bluuebunny/crossref_metadata_2025 huggingface dataset:
CLINICAL OBSERVATlON OF TUBERCULOUS MENlNGlTlS IN CHILDHOOD
Authors: Shin Youbg Shik , Kim Byung Tae , Kim Im Dong , Han Dong Sup
Published: May 2022

During the last 10 years since 1954, statistical radiological studies and analyses of the effects of the chemotherapy were done on 105 children with tuberculous meningitis, aged 4 months to 14 years and 8 months old. The results were as follows: 1) The statistical studies indicated a gradual increase in the incidence after 1960. Concerning the age difference, the highest incidence was noted in the group of the children from 2 to 6 years old, and numbers of the infants and children under 6 years old were 74.3% of the total patients. Concerning sex difference, the incidence of the male patients were slightly higher than that of the female patients. Concerning the seasonal difference the incidence in spring was found to be the highest. The source of the infection was mainly familial and this was found only in 17.1% of the cases with the established infectious sources. As the initial manifestations, vomiting and fever were complained from most of the patients. In many of the cases, it took more than 3 weeks to establish the diagnosis. 2) Concerning the radiologic findings. 93.5% of the cases were found to have abnormal findings in the chest X-ray pictures. As a whole, calcified primary complex was the most. However, as the age difference, primary complex was found in most of the patients less than 2 years old and that of calcified primary complex in most of the patients, 2 to 6 years old and in most of the patients older than 6 years old. 3) The effect of the chemotherapy and prognosis on the cases were analyzed. Annual survival rate was slightly elevated since 1957. The total survival rate of the last 10 years was 40% at present. Concerning the age difference, the patients less than 1 year old showed the lowest rate, that was 25% at present. Concerning the difference dependent on the chemotherapeutic drugs, the follow-up study indicated that a combination therapy using INH mainly with Steroid Hormone was best, showing the survival rate of 44.4%. Concerning relationship between the length of the treatment period and the survival rate, it was found that the rate of the patients receiving the treatment for more than 12 months was 97%, while no patient survived by the treatment for shorter than 2 months. Concerning relationship between the survival rate and the length from the noset of the disease to the starting of the treatment. the follow-up study indicated the highest rate(56.9%) in the group with treatment started within a week after the onset. The rate became remarkably low when the treatment was delayed. The survival rate was 18.4% in the group of the patients, who showed disturbance in the consciousness already on the admission, and almost all of them developed sequelae. As sequelae hemiplegia(motor disturbance) was found mostly.
RESULTS OF AMBULATORY TREATEMENT v. s. HOSPITAL TREATMENT IN PULMONARY TUBERCULOSIS
Authors: Lee Hyo keun
Published: May 2022

The purpose of this study is to compare the therapeutic results of Pulmonary tuberculosis treated on an inpatient as contrasting on an ambulatory (home treatment) basis.1. Under similar conditions, 108 cases of Pulmonary tuberculosis were treated in a hospital as inpatients and 106 cases on ambulatory basis.2. ln minimal cases, there was no signifìcant difference in the therapeutic results between the two groups.3. ln moderately advanced or far advanced cases, both the roentgenologic improvements and the sputum conversion of the hospital treatment group occurred more quickly and the fìnal results were much superior to that of the ambulatory group.4. Cavity closure rates of the hospital-treated (inpatient) group were also superior to that of the ambulatory group.5. For best results it would seem advisable that the patients with moderately or far advanced, particularly cavitary cases, should be treated in a hospital for at Ieast the first few months of treatment.
EXPERIENCE OF RE-TREATMENT WITH SO-CALLED SECONDARY ARUGS IN DRUG-RESISTANT PULMONARY TUBERCULOSIS
Authors: Song Ho Sung , Hong Young Pyo , Back Jung Dae , Cho Jae Sung
Published: May 2022

A re-treatment by double or triple regimen with ethionamide, cycloserine, and pyrazinamide was evaluated in 27 patients of advanced primary drug-resistant pulmonary tuberculosis who han 6 to 17 months of therapy with Primary drugs. Reversal of infectiousness was observed in 64% of far-advanced patients. There was no deaths. Four patients have discontinued ethionamide because of severe gastrointestinal troubles. Liver toxicity to pyrazinamide as evidenced by an abnormal liver function test occurred in one patient. There was no jaundice. Several patients were required to discontinue certain drugs temporarily.
STUDIES ON THE DEVELOPMENT OF GAMMA-IRRADIATED VACCINE AGAINST TUBERCULOSIS
( 1) Oxidative metabolism of Gamma-irradiated M. Tuberculosis H37Rv
Authors: Ahn Tai Hew
Published: May 2022

