bluuebunny/crossref_metadata_2025 huggingface dataset:
Alcohol misuse in patients attending a defence force general medical clinic
Authors: Bekker D , Van Velden DP
Published: May 2024

Aim: To determine the prevalence of alcohol misuse in adult patients attending a defence force general practice clinic.Design: Descriptive cross-sectional survey.Methods: The setting is a military sickbay situated in the Cape Town metropolitan area, South Africa. Participants included all adult patients (≥ 18 years) attending the clinic during a three-week period midyear. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was completed by patients. Two direct alcohol consumption questions were added determining the total drinks per week as well as the maximum number of drinks per occasion.Results: Of the 958 patients approached, 40 (6%) declined to fill in the questionnaire. 42% of the 618 patients surveyed were female and 58% were male with an average age of 41 years. The group consisted of 44% current defence force members, 25% retired defence force members, 22% medical dependents and 7% civilians. The overall rate of alcohol misuse according to the AUDIT-questionnaire was 13.27%. Among male patients, 20,6% scored as misusers of alcohol, compared with 2.7% among females. A much higher level of misuse was also found under younger age groups, 38.1% of male apprentices at the technical college and 40.0% of male current defence force members staying on the base scored 8 or more on the AUDIT. In the group scoring less than 8 on the AUDIT-questionnaire a further 9 patients reported drinking on average more than 14 drinks per week for males and more than 9 drinks per week for females. In this group (AUDIT-score 8) 76 patients reported maximum number of drinks per occasion of more than 4 for men and more than 3 for women. If these two questions are included the overall rate of alcohol misuse found was 26.05%.Conclusion: The rate of alcohol misuse found in this group of patients is need for concern. The overall rate of alcohol misuse was not found to be higher than what was found in other studies in South Africa as well as other countries. This study supports the implementation of screening and intervention strategies in general medical clinics in the defence force.
Assessment of post-COVID 19 symptoms
Authors: Saxena Prachi , Chandra Eshutosh , Sahay Sanjay , Mahendran C. S. , Das Pooja , Jose Jijo Varghese , Reddy Bhaskar , Sivaji Sarath
Published: May 2024

Introduction:

A substantial number of patients continue to have symptoms even after testing negative for COVID 19. Ours is a single-center, observational, cross-sectional study that describes the prevalent symptoms in patients who have recovered from mild-to-moderate COVID 19 disease.

Materials and Methods:

In a span of 3 months, from November 2020 to January 2021, we collected self-reported data from all post-COVID patients who consulted the post-COVID 19 outpatient department. Data on the pertinent history related to their diagnosis of COVID-19 disease like the date of reverse transcriptase-polymerase chain reaction positive and negative reports and length of stay in hospital were collected. Self-reported data were collected in simple Yes/No format for the presence of common respiratory and general post-COVID-19 symptoms. The final data were analyzed and presented using the using R software version 4.0.2.

Results:

The mean age of the patients was 42.89 years with majority being from the age group of above 50 years of age. The mean duration of hospital stay was found to be 14 ± 7 days. A higher percentage were admitted for >10 days among all age groups, more predominantly among >60 years of age. Only 5 male patients gave a history of receiving noninvasive ventilation. Significantly a greater number of females complained of fatigue. Other symptoms that were found more commonly in females were headache, loss of hearing, and wheeze.

Conclusion:

In our study, fatigue is the most common presenting symptoms followed by cough and breathlessness. Further evaluation and regular follow-up required to substantiate this observation.
Effect of coronavirus disease 2019 outbreak on the specialty of maxillofacial surgery
Authors: Tomar Sanjeev , Lall Amit B. , Singhal Mayank , Mediratta Akshat
Published: May 2024

The outbreak of coronavirus disease 2019 (COVID-19) has specific implications for oral and maxillofacial surgeons due to an accrued risk of exposure to the virus throughout surgical procedures involving the aerodigestive tract. Maxillofacial surgical procedures due to direct contact with oral and nasal mucosa that area unit thought of areas of high risk of infection in virtue of viral charge and great risk of exposure to COVID-19. Maxillofacial surgery represents associate example of a specialty that has had to adapt to the present outbreak, due to the subspecialties of medical specialty and medicine. Considering the numerous sociopolitical things in every country, the oral and maxillofacial surgery model was thought of acceptable to evaluate the safety measures taken by the healthcare establishments.
Characterization of the infectivity of an Indonesian Zika virus strain in mammalian cell lines
Authors: Sievers Justus Thomas Obiajulu , Bowolaksono Anom , Tedjo Sasmono R.
Published: May 2024

Objective:

To characterize the infection patterns and growth characteristics of the Zika virus (ZIKV) strain JMB-185 from Indonesia in various mammalian cell lines.

Methods:

ZIKV was grown in human (A549, HEK293, HepG2, Huh7, Jurkat, and THP-1) and non-human mammalian (RAW264.7, Vero, and Vero76) cell lines. Viral replication kinetics were measured using plaque assay, while intra- and extracellular viral RNA concentrations were assessed using RT-PCR. Flow cytometry was used to quantify the infected cells and cell viability was measured using an MTT assay. The ability of ZIKV to infect cell lines was visualized using a fluorescence immunostaining assay.

