bluuebunny/crossref_metadata_2025 huggingface dataset:
Opportunities and Challenges of Culinary Tourism and Hospitality
Authors: Sharma Vikas , Srivastav Dhananjay Kumar
Published: June 2024

This study aims to understand the state of culinary tourism in Braj, India, by examining perceptions of local cuisine among hosts and tourists. Through surveys of 200 respondents, it seeks to identify opportunities and challenges in promoting culinary tourism. By quantifying past perceptions and experiences, the study provides insights for stakeholders to enhance destination branding and attract visitors. Grounded in theories of culinary tourism and cultural heritage, the research contributes to the advancement of knowledge in this field, highlighting Braj's potential as a culinary tourism destination.
Biodiversity Loss in Streams Due to Human Diversion Activities
Authors: Sadhiyan Bharti , Kumari Monika , Madan Sangeeta , Maurya Ritika
Published: June 2024

Stream biodiversity loss is a major environmental issue that directly affects the delicate ecological balance of these aquatic habitats. The stability and health of the surrounding environment are supported by the wide variety of plants, fish, and invertebrates that may be found in streams. These habitats are becoming less healthy largely because of human activity, which may lead to a decline in biodiversity and the extinction of many species. Understanding the origins, impacts, and challenges involved, as well as increasing awareness of the issue, are crucial goals for the preservation of stream ecosystems.
Biodiversity Loss Due to Forest Diversion
Authors: Tari Vinaya Satyawan , Gupta Vandana , Joshi Ashutosh S. , Kurve Poonam Nirmalkumar , Chandra Naresh
Published: June 2024

The world is continuously progressing towards technological advancement. Eventually, global biodiversity is taking a consistent downfall. This is not only disrupting the ecosystem services and livelihood spatially but also impacts carbon offsetting globally in the present context. In the arena of biodiversity loss in the last three decades the problem remains unresolved, despite environmental regulations present at national and international levels to protect biodiversity. Forest diversion has been observed to be one of the major root causes for these losses which is further resulting in habitat deterioration and fragmentation. Numerous case studies have been reported that support biodiversity loss due to forest diversions. The conversion of forest land to commercial purposes such as plantations, infrastructural developments, and residential projects has shown a major impact on biodiversity loss, especially in the tropics.
Methodology and Approaches for Biodiversity Conservation
Authors: R. Sanjeevi , Sathvara Prashantkumar , Tripathi Sandeep , J. Anuradha
Published: June 2024

“Harmony in Nature” offers a thorough examination of biodiversity conservation methods. It serves as a guide for scientists, policymakers, and enthusiasts. Beginning with the urgent need for conservation, it emphasizes ecosystems' role in sustaining life. The book covers traditional and modern assessment methods, including field studies and advanced technologies like satellite imagery. It stresses integrating indigenous knowledge, citizen science, and community-based approaches. Adaptive management, policy frameworks, and global collaborations are discussed. Case studies illustrate successful initiatives and lessons learned. Ethical considerations and sustainability are integrated throughout. The book concludes with a call to action for global biodiversity preservation. It aims to be a valuable resource for academia, practitioners, and policymakers, fostering understanding of essential methodologies for successful conservation amidst environmental challenges.
Metabolic Plasticity of Regulatory T Cells in Health and Autoimmunity
Authors: Carbone Fortunata , Colamatteo Alessandra , La Rocca Claudia , Lepore Maria Teresa , Russo Claudia , De Rosa Giusy , Matarese Alessandro , Procaccini Claudio , Matarese Giuseppe
Published: June 2024

Immunometabolism has been demonstrated to control immune tolerance and the pathogenic events leading to autoimmunity. Compelling experimental evidence also suggests that intracellular metabolic programs influence differentiation, phenotype, proliferation, and effector functions of anti-inflammatory CD4+CD25+Foxp3+ regulatory T (Treg) cells. Indeed, alterations in intracellular metabolism associate with quantitative and qualitative impairments of Treg cells in several pathological conditions. In this review, we summarize the most recent advances linking how metabolic pathways control Treg cell homeostasis and their alterations occurring in autoimmunity. Also, we analyze how metabolic manipulations could be employed to restore Treg cell frequency and function with the aim to create novel therapeutic opportunities to halt immune-mediated disorders.
A case series of Mediterranean spotted fever and murine typhus with neurological manifestations
Authors: Hammami Fatma , Koubaa Makram , Chakroun Amal , Rekik Khaoula , Mezghani Sonda , Hammami Adnane , Marrakchi Chakib , Smaoui Fatma , Jemaa Mounir Ben
Published: June 2024

Background & objectives:

Severe cases with neurological manifestations of rickettsiosis have been reported. We aimed to identify the epidemiological, clinical and laboratory features of central nervous system rickettsial infections and to describe the treatment.

Methods:

We carried out a retrospective study that included all patients hospitalized with rickettsiosis in the infectious diseases department of Hedi Chaker University Hospital in Sfax, Tunisia between 1993 and 2018.

Results:

We identified 47 patients with central nervous system rickettsial infections among 440 patients with rickettsial infections (10.7%). Skin rash (31.9% vs 87.8%; p<0.001) and eschar (4.2% vs 27.7%; p<0.001) were less frequent among patients with central nervous system rickettsial infections. Complications (6.4% vs 0.5%; p=0.01) and death (4.2% vs 0.3%; p=0.03) were more frequent among patients with central nervous system rickettsial infections.

