bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Evaluation of Penetration Depth and Antimicrobial Efficacy of Calcium Hydroxide, MAS Paste, Nitrofurantoin, and Levonadifloxacin against Enterococcus faecalis: A Confocal Laser Scanning Microscopic Study
Authors: Gunnam Nishitha , Aravelli Swathi , Ramachandruni Nimeshika , Gandla Mounika , Kasam Swetha , Kumar Podugu Uday 
Published: October 2024

Abstract

Aim:
The most prevalent species in persistent and secondary infections linked to endodontic failure is Enterococcus faecalis. The objective of this in vitro investigation was to assess the antibacterial efficacy and penetration depth of calcium hydroxide, nitrofurantoin, levonadifloxacin, and a mixture of antibiotic and steroid paste (MAS paste) against E. faecalis.

Materials and Methods:
A total of 40 single-rooted tooth samples were decoronated apically and coronally to yield 10 mm root sections. All tooth samples were biomechanically prepared and were inoculated with E. faecalis bacteria for 21 days. The study involved four groups, each containing 10 teeth as follows: group 1—calcium hydroxide, group 2—MAS paste consisting of ciprofloxacin, metronidazole as antibiotics, and dexamethasone as corticosteroid, group 3—nitrofurantoin, and group 4—levonadifloxacin. For 7 days, the corresponding intracanal medications were injected into the canals. On the seventh day, dentinal debris was extracted from the blocked lumen to quantitatively evaluate the antibacterial activity of the experimental medications. The depth of penetration (DOP) of medicaments under study was assessed by viewing 1 mm thick horizontal sections under a confocal laser scanning microscope, one from each of the four subgroups. The sections were stained with florescent stain before being under the microscope.

Results:
Results showed that on day 7, the mean colony-forming units were lowest for levonadifloxacin, indicating the highest antimicrobial efficacy (P < 0.05). This was followed by nitrofurantoin, MAS paste, and calcium hydroxide. Additionally, levonadifloxacin achieved the greatest DOP, followed by nitrofurantoin, MAS paste, and calcium hydroxide. These results suggest a correlation between DOP and antimicrobial efficacy.

Conclusion:
Within the confines of this study, it can be concluded that levonadifloxacin exhibited the highest antimicrobial efficacy, even at a low concentration of 8 µg/mL. Therefore, it can serve as a viable intracanal medicament in endodontic therapy.
Bibliometric Mapping of the Scientific Production of Lasers in Endodontics: Collaborative Networks, Impact, and Trends
Authors: Vargas-Lindo Suleika , Cárdenas-Cueva Diani , Tinedo-López Pedro Luis , Espinoza-Carhuancho Fran , Pacheco-Mendoza Josmel , Mayta-Tovalino Frank 
Published: October 2024

Abstract

Aim:
The objective of this study is to perform a bibliometric mapping of the scientific production of lasers in endodontics using collaborative networks, impact, and trends.

Materials and Methods:
This retrospective and descriptive study used a bibliometric design to analyze laser use in endodontics in Scopus from 2018 to 2024. In total, 877 documents were identified using key terms and MeSH. Bibliometric indicators were used to explore scientific activity and impact, and VOSviewer was used for data analysis.

Results:
It was found that the year with the highest number of publications was 2023, with 166, and the quartiles with the highest productivity were Q1 (40.3%) and Q2 (31.1%). Among the top 5 countries with the highest publications production, Brazil led the group with 125, followed by India (111). Among the institutions with the highest production, the Universidade de São Paulo tops the list with 51 research papers, closely followed by the Tehran University of Medical Sciences with 32 and the Universidade Estadual Paulista Júlio de Mesquita Filho with 30. Among the most outstanding authors, we have Chiniforush Nasim, who has 20 papers; however, Duarte Marco has an h-index of 48, and Sivieri-Araújo Gustavo has the highest number of citations.

