bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Efficacy of Intubation with HugeMed Non-channelled Video Laryngoscope, McCoy and Macintosh Laryngoscope in Simulated Difficult Laryngoscopy Using Rigid Cervical Collar: A Prospective Randomized Trial
Authors: Murdeshwar Greeshma N. , Yashodha V. , Poolandevi Kempaiah , Malini S.
Published: April 2024

Background and Aims:

In cervical spine injuries, there is an impairment in positioning of the patient to maintain the airway axis during endotracheal intubation (ETI). Literature shows video laryngoscope (VLS) facilitating the intubation in these patients with cervical immobilization. VL3 VLS (HugeMed Medical Technical Development, Shenzhen, China) is a newer VLS with limited studies. The primary aim of this study is to compare the efficacy of ETI using VL3 VLS with Macintosh and McCoy (MC) blades for simulated difficult airway with rigid cervical collar (RCC). The secondary aim was to compare the oral insertion of laryngoscope and intraoral bleeding.

Methods:

One hundred and fifty patients were randomly divided into three groups depending on laryngoscope used for ETI. Group M, Group V, and Group MC used Macintosh, VL3, and MC laryngoscopic blades, respectively, for ETI. During ETI, the Intubation Difficulty Scale (IDS), intubation time (IT), ease of laryngoscope insertion, and any bleeding intraorally were noted. The data collected were further analyzed.

Results:

IDS was statistically significantly least (0.9 ± 1.5) with VL3 VLS compared to direct laryngoscopy with Macintosh and MC blades. There was significantly no difference in IT among the three groups. Insertion of blade of VL3 was significantly more difficult than Macintosh or MC. Intraoral bleeding was present in 8% of patients with VL3.

Conclusion:

VL3 VLS can be used for ETI during cervical immobilization using RCC. More studies are needed to define its efficacy in different difficult airway situations compared with different VLS.
Transesophageal Echocardiography-Guided Elephant Trunk Procedure for Repair of Descending Thoracic Aorta: A Case Report
Authors: Egawa Atsushi
Published: April 2024

The elephant trunk procedure, an endovascular strategy for retrograde type A acute aortic dissection, is associated with several complications, hemolytic anemia being a rare one. We performed endovascular stent-graft insertion in a patient who developed hemolytic anemia. Transesophageal echocardiography (TEE) detected turbulent jet flow and stenosis position, which was not detected by angiography and intravascular ultrasound (IVUS). This imaging technique proved effective for malperfusion diagnosis and enabled us to confirm its resolution after the endovascular procedure. Intraoperative TEE is a useful adjunct to angiography and IVUS for diagnosis and therapeutic assessment during endovascular repair of a stenosed elephant trunk.
Evaluation of Postoperative Pain After Cardiothoracic Surgery in Patients With and Without Significant Preoperative Anxiety: A Prospective Observational Study
Authors: Shreya Agarwal , Rath Durga P. , Parida Satyen , Munuswamy Hemachandren , Prasad Sreevathsa , Padmanabhan Ramsankar
Published: April 2024

Background and Aims:

Anxiety plays a distressing role in cardiothoracic operations. It may trigger hemodynamic instability, increased morbidity, and very crucially, postoperative pain and analgesic use. Our aim is to look at the association between anxiety, postoperative pain, and analgesic use.

Materials and Methods:

One hundred and twenty-two patients scheduled for cardiothoracic surgeries were asked questions according to the Amsterdam Preoperative Anxiety and Information Scale (APAIS), the evening prior to the surgery. Different factors that could affect anxiety perioperatively were recorded through the patient’s hospital records. The visual analog score (VAS) was recorded at arrival in the ICU after surgery. Paracetamol (1 g) and Inj Tramadol (1 mg/kg) were administered as postoperative analgesia. Additional fentanyl boluses (1 mcg/kg) were administered whenever the VAS exceeded 4. Analgesic doses were documented. All the data were then analyzed statistically.

Results:

Preoperative anxiety was recorded in 63.9% of the 122 subjects included in the study, with younger patients and patients with very low socioeconomic status being the majority. VAS, at 20 and 24 hrs of assessment, was higher in both groups, and there was a statistically significant difference, with patients that were preoperatively anxious, recording higher VAS scores. Postoperative analgesic doses were also significantly higher for patients with anxiety.

Conclusions:

This clinical trial demonstrated that greater than 60% of the participants presented with preoperative anxiety, the majority being young participants. Lower socioeconomic status is also a risk factor for preoperative anxiety. Patients who suffered from preoperative anxiety are more likely to have greater pain scores and analgesic needs during postsurgical assessment.
Early Quality of Recovery after Elective Cardiothoracic and Aortic Surgeries in Adult Patients: A Pilot Report
Authors: Ishida Ayu , Ida Mitsuru , Kinugasa Yuki , Nakatani Hitomi , Uyama Kayo , Kawaguchi Masahiko
Published: April 2024

Background:

Patient-centered outcome measures should be evaluated postoperatively as the recovery after surgery varies between patients. We aimed to evaluate the feasibility, reliability, and trajectory of the quality of recovery-15 (QoR-15) in patients undergoing cardiothoracic and aortic surgeries.

Materials and Methods:

This retrospective study included adult patients who underwent elective cardiothoracic and aortic surgeries. The primary outcome was the QoR-15, with a minimal clinically important difference of 6.8, assessed on postoperative days (POD) 2, 4, and 7. The final analysis included patients with at least one valid outcome. Feasibility and reliability were assessed by the successful completion rate on each POD and using Cronbach’s alpha of the QoR-15 on POD 4. A linear mixed model was used to evaluate the trajectory of the postoperative QoR-15 scores.

