bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative assessment of tumor-associated tissue eosinophilia and nuclear organizing region activity to validate the significance of the pattern of invasion in oral squamous cell carcinoma
Authors: Sharma Hidangmayum Denish , Mahadesh Jyothi , Monalisa Wakambam , Gopinathan Pillai Arun , Laxmidevi B L , Sanjenbam Nelson 
Published: April 2023

Introduction:
Pattern of invasion (POI) in scoring system of oral squamous cell carcinoma (OSCC) can predict local recurrence and overall survival rate. Argyrophilic nucleolar organizer region (AGNOR) counts are considered to reflect the biosynthetic and nucleolar activity of a cell and thus serve as an indicator of the rapidity of the cell cycle thereby indicating the proliferative index of the tumor. It is implied that higher tumor associated tissue eosinophilia (TATE) showed lesser venous invasion, lymph node metastasis and clinical recurrence. The aim of the study was to assess and evaluate the following criteria's: POI-1 to POI-4 as defined by Bryne et al. in OSCC, proliferative index by AgNOR stain and TATE with carbol chromotrope stain in OSCC, validity of POI by correlating the AgNOR proliferative index and TATE.

Materials and Methods:
Forty samples of formalin fixed paraffin embedded tissue blocks diagnosed of OSCC were taken for the study. Three sections were taken from a single block and then the tissues were stained differently with H & E Stain, AgNOR stain and Carbol chromotrope stain. First section stained with H & E was observed for POI and grading was done according to Bryne's criteria. The second and third sections were stained with AgNOR stain and Carbol chromotrope stain for proliferative index and TATE. One way analysis of variance was used to test the significance.

Results:
Mean AgNORs count increases gradually from type 1 to type 4, depicting the increase in the nucleolar proliferative index of the cells and was statistically significant. In the case of the mean eosinophilic count, type 1 shows the highest mean eosinophilic count and the count shows drastic decrease till type 3 and from type 3 to type 4 the decrease is more gradual and was statistically significant.

Conclusion:
The study validated that POI is a good predictor for prognosis and also can be included in grading OSCC along with routine histopathological criteria.
Efficacy of curcumin in the treatment of denture stomatitis
Authors: Tatapudi Ramesh , Abdul Samad S K , Manyam Ravikanth , Dasari Divya , Lakshmi Roja Vara 
Published: April 2023

Background:
The prevalence of denture stomatitis has been shown to vary from 15% to 65% in complete denture wearers. In recent years, a number of studies across the globe have investigated the various biological effects of curcumin, curcumin, a polyphenolic compound derived from dietary spice turmeric, possesses diverse pharmacologic effects including anti-inflammatory, antioxidant, antiproliferative and antiangiogenic activities. The aim of this study was to evaluate the efficacy of curcumin local application with common antifungal agent clotrimazole for the treatment of denture stomatitis.

Materials and Methods:
A randomised double-blind clinical trial with approval of institutional ethical committee consisting fifty participants divided into two groups (17 men–33 women) with the clinical signs and symptoms of oral candidiasis. The diagnosis was supported by microbiological cultures. Group A patients were prescribed the clotrimazole and Group B patients were prescribed the curcumin ointment which was dispensed in similar amber coloured bottles. Data were analyzed using Chi-squared tests, Wilcoxon's signed rank sum test and Mann-Whitney test.

Results:
The mean candidal colony counts before treatment in Groups A and Group B were 63.960 and 37.080, respectively. The mean candida colony counts after treatment in both the groups were 14.080 and 3.720, respectively. There was a statistically significant difference between the two groups when mean candida colony counts were calculated before and after treatment. However, intergroup comparison between the two groups considering the mycological eradication showed that there was no statistically significant difference with P = 0.404.

