bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Anxiety, Depression, Kinesiophobia, and Impaired Shoulder Function in Patients following Coronary Artery Bypass Grafting: An Observational Study
Authors: Ratnoo Bhumika , Mulla Ayesha , Oza Falak , Vyas Miral
Published: December 2023

Background:

Coronary artery bypass grafting (CABG) is an effective coronary revascularization technique. Anxiety and depression are associated with risks of re-hospitalization, heart failure, stroke, myocardial infarction, and death after CABG. Kinesiophobia and impaired shoulder function are associated with impaired physical performance and self-reported disability. Hence, early identification is essential for initiating supportive or preventive measures. This study aimed to find out the prevalence of anxiety, depression, kinesiophobia, and impaired shoulder function in patients following CABG.

Materials and Methods:

A cross-sectional study was carried out on 300 patients who underwent CABG in a tertiary cardiac care hospital. After obtaining informed consent, this study assessed the following patient-reported outcome measures – demographic information, Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder-7 scale for anxiety, Tampa Scale for Kinesiophobia-17, and Shoulder Pain and Disability Index for shoulder impairments.

Results:

Analysis was done using SPSS software (version 20.0). The prevalence of anxiety in this study was minimum (33%), mild (32%), moderate (34%), and severe (2%) out of total population. Prevalence of depression was minimum (15.33%), mild (35%), moderate (39.33%), and moderately severe (10%) out of total population. Prevalence of kinesiophobia was mild (15%), moderate (84%), and severe (1%) out of total population. Shoulder impairments were up to 20% in 55% of the population, 40% in 30%, and 0% in 16% of the total population.

Conclusions:

From the entire population, 34% had moderate anxiety, 40% had moderate depression, 84% had moderate kinesiophobia, and 30% had shoulder impairments. This prevalence study helps identify these risk factors and could guide the secondary complications after CABG.
Influence of Zirconia/Glass Veneer Thickness and Implant Abutment Material on the Final Shade of Implant Restorations
Authors: Kumari Nishu , Shukla Anuj K. , Malviya Rohit , Raj Aman , Sutaria Bhagyashree , Kumari Lalima , Makkad Ramanpal S.
Published: December 2023

ABSTRACT

Background:

Achieving an optimal shade match for these restorations is crucial for aesthetic outcomes. The thickness of zirconia/glass veneer and the choice of implant abutment material play vital roles in determining the final shade of implant restorations

Materials and Methods:

This study investigated the influence of zirconia/glass veneer thickness (0.5 mm and 1.0 mm) and implant abutment material (zirconia and titanium) on the final shade of implant restorations. A total of 60 identical implant restorations were fabricated and divided into four groups based on the combinations of veneer thickness and abutment material. The shade of each restoration was assessed using a shade guide, and color differences (ΔE) were measured with a spectrophotometer. Data were analyzed using statistical tests (e.g., ANOVA).

Results:

The results indicated that the veneer thickness significantly influenced the final shade of implant restorations. Restorations with 0.5 mm veneer thickness exhibited a lower ΔE value (indicating a closer shade match) compared to those with 1.0 mm veneer thickness. Additionally, the choice of implant abutment material had a minor but statistically significant effect on shade. Zirconia abutments yielded slightly better shade-matching results compared to titanium abutments

Conclusion:

In implant restorations, the thickness of the zirconia/glass veneer plays a critical role in achieving a desirable shade match. A veneer thickness of 0.5 mm is recommended for optimal aesthetic outcomes.
Assessment of Stress Distribution with 3 Taper Design Preparation of Root Canal Using Finite Element Analysis
Authors: Rathod Tejasree , Durgabhavani G. , Tirupathi Pudu , Parveen Nusrath , Paramesh Yelloji , Dharavattu Prabhakar
Published: December 2023

ABSTRACT

Aim:

Present research was done to assess stress distribution in three different taper design preparation of root canal with the help of finite element analysis.

Materials and Methods:

Lower incisors teeth having single canals that were cleaned and shaped with the help of NeoEndo Flex Titanium (NiTi) rotary file and later three designs were created such as 4%, 6%, and 8% canal preparation taper. Cone beam computed tomography (CBCT) was done for all teeth and subjected to finite element analysis for stresses. The collected data were statistically analyzed.

Results:

Highest stress was found in the coronal followed by the middle and least in the apical part in all three designs. The highest stress value was found in enamel than dentin (MPa). The highest stress value was found with design 3 (8% taper) followed by designs 2 (6% taper) and 1 (4% taper) for enamel and dentin with either oblique or vertical stress loading.

Conclusion:

All canals preparation exhibited maximum enamel stress at the coronal load points compared to apical and middle portions. The stress increases with increase in canal tapering.
Efficacy of Aloe Vera, Amlexanox (5%), and Triamcinolone Acetonide (0.1%) in the Management of Oral Lichen Planus
Authors: Kaur Manpreet , Gulati Prerna , Verma Sugandha , Khare Parul , Garg Ruchi , Dutta Jahnobi , Rao Kumuda
Published: December 2023

ABSTRACT

Objective:

This research assessed the efficiencies of aloe vera, 0.1% triamcinolone acetonide, and 5% amlexanox in the management of OLP.

