bluuebunny/crossref_metadata_2025 huggingface dataset:
PIGG gene mutation associated with Uner Tan syndrome
Authors: Wali Gautam , Wali Gurusidheshwar M. , Sue Carolyn M.
Published: May 2024

Uner Tan syndrome (UTS) is a rare neurogenetic disorder characterized by poor cognition, dysarthric speech, and habitual quadrupedal locomotion, and is associated with cerebellar hypoplasia. Mutations in the VLDLR, CA8, WDR81, ATP8A2, and TUBB2B genes are commonly associated with UTS. However, here, we report the case of a patient presenting with quadrupedal locomotion and other clinical features similar to UTS caused by a mutation in the PIGG gene. To the best of our knowledge, this is the first case in which a mutation in the PIGG gene is associated with UTS. We believe that our finding will help broaden the genetic spectrum of the syndrome.
Dystonia gravidarum
Authors: Lenka Abhishek , Prashanth L. K.
Published: May 2024

Objectives:

To highlight the clinical significance of de novo dystonia and its spontaneous resolution during pregnancy.

Methods:

Two patients were evaluated in a movement disorder clinic during their first trimester of pregnancy and followed up longitudinally.

Results:

Our first patient developed severe right torticollis and laterocollis during the sixth week of pregnancy. No etiology could be identified by a series of laboratory and imaging investigations for dystonia. The patient had near-complete resolution of cervical dystonia, without any therapeutic interventions. The second patient developed cervical dystonia and severe neck spasms during the eighth week of pregnancy, and no identifiable etiologies were found. Because of the extreme severity of dystonia, the patient had to undergo medical termination of pregnancy, after which the dystonia subsided.

Discussion:

The literature on de novo dystonia in pregnancy or “dystonia gravidarum” is limited. To date, only three such cases have been reported. Our report expands the literature on this rare phenomenon. The cases in our study highlight that new movement disorders during pregnancy may indicate aberrant dopamine receptor sensitivity in a hyperestrogenic environment and that they are often self-limiting.
Botulinum neurotoxin for the treatment of movement disorders
Authors: Cherian Ajith , Vijayaraghavan Asish , K.P. Divya , Krishnan Syam
Published: May 2024

Botulinum neurotoxin (BoNT), produced by spore-forming anaerobic bacteria, is the most potent biological toxin and is a powerful therapeutic tool for several clinical indications in neurology and beyond. BoNT inhibits the release of acetylcholine from the presynaptic terminals of the neuromuscular junction by interfering with the normal process of vesicle–plasma membrane fusion. The spectrum of indications for the use of BoNT in the treatment of various disorders in neurology, ophthalmology, gastroenterology, urology, autonomic, and dermatology is widening. The major indications for BoNT are in hyperkinetic movement disorders. Because BoNT must be injected locally, neurologists should possess the appropriate expertise to effectively deliver the therapy. Although it is considered to be effective and safe, there are many limitations to its use such as the therapeutic effect wearing off and high cost. Here, we review the indications, techniques of muscle selection, and administration of BoNT for maximum benefit in various movement disorders.
Stem cell therapy for spinocerebellar ataxias
Authors: Singh Rakesh Kumar , Bhartiya Manish , Agarwal Ayush , Radhakrishnan Divya M. , Rajan Roopa , Srivastava Achal Kumar
Published: May 2024

Stem cells have proved to be the “wonder treatment” for various genetic diseases and holds great potential for the treatment of numerous, but presently incurable maladies. However, stem cells may not be the answer for all such diseases. With the rampant growth of clinics offering stem cell therapy for almost every incurable disease, it is prudent that the indications, ethical considerations, and potential side effects of this treatment are known to the physicians and patients. In this article, we have summarized the available evidence on stem cell therapy in spinocerebellar ataxias.
Analysis of dysgraphia in advanced Parkinson’s disease patients following bilateral STN-DBS
Authors: Kolpakwar Swapnil , Alugolu Rajesh , Mudumba Vijaya Saradhi , Kandadai Rukmini , Borgohain Rupam
Published: May 2024

BACKGROUND:

Parkinson’s disease (PD) is characterized by varying intensities of bradykinesia, rigidity, and tremor leading to disturbances in writing skills of the patient. We undertook this study to evaluate dysgraphia features in advanced PD cases and changes in these features after bilateral subthalamic nucleus deep brain stimulation (DBS).

METHODS:

All idiopathic PD cases who underwent DBS at our center were included in this study. Patients were assessed preoperatively for dysgraphia by analysis of handwriting in “off” phase by a single investigator on bedside testing. For quantification of micrographia, vertical length of first letter and width of the word written were calculated. An analysis of legibility of handwriting was also done for all patients using Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS). Patients were analyzed for dysgraphia at 6 months post-surgery in drug ‘off’ phase, and outcomes were correlated with baseline parameters.

RESULTS:

There were a total of 51 patients who were included in our study. Significant reduction was noted in postoperative Unified Parkinson’s Disease Rating Scale part III (UPDRS III) scores (P = 0.0001). Age more than 65 years was associated with less improvement in FTMTRS grades. Prevalence of micrographia reduced in the postoperative period, but the difference was not statistically significant. Median FTMTRS grade in preoperative and postoperative “off” phase was 3 and 2, respectively. Difference in pre- and postsurgery FTMTRS grades was found to be statistically significant (P = 0.00001).

