bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intubation Learning Curve with the HugeMed Video Laryngoscope among Anesthesiology Postgraduate Students: An Observational Study
Authors: Naithani Udita , Khatri Siddharth , Jain Shweta , Sethi Surendra Kumar , Choudhary Santosh , Sharma Chandra Prakash 
Published: September 2024

Abstract

Background:
Video laryngoscopy (VL) facilitates intubation by providing an indirect view of the glottis. To determine VL intubation success, establishing its learning curve is important. This study aimed to evaluate the learning curve of VL intubation in anesthetized patients, performed by anesthesiology postgraduate (PG) students.

Materials and Methods:
Thirty-six anesthesiology PGs with a direct laryngoscopic (DL) intubation experience of >1 year, but new to VL, participated in this study. Each PG performed five VL intubations in anesthetized patients having normal airways (total 180 VL intubations). The primary outcome variable was intubation time, and the secondary outcome measures were first attempt success rate and difficulties encountered.

Results:
Mean intubation time decreased significantly from the first VL experience [57.81 s (95% CI 52.09–63.54)] to the fifth VL experience [24.14 s (95% CI 22.28–25.99)], P < 0.001. The first attempt success rate showed a significant increase from 83.3% (n = 30) in the first, 97.2% (n = 35) in the second, and 100% (n = 36) in the next three VL experiences (P < 0.001). The incidence of difficulty in laryngoscopy and endotracheal tube (ETT) insertion progressively decreased in successive VL experiences, and by the fifth VL experience, none of them faced any difficulty (P < 0.001).

Conclusion:
The learning curve of VL intubation showed a significant reduction in intubation time and improvement in the first attempt success rate over successive experiences, emphasizing the need for prior training even if the user is familiar with the process of DL intubation.
Successful Anesthesia Management in Landau–Kleffner Syndrome Undergoing Laparoscopic Surgery: A Case Report
Authors: Uslu Ahmed , Çekmen Nedim 
Published: September 2024

Abstract
Landau–Kleffner syndrome (LKS), also known as acquired epileptic aphasia, is a childhood disease associated with acquired aphasia and epileptiform abnormalities on the electroencephalographic. We report the uneventful anesthesia management of a 17-year-old female patient with LKS syndrome. Her vital signs and laboratory results were normal, and plasma levels of valproic acid (73.6 µg/mL) were within therapeutic limits. She had mild micrognathia, short thyromental distance, and normal neck movements and mouth opening. An intravenous induction was performed with 100 mg lidocaine, 100 µg fentanyl, 200 mg propofol, and 60 mg rocuronium intravenously. After preoxygenation with 80% O2 for 3 min, she was intubated without complications with a number 7.5 mm endotracheal tube connected to a ventilator. Anesthesia maintenance was provided with 2.2% sevoflurane and 50% oxygen–50% air mixture, 0.01–0.05 μg/kg/min infusion of remifentanil. The target partial pressure of carbon dioxide was 30–35 mm Hg. Care was taken to ensure that intra-abdominal pressure did not exceed 14 mm Hg. Spontaneous breathing returned in 5 min after discontinuation of sevoflurane. She was extubated after following commands and transferred to the post-anesthesia care unit. It is unknown whether general anesthesia has a short- or long-term effect on patients with LKS. Since epileptic seizures are essential in patients with LKS, the correct selection of anesthetic agents is significant. In addition, hypoxemia, hypercarbia, hypocapnia, high positive end-expiratory pressure, and acidosis should all be avoided as they may trigger seizure activity.
Modified Ultrafiltration Technique in Valvular Heart Surgery: A Case Series
Authors: Kharmayani Made Ryan , Soenarto Ratna Farida , Alatas Anas , Putra Muhammad Arza 
Published: September 2024

