bluuebunny/crossref_metadata_2025 huggingface dataset:
La psychiatrie de l’enfant en France, une affaire de l’État ?
Authors: Coffin Jean-Christophe
Published: December 2023

La psychiatrie de l’enfant en France : une affaire de l’État ? L’article explore les relations entre l’État et les psychiatres, à partir notamment de Georges Heuyer et Édouard Toulouse. Au cours de la période de l’entre-deux-guerres, ces psychiatres construisent une expertise (diagnostics et solutions pour l’enfant) car ils veulent être considérés comme des experts et des interlocuteurs de l’État pour convaincre de l’urgence d’une politique de prise en charge de l’enfant. L’article s’intéresse aux moyens mis en œuvre : sensibilisation, dénonciations, et participation à des commissions officielles, telles sont les principales caractéristiques de leur stratégie. L’article propose de considérer ces psychiatres comme des figures de psychiatre éducateur et d’entrepreneur de morale. Il est également discuté de leurs diagnostics et de leurs options par quelques-uns de leurs jeunes collègues qui incarnent la psychiatrie de l’après seconde guerre mondiale.
Patient Dossiers and Clinical Practice in 1950s French Child Psychiatry
Authors: Gross Solomon Susan
Published: December 2023

Cet article examine certaines pratiques de la psychiatrie de l’enfant dans la France d’après la deuxième guerre mondiale à partir de dossiers de patients. Central à cet article est le cas d’une jeune fille qui, depuis sa première enfance, fut placée dans une institution d’enfants dirigée par une institution juive de service social, l’Œuvre de secours aux enfants (OSE). Entre 12 et 15 ans, la jeune fille fut hospitalisée à trois reprises dans le service de psychiatrie du Dr Georges Heuyer puis de son successeur Léon Michaux. La comparaison entre les épais dossiers de l’OSE et de l’hôpital de la Salpêtrière de cette jeune fille nous permet d’identifier avec précision le processus de fabrication d’un dossier de patient. La lecture parallèle des deux séries de dossiers révèle des obstacles structurels pour la coopération des institutions françaises de psychiatrie de l’enfant.
Notariat et infrajustice : le rôle de médiation du notaire sous l’Ancien Régime à travers la pratique de Pierre Thoumas de Bosmie, notaire royal à Limoges (1735-1740)
Authors: Trayaud Stéphane
Published: December 2023

Les historiens du notariat n’ont accordé jusqu’à présent qu’une attention limitée à un phénomène que les historiens du droit ont, quant à eux, cerné depuis de nombreuses années : la fonction de médiateur du notaire sous l’Ancien Régime. Ce dernier a en effet été trop souvent cantonné dans le rôle passif du praticien chargé de traduire par écrit les volontés des parties, en omettant sa dimension sociale. Cette contribution s’attache donc à replacer l’infrajustice dans la pratique notariale en présentant l’état de la recherche sur le sujet, mais aussi déterminer la place de cette notion dans l’activité professionnelle de Pierre Thoumas de Bosmie, notaire royal à Limoges (1735-1739).
Vigny lecteur de Corneille
Authors: Chotard Loic
Published: December 2023

Résumé
Le Christ aux Oliviers: Vigny et Nerval
Authors: Chamarat-Malandain Gabrielle
Published: December 2023

Résumé
Vigny et l'homme des lettres
Authors: Sabourin Lise
Published: December 2023

Résumé
Le maire, la police administrative et la pandémie : l’affirmation de la prééminence de l’État
Authors: Vallar Christian
Published: December 2023

Le maire aurait dû être un acteur essentiel dans la lutte contre la Covid-19 au regard de ses compétences en matière sanitaire entrant dans le cadre de ses pouvoirs de police administrative. L’histoire, déjà, le justifiait. La loi des 16-24 août 1790 confiait aux maires des attributions de police en matière sanitaire, texte qui fut le fondement de l’article L. 2212 du CGCT habilitant le maire à prendre toute mesure pour assurer la salubrité publique. D’autres textes furent pris dans ce sens. Cependant, aujourd’hui, c’est l’État qui a renforcé ses pouvoirs en matière de police sanitaire. En fin de compte, les maires sont restés cantonnés à une fonction de complément au rôle de l’État, sous le contrôle du juge administratif.
Impact of Post-mortem PCR Testing on Lead Time of the Medico-legal Death Investigation. A Retrospective Study During the COVID-19 Pandemic in a Tertiary Care Hospital in Sri Lanka
Authors: Appuhamy H. D. S. C. P. , Samaranayake R. , Manjika S.
Published: December 2023

