bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical Role of Pleural Wrap and Post-operative Neonatal Protocol in Long-gap Oesophageal Atresia: A Team Effort
Authors: Khanna Sanat Kumar , Tiwari Vishal Vishnu , Singh Gurjot , Panchal Gaurav 
Published: September 2024

Abstract

Background:
The objectives of this study were to bring out the results of application of pleural wrap in primary repair of tracheo - esophageal fistula (TEF) with long-gap oesophageal atresia (LGEA) and also define the role of neonatologists and paediatric intensivists in post-operative management in these patients by laying down standard neonatal management protocol.

Materials and Methods:
This was a retrospective descriptive observational study conducted between March 2011 and April 2019 on 23 cases of LGEA with TEF. The study was conducted at two tertiary care paediatric surgery centres in Northern part of India wherein these newborn babies were operated by two paediatric surgeons with variable experience of 8–12 years. It also describes the neonatal management protocol used in post-operative period.

Results:
Out of 23 patients, 15 were boys and 8 were girls, with a mean age of 32.25 weeks and a mean birth weight of 2.02 kg. The mean hospital stay was 23.5 ± 8 days. Eleven cases had gap between 3 and 3.5 cm, 8 cases between 3.5 and 4 cm and 4 cases had gap more than 4 cm. The incidence of associated anomalies was 52%. Anastomotic leak rate was 8.69%, and 3 (13.04%) patients died in the post-operative period. All the operated patients were managed postoperatively as per strict neonatal management protocol exclusively by the team of neonatologists and neonatal intensivists.

Conclusion:
Application of pleural wrap over anastomosis following primary repair of LGEA with TEF significantly reduced the incidence of anastomotic leak in our study. Apart from the pleural wrap, the key to successful outcome also is contributed by the little prolonged, controlled ventilation and patience and perseverance in post-operative feeds. This post-operative management protocol that has been followed by us in our study is easily reproducible and can be adopted by paediatric surgeons working alongside neonatologists as a team.
The validity and reliability of CT scan based tibial plateau mapping for tibial plateau fractures
Authors: Metwaly Radwan G. , Diab Hossam Saeed , Niaz Mohamed Nader 
Published: September 2024

Introduction
The Schatzker and computed tomography (CT)-based three-column classifications are the most used for tibial plateau fractures. The newer “10-segment classification” suggested to have better fracture identification and more accurate planning. This study aimed to assess the interobserver and intraobserver reliability of this new classification and to clarify its validity in clinical practice.

Patients and methods
A retrospective analysis of 30 patients with tibial plateau fractures who were admitted to a university hospital through the period between January 2020 and December 2022 was done. Patients with complete preoperative imaging, including radiographs, CT scans with three-dimensional reconstruction, and postoperative radiographs were included. Missing imaging, open fractures, pathological fractures, conservative management, or definitive fixation by circular external fixator were excluded. Data were reviewed independently by three expert trauma surgeons twice with 2-week intervals with randomization of case sequencing to evaluate their interobserver and intraobserver reliability for the Schatzker, CT-based three-column, and the new 10-segment classifications. The validity of the 10-segment classification was assessed by the agreement on the approach and implant position suggested by the observers.

Results
Good interobserver and intraobserver reliability was found as regards the Schatzker and CT-based three-column classifications on both intervals. Moderate and poor interobserver reliability “on both intervals respectively” and poor intraobserver reliability was found for the 10-segment classification. As regards the agreement on surgical approach on both time intervals, moderate and good interobserver agreements were found. For the implant position, poor interobserver agreement on both intervals was found. Intraobserver agreement for the surgical approach was good, while the intraobserver agreement for the implant position was moderate.

Conclusion
The Schatzker and CT-based three-column classifications are still more reliable than the newer 10-segment classification. This may be explained as it is still not familiar to surgeons and needs more training to be applied in clinical practice.
Arthroscopic assisted foveal repair of triangular fibrocartilage complex injuries associated with distal radioulnar joint instability
Authors: Kamaleldin Mahmoud M. , Shekedaf Saeed M. 
Published: September 2024

Introduction
Foveal tears of tfcc are common causes of ulnar sided wrist pain. They are usually associted with druj instability. Reattachment using either arthroscopic or open techniques is considered the best treatment in acute settings. This is a retrospective study to evaluate clinical and functional results of arthroscopic assisted technique.

