bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization and Performance of CA/Chitosan Membrane from Golden Snail Shell in the Application of Humic Acid Purification
Authors: Mulyati Sri , Luthfiana Anisa , Ambarita Aulia Chintia , Nanda Chyva Rizka , Rosnelly Cut Meurah
Published: December 2024

The removal of humic acid from water is accomplished by a process known asultrafiltration membrane. This study investigates the simple method of preparing cellulose acetate (CA)-based ultrafiltration membranes by introducing chitosan into the dope solution. The result shows the positive effect of incorporating chitosan (1-3 wt%) as a membrane additive on their characteristics and performance. The membranes exhibit improved properties including increased bulk porosity and hydrophilicity. The pure water flux is significantly improved, reaching 100 L/m2.h with 3 wt% chitosan compared to 47 L/m2.h for the pure CA membrane. In particular, the 1% chitosan modification shows optimal performance, achieving high flux (82 L/m2.h) and humic acid rejection (80%). Furthermore, the modified CA membrane shows stability in both acidic and alkaline solutions over a 24 h exposure. These results suggest promising prospects for the application of chitosan-modified CA membranes in efficient water purification processes.
Advances on Tungsten Trioxide Based Additive Materials: Strategies to Fabricate Photocatalytic Membranes for Wastewater Treatment
Authors: Mizar Khalid , Mulyati Sri , Aprilia Sri , Arahman Nasrul
Published: December 2024

Due to their ability to combine the physical separation of membrane filtration with organic degradation in one unit, photocatalytic membranes have demonstrated enormous potential for application in energy-efficient water purification and wastewater treatment. Titanium dioxide (TiO2) is the substance most frequently utilized to create photocatalytic membranes. However, TiO2's use is constrained by its substantial band gap (3.2 eV). On the other hand, tungsten trioxide (WO3) has a fairly small band gap (2.7-2.8 eV) which makes it able to absorb visible light, making the photocatalytic process more efficient. This article examines recent developments in WO3 photocatalytic membranes for wastewater treatment and water purification with a focus on the photocatalytic mechanism, photocatalytic membrane fabrication and development. The mechanism of WO3 semiconductor in pollutant removal is explained in detail. Blending, coating and grafting methods, which are three methods commonly used when fabricating photocatalytic membranes, are discussed. Likewise with the development of WO3 photocatalytic membranes using pure WO3, heterojunction or doping with metal.
Techno-Economic Analysis between Traditional and Fused-Deposition Modeling-Based Additive Manufacturing
Authors: Nivasanon Chanipa , Anussornnitisarn Pornthep , Ransikarbum Kasin
Published: December 2024

In this study, we conduct a techno-economic comparative analysis between traditional manufacturing and 3D printing technology (i.e., additive manufacturing (AM)) for fused deposition modeling (FDM) --based finger casts. Manufacturing costs are initially collected for machine cost, material cost, and labor cost, in which the Monte Carlo method is also implemented to simulate the number of pieces manufactured in each manufacturing cycle. Traditional manufacturing based on injection technology is found to have high manufacturing costs due to the mold requirement, in which the economies of scale are applied with the increase in manufacturing quantity. In addition, manufacturing costs with AM technology are analyzed using the Cura platform to assess the designed experiment from the FDM-based AM printer to fabricate single and multiple healthcare workpieces per time, respectively. In particular, the breakeven point analysis is investigated, where manufacturing one and five workpieces with AM technology is comparable to producing 1,854 and 6,048 pieces using traditional, injection manufacturing technology in our exemplified case study. The results from the techno-economic evaluation in this study are expected to be further used as a guideline for studies relevant to operational and tactical planning for AM-related applications.
Impact of Surface Treatment and Curing Conditions on the Mechanical Properties of OPS Lightweight Concrete
Authors: Ahmad Zamri Nurhasyimah , Ismail Sallehan , Husin Azamuddin , Abd Rashid Mohd Najib
Published: December 2024

This study investigated the use of Styrene Acrylic Emulsion (SAE) as a surface treatment for Oil Palm Shell (OPS) aggregates to enhance the mechanical properties of lightweight concrete. SAE, known for its superior adhesion, was applied to OPS to create a protective layer, addressing a gap in current research on OPS concrete. The research examined the impact of SAE-treated OPS under various curing conditions, assessing the compressive, flexural, and splitting tensile strengths. Results demonstrated that continuous water curing (NW) was the most effective for improving the compressive strength of treated specimens, particularly those with moderate SAE treatment (5%, 10%, and 15%). Specimens with 25% SAE treatment (ST25) exhibited reduced strength due to clumping and increased porosity. Flexural and splitting tensile strengths also improved with SAE treatment, with ST5 showing the highest flexural strength and ST10 performing best in splitting tensile strength tests. Alternating curing (AC) conditions showed moderate success, while external curing (EC) conditions negatively impacted strength due to rapid thermal cycling. Overall, the SAE treatment significantly enhanced the bond between the OPS particles and cement matrix, improving the mechanical performance of OPS lightweight concrete. These findings suggest that SAE-treated OPS could provide a sustainable and effective solution for concrete production.
Influence of Alumina Bubble as Pore Former on the Vitrified Bond Diamond Grinding Wheels
Authors: Wang Chao Chao , Tan Qing Neng , Huang Yi Jie , Zeng Jie Qiong
Published: December 2024

