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Ashok Kumar, Kaushik Pandit, Purushottam Chatterjee, Pradip Mukhopadhyay,
Indian Journal of Endocrinology and Metabolism, Volume 25, pp 20-22; https://doi.org/10.4103/ijem.ijem_396_20

Abstract:
Alteration in lipid parameters at birth has a strong association with the development of cardiovascular disease in later life. Sixty-one infants below the age of 6 months underwent evaluation of lipid parameters. The infants studied were categorized into two groups of ≤4 and >4 weeks of age, wherein their lipid parameters were compared. The normal distribution of lipid parameters of infants 4 weeks of age groups were statistically not different (total cholesterol 125.0 ± 30.1 mg/dl vs 127.4 ± 23.4 mg/dl, P = 0.727, and LDL-cholesterol 66.0 ± 19.2 mg/dl vs 75.4 ± 21.2 mg/dl, P = 0.780). However, the HDL-cholesterol and triglycerides measured at ≤4 weeks versus >4 weeks age groups were statistically different (HDL-cholesterol 44.9 ± 17.2 mg/dl vs 36.9 ± 10.8 mg/dl, P = 0.031, and triglyceride 147.4 ± 60.2 mg/dl vs 186.5 ± 75.7 mg/dl, P = 0.030). The mean lipid parameters were significantly more atherogenic compared to the Western population. Triglyceride levels and HDL-cholesterol levels change significantly after 4 weeks of age compared to that observed before 4 weeks of age.
Bharat Kumar, Maya Gopalakrishnan, Mahendra Kumar Garg, Purvi Purohit, Mithu Banerjee, Praveen Sharma, Satyendra Khichar, Nikhil Kothari, Pradeep Bhatia, Vijay Lakshmi Nag, et al.
Indian Journal of Endocrinology and Metabolism, Volume 25, pp 14-19; https://doi.org/10.4103/ijem.ijem_577_20

Abstract:
COVID-19 has emerged as a multi-system disease with the potential for endocrine dysfunction. We aimed to study the hormonal profile of hospitalized patients with COVID-19 at a tertiary care referral hospital at Jodhpur, India. A hospital-based clinical study of endocrine profile of COVID-19 patients conducted from 15th May to 30th June 2020 after ethical approval. Fasting blood samples for free thyroxine (T4), free tri-iodothyronine (T3), thyroid stimulating Hormone (TSH), serum prolactin; basal and 1 h post-intramuscular adrenocorticotropic hormone (ACTH) stimulated cortisol, interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP) were collected within 24 h of admission after written informed consent. All hormones and IL-6 were analyzed by chemiluminescent immunoassay. hsCRP was measured by immune-turbidimetric assay. Of 235 patients studied, 14% had severe disease and 5.5% died. Adrenal insufficiency was present in 14%, most of whom had mild disease. A robust adrenal response was observed in those with severe disease. Basal and post-ACTH serum cortisol were significantly increased in severe disease or those who died compared to those who were mild or asymptomatic. Basal and post-ACTH serum cortisol showed a significant positive correlation with hsCRP but not with IL-6. Low T3 and low T4 syndrome were documented in 25% and 5%, respectively. Serum TSH and FT3 levels declined significantly from asymptomatic to severe category. Hyperprolactinemia was found in 21 patients. hsCRP showed a rising trend with disease severity while IL-6 did not. Endocrine dysfunction in the form of adrenal insufficiency, low T3, and low TSH syndrome and hyperprolactinemia were common COVID-19 hospitalized patients.
Latika Rohilla, , Priyanka Walia, Jaivinder Yadav, Devi Dayal
Indian Journal of Endocrinology and Metabolism, Volume 25, pp 23-30; https://doi.org/10.4103/ijem.ijem_519_20

