bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative study between intralesional injection of prostaglandin F2α alone or combined with corticosteroids in the treatment of alopecia areata
Authors: Mikhael Nancy W. , Ahmed Nesma Y. , El Habak Doaa M.
Published: September 2024

Background

Alopecia areata (AA) is an autoimmune disorder causing hair loss, yet its treatment remains challenging due to limited Food and Drug Administration approved therapies. Prostaglandin F2α (PGF2α) has emerged as a potential therapy.

Objective

To assess the efficacy of PGF2α intralesional injection in AA treatment.

Patients and methods

This case comparative work was performed on 75 localized AA patients who were split into three groups receiving different intralesional injections: group A received triamcinolone acetonide (TRA), group B received a combination of TRA and latanoprost (a PGF2α analog), and group C received latanoprost alone. Treatment response was assessed using the Severity of Alopecia Tool score, Severity of Alopecia Tool II, and Alopecia Areata Severity Index.

Results

High treatment response was observed in 76% of group B, compared to 64% in group A and 40% in group C. Group B showed the most significant reduction in severity score (median=0), followed by group A (median=1), and group C (median=3). Multivariate analysis identified group B as a significant predictor of a high treatment response (odds ratio=10.292, 95% confidence interval=1.904–55.632, P=0.007).

Conclusion

Intralesional injection of TRA and latanoprost (PGF2α analog) demonstrated superior efficacy in treating localized AA compared to other treatment modalities.
Male sexual disorder in coronavirus disease 2019 pandemic
Authors: Hammad Refaat R. , Abdalaleem Hazem L. , Abdalaziz Abdalaziz S. , Abdalfattah Abdalrahman M.
Published: September 2024

Background

At the end of 2019, a new coronavirus infection disease, named COVID-19, emerged in China. In this context, couples’ sexual lives could have been significantly altered. Fear of the COVID-19 pandemic implications affects their lives, or the lives of friends and relatives might produce feelings of anxiety and panic. Sometimes, these feelings can degenerate into further negative psychological reactions, including adjustment disorder and depression.

Aim

To find the relation between COVID-19 pandemic and occurrence of male sexual disorders.

Patients and methods

In this retrospective study 300 cases with past history of COVID-19 virus infection were included in this study. They were recruited from the Dermatology Outpatient Clinic of Al-Azhar University (Assiut) Hospital.

Results

There was a statistically significant difference between the prepandemic and postpandemic erectile dysfunction scores (P=0.043). There was a statistically significant difference between prepandemic and postpandemic scores according to premature ejaculation (P=0.022). There was a significant difference among erectile dysfunction and both depression degree (χ
2=90.706, P<0.001) and anxiety degree (χ
2=263.652, P<0.001) likewise, it has been found that there was a significant difference among premature ejaculation and both depression degree (χ
2=109.542, P<0.001) and anxiety degree (χ
2=165.382, P<0.001).

Conclusion

Significant difference between prepandemic and postpandemic scores according to erectile dysfunction and premature ejaculation. Among erectile dysfunction and both depression degree and anxiety degree likewise, it has been found that there was a significant difference among premature ejaculation and both depression degree and anxiety degree.
A case of squamous cell carcinoma of glans penis in lichen sclerosus-when to biopsy?
Authors: Das Pankaj , Singh Gautam K. , Singh Vikram , Vasudevan Biju , Priya K Lekshmi , Mannu Anand
Published: September 2024

Squamous cell carcinoma of penis is rare. Even rare are cases of squamous cell carcinoma reported in lichen sclerosus. We report a case of 36 year old male suffering from lichen sclerosus (LS) who developed squamous cell carcinoma of penis in relatively early age as well as in the course of lichen sclerosus. It is important to recognize the possibility of malignant change and educate patients and keep them under close follow-up aiming for a better outcome in terms of quality of life as well as survival.
Does low-energy fractional carbon dioxide laser therapy improve hair regrowth in female-pattern hair loss?
Authors: Tawfik Abeer , Gahdan Noha , Nosseir Moataz
Published: September 2024

Background

Female-pattern hair loss (FPHL) has the potential to impact the quality of life, physical attractiveness, and interpersonal relationships of many patients.

In recent years, lasers and light therapy have been used as alternatives or supplementary therapy for hair loss.

Objective

To evaluate the efficacy of ablative fractional carbon dioxide (CO2) laser therapy alone in improving hair growth in FPHL.

Patients and methods

Thirty patients presenting with FPHL were included in a split-scalp prospective interventional study.

Two areas of the scalp were studied. One area was treated with fractional CO2 laser and the second was injected with intradermal saline as control.

The sessions were scheduled every 2 weeks for four sessions then monthly for 2 months.

Patients were evaluated after each session and 2 months after the last session.

Results were evaluated by clinical photography, trichoscopic, and folliscopic examination regarding the count of terminal and vellus hair, the thickness and density of hair shafts, and the patient’s satisfaction score.

Results

Fractional CO2 laser therapy alone was found to be effective in improving hair growth in FPHL.

