bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative efficacy of three deproteinizing agents on the shear bond strength of pit and fissure sealant
Authors: Thankachan Saranya P , Emmatty Tharian B , Jose Bijimol , Krishna Kumar Kavita , Peter Joby , Methippara John Joseph , Sebastian Ronin 
Published: September 2022

Objective:
The objective of this study was to evaluate and compare the shear bond strength (SBS) of pit and fissure sealant with and without deproteinization with agents such as 5% NaOCl, papain gel, and bromelain gel.

Materials and Methods:
In this in vitro study, 60 premolar teeth were divided into four groups of 15 teeth each. In control Group 1, enamel was etched for 60 s with 37% phosphoric acid and rinsed with water. In Group 2, deproteinizing agent 5% sodium hypochlorite was applied for 60 s before acid etching. In Group 3, deproteinizing agent papain gel was applied for 60 s before acid etching. In Group 4, deproteinizing agent bromelain gel was applied for 60 s before acid etching. Following this, Clinpro™ 3M™ ESPE™ pit and fissure sealant disc was built on the enamel buccal surface of each tooth. Samples were then tested for SBS using Universal Testing Machine after storage in distilled water for 24 h.

Results:
The mean SBS was highest for Group 4 and lowest for Group 1. SBS was significantly higher in the bromelain gel group, followed by the papain gel group (P < 0.001), 5% NaOCl group (P < 0.001), and control group (P < 0.001).

Conclusion:
Among deproteinizing agents, deproteinization when carried out with bromelain gel showed effective bond strength and lowest for the control group.
Who's Who in the Trauma Bay? Association between Wearing of Identification Jackets and Trauma Teamwork Performance
Authors: Saleten Marie , Laitselart Philippe , Martinez Thibault , Descamps Chloé , Debien Bruno , Boutonnet Mathieu , Pasquier Pierre 
Published: September 2022

Introduction:
Trauma is the leading cause of under-45 mortality worldwide, and the leading cause of years of life lost. To manage the severe trauma patients, trauma teams require both improved technical and nontechnical skills, such as communication, leadership, teamwork, and team resource management. The objective of this study was to measure the impact of the identification of trauma team members on teamwork performance. The hypothesis was that wearing identification jackets was associated with better teamwork performance.

Methods:
The study was conducted from 2015 to 2019 at the Percy Army Training Hospital, a trauma center in the Ile-de-France region. In 2016, the protocol for receiving severe trauma patients was modified, including the obligation to wear identification jackets. Thus, each member of the trauma team wore a jacket identifying his or her function. This study was carried out by analyzing videos of medical simulation sessions during the reception of trauma patients in the trauma bay. The study compared the teamwork performance before 2016, a period with no identification jackets wearing, with the teamwork performance after 2016, a period with identification jackets wearing. The Team Emergency Assessment Measure (TEAM)Scale was used. This TEAM scale is a benchmark measure of teamwork performance, particularly adapted to the context of trauma.

Results:
A total of 48 participants were included in the study. Six videos of medical simulation sessions “arrival of severe trauma patients” were analyzed and divided into two groups. A first group of three videos with no identification jackets wearing was the GROUP ID(-). A second group of three videos with identification jackets wearing was the GROUP ID(+). An 11-item TEAM scale was used to rate each video for a total of 33 scores per group. The distribution of the median scores for the GROUP ID(+) was significantly different from the distribution of the median scores for the GROUP ID(-) (P = 0.001). These results were consistent with those of other single-center studies conducted in operating theaters and in emergency departments, where clearly identifying the roles of each member of the medical teams was associated with less communication errors. The main limits of this study were its single-center nature and a limited data sample.