Abstract:
This study was conducted to investigate the pathway from first symptoms to initiation of insulin regimen in children with new-onset Type 1 Diabetes Mellitus (T1DM) and explore the reasons behind diabetes ketoacidosis (DKA) at onset among children with T1DM. An exploratory study was conducted using a pretested questionnaire, among parents of children diagnosed with T1DM within preceding 3 months. Out of the total 105 children, 56.1% were males. The median age was 7 years. The commonest reported symptoms were polydipsia (97.8%), polyuria (75.2%), and nocturia (75.2%). The mean time taken by parents from onset of symptoms to decide to visit the physician (appraisal gap) was 7.85 ± 7.95 days. The help-seeking gap (from decision-making to visiting a physician) was 3.01 ± 8.31 days, diagnostic gap (from first visit to diagnosis) was 4.19 ± 6.72 days, and the treatment gap (from diagnosis to the start of insulin) was 2.12 ± 6.87 days. The DKA at onset (was present in 39 out of 105 children 37.1%) and was higher among children with lower per-capita income (P-0.017), lack of previous experience among parents (P-0.017), longer appraisal (P-0.023), and treatment gap (P-0.009). Increasing awareness about the diabetes among children among the public and primary healthcare workers can help prevent DKA at onset.
Ipsita Ghosh, Madhurima Basu, Beatrice Anne, Pradip Mukhopadhyay, Sujoy Ghosh
Published: 21 July 2021
Kolsoom Zarei, Amir Musarezaie, Elaheh Ashouri
Iranian Journal of Nursing and Midwifery Research, Volume 26, pp 289-294; https://doi.org/10.4103/ijnmr.ijnmr_284_20

Abstract:
Patients with Gastrointestinal (GI) cancer experience a range of physical and psychological memorial symptoms after developing cancer and beginning to receive medical care. The present study was conducted to investigate the relationship between self-compassion and the experience of memorial symptoms in patients with GI cancer. This descriptive-correlational study was conducted in July to August 2019. The study sample included 190 patients admitted to Seyed Al-Shohada Hospital, with GI cancer who entered the study by convenience sampling. Data were collected using a patient demographic information form, Neff's Self-Compassion Scale (SCS), and the Memorial Symptoms Assessment Scale (MSAS) and then analyzed by Pearson correlation coefficient in SPSS-20. The mean (SD) total score of self-compassion was 86.67 (16.65) out of 130, and the mean (SD) total score of memorial symptoms was 1.40 (0.64) out of 4 in patients with GI cancer. The most frequently reported physical symptom was lack of energy, with an 86.84% prevalence, and the most frequently reported psychological symptoms included worrying and feeling nervous, with 70.52% prevalence rates. The total score of self-compassion was inversely correlated with the total score of memorial symptoms, the score of psychological symptoms, and the score of physical symptoms. Furthermore, the total score of the memorial symptoms was inversely correlated with the scores of all the self-compassion components (p < 0.001). Cancer patients had memorial symptoms in both physical and psychological domains. These symptoms decrease with an increase in self-compassion, so compassion-based educational interventions by nurses can be used to reduce these symptoms.
Nayerhe Namazi, Firozeh Mostafavidarani, Amirmansour Alavinaini,
Iranian Journal of Nursing and Midwifery Research, Volume 26, pp 355-360; https://doi.org/10.4103/ijnmr.ijnmr_297_19

Abstract:
The positive impact of post-needs assessment training on the correction of eating habits is remarkable. The aim of present study was to determine the relationship between cognitive-behavioral processes and stages of change in nutrient use in overweight women referring to health centers in Isfahan. The present study was a cross-sectional study conducted in 2017 during a three-month period. Using systematic random sampling, 260 overweight women referring to Isfahan comprehensive health centers were chosen. Data collection was performed by a four-part researcher-made questionnaire including demographic information form, stages of change of behavior, cognitive and behavioral processes questionnaire, and standard 168-item Food Frequency Questionnaire. After confirming its validity and reliability, it was completed by the researcher. Data were then entered N4 software perfect and analyzed using descriptive and analytical tests (ANOVA and Bonferroni Post-Hoc). 59.30% of the subjects were in an inactive and 40.70% in an active phase. There was a significant difference with respect to different stages of change and the use of all behavior change processes (F4= 11.42, p < 0.001). The rate of using cognitive and behavioral processes increased during the nutrient change behavior (p < 0.001). The results of the study showed that moving away from pre-contemplation stage to maintenance phase increases the rate of using these processes that is due to the stability and improvement of changed behavior. Therefore, health plans should be designed based on the stage of the target group.
Seyed Hamid Seyed-Bagheri, , Mahlagha Dehghan, Fazlollah Ahmadi
Iranian Journal of Nursing and Midwifery Research, Volume 26, pp 324-331; https://doi.org/10.4103/ijnmr.ijnmr_118_20

