bluuebunny/crossref_metadata_2025 huggingface dataset:
Biodiversity Loss Due to Climate Change and Pollution
Authors: Maurya Ritika , Madan Sangeeta , Kumari Monika , Sadhiyan Bharti
Published: June 2024

The variety among living things from various environments, such as desert, marine, and terrestrial ecosystems, as well as the ecological complexes they are a part of, is known as biodiversity. The wellbeing of the earth and all of its people depends on the preservation of biodiversity. Human-induced long-term changes in temperatures and weather patterns disrupt the delicate life-supporting equilibrium, causing climate change. Pollution of land, water, and air jeopardizes ecosystems and species globally. According to the World Health Organization, air pollution affects 92% of the population and contributes to 11.6% of global fatalities. Climate change impacts biodiversity through altered breeding and migration behaviors, shifting distribution patterns, invasive species incursions, increased insect attacks, and heightened forest fire risks. India can enhance coordination by enacting eco-friendly laws, integrating these issues into national plans, and adopting biodiversity-based climate change mitigation strategies.
Carbon Sequestration by Terestrial, Aquatic, and Marine Biodiversity
Authors: Parida Pradosh Kumar , Asha Selvi G. , Vinodhini S. M. , Reddy Maram Bhargav
Published: June 2024

The concentration of atmospheric CO2 is currently at around 415 ppm and is increasing by approximately 2-3 ppm annually. This rise is mainly caused by human activities, particularly the burning of fossil fuels for energy production, industrial processes, and changes in land use. Although annual emission rates have fluctuated, they generally remain high, with recent estimates indicating around 40-45 GtCO2 being emitted each year. This chapter examines the crucial involvement of terrestrial, aquatic, and marine ecosystems in carbon sequestration, a key process in contending climate change. By investigating various mechanisms such as terrestrial vegetation absorption of carbon dioxide through photosynthesis and the deposition of organic material in marine sediments, the chapter elucidates the intricate connections between these ecosystems and their impact on the global carbon cycle and regulating climate and stresses the vital requirement for cooperative efforts to ensure their ability to sequester carbon for the benefit of future generations.
Urbanization's Ecological Toll
Authors: Makwana Vishal M. , Patel Foram P. , Dodia Pravinsang P.
Published: June 2024

In this book chapter, the authors explore the intricate relationship between urbanization and biodiversity conservation. Despite urban environments being traditionally associated with habitat loss and fragmentation, they hold immense potential as critical arenas for safeguarding biodiversity. The authors delve into innovative conservation strategies that capitalize on the unique opportunities offered by urban settings, including the utilization of unconventional spaces and the integration of Indigenous perspectives. Through case studies and examples, they highlight the importance of community involvement and citizen science initiatives in fostering urban biodiversity. By reconceptualizing urban areas as vital components of conservation efforts, the authors aim to ensure the survival and recovery of threatened species within their natural habitats. This chapter offers insights into how urban landscapes can be transformed into resilient ecosystems that coexist harmoniously with human communities.
O ensino da língua na Corte Imperial: estudo da ‘Grammatica analytica e explicativa da língua portuguesa’, de Ortiz e Pardal (1871)
Authors: Oliveira Fernando Rodrigues de , Molina Márcia Antonia Guedes
Published: June 2024

Com os objetivos de contribuir para a produção de uma história do ensino de língua portuguesa no Brasil e de compreender os diferentes aspectos envolvidos na adoção e circulação de dispositivos didáticos para esse ensino no século XIX, focaliza-se neste artigo a análise do livro ‘Grammatica analytica e explicativa da língua portugueza’, de José Ortiz e Candido Pardal, adotado oficialmente para uso nas escolas primárias do Rio de Janeiro entre as décadas de 1870 e 1880. Mediante as contribuições da Nova História Cultural e da História da Ideias Linguísticas, analisou-se a configuração textual dessa gramática, a qual se apresenta estruturada sob a ideia de gramática como arte de escrever e falar bem, tal como pressupunha o modelo greco-latino de base filosófica e geral. Verificou-se que a adoção dessa gramática se deu em meio à ausência total de debate pedagógico ou justificativas metodológicas que explicassem a necessidade de renovação dos materiais até então em uso, o que possibilita presumir que sua aprovação e consequente distribuição esteve ligada a interesses de natureza política e ao espaço de privilégio e poder de decisão que ocupava um de seus autores.
A Cluster of Severe Myositis with Rhabdomyolysis Identified During the Zika Virus Outbreak in Thiruvananthapuram, India, 2021
Authors: Niyas Vettakkara Kandy Muhammed , Arjun Rajalakshmi , Vijayan Deepak , Yadav Pragya D. , Muralidharan Raman , Thomas Sujith , Sahay Rima Rakeshkumar , Pookunju Shamnad , Murlidharan Praveen , Balan Satish , Deshpande Gururaj Rao , Sapkal Gajanan N. , Rajesh Subramonia Pillay , Mahendran Bhuvanesh , Chandran Suresh , Sasidharan Syamlal , Abraham Rachel , Leenadevi Kokkuvayil Raghavan
Published: June 2024

Background:

A cluster of patients with severe myositis and rhabdomyolysis was identified in a tertiary care hospital during the Zika virus (ZIKV) outbreak in Thiruvananthapuram district of Kerala state, India, 2021. We report their clinical features, laboratory investigations and virological studies.

