Pakistan Heart Journal

Evaluating medication adherence and its impact on glycemic control in elderly diabetic patients: a cross-sectional analysis

Tue, 02 Jan 2024 00:00:00 +0000

Medication nonadherence is a critical obstacle to optimum diabetes management. This study aimed to evaluate adherence and its impact on glycemic control in elderly (≥60 years) type 2 diabetics in Saudi Arabia. In this cross-sectional analysis, 65 outpatients completed the 8-item Morisky Medication Adherence Scale (MMAS-8) and had HbA1c values extracted from records. 44.6% exhibited low adherence per MMAS-8. Forgetfulness was a major barrier (70.8%). Mean HbA1c was suboptimal at 8.1%; only 26.2% achieved HbA1c<7%. Lower MMAS-8 scores strongly correlated with higher HbA1c. Patients aged over 80 years showed worse adherence (mean score 6.5) compared to 60-69 years (mean score 7.3). Longer diabetes duration (>10 years) and more comorbidities (≥4) were also associated with poorer adherence. This study demonstrates high prevalence of medication nonadherence among elderly Saudi diabetics significantly linked to inadequate glycemic control. Routine adherence screening and targeted interventions for individuals with identified barriers are imperative to optimize outcomes. Healthcare policies must prioritize resources and models supporting geriatric diabetes management.

Prevalence of Otolaryngology Refferal from Primary Health Care in Al-hasa Saudi Arabia

Tue, 02 Jan 2024 00:00:00 +0000

Background: Primary healthcare (PHC) is prioritized in the Kingdom of Saudi Arabia's health reforms, with ENT services playing a vital role due to the high prevalence of ENT-related complaints, particularly in children. While most patients are successfully managed by primary care physicians, complex cases beyond their expertise are referred to specialists, making ENT complaints the third-largest group of patients referred to hospital specialist clinics. However, resource limitations, a shortage of qualified specialists, and patient requests for alternative services sometimes result in the need for further management that some hospitals are unable to provide, leading to costly and time-consuming transfers to other facilities. In the pediatric emergency department, ENT complaints are common, and paediatricians frequently consult otolaryngology specialists for various conditions such as foreign bodies, infections, trauma, and congenital issues.

Objectives: To assess the prevalence of referrals to ENT clinics in King Abdulaziz Hospital, Alhasa.

Method: A retrospective descriptive study took place. A total of 269 referred patients from different age groups were included. After the data were extracted from the referral system at King Abdulaziz Hospital in 2022, they were revised, coded, and then fed to the statistical software IBM SPSS version 22.

Result: A total of 269 referred patients were included. The most reported chronic health problems of referred patients from PHC to ENT clinics in King Abdulaziz Hospital are DLP (11.2%), HTN (10.4%), and DM (9.3%), respectively. However, most of the referred patients (70.6%) had no chronic health problems. The most common symptoms in family medicine clinics among the study population were hearing loss, snoring and mouth breathing, recurrent tonsillitis, impacted wax, recurrent epistaxis, and tinnitus. The vast majority of study patients (98.5%) had regular referrals, while only (1.5%) needed urgent referrals. Urgent referral was needed for 5.5% of patients under 10 years, comparable with older participants with statistical significance.

Conclusion: There is a high prevalence of regular referrals to ENT clinics in King Abdulaziz Hospital by 2022. Patient age was the only significant factor associated with the type of referral. It would be beneficial to evaluate patient preferences and clinical outcomes in future research.

PERSONALIZED NUTRITION WITH AI: INVESTIGATE HOW AI CAN BE USED TO ANALYZE INDIVIDUALS' DIETARY HABITS, HEALTH DATA, AND GENETIC INFORMATION

Thu, 04 Jan 2024 00:00:00 +0000

Clinical nutrition may soon see a dramatic shift due to the advent of artificial intelligence (AI), a cutting-edge medical technology. Complex data analysis, medical picture interpretation, and patient-specific dietary therapies can all benefit from AI's assistance. More and more people are looking to AI-powered software apps that can tailor their diet plans to their specific needs in order to encourage them to lead healthier lives. We provide a knowledge-based recommendation system that can deliver amazingly accurate diet plans to 10 separate user categories, including healthy persons and those with medical issues, by using an explicit dataset of expert-validated meals. A quantitative layer to combine meal ideas and a qualitative layer to ensure ingredients are compatible make up the suggested advisor's novel design. In the first level, you'll find an expert system that employs fuzzy inference based on an ontology of rules discovered by nutritionists. In the second layer, you'll find an optimization process that creates daily meal plans based on target and range nutritional values. We test the system extensively to see how successfully it recommends meal plans, how varied the meals are, and how appropriate the meals and meal plans are. A total of three thousand synthetic user profiles and weekly food plans were generated for the purpose of the evaluations.

DATA ANALYTICS AND ARTIFICIAL INTELLIGENCE (AI): IOT DATA: DATA ANALYTICS AND AI APPLICATIONS, PROVIDING INSIGHTS INTO PATIENT TRENDS, TREATMENT EFFICACY, AND POPULATION HEALTH

Thu, 04 Jan 2024 00:00:00 +0000

Internet of Things (IoT) systems may now generate data at a dizzying rate, thanks to the proliferation of sensors and smart gadgets. To enable diverse IoT services and functions, IoT systems often process, transform, and analyze huge volumes of data. Data analytics using Machine Learning (ML) techniques have proven effective for the Internet of Things (IoT). There is a huge need for skilled data scientists because there are still numerous obstacles to overcome when applying ML models to data analytics jobs related to the Internet of Things (IoT), such as successful model selection, design/tuning, and updating.In this paper, we extend the potential of AI-enabled IoT healthcare to theorize how AI and IoT can make preventative public health services more accessible and help us move from a reactive to a proactive, continuous, and coordinated system of secondary and tertiary healthcare. The Internet of Things (IoT) and artificial intelligence (AI) also aid in achieving responsibility and satisfaction by encouraging patients to work more closely with their healthcare providers. On top of that, there are a lot of ways in which the Internet of Things (IoT) may improve healthcare delivery, including the ability to better anticipate health problems, diagnose them, treat them, and keep tabs on patients both inside and outside of hospitals. In this research, we use artificial intelligence and the internet of things to survey the healthcare industry's problems and potential solutions in a nutshell. It also gives a general idea of what artificial intelligence and the internet of things are, how they work, what the present trends are, what the future holds, and the difficulties faced by healthcare systems.

INTEGRATION OF AI, ML, AND IOT IN HEALTHCARE DATA FUSION: INTEGRATING DATA FROM VARIOUS SOURCES, INCLUDING IOT DEVICES AND ELECTRONIC HEALTH RECORDS, PROVIDES A MORE COMPREHENSIVE VIEW OF PATIENT HEALTH

Mounika Nalluri, Chinna babu Mupparaju, Dr. Rahul Pulimamidi, Aruna Sri Rongali — Thu, 04 Jan 2024 00:00:00 +0000

An abundance of new avenues for information sharing have opened up thanks to the IoMT, or Internet of Medical Things. Empowering patients, fostering healthcare collaboration, educating and training medical professionals, utilizing data for innovation, creating personalized treatment plans, managing supply chains, promoting public health, utilizing wearable health devices, and implementing quality improvement initiatives are all possibilities. Concerns about infrastructure costs, data privacy and security, regulations, and interoperability are only a few of the obstacles to the widespread use of IoMT. The purpose of this research is to fill a gap in the literature by discussing the possible solutions to the security issues related to data fusion in IoMT and its ramifications. Prediction accuracy is directly affected by the quantity, quality, and relevance of data acquired from IoMT devices. The most effective algorithm for identifying epileptic seizures in IoMT networks is the Epilepsy seizure detector-based Naive Bayes (ESDNB) algorithm, which achieves an accuracy ranging from 99.53% to 99.99%. On the other hand, data storage needs a complete overhaul, with enhancements needed at every stage (collection, protection, and storage). Possible improvements in the detection of security threats and compromises could result from standardizing architecture and security measures.

REVIEW AND ANALYSIS ON TOWARDS EMOTION ARTIFICIAL AND MACHINE LEARNING APPLICATIONS TO NEXT GENERATION HEALTHCARE AND EDUCATION

Mounika Nalluri, Aruna Sri Rongali, Chinna babu Mupparaju, Govind Prasad Buddha — Thu, 04 Jan 2024 00:00:00 +0000

In order to interact socially appropriately, humans rely on our capacity to accurately infer the intentions and emotions of other people. Conversely, a human-machine collaboration environment is born out of AIEd, or the use of AI in education. This, in turn, modifies the manner in which individuals interact with one another and may have an effect on them. This research was conducted with the intention of determining whether or not being exposed to AIEd had an impact on the emotional perception of adolescents. It is becoming increasingly plausible that artificial intelligence (AI) will be included into clinical treatment on a daily basis in the not too distant future. This is due to the growing body of evidence demonstrating AI's ability to enhance several facets of healthcare delivery. As a result of this potential, governmental bodies and technical firms are placing a greater emphasis on and expanding their investments in artificial intelligence medical applications. Concern, on the other hand, has been voiced over the ethical and regulatory implications of implementing AI in the medical field. Furthermore, AI could be biased, some algorithms aren't very open about their inner workings, data used to train AI models could be private, and there are safety and liability problems with using AI in healthcare settings. All of these difficulties are related to artificial intelligence. While much has been said about the ethical considerations of AI in healthcare, very little has been said on how to really address these issues in the industry. This article's goals are twofold: first, to foster additional conversation about how to regulate AI in healthcare by outlining a governance model that attempts to handle the ethical and regulatory challenges that emerge from implementing AI in healthcare.