Materials and Methods:

A total of 120 participants diagnosed with oral lichen planus (OLP) were equally divided into three groups and treated with: aloe vera, (Group A), 0.1% triamcinolone acetonide (Group B), and 5% amlexanox (Group C) topical medicaments. The patients were evaluated for pain, using the visual analogue scale (VAS). They were also evaluated for ulcerative lesion type and erosive area on days 1, 7, and 15 of the study.

Results:

There was a statistically considerable decrease in the VAS pain scale score, reduction in the erosive area on buccal mucosa, and healing of ulcer from day 1st to 15th day with all three tested drugs.

Conclusion:

All drugs used in this study; aloe vera, triamcinolone acetonide, and amlexanox were effective in treating OLP patients.
Efficacy of Laser-assisted Periodontal Therapy vs. Conventional Scaling and Root Planing
Authors: Sinha Sachin , Nair Vineet , Das Indrasri , Saha Arindam , Bhowmick Debarati , Pal Moumita , Mehta Dhaval N.
Published: December 2023

ABSTRACT

Background:

This study aimed to compare the effectiveness of laser-assisted periodontal therapy (LAPT) with conventional scaling and root planing (CSRP) in the treatment of periodontal disease. The objective was to assess the outcomes of these two treatments on a sample of 30 patients in each group.

Materials and Methods:

In this study, a total of 60 patients diagnosed with periodontal disease were divided into two groups: the LAPT group and the CSRP group, with 30 patients in each group. The LAPT group received periodontal treatment using laser therapy, while the SRP group underwent traditional SRP. The patients were evaluated for periodontal parameters, including probing depth and clinical attachment level before and after the treatments.

Results:

After the treatment interventions, both the LAPT group and the CSRP group showed significant improvements in periodontal health. The mean reduction in probing depth was 2.5 mm in the LAPT group and 2.2 mm in the SRP group. In addition, the clinical attachment level increased by 2.8 mm in the LAPT group and 2.5 mm in the SRP group. Statistical analysis using the paired t-test demonstrated a P-value of less than 0.05, indicating the significance of these improvements in both groups.

Conclusion:

This study suggests that both LAP and CSRP are effective in improving periodontal health in patients with periodontal disease.
Clinical Efficacy of Topical Kenacort and Aloe Vera Gel in Minor Aphthous Stomatitis: A Comparative Study
Authors: Tariq Mehak , Jalli Vishwanath V. , Dhurubatha J. , Medhi Reeturaj , Malawat Kanchan , Gowdar Inderjit M. , Arya Sugandha
Published: December 2023

ABSTRACT

Aim:

The aim of the study is to compare the clinical efficacy of both the topical agents—aloe vera gel and Kenacort oral paste (0.1% triamcinolone acetonide) in patients with minor aphthous stomatitis.

Materials and Methods:

60 patients were recruited for the study and were randomly divided into two groups—Group A (aloe vera gel group) and Group B (Kenacort oral paste group). The baseline parameters were taken and recorded on the day of the first visit which included ulcer size, pain, and burning sensation. Evaluation of reduction in ulcer size, pain, and burning sensation were made on day 3 and day 7.

Results:

The results of the present study revealed that both the study groups showed no significant difference in the size of ulcer at day 1, day 3, and day 7 when compared using independent t-test as P > 0.05 at all study intervals. Therefore, both the agents were found to be equally effective against reducing the size of ulcer, pain, and burning sensation.

Conclusion:

The present study findings demonstrate that topical application of the aloe vera gel was able to decrease the ulcer size, intensity of pain, and burning sensation, thereby accelerating the healing without any side effects. Thus, topical aloe vera could be safe and a better alternative to topical steroid for RAS.
Assessment of Patient Satisfaction and Treatment Outcomes in Digital Smile Design vs. Conventional Smile Design: A Randomized Controlled Trial
Authors: Luniyal Chetan , Shukla Anuj K. , Priyadarshi Mayank , Ahmed Farah , Kumari Nishu , Bankoti Pinki , Makkad Ramanpal S.
Published: December 2023

ABSTRACT

Background:

The esthetics of a smile holds significant importance in an individual’s self-esteem and overall quality of life. In the realm of cosmetic dentistry, smile design has traditionally relied on conventional methods, but recent advances in technology have introduced digital smile design (DSD) as a promising alternative.

Materials and Methods:

In this randomized controlled trial, 150 adult patients seeking smile enhancement procedures were enrolled and randomly assigned to one of two groups: the DSD group or the conventional smile design group. The DSD group underwent smile design using digital technology, including intraoral scans, computer-aided design, and 3D simulations. Meanwhile, the conventional smile design group received smile design through traditional methods, involving manual impressions, stone models, and manual wax-ups. Patient satisfaction was measured using a visual analog scale (VAS) ranging from 0 to 100 immediately after the procedure, while treatment outcomes were assessed three months post-procedure by dental professionals using a standardized assessment scale.

