bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract No.: ABS3221: Comparison of Fentanyl and Dexmedetomidine as adjuvants to 0.2 % Ropivacaine Epidurally in Labour Analgesia
Authors: Dhumal Shital 
Published: September 2024

Background & Aims:
Childbirth being the most exciting event in the life of a female gets ruined because of cruciating and intolerable labour pain. This study compared quality of labour analgesia by using fentanyl and dexmedetomidine as adjuvants to 0.2% ropivacaine epidurally .

Methods:
Institutional Ethical Committee approval and patient consent was obtained. 60 enroled patients were divided into 2 groups Group RF: 0.2% ropivacaine + fentanyl 15µg (15ml) Group RD: 0.2% ropivacaine + dexmedetomidine 7.5 µg (15ml) Epidural catheter was inserted at the L2-L3 space and drug was administered. VAS, sensory, motor levels were assessed. Maternal and foetal adverse effects were noted. Maternal satisfaction was evaluated after 24 h. The results were expressed as mean Â± standard deviation for continuous variables while frequency and percentage for discrete data. Continuous variables were analysed by using unpaired two-tailed Student t- test. Discrete data was analysed using Chi-square test. P<0.05 considered as statistically significant.

Results:
The demographical data like age, weight and height were comparable and had no influence on outcome of the study. Quality of analgesia was comparable in both groups (p>0.05) with no patient having poor quality. Early onset and longer duration of analgesia, less epidural top-ups, shorter duration of labour, less incidence of instrumental delivery and adverse effects were observed in Group RD compared with Group RF (p<0.05). Neonatal APGAR score was comparable between the groups.

Conclusion:
Both fentanyl and dexmedetomidine with 0.2% ropivacaine epidurally provide safe, effective and excellent quality of labour analgesia and equal foetal well-being and neonatal outcomes. Dexmedetomidine as adjuvant prolongs labour analgesia and shortens duration of labour.

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Abstract No. : ABS3228: Perfusion index - a novel and objective parameter to predict successful lumbar sympathectomy: a case series.
Authors: Arora Prateek 
Published: September 2024

Background and Aims:
Lumbar sympathectomy interrupts the sympathetic system of the lower limb, thereby augmenting the flow in microcirculation. This block is assessed by resolution of symptoms, reduced nociception, decreased sweating, and rise of local temperature. Perfusion index(PI) can objectively predict a successful block. complex regional pain syndrome

Methods:
The trend of perfusion index from the ipsilateral great toe of ten patients undergoing diagnostic lumbar sympathectomy for CRPS (6 patients) and peripheral vascular disease (4 patients), was observed and recorded using Mindray Beneview T8 monitor. The PI at zero and thirty minutes was plotted and the percentage of change was calculated.

Results:
The trend and behaviour of perfusion index in all patients, irrespective of the chronicity and underlying pathology, was consistent. The rise in PI in the lower limb can be taken as an objective marker of a successful lumbar sympathectomy. Further controlled studies are needed to pin down an absolute percentage rise in PI to predict a successful blockade.

Conclusion:
PI is a novel and promising parameter which is readily available in operating rooms and can objectively demonstrate a successful lumbarsympathectomy.
Perfusion index, lumbosacral plexus, sympathectomy, complex regional pain syndrome
Abstract No.: ABS2191 : Comparative study between perfusion index and sensory function tests for determination of successful supraclavicular brachial plexus block
Authors: Joshi Priyanka 
Published: September 2024

Background & Aims:
Conventional tests are time consuming, subjective and require patient’s cooperation. The aim was to compare perfusion index with tactile stimulation in both blocked and unblocked arm to determine onset and more reliable indicator for PNS guided supraclavicular block success.

Methods:
Comparative study conducted in MY hospital Indore over 1 month included 30 patients undergoing elective upper limb procedures under supraclavicular block. After local anaesthetic instillation, perfusion index (PI) readings by pulse oximeter and tactile stimulation by cold sensation in both arms were noted. They were graded as 2= normal,1= reduced, 0=absent. These were noted at baseline, 1,3,5,10 and 20 min. Graphs were constructed for comparison.

Results:
PI was higher in blocked limb at all time points and tripled at 3 min while tactile stimulation showed a mean absent grade at 4 min
45 sec PI showed 100% sensitivity and specificity for block success at and after 3 mins when compared with tactile stimulation in both blocked and unblocked limbs. Comparison between both parameters was statistically significant (p value<0.001) at 3 min stating PI was faster and reliable indicator.