CONCLUSION:

Subthalamic nucleus DBS results in substantial improvement in legibility of handwriting of patients, particularly in cases with age less than 65 years.
Spectrum of de novo movement disorders in the setting of COVID-19 infection
Authors: Chandarana Mitesh , Shah Heli , Desai Soaham
Published: May 2024

Movement disorders are relatively sparse amongst COVID-19 patients. However, in the setting of large number of COVID-19 cases, relatively rare acute to subacute onset, para-infectious or post-infectious movement disorders such as myoclonus and myoclonus-ataxia with or without opsoclonus have increasingly become more evident. Our objective of writing this paper is to summarize the available evidence documenting new onset hyperkinetic movement disorders associated with COVID-19. Myoclonus is the most frequently reported movement disorder associated with COVID-19 alone or in combination with ataxia and tremors. Apart from isolated myoclonus, myoclonus with ataxia, opsoclonus myoclonus ataxia syndrome have been reported post COVID. Isolated cerebellar ataxia is the other most commonly described movement disorder post COVID. Tremors, Chorea and dystonia are rarely described hyperkinetic movement disorders in association with COVID. Treatments being offered for hyperkinetic movement disorders consists of symptomatic treatment with benzodiazepine, anti-seizure drugs, immunomodulatory treatment with steroids, intravenous immunoglobulin and rehabilitative therapies. In this review we summarize the neurological features, investigations, treatments, and outcomes of all the published cases of hyperkinetic movement disorders associated with COVID-19.
Quantitative gait analysis in patients with spinocerebellar ataxia—An explorative analysis
Authors: James Tittu Thomas , SelvaGanapathy V. , Kamble Nitish , Dhargave Pradnya , Pal Pramod K. , Muralidharan Kesavan
Published: May 2024

BACKGROUND:

Quantitative gait analysis is aimed at quantifying the degree of gait impairment in a patient. It helps to estimate the severity, track the prognosis, and identify the treatment effect in patients. There is a paucity of studies assessing gait characteristics in patients with spinocerebellar ataxia (SCA) using instrumental gait analysis. Here, we aim to identify the gait characteristics in patients with SCA and compare them with age-matched healthy individuals.

METHODS:

In this retrospective cross-sectional study, we analyzed the gait analysis data of patients with SCA from May 2018 to January 2020 in the gait and balance laboratory of the Physiotherapy Center in NIMHANS and compared them with age-matched controls from the existing database. The data were analyzed using an independent t-test.

RESULTS:

Each group consisted of 49 subjects. The SCA group had a mean age of 37.88 ± 13.25 years and the control group has a mean age of 40.88 ± 14.57 years, with a male to female ratio of 1:0.96 and 5:2, respectively. A significant difference was observed in all gait parameters (p < 0.001) between the SCA and control groups, except for swing time (p = 0.396). The SCA group demonstrated reduced velocity and cadence compared to the control group. The values of spatial parameters were reduced in the SCA group, with increased temporal parameters along with the base of support. The coefficient of variation was significantly increased in the SCA group, and the highest value was recorded for step length (10.45 ± 7.14).

CONCLUSION:

Patients with SCA demonstrated significant deviation in gait parameters from the normal values. The increased step-to-step variability in this patient population suggests an increased risk of falls. Identifying the changes in gait parameters at an early stage may help in planning the rehabilitation of patients with SCA, with focus on fall prevention strategies by targeting improvements in gait variability.
Learning from negative consequences is impaired by STN-DBS and levodopa in Parkinson’s disease
Authors: Raina Abhinav , Rajan Roopa , Sarma Gangadhara , Krishnan Syam , Kesavapisharady Krishnakumar , Kishore Asha
Published: May 2024

CONTEXT:

Subthalamic nucleus deep brain stimulation (STN-DBS) and levodopa therapy are reported to produce impulsivity in PD. We tested the hypothesis that STN-DBS enhances impulsive decision-making and that this effect is masked by the beneficial influence of the concomitant reduction in levodopa therapy.

AIMS:

To compare learning from negative consequences in patients with PD receiving STN-DBS to those without surgery.

SETTINGS AND DESIGN:

We conducted a prospective study in the Movement Disorder Clinic of a tertiary care university hospital in India, recruiting 26 PD patients treated with STN-DBS (PD-DBS) and 25 matched control patients on medical therapy (PD-MED) alone.

METHODS:

Impulsivity and decision-making were assessed using the Iowa Gambling Task (IGT) at baseline and 3 months. Dopamine agonist dose was unchanged during the study period. IGT total and block scores were used to assess impulsive decision-making and task learning.

STATISTICAL ANALYSIS:

General linear mixed model involving repeated measures ANOVA was used to compare IGT total and block scores.

RESULTS:

There was no independent effect of STN-DBS on the IGT total score (P = 0.198). In the PD-DBS group, block scores worsened after surgery with a negative slope across blocks, suggesting a lack of task learning [TIME*BLOCK*INTERVENTION [F (4, 46) = 4.810, P = 0.003, partial Eta-squared = 0.095]. In the PD-MED group, block scores were seen to improve from baseline and across the blocks. These contrasting effects remained robust when tested in the Drug ON or OFF states. In the PD-DBS group, better task learning and higher block 5 scores were associated with greater post-operative reductions in total LEDD [TIME*BLOCK*LEDD [F (4, 46) = 3.818, P = 0.012, partial Eta-squared = 0.077].

CONCLUSIONS:

STN-DBS did not independently affect a global measure of decision making. However, STN-DBS and dopaminergic medications were shown to exert subtle yet significant opposing effects on the ability to learn from negative consequences.
Pattern reversal and flash visual evoked potentials in essential tremor
Authors: Buturak Şencan , Fidanci Halit
Published: May 2024

BACKGROUND:

There is evidence that nonmotor clinical findings may occur in essential tremor (ET). The aim of the study was to determine whether there is a subclinical impairment of visual pathways in ET by conducting visual evoked potential (VEP) studies on patients with ET.

