bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic Efficiency of Rice Farming: A Performance Difference among Agricultural Insurance Participant and Non-participant Farmer
Authors: Helmy Eva , Sulistyowati Lies , Noor Trisna Insan , Setiawan Iwan
Published: April 2023

Agricultural insurance is a risk-sharing business arrangement to protect farmers who encounter problems with adverse selection and moral hazards caused by asymmetric information. This situation leads to market inefficiencies since people with more information commonly take advantage of less informed people. This study aimed to compare the performance difference in the economic efficiency of rice farming between Rice Farming Insurance (RFI) participants and non-participant farmers. Primary data were collected from 202 farmers in Tangerang Regency. The marginal value product–marginal factor cost (MVP-MFC) approach was utilized to estimate resource use efficiency in rice production. The t-test was applied to determine differences in input allocation. The MVP-MFC discovered that the use of seeds was efficient for RFI participant farmers. Meanwhile, land, organic fertilizer, and pesticide had not been efficient, and inputs of inorganic fertilizer and labor were inefficient. Conversly, non-participant farmers indicated that the use of land, seeds, organic fertilizers, and pesticides had not been efficient, but the use of inorganic fertilizers and labor was inefficient. However, the comparison test revealed no difference in the input allocation efficiency between RFI participants and non-participant farmers. Hence, innovation in media and extension methods were required to change farmers’ behavior. Government policies were also necessary to ensure the availability of inputs. In addition, avoiding adverse selection and moral hazards in agricultural insurance was required to identify hazardous groups.
Risk of progression to vaginal cancer after successful treatment of high-grade cervical intraepithelial neoplasia: a long-term cohort study in a single institution
Authors: Almeida Gisela , Bernardino Margarida , Jorge Ana Francisca , Luís Catarina , Charepe Nadia
Published: April 2023

Background: Studies on the long-term risk of treated cervical intraepithelial neoplasia (CIN), have shown that these women have a higher risk of invasive cancer in the remaining cervix or vagina, when compared to the general population. This risk persists, for at least, ten years after initial treatment.
Methods: Retrospective cohort study to evaluate the long-term risk of vaginal cancer after treatment of high-grade cervical intraepithelial neoplasia.
Results: The data comprised 460 women with high-grade cervical intraepithelial neoplasia treated at our institution, from January 2012 to December 2020. Three women developed vaginal cancer. The rate of invasive cancer during this period was 181 per 100 000 woman-years. The increased risk of developing cancer was noticed during the first 5 years of follow-up, in women older than 50, and with human papillomavirus (HPV) 16 infections.
Conclusions: Women previously treated for high-grade lesions, are at an increased risk of developing invasive vaginal cancer. This risk is higher in older women. Follow-up of these women should be based on risk, by a combination of co-testing and clinical evaluation.
Analyzing indications for caesarean delivery in a tertiary care facility in India by Robsons Ten Group Classification System: journey to reduce maternal mortality-audit caesarean rates: a prospective observational design
Authors: Mahadik Kalpana , J. S. Shany John , Vohra Shivangani
Published: April 2023

Background: Rising caesarean rates pose a challenge to obstetricians, the healthcare system, and the national economy. High rate of caesarean without clear evidence of a decrease in maternal and neonatal morbidity is matter of concern. The era of impatient obstetricians, and caesareans on demand are major contributing factors. The purpose of this study is to validateTGCS classification for indications of caesarean. This would help to audit and streamline the indications of caesarean. Standardization of indications is the need of the hour. Learning from what has happened in background of local situations is the main aim of this work.
Methods: In a prospective observational design, 1140 women who underwent caesarean for varied indications in C R Gardi Hospital Ujjain were recruited. Patients were classified according to Robson’s Ten Group Classification System. Every woman was observed for post-cesarean morbidities like wound dehiscence, anemia, postpartum hemorrhage, and puerperal sepsis. Neonates were observed for NICU admission, low birth weight, prematurity, respiratory distress syndrome, meconium aspiration syndrome, and death. Chi- Square and student t test were used for analysis.
Results: 45.8% of women were of group 5. Modifiable indications were 60.2% in the primary caesarean of group 5. PPH, puerperal sepsis, PNC anemia, wound dehiscence, DVT, rupture uterus and NICU admission, respiratory distress syndrome of neonates were significantly high in group 5 ( p= less than 0.05).
Conclusions: Out of all caesarean 45.8% are second caesarean for previous one caesarean. PPH, puerperal sepsis, wound dehiscence and PNC anemia are significantly high in group 5.
A study on prevalence of gestational diabetes mellitus and its associated risk indicators in pregnant women attending antenatal clinic in a tertiary health centre
Authors: N. Vinoth
Published: April 2023

Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance (IGT) with onset or first recognition during pregnancy it is associated with adverse maternal and perinatal outcome. The prevalence of gestational diabetes mellitus (GDM) has been increasing globally, with urbanization, sedentary lifestyle, physical inactivity and dietary changes as significant contributing factors. Hence this study was done to study the prevalence of GDM and its associated risk indicators.
Methods: This was a cross sectional study. During the study period, 164 antenatal women between on her first visit were screened for GDM using 50 gm glucose challenge test in all patients if normal it was repeated between 24- 28 weeks of pregnancy and then at 32 weeks. If abnormal 75 gm oral glucose tolerance test (OGTT) done and also repeated at 24-28 weeks of gestation and diagnosed to have GDM. Risk factors for GDM were noted.
Results: The prevalence of GDM in the study population was 23.78%. Prevalence of GDM cases was significantly associated with increased body mass index (BMI). BMI>25 kg/m2 (0.001%) has strong association. Family history of diabetes, previous macrosomia/large for gestational age (LGA) baby and past history of GDM (p<0.00001) also has strong association. Maternal age >25 years (0.001) significantly associated with increased prevalence of GDM but parity was not statistically associated (p=0.358). Incidence of pre-eclampsia and polyhydramnios were significantly higher among GDM cases.
Conclusions: The prevalence of gestational diabetes mellitus (GDM) has been increasing globally, with urbanization, sedentary lifestyle, physical inactivity and dietary changes as significant contributing factors. Maternal age >25 years, BMI>25 kg/m2, family history of diabetes, past GDM and previous LGA baby were important risk factors for GDM. Most of the adverse outcome are preventable by early detection and proper glucose control. Therefore, we recommend screening pregnant women for GDM and establishment of separate diabetic antenatal clinic with availability of diabetician and diabetic councillor.
Evaluation of intrauterine pathologies by hysteroscopy in abnormal uterine bleeding
Authors: Sonam Dhakad  , Sandhya Gadre  , Gunjan Chaudhary
Published: April 2023

Background: Hysteroscopy is the gold standard for uterine cavity evaluation because it allows direct visualization of the uterine cavity, mitigate characteristics of lesions such as nature, size, shape, location and vascular pattern.
Methods: This was a prospective observational study conducted in department of obstetrics and gynecology at Chirayu Medical College and Hospital, Bhopal (MP). Patients presenting to general gyne OPD with abnormal uterine bleeding at Chirayu Medical College and Hospital between January 2021 to May 2022 were studied. All patients selected for study had a thorough evaluation with detailed history, clinical examination, lab tests and sonography followed by hysteroscopy and endometrial biopsy.
Results: Mean age of patients in our study was 44 years with majority of patients in 41-50 years age group. Predominant complaint reported was heavy menstrual bleeding (HMB) (47.50%) followed by HMB with frequent cycle (11.25%). Hysteroscopy detected intrauterine abnormality in 42.50% cases. Most common finding on hysteroscopy in our study was hyperplastic endometrium in 17.50% patients followed by endometrial polyp in 15% of patients. Atrophic endometrium was seen in 2.5% and 2.5% had submucous fibroid.
Conclusions: Hysteroscopy allows diagnosis or exclusion of intracavitary pathologies, which are underdiagnosed on routine pelvic sonography. It also enables treatment in the same sitting with accurate tissue biopsy from the representative areas and facilitates planning of further management. When combined with endometrial biopsy and pelvic ultrasonography, it can establish an accurate diagnosis in a majority of patients thereby reducing the burden of hysterectomy.
Prevalence of gestational diabetes mellitus in intrahepatic cholestasis of pregnancy
Authors: Umaira Fathima R. M.  , K. Garima , Arya Sugandha , Roohat Parveen
Published: April 2023

Background: Incidence of IHCP in Indian population is 0.02%-2.4% and that of GDM is 3.8%-17.9%. Frequent co-existence of both has raised the question of any association. There exists only few studies to prove or disprove any association. Objective of current study was to determine the prevalence of GDM in women with IHCP and to compare the feto-maternal outcome in women with GDM with or without IHCP.
Methods: The study was conducted in the Department of Obstetrics and Gynaecology, VMMC and SJH, New Delhi. Women with singleton pregnancy ≥28wks were recruited for the study and further categorized as women with IHCP and women without IHCP according to their diagnosis of IHCP by the RCOG guidelines. OGTT with 75g glucose was done to make the diagnosis of GDM. Management was as per obstetrics protocol and feto-maternal outcomes recorded till delivery.
Results: No statistically significant difference in the prevalence of GDM observed in both groups (5.4% in women with IHCP and 8.2% in women without IHCP, p=0.220). Significantly higher number of preterm deliveries (21%, p<0.001), induced labour (53.6%, p<0.001), women undergoing LSCS (46.3%, p<0.001) in women with IHCP. No association of FGR, MSL, Fetal maturity, labour onset, mode of delivery, stillbirth, low APGAR score, NICU admission, or PPH in women with GDM with or without IHCP.
Conclusions: The prevalence of GDM is not higher in women with IHCP but significantly higher incidence of preterm delivery, induced labour, and Caesarean sections in women with IHCP. No significant difference in feto-maternal outcome in women with GDM with or without IHCP.
Thrombocytopenia in pregnancy
Authors: Tiwari Nikita , Anjali Kanhere  , Satarupa Paul Dutta  , Nipun Madhav
Published: April 2023