Conclusion:
Perfusion index is a faster and more accurate parameter of successful supraclavicular brachial plexus block than sensory function test. A tripling of PI around 3 min is a good predictor.
Abstract No.: ABS3251: A comparative study of oral clonidine and oral midazolam as premedication in paediatric surgery.
Authors: Dhalwani Karishma 
Published: September 2024

Background & Aims:
Premedication plays animportant role in allowing smooth parent-child separation. Oral midazolam 1hour before surgery,as a premedication in children-is considered safeandeffective at separation and induction. Oral clonidine 1hour before surgery-providessedation, anxiolysis, analgesia. The aim of the study was to access the parent-separation anxiety score and mask acceptance score.

Methods:
A total of 60 children, aged 2 to 10 years and American Society of Anesthesiologists (ASA) physical status classification of I–II, were included after random allocation into two groups. Group C- oral clonidine 3 µg/kg, Group M- oral midazolam (0.5 mg/kg) were given as premedication 1 hour before surgery. Patients were assessed for parent separation anxiety score (PSAS) and mask acceptance score. Patients were monitored for pulse, blood pressure, saturation at regular intervals. Statistical analysis was done using Pearson chi square test.

Results:
There was a significant association between the groups and PSAS (P=0.001). Lower PSAS was seen in clonidine as compared to midazolam. Significant association was found between the groups and Mask acceptance scale (MAS) (P=0.001). Excellent maskacceptance was seen in clonidine as compared to midazolam group.

Conclusion:
From our observations and data analysis. we concluded that clonidine is better than midazolam when used as premedication and provides better parent separation score and mask acceptance in paediatric patients undergoing surgery.
Abstract No. : ABS3567: The feasibility and impact of acute normovolaemic haemodilution in on-pump cardiac surgery: a descriptive study
Authors: Soni Richa 
Published: September 2024

Background & Aims:
Cardiac surgeries have the potential of perioperative blood loss, allogenic blood transfusion, prolonged postoperative hospitalstay and thus increase the load on the blood bank in the hospital. We evaluated the feasibility and impact of acute normovolaemic haemodilution (ANVH) in on-pump cardiac surgery.

Methods:
The data of 195 patients undergoing on-pump cardiac surgeries (coronary artery bypass graft surgeries, single/double valve repair surgeries) was retrospectively retrieved. Pre-operative haemoglobin >12 gm % was taken as criteria for ANVH. The amount of blood withdrawn was replaced withcrystalloid in a 1.5:1 ratio. The noradrenaline 4 µg/ml bolus was used to maintain the haemodynamics if required. The bloodwas re-transfused after protamine administration. The threshold for autologous blood transfusion was taken as <8 gm/dl.

Results:
In 75.38% (147) patients, ANVH was carried out. The mean pre-operative haemoglobin of patients who underwent ANVH was 13.5 gm%. An average of 1.44 units of blood was withdrawn. Allogenic blood transfusion was required in 23.40% of patients.Six patients were re-explored for surgical cause and excluded from the analysis. Mean 0.5 units of packed red blood cells (PRBC) were transfused in the post-operative period. The haemodynamics were maintained during ANVH.

Conclusion:
ANVH is feasible in the majority of patients, drastically reduces the requirement of allogenic blood transfusion in patients undergoing on-pump cardiac surgeries without much problem in maintaining haemodynamics.
Abstract No. : ABS3660: Comparative study of perioperative effect of premedication with melatonin versus pregabalin total hip arthroplasty under spinal anaesthesia.
Authors: Mishra Akash 
Published: September 2024

Background & Aims:
The aim of the present study was to compare the efficacy of melatonin and pregabalin in reducing perioperative anxiety and postoperative pain along with effects on onset and duration of spinal anaesthesia and level of sedation in patient undergoing total hip arthroplasty under Spinal anaesthesia

Methods:
The present study was a randomised double blind placebo controlled studyand included96 American society of Anesthesiologists (ASA) I and II patients of either sex, aged between 30 to 60 years scheduled for total hip replacement under spinal anaesthesia. The patients were randomly allocated to one of three groups of 32 each to receive placebo (group 1), melatonin 6 mg (group 2), pregabalin 150 mg (group 3) orally 2 hours before spinal anesthesia. Perioperative anxiety using Beck anxiety inventory, postoperative pain along with onset and duration of spinal anaesthesia and sedation were assessed at multiple time points in the first 24 hours after surgery.

