bluuebunny/crossref_metadata_2025 huggingface dataset:
COTPA implementation status: An observational study in South Indian city
Authors: Tripathi Surbhi , Chinnakali Palanivel , Naik Bijaya Nanda , Kar Sitanshu Sekhar
Published: April 2024

Background & objectives:

The World Health Organization (WHO) document released on the World No Tobacco Day, 2020, mentions that tobacco kills over 22,000 people worldwide every day either from its use or second-hand smoke exposure, which is one person every 4 sec. In 2003, the Cigarettes and Other Tobacco Products Act (COTPA) was enacted by the Indian government to control/regulate use of tobacco and tobacco products. Despite various amendments to this law, there has not been any appreciable decrease in tobacco use. The objective of this study was to assess the compliance level with sections 4-10 of COTPA in urban Puducherry in South India.

Methods:

Random sample survey of 13 wards was carried out in selected parts of the city of Puducherry. The estimated sample size was minimum 160 public places and point of sales (PoS) each. A pre-tested checklist was used to obtain information on compliance with COTPA. Statistical and spatial analysis was performed using STATA v12.0 and QGIS v2.14.21, respectively.

Results:

Eight per cent of public places, 0 per cent of PoS, 1.7 per cent of educational institutions and 48 per cent of tobacco packages were found compliant with COTPA specifications. The compliance in public places varied from 0 (bus stops) to 55 per cent (religious places).

Interpretation & conclusions:

The overall compliance with COTPA was found to be very low in urban Puducherry. In order to ensure proper implementation of the laws, effective enforcement with periodic monitoring of various sections of COTPA are needed.
Cost of implementing the QualityRights programme in public hospitals in Gujarat providing mental healthcare
Authors: Chatterjee Susmita , Pathare Soumitra , Funk Michelle , Drew-Bold Natalie , Das Palash , Chauhan Ajay , Kalha Jasmine , Krishnamoorthy Sadhvi , Sapag Jaime C. , Bobbili Sireesha J. , Shah Sandip , Mehta Ritambhara , Patel Animesh , Gandhi Upendra , Tilwani Mahesh , Shah Rakesh , Sheth Hitesh , Vankar Ganpat , Parikh Minakshi , Parikh Indravadan , Rangaswamy Thara , Bakshy Amritkumar , Khenti Akwatu
Published: April 2024

Background & objectives:

Investment in mental health is quite meagre worldwide, including in India. The costs of new interventions must be clarified to ensure the appropriate utilization of available resources. The government of Gujarat implemented QualityRights intervention at six public mental health hospitals. This study was aimed to project the costs of scaling up of the Gujarat QualityRights intervention to understand the additional resources needed for a broader implementation.

Methods:

Economic costs of the QualityRights intervention were calculated using an ingredients-based approach from the health systems’ perspective. Major activities within the QualityRights intervention included assessment visits, meetings, training of trainers, provision of peer support and onsite training.

Results:

Total costs of implementing the QualityRights intervention varied from Indian Rupees (

JOURNAL/ijmer/04.03/02223309-202306000-00006/524FF01/v/2023-09-02T030054Z/r/image-tiff

) 0.59 million to

JOURNAL/ijmer/04.03/02223309-202306000-00006/524FF01/v/2023-09-02T030054Z/r/image-tiff

2.59 million [1United States Dollars (US $) =

JOURNAL/ijmer/04.03/02223309-202306000-00006/524FF01/v/2023-09-02T030054Z/r/image-tiff

74.132] across six intervention sites at 2020 prices with 69-79 per cent of the cost being time cost. Scaling up the intervention to the entire State of Gujarat would require about two per cent increase in financial investment, or about 7.5 per cent increase in total cost including time costs over and above the costs of usual care for people with mental health conditions in public health facilities across the State.

Interpretation & conclusions:

The findings of this study suggest that human resources were the major cost contributor of the programme. Given the shortage of trained human resources in the mental health sector, appropriate planning during the scale-up phase of the QualityRights intervention is required to ensure all staff members receive the required training, and the treatment is not compromised during this training phase. As only about two per cent increase in financial cost can improve the quality of mental healthcare significantly, the State government can plan for its scale-up across the State.
Cingulum bundle integrity in schizophrenia with auditory verbal hallucinations: A diffusion tensor imaging tractographic study
Authors: Chawla Nishtha , Deep Raman , Khandelwal Sudhir Kumar , Garg Ajay
Published: April 2024

Background & objectives:

Cingulum bundle (CB) is frequently implicated in schizophrenia; however, its role in specific symptoms of schizophrenia such as auditory verbal hallucinations (AVHs) is less explored. Few studies have reported association between reduced integrity of CB and severity of AVH. Using a symptom-based approach, this diffusion tensor imaging (DTI) tractographic study was aimed to assess and compare the integrity of CB in schizophrenia with AVH, schizophrenia without AVH and healthy controls.