Interpretation & conclusion:

Cardinal clinical features and typical laboratory results including thrombocytopenia were less frequent, and prognosis was more severe in patients with central nervous system rickettsial infections.
Role of Baricitinib in Moderate-to-severe COVID-19: A Case–Control Study from a South Indian Tertiary Care Setting
Authors: Kulirankal Kiran G. , Mary Ann , Mehta Asmita Anilkumar , Razak M. Abdul , Abhinandh B. , Nair Chithira V. , Hakeem Sai Chandra , Edathadathil Fabia , Chandra Subhash , Pillai M. Gopala Krishna , Balachandran Sabarish , Purushothaman Shyam Sundar , Sathyapalan Dipu T. , Moni Merlin
Published: June 2024

Background:

Baricitinib is a Janus-kinase inhibitor with known anti-inflammatory effects with beneficial outcomes in COVID-19 management. We aim to assess the efficacy and all-cause mortality among moderate-to-severe COVID-19 patients who received baricitinib as an add-on to the standard of care.

Methods:

The retrospective case–control study recruited moderate-to-severe COVID-19 patients receiving baricitinib therapy for at least 72 h as cases from April 2021 to October 2021. Age- and severity-matched COVID-19 patients receiving standard of care without baricitinib served as control. The clinical and demographic data of the study groups were collected. Study outcomes evaluated included all-cause mortality, clinical improvement as assessed by the WHO Ordinal Scale scores, multiorgan dysfunction syndrome, thrombotic events, and secondary infections.

Results:

Among 527 moderate-to-severe COVID-19 patients in the study period, 75 patients each were recruited into the case and control groups who fulfilled the study eligibility criteria. The average age was found to be 60.82 ± 13.03 and 61 ± 13.48 years in case and control groups, respectively. All-cause mortality was 42.7% (64), with 27 (36%) and 37 (49.3%) deaths in the case and control groups, respectively (P = 0.09). Kaplan–Meier survival analysis revealed the survival distributions to be significantly different between case and control groups (Log-rank: P =0.048). Clinical improvement was observed in 35 (47%) and 28 (37.7%) patients among cases and controls, respectively (P = 0.32).

Conclusion:

The study demonstrated improved clinical outcomes, including mortality reduction and higher proportion of patients attaining clinical improvement as measured by at least 1-point improvement of the WHO ordinal scale, though a statistical significance was not observed.
Diagnostics for Tuberculosis
Authors: Kambli Priti , Rodrigues Camilla
Published: June 2024

Accurate diagnosis and treatment of Tuberculosis (TB) continues to elude us. To overcome this, detection of Mycobacterium tuberculosis (MTB) and testing for drug resistance is of paramount importance. Globally, only one in three patients are bacteriologically confirmed and just one in five is diagnosed with a WHO endorsed molecular test, emphasising that diagnostic gaps continue to preclude patients from accessing care. Therefore, it is essential that newer and affordable technologies for the detection of MTB in low and middle income countries (LMICs) reach that last mile. In this review we discuss various recent technologies for detection of active TB disease, that have the possibility of being considered, or are already WHO endorsed.
A Cross-sectional Study on Body Image Dissatisfaction, Depression, Anxiety and Stress among Medical Students and Interns
Authors: Sindhu B. M. , Rashmi B. M. , Kumbar Abhinandan S.
Published: June 2024

Background:

Body image dissatisfaction is hypothesized to be associated with depression, anxiety, psychological distress and low self-esteem. This study was conducted to assess body image concerns and weight control behaviors and the associations of body image concerns with depression, anxiety and stress among medical students in Central Karnataka.

Methodology:

A cross-sectional study among medical students was conducted at Basaveshwara Medical College and Hospital, Chitradurga. Each participant was asked to self-select the silhouette that best indicated his or her current body size and the silhouette that reflects his or her preferred ideal body size, from Stunkard Figure Rating Scale. Body Shape Questionnaire (to assess body shape concern) and Depression, Anxiety and Stress Scale-21 instrument (to assess depression, anxiety and stress) were utilized.

Results:

66.9% students had normal body mass index. 74.6% students desired to change current weight, which was mainly influenced by family members, media icons and friends (47.9%, 40.8% and 31.7%). 42.3% reported that they did physical activity/exercises, 35.2% followed diet to control their weight. Higher proportions for depression, anxiety and stress were noted among those students who had body image misconception.

Conclusions and recommendations:

Counseling and if required treatment by psychologists and psychiatrists would be recommended to address wrong thoughts towards the ideal body image among college students and associated depression, anxiety, stress. Nutritional health education can be given about the importance of a healthy diet and provide free nutritional consultations and counseling.
Current and Future Impact of COVID-19 Pandemic Lockdowns on the Confidence Level of Clinical Practice among Female Dental Students in Namakkal District – A Cross-sectional Study
Authors: Sundararajan Shanmathi , Shavi Girish R. , Shanmugam Shankar , Gunasekaran Lalithambigai , Sennan SenthilKumar
Published: June 2024

Introduction:

Coronavirus has influenced the health-care system and human life in several aspects. Education being an important factor has decreased the level of interest and confidence among the students.

