bluuebunny/crossref_metadata_2025_split huggingface dataset:
Should pipeline nitrous oxide be discontinued in secondary care: A cost-benefit analysis
Authors: Majeed Amer , Awan Amreen M. 
Published: March 2024

Background:
Nitrous oxide (N2O) has seen a marked decline in its usage in recent years due to its adverse clinical effects. We audited the practice in our department to evaluate the N2O consumption and cost-effectiveness of its supply.

Methodology:
Electronic anesthesia records of all patients anesthetized in our main operating rooms in a typical month were reviewed retrospectively, and utilization of N2O was noted in addition to the patient demographics, surgical procedure, and specialty.

Results:
A total of 950 patients were anesthetized, and 3.1% received N2O. The annual usage was estimated to be 72,871 liters, with a leakage of 3,883,105 liters to the environment, posing a safety hazard and wasting 149,612.50 SAR.

Conclusion:
Notable costs and environmental benefits may be achieved by substituting a piped supply of N2O with portable E-cylinders on demand in operating rooms for rational use.
Pericapsular nerve group block and lateral femoral cutaneous nerve block versus fascia iliaca block for multimodal analgesia after total hip replacement surgery: A retrospective analysis
Authors: Girombelli Alessandro , Vetrone Francesco , Saglietti Francesco , Galimberti Andrea , Fusaro Andrea , Umbrello Michele , Pezzi Angelo 
Published: March 2024

Background:Optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and early discharge. Fascia iliaca compartment block (FICB) has been recommended since it offers good pain control with a low risk of motor block. Pericapsular nerve group (PENG) block with lateral femoral cutaneous block (LFCN) has been proposed as an effective alternative to FICB that offers better pain control with a considerably lower risk of motor block. We aimed to compare the aforementioned blocks and determine which one yielded the lowest numeric rating scale (NRS) score.Methods:We designed a retrospective analysis of patients undergoing elective total hip arthroplasty. The primary outcome was the NRS score at 6, 12, and 24 hours. The secondary outcomes were total opioid consumption, time to first PRN opioid, and time to first postoperative ambulation.Results:52 patients were recruited, (13 PENG plus LFCN, 39 FICB). PENG plus LCFN resulted in a lower NRS at all three-time points (mean difference and 95%CI at 6 h 0.378 [-0.483; 1.240], at 12 h 0.336 [-0.378; 1.050], and at 24 h 0.464 [0.013; 0.914]P= 0.02). Moreover, less PRN opioids were requested in the PENG plus LCFN vs. FICB group (0 [0;7.5] vs 60 [15;80] milligrams of morphine equivalents,P= 0.001). No delay in the first ambulation or initiation of physical rehabilitation was reported in either group.Conclusions:PENG plus LCFN seems to offer better pain control and lead to less PRN opioids. Neither block hindered physical therapy nor ambulation. These results need to be confirmed with a larger prospective and randomized study.
Comparative evaluation of pre-emptive analgesic efficacy of Posterior Transversus Abdominis Plane block with Fascia Transversalis Plane Block in adult patients undergoing unilateral inguinal hernia repair: A prospective, randomized, single-blind, two-arm parallel study
Authors: Priya Vansh , Shamim Rafat , Singh Brijesh , Singh Shipra , Bais Prateek S. , Prasad Ganpat 
Published: March 2024

Introduction:
Abdominal wall blocks, in conjunction with multimodal analgesia, have demonstrated efficacy in providing post-operative analgesia, reducing opioid requirements in patients undergoing inguinal hernia repair. The inguinal region is primarily innervated by the ilioinguinal nerve (IIN) and iliohypogastric nerve (IIH). Posterior transverse abdominis plane block (pTAP) and fascia transversalis plane block (TFP) have been observed to reliably block IIN and IIH. We hypothesized that posterior TAP block (pTAP) owing to its potential paravertebral spread will provide better post-operative analgesia than TFP block in patients undergoing unilateral open inguinal hernia repair.

Methods:
This prospective, randomized, single-blind, two-arm parallel study was conducted over a duration of one year for which sixty patients undergoing unilateral open inguinal hernia repair under spinal anesthesia were enrolled. They were equally and randomly assigned to receive either preoperative pTAP block or TFP block. The primary aim of the study was to compare median static and dynamic NRS scores during a 24-hour period, with the secondary aim to compare the number of patients who required rescue analgesics in each group.

