bluuebunny/crossref_metadata_2025 huggingface dataset:
Les défis de la méta-analyse pour produire des conclusions générales sur les dispositifs d’aide à la réussite dans l’enseignement supérieur
Authors: Perret Cathy , Villeneuve Elysa
Published: June 2024

Face à la multiplication des dispositifs visant l'amélioration de la réussite des étudiants du 1er cycle de l'enseignement supérieur, les travaux de recherche en sciences de l'éducation et de la formation se sont multipliés. Toutefois, il reste difficile d'avoir une vue globale des effets de ces dispositifs : qu'impactent-ils ? dans quelles mesures ? sous quelles conditions ? Dans cet article, nous discutons de l’intérêt de la méta-analyse pour répondre à ces interrogations. Très répandue dans la recherche médicale, cette méthode consiste à ré-exploiter des données de recherches antérieures afin d'en proposer une revue critique ainsi qu'une combinaison évaluative pour identifier une tendance centrale. Dans le domaine des sciences de l'éducation et de la formation, il s'agit d'une méthode encore peu mobilisée. Elle possède pourtant de nombreuses forces tout en n’étant pas exempte de limites (hétérogénéité des données mobilisées, qualité méthodologique des études…). Si la mise en œuvre d’une telle méthode nécessite de déterminer des critères d’inclusion sur les études primaires mobilisées, elle suppose de surcroit la nécessité d’une forte définition de l’objet étudié, c’est-à-dire les dispositifs, leurs effets et les contextes dans lesquels ils sont déployés. En donnant à voir la pluralité des définitions possibles, des effets et des contextes dans lesquels ces dispositifs sont déployés, cet article propose une réflexion de nature méthodologique pour la mise en œuvre de futurs programmes de recherche mobilisant la méta-analyse pour étudier les dispositifs d’aide à la réussite étudiante.
Entre socialisation à l'individualisation et sélection : expériences de la transition secondaire-supérieur des nouveaux bacheliers généraux
Authors: Nakhili Nadia
Published: June 2024

La période récente est marquée par des réformes (ORE et Nouveau Baccalauréat Général) qui ont transformé la transition secondaire-supérieur, introduisant une forme de régulation des flux via la plateforme Parcoursup d’une part, et davantage de flexibilité via une logique d’individualisation des parcours d’autre part. Dans cet article, nous analysons les processus de socialisation à l’individualisation en amont et lors de la transition secondaire-supérieur à l’heure de la mise en place de cette nouvelle organisation. À partir d’une enquête qualitative auprès de 20 bacheliers 2021 nous décrivons la manière dont ils se sont approprié ces nouvelles règles. In fine, le cadre, les agents et les processus de socialisation mis à jour sont : la déstabilisation de la sociabilité lycéenne, une liberté de choix amenant les lycéens à gérer les incertitudes et à peser ou assumer les conséquences de leurs choix, un accompagnement procédural invitant à la prudence et à la multiplication des choix d’études supérieures en terminale. Tout cela prépare les lycéens à une expérience de la transition secondaire-supérieur éprouvante, opaque et souvent inégalitaire.
Left paraduodenal hernia: An overlooked cause of acute abdomen - A case report
Authors: Shah Bhushan , Bajaj Jayant , Reddy Vijendra Adithya , Yadav Devendra S.
Published: June 2024

Internal abdominal hernias are uncommon causes of intestinal obstruction, making them elusive in diagnosis. Paraduodenal hernias (PDH) represent the most common subset, accounting for up to 53% of all internal hernias. They occur due to herniation of the small bowel into the paraduodenal fossa. Symptomatology in a patient ranges from asymptomatic, chronic abdominal pain to acute abdomen. Although rare, a high index of suspicion of PDH is required to prevent its fatal complications such as bowel incarceration, volvulus, or strangulation. Preoperative evaluation with a computed tomography scan of the abdomen facilitates diagnosis and timely surgical intervention. We present a case of a 26-year-old male patient managed with an open surgical approach for a left PDH in an emergency with a good clinical outcome. This case report emphasizes the importance of awareness of this uncommon condition and its consideration in the differential diagnosis of acute abdomen to avert unnecessary hospitalization and surgery.
Retrospective evaluation of a single surgeon’s experience in robot-assisted inguinal repair with the Dexter System™ during the learning curve
Authors: Mignot Hubert , Diack Bineta , Capitaine Juliette , Emeriau Damien
Published: June 2024

BACKGROUND:

Robot-assisted transabdominal preperitoneal (r-TAPP) inguinal hernia repair is a safe and feasible approach for hernias of varying etiology. This retrospective study aims to report the feasibility and the learning phase of a single surgeon using the Dexter Robotic System based on operative times while accounting for bilaterality and complexity.

MATERIALS AND METHODS:

This is a retrospective data analysis of the first 41 consecutive cases of TAPP inguinal hernia repair procedures (25 unilateral and 16 bilateral) that were performed using the Dexter System. The procedures were performed by a single surgeon over 12 months. We report the feasibility of solo surgery in robot-assisted inguinal hernia repair using Dexter.

