bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Limitation among Older Adults in a Rural Area in South Kerala and its Associated Factors
Authors: Pillai Rahul S. , Paul Sherin Susan 
Published: August 2023

Background:
A person is said to have a functional limitation when he/she does not have the physical or cognitive ability to independently perform the routine activities of daily living. If recognized at an early stage, these can often be improved greatly, helping them regain their functional abilities and independence.

Objective:
The objective of the study was to determine the prevalence of functional limitations among older adults in a rural area in south Kerala.

Materials and Methods:
The cross-sectional study was conducted among older adults residing in the field practice area of a rural health training center of a medical college in south Kerala for 3 months from October 2019 to December 2019. Data were collected by interview of the participants by the investigator. The modified Barthel Index for activities of daily living was used to determine the prevalence of functional limitations.

Results:
The overall prevalence of functional limitations among older adults in a rural area in south Kerala was 35.9%. The most common functional limitation experienced by the participants was difficulty in climbing stairs. Functional limitation was found to be significantly associated with the age, socioeconomic status, and type of family of the participants.

Conclusion:
There is an urgent need to focus on the functional limitation among older adults, especially among the oldest old and those in lower socioeconomic status with emphasis on the need to strengthen the health-care facilities for them, with respect to early identification and management of their functional limitations.
Histopathological evaluation of the effect of melatonin gel on bone regeneration in rat model
Authors: Golpasandhagh Leila , Samie Neda , Sabiza Soroush , Rezaie Annahita 
Published: August 2023

Background:
The purpose of this research was to investigate the effects of different doses of topical melatonin gel on bone regeneration in rat calvarial defects using histological analysis.

Materials and Methods:
Fifteen adult female Wistar rats weighing approximately 200 g were used and 8 mm in diameter defects were created in their calvaria. The rats were divided into three groups: 1.2% melatonin gel, 5% melatonin gel, and the control group. The animals were sacrificed after 4 weeks. Hematoxylin and eosin staining were used to prepare histological sections. Statistical analysis was performed using the Analysis of variance and Tukey’s post-hoc test. P < 0.05 was considered significant.

Results:
The results showed a significant difference in rate of ossification (P < 0.001), area of new capillaries (P = 0.002), and mean degree of inflammation (P < 0.001) between the three groups. Comparing groups pairwise, degree of inflammation (P = 0.003) and area of new capillaries (P = 0.019) were significantly lower in the 5% melatonin gel group than the 1.2% melatonin gel group (P = 0.003). The percentage of ossification was substantially greater in the 5% melatonin gel group than in the control and 1.2% melatonin gel groups (P < 0.001).

Conclusion:
Within the limitations of this animal study, our findings revealed that melatonin gel can be used as a stimulant of bone formation. Outcomes in this study show increased percentage of ossification in the melatonin groups when compared with the control, in a dose-dependent manner, as 5% melatonin gel has a greater effect on ossification.
Risk of periodontitis & dental caries among 35 to 44 year old diabetic individuals: A case control study
Authors: More Saudamini G. , Sankeshwari Roopali M. , Ankola Anil V. , Gadgade Akash 
Published: August 2023

Background:
The World Health Organization (WHO) has recommended the age group of 35–44 years for surveillance of oral health conditions in adults. There is a growing incidence of early onset of Type 2 diabetes mellitus (T2DM) worldwide.

Objective:
This study was conducted to find the strength of association between dental caries and periodontitis in patients with T2DM.

Materials and Methods:
This was a case–control study conducted among 35–44-year-old patients with T2DM (n = 185) reporting to various hospitals of Belagavi city and controls (n = 185), who met the inclusion criteria. Group matching was done for age and gender. The study participants were interviewed for their sociodemographic details, relevant medical history, oral health behaviors, and dietary behaviors using a self-designed questionnaire. Dental caries and periodontal status were recorded using the WHO criteria, 2013.

Results:
The mean decayed missing filled teeth was significantly higher among controls than cases (P = 0.006). A significantly higher number of cases had periodontal pockets (crude odds ratio: 6.6) as compared to controls. Regression analysis showed that loss of attachment was significantly associated with T2DM (adjusted odds ratio: 5.9, 95% confidence interval: 2.81–6.89).