Results:

This ZIKV strain preferentially infected the lung, kidney, and liver cell lines A549, HEK293, Huh7, Vero, and Vero76, but not the immune cells Jurkat, RAW264.7, and THP-1. By contrast, the ZIKV showed no sign of infection in HepG2 cells, while maintaining viral titer over 3 days post-infection, with no infection recorded in immunostaining, no increase in viral RNA, and no indication of cell deterioration.

Conclusions:

The Indonesian ZIKV strain has a similar infection profile as other strains, except for its poor infectivity on HepG2 cells. Information on the growth characteristics of Indonesia ZIKV will help expand our understanding of the biology of ZIKV which will be useful for various applications including antiviral discovery.
Moisturizing Nanoemulgel of Turmeric (Curcuma longa) Rhizome Extract Ameliorates Atopic Dermatitis-like Skin Lesions in Mice Model through Thymic Stromal Lymphopoietin, Interleukin-13, and Interleukin-17
Authors: Suryawati Nyoman , Wardhana Made , Bakta I Made , Jawi Made
Published: May 2024

Introduction:

Various moisturizers have been developed for mild and moderate atopic dermatitis (AD). Turmeric (Curcuma longa), containing a potent anti-inflammatory substance, is one of the promising ingredient for moisturizers. By formulating turmeric into nanoemulgel preparation, cutaneous absorption is enhanced. This study aims to determine the effect of 1% turmeric rhizome extract moisturizing nanoemulgel on thymic stromal lymphopoietin (TSLP), interleukin (IL)-13, IL-17 levels, histopathological feature, transepidermal water loss (TEWL) value, and dermatitis score in an AD-like mouse model induced by dinitrochlorobenzene (DNCB).

Methods:

This study used 35 female BALB/C mice aged 6–8 weeks, weighing 20–30 g. Mice were divided into the treatment group (DNCB and 1% turmeric rhizome extract moisturizing nanoemulgel) and the control group (DNCB and vehicle gel). The DNCB application was carried out twice a week, from day 14 to day 29. On day 30, skin tissue samples were taken to examine TSLP, IL-13, IL-17 levels, and histopathological examination.

Results:

The treatment group showed lower TSLP, IL-13, and skin tissue IL-17 levels than the control group (P < 0.05). In addition, applying 1% turmeric rhizome extract, moisturizing nanoemulgel improved the treatment group’s dermatitis score and histopathological features compared to the control group (P < 0.05). The 1% turmeric extract moisturizing nanoemulgel decreased the TEWL but was statistically insignificant compared to the control group (P > 0.05).

Conclusions:

Applying 1% turmeric rhizome extract moisturizing nanoemulgel ameliorates AD-like skin lesions by decreasing TSLP, IL-13, and IL-17 levels in the DNCB-induced BALB/c mouse model.
Goldenhar Syndrome with New Oral Findings!
Authors: Desai Vela D.
Published: May 2024

Goldenhar syndrome (GS) is a condition with a multitude of abnormalities, classically involving ocular and ear defects, hemifacial microsomia, and vertebral anomalies, which may also be associated with cardiovascular and renal malformations. It is a rare congenital anomaly of unclear etiology. The purpose of reporting this case of a 16-year-old boy with GS is, to update, the existing literature of new oral findings observed.
What Went Wrong with Rashtriya Swasthya Bima Yojana
Authors: Das Suman , Naskar Somnath , Das Dilip Kumar
Published: May 2024

Context:

Rashtriya Swasthya Bima Yojana (RSBY) had been implemented in India to improve access to quality health care, reducing out-of-pocket (OOP) and catastrophic health expenditure.

Aims:

We aimed to evaluate the current status of RSBY in rural areas of a district in West Bengal.

Settings and Design:

A cross-sectional study was done in erstwhile “Burdwan Health District,” West Bengal.

Subjects and Methods:

This study was conducted from September 2016 to August 2018. Primary study units were below poverty line (BPL) families; members of selected families comprised the study subjects. The calculated sample size was 350 families, out of which 324 could be studied covering 22 blocks following multistage sampling technique. Data were collected by interviewing head of the family (HOF).

Statistical Analysis Used:

Descriptive statistics and logistic regression were used for statistical analysis.

Results:

Awareness on different benefits and features of RSBY varied widely from 6.8% to 97.2%. Overall current enrollment rate was 79.6%, while 20.4% of families remained nonenrolled. On the multivariable logistic regression, type of family, socioeconomic status of the family, and education of HOF were significant variables predicting nonenrollment. Among enrolled BPL families, 24.0% and 8.1% utilized services under RSBY since their enrollment and in the last 1 year, respectively. OOP expenditure, nonprovision of free food, inadequate posthospital treatment, inattentiveness of doctor and hospital staff, etc., were major difficulties faced in utilization of services.

Conclusions:

Nonenrollment in RSBY was quite high in the area with few predicting variables. Low level of utilization of services was also noted with some obstacles.
Responsiveness to Hemophilia Joint Health Score and Functional Independence Score in Patients with Hemophilia with Intermittent Factor Support and Physiotherapy
Authors: Singh Ripudaman , Dinakaran Mullai , Vandhiyadevan G. D. , Mathangi Santhosh , Pandey Ritesh Arvind , John M. Joseph
Published: May 2024

Introduction:

Hemophilia is a hereditary bleeding disorder with significant consequences involving the joints, leading to debilitating functions. Prophylactic replacement therapy is limited in lower-middle-income countries, and often it is the episodic or intermittent factor replacement which is feasible. Although many tools are available to evaluate the assessment of joints at the time of initial contact, its utility in response evaluation to intervention is limited.