Results:

In terms of patient satisfaction, the DSD group demonstrated a mean score of 85.4 (SD ± 6.2), while the conventional smile design group had a mean score of 79.8 (SD ± 7.1). This suggests that patients in the DSD group reported higher levels of satisfaction with their smile enhancements. Regarding treatment outcomes, 92% of patients in the DSD group exhibited excellent restoration fit, occlusion, and esthetics, whereas 78% of patients in the conventional smile design group achieved the same level of excellence. These findings collectively indicate that digital smile design (DSD) may yield superior patient satisfaction and improved treatment outcomes when compared to conventional smile design methods, particularly with regard to esthetic results and overall patient contentment.

Conclusion:

In conclusion, the results of this randomized controlled trial emphasize the potential advantages of integrating digital technology into smile design procedures.
Effectiveness of Miniscrew-Supported Molar Intrusion: A Clinical Study
Authors: Patel Sejal D. , Ghosh Anirban , Parashar Pranav , Shenavi Lina , Agarwal Satendra Kumar , Rawat Siddharth , Makkad Ramanpal Singh
Published: December 2023

ABSTRACT

Mini-screws, also known as temporary anchorage devices (TADs), offer enhanced control and versatility in orthodontic treatment by providing stable anchorage points. This clinical study aims to evaluate the effectiveness of mini-screw-supported molar intrusion in orthodontic practice. For this clinical study, a cohort of 40 orthodontic patients with various malocclusions requiring molar intrusion as part of their treatment plan was recruited. The age range of the participants spanned from 14 to 35 years, representing a diverse patient population. The intervention involved the implementation of mini-screw-supported molar intrusion on one side of the maxillary arch in each patient. To achieve this, temporary mini-screws were strategically placed, and a combination of orthodontic forces and mini-screw anchorage was employed to intrude the molars. The primary outcome measure for this study was the amount of molar intrusion achieved, which was quantified in millimeters from the initial evaluation to the final visit. Additionally, the duration of treatment required to achieve the desired molar intrusion was recorded in months. The results of this clinical study demonstrated that mini-screw-supported molar intrusion was an effective and safe orthodontic technique. On average, a significant mean molar intrusion amount of 4.8 mm (standard deviation [SD] ± 0.6) was achieved with the mini-screw-supported approach. Furthermore, the treatment duration required to attain the desired molar intrusion was relatively short, with a mean of 6.2 months (SD ± 1.1). In conclusion, this clinical study provides evidence that mini-screw-supported molar intrusion is an effective and safe approach in orthodontic practice. It offers orthodontists the advantage of enhanced control and predictability in molar intrusion procedures.
Enhancement of Oral Bioavailability of Drugs through Nanotechnology: Comprehensive Review and Meta-Analysis
Authors: Thangam C. , Cyril Rozario , Jayasree R. , Kumar Y. Santhosh , Kulanthaivel Langeswaran , Subbaraj Gowtham Kumar
Published: December 2023

In terms of drug delivery methods, oral administration stands out as the preferred option, as it ensures better patient compliance. However, the challenges of poor water solubility and limited metabolic/enzymatic stability hinder the effectiveness of oral drug delivery. Nanotechnology-based drug delivery systems offer promising solutions to overcome these barriers and enhance oral medication delivery. They provide an avenue for administering antihypertensive drugs with improved therapeutic impact and bioavailability. To compile information on enhancing oral bioavailability through nanotechnology, we conducted searches in various databases, including PubMed, Google Scholar, and ScienceDirect. We reviewed a total of 12 studies from different countries that investigated the oral bioavailability of various nanoparticles. Based on our analysis, nanotechnology-based formulations demonstrated a substantial potential for improving medication bioavailability, with a 95% confidence interval (1.08–4.30). The results of this meta-analysis indicate that a significant majority of the treatments yielded enhanced relative bioavailability.
Linezolid-associated neurologic toxicity in patients with drug-resistant tuberculosis in a bedaquiline-based regimen: A scoping review
Authors: Putra Oki Nugraha , Adiwinoto Ronald Pratama
Published: December 2023

Bedaquiline and linezolid have shown a high efficacy in treating drug-resistant tuberculosis (DR-TB). Neurologic toxicity is the primary adverse effect of linezolid, leading to dose reduction or early discontinuation. We comprehensively reviewed the incidence of neurologic toxicity, including peripheral and optic neuropathy associated with linezolid in patients with DR-TB in bedaquiline-based regimens. We conducted a scoping review under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline for a scoping review. We retrieved ten cohort studies that met the inclusion criteria. Of 3640 DR-TB patients in the included studies, 653 (17.9%) were HIV. 1154/3640 (31.7%) patients experienced neurologic toxicity, and among them, 982 (85.0%), 162 (14.0%), and 10 (1.0%) had peripheral neuropathy, optic neuritis, and both, respectively. Peripheral and optic neuropathy occurred at a median time from 18 weeks and 23 weeks, respectively, after the first initiation of linezolid. Linezolid interruption, including dose adjustment and temporary discontinuation, ranged from 13.8% to 34.9%. None of the studies reported that HIV was associated with neuropathy. However, it was significantly associated with linezolid interruption. The incidence of peripheral and optic neuropathy occurred more in DR-TB patients with trough linezolid concentration ≥2 mg/L. However, trough linezolid concentration ≥2 mg/L was not associated with peripheral and optic neuropathy. The incidence of neurologic toxicity was relatively high in DR-TB patients with a regimen containing linezolid. Peripheral neuropathy was the most prevalent neurologic toxicity during the treatment of linezolid. It considers conducting therapeutic drug monitoring of linezolid to improve patient safety.
Accordance Assessment of Structural and Environmental Elements of Iranian Medical Sciences Universities with the Corresponding Components of Third-millennium Universities: A National Study in a Developing Country
Authors: Hassanzad Maryam , Kalantari Abdolhossein , Valinejadi Ali , Velayati Ali Akbar
Published: December 2023