Conclusion:
In this single-center simulation study, wearing identification jackets was associated with an improvement in the trauma team performance TEAM scores. Further studies are needed to confirm these results but they already encourage the consideration of nontechnical skills in the management of severe trauma patients.
Outcomes and Factors Associated with Occult Septic Shock in Emergency Department Patients with Soft Tissue Infection
Authors: Tiffany Laura Marie , Tran Quincy K. , Abdel-Wahab Maie , Widjaja Austin , Aligabi Aya , Albelo Fernando , Asunción Samantha , Gelmann Dominique , Haase Daniel J. , Henry Sharon , Leibner Evan , Sjeklocha Lucas 
Published: September 2022

Introduction:
Patients who develop occult septic shock (OSS) are associated with worse outcomes than those with early septic shock (ESS). Patients with skin and soft tissue infection (SSTI) may have underlying organ dysfunction due to OSS, yet the prevalence and the outcomes of patients with SSTI and early versus occult shock have not been described. This study compared the clinical characteristics of SSTI patients and the prevalence of having no septic shock (NSS), ESS, or OSS.

Methods:
We retrospectively analyzed charts of adult patients who were transferred from any emergency department to our academic center between January 1, 2014, and December 31, 2016. Outcomes of interest were the development of OSS and acute kidney injury (AKI). We performed logistic regressions to measure the association between clinical factors with the outcomes and created probability plots to show the relationship between key clinical variables and outcomes of OSS or AKI.

Results:
Among 269 patients, 218 (81%) patients had NSS, 16 (6%) patients had ESS, and 35 (13%) patients had OSS. Patients with OSS had higher mean serum lactate concentrations than patients with NSS (3.5 vs. 2.1 mmol/L, P < 0.01). Higher sequential organ failure assessment (SOFA) score was associated with higher likelihood of developing OSS (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.23–1.62, P < 0.001). NSS was associated with very low odds of developing AKI (OR 0.16, 95% CI 0.08–0.33, P < 0.001).

Conclusions:
13% of the patients with SSTI developed OSS. Patients with OSS had elevated serum lactate concentration and higher SOFA score than those with NSS. Increased SOFA score is a predictor for the development of OSS.
Histopathological Evaluation of Estrogen Receptors, Progesterone Receptors, and Human Epidermal Growth Factor Receptor-2/Neu Expressions in Breast Carcinoma and their Correlations with Other Prognostic Factors
Authors: Kawsar Hena , Sinha Anuradha , Ali Md. Sadakkas , Phukan Jyoti Prakash , Pathak Swapan 
Published: September 2022

Background:
Breast carcinoma is a leading cause of death among women. Factors such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER-2/neu) have important prognostic and predictive value.

Aim:
The aim of the study is to demonstrate ER, PR, and HER-2/neu expression in breast cancer specimens and to correlate these expressions with other prognostic factors such as tumor size, type, grade, and lymph node status.

Methods:
This prospective study included 70 cases of female breast carcinoma. Histopathological evaluation of all cases done and tumor size, site, presence, or absence of lymph node was recorded. Typing of tumor, grade, and lymph node status were determined. Immunohistochemical staining for ER, PR, and HER-2/neu of breast lesions was done, and the data were analyzed to find out any correlation of expression of ER, PR, HER-2/neu with the above prognostic factors.

Results:
The majority of patients were in 41–50 years (44.29%). Most of tumors were 2–5 cm in size and the infiltrating duct carcinoma-not otherwise specified was the commonest type. ER and PR expression decreases (P = 0.02340 and P = 0.02413 respectively), while HER-2/neu expression increases with increase tumor size (P = 0.02289). ER and PR expression were low while Her-2/neu expression was more in higher tumor grade (P = 0.022472, P = 0.04149 and P = 0.03339 respectively). No significant association was identified between ER, PR, HER-2/neu and number of metastatic lymph node.

Conclusion:
ER, PR, and HER-2/neu status correlates well with histopathological grading and tumor size. However, no significant association is seen with cancer type and lymph node status.
Comparing the Efficacy of Ultrasound-Guided Supraclavicular Brachial Plexus Block with or without Intercostobrachial Nerve Block for Forearm Surgeries – An Observational Study
Authors: Dmello Diksha , Santha Neeta 
Published: September 2022

Background:
Supraclavicular block is a commonly used block for regional anesthesia in forearm surgeries. The rationale behind this study is to prove that ultrasound (USG)-guided supraclavicular block is sufficient to provide adequate analgesia and eliminates the need for an intercostobrachial (ICB) block for forearm surgeries.