RESULTS:

Mean skin-to-skin operative time was 53 min for the unilateral hernia with a significant decrease in operative time from 65 min for the first tertile to 38 min for the third tertile (P < 0.05). For bilateral hernia, the mean skin-to-skin operative time was 81 min with a decrease from 88 min for the first tertile to 71 min for the third tertile, nonstatistically significant. All procedures were conducted fully robotically without any conversion to open surgery or laparoscopy. There were no major complications. Minor postoperative complications were reported in three patients (pain at one trocar site with spontaneous resorption, one trocar hematoma with total resorption at 30 days, and one small seroma). Once the surgeon achieved a consistent level of performance with various types of groin hernia repair, the surgeries were conducted with the surgeon operating independently (solo surgery).

CONCLUSIONS:

This study demonstrates the feasibility and safety of the robotic approach for inguinal hernia repair using the Dexter system for a surgeon new to robotic techniques. During the initial learning phase observed in the first 41 cases, r-TAPP was associated with an early reduction in operative time.
Objective Assessment of Bowel Perfusion in Colorectal Surgery: Review of Intraoperative Infrared Thermography
Authors: Singh Barun Kumar , Rawat Saumitra , Singhvi Suresh Kumar , Yadav Amitabh , Dhir Ushast , Mustafa Sheikh Muhammad Taha , Agarwal B. B.
Published: June 2024

ABSTRACT

Introduction:

Anastomotic leak (AL) is the Achilles’ heel of colorectal surgery. Adequate perfusion of the bowel segments to be anastomosed is a prerequisite for healing. Traditionally surgeons have assessed bowel perfusion subjectively, and studies indicate that it is not sensitive in predicting anastomotic leak rates. Hence, a need for objective assessment of bowel perfusion was advocated and various techniques have been developed to assess bowel perfusion. The purpose of this review is to study the clinical application of intraoperative infrared thermography (IRT) in assessing bowel perfusion in colorectal surgery and its effect on the rate of AL.

Methods:

Literature search using keywords ‘colo-rectal surgery’ ‘bowel perfusion’, ‘anastomotic leak’, ‘infra-red thermography’ was done. All english language studies investigating role of infra-red thermography in assesing bowel perfusion were included in analysis.

Results:

Nine studies were found where bowel perfusion was assessed using IRT in humans as well as animals. These studies demonstrated that IRT is a sensitive and safe investigation and can be used as an adjunct in colorectal surgery. None of the studies were large enough to demonstrate a statistically significant effect on AL rates.

Conclusion:

IRT appears to be a feasible adjunct in colorectal surgery and appears to be a safe and sensitive method to assess bowel perfusion. Further randomized controlled trials with larger patient population are required to advocate its routine use in colorectal surgery.
Gout Arthritis of Temporomandibular Joint - A Rare Case Report and Review of Literature
Authors: Kumar Nishant , Jyotsana Kumari , Srinivasa Raju M. , Bhagawati Basavaraj T.
Published: June 2024

Gout is a metabolic disorder that leads to elevated serum uric acid levels and deposition of urate crystals in the joints. The disease is usually confined to the joint space and leads to pain and limitation of jaw opening. The case describes a 45-year-old female patient with a chief complaint of ‘occasional pain in the left temporal muscle region’. The case disclosed a gout manifestation in the temporomandibular joint (TMJ) after physical and radiographic findings. Gout manifestation in the TMJ is an unusual presentation and a few reports in the English literature address the subject. Gout in the TMJ should be included as a differential diagnosis for joint disorders because of its rarity. A clinician may overlook gout involving the TMJ in the differential diagnosis of facial pain even when the patient has received a diagnosis of gout in other joints.
Effects of Water Sorption and Solubility on Degradation of Silorane and Methacrylate-Based Dental Composites
Authors: Madhyastha Prashanthi S. , Naik Dilip G. , Natarajan Srikant , Kumar Bhat M.R. , Vinodhini Rachel S.
Published: June 2024

Introduction:

Wet oral environment may have deleterious effects on performance of the composites due to influences of water sorption and solubility. The study evaluated the hydrolytic degradation caused because of water sorption and solubility of silorane and methacrylate-based dental composites.

Methods:

Ten disc samples (2 mm × 10 mm) were prepared. Samples were analyzed for water solubility and sorption according to ISO 4049:2000 regulations and tested for mass gain or loss following immersion in water or in artificial saliva at 1 day, 15 days, and 30 days period. Student’s ‘t’ test, repeated measures analysis of variance (ANOVA), and Tukey’s post-hoc tests determined statistical significance of the experimental results with global significance set at P = 0.05.

Results:

Considerable sorption and solubility was observed with time in both materials on immersion. Silorane composites showed lower water sorption and solubility than methacrylate-based composite (MBC). Artificial saliva demonstrated higher sorption and solubility compared to distilled water.

Conclusion:

Silorane composites display enhanced hydrolytic stability even after a month of immersion in contrast to conventional methacrylate-based composites (MBCs), making it a better alternative to MBC resins clinically.
A Simplified Technique to Record Neutral Zone and Cameo Surface in Complete Denture
Authors: Nanda Aditi , Kaur Harsimran , Koli Dheeraj , Verma Mahesh
Published: June 2024

Introduction:

Providing complete denture therapy to patients with atrophic residual alveolar ridges is challenging, because these patients suffer ongoing resorption of the denture foundation; regardless of contemporary treatment options, physiologically optimal denture contours and appropriate denture tooth arrangement should be achieved to maximize prosthesis stability, comfort and function for patients. One of the methods used to achieve the stability is the neutral zone technique.

Aim:

It is in this zone that the natural dentitions lie and this is where the artificial teeth should be positioned. This article describes a preview of faciolingual positioning of denture teeth along with a novel approach of recording the neutral zone.

