bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anesthetic challenges in a child with congenital pulmonary airway malformation for right lower lobectomy
Authors: Natarajan Sumitha , Palanisamy Nagalakshmi , Zachariah Mamie , Johny Pradeesh T 
Published: August 2024

Abstract
Congenital pulmonary airway malformation is a rare benign airway malformation, affecting the trachea, bronchi, bronchiolar, or alveolar systems with cystic and adenomatous lesions. This sequestered part of the lung becomes nonfunctioning and causes recurrent pulmonary infections. The definitive treatment is surgical resection of the diseased segments by thoracotomy requiring general anesthesia and controlled ventilation. The anesthetic challenges in pediatric lung surgeries are airway management, the requirement of one-lung ventilation, and maintaining saturation. The lung separation maneuvers in pediatric patients are difficult due to the nonavailability of appropriate size double-lumen endotracheal tube (ETT) or one-lung ventilation with bronchial blockers. We present how we managed to provide general anesthesia and controlled ventilation using single-lumen ETT to provide a good operating condition for right lower lobectomy.
A case report of Rosai–Dorfman disease of the breast
Authors: Francis Rini , Thaj Riyana R. , Anu J. , Mathew Apuca Susan 
Published: August 2024

Abstract
Rosai-Dorfman disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a benign, self-limiting disease. In the majority of cases, there is massive and painless lymphadenopathy in any lymph node group but most commonly in the cervical lymph nodes, associated with constitutional symptoms. Extranodal involvement has been reported to occur in almost every organ system, with or without concomitant nodal disease. The breast is a rare site of presentation of this disease. A 52-year-old female presented with a hard, nodular swelling(3x2cm) in the left breast, with a clinical suspicion of malignancy. Atypical cells were note in fine needle aspiration smears. Histopathology and immunohistochemistry were of critical importance and showed a specific pattern of histiocytosis. A diagnosis of Rosai-Dorfman disease (RDD) was made. RDD of the breast is a rare form of histiocytosis, with fewer than 100 globally published cases. Although the management of this disease is not established yet by guidelines, a follow-up approach should be enough for these patients, and surgery might be overtreatment. Mortality from RDD is very low due to comorbidities. A multidisciplinary team decision is important, and abstinence might significantly benefit these patients.
Evaluation of quality assurance in the cytopathology laboratory of a tertiary care hospital in Eastern India
Authors: Mallick Debjani , Kundu Sayan , Chakrabarti Sudipta 
Published: August 2024

Background:
In this era of evidence-based medicine, clinical laboratories play a critical role in patient diagnosis and management.

Aims:
The present study aims to study the quality assurance in the cytopathology laboratory of a tertiary care hospital in the Eastern region of India.

Materials and Methods:
An observational, retrospective, and analytic study for 1 year was conducted. The sample size was 600. Simple random samples were selected including pleural fluids, ascitic fluids, cerebrospinal fluids, cervical cytology Pap smears, fine needle aspiration (FNA) cytology, and guided FNA samples.

Results:
Maintenance of authentication of reports and ISO accreditation showed no deficiency, whereas report generation, dispatch, and documentation of duplicate reports showed the highest deficiency (593, 98.8%) in maintaining quality assurance. Incomplete requisition was the most common cause of registration failure (3, 42.8%), whereas samples sent in wrong vials was the most common cause of sample collection failure (3, 37.5%). The presence of artifacts was the major factor affecting smearing technique (3, 50%). Lack of compliance to standardized protocol in manual staining and mechanical factors of automated strainers affected the staining quality (3, 37.5% each). Power cut and lack of adequate UPS backup affected the productivity of equipment mostly (3, 50%). Technical issues were the major factor affecting turnaround time (3, 50%). Lack of manpower at the report dispatch counter and logistics affected report generation and dispatch (2, 33.3% each). Randomly selected reports were crosschecked with histology and prediction accuracy measures were calculated.