METHODS:

Healthy individuals and patients with ET were included in the study. Individuals with visual impairment, eye disease, neurodegenerative diseases, or migraine were not included in the study. Pattern reversal VEP (PrVEP) and flash VEP (FVEP) were applied to all individuals. N75, P100, and N135 waves were obtained by PrVEP, whereas N1, P2, N2, P2, N3, and P3 waves were obtained by FVEP. The latencies and amplitudes of these waves were analyzed.

RESULTS:

Thirty-five healthy individuals (12 male, 23 female) and 29 patients with ET (16 male, 13 female) were included in the study. The mean age of the patients in the control group and the patients with ET was 33.9 ± 8.5 and 35.9 ± 16.8 years, respectively. Age and gender were not statistically significantly different between the two groups. The mean right/left P100 wave latencies of the control group and ET group were 90.3 ± 7.3/91.5 ± 6.1 ms and 99.4 ± 9.1/101.1 ± 7.8 ms, respectively (P = 0.009/P < 0.001). The mean right/left P2 wave latencies of the control group and ET group were 104.9 ± 15.1/104.8 ± 13.8 ms and 117.6 ± 15.4/118.3 ± 15.6 ms, respectively (P = 0.001/P = 0.001).

CONCLUSION:

This study showed that subclinical involvement of visual pathways may occur in ET.
Burden of nonmotor symptoms in Parkinson’s disease patients from eastern India
Authors: Sahu Sulagna , Mukherjee Adreesh , Biswas Samar , Leta Valentina , Rukavina Katarina , Das Shyamal Kumar , Biswas Atanu
Published: May 2024

BACKGROUND:

Parkinson’s disease (PD) is classically characterized by motor features. However, nonmotor symptoms (NMSs) represent an important aspect of the disease with a significant impact on quality of life (QoL).

OBJECTIVES:

The aim of this study was to evaluate NMS in patients with PD, to determine their various correlates, and to assess the impact on QoL.

METHODS:

This cross-sectional study included 150 consecutive patients with PD and 150 age- and sex-matched healthy controls. NMSs were assessed using the NMS Questionnaire (NMSQuest) and NMS Scale (NMSS). QoL was evaluated by the 8-item Parkinson’s Disease Questionnaire scored as summary index (PDQ-8-SI).

RESULTS:

Every patient experienced NMS and 90% had more than five NMSs. Patients with PD had a significantly higher prevalence of NMS compared to healthy controls. The most common NMSs in patients with PD were unexplained pain, anxiety, constipation, insomnia, and memory impairment. Miscellaneous was the most prevalent domain of NMSS, followed by sleep/fatigue, gastrointestinal tract, and mood/cognition. Attention/memory impairment and pain were greater in females. Cardiovascular/falls and perceptual/hallucination showed a positive correlation with duration of disease. Sexual dysfunction decreased with increasing age. In the young-onset group (YOPD), mood/cognition involvement was higher. PDQ-8-SI showed a significant correlation with total NMSS score and most of the individual domain scores. Contrary to other Indian studies, our patients reported restless legs more frequently, whereas urinary symptoms were less common. Our observations showed a greater prevalence of pain and constipation compared to the Western studies.

CONCLUSIONS:

All of our patients experienced NMS. The prevalence of various NMS in our study showed differences with previous reports. NMS had a significant impact on QoL.
Autosomal recessive spastic ataxia of Charlevoix Saguenay (ARSACS) in three brothers of a family from Kerala
Authors: Sheetal Sasikumar , Sasikumar Amith K. , Tomy Lovin G.
Published: May 2024

Autosomal recessive spastic ataxia of Charlevoix Saguenay (ARSACS) is an uncommon spastic-ataxic syndrome that is characterized by cerebellar ataxia, spasticity, and peripheral neuropathy. Though initially reported from Charlevoix-Saguenay-Lac-St-Jean region in Canada, this neurodegenerative disorder has been reported from other regions of the world. There have been very few reports on this condition from Kerala, India. We hereby report a family of three brothers from Kerala who were diagnosed with this condition.
Opsoclonus–myoclonus–ataxia syndrome associated with dengue encephalitis
Authors: Sikariya Kusum , Agrawal Nishant R. , Chouksey Dinesh , Jain Rahul , Jain Akansha , Sodani Ajoy
Published: May 2024

Opsoclonus–myoclonus–ataxia syndrome (OMAS) is an inflammatory neurological disordercharacterized by chaotic uncontrolled movements of the eyes and involuntary jerk-like movements of the body. We report the case of a 45-year-old man who presented with fever without any seizures or focal deficits. On examination, he had opsoclonus in his eyes and cortical myoclonus in his hands and body. On evaluation, he tested positive for the dengue NS1 antigen. Furthermore, he had low platelets, normal metabolic workup, normal brain imaging, and normalcerebrospinal fluid analysis. He was managed conservatively and showed improvement in opsoclonus–myoclonus by day 7 of his illness and complete recovery in 2 weeks. Although dengue is primarily considered to be a hematotropic virus, it can involve the nervous system and manifest with OMAS. To the best of our knowledge, OMAS has been reported in only four cases of dengue infection in adults to date.
Recent Advances of Nanotechnology in Conservative Dentistry and Endodontics
Authors: Saroch Rinshul , Gupta Priti , Singh Arvinder Pal , Gupta Hitesh , Saini Roseka , Rana Ishani , Bhardwaj Kaustubh
Published: May 2024

