bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of darolac probiotic and chlorhexidine mouth rinse in reducing plaque and gingival inflammation in children
Authors: Bande Yogesh , Ade Sharda , Baroopal Sudhir , Joshi Akshada , Pathak Janhabi , Deshmukh Abhinay V , Arya Sugandha 
Published: September 2021

Background:
Chemical agents have been increasingly used as an adjunct to mechanical control. The use of a mouthwash augments maintenance of oral health through its antiplaque and antibacterial chemical properties. Recently, Probiotics can be used an effective alternative for other traditional mouthrinses in reducing plaque accumulation and gingival inflammation.

Aim:
To evaluate the clinical efficacy of a probiotic and chlorhexidine mouth rinses on plaque and gingival accumulation in children.

Materials and Methods:
Randomized controlled 14 day trial including 30 healthy children (6–8 years) was done in which 10 children were in control group and 20 children were instructed to rinse 5ml/day for 1 min of each solution (probiotics and chlorhexidine) for 14 days.

Results:
A Statistically significanct difference was noted between mean PI and mean GI score of control group when compared with probiotic and chlorhexidine after 14 days in comparison to baseline (P < 0.001). However, there was no significant difference in mean plaque accumulation and gingival inflammation between the probiotics and chlorhexidine on the 14th day examination.

Conclusion:
Probiotics mouth rinse was effective in reducing plaque accumulation and gingival inflammation in 6 to 8 year old children.
Impact of COVID-19 pandemic on learning of the undergraduate and postgraduate dental students
Authors: Manohar Swati P , Sneharaj N. , Shakir Arshiya , Talukdar Manjaree , Pavana M. P. 
Published: September 2021

Background:
More than 95% of all countries worldwide reported infections with the severe acute respiratory syndrome coronavirus-2 described as coronavirus disease-2019 (COVID-19). Therefore, most countries put physical distancing measures (e.g., closing of public, cultural, and educational institutions) in place to decelerate the infection rate. Consequently, dental education at universities worldwide is strongly affected by the COVID-19 pandemic. The present study was done to know the effect of COVID-19 pandemic on dental education.

Materials and Methods:
A self-designed, structured, online questionnaire of 22 close-ended questions was generated and distributed among the undergraduates and postgraduate dental students in Bangalore city. A total of 450 forms were sent through online by messages, WhatsApp, and emails. Online consent was obtained before participation in the study and it was mandatory to answer all questions. Data obtained were subjected to descriptive and inferential statistics, and significant proportions were available. The level of significance was considered as P ≤≤≤ 5.

Results:
The study showed that in this pandemic, 73.4% of the students feel e-learning as a boon for learning dental students, but 87.1% of students feel classroom lectures are more interactive compared to online lectures. About 12.4% of the students felt difficult to access the Internet for online classes, whereas 87.6% of students had access. Students feel understanding clinical procedures is difficult through e-learning; hence, 83.6% of students search web for better understanding. Almost 92.5% of the students feel they are lacking clinical experience due to online classes.

Conclusion:
COVID-19 has definitely affected the world; similarly, it has affected the clinical practice of dental students in dental schools. As education continues through e-learning, still, few students are deprived of education due to access to the Internet.
A study of high-volume, high-quality, and low-cost cataract surgeries in a rural setup in an emerging and developing country
Authors: Singh Shipra , Mehrotra Neelima 
Published: September 2021

Aim:
Evaluation of visual outcome following high volume, high quality and low cost cataract surgeries in a rural setup in North India.

Methods:
A retrospective study was done on all patients who underwent MSICS from March 2018 to March 2020 in a tertiary care hospital. Postoperative best-corrected visual acuity (BCVA) was assessed at day 1, between 1 and 3 weeks, and after 1–2 months of surgery.

Results:
A total of 6514 patients were included, out of which 1952 patients had ocular comorbidities; BCVA for each patient was categorized according to the World Health Organization criteria of visual impairment. It was seen that a statistically significant number of patients had good visual outcome following surgery at 1–2 months (3017 patients) 57.6%. Among the complications following surgery, posterior capsular rent was the most common and statistically significant.

