bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urine Zinc-alpha-2-glycoprotein as a Potential Biomarker for Incipient Diabetic Nephropathy: A Pilot Study at a Tertiary Care Hospital
Authors: Tamizhan Sudhahar , Rajput Swati , Rabari Kamlesh , Mamgain Garima , Naithani Manisha 
Published: December 2023

Introduction:
Urine albumin-creatinine ratio (UACR) continues to be used as an indicator for detecting diabetic nephropathy (DN); however, damage starts much before that. Currently, no biomarkers are there to indicate incipient damage. As a result, researchers are looking for new biomarkers that could be used to detect DN threats sooner and perhaps hinder the development of end-stage renal disease. The present study intended to know if urine Zinc-alpha-2-glycoprotein (ZAG) levels correlate with glomerular filtration rate (GFR) in the study participants of type 2 diabetes mellitus (T2DM).

Materials and Methods:
The study included 68 participants with a known history of T2DM. Serum urea and creatinine levels, fasting plasma glucose, serum cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total protein, glycated hemoglobin (HbA1c) and urine ZAG were estimated and UACR along with estimated GFR (eGFR) were calculated for all individuals. The characteristics of the study participants in the microalbuminuric and normoalbuminuric groups were compared.

Results:
The levels of urine ZAG in the microalbuminuric and normoalbuminuric groups were not observed to be substantially different. The relationship between urine ZAG and diabetes mellitus duration was found to be highly significant in normoalbuminuric patients. Urinary ZAG and correlation with categories of HbA1c % (good <7, 7–9 moderate, >9 poor) among normoalbuminuric individuals were not found to be significant.

Conclusion:
Despite previous research, we were unable to find a positive relationship between urinary ZAG concentrations and eGFR in this study. Prospective studies with greater sample sizes and follow-up are required to fully comprehend the possible use of ZAG as a biomarker in diabetic nephropathy.
Comparison of Intravenous Ketamine Dosages for Postoperative Analgesia: Efficacy and Adverse Reactions in Abdominal Hysterectomy
Authors: Pauranik Ritu , Girwal Kiran , Sharma Aseem , Arora Kishore Kumar 
Published: December 2023

Introduction:
Following an abdominal hysterectomy, preemptive analgesia with two intravenous ketamine injections has been used as multimodal analgesia for postoperative pain. Ketamine’s ideal dosage for postoperative analgesia that has the least amount of adverse reactions is still up for discussion.

Materials and Methods:
This investigation was conducted at M.G.M. Medical College and M.Y. Hospital, Indore. The study included a total of 90 participants, classified as the American Society of Anesthesiologists classes 1 and 2, within the age range of 18–65 years. There were three groups made after dividing the patients with the help of the chit method so that no preference could be done. Group A was given an intravenous ketamine injection of 0.3 mg/kg, Group B was given an intravenous ketamine injection of 0.2 mg/kg, and Group C then got an intravenous ketamine injection of 0.1 mg/kg. In addition, all groups received subsequent 0.1 mg/kg ketamine injections every 30 min until the completion of the surgery. Various parameters were recorded for 24 h following the procedure, including the time to the first dosage, combined dose of rescue analgesia, combined number of doses of rescue analgesia, and incidence of adverse reactions.

Results:
The demographic profiles of all three groups were found to be comparable. The average time to request the first dosage of rescue analgesia was 316.33 ±66.345, 230± 44.721 & 89 ±26.698 minutes and 89 min, respectively, in Groups A, B, and C. Group A exhibited a significantly longer duration compared to Groups B and C. Postoperatively, at the 24-h mark, Group A displayed the lowest mean pain score (Visual Analog Scale) compared to Group B and Group C, with a statistically significant difference observed at P = 0.05. However, the frequency of nausea and vomiting between Groups A and B, as well as C, was not significant.

Conclusion:
Patients undergoing abdominal hysterectomy under spinal anesthesia experience reduced postoperative discomfort when administered intravenous ketamine at a dosage of 0.3 mg/kg, as opposed to lower doses. These results emphasize the potential benefits of higher dosage administration in enhancing postoperative analgesia in such procedures.
A Comparative Study of Endoscopic Endonasal Dacryocystorhinostomy with and without Stenting
Authors: Prinja Sumit , Dhanoa Simran , Singh Gurbax , Kaur Kanwalpreet , Gupta Shivangi , Bansal Garima 
Published: December 2023

Introduction:
The definitive management of complete nasolacrimal duct obstruction from chronic dacryocystitis is surgical. The surgery of choice is dacryocystorhinostomy (DCR), which can be done external or endonasal with or without stenting. We aim to compare the anatomical and functional outcomes of endoscopic endonasal DCR with and without stenting.

