bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Clinical Study for Removal of Impacted Mandibular Third Molar under Local Anaesthesia, with and without Ketamine - A Split Mouth Comparative Study
Authors: Dutta Subham , Kumar R. Mahesh , Kumar K. R. Ashok , Marimallappa T. R. , Pal Supriyo , Rao Keerthana 
Published: July 2023

Abstract

Introduction:
Disimpaction is one of the most common operations done by oral and maxillofacial surgeons around the world. Ketamine is a well-known general anaesthetic and short-acting intraoperative analgesic. The aim of this study was to measure the efficacy of anaesthesia using combined treatment with local anaesthetic plus a subanaesthetic dose of ketamine and local anaesthetic alone in bilaterally impacted mandibular third molar surgery.

Methods and Materials:
A total of 24 patients who consented were taken up for a split-mouth study. In the control group, surgical extraction of the impacted lower third molar was done using local anaesthesia (lignocaine 2% with 1:80,000 adrenaline) only, and in the study group, local anaesthesia with ketamine extraction was done using ketamine (0.2 mg/kg) along with local anaesthesia (LA). The time of onset and the duration of anaesthesia intraoperatively were recorded using a digital stopwatch. The depth of anaesthesia was noted on the 10th, 30th and 60th min. After extraction, the post-operative pain on the first, fourth, eighth and 12th hour was evaluated using a Visual Analogue Scale (VAS) score rating of 1–10. The pulse was also noted and compared for any differences in either of the groups.

Results:
A statistically significant (P < 0.005) difference in result was obtained for the onset, duration, depth and pain score after surgical extraction in both the evaluated groups. The pain index score by the ketamine group was significantly low as compared to the local anaesthesia-only group. Intraoperative onset, duration and depth of anaesthesia obtained had a significant difference.

Discussion:
Ketamine can be used as a viable option for surgical third molar extractions with reduced discomfort and post-operative pain.
Attached Oral Mucosal Wound Closure using Blue Glue - A Prospective Clinical Study
Authors: Narsingyani Roma Gopaldas , Patel Shital Mayank , Sood Ramita Atul , Bhimani Kruna K. , Makwana Sanjaykumar V. , Savani Rajan R. 
Published: July 2023

Abstract

Introduction:
Traditionally, sutures have been widely used to close intraoral wounds. Various alternatives have been developed amongst which newer tissue adhesives such as N-butyl-2-cyanoacrylate having accepted clinical properties are gaining popularity. The primary purpose of the present study is to evaluate the efficacy of N-butyl-2-cyanoacrylate for intraoral attached mucosal wound closure following alveoloplasty.

Materials and Methods:
In this prospective split-mouth study, 25 patients requiring alveoloplasty in either maxillary or mandibular arch bilaterally with a total of 50 sites were divided into two equal groups, namely silk suture (Group 1) and cyanoacrylate (Group 2). Each patient was evaluated on the first, third, seventh, 14th and 21st post-operative days. Parameters evaluated were time taken to close incision and to achieve haemostasis, pain, oedema, post-operative wound healing, patient discomfort and possible complications.

Results:
Time taken to close incision, time taken to achieve haemostasis, post-operative pain and oedema were found to be less in Group 2. Wound healing too was found to be better in Group 2. There was one case of adhesive peel off on the first post-operative day which was managed by reapplying the tissue adhesive. The incidence of wound dehiscence and wound infection was observed more in Group 1 on the third post-operative day. Suture breakage (16%) and adhesive dislodgement (8%) were reported on the seventh post-operative day.

Discussion:
The use of cyanoacrylates’ inherent benefits, such as improved wound seal off in attached mucosa, quick polymerisation and bacteriostatic characteristics can be beneficial when performing minor oral surgical procedures on elderly, young and mentally challenged patients.
Comparison of the outcome of limited protocol Ranibizumab injection in naïve choroidal neovascular membranes secondary to pathological myopia versus age-related macular degeneration
Authors: Fawzy Samah M. , Al-Tawab Mohammed S.A. , Ismail Zafer F. , Ebeid Weam M.A. 
Published: July 2023

Aim
We aimed to compare the anatomical and visual response of newly diagnosed choroidal neovascularization (CNV) secondary to pathological myopia or age-related macular degeneration with relatively poor initial vision to treatment with three intravitreal injections of ranibizumab.