In our country, B.C.G. has been used as one of the most effective vaccines against tuberculosis. Non-living vaccines against tuberculosis have, however, been extensively studied by many workers so that the living vaccine, B.C.G. may be replaced with them, for various side reactions, decrement of titer and inconveniences of handling B.C.G. are serious problems yet to be solved. Gamma irradiated tubercle vaccine, at this point, is the one we long hoped for, because it is non-living and as effective as B.C.G. in protecting experimental animals against tuberculosis. In the present experiment, the characteristics of gamma-irradiated tubercle bacillus, the oxidative metabolism, were investigated through manometric studies and the following results were obtained. 1. Lethal dosage of gamma rays for lyophilized tubercle bacillus was 1.5×106r which was double of the one required for the bacillus of liquid suspension. Yet, the oxygen uptake rate of lyophilized cell was as much as 2.5 time the one of suspension cell. 2. Pretreatment of tubercle bacillus with lactic acid or pyruvic acid brought about greater protection of respiratory enzymes from the gamma irradiation damage than non-treated one, though no difference in lethal dosages of gamma rays was observed between them.
SURGICAL TREATMENT FOR PULMONARY TUBERCULOSIS ON 161 CASES
Authors: Lee Tong Wook , Yoo Seung wha
Published: May 2022

This clinical report is made on 161 cases of surgical treatment of pulmonary tuberculosis from March 1964 to June 1964 at the National Kongjoo Hospital. 1) The prevalent year for surgical treatment is 83 cases of 161 cases on 1963 and more than each other year. 2) Prevalent age of patient is second decade and number of male patient is 141(87.6%) and 20(12.4%) of female. 3) Duration of the discases before surgical treatment comparatively long, the duration within 1-2 years is 33 cases of all patients and lobectomy is 58 cases of all operation and more than other kind of operation. 4) Chemotherapy before surgical treatment is used on all patients and three primary drugs of 102(63.4%) and secondary drugs of 12(7.5%). 5) Sensitive to three primary drugs is 21 cases and resistant of 48 cases to three primary drugs, also, resistant to streptomycin is 122 cases of all patients. 6) Chest X-ray finding before surgical treatment showed cavitary lesion on all patients and bilateral lesion of 86 cases(53.4%) and unilateral lesion of 75 cases(46.6%), also far advanced tuberculosis is 84 cases(52.2%) and moderately advanced of 77 cases(47.8%). 7) Negative conversion for acid fast bacilli in sputpm after surgical treatment is 96.4% of resectional surgery and 96.0% of thoracoplasty. 8) Complication is 27 cases(16.7%) of all patients and bleeding of 9 cases(5.6%) and resectional surgery of 15 cases(28.0%) is more than other kind of operation. Also treatment of complication has been done on 24 cases(88.9%) and no treatment was done on 3 cases. Mortalily after surgical treatment is one case of psychosis.
CLINICAL OBSERVATION ON 41 CASES OF EXTRAPLEURAL PNEUMONECTOMY
Authors: Choi Dae Han , Kang Joong Won , Lee Tong Wook
Published: May 2022

Among the patients coming to thoracic surgery department of National Medical Center from July to Aug. 1965, 41 cases of extra pleural pneumonectomy excluding 2 cases of lung cancer are presented together with indication, post-operative complication and result of treatment. Among 41 cases, pulmonary tuberculosis with empyema, and tuberculous destroyed lung without empyema were 25 cases, non-tuberculous empyema with ore without destroyed lung 14 cases, lung abscess and bronchiectasis each one case. In cases with low pulmonary function pre-operatively, extra-pleural pneumonectomy was performed aggressively with the aids of AGA&Engstroem respirator, although there was some wonder of high operative risk, and if pulmonary insufficiency occurred post=operatively, these respirators were applied under tracheostomy with effective results. Post-operative complications wrer 29% of empyema, 7% of brocho-pleural fistula, 27% of post-operative bleeding and 2% of spread to contra-lateral lung. Among 25 cases of empyema sac or lung cavity rupture during operation which brought about contamination of ches cavity, empyema occurred in 36%. The follow-up study in one month to 5 years and 5 months of duration after discharge showed 63% of improved 12% of worse, and 15% of unknown which indicates that patients have not visited our OPD since discharge. Operative death rate in one month post-operative course was 10% and the average blood amount needed for patients during and after operation until recovery was 11 to 20 points. Tracheostomy was performed in 8 cases just after or late operation and among them 6 cases were in below 50 L of M.B.C. and 2 cases in above 50 L. These 2 cases had to have tracheostomy in spite of above 50L because of pulmonary insufficiency.
UNCLASSIFIED MYCOBACTERIA IN KOREA
Authors: Kim Kyung Soo , Shin Yong Dal , Ahn Jae Won
Published: May 2022

Purified tuberculin protein-π prepared from unclassified mycobacteria and human tubercle bacillus was examined on 4,461 normal healthy persons and 391 tuberculous inpatients of the some hospitals in Korea during 1963 to 1964.The results obtained in the group of normal healthy persons are as follow: The rate of positive reaction of unclassified mycobacteria was found to be 0.9 to 6.2 percent in the primary school children, 0.2 to 7.7 percent in the middle school pupil, 0.4 to 5.7 percent in the college students. The older the age of the persons examined, the lower became the rate of positive reaction. The Positive rates observed from three different purified tuberculin protein-π photochromogens-π, scotochromogens-π and nonphotochromogens-π, were 0.4 0.9 and 6.1 percent. All positive reactors to unclassified mycobacteria-π in the primary school children showed a low-grade tuberculin reaction was decreased as the age of reactors became older, seventy-five percent of the positive reactors who had BCG vaccination were those who had vaccination three years previously. The raters of positive reaction in the tuberculous inpatients were 0.5 percent with photochromogens-π and scotochromogens-π, and 2.85 percent with nonphotochoro-mogens-π. Most of them were composed of advanced cases.
A RAPlD DIRECT SENSITlVITY TEST WITH YOUMAN’S LIQUID MEDIA.
Authors: Song Ho Seung , Hong Young Pyo , Jin Hong Woo , Kang Shin ll
Published: May 2022