Conclusion:
Topical application of curcumin as a natural ingredient could be an effective agent for the treatment of denture stomatitis as an alternative to regular clotrimazole therapy.
Neutrophil-to-lymphocyte ratio as a prognostic factor in oral squamous cell carcinoma – A single-institutional experience from a developing country
Authors: Mishra Vigyan , Giri Ranjana , Hota Subhranshu , Senapati Urmila , Sahu Subrat Kumar 
Published: April 2023

Background:
Cell-mediated inflammatory response, neutrophils, lymphocytes and monocytes are being recognized as an important role in carcinogenesis. Neutrophil-to-lymphocyte ratio (NLR) has been used as an independent prognostic factor in varieties of cancers. NLR can be easily determined from complete blood count, and it could be considered as a simple and inexpensive prognostic marker.

Aim:
In this study, we evaluate the prognostic significance of NLR in patients with oral squamous cell carcinoma (OSCC).

Materials and Methods:
Clinical and epidemiological data of all biopsy-proven nonmetastatic OSCC treated between 2014 and 2018 were taken into consideration. Pretreatment absolute neutrophil and lymphocyte counts were used to get NLR. Using univariate and multivariate analysis, the impact of NLR on overall survival (OS) and progression-free survival (PFS) was investigated.

Results:
A total of 50 patients of OSCC with median pretreatment NLR ratio of 2.52 were identified. Based on the median NLR as a cutoff, patients were classified into two groups, i.e., high NLR and low NLR. Elevated NLR was significantly associated with lymph node metastasis (P = 0.01). Four-year OS and PFS were significantly better for patients with low NLR when compared with high NLR group (51.4% vs. 100%, P = 0.001). Four-year PFS for high and low NLR groups was 38.8% and 87.8% (P = 0.002). Multivariate analysis confirmed that NLR is an independent prognostic factor (P = 0.003).

Conclusion:
Pretreatment NLR provides a simple, cheap and early predictor of outcome in this group of patients. However, an optimal cutoff value of NLR should be determined, for which larger sample size and prospective studies are required.
Geometric morphometric analysis for sex determination using lateral cephalograms in Indian population
Authors: Johnson Abraham , Singh Sraddha , Thomas Anju , Chauhan Nipa 
Published: April 2023

Background:
Orthodontic science centers primarily on the growth, development and advancement of the craniofacial structures. Geometric morphometrics (GMM) is a new approach for shape identification in forensic sciences.

Purpose:
The aim of this study was to examine the shape variation in the Indian sample in order to assess sexual dimorphism by application of two-dimensional GMM.

Materials and Methods:
The sample comprised a total of 105 lateral cephalograms (54 males–51 females) of Angle's Class I malocclusion patients that were later subjected to principal component (PC) analysis and discriminant analysis.

Results:
The PC analysis showed over 96% of shape variation. The initial three PCs were statistically significant that depicted as 58.37% of total shape variability, with PC1 represent for the most significant variance 28.48%, PC2 described 18.83% and PC3 11.06%.

Conclusion:
Sex of an individual was clearly associated with occlusion of teeth and showed considerable variation. GMM is an alternative research tool and can be utilized for diagnosing individual characterization and classification of malocclusion.
Antibacterial effects of aqueous and alcoholic extracts of Zataria multiflora in comparison with chlorhexidine mouthwash on some pathogenic oral streptococci: An in vitro study
Authors: Noveiri Parnian Baradaran , Rezvaninejad Rayehehossadat , Azarm Ali , Rezvaninejad Raziyehsadat 
Published: April 2023

Background:
Increasing antibiotic resistance to pathogenic microorganisms (Streptococci) has led scientists around the world to turn to medicinal plants. In this study, the effects of aqueous and alcoholic extracts of Zataria multiflora on the in vitro growth of Streptococcus mutans and Streptococcus sanguis have been considered and compared with 0.2% chlorhexidine mouthwash.

Materials and Methods:
In this in vitro study, the inhibitory growth zone was accessed by the disc diffusion method after 48 h of incubation at 37 C. To find out the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of treatments, colony counts of cultured bacteria on nutrient agar have been considered at serial dilution at 1/2-1/1024 dilution rates. An independent t-test was used to compare the antibacterial effects of extracts while the level of significance of was considered to be 5% (P < 0.05).

