bluuebunny/crossref_metadata_2025 huggingface dataset:
Loan Default Prediction Based on Convolutional Neural Network and LightGBM
Authors: Zhu Qiliang , Ding Wenhao , Xiang Mingsen , Hu Mengzhen , Zhang Ning
Published: December 2022

With the change of people's consumption mode, credit consumption has gradually become a new consumption trend. Frequent loan defaults give default prediction more and more attention. This paper proposes a new comprehensive prediction method of loan default. This method combines convolutional neural network and LightGBM algorithm to establish a prediction model. Firstly, the excellent feature extraction ability of convolutional neural network is used to extract features from the original loan data and generate a new feature matrix. Secondly, the new feature matrix is used as input data, and the parameters of LightGBM algorithm are adjusted through grid search so as to build the LightGBM model. Finally, the LightGBM model is trained based on the new feature matrix, and the CNN-LightGBM loan default prediction model is obtained. To verify the effectiveness and superiority of our model, a series of experiments were conducted to compare the proposed prediction model with four classical models. The results show that CNN-LightGBM model is superior to other models in all evaluation indexes.
Personal Health and Illness Management and the Future Vision of Biomedical Clothing Based on WSN
Authors: Zhang Ge , Ning Zubin
Published: December 2022

It is essential to have a fast, reliable, and energy-efficient connection between wireless sensor networks (WSNs). Control specifications, networking layers, media access control, and physical layers should be optimised or co-designed. Health insurance will become more expensive for individuals with lower incomes. There are privacy and cyber security issues, an increased risk of malpractice lawsuits, and more costs in terms of both time and money for doctors and patients. In this paper, personal health biomedical clothing based on wireless sensor networks (PH-BC-WSN) was used to enhance access to quality health care, boost food production through precision agriculture, and improve the quality of human resources. The internet of things enables the creation of healthcare and medical asset monitoring systems that are more efficient. There was extensive discussion of medical data eavesdropping, manipulation, fabrication of warnings, denial of services, position and tracker of users, physical interference with devices, and electromagnetic attacks.
Vulnerability to human immunodeficiency virus infection and associated factors among married women in northwest Ethiopia: a cross-sectional study
Authors: Hussien Asiya , Boka Abdissa , Fantu Asnake
Published: December 2022

Purpose: This study investigated the vulnerability to human immunodeficiency virus (HIV) infection and associated factors among married women in northwest Ethiopia.Methods: A community-based cross-sectional survey (n=657) was conducted from April 1 to 15, 2020, in Metema District, northwest Ethiopia, in four randomly selected kebele administrations (the lowest level of local government). The inclusion criteria were married women aged ≥18 years residing with their husbands. Logistic regression analysis was conducted to identify factors associated with married women’s vulnerability to HIV infection.Results: Participants were on average 33.70±9.50 years and nearly one-fourth (n=148, 22.5%) were identified as vulnerable to HIV infection (i.e., experienced sexually transmitted disease symptoms or an extramarital affair of either spouse within the past 12 months). Only 18.9% reported sexual communication with their husband. Respondents who did not discuss the risk of HIV infection with their husbands had fivefold odds of vulnerability (adjusted odds ratio [AOR], 5.02; 95% confidence interval [CI], 1.43–17.5). Those who did not have premarital sex (AOR, 0.20; 95% CI, 0.05–0.77) had no worries about HIV infection (AOR, 0.27; 95% CI, 0.08–0.94), sufficient income (AOR, 0.56; 95% CI, 0.16–0.86), and less than four children (AOR, 0.69; 95% CI, 0.50–0.97) had decreased odds of being vulnerable to HIV than their counterparts.Conclusion: Not discussing risk of HIV infection with husband was a major factor of vulnerability to HIV infection as was premarital sex, worry about HIV, income, and number of children. Measures to strengthen couple’s sexual communication and support economical stability is important for decreasing HIV vulnerability.
Maternal, infant, and perinatal mortality statistics and trends in Korea between 2018 and 2020
Authors: Choi Hyunkyung , Nho Ju-Hee , Yi Nari , Park Sanghee , Kang Bobae , Jang Hyunjung
Published: December 2022

Purpose: This study aimed to identify maternal, infant, and perinatal mortality using the national population data of South Korea between 2018 and 2020, and to analyze mortality rates according to characteristics such as age, date of death, and cause of death in each group. This study updates the most recent study using 2009 to 2017 data.Methods: Analyses of maternal, infant, and perinatal mortality were done with data identified through the supplementary investigation system for cases of death from the Census of Population Dynamics data provided by Statistics Korea from 2018 to 2020.Results: Between 2018 and 2020, a total of 99 maternal deaths, 2,427 infant deaths, and 2,408 perinatal deaths were identified from 901,835 live births. The maternal mortality ratio was 11.3 deaths per 100,000 live births in 2018; it decreased to 9.9 in 2019 but increased again to 11.8 in 2020. The maternal mortality ratio increased steeply in women over the age of 40 years. An increasing trend in the maternal mortality ratio was found for complications related to the puerperium and hypertensive disorders. Both infant and perinatal mortality continued to decrease, from 2.8 deaths per 1,000 live births in 2018 to 2.5 in 2020 and from 2.8 in 2018 to 2.5 in 2020, respectively.Conclusion: Overall, the maternal, infant, and perinatal mortality statistics showed improvements. However, more attention should be paid to women over 40 years of age and specific causes of maternal deaths, which should be taken into account in Korea’s maternal and child health policies.
A case of chronic granulomatous disease and acne: is isotretinoin a safe treatment?
Authors: Brusasco Marco , Feliciani Claudio , De Felici del Giudice Maria Beatrice
Published: December 2022