Patients and methods
This prospective, comparative study included 29 eyes of 29 patients newly diagnosed with subfoveal active CNV, either secondary to age-related macular degeneration (AMD-CNV, 15 eyes) or to pathological myopia, that is, myopic CNV (MCNV, 14 eyes). All patients had an initial best-corrected visual acuity (BCVA) equal to or worse than 1.00 Log Mar. Patients received three intravitreal injections of 0.50 mg ranibizumab on a monthly basis. Patients were evaluated before injections and one month after each injection for BCVA and optical coherence tomography-measured retinal parameters: central macular thickness, total volume, and average thickness (AT). Amsler's chart was used to detect scotomas and metamorphopsias.

Results
One month after the three injections, a significant improvement was noted in the two groups in central macular thickness, total volume, and AT. The improvement was significantly better in AT of the AMD group. The mean BCVA improved significantly in the AMD group only as patients either improved or remained stationary, whereas in the MCNV group, 21% of patients deteriorated, which affected the significance of the overall mean of improvement (P=0.7823); the difference in the overall mean was insignificant. Despite that, almost half of the patients in each group had their visual acuity improved by an average of 9.5 letters in AMD and 10.7 in MCNV.

Conclusion
Naïve AMD-CNV and MCNV of initially poor VA can get significant improvement in all optical coherence tomography-measured retinal parameters following a three-injection course of ranibizumab on a monthly basis. VA improvement is more predictable in AMD, as no patients deteriorated after the injections, yet the overall difference in VA improvement between groups was insignificant.
Study of corneal endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty
Authors: Kamhawy Amira S.M. , Salem Osama A. , El Zankalony Yasser A. , Ebeid Ahmed A. 
Published: July 2023

Background
To study the endothelial cell layer 3 months after Descemet membrane endothelial keratoplasty (DMEK) using specular microscopy to provide data about the endothelial cell density (ECD), endothelial cell loss (ECL) percentage, and changes in endothelial cell shape (hexagonality) and size [coefficient of variation (CV)] and to study the factors causing these changes in endothelial cell layer after DMEK.

Patients and methods
This study included 20 patients investigated by specular microscopy 3 months after DMEK. We discuss the postoperative ECD, factors that affect the ECD, factors that affect hexagonality and CV, visual outcome, and advantages of DMEK. The study was approved by the ethics committee of Ain Shams University.

Results
This study showed that the mean ECD postoperative was 1664.80 cells/mm2, with mean ECL of 34.67%. This cell loss increased in cases of difficult graft unfolding. Donor age and preservation time had no effect on postoperative ECD. A percentage decrease in hexagonal cells and a percentage increase in CV were noticed in cases that received grafts from donors with history of diabetes mellitus. Postoperative ECD and hexagonal cell percentage had no correlation with central corneal thickness in this study.

Conclusion
DMEK results in significant improvement of postoperatively visual acuity (VA). Advantages of DMEK like no corneal sutures, short recovery time, less cylindrical aberration, decreased incidence of graft rejection, and good visual outcome make it the best choice to treat eyes with corneal endothelial dysfunction.
Antimicrobial resistance pattern in aerobic bacteria isolated from endotracheal aspirate in ventilator-associated pneumonia: Ten years observation from a tertiary care hospital
Authors: Rao Surlu Vidya , Thilakchand Karadka Ramdas , Boloor Rekha , Suresh Sucharitha , George Thomas , Pais Michael LJ. , Jakribettu Ramakrishna Pai , Baliga Manjeshwar Shrinath 
Published: July 2023

Abstract

Background and Aims:
Ventilator-associated pneumonia (VAP) is a nosocomial infection associated with high morbidity and mortality. This study was undertaken to monitor the trend of the demographical details, comorbid conditions, bacterial etiological agents, and their antibiogram causing VAP in adults in the year 2008, 2013 and 2018.

Material and Methods:
A retrospective study conducted at the Department of Microbiology, Hospital Infection control and Quality Control at a tertiary care teaching hospital. All the adult patients with more than 48 h of the mechanical ventilator with endotracheal intubation with Clinical Pulmonary infection Score >6 with suspicion of VAP were included in the study at a difference of 5 years, i.e., 2008, 2013, and 2018.