Objective:

The objective of this study was to assess the impact of the COVID pandemic on the self-confidence level of clinical practice.

Materials and Methods:

A cross-sectional study was conducted among 120 female dental students in the Namakkal district. Students were selected using a simple random sampling lottery method. Their level of self-confidence was assessed using a pretested questionnaire framed in all specialties regarding clinical work. The questionnaire was distributed via Google Forms and evaluated using a five-point Likert scale.

Results:

Among 120 students, a higher level of confidence was seen in endodontic procedures followed by periodontics. A lower level of confidence was seen in managing dental emergencies and procedures such as pulpotomy/pulpectomy and extractions. Only 24% were confident in class I cavity preparation, 30% in instructing patients about oral hygiene, 13% in recording case history, and 6.7% in fluoride application. Most of the students wish to improve their level of confidence through extra training because only 20% were satisfied with their self-confidence.

Conclusion:

In the field of dentistry, contact with clinical practice has been severely affected, and it is understood that online educational platforms can only improve the theoretical part and have lower performance in clinical education.
Glycated hemoglobin as a predictive factor for postoperative outcome in controlled versus uncontrolled diabetic patients with ankle fractures
Authors: Zakaria Ahmed R. , Hussein Abdalla R. , Abouzied Mahmoud
Published: June 2024

Background

Ankle fracture in diabetic patients is a challenging condition owing to the inherent risk of complications with either operative or nonoperative treatment. However, operative treatment is considered the gold standard treatment for such cases. In this study, the hypothesis is that the glycated hemoglobin (HbA1c) could have a predictive value for postoperative outcomes and complications.

Patients and methods

A total of 34 diabetic patients with ankle fractures were included in this study. The patients are divided into two groups: the first group included patients with controlled diabetes (HbA1c<7) and the second group included patients with uncontrolled diabetes (HbA1c≥7). All patients were treated by standard open reduction and internal fixation.

Results

The complications rate was higher in the uncontrolled diabetes group (63.2%) than in the controlled diabetes group (26.6%). Preoperative HbA1c was higher in complicated patients than in uncomplicated patients (P=0.033), and postoperative HbA1c was also higher in complicated patients than in uncomplicated patients (P=0.031). The postoperative American Orthopedic Foot and Ankle Society (AOFAS) score was significantly higher in the controlled diabetes group than in the uncontrolled diabetes group (P=0.046).

Conclusion

The overall rate of complications was higher in the uncontrolled diabetes group (HbA1c≥7) than in the controlled diabetes group (HbA1c<7), with a statistically significant difference. These complications were mainly related to wound healing. Despite being statistically insignificant, poor radiological outcome was more common in the uncontrolled diabetes group. According to the postoperative AOFAS score, clinical outcome was more superior in the controlled diabetes group than in the uncontrolled diabetes group.
Single-level interbody fusion in treatment of lumbar fractures
Authors: Abdelrady Abdelrady M. , El Zahlawy Hany , Ibrahim Mohammed Z.
Published: June 2024

Background

The purpose of this study was to evaluate the effectiveness of treating lumbar fractures by performing instrumented interbody fusion with the adjacent vertebra.

Patients

and methods In a prospective study, 69 consecutive patients with lumbar fractures were treated by single-level interbody fusion. The fractures involving either the superior or inferior endplate with intact pedicles were included.

Results

The follow-up period was between 24 and 37 months, with a mean of 28.3 months. The mean preoperative local kyphosis was 10.39° and anterior vertebral height loss was 50.55%. In the final follow-up, they were 2.98° and 16.78%, with a statistically significant difference. On Denis scale for back pain, six patients were P3 with occasional use of medications, and two were P4 with constant use of analgesics at the final follow-up. No case of pesudoarthrosis nor neurologic deterioration was recorded.

Conclusion

Single-segment interbody fusion is an effective option in fractures of the lumbar region, involving either endplate, provided the body is not severely comminuted.
Coronavirus disease and the musculoskeletal system
Authors: Daher Mohammad , Sebaaly Amer
Published: June 2024

Coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome-coronavirus-2). This virus uses as receptors the angiotensin-converting enzyme 2 and the transmembrane protease serine 2, which are also present in cells of the musculoskeletal system. Their presence can explain how coronavirus disease 2019 can cause general symptoms such as myalgia and arthralgia, as well as chronic back pain and articulation-specific symptoms such as shoulder capsulitis and hip and knee osteonecrosis.
Three-dimensional printing in orthopedics − what an orthopedic surgeon should know
Authors: Barakat Ahmed S. , Alhashash Mohamed
Published: June 2024

Background

In complex situations, regular on-shelf orthopedic implants are not suitable or sufficient to ensure the expected biomechanical or biological function, and customized implants could theoretically offer a solution. Preoperative planning, procedure rehearsal, patient teaching, and three-dimensional (3D) bioprinting are other uses of the fast-spreading 3D printing technology.

Aim

This review deals with the status and future uses of 3D printing and its various applications in orthopedic surgery. In the past decades, enormous technological progress in the field of radiological data acquisition, processing, and 3D printing technologies led to an explosive advancement of this promising industry.

Materials and methods

A literature review of the recent and relevant publications with a special focus on the various orthopedic applications of 3D printing technology was done.