In this study, a vitrified bond diamond wheel was prepared with alumina bubbles as a pore former. The effect of the size and content of the alumina bubble on the flexural strength, porosity, and hardness of the prepared wheels has been studied. The results showed that the porosity of the grinding wheel samples increased with the rise of the content of the alumina bubble. The porosity of the grinding wheel with finer alumina bubbles is higher than that of the coarser one. The hardness and flexural of the samples with finer alumina bubbles are lower than those with the coarser ones. The research result shows that the content and the size of the alumina bubble have a great influence on the flexural strength and hardness of grinding wheel samples.
Quantification and risk assessment of antibiotic residues among milk and fermented milk products vended around Zaria and Sabon-gari Local Government Areas, Kaduna State, Nigeria.
Authors: Fathuddin Muhammad Muhsin , Ado Saleh Alhaji , Tijjani Muhammad Bashir , Kazeem Haruna Makonjuola , Fathuddin Rafeedah , Obidah John Solomon
Published: December 2024

This study detected and determined the hazard quotient of residue levels associated with ampicillin, ciprofloxacin, gentamicin, and tetracycline in milk and milk products vended in Zaria and Sabon-gari Local Government Areas. Overall, 400 milk and fermented milk products were gathered randomly. After screening via a microbial inhibition assay, sixty-five (65) samples showed the presence of antagonistic agents. The residues of ampicillin, ciprofloxacin, gentamicin, and tetracycline were quantified using high-performance liquid chromatography and were detected in 29 (44.62%), 21 (32.31%), 21 (32.31%), and 34 (52.31%) samples respectively. The residual levels in all the positive samples for ampicillin and ciprofloxacin exceeded the Codex Alimentarius Commission's recommended limits. In contrast, residue levels exceeded the Codex limits in 15 (71.43%) gentamicin samples and 32 (94.12%) tetracycline samples. The mean residue levels of ampicillin, ciprofloxacin, gentamicin, and tetracycline were 429.70±297.12, 374.28±262.74, 411.52±226.73, and 407.60±262.69 µg/L, respectively. In Nigeria, the average per capita milk consumption contributed to a mean estimated daily intake (EDI) of 0.14 for adults and 0.55 for children for ampicillin, while EDI for ciprofloxacin, gentamicin, and tetracycline were at 0.13 and 0.52; 0.14 and 0.57; and 0.14 and 0.54, for adult and children respectively. The hazard quotient (HQ) calculated using the Nigerian average data was less than one (1) for adults and children. Based on the global average per capita milk consumption, the overall EDI values for tetracycline were 1.42 and 5.69, gentamicin was 1.50 and 6.01, ciprofloxacin was 1.37 and 5.47, and ampicillin was 1.44 and 5.75 for adult and children respectively. The HQ (Global Average) for all antibiotics was less than one in adults, but only ampicillin and ciprofloxacin exceeded one in children. The novelty of this study lies in the comprehensive assessment of the hazard quotient of antibiotic residues in milk and milk products sold in Zaria and Sabon-gari Local Government Areas.
Potential factors affecting organizational readiness for the industry 5.0 for the Sri Lankan apparel industry: a systematic literature review
Authors: Keenavinna Hiruni , Wickramarachchi A. P. R.
Published: December 2024

5.0 in the apparel sector represents a transformative shift towards a human-centric and sustainable production model compared to Industry 4.0, which mainly focuses on technology-driven digitization. By leveraging advanced technologies including artificial intelligence (AI), robotics, and the Internet of Things (IoT), Industry 5.0 enables hyper-customization, real-time data analysis, and seamless integration of human expertise with machine capabilities. This shift enhances product quality, optimizes resource utilization, and prioritizes ethical manufacturing practices, focusing on both worker well-being and environmental responsibility. These changes fundamentally redefine the garment production landscape, positioning the industry for long-term sustainability and competitiveness.This systematic literature review (SLR) aims to identify the key readiness potential factors influencing the Sri Lankan apparel industry's transition to Industry 5.0. Specifically, the research explores the domains affecting readiness, including technological advancements, human-machine collaboration, sustainability practices, and resilience within the supply chain. The findings reveal that the Sri Lankan apparel industry is transitioning from Industry 4.0 to Industry 5.0, focusing on human-machine collaboration, integrating AI and robotics, and enhancing sustainability efforts. The readiness potential factors in this transition are categorized into four main domains human-centric, sustainability, resilience, and technological advancements. Despite notable progress in automation and sustainable practices, gaps persist, particularly in fully realizing human-machine collaboration and achieving complete supply chain transparency. Finally, this acknowledges certain limitations and suggests areas for future research.
A modern management model for patients with acute and subacute psychiatric problems in the emergency department of Trento (Northern Italy)
Authors: Sano' Mjriam , Marchiori Michela , Di Napoli Wilma Angela Renata
Published: December 2024