Introduction: The lead time is defined as the time between the beginning of a process or project and the appearance of its results. A post-mortem nasopharyngeal swab is the preferred specimen and Real-time reverse transcriptase-polymerase chain reaction-based assays remain the “gold standard” for the detection of severe acute respiratory syndrome coronavirus 2. Although the RT-PCR provides a relatively rapid result (average 6 hours) the process of post-mortem specimen collection, transportation, and real-time polymerase chain reaction testing lead to the increased time duration of releasing the deceased to the next of kin. This study aims to assess the effectiveness of the institutional policies governing autopsies adopted during the COVID-19 pandemic at the medico-legal unit of Matale in decreasing the lead time of medico-legal death notification.Methods: This study was conducted at the medico-legal unit of District General Hospital Matale, Sri Lanka. All data was collected from the post-mortem reports and records maintained at MLU of Matale from May 2021 to December 2021. All the post-mortems conducted by the author (442 autopsies) were included.Results: The study population comprised of 283 (64%) males. The majority (30%, n=134) of the decedents were more than 80 years. The mean age of the deceased was 69.20 years and the standard deviation was 17.881. The majority (66%, n=291) of the descendants were Sinhala. The majority of inquests (n= 423, 96%) were conducted by inquire into deaths. In the months of August and October number of autopsies performed had increased 4 times and 3 times respectively to that of the same period in previous years and the following year. Out of the autopsies, 23% (n= 101) of the lead time of autopsy was on the same day of death. In the majority (64 %, 85) of the deaths lead time of autopsy was the next day of the death.Conclusion: During the COVID-19 pandemic, excess mortality was detected, lead time of autopsy was reduced due to the policies adopted by the medico-legal unit. Lessons learned during the pandemic may help improve resource utilization without negatively influencing outcomes in a low-resource setting.
Development and Validation of an Active Educational Resource to Address Quality Gaps Regarding Clinical Documentation
Authors: Welch Bacon Cailee E. , Nottingham Sara L. , Kasamatsu Tricia M.
Published: December 2023

Context

Athletic trainers (ATs) have self-reported inadequate documentation of patient encounters and a desire for more educational resources to inform their documentation practices. However, continuing education opportunities regarding clinical documentation are limited and not easily accessible by all ATs.

Objective

To develop and validate a comprehensive educational resource on clinical documentation using an established personalized learning pathway (PLP) framework.

Design

Multiphase development process consisting of consensus development, subject matter expert content validation, and pilot implementation.

Setting

Asynchronous, web-based educational resource.

Participants

Three subject matter experts thoroughly reviewed the educational resource for face and content validity. Ten ATs and 23 professional athletic training students participated in pilot implementation.

Main Outcome Measure(s)

Through a consensus process, the research team developed a comprehensive educational resource regarding clinical documentation in athletic training. The clinical documentation PLP includes 7 overarching topic areas that are necessary for a comprehensive understanding of clinical documentation. A variety of learning formats were used to help engage learners, and content was curated and delivered by members of the research team, 14 practicing ATs, and 2 content area experts.

Results

Subject matter experts considered the content of the Clinical Documentation PLP and the delivery mechanism of the learning resource to be excellent; minor feedback to enhance the overall face and content validity was implemented as suggested by the subject matter experts. All 10 ATs and 23 professional athletic training students completed the PLP in its entirety. Minor feedback to enhance the overall user experience was implemented as suggested by the pilot participants.

Conclusions

The Clinical Documentation PLP was developed based on central principles of adult learning theory and cognitive load theory to provide comprehensive knowledge and best-practice recommendations regarding clinical documentation to ATs. The PLP is relatable, cost-free, continuously available, and conveniently accessible from any location or device.
Lipid metabolism, amino acid metabolism, and prostate cancer: a crucial metabolic journey
Authors: Chen Lin , Xu Yu-Xin , Wang Yuan-Shuo , Zhou Jian-Liang
Published: December 2023

Prostate cancer (PCa) is one of the most common malignancies in males worldwide, and its development and progression involve the regulation of multiple metabolic pathways. Alterations in lipid metabolism affect the proliferation and metastatic capabilities of PCa cells. Cancer cells increase lipid synthesis and regulate fatty acid oxidation to meet their growth and energy demands. Similarly, changes occur in amino acid metabolism in PCa. Cancer cells exhibit an increased demand for specific amino acids, and they regulate amino acid transport and metabolic pathways to fulfill their proliferation and survival requirements. These changes are closely associated with disease progression and treatment response in PCa cells. Therefore, a comprehensive investigation of the metabolic characteristics of PCa is expected to offer novel insights and approaches for the early diagnosis and treatment of this disease.
The role of adipokines in the disease of metabolic-associated fatty liver disease
Authors: Chen Chieh
Published: December 2023

According to the World Health Organization’s reports, the prevalence of fatty liver disease is increasing worldwide, and that of type 2 diabetes in adults aged over 18 years has increased from 4.7% in the 1980s to 8.5% in 2014. Metabolic (dysfunction)-associated fatty liver disease (MAFLD) does not only affect the liver but also poses as a serious threat to the entire body, with approximately 25% of the patients have cardiovascular diseases, which are aging-associated health issues. This literature review obtained data from databases such as Cochrane Library, PubMed or Medline, UpToDate, and Google Scholar, using terms from Medical Subject Headings for keywords such as adipokines, digestive disease, MAFLD, microbiota, and microbiome. Articles on the molecular biological mechanism would be included, along with case–control studies, systematic review and meta-analysis, analytical research, and randomized control studies, to explore the effect of adipokines or myokines on MAFLD epidemiology and prevention. Thus, this article describes the adipokines and its function related to MAFLD.
Multiple Renal Veins in Donor Nephrectomy-Preoperative Assessment of Feasibility for Safe and Selective Ligation
Authors: Kriplani Akshay , Sureka Sanjoy Kumar , Rustagi Sanchit , Singh Uday Pratap , Ansari M. S. , Srivastava Aneesh
Published: December 2023