Conclusion

Fractional CO2 laser therapy would have potential mechanisms in inducing hair regrowth in FPHL. However, the detailed mechanisms underlying hair regrowth and injury induced by the laser need further clarification.
Role of serum cd4+, cd25+, and foxp3+ cells’ segmental and nonsegmental vitiligo
Authors: Mohammed Mohammed H. , Raheem Talal A.A. , Farouk Ahmed M. , Mohammed Shereen R. , Gamal Ahmed S.
Published: September 2024

Background

Vitiligo is an autoimmune skin disease presented with depigmented macules and patches. Vitiligo has an impact on the quality of life. The etiopathogenesis of vitiligo is multifactorial, including genetic, immune dysregulation, and oxidative stress mechanisms. Lately, several researches have underlined the pivotal function of regulatory T cells (Tregs) in the vitiligo pathogenesis with lack of data regarding their role in segmental vitiligo (SV).

Objective

To investigate the role of Tregs in SV and nonsegmental vitiligo (NSV) pathogenesis and its correlation with disease activity and severity.

Patients and methods

This case–control study included 20 cases with NSV and 10 cases with SV in addition to 10 healthy volunteers. Vitiligo Area Scoring Index and Vitiligo Disease Activity scores were estimated for vitiligo cases and all the included participants were assessed for the percentage of serum CD4+, CD25+, and FOXP3+ T cells using flow cytometry staining buffer.

Results

There was significant reduction of the peripheral Tregs in NSV cases in comparison with healthy participants and negative correlation with their percentage to disease activity. On the other hand, there was insignificant difference between the percentage of peripheral Tregs in SV cases and healthy participants. Also, there was insignificant correlation between peripheral Tregs and both severity and activity of the disease among SV cases.

Conclusion

NSV cases showed significant reduction of the peripheral Tregs and negative correlation with disease activity, indicating the importance of Tregs in the etiopathogenesis of NSV and hence future targeting therapy. On the other hand, in SV cases, there was insignificant reduction of peripheral Tregs and insignificant correlation between their percentage and both severity and activity indicating mosaic etiopathogenesis.
A Cautionary Tale of an Unfortunate Testis: Testicular Infarction and Rupture as a Rare Complication of Acute Epididymitis
Authors: Xanicia Long Jiahuan , Long Welras
Published: September 2024

Epididymo orchitis is a common cause of unilateral scrotal pain. Infection is caused by retrograde ascent of pathogens to the epididymitis and extension to the testis. This condition typically follows an indolent course and responds well to a course of culture directed antibiotics along with analgesiaand scrotal support. Albeit rare, more severe complications such as abscess formation, testicular infarction, and testicular loss are still possible despite receiving appropriate extended antibiotic therapy. A high index of suspicion of these complications should be maintained in any presentation of acute scrotum, as early recognition could allow for salvage of the testis. We hereby present a rare case of acute epididymo-orchitis progressing to testicular infarction and rupture in a 50 year old male.
A Prospective Study of Hyperbaric Oxygen as a Treatment Option for Radiation-induced Hemorrhagic Cystitis
Authors: Stamatakos Panagiotis Velissarios , Papadimitriou Evangelia , Paizis Theodoros , Georgios Papadopoulos , Ntoumas Konstantinos
Published: September 2024

Introduction and Objective:

Hemorrhagic cystitis (HC) is a diffuse bladder inflammation that causes hematuria and other urinary tract complaints. Noninfectious hemorrhagic cystitis most commonly occurs in patients who have undergone pelvic radiation. In cases with refractory disease and persistent hematuria, the bladder can be irrigated with a variety of agents. Hyperbaric oxygen (HBO) therapy has been used with some success in difficult cases. In the present article, the safety and efficacy of HBO was examined as the primary treatment choice for radiation-induced HC.

Evidence Acquisition:

Prospective data were collected among patients with HC and previous radiotherapy. HBO was applied as a primary treatment. The primary endpoint of our study was the incidence of complete and partial response to treatment, whereas a variety of secondary endpoints were examined including the duration of response, blood transfusion rate, the avoidance of surgery, and the overall survival. Moreover, the correlation between the interval between the onset of hematuria and initiation of therapy and the success of treatment was recorded.

Evidence Synthesis:

A total of 20 patients participated in the study. The complete and partial response rate was 85% and 15%, respectively. All patients completed therapy while the median number of sessions needed was 31. No complications were recorded during treatment. Patients with complete response received therapy within 3 months of the hematuria onset. One patient needed cystectomy, whereas 19 patients were alive at the end of follow-up.

Conclusions:

HBO consists of an effective and safe treatment option in the management of radiation-induced severe HC. Further prospective studies should be undergone in order to validate its efficacy and safety profile.
Intracorporeal Urinary Diversion versus Extracorporeal Urinary Diversion during Robot-Assisted Radical Cystectomy
Authors: Mourmouris Panagiotis , Kotrotsios Konstantinos D
Published: September 2024

Background/Aim:

Radical cystectomy (RC) is a fundamental step in the therapeutic plan of nonmuscle and muscle-invasive urinary bladder cancer. Open RC is a surgical procedure with high morbidity and as such robot-assisted RC (RARC) has been established as an efficient alternative. Although in the beginning, the urinary diversion step during RARC was mostly performed extracorporeally nowadays a preference of the intracorporeal approach is yearly increasing. The aim of this review is to compare these two techniques of urinary diversion and depict the latest trends of current research on this field.

Materials and Methods:

A literature search of MEDLINE database (March 26, 2022) was performed to retrieve the articles published in English that are dated between January 1, 2010 and February 28, 2022. The search strategy included terms: “intracorporeal,” “vs,” “extracorporeal,” “urinary,” “diversion,” “comparison,” “after,” “RARC” and “or”.

