bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound-guided pericapsular nerve group (PENG) block versus femoral nerve block for positioning during spinal anaesthesia in proximal femur fractures: A randomised comparative study
Authors: Chaudhary Kinjal , Bose Neeta , Tanna Dhara , Chandnani Anup 
Published: October 2023

Background and Aims:
Femoral nerve block is a widely used analgesia technique for positioning before spinal anaesthesia for proximal femur fracture surgeries. Pericapsular nerve group (PENG) block is a newer technique with motor-sparing characteristics. We compared the analgesic efficacy of these blocks for patient positioning for spinal anaesthesia.

Methods:
In this study, 60 patients were randomised to either the PENG group (n = 30) or the femoral group (n = 30). After performing the block, the pain was assessed every 10 min using a visual analogue scale (VAS) score for 30 min. The primary objective was the median [interquartile range (IQR)] reduction in pain (dynamic VAS with 15-degree passive limb elevation) at 30 min. Secondary objectives were ease of spinal position score (EOSP), angle obtained during positioning, duration of postoperative analgesia and quadriceps weakness.

Results:
The demographics were comparable in both groups. After 30 min, the median (IQR) VAS was 6 (5–7) in the PENG group and 5 (5–6) in the femoral group (P = 0.004). Secondary outcomes such as EOSP score and angle obtained by patients were comparable. In the postoperative period, patients had significantly lower pain in the PENG group compared to the femoral group. The duration of analgesia was prolonged with PENG block. Quadriceps weakness was significantly low with PENG block (P < 0.001).

Conclusion:
PENG block provides better analgesia than a femoral block before spinal anaesthesia for proximal femur fracture surgery. The postoperative duration of analgesia was also longer.
Ectopic, inverted, and impacted mandibular third molar: A case report with review of literature
Authors: Jain Nikil Kumar , Dutta Abhishek , Nishant N 
Published: October 2023

Abstract
Ectopic and inverted impaction of a tooth together is a rare occurrence. It is commonly associated with pathologic lesions. The common symptoms of the clinical examination were pain, trismus, swelling, and temporomandibular joint syndrome. Asymptomatic impactions go undetected. The associated lesions, if any, can grow to a considerable size and cause significant morbidity. Since few cases have been detected and reported, the etiology of such impactions remains unclear. Here, we are presenting a case that was impacted, inverted, and presented at the ascending ramus of the mandible.
A survey to assess utilization and effectiveness of digital smile design techniques in prosthodontics
Authors: Chhabra Supreet Kaur , Kaur Kirandeep , Arora Akshita , Dugar Preksha 
Published: October 2023

Abstract

Background:
This study aimed to explore the utilization and effectiveness of digital smile design (DSD) techniques in prosthodontics, based on responses from 250 licensed prosthodontists. The investigation provides insights into DSD adoption, its impact on clinical practice, and perceived benefits and challenges.

Materials and Methods:
A cross-sectional survey collected data on DSD utilization, familiarity, training, benefits, challenges, and clinical outcomes. The questionnaire covered demographics, familiarity, utilization frequency, case types, benefits, challenges, and clinical case examples.

Results:
Results indicated that 56% of prosthodontists frequently integrated DSD techniques into treatment planning, indicating growing digital technology adoption. Notably, 82% utilized DSD primarily for aesthetic and complex cases, enhancing precision, and patient satisfaction. High DSD utilization aligns with patient-centered care trends and comprehensive treatment planning, especially for aesthetics. Familiarity with DSD was notable (44.8%) and positively correlated with formal training (66%). Education’s role in enabling effective DSD use was underscored. Higher familiarity with training suggests education’s importance in promoting DSD adoption. Continued professional development and tailored training can enhance DSD utilization. DSD benefits aligned with digital dentistry potential. Improved treatment predictability (72%), enhanced communication (65%), and precise aesthetic planning (53%) were primary advantages. Challenges included the initial learning curve, software complexity, necessitating user-friendly interfaces, and structured education. Participant case examples highlighted DSD’s positive clinical impact. Improved aesthetics (78%), functional outcomes (63%), and patient satisfaction (71%) demonstrated DSD’s bridging role between expertise and patient expectations.