The aim of the study is to provide an objective preoperative assessment protocol by computerized tomography angiography by measuring the vein volume (pr2h) instead of the vein diameter for accurate size and blood flow assessment in case of multiple renal veins during donor nephrectomy. To reduce rewarm ischemia time, smaller renal veins were safely ligated without compromising drainage due to their robust intrarenal anastomotic communications. The selection of vein for safe ligation is crucial to avoid congestion and high intrarenal pressures in the allograft venous system and was made by calculating the vein volume. Application of this formula in 343 donors with multiple veins (2003–2021) has led to uneventful intra- and postoperative course. This method prevails over the existing subjective assessment techniques, thereby ensuring the best possible perfusion and drainage of the allograft.
A Case of Orthotopic Renal Transplant in a Patient with Diffuse Atherosclerosis
Authors: Khan Mohammed Fahad , Subramanya Abhishek M. , Siddini Vishwanath , Dubey Deepak , Lochan Rajiv , Ballal Sudarshan
Published: December 2023

A 60-year-old male with long-standing diabetes, hypertension, and smoking developed an end-stage renal disease that necessitated hemodialysis. His drive-by angiograms revealed significant carotid and iliac calcifications and a triple-vessel disease on cardiac assessment. The abdominal aorta, common iliac, and the vascular tree below were all heavily calcified, according to a computed tomography angiography. Concerned about the location of the donor renal artery anastomosis, the decision was taken to do a left native kidney nephrectomy and orthotopic renal transplant. End-to-end anastomoses were made between the donor renal artery and splenic artery and between the donor renal vein and the recipient native kidney renal vein. The patient is doing well after the transplant, and the graft is functioning excellently with a creatinine of 0.9 mg/dl.
An Unusual Case of Late, Isolated Involvement of Renal Allograft with Tuberculosis
Authors: Dalvi Sayali , Bichu Shrirang , Tilve Parag Vasant
Published: December 2023

Tuberculosis is endemic in India, with a prevalence of 8%–13% in kidney transplant patients. Atypical presentations have been described in immunocompromised individuals, and we present an unusual and rare case of isolated tuberculous involvement of the kidney allograft presenting 6 years posttransplant. Our patient presented with fever, poor appetite, and malaise of very short duration without ongoing weight loss; a normal urine examination as well as ultrasonography of allograft, requiring positron emission tomography-computed tomography to determine the source of infection. A vigilant approach with a high degree of suspicion in this case led to early detection and good outcomes.
Assessment of the Impact of a Multistrain Probiotic on the Quantity of Saliva in Completely Edentulous Patients: An Observational Study
Authors: Gupta Navdha , Dhawan Pankaj , Kaur Harsimran , Tomar Shivam Singh , Mahesh Shakila , Tandan Piyush
Published: December 2023

Background:

Probiotics are being used to treat oral infections, for instance, periodontitis, caries, fungal infections, and halitosis. Probiotics play a significant role in the overall health of infants, teenagers, adults, and the elderly. However, there is scarce literature regarding its role in completely edentulous patients.

Aim:

The aim of this study was to assess the impact of multistrain probiotics on the quantity of saliva in completely edentulous patients.

Materials and Methods:

A total of 52 patients were recruited for the study, who were completely edentulous and wearing removable complete denture prostheses. These patients were divided into two groups. Group I (experimental) patients on multistrained probiotics named Lee-Biotic (Leeford Healthcare Ltd.) and Group II (control) consisted of patients who were not prescribed any probiotics. Saliva samples of all the patients were collected at the baseline, after 2 months, and after 3 months. The complete data were formulated systematically on the Microsoft Excel sheet, and then, it was analyzed using the Statistical Package for the Social Sciences version 21.

Results:

The mean value of the amount of saliva at the baseline in probiotic and nonprobiotic groups was 2.042 ml and 0.888 ml, respectively (P < 0.001 for both). After 3 months, there was a significant increase in the amount of saliva; i.e. for the probiotic group, it was 2.219 ml, and for nonprobiotic, it was 1.273 ml.

Conclusion:

Commercially available multistrain probiotic supplements increased the quantity of saliva in edentulous patients who were old denture wearers.
Assessment of the Difference in Perception and Attitude of Generations of Dentists for Tooth Shade Selection
Authors: Minase Dhanashree , Sathe Seema , Borle Anjali , Jaiswal Tanvi
Published: December 2023

Aims:

The aims of the study were to assess the perception and attitude of the new generation dentist and old generation dentists toward tooth shade selection.

Materials and Methods:

The observations from the participants of their perception and attitude toward tooth shade selection were established with the prevalidated anonymous questionnaire, containing a total of 10 close-ended questions was obtained.

Results:

Among the 50 participants from each group, a significant difference of perception is seen in managing patients with tooth shade and with unrealistic patient demand. Clinicians with less experience do what is ideal for patients, while clinicians with more experience match patient demands. Furthermore, it is seen that the involvement of dental technicians is less in more experienced participants than less experienced participants.