In Italy, over 86% of patients with mental disorders have one emergency department visit per year, with 6–9% having two visits and approximately 2% having three visits. It is not significant to include those with four or more visits in this data set. In the context of the COVID-19 pandemic, there has been a notable increase in the utilisation of emergency services for psychiatric concerns. In our emergency department (ED), we observed a 10% increase in admissions for psychiatric problems, psychomotor agitation, behavioural disorders, and drug intoxication between 2022 and 2023. We present an organisational management model that has been found to be effective for patients with minor psychiatric problems, those who repeatedly present to the emergency department, and/or those with discontinuous referrals to the relevant mental health centre or acute episodes. One possible strategy could be to consider directing psychiatric emergencies that can be deferred to territorial crisis management from the Trento emergency department to the mental health centre.
The impact of environmental health facilities and maternal behaviors on the incidence of diarrhea among children under five
Authors: Yusmidiarti Yusmidiarti , Husodo Adi Heru , Iravati Susi , Yulianti Risda
Published: December 2024

The objectives of this study were to determine the prevalence of diarrhea among children under five and assess the relationship between its risk factors related to environmental health facilities and maternal behavior. A prospective case-control community-based study was conducted in the service area of Pasar Ikan Community Health Center, Teluk Segara Subdistrict, Bengkulu City, Indonesia. A total of 140 participants were included, comprising 70 cases and 70 controls. The study found that poor qualification of clean water resources (OR=4.026, p-value=0.000), inadequate utilization of clean water (OR=5.813, p-value=0.000), poor qualification of family latrines (OR=3.574, p-value=0.000), and inadequate utilization of family latrines (OR=3.377, p-value=0.001) were significantly associated with an increased risk of diarrhea prevalence among children under five. Furthermore, unhealthy mothers’ behaviors, including frequent feeding of children outside the home (OR=2.728, p-value=0.000) and poor personal hygiene (OR=3.377, p-value=0.001), were also significantly related to a higher prevalence of diarrhea in this age group. Therefore, both substandard environmental health facilities and unhealthy maternal behaviors were identified as significant risk factors for diarrhea prevalence in children under five. These findings emphasize the critical importance of improving environmental health facilities and promoting positive changes in mothers’ behavior to reduce the incidence of diarrhea in this vulnerable population.
Aging mechanisms and their relationship with the ontogenesis program: a narrative review
Authors: Salnikov Lev
Published: December 2024

The main challenge in understanding the mechanisms and causes of aging is that separating the consequences of aging from its causes is very difficult. This review presents our perspective on the underlying mechanisms of aging and their relationship with the process of ontogenesis. The present data show the discrimination of RNA production for the part of the genome responsible for the cellular infrastructure, which begins after fertility is reached. This discrimination is also present at the level of translation, as shown by evidence for age-related changes in the distribution between membrane-bound and free ribosomes in cells, where their number decreases with age. This review also provides an assessment of the useful information of hallmarks of aging in terms of their importance in understanding the mechanisms of aging. A direction for rejuvenation is presented, which follows from our understanding of aging mechanisms and leads to the idea of cellular autocloning, which is designed to stop aging. The principle of the proposed method is to initiate a periodic process of autocloning in the cell nucleus. In the process of such division, two daughter nuclei are formed, one of which is self-liquidated, leaving in the cell its renewed nucleus without physical division of the cell itself. This process, when started periodically, allows aging to be nullified or stopped at the “cellular age” when the process is initiated.
Common features between aging and cancer: a narrative review
Authors: Abubakar Muhammad , Hameed Yasir , Kiani Muhammad Naeem , Aftab Anam
Published: December 2024

Aging is a complex biological process characterized by a gradual deterioration in physiological activities, contributing to an elevated risk of different age-associated malignancies, including cancer. The current review paper aims to elucidate the complex association between the hallmarks of aging and the parallel development of cancer. Various cellular and molecular mechanisms underlying aging such as senescence, genomic instability, and telomere shortening play a significant role in the accumulation of genetic mutations and disruption in cellular activities. It has also discussed the immune system’s role in aging, indicating how age-linked immune dysfunction compromises the body’s capacity to recognize and eradicate pre-tumorous cells, thus promoting cancer development and advancement. This review also examines how aging affects the tumor microenvironment, where age-related alterations in stromal cells, immune cells, and extracellular matrix factors lead to conditions that promote cancer growth and proliferation. Furthermore, it discusses the concept of “accelerated aging” in cancer survivors, highlighting how the negative effects of cancer and its therapy intensify the aging process, resulting in greater physical and cognitive decline. The review also explores the prospect of new therapies that target aging-related processes to ameliorate cancer outcomes. Overall, it underscores the need for ongoing interdisciplinary research to understand the complex relationship between aging and cancer, ultimately aiming to develop more effective prevention and treatment approaches.
Determinants of Survival in Cancer Rectum: Our Experience at a Tertiary Care Center
Authors: Singh Rashmi , Kumar Anup , Verma Manika , Raina Payal
Published: December 2024

Introduction:

As per GLOBOCON 2018, colorectal cancer is the seventh leading cancer in India. Our primary aim was to look for various clinical, radiological, and pathological factors in the cancer rectum and their impact on overall survival (OS) and disease-free survival (DFS) at our tertiary care center.

Materials and Methods:

Nineteen patients’ clinical and treatment details were compiled from the physical records stored in the department. Calculation of median survival (MS), mean OS, and DFS was done using the Kaplan–Meier method, and the Log-rank test was applied.

