bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers in exclusive breastfeeding encountered by mothers in urban slum area of a metropolitan city
Authors: Gala Zil , Shetye Sonal , Sadawarte Deepika M. , Autade Mrunali 
Published: November 2023

Background:
Breastfeeding is considered the most important source of nutrients for the baby. But owing to ignorance, lack of education, and cultural norms, exclusive breastfeeding (EBF) is not done by majority of the mothers. Hence, this study is carried out to determine various barriers faced by the mothers that influenced their decision on EBF.

Methods:
A descriptive qualitative study was conducted among the mothers whose children were less than 1 year of age visiting a well-baby clinic and Immunisation OPD of Urban Health Centre catering to the Urban Slum of Malvani in the Metropolitan city of Mumbai. In-depth interviews (IDIs) were done with 17 participants from August to November 2022. Thematic analysis was conducted on the qualitative data obtained.

Results:
Four major themes were generated from the transcripts. They are –barriers and concerns faced by mothers to exclusively breastfeed, enablers/motivators, sources of knowledge regarding EBF, and breastfeeding practices. Various barriers faced by mothers were gaps in knowledge, maternal Illness, religious reasons, inadequate milk production, bias toward top feeds, lack of autonomy to take decisions, and cultural norms, while positive family support, good knowledge about breastfeeding, and a supportive home environment motivated mothers to exclusively breastfeed their infants. Sources of knowledge were identified to be doctors and health care workers, mothers/mothers-in-law, sisters, friends, and social media.

Conclusions:
There are various challenges as well as motivators identified for EBF. Barriers, such as gaps in knowledge, and the negative influence of social media can be improved upon by health education. Therefore, it is crucial to teach expectant mothers as well as families about breastfeeding. Additionally, we advise stepping up public health education initiatives to support breastfeeding.
Impact of telemedicine on antenatal care at a teaching institution in Eastern India: An insight into the future of better India
Authors: Mohapatra Ipsita , Rai Vikash K. , Samantaray Subha Ranjan 
Published: November 2023

Objectives:
Telemedicine (TM) emergence has been profound in using technology to address the problems of obstetrics in remote and rural places, especially in low-risk pregnancy. Through this study, we made an effort to assess the satisfaction level and concerns of antenatal and postnatal patients who availed the telemedicine facility during the study period. We also made an effort to facilitate improved access to antenatal and postnatal care, especially the low-risk pregnancies through telemedicine for patients from remote areas of eastern India that do not have the availability of specialists.

Materials and Methods:
Primary data were collected by means of a telephonic survey of all the antenatal patients who used telemedicine services of AIIMS, Kalyani, based on a preformed questionnaire.

Results:
A total of 80 antenatal patients gave consent to participate in the study. Most of the patients were from the upper lower class [43.75%] followed by the lower middle class [35%]. The average gestational age of respondents was 23.95 weeks. Seventy-one out of 80 patients felt that the appointment was made within a reasonable time. Only 12 patients [15.3%] had waiting time greater than 10 min. The average waiting time was 6.93 min. 56.3% of respondents felt that the person who attended their call was very cooperative. 86.3% of respondents strongly agreed that the consultant was able to understand their health issues completely. Eighty percent of the respondents said that they would like to continue using telemedicine in the future. There is a significant difference between those preferring to use telemedicine in the future and those who do not prefer telemedicine in the future. Poor internet facility and privacy were prominent reasons for not opting for telemedicine in the future by some respondents.

Conclusion:
From this study, it was concluded that TM certainly has great potential to make health care accessible to people residing in rural and far-off places.
Oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh: A cross-sectional multi-stage cluster survey
Authors: Praveen Gadde , Sravani Manchikatla , Kadiyala Chaitanya Ram , Indukuri Sai Lakshmi Durga , Poornima ULS , Pampana Sravani 
Published: November 2023

Background:
Community health depends on the leadership duties of a diverse population, such as village volunteers. Hence, a study was conducted to assess oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh state.

