bluuebunny/crossref_metadata_2025_split huggingface dataset:
mRNA Expression of Ezrin in Gingival Crevicular Fluid and Whole Blood of Gingivitis and Chronic Periodontitis Patients – A Polymerase Chain Reaction Study
Authors: Cecil Anju , Sambashivaiah Savita , Bilichodmath Shivaprasad , John Rubin S. 
Published: December 2022

Background:
A comparative analysis of protein expression of gingival crevicular fluid (GCF) obtained from healthy individuals and individuals with periodontal diseases would help to identify proteins involved in periodontal disease progression. Among the identified proteins, Moesin which is a disease-associated protein belongs to the ezrin-radixin-moesin protein family and was proved to play an important role in the recognition of oral bacteria contributing to the consequent development of inflammatory immune responses involved in periodontal disease development.

Aim:
The aim of the study is to quantify and compare mRNA expression levels of ezrin in GCF and whole blood of gingivitis and chronic periodontitis patients.

Materials and Methods:
A total of 60 patients were selected for the study and were divided into three groups as follows: Group 1 (20 participants with healthy gingiva), Group 2 (20 participants with gingivitis), and Group 3 (20 participants with chronic periodontitis). Clinical parameters such as gingival index, periodontal index, probing pocket depth, and clinical attachment level were assessed. GCF and blood samples were taken from these patients and assessed for the mRNA expression of ezrin using real-time polymerase chain reaction.

Results:
The expression and mean relative quantification of mRNA expression of ezrin in GCF and blood were higher for periodontitis (18.32 ± 8.398, 19.34 ± 9.487) when compared to that of gingivitis (5.34 ± 3.609, 5.48 ± 4.428) and healthy individuals (2.33 ± 0.643, 3.47 ± 1.923) and they positively correlated with the clinical parameters.

Conclusion:
The increased expression of ezrin can be considered as a good indicator to assess the inflammatory activity in periodontitis and gingivitis.
Dentists' Knowledge, Practices, and Mishaps in Relation to Post Placement for Endodontically Treated Teeth
Authors: Singh Abhinav Kumar 
Published: December 2022

Background:
When restoring teeth, the post and core method is often employed. Unfortunately, several reports of endodontically treated teeth failing after placement of this material exist.

Objective:
The purpose of this research is to determine whether or not dentists have a thorough understanding of the causes of post and core failure. The goal is to evaluate patient outcomes following post coronal restoration procedures, such as post space preparation, post placement, and post final coronal restoration.

Methodology:
The quantitative methodology has informed a cross-sectional study design. One hundred dentists were chosen at random to fill out the questionnaire, which was then examined statistically.

Results:
Sodium hypochlorite irrigation, rubber dams, mineral trioxide aggregate management, and follow-up were all mentioned in the findings. Further, it was demonstrated that factors such as tooth size, tooth type, repair time, and repair material all play a role in whether or not a restorative tooth fails.

Conclusion:
According to the results, the study population had varying degrees of understanding of the post- and core-restorative system. Guidelines should be established to improve restorative practices and expand understanding. Likewise, this aids in avoiding any accidents that could arise as a result of the same causes.
An Appraisal of Knowledge, Attitude and Practices of Anganwadi Workers under Integrated Child Development Services Scheme on Infection Prevention and Control in the Initial Months of COVID-19 Pandemic in District Lucknow, UP, India
Authors: Singh Manish Kumar , Maurya Mukesh , Yoosuf Ahmed Shammas , Nargotra Shikha , Pawar Priyanka J , Mukherjee Ritika , Mahapatro Archisman 
Published: December 2022

Background:
During the COVID-19 pandemic, Anganwadi workers (AWWs) were repositioned for community support, community surveillance, community awareness on infection prevention and mitigating stigma/discrimination entailing infection, going door to door. The job entailed good knowledge, attitude and practices (KAP) with regard to infection prevention and control (IPC). Aims

:
To assess the KAP of AWW with regard to IPC in context of COVID-19 in Lucknow district.

