bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Tranexamic Acid in Bleeding Control of Transabdominal and Transvaginal Hysterectomy
Authors: Bahadori Azadeh , Hirmanpour Anahita , Bahadoran Ensiyeh 
Published: August 2022

Background:
Hysterectomy is one of the most common gynecology surgeries. This study aimed to compare perioperative bleeding in transabdominal and transvaginal hysterectomy.

Materials and Methods:
This prospective, double-blind, randomized, controlled clinical trial was performed on 80 patients undergoing hysterectomy referred to Shahid Beheshti Hospital, Isfahan, Iran. Patients were divided into two groups of 40; the first group (T) received 1 g intravenous tranexamic acid (TXA) for 20 min preoperatively. The second group (S) received 10 cc normal saline as placebo. Blood samples were taken before and 12 h after surgery for assessment of hemoglobin, hematocrit, and platelet count, the prothrombin time, activated partial thromboplastin time, and serum creatinine as well as volume of blood transfusion.

Results:
There were no significant differences between the two groups in heart rate, diastolic blood pressure (BP), systolic BP, and mean arterial pressure before, during, and after surgery (P > 0.05). There was no significant difference in blood variables before and after surgery (P > 0.05) except the platelet count that was in the normal range in both groups after surgery (P = 0.022). The mean volume of blood transfused in the case group was significantly lower than the control group during surgery (P = 0.008) and 12 h after surgery (P = 0.01).

Conclusion:
The prophylactic administration of TXA results in a significant reduction in need for blood transfusion and the duration of surgery. Given the lower risks of using TXA compared to the other drugs, it is recommended in hysterectomy to control bleeding.
A Method to Measure Oil Penetration into Hair and Correlation to Tensile Strength
Authors: Sureka Priyanka , Agrawal Tanu , Majumder Suman , Ritambhara Kr 
Published: August 2022

Aim:
The aim of this study is to identify a new method to measure oil penetration into hair, compare penetration ability of two types of oil: Type 3 hair oil and coconut oil into the hair shaft and explore its correlation to a physical property of hair, tensile strength.

Materials and Methods:
The study utilizes the measurements of two parameters, thickness, and cohesive force to define penetration of oil. The hypothesis was that an increase in hair fiber thickness along with reduction in cohesive force would indicate higher penetration of oil into the hair strand. The tensile strength of hair was then determined by measuring the behavior of treated hair strands while an axial stretching load was applied.

Results:
In experiment of hair thickness measurement, there was a significant increase in the hair fiber thickness post oil application in both the test oils as compared to baseline (untreated control). However, this increase was higher in hair swatches treated with Type 3 hair oil. For cohesive force measurement, significantly lower force was required for hair swatches treated with Type 3 hair oil when compared to coconut oil. For tensile strength, both test oils exhibited increase versus baseline but increase in tensile strength was significantly more with type 3 hair oil when compared to coconut oil.

Conclusions:
The present study shows that conjoint assessment of hair thickness and cohesive force post oil application can be a suitable method to indicate the extent of oil penetration into the hair. Overall, the study indicated the positive influence of oil penetration on hair strength.
Characteristics of Patients with Hair Loss after Isotretinoin Treatment
Authors: Tran Patrick Thanh , Evron Evyatar , Goh Carolyn 
Published: August 2022

Background:
Oral isotretinoin has been used to treat acne for decades. Although the side effects of isotretinoin are mostly predictable, one less common side effect of isotretinoin use is hair loss, typically telogen effluvium.

Objective:
This study is a retrospective report on the development of alopecia in patients on isotretinoin therapy.

Methods:
To characterize these patients, they were further compared to other patients in the same time period who were prescribed isotretinoin and did not experience hair loss.

Results:
Of 6330 patients with hair loss, 48 had been prescribed isotretinoin at some time between 2013 and 2018. Of these 48 patients, hair loss occurred concurrently or within two years after taking isotretinoin in 19 patients. When compared to controls, patients who experienced hair loss from isotretinoin were older, had greater cumulative isotretinoin doses, and had longer durations of treatment.

