bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Implementation of Learner-Centered Teaching Methods in the Quest Forward Learning Program Secondary Schools in Tanzania
Authors: Bakari Fadhili Mwajuma , Ogoti Evans , Salema Rev.  Victorini
Published: September 2024

This study evaluated whether the Quest Forward Learning Program (QFLP) in Tanzania successfully shifted secondary school mentors from traditional teacher-centred methods (TCMs) to implementing learner-centred teaching methods (LCMs). The evaluators employed a convergent design within a mixed evaluation approach, whereby 643 participants were selected from a population of 948, including heads of schools, mentors, and students—data collection methods involved questionnaires, observations, and interview guides. The validity of data collection instruments was determined through expert evaluation and a pilot study, while reliability was determined using Cronbach's Alpha, member checking, and cross-checking transcripts. Data were analysed using thematic analysis for qualitative, inferential, and descriptive statistics, with the help of SPSS software for statistical analysis, which was used to analyse quantitative data. Findings indicated that mentors mainly employed LCMs, such as case studies, projects, peer coaching, role plays, group discussions, and multimedia tools. The study concluded that QFLP training, provided by the Opportunity Education Foundation (OEF), effectively equipped mentors to transition to LCMs, aligning with the competency-based curriculum in Tanzania. It was concluded that mentor experience did not impact the frequency of LCM usage; comprehensive training was vital. The study recommended expanding OEF's reach to include public schools, ongoing mentor training, and further research on the effectiveness of specific LCMs in enhancing student engagement.
The Antioxidant and Antibacterial Effects of Gambier Catechin (Uncaria gambir Roxb) in Streptococcal Gingivitis: A Review
Authors: Rahmaddiansyah Refa , Amriza Muhammad Zidan , Rita Rauza Sukma
Published: September 2024

BACKGROUND: Oral health is very important for general health and well-being. Oral diseases such as caries and periodontitis are common throughout the world. Periodontal is the main cause of tooth loss in adults. This disorder begins with gingivitis (swelling of the gums due to plaque), which, if left untreated, will result in periodontitis or infection that can destroy the teeth and surrounding tissue. The current management of this disease is to give analgesia and antibiotics, but early prevention and treatment are needed, one of them by using toothpaste.
AIMS: This study aims to assess the effectiveness of Gambier catechin as a preventive approach for streptococcal gingivitis.
METHODS: The research design used is a literature review study conducted from preclinical and clinical studies extracted from indexed international journals. Studies from 2012 to 2022 in English and related to the keywords are reviewed and synthesized.
RESULTS: The pathophysiology of the majority of gingivitis is related to inadequate cleaning of the oral cavity, which leads to the accumulation of plaque and bacteria. Catechins from Gambier also have a stronger capacity as antioxidants. Preclinical studies stated that Gambier has a strong potential for antioxidants. Catechins have stronger antioxidant capabilities than vitamins C and E. Catechins from Gambier also have a stronger capacity as antioxidants than vitamin E. Gambier catechin contains polyphenolic compounds that have antibacterial activity so that they can inhibit the formation of dental plaque. The catechin compound as an antibacterial has two properties, namely being able to inhibit (bacteriostatic) and kill (bacteria) the growth of bacteria.
CONCLUSION: Gambier catechin has antioxidant and antibacterial effects and has potential for treating streptococcal gingivitis.
The MOVECLIM – AZORES project: Bryophytes from Terceira Island along an elevation gradient
Authors: Gabriel Rosalina , Morgado Leila , Henriques Débora , Coelho Márcia , Hernández-Hernández Raquel , Borges Paulo
Published: September 2024

Systematic studies on the biodiversity of bryophytes along elevational gradients have been conductuted within the native vegetation of the Azores, using the MOVECLIM framework. The primary objective of this study was to inventory the bryophytes present within preserved areas of native vegetation in Terceira Island (Azores). From 25 to 28 September 2012, an inventory of the bryoflora was carried out along an elevational gradient, starting near Serreta lighthouse (38.76658 Latitude; -27.37539 Longitude; 40 m a.s.l.) and culminating on the top of Santa Bárbara Mountain (38.73064 Latitude; -27.32164 Longitude; 1000 m a.s.l.). The study followed the adapted MOVECLIM standardised protocol, as follows: i) six sites were selected along an elevational transect, each site spaced at 200 m elevation intervals; ii) within each site, two 10 m x 10 m plots were established in close proximity from each other (10-15 m); iii) within these plots, three 2 m x 2 m quadrats were randomly selected and sampled for bryophytes. The following substrates were surveyed in each quadrat: rock, soil, humus, organic matter, tree bark at three different heights and leaves/fronds. For each available and bryophyte-colonised substrate, three replicate microplots of 10 cm x 5 cm were collected, resulting in a maximum of 24 microplots per quadrat.