Conclusion

3D printing offers already a valid yet still an expensive solution in certain orthopedic indications. Soon, orthopedic surgeons will be able to use this emerging technology more frequently as more and more companies offer cheaper rapid prototyping manufacturing solutions. Nevertheless, the technology still needs improvement, and many issues such as accuracy, long-term survivorship, and legal liability for the customized implants are still not fully solved.
Scarf osteotomy for the correction of moderate and severe degrees of hallux valgus
Authors: Tawfik Ayman , Sokkar Sheriff , Metwaly Ahmed
Published: June 2024

Aim

The aim of this study was to evaluate the clinical and radiological results of scarf osteotomy in correction of moderate and severe degrees of hallux valgus (HV).

Patients and methods

Between April 2011 and June 2014, 21 patients with 25 feet of moderate to severe HV deformity were included in this prospective study. The study was conducted to evaluate the clinical and radiological results of correction of moderate to severe HV deformity using scarf osteotomy. While a Z-shaped step-cut osteotomy was used to realign the first metatarsal bone, and another closing-wedge osteotomy of Akin osteotomy may be needed in severe cases to complete the correction of the proximal phalanx of the HV in 15 feet. There were five men and 16 women, with a mean age of 24 years. The mean follow-up time was 24 months.

Results

Overall, 84% of the patients were very satisfied, 12% were satisfied, and 4% were not satisfied. The mean American Orthopedic Foot and Ankle Society score improved significantly from 36 points preoperatively to 94 at the final follow-up. The intermetatarsal and HV angles improved from the mean preoperative values of 18° and 37° to 8° and 13°, respectively. Satisfactory healing time was expressed as an average return back to work after 6 weeks and back to sports after 12 weeks. Persistence or recurrence of HV was seen in one patient; wound infections occurred in two patients, which settled after the administration of antibiotics; and one patient required further surgery to remove a long distal screw.

Conclusion

The scarf osteotomy combined with the Akin closing-wedge osteotomy is safe and effective for the treatment of HV.
Endoscopic Plastic Pigtail Stents for Leak after Bariatric Surgery: Effective as Primary and Rescue Therapy
Authors: Philip Thomas Cherukara , Thomas Noble , Al-Serkal Yousif , Dutta Amit Kumar
Published: June 2024

Bariatric procedures are increasingly being performed to manage obesity. Postoperative leak is one of the serious complications after bariatric surgery. The management of leaks includes surgery and endoscopic interventions. Endoscopic interventions are less invasive and have shown good efficacy in treating leaks. This includes placement of stents (plastic or metal) or closure of leak by stitching or clipping. Among these, internal drainage by placement of plastic stents is probably the least expensive intervention. In this case series, we show the effectiveness of plastic stents in the management of postbariatric surgery leak in three different scenarios – early postoperative leak, delayed postoperative leak, and prior failed metal stent for treatment of leak.
Complications of Forgotten or Neglected Biliary Plastic Stents and Their Outcome
Authors: Zumu Mhasisielie , Arun R. S. , Rao Nageswara , Kumar S Krishna , Sri Nayan , Tirupati Vaibhav
Published: June 2024

Introduction:

Before cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) with common bile duct (CBD) stent placement is the standard therapy for choledocholithiasis. Prolonged stents in situ may present with various complications, some of which may be life-threatening.

Methodology:

A study in a tertiary center in South India from January 2018 to July 2023. A total of 624 patients underwent ERCP for biliary stent procedures, out of which 29 had biliary plastic stents in situ for more than 6 months. We retrospectively analyzed these 29 cases for complications and their treatment outcomes.

Results:

The mean ± standard deviation age was 57.5 ± 16.6 years, male-to-female ratio was 2.2:1, 55.17% had a cholecystectomy (n = 16), the most common indications for CBD stent placement were choledocholithiasis 75.8% (n = 22); the median duration of stent in situ was 7 months interquartile range (6–9). The reasons for delayed CBD stent removal were: 27.6% due to the COVID-19 pandemic (n = 8), 13.8% surgically unfit (n = 4), 6.9% financial constraints (n = 2), 3.4% of patients were unaware of the stent in situ (n = 1), and 48.3% were unknown (n = 14). The complications associated were that 69% had calculi/sludge (n = 20), 24.14% had cholangitis (n = 7), 7% were asymptomatic (n = 2), and 3% had intestinal perforation (n = 1).

Conclusion:

Early complication identification and treatment lead to successful clinical outcomes. Irrespective of cholecystectomy, a check cholangiogram, and CBD clearance should be done in all cases of biliary stent removal.
Ectopic Nasal Tooth Associated with Cleft Lip and Palate
Authors: Basu Subhransu , Sahu Sudipto , Bose Abhinaba , Ghosh Sucharu
Published: June 2024

Ectopic nasal tooth is a rare phenomenon with only 0.1%–1% incidence rate. They are more frequently found coupled with cleft lip and palate. Here, we present a case of intranasal tooth in a 12-year-old male child with operated cleft lip and palate. The condition was diagnosed only on the basis of intraoral periapical radiograph and was extracted using gauge-holding forceps at a rural health-care center. We discuss the possible etiology, clinical findings, diagnosis, and treatment modalities of this condition. The purpose of this paper is to highlight that this rare condition can be managed with minimum available equipment in a rural setup.
Prosthodontic Rehabilitation using Balancing Ramp-Guided Flexible Prosthesis in a Squamous Cell Carcinoma Patient Treated with Hemimandibulectomy
Authors: Rathee Manu , Jain Prachi , Shetye Akanksha Gopal , Alam Maqbul
Published: June 2024

