bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Value of CEUS LI-RADS combined with AFP in early diagnosis of hepatocellular carcinoma in low- and high-risk patients
Authors: Wu Yafei , Chen Yuanyuan , Wei Lili , Ding Zhanling , Zhao Shengfa , Bao Shengxian , Tang Jiali , Li Hang , Liu Junjie , Zhu Shangyong 
Published: July 2024

ABSTRACT

Background:
We found that the occurrence of hepatocellular carcinoma (HCC) has increased significantly in non-cirrhotic individuals, with HCC being frequently overlooked or misdiagnosed. Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is known to have a high diagnostic quality in high-risk HCC patients. Therefore, we aimed to compare the detection accuracy of CEUS LI-RADS for HCC between low- and high-risk individuals, to confirm its value in low-risk patients at increased risk of HCC, but not yet included in the high-risk groups of LI-RADS. In addition, since CEUS LR-4 and LR-M categories contain a relatively high proportion of HCC, and serum alpha-fetoprotein (AFP) is the most commonly used biomarker for HCC, and the clinically valid, we attempted to further improve the early diagnostic capability of CEUS LI-RADS for HCC in the low-risk and high-risk patients by combining CEUS LR-4 and LR-M categories with AFP.

Methods:
We defined high-risk groups (HR)-included in the high-risk patients of LI-RADS, low-risk groups (LR)-not included in the high-risk patients of LI-RADS and enrolled 189 HCC patients with LR and HR settings in a retrospective study. All lesions were confirmed histopathologically. The CEUS LI-RADS accuracy for detecting HCC in these two patients was compared. In addition, the diagnostic algorithm in our study was proposed (for CEUS LR-4 and LR-M patients with AFP>20 ng/ml). we analyzed the ability of CEUS LI-RADS as a valid method of establishing the early diagnosis of HCC in LR and HR patients by combining LR-4 and LR-M categories with AFP.

Results:
Through comparative analysis, the specificity of the CEUS LR-5 category for HCC in the HR group was 78.4%, whereas in the LR group, it was 94.2%. Meanwhile, the sensitivity (63.2% vs. 63.0%) and positive predictive value (PPV) (75.0% vs. 88.7%) did not differ between the LR and HR groups (P = 0.990, P = 0.299). It is noteworthy that there were the high proportion of HCC in CEUS LR-4 and LR-M categories in our cases and when we combined CEUS LR-4 and LR-M categories with AFP significantly improved the sensitivity by 21.0% (84.2%) in the LR group, and by 16.0% (79.0%) in the HR group, with statistically difference in sensitivity after combination in the HR group (P = 0.014).

Conclusions:
The CEUS LR-5 category has real meaningful utility in the diagnosis of HCC in both LR and HR patients. The early detection power of the CEUS LI-RADS category for HCC patients was further increased when the CEUS LR-4 and LR-M categories were combined with elevated AFP.
The Efficacy of the Combination of Microneedling with Jessner’s Plus 35% Trichloroacetic Acid Peel versus the Efficacy of the Combination of Microneedling with Platelet-rich Plasma Therapy for the Treatment of Atrophic Acne Scars: A Comparative Study
Authors: Deepika Meda , Chittla Sravan , Swetha Donakonda , Dheeraj Sathaiahgari , Sougandhika Bandaru 
Published: July 2024

Background:
Acne is a common skin condition that is prevalent in 90% of the adolescent population. Inflammatory lesions of acne may lead to scarring. Various treatment modalities such as subcision, punch excision, chemical peels, microdermabrasion, and fractional lasers have been tried for acne scars but with unsatisfactory results.

Purpose:
The aim of the present study is to compare the efficacy of microneedling with Jessner’s plus 35% trichloroacetic acid (TCA) peel versus the efficacy of microneedling with platelet-rich plasma (PRP) therapy for the management of atrophic acne scars.

Methods:
Sixty patients having atrophic scars due to acne were segregated into two groups each containing 30 patients. On Group A, patients microneedling was performed at weeks 0, 6, and 12 and Jessner’s plus 35% TCA peel was performed at weeks 3, 9, and 15. On Group B, patients microneedling and intradermal PRP were performed sequentially at weeks 0, 3, and 6. Patients were followed at the outset of the procedure and 24 weeks after the procedure using the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA) score.