Results:

Intracorporeal urinary diversion (ICUD) is strongly associated with lower perioperative blood loss and blood transfusion needs compared with the extracorporeal urinary diversion (ECUD). ICUD prolongs the operative duration. However, when ICUD is performed by experienced surgeons or in high volume centers, operative duration is comparable for ICUD and ECUD. The two approaches are assessed as equal in respect of postoperative complications.

Conclusion:

The debate as to whether ICUD must replace ECUD and become the standard of care does not end with this review. Intracorporeal approach in most of the studies seems to be associated with prolonged operative duration, lower transfusion needs, and equal complication rates when compared with ECUD. However, the contradiction of the results and the low quality of the available data demand the conduction of randomized prospective studies comparing ICUD and ECUD in order to offer the best available treatment to the patient.
Comparison of percutaneous tracheostomy methods in ICU patients: Conventional anatomical landmark method versus ultrasonography method - A randomised controlled trial
Authors: Kumar Pankaj , Kumar Sanjeev , Hussain Mumtaz , Singh Ritu , Ahmed Waquas , Anand Ravi
Published: September 2024

Background and Aiims

Percutaneous dilational tracheostomy (PDT) is a common procedure in intensive care unit (ICU) patients requiring long-term mechanical ventilation. PDT has gradually replaced surgical tracheostomy because it is associated with minimal invasiveness, reduced bleeding and simplicity in technique.This study was conducted to compare ultrasound-guided PDT versus conventional tracheostomy in terms of duration of the procedure, number of passes and immediate peri-procedural complications.

Methods

A total of 72 patients with clinical indications of tracheostomy were recruited. A total of 12 patients met the exclusion criteria. The remaining were randomly assigned into two groups of 30 each: Group A (Landmark) with traditional anatomical landmark and Group B (USG) with real-time ultrasound guidance. Puncture positions were recorded with bronchoscopy. Midline deviation was captured on a bronchoscopy image using a protractor. Data on procedural safety and efficacy were also collected.

Results

: Group B had significantly fewer cases of midline deviation (11.33 ± 9.51) in comparison to Group A (16.60 ± 12.31). Trials > 2 were equal to 11 in Group A and 2 in Group B. However, the duration of the procedure was higher in Group B (20.07 ± 3.25 min) as compared to Group A (15.20 ± 3.71 min). Peri-procedural and post-procedural complications were also higher in the Landmark group.

Conclusion

: Ultrasound-guided PDT showed superiority over landmark PDT in terms of less number of trials, midline puncture and fewer complications. However, it took a little longer to perform USG-guided PDT.
Comparison of effects of dexmedetomidine added to ropivacaine versus ropivacaine alone infiltration scalp block for attenuation of the haemodynamic response to skull pin placement in neurosurgical procedures: A double-blind, randomised clinical trial
Authors: Sahana B. N , Sri Devi Radhapuram , Samantaray Aloka , Hemanth Natham , Pasupuleti Hemalatha , Mangu Hanumantha Rao
Published: September 2024

Background and Aims:

Skull pin head holder application is intensely painful and is accompanied with abrupt increase in heart rate and arterial blood pressure. We aimed to determine the effects of adding dexmedetomidine to ropivacaine scalp block in attenuating the haemodynamic response to skull pin insertion in neurosurgical procedures.

Methods:

Sixty patients were randomly allocated to receive scalp block with 25 ml of 0.5% ropivacaine added with either normal saline (control group) or dexmedetomidine (1 μg/kg) after anesthesia induction. A standard uniform general endotracheal anaesthesia protocol was followed in all study subjects. Heart rate and blood pressure measurements were made at baseline, 1, 3, 5, 10, and 15 min following skull pin placement. Student’s independentt-test, Chi-square test and repeated measure analysis of variance were used to analyse the obtained data.

Results:

There was no significant attenuation of heart rate (P= 0.418), systolic (P= 0.542), diastolic (P= 0.793) and mean blood pressure (P= 0.478) with addition of dexmedetomidine to ropivacaine.

Conclusions:

The addition of dexmedetomidine (1 μg/kg) to 25 ml of 0.5% ropivacaine offers no additional benefit over 25 ml of 0.5% ropivacaine alone scalp block in attenuating the haemodynamic response to skull pin placement in neurosurgical procedures.
Role of nebulised dexmedetomidine, midazolam or ketamine as premedication in preschool children undergoing general anaesthesia—A prospective, double-blind, randomised study
Authors: Shereef K Muhammed , Chaitali Biswas , Swapnadeep Sengupta , Gauri Mukherjee
Published: September 2024

Background and Aims

Preschool age children are psycho-biologically vulnerable to all surgical procedures. In this study, we investigated the effect of nebulised dexmedetomidine, midazolam and ketamine as sedative premedication for alleviating parental separation anxiety, facilitating face mask acceptance and reducing emergence agitation in paediatric patients undergoing general anaesthesia.

Methods

A prospective, randomised, double-blind study was done involving 96 children of age 3–7 years, randomly allocated into three equal groups and pre-medicated with either nebulised dexmedetomidine 2 mg/kg (GroupD), midazolam 0.2 mg/kg (GroupM) or ketamine 2 mg/kg (Group K). The scores of sedation scale, parental separation anxiety scale, mask acceptance scale and emergence agitation scale were recorded along with haemodynamic parameters. Two-way repeated measures analysis of variance (ANOVA), post hoc test and Kruskal–Wallis test were used for statistical analysis.

