bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mother’s knowledge as a dominant factor for the success of exclusive breastfeeding in Indonesia
Authors: Kapti Rinik Eko , Arief Yuni Sufyanti , Azizah Nurona 
Published: February 2023

Introduction: Exclusive breastfeeding is one of the important indicators in achieving nutritional problems in children. Unfortunately, only 1 in 2 babies are exclusively breastfed in Indonesia. Therefore, this study aims to examine the factors associated with exclusive breastfeeding in the country.
Design and Methods: Data were obtained from the Indonesian Family Life Survey (IFLS), by using a cross-sectional design involving a total of 2,217 mothers. The independent variables include weaning food, knowledge, labor difficulties, postpartum visits, number of children, marital status, sex of children, and low birth weight (LBW), while the dependent variable include exclusive breastfeeding. Subsequently, chi-square test and logistic regression were used to examine the relationship between exclusive breastfeeding and the related factors.
Results: The prevalence of exclusive breastfeeding in Indonesia was 36.5%. Bivariate analysis showed that the variables associated with exclusive breastfeeding were weaning feeding, knowledge, low birth weight, and difficulty in labor with p-values of 0.005, 0.000, 0.040, and 0.005, respectively. The most dominant variable for exclusive breastfeeding behavior is knowledge with a value of OR = 1.85.
Conclusions: There is a significant relationship between knowledge of mothers, weaning food, and low birth weight with exclusive breastfeeding behavior. Meanwhile, the main determinant among the variables is mother's knowledge. Therefore, health workers and community service cadres need to provide counseling about health, assistance, and motivation to mothers, thereby they will be able to properly provide exclusive breastfeeding.
<em>Brassica oleracea</em> var. italica extract reducing free radicals and inflammation initiated by an exposure to cigarette smoke
Authors: Suryadinata Rivan Virlando , Aditya Dwi Martha Nur , Wiana Viera Permatasari , Rahman Diana 
Published: February 2023

Introduction: Herbal extracts are often administered to cigarette smokers to prevent excessive free radicals. These include Brassica oleracea var. Italica, known to contain high antioxidant flavonoids and selenium micronutrients. Therefore, this study aims to determine the efficacy of Brassica oleracea var extract. italica in reducing the free radicals and inflammation present in experimental animals exposed to cigarette smoke.
Design and Methods: This research was conducted based on an experimental method using a randomized controlled trial (RCT) for 21 days. The animals used were divided into six groups (negative control, positive control, and four treatments). Particularly, the positive control and treatment groups were exposed to cigarette smoke for 2 minutes, twice a day, at 50 PPM CO levels. The treatment groups were administered the extract at different doses (0.5 ml; 0.75 ml; 1 ml; 1.25 ml), before assessing the blood level of malondialdehyde and C-Reactive Protein.
Result: The results showed the tendency for exposure to smoke to increase the number of free radicals and stimulate inflammation responses in the body (P<0,05). In addition, a strong correlation between variables was established (p=0.000; r=0.713).
Conclusions: Broccoli extracts (Brassica oleracea L. var. Italica) administration has the potential to cause a decline in the two aspects, including free radicals and inflammation responses resulting from exposure to cigarette smoke.
The correlation between family support and health status in patients with diabetes mellitus
Authors: Setyoadi Setyoadi , Yusuf Ah , Kristianingrum Niko Dima , Hayati Yati Sri , Noviyanti Linda Wieke , Syafiky Nurmalia Filda 
Published: February 2023

Introduction: The health status of a patient is strongly influenced by the family members because they play an important role during the health care process, and in healthy living. This implies that they must be involved in decision-making and therapeutic actions at every stage of the treatment. Therefore, this study aims to determine the relationship between family support and the health status of diabetes mellitus patients in Malang.
Design and Methods: This study used a descriptive correlational design with a cross-sectional approach, which was carried out by filling questionnaires to determine the relationship between family support and the health status of diabetes mellitus patients. The sample population consists of 327 diabetes mellitus patients and 327 family caregivers of patients with the disease. Meanwhile, the respondents were selected through a cluster random sampling technique.
Results: The results showed that 62.7% of the caregivers provided a good family support, while 90.8% of the patients have a good health status. This indicates that there is a positive correlation between family support and the health status of people with the disease (p-value= 0,000, α<0.05, r= 0,400).
Conclusions: Further studies are advised to explore the use of nursing interventions as an effort to maintain and improve the ability of families in providing long-term care for members with diabetes mellitus.
Communicating Risk
Authors: Chahar Puneet , Karnani Manasi , Mohanty Vikrant R. 
Published: February 2023

Background:
Tobacco is a public health problem with both health and economic consequences. Pictorial health warning (PHW) under cigarettes and other tobacco products Act, May 2003 (COTPA), offers advantages of being more universally available, low cost, and high exposure. The current study aims to assess compliance of smoking and smokeless tobacco products to Section 7, 8, and 9 of COTPA Amendment Rules 2015.