Conclusions:
Findings highlight DSD’s adoption and effectiveness in prosthodontics. DSD’s significance in treatment planning, patient-centered care, and outcomes is evident. Addressing challenges through education and user-friendly tools can enhance DSD integration, contributing to treatment success, and patient satisfaction.
The International System for Reporting Serous Fluid Cytopathology: An Institutional Experience on its Implication and Assessment of Risk of Malignancy in Effusion Cytology
Authors: Kala Chayanika , Kala Sanjay , Singh Anurag , Jauhari R. K. , Bajpai Ashutosh , Khan Lubna 
Published: October 2023

Background:
The “international system for reporting serous fluid cytopathology”(TIS) consists of five diagnostic categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). The study was conducted to reclassify effusion cytology samples according to the newly proposed TIS to calculate the risk of malignancy (ROM) for each category and to conduct performance analysis.

Materials and Methods:
The study was a retrospective observational study conducted at a tertiary care institution in North India. Clinical data of the cases from June 2013 to July 2021 were retrieved and the cases were reviewed by two cytopathologists. All cases were reclassified according to the proposed TIS system into five categories.

Results:
A total of 2318 patients were included in the study over a time span of 8 years, and 1614 (69.6%) cases of pleural effusion cytology, 612 (26.4%) cases of peritoneal effusion cytology, and 92 (3.9%) cases of pericardial effusion cytology were included. All effusion cytology smears were recategorized as per TIS guidelines into ND, NFM, AUS, SFM, and MAL with 4 (0.17%), 1756 (75.75%), 12 (0.51%), 57 (2.46%), and 489 (21.11%) cases, respectively, and ROM was 25%, 17.9%, 66.7%, 75.4%, and 96.5%, respectively, for the categories.

Conclusion:
Besides being a simple, easy, and user-friendly system, TIS has the benefit of risk stratification and ROM for each category. The TIS system proposed a tiered scheme, which places the effusion cytology into well-defined categories, and therefore has lesser chances of false-positive and false-negative cases.
Determination of Autophagy in Human Cervicovaginal Smears by Cytological and İmmunocytochemical Methods
Authors: Özcan Türkmen Merve , Demirezen Sayeste , Beksaç Mehmet Sinan 
Published: October 2023

Background:
Autophagy is a catabolic process whereby organelles and long-lived proteins are recycled through lysosomes to maintain cellular homeostasis. This process is being widely studied using culture techniques and animal models; however, cervicovaginal smears have not been used to detect autophagy.

Aims:
Our study aims to detect and evaluate autophagy in normal, malignant, infectious, and atypical cells in cervicovaginal smears by using cytological and immunocytochemical methods.

Materials and Methods:
Papanicolaou-stained 200 cervicovaginal smears were examined and 55 of 200 (27.5%) smears containing negative for intraepithelial lesion or malignancy (NILM) with identifiable infections and/or reactive/reparative changes (INF); briefly, NILM-INF (n = 31, 56.4%), atypical (n = 4, 7.3%), and malignant cells (n = 20, 36.3%) were evaluated as a study group. One hundred forty-five of 200 (72.5%) normal smears were accepted as the NILM without any identifiable infections (control group). The autophagy marker protein Microtubule-associated protein 1 light chain 3 A (MAP1LC3A) was used for immunocytochemical examination.

Results:
The staining intensity of the MAP1LC3A protein and autophagy positivity were lower in the malignant cells; however, they were higher in the NILM-INF and atypical cells. A statistically significant correlation between the malignant and normal cells was obtained for the autophagy positivity (P = 0.012). In view of the staining intensity of MAP1LC3A protein by the H-score method, a significant correlation was found between the NILM-INF and the normal cells (P = 0.015).

Conclusions:
Autophagy was detected in various cervicovaginal smears for the first time in this study. Our findings indicate that an autophagy process is essential in infectious cells as well as in the transformation of atypical cells into malignant cells in carcinogenesis.
Diagnostic Performance Comparison of Liquid-Based Preparation Methods in Thyroid FNAs
Authors: Erdoğan Bahattin , Karabağ Aral , Kasap H. Ahmet , Çivi Çetin Kısmet , Bal Cengiz , Şimşek Gülay 
Published: October 2023

Introduction:
Fine needle aspiration (FNA) is recognized worldwide as the primary diagnostic method for evaluating thyroid nodules. Samples collected by FNA can be spread directly onto slides, prepared for cell blocks, or processed as liquid-based cytology. Advocates of the traditional smear technique emphasize that background material such as colloid, cell sequencing characteristics in cell clusters, and cellularity is important in cytological diagnosis. They state that these properties are not observed in liquid-based liquids. Liquid-based cytology techniques aim to provide standardized slides of homogeneous cellular smears with well-preserved cell morphology, producing more precise visualization, shorter interpretation time, and more reproducible results. This study aimed to investigate and compare the diagnostic performance of liquid-based thyroid FNA samples prepared with SurePath and Cytospin over the last 6 years.