Conclusion:
Periodontitis was found to be associated with T2DM. However, no such association was found between dental caries and T2DM.
Formation and stability of mucogingival junction on teeth without clinically detectable mucogingival junction secondary to vestibular extension procedure done for multiple adjacent teeth: A clinical study
Authors: Baghele Om Nemichand , Bezalwar Khushbu Vilasrao , Bhandari Vishnudas Dwarakadas , Ugale Gauri Mahesh 
Published: August 2023

Context:
There are very limited data on the postsurgical formation of a mucogingival junction (MGJ) on teeth without its clinical detectability.

Aims:
The purpose of this study was to assess the formation and stability of MGJ on teeth without clinically detectable MGJ secondary to vestibular extension procedures for multiple adjacent teeth evaluated 6 months postoperatively.

Settings and Design:
This prospective interventional single-arm clinical study was conducted in the department of Periodontology, which was approved by the institutional ethical committee, MUHS, Nashik, and registered with the Clinical Trial Registry of India.

Materials and Methods:
This trial included 22 participants aged between 18 and 50 years of either gender, including teeth without clinically detectable MGJ along with adjacent teeth having detectable MGJs. The following clinical parameters were taken at baseline, presurgical, immediate postsurgical, 1-month and 6-month follow-ups: plaque index, gingival index, and position of MGJ. gingival margin level, probing depth, width of keratinized gingiva, width of attached gingiva, clinical attachment level, and vestibular depth.

Statistical Analysis Used:
Descriptive statistics included mean, median, mode, etc., and the inferential statistics done were analysis of variance along with post hoc Tukey and independent sample tests.

Results:
Apical shift of MGJ was observed from baseline to 6 months secondary to split-full-split repositioning MGJ with vestibular extension procedure, which was statistically significant (P < 0.05). The formation of MGJ was delineated by clinical and biochemical methods at sites with nondetectable MGJ. The coronal migration of MGJ at 6 months as compared to 1 month was not statistically significant (P > 0.05). The MGJ remained stable at 6 months postoperatively at detectable and nondetectable sites.

Conclusion:
Within the limitations of this study, we can conclude that there is a definite formation of MGJ in participants without clinically detectable MGJ treated with “split-full-split MGJ-repositioning vestibular extension procedure.” The MGJ, which formed apically at a 1-month postsurgical visit compared to the presurgical position, remained stable for 6 months to 1-year follow-up period at both detectable and nondetectable sites.
The Effect of C-Reactive Protein and Interleukin 12 in Dental Caries Class V among Diabetic Patients
Authors: Hashim Ghadeer Lafta , Al-Mosawi Ahmed Mohammed A. , Al-Ameedee Ameer H. H. 
Published: August 2023

Background:
Dental caries is a multifactorial disease; it is affected by many factors such as sugar consumption, exposure, fluoride, and others.

Objectives:
To investigate the immune status by studying the levels of interleukin 12 (IL-12) and C-reactive protein (CRP) in gingival crevicular fluid (GCF) of individuals with dental caries among diabetic patients compared with diabetic patients with free dental caries and control groups.

Materials and Methods:
The study was designed to include 90 samples of GCF obtained from patients with diabetes and dental caries, patients with diabetes only without dental caries, and healthy subjects attending the Marjan medical city. The study duration was prolonged from November 2021 to March 2022.

Results:
The results showed that there were highly significant differences (P ≤ 0.05) in the concentration of IL-12 among healthy subjects. Both diabetetic patients with and without dental caries were represented by the increase in the concentration of IL-12. However, diabetetic patients with dental caries (74.86 ± 37.45) were more than those with free dental caries (53.26 ± 17.75) and even more than the control group. The contrast result showed a decrease in the level of CRP concentration in patients with diabetic and dental caries (2.589 ± 2.262) less than in patients with diabetes only (3.783 ± 2.408) and less than healthy subjects with significant differences (P ≤ 0.05).