Materials and Methods:
This cross-sectional study was conducted in the city of New Delhi during November–December. 2017. All nine districts were included in the study and in each districts, three public places, a Metro station, a hospital, and a public park, were randomly chosen for tobacco products collection. A standardized protocol was implemented for acquiring tobacco products from these 27 diverse points. Data collected were entered into MS Excel to make digital spreadsheets and were analyzed using SPSS version 21.

Results:
Among 98 tobacco products, 57 (58%) and 41 (42%) were smoke form and smokeless form, respectively. Foreign Cigarette Brands and Beedi showed the least compliance followed by khaini and Gutkha. PHW was absent on 12 products (8 foreign brands of smoking type and 4 smokeless type). 42.8% (n = 42) of packaging was found to contain promotional inserts, while just 20.4% (n = 20) of the total sample size contained the presence of legislative information.

Conclusions:
Foreign brands and locally manufactured products (Beedi and Khaini) showed low compliance to new amendments of COTPA. Along with this, the presence of promotional inserts on tobacco packaging might be another issue to be dealt with in the future.
Fluoride Concentration in Saliva following Professional Topical Application of 2% Sodium Fluoride Solution
Authors: Talwar Manjit , Tewari Amrit , Chawla H. S. , Sachdev Vinod , Sharma Suresh 
Published: February 2023

Background:
Topical fluoride application in moderate and high-risk individuals and in those living in low-fluoride communities has been a common practice by dental professionals.

Objectives:
The objective of this study was to assess fluoride concentration available in saliva after a professional 2% sodium fluoride solution application (9000 ppm), and the duration of its availability to have an evidence-based practice for application.

Materials and Methods:
Two percent sodium fluoride application was carried out in 45 participants residing in a boarding school. The participants were non tea drinkers and nonfluoride users. Water fluoride of the area ranged from 0.34 ppm to 0.38 ppm. Whole mixed saliva samples were collected at baseline and various time intervals postapplication of 2% sodium fluoride solution. Fluoride in saliva was estimated using the fluoride combination electrode (Orion model 94–09, 96–09) coupled to an ionanalyzer.

Results:
IBM SPSS statistics version 23.0 was used for the analysis. Normality of the data was assessed using the Kolmogorov–Smirnov test and box plot, and it was found to be nonnormal. Wilcoxon signed-rank test was used to compare all time intervals with baseline, and statistically significant differences were observed (P = 0.0001). Salivary fluoride according to this study showed a biphasic clearance pattern with a peak at 15 min and a rapid fall in 60 min followed by a slow, consistent decline over a 20-h period. The fluoride concentration in saliva remained elevated above baseline from 0.03 ppm to 0.076 ppm even 3 months after application.

Conclusion:
Findings of this study show that, in this population, the frequency of application should be between 2 and 3 months (four applications per year).
Correlation of Mother and Child‘s Taste Perception and their Caries Experience
Authors: Abhiram K. , Sai Sankar A. J. , Sridevi E. , Sridhar M. , Pranitha K. , Aruna D. 
Published: February 2023

Aim and Background:
Nowadays, clinical assessment of caries susceptibility is evaluated by the individuals taste perception. As food habits of the child are mostly influenced by the parents (mothers), it would be beneficial to assess the relation between mother and child's taste status and their caries experience to predict the caries susceptibility of the child.

Methodology:
A convenience sample of 310 mother–child dyads of both the sexes were selected. After obtaining the data on the taste preferences, dietary habits, and oral hygiene practices, caries experience of both the mother and child were recorded using the DMFT and defs indices, followed by the taste assessment using 6-n propylthiouracil (PROP) tester strips.

