bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative evaluation of the remaining dentin thickness using Solite RS3 and ProTaper Universal retreatment files: A nanocomputed tomography study
Authors: Sairaman Sruthi , Solete Pradeep , Jeevanandan Ganesh , Antony S. Delphine Priscilla , Kavoor Sowmya , Sandeep Adimulapu Hima 
Published: June 2024

Aim:
One of the main goals of instrumentation during retreatment is to preserve the remaining dentin during gutta-percha retrieval. The current study assesses the remaining dentin thickness after retreatment using two different retreatment file systems.

Methods:
Forty extracted single-rooted teeth were obturated and decoronated at a standard root length of 16 mm. Two groups of twenty single-root teeth each were randomly divided from the samples, and Solite RS3 retreatment and ProTaper Universal retreatment (PTUR) files were used for instrumentation, respectively. Pre- and postoperative nanocomputed tomography scans were obtained, and 3D reconstruction was carried out for analysis. The remaining dentin thickness was determined by taking sections of the preoperative and postoperative samples at 7, 5, and 3 mm from the apex. The mean volume of dentin removed was also calculated. The statistical analysis between the two groups was conducted using an independent t-test.

Results:
When compared to PTUR files, Solite RS3 retreatment files demonstrated a significant difference at all three levels: 3, 5, and 7 mm from the apex (P < 0.000). The mean volume of dentin removed was lesser in Solite RS3 files in comparison to PTUR files (P < 0.001).

Conclusion:
Based on the aforementioned findings, we conclude that Solite RS3 preserves more dentin in comparison to the PTUR system.
Alteration of gastric microbiota in Helicobacter pylori-infected individuals suffering from GERD, DU, and gastritis
Authors: Sharma Prateek , Singh Sarika , Singh Aditya V. , Das Kunal , Bhaskar Yogendra , Goel Isha , Singh Harpreet , Das Rajashree 
Published: June 2024

ABSTRACT

Background/Aim:

Helicobacter pylori (H. pylori) colonization affects the gastric microbiome, causing gastrointestinal (GI) diseases. Modern sequencing technology provides insights into GI microbe interaction with H. pylori and their metabolic pathways in causing GI diseases. We aim to compare the gastric microbiota alteration due to H. pylori infection in patients suffering from GI diseases.

Materials and Methods:
Genomic DNA were isolated from gastric antrum tissue from 37 H.pylori-infected patients diagnosed with GERD, duodenal ulcers, and gastritis. We conducted the genomic library preparation and sequencing of the amplified product using 16S rRNA NGS analysis. Using microbiome analyst tool diversity analysis, random forest analysis and ANOVA were conducted to find out the comparison of microbial abundance. We have also conducted functional pathway prediction analysis using PICRUSt.

Results:
Metagenomic analysis shows high bacterial diversity in H. pylori-positive gastritis patients. Streptococcus infantis and Neisseria subflava were significantly higher in duodenal ulcer (DU) and gastritis groups. Acinetobacter lwoffii and Helicobacter pullorum were significantly high in the gastritis group only. The functional metabolic pathway analyses revealed that gastroesophageal reflux disease (GERD) samples were significantly enriched with the energy metabolism and xenobiotic biodegradation and metabolism pathways, whereas fructose-1,6-bisphosphatase III was found less in gastritis and DU groups.

Conclusion:
There is a difference in microbiota composition in different disease outcomes. We found positive association between microbial diversity and H. pylori in gastritis group only, whereas negative association was found in DU and GERD groups. The functional metabolic pathway analysis revealed significant differences in various disease outcomes.
Serum IgG level in autoimmune liver diseases and its significance: Is there a need to revisit existing criteria? Experience from a tertiary care center
Authors: Varadarajan Annapoorani , Rastogi Archana , Maiwall Rakhi , Bihari Chaggan , Thomas Sherin , Shasthry Saggere Muralikrishna 
Published: June 2024

ABSTRACT

Background:
Serum immunoglobulin G (IgG) level is elevated in autoimmune liver diseases (AILDs), especially autoimmune hepatitis (AIH). However, its utility is limited in current practice as different criteria propose different cut-off values leading to considerable ambiguity.

