bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Study of b3 Agonists versus Anticholinergics Administration in Patients with Multiple Sclerosis and Lower Urinary Tract Dysfunction
Authors: Stamatakos Panagiotis Velissarios , Mari Victoria , Moschotzopoulos Dimitrios , Stathouros Georgios , Ntoumas Konstantinos 
Published: January 2024

Abstract

Introduction and Objective:
Multiple sclerosis (MS) is the most frequent autoimmune demyelinating disease of the central nervous system usually affecting lower urinary tract function. In the present study, we compare the efficacy and safety of either a b3 agonist (mirabegron) or anticholinergics in treating MS patients with lower urinary tract dysfunction (LUTD) and assess the LUTD symptom improvement.

Evidence Acquisition:
A multi-center, single-blinded, comparative study was designed, including MS patients with LUTD. Patients were administered either mirabegron or anticholinergics in combination with standard MS treatment. All cases underwent clinical examination and completed urination diaries and validated questionnaires (Neurogenic Bladder Symptom Score and MS International Quality of Life). Furthermore, urine test analysis, as well as abdominal ultrasound imaging examination, was performed. Data on several clinical and imaging parameters were collected between the two groups at the first visit and after 3 months of treatment.

Evidence Synthesis:
A total of 61 patients with LUTD participated in the survey. An improvement regarding LUTD was noted in all patients. However, no statistical difference was recorded between the mirabegron and the anticholinergic group. Medical treatment was well tolerated, and no patient discontinued medication due to side effects.

Conclusions:
Both mirabegron and anticholinergic therapy can be administered for LUTD in MS patients. In terms of drug efficacy, no statistical difference was noted between the two cohorts at 3 months.
Therapeutic Options in Metastatic Renal Cancer
Authors: Bellos Themistoklis Ch. , Manolitsis Ioannis S. , Katsimperis Stamatios N. , Kyriazis Ioannis P. , Angelopoulos Panagiotis A. , Neofitou Panagiotis N. , Kapsalos-Dedes Sotirios G. , Deligiannis Panagiotis K. , Tzelves Lazaros I. , Kostakopoulos Nikolaos A. , Lazarou Lazaros C. , Markopoulos Titos P. , Berdempes Marinos V. , Kiriakidis Alexandros A. , Livadas Konstantinos E. , Mitsogiannis Iraklis C. , Varkarakis Ioannis M. , Papatsoris Athanasios G. , Skolarikos Andreas A. , Deliveliotis Charalampos N. 
Published: January 2024

Abstract

Background:
Renal cancer is the 3rd most common cancer of the urinary tract. It peaks at the age of 64 years and appears more common in men than women.

Methods:
The purpose of this study is to review the potential therapeutic options in metastatic renal cancer. A thorough MEDLINE/PubMed nonsystematic literature review was conducted from 1990 to May of 2023. The terms used for the search were “metastatic” AND “renal cancer” OR “renal cell carcinoma” AND “therapy” OR “treatment” AND “metastasectomy” AND “immunotherapy”.

Results:
Metastasectomy is advantageous when the metastatic foci are completely excised. When there is no clinical suspicion of any remaining metastatic disease, there is no need for further systemic therapy. Patients at intermediate risk may initiate neoadjuvant systemic therapy with immune-oncology (IO) and IO or tyrosine kinase inhibitor and IO; once the tumor regresses, metastasectomy is performed.

Conclusion:
In conclusion, there are many modalities for metastatic renal cancer treatment which depend on the prognostic factors of the disease itself.
A Rare Case of Complete Urethral Duplication and Short Review of the Literature
Authors: Joshi Prashant B. , Babu Sreelakshmi Suresh , Prabhu Shailee , Kunte Maithili , Mishra Baleshwar , Thanki Meet 
Published: January 2024