Patients and methods
20 patients were enrolled in the study. 13 males and 7 females. Mean age was 26 years.
Technique involved arthroscopic reattachment of the tfcc to its foveal foot print using direct foveal portal as described by Atzei et al.

Results
The mean follow-up period was 14 months ranging from 8 to 20 months No pain was recorded in 13 patients, mild pain in 4 patients, and moderate pain in 3 patients. The mean VAS score was 3.2. The mean Mayo score was 70%.

Conclusion
Arthroscopic assisted technique using direct foveal portal is a valuable technique with good reproducible results.
Superior versus anterior plating of midshaft clavicle fractures: 6 months follow up (union rates, risks, and complications: hardware irritation and need for removal)
Authors: El-Safty Ahmed M.H. , Mesbah Hesham , Hesham Begad , Refaat Mohamed 
Published: September 2024

Background
Operative management of midshaft clavicle fractures is gaining popularity. The clavicle is a tubular bone with a flat lateral end. Open reduction and internal fixation could be achieved by the application of plates and screws either to the superior or anterior surface of the clavicle. However, there is no consensus in the literature to support one technique over the other. This study aims to compare the early functional and radiographic outcomes of anterior versus superior plating for the treatment of midshaft clavicle fractures.

Patients and methods
From March 2021 to November 2022, a prospective randomized clinical trial was conducted at our institute. We included all patients with isolated midshaft clavicle fractures. Thirty-six patients were randomized by the closed envelope technique, 18 were managed with superior plating (superior group), and the other 18 patients were managed using anterior plating (anterior group). All patients were followed up for 6 months. All patients were assessed clinically for union, range of motion, and functional scores. The secondary outcome measures included operative time, complications, hardware irritation, and the need for hardware removal or secondary procedure.

Results
The mean time to full union was 11.28 weeks in the anterior group and 11.72 weeks in the superior group. Mean constant shoulder score for the anterior group was 84.11 while for the superior group it was 82.67. No patients had skin and wound complications in the anterior group versus one patient in the superior group that got superficial infection successfully managed by repeated dressing and antibiotics. There was no statistically significant difference between superior and anterior plating regarding union, functional scores, return to ADLs, hardware problems, or complications.

Conclusion
Both superior and anterior plating of the clavicle fractures are safe treatment options for displaced midshaft clavicle fractures, and they lead to similar functional outcomes, functional scores, and complication rates. Moreover, the selection of the technique of plating depends on surgeon preferences.
Surgical management of combined osteoarthritis knee and proximal tibial stress fracture via long tibial stem total knee arthroplasty: assessment of medium-term results
Authors: El-Aidy Sherif , Abd El Wahab Ahmed Mohammed , Safwat Yamen 
Published: September 2024

Background
The combined osteoarthritis knee and proximal tibial stress fracture is an uncommon condition that increases the complexity of the management for both. No common consensus among surgeons regarding management guidelines. We assessed the medium-term results (minimum 5 years) of using long tibial stem total knee arthroplasty (TKA) to restore limb alignment, achieve fracture union, and resurface the arthritic joint in a single procedure.

Methods
Total of 23 patients with combined osteoarthritis knee and proximal tibial stress fracture were enrolled in this study. Of those 23 patients, 18 were females and five were males. All patients were managed surgically by TKA (PCL sacrificing) with a long tibial stem (straight or with offset). Assessments of union and tibiofemoral alignment were carried out using radiographs. Clinically, patients were evaluated by assessment of knee range of motion, knee society score (KSS), and knee injury and OA outcome score.

Results
The average follow-up period was 6.5 ± 2.3 years (range from 5 to 9 years) all fractures united in 3–8 months (average 3.2 months), and mean range of motion improved from 89°±8° to 119°±6°, mean knee society score improved from 32 ± 8 to 87 ± 5, mean knee injury osteoarthritis outcome score improved from 27 ± 6 preoperatively to 79 ± 5 after a minimum of 5 years follow-up. no complications (instability, infection, or patella mal-tracking) were reported, although 1 case had a femoral intraoperative condyle fracture which was fixed by screws with no effect on the outcome.