A description is made of a rapid direct sensitivity test using Youman's Liquid media. The result with this direct test and with indirect test on 135 positive sputum specimens are compared. The evidence of growth is judged by the presence of serpentine microcolonies by microscopy at 7th day of culture.There have been no growth in control tubes of 26 cases of direct test, and 8 cases of direst test were contaminated, In indirect test, there were 9cases of contamination and one case of no growth on control tube.Comparisons are made in remaining 101 cases. Results of both tests were identical in 84 cases, and there were one step difference in 17 cases, including 3 false resistances and 2 false sensitivities.
EPIDEMIOLOGICAL STUDY ON THE UNCLASSIFIED MYCOBACTERIA IN KOREA
Authors: Lee Sung Kwan , Shin Yong Dal
Published: May 2022

An extensive study has been done for one year from 1965 to 1966 to estimate the geographical distribution in the four different districts with Japan-made Purified Tuberculin Protein-π.The skin tests were done on 4,822 healthy persons covering the selected areas of urban, rural, seacoast, and mountain. The criteria of positive limits adopted tentatively in reading was that the reaction to the unclassified mycobacteria-π should be more than 10mm in size and this reaction should be more than 25% compared with the reaction to the human tuberculin-π simultaneously injected.followings are the results obtained.:1. The rate of positive reaction of unclassified mycobacteria to the healthy persons examined was found to be 31.7% in all areas.2. The higher rates of positive reaction by the Runyon's classification groups were noted in scotochromogens and non- photochromogens, while the lower reactions were in the photochromogens and rapid grower.3. The rate of positive reaction by districts was found to be 13.0% in the urban area. 36.8% in the rural area, 36.8% in the mountain area. 4. The highest rate of positive reaction among four different groups by districts was noted in the nonphotochromogens in the urban area, while the scotochromogens were higher in the other areas.5. The younger the age of persons examined the higher the rate of positive reaction in the urban area, while in the other areas, the older, the higher. 6. The rate of positive reaction by unclassified mycobacteria in the low grade tuberculin reactors to the human tuberculin-π was found to be 58.7% in the urban area and almost 100% in the other areas.7. No significant changes in the positive rate were noted in general by sex, however in the female groups, slightly higher incidences were found in the rural and mountain area.
A cross-sectional study on domestic violence, marital satisfaction, and quality of life among partners of patients with alcohol use disorder
Authors: Bunga Divija , Bipeta Rajshekhar , Molanguri Umashankar
Published: May 2022

Introduction:

Alcohol use disorders (AUDs) have adverse effects on physical and psychosocial health and results in marital problems with reduced quality of life in partners.

Aims and Objectives:

The aims and objectives of the study are to investigate the relationship between domestic violence (DV), marital satisfaction, and well-being in partners of AUD patients.

Materials and Methods:

This was a cross-sectional study on patients with AUD and their partners. We administered the Severity of Alcohol Dependence Questionnaire to the participants and DV questionnaire, marital satisfaction scale, coping questionnaire, and the World Health Organization (WHO-5) well-being index scales to the partners.

Statistical Analysis Used:

Descriptive statistics were depicted using frequency tables, and linear regression analysis was performed.

Results:

DV was reported by 36.98% of the partners, and the marital satisfaction rate was 62.58%. The WHO-5 well-being was 33.88%, engaged coping was 38.60%, tolerant coping was 23.60%, withdrawal coping being 6.18%, and total coping was 72.76%. The severity of alcohol dependence syndrome (ADS) negatively correlated with well-being (r = 0.24) and marital satisfaction (r = 0.17). Furthermore, DV showed a negative correlation with the marital satisfaction (r = 0.32; P = 0.02) and well-being (r = 0.50; P = 0.0001) with statistical significance.

Conclusions:

The majority of the partners experienced DV, marital dissatisfaction, and poor well-being.
Assessment of social functioning, quality of life, and social support in persons with schizophrenia
Authors: Dahuja Shrishti , Singh Upendra , Beniwal Ram Pratap
Published: May 2022

Context:

The outcome of schizophrenia (SZ) is impaired psychosocial functioning and poor quality of life (QOL) which is associated with burdens and societal expenditure to the caregivers.

Aims:

This study was aimed to access the difference in social occupational functioning, QOL, and social support between male and female patients with SZ.

Settings and Design:

This is a cross-sectional observational study conducted on persons with SZ visiting the psychiatry outpatient department in a tertiary care teaching institute.

Materials and Methods:

The sample consisted ofN= 200 persons with SZ (International Classification of Diseases-10) aged 21–45 years of both genders. The assessment of socio-occupational functioning, QOL, and social support with administering the Social Occupational Functioning Scale (SOFS), World Health Organization Quality of Life-BREF Scale, and PGI Social Support questionnaire.

Statistical Analysis:

A Chi-square test was applied for discrete variables and at-test for continuous variables. An independent samplet-test was used to assess differences between the males and females.