The age of nanotechnology is the biggest scientific and technical innovation in history. Nanotechnology is the study of manipulating matter at the atomic and molecular levels. The word “nano” means “dwarf” in Greek. Total oral health maintenance has been made achievable by nanodentistry through the use of nanomaterials, biotechnology, tissue engineering, and eventually dental nanorobotics. Thanks to nanotechnology, hopes for better oral health-care delivery and ongoing maintenance have increased while the diagnosis, treatment, and prevention of oral illnesses are still being studied. This review article aims to emphasize the safety and ethical issues surrounding the use of nanotechnology in dentistry, as well as to detail the current state of nanotechnology in the field and the many nanomaterials utilized in it.
The effect of serum estrogen level on male infertility & semen parameters on Sudanese males attending Khartoum Dermatology Teaching Hospital
Authors: Mohamedkhier Nihad A. , Elghazali Essam , Seedahmed Khalid M.
Published: May 2024

Background

Infertility is defined as the inability to achieve pregnancy after one year of unprotected intercourse. As estimated 10–15% of couples were considered infertile by W.H.O. One of the major causes of non-obstructive infertility is hormonal disturbance. Testosterone and Estrogen, traditionally, have been regarded as male and female sex hormones respectively. However, Estradiol, the predominant form of Estrogen, also plays a pivotal role in male sexual function. Estradiol in men is quintessential in many sexual physiological processes.

Objectives

To evaluate the effect of Estrogen levels on infertile men and their semen parameters

Method

In this prospective case-control hospital based study, a total number of 50 infertile men with primary and secondary infertility (case group) and 50 fertile men (control group) were included. The medical histories of all the participants were taken and physical examinations were conducted thoroughly. Serum Estradiol (E2) levels were measured for both infertile and fertile group. Seminal analysis was done for the infertile group. Serum E2 was measured by Radio-Immunosorbent Assay (RIA) using Estradiol kits for measurement. Standard semen analysis was done by computer-assisted seminal analysis (CASA) using the WHO manual 2010.

The collected data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. The results were obtained and presented in tables and diagrams. The significance of testing was assessed by Chi-Square T test with P value ≤0.05 was considered statistically significant.

Results

A significant correlation was observed between the fertility status and serum E2 levels. 18% (n=9) of the subfertile patients were found to have serum E2 levels more than 55 pg/ml. on the other hand, only 6% (n=3) of the fertile group (control group) were above 55 pg/ml (P value less than 0.05).

Azoospermia was found to be the most semen parameter among patients with elevated serum E2 level (P value less than 0.05). It is also observed that 46% of the infertile patients were found to be overweight (BMI=25–29.9) & they have significantly high serum E2 levels (P value less than 0.05).

Conclusion

High serum Estradiol levels were found significantly correlated with male infertility; Azoospermia was the most commonly observed abnormal semen parameter. Overweight patients have significantly elevated Serum E2 levels.
Study of the epidemiologic characteristics of childhood vitiligo in Egyptian children
Authors: Aboeldahab Soha , Mohammed Sarah El-Sayed , El-Hamd Mohammed A. , Saleh Ramadan
Published: May 2024

Background

Vitiligo during childhood is common. Pediatric vitiligo has a profound effect on the quality of life of both children and their parents.

Aims and objectives

To investigate the epidemiologic characteristics of vitiligo among Egyptian children.

Patients and methods

A cross-sectional study was conducted and included children of both sexes from birth to less than 18 years of age. The study included schools and maternity and childhood care centers in Sohag Governorate, Upper Egypt, during the period from March 2019 to February 2020. Complete demographic and clinical information of children with vitiligo were recorded. Dermatological examination of patients with vitiligo was done. Vitiligo area and severity index of patients was calculated.

Results

Of 2594 screened children, 18 (0.7%) had vitiligo. The median age of children with vitiligo was 12 (2–17) years. The age interval from 13 to less than 18 years accounted for 44.4% of vitiligo cases. Females cases of vitiligo were more prevalent (61.1%). Overall, 72.2% of patients with vitiligo were resident of rural areas. Of the 18 cases with childhood vitiligo, 83.3% of cases had a history of consanguineous marriage and 66.5% had vitiligo vulgaris. A proportion of cases related the exacerbation of the disease to exposure to psychological stress.

Conclusions

Childhood vitiligo was detected in 0.7% of pediatric population in Upper Egypt. The majority of cases with childhood vitiligo had a history a consanguineous marriage between the parents. Psychic trauma was identified as a potential exacerbating factor of childhood vitiligo.
Side effects of anti-acne medications: a narrative review
Authors: Kandhari Rajat
Published: May 2024

Acne vulgaris is a chronic inflammatory disorder of the skin, which may present in various forms such as papules, comedones, pustules, cysts, or nodules. Due to the underlying varied pathogenesis involving excess sebum production, underlying infection, genetic causes, and environmental factors, a multitude of treatment options has been used on an individual basis. Although the therapeutic armamentarium for acne treatment has grown, it brings with it, its share of adverse effects. Here, we review the side effects associated with topical and systemic acne therapy and their management.
Systemic lupus erythematosus masquerading as gangrene − an infrequent presentation
Authors: Singh Aditi
Published: May 2024

Systemic lupus erythematosus (SLE) is an auto-immune disease affecting multiple organs. Among the cutaneous features, digital gangrene is considered to be very rare, occurring in only 1.3% of SLE patients. It is considered to be due to compromised perfusion of digits secondary to vasculitis, vasospasm and thomboembolism. This is the case report of a 35-year-old female who presented with acute blackish discoloration of toes of both feet associated with pain. She had no other features of SLE. But serology came out positive for SLE. The patient responded well to steroids, hydroxychloroquine, antiplatelet and anticoagulant medications and is currently under follow-up.