Abstract
Duplication of the urethra is a rare congenital anomaly, predominantly seen in males. Due to the rarity of the condition, there is no fixed consensus regarding the management of these patients. We report the case of a 4-year-old male child who presented with phimosis and balanoposthitis, with the occasional double stream of urine and was incidentally found to have duplication of the urethra. Cystoscopy revealed the duplication to be Effman Type II A-1. No surgical intervention was done for the duplication as the patient was asymptomatic. Our aim is to report this rare case and to enhance the knowledge by reviewing the already existing scanty literature of this rare condition.
Transient Ischemic Attack Following Foam Sclerotherapy for Chronic Venous Ulcer with No Cardiac Defect - A Rare Case Scenario
Authors: Egappan A R Satthish , Prathap K 
Published: January 2024

Abstract
Chronic venous insufficiency (CVI) constitutes one of the main causes for lower limb ulceration. Foam sclerotherapy forms an important part of CVI treatment. It is used to treat truncal incompetence, perforating veins, and primary and secondary varicosities as well as reticular and spider veins. It is used either alone or in addition to the endovenous ablative techniques. Although usually done as an office procedure, it can cause serious complications which include allergic reaction, deep-vein thrombus formation, superficial vein thrombosis, and ulceration if extravasated into the subcutaneous plane and rarely can cause various neurological manifestations such as transient visual loss, migraine, transient ischemic attack, speech disturbances, and stroke. Neurological complications amount to only 0.90% among all the complications according to a systematic review by Tharsi Saravananthan et al. The neurological complications are usually transient and generally occur due to patent foramen ovale (PFO). There are very few case reports mentioned in the literature where the neurological symptoms occur without any evidence of cardiac defects. Herein, we report a case where foam sclerotherapy was given for chronic venous ulcer, and the patient developed speech disturbance in the immediate postprocedure period which resolved on its own. His preoperative echocardiography was normal without any structural heart defects. This is one of the few cases to be reported in the literature where sclerotherapy-induced neurological complication has occurred without any evidence of PFO.
Bovine Pericardial Tube as a Conduit for Left Renal Vein Transposition in Treatment of Nutcracker Syndrome
Authors: Shah Kesha , Saini Devi Prasad , Sain Ram Swaroop , Yadav Rajkumar 
Published: January 2024

Abstract
Nutcracker syndrome (NCS) is caused by compression of the left renal vein (LRV) between the aorta and the superior mesenteric artery. This results in left renal venous hypertension and the subsequent development of venous varicosities of the renal pelvis, ureter, and gonadal vein, also called renal vein entrapment syndrome. Its treatment includes open surgical technique as well as minimally invasive technique, namely laparoscopic and endovascular techniques. Here, we report the case of a young male diagnosed with NCS treated with LRV transposition using bovine pericardium as conduit interposing between inferior vena cava and LRV.
Prescription Patterns of Analgesics for Oral Conditions in India - Analysis of Large Medical Audit Data of Outpatients in India’s Private Healthcare Sector
Authors: Sayeed Saif , Mathur Manu Raj , Mishra Vijay Kumar , Nagrath Deepti , Watt Richard G. 
Published: January 2024

Abstract

Background:
Analgesic use needs to be regulated due to its adverse effects. This study aimed to analyse the change in prescription rates and patterns of the analgesics prescribed for various oral conditions and to analyse their trends across different age groups and gender to promote rational prescription of drugs and eventually influence regulatory policies.

Methods:
Secondary analysis was conducted on medical audit data collected from the private health sector in India. The prescription rate per 1000 persons per year was calculated from May 2013 to April 2016 using the mean projected population (PP) of India. Cross-tabulations were conducted to analyse the prescription rate and their changes across different age groups, gender and oral conditions.

Findings:
The mean analgesic prescription rate was highest among the 20-40 age group, and the highest increase was noted in ‘non-steroidal anti-inflammatory drug (NSAID) combinations’ (3.56 per 1000 persons per year) from May 2013 to April 2016. The ‘NSAID combinations’ group was also the most prescribed medication across all the oral conditions, with ‘diseases of hard tissues’ having the highest prescription rate (41.4 and 45.6 per 1000 persons per year, respectively, for 2013–14 and 2015–16).