Nearly three-quarters of the maximum expected number of microplots (636 out of 864; eventID) were found across the six sites on Terceira Island, resulting in a total of 3677 records (occurrenceID). A high proportion of the specimens could be identified to the species rank (n = 3661; 99.6%), representing 38 families, 60 genera and 92 species, including 58 species of liverworts (Marchantiophyta) and 34 species of mosses (Bryophyta). The inventory included several endemic species: two liverwort species endemic to the Azores, five species endemic to Macaronesia (three mosses and two liverworts) and 11 European endemic species (three mosses and eight liverworts). The elevations with the highest species richness, the highest number of endemic species and the highest number of conservation concern species, spanned between 600 and 1000 m a.s.l. above sea level, coinciding with the best preserved forest vegetation. Overall, tree-dwelling and ground-dwelling substrates showed similar levels of bryophyte occupation (75% vs. 72%). However, the 636 events were unevenly distributed across substrates: leaves and rocks had the fewest replicates (n = 54; 50.0%), while humus and the lowest tree height had the highest values (n = 106; 98.1% and n = 98; 90.7%, respectively).

The study contributed to expanding knowledge about the diversity and distribution of the Azorean Bryoflora, both on a local and a regional scale.
Dental plaque caries related microorganism in relation to demographic factors among a group of Iraqi children
Authors: Khalaf Muna Saleem , Qasim Alhan Ahmed , Jafar Zainab Juma , Mohammad Ahlam Taha
Published: September 2024

Introduction: Streptococcus mutans and lactobacilli are most important bacteria in the pathogenesis of dental caries. Cariogenic microflora has been associated to the primary caregiver transmission and sugary diets.

Aim: This study aimed to relate S. mutans and lactobacilli in the plaque to demographic factors in Iraqi children.

Materials and methods: The study included 135 children aged 3-10 years. Samples of their dental plaque were taken from the upper second primary molars on the buccal surfaces using a clean toothpick. Each sample was stored in 1 ml of normal saline followed by dispersion for 30 seconds using Vortex mix. Before inoculation, serial dilutions were done. Inoculation was done in the selective media for each microorganism: mitis salivarius-bacitracin agar for S. mutans and Rogosa agar for lactobacilli. The bacterial count was estimated by counting CFU and a dissection microscope (×15). A questionnaire on the demographic factors was sent to each child to be filled in by their parents.

Results: S. mutans was demonstrated to be greater in the dental plaque of 3-6-year-old children whose mothers are housewives, groups that add sugar to milk, groups without any history of systemic disease, mother’s age, and normal-weight children, whereas lactobacilli increased in the plaque of children aged 7–10 years, women, children with fathers who are government employees, mother’s occupation, children who were not nursed during sleep, father’s age, normal weight, and times of teeth brushing.

Conclusion: S. mutans and lactobacilli are clearly associated with different demographic factors. Education of parents and children has an effective impact on controlling their number, reducing dental caries.
Analysis of clinico-investigative correlation of congenital heart disease
Authors: Sisodia Akansha , Yadav Suresh Kumar , Yadav Kiran
Published: September 2024

Introduction: Congenital heart disease (CHD) accounts for 1/3 of all congenital birth defects. It is a leading cause of mortality in children. Hence, the diagnostic reliability of clinical profile needs to be explored for timely intervention and optimal patient outcome.Objectives: To know the clinical profile of CHD cases and correlate clinical profile with investigations like chest x-ray, electrocardiography (ECG) and echocardiography.Method: A prospective observational cross-sectional study was conducted in the Department of Paediatrics of Vikhe Patil Medical College, Ahmednagar, Maharashtra, India. The duration of the study was 18 months, from March 2017 to September 2018. All children aged one day to 14 years with features suggestive of CHD were included in the study. Clinical diagnosis was based on a detailed history and physical examination supported by chest X-ray and ECG. Final diagnosis was confirmed by echocardiography.Results: A total of 7438 suspected cases was studied, of which 246 had CHD, resulting in a hospital incidence of 2.9%. Common age of presentation was <1year (43.5%) with a male to female ratio of 1.39:1. Acyanotic congenital heart disease (ACHD) comprised 81.3% and cyanotic congenital heart disease (CCHD) 18.7%. Clinical diagnosis was well correlated with final diagnosis in 80.5%, partially correlated in 11.4% and not correlated in 8.1%.Conclusions: ACHD was found in 81.3% cases and CCHD in 18.7%. Clinical diagnosis, supported by chest x-ray and ECG correlated well with echocardiographic diagnosis in 80.5%, partially correlated in 11.4% and was not correlated in 8.1%.
Bone mineral density in children with systemic lupus erythematosus and juvenile idiopathic arthritis: A cross-sectional study in a tertiary care hospital from Eastern India
Authors: Manna Debabrata , Guha Suparna , Basu Sumita , Pal Samar Ranjan , Pal Priyankar , Roy Ajitesh
Published: September 2024

Objectives: To determine the Bone Mineral Density (BMD) of paediatric Systemic Lupus Erythematosus (pSLE) and Juvenile Idiopathic Arthritis (JIA) patients and determine its association with predefined variables.Method: This was a cross-sectional study involving consecutive pSLE and JIA patients attending the paediatric rheumatology clinic. Healthy age and sex matched controls were selected from neighbouring schools. BMD was assessed  at the lumbar spine  by Dual Energy X-ray Absorptiometry (DEXA) scan and expressed as Z-score. Its correlation with variables like Body Mass Index (BMI), onset of puberty, disease duration, disease activity, duration of steroid intake and cumulative dose of steroids was assessed. Results: There were 45 cases (33 JIA, 12 SLE) and 23 controls. DEXA Z-score of cases (-1.58±1.22) was significantly lower than controls (0.096±1.19).  BMI and onset of puberty also differed significantly between cases and controls. However, there was no significant difference in  DEXA Z-scores of pSLE and JIA. There was a significant  negative correlation of DEXA Z-score with disease duration, duration of steroids and cumulative steroid dose. However, there was no significant correlation with disease activity. There was a significant positive correlation with BMI .Conclusions: Patients with pSLE and JIA had significantly less DEXA Z-scores compared to healthy matched controls. Major contributing factors were disease duration, duration of steroid intake and their cumulative dose.
Snake bites in Sri Lankan children
Authors: Lucas Gerard Nimal
Published: September 2024