Methods:

A total of 92 right-handed adult individuals (aged 18-50 yr) were recruited across three study groups. Those with Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) diagnosis of schizophrenia with AVH (group I; n=30) were compared to those with DSM-5 schizophrenia without lifetime AVH (group II; n=32) and healthy controls (group III; n=30; screened using Mini International Neuropsychiatric Interview version-7.0.0. and negative family history). Clinical assessments (groups I and II) included scale for assessment of positive symptoms, scale for assessment of negative symptoms, clinical global impression-schizophrenia and psychotic symptom rating scale. All participants underwent DTI, and quantitative tract-based measurements of fractional anisotropy (FA) were obtained for images using DTI studio version-3.0.

Results:

All groups were comparable for age, gender, education and severity of illness. Group I had significantly lower FA values in the cingulate gyrus (CG) part of the left CB compared to groups II and III. No significant difference was found between groups II and III.

Interpretation & conclusions:

The findings of this study suggest that the disruption in the left CB appears to be specific for AVH-positive schizophrenia. The finding is, however, preliminary subject to replication in future studies. Further investigations are needed to understand its relevance in the context of AVH-positive schizophrenia.
A retrospective analysis of serological & molecular testing data on dengue fever in Kolkata & adjacent districts during 2016-2019
Authors: Majumdar Agniva , Gupta Rajarshi , Chatterjee Ananya , Banu Hasina , Biswas Madhumonti , Gupta Rudrak , Mukherjee Soumen , Sadhukhan Provash , Dutta Shanta
Published: April 2024

Background & objectives:

Regional Virus Research and Diagnostic Laboratory established at ICMR-National Institute of Cholera and Enteric Diseases (NICED) regularly receives samples for dengue screening and serotyping from patients of acute febrile illness (AFI) from Kolkata and adjacent districts. In this study, data over a three year period (August 2016-July 2019) was retrospectively analyzed to provide insight into the epidemiological trends of dengue fever in this region.

Methods:

Serological screening of dengue was performed by detection of NS1 antigen and/or immunoglobulin M (IgM) antibody. Dengue serotyping was done by conventional or real-time reverse transcriptase–PCR. The data were analyzed to describe the distribution of dengue with respect to age of patient, duration of fever on the day of blood collection and month of the year. Zip codes were used for spatial plotting.

Results:

Out of the 24,474 samples received from Kolkata and its adjacent districts (Hooghly, Howrah, North and South 24 Parganas), 38.3 per cent (95% confidence interval: 37.7-38.9%) samples were screened positive for dengue. The correlation between age and dengue positivity was found to be weak. A combination of dengue NS1 antigen and dengue IgM antibody detection may be a better option for detecting dengue positivity compared to a single test. Most AFI cases were tested from August to November during the study period, with maximum dengue positivity noted during September (45.9%). The predominant serotype of 2016, dengue virus serotype 1 (DENV-1), was almost entirely replaced by DENV-2 in 2017 and 2018.

Interpretation & conclusions:

Dengue continues to be an important cause of AFI in the region and round-the-year preventive measures are required for its control. Serotype switching is alarming and should be monitored routinely.
Implications of the revised cervical cancer FIGO staging system
Authors: Bhatla Neerja , Singhal Seema , Dhamija Ekta , Mathur Sandeep , Natarajan Jayashree , Maheshwari Amita
Published: April 2024

The 2018 revised International Federation of Gynaecology and Obstetrics (FIGO) staging of cervical cancer has brought about a paradigm shift by offering the option of adding imaging and pathology to clinical staging. This makes it applicable to all types of resource situations across geographies with implications for all stakeholders, including gynaecologists, gynaecologic oncologists, radiologists, pathologists and radiation and medical oncologists. The new staging classification has more granularity, with three sub-stages of stage IB and a new category of stage IIIC for all cases with lymph node (LN) involvement. The major limitations of clinical staging were inaccurate assessment of tumour size and inability to assess pelvic and para-aortic LNs with the limited investigations permitted by FIGO to change the stage. This resulted in understaging of stages IB-III, and overstaging of stage IIIB, which has been largely overcome by incorporating imaging findings. Although any imaging modality can be used, magnetic resonance imaging appears to be the best imaging modality for early-stage disease owing to its better soft-tissue resolution. However, the use of contrast-enhanced computed tomography or ultrasonography are also feasible options, depending on the availability and resources. But wherever pathological evaluation is possible, it supersedes clinical and radiological findings.
Aflibercept vs. dexamethasone implant for recalcitrant diabetic macular edema in pseudophakic eyes – 1-year outcomes from a quazi-randomized study in India
Authors: Chakraborty Debdulal , Mondal Soumen , Sengupta Sabyasachi , Maiti Aniruddha , Boral Subhendu , Das Arnab , Sinha Tushar K , Nandi Krishnendu
Published: April 2024

Purpose:

To assess the safety and efficacy of intravitreal Aflibercept (IVA) versus dexamethasone (DEX) implant for treating recalcitrant diabetic macular edema (DME) in pseudophakic eyes at 1-year follow-up.

Design:

Retrospective comparative case series.

Participants:

Data of all patients diagnosed with DME between January 2019 and December 2021, who underwent 4-monthly doses of intravitreal ranibizumab but had persistent DME [central macular thickness (CMT) within 10% of baseline value] were extracted from a computerized database. Of these, only pseudophakic eyes that underwent either IVA or DEX implant and had at least 1-year follow-up were included for analysis.