Methodology:
A cross-sectional study was conducted among 400 village volunteers in Andhra Pradesh state, India. A multi-stage cluster sampling procedure was employed in sample selection. A questionnaire was used to review the pattern of utilization of dental services. World Health Organization Oral Health assessment form 1997 was used to evaluate oral health status and treatment needs. Data collected were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Descriptive statistics were done.

Results:
Out of 400, 18% had never visited the dental clinic in their lifetime. The majority (33.5%) considered that dental problems were not a serious concern. Dental caries was seen in 69.5%, and 78.5% were presented with periodontal conditions. About 19.8% and 24.3% had crowding and spacing in incisal segments, respectively. The prevalence of oral mucosal disorders and dental fluorosis was 4.25% and 8.75%, respectively. Overall, 94% of the study participants needed dental treatment for various reasons.

Conclusion:
This study provides sufficient evidence to conclude that this population's oral health was poor, with increasing unmet dental treatment needs. Selected interventions and strategies should focus on these factors to decrease the burden of oral diseases among village volunteers.
Management of Vitamin B12 Deficiency: A Comparative Analysis of Intramuscular Injections versus Oral Medications
Authors: Panda Prasenjit , Kumar Anupam , Shivaram G. , Singh Rohit 
Published: November 2023

Abstract

Introduction:
Regular monitoring of Vitamin B12 (VB12) levels and intake of supplements is crucial since their deficiency may cause serious health conditions including neurological and cardiovascular complications. Medical professionals recommend supplements in the form of oral tablets and parenteral replacement for patients who cannot obtain these nutrients through diet or who are deficient due to other health conditions. This study aimed to compare the efficacy of oral medications and parenteral administrations, especially intramuscular (IM) injections for managing VB12 deficiency.

Methods:
The patients diagnosed with confirmed VB12 deficiency (<211 pg/mL) were divided into two groups. One group received oral tablet (Mecobal 1000 mg); the other received VB12 injection (1000 mg) IM. The blood levels of both the groups were assessed after 6 months. The data were statistically analyzed to compare the efficacy of both routes.

Results:
The mean age of oral and IM groups was 57 ± 10 years and 53 ± 11 years, respectively. The baseline serum VB12 values for the oral and IM groups were 158 pg/mL and 139 pg/mL, respectively (P = 0.01), and the mean VB12 values after treatment for the oral and IM groups were 301 pg/ml and 1416 pg/ml, respectively (P < 0.0001). The oral group observed a mean change of 143, while the IM group experienced a change of 1277 pg/ml (P < 0.0001).

Conclusion:
Our findings support the use of parenteral replacement over oral medications for the management of VB12.
A Survey on Patients’ Opinions of Alternative Drug Delivery Systems for the Treatment of Glaucoma in South-South Nigeria
Authors: Echieh Chigozie I. , Mercieca Karl , Eze Ugochukwu A. , Weber Constance , Akinyemi Adedeji , Ibanga Affiong A. , Echieh Chidiebere P. 
Published: November 2023

Abstract:

PURPOSE:
Despite the human ocular surface being easily accessible, ocular drug delivery can be challenging. When applied improperly, topical medications, the most popular first-line treatment used to treat glaucoma, can have a very brief contact time with the ocular surface and may not have the desired therapeutic impact. Drug delivery devices are gadgets that can address some of these problems. This study aims to determine patients’ opinions on ocular drug delivery devices used in the treatment of primary open-angle glaucoma (POAG).

METHODS:
A pretested interviewer-administered questionnaire was used in a cross-sectional study of 115 POAG patients recruited from outpatient clinics in two Nigerian tertiary health institutions. Participants were asked about their understanding and acceptance of five Ocular drug delivery systems (ODD), namely drug-emitting contact lenses (CL), punctual plugs, subconjunctival injections, intracameral implants, and trabecular meshwork micro-stents, for the treatment of POAG.

RESULTS:
Sixty (52.2%) participants, whose average age was 50 ± 9.8 years, were men. Self-pay was used for eye health treatments by 65% of participants. Of the participants, 68.7% admitted to using eye drops on their own. 57% of people were said to take their glaucoma medications consistently. CL and subconjunctival implants were seen to be most acceptable according to 39% and 30% of participants, respectively. Major factors determining the acceptability of ODD for POAG treatment were observed to be cost and effectiveness.