Interpretation:
The results indicate an overall increase in the analgesic prescription rate, especially ‘NSAID combinations’ for each dental disease and age group, a finding that is hard to explain. Due to the lack of prescription guidelines in India, it is difficult to assess whether these analgesics were prescribed rationally or not.
Effect of Novel Biomodification Strategies on Bonding to Pulp Chamber Dentin – An In Vitro Study
Authors: Radhakrishnan Saranya , Devadiga Darshana 
Published: January 2024

Abstract

Context:
Adhesion to dentin remains a tough challenge due to its heterogeneous composition, complex histologic structure and high tubular content, warranting the need to investigate methods to improve the bond strength of the commonly used access restorative materials to pulp chamber dentin.

Aims:
To evaluate the effect of dentin biomodification using 6.5% grape seed extract and a 980 nm diode LASER on the shear bond strength of resin-based bonded restoration to pulp chamber dentin.

Methods and Materials:
Access cavities were prepared in 42 extracted human maxillary premolars, which were then sectioned in a buccolingual direction. The samples were serially immersed in 5.25% NaOCl for 40 minutes and 17% EDTA for 3 minutes and allocated into three groups: the control group, the group pre-treated with 6.5% grape seed extract (GSE) and the group pre-treated with a 980 nm diode light amplification by stimulated emission of radiation (LASER). All the samples were restored with resin composites and subjected to shear bond strength testing using a universal testing machine.

Statistical Analysis Used:
Statistical analysis was done using SPSS version 23 software.

Results:
The mean shear bond strength was highest in the group pre-treated with GSE, followed by that pre-treated with diode LASER and finally in the control group.

Conclusions:
Dentin biomodification using both chemical and physical agents such as grape seed extract and diode LASER was shown to improve the shear bond strength of resin composite endodontic access restorations to the pulp chamber dentin.
Clinical Usability of Vasundhara’s Transit for Gutta-Percha (V Transit GP) - A Questionnaire-Based Survey
Authors: Vijayaraghavan Siddheswaran , Menon Krutika , Dhanyakumar N. M. , Shivanna Vasundhara 
Published: January 2024

Abstract

Context:
The lack of a suitable armamentarium to aid in the disinfection and handling of gutta-percha (GP) cones during obturation has been a common challenge amongst dentists.

Aims:
This study assessed the clinical usability of ‘Vasundhara’s (V) Transit GP’ through a questionnaire-based survey.

Settings and Design:
This questionnaire-based study was conducted in Davanagere, Karnataka, in February 2021 for 4 months.

Methods and Material:
The design was 3D printed using a heat-resistant polypropylene material and named ‘Vasundhara’s Transit for Gutta Percha (V Transit GP)’. Eighteen postgraduate students participated in the study. Fourteen cases were done by each student, seven without and seven with the use of ‘V Transit GP’. The GP cones, before obturation, were transferred to their respective canal slots containing 5.25% sodium hypochlorite for one minute and then transferred to their respective distilled water slots. The cones were dried with sterile gauze and taken for obturation. At the end of the procedure, a questionnaire was handed out, the responses were recorded, and the results were tabulated and analysed using Statistical Package for the Social Sciences (SPSS) version 22.0 software.

Results:
The results showed that without the use of ‘V Transit GP’, 84.2% of the dentists felt that the disinfection and handling of GP cones were difficult, whereas with the use of ‘V Transit GP’, 94.2% of the participants found it to be extremely easy.

Conclusions:
‘V Transit GP’ proved to be an extremely efficient and user-friendly equipment for easy handling and disinfection of GP cones during obturation.
Effect of Various Preparation Designs on Pull-Out Bond Strength of Endocrown
Authors: Thangarasu Naveen , Venkatesh K. Vijay 
Published: January 2024

Abstract

Background:
The endocrown is described as monobloc ceramic component. The pull-out bond strength acts as a real-life scenario of failure that occurs in endocrown. The different preparation designs have been included to assess the type of preparation that resists the least failure.

Aim:
To evaluate the effect of three different types of preparation designs on the pull-out bond strength (PBS) of computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic endocrowns.

Methods and Materials:
Thirty extracted mandibular first molars were used for this study. Root canal treatment was done. Samples were divided into three groups of 10 samples each. Group A consists of traditional endocrown preparation with a butt joint preparation. The group B consists of a modified preparation with 50-60 degree inward slope. The group C consists of preparation with a 50-60 degree outward slope. Endocrowns were fabricated using CAD/CAM lithium disilicate glass-ceramics. The endocrowns were adhesively bonded to the respective preparations. Pull-out bond strength was calculated using the universal testing machine at a crosshead speed of 1 mm/min.