Methods:

DEX implant was preferred before December 2020 and IVA after this time point. In the IVA group, patients were followed up every month while DEX were followed at least every 3 months. Reinjections were considered when vision dropped by at least 1 Snellen’s line or CMT increased by at least 10% from the previous visit in both groups.

Main Outcome Measures:

Comparison of change in vision and CMT at 1-year follow-up in DEX versus IVA groups.

Results:

Eighty-four eyes of 84 patients aged 54.4 + 4.4 years were included, 39 (46%) received DEX and 45 (54%) received IVA. Groups were comparable for baseline vision and CMT. Vision improved equally in both groups from 0.83 + 0.15 logMAR to 0.52 + 0.10 logMAR at 3 months (P < 0.01) and then stabilized till 1 year. However, eyes in the IVA group were 6.5 times more likely (Odds ratio = 6.45, 95% CI = 1.3 – 31.9) to achieve >3-line improvement in vision. The CMT reduction was also comparable between groups (-169 + 51 in DEX vs. -174 + 49 in IVA, P = 0.67). More eyes in the IVA group required >3 injections (91% vs. 69% in DEX, P = 0.01). The IOP was significantly higher at 6 and 9 months in the DEX group and 5 eyes (13%) required IOP lowering medications.

Conclusion:

In pseudophakic eyes with recalcitrant DME not responding to ranibizumab, switching to IVA or DEX implant results in equal visual improvement and CMT reduction. Though >3-line improvement occurs more frequently with IVA, this comes at the expense of a greater number of injections and follow-up visits.
Lactational optic neuritis – A case series with review of the literature
Authors: Chaudhary Sameer , Gandhi Adit S , Das Sumita , Jayasri KN , Maheshkumar S , Kowsalya Akkayasamy
Published: April 2024

Purpose:

Optic neuritis is the most common optic neuropathy affecting adults, especially women. Lactational optic neuritis is a rare entity occurring during the postpartum period with a high chance of recurrence. Through this study, we evaluated the clinical profile and visual outcome of lactational optic neuritis.

Methods:

This was a retrospective study where patients with optic neuritis presenting during the first year of the postpartum period to the neuro-ophthalmology clinic between January 2016 and December 2022 were included in the study.

Results:

This study included seven eyes of six patients. The mean age of presentation was 24.6 years, with all patients presenting after the first 3 months of the postpartum period. All patients had unilateral involvement except one, presenting with painful vision loss. Best corrected visual acuity ranged from 6/18 to hand movements. Relative afferent pupillary defect and dyschromatopsia were present in all patients. Disc edema was seen in all but one case. Three patients were treated with steroids along with multivitamins, and the remaining three refused treatment with steroids, receiving multivitamins alone. All patients had complete recovery by the end of 12 weeks.

Conclusion:

Optic neuritis during lactation is attributed more to post-pregnancy immunological changes rather than lactation itself. The presentation and clinical features are similar to classic optic neuritis and remain an important differential diagnosis for visual dysfunction in the postpartum period.
Age-related reduction in the functional properties of adult stem cells located in the peripheral region of human retinal pigment epithelium
Authors: Arif Waseema , Narendran Siddharth , Kannan Naresh Babu , Ramasamy Kim , Veerappan Muthukkaruppan , Chidambaranathan Gowri Priya
Published: April 2024

Purpose:

Adult stem cells (SCs) with self-renewal and multilineage potential have been reported upon culturing human retinal pigment epithelial (RPE) cells. The current study aimed to identify the location of SCs in human RPE and to elucidate the age-related changes.

Methods:

Peripheral, equatorial, and central RPE cells from donors of three age groups were analyzed for their sphere-forming, clonal, and label-retaining cell properties. Furthermore, native human RPE flatmounts were immunostained for SC and proliferating cell markers.

Results:

Cells with higher sphere-forming and clonal ability were identified only in young donors (<30 years) and were restricted to the periphery. Upon culturing, cells from peripheral and equatorial regions had the label-retaining cell (LRC) property. With aging, the LRCs were restricted to the periphery and were reduced. In young donors, Ki67+ proliferating cells were not observed in native RPE. However, such cells were observed in the peripheral RPE of older donors correlating with the need for regeneration. The native RPE cells were negative for SC marker expression.

Conclusion:

The above findings highlighted the presence of SCs with the ability to proliferate in the peripheral RPE and a reduction in these functional properties of SCs with aging.
Bimanual technique for placement of footplates of phakic intraocular lens in eyes with intraoperative miosis
Authors: Sinha Rajesh , Anjum Shahnaz , Bari Aafreen
Published: April 2024

We describe and assess the efficiency of a novel technique of placing implantable collamer lens (ICL) footplates in the sulcus in poorly dilated pupils utilizing perioptic holes and two instruments simultaneously (Sinskey hook and ICL manipulator). Twelve eyes of 10 patients underwent ICL implantation through this technique. The technique employs a bimanual approach engaging perioptic holes in the eyes with intraoperative miosis. Perioptic holes were engaged with a Sinskey hook and pulled slightly back, while the footplates were tucked under the iris by using an ICL manipulator. All patients had uneventful surgery. At 1 week follow-up, uncorrected distance visual acuity (UCDVA) was −0.01 ± 0.04 logMAR with a mean vault of 606.17 ± 108.33 microns. No complications were noted. However, too small a pupil is a limiting factor; this technique can be of use in up to mid-dilated pupils. Bimanual placement of haptics of ICL may represent a safe and effective technique in insufficient mydriasis or intraoperative pupillary miosis.
Clinical applications of aqueous angiography in glaucoma
Authors: Beri Nitika , Bukke Anand Naik , Gupta Ashi , Huang Alex S , Angmo Dewang , Sharma Namrata , Dada Tanuj
Published: April 2024

