bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study of Positive Predictive Value of Diagnostic Single Versus Dual Median Branch Block for Radiofrequency Neurotomy in Lumbar Facet Joint Syndrome
Authors: Bhandari Baibhav , Ray Subrata , Goswami Subrata 
Published: April 2023

Background:
Almost 60%–85% of people suffer from low back pain once in their lifetime. Due to a large number of pain generators, many a times lower back pain pose as enigma. Many clinical trials have shown validity of median branch block (MBB) in the management of chronic low back pain arising from facet joint pathology. Single blocks result in 27%–63% false positives, whereas double controlled blocks significantly decrease the false positives and increases the sensitivity to 54% and specificity to 88%. The aim of our study was to determine positive predictive value of diagnostic single and dual MBB for radiofrequency (RF) neurotomy in patients with facet joint arthropathy in Indian population.

Subjects and Methods:
Thirty patients allocated into two groups (n = 15), Group S - Single diagnostic MBB and Group D - Dual diagnostic MBB. Numerical Rating Score (NRS) and Roland Morris Disability Questionnaire (RMDQ) were recorded in all patients in both the groups at multiple times. Pre and postprocedure NRS and RMDQ score in both the groups were statistically compared.

Results:
NRS in Group D was lower as compared to Group S 1 month after neurotomy (P = 0.034). RMDQ in Group D 1 month after RF neurotomy was lower as compared to Group S (P = 0.045). The positive predictive value in Group S with single MBB is 66.6%, whereas the positive predictive value in Group D with dual MBB is 86.6% at the end of 1 month post-RF ablation.

Conclusions:
Single MBB injection for diagnosis of facet joint syndrome yields many false positives results and the positive predictive value for the same is lower as compared to Dual MBB.
An Observational Study on Clinical Profile and Management of Transatlantic Intersociety Consensus II C and D Aortoiliac and Femoropopliteal Occlusive Diseases: Role of Hybrid Procedures in Hybrid Operation Theater
Authors: Biswas Brijesh , Prakash Marasandra S , Singh Bhanu Pratap , Agrawal Vivek , Anand Vembu 
Published: April 2023

Objective:
Peripheral arterial disease is a powerful predictor of the loss of limb and even loss of life. Endovascular treatment (ET) and hybrid procedures are gradually replacing open procedures. The purpose of this study is to evaluate the management outcome of transatlantic intersociety consensus (TASC) C and D aortoiliac (AI) and femoropopliteal (FP) disease by various methods.

Materials and Methods:
Prospective observational study was done at Army Hospital (Research and Referral) Delhi Cantt from June 2015 to January 2017. Patients with TASC C and D AI and FP lesions were included. Patients were treated with either open, endovascular or hybrid technique and followed at 1, 3, and 6 months.

Results:
A total of 110 (36 AI and 74 FP) patients were included. 96.3% were smokers. Seventeen were TASC C and 93 were TASC D lesions. Fourteen out of 17 TASC C lesions could be managed by endovascular, two by hybrid and only one required open reconstruction. Whereas 58 out of 93 TASC D lesions needed to be opened, 15 were endovascular, and the rest 20 cases were managed by hybrid procedures. One had an iliac artery rupture managed with bypass graft. We have seven mortalities two within 30 days and five from 30 days to 1-year primary and secondary patency for ET was 72.4% and 80%, for open surgery was 76.2% and 93% and for hybrid procedure was 60% and 77.7%.

Conclusions:
Hybrid therapy simplifies and allows the one-step treatment with complex peripheral multifocal steno-obstructive vascular disease with high technical success rate and excellent long-term patency in few patients.
A Study of Arterial Supply to Carotid Body Tumor and Its Prospective Implication in Clinical Practice
Authors: Singh Devender , Praveena Madavan , Aryala Shalini 
Published: April 2023

Introduction and Objectives:
Arterial supply to carotid body tumor is primarily from ascending pharyngeal artery (APA), a branch of the external carotid artery, and with infrequent feeders from other branches of the latter described in the literature. The present study attempted in describing other sources of arterial supply to carotid body tumor and its implication in clinical practice.