Results:
Perioperative anxiety scores was significantly decreased in group 2 (11.08) and group 3 (7.26) when compared to group1(17.25) and significant decrease in group 3 when compared to group 2. Post operative Visual analogue scale VAS scores were decreased in group 2 and 3 when compared to gropup1. Request for rescue analgesic during the first post operative 24 hour were lower among groups 2 and 3. The duration of sensory and motor blockade was prolonged in groups 2 and 3.

Conclusion:
Premedication with single dose of melatonin 6mg and pregabalin 150mg 2 hours before surgery decreases perioperative anxiety and postoperative pain in patients undergoing total hip arthroplasty under spinal anaesthesia and pregabalin has an added advantage of anxiolysis when compared to melatonin.

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Assessment of Immunoreactivity Patterns in the Excised Cervical Lymph Nodes of Oral Squamous Cell Carcinoma
Authors: Jadeja Nileshwariba , Parikh Neelampari , Nandini C , Gohil Raviraj 
Published: September 2024

Introduction:
Epidermoid carcinoma (oral squamous cell carcinoma [OSCC]) comprises approximately 80% of the malignancies of the oral cavity, which is also responsible for the morbidity and mortality due to the distant spread of the neoplastic cells. The regional draining lymph node has been considered an anatomic barrier to the systemic dissemination of malignant cells. It has been postulated that the microscopic architectural pattern of a regional lymph node (RLn) represents the immunologic reactivity in that node and the host response. Morphological assessment of the regional nodes aids in a better understanding of the immune response and its correlation with the stage of the tumour.

Materials and Methods:
A total of 51 head-and-neck dissection cases were assessed for immunomorphological patterns and the degree of tumour involvement in positive lymph nodes. 49 lymph nodes were in the early stage (TNM Stage l and ll) and 71 lymph nodes were in the advanced stage(TNM stage lll and lV). A total of 595 lymph nodes were histologically evaluated and were categorised into metastatic and non-metastatic nodes showing four different patterns: lymphocyte predominance (LP) pattern, germinal centre predominance (GCP) pattern, sinus histiocytosis (SH) pattern and lymphocyte-depleted pattern.

Results:
The most frequently encountered pattern of lymph nodes was of LP (436 nodes), followed by GCP (61 nodes), SH (36 nodes) and lymphocyte depleted (18 nodes), respectively. Out of 595, 120 nodes were positive for metastasis, indicating that as the stage advances, the GCP type predominates (the predominant immunomorphological pattern shifts from LP to GCP), facilitating metastasis.

Conclusion:
Immunomorphological changes in the RLns of OSCCs seem to be pivotal factors that serve as an important prognostic indicator. Whereas the cell-mediated immune response represented by LP and SH appears to resist the metastasis process, the humoral response reflected by GCP favours metastasis.
Retention of Candida Species on Plastic and Bamboo Toothbrushes. A Comparative Study
Authors: Avaneethram A R , Peedikayil Faizal C. , Chandru T. P. , Kottayi Soni , Aparna T. P. , Ismail Shabnam 
Published: September 2024

Abstract

Background:
Tooth brushing is the basic mode of oral hygiene practice. Various studies have shown that microorganisms can colonize on the tooth brush heads. Newer tooth brushes which are biodegradable are available in the market. This study compares the fungal colonization of plastic brush head and bamboo brush head.

Materials and Methods:
Fifty patients were randomly allocated into two groups with 25 each in both groups. Group 1 was given toothbrush with plastic brush head and group 2 was given toothbrushes with bamboo head. After 30 days, toothbrushes were collected. The bristles of the brush was removed from its base and put on to the petri dishes with sabouraud dextrose agar and, incubated at 28°C, with chloramphenicol and cycloheximide for 5 days. After growth was identified, pure colonies were transferred on Chromagar for the identification of Candida species.

Results:
Fungal growth was observed in 48% of plastic brush heads and 76% in bamboo brush heads. Candida Albicans was the most common species isolated from both plastic and bamboo tooth brushes, followed by Candida tropicalis. C. Albicans were seen as light green-colored smooth colonies; Candida tropicalis appeared as metallic blue-colored raised colonies. Candida tropicalis, Candida glabrata, Candida krusei and Candida guilliermondii were also observed.

