bluuebunny/crossref_metadata_2025 huggingface dataset:
Taste Disorder and Tongue Numbness After Lithium Overdose
Authors: Chu Si-Yu , Wang Huang-Chi , Hsieh Ming-Hong , Chang Cheng-Chen
Published: December 2024

Purpose:

Drug-induced taste disturbances are prevalent in clinical practice, with dysgeusia being a frequent manifestation. This study aims to present a case of taste disorders and tongue numbness induced by a lithium overdose.

Case Report:

A 33-year-old woman with bipolar II disorder attempted suicide by ingesting multiple drugs, including lithium and benzodiazepines. She exhibited weakness but was conscious after admission. Laboratory analyses indicated elevated serum lithium and urine benzodiazepine levels. Admitted to a psychiatric ward, her symptoms included diarrhea, poor appetite, and postprandial nausea. Two weeks later, she reported altered taste sensations and tongue numbness following the overdose. Her ongoing medication included venlafaxine, valproate sodium, and clozapine. Symptoms improved over time without specific treatment, aligning with increased appetite and weight gain.

Conclusion:

Drug-induced taste disturbances have a substantial impact on patients’ quality of life and medication adherence. This case brings attention to taste disorders induced by lithium and suggests potential mechanisms that could contribute to taste alterations. It underscores the importance of conducting thorough assessments in patients experiencing gustatory symptoms, particularly during the ongoing pandemic.
Lafora Disease Presenting with Ataxia and DM1: A Case Study
Authors: Khanalizadeh Ramin , Karimi Kosar
Published: December 2024

Here we presented a rare case of Lafora disease with neuropathy, ataxia and progression of symptoms into type one DM, GTCS and myoclonus during years. We believe that it is important to keep the diagnosis of Lafora disease in mind in every child presenting with myoclonus especially when mental and cerebellar deficits develop as well.
Guillain-Barré Syndrome as a Paraneoplastic Neurological Disease of Pulmonary Adenocarcinoma and Squamous Cell Carcinoma: A Case Report
Authors: Lin Zong-Han , Hoe Zheng-Yu
Published: December 2024

We present the case of a 69-year-old male who presented with profound weakness in the extremities. Remarkably, he lacked any identifiable precipitating factors preceding the onset of his illness. However, a diagnosis of Guillain-Barré syndrome (GBS) was established based on typical clinical symptoms, cerebrospinal fluid analysis, and neurological examination. During his hospitalization, an incidental discovery of lung cancer was made. Subsequent pathology confirmed adenocarcinoma and squamous cell carcinoma in the lungs. This case report serves to underscore the exceptional rarity of the simultaneous occurrence of lung cancer and GBS, renewing interest in investigating GBS as a potential paraneoplastic neurological syndrome.
Cure the Incurable: Update of Treatment in Inherited Neuromuscular Disorders
Authors: Yu Cheng-Hao , Lai Kuan-Lin
Published: December 2024

Originally thought to be incurable, huge therapeutic progress has been made in recent years in the field of inherited neuromuscular disorders. Approaches aiming to rescue the underlying pathophysiology, i.e. loss-of-function or gain-of-function mutations, have been developed via end-product replacement or gene delivery/modulation, with promising results. In the review, advanced treatment in some of the inherited neuromuscular disorders will be discussed. On the other hand, it has been found more than 1000 genes are responsible for the clinical diversities in this group of diseases, and finding a way which owns the therapeutic potential to various diseases is the optimal goal. The discovery of CRISPR-Cas9 system in the last decade offers such an opportunity and is under rigorous investigation. This important issue will also be discussed.
Prevalence and risk factors of soil transmitted helminth infections among school-aged children in Garut, Indonesia: Insights from a six-year deworming intervention
Authors: Astuti Endang Puji , Hendri Joni , Yuliasih Yuneu , Sulaeman Rizal Pratama , Isnani Tri , Saputra Sugiyono , Nugroho Herjuno Ari , Dhewantara Pandji Wibawa , Murni Indah Kartika
Published: December 2024

Objective:

To assess prevalence and factors associated with soil-transmitted helminth (STH) infections among rural school children.

Methods:

This school-based survey applied a cross-sectional design which included children aged 6-14 years enrolled in 12 elementary schools in Banjarwangi, Garut, West Java Province. Stool and blood samples were collected from 388 randomly selected students to examine the STH infections and anemia status, respectively. Anthropometric assessment was performed to profile nutritional status. A structured questionnaire was employed to collect socio-demographic and school performance data. Multivariable logistic regression models were built to assess the factors associated with STH infections in school children.

Results:

Among 386 schoolchildren, 9.8% children were positive for one or more STH infections, predominantly Trichuris trichiura (9.0%), with males (n=23), significantly more infected than females (n=13) (5.9% vs. 3.4%, P=0.04). The most infected age group was 6-10 years (n=25, 6.5%). The prevalence of STH infection was significantly higher among students that practicing open defecation (n=22, 5.7%) (P=0.03). The odds risk of STH infections was associated with practicing open defecation (aOR 2.54, 95% CI 1.17-5.53, P=0.02).