Results:
The difference in the mean ECCA score at the outset of the procedure and 24 weeks after the procedure was more in Group B as compared to Group A (47.8 ± 13.6 vs. 39.1 ± 11.4).

Conclusion:
The efficacy of the combination of microneedling with PRP was higher than the combination of microneedling with Jessner’s plus 35%TCA peel for the treatment of atrophic acne scars.
Utility of Hyaluronidase in Combination with Triamcinolone Acetonide and 5-Fluorouracil in Treatment of Hypertrophic Scars and Keloids: A Comparative Study
Authors: Bhangdiya Divya , Dhurat Rachita , Sharma Richa , Shah Bhavika , Shinde Geeta 
Published: July 2024

Background:
Keloids and hypertrophic scars are a commonly encountered problem in dermatology. There are many treatment modalities available with variable efficacy and recurrences. This study highlights the use of hyaluronidase with triamcinolone acetonide (TAC) and 5-fluorouracil (5-FU).

Purpose:
To assess the utility of hyaluronidase in combination with TAC and 5-FU in treatment of hypertrophic scars and keloids.

Methods:
In this study a combination of hyaluronidase along with TAC and 5-FU was given in one part and a combination of TAC and 5-FU was given in another half of same hypertrophic scar/keloid keeping 1cm gap in between the two untreated at 4 weekly interval for 24 weeks. Results were assessed by measuring height, volume of lesion and their percentage decrease. Also, pliability, vascularity, pigmentation of lesion and Vancouver scar assessment scale score were assessed. Side effects like ulceration, surrounding skin atrophy and telangiectasias were noted.

Results:
There was a reduction in all the parameters in both the treatment segments. Faster improvement in height, volume, pliability, vascularity, pigmentation, and Vancouver scar assessment scale score was noted with combination of hyaluronidase, TAC, and 5-FU compared to TAC and 5-FU alone. Side effect profile of ulceration, surrounding skin atrophy and telangiectasias was comparable in both the segments.

Conclusion:
Combination of hyaluronidase along with TAC and 5-FU offered a better outcome and faster response when compared to combination of TAC and 5-FU.
Tildrakizumab in Psoriasis and Beyond
Authors: Bubna Aditya K. , Patil Nitin 
Published: July 2024

Background:
Tildrakizumab is an interleukin-23p19 inhibitor, approved by the Food and Drug Administration for the management of moderate-to-severe plaque psoriasis.

Purpose:
This review aims to describe the dermatological implications and applications of tildrakizumab.

Methods:
PubMed and Google Scholar were searched for scholarly articles related to tildrakizumab and its utility in dermatology using the search terms “Tildrakizumab” AND “Psoriasis” AND “other dermatological disorders.”

Results:
Tildrakizumab is a valuable biologic agent for the management of psoriasis. It has also been successfully used for other dermatologic disorders such as hidradenitis suppurativa, lichen planus, pityriasis rubra pilaris, lupus erythematosus tumidus, and pyoderma gangrenosum.

Conclusion:
Tildrakizumab’s usage is not limited to psoriasis. Its benefit extends to many more dermatologic conditions. Besides, it has an acceptable safety profile.
Outcomes in Older Inpatients with Hyperkalemia: A Follow-up Observational Study
Authors: Ramesh Bharathi , Felix Reuben Jerrald , Viggeswarpu Surekha , Belavendra Antonisamy 
Published: July 2024

Abstract

Objectives:
Hyperkalemia is a common electrolyte disturbance encountered in hospitalized older patients secondary to age-related physiological changes in the kidneys, multiple comorbidities, and the burden of multiple medication usage. Metabolic acidosis, rhabdomyolysis, and tumor lysis syndrome cause the shift of potassium into the extracellular space. This contributes to hyperkalemia. This study aims to determine the outcomes in patients with hyperkalemia admitted to a tertiary care center and to list the factors contributing to the development of hyperkalemia in these patients.