Materials and Methods:
This study was retrospective to start with turning a prospective midway for 5 years from July 2017 to July 2022. The data of all the 12 patients, in whom seven males and five females with a mean average of 45 years, were analyzed, There were seven males and five females with the mean age of 45 years; the average size of the tumor documented was 5 cm. All the patients underwent computed tomography angiography for confirming the diagnosis. Three-dimensional volume-rendered images from the rotational angiogram were analyzed for assessing the arterial supply. All patients underwent surgical excision without embolization.

Results:
In all 12 patients, APA was found primarily the main source of blood supply. Four patients, in addition, had occipital artery and superior thyroid in one. Two patients were identified to have glomic artery arising from the bulb of the common carotid artery supplying the tumor. The thyrocervical trunk was also supplying the tumor in a patient. Anomalous branches from the internal carotid artery were found to be the sole source of arterial supply to the tumor in a patient.

Conclusion:
Surgical excision of carotid body tumors still continues to be a challenge due to multiple arterial feeders leading to hypervascularity. A detailed knowledge of arterial supply helps in proper planning and reducing perioperative bleeding. The glomic artery, and in rare cases, the internal carotid artery, also contribute as a feeder to the tumor. These unusual arterial feeders give an important warning before routine embolization to avoid cerebrovascular events.
Is Revascularization the Only Mode of Treatment for Diabetic Foot Ulcer?
Authors: Joshi Parth Devdatt , Desai Sanjay C , Ramswamy Chandrashekar Anagavalli , Pandya Radhika Himanshu , Vinaykumar  
Published: April 2023

Introduction and Objective:
Diabetic foot infection is a common cause for hospital admissions among diabetics in India. This could be attributed to sociocultural practices, such as walking barefoot, inequitable access to diabetes care, poor education, and poor socioeconomic conditions. The purpose of this study is to highlight the role of diabetic footwear in care of diabetic foot.

Materials and Methods:
The observational study included 170 patients, presenting with diabetic foot ulcers, studied over a period of 19 months. The patients were categorised in those suffering from neuropathic ulcers and neuroischemic ulcers using biothesiometery and Ankle Brachial Pressure Index. Diabetic foot wears were prescribed based on plantar pressure measurement. The mode of management was noted and need for incidence on follow up was recorded.

Results:
Our study population predominantly consisted of elderly males with a mean age of 63.2 years and 71.7 % males. Out of 170 patients presenting with diabetic foot ulcer, neuroischemic ulcers were diagnosed in 35 patients, and the rest 135 patients were diagnosed to have neuropathic ulcers. (Graph 1) NIU was observed more common among male patients with 25 males out of 35 patients [71.4 %], similarly NPU were more common in males [72.8 %]. Among the 35 patients who were diagnosed to have neuroischemic ulcers, all required diabetic foot wear, however 10 patients required revascularization procedure, 2 patients required Prostaglandin therapy infusion and 1 patient required stem cell implantation. The group of patients who were diagnosed to have neuropathic ulcers, required only diabetic foot wear and medical therapy which involved antibiotics, antiplatelets, vasodilators and Prostaglandin infusion. Amputation was required in 8 (23%) out of 35 patients suffering from NIU and in 12 (9%) out of 135 patients suffering from NPU.

Conclusion:
ABI, bioethesiometry and plantar pressure measurement play an important role in planning management and need of diabetic foot wear. Majority of the patients may have neuropathic involvement with recurrence rate and need of amputation significantly reduced by use of diabetic foot wear.
Endovascular Treatment of Superficial Femoral Artery Ostial Occlusions and Outcomes of Unexpected Postprocedural Deep Femoral Artery Occlusion
Authors: Igus Behlul , Firat Ali 
Published: April 2023

Introduction:
This study aimed to demonstrate different revascularization approaches to superficial femoral artery (SFA) ostial occlusion and to evaluate the outcomes of unexpected deep femoral artery (DFA) occlusion encountered during the endovascular treatment (EVT).

Materials and Methods:
This retrospective study included 56 patients diagnosed with ostial SFA occlusion between March 2014 and December 2019.