Conclusions:

The findings from this study demonstrate the persistent STH transmission among children underscoring the need for sustained post-MDA intervention strategies in resource-limited settings.
Genetic diversity and population structure of the helminths intermediate host Anentome helena (von dem Busch, 1847) in northern Thailand
Authors: Chomchoei Nithinan , Wongsawad Chalobol , Butboonchoo Preeyaporn , Nantarat Nattawadee
Published: December 2024

Objective:

To investigate the genetic diversity and population structure of the helminth intermediate host, Anentome (A.) helena, populations from northern Thailand and reveal the effect of parasitic infection on snail host populations.

Methods:

A. helena was collected throughout river drainages from northern Thailand and investigated for larval trematode infection. Seventy-three A. helena specimens were used to examine and re-construct the molecular phylogenetics (neighbour-joining, maximum likelihood, and Bayesian inference methods), genetic diversity, and population structure based on the concatenated datasets of COI and 16S rRNA (1 178 bp).

Results:

The infection of zoogonid cercariae, heterophyid metacercariae, and echinostome metacercariae in the snail was found from 2 localities, including Mae Sa and Mae Pu Kha populations, with a total prevalence of 6.7% and 16.3%, respectively. The phylogenetic tree and haplotype network revealed three main clades and three haplogroups for each region (COI and 16S rRNA). High levels of genetic diversity in terms of haplotype diversity were found in parasitic infected populations.

Conclusions:

This is the first time that Echinostoma mekongi has been discovered from A. helena in northern Thailand. The results also showed that parasitic infection can affect the population genetic structure of the snail intermediate host, A. helena. Moreover, habitat and historical demographic changes could be other important factors that can affect the degree of population genetic structure in A. helena. Understanding the population structure of intermediate host species can inform parasite transmission dynamics and is useful for the creation of effective public health management strategies.
Psychotherapeutic Effect of Listening to Quran Recitation on Dental Anxiety: A Randomized Controlled Trial
Authors: Alattar Abrar N. , Hamzah Baydaa F.
Published: December 2024

Introduction: This study aimed to investigate the psychotherapeutic effects of listening to Quran recitation on the perception of discomfort and fear in patients undergoing dental treatment. Methods: This research was designed as a randomized controlled trial in which 30 participants (20 females and 10 males) were assigned randomly to either an experimental (Quran listening) or a control group. Fear and discomfort were assessed before, during, and after the treatment session using a questionnaire specifically prepared for the study and based on the Dental Anxiety Scale. Results: The differences in the outcome variables were not statistically significant between the two groups, except for fear perception prior to the local anesthetic injection (P = 0.02). The decrease in mean ranks of fear and discomfort perception in the Quran listening group was statistically significant (P = 0.003 and 0.021 for fear and discomfort, respectively). Conclusion: Listening to Quran recitation during dental appointments can help to decrease patients’ fear and, consequently, their discomfort.
Role of Nanomedicine and Nanotechnology in Dentistry – A Narrative Review
Authors: Singh Richa , Kumar M Sathya , Magesh K T , Manohar Nivedidha , Ravi Aravindhan , Sivachandran A
Published: December 2024

Nanotechnology is a multidisciplinary field that involves the manipulation and control of matter at the nanoscale, typically ranging from 1 to 100 nm. Nanomedicine integrates nanotechnology with medicine to develop novel approaches for targeted drug delivery, imaging, sensing, and regenerative medicine. By utilizing nanoparticles and nanostructures, scientists and researchers are able to enhance the efficacy and specificity of therapeutics, improve diagnostic capabilities, and revolutionize healthcare. Nanodentistry utilizes nanoparticles and nanodevices for targeted drug delivery, continuous oral health maintenance, and preventive and restorative dentistry. This article is an overview that highlights the role of nanotechnology in dentistry.
Periodontal Diseases in Spouses
Authors: Babu N. Aravindha , Priya P. , Anusha M. N.
Published: December 2024

Spousal members who share no genetic relatedness show similar oral microbiomes. Whether a shared microbiome increases the risk of periodontal disease is challenging to investigate. The presence of periodontitis in one member of the couple is a strong indicator of risk for the colonization of the spouse by periodontophatic bacteria. Periodontal disease can be transmitted, suggesting the importance of early detection of oral pathogens in the familial pattern of periodontitis to clarify the source of infection and to assess correct prevention protocols based on potential infectivity within spouses. Recent findings suggest that two major periodontal pathogenes, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, are transmitted among family members.
Study on the prognostic impact of interferon-gamma-inducible protein 16 level in multiple myeloma patients
Authors: Nassar Israa G.I. , Saad Mohamed A. , Elkholy Rasha A. , Allam Alzahraa A.
Published: December 2024

Background

Interferon-gamma-inducible protein 16 (IFI-16) is a member of the pyrin and hematopoietic interferon-inducible nuclear domain 200 gene family, which modulates proliferation, survival as well as various cell lineage differentiation. Recent studies have shown that IFI-16 predicts prognosis in many cancers as enhanced IFI-16 expression was linked to favorable prognosis of hematological malignancies, involving chronic lymphocytic leukemia and mantle cell lymphoma.

Aim

To investigate IFI-16 serum levels as a diagnostic and prognostic marker for newly diagnosed multiple myeloma (MM) cases.

Patients and methods

Our prospective study involved 30 newly diagnosed MM cases and 30 healthy volunteers. Serum IFI-16 was measured using the enzyme-linked immunosorbent assay.

