bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macular morphological changes in retinal vein occlusion with macular involvement and their association with macular ischemia
Authors: Rawat Renuka , Chalisgaonkar Charudatt , Tripathi Divya , Jain Shashi 
Published: August 2023

Aim:
The aim is to study the association between macular morphological changes and macular ischemia in retinal vein occlusion (RVO) involving macula by spectral domain-optical coherence tomography (SD-OCT).

Settings and Design:
Observational cross-sectional study.

Materials and Methods:
The study included a total of 31 eyes of 30 RVO patients involving macula divided into two groups on the basis of fundus fluorescein angiography: Group A (RVO with macular ischemia) and Group B (RVO without macular ischemia). In each patient, macular cube and horizontal HD raster scans of the macula were performed to evaluate quantitative (central foveal thickness [CFT]) and qualitative (loss of inner retinal layers, loss of foveal inner segment/outer segment [IS/OS] junction, and prominent middle-limiting membrane [p-MLM] sign) macular morphological changes, respectively.

Statistical Analysis:
The continuous and categorical data were analyzed using unpaired t-test and Fisher’s exact test, respectively, with GraphPad Prism 9 software.

Results:
The mean CFT was thinner in Group A (432.71 ± 172.30 µm) as compared to Group B (564.57 ± 151.16 µm) and the difference between the two groups was statistically significant (P < 0.05). In this study, we found that the loss of inner retinal layer and loss of foveal IS/OS junction were more commonly associated with the macular ischemia group and this difference was statistically significant P = 0.0245 and 0.0292, respectively. We did not find any significant relationship between p-MLM sign with macular ischemia.

Conclusion:
SD-OCT parameters such as CFT, loss of inner retinal layer, and loss of foveal IS/OS junction were observed to predict macular ischemia to some extent.
Ophthalmic prostaglandin analogs revisited - A systematic review of commonly used formulations
Authors: Feroze Kaberi Biswas 
Published: August 2023

Aim:
To systematically review the randomized control trials (RCTs) of the various prostaglandin(PG) analogues, comparing the effectiveness in treating glaucomas, safety and adverse effects of the individual agents.

Methods:
Articles were searchedusing the following key words “PG analogues”, “Latanoprost”, “ Bimatoprost”, “Travoprost”, “ Tafluprost”, “Unoprostone”, “ophthalmology”, “randomized controlled trial”, either singly or variably combined. Databases searched included Pubmed, Embase, Cochrane library, and Science direct. The search strategy was to identify randomized control trials (RCTs), either singly or variably combined.

Results:
24 Randomised control trials that had evaluated the efficacy and adverse effects of different PG analogue agents were selected and were used in this review Average JADAD value of the researches was found to be 2.83. Bimatoprost was found to be the most effective agent in IOP lowering efficacy but it had the maximal incidence of local adverse effects. Latanoprost, Travoprost and Tafluprost had similar efficacy. Latanoprost had the best tolerability. Unoprostone had weaker antiglaucoma action, compared to the other agents.

Conclusions:
Bimatoprost is probably one of the best antiglaucoma medications available at present. Its tolerability could be improved by using preservative free formulations. Latanoprost is a well tolerated agent with reasonably good antiglaucoma action.
Awareness and attitude regarding eye donation among undergraduate students of an engineering institution and its implication in Tamil Nadu
Authors: Subramaniam Gnaneswaran , Kumarasamy Murugan , Siraja Ameenah A. H. 
Published: August 2023

Background:
Corneal blindness is estimated to be the second most prevailing cause of blindness in developing nations. Visual rehabilitation by corneal transplantation is the main choice for the restoration of vision in these cases. The corneal transplant success relies on the availability of high-quality donor eyes. At present, there is a gap between the demand and supply of donor corneal tissues in the developing world. Our study aims to assess the awareness and willingness to eye donation among undergraduate students, especially those from a non-medical background.

Methods:
A single-center, cross-sectional study was conducted on engineering undergraduate students studying in a reputed Multi-disciplinary Institution, located in rural Tamil Nadu during the period August 2018 to March 2019 (8 months). Using random sampling, 507 students were selected for the study. A structured questionnaire was administered to all the participants. For statistical analysis, SPSS software, version 22, was used.