We report the case of a patient with chronic granulomatous disease and acne treated with isotretinoin, who developed a diffuse staphylococcal skin infection during the therapy. Chronic granulomatous disease is a rare genetic disorder characterized by an altered innate immunity with an increased risk of potentially lethal bacterial and fungal infections. Although chronic granulomatous disease is rare, acne is a common manifestation in these patients, but there are no data about the gold standard therapy.
Prevalence, case fatality rate and risk factors for mortality among neonates admitted with perinatal asphyxia at a tertiary hospital in northern Nigeria
Authors: Farouk Zubaida Ladan , Gambo Mahmud Jahun , Usman Fatima , Abdullahi Hauwa Musa , Imam Abdulazeez , Abdussalam Mohammed , Aliyu Labaran Dayyabu
Published: December 2022

Documenting the burden and the risk factors for perinatal asphyxia-related mortality is key to its prevention. The goal was to document the factors associated with mortality in perinatal asphyxia in a tertiary health facility in Nigeria. Records of consecutive neonatal admissions (between January 2016 and January 2017) underwent a retrospective analysis. Data were analyzed using Stata statistical software version 16 (Statacorp® Texas, USA). 102 (12.1%) of 841 admitted neonates had perinatal asphyxia; the median age (inter quartile range [IQR]) was 6 (0-168) hours. The mean admission weight ±(SD) was 2.96kg±(0.66) kg. Among inborn neonates, the incidence was 9.7 per 1000 live births. In 49% (50/102) pregnancies the amniotic fluid was clear; in 42% (43/102) it was meconium-stained; and 9 staining was unreported. Case fatality rate was 20.6% (21 of 102). 77(75%) neonates had no HIE, while 24 (24.5%) did. When compared to neonates without HIE, those with HIE II had about 7000 times higher odds of mortality (aOR = 68132.19, P0.01, 95% CI 3 to 1.4X 109). The adjusted odds of mortality for neonate with meconium-stained liquor were about 1900 times higher compared to clear meconium (aOR =1895, P = 0.02, 95%CI = 2.7 to 13072). Neonates with higher mean admission lengths (49.4cm [range = 48.8 to 50]) had 88 times lower odds of death compared to shorter neonates (aOR of 0.12 (95% CI: 0.17 to 0.85; p = 0.03).
Nailfold capillaroscopy in the rheumatological current clinical practice in Italy: results of a national survey
Authors: Ingegnoli F. , Cornalba M. , De Angelis R. , Guiducci S. , Giuggioli D. , Pizzorni C. , Riccieri V. , Sebastiani M. , Sulli A. , Cutolo M.
Published: December 2022

This cross-sectional online study was designed by the study group on Capillaroscopy and Microcirculation in Rheumatic Diseases (CAP) of the Italian Society of Rheumatology (SIR) to provide an overview of the management of nailfold capillaroscopy in Italian rheumatology centers. Therefore, SIR distributed the survey to its members in July 2021, and each center’s physician with the most expertise in capillaroscopy completed the questionnaire. The survey was completed by 102 centers, with at least one representative from each Italian region. Ninety-three centers perform capillaroscopy, and 52 (56) conduct more than 200 investigations annually. Seventy-eight (84%) of respondents have more than five years of experience with the technique, and 75 centers (80.6%) have received certification from specific national or international training courses. In 85 centers, a videocapillaroscope with 200x magnification is employed (91.4%). The average waiting period for the examination is 2.4 months, and less than 3 months in 64 of the locations (68.8%). The study demonstrates that capillaroscopy is an integral part of both the diagnostic phase of Raynaud’s phenomenon and the monitoring of autoimmune connective tissue diseases (CTDs). However, the reporting methods and timing of patient followup are heterogeneous.
Effectiveness and safety profile of tofacitinib and baricitinib in rheumatoid arthritis patients: results from a 24-month real-life prospective study in Southern-Italy
Authors: Tasso M. , Bertolini N. , Mostacciuolo E. , Passavanti S. , Luppino J.M.E. , Del Puente A. , Peluso R. , Santelli F. , Scarpa R. , Costa L. , Caso F.
Published: December 2022