No Abstract available
Paediatricians and pregnant women in Sri Lanka are willing to expand the disease panel in the newborn heel prick test 
Authors: Kankananarachchi Imalke , Hettiarachchi Manjula
Published: September 2024

No abstract available
Editorial
Authors: Chief Editor-in-
Published: September 2024

No abstract available
Food for Thought: The Effect on Employee Relations on Employee Performance with Special Reference to Food and Beverage Operations in Hotel Industry
Authors: Prabuddhini D. H. U. , Harshani G. H. V.
Published: September 2024

Hospitality industry has become turbulent and dynamic exposing to externalities whereas human resources in hospitality organizations have emerged as a significant area to achieve corporate goals and objectives. Food and beverage operations contribute the highest productivity in this sector by directly interacting with guests making satisfied employees as an integral component to deliver the expected customer value. Hence, this study examines the effect of employee relations on employee performance in food and beverage operations. Five-star hotels in Colombo district being the research site for the study, and from them a sample of 150 employees from six hotels in the food and beverage operations were chosen using convenience sampling technique. Adopting mixed method approach, the primary data was collected through self-administered questionnaire and in-depth interviews. Primary data was analysed using descriptive analysis, Pearson’s correlation and regression analysis through SPSS software. Qualitative data was analysed using the content analysis. The results revealed that employee relations have a significant positive relationship with employee performance. Further, it showed that, the strategies such as training and development programmes, leadership programmes, reward and recognition schemes are predominantly practiced by employers to improve relationship with employees for better performance. Based on the findings, the study recommends that immediate supervisors have to be more concerned about employees’ motivational factors. Furthermore, the management should ensure transparent and open communication channels, and mutual respect among employees that ultimately creates a positive work environment.
Utilizing Digital Functional Touchpoints to Formulate Brand Loyalty among Millennial Consumers
Authors: Samarasinghe K. R. , Razi M. J. M. , Dissanayaka D. M. R.
Published: September 2024

Brand loyalty has become a vital need in today’s competitive market. It’s not only about repeat purchase intention that creates brand loyalty but also about the content of digital platforms.
Book Review on David B. Grant, Alexander Trautrims, And Chee Yew Wong (2017) Sustainable Logistics and Supply Chain Management: Principles and Practices for Sustainable Operations and Management, Second Edition
Authors: Gunasekara K. R. Hemendra Lal
Published: September 2024

No abstract available
A rare case of community-acquired pneumonia complicated by severe Acute Respiratory Distress Syndrome in an immunocompetent male: Aeromonas jandaei
Authors: Palanivel Jayabharathi , Upadhya Pratap , Mohapatra Madhusmita Mohanty , Bagarhatta Prateek , Karthikeyan Mounicka
Published: September 2024

Aeromonas jandaei is an oxidase-positive Gram-Negative (GN) motile rod and is usually found in aquatic environments. It is commonly associated with gastrointestinal infections, wound infections, and septicemia. While species like A. veronii and A. hydrophila are known to cause pneumonia, we report a rare incidence of severe pneumonia complicated by Acute Respiratory Distress Syndrome (ARDS) caused by A. jandaei, highlighting the challenges in diagnosing and managing infections caused by rare, multidrug-resistant pathogens. This report describes a case of pneumonia caused by Aeromonas jandaei, a bacterium previously less documented in respiratory infections.
Correlation between CT volumetry and actual graft weight in living donor liver transplants in South Africa
Authors: Calver Katherine D. , Terreblanche Owen , Warnich Ilonka , Van der Schyff Francisca
Published: September 2024

Background: Liver transplantation is the definitive management for patients with end-stage liver disease. Preoperative computed tomography (CT) is used in living donor liver transplant (LDLT) for donor and graft selection as well as predicting graft weight.Objectives: The aim of this study is to establish the relationship between estimated graft volume (EGV) and actual graft weight (AGW) and ascertain a correlation coefficient that will improve the accuracy of EGV in a South African population.Method: The study included 117 LDLT between March 2013 and August 2022. Of these, 86 were left lateral (LL), 15 right lobe (R), 10 left lobe with caudate (LC), five left lobe (L) and one segment two (monosegment) grafts. Estimated graft volume and actual graft weight were compared using the Pearson coefficient and the relationship was illustrated with scatter plots.Results: Estimated graft volume and AGW had a strong positive correlation with a Pearson correlation (R) of 0.95 (p  0.001). The relationship was significantly linear with a correlation coefficient of 0.71. The mean EGV was significantly higher than that of AGW (388 mL ± 249 mL vs. 353 g ± 184 g) with overestimation in 61% of cases. Left lateral and R grafts were the most prevalent LDLT graft type, both having a strong linear correlation between EGV and AGW.Conclusion: Applying a correlation coefficient of 0.71 will improve the accuracy of CT volumetry graft weight predictions.Contribution: A unique correlation coefficient will improve EGV accuracy, aiding in preoperative planning and mitigating post-operative complications in both donors and recipients.
Knowledge and Practices Related to Oral Potentially Malignant Disorder among the Youth Living in Urban Slum Areas in a Commercial City in Sri Lanka
Authors: Manori Dhanapriyanka Halgamuwe Hewawasam , Chandrika Kanthi Raluwa Dona Fransisco
Published: September 2024

Background:

Oral potentially malignant disorder (OPMD) is an emerging problem among the youth due to the increase in use of different addictive substances. This study aims to assess the level of knowledge and selected practices related to OPMD among the youth between 15 and 24 years residing in urban slum areas in a commercial city in Sri Lanka.