AUTONOMOUS HEALTH MONITORING AND ASSISTANCE SYSTEMS USING IOT

Mounika Nalluri, Aruna Sri Rongali, Dr. Rahul Pulimamidi, Chinna babu Mupparaju — Thu, 04 Jan 2024 00:00:00 +0000

The Internet of Things (IoT) is an essential component of all applications that are focused on the future, including but not limited to smart cities, smart homes, educational institutions, healthcare facilities, transportation networks, and military operations. Apps for the internet of things are extremely crucial to the process of providing medical care because they make it feasible to conduct remote patient monitoring that is both secure and in real time. In the long run, this makes a contribution to an improvement in the overall quality of people's lives. This review article takes a look at the most recent developments that have been made in healthcare monitoring systems by taking a look at how the internet of things (IoT) functions. This research studies the advantages of healthcare systems that are based on the Internet of Things and examines their significance. Additionally, this research investigates the advantages of employing IoT in the medical industry. By doing a literature review on the subject, we are able to present a comprehensive analysis of the most recent research conducted on healthcare monitoring systems that are based on the Internet of Things. The evaluation of the relevant literature incorporates comparative analyses of a number of monitoring, data protection, privacy, and safety measures, as well as the efficacy and efficiency of a variety of different systems. In addition to this, the study offers a classification system for healthcare monitoring sensors and conducts an investigation into monitoring solutions for the Internet of Things that are predicated on wireless and wearable sensors. In addition, we delve even deeper into the challenges that are faced by the healthcare business in terms of maintaining the confidentiality of patient information and ensuring that patients receive adequate levels of service. At the very conclusion of the research project, proposals and recommendations for Internet of Things healthcare applications are offered, along with future directions linked to a range of current advancements in technical innovation.

MACHINE LEARNING AND IMMERSIVE TECHNOLOGIES FOR USER-CENTERED DIGITAL HEALTHCARE INNOVATION

Mounika Nalluri, Chinna babu Mupparaju, Dr. Rahul Pulimamidi, Aruna Sri Rongali — Thu, 04 Jan 2024 00:00:00 +0000

Virtual reality (VR), augmented reality (AR), and mixed reality (MR) are all examples of immersive technologies that improve data visualization and hence facilitate human connection. Stakeholders can be more effectively incorporated as essential members of the process with the aid of these technologies. Research on multidimensional genetic data processing for the development of better disease diagnostic and treatment procedures has begun to be influenced by immersive technologies. Some research aimed at addressing health and therapeutic requirements highlights the importance of immersive technologies, particularly for the creation of precision medicine. The research community has recently begun to pay attention to the possibility of employing immersive technology in the process of analyzing genetic data. Incorporating immersive technologies into the design of more realistic human-computer interactions that enable improved perception engagements is a primary focus of study in the field of genomic data analytics. Virtual reality and other forms of immersive technology have made it possible for people to believe that the digital world is just as real as the actual one. This leads to more accurate and error-free results from the learning process. However, there is a dearth of literature discussing the use of immersive technologies for healthcare and genomic data processing in specific digital health applications. This study contributes by giving a thorough analysis of the potential of immersive technologies in the field of digital health. Patient-centered apps, medical domain education, and data analysis (including genetic data visual analytics) are all examples of this type of software. As a case study for the gradual incorporation of immersive technologies into the field of genomic data analysis, we use the development of a visual analysis carried out with virtual reality (VR) as our focal point. Both the discussion and the conclusion provide a synopsis of the usability of the immersive technology applications that are already available, as well as their innovations and the future work that will be done in the field of healthcare and digital health data visual analytics.

HUMAN-AI COLLABORATION IN HEALTHCARE STUDYING THE IMPACT OF AI ON HEALTHCARE PROFESSIONALS DECISION-MAKING PROCESSES

Thu, 04 Jan 2024 00:00:00 +0000

The emergence of human-AI collaboration can be attributed to the advancements that have been made in artificial intelligence (AI). The shortage of skilled healthcare workers might be alleviated through such collaboration in the healthcare industry, which would also help medical professionals who are working too much and improve the overall quality of healthcare. Nevertheless, there are still many challenges that need to be addressed, including the examination of biases in clinical decision-making, the distrust of AI, and issues with adoption. Even while there is a growing body of research on the topic, it is coming from all over the place, and our understanding of it is limited. This study does a literature analysis in order to address this issue. The purpose of this review is to assess previous research, identify gaps in the research, and offer future research possibilities. Our review found that few studies have addressed topics such as the increasing and dynamic nature of healthcare industry collaboration, the ways in which humans and AI complement one another, public opinion and understanding of AI, and its potential effects on both individuals and healthcare organizations in the future. Additionally, there is a need for additional research that is driven by theory in order to reap the benefits of collaborative artificial intelligence for healthcare and to shape its design, implementation, and application.

Beneficiary outcomes of abciximab in COVID-19 patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.

Dr. Naresh Sen, Dr. Sonal Tanwar, Dr. M . Mehta — Sat, 06 Jan 2024 00:00:00 +0000

Background: SARS CoV2 pandemic affected the whole world with a high thrombotic burden during ST-segment elevation myocardial infarction (STEMI of the acute coronary syndrome. Meta-analysis and previous data have shown about GP2b3a inhibitor (Abciximab) has short and long-term efficacy in patients with STEMI undergoing PCI with high thrombotic burden.

Objectives: It was performed to verify the short-term & long-term efficacy and safety of abciximab in patients with STEMI undergoing percutaneous coronary intervention (PCI) during the COVID-19 era.

Method: We conducted a multicentre cross-sectional observational study in north India among 433 patients of ACS presented STEMI with SARS CoV2 RT PCR positive cases followed by PCI with DES drug-eluting stents.Meta-analysis and systematic review equated with or without abciximab in STEMI with PCI.We divided into two groups: A (with abciximab) n=197 and B (without abciximab) n=236 during PCI.

Result: Results found in group A versus B about significant differences in risk of 30 days mortality (RR 0.51, CI 0.13–1.95, p =0.034) but major bleeding (1.17, 0.63–1.71, p =0.042), and transfusion (1.21, 0.94–1.61,) between the two groups. However, there were significant differences in risk of mortality at 6 months (0.40, 0.14–0.66,p=0.034), and mortality at 12 months (0.43, 0.22–0.64,p=0.013). At the 12month follow up showed MACE rate (0.51, 0.43–0.72,p=0.023), recurrent myocardial infarction (0.54, 0.23–0.85, p=0.053), repeat revascularization (0.57, 0.33–0.81, p=0.041),minor bleeding (1.28, 1.12–1.44, p=0.051), and thrombocytopenia (1.84 1.30–2.07, p=0.048).

Conclusion: The role of abciximab could lead to a lower risk of reinfarction, revascularization, and all-cause death but a higher risk of minor bleeding, and thrombocytopenia during COVID 19 era.

Advanced Role of LV GLS to Access Cardiovascular Morbidity in Diabetic Cardiomyopathy Presenting Heart Failure.

Prof (Dr.) Naresh Sen, Dr. Sonal Tanwar, Dr. Ashok Jain — Sat, 06 Jan 2024 00:00:00 +0000

Background: Diabetes-associated changes in the structure and function of the myocardium leads to heart failure (HF) that is not directly attributable to other confounding factors such as coronary artery disease (CAD) or hypertension called diabetic cardiomyopathy (DbCMP). NT‐pro BNP is an excellent and easy-to-perform biomarker in HF but has limited ability to assess HF in patients with normal ejection fraction.

Objectives: To admittance the left ventricular global longitudinal strain in DbCMP with HF for justification to access cardiovascular adverse events.

Methods: Retrospective study between 2017 to 2020 followed by 12 months of observation for morbidity and mortality. We enrolled 370 cases of DbCMP patients and compared them with the control (n=350). We included adults, age 58+/- 16.5 years, with New York Heart Association (NYHA) class I through IV. Specially LV Global Longitudinal Strain (LVGLS) was assessed by velocity vector imaging using 2-, 3-, and 4-chamber views apart from routine LV diastolic function; IVRT, DT, E/A ratio, E/e’, LA Volume, LV Systolic function.

Results: We initiate considerable difference of left LVGLS in the DbCMP group -10.6 ± 4.3% as compared to the control group LVGLS was -18.7 ± 2.3%. Left ventricular ejection fraction (LVEF) was assessed in the case versus the control group (46±11% vs 59±6%). LV GLS <-9% was significantly associated with higher 12 months mortality and HF patients with DbCMP, not only in reduced LVEF but also in fair LVEF.

Conclusions: LVGLS has a more significant value to assess heart failure and mortality among DbCMP.

Evaluation of Cystatin C and Intercellular adhesion molecule –1 as markers of preclinical coronary artery disease in normoalbuminuric early type 2 diabetes individuals

Sat, 06 Jan 2024 00:00:00 +0000

Introduction: The presence of sub-chronic inflammation characterized by elevated intercellular adhesion molecule 1 (ICAM-1) and other cytokines has been quite evident in diabetes-associated coronary artery diseases. Cystatin-c, primarily developed as an early renal dysfunction marker, is found to be associated with insulin resistance and inflammation independent of renal function. The present study was designed to evaluate Cystatin-c and ICAM-1 as markers of pre-clinical coronary artery disease in normoalbuminuric early type 2 diabetes mellitus individuals.

Materials and Methods: Post-screening, study participants of both genders aged 35-55 years were divided into group 1 (31 healthy controls) and group 2 (31 normoalbuminuric early diabetes cases with a diabetes duration of 2-7 years). Fasting plasma glucose (hexokinase method), HbA1c (high-performance liquid chromatography) and random urine microalbumin (immuno-turbidometry) were estimated. Serum ICAM-1 and Cystatin-c levels were quantified by ELISA. Data analysis was performed using SPSS version 20.

Results: The average age of diabetes and control groups was found to be 49.68±4.60 and 45.23±5.73 years respectively. The mean diabetes duration was found to be 5.58±1.50 years. Compared to controls, diabetes group showed elevated ICAM 1 (630.26±266.062 vs 856.58±233.36 ng/mL, p=0.001) and cystatin-c (1118.26±262.980 vs 1229.10±457.74 ng/mL, p=0.383)

levels. Correlation of ICAM 1 with cystatin-c in both diabetes (r = 0.009, p = 0.96) and control (r = - 0.07, p = 0.68) groups was insignificant.

Conclusion: The significant increase in ICAM-1 levels over Cystatin-c in normoalbuminuric early diabetes individuals discriminates its superior role in assessing preclinical endothelial dysfunction and inflammation.