Results:

Bleeding per rectum (84.2%), increased serum carcinoembryonic antigen (63.2%), Grade 2 adenocarcinoma (95%), ulceroinfiltrating type (57.89%), and tumor length >5 cm (73.68%), and stage III (57.89%) were most common observation. Fifteen patients underwent upfront surgery, among them 66.6% of cases had ≤12 lymph node removal. 40% (6 / 15) of patients had either proximal (n = 1), distal (n = 2), or CRM positive (n = 3) (3 / 6). The MS was 45 months, and increased mean OS, as well as DFS, was observed in patients having younger age, female sex, stage II, N0, ulcer-infiltrating tumor, tumor length <5 cm, negative margin, abdominoperineal resection, LN resected <12 but P value were nonsignificant.

Conclusions:

We observed that increased nodal burden, margin positivity, and advanced T in histopathology are associated with locoregional and distant failure.
A Case Series Analysis of Basal Cell Carcinoma (BCC): Not the Deadliest but Certainly the Most Destructive Form of Skin Cancer
Authors: Sharma Aditya , Khanna Ritika , Khanna Parul , Khanna Rahul , Khanna Seema
Published: December 2024

Introduction:

Basal cell carcinoma (BCC) is the most commonly prevalent variety of skin cancer worldwide. The primary aim of the study was to see the epidemiological, demographic profile, and different variants of BCC along with the outcomes posttreatment in such patients seen in the tertiary healthcare center at our institute, keeping in mind the rising trends in BCC.

Materials and Methods:

This is a retrospective analysis of 12 patients in whom facial region-related BCC was surgically excised. The details of each patient, including age, gender, BCC type, location, defect size (cm), type of reconstruction, esthetic outcome, and recurrence, were analyzed. Over the course of 2 years (January 2022–December 2023), a total of 12 individuals were diagnosed with BCC and received treatment. With an average age of 66 years (range: 61–70 years), there were 4 males and 8 females.

Results:

We evaluated the outcomes in the patients who underwent surgical excision for BCC involving the facial region at the surgery department of our tertiary healthcare centre. All our patients responded well to the surgical procedures, i.e., wide local excision of the tumor, and experienced no problems associated with anesthesia or any other systemic complications. Postoperatively, no hematomas or wound site infections were observed in any of the patients. Our patients were followed up for 18 months. During this period, no patient reported graft or flap loss. No patient experienced a recurrence of the tumor or similar lesions. Functionally, the margin was stable and well-aligned.

Conclusion:

The diagnosis and characterization of BCC must be based on the clinical, imaging, and histopathology features of the tumor mass in addition to the patient’s characteristics. BCC treatment seeks to achieve the best cosmetic results, especially in critical areas like the face, while minimizing side effects and increasing patient satisfaction. Future research may use the clinical and epidemiological data gathered in this study as a reference.
Varied Presentations of Basal Cell Carcinoma and Its Management with Reconstruction of Defects: An Experience from a Tertiary Healthcare Centre
Authors: Prakash Gautam , Jain Vaibhav , Sharma Aditya
Published: December 2024

Introduction:

Basal cell carcinoma (BCC) originates in the basal layer of the epidermis and spreads slowly, usually locally before metastasizing. Adequate margins of excision during surgery are curative. Reconstruction of facial abnormalities resulting from excision is crucial yet difficult.

Materials and Methods:

A literature review was conducted to determine the most prevalent guidelines guiding the best reconstruction of postexcisional defects on the face, and a retrospective review of hospital records for patients treated for BCC of the face at our institute during the previous 3 years, which ranged from September 2020 to September 2023, was carried out. The records of 28 patients with BCC over the face who underwent surgical management including reconstruction at our hospital were identified and details were recorded. The details of each patient including age, sex, BCC type, location, defect size (cm), type of reconstruction, and esthetic outcome were analyzed.

Results:

All patients responded well to the surgical procedures and experienced no problems associated with anesthesia or any other systemic complications. Postoperatively, no hematomas or wound site infections were observed in any of the patients. There were no cases of graft loss, and all flaps fully survived.

Conclusion:

After BCC is excised, reconstruction of face abnormalities in various facial esthetic units is crucial. Important factors influencing esthetic results include the surgeon’s skill level, the patient’s preference, and the location and size of the defect. Better results can be achieved with more recent reconstructive techniques, such as freestyle perforator flaps, but expertise from the operator is paramount.
Evaluation of some microRNAs dysregulation in obesity and obesity-related hypertension
Authors: Nabawy Mai , Gouda Weaam , Afify Mie , Hamimy Waleed I. , Hozayen Walaa G. , Abdelmaksoud Mohamed D.E. , Mosa Tamer , Ahmed Amr E.
Published: December 2024

Background

MicroRNAs (miRNAs) are implicated in regulating obesity, but clinical trials have yielded conflicting results.

Objective

This study aimed to investigate the relationships between circulating levels of miRNA-221 and miRNA-222 in obesity and hypertension-related obesity in humans. This may shed light on the pathogenic pathways controlling obesity and provide noninvasive molecular indicators to identify and predict the disease. The relationships between circulating levels of the above miRNAs and variables related to adiposity and lipid profiles were further investigated.