Aim:
We aimed to find whether there is any additional advantage in performing ICB block along with supraclavicular brachial plexus block in forearm surgeries.

Methods:
In this study, 110 patients undergoing elective forearm surgeries under USG-guided supraclavicular block were observed. A block solution of 30 ml was made and 20 ml was given as supraclavicular block. Group ICB, received an additional 10 ml ICB nerve block (ICBN) and group Non-ICB who did not receive an additional block. The outcomes assessed were intraoperative and postoperative tourniquet pain scores, hemodynamic changes, the onset of sensory and motor block, sensory and motor scoring, postoperative rescue analgesia time, and patient satisfaction. Data were analyzed using SPSS 25.0 version.

Results:
The mean intraoperative and postoperative pain scores in the group ICB was 0.76 ± 1.677 and in the non-ICB was 0.69 ± 1.439 and was no significant. Furthermore, there was no statistically significant difference between the immediate and late postoperative pain scores between the two groups.

Conclusion:
Our study has concluded that a sole USG-guided supraclavicular block provides adequate anesthesia of the operated forearm. Additional blocking of the ICBN does not affect the incidence or course of tourniquet pain.
The Prevalence Rate of Energy Drinks Consumption Among Young Adults in Iraqi Society
Authors: Mekkey Shereen M. , Tizkam Hussam H. 
Published: September 2022

Background:
Energy drinks (ED) consumption is an increasingly occurring phenomenon in our Iraqi society. ED marketing should be limited or forbidden particularly among adolescents until independent research confirms their safety.

Objectives:
To estimate the prevalence of energy drinks consumption among young people in Iraq in regard to: gender, sport habits, disease state, purpose of use, addiction liability.

Materials and Methods:
A cross- sectional study was conducted for Iraqi young adult people from October/2021 to January/ 2022 using a questionnaire. This survey included (784) person aged 15 to 35 years old after obtaining approval from the directors of each college and receiving oral approval from each participant. Data was collected through the questionnaire.

Results:
A very high proportion of ED consumers are males, and are actually sport practitioners, with no chronic disease. Tiger is the ED No.1 in Iraq. Mainly consumed on monthly basis, mainly for energy provision and improved performance. The general people attitude for these ED is to stay awake, and is therefore associated with sleep disturbance, however consumers do not think that it is difficult to give up ED and do not consider themselves addicted to it, and are aware of most of its risks.

Conclusions:
Most consumers are athletics with no chronic disease, almost monthly consumers ED for energy provision with Tiger being the most consumed ED, most consumers with able to give up ED consumptions were aware of risks of ED with a steep rise was observed recently compared to the past years.
Association Between Zinc Level and Prelabour Rupture of Membranes
Authors: Mahmood Huda Mohamed , Al-Moayad Hala Abd Al-Qadir 
Published: September 2022

Background:
Assessment of micronutrients in pregnant women particularly ZINC and whether its concentration is different between term and preterm birth is important to optimize the normal pregnancy and to reduce the incidence of pregnancy complications, especialy preterm labour and pre labour rupture of membrane.

Objectives:
Assessment of correlation between maternal serum ZINC level and the prelabour rupture of membrane in both preterm and term pregnant women.

Study Design:
Case control study.

Materials and Methods:
A case control study performed in Al-Imamain Al- Kadhumain Medical City/Obstetrics and Gynecology department from 1st of February to 1st of November 2019, Including 400 pregnant women their gestational age ranged between (24 to 42) divided in to 4 group: group A, group B, group C, group D which all undergo serum Zinc level measurement.

Result:
The mean ± SD of serum ZINC in group A which include the preterm prom, which is less than the control group (B) preterm intact membranes which, and the mean ± SD of serum zinc of group (C) which include the term prelabour rupture of membranes which is less than group (D) which is the control group of group (C) term intact membranes. This study shows significant relationship between ZINC deficiency and prelabour rupture of membrane in both term and preterm pregnant women at a P value< 0.001 and <0.001 respectively, also this study show inverse relationship between serum zinc and increasing parity, maternal age, vaginal infection, and BMI.