This case report basically shows us that SLE should be considered as a possible differential diagnosis whenever there is a young patient presenting with digital gangrene without any other medical history.
Evaluation of serum adiponectin and lipid profile in patients with acne vulgaris
Authors: Alashry Shereen Ezzalregal , Sallam Manar Elsayed , Hassan Manar Ali , Saber Eman
Published: May 2024

Background

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit and is among the most common dermatological conditions worldwide. Adipokines are bioactive molecules secreted by adipocytes. Adiponectin is the most abundant adipokine. It has multiple properties, which includes sensitization of insulin, anti-inflammatory, and antiatherogenic effect.

Objectives

This study aims to evaluate serum adiponectin and lipid profile levels in patients with acne vulgaris and their correlation with each other and disease severity.

Patients and methods

This is a case-control study, conducted on a total of 90 patients with acne vulgaris and matched age, sex, and body mass index 70 healthy controls. Serum adiponectin and lipid profile levels were evaluated in all subjects.

Results

Total cholesterol (TC), total triglycrides (TG) and low density lipoprotein (LDL) were significantly higher in acne vulgaris cases, while high density lipoprotein (HDL) was statistically significant lower in cases compared to controls. Adiponectin concentration was significantly higher in acne vulgaris cases when compared to control group with positive correlations with female gender, disease severity, TC, LDL and significant negative correlation with HDL.

Conclusions

Adiponectin may play a role in the pathogenesis of acne vulgaris and may affect its severity. Evaluation of all acne patients for lipid profile and advice for healthy diets as an adjuvant method to acne treatment.
Psychological burden of care in parents/caregivers of children with surgical conditions – A local experience
Authors: Elebute Olumide Abiodun , Campbell Elizabeth A. , Ademuyiwa Adesoji O. , Ihediwa Chibuike GGeorge , Bode Christopher O.
Published: May 2024

Background:

There is a paucity of literature on the psychological burden on parental caregivers of children with surgical conditions. Knowledge of the peculiar psychological challenges faced by the parents or caregivers could help to advocate for the incorporation of a psychologist or psychiatrist as part of a multidisciplinary approach to patient care.

Methods:

This is a cross-sectional study over 6 months on caregivers of pediatric surgical patients at the Lagos University Teaching Hospital. Zarit Caregiver Burden Scale (ZCBS) and the General Health Questionnaire – 28 (GHQ-28) were used to obtain data on the burden of care and psychiatric morbidity. Data obtained were analyzed using SPSS (version 23). A ZCBS score ≥21 and a GHQ-28 value above 4 were considered significant.

Results:

A total of 120 caregivers were recruited for the study. The mean GHQ score was 6.3 (standard deviation [SD] ±5.9), whereas the mean ZCBS was 24.96 (SD ± 14.67). Sixty (50.0%) caregivers had a GHQ score over 4 and 71 (59.2%) had a ZCBS score ≥21.

Conclusions:

The care of children undergoing surgical procedures is associated with a significant burden and psychological distress among first-degree family caregivers. There is a need for further studies to know the pattern of their psychologically ill health as this could impede their quality of care.
Evaluation of risk factors for postoperative neurologic intensive care admission after brain tumor craniotomy: A single-center longitudinal study
Authors: Biswas Konish , Agrawal Sanjay , Gupta Priyanka , Arora Rajnish
Published: May 2024

Background and Aims:

Perioperative variable parameters can be significant risk factors for postoperative intensive care unit (ICU) admission after elective craniotomy for intracranial neoplasm, as assessed by various scoring systems such as Cranio Score. This observational study evaluates the relationship between these factors and early postoperative neurological complications necessitating ICU admission.

Material and Methods:

In total, 119 patients, aged 18 years and above, of either sex, American Society of Anesthesiologists (ASA) grades I–III, scheduled for elective craniotomy and tumor excision were included. The primary objective was to evaluate the relationship between perioperative risk factors and the incidence of early postoperative complications as a means of validation of the Cranio Score. The secondary outcomes studied were 30-day postoperative morbidity/mortality and the association with patient-related risk factors.

Results:

Forty-five of 119 patients (37.82%) required postoperative ICU care with the mean duration of ICU stay being 1.92 ± 4.91 days. Tumor location (frontal/infratemporal region), preoperative deglutition disorder, Glasgow Coma Scale (GCS) less than 15, motor deficit, cerebellar deficit, midline shift >3 mm, mass effect, tumor size, use of blood products, lateral position, inotropic support, elevated systolic/mean arterial pressures, and duration of anesthesia/surgery were associated with a higher incidence of ICU care. Maximum (P = 0.035, AOR = 1.130) and minimum systolic arterial pressures (P = 0.022, Adjusted Odds Ratio (AOR) = 0.861) were the only independent risk factors. Cranio Score was found to be an accurate predictor of complications at a cut-off point of >10.52%. The preoperative motor deficit was the only independent risk factor associated with 30-day morbidity (AOR = 4.66).

Conclusion:

Perioperative hemodynamic effects are an independent predictor of postoperative ICU requirement. Further Cranio Score is shown to be a good scoring system for postoperative complications.
Comparison of midpoint transverse process to pleura (MTP) block and erector spinae plane block (ESP) for postoperative analgesia in modified radical mastectomy patients: A double-blinded, randomized control trial
Authors: Sethi Priyanka , Kaur Manbir , Bhatia Pradeep K. , Goyal Shilpa , Sharma Ankur , Roy Shipra , Kaloria Narender
Published: May 2024

Background and Aims:

Modified radical mastectomy (MRM) is associated with moderate severity of postoperative pain. Besides intravenous (IV) analgesics, various nerve blocks are being described for pain relief of MRM patients. We compared erector spinae plane (ESP) block with midpoint transverse process to pleura (MTP) block in these patients for postoperative analgesia.