Results:
The inhibitory growth zones of aqueous and alcoholic extracts on S. mutans were 26.8 mm and 35.8 mm, respectively, whereas growth zones for S. sanguis were considered as 25.8 mm and 33.2 mm, sequentially. Comparisons showed better effects of alcohol compared to aqueous extract (P > 0.05). The MIC and MBC assessments showed the same results (P > 0.05). In all comparisons, the effects of 0.2% chlorhexidine mouthwash were significantly better than both Z. multiflora aqueous and alcoholic extracts (P > 0.05).

Conclusion:
The different solvents may have contributed to the better effects of an alcoholic to aqueous extract of Z. multiflora on the growth of both bacteria. These two extracts could be used for early inhibition of the growth of the planktonic phase, as well as for better oral taste after chlorhexidine applications.
Effects of oxygen therapy on the outcome of patients with acute myocardial infarction
Authors: Ziaei Maryam , Rastegari Najafabadi Hojjat , Keykha Mahjoubeh , Galavi Mehdi , Abdolrazaghnejad Ali , Bahmani Alireza 
Published: April 2023

Objective:
To investigate the therapeutic effects of supplemental oxygen on patients with myocardial infarction.

Methods:
This study was a randomized, double-blind clinical trial. The study population included all patients who were admitted to the emergency room of Ali-ibn-Abitaleb and Khatam-al-Anbia hospitals in Zahedan within six hours of the onset of classic symptoms of myocardial infarction. The patients (n=47) were divided into two groups: the case group (with oxygen therapy) and the control group (without oxygen therapy). The initial follow-up was evaluated after one month and the second follow-up was evaluated after three months in the target population in terms of mortality caused by acute myocardial infarction, mortality caused by any other cause, and re-hospitalization caused by acute myocardial infarction.

Results:
Out of the 47 patients, 27 were male (57.4%). The average age of the patients was (60.9±8.1) years. One month after admission, 2 patients (8.7%) in the case group and 2 patients (8.3%) in the control group died due to acute myocardial infarction. A total of 7 patients (14.9%) died three months after admission. There was no significant difference between the control and case groups in terms of mortality caused by acute ischemia within one and three months. After one month, 2 patients (8.7%) in the case group and 1 patient (4.2%) in the control group died of other causes. After three months, 4 patients (8.5%) in total died for other causes. There was no significant difference between the control and case groups in terms of mortality due to other causes within one and three months. One month after admission, 5 patients (21.7%) of the case group and 4 patients (16.7%) of the control group were re-hospitalized due to acute myocardial ischemia. During the next three months, 3 patients (13.0%) of the case group and 5 patients (20.8%) of the control group were re-hospitalized. There was no significant difference between the control and case groups regarding the rate of re-hospitalization caused by acute myocardial infarction within one and three months after admission.

Conclusions:
There is no significant relationship between oxygen therapy and death by acute myocardial ischemia, or any other causes. The relationship between oxygen therapy and the rate of re-hospitalization caused by acute myocardial ischemia is not found within one and three months after admission. The results show that oxygen therapy does not affect patients with acute myocardial ischemia within three months after admission.
Perceived stress and coping capacities among frontline healthcare workers of AIIMS during COVID-19 pandemic
Authors: Sharma Mudita , Chundawat Digpal Singh , Richhariya Rohit , Tailor Sunil Kumar , Pareek Shatrughan 
Published: April 2023

Objective:
To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.

Methods:
This cross-sectional study conducted from May to July 2021 enrolled 694 participants. An online questionnaire based on Google Forms was developed to collect the data. Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale.

Results:
The age of participants were 27 (23-52) years old. The majority of respondents (73.5%) felt moderately stressed. Of the 694 participants, 83.0% of the 576 participants had average stress management skills. Sex, marital status, and profession were significantly associated with perceived stress. In addition, marital status and profession were significantly associated with coping capacity.