Loss of any anatomical structure leads to functional insufficiency and psychological trauma. Malignant neoplasms of mandible are often surgically treated by hemimandibulectomy which greatly affects the function postoperatively. The amount of dysfunction depends upon the size of resected segment, effect on tongue, number of remaining teeth, and the extent of loss of sensory and motor innervations. This clinical report describes the prosthodontic management of a squamous cell carcinoma patient treated with hemimandibulectomy and rehabilitated using balancing ramp-guided flexible prosthesis to accommodate mandibular deviation and limited mouth opening.
Emergency Management of Symptomatic Children with Severe Early Childhood Caries in the Time of COVID-19 - Protocols and Procedures - A Case Series
Authors: Dempsy Chengappa M. M. , Kumar Andrews Navin , Sharma Dhruv , Kaul Rahul
Published: June 2024

Severe early childhood caries (S-ECC) is a health concern which can lead to reduced overall quality of life. In most cases, due to the extent of rehabilitation required and difficulty in obtaining cooperation of the patient due to their age necessitates management under general anesthesia (GA). However, the COVID-19 pandemic limited dental treatment to emergency procedures only. The objective of this study was to report two cases of emergency management of S-ECC, under GA, emphasizing on the protocols and procedures required to be followed to safely deliver treatment in the background of the pandemic. Two children aged 3.5 years and a 5 years, respectively, were brought to the department by their parents due to severe pain, difficulty in chewing, and disturbed sleep. They were taken up as emergency cases for rehabilitation to alleviate pain and restore function. Protocols and procedures to prevent transmission of COVID-19 during treatment were followed stringently. In emergency management to rehabilitate patients suffering from S-ECC, care should be taken to follow all protocols instituted to prevent transmission of COVID-19 infection. This is highlighted in the oral cavity due to an increased chance of transmission during aerosol-generating procedures.
Evolution of Indices in the Screening of Periodontal Diseases
Authors: Bangera Danavanthi , Vishwanathan Krishnan , Sreedharan Jayadevan , Natarajan Prabhu Manickam
Published: June 2024

Periodontal disease is the inflammation of the periodontal supporting structures of teeth. An index is an important tool of surveillance system based on the requirements of reliability, simplicity, and validity to screen oral health disease of the population. This paper aims to discuss on various indices formulated to measure periodontal disease from past to present. This paper reviews indices and different recording systems used to measure periodontal diseases at the population level by retrieving articles, selecting, writing, and summarizing the article. The advantages and disadvantages of various indices used for measuring periodontal disease are discussed in this article. Community Periodontal Index is the most widely accepted index used in larger research studies. However, presently, clinical attachment loss is a widely accepted tool for the diagnosis of periodontal disease. Future advances in new screening methods will be able to provide new opportunities in the diagnosis of active and progressive periodontal disease, which will further help in more precise screening of periodontal disease in larger research studies.
Dermoids of the Maxillofacial Region
Authors: Sharma Divashree , Tripathi Geeta Mishra , Mishra Ambrish , Shakya Neelam
Published: June 2024

Introduction:

Dermoid and epidermoid cysts commonly termed as “Dermoids” are known to be developmental benign swellings that possibly occur as a result of traumatic implantation of epithelium or entrapment of epithelial remnants during embryonic fusion. The occurrence is rare (about 7%) in the head-and-neck region and they represent <1.6% of all cysts of the oral cavity.

Patients and Methods:

A retrospective study was done on 12 histopathologically proven cases of epidermoid and dermoid cysts of the maxillofacial region that were treated in Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from January 2013 to December 2019. The cases were evaluated for clinical presentation, demographic characteristics, and treatment performed.

Results:

Out of a total of 12 cases that were included in this study, 10 cases were diagnosed as epidermoid and 2 cases as true dermoid cysts. The mean age of occurrence was 31.66 ± 9.97 years. Male predominance was seen with a male-to-female ratio of 1.4:1. The floor of the mouth was the most commonly involved site in ten (83.34%) cases. Sublingual cysts were seen in five (41.67%) cases, combined sublingual–submandibular involvement in three (25%) cases, and midline floor of the mouth cyst in two (16.67%) cases. All the cases were treated by surgical enucleation, and no recurrence or malignant transformation was reported in any case at a minimum follow-up of 2 years.

Conclusion:

Based on the findings of this retrospective study, it is suggested that these lesions are very rare in the maxillofacial region and pose a diagnostic challenge. However, fine-needle aspiration cytology, ultrasound imaging, computerized tomography, and magnetic resonance imaging techniques can be relied upon for precise treatment planning. Surgical enucleation of these lesions is the preferred treatment modality.
Coronavirus (COVID-19)
Authors: Parimoo Rajneesh , Singh Baljeet , Sharma Divya , Sharma Vanshika
Published: June 2024