Conclusion:
This bibliometric mapping reaffirmed the vision and trends of lasers in endodontics, with 2023 being the most relevant in terms of scientific production and, among the countries with the highest number of publications, Brazil stood out.
Quantitative Analysis of Tooth-Whitening Efficiency Using Natural Bleaching Agents: An In Vitro Spectrophotometric Evaluation
Authors: Tan Pei Ying , Narayanan Asha Sharma Pusnaa S. , Tay Kit Ken , Nor Azmi Nuruljannah , Yap Yeannie Hui-Yeng 
Published: October 2024

Abstract

Aim:
While conventional whitening agents provide effective color change, concerns linger regarding enamel health. This study explored the potential of natural alternatives for coffee stain removal on extracted teeth, aiming to identify safe and efficacious options for patients seeking noninvasive bleaching solutions.

Materials and Methods:
This study employed 50 extracted permanent anterior teeth divided into five groups (negative control, positive control, strawberry, pineapple, and honey). Standardized coffee staining was applied to all teeth followed by 3 weeks of twice-daily treatment with their respective solutions. Shade changes were measured objectively using a Konica Minolta Spectrophotometer CM-5 at baseline and after 1, 7, 14, and 21 days post-treatment. Statistical analysis was conducted with Kruskal–Wallis and Tukey post hoc tests (IBM® SPSS®).

Results:
Strawberry juice exhibited equivalent ΔE (color change) compared with 35% hydrogen peroxide (P > 0.99), indicating similar stain removal efficacy. Both pineapple juice and honey solution displayed significantly lower ΔE values compared with the control and strawberry juice groups (P = 0.002 and <0.001, respectively), suggesting limited bleaching capability.

Conclusion:
This study demonstrates the potential of strawberry juice as a viable alternative to conventional bleaching agents, offering comparable stain removal efficacy on coffee-stained teeth and further highlighting the need for further research on their effectiveness in clinical settings. Meanwhile, pineapple juice and honey solution exhibited limited bleaching potential. These findings contribute to the expansion of safe and potentially noninvasive teeth-whitening options.
Trends and Patterns of Endodontic Therapy in Primary Teeth: A Visualized Bibliometric Analysis of Research Output in Saudi Arabia
Authors: Mirah Mahir A. , Hamadallah Hatem H. , Madkhaly Mohammad A. , Sharqawi Abdulwadood J. , Altarjami Ammar A. 
Published: October 2024

Abstract

Aim:
To analyze research trends and collaboration patterns in endodontic therapy of primary teeth in Saudi Arabia using bibliometric analysis.

Materials and Methods:
A search was conducted in the Web of Science database on March 1, 2024, to identify relevant publications. A total of 54 articles were retrieved and ranked according to citation counts. The key indices contain total citation counts, h-index, and publication counts. The analysis used Biblioshiny (Bibliometrix R package) and VOSViewer to show the collaboration networks and publication trends. Two reviewers were used for extraction to ensure validity and reliability.

Results:
The bibliometric analysis showed an increase in research output and citations, with peaks in 2020 and 2023. King Abdulaziz University and King Saud University were the leading institutions in this field, with the most publications and extensive collaboration networks. The most highly cited article was published by Bawazir OA in 2006, which was about root canal obturation methods in primary teeth. The keyword used most was “Mineral trioxide aggregate.” The key journals in this field were Pediatric Dentistry and the Saudi Dental Journal.

Conclusion:
This study confirms the emergence of Saudi Arabia as a significant contributor to research in primary tooth endodontics, demonstrating increasing scholarly impact and academic interest in this field. The results highlight the country’s growing role on the global research stage. Collaboration patterns suggest that this positive trend is likely to enhance impactful collaborative research in the future.
Clinical Performance Evaluation of Ambu AuraGain versus I-gel in Obese Female Patients Undergoing Short-duration Surgeries for Breast Cancer: A Randomised Controlled Trial
Authors: Mitra Suparna , Banerjee Sumantra Sarathi , Debroy Debashis , Nandi Rudranil , Rudrapal Angshuman , Goswami Jyotsna 
Published: October 2024

Background and Aims:
Supraglottic airway devices (SADs) secure and maintain airways in patients undergoing breast cancer surgery. I-gel and Ambu AuraGain (AAG) are two common second-generation SADs used. However, data comparing their efficacy are limited in adult obese breast cancer patients. This study was planned with the primary objective of comparing the oropharyngeal leak pressure (OLP) of these two SADs at 1 min after insertion.