Conclusion:
Although the exact mechanism of how retinoids affect hair loss is still unclear, our findings suggest dosage or duration of usage may be associated. This information may be useful in counseling patients who may be concerned about hair loss when considering isotretinoin treatment.
Respiratory Syncytial Virus Infection among Adults after Hematopoietic Stem Cell Transplantation
Authors: Samad Sameer Abdul , Jethani Jyoti , Kumar Lalit , Choudhary Aashish , Brijwal Megha , Dar Lalit 
Published: August 2022

Introduction:
Respiratory syncytial virus (RSV) is a common cause of morbidity among hematopoietic stem cell transplant (HSCT) recipients, with RSV-associated lower respiratory tract infection carrying high mortality rates. There have been no large studies till date, describing the incidence, clinical features, and outcomes of RSV infection among adult HSCT recipients in India.

Methods:
A prospective cohort of 100 adults who underwent HSCT was followed up for a maximum period of 18 months starting from the date of transplantation for any episode of respiratory tract infectious disease (RTID). Respiratory samples were collected for laboratory confirmation of the presence and subtyping of RSV by real-time reverse transcriptase-polymerase chain reaction.

Results:
The study population comprised of 66% (66/100) males and 34% (34/100) females. Autologous HSCT recipients constituted 78% (78/100) and allogeneic HSCT recipients constituted 22% (22/100) of the study population. The incidence of RSV-RTID among adults after HSCT was 0.82/100 patient months. Most cases occurred during the winter season and the predominant subtype was RSV-A (9/11, 81.8%). Lower RTID was the most common clinical diagnosis made at presentation (9/11, 81.8%). Female gender was predictive of RSV-RTID (log rank P = 0.002). All the RSV-RTID episodes recovered completely without targeted therapy.

Conclusion:
RSV is a significant cause of morbidity among adult HSCT recipients in India. Prophylaxis and treatment measures need to be instituted after a proper risk-benefit assessment. Longitudinal studies with larger sample sizes are needed to confirm these results.
A Randomized Clinical Trial Comparing Triple Therapy versus Non-bismuth based Quadruple Therapy for the Eradication of Helicobacter Pylori in Kuwait
Authors: Alfadhli Ahmad , Alboraie Mohamed , Afifi Mostafa , Dangi Abhijit 
Published: August 2022

Introduction:

Helicobacter pylori-induced chronic infection is associated with peptic ulcer, chronic gastritis, gastric cancer, and increasing antibiotic resistance. We aimed to evaluate the efficacy of clarithromycin-based triple therapy and non-bismuth based quadruple therapy for eradicating H. pylori in patients with chronic gastritis in Kuwait.

Methods:
We enrolled a total of 603 treatment-naive dyspeptic patients with gastric biopsy-proven chronic gastritis secondary to H. pylori in a prospective, open-label, randomized study. Patients were randomized into two groups: a group received the standard triple therapy (omeprazole, amoxicillin, and clarithromycin) for 14 days and a group received quadruple therapy (omeprazole, amoxicillin, clarithromycin, and metronidazole) for 14 days. All patients were tested for the eradication of H. pylori by carbon-13 urea breath test 1 month after eradication therapy.

Results:
The overall eradication rate was 63.2%. The eradication rates in intention-to-treat (ITT) and per protocol (PP) population were 58.4% and 64.6%, respectively, in triple therapy group. In the quadruple therapy group, the eradication rates in ITT and PP population were 68.0% and 78.5%, respectively, with a statistically significant higher eradication rate in patients treated by quadruple therapy than the triple therapy (P < 0.01). Multivariate logistic regression analysis revealed that treatment regimen was the only significant predictor for successful H. pylori eradication. The most common adverse events were abnormal taste, headache, dizziness, and abdominal pain.

Conclusion:
Non-bismuth based quadruple therapy is more effective than standard clarithromycin-based triple therapy for eradicating H. pylori in patients with chronic gastritis.
ClinicalTrials.gov Identifier: NCT04617613
Laboratory Cost Analysis of Conventional and Newer Molecular Tests for Diagnosis of Presumptive Multidrug-Resistant Tuberculosis Patients
Authors: Yadav Raj Narayan , Verma Ajoy Kumar , Kaushik Gaurav 
Published: August 2022

Introduction:
Tuberculosis (TB) remains a deadliest infectious disease. Lack of rapid test with low cost is one of the important challenges to eradicate the TB. The objective of the study was to analyze the laboratory costs of conventional and newer molecular tests, for diagnosis of presumptive multidrug-resistant TB (MDR-TB) patients.