Aqueous humor outflow (AHO) pathways are the main site of resistance causing elevated intraocular pressure in glaucoma, especially primary open-angle glaucoma patients. With the recently introduced technique of aqueous angiography (AA); functional, real time assessment of AHO from proximal (trabecuar meshwork) to distal pathways under physiological conditions has been made possible. AHO pathways are segmental, and AA can identify high-flow region (increased angiographic signals) and low flow region (decreased angiographic signals) in an individual. With the introduction of canal-based minimally invasive glaucoma surgeries (MIGS), the assessment of AHO can help guide the placement of stents/incisions during MIGS procedures. This can allow individualized and targeted MIGS procedures in glaucoma patients for better results. Based on the density of AHO pathways visualized on AA, surgeons can decide whether to perform MIGS or conventional glaucoma surgery for improved outcomes for the patient. Immediate intraoperative assessment for functionality of the MIGS procedure performed is possible with AA, allowing for surgical adjustments of MIGS procedure in the same sitting, if needed. This review provides a summary of the studies performed with AA to date, with a special focus on Indian patients. It covers the basics and clinical applications of AA for improving surgical outcomes in glaucoma patients.
Ocular morbidity profiles of out-of-school children in a North Indian urban slum
Authors: Bhartiya Shibal , Wadhwani Meenakshi , Ichhpujani Parul , Parmar Uday Pratap Singh
Published: April 2024

Purpose:

This study evaluates the recent trends in ocular morbidities and vision-related practices in “out-of-school” children in urban slums of Gurugram in North India.

Methods:

In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded.

Results:

A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot’s spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye–related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month–6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years (P = 0.003) and children playing outdoors (P = 0.001). There was a significant association noted for age and use of digital devices (P = 0.037).

Conclusion:

The prevalence of refractive errors in “out-of-school” children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot’s spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children.
Measurement of dynamic pupillometry parameters in adult Indian population
Authors: Rattan Yamini , Girgla Kawalinder K , Mahajan Gaurav , Prasher Pawan
Published: April 2024

Purpose:

To determine normative dynamic pupillometry data in healthy Indian adults and to investigate the effect of age on various pupillary parameters.

Methods:

Pupillometry measurements were obtained on healthy participants using an automatic dynamic pupillometry device, the NPi-200 (NeurOptics Inc., Irvine, CA, USA). Various measurements, including neurologic pupil index (NPi), resting pupil size (Size), minimum pupil diameter (MIN), percentage change in pupil size (CH), constriction velocity (CV), maximum constriction velocity (MCV), latency (LAT), and dilatation velocity (DV), were obtained in routine clinical settings and analyzed statistically for change with age.

Results:

A total of 470 participants (470 eyes) were analyzed. Mean NPi was 4.31 ± 0.31, Size was 4.38 ± 0.80 mm, MIN was 2.87 ± 0.49 mm, CH was 34.67 ± 4.15%, CV was 2.74 ± 0.68 mm/s, MCV was 4.16 ± 0.98 mm/s, LAT was 0.23 ± 0.02 s, and DV was 1.13 ± 0.25 mm/s. NPi and LAT were positively correlated (P < 0.01), whereas Size, MIN, CH, CV, MCV, and DV were negatively correlated with age (P < 0.01). No statistically significant difference was observed between males and females.

Conclusion:

The study offers normative data on dynamic pupillometry parameters across various age groups within a healthy Indian population, which would serve as a reference for future studies in diverse clinical scenarios. It also elucidates that age significantly influences values in the NPi algorithm.
Prevalence of Handwriting Difficulty among Second Grade School Students in North Chennai: A Cross-sectional Study
Authors: Raghuram P. , Ramachandran P. , Sethuraman Lakshmanan , Sushmita S. , Udayakumar N.
Published: April 2024

Background:

Handwriting is one of the important skills, i.e., a child needs to meet the needs of the elementary school classroom. Handwriting difficulties affect children’s school performance. The prevalence of handwriting difficulties among the school children was 34%. Handwriting, a complicated perceptual-motor skill, requires a variety of talents, including visual-motor coordination, motor planning, cognitive and perceptual skills, as well as tactile and kinesthetic sensitivity. A child spends 30%–60% of their school day performing fine motor activities, mainly handwriting activities. Occupational therapy services are often recommended for children with handwriting problems. Handwriting interventions commonly focus on learning, acquisition, and maintaining a new skill. Thus, this study interprets the handwriting difficulties among school-going children.

Objective:

The objective of this study is to estimate the prevalence of handwriting difficulty among second grade school students in North Chennai.

Study Design:

The study design was a cross-sectional study.