Conclusions:

Older-generation dentist tends to meet the patient demands as compared to dentist with less experience by choosing what is ideal for the patient with unrealistic tooth shade demands. A shift in the trend is seen in newer generation dentist by involving dental technicians in tooth shade selection.
Prevalence of Hypovitaminosis D among Athletes and its Impact on Athletic Performance: A Scoping Review
Authors: Saju Ansa , Swaminathan Narasimman , Gopalakrishnan Janani , Sivaraman Arumugam
Published: December 2023

Recent studies have documented the importance of Vitamin D in improving immunity, mental health, and quality of life in various diseased conditions. Vitamin D is a genetic modulator involved in protein synthesis, immune activity, and optimal mineralization of bone which are essential to performance and training. This scoping review aims to identify the lacunae in the literature regarding hypovitaminosis and its impact on athletic performance. The methodology prescribed by Arksey and O’Malley and the methodological advancement by Levac were followed. Electronic databases, such as PubMed, Embase, Ovid Emcare, ProQuest, and Google Scholar, were searched for original research published in English between 1981 and 2021. Two authors completed the independent screening of titles, abstracts, and full-text articles to identify studies that met the inclusion criteria. Data was extracted and collated in a table to synthesize the results. Forty studies measured the prevalence rate of hypovitaminosis among athletes, of which nine assessed its impact on athletic performance. Hypovitaminosis D is prevalent among the athletic population, and factors such as race, training environment, location, and season impact the serum levels of cholecalciferol. The impact of hypovitaminosis D on athletic performance is inconclusive, with research showing divided results.
Poor Oral Health among Elderly Patients in Rural India: An Overview
Authors: Shende Vaibhavi , Wagh Vasant
Published: December 2023

In the world, India ranks number 1 in the list of population. According to the World Health Organization, Global Oral Health Status Report (2022), oral disease affects 3.5 billion people. The purpose of doing the study is to know about the oral condition of the rural people. After doing studies, it is observed that there is a lack of knowledge, low level of awareness, motivation among people, and involvement of government. There are several oral health-care systems in India such as governmental and nongovernmental organizations and private practitioners. Poor dental hygiene leads to tooth decay, bad breath, periodontal diseases, gum diseases, loosening of teeth, clicking of jaws, and ulcers. Moreover, if these problems remain untreated, they may lead to some systemic diseases such as cardiovascular diseases, cancer, endocarditis, pregnancy complications, diabetes, kidney disease, and rheumatoid arthritis. Therefore, it is very important to resolve these problems and special attention should be provided. This study will provide a clearer view of the challenges for rural people in India.
Rehabilitation of Partially Edentulous Esthetic Zone with Custom-made Abutment in Young Patient
Authors: Sonar Prasanna Ravindra , Panchbhai Aarati S.
Published: December 2023

Implant positioning plays an important role in giving esthetics as well as in proper functioning of prosthesis. To achieve the best results, extensive evaluation and treatment planning are necessary for placing dental implants in an esthetically pleasing area. Important factors include the soft-tissue architecture, bone quantity and quality in both the horizontal and vertical planes. Thin labial cortical plate and gingival tissue in the upper anterior region are issues for esthetic outcomes. The use of high-performance ceramic material, the ability to customize the position, the angulation, the emergence profile, and the future position of the crown margin of the final restoration are all advantages of the custom abutment. Many cases of correcting the divergence between implants in total rehabilitation of the maxilla or mandible or in screw-retained single crowns are mentioned in the literature. This case report describes prosthetic rehabilitation of missing lateral teeth with customized abutments in young patients.
An Enquiry into Application-Based Diagnostic Support System for Distal Humerus Fracture using Deep Learning
Authors: Kekatpure Aashay L. , Deshpande Sanjay Vyankatesh , Kekatpure Aditya Laxmikant , Saoji Kiran Madhukar
Published: December 2023

Background:

Recently, the development of deep learning has been remarkable and the accuracy of the image recognition has improved. Distal humerus fracture treatment is a complex injury requiring good diagnostic judgment and management protocol. There have been no attempts toward development of artificial intelligence (AI) in treating distal humerus.

Objectives:

To find out whether deep learning (AI) gives reasonable image-based recommendation for the surgical procedure of distal end humerus fractures.

Methods:

The image of the distal end humerus will be sent to application (app)-based deep learning software. The result of the deep learning software diagnosis and intervention will be compared with two senior orthopedic surgeons’ opinion. Intra- and inter-observer reliability will be studied, and Student’s t-test will be used for identifying the P value of the objective.

Expected Outcome:

We will identify the layers required for the deep learning software to process the distal humerus fractures and reach a conclusion. The app will help in identification and planning the management of the fracture.