Material and Methods:

After receiving ethical committee approval from the institutional ethics committee (AIIMS, Jodhpur) and written informed consent from study participants, 66 patients who were assigned American Society of Anesthesiologists (ASA) physical status I and II, aged 18–75 years, and were scheduled to undergo MRM were enrolled and randomly allocated into two groups. Unilateral block was given before surgery at T3 or T4 level and with 15 ml of 0.5% ropivacaine in both the groups. Infusion of 0.5% ropivacaine (Neon laboratories limited, Mumbai, India) and 0.2% ropivacaine at a rate of 5 ml/h was maintained intraoperatively and postoperatively, respectively. Pain was assessed using the Visual Analogue Scale (VAS) for the next 24 hours. The total number of patients needing rescue analgesia, the total amount of rescue analgesics consumed in the next 24 hours, and patient satisfaction score were also compared between groups.

Results:

Demographics and baseline vitals were comparable in the groups. On comparing VAS scores in both the groups during rest and movement at different time intervals, there was no difference in pain scores during the initial two hours. From the third hour, there was a statistically significant difference (P < 0.001) in pain VAS scores in both groups. The ESP group had lower VAS scores compared to the MTP group when followed for the next 24 hours. There was a statistically significant difference in patient satisfaction.

Conclusion:

ESP block is more efficacious when compared to MTP block for postoperative analgesia in MRM patients.
Rehabilitation with Tooth-supported Overdenture Incorporating Matrix Attachment System in a Teenager and a Hexagenerian: A Clinical Technique
Authors: Chugh Anshul , Alam Maqbul , Hooda Anita , Dixit Pritish
Published: May 2024

The aim of this study is to evaluate the improvement in masticatory efficiency and retention of tooth-supported overdenture using customized copings over abutment teeth with a silicone-based matrix attachment system present an alternative to prefabricated precision attachments. Saving mutilated teeth and using them for overdenture has been a good alternative to the conventional dentures. Using customized attachments improved the retention of the prosthesis. The new material which has been widely used for implant-supported overdentures has been used with tooth-supported overdentures for improved function and comfort. A 14-year-old patient reported with difficulty in eating due to decayed teeth. Customized copings were fabricated on endodontically treated teeth 13, 23, 33, and 43 and overlay prosthesis was conventionally fabricated. The intaglio surfaces corresponding to the abutments were lined with Multisil primer and retention. Sil 600 and the patient were asked to bite to aid the removal of excess material. A 65-year-old patient complained of missing teeth and inability to chew. A thimble-shaped coping was fabricated on endodontically treated teeth 33, 34, and 43. Subsequent procedures were similar to the aforementioned case. The use of polyvinyl siloxane-based resilient liners has proven to be able to provide clinically satisfactory retention in patients with compromised manual dexterity. Significant results, in retention with the use of two different coping designs and single-matrix system, masticatory efficiency, and esthetics have been observed and economical alternative to the use of expensive attachments.
Comparative Evaluation of Novel Herbal Mouthwash with 12.5% Xylitol Mouthwash and 0.7 M Saline Mouthwash on Plaque Control: An Interventional Study
Authors: Prasad. S.Vishnu , Indrapriyadharshini. K , Mahesh. J
Published: May 2024

Background and Aim:

Among the wide array of herbal plants possessing medicinal values, Andrographis
paniculata (Nilavembu) stands out as a time-tested premiere medicinal herb. A. paniculata (Nilavembu) extracts exhibited varying degrees of inhibitory activity against the growth of all the microorganisms. Hence, this research was made to assess and compare the effect of Nilavembu extract (A. paniculata) with 12.5% xylitol mouthwash and control group (0.7 M saline mouthwash) on dental plaque and gingival inflammation.

Materials and Methods:

A double-blinded parallel-arm randomized clinical trial was done among 40 participants aged 20–30 years. Participants were randomly allotted into four groups: Group 1 - Nilavembu extract with 0.7 M saline wash; Group 2 - Nilavembu extract with 12.5% xylitol mouthwash; Group 3-0.7 M saline mouthwash; and Group 4-12.5% xylitol mouthwash. The plaque and gingival status were assessed using oral hygiene simplified index and Loe and Silness index at baseline and end of the study (7th day). Statistical analysis was carried out to compare the effect of all four treatments groups using the Kruskal–Wallis test, Wilcoxon sign rank test, and post
hoc test; P ≤ 0.05 was considered statistically significant.

Results:

Among four groups, Group 2 showed a greater mean reduction followed by Group 1 in oral hygiene index score and gingival score. There was a statistically significant difference between the scores of the four groups.