Materials and Methods:

An electronic medical record based retrospective analysis of these cases was done. Clinical details, laboratory investigations including virological investigations were noted.

Results:

11 patients with severe myositis and rhabdomyolysis were admitted in July-August 2021. Most patients developed severe rhabdomyolysis with acute kidney injury. Virological investigations were available in six patients. ZIKV RNA was detected by reverse transcription polymerase chain reaction in urine sample of one patient. Four patients tested positive for anti-ZIKV immunoglobulin M (IgM) antibodies by ELISA. Among the four patients who tested positive for ZIKV by ELISA, two tested positive for anti-dengue IgM antibodies by ELISA; while in the other two, the test was equivocal. PRNT90 assay performed in all six patients showed flaviviruses cross-reactive neutralizing antibodies.

Conclusion:

Our observations point toward a possible association between ZIKV disease and severe myositis. Further epidemiological and virological studies are warranted.
Face Masks: Boon or Bane? A Multimethod Study on Utilization Pattern and Short-term Effects of Face Masks on Adults in Central Kerala
Authors: Kumar Varun V. , Thomas Ankita Mariam , Saji Liya Anna , Sebastian Shaliet Rose
Published: June 2024

Background:

Face masks have been an inseparable part of one’s day to day ensemble worldwide for over the past two years. There is no two opinion regarding the usefulness of face masks in the control of the community transmission of COVID-19. However the use of mask is not without adverse effects.

Objective:

To study the utilization pattern and short term effects of facemasks on health of study participants.

Materials and Methods:

A cross-sectional mixed method study was carried out among the 210 adult participants of age above 18 years. Variables were expressed using proportions. The qualitative data collected was analysed using thematic analysis and classified into themes and subthemes.

Results:

The present study found that there was a decrease in the incidence of allergies and headaches by 52% and 49 % respectively. An extensive majority of 134 (63.8%) study participants reported an increased incidence of sweating and disturbance around the orofacial region with continued usage pattern.

Conclusion:

On a positive note, in healthy populations, wearing a mask does not appear to cause any harmful physiological alterations on the health of the community.
Comparison of treatment outcomes between nonsurgical and percutaneous pinning of distal radius fracture in elderly
Authors: Hegazy Mohammed O. , Farag Hossam E. , Abdellatif Ahmed E.
Published: June 2024

Background

Distal radius fractures (DRFs) are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results.

Purpose

To introduce a systematic review and meta-analysis about the results of DRF treatment in the elderly with nonoperative treatment in comparison with percutaneous pinning.

Patients and methods

This meta-analysis and systematic review were conducted in accordance with PRISMA guidelines. Medline, Cochrane, EMBASE, and Google Scholar databases were searched until November 2020, using combinations of the following search terms: DRF, wrist fractures, Colles fractures and Smith fractures, conservative treatment, nonoperative treatment, nonsurgical treatment, surgical treatment, operative, pinning, elderly, and older. Reference lists of relevant studies were manually searched.

Results

In total, five studies were included from 2005 to 2011 with total cases 265. There was statistically significant heterogeneity in the studies (I2=86.21%, P<0.0001). Using the random-effect model, the outcome results revealed that extension was significantly different in percutaneous pinning and casting group versus nonsurgical group (mean, 95% confidence interval: 69.89–93.69) with absence of publication bias.

Conclusion

The outcome results revealed that there was no significant difference between the nonsurgical and percutaneous pinning treatments of DRF in the elderly regarding grip strength, pronation, supination range of motion, and ulnar variance (pre). We also found that there was no clinically significant difference in the functional (Patient-Rated Wrist Evaluation and Disabilities of Arm, Shoulder and Hand) scores. Thus, the two methods have similar results.
Intra-articular platelet-rich plasma versus hyaluronic acid injections in patients with advanced knee osteoarthritis
Authors: El-Zayat Ahmed Ramzy , El Sayed Haytham
Published: June 2024

Background

Osteoarthritis (OA) is a chronic disease that can be treated by several modality, one of which intra-articular injection. Hyaluronic acid (HA) and platelet-rich plasma (PRP) were approved in the management of OA grade 2 and grade 3 with good response. The aim of this study was to compare the effect of intra-articular injection of PRP versus HA in patients with knee OA grade 4.

Patients and methods

The study was carried out on 67 patients having knee OA grade 4, who were divided into two groups: group 1 included 33 patients who were treated with intra-articular injection of leukocyte-low PRP, and group 2 included 34 patients who were treated with intra-articular injection of high-molecular-weight hyaluronic acid. Both groups were evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and MRI before and 6 months after injection.

Results

In group 1, there were no statistically significant improvements in total WOMAC score and WOMAC score of pain, stiffness, and function in both knees and no statistically significant difference in cartilage thickness of the knee measured by MRI. In group 2, there were statistically significant improvement in total WOMAC score and WOMAC score of pain and function in both knees, no statistically significant improvement in WOMAC score of stiffness, and no statistically significant differences in cartilage thickness of the knee measured by MRI. Comparing the two groups, intra-articular injection of HA showed significant improvement than that of PRP in the management of grade 4 knees OA.

Conclusions

The effect of intra-articular injection of HA is better than that of PRP in the management of grade 4 knees OA.
MRI versus diagnostic arthroscopy of the knee to evaluate meniscal tears
Authors: Ali Hesham , Yehya Mohamed
Published: June 2024

Background

This study compares between the results of MRI and diagnostic arthroscopy of the knee to evaluate meniscal tears.