Results:
All enrolled patients completed the study. Results showed no statistically significant difference in median static NRS scores between Group pTAP and Group TFP at the designated time of observation during the 24-hour period [1.2 (0.4-1.60 vs. 1 (0.6-1)]. Group pTAP reported a higher median dynamic NRS scores during the 24-hour period [2.6 (1.2-3) v/s 2 (1.6-2.4); P < 0.035], although this difference was clinically insignificant. The mean time to request for the first rescue analgesia was comparable (11.7 h v/s 12 h; P = 0.99). In all the patients of both groups, loss of pinprick and cold touch sensation was observed at T10, T12, and L1 dermatomal levels. However, sensory assessment at T6 and T8 levels showed variability between the two groups (P > 0.05).

Conclusion:
In conjunction with background analgesia and the use of dexamethasone as an adjuvant, both blocks (pTAP and TFP) were observed to be equally effective for post-operative pain relief with similar patient satisfaction scores.
Validation of FIB-6 score in assessment of liver fibrosis in chronic hepatitis B
Authors: Alswat Khalid , Soliman Riham , Mikhail Nabiel N. H. , Örmeci Necati , Dalekos George N. , Derbala Moutaz F. M. , Al-Busafi Said Ahmed , Hamoudi Waseem , Shiha Gamal 
Published: March 2024

Background:
We recently developed a simple novel index called fibrosis 6 (FIB-6) using machine learning data analysis. We aimed to evaluate its performance in the diagnosis of liver fibrosis and cirrhosis in chronic hepatitis B (CHB).

Methods:
A retrospective observational analysis of data was obtained from seven countries (Egypt, Kingdom of Saudi Arabia (KSA), Turkey, Greece, Oman, Qatar, and Jordan) of CHB patients. The inclusion criteria were receiving an adequate liver biopsy and a complete biochemical and hematological data. The diagnostic performance analysis of the FIB-6 index was conducted and compared with other non-invasive scores.

Results:
A total of 603 patients were included for the analysis; the area under the receiver operating characteristic curve (AUROC) of FIB-6 for the discrimination of patients with cirrhosis (F4), compensated advanced chronic liver disease (cACLD) (F3 and F4), and significant fibrosis (F2–F4) was 0.854, 0.812, and 0.745, respectively. The analysis using the optimal cut-offs of FIB-6 showed a sensitivity of 70.9%, specificity of 84.1%, positive predictive value (PPV) of 40.3%, and negative predictive value (NPV) of 95.0% for the diagnosis of cirrhosis. For the diagnosis of cACLD, the results were 71.5%, 69.3%, 40.8%, and 89.2%, respectively, while for the diagnosis of significant fibrosis, the results were 68.3%, 67.5%, 59.9%, and 75.0%, respectively. When compared to those of fibrosis 4 (FIB-4) index, aspartate aminotransferase (AST)-to-platelet ratio index (APRI), and AST-to-alanine aminotransferase (ALT) ratio (AAR), the AUROC for the performance of FIB-6 was higher than that of FIB-4, APRI, and AAR in all fibrosis stages. FIB-6 gave the highest sensitivity and NPV (89.1% and 92.4%) in ruling out cACLD and cirrhosis, as compared to FIB-4 (63.8% and 83.0%), APRI (53.9% and 86.6%), and AAR (47.5% and 82.3%), respectively.

Conclusions:
The FIB-6 index could be used in ruling out cACLD, fibrosis, and cirrhosis with good reliability.
Evaluation of retentive force between stud and resilient telescopic crown attachment for implant-retained mandibular overdentures
Authors: El-Hussein Ibrahim Gamal 
Published: March 2024

Purpose
This study aimed to evaluate the retentive force between stud and resilient telescopic crown attachments for implant-retained mandibular overdenture.

Patients and methods
A total of 20 male patients were selected from the Clinic of Removable Prosthodontics Department. Faculty of Dentistry, Sinai University (Kantara). Patients were divided into two equal groups. Group I (control group): patients were treated with two implants of 3.7 mm diameter and 13 mm length (in the canine regions), retaining mandibular overdentures with ball abutments, and by conventional maxillary complete dentures. Group II: patients were treated with two implants of 3.7 mm diameter and 13 mm length (in the canine regions), retaining mandibular overdentures with conical abutments with a 6° taper, and by conventional maxillary complete dentures. Retention force was recorded at the time of insertion (T0), 6 months (T6), and 12 months (T12) later.