Results:
Irrespective of the taste status, the majority of the mother and child dyads showed preference to sweet foods. A statistically significant relationship between taste status and caries experience was noticed among mothers and children individually. However, there was no significant association between mother and child taste status. Whereas, a weak-positive correlation is observed between the mother and child's caries experience. The children of supertaster mothers have relatively less caries experience compared to children of moderate and nontaster mothers, which was not statistically significant.

Conclusion:
Mother's taste perception or caries experience may not always be a risk predictor for their child's caries experience, but the PROP tester strips were very effective in predicting the caries risk of an individual.
Effect of Dentifrice Containing Crab-Shell Chitosan on the Accumulation of Dental Plaque in Fixed Orthodontic Appliances Patients
Authors: Heryumani Sulandjari J. C. P. , Chairunnisa Afina Zahra , Alhasyimi Ananto Ali 
Published: February 2023

Background:Patients with fixed orthodontic encounter problems in cleaning their teeth and mouths. Dental plaque tends to accumulate on wires, brackets, and surfaces between bonding materials and brackets. Plaque accumulation increases the risks of decalcification, caries, and gingivitis. Chitosan extract is a potential antibacterial agent and inhibitor of dental plaque formation. This study aims to assess the effectiveness of chitosan-containing dentifrice in decreasing plaque accumulation in patients with fixed orthodontic appliances.Materials and Methods:This was a prospective, randomized, double-blind study which involved 32 samples (randomly allocated to the control and chitosan groups, after the power of the study was considered) from patients with orthodontic appliances undergoing the last stage of fixed active orthodontic treatment. Plaque accumulation before and after dentifrice use was measured using a plaque index according to O'leary, before and after using toothpaste within 5 days. The patients were instructed to brushing with chitosan-containing dentifrice and chitosan-free dentifrice as a control. Washout period that needed between brushing with chitosan-containing dentifrice and chitosan-free dentifrice as a control was 7 days. Each mouthwash used routinely for 5 days with the same duration and intensity. The data obtained was then analyzed with one-way analysis of variance followed bypost hocleast significant difference. The level of significance was set as 0.05.Results:Plaque accumulation before and after dentifrice use significantly differed (P< 05) between the control and chitosan groups. The average reductions in plaque accumulation were greater in the chitosan group and control group brushing using chitosan-containing dentifrice.Conclusion:Dentifrice-containing chitosan more effectively reduces dental plaque accumulation in patients with fixed orthodontic appliances than dentifrice without chitosan.
Effect of Indigenously Developed Nano-Hydroxyapatite Crystals from Chicken Egg Shell on the Surface Hardness of Bleached Human Enamel
Authors: Kunam Divya , Sampath Vidhya , Manimaran Sujatha , Sekar Mahalaxmi 
Published: February 2023

Objective:
The objective was to evaluate the effect of nano-hydroxyapatite (nHA) derived from chicken eggshell on bleached human enamel in comparison with commercial casein phophopeptide-amorphous calcium phosphate (CPP-ACP) paste using Vickers microhardness test.

Materials and Methods:
nHA powder was prepared from chicken eggshell using combustion method. nHA slurry was prepared by mixing 1.8 g of nHA powder with 0.3 ml of distilled water. Forty intact maxillary anterior teeth were collected and decoronated, and the crowns were embedded in acrylic mold with the labial enamel surfaces exposed. Baseline microhardness evaluation was done (T0). The specimens were randomly divided into the following four groups (n = 10) based on the surface treatment of enamel: Group 1: no bleaching treatment; Group 2: bleaching with 30% hydrogen peroxide (HP) solution; Group 3: bleaching followed by the application of CPP-ACP; and Group 4: bleaching followed by the application of nHA. The specimens were stored in artificial saliva at 37°C for 2 weeks, after which they were subjected to Vickers microhardness test (T14). One-way ANOVA and Tukey's post hoc multiple comparison tests were used for statistical analysis (P < 0.05).

Results:
Bleaching with HP significantly decreased the enamel microhardness. CPP-ACP and nHA derived from chicken eggshell increased the enamel microhardness significantly. There was no significant difference in microhardness values among the CPP-ACP and nHA groups.