Conclusion:

It can be concluded that A. paniculata (Nilavembu extract) could serve as a potential herbal alternative in the therapeutic management of dental plaque and gingivitis.
A Gradually Increasing Painless Swelling in the Upper Maxilla – A Case Report of Peripheral Giant Cell Granuloma
Authors: Pradhan Lucy , Manna Arpan , Khan Tanha
Published: May 2024

Peripheral giant cell granuloma (PGCG) is a benign inflammatory hyperplasic, exophytic lesion of unknown etiology. It develops on the gingiva and alveolar ridge. It could represent a local reaction to trauma or irritation. Management requires a surgical excision of the lesion and elaborate recall due to possible recurrence. This article describes the clinical and histopathological features and management of PGCG as it appeared in the maxillary anterior region of a 35-year-old female patient with a chief complaint of painless swelling in the anterior maxillary region. Intraoral periapical radiograph showed the features that suggested a soft-tissue lesion causing cupping resorption of the maxilla. The lesion was completely excised, biopsy was performed after that, under local anesthesia, and the tissue was examined histopathologically. The lesion was diagnosed as PGCG after thorough clinical, radiologic, and histopathologic examinations. A surgical excision of the growth, including its base, as well as the eradication of any underlying causes should be included in the therapy due to its fast growth pattern and propensity to resorb bone with subsequent tooth movement. Regular postsurgical follow-up is crucial to preventing the tumor from reoccurring.
The Adoption of Network Codes in the Field of Energy: Availability of Judicial Review in a Multi-Stage Procedure
Authors: Vlachou Chara
Published: May 2024

The adoption of network codes is a crucial step towards the conclusion of the internal energy market by the year 2014. This paper aims to assess the availability of judicial review in the multi-stage procedure established by the Electricity and Gas Regulations. In this respect, it first provides a brief overview of the establishment of the European Networks of TSOs (ENTSOs), whose expertise serves as the basis for the elaboration of the network codes. Subsequently, it critically assesses the three-stage adoption procedure set in the Regulations. The analysis then shifts to a more normative dimension through the examination of the legal characterization of the basic acts involved in the adoption procedure, namely, the framework guidelines and network codes, and of the availability of judicial review.
KEMAMPUAN PEMECAHAN MASALAH PELUANG PADA SISWA SMP BERDASARKAN GENDER
Authors: Fatqurhohman Fatqurhohman , Jatmikowati Tri Endang , Suryaningrum Christine Wulandari
Published: May 2024

Penelitian ini mengkaji perbedaan gender dalam pemecahan masalah siswa SMP. Tes dan wawancara terstruktur digunakan untuk mengumpulkan data. Subjek penelitian adalah siswa Kelas VIII SMP Islam Ambulu-Jember yang berjumlah 11 (laki-laki) dan 9 (perempuan). Dari hasil evaluasi diketahui bahwa rata-rata nilai siswa perempuan tinggi (81,67) dan rata-rata kemampuan (61,67), sedangkan rata-rata nilai siswa laki-laki tinggi (85,56) dan kemampuan berbahasa (65). Karena perempuan lebih baik dalam bidang bahasa dan budaya, laki-laki lebih baik dalam bidang teknis. Perbedaan gender merupakan karakteristik psikologis yang menentukan bagaimana seseorang bertindak atau menyelesaikan masalah berdasarkan sudut pandang yang berbeda. Namun kemampuan menyelesaikan permasalahan tersebut tidak berbeda secara signifikan antara siswa laki-laki dan perempuan. Meskipun ada sedikit kesalahan terkait dengan kesalahpahaman makna pertanyaan dan mengandalkan tebakan alih-alih mengikuti prosedur yang ditetapkan. Oleh karena itu, anak laki-laki cenderung mengembangkan otak kiri yang bertanggung jawab atas pemikiran logis, abstrak, dan analitis, sedangkan anak perempuan cenderung mengembangkan otak kanan yang bertanggung jawab atas pemikiran artistik, keutuhan, imajinasi, dan rasionalitas. Oleh karena itu, keterampilan pemecahan masalah matematis bertujuan agar siswa dapat mengidentifikasi informasi yang relevan, menganalisis berbagai metode, dan mengembangkan keterampilan penalaran dan berpikir mereka.AbstractThis research examines gender differences in problem-solving among high school students. Tests and structured interviews were used to collect data. The research subjects were Class VIII students of Ambulu-Jember Islamic Middle School, totaling 11 (boys) and 9 (girls). From the evaluation results it is known that the average score of female students is high (81.67) and average ability (61.67), while the average score of male students is high (85.56) and language ability (65). Because women are better in language and culture, men are better in technical fields. Gender differences are psychological characteristics that determine how someone acts or solves problems based on different points of view. However, the ability to solve these problems is not significantly different between male and female students. Although there were a few errors related to misunderstanding the meaning of the questions and relying on guesswork instead of following the established procedures. Therefore, boys tend to develop the left brain which is responsible for logical, abstract and analytical thinking, while girls tend to develop the right brain which is responsible for artistic thinking, wholeness, imagination and rationality. Therefore, mathematical problems-solving skills aim to enable students to identify relevant information, analyze various methods, and develop their reasoning and thinking skills.
La metafísica del nosotros de Gabriel Marcel
Authors: Grassi Martín
Published: May 2024

Marcel (1889-1973) es considerado uno de los grandes representantes de la tradición de la filosofía personalista, junto con Martin Buber y Emmanuel Mounier. Su obra es una aproximación al sentido ontológico de las experiencias humanas más significativas. A partir de estas experiencias existencias, Marcel muestra que la existencia se despliega relacionalmente en el seno de una realidad en la cual participa. A diferencia de otras filosofías de corte existencial, la de Marcel no comprende la existencia como una singularidad separada cuyo auténtico desarrollo se juega en su autonomía y libertad absoluta. Muy al contrario, existit (esse) significa-con (co-esse), y no hay nada en el ser humano que no esté afectado por esta relación con lo otro. Este libro explora las diferentes dimensiones en que esta participación del existente con lo otro tiene lugar, desde la dimensión del ser encarnado y su ser en el mundo, pasando por la dimensión intersubjetiva y su ser con otros, hasta llegar a la dimensión del ser encarnado y su ser en el mundo, pasando por la dimensión intersubjetiva y su ser con otros, hasta llegar a la dimensión trascendental en la que el existente se comunica con el ser y con lo divino. A partir de este recorrido se muestra que la relación entre el existente y lo otro se sutenta en una comunidad, en un nosotros que es originario. La filosofía de Marcel, por ello, no es ni una metafísica de la mismisidad, no tampoco una de la alteridad, sino una del nosotros. A ciencuenta años de la muerte del filósofo francés, este libro invita a conocer esta obra que ha tenido un profundo impacto en el pensamiento de la segunda mitad del siglo XX, poniendo sobre la mesa varias categorías que hoy son parte fundamental de la reflexión filosófica.
Hubungan Pengetahuan Ibu Bekerja Tentang Asi Ekslusif Dengan Kesehatan Bayi Di Desa Kelambir Lima Kebun Tahun 2023
Authors: Rosi Anastacia Enos , Zuwita Harefa Ester , Br Sembiring Erlinta Selviani , Nababan Tiarnida
Published: May 2024

