bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric spectacle prescription
Authors: Malaika Rawan , Raffa Lina , Algethami Mohammed , Alessa Sara 
Published: July 2021

PURPOSE:
This study aims to understand the approach to prescribing spectacles for children and the interpretation of refractive errors among ophthalmologists/optometrists in Saudi Arabia.

METHODS:
A cross-sectional survey was conducted between September and November 2018 using a database of online registrants for ophthalmologists and optometrists practicing in Saudi Arabia. The survey included 10 multiple-choice questions designed to elicit information about how ophthalmologists and optometrists deal with commonly encountered case scenarios covering different practical aspects of pediatric refraction. The responses were compared using the proportion of pediatric clientele received in the respondents' practices (Group A: <25%, Group B: 25%) and drawing upon concepts from the published literature.

RESULTS:
One hundred and three participants, including ophthalmologists, specialists/registrars, and optometrists from across Saudi Arabia, participated in this survey. Approximately 25% were classified as Group A. Large discrepancies were observed between the participants' responses and actual practices based on guideline recommendations. Responses varied significantly between Groups A and B on certain issues pertaining to pseudomyopia (P < 0.001), anisometropia (P = 0.033), and high astigmatism (P = 0.023).

CONCLUSION:
Practice patterns regarding pediatric spectacle prescription varied among ophthalmologists and optometrists in Saudi Arabia. The approach to managing refractive errors in children was better among ophthalmologists/optometrists servicing a larger pediatric clientele, suggesting the need to increase awareness among all groups of ophthalmologists/optometrists.
Optical coherence tomography analysis of surgical outcomes of combined hamartoma of retina and retinal pigment epithelium
Authors: Gupta Rajan , Ayachit Apoorva , Joshi Shrinivas , Nayak Sameera , Sahoo Niroj K. , Sacconi Riccardo , Singh Sumit R. , Muftuoglu Ilkay K. , Querques Giuseppe , Chhablani Jay 
Published: July 2021

PURPOSE:
To evaluate the surgical outcomes in combined hamartoma of retina and retinal pigment epithelium (CHRRPE) using optical coherence tomography (OCT).

METHODS:
This was a retrospective interventional study, in which medical records of 12 eyes with CHRRPE that underwent vitrectomy and membrane peeling at three tertiary vitreoretinal institutes were reviewed. Preoperative and postoperative color fundus photographs and OCT were reviewed for each follow-up visit.

RESULTS:
Five out of 12 eyes had a good visual outcome (equal or more than 2 lines gain in visual acuity), four had stable visual outcome (<2 line gain), and three had poor visual outcome (loss of visual acuity). Preretinal fibrosis preoperatively was seen in 80% of cases with good outcomes as compared to 50% and 0% of cases in the cohorts with stable and poor outcomes, respectively. Preoperatively all 5 cases with good visual outcome had Grade 4 epiretinal membrane (ERM), while only 1 case with stable and poor visual outcome had grade 4 ERM and the rest had Grade 3 ERM. Maxi peaks were seen in 80%, 50%, and 0% of cases preoperatively in the three cohorts, respectively. Hyperreflectivity of inner retinal layers preoperatively was evident in all cases having good visual outcomes, in 75% of cases with stable visual outcomes, and in 33% of cases with poor outcomes.

CONCLUSION:
Surgical intervention in CHRRPE with preretinal fibrosis seems to be beneficial. The visual recovery as defined by conventional predictors in cases of surgical removal of ERM fails to explain the visual outcome in CHRRPE.
The validity of diabetic retinopathy screening using nonmydriatic fundus camera and optical coherence tomography in comparison to clinical examination
Authors: Aljefri Sarah , Al Adel Fadwa 
Published: July 2021

PURPOSE:
To evaluate the use of non-mydriatic fundus camera as a screening modality for diabetic retinopathy in a sample of population in Riyadh, Saudi Arabia.

METHODS:
Patients coming, from April 2015 till September 2018, for their diabetic check up at the diabetic center clinics in King Abdul-Aziz University hospital were screened using a non-mydriatic fundus camera (NMFC). Photos were graded by retina specialist and compared to the findings of dilated fundus examination (DFE) by retina specialists.