Conclusion:
This study found that there was an elevation of the IL-12 level in patients with significant differences compared with control groups in contrast to a reduction in the concentration level of CRP patients with significant differences compared with the control group.
Role of Interleukin-17A in Endodontic Disease
Authors: Ghanim Tuqa’a Rahman , Al-Warid Rasha Jasim , Al Ameedee Ameer H. H. 
Published: August 2023

Background:
Endodontic disease is a complicated condition marked by inflammation of the apical tissues and is influenced by microbial, immunological, and environmental variables. Inflammatory cells, proinflammatory, and immunoregulatory cytokines are all recruited as part of the intricate immunological host response that occurs here; one of these cytokines is interleukin-17A (IL-17A).

Objectives:
This study aimed to determine the concentration of IL-17A by Enzyme Linked ImmunoSorbent Assay (ELISA) in the saliva of patients with endodontic disease to find the correlation between IL-17A and endodontic disease.

Materials and Methods:
The samples are collected from 60 patients (n = 60) with an age range of 20–50 years. The samples are collected from specialized dental centers and private clinics throughout the time period (December 2021–February 2022). The control samples are 20 (n = 20). The rate of samples was divided between males and females with ratios of 43.33% and 56.66%, respectively.

Results:
The result showed that the concentration of IL-17A was increased in patients compared with the control P-value (0.000). The difference in age showed no effect on the results of this study.

Conclusion:
This study showed that proinflammatory cytokines start immune responses in pulp tissues after bacterial infections and imply IL-17A endodontic illness.
Effects of Empagliflozin on a Model of Chronic Depression and Brain Toll-Like Receptors Gene Expression in Male Rats
Authors: Mijwel Hatem Kareem , Salman Salman M. , Al-Charrakh Alaa H. 
Published: August 2023

Background:
Empagliflozin is an antidiabetic medication having anti-inflammatory and antioxidant properties.

Objectives:
To develop a chronic unpredictable stress (CUS) model in male rats, evaluate empagliflozin’s antidepressant effects, and describe the link between stress, an antioxidant enzyme, and Toll-like receptor (TLR)-4 gene expression in male rats.

Materials and Methods:
In this experiment, 50 rats were divided into five groups: G1–G5. The forced swimming test (FST) was used to examine the antidepressant effects of fluoxetine and empagliflozin, and real-time polymerase chain reaction was used to measure TLR-4 gene expression. FST was performed on each rat on days 0, 10, and 25. CUS was performed on each rat for 24 days.

Results:
By the end of day 10, all animals subjected to the CUS program had a substantial (P < 0.05) increase in immobility duration compared with day 0. The immobility duration in the CUS group was statistically significantly greater than the baseline. Stressed rats demonstrated a statistically significant reduction in immobility duration compared with CUS group G2. In comparison to the CUS group, fluoxetine significantly reduced immobility duration (P < 0.05). In terms of gene expression, the mean of fold changes in TLR-4 mRNA level in group 2 was considerably greater than in group 1. When compared with group 2, the means of the fold changes in TLR-4 mRNA level were considerably lower in groups 3, 4, and 5.

Conclusions:
Empagliflozin has antidepressant-like effects and can counteract the impact of stress-induced TLR-4 overexpression in the hippocampus and elevate the activity of antioxidant enzymes in the brains of depressed rats.
Molecular Detection of Candida albicans Virulence Genes That Isolated from Periodontitis Patients in Al-Hillah City
Authors: Obais Ali A. , Al-shukri Maysaa S.M. , Al-Rubaye Abeer Fauzi M. 
Published: August 2023

Background:
An inflammatory condition known as periodontitis causes the tooth’s supporting tissues to be destroyed over time. One of the current dental problems is its high prevalence and detrimental consequences on quality of life. An oral candidiasis lesion often develops as a result of the development of a complex biofilm containing Candida albicans and other bacteria.

Objectives:
The objective of this study was to detect C. albicans virulence gene agglutinin-like sequence 1 and hyphal wall protein 1 (ALS1 and HWP1) by molecular method from clinical oral infection sample.

Materials and Methods:
One hundred fifty oral swabs were obtained from periodontitis patients who attended to a specific dental health center and outpatient clinics of dentistry in Al-Hillah city, Iraq during the period from April 2022 to September 2022. Patient age ranges from 5 to 72 years. The sample was taken by disposable cotton swabs. This swab was cultured on various culture media including CHROM agar and Sabouraud’s dextrose agar for isolation of C. albicans. After that genomic DNA was extracted from confirmed colony. Virulence genes (ALS1 and HWP1) were detected by polymerase chain reaction technique.