Conclusion:
Fungal growth was more in bamboo tooth brushes than in plastic tooth brush even though it is statistically insignificant C. albicans is most predominant species found in the tooth brush head.
Comparative Assessment of Width of Neutral Zones Recorded Using Two Neutral Zone Impression Methods (Phonetic and Swallowing) and Two Different Materials (Tissue Conditioner and Polyether)
Authors: Parab Manjita M. , Aras Meena A. , Chitre Vidya , Qanungo Anchal 
Published: September 2024

Abstract

Statement of Problem:
Medium body polyether impression material has been recently used as neutral zone recording material. However, there is a lack of studies comparing it with routinely used material.

Purpose:
The purpose of the study is to compare neutral zone width of phonetic (PNZ) and swallowing (SNZ) neutral zone impression techniques with a tissue conditioner and a polyether impression material within the same subjects.

Materials and Methods:
Assessments of neutral zone width were carried out in ten completely edentulous patients with advanced mandibular resorption. On each patient, four neutral zone impressions were recorded as follows: SNZ with tissue conditioner material, PNZ with tissue conditioner material, SNZ with polyether impression material, PNZ with polyether impression material. Putty indices were made of each neutral zone and traced on graph paper. The buccolingual measurements were made at five different locations, midline, right first premolar, left first premolar, right first molar, and left first molar. Statistical analysis was done using Mann–Whitney U test.

Results:
There was no significant difference observed when comparison was done either between materials or techniques.

Conclusion:
Medium body polyether can be a viable alternative to conventional tissue conditioner material and can be used with both swallowing and phonetic techniques with equal efficacy.
Percutaneous Nephrolithotomy as Minimally Invasive Treatment of Urinary Calculi
Authors: Bellos Themistoklis Ch. , Makris Georgios S. , Chatzikrachtis Nikolaos A. , Chrisofos Michael 
Published: September 2024

Abstract
The management of urolithiasis has radically changed over the past two decades. Open surgery has been almost completely replaced by minimally invasive procedures. Percutaneous nephrolithotomy (PCNL) is considered to be the first line of treatment for large renal stones. Its use is associated with a multitude of complications. A thorough bibliographic search was performed for this review. Although PCNL comes with higher morbidity, its efficacy is unbeaten by other minimally invasive modalities. Improved skills and modifications of the procedure may reduce the probability of adverse outcomes. However, it is still associated with complications, even life-threatening ones. Since its introduction more than 30 years ago, PCNL has claimed its position as the minimally invasive procedure of the first choice for the treatment of large and complex renal stones. PCNL numbers are rising in recent years.
Schwannoma of the Nasal Septum: A Rare Clinicopathological Case Report in an 18-Year-Old Female
Authors: Kaushik Nupur , Rani Deepa , Kumar Lalit , Singh Akhil Pratap 
Published: September 2024

Abstract
Schwannoma, a benign tumor, arise from schwann cells of myelin sheath; occur anywhere in the body but commonly occur on flexor aspect of extremities. Nasal septum being the rarer site. We report a case of nasal septum schwannoma in an 18-year-old female presented with intermittent epistaxis and progressively increasing nasal obstruction for 2-year duration. The differential diagnosis of juvenile angiofibroma, pyogenic granuloma, and pleomorphic adenoma was made and complete surgical excision was done. Histopathological examination revealed ciliated stratified columnar epithelium, underlying tumor area with two distinct patterns, mainly hypercellular and few hypocellular areas. The cells have spindle shaped pointed basophilic nuclei with abundant eosinophilic cytoplasm. Overall feature was suggestive of nasal septum schwannoma. For confirmation, immunohistochemical staining with S-100 was done and tumor was found positive. Herein, we report the clinicopathological features of nasal septum schwannoma in an 18-year-old female.
Screening for Janus kinase-2 exon 12 mutations among Janus kinase-2 V617F-negative polycythemia vera suspected Iraqi patients
Authors: Khazeem Mushtaq M. , Alwan Alaa Fadhil 
Published: September 2024

Abstract:

BACKGROUND:
Diagnosis of myeloproliferative neoplasms including polycythemia vera (PV) has been greatly improved following the identification of driver mutations at exon 12 and exon 14 of the Janus Kinase 2 (JAK2) gene. There are limited academic studies that report the frequency of the JAK2 exon 12 gene with limited number of patients.

OBJECTIVES:
The aim of this study was to evaluate the frequency of JAK2 exon 12 mutations among JAK2V617F-negative PV-suspected Iraqi patients.