Abstract
Application of cardiopulmonary bypass (CPB) in cardiac surgery may cause systemic inflammatory reactions, possibly causing clinical sequelae and multiple organ failures such as systolic or diastolic dysfunction, regional or global left ventricle or right ventricle low contractility, and the function of vascular tone. The use of drugs (i.e., corticosteroids) and the ultrafiltration method during the CPB application has been known to prevent or minimize the complication of CPB in cardiac surgery. One of the non-pharmacological approaches to minimize those inflammatory responses is the modified ultrafiltration (MUF) technique. Theoretically, this is due to ultrafiltration which may reduce the interstitial fluid and inflammatory mediator. MUF can be used to counteract inflammatory responses in pediatric cardiac surgery. This ultrafiltration method became a recommended procedure in minimally invasive surgery and conventional open-heart surgery. However, studies about effectiveness in adults are limited. In this case series, the MUF technique was used in three patients who underwent valvular heart surgery with a CPB machine. Following the application of the CPB, the MUF technique is performed for 10 min at a speed of no more than 10% full flow. Hemodynamic measurements and interleukin-6 (IL-6) levels were taken during surgery and 24 h post-CPB. At 24 h post-CPB, the vasoactive inotropic score and duration of mechanical support use were less than 20 and 18–24 h, respectively, and the IL-6 level ranged from 7.22 to 14.22 pg/mL. The cardiac index increased, ranging from 2.43 to 3.47 L/min/m2, and pulmonary vascular resistance decreased, ranging from 78 to 146 dyne s/cm5.
Predictors of Renal Replacement Therapy in Cardiac Surgery-Associated Acute Kidney Injury Patients: A Single-Centered, Retrospective Study
Authors: Adriane Prieta , Ardiyan Ardiyan , Dewi Ni Luh Kusuma , Andria Krisna 
Published: September 2024

Abstract

Background:
Studies have reported that cardiac surgery-associated acute kidney injury (CSA-AKI) patients requiring dialysis or renal replacement therapy (RRT) have a higher risk of in-hospital mortality. This study aimed to investigate the predictors contributing to postoperative RRT.

Materials and Methods:
This retrospective observational study was conducted at a single cardiovascular center. Patients who underwent cardiac surgery complicated with CSA-AKI in the intensive care unit (ICU) from January 2020 to December 2022 were included. They were categorized into two groups: those who required RRT (group A, n = 302) and those who did not (group B, n = 811). Bivariable and multivariable analyzes were conducted to compare the risk with odds ratio (OR) for in-hospital mortality between those groups.

Results:
We analyzed 1113 patients (29.4%) in the final analysis. The in-hospital mortality rate was 31.8% vs. 4.2% (OR = 10.6, P < 0.001). Variables that significantly predicted postoperative RRT requirements in CSA-AKI patients included female sex (P = 0.038), coronary artery bypass graft (P = 0.001), multiple valves surgery (P = 0.032), diabetes (P = 0.01), renal disease (P = 0.005), postoperative serum creatinine >3.0 mg/dL (P < 0.001), mechanical ventilation use of ≥48 h (P < 0.001), ICU length of stay of >5 days (P < 0.001), use of more than two inotropes and vasoactive agents, (P < 0.001), and postoperative intra-aortic balloon pump (IABP) (P < 0.001).

Conclusion:
CSA-AKI patients who require dialysis are associated with a higher mortality. Predictors of postoperative RRT included female sex, certain types of surgery, diabetes, postoperative serum creatinine >3.0 mg/dL, mechanical ventilation use of ≥48 h, ICU length of stay of >5 days, use of more than two inotropes and vasoactive agents, and postoperative IABP.
Anesthesia Management of a Patient with Idiopathic Thrombocytopenic Purpura Undergoing Laparoscopic Esophageal Hiatal Hernia Surgery: A Case Report
Authors: Seri Zoukou Marie France Dominique , Uslu Ahmed , Çekmen Nedim 
Published: September 2024

Abstract
Perioperative management of patients with immune thrombocytopenic purpura (ITP) has significant challenges for anesthesiologists. Perioperative bleeding due to thrombocytopenia in patients with ITP can be an essential challenge and is the most significant risk to anesthetists. Laparoscopic surgery can also be an additional challenge in such patients because of the risk of pneumoperitoneum that can lead to hemodynamic instability and bleeding deterioration. We present a 77-year-old successful anesthesia management of a female patient with ITP who underwent elective laparoscopic esophageal hiatal hernia surgery. A multidisciplinary team approach and comprehensive perioperative assessment and treatment are critical to ensure successful perioperative management of patients with ITP. We also aim to suggest that intravenous immunoglobulins therapy is not always mandatory in perioperative management of patients with ITP.
Preventive Effect of Ultraviolet Photofunctionalization on Peri-implant Biofilm Formation: An In vivo Randomized Study
Authors: Goel Akanksha , Swami Vinit , Patil Amol Somaji , Swami Vasanthi Vinit 
Published: September 2024

Abstract

Background:
Peri-implant biofilm formation due to local bacterial colonization is one of the important factors for the instability of temporary anchorage devices (TADs).