Conclusion:

The Application based diagnostic support system for the distal humerus fracture is an initial investigation for the usage of AI in peripheral centres and can provided further diagnostic support.
Frontal Bone Fracture – Challenges and Solutions
Authors: Agrawal Pooja , Bhola Nitin D. , Agarwal Anchal
Published: December 2023

Fractures of the frontal bone are relatively infrequent maxillofacial injuries. Various classifications and treatment modalities ranging from simple conservative observation to complex surgical intervention are available in the literature. Treatment of frontal bone fractures hinges on numerous aspects such as involvement of frontal sinus, presence of cerebrospinal fluid (CSF) leak, degree of displacement of anterior and posterior table fracture, and presence of nasofrontal duct obstruction. Various complications may arise if there is a delay in treatment or improper treatment is given. The present article aims to describe the management of severely comminuted frontal bone fractures and other complications and challenges related to the same.
Knowledge, Attitude, and Compliance of Infection Control Guidelines in a Dental Hospital of Wardha District during COVID-19 Pandemic: A Cross-sectional Study
Authors: Thosar Nilima Ramdas , Mehta Jayati , Srivastava Rashi , Waykar Rutuja Bhalchandra , Malviya Nishi
Published: December 2023

Objective:

The study aims to assess the knowledge of the health-care professionals regarding the prevention of the spread of infection.

Study Design:

This is a cross-sectional study.

Materials and Methods:

An online survey-based cross-sectional study was conducted, which included all the faculty, postgraduate, and interns of Sharad Pawar Dental College. Questions were related to documented infection control (IC) policies, materials used for IC in dental operatory, precautions taken during treatment, and biomedical waste management.

Results:

A total of 255 participants responded to the survey questionnaire. Sixty-five participants were faculties, 90 participants were postgraduate, and 100 participants were interns. After conducting the survey, it was observed that faculty and postgraduate students were more aware about the IC guidelines than interns in the dental operatory.

Conclusion:

In the present scenario of the COVID-19 pandemic, it is important to note different IC measures that are required to prevent the spread of the disease.
A Narrative Review on Knowledge and Practice Regarding Family Planning Methods and Knowledge and Effectiveness of Six Sigma in the Health Sector
Authors: Barari Neha , Sethi Deepak
Published: December 2023

Family planning is a method and standard of living adopted by couples by their own choice that is based on knowledge and attitude regarding various methods of contraception. In 1952, India become the first country to implement National Family Program. It was very difficult for Indian Government to make people accept family planning methods. All over the world after China, India is the second highest populated country. India also felt the need to control this population explosion that is why India became 1st country to introduce Family Planning Program in 1952. However, this problem is still present in our country. The utilization or practice of contraceptive methods is affected by some barriers that are present in our society and in our surroundings only. There is a clear need to investigate the hurdles that prevent family planning approaches from being accepted and used. Based on the information gaps and identified obstacles, proactive advocacy and a systematic awareness program are required. The present review article gathered the best possible published literature with an aim to assess the knowledge and practice about contraceptive measures and to assess the effectiveness of Six Sigma methodology in the health sector. Today’s health care is a complex and contradictory web. It provides incredible improvements in therapeutics and the technology that we use to treat patients. However, because of inaccuracies of equipment, less number of resources, and some other challenges, it compromises patient access and their security. A management approach that is six sigma came in light to increase process productivity by lowering faults to improve service standards. This article concluded the level of knowledge and practice of contraceptive measures and knowledge and effectiveness of Six Sigma in the health sector.
Nonscholastic Qualities and their Association with Internet Addiction among Medical Students
Authors: Jain Animesh , Hussain Sahil , Malhotra Kareena , Mahanta Chandan Kumar , Choudhury Shinjinee Roy , Bansal Tanisha , Praveen Vrinda , Hegde Pratyaksh , Gupta Arjun , Motappa Rohith
Published: December 2023

Background:

For health professionals, medical students’ nonacademic skills are a major topic of concern. These traits, which include personality traits, social skills, and communication abilities, are necessary for a medical professional to perform well. On the other hand, concerns are starting to be raised as the rate of Internet addiction rises in popularity. Despite the fact that the Internet is a great resource for research, students frequently had serious academic issues. Furthermore, their personal qualities outside of school must be impacted.

Objectives:

The objective of the study was to assess the nonscholastic qualities of medical students, to assess the level of Internet addiction, and to establish an association between the nonscholastic qualities and Internet addiction among the students.

Materials and Methods:

A cross-sectional study was done on the undergraduate students of Kasturba Medical College, Mangalore. The questionnaire was prepared after an extensive review of the literature. Hence, the semi-structured questionnaire consists of three sections – Section I consists of a demographic study; Section II consists of nonscholastic qualities determinant questions; and Section III consists of questions focused on studying Internet addiction. The questionnaires used are standard questionnaires, and prior permission from the creators was taken.

Results:

In our survey, the majority of students (67.7%, 174/257) were determined to have strong nonacademic traits. Few (3.11%, 8/257) had poor nonacademic qualities, whereas 29.18% (7/257) had average nonacademic qualities. Only 7.00% (18/257) of students were found to have severe Internet addiction levels, whereas the bulk of students, 47.85% (123/257), had moderate levels. The remaining 116 kids had a similar distribution of moderate and normal Internet addiction.