Conclusion:
Good visual outcome in high volume of patients can be achieved with compliance to treatment and follow-up and proper management of complications.
Eyelid trichoblastoma – A case series
Authors: Chowdhury Gunja , Tanwar Meghana , Kim Usha , Krishnan Shanthi R. 
Published: September 2021

Purpose:
This study aims to explore the clinicopathological features of a rare eyelid tumor, trichoblastoma (TBL).

Methods:
This is a retrospective study of patients undergoing excision biopsies of eyelid masses at a tertiary eye care center in South India, between January 2017 and December 2018. Patient demographics, clinical and differentiating histopathological features, and recurrence of TBL were studied.

Results:
Amongst all eyelid masses, 15 were histopathologically diagnosed with TBL. The average age at presentation was 64 years as female preponderance and average duration of mass being 786 days. Change in color was noted in three patients, change in size in 14 cases and history of bleeding from the mass in three. Lower lid was the most common site involved (eight patients). The average dimension of the lesions was 158.67 mm2. One patient had lid margin involvement with loss of lashes noted in three cases and conjunctival involvement in three patients. Morphologically, eight lesions were nodular while five were noduloulcerative. Pigmented TBL was noted in eight patients, TBL with atypia in three patients. TBL, malignant TBL, rippled variant and TBL with trichofolliculoma were noted in one patient each. Clinical and histopathological diagnoses correlated in four patients. No recurrence was noted with the maximum follow-up period being 23 months.

Conclusion and Relevance:
A differential diagnosis of TBL should be kept in mind while managing eyelid tumors because benign lesions can mimic commonly diagnosed malignancies and vice versa.
A review article on Ahara Vidhi Vidhana (Rules for consuming food) in consonance with Charaka Samhita
Authors: Sankar Raveendran Nair Kumari Lekha Jinu , Harjpal Lalchand , Chandrakar Rupendra , Naik Shrikant 
Published: September 2021

Introduction:
It is not just the quantity or quality of food that determines the maintenance of health but also the way of consuming food. The digestion, absorption, and assimilation of food are complex procedures where physical, physiological, social, and emotional factors play a critical role. For achieving complete benefits of food, one should also follow certain rules as told in Ayurveda regarding what, when, where, and how the food should be consumed.

Objectives:
To evaluate and prepare data regarding various dietary and dining rules (Ahara Vidhi Vidhana) recorded in Ayurveda texts, along with their design and utility under the purview of Charaka Samhita.

Materials and Methods:
For this Ayurveda books such as Charaka Samhita, Susrutha Samhita, Ashtanga Sangraha, Ashtanga Hridaya, Sharangadhara Samhita, Bhavaprakasha, and Yogaratnakara were reviewed for gaining information regarding dietetic rules said in Ayurveda and the concept has been presented while keeping the view of Charaka Samhita at the center.

Observations:
The rules are divided into dietary rules and dining rules. The first one explains what food should be consumed depending on the quality of the food and the condition of the person. The latter one deals with the way the food should be consumed, which has direct effects on hygiene of the food and the condition of the mind.

Conclusion:
The findings from the review suggests that by not following these rules, it is understood that tan individual may land up in a sea of many diseases and following them will benefit the overall health.
A survey among Ayurveda wholesalers and retailers in Pune city for understanding the demand for Ayurvedic medicines during the COVID-19 pandemic
Authors: Kolhe Rasika , Pushpan Reshmi , Prasad Goli P. , Gurav Arun , Srikanth N. 
Published: September 2021

Background:
After the outbreak of Covid-19, a set of guidelines for boosting immunity and self-care measures were promoted by the Ayurveda, Yoga, Naturopathy, Unani, Siddha Sowa Riga, and Homeopathy (AYUSH) department. Pune has surpassed many metro cities of India and is recognized as one of the worst-hit places of Covid-19. Ayurveda is very popular among the citizens of Pune, but there is a lack of systematic data regarding the demand for Ayurveda products and the impact of the pandemic on the sales of Ayurveda medicines.