Aim:
The aim of this study was to quantify and compare the colonization of Streptococcus sanguinis on ultraviolet (UV) treated and untreated titanium TADs.

Materials and Methods:
This prospective, in vivo study included 20 subjects requiring orthodontic treatment with first premolar extraction, followed by retraction of the anterior teeth with absolute anchorage using TADs. TADs were placed interdentally, in the keratinized tissue between the upper second premolar and the first molar on the buccal side, at the mucogingival junction. It was a split-mouth study where one side of TAD was UV-treated for 15 min, and the other side was kept untreated as a control. TADs were removed after 6 months for S. sanguinis quantification on both sides and were compared for biofilm reduction.

Statistical Analysis:
Statistical software was used to perform unpaired t-tests for the individual samples as well as for comparing total UV-treated and untreated samples. P <0.05 was considered significant.

Results:
The mean bacterial count (per ml) was found to be 2.2 × 106 copy numbers and 8.9 × 106 copy numbers in the UV group and untreated group, respectively. The total count of bacteria was found to be less in the UV-treated group compared to the untreated group.

Conclusions:
The study concludes that UV photofunctionalization results in a significant reduction of S. sanguinis colony on TADs with reduced chances of failure due to inflammation.
Atypical Presentation and Surgical Management of Ectopic Mandibular Third Molar in Subcondylar Region: A Rare Case Report
Authors: Khandelwal Pulkit , Saluja Harish , Shah Seemit , Dadhich Anuj 
Published: September 2024

Abstract
Ectopic teeth arise from developmental abnormalities and can be supernumerary, deciduous, or permanent teeth. They can cause orofacial pain, swelling, and infection. There is a major paucity in literature about ectopic mandibular third molar (EMTM) and its causes, symptoms, and treatment. We present an unusual case of EMTM in the mandibular subcondylar region and its surgical management. A 58-year-old female reported with complain of pain and swelling in the right preauricular region. On radiographic assessment, the right mandibular third molar was ectopically present in the subcondylar region and associated with a small dentigerous cyst. Complete removal of cystic lining and extraction of EMTM was done under general anesthesia using a retromandibular approach. After surgery, there was a complete resolution of symptoms within 1 month with uneventful healing and no postoperative complications.
Technique for Spacer Adaptation and Custom Tray Fabrication in Impression Making for Fixed Prosthodontics
Authors: Nanda Aditi , Koli Dheeraj Kumar , Kaur Harsimran 
Published: September 2024

Abstract
The objective is to minimize the inaccuracies in two-step impressions by homogenizing the polymerization shrinkage of elastomeric impression material in fixed prosthesis fabrication. The objective is accomplished by the technique of spacer adaptation and custom tray fabrication for two-step impressions. The technique makes the use of two vacuum-adapted spacers, selected based on the viscosity of elastomeric impression, and a vacuum-adapted custom tray. The procedure of using the specially fabricated custom tray for impression making is also presented. Consistent thickness of the two different viscosities of impression material is maintained due to vacuum adaptation of the spacers. This homogenizes the polymerization shrinkage of the elastomeric material in different regions of impression, as uniform space is occupied by the material in the space created by the spacer. The procedure of vacuum adaption of the tray material also limits the dimensional change of the tray. The technique minimizes the inaccuracies of impression by homogenizing the polymerization shrinkage of the elastomeric impression, thus promising a well-fitting prosthesis.
A Single-Step Root Coverage Procedure Using Modified Bridge Flap Technique and De-epithelialized Gingival Unit Graft: A Prospective Clinical Study
Authors: Katti Neelima , Mohanty Devapratim , Srivani Peri , Siddiqui Humaira , Raj Subash Chandra , Baral Debajani 
Published: September 2024

Abstract

Background:
The mucogingival conditions associated with the recession defects at the mandibular anterior region, not only make plaque control difficult to be performed by the patient but also pose a problem in passively advancing the tissues at the recipient site. This surgical technique is used to treat multiple recession defects in the mandibular anterior region.