Materials and Methods:
A cross-sectional study was conducted among patients with AILD who underwent a liver biopsy over a ten-year period. From 17644 liver biopsies, 630 patients were included and divided into three groups—AIH (455 patients), primary biliary cholangitis (PBC) (97 patients), and overlap (78 patients). Clinical and laboratory details were collected and histological findings were reviewed. Non-cirrhotic non-alcoholic steatohepatitis (NASH) cases were taken as the control group for IgG level comparison.

Results:
Among AIH patients, IgG values of >2 times the upper limit of normal (ULN) were associated with significant elevation of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, and necroinflammatory activity. IgG level of >1.1 times ULN lacks specificity in differentiating AIH from the control group. The receiver operating characteristic (ROC) curve demonstrates maximum sensitivity and specificity at a cut-off value of >1.3 times ULN.

Conclusion:
Serum IgG cut-off value for diagnosing AIH, either in isolation or as a component of overlap syndrome, needs revision and uniformity. IgG value of >2 times ULN in AIH is associated with severe AIH. A new cut-off value of >1.3 times ULN is proposed.
The curious case of light chain cast nephropathy in a renal allograft recipient
Authors: Choudhury Debarun , Chadha Shiv , Gupta Pallav , Malik Manish 
Published: June 2024

ABSTRACT
Myeloma cast nephropathy in renal allograft recipients without pre-transplant diagnosis of multiple myeloma is rare. A 32-year-old hypertensive male presented to our institute as a prospective renal allograft recipient. Hemoglobin was 10.1 mg/dl. He did not have hypercalcemia, and the albumin/globulin ratio was 1.33. Urinalysis did not show any proteinuria or active sediments. Ultrasonography of the abdomen showed bilateral contracted kidneys. He underwent an uneventful renal transplant surgery and had immediate graft function. After 1 month, he tested positive for severe acute respiratory syndrome coronavirus 2 and developed graft dysfunction. Graft biopsy showed features of myeloma cast nephropathy. He had elevated lambda chains with an involved-to-uninvolved free light chain ratio of >100. Serum immunofixation electrophoresis showed a monoclonal band in the lambda region. Bone marrow biopsy showed plasmacytosis with 18.6% immature plasma cells. He improved on cyclophosphamide, bortezomib, and dexamethasone regimens.
Comparison of Single Dose with Continuous Infusion of 0.2% Ropivacaine in Interscalene Brachial Plexus Nerve Block for Pain Relief in Rotator Cuff Repair Surgery
Authors: Shetty Sanath Kumar , Mehta Meher Pradeep Kumar , Mathias Lawrence John , Shetty Siddharth M. , Kandavar Siri , Ballal Arjun 
Published: June 2024

Background:
Severe postoperative pain is the most common complication after arthroscopic rotator cuff surgery. Peripheral nerve blocks, whether single-shot interscalene block (SSISB) or continuous interscalene nerve block, have consistently demonstrated superior analgesia after upper extremity surgery compared to general anesthesia alone.

Aims:
The aim of this study was to evaluate the difference in pain relief provided by single shot versus catheterized interscalene block.

Materials and Methods:
A prospective observational study was conducted in the Department of Orthopedics of Justice K.S.Hegde Charitable Hospital, Mangalore, from January 2020 to June 2021. Thirty patients who were diagnosed of complete rotator cuff tear were included in the study. All of them underwent arthroscopy-assisted single-row rotator cuff repair by the same surgeon under general anesthesia. They were randomly allocated into Groups I and B of 15 each. Patients in Group A received a SSISB and Group II received continuous infusion after the insertion of catheter. The catheter was removed after 24 h of surgery. Both groups followed the same postoperative management protocol. The pain perception assessment was measured using the Visual Analog Scale (VAS) at 6, 24, 48 h after surgery, and at 2nd week postoperative during suture removal. Power was assessed for the wrist (wrist flexion and extension) and for the fingers (finger flexion and abduction) at 6 h, 24 h, 48 h, and after 2 weeks on day 14 when suture removal was done. The results were calculated and tabulated using an independent “t-test” and “Chi-square test.”