Methods:
This was a prospective observational study conducted among older inpatients (≥60 years of age) admitted to the geriatric and medical wards in a tertiary care hospital. The patients with hyperkalemia were followed up till discharge or death.

Results:
Among the 225 study participants who presented with hyperkalemia, the mortality rate was found to be 22.2%. In the multivariate analysis, older people aged more than 70 years (P = 0.007) and those who were male had a significantly higher mortality (P = 0.009). The use of angiotensin-converting enzyme inhibitors (ACEIs) (P = 0.049) and beta-blockers (P = 0.02) was significantly associated with the development of hyperkalemia.

Conclusions:
ACEIs and beta-blockers increased the risk of developing hyperkalemia in the study population. Hyperkalemia was found to be associated with an increase in mortality, especially in the very old (>70 years) and in males.
Frailty and Associated Factors in the Elderly: A Cross-sectional Study from a Tertiary Care Hospital of Northeast India
Authors: Modi Tanmoy , Devi Th. Shanti , Deb Abhik , Das Abhijit , Majumder Abhishek Paul 
Published: July 2024

Abstract

Background:
Despite the unfavorable impact of frailty on the health of the elderly, research on frailty in Northeast India remains scarce. This study aimed to assess the prevalence of frailty among elderly inpatients and identify associated factors.

Subjects and Methods:
This cross-sectional study was conducted among 200 elderly (above 60 years of age) inpatients at a tertiary care hospital. A semistructured pro forma was used to collect data on sociodemographic details and other laboratory parameters. The Fried frailty phenotype was used to assess frailty. Quantitative data were presented as means ± standard deviation, whereas qualitative data were presented as frequency and percentages. The Chi-square/Fisher’s exact test was applied to determine the association, and P < 0.05 was considered statistically significant.

Results:
The majority of the study participants were male, <70 years, and had a caretaker at home. The proportion of frail among the hospitalized elderly was 50% (95% confidence interval = 42.87%–57.13%). The rest 49.5% were categorized as robust and 0.5% were categorized as prefrail. Frailty was significantly associated with increased age, status of presence of caretaker, addiction, and higher body mass index. Comorbidities such as hypertension, chronic kidney disease, stroke, anemia, diabetes, chronic pulmonary disease, ischemic heart disease, and malignancy were also significantly associated.

Conclusions:
Frailty is a significant concern among hospitalized elderly individuals. Further research is needed to identify effective interventions to alleviate its impact. Community-level studies should elucidate the relationship between modifiable risk factors and frailty, aiming to enhance the quality of life for our aging population.
Fever in Older Persons
Authors: Maini Aseem , Singh Amanpreet , Kaur Baldeep , Goel Ashish 
Published: July 2024

Abstract
Fever in older adults poses unique challenges due to atypical symptoms, weakened immune responses, and comorbidities. This chapter explores the diverse presentations of fever in the elderly, emphasizing the importance of vigilant monitoring and tailored interventions by healthcare providers and caregivers. Challenges in temperature measurement, communication barriers, and polypharmacy further complicate fever management. The chapter discusses the differences between fever presentations in young and older individuals and addresses the complexities of managing fever in long-term care facilities. In addition, it highlights fever of unknown origin in older persons, stressing the need for timely diagnosis and tailored investigations. Finally, preventive strategies, including vaccination campaigns and infection control measures, are proposed to mitigate fever occurrences in older adults.
Inferior alveolar nerve block anesthesia in children: The effect of ibuprofen and phentolamine mesylate on pain perception
Authors: Nayak Ullal Anand , Ramasamy Saravanan , Marusamy Kavitha Odathurai , Nayak Prathibha Anand , Vanka Amit 
Published: July 2024

ABSTRACT

Context:
For successfully managing pediatric dental patients, local anesthesia is essential to eliminate pain during or after the operative period. An early recovery from soft-tissue anesthesia after an inferior alveolar nerve block (IANB) should benefit a young child patient by avoiding the risk of inadvertently biting the soft tissues.

Aims:
Hence, the purpose of the study was to (1) evaluate and compare the efficacy of pre- and postoperative ibuprofen on pain perception in children who undergo IANB anesthesia with or without the use of PM and (2) evaluate the average time required for reversal of anesthesia symptoms using phentolamine mesylate.

