bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostics for Tuberculosis
Authors: Kambli Priti , Rodrigues Camilla 
Published: June 2024

Abstract
Accurate diagnosis and treatment of Tuberculosis (TB) continues to elude us. To overcome this, detection of Mycobacterium tuberculosis (MTB) and testing for drug resistance is of paramount importance. Globally, only one in three patients are bacteriologically confirmed and just one in five is diagnosed with a WHO endorsed molecular test, emphasising that diagnostic gaps continue to preclude patients from accessing care. Therefore, it is essential that newer and affordable technologies for the detection of MTB in low and middle income countries (LMICs) reach that last mile. In this review we discuss various recent technologies for detection of active TB disease, that have the possibility of being considered, or are already WHO endorsed.
A Cross-sectional Study on Body Image Dissatisfaction, Depression, Anxiety and Stress among Medical Students and Interns
Authors: Sindhu B. M. , Rashmi B. M. , Kumbar Abhinandan S. 
Published: June 2024

Abstract

Background:
Body image dissatisfaction is hypothesized to be associated with depression, anxiety, psychological distress and low self-esteem. This study was conducted to assess body image concerns and weight control behaviors and the associations of body image concerns with depression, anxiety and stress among medical students in Central Karnataka.

Methodology:
A cross-sectional study among medical students was conducted at Basaveshwara Medical College and Hospital, Chitradurga. Each participant was asked to self-select the silhouette that best indicated his or her current body size and the silhouette that reflects his or her preferred ideal body size, from Stunkard Figure Rating Scale. Body Shape Questionnaire (to assess body shape concern) and Depression, Anxiety and Stress Scale-21 instrument (to assess depression, anxiety and stress) were utilized.

Results:
66.9% students had normal body mass index. 74.6% students desired to change current weight, which was mainly influenced by family members, media icons and friends (47.9%, 40.8% and 31.7%). 42.3% reported that they did physical activity/exercises, 35.2% followed diet to control their weight. Higher proportions for depression, anxiety and stress were noted among those students who had body image misconception.

Conclusions and recommendations:
Counseling and if required treatment by psychologists and psychiatrists would be recommended to address wrong thoughts towards the ideal body image among college students and associated depression, anxiety, stress. Nutritional health education can be given about the importance of a healthy diet and provide free nutritional consultations and counseling.
Current and Future Impact of COVID-19 Pandemic Lockdowns on the Confidence Level of Clinical Practice among Female Dental Students in Namakkal District – A Cross-sectional Study
Authors: Sundararajan Shanmathi , Shavi Girish R. , Shanmugam Shankar , Gunasekaran Lalithambigai , Sennan SenthilKumar 
Published: June 2024

Abstract

Introduction:
Coronavirus has influenced the health-care system and human life in several aspects. Education being an important factor has decreased the level of interest and confidence among the students.

Objective:
The objective of this study was to assess the impact of the COVID pandemic on the self-confidence level of clinical practice.

Materials and Methods:
A cross-sectional study was conducted among 120 female dental students in the Namakkal district. Students were selected using a simple random sampling lottery method. Their level of self-confidence was assessed using a pretested questionnaire framed in all specialties regarding clinical work. The questionnaire was distributed via Google Forms and evaluated using a five-point Likert scale.

Results:
Among 120 students, a higher level of confidence was seen in endodontic procedures followed by periodontics. A lower level of confidence was seen in managing dental emergencies and procedures such as pulpotomy/pulpectomy and extractions. Only 24% were confident in class I cavity preparation, 30% in instructing patients about oral hygiene, 13% in recording case history, and 6.7% in fluoride application. Most of the students wish to improve their level of confidence through extra training because only 20% were satisfied with their self-confidence.

Conclusion:
In the field of dentistry, contact with clinical practice has been severely affected, and it is understood that online educational platforms can only improve the theoretical part and have lower performance in clinical education.
Glycated hemoglobin as a predictive factor for postoperative outcome in controlled versus uncontrolled diabetic patients with ankle fractures
Authors: Zakaria Ahmed R. , Hussein Abdalla R. , Abouzied Mahmoud 
Published: June 2024

Background
Ankle fracture in diabetic patients is a challenging condition owing to the inherent risk of complications with either operative or nonoperative treatment. However, operative treatment is considered the gold standard treatment for such cases. In this study, the hypothesis is that the glycated hemoglobin (HbA1c) could have a predictive value for postoperative outcomes and complications.