Patients and methods

A total of 32 patients who had undergone MRI of the knee between March 2018 and May 2020 were selected for the study in whom arthroscopy had also been performed. All knees had been investigated for possible meniscal tears. The MRI results were compared with those of arthroscopy. The arthroscopic results were used as the gold standard to recognize if meniscal tear is present or not. Of the 32 patients, 24 were males and eight were females. The average age was 31 years (range, 22–45 years). Patients who had a discoid lateral meniscus, history of meniscal surgery, or prior surgery on the injured knee were excluded from the study. The sensitivity, specificity, and accuracy were calculated based on arthroscopic findings.

Results

The time between MRI and arthroscopy was 7–10 weeks (average, 8 weeks). In certain cases, a difference was noted between the MRI and arthroscopic findings for revealing the meniscal tears. False-positive MRI result was found in one (3.1%) patient and false-negative MRI result was found in five (15.6%) patients. The accuracy of MRI in the evaluation of meniscal tears was 90.58%.

Conclusions

MRI is a noninvasive and exceptionally a sensitive method of investigation that may detect early and slight abnormalities within the menisci. However, MRI is not 100% accurate; if MRI result is reported as negative but the patient keeps complaining of continuing symptoms, then arthroscopy should be considered.
Short-term evaluation of combined Scarf and Akin osteotomies for treatment of hallux valgus
Authors: Zakaria Ahmed R. , Bayomy El Sayed M.
Published: June 2024

Background

Despite Scarf osteotomy was described earlier in the 20th century, it was popularized later in 2000 after modification of the original technique. The combined Scarf–Akin osteotomies were described for surgical correction of the hallux valgus, but with no significant consideration for the patient satisfaction.

Patients and methods

Twenty-three patients with unilateral painful hallux valgus deformity were treated with combined Scarf and Akin osteotomies. All patients were evaluated clinically (using American Orthopedic Foot and Ankle Society-Hallux Metatarsophalangeal–Interphalangeal scale scores) and radiologically (hallux valgus angle, intermetatarsal angle, union, evidence of degenerative changes, and joint congruity) after 12 months of follow-up. All the patients were then asked about their satisfaction and if they would undergo the same surgery under similar circumstances in the future.

Results

There were 15 females and eight males with an average age 38.8 ± 2.4 years. The mean preoperative American Orthopedic Foot and Ankle Society was 55.4 that significantly improved to 87.2 postoperatively (P<0.001). There was a significant reduction of the mean hallux valgus angle and the mean intermetatarsal angle preoperatively and postoperatively (P=0.03 and 0.034, respectively). One patient complained of a prominent screw postoperatively, while two patients suffered from superficial wound infection. At 12 months postoperatively, all operated patients were satisfied with their results and indicated that they would be happy to undergo surgery again under similar circumstances.

Conclusion

Despite the short follow-up period in our study, the combined Scarf and Akin osteotomies are a safe and effective method for treatment for hallux valgus deformity that provides statistically significant clinical and radiographic improvements with excellent patient satisfaction.

Level of evidence

Level-IV case-series study.
Open reduction and internal fixation of depressed intra-articular calcaneal fractures through a miniopen approach
Authors: Abdelrazek Begad H.M.Z. , Waly Mohamed R.
Published: June 2024

Background

Fractures of the calcaneus pose a great challenge both to surgeons and patients. They are considered life-changing injuries. Anatomical reduction of fragments is one of the important variables affecting outcome. Extensile lateral approach has been used widely to facilitate good visualization and reduction. Skin complications like wound infection and dehiscence are a major concern. Therefore minimally invasive approaches came to fame. However, the use of less rigid fixation in minimally invasive techniques has led to inferior results.

Aim

The aim was to combine the merits of rigid fixation and minimally invasive approaches.

Patients and methods

Twenty-three patients with calcaneal fractures were operated upon and followed for a mean of 6 months. All patients were operated upon in the prone or lateral position under tourniquet. A miniopen sinus tarsi approach was used for fracture reduction and fixation. The latter was achieved using a calcaneal miniplate and screws. Patients were assessed radiographically for restoration of Bohler and Gissane angles, clinically using American Orthopedic Foot and Ankle Society score (AOFAS) and the visual analog score for pain.

Results

All patients showed a significant improvement in the mean Bohler and Gissane angles. The majority of the patients scored very good on the AOFAS score, the mean being 83 ± 4. The mean visual analog scale was 3. Mean time to full weight bearing was 12.5 ± 2 weeks after full radiological union was achieved.

Conclusion

Miniplate fixation through miniopen approach combines the merits of open reduction and internal fixation and minimally invasive techniques. Longer follow-up is however required to establish its superiority over screw-only fixation constructs.
Primary treatment of femoral neck fracture in young adults using valgus osteotomy and fixation by dynamic hip screw combined with cannulated screw
Authors: El Naggar Ahmed , Nafea Waleed , Fawzy Mohsen
Published: June 2024

Background

For most femoral neck fractures in young adults, the recommended fixation technique is with multiple cancellous lag screws. The Pauwels types I and II fractures are the most amenable to this type of fixation. A Pauwels type III fracture is a vertically oriented fracture with more than 50° inclination angle from the horizontal line on an anteroposterior radiograph. This fracture is both axially and rotationally unstable and experiences increased shear forces leading to a higher rate of failure and nonunion. The treatment of this type of fracture remains controversial. Various treatment modalities have been proposed to improve the outcome of the treatment, such as treatment with valgus osteotomy and fixation with dynamic hip screw (DHS) and cannulated screws. The valgus osteotomy converts the shear force into compression increasing the stability of the implant.