The primary objectives of the study were to evaluate the efficacy and safety of tofacitinib and baricitinib up to 24 months of follow-up in patients with rheumatoid arthritis (RA) treated in Southern Italy. Patients’ data, activity index, and clinimetric scores were collected at baseline (T0), six (T6), twelve (T12), and twenty-four (T24) months following treatment initiation. At six, twelve, and twenty-four months, adverse events and treatment cessation were also recorded. Sixty-eight patients (mean age: 62.2±10.9 years; mean RA duration: 15±9.6 years) were enrolled over a period of 12 weeks. At baseline, twenty-four patients (35.3%) were treated with tofacitinib, and forty-four patients (64.7%) were treated with baricitinib. The baseline mean disease activity was moderate as measured by DAS28- ESR (5.0±1.0), DAS 28 CRP (4.69±0.94), and SDAI (26.87±10.73) score. Before beginning JAKinhibs therapy, thirty-two patients (61.8%) were taking bDMARDs, while the remaining thirty-six (38.2%) were bDMARDs-naïve. The 24-month retention rate for JAKinhibs was 91.1%. Six months after beginning treatment with JAKinhibs, a statistically significant improvement was observed in all evaluated activity indices and clinimetric scores. Improvement was confirmed during the 12- and 24-month follow-up evaluations. The positive correlation between baseline-T6 SDAI delta and discontinuation of JAKinhibs (p=0.02) suggests that RA worsening in the first six months may be a predictor of therapy withdrawal. Patients with RA responded favorably to tofacitinib and baricitinib in this prospective, real-world study from a single center in Southern Italy. Efficacy was observed despite an underlying persistent and treatment-resistant disease.
Tirzepatide, A New Antidiabetic Drug with Change in the Treatment of Patients with Type 2 Diabetes
Authors: Kim Soo Kyoung
Published: December 2022

Mounjaro® (tirzepatide) was approved by the U.S. Food and Drug Administration for type 2 diabetes treatment in August 2022. Tirzepatide, a synthetic peptide consisting of 39 amino acids, is a dual GLP-1 (glucagon-like peptide-1)/GIP (glucose-dependent insulinotropic polypeptide) receptor agonist. Tirzepatide showed marked reductions in glycated hemoglobin and body weight in the SURPASS study among participants with type 2 diabetes that surpassed existing diabetes drugs. Other benefits included blood pressure reduction and lipid lowering effects. On meta-analysis and post-hoc analysis, tirzepatide did not increase the risk of major cardiovascular events and is expected to have cardiovascular benefits in future studies. In addition, it showed a protective effect on the kidney by slowing the rate of renal function decline and reducing new-onset macroalbuminuria. However, the fact that it is an injectable drug, the cost of the drug, and the high rate of gastrointestinal side effects are disadvantages to tirzepatide. Considering the superior degree of glucose reduction and weight reduction observed in tirzepatide clinical trials compared to clinical trials of other anti-diabetic drugs, we expect tirzepatide to bring about a paradigm shift in the treatment of obese type 2 diabetes patients.
Application of Automated Insulin Delivery in Korean Clinical Practice
Authors: Jin Sang-Man
Published: December 2022

In contrast to Europe and the United States (US), conventional insulin pumps have not been widely used in East Asia, even among people with type 1 diabetes. Clinical experiences in Europe and the US indicate that automated insulin delivery (AID) can successfully improve the quality of glucose control even in people with type 1 diabetes who do not have experience with conventional insulin pumps. Therefore, prior use of a conventional insulin pump was not a requirement for successful introduction of AID. However, use of AID still requires full understanding of conventional insulin pump management, and AID-specific education as well. Besides basic information on continuous glucose monitoring and conventional insulin pumps, people with type 1 diabetes starting AID should understand the difference between closed-loop and open-loop insulin delivery, should have reasonable expectations for AID, and should be motivated to engage in clinical follow-up to prevent discontinuation of the use of AID devices. Failure to provide AID-specific education before and after the introduction of AID would result in discontinuation of the use of AID devices, which would in turn result in suboptimal glucose control. In this review, I summarize lessons from clinical experience where AID is already in clinical use, and discuss what preparations should be made for successful introduction of AID in Korean clinical practice.
Management of Intractable Painful Diabetic Peripheral Neuropathy: The Perspective of a Pain Specialist
Authors: Moon Jee Youn
Published: December 2022

Peripheral neuropathy is one of the most common complications of both type 1 and type 2 diabetes. The most common diabetic neuropathy (DN) is distal symmetric polyneuropathy, with characteristic glove- and stocking-like presentation of distal sensory or motor function loss. Because painful DN is associated with increased mortality and morbidity, early recognition and preventive measures are essential. Nevertheless, diagnosing DN or painful DN is challenging, particularly in patients with early and mild neuropathy, and there is no established gold standard. Furthermore, there is no established DN treatment other than improved glycemic control, and only symptomatic management is available for painful DN. However, thanks to health-conscious living, almost one-third of patients with painful DN derive sufficient pain relief with existing pharmacotherapies. These include antidepressants (tricyclic acid, serotonin-norepinephrine reuptake inhibitor), anticonvulsants (calcium-channel blocker, sodium channel blocker), and others (sarpogrelate). A more precise and distinct symptom profile from patients with painful DN may help identify patients more responsive to one treatment versus another. In addition to pharmacological, physical, cognitive, or educational management for painful DN, large randomized clinical trials are needed to identify the most effective minimally invasive interventions. Transcutaneous electrical nerve stimulation, pain scrambler therapy, sympathetic ganglion block, and botulinum toxin injections have been investigated as alternative therapeutic outcomes.
Diabetic Neuropathy and Risk of Cardiovascular Disease
Authors: Yun Jae-Seung
Published: December 2022