Conclusion:
Pregnant women with prelabour rupture of membranes wether term or preterm tend to have lower Zinc level. Increasing maternal age, increasing parity, high BMI, vaginal infection are associated with low Zinc.
Rapid Microwave Tissue Processing and Staining Method Using a Kitchen Microwave Oven in Histopathology Laboratory
Authors: Shirbhate Pranav Naresh , Deshmukh Abhay Vilas , Shivkumar Vitaladevuni Balasubramanyam 
Published: September 2022

Background:
Histopathological diagnosis of a specimen requires good histoprocessing. It ultimately depends on sample preparation and staining, which is time consuming by routine tissue processing technique. The objective of the present study was to compare the reliability of kitchen microwave for tissue processing and staining with the standard conventional processing and staining in different tissue samples.

Materials and Methods:
The study sample included 204 specimens from different parts of the body. Three set of tissues were processed and three set of slides from each sample were stained by routine as well as microwave method and the quality of microscopic features was compared.

Results:
No significant difference was found in nuclear and cellular characters in case of staining by both methods. While, in case of processing, mean scoring for nuclear characters for routinely processed and microwave-stained (RM) slides was 6.95 ± 0.09 (confidence interval [CI] 6.83–0.09), for microwave-processed and microwave-stained (MM) slides, it was 6.82 ± 0.07 (CI 6.74–6.90) by observer 1 (P = 0.068). The mean score of cellular character of RM slides was 7.85 ± 0.06 (CI 7.76) and for MM slides, it was 7.65 ± 0.17 (CI 7.47–7.88) by observer 2 (P = 0.076). The microwave method was better for both processing (P = 0.001) and staining (P = 0.003) in case of small biopsies (P = 0.057). The microwave method was as good as routine method for processing of aorta and staining of breast and kidney tissues (P = 0.23, 0.32, and 0.38, respectively). The time taken by the microwave method is considerably less for both processing and staining.

Conclusion:
The microwave method requires less time when compared with the routine method, thus reducing the overall turnaround time which ultimately helps in rapid same-day diagnosis and patient management. Microwave can be preferred method for smaller biopsies when compared with large biopsies. Lack of automation and requirement of more manpower remain the major disadvantages for use of microwave method in large turnover histopathology laboratories.
Diaphragmatic Thickness in Chronic Obstructive Pulmonary Disease
Authors: Kareem Jumana Mahdi , Al-Waely Noor Kathem , Al-Hashimi Ali F. 
Published: September 2022

Background:
Chronic obstructive pulmonary disease, characterized by chronic airway inflammation and progressive airflow limitation, and is considered as common, preventable and treatable disease. The defining standard values for diaphragm thickness and thickening ratio using B-mode ultrasound may provide a simpler, safer means of evaluating diaphragmatic function in chronic obstructive pulmonary disease patients.

Objective:
to assess the diaphragmatic structure and function using B-mode ultrasonography studying the diaphragm muscle inspiratory and expiratory thickness and thickening fraction in patients with COPD compared to healthy controls, and to study their sensitivity and specificity as well as their correlation with certain pathophysiologic parameters namely (peripheral capillary oxygen saturation, body mass index and C-reactive protein) to establish possible relation with the pathophysiology of the disease.

Materials and Methods:
The present study is a case control study was conducted in Al-Imamein Al-Kadhimein Medical City, Baghdad, Iraq in the period extended from November 2019 to October 2021. Forty patients with the diagnosis of COPD underwent B-mode ultrasound analysis. Three images were captured both at end expiration (Tmin) and at maximal inspiration (Tmax). The thickening fraction was calculated as (Tmax-Tmin/Tmin), and each set of values was averaged. Findings were compared with a database of 40 healthy control subjects.

Results:
Diaphragm thickness and thickening fraction were significantly higher in COPD patients compared to control subjects with the mean of the Rt. inspiratory diaphragmatic thickness equals (3.23 ± 0.68mm versus 2.8 ± 0.55mm; respectively, p=0.006) compared to control, and (2.44 ± 0.71 versus 1.96 ± 0.6; respectively, p=0.004) for the mean Rt. diaphragmatic thickening fraction, while the mean of the Lt. inspiratory diaphragmatic thickness was (3.22 ± 0.63mm versus 2.79 ± 0.51mm; respectively, p=0.003) compared to control, and (2.45 ± 0.63 versus 1.95 ± 0.54; respectively, p=0.003) for the mean Lt. diaphragmatic thickening fraction, ROC analysis shows that the right and left diaphragmatic fractions had the highest sensitivity and specificity parameter for COPD. No correlations were found between body mass index, SpO2 with diaphragmatic parameters.