Methods:

A descriptive cross-sectional study was conducted among a sample of 1435 youths. Cluster sampling technique combined with probability proportionate to size technique was used to select the sample. Data were collected using an interviewer-administered questionnaire.

Results:

The response rate was 99.7%. The mean age of the study sample was 17.53 years (95% confidence interval: 17.40–17.65). A higher percentage of youths had poor knowledge on OPMD (72%). The majority (around 85%) knew that smoked and smokeless forms of tobacco were risk factors for OPMD. However, the knowledge on areca nut packets, alcohol, and areca nut in betel quid as risk factors for OPMD was found to be relatively poor with proportions 31.9%, 21.6%, and 16.3%, respectively. In addition to that, study participants showed very poor Knowledge regarding the clinical presentations of OPMD. Around 10.9% and 2.3% knew that OPMD can present as a white patch and a red patch, respectively. Very few of the study sample (1.2%) were knowledgeable about the self-mouth examination for identification of OPMD.

Conclusion:

Poor knowledge on OPMD among the youth living in urban slum areas in a commercial city in Sri Lanka alarmed the need of implementing targeted interventions among these high-risk groups.
Facial Masks for COVID-19 Pandemic an Approach toward Awareness among Health Practitioners
Authors: Sachdeva Shivani , Saluja1 Harish , Mani Amit , Mani Shubhangi , Chawla Kirti , Mohammadi Syeda Nikhat
Published: September 2024

Objective:

Coronavirus pandemic is a human respiratory disease caused by the severe acute respiratory syndrome (SARS-CoV-2). The objective of the present study was to evaluate the type of mask, frequency of change, difficulties in breathing, dryness of mouth, hazards, and treatment taken for skin allergies if any due to use of facial masks in the present Coronavirus pandemic.

Materials and Methods:

The present survey was carried on dental practitioners for evaluating knowledge and attitude among 1640 participants. The anonymous survey was carried among different groups of age, gender, and qualifications among dentists all around the globe. SPSS 23.0 statistical software was used for statistical analysis. GraphPad Prism 6 was used for statistical analysis and visualization using Chi-square test, one-way ANOVA and post hoc test. The validity of the questionnaire was pilot tested and measured. The Chron bach's alpha value was 0.71.

Results:

Among the participants 46.3% used respirators such as N95, filtering facepiece respirators 2, or the equivalent. Surgical masks were used by 43.9% and the remaining used cloth masks. When inter group comparison was done for different age groups, it was found that there was a statistically significant for the type of mask used. Sixty-six percent participants reported oral malodor after using the facial masks while dryness of the mouth was reported in 41.5 and 9.1% reported acne.

Conclusion:

The use of face masks has become mandatory ornament along with social distancing to avoid transmission. Hypercapnia and breathing difficulties reported were less. For treating the face after long use of facial mask many of the participants reported that no treatment was taken while, others hydrated the face frequently with water, moisturizer and very few used antifungal agent.
Sulcus Preservation to Improve Functional Outcomes in Compartmental Tongue Resection
Authors: Bylapudi Bhanu Prakash , Kudpaje Akshay , Hegde Prasanna , Thakur Shalini , Rao Vishal U.S. , Palme Carsten E.
Published: September 2024

The primary aim of surgery in tongue cancers is tumor ablation with clear margins. Apart from tumor clearance, it is equally important to incorporate a technique that can improve the functional outcomes. It is a well-known fact that compartmental surgery has evolved as a propitious approach for early tongue and floor of mouth cancers. To overcome the functional deficits, we propose a technique of tongue reconstruction in cases where attached and reflected gingiva could be preserved when the tumor is not involving the floor of the mouth. We present a case series of three patients with our initial functional results in which this modified approach was performed. The parachute technique of flap inset maintained adequate sulcus. Regular sessions of speech and swallowing assessments were done and functional outcomes in these patients were assessed and compared with three other patients who underwent compartmental resection of tongue followed by interdental flap inset. Incorporation of a simple sulcus preservation technique by parachuting the remnant natural attached gingival mucosa after compartmental resection showed superior functional outcomes. It was also observed that the overall efficiency of chewing and clearance of food from oral cavity was better with this proposed technique as the lateral gutter was well maintained. The results of this study could help clinicians to provide a better functional outcome to the patients by this technique.
A Middle Ear Paraganglioma Masquerading as a Facial Nerve Schwannoma
Authors: Raj Reshma , Panda Naresh , Rathore Ramya , Nayak Gyanranjan , Chatterjee Debajyoti
Published: September 2024

We report the rare case of a 36-year-old female with complaints of unilateral facial weakness and hearing loss with clinical, imaging, and intraoperative findings suggestive of facial nerve schwannoma, but the postoperative histopathology report was consistent with paraganglioma (PGL). After a primary excision, the patients developed recurrence and was accordingly managed by surgical excision again.
Carotid Body Tumor
Authors: Singh Ishwar , Meher Ravi , Bhandari Padam Singh , Singh Karandeep
Published: September 2024

Introduction:

Carotid body tumors (CBT) or paragangliomas account for approximately 3% of all paragangliomas occurring in the head-and-neck region. Delay in the surgical resection of tumors may be associated with high morbidity or mortality and risk of malignant transformation.