Conclusion:
The preanalytical, analytical, and postanalytical factors have to be maintained adequately for ensuring quality assurance.
Evaluation of ocular manifestations of patients with pathological myopia at a tertiary eye care institute in Western India
Authors: Trivedi Kinjal , Madhani Charmi , Kondapurkar Aditi , Aggarwal Somesh 
Published: August 2024

Introduction:
Pathological myopia (PM) is defined as a refractive error ≥(−6) D or an axial length >26 mm causing complications such as early nuclear sclerosis, zonular dehiscence, macular hole, lacquer cracks, Forster-Fuchs spots, myopic traction maculopathy, macular choroidal neovascularization, and peripheral degenerations predisposing to rhegmatogenous retinal detachment (RRD).

Materials and Methodology:
In this cross-sectional observational study, we have studied 106 eyes of 56 patients. After history and examination, axial length was measured using A-scan biometry. Patients having myopic maculopathy underwent optical coherence tomography and fundus fluorescein angiography and were treated appropriately. The data were entered into Microsoft Excel sheet for statistical analysis.

Results:
Incidence of high myopia was maximum in 21–30 years (36%). Eighteen percent had positive family history, and in 89%, the presentation was bilateral. About 43.39% eyes had refraction value in the range of −6 to −10 D and 70.75% eyes had axial length between 26 and 30 mm. Nearly 39.62% eyes had best-corrected visual acuity in the range of 6/18–6/36. Fifty-two percent eyes had some vitreous degeneration. Myopic choroidal neovascular membrane (CNVM) was seen in 4.71% eyes. Lattice degeneration was the most common (43.39%) lesion predisposing to RD, majority seen in superotemporal quadrant (63.04%). Incidence of RRD was 6.52% and 15% in eyes with refractive error less than and more than −10 D, respectively.

Conclusion:
PM can cause irreversible vision loss with its complications such as CNVM and RRD. Awareness among myopic population regarding visual hygiene, safety precautions, risks, and complications involved can detect complications at the earliest helping in retaining useful ocular function.
Nonalcoholic fatty liver disease in prediabetes – Predisposing and protective factors
Authors: Miranda Jennifer , Bhat Smitha 
Published: August 2024

Introduction:
Nonalcoholic fatty liver disease (NAFLD) is increasing worldwide with a prevalence ranging from 5% to 28% in India. It is a common cause of chronic liver disease and can lead to complications including cirrhosis and portal hypertension. NAFLD and insulin-resistant states such as obesity, type 2 diabetes, and prediabetes are interlinked. We studied the role of diet, dyslipidemia, and glycemia in the genesis of NAFLD in patients with prediabetes.

Methods:
This case–control study was done in 86 prediabetic subjects availing the services of a medical college hospital. Cases of NAFLD were diagnosed and categorized by severity by ultrasonogram. Symptoms, demographic profile, dietary history by 24 h recall method, anthropometry, liver function tests, lipid profile, and blood glucose were recorded.

Results:
Cases of NAFLD were found to have higher fat consumption and lower carbohydrate and protein in their diet. Fatigue and right hypochondriac pain were common symptoms among the cases, and their mean body mass index (27.2 kg/m2) was higher. When compared with prediabetic controls, cases of NAFLD had higher mean systolic and diastolic blood pressures, as well as impaired lipid profile and postprandial hyperglycemia.

Conclusion:
Obesity, dyslipidemia, and specific dietary patterns predispose patients with prediabetes to develop NAFLD. Additionally, postprandial hyperglycemia is associated with NAFLD. Thus, targeting postprandial hyperglycemia in patients with prediabetes may retard the development of NAFLD.
Health-seeking behavior of patients with diabetes mellitus
Authors: Vaishnavi Balakrishnan , Mishra Amit Kumar 
Published: August 2024

Introduction:
Health-seeking behavior is a complex outcome of many independent factors operating at individual, family, and community level. Studies have shown that there is an improvement in compliance to treatment and a decrease in the complications with an increase in patients' knowledge about the disease and its complications. The current study was done to explore the health-seeking behavior among patients diagnosed with diabetes mellitus (DM).