Methods:
A cross-sectional survey was conducted using Google form between 30 June and 28 July 2020. AWWs were recruited from Lucknow district irrespective of their training status; data analysis was done on 137 participants. The mean KAP score was calculated and student t-test was applied. Chi-square test was performed between categorical variables and KAP. Univariate and multivariate logistic regression was applied between independent and dependent variables.

Results:
The mean score of knowledge was 7.22 ± 2.64, attitude was 4.34 ± 1.14 and practice was 4.44 ± 1.11. There was a significant difference between good and poor score for KAP. Participants with older age, good knowledge and attitude scores were more likely to have good practices.

Conclusion:
AWWs had good attitude and practices, but lacked adequate knowledge on IPC measures. Ensuring training for AWW on IPC is important.
Prevalence of Iodine Deficiency and Urinary Iodine Excretion among School-Going Children in a Southern District of Karnataka – A Cross-Sectional Study
Authors: Kamath Ramachandra , Kotabal Rajashree , Kruthika K , Udayar Sharvanan E. , Gangani Jagadish 
Published: December 2022

Background:
Iodine deficiency is a major public health problem, which leads to impaired neurodevelopment, particularly in early life and is the single most preventable cause of mental retardation and brain damage in children and fortunately, it is preventable.

Aims:
To estimate the prevalence of goitre among school children in Kodagu District and to estimate the urine iodine excretion and salt iodine content in a subsample.

Patients and Methods:
A cross-sectional study was conducted among school children of 6-12 years in the Kodagu district. Sampling was done by population proportionate to size cluster sampling method with 2700 study participants, 540 salt samples and 270 urine samples.

Results:
Out of 2700 study participants, the prevalence of goitre was 15.50%. Students of Madikeri Taluk, rural area students, 11-year-old students, Consumption of Goitrogens among students show significant association with goitre after multivariate logistic regression analysis. Urinary iodine excretion test shows 0.36%, 1.80% and 12.99% of the participants had severe, moderate and mild iodine deficiency, respectively.

Conclusion:
The prevalence of goitre was high indicating that it is an endemic area. Activities such as periodic surveys, provision of iodised salt and intensified monitoring and further evaluation of the IDD programme is obligatory to reduce the goitre rate.
Present Status of Department of Health Research Registered Ethics Committees in India after Implementation of New Drugs and Clinical Trials Rules 2019
Authors: Agrawal Neeraj Kumar , Gupta Uma 
Published: December 2022

Background:
Under the New Drugs and Clinical Trials Rules -2019 that came into force on 14th September 2019, all Ethics Committees (ECs) reviewing biomedical and health research should register with the authority designated by the Central Government of India.

Study Objective:
We investigated the status of registration of ECs in the Department of Health Research (DHR) to date.

Materials and Methods:
The data collection was started on 1 April, 2021 and was last updated on 10 April, 2022. The ECs registered with DHR were extracted from NAITIK online portal. The ECs were segregated according to the state and Union territories, medical colleges, dental colleges, and hospital and research institutes.

Results:
Total of 836 registered ECs were uploaded on the DHR website to date. Out of which, 822 (98.32%) were Institutional and 14 (1.67%) were independent. Among total ECs, 518 (61.96%) were in hospitals and research institutes, 231 (27.63%) in medical colleges, and 73 (8.73%) in dental colleges. 76 (9.09%) got the final certificate after completion of a provisional period of two years. Among 606 medical colleges and 316 dental colleges, 38.11% and 23.10% of colleges had registered ECs respectively. Maharashtra has the highest number with 129 (15.43%) registered ECs whereas Gujarat is number one (53.33%) in terms of percent registered ECs in medical colleges of particular states.