CONCLUSION:
Patients in our cohort who are being treated for POAG have a fairly positive attitude towards ODD. The prospective use of these devices for POAG treatment in Nigeria will depend on their efficacy and cost, as well as how ophthalmologists will weigh ODD options.
Efficacy of Lacrimal Sac Massage in Management of Congenital Nasolacrimal Duct Obstruction in Infants: An Observational Study of 853 Cases from a Single Institute of Eastern Asia
Authors: Nanda Debajyoti , Sarkar Manisha 
Published: November 2023

Abstract:

PURPOSE:
Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora in infants. It usually resolves completely by the end of 1st year with conservative management in most cases. Many studies have confirmed high frequency (80%–90%) of spontaneous resolution of symptoms during the 1st year of life. The aim of this study is to determine the effectiveness of the lacrimal sac massage in the treatment of CNLDO.

METHODS:
The study was done in a tertiary care hospital in eastern Asia over 5 years. Each infant presenting with epiphora and diagnosed as CNLDO was treated with lacrimal sac massage and reviewed after every 1 month. The resolution of CNLDO was judged by the improvement of epiphora and from the fluorescein dye disappearance test.

RESULTS:
Following conservative management, 740 (86.75%) infants recovered completely after 3 months of continuous lacrimal sac massvage. One hundred and five (12.31%) infants did not recover with sac massage even at 12 months, in which cases probing was done. Repeat probing was needed in six patients (0.07%). Two patients did not recover, and a dacrocystorhinostomy was carried out. About 70.6% of infants recovered within 6 months of age. Earlier the age of presentation, the lesser the morbidity.

CONCLUSION:
The incidence of CNLDO is about 6%–20% among infants. Several studies showed spontaneous resolution within 1st year of life. In this study, the success rate of resolution of symptoms in CNLDO with sac massage is 86.75%. Conservative management should be the first line of treatment till 12 months of age in CNLDO.
Corneal Haze Secondary to Corneal Collagen Cross-linking in Keratoconus Patients: Treatment and Outcomes
Authors: Sayegh Kevin H. , Sammouh Fady K. , Ayash Jad G. , El Chakik Ghina F. , Haddam Majd S. , Warrak Elias L. 
Published: November 2023

Abstract:

PURPOSE:
The purpose of this study was to evaluate the outcome of patients presenting with mild-to-moderate corneal haze after undergoing corneal collagen cross-linking (CXL) for keratoconus (KCN) and their response to a proposed standardized topical steroid-based treatment.

METHODS:
This study included 19 eyes of 14 patients presenting with corneal haze after undergoing CXL for KCN. Corrected distance visual acuity, corneal thickness and Kmax values by Pentacam® Scheimpflug tomography, as well as subjective corneal haze changes were evaluated before and after a topical steroid- and cyclosporine-based treatment.

RESULTS:
Visual acuity improved after the completion of the treatment by 0.043 logMAR (P = 0.017) and Kmax values decreased by 1.17D (P = 0.0024), while the corneal thinnest pachymetry remained stable. Data collected from the examiner’s slit-lamp examination description revealed that seven eyes had a decrease in haze compared to 12 eyes with stable or no changes in the haze.

CONCLUSION:
Our findings suggest an improvement in visual acuity and possible corneal flattening with decreasing Kmax after the completion of topical steroids with taper course treatment in patients suffering from corneal haze post-CXL. This paper also highlights the importance of postcross-linking anti-inflammatory treatment and close follow-up.
Oral Cavity Manifestations in Coronavirus Disease 2019 Patients: A COVID Hospital-based Study
Authors: Swain Santosh Kumar , Baliarsingh Prasenjit , Dubey Debasmita 
Published: November 2023

Background:
Coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by novel severe acute respiratory syndrome coronavirus 2. COVID-19 infection presents with mild flu-like symptoms to severe respiratory illness, even respiratory failure. Oral cavity lesions are currently documented in the COVID-19 infections, which increases the morbidity of the patients.