BACKGROUND:

Medical sciences universities should be accountable to the knowledge, attitudes, skills, and abilities of graduates; it is needed to investigate the structural and environmental components of universities in order to assess the accordance of these components with the third-millennium universities’ components.

OBJECTIVE:

In this study, we focus on accordance assessment of structural and environmental elements of Iranian medical sciences universities with the corresponding components of third-millennium universities.

MATERIALS AND METHODS:

This cross-sectional study was conducted in 2023. The population included all faculty members of universities of medical sciences in Iran in the academic year 2020–2021. The sample size was obtained using Morgan table and cluster random sampling. A reliable and valid researcher-made questionnaire was developed to collect the data based on the characteristics of higher education institutions in the third millennium (CVI > 0.79, CVR > 0.62, α =0.88). Statistical analysis was done in both descriptive and inferential methods by SPSS 25.

RESULTS:

The results showed that the highest mean score of population’s attitude toward structural components was attributed to faculty members (mean = 3.53), and the lowest mean score belonged to the curriculum (mean = 3.45). Besides, the results demonstrated that the highest mean score of attitudes toward environmental components was related to the university’s accountability (mean = 3.52). The findings also showed that there was a significant difference between the scores of faculty members’ attitudes (P< 0.01).

CONCLUSION:

The results conveyed that the structural and environmental status of universities is not in line with developed universities. Of course, we should not be cynical about the challenges of these universities, but we should detect them and adopt logical and realistic strategies to deal with them. If these challenges are considered opportunities, they will surely motivate and promote the higher education system.
Mycobacteria’s Antibodies Search: Serology, an Important Neglected Means to Establish a Diagnosis and a Prognosis
Authors: Maes Roland
Published: December 2023

The WHO has banned the use of blood tests for the diagnostic and prognostic of tuberculosis. This is a monumental error that it never corrected. The current ban deprives the mycobacterial community of a tool that is essential to combat the disease. Serology estimates the humoral immune status of a patient or a population. It is not a substitute to antigen detection, but it is comparable to the tuberculin test which estimates the cellular immune status. Both give an evocative expression of the tubercle bacillus immunosuppressive activity and indicate the mobilization level of the infected patients’ immune defense. In opposition to the tuberculin reaction which makes the cutaneous test devoid of interest after a positive turn, the serology fluctuates according to the antigenic load.
The Promise of Technology: Overcoming Challenges in Rural and Remote Health Care in India
Authors: Padhan Srikanta
Published: December 2023

Access to quality health care in rural and remote areas of India is a significant challenge due to the need for health-care infrastructure, medical personnel, and funding. However, technology-based health-care solutions such as telemedicine, mobile health technologies, artificial intelligence, and electronic health records can improve health-care outcomes by increasing access, reducing costs, and enhancing delivery efficiency. Implementing technology in these areas faces several obstacles, such as lack of infrastructure, cost, digital literacy, cultural and linguistic barriers, and political and regulatory factors. Collaborative approaches involving government, private sector, and civil society organizations can help overcome these challenges. Successful examples of technology-based health-care solutions in rural and remote areas of India include eSanjeevani and eVIN. Ultimately, technology can play a critical role in delivering quality health-care services to those who need it most in rural and remote areas of India.
Ukraine Health System during the 2022 War Crisis: The Battling Concern of the Hour
Authors: Boppana Sri Harsha , Kunden Vikram Das , Mamidi Shanteja , Kutikuppala L. V. Simhachalam , Kalyani Ponnaganti Sai Venakata
Published: December 2023

While Ukraine and Russia have similar historical beginnings, the country's west has far deeper relations with its European neighbors, notably Poland, and nationalist fervor is greatest there. In the metropolis and the industrialized east, a considerable minority of the population speaks Russian as their native tongue. Among postcommunist European states, Ukraine's system is without a doubt one of the worst. Throughout the postcommunist transition era, it was characterized by organizational and budgetary inefficiencies, inadequacy to the population's health demands, and a lack of broader reform attempts. Ukraine's citizens have been subjected to a series of cruel regimes. Stalin's deliberate campaign of starvation murdered three and a half million Ukrainians during the Holodomor, or Great Famine, of 1932–33. Hitler invaded Ukraine in June 1941, and during the German occupation, three and a half million Ukrainians were slaughtered. There can be no true prospect for human health or thriving without peace. For today's Ukrainians, the invasion is more than a tragedy. It will also have a significant impact on future generations' well-being.
The Efficacy of Body Acupuncture Combined with Ear Acupressure versus Frequent Counseling as Adjuvant Therapy for Quitting Smoking – An Intervention Pilot Study
Authors: Mohammed Asmaa Mahmoud , Allam Mona Samir , Rashad Hend , Hashish Adel F.
Published: December 2023