Results:

Of the 36 eligible patients, 30 with a mean age of 70 years were included in the final analysis. The successful completion rates on POD 2, 4, and 7 were 72.7%, 87.8%, and 87.8%, respectively. The mean QoR-15 scores on POD 2, 4, and 7 were 89.9, 98.0, and 108.3, respectively. The QoR-15 scores on POD 2 and 4 were not statistically different (P = 0.06) but were clinically significant. The QoR-15 score on POD 7 was statically (P < 0.001) and clinically higher than the QoR-15 score on POD 2. Cronbach’s alpha for the QoR-15 score measured on POD 4 was 0.85.

Conclusion:

The QoR-15 is a feasible and valid measurement after elective cardiothoracic surgery, which increases significantly over time after surgery.
Morning or Afternoon Scheduling for Elective Coronary Artery Bypass Surgery: Influence of Longer Fasting Periods from Metabolic and Hemodynamic Perspectives
Authors: Santonocito Cristina , Cassisi Cesare , Chiarenza Federica , Caruso Alessandro , Murabito Paolo , Maybauer Marc O. , George Shane , Sanfilippo Filippo
Published: April 2024

Background:

Prolonged preoperative fasting may worsen postoperative outcomes. Cardiac surgery has higher perioperative risk, and longer fasting periods may be not well-tolerated. We analysed the postoperative metabolic and hemodynamic variables in patients undergoing elective coronary artery bypass grafting (CABG) according to their morning or afternoon schedule.

Methods:

Single-centre retrospective study at University teaching hospital (1-year data collection from electronic medical records). Using a mixed-effects linear regression model adjusted for several covariates, we compared metabolic (lactatemia, pH, and base deficit [BD]) and haemodynamic values (patients on vasoactive support, and vasoactive inotropic score [VIS]) at 7 prespecified time-points (admission to intensive care, and 1st, 3rd, 6th, 12th, 18th, and 24th postoperative hours).

Results:

339 patients (n = 176 morning, n = 163 afternoon) were included. Arterial lactatemia and BD were similar (overall P = 0.11 and P = 0.84, respectively), while pH was significantly lower in the morning group (overall P < 0.05; mean difference −0.01). Postoperative urine output, fluid balance, mean arterial pressure, and central venous pressure were similar (P = 0.59, P = 0.96, P = 0.58 and P = 0.53, respectively). A subgroup analysis of patients with diabetes (n = 54 morning, n = 45 afternoon) confirmed the same findings. The VIS values and the proportion of patients on vasoactive support was higher in the morning cases at the 18th (P = 0.002 and p=0.04, respectively) and 24th postoperative hours (P = 0.003 and P = 0.04, respectively). Mean intensive care length of stay was 1.94 ± 1.36 days versus 2.48 ± 2.72 days for the afternoon and morning cases, respectively (P = 0.02).

Conclusions:

Patients undergoing elective CABG showed similar or better metabolic and hemodynamic profiles when scheduled for afternoon surgery.
Incidence and Risk Factors for Postoperative Visual Loss after Cardiac Surgical Procedures: A Systematic Review
Authors: Gupta Bhavna , Singla Deepak , Gupta Anish , Mahaseth Ranjay
Published: April 2024

Postoperative visual loss (POVL) is an infrequent yet consequential complication that can follow cardiac surgical interventions. This systematic review aims to provide a comprehensive analysis of the incidence of POVL after cardiac surgery and to delineate the associated risk factors. A comprehensive search was conducted in major medical databases for relevant studies published up to September 2022. Eligible studies reporting on the incidence of POVL and identifying risk factors in patients undergoing cardiac surgery were included. Data extraction was performed independently by two reviewers. The pooled incidence rates and the identified risk factors were synthesized qualitatively. POVL after cardiac surgery has an overall incidence of 0.015%, that is, 15 cases per 100,000 cardiac surgical procedures. Risk factors for POVL include patient characteristics (advanced age, diabetes, hypertension, and preexisting ocular conditions), procedural factors (prolonged surgery duration, cardiopulmonary bypass time, and aortic cross-clamping), anesthetic considerations (hypotension, blood pressure fluctuations, and specific techniques), and postoperative complications (stroke, hypotension, and systemic hypoperfusion). Ischemic optic neuropathy (ION) is an uncommon complication, associated with factors like prolonged cardiopulmonary bypass, low hematocrit levels, excessive body weight gain, specific medications, hypothermia, anemia, raised intraocular pressure, and micro-embolization. Diabetic patients with severe postoperative anemia are at increased risk for anterior ischemic optic neuropathy (AION). Posterior ischemic optic neuropathy (PION) can occur with factors like hypertension, postoperative edema, prolonged mechanical ventilation, micro-embolization, inflammation, hemodilution, and hypothermia.