Abstract:
Teamwork in the health care domain is the preferred mode of care delivery. Few instruments have been developed to assess teamwork in the field of health care, particularly in Iran. This study aimed to validate the Persian version of the Team Assessment Questionnaire (P-TAQ) in care for Congestive Heart Failure (CHF) patients. In this cross-sectional study, the validity (face, content, and construct validity) and the reliability (internal consistency and stability) of the cross-cultural adaptation of the Persian version of the Team Assessment Questionnaire (P-TAQ) were assessed. The P-TAQ had adequate face and content validity. The confirmatory factor analysis confirmed the seven dimensions of the questionnaire. The internal consistency of the P-TAQ was 0.91, and the Intraclass Correlation Coefficient (ICC) was 0.89. The P-TAQ is a valid questionnaire in terms of dimensions and items. Assessing teamwork is an essential component of delivering adequate care. By examining the status of teamwork using this questionnaire, it is possible to promote teamwork and to understand its strengths and weaknesses. Future research is necessary to better understand the P-TAQ so that it can be used for the assessment of teamwork outcomes regarding patient safety, cultural barriers, and medical errors.
Mohsen Torabikhah, , Amir-Hossein Monazami Ansari, Amir Musarezaie
Iranian Journal of Nursing and Midwifery Research, Volume 26, pp 310-315; https://doi.org/10.4103/ijnmr.ijnmr_291_19

Abstract:
Patients undergoing orthopedics surgery experience the most severe postoperative pain. The fasting time is a factor that affects this complication. The aim of this study was to investigate the impact of fasting time reduction by using oral carbohydrate on postoperative pain and analgesic consumption in orthopedic patients. This randomized control trial was conducted between November 2017 and December 2018. Sixty-four patients were randomly assigned into the intervention (which consumed 200 mL of the 12.50% carbohydrate, 2 h before the surgery) and the control group (which was fasted from midnight). Postoperative pain was measured by visual analog scale; the amount of the consumed analgesics was also recorded. The data were analyzed by using Chi-square and t-test. The mean (SD) of the pain scores in the control group immediately and 2, 4, 6, 12 and 24 h after consciousness were 7.19 (2.64), 6.69 (2.17), 6.31 (2.05), 6.16 (2.08), 6.06 (2.24), and 5.38 (1.86), respectively. These scores for the intervention group were 7.44 (1.48), 6.31 (1.25), 5.72 (1.17), 5.59 (1.43), 5.25 (1.13), and 4.97 (1.57). The mean of the pain scores between two groups was not different (p > 0.05). The amount of the consumed morphine (t61= -2.10, p = 0.039), pethidine (t62= -2.25, p = 0.028), and diclofenac (t62= -2.51, p = 0.015) were significantly different between the two groups. The pain intensity in the patients with shortened fasting time was lower, but it was not statistically significant. Moreover, reducing fasting time by using carbohydrate significantly reduced the use of analgesics.
Azadeh Nouri, , Leila Jouybari, Fariba Taleghani
Iranian Journal of Nursing and Midwifery Research, Volume 26, pp 349-354; https://doi.org/10.4103/ijnmr.ijnmr_274_20

Abstract:
Respectful relationship among nurses is an important influencing factor of positive work environment and nursing outcomes. Disrespectful interpersonal behaviors set the scene for an unpleasant and unhealthy workplace in nursing. This can be harmful to persons and their organization and affect health care outcomes. This study was designed in order to search for contextual barriers to respectful behaviors in the context of nursing. This study was a focused ethnography that was carried out in medical-surgical wards of Shahid Chamran Hospital in Isfahan in 2018-2019. The data collection method consisted of 140 h of participant observation and semi-structured interviews with 34 informants. The nformants comprised 29 nurses, 2 assistant nurses, a physician, and 2 patients who were selected by purposive sampling. The first author of the study made direct observations as an outsider. The data were analyzed by Spradley's method. Three main categories and eight subcategories were obtained from data analysis that are as follows: 1) Personal self: challenges of perceived respect (negative self-concept, unpleasant feelings, and ineffective communication), 2) Organizational-based perceived disrespect (poor organizational climate, inadequate job condition, restrictive organizational structure), 3) Social self: challenges of showed respect (implicit social norms, cultural gap). Individual and social attitudes, interactive communication, and organizational factors are the contextual determinants of a respectful workplace in nursing. Consequently, improving self-concept and effective communication skills as well as adjust organizational conditions and value conceptualization in society may effect a respectful workplace in nursing.
Samira Foji, Eesa Mohammadi, Akram Sanagoo,
Iranian Journal of Nursing and Midwifery Research, Volume 26, pp 342-348; https://doi.org/10.4103/ijnmr.ijnmr_178_20