Thrombocytopenia is defined as a platelet count of <150x109/l. It is the second most common hematological abnormality during pregnancy. We present a case series of thrombocytopenia in pregnancy. The aim of this study was to evaluate thrombocytopenia in pregnancy at tertiary care center, Bhopal and to identify, treat and assess the maternal complications and neonatal outcome. In a year, 10 cases were evaluated out of which the diagnosis of 3 cases was immune thrombocytopenic purpura, 3 cases of gestational thrombocytopenia, 3 cases of thrombocytopenia associated with hypertensive disorders of pregnancy and 1 case of HBV induced chronic liver disease associated with thrombocytopenia.
A life threatening secondary postpartum haemorrhage due to AV malformation of uterus: a missed diagnosis
Authors: Mathuriya Sanjay , Mathuriya Gayatri , Jaiswal Ayushi , Tiwari Devyani
Published: April 2023

In current practice, the incidence of c section and other pelvic surgeries has been risen steadily worldwide, so is the complications of surgeries one such rare complication is "AV malformation". The classical presentation of uterine AVM is recurrent profuse vaginal bleeding. Presence of retained product of conception can cause diagnostic dilemma and clinical presentation could be similar. We presented a case report of 19 year old primigravida with secondary post-partum hemorrhage, 1 month following caesarean section. USG shows RPOC so patient was managed conservatively and discharge. Again she had massive bleeding per vaginum on Post LSCS day 57, was re-admitted, as the patient was hemodynamically unstable to save her life hysterectomy was performed, patient  condition improved and was discharged successfully but at the cost of her fertility. HPR showed ‘vascular lesions in lower uterine segment’. Uterine AVM could present in a variety of ways from asymptomatic to periodic or episodic vaginal bleeding or secondary PPH to life threatening torrential vaginal bleeding. The proper diagnosis of AVM is crucial because the primary treatment modalities for the alternative diagnosis of RPOC is dilation and curettage that can worsen the condition. In past AVM were difficult to diagnose. However, availability of Doppler USG scanning has made diagnosis of AVM more feasible. Prompt resuscitation, a high index of suspicion and timely treatment is essential for avoiding a catastrophic outcome in this situation.
Fertility sparing treatment in an infertile patient with severe adenomyosis and a uterine fibroid: a case report
Authors: Yaramareddy Swapna , Siyonu Kumari Sardena  , Nom Kumar Naik Bhukya  , Tulasi Ram Naik Menavath
Published: April 2023

Adenomyosis and uterine leiomyoma are benign lesions of the myometrium. Adenomyosis is a myometrial lesion characterised by the presence of ectopic endometrium with or without hyperplasia of the surrounding myometrium. Uterine fibroids, also called leiomyomas or myomas, are benign tumours that arise from the smooth muscle of the uterus. A 33-year-old nulliparous woman attended the clinic with primary infertility for 18 years. She was diagnosed with severe adenomyosis and uterine fibroids. She conceived successfully after undergoing in vitro fertilization (IVF) and a downregulated frozen embryo transfer (FET). Adenomyosis is a common cause of primary and secondary dysmenorrhea associated with infertility in young, nulliparous women. Fertility preservation is the primary goal in this population. Medical management is essential, and a properly downregulated and planned FET is the treatment of choice.
Factors associated with depression among street vendors inside Kathmandu valley
Authors: Thapaliya Roja , Chaudhary Pramodh , Adhikari Luna , Sangroula Raj Kumar , Thapa Janak
Published: April 2023

Background: Depression is considered a common mental disorder and a major contributor to the global burden of disease. Depression is estimated to affect 3.8% of the population including 5% of adults and 5.7% among adults older than 60 years, and approximately 280 million people in the world (WHO 2021). Major symptoms of depression include depressed mood, loss of concentration, feeling of excessive guilt, dying thoughts, disrupted sleep, changes in appetite etc. Street vending is informal work that has been contributing in millions of people living status and supporting country’s economy.
Methods: A cross-sectional analytical study was conducted among street vendors inside Kathmandu Valley with sample size 316. The study period was from August 2018 to April 2019. Data was collected using standard semi- structured tools using Kobo Toolbox. Data analysis was done in SPSS. Mendeley desktop and statistical package of social science software was used.
Results: Out of 316 respondents, higher number were male i.e., 52.2% whereas females were 47.8%. Respondent with age group 25-35 years was high in number. Respondents engaged in street vending for 8-16 years were found high in number. 32.6% respondents had depressive symptoms while measuring with PHQ and the prevalence of depression was 55.4% which was measured using MDI.
Conclusions: This cross-sectional study was conducted among the street vendors of Kathmandu valley. Among the respondents with low economic status, lack of physical activity, habit of alcohol and smoking had higher prevalence of depression. Respondent with basic and non- formal education, lack of job and income satisfaction showed a positive association with depression.
Adherence to HIV pre-exposure prophylaxis (PrEP) among key populations (KPs): an analytical cross-sectional study in Matayos Sub County, Busia County, Kenya
Authors: Barasa Joseph Wanyama , Kerochi Atei , Mogere Dominic
Published: April 2023