Results

A statistically significant difference in sedation score was seen between the different study groups, χ2(2) = 8.561, P = 0.014 with mean rank sedation score of 56.50 for Group D, 38.92 for Group M and 43.84 for Group K. Parental separation anxiety scale score and Mask acceptance scale score also showed statistically significant difference between the different study groups, χ2(2) = 9.369, P = 0.009 and χ2(2) = 11.97, P = 0.003, respectively.

Conclusion

Nebulisation with dexmedetomidine produced easy parental separation, more satisfactory sedation and face mask acceptance with less postoperative agitation than nebulisation with midazolam or ketamine.
Comparison of liquid-based cytology and conventional preparations in nongynecological cytology
Authors: Buch Archana Chirag , Londhe Mangesh M. , Patil Tushar V. , Rathod Hetal , Dhaliwal Sargam , Gore Charusheela Rajesh
Published: September 2024

Introduction:

The liquid-based cytology (LBC) has shown significant advantages over conventional preparation in cervical cytology. The use of LBC in aspiration and exfoliative nongynecologic cytology has been on the rise since the last few years with relatively few studies being available depicting its role in fine-needle aspiration cytology (FNAC) from other sites. The study aimed to determine the diagnostic efficacy of LBC in nongynecological exfoliative as well as FNAC samples and compare the conventional and LBC methods for cytomorphological differences.

Materials and Methods:

This is a cross-sectional, analytical study that included the samples collected from two tertiary care centers over 8 months (January 2022 to August 2022). A total of 168 consecutive samples of aspiration and exfoliative nongynecological cytology were included. In each case, two passes were carried out one for a conventional smear (CS) and the other for LBC by Eziprep/Thin Prep (TP) method followed by smear staining with H and E stain and Leishman’s stain. The slides were studied by two observers for cellularity, background (blood and necrotic cell debris), informative background (such as colloid, stromal fragments, etc.), presence of monolayer cells, and cell architecture with nuclear and cytoplasmic details by a semiquantitative scoring system. Statistical analysis was performed using Wilcoxon signed-rank test on the SPSS program and histopathology correlation was attempted wherever available by using OpenEpi software version 3.

Results:

The mean age was 40 years, with the majority being females (70%). The TP smears were qualitatively superior to CS with statistical differences observed in fluid cytology. There was no statistical difference observed at other sites; except TP being superior to CS with regard to the background in breast cytology. The arithmetic mean in TP was higher than CS in all the parameters.

Conclusions:

The cytology smears of TP were qualitatively superior to CS in aspiration and nongynecological cytology. Overall diagnostic accuracy was comparable in both techniques.

The core competencies addressed in this article are:

Medical knowledge, Procedural skills, Practice-based learning and improvement, and Professionalism.
Association between cumulative fluid balance and clinical outcome in patients with septic shock: A retrospective observational study
Authors: Dash Abhilash , Jena Sunil Kumar , Chhotray Pritam , Panda Sagarika , Mishra Shakti Bedanta , Nayak Biswajit
Published: September 2024

Introduction:

Aggressive fluid replacement is done in septic shock to compensate for the decreased stressed volume in view of peripheral vasodilatation. However, excessive fluid administration may lead to fluid overload, edema formation, and organ damage such as renal congestion and acute kidney injury. Hence, this study was conducted to estimate the effect of fluid balance in the 1st week of septic shock on mortality.

Materials and Methods:

We conducted a retrospective analysis of the use of intravenous fluids and cumulative fluid balance (CFB) during the first 7 days of septic shock in a 25-bed multidisciplinary intensive care unit (ICU) in Northern India at a tertiary care teaching hospital.

Results:

Based on the CFB, we classified patients as low CFB when CFB is <20 mL/kg and high CFB when it is >20 mL/kg. The 28-day mortality in the low CFB group was 4.7% and in the high CFB group 26.15%, which was statistically significant. With an odds ratio of 7.17, CFB in septic shock was a predictor of ICU mortality (confidence interval of 3.87–13). The length of stay between the two groups was also found to be statistically significant (11.7 ± 3.2 vs. 12.6 ± 3.8; P = 0.02).

Conclusions:

In patients with septic shock, a higher CFB on day 7 of ICU admission is independently associated with an increased risk of mortality and a longer ICU stay.

The following core competencies are addressed in this article:

Practice-based learning and improvement, Medical knowledge.
Postoperative urinary retention in colorectal surgery patients on an enhanced surgical recovery pathway
Authors: Nguyen Tuan A. , Beal Eliza W. , Gerlach Anthony T. , Shabsigh Ahmad , Husain Syed G. , Brower Kristin I.
Published: September 2024

Introduction:

Postoperative urinary retention (POUR) is a complication of surgery defined as the inability to empty a full bladder. POUR can prolong hospital length of stay and increase rates of urinary tract infection in the postoperative period. Risk factors for the development of POUR include male sex, older age, select medications, and certain comorbid conditions. Surgical factors may also increase the risk of POUR. POUR occurs in up to 50% of patients undergoing colorectal surgery.

Materials and Methods:

This retrospective, single-center cohort study evaluated the incidence of POUR in patients admitted for colorectal surgery and were enrolled in a Colorectal Enhanced Surgical Recovery (CERAS) protocol. Our primary objective was to determine the incidence of POUR in patients treated under the CERAS protocol. Secondary objectives included evaluating the incidence of POUR in patients receiving intrathecal anesthesia.