Background and Objectives:

Quitting smoking is a primary preventive measure for many chronic and fatal diseases including various types of cancers, cardiovascular and respiratory diseases. Unfortunately, the available pharmacological therapies may have potential side effects and may be unsuitable for all smokers. The present study aimed to evaluate the efficacy of using Chinese acupuncture as a nonconventional aid for smoking cessation.

Subjects and Methods:

The smokers have been randomized into one of two groups, the acupuncture group (n = 20) or the interpersonal canceling group (n = 26) as control. All smokers were interviewed to fill pretested, well-structured questionnaire form to assess their smoking and nicotine-dependent status. In the acupuncture group, the body acupuncture needles were retained for 30 min and then removed while the ear press needles were inserted to be maintained in place for a few days. The treatment in the two groups continued once weekly for successive 12 weeks.

Results:

The smokers in the acupuncture group showed significantly higher continuous abstinence rate, incomplete abstinence rate, and lower failure rates, at 4 weeks, 8 weeks, and 12 weeks (P = 0.04, 0.003, and 0.02 respectively) than the counseling group. In the 24th week, no significant differences were detected in the treatment outcome between the two treatment groups (P > 0.05). In addition, fewer occurrences of nicotine withdrawal symptoms have been detected including craving for smoking.

Conclusion:

According to the results of this pilot study, the use of acupuncture therapy in the form of body acupuncture combined with ear acupressure was a successful aid for smoking cessation superior to counseling alone. Based on the literature review, this is the first Egyptian study addressing this research point. A large-scale multicenter study is intended to work in the future.
Effectiveness of Training on Basic Life Support for Nurses: A Quasi-Experimental Study
Authors: Kalyani C. Vasantha , Belsiyal Xavier , Naithani Manisha , Varghese Arun , Kathrotia Rajesh , Aggarwal Pradeep , Rohilla Kusum K. , Rao Shalinee
Published: December 2023

Background:

Basic life support (BLS) training is important for health professionals. Nurses are key persons in health system. In each hospital, there must be facilities of proper training for nurses to update their knowledge, skills, and training regarding BLS. The main aim of the present study was to assess the effectiveness of BLS training for nurses in terms of their knowledge and practical skills.

Materials and Methods:

The quasi-experimental design was used for this study with pretest–posttest design with one group only. The present study was conducted in a tertiary care institution, North India. Study participants consist of 440 registered nurses selected by convenience sample technique. Training for BLS consists of theoretical and practical sessions. Nurses’ knowledge and practices skill were checked before and after BLS training. Data were collected by using 25 multiple-choice questions of knowledge and a 3-point 15-step practice skill checklist and their pre- and postknowledge and practical skill scores were compared.

Results:

Knowledge and practical skill scores of BLS training after training were higher than pretraining scores (t = 85.96, P = 0.00*; t = 86.40, P = 0.00*). Association was found among nurses who did cardiopulmonary resuscitation had higher knowledge (0.72 times) and more skills (0.5 times).

Conclusion:

The study concludes that nurses’ knowledge and skill were improved by BLS training program. Regular training of BLS is important to gain competency, efficacy, and up-to-date information in this area.
Ethics in Publication
Authors: Rohilla Kusum K. , Gupta Pratima , Kalyani C. Vasantha , Fernandes Sharal , Varikasuvu Seshadri Reddy , Varshney Saurabh
Published: December 2023

Academic research requires careful planning of study, execution, collection of data, data analysis, and publications. Although by following all steps and then receiving publication are always wonderful, the main aim of this research paper was to know about publication’s ethics. Researcher did extensive review of literature on searching of search engines such as PubMed, Google Scholar, and Embase using various search studies from December 2022 to January 2023. Review of literature identified that before beginning of any study, the Clinical Trial Registry of India approval, Institutional Ethics Committee approval, and informed consent from study participants are always required. Research fraud such as data fabrication or data falsification should be taken care while doing any research. Before publication, always verify plagiarism and give researcher’s credit according to their contributions. Simultaneous submission of the same manuscript in various journals at a time must be avoided. Most of journals are following the International Committee of Medical Journal Editors recommendations and that is must requirement for considering authorship for any paper. Conflicts of interest must be declared in each research paper. You can use the checklist for publication’s ethics as a guide; if the score is ≥7, the publication is violating publication’s ethics. Authors or researchers should be clear, must know publication behavior, do honest research, and pursue publication ethics.
A Retrospective Study of Breast Reconstruction in Northern Ontario
Authors: Anthes Christina , Tremblay Cory , Azad Sanjay
Published: December 2023

Background:

Breast reconstruction is often the final step for women diagnosed with breast cancer. For many in Northern Ontario, lack of access to a plastic surgeon is a significant barrier to breast reconstruction surgery. The aim of this study is to characterize the types of breast reconstruction surgeries performed in Northern Ontario by describing patient demographics and identifying the most commonly performed procedures.