Materials and Methods:
A community-based cross-sectional descriptive study was conducted among patients diagnosed with DM in an urban area of Pondicherry. A simple random sampling method was used to recruit the study participants in the community. A predesigned structured questionnaire was used to collect information from the participants by conducting face-to-face interview. Data entry was done in EpiData and the analysis was done using the Statistical Package for the Social Sciences Version 21.

Results:
In the present study, 109 participants were included and interviewed. Majority of participants (29.4%) belonged to 61–70 years. Most of the respondents (56.8%) seek treatment from a private health facility. The most common comorbidity reported was hypertension (59.6%). Participants shared that unhealthy diet (55%), family history (25.7%), sedentary lifestyle (23.9%), and obesity (17.4%) were the risk factors of DM. Only 12.8% of participants were testing their blood glucose level at monthly intervals. Eight participants were on irregular medication, and among them, three participants told that they were irregular on treatment because their blood glucose levels were normal.

Conclusion:
The level of awareness on diabetes among the participants is not satisfactory though the overall treatment-seeking behavior is found to be satisfactory among the study participants. It is recommended to plan and implement various Information, Education and Communication (IEC) activities in the study area to increase the level awareness.
Skin staples
Authors: Ravi Swaminathan , Purushothaman Vijayan , Chase Suchita , Nayak Sukria 
Published: August 2024

Abstract

Background:
Inguinal hernia is a common condition in the general population requiring surgical treatment. The lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. Lichtenstein et al. in 1989 introduced a tension-free repair technique using a polypropylene mesh to reinforce the posterior wall of the inguinal canal. The current practice world over is to secure the mesh in place using polypropylene sutures. The time taken from mesh preparation to skin closure may be significantly reduced if skin staples are used in place of polypropylene sutures. The use of skin staples may also lead to a reduced incidence of certain postoperative complications such as seroma formation, nerve impingement, and superficial surgical site infections owing to reduced tissue handling. The aim of this study was to evaluate the use of skin staples in place of polypropylene sutures for mesh fixation and wound closure in patients undergoing elective inguinal hernia repair.

Methodology:
A single-arm study was designed to observe the effects of skin staples for mesh fixation and wound closure in 50 consecutive cases of primary unilateral adult inguinal hernia open mesh repair from November 1, 2015, to July 31, 2017. The mesh fixation time was noted, and the incidence of postoperative complications was calculated. The data were compared with 50 retrospective controls for the postoperative complications who had undergone Lichtenstein’s hernioplasty with polypropylene sutures for mesh fixation.

Results:
The median mesh fixation time was noted to be 14.15 min with a range of 8:30–30:00 min. The median pain score measured by the Visual Analog Score was 7 on the day of the operation and 5 on the next day after operation. The median pain score was 2 on the 1st week after the operation, and then, it was 0. There was no statistically significant difference between the cases and the retrospective controls in terms of postoperative complications such as reexploration (P = 0.500), seroma formation (P = 0.951), surgical site infection (P = 0.282), and recurrence (P = 0.278).

Conclusion:
The mean mesh fixation time calculated from this study can be used as a reference for future interventional trials. The incidence of postoperative complications was comparable with the standard procedures.
Vitamin D levels among adults in a tertiary care hospital in Wayanad
Authors: Raj Aiswarya , Cherian Shreya , Srinivasan Shuba 
Published: August 2024

Background:
Vitamin D insufficiency affects nearly 50% of the population worldwide. Inadequate serum Vitamin D levels are associated with multiple conditions such as secondary hyperparathyroidism and increased fracture risk. Multiple studies carried out also showed a correlation between Vitamin D deficiency and occurrence of diabetes and hypertension (HTN) in these deficient individuals. This study aimed to determine the serum levels of Vitamin D among patients frequenting a tertiary care hospital in Wayanad and the associations with sunlight exposure, gender, dietary factors, and diabetes and HTN.

Settings and Design:
Cross-sectional study.