Patients and methods
A total of 34 diabetic patients with ankle fractures were included in this study. The patients are divided into two groups: the first group included patients with controlled diabetes (HbA1c<7) and the second group included patients with uncontrolled diabetes (HbA1c≥7). All patients were treated by standard open reduction and internal fixation.

Results
The complications rate was higher in the uncontrolled diabetes group (63.2%) than in the controlled diabetes group (26.6%). Preoperative HbA1c was higher in complicated patients than in uncomplicated patients (P=0.033), and postoperative HbA1c was also higher in complicated patients than in uncomplicated patients (P=0.031). The postoperative American Orthopedic Foot and Ankle Society (AOFAS) score was significantly higher in the controlled diabetes group than in the uncontrolled diabetes group (P=0.046).

Conclusion
The overall rate of complications was higher in the uncontrolled diabetes group (HbA1c≥7) than in the controlled diabetes group (HbA1c<7), with a statistically significant difference. These complications were mainly related to wound healing. Despite being statistically insignificant, poor radiological outcome was more common in the uncontrolled diabetes group. According to the postoperative AOFAS score, clinical outcome was more superior in the controlled diabetes group than in the uncontrolled diabetes group.
Single-level interbody fusion in treatment of lumbar fractures
Authors: Abdelrady Abdelrady M. , El Zahlawy Hany , Ibrahim Mohammed Z. 
Published: June 2024

Background
The purpose of this study was to evaluate the effectiveness of treating lumbar fractures by performing instrumented interbody fusion with the adjacent vertebra.

Patients
and methods In a prospective study, 69 consecutive patients with lumbar fractures were treated by single-level interbody fusion. The fractures involving either the superior or inferior endplate with intact pedicles were included.

Results
The follow-up period was between 24 and 37 months, with a mean of 28.3 months. The mean preoperative local kyphosis was 10.39° and anterior vertebral height loss was 50.55%. In the final follow-up, they were 2.98° and 16.78%, with a statistically significant difference. On Denis scale for back pain, six patients were P3 with occasional use of medications, and two were P4 with constant use of analgesics at the final follow-up. No case of pesudoarthrosis nor neurologic deterioration was recorded.

Conclusion
Single-segment interbody fusion is an effective option in fractures of the lumbar region, involving either endplate, provided the body is not severely comminuted.
Three-dimensional printing in orthopedics − what an orthopedic surgeon should know
Authors: Barakat Ahmed S. , Alhashash Mohamed 
Published: June 2024

Background
In complex situations, regular on-shelf orthopedic implants are not suitable or sufficient to ensure the expected biomechanical or biological function, and customized implants could theoretically offer a solution. Preoperative planning, procedure rehearsal, patient teaching, and three-dimensional (3D) bioprinting are other uses of the fast-spreading 3D printing technology.

Aim
This review deals with the status and future uses of 3D printing and its various applications in orthopedic surgery. In the past decades, enormous technological progress in the field of radiological data acquisition, processing, and 3D printing technologies led to an explosive advancement of this promising industry.

Materials and methods
A literature review of the recent and relevant publications with a special focus on the various orthopedic applications of 3D printing technology was done.

Conclusion
3D printing offers already a valid yet still an expensive solution in certain orthopedic indications. Soon, orthopedic surgeons will be able to use this emerging technology more frequently as more and more companies offer cheaper rapid prototyping manufacturing solutions. Nevertheless, the technology still needs improvement, and many issues such as accuracy, long-term survivorship, and legal liability for the customized implants are still not fully solved.
Scarf osteotomy for the correction of moderate and severe degrees of hallux valgus
Authors: Tawfik Ayman , Sokkar Sheriff , Metwaly Ahmed 
Published: June 2024

Aim
The aim of this study was to evaluate the clinical and radiological results of scarf osteotomy in correction of moderate and severe degrees of hallux valgus (HV).