Results:

Overall, males were more educated than females. Occupationally, there was a significant difference between males and females (P= 0.000). A significant difference (P= 0.000) was found between males and females on total socio-occupational functioning and social support (P= 0.000). The difference between males and females on QOL was observed on perceived physical health (P= 0.000) and psychological health (P= 0.039).

Conclusions:

This study confirms that there is a definite gender difference in SZ on psychosocial and QOL. Males were physically, psychologically healthier and had better socio-occupational functions as well as strong social support compared to females.
A case report on escitalopram-induced galactorrhea with euprolactinemia
Authors: Pasupula Saikiran , Pasupula Rajeshwari , G D V Satyamurthy , Meghana Saka
Published: May 2022

Galactorrhea is defined as the spontaneous flow of a milky or colorless fluid-like discharge from the nipple. The condition occurs most often in women but can also develop in men and children. Galactorrhea is more common with antipsychotics when compared to antidepressants. Limited literature is available regarding escitalopram-induced galactorrhea on which the current case report focuses. The current study advances the earlier studies in presenting galactorrhea with normal prolactin levels. The following case report depicts the development of galactorrhea by the use of escitalopram at a low dose when compared to other studies.
Autoregulation Disturbance Events Correlate with History of Loss of Consciousness in Mild Traumatic Brain Injury Patients
Authors: Sutawan Ida Bagus Krisna Jaya , Bisri Tatang , Suarjaya I Putu Pramana , Putra I Made Prema , Ryalino Christopher
Published: May 2022

Introduction:

Cerebral autoregulation disturbance may compromise cerebral blood flow, thereby increasing the risk of hypoperfusion, which increases the risk of loss of consciousness (LOC). Transient hyperemic response test (THRT) using transcranial Doppler (TCD) can be used to assess cerebral autoregulation disturbance. The goal of this study was to assess the relationship between impaired cerebral autoregulation assessed using TCD and a history of LOC in patients with a mild head injury.

Patients and Methods:

This study was a comparative analytic study with unpaired data and cross-sectional design that involved 73 people divided into two groups. Group A (36 subjects) consists of mild brain injury patients with a history of LOC, and Group B (37 subjects) consists of mild brain injury patients without a history of LOC. THRT was assessed using TCD by identifying the absence (negative result) in flow velocity increase upon applying pressure on ipsilateral carotid artery. We employed the chi-square and logistic regression tests to assess any correlation between variables. A value of P < 0.05 was considered significant.

Results:

Approximately 93% of subjects who experienced LOC also showed negative THRT results. We found a statistically significant relationship (P < 0.001) between the history of LOC and THRT. In the logistic regression test, we found that age, gender, and hematocrit were not statistically related to negative THRT results.

Conclusion:

There is a statistically significant relationship between cerebral autoregulation disturbance and decreased consciousness event in mild head injury patients.
Vancomycin-related thrombocytopenia in neonates
Authors: Osman Hassan Suhair A.R.
Published: May 2022

Background

With the improvement of neonatal care in the country and survival of the preterm infants and sick neonates, many arising problems are being observed. One of these is the significant presence of neonatal thrombocytopenia and the need for lots of platelet transfusions per an infant. Many neonatal factors can cause thrombocytopenia, but we observed severe, prolonged thrombocytopenia in infants who received specifically vancomycin for sepsis or other medical/surgical conditions. Literature search revealed that vancomycin can cause immune thrombocytopenia by inducing platelet antibodies, though this is scarcely described in neonates.

Participants and methods

This is a hospital-based longitudinal study held in NICU during February 2017 to February 2019. All admitted neonates (term and preterm) who received vancomycin were involved, but those with maternal thrombocytopenia, systemic lupus erythematosus (SLE), maternal eclampsia/HELLP (Haemolysis, Elevated Liver enzymes, Low Platelets) syndrome, and Intr Uterine Growth Rrestriction (IUGR) were excluded.

Results

Of 117 infants admitted in this period, 68 infants fulfilled the inclusion criteria. The severe decline in platelet count observed on the second to third day of vancomycin treatment continued throughout the treatment and started to rise 2–3 days after discontinuation. During treatment with vancomycin, platelet transfusion 2–3 times a day was observed not to raise platelet level significantly, but it prevented serious bleeding.

Conclusion

Vancomycin-induced thrombocytopenia in neonate is a rising new problem in NICUs. The authors may need to add adjunctive intravenous immunoglobulins or methylprednisolone or change the dosing system to smaller frequent doses, given over longer time, to overcome this serious problem.
Evaluating the rate of blood components discarded at a private transfusion facility as a first step toward tailoring wastage
Authors: Ali Sidra A. , Mansoori Huma , Ali Maria
Published: May 2022

Background

and objectives Abstract Transfusion of blood and blood products plays a central role in various life-saving procedures and clinical conditions. Wastage of blood and blood products in a country where concept of voluntary blood donation is still naïve and blood banks strive to fulfill the ongoing requirement is inexcusable. This study focused on collecting the baseline wastage data of various blood products and identifying reasons behind wastage.

Materials and methods

The study was conducted from January 2018 to December 2019 in a hospital blood bank of a tertiary care center. Retrospective analysis was done on the data retrieved. Wastage rate and potential reasons of wastage of different blood products were analyzed.