Results:
A total of 338 patients were included in the study, of which males accounted for more than two-third of the patients studied. Nearly 45% of the patients belonged to geriatric (>60 years) age group. The most common comorbid conditions were chronic obstructive pulmonary disease, hypertension and diabetes mellitus. Among the gram-negative isolates, Klebsiella pneumoniae, Acinetobacter species, and Pseudomonas aeruginosa were the most common. There is an emergence of resistance to most commonly administered antimicrobial agents like aminoglycosides, levofloxacin, piperacillin/tazobactum, and carbapenems during the study period.

Conclusion:
This is a ten-year study on the antibiotic resistance pattern of organisms causing VAP. As far as the authors are aware, this is the first study addressing the pattern of change in drug resistance in the organisms causing VAP over a decade. The emergence of multi-drug resistant (MDR) MDR pathogens, especially in intensive care unit (ICU), is a great concern for the intensivist and infection control physicians. Preventive measures need to be undertaken to control the spread of these pathogens to the patients in the ICU.
Clinical Characteristics and Prognosis of Pediatric Phthirus pubis Coinfestation of the Eyelashes and Scalp Hairs
Authors: Yao Bangtao , Hu Chang’an , Yue Xiaoli , Liu Gang , Wang Bei 
Published: July 2023

ABSTRACT.
Phthirus pubis infestation is a highly infectious parasitic disease, affecting 1.3–4.6% of people globally. However, the coinfestation of P. pubis on the eyelashes and scalp hairs in children is uncommon, and the clinical characteristics and prognosis have not been fully studied. In this retrospective study, we report five pediatric patients diagnosed with eyelash and scalp coinfestation of P. pubis. The samples were obtained after treatment and sent for pathological examination. The demographic and clinical characteristics of the study participants were analyzed in detail. Numerous lice and nits were detectable on the eyelashes and scalp hairs in all enrolled patients. The ages ranged from 2 to 5 years. The duration of onset ranged from 3 to 10 days. The common clinical presentations were itching (100%) and conjunctivitis (60%). Treatment included eyelash and scalp hair trimming to the root (100%) and mechanical removal of the parasites (100%), in addition to topical tobramycin eye ointment (100%) and phenothrin shampoo (80%). Symptoms resolved by a 1-week follow-up. Pediatric P. pubis coinfestation mainly occurs on the eyelashes and temporal scalp in females, and sometimes contact tracing fails to identify the source. Phthirus pubis infestation of eyelashes can be misdiagnosed as blepharoconjunctivitis. Sexually transmitted diseases should be ruled out for patients with P. pubis infestation. Untreated or persistent cases may lead to several serious infections.
Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease
Authors: Luan Haopeng , Liu Kai , Tian Qi , Chen Yuanxin , Peng Cong , Sun Xiaoyue , Song Xinghua 
Published: July 2023

ABSTRACT.
Hydatid bone disease is a zoonotic parasitic infection that is caused primarily by the tapeworm Echinococcus granulosus, and it continues to be a major public health concern in pastoral regions. The reconstruction of limb function after limb salvage surgery remains a challenge for clinicians. The purpose of this study was to determine the clinical efficacy of palliative treatment of the management of advanced pelvic hydatid bone disease. From March 2005 to December 2018, medical records and images of patients with advanced pelvic hydatid bone disease treated with surgery combined with antiparasitic chemotherapy were evaluated retrospectively. The Enneking classification was applied to determine the location of the lesion, and the Musculoskeletal Tumor Society score system was used for outcome evaluation. Fifteen patients who met the criteria were included in this study, with a mean follow-up of 4.40 ± 1.76 years. All patients received treatment with surgery combined with antiparasitic chemotherapy. The mean number of surgical interventions per patient for pelvic cystic echinococcosis was 5.3 (range, 2–9 interventions per patient). Recurrence of pelvic hydatid bone disease occurred in 5 patients and was managed successfully through repeated debridement procedures. Palliative treatment with limb salvage surgery was an effective and practical approach to the management of advanced pelvic hydatid bone disease. Standard antiparasitic chemotherapy, which included albendazole at a dose of 10 mg/kg/day administered in two daily doses for 3 to 6 months, was also considered an essential part of the overall treatment strategy.
Temporal Dynamics of Serum Perforin and Granzymes in Three Different Clinical Stages of Virus-Induced Severe Fever with Thrombocytopenia Syndrome
Authors: Ryu Sukhyun , Choi Jin Kyeong , Achangwa Chiara , Cho Soojung , Hwang Joo-Hee , Hwang Jeong-Hwan , Bovenschen Niels , Lee Chang-Seop 
Published: July 2023