Patients and methods
Between April 2011 and June 2014, 21 patients with 25 feet of moderate to severe HV deformity were included in this prospective study. The study was conducted to evaluate the clinical and radiological results of correction of moderate to severe HV deformity using scarf osteotomy. While a Z-shaped step-cut osteotomy was used to realign the first metatarsal bone, and another closing-wedge osteotomy of Akin osteotomy may be needed in severe cases to complete the correction of the proximal phalanx of the HV in 15 feet. There were five men and 16 women, with a mean age of 24 years. The mean follow-up time was 24 months.

Results
Overall, 84% of the patients were very satisfied, 12% were satisfied, and 4% were not satisfied. The mean American Orthopedic Foot and Ankle Society score improved significantly from 36 points preoperatively to 94 at the final follow-up. The intermetatarsal and HV angles improved from the mean preoperative values of 18° and 37° to 8° and 13°, respectively. Satisfactory healing time was expressed as an average return back to work after 6 weeks and back to sports after 12 weeks. Persistence or recurrence of HV was seen in one patient; wound infections occurred in two patients, which settled after the administration of antibiotics; and one patient required further surgery to remove a long distal screw.

Conclusion
The scarf osteotomy combined with the Akin closing-wedge osteotomy is safe and effective for the treatment of HV.
Complications of Forgotten or Neglected Biliary Plastic Stents and Their Outcome
Authors: Zumu Mhasisielie , Arun R. S. , Rao Nageswara , Kumar S Krishna , Sri Nayan , Tirupati Vaibhav 
Published: June 2024

Introduction:
Before cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) with common bile duct (CBD) stent placement is the standard therapy for choledocholithiasis. Prolonged stents in situ may present with various complications, some of which may be life-threatening.

Methodology:
A study in a tertiary center in South India from January 2018 to July 2023. A total of 624 patients underwent ERCP for biliary stent procedures, out of which 29 had biliary plastic stents in situ for more than 6 months. We retrospectively analyzed these 29 cases for complications and their treatment outcomes.

Results:
The mean ± standard deviation age was 57.5 ± 16.6 years, male-to-female ratio was 2.2:1, 55.17% had a cholecystectomy (n = 16), the most common indications for CBD stent placement were choledocholithiasis 75.8% (n = 22); the median duration of stent in situ was 7 months interquartile range (6–9). The reasons for delayed CBD stent removal were: 27.6% due to the COVID-19 pandemic (n = 8), 13.8% surgically unfit (n = 4), 6.9% financial constraints (n = 2), 3.4% of patients were unaware of the stent in situ (n = 1), and 48.3% were unknown (n = 14). The complications associated were that 69% had calculi/sludge (n = 20), 24.14% had cholangitis (n = 7), 7% were asymptomatic (n = 2), and 3% had intestinal perforation (n = 1).

Conclusion:
Early complication identification and treatment lead to successful clinical outcomes. Irrespective of cholecystectomy, a check cholangiogram, and CBD clearance should be done in all cases of biliary stent removal.
Dermoids of the Maxillofacial Region
Authors: Sharma Divashree , Tripathi Geeta Mishra , Mishra Ambrish , Shakya Neelam 
Published: June 2024

Introduction:
Dermoid and epidermoid cysts commonly termed as “Dermoids” are known to be developmental benign swellings that possibly occur as a result of traumatic implantation of epithelium or entrapment of epithelial remnants during embryonic fusion. The occurrence is rare (about 7%) in the head-and-neck region and they represent <1.6% of all cysts of the oral cavity.

Patients and Methods:
A retrospective study was done on 12 histopathologically proven cases of epidermoid and dermoid cysts of the maxillofacial region that were treated in Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from January 2013 to December 2019. The cases were evaluated for clinical presentation, demographic characteristics, and treatment performed.