Patients were divided into two groups:
the percutaneous transluminal balloon angioplasty (PTA) group, which included 32 patients treated with PTA, and the stent group, which included 24 patients treated with stents. The preferred access site was the contralateral femoral approach, and in 20 patients, access was performed with the popliteal artery (n: 13), pedal arteries (n: 4), and retrograde occluded SFA (n: 3).

Results:
Technical success was 100%. In the PTA group and stent group, primary patencies were 81%, 75%; 62%, 66%; and 56%, 58% and secondary patencies were 92%, 90%; 64%, 63%; and 50%, 54% at 6, 12, and 24 months, respectively, with no significant differences determined between the groups (P = 0.943 and P = 0.640 by log-rank). DFA occlusion occurred in 8 patients during the EVT. Rutherford score was a statistically significant decrease in both the groups (Wilcoxon signed-rank test, P = 0.010).

Conclusion:
Even in challenging SFA ostial lesions, using several different approaches has high success rates in EVT. This study showed no significant difference in PTA and stenting patency rates. Accidentally, DFA occlusion may be encountered, in which case revascularization of the SFA is the priority, even if the procedure ends with occluded DFA. A patent SFA and good distal flow will be sufficient for foot perfusion in DFA’s occluded patients.
An Alternative Route for Petroclival Tumors: Without Mastoidectomy and Superior Petrosal Sinus Ligation: A Cadaveric Study
Authors: Özbek Muhammet Arif , Başak Ahmet Tulgar 
Published: April 2023

Objective:
Retrosigmoid approach and presigmoid approach and its derivatives including retrolabyrinthine, translabyrinthine, and transpetrosal approaches have long been used for reaching posterior and middle cranial fossa. In neurosurgery perspective, many types of tumors arise extradurally and surgical resection of these tumors is still challenging. We aimed to describe a modified way to approach posterior and middle fossa to contribute to the surgical management of petroclival tumors with posterior extension.

Methods:
Modified sigmoid approaches were performed bilaterally in 5 fresh adult cadaver heads.

Results:
In this approach, it was possible to reach the middle and posterior fossa with a single craniotomy. Temporal dura matter was dissected from the temporal bone with extradural gentle dissection. In addition, sigmoid sinus and superior petrosal sinus (SPS) were dissected off from the petrous bone meticulously. Subsequently, the posterolateral superior arcuate petrosectomy was performed with high-speed surgical drill extradurally by protecting the semicircular canal, labyrinthine channel, and cochlea. Dura matter was elevated for 1.5 cm with retractor above the mastoid bone. Dura was opened from an alternative area of Trautmann’s triangle. After having exposed and opened the dura, posterior fossa was reached at the level of 7.−8. cranial nerves.

Conclusion:
We described an alternative route which seems to be a feasible way to reach posterior and middle fossa without mastoidectomy and SPS ligation. Notably, this technique can be applicable to petroclival tumor surgery after more anatomic studies with cadaveric specimens.
The mediating role of perceived stress in the relationship between neuroticism and death anxiety among women in Isfahan during the coronavirus pandemic
Authors: Joneghani Neda Amani , Sajjaian Ilnaz 
Published: April 2023

BACKGROUND:
The aim of this study was to evaluate the structural modeling of the mediating role of perceived stress in the relationship between neuroticism and death anxiety among 25–50-year-old women during coronavirus infection.

MATERIALS AND METHODS:
The present correlational study was conducted with the presence of 130 people (women) using the available sampling method in Isfahan. The Perceived Stress Scale, BFI Five Factor Scale and Death Anxiety Scale were used to measure the research variables. Data analysis was performed using structural equation modeling, and also SPSS version 23 and Smart PLS3 statistical.

RESULT:
Findings show that the indirect coefficient of neuroticism on death anxiety mediated by perceived stress in the model was significant (P < 0.05) although the mediation rate was partial. Also, in modeling structural equations, the direct effect of perceived stress on death anxiety (0.195), neuroticism on perceived stress (0.305), neuroticism on death anxiety (0.407) were achieved significantly (05/0p).