Patients and methods

Using a quantitative real-time P technique, the expression levels of circulating miRNAs were determined in serum samples from 65 obese patients (35 without and 30 with hypertension) and 45 age-matched and sex-matched normal-weight individuals.

Results and conclusion

MiRNAs (221 and 222) have been shown to be differentially expressed in the sera of obese patients compared to controls. In addition, obese hypertensive patients were shown to have higher serum levels of miRNA-222 and miRNA-221 than healthy controls. Serum miRNA-221 was correlated with BMI, cholesterol, triglycerides, and low-density lipoprotein cholesterol. Thus, circulating levels of miRNA-221 and miRNA-222 inease in obesity and obesity-associated hypertension. These miRNAs may serve as markers for obesity and obesity-induced hypertension.
Unsuspecting Plaque on the Forearm: A Diagnostic Challenge
Authors: Shetty Ramith P. , Bhat M. Ramesh , Dsouza Myfanwy Joanne , Fernandes Michelle S.
Published: December 2024

Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, locally aggressive malignant, and recurring appendageal tumor. Prolonged UV exposure, immunosuppression, and radiotherapy are a few frequently associated risk factors. MAC classically presents as an asymptomatic skin coloured plaque on the face. The key to diagnosis is a deep-sectioned biopsy. Surgical modalities are the first line of treatment.
Effect of National Accreditation Board for Hospital-Recommended Trainings on Patient Care Standards: A Comparative Study Based on the National Quality Assurance Standards Guidelines in a Tertiary Health-care Institute
Authors: Singh Vikram , Singh Arvind Kumar , Kulshrestha Manish Raj , Singh Dimpi , Khan Adeeba , Singh Mridu
Published: December 2024

Background:

The National Quality Assurance Standards (NQAS) have been developed keeping in specific requirements for public health facilities as well global best practices. Standards are primarily meant for providers to assess their quality for improvement through predefined standards and to bring up their facilities for certification.

Objectives:

To study the effect of National Accreditation Board for Hospitals (NABH)-recommended training on patient care standards based on NQAS guidelines.

Materials and Methods:

The research was conducted at a tertiary-level teaching institute and medical care center in North India. The institute has multiple blocks, few have undergone training for NABH standards, and few have not due to administrative reasons. Only the NABH-trained blocks underwent accreditation process through NABH and provided an opportunity to study whether there is a difference in patient care standards between NABH-trained staff and nontrained staff. It was a checklist-based observational study.

Results:

The evaluation covered seven key areas in intensive care unit (ICU) and wards in both NABH-trained and nontrained hospital blocks: patient rights, inputs, support services, clinical services, infection control, quality management, and outcome. The compliance percentage of ICU and wards was measured for NABH-trained and nontrained hospital blocks. NABH-trained blocks in both areas showed better compliance adhering to standards as compared to nontrained blocks for all seven key areas.

Conclusion:

The study findings indicate that NABH-recommended training showed positive impact on patient care standards as per the NQAS guidelines. The NABH-trained hospital block exhibited superior compliance with various domains including patient rights, inputs, support services, clinical services, infection control, and quality management.
Dynamics of Covid-19 Vaccine-Hesitancy among Primary Health Care Workers in an Urban City in India: An Exploratory Study
Authors: Ali S. Sana , Iyer Gowri , Mahajan Hemant , Kannuri Nanda Kishore
Published: December 2024

The health-care workers (HCWs) were one of the vulnerable populations prioritized during the COVID-19 vaccination (COVISHIELD and COVAXIN) campaign. We aimed to estimate vaccine hesitancy and explore influencing factors among 238 HCWs in 21 Urban Primary Health Centres (UPHCs) across Hyderabad during June and July 2021. We used a semi-structured questionnaire and the SAGE determinants of vaccine hesitancy to determine factors underlying vaccine hesitancy and acceptance. A thematic framework was developed to unpack the factors that shaped the perceptions about the COVID-19 vaccine. We found a 17% hesitancy rate, primarily due to concerns about “vaccine-safety.” HCWs were susceptible to misinformation, potentially shaping their views on COVID-19 vaccines. Despite regulatory approval, one in six HCWs in Hyderabad’s UPHCs delayed or refused vaccinations, citing limited “vaccine-safety” information. This underscores the urgent need to address HCW vaccine hesitancy early, given its potential impact on general vaccine acceptance.
Profile of Falls and Its Associated Factors among Adults with Visual Impairment: A Cross-sectional Study from a Tertiary Eye Hospital
Authors: Sachidanandam Ramya , Narayanan Anuradha
Published: December 2024

Background:

Falls among adults with visual impairment (VI) are underreported or underrepresented compared to elderly falls.

Objectives:

To report falls among the young, middle-aged, and elderly adults with VI.

Materials and Methods:

This cross-sectional study recruited subjects from a tertiary eye care center with VI aged ≥18 years based on clinical records. Occurrence and characteristics of falls in the past year were obtained over telephone. Falls and fear of falling were considered the primary and secondary outcomes, respectively.