Results

The IFI-16 level exhibited a significant increase among the patient’s group compared with the control group. It was significantly increased within stage III compared with stages I and II, and in relapsed cases compared with nonrelapsed cases. IFI-16 was significantly positively correlated with serum creatinine, lactate dehydrogenase enzyme, β2 microglobulin, and serum calcium while negatively correlated with serum albumin. IFI-16 at a cutoff more than 1.43 ng/ml can significantly differentiate MM cases from controls. IFI-16 was significantly associated with disease-free survival (DFS) in both univariate and multivariate analyses, and patients with high IFI-16 had a shorter DFS compared with those with low IFI-16.

Conclusion

Our study concluded that a high level of IFI-16 was associated with advanced myeloma staging, and correlated with negative prognostic markers such as β2 microglobulin, lactate dehydrogenase, serum calcium, creatinine, and albumin, which are linked to greater relapse rate as well as shorter DFS.
Soluble transferrin receptor and soluble transferrin receptor/log ferritin index in coronavirus disease 2019
Authors: Abdalla Abdalla E. , Doha Saad A. , Nashaat Soliman M. , Alaa El-Din Abdel-Hamid S. , Mohammed Saad A. , Hebat-Allah Nashaat H.
Published: December 2024

Background

The coronavirus disease 2019 (COVID-19) pandemic impacted a huge number of people worldwide, with high morbidity and mortality. Consistent findings indicated a potential role of iron parameters, hyperferritinemia, and ferroptosis in the pathogenesis of multiorgan failure, and it might serve as a new treatment target. However, no single reliable marker of iron homeostasis exists, as all traditional parameters are influenced by inflammation. Studying soluble transferrin receptor (sTfR) and sTfR/log ferritin takes advantage of the reciprocal relationship between the two variables influenced by iron deficiency and may provide a better understanding of the iron derangement that occurs in COVID-19 infection.

Aim

To assess the pattern of hepcidin, sTfR, and sTfR/log ferritin index in COVID-19 patients, its association with disease severity, complications, and mortality, as well as its validity to be used as a biomarker for complications, severity, and mortality.

Patients and methods

It is a case–control study conducted at Suez Canal University Hospital. A 100 participants were selected and divided into two groups: a study group (50 adult COVID-19 patients) and a control group (50 healthy blood donor volunteers). Clinical data were obtained using a questionnaire, clinical examination, laboratorty, and radiological tests. All participants were tested for iron parameters: serum iron, total iron binding capacity, transferrin saturation percentage, ferritin, sTfR, and serum hepcidin.

Results

COVID-19 patients showed a statistically significant higher sTfR, hepcidin, and sTfR/log ferritin index (P<0.0001) and statistically significant lower serum iron and total iron binding capacity (P<0.001). High sTfR was associated with higher mortality 58.1% and a lower percentage of recovery 41.9%. The relative risk of fatal outcome in the high sTfR subgroup is 4.07 times that in the normal sTfR subgroup.

Conclusion

sTfR level and sTfR/log ferritin index are significantly elevated in COVID-19 infection. They could be considered significant biomarkers correlated to the severity, complications, and outcome of COVID-19 infection and add clinical value to predict disease progression among COVID-19 patients.
Interleukin-6 and tumor necrosis factor-α levels in chronic lymphocytic leukemia: correlation with patients’ characteristics and outcome
Authors: Al-Adl Menna , Elwasefy Shereen Ahmed , Youssef Magdy M. , El-Said Afaf , Refaat Sherif , EL-Sebaie Ahmed , Badawy Heba K.
Published: December 2024

Background

Chronic lymphocytic leukemia (CLL) is a malignant disease of the blood characterized by the proliferation of mature B-lymphocytes in the bone marrow and lymphoid tissues. The altered functions of innate immune elements and adaptive immune factors are interconnected in CLL and are decisive for its onset, evolution, and therapeutic response. This study aimed to investigate the correlation between serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels and outcomes in CLL.

Patients and methods

Serum IL-6 and TNF-α levels were measured by enzyme-linked immunosorbent assay from 100 Egyptian patients newly diagnosed with CLL and 100 age-matched and sex-matched healthy individuals. Cytokine levels were correlated with clinical features and the response after receiving chemotherapy.

Results

Serum IL-6 and TNF-α levels were significantly higher in CLL patients than controls (median, 49 vs. 6.2 ng/l and median, 38.5 vs. 4.16 ng/l, respectively). A significant association was found between IL-6 and TNF-α levels and abnormal karyotyping, advanced disease stage, higher white blood cells, lymphocyte count, β2 microglobulin, and lactate dehydrogenase concentrations (P<0.001 for each). No significant difference between the responder and nonresponder patients after receiving chemotherapy was noticed regarding both IL-6 and TNF-α levels.

Conclusion

Serum IL-6 and TNF-α levels were correlated with advanced CLL stage and worse prognosis but were related to the patient’s outcome after receiving chemotherapy.
Assessment of renal function in long-term surviving children after hematopoietic cell transplantation
Authors: Sallam Dina E. , Mohamed Wafaa E.I. , Ahmed Abdel-Rahman H. , Taha Sara E.A.-F. , Matbouly Safa
Published: December 2024

Background

Hematopoietic stem cell transplantation (HSCT) is the standard therapy for many disorders, however long-term complications post-HSCT in pediatrics remain a significant concern, where a pre-existent subclinical kidney damage, the use of nephrotoxic medications, or consequences of primary disease carry the hazard of acute kidney injury (AKI) and chronic kidney disease (CKD), which could be devastating complications, therefore identification of risk factors, prompt diagnosis, and treatment of CKD is vital for secure HSCT. So, we aimed to assess the kidney function to detect the development of CKD in our pediatric patient, using different formulas to measure the estimated glomerular filtration rate (eGFR).