Methodology:

Three cases of CBTs were included in the study, out of which one case presented as bilateral neck swelling. All the patients were clinically and radiologically evaluated and taken up for surgical excision of the tumor. In case with bilateral tumor, a staged removal was planned.

Results:

Out of three patients, a female patient developed stroke postoperatively, she was managed and discharged in stable condition, and another male patient developed left vagal palsy.

Conclusion:

Excision of shambling Type III CBTs is difficult and one should know the collateral circulation of the tumor preoperatively. Bilateral CBT resection requires staging procedures to reduce the risk of cardiovascular and neurological issues.
Thyroid Surgery Outcome Benefits with Energy Based Devices Over Conventional Technique
Authors: Yousuf Aamir , Shamim Anjum , Hannan Abdul , Sideeq Kouser , Qazi Sajad Majid
Published: September 2024

Background:

Thyroidectomy is the most commonly performed surgery worldwide for both benign and malignant lesions of thyroid. New surgical technologies have been introduced in thyroid surgery to achieve vessel sealing and hemostasis with an added advantage over conventional method.

Aim:

The primary aim of study was to compare the surgical outcome benefits of harmonic focus, LigaSure vessel sealer with conventional techniques of clamp and suture in thyroid surgeries.

Objectives:

The objectives of this study were to compare the three methods in terms of the overall time difference, the total blood loss in thyroid surgery, postoperative drainage output, and surgical complications.

Methodology:

The prospective study was conducted in Government Medical College, Anantnag, Kashmir, between 2020 June and May 2022, over a period of 2 years by the Department of ENT and HNS. A total of 84 patients who underwent thyroid surgeries (total/hemithyroidectomy) were divided into three groups: Group H (n = 28), Group L (n = 28), and Group C (n = 28). The patients were divided according to age, preoperative diagnosis (benign and malignant), and thyroid nodule size and stage of thyroid lesion to generate homogeneous groups. All cases were operated by the same surgeon to prevent surgical bias.

Results:

The three groups were homogeneous in terms of age, gender, clinical status, and pathology. In Group H and Group L, the mean operative time was 25–30 min shorter than Group C (P < 0.001). In Group H and Group L, the blood loss was significantly less as compared to Group C (P < 0.001). The comparison of pain score, postoperative drainage, complication rates as well as mean hospital stay was similar between the three groups (P = Statistically non significant).

Conclusion:

The use of surgical devices is as safe and effective for vessel dissection and hemostasis likewise conventional clamp suture technique. A significant reduction of the operative time and intraoperative blood loss was found with harmonic focus and LigaSure method compared to conventional method with comparable differences in postoperative complications, pain score, and drainage in all the three groups.
Causes and pattern of neonatal mortality in tertiary care neonatal unit of medical college hospital at Jammu, Jammu and Kashmir
Authors: Dar Mohammad Irfan , Jamwal Ashu , Raina Sandeep , Bhat Vidhushi
Published: September 2024

BACKGROUND:

Infant mortality rate is the best indicator of effectiveness of maternal and child health services in general. Seventy percent of total infant deaths fall in neonatal period that is the neonatal mortality rate. The neonatal mortality is not uniform across the country. Substantial variations are observed in survival rates between the states and between districts within states. Focusing on local changes using local data can lead to improved outcomes. Health facility-based interventions can reduce neonatal mortality by 23%–50% in different settings.

OBJECTIVES:

This research article provides an overview of the causes of neonatal mortality and the relative public health importance of different causes that will help in reorganization and strengthening of neonatal services in our setup.

MATERIALS AND METHODS:

This was a record-based observational study of all the neonatal deaths in the neonatal unit over a period of 2 months from November 1, 2019 to December 31, 2019. Details of each neonatal death were analyzed.

RESULTS:

Most common cause of death was prematurity (56.44%) followed by neonatal sepsis (37.62%), birth anoxia (30%), and respiratory distress syndrome (26.73%). Seventy percent (71.29%) of deaths were inborn, whereas 24.75% and 3.96% were outborn and home-delivered, respectively. Sixty-seven percent (67.32%) were less than 2.5 kg among which 36.63% were less than 1.5 kg. Median weight was 2 kg. Fifty-seven (57%) of deaths occurred within 48 h after birth and median age at admission was 2 h and median hospital stay was 1.5 days.