Materials and Methods:
This prospective study was carried out involving 30 patients of either sex randomly divided into two groups of 15 patients each. Group A underwent endoscopic DCR with stenting of the canaliculi, whereas Group B underwent endoscopic DCR without stenting. These patients were followed up at week 1, 6, and 12. The success of surgery in each group was determined by the absence of epiphora (Munk scale grades: 0 and 1), patent ostium on irrigation, positive Jones test, and decrease in the marginal tear film volume as seen on dye disappearance test (grade: 0 and 1) at week 12. Final data were analyzed using SPSS 21 version.

Results:
About 86.6% success rate was noted in the group where stenting was done (Group A) compared to 100% success in the group without stenting (Group B). This difference was, however, not statistically significant (P = 0.143). Failures in the study were attributed to the closure of rhinostomy ostium at week 12 follow-up. The most common complication noted was postoperative pain around the bridge of nose. Stent-related complications such as conjunctivitis and difficulty in removal of the stent were also noted.

Conclusion:
In our study, the surgical results of endoscopic endonasal DCR without stenting were better than endoscopic dacryocystorhinostomy with stenting both anatomically as well as functionally.
A Retrospective Study on Smell Dysfunction in COVID-19 Patients Presenting to a Tertiary Care Teaching Hospital in Northern India
Authors: Singhal Aditya , Jain Akshay , Agarwal Shradha 
Published: December 2023

Introduction:
The smell dysfunction in COVID-19 patients has remained an unexplained topic. The blood parameters’ variability in COVID-19 patients with anosmia has been studied in few literatures. The study is aimed to find the association of anosmia with the blood grouping and C-reactive protein (CRP) levels in coronavirus-infected patients.

Materials and Methods:
Database from Medical Records Department of a Tertiary Care Teaching Hospital in Northern India was searched from July 2020 to December 2020. Every fifth file was selected using the stratified random sampling. Laboratory-confirmed COVID-19 cases by reverse transcription-polymerase chain reaction files were included. Blood grouping and CRP levels were assessed and statistically correlated.

Results:
A total of 103 patients of coronavirus-associated infection with anosmia were included among which 52 (50.48%) patients were from moderate category of AIIMS-ICMR joint task Force’s clinical guidelines. A total of 44 (42.71%) patients had moderate levels of elevated CRP. The blood Group B-type was found most commonly in 35 (33.98%) patients. The correlation of severity of COVID-19 infection with CRP was found to be statistically significant (Chi-square test statistic was 31.203 and P = 0.00023) in patients presenting with smell dysfunction.

Conclusion:
Anosmia was found to a suggestive symptom for the early identification of coronavirus-infected cases. In this study, CRP levels showed statistically significant association with anosmia in COVID-19 patients. Predilection for specific blood groups serves as platform for further research.
Impact of Maternal Obesity on Obstetric Outcome: A Prospective Study in a District Hospital of West Bengal
Authors: Mukherjee Saswati , Mandal Aparna Khan , Chakraborty Atanu , Pal Amitabha , Sarkar Ashis 
Published: December 2023

Introduction:
The prevalence of obesity among women is an increasing problem, especially in urban population due to sedentary lifestyles and altered dietary habits. Maternal obesity has consequences on pregnancy and perinatal outcome. The present study was conducted to determine the impact of maternal obesity on maternal and perinatal outcome.

Materials and Methods:
A prospective hospital-based study was conducted on 176 pregnant women with body mass index (BMI) <25 kg/m2 and 166 pregnant women with BMI ≥25 kg/m2. Data on maternal outcomes and perinatal outcomes were collected by following up on antenatal women till the end of the pregnancy and results were analyzed among the two groups using SPSS version 27.

Results:
Around 31.3% of pregnant women with BMI ≥25 kg/m2 had developed gestational hypertension, 22.9% had gestational diabetes mellitus (GDM), 7.8% had preeclampsia/eclampsia, 9.6% had prolonged labor, and more than half (53%) of them had emergency lower segment cesarean section (LSCS). Less than 1/3rd of pregnant women with BMI ≥25 kg/m2 had induction of labor and perineal injuries. Association of gestational hypertension, GDM, preeclampsia/eclampsia, prolonged labor, and mode of delivery (emergency LSCS) was found to be significant with maternal obesity. About 16.9% and 7.2% of pregnant women with BMI ≥25 kg/m2 had preterm and postterm delivery, respectively. Only 0.6% of pregnant women with BMI ≥25 kg/m2 had weight of newborn >4 kg.