While the overall incidence of POVL postcardiac surgery remains modest, its potential impact is substantial, necessitating meticulous consideration of modifiable risk factors. Notably, prolonged surgical duration, intraoperative hypotension, anemia, and reduced hematocrit levels remain salient contributors. Vigilance is indispensable to promptly detect this infrequent yet visually debilitating phenomenon in the context of postcardiac surgical care.
Anesthetic Considerations in Combined TAVR and Aortic Endovascular Procedures, a Case Report
Authors: Zaccarelli Mario , Testa Tarek S. , Buscaglia Giuseppe , Pratesi Giovanni , Crimi Gabriele , Balbi Manrico , Gregorio Sara Di , Silvetti Simona
Published: April 2024

We report a case of simultaneous transcatheter aortic valve replacement and endovascular aneurysm repair. Our aim was to advocate the role of local and regional anesthesia as a key contributor in maintaining hemodynamic stability and avoiding abrupt blood pressure change. Endovascular combined procedures are gaining popularity for their numerous advantages. Nevertheless, they carry significant risks for their hemodynamic implications. It is imperative to acknowledge the modifications occurring after each correction and act accordingly. Different anesthesia approaches can dramatically influence hemodynamics; among all, we found local and regional anesthesia would better serve this objective.
Revisiting Friedreich’s Ataxia: Phenotypic and Imaging Characteristics
Authors: Mahale Rohan , Purushottam Meera , Singh Raviprakash , Yelamanchi Ramachandra , Kamble Nitish , Holla Vikram , Pal Pramod K. , Jain Sanjeev , Yadav Ravi
Published: April 2024

Background and Aim:

Friedreich’s ataxia (FRDA) is a common cause of autosomal recessive cerebellar ataxia. The phenotype is dependent on the repeat size and duration of the disease. We aimed to study the clinical, electrophysiologic, and radiologic profiles in a large Indian cohort of genetically proven FRDA patients.

Subjects and Methods:

A retrospective cross-sectional, descriptive analysis of genetically proven FRDA patients was performed. A detailed review of all the hospital case records was done to analyze the clinical, radiologic, and electrophysiologic details.

Results:

A total of 100 FRDA patients were selected for the analysis. Eighty-six patients had an age at onset between 5 and 25 years. Eight patients (8%) were classified as late-onset FRDA and six patients (6%) as early-onset FRDA. The median age at presentation was 19 years. The median age at onset was 14 years, and the median duration of illness was 4 years. All patients had gait ataxia as the initial symptom. Gait ataxia, loss of proprioception, and areflexia were seen in all patients. Dysarthria, nystagmus, amyotrophy, spasticity, extensor plantars, pes cavus, and scoliosis occurred in one-third of patients. Cardiomyopathy (18%) and diabetes (5%) were less common. Sensory polyneuropathy (87.5%) was the most common nerve conduction abnormality. Cortical somatosensory evoked responses were absent in all 43 tested patients (100%). Brainstem auditory evoked response test was done in 24 patients and it showed absent reactions in six patients (25%). Visual evoked potential was tested in 24 patients and it showed absent P100 responses in five patients (21%). Cerebellar and cord atrophy was seen on magnetic resonance imaging in 50% of patients.

Conclusion:

Most FRDA patients (86%) had an age at onset of less than 25 years, with typical symptoms of gait ataxia, areflexia, and loss of proprioception found in all patients. Dysarthria, nystagmus, amyotrophy, spasticity, extensor plantars, pes cavus, scoliosis, cardiomyopathy, and diabetes were not seen in all patients. Cerebellar atrophy can occur in FRDA patients. Knowledge regarding the clinical, radiologic, and electrophysiologic profile of FRDA will aid in proper phenotypic characterization.
Endovascular Treatment for Cerebral Venous Sinus Thrombosis: Comparison among Different Endovascular Procedures
Authors: Rangarajan Anush S , Ramachandran Dileep , Mishra Tanaya , Gunaseelan Vikneshwaran , Dash Gopal K. , Philip Vivek J. , Manohar Radhika , Shetty Kuldeep , Thomas Pavin , Huded Vikram
Published: April 2024

Background:

Cerebral venous sinus thrombosis (CVST) is a rare, treatable cause of stroke. Even though CVST has an established medical treatment, 15% of patients remain refractory to treatment. These patients may be candidates for endovascular treatment (EVT), yet the selection of patients remains a challenge. The study aims to understand the profile and outcome of patients treated with EVT and the type of procedure associated with good outcomes.

Methods:

This is a single-center, retrospective analysis of CVST patients who underwent EVT from 2009 till 2022. Patients who received only medical management were excluded. Modified Rankin Scale (mRS) ≤2 at 3 months was taken as the primary outcome. Secondary outcomes assessed were hospital stay, death, recurrence, mRS ≤ 2 at discharge, and angiographic recanalization.

Results:

Fifty-two patients were included. Twenty-eight (53.8%) were males; the mean age was 33.3 ± 12.3 years. Headache (n = 44, 84.6%) predominated among the symptoms. The common risk factors were anemia (n = 13, 25.5%) and hyperhomocysteinemia (n = 13, 25.5%). Worsening of sensorium (n = 21, 40.3%) and non-improvement of symptoms (n = 15, 28.8%) were the common indications for the procedure. Twenty-five (48.1%) people underwent in situ thrombolysis (IST). Death occurred in eight (15.3%) patients. Thirty-six (73.5%; 36/49) patients had a good outcome at 3 months. IST had a significantly better outcome (mRS ≤ 2, n = 20, 80%) compared to other procedures (P = 0.04). Hospital stay was lesser in the IST subgroup, but without statistical significance. Midline shift >5 mm (odds ratio [OR] 6.8 [1.5–30.9], P = 0.01) and Glasgow Coma Scale <9 before the procedure (OR 27.2 [3.1–236.4], P = 0.002) predicted bad outcomes at 3 months. Female gender (OR 4.5 [1.07–8.8], P = 0.03), presence of altered sensorium (OR 10.2 [1.2–87.5], P = 0.01), encephalopathic syndrome (P = 0.02), presence of parenchymal bleed (OR 3.7 [0.9–4.5], P = 0.04), and midline shift (OR 4.8 [1.1–20.2], P = 0.03) were associated with poor outcome at discharge.