Conclusions:
Timely registration of ECs should be encouraged by the concerned stakeholders and try to make a robust mechanism for bringing transparency, uniformity, and accountability to the ECs across the states.
Effectiveness of ultrasonography-guided cardiac sympathetic denervation in acute control of electrical storm: A retrospective case series
Authors: Dhanse Suheil , Rao Mugula Sudhakar , Ramachandran Padmakumar , Devasia Tom , Ashwal A J , Paramasivam Ganesh , Prabhu Manjunath 
Published: December 2022

Background and Aims:
Ultrasonography-guided left cardiac sympathetic denervation (LCSD) or bilateral cardiac sympathetic denervation (BCSD) may be a useful intervention in the electrical storm (ES) that persists despite pharmacological therapy. The aim of our study was to evaluate the effectiveness of ultrasonography-guided LCSD or BCSD in the acute control of ES. We conducted a retrospective case series of patients who underwent ultrasonography-guided CSD for control of ES at a tertiary care hospital.

Material and Methods:
Data of all patients who underwent unilateral or bilateral CSD were collected from January 2017 to December 2019. Eleven patients with ES refractory to standard antiarrhythmic therapy underwent ultrasonography-guided pharmacological CSD (eight underwent LCSD and three underwent BCSD). Quantitative data was expressed as mean and median with interquartile range (IQR). Non-quantitative data was expressed in proportions.

Results:
Eleven patients underwent ultrasonography-guided pharmacological CSD (eight underwent LCSD and three underwent BCSD). Six of the eleven patients were female (54.5%). Ischemia was the underlying substrate in nine patients (81.8%). Five patients (46%) had complete resolution of ventricular tachycardia (VT) after CSD and one had 90% reduction in episodes of VT. The median follow-up duration was 8 months inter-quartile range IQR (7–18). One patient succumbed to heart failure and one patient was lost to follow up. The other patients had no further events and were well at last follow up.

Conclusion:
Ultrasonography-guided pharmacological CSD is effective in the acute control of ES. It is easily performed with equipment that is readily available and relatively safe in terms of immediate complications and is an ideal second-line intervention when ES persists despite drug therapy.
Perfusion index as a predictor of working pediatric caudal block under general anesthesia- A prospective observational study
Authors: Rajan Karthika , Dave Nandini , Dias Raylene , Muneshwar Priyanka , Kesarkar Nikhil , Saxena Vishal 
Published: December 2022

Background and Aims:
Advances in pulse oximeter technology have enabled us to measure parameters such as perfusion index (PI). We aimed to ascertain the utility of PI in the lower limb for evaluating the onset and adequacy of the pediatric caudal block under general anesthesia. The primary objective was to monitor PI trends after caudal block. The secondary objective was to compare the role of PI, heart rate (HR), and mean arterial pressure (MAP) in detecting onset and adequacy of caudal block and to ascertain whether PI was an earlier indicator in detecting adequate block.

Material and Methods:
Twenty-five children between 1 and 6 years, who underwent general anesthesia (GA) with caudal block were included. Baseline PI, HR, and MAP were recorded prior to and post caudal block at 5, 10, 15, 20 min and on skin incision. The onset of adequate block was defined as 100% increase of PI from baseline, 15% decrease of MAP or HR from baseline. T-test was used to compare trends of PI with baseline and the number of patients who met or failed these criteria for each of these three parameters at various time intervals wasnoted.

Results:
PI increased at all time intervals in 23 of 25 patients with working caudal block (P < 0.0001). By 10 min all those with a working caudal showed a 100% increase in PI. In contrast, 15% decrease in HR was not attained until 15 min where only 8 out of 23 achieved the above criteria, reaching a maximum of 20 patients at the time of incision; a 15% decrease in MAP was observed only in one patient at 5 min, reaching a maximum of eight patients at the time of incision.

Conclusion:
PI is an earlier and more sensitive indicator of the onset of the caudal block under general anesthesia (GA) than HR and MAP.
Prospective analysis of intraoperative critical incidents relevant to anaesthesia in a tertiary care teaching hospital in India
Authors: Shah Saloni K. , Kulkarni Aarti D. 
Published: December 2022

Background and Aims:
Critical incidents associated with anesthesia can affect the patient’s outcome, may cause transient damage, and contribute to mortality. We aimed at recording anesthesia-related critical incidents in patients undergoing general surgical, ear, nose, and throat (ENT) and orthopedic surgical procedures in our institution. The critical incidents data were analyzed regarding the cause to establish protocols to prevent recurrences.