Conclusions:
Maternal obesity leads to adverse maternal and perinatal outcomes and is an important contributor to the burden of obstetric care. Thus, effective intervention is required in preconception period to reduce the obstetric complications.
Iodine-125 brachytherapy for choroidal melanoma by using Ocuprosta seeds with indigenous non-collimated plaques: Our initial experience
Authors: Narang Subina , Pandey Awadesh K , Kaur Gurbir , Giran Mannat , Saxena Sanjay K , Moudgil Sandeep , Walia Dinesh K , Handa Uma , Meena Vijay K , Kaur Ravinder , Astrahan Melvin 
Published: December 2023

Purpose:
Brachytherapy is the gold-standard treatment for choroidal melanoma. This study evaluated iodine-125 brachytherapy by using Ocuprosta seeds with indigenous non-collimated plaques in Asian patients.

Methods:
Retrospective single-center study in a tertiary care hospital of 12 eyes with choroidal melanoma in 12 Asian patients who underwent brachytherapy with Ocuprosta seeds fixed on non-collimated plaques and had a follow-up of at least 32 months (mean: 42.4 ± 9.5 months; median: 40 months). Radiotherapy was planned after developing the digital 3D model of the tumor within the eye by using radiological images and clinical pictures. Ocuprosta iodine-125 seeds were used on indigenous non-collimated gold plaques to deliver the radiation for precalculated time. “Successful outcome” was taken as a decrease in the volume of the tumor, and “unsuccessful outcome” was defined as no change in the tumor volume or increase in the tumor volume at 24 months after brachytherapy.

Results:
The mean decrease in tumor volume was 21% (914.5 ± 912.2 mm3 to 495.7 ± 633.6 mm3) after brachytherapy, which correlated with the baseline volume of the tumor. Ten eyes (83.3%) showed a reduction in tumor volume, whereas two eyes showed an increase in the volume of the tumor after brachytherapy. One of the cases with a reduction in tumor size developed neovascular glaucoma. Enucleation was done in three eyes. A globe salvage rate of 75% and tumor regression rate of 83% were seen in the present study using Ocuprosta seeds.

Conclusions:
Iodine-125 brachytherapy with uncollimated indigenous gold plaques is an effective treatment modality for choroidal melanomas in Asian patients.
Real-world experience of brolucizumab in nAMD
Authors: Narnaware Shilpi H , Bansal Anju , Bawankule Prashant K , Raje Dhananjay 
Published: December 2023

Purpose:
To evaluate real-world outcomes with neovascular age-related macular degeneration (nAMD) in relation to anatomical success, visual outcomes, and safety of intravitreal brolucizumab (IVBr) injection at 1.5 years.

Methods:
Prospective, randomized, single-center study between December 2020 and December 2022 that included 71 eyes of 62 patients with nAMD, who received IVBr. Patients were divided into three groups, i.e., naïve choroidal neovascular membrane (CNVM), switched therapy (st) CNVM, and st polypoidal choroidal vasculopathy (stPCV). They were subdivided into dry, minimal fluid (fluid <50 microns)/pigment epithelial detachment (PED) and persistent fluid (fluid >100 microns)/PED subgroups depending upon the fluid level at the end of 1.5 years. Best‐corrected visual acuity (BCVA), central macular thickness (CMT), status of fluid, and number of injections at 1.5 years were evaluated. From the beginning, patients were treated on pro re nata (PRN) basis.

Results:
Of the 71 eyes, 27 eyes (38%) were naïve CNVM, 35 eyes (49.3%) were stCNVM, and 9 (12.7%) were stPCV cases. Significant vision improvement after 1.5 years was seen in the stCNVM category (P = 0.001), while CMT reduction was significant in all three groups (P < 0.05). The mean number of injections required in naïve CNVM and stCNVM groups was significantly less as compared to the stPCV group (P = 0.017). Further, vision improvement was significant in the “Minimal fluid” subgroup (P = 0.002), while the CMT improvement was significant in the “Minimal fluid” and “Dry” subgroups each with P < 0.0001. No ocular/systemic adverse events including intraocular inflammation (IOI) were noted.