Conclusions:
The majority of participants have moderate stress levels and average coping skills. Frontline healthcare workers have to maintain mental and physical health. Achieving this requires early screening and stress management for healthcare workers.
Stress perceptions of nurses serving in home healthcare services during the COVID-19 pandemic
Authors: Karakaya Arzu , Uçar Mehmet 
Published: April 2023

Objective:
To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.

Methods:
This study was qualitative research with a phenomenological design. Data were collected and recorded through in-depth interviews with 6 nurses working in Muş State Hospital, Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021. The audio recordings were transcribed by the researcher and content analysis was performed by creating codes, categories, and themes.

Results:
The interviews yielded 10 categories and 59 sub-codes. These codes were addressed under the theme of "COVID-19 pandemic". Under this main theme, nurses expressed the problems they experienced in issues such as stress, support mechanisms, and family and social problems during COVID-19. They mentioned that they experienced high stress in this process, as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.

Conclusions:
Nurses working in home healthcare services frequently express negativities such as high stress, isolation from society, and increased workload. Therefore, actions should be taken to raise awareness of society on these issues, increase the number of personnel, conduct more research, and share the results with the public.
Post-COVID recurrent dyspnoea
Authors: Balani Kiran A. , Sahasrabudhe Tushar R. , Barthwal M. S. 
Published: April 2023

Rationale:
Post-COVID symptoms need aggressive evaluation.

Patient’s Concern:
A 29-year-old male patient who had suffered from COVID-19 eight weeks earlier, presented with an acute onset of breathlessness and right-sided chest pain due to pneumothorax. Emergency tube thoracostomy was performed. However, it failed to improve hypoxia.

Diagnosis:
High-resolution computed tomography of the thorax with computed tomography pulmonary angiography revealed pulmonary arterial thrombosis, ground-glass opacities, and bilateral pneumatoceles.

Interventions:
Hospital admission and treatment with low molecular weight heparin at a dose of 1.5 mg/kg every 24 h.

Outcomes:
The large pneumatocele showed significant resolution after three months of follow-ups.

Lessons:
Being increasingly reported after having a SARS-CoV-2 infection, pneumatocele formation, due to post-COVID lung scarring and late vascular thrombotic events, is a peculiar sequela and can present as acute dyspnoea. Long-term preventive anticoagulants after recovery from COVID-19 are necessary. Breathing exercises during recovery should be done with caution.
Primary care level prevalence of osteitis pubis in non-athlete patients in hill region: A short communication and a proposal for simple radiological grading
Authors: Dharmshaktu Ganesh Singh 
Published: April 2023

ABSTRACT

Background:
Osteitis pubis (OP) is inflammation of pubic symphysis associated with varying degrees of supra-pubic, pelvic, or lower abdominal pain. The condition may be severe in many patients with significant disability and protracted course of recovery. The condition is frequently described in sportspersons or athletes but consensus on classification and treatment guidelines is non-existent due to rarity of the condition. Its presence in non-athletic population is limited to a series of few cases or anecdotal case reports. Our study describes salient features of pattern of this disorder diagnosed on clinico-radiological basis in cases referred from primary care centers to our tertiary care center.

Materials and Method:
A total of 26 patients (mean age of 36.28 years, 25 females, and 1 male case) with radiological features suggestive of OP were included in the study and relevant demographic details were noted for each. A radiological grading (Grade A to E) for notification was developed and the cases were categorized accordingly.

Results:
Most of the cases were hard-working women from villages. Pregnancy was the major condition for which they ever consulted a health-care facility. Chronic, but not disabling, supra-pubic pain was the chief complaint in most cases. In some cases, the primary presentation was for some other disorder like low back pain in two, hip pain in six cases, adjacent fracture in three, and old lumbar osteoporotic compression fracture in one case. Other notable associated disorders included polio, ankylosing spondylitis, femoroacetabular impingement, and hip dysplasia. Conservative management was done in all cases except one with associated fracture. Good clinical outcome was noted in all but one case. Grade A cases were maximum (7) followed by grade B (6), grade D (4), and grade C (3). Only one case of grade E was noted with almost ankylosed symphysis.