Conclusion:

EVT yielded good outcomes in carefully selected, medically refractory patients of CVST. IST performed well compared to other procedures.
Network meta-analysis of combination strategies in metastatic hormone-sensitive prostate cancer
Authors: Wang Shan-Shan , Bian Xiao-Jie , Wu Jun-Long , Wang Bei-He , Zhang Sheng , Ye Ding-Wei
Published: April 2024

This study compared different doublet and triplet therapies for efficacy and safety in metastatic hormone-sensitive prostate cancer (mHSPC). PubMed, EMBASE, and the Cochrane Library were comprehensively searched for eligible randomized controlled trials (RCTs) published from inception to October 2023. Interventions included abiraterone, apalutamide, enzalutamide, docetaxel, darolutamide, and androgen deprivation therapy (ADT), either as doublet or triplet therapies. The outcomes examined were overall survival (OS), progression-free survival (PFS), castration-resistant prostate cancer (CRPC)-free survival, time to symptomatic skeletal event (SSE), and toxicity. The surface under the cumulative ranking curve (SUCRA) was determined to identify the preferred treatments. Ten RCTs were included. The combination of darolutamide, docetaxel, and ADT had the highest SUCRA of 84.3 for OS, followed by combined abiraterone, docetaxel, and ADT (SUCRA = 71.6). The highest SUCRAs for PFS were observed for triplet therapies (abiraterone, docetaxel, and ADT [SUCRA = 74.9], followed by enzalutamide, docetaxel, and ADT [SUCRA = 74.3]) and other androgen receptor axis-targeted therapy-based doublet therapies (SUCRAs: 26.5–59.3). Darolutamide, docetaxel, and ADT had the highest SUCRAs, i.e., 80.8 and 84.0 regarding CRPC-free survival and time to SSE, respectively. Regarding Grade >3 adverse events (AEs), the SUCRAs of triplet therapies (SUCRAs: 14.8–31.5) were similar to that of docetaxel and ADT (SUCRA = 39.5). Three studies had a low risk of bias in all categories; the remaining studies had at least an unclear risk of bias in at least one category. Triplet therapy demonstrated potentially enhanced effectiveness than doublet therapy in mHSPC, with acceptable safety concerns. Darolutamide might be the optimal option for triplet therapy in combination with docetaxel and ADT.
Effect of bonding pericervical dentin with reinforcing materials on strength of root-filled mandibular single-canal premolars: An in vitro study
Authors: Sharma Manisha , Mathew Tony , Kaur Gurmeen
Published: April 2024

Aim:

The present study examined the effect of bonding the pericervical dentin using resin-modified glass-ionomer cement (RMGIC), nanohybrid composite (Endure Nano), and Biodentine on the fracture resistance of root-filled mandibular premolars.

Methods:

Twenty-four human single-rooted mandibular premolars were decoronated, cleaned, and shaped with ProTaper Universal till size F3. The roots were obturated with gutta-percha using a single-cone technique. The teeth were randomly grouped into four groups of n = 6 each. After removing the 3 mm coronal gutta-percha in Groups I, II, and III, the intra-orifice barriers of RMGIC, nanohybrid composite (Endure Nano), and Biodentine were placed, respectively. Group IV served as the control. The fracture resistance of the specimens was analyzed using the universal testing machine. The derived data were statistically evaluated using one-way ANOVA and post hoc Tukey’s honestly significant difference test.

Results:

A significantly high fracture strength was exhibited by specimens of Group I, followed by Groups II and III, respectively. The lowest fracture strength was shown by the control group.

Conclusion:

Within the limitation of the present study, the fracture resistance of an endodontically treated tooth was significantly influenced by the type of intra-orifice barrier.
Surgical Repair of Atrial Septal Defect in a Patient with 3-Methylcrotonyl-CoA Carboxylase Deficiency
Authors: Alhamoud Nawarah , Alhussaini Omar , Dawary Mohannad A. , Khouqeer Fareed
Published: April 2024

3-Methylcrotonyl-CoA carboxylase (3-MCC) deficiency is a rare autosomal recessive disease of leucine catabolism. 3-MCC deficiency may lead to metabolic decompensation under stress; however, outcomes of elective surgery requiring cardiopulmonary bypass (CPB) are unknown. We report a 4-year-old girl with asymptomatic 3-MCC deficiency and atrial septal defect (ASD) who’s undergone surgical ASD repair under CPB. She was otherwise normal developmentally and medically. Although patients with 3-MCC may face metabolic crises, the ASD repair under CPB was uneventful.
K-clip™, a Novel Transcatheter Treatment in Patients with Severely Tricuspid Regurgitation
Authors: Ding Jiandong , Xu Rongfeng , Zhang Xiaoli , Ma Genshan
Published: April 2024

Patients who suffer from severe tricuspid regurgitation (TR) and who are at high surgical risk have no standard care therapy. Therefore, minimally invasive and safer methods are sought. K-clip™, the first ultrasound-positioned interventional tricuspid annuloplasty instrument intended for percutaneous transcatheter repair. We report a patient with severe functional TR and high surgical risk who underwent K-clip™ tricuspid annuloplasty under echocardiography and fluoroscopy guidance.
Perioperative adverse cardiac events in maxillofacial surgery: A systematic review and meta-analysis
Authors: Chohan Mehak , Liu Winnie , Chowdhury Tumul
Published: April 2024

Background and Aims:

Maxillofacial surgeries, including procedures to the face, oral cavity, jaw, and head and neck, are common in adults. However, they impose a risk of adverse cardiac events (ACEs). While ACEs are well understood for other non-cardiac surgeries, there is a paucity of data about maxillofacial surgeries. This systematic review and meta-analysis report the incidence and presentation of perioperative ACEs during maxillofacial surgery.