Conclusion:
In a real-world scenario, with 203 procedures and 1.5-year follow-up, brolucizumab is found to be efficacious and safe with the need for a lesser number of injections and more interval-free period in the management of naïve CNVM, stCNVM, and stPCV patients.
Prediction of Operability by Pulmonary Artery Acceleration Time and Right Ventricular Ejection Time in Large Ventricular Septal Defects with Severe Pulmonary Arterial Hypertension
Authors: Bandyopadhyay Sudipta , Sridhar Anuradha , Sivaprakasam Muthukumaran Chinnaswamy 
Published: December 2023

Background:
Diagnosing and treating cardiopulmonary illnesses in children depend heavily on evaluating pulmonary hemodynamics. Severe pulmonary artery hypertension (PAH) and Eisenmenger’s syndrome are most frequently seen in post-tricuspid shunts. Right heart catheterization is the gold standard test for calculating pulmonary vascular resistance and pulmonary artery pressures, but it has many flaws, especially regarding shunt abnormalities. Right ventricular ejection and pulmonary artery acceleration times can be useful alternatives for determining pulmonary vascular resistance.

Aims and Objectives:
This study aimed to correlate pulmonary artery acceleration time (PAAT) and right ventricular ejection time (RVET) with PAH.

Materials and Methods:
We included 52 patients with large ventricular septal defects (VSD) and severe pulmonary artery hypertension. All children with large VSD and severe PAH admitted for diagnostic catheterization after satisfying the inclusion criteria were included in the study following approval from the institutional ethics committee. All pre-catheterization echocardiographic data were collected with a Philips iE33 ultrasound machine. All of them underwent diagnostic catheterizations.

Results:
We observed that the chance of operability was high earlier in the age of presentation. PAAT: RVET had a positive correlation with Qp:Qs (pulmonary flow: systemic flow) and were negatively correlated with pulmonary vascular resistance index (PVRI), pulmonary vascular resistance: systemic vascular resistance (PVR:SVR), and mean pulmonary artery pressure (mPAP). In our study, we found that both PAAT and PAAT: RVET were moderately negatively correlated with PVRI and PVR: SVR (r: -0.72, P < 0.001, r: -0.71, P < 0.001 and r: -0.67, P < 0.001, r: -0.71, P < 0.001 respectively). PAAT and PAAT: RVET were moderately negatively correlated with mPAP (r: -0.7. P < 0.001; r: -0.71, P < 0.001 respectively) and positively with Qp:Qs (r: +0.63, P < 0.001; r: 0.67, P < 0.001 respectively).

Conclusion:
PAAT and PAAT: RVET index are important parameters in assessing pulmonary arterial pressure in large VSD with severe PAH.
How Many Echocardiograms Should be Performed to Detect One Cardiac Abnormality in Patients <18 Years? Results from the “Performing Echocardiography to Detect Heart Disease (PED-HEART) Study”
Authors: Jain Pradeep Kumar , Upadhyay Jaya , Soni Shishir , Rai Nimish , Siddiqui Suhel , Mishra Vikas , Kinare Amit 
Published: December 2023

Introduction:
Echocardiography is an important cardiac investigating tool, however, its appropriate use in patients <18 years has to be ascertained.

Aim:
The aim of this study was to assess the clinical indication of the referral for echocardiography in patients with abnormal and normal echocardiographic examination.

Methods:
Single-center, retrospective observational analysis was done in patients <18 years who underwent echocardiography. This included patients’ clinical profiles and echocardiography examination findings.

Results:
Out of 7500 patients, normal echocardiography examinations (Group 1) were found in 75.33% (n = 5650) of the patients. Out of these (Group 1), 32.8% were referred for electrocardiographic changes, while 25% and 31% were for palpitation and chest pain, respectively. Patients with trivial findings on echocardiography were 350 (Group 2). Patients with a significant abnormality on echocardiography requiring medical management (Group 3) or cardiac intervention (Group 4) were 1250 and 250, respectively. The comparison of Group A (combined Groups 1 and 2 patients) with Group B (combined Groups 3 and 4 patients) showed that the referrals made for murmur, suspected heart failure, chest X-ray abnormalities, abnormal blood pressure/shock, and multiple parameters were found to be an independent predictor of abnormal findings on echocardiography.