Methods:
Patients who underwent ultrasound-guided FNA between January 2015 and December 2021 were included in the study. Cytology reports, pathology reports, and demographic information of the patients were collected from the Hospital Information Management System. The programs “SPSS for Windows 21” and “MedCalc Diagnostic Test Evaluation Calculator” were used for data analysis. Chi-square tests were used in crosstab analysis. The Kolmogorov-Smirnov two-sample test, two proportions test, and the confidence interval tests were used to analyze the variables of the methods. P < .05 was considered statistically significant.

Results:
The study population comprised 4,855 patients, 83.8% female and 16.2% male. There were no statistical differences in age and gender distribution in the population of both methods. Nondiagnostic outcome rates were 11.2% for SurePath and 12.8% for Cytospin. Sensitivity, specificity, and accuracy values for SurePath and Cytospin methods were determined as 58.57%, 98.28%, and 91.12% and 79.07%, 96.88%, and 94.03%, respectively.

Conclusion:
In our study, although the qualitative analytical results were slightly in favor of the cytospin method, we think both ways can be used safely, especially in hospitals where the clinics performing sampling activities are variable and many, as well as in pathology laboratories where the workload is intense.
MASC Gets UNMASKED: Visiting a Rare Tumor with Emphasis on Cytomorphological Features
Authors: Anthony Michael L. , Kumari Neha , Jeladharan Reshma , Gowda Vinay N. , Joshi Prashant Pranesh , Durgapal Prashant , Kumar Arvind , Singh Ashok 
Published: October 2023

Background:
Secretory carcinoma (SC) is a newly described entity which has been often misdiagnosed earlier as acinic cell carcinoma on cytology. Diagnosing SC was initially based upon identifying the ETV6:NTRK3 fusion gene with the help of fluorescence in situ hybridization (FISH). Lately, with more knowledge of the reliable histomorphology, cytology, and immunohistochemistry features, definitive diagnosis can be confidently made without the help of FISH in almost every case.

Materials and Methods:
Six histologically confirmed cases of SC were studied. The cytology slides of all the six cases were retrieved and reviewed to identify the characteristic features which could have helped in raising the possibility of SC on fine needle aspiration cytology itself. Cell blocks were also studied, wherever available.

Results:
Patients were all male with average age of 35.2 years. The six cases in the current study demonstrated at least focal cytoplasmic vacuolization of varying sizes, papillae formations, and bland nuclear features on fine needle aspirate smears. It was also seen that S-100 and mammaglobin immunohistochemistry (IHC) are very helpful in confirming the diagnosis.

Conclusions:
The results of the current study highlight the cytomorphological features which may help in clinching the diagnosis SC on cytology itself. They also highlight certain cytological features which help to rule out the other differential diagnoses.
Endometrial Secrets Unmasked through Cytology Analysis
Authors: Shinde Sweety V. , Jashnani Kusum D. , Haldankar Padmashree K. , Dodake Kallappa D. 
Published: October 2023

Background:
Endometrial aspiration (EA) is an economic, painless technique on an outpatient basis. Present study aimed at cytological evaluation of EA for (a) cellular yield and morphology and (b) utility of cell block (CB) and cytocentrifuge (CC) techniques.

Materials and Methods:
EA samples were divided into two aliquots. Colorless samples were processed (1000 rpm × 6 min) for conventional smear (CS) and CC, both stained by Papanicolaou. Hemorrhagic samples were processed for CS and CB (paraffin embedding, hematoxylin–eosin stain).

