bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, materials, methods, and attitudes employed during endodontic treatment by dentists to evaluate and improve the quality of practice of endodontic treatment
Authors: Sasidharan Rahul 
Published: December 2022

Background:
This procedure, known as root canal treatment, is widely used in modern dental care. Modern endodontics frequently includes the introduction of many modern devices, materials, and methods, and yet it is one of the fastest-expanding fields in everyday clinical practice. Root canal fillings, coronal restorations, and the dentist's own knowledge, attitude, and expertise all have a role in the success of endodontic therapy, which is why it is important to maintain these high standards.

Aim and Objectives:
This study's objectives were similar to those of the aforementioned audit to collect data on the various approaches, specific and regular strategies, materials, and attitudes utilized by both general dental specialists and endodontists during root trench treatment, to analyze these choices in depth, and to disseminate endodontic treatment standards to evaluate the state of current practice and make adjustments as necessary.

Methodology:
The materials and techniques used by general dentists during root canal treatment were the subjects of a survey. Before the research itself could begin, a questionnaire had to be created and tested in advance.

Results:
The current study's findings provide light on the mindsets, strategies, supplies, and procedures used by dentists during root canal treatment. In the field of health-care evaluation, the survey questionnaire is a frequent tool. In this investigation, data were acquired by interviewing dentists in person and writing down their responses, a method that ultimately helped eliminate bias.

Conclusion:
Using the tried-and-true method of positioning the apical stop 1 mm from the radiographic apex, most dentists today continue to do so. The trend toward doing root canal treatment in a single office visit applies to all patient types. As a remarkable characteristic, both types of responders made very little use of rubber dams for isolation purposes during endodontic treatment.
A study to evaluate the preferences of dentists for the materials chosen to restore endodontically treated teeth and the influence of both clinical experience and level of specialization on the dentist's choice of posts
Authors: Talkal Arun Kumar , Prajapati Ushma Hardik , Shashank S. N. , Swamy Mahesh C. , Patil H. G. , Reddy Mahesh Kumar 
Published: December 2022

Background:
In endodontics, dentist's choice for using posts/materials relevant to posts used to restore endodontic-treated teeth is influenced by clinical experience, whether concerning the length of practice time and level of specialization.

Objective:
Traditional restorative approaches are being modified as newer materials become available and patient preferences shift. The purpose of the study was to see if dentists' preferences for using posts and other materials associated to post used to restore endodontically treated teeth are influenced by practical experience, whether measured by the length of clinical practice time or level of specialty.

Methodology:
A cross-sectional study was conducted with dentists (n = 100) working in Karnataka utilizing a questionnaire. Data on sociodemographics, clinical experience, postgraduate training, and postendodontic restoration characteristics (posts/types of cement and rubber dam application) were obtained. The samples only included general and specialist dentists. A descriptive analysis was performed on the data. The Chi-square test and Fisher's exact test investigated the relationships.

Results:
The most chosen materials were metal posts (60%) and resin cement (70%). There was a statistically significant association between clinical practice duration and postuse type (P = 0.017). In addition, there was a highly significant relationship (P = 0.001) between clinical practice time, level of specialty, and the use of rubber dams.

Conclusions:
Dentists favored metal posts for post endodontic restorations, while resin-based cement was the preferred luting cement for the posts' cementation. Additional training and more clinical practice time were factors in several dental postselection decisions.
Relationship between prognostic nutritional index and neutrophil lymphocyte ratio with overall survival in patients with metastatic colorectal cancer receiving regorafenib
Authors: Erdogan Bulent , Ozcan Erkan , Gokmen Ivo , Gokyer Ali , Kucukarda Ahmet , Kostek Osman , Hacıoglu Muhammet Bekir , Uzunoglu Sernaz , Cicin Irfan 
Published: December 2022

ABSTRACT

Aim:
In this study, we aimed to analyze the effect of prognostic nutritional index and neutrophile lymphocyte ratio on the overall survival (OS) in patients treated with regorafenib.