Materials and Methods:
Twenty-five sites in 17 subjects (11 women and 6 men) underwent modified bridge flap and de-epithelized gingival unit graft (d-GUG) as a single-step treatment modality to cover the denuded root surface, as well as increase the width of keratinized gingiva in recession type 1 gingival recession defects in the mandibular anterior region.

Results:
Nearly 60% of sites in our study showed complete root coverage, with a mean root coverage percentage of 88.08%. Furthermore, keratinized tissue width, keratinized tissue thickness as well as vestibular depth showed statistically significant increases as compared to baseline levels.

Conclusion:
Thus, the modified bridge flap technique using d-GUG within the limitations of our study design, showed promising results in terms of recession coverage as well as management of the difficult mucogingival conditions at the mandibular anterior region.
Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor) as a Rare Entity on Upper Lip: A Case Report and Review
Authors: Shetty Lakshmi , Raut Shreya Jeetendra , Camblay Gauri , Brahma Tirtha Raj 
Published: September 2024

Abstract
Masson’s tumor is a benign intravascular lesion of proliferating endothelial cells that accounts for 2% of vascular and subcutaneous lesions. It manifests clinically as a bluish swelling, resembling a mucocele or hemangioma. Intravascular papillary endothelial hyperplasia (IPEH) was coined by Clearkin and Enzinger in 1976 to describe reactive vascular expansion, following traumatic vascular stasis mimicking angiosarcoma. Clinically, this condition manifests as a bluish enlargement resembling a mucocele or hemangioma. We reported a rare case of IPEH located on the upper lip in an 18-year-old female. A diagnosis of IPEH was reported based on the histopathological findings of papillary proliferating endothelial cells with engorged red blood cells. There was no evidence of recurrence after 6 months of follow-up.
Benign Fibrous Histiocytoma of Gingiva: A Rare Case Report
Authors: Sangala Bhavani Nagendra , Jawdekar Ashwin , Choudhari Sheetal S. , Tank Urvashi R. , Buva Kirti Balkrishna , Deshpande Sneha Masne 
Published: September 2024

Abstract
Fibrous histiocytoma is a benign soft-tissue neoplasm that commonly involves the dermis. It is rare in the oral cavity. This lesion creates a diagnostic dilemma due to its nonspecific clinical appearance and microscopic similarities with other benign fibrous tissue lesions. Microscopically, it shows the proliferation of both spindle-shaped fibroblasts and histiocytes. Surgical excision is the treatment of choice with a good prognosis. The purpose of this paper is to report a rare case of gingival benign fibrous histiocytoma occurring in an 11-year-old female patient. The diagnosis of this lesion is based on combined clinical, histopathological, and immunohistochemical features.
Variations in Root Canal Morphology of Mandibular Incisors in a North Indian SubPopulation: A Retrospective Cone-Beam Computed Tomography Analysis
Authors: Kaur Brar Prabhleen , Rajdeep Brar , Ruchi Vashisht , Nishant Mehta , Richa Shrivastava , Rigzin Tamchos 
Published: September 2024

Abstract

Background:
There is a high failure rate of endodontic treatment in the mandibular incisors due to insufficient knowledge of the morphology.

Aim:
The aim of this study was to analyze the root canal morphology in mandibular incisor teeth in the North Indian subpopulation to improve the outcome of endodontic treatment.

Setting and Design:
A cross-sectional study was conducted at the OPD of a tertiary care institute.

Materials and Methods:
A total of 200 mandibular central incisors and 200 mandibular lateral incisors were selected from available cone-beam computed tomography examinations of 100 patients aged 18–79 years. They were evaluated for root canal system configuration and symmetry between right and left elements in the same individual.

Statistical Analysis:
Chi-square/Fisher’s exact test was used to find the association between different study variables.

Results:
For mandibular central incisors, type I Vertucci classification was present in 69% of cases, type II in 3.5%, type III in 18.5%, type IV in 2%, and type V in 7% of cases. For mandibular lateral incisors, type I was present in 70.5% of cases, type II in 4% of cases, type III in 19.5%, type IV in 2%, and type V in 4% of cases. There was no evidence of types VI, VII, and VIII. Symmetry of root canal morphology between left and right teeth was observed in 90% of central incisors and 93% of lateral incisors.