Results:

Of the 888 subjects, 18% (n = 160) reported having fallen at least once, and among them, 45.6% (n = 73) had multiple falls. Overall, fallers were more among the “young” (21.1%) than the “middle-aged” (16.0%) and the “elderly” (17.3%). Risk of falling was more among the blind (odds ratio (OR): 7.1; 95% confidence interval [CI]: 2.8–18.4, P < 0.001) than other categories of VI. Retinitis pigmentosa (RP) (OR: 4.4; 95% CI: 1.5–12.9, P = 0.007) and glaucoma (OR: 3.5; 95% CI: 1.3–9.8, P = 0.016) showed increased risk of falls. Overall “fear of falling” was reported by 11.3% (n = 100), out of which 30% (n = 48) were by fallers. Side vision difficulty was predominantly associated with falling, followed by staircase and night vision difficulties as perceived by subjects. Most of the falls happened outdoors and overall 38.8% had an injury after falls.

Conclusion:

This study reported unique trend of increased occurrence of falls among the young with VI compared to older age groups. RP and glaucoma being peripheral vision loss causing diseases and increased severity of VI were more associated with falls and fear of falling.
A Case Report on Rare Neck Liposarcoma of Dedifferentiated Type
Authors: Srivastava Swati , Fatima Zikki Hassan , Qayyumi Burhanuddin
Published: December 2024

Liposarcoma of the head and neck is a rare, life-threatening but largely treatable malignancy. However, in the case of dedifferentiated liposarcoma (DDLPS), a higher rate of recurrence has been observed which is approximately 40%. These malignancies require critical assessment through imaging, histopathological, and immunohistochemical expertise. In this report, we present the case of a 54-year-old male with a large mass measuring 30 cm × 30 cm × 25 cm on the supraclavicular region. Biopsy with immunohistopathological examination diagnosed it as DDLPS, a low grade with Cyclin-dependent kinase 4 and mouse double minute 2 homolog gene amplification. The tumor was treated by wide excision of the neck mass followed by adjuvant radiotherapy. The patient is on follow-up and is disease-free for 1.5 years. This report pays extra attention over minute details and the challenges associated with the surgical management and histological features of this variant.
Periodontal Microsurgery: Systematic Review and Meta-analysis
Authors: Kalburgi Veena , Bhole Shravani
Published: December 2024

Conventional surgeries involve larger areas including more soft- and hard-tissue manipulation which results in greater postoperative edema, inflammation, and pain. Microsurgery is an advanced surgical technique in which normal vision is enhanced through magnification of ×10 or more performed under a surgical microscope. Application of microsurgical principles is to achieve passive and primary wound closure. This systematic review was carried out in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Microsurgery was observed to be better following different periodontal surgeries when compared to the parameters of recession depth, recession width, and clinical attachment level. However, inconclusive evidence was seen for the variables of probing depth and width of keratinized tissue. The study found that the microsurgical approach resulted in less postoperative pain and discomfort compared to the macrosurgical method. The microsurgical instrument tools contributed to improved wound stabilization and better flap adaptation. When deciding between macrosurgical and microsurgical procedures, it is important to consider factors such as treatment outcomes, logistics, cost, and patient-centered parameters.
Evaluating the Analgesic Efficacy of Conventional versus Ultrasound-guided Bilateral Superficial Cervical Plexus Block in Thyroid Surgeries: A Randomized Controlled Trial
Authors: Gautam Shivani , Guria Sushil , Krishna Bhavya
Published: December 2024

Objectives:

Thyroid surgery is a painful procedure for which bilateral superficial cervical plexus block (BSCPB) can be given to potentially reduce postoperative pain. Ultrasound guidance provides real-time visualization of anatomical structures, needle movement, and accurate deposition of local anesthetic in close proximity to nerves, thus making the procedure safer and more effective. Our aim was to compare the analgesic efficacy of ultrasound-guided versus the landmark technique of BSCPB in patients undergoing thyroid surgeries.

Materials and Methods:

Sixty patients (19–64 years) undergoing thyroid surgeries were divided into two groups – Group US (n = 30): patients undergoing ultrasound-guided BSCPB and Group LM (n = 30): patients undergoing landmark technique for BSCPB. Visual Analog Scale (VAS) pain score at 0, 2, 4, 6, 12, and 24 h, total fentanyl requirement during the intraoperative period, time taken to first rescue analgesia demand, and total tramadol consumption during the first 24 h postoperatively were compared among the two groups.

Results:

In Group US, there was less intraoperative fentanyl requirement (102.07 ± 18.96 μg vs. 113.33 ± 22.65 μg in group LM, P - 0.037), lower VAS pain score at 0, 2, 4, 6, and 12 h (P = 0.03, <0.001, 0.017, 0.046, and 0.048, respectively), longer time taken to first rescue analgesia demand (491.23 ± 123.43 min vs. 291.00 ± 119.77 min in LM group, P < 0.001), and lesser total tramadol consumption during first 24 h postoperatively (51.67 ± 6.34 mg vs. 75.83 ± 24.11 mg in Group LM, P < 0.001).