Background: A large percentage of the new cases of HIV/AIDs in Kenya are attributed to Key Populations (KPs). In Kenya, KPs contribute 33% of all new infections of HIV. It is with this realization that in 2017 the government of Kenya launched The Pre-Exposure Prophylaxis (PrEP) for HIV. The study aimed at assessing the factors influencing adherence to PrEP by KPs in Matayos sub-county, Busia County, Kenya.
Methods: An analytical cross-sectional study that utilized a mixed-method data collection approach (n=343) was used to assessing the factors influencing adherence to PrEP by KPs in Matayos sub-county, Busia County, Kenya.
Results: The level of adherence to PrEP using the Morisky Medical Adherence Scale-4 was established to be 37% among all KPs and 36%, 37% and 52% among CSWs, MSMs and PWIDs respectively. Chi-square analysis revealed significant relationship between Level of education (p=0.05), marital status (p=0.001), KP category (p=0.034), occupation (p=0.014), stigma (p=0.00), the perceptions of side effects (p=0.011), facility accessibility (P= 0.00), side effects (p=0.001) and adherence to PrEP. Among the MSMs condom use was established to have association to PrEP adherence (p=0.00).
Conclusions: The study concluded that socio-demographic, individual characteristics, and clinical factors influence adherence to pre-exposure prophylaxis among key populations. The study recommended that key populations need more information on how to use pre-exposure prophylaxis, how it works, the side effects, what to do in case they experience the side effects and why adherence to pre-exposure prophylaxis is important.
Differential of physical activities and its association with hypertension and diabetes in Myanmar
Authors: Win Hla Hla , Mon Aye Sandar , Sandar Win Pa , Rusnak Martin , Walton Poppy , Krishna Anil , Swe Khin Hnin , Koot Jaap J. A. R.
Published: April 2023

Background: Myanmar has been facing a high and growing burden of NCDs. Since regular physical activity has been recognized as one of the effective strategies in prevention and control of NCDs, promotion of physically active lifestyle might help in combatting a number of NCDs. This study was conducted to assess the sociodemographic differentials of physical activity and to identify the association between the insufficient physical activity and occurrence of hypertension and diabetes using data extracted from Myanmar STEP-2014-data.
Methods: This study was further data analysis on 2014 STEP survey and included (5791) 40-64-year-aged participants, a subsample of STEP survey. Binary logistic regression with clustered robust standard error method was applied to estimate the effect of insufficient physical activity on occurrence of hypertension and diabetes.
Results: The findings revealed that 17.5% [95%CI: 16.5%, 18.5%] of participants had the insufficient physical activity, 41.9% [95%CI: 40.6%, 43.2%] had raised blood pressure and 16.9% [95%CI: 15.9%, 17.9%] had raised blood glucose. After adjusting other covariates, the significant association between insufficient physical activity and raised blood pressure was not found; whereas insufficient physical activity was significantly contributed to occurrence of raised blood glucose.
Conclusions: The present study highlighted the importance of physical activity in occurrence of raised blood glucose. The proportions of insufficient physical activity, raised blood pressure and raised blood glucose were observed as a rising pattern with increasing in age. Community-based health promotion program targeted at promoting physically active lifestyle should be adapted to interventions that are appropriate to different age structures.
Assessment of knowledge of hypertension and its risk factors among urban school children of Belagavi: a cross sectional study
Authors: Gunagi Praveena , Harikanth Disha Rama
Published: April 2023

Background: Hypertension has not just remained the disease of adults, but the prevalence is also increasing in children and adolescents. Knowledge of the predisposing risk factors of hypertension is an important step in the modification of lifestyle behaviours to prevent further morbidity and mortality.
Methods: This cross sectional study was conducted among 270 students of 10th standard, belonging to 3 urban schools of Belagavi in 2016 using a structured questionnaire with an intention to assess their knowledge regarding hypertension and its risk factors.
Results: Majority students (69.26%) belonged to class II and III of B.G Prasad socio-economic status and 70.37% came from nuclear family. While headache (80%) was the most answered symptom, heart diseases (67%) was the commonly answered complication. Most students had good knowledge regarding prevention and risk factors like unhealthy diet, physical inactivity etc. Majority had fair knowledge about general factors (54.81%), symptoms (41.11%) and complications (34.11%). Knowledge about stress factors (46.67%) and preventive measures (62.22%) was very good. All these differences were statistically significant (p<0.001).
Conclusions: The overall knowledge about hypertension and its risk factors among the school students was good (68.52%) and there was significant association between the overall knowledge levels with the mothers education and family history of chronic diseases.
The prevalence of musculoskeletal disorders among computer related professionals of Dahod City, Gujarat: a cross sectional study
Authors: Kumar Sanjay , Chinchodkar Kishor N. , Bute Jayashri
Published: April 2023