Abstract:
Neurofibromatosis Type 1 (NF1) is a common autosomal disorder; the criteria for the diagnosis of NF1 includes café au lait spots, freckling, and Neurofibromas (NF). Skin symptoms have a major impact on patients' Quality of Life (QOL) but little is known about the burden of the disease on patients. The aim of this study was to explore the experiences of patients with NF. Using purposive sampling, 20 participants were enrolled in this qualitative content analysis study. The study was carried out between 2019 and 2020. Unstructured interviews and field notes were used to gather data. Data collection was stopped when data saturation was achieved. Data analysis revealed 14 subcategories and 4 categories including “failing and falling behind in life”, “deprivation and restriction”, “social isolation”, and “ineffective adaptation to the disease”, which indicate the perception of patients with NF. In addition to the physical burden due to physical complications and problems, NF imposes a high degree of psychological and social burden on patients causing mental conflicts, which in turn results in them failing and falling behind in life. These findings illustrate the need to develop strategies and use multidisciplinary approaches to support patients, and thus to reduce the burden of NF.
Nitesh Tewari, Morankar Rahul Gangadharrao, Vijay Prakash Mathur, Shubhi Goel
Published: 17 July 2021
Ujjwal A Ujala, N R Diwakar
Published: 17 July 2021
Abstract:
Hemangioma is a relatively common benign proliferation of blood vessel that primarily develops during childhood. It is a most common benign tumor of vascular origin is the region of head and neck. The common sites are lips, tongue, buccal mucosa, and palate in oral cavity. Due to aesthetic concern and appearance problems of the hemangioma of lower lip and face it requires appropriate management. This is a case report of a rare hemangioma of lower lip and face bilaterally with involvement of mandible, floor of mouth, oropharynx, anterior 2/3rd of tongue parotid/submandibular glands in a 46-years-old female along the course of facial artery bilaterally with arterial feeders from the facial artery bilaterally, and draining into the jugular veins. This type of case is being reported first time in English literature.
Pallavi Chaubey, Saurav Chandra, Mohammed Ahsan Razi, Seema Qamar
Published: 17 July 2021
Abstract:
Gingival enlargement (GE) is a well-known clinical phenomena with the primary aetiology being plaque and poor oral hygiene. Many reasons for GE have been known. Most of the time good oral hygiene is sufficient to achieve normal healthy gingiva. GE is a heterogeneous group of disorder characterized by progressive enlargement of the gingiva with an increase in submucosal connective tissue elements. Some of them are inherited and iatrogenic while others are idiopathic. In this case, we report a case with massive idiopathic GE in a 9-year-old female child; treatment received, histopathological description and follow-up are discussed.
Lalitkumar P Gade, Snehal D Lunawat, Kiran S Jagtap, Sneha H Choudhary, Monica Mahajani, Vishwas D Kadam
Indian Journal of Dental Research, Volume 32, pp 115-119; https://doi.org/10.4103/ijdr.ijdr_649_19