Results:
Endometrial aspirates from January 2021 to January 2022 were included. Indications comprised abnormal uterine bleeding (AUB; 87), prolapse (eight), and infertility (two). Among 77 hemorrhagic aspirates, the yield was 85.7% by CS and 90.9% by CB. Among 20 colorless aspirates, the yield was 55% by CS and 65% by CC. The yield was 85.7%, 84.4%, and 83.3% with endometrial thickness 1–5, 6–10, and 11–15 mm, respectively. The yield was 83.9%, 50%, and 0% in AUB, prolapse, and infertility, respectively. CS morphology showed the categories of benign (93.5%) and atypia (6.5%). All cases with benign morphology correlated with CB and CC. CB offered architectural evaluation, while CC had a shorter turnaround time.

Conclusion:
Focusing on menorrhagia cases in secretory phase, nondilution of EA samples, and simultaneous endometrial biopsy can enhance cytology evaluation. In an era where “less should convey more,” EA shows potential as a screening technique vis-à-vis invasive “dilatation–curettage” technique.
Knowledge of adequate diet among nursing students at Achievers University, Owo, Nigeria
Authors: Olorunfemi Olaolorunpo , Ijadeyila Adedamola , Fadipe Omolayo Ololade , Osunde Ngozi Rosemary , Oahimijie Florence Onyemaechi , Adebiyi Joseph Adekunle , Akindipe Adewole Peter 
Published: October 2023

Abstract

Context:
A well-rounded and nutritionally balanced diet forms a foundational pillar of a healthy lifestyle, underscoring the pivotal role of sound nutrition. Studies have indicated a prevalence of malnutrition among student nurses, yet the underlying factors contributing to this prevalent issue remain to be fully elucidated.

Objective:
This study aims to evaluate the depth of knowledge concerning an appropriate diet among nursing students enrolled at Achievers University, situated in Owo, Ondo State, Nigeria.

Materials and Methods:
From August 2022 to September 2022, a descriptive cross-sectional investigation was conducted, employing a Purposive sampling technique to ascertain a representative sample size of 307 participants. A carefully crafted and validated questionnaire was used for data collection, and tables, percentages, and Chi-square analysis were all used in the analysis to assess the level of statistical significance. A P-value of less than 0.05 was designated as indicative of statistical significance.

Results:
The study’s findings indicated that a significant proportion of participants (96.4%) agreed regarding the beneficial effects of consuming more than three meals daily for maintaining a healthy lifestyle. Additionally, all participants clearly understood the significance of maintaining a healthy diet. Notably, a considerable majority (89.6%) exhibited a commendable grasp of proper nutritional principles, while 3.6% demonstrated lower levels of understanding. Regarding participants’ weight status, the distribution was as follows: 50.8% were categorized as having an average weight, 36.2% fell into the overweight category, 10.1% were classified as obese, and 2.9% were underweight. The analysis of collected data yielded a noteworthy observation. Such as, it shows that there is no statistically significant correlation was found between the participants’ knowledge of sufficient nutrition and the practical implementation of this knowledge (χ
2 = 11.550, P = 0.072).

Conclusion:
In this study, nursing students who took part deeply understood a balanced diet, but this did not translate into the practice of an adequate diet. As a result, it is necessary to use other methods to encourage student nurses to practice good nutrition.
A prospective study to analyze the functional outcome of the femoral neck system in femoral neck fractures
Authors: Kale Sachin , Mishra Ronak , Singh Sushmit , Chalak Ajit , Vatkar Arvind , Ghodke Rahul , Das Sonali , Issacs Nikhil , Doshi Suraj 
Published: October 2023

Abstract

Background:
In 2017, a new fixation device called the femoral neck system (FNS), manufactured by DePuy Synthes orthopedics company of Johnson & Johnson, was introduced to manage femoral neck fractures. The primary objective of this study was to present our firsthand experience with this device in treating femoral neck fractures and to evaluate its clinical outcomes.

Materials and Methods:
With ethical committee approval, we conducted a prospective study involving patients aged 18 years or older but no more than 60 years. The study included a final sample size of 30 participants, selected based on specific inclusion and exclusion criteria. Patient records were reviewed to collect data on blood loss, fracture type, internal fixation methods, and the duration of clinical follow-up. Continuous variables were analyzed, and their mean values, standard deviations, and ranges were reported. The clinical assessment of patients was carried out using the Harris hip score and postoperative X-rays at regular intervals.