Material and Methods:
We conducted a prospective analysis of voluntarily reported perioperative critical incidents occurring in patients subjected to anesthesia over 1 year. Critical incidents were noted in terms of time (while inducing/intraoperative/while extubating), location (operating theater/recovery room) of the incident, anesthesia-related or surgery-related complications. Data collected were expressed as numbers and proportions to calculate incidence.

Results:
Anesthesia was administered to 5,645 patients of which 131 (2.32%) patients had critical incidents. Of these 131, 46 (35.11%) patients had more than one critical incident. A total of 216 (3.82%) critical incidents were noted. A majority of the patients were in the age range of 51–60 years. The maximum incidents occurred during the intraoperative period (35.11%) and in the operating theater (86.25%). Of the 216 incidents, 154 (71.30%) were anesthesia-related, 18 (8.33%) were surgery-related, 1 (0.46%) was patient-related and 43 (19.91%) were recovery-related. Of the 216 incidents, cardiovascular-related incidents accounted for the maximum incidents (18.05%, n = 39). Most of the events were preventable.

Conclusion:
The critical incident reporting system should be encouraged and protocols established to reduce the frequency and severity of these occurrences.
Evaluation of the HemoCue® for blood loss estimation in suction fluid in patients undergoing neurosurgical procedures: A prospective observational study
Authors: Ranjitha Y. S. , Shetty Anita N. , Hemantkumar Indrani , Gangakhedkar Gauri R , Choudhari Ashwini 
Published: December 2022

Background and Aims:
Blood loss in neurosurgical procedures can be rapid and tremendous leading to consequential hemodynamic instability. HemoCue is a portable photometer used for the measurement of blood hemoglobin concentration. Using this point of care device, we contemplated this study to assess the reliability of HemoCue for suction hemoglobin determination and calculation of surgical blood loss by comparing with the gold standard laboratory Coulter Counter method in patients undergoing neurosurgical procedures.

Material and Methods:
This prospective observational study was conducted in 233 patients undergoing elective neurosurgical procedures in the age group of 18 to 60 years and having preoperative hemoglobin (Hb) values above 9 g/dL. Values of preoperative hemoglobin, suction hemoglobin, and volume in the suction container were used to obtain the estimated blood loss. The normality of the data was tested using the Kolmogorov Smirnov test. Bland Altman analysis was used to test the reliability of HemoCue in estimating hemoglobin and blood loss with reference to the gold standard laboratory Coulter Counter automated hematology analyzer.

Results:
Median blood loss calculated in our study using HemoCue was 554.65 mL with an interquartile range of 336.81 mL to 982.39 mL. Laboratory counter method estimated median blood loss was 533.37 mL with an interquartile range of 335.21 mL to 994.73 mL. The majority of the data obtained and analyzed using the Bland and Altman analysis method were within a 95% confidence interval.

Conclusion:
The HemoCue method is a reliable method and henceforth can be used to estimate blood loss in suction fluid in patients undergoing neurosurgical procedures.
Intraocular Complications after Caudal Epidural Steroid Injection for Discogenic Lumbar Pain with Radiculopathy
Authors: Nazm Nazneen , Keshkar Lata , Agrawal Manju , Akhtar Mohammad Nasim , Keshkar Sanjay , Agrawal Alok C. 
Published: December 2022

Background:
Epidural steroid injection is a common intervention for symptomatic lumbar disc herniation. It is safe, but not absolutely free from complications. Visual complications and adverse intraocular events are sparse in the literature. This study is done to determine any intraocular complication after caudal epidural steroid injection for discogenic low back pain and radiculopathy.

Materials and Methods:
It was a prospective study, conducted from April 2018 to December 2019 by the orthopedics and ophthalmology departments of our institute. A total of 31 patients were recruited based on inclusion/exclusion criteria. All the patients presented to this institute with complaints of low back pain and sciatica were investigated. After proper diagnosis, the decision was made for caudal epidural steroid injection as per the standard principles of orthopedic surgery. Eye evaluations (intraocular pressure [IOP], visual acuity, and ocular examination) were done 1 day before, and 2–4 h, 1 week, and 2 weeks after epidural injection. The differences in eye evaluation values between time points were determined and discussed.