ABSTRACT.
Virus-induced severe fever with thrombocytopenia syndrome (SFTS) induces a cell-mediated immune response that likely contributes to virus control in SFTS patients. To identify the temporal changes of the cell-mediated immune response, we investigated the changes in serum levels of perforin and granzymes at early periods after illness onset in SFTS patients. We analyzed 32 SFTS patients and compared the temporal patterns of serum perforin and granzyme A and B to that of 20 healthy control adults using the Mann-Whitney U test. Compared with healthy controls, the mean level of perforin was significantly reduced by 81% (P < 0.01) during the first week after illness onset, whereas granzyme B significantly increased by 4.6-fold (P = 0.02) in the first week after illness onset and decreased to normal afterward. During the study period, there was no significant difference in serum perforin and granzyme. These findings indicate that perforin and granzyme B in serum can be considered possible serologic markers that reflect the clinical stage of SFTS. Additional study is warranted for tracking circulating perforin and granzyme in different ages and for an extended period after illness onset.
The epidemiological characteristics, clinical manifestations, and outcomes of individuals diagnosed with COVID-19 infection at Al-Salama, Al-Ameria Hospital, during the period of April to August 2022.
Authors: Atshan Fawzi Hashim , Hasan Ibtisam Faraj , Ghali Ehab Jumaa , Alsherees Hashim 
Published: July 2023

Background: The majority of individuals who contract COVID-19, a disease caused by a novel coronavirus, are capable of recuperating at home without requiring hospitalization. However, elderly individuals and those with pre-existing medical conditions, such as heart disease, diabetes, chronic lung disease, or cancer, are at a greater risk of developing severe illnesses and may require hospitalization. The objective of this study: is to provide a detailed account of the epidemiology, clinical manifestations, and outcomes of COVID-19 patients who were admitted to Al-Salama Hospital, Al-Ameria, Baghdad, Iraq. Method: In this study, a retrospective analysis was conducted to investigate cases of COVID-19 infection that were admitted to Al-Salama Hospital, located in Al-Ameria, of Al-Karkh Health Directorate in Baghdad. Demographic data, clinical presentation, and outcomes were extracted using a specialized form. Results: The study included 101 cases admitted to Al-Salama Hospital from April to August 2022, out of which 87 were confirmed positive for COVID-19 through PCR testing while 14 were not tested. Among those who were tested, 5 cases tested negative and were discharged, while 9 cases tested positive, resulting in a total of 96 diagnosed cases of COVID-19.The duration of hospitalization was determined based on the severity of the illness. Moderate-severe cases (85/96) were discharged improved after a hospital stay of 3-7 days, while severe-critical cases (11/96) resulted in fatalities. The primary causes of death were respiratory failure and sepsis, and the patients stayed in the hospital for 8-21 days. Of the cases studied, 35/96 had been vaccinated against COVID-19. Out of the 11 deceased patients, 9 had a history of vaccination, while 26/85 of the discharged patients had been immunized. Males accounted for 56% of the cases, and the age range of 60-69 years had the highest number of male patients. Most female patients were in the age group of 80-95 years. The distribution of hospital admissions followed a trend similar to the 3rd and 5th waves of the epidemic that hit Iraq in July 2021 and 2022, respectively. Respiratory symptoms were the most common clinical presentation (74%), followed by gastrointestinal symptoms (12%), headache (8%), and chest pain (7%). Comorbidities were prevalent, with hypertension (43%), diabetes mellitus (32%), and cardiovascular disease (15%) being the most common. Conclusions: In conclusion, the findings of this study may have implications not only for Al-Salama Hospital Al-Ameria in Iraq but also for other countries with comparable epidemiological and clinical characteristics and disease outcomes during the pandemic.
Influence of Stakeholder Engagement on Sustainability of Donor Funded Projects in the Health Sector in Kenya
Authors: Micheni Alice , Were Susan , Namusonge Gregory 
Published: July 2023