Materials and Methods:

In this quasi-experimental study, we compared the Hemophilia Joint Health Score (HJHS) and Functional Independence Score in Hemophilia (FISH) scores pre and postphysiotherapy with intermittent factor support.

Results:

Forty-eight patients with hemophilia (PwH) were screened, and 18 PwH consented and completed the treatment protocol. The mean duration of physiotherapy was 11 days, with an average total factor consumption of 120 U/Kg. The pre and postphysiotherapy HJHS was 40 ± 18.8 and 19.5 ± 11.9 with a standardized response mean (SRM) of −2.41 (95% confidence interval [CI] −3.25–−1.53) and FISH, 16.89 ± 3.44 and 22.33 ± 3.36 with SRM of 1.78 (195% CI.29–2.23). Both the SRMs were statistically significant (both the P values were 0.000).

Conclusion:

This study highlights the utility of HJHS and FISH in assessing responsiveness to intermittent prophylaxis and physiotherapy.
Faculty Development Programs in Dentistry
Authors: Jain Ritu , Mahajan Anushi , Badyal Dinesh K
Published: May 2024

Oral health-care delivery in India is rapidly evolving given the increasing awareness about oral health among the public, advances in dental science and technology, and the demand for high-quality care. The dental workforce needs to be trained to develop the required skills and attitudes for delivering quality dental care. Modifications are required in the dental curriculum to accommodate the changing needs of the society. There is an urgent need to incorporate advances in educational methods and technology in dental teaching/learning to prepare future dental practitioners for real-world challenges. The conventional training of dental faculty in India does not involve any training in educational methods and techniques. Faculty development programs organized on a regular basis in the institutions can be very helpful in training the teachers in the latest and evidence-based teaching/learning methods. This article highlights the current status of faculty development initiatives for improving dental education and also makes suggestions to improve faculty training in Indian dental institutions for future.
A Cross-Sectional Study of Anxiety, Depression, and Stress among Health-Care Workers Managing COVID-19 Patients in a Tertiary Care Hospital in North India
Authors: Haryal Aneesha , Singh Aradhana , Abhilasha Pallavi , Singla Mamta , Salwan Divya , Agrawal Nidhi
Published: May 2024

Objective:

The objective of the study was to identify the incidence of anxiety, depression, and stress in health-care workers managing COVID-19 patients in a tertiary care hospital in North India.

Methodology:

A cross-sectional online survey was conducted using Depression, Anxiety, and Stress Scale-21 Questionnaire (Google Form). All health-care workers (HCWs) of the hospital were included in the study. HCWs with a past or current history of psychiatric illness and on psychotropic medication were excluded from the study.

Results:

Two hundred and twenty HCWs answered the questionnaire, of whom 114 (51.8%) were female. Of the 220, 128 (58.2%) were single, 97 (44.1%) were physicians. Level one exposure (direct interaction with COVID-19 patients) was seen in 111 (55.5%). One hundred and thirty-three (60.5%) HCWs worked for 8–12 h/day.

Conclusions:

Our findings highlight the factors which need to be taken into consideration to protect the mental well-being of doctors while fighting with a disaster that has major impacts on society worldwide.
A Study of the Clinical Characteristics and Severity of Amyotrophic Lateral Sclerosis from North India
Authors: Mani Vinita Elizabeth , Thomas Justin
Published: May 2024

Introduction:

Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease, and severity of disease at presentation decides prognosis and therapeutic options. We aimed to study the clinical characteristics and severity of ALS, and establish a correlation between King's ALS clinical staging and revised ALS Functional Rating Scale (ALSFRS-R) scores.

Materials and Methods:

All patients with clinically definite ALS presenting to the outpatients clinic of a tertiary care institute in North India were included. Their demographic and risk factor profiles were noted, and patients were categorized according to King's ALS clinical staging and ALSFRS-R scores. Correlations between the two scores were done using appropriate statistical tests. All data were analyzed using IBM SPSS version 26 for Macintosh.

Results:

Sixty-three patients with clinically definite ALS were included; of which 42 (66.7%) were male, with a sex ratio of 2:1. The mean duration of symptoms was 11.9 ± 6.6 months (range 3–24 months). Forty-five patients (71%) had limb-onset, and 18 (29%) had bulbar-onset ALS. The mean ALSFRS-R score was 36.5 ± 6.3 (range 16-48), and the scores were significantly lower in females (33.76 ± 5.60 vs. 37.81 ± 6.31; P = 0.01). On correlating the King's ALS clinical staging and ALSFRS-R scores, we found a score of >41 on ALSFRS-R was predictive of Stage 1, 34–41 of Stage 2, and 16–34 of Stage 3 disease.