Methods:
The present study was a randomized, clinical trial performed among 60 children between 6 and 8 years of age using a convenient sampling method. The children were randomly assigned into four equal groups of 15 each using the computer-generated randomization sequence. IANB anesthesia was performed using 2% lignocaine with 1:100,000 epinephrine, and a mandibular primary molar pulpotomy was performed on each group. Group 1: the ibuprofen tablet was taken 1 h before the onset of the procedure. Group 2: ibuprofen tablet 30 min after the pulpotomy procedure. Group 3: the ibuprofen tablet was taken 1 h before the onset of the procedure, and the Phentolamine mesylate (PM) injection was administered. Group 4: immediately after the pulpotomy, the PM injection was administered, and an ibuprofen tablet was taken 30 min after the pulpotomy procedure. All children were assessed for the duration of soft-tissue anesthesia, their behavior scores and pain rating, as well as the incidence of postoperative self-inflicted injuries.

Statistical Analysis Used:
A one-way ANOVA was used to compare the average time needed for the reversal of anesthetic symptoms between groups. The effects of phentolamine, local anesthetics, and ibuprofen on the child’s behavior and pain scores were compared using the Student’s t-test. For the study, P < 0.05 was accepted as statistically significant.

Results:
The time needed for the full reversal of anesthetic symptoms to manifest on the tongue and lip was substantially reduced by the injection of phentolamine (P < 0.001). The use of phentolamine for reversal or the intake of ibuprofen pre- or postoperatively did not exhibit any significant variation in the behavior, pain experience, or incidence of self-inflicted injuries in the child.

Conclusion:
It is evident that although phentolamine injections shorten the duration of anesthesia, the adjunctive use of pre- or postoperative ibuprofen did not significantly alter pain scores.
Custom-made versus prefabricated zirconia crowns for primary molars: A 12-month follow-up
Authors: Alassar Roqia Mohammad , Metwally Noha Ibrahim , Abdelgawad Asmaa Mohammad , Elsherbeny Selwan Hassan , Mohamed Eman Abdelraouf 
Published: July 2024

ABSTRACT

Background:
Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely decayed primary molars. The objective of this study was to compare the periodontal health and clinical performance of primary molars restored with custom-made zirconia crowns (CZCs) and prefabricated zirconia crowns.

Methods:
Twenty primary molars indicated for crown restorations were selected from ten patients (5–9 years old) randomly. Each patient received two pediatric zirconia crowns constructed by two different methods: one custom-made and one prefabricated. The primary molars were divided into two groups: Group 1: primary molars received CZCs and Group 2: primary molars received prefabricated zirconia crowns (PZCs).

Results:
After a 12-month follow-up, there was no statistically significant difference between the periodontal health of primary molars restored with custom-made and prefabricated zirconia crowns. The clinical performance of primary molars restored with CZCs was statistically significantly higher than those restored with PZCs in terms of retention and fracture resistance (P ≤ 0.05).

Conclusions:
The construction method of pediatric zirconia crowns does not significantly affect the periodontal health of primary molars; however, clinical performance is significantly affected in terms of retention and fracture resistance.

Clinical Significance:
A CZC is an excellent alternative option, especially for primary molars whose permanent successors still have a long time to erupt. The PZC is a quick and easy restoration, but the technique is sensitive.
Comparative evaluation of the efficacy of the Pro AF Baby Gold and Kedo-S pediatric endodontic files for canal instrumentation, transportation, and centering ratio – A systematic review and meta-analysis
Authors: Shroff Yashshwini , Dutta Brahmananda N. , Verma Rajnish Kumar , Sharma Varsha 
Published: July 2024

ABSTRACT

Background:
Traditionally, pediatric endodontics lacked access to the full potential of rotary instruments. These instruments, designed for the permanent root canal system, often presented limitations when used in primary teeth. To address this, exclusive pediatric rotary files with regular improvements have been introduced, featuring superior cutting efficiency with a focus on precise alignment. This design offers the advantage of reduced risk of ledges, perforations, instrument separation, and canal transportation. This study aimed to compare and evaluate the effectiveness of Pro AF Baby Gold and Kedo-S rotary files in preparing primary tooth root canals during pulpectomy procedures through a meta-analysis.