COMPARATIVE STUDY OF CRITICAL MOMENT HYPOTENSION VERSUS CONTROLLED HYPOTENSION ON INTRA-OPERATIVE BLOOD LOSS DURING BILATERAL SAGITTAL SPLIT OSTEOTOMY SURGERY: A RANDOMIZED CONTROLLED TRIAL

Mon, 08 Jan 2024 00:00:00 +0000

Introduction: Despite the fact that orthognathic surgery is generally regarded as safe, it does result in significant blood loss. Numerous pharmacological and non-pharmacological approaches have been utilised to address this issue. Controlled hypotensive anaesthesia administered throughout surgery and critical moment hypotension anaesthesia administered at a specific time, such as during the LeFort down fracture or the Sagittal Split, have both been used effectively to limit blood loss. There is currently no research that contrasts these two techniques to determine which is more applicable at minimising the loss of blood throughout the procedure of orthognathic surgery.; however, numerous authors have examined the use of both procedures. This study's objective is to compare the effects of general versus critical moment hypotension anaesthesia on the loss of blood throughout the procedure of orthognathic surgery.

Materials and methods- Eighteen adults with dentofacial deformities necessitating the orthognathic procedure Bilateral Sagittal Split Osteotomy were considered. They were split into three categories using a simple randomization strategy. Throughout the operation, Group I received a 10mg/kg body weight intravenous infusion of controlled hypotension anaesthesia. Group II received normotensive anaesthesia during surgery, while Group III received critical moment hypotension anaesthesia. Blood loss is estimated by calculating the total amount of blood suctioned, excluding saline solution and gauze saturated with blood. Also compared were haemoglobin and hematocrit levels before and after surgery.

Results-There were no statistical significant disparities between the sexes in hematocrit, surgical duration/time, bleeding/blood loss, or HB loss. Age was found to have a weak negative correlation (-0.19) with postoperative blood loss and hematocrit decrease (-0.30). There was no significant disparity among the interventions' total durations/time taken for surgery. There were statistically significant disparities in postoperative loss of blood, Hb loss, and haematocrit decrease between the groups. Loss of blood was found to correlate positively with hematocrit and Hb loss, whereas hematocrit loss was found to correlate positively with hematocrit loss. In the controlled hypotension group, mean blood loss was less than in the critical moment hypotension group.

Conclusion-Both critical moment hypotension anaesthesia and controlled hypotension anaesthesia are superior to full normotensive anaesthesia for minimising intraoperative blood loss. In addition, the effectiveness of critical moment hypotension anaesthesia was comparable to that of controlled hypotension anaesthesia. Therefore, it is possible to reduce the use of controlled hypotension anaesthesia in orthognathic surgeries

Keywords: Bilateral sagittal split surgery, Quality of life, hypotension anesthesia , Blood loss.

The effect of female hormones on dopamine release: a comprehensive review

Chaitali Nath — Mon, 08 Jan 2024 00:00:00 +0000

Background:

Sexual function is a complex interplay of physiological, psychological, and neurobiological factors. Among these, dopamine, a monoamine neurotransmitter synthesized in the brain's substantia nigra and ventral tegmental area, plays a critical role in regulating various aspects of human behavior, including sexual function. Dopamine operates within the limbic system, encompassing structures like the amygdala, hippocampus, and nucleus accumbens, which are central to emotional responses, motivation, and reward-related behaviors.

Objective:

This study aims to explore dopamine's influence on sexual function, specifically focusing on its role in motivation, emotional aspects, and physiological components. Additionally, it seeks to investigate gender-specific variations in dopamine's impact on sexual function.

Methods:

This study employed the Preferred Reporting Items for Systematic Review and Meta-Analysis approach to identify relevant studies. Searches were conducted in MEDLINE, Embase, ProQuest, and Scopus, utilizing criteria related to sex, intervention, comparison, and outcome. The study also assessed the risk of bias and evaluated the diagnostic value of selected studies.

Results:

The findings indicate that dopamine plays a pivotal role in sexual function by influencing motivation, emotional responses, and physiological processes. Increased dopamine transmission within the limbic system, particularly in the nucleus accumbens, is associated with heightened sexual desire and arousal. Moreover, dopamine within the amygdala modulates emotional responses to sexual stimuli, potentially enhancing the overall sexual experience. Dysregulation of dopamine can impact the release of nitric oxide, contributing to sexual dysfunction, such as erectile dysfunction. Gender-specific differences in dopamine's regulation of sexual function were observed.

Conclusion:

In conclusion, this study highlights the multifaceted role of dopamine in sexual function. It influences motivation, emotional aspects, and physiological components of sexual response. Understanding these mechanisms is crucial for addressing sexual dysfunction and tailoring interventions to gender-specific needs. Further research in this area is warranted to explore the intricate interplay between dopamine and gender-specific behaviors in greater depth.

A CLINICAL STUDY OF CARDIOVASCULAR CHANGES IN HYPOTHYROIDISM

Gangesh Tandia, Dr. Kiran Tandia — Fri, 12 Jan 2024 00:00:00 +0000

Background-Hypothyroidism is a clinical syndrome resulting from deficiency of thyroid hormones, which in turn results in generalised slowing down of metabolic processes.¹Hypothyroidism is second most common endocrinopathy next to diabetes mellitus. Apart from other complications Cardiovascular complications² are the most profound and reproducible clinical findings associated with thyroid disease. The cardiovascular complications ranges from functional systolic/diastolic dysfunction to overt heart failure and coronary artery disease. Hypothyroidism leads to changes in cardiac contractility, myocardial oxygen consumption, cardiac output, blood pressure and systemic vascular resistance. A variety of case reports demonstrated that hypothyroidism may cause prolongation of QT interval. They can develop protein rich pericardial effusion.⁶Hypothyroidism is an important individual and public health issue. The completely reversible nature of these complications is well known that lead to the need of this study to assess the Cardiovascular parameters in newly diagnosed hypothyroid patients and patients on treatment by performing various investgations including Echocardiography.

Aims & objectives-To evaluate the echocardiographic changes in newly diagnosed patients and patients who are taking treatment. To find out the incidence of cardiac dysfunction in newly diagnosed hypothyroid patients and the patients who are on treatment.

Material & methods- 25 newly detected hypothyroidism and 25 known cases of hypothyroidism who are on treatment for less than 4 months were taken for study, Cases were undergone for cardiovascular examination including electrocardiography and echocardiography. All patient’s examination records were collected by using structured schedule (Case Report Form) and data entered in Microsoft Excel Sheet and analysed by using SPSS SOftware.

Results-Hypothyroidism is more common in females as compare to male. Majority of study population (34%) belonged to 21-40 years of age group. Most common clinical symptoms found were easy fatiguability (62%) ,body swelling (42%) , weight gain (38%) BMI more than 25 (34%) and dry skin (32%). Among 50 cases 30 (60%) cases had normal electrocardiographic changes.⁷ normal Echocardiographic study was observed in 20(40%) of cases. Most common Echocardiographic finding was Grade-I & Grade-II diastolic dysfunction that was found in 16 (32%) cases. Other abnormal finding were pericardial effusion found in 10% cases , Increased LV thickness (8%) and LVH (8%) followed by systolic dysfunction.

Conclusion- This study suggest that it is very important to evaluate patients of primary hypothyroidism for cardiovascular changes. prior cardiovascular investigation should be performed to improve the clinical outcomes.

Occupational Therapy Intervention on Sexual Dysfunction among Epilepsy Patients: A Pilot Study

Usha Kasar, Amitabh K Dwivedi — Thu, 18 Jan 2024 00:00:00 +0000

Around 50 million people worldwide are estimated to have epilepsy, making it one of the most common neurological diseases globally [1]. It is characterised by a lasting predisposition to generate spontaneous epileptic seizures and has numerous neurobiological, cognitive, and psychosocial consequences [2]. Sexual dysfunction is more common among epilepsy patients as compared to the general population and is an important yet under-diagnosed co-morbidity. Sexual dysfunction is difficult to diagnose because of the taboo attached to it. The epilepsy patients are often not forthcoming with these complaints and at times think them to be unrelated to epilepsy

Effects Of Maitland Mobilization And Mckenzie Exercises In Sacroiliac Joint Dysfunction

Tue, 02 Jan 2024 00:00:00 +0000

Aim of Study: This study aimed to investigate the effects of two distinct interventions, Maitland Mobilization and McKenzie exercises, on individuals suffering from Sacroiliac Joint Dysfunction (SIJD).

Material and Methods: Over a 10-month period, an experimental investigation was conducted at the Body Expert Physical Therapy Clinic, enrolling 60 male and female participants aged 18 to 60 years, all experiencing sacroiliac joint pain. Participants exhibited acute or sub-acute pain lasting 4 to 12 weeks and met specific diagnostic criteria. Patients with certain medical conditions were excluded. The participants were randomly assigned to either Group A (Maitland Mobilization) or Group B (McKenzie exercises). Pre- and post-treatment assessments were conducted, and patient data was collected using various measures, including the Visual Analogue Scale (VAS) for pain assessment and the Oswestry Disability Index (ODI) for disability evaluation. Both groups also received a standard 20-minute hot therapy session.

Results: The results demonstrated significant improvements in pain levels, lumbar flexion, lumbar extension, and disability scores for both groups <0.05. In Group A, Maitland Mobilization led to a substantial reduction in pain scores and notable enhancements in lumbar mobility. Similarly, Group B, which underwent McKenzie exercises, experienced significant pain reduction and improved lumbar flexibility and extension.

Conclusion: These findings underscore the effectiveness of both Maitland Mobilization and McKenzie exercises as interventions for individuals with SIJD. Patients and healthcare providers can consider these approaches to effectively manage pain and enhance functional outcomes. Further research is warranted to explore the comparative effectiveness of these interventions in specific patient populations and clinical settings.

Keywords: Sacroiliac joint, mobilization, dysfunction, Maitland, McKenzie exercises.

Use of Chat GPT in Dental Research

Tue, 09 Jan 2024 00:00:00 +0000

This review explores the transformative role of Chat GPT, a state-of-the-art language model, in the realm of dental research. Developed by Open AI, ChatGPT exhibits a pre-trained, transformer-based architecture that excels in understanding and generating human-like text. Within dental research, its applications extend across key domains. The review first delves into the acceleration of literature reviews facilitated by ChatGPT. By efficiently summarizing vast amounts of textual data, the model expedites the review process, distilling crucial information from dental articles, journals, and clinical notes. It also contributes to systematic reviews by automating the identification of relevant studies, saving researchers’ valuable time. However, the review acknowledges certain limitations, such as the model's potential challenges in comprehending highly specialized aspects of dentistry. Ethical considerations, including bias in training data and responsible AI use, are also emphasized, urging researchers to exercise caution. In conclusion, the integration of Chat GPT in dental research signifies a paradigm shift, offering efficiency gains and transformative possibilities. The collaborative synergy between AI and human expertise holds promise for reshaping the landscape of dental research, fostering innovation, and advancing our understanding of oral health.