Results:
In our study, the gender distribution among the patients showed that 60% were females and 40% were males. The patient’s average age was 44.12 years, with a standard deviation of 2 years. The functional outcomes of patients treated with FNS using the hospital for special surgery (HSS) method were compared at different postoperative time points: 6 weeks, 3 months, and 12 months. The statistical analysis revealed significant differences in functional outcomes at these time intervals. During the study, two cases of postoperative complications were observed among the patients. These complications were addressed through specific interventions, namely bipolar hemiarthroplasty and shoe raise to correct limb shortening.

Conclusion:
Our study demonstrated that FNS yielded positive outcomes, significantly improving the HSS scores. Additionally, we observed that FNS was associated with minimal intraoperative blood loss in the cases we examined.
Association of sleep quality and glycemic control in type 2 diabetes mellitus
Authors: Bhagat Sweta , Khadkikar Rita , Rai Sandeep 
Published: October 2023

Abstract

Background:
Sleep is a modifiable risk factor for many chronic diseases, including type 2 diabetes mellitus. Poor quality of sleep leads to poor management of diabetes, adversely affecting sleep. The vicious cycle can be curtailed by good quality of sleep. Our study observed the association of glycemic control (glycosylated hemoglobin [HbA1C]) with sleep quality.

Materials and Methods:
A cross-sectional, observational study was conducted in the Diabetic Clinic of MGM Hospital, Kamothe, Navi Mumbai, India. Type 2 diabetes patients in the age group of 30–60 years were assessed for sleep quality using the Pittsburgh Sleep Quality Index questionnaire, and their HbA1C was measured by high-performance liquid chromatography.

Results:
A total of 101 type 2 diabetes patients aged 30–60 were assessed. A total of 25% were good sleepers, and 75% were poor sleepers. The mean ± standard deviation of HbA1C in good sleepers was 7.14 ± 1.30, and in poor sleepers was 8.9 ± 2.44. The correlation between sleep quality and glycemic control gave an r value of 0.36, and the P value was 0.002, which shows a highly significant correlation between poor sleep and glycemic control.

Conclusion:
The study shows poor sleep quality leads to poor glycemic control in type 2 diabetic patients with higher HbA1c levels. Creating awareness among diabetic patients about the good quality and duration of sleep for better management of diabetes is essential.
Incision and drainage and ultrasound-guided suction drainage for the management of breast abscess: A prospective randomized comparative study
Authors: Soni Mukesh , Chhabra Maninder K , Deshpande Preety , Ranjan Nikita , Nagwani Akshay 
Published: October 2023

Abstract

Background:
Breast abscesses commonly arise during lactation, with the conventional treatment method involving incision and drainage. Nevertheless, a promising, less invasive alternative for managing extensive and multilocular abscesses involves employing ultrasound-guided suction drainage and a fistulotomy probe.

Aims and Objectives:
This study evaluates and contrasts the results of two approaches in treating breast abscesses: ultrasound-guided suction drainage and the conventional incision and drainage method. The comparison will be centered around various parameters, such as procedural duration, patient-reported pain levels, breastfeeding capability, incidence of complications, overall hospitalization duration, and cosmetic results.

Materials and Methods:
In this research, we enrolled a total of 60 patients who had been diagnosed with breast abscesses. These patients were randomly assigned to two groups of 30 individuals. The control group underwent the conventional incision and drainage procedure under general anesthesia. In contrast, the study group received an innovative treatment method involving ultrasound-guided suction drainage using a fistulotomy probe to address the abscess’s compartments. This intervention was carried out under local anesthesia. The process involved the percutaneous insertion of an 18Fr suction catheter connected to the fistula probe. The catheter was carefully guided into the abscess cavity with the assistance of ultrasound imaging, following its longest axis. In multilocular abscesses, the catheter was threaded through all the compartments. Subsequently, the fistulotomy probe was detached from the drain within the abscess cavity to disrupt the compartments.

Results:
Using ultrasound-guided suction drainage showcased numerous benefits compared to the conventional method. It led to a shorter procedure duration, decreased patient discomfort, no interference with breastfeeding, accelerated healing, reduced hospitalization periods, enhanced cosmetic results, and a lower incidence of complications compared to the traditional approach.

Conclusion:
Using ultrasound-guided suction drainage for breast abscesses provides all the benefits associated with a minimally invasive strategy. Furthermore, using a fistulotomy probe demonstrates the equal effectiveness of this technique in addressing both large and multilocular abscesses compared to the traditional incision and drainage method.