Conclusion:
Nano-hydroxyapatite sourced from chicken eggshell was as effective as CPP-ACP in remineralizing and restoring the lost microhardness of bleached enamel.
Role of gabapentinoids in post-operative pain management in thoracic surgeries: A single-centre propensity score-matched audit
Authors: Karkhanis Dhanashri R. , Bakshi Sumitra G. , Divatia Jigeeshu V. , Kannan Sadhana 
Published: February 2023

ABSTRACT

Background and Aims:
The analgesic role of gabapentinoids following thoracic surgeries is not clear. In this study, we evaluated the benefits of gabapentinoids for pain management in patients undergoing thoracic onco-surgery in terms of opioids and non-steroidal anti-inflammatory drugs (NSAIDs) sparing effect. We also compared pain scores (PSs), number of days of active surveillance by the acute pain service team, and side effects associated with gabapentinoids.

Methods:
After ethics-committee approval, data were retrieved retrospectively from clinical sheets, an electronic database, and nurses’ charts from a tertiary cancer care hospital. Propensity score matching was performed for six covariates, that is, age, gender, American Society of Anesthesiologists grading, surgical approach, analgesia modality, and worst PS in the first 24 hours performed. A total of 272 patients were grouped into group N (not given gabapentinoids, n = 174) and group Y (given, n = 98).

Results:
The median opioid consumption in terms of fentanyl equivalent by group N was 800 µg [inter-quartile range (IQR): 280–900], and the median opioid consumption by group Y was 400 µg (IQR: 100–690) (p = 0.001). The median number of rescue doses of NSAIDs administered to group N was 8 (IQR = 4–10), and the median number of rescue doses to group Y was 3 (IQR = 2–5) (p = 0.001). No difference was found in subsequent PS and for the number of days under acute pain service surveillance for either group. Group Y had an increased incidence of giddiness compared to group N (p = 0.006), with a relative reduction in post-operative nausea and vomiting scores (p = 0.32).

Conclusion:
Gabapentinoids used following thoracic onco-surgeries result in a significant reduction in concomitant use of NSAIDs and opioids. There is an increased incidence of dizziness with the use of these drugs.
Comparison of the effects of intravenous lignocaine and ketamine on postoperative pain after lower abdominal surgeries under general anaesthesia
Authors: Singariya Geeta , Sharma Jyoti , Kumari Kamlesh , Kamal Manoj , Khatri Chanda , Selvin Caren Candace 
Published: February 2023

ABSTRACT

Background and Aims:
As a component of multimodal analgesia, the administration of systemic lignocaine and ketamine is a well-known technique. This study was designed to compare the effect of intravenous lignocaine and ketamine on postoperative pain in the patients undergoing lower abdominal surgeries under general anaesthesia.

Methods:
Total 126 patients, aged between18 to 60 years, American Society of Anesthesiologists (ASA) physical status I and II, were randomly allocated into lignocaine (Group L), ketamine (Group K), or control (Group C). We assessed the mean fentanyl consumption 24 hours postoperatively, visual analogue score (VAS), time to first rescue analgesia, haemodynamic parameters, postoperative complications patient satisfaction score, and duration of hospital stay among three groups.

Results:
The mean fentanyl consumption in first 24 hours postoperatively was higher in group C (194.65 ± 48.48 μg) compared to group L (139.69 ± 46.96 μg) and group K (161.37 ± 46.31 μg) (P < 0.05). The VAS pain scores were lower in group L and group K compared to group C (P < 0.05). The time to first rescue analgesia was prolonged in group L and group K as compared to group C (P < 0.05). The patients were more satisfied in group L and group K as compared to group C (P < 0.05).

Conclusion:
The mean fentanyl consumption in 24 hours postoperatively and pain intensity were less with intraoperative lignocaine and ketamine infusion with improved patient satisfaction in patients undergoing lower abdominal surgery under general anaesthesia.
Major complications following central neuraxial block – A multi-centre observational study in Maharashtra (MGMM CNB Study)
Authors: Kulkarni Sadhana S. , Tayade Deepak N. , Kane Pratibha P. , Bhingarde Kiran R. , Jain Paramanand N. , Futane Savani S. , Kelkar Vasanti P. , Parchandekar Mukund K. , Kulkarni Jyoti V. , Prabhu Santosh K. , Kaddu Anjali S. , Bhosle Deepak S. , Deshpande Rajas K. , Deshpande Archana S. , Shetkar Shubhangi V. , Nayak Prabha P. , Gunjale Yashoda S. , Dhulkhed Pavan V. , Kanase Naseema V. , Deshmukh Prakash R. 
Published: February 2023

ABSTRACT

Background and Aims:
Major complications of central neuraxial block (CNB) are rare and their incidence in India is not known. This information is essential for explaining risk and medico-legal concerns. The present multi-centre study in Maharashtra was conducted to provide insight into the characteristics of rare complications following this popular anaesthetic technique.