Conclusion:
This article highlights acknowledgment and knowledge of OP in primary care settings and its anticipation even in normal population for a better understanding of prevalence and radiological presentation.
Program management challenges of clinical studies: A qualitative critical assessment
Authors: Gupta Girjesh , Mahor Rajendra , Pawar Neeraj , Gumashta Raghvendra , Gumashta Jyotsna 
Published: April 2023

ABSTRACTBackground:Organization, coordination, and discipline are required to complete any intricate operation, conducting a clinical experiment is no different. There are usually many moving components, from designing a plan, to conveying changes, to calculating risk, and excellent project management which are necessary to guarantee the study works successfully. Past evidence suggested that roadblock at any level hampers the progress of the clinical research. Understanding program management challenges hence becomes the key for timely and effective completion of clinical research.Methods:A cross-sectional qualitative enquiry involving stakeholders in clinical research program management. We used problem tree-based approach wherein we documented views of various stakeholders to understand the interaction, interdependence, and related interventional needs of bottlenecks for long-term research gains using modern management methods applicable in clinical settings. The best fit approach was also explored to augment maximum benefit in limited resource settings.Results:Non-alignment with state policy aims, a lack of effective coordination and communication among members, challenging logistic management, limited use of technology, a need for training, and an inefficient monitoring mechanism were among the major issues highlighted, and solutions were proposed.Conclusion:Study concludes that an Integrated Process-cum-Timeline-Based Management strategy with multisectoral emphasis is ideal for program management of clinical projects.
Household secondary attack rate in mild COVID-19
Authors: Narayan Ananthu , Saraswati Ushasi , Kaur Ishmeet , Kumari Aakansha , Kumar Arvind , Vishwakarma Vishal Kumar , Kumar Upendra , Sahoo Vishwajeet , Wig Naveet 
Published: April 2023

ABSTRACT

Background:
The coronavirus disease 2019 (COVID-19) pandemic has reached a staggering number of almost 280 million cases worldwide, with over 5.4 million deaths as of 29 December 2021. A further understanding of the factors related to the household spread of the infection might help to bring about specific protocols to curb such transmission.

Objective:
This study aims to find the secondary attack rate (SAR) and factors affecting SAR among the households of mild COVID-19 cases.

Methods:
An observational study was designed where data of patients admitted at All India Institute of Medical Sciences, New Delhi due to mild COVID-19 were collected, and outcome was noted after the discharge of the patient. Index cases who were the first in the household to have a positive infection only were included. Based on these data, the overall household SAR, factors related to the index case and contacts that affected transmissibility were noted.

Results:
A total of 60 index cases having contacts with 184 household members were included in the present study. The household SAR was measured to be 41.85%. At least one positive case was present in 51.67% households. Children below 18 years old had lower odds of getting a secondary infection compared to adults and elderly [odds ratio (OR) = 0.46, 95%CI = 0.22–0.94, p = 0.0383). An exposure period of more than a week was significantly associated with a higher risk of infection (p = 0.029). The rate of transmissibility drastically declined with effective quarantine measures adopted by the index case (OR = 0.13, 95%CI = 0.06–0.26, p < 0.00001). Symptomatic index cases contributed more to the SAR than asymptomatic primaries (OR = 4.74, 95%CI = 1.03–21.82, P = 0.045). Healthcare worker index cases had lower rates of spread (OR = 0.29, 95%CI = 0.15–0.58, P = 0.0003).

Conclusion:
The high SAR shows the household is a potential high-risk unit for transmissibility of COVID-19. Proper quarantine measures of all those exposed to the index case can mitigate such spread and lead to reduction of risk of COVID-19 within a household.