Patients and methods

A prospective cross-sectional study was conducted at the Bone Marrow Transplantation Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt, where we included all available HSCT long-term survivors, who underwent HSCT during the period between 2011 and 2018. A detailed medical history and complications were collected from patient’s medical records, while clinical examination with measurement of serum creatinine, and Cystatin C (CysC) were done to determine eGFR, and hence CKD, using different methods; bedside Schwartz and Cockcroft Gault formulas (according to the age), serum CysC, and Chronic Kidney Disease in Children (CKiD) Creatinine-Cystatin C-based CKiD equation (CKiD-eGFR CysC formula).

Results

We included 23 pediatric HSCT survivors, with a mean (±SD) age of 14.35 (±5.27) years. Most of our patients were diagnosed with aplastic anemia (43.5%) and beta-thalassemia major (26.1%), where HSCT, 87% was allogeneic, 4.3% cord blood; meanwhile 8.7% was autologous. The most common reported complications were AKI (56.5%), and acute Graft-versus-host disease (43.5%), meanwhile, CKD was reported in 4/23 (17.4%) according to serum creatinine bases formulas, and one (4.3%) patient according to serum cystatin C, and two (8.6%) patients based on CKiD-eGFR CysC formula. CKD was linked to the conditioning regimen by Cyclophosphamide and antithymocyte globulin, the use of vancomycin and aminoglycoside, and the history of AKI.

Conclusion

CKD is not uncommon complications post-transplantation, and is strongly correlated to the previous conditioning regimen, antimicrobials, and history of AKI. The accuracy and early diagnosis of CKD necessitated the use of combined equations of eGFR calculation. CKD Controllable measures are needed to prevent renal insult in children post-transplantation.
Genetic analysis of driver mutations in classical myeloproliferative neoplasms – a study from a South Indian Tertiary Care Center
Authors: Pai Usha K.N. , Sankarankutti Ragitha T. , Rafi Aboobacker M. , John Mithun C. , Raj Soumya , Earali Jerry , Raveendran Suresh K.
Published: December 2024

Background

Despite being one of the most populated and diverse countries in the world, there is a paucity of data on the prevalence of driver mutations in classical myeloproliferative neoplasms (MPN) in India.

Aim

In the present study, we aimed to analyze somatic driver mutations such as JAK2, CALR, and MPL in classical MPNs in a South Indian Tertiary Care Center.

Patients and methods

Out of 185 suspected MPN patients screened, based on WHO 2016 criteria, 72 MPN patients were included in this study. JAK2V617F and MPL mutations were screened using an allele-specific PCR assay. JAK2 exon 12 and CALR exon 9 mutations were screened by PCR Sanger sequencing.

Results

In the present study, JAK2V617F mutation was detected in 88.8% of polycythemia vera, 66.6% of essential thrombocythemia, and 53.3% of primary myelofibrosis (PMF) cases. CALR mutations were observed in 16.6% of essential thrombocythemia and 13.3% of PMF patients. In addition to the common type 2 mutation, we identified a rarely reported type 2-like mutation (c.1154_1155insATGTC) in a PMF patient. The identified mutations were mutually exclusive. We observed an absence of JAK2 exon 12 and MPL mutations in our study participants.

Conclusion

In the present study, we observed JAK2 and CALR mutations in 77.7 and 5.5%, respectively, in classical MPNs. We identified a rare CALR type 2-like mutation in a PMF patient, a first report from India.
Efficacy of vitamin D supplementation on clinical outcomes of children with sickle cell disease
Authors: Ebeid Fatma S.E. , Sallam Sara F.A. , Mostafa Salwa , Gohar Ahmed M.S. , Tolba Marwa W. , Adly Amira A.
Published: December 2024

Background

Vitamin D deficiency (VDD) is a common nutritional burden among children with sickle cell disease (SCD).

Aims

To measure VD levels in children with SCD and to assess the safety and efficacy of its supplementation on clinical outcomes.

Patients and methods

This follow-up prospective study recruited 50 children and adolescents with SCD at their steady state. Patients were clinically assessed and had their complete blood count, liver and kidney function tests, serum ferritin, and serum 25-hydroxyvitamin D level assessed. Patients with VDD were treated with oral VD supplementation (6000 units daily) for 3 months and reassessed.

Results

A high prevalence of VDD (46%) is found in children with SCD. Those with VDD had statistically significant higher frequencies of fracture (P=0.023), joint and bone pain (P=0.001), sickle crisis (P=0.004), hospital admission (P=0.019), and infections (P=0.042). There was a statistically significant negative correlation between pretreatment VD levels and the number of crises (P=0.043). After VD supplementation, there was a statistically significant improvement in VD level (P≤0.001) and a reduction in the number of crises (P≤0.001) and hospital admission rate (P≤0.001).