Patient and methods

A total of 12 patients (10 males and two females) with acute Pauwels type III femoral neck fractures in the age group 22–48 years (mean, 28.5 years) were managed with valgus osteotomy and fixation with DHS and cannulated screws. The patients were followed up from 1 to 3 years (mean, 20 months).

Results

Clinically, the patients were evaluated according to the Harris Hip Score. Excellent results were achieved in eight patients, good in three, and fair in one. No evidence of infection occurred in any patient. Radiologically, the fracture united in all cases 6 months postoperatively. Avascular necrosis occurred in one case.

Conclusion

Vertical femoral neck fractures in young adults can be safely managed using valgus osteotomy and fixation with DHS augmented by cannulated screws.
Making short-segment posterior fixation more successful in treatment of unstable thoracolumbar fracture
Authors: Nafea Waleed , Fawzy Mohsen
Published: June 2024

Background

Short-segment posterior fixation (SSPF) is liable to failure in unstable thoracolumbar fracture because of disruption of load-bearing anterior column. Intermediate screw and intracorporeal transpedicular grafting increase the stability of construct and enhance fracture healing, thereby avoiding long-segment posterior fixation and demanding anterior surgery in unstable thoracolumbar fracture.

Patients and methods

There were 20 patients with unstable thoracolumbar fractures treated with SSPF and TIG. These patients were followed for at least 14 months for to assess clinical improvement and the ability of the technique to reduce the fractures and maintain kyphosis correction with absence of implant failure.

Result

All patients were operated within the first week, with a mean time delay of 3.4 days. There were no cases with deep postoperative infection, iatrogenic dural tear, deterioration of neurologic deficit, or implant failure. The mean local kyphosis angle was 22.9° preoperatively, 9.7° postoperatively, and 11° at final examination. The mean anterior height collapse was 55.9% preoperatively, 87.5% postoperatively, and 79.8% at final examination.

Conclusion

SSPF with intermediate screw and TIG is an effective and safe technique in the treatment of unstable thoracolumbar fracture, with good clinical and radiological results.
Is it sufficient to reconstruct the superficial medial collateral ligament only in medial knee instability? A comparative study
Authors: Rashwan Amr S.S.A.
Published: June 2024

Introduction

The medial collateral ligament (MCL) is the primary static stabilizing structure on the medial aspect of the knee, contributing up to 78% of the restraining force to valgus loads. Sims and Jacobsen reported that 99% of medial injuries requiring operation had an associated injury to the posterior oblique ligament (POL), which was overlooked in many reports.

Hypothesis

Reconstruction of both superficial MCL and POL might be clinically advantageous in regaining valgus stability compared to superficial MCL reconstruction alone. Both groups were compared regarding the following parameters: clinical evaluation according to the Lysholm and the International Knee Documentation Committee rating scoring systems and stress valgus x-ray.

Patients and methods

Between January 2015 and April 2017, we conducted a prospective randomized analytical study, including 30 patients suffering from grade III MCL injury. They were divided into two groups (A) and (B). For group A, 15 patients underwent superficial MCL reconstruction only, while for group B, concomitant reconstruction of the superficial MCL and POLs.

Results

The mean Lysholm score in group A preoperatively was 37.9±8.1 and became 91.0±6.3 postoperatively with P value less than 0.001, while in group B, it was 38.7±11.4 and became 92.9±8.3 with P value less than 0.001. There was no statistical significant difference between both groups postoperatively (P=0.478). Regarding ligament examination of International Knee Documentation Committee score postoperatively, the frequency of cases of A, B, C, and D grades of Lachman in group A was 53.3, 40, 6.7, and 0%, respectively, versus 80, 20, and 0% in group B, and this difference was not statistically significant (P=0.4). According to valgus stress test, the frequency of cases of A, B, C, and D grades in group A was 66.7, 33.3, and 0%, respectively, versus 73.3, 26.7, and 0% in group B, and this difference was not statistically significant (P=0.7). The stress valgus x-ray evaluation of the degree of gapping in extension in group A was 1.7±0.5 versus 1.3±0.7 in group B and this difference was not statistically significant (P=0.1), and the degree of gapping in flexion in group A was 1.8±0.4 versus 1.4±0.7 in group B and this difference was not statistically significant (P=0.1).