Materials and Methods:
Hundred patients were randomly selected from the outpatient department over 6 months and asked to fill up a questionnaire. Vitamin D analysis was done by Elecsys Vitamin D total assay. Statistical analysis used was IBM SPSS statistics for Windows, version 20.0: Association between continuous data was determined using t-test/Mann–Whitney test depending on normality of data and association between categorical variables was determined using Pearson's Chi-square test.

Results:
Fifty-seven percentage of patients had Vitamin D deficiency. Significantly lower values of Vitamin D were seen among women.

Conclusions:
The median Vitamin D levels in men were 22.785 ng/ml and 17.81 ng/ml in women. No association was established between >1 h of daily sunlight exposure, the prevalence of diabetes and HTN, and daily consumption of dairy products and Vitamin D deficiency.
Epidemiological characteristics of COVID-19-positive health-care personnel and their workplace contacts at a tertiary care hospital
Authors: Fazili Anjum B. , Qadri Shamila Hamid , Allaqband Uroosa Farooq , Shah Rohul jabeen , Shah Suhail Manzoor , Parray Javeed Ahmad 
Published: August 2024

Background:
Health care personnel (HCP) are at risk for nosocomial acquisition of severe acute respiratory syndrome-COV 2 from the exposure to infected patients and co-workers.

Aim and Objective:
This study was done to assess the epidemiological characteristics of HCP with COVID-19 and their workplace contacts.

Methodology:
This is a cross-sectional study done from April to July 2020. Data were collected telephonically from the cases, whereas the data from contacts were collected by both face-to-face interview and telephonically. A total of 125 cases and their 552 workplace contacts were included in the study.

Results:
Majority of study participants were symptomatic, young males with majority reporting exposure within the health facility.

Conclusion:
Ensuring workplace safety and adequate availability of personal protective equipment and sanitizers are the responsibility which every HC facility has to take care of COVID-19, health-care.
Comparative evaluation of accuracy of implants placed with thermoplastic and three-dimensional-printed surgical guides: A randomized controlled trial
Authors: Husain Firasat , Grover Vishakha , Bhaskar Nandini , Jain Ashish 
Published: August 2024

Abstract

Background:
The current study was planned to evaluate the accuracy of dental implant placement with two different types of surgical guides: Thermoplastic and three-dimensional (3D) printed.

Materials and Methods:
A total of 32 implants were placed in 20 healthy, partially dentate individuals with an isolated single missing tooth. The implant sites were randomly allocated into two treatment groups: Group A (thermoplastic implant surgical guide, n = 16 implants) and Group B (3D printed implant surgical guide, n = 16 implants). All the cases in both groups were digitally planned according to a defined protocol, and a comparison of the planned and actual implant positions was performed using the medical image analysis software. The differences in the outcome variables, i.e., angular deviation (AD), 3D error at the entry, 3D error at the apex (3D EA), vertical deviation (VD), and composite deviation, were statistically analyzed.

Results:
All the outcome variables showed improvements, but statistically significant improvement was shown by AD (P = 0.005), 3D EA (P = 0.01), and VD (P = 0.007). The mean and standard deviation (SD) for AD, (3D EA), and VD were 5.58° ±1.93°, 0.96 ± 0.32 mm, and 0.58 ± 0.36 mm, respectively, for group A. The mean and SD for AD, (3D EA), and VD were 3.94° ± 0.64°, 0.64 ± 0.35 mm, and 0.29 ± 0.13 mm, respectively, for group B (P < 0.05).