Results:
Out of a total of 12 cases that were included in this study, 10 cases were diagnosed as epidermoid and 2 cases as true dermoid cysts. The mean age of occurrence was 31.66 ± 9.97 years. Male predominance was seen with a male-to-female ratio of 1.4:1. The floor of the mouth was the most commonly involved site in ten (83.34%) cases. Sublingual cysts were seen in five (41.67%) cases, combined sublingual–submandibular involvement in three (25%) cases, and midline floor of the mouth cyst in two (16.67%) cases. All the cases were treated by surgical enucleation, and no recurrence or malignant transformation was reported in any case at a minimum follow-up of 2 years.

Conclusion:
Based on the findings of this retrospective study, it is suggested that these lesions are very rare in the maxillofacial region and pose a diagnostic challenge. However, fine-needle aspiration cytology, ultrasound imaging, computerized tomography, and magnetic resonance imaging techniques can be relied upon for precise treatment planning. Surgical enucleation of these lesions is the preferred treatment modality.
Diagnostic and prognostic utility of serum adenosine deaminase in tuberculosis: Worth a revisit or are we flogging a dead horse?
Authors: Agarwal Deeptika , Yadav Aseem , Sharma Neeraj 
Published: June 2024

Background
Measurement of adenosine deaminase (ADA) activity in body fluids is one of the biochemical methods for the diagnosis of tuberculosis (TB). While the role of ADA levels in pleural fluid and cerebrospinal fluid for diagnosis of TB has been established, the role of serum ADA is yet to be established.

Aims
To study the role of serum ADA levels in diagnosis and prognosis of TB.

Settings and Design
This prospective observational study was carried out at a hospital in central India. All TB patients managed at the center in 2021 were included in the study.

Materials and Methods
Two hundred and thirty-three TB patients who met the inclusion criteria were recruited for the study. The subjects were divided into various study groups on the basis of TB subtypes. The study subjects were treated with first-line DOTS antitubercular therapy (ATT). The subjects underwent analysis of serum ADA levels at 0, 2, and 5 months of ATT initiation. Various factors affecting serum ADA levels were studied.

Results
There was no statistically significant difference in mean serum ADA levels among all study groups (I–IV) at month 0 (treatment initiation). The mean serum ADA levels of TB patients in all study groups (17.8 ± 5.1) were significantly higher than in the control group (10.1 ± 1.2). Mean serum ADA levels showed a sustained fall from month 0 to month 5 of treatment in all study groups. Low vitamin D levels (below 20 ng/mL), Mantoux negativity, and sputum smear status were not found to affect serum ADA levels.

Conclusion
Serum ADA levels can be used to evaluate response to ATT and for disease prognostication.
Myocardial Work Efficiency in Physiologic Left Ventricular Hypertrophy of Power Athletes
Authors: D’Andrea Antonello , Carbone Andreina , Radmilovic Juri , Russo Vincenzo , Fabiani Dario , Maio Marco Di , Ilardi Federica , Giallauria Francesco , Caputo Adriano , Cirillo Teresa , Bossone Eduardo , Picano Eugenio 
Published: June 2024

Aims:
The athlete's heart in power training is characterized by physiologic concentric remodeling. Our aim was to analyze left ventricular (LV) myocardial deformation and contractile reserve (CR) in top-level power athletes (PA) at rest and during exercise and their possible correlations with functional capacity.

Methods:
Standard echo, lung ultrasound, and LV 2D speckle-tracking strain were performed at rest and during exercise in PA and in age- and sex-comparable healthy controls.

Results:
250 PA (male: 62%; 33.6 ± 4.8 years) and 180 age- and sex-comparable healthy controls were enrolled. LV ejection fraction (EF) at baseline was comparable between the two groups, while LV global longitudinal strain (GLS) was reduced in PA (GLS: −17.8 ± 2.4 in PA vs. −21.9 ± 3.8 in controls; P < 0.01). Conversely, myocardial work efficiency (MWE) did not show significant difference between the two groups (94.4 ± 3.2 in PA vs. 95.9 ± 4.6% in controls; P NS). At peak exertion during exercise stress echocardiography (ESE), PA showed better exercise capacity and peak VO2 consumption (51.6 ± 10.2 in EA vs. 39.8 ± 8.2 mL/Kg/min in controls, P < 0.0001), associated with augmented pulmonary artery systolic pressure (PASP). By multivariable analysis, MWE at rest was the most predictive factor of maximal watts (P < 0.0001), peak VO2, (P < 0.0001), PASP (P < 0.001), and number of B-lines (P < 0.001), all measured at peak effort.