Results:
A total of 507 students participated in the study. The mean age of participants was 19 ± 2 years. In the study group, more than half (499) of the students had awareness about “eye donation,” but only 62.2% of students were willing to donate eyes. Among the study participants, 74% showed a poor attitude toward eye donation. Lack of knowledge regarding the process of eye donation was seen as the major cause attributing to this poor attitude.

Conclusion:
We conclude that if more intensive awareness program activities are carried out to make the younger generation, making them more aware of the process of eye donation, we can significantly increase the rate of eye donation in India.
Clinical and microbiologial profile of bacterial and fungal keratitis: A comparison of patients with and without diabetes mellitus
Authors: Paul Jincy Mariya , Jyothi P. T. 
Published: August 2023

Aims:
The aim of the study was to evaluate the predisposing factors, clinical features, causative microorganism, and response to treatment, among persons of infective keratitis, with and without diabetes mellitus and to determine differences between the two groups.

Subjects and Methods:
This prospective study enrolled 26 patients of infective keratitis who had diabetes mellitus and 52 patients without diabetes mellitus, by consecutive sampling who attended the ophthalmology department at a tertiary care institute. Detailed clinical evaluation and microbiological evaluation were done. Treatment was initiated according to clinical diagnosis. The patients were followed up at 2 weeks, 1 month, and 3 months.

Statistical Analysis Used:
Statistical testing was done using Chi-square test and Fisher’s exact test for qualitative variables. Quantitative variables were expressed as means and standard deviations. The variables between the two groups were compared using Student’s t-test and Wilcoxon test, where appropriate. Shapiro–Wilk test was used to test normality of data. Analysis was done using the SPSS software.

Results:
Urban population, monsoon season, and outdoor work were associated more commonly with microbial keratitis. Ocular trauma (69.2%) was the most common risk factor. A greater proportion of patients with diabetes (46.2%) did not have a history of ocular injury compared to those without (23.8%). Poor glycemic control increased severity of keratitis (P = 0.023). Redness and pain were the most common symptoms in both groups. Corneal sensations were significantly reduced in patients with diabetes mellitus. Diabetes mellitus was significantly associated with central ulcers (46.2%), hypopyon (50%) in anterior chamber, and fungal keratitis (35%). Hypopyon and depth of ulcer were significant predictors (P = 0.018 and 0.006) of the time taken for the infective keratitis to heal. Pseudomonas aeruginosa (19.2%) was the most common bacteria isolated in diabetic patients and Methicillin-sensitive Staphylococus aureus (10.3%) among nondiabetic patients. Fusarium was the most common fungus isolated among both groups. Ulcers healing with leukomatous opacities were higher, and the frequency of perforated corneal ulcers was also higher among diabetic patients (P = 0.026). Posttreatment visual acuity showed a statistically significant improvement only in patients without diabetes mellitus.

Conclusions:
Significant differences existed between the two groups regarding clinical and microbiologial profile. Aggressive treatment, strict glycemic control, and high index of suspicion for fungal keratitis are important in managing microbial keratitis patients with diabetes mellitus.
Evaluation of the Relationship Between Dental Caries and Dermatoglyphics in 3 to 6-Year-Old Iranian children
Authors: Mokhtari S , Mokhtari S , Sabour S , Hosseini Z 
Published: August 2023

Background:
As enamel and finger buds have an ectodermal origin and grow at the same time, it might be supposed that factors and agents that affect dental caries might give rise to the diversity of dermatoglyphic dermal ridge patterns.

Aim:
The present study aimed to evaluate the relationship between dental caries and dermatoglyphics in 3 to 6-year-old Iranian children.

Methods:
The present case-control study was performed on 3 to 6-year-old children. The decayed, missing, and filled teeth (dmft) scale was used to evaluate the oral and dental health status in the participants. Then, the patients were divided into two groups: 1) The case group: patients with a dmft of ≥3 (101 cases); 2) the control group: those with dmft value of zero (86 cases). Afterward, using a fingerprint recording device, the fingerprints were obtained from both hands of the participants.