Background: Use of any gadgets like Laptops/Desktops etc. on daily basis generates disorders in body. The term use to denote this disorder as ‘Musculoskeletal Disorder’ (MSD).
Methods: Observational cross-sectional study was conducted by a random sampling method. A total 350 study subjects taken from Dahod city, Gujarat of various professionals like offices, institutions etc., who were working minimum one year with laptops/desktops at least four hours in a day with age 18-60 years. With the help of Neck Disability Index (NDI), Cornell Hand Discomfort Questionnaire (CHDQ) proforma data were collected. Descriptive statistics, Spearman’s correlation, Chi-square test and Binary logistic regression was used to find role of predictors with an increased risk of pain.
Results: The mean±SD age of participants was 31.03±10.031 while males were higher than females (69.1% vs 30.9%). 53% subjects reported pain in hand, neck and/or back due to prolonged use of laptops/desktops. There exists positive correlation between NDI with CHDQ (r=0.57, p<0.001), significant association between working time (hours) and pain intensity (χ2=6.94, p<0.001). Computer use, age, gender, education were statistically significant predictors (p<0.05), with an increased risk of pain.
Conclusions: The results of this study showed MSD at different areas of hand and neck, back site of the body. To prevent MSD’s some exercises, ideal posture at time of working on computers are recommended, for eye safety, professionals should regular check their eyes. Proper diet plan is proposed. With the help of these suggestions, one can increase work efficiency without MSD.
Community based cross-sectional survey to assess the conditions of refractive error by eye-screening program in remote area of Saifai, Etawah
Authors: Dubey Gaurav , Ali Jamshed , Hayat Zeba , Manik R. K. , Afroz Simi , Das Prasenjit , Kumar Sunil
Published: April 2023

Background: Refractive error is a state where an optical system of the eye fails to bring parallel light rays on a point focus at the fovea, due to increase or decrease of the size of the eyeball through any reasons, changes in the refractive index of the component of the eyes or the age related factors.
Methods: A community-based cross-sectional survey was conducted in the systemic random sampling without repetitions (SRSWOR) method at the circumference area of 5 km of the Saifai Medical University UPUMS Saifai, Etawah (Uttar Pradesh). The data was collected through the rural program for the control of blindness. Among 1032 samples, for the refractive error, total 237 individuals were registered for the study through the screening programme.
Results: The age group 0-19 years concludes 22 (9.28%), for 20-39 concludes 71 (22.95%), for 40-59 years concludes 101 (18.14%) and for the age group above 60, it was 43(48.94%) respectively. Among all the age groups a total of 22.96% responders were diagnosed for the prevalence of refractive error and it was observed more for females 50.63% as compared to males 49.36%.
Conclusions: The prevalence of refractive errors refers to the age group of 40-59 years, so for early diagnosis eye care must be included at a particular time difference at a community level through an eye screening program for all the age groups with the main intention to give special cover to the age group of 40-59 years.
Adverse events with COVID-19 vaccination (precaution dose) among the elderly population aged 60 years and above in South India
Authors: Ade Anju Damu , Vallepalli Chandrashekhar , Guthi Visweswara Rao , Prathyusha T. V. D. , Nagraj K.
Published: April 2023

Background: India started administering the precaution dose or the Booster dose of COVID vaccine from 10 January 2022 to comorbid people aged 60 and above. To identify the adverse events with COVID-19 vaccination (precaution dose) among the elderly population aged 60 years and above. To determine the association between adverse reactions and sociodemographic factors, morbidity profile and previous history of COVID 19.
Methods: This cross-sectional study was undertaken at COVID- 19 vaccination centre, of SVIMS, Tirupati. AP from January 2022 to July 2022. Data was collected by interviewing the study subjects. Study respondents who received COVID-19 vaccine were observed for a period of 30 minutes and after 48 hours, study participants were contacted through telephone to find out any vaccine related adverse effects.
Results: Overall, 676 of 60 years or older received their precaution dose. Majority of the respondents were in 60-70 years age group (60.8%) males (n=397, 58.7%) were higher than females (n=279,41.3%). Out of 676, 34 (5.0 %) participants reported adverse effects after 1st or 2nd dose. With regard to precaution dose, only 43 (6.4%) reported adverse events within the 30 minutes of receiving COVID-19 vaccine. While 54 (8.0%) reported adverse events in last 48 hours after receiving COVID-19 vaccine (precaution dose). Spectrum of symptoms reported were fever, anxiety, dizziness/giddiness, body pains, headache, nausea, pain at injection site, pain in abdomen, swelling at injection site, rash.
Conclusions: Only 43 (6.4%) reported adverse events within the 30 minutes of receiving COVID-19 vaccine while 54 (8.0%) reported adverse events in last 48 hours after receiving COVID-19 vaccine(precaution dose).There were no reports of serious adverse effects.
Artificial intelligence in dental practice: a review
Authors: Prasannam Reemitha P. , A. Arul Murugan Priyanka , L. Narayanan Rajesh , Jagadeson Mahesh , S. Vishnu Prasad , K. Indrapriyadharshini
Published: April 2023

The human brain is a distinctly complex structure with several interlinked neurons that transmit signals all over the body. The search for an excellent model mimicking the human mind has led to a sophisticated breakthrough in what's referred to as artificial intelligence (AI). AI methodologies have determined programs in numerous disciplines ranging from telecommunication, aerospace, robotics, medical analysis, alternate marketplace, law, science, or entertainment to name some. Medical clinical decision support system (CDSS), a factor of AI is being carried out in dentistry which includes Artificial neural networks (ANN), genetic algorithms (GA) and Fuzzy logic. Various fields of drugs such as diagnostic systems, biomedical analysis, image analysis, and drug development have utilized this complicated and tremendously advanced detail of AI. The AI systems along with virtual reality have been used now not handiest to lessen dental anxiety but also to appear as an effective tool for the non-pharmacological manipulation of pain. Ordinary, AI offers us a glimpse of the destiny tool to be able to assist dentists in an inconceivable manner.
Predictive factors of malunion and nonunion at the Aristide le Dantec hospital
Authors: Fode I. Keita  , Pape A. Diouf  , Youssef Benadada  , Alioune B. Dione  , Badara Dembele  , Charles B. Dieme
Published: April 2023