Abstract:
Grinspan syndrome is characterised by presence of the triad: hypertension, diabetes mellitus (DM) and oral lichen planus (OLP). OLP, seen in hypertension and diabetes mellitus, is caused by drugs used to treat these diseases according to literature, however the incidence of this syndrome in India has not yet been reported anywhere. Hence the present study was conducted with the following objectives: (i) To determine the incidence of Grinspan syndrome amongst tribal and suburban study population of Maharashtra in different gender and age groups (ii) To correlate occurrence of OLP with DM type 2 and hypertension (iii) To find out the number of patients with OLP, DM type 2 and hypertension either alone or in combination. The present study was conducted on 4681 new patients attending the routine outpatient department (O.P.D.) of the dental hospital between January 2017 and December 2018. Patients with OLP or DM (type-2) or hypertension or any combination of these diseases were included in the present study. Brief case history of each patient was recorded. Data thus collected were analysed using SPSS version 20 for Chi-square test. Grinspan syndrome was found in 1.62% of the study population. Syndrome was seen in 1.02% of female and 0.59% of male. Maximum patient affected by syndrome were in 35-50 years of age group. Incidence of Grinspan syndrome was 1.62%, mainly seen in sub-urban females of 35-50 years and OLP seen in hypertension and diabetes mellitus has different etiology and is not caused by drugs used to treat these diseases.
Ajinkya Pawar, Bhagyashree Thakur, Ricardo Machado, Sang W Kwak, Hyeon-Cheol Kim
Indian Journal of Dental Research, Volume 32, pp 104-109; https://doi.org/10.4103/ijdr.ijdr_782_19

Abstract:
The root and canal morphology of maxillary first permanent molars (MFPMs) is a very widely studied issue in endodontics. However, only one study has been conducted to date on this issue using cone-beam computed tomography (CBCT) in India, and the sample consisted of extracted teeth. To investigate the root and canal morphology of MFPMs in an Indian population, by using CBCT. 487 bilateral MFPMs (974 teeth) were assessed and the root and canal morphology were determined according to Vertucci's classification. In addition, the prevalence of a second mesiobuccal canal in the mesiobuccal root (MB2) was correlated with gender, age and arch side. Three roots were most commonly found in the MFPMs regardless of gender (P > 0.05), but this prevalence varied according to the side of the dental arch (P < 0.05). MB2 was present in 77.5% of 3-rooted teeth. Patients above 60 years had a higher incidence of these canals (84.7%) (P < .05). The occurrence of bilateral MB2 was 71.8% in 3-rooted MFPMs. Gender had no significant impact on the occurrence of bilateral MB2 in 3-rooted MFPMs (P > .05). The most common canal configuration was type IV (46.5%) and I (98.9%) in the mesiobuccal and distobuccal roots, respectively (P < .05). The prevalence of MB2 in 3-rooted MFPMs was higher in patients above 60 years of age. The root and canal morphology of MFPMs in an Indian population may have significant variations depending on the dental arch side and patient age.
Vijay Wadhwan, Arvind Venkatesh, Preeti Sharma, Sangeeta Malik, Chitrapriya Saxena
Indian Journal of Dental Research, Volume 32, pp 27-30; https://doi.org/10.4103/ijdr.ijdr_718_18

Abstract:
Oral submucous fibrosis (OSMF) is a chronic progressive scarring oral disease caused due to areca quid chewing. The constituents of areca nut can enter into the circulation by swallowing the liquid mixture of areca quid which evokes oxidative stress on RBC membrane integrity. To study the morphometric characteristics of erythrocytes under light microscopy and to assess the role of areca quid constituents on the morphology of circulating erythrocytes. Peripheral blood smears prepared from blood samples of 50 patients selected according to Lai's classification. Group I: Normal individuals (10 cases); Group II: Mouth opening > 35 mm (10 cases); Group III: Mouth opening 30-35 mm (10 cases); Group IV: Mouth opening 20-30 mm (10 cases) and Group V: Mouth opening < 20 mm (10 cases). The slides were stained with Leishman's stain and assessed by light microscopy. A total of 100 randomly selected RBCs from 5 different fields in each smear were selected and the RBC circumference was measured and tabulated. Data was analyzed using GraphPad Prism 5.03 software. Tukey's multiple comparison test showed statistically significant difference (p < 0.05) between groups I and IV; I and V; II and IV; II and V; III and IV; III and V. These results suggest the possibility of cytotoxic effect of areca quid constituents on circulating erythrocytes in advanced cases of OSMF, which might result in microcytic anaemia.
Arush Thakur, Shuddhodhan Gaikwad, Jagdish Vishnu Tupkari, Easwaran Ramaswami
Published: 17 July 2021
Abstract:
Cemento-osseous dysplasia is non-neoplastic, reactive fibro-osseous lesions that affect the tooth-bearing areas of the jaws. Osseous dysplasia is further divided into three subtypes: Periapical osseous dysplasia, focal osseous dysplasia, and florid osseous dysplasia. We hereby, present a case of florid cemento-osseous dysplasia occurring in a 40-year old dentulous Indian woman. The patient presented with lesions involving the mandibular right and left quadrant.
C V Divyambika, K Satish Srinivas, S Sathasiva Subramanian, S Elengkumaran, N Malathi
Published: 17 July 2021
Abstract:
Accidental detection of asymptomatic clinically suspicious lesions is a common occurrence in routine clinical examination of the oral cavity. In certain cases, these lesions may mimic benign lesions further adding to confusion. In this case report, we have discussed the case of a 51-year-old male patient with an asymptomatic palatal mass which was detected during a routine dental check-up and subsequently confirmed to be an adenoid cystic carcinoma (ACC) arising from the minor salivary glands. The patient underwent right partial maxillectomy followed by radiation therapy and has been disease-free for 6 years and is on follow-up. ACC is a malignant tumour of the salivary glands commonly occurring in the palate, characterized by a slow indolent growth phase, with a high predilection for late recurrences which can be local or systemic. This article describes the importance of recognizing this clinical entity as a differential diagnosis in the evaluation of asymptomatic palatal lesions to enable early diagnosis and institution of appropriate treatment to successfully treat the disease.
Ratheesh Rajendran, K Radhakrishnan Nair, Raghu Sandhya, Anandhu V Krishnan, Aadit Anilkumar, P V Rakhi
Indian Journal of Dental Research, Volume 32, pp 92-97; https://doi.org/10.4103/ijdr.ijdr_238_19