Conclusion:

The neutral zone is the area where the displacing forces of the lips, cheeks and tongue are in balance. Physiologic recording of the neutral zone aids in stability to the prosthesis.
Effectiveness of Plaque Removal Using Different Toothbrushes in Children - A Comparative Study
Authors: Obukavitha D , Geetha Priya PR , Asokan Sharath , Yogesh Kumar TD
Published: June 2024

Background:

Effective plaque control is essential for improved oral health. Advancements in mechanical plaque removal using toothbrushes still continue. One such sophisticated intervention is the app-based toothbrush, a new innovative technology that helps to track the child’s brushing habits.

Aim:

The aim of this study is to evaluate the plaque removal efficacy of three different toothbrushes in children aged 6–8 years.

Methods:

A randomized controlled clinical trial was conducted among primary school children with decayed missing filled teeth (dmft) score of ≤2. Baseline plaque score was collected using Turesky modification of the Quigley and Hein Index 1 week after oral prophylaxis. Children were randomly divided into three groups. Group I received conventional toothbrush (n = 25), group II received powered toothbrush (n = 25), and group III received app-based toothbrush (n = 25). Post-intervention plaque score, toothbrush wear and bite mark scores were done at the 15th, 30th, 45th and 90th day. Participant’s opinion on their toothbrushes was evaluated using a questionnaire.

Results and Conclusion:

App-based toothbrush showed maximum plaque reduction followed by powered and conventional toothbrush. Significant reduction in plaque score was seen at 30th-, 45th- and 90th-day follow-up in group II (<0.001) and group III (<0.001). There was no appreciable difference in the toothbrush wear and bite mark score between the three groups. Children preferred app-based toothbrush in spite of the complex nature of using it.
Prostate Metastasis in Oral Malignant Melanoma - A Case Report
Authors: Muthukumaran Vaishnavi , Warrier S Aravind , Balaji Barath , Elengkumaran S , Thamizhchelvan H , Divyambika CV
Published: June 2024

Melanoma is the ninth most prevalent and the second most lethal tumour. The aetiology and pathogenesis remain uncertain. It occurs in elderly people, over the fifth decade, and is predominant in males. Clinically, they present as an asymptomatic macular or nodular growth. The prognosis is impacted by the size of the tumour and distant metastases. Patients with distant metastases have a 5-year survival rate of less than 30%, constituting metastasis as the major cause of melanoma-related fatality. Currently, the mainstay of treatment for metastatic melanoma is immunotherapy due to the inoperable state, radioresistant nature of the tumour and high chances of cytotoxicity in chemotherapy. A senile male patient, who was diagnosed with oral malignant melanoma of the maxillary buccopalatal gingiva with distant metastasis to the liver and the prostate, is reported here. Although metastasis to the liver is common among malignant melanomas, in this case metastasis to the prostate gland highlights the rarity.
Microbial Contamination of Dental Unit Waterlines among Dental Clinics of India- An In vitro Study
Authors: Kengadaran Shivashankar , Vikraman Rakshagan , Indumathi K.P , Sundaragopal Arun Kumar , Adiraju Vani Anusha , Anusha Divvi
Published: June 2024

Background:

Dental Unit Water Line (DUWL) deliver water to different handpieces in a dental unit. The water in DUWL circulates in a closed system, where it is taken from a container. The quality of dental water is of considerable importance since patients and dental staff are regularly exposed to water and aerosols generated from dental equipment. Output water from DUWLs may be a potential source of infection for both dental health care personnel and patients.

Aim:

To assess the microbial contamination in the DUWL among dental clinics in Chennai.

Materials and Methods:

An in vitro study was conducted on 60 water samples from 20 dental clinics in Chennai in December 2019. Water samples were collected from three different sources of the Dental unit according to ADA guidelines. The collected samples were assessed for the presence of Aspergillus, Acinetobacter, Pseudomonas aeruginosa, and Legionella by agar plate method. The data were analysed using SPSS software version 20.

Results:

Legionella was the most prevalent microorganism with 70% prevalence in a three-way syringe and 50% in scaler and airotor, followed by Pseudomonas aeruginosa and Acinetobacter with 10% prevalence in scaler and airotor and Aspergillus with a prevalence of 10% in the three-way syringe.

Conclusion:

Most of the dental units were contaminated with Aspergillus, Legionella, Pseudomonas aeruginosa and Acinetobacter which pose a serious threat to the patients as well as the dentists.
A Comparison of Preparation Times between Manual, Rotary, and Reciprocating Files in Primary Molar Pulpectomy
Authors: Middleton Ilana , Vorster Martin , van der Vyver Peet J.
Published: June 2024

Aim:

To compare preparation times using manual, rotary, and reciprocating files during pulpectomy treatment of primary molars.

Settings and Design:

This study was an in vitro, randomised, cross-sectional study.

Methods:

The study was performed on 60 extracted human primary mandibular second molars. Only mesiobuccal canals were prepared using one of three preparation techniques; each preparation technique group comprised 20 canals. Canal preparations were performed by a single, skilled operator using stainless-steel (ss) K-files (ISO size 20–35), a ProTaper Gold SX file, and a WaveOne Gold Medium file following glide path preparation. Preparation times were recorded in second (s) with a digital stopwatch.

Statistical Analysis:

Preparation times were compared using analysis of variance and the Kruskal–Wallis analysis of variance, where appropriate. The level of significance was set at P ≤ 0.05.