Conclusion

There was no difference in the clinical and the radiological outcome between the reconstruction of the superficial MCL alone versus the concomitant reconstruction of the POL in patients with medial knee instability.
An Interesting Case of Bleeding per Rectum in a Patient with Chronic Myeloid Leukemia
Authors: Rajin Porselvi , Pandurangan Prabu , Kannan Deepak , Kumar Aishwarya Mahesh
Published: June 2024

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by uncontrolled growth of myeloid cells. The challenge in diagnosis of rectal bleeding in a patient with CML lies in differentiating whether the bleed is due to underlying lymphoma related or any unrelated conditions. Here we report a case of 73-year-old woman with CML who presented with recurrent rectal bleeding and was diagnosed with a infectious disease as a cause of bleeding per rectum. We like to emphasise the need for broader differential diagnosis in a case of bleeding per rectum with underlying CML on immunosuppresives.
Salivary Interleukin-6 as a Non-Invasive Biomarker for Chronic Periodontitis and Tooth Loss in Type 2 Diabetes
Authors: Sangappa Sunila Bukanakere , Babu Harsha Mysore , Savadi Ravindra C. , Krishnamurthy Praveen T. , Ravi Kiran Ammu V. V. V.
Published: June 2024

Background:

Periodontitis and type 2 diabetes are chronic inflammatory diseases that increase inflammatory Interleukin-6 (IL-6) levels that induce the production of advanced glycation end products (AGEs) causing receptor activator of nuclear factor-kappa B ligand (RANKL) expression on osteoclasts, contributing to further alveolar bone destruction.

Aim:

To assess the role and diagnostic potential of salivary IL-6 (SIL-6) in the detection and evaluation of chronic periodontitis (CP) and tooth loss in type 2 diabetes mellitus (T2DM).

Materials and Methods:

This cross-sectional study comprised 240 subjects aged 30-69 years with minimum of 15 natural teeth. Fasting, unstimulated whole saliva was collected, full-mouth intra-oral examination and periodontal evaluation were performed using PCP-UNC 15 probe and glycaemic (HbA1c) levels were analysed by high-performance liquid chromatography (HPLC) method. Subjects were categorised into four groups of 60 participants each: Group 1 (controls); Group 2 (CP); Group 3 (T2DM with CP); Group 4 (T2DM with CP and tooth loss). Salivary IL-6 levels were quantitatively assessed by enzyme-linked immune sorbent assay method.

Results:

Average SIL-6 levels were significantly elevated in Group 4 (T2DM with CP and tooth loss) (P = 0.001) and in severe periodontitis (P = 0.001). Karl Pearson Correlation found a significant association between average SIL-6 and average periodontal pocket depth (APPD) (r = 0.180), average clinical attachment loss ≥3 mm (ACAL3) (r = 0.289) and severity of periodontitis (r = 0.3228). The receiver operating characteristic (ROC) curve depicted an overall sensitivity of 53.3%, specificity of 68.6% and accuracy of 60% in the detection and assessment of CP in T2DM with tooth loss.

Conclusion:

IL-6 in saliva is a valuable, non-invasive biomarker in the detection and evaluation of CP in T2DM with tooth loss.
Accidental Displacement of Third Molar Root into the Lingual Pouch
Authors: Agarwal Mudit , Muthunagai R. , Agarwal Amit , Aeran Himanshu
Published: June 2024

Third molar surgery is the most common procedure performed by oral and maxillofacial surgeons. A thorough understanding of the complications associated with this procedure will enable the practitioner to identify and counsel high-risk patients, appropriately manage more common complications, and be cognizant of less common sequelae and the most effective methods of management. We present a case of displaced third molar root into the lingual pouch (submandibular space) and ways to prevent and manage this rare complication. In this article, we have compared different surgical approaches for the removal of displaced root from the submandibular space.
Diode Laser-Assisted Bridge Flap
Authors: Gupta Shruti , Das Neelam , Suruchi  , Pratik Shashwat
Published: June 2024

Mucogingival problems are associated with recession of gingival margin, shallow vestibular depth, and gingival margin pull by aberrant frenum. Till now, various individualistic and successful surgical techniques have been described in the literature for mucogingival problems. These case series enumerate the gingival recession cases, managed by bridge flap technique using diode laser which is a single-step procedure to cover the earlier exposed root surfaces and extend the width of the attached gingiva. Postsurgical parameters were recorded at 6 months and 1 year.
Correlation of Geographic Tongue with Early Childhood Caries in Pediatric Patient
Authors: Mahant Sucheta , Thakur Sanjay Kumar
Published: June 2024

Background:

Benign migratory glossitis(GT) is a recurrent asymptomatic lesion found on the tongue) shows multiple, circinate, and irregular erythematous patches surrounded by slightly elevated white-colored keratotic band. Early childhood caries (ECC) is one of the most common oral disease in children in developing countries.

Aim:

To find correlation of geographic tongue, anaemia with Early Childhood Caries in children.

Result:

Early childhood caries (ECC) was found to be high in children with Geographic tongue. In this case series, anemia was also found to be contributory factor for both GT and ECC.

Conclusion:

GT, a benign recurrent condition on tongue found in children, has ECC can be associated with fissured tongue and anemia.
Miniature Pediatric Dental Office Model
Authors: Singh Shivani , Mendiratta Priya , Saraf Bhavna Gupta , Sheoran Neha , Kapil Disha , Singh Ritu
Published: June 2024

Background:

Dental fear and anxiety remains the most common emotions experienced by the child who visit the pediatric dentist. The success of pedodontics is determined by the odontologist's capability to gain the confidence and maintain the cooperation of the child.

Objective/Aim:

The aim of the study was to assess the behavior and anxiety levels of school-going children in a dental setting using a Miniature Pediatric Dental Office Model during the first dental visit of the child.