Methods:

We included primary studies that reported on perioperative ACEs in adults. To standardise reporting, ACEs were categorised as 1. heart rate and rhythm disturbances, 2. blood pressure disturbances, 3. ischaemic heart disease and 4. heart failure and other complications. The primary outcome was ACE presentation and incidence during the perioperative period. Secondary outcomes included the surgical outcome according to the Clavien–Dindo classification and trigeminocardiac reflex involvement. STATA version 17.0 and MetaProp were used to delineate proportion as effect size with a 95% confidence interval (CI).

Results:

Twelve studies (34,227 patients) were included. The incidence of perioperative ACEs was 2.58% (95% CI 1.70, 3.45, I
2 = 96.17%, P = 0.001). Heart rate and rhythm disturbances resulted in the greatest incidence at 3.84% among the four categories. Most commonly, these ACEs resulted in intensive care unit admission (i.e. Clavien–Dindo score of 4).

Conclusion:

Despite an incidence of 2.58%, ACEs can disproportionately impact surgical outcomes. Future research should include large-scale prospective studies that may provide a better understanding of the contributory factors and long-term effects of ACEs in patients during maxillofacial surgery.
Comparison of genicular nerve block with adductor canal block for postoperative pain management in patients undergoing arthroscopic knee ligament reconstruction: A randomised controlled trial
Authors: Sujatha Sandeep S. N. , Gupta Kapil , Guria Sushil , Chhabra Priyanka H.
Published: April 2024

Background and Aims:

Genicular nerve block (GNB) is beneficial in early ambulation and faster patient discharge since it selectively blocks articular branches and is motor-sparing. This study aimed to compare the analgesic efficacy of ultrasound (US)-guided GNB with adductor canal block (ACB) in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR).

Methods:

This randomised, double-blind study was conducted on 38 adults undergoing arthroscopic ACLR. Patients in Group GNB (n = 19) received US-guided GNB with 3 ml of 0.25% bupivacaine and 2 mg dexamethasone. Patients in Group ACB (n = 19) received US-guided ACB with 20 ml of 0.25% bupivacaine with 6 mg dexamethasone. Postoperative rescue analgesia was provided by intravenous Patient Controlled Analgesia (PCA) with morphine. The primary outcome was Numerical Rating Scale (NRS) pain scores over 24 h. The secondary outcome was the duration of analgesia and 24-h morphine consumption. The Chi-square test was used to test the statistical significance between categorical variables. Independent t-test or Mann–Whitney U test was used to compare continuous variables.

Results:

NRS scores at rest and physical activity at 24 h were similar in both the groups (P = 0.429 and P = 0.101, respectively). The mean time to rescue analgesia was comparable in both groups (Group GNB: 820.79 [483.65] min [95% confidence interval {CI}: 603.31–1038.27] and Group ACB: 858.95 [460.06] min [95% CI: 652.08, 1065.82], P = 0.805), and the mean 24-h morphine consumption was also comparable in both groups (P = 1.000).

Conclusion:

US-guided GNB has an analgesic efficacy similar to US-guided ACB for patients undergoing arthroscopic ACLR.
Juvenile psammomatoid ossifying fibroma: A case report and a review of the literature
Authors: Bala Mujtaba , Braimah Ramat Oyebunmi , Taiwo Abdurrazaq Olanrewaju , Aliyu Salihu , Alani Yekini Lateef
Published: April 2024

Juvenile psammomatoid ossifying fibroma (OF) is a rare histological variant of OF with aggressive behavior. It is a benign fibro-osseous lesion with a high rate of recurrence. It occurs mainly in male children with paranasal sinuses and orbits the most common sites. The diagnosis depends on clinical, radiologic, and pathologic correlation. This study aims to present a case report of juvenile psammomatoid OF (JPOF) in a 9-year-old boy and to also review the relevant literature. A case of a 9-year-old boy who presented with a 1-year history of the left maxillary swelling was presented. There was no associated history of pain, ulceration, bleeding, or teeth mobility. There was no history of previous trauma to the site or teeth extraction. The patient had no difficulty in chewing, speaking, nasal blockage, or discharge. Examination revealed an ovoid left maxillary buccal mass measuring about 4 cm × 3 cm, which was hard, nontender with no teeth mobility. The diagnosis of JPOF made was confirmed through a combination of clinical, radiological, and histopathological findings. The patient had enucleation of the lesion under general anesthesia. Follow-up was satisfactory with no recurrence. JPOF is a rare histological variant of OF that is known to exhibit a high rate of recurrence. Although clinical and radiological features contribute to its diagnosis, histopathological examination has been the main diagnostic modality. Early detection and treatment are essential.
Role of Artificial Intelligence in Transforming Public Health Dentistry: A narrative review
Authors: Sulthana DS Gazala , Sapna B , Yavagal Puja C
Published: April 2024

Artificial intelligence (AI) has the ability to process huge datasets, disclose human essence computationally, and perform tasks like humans as technology advances. Because of the necessity for precise diagnosis and improved patient care, AI technology has greatly influenced the health-care industry and dental public health. This narrative review summarizes the important applications of AI in the specialty of dentistry and public health dentistry. A literature review through various databases such as Web of Science, PubMed, Scopus, Cinahl, Google Scholar, Embase, Science Direct, and Directory of Open Access Journals was done. Results of the review highlight the scope of AI from the patient observation, examination, and collection of patient information to the interpretation of the information obtained from the patient on the basis of the clinician’s knowledge and experience, formulation of a diagnosis and treatment plan for various clinical conditions, telemedicine and remote patient monitoring, Dental Therapeutics, Care navigation for self-triage of patients, Maintaining Electronic health records and also in Evidence synthesis for policy, clinical decision making and public health literacy. However, its flaws include system complexity, Costly setup, need for adequate training, and data snooping bias. Still, there exists a scope for AI to come a long way in the domains of public health dentistry nevertheless, the human element must never be dismissed.
The association of geographic tongue and epilepsy
Authors: Sadrabad Maryam Jalili , Yazdandoost Mehran , Maleki Sahar
Published: April 2024

Objectives:

Geographic tongue (GT) is enclosed circular plaques with margins of yellowish-white lines. It usually occurs in the anterior two-thirds of the dorsal and ventral surfaces of the tongue. The purpose of this research is to investigate the prevalence of GT and some related factors in Semnan Dental Faculty in 2022.