Abstract:
To develop and evaluate the efficacy of synthesised strontium-doped nano hydroxyapatite dentifrice and compare its remineralizing potential with a topical cream containing Casein Phospho Peptide - Amorphous Calcium Phosphate, in remineralizing artificial carious lesion on enamel. Enamel specimens of 4 x 4 x 1 mm were prepared from 90 freshly extracted teeth. Specimens were divided into 3 groups of 30 samples each, based on the type of dentifrice applied that is a control group (Group I) and two experimental groups (Groups II, III). Surface topography and the calcium/phosphorous ratio of all sound specimen were evaluated using Scanning electron microscope and Energy Dispersive X-ray Analysis (SEM-EDAX). The samples in group I and each of the experimental groups were subjected to demineralisation and the calcium/phosphorous ratio of the demineralized specimen were analysed. The samples were then subjected to remineralisation using different agents in each group. Samples in the control group (Group I) were brushed with a conventional dentifrice. In the experimental groups, Group II topical cream with Casein Phosphopeptide and Amorphous Calcium phosphate (CPP-ACP) was used and in Group III laboratory synthesized Strontium-doped nanohydroxyapatite paste (Sr-nHAP), respectively for 28 consecutive days. The samples in the both the control and the two experimental groups were again subjected to SEM-EDAX analysis to analyse the calcium phosphorus ratio following remineralisation cycle. Groupwise comparison of the data was done with one way ANOVA followed by Tukeys Post hoc Test. Both experimental groups (II, III) showed statistically significant remineralisation potential after demineralisation, compared to the control group I. Intergroup comparison showed that the samples in Group III showed the higher remineralisation potential than Group II and was statistically significant. Both CPP- ACP containing tooth cream as well as Sr doped nHAp showed remineralisation potential. Sr doped nanohydroxyapatite showed better remineralisation than CPP ACP and can be considered for enamel repair in incipient carious lesions.
M V Mavishna, Kondas Vijay Venkatesh
Indian Journal of Dental Research, Volume 32, pp 79-86; https://doi.org/10.4103/ijdr.ijdr_328_20