Results:

The mean preparation time using the ss K-files was significantly longer (186.4 s) than when using the ProTaper Gold SX (29.6 s) or WaveOne Gold Medium files (30.5 s) (P < 0.001). Similar preparation times were recorded when using the ProTaper Gold SX and WaveOne Gold Medium files (P = 0.939).

Conclusion:

Preparation times with the ProTaper Gold SX and WaveOne Gold Medium files were significantly faster than when using the ss K-files to prepare primary tooth root canals for pulpectomy. Similar preparation times were noted when using the rotary and reciprocation instrumentation groups (P > 0.05).
Assessment of Phubbing, Smart Phone Addiction and Related Psychological Variables among Dental Undergraduates: A Multicentric Study
Authors: Gijwani Deeksha , Batra Manu , Jindal Aanchal , Vishnupratap Dwivedi R. , Kaur Puneet
Published: June 2024

Background:

Internet Addiction and phubbing are prevalent disruptive behaviours among students. The aim of this study was to assess the relationship between phubbing, smartphone addiction and some of the related psychological effects among dental undergraduates.

Materials and Methods:

A multi-centric cross-sectional pre-validated questionnaire-based study was conducted among undergraduate students of five different dental colleges across India. The questionnaire included the Phubbing Scale, Barratt Impulsiveness Scale (BIS), Smartphone Application-based Addiction Scale (SABAS), and Rosenberg Self-Esteem Scale (RSES). The data were analysed with IBM SPSS version 21, followed by a t-test, analysis of variance (ANOVA), and Spearmen’s co-relation to find the association between different psychological variables among study subjects.

Results:

The total sample comprise of 1226 with mean age of 22.35. The SABAS showed a higher mean ± standard deviation (SD) score (3.17 ± 0.93). The Phubbing Scale showed a positive correlation with the SABAS (0.658), the results were found to be highly statistically significant (P = 0.01).

Conclusion:

The present study found a higher prevalence of phubbing and smartphone addiction among dental students. Our results showed that impulsiveness leads to internet addiction and thus phubbing is becoming a way to find solace during communication to escape anxiety and distress.
Oral Health Behaviour and its Influence on Oral Health Status and Related Quality of Life among Dental Outpatients - A Cross-Sectional Study
Authors: Divvi Anusha , Junaid Mohammed , Indumathi K.P , Bhogte Seema Ashwin , Chaly Preetha Elizabeth , Kengadaran Shivashankar
Published: June 2024

Objectives:

This study aimed to predict oral health behaviour (OHB) using the theory of planned behaviour (TPB) and determine its influence on oral health status and oral health-related quality of life (OHRQoL) among subjects attending the outpatient department of a tertiary dental hospital in India.

Methods:

A pre-validated questionnaire was used among 240 randomly selected study subjects to record their demographic details, attitudes (Att), subjective norms (SN) and perceived behaviour control (PBC) with regard to dietary habits (DH), oral hygiene habits (OH) and dental attendance (DA) behaviours. OHRQoL and oral health status of study participants were recorded using Oral Health Impact Profile-14 (OHIP-14) and World Health Organization (WHO) Oral Health Assessment Form (2013), respectively. Multivariate analysis was performed after the necessary bivariate comparisons.

Results:

Among demographic characteristics, the Socioeconomic status (SES) of the study subjects highly influenced their DH and OH (P < 0.05). DA was largely affected by the age of the study subjects (P < 0.05). While attitude of the study participants greatly affected their DH, PBC largely influenced their OH and DA behaviours (P < 0.05). The OHRQoL and Decayed Missing Filled Teeth (DMFT) levels were strongly influenced by the participants’ DA behaviours (P < 0.05).

Conclusions:

DMFT scores and OHRQoL were highly influenced by DA behaviour besides others. DA instead was influenced by PBC. Hence, there needs to be a conscious shift towards strengthening the skills of the population to promote oral health.
Assessment of Perception of Pain with E-Speed Film, CCD Sensor and Photostimulable Phosphor Plates for Intraoral Radiographs in Children using Three Pain Rating Scales
Authors: Juneja Suruchi , Dalvi Shital , Aggarwal Rajni , Sukhija Manish , Singh Sohajpreet , Bansal Shaveta
Published: June 2024

Background:

Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the soft tissues. Thus, the perception of pain with three intraoral radiographic methods in children was evaluated using three subjective pain rating scales.

Aim:

To evaluate the discomfort with three different techniques, that is, intraoral periapical (IOPA) radiograph, charge-coupled device (CCD), and photostimulable phosphor (PSP) luminescence (PSPL), using the Wong–Baker Faces Pain Rating Scale (WBFPRS), numerical rating scale, and visual analog scale (VAS).

Materials and Methods:

A sample of 35 children aged 6–12 years were divided into two groups: group 1 (6–8 years) and group 2 (9–12 years). For each child, simulations of the three radiological methods (IOPA, CCD, and PSPL) were performed. The meaning of each facial expression on the WBFPRS, VAS, and the numbers on the numerical rating scale was explained to each child before the procedure.

Statistical Analysis Used:

A one-way analysis of variance (ANOVA) test and paired-samples t-test are used.