Conclusions:

We conclude that ultrasound-guided BSCPB is more effective than landmark technique for reducing pain both intra and postoperatively in patients undergoing thyroid surgery.
Comparative Evaluation of the Efficacy of Different Solvents on the Removal of Endodontic Bioceramic Sealers: An In vitro Study
Authors: Alamoudi Ruaa A.
Published: December 2024

ABSTRACT

Background:

Bioceramic-based root canal sealers are recently utilized in endodontic treatments as materials for root canal obturation. Ensuring the complete removal of these materials during root canal retreatment is essential for proper disinfection. This investigation was carried out to evaluate the effectiveness of D-limonene, 10% formic acid, and 20% hydrochloric acid as solvents in retreating teeth previously filled with gutta-percha and AH Plus or bioceramic sealers.

Materials and Methods:

A total of 108 single-rooted human premolars underwent initial root canal treatment using ProTaper rotary file system. Nonsurgical retreatment was then performed using ProTaper retreatment files. The interaction between the tested sealers and solvents was examined under a stereomicroscope. ImageJ software was also used to precisely evaluate the areas covered by residual root canal obturating material. Mann–Whitney and Kruskal–Wallis tests were used to identify significant differences between the groups at a significance level of 0.05.

Results:

The results revealed that none of the solvents were successful in completely removing the sealers. However, greater retreatability was observed in case of AH Plus sealer characterized by the presence of less remnants as compared to bioceramic sealers.

Conclusions:

These findings indicate that D-limonene can effectively dissolve resin-based sealers, but not bioceramic sealers. Irrespective of the solvents used, complete elimination of BC and BCH sealers could not be accomplished. This suggests that bioceramic-based sealers significantly caused the retention of more residual material than resin-based sealer after their removal with different solvents.
Comparison of caudal bupivacaine and dexmedetomidine with caudal bupivacaine and intravenous dexmedetomidine for postoperative analgesia in children: A randomized controlled trial
Authors: Singh Kuldeep , Bajaj Jeetendra , Bathla Sapna , Mehta Khushboo
Published: December 2024

Background and Aims:

Caudal block is a part of multimodal analgesic regimen to alleviate pain in pediatric patients undergoing variety of surgeries. This study compares the effectiveness of caudal versus intravenous dexmedetomidine as an additive to caudal bupivacaine for prolonging analgesia in children posted for elective lower abdominal surgeries. The level of sedation and hemodynamic effects through both routes were also compared.

Material and Methods:

Ninety-six children (aged 1–8 years) of either gender scheduled for elective lower abdominal and pelvic surgeries were prospectively enrolled and randomized into two groups of 48 each: Group A (caudal bupivacaine + caudal dexmedetomidine) and Group B (caudal bupivacaine + intravenous dexmedetomidine). The postoperative pain was monitored using the Face, Legs, Activity, Cry, Consolability (FLACC) scale, and sedation was assessed using the Ramsay sedation scale (RSS).

Results:

The degree of analgesia was comparable in both groups in the initial hours after surgery. Significantly higher FLACC scores were seen in Group B at 8 h (P- 0.016), 12 h (P < 0.001), and 16 h (P < 0.001), with 89.58% patients needing two rescue analgesic doses. RSS was higher in Gr=oup A till 12 h postsurgery.

Conclusion:

Caudal dexmedetomidine with bupivacaine provides improved analgesia after 8 h of surgery in comparison to caudal bupivacaine with intravenous dexmedetomidine in children undergoing lower abdominal surgeries.
Ecological impact of anesthesia: Analysis of sevoflurane consumption as a greenhouse gas
Authors: Giulia Scandurra , Carmen Cristea , Philippe Dony
Published: December 2024

Background and Aims:

According to the World Health Organization, climate change represents a threat to global health. Healthcare activities must understand their ecological impact and reduce their environmental footprint. Decreasing greenhouse gas emissions is a major health priority, to which all healthcare establishments should commit. We sought to understand whether anesthesiologists were aware of the impact of sevoflurane consumption on climate and whether they were inclined to implement eco-friendly strategies.

Material and Methods:

We assessed the knowledge of anesthesiologists about sevoflurane consumption and its impact on climate change. Overall, 152 anesthesiologists from Belgium, France, and Italy answered our questionnaire in April 2024. The database from the computerized anesthesia protocol was used to evaluate the average annual sevoflurane consumption at our Belgian institution between January 2015 and March 2022. The sevoflurane quantities used were obtained from information provided by the ventilator after each procedure. Potential savings were based on scientific recommendations regarding anesthesia ventilator settings. The analysis was based on the comparison between these data.

Results:

With optimized sevoflurane consumption conditions, the emission of 36.156 tons of CO2 could have been avoided, corresponding to 144,623 Km driven per year. The financial impact calculated was a saving of 533,525€ over 8 years. The survey highlighted that anesthesiologists were ready to embrace eco-friendly practices to reduce global pollution.