In the past many years, different viruses have created an atmosphere of menace, all over the world. In 2003, severe acute respiratory syndrome epidemic, 2009 H1N1 influenza pandemic, 2014 Middle East respiratory syndrome epidemic, and recently to join the list is the deadly novel coronavirus, COVID-19. It is a global health emergency with implications for all the sections of the society, including health-care professionals. In the current scenario of panic, the health-care professionals, including dental surgeons have to play a pivotal role in the prevention of the future spread of COVID-19. Dental practice being a major route of aerosols, dentists definitely will have to contribute handsomely toward this end. This article attempts to draw the attention of dental surgeons toward the etiology, transmission, and prevention of COVID-19 infection, with special emphasis on infection control measures as they relate to COVID-19 infection.
Role of Interleukin Gene Polymorphism in Patients with Chronic and Aggressive Periodontitis
Authors: Preeti Shukla , Jyoti Batra , Shweta Bali , Pradeep Shukla
Published: June 2024

Periodontitis is a microbial disease of tooth-supporting tissues that results in progressive destruction of surrounding soft and hard tissues with eventual loss of tooth or tooth mobility. A comprehensive literature search was performed by using the keywords: periodontitis, periodontal disease, combined with the word genes, mutation, or polymorphism. Gene polymorphism studies with a reported genotype frequency in chronic periodontitis (CP) and aggressive periodontitis (AgP) patients were searched and reviewed. There has been a growing evidence of polymorphisms in the interleukin (IL)-1, IL-4, IL-6, IL-10, IL-12, and tumor necrosis factor-alpha with CP and AgP in certain populations. However, carriage rates of the rare (R) allele of any polymorphism varied considerably among studies, and most of the studies appeared underpowered and did not correlate for other risk factors, hence furthermore researches are required including large sample size, different races, genotypes, and other risk factors which were found to be influential in expression and severity of CP and AgP to get a more comprehensive insight into the contribution of IL gene polymorphisms in CP and AgP.
Diagnostic and prognostic utility of serum adenosine deaminase in tuberculosis: Worth a revisit or are we flogging a dead horse?
Authors: Agarwal Deeptika , Yadav Aseem , Sharma Neeraj
Published: June 2024

Background

Measurement of adenosine deaminase (ADA) activity in body fluids is one of the biochemical methods for the diagnosis of tuberculosis (TB). While the role of ADA levels in pleural fluid and cerebrospinal fluid for diagnosis of TB has been established, the role of serum ADA is yet to be established.

Aims

To study the role of serum ADA levels in diagnosis and prognosis of TB.

Settings and Design

This prospective observational study was carried out at a hospital in central India. All TB patients managed at the center in 2021 were included in the study.

Materials and Methods

Two hundred and thirty-three TB patients who met the inclusion criteria were recruited for the study. The subjects were divided into various study groups on the basis of TB subtypes. The study subjects were treated with first-line DOTS antitubercular therapy (ATT). The subjects underwent analysis of serum ADA levels at 0, 2, and 5 months of ATT initiation. Various factors affecting serum ADA levels were studied.

Results

There was no statistically significant difference in mean serum ADA levels among all study groups (I–IV) at month 0 (treatment initiation). The mean serum ADA levels of TB patients in all study groups (17.8 ± 5.1) were significantly higher than in the control group (10.1 ± 1.2). Mean serum ADA levels showed a sustained fall from month 0 to month 5 of treatment in all study groups. Low vitamin D levels (below 20 ng/mL), Mantoux negativity, and sputum smear status were not found to affect serum ADA levels.

Conclusion

Serum ADA levels can be used to evaluate response to ATT and for disease prognostication.
Myocardial Work Efficiency in Physiologic Left Ventricular Hypertrophy of Power Athletes
Authors: D’Andrea Antonello , Carbone Andreina , Radmilovic Juri , Russo Vincenzo , Fabiani Dario , Maio Marco Di , Ilardi Federica , Giallauria Francesco , Caputo Adriano , Cirillo Teresa , Bossone Eduardo , Picano Eugenio
Published: June 2024

Aims:

The athlete's heart in power training is characterized by physiologic concentric remodeling. Our aim was to analyze left ventricular (LV) myocardial deformation and contractile reserve (CR) in top-level power athletes (PA) at rest and during exercise and their possible correlations with functional capacity.

Methods:

Standard echo, lung ultrasound, and LV 2D speckle-tracking strain were performed at rest and during exercise in PA and in age- and sex-comparable healthy controls.

Results:

250 PA (male: 62%; 33.6 ± 4.8 years) and 180 age- and sex-comparable healthy controls were enrolled. LV ejection fraction (EF) at baseline was comparable between the two groups, while LV global longitudinal strain (GLS) was reduced in PA (GLS: −17.8 ± 2.4 in PA vs. −21.9 ± 3.8 in controls; P < 0.01). Conversely, myocardial work efficiency (MWE) did not show significant difference between the two groups (94.4 ± 3.2 in PA vs. 95.9 ± 4.6% in controls; P NS). At peak exertion during exercise stress echocardiography (ESE), PA showed better exercise capacity and peak VO2 consumption (51.6 ± 10.2 in EA vs. 39.8 ± 8.2 mL/Kg/min in controls, P < 0.0001), associated with augmented pulmonary artery systolic pressure (PASP). By multivariable analysis, MWE at rest was the most predictive factor of maximal watts (P < 0.0001), peak VO2, (P < 0.0001), PASP (P < 0.001), and number of B-lines (P < 0.001), all measured at peak effort.