Results

A total of 11 594 U of blood were issued from blood bank during the study duration. Expired platelets were found to be the most frequently wasted blood products (3998/4861). Overall wastage rate as a percentage of issue was 41.9%.

Conclusion

Blood product wastage in our institute is high, translating to immense financial burden. The study highlighted various key elements and malpractices that contributed to overall wastage. A follow-up study after implementation of corrective measures is planned to regularly monitor wastage of blood and blood products.
A retrospective analysis of clinicopathological features and treatment outcomes of patients with chronic myeloid leukemia at a tertiary hospital
Authors: Fatima Sohaila , Alshehri Abdulrahman , Siddiqui Wajih A. , Aziz Shahid
Published: May 2022

Introduction

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm that shows the characteristic formation of the Philadelphia chromosome, containing the BCR-ABL1 fusion gene.

Objective

The experience with patients with CML regarding clinical features, as well as efficacy and safety of tyrosine kinase inhibitors (TKIs) as a treatment for CML was analyzed in this study.

Materials and methods

A retrospective study was conducted in patients diagnosed with CML regarding clinicomorphological features and treatment outcome in a tertiary hospital located in southwest Saudi Arabia from July 2004 to June 2020. The study population included patients diagnosed with CML who were older than 12 years. Patients younger than 12 years, BCR-ABL-negative CML, and other myeloproliferative neoplasm were not included in the study. Medical records of patients were reviewed, and data were collected.

Results

During this period, 80 patients with CML were treated. The mean age was 41.6 years, with a slight male predominance. Overall, 90% of patients presented with abdominal discomfort and fatigue. Chronic phase represented 90% of all cases, with 55.5% showing intermediate-risk category of the Sokal score. Patients receiving a first-line treatment with first-generation TKI represented 42.5% and second-generation TKIs represented 52.5%. Complete hematological response was noted in 96.2% of patients after 3 months of treatment, and a major molecular response was seen in 77.2% of patients after 12 months of treatment. Adverse events (AEs) of TKI noted were 16 (20%), of which 81.2% were grade 1. They were as follows: pleural effusion in four (5%), neutropenia in two (2.5%), bone marrow suppression in four (5%), and skin itching in six (7.5%) in patients with dasatinib, contributing to 56.2% of all AEs. Overall, four (5%) patients were in treatment-free remission. Mean survival period in chronic phase CML was found to be 15.4 years, whereas in advanced phase CML was 4.7 years.

Conclusion

Our study revealed that patients with CML were predominantly middle aged with a slight male preponderance. Most patients presented in the chronic phase, with the Sokal score in the intermediate-risk category. Patients were treated upfront with TKIs with a significant number receiving second-generation TKIs. First-generation TKIs had lesser AEs as compared with second-generation TKIs, but these toxicities were mild.
Identification of subpopulations of multipotent progenitor cells in hematopoietic stem-cell transplant patients using flow cytometry
Authors: Elsayed Amera H. , Youssef Soha R. , Moussa Mohamed M. , Elsakhawy Yasmine N. , Salem Dalia D. , Youssef Mariam K.
Published: May 2022

Background

The implemented flow-cytometric protocol for enumeration of CD34+ cells in bone marrow, peripheral, or cord blood addresses only CD34+ cells, irrespective of their distinct subsets. However, the definition of CD34+ different subsets has gained importance concerning the engraftment kinetics and immune reconstitution, after hematopoietic stem-cell transplantation.

Objectives

This study aimed to describe and enumerate CD34 subpopulations, using a multicolor flow-cytometric protocol, based on the expression of CD133, SSEA-4, CD38, and CD10, in an attempt to explore the impact of the different CD34 subsets on engraftment kinetics, patient, and graft outcomes.

Methods

A total of 33 bone marrow transplant (25 autologous and 8 allogenic) Egyptian patients were included. Detailed demographic, clinical, and laboratory data, as well as echocardiography and pulmonary-function tests, were collected from all participants enrolled in the study, before transplantation. All patients were monitored up to 1 year post transplantation, for the development of complications. Discrimination of the distinct stem-cell subsets in the harvest was performed on NAVIOS flow cytometer, using multicolor FCM phenotyping.

Results

Seven CD34+ hematopoietic stem cell subpopulations were identified in the harvest blood by flow cytometry: the multipotent progenitor (MPP), erythromyeloid progenitor, B-lymphoid progenitor (BLP), multilymphoid progenitor (MLP), lymphomyeloid progenitor (LMPP), granulocyte and macrophage progenitor (GMP), and the late GMP. The MPP was the most frequently encountered subpopulation, whereas the BLP was the least-encountered one. In addition, the % population and absolute count of the late GMP were significantly higher after autologous transplantation (P=0.049 and 0.048, respectively). The absolute count of the MLP was significantly higher after G-CSG + chemotherapy-mobilization technique (P=0.039). Higher absolute count of the MLP in the harvest was associated with longer post-transplant 1-year survival of patients (P=0.025). The % population of the GMP in the harvest was significantly correlated with faster engraftment (P=0.039). However, a higher proportion of the late GMP (P=0.041and 0.028, respectively), along with higher absolute count of the LMPP, has been significantly encountered in patients who developed post-transplant disease relapse (P=0.050). By drawing a receiver-operating characteristic curve, only the size of the MPP population at cutoffs of ≤18.85% and ≤165312, respectively, could be significantly used to predict the persistence of cytopenia at 3 months after transplantation.