Neuropathy is a common complication of diabetes that can appear in the early stages of diabetes or even in the prediabetes stage. The relationship between autonomic neuropathy and cardiovascular disease (CVD) is well established. Resting tachycardia, exercise intolerance, and non-dipping/reverse dipping caused by the relative overactivity of the sympathetic nervous system are the main factors that lead to the increased risk of CVD and cardiovascular mortality. Little is known, however, about the cardiovascular consequences of peripheral neuropathy (PN). Two recent major studies suggested the possibility of a significant association between PN and CVD and mortality; thus, cardiovascular risk management for patients with PN may be necessary. Positive results on MNSI (Michigan Neuropathy Screening Instrument) questionnaires and 10-g monofilament test are convenient methods for early screening and management of PN that may also be useful in evaluating PN-related CVD risk.
Nutrition Therapy for Diabetic Patients with Malnutrition
Authors: Kim Min Ji
Published: December 2022

Recently, the prevalence of diabetic mellitus patients in Korea has been increasing, and it increasing with age. The treatment goal of diabetes is to prevent complications through blood sugar management, for which it is important to maintain an appropriate nutritional state. Unbalanced diet refers to excessive or insufficient nutrition, which can be generally confirmed through weight conditions. Therefore, medical nutrition therapy in diabetic patients with unbalanced diet aims to maintain a moderate body mass index. Older people with diabetes have a higher risk of unbalanced diet than those without diabetes. Clinical nutritional intervention in diabetic patients should shift from strict dietary restrictions for treatment of metabolic syndrome/obesity to diet for prevention of frailty and sarcopenia with age. Therefore, clinical nutrition therapy for diabetic patients with unbalanced diet should be individualized in consideration of age, gender, and medical condition. Medical nutrition therapy tailored for each patient can contribute to improving the nutritional status of diabetic patients, prolonging healthy life expectancy and improving quality of life.
Validation of Foot Pressure Variables during Walking according to Glycated Hemoglobin Levels
Authors: Yi Kyung-Ock , Kang Youn-Hee , Hong Young-Sun , Kwon Oran , Kim Jae-Won , Jin Yin-Zhu
Published: December 2022

The purpose of this study was to explore the variables of foot pressure according to glycated hemoglobin level during walking in diabetic patients with pes rectus. The subjects of this study were 39 people (78 feet) in their 40s and 60s, and they were divided into 11 pre-diabetic patients (22 feet) and 14 diabetic patients (28 feet) based on glycated hemoglobin; 14 patients without diabetes (28 feet) was used as a control. Foot pressure was measured using the EMED-LE Measurement system. The sole of the foot was divided into 12 parts, each of which was analyzed for pressure, force, contact area, and grounding time. For statistics, nonparametric Kruskal–Wallis and Wilcoxon signed rank test were used. Prediabetic and diabetic patients had lower hindfoot and second and third metatarsal foot pressure but higher first and third toe pressure compared to those without diabetes. In addition, the maximum and minimum force were high in all parts of the sole, and the contact time was long, signifying strong downward force for a long duration. Measurement of foot pressure by parts allowed detailed analysis of abnormal foot pressure and is valuable as basic data for diagnosis, prediction, and treatment of diabetic foot. Based on these data, maximum and minimum pressure better explain the problem of plantar pressure distribution rather than mean maximum pressure.
Effect of total intravenous versus inhalation anesthesia on long-term oncological outcomes in patients undergoing curative resection for early-stage non-small cell lung cancer: a retrospective cohort study
Authors: Seo Kwon Hui , Hong Ji Hyung , Moon Mi Hyoung , Hwang Wonjung , Lee Sea-Won , Chon Jin Young , Kwon Hyejin , Hong Sook Hee , Kim Sukil
Published: December 2022

Background: Propofol-based total intravenous anesthesia (TIVA) improves long-term outcomes after cancer surgery compared with inhalation anesthesia. However, its effect on patients undergoing non-small cell lung cancer (NSCLC) surgery remains unclear. We aimed to compare the oncological outcomes of TIVA and inhalation anesthesia after curative resection of early-stage NSCLC. Methods: We analyzed the medical records of patients diagnosed with stage I or II NSCLC who underwent curative resection at a tertiary university hospital between January 2010 and December 2017. The primary outcomes were recurrence-free survival (RFS) and overall survival (OS) according to anesthesia type.Results: We included 1,508 patients with stage I/II NSCLC. The patients were divided into the TIVA (n = 980) and Inhalation (n = 528) groups. The two groups were well-balanced in terms of baseline clinical characteristics. The TIVA group demonstrated significantly improved RFS (7.7 years, 95% CI [7.37, 8.02]) compared with the Inhalation group (6.8 years, 95% CI [6.30, 7.22], P = 0.003). Similarly, TIVA was superior to inhalation agents with respect to OS (median OS; 8.4 years, 95% CI [8.08, 8.69] vs. 7.3 years, 95% CI [6.81, 7.71]; P < 0.001). Multivariable Cox regression analysis revealed that TIVA was an independent prognostic factor related to recurrence (hazard ratio [HR]: 1.24, 95% CI [1.04, 1.47], P = 0.014) and OS (HR: 1.39, 95% CI [1.12, 1.72], P = 0.002).Conclusions: Propofol-based TIVA was associated with better RFS and OS than inhalation anesthesia in patients with stage I/II NSCLC who underwent curative resection.
Cytomorphological Analysis of Urinary Cells Among Active and Passive Cigarette Smokers in South-West, Nigeria
Authors: Ajileye Ayodeji Blessing , Akinbo Frederick Olusegun
Published: December 2022

Introduction:

Cigarette smoke contains thousands of identified chemicals, among which sixty-nine (69) of these chemicals are known to be poisonous to humans and are capable of causing cancer in any part of the body. This study was conducted to evaluate the cytology of urinary cells among active and passive cigarette smokers in South-Western Nigeria.