Results:

Two hundred and twenty-eight patients were included. Sixty-six patients (28.9%) developed POUR during their hospitalization. Patients who developed POUR were more likely to be male (61.6% vs. 44.4%, P = 0.029) and tended to be older (mean ± standard deviation age, 61.4 ± 17.7 years vs. 56.8 ± 16.4 years; P = 0.069) compared to the non-POUR group. Regional anesthesia did not affect the incidence of POUR.

Conclusions:

We identified a rate of POUR in our CERAS patients consistent with previous studies. The risk of POUR increased with increasing age, male sex, and history of benign prostatic hyperplasia and diabetes mellitus. We found no difference in POUR incidence with the type of regional anesthesia utilized.

The following core competencies are addressed in this article:

Practice-Based Learning and Improvement and Medical Knowledge.
A Comparative Evaluation of Apical Microleakage in Immediate vs Delayed Postspace Preparation using Four Endodontic Sealers seen under Stereomicroscope - An in vitro study
Authors: Megha Rani , Neetu Jindal , Renu Aggarwal , Bharati Lisam , Monika Choudhary
Published: September 2024

Context:

An In-vitro research.

Introduction:

To evaluate the apical microleakage in immediate v/s delayed postspace preparation using four endodontic sealers; Endomethasone N, AH Plus, MTA Fillapex and Gutta Flow.

Materials and Methods:

One hundred and thirty recently excised single-rooted permanent teeth without caries were decorated. The postspace was created with a Peeso reamer from size 1–4, and 5 mm of gutta-percha was left after the root canals were biomechanically prepared up to F3 (ProTaper file) and obturated using the lateral condensation method. According to immediate and delayed postspace preparation, the samples were separated into eight groups, with 15 samples in each experimental group and 5 samples in each of the two control groups. Except for the apical 2 mm and the negative group, which were entirely sealed with two layers of sticky wax, all of the samples were covered with two layers of oppressive wax. Then, the samples were immersed in 2% methylene blue dye, centrifuged at 3000 rpm for 3 min, sectioned longitudinally and observed the extent of dye penetration under stereomicroscope. To compare the results between study groups and within each group, the Post
hoc Tukey’s honestly significant difference comparison test and one-way ANOVA were utilized. When the P value was proved to be less than 0.05, the findings were deemed statistically significant.

Results:

Between all experimental groups, all samples revealed statistically significant differences. Group V (Endomethasone N-D) 3.46 ± 0.26 showed the greatest microleakage, whereas Group II (AH Plus I) 1.50 ± 0.40 showed little microleakage.

Conclusions:

Within the constraints of this study, postspace that was promptly prepared with all sealers experienced much-reduced microleakage.
Comparing and Evaluating the Antimicrobial Efficacy of Endodontic Root Canal Sealers against Enterococcus faecalis, Staphylococcus aureus, and Candida albicans at 24, 48, and 72 h: An in vitro study
Authors: Ajisha Raju , Neetu Jindal , Aggarwal Renu , Kaur Amandeep , Monika Choudhary
Published: September 2024

Introduction:

Examining the effectiveness of root canal sealants next to Staphylococcus
aureus, Enterococcus
faecalis, and
Candida
albicans using the agar well diffusion technique was the focus of this research.

Materials and Methods:

Antimicrobial effectiveness was evaluated using a selection of endodontic root canal sealers, including AH Plus, Endomethasone, Sealapex, and GuttaFlow. Antimicrobial zones of reserve were evaluated at 24, 48, and 72 h using the agar well diffusion method. The effectiveness of sealers against a few common germs was evaluated using the ANOVA and Tukey’s post
hoc testing.

Results:

Large antimicrobial inhibitory zones were seen across all experimental groups. Endomethasone sealer showed the largest inhibition zones, measuring 16.40 (±1.02) mm at 24 h, 23.33 (±1.66) mm at 48 h, and 28.93 (±1.97) mm at 72 h. Sealapex and AH Plus came in the second and third, respectively; GuttaFlow showed no inhibition zones.

Conclusions:

The antibacterial efficacy of Endomethasone sealer against S. aureus, E. faecalis, and
C. albicans was the greatest at 24, 48, and 72 h.
Tramadol HCL as an Effective Alternative to Lignocaine HCL for Extraction of Tooth under Supraperiosteal Infiltration
Authors: Basu Subhransu , Mukherjee Oishee , Sahu Sudipto , Banerjee Rajarshi , Pachisia Sandeep , Biswas Abhishek
Published: September 2024

Purpose:

To evaluate the efficacy of tramadol as a local anesthetic effect.

Materials and Methods:

Fifty patients were evaluated. Group A given tramadol and Group B given lignocaine. Parameters such as pain on injection, onset of action, duration of effect, and side effects if any were recorded.

Results:

None of the patients showed any allergic response to the respective drug administered. The onset of anesthesia (objective) for tramadol and lignocaine was, respectively, 165.0 ± 39.80 s and 159.60 ± 35.09 s, not statistically significant (P = 0.613). Mean duration of anesthesia for them was 47.50 ± 7.51 min for tramadol and 45.70 ± 7.10 min for lignocaine, also statistically nonsignificant (P = 0.388). Regarding intraoperative pain, mean was 0.41 ± 1.013 of tramadol and of lignocaine was 0.31 ± 0.451, P = 0.654 also being statistically nonsignificant. Two patients receiving tramadol had nausea and 1 had pain. Those receiving lignocaine, only 1 patient had pain (P = 0.214).