Conclusion:

We can conclude that students should understand the harmful effect of Internet addiction and how it could affect them and focus more on developing their nonscholastic qualities to complement their professional careers in the future.
Bedside Transillumination Test – A Clinical Tool for Diagnosis of Pneumothorax in Newborn: A Need of Time for the Medical Graduate
Authors: Lakra Ashwini , Lakra Mahaveer Singh , Taksande Amar , Arora Ishani , Bhandekar Heena Sudhir
Published: December 2023

The basic signs and symptoms in clinical practice are losing its glory nowadays due to final jumping at diagnosis and due to the easy availability of sophisticated investigations and handy literature. The level of teaching has also gone down in medical colleges, and these clinical signs are not taught and not illustrated, as everyone feels that these are outdated. Although this case looks very simple, it carries lots of importance. A preterm baby who was suffering from respiratory distress and was doing well suddenly desaturated and deteriorated while on ventilator. We worked out the possible causes of displacement, obstruction, pneumothorax, equipment failure, and suspected pneumothorax. Immediately, bedside transillumination test (which is nowadays thought to be outdated) was performed, and a chest drain was put in urgently without waiting for the X-ray and lung ultrasound. Chest drainage was put in immediately, and the baby started improving immediately. and later on, an X-ray was taken, which was suggestive of improving pneumothorax. The present article highlights the importance of elicitation of proper signs and symptoms, the importance of performing illumination tests in newborns, along with the significance of clinical teaching.
Methionine Metabolism – A Gateway to Oral Cancer Epigenetics
Authors: Zade Prajakta R. , Chaudhary Minal S. , Hande Alka Harish , Gawande Madhuri Nitin , Sharma Preethi N. , Thakare Eesha Deepak
Published: December 2023

One of the seminal hallmarks of cancer includes nonmutational epigenetic reprogramming. Epigenetic changes are reversible unlike genetic changes which are irreversible and thus hold tremendous potential to be explored for better practical outcome. DNA methylation is the most commonly studied epigenetic alteration. Methionine pathway is linked to DNA methylation. Cancer cells for their metabolism require increased uptake of amino acid and methionine. However, the exact mechanism of DNA methylation in cancer in association to methionine pathway still remains enigmatic. Oral cancer is most commonly associated to smokeless tobacco use. There is sufficient evidence that nitrosamines in tobacco alter the methionine pathway and thus induce aberrant methylation. Moreover, methionine restriction is an emerging strategy to target tumor metabolism. Thus, it makes it all more imperative to understand the basic mechanism operating at the molecular level. This article is an attempt to hypothesis and proposes the possible fundamental changes occurring in the methionine pathway pertaining to oral cancer epigenetics.
Dynamic Muscle Stimulation for Pain, Tenderness, and Stiffness on Upper Back Muscles: A Novel Approach and Analysis on Shear-wave Elastography
Authors: Naqvi Waqar Mohsin , Arora Sakshi Pritam , Mishra Gaurav Vedprakash , Gabr Mamdouh Y. , Naqvi Ifat Waqar , Kandkurti Praveen Kumar
Published: December 2023

Upper back myalgia is a complaint of pain, stiffness, and tightness in the upper back muscles. It is characterized by acute or persistent neck–shoulder pain. We report the case of a 24-year-old male who presented with pain and swelling in the neck and upper back region, along with gradual restriction in cervical range of motion (ROM) for 2 months. The pretreatment assessment revealed severe tightness of the middle fibers of the trapezius and upper fibers of the rhomboid major muscle. Pretreatment elastography revealed high elasticity contrast index (ECI) values of 8.59 and 9.01, respectively, and a red region indicative of increased stiffness of the muscle fibers. The patient was treated with Naqvi’s-Dynamic Electrical Therapy Approach (Naqvi’s DELTA) which is a novel method of using interferential current with a dynamic stimulation probe for 15 min using ultrasound gel on the affected area and examining the patient for the effect of the DELTA on muscle elongation by shear wave elastography which is a unique variation in ultrasound imaging. The pre- and posttreatment findings revealed a significant reduction in stiffness of the muscle fibers, indicated by decreased ECI values of 2.14 and 0.94, respectively, in the blue region. In addition, posttreatment also had an impact on pain reduction and a significant increment in the overall cervical ROM.
The Effect of Menopause on the Sexual Functions and Marital Adjustment of the Spouses
Authors: Yildirim Fatma , Duman Nuriye Büyükkayaci , Kulakaç Özen
Published: December 2023

Background:

This study was conducted as a cross-sectional descriptive study to determine the effect of menopause on the SFs and marital adjustment (MA) of the spouses.

Materials and Methods:

The sample of the study consisted of a total of 254 people, 127 of whom were postmenopausal women and their spouses. The data were collected with the Descriptive Information Form, the Female Sexual Function Scale (FSFS), the Arizona Sexual Experiences Scale (ASES), and the Marital Adjustment Scale (MAS). The t-test, Mann–Whitney U-test, Kruskal–Wallis test, and correlation analysis were used in the analysis of the data.

Results:

Sexual dysfunctions (SDs) were detected in 91.3% of women and 77.2% of men. MA was found to be low in 74.1% of the women. The relationship between the level of MA and the total mean score of the women’s FSFS was found to be statistically significant (P < 0.05). In addition, the relationship between the presence of SD in the postmenopausal women and the mean ASES score in the husband was found to be statistically significant (P < 0.05). According to Spearman’s rho correlation coefficient, the positive correlation between the total mean score of the MAS and the mean total score of the FSFS was weak (r = 0.290; P = 0.001), and the negative correlation between the mean score of the total score of the ASES was weak (r = −0.381; P = 0.000) which was found to be a relationship (P < 0.05).