Materials and Methods:

Urine samples were collected from 250 active cigarette smokers and 200 passive cigarette smokers who live in South-Western, Nigeria. The urine specimen was collected from participants and processed using the standard technique for microscopic examination. Smears were stained with haematoxylin and eosin and Papanicolaou stain.

Results:

The urinary smears of passive cigarette smokers revealed normal superficial squamous cells, transitional cells, cast, necrotic debris and mild inflammatory cells, while that of active cigarette smokers revealed high cellular turnover, protein casts, dysplastic epithelial cells and atypical urothelial cells with degenerative features.

Conclusion:

On the basis of this study, the cytomorphological analysis of urinary smears among active cigarette smokers revealed cytopathological features which connote the harmful effects of the chemical constituents present in cigarette smoke.
Efficacy Comparison of Magnesium Sulphate, Ketamine and Neostigmine Adjuvants to Bupivacaine 0.5% on Onset, Duration and Quality of Ultrasound-Guided Supraclavicular Block Characteristics for Forearm Surgery
Authors: Nadimi-Bajandi Habib , Moshiri Esmail , Modir Hesameddin , Parsi-Khamene Mohsen
Published: December 2022

Introduction:

This study aimed to provide an evidence-based foundation for appraising the efficacy of magnesium sulphate, ketamine and neostigmine plus bupivacaine 0.5% on key supraclavicular block (SCB) characteristics made up of onset, duration and quality for forearm surgery.

Materials and Methods:

This double-blind trial enrolled ninety patients who were identified as having needed forearm surgery and been hospitalised in the Arak-based Valiasr Hospital, Iran, stratified participants into triad randomised groups receiving the aforementioned adjuvants. The basic requirements were met to incorporate the underneath groups' data to be recorded and analysed within SPSS release 20: (a) haemodynamic parameters (including mean arterial pressure/heart rate/oxygen saturation) documented at 5-min intervals until the end of surgery; (b) the onset and next to the duration of complete sensory and motor block, the time to administration of the patient's first post-operative analgesia and the overall dose of analgesic administered; (c) all block failures; (d) opioid consumption during post-operative 24 h and (e) pain score measured on a visual analogue scale throughout recovery time and scheduled post-operative times (2, 4, 8, 12 and 24 h).

Results:

Notwithstanding the shorter onset of sensory and motor block manifested in the magnesium sulphate group and longer duration of motor block in those receiving neostigmine regimen (P < 0.001), the findings endorsed strong support for the potential efficacy of ketamine in affording the longer duration of sensory block, better clinically meaningful pain relief at all scheduled times and diminished opioid consumption during 24 h (all P < 0.001).

Conclusion:

Bearing in mind the lack of complication needing to be thought of and the trial's clinical findings, which bespeak the shorter onset of the block (both sensory and motor) in the group receiving magnesium sulphate versus the longer duration of motor and sensory block in the neostigmine- and ketamine-treated groups, respectively, and diminished pain score and opioid consumption in the latter, all the adjuvants, thus, could be suggested to be contributed to achieving successful SCB in forearm fracture patients, depending on the patient's general condition and the anaesthesiologist's discretion.
Comparison of the Efficacy of Supraclavicular Block with Bupivacaine (0.5%) Combined with Dexmedetomidine, Granisetron and Magnesium Sulphate in Sensory and Motor Block and Haemodynamic Parameters of Patients in Upper-Extremity Orthopaedic Surgery
Authors: Modir Hesameddin , Mahmoodiyeh Behnam , Moradi Amir Hossein , Mohseni Fatemeh , Almasi-Hashiani Amir
Published: December 2022

Introduction:

Peripheral nerve block leads to effective pain control. Peripheral nerve blocks are used both in general anaesthesia and as regional anaesthesia alone. The aim of this study was to compare the characteristics of the supraclavicular block with bupivacaine (0.5%) in combination with dexmedetomidine, granisetron and magnesium sulphate in upper-limb orthopaedic surgery.

Materials and Methods:

This double-blind clinical trial was carried out on 105 patients who were candidates for upper-limb orthopaedic surgery in Valiasr Hospital in Arak. The patients were divided into three equal groups (dexmedetomidine, granisetron and magnesium sulphate) using the block method for randomisation. Mean arterial pressure, heart rate and arterial oxygen saturation every 5 min until the end of the surgery, onset and duration of sensory and motor block, mean opioid consumption in 24 h and post-operative pain during recovery and 2 h after surgery at 4, 8, 12 and 24 h were recorded. Data were analysed by SPSS.22 software.

Results:

The lowest heart rate at all times and the lowest blood pressure from 40 min to the end of surgery were observed in the dexmedetomidine group (P < 0.05). The time to the onset of sensory block and the time to the onset of motor block were shorter in the magnesium sulphate and dexmedetomidine groups, respectively. Moreover, the duration of the sensory and motor block was longer in the dexmedetomidine group (P = 0.0001). In addition, pain and amount of opioid consumption were lower in the dexmedetomidine group (P = 0.0001).