Methods:
A detailed laboratory cost of various conventional tests (Ziehl − Neelsen [ZN] microscopy, light-emitting diode-fluorescent microscopy [LED-FM], culture and drug susceptibility testing [DST] using solid Lowenstein–Jensen media and liquid media [BACTEC MGIT 960]) was compared with rapid methods (GenoType MTBDRplus line probe assay [LPA] and GeneXpert MTB/RIF assay). Laboratory cost was also calculated in terms of cost per TB and MDR-TB case detected by using different diagnostic scenarios.

Results:
Cost per test for ZN microscopy, LED-FM, LPA, GeneXpert MTB/RIF assay, solid culture plus DST, liquid culture plus DST was found as $2.5 (INR 156.8), $2.0 (INR128.9), $18.6 (INR1210), $13.8 (INR 895.2), $21.5 (INR 1396.6), and $29.1 (INR 1888.2), respectively. The laboratory cost for detecting TB and MDR-TB by diagnostic scenarios involving molecular DST was found to be less as compared to involving only conventional liquid culture-based test.

Conclusions:
The implementation of rapid molecular tests with selective use of liquid culture-based DST may be less in cost as compared to the use of culture-based DST alone, at high burden reference TB laboratory.
Antimicrobial and cytotoxicity properties of Plumeria alba flower extract against oral and periodontal pathogens
Authors: Kaur Jaskirat , Sanghavi Amee Dilip , Chopra Aditi , Lobo Richard , Saha Swagata 
Published: August 2022

Context:

Plumeria alba, commonly known as frangipani or West Indian jasmine, is a traditional and ancient folklore medicine known for its antimicrobial, anti-inflammatory, and antioxidant properties. The extracts from P. alba obtained from the leaves, bark, and flowers, are commonly used to manage bacterial, fungal, and viral infections such as herpes, scabies, and fungal infections. The constituents of the P. alba plant have shown promising antihelmintic, antipyretic, and antirheumatic properties. Although studies have confirmed that extracts from Plumeria species are effective against microbial infections and cancer, its role in managing oral diseases, particularly the chronic inflammatory disease of the gums (gingivitis and periodontitis), has never been explored. Therefore, the current study aimed to explore the antimicrobial and cytotoxic properties of the P. alba flower extract against oral and periodontal pathogens compared to chlorhexidine and doxycycline.

Settings and Design:
This was an in vitro study.

Materials and Methods:
The ethanolic extract was prepared from the freshly plucked P. alba flowers. The antimicrobial properties of the extract were evaluated by testing the minimal inhibitory concentration, minimal bactericidal concentration, and well-diffusion assay against Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Tannerella forsythia, Streptococcus mutans, Actinomyces viscosus, Streptococcus salivarius, and Candida albicans. The results were compared to chlorhexidine and doxycycline. The cytotoxicity was checked by the against human-derived gingival fibroblast and keratinocytes.

Statistical Analysis Used:
One-way ANOVA for the mean zones of inhibition against all the microorganisms was done.

Results:

P. alba extract inhibited the growth for all the tested oral and periodontal pathogens at 25 μg/ml. The well-diffusion assay of P. alba extract was comparable to chlorhexidine but was not statistically significant compared to doxycycline.

Conclusion:

P. alba can be used as a promising alternative to chlorhexidine for the management of oral and periodontal infections.
Clinical evaluation of periodontal status in subjects with multibracket appliances and the role of age and gender during initial months of fixed orthodontic treatment
Authors: Singla Sapna , Kamboj Monika , Gupta Priyanka , Lehl Gurvanit , Talwar Manjit 
Published: August 2022

Background:
During fixed orthodontic treatment, the presence of various fixed appliances like brackets in the oral cavity for a long period leads to various changes in the oral microflora, ultimately affecting the periodontal health of the teeth. Hence, the current study was performed to clinically assess the periodontal status of the subjects undergoing fixed orthodontic treatment and to evaluate the role of age and gender during the first 6 months of treatment.

Materials and Methods:
Forty-one subjects (26 females and 15 males) in the age range of 12–28 years scheduled for fixed orthodontic treatment were included in the study. Twenty-eight subjects were adolescents with a mean age of 13.96 years and 13 were adults with a mean age of 22.38 years. Plaque index (PI) and gingival index (GI) were recorded at the beginning and the end of 1, 2, 3, and 6 months of the treatment, and pocket probing depth (PPD) was evaluated at the start and after 6 months of fixed orthodontic treatment.