Objective:
The aim of this study is to evaluate the different types of the oral cavity lesions in COVID-19 patient, including its symptoms and signs.

Materials and Methods:
This is a prospective observational study. COVID-19 patients were evaluated for oral cavity manifestations. The age ranges from 18 years to 65 years. All these patients underwent detailed examinations of the oral cavity and oropharynx with the help of headlight, along with wearing personal protective equipment.

Results:
Fifty-six COVID-19 patients showed oral cavity manifestations during their treatment period. The most common clinical entity in this study was gustatory disturbance (26.78%), followed by oral mucositis (14.28%), glossitis (12.50%), and ulcers (8.92%) in the oral cavity of the COVID-19 patients.

Conclusion:
COVID-19 infection significantly affects the oral cavity and salivary glands. Clinicians should keep in mind different lesions in the oral cavity and taste disturbances of COVID-19 patients, which will help the early diagnosis, treatment and avoid the morbidity of the patient.
Epithelioid extragastrointestinal stromal tumor in the pelvic cavity: A rare case at a rare location
Authors: Vishvam Divvay , Ahuja Sana , Zaheer Sufian , Ranga Sunil 
Published: November 2023

ABSTRACT
Extraintestinal gastrointestinal stromal tumors (EGISTs) are rare stromal tumors involving mesentery, omentum, and retroperitoneum. EGISTs of the pelvic cavity are extremely uncommon, and till date, no case of pure epithelioid type arising from the pelvic cavity has been reported. They pose a diagnostic pitfall as they may mimic ovarian malignancy. We present a unique case of an epithelioid extraintestinal stromal tumor arising from the pelvic cavity. A 43-43-year-old woman presented with complaints of abdominal pain and menstrual irregularities. Ultrasound examination revealed a large well-defined hypoechoic mass in the right pelvic cavity with a possible site of origin from the right ovary. A total hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination revealed an encapsulated tumor comprising predominantly of nests and lobules of epithelioid cells with round-to-oval nuclei, vesicular chromatin, and moderate amount of eosinophilic to clear cytoplasm. Mitotic activity was brisk along with focal areas of necrosis. On immunohistochemistry, tumor cells were diffusely and strongly positive for DOG1 and CD117. They were negative for smooth muscle actin, vimentin, S-100, and HMB-45. Based on these findings, a final diagnosis of the high-grade GIST epithelioid variant was made. It is crucial to make the correct preoperative diagnosis of GIST, since these patients may benefit from neoadjuvant imatinib, especially in case of large tumor size.
Artificial intelligence and skull imaging advancements in forensic identification
Authors: Zain-Alabdeen Ebtihal Habeeb , Felemban Doaa Fared 
Published: November 2023

ABSTRACT
Managing the massive losses associated with large-scale disasters requires significant resources. The unexpected violence of these events generally remains a matter of casualties that urgently need to be identified in a reliable and cost-effective manner. To overcome these difficulties, many researchers have attempted to develop automated methods; moreover, a few recent research have investigated the applicability of artificial intelligence (AI)-based methods using skull, dental, and maxillofacial forensic imaging. In this review, we speculate on the advancement and potential of AI in Dental and Maxillofacial imaging that can help simplify person or victim identification and speed up the process with good accuracy. Using a few prefix search phrases, an online literature search was conducted (AI, Forensic, Skull, Dental, Imaging, Radiology) to identify papers about the advancement of AI in forensic dentistry in all kinds of radiographs, including two-dimensional (2D) and three-dimensional (3D) radiographs, cone beam computed tomography (CT) and CT. Most of the studies reported that automated methods of human identification based on 2D and 3D Dental and Skull radiographs using a convolutional neural network showed to assist in the fast and accurate identification by expertise evaluating a lot of images and quickly coming up with potential matches for identification. We advocate the application of AI techniques in the identification of individuals. However, there is a need to continue research with emphasis to validate models in skull identification.
Utility of next-generation sequencing in the diagnosis of neurological disorders
Authors: Raina Adnan Firdous , Ahuja Sana , Razdan Sushil , Khan Adil Aziz , Habib Murtaza 
Published: November 2023

ABSTRACT

Background:
The spectrum of neurological diseases encompasses a large number of disorders, including neuromuscular disorder (NMDs), ataxias, and muscular dystrophies. A detailed clinical examination, followed by electromyography and muscle biopsy, is a traditional diagnostic approach. However, it is never helpful in the identification of the subgroups of either neuropathies or muscular dystrophies apart from being a painful procedure.