Methods:

The students were selected based on the selection criteria. Multistage sampling method was used. The North Chennai wards were chosen first, and then, the areas within them, using the table of random numbers. The lottery method was used to choose a total of 9 schools and a total of 821 students were included. Prior to the child’s participation in the study, the parent’s consent was obtained. Then, the Screener of Handwriting Proficiency and student assessment were administered to all the participants. The collected data were analyzed and results were inferred.

Results:

Handwriting difficulty was prevalent among 240 students which accounted to be 29.2% of second grade students, while 581 students with 70.8% were found to have without handwriting difficulty. Out of 459 male students, 172 students (37.5%) and a total of 363 female students, 68 students (18.8%) have handwriting difficulty. Comparatively, male students were found to have more difficulty than female students. This difference of observation was identified statistically significant which denotes gender contributing factor with respect to handwriting difficulty.

Conclusion:

This study concludes that handwriting difficulties were more prevalent in boys than in girls. Errors in memory were more remarked when compared to other components and placement component was found to have least errors.
Prehabilitation and its Outcomes in Cancer Patients: A Narrative Review
Authors: Rajendran A. J. , Raja M. A. , Suresh S. Benedic Kingslin
Published: April 2024

Prehabilitation is a multidisciplinary health enhancement programme offered before a disease intervention, such as surgery or chemotherapy/radiotherapy. It is a holistic patient care model that focuses on providing nutritional, psychological and functional care to patients before their intervention. Researchers have found that prehabilitation can improve patient outcomes by preparing for a surgery-associated physiological challenge. While studies have been limited, prehabilitation remains a promising strategy for cancer surgery with potential benefits such as improved outcomes, early recovery and lower hospital stay. The concept of prehabilitation has been growing rapidly, and it aims to enhance a patient’s overall health and well-being before surgery or other therapeutic interventions. Prehabilitation can be a valuable tool for cancer patients, providing advantages such as improved outcomes, early recovery and reduced hospital stay after surgery. However, more evidence is needed to support the effectiveness of prehabilitation. This review paper provides an overview of current knowledge and results of studies on the role of prehabilitation in cancer surgery, highlighting the positive effects of prehabilitation on physical performance, nutritional status, quality of life and sometimes reduced morbidity. Allied interventions, such as cardiac and pulmonary rehabilitation, can also provide valuable lessons for prehabilitation in practice. This comprehensive review provides a well-structured and informative presentation, ensuring clarity and ease of understanding for a technical audience. The technical details are well-supported by appropriate references, ensuring accuracy and credibility. Overall, the paper is a thorough and informative review of prehabilitation in cancer patients, outlining key concepts and evidence and providing insights for future research and practice.
Stroke Care Planner: A Delphi Study
Authors: Sankaran Ravi , Ramachandran Unnikrishnan , Jayaram Nitha , Ali Noufal , Beegum Shadiya , Vidya G.
Published: April 2024

Objective:

The objective of the study was to analyse the efficacy and acceptability of a care planning tool for comprehensive post-stroke rehabilitation.

Materials and Methods:

An expert panel of physiatrists from Kerala, India, participated in a three-round Delphi study.

Intervention:

Nil.

Results:

Consensus was reached on 13 deficit-oriented modules with best practice key statements. They stress the need for supervised rehabilitation interventions provided by trained health professionals early after discharge from the acute care setting to optimise patient outcomes. Patient-specific, centre-specific and culturally appropriate factors were considered during formulation. Acute care, triage, routine workflow, outcome assessment, trajectory assessment and rationale were recommended, and several standardised outcome measures were identified. Follow-up and community-based rehabilitation suggestions were provided. Specifics on timing, service providers, need for long-term follow-up and interventions differed per module.

Conclusion:

A rigorous consensus method led to key recommendations in modular form using the available evidence and consideration of contextual factors to facilitate clinical practice. This is an important step towards reducing practice variation, closing the evidence–practice gap and improving the quality of rehabilitation services after stroke.

Significance and Innovations:

This is the first formal consensus process to integrate available evidence and expert opinion with a ‘deficit to metric to treatment to outcome’ approach to recommend key aspects of post-stroke rehabilitation from admission to return to the community. The expert panel recommended structured physiatrist-led rehabilitation, initiated early to optimise patient outcomes. In addition to physical rehabilitation, it is important to recognise cognitive and psycho-social deficits along with the influence of contextual factors that impact rehabilitation structures, processes and outcomes.
Unmasking Late Neurological Recovery through Reduced Intrathecal Baclofen
Authors: Patel Chittaranjan P. , DiTommaso Craig C.
Published: April 2024

This case report explores the intricacies of utilising intrathecal baclofen (ITB) therapy for spasticity management and its impact on neurological recovery. Baclofen, a GABAB agonist with antispasmodic properties, has gained prominence in treating spasticity and muscle spasms related to neurological conditions. This report sheds light on a patient who was under ITB treatment and experienced unexpected late-stage improvements in motor function after the dose was inadvertently reduced. The study underscores the need for careful dosing adjustments to unveil potential neurological recovery masked by ITB therapy. The case highlights the importance of multi-physician communication and frequent dosage evaluation in long-term intrathecal therapy. Moreover, it calls attention to the possibility of motor recovery years following a traumatic brain injury, emphasising the role of neuroplasticity in such cases.
Treatment of Acne Keloidalis Nuchae by Simply Combining Two Conventionally Available Modalities: Ablation with Carbon Dioxide Laser and Intralesional Triamcinolone Acetonide
Authors: Bhingradia Yogesh M , Salunke Tejaswini
Published: April 2024