OTC drug trend and its social impact – A Review

Shubham Nath — Tue, 30 Jan 2024 00:00:00 +0000

Over-the-counter medicines (OTC), also known as nonprescriptionmedicines (NPMs), are medicines that canbe obtained or supplied without a prescription from registeredmedical practitioners. OTC medicines are frequentlyused to manage various minor ailments. Theyare conveniently obtained from community pharmaciesand other retail outlets such as petrol stations, supermarketsand are now increasingly purchased on the internet¹. OTC medicines promote self-care, benefiting bothindividuals and the health care systems by reducing theburden on other health care settings².

Self-medication also has advantages for healthcaresystems as it facilitates better use of clinical skills ofpharmacists, increases access to medication and maycontribute to reducing prescribed drug costs associatedwith publicly funded health programmes.³ However,increasing availability of non-prescription medicinesmay encourage patients to believe that there is a drugtreatment for every ailment. Furthermore, the use ofsuch products may delay/mask the diagnosis of seriousillness, with increased risks of interactions and adversereactions and of self-treatment being undertaken whenmedical aid should have been sought.⁴ There is also thepotential for misuse and abuse of such products.⁵

Comparison of Graham Omentoplastyand Modified Graham Omentopexyin PerforatedDuodenalUlcer: A Prospective Cohort Study

Euvalingam Deivassigamany, SakthivelChinnakkulam Kandhasamy — Tue, 30 Jan 2024 00:00:00 +0000

Background: Duodenal perforation is a surgical emergency and accounts for the majority of the causes of death in the elderly population. Various treatment modalities have been enrolled in the management. Still, the management of the cases is under debate. We aimed to prospectively analyse the outcome and complications of Graham Omentoplasty (GO) and Modified Graham Omentopexy (MGO).

Methodology: It was a prospective cohort study that was carried out in the tertiary care teaching hospital for a period of six months. A total of 60 patients were included and randomised using sealed envelope techniques, as group GO (n = 30) underwent GO surgical procedures and group MGO (n = 30) underwent MGO procedures. Patients were analysed for outcome and complications between both types of procedures.

Results: Age, sex, comorbid conditions, ventilatory support, return to normal bowel function, Mannheim peritonitis index, and average duration of hospital stays were statistically insignificant between GO and MGO. Duration of surgery (96 minutes in GO vs. 113 minutes in MGO) and surgical site infection (26.67% in GO vs. 20% in MGO) were found to be higher in GO than MGO but not significant. Postoperative systemic complications (6.67% in GO vs. 6.67% in MGO) and mortality (13.33% in GO vs. 13.33% in MGO) were similar in both groups and did not have a statistical difference.

Conclusions: Perforated duodenal ulcer cases can be effectively managed with either GO or MGO. Both procedures have equivalent outcomes and choices based on surgeon preference in the available clinical settings.

ASSESSMENT OF RISK FACTORS ASSOCIATED WITH PCOS IN PREMENOPAUSAL WOMEN IN A TERTIARY CARE CENTRE

Tue, 30 Jan 2024 00:00:00 +0000

Introduction: PCOS is a heterogeneous endocrine disorder seen in women of reproductive age. It causes abnormality like polycystic ovaries, hyperandrogenism and irregular menstrual cycle. PCOS is thought to be associated with risk factors like Type 2 Diabetes mellitus. It is also associated with risk factors which can be life threatening.

Aim: The aim of the current study was to analyze and correlate the biochemical parameters and hormonal parameters of women with PCOS and to identify the risk factors associated with PCOS

Material & Methods: Group I comprising of 70 women with PCOS; Group II with 70 women without PCOS were included in the present study. Blood samples from participants of both groups were assessed for biochemical parameters like FBS, Lipid profile, uric acid and hormonal parameters like TSH, prolactin, insulin & HOMA-IR. Premenopausal women in the age range of 18-40yrs diagnosed with PCOS Patients with diabetes mellitus, hypertension, thyroid disorders, cardiovascular disease, Cushing’s syndrome, pregnant or lactating women and women on medication for oral contraception, hypoglycemic, lipid lowering drugs, hormonal medications within previous 6 weeks were excluded from the present study

Results: The participants of the study were 100% females and in the age group of 18-40years.There was a positive correlation of FBS and Lipid profile among Group I and Group II and the p value was <0.05. Serum uric acid was found to be in normal range in both patients with p value of 0.606. Serum TSH level, Prolactin level, serum insulin level and HOMA-IR were significantly increased in women with PCOS than in healthy controls and the p value was <0.05.

Conclusion: The use of simple and cost-effective biochemical parameters might prove to be biomarkers in early detection of these metabolic changes and may help to identify women with PCOS and the associated risk factors.

Comparative study of Clomiphene Citrate and Letrozole in Ovulation Induction

Sun, 04 Feb 2024 00:00:00 +0000

Abstract
Background: Infertility is a life crisis with invisible losses and its consequences are manifold. Infertility
can threaten women’s identity, status and economic security and consequently be a major source of
anxiety, leading to lowered self-esteem and sense of powerlessness. For a couple without contraception
the chances of conception are about 25% each month. So even ovulation happens, a couple is not
guaranteed to conceive. Clomiphene citrate has been the most widely used treatment for fertility
enhancement for the past 40 years. Clomiphene citrate (CC) is an anti estrogenic agent resulting in a 60-
85% ovulation rate and 10-20% pregnancy rate / cycle. Aims and Objectives: The aim of the study was
to compare the efficacy of ovulation induction by Clomiphene citrate and Letrozole in terms of no of
maturing follicle, size of dominant follicle, ovulation (monofollicular or multifollicular), endometrial
thickness and pregnancy and its outcome. Method: It was a prospective longitudinal study conducted in
the Obstetrics & Gynecology Department of M.K.CG Medical College and Hospital. Berhampur; Odisha
from October 2017 to October 2020. A careful & detailed history was elicited from the female as well as
from male partner with special reference to certain specific history concerning the problem of infertility
such as the age, duration, menstrual problem, past medical & surgical history, coital habits, use of
contraceptive methods and treatment history. Subsequently thorough general & systemic examination was
done to exclude any other organic disease in the female patient. Examination of breast, other secondary
sexual characters, thyroid and presence of galactorrhea, hirsutism, and thorough pelvic examination was
done. Patients randomized in to two groups out of 150 cases on anovulatory infertility: first group (CC
group) of 75 cases was given Clomiphene citrate 50 mg starting from D3 to D7 of cycle and second group
(Letrozole group) of 75 cases was given Letrozole 2.5 mg starting from D3 to D7 of cycle. In the both
groups follicular study was done by serial transvaginal sonogram starting from D12 of cycle on alternate
day till ovulation. The number of developing follicles, size of dominant follicle and endometrial thickness
were observed serially by TVS. Results: Ovulatory factors contributing to primary infertility was 150
cases (49.83%) as majority where as tubal factors contribute to 81 cases (26.91%) and other factors
contribute to 70 cases (23.26%). Most of the cases in both groups were of 2-4 year of infertility. Among
http://www.pkheartjournal.com
Pak Heart J 2024:57(01)
ISSN: 0048-2706 (Print), ISSN: 2227-9199 (Online)
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all cases, 60 cases (80%) of Clomiphene citrate group and 55 cases (74%) of Letrozole group were of 2-4
years of infertility as majority followed by 15 cases (20%) of CC group and 15 cases (20%) were of 5-7
years of infertility and 5 cases (6.7%) in Letrozole group were of > 7 years of infertility. In CC group, 56
cases (78.9%) and in Letrozole group, 60 cases (82.2%) had dominant follicle size of 18-20 mm as
majority followed by 9 cases(12.7%) in CC group and 11 cases(15.1%) in Letrozole group had DF of size
< 18mm and 4 cases (5.6%) in CC group and 2 cases (2.7%) had dominant follicle of size 21-25mm,.
Only 2 cases (2.8%) in CC group had DF of size >25mm. The endometrial thickness (ET) varied from 5-
12mm in all cases of both groups. In Clomiphene citrate group 39 cases (55%) had ET of 7-8 mm, 14
cases (19.7%) had ET of 9-10 mm, 6 cases (8.4%) had ET of 11-12mm and 12 cases (16.9%) had ET of
5-6mm. In Letrozole group, 44 cases (60.3%) had ET of 9-10mm, 21 cases (28.8%) had ET of 7-8 mm, 6
cases (8%) had ET of 5-6 mm and 2 cases (2.7%) had ET of 11-12mm. The ovulation occurred in 46
cases (64.8%) and 52 cases (71.2%) in Clomiphene citrate group and Letrozole group respectively.
Conclusion: More number of DF was found in case of Letrozole as compared to Clomiphene citrate.
Ovulation rate of letrozole is higher than that of Clomiphene citrate. More over pregnancy rate for
Clomiphene citrate was lower than that of Letrozole. So Letrozole is found superior to Clomiphene citrate
as an ovulation inducing agent in anovulatory infertility.
Keywords: Ovulation, Clomiphene Citrate, Letrozole, Dominant follicle.

Association of α-TNF and Iron parameters in anemic and non-anemic Pulmonary Tuberculosis (PTB)

Priti Yadav, DVSS Ramavataram, Tejas J. Shah, Mritunjay Kumar Mishra — Wed, 07 Feb 2024 00:00:00 +0000

Background: Tuberculosis has been a major killer globally for centuries and has now become the tenth leading cause of death worldwide. It is an air-borne chaos that induces systemic inflammation and is commonly linked with different comorbid clinical conditions such as anemia. In chronic diseases such as pulmonary tuberculosis (PTB), inflammation due to bacterial burden plays a vital role in the Pathophysiology of anemia.

Methodology: A comparative type of case-control study that included 40 newly diagnosed anemic PTB (cases) and 40 newly diagnosed non-anemic PTB (controls) of either gender having age group of 20-70 years. The PTB was confirmed by microscopic examination of sputum specimen for the detection of Acid-Fast Bacilli (AFB). Serum iron was analyzed by ferrozine method and α-TNF were analyzed by ELISA method. SPSS 20 version were used for the statistical analysis.