Conclusion

The high prevalence of VDD in young SCD patients highlights the importance of early VD supplementation that improves their clinical outcomes without affecting their safety.
Rare bleeding disorders in girls and adolescent females with bleeding symptoms
Authors: Mokhtar Galila M. , Ramzy Mina E. , Mohammed Walid E. , Fadel Michael , Ebeid Fatma S.E. , Tolba Marwa W.
Published: December 2024

Background

Females with rare bleeding disorders who suffer from mild bleeding symptoms and extra bleeding symptoms related to menstruation are usually delayed in their diagnosis, necessitating early evaluation for an underlying bleeding diathesis based on clinical suspicion.

Objectives

We aimed to assess the frequency of rare bleeding disorders among female children and adolescents presenting with bleeding symptoms and to evaluate their health-related quality of life.

Patients and methods

Sixty females with bleeding symptoms younger than 18 years old were recruited and were subjected to detailed medical assessment and evaluation of different bleeding symptoms using the ISTH-BAT, the menstrual pictogram for assessing menstrual blood loss in pubertal females, and the Arabic version of the pediatric quality of life multidimensional fatigue scale. Laboratory investigations are tailored according to the institutional guidelines.

Results

The median age of the studied population was 8.25 years and 48.3% had a positive family history of bleeding. The mean age of presentation/diagnosis of Von Willebrand disease and Glanzmann disease were 6.1/8.2 and 5.3/7.6 years, respectively. Forty-five females had inherited bleeding disorders, and 15 had acquired ones. The most common diagnosis was Von Willebrand disease (30%), followed by Glanzmann disease (18.3%). The most common acquired disorder was aplastic anemia (13.3%). There was a higher ISTH-BAT total score in those with inherited disorders than in those with acquired disorders (P=0.006).

Conclusion

Adolescent females who present to a tertiary pediatric or gynecology service with bleeding manifestations should be screened for underlying bleeding disorders.
Screening for extended blood grouping in children with transfusion-dependent beta thalassemia
Authors: Elfadaly Heba E. , Elagamy Osama A. , Eldegwi Marwa , Elhawary Eslam E.
Published: December 2024

Background

Beta-thalassemia is the most common genetic disorder that causes chronic hemolytic anemia. Transfusion therapy and iron chelation are the cornerstones in the management of thalassemia.

Aim

To screen children with transfusion-dependent beta-thalassemia for the presence of minor blood groups.

Patients and methods

This cross-sectional study was carried out on 30 children on transfusions for at least a year.

Results

Nine (30%) patients were negative for RH and 21 (70%) were positive. Ten children had type A blood, twelve had type O blood, five had type B blood, and three had type AB blood. Four (13.33%) patients tested positive for minor blood group antigens, whereas 26 (86.67%) tested negative. Two children tested positive for e-antigen, one for the Kell antigen, and one for the Fya antigen. Five (16.67%) patients tested positive for minor blood group antibodies and 25 (83.33%) tested negative. There was a robust relationship between the frequency of blood transfusions and minor blood group antibodies. There was a significant correlation between patients’ minor blood group antibodies and their RH phenotype.

Conclusion

This study highlights the importance of considering minor blood group antibodies in managing blood transfusions for children with thalassemia. Positive minor blood group antibodies are associated with a need for more frequent transfusions. However, ABO blood group and minor blood group antigens themselves did not significantly affect transfusion frequency in this study.
The Essentials of Clinical Trial Management: Addressing Needs for Successful Outcomes
Authors: Kumar Gunjan , Mukherjee Aparna
Published: December 2024

Clinical trials are essential for evaluating the safety and efficacy of new medical interventions, ensuring evidence-based advancements in healthcare. They play a critical role in improving patient outcomes and guiding regulatory approvals for new treatments. India has emerged as a key player in clinical trials, owing to its skilled manpower, state-of-art infrastructure and robust regulatory framework. The manuscript has been written with the objectives of summarising the key imperatives of clinical trial administration including strategic planning, focusing on the development of protocol, appropriate study designs and the establishment of SMART objectives. It further emphasises regulatory compliance, ethics and the selection of study sites based on epidemiological and infrastructural factors. The role of data management, especially electronic data capture, and the necessity of robust monitoring, including risk-based approaches, are then highlighted. The document also addresses common challenges such as patient recruitment, retention, budgeting and site coordination, and proposes solutions, such as leveraging technology and ensuring ethical standards. Finally, it examines the complexities of multi-centric clinical trials, offering strategies for overcoming these hurdles.
Fostering Specialised Higher Nursing Education in India: Identifying Challenges and Crafting Solutions
Authors: Sharma Suresh K , Podder Lily
Published: December 2024

As healthcare systems worldwide evolve to meet the increasing complexities of patient care, specialised higher nursing education has emerged as a pivotal component in enhancing the quality of healthcare delivery. In India, nurses constitute approximately 30.5% of the healthcare workforce; however, the nation faces significant challenges in developing a competent specialised nursing cadre. This article provides a comprehensive review of the obstacles in preparing specialised nurses, the challenges of retaining them and proposed strategies to overcome these issues. A systematic search of multiple electronic databases for studies published between 2013 and 2023 identified 28 relevant studies. Key obstacles in preparing specialised nurses were identified and categorised into educational barriers, institutional challenges and policy and regulatory issues. Retaining specialised nurses poses equal challenges, primarily due to job dissatisfaction, inadequate compensation, limited career advancement opportunities and the impact of international migration. Proposed solutions include modernising nursing curricula, establishing clear career pathways, enhancing work environments and reforming policies to improve retention. By addressing these challenges and implementing strategic recommendations, this review aims to contribute to the development of a more capable and specialised nursing workforce, ultimately enhancing healthcare delivery and outcomes in India.
An Observational Study Comparing Laminoplasty versus Lateral Mass Screw Fixation in Multilevel Cervical Compressive Myelopathy
Authors: Sarathy R. Partha , Bansal Sumit , Sekar Arunkumar , Patnaik Ashis , Sahu Rabi Narayan
Published: December 2024

Background:

The management of multilevel degenerative cervical myelopathy (DCM) is still controversial. Patients with DCM can be treated nonsurgically or surgically, depending on symptom progression, severity, and radiological characteristics. Surgical treatment can be performed using either an anterior or posterior approach or both in some circumstances, each with a unique set of indications and limitations.