Conclusion
The use of a long tibial stem TKA is an effective and reproducible single surgical procedure in the management of combined osteoarthritis knee and proximal tibial stress fracture. Satisfactory clinical scores and radiological outcomes were achieved and proper limb alignment was restored obviating the need for further fixation or grafting.
Scaphocapitate arthrodesis in late stages of Kienbock’s disease
Authors: Romeih Mohamed A. 
Published: September 2024

Background
Kienbock’s disease is characterized by osteonecrosis of the carpal lunate. Kienbock’s disease treatment remains controversial.

Objective
To evaluate the short-term clinical and radiologic outcomes of scaphocapitate arthrodesis (SCA) in treating symptomatic late-stage Kienbock’s disease.

Methods
According to Lichtman’s classification, this prospective study included 21 patients with Kienbock’s disease stage III. All patients underwent SCA under general anesthesia. Patients were followed up at 1 and 2 weeks, 1, 3, 6, 9, 12, and 18 months postoperative.

Results
At the end of follow-up, 33.3% of patients achieved excellent outcomes, 47.6% achieved good outcomes, and 19.0% achieved poor outcomes. Patients with excellent and good outcomes are younger than patients with poor outcomes (38.9 ± 11.0, 42.2 ± 10.1, and 54.5 ± 3.3 years, respectively). Patients in the excellent and good groups had significantly lower disabilities of the arm, shoulder, and hand score (21.7 ± 14.8, 23.5 ± 16.8, and 47.3 ± 7.4, respectively, P=0.028), significantly higher extension/flexion arc (72.1 ± 17.2, 70.3 ± 22.0, and 38.5 ± 5.1, respectively, P=0.019) and a significantly shorter time to complete union (8.4 ± 1.4, 10.7 ± 1.3, and 14.8 ± 1.9, respectively, P=0.001).

Conclusions
SCA for late-stage Kienbock’s disease (stage III) was associated with significant improvements in carpal height length and grip strength postoperatively. Age, disease stage, disabilities of the arm, shoulder, and hand score, extension/flexion arc, and time to full union are critical factors in determining the prognosis of Kienböck’s disease.
Higher Prevalence of Hepatitis B and C Infections among Indian Patients with Von Willebrand Disease
Authors: Amruthavarshini N. , Sindhuvi Eunice , Kumar Santhosh E. , Abraham Aby , Mammen Shoba , Daniel Dolly , Nair Sukesh C. , Kodiatte Thomas Alex , Zachariah Uday George , Goel Ashish , Eapen C. E. 
Published: September 2024

Background:
The use of recombinant coagulation factors has reduced the incidence of hepatitis B and C infections in hemophilia patients. As recombinant von Willebrand factor is not easily available, patients with von Willebrand disease (VWD) may be at higher risk for acquiring hepatitis B and C infections. The prevalence of hepatitis B and C infections in the Indian population is ~0.95% and ~0.3%, respectively.

Aims:
This single tertiary center study aimed to assess the prevalence of hepatitis B and C infections and the profile of liver disease caused by these viruses among patients with VWD.

Methodology:
We retrospectively enrolled VWD patients treated in our center from January 2012 to December 2022 and analyzed the prevalence of hepatitis B and C infection and stage of liver disease.

Results:
Among 189 patients with VWD during the study period, 5 of 61 (8.1%) VWD patients screened were hepatitis B surface antigen positive (age: 34 [24–42] years; median (range); plasma VWF antigen: 10.1, [0–40] IU/dL). One patient had cholangiohepatoma at presentation, whereas none had chronic liver disease. Four of five patients received multiple bloodproduct transfusions before coming to our institution, with 10 (7–18) years interval between 1st transfusion and to detection of hepatitis B infection. Four of the 47 VWD patients (8.5%) screened were positive for hepatitis C virus antibody (48 [43–59] years, plasma VWF antigen: 20 [0–21.5] IU/dL). One patient had chronic liver disease. All four patients received multiple blood product transfusions before coming to our institution, with 15.5 (2–39) years interval between 1st transfusion and to the detection of hepatitis C infection.