Conclusion:

Tramadol has an almost similar local anesthetic efficacy with that of lignocaine.
Morphological Variability of Permanent Mandibular First Premolar Teeth in Manipuri Population
Authors: Premlata Takhellambam Devi , Priyadarshini Shamurailatpam , Kaur Amandeep , Deepak B.S. , Kshetrimayum Nandita , Sanjeeta Ng.
Published: September 2024

Aim:

To investigate anatomical and morphological variability of permanent mandibular first premolar teeth in the population of Manipur state of Indian subcontinent.

Materials and Methods:

Four hundred and eighty teeth from a pool of Manipuri population were studied for anatomical and morphological variability using staining and clearing technique. All samples were evaluated for the number of roots, root canals, root canal configuration, presence of lateral canals, intercanal communications, and apical deltas.

Results:

Single root with one canal was present in 81.25% (390/480) and single root with two canals in 18.75% (90/480) of samples. Root canal configuration according to Vertucci's classification was as follows: Type I (43.7%) followed by Type V (25%), Type VI (12.5%), and Type II, III, and VII (6.25%). Intercanal communications in the apical third were 12.5% (60/480) and 6.25% (30/480) in the middle third of the root. Occurrence of lateral canals in the apical third was 18.75% (90/480). Apical delta was found in 37.75% (180/480) of samples.

Conclusion:

The results of this study highlight the variability patterns of mandibular first premolar tooth existent in the population of the state of Manipur. Single-rooted teeth are most common with predominantly Vertucci's Type I root canal configuration and significant presence of lateral canals and apical ramifications.

Clinical Significance:

Sound knowledge of anatomy of the root canal and possible variations can contribute to a successful treatment outcome.
Student-led Seminars as an Enforcement-learning Method for Human Anatomy – Dentistry Students’ Perspectives
Authors: Patnaik Poonam , Singh Dalvinder
Published: September 2024

Background:

The “student led seminar (SLS)” is one in which students prepare and present selected topics through multi-source research with the assistance and guidance of the faculty. Teamwork is increasingly emphasized in health care, and team training is now considered to be essential in medical education. Small group learning promotes active learning and develops communication and teamwork skills. It also improves problem-solving skills, attitudes, and the development of interpersonal skills.

Aim of the Study:

The aim of this study was to evaluate the efficacy of SLSs as a teaching-learning method for Bachelor of Dental Surgery undergraduates through students’ perception.

Methodology:

This was a prospective, observational study conducted for 5 months among 1st year dentistry students. The students were divided in small groups and the topics for the seminar were allocated for presentation according to the roster. Each group was given 20 min for presentation, 10 min for question time and discussion. A hard copy of the slides presented was also collected. Feedback was taken on pretested questionnaire containing 11 Likert-based items on a five-point scale. Descriptive statistics were applied for each item question. Cronbach’s alpha test was applied to check the internal validity of the questionnaire. Satisfaction rate and index were calculated. Fischer’s exact test was applied to find the odds ratio of satisfaction rate between male verses female students and hosteller verses day scholar students for each item question separately. Student’s t-test was applied to determine the difference in the performance of students in the first and second internal assessments at P = 0.05 significance level.

Results:

Among the participants, 32 were female (mean age 19 ± 1.46) and 18 were male (mean age 20 ± 1.82) students. Ninety-five percent of students agreed that the seminars improved their self-confidence and enhanced their presentation skills, helped them acquire a deeper understanding of the topic, an opportunity to use resources (time, electronic gadgets, and media) responsibly, even outside the bounds of the lecture theatre. Overall, mean score on Likert scale was 3.9 ± 0.307. The satisfaction rate and index were the highest for question 3. The second term examination result showed statistically significant improvement over that of the 1st term.

Conclusions:

The student seminar is a potentially important resource of the teaching-learning method that has yet to be fully implemented and therefore needs to be incorporated into the medical curriculum on a regular basis.
Oral Hygiene Awareness among Pregnant Women in Chennai
Authors: Somasheker Gayathri , Lakshmi S Pudhumai , Vishwanath Nandhini , Rao Sumathi H. , Thirugnanasambandam Geetha
Published: September 2024

Background:

The association between preganancy and poor oral health and its effects on preterm low birth infants are well documented in scientific literature. A pilot study was conducted with 160 pregnant women in the year 2016 showed that oral hygiene awareness among pregnant women was least among those who did not complete basic school education. This was the motive to conduct the present survey.

Aims and Objectives:

The Aim of this survey is to determine the knowledge and awareness on oral hygiene practices and to evaluate the role of education status on awareness of poor oral health and pregnancy outcomes among 500 pregnant women in Chennai city, Tamil Nadu, using self-tested questionnaire.

Materials and Methods:

A Descriptive cross sectional study was conducted among 500 pregnant women attending maternity clinics in Chennai using Self administered questionnaire.

Results:

Among 500 participants majority of them 72% of school educated never visited dentist. Only 6.2% of Undergraduate women was referred by gynecologist for dental check up during pregnancy. 31.3% of school educated felt that first trimester was safe to undergo dental treatment with p=0.000.