Results:
The result showed that out of 150 samples 25 (16.66%) belong to C. albicans isolated; also the result showed that ALS1 gene detected in a rate 15 (22.05%) while HWP1 detected in a rate 19 (27.94%).

Conclusion:
The Als1 and HWP1 virulence genes were expressed in most isolates of C. albicans which suggests that the ALS1 and HWP1 protein play an important role in the pathogenesis of infection.
The Bacterial Contamination in the Burn Unit of Al- Hussain Teaching Hospital at Al-Samawa City, Iraq
Authors: Kadhim Taisir Abdulelah , Al Sa’ady Amal Talib , Khayoon Hussein Ali , Hameed Dergham Majeed , Hussain Suha Suhial , Kareem Ahmed Shayaa , Al-Helli Ammar Mudher Sulaiman 
Published: August 2023

Background:
The main causes of a burn patient’s mortality are microbial infection which is related to burn unit contamination, which represents a significant health problem in the burn ward.

Objectives:
The aim of this study was to determine the types and microbial contamination degree in eleven different burn wards at AL-Hussain Teaching Hospital in Al-Muthanna Province-Iraq.

Materials and Methods:
This survey study included 770 samples (burn unit swabs) from June 2019 to march 2021 distributed into 70 swabs for each one of the different sources with missing system 3 for each (Floor of the Burn Ward, Locker of the Burn Ward, Bed of the Burn Ward, Floor in Bathroom of the Burn Ward, Chart of the Burn Ward, Door in Bathroom of the Burn Ward, Shower in Bathroom of the Burn Ward, Wall of the Burn Ward, Wall In Bathroom of the Burn Ward, Gauze of the Burn Ward, and Surgical Instruments of the Burn Ward).

Results:
The data of samples cultivation, 284(39%) samples yielded bacterial growth and 453(61%) samples showed no bacterial growth. The highest rate of positive growth was seen in samples of Floor of the Burn Ward 5 (78%) while the lowest incidence of positive growth was 1(1%) in samples of Surgical Instruments of the Burn Ward. Gram-positive bacteria were the predominant 173(61%) as compared with gram negative bacteria 111(39%).

Conclusion:
On the basis of data results we conclude that burn ward especially Floor harbor bacteria. Although some bacteria were normal flora, potentially pathogenic bacterial rates diverse between places.
Effect of dexmedetomidine on hemodynamics and recovery profile in children undergoing laparoscopic Stephen–Fowler's Stage-2 orchidopexy under general anesthesia
Authors: Shruthi A. H. , Anuradha G. , Chandrika Y. R. 
Published: August 2023

Background:
Stephen–Fowler's Stage-2 (SF-2) orchidopexy for high intra-abdominal testes poses the challenge of both laparoscopic and open urogenital surgery to the pediatric anesthesiologist. Balanced anesthesia supplemented with regional analgesia remains the standard technique adopted. Studies involving intravenous (IV) dexmedetomidine as an adjuvant anesthetic in children are sparse.

Aims and Objectives:
The aim and objective was to study the effect of IV dexmedetomidine on intraoperative hemodynamic stability, airway reflexes, and hemodynamic responses to extubation and postoperative analgesia.

Materials and Methods:
This prospective randomized controlled study was conducted on thirty children undergoing laparoscopic SF-2 repair to receive balanced anesthesia with isoflurane. Group D patients received IV dexmedetomidine 1 μg/kg bolus over 10 min after induction followed by an infusion at 0.5 μg/kg/h and Group C patients received regional analgesia. Hemodynamic parameters, sedation, agitation, pain scores, time to rescue analgesia, and time to discharge were documented.

Results:
A significant change was discernible in the heart rate and systolic blood pressure with intraoperative hemodynamic stability in Group D patients, which was comparable to baseline values. Smoother extubation with better hemodynamic stability (P < 0.001) and decreased agitation (P < 0.05) were noted in Group D patients. Children in Group C were observed to have lower sedation scores postoperatively (P < 0.05). Time to rescue analgesia was statistically significantly prolonged in Group D (P < 0.001) without any change in time to discharge from hospital.