Results:

The results revealed that the CCD sensors elicited higher pain scores than those obtained with IOPA and PSPL, whereas the IOPA film showed the least pain score. Higher score values were obtained in group 1 than in group 2, indicating that children aged 6–8 years felt higher discomfort than the 9- to 12-year age group for the same procedure. This difference was statistically significant (P < 0.001).

Conclusion:

It was concluded that conventional IOPA films were tolerated better by children when compared to PSP plates and CCD sensors.
Management of Broken Screw Inside Implant Screw Channel: A Case Report
Authors: Azim Sabrin Ali , Aldrissi Hafsa Ali , Annamma Lovely M. , Warreth Abdulhadi
Published: June 2024

Rationale:

This case report outlines a novel prosthodontic approach for managing a broken screw inside an implant screw channel, emphasising the importance of innovative solutions in implant dentistry.

Patient Concerns:

A 57-year-old male patient sought restoration for implant-supported crowns (#46 and #47). A broken screw inside the implant screw channel posed a significant concern for both the patient and the dental team.

Treatment:

Utilising an impression pickup technique of the inner surface of the implant body, a custom titanium abutment was fabricated in the laboratory and restoration was successfully replaced. A follow-up of 6 months was performed, ensuring optimal function and patient satisfaction.

Outcome:

The custom titanium abutment with a zirconia crown was placed, leading to a successful restoration. The patient reported no discomfort, demonstrating improved function and aesthetics.

Take-away Lesson:

This case highlights the effectiveness of tailored prosthodontic interventions in addressing complex implant-related complications.
Maxillomandibular Fusion Along with Fusion of Dorsal Surface of the Tongue to the Hard Palate—A Case Report
Authors: Balaji S. M. , Munnee Krishna , Balaji Preetha , Chellaraj Chris Joseph , Nishanth Sachin , Balaji Varsha Christy Rani
Published: June 2024

Rationale:

This case report presents a rare combination of congenital anomalies in an otherwise healthy male infant born at 36 weeks. The infant was diagnosed with congenital maxillomandibular synechia, ectrodactyly, and ankyloglossia superior syndrome (ASS).

Patient Concerns:

Inability to open the mouth completely, feeding challenges, and a cleft palate. The infant was stabilized through successful positive pressure ventilation via a face mask at birth and enteral feeding was initiated via a feeding gastrostomy.

Examination:

Diagnostic tests revealed a midline palatal cleft, hypoplastic jaws, persistent metopic suture, and a bony fusion at the midline.

Treatment:

Sectioning of the bony spur along the midline and achieving a mouth opening of 2 cm post-manipulation. The patient is under follow-up, with future treatment plans including cleft palate correction at 12 months and potential frontomandibular and lower jaw advancement depending on growth trajectories.

Take-away Lessons:

This case underscores the complexity of managing multiple congenital anomalies and the need for individualized treatment plans.
Management of Partially Edentulous Arches Using a Cast Metal Framework with Thermoplastic Denture Base Clasp-Like Extension on Anterior Abutment Teeth – A Case Report
Authors: Mithula MS , Manoj Smita Sara , Varghese Kurien , Ravi Radhika
Published: June 2024

Rehabilitation of partially edentulous arches with a cast partial denture is a commonly opted treatment modality where fixed prosthesis is not indicated. However, due to the aesthetic compromise of the various metal components when placed in the esthetic zone, different modifications have been considered for its fabrication. This case report describes a novel way of restoring partially edentulous arches with increased masticatory efficiency and good emergence profile without compromising the patient’s esthetic desires. The report describes an aesthetic alternative using thermoplastic denture base clasp like extension for anterior abutment teeth while restoring the missing teeth with a cast partial denture.
Etiology of Community Acquired Pneumonia at a Tertiary Care Hospital
Authors: Jha Ritika , Sengupta Sumit , Mukhopadhyay Anshuman , Chakraborty Ritam
Published: June 2024

Background: Data regarding etiological profile of community acquired pneumonia are sparse, and a variation is seen in studies from different parts of India, hence underlining the need for local data for better patient management. Methods: Retrospective database analysis was done. Patients aged >18 years admitted from August 2019 to February 2020 at AMRI Hospital, Salt Lake, Kolkata, India with a diagnosis of community acquired pneumonia were included in the study. Pneumonia Severity Index and CURB 65 were used to assess the severity. Chest radiographs were thoroughly examined. Upper and lower respiratory BIOFIRE panels, sputum culture, blood culture, urinary pneumococcal antigen, and Xpert Flu were used to identify the pathogens. Outcomes were recorded. Result: No pathogen could be isolated in 30 (36.14%) cases. Viral agents were isolated in 21 (25.3%) cases. Streptococcus pneumoniae was the most common pathogen, isolated in 17 (20.48%) cases followed by Haemophilus influenzae in nine cases (10.84%), influenza virus in six cases (7.2%), Moraxella catarrhalis, rhino virus, and parainfluenza virus in five (6.02%) cases each, Staphylococcus aureus and Corona virus in four cases (4.8%), Klebsiella pneumoniae in three cases (3.61%), Mycoplasma pneumoniae in two cases (2.41%), as well as RSV, adenovirus, pseudomonas, proteus, acinetobacter, and Aspergillus fumigatus were in one (1.2%) case each. Severity of pneumonia at presentation was significantly associated with outcome. Conclusion: A total of fifty-three cases, in which a pathogen could be isolated, viral agents were isolated in 21. S. pneumoniae was the most common pathogen isolated (17 cases) followed by H. influenzae (9 cases). More than 1 pathogen was isolated in 12 cases, of which nine had one viral and one bacterial agent; S. pneumoniae being the most common bacterial co-pathogen.
The roles and outcomes of surgery in large anterior mediastinal tumors
Authors: Ho Yan Le , bin Jamaluddin Mohammad Fauzi , Lopez Gerard Francis , Krishinan Sotheenathan , bin Khamis Abu Yamin , bin Abdul Kareem Basheer Ahamed
Published: June 2024