Study Design:

This cross-sectional research was carried out in a dental institute in the department of pediatrics and preventive dentistry. The study protocol was explained to the parents of 3–9-year-old children. Demographics were elicited from the parents and their correlation with the placement of the doll in the pediatric dental office model and a modified Frankl's behavior rating scale was used to assess the child's behavior.

Results:

Of 84 participants, 47 children were under the age of 6 years and 37 children were ≥6 years of age. In the doll placement test, the majority (36.9%) of the children preferred pattern 2 (the child is on the chair, the dentist is inside the operatory, the mother is inside the operatory, and the father is outside the operatory) in the doll placement test, and the least (8.3%) preferred pattern 1 (the child is on the chair, the dentist is inside the operatory, the father is inside the operatory, the mother is outside the operatory). Thirty-four percent children up to the age of 6 years exhibited a mix of negative-positive behavior, and 43.2% of children aged 6 years showed a positive behavior according to the modified Frankl's rating scale.

Conclusion:

The doll placement test using a miniature pediatric office aided us in determining the child's anxiety level during their first dental visit. To achieve emotional support and avoid the impact of traumatic separation, especially in younger children, our study showed that mothers should be present in the dental office to remove behavior-related problems.
Simultaneous occurrence of tubercular cervical and mediastinal lymphadenopathy in two members of the same family
Authors: Tandon Rajeev , Agarwal Anoushka , Kumar Prabhat
Published: June 2024

Tuberculosis (TB) is a major public health problem, with India alone accounting for one-fifth of the global disease burden. Lymph node TB (LNTB) refers to Mycobacterium tuberculosis (MTB) infection of the lymph nodes and may occur as the sole manifestation of TB infection or alongside pulmonary or miliary TB. LNTB is the most common form of extrapulmonary TB (EPTB) in India, accounting for around 35% of EPTB cases, with cervical lymphadenopathy being the most common site, followed by mediastinal lymphadenopathy. Tubercular mediastinal lymphadenopathy, however, in the absence of a parenchymal lesion, is a rare presentation and is seen in only 0.25 to 5.8% cases. Often associated with mild or no symptoms, these cases are often diagnosed incidentally. This case report summarizes an unusual occurrence of massive tubercular mediastinal lymphadenopathy simultaneously in two members of a family.
25-OH vitamin D3 level in tuberculosis
Authors: Chatterjee Surajit , Biswas Pratik , Bose Rituparna , Agarwal Megha
Published: June 2024

Introduction:

The immunomodulatory role of 25-hydroxycholecalciferol (25-OH vitamin D3) has been under evaluation for a long time. As tuberculosis (TB) and MDR-TB continue to be global health problems, evaluation of the role of 25-OH vitamin D3 deficiency in TB and its relation with bacillary load may help us in formulating a preventive therapy for the disease.

Aims and Objectives:

To assess serum 25-OH vitamin D levels in patients suffering from TB for the first time and to find the relation between serum 25-OH vitamin D levels in patients with bacillary load in respiratory samples.

Results:

The serum 25-OH vitamin D level was analyzed for bacillary load in the respiratory specimen in this study, which revealed that as the serum 25-OH vitamin D level decreased, the bacillary load was found to increase in the respiratory specimen.
COVID-19: Two years in the history and still a mystery! A case series of three interesting cases
Authors: Anand Shweta , Patro Mahismita , Gothi Dipti , Malhotra Nipun , Jain Anshul
Published: June 2024

COVID-19 was first identified as a new disease in December 2019. It’s now more than 2 years since its discovery and much research has been done. Still, there are some aspects in the pathogenesis and management that have not been completely understood. The cornerstone of therapy lies in the supportive treatment to maintain oxygenation. To the best of our knowledge, there are no earlier reports of severe COVID-19 with respiratory failure that have recovered without supplemental oxygen therapy. We present three unique cases of severe COVID-19 who were managed at home despite hypoxemia. The scarcity of oxygen during the second wave in Delhi deprived them of essential oxygen therapy. The patients survived and recovered well. Happy hypoxemia and hypoxic preconditioning played their role in symptoms tolerance. Therapeutically, the role of awake proning and steroid in the management cannot be undermined. Lastly, the technology in terms of video consultation definitely was useful in allaying the anxiety and guiding the right treatment.
Tuberculosis preventive therapy – Clinical practice issues
Authors: Ghoshal Aloke Gopal , Sarkar Supriya , Halder Arup Kumar , Dhua Aparup , Das Chandra Sekhar , Das Parthajit , Chowdhury Abhra Chandra , Thakur Sanjay Kumar Daulat , Majumder Anindya Kishore
Published: June 2024

Latent tuberculosis (LTB) is now termed as tuberculosis infection (TBI). Prevention of active TB disease by treatment of tuberculosis infection is a critical component of the National Strategic Plan 2017-25 for TB Elimination in India by 2025. Programmatic Management of Tuberculosis Preventive Therapy (PMTPT) is a public health document while treatment of tuberculosis infection is essentially a clinical approach. Here we have attempted to address the gray areas answering from clinical viewpoint.
A Case of Type B Aortic Dissection: The Role of Transesophageal Ultrasound Guidance in Thoracic Endovascular Aortic Repair
Authors: Trimarchi Giancarlo , Benedetti Giovanni , Palmieri Cataldo , Rizza Antonio
Published: June 2024