Conclusion:

This survey showed that level of education played a significant role in awareness about oral hygiene among pregnant women.
Evaluation of phototherapy effects on platelet numbers and volumes in neonates with unconjugated hyperbilirubinemia in Sulaimani city/Kurdistan region/Iraq
Authors: Mohammad Hayder Fakhir , Abdulqadir Shano Yassin , Abdulla Dea Ali , Ibrahim Hawnaz Muhamad
Published: September 2024

BACKGROUND:

Unconjugated hyperbilirubinemia is a rather common disease that affects 60% of term and 80% of preterm infants within their 1st week of life. Phototherapy is considered the safest method for the treatment of unconjugated hyperbilirubinemia in neonates, which is the most common problem in the neonatal period.

OBJECTIVES:

To identify the effect of phototherapy on platelet numbers and volumes, and if the duration of treatment, gestational age, birth weight and other factors have some influences on this effect.

PATIENTS, MATERIALS AND METHODS:

A prospective cohort study was conducted from November 1, 2023, to April 1, 2024. Seventy-four neonates were enrolled in this study including males and females (1.39:1), with different gestational ages and birth weights. Neonates were selected according to the specific inclusion and exclusion criteria. Thorough history and physical examination performed with several laboratory investigations sent. Total serum bilirubin measured before starting phototherapy, after 24 hours, 48 h, 72 hours, and 4 days later. SPSS program was used to code, enter, and process the gathered data.

RESULTS:

Platelet number in general decreased with increasing duration of phototherapy regardless of other parameters (P = 0.045). In correlation to the duration of phototherapy and time of jaundice appearance, it was statistically significant for only neonates who required phototherapy for more than 4 days and time of jaundice appearance between 1 and 3 days (P = 0.042). Platelets number decreased with increasing duration of phototherapy especially in low birth weight and very low birth weight neonates, P value 0.028 and 0.047 respectively. There were statistically significant values (P = 0.002 and P = 0.001) in the correlation of decreasing platelet numbers to gestational age and duration of phototherapy, especially more evident with gestational age below 37 weeks (preterm) and in periods after 24 h and 72 h. There were no statistically significant values in platelet volumes in correlation to any of the previous parameters.

CONCLUSIONS:

Platelets number decreased with phototherapy management, and it is more evident with longer phototherapy duration, low birth weight and early onset, while platelet volume not affected. Hence, it is recommended to avoid unnecessary prolongation of phototherapy.
Extraspinal Osteoarticular Tuberculosis: A Diagnostic and Therapeutic Challenge
Authors: Bouaicha Walid , Nouicer Saffet , Jlidi Mohamed , Chaabane Imen , Bachrouch Sabrine , Tounsi Haifa , Mallek Karim , Daas Selim
Published: September 2024

Tuberculosis (TB) is a major cause of morbidity and mortality, representing a challenge for health-care providers worldwide. Extraspinal osteoarticular tuberculosis (ESOTB) represents a rare location of TB. We aim to describe ESOTB focusing on clinical, diagnostic, and therapeutic characteristics of this entity. We report a retrospective case series of patients diagnosed with ESOTB, treated, and followed up between 2015 and 2022. The diagnosis was based either on bacteriological results (culture and polymerase chain reaction [PCR]) or histological analysis. Five patients with confirmed ESOTB, three women and two men, with a mean age of 46.4 (16–72), were enrolled in study. The affected sites were the elbow (one case), the shoulder (one case), the greater trochanter (one case), the second metatarsal (one case), and the distal interphalangeal joint (one case). The mean delay to diagnosis was 5.8 months (3–10)]. The most common symptoms on presentation were pain (all cases), swelling (all cases), and limited joint range of motion (all cases). One case presented with a draining sinus (20%). Radiological findings were soft tissue swelling (two cases) and periarticular bone destruction (all cases). Four patients presented with pathognomonic histology. PCR was performed in two patients and was positive in both of them. All cases were cured after 9–12 months of oral TB treatment without relapse for the 12–18 months of follow-up. Only one patient underwent surgery for abscess drainage to gain local infection control. ESOTB is a mysterious condition that must not be overlooked and should be suspected in cases of long-standing bone and joint pain and swelling.
Immunological Depiction of Synthetic B-cell Epitopes of Mycobacterium tuberculosis
Authors: Sharma Niharika , Khandelwal Vishal , Kumar S , Joshi B , Mohanty Keshar Kunja
Published: September 2024

Background:

To combat the tuberculosis (TB) epidemic, the development of a better and faster diagnosis or more effective vaccine is essential. Pulmonary TB (PTB) is one of the major causes of morbidity and mortality. Early diagnosis of TB is difficult. Serological assays have been performed with several antigens of laboratory strains such as Mycobacterium tuberculosis H37Rv which have not been found to be highly sensitive. In the present study, various peptides were synthesized which were predicted on the basis of immunoreactivity and differential expression in clinical isolates of M. tuberculosis compared to their expression in a laboratory strain of M. tuberculosis. Therefore, the aim of this study was to compare the antibody levels in PTB and healthy controls against these peptides.

Methods:

An effort was made to evaluate antibody response to peptides derived from proteins Rv2588c, Rv0512, Rv0148, Rv0896, and Rv0635 of M. tuberculosis in PTB patients and healthy individuals through enzyme-linked immunosorbent assay. Five milliliters of venous blood samples was collected from each participant, and serum was separated and stored until use.

Results:

Antibody levels against these peptides, Rv2588c, Rv0512, Rv0148, Rv0896. and Rv0635 in 139 PTB patients and 52 healthy controls were evaluated. Higher immune response was observed in PTB patients when compared with healthy individuals. Strong immunoglobulin G responses with high percentage, considerable difference among patients and healthy controls was observed with P < 0.0001.