Introduction: Large anterior mediastinal tumors are rare and encompass a wide diversity of neoplasms. The anatomical complexity of large mediastinal tumors poses clinical challenges in term of surgical feasibility, tumor resectability, and disease curability. Due to the rarity of this clinical entity, very few studies have been conducted on large mediastinal tumors. Here, we describe the surgical approach and outcomes of surgery for large mediastinal tumors. Method: A retrospective analysis was conducted on patients with large anterior mediastinal tumors who underwent biopsy and surgical resection at our center from January 2018 to December 2020. Results: A total of 87 patients were referred for anterior mediastinal tumors, and 42 of them (48.3%) had tumors larger than 8 cm. The average age was 36.4 years, with a male-to-female ratio of 4:6. The average tumor size was 13.2 cm. Twenty-six patients (61.9%) underwent surgical biopsy; 16 of them were diagnosed with lymphoma, and another 10 patients had nonlymphoma tumors. Complete surgical resection was performed on 24 patients (57.1%). Surgical biopsies were performed using video-assisted thoracoscopic surgery (61.5 %) and the Chamberlain procedure (38.5%). Surgical resection was performed with median sternotomy (66.7%), thoracotomy (20.8%), and hemiclamshell approach (12.5%). There were no immediate postoperative mortality. Conclusion: This series has shown the clinical feasibility of definitive surgical management for large mediastinal tumors, with positive clinical outcomes. Given the rarity of large mediastinal tumors, detailed preoperative preparation with multimodal imaging and multidisciplinary team discussion are essential for favorable surgical outcomes.
Left Ventricular Noncompaction: Often Forgotten Cause of Heart Failure
Authors: Sathyamurthy Immaneni
Published: June 2024

Left ventricular (LV) noncompaction is a form of genetic cardiomyopathy characterized by hypertrabeculations with deep intertrabecular recesses of the LV myocardium. The diagnosis can be confirmed by echocardiography and magnetic resonance imaging. These patients can be asymptomatic or may present with heart failure, arrhythmias, or thromboembolic episodes. The management is guideline directed. When associated with congenital heart defects or correctable valvular lesions, surgical management should be advised. Familial screening and counseling of first-degree relatives are essential. In this review, an attempt has been made to give an overview of this condition.
C3PW: A Novel Machine Learning Method for Assessing Percutaneous Transvenous Mitral Commissurotomy Outcome in Patients with Mitral Stenosis
Authors: Mani Subramaniyan , Kini Prayaag , Rachakonda Raghunatha Sarma
Published: June 2024

Background:

Patients with symptomatic moderate-to-severe mitral stenosis (MS) with pliable valves are indicated for percutaneous transvenous mitral commissurotomy (PTMC) typically over a valve replacement based on favorable anatomic characteristics. Currently, this decision is arrived based on Wilkins’ echocardiographic score which is considered to be a simplistic estimate often. In the current work, the authors present a novel machine learning (ML) framework that considers a comprehensive set of clinical and echocardiographic variables to indicate the possible outcome for choosing the transvenous procedure over an invasive surgery.

Methods:

Data considered for this retrospective study included demographic, clinical, and preprocedural echocardiographic variables pertaining to patients with moderate-to-severe MS without significant mitral regurgitation (MR). The success of the procedure was defined by four different postprocedural variables such as the final mitral valve area (MVA), MR, left atrial pressure, and right ventricular systolic pressure (RVSP). Three data mining tasks highlighting the importance of ML techniques to predict the outcome of the PTMC procedure in patients with MS have been demonstrated. The potential predictive value of the outcome of a PTMC procedure considering a comprehensive set of variables using ML techniques has not been investigated till date according to the authors’ knowledge. Cover coefficient-based clustering power as weights (C3PW), a novel problem transformation technique which deals with the multilabel classes, is proposed to correctly classify the patients having successful PTMC procedure.

Results:

Extreme gradient boosting (XGB), an ML technique, gave the best performance (accuracy: 0.79; F-score: 0.87) on the transformed single-label problem. Application of association rule mining revealed that a combination of the following parameters such as “initial MVA” <1 cm2, “RVSP” <50 mmHg, “valvular calcification” score ≤2, “leaflet mobility” score ≤2, and “normal sinus rhythm” plays a crucial role in determining the success of the PTMC procedure. The identified variables with their indicated ranges having a significant “I-rule” value can be put together as a scoring index to predict the successful outcome.