RESULTS:
The grading results of NMFC and DFE were compared and the overall sensitivity and specificity for detection of diabetic retinopathy within one grade of retinopathy was 98.7% and 80% respectively. The sensitivity for detection of sight threatening conditions such as proliferative diabetic retinopathy, severe non-proliferative diabetic retinopathy, and diabetic macular edema (by Ocular Coherence Tomography) was found to be 86.7%, 90.3% and 100% respectively; while the specificity was found to be 96.5%, 93%, and 100% respectively.

CONCLUSION:
Non-mydriatic fundus camera has a high sensitivity and specificity in screening for diabetic retinopathy. It is a great screening tool, which is user friendly and can be operated by trained nurses in primary clinics during patient's regular routine diabetic checkups. It aids in early detection of sight threatening conditions which need urgent referral to ophthalmologists.
Topical Oral Melatonin Application Could Potentially Reduce the Risk of Orthodontic Appliance-Induced Periodontal Deterioration
Authors: Balaji Thodur Madapusi , Jagannathan Raghunathan , Murukesan S. , Rajendran Swaminathan , Sridhar Lakshmi Priya , Varadarajan Saranya , Rajendiran Deepika 
Published: July 2021

Introduction:
Although patients derive numerous aesthetic and functional benefits by wearing orthodontic appliances, they also undergo some adverse changes in the oral cavity such as chronic generalized marginal gingivitis and localized gingival enlargements that can be concerning. Salivary changes following placement of fixed orthodontic appliances have been documented by numerous research papers.

The Hypothesis:
Melatonin in the form of an orabase gel with 1% to 2% concentration applied daily topically on the gingival tissues throughout the orthodontic treatment phase could boost the salivary antioxidant levels, neutralize the nickel and chromium toxicity, potentially attenuating inflammation, and fibrotic enlargements of the periodontal tissue.

Evaluation of the Hypothesis:
Testing the abovementioned hypothesis will involve a randomized double-blinded clinical trial with a placebo and test orabase gel with 1% to 2% melatonin as an active drug agent. Testing and validating the proposed hypothesis will throw open a new vista in using melatonin as a topical adjuvant in orthodontic appliance wearers.
Comparison of Commercially Available 0.12% And 0.2% Chlorhexidine Mouthrinses on Plaque and Gingiva
Authors: Swarnalatha C. , Suresh Babu J. , Almansour Nada Nasser , Almalaq Saleh Ali , Alnasrallah Fahad Abdulrahman , Alshammari Tayf Naif Radhi , Alshammari Mohammad Saafaq , Nayyar Abhishek Singh 
Published: July 2021

Introduction:
Regardless of potent anti-microbial and anti-plaque properties of Chlorhexidine (CHX), its widespread and comprehensive uses are restricted by local side effects which are mostly dose dependent. Thus, by understanding the properties and limitations of the CHX molecule, consideration has been given to CHX with lower concentrations, though, this, may produce an impact on its activity emphasizing the need for further clinical trials. The present study was, thus, designed to assess and compare the efficacy of commercially available 0.12% (Periogard) and 0.2% (Hexidine) of CHX mouthrinses on dental plaque and gingiva over a period of eight weeks.

Materials and Methods:
A randomized control, triple blind parallel clinical trial was designed among ninety-nine subjects. The study subjects were randomly distributed into three groups with random allocation of mouthrinses to each group. Plaque and gingival indices were recorded by using Plaque and Gingival indices were recorded by using Turesky, Gilmore and Glickman’s modification of Quigley Hein Plaque Index and Loe and Silness Gingival Index. Statistical analysis was done using IBM SPSS Statistics for Windows version 21 (IBM Corp, Armonk, USA). Wilcoxon matched pairs signed rank test was applied to compare reduction in mean plaque scores and mean gingival scores at different time intervals while pair-wise comparison in between the groups was done by using Mann-Whitney U test. P < 0.05 was considered as statistically significant.

Results:
Both the 0.2% and 0.12% CHX mouthrinses were effective in controlling plaque and gingivitis over a period of eight weeks. These mouthrinses exhibited significant decreases in mean plaque and gingival scores during baseline to 4th week examination, however, a significant rise in mean plaque and gingival score was noted again from 4th week to 8th week examination.