Materials and Methods:
Metastatic colorectal cancer (CRC) patients who treated with regorafenib between 2016 and 2020 in a single center were evaluated retrospectively. ROC analysis was used for neutrophile lymphocyte ratio (NLR’s) and prognostic nutritional index (PNI’s) optimum cut-off value. The relationship between OS with PNI and NLR was investigated.

Results:
Fifty-two patient’s data were analyzed. The median age was 57 years, 22 (41.5%) of the patients were female. The optimal cut-off value of PNI for OS was 45.7 according to ROC curve analysis. The median NLR value was accepted as 2.7. Median OS was 8.3 months. Patients who have high PNI value than 45.7 had longer OS (12.09 months vs. 6.31 months hazard ratio [HR]: 0.37 95% confidence interval [CI]: 0.19–0.73 P = 0.003) and there was a tendency for longer OS with low NLR value then median (12.05 months vs. 6.14 months HR: 0.54 95% CI: 0.29–1.23 P = 0.057). Primary tumor resected patients had longer OS than nonresected patients (12.05 months vs. 6.30 months HR: 0.34 95% CI: 0.17–0.66 P = 0.001). In multivariate analysis, high PNI value more than 45.7 (HR: 0.40 95% CI: 0.18–0.88 P = 0.02) and resection of the primary tumor (HR: 0.40 95% CI: 0.21–0.80 P = 0.01) were the only independent factors for longer OS.

Conclusion:
Metastatic CRC patients with high pretreatment PNI and primary tumor resected are more likely to have longer OS with regorafenib. PNI is more reliable index than NLR to predict OS in metastatic CRC patients treated with regorafenib.
Incidence of and modifiable risk factors for inadequate epidural analgesia in pediatric patients aged up to 8 years
Authors: Pangthipampai Pawinee , Sutthibenjakul Karuna 
Published: December 2022

Background and Aims:
Postoperative pain in pediatric patients is one of most inadequately treated conditions. This study aimed to investigate the incidence of and modifiable risk factors for inadequate epidural analgesia in pediatric patients aged up to 8 years at Siriraj Hospital—Thailand’s largest national tertiary referral center.

Material and Methods:
This retrospective study included pediatric patients aged 0–8 years who underwent surgery with epidural catheter during January 2015 to January 2020. Patients with missing data were excluded. Records from both the ward staff and the acute pain service were reviewed. All relevant data were extracted until the epidural catheters were removed.

Results:
One hundred and fifty pediatric patients were included. The median age was 29 months and the range varied from 12 days to 98 months on the day of surgery, and 86 (57.3%) were male. The incidence of inadequate epidural analgesia was 32%. Most patients (95.8%) had an unacceptably high pain score within 4 hours after arriving at the ward. Univariate analysis revealed direct epidural placement, the length in epidural space less than 5 cm, and postoperative leakage to be substantially higher in the inadequate pain epidural analgesia group. When those factors were included in multivariate analysis, only length in epidural space less than 5 cm was identified as an independent risk factor.

Conclusion:
The incidence of inadequate epidural analgesia in this pediatric study was 32%. Multivariate analysis showed length of catheter in epidural space less than 5 cm to be the only factor independently associated with inadequate epidural analgesia.
Comparative evaluation of three methods of endotracheal tube cuff inflation for adequacy of seal
Authors: Satya Prakash M.V.S. , Aravind C , Mohan V.K. 
Published: December 2022

Background and Aims:
Intubation with cuffed endotracheal tube (ETT) is common in operation rooms, critical care, and emergency rooms. The pressure exerted by the cuff on the tracheal mucosa can lead to a reduction in blood flow to the tracheal wall and result in mucosal ischemia. There are many methods for ETT cuff inflation. Aim of the study was to compare the cuff pressures and volumes between the three methods of ETT cuff inflation.