Results:
There was no significant relationship between the patterns of fingerprints and dental caries. The percentages of whorls, loops, and arches in the case group were higher than those in the control group; however, these differences were not statistically significant.

Conclusion:
Dermatoglyphic patterns could not be used as a variable for the detection or prediction of dental caries in Iranian children.
The Effect of Different Positions of Unerupted Lower Third Molar Teeth on the Fragility of Mandibular Angle
Authors: Seyrek NK , Kahraman OE 
Published: August 2023

Background:
The mandibular bone is the largest and strongest bone in comparison to the other bones in the face skeleton. However, it is the most commonly fractured in facial injuries. The location of the fracture in mandible depends on various factors. The relationship of the impacted lower third molar teeth to mandibular angle fracture has been the subject of many epidemiological studies. It is argued that the risk of fracture in mandibular angle is two to four times more when there are particularly an impacted or partially impacted third molar teeth. However, the effect of the position of the impacted tooth on mandibular angle fracture is not clear yet.

Aim:
This study seeks to reveal the effect of third molar teeth that are impacted in various positions on the angle fragility.

Materials And Methods:
This study was performed using three-dimensional finite element stress analysis and static linear analysis methodology. Computed tomography (CT) images obtained previously from a patient were used to construct models of the bone tissue. An ILUMA CBCT device (3M Imtec, OK, USA) was used for tomographic scans. Impacted teeth in various positions were digitally modeled separately. Different direction forces were applied to the mandible, the stress values on the bone surrounding the third molar teeth impacted in different positions were determined.

Results:
Third molar teeth are impacted in mandibular bone in the following positions: mesioangular, vertical, horizontal, and distoangular positions. The study showed that the force that created the highest stress in the Mandibular angle among the modelled groups is the force by ipsilateral angle.

Conclusion:
For all kinds of impacted teeth, there was more stress accumulation in the buccal area than in the lingual area when the force is from the symphisis.
Noninvasive Ventilation with Nursing Perspective
Authors: Yaman Ö , Aygün M , Erten H 
Published: August 2023

Background:
The success of noninvasive ventilation (NIV) treatment is closely related to high levels of clinical support.

Aims:
In this study, we sought to analyze patient mask compliance and minor side effects and to evaluate additional nursing workload needed for the NIV care.

Materials and Methods:
The study was designed as a prospective and observational. The data were collected from an intensive care unit. Clinical and physiological data, patient tolerance and adverse effects, subjects' complaints about their experience, and additional nursing workload associated with NIV treatment were assessed.

Results:
Statistically significant improvements were obtained in arterial blood gas analysis, respiratory rate, and heart rate during treatment. In the first 2 h, 65% of subjects had poor mask compliance, patients' comfort scores were poor, and incompliance was associated with discomfort. The ratio of skin problems was 15% in the first 24 h and reached 60% at 48 h. The pain rate due to mask ties was 80% and then increased to 90% at 48 h. There was a significant relationship between the problems detected by the nurses and problems described by the subjects. Additional nursing workload was found as 110 min for 0–6 h.

Conclusions:
We observed that the mask compliance and comfort levels of the subjects were poor. Skin breakdowns increased depending on the duration of treatment. Treatment would require continuous nursing support in seven areas. NIV treatment generated a significant amount of workload for nurses. Additional nursing workforce planning is required for NIV units for successful NIV treatment.
Complex Congenital Heart Diseases Among Children Presenting for Cardiac Surgery in a Tertiary Health Facility in Enugu; South-East Nigeria. A rising trend
Authors: Ujunwa FA , Ujuanbi IS , Chinawa JM 
Published: August 2023

Background:
Complex cardiac anomalies are a set of associated heart structural anomalies requiring some adaptive mechanism to maintain life.

Objectives:
This is to determine pattern and prevalence of common complex cardiac anomalies among children presenting for cardiac surgery in Enugu.