Background: Malunion and nonunion are late complications that can occur during the fracture healing process. The aim of this study was to determine the predictive factors for malunion and nonunion
Methods: This was a retrospective study over a period of 43 months. Predictive factors were sought from patient, fracture and initial management data
Results: We recorded 72 consolidation disorders in 69 patients. malunion accounted for 54.1% and nonunion for 45.9%. The study population was divided as follows: 53 men and 16 women. The average age was 37.8 years. The patients lived in urban areas in 81.2% of cases. Comorbidities were present in 14.5%. The circumstances of fracture occurrence were dominated by traffic accidents, especially for 39 patients. The initial fracture was closed in 91.3%. Long bones were involved in 97.2% of cases, with a diaphyseal location in 52.8%. The fracture was simple in 79.1%, with 84.7% of the fractures being transverse. The tibia was the bone most affected by malunion (53.8%). Nonunion occurred in the humerus, femur and tibia in 27.3% each. Initial treatment was undertaken in 91.3% of patients.
Conclusions: Malunion and nonunion are a reality in our daily practice. These consolidation problems occur in young patients who are victims of road traffic accidents. Diaphyseal fractures of long bones with a transverse line have been the most frequently incriminated. conservative treatment and traditional practice have favoured the development of these complications.
Comparison of functional outcomes of pertrochanteric fractures of the femur managed with dynamic hip screw with a locking side plate versus proximal femoral nail
Authors: Momin Bin Latheef  , Sharvin Sheth  , Abhinav Basu  , Ashok Kumar Reddy Karnati  , Prajwal Sadalagi
Published: April 2023

Background: In current practice, proximal femoral nail (PFN) and dynamic hip screw (DHS) with locking side plate are the implant of choice in stable trochanteric fractures. Most of the deficiencies of the standard DHS have been addressed by the introduction of the Locking side plate. There are plenty of studies comparing standard DHS and PFN. But studies comparing locking DHS and PFN are scarce in current literature. This study aimed to compare the outcomes of both implants in stable pertrochanteric fractures.
Methods: The objective of this study was to assess and compare the clinical outcomes of using locking DHS and PFN for fixation in 40 patients who were admitted to SUT Academy of Medical Sciences between October 2017 and April 2019. The modified Harris hip score was used to evaluate the patients' progress, and regular follow-up was conducted to compare their outcomes.
Results: Among the DHS group, the mean Harris hip score was 83.05, with excellent results observed in 2 patients (10%), good results in 12 patients (60%), fair results in 5 patients (25%), and poor results in 1 patient (5%). In comparison, the PFN group had a mean Harris hip score of 85.50, with excellent results seen in 6 patients (30%), good results in 10 patients (50%), fair results in 3 patients (5%), and poor results in 1 patient (5%).
Conclusions: The DHS group had more patients with good and fair outcomes, while the PFN group had more patients with excellent and good outcomes. Based on these findings, we can conclude that both the PFN and DHS with locking side plate are similarly effective in treating stable intertrochanteric fractures.
Bilateral simultaneous rotational ankle fractures: case series and literature review
Authors: Alrashedan Bander S. , Alghamdi Elham A. , Alromaih Norah I.
Published: April 2023

Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases reported in literature. Unlike axial type ankle fractures, they tend to happen as a result of pivoting trauma on the supportive limb. We conducted a case series and literature review of patients who presented with simultaneous bilateral ankle injuries and discussed their presentation and imaging. A total of Four cases in our institute and 6 separate cases reported in literature were found who sustained bilateral simultaneous rotational ankle fractures. There were 10 cases, nine of which were simultaneous and symmetrical ankle injuries. Injuries found were; Maisonneuve fracture, Tillaux fracture, Syndesmotic injury, Lauge-Hansen’s supination external rotation (SER), pronation external rotation (PER), supination adduction (SAD), and pronation abduction (PA). Four cases were presented in our institute over the last 10 years. A single case was asymmetrical in nature given the presence of an associated distal tibial metaphyseal fracture. Bilateral rotational ankle injuries are rare entity presenting simultaneously unlike axial type ankle fractures. When they present, they are likely caused by higher mechanism of injury than typical unilateral rotational ankle fractures. SER injuries are the most commonly found mechanism in both unilateral and bilateral ankle injuries.
Two rare cases of management of proximal phalanx spina ventosa
Authors: Mahajan Neetin , Patil Tushar C. , Sangma Sunny , Pande Kartik P.
Published: April 2023