Objective:
This survey was planned to collect information from Ayurveda medicine retailers regarding the trends in the usage and demand for Ayurveda medicines among the citizens of Pune in the background of Covid-19.

Materials and Methods:
It was a semi-structured questionnaire-based survey study consisting of 43 questions to assess the demand for Ayurveda medicines during the Covid-19 pandemic in Pune city. The study was conducted from August 2020 to September 2020, and the respondents were selected by the convenience sampling method. Data were collected from a total of 33 respondents (retailers and wholesalers of Ayurveda medicine).

Analysis:
The data of the completed questionnaire were systematically summarized in Microsoft excel sheet 2007, and descriptive analysis, including percentages, was used.

Result:
The survey shows that certain raw herbs such as Ashwagandha (Withania somnifera L.), Guduchi (Tinospora cordifolia Miers), and finished products such as AYUSH Kwatha (Formulation to be prepared as a decoction), Chyavanprasha were in high demand during the Covid-19 outbreak. However, the demand for Amritarishta, Guduchi Ghana Vati, and Ashwagandha tablet was also high.

Conclusion:
These preliminary data of the survey study demonstrate the need for conducting similar studies in larger sample sizes across the country, which would enable the concerned authorities to frame policies.
Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia
Authors: Nandan Devki , Nimesh Manju , Kumar Sushil , Manik Lucky , Sudarshan J , Duggal Nandini 
Published: September 2021

Background:
Delayed diagnosis of ventilator-associated pneumonia (VAP) in pediatric patients is associated with accentuated risk of morbidities and mortality. Early diagnosis of VAP is challenging. Serum procalcitonin has been proposed as a promising inflammatory marker for the early diagnosis of VAP, but there is a lack of sufficient evidence for the use of serum procalcitonin for early diagnosis of VAP in children. The present study was conducted to determine the role of serum procalcitonin as an early inflammatory marker for an early and provisional diagnosis of VAP among clinically suspected VAP patients in pediatric intensive care unit settings.

Subjects and Methods:
Seventy-nine pediatric patients (age: 1 month–18 years) with suspected VAP (Simplified Clinical Pulmonary Infection Score >6) were prospectively evaluated with quantitative bronchoalveolar lavage cultures and simultaneously tested for serum procalcitonin levels. Two groups were identified based on culture results and comparatively evaluated for procalcitonin levels, its diagnostic efficacy, antibiotic usage patterns, and mechanical ventilation duration.

Results:
The VAP group had 39 patients, and the non-VAP group had 40 patients. Thirty-two (82%) patients in the VAP group had a procalcitonin value ≥10 ng/ml as against 10 (25%) from the non-VAP group. Two (5.1%) patients in the VAP group had procalcitonin levels ≤1 ng/ml as against 21 (52.5%) patients in the non-VAP group. The receiver operating characteristic area under curve for procalcitonin with a cutoff >10 ng/ml was 0.785 (95% confidence interval = 0.678–0.870) with a sensitivity of 82.05% and specificity of 75%.

Conclusions:
Serum procalcitonin is a reliable biomarker to augment the provisional diagnosis of VAP in clinically suspected cases. Such diagnosis may help in an early institution of definitive therapy for VAP.
A Lung Ultrasound Scanning Technique for Children and Adults in Low-Resource Settings: Preliminary Experiences in Sub-Saharan Africa
Authors: Fentress Matthew , Ezibon Phillip , Bulabek Akuot , Schwanfelder Carla , Schrift David , Shah Sachita , Tsung James , Nadimpalli Adi 
Published: September 2021