Results:
The study showed a statistically significant increase in the mean values of PI (1.10 ± 0.264) and GI (0.929 ± 0.220) over a period of 6 months when compared with the baseline mean values, i.e., 0.557 ± 0.224 and 0.423 ± 0.329, respectively (P < 0.001). The mean PPD values exhibited no significant change. Effect of orthodontic treatment on adolescents/adults and between genders did not statistically differ.

Conclusions:
Fixed orthodontic treatment with multibracket appliances significantly increases plaque accumulation leading to significant inflammatory changes in the gingival tissues without any significant changes in the clinical probing depths of the pockets regardless of age and gender.
Matrix metalloproteinase-9-1562 C/T promoter gene polymorphism in chronic periodontitis
Authors: Sarkar Puja , Muthuraj Thamil Selvan , Bandyopadhyay Prasanta , Ghosh Papita 
Published: August 2022

Background:
Matrix metalloproteinases (MMPs) are a major group of enzymes, released in inflamed periodontal tissues in large quantities, resulting in connective tissue matrix breakdown. One of the most predominant MMPs is MMP-9. Association between chronic periodontitis (CP) and MMP-9 gene polymorphism (GP) in some ethnic populations has been already established. The aim of the current study was to assess the association of single-nucleotide polymorphism in the promoter region of MMP-9 gene with CP in Kolkata population, if any.

Materials and Methods:
Forty eligible individuals were recruited for the study and grouped as A and B: Group A (twenty periodontally healthy individuals) and Group B (twenty CP patients). Venous blood samples collected from all the forty individuals were used to isolate the genomic DNA. GP for MMP-9 gene was detected using polymerase chain reaction and sequencing method. The data obtained were then analyzed statistically.

Results:
A significantly different genotypic and allelic variation was observed in the control and test groups, with C/T genotype and T allele present in only CP group.

Conclusion:
Within the limitations of this study, we can conclude that there was no significant association between patients with periodontitis and MMP-9-1562 C/T promoter GP.
Clinicoradiographic evaluation of advanced-platelet rich fibrin block (A PRF + i PRF + nanohydroxyapatite) compared to nanohydroxyapatite alone in the management of periodontal intrabony defects
Authors: Mallappa Jayasheela , Vasanth Deepa , Gowda Triveni Mavinakote , Shah Rucha , Gayathri Gunjiganuru Vemanaradhya , Mehta Dhoom Singh 
Published: August 2022

Background:
Several bone grafting formulations have been given clinically acceptable outcomes in treating intrabony defects. Platelet rich fibrin (PRF), an autologous platelet concentrate holds potential to be used for regenerative treatment. The purpose of this study was to evaluate clinical and radiographic outcomes in periodontal intrabony defects treated with advanced-PRF block (A PRF + i PRF + nanohydroxyapatite [nHA]) compared to nHA alone.

Methods:
Twenty-eight sites in chronic periodontitis patients having probing pocket depth (PPD) ≥6 mm and 3 walled intrabony defects (depth of ≥3 mm) were selected, randomly allotted into two groups: Group A was treated with A-PRF block and Group B with nHA (Sybograf™). Clinical parameters including plaque index (PI), gingival index (GI), PPD, relative attachment level (RAL) and radiographically linear and volumetric defect fill were assessed using cone beam computed tomography at baseline and 6 months postoperatively.

Results:
Intragroup comparison using paired t-test and intergroup comparison using unpaired t-test was done. Group A demonstrated significantly higher reduction in PPD and gain in RAL when compared to Group B (P ≤ 0.05) at the end of 6 months. Similarly gain in bone volume was greater in Group A (0.1 ± 0.05) as compared to Group B (0.04 ± 0.02) (P ≤ 0.05).

Conclusion:
Advanced-PRF block showed significant clinical and radiographic improvement as compared to nHA alone which depicts that, it may be an ideal graft to be used for the treatment of periodontal intrabony defects.
Use and Safety of the Precice Antegrade Femoral Nail in Pediatric Patients
Authors: Geffner Adam D. , Reif Taylor J. , Fragomen Austin T. , Rozbruch S. Robert 
Published: August 2022

Context:
The Precice internal magnetic lengthening nail is used commonly for adult femur lengthening given its accuracy, precise control of lengthening, and patient comfort throughout the process. The nail is not currently approved by the Food and Drug Administration (FDA) for use in children, although many practices continue to use it off label.