Conclusion:
The study concluded that lower concentrations of CHX (0.12%) are as effective as 0.2% of CHX, thereby, use of lower concentrations of CHX can be recommended.
The Effect of Home Visit on Anxiety of Mothers with Preterm Infant Discharged from Neonatal Intensive Care Unit
Authors: Beigy Somayeh , Salmani Naiire , Khodayarian Mahsa 
Published: July 2021

Context:
After being discharged from hospital, most preterm infants need to receive treatments such as gastric gavage, oxygen therapy, apnea control, and medication. Mother's unpreparedness to care for their infants causes anxiety for them.

Aims:
The purpose of the present study was to investigate the effect of home visit on anxiety of mothers having preterm infant discharged from neonatal intensive care unit (NICU).

Settings and Design:
This was a experimental control group study on 50 mothers with preterm infant discharged from NICU of Shahid Sadoughi Hospital, an educational hospital with 30 beds in a city in the west of Iran in 2019.

Subjects and Methods:
Participants with a convenience sampling were randomly assigned in the experimental and control groups. In the experimental group, home visit was done on the 3rd and 5th days after discharging the infants, and the mothers received necessary instructions proportional to their needs. Data collection tools included demographic information and Spielberger State-Trait Anxiety Inventory.

Statistical Analysis Used:
The findings were analyzed by SPSS 20 software using Kolmogorov–Smirnov, independent t-test, and Chi-square.

Results:
The mean ages of the participants in the intervention and control groups were 30.59 ± 6.38 and 28.67 ± 5.05 years, respectively. There was no significant difference between the mean obvious and hidden anxiety in the two groups (P > 0.05) before the intervention. However, after the intervention, the mean obvious and hidden anxiety in the experimental group was lower than the mean of the control group, and this difference was significant (P < 0.001).

Conclusions:
Home visit is effective in decreasing anxiety in mothers of preterm infant who have been discharged from NICU.
Oral Mucosal Lesions in Newborns
Authors: Cruz Poliana Valdelice , Bendo Cristiane Baccin , Bouzada Maria Cândida Ferrarez , Machado Márcia Gomes Penido , Martins Carolina Castro 
Published: July 2021

Background:
An increase in prematurity and low birth weight (LBW) has been observed worldwide, to which several factors may be associated. This cross-sectional study aimed to evaluate the relationship between gestational age and LBW with oral mucosal lesions in newborns, maternal health conditions, newborn health conditions, and socioeconomic levels.

Materials and Methods:
The sample was comprised of 431 pairs of mothers-newborns born from a high and medium complexity hospital (CAAE nº: 57295316.3.0000.5149). Maternal health conditions and childbirth information were collected through the medical records and mothers answered a questionnaire on socioeconomic indicators. Oral mucosal lesions were evaluated by oral clinical examination. Gestational age and birth weight were analyzed, together with oral mucosal lesions and related factors, through bivariate and multivariate logistic regression models (α = 5%).

Results:
Prematurity and LBW were associated with Epstein pearls (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.03–3.0; OR: 1.8; 95% CI: 1.1–3.2, respectively) and mucocele (OR: 4.6; 95% CI: 1.3–16.1; OR: 3.7; 95% CI: 1.1–13.1, respectively), but not ankyloglossia (OR: 1.0; 95% CI: 0.5–2.1; OR: 0.7; 95% CI: 0.3–1.6, respectively) or breastfeeding (OR: 0.5; 95% CI: 0.1-2.1; OR: 1.9; 95% IC: 0.2–15.6, respectively).

Conclusion:
Preterm and LBW newborns were more likely to have Epstein pearls and mucocele than full terms. Breastfeeding and ankyloglossia were not associated with prematurity and LBW.
Shock Index and Modified Shock Index among Survivors and Nonsurvivors of Neonatal Shock
Authors: Bhat Ramitha R. , Batra Prerna , Harit Deepika 
Published: July 2021

Background:
Neonatal shock is associated with high mortality and morbidity. Shock index (SI), a ratio of heart rate (HR) to systolic blood pressure (BP), has been evaluated as a simple tool for early predictor of mortality in adult as well as pediatric patients.

Objective:
The objective of this study was to compare SI and modified SI (MSI) among survivors and nonsurvivors of neonatal shock and healthy controls.

Materials and Methods:
HR and BP were measured in neonates presenting with clinical shock at 0, 2, and 6 h after admission and in healthy controls. SI and MSI were calculated and compared between three groups.