Materials and Methods:

In this cross-sectional descriptive study, the files of 1000 patients were examined in terms of frequency of GT and suspected related factors such as age, sex, smoking, diabetes, epilepsy and seizures, gastrointestinal problems, thyroid problems, blood pressure, liver disease, anemia, cardiovascular disease, and coagulation diseases.

Results:

63.6% of patients were women, and 36.4% were men (age range of 15–78 years). 27.7% had at least one systemic disease. 80 (8%) patients had GT, which had a 4.8 times chance of occurrence in patients with epilepsy and seizures with a significant relationship. However, there was no significant relationship between gastrointestinal problems, thyroid problems, blood pressure, diabetes, liver disease, anemia, cardiovascular disease, and coagulation diseases.

Conclusion:

The relationship between GT and epilepsy and seizures shows the need for periodic examinations of the mouth and especially the tongue by dentists to help in the timely diagnosis of systemic diseases.
Halting the Progression of Cicatricial Alopecia with Injectable Platelet-Rich Fibrin
Authors: Chikhalkar Siddhi Bhalchandra , Singh Surender , Shah Avani Jatin Kumar , Madke Bhushan , Kabbannavar Yallappa Ramchandrappa
Published: April 2024

Discoid lupus erythematosus (DLE) is a chronic variant of cutaneous lupus erythematosus characterized by well-defined erythematous plaques with adherent scales and follicular plugging. The affected scalp shows erythema, edema, atrophy, alopecia, and telangiectasia. Trichoscopy of DLE shows branching capillaries, white patches, keratin plugs, reduced follicular ostia, and white dots and blue-gray dots arranged in speckles pattern. Prompt diagnosis and aggressive, early multimodal therapy helps in preventing disfiguring hair loss and psychosocial sequelae. Hereby, we present a case of reversal of hair loss in DLE with newer modalities of treatment such as injectable platelet-rich fibrin.
Photodistributed Lichenoid Eruption with Alopecia: A Unique Presentation of Graham–Little–Piccardi–Lasseur Syndrome
Authors: Ambur Austin , Bhukhan Aashni , Dunn Charles , Nathoo Rajiv
Published: April 2024

Graham–Little–Piccardi–Lasseur syndrome (GLPLS) is characterized by diffuse alopecia and a lichenoid follicular eruption affecting the scalp, eyebrows, and intertriginous regions. It is considered a variant of lichen planopilaris. The condition often begins as hyperkeratotic papules on the trunk and extremities followed by the development of alopecia. Several subtypes of lichen planus have been associated with a photodistriubuted eruption including lichenoid drug reactions, actinic lichen planus, and lichen planus pigmentosus; however, there are no reported cases associated with GLPLS. We herein report the first case of GLPLS displaying a photodistributed lichenoid eruption to expand upon the differential diagnosis of photoaggravated conditions. We also use this case to review the pathophysiology and therapeutic modalities to manage GLPLS.
Management of pediatric sensory neural hearing loss: a case report
Authors: Singh Abhishek , Paudel Pratima , Fiaz Shamsa
Published: April 2024

Early childhood is the age of learning and experiencing various things through hearing or seeing. Any abnormality in hearing in this age group makes the child dull and self-isolating, affecting his morale. This is a case of an 8-year-old boy with deficient hearing from both ears, which was left unnoticed until the age of 5 years. There is no similar family history. The antenatal and neonatal history was found to be normal, but the child used to get fever and upper respiratory tract infection very frequently. The patient was taken for an otorhinology consultation after being noticed nonresponsive to moderately loud sounds and calls from behind. Otologic investigations—brain-evoked response audiometry and distortion product otoacoustic emissions—revealed bilateral mild-to-moderate hearing loss. Ayurveda treatment was given with 8 months of follow-up, and investigations were recorded. The aim of this report was to analyze a case of sensorineural hearing loss (SNHL) in a pediatric age group and its management through Ayurveda. The site of this study was the National Institute of Ayurveda Hospital, Jaipur, and this is a single-case report. All the relevant history was taken, followed by the investigations required for the case. Since the patient was a minor, consent was obtained from his father for the publication of this case report. For the conceptual part, various textbooks and research papers on Ayurveda and allopathy available online and offline were referred to. The patient was advised to go for speech therapy along with the Ayurvedic treatment Karnapoorana and other oral formulations. After 8 months of follow-up, this patient was found to be more responsive with improved hearing and general immunity.
Nutritional and health benefits of millets: a review article
Authors: Gahalawat Preeti , Lamba Neha , Chaudhary Piyush
Published: April 2024