Aims:
We aim to support the notion that the implant is efficient, reliable, and safe for femur lengthening in skeletally immature pediatric patients.

Subjects and Methods:
We performed a retrospective chart review of all skeletally immature patients who underwent treatment with a precice antegrade femoral nail to help establish the nail's safety and efficiency in this population.

Results:
We implanted 30 precice antegrade femoral nails (all trochanteric entry) in 25 patients (11 males, 14 females). The average lengthening goal for all surgeries was 47.62 mm (15 mm to 80 mm), and the average length achieved was 47.63 mm (15 mm to 80 mm). Twenty-four out of 25 patients (96%) achieved their lengthening goal within 5 mm. Average distraction rate was 0.97 mm/day (0.75 mm/day to 1 mm/day), and average bone healing index (time to consolidation/cm lengthened) was 19.69 days/cm (13.77 days/cm to 35.33 days/cm). Three patients experienced complications that required additional surgery, including a hip and knee flexor tendon lengthening, guided growth to correct a knee flexion contracture, and bilateral exchange nailing for implant fracture and delayed union. No patients experienced avascular necrosis of the hip, and all complications were ultimately resolved without permanent deficits.

Conclusions:
The precice antegrade femoral nail can safely and efficiently manage large lower extremity lengthening in skeletally immature children. Concurrent angular or rotational deformity correction was also possible, and postoperative complications were infrequent and manageable.
Intra-articular Osteotomies for Medial Compartment Osteoarthritis
Authors: Apte Aditya P. , Bhadiyadra Ravi , Chaudhary Milind 
Published: August 2022

Background and Aims:
Medial compartment osteoarthritis (MCOA) of the knee presents with varus deformity arising from the upper tibia or lower femur. High tibial osteotomies relieve pain by correcting the varus and improving the mechanical axis deviation (MAD). Closing wedge, opening wedge, and dome osteotomies are popular choices in the upper tibial metaphysis. These are all extra-articular osteotomies (EAO). Recently, attention has turned to detection and treatment of intra articular deformity arising from the knee to treat MCOA. Tibial condylar valgus osteotomy (TCVO) is an intra-articular osteotomy (IAO) which corrects the varus malalignment by elevating the medial tibial condyle and is usually fixed with a plate (Tibial condylar valgus osteotomy-plating [TCVO-P]). A second distal extra articular osteotomy, fixed with an Ilizarov fixator (tibial condylar valgus osteotomy-Ilizarov [TCVO-I]) is performed in some patients for better correction of the mechanical axis. The two groups were treated with different surgical approaches based on preoperative analysis of deformity. Hence this is a level IV study. We aimed to study the improvement in radiological parameters after TCVO in MCOA. We also compared the results between TCVO-P and TCVO-I.

Patients and Methods:
We performed 64 osteotomies in 55 patients over the last 7 years. 30 (33 tibiae) had a TCVO-P. 25 (31 tibiae) had a TCVO-I. The mean age in TCVO-P was 55 years, and in TCVO-I was 48 years.

Results:
The mean preoperative (bo) MAD was more in TCVO-I at –37.4% and improved to a mean postoperative MAD of 53.8%. TCVO-P had a lesser mean bo MAD of –7.4%, which corrected to 46.4%. MAD was better corrected by TCVO-I (P = 0.0058). Correction of medial proximal tibial angle, hip knee ankle angle, ankle joint line orientation improved significantly in both groups. The knee joint line orientation was improved by TCVO-I (P = 0.001), but not by TCVO-P (P = 0.075). Joint line convergence angle (JLCA), spine edge angle, and spine vertical distance were all significantly improved in both groups. Condylar plateau angle was not changed significantly in either group.

Conclusion:
TCVO is an Intra articular osteotomy which effectively corrects the varus deformity arising from the knee joint in MCOA. An isolated TCVO-P slightly under-corrects the mechanical axis. TCVO-I is better at restoring mechanical axis to beyond neutral and is better for younger patients and with intorsion deformities.