Conclusions:

ALS has a male preponderance, but females present with more severe symptoms. There is a definite correlation between King's ALS clinical Stages 1-3 and ALSFRS-R scores.
Impact Evaluation and Cost–Benefit Analysis of Remote Orthopedic Consultation Methods in a Low-Resource Health-Care Setting
Authors: James Deeptiman , Kurian Nirmal , John Arun , Verghese Viju Daniel , Cherian Vinoo Mathew
Published: May 2024

Background:

Geographic barriers, inadequate infrastructure, and large-scale logistics severely limit telemedicine and e-health systems' ability to make orthopedic care accessible to masses in rural centers. With <1% of the registered hospitals in our country connected through telemedicine, novel alternatives are necessary for effective remote consultation in low-resource health-care settings.

Materials and Methods:

A retrospective cohort analysis to compare the impact of “e-mail and telephone-” and “WhatsApp-” assisted remote orthopedic consultations (ROCs) on surgical decision-making and outcome of complex orthopedic conditions treated at a remote location hospital in Central India was conducted by assessing the response time, clarity, peer review accessibility, cost-effectiveness and functional outcome parameters (Visual Analog Score [VAS] and Single Assessment Numerical Evaluation [SANE]), complication rates, and duration of hospital stay. Unpaired t-test was used for statistical analysis.

Results:

Forty-eight patients were included in the study. Remote consultation was carried out through “e-mail and telephone” for 17 patients and through “WhatsApp” for 31 patients. “WhatsApp-” assisted remote consultation enabled quicker response (P < 0.0001), ensured nonambiguity (P < 0.0001), was cost-effective, and facilitated more peer review (P < 0.0001). Mean VAS and SANE scores reflected better outcome in the “WhatsApp-” assisted remote consultation (P < 0.0001), but hospital stay and complication rates were higher in this group.

Conclusions:

“WhatsApp-” assisted ROC had a higher impact and was cost-effective in management of complex orthopedic conditions in the low-resource setting.
Association of herpes zoster with dementia: A systematic review and meta-analysis with GRADE assessment
Authors: Lin Huang-Shen , Lin Yu-Sheng , Tsai Yu-Shiun , Chang Pey-Jium , Chi Ching-Chi
Published: May 2024

Background:

Herpes zoster (HZ) is the reactivation of varicella zoster virus predominantly affecting individuals aged over 50 years. Dementia is a prevalent age-related condition. The association between HZ and dementia was under dispute.

Objectives:

The objective of this study was to evaluate the evidence on the association of HZ with dementia.

Methods:

We conducted a systematic review and meta-analysis to evaluate the risk of dementia in individuals with a history of HZ compared to those without such a history. We searched PubMed, Embase, Medline, and Cochrane Library for studies published up to February 24, 2024. The risk of bias of studies was examined by the Newcastle–Ottawa Scale. A random effects model meta-analysis was performed to calculate the pooled hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses on Alzheimer’s disease (AD), vascular dementia (VD), and cranial nerve involvement of HZ were executed. We used the GRADE methodology to assess the certainty of evidence.

Results:

We included seven cohorts and two case–control studies involving 3,550,251 subjects. The risk of bias of included studies was generally low. The meta-analysis found no association of HZ with dementia (pooled HR 1.00, 95% CI 0.94–1.07 for cohort studies; pooled OR 1.05, 95% CI 0.84–1.30 for case-control studies), with the certainty of evidence being very low. Subgroup analyses for AD, VD, and cranial never HZ also revealed no significant differences (pooled HR being 0.99, 95% CI 0.89–1.09; 1.04, 95% CI 0.85–1.27; and 1.36, 95% CI 0.76–2.43, respectively).

Conclusion:

The current evidence does not support an association of HZ with dementia.
Does Much Hyped Alkaline Electrolyzed Water Provide Health Benefits? A Systematic Review and Narrative Synthesis
Authors: Anantharamu Tejus , Vishnuprasad R. , Sinha Sharmila , Santhanalakshmi D. , Pradhan Sapna , Salmani Fadil
Published: May 2024

Alkaline electrolyzed water (AEW) usually has a pH value ranging from of 8 to 10, and is postulated to produce many health benefits. Alkaline water consumption still invites a lot of controversy among health professionals and researchers. There were no comprehensive large-scale studies till date that compared the effects of AEW across various disease states targeting multiple system changes as outcomes. The present literature review was carried out to collate all the available clinical research works on Alkaline Water or AEW in improving disease state or promoting health. Search in various databases and search engines brought out 19 articles, of which nine met the eligibility criteria and were included for the analysis in the present study. The risk of bias and quality for every study included in the study were assessed. For all the randomized trials included in the study bias assessment was carried out using the Cochrane Risk-of-bias tool, and nonrandomized trials were assessed using nonrandomized studies of interventions tool. Reviewed studies have reported effects of AEW on oxidative stress, gastric cancer, blood sugar levels, exercise performance, blood viscosity, and gastrointestinal symptoms. AEW has shown considerable positive health effects in small-scale clinical studies. However, presently available evidence from the research works are not sufficient enough for recommendation to the mass in general or for use as a therapeutic intervention. Research works with larger study samples and among population of different demography are required.
Modeling Causes and Extent of Negligence of Occupational Accidents Assessed by Labor Office Inspectors and Official Experts of the Judiciary
Authors: Yazdi Maryam , Zeverdegani Sara Karimi , Amirkhani Reza , Rismanchian Masoud
Published: May 2024

Aim:

The purpose of this study was to model the causes and negligence of occupational accidents assessed by labor inspectors and justice official experts of Isfahan province from the perspective of health, safety, and environment management.