Conclusion:

In this study, it was determined that menopause affects the marriage and sexual adjustment of spouses negatively.
Exploratory Study on Micronuclei and Metanuclear Abnormalities in Exfoliated Buccal Cells of COVID-19 Suspected Patients
Authors: Vishnu B , Murugan Senthil , Kalidoss Vinoth K. , Sesham Kishore , Ramamurthy Sarah , Bakshi Satvinder S. , Francis Yuvaraj M. , Kasirajan Sankaran Ponnusamy
Published: December 2023

Context:

SARS-CoV-2 virus causes COVID-19 by infecting nasal and oral cavities primarily by attaching its spike proteins to ACE 2 receptors expressed in epithelial cells.

Aim:

This study was done to evaluate the micronucleated cell count, metanuclear abnormalities, and genotoxic factor in exfoliated buccal mucosal cell among the COVID-19 suspected patients.

Settings and Design:

This cross-sectional study was conducted at AIIMS, Mangalagiri, between August and October 2022.

Methods:

One hundred COVID-19 suspected patients were recruited for this study after obtaining informed and written consent; buccal smear was obtained and stained for papanicolaou test (PAP). The PAP-stained slides were analyzed for micronuclei (MN), pyknotic, karyolytic, and karyorrhexic cell count, respectively. Based on their reverse transcription-polymerase chain reaction (RT-PCR) report, the patients were grouped into COVID-19 positive and negative groups.

Statistical Analysis:

The genotoxicity factor was calculated using the micronucleated cell count from both the groups using mean and standard deviation.

Results:

The MN, micronucleated cell, pyknotic, karyolitic, and karyorrhexic cell count in COVID-19 positive patients were 24.12, 15.24, 3.08, 2.88 and 4.40, respectively, than COVID-19 negative patients 5.69, 8.17, 1.08, 1.00 and 2.43, respectively. The genotoxicity factor for SARS-CoV-2 was 2.68 which is a positive genotoxic effect on buccal mucosal cells.

Conclusion:

SARS-CoV-2 increases the expression of micronucleated cells, pyknotic cells, karyolytic cells, and karyorhexic cells and concludes SARS-CoV-2 is having cytogenotoxic effect on the buccal mucosal cells. This can be used as a reliable marker in identifying the early carcinogenic effects of virus causing COVID-19.
A case of metabolic encephalopathy due to recurrent hypoglycemia caused by insulin: A case report
Authors: Dave Kinjal A , Gupta Sapna D , Malhotra Supriya D
Published: December 2023

A metabolic encephalopathy brought on by dangerously low blood glucose levels is called hypoglycemic encephalopathy. Transient hypoglycemic episodes are frequent, particularly in diabetic patients. This complication is seen in diabetes patients who are taking insulin/insulin secretagogues. Severe persistent hypoglycemia can result in seizures, a protracted state of coma, and a wide range of other global and focal neurologic impairments. The main pathological alterations in hypoglycemic encephalopathy include widespread denaturation and necrosis of the neurons as a result of a lack of energy, which is accompanied by a significant number of glial cells entering the brain. In our case, the patient had recurrent hypoglycemic episodes, which led to the development of hypoglycemic encephalopathy caused by insulin. It is important for clinicians to be aware of this potential complication and to closely monitor patients with diabetes who are being treated with insulin.
Outcomes of heel ulcers in people with diabetes visiting tertiary care diabetes center of Karachi, Pakistan
Authors: Nawaz Rabel , Riaz Musarrat , Miyan Zahid , Hatim Arwa , Zafar Awn Bin , Ulhaque Muhammad Saif , Shareef Abdul Majid , Ahmedani Muhammad Yakoob , Basit Abdul
Published: December 2023

Objective:

To determine the outcome of heel ulcers in people with diabetes.

Materials and Methods:

This retrospective cohort study was conducted at the Diabetic Foot Department of Baqai Institute of Diabetology and Endocrinology (BIDE), Karachi. Ethical approval was obtained from the Institutional Review Board of BIDE. Relevant records of all patients of both genders with diabetes aged 18–80 years and ulcer over the heel visiting the Diabetic Foot Clinic from January 2016 to December 2020 were retrieved from the hospital management system of BIDE for evaluation. Pre-designed proformas were filled and Statistical Package for Social Science version 20 was used to analyze data.

Results:

Overall data of 1073 diabetic people with heel ulcers was retrieved, among them the mean age was 57.95 ± 11.96 years, and 715(66.6%) participants were male. Type 2 diabetes was found in 821 (97.9%) participants and 548 (65.6%) had >10 years duration of diabetes. In regard to type of ulcer, 876 (81.6%) were neuropathic ulcers, 91 (8.5%) were ischemic, and 89 (8.3%) were neuroischemic ulcers. According to university of Texas classification wound classification, 725 (67.6%) fell in stage B followed by 238 (22.2%) in stage A. Regarding heel ulcer outcome, a majority of 459 (95.8%) healed without amputation and only 15 (3.1%) healed with major amputation.