Tubercular dactylitis or spina ventosa is the tubercular infection of phalanges, metacarpals and metatarsals termed after cystic swelling of short tubular bones by tubercular infection. Here we presented two rare cases of spina ventosa in a 10 years old female and a 16 years old male patients. In both cases there was swelling of digits with stiffness. The radiographs were suggestive of chronic osteolytic infection with cortical destruction and diffuse sclerosis. We managed them with adequate surgical debridement, splintage and anti-tubercular therapy with good functional recovery. Spina ventosa or tubercular dactylitis is a rare condition and is often missed on diagnosis due to vague non-specific presentation, unavailability of rapid diagnostic tests and can be confused with other mimicking diseases. Any swelling over small tubular bones of hand or feet should raise the suspicion of spina ventosa, especially in endemic countries for tuberculosis. In neglected chronic infections, surgical debridement, curettage and splintage followed by anti-tubercular therapy based on histo-pathological reports is the treatment of choice with high protein diet and vitamin D supplementation ensures good outcome.
Closed atraumatic flexor hallucis longus tendon rupture following hallux valgus correction repaired using a turn down flap
Authors: Nair Abhinav , Jayachandran Rajkumar , Nadar Nisha , Pillai Anand
Published: April 2023

A case report of closed atraumatic rupture of flexor hallucis longus (FHL) tendon few months after hallux valgus correction in a high functioning individual is presented. There have been only two cases of FHL tendon rupture reported following hallux valgus correction in literature till now. Our patient underwent Hallux valgus corrective osteotomy, 4 months after which he presented with rupture of the FHL tendon, he subsequently underwent successful surgical turn down flap repair with good clinical outcome. Closed atraumatic rupture of FHL tendon as an isolated injury is a rare event evidenced by systematic review reporting only 10 cases in literature till now. Low clinical suspicion of FHL rupture in closed foot injuries could be one factor resulting in fewer cases being reported in literature. Acute rupture of FHL tendon following open foot injuries and partial closed rupture due to tendinitis in dancers have been reported frequently in literature. In conclusion, we emphasize careful handling of FHL tendon while performing corrective osteotomy of the hallux in any patient. Although, turn down flap is a well-documented technique to bridge gaps and repair chronic tendo-achilles rupture, we were able to replicate the same technique in our patient and produce good functional result using this effective tendon repair technique to bridge segmental gap as evidence by return of almost normal power of great toe plantar flexion.
Characterisation of uropathogenic E.coli by detecting the virulence factors and its drug resistance pattern in a tertiary care hospital in India
Authors: Khelgi Amit , Ramesh Athira , Anandam Sathya , Sateesh K
Published: May 2023

Urinary tract infections (UTIs) are among the most prevalent nosocomial and community-acquired bacterial diseases in humans, with E.coli being the most typical pathogen isolated.

To detect the prevalence of virulence factors like haemolysin, haemagglutination of human erythrocytes with its effect of D-mannose, and cell surface hydrophobicity, the antibiotic sensitivity pattern and ESBL production in urinary isolates of E.coli obtained from clinical samples.

We included the E.coli isolates obtained from a midstream urine sample for the study. Virulence factors like haemolysin, hemagglutination and salt aggregation were detected as per standard protocols. Antibiotic sensitivity testing was performed by the Kirby Bauer disc diffusion method. Extended-spectrum beta-lactamase (ESBL) production was seen by the combined disc diffusion method on Muller Hinton agar as per CLSI guidelines.

A total of 103 E.coli isolates were tested, and among them, 24(23.30%) produced haemolysin, 65(63.10%) produced hemagglutination and 38(36.89%) had salt aggregation properties. Most isolates obtained were resistant to beta-lactam antibiotics but showed high sensitivity towards antibiotics like chloramphenicol, meropenem, amikacin, imipenem and nitrofurantoin. Around 48% of them were ESBL producers.

The common virulence factors associated with UTI were P-fimbriae (MRHA), haemolysin production, cell surface hydrophobicity and type-1 fimbriae. Because of the emerging drug resistance among UPEC, therapy should be advocated as far as possible after obtaining the culture and sensitivity results to determine exact aetiology and susceptibility patterns.

The sensitivity to nitrofurantoin is very high, suggesting that antibiotic recycling will help clinicians treat UPEC.
Insight review of the first surviving case of Ludwig’s angina caused by Gemella morbillorum
Authors: Sayed Huda Ali , Chowdhary Abhay , Swaminathan Rita , Shekhar Karnam Ravi , Mishra Sudha
Published: May 2023

Our case report is presumably the second reported case of Ludwig’s Angina caused by Gemella morbillorum and the first case reported that survived. We reviewed literature on Gemella morbillorum which is often a misunderstood microorganism but has the potential to cause serious infections and lethal complications in certain cases; its historical identification, characteristic features, advanced studies on its virulence, pathogenicity and other key information for identification. We also briefly reviewed the interesting details of Ludwig’s Angina.
Peels extract of, and and it\'s antioxidant efficacy
Authors: Shaikh Afroj A. , Anbhule Sachin J.
Published: May 2023