Results: Significantly higher levels of α-TNF (225.77±77.49) were observed in anemic PTB cases than that of non-anemic PTB cases (p<0.001). A significant inverse correlation was observed between α-TNF and iron(p<0.05) and a positive association between α-TNF and Ferritin (p<0.05) in both groups.

Conclusion: Increased α-TNF gives rise to higher bacterial burden, lower iron levels and higher ferritin levels in anemic PTB patients than in non-anemic PTB.

INDIVIDUALIZED TREATMENT STRATEGY FOR ACUTE EXACERBATION OF CHRONIC HEART FAILURE IN PATIENT WITH DILATED CARDIOMYOPATHY: WHAT IS THE OPTIMAL TREATMENT?

Si Dung Chu, Huy Quang Doan, Minh Thi Tran, Linh Tran Pham, Khanh Quoc Pham — Sat, 10 Feb 2024 00:00:00 +0000

Objective: To study clinical cases of acute heart failure based on dilated cardiomyopathy to clearly see what is the most optimal treatment in each clinical case.

Research method: Clinical case report and review of the literature. Research on a clinical case of acute heart failure in a patient with chronic heart failure with dilated cardiomyopathy at the Vietnam National Heart Institute, Bach Mai Hospital. Optimal medical treatment of heart failure while treating the underlying disease well helps improve heart function and clinical improvement.

Case report: The 59-year-old male patient was admitted to the Vietnam National Heart Institute - Bach Mai Hospital because of New York Heart Association (NYHA) III-IV dyspnea and bilateral lower extremity edema, with less urine about 700 - 800 ml/24 hours, Ejection Fraction (EF) 18%. History of type 2 diabetes, hypertension, old pulmonary tuberculosis, newly discovered dilated cardiomyopathy 6 months ago, and hospitalized without any treatment. Do not smoke and use alcohol. Patients were treated aggressively during the acute decompensated heart failure episode as well as optimized with foundational medications such as Angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, aldosterone antagonists, and digitalis (Digoxin) to help Stabilize treatment of NYHA II, and EF 45% before discharge, and myocardial resynchronization therapy with CRT implantation was prescribed.

Conclusion: The treatment strategy for this patient is to first treat acute decompensated heart failure, then stabilize medical treatment with foundational drugs at the target or optimal dose for the patient. The addition of 2 therapies, Ivabradine and cardiac resynchronization, is a very reasonable indication that will improve functional status and quality of life while reducing the patient's risk of hospitalization and death; However, while waiting for the decision to intervene in CRT implantation from the patient's family, optimal medical treatment is needed. Current clinical evidence has shown that optimal medical treatment is individualized. Chemotherapy helped improve and stabilize this patient's clinical condition, helping to improve the prognosis.

COMPARISON OF GENERAL AND EPIDURAL ANESTHESIA FOR CESAREAN DELIVERY IN HEART DISEASE COMPLICATING PREGNANCIES – A RANDOMIZED PROSPECTIVE STUDY

M.Suguna, R.Karthikeyan — Mon, 12 Feb 2024 00:00:00 +0000

Background: Significant cardiovascular system hemodynamic alterations during pregnancy have been linked to increased morbidity and mortality in women with underlying heart disease.

Objective: Study to compare hemodynamic changes and complications in General and Epidural anesthesia for cesarean delivery in Heart disease complicating pregnancy.

Methods: A total of 100 patients were randomly allocated into two groups. After approval by ethical committee, informed consent to be obtained. Information to be collected including age, gestational age, parity, cardiovascular disease. Baseline physical examination, Basic investigations to be done. The patients undergoing general anaesthesia are premedicated with i.v. glycopyrrolate (0.2 mg). Preoxygenation with 100% oxygen for 3 min. Patient induced with inj.Thiopentone 3-5mg/kg, Intubated with appropriate size ET tube after Inj. Succinylcholine 1.5mg/kg IV. After delivery, anaesthesia maintained with oxygen in nitrous oxide (33:66), with the addition of i.v. fentanyl. Relaxation to be maintained with inj. Atracurium 0.5mg/kg. The patients undergoing epidural anaesthesia, 18 G Tuohy needle inserted into L2-L3 space, Test dose of 3ml 1.5% lidocaine and 1:2,00000 epinephrine to be injected into the catheter, when patients shown no ill effects, 10ml of 1.5% lignocaine to be injected. Hemodynamic changes and complications to be noted.

Results: cardiovascular events decreased in epidural group. Complications occurred in general anesthesia, not in epidural group.

Conclusion: Epidural anesthesia is better than general anesthesia in maintaining hemodynamics & less complication.

Investigating the effect of Habolzahab (Iranian medicinal products based on Sabr, Hallila and rose flower) on the intraocular pressure of patients with open-angle glaucoma: A randomized, double-blind clinical trial

Ebrahim Heidari, Assie Jokar, Ebrahim Nasiri, Kiumars Nowroozpoordailami — Fri, 16 Feb 2024 00:00:00 +0000

Introduction: Glaucoma is the name of a group of diseases that is characterized by irreversible optic neuropathy, which is in the form of depression and analysis of the connective and nerve tissue elements of the optic disc, which ultimately causes a specific pattern of visual impairment, in the form of loss of the visual field and blindness becomes. Scholars of traditional medicine had opinions and opinions in the field of recognition, description and treatment of eye diseases and definitions of functional terms, and almost all traditional medicine books deal with the diagnosis and treatment of eye diseases. The purpose of this research was to explain the glaucoma disease in Iranian medicine and compare the medicine of Hab-al Zahab with routine drugs on the intraocular pressure and symptoms of patients with glaucoma. In order to have a positive effect, this medicine can be recommended as a natural product made in Iran, for auxiliary treatment in patients.

materials and methods:This study was done in two stages, in the first stage of this study, there was a library of text analysis type And in the second step of this study, it was a double-blind clinical trial research. All patients aged 18-75 who referred to the eye clinic of Bo Ali Hospital were included in the study according to the inclusion and exclusion criteria. Data collected from patients who had a confirmed diagnosis by an optometrist and had chronic glaucoma under routine treatment. They were entered into spss21 software and analyzed.

Results: The results of data analysis showed that the average weight of the studied patients was 71.6±10.3 and the average height was 166.1±7.4 and their average age was 47.6±13.6 years. 67.6% were women, 50% had a diploma or lower education level.88.2% had no history of eye surgery. 51.5% had House keeping, 82.4% did not consume alcohol. The simultaneous effect of time in the studied groups and based on the Greenhouse test shows that there is no significant difference between the left eye pressure in the intervention and control groups (p<0.222), The right eye pressure simultaneously in the study groups. And in the passage of time, they have a statistically significant difference (p<0.042), There is a significant difference in the frequency of Shedding tears in the intervention and control groups (p<0.031), There is no significant difference in the frequency of blurred vision in both groups (p<0.374), The simultaneous effect of group and time shows a significant difference between the two groups of abdominal pain (p=0.019), There is a significant difference in the rate of constipation reduction in both groups (p<0.014).

If additional studies are confirmed, the use of habolzahb drug can reduce intraocular pressure in the long term as an adjunctive treatment along with routine drugs.

Conclusion: Medicinal plants along with latanoprost, timolol and dorzolamide drugs reduce intraocular pressure in people suffering from this disease.

Systematic Examination of Patients with Lower Limb Plastic Surgery (femur fracture) and Vascular Embolism Based on Ultrasound, Radiology and ICU Points

Fri, 16 Feb 2024 00:00:00 +0000

This study systematically investigated patients with lower limb plastic surgery (femur fracture) and vascular embolism based on ultrasound, radiology and ICU points. Bone fracture after hip replacement surgery is one of the complications after surgery that rarely happens. This condition is mainly common in elderly people who have reduced bone thickness or have special medical conditions. When a person needs physiotherapy after femur surgery, when the femur is fractured. Femur fracture is an injury, crack or fracture caused by contact in the femur. If a fracture occurs in the upper part of the femur or adjacent to the hip joint, sometimes this fracture is also called hip fracture or hip fracture. One of the most important symptoms of a femur fracture is severe and excruciating pain in the thigh, which increases with pressure on the fracture site or movement. Inability to move the lower limb, deformation of the lower limb in the form of shortening and outward rotation, and thigh swelling are symptoms of this bone fracture. All hip fractures are treated with surgery. In such a way that they first fix the fracture, then through small slits in the skin. The intraosseous rod or plate is attached to the bone and fixes it. In this way, it is called closed reduction and internal or external fixation. When the closed reduction is not done, the surgeon uses the open reduction method and fixes and immobilizes the fracture with the methods of using rods. Other treatments include physiotherapy, water therapy, exercise therapy.

Invasive Device-Associated Hospital Infection Rates and Etiological Agents in Pediatric Intensive Care Unit During Covid-19 Pandemic

Fri, 16 Feb 2024 00:00:00 +0000

Aim: Firstly, compared the rate and etiological agents of invasive device-associated hospital infections (IDAHIs) in the Pediatric intensive care unit before and during Covid-19 Pandemic

Materials and methods: Between February and December 2020, 73 IDAHI cases (evaluated in 653 patients) compared with the 78 IDAHI cases (evaluated in 768 patients) in same period of the previous year (February – December 2019)

Results: Ventilator associated pneumonia were observed in 53 IDAHI cases during 2019 and 42 cases in 2020, that was no statistically significant difference. catheter-associated urinary tract infection observed in 1 IDAHI patient during 2019 and 2 patients in 2020 and p value achieved is not statistically significant. central venous catheter-associated blood stream infection observed in 24 IDAHI patient during 2019 and in 27 patients during pandemic situation that was no statistically significant difference. The most frequently isolated etiological agents before and during COVID-19 pandemic were: klebsiella, coagulase-negetive staphylococci(CONS), Candida spp, Acinetobacter, Enterobacter and Non-albicans candida that despite the decrease in the prevalence of these microorganisms during Covid-19 pandemic, there was no significant decrease compared to the previous pandemic.

Conclusion: Despite limited studies, our results have shown that the rate IDAHIs in Pediatric Intensive Care Unit has not decreased and like before the Covid-19 pandemic and maybe more proper cleaning and sterilization or a high level disinfection of Invasive equipment is essential.