Materials and Methods:

This is a descriptive-analytical cross-sectional study that was conducted cross-sectionally to determine the causes of occupational accidents in some industries and workshops in Isfahan province. Data collection was by census, which after reviewing all cases, finally 367 cases completed by inspectors of the labor and justice official experts of Isfahan province have been reviewed.

Results:

The results showed that regarding the injured person's negligence percent, the least agreement was related to the opinion of the inspector and the opinion of the 7-member panel (intra-class correlation coefficient = 31.5%) and then the lowest agreement was related to the opinion of the inspector with the opinions of 3- and 5-member panels. There is a high level of agreement among all groups to determine the percentage of negligence for the contractor (>60%). There was no statistically significant difference between the 3-member and 5-member staff in any of the potential causes of the accident (P > 0.05). This disagreement is seen in 40% of cases. The results showed that the disagreement between the 3-member and the 5-member panels is 27%. The rate of disagreement between the 5-member and 7-member panels is 10%.

Conclusion:

Based on the results, people who have more work experience receive less negligence percentage. However, if the injured person has a higher work experience in the current job, the accident occurred with a higher percentage of negligence.
Evaluation of the Performance of Two Types of Low Volume High Velocity Ventilation Systems for the CO2 Welding Process
Authors: Sabzehali Saeid , Rismanchian Masoud , Feizi Awat
Published: May 2024

Aim:

Millions of workers worldwide are exposed to the complications of fumes and gases welding process. This study aimed to evaluate the performance of two types of hoods installed on CO2 welding torch in a low volume high velocity (LVHV) ventilation system to control its pollutants.

Materials and Methods:

Two designs of slots and bell-shaped hoods were designed with an inner diameter of 46 and 37 mm, respectively. To determine the efficiency of the studied hoods, personal sampling at the source of pollutant production (at a distance of 15 cm from the tip of the torch), was performed by the National Institute of Occupational Safety and Health Method No. 7302. The concentration of iron metals, manganese, and total chromium was measured and analyzed when the LVHV ventilation system was on and off.

Results:

The two designed hoods, showed different efficiencies against the studied metals. The highest efficiency obtained was related to manganese metal in the bell-shaped hood with an average of 84.92%, and the lowest efficiency was related to chromium metal in the slot hood with an average of 13.39%. Optimal exhaust flow rate ventilation obtained for low volume – high-velocity ventilation system was 14 m3/h.

Conclusion:

In general, the bell-shaped hood with 75.34% efficiency had better performance in eliminating welding fumes than the slot-shaped hood, which is due to the physical form of the hood. Therefore, the shape of the hood, distance of the hood from the point of electric arc and exhaust flow rate at the hood opening, are important factors in the design and efficiency of a low volume - high-velocity ventilation system.
Assessing the Knowledge and Attitude of Residents of an Urban Community in Relation to Health Performance of Housing in Kermanshah, Iran
Authors: Nafez Amir Hossein , Rajati Fatemeh , Rahimi Shoeib
Published: May 2024

Aim:

The aim of this study was to investigate the knowledge and attitude of the staff of a university of medical sciences about housing health in Kermanshah, Iran.

Materials and Methods:

For this cross-sectional descriptive-analytical study, based on Morgan Table 100 people were randomly selected and knowledge and attitudes about housing health were assessed based on a researcher-made questionnaire in 2017. The obtained data were analyzed using SPSS software version 18 and paired t-test on Likert scale.

Results:

A total of 100 employees were studied, more than half of them (60%) were female and more in the group of 20–29 years. The mean scores of knowledge and attitude of the target group regarding housing health were 18.35 and 78.00, respectively. The mean score of knowledge in men and women is significantly different (P < 0.001). However, the attitude scores of the two groups were not statistically significant (P = 0.15). Although knowledge of housing quality was reasonable among respondents, the method of disposing of sanitary waste and housing maintenance was poor. The highest score of women's attitude was related to the groups with diploma and/or associate degree and the highest score of knowledge and attitude in men was related to the groups with bachelor's degree or higher.

Conclusion:

This study showed that people with higher education have better knowledge and attitudes about housing health than people with lower education. However, more research is needed to fully understand the link between housing and adverse health outcomes.
Fragility fracture as the first presentation of Cushing’s disease
Authors: Ghosh Jayaditya , Arjunan Durairaj , Aggarwal Piyush , Pal Rimesh , Walia Rama , Singh Harmandeep , Bhadada Sanjay Kumar
Published: May 2024

Cushing’s syndrome (CS) is a state of glucocorticoid excess with its effect on all the systems of the body. Steroids are known to affect bone health, leading to altered bone microarchitecture. Patients of CS are at increased risk for the development of fracture but fracture as the initial presentation of CS is relatively uncommon. Here, we describe a 31-year-old female who presented with pain in the bilateral hip joint and was found to have a fracture in the right neck of the femur. Though she did not have the classical features of CS, she had striae in the bilateral thigh region. On evaluation, she had a pituitary microadenoma with cortisol dynamics suggestive of Cushing’s disease. The F-18 Fluoride positron emission tomography scan was done, which showed multiple areas of uptake suggestive of fracture. She underwent transsphenoidal surgery and later gamma knife radiotherapy due to the persistence of the disease even after surgery.
An infected case of small dentigerous cyst on intraoral radiograph and orthopantomography
Authors: Singh Manisha , Bagewadi Anjana
Published: May 2024