Statistical Analysis:
The results were statistically evaluated by one-way ANOVA and Tukey’s post hoc analysis.

Results:
Group B had higher pull-out bond strength compared to the other two types of preparation designs and showed a statistically significant value with a mean significant difference at 0.05 level (P < 0.05).

Conclusion:
The 50-60 degree inward bevel in endocrown preparation increased the pull-out bond strength in lithium disilicate endocrowns.
Mucormycosis in COVID-19 Patients – A Case Series from a Dental College in South India
Authors: Sevagaperumal Annapoorani , Winnifred A. Christy , Thambi T. Jones R. Deva 
Published: January 2024

Abstract

Introduction:
Incidence of mucormycosis has increased recently due to rapid spread of coronavirus disease 2019 (COVID-19), which is a hyper-ferritemic state paving a way for easy growth of mucor species. COVID-19 infection results in an immunocompromised state due to the steroid therapy administered to patients and the infection itself. The presence of co-morbidities makes patients more susceptible to acquire mucor infection. Mucormycosis spreads rapidly, associated with aggressive angioinvasion, leading to ischemic necrosis of surrounding tissues. Due to its rapid spread and angioinvasion, mucormycosis is associated with increased mortality and morbidity.

Treatment Planning:
Early diagnosis and proper treatment planning are crucial to prevent further spread of infection, where dentists play an important role.

Discussion:
This case series is mainly focused on patients reported to the oral medicine department with complaints of discomfort or mobility of teeth in the maxillary region while explaining the role of dentists in diagnosing and treating the disease.
Evaluation of Efficacy of Artificial Intelligence in Orthopantomogram in Detecting and Classifying Radiolucent Lesions
Authors: Singar Sheetal , Parihar Ajay , Reddy Prashanthi 
Published: January 2024

Abstract

Aim and Objective:
The objective of our study was to build a convolutional neural network (CNN) model and detection and classification of benign and malignant radiolucent lesions in orthopantomogram (OPG) by implementing CNN.

Method:
Two basic CNN models were implemented on Anaconda with Python 3 on 64-bit, CNN-I for detection of radiolucency and CNN-II for classification of radiolucency into benign and malignant lesions. One hundred fifty eight OPG with radiolucency and 115 OPG without radiolucency was used for training and validation of CNN models. Data augmentation was performed for the training and validation dataset. The evaluation of the performance of both CNN by new data consisting (60 OPG images) 30 benign and 30 malignant lesions.

Statistical Analysis:
Performed using SPSS (Statistical package for social science) 20.0 version. The descriptive statistics was performed. The Cohen kappa correlation coefficient was used for assessment of reliability of the diagnostic methods. P < .05 was considered statistically significant. Determination of sensitivity, specificity, positive and negative predictive value was also performed.

Result:
CNN-I showing sensitivity for detection of the benign lesion is 76.6% and sensitivity for the malignant lesion is 63.3% with overall sensitivity is 70%. CNN-II showing sensitivity for classification of the benign lesion is 70% and for classification of the malignant lesion is 63.3% with overall classification sensitivity is 66.6%. The kappa correlation coefficient value for diagnosis made by CNN-II is 0.333 and P < .05.

Conclusion:
Both CNN showed statistically significant and satisfactory results in detecting and classifying radiolucency in OPG.
Adherence and Effectiveness of HBV Vaccination among Healthcare Workers in Egypt
Authors: Elshaer Mohammed , Elsayed Eman , El-Gilany Abdel-Hady , El-Mashad Noha , Mansour Mostafa 
Published: January 2024

Context:
Healthcare workers (HCWs) face a potential risk of acquiring different bloodborne pathogens, by occupational exposure to contaminated blood and body fluids. Hepatitis B vaccine is a safe, effective method of conferring long-term protection against HBV infection.

Aims:
The study aimed to assess the adherence and effectiveness of HBV vaccination among HCWs at Gastrointestinal Surgical Center, Mansoura University, Egypt.