Results:
The patients in Group A had a higher VAS score with a mean of 0.26 ± 0.06 as compared to Group B which showed a mean VAS score of 0 (P = 0.01). Six patients needed analgesia of postoperative day 2. Eight patients of Group B required rescue analgesia on postoperative day 2.

Conclusion:
Continuous infusion scalene block was noted to be superior to SSISB in the management of postoperative pain postarthroscopy assisted single-row rotator cuff repair.
Evaluation of Proprotein Convertase Subtilisin/Kexin Type 9 in Patients with Acute Coronary Syndrome: An Observational Study
Authors: Sanober Arshi , Noorjahan M , Kumari J Ashwini , Satish Oruganti Sai , Sreedevi N N , Bhaskar M Vijaya , Kompella Sai Baba S S , Khan Siraj Ahmed 
Published: June 2024

Background:
Proprotein convertase subtilisin kexin/type 9 (PCSK9) plays a pivotal role in low-density lipoprotein cholesterol (LDL-C) metabolism, by decreasing the clearance of LDL-C by promoting the degradation of the LDL receptor and prevents it from recycling to the membrane. Thus, in this study, we aim to assess the serum PCSK9 levels in patients of acute coronary syndrome (ACS) and to evaluate its association with the severity of coronary artery disease based on angiographic findings.

Materials and Methods:
A cross-sectional case–control study comprised 60 cases and 30 age- and sex-matched healthy controls. Sixty cases were divided into groups depending on the number of vessels involved based on coronary angiogram; Group 1 (single vessel) – 20, Group 2 (double vessel) – 20, and Group 3 (triple vessel) – 20. The serum PCSK9 levels were assessed using the sandwich enzyme-linked immunosorbent assay.

Results:
The mean concentrations of PCSK9 in single-vessel disease (SVD), double-vessel disease (DVD), and triple-vessel disease (TVD) were 153 mg/ml, 214.5 mg/ml, and 290 mg/ml, respectively, whereas, in controls, it was 133 mg/dl. The serum PCSK9 levels were significantly higher in cases compared to controls (P < 0.0001). There was a significant difference in serum PCSK9 when compared between various groups (controls vs. DVD, controls vs. TVD) (P = < 0.0001), except controls versus SVD which was not statistically significant (P = 0.113).

Conclusion:
The levels of serum PCSK9 were high in cases compared to healthy controls and were positively associated with the disease severity. Hence, it can be used as a marker in assessing the disease severity in ACS patients with coronary angiography.
Cardiovascular Risk Assessment and Utilization of Pharmacological Agents for the Management of Cardiovascular Disease Risk among Diabetic Patients with Variable Risk Profiles
Authors: Deb Pooja , Mohanty Ipseeta Ray , Rai Sandeep 
Published: June 2024

ABSTRACT

Background and Aims:
The adverse cardiovascular disease (CVD) outcomes in diabetes mellitus can largely be prevented by using effective utilization of CVD risk-modifying medications such as oral hypoglycemic agents (OHAs), anti-hypertensives, anti-platelets, and hypolipidemics. Results of the study will aid in planning appropriate preventive measures to decrease morbidity and mortality from cardiovascular events with the help of CVD risk classification and analysis of CVD risk modification medications prescribed among diabetic patients of various risk categories.

Materials and Methods:
Two hundred and twenty people with Type 2 diabetes who matched the inclusion and exclusion criteria for the study were enrolled after giving their consent. The stratification of CVD risk using the World Health Organization/International Society of Hypertension CVD risk prediction tables was done to possibly prevent CVD. A case record form was presented to these patients, which contained details about their medical treatment, patient profile, and CVD risk factors.

Results:
The percentage of diabetic individuals with low CVD risk was 64.5%, medium CVD risk was 17.7%, high CVD risk was 6.4%, and extremely high-risk CVD risk was 11.4%. Aside from antidiabetic medicines, the analysis indicated that 72% of patients in the extremely high-risk group were administered anti-hypertensive drugs, 60% were on concomitant antiplatelet drugs, and 64% were prescribed hypolipidemic drugs for cardiovascular risk reduction.