ASI exclusive merupakan aktivitas perawatan pada anak yang baru saja lahir sampai dengan 6 bulan dengan tanpa memberikan makan dan minum (begitu juga air putih) selain ASI. Ibu bekerja merupakan ibu yang berkarir di lingkungan selain rumah guna memperoleh pemasukan sembari mengasuh dan membesarkan anak di rumah. Tujuan dari penelitian yaitu hubungan pengetahuan ibu bekerja tentang ASI eksklusif dengan kesehatan bayi di Desa Kelambir Lima Kebun. Jenis penelitian memakai survei analitik dengan desain cross sectional. Populasi mencakup semua ibu bekerja. Teknik penarikan sampel memakai random sampling, sehingga sampel berjumlah 44 orang. Hasil penelitian menunjukan bahwa Pengetahuan ibu bekerja tentang ASI eksklusif dengan kesehatan bayi di Desa Kelambir Lima Kebun Sudah baik. Kualitas ibu bekerja di Desa Kelambir Lima Kebun yang mempunyai bayi 0-12 bulan sudah menerapkan ASI eksklusif kepada bayi nya. Adanya hubungan pengetahuan ibu bekerja tentang ASI eksklusif dengan kesehatan bayi di Desa Kelambir Lima Kebun. Bagi ibu perlu meningkatan pengetahuan tentang ASI eksklusif bagi bayi untuk pertumbuhan dan kesehatannya. Kesimpulannya, pengetahuan ibu yang bekerja tentang ASI eksklusif di Desa Kelambir Lima Kebun cenderung baik, yang berdampak positif pada kesehatan bayi. Oleh karena itu, upaya untuk meningkatkan pengetahuan ibu tentang pentingnya ASI eksklusif dapat menjadi strategi efektif dalam meningkatkan kesehatan bayi di wilayah tersebut.
Pembenahan Layanan Kependudukan: Lonjakan Efisiensi Perangkat Desa di Indonesia
Authors: Solichah Maulidatus , Rodiyah Isnaini
Published: May 2024

Penelitian ini menyelidiki kinerja pegawai kantor desa dalam pelayanan administrasi kependudukan di Indonesia, dengan fokus pada produktivitas, kualitas pelayanan, dan akuntabilitas sebagaimana diuraikan oleh Agus Dwiyanto. Analisis didasarkan pada data kualitatif yang dikumpulkan melalui wawancara, observasi, dan dokumentasi dari para informan termasuk Sekretaris Desa, Kepala Urusan Keuangan, dan anggota masyarakat. Dengan menggunakan model analisis data interaktif Miles dan Huberman, temuan menunjukkan bahwa meskipun produktivitas dan akuntabilitas cukup memuaskan, kualitas layanan masih kurang. Secara khusus, standar waktu pelayanan tidak terpenuhi, sehingga menimbulkan banyak keluhan dari masyarakat mengenai penundaan dan inefisiensi. Penelitian ini menyoroti kesenjangan yang signifikan dalam kualitas layanan, yang menunjukkan perlunya perbaikan yang ditargetkan untuk meningkatkan efisiensi layanan administrasi kependudukan secara keseluruhan di kantor-kantor desa.
Criação e implantação do primeiro curso de graduação de Terapia Ocupacional na Amazônia Paraense (1980-1991).
Authors: Da Costa Braga Matheus , Alves da Silva Letícia , Messias Passos da Costa Marlissom , Da Silva Araújo Lucivaldo , De Araújo Costa Folha Otavio Augusto , Braga Ferreira Nascimento Cibele
Published: May 2024

Introdução: Compreender a história local sobre o desenvolvimento da Terapia Ocupacional torna-se necessário, por isso o estudo objetiva investigar os processos de criação e instauração do primeiro curso de graduação em Terapia Ocupacional na Amazônia Paraense, no período de 1980 a 1991. Métodos: Trata-se de uma pesquisa histórica que utilizou dezoito fontes documentais (matérias de jornais, mensagens de governo e documentos oficiais) e realizou a análise nos preceitos da História Cultural. Resultados: os achados foram organizados nas categorias: motivações para a criação do curso, primeiro processo seletivo, infraestrutura e organização curricular. Discussão: o curso foi criado com motivações internas e externas à Fundação Educacional do Pará, adotando a estrutura curricular organizada em ciclos de aprendizagem, com professores advindos de outras regiões do país e com uma infraestrutura inicialmente adaptada. Conclusão: O curso teve relevância local e regional. A pesquisa é relevante por descortinar histórias locais da configuração da profissão. Os achados poderão incentivar ou auxiliar outras pesquisas históricas, contribuindo para a escrita plural e diversa da história da profissão no país.
Palavras-chave: Terapia Ocupacional. História. Instituições Acadêmicas. Amazônia