Material and Methods:
One hundred and twenty patients were randomized into three groups: Group SG (stethescope guided), group AL (audible leak), and group P (palpation). In group SG, the cuff was inflated by auscultating with the bell of the stethoscope over the thyroid cartilage for leak around cuff. In group AL, the cuff was inflated by listening for an audible leak around the cuff with observer’s ear 5 cm away from the mouth of the patient. In group P, the cuff was inflated by palpating for a leak over the cricoid and trachea. The adequacy of the cuff seal was compared between the groups by assessing the volumes of additional air needed to stop the leak around the cuff as confirmed by supraglottic capnometry.

Results:
The initial volumes needed to inflate the cuff were significantly more in the stethoscope (SG) and hearing (AL) groups than in the palpation (P) group (SG = 5.1 ± 1.4 ml, AL = 4.6 ± 1.6 ml, P = 3.1 ± 0.9 ml; SG and AL vs. P, P < 0.001). Additional cuff volumes required to achieve zero leak around cuff by supraglottic capnometry were 0.85 ± 1 ml in group SG, 1.3 ± 1.1 ml in group AL, and 2.237 ± 0.8 ml in group P (SG vs. P and AL vs. P; P < 0.001).

Conclusion:
Out of the auscultation-guided, audible leak-guided, and palpation-guided methods of ETT cuff inflation, the auscultation-guided and audible leak-guided methods achieve significantly better tracheal seal than the palpation-guided method.
Comparison of double lumen tube insertion using the McGrath MAC versus direct laryngoscopy in adult patients with a limited glottis view: A prospective interventional study
Authors: Bakshi Sumitra G. , Panigrahi Amit R. , Bhawalkar Pranay , Divatia Jigeeshu V. 
Published: December 2022

Background and Aims:
Passage of double-lumen tubes (DLT) can be challenging in patients with limited glottis view. This study aims to determine the usefulness of McGrath® MAC videolaryngoscope (VL) in cases with limited glottis view on direct laryngoscopy with Macintosh blade.

Material and Methods:
After study approval and registration of trial, consent was sought from all adult patients planned for elective DLT insertion for lung isolation during the course of general anesthesia. Patients not consenting, less than 18 years, with anticipated difficult mask ventilation or need for rapid sequence induction were excluded. Following routine anesthetic induction, laryngoscopy was attempted by an experienced anesthesiologist using Macintosh scope. If the view obtained was Cormack and Lehane (CL) view IIB and above or the attempt at intubation using DLT failed despite a CL I/IIA view, the patient was included in the trial. The laryngoscope was removed and after ensuring adequate oxygenation and depth of anesthesia, intubation was attempted using McGrath® MAC VL. The percentage of glottis opening (POGO) score was noted for both the scopes.

Results:
DLT insertion was attempted in 76 patients in the study period. Eight patients were included in the trial on account of limited glottis view/failure with Macintosh scope. Insertion of DLT with McGrath MAC was tried only in six patients, in two patients, the VL was not available for use. The mean (standard deviation) POGO score with Macintosh scope was 9 (±20), which significantly improved with the use of VL to 71 (±24), P = 0.01.

Conclusion:
McGrath MAC is helpful in inserting DLT in patients with limited glottis view with Macintosh scope.
Effect of two barrier devices on the time taken and ease of intubation of a paediatric intubation manikin - A randomised cross-over simulation study
Authors: Kamabathula Sailaja , Nath Gita 
Published: December 2022

Background and Aims:
During the present COVID-19 pandemic, several inventions have been employed to protect personnel involved in intubation from inhalational exposure to the virus. In this study, we compared the effect of two barrier devices, Intubation Box versus Plastic Drape, on the time taken and difficulty in intubating a pediatric manikin.

Material and Methods:
Nineteen experienced anesthesiologists performed six different intubations: without barrier, with intubation box, with plastic drape; with and without a bougie, using the Latin Square Design for randomizing order of intubations. The time taken for intubation (TTI) was compared using Student’s t test, and nonparametric values were analyzed using Chi-square test with Yates correction.