Conclusions:

We must invest in information and awareness-raising for anesthesiologists from the start of their medical training so that we can move toward a more eco-responsible practice to achieve major ecological and economic benefits.
Perioperative outcomes in patients with symptomatic versus asymptomatic previous COVID-19 infection undergoing neurosurgical treatment (post–COVID-19 study)
Authors: Bansal Sonia , Giribabu Parthiban , Sriganesh Kamath , Shukla Dhaval
Published: December 2024

Background and Aims:

The long-term effects of coronavirus disease 2019 (COVID-19) infection (long-COVID) are being increasingly recognized. The long-COVID effects are more likely in individuals who were symptomatic than asymptomatic during their previous COVID-19 infection. The data on perioperative outcomes of patients undergoing elective neurosurgery long after their recovery from COVID-19 infection is lacking. The primary objective of this study was to compare the perioperative outcomes after elective neurosurgery between patients who were symptomatic and those who were asymptomatic during their previous COVID-19 infection. The secondary objectives were to compare the earlier COVID-19 characteristics and the perioperative pulmonary profile during current surgery between these groups.

Material and Methods:

This prospective observational study was performed in adult patients undergoing elective neurosurgery with history of previous COVID-19 infection. Data was collected regarding previous COVID-19 infection (symptoms, hospitalization, treatment, complications, etc.) and current perioperative characteristics (pulmonary profile, perioperative complications, hospital stay, mortality, etc.).

Results:

A total of 50 patients were recruited during the study period, of which 35 (73%) patients were symptomatic during previous COVID-19 infection (two patients were excluded). The mean duration between current surgery and previous COVID-19 infection was 7 months. Patients symptomatic during earlier COVID-19 infection were females, older, and had a lower oxygen level during current surgery. There was no difference between symptomatic and asymptomatic groups in adverse perioperative outcomes such as desaturation, pulmonary or extrapulmonary complications, or non-extubation.

Conclusion:

The perioperative outcomes of patients undergoing elective neurosurgery with previous mild to moderate symptomatic COVID-19 infection may not be different from those of patients with asymptomatic COVID-19 infection.
Charting your career graph post residency
Authors: Mohan Monisha , Mathew Mini
Published: December 2024

Overview on the opportunities available for an ophthalmology resident. Included are the options for those who want to start working immediately after PG and for those who want to do fellowships (both long term and short term.) both in India and abroad.
How to write an introduction and literature review for your research?
Authors: Sruthi MV
Published: December 2024

Writing an engaging Introduction and Literature Review is essential for any research paper. These segments lay the foundation for your research, offering context, pinpointing deficiencies, and substantiating the necessity of your study.
Radiology Pearl - An Uncommon Cause of Hemoptysis
Authors: Panicker Venugopal , Paulson Mithila , Vijay Vivek N. , Sajitha M. , Parameswaranpillai Venugopal , Kallarackal Sonia John , Parameswari Rekha , Seetha Anusree Prasad , Kumar Athulya S.
Published: December 2024

A cause of hemoptysis with unusual radiology findings is discussed for the benefit of postgraduate students.
Unmasking Kikuchi Disease: A Rare Treatable Cause of Lymphadenopathy
Authors: Adiody Supriya , Krishnakumar Krishnanand , Chimmen Jeena
Published: December 2024

Kikuchi–Fujimoto disease (KFD) is a rare, benign disease characterized by histiocytic nonnecrotizing, self-limiting lymphadenopathy. It is usually seen in females of Asian lineage. The diagnosis is made by excision biopsy of the lymph node with characteristic histopathologic findings of KFD. Misdiagnosis may lead to the patient being wrongly treated with antituberculosis medications or be aggressively investigated for a lymphoma. Here, we present the case of a young female presenting with evening rise of temperature and lymphadenopathy who was diagnosed to have KFD.
Decellularization techniques pave the way for tissue engineering and regenerative medicine: a narrative review
Authors: Zhao Jingjing , Chao Tianhui , Zhou Min , Yue Ke , Xu Fang , Wang Huan , Guo Jianrong , Gao Zhengliang
Published: December 2024

Decellularization refers to the removal of cellular components from animal tissues or organs via specific methods to obtain an extracellular scaffold comprising an extracellular matrix. Physical, chemical, and biological methods can be used to remove cellular components from tissues or organs. The obtained decellularized extracellular matrix retains both the original structural framework and bioactive components and significantly reduces immune rejection. This is an ideal three-dimensional scaffold for cell growth and tissue repair. Despite the remarkable progress in decellularization technology, some challenges remain. For example, how to achieve efficient and uniform decellularization without compromising the integrity and bioactivity of the extracellular matrix, how to ensure that sterilization methods do not damage the structure and function of the decellularized extracellular matrix, and how to improve the clinical safety and efficacy of the decellularized extracellular matrix are important. This paper delves into various methods of decellularization, evaluation techniques of decellularized extracellular matrices, and their potential applications in multiple fields of organ regeneration, bio3D printing, and disease modeling, with a special emphasis on the critical role of decellularized extracellular matrices as bioinks in bio3D printing to support cell adhesion and differentiation, highlighting the significant value of decellularization technology in the construction of complex biological structures. The use of the extracellular matrix as a bioscaffold can better support cell growth and functional recovery. By optimizing the decellularization and sterilization processes, the performance of decellularized extracellular matrix can be further improved to advance its progress in clinical applications. In conclusion, the clinical application of decellularized extracellular matrix, which can be used for repairing damaged tissues, customizing personalized therapeutic solutions, and developing new drug testing platforms, is promising. Further research and application of decellularized extracellular matrix are expected to advance the development of regenerative medicine, thereby providing patients with safer and more effective treatment options.