Conclusion

This study found that discrimination and quantification of the different CD34 stem-cell subsets might play a pivotal role for better understanding of engraftment kinetics and prediction of post-transplant graft and patient outcomes.
Automated versus manual B-lines counting, left ventricular outflow tract velocity time integral and inferior vena cava collapsibility index in COVID-19 patients
Authors: Damodaran Srinath , Kulkarni Anuja Vijay , Gunaseelan Vikneswaran , Raj Vimal , Kanchi Muralidhar
Published: May 2022

Background and Aims:

The incorporation of artificial intelligence (AI) in point-of-care ultrasound (POCUS) has become a very useful tool to quickly assess cardiorespiratory function in coronavirus disease (COVID)-19 patients. The objective of this study was to test the agreement between manual and automated B-lines counting, left ventricular outflow tract velocity time integral (LVOT-VTI) and inferior vena cava collapsibility index (IVC-CI) in suspected or confirmed COVID-19 patients using AI integrated POCUS. In addition, we investigated the inter-observer, intra-observer variability and reliability of assessment of echocardiographic parameters using AI by a novice.

Methods:

Two experienced sonographers in POCUS and one novice learner independently and consecutively performed ultrasound assessment of B-lines counting, LVOT-VTI and IVC-CI in 83 suspected and confirmed COVID-19 cases which included both manual and AI methods.

Results:

Agreement between automated and manual assessment of LVOT-VTI, and IVC-CI were excellent [intraclass correlation coefficient (ICC) 0.98, P < 0.001]. Intra-observer reliability and inter-observer reliability of these parameters were excellent [ICC 0.96-0.99, P < 0.001]. Moreover, agreement between novice and experts using AI for LVOT-VTI and IVC-CI assessment was also excellent [ICC 0.95-0.97, P < 0.001]. However, correlation and intra-observer reliability between automated and manual B-lines counting was moderate [(ICC) 0.52-0.53, P < 0.001] and [ICC 0.56-0.69, P < 0.001], respectively. Inter-observer reliability was good [ICC 0.79-0.87, P < 0.001]. Agreement of B-lines counting between novice and experts using AI was weak [ICC 0.18, P < 0.001].

Conclusion:

AI-guided assessment of LVOT-VTI, IVC-CI and B-lines counting is reliable and consistent with manual assessment in COVID-19 patients. Novices can reliably estimate LVOT-VTI and IVC-CI using AI software in COVID-19 patients.
Epidural volume extension technique in high risk obstetric patients – Case series
Authors: Y Smitha , CP Naveen Kumar
Published: May 2022

Epidural volume extension involves injection of normal saline into the epidural space soon after an intrathecal injection, with the aim of augmenting the sensory block height. It has significant dose-sparing effect, providing adequate level of anaesthesia and analgesia with minimal haemodynamic disturbances. We present this case series that shows the successful use of this technique in high risk cardiac patients coming for elective lower segment caesarean section.
Comparing the Efficacy of Chemiluminescence with Lugol'S Iodine versus Toluidine Blue in the Diagnosis of Dysplasia in Tobacco Associated Oral Lesions - A Diagnostic Study
Authors: Swathi KV , Maragathavalli G , Maheswari TN Uma
Published: May 2022

Background:

Chemiluminescence is the production of light as a result of a chemical reaction. Oral potentially malignant disorders (OPMDs) include both precancerous lesions and conditions that carry an increased risk of cancer. There are different etiological and risk factors for OPMDs such as smoking, alcohol consumption, infections such as viral and fungal, sun exposure and certain other genetic factors. The most common etiological factor for OPMDs is tobacco usage. Chemiluminescence is a light-based detection system and is very useful for detecting OPMDs for early intervention. Because it is a non-invasive procedure, it can be used to evaluate dysplastic changes in various OPMDs at their initial stage for timely intervention. Vital staining has also been used as a chair-side marker for delineating normal and dysplastic oral mucosal tissues.

Aim:

To compare the efficacy of chemiluminescence with Lugol's iodine to that with toluidine blue in diagnosing dysplastic changes in tobacco associated oral lesions.

Methodology:

A total of 84 patients with clinically suspicious oral mucosal lesions and OPMDs with tobacco habit history were included and randomly assigned to either of the diagnostic study groups (Group A: chemiluminescence with Lugol's iodine or Group B: chemiluminescence with toluidine blue). All these patients were subjected to a histopathological examination (reference standard).

Results:

The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) were 91.7%, 66.7%, 84.6%, 80%, and 0.792 for chemiluminescence with Lugol's iodine group (P = 0.001) respectively whereas for chemiluminescence with toluidine blue, the sensitivity, specificity, PPV, NPV and ROC were 100%, 60%, 93.3%, 100% and 0.800 (P = 0.002), respectively.