Results
One-way anova revealed significant differences between the two groups in initial retention forces (T0). However, no significant difference was observed between the two groups at T6 and T12. Group II (telescopic attachment) was associated with significantly higher retention losses than Group I (ball attachment). In comparing the mean retention loss values for the two groups at different follow-up periods, significant differences were observed for both groups.

Conclusion
Within the limitations of this study, it can be concluded that: telescopic attachment with taper 6° can provide acceptable retention compared to ball and socket attachment during 12 months of overdenture use.
Impact of nylon versus heat cure acrylic resin on microbial adhesion of closed hollowed obturators
Authors: El-Hussein Ibrahim Gamal 
Published: March 2024

Purpose
This study aimed to evaluate the effect of nylon versus heat-cure acrylic resin on microbial adhesion of a closed hollowed obturator.

Patients and methods
Twelve male patients with a unilaterally acquired maxillary defect (Aramany Class IV) were chosen from the outpatient clinic of the Prosthodontics Department at the Faculty of Dentistry, Sinai University (Kantara branch). These patients were divided into two equal groups: group I was provided with an obturator made of heat-cured acrylic resin (P.M.M.A.-Vertex), while group II received an obturator made of thermopress resin (nylon breflex, 2nd edition). Each group underwent microbial evaluation through follow-up recall visits at 2 and 4 weeks. The results were recorded, tabulated, and subjected to statistical analysis.

Results
There is a significant difference between group I and group II. The conventional acrylic resin group showed higher bacterial adhesion than the nylon.

Conclusion
Within the limitations of the study, a closed hollow bulb constructed with thermopress resin exhibits reduced bacterial colonization when compared to heat-cured acrylic resin.
Reliability of Dhaval–Rohan angle for assessment of vertical dysplasia
Authors: Harpy Mohamed A.A. Gawad , Gaballah Safaa M. , Fakhry Neveen M. 
Published: March 2024

Objectives
Assessment of Dhaval–Rohan (DR) angle as a vertical dysplasia indicator.

Materials and methods
One hundred and forty lateral cephalometric radiographs of Egyptian orthodontic patients of both sexes with age ranging from 16 to 28 years old, collected from the record files of patients admitted for treatment of various malocclusions. The enrolled cases were subdivided based on SN/MP angle, FH/MP angle, Y-axis/FH angle, gonial angle, and LAFH/TAFH, into high angle (hyperdivergent), low angle (hypodivergent), and average (normodivergent) cases according to Aboul-Azm and colleagues. Each case had to have a minimum of three of the five parameters indicating its pattern of growth, DR angle was constructed by using three skeletal points; C (center of condyle where the angle located), M (center of premaxilla), and G (center of symphysis of mandible), the measured data were led to the computer and statistically analyzed using the Statistical Package for Social Sciences software, version 24. Quantitative data were expressed using range (minimum and maximum), mean, and SD. Significance of the obtained results was judged at P value less than 0.05.

Results
There is a strong correlation between the conventional parameters and DR angle. The cutoff point of the DR angle below 28° indicates a horizontal growth pattern, between 28.5 and 32.5° indicates an average growth pattern, and above 32.5° indicates a vertical skeletal growth pattern.

Conclusion
The DR angle is a reliable parameter in assessing vertical skeletal growth pattern with minimal cephalometric landmarks that easily and accurately located.
Piroxicam gel versus injectable platelet rich fibrin in the treatment of stage III periodontitis
Authors: Khallaf Nourhan T. , Sabra Reda Saber , Ghoraba Sahar M. , Attia Mohamed Attia Saad 
Published: March 2024

Background
In view of the importance and prevalence of chronic periodontitis, there is still an urgent need to search for an effective therapy that is less expensive, easy to use, and readily available with no side effects. Injectable platelet rich fibrin (i-PRF) and piroxicam were considered as possible treatment options of periodontitis.

Aim
To evaluate the efficacy of piroxicam gel versus i-PRF in treatment of stage III periodontitis.

Materials and method
The current study was carried out as a randomized clinical trial. The participants diagnosed as having stage III, grade B periodontitis were selected from the patients attending Department of Periodontology and Oral Medicine, Faculty of Dentistry, Tanta University. The selected individuals randomly assigned into two groups (by means of a sealed envelope via masked supervisor): group I and group II. Forty sites (the deepest periodontal pockets) were selected. Twenty sites from GI was treated by piroxicam gel and 20 sites in GII were treated by i-PRF. The application was done 2 weeks after scaling and root planing and applied for five times one application every 2 weeks over 10 weeks.
The comparison was assessed clinically and immunologically. Clinically, via recorded: probing pocket depth, clinical attachment loss, and bleeding on probing. Immunologically, via measuring: the levels of matrix metalloproteinases-8 in gingival cervical fluid samples. Clinical and immunological were recorded at baseline (before scaling and root planing), 4 weeks (2 weeks after first application), 8 weeks (at fourth application), and 12 weeks (2 weeks after the last application).