Conclusion:
Type I Vertucci configuration was the most prevalent; however, the prevalence of other configurations is also evident. Therefore, endodontists should explore the morphology of these teeth carefully while performing root canal treatments.
Intracranial multiple glioblastomas resembling metastases: A case report
Authors: Dong Qiufeng , Hu Peizhen , Huo Junli , Yang Shuangwu , Zou Peng , Zhang Xiang , Zhen Haining 
Published: September 2024

Abstract
The diagnosis and treatment of gliomas have traditionally been both a research hotspot and a challenge in clinical medicine. Intracranial multiple gliomas are rare, and their diagnosis and treatment are often more difficult than those of solitary gliomas. In this article, we report our experience with the diagnosis and treatment of a case of intracranial multiple glioblastomas that closely resembled metastatic tumors in terms of neuroimaging and anatomy. This case may provide a useful reference and insight into the clinical management of this type of disease.
A Cross-Sectional Study for the Assessment of Fractional Exhaled Nitric Oxide in Children with Atopic Dermatitis and Reactive Airway Disease in Comparison to Healthy Controls
Authors: Ganguly Mimi , Ghosh Aniruddha , Dhar Sandipan , Roy Indrani , Kundu Ritabrata 
Published: September 2024

Introduction:
Nitric oxide (NO) is an important biological mediator of inflammation which is exhaled after being produced in the lungs. Fractional exhaled NO (FENO) is a new tool which measures the amount of NO exhaled.

Aims and Objective:
The objective of our study was to find the correlation between the FENO levels between atopic dermatitis and asthma patients in comparison to healthy controls and hence identify steroid responsiveness.

Methodology:
Our study was a cross-sectional observational study performed in a tertiary care hospital involving 150 children (>5–<18 years) who were either attending the outpatient departments or were admitted as inpatients. Relevant history and physical findings were noted and severity scorings were done in the preformed pro forma. Their FENO levels were then recorded and compared.

Results:
The level of FENO was higher in both bronchial asthma and atopic dermatitis patients as compared to controls. The level of FENO was higher in treatment-naïve patients as compared to treated cases. There was also a strong positive correlation between the levels of FENO and disease severity in both the groups.

Conclusion:
FENO is a relatively new tool and as such still requires standardization and acceptance in the medical field. It can be a very useful tool in not only identifying these atopic diseases, but it can also act as a prognostic marker as well as a marker for patient compliance. There being a gap in literature related to FENO, hopefully our study will provide some insight to its usefulness.
Clinical Spectrum of Atopic Dermatitis in Pediatric Age Group from a Tertiary Care Center in India: A Cross-sectional Study
Authors: Mendiratta Vibhu , Verma Damini , Himadri  
Published: September 2024

Introduction:
Atopic dermatitis (AD) is a chronic, inflammatory, relapsing skin disorder with early age of onset in infancy and early childhood. A gradual increase in the prevalence of AD has been observed recently, especially in low-income countries like ours.

Objective:
We aimed to study the epidemiology and clinical profile of AD among pediatric age group in a tertiary care hospital in North India.

Materials and Methods:
A hospital-based cross-sectional study was conducted over 1 year in the department of dermatology and sexually transmitted diseases in a tertiary care center in India. All children diagnosed with AD, aged 0–18 years, were recruited, and their clinical and demographic data were recorded.

Results:
In the 62 children having AD, the mean age was 7.7 ± 6.3 years. Majority of children belonged to the age group of 1–5 years. The mean age of onset of AD was 2.3 ± 2.2 years. A personal history of atopy was present in 53.2% of children, whereas 48.3% of children had a family history of atopy. Acute AD was the most common clinical type that was noted in 43.5%. Hyperlinearity of palms, keratosis pilaris, pityriasis alba, and periorbital darkening were found in 59.6%, 33.8%, 24.1%, and 29% of children, respectively.

Conclusion:
The prevalence of AD is low in developing countries like India, but it is slowly rising due to rapidly evolving urbanization and environmental changes. Disease manifestation is usually mild to moderate in Indian patients; hence, vigilant eyes and high clinical suspicion are required for accurate diagnosis and efficient management of AD in Indian settings.