CONCLUSIONS:
Based on the results of the study, it can be concluded that with increase of neuroticism, death anxiety increases in women and with the entry of perceived stress in this regard and increasing this variable in women, the effect of neuroticism on death anxiety increases. Paying attention to this mechanism can be useful in formulating effective preventive and therapeutic interventions for women to reduce the effects of neuroticism and death anxiety.
Evaluation of effects of platelet-rich fibrin on treatment outcomes after impacted mandibular third molar surgery
Authors: Shruthi T. M. , Shetty Akshay D. , Akash K. S. , Ahmed Fazeel , Shetty Navya , Singarapu Ravalika 
Published: April 2023

Background and Objective:
Impaction of the third molar teeth is a common disorder which often necessitates their removal. After third molar surgery, the common postoperative sequelae are pain, trismus, and buccal swelling. Our study sought to evaluate the effect of platelet-rich fibrin (PRF) on postoperative pain, swelling, trismus after surgical extraction of impacted mandibular 3rd molars.

Materials and Methods:
Over a period of 22 months (December 1, 2016–September 30, 2018), 44 patients in the age group of 18–40 years, who required surgical extraction of impacted third molar and met the inclusion criteria were recruited. After surgical extraction of the third molar, only primary closure was performed in the control group (22 Group), whereas PRF was placed in the socket followed by primary closure in the study group (22 patients). The outcome variables were pain, swelling, and maximum mouth opening were measured with a follow-up period of 1 week.

Results:
The application of PRF in the study group lessens the severity of immediate postoperative sequelae such as pain, swelling, and trismus compared to the control group.

Conclusion:
The treatment outcomes and postoperative sequel were better in the PRF group as compared to other control group on days 1, 3, and 7 postoperatively.
Efficacy of tranexamic acid in prevention of alveolar osteitis following surgical removal of impacted mandibular third molar
Authors: Jadhav Ajinath Nanasaheb , Shushma G. , Deshmukh Vijay Dnyandev 
Published: April 2023

Context:
Many preventive measures are described to avoid alveolar osteitis (AO) during third molar surgery (TMS), but very few are found to be effective. Tranexamic acid (TA), an antifibrinolytic agent, impedes the proteolytic degradation of fibrin and prevents blood clot disintegration.

Aims:
The study was conducted to determine the efficacy of intra-alveolar application of TA soaked in Gelfoam in prevention of AO.

Settings and Design:
This was a randomized control trial.

Materials and Methods:
A total of 200 patients (100 in control group and 100 in study group) reporting for TMS were allocated randomly. Following surgery, TA soaked in gel foam was placed in socket and sutured in the study group, while in the control group, closure was done by suturing. Patients followed subsequently to observe the incidence of AO, pain severity, and duration of healing after AO.

Statistical Analysis:
Z-test, Mann–Whitney test, and t-test were applied, respectively, to compare the incidence of AO, severity of pain, and duration of healing between the two groups.

Results:
The incidence of AO in the control group was 18% and 6% in the study group. Patients in the control group experienced severe pain as compared to patients in the study group. The duration of healing varied from 12 to 16 days in the control group, but in the study group, it was <10 days.

Conclusion:
TA significantly reduces the incidence of AO in addition to the reduced severity of pain and enhanced healing. We recommend the routine use of TA, owing to its astonishing rewards.
Minimally traumatic extraction techniques in nonrestorable endodontically treated teeth
Authors: Sharma Sneha D. , Gupta Ashish , Bansal Pankaj , Alexander Mohan , Vidya B , Gupta Himani 
Published: April 2023

Aim:
The goal of this study was to assess the effectiveness of piezotome as compared to periotome extractions of nonrestorable endodontic treatment of teeth in terms of operational time, pain control, and postoperative bone loss considering the prosthetic rehabilitation in future.