Conclusions:

A ML-based artificial intelligence tool has been demonstrated to serve as an alternative to the Wilkins score to select patients for a successful PTMC procedure. Of the various models tested, the C3PW approach with XGB algorithm demonstrated the best evaluation metrics. A systematically analyzed ML framework that yields highly interpretable and conclusive findings with high confidence has been demonstrated to be a useful tool in clinical decision-making.
The Positive Effect of Deep Breathing Exercises on Blood Pressure Values among Hypertensive Persons
Authors: Verma Niharika , Verma Ravita
Published: June 2024

Background: Hypertension is a medical condition in which the blood pressure in the arteries increases. Hypertension is characterized by an increase in systolic pressure or a rise in diastolic pressure above the normal values. Aim: The aim of the study is to assess the effect of deep breathing exercises on blood pressure values among hypertensive persons in selected areas in district Mohali, Punjab. Subject and method: A quantitative research approach design has been adopted for the study. 80 hypertensive persons were selected through convenient sampling technique. Results: Results revealed that the mean score of systolic blood pressure values in pre-test and post-test among hypertensive persons in experimental group was 140 ± 8.929 and 123 ± 7.663 respectively whereas the mean score of systolic blood pressure values in pre-test and post-test among hypertensive persons in control group was 139.37 ± 8.101 and 137.50 ± 6.097 respectively. Findings depicted that the mean score of diastolic blood pressure values in pre-test and post-test among hypertensive persons in experimental group was 88.50 ± 5.089 and 77.13 ± 4.921 respectively. Whereas, the mean score of diastolic blood pressure values in pre-test and post-test among hypertensive persons in control group was 88.625 ± 5.062 and 87.50 ± 3.755 respectively. Conclusion: It has been concluded that deep breathing exercises are effective to reduce the blood pressure values among hypertensive persons in experimental group.
Assessment of the Relationship between High Blood Pressure and the Risk of Prostate Cancer among Patients in South-West, Nigeria
Authors: Chima Sowunmi Anthonia , Samuel Oyerinde Adebowale , Fisayo Asaolu M. , Ibukunoluwa Ayo Ebunolorun
Published: June 2024

Introduction:

Prostate cancer is the sixth leading cause of death worldwide. Nonmodifiable and modifiable lifestyle risk factors have been implicated and associated to its development and progression. There is a need to assess and establish the relationship between blood pressure (BP) and the risk of prostate cancer.

Materials and Methods:

This was a multicenter, prospective cross-sectional study of 400 patients at four tertiary hospitals in South-West, Nigeria. Participants were recruited into four arms, namely freshly diagnosed prostate cancer, hypertensive, combined hypertensive with prostate cancer, and control. Anthropometric measurements, BP, and family history were extracted from the case files. Biochemical analyses of venous samples were performed. One-way analysis of variance followed by post hoc Duncan test was conducted to determine the difference in the mean BP levels among the four arms.

Results:

High-density lipoprotein cholesterol in hypertensive patients was significantly lower (P ≤ 0.035) when compared with the other arms. Plasma total cholesterol (P < 0.074), low-density lipoprotein cholesterol (P < 0.029), and the mean C-reactive protein (P < 0.017) were significantly high in the hypertensive with prostate cancer group when compared with the other arms. The mean plasma testosterone concentration (P < 0.041) and the plasma calcium levels (P < 0.055) were significantly higher in the control group compared with other arms.

Conclusion:

Virtually, the same parameters were altered in hypertensive, prostate, and hypertensive prostate cancer patients, showing an association between hypertension and prostate cancer, which can be concluded that hypertension may be a predisposing factor to the development of prostate cancer.
Etiology, Clinical Profile, and Outcome of Unprovoked Seizure in Children: A Prospective Observational Study from Eastern India
Authors: Biswal Basudev , Agarwalla Sunil Kumar , Das Monalisa
Published: June 2024

Background:

Unprovoked seizures in children refer to seizures that occur without an immediate precipitating factor, such as fever, infection, or head injury. These seizures are often a manifestation of an underlying neurological condition and can be indicative of epilepsy if recurrent. Understanding the causes, diagnosis, and treatment options for unprovoked seizures in children is crucial for proper management and care.

Materials and Methods:

This prospective observational study was carried out in the pediatrics department of a tertiary care teaching hospital over a period of 2 years. A total of 85 children aged <14 years were included in this study. All the data related to demography, clinical and laboratory parameters, and treatment outcomes were recorded. Descriptive statistics were used to analyze and report the data.

Results:

In the present study, 5-10 year age group constituted the majority with male dominance. Generalized seizure was the most common type. The complex partial seizure was common in the remote symptomatic group than in the idiopathic seizure (IS) group. History of febrile seizure was present in <10% of cases. Around 16.5% of cases had developmental delay or mental retardation. Status epilepticus at presentation was seen in 36.37% of cases, and 37.65% were newly diagnosed epilepsy. Neurocysticercosis alone accounted for 14.12% of all cases and euro-tuberculosis alone accounted for 12.94% of all cases of unprovoked seizure. Seizure recurrence was common in the idiopathic group, complex partial seizure type, and those not taking an antiseizure medication (ASM).

Conclusions:

Unprovoked seizure is a common problem in children. IS/cryptogenic seizure is more common than remote symptomatic etiologies. Electroencephalogram and neuroimaging should be done in all cases. Seizure recurrence was common in the idiopathic group, complex partial seizure type, and those not taking an ASM.
Clinical Profile and Outcome of Pediatric Scrub Typhus: A Prospective Observational Study from Eastern India
Authors: Sethy Geetanjali , Das Rashmi Ranjan , Mallick Manas Ranjan , Sahu Satyapriya , Ghoshal Preetam
Published: June 2024

Background:

Scrub typhus is a bacterial infection caused by Orientia tsutsugamushi, which is transmitted to humans through the bite of infected chiggers (larval mites). While scrub typhus can affect individuals of all ages, including children, its clinical presentation and management in children may differ slightly from adults. There is a dearth of studies on pediatric scrub typhus from Eastern India.