This review article systematically examines the nutritional composition, health benefits, and economic significance of millets. A comprehensive search of academic databases, including PubMed, Scopus, and Google Scholar, was conducted to collect relevant literature from scientific journals, books, and reports. Millets are small-seeded grasses cultivated globally as cereal crops, and they are recognized for their resilience and adaptability to various climates, particularly in regions with low or erratic rainfall. India stands out as the world’s largest millet producer. This review focuses on the nutritional value of millets, which are high in dietary fiber, vitamins, minerals, and proteins. Additionally, millets are suitable for individuals with celiac disease or gluten intolerance due to their gluten-free nature. Moreover, millets offer several health benefits, such as preventing diabetes, cardiovascular conditions, and some types of cancer. The cultivation of millets requires relatively low inputs compared to other cereals, as they demand less water and exhibit resilience to diseases and pests. The growing season for millets is very brief. Despite their nutritional and agronomic advantages, millets have received less attention than wheat, rice, and maize. However, there is a growing interest in millets due to its potential to support sustainable agriculture, nutrition, and food security. Observations from the review underscore the importance of millets as a wholesome and sustainable food source with significant health benefits. However, further research is necessary to fully explore their potential and promote their cultivation and consumption on a larger scale.
Uncovering Chemical Interactions between Danshen and Danggui Using Liquid Chromatography–Mass Spectrometry and Network Pharmacology-Based Research on Stroke
Authors: Pang Han-Qing , Guo Jia-Xiu , Shang Xiao-Yu , Wang Jian , Liu Hui , Tian Jing , Zhang Lu , Wang Jian-Bin , Shi Wei , Yan Bing-Chun , Liu Liang
Published: April 2024

Objective:

The objective of this study was to decipher chemical interactions between Danshen and Danggui using liquid chromatography–mass spectrometry (LC-MS) and explore the mechanisms of Danshen–Danggui against stroke using network pharmacology and molecular docking.

Materials and Methods:

First, the chemical compounds of Danshen–Danggui were profiled using ultra-high-performance liquid chromatography (HPLC)-quadrupole time-of-flight MS. Accurately characterized compounds in various proportions of Danshen–Danggui were quantified using HPLC combined with triple quadrupole electrospray tandem MS. Network pharmacology was used to uncover the essential mechanisms of action of Danshen–Danggui against stroke. Discovery Studio Software was used for the molecular docking verification of key active chemicals and stroke-related targets.

Results:

A total of 53 compounds were characterized, and 22 accurately identified constituents (10 phenolic acids, 8 phthalides, and 4 tanshinones) were quantified in 15 proportions of Danshen–Danggui. The quantification results showed that Danggui significantly increased the dissolution of most phenolic acids (compounds from Danshen), whereas Danshen promoted the dissolution of most phthalides (compounds from Danggui). Overall, the combination of Danshen and Danggui at a 1:1 ratio resulted in the maximum total dissolution rate. Further network pharmacology and molecular docking results indicated that Danshen–Danggui exerted anti-stroke effects mainly by regulating inflammation-related (tumor necrosis factor, hypoxia-inducible factor, and toll-like receptor) signaling pathways, which ranked among the top three pathways based on Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis.

Conclusion:

The chemical compounds in Danshen–Danggui could interact with each other to increase the dissolution of the most active compounds, which could provide a solid basis for uncovering the compatibility mechanisms of Danshen–Danggui and Danshen–Danggui-based formulae.
Compatibility with Fructus Ligustri Lucidi Effectively Mitigates Idiosyncratic Liver Injury of Epimedii Folium by Modulating NOD-like Receptor Family Pyrin Domain Containing 3 Inflammasome Activation
Authors: Zhao Xiao-Mei , Wu Zhi-Xin , Wang Yan , Xu Ying-Jie , Xiu Ye , Dong Xu , Li Jun-Jie , Lv Gui-Ji , Wang Si-Hao , Li Yu-Rong , Bai Zhao-Fang , Xiao Xiao-He
Published: April 2024

Background:

Idiosyncratic drug-induced liver injury (IDILI) is a serious side effect of drugs, Epimedii Folium (EF) is unequivocally implicated in idiosyncratic liver injury onset, potentially due to its ability to perturb the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome. Fructus Ligustri Lucidi (FLL), a frequently used medicinal combination with EF, has not yet been investigated for its ability to ameliorate EF-associated hepatotoxicity.

Aims and Objectives:

Study on the mechanism of compatibility of FLL to alleviate liver injury caused by EF.

Materials and Methods:

Western blot was used to determine the expression of related proteins, ELISA was used to detect the secretion of related inflammatory factors IL-1β, IL-18, IL-6 and TNF-α, liver injury indexes were detected and liver pathological tissue staining was used to evaluate the liver injury.

Results:

Our results demonstrated that EF exerted a particular augmenting effect on the stimulation of the NLRP3 inflammasome mediated by nigericin or ATP, whereas FLL suppressed the NLRP3 inflammasome stimulation. Furthermore, an equal EF to FLL ratio significantly reduced the stimulatory effects of EF. Moreover, EF has the potential to induce hepatic injury and augment pro-inflammatory cytokine synthesis in rats subjected to LPS. However, when combined with FLL, the detrimental effects of EF were mitigated.