ABSTRACT.
Lung ultrasound is increasingly used as a diagnostic tool for pulmonary pathologies by nonspecialist clinicians in resource-limited settings where chest X-ray may not be readily available. However, the optimal technique for lung ultrasound in these settings is not yet clearly defined. We describe here our experience of implementing a standardized, focused six-zone, 12-view lung ultrasound scanning technique with a high-frequency probe in both adults and children in a resource-limited setting in sub-Saharan Africa. Our experience suggests that this may be a feasible technique to rapidly introduce lung ultrasound to new learners that can be adapted to emergency or outbreak settings. However, research is needed to determine how this technique compares with clinical examination and other available tests for the diagnosis of pathology commonly encountered in resource-limited settings.
Triangulating Evidence to Infer Pathways that Influence Ebola Virus Disease–Related Stigma and Clinical Findings among Survivors: An Observational Cohort Study
Authors: Kelly J. Daniel , Badio Moses , Drew Clara , Wilson Barthalomew , Cooper Joseph B. , Glayweon Meekie , Johnson Kumblytee , Moses J. Soka , Gayedu-Dennis Dehkontee , Torres Jacqueline M. , Oldenburg Catherine E. , Davidson Michelle C. , Huang Chiung-Yu , Steward Wayne T. , Sneller Micheal C. , Rutherford George W. , Reilly Cavan , Fallah Mosoka P. , Weiser Sheri D. 
Published: September 2021

ABSTRACT.
Visible signs of disease can evoke stigma while stigma contributes to depression and mental illness, sometimes manifesting as somatic symptoms. We assessed these hypotheses among Ebola virus disease (EVD) survivors, some of whom experienced clinical sequelae. Ebola virus disease survivors in Liberia were enrolled in an observational cohort study starting in June 2015 with visits every 6 months. At baseline and 18 months later, a seven-item index of EVD-related stigma was administered. Clinical findings (self-reported symptoms and abnormal findings) were obtained at each visit. We applied the generalized estimating equation method to assess the bidirectional concurrent and lagged associations between clinical findings and stigma, adjusting for age, gender, educational level, referral to medical care, and HIV serostatus as confounders. When assessing the contribution of stigma to later clinical findings, we restricted clinical findings to five that were also considered somatic symptoms. Data were obtained from 859 EVD survivors. In concurrent longitudinal analyses, each additional clinical finding increased the adjusted odds of stigma by 18% (95% CI: 1.11, 1.25), particularly palpitations, muscle pain, joint pain, urinary frequency, and memory loss. In lagged associations, memory loss (adjusted odds ratio [AOR]: 4.6; 95% CI: 1.73, 12.36) and anorexia (AOR: 4.17; 95% CI: 1.82, 9.53) were associated with later stigma, but stigma was not significantly associated with later clinical findings. Stigma was associated with select symptoms, not abnormal objective findings. Lagged associations between symptoms and later stigma substantiate the possibility of a pathway related to visible symptoms identified by community members and leading to fear of contagion.
Nonrandom Selection and Multiple Blood Feeding of Human Hosts by Anopheles Vectors: Implications for Malaria Transmission in Papua New Guinea
Authors: Keven John B. , Katusele Michelle , Vinit Rebecca , Rodríguez-Rodríguez Daniela , Hetzel Manuel W. , Robinson Leanne J. , Laman Moses , Karl Stephan , Foran David R. , Walker Edward D. 
Published: September 2021

ABSTRACT.
Nonrandom selection and multiple blood feeding of human hosts by Anopheles mosquitoes may exacerbate malaria transmission. Both patterns of blood feeding and their relationship to malaria epidemiology were investigated in Anopheles vectors in Papua New Guinea (PNG). Blood samples from humans and mosquito blood meals were collected in villages and human genetic profiles (“fingerprints”) were analyzed by genotyping 23 microsatellites and a sex-specific marker. Frequency of blood meals acquired from different humans, identified by unique genetic profiles, was fitted to Poisson and negative binomial distributions to test for nonrandom patterns of host selection. Blood meals with more than one genetic profiles were classified as mosquitoes that fed on multiple humans. The age of a person bitten by a mosquito was determined by matching the blood-meal genetic profile to the villagers’ genetic profiles. Malaria infection in humans was determined by PCR test of blood samples. The results show nonrandom distribution of blood feeding among humans, with biased selection toward males and individuals aged 15–30 years. Prevalence of Plasmodium falciparum infection was higher in this age group, suggesting males in this age range could be super-spreaders of malaria parasites. The proportion of mosquitoes that fed on multiple humans ranged from 6% to 13% among villages. The patterns of host utilization observed here can amplify transmission and contribute to the persistence of malaria in PNG despite efforts to suppress it with insecticidal bed nets. Excessive feeding on males aged 15–30 years underscores the importance of targeted interventions focusing on this demographic group.
Response to Valle and Zorello Laporta: Clarifying the Use of Instrumental Variable Methods to Understand the Effects of Environmental Change on Infectious Disease Transmission
Authors: MacDonald Andrew J. , Mordecai Erin A. 
Published: September 2021