Objective:

The objective of the study was to compare the outcomes of laminoplasty (LP) and laminectomy with lateral mass fixation (LMS) in multilevel DCM.

Material and Methods:

Patients with cervical compressive myelopathy operated by posterior approach between January 2021 and December 2023 were included. Outcomes were assessed with a modified Japanese Orthopaedic Association score (mJOA), Nurick grade, neck disability index (NDI), and Ishihara score (cervical curvature index [CCI]).

Results:

Forty patients were included of which 16 patients underwent LP and 24 patients underwent LMS. Significant improvement was noted postoperatively in both the groups in mJOA score, Nurick grade, and NDI. No gross improvement was seen in CCI. Operative time and implant cost per level were significantly less in LP. Recovery rates were comparable in all the measured parameters, namely mJOA score, Nurick grade, NDI, and Ishihara index in both groups.

Conclusions:

LP and lateral mass fixation lead to significant clinical improvement with no significant worsening in cervical lordosis. LP had less operative time with a better range of cervical motion and a cost-effective procedure in patients without cervical deformity while LMS was found to be more appropriate for kyphotic/deformed cervical spine.
A Case of Osteoid Osteoma of a Rib Masquerading as Painful Scoliosis
Authors: Sha I. Ibad , Majeed Ibrahim S. , Kurian Nishant
Published: December 2024

Osteoid osteoma (OO) is a benign bone tumor that typically affects the long bones of the lower extremities. Rare cases of rib involvement present with atypical symptoms, such as painful scoliosis, which can complicate diagnosis. Here, we describe a case of a 10-year-old girl who presented with scoliosis and back pain initially misattributed to idiopathic scoliosis. Comprehensive radiologic assessment ultimately revealed an OO in the rib, which was successfully treated with computed tomography-guided radiofrequency ablation (RFA). This case highlights the necessity of thorough diagnostic evaluation for atypical presentations of scoliosis and supports the use of RFA as an effective treatment for rib OO.
Bilateral Cruciate-retaining Image-free Robot-assisted Total Knee Arthroplasty Using Extended Restricted Kinematic Alignment in a Patient with Severe Varus Deformities
Authors: Parameswaran Apurve , Apsingi Sunil , Ponnala Vinay Kishore , Eachempati Krishna Kiran
Published: December 2024

The management of severe coronal deformities during total knee arthroplasty (TKA) is challenging. Although conventionally considered to be a contraindication for cruciate-retaining TKA, severe varus deformities of ≥15° can be managed using cruciate-retaining prostheses and result in satisfactory outcomes if appropriate alignment and gap balance can be achieved. Robotic technology has enhanced the correction of complex deformities through virtual surgical planning, alternative alignment strategies, superior soft-tissue management, and personalized surgery. We present a case of bilateral osteoarthritis of the knees with severe varus deformities, managed through image-free robot-assisted TKA using extended restricted kinematic alignment and cruciate-retaining prostheses. Arthroplasty surgeons in developing countries need to be well-versed in multiple techniques for the management of osteoarthritis of the knee with severe coronal deformities. The technique presented by the authors would be a valuable tool in their armamentarium.
The Role of Electrosurgery in the Management of Orthodontic Treatment-Induced Inflammatory Gingival Enlargement: A Report of Three Cases
Authors: Sharma Himani , Deka Jagriti , Thakur Srishti , Kashid Amit
Published: December 2024

Orthodontic treatment, while beneficial for correcting dental alignment and improving oral health, can sometimes lead to complications such as inflammatory gingival enlargement (IGE). This condition, characterised by the overgrowth of gingival tissues, can cause discomfort and aesthetic concerns and impede oral hygiene, potentially leading to further periodontal issues. Electrosurgery has emerged as an effective treatment modality for managing this condition. This report examines the use of electrosurgery in three cases of orthodontic treatment-induced IGE, highlighting its efficacy, advantages and outcomes.
Odontogenic Keratocyst: Theory of Its Origin
Authors: Dhanrajanijani Parmanand
Published: December 2024

Generally, it is believed odontogenic keratocyst (OKC) originates from remnants of the dental lamina. However, a tooth is generally not missing and, therefore, they are believed to originate from additional remnants of the lamina not involved in tooth formation. A case of an OKC arising in the mandible 4 years after the removal of a wisdom tooth is presented to discuss its likely origin. This present case might be one in which the remnants of dental lamina might have stirred up in developing OKC post-removal of wisdom tooth.
Analysis of the positive influence of hyperbaric oxygen therapy on the prognosis and hearing control of patients with noise-induced hearing loss
Authors: Tan Zhen , Xu Jianbo , Li Junfan , You Yating
Published: December 2024