Acne keloidalis nuchae is a chronic inflammatory condition affecting the occipital area or nape of the neck characterized by fibrotic papules, firm pustules, and nodules that coalesce into keloid like mass or plaques. It was first described by Kaposi in 1969. It is also known as lichen keloidalis nuchae, dermatitis papillaris capillitia, and folliculitis nuchae scleroticans. If not treated in the early stages of the disease it tends to be refractory to conventional methods like topical, intralesional steroids with antibiotics or retinoids. Surgical interventions remain the only choice in such cases. Various surgical modalities including surgical excision with primary or secondary closure, split-thickness skin grafts, and laser-assisted treatments have been tried. Most surgical methods have longer downtime with a higher chance of relapse. We studied the results of a combined treatment option carbon dioxide laser ablation followed by intralesional triamcinolone injection in the same sitting. This outpatient procedure has shown good results with no relapse and less downtime.
Evaluation of the Impact of Different Surface Treatments on Implant Surface: An In Vitro Study
Authors: Jalaluddin Mohammad , Subramanian Deepa , Mathew Joel , Mailankote Shilpa , Almuraikhi Turki , Daghriri Alhussain
Published: April 2024

ABSTRACT

Aim:

The current study was conducted to assess the effects of various surface treatments on the implant surface.

Materials and Methods:

A total of 45 dental implants measuring 16 mm in length and 5 mm in diameter were used, along with the appropriate abutments. Depending on the surface treatment used, the samples were randomly split into three groups, with 15 implants in each group: Group 1: Control, Group 2: UV light-treated, Group 3: Sandblasted and acid-etched (SLA)-treated. After surface treatment, a scanning electron microscope (SEM) was used to assess the test samples’ surface properties. All sample images were captured using a 3000× magnification. After all three groups’ surfaces were treated, the surface roughness was measured using a digital optical profilometer with a stylus speed of 0.5 mm/s that was connected to computer software.

Results:

The maximum surface roughness was found in the group treated with SLA (0.714 ± 0.12), followed by the group treated with UV light (0.692 ± 0.09) and the control group (0.516 ± 0.12). There was a significant difference found between different surface treatment methods.

Conclusion:

The present study concluded that the group that received the SLA treatment had the highest surface roughness when compared to the UV light and control groups.
Dentists’ Perception of Mysmartalign Clear Aligner Treatment
Authors: Shaga I. Bevin , Priya K , Ramar Selvakumar , Srinidhi S. , Mohan G. Chandra , Ranganathan Sukanya , Moulvi S. M. M. , Mani Bhuvaneswari
Published: April 2024

ABSTRACT

Aim and Objective:

To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT).

Materials and Method:

A cross-sectional web-based questionnaire survey was carried out to evaluate the dentist perception of MYSMARTALIGN (MSA). To determine the sample size, a pilot study has been carried out and the final sample arrived was 4990 subjects. The current study’s inclusion criteria took into account those who had finished their BDS and MDS as well as dentists and orthodontists who had been using the MSA CAT system on their patients for the previous 7 years.

Results:

The result of the study showed that most research participants (3650) used MSA to treat mild to moderate malocclusion, and 3996 participants said that initial digital treatment plans have been authorised with no revisions. In view of efficiency, 3894 doctors were satisfied with the final outcome.

Conclusions:

Finally concluded that recent survey showed that dentists were very satisfied with the effectiveness and treatment results of the MSA clear aligner procedure.
Evaluation of Shoulder Injuries: A Comparative Study of Imaging by Magnetic Resonance Imaging (MRI) and Magnetic Resonance Arthrography (MRA)
Authors: Dwivedi Abhishek , Sharma Rachit , Sharma Ankur , Gupta Pallav
Published: April 2024

ABSTRACT

Background:

In contrast to the standard shoulder arthroscopy, current radio-diagnostic techniques like magnetic resonance arthrography (MRA), and magnetic resonance imaging (MRI) provide less invasive intricate structural detail of shoulder anatomy.

Objectives:

Comparison of efficacy of MRA and MRI for diagnosing suspected rotator cuff injury.

Materials and Methods:

Over the course of 4 years (from June 2017 to June 2021), a comparative study, including 100 individuals with suspected rotator cuff pathology, was conducted. For the evaluation of shoulder injuries, the assessment and comparison of MRA and MRI were done in terms of sensitivity (Sn), positive predictive value (PPV), and diagnostic accuracy (DA).

Results:

MRI and MRA were positive in 76 (76%) and 98 (98%) patients, respectively. The Sn and PPV of MRI for diagnosing the shoulder injury were 76% and 100%, respectively, whereas the Sn and PPV of MRA were 98% and 100%, respectively. MRA was better than MRI in terms of diagnostic accuracy (98% vs. 76%, P = 0.03).