Results
Both groups showed significant improvement in all clinical and immunological parameters. Comparing GI and GII at each follow-up time point, there was significant amelioration in all assessed parameters in favor to GII.

Conclusion
The use of i-PRF is preferred over the use of piroxicam gel in the treatment of stage III chronic periodontitis, as it gives better clinical and immunological results.
Erosive effects of different pediatric medicaments on primary teeth enamel with and without remineralizing agents
Authors: Al-Olimy Yousra H. , El-Hosary Amina M. , El-Dosoky Ahmed I. 
Published: March 2024

Background
Children with chronic diseases may require several liquid medications daily. As most of pediatric drugs are acidic in nature, dental erosion becomes a potential issue when medicines with prolonged oral clearance are taken for long term. The enamel of deciduous teeth is less calcified and porous which is more easily dissolved by acids. So, erosion can be a particular problem and easier to occur in primary teeth than in permanent teeth.

Objectives
Assess the erosive effects of pediatric medicaments on primary teeth enamel, and the remineralizing effect of Proshield varnish and MI varnish on demineralized enamel.

Patients and methods
This experimental controlled trial conducted on 70 extracted primary teeth divided into seven groups. The control group was exposed to artificial saliva. Three groups exposed to Probric syrup, one of them to assess the demineralization occurred in enamel surface, second one was treated first with Proshield and the third one was treated with MI varnish. The remaining three groups were exposed to Depakine syrup, one of them to assess the demineralization effects of the drug, the second one was treated with Proshield, and the third one was treated with MI varnish. Scanning is done to reveal surface changes occurred to the enamel surface and to assess how much the pediatric medicaments affected the enamel. Energy dispersive radiography analysis was done to accurately measure the percentage of elements by weight especially calcium and phosphate percentage.

Results
The study showed that both pediatric medicaments have erosive potential that led to surface changes and decrease in mineral content of the enamel. Both Proshield and MI varnishes have remineralizing effects on enamel and had decreased the effects of these medicaments but with different levels. Proshield varnish proved more remineralization efficacy with both medicaments.

Conclusions
Both Probric and Depakine syrups have erosive potential on primary teeth enamel. Proshield varnish showed better remineralization ability as compared to MI varnish.
Antibacterial effect of ozone versus chlorhexidine gel for disinfection of cavitated carious lesions in young permanent teeth
Authors: Elmestkawy Amira S. , Elhosary Amina M.E. , Shoker Nahed S. , Amer Wessam H.S. 
Published: March 2024

Purpose
The study was directed to evaluate the antibacterial effect of ozone versus chlorhexidine gel for disinfection of cavitated carious lesions in young permanent teeth.

Patients and methods
Forty young permanent molars out of 20 children were allocated into two groups in a randomized technique according to the material used for cavity disinfection either ozone or chlorhexidine gel. Each child had two bilateral vital cavitated class I carious lesions in young permanent first molars. Dentin samples from deep caries lesions were collected before additionally after application of either ozone or chlorhexidine gel and cultured into freshly prepared appropriate media for microbiological examination.

Results
There were statistically significant decrease in both Streptococcus mutans and Lactobacillus bacterial count after application of either ozone or chlorhexidine gel in both groups.

Conclusion
Application of ozone or chlorhexidine gel as cavity disinfectant in deep carious lesions after incomplete dentin caries removal provide an obvious antibacterial effect reducing S. mutans and Lactobacillus counts.
Silver diamine fluoride: knowledge of dentists in Upper Egypt – a cross-sectional study
Authors: Samer Faten A. , Hussein Osama S.E.-N. , Moness Amro M. 
Published: March 2024

Objectives
To assess knowledge level about silver diamine fluoride (SDF) among dentists in Upper Egypt.

Patients and methods
An observational cross-sectional study was conducted on a sample of registered dentists in Upper Egypt using a validated, well-constructed electronic questionnaire to assess dentists’ knowledge level regarding using SDF.