Methodology:
The children that present for cardiac surgery in our center over a six-month period were admitted and rescreened using a standardized echocardiographic method, information on biodata, oxygen saturation and 2D echo diagnosis were recorded in a proforma.

Results:
A hundred and one (101) children with different structural heart diseases presented for cardiac surgery, 53 females and 48 males, 99 (98%) had congenital heart defects (49 cyanotic and 50 acyanotic). Complex cardiac anomalies were noted among 49 and 50 were non-complex, 6 (12.2%) acyanotic, and 43 (87.8%) cyanotic complex P < 0.01. This was noted among 21 females and 28 males. Children less than 3 years had 31 cases (63.3%) of the complex heart diseases while children between 5 years to 18 years had 14 (28.6%). The top three complex congenital heart disease were complex Tetralogy of Fallot which was found among 26 (53%) subjects. Tricuspid atresia and Truncus arteriosus were found in 3 children with congenial heart disease each, Shone complex was found in a child, Hypoplastic left heart syndrome was also noted in a child.

Conclusion:
The incidence of complex congenital heart diseases among prospective Paediatric cardiac surgery patients is high. Efforts should be made to improve access to preventive cardiology in order to curb these diseases.
Thoracoscopic Repair of Congenital Diaphragmatic Hernia in Neonates
Authors: Sundaram J , Ramasundaram M , Agarwal P , Barathi S , Rajan M 
Published: August 2023

Background:
Congenital diaphragmatic hernia (CDH) is an anomaly with significant morbidity in neonates. It has been traditionally managed by an open approach with a recent trend toward a minimally invasive approach.

Aim:
This is a retrospective study of our institutional experience with neonatal thoracoscopic management of CDH, with the impact of few technical nuances.

Patients and Methods:
The data was collected on neonatal thoracoscopic CDH repair between January 2015 and December 2018, in terms of the demographics, intra-operative parameters, post-operative status, recurrence, and mortality. While analyzing data, we found few technical modifications adopted by the surgeon such as trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO2, maximal use of muscle relaxant, extra-corporeal corner hitch stitch at some point, and continuation for further cases. An internal comparison was made to analyze the technical modifications influencing the outcomes, by dividing them into two groups, those with (group A) and without modifications (group B). The data was analyzed using SPSS software (IBM, Version 23). A P value of <0.05 was considered statistically significant.

Results:
Out of 45 newborns 64.4% were males with an average birth weight of 2.6 kg. Baseline variables were comparable between the groups. The operating time significantly reduced after a higher-level camera port was used (P-value: 0.0001). The mean follow-up was 30.8 months. There were totally seven recurrences (6 in group A and 1 in group B), all within 12 months. Seven parents gave the overall post-treatment feedback as “unsatisfied”. The operating time, recurrence rate, and parental satisfaction feedback were significantly less in group B (P-value: 0.001).

Conclusion:
We recommend trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO2, maximal use of muscle relaxant, extra-corporeal corner hitch stitch to reduce the operating time, and recurrence after thoracoscopic CDH repair.
Change in Surface Characteristics and Permeability of Human Enamel after Subjecting to Radiation Therapy
Authors: Suri S , Raura N , Thomas MS , Kumar PS , Lewis AJ 
Published: August 2023

Background:
Radiation-related caries is a complex destructive lesion leading to uncompromising damage of enamel and dentin in patients suffering from head and neck cancer managed with radiotherapy.

Aim:
The purpose of this study was to evaluate the changes in the permeability of enamel and to assess the morphological and chemical changes of teeth surface subjected to 6 MV photon beam irradiation.

Materials and Methods:
For this in vitro study, coronal portion of 20 premolars were sectioned mesiodistally into halves and then grouped into two. Samples in group 1 (control) were not subjected to cycles of irradiation and those in group 2 (experimental) were subjected to a cumulative uniform radiation dose of 70 Gray fractioned in 35 fractions with 6 MV photons. The silver nitrate penetration method was used to assess the change in permeability of enamel. The variations in surface topography and mineral content were assessed using scanning electron microscopy with energy dispersive X-ray analysis. Dye penetration scores of surface texture changes were compared between the two groups utilizing the Chi-square test. The change in the elemental levels between enamel surfaces of the two groups was compared using an independent t-test.