PATIENTS, MATERIALS AND METHODS:
This is a retrospective study conducted at the National Center of Hematology/Mustansiriyah University from December 2019 to January 2022; patients with suspicion of PV were enrolled in this study. Screening for JAK2 exon 14 (JAK2V617F) mutations was done for all 323 patients. Out of them, there were 102 patients with JAK2V617F-negative who retrospectively screened for JAK2 exon 12 mutations by direct sequencing (Sanger sequencing).

RESULTS:
Initial evaluation for the total 323 patients suspected with PV revealed that 84 cases were mutated for the JAK2V617F gene, and 239 were unmutated. The frequency of JAK2 exon 12 was about 1% among JAK2V17F-negative patients. The median age for all patients was 35 years. Among the total cases, 21 cases (20.59%) showed splenomegaly at the time of clinical onset sequencing of these cases revealed only one case mutated with JAK2 exon 12 (E543-D544del).

CONCLUSION:
The current study showed that the frequency of JAK2 exon 12 mutations in JAK2V617F-negative cases was very low. Despite PV patients with JAK2 exon 12 mutations represent a small proportion of total PV cases, JAK2 exon 12 mutations should be routinely screened in JAK2V617F-negative cases.
Predicting Antitubercular Drug-Induced Liver Injury and Its Outcome and Introducing a Novel Scoring System
Authors: Raj Mani Selvin Sundar , Iyyadurai Ramya , Mishra Ajay Kumar , Manjunath Krishna , Prasad Jasmin , Lakshmanan Jeyaseelan , Yadav Bijesh , Reginald Alex , Jasmine Sudha , Hansdak Samuel George , Zachariah Anand 
Published: September 2024

Background:
Tuberculosis (TB) is a major global health problem, mainly in developing countries. Despite the availability of highly effective first-line antitubercular (ATT) drugs, ATT drug-induced liver injury (ATT DILI) leads to treatment interruption and consequently loss of therapeutic efficacy.

Methods:
In this prospective cohort study from India, all consecutive patients who met inclusion criteria and started on ATT were included. The incidence, risk factors, and outcome of ATT DILI were determined. A clinical prediction score for ATT DILI was derived.

Results:
A total of 393 patients were included. The incidence of ATT DILI was 9.7% (95% confidence interval 7%–13.2%). HIV infection, daily regimen, disseminated disease, and chronic liver disease were identified as significant risk factors (P < 0.05) for developing DILI. A prediction score derived from the risk factors showed that a score of >5 could predict DILI with a sensitivity of 74% and a specificity of 67%. All-cause mortality in DILI was 4.7%.

Conclusion:
The incidence of ATT DILI was 9.7% in our cohort with higher incidence among the patients on daily regimen. The study suggests that the combination of risk factors of extensive TB disease, HIV infection, chronic liver disease, and under nutrition increases the vulnerability to DILI, particularly with daily treatment regimen, emphasizing the role of acquired risk factors in the development of DILI.
Evaluation of a New Interferon Gamma Release Assay, in Comparison to Tuberculin Skin Tests and Quantiferon Tuberculosis Goldplus for the Detection of Latent Tuberculosis Infection in Children from a High Tuberculosis Burden Setting
Authors: Benachinmardi Kirtilaxmi , Sampath Sangeetha , Rao Mohan 
Published: September 2024

Background:
Detection of latent tuberculosis infection (LTBI) in children, exposed to tuberculosis (TB) infections, followed by appropriate treatment, could be instrumental in reducing TB burden. Interferon Gamma release assays (IGRA) have higher specificity than tuberculin skin tests (TST), hence are more effective option for diagnosis. Hence, the present study was aimed to diagnose the presence of latent TB in children with the help of a new Standard E TB-Feron Enzyme-Linked Immunosorbent Assay (TBF) and evaluating its efficiency as compared to TST and Quantiferon TB Gold plus (QFT Plus).

Methods:
Diagnosis of LTBI in participants, <18 years old, who were the close household contacts of patients with active TB was carried out employing techniques such as TST, QFT Plus, and TBF.

Results:
Higher positive results were obtained with IGRA assays QFT Plus and TBF than TST. The perfect agreement was observed between QFT Plus and TBF assays with a Kappa value of 0.9176 whereas TST and TBF assay showed moderate agreement with a Kappa value of 0.42365. The level of cytokines secreted as a result of stimulation by the antigens from QFT Plus tubes was lower in comparison to antigens from TBF tubes.

Conclusion:
Hence, TBF, which showed similar efficiency as the widely used QFT Plus, can be a useful detection technique for LTBI in children. Moreover, it could prove to be an efficient alternative to expensive IGRAs like QFT Plus.