Conclusions:

In power athletes, MWE showed less load dependency than GLS. Normal resting values of MWE in PA suggest a physiological LV remodeling, associated with a better exercise capacity and preserved CR during physical stress.
Global Longitudinal Strain in Wellens’ Syndrome
Authors: Agarwal Rakesh , Verma Aditya
Published: June 2024

We present the case of a young man with “noncardiac” chest pain, subsequently diagnosed as Wellens’ syndrome. We report the early changes in left ventricular global longitudinal strain imaging findings in these patients despite preserved ejection fraction, and review the features associated with this stereotypical cardiac condition. The patient underwent a successful percutaneous coronary intervention.
Left Atrial Volumetric and Functional Properties in Hemophilia – Insights from a Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study
Authors: Nemes Attila , Kormányos Árpád , Vezendi Klára , Marton Imelda , Borbényi Zita
Published: June 2024

Introduction:

Hemophilia is an inherited disorder due to deficiencies in factor VIII (type A) and factor IX (type B). Abnormalities in myocardial mechanics could be theorized due to hemophilia-associated hypocoagubility and related quantitative and qualitative changes of the blood. The present study aimed a detailed assessment of left atrial (LA) volumetric and functional properties in patients with hemophilia using three-dimensional speckle-tracking echocardiography (3DSTE).

Materials and Methods:

The study consisted of 12 subjects with hemophilia type A and 2 cases with hemophilia type B (mean age: 40.8 ± 19.1 years, all males). Results of hemophilia patients were compared to that of 23 age-, gender- and risk factor-matched controls (42.4 ± 9.0 years, all males). Routine two-dimensional Doppler echocardiography and 3DSTE were performed in all subjects.

Results:

LA volumes respecting cardiac cycle did not differ between controls and hemophilia patients. From LA volume-based functional properties, LA stroke volumes were similar between the groups examined in all phases of LA function. While total atrial emptying fraction featuring LA reservoir function was reduced in patients with hemophilia compared to that of controls, passive and active atrial emptying fraction characterizing LA conduit and booster pump functions were similar between the groups. From LA strains, peak mean segmental circumferential and longitudinal LA strains were impaired in patients with hemophilia, other peak LA strains were similar between the groups. LA strains at atrial contraction did not differ between groups of hemophilia patients and controls.

Conclusions:

Hemophilia is not associated with LA volumetric changes, but mild LA functional abnormalities are present.
Left Ventricular Functional Remodeling after Primary Percutaneous Coronary Intervention
Authors: Batra Mahesh Kumar , Malik Muhammad Atif , Khan Kamran Ahmed , Rai Lajpat , Kumar Rajesh , Shah Jehangir Ali , Sial Jawaid Akbar , Saghir Tahir , Khan Naveedullah , Karim Musa
Published: June 2024

Background:

Improvement in left ventricular (LV) function after revascularization is an important determinant of long-term prognosis in a patient with acute myocardial infarction (AMI). However, data on the changes of LV function after revascularization are scarce in our population. Hence, this study was conducted to evaluate the changes in LV function and dimensions by echocardiography at 3 and 6 months after primary percutaneous coronary intervention (PCI).

Materials and Methods:

A total of 188 patients were recruited in this study who had undergone primary PCI. Patients with preexistent LV dysfunction, prior PCI, or with congenital heart disease were excluded. Echocardiography was performed at baseline (within 24 h of intervention), 3 months, and 6 months of intervention. Remodeling in terms of change in LV ejection fraction (LVEF), LV end-diastolic dimension (LVEDD), LV end-systolic dimension, and wall motion score index (WMSI) was evaluated.

Results:

Out of the 188 patients, 90.4% were male, and mean age was 53.94 ± 9.12 years. Baseline mean LVEF was 39.79 ± 6.2% with mean improvement of 5.11 ± 3.87 (P < 0.001) at 3 months and 6.38 ± 4.29 (P < 0.001) at 6 months. Baseline LVEDD was 46.23 ± 3.86 mm which improved to 44.68 ± 2.81 mm at 6 months. Basal WMSI decreased by -0.09 ± 0.08 and -0.13 ± 0.09 at 3 and 6 months, respectively, after revascularization.

Conclusions:

Primary PCI is the recommended mode of reperfusion in patients with AMI. It reduces infarct size, maintains microvascular integrity and preserves LV systolic function hence improving LV function.
Assessment of Aortic Stiffness by Transthoracic Echocardiographic in Young COVID-19 Patients
Authors: Mansiroglu Asli Kurtar , Disikirik Tuba , Seymen Hande , Cosgun Mehmet , Sincer Isa
Published: June 2024

Background:

Deteriorated aortic elasticity is part of the atherosclerotic process. Inflammation is an underlying factor in both COVID-19 and atherosclerosis.

Aims and Objectives:

Using aortic elastic properties, we aimed to assess the subclinical indicators of susceptibility to inflammatory atherosclerosis in patients with COVID-19.

Materials and Methods:

Out of 194 participants included in this study, 100 were diagnosed with COVID-19 in the last 6 months (60 women and 40 men with a mean age of 34.13 ± 6.45 years) and 94 were healthy controls (55 women and 39 men with a mean age of 30.39 ± 7.21 years). We analyzed transthoracic echocardiographic and aortic stiffness parameters in all participants.