Thoracic endovascular aortic repair (TEVAR) plays a central role in managing acute and chronic aortic pathologies. With the advancement of transcatheter structural heart procedures, echocardiography has become a key in procedural guidance. Despite consensus on its use for cardiac interventions, ultrasound assistance in aortic procedures is not widely standardized. A 71-year-old obese man with chronic type B aortic dissection underwent a TEVAR procedure, using a single-branched aortic stent graft (Endovastec™ Castor™) and with transesophageal ultrasound guidance. The preprocedural assessment confirmed the presence of aortic dissection of the descending thoracic aorta with a posterior true lumen (TL) and an anterior false lumen (FL), normal aortic valve anatomy and function, normal left ventricular function, absence of intracavity thrombus, and absence of aortic plaques that could prevent the optimal implantation of the stent graft. During the procedure, a transesophageal echocardiogram (TEE) monitored the positioning of the guide wires, the arrival of the catheter of the thoracic endoprosthesis, and then the implantation of this at the level of the aortic arch and the descending thoracic aorta. Postprocedure TEE evaluation underlined full stent-graft deployment without leaks and successful exclusion of FL with the beginning of thrombosis. Angiography confirms the exclusion of the aneurysm and the absence of endoleaks. This clinical case demonstrates how transesophageal echocardiographic guidance can improve the TEVAR procedure by minimizing fluoroscopy time, contrast medium use, and enabling a better assessment of the dissection anatomy with real-time monitoring of both the TL and the FL. In conclusion, TEE can serve as an auxiliary intraoperative imaging tool to provide good information before, during, and after the procedure, increasing the success and safety of the TEVAR.
Importance of Coronary to Pulmonary Artery Fistulae Incidentally Detected on Echocardiography
Authors: Dedeoğlu Savas , Bornaun Helen
Published: June 2024

Backround:

Coronary artery fistula (CAF) is an abnormal precapillary connection between a coronary artery and an adjacent structure. The incidence of CAF in children as estimated from echocardiography is 0.06-0.2%. We aimed to establish the follow up results of clinically silent CAF found incidentally by colour Doppler echocardiography.

Methods:

The study included patients with abnormal fistulous flow in the pulmonary artery who had been studied between 2008 and 2020. Patient demographics, clinical findings, indication for echocardiography, electrocardiographic findings at presentation, follow-up times and any fistula progress were obtained from the recorded files.

Results:

Among the 78,000 patients who had had an echocardiographic examination, 118 had been found by colour Doppler flow mapping to have a clinically silent CAF. The exit point of CAF was clearly visualized with colour Doppler in all patients. In most patients the CAF was located around the pulmonary valve and the bifurcation; in 76 patients, it was on the aortic side of the main pulmonary artery, 26 patients had fistulous flow through the anterior wall of the main pulmonary artery, two had the right ventricular outflow tract (RVOT) as the exit site, for 12, it was the right pulmonary artery, and for another two, the left pulmonary artery. The 118 patients had ongoing follow-up to mean 41 months. There was no spontaneous resolution of fistula. The patients were asymptomatic without intervention and with ongoing echocardiographic evidence of small CAF at the last follow-up.

Conclusion:

We recommend the treatment strategy for paediatric patients should be individualized according to fistula origin, size, chamber enlargement, draining site, age of the patient and cost of imaging during follow up.
Oculopalatal Tremor: A Narrative Review of Pathophysiology, Clinical Presentation, and Management Strategy
Authors: Ray Ravi Kumar , Verma Deepak , Sah Michael Kumar , Singh Roshan , Das Merina , Mehta Binod , Yadav Pooja , Chandra Avinash
Published: June 2024

Oculopalatal tremor (OPT) is a complex neurological disorder characterized by acquired oscillatory nystagmus synchronized with tremors of the soft palate and other muscles. The article discusses the pathology, clinical manifestations, and diagnostic methods of OPT. A comprehensive literature search was conducted in PubMed and Google Scholar using keywords and relevant articles were studied and analysis was done. Vertical pendular nystagmus is the hallmark, while other muscles such as the neck, head, larynx, and diaphragm may be affected. The pathophysiology is due to lesions of the Guillain–Mollaret triangle (GMT), which causes hypertrophy of the inferior olivary. Neuroimaging reveals hypertrophy of the inferior olivary medulla, which aids in diagnosis. Drug treatments such as gabapentin and memantine can reduce nystagmus, although the visual quality may not permanently improve. The study explores the complexity of the pathophysiology and clinical presentation of OPT. New treatments that target abnormal neuronal connections with drugs such as quinine or mefloquine are being investigated. The potential of deep brain stimulation (DBS) remains uncertain, with promising aspects but limited efficacy. A synergy of technology and treatment is proposed to advance OPT treatment. Future studies will aim to clarify the nuances of responses to OPT and may include a comparative study of medication and DBS. OPT is mainly caused by a disruption in GMT/dentato-rubro-olivary pathway, presenting with tremor, and nystagmus is diagnosed with magnetic resonance imaging. Gabapentin and memantine have proved to be effective in improving the condition except for visual changes.
Effect of Murr makki (Commiphora myrrha) in abnormal vaginal discharge – A pre and post interventional study
Authors: Rajak Vandana , Shameem Ismath , Meherunissa
Published: June 2024

Background and Objectives:

Abnormal vaginal discharge (AVD) is the most common complaint in reproductive age group women. The objective of the study is to evaluate the effect of Murr makki (Commiphora myrrha Linn) in AVD.