Conclusion:

MRA is a nonsurgical effective method in evaluating and diagnosing rotator cuff injuries in comparison to MRI.
A Systematic Review of Radiological Diagnosis and Management of May–Thurner Syndrome
Authors: Dwivedi Abhishek , Singh Satyender N. , Sharma Ankur , Sharma Rachit , Mishra Tanu
Published: April 2024

ABSTRACT

May–Thurner syndrome (MTS) is an anatomical condition of external luminal compression of common iliac vein due to a partial obstruction of the common iliac vein between common iliac artery and lumbar vertebra causes deep-vein thrombosis, venous hypertension, and chronic venous insufficiencies. In this article, we review present evidence of the clinical diagnosis and management of MTS. Here, we conducted a literature review of studies on MTS. We also reviewed different clinical features, presentation, diagnostic methods, and therapeutic procedure for this condition. Most studies mentioned the diagnosis of this condition is performed by color Doppler, computed tomographic angiography, venography, and problem-solving cases by intravascular ultrasound technique. Nonsurgical methods of management are first line, and vascular surgery is reserved for refractory cases. Multiple modalities are required to reach the diagnosis of MTS, and noninvasive intervention radiology methods are the first line of management. This review highlights the presentations of MTS and outlines diagnostic procedure and management.
Pattern of Traumatic Dental Injuries and Treatment Receipt among Children Attending the University Dental Hospital in Saudi Arabia
Authors: Madiraju Guna Shekhar
Published: April 2024

ABSTRACT

Objective:

The aim of this study was to investigate the pattern and distribution of traumatic injuries to primary and permanent anterior teeth in 2–14-year-old pediatric dental patients in AlHassa region of Saudi Arabia.

Methods:

The study sample consisted of pediatric dental patients visiting the university dental complex seeking treatment for traumatic dental injuries (TDIs) during the period from February 2022 to April 2023. Data were collected by means of interviewing the children and/or parents regarding the history of trauma and clinical examination for evidence of dental trauma to primary and permanent teeth.

Results:

A total of 122 children (184 teeth) including 78 (63.9%) boys and 44 (36.1%) girls sustained traumatic injuries to their teeth. The most common reason for dental trauma was falls, and maxillary right central incisor was the most frequently affected permanent teeth. Enamel-dentine fractures in permanent teeth and luxation injuries among primary teeth were predominantly noted. Majority of the injuries (47.5%) have been found to have not received timely attention for treatment.

Conclusions:

Early treatment of dental trauma should be emphasized, and preventive strategies targeted at parents and teachers at the community level are needed to promote and reduce the burden of TDIs.
Knowledge and Attitude Toward Otitis Externa: A Saudi Arabian Perspective
Authors: Albulayhid Naif A. , Al-jabr Khalid H. , Almazroua Mohammed M. , Aldossari Mubarak H. , Alsannat Ibrahim A. , Alotaibi Abdulwhab M. , Almalki Yazeed F. , Alotaibi Faihan T. , Alselmi Faris A. , Alsharif Mohammed H. Karrar
Published: April 2024

ABSTRACT

Objectives:

This study intended to assess the level of awareness and attitude toward otitis externa (OE) and specific limitations that counter the attempts to uplift the understanding and notion related to OE among the general population of Saudi Arabia.

Methods:

A cross-sectional quantitative study using a questionnaire was done via Google Forms between May 2023 and July 2023. The scoring method was used to determine the participant’s awareness or attitude; participants who scored >50% were considered aware or to have a good attitude.

Results:

Approximately 52.2% had a good attitude toward the OE, and majority were willing to visit healthcare professionals (81%) to provide care and receive proper education during office visits (80.1%). Of all the participants, 69%, 33.4%, and 30.8% suggested that a lack of awareness, cost, and health insurance, respectively, might prevent patients from seeking a healthcare professional. Only 10.9% of participants demonstrated good awareness (score >13) of outer ear inflammation.

Conclusion:

The findings indicate a poor level of awareness regarding OE, and a positive attitude toward seeking healthcare, with the majority recommending professional visits and relying on healthcare professionals for information.
Comparison of Patient Satisfaction between Invisible Appliance and Fixed Orthodontic Appliances – A Systematic Review
Authors: Tania Milling , Veerasankar S , Ponniah Harish , Dhayananth L Xavier , Preeti R , Missier Mary Sheloni
Published: April 2024

ABSTRACT

To compare the patient acceptance between fixed orthodontic appliances and clear aligners. An electronic search was completed in PubMed, Cochrane Database, Web of Science, Scopus, Lilacs, Google Scholar, and Open Grey databases without any restrictions until August 23. All comparative study types contrasting patient perception between clear aligners and fixed appliances were included. After removal of duplicates, exclusion by title and abstract, and reading the full text, only eight articles were included. The studies used an observational questionnaire study design. Of the observational studies, one was retrospective and three prospective, one online survey, and the other three cross sectional. Though the response varied in terms of patient preference and acceptance, it was found that clear aligners have a positive impact with respect to quality of life, tolerance, and improved confidence. However, there is not enough evidence to make a final conclusion about treatment outcomes.
Ultrastructural Changes of Synapses in the Hippocampus of Sprague Dawley Rat Brain following Exposure to Naphthalene Balls
Authors: Angu Bala Ganesh Koduvai S. V. , Soman Sharath , Reginald Sharon Roshin , Yamunadevi Andamuthu , Yadav Omnath P.
Published: April 2024

ABSTRACT

Introduction:

The synaptic contacts play an important role in central nervous system (CNS) functioning. Ultrastructural features of synapses in CNS are not studied in naphthalene neurotoxicity model.