Methods:
A total of 80 patients scheduled for breast cancer surgery were recruited and randomised into two groups: Group A (AAG) and Group I (I-gel). The insertion time of the SADs, the number of insertion attempts, the OLP at 1 min after insertion, the ease of insertion, the fibre-optic bronchoscopy view (FOB), the ease of suction catheter placement, additional manipulation during insertion and maintenance, the OLP at 30 min after insertion and complications, etc., were assessed.

Results:
OLP was significantly higher (P < 0.05) in Group I compared to Group A at 1 min and 30 min after the SAD placement. Ease of insertion and FOB view score were significantly better in Group I than in Group A (P < 0.05). Moreover, patients in Group A reported a higher incidence of sore throat compared to Group I patients (P < 0.05).

Conclusion:
The I-gel demonstrated superior sealing pressures and mitigated sore throat significantly compared to the AAG in obese female patients undergoing breast cancer surgery. Furthermore, as confirmed by FOB, its enhanced perilaryngeal positioning underscores its efficacy over the AAG in this patient demographic.
Evolving Strategies of Acute Post-operative Pain Management Service across Three Time Periods – A Single-centre Retrospective Analysis
Authors: Sarkar Anshuman , Haldar Srimanta Kumar , Banerjee Sumantra Sarathi , Nandi Rudranil , More Shikhar , Pal Angshuman Rudra , Burman Suparna Mitra , Goswami Jyotsna , Bose Shiladitya 
Published: October 2024

Background and Aims:
Pain alleviation is essential to enhanced recovery after surgery. In India, the acute pain service (APS) is still not well organised, and there is a wide variation in practices. In this retrospective cohort study, we have aimed to analyse how introducing a structured APS and its subsequent evolution with time has affected the pain scores of our post-operative patients undergoing major abdominal oncosurgeries.

Methods:
All adult patients who underwent elective major open abdominal oncosurgeries in our institution during the three time periods based on different levels of APS development: Timeline-1 (April 2021–September 2021), Timeline-2 (April 2022–September 2022) and Timeline-3 (January 2023–June 2023) were included, and data on post-operative dynamic pain scores were collected. The pain service delivery was reorganised, and from January 2021 onwards, there was an evolution from once-daily pain rounds to twice-daily pain rounds, facilitated by including a designated pain nurse and further refinement to include pre-operative patient education and staff training. The data were collected and analysed for change in various outcomes related to APS and its outcomes.

Results:
A total of 936 patients were included in the study. A statistically significant decline in dynamic pain scores was observed over time. Subgroup analysis conducted according to the extent of surgical incision revealed significant declines in dynamic pain scores over time.

Conclusion:
The study underscores the significance of a structured APS in optimising post-operative outcomes and highlights the need for continued efforts to enhance acute surgical pain management practices in healthcare settings.
A Comparative Study between Epidural Morphine Bolus and Ropivacaine-fentanyl Infusion in Gastrointestinal Oncosurgeries: A Randomised Clinical Trial (MORFIN Study)
Authors: Nandi Rudranil , Haldar Srimanta Kumar , Mitra Suparna , More Shikhar , Sarkar Anshuman , Goswami Jyotsna , Roy Bipradas 
Published: October 2024

Background and Aims:
Epidural local anaesthetic infusion is the gold standard analgesia technique after abdominal surgery. However, hypotension associated with it often leads to the administration of large amounts of fluid, increased vasopressor requirement, reduction of epidural drug dose and thus increased intravenous opioid consumption. Epidural morphine can be an alternative technique.

Methods:
Eighty-six patients scheduled for open elective gastrointestinal (GI) oncosurgery were enroled in the study. In Group ROP, analgesia was provided with a 6 ml bolus of epidural ropivacaine (0.2%)-fentanyl (2 µg/ml) followed by an infusion at 3–10 ml/h during the perioperative period. In Group MOR, a bolus of epidural morphine 0.05 mg/kg in 10 ml bupivacaine 0.1% was administered every 8–24 h. In both groups, rescue analgesia was provided with intravenous fentanyl. The primary outcome of the study was to compare post-operative fentanyl consumption between the two groups.