Materials and Methods:
A double-blind, randomized controlled trial was conducted with 100 patients who wanted single-rooted teeth to be extracted (which failed endodontically). The participants have been randomized into two equal groups named as - (i) a periotome group (ii) and a piezotome group. Duration of the surgery, postoperative pain within 7 days, complications (if any) associated with the extraction process were performed as a part of clinical assessment. Bone loss has been analyzed 6 months after the surgery radiographically. The data have been recorded and analyzed using the version 22.0 of the SPSS software package.

Results:
All parameters in the periotome category (P < 0.05) were statistically significant except for bone loss and gingival laceration in comparison to piezotome group. In the piezotome group, a longer time was observed for surgery and delayed pain control was achieved. In our study, we found statistically significant more marginal bone loss in piezotome group in comparison with periotome group.

Conclusion:
The findings of this study indicate that for intraoperative and postoperative comfort periotome could be used as a safer and cheaper option for atraumatic extractions but piezosurgery may prove as a better choice soon for surgeries in the maxillofacial region to maintain soft-tissue integrity.
Insights of dental postgraduate students and guides toward change in MDS examination pattern
Authors: Kalghatgi Shrivardhan , Khairnar Mahesh Ravindra , Dalvi Tanushri Mahendra , Dwivedi Archana , Saoji Hrishikesh , Chandra Akhilesh 
Published: April 2023

Introduction:
According to the notification dated May 17, 2018, no. DE-14-MDS-2018/2131 published by the Dental Council of India, basic sciences theory examination (Paper-1) will be conducted before the commencement of II-year MDS academic year instead of III-year MDS end. Hence, this study was conducted to assess the opinions regarding this recent change in the curriculum among I MDS students, II MDS students, and their respective postgraduate (PG) guides.

Methodology:
The study was conducted on 120 participants from three dental colleges. All the participants were interviewed using a pretested, structured questionnaire. The initial part of questionnaire consisted of demographic information of the study participants followed by ten questions targeted to assess the perception toward change in MDS examination pattern. Statistical analysis was performed using SPSS software v20, and Chi-square test was used for comparison of responses among PG students and PG guides.

Results:
Questions pertaining to the need of allowed to keep term (ATKT), assumption to improved concentration on specialization subjects, and increase in understanding of the subject have received maximum positive response. Negative responses were more for the questions such as hampering of PG curriculum, effect on dissertation selection process, and rendering quality treatment to the patient. Responses to necessity of ATKT and the assumption to better concentrate on specialization subject later differed significantly among the participants.

Conclusion:
The present study results revealed an overall positive perception toward the change in MDS curriculum pattern among the study participants.
Sandwich osteotomy with interpositional grafts for vertical augmentation of the mandible
Authors: Bera Rathindra Nath , Tandon Sapna , Singh Akhilesh Kumar , Bhattacharjee Bappaditya , Pandey Sapna , Chirakkattu Tomin 
Published: April 2023

ABSTRACT
Sandwich osteotomy is a technique for vertical augmentation based on the principle of a graft being placed between two pedicled native bones. The inherent vascularization helps in graft consolidation. The aim is to review the bone height gained, implant survival and pitfalls with sandwich osteotomy. The PICO model was used to identify the suitable studies for the review. Oxford level of evidence, Newcastle Ottawa Scale and Cochrane's tool for Systematic Reviews of Interventions was applied for identifying study quality. Meta-analysis was performed with the help of RevMan. Funnel plot was used to evaluate publication bias and bias during article selection. Difference in means was used as principal summary measure. Fixed effects model with inverse variance statistics was used. I2test statistics was applied to identify study heterogeneity. Forest plots were produced for the outcome variables with 95% confidence interval (CI) and overall treatment effects and subgroup effects at a significance level of 0.05. The overall implant survival rate ranged from 90%-100% and prosthetic survival rate from 87%-95%. An overall 6-10mm of bone can be gained in the anterior mandible and 4-8mm in the posterior mandible. A total of 1030 implants were placed of which 988 implants survived after the mean follow up periods (odds ratio: 0.77, 95% CI: 0.49-1.21). Implant survival is independent of the graft being used. Vertical augmentation in the posterior mandible is limited compared to anterior owing to the presence of inferior alveolar nerve and the keratinized tissue deficiency.