Dentigerous cyst is the second most common odontogenic cyst, which affects the jaws. It accounts for 15% of all true cysts in the jaws. This cyst is mostly associated with the crown of unerupted teeth involving crown of impacted mandibular third molars followed by maxillary canine and maxillary third molars. Dentigerous cysts can occur at any age, but the greatest incidence is in the second to fourth decades of life. Dentigerous cysts have the potential for attaining large size and tend to absorb roots of involved teeth. Dentigerous cysts have the potential to develop odontogenic tumors such as ameloblastoma and malignancies such as oral squamous cell carcinoma and mucoepidermoid carcinoma. The progressive nature of dentigerous cysts may show expansion and result in pathological fractures of jawbones. The early detection of this cyst decreases the severity of the disease. Here is a case report of an infected dentigerous cyst that was detected on intraoral radiograph and orthopantomography.
Effect of Various Lengths of Respiration on Heart Rate Variability during Simple Bhramari (Humming)
Authors: Trivedi Gunjan Y. , Kathirvel Soundappan , Sharma Kamal , Saboo Banshi
Published: May 2024

Background:

Heart rate varies during breathing and the heart rate variability (HRV) facilitates the autonomic homeostatic capacity. The maximum HRV was observed at around 10 s of prolonged respiration as per HRV biofeedback literature. However, there is a gap in understanding the variations in HRV by different respiration lengths during simple Bhramari practice.

Objective:

To assess the effect of various respiration lengths (8, 10, 12, and 14 s) on HRV during the simple Bhramari (humming) practice.

Methodology:

A total of 118 individuals (67 males, 51 females) signed up for the study based on convenience sampling at a wellness center. A randomized (simple permutation) within-subject crossover design with repeated measures was used to measure their HRV during the simple Bhramari practice. The results were analyzed with one-way ANOVA and paired samples t-test.

Results:

The results indicate that, unlike the 10 s of respiration during HRV biofeedback breathing, maximum HRV during humming happens between 12 and 14 s of long breathing.

Conclusions:

The unique findings of the study demonstrate the maximization of HRV between the respiration lengths of 12 and 14 s. Future work should explore expanding the research to a broader group of participants, including individuals with chronic conditions and other demographic variables and mantra chanting.
Beyond the Mat: Exploring the Potential Clinical Benefits of Yoga on Epigenetics and Gene Expression: A Narrative Review of the Current Scientific Evidence
Authors: Giridharan Selvaraj
Published: May 2024

Yoga, an ancient practice rooted in Indian philosophy, has gained widespread popularity for its numerous physical and mental health benefits. In the recent years, there has been growing interest in understanding how yoga influences gene expression and epigenetic modifications. This narrative review investigates the molecular mechanisms, by which yoga influences gene expression, focusing on deoxyribonucleic acid (DNA) methylation, and histone modifications. Research literature was sourced from various databases to select randomized clinical trials and comparative cohort studies examining yoga's impact on gene expression and epigenetic changes. Our findings suggest that yoga could exert anti-inflammatory effects, as it downregulates pro-inflammatory cytokines, soluble interleukin IL-2 receptor gene expression, and transcription factors. Yoga also boosts the innate antiviral response and brain health by enhancing natural defense genes and microRNA-29c expression. Notably, it activates telomerase, linked with cellular longevity, and promotes nitric oxide synthetase and neuroprotective gene expression, implying benefits for ocular health. In addition, yoga fosters DNA repair and cellular integrity maintenance by increasing oxoguanine glycosylase one protein and p53 gene expression. However, the diversity of yoga interventions in these studies complicates direct comparisons and broader application. The current research primarily focuses on short-term outcomes, offering a limited understanding of yoga's long-term epigenetic impacts. Future research should address these gaps by studying the enduring effects of Yoga, personalizing interventions, and contrasting techniques.
Breath Phase Durations, Affect, and Attention: A Pilot Randomized Crossover Trial
Authors: Telles Shirley , Sharma Sachin Kumar , Kumar Ankur , Gandharva Kumar , Balkrishna Acharya
Published: May 2024

Objectives:

Previously, yoga volitional breathing with low inspiration to expiration ratios (i/e) (as in bhramari pranayama) improved cognition and reduced state anxiety. This study compared the effects of low, high and equal i/e ratio breathing on affect and attention.

Material and Methods:

Affect, vigor and attention were assessed in forty healthy participants (group mean age± SD; 22.58±3.83; M:F= 2.33:1) while breathing with three different i/e regulated by a visual metronome on separate days viz., (i) low i/e (28:72), (ii) equal i/e (50:50), (iii) high i/e (72:28) compared to control, without conscious breath modification. Assessments were: (i) brief mood introspection scale (BMIS), (ii) global vigor and affect scale (GVAS), (iii) Spielberger's state trait anxiety inventory-state (STAI-S) and a six letter cancellation test to assess sustained attention. Data were analyzed with repeated measures analysis of variance with Bonferroni adjusted post-hoc tests.