A comprehensive investigation of radio-oncology in breast cancer patients based on psychological and radiological problems in these patients

Fri, 16 Feb 2024 00:00:00 +0000

Breast cancer is one of the most common cancers and a common cause of death among women in the world. Breast tissue is dense in young people, and with age, fat tissue gradually replaces dense breast tissue. Despite the severe prognosis and high morbidity and mortality, the patient's prognosis will be better if diagnosed early.

Materials and methods: The current research is a clinical trial with an experimental and control group. The statistical population of the present study is all patients diagnosed with breast cancer who referred to Imam Khomeini Hospital in Tehran in 1402. Patients with breast cancer were selected for inclusion in the study. According to the statistician's opinion, 60 people were selected as available. The random replacement method and covariance analysis method were used to control the initial significant differences.

Conclusion: The results of this study show that psychological treatments have an effect on psychological components related to cancer diseases and treatment based on acceptance and commitment can help the patient to see negative thoughts and conditions of his illness as an acceptable part. Taking advantage of the therapeutic approach based on acceptance and commitment has been able to help improve the cognitive regulation of emotions in breast cancer patients and reduce the pain anxiety of these patients. Get to know themselves, be able to observe their negative emotions, identify their negative thoughts, learn ways to reduce the judgmental view of these thoughts, express their thoughts and concerns easily in a therapy team, and with the help of each other, deal with the stresses of the therapeutic environment Actively adapt. According to the above, the present study was conducted with the aim of comprehensive investigation of radio-oncology in breast cancer patients based on psychological and radiological problems in these patients.

Neurological manifestations in adult and pediatric patients with COVID-19: A systematic review and meta-analysis

Fri, 16 Feb 2024 00:00:00 +0000

Background and aim: In light of evidence for the possible long-term effects of Covid-19 on the nervous system, the aim of present study was to evaluate the Neurological manifestations in adult and pediatric patients with COVID-19.

Method: The present study is based on PRISMA guidelines, which includes all articles published in international databases such as PubMed, Scopus, Science Direct and Embase between January 2019 and May 2022. 95% confidence interval was done with fixed effect model and inverse variance method. Analysis of data collected from selected studies was done using STATA.V16 software.

Result: In the initial review, the abstracts of 730 studies were reviewed, the full text of 249 studies was reviewed by two authors and finally, 16 studies were selected. Proportions of headache, Myalgia and Dizziness associated with COVID-19 infection was 12% (effect size: 0.12; 95% CI, -0.16 to 0.40), 20% (effect size: 0.20; 95% CI, -0.06 to 0.46) and 9% (effect size: 0.9; 95% CI, -0.40 to 0.48).

Conclusion: The meta-analysis of the present study shows that the incidence of neurological symptoms such as headache and myalgia in Covid-19 patients is higher than other neurological symptoms.

Comprehensive evaluation of radiation oncology, Medical and Nursing care treatments in women with breast cancer based on sonographic and radiological points

Fri, 16 Feb 2024 00:00:00 +0000

Breast tissue is dense in young people, and with age, fat tissue gradually replaces dense breast tissue. Despite the severe prognosis and high morbidity and mortality, the patient's prognosis will be better if diagnosed early. Early diagnosis of breast cancer is the ultimate goal of radiology and the role of radiologist is very crucial in this stage. The aim of the present study is to comprehensively evaluate radiation oncology treatments in women with breast cancer based on ultrasound and radiology points.

Materials and methods: The present study was a clinical trial that was conducted on 50 people with breast cancer. People were divided into two intervention and control groups. In the control group, oncology radiation therapy with ultrasound and radiology was used. Other available treatment methods were used in the intervention group. In order to blind the study, the attending physician was not aware of the division of subjects into two intervention and control groups. SPSS version 16 software was used for data analysis. A significance level of 0.05 was considered.

Conclusion: Ultrasound is the first and best diagnostic method. Ultrasound is the first and best diagnostic imaging method for examining palpable breast masses. Mammography and ultrasound are two complementary diagnostic methods, and mammography can help in investigating microcalcifications and asymmetric densities and confusion of the natural system of breast tissue, which are difficult to detect in ultrasound due to increased echogenicity and non-uniform appearance of the breast parenchyma. Suspicious or lacking a specific profile for benign or possibly benign lesions should be biopsied and histologically examined. If there is a palpable mass or other suspicious clinical signs and mammography and ultrasound are negative, it is necessary to perform a biopsy of the target area to rule out malignancy. Mammography and ultrasound are two complementary diagnostic methods, and mammography can help in investigating microcalcifications and asymmetric densities and confusion of the natural system of breast tissue, which are difficult to detect in ultrasound due to increased echogenicity and non-uniform appearance of the breast parenchyma. Suspicious or lacking a specific profile for benign or possibly benign lesions should be biopsied and histologically examined. If there is a palpable mass or other suspicious clinical symptoms and mammography and ultrasound are negative, it is necessary to perform a biopsy from the target area to rule out malignancy.

A Systematic Review of Digestive Problems in Children and the Elderly Involved in Infectious Diseases, Relying on Nursing and Medical Measures

Fri, 16 Feb 2024 00:00:00 +0000

Children due to their playfulness and the elderly usually have a weak immune system due to underlying diseases and old age. Poor functioning of the digestive system and digestive diseases of children and the elderly can directly affect their growth. Most diseases occur in old age. The cause of this can be wrong lifestyle, environmental factors or genetic factors. But what is important is familiarity with these diseases and ways to prevent their occurrence. In the present study, by examining more than 50 articles according to the key words "Child and elderly immune system", "Genetic factors", "Underlying diseases", it was concluded that digestive problems in children, when they continue, can cause concern. But for most children, many digestive problems arise due to an underdeveloped digestive system or non-rich diets. Dysphagia (difficulty or discomfort when swallowing), gastroesophageal reflux, gastric cancer, irritable bowel syndrome, intestinal obstruction, and constipation are the most common digestive problems in children and the elderly, which may present with various symptoms such as pain, fever, diarrhea, and vomiting. In addition to examining the patient at the bedside, doctors may prescribe various diagnostic methods such as endoscopy and colonoscopy. In summary, digestive problems in the elderly and children can be largely controlled by changing lifestyle and diet in the early stages. But in the middle stages, drug interventions are usually needed for treatment, finally, in the advanced stage of this disease and for the rapid improvement of the patient's condition, it may be necessary to perform surgery in the digestive system.

Pattern of filler and Botulinum toxin induced facial Ischemia and prevention of hypertrophic scars and keloids Relying on the points of clinical psychology

Vahid Sabri, Naghmeh Nikzad, Saeed Golparvaran, Mohammad Deylami, Kamran As’adi — Fri, 16 Feb 2024 00:00:00 +0000

Background and purpose: hypertrophic scar is a lesion that is caused by excessive healing of the wound and leaves aesthetic and sometimes functional problems for affected patients and causes physical, mental and change in their quality of life. Nowadays, various methods including surgery It is used to treat these lesions, but due to frequent recurrence, the patient's problems persist.

Materials and methods:

This prospective study was a randomized controlled trial on 40 patients with hypertrophic scars who were referred to the plastic surgery clinic of Waliasr Hospital in Imam Khomeini Hospital Complex (RA). It was done during the year 1402. The findings and results obtained in terms of the relationship between the control group and the study variables were analyzed with SPSS software version 16 and the significance level was considered to be less than 0.05.

Conclusion:

Botulinum toxin type A injection in hypertrophic scar not as an independent method but along with other treatment methods such as surgery can be useful in controlling and improving the symptoms caused by scar.

Sensitivity, Specificity of Pulse Wave Velocity (PWV) test for Cerebral Small Vessel Disease (CSVD): A diagnostic Study

Fri, 16 Feb 2024 00:00:00 +0000

Background: present study assessed the sensitivity, specificity and optimal cut-off point of Pulse Wave Velocity (PWV) test for the diagnosis of Cerebral Small Vessel Disease (CSVD).

Methods: 143 Patients candidates for brain MRI in 2022 were included in this observational, prospective diagnostic study. The MRI results were interpreted by two radiologists and the patients with lesions of small cerebral vessels were divided into three groups based on the Fazekas scale, and those diagnosed with CSVD were subjected to PWV. In order to measure the diagnostic value and cut-off point of PWV test in diagnosing CSVD, ROC diagram was used. The sensitivity and specificity of the test were also determined using a cross table and then ICC analysis. The data were analyzed using IBM SPSS Statistics v24.

Results: Rock curve for MeanPWV showed that specificity and sensitivity are 93 and 65.3, respectively. The area under the ROC curve (AUC) was equal to 0.86 with P value <0.001 and the proposed cut-off point was equal to 10.66, and the Youden index of 0.58 shows the high diagnostic value of this test.

Conclusion: The results of the present study show that PWV has sufficient diagnostic power to distinguish healthy people from patients with CSVD, and its use can help in the early diagnosis of lesions of small cerebral vessels and in the direction of Reducing the diagnostic costs of patients with brain lesions will be very useful.

INTRALESIONAL INJECTION OF 5-FLUOROURACIL IN COMBINATION WITH TRIAMCINOLONE ACETONIDE IN KELOID TREATMENT

Fri, 16 Feb 2024 00:00:00 +0000

Objective: to evaluate the efficacy of 5-Flurourasil (5-FU) and Triamcinolone Acetonide (TAC) injection combination in the management of Keloids.

Methods: Thirty patients with the diagnosis of keloid were treated with a combination injection of 5-FU & TAC. Objective assessments were done. Scar scales were assessed at baseline, 1 month, & 1 year follow-up.

Results: Ultrasound measurements shows a significant decrease in volume (baseline mean score: 1,105 911.5 mm3, 1-month follow up mean score: 416.1 218.1 mm3, 1-year follow-up mean sore: 431.2 253.6 cu. , P= <0.0001, respectively) and penetration depth of keloids (relative reduction between baseline and 12-month FU of 74.4%, P= <0.0001). The patient & observer scar assessment scales (POSAS) also show objective & subjective improvement in keloid size.

Conclusion: 5-FU in combination with TAC intralesional injection is effective for keloid management.

Study of Blood Group and its Relation with Bleeding and Clotting Time

Dr. Anupama VithalkumarBetigri, Anjali, Priya Sakshi, Kirti Joshi — Thu, 22 Feb 2024 00:00:00 +0000

BACKGROUND Haemostasis is the process of clot formation in the damaged vessel wall that prevents further blood loss and conserves blood in the fluid state within the circulatory system .It is an essential factor to keep in mind before performing any type of surgical process.