Materials and Methods:

This is a retrospective review of patient electronic medical records who received reconstructive breast surgery in Thunder Bay between January 2013 and August 2019. Outcome measures included place of residence, clinicopathologic characteristics, complications, timing of reconstruction, type of procedure, and adjunctive procedures.

Results:

A total of 95 breast reconstruction procedures were performed, 37 patients underwent immediate reconstruction postmastectomy and 58 patients had reconstruction delayed. The average distance traveled by patients was 253.39 km. Of these patients, 36 had tissue expander with implants, 11 each received 1-step implants and autologous flaps with implants, 4 underwent a resection-reduction approach, 13 received a delayed balancing procedure, 9 received fat grafting, 3 received nipple reconstruction, and 8 were referred elsewhere. Some postsurgical complications included infections, seromas, hematomas, tissue expander exposures, T-junction wound breakdown, flap necrosis, implant failure, and blocked drains.

Conclusion:

Providing information to physicians and patients about patient trends within their population can not only help improve referral rates but also can enhance patient-provider communication and increase patient involvement in care.
Respectful Maternal Care Initiative: Experiences at a Tertiary Care Center in Haryana
Authors: Dahiya Priyanka , Beniwal Atul , Kaur Harpreet , Kansal Richa
Published: December 2023

Objective:

Respectful Maternity Care (RMC) is a part of the prescribed standard of health care norms globally today. The RMC has been defined under seven broad domains, which are useful in identifying and quantifying maternal disrespect and abuse and dealing with solutions. Evidence on the nature and frequency of maternal disrespect and abuse is essential for effective policy and advocacy. The present study is directed to assess the current status of RMC.

Materials and Methods:

It was a hospital-based cross-sectional study carried out in a tertiary care center over a period of 3 months. A total of 220 women who delivered at our institute during the data collection period and met inclusion criteria were enrolled for the study. Data were collected using a predesigned and pretested questionnaire based on seven major categories per the respectful maternity care (RMC) charter and included sociodemographic details of respondents.

Results:

Of all, nearly half of them experienced at least one or theother form of disrespect during their labor, childbirth, or postnatal period at the hospital. The lowest mean scoring was seen in domains of confidential care (3.32), dignified care (3.07), and abuse related to cost of detention (3.38).

Conclusion:

Although mothers are noticing and reporting positive changes in maternity care practices, respectful maternity care still has miles to go. Effective and sustainable measures need to be implemented within the context of the Indian health system to stop the disrespect and abuse surrounding childbirth!
Neglected Biliary Stent with Hepatico-lithiasis Causing Left Lobe Pyogenic Liver Abscess with Rupture into Left Pleural Cavity: A rare Life-threatening Emergency
Authors: Karnik Amit , Pal Ajay Kumar , Pahwa Harvinder Singh , Kumar Awanish , Singh Abhishek
Published: December 2023

Biliary tract disease is currently the leading cause of pyogenic liver abscess (PLA) and complications of rupture are associated with high mortality and morbidity even with current medical knowledge advancement. We report a 35-year-old female who presented in emergency setting with complaints of jaundice, abdominal pain, fever, and respiratory distress. Patient had prior history of endoscopic management of biliary stones about 6 years back followed by asymptomatic period. Patient was managed by percutaneous drainage of left lobe liver abscess and left pleural empyema after initial resuscitation with further investigations revealing biliary stent with left hepatic abscess with transdiaphragmatic extension into left hemithorax. Neglected biliary stent has been reported to cause severe cholangitis with PLAs and these patients require immediate timely attention to the management of abscess and its complications.
Nutritional Status of Women of Reproductive Age in a Rural Area of Southwestern Bihar during COVID-19 Pandemic: A Cross-sectional Study
Authors: Kumar Abhishek , Lohani Pallavi , Ayub Arshad , Shikha Swati
Published: December 2023

Introduction:

Health and well-being of any population are reflected by its nutritional status, which is mainly determined by two important factors, namely dietary intake and the food habits. About 22.9% of women in reproductive age (15–49 years) in India and about 30.4% of women in Bihar are undernourished, with a body mass index (BMI) of <18.5 kg/m2.

Aims and Objectives:

The aims and objectives of the study were to assess the nutritional status and to find out the association between sociodemographic variables and nutritional status of women in the reproductive age group in a rural area of southwestern Bihar.

Methodology:

A cross-sectional study was conducted among 311 women of the reproductive age group residing in rural field practice area of NMCH, Sasaram, who gave informed consent to participate in the study.

Results:

After analysis, it was found that 74% of the women consumed a mixed Indian diet, 24% of women took their first meal in the afternoon and in 64% of women, diet diversity was not maintained, about 74% of the women are within the normal range of BMI. Diet diversity was maintained in the literate group with educational status above the primary level and the association between diet diversity and educational status was statistically significant (P < 0.05).