Conclusion:
It is desirable to increase the usage of CVD risk-modifying medications, especially antiplatelet and hypolipidemic medications, in Type 2 diabetes patients with a high CVD risk.
Epidemic of Coronary Artery Disease in Young Indians: Comparative Study of Lipid Indices in Children of Patients with and without Premature Coronary Artery Disease
Authors: Shetty Laxmi H , Reddy Vijay Kumar J , Patil Rahul S , Jayaprakash Shilpa , Sheethal K C , Manjunath Cholenahally N 
Published: June 2024

Aims and Objectives:
The aim is to study the role of routine and advanced lipids in predicting the premature coronary artery disease (PCAD) risk in children of patients who have presented with PCAD.

Subjects and Methods:
Our study enrolled 193 children (of PCAD patients-as cases) and 193 children of healthy adults as controls after satisfying the inclusion and exclusion criteria. Both groups had children aged between 4 and 21 years and were age-matched. Fasting samples were drawn for conventional lipid profile, lip (a), small dense low-density lipoprotein (SD LDL), Apolipoprotein-A1 (Apo A1), and Apolipoprotein-B (Apo B). Furthermore, lipid indices such as lipid pentad index (LPI), lipid tetrad index, atherogenic index, and lipid ratios such as Apo B/Apo A1, total cholesterol/high-density lipoprotein (TC/HDL), and HDL/LDL ratio were calculated.

Results:
The group had 51.8% males and 48.2% females. Body mass index was normal in the study group, but reached statistical significance in cases (19.2 ± 3.27 vs. 17.6 ± 2.98; P = 0.01). History of smoking, either active or passive, and gender had a neutral effect on the lipid parameters. The levels of TC, LDL-C, non-HDL, triglycerides, non-HDL, very LDL, Lip (a), and Apo-B were higher and reached statistical significance in cases and the levels of HDL-C and Apo A-I were low in cases. The LDL-C/HDL-C ratio (2.99 ± 1.31 vs. 2.3 ± 0.74; P < 0.001) and TC/HDL-C ratio (5.35 ± 3.2 vs. 4.0 ± 1.01; P < 0.001) was higher in cases. In addition, the LDL-C/HDL-C ratio and LPI were found to be a better predictors of PCAD.

Conclusions:
Children of PCAD patients were noted to have a higher association of dyslipidemia when compared to controls. Conventional lipids and Lip (a) were high whereas Apo A-I levels were found to be low when compared to controls. SD LDL, LDL/HDL ratio, and LPI can be used as screening tests to predict the occurrence of premature CAD. Therefore, these children should undergo screening for the presence of dyslipidemia. Thereby measures for a healthy life can be initiated early.
Quality of Life among Myocardial Infarction Patients Attending a Tertiary Care Center in Puducherry, South India
Authors: Sahanaa Chandar , Purty Anil Jacob , Prabakaran Stalin , Arokiaraj Mark Christopher , Manjunatha Chalawadi H 
Published: June 2024

Background:
Coronary artery disease (CAD) is a major cause of mortality and morbidity worldwide. The prevalence of CAD in India is estimated to vary from 2% to 4%. Quality of life (QOL) is an essential component in the assessment and follow-up of CAD patients. The QOL of acute myocardial infarction (MI) survivors improves over time. This study aims to assess the QOL of MI and also find the association between clinico-epidemiological factors and QOL among MI patients attending a tertiary care center.

Materials and Methods:
This study was a hospital-based cross-sectional study. The study participants include patients attending cardiology outpatient department, who have had MI in the past, i.e. between 3 months and 3 years. The study was conducted between January 2018 and December 2019. The study recruited 330 study participants. The patient’s perspective on QOL post-MI was collected using a short form 36 questionnaire. The data analysis was performed using SPSS software version 24.0.