AIM The study aimed to assess blood group distribution, clotting, and bleeding time.

METHODS The study was conducted in the physiology department at Manav Rachna Dental College. Data is available for 54 students in the BDS 1st year. Information about the student includes sex, ABO and Rh blood groupings, bleeding time, and clotting time. Standard antiserum A, B, and D were used to determine the blood group. For the determination of bleeding time, Duke's method was used. The capillary glass tube method was used for determining clotting time. At last, all the parameters are combined and compared for statistical analysis of the relation with the blood Heamostasis as parameter like bleeding time and Clotting time.

RESULTS In the analysis, a significant level of 0.05 was employed for the one-way ANOVA, indicating the threshold for statistical significance. In terms of mean bleeding time, blood group AB exhibited the highest value, followed by blood groups O and A, with blood group B demonstrating the lowest mean bleeding time. Clotting time was found to be highest in blood group A, followed by O, B, and AB in contrast to a study showing higher clotting time in B followed by O, A and AB ^[10]. Kaur M et al, conducted a study showing that BT was prolonged in O blood group followed by B, AB and lowest in A^[11], while in our studies it was highest in blood group AB then O followed by B and A. Both bleeding time and clotting time showed no significant difference with respect to blood grouping.

CONCLUSION The study at Manav Rachna Dental College assessed blood group distribution, clotting, and bleeding time among 54 BDS 1st year students. Data was collected using standard antiserum A, B, and D, Duke's method for bleeding time, and capillary glass tube method for clotting time. The results showed that blood group AB had the highest mean bleeding time, followed by O and A, while blood group B had the lowest. Clotting time was highest in blood group A, followed by O, B, and AB.

MIDTERM OUTCOME OF FEMOROFEMORAL CROSS OVER BYPASS GRAFTS

Wed, 06 Mar 2024 00:00:00 +0000

Background: Femorofemoral crossover bypass (FCB) is a procedure for patients with unilateral iliac artery disease. Our goal was to assess mid-term patency of graft used in FCB.

Methods: A retrospective review from a single centre of consecutive patients who underwent Femorofemoral crossover bypass from November 2017 to February 2021 was done. Data was collected from hospital records and follow-up done up to February 2022. We have analysed the graft material used, size of graft and operative procedures.

Results: The indications for FCB were claudication in 42 and critical limb ischemia in 10 patients. The 1-month patency rate is 100%, 3 month patency rate is 96%, 6 month patency rate is 94% and 1 year patency rate is 90%.

Conclusion: Our mid-term analysis suggests that FCB might be a valuable alternative treatment modality in patients with unilateral iliac artery disease.

Evaluation of Serum and Salivary C-Reactive Protein in Oral Potentially Malignant Disorders

Sat, 16 Mar 2024 00:00:00 +0000

Abstract

Background: C-Reactive Protein (CRP) is a marker of systemic inflammation often associated with various pathologies, including potentially malignant disorders of the oral cavity. Estimating CRP levels in both serum and saliva could offer valuable insights into the inflammatory status of oral tissues. This study aimed to assess the correlation between serum and salivary CRP levels in individuals with oral potentially malignant disorders.

Materials and Methods: Serum and saliva samples were collected from 50 participants diagnosed with oral potentially malignant disorders. CRP levels were quantified using enzyme-linked immunosorbent assay (ELISA). Pearson correlation coefficient (r) was employed to assess the relationship between serum and salivary CRP levels. Statistical significance was set at p < 0.05.

Results: The mean serum CRP level was found to be 3.8 mg/L (± 1.2 mg/L), while the mean salivary CRP level was 2.5 mg/L (± 0.9 mg/L). Pearson correlation analysis revealed a strong positive correlation between serum and salivary CRP levels (r = 0.78, p < 0.001), indicating a significant association between systemic and local inflammatory responses in oral potentially malignant disorders.

Conclusion: This study demonstrates a significant correlation between serum and salivary CRP levels in individuals with oral potentially malignant disorders, suggesting salivary CRP as a potential non-invasive biomarker for assessing systemic inflammation in oral pathologies. Further research is warranted to explore the utility of salivary CRP in early diagnosis, monitoring, and prognostication of oral potentially malignant disorders.

Keywords: C-Reactive Protein, Oral Potentially Malignant Disorders, Serum, Saliva, Inflammation, Biomarker.

Attenuating Potential of Modified Diets on Testicular Inflammatory Biomarkers in Streptozotocin-Induced Diabetic Wistar Rats

Sun, 10 Mar 2024 00:00:00 +0000

In vascularized tissues, inflammation is a complex and dynamic defensive response to cell injury, infection by bacteria, trauma, or toxins. Inflammatory biomarkers are molecules that regulate the inflammatory response in all immune system cells. Numerous mediators are released from the attack site, and different host immune system cells infiltrate the area during inflammation. Without the combination of regulated leukocyte population migration, different inflammatory mediators, inflammatory biomarkers (acute or systemic inflammatory marker), and subsequent physiologic changes that carry inflammatory responses, it would be impossible to assemble and regulate inflammatory responses. This study focuses on the attenuating potential of modified diets on testicular inflammatory biomarkers in streptozotocin-induced diabetic Wistar rats. Ninety-six adults male Wistar rats were divided into four units, of four groups/unit and each group consisting of six rats. Unit 1 is non-diabetic unit, whereas Units 2, 3, and 4 were induced with type 2 diabetes. While the rats in group one in all the units were fed with standard rat chaw, group 2 received HFD, group three received HPD, while groups four received HCD. Alpha lipoic acid (200 mg/kg body weight) and metformin (50 mg/kg body weight) were also given to the rats in units three and four, respectively. After 12 weeks of treatment and feeding, each rat was euthanized and testes were excised for biochemical analysis. Data were examined using GraphPad Prism. Two-way analysis of variance (ANOVA) was used to examine the mean variations between groups. The Tukey post hoc test was then performed, with p-values of 0.05 being deemed statistically significant. According to the current study's findings, high-protein meals, both by themselves and in conjunction with ALA, reduce blood glucose levels and the inflammatory damage brought on by streptozotocin toxicity. For this reason, they may be utilized to treat diabetes mellitus and autoimmune-induced inflammation.

A PROSPECTIVE OBSERVATIONAL STUDY FOR THE ASSESSMENT OF MEAN PLATELET VOLUME IN ACUTE CORONARY SYNDROME PATIENTS

Divya Lakshmi.V, Ashok Govindaraj, Abishkauf Jenish Beautlin, Binodini — Sun, 10 Mar 2024 00:00:00 +0000

BACKGROUND:

Acute coronary syndrome refers to group of clinical signs and symptoms which includes unstable angina, Non ST segment elevation myocardial infarction(NSTEMI), ST segment elevation myocardial infarction(STEMI). Due to rupture of plaque and results in the coronary thrombus formation. Platelet play a major role in initiation of thrombosis. MPV is useful biomarker for the activity of platelets. Elevated MVP is associated with impaired angiographic perfusion in ACS patients.

AIM:

To evaluate the levels of mean platelet volume in ACS patients.

METHODS:

Prospective observational study was done in 500 patients, Complete clinical details of patients were taken. Blood investigations were done as a part of routine investigation. Platelet count and MPV were determined using STKS automated hematology analyzer (Beckman coulrter). Mean platelet volume is statistically analyzed using Pearson correlation between ACS and control groups and One way ANOVA test between ACS groups.

RESULT:

A total number of 250 cases with ACS and 250 normal healthy individuals were taken up for the study. About 85% of patients with ACS had significantly elevated MPV value compared with control groups. Among ACS groups significant difference was obtained with elevated MPV in STEMI patients compared to NSTEMI and UA.

CONCLUSION:

MPV value was significantly higher in ACS patients and MPV values vary significantly between ACS groups. Hence it can be used as reliable marker for early risk stratification of ACS.

Comparative Analysis of Pre-existing Comorbidities, Symptomology, and Clinical Course of Young and Older Stroke Patients: A Retrospective Study from Aseer Region

Mon, 18 Mar 2024 00:00:00 +0000

Background: Although advanced age is a well-known non-modifiable risk factor for stroke, the prevalence of stroke has been increasing in younger adults. However, only a few studies have instigated the differences in comorbidities and symptom presentation between young and older stroke patients. Therefore, the primary objective of this retrospective study is to systematically compare pre-existing comorbidities, symptoms, and clinical outcomes of young (<45 years) and older (≥ 45 years) hospitalized stroke patients.

Methods: This single-centered study utilized data from Aseer Central Hospital (Abha City, Kingdom of Saudi Arabia) from inception to 2019 to avoid potential confounding effects of the COVID-19 pandemic. Multivariable analysis was performed to detect differences in symptomology and clinical course of young versus older stroke patients.

Results: Young patients were significantly more likely to present with elevated HbA1c [OR=1.927 (95%CI 1.195-3.107); p=0.007] and visual symptoms [OR=16.429 (95%CI 3.92-68.865); p<0.0001] than older patients. However, younger patients were less likely to have pre-existing hypertension [OR=0.0472 (95%CI 0.006-0.342); p=0.003] and T2DM [OR=0.080 (95%CI 0.016-0.392); p=0.002] or present with arm weakness [OR=0.197 (95%CI 0.046-0.844); p=0.028], and slurred speech [OR=0.159 (95%CI 0.035-0.731); p=0.018] than older patients.

Conclusion: Pre-existing comorbidities and stroke symptoms vary considerably between young and older patients.

OPTOMETRY AND PUBLIC HEALTH: BRIDGING GAPS IN VISION CARE ACCESS

Rakibul Hasan Khan — Tue, 19 Mar 2024 00:00:00 +0000

Vision care access is a major public health issue that affects millions of people around the world, especially the most vulnerable and marginalized populations. Optometry is a health care profession that can play a vital role in bridging the gaps in vision care access, by providing comprehensive eye care services, collaborating with other health professionals and stakeholders, and engaging in advocacy and policy making. This article examines the current state of vision care access in the world, the role and potential of optometry in public health, and the best practices and recommendations for optometry and public health. The article uses evidence and examples from the web search results and other sources to support the main points and arguments. The article also discusses the implications and limitations of the findings, and provides a call to action or a direction for future research and practice.