Results:
Both barrier devices increased the TTI from 14.8 (3.5) s to 19.8 (6.8) s with intubation box (P = 0.068) and 19.3 (8.9) s with plastic drape (P = 0.099). Use of bougie significantly prolonged TTI to 25.8 (6.7) s without barrier (P = 0.000), 32.5 (13.3) with intubation box (P = 0.000), and 29.8 (7.3) s with plastic drape (P = 0.000). The number of attempts was not different (P = 0.411), and the visibility was slightly impaired with both barriers (P = 0.047). The ease of intubation, even without the bougie, was significantly different compared to default, with P values of 0.009 and 0.042 for intubation box and plastic drape, respectively. The highest significance was with intubation box with bougie with a P value of 0.00017.

Conclusion:
Both the intubation box and plastic drape increased the time taken as well as difficulty in intubation. The extra protection afforded should be balanced against risks of hypoxia in the patient.
Radiomorphometric analysis of the clivus – A soothsayer of age and gender
Authors: Shalini Karnam , Katne Tejaswi , Gotoor Srikanth , Gantala Ramlal , Kanaparthi Alekhya , Parthasarathy Nivedhitha 
Published: December 2022

Purpose:
Skull is the most studied skeletal remaining as enamel and bones are the last ones to disintegrate after death. The clivus is one such dense part of the skull base and most of the time it is recovered intact from a damaged or incinerated skull and can be used as an indicator in identification. The present study is aimed to perform a radiomorphometric analysis of the clivus using cone-beam computed tomography (CBCT) and to assess its pertinence in age and gender estimation.

Materials and Methods:
The CBCT images of 254 (162 males, 92 females) subjects were obtained from New tom Giano HR (QR SRL Company, Verona, Italy) CBCT machine at 90 kVp, 6 mA for 7.2 s at the field of view (16 × 18), voxel size of 300 in the age group of 6–70 years were chosen. The clivus widths and lengths were measured using NNT software programs on axial and sagittal reconstructed images.

Results:
Mean clivus lengths and widths were significantly different in male and female patients. Bivariate correlations showed that there was a stronger association of the clivus lengths and widths to age when considered a linear combination as opposed to when taken individually in both female and male patients. Association between the linear combination of the clivus lengths and widths with age was found to be the highest in female patients among all the results (R = 0.553). All the above results were statistically significant (P < 0.05).

Conclusion:
CBCT measurements of clivus dimensions can be used reliably for anthropometric analysis as they are precisely associated with age and gender. Hence, it can be concluded that these dimensions can be used as a supplementary or only parameter when other parameters are uneventful in medicolegal cases.
Seroprevalence of acute leptospirosis in a tertiary care hospital of western India
Authors: Baveja Bhumika , Palewar Meghna S. , Joshi Suverna , Karyakarte Rajesh 
Published: December 2022

Background:
Leptospirosis is a widespread re-emerging zoonotic disease, especially in developing countries. According to World Health Organization, despite being severe, the disease is neglected in most endemic countries because of a lack of information and awareness about the extent of the problem.

Objective:
The objective was to study the seroprevalence and epidemiology of leptospirosis with its biochemical correlation in the general population in Pune, Maharashtra.

Materials and Methods:
It is a retrospective observational laboratory-based study over 1 year from January to December 2020 in a tertiary care hospital in western India. A total of 561 blood specimens received during 1 year for the diagnosis of fever were processed for Leptospira IgM antibodies using enzyme-linked immunosorbent assay (ELISA).

Results:
A total of 111 of 561 blood specimens that were received during the study period tested positive for IgM antibody against Leptospira. The seroprevalence of Leptospira spp. was found to be 19.78%. In seropositive patients, the age ranged from 4 to 77 years. The highest seropositivity was observed in the age group of 21–30 years (42%). There were 34% (n = 38) males and 66% (n = 73) females, among those who tested positive. Seroprevalence in Pune was highest in the months of June–August. Renal function tests were deranged in 44 (39.63%) patients (serum creatinine > 1.5 mL). Hyponatremia and hypokalemia were observed in 37.84% and 21.62% of patients, respectively. In liver function tests, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) both were deranged (SGOT > 40 U/L; SGPT > 56 U/L) in 36 (32.43%) patients, whereas SGOT alone was deranged in additional 18 patients (48.64%). Serum bilirubin was deranged in 65.45%. Coinfection was observed with chikungunya, dengue, and malaria in 7.2%, 6.3%, and 0.90% of patients, respectively.