Results:

Pleasant feelings increased after low and equal i/e. Low i/e also increased positive feelings whereas equal i/e decreased scores in the cancellation test for sustained attention. All three breathing practices and the control session decreased state anxiety and increased vigor. High i/e breathing alone did not decrease negative feelings. For all the breath ratios the breath frequency cue was set at twelve breaths per minute.

Conclusion:

In summary, varying breath phase ratios influenced positive and pleasant feelings but did not influence state anxiety or vigor. Understanding the mechanisms underlying the findings would be improved with concurrent physiological assessments.
Applying Yogic Knowledge to Medical Practice
Authors: Beckman Thomas J.
Published: May 2024

The body and mind are instruments that, through the senses, provide a gateway to conscious experience. One could reduce the totality of human existence to the body and mind alone, yet superficial appearances can be misleading. According to the yogic system, humans are comprised progressively subtle sheaths or koshas, ranging from the physical to the mind, energy, intellect, and bliss body. Furthermore, harnessing the intellect brings a level of control over energy, thoughts, behaviors, and quality of life. This understanding reorients the traditional, allopathic approach, which tends to emphasize the physical body in terms of anatomy, physiology, and clinical pathology. Recognizing deeper layers of self reminds physicians to see patients more holistically, while empowering patients to have greater authority over their own health outcomes.
Evaluation of the histopathological spectrum of skin biopsies in patients with chronic kidney disease: A single-center experience
Authors: Fathaddin Amany A
Published: May 2024

Background and Aim:

Patients with chronic kidney disease (CKD), particularly those with end-stage renal disease (ESRD), frequently experience skin problems. Here, we present and discuss the histopathology results of skin biopsies performed on renal patients at our facility.

Materials and Methods:

We retrospectively reviewed all histopathological reports and slides of skin biopsies taken from CKD patients for the last 5 years at the Pathology Department of King Saud University Medical City, King Saud University in Riyadh.

Design:

This is a retrospective cross-sectional study.

Results:

Patients were 19 (43.2%) males and 25 (56.8%) females, with a mean age of 53.4 19.8 years. Diabetic nephropathy, hypertensive nephropathy, and lupus nephritis were the three most common kidney pathologies (59.1%, 11.4%, and 11.4%, respectively). Seventeen patients (38.5%) were receiving hemodialysis. Acquired perforating collagenosis (APC), which was observed in 16 (36.4%) of our patients, was the most prevalent skin pathology, followed by bullous drug reactions in nine (20.5%), leukocytoclastic vasculitis (LCV) in eight (18.2%), calciphylaxis in six (13.6%), and prurigo nodularis in five (11.4%) patients. Erythematous plaques and papules were the most prevalent skin conditions at the time of presentation in 12 patients (27.3%), followed by pruritus in six (13.6%) and ulcerations in six (13.6%) patients. Collected data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26.0.

Conclusion:

A spectrum of skin conditions may be seen in CKD patients. The quality of life of CKD patients will be significantly improved by identifying and managing these conditions. Pathologists’ familiarity with this spectrum is important, as a correct histopathologic diagnosis will lead to a better outcome.
The teaching pathologists association of Mumbai: A legacy that lives on
Authors: Deshpande Jaya , Binayke Rachana , Kandalkar Bhuvaneshwari , Khare Manisha
Published: May 2024

The Teaching Pathologists Association of Mumbai was started by two doyens of pathology, Dr V. R. Khanolkar and Dr. P. V. Gharpure. They were the heads of the departments of pathology at Seth G S Medical College and Grant Government Medical college. The first meeting of the association was held in July 1935 at the Grant Medical College. The idea of the meetings was to know about the work done in other institutes and was attended by staff and students of these institutes. Soon Haffkine Institute joined, followed by Tata Memorial Hospital, TN Medical College, and Lokmanya Tilak Medical College in the late 1960s, with the latest entrant being HBT Medical College in 2023. The meetings that started in 1935 have continued till date (2023) with over 500 meetings being conducted so far. The nature of the meetings was in the form of a presentation by a postgraduate or faculty member. It was left to the discretion of the head of the department. This has been a unique association with no formal office bearers and runs purely on the understanding and cooperation of the senior teachers of these institutes. It has nurtured the spirit of mutual cooperation among the various medical institutes in Mumbai with the exchange and sharing of views and material. This article describes the beginning and subsequent growth of this association, the likes of which are yet to be seen elsewhere.
Evaluation of the significance of tumor stromal patterns and peri-tumoral inflammation in head and neck squamous cell carcinoma with special reference to the Yamamoto–Kohama classification
Authors: Bhuyan Geet , Hazarika Prabir , Rabha Anju M.
Published: May 2024

Introduction:

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with 878,348 new cases. Cancer-associated fibroblasts (CAFs) are the predominant cell type in tumor stroma and are important promoters of tumor progression.

Objective:

The aim of the study was to evaluate the pattern of desmoplastic stromal reaction and peri-tumoral inflammatory infiltrate with the histological grade and clinical data.