Results:
The mean (standard deviation) SI was significantly higher at 2 and 6 h of admission (2.57 [0.54] vs. 2.93 [0.78], P = 0.029; 2.42 [0.41] vs. 3.04 [0.91], P = 0.0005) among nonsurvivors of neonatal shock as compared to survivors. MSI was also significantly raised at both 2 and 6 h of admission in nonsurvivors (3.32 [0.64] vs. 3.78 [1.05], P = 0.03; 3.16 [0.63] vs. 4.10 [1.85], P = 0.005).

Conclusions:
SI and MSI are significantly higher in nonsurvivors of neonatal shock than survivors and healthy controls. These metrics can be used as bedside tools for early identification of at-risk neonates with shock.
Basic behavior guidance techniques
Authors: Segarra-Ortells Cristina , Leyda-Menéndez Ana Maria , Ribelles-Llop Marta , Gavara-Navarro María Jose , Marqués-Martínez Laura 
Published: July 2021

Background:
Over the last 20–30 years social trends, educational and parenting patterns, and the ethical and legal factors guiding them have led to the revaluation and even abandonment of some traditionally used behavior guidance techniques (BGTs).

Aims:
To profile the professionals providing specialized pediatric treatments in Spain and understand changes in their preferences and use of basic BGTs, and the evolution of these preferences.

Settings and Design:
A cross-sectional, descriptive, and correlational study was designed.

Methods:
One hundred and twenty-six dentists completed a previously validated survey.

Statistical Analysis:
Descriptive statistics and Chi-square tests were performed to analyze the questionnaire data.

Results:
The most common BGTs were “Tell/Show/Do” (98%) and positive reinforcement (92.1%), and the most abandoned BGT was: “hand-over-mouth” (15%), because it was rejected by parents and because of potential legal problems and psychological consequences for the patients. Of note, 37% of the professionals allowed the patient's parents to be present during the treatment.

Conclusions:
There has been a notable decrease in the use of certain BGTs in Spain, especially hand-over-mouth and voice control, because they are becoming less socially acceptable as the way society relates to and educates children changes.
Acute toxicity study of the ethanolic extract of Eleutherine bulbosa Urb in Wistar rats
Authors: Wati Helmina , Muthia Rahmi , Kartini  , Setiawan Finna 
Published: July 2021

Introduction: Eleutherine bulbosa Urb is a plant species with medicinal properties, including anti-inflammatory, widely relied upon in traditional practices. For this reason, the present research was intended to assess and, thus, ensure the safety of this plant for conventional medicinal purposes using a toxicity test study.
Methods: The acute toxicity test of the ethanolic extract of E. bulbosa Urb (EEEB) used the method adopted from the Organization Economic Cooperation and Development (OECD) guidelines 425 for testing Wistar rats.
Results: During 14 days of the acute toxicity study, there were no significant changes in rat weight, no mortality, and no signs of toxicity after the oral EEEB administration at 2000 mg/kg body weight (bw). The limit test showed that the LD50 of EEEB was higher than 2000 mg/kg bw.
Conclusion: EEEB has low toxicity because its LD50 is higher than the limit test results.
The comparison of the actual cost to case-mix of type 2 diabetes mellitus inpatient in Pandan Arang Boyolali hospital
Authors: Negara Sri Bintang Sahara Mahaputra Kusuma , Octavia Devi Ristian , Utami Primanitha Ria 
Published: July 2021

Aim: The objective of this study was to determine the conformity of diabetes mellitus (DM) actual cost with the rate of Indonesia Case-Based Groups (INA-CBGs) among Universal Health Coverage (Jaminan Kesehatan Nasional - JKN) and non-JKN patients diagnosed with DM.
Methods: This retrospective cross-sectional study was observational and analytic. It recruited DM inpatients with or without JKN. The data were analysed to identify the total actual cost of DM management among inpatients.
Results: The results showed that the average cost for treating inpatient with diabetes mellitus at classes 1, 2, and 3 was IDR 2,677,003±906,406, IDR 2,881,023±851,483, and IDR 2,323,768±802,828, respectively. A positive difference of 378,509,126 was found between the actual cost and the INA-CBGs rate in 101 patients. There was a discrepancy between the real cost and the INA-CBGs rate for all treatment classes and the treatment levels. Factors influencing the real cost of treatment for DM were the length of stay and the severity level.
Correlation between the level of knowledge of drug managers and drug management in several primary health centres in Malang regency
Authors: Hariadini Ayuk Lawuningtyas , Ishmah Nur , Pramestutie Hananditia Rachma 
Published: July 2021