Methods:
Data were collected from 141 institutes to study the clinical profile of CNB. Incidence of complications like vertebral canal haematoma, abscess, meningitis, nerve injury, spinal cord ischaemia, fatal cardiovascular collapse, and drug errors was collected over one year. Complications were reviewed by audit committee to assess causation, severity, and outcome. ‘Permanent’ injury was defined as death or neurological symptoms persisting for more than six months.

Results:
Spinal anaesthesia (SA) was the most frequently used CNB in 88.76% patients. Bupivacaine and an adjuvant were used in 92.90% and 26.06% patients, respectively. Eight major complications (four neurological and four cardiac arrests) were reported in patients receiving SA. In seven of eight instances, SA was responsible or contributory for complication. The pessimistic incidence of complications (included cases where CNB was responsible; contribution was likely, unlikely and could not be commented) was 8.69/lakh and optimistic incidence (included cases where CNB was responsible or contribution was likely) was 7.61/lakh. ‘Pessimistically’ and ‘optimistically’ there were three deaths including one death due to quadriplegia following epidural haematoma after SA. Five out of eight patients recovered completely (62.5%). As only eight patients had complications of different types, it was difficult to establish statistical correlation of major complications with demographic or clinical parameters.

Conclusion:
This study was reassuring and suggested that the incidence of major complications following CNB was low in Maharashtra.
Sagittal Pelvic Tilt Change after Total Hip Arthroplasty: An Evaluation using Supine Frontal Pelvic Radiographs
Authors: Deep Kamal , Sameer M. Mohamed , Shah Siddharth M. 
Published: February 2023

Purpose:
Pelvic tilt (PT) affects acetabular orientation which in turn influences the outcome after total hip arthroplasty. Calculating sagittal PT using parameter measured on frontal supine pelvic radiograph can increase ease of its recognition, quantification, and potentially predict change.

Materials and Methods:
In this retrospective study of 80 patients, who underwent unilateral THA for primary osteoarthritis, PT was calculated from standard supine frontal pelvic radiographs preoperatively and its change at 1 year follow-up. This was analyzed and correlated with published literature which utilized standing lateral pelvic radiographs.

Results:
The majority of our patients had change in the PT which correlated well with other studies which use standing lateral radiographs. One-fourth of them had more than 10° change in the PT at 1-year postoperative.

Conclusion:
The technique is easy and reproducible. Larger studies are needed to analyze the subgroups, especially “supertilters” and prescribe tilt correction.
Supplementary Fixation of Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction on Tibial Side with Intraosseous Tunnel: A Prospective Interventional Study
Authors: Jaidev Kailash P. Dev , Bhaskarwar Ajit , Singh Chander Mohan 
Published: February 2023

Objective:
To find and evaluate the results of a cost-effective technique for supplementary tibial side fixation of hamstring graft without complications which are usually associated with the use of hardware (staples, suture disc, suture post, etc.).

Materials and Methods:
A study was done on 20 young high demand male patients (military soldiers) at our hospital from December 2018 to July 2020 who fulfilled the inclusion criteria. All patients underwent arthroscopic anterior cruciate ligament (ACL) reconstruction ± meniscus repair/balancing and supplementary fixation of hamstring graft on tibial side via intraosseous tunnel by a single surgeon. Subjects were followed up to 1 year for ligament laxity via anterior drawer test/Lachman test, Lysholm knee score and visual analog score (VAS). Average time of surgery and complications if any were noted.

Results:
Out of 20 patients 18 had a mean Lysholm score of 95.6 and VAS was 0 in all patients by the end of 48 weeks. Two patients who underwent ACL reconstruction with meniscus repair (outside-in technique) had a score of <90 at the end of 48 weeks. None of the patients had ligament laxity, tunnel blowout.

Conclusion:
Study concluded that intraosseous tibial side supplementary fixation of hamstring tendon graft when done is a safe, cost-effective procedure and does not have any complications which otherwise are associated with a hardware use.