Conclusion:

Magnesium sulphate caused earlier onset of sensory block, while dexmedetomidine increased the duration of sensory and motor block. In the dexmedetomidine group, haemodynamic changes were made in the form of a decrease in heart rate and blood pressure, which, of course, did not require special treatment. As such, magnesium sulphate as an adjuvant is recommended to be used in cases where there is a requirement for the rapid onset of sensory block. Meanwhile, dexmedetomidine should be used as an adjuvant for the rapid onset of motor block and increase of the duration of sensory and motor block when taking into account the patients' physical conditions and the anaesthesiologist's discretion.
Histopathological Spectrum of Myxoid Soft-Tissue Neoplasms in a Tertiary Care Center with a Special Focus on Vascular Patterns
Authors: Chandrashekhar Thotadamane Nagaraja , Bargunam Priyadharshini , Boya Kusumanjali
Published: December 2022

Introduction:

Myxoid soft-tissue tumors are a diverse group of tumors which have similar histomorphology but have varied genetic sequence and clinical outcome, hence differentiating and diagnosing them is a challenge for any pathologist. This study describes the various histomorphological spectrum and vascular pattern of various myxoid soft-tissue tumors.

Materials and Methods:

This was a retrospective and prospective observational study of myxoid soft-tissue tumors over a period of 13 years. A total of 224 cases with myxoid morphology were included and were examined morphologically with a special focus on the vascular pattern. SPSS v 24 was used for statistical analysis.

Results:

The predominant lesions were benign in 164 (73.21%) cases, followed by malignant lesions in 43 (19.19%) cases and intermediate lesions 17 (7.58%) cases. Both benign and malignant lesions showed a male preponderance and were seen to arise predominantly from the extremities. The most common benign myxoid lesions in this study were of neural origin with myxoid neurofibroma constituting 65 (29. 01%) cases, followed by schwannoma 38 (16.9%) cases. Myxoid dermatofibrosarcoma protuberans was the most common intermediate lesion. Tumors with adipocytic differentiation were the predominant lesions among the malignant group, i.e myxoid liposarcoma seen in 17 (7.5%) cases.

Conclusions:

Vascular pattern in the myxoid lesions are subtle yet crucial in arriving at a histo-morphological diagnosis. Further studies correlating the vascular pattern with the genetic profile of these tumours can help arriving at a histo-morphological diagnosis of myxoid lesions.
Histomorphological Analysis of Nephrectomy Specimens
Authors: Soumya B. M. , Devi Rajkumari Jayshree , Kulkarni Sriharsha , Kulkarni Vardendra G
Published: December 2022

Introduction:

For a range of kidney abnormalities, including both neoplastic and nonneoplastic disorders, nephrectomy is a popular surgical treatment. We conducted this study to examine the range of lesions found in the nephrectomy specimens obtained and to ascertain the distribution of these lesions by age and sex.

Materials and Methods:

This study was conducted in the department of pathology, from 2017 to 2022. All nephrectomy specimens received during 5 years were included.

Results:

The spectrum of renal lesions observed in the study included both neoplastic (43.75%) and nonneoplastic (56.25%) conditions. Nineteen patients were males (59.37%) and 13 were females (40.62%) (M: F = 1.4:1). The most common entity in the nonneoplastic category was chronic pyelonephritis (n = 9, 28.12%). In our study, we documented two unusual cases of renal replacement lipomatosis (RRL), a type of pseudotumor related to nonfunctioning kidneys. Fourteen patients underwent nephrectomy for neoplastic conditions such as Wilm's tumor and renal cell carcinoma (RCC).

Conclusion:

Nephrectomy for the nonneoplastic condition was performed more frequently in our series. Histopathological evaluation of nonneoplastic nephrectomy specimens must be thoroughly considered, particularly in unusual circumstances such as RRL, where a preoperative erroneous initial impression of a malignant lesion such as angiomyolipoma or liposarcoma is possible.
Surfactant administration via laryngeal mask or supraglottic airway
Authors: Kansakar Prerana , Saluja Satish , Modi Manoj , Thakur Anup , Soni Arun
Published: December 2022

Surfactant therapy has been the mainstay of treatment in preterm neonates with respiratory distress syndrome. Delivery of surfactant through endotracheal intubation has been the commonly used technique. Intubation requires expertise and is associated with complications. In addition, there is also an increased future risk of chronic lung disease. Newer techniques of surfactant delivery abating the need of intubation have been reported. One such minimally invasive technique is surfactant administration through a supraglottic airway device. In this report, we describe the delivery of surfactants using this technique.
Are you ready for Patient Engagement in Health Care?
Authors: Patil Vinit Shashikant , Sidhulal K , Vaghela Nilima , Belgaumi Uzma , Abdulla PP Javad Ebn Mohammed , Ahmed Junaid Bin
Published: December 2022

Active patient engagement (PE) is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout public health and the research process. However, guidance for PE in research does not exist, the evidence base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. An explicit statement of values seeks to align all stakeholders on the purpose, practice, and credibility of PE activities. An innovative, flexible, and transparent research environment is valued as essential to developing a trustworthy evidence base with which to underpin future guidance for good PE practice. The recent focus on PE acknowledges that patients have an important role to play in their own health care. This includes reading, understanding and acting on health information (health literacy), working together with clinicians to select appropriate treatments or management options (shared decision-making), and providing feedback on health-care processes and outcomes (quality improvement). This review explores the values that should underpin PE in contemporary public health research to help inform future good practice guidance.
Prosthodontic management of Atwood's order V and VI mandibular ridge with cocktail impression technique
Authors: Sharma Riddhi , Oberoi Naveen , Kaur Gurpreet , Singh Ravpreet , Singh Jaspreet
Published: December 2022