Settings and Design:
A prospective descriptive study was carried out between June 2019 and December 2019 at Gastrointestinal Surgical Center, Mansoura University, Egypt.

Methods and Material:
All HCWs with anti-HBs levels below 10 mIU/mL were advised to receive 3 doses of recombinant HBV vaccine, at 0, 1, and 6 months. The anti-HBs levels were checked 3 months after the third dose of the HBV vaccine.

Statistical Analysis Used:
Data was analyzed using the Statistical Package of Social Science (SPSS) program for windows (version 16).

Results:
A total of 442 healthcare providers were included. Most of them completed the 3 doses of the vaccine (81.7%), 10.2% refused the vaccine, while 0.9% and 7.2% received 1 and 2 doses, respectively. Odds of vaccination were the highest (88.1%, 273/310) among nurses (OR, 4.7; 95% CI, 2.6–5.2; P ≤ 0.001). The overall anti-HBs positivity of 97% (350/361) was observed. The main reasons for not being vaccinated included the fear of vaccine side effects 25/81 (30.9%) and lack of trust in the vaccine effectiveness 18/81 (22.2%).

Conclusions:
The outcome of the present study emphasizes the need to apply alternative and innovative measures to build a positive attitude toward the HBV vaccine among HCWs.
Dealers in Black Gold
Authors: Thattil Anissa Mary Thomas , Gnanaselvam Nancy A. , Rajitha K , Goud B. Ramakrishna 
Published: January 2024

Background and Objectives:
Fecal sludge management (FSM) is an unorganised sector, which is wrought with occupational health hazards for fecal sludge operators (FSOs). This study was conducted to identify the knowledge, attitude, and practices regarding FSM among FSOs.

Study Setting and Design:
This cross-sectional study was conducted in a rural area of Anekal Taluk, Bengaluru Urban District, Karnataka and in Hosur, Krishnagiri District, Tamil Nadu.

Methods and Materials:
Snowball method of sampling was employed and, 60 participants were interviewed using an interviewer administered semi-structured questionnaire.

Statistical Analysis:
The data has been described using measures of central tendency, frequencies, and percentages.

Results:
All 60 participants were males with a mean age of 33.7 ± 7.9 years. Majority practised Hindu religion (98.3%) and 95.0% belonged to the scheduled castes; only 3.3% were illiterate. According to modified SLI, 45.0% belonged to high standard of living. The common occupational hazards reported were injuries, social stigma, and alcoholism. Although 91.7% felt that personal protective equipment (PPE) would protect against health hazards, 65.0% felt that it hampered work. Most (86.7%) felt that FSM was attached to social stigma. None reported the use of the full set of required PPE. All participants reported washing their hands and feet with only water at the end of each operation.

Conclusion:
The knowledge and practices followed by the FSOs were found to be inadequate in this study. Health awareness generation and provision of PPE must be employed to ensure sustained behaviour change.
Healthcare Workers Exposure to Ionizing Radiation
Authors: Bolbol Sarah A. , Zaitoun Mona F. , Abou El-Magd Sahar A. , Mohammed Noha A. 
Published: January 2024

Background:
Ionizing radiation is well known to cause oxidative stress which is responsible for various health hazards. Controlling healthcare workers' exposure and raising attention toward continuous monitoring is the first step for improving both the health of healthcare workers and the quality of patient care, thus decreasing both human and economic costs.

Objectives:
To assess oxidative stress by measuring the level of lipid peroxidation, antioxidants, and measure complete blood count (CBC) among healthcare workers exposed to ionizing radiation.

Methods:
A cross-sectional study conducted at the diagnostic radiology department on 31 healthcare workers exposed to ionizing radiation and a non-exposed group of 31 healthcare workers from outpatient clinics. Malondialdehyde (MDA), superoxide dismutase (SOD), and CBC were measured among both groups.

Results:
MDA was significantly higher among the exposed group, while the level of SOD was significantly lower. Red blood cells and hemoglobin were significantly lower among the exposed group. The most significant predictor of oxidative stress was the duration of work.

Conclusion:
Ionizing radiation exposure induce oxidative stress which has an important role in radiation-related health effects. Anemia was the most common hematological health hazards among the exposed group.