Results:
The application of 6 MV photon radiation did not change enamel permeability and surface topography. However, a noteworthy reduction in the carbon content (P = 0.002) was observed in teeth subjected to irradiation.

Conclusions:
Though radiation exposure did not alter the enamel permeability and surface topography, it had caused significant chemical compositional changes. Carbon content was significantly reduced in irradiated enamel samples.
Cyclic Fatigue Resistance and Shaping Ability of Heat-Treated Nickel-Titanium Instruments after Repeated Use
Authors: Kamali SG , Turkaydin D 
Published: August 2023

Aims:
To evaluate the effect of multiple-use and sterilization on cyclic fatigue and shaping ability of heat-treated nickel-titanium (NiTi) rotary instruments.

Methods:
A total of 120 acrylic blocks with S-shaped canals were photographed and prepared by HyFlex CM, ProTaper Next, and Twisted File. Ten new sets of each rotary instruments were used for four times. The autoclaving process was repeated after each use. Pre- and post instrumentation images were superimposed. The amount of resin removal and canal transportation by each system was measured in eleven different points. Instruments were subsequently subjected to a cyclic fatigue test in a double-curved artificial canal. The means and standard deviations of the number of cycles to failure (NCF) were calculated and statistically analyzed (P < 0.05).

Results:
No fractures occurred during the shaping of the simulated canals. The ProTaper Next removed the greatest amount of resin, whereas the Twisted File had the lowest values at all levels. Repeated clinical use and sterilization resulted in a decrease in the resin removal at most levels in Twisted File and ProTaper Next. In terms of canal transportation, an increase in a limited number of levels was detected after repeated use of all rotary files. Twisted File had the greatest cyclic fatigue resistance, followed by HyFlex CM and ProTaper Next (P < 0.05).

Conclusions:
The effects of repeated use and autoclaving on the cyclic fatigue resistance of HyFlex CM, ProTaper Next, and Twisted File were not significant. Canal transportation increased mostly in the apical region. The amount of resin removal decreased as the number of use increased for ProTaper Next and Twisted File instruments.
Impact of the COVID-19 Pandemic on the Academic Training and Psychosocial Well-Being of Undergraduate Dental Students in Nigeria
Authors: Umeizudike KA , Isiekwe IG , Akinboboye BO , Aladenika ET , Fadeju AD 
Published: August 2023

Background:
Most educational institutions in Nigeria were shut down for a long while at the onset of the COVID-19 pandemic as a preventive measure, and this affected dental students' academic and clinical training.

Aim:
To determine the influence of the pandemic on the academic, clinical training, and psychosocial well-being of dental students in Nigeria.

Subjects and Methods:
This cross-sectional survey was conducted among undergraduate dental students in clinical years in Nigerian dental schools. Participants received the questionnaire through an online platform, it had four sections; socio-demographics, impact on academic training, psychosocial well-being, and an open-ended segment for participants' suggestions to challenges. A mixed method was utilized to analyze the data. The statistical significance level was P < 0.05.

Results:
One hundred two dental students from nine dental schools participated, with a mean age of 25.3 ± 2.4 years. There were 56 (54.9%) males. Most students, 80 (78.4%) reported that their stay-at-home had not been rewarding academically. The majority, 90 (88.2%) were worried about contracting COVID-19 on school resumption. Participants' psychosocial well-being had significant associations with gender (P = 0.001) and self-directed learning during their stay-at-home (P = 0.001). More female students, 33 (71.7%) were severely worried compared to males 20 (35.7%). Their major suggestions were to commence online teaching and examinations (40.1%) and be provided with adequate personal protective equipment (18.6%).

Conclusion:
Most undergraduate students in Nigeria were anxious about COVID-19, and females were more affected. This negatively impacted their academic and clinical training. This underscores the importance of adequate psychological support for undergraduate dental students by school authorities.