CONCLUSIONS:

Improvement in female literacy rate, nutritional status of mother, providing good and essential antenatal care will reduce endogenous factors (prematurity and birth injuries) of neonatal mortality. Improving level 2 special newborn care and level 3 neonatal intensive care unit (NICU) beds, upgrading and operationalizing the newborn stabilization unit beds along with quality improvement and a functional back-referral system will substantially bring down neonatal mortality
Primary response to COVID-19 situation by Himachal Pradesh, India, during pandemic year 2019–20
Authors: Sharma Gopal A. , Barwal Vijay K. , Gupta Anmol
Published: September 2024

BACKGROUND:

India announced its first incidence of corona virus disease-2019 (COVID-19) in the state of Kerala on January 30, 2020. The severe acute respiratory syndrome- coronavirus-2 (SARs-CoV-2) pandemic was also unavoidably pounding on the doors of the state of Himachal Pradesh (HP), with enormous regional discrepancies necessitating remarkable insight.

SETTINGS:

On February 5, 2020, HP’s health authority took its first reaction step and followed it with a swift, adequate, and innovative response subsequently. Assuming R0 of 2.28 at the early stages of an epidemic, the outbreak threshold (T0 = 1/Log R0) is estimated to be mere 2.7 infections. However, with the emergence of only two positive cases, the state acted conscientiously vigilant to announce a lockdown at an opportune moment.

METHODS:

Department of Information and Technology developed a “CORONA Mukht (free) App” for keeping a digital record of all home-quarantined persons on the administration vigil list. During the active house-to-house case-finding campaign, an exercise involving 16,000 healthcare workforces, around 10,000 individuals with influenza-like illness (ILI) were screened. The ambulances were modified innovatively as “mobile sample collection kiosks” for sample collections throughout. The state added additional categories in the sampling protocol to keep a vigil for any community transmission. The protocol included samples from Flu clinics, ILI patients from the community, and occupants with ILI from migrant relief camps.

DISCUSSION:

On April 20, 2020, there were 23 incident cases in the state and declined to 10 on April 27, 2020. On May 3, 2020, out of 40 positive cases reported, there was only one active case under treatment. Subsequently, with effective containment measures, the state succeeded in keeping the test positivity rate below 2% from May to August 2020. Effectively during the specified period, cumulative deaths reported were 33 only in the state, with a case fatality rate of 0.56% at the end of August 2020, lower than the national average of 2.1%.

CONCLUSION:

It can be concluded that HP’s initial response to SARS-CoV-2 pandemic was exceptional and emphatic.
Gender-Specific Biases in Age Estimation Methods: A Comparative Analysis of Chaillet and Morris Methods in Forensic Anthropology
Authors: Jha Reeta , Nimavat Abhishek , Khatri Mansi , Jani Yesha , Thakkar Shweta , Gohil Janvi
Published: September 2024

ABSTRACT

Background:

Accurate age estimation is crucial in various fields, particularly in forensic and anthropological contexts, where it aids in identification and legal proceedings. However, discrepancies and biases may exist in age estimation methods, necessitating comprehensive evaluation, especially across gender groups.

Materials and Methods:

This study used ANOVA and t-tests to analyze age estimation data obtained from the Chaillet and Morris methods, alongside actual ages, across male and female groups. Descriptive statistics including mean, median, standard deviation, and range were calculated to provide detailed insights into the distribution of age estimates.

Results:

ANOVA revealed significant differences in age estimates between the Chaillet and Morris methods, as well as actual ages, for both males and females (P < 0.05). However, t-tests did not indicate statistically significant gender differences in age estimates from either method. Notably, a significant difference was observed in actual ages, with males having lower ages on average than females. Descriptive statistics showed consistent underestimation of actual ages by both estimation methods, with females exhibiting higher actual ages compared with males.

Conclusion:

This study underscores the importance of considering gender-specific biases and variations in age estimation methods. Although the Chaillet and Morris methods may not show significant gender disparities in estimates, they consistently underestimate actual ages, with females having higher actual ages on average. These findings highlight the need for continued refinement and validation of age estimation techniques to ensure accuracy and fairness across diverse populations.
A Prospective, Observational Study on Adverse Drug Reactions in Hospitalized Pediatric Cancer Patients in a Tertiary Care Teaching Hospital
Authors: Khajuria Nancy , Menia Nikhil , Gupta Seema
Published: September 2024

ABSTRACT

Background:

Adverse drug reactions (ADRs) pose a major health concern worldwide, especially in paediatric oncology where unlicensed or off-label drugs are commonly used. These reactions can have a significant impact on the quality of treatment and the safety of patients, particularly in vulnerable paediatric populations.

Aims and Objectives:

The purpose of this study is to examine the occurrence and characteristics of chemotherapy-related adverse drug reactions in children with cancer at a teaching hospital specialising in advanced medical care. Furthermore, it aims to evaluate the intensity and cause of these reactions by utilising the NARANJO probability scale and other assessment instruments.

Materials and Methods:

During a three-month period, we conducted a study at SMGS Jammu, in collaboration with GMC Jammu’s Pharmacology Department. The study was observational in nature and followed a prospective approach. The study included 45 children undergoing chemotherapy, utilising both spontaneous and intensive monitoring systems to report and analyse adverse drug reactions. We conducted statistical analysis using Chi-Square and Fisher Exact tests.

Results:

Among the 45 patients included in the study, 20 individuals (44.44%) experienced adverse drug reactions (ADRs), with a higher prevalence observed among female patients (55%). Fever and vomiting were the most common adverse drug reactions observed, with most of them being classified as moderate in severity based on the Modified Hartwig and Siegel Scale. Commonly linked medications to adverse drug reactions include Methotrexate, Vincristine, L-asparaginase, and Cytarabine. There was no significant statistical link discovered between different categories of anticancer drugs and adverse drug reactions.