Conclusion:

The combination of chemiluminescence with toluidine blue had a better diagnostic efficiency in detecting dysplasia in tobacco-associated oral lesions when compared to the group of chemiluminescence with Lugol's iodine.
Complete Ankylosis of Temporomandibular Joint and Cervical Spine – A Case Report
Authors: Balaji S. M. , Balaji Preetha
Published: May 2022

Ankylosing spondylitis (AS) is a chronic, multi-systemic inflammatory disorder. It rarely involves peripheral joints such as Temporomandibular joint (TMJ). Here, we present a case of a 44-year-old male, known case of AS for eight years who had TMJ-related complaints for two years. On examination, bony ankylosis of TMJ possibly due to pre-existing AS was made. A bilateral standard gap arthroplasty procedure was done. The challenges faced during the surgical procedure are discussed.
Endodontic Management of Pulp Canal Obliteration Using a New Single-Tooth Template
Authors: Velmurugan Natanasabapathy , Sundar Sathish , Saumya-Rajesh Parashar , Kasabwala Kinnari , Shilpa-Jain D.P. , Sarathy Sarath , Prabakaran Keerthana , Haritha J S , Bjørndal Lars
Published: May 2022

Background:

Guided Endodontics is suggested as a reliable method for management of teeth with pulp canal obliteration (PCO). The guide used for this usually involves multiple teeth to gain stability but is bulky. It is therefore suboptimal to be used along with rubber dam.

Aim:

To describe the use of a minimized single-tooth guide template in three patients with radiographic evidence of PCO.

Design:

The template was designed and fabricated using the cone-beam computed tomography (CBCT) scan and a surface scan image of the involved teeth. In all three patients, the root canals were successfully negotiated within 15 minutes, with the template involving only the tooth in focus or with neighboring half of the teeth. The operator stabilized the template if required.

Conclusions:

This case series shows clinically that successful outcome can be obtained during guided endodontics with the use of a single-tooth template in previously traumatized anterior teeth with PCO.
Association between Dental Neglect and Alexithymia among Adult Dental Patients
Authors: Nanamadri Nitya Krishna , Doshi Dolar , Kulkarni Suhas , Reddy Madupu Padma , Srilatha Adepu
Published: May 2022

Aims:

To show the association between dental neglect and alexithymia among adult dental patients.

Settings and Design:

At times, certain individuals with dental neglect may experience trouble in communicating and/or understanding information, ability to identify, and describe their feelings termed as alexithymia. Hence, recognition of alexithymia in a dental setting is important, because it worsens the dentist–patient relationship, especially among patients who neglect their dental health. Materials and Methods: A cross-sectional survey was conducted among adult patients (≥20 years). Patients received a questionnaire assessing dental neglect [six-item Dental Neglect Scale (DNS)], alexithymia [20-item Toronto Alexithymia Scale (TAS-20)], and demographic profile.

Statistical Analysis:

Data were analyzed with standard statistical software (Statistical Package for the Social Sciences, version 22). P <0.05 was considered statistically significant.

Results:

A total sample of 1067 individuals comprising 553 (51.8%) females and 514 (48.2%) males with a mean age 35.33 ± 11.49 years participated in the study. Our findings showed that females had higher mean scores for both DNS and total TAS-20 and its factors. With increase in age and education, the mean scores of the DNS had significantly increased and mean scores of total TAS-20 and its factors had decreased with increase in age and education.

Conclusion:

The above study findings have supported the hypothesis that there is no association between dental neglect and alexithymia among adult dental patients.
Comparison of Dentofacial Morphology between Parents of Children with and without Craniofacial Anomalies using Cephalogram Imaging
Authors: Arora Anika , Batra Puneet , Sood Sundereshwer Chander , Raghavan Sreevatsan , Sood Anubhuti
Published: May 2022

Objective:

To compare cephalometric parameters in parents of children with bilateral cleft lip and palate (BCLP) and parents of children without any craniofacial anomaly.

Methods:

A sample of 100 sets of parents were segregated into two groups of 50 parents each. The two groups included parents of children with BCLP and the parents of children with no craniofacial anomaly. Lateral cephalograms and postero-anterior (PA) cephalograms were examined for 100 parents of both the BCLP and control group, respectively. Tracings were scrutinized for 34 linear and angular parameters of dentocraniofacial skeleton. Data were analysed using unpaired Student's t-test. Result: Evaluated lateral cephalograms revealed 15 significant parameters in parents of children with BCLP including a significant increase in Ptm-S, maxillary length, SNA, articular angle and gonial angle. A significant decrease was noted in SN length, cranial base flexion, mandibular length, mandibular body length, total facial height, upper facial height, posterior facial height, Y-axis length and soft tissue total anterior facial height. Upon evaluation of PA cephalograms, four significant parameters were found in parents of children with BCLP. Cranial width, bizygomatic width, maxillary width and lateral interorbital width were significantly decreased in the parents of children with BCLP.

Conclusion:

Distinct dentocraniofacial morphological features have been found in parents of children with BCLP. Evaluation of these features might be the key to predicting the occurrence of clefts in their children and also planning for future linkage analysis studies amongst them.
Radiographic and Histochemical Assessment of Root Resorption during Canine Retraction through Piezocision Site
Authors: Ravi MS , Murali PS , Kumari Varthika , Hamidi Waliullah , Sneha K , Soans Crystal
Published: May 2022

Introduction:

The number of adult patients seeking orthodontics treatment has increased drastically. There is increased need for faster tooth movement and good esthetics. Piezocision is one of the methods used for accelerating the rate of tooth movement.