Conclusion:
the current study found diaphragmatic ultrasonographic characteristics in patients with COPD show significant increase in inspiratory thickness and thickening fraction compared to control group, yet they were of low diagnostic accuracy.
Diagnosis of Extrapulmonary Tuberculosis by Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) and Detection of Rifampicin Resistance on Fine-Needle Aspiration Samples
Authors: Adhikary Moumita , Das Sanjushree , Lath Abhisek , Phukan Jyoti Prakash 
Published: September 2022

Background:
Extrapulmonary tuberculosis (EPTB) is still a major health problem in developing countries. Diagnosis of EPTB is difficult due to paucity of acid-fast bacilli in clinical specimens.

Objectives:
To study the diagnostic role of cartridge-based nucleic acid amplification test (CBNAAT) and rifampicin resistance in EPTB on fine-needle aspiration samples.

Materials and Methods:
It is a prospective study comprising 79 patients of clinically suspected EPTB cases for 1 year duration. All patients underwent fine-needle aspiration cytology (FNAC) with Ziehl–Neelsen (ZN) staining followed by CBNAAT for confirmation of tuberculosis (TB) and to detect rifampicin resistance. Data have been collected and analyzed regarding sensitivity, specificity, positive predictive value, and negative predictive value of FNAC in comparison with CBNAAT.

Results:
Out of 79 patients, 47 (59.49%) patients were male and cervical lymph node was the most common site of aspiration (42, 52.16%). Granuloma with necrosis (38, 48.10%) followed by necrosis only (14, 17.72%) were the common findings on FNAC. Out of 79 suspected EPTB patients, CBNAAT confirmed 62 patients as having TB. Specificity of FNAC with ZN staining was 100.0%; however, sensitivity was low (43.55%) compared to CBNAAT. Only three cases were detected as rifampicin resistant.

Conclusion:
Compared to FNAC, CBNAAT has very good sensitivity and specificity in the diagnosis of EPTB. It has also as added advantage of detecting rifampicin resistance at the same time. CBNAAT should be used for diagnosis of EPTB wherever the facility is available.
Use of Limited Hip Abduction as a Predictor for Developmental Dysplasia of the Hip
Authors: Al-Saeedy Bahjat Abdulridha Thabit , Redah Samer Mohammed 
Published: September 2022

Background:
Developmental dysplasia of the hip (DDH) includes multiple abnormalities. Females are more susceptible for DDH. The clinical examination is used for diagnosis, but its sensitivity is generally low. Ultrasound (US) examination identifies DDH in infants younger than 6 months of age. Because of its accessibility and the lack of exposure to radiation, the clinical applications of US in the diagnosis of DDH have expanded, making it the gold standard test for DDH.

Objective:
This study aimed to measure sensitivity and specificity of limited hip abduction (LHA) as a screening test for the detection of DDH.

Materials and Methods:
A cross-sectional study including 60 infants were brought to the Al-Wasity Teaching Hospital, Baghdad and Al-Rusafa Health Directorate, Ministry of Health and Environment, Baghdad, Iraq, within the period from January 2020 to October 2020. They were referred by other physicians and clinics or their parents suspected that they have abnormal hip. We excluded infants with associated congenital abnormality such as arthrogryposis or spina bifida. The diagnosis was made by clinical and US examination. The clinical examination included identification of LHA. Data regarding age and gender were recorded and were statistically analyzed. Frequencies and means were used to express data, and the χ2 goodness of fit test and Student’s t-test were used as appropriate to detect significance of difference between frequencies and means.

Results:
The sensitivity and specificity of unilateral and bilateral LHA were 51.35%, 95.18% and 27.03%, 63.86%, respectively.

Conclusion:
Unilateral LHA was more sensitive and specific than bilateral.