Background: Drug management is one of the primary health centre management activities that aims to ensure the continuity and affordability of pharmaceutical preparations.
Aim: This study aims to determine the relationship between the level of knowledge of drug managers and drug management in several primary health centres of Malang regency.
Method: The study was observational analytic using questionnaire instruments to analyse the level of knowledge of drug managers and three checklists to analyse drug management through three indicators of drug management: (1) conformity of stock to the national formulary, (2) conformity of stock to the disease patterns, and (3) the percentage of expired drugs.
Result: There was no significant relationship between the level of knowledge and the first (p = 0.842), second (p = 0.236), and the third indicator (p = 0.361).
Conclusion: Not all drug lists in the national formulary are required by each primary health centre. The inventory is adjusted to the consumption and epidemiology.
The effect of stress level on the therapeutic outcomes of type 2 diabetes mellitus at the regional public hospital of West Nusa Tenggara province
Authors: Nopitasari Baiq Leny , Nurbaety Baiq , Jaya Made Krisna Adi 
Published: July 2021

Introduction: Diabetes Mellitus (DM) is a complex chronic disease that requires ongoing medical care with a multifactorial risk reduction strategy beyond glycemic control. Self-management, education, and support are essential to prevent acute complications and reduce the risk of long-term complications. Stress levels may affect fasting blood glucose (FBG) and 2-hours postprandial blood glucose (2HPPBG).
Objectives: This study aims to determine the effect of stress levels on the therapeutic outcomes of type 2 DM patients at the regional public hospital of West Nusa Tenggara province.
Methods: This observational, cross-sectinal research was carried out on a sample of 37 patients using the Perceived Stress Scale (PSS). Data analysis used a linear regression test.
Results: The results showed that stress had a significant effect on FBG (p=0.038) and 2HPPBG (p=0.001) levels.
A pharmacoeconomic study: cost-utility analysis of modern wound dressings vs conventional wound dressings in patients with diabetic foot ulcer
Authors: Rahmawati Cyntiya , Nopitasari Baiq Leny 
Published: July 2021

Introduction: Duration of treatment and outcome of therapy of diabetic foot ulcers are some of the factors that affect the quality of life and will require higher medical costs.
Aim: This study aimed to choose an alternative wound dressing that provides the best utility at the most cost-efficient.
Methods: The research method used was pharmacoeconomics with a patient’s perspective.
Results: The results showed the mean cost of modern wound dressings per visit was IDR 347,131, while that of conventional wound dressings was IDR 47,140. The quality of life with modern vs conventional wound dressing was significantly different (p < 0.05). The incremental cost utility ratio (ICUR) value was IDR 22,813 per quality of life (QoL).
Conclusions: This study showed that modern wound dressings provide a higher quality of life at a higher cost. Indeed, it cost more than IDR 22,813 to change from conventional to modern wound dressings and increase 1 unit of quality of life, but patients obtained an additional 13.15 quality of life.
The impact of pharmacist shortage on the inventory management of medicines at primary healthcare centres in East Java, Indonesia
Authors: Rahem Abdul , Athiyah Umi , Setiawan Catur Dian , Hermansyah Andi 
Published: July 2021

Background: Pharmacists are the only people authorised to manage the medicines inventory. However, in the case of pharmacist shortage, other personnel may take over this function. This is particularly the case in most primary healthcare centers (puskesmas) in Indonesia.
Aim: To compare the outcome of medicine inventory management between pharmacists and non-pharmacists in primary healthcare centres (PHCs).
Methods: A survey of 146 puskesmas in East Java was conducted involving 73 pharmacists and 73 non-pharmacist staff. This study was conducted from July to January 2020. Each respondent completed a questionnaire focusing on the inventory aspects of medicine management.
Results: Purchasing accuracy is higher for pharmacists (90%) than for non-pharmacists (68%). Pharmacists manage the inventory more efficiently with only 2% of the drugs expired and wasted while non-pharmacist staff wasted 16% of the drugs and 18% of the drugs expired.
Conclusion: The role of pharmacists in medicine inventories is vital as they carry out more efficient and accurate medicine management.