Conclusions:

FLL possesses the capacity to attenuate EF-associated hepatotoxicity by suppressing EF-triggered NLRP3 inflammasome activation. Thus, FLL holds promise for improving the clinical safety profile of EF, shedding light on the potential of compatibility and detoxification theories in traditional Chinese medicine.
Micro robot as the feature of robotic in healthcare approach from design to application: the State of art and challenges
Authors: Moshayedi Ata Jahangir , Khan Amir Sohail , Davari Mehdi , Mokhtari Tahmineh , Emadi Andani Mehran
Published: April 2024

Micro robots, miniature robotic devices typically ranging from micrometers to a few millimeters in size, hold immense potential in various fields, particularly healthcare. Their diminutive stature enables access to intricate anatomical regions previously unreachable, facilitating targeted drug delivery, localized treatment, and precise monitoring. These robots offer numerous advantages, including enhanced maneuverability, reduced invasiveness, and minimized tissue damage. By navigating through complex biological environments, micro robots can deliver therapies with unprecedented precision, improving treatment efficacy and patient outcomes. Additionally, their small size allows for minimally invasive procedures, reducing recovery times and enhancing patient comfort. Overall, micro robots represent a groundbreaking technological advancement with the potential to revolutionize healthcare delivery and significantly benefit human well-being.Their small size enables access to intricate anatomical regions for targeted drug delivery, localized treatment, and precise monitoring. Despite challenges like size constraints and navigation complexities, innovative solutions and interdisciplinary collaboration are driving their advancement in improving healthcare outcomes.
Image Recognition of Photovoltaic Cell Occlusion Based on Subpixel Matching
Authors: Jin Yuexin , Yu Jinchi , Yin Xiaoju , Wang Yuxin
Published: April 2024

INTRODUCTION: During the operation of large photovoltaic power stations, they are often shielded by dust and bird droppings, which greatly reduce the power generation and even cause fires. Analysis of PV cell occlusion image recognition accuracy based on sub-pixel matching.
OBJECTIVES: In order to find the location of the pv cells, we use the method of subpixel image matching. Improve recognition accuracy.
METHODS: When the power plant is running normally, taken the original image for photovoltaic power station as the original sample, and then using the subpixel gradient matching algorithm, to match the original image and find out that the minimum matching values.
RESULTS: If the calculation results is greater than a specified threshold, When the calculated result is greater than the specified threshold, the power station is considered abnormal.
CONCLUSION: The experimental process shows that this method can better judge the operating status of photovoltaic power station, and can find out the location of mismatched photovoltaic cells more accurately, and the calculation accuracy reaches sub-pixel level.
Maximum Power Point Tracking Control Method of Photovoltaic Cell under Shadow Influence
Authors: Meng Yifeng
Published: April 2024

In view of the poor effect of battery power tracking control in the current solar power generation system, the maximum power point tracking (MPPT) control method of photovoltaic cell under the influence of shadow is proposed. The MPPT control method of photovoltaic cell is optimized by using the influence of shadow, the structural characteristics of photovoltaic cell are optimized, and the voltage rise and fall DC / DC conversion circuit is adopted, The maximum power identification algorithm of photovoltaic cells is set, and the voltage disturbance method is used to realize the MPPT, so that the solar photovoltaic cells always maintain the maximum power output, so as to ensure the control effect. Finally, the experiment shows that the MPPT control method of photovoltaic cells has high practicability and fully meets the research requirements.
Incidence estimates for $\alpha$-dimensional tubes and $\beta$-dimensional balls in $\mathbb R^{2}$
Authors: Fu Yuqiu , Ren Kevin
Published: April 2024

We prove essentially sharp incidence estimates for a collection of

\delta

-tubes and

\delta

-balls in the plane, where the

\delta

-tubes satisfy an

\alpha

-dimensional spacing condition and the

\delta

-balls satisfy a

\beta

-dimensional spacing condition. Our approach combines a combinatorial argument for small

\alpha, \beta

and a Fourier analytic argument for large

\alpha, \beta

. As an application, we prove a new lower bound for the size of a

(u,v)

-Furstenberg set when

v \ge 1

,

u+v/2\ge 1

, which is sharp when

u+v \ge 2

. We also show a new lower bound for the discretized sum-product problem.
Transversal family of non-autonomous conformal iterated function systems
Authors: Nakajima Yuto
Published: April 2024

We study Non-autonomous Iterated Function Systems (NIFSs) with overlaps. A NIFS on a compact subset

X\subset\mathbb{R}^{m}

is a sequence

\Phi=(\{\phi^{(j)}_{i}\}_{i\in I^{(j)}})_{j=1}^{\infty}

of collections of uniformly contracting maps

\phi^{(j)}_{i}\colon X\rightarrow X

, where

I^{(j)}

is a finite set. In comparison to usual iterated function systems, we allow the contractions

\phi^{(j)}_{i}

applied at each step

j

to depend on

j

. In this paper, we focus on a family of parameterized NIFSs on

\mathbb{R}^{m}

. Here, we do not assume the open set condition. We show that if a

d

-parameter family of such systems satisfies the transversality condition, then for almost every parameter value the Hausdorff dimension of the limit set is the minimum of

m

and the Bowen dimension. Moreover, we give an example of a family

\{\Phi_{t}\}_{t\in U}

of parameterized NIFSs such that

\{\Phi_{t}\}_{t\in U}

satisfies the transversality condition but

\Phi_{t}

does not satisfy the open set condition for any

t\in U

.
The Dirichlet problem of translating mean curvature equations
Authors: Zhou Hengyu
Published: April 2024

In this paper, we study the Dirichlet problem of translating mean curvature equations over a domain via topological restrictions. Its main difficulty is the non-existence of a

C^{0}

a priori estimate for their classical solutions except few cases. Inspired by the work of Miranda and Giusti, we define a generalized solution of these Dirichlet problems and establish its general existence. We propose a non-closed-minimal (NCM) condition on the underlying domain. When the domain is mean convex and NCM, the generalized solution with continuous boundary data is the classical smooth solution. Moreover, the NCM assumption cannot be removed by a hemisphere example.
“Os desafios para uma sociedade democrática”
Authors: Ferreira da Silva Geélison , Bonifácio da Silva Robert , Ávila Casalecchi Gabriel
Published: April 2024

Apresentação do Dossiê “Os desafios para uma sociedade democrática”