Results
40.3% of dentists had never heard about SDF. Sixty four percent of dentists had low knowledge about SDF as they answered less than 50% of knowledge questions correctly, and only 25% of dentists had good knowledge about SDF as they answered more than 70% of knowledge questions correctly.

Conclusion
Majority of dentists in Upper Egypt had low level of knowledge regarding SDF material. Pediatric dentistry speciality, years of professional experience and respondents practicing in teaching hospitals were more likely associated with good knowledge about SDF [odd ratio (OR)=3.30; 95% confidence interval (CI)=1.58 to 6.89; P = 0.001, OR = 2.77. 95% CI = 1.37 to 5.59; P = 0.005, and OR = 2.02; 95% CI = 1.09 to 3.74; P = 0.025, respectively].
Muco-bioadhesive gel containing basil extract (Ocimum basilicum) in the management of recurrent aphthous stomatitis: a randomized clinical and immunological study
Authors: Shoukheba Malak Y.M. , Eagab Amany E. , Shoeib Nagwa A. , Abdelkader Dalia H. , Mahmoud Mona M.W. , Sabra Reda S. , Yousef Doaa A. 
Published: March 2024

Background
Recurrent aphthous ulcer (RAU) is a widespread highly prevalent disorder that impairs the life quality of the affected persons and leads to difficulties in daily activities such as talking, eating, and oral hygiene maintenance.

Aim
To evaluate the efficiency of basil extract (Ocimum basilicum) loaded in poly (vinylacohol)–borate hydrogel for topical application in the treatment of RAU.

Patients and methods
Twenty patients with a clear history of frequent eruption of RAU, their ages ranges between 18 and 45 years, and presented with mucosal ulcer (2 days or less duration and ≥4 mm in diameter). The patients were randomly allocated into two groups, group I (test group): 10 patients treated with mucoadhesive gel containing 2% of basil extract. Group II (placebo group): 10 patients treated with placebo gel. The healing period, pain scale, and the size of the ulcer were evaluated. Salivary endocan was collected at baseline and 5 days after materials application.

Results
There was no significant difference between the test and control group, while there were statistically significant differences between them and the healthy group at baseline clinically and immunologically. At 5 days there was a significant reduction in the degree of pain sensation, healing period, ulcer size, and decrease in the level of salivary endocan for both groups with statistically significant differences between them observed in the test group more than the control group in all tested parameters.

Conclusion
Using the muco-bioadhesive gel containing basil extract (O. basilicum) shows promise as a therapy for the management of patients with RAU.
Using a novel hemostatic peptide solution to prevent bleeding after endoscopic submucosal dissection of a gastric tumor
Authors: Gomi Kuniyo , Yamamoto Yorimasa , Yoshida Erika , Tohata Misako , Nagahama Masatsugu 
Published: March 2024

BACKGROUND
Endoscopic mucosal dissection has become the standard treatment for early gastric cancer. However, post-endoscopic submucosal dissection (ESD) ulcer occurs in 4.4% of patients. This study hypothesized whether applying PuraStat, a novel hemostatic peptide solution, prevents post-ESD bleeding.
AIM
To investigate the preventive potential of PuraStat, a hemostatic formulation, against bleeding in post-ESD gastric ulcers.
METHODS
Between May 2022 and March 2023, 101 patients (Group P) underwent ESD for gastric diseases at our hospital and received PuraStat (2 mL) for post-ESD ulcers. We retrospectively compared this group with a control group (Group C) comprising 297 patients who underwent ESD for gastric diseases at our hospital between April 2017 and March 2021. P values < 0.05 on two-sided tests indicated significance.
RESULTS
Post-ESD bleeding occurred in 6 (5.9%) (95%CI: 2.8–12.4) and 20 (6.7%) (95%CI: 4.4–10.2) patients in Groups P and C, respectively, with no significant between-group difference. The relative risk was 1.01 (95%CI: 0.95–1.07). The lesser curvature or anterior wall was the bleeding site in all 6 patients who experienced postoperative bleeding in Group P. In multivariate analysis, the odds ratios for resection diameter ≥ 50 mm and oral anticoagulant use were 6.63 (95%CI: 2.52–14.47; P = 0.0001) and 4.04 (1.26–0.69; P = 0.0164), respectively. The adjusted odds ratio of post-ESD bleeding and PuraStat was 1.28 (95%CI: 0.28–2.15).
CONCLUSION
PuraStat application is not associated with post-ESD bleeding. However, the study suggests that gravitational forces may affect the effectiveness of applied PuraStat.