Conclusion:

In our study, we found significant statistical differences in antibody levels in PTB patients and healthy individuals against these peptides. These peptides are suggestive of being a potential new candidate (s) for early diagnosis of TB.
The Impact of IgG Administration on the Cellular Immunity Status in the Patients with Multidrug-Resistant tuberculosis/HIV with CD4 + Lymphocyte Cells below 50 Cells/ μl
Authors: Matsegora Nina , Kaprosh Antonina , Antonenko Petro
Published: September 2024

Background:

Treatment of the patients with multidrug-resistant tuberculosis (MDR-TB)/HIV coinfection in a state of severely suppressed immune system remains unsatisfactory.

Methods:

The study involved 52 HIV-positive patients with MDR-TB and CD4+ lymphocyte cells below 50 cells/μCL. Patients in control group (Group 1) and in basic group (Group 2) received standard treatment with second-line antituberculosis agents and antiretroviral agents. In addition, the patients in basic group were treated by immunoglobulin G (IgG) intravenously. Immunological diagnostics with the determination of the level of lymphocytes subgroups (CD3+, CD4+, CD8+, CD4+/CD8+) was carried out using an AQUIOS™ CL flow cytometry device at the beginning and after 3–20 months of treatment. Statistical analysis was performed using the Statistica 10.0 software (Stat. Soft Inc., USA). Results: In the patients of Group 2, the absolute number of CD3+ and CD4+ cells at the end of the 20th month of the treatment normalized in 26.9% (absolute amount) and 42.3% (relative amount) of subjects, while in Group 1, this indicator remained below the normal level (P < 0.05). The addition of IgG into standard therapy caused normalization of CD8+ count in 76.9% of patients, while in the control group-only in 46.2% of patients (P < 0.05). Conclusions: The administration of IgG in combination with standard anti-tuberculosis and antiretroviral therapy (ART) contributes to the normalization of the cellular immunity status in patients with MDR-TB/HIV coinfection and severe immunosuppression and allows you to start ART earlier than in patients with single standard therapy
Early Safety and Efficacy of Linezolid-Based Combination Therapy among Patients with Drug-Resistant Tuberculosis in North-Western Nigeria
Authors: Dayyab Farouq Muhammad , Iliyasu Garba , Ahmad Bashir Garba , Habib Abdulrazaq Garba
Published: September 2024

Background:

The emergence of drug-resistant tuberculosis (DRTB) has continued to pose a threat to public health in sub-Saharan Africa and globally. Despite the high burden of tuberculosis (TB) in Nigeria, there are paucity of data on the safety and efficacy of newer agents and repurposed drugs used in the treatment of DRTB.

Methods:

This prospective cohort study was conducted at a regional DRTB treatment center in Kano, Northwestern Nigeria. Descriptive statistics, Mann–Whitney U-test, and Chi-square or Fisher's exact test were used to analyze the data as appropriate.

Results:

The median age of the patients was 32 years (interquartile range 26–42 years). Of the 39 patients, 34 (87.18%) were males. The majority of the patients came from the rural areas 25 (64.10%). By 10 months of initiation of combination therapy, 25 (64.10%) of the patients were alive, culture negative and on treatment while 14 (35.90%) of the patients have died. Out of the 39 patients in the cohort, 26 (66.67%) patients had at least one serious adverse event. The most common serious adverse events were hematological disorders (13 [35.14%] of 37 events) and neurological disorders (11 [29.73%] of 37 events). Peripheral neuropathy (P< 0.0001), anemia (P= 0.029), and skin reaction (P= 0.021) occurred more frequently among linezolid interrupters.

Conclusions:

In conclusion linezolid-based combination therapy, with linezolid at a dose of 600mg daily is associated with satisfactory culture conversion rate by 10 months of therapy. However, linezolid may be associated with peripheral neuropathy that may warrant interruption of the drug.
Cost Analysis for Patients with Presumed Pulmonary Tuberculosis Attended in the Public Health System of Rio de Janeiro, Brazil
Authors: Vater Maria Claudia , Maximo Mário Motta , Silva Rezende Moreira Adriana da , Alves da Silva Suely Conceição , de Almeida Isabela Neves , Kritski Afrânio Lineu
Published: September 2024

Background:

In last years, few attention has given to the patient's prediagnostic costs when evaluating the introduction of new technologies for tuberculosis (TB) and in this context, this study evaluated patient's costs and cost-effectiveness incurred with TB diagnosis comparing BactecTMMGITTM960 system (MGIT) to the Löwestein–Jensen (LJ) culture in a health center and in a university hospital, in Rio de Janeiro City, Brazil.

Methods:

Patient's mean costs were evaluated during the diagnosis process and cost-effectiveness based on mean time in days for the adoption of appropriate clinical anti-TB treatment in two health units comparing culture by means LJ and MGIT.

Results:

The mean cost of LJ and MGIT in the health center was U. S. dollars (US$) 26.6 and US$ 45.13, respectively, and in university hospital was US$ 206.87 and US$ 285.48, respectively. Comparing the two approaches for TB diagnosis incurred by the patients, the incremental cost-effectiveness of MGIT compared to LJ was US$ 0.88 and US$ 4.03 per patient, respectively, to reduce the average time to adopt appropriate treatment.

Conclusions:

The culture method directly impacts patient costs while waiting for the correct diagnosis and contributing to aggravating costs with patients with TB.