Materials and Methods:

A total of 60 cases of HNSCC were included in the study. The hematoxylin and eosin (H and E)-stained sections from all cases were examined by two experienced pathologists for the grade, nature of stomal reaction (SR), peri-tumoral inflammatory infiltration, Yamamoto–Kohama classification grade, worst pattern of invasion (WPOI), depth of invasion (DOI), and other histopathological parameters. Correlation analysis was conducted using the Chi-square test. P-value less than 0.05 was considered statistically significant.

Results:

Immature SR was not observed in any of the well-differentiated squamous cell carcinoma (SCC) cases. However, one (3.7%) case of moderately differentiated SCC and two (28.6%) cases of poorly differentiated SCC showed signs of immature SR. In the case of the higher grades of the YK classification, specifically grades 4C and 4D, a more profound depth of tumor cell invasion, equal to or exceeding 10 mm, was evident in six (66.67%) and two (28.57%) cases, respectively. Additionally, among the seven (11.7%) cases classified as poorly differentiated carcinoma, three (42.85%) displayed a WPOI score of 5.

Conclusion:

SR and the tumor invasive pattern in HNSCC are related to prognosis and may indicate tumor aggressiveness.
Overview of obstructive sleep apnea treatment
Authors: Haldar Arup
Published: May 2024

Once diagnosed with obstructive sleep apnea (OSA), a titration with either continuous positive airway pressure (CPAP) or automatic positive airway pressure (APAP) is planned to know the pressure required to abolish the airflow limitation during sleep. Majority of OSA patients are treated with such positive pressure therapy (PAP) devices, but it is not the only form of therapy of OSA. The static obstruction in OSA can be counterbalanced by increasing the pressure from inside and this is being exactly done by PAP therapy. The static obstruction can also be relieved with surgery. IOD (intraoral device) or OPT (oral pressure therapy) is a device which also try to open the upper airway during sleep or prevent collapse. But a dynamic obstruction during sleep, on top of this static obstruction causes complete or partial closure of the upper airway. There are different therapies available to address dynamic obstruction during sleep. Like myofunctional therapy or devices which improve muscle responsiveness are such mode of treatment. Similarly, arousal threshold or loop gain can be addressed with different medications. Sometimes OSA occur only in a particular decubitus and can be addressed with positional therapy. The different form of therapies can be broadly divided into three categories: primary treatment, alternative treatment, and adjunctive treatment. In this review article, a brief description of different forms of therapy in OSA will be presented.
Can long term add-on doxycycline improve lung function in asthma: The result of an open prospective real-world observation
Authors: Bhattacharyya Parthasarathi , Das Soumen Kumar , Saha Dipanjan , Bhattacherjee Pratyaya Deep
Published: May 2024

Background: The inhibition of matrix metalloproteinases and IgE could be a prospective target of treating inflammation and remodelling of asthma. Doxycycline, a known antibiotic may qualify for the job for having both the properties. Objective: To look for effect on long term add-on oral doxycycline in patients of asthma. Methods: In an open prospective, real-world observation, a cohort of asthmatics was given to choose treatment either with a “standard” therapy (long-acting β-2 agonist + inhaled corticosteroid) or with the same and add-on long term doxycycline orally. The changes in postbronchodilator FEV1, FEV1/FVC, and FEF25–75 were noted for comparison with repeat spirometry after nearly a year. Results: The two groups (standard therapy alone [n = 73] and standard therapy plus doxycycline [n = 72]) were similar (p < 0.05) as regards to age and BMI, but the subjects opting for add-on doxycycline had significantly lower baseline postbronchodilator FEV1 (1.25 ± 0.50 and 1.66 ± 0.73 Litres; p < 0.0001). Both the groups had received treatment for similar length of time (346.89 ± 269.61 and 335.82 ± 274.51 days, respectively). The add-on doxycycline group had a significant improvement in absolute value of postbronchodilator FEV1 (130 mL [p = 0.0000]), whereas the subjects on standard therapy alone showed a reduction (70 mL [p = 0.027]) compared to the baseline values. There was a parallel increase in FEV1/FVC (p < 0.005) and FEF25-75 (p < 0.0001) in the doxycycline-treated patients, suggesting an overall improvement in airflow limitations. Conclusion: The add-on oral doxycycline tolerated well on long term and resulted in a significant improvement in spirometric indices of airflow limitations in the asthmatics. The observation deserves further validation.
Is it Non-Hodgkin's Lymphoma or Tubercular Lymphadenitis
Authors: Aashita  , Yadav Vikas , Sharma Rajiv , Kapoor Anuja , Thakur Pragyat
Published: May 2024

The incidence of non-Hodgkin's lymphoma (NHL) is increasing, more so in tuberculosis (TB) endemic low and middle-income countries. Both of them have overlapping presentation that makes it difficult to differentiate them clinically. Here, we describe a case of 60-year-old male with oropharyngeal NHL with cervical and axillary lymphadenopathy. After completion of chemotherapy, there was complete resolution of oropharyngeal mass, but lymph nodes (LN) had responded partially. At this point, he was diagnosed with pulmonary TB and was started on antitubercular treatment (ATT). The residual LN resolved completely with the ATT. The patient is currently disease free. The case reported here highlights the dilemma in diagnosing a LN to be tubercular or lymphomatous.