Conclusions:
In power athletes, MWE showed less load dependency than GLS. Normal resting values of MWE in PA suggest a physiological LV remodeling, associated with a better exercise capacity and preserved CR during physical stress.
Left Atrial Volumetric and Functional Properties in Hemophilia – Insights from a Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study
Authors: Nemes Attila , Kormányos Árpád , Vezendi Klára , Marton Imelda , Borbényi Zita 
Published: June 2024

Introduction:
Hemophilia is an inherited disorder due to deficiencies in factor VIII (type A) and factor IX (type B). Abnormalities in myocardial mechanics could be theorized due to hemophilia-associated hypocoagubility and related quantitative and qualitative changes of the blood. The present study aimed a detailed assessment of left atrial (LA) volumetric and functional properties in patients with hemophilia using three-dimensional speckle-tracking echocardiography (3DSTE).

Materials and Methods:
The study consisted of 12 subjects with hemophilia type A and 2 cases with hemophilia type B (mean age: 40.8 ± 19.1 years, all males). Results of hemophilia patients were compared to that of 23 age-, gender- and risk factor-matched controls (42.4 ± 9.0 years, all males). Routine two-dimensional Doppler echocardiography and 3DSTE were performed in all subjects.

Results:
LA volumes respecting cardiac cycle did not differ between controls and hemophilia patients. From LA volume-based functional properties, LA stroke volumes were similar between the groups examined in all phases of LA function. While total atrial emptying fraction featuring LA reservoir function was reduced in patients with hemophilia compared to that of controls, passive and active atrial emptying fraction characterizing LA conduit and booster pump functions were similar between the groups. From LA strains, peak mean segmental circumferential and longitudinal LA strains were impaired in patients with hemophilia, other peak LA strains were similar between the groups. LA strains at atrial contraction did not differ between groups of hemophilia patients and controls.

Conclusions:
Hemophilia is not associated with LA volumetric changes, but mild LA functional abnormalities are present.
Left Ventricular Functional Remodeling after Primary Percutaneous Coronary Intervention
Authors: Batra Mahesh Kumar , Malik Muhammad Atif , Khan Kamran Ahmed , Rai Lajpat , Kumar Rajesh , Shah Jehangir Ali , Sial Jawaid Akbar , Saghir Tahir , Khan Naveedullah , Karim Musa 
Published: June 2024

Background:
Improvement in left ventricular (LV) function after revascularization is an important determinant of long-term prognosis in a patient with acute myocardial infarction (AMI). However, data on the changes of LV function after revascularization are scarce in our population. Hence, this study was conducted to evaluate the changes in LV function and dimensions by echocardiography at 3 and 6 months after primary percutaneous coronary intervention (PCI).

Materials and Methods:
A total of 188 patients were recruited in this study who had undergone primary PCI. Patients with preexistent LV dysfunction, prior PCI, or with congenital heart disease were excluded. Echocardiography was performed at baseline (within 24 h of intervention), 3 months, and 6 months of intervention. Remodeling in terms of change in LV ejection fraction (LVEF), LV end-diastolic dimension (LVEDD), LV end-systolic dimension, and wall motion score index (WMSI) was evaluated.

Results:
Out of the 188 patients, 90.4% were male, and mean age was 53.94 ± 9.12 years. Baseline mean LVEF was 39.79 ± 6.2% with mean improvement of 5.11 ± 3.87 (P < 0.001) at 3 months and 6.38 ± 4.29 (P < 0.001) at 6 months. Baseline LVEDD was 46.23 ± 3.86 mm which improved to 44.68 ± 2.81 mm at 6 months. Basal WMSI decreased by -0.09 ± 0.08 and -0.13 ± 0.09 at 3 and 6 months, respectively, after revascularization.

Conclusions:
Primary PCI is the recommended mode of reperfusion in patients with AMI. It reduces infarct size, maintains microvascular integrity and preserves LV systolic function hence improving LV function.