Residual ridge resorption is the reduction in size of the bony ridge under the mucoperiosteum. The resorption occurs faster in the mandibular arch as compared to the maxillary arch. Fabrication of any dental prosthesis over a compromised residual alveolar ridge is really a challenge for prosthodontists. The pattern of bone resorption observed in Atwood's Orders V and VI causes difficulty in providing successful dentures, especially lower denture where stability of denture may get compromised. This clinical case report elicits a combination of different impression techniques to improve mandibular denture stability in severely resorbed ridges preventing their further resorption.
Primary fallopian tube endometroid carcinoma: A rare case report
Authors: Vats Barkha , Yadav Reena , Parihar Meena , Jaiswal Nishtha , Chatterjee Priti , Osama Md Ali
Published: December 2022

Primary fallopian tube carcinoma is an extremely rare tumor accounting for only 0.14–1.8% of genital tract cancers. A 47-year-old female presented with post-menopausal bleeding and heaviness in the lower abdomen. Imaging revealed the right adnexal mass, suggestive of neoplastic origin. She was prepared for surgery. Per-operatively, there was a solid irregular mass, firm to hard in consistency, around 8 × 5 cm involving the whole of the right fallopian tube, and the right ovary appeared normal. Histopathological examination of the specimen showed endometroid adenocarcinoma of the right fallopian tube. Endometroid carcinoma is important to recognize because it carries the best prognosis of all the fallopian tube cancers. The patient underwent surgery, followed by adjuvant chemotherapy, and was doing well in follow-up.
Clinico-Aetiological Profile of Children with Fever and Rash with Special Reference to Dengue
Authors: Thakur Srishty , Patil Rajesh , Choubey Bharati , Shrivastava Jyotsana
Published: December 2022

Aim:

Fever with rash is a common presentation in paediatric patients with a variety of differential diagnosis ranging from minor to life-threatening illnesses. Establishing an early diagnosis particularly of dengue infection, especially in a resource-limited setting is essential to reduce morbidity and mortality. The aim of this study is to evaluate the clinico-aetiological profile of children admitted with fever and rash and to find out different clinical and laboratory parameters for diagnosing dengue infection using screening tests.

Methods:

It is an observational cross-sectional study. All consecutive patients admitted to tertiary care centre during the study period (n = 120) between age group 1 month and 12 years were evaluated with detailed history and clinical examination and relevant investigations. For screening dengue infection, various clinical and laboratory parameters were used to find the best combination comprising the desired sensitivity, specificity, positive and negative predictive values (NPV) and likelihood ratio.

Results:

The most commonly affected age group was below 5 years. Among 120 patients, 64% had a laboratory-confirmed diagnosis out of which 45% patients were of viral aetiology, 10% patients had bacterial aetiology and 9% had non-infectious aetiology. Among viral infections, 18 patients were diagnosed as dengue immunoglobulin M enzyme-linked immunosorbent assay positive. Headache (100%), was the most common symptom followed by diarrhoea (83.3%), vomiting (83.3%) and altered sensorium (72.2%) in dengue-positive patients. All dengue patients had thrombocytopenia, 88.9% had leucopenia and liver function tests deranged in 77.8% of patients. The highest sensitivity and specificity values were found in the combination of fever, maculopapular rash, headache, absence of cough and thrombocytopenia (55.6% and 94.12%, respectively), followed by fever, maculopapular rash, headache, no cough, thrombocytopenia and leucopenia (with 50% sensitivity and 100% specificity). Both combinations also showed the highest values for positive and NPVs, positive likelihood ratio and maximum area under the curve using a receiver operating characteristic.

Conclusion:

Establishing the diagnosis of fever with rash in children can be challenging. A combination of parameters such as fever, maculopapular rash, headache, absence of cough, thrombocytopenia and leucopenia can be used as a screening tool for early diagnosis of dengue infection in a resource-limited setting.
Correlation of arterial PaCO2 to end tidal CO2 in children undergoing laparoscopic abdominal surgery: An observational study
Authors: Jain S. , Kumar L. , Babu S.C. , Sadhoo A. , Ravindran G.C. , Rajan S.
Published: December 2022

Background and Aims:

The reliability of end tidal carbon dioxide (ETCO2) as a measure of arterial carbon dioxide (PaCO2) in pediatric laparoscopy is unclear. We evaluated the correlation of arterial to end tidal P(a-ET) CO2 during pediatric laparoscopy at two hours of pneumoperitoneum as the primary objective. We also compared P(a-ET) CO2 and alveolar to arterial oxygen gradient P(A-a) O2 and haemodynamics at fixed time points during surgery.

Material and Methods:

A cross-sectional study was conducted in 25 children undergoing laparoscopic abdominal surgery. Arterial blood gases were drawn at T0, baseline, T10: ten minutes, T1h: 1 hour, T2h: 2 hours of pnuemoperitoneum and T 10d: 10 mins after deflation. The P(a-ET) CO2, P(A-a) O2, were measured from the blood gas and ETCO2 and FiO2 values on the monitor. The Pearson’s correlation coefficient, the Wilcoxon rank test and Chi square test were used for statistical analysis.