Conclusions:
The prevalence of hepatitis B infection (8.1%) and hepatitis C infection (8.5%) was 8-fold and 28-fold higher, respectively, in VWD patients than the general population in India. VWD patients remain at high risk for acquiring transfusion-transmitted viral infections and appropriate interventions are needed to address this.
Effect of Bisoctrizole on Ultraviolet (UV) Absorption Properties of Silicone and Effect on Surface Roughness - An In Vitro Study
Authors: Ahmed Widyan Abbas , Khalaf Bayan Saleem 
Published: September 2024

Abstract

Background:
Premature degradation is the problem of maxillofacial silicones, significantly affected by ultraviolet exposure, contributing to silicones photodegradation. Degradation necessitates frequent replacement of prostheses that increase the total cost of rehabilitation.

Aims:
This study evaluated the effect of bisoctrizole on the ultraviolet absorption properties of silicone material and the stability of this absorption over time. Also, the bisoctrizole effect on the surface roughness of silicone was evaluated.

Methods:
There were 60 prepared specimens of room temperature-vulcanising maxillofacial silicone equally divided into two groups according to the conducted tests: ultraviolet absorption test and the surface roughness test. Each group was further subdivided into groups of 10 specimens based on the weight concentration of the ultraviolet (UV) absorber added: 0%, 1% and 2%. The UV absorbance of coloured specimens was measured before and after artificial weathering for 100 and 200 hours. Repeated-measures analysis of variance (ANOVA) was applied for UV absorption results, and one-way ANOVA was applied for the roughness test results to test the changing significances.

Result:
Bisoctrizole incorporation led to a highly significant improvement in ultraviolet absorption in all groups, maintaining a high level even after subjecting the specimens to artificial weathering. Furthermore, the addition resulted in a significant increase in surface roughness as the concentration of bisoctrizole increased.

Conclusion:
Despite the surface roughness changes, bisoctrizole demonstrated efficacy as a UV absorber for maxillofacial silicone, making it valuable for applications such as maxillofacial prosthetics that require UV protection.
The Effect of Gold Nanoparticle-Coated Dental Implants on Osseointegration – A Systematic Review
Authors: Faiz Nadhirah , Venugopal Suresh , Sivasamy Vinay 
Published: September 2024

Abstract

Introduction:
Dental implants are used in dentistry to replace teeth, restore function and improve the quality of life for patients. Osseointegration is critical for the success of dental implants. Implant surface modification can enhance osseointegration. Gold nanoparticles have emerged as a promising coating material for dental implants owing to their unique physicochemical properties. We aimed to review published literature to assess the effect of gold nanoparticle coating in increasing osseointegration of dental implants.

Data Collection:
A database search yielded a total of 14 articles between January 2011 till December 2021, of which nine articles were excluded and five studies met the inclusion criteria. All studies reported improved osseointegration outcomes with gold nanoparticle coating compared to uncoated controls.

Results:
The most reported osseointegration outcomes were bone–implant contact, removal torque (RTQ) and histological analysis of bone formation around the implant. Mean RTQ values for coated implants ranged from 6.7 to 52.8 Ncm, compared to 3.7–40.8 Ncm for uncoated controls. The histological analysis showed greater bone formation and density around the coated implants compared to uncoated implants. Gold nanoparticle coating appears to have a positive effect on osseointegration. The results of included studies suggest that gold nanoparticle-coated implants promote greater bone–implant contact (BIC), RTQ and bone formation around the coated implant than the uncoated implant.

Conclusion:
With increasing usage of dental implants, the most prevailing concern among clinicians remains to be peri-implantitis. Peri-implantitis is observed despite the biocompatibility and osseointegration properties of titanium. Surface coatings with antimicrobial effectiveness can help in preventing the onset of peri-implantitis and bone loss, while increasing BIC.
Effect of Andrographis paniculata Herbal Extract on Cytotoxicity, Proliferation and Osteogenic/Odontogenic Differentiation of Human Dental Pulp Stem Cells: An In Vitro Study
Authors: Naik Savitha B. , Kumar N Kiran , Swathisha P Annie , Brigit Biji , Preetham H.S , Karumaran Chella S. 
Published: September 2024

Abstract

Background:
Research has been conducted to assess the regenerative potential of dental pulp stem cells (DPSCs) following pretreatment of stem cells with certain molecules, bioactive compounds, plant extract and physical stimulation. Andrographis paniculata (AP) herbal extract with important medicinal properties is proven to have a preosteogenic effect on osteoblasts.