Conclusion:

It was concluded from the study that women of reproductive age in this part of Bihar also suffer from a dual burden of malnutrition, with the majority being undernourished, whereas a few also being suffering from a higher waist–hip ratio.
Laparoscopic Totally Extraperitoneal Repair Using Self-gripping Polyester Mesh (ProGrip™) in Inguinal Hernia: A Retrospective Study in a Tertiary Care Hospital
Authors: Thakur Mukund Narayan , Choudhary Abhay Vijay , Deshmukh Abhijit Babanrao
Published: December 2023

Introduction:

Surgical management of inguinal hernia (IH) is advanced with laparoscopy surgery, and total laparoscopic totally extraperitoneal (TEP) repair is gaining popularity. The use of self-gripping mesh (ProGrip™) further provided substantial advancements with improved postoperative outcomes and early recovery.

Objectives:

The objective of our study was to determine the short-term outcomes, complications, postoperative hernia recurrence, and chronic inguinal pain in laparoscopic IH. Furthermore, we assessed the factors associated with longer operative time.

Subjects and Methods:

We retrospectively analyzed the data of adult IH patients who had undergone TEP repair with ProGrip™ mesh. Data on demographics, hernia characteristics, operating time, surgical details, and postoperative outcomes such as infection, hernia recurrences, chronic pain, and other complications were collected and analyzed. P <0.05 was considered statistically significant.

Results:

During January 2020 to January 2022, we collected the data of 208 patients and analyzed them. The mean age of the patients was 59.7 ± 13.1 years and 96.2% were males. Hernia was bilateral in 26% of cases and 78.8% were indirect hernias. The mean duration of surgery was 60.4 ± 8.6 min. Hernia size ≥2.5 cm was associated with significantly longer operative time. After a median follow-up of approximately 1 year, there were no postoperative complications, recurrence of hernia, or chronic inguinal pain.

Conclusion:

In experienced hands, laparoscopic TEP repair of IH using ProGrip™ mesh is effective and safe without significant complications or recurrences.
Unmasking the Silent Threat: Colorectal Cancer’s Alarming Surge in India’s Young Adults
Authors: Mahajan Divya
Published: December 2023

Colorectal cancer (CRC) incidence is rising in young population in India due to increasing influence of Western food habits and increase in sedentary lifestyles. Due to unhealthy eating habits and sedentary lifestyle, obesity is another problem faced by the youth of our country. Physical inactivity, overweight and obesity, red and processed meat consumption, and smoking and excessive alcohol consumption are the factors which have been responsible for the complex etiology and pathogenesis of CRC. These factors individually or synergistically may help in the rapid progression and multistep development of this disease. This review article is aimed to raise the concern of the harmful effect of Western culture on our health and create awareness to adopt a healthy lifestyle and maintain ideal weight. Efforts should be made to increase screening and raise awareness about eating and drinking habits along with lifestyle modification to decrease the rate of CRC.
Assessment of Cervical Cancer Prevention Strategy among Adolescent Girls: Cross-Sectional Study from North Gujarat, Western India
Authors: Landge Jyoti A. , Rawal Diya , Lunagariya Ruchita , Gaikwad Mrinalini
Published: December 2023

Background:

Cervical cancer is one of the preventable and curable cancer. India has a high burden of cervical cancer than other South Asian countries. National Cancer Control Program has been implemented for long time still there is not much awareness about prevention and control strategies of cervical cancer in reproductive women as well as adolescent girls.

Objectives:

The present study was conducted to determine level of knowledge and awareness about screening and vaccination program for cervical cancer among late adolescent girls in a university campus.

Methodology:

A cross-sectional study was carried out in the Parent University of Medical College (Sakalchand Patel University), in 6-month duration. For study purpose, we had chosen a study population of late adolescent girls studying in various streams inside university campus. A total of 105 girls were enrolled as study participants after taking written consent from the head of the institute and girls’ student.

Results:

All study participants were in the age group of 19–23 years learning in different streams of the university campus, residing in urban area, and upper-middle-class family. Very few were aware about cervical cancer screening test and 16.2% were aware about the correct age for screening. Only one-fourth of girls were aware about the availability of vaccine for cervical cancer and out of them 18.5% could tell correct name of vaccine, 37% correctly answered the age for vaccination.

Conclusion:

In our study, participants were late adolescents and young girls attending higher education (Graduate) in a university campus still the awareness of cervical cancer screening and vaccination was low.
Assessment of Travelers’ Knowledge about Symptoms and Prevention Strategies of Otic Barotrauma in Saudi Arabia: A Cross-sectional Study
Authors: Almufarrej Abdulrhman A. , Almutairi Khalid A. , Alzamel Omar M. , Alsubaie Nasser S. , Alghamdi Mohanad S. , Hajr Eman A. , Alotaibi Fahad Z.
Published: December 2023

Background:

Otic barotrauma (OBT) is the most common medical complication related to aviation, which is caused by traumatic inflammation of the middle ear produced by a pressure differential between the air in the middle ear and surrounding environment.

Objective:

We aim to assess the incidence of OBT, travelers’ knowledge about symptoms, and prevention strategies of OBT in Saudi Arabia.