The primary supply of minerals, vitamins, carbohydrates, flavonoids, phenolic compounds, and other nutrients in the globe is found in fruits and fruit peels. They are a source of supplementary antioxidants as well. DPPH radical scavenging, Catalase activity, and Total Reducing Power were used to assess the antioxidant potential of Punica granatum, Citrus limetta, and Musa paradisiaca. The best antioxidant activity for DPPH assays is demonstrated by methanol peel extracts of Punica granatum (97.35), Musa paradisiaca (98.1), and Citrus limetta (96.08) at a concentration of 0.1 mM/ml. Citrus limetta and Musa paradisiaca had the highest antioxidant capabilities, with catalase activity of fresh Punica granatum peel measuring 0.13 mg/ml, 0.02 mg/ml, and 0.02 mg/ml, respectively. The greatest total decreasing inhibition. Citrus limetta (98.35%), Musa paradisiaca (97.53%), and Punica granatum peel extract have the highest levels of overall reducing power inhibition. The antioxidant efficiency of each fruit peel extract used in the current study is good.
Surgical management of oral squamous cell carcinoma of the lower gingivobuccal complex: A case report
Authors: Sachdev Sanpreet Singh , Wadewale Maroti , Chhapane Ashwini , Latke Siddhesh , Kalamkar Jayashree
Published: May 2023

Head and neck cancers are one of the most common cancers in India, the majority of which hare comprised of Oral squamous cell carcinoma (OSCC). Managing such tumours necessitates not only astute clinical judgement but also precise imaging and a full understanding of the biology of tumour dissemination paths. Despite the fact that radical excision with adjuvant radiotherapy is the conventional treatment, advanced gingivobuccal tumours have extremely high locoregional failure rates. The current case report describes the presentation and management of OSCC of the lower gingivobuccal complex. It would serve to guide clinicians in the decision-making aspect during the management of extensive gingivobuccal OSCC.
The Need for Revision of Food Literacy Policies in Iranian Universities during COVID-19: Solutions from the Scientific Evidence
Authors: Bamir Mousa , Farahbakhsh Salman , Daneshi Salman , Sadeghi Reza , Jafari Hamid
Published: May 2023

The Article Abstract is not available.
Validity and Reliability of the Persian Version of the Council on Nutrition Appetite Questionnaire and Its Simplified Version in Iranian Community-Dwelling Older Adults
Authors: Sajadi Hezaveh Zohreh , Golafrouz Haniyeh , Piran Arezoo , Vafa Mohammadreza
Published: May 2023

Background: It is important to use a valid and reliable tool to measure appetite in practice and clinical research. This study aims to evaluate the characteristics, reliability, and validity of the Persian version of the Council on Nutrition Appetite Questionnaire (CNAQ) and Simplified Nutritional Appetite Questionnaire (SNAQ).
Methods: After assessing the content validity of CNAQ and SNAQ questionnaires by both a group of experts and participants, the reliability and validity of the Persian version of these questionnaires among 250 community-dwelling elderlies (≥ 65 years, non-hospitalized in nursing homes or hospitals) were assessed. Pearson’s correlation coefficient between the appetite questionnaires and Mini Nutritional Assessment (MNA), weight, and body mass index (BMI) were evaluated. In addition, the internal reliability of the SNAQ and CNAQ was evaluated by Cronbach’s alpha coefficient. Factor analysis was also performed.
Results: According to CNAQ, 142 (56.8%) participants and according to SNAQ, 124 (49.6%) participants had poor appetite (P = 0.0001). Both CNAQ and SNAQ were significantly associated with the MNA score (r = 0.57 and 0.64, respectively, P = 0.001). Appetite also had a significant, but moderate correlation with weight (r = 0.38 and 0.31 for CNAQ and SNAQ, respectively) and BMI (r = 0.39 and 0.36 for CNAQ and SNAQ, respectively), and Cronbach’s alpha coefficient was 0.74 for CNAQ and 0.70 for SNAQ. The confirmatory factor analysis (CFA) demonstrated that the CNAQ and SNAQ were both constructed of one factor (appetite).
Conclusions: The Iranian version of CNAQ and SNAQ are both simple and applicable tools to assess the appetite of Iranian community-dwelling older adults.
Nomad-Farmer Conflict and Food Security among Arable Crop Farmers in Iwajowa Local Government Area, Oyo State, Nigeria
Authors: Obi-Egbedi Ogheneruemu , E. Awoyemi Abiodun , O. Ehinlomo Alphonsus
Published: May 2023

Background: The frequent conflict between nomads and farmers has been recently a major challenge in Nigeria, resulting in a huge economic setback which may have serious consequences on food security in Nigeria. There are limited studies linking to food security; hence, this study aims to examine the effect of the nomad–farmer conflict on food security among arable crop farmers in Iwajowa, Oyo State, Nigeria.
Methods: Primary data was used for the study. A semi-structured questionnaire was employed to collect data from 150 arable crop farmers through a multistage sampling procedure from two wards and three villages, which were randomly selected. The food security index (FSI) and Logit regression model were used for data analysis.
Results: The result revealed that the majority (74.67%) of the arable crop farmers were affected by the nomad-farmer conflict. Most of the arable crop farmers (54.00%) were food insecure. The factors that predisposed the arable crop farmers to being affected by the conflict were access to water point, land tenure system, bush burning, and years of education at different levels. Being affected by the nomad–farmer conflict caused food insecurity along with age, sex, and household size.
Conclusion: It was therefore concluded that arable crop farmers in the study area were mostly affected by the nomad-conflicts that influence food insecurity. Policy measures by the government aimed at reducing the conflict between arable crop farmers and nomads should include water supply and increasing farmers’ years of education.