Methodology:
The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The review searched electronic databases from 2000 to February 2024 for studies evaluating the efficacy of Pro AF Baby Gold and Kedo-S files in terms of canal instrumentation, transportation, and centering ratio. The Cochrane risk of bias (ROB)-2 tool assessed quality, with analyses conducted using RevMan software version 5.3. The standardized mean difference (SMD) served as the summary with a random effects model (P < 0.05).

Results:
Out of the five studies identified through the eligibility criteria, three were deemed suitable for a meta-analysis, while all five were included in a qualitative synthesis. The quality assessment revealed a presence of moderate-to-low ROB. The pooled analysis using SMD did not show any statistically significant differences between the files, except for the centering ratio in the mesiobuccal canal, where the Kedo-S file performed slightly better. In addition, the absence of any significant asymmetry in the funnel plot suggests that there is likely no publication bias present in the data.

Conclusion:
Pro AF Baby Gold files can be used as an alternative adjunct in pediatric endodontics to Kedo-S files and manual files.

Prospero Registration: CRD42023469406.
A comparative evaluation of the efficiency of warm local anesthetic solution delivered on precooled injection sites with the conventional local anesthetic technique in 7–9-year-old children: A randomized split-mouth cross-over trial
Authors: Chittora Megha , Rao Dinesh , Panwar Sunil , Samaddar Krittika , Remi R. V. 
Published: July 2024

ABSTRACT

Background:
Both precooling the site and injecting a warm anesthetic solution have proven to be efficient in reducing pain individually. However, there is insufficient data on evaluating the efficiency of precooling the site of injection along with the simultaneous administration of a warm local anesthetic solution on the same site in a single patient.

Aim:
The aim of this study was to evaluate and compare the efficacy, pain perception, hemodynamic changes, and adverse effects of a warm local anesthetic solution injected on precooled injection sites using 2% lignocaine with the conventional local anesthetic technique during inferior alveolar nerve block in 7–9-year-old children.

Methods:
A split-mouth, double-blinded, randomized clinical trial was conducted on 70 children who received 2% lignocaine with either technique A or B during the first or second appointment of the treatment procedure. The pain perception, anesthetic efficacy, pulse rate, oxygen saturation levels, and adverse events were evaluated.

Results:
Pain during injection and treatment after administration of the warm local anesthesia (LA) technique was less as compared to the conventional block technique. Anesthetic success was observed with a faster onset of action (212.57 ± 32.51 s) and shorter duration of LA (165.16 ± 33.09 min) in the warm local technique as compared to the conventional technique. No significant differences were found with regard to heart rate and oxygen saturation levels between the two techniques. Administrating warm LA solutions at precooled injection sites revealed fewer adverse events.

Conclusion:
Injecting warm LA solution on precooled injection sites causes less discomfort and anxiety in children, which makes it more suitable for the child as well as the pediatric dentist.
Impact of Knack Manoeuvre Among Women with Urinary Incontinence: A Quasi Experimental Study
Authors: Jagadeeswari J , Kalabarathi S. , Bhuvaneswari G. 
Published: July 2024

ABSTRACT

Objective:
The Objective of the study is to assess the effectiveness of Knack manoeuvre among women with urinary incontinence.

Methods:
A quasi-experimental study with a repeated measures design was used to conduct study at Saveetha Medical College Hospital. Experimental group received Knack manoeuvre for 6 months and control group received routine care. The sample size was 100, which was recruited by purposive sampling technique. The data were collected with structured questionnaire, and questionnaire for urinary incontinence diagnosis and biophysiological parameters were assessed by abdominal leak peak pressure (ALPP).

Results:
The study results depict that frequency and percentage distribution of pretest and post-test level of ALPP. Between group comparison of post-test at 6 months of control and experimental showed significance (P < 0.001). There was a progressive decrease in ALPP of control and experimental groups.

Conclusion:
To our knowledge, this is the first prospective nonrandomized study that assesses the efficacy of the Knack manoeuvre on urine incontinence by assessing biophysiological parameters.