Objective: In this study, the research team aimed to explore the therapeutic effectiveness of hyperbaric oxygen therapy (HBOT) for noise-induced hearing loss (NIHL), its influence on patient prognosis, and its impact on hearing to provide valuable clinical evidence. Methods: Ninety-four patients with NIHL admitted to The First People’s Hospital of Changde City, Hunan, China, from May 2021 to January 2023 were selected for this retrospective analysis. Among them, 43 were given conventional treatment (control group) and 51 were given HBOT (observation group). The clinical efficacy, symptom improvement, and pure-tone hearing thresholds (PTHTs) at different frequencies were detected. All cases were followed up for 12 months to record the NIHL recurrence rates and hearing (hearing threshold), and their quality of life was investigated. Results: The observation group had higher total effective rate and excellent rate and lower incidence of insomnia, tinnitus, and other symptoms than the control group (P < 0.05). PTHTs were lower in the observation group than in the control group at different frequencies (P < 0.05). Follow-up analysis showed no notable intergroup difference in the NHL recurrence rate (P > 0.05), but the hearing threshold was lower and the quality of life was better in the observation group than in the control group (P < 0.05). Conclusions: Compared to conventional treatment, HBOT is effective in treating NIHL and can improve the hearing and coagulation function of patients and provide a reliable guarantee for their prognostic health.
Correlation between Occupational Noise Exposure and Renal Dysfunction in Male Workers
Authors: Zhang Shujian , Shen Li , Wang Qian , Yu Shuhong
Published: December 2024

Objective: This study aimed to explore the relationship between occupational noise exposure and renal dysfunction in male workers. Methods: A total of 160 male workers (the number of people who met the inclusion criteria) who underwent health examinations in Qingdao Municipal Hospital from January 2023 to December 2023 were grouped into a noise group (80 cases) and a control group (80 cases) based on whether they engaged in noise work. We compared the differences in creatinine (CREA), cystatin C (CysC) and blood urea nitrogen (BUN) levels between the two groups. We also compared the differences in the above renal function indicators among workers with different working years in the noise group, as well as observed the relationship between renal dysfunction and noise exposure. Results: The levels of BUN, CREA and CysC in the noise group were significantly higher than those in the control group (P < 0.05). The overall abnormal rate of renal function in the noise group (42.50%) was significantly higher than that in the control group (11.25%, P < 0.05). The levels of BUN, CREA and CysC all significantly increased with the increase in working years (P < 0.05). The noise exposure intensity and cumulative noise exposure (CNE) of the group with renal dysfunction were higher than those of the group with normal renal function (P < 0.05). The area under the curve was 0.811 (95% confidence interval: 0.714–0.908), the optimal cut-off value of CNE was 96.53 dB (A) · year, the sensitivity was 89.29%, the specificity was 83.32% and the Youden index was 72.61%. Conclusion: There may be a correlation between long-term noise exposure and renal function. The intensity of noise exposure and CNE may have a certain correlation with renal function damage in occupational noise-exposed workers.
Role of Nursing in Managing Noise-Related Hearing Loss in Children: A Retrospective Study of Earmuffs as a Protective Intervention
Authors: Shu Yi , Zhang Wenwen , Zhou Jiaji
Published: December 2024

Background: Noise-induced hearing loss (NIHL) in children is a growing public health concern due to increased exposure to high noise levels in various environments. Early intervention is crucial to prevent long-term developmental and social impacts. This study evaluates the effectiveness of earmuffs as a protective intervention in managing NIHL in children. Methods: A prospective study was conducted involving 120 paediatric patients aged 5–12 years diagnosed with NIHL. Patients were divided into an intervention group (n = 60), who received standard treatment plus earmuffs, and a control group (n = 60), who received standard treatment only. Pure-tone audiometry tests were used to assess hearing thresholds at baseline and post-intervention. Family satisfaction was also assessed using a self-administered questionnaire. Results: Hearing thresholds substantially improved in the intervention group compared with those in the control group. After the intervention, hearing thresholds in the intervention group reduced by 7.31 decibels (dB) at 500 Hertz (Hz), 6.73 dB at 1000 Hz, 6.66 dB at 2000 Hz and 6.92 dB at 4000 Hz (P < 0.05). In the control group, reductions were 3.74, 3.72, 3.64 and 3.80 dB, respectively (P < 0.05). Family satisfaction was significantly higher in the intervention group, with 91.7% expressing satisfaction, compared with 65.0% in the control group (P = 0.030). Conclusion: This study demonstrates the effectiveness of earmuffs in preventing NIHL in children, showing improvements in hearing thresholds and increased family satisfaction. These findings suggest that earmuffs could be beneficial as part of standard preventive measures for paediatric patients exposed to high noise levels and highlight their potential practical and clinical value.
Evaluation of Noise in Paediatric Dentistry and Change in Perception of Operators with Use of Ear Protection Devices
Authors: Deshpande Anshula Neeraj , Baishya Simron , Saha Sonali , Sodani Vasudha , Shah Riddhika , Antala Aishwarya
Published: December 2024