Materials and Methods:

This prospective observational study was carried out in the pediatrics department of a tertiary care teaching hospital for 18 months. A total of 64 children aged <14 years were included. All the data related to demography, clinical and laboratory parameters, and treatment outcomes were recorded. Descriptive statistics were used to analyze and report the data.

Results:

The children affected most commonly belonged to the age group of 5–10 years (53.1%). Males were most commonly affected (61%). Fever was the presenting complaint in all but one case (98.4%). Other common symptoms were headache, vomiting, cough, seizure, and pain abdomen. Hepatomegaly was the most common physical finding seen in 84.4% of cases and Eschar in 75% of cases. Meningitis/encephalitis was the most common complication seen (43.8%). All children responded to the injection doxycycline, but one died (mortality rate 1.6%). Children who were cured did not show any sequelae at discharge.

Conclusions:

This study concludes that scrub typhus is a neglected rickettsial disease prevalent in our country. For timely diagnosis, treatment, and favorable outcome, a high degree of suspicion and knowledge about geographical distribution and clinical manifestations is important. This study can provide clues for primary care physicians to diagnose and treat scrub typhus early.
Serological Response to COVID-19 Vaccination is Impaired in Adults with Hematologic Malignancies when Compared to Adults with Solid Tumors and HIV: Observations from a Single Tertiary Institution
Authors:   Virginia Mason Medical Center, WA, Seattle,, He Bowen , Vishnu Prakash , DeBerg Hannah A , Aboulafia David M
Published: June 2024

Background: Hematologic malignancies can impair immune responses following COVID-19 vaccination. We analyzed seroconversion rates following a primary two-dose COVID-19 vaccination series and subsequent seroconversion rates after booster doses (doses 3 and above) in patients with various subtypes of hematologic malignancies (HM), human immunodeficiency virus infection (HIV), and solid tumors (ST). Methods: We conducted a retrospective study of 299 fully vaccinated adults with HM (n=202), HIV without diagnosed cancer (n=48), HIV and cancer (n=17), ST (n=12), autoimmune diseases (n=12), or other hematologic diseases (n=10) seen in a single tertiary institution between May 2020 and July 2022. A serum spike antibody level ≥0.8U/mL was considered evidence of seroconversion as defined by the manufacturer (Roche Elecsys®). A Mann-Whitney test was utilized to analyze continuous variables and a chi-square test for categorical variables. Results: Seroconversion after initial vaccination was significantly associated with disease category and treatment. Seroconversion rates were lowest in people with B-cell lymphomas (including patients not currently receiving treatment) (44/68) and patients receiving anti-B-cell monoclonal antibodies (23/57). All individuals with HIV alone or ST (n=60) demonstrated seroconversion after initial vaccination as did 94% of individuals with HIV and cancer (16/17) and 86% of those with plasma cell dyscrasias (37/43). Of the 51 people who did not seroconvert after their primary vaccination course, 25 achieved seroconversions after one booster dose. Conclusion: Our study supports the potential utility of COVID-19 serological testing to identify those at high risk of impaired response to COVID-19 vaccination and to help physicians develop personalized vaccination strategies. Continued research is needed to refine our understanding of immune response in these patients and improve their protection against COVID-19. Keywords: COVID-19 Vaccination, Impaired Immune Response, Seroconversion, HIV, Hematologic Malignancies
Spectrum of Special Variants of Breast Carcinoma and Differentiated Ductal Carcinomas with their Immunohistochemistry Profile in a Tertiary Care Centre
Authors:   Dhanalakshmi Srinivasan Institute of Medical Sciences and Hospital, Thuraiyur Road, Perambalur, 621 212, Tamil Nadu, India, Manjula N , Jayanthi C , Srivani S , Kumaran Damodara
Published: June 2024

Background: Breast cancer is a diverse disease with varying characteristics in morphology, presentation, treatment, and prognosis. It constitutes 25% of cancers in Indian women. This study delves into rare special variants and differentiated ductal carcinomas, focusing on their unique histological features and molecular profiles. Aim: To scrutinize the spectrum of special forms of breast carcinoma and their immunohistochemistry (IHC) profile. Material and methods: A retrospective analysis of all the breast carcinomas over a period of 11 months was carried out. The clinical, gross, microscopic and immunohistochemistry findings of 15 special variants and differentiated ductal carcinomas were noted down. Results: In a retrospective analysis of 50 cases of breast carcinoma, 15 were diagnosed as special variants of breast malignancy which accounted to be 30%. Out of the 21 rare histologic subtypes of breast carcinoma 10 variants were encountered by us that included mucinous carcinoma, lobular carcinoma, papillary carcinoma, invasive breast carcinoma with medullary pattern, invasive breast carcinoma with oncocytic pattern, metaplastic carcinoma, cribriform carcinoma, malignant adenomyoepithelioma, secretory carcinoma, and invasive breast carcinoma with neuroendocrine differentiation. Conclusion: This study provides a comprehensive overview of the gross and microscopic features, as well as the immunohistochemistry profiles of these special variants and differentiated ductal carcinomas of the breast. We anticipate that this research will enhance our understanding of these uncommon breast cancer variants, with a particular emphasis on their molecular characteristics, contributing to improved management strategies in the future. Keywords: Breast Cancer, Immunohistochemistry, Molecular Classification