Conclusion:

this study highlights the prevalence of adverse drug reactions (ADRs) in children undergoing chemotherapy, particularly in those receiving treatment for acute lymphoblastic leukaemia. The findings emphasise the significant impact of ADRs on these patients. It is of utmost importance to closely monitor and manage adverse drug reactions (ADRs) in paediatric oncology, emphasising the importance of implementing improved drug safety measures.
Asthma and Atopic Diseases in Children with Autism Spectrum Disorders
Authors: Saad Khaled , Ezzat Mohamed , Elhoufey Amira , Ahmed Mahmoud Elsaeed , Al-Atram Abdulrahman A. , Fageeh Mohsen M. , Hamed Yasser
Published: September 2024

ABSTRACT

Objective:

Autism spectrum disorders (ASD) and atopic diseases are prevalent conditions affecting numerous children globally, with rising incidence rates. While both environmental and genetic factors are involved, the precise cause of this rise remains elusive. This study aims to assess the frequencies of atopic diseases in a cohort of Egyptian children with ASD.

Patients and Methods:

We employed a survey consisting of 23 points relating to atopic conditions, which were modified from the International Study of Asthma and Allergies in Childhood (ISAAC). Parents of all participants with ASD and controls completed the questionnaires.

Results:

Our study included 150 ASD and 100 control children. All allergic diseases were significantly higher in ASD patients except food allergy.

Conclusion:

Allergic diseases are complex conditions influenced by both genetic predisposition and environmental factors, which play pivotal roles in their development. Our investigation has revealed a heightened prevalence of allergic diseases alongside ASD, reinforcing the link between ASD and allergic conditions. Hence, further comprehensive studies with larger sample sizes are warranted to thoroughly assess and validate these findings.
Doxycycline Proniosomal Gel as Local Drug Delivery System in Periodontal Disease: A Vitro Study
Authors: Mody Dhawal Rajendra , Lathiya Vrushali , Kolte Abhay P. , Biradar Vaishnavi , Langde Vaishnavi
Published: September 2024

ABSTRACT

Background:

Periodontitis is an inflammatory condition of the oral cavity in which microorganisms play a significant role in the pathogenesis and onset. The host immune system starts as an inflammatory process in response to microbial attack that protects and kills the periodontium. Doxycycline is a semi-synthetic variant of tetracycline that is made from oxytetracycline. Doxycycline inhibits the production of both aerobic and anaerobic microbial protein through its potent activity against both Gram-positive and Gram-negative bacteria.

Materials and Methods:

The preparation method of doxycycline proniosomal gel involved accurately weighing doxycycline and all excipients (12 Batches). Doxycycline was mixed with 1 ml of ethanol, and all the excipients, like surfactant, lecithin, cholesterol, were added in precisely weighed amounts. The characterization of proniosomal gel and determination of drug entrapment efficacy is calculated.

Result:

Doxycycline release from the doxycycline proniosomal gel (Batch F12) was studied using Franz diffusion cell assembly with dialysis membrane for 7 days in phosphate-buffered saline (7.4) indicated sustained release of doxycycline from the formulation.

Conclusion:

Proniosome containing doxycycline may therefore be a locally effective drug delivery method for treating periodontitis. Current in vitro study is mainly focused on preparation of proniosomal gel containing doxycycline as local drug delivery system in periodontal disease.
Impact of Occlusal Schemes on Implant-Supported Overdentures
Authors: Kuriakose Rene , Nair Achuthan , Bamigdad Malak S. , Pai Deepika R. , Rahman Nadeem A. , Paul Lino
Published: September 2024

ABSTRACT

Background:

The occlusal scheme is a crucial factor in the success and patient satisfaction of implant-supported overdentures. Different occlusal schemes, such as balanced, lingualized, and monoplane occlusion, can influence the functional and biomechanical outcomes.

Materials and Methods:

A randomized controlled trial was conducted with 60 edentulous patients who received mandibular implant-supported overdentures. The patients were divided into three groups based on the occlusal scheme: Group A (balanced occlusion), Group B (lingualized occlusion), and Group C (monoplane occlusion), with 20 patients in each group. All patients received two implants in the mandibular canine regions. The overdentures were fabricated and adjusted according to the assigned occlusal scheme. Clinical assessments, including bite force measurement and masticatory efficiency, were performed at baseline, 3 months, and 6 months post-insertion. Patient satisfaction was evaluated using a validated questionnaire.

Results:

At 6 months, Group A (balanced occlusion) exhibited the highest mean bite force (200 N ± 20), followed by Group B (lingualized occlusion) with 180 N ± 15, and Group C (monoplane occlusion) with 160 N ± 10. Masticatory efficiency was significantly higher in Group A (80% ± 5) compared to Group B (75% ± 4) and Group C (70% ± 3). Patient satisfaction scores were highest in Group A (9.0 ± 0.5), followed by Group B (8.5 ± 0.4) and Group C (8.0 ± 0.3). There were statistically significant differences between the groups in terms of bite force, masticatory efficiency, and patient satisfaction (P < 0.05).