Aims and Objectives:

To assess the amount of root resorption after retraction of canine through piezocision site and compare it with that of recently extracted site using cone-beam computed tomography (CBCT) and assessment of dentin sialoprotein (DSP) levels in gingival crevicular fluid (GCF).

Materials and Methods:

A split mouth design was used in 15 patients who were undergoing first orthodontic treatment with premolar extractions. Randomly one of the sides was chosen as control (Group I) and the other side underwent piezocision procedure (Group II). 0.022 × 0.028” MBT system was used with 0.017 × 0.025 SS wire for canine retraction using 150 grams of force. GCF samples were collected from mesio-buccal and disto-buccal of the canine with micropipette at baseline (TO) and day 90(T1) to detect the levels of DSP and the root resorption was measured using CBCT.

Results:

Statistically significant amount of root resorption was observed after retraction in both the groups. DSP levels were increased in both the groups, though little higher in Group II when compared to group I.

Conclusion:

DSP level was increased on the piezocision side but it was statistically insignificant which suggests the amount of root resorption on both the sides is similar.
Challenges in Implementation of Biomedical Waste Management among the Dental Practitioners in a Tier 2 Town in India – A Cross-Sectional Study
Authors: Sarvathikari Ramasamy , Pavithran Varsha K. , Ravichandiran Reethu
Published: May 2022

Aim:

This study is proposed to assess the knowledge and practices among dental practitioners in the implementation of biomedical waste (BMW) management rules (2016) in Kumbakonam, Tamil Nadu; to assess the effective usage of the four colour-coded bins, those are used to handle the BMW; and to assess the service of the BMW collecting and disposing agents.

Methodology:

A questionnaire comprising of 12 closed-ended and 1 open-ended question regarding the dental practitioner's management of BMW in their daily clinical practice was developed. After validation, the questionnaire was sent as Google forms to 54 dental practitioners who are practicing at Kumbakonam, and responses were received from all. The collected data was entered in an Excel sheet, and then percentages were obtained for each response from the participants.

Result:

The most common challenges were, space-occupying BMW disposal bins as well as the lack of regular collection of BMW, this may be because the disposal agent's services cover a larger geographical area with lesser wastage collecting manpower. Though most of the study participants were well aware and practiced the management, still a small percentage of practitioners were lacking in this. The responses on storage and handling the BMW management reflect the knowledge gap in more than half of them.

Conclusion:

These challenges indicate the need for a well-established network of BMW collecting agencies and cost-effective, tailor-made colour-coded bins for suitable and continuous usage in dentistry.
Anesthetic challenges in a case of hydatid cyst of liver posted for laparoscopic-assisted excision of the cyst
Authors: Thangavelu Ramyavel , Raman Vikasini , Ranjan R. V. , Poral Sampath Kumar
Published: May 2022

Hydatid cyst caused by Echinococcus granulosus is a common health problem in developing countries. The rupture of hydatid cyst can cause anaphylactic shock or even death during the surgical treatment. We present a report regarding anaphylactic reaction due to surgery to the liver for a hydatid cyst. Clinical examination and contrast-enhanced computed tomography preoperatively revealed a large hydatid cyst measuring 18 cm × 13 cm × 11 cm with few thin septations in the right lobe causing mass effect and splaying of intrahepatic vessels. Intraoperatively, the patient was successfully managed with antihistamines, steroids, crystalloids, and a small dose of vasopressor. After the surgery, she was transferred from the Intensive care unit to the surgical ward on the first postoperative day. The possibility of anaphylactic reactions should be kept in mind, and close monitoring for early diagnosis and appropriate management of anaphylaxis is essential for a favorable perioperative outcome in the case of hydatid cyst surgery.
Kidney transplantation versus dialysis in Zimbabwe
Authors: Obadiah Moyo , Carl Sheridan , Ahmed Halawa
Published: May 2022

In Zimbabwe, the population of patients with chronic kidney disease is rising, putting a strain on the nation's few dialysis treatment centers, whether government or private. The government covers the whole expense of delivering dialysis in the government facilities, increasing the financial burden. Patients from both public and private dialysis units opting for kidney transplantation (KT) are referred abroad at high foreign currency costs. The goal of this study focused on reviewing the economic advantage of KT in relation to renal dialysis as a means of establishing a KT program in Zimbabwe. Economic advantage studies on KT versus renal dialysis were obtained using various digital resources. The search strategy was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses recommendations. Economic assessment tools such as the Markov model, cost–utility analysis, cost-effective analysis were utilized to substantiate the relevance of KT in improving survival of end-stage renal disease patients at a lower expenditure. In studies where cost-effectiveness between KT and dialysis was compared, it was shown that KT is a cheaper solution with a higher quality of life than dialysis. It was also shown in most of the studies that among the dialysis modalities, hemodialysis (HD) was more expensive than peritoneal dialysis (PD). In one of the studies, the cost values were Euro 36 000 for HD, Euro 26 000 for PD, and Euro 11 000 for KT. The quality-adjusted life years per patient were 0.46 for HD, 0.49 for PD, and 0.61 for KT. As far as cost-effectiveness and raising the health status, wellness level, good living, and survival, KT is rated highly and a better modality than dialysis. It is a more appropriate renal treatment for introduction in Zimbabwe to save on the scarce foreign currency. The barriers to the commencement of KT were identified, and the solutions were enumerated.