Results:
A total of 31 patients were recruited for this study, out of which the majority of the patients (27 patients) were between 41 and 60 years of age, and males (22 patients) outnumbered females (nine patients). Most of the patients (17 patients) had prolapsed IV disc of L5-S1. IOP was found to be raised after the intervention of epidural steroid injection which gradually came down to a preinjection level within 2 weeks. There was no change in visual acuity and no other intraocular complications, like hemorrhages.

Conclusion:
Epidural steroid injection for discogenic low backache (LBA) with radiculopathy did not adversely affect IOP, and neither had any ocular complication (in an ophthalmologically normal set of patients). A prudent approach should always be implemented.
Association between sleep quality and stress among medical students of a rural indian tertiary care setting
Authors: Periasamy Panneerselvam , Vajiravelu Suganthi , Gunasekaran Sasikala , Balakrishnan Ragavendrasamy , Manivannan Janani 
Published: December 2022

Background:
Due to the rigorous academic standards and demanding professionals, the medical field is thought to be a stressful subject of study. This has a negative impact on the student’s mental and physical health. The long-term effects of this study will have an impact on identifying major issues that our students are facing, which will ultimately improve the level of medical treatment offered by future doctors.

Materials and Methods:
This cross-sectional study was conducted from October to December 2020 at a tertiary care institution in Tamil Nadu, India for three months. After getting the necessary ethical permissions from the institution with reference number GEMC/2020/002, the undergraduate students from the first year to the internship were included in the study.

Results:
The educational status of the students indicated that around 147 (31.1%) of respondents belonged in the first year. The mean + Pittsburgh Sleep Quality Index (PSQI) was observed to be 6.33 + 2.13, where undesirable sleep quality was predominant among 370 (78.3%) of the respondents with a p-value of less than 0.0001. The majority of the students (70.1%) have normal levels of stress which were significant with a p-value of 0.0027.

Conclusion:
Medical students experience poor sleep and ongoing stress, which can result in harmful behaviors like overindulging in junk food and a reduced likelihood of exercising. They are undeniably more prone to developing chronic illnesses. If these issues are not addressed, they will affect the medical care that is given to their incoming patients.
Pattern of comorbidities and clinical profile of young adults who died due to severe coronavirus disease
Authors: Mary Grace N. C. , Babu Shinas , Joseph Anoop , Jacob Dayan , Benjamin Allen S. , Anaghajyothi V. , Pulpandi Sanjay , Jacob Crisanta 
Published: December 2022

Introduction:
Mortality due to coronavirus disease (COVID-19) is a significant problem among the non-elderly population.

Aims:
The primary objective was to estimate the prevalence of comorbidities among the deceased in the age group of 18–64 years and the secondary objective, was to describe their clinical profile.

Settings and Design:
The study setting was a tertiary care center catering to COVID-19 patients. This was a record-based descriptive study.

Materials and Methods:

Sampling strategy and Sample size: The formula used for sample size calculation is Z2 * P(1 – P) / d2. The sample size required was 97. The study period was from July 1 to November 30, 2021. Data collection: Demographic data including comorbidities, and clinical and laboratory features were studied. The laboratory investigations were done on the day of admission, and either on the last day or one day before death were taken for analysis. Statistical analysis used: Statistical analysis was carried out in IBM SPSS Version 26. Chi-square and Fisher’s exact tests, Mann–Whitney U and Kruskal–Wallis tests, Wilcoxon signed rank test, and Correlation tests were used for analysis.

Results:
The majority of the patients had more than one comorbid condition. The parameters which showed significant variation as the illness progressed were lymphocyte count, total protein, and albumin.

Conclusion:
Special vigilance should be kept while managing young patients with comorbidities. Lymphocyte count and serum albumin can be helpful in prognostication.