Conclusion:

Balanced occlusion provided superior functional outcomes and higher patient satisfaction for implant-supported overdentures compared to lingualized and monoplane occlusion schemes.
An Overview of Avascular Necrosis of the Hip in Patients with Sickle Cell Disease
Authors: Ocloo Agbeko K. , Kwafo-Armah Abena , Lartey Samuel Quarshie
Published: September 2024

Background:

Avascular necrosis (AVN) of the femoral head is a devastating complication of sickle cell disease characterised by hip pain and dysfunction. The prevalence of this condition in patients with sickle cell disease in Ghana is unknown.

Objectives:

This study aims to look at the demographics of sickle cell disease patients presenting with AVN, the pattern of the disease on presentation, and the severity of the disease.

Materials and Methods:

Data were collected from patients referred to the Orthopaedic clinic over three years. Data collection forms were created and filled out for all patients. Analysis was done with Microsoft Excel (Windows 10 version), and the ensuing data were represented with descriptive statistics such as proportions, ratios, percentages, tables, and histograms.

Results:

A total of 134 patients were seen over a 3-year study period. The vast majority, 109 (85.3%), were below 40 years of age. The sex distribution of the patients was predominantly female (78%). Genotype SS was in the majority (89), representing (66.4%).

The majority of the patients, 104 (77.6%), were regular attendees of the Ghana Institute of Clinical Genetics or other specialised sickle cell disease clinics. The main reason for referral was on account of X-ray changes seen by the referring doctor (90, 67.1%). Unilateral disease was seen in 94 (70%) patients. Seventy (52.2%) presented with stage III disease, and 42 (31%) had symptoms for more than 2 years.

Conclusions:

Most of our patients were young, predominantly with genotype SS. They presented late with advanced disease stages and were referred to the orthopaedic clinic only after X-ray changes were seen.
Aetiology and Feasibility of Endoscopic Interventions for Massive Upper Gastrointestinal Bleeding in Makurdi, North-Central Nigeria
Authors: Omolabake Bamidele Israel , Iwuozo Emmanuel , Abi Innocent , Oche Joseph O. , Ochoga Martha , Ashinze Lewis
Published: September 2024

Introduction:

Massive upper gastrointestinal bleeding (UGIB) is a life-threatening emergency with high mortality. Emergency upper gastrointestinal (GI) endoscopy, endotherapy, interventional radiology, and surgery are necessary to control the bleeding source and restore normal physiology. However, these interventions are suboptimal in most centres in Nigeria, contributing to the dismal mortality observed in this condition.

Objectives & Methodology:

We aimed to determine the aetiology, feasibility of endoscopic intervention, and outcome of management of massive UGIB in Madonna Hospital, Makurdi, over a 30-month-period by retrospectively reviewing the medical and procedural records of patients presenting with hypotension from an endoscopically diagnosed upper GI bleeding source.

Result:

A total of 39 patients were identified, with a mean age of 49.3 ± 17.7 years. Among them, 27 were males (69.2%) and 12 were females (30.8%). Bleeding peptic ulcers were the cause of massive UGIB in 21 cases (53.8%), followed by variceal bleeding, observed in 10 (25.6%) cases. Most of these cases were amenable to endoscopic treatment using adrenaline injection, endoclips, endoscopic variceal band ligation, and diathermy fulguration. Thirty-three (84.6%) patients survived, while the in-hospital mortality following initial endoscopic intervention was 6 out of 39 patients (15.4%), which is comparable to figures from more advanced climes.

Conclusion & Recommendation:

Endoscopic management of massive UGIB is feasible in a low-resource setting. However, timely access to emergency endoscopy is vital to reduce mortality. Strategies to reduce risk factors for peptic ulcers and oesophageal varices are necessary to reduce the incidence of massive UGIB in Makurdi, Nigeria.
Pattern of Road Traffic Injuries Presenting at a Tertiary Hospital in North-Central Nigeria
Authors: Afolabi Gabriel Oluwatosin , Udeogu Kosisochukwu Elijah , Onyemaechi Ndubuisi Onu
Published: September 2024

Background:

Road traffic injuries (RTIs) constitute a major economic and health challenge globally, particularly in developing countries. Nasarawa state, north-central Nigeria, is heavily motorised due to the use of motorcycles as a popular means of transportation. The study aims to determine the pattern and prevalence of RTIs within the state.

Materials and Methods:

A 6-year retrospective study was conducted at the Dalhatu Araf Specialist Hospital (DASH) in Lafia, Nasarawa state. Data were obtained from the medical records of patients admitted with RTIs at the hospital and were analysed using the Statistical Package for the Social Sciences version 26.

Results:

A total of 929 patients with 1307 injuries were reported. There were 518 (55.8%) males and 411 (44.2%) females, with a male-to-female ratio of 1.3:1. The age of the patients ranged from 1–85 years, with a mean age of 30 ± 20 years. Young adults aged 18–44 years constituted the most injured age group. Motorcycle-related crashes accounted for injuries in 530 (57.1%) patients. These injuries were predominantly traumatic brain injuries (TBIs) and extremity injuries. The body region most affected was the head and face (560, 42.8%), with traumatic brain injuries (448, 32.7%) being the most common type. After treatment, most patients (571, 61.5%) were discharged home, while the mortality rate was 2.4%.

Conclusion:

In our study, motorcycle-related crashes were prevalent. Young adult males were mostly the victims of RTIs. Traumatic brain injuries and extremity injuries were the predominant types of injuries, often associated with motorcycle and pedestrian crashes. Multisystem injuries and TBIs were major factors contributing to mortality.