Conclusion:
IV dexmedetomidine 1 μg/kg bolus followed by an infusion of 0.5 μg/kg/h gives better intraoperative hemodynamic stability with smoother extubation and prolonged postoperative analgesia without undue side effects in children undergoing SF-2 orchidopexy.
Ultrasound-guided radial artery cannulation in pediatric surgical patients <24 months of age
Authors: Parikh Badal , Simalti Ashish Kumar , Shankhyan V. K. , Joshi Saajan 
Published: August 2023

Background:
Arterial cannulation is increasingly becoming the standard of care in the perioperative management of complex pediatric surgeries and in patients with congenital cardiac anomalies. These indwelling arterial cannulas are used for invasive blood pressure (IBP) monitoring and blood gas analysis. With advent of ultrasound era, there is rising interest for its application in pediatric arterial cannulation. However, limited literature is available on its benefit in terms of success rate and complications.

Aims:
The aim of this study is to assess the success rate and complications when ultrasound guidance was used for arterial line insertion in the pediatric surgical patients.

Setting and Design:
Operation Theatre of Tertiary Care Centre / Prospective Observational Study.

Statistics:
Descriptive statistics.

Materials and Methods:
This study was conducted in children aged below 24 months requiring IBP monitoring during surgery. Parameters observed included rate of successful cannulation subdivided into first attempt success rate, successful cannulation within first two attempts, time to successful cannulation, and number of cannula. Complications namely hematoma and ischemic damage were also documented.

Results:
A total of 258 children were included in this study. We achieved successful radial artery cannulation in 95.74% patients, of which 77.9% were in first attempt while 8.1% required two attempts. The median time taken was about 168 s. In 33 (13%) cases, the site was changed before pricking based on thrombus or very narrow diameter of the artery. Hematoma formation was seen in 21 (8.1%) children, and only 2 (0.7%) children had features of ischemia in the distal part requiring removal of the cannula from radial artery.

Conclusions:
This study emphasized benefits of routine use of ultrasound in terms of higher chances of first-attempt success, lesser time for cannulation, lesser time taken, and more objective training benefit from ultrasound-guided radial artery cannulation in pediatric patients less than 24 months of age.
Therapy for Chikungunya Arthritis: A Study of 133 Brazilian Patients
Authors: Amaral José Kennedy , Bingham Clifton O. , Taylor Peter C. , Vilá Luis M. , Weinblatt Michael E. , Schoen Robert T. 
Published: August 2023

ABSTRACT.
Chikungunya fever is a global vector-borne viral disease. Patients with acute chikungunya are usually treated symptomatically. The arthritic phase may be self-limiting. However, many patients develop extremely disabling arthritis that does not improve after months. The aim of this study was to describe the treatment of chikungunya arthritis (CHIKA) patients. A medical records review was conducted in 133 CHIKA patients seen at a rheumatology practice. Patients were diagnosed by clinical criteria and confirmed by the presence of anti-chikungunya IgM. Patients were treated with methotrexate (20 mg/week) and/or leflunomide (20 mg/day) and dexamethasone (0–4 mg/day) for 4 weeks. At baseline visit and 4 weeks after treatment, Disease Activity Score 28 (DAS28) and pain (using a visual analog scale) were ascertained. Five months after the end of treatment, patients were contacted to assess pain, tender joint count, and swollen joint count. The mean age of patients was 58.6 ± 13.7 years, and 119 (85%) were female. After 4 weeks of treatment, mean (SD) DAS28-erythrocyte sedimentation rate (6.0 [1.2] versus 2.7 [1.0], P < 0.001) and pain (81.8 [19.2] to 13.3 [22.9], P < 0.001) scores significantly decreased. A total of 123 patients were contacted 5 months after the end of treatment. Pain score, tender joint count, and swollen joint count significantly declined after 4 weeks of treatment, and the response was sustained for 5 months. In this group of patients with CHIKA, 4-week treatment induced a rapid clinical improvement that was maintained 5 months after the end of therapy; however, the contribution of treatment to these outcomes is uncertain.