Conclusion:

We found that the majority of the people with heel ulcers had a favorable outcome and healed without an lower extremity amputation.
Effect of single-dose oral vitamin D (200,000 IU) for the treatment of painful diabetic neuropathy
Authors: Fawwad Asher , Basit Khalid Abdul , Zafar Awn Bin , Tahir Bilal , Anwar Maria , Siddiqui Iftikhar Ahmed , Basit Abdul
Published: December 2023

Objective:

To assess the effect of a single-dose, oral vitamin D supplementation (soft gel capsule of 200,000 IU) in subjects with painful diabetic neuropathy (PDN) in Pakistan.

Design:

Randomized control trial.

Materials and Methods:

This randomized control trial was conducted at the Baqai Institute of Diabetology and Endocrinology (BIDE), Pakistan from November 2021 to August 2022. Subjects with diabetes without any signs of vitamin D deficiency were included. Baseline details were obtained by a predesigned questionnaire. Douleur neuropathy 4 (DN4) score was used for diagnosing PDN. Biochemical tests include serum 25-hydroxyvitamin D (OH)D and HbA1c for screening at baseline and at 3 months follow-up were analyzed. Subjects were categorized into two: a control group and an intervention group. The intervention group was given a single soft gel vitamin D capsule (200,000 IU) after screening by expert paramedical staff. Based on baseline serum vitamin D levels, the intervention group was further categorized into insufficient vs. deficient groups, and the control group was categorized into insufficient vs. sufficient.

Results:

Of 159 participants, 19.5% vs. 44.7% subjects were with insufficient vs. deficient vitamin D levels in the intervention group, and 10.7% vs. 25.1% were with insufficient vs. sufficient vitamin D levels in the control group, respectively. Though the findings are insignificant, DN4 score at follow-up in intervention groups and control groups was reduced compared to the baseline DN4 score. Furthermore, we observed a reduction in post-HbA1c levels in both the intervention groups (insufficient vs. deficient) and the control-sufficient group.

Conclusion:

Treatment with vitamin D supplementation in people with PDN helps to improve vitamin D levels, DN4 score, and HbA1c levels, though dose-response is yet to be compared.
Application of Noise Control Combined with Relaxation Training in Patients with Skin Laser Cosmetology: A Single-center Retrospective Study
Authors: Wang Miaohao , Bi Haiqing , Ma Qichao
Published: December 2023

Objective: Noise pollution has been listed as one of the three major types of pollution, along with air and water pollution. Hospitals should pay attention to noise control, which is of great importance for the treatment and rehabilitation of patients. This study focuses on the application value of noise control and relaxation training. Methods: This study retrospectively collected and analyzed the clinical data of 184 patients who underwent skin laser cosmetology in Ningbo Yinzhou No. 2 Hospital from January 2021 to December 2022. Twelve patients who did not meet the criteria were excluded, and the remaining 172 patients were divided based on the type of intervention into the control group (CG, n = 82) and the study group (SG, n = 90). The CG received relaxation training and routine noise management, while the SG received noise control combined with relaxation training. The intervention effect was discussed from the aspects of noise, psychology, and satisfaction. Results: After the intervention, the SG had overtly lower noise levels and lower scores of anxiety and depression compared to the CG (all P < 0.001). Correlation analysis showed that noise levels were positively correlated with scores of anxiety and depression (r = 0.553, r = 0.592, P < 0.001). The two groups had no significant difference in total satisfaction (P > 0.05). Conclusion: Noise poses a significant threat to the human body. Strengthening noise control in hospitals is beneficial for patients’ recovery. Combining noise control with relaxation training is an intervention method worthy of clinical application. It can improve the hospitalization environment and reduce the noise levels to a great extent, thereby improving the psychological state of patients and enhancing the medical satisfaction.
Effect of Ward Noise Reduction Technology Combined with Music Therapy on Negative Emotions in Inpatients Undergoing Gastric Cancer Radiotherapy: A Retrospective Study
Authors: Zhao Fengyun , Sun Zhen , Niu Wenbo
Published: December 2023

Background: Gastric cancer is a common malignant tumour in clinics. Noise affects the condition of patients with gastric cancer to a certain extent. This study aims to explore an effective noise control measure. Methods and materials: This study retrospectively analysed the clinical data of 108 patients with gastric cancer who received radiotherapy in the oncology department of JiaoZhou Central Hospital from March 2021 to March 2022, and excluded eight patients who did not meet the inclusion criteria. The remaining patients were divided into a control group (CG, music therapy, n = 48) and a study group (SG, ward noise reduction technology + music therapy, n = 52) in accordance with different management modes. The key causes of noise in the ward that each patient thought were collected by questionnaire, and the ward noise, psychological state, and sleep changes in the two groups were observed under different management modes. Results: The noise was mainly from patients and their family members, call bell, monitors, treatment carts, medical staff and surrounding environment. After the management, SG had lower noise decibel values in daytime and nighttime and significantly lower scores of anxiety and depression than CG (P < 0.01). The sleep quality scores of the two groups after the management were lower than those before management (P < 0.001) and the sleep quality score of SG was significantly lower than that of CG (P < 0.01). Conclusions: Ward noise reduction technology combined with music therapy is an effective method to effectively reduce the ward noise and improve the clinical condition of patients.