Materials and Methodology:

In the present work, transmission electron microscopy was used for studying the ultrastructural features of synapses in the hippocampus of Sprague Dawley rat brain, on subsequent exposure to naphthalene balls. The ultrastructural changes were observed for naphthalene low dose (200 mg), high dose (400 mg) after the treatment for 28 days, and post-delayed toxicity phase after 14 days in Sprague Dawley rats.

Results:

In comparison with different groups of naphthalene exposure including control and satellite, axon degeneration, axonal demyelination and abnormal synapses was observed in high dose naphthalene administration group. In the post-delayed naphthalene toxicity group, degeneration of synaptic contacts was observed.

Conclusions:

This exploration of ultrastructural variations in the synapses of Hippocampus gives information that will be valued in naphthalene neurotoxicological research.
Clinico-Radiological Perspectives of Pycnodysostosis – A Rare Case Series
Authors: Shanmugapriya SundarRaj. , Priya Sairam Sugantha , Priya Mohankumar Saravana , Selvam Alagarsamy , Anupriya Mahalingam
Published: April 2024

ABSTRACT

Pycnodysostosis is an inherited autosomal recessive disorder characterized by dysplasia of the skeletal system. It occurs in any human races with no disparity in gender or age predilection. The disease is diagnosed at a young age owing to the frequent fragile bone fractures. Craniofacial and dental manifestations may overlap with those of other craniofacial dysostosis; therefore, precise knowledge is essential in differential diagnosis as it may affect the treatment outcome. Here, we report three cases with typical clinical and radiological features, among which one presented with osteomyelitis of the mandible.
Preformed Stainless-Steel Crowns: Their Effects on Oral Hygiene Maintenance and Gingival Health – A Prospective Original Research
Authors: Alharbi Majed , Sayed Arshad Jamal , Habibullah Mohammed Ali , Almulhim Basim , Alharthi Naji , Ravi Prakash Sasankoti Mohan , Ahmad Muhammad Zubair
Published: April 2024

ABSTRACT

The stainless-steel crown (SSC) is a durable restoration and has several indications for use in primary teeth such as following a pulpotomy/pulpectomy, fractured teeth, teeth with developmental defects, or large multi-surface caries lesions where amalgam is likely to fail. Due to its durability and a lifespan like the primary tooth, it could well be the gold standard in restorative care. SSCs protect the crown from fracture, reduce the possibility for leakage, and ensure a biological seal. However, the placement of the SSC should follow a meticulous technique. There are some clinical situations where the SSC may fail, leading to plaque accumulation and gingivitis. This could be secondary to improper crimping of crown margins, which lead to poorly adapted SSC. In some clinical situations, ledge formation under the crown or failure to clean excess cement can contact the gingiva and cause gingival inflammation. This study was carried out on 41 children between the ages of 4 and 10 in Al Qassim region to study the effects of SSCs on gingiva and oral hygiene. The study also aims to establish the correlation between SSC adaptation and post-insertion inflammation. The plaque and gingival index were recorded at 3 months’ post SSC insertion. Clinical examination was undertaken, and gingival index (Loe and Silness 1967) and plaque index (Silness and Loe 1967) were used to record gingival health and plaque accumulation, respectively. The result for post-inflammation and SSC adaptation showed that there was no statistically significant difference in post-insertion inflammation and crown adaptation (P value = 0.216). The result for pre-operative inflammation and post-operative inflammation shows that there is no significant difference in post-inflammation and adaptation (P value = 0.47). We found that oral hygiene care had a heightening effect and oral hygiene maintenance plays a key role in preventing gingival inflammation irrespective of the SSC adaptation over short periods of time (3 months).
Clinical Dental Student Perception of Oral and Maxillofacial Surgery as a Specialty at Qassim University
Authors: Alotaibi Khalid Z. , Altuwaijri Abdulrahman
Published: April 2024

ABSTRACT

The objective of the current research was to assess and gain insight into the perceptions held by dental students enrolled in the clinical program at Qassim University regarding the specialty of oral and maxillofacial surgery (OMFS). A survey-based cross-sectional study was carried out at the dental clinics of Qassim University, following approval from the Dental Research Center of the university. The study targeted a population consisting of 80 dental interns and undergraduate students (BDS) enrolled at Qassim University. From each academic year (third year to interns), a random selection of 20 students was made, ensuring representation from both male and female sections. Upon analyzing the data regarding the intern and class year of dental students, it was found that there were no statistically significant associations with regard to question 3: “What do you perceive as the most commonly performed procedure by oral and maxillofacial surgeons in practice?” (P = 0.759a). Among intern and dental students, a significant majority identified extraction of the third molars as the most frequent procedure carried out. The lowest percentage (70.4%) was reported among the intern classes, whereas the highest percentage (91.7%) was reported among the fourth-year students. The perceptions of dental students toward OMFS undergo changes during their undergraduate training. By gaining a deeper understanding of these perceptions, the academic faculty specialized in OMFS can enhance their ability to educate students and, in turn, strengthen the overall specialty.