Conclusion:
Abnormal findings on echocardiography requiring cardiac intervention in patients <18 years is one in every five echocardiograms performed in this study. The implementation of appropriate use criteria for echocardiography may help in improving this ratio.
Evaluation of antifungal activity of vanilla pods silver nanoparticles against various oral candidal species: An in-vitro study
Authors: Sri V.L Premika , Srinivasan Samyukta , Muthukumar Sathish , Chellaswamy Sreeja , Nachiappan N. Nachiammai , Thamilselvan Snega 
Published: December 2023

Background:
The oral health of individuals is undoubtedly affected by the fact that fungal microorganisms are currently resistant to the conventional antifungal drugs used. Still, there are numerous emerging therapeutic alternatives available like phytotherapy. The phytochemistry of various plant species has indicated that phytochemicals could be a better source of medicine with outstanding antifungal, healing, anti-inflammatory spectrum, and antioxidant properties.

Aim:
To evaluate the antifungal efficacy of silver nanoparticles of vanilla pods against Candida albicans, Candida glabrata, and Candida krusei and to compare with Fluconazole.

Materials and Methods:
The vanilla pods were procured from the organic store. The aqueous extracts were prepared. Ten percent of the vanilla extract was utilized to generate the silver nanoparticles. The generated silver nanoparticles were characterized visually based on color change and confirmed by UV spectroscopy. Disk diffusion method was used to determine the antifungal activity of the vanilla pods reinforced silver nanoparticles at different concentrations (20 μl, 40 μ, 40n μ, and 80 μand 80ratioC. albicans, C. glabrata, and C. krusei. The antifungal efficacy of the produced nanoparticles was evaluated against a standard of ketoconazole (30 μ30.

Results:
Vanillin silver nanoparticles exhibit commendable antifungal activity against C. albicans, C. glabrata which is equivalent to that of ketoconazole, and amplified activity against drug-resistant C. krusei was evident.

Conclusion:
Silver nanoparticles from vanilla pods were studied and their wider zones of inhibition indicated exemplary antifungal efficacy compared with conventional antifungal drugs like ketoconazole.

Clinical significance:
Future research on vanillin nanocarrier systems might enhance their stability, bioavailability, and bioactivity. As an outcome, with some promising advances in this area, it would be captivating to pursue a systematic investigation into the potential effects of vanillin at the cellular and molecular levels. This will enable us to further assess its applicability as an active biopharmaceutical ingredient in mouthwashes, probiotic lozenges, and denture resin for use as an effective strategy against the biofilm growth of various Candida species.
Assessment of Microgap and Bacterial Leakage of Two Types of Internal Implant–Abutment Union
Authors: Basha Shaik Riyaz , Channamsetty Praveena , Janapati Divya , Badugu Satyavathi , Kodipalli Sravalli , Ireddy Kavya Sri , Mitra Nirban 
Published: December 2023

ABSTRACT

Objective:
The current research was done to assess microbial seepage of two types of internal implant–abutment connections

Materials and Methods:
Twenty dental implants are categorized into two groups. Group A fixtures with an internal hexagonal geometry and group B fixtures with a tri-lobe internal connection. All implant–abutment assemblies underwent a three-week incubation period at 37°C in sterile tubes containing 5 mL of Staphylococcus aureus broth culture. Through the use of Gram stain and biochemical processes, the resultant colonies were recognized.

Results:
The mean Log10 colony forming unit (CFU) in group A was 8.4 and in group B was 7.2. The variation between both groups was found to be considerable (P < 0.05). Microgap was more in group B compared to group A

Conclusion:
Bacteria may infiltrate the small area between the implant and the abutment. Compared to dental implant fixtures with a tri-lobe internal connection, there was a noticeably higher Log10 CFU in dental implant fixtures with an internal hexagonal geometry.
Clinical Correlation of Vitamin D Deficiency and Early Childhood Caries: A Cross-Sectional Study in Western Rajasthan
Authors: Aijaz Amreen , Chaudhary Pankaj , Malawat Kanchan , Almalki Sultan A. , Sharma Tanvi , Jameel AlBandary H. Al , Arya Sugandha 
Published: December 2023

ABSTRACT

Objectives:
To ascertain whether a link exists between vitamin D insufficiency and early childhood caries or not.

Method:
From the out patient department (OPD) of the Pedodontics Department at Vyas Dental College, a random sample of 40 kids between the ages of 8 months and 5 years old was chosen. Each kid had blood drawn to check their serum 25(OH) vitamin D levels. All of the data was collated and given the necessary statistical analysis.

Result:
The case group’s mean serum 25(OH) vitamin D level was 10.19 ng/mL (with a standard deviation of 3.46), while the control group’s was 20.84 ng/mL (2.54 SD).

Conclusion:
A significant modifiable risk factor for childhood dental caries is a vitamin D deficiency. Therefore, cavities in teeth can be avoided by giving youngsters vitamin D supplements and avoiding vitamin D insufficiency.