Aim:
This study aimed to determine the effect of various concentrations of AP extract on the cytotoxicity and osteogenic and odontogenic potential of DPSCs.

Methods and Material:
Dental pulp stem cells were subjected to treatment with various concentrations of AP herbal extract (7 ug/ml, 5.2 ug/ml, 3.5 ug/ml, 1.7 ug/ml and 0.8 ug/ml), following which the cells were subjected to tests-3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) analysis for cytotoxicity and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test for expression of genes (bone morphogenetic protein (BMP), osteocalcin (OCN), dentin sialophosphoprotein (DSPP) and alkaline phosphatase (ALP)).

Results:
AP extract at concentration of 0.8 ug/ml–5.2 ug/ml had no cytotoxicity supporting cell growth. 3.5 ug/ml showed significant upregulation of genes on the third day.

Conclusion:
AP, a commonly occurring medicinal plant through its effect on DPSCs, could serve as an effective pretreatment modality for cell-based regenerative therapy and vital pulp therapy.
Effect of Densah Burs on Primary and Secondary Stability of Immediately Loaded Implants in Addition to Crestal Bone Loss and Gingival Probing Depth - An Evaluative Study
Authors: Rathi Shraddha , Gupta N D , Hashmi Sarwar , Abirami S , Yusufi Faiz Noor Khan 
Published: September 2024

Abstract

Introduction:
Osseodensification (OD) compaction increases primary stability by leaving the residual bone particles in the osteotomy site, which in turn act as an autograft.[1] Condensing the bone trabeculae through OD has demonstrated to have a potentiating influence on secondary stability.[2]

Materials and Methods:
A split-mouth study was conducted in 40 patients to determine the effect of OD on implant success rate in terms of primary and secondary stability in situations including immediate loading of implants placed in low-density bone, which was tested using resonance frequency analysis (RFA) at the interval of 0, 6th month. In order to assess the implant success rate, gingival probing depth and crestal bone loss (CBL) around the implant were also assessed at baseline and 6 months.

Results:
With respect to primary stability, at baseline, the mean RFA of Densah burs is 71.6 ± 9.5 and of conventional drills is 67.6 ± 10.4. The mean stability of Densah burs is significantly higher than conventional drills, both at baseline and after 6 months as well. CBL, at baseline, the mean CBL of Densah burs is 0.58 ± 0.11 and of conventional drills is 0.64 ± 0.12. The mean CBL of Densah burs is significantly lower than that of conventional drills for both.

Conclusion:
The implant stability values found in the present study were remarkable when compared between OD and conventional osteotomy techniques. Decreased loss of bone at the crest probing depth also aided in the increased success rate.
Microleakage of Class II Posterior Composite Restorations with and Without use of Liners - A Comparative Study
Authors: Shekh Tariq Mohammad , Kumar Pravin , Kumar Yogender , Pathak Karishma , Punia Sandhaya Kapoor , Patnana Arun K. 
Published: September 2024

Abstract

Aim:
This study aims to compare the effect of liner on microleakage in Class II restorations at the occlusal and gingival levels when restored with a nanocomposite.

Methodology:
A total of 60 mandibular molars were selected and divided into three groups. Cavities in Group A were restored with posterior nanocomposite without liner, samples of Group B were restored with posterior nanocomposite with flowable composite liner and in Group C samples were restored with posterior nanocomposite with resin-modified glass ionomer cement (RMGIC) liner. Samples were stored at 37°C in 100% humidity for 14 days. Samples were subsequently immersed in 0.5% methylene blue dye and then placed under water for 15 mins. Teeth were sectioned mesiodistally with a diamond disc and examined under a stereomicroscope.

Results:
All the cavities exhibited dye penetration along the occlusal and gingival margins of the restored cavities. Group A showed maximum leakage compared to Groups B and C, which was statistically significant (P = 0.001 and P < 0.0001). No significant difference in microleakage was observed between Groups B and C. Microleakage was more in gingival margins as compared to occlusal margins in all the groups.

Conclusion:
Based on the results of the present study, it may be concluded that the placement of liner beneath nanocomposite restoration results in a significant reduction in microleakage.