Design:

This cross-sectional study was conducted at King Khalid International Airport in Riyadh, Saudi Arabia, between August 2022 and December 2022.

Participants and Methods:

Data were collected from the adult travelers using Google Forms questionnaire in either Arabic or English, distributed to travelers at the arrival or departure departments of the airport using a quick response code. Data are presented as frequencies and percentages for categorical variables. Statistical significance was set at P < 0.05.

Main Outcome Measures:

To measure the prevalence of OBT and travelers’ knowledge of OBT in Saudi Arabia.

Sample Size:

The sample size was 403.

Results:

Of the 403 respondents, 381 met the study criteria, and 91.9% (n = 114) had noticed positive symptoms. Individuals who traveled more than seven times reported lower positive signs than others. The logistic regression analysis of positive symptoms and potential risk factors showed that female participants had more positive symptoms than male participants (odds ratio = 4.269, P < 0.001).

Conclusions:

The number of people complaining of symptoms is significant. Therefore, a strong need exists to educate the public regarding OBT.

Limitations:

This study was limited by the small sample size; the cross-sectional study was conducted in only one airport, despite a good response rate.
Self-Esteem Post-Rhinoplasty: A Detailed Analysis of Influencing Factors
Authors: Obeid Faisal M. , Al Qurashi Abdullah A. , Mortada Hatan , Abualnaja Amani Abdulrahman , Alqahtani Reemah Farhan , Alqam Rakan Abu , AlHadlaq Abdulmajeed Saad , Almodumeegh Abdulaziz Saleh , Arkoubi Amr
Published: December 2023

Background:

Esthetic procedures such as rhinoplasty can have profound effects on individuals’ self-esteem. However, the relationship between sociodemographic factors, self-perception, and self-esteem postrhinoplasty remains underexplored.

Methodology:

We conducted a comparative study between individuals who have undergone rhinoplasty (rhinoplasty group) and those who have not (nonrhinoplasty group). Variables such as education level, employment status, household income, and family circumstances were studied. The Rosenberg Self-Esteem Scale (RSE) was used to evaluate self-esteem.

Results:

The rhinoplasty group was more likely to be employed and represented in the lower household income range. Those with a Master’s degree within the rhinoplasty group showed higher self-esteem scores. The rhinoplasty group demonstrated higher levels of body dissatisfaction yet also reported more positive attitudes toward themselves. Gender differences in RSE scores were noted, with females showing higher median scores. Age did not significantly influence RSE scores across the groups.

Conclusion:

The results suggest a multifaceted relationship between rhinoplasty and self-esteem, influenced by a variety of sociodemographic factors. Our findings highlight the need for a comprehensive approach in the pre- and post-operative management of patients considering rhinoplasty, considering not only the physical but also the psychological aspects. Further research is needed to elucidate the complex interplay between self-esteem, self-perception, and sociodemographic factors in individuals undergoing rhinoplasty.
Diplopia in Silent Sinus Syndrome – From Diagnosis to Minimal Surgical Intervention
Authors: Ali Hayat Yahia Omar , Alfadhli Alanood Omar , Ali Ahmed Al , Omar Hilal , Elbadawey Mohamed , Elbadawey Morouge
Published: December 2023

Silent sinus syndrome (SSS) is a rare disease mostly affecting the maxillary sinus. It is described as a slowly progressive painless enophthalmos with hypoglobus secondary to atelectasis of the maxillary sinus in patients with an unremarkable history of preexisting sinonasal or ophthalmological pathologies. Diplopia is an unusual presentation of SSS and opting for orbital floor correction is a matter of debate. Limited reports in the literature show the efficacy of endoscopic maxillary antrostomy alone without orbital floor reconstruction in patients with diplopia. This study reports a case of an unusual presentation of SSS. The paper also reviews the diagnostic approach and focuses on the treatment by minimally invasive endoscopic antrostomy for aeration of the maxillary sinus without the need of orbital floor reconstruction for correction of diplopia and enophthalmos. This paper discusses a 41-year-old previously healthy male presenting with gradually progressive hypoglobus and enophthalmos associated with diplopia and mild facial asymmetry. There was no past medical history of sinonasal or ophthalmological diseases, surgeries, or trauma. The differential diagnoses initially were variable. Endoscopic evaluation in the outpatient clinic along with computed tomography and magnetic resonance imaging of the paranasal sinuses and orbit confirmed the diagnosis of SSS. Relieving the negative maxillary pressure with endoscopic wide middle meatal maxillary antrostomy without orbital floor reconstruction restored the normal extraocular muscle movement and improved the diplopia, hypoglobus, and enophthalmos. Our case report demonstrates the association between SSS and diplopia, and it reviews the diagnostic approach to the disease including comprehensive clinical assessment, endoscopic evaluation, and radiological studies. The case report also signifies the effectiveness of endoscopic maxillary antrostomy without orbital floor reconstruction in re-establishing the ventilation of the atelectatic maxillary sinus and allowing spontaneous resolution of diplopia, enophthalmos, and hypoglobus.