Results:
Mean ± standard deviation (95% confidence interval) fentanyl consumption was significantly lower in Group MOR in the first 24 h (92 ± 191 [33, 151] vs. 255 ± 263 [173, 338] µg in Group ROP; P < 0.01), 24–48 h (71 ± 203 [9, 134] in Group MOR vs. 261 ± 357 [150, 372] in Group ROP; P < 0.001) and 48–72 h (51 ± 168 [0, 103] in Group MOR vs. 240 ± 319 [140, 339] in Group ROP; P < 0.001) in the post-operative period. Pain scores at rest and during movement were significantly lower in group MOR in the immediate post-operative period. The post-operative fluid requirement in the first 24 h was also significantly lower.

Conclusion:
Intermittent boluses of epidural morphine with low-dose bupivacaine are associated with lesser post-operative fentanyl consumption compared to epidural ropivacaine-fentanyl infusion after GI oncosurgery.
Complex of Hybrid Diabetes Mellitus With Severe Insulin Resistance and Cerebrovascular Complications: A Case Report
Authors: Shah Pranjali 
Published: October 2024

Abstract
Some type 1 diabetes mellitus (T1DM) patients develop features of insulin resistance, typically seen in type 2 diabetes mellitus, leading to a condition termed hybrid diabetes mellitus (HDM). We present a case of a 30-year-old female diagnosed with HDM and cardiovascular complications. She had a history of T1DM from the age of 7 years and presented with acute right-sided limb weakness. She had comorbidities, including hypertension, polycystic ovarian syndrome, hypothyroidism, and a high Body Mass Index (37 kg/m2). Initial evaluations revealed elevated blood pressure, pulse rate, thrombocytosis, homocysteine level, and hemoglobin A1c. Magnetic resonance imaging showed a completely blocked carotid artery and cardiological assessments indicated mild left ventricular hypertrophy and diastolic dysfunction. Glutamic acid decarboxylase antibodies were positive, and C-peptide was absent, confirming T1DM with insulin resistance HDM. Treatment involved anticoagulants, antiplatelets, statins, and supportive care. The patient showed significant clinical improvement, although surgery was not viable due to completely blocked vessels.
Real-World Effectiveness of Oral Semaglutide in Indian Adult Diabetic Patients: Evaluation of EMR-based Data
Authors: Gudibanda Sandeep , Govardhane Sharayu , Kaloo Supriya , Shah Snehal , Miglani Vaibhav , Verma Garima 
Published: October 2024

Abstract

Introduction:
Diabetes is increasingly becoming a significant health concern globally, including in India, where its prevalence continues to increase. Being overweight often acts as a catalyst for developing diabetes, exacerbating the condition and increasing the risk of other serious health complications such as heart disease, kidney problems, and nerve damage. Peptide-based molecules like semaglutide have proved their efficacy in controlling glycated hemoglobin (HbA1c) levels and body weight in diabetic patients.

Objective:
The present study aims to determine the effectiveness of oral semaglutide in a real-world setting.

Materials and Methods:
This retrospective study included patients ≥18 years of age prescribed oral semaglutide with a follow-up visit between 80 and 160 days post-prescription and had baseline body mass index (BMI) ≥ 30 kg/m2 and HbA1c levels ≤10.0%. The primary endpoints were to assess changes in HbA1c level, BMI, and body weight from the baseline. The secondary endpoints were to determine the changes in postprandial blood sugar (PPBS), fasting blood sugar (FBS), and blood pressure. The analysis also encompassed data on comorbid conditions and concomitant medications prescribed.