Results:
The maximum number of participants was 51–60 years of age, and the majority were men. More than 93% underwent invasive procedures such as angioplasty, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft, whereas 6.8% of the participants were medically managed. The physical functioning and energy components had a median score of 70 and 57.5, respectively. Increasing age has a significant association with QOL. The QOL scores in the domains of physical functioning (P = 0.003), physical role (P = 0.017), general health (P = 0.005), energy (P = 0.001), and social functioning (P = 0.047) decrease as age advances. The QOL score was greater in the study participants 1–2 years post-MI (65–100 across all domains), whereas the scores were less in the 3 months to 1 year period (0–64 across all domains) and the 2–3 year period (60–87 across all domains).

Conclusion:
Quality of life scores had improved, were estimated in one year post myocardial infarction patients.
Assessment of Willingness and Ability of Doctors to Manage Tobacco Abuse
Authors: Khan Abdul Allam , Jain Peeyush 
Published: June 2024

ABSTRACT

Background:
Tobacco is a major concern in the field of public health which is a contributor to high morbidity and mortality. In the year 2017, tobacco usage caused 7.1 million deaths worldwide, and it has rightfully claimed the word silent pandemic.

Main body:
The research was based on a questionnaire form filled out by 412 doctors belonging to varied age groups and clinical specialties. Doctors were not only asking their patients about tobacco usage but also 83% of them advised their patients to quit or at least cut down tobacco use. Based on the survey report of our questionnaire, we are reassured that most doctors are aware of the public health implication of tobacco users although a very small number prescribes pharmacotherapy for tobacco cessation.

Conclusion:
This silent pandemic needs to be acknowledged and doctors need to be better equipped in their skills to help the patients quit using tobacco.
Applications of Ultrasonography in Limb Lengthening and Reconstruction
Authors: Munger Alana M. , Amick Michael , Frumberg David B. 
Published: June 2024

Introduction:
Ultrasound technology offers multiple benefits including cost-effectiveness, portability, and lack of radiation. It allows for a wide range of diagnostic and therapeutic applications to the musculoskeletal health. We examined the utility of ultrasound in the field of limb lengthening and reconstruction (LLR), believing that this technology’s ability to improve surgical safety and improve diagnostic accuracy has a large potential to improve patient outcomes and satisfaction.

Methods:
A literature review was performed to determine the musculoskeletal applications of ultrasound that could be applied to LLR. In addition, four cases are presented to highlight the examples of diagnostic and therapeutic functions of ultrasonography in LLR.

Results:
Many widely accepted uses of ultrasonography for musculoskeletal pathologies have diagnostic and therapeutic utility in LLR. Diagnostic purposes include the evaluation of vascularity and assessment of regenerate bone quality, size, and shape. Therapeutic benefits include localization of anatomic structures, enhancing bone formation with the use of low-intensity pulsed ultrasound bone stimulation, and assisting percutaneous procedures including injections, biopsies, and drilling for nonunion/docking.

Conclusions:
Ultrasound can be effectively utilized for both diagnostic and therapeutic purposes in LLR. Its portability and cost-effectiveness pose a great asset to those practitioners who are trained in the techniques to utilize the technology properly. The ability to use a radiation-free modality is attractive as a means to improve the safety profile of treatment, as there is often a high radiation burden for these patients. More research is required to determine the reliability of this technology in its applications for LLR.
New Minimal-Invasive Technique for Cosmetic Treatment of Pin Site Scars after Removal of External Fixations
Authors: Laymouna Khaled , Hammouda Ahmed I. , Elbatrawy Yasser , Artemiev Alexander 
Published: June 2024

Introduction:
Scars and dimpled skin appearance is a common complaint in patients undergoing surgery using external fixators. Former studies described different methods to manage these scars. In current study, we demonstrate in details a new surgical technique to release the scars.

Patients and Methods:
Twenty-five females (mean age of 28 years) underwent cosmetic lower limb (16 Femurs and 34 tibias) lengthening or deformity correction using circular hybrid Ilizarov frame.

Results:
Time interval between frame removal and surgical release using the technique was 30 days. Average number of scars released using the technique was 382 (144 femur scars and 238 tibia scars). Two and half minutes is the average time for the whole procedure. Immediate scar release and disappearance of dimples was the result in all patients. This maintained for the whole time of follow-up after the procedure.

Conclusion:
This surgical technique is a quick, easy, efficient, and cost-effective while managing scar dimpling after using external fixator elements.