Aim:
The present study was to assess the diagnostic yield of next-generation sequencing (NGS) in the diagnosis of neurological disorders.

Materials and Methods:
It was a cross-sectional study where consecutive neurological patients for whom NGS was done were included. These variants were classified as pathogenic/likely pathogenic, variants of uncertain significance (VUS), likely benign and benign.

Results:
Among the 45 cases included, 31 variants were identified in 30 genes, and in 15 patients, no variants were detected. Among 31 variants, 14 were previously reported for the causal of neurological disorder, including NMD, whereas 16 were novel variants (14 missense, 1 frameshift, and 1 splice donor). A definite molecular diagnosis was achieved in 21 cases that were either pathogenic/likely pathogenic, whereas 9 came to be VUS; however, the clinical manifestations correlated well. The phenotype-based sequencing showed a high diagnostic yield of 66% in the present study.

Conclusion:
NGS improves diagnostic efficiency with quicker and earlier diagnosis. In addition, it is a reliable and noninvasive technique that is effective in the detection of single nucleotide polymorphisms and small deletions.
Review of Echocardiographic reports of children undergoing noncardiac surgery in a tertiary health center in Nigeria
Authors: Asani Mustafa O. , Ahmadu Ibrahim , Garba Nuhu Abubakar , Abubakar Muhammad Shakur , Daniel Apollos , Aliyu Ibrahim 
Published: November 2023

Background:
The risk of cardiac anomalies, both acquired and congenital, is high in children undergoing noncardiac surgeries. These cardiac anomalies are associated with increased risk of perioperative complications.

Objectives:
This study, therefore, determined the common indications as well as the echocardiographic findings findings in children undergoing noncardiac surgery in Aminu Kano Teaching Hospital (AKTH), Kano.

Materials and Methods:
This is a retrospective descriptive study. The echocardiographic records of 25 children that underwent noncardiac surgery in AKTH over a 4 year period (from January 2015 to December 2018) were retrieved. The data obtained were analyzed using SPSS version 20 and the result was displayed using a frequency distribution table and bar chart.

Results:
There were 14 males and 11 females, with male to female ratio of 1.3:1. The ages of the patients range from 5 days to 8 years (median age of 8 months). The most common indication for echocardiography is orofacial cleft (cleft lip and/or palate), followed by adenotonsillar hypertrophy. The overall cardiac anomaly was found in 28% of the patients, with the highest anomaly being the atrial septal defect.

Conclusion:
The prevalence of cardiac anomaly was high in children with noncardiac surgical conditions.
Justice, écriture et littérature d’après l’Å“uvre de Dame Cornet
Authors: Regina Christophe 
Published: November 2023

Nous nous proposons d’étudier dans cet article des libelles judiciaires, aussi bien dans leurs formes que dans leurs finalités, afin de montrer que leur construction rhétorique est fortement influencée par la littérature qui donne Ã l’écriture judiciaire les moyens de son efficacité.Afin d’appréhender la richesse et la diversité des ces sources judicaires, nous nous proposons d’étudier un procès qui impliqua des membres de l’élite marseillaise. Véritable guerre conjugale, ce conflit opposa un consul vénitien Ã son épouse qu’il accusa d’Ãªtre adultère, Ã quoi l’épouse répondit en l’accusant de la maltraiter et de vouloir la spolier de ses biens. La qualité sociale des partis et l’importance des réseaux (parentés, amis, voisins, hommes de loi) qui les soutiennent respectivement, donnent Ã cette affaire un tournant inattendu, quitte la sphère privée, dépasse la sphère publique et s’étend au-delÃ de la ville de Marseille.