Deep Neck Space Infections Leading To Life - Threatening Condition: Case Series

Wed, 20 Mar 2024 00:00:00 +0000

Abstract

Deep neck space infections typically has odontogenic origin and pose a therapeutic challenge because of the intricate anatomy and the potential for spreading to neighbouring neck spaces.An odontogenic space infection is a perfect example of how minor ailments left unaddressed can escalate into life-threatening conditions in the realm of dental practice. Odontogenic space infections, basically originates from dental sources and potentially spread into the deep fascial spaces in the head and neck due to complex anatomy. Deep space infections can possibly lead to serious complications, including the risk of fatal transformations such as mediastinitis, airway obstruction, Ludwig’s angina and sepsis which can even cause death. We present three such cases that were complicated by deep neck space infection. In one case, the patient presented pain and swelling in the lower left side of face which on clinical examination and pathological findings revealed to be a submandibular space infection which later was spread towards the mediastinum. The second case was necrotizing fasciitis where the patient was unable to maintain oxygen saturation throughout. In the third case, the patient presented with pain and swelling over the right side of the face leading to deep neck space infection causing tracheal compression. The fourth case was again of necrotizing fasciitis which landed the patient in quite critical condition.

Keywords: Deep neck space infection (DNIs), Odontogenic, Risk factors, Mediastinitis, Ludwig’s angina, Necrotizing fasciitis

The Treatment For Radicular Cysts Involves Complete Resection And Immediate Reconstruction Using Rib Bone Grafting: A Case Report

Thu, 21 Mar 2024 00:00:00 +0000

Abstract

Radicular cysts are the most common cystic lesions affecting the jaws which are arise from the epithelial residues in the periodontal ligament as a result of inflammation. They generally result due to pulpal infection following dental caries. Due to destructive growth characteristics of radicular cyst during the intraosseous stage, they appear to reach considerable size, then the treatment often requires complete enucleation and skeletal reconstruction. Here we present the case of a 19-year-old male patient who was come to our department, because of a huge, bulging mass in his right cheek region. Surgery consisted of complete removal of the cyst and immediate reconstruction of the midfacial buttress using an autologous rib graft. This case underscores the nature of the frequently asymptomatic and long-term evolution of maxillary radicular cysts, with their growth causing massive bone destruction for which skeletal reconstruction is required.

Keywords: Maxillary Radicular cyst, Maxillary Reconstruction, Rib bone graft.

The Treatment For Radicular Cysts Involves Complete Resection And Immediate Reconstruction Using Rib Bone Grafting: A Case Report

Thu, 21 Mar 2024 00:00:00 +0000

Abstract

Keywords: Maxillary Radicular cyst, Maxillary Reconstruction, Rib bone graft.

Surgical Treatment Of Unusal Medially Displaced Condylar Fracture: A Case Series

Fri, 22 Mar 2024 00:00:00 +0000

Abstract

Mandibular fractures are the most common type of facial bone fractures. The displacement of the mandibular condyle into the skull following glenoid fossa is known as dislocation of the mandibular condyle into the middle cranial fossa. Medially displaced condylar fractures represent a significant subset of mandibular fractures, posing challenges in diagnosis and management. The etiology and biomechanics underlying medially displaced condylar fractures are discussed, emphasizing the common mechanisms of injury such as direct trauma or indirect forces transmitted through the mandible. The management of medially displaced condylar fractures requires a tailored approach considering various factors including patient age, fracture displacement, associated injuries, and functional outcomes. Surgical techniques such as open reduction and internal fixation gives a better result in achieving occlusion and mouth opening. A guardsman fracture, which is typically observed in elderly people after a fall on the chin, is characterised by bilateral condylar fractures combined with a symphysis fracture. The purpose of this article is to present a case series of condylar fracture with their management.

Keywords: condylar fracture

Retracted

Thu, 28 Mar 2024 00:00:00 +0000

Retracted

Lethal Left Anterior Descending Perforation in Anterior Myocardial Infarction During Primary Percutaneous Coronary Intervention. A Rare Case Finding and Literature Review

Prakoso, Adhitia B, Ardhianto, Pipin, Yolanda, Ega L — Thu, 28 Mar 2024 00:00:00 +0000

Introduction: Artery perforation during Percutaneous Coronary Intervention (PCI), is a rare but potentially life-threatening complication that may occur during cardiac catheterization procedures.

Case Illustration: A 57 years old male with chest pain sought for further medical care due to persistence in chest pain. The clinical case shown is a match for acute coronary syndrome (ACS). During angiography study, perforation occurred seemingly radiates towards distal with every intervention given to stop perforation in the proximal.

Discussion. It is important to assess ACS at once to reduce myocardial death. The potential perforation evident in our observation from the replay may be attributed to severe calcification at the lesion, potentially fostering cavitation-induced plaque rupture, collateral perforation, indicating a blood supply from a ruptured collateral artery, guidewire dissection of subintimal, causing the wire to enter the subintimal space rather than the true lumen of the blood vessel, and may create a small dissection in artery and lead to rupture. Employing an angiographic categorization system proves to be of significant value in guiding the treatment strategy.

Evaluate and measure the changes in retention of mandibular denture by determining the effect of tongue movement on depth & width of anterior lingual flange

Dr. Shabeena Mustafa, Dr.Manmeet Gulati — Tue, 02 Jan 2024 00:00:00 +0000

Abstract

Background: To evaluate the changes in retention of mandibular denture by determining the effect of tongue movement on depth & width of anterior lingual flange.

Materials & Methods:A total of10 healthy male and female edentulous subjects werechosen from the outpatient department. The mean age was 59.58 years. A two-tailed test was used for data obtainedby measuring vestibular depth and width at five different locations from the center of crest using periodontal probe and boley’sguageand, the testing apparatus was used to measure magnitudeof forces required to dislodge the denture bases. The result was analysed using SPSS software.

Results:The conventional border molding technique was used for the patients and range of meandepth of alveolo-lingual sulcus was 1.5 mm to 5.5 mm with standard deviation of ± 0.48210, indicating statistically significant result in retention, mean vestibular depth and width of denture bases after conventional border molding

Conclusion: There is a significant change in the retention of mandibular denture and, also on the depth and width of anterior lingual flange by asking the patient to do wide range of tongue movements. Thus, it’s very important to make the patient do the right tongue movements for recording anterior lingual space to provide seal for better retention and stability of lower denture during functional movements.

Keywords: border moulding, impression technique, retention.

Measure the changes in retention of mandibular denture with extension in sublingual region, evaluate the impression method best suited for patients with mandibular ridge resorption

Dr. Shabeena Mustafa, Dr. Manmeet Gulati — Fri, 05 Jan 2024 00:00:00 +0000

Abstract

Background:Tomeasure the changes in retention of mandibular denture with extension in sublingual region and evaluate the impression method best suited for patients with mandibular ridge resorption.

Materials & Methods:A total of 15 subjects were enrolled. The mean age of subjects was 60.52 years. The subjects were divided with impression of denture bases as group A using conventional technique and group B as mandibular denture bases fabricated using sublingual extension.

Results:A total of 15 subjects were enrolled. Range of means for group A was 11.0 grams to 75.50 grams and standard deviation of ±22.5204.

Conclusion:There was a statistically significant increase in retention, mean vestibular depth and width of denture bases after border molding with sublingual extension as compared to denture bases with conventional border molding.

Keywords: mandibular denture, ridge resorption, retention.

Measure the changes in retention of mandibular denture with extension in sublingual region, evaluate the impression method best suited for patients with mandibular ridge resorption

Dr. Shabeena Mustafa, Dr. Manmeet Gulati — Fri, 05 Jan 2024 00:00:00 +0000

Abstract

Results:A total of 15 subjects were enrolled. Range of means for group A was 11.0 grams to 75.50 grams and standard deviation of ±22.5204.

Keywords: mandibular denture, ridge resorption, retention.

Breathing Exercises in Lung Cancer - A Systematic Review

Jagurothula Bhaskara Rao, Kshitija Bansal — Sat, 30 Mar 2024 00:00:00 +0000

BACKGROUND:

Lung cancer is a leading global cause of cancer-related mortality, with a significant impact on public health. Dyspnea and reduced quality of life are common among lung cancer patients. Breathing exercises have been explored as potential interventions to mitigate these symptoms. This systematic review aims to assess the comparative impact of various breathing techniques on dyspnea and quality of life in individuals diagnosed with lung cancer.

METHODS:

We conducted a comprehensive literature search across multiple databases, including Medline, EMBASE, AMED, and PsycINFO. The eligibility criteria included original research studies, encompassing randomized controlled trials, quasi-experimental investigations, and controlled before-after studies, involving adult individuals diagnosed with lung cancer. We evaluated various breathing techniques, such as diaphragmatic breathing, pursed-lip breathing, and incentive spirometry, and assessed outcomes related to dyspnea and quality of life.

RESULTS

The review included studies from different countries, primarily utilizing randomized controlled trials. The findings revealed that inspiratory muscle training, deep breathing exercises, and diaphragmatic breathing showed promise in reducing dyspnea and improving quality of life among lung cancer patients. Some studies highlighted the benefits of combined interventions, particularly when incorporating aerobic exercise. However, intervention protocols varied across studies, emphasizing the need for standardized guidelines in clinical practice.

CONCLUSION:

This systematic review underscores the potential benefits of breathing exercises in alleviating dyspnea and enhancing the quality of life in lung cancer patients. Multifaceted approaches may offer more comprehensive benefits. Further research with standardized protocols is essential to provide evidence-based recommendations for lung cancer rehabilitation.

Exploring the Benefits of Animal Antioxidants for Optimal Health

Nivedan Bhardwaj, Sachin Yadav, Sanjeet kumari, Babita Sharma — Sat, 30 Mar 2024 00:00:00 +0000

An essential component of human nutrition and health is the study of animal-based proteins, which provide a plentiful source of vital nutrients for physiological functions as well as general wellness. These proteins provide the complete amino acid profile required for the synthesis and maintenance of tissues, enzymes, hormones, and immunological components. They can be derived from a variety of animal sources, including meat, chicken, fish, eggs, and dairy products. Throughout human history, animal proteins have been an integral part of diets, greatly influencing gourmet diversity, cultural traditions, and nutritional sufficiency. We now have a better grasp of the nutritional makeup and functional properties of animal proteins because to developments in food science and technology. This has created space for creative