Materials and Methods:

Married women in the age group of 18–45 years presenting with complaint of AVD irrespective of pathology were included in the study and patients with recurrent vaginal discharge, sexually transmitted diseases, pelvic inflammatory diseases, systemic diseases, and malignancy, using antibiotics or contraceptives, pregnant and lactating women were excluded. Three grams Murr makki powder was administered orally with Baiza Neem Baristh (half-fried egg) in empty stomach once daily for 3 days. Clinical improvement (changes in white discharge per vaginum, pruritis vulvae, low back ache was assessed on three-pointer scale), and laboratory improvement (changes in vaginal pH and wet mount) was assessed during the trial. Follow-up was done weekly once for 2 weeks during the study period to assess the effect of treatment. Results were analyzed using Student’s t-test.

Results:

About 76.7% of patients showed clinical improvement and 23.3% of patients had no improvement, while 43.3% of patients had laboratory improvement and 56.7% had no improvement.

Interpretation and Conclusion:

Murr makki can offer an appropriate safe alternate medicine for women with AVD, who like to use herbal medicines, or who are resistant to antibiotics. Further, no adverse effect of Murr makki was reported during the trial and safety parameters are within normal limits, thus indicating that Murr makki can be safely used in the prescribed dosage in patients with AVD.
A journey through Unani medicine in the West: An exploratory case study
Authors: Graz Bertrand , Itrat Malik
Published: June 2024

The ancient Hippocratic medicine, which prevailed in Europe for nearly two millennia, has undergone a transformation and found contemporary expression in the form of Unani medicine. This tradition, rooted in the Ionian (Greek) approach, revolves around the theory of humors. Unani medicine migrated from Greece to the Arab world and subsequently to India and Pakistan, where it has been widely embraced and practiced. Exploring the educational journey of a practitioner in Liverpool has revealed the existence of an international network of Unani medicine. Many of its teachers and practitioners originate from the Indian subcontinent. This once-dominant therapeutic system is experiencing a resurgence in the West, particularly within the realms of complementary, alternative, or integrative medicine. This article aims to highlight the historical journey of Unani medicine, emphasizing its evolution from ancient Greece to its current status as a relevant and practiced system in the West.
CADCare: Smart System for CHD Identification & Sensor Alerts
Authors: Patle Arti , Ajalkar Deepika , Jain Atharva A , Fulsundar Yashashree D , Survase Chaitanya P , Parodhi Rohit A
Published: June 2024

INTRODUCTION: Cardiovascular diseases, particularly coronary artery disease (CAD), present a global health challenge, necessitating effective detection and diagnosis methods for early intervention. Various machine learning and deep learning approaches have emerged, utilizing diverse data sources such as electrocardiogram (ECG) signals and clinical features to enhance CAD detection. Additionally, circadian heart rate variability (HRV) has been explored as a potential diagnostic marker for CAD severity. This research aims to contribute to the burgeoning field of medical AI and its application in cardiology.OBJECTIVES: This study seeks to develop a Comprehensive Coronary Artery Disease Detection System integrating real-time heart rate monitoring and CAD prediction via an Android application. The objectives include seamless data transmission, efficient cloud-based data management, and the utilization of AI models, including ANNs, CNNs for ECG images, and hybrid models combining clinical and ECG data, to improve early CAD detection and management.METHODS: The system architecture involves integrating key sensors, an Arduino microcontroller, a Bluetooth module, and AI models to facilitate early CAD detection. An Android application complements the system, offering heart rate monitoring and CAD prediction using various data sources. Cloud computing is employed for efficient data management and analysis.RESULTS: The developed system successfully integrates cutting-edge technology to enhance CAD detection, achieving accurate and efficient results in real-time heart rate monitoring and CAD prediction.CONCLUSION: The Comprehensive Coronary Artery Disease Detection System, leveraging AI and cloud computing, contributes to proactive health monitoring and informed decision-making in CAD management and prevention, thereby addressing a critical need in cardiovascular health care.
Dairy wastewater treatment employing microencapsulated Pseudomonas aeruginosa on low acyl gellan gum
Authors: Cuello Rafael Emilio González , Alcázar Lena Beatriz Morón , Castellanos Heliana Milena
Published: June 2024

This study assessed the ability of Pseudomonas aeruginosa, microencapsulated in gellan gum, to decontaminate dairy wastewater and explored the potential reuse of microcapsules. P. aeruginosa was microencapsulated using the internal ionic gelation technique, employing low-acyl gellan gum as the wall material. The free and microencapsulated P. aeruginosa were inoculated into 150 mL of sterile wastewater and incubated in a shaking flask (150 rpm) at 30°C. Subsequently, the Baranyi Model was employed to calculate the growth parameters of P. aeruginosa. Concurrently, Biological Oxygen Demand (BOD) and Chemical Oxygen Demand (COD) were determined. The obtained results indicated that the microencapsulation process reduced the growth rate of the encapsulated microorganism. However, the microencapsulated bacteria achieved COD and BOD reduction percentages of 61.54% and 64.05%, respectively. Similarly, when reusing the microcapsules, removal percentages exceeding 57.00% were achieved. These findings could have significant implications for the industry in terms of reducing effluent contamination caused by substantial amounts of pollutants.
Keywords: dairy wastewater, gellan gum, microencapsulation, Pseudomonas aeruginosa.