syndrome with extra-ocular manifestations in the kidneys and hearing abnormalities due to mutations in the alpha 5 chain of the Type IV collagen gene. Recognition of these manifestations and obtaining a genetic diagnosis is an important step in the management. The level of visual impairment and amblyopia dictates the outcomes in patients managed either conservatively with optical correction as well as surgically where deemed necessary. This review discusses the various anomalies of the lens shape with its related genetics and the management involved in these conditions.