Conclusion:
Within the limits of the study, dental implants placed using 3D-printed surgical guides were positioned clinically with greater accuracy, and fewer deviations were observed from their presurgical planned positions as compared to the thermoplastic surgical guides.
Applications of a minimally invasive roll flap technique in peri-implant soft-tissue augmentation – A case series
Authors: Kulkarni Mihir Raghavendra , Chhabariya Anjali Mahesh , Sinha Shiphalika , Sahana L. , Jain Anushtha 
Published: August 2024

Abstract
Deficiency of peri-implant tissue contours is commonly seen due to the process of alveolar ridge resorption after tooth loss. Minor deficiencies can be effectively managed by soft-tissue augmentation procedures to create a more biomimetic tissue contour. The minimally invasive roll technique is a modification of the palatal roll-flap technique and can be carried out at both stages of implant surgery. In this technique, the crestal keratinized tissue is marked and de-epithelialized using a circular partial-thickness incision. The crestal connective tissue is then reflected using a lingual full-thickness semi-circular incision, keeping the buccal attachment intact. This buccal attachment serves as the pedicle. The crestal connective tissue is then rolled into a pouch on the buccal aspect of the ridge to obtain soft-tissue augmentation. The present case study documents the clinical results of the minimally invasive roll flap technique (MIRT) in three clinical scenarios, namely single-stage implant surgery, second-stage implant surgery, and anterior esthetic soft-tissue contouring. In all the cases, excellent soft-tissue contour and thickness has been obtained around dental implants. The MIRT is a simple and efficient technique for areas that require minor soft-tissue augmentation. The technique can be used both in the maxilla and the mandible and facilitates a suture-free surgery.
Spontaneous postoperative bleeding after periodontal procedure: An alarming sign of bleeding disorder
Authors: Mishra Shivani , Ratre Madhu Singh , Jain Parul 
Published: August 2024

Abstract
The prevalence of inherited bleeding disorders (BDs) is low in the general population (10–20 per 100,000 individuals), particularly hemophilia B cases, which may remain undiagnosed for a very long time until exposed to some surgical procedure. The dental professional must be aware of the possibility that patients with no previous history of abnormal bleeding may manifest their first bleeding episode in the dental office. Particularly as periodontists, we often encounter patients with bleeding gums and severe bleeding complications may precipitate while performing routine periodontal procedures. Hence, we must have a thorough knowledge of BDs and their management in challenging hemorrhagic situations. Management of such patients necessitates a multidisciplinary approach by involving the patient’s hematologist and advanced laboratory facilities. The present case report is an attempt to discuss the diagnosis and management of a bleeding episode that occurred post periodontal flap surgery in an undiagnosed hemophilia B patient.
Quantification of Porphyromonas gingivalis using real-time polymerase chain reaction in subjects suffering from chronic periodontitis with and without rheumatoid arthritis
Authors: Bhatsange Anuradha , Rajput Ketan 
Published: August 2024

Abstract

Background:

Porphyromonas gingivalis, highly virulent bacteria, is said to play an important role in the pathogenesis of periodontal disease and rheumatoid arthritis (RA). Chronic periodontitis (CP) is a microbial-induced inflammatory disease leading to tooth loss if undetected and untreated. RA is a systemic inflammatory disease affecting the joints with subsequent morbidity and mortality. These two diseases share a common pathobiology. Although the presence of P. gingivalis has been investigated as a bridging link between these two diseases, its quantification has not been fully elicited. Hence, this case–control study primarily aimed at quantifying P. gingivalis using real-time quantitative polymerase chain reaction (qPCR) and secondarily assess the influence of age and gender on the clinical and biochemical parameters of these two diseases.

Materials and Methods:
The study population consisted of 51 patients divided into two age groups, i.e., 35–55 and 55–76 years. Twenty-five patients belonged to the test group (RA with CP) and 26 to the control group (CP without RA). Both the groups were analyzed for quantification of P. gingivalis using the qPCR technique along with periodontal and biochemical parameters. The study also analyzed the influence of age and gender on clinical characteristics.

Results:

P. gingivalis count was exponentially raised in younger females having CP with RA. Age had no effect on clinical variables in CP patients with and without RA. However, gender comparison revealed RA factor and erythrocyte sedimentation rate to be more sensitive for females with significant relationship.

Conclusion:

P. gingivalis count increased exponentially in CP patients with RA compared to those without RA. Younger females harbored more P. gingivalis.