Results:

At T2h moderate correlation of P(a-ET) CO2 (r = 0.605, P = 0.001) with 40% children documenting accurate P(a-ET) CO2, -1 to +1 mm Hg was seen. Moderate correlation was also seen at T0, T10, T 10d but poor correlation at T 1h. The P(A-a) O2 increased progressively with surgery and did not correlate with P(a-ET) CO2. Heart rate was stable, but systolic blood pressures at T 10 and diastolic at T10, T 1h, T 2h were higher than baseline.

Conclusion:

Moderate correlation was seen between PaCO2 and ETCO2 at 2 h of pnuemoperitoneum and at T0, T 10, and T 10d. P(A-a) O2 increased with surgery but did not correlate with P(a-ET) CO2.
Impact of long duration wearing of N95 masks on cardiorespiratory system and subjective sensations of health-care workers during COVID-19 era
Authors: Singla Monika , Soni Ravinder Kumar , Chhina Rajoo Singh , Chhabra Shiba Takkar , Wander Gurpreet Singh
Published: December 2022

Background and Aims:

N95 mask being an essential element of personal protective equipment to be worn by health-care workers (HCWs) may lead to adverse effects and physiological stress as HCWs have to wear it for prolonged hours. Therefore, we planned to conduct a study in our intensive care unit staff to look for the effects of N95 masks on their health as well as to plan recommendations to ease them.

Material and Methods:

We conducted this study on our intensive care unit nursing staff and HCWs. We noted their oxygen saturation and heart rate at baseline as well as after 1 h, 2 h, 3 h, and 6 h of duty along with their subjective sensations. Institutional ethical clearance for the same was taken. Collected data were entered in MS Excel database and analyzed using SPSS version 20.0. Fisher’s Z test was applied for comparing proportion and analysis of variance for comparing two means.

Results:

One hundred and nine HCWs participated in this, out of which 93 (85.3%) were females and 16 (14.7%) were males. Eighty-four (77.1%) participants were below 40 years. Twenty-three participants (21.1%) were overweight and 37 (33.9%) were obese. There was no significant drop in saturation and rise in heart rate during these hours.

Conclusions:

On comparing subjective sensations of HCWs, our study found that feeling of uneasiness was found more in less than 40 years age group as compared to more than 40 years. N95 masks were found to have no impact on cardiovascular system and do not lead to hypoxia while working routinely even for prolonged hours.
Anatomical relationship between the internal jugular vein and the vertebral artery: An observational study in pre-school children using ultrasound imaging
Authors: Ganesh Anand , Paarel Joseph P. , Punnen Geethu E. , Siddarth Ragul , Prakash Kunder S. , Sahajanandan Raj
Published: December 2022

Background and Aims:

Central venous cannulation is performed in children requiring vasopressor use, long-term antibiotics, chemotherapy or parenteral nutrition. The internal jugular vein is the preferred site for cannulation. Though, there are several studies describing the relation of the common carotid artery (CCA) and internal jugular vein (IJV) in the neck, there is a paucity of data regarding the anatomical relationship between the vertebral artery (VA) and the IJV. This study aims to describe the anatomical relationship between the IJV and the VA using ultrasound imaging in pre-school children in India.

Material and Methods:

Prospective observational cross-sectional study of 67 randomly selected children (age <5 years) who underwent an ultrasound examination of the right side of the neck, in a position mimicking central venous cannulation, to identify the relationship between the IJV and VA. The skin to the vertebral artery depth (D), width of the VA (W), distance between the IJV and the VA (DIV) was measured. Based on these, children were classified into high risk, moderate risk and low risk category for VA puncture.

Results:

Of the 67 children, 15 (22.4%) patients belonged to the high-risk group, 25 (37.3%) belonged to the moderate-risk group and 27 (40.23%) belonged to the low-risk group.

Conclusion:

In addition to localizing the carotid artery, pre-procedural scanning or real-time ultrasound examination to establish the anatomical relation of the IJV to the VA is imperative to alert the clinician of the possible risk of VA puncture.
Artificial intelligence in oral radiology
Authors: Silva Filho William J. , Santana Lima Bruno Natan , De Souza Laura Luiza Trindade , Silva Thaísa Pinheiro , Takeshita Wilton Mitsunari
Published: December 2022

To develop and present a checklist proposed to assist in planning, conducting, and reporting artificial intelligence (AI) studies in dentomaxillofacial radiology (CAIDMR - Checklist for AI in Dentomaxillofacial Radiology). To prepare the CAIDMR, a review was performed with searches in the PubMed, Embase, Scopus, and Web of Science databases with the descriptors of “Artificial Intelligence,” “Deep learning,” “Machine learning,” “Checklist,” “Dental,” and “Radiology,” using the PICOT strategy. In addition, pre-existing guidance documents and the AI management and ethical principles manual provided by the WHO were evaluated. After searching, 81 manuscripts were recruited: 27 from PubMed, 34 from Embase, 10 from Scopus, and 10 from Web of Science. Duplicate articles were removed. The studies were selected by reading the titles and abstracts and finally, the full article, resulting in six manuscripts for the full reading. The checklist was developed with the topic of planning and conducting research and 27 structured items for verification divided into the title, abstract, introduction, method, result, discussion, and other information. The CAIDMR is a guideline with a checklist for reports and studies on the application of AI in oral radiology.