Purpose: The study sought to find out the influence of stakeholder engagement on the sustainability of donor funded projects in the health sector in Kenya.
Methodology: This study used a mixed method research design where both quantitative and qualitative data were collected, then analyzed, and conclusions drawn. The research design used was explanatory. The target population was 700 employees drawn from various stakeholders in the health sector. The study adopted stratified, purposive, and simple random sampling techniques to select a sample of 230 respondents. The study used questionnaires to collect primary data. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 27. Both descriptive and inferential statistics were computed. The data was presented using Tables.
Findings: The study found out that there exists a relationship between stakeholder engagement and sustainability of donor funded projects in the health sector in Kenya. The statistical results of coefficients showed that the legal and regulatory framework moderates the relationship between stakeholder engagement and sustainability of donor funded projects in the health sector in Kenya. The study therefore concludes that an improvement in stakeholder engagement will lead to an improvement in sustainability of donor funded projects in the health sector in Kenya.
Unique Contribution to Theory, Practice and Policy: The study was anchored on Ladder of Participation Model. The study therefore recommends that the health sector in Kenya should work towards strengthening the frameworks for stakeholder engagement in the health-related projects if sustainability of the projects must be attained. There is great need to review and ensure stakeholder relationship management, stakeholder participation in decision making of key activities as well as ensure avenues to enable stakeholders actively participate in project activities across the entire project life cycle. The study recommends stakeholder mapping to be done based on meritocracy. The study recommends that the legal and regulatory framework around the stakeholder engagement should be strengthened to ensure compliance.
Índice de caminabilidad en las centralidades urbanas de los distritos de Huánuco, Amarilis y Pillco Marca
Authors: Barzola Gómez Renato Edu 
Published: July 2023

Este trabajo explora el entorno urbano construido de Huánuco donde la infraestructura de espacios viales tiene casi exclusividad para los autos, motos y trimotos. Así, el trabajo se propone medir el entorno urbano construido de tres centralidades urbanas (Huánuco, Amarilis y Pillco Marca). Mediante el análisis del índice de caminabilidad, basado en cuatro variables: calidad ambiental, densidad, confort peatonal y entropía, y con instrumentos como la observación, mapeo y análisis de bases de datos espaciales, se construye un índice de caminabilidad que permite entender las condiciones del entorno construido urbano existente. Los resultados nos permiten identificar que la centralidad urbana del distrito de Amarilis presenta mejores condiciones en la variable de calidad ambiental, densidad y confort peatonal que garantizan un mejor entendimiento a una escala local. Esto permite plantear políticas locales para la mejora de los espacios urbanos y recuperar la caminabilidad en las centralidades.
INSEMINAÇÃO ARTIFICIAL HOMOLOGA DE EMBRIÃO CRIOPRESERVADO POST MORTEM E O DIREITO SUCESSÓRIO À LUZ DOS PRINCÍPIOS CONSTITUCIONAIS
Authors: Da Silva Costa Gui Pagnoncelli , Dos Santos Alfredo José Edecio , Costa Silva Maria Eliete 
Published: July 2023

Este artigo pretendeu tratar do tema da inseminação artificial homóloga post mortem que é uma das técnicas de reprodução humana, assim como na proteção dos direitos do nascituro concebido por tal método em relação ao direito à herança, com foco nos princípios constitucionais presentes em nossa CF/88. Como a proteger e preservar os direitos do concebido por tal técnica, não permitindo, a diferenciação entre os filhos em detrimento da reprodução humana e sua relação ao direito sucessório no Brasil. Investigou-se a seguinte problemática: Existe regulamentação e possibilidade para utilização do material genético do casal para fins de inseminação, mesmo após sua morte? Na possibilidade, necessita de autorização do cônjuge falecido prévia?. como hipótese: Por se tratar de um tema polêmico e atual, que merece a doutrina se debruçar em busca de se chegar a uma jurisprudência, tendo em vista a omissão em nosso ordenamento jurídico, e essa omissão possibilita diversas correntes doutrinárias. O objetivo geral foi analisar a possibilidade de conceder os direitos sucessórios aos filhos concebidos pela técnica, levando em consideração os princípios constitucionais. Os objetivos específicos foram: investigar as disposições legais e constitucionais sobre herança, testamentária e sucessão legal no Brasil. A metodologia que se utilizou para o desenvolvimento deste artigo foi a pesquisa qualitativa-téorica, por meio de levantamento bibliográfico, como instrumento de pesquisa foram utilizados as fontes como livros, doutrinas, revistas científica, documentos legais, Código Civil, a Constituição Federal e as resoluções do Conselho Federal de Medicina. Por meio da modalidade exploratória.