Results:

Values of systolic blood pressure (110 [85–140] vs. 110 [80–140], P = 0.037) and pulse pressure (PP) (37 [25–55] vs. 40 [25–55], P < 0.01) were significantly different between the groups. As for laboratory parameters, levels of glucose (97.89 ± 20.23 vs. 92.00 ± 9.95, P = 0.003) and creatinine (0.80 ± 0.13 vs. 0.75 ± 0.09, P = 0.003) were significantly higher in the COVID-19 group. Echocardiographic parameters showed that both groups differed significantly in diastolic aortic diameter (2.42 ± 0.28 vs. 2.31 ± 0.35, P = 0.017), aortic strain (9.66 [1.20–31.82] vs. 12.82 [2.41–40.11], P = 0.025), aortic distensibility (0.502 [0.049–2.545] vs. 0.780 [0.120–2.674], P < 0.01), and aortic stiffness (16.67 [4.19–139.43] vs. 11.71 [3.43–65.21], P = 0.006).

Conclusion:

Measurement of aortic stiffness is a simple, practical yet inexpensive method in COVID-19 patients, and therefore, may be used as an early marker for COVID-19-induced subclinical atherosclerosis.
Severe Mitral Regurgitation Following Partial Rupture of Papillary Muscle
Authors: Chamos Christos , Balfour Paul
Published: June 2024

Papillary muscle rupture (PMR) is an uncommon mechanical complication of myocardial infarction which warrants timely diagnosis and urgent surgical intervention to maximize survival chances. Echocardiography is an essential diagnostic tool, whereas transesophageal echocardiography can provide accurate diagnosis and guide decision-making. We hereby present the case of a patient with partial PMR that presented for cardiac surgery in our institution, with the respective intraoperative echocardiographic findings.
Focused Transesophageal Echocardiography in Critical Care
Authors: García-Cruz Edgar , Manzur-Sandoval Daniel , Martínez Daniel Sierra-Lara , Gopar-Nieto Rodrigo , Jordán-Ríos Antonio , Díaz-Méndez Arturo , Lazcano-Díaz Emmanuel , Rojas-Velasco Gustavo , Baranda-Tovar Francisco
Published: June 2024

Background:

The use of transesophageal echocardiography (TEE) is controversial in patients with COVID-19. The aim of this case series was to demonstrate the usefulness of transesophageal echocardiography in acute cardiovascular care settings in patients with COVID-19 infection.

Materials and Methods:

We enrolled 13 patients with confirmed SARS-CoV-2 infection admitted to the critical care unit of our center from April 1, 2020, to July 30, 2020, in which transesophageal echocardiography was performed. TOE was performed by three cardiologists with training in echocardiography.

Results:

The main indication was suspected infective endocarditis in four cases, venovenous extracorporeal membrane oxygenation cannulation in four cases, suspected prosthetic mitral valve dysfunction in two patients, suspected pulmonary embolism in two patients, and acute right ventricular dysfunction and prone position ventilation in one patient. The final diagnosis was confirmed in 11 patients and discarded in 2 patients. None of the operators result infected.

Conclusions:

TOE is safe in the context of COVID-19 infection; it must be performed in well-selected cases and in a targeted manner.
Case of Unilateral Linear Lichen Planus with Bilateral Mucosal Involvement
Authors: Singh Adarshlata , Rusia Kaveri , Bhatt Drishti , Kondalkar Ambika , Madke Bhushan
Published: June 2024

A form of lichen planus (LP) which follows the Blaschkos line pattern known as linear LP, presents with lichenoid eruptions and violaceous papules in a linear distribution. It is a rare form of LP affecting <0.2% population with LP. We present a case of a 52-year-old female with hyperpigmented patches and plaques distributed linearly along the Blaschkos line in her right leg. From a clinical perspective, the lesions on the patient’s right leg resembled those of lichenoid epidermal naevus, which is a type of linear verrucous epidermal nevus but the dermoscopic findings and the presence of oral mucosa LP indicate that the patient has the uncommon variant of LP which is called linear LP. It is thus critical for clinicians to distinguish linear LP from other acquired dermatoses following the lines of Blaschko both clinically and dermoscopically.
Understanding the pathophysiology of Akhlāṭ (humor) and their predisposing factors
Authors: Amir Momin Shezad , Ahmad Wasim , Saltanat Sabba
Published: June 2024

Pathology deals with the study of disease or how the organism’s normal and healthy physiological functioning can become dysfunctional or altered. To understand humoral pathology is to recognize a departure from the normal state of health. According to the Unani medicine philosophy, we should be aware of the necessary constituents of the body. The normal physiology of the body and the normal state of its organs are defined under the heading of Umūr Tabī'iyya (seven natural factors). Therefore, pathology involves an imbalance, dysfunction, or breakdown of one or more of these seven natural factors. Out of these, mizāj (temperament/constitution) and akhlāṭ (humors) are of utmost importance for the maintenance and preservation of health in human beings. Unani physicians described that the right proportion and intermixture of akhlāṭ based on quantity and quality constitute health, whereas an imbalance in quantity or quality leads to disease. These akhlāṭ primarily provide nutrition to respective organs and serve various bodily functions. Various factors can alter the proper balance of these akhlāṭ resulting in disease. An attempt is made to organize and systematize the scattered factors responsible for humoral disproportion. Therefore, the present article examines and scrutinizes the aforementioned issues in a painstaking way.