Results:
A total of 188 patients met the study eligibility criteria. At the follow-up visit, a statistically significant mean reduction of 0.34% in HbA1c levels and a weight loss of 1.83 kg were observed. The average duration between baseline and follow-up visit was 114.14 ± 21.5 days. The mean reduction in the BMI was 0.73 kg/m2 (P < 0.001). During the follow-up visit, the PPBS level decreased by 9.95 mg/dL and the FBS level decreased by 5.02 mg/dL. Additionally, the effect of semaglutide on blood pressure was evident, with a reduction in systolic blood pressure by 1.69 mm Hg and diastolic blood pressure by 1.30 mm Hg. The most common comorbid condition was dyslipidemia (66.49%), followed by hypertension (51.60%) and obesity (39.36%).

Conclusion:
Semaglutide demonstrated significant reductions in glycemic parameters, body weight, and blood pressure.
Vitamin D Deficiency Prevalence in Pakistan: Common, Important, and Neglected: A Comprehensive Meta-Analysis
Authors: Mahar Benazir , Shah Tazeen , Sadiq Noman , Mangi Rozina , Warsi Jamshed , Abbas Qamar 
Published: October 2024

Abstract
Vitamin D is crucial for normal body metabolism. Two important vitamin D sources are synthesis in the lower layers of the skin (90%) and diet (10%). This systematic review and meta-analysis attempted to determine the incidence of vitamin D deficiency in Pakistan by using the findings of numerous cross-sectional studies. For subgroup analysis, a population-based subgroup analysis and a geographical location-based subgroup analysis were done. Different search techniques were utilized on various databases using the terms “vitamin D deficiency,” “Pakistan,” and “prevalence.” The article names and abstracts were scrutinized, and associated complete texts were evaluated. The articles that satisfied the inclusion requirements were chosen for the meta-analysis. The I
2 test was used to determine heterogeneity. They were combined with the random-effect method. Out of 429 articles, 37 studies, with a total sample size of 19,338, were selected for the final analysis. The highest and lowest reported percentages observed were 100% and 15%, respectively. The overall pooled prevalence reported was 78% (95% CI = 74.2–82%). In subgroup analysis, children/adolescents showed a higher pooled prevalence of 84% (95% CI = 76.1–93.6%), and among province-wise subgroup analysis, Punjab province has shown a higher pooled prevalence of 84% (95% CI: 74–94%). Meta-analysis of the data showed a higher proportion of the population with deficient states. Interventions in public health are essential to address the high incidence of vitamin D insufficiency. Vitamin D levels can be increased, and related health concerns can be minimized through dietary supplementation, recommended sun exposure, and awareness initiatives.
The Application of Case-Based Learning (CBL) Combined with PDCA Cycle in the Clinical Teaching Practice of Breast Ultrasound in Standardized Residency Training
Authors: Wu Y , Zhou Q , Ju X , Zhang H 
Published: October 2024

Background:
The integration of case-based learning (CBL) with the plan-do-check-act (PDCA) cycle has potential benefits for clinical education, yet its efficacy in ultrasound residency training, particularly for breast ultrasound, requires evaluation.

Aim:
This study aimed to assess the impact of a combined CBL and PDCA cycle teaching model on the clinical thinking and skills of ultrasound residents compared to traditional teaching methods.

Methods:
A comparative study was conducted at Sichuan Provincial People’s Hospital’s ultrasound medicine base, from August 2020 to June 2023, focusing on residents in training. Sixty-one trainees were randomly divided into two groups: a joint group (n = 31) taught using a PDCA cycle-based model integrated with CBL and a traditional group (n = 30) taught with conventional methods. Both groups underwent a 20-hour course and were subsequently evaluated on theoretical knowledge, clinical thinking, and skills. Comparative statistical analysis was performed to evaluate the performance differences between the two groups.

Results:
The joint group demonstrated significantly better clinical thinking and skills operation than the traditional group (P < 0.05). No significant difference was observed between the groups regarding theoretical knowledge (P > 0.05).

Conclusions:
The combined CBL-PDCA cycle teaching mode significantly enhances the clinical thinking abilities and operational skills of residents in breast ultrasound training. This innovative approach shows promise as an effective educational strategy to foster intrinsic motivation and higher order learning capabilities among ultrasound residents.