Conclusion:
Because morbidity is high in this infection, early diagnosis of leptospirosis is essential because antibiotic therapy provides the greatest benefit when initiated early in the course of illness.
Effectiveness of health education on knowledge, attitude, and practice of fertility preservation among parents of adolescents, young adults and among young adults with malignancies at a tertiary care centre in South India
Authors: Harshit D J , Dasari Papa , Dubashi Bishwajit 
Published: December 2022

Background:
The incidence of cancer among children, adolescents and young adults is on the rise and 80% survive. Fertility preservation is not practiced due to lack of knowledge of affects of cancer and its therapy on fertility and the availability of fertility preservation methods. The objective of this study was to assess Knowledge, Attitude and Practice (KAP) of Fertility preservation among parents of adolescents, young adults and among young adults at base line and after intervention of a dedicated health education programme.

Materials and Methods:
Prospective interventional study undertaken in a tertiary care set up. Assuming baseline knowledge of fertility preservation as10% with absolute precision of 5%, 67 parents of adolescents and 75 young adults with cancer were included. Preformed questionnaire was used to assess the KAP at base line and after health education programme. The pre-test and post- test values were expressed as proportions and were compared by using McNemar test. SPSS version 20 was used

Results:
Baseline knowledge about affect of cancer and its treatment on fertility and availability of fertility preservation methods was 26.7% and16.4%. After health education it was improved to 97.2% and 93.8%. Baseline knowledge about awareness of starting Fertility preservation prior to cancer, types of fertility preservation methods available was 8.9%, and 3.4%, and it was increased to 93.1% and 62.4%. Willingness to practice FP methods increased from 44.7% to 70.2% among parents and 40.5% to 59.5% among young adults.

Conclusion:
Baseline knowledge regarding

fertility preservation
and

methods available
was very poor. The health education programme is the need of the hour as it significantly improved their knowledge and attitude to practice fertility preservation.
Can the pregnancy outcome be improved by incrementing progesterone supplementation on the day of embryo transfer in women undergoing fresh and frozen embryo transfer cycles?
Authors: Kaur Jasneet , Mahajan Nalini 
Published: December 2022

Context:
Luteal phase defect has been identified in all assisted reproductive technology cycles, necessitating optimal progesterone levels during the window of implantation (WOI) to improve reproductive outcomes.

Aims:
The aim of this study was to determine if incrementing progesterone supplementation based on the levels of serum progesterone(P) measured on the day of embryo transfer (ET) has an impact on the pregnancy outcome in fresh and frozen ET cycles.

Settings and Design:
A total of 220 women undergoing fresh and frozen ET were prospectively enrolled and received standard luteal phase support, an increment in P supplementation made if serum P levels were less than 15 ng/mL.

Materials and Methods:
Serum progesterone levels were assessed for all the patients on the day of ET. Patients undergoing fresh and frozen ETs were divided into two groups based on serum progesterone levels on the day of ET. If serum progesterone levels were found to be less than 15 ng/mL on the day of ET, the dose of progesterone supplementation was incremented. A correlation between the groups with serum progesterone less than and more than 15 ng/mL on the day of ET with the pregnancy outcome was then made.

Results:
No statistically significant difference was observed in the clinical pregnancy rate and biochemical pregnancies in the groups with serum progesterone levels less than or more than 15 ng/mL on the day of ET when an increment in the progesterone supplementation was performed (both fresh, P = 0.35 and frozen cycles, P = 0.056).

Statistical Analysis Used:
Chi-square test was used for qualitative analysis, and the Student’s t test was used for comparison of means.

Conclusions:
Measuring serum progesterone levels on the day of ET and incrementing P supplementation if serum levels of progesterone are less than 15 ng/mL to obtain optimal progesterone levels during the WOI in both fresh and frozen ET cycles might help in improving our pregnancy outcomes.