Background: Noise sources in paediatric dental offices include machinery and children’s cries and screams. Although the presence of occupational noise-induced hearing loss (ONIHL) among dental operators is established, preventive measures such as ear protection devices (EPDs) are not frequently employed as prophylactic intervention. The primary aim of this study was to quantitatively assess the noise levels in paediatric dental clinics and to qualitatively evaluate the operators’ perception of noise with and without the use of EPDs. Methods: A crossover study was conducted with 93 operators; half of whom first worked without EPD, and the other half worked with EPD. Sound produced near each operator was recorded in decibels (dBs) for five working days, and the maximum sound in decibel for each day was noted and averaged. The results were then compared with the Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) exposure limits. A questionnaire was handed out before the commencement of the study, and another at the end of the study. Results: The average noise level was 86.68 dB without EPD and 86.83 dB with EPD. About 65.59% dentists considered the level of noise at their workplace to be medium level, and 98.92% did not wear EPD. Most common findings, such as irritability at the end of the day (77.42%), were relieved after use of EPD in 92.47% dentists. Conclusion: The noise in the paediatric department is above the NOISH-recommended exposure limit, which is harmful to the auditory system. In general, dentists are knowledgeable about the noise in the operatory, although their knowledge about EPDs is not high.
Influence of Gaussian White Noise on Medical Students’ Capacity to Accurately Identify Pulmonary Sounds
Authors: Razvadauskas Haroldas , Razvadauskienė Jurgita , Aliulis Martynas , Aliulytė Rūta , Naudžiūnas Albinas , Paukštaitienė Renata , Sadauskas Saulius
Published: December 2024

Background: The effect of background noise on auscultation accuracy for different lung sound classes under standardised conditions, especially at lower to medium levels, remains largely unexplored. This article aims to evaluate the impact of three levels of Gaussian white noise (GWN) on the ability to identify three classes of lung sounds. Methods and materials: A pre-post pilot study assessing the impact of GWN on a group of students’ ability to identify lung sounds was conducted. The three intensities were applied to the three classes of lung sounds: no GWN, signal-to-noise ratio (SNR), SNR-40 (medium level) and SNR-20 (high). This resulted with three exams, each containing nine questions. Fifty-two participants underwent a 4-day training programme and were tested on their identification of lung sound classes under the three levels of GWN, but seven subjects were excluded for not completing all three assessments. Statistical analysis was performed on 45 subjects, using non-parametric tests to analyse the data. A P-value of 0.05 was considered statistically significant. Results: The GWN did not impact the overall lung sound identification capacity of medical students, with consistent scores of 66.7% across the three noise levels for all three lung sound classes combined. However, when considering sound classes separately, GWN affected the identification of normal (NAS) and discontinuous (DAS), but not continuous (CAS) types. Exam scores for NAS varied significantly across the three noise levels, with respective scores of 66.7%, 100% and 66.7%. Scores for DAS also varied, revealing 66.7%, 33.3% and 66.7%. Conclusion: This study introduces a standardised simulation-based approach to investigate the effect of GWN on the accuracy of auscultation amongst medical students. Findings indicate that whilst CAS sounds are robust to background noise, the identification of NAS and DAS sounds can be compromised. The medium noise levels (SNR-40) of noise pollution had the greatest effect on the DAS lung sounds.
Postthoracotomy Pain: The Unanswered Question Yet – A Clinical and Technical Report
Authors: Singh Dewan Roshan
Published: December 2024

Thoracotomy which is a major surgical procedure of making an incision through the thoracic wall in order to gain access to the thoracic organs, is a cornerstone of diagnosis and management of numerous cardiopulmonary disorders. Nonetheless, most essential area of patient care, postoperative pain management, presents several obstacles. Published literature shows that about three-quarters of the thoracotomy patients reported immediate pain or discomfort during the early postoperative period, and up to 30%–50% patients might even develop chronic pain that has implications on their health related quality of life. Consequently, the causes of continued pain after thoracotomy are numerous and range from the intricacy of the procedure, patients’ tolerance to pain and diseases among others. Pain control is essential to avoid the risk of the deterioration of lung function, poor patient mobilization, and prolonged hospital stay. It is therefore undoubted that if pain continues for a long period, one may develop chronic pain syndromes that drag down the quality of life even further. In attempts to resolve these problems, different types of analgesic measures have been attempted. Some interventional procedures have been reported recently to be useful: Fascial plane blocks, which interfere with the flow of pain messages. Routes such as thoracic paravertebral block, intercostal nerve block, serratus anterior plane block, pectoral nerve block, and the retrolaminar block give variable levels of anesthesia in the required area. Some newer blocks such as the rhomboid intercostal and serratus sparing (RISS) block seem to provide a wide complete analgesia of the posterior and lateral chest walls. Thus, in an intermediate-term pain management strategy, fascial plane blocks can be used together with medications such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs). It is a kind-of medicine that is frequently used because of its effectiveness accompanied by a tendency to produce minimal side effects and interact well with opioids without posing the risks inherent in the application of NSAIDs. They have significant analgesic and anti-inflammatory properties thus decreasing the dependence on opioids. Their use, therefore, comes with a lot of precautions due, prompt for example per both gastrointestinal bleeding and renal impairment, hence, requires patient spotlight and assessment. Therefore, in enhancing postthoracotomy pain regime, a multimodal approach that includes the use of fascial plane blocks in combination with paracetamol and prudent use of NSAID can improve the recovery process and henceforth the patient’s outcomes without subjecting the patients to adverse effects.