ABSTRACT.
Identifying the effects of environmental change on the transmission of vectorborne and zoonotic diseases is of fundamental importance in the face of rapid global change. Causal inference approaches, including instrumental variable (IV) estimation, hold promise in disentangling plausibly causal relationships from observational data in these complex systems. Valle and Zorello Laporta recently critiqued the application of such approaches in our recent study of the effects of deforestation on malaria transmission in the Brazilian Amazon on the grounds that key statistical assumptions were not met. Here, we respond to this critique by 1) deriving the IV estimator to clarify the assumptions that Valle and Zorello Laporta conflate and misrepresent in their critique, 2) discussing these key assumptions as they relate to our original study and how our original approach reasonably satisfies the assumptions, and 3) presenting model results using alternative instrumental variables that can be argued more strongly satisfy key assumptions, illustrating that our results and original conclusion—that deforestation drives malaria transmission—remain unchanged.
Hepatitis B Transmission: Is Vertical Transmission the Major Route in Intermediate Endemic Areas? A Proof-of-Concept Study Based on Mother–Child Genotypes
Authors: Poddar Ujjal , Benjamin Mercilena , Aggarwal Rakesh , Sarangi Aditya Narayan , Mathias Amrita , Yachha Surender Kumar , Srivastava Anshu 
Published: September 2021

ABSTRACT.
The route of hepatitis B transmission is believed to be horizontal in India, though pediatric studies showed mother as source in the majority of chronic HBV (CHB) cases. We aimed at establishing the fact that mother–child transmission is the main route of acquisition by documenting genotypically identical viruses in mother–child pairs. Blood samples of consecutive children (≤ 18 years) with CHB and high DNA (> 10,000 IU/mL) and their positive mothers were collected from January 2013 to December 2015. Polymerase chain reaction (PCR) products of HBV-DNA were amplified and sequenced by using BigDye Terminator Cycle Sequencing Kit v3.1 and aligned with previously described sequences in the region of interest for genotypes A to G by using BioEdit software. Phylogenetic tree was generated using p-distance algorithm in MEGA software version 6. Genotyping of 59 (33 children and 26 mothers) subjects include genotype A in 24 (40.7%) and genotype D in 35 (59.3%). Both mother–child pair genotyping was possible in 25. The median age of 25 children (20 males) was 9 (interquartile range, IQR: 4–11) years. The distribution of genotypes among mother–child pairs was similar. The concordance between children and their mothers was 24 of 25 (96%). Evolutionary analysis showed significant similarities between mother and child sequences for both genotype A and D, suggesting thereby the same virus. In conclusion, mother–baby transmission seems to be the major route of acquisition of HBV in children in India and near-complete homology in genetic sequences between mother–child pairs is definite proof for that. However, a larger epidemiological study is required to substantiate our findings.
On the Dangers of Tropical Spiders as a Pet: A Review of Ocular Symptoms Caused by Tarantula Hairs
Authors: Jalink Maarten B. , Wisse Robert P. L. 
Published: September 2021

ABSTRACT.
Tarantulas are large spiders that can defend themselves by shedding urticating hairs (setae). In this paper, we aim to discuss the ocular conditions caused by these setae through a literature review. In total, 25 cases were identified in the PubMed database. Tarantula setae have a barbed structure that enables migration through the globe. They give rise to a spectrum of complaints, causing a granulomatous inflammatory reaction in the compartment they settle. Superficial corneal hairs cause a mild keratitis, while hairs that penetrate Descemet’s membrane can induce an anterior uveitis. Both can be treated with local steroids; when possible, hairs should be debrided. Setae that migrate into the posterior segment can cause a focal vitritis that can be more difficult to treat, sometimes requiring vitrectomy.