Abstract:
To compare and evaluate the retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals using micro-CT scanning. Forty-five maxillary molars with curved roots were selected after confirming with the Schneiders test. Teeth were decoronated near the cemento-enamel junction and moderate to severely curved canals were selected for the study using cone-beam computed tomography. All the samples were subjected to pre-operative micro-CT scanning. Cleaning and shaping were done using step-back preparation, obturation was done using lateral compaction technique, and homogeneous obturation was achieved. All the specimens were kept in 10 mL of phosphate buffered-saline solution at a pH of 8.4 for 48 h and transferred to a plastic container containing moistened foam with 10 mL of phosphate- buffered saline solution, and stored at 37 °C with 100% relative humidity for 4 months. Retreatment was performed for all the samples using Protaper universal retreatment files. Micro-CT scanning was performed to compare and evaluate the remaining sealer volume and resultant cracks formed in the root canal after retreatment. The volume of sealer remaining in the root canal and the length of a crack within the groups were analysed using kruskal-Wallis test and among the groups using post-hoc scheffe test showed that more sealer present in the Diaproseal sealer followed by MTA Fillapex and Bioroot RCS and more crack length was seen in Diaproseal sealer followed by MTA Fillapex and no visible cracks were seen in Bioroot RCS, which had statistically significant results with a P value of < 0.05. Within the limitations of the study it was concluded that in-terms of retrievability, Diaproseal sealer was the best among the tested groups followed by MTA Fillapex and Bioroot RCS.
Vijay Kumar, Bhavna Sabbarwal, Amrita Jaggi, Pratibha Taneja
Indian Journal of Dental Research, Volume 32, pp 56-60; https://doi.org/10.4103/ijdr.ijdr_904_19

Abstract:
Effective tobacco cessation programs using advice and counselling, have helped a substantial proportion of people quit smoking. Effectiveness of this tobacco cessation counselling needs to be evaluated. The aim of the present study was to evaluate the effectiveness of tobacco cessation counselling and behavioural changes using Multi Theory Model (MTM). A non-randomised uncontrolled trial was conducted on 100 tobacco users visiting dental college in Bangalore. A 28 item questionnaire multi-theory model (MTM) for health behaviour was administered at baseline, 2 weeks, 6 weeks and 12 weeks after providing standardized tobacco cessation counselling (TCC) intervention at baseline. Data were analysed and comparison were made using repeated measure ANOVA and Bonferroni adjustment (p < 0.05). A total of 64 participants completed the 12 week follow-up. The mean age was 44.3 ± 10.1 years and 75.8% were males. There was significantly increase in mean MTM behaviour change score from baseline (32.78 ± 4.8) to 2 weeks (52.37 ± 5.27), 6 weeks (49.81 ± 4.34) and 12 weeks (48.7 ± 3.50) (p < 0.001). There was increase in MTM model scores in subsequent follow up suggesting behavioural changes and overall effectiveness of the Tobacco cessation counselling (TCC) among tobacco users.
Manu Raj Mathur, Matthew Sunil George, Deepti Nagrath, Richard G Watt
Indian Journal of Dental Research, Volume 32, pp 39-43; https://doi.org/10.4103/ijdr.ijdr_607_20

Abstract:
To understand perceptions, attitudes and experiences of school-going adolescents, their parents, teachers and school management towards sugar-sweetened beverages (SSBs). An exploratory qualitative study was undertaken. The study was conducted in selected, mixed, unaided schools in the state of Delhi. Students of classes 8 to 12th, principals of schools, teachers, parents and school canteen owners. SSBs formed an integral part of the diet of adolescents due to its taste and role as a thirst quencher. Respondents had a fair knowledge of health effects of SSBs. However, they were not aware of the range of drinks that constitute SSBs. Respondents associated SSBs with positivity and happiness. Promotion of SSBs by sports and film stars was cited as a major driver influencing consumption of SSBs by young people. SSBs were readily available even though schools had put in measures to restrict their availability in the premises. Peer pressure emerged as a key factor that drove the consumption of SSBs. Advertisements for SSBs involved individuals who were considered role models and these focused on themes that were important for young people such as belongingness, machismo and friendship among others. On the contrary, health promotion messages around obesity or the consumption of SSBs hardly had any brand ambassador or the visibility of campaigns that promoted SSBs.
Radhey Shyam, B C Manjunath, Adarsh Kumar, Ridhi Narang, Geeta Rani, Saumya Singh
Indian Journal of Dental Research, Volume 32, pp 110-114; https://doi.org/10.4103/ijdr.ijdr_835_18

Abstract:
Dental fluorosis is a major endemic oral disease characterized by hypo mineralization of enamel caused due to consumption of water containing high concentration of fluoride during developmental stages of teeth. To assess the prevalence of dental fluorosis among 11-14 years old school children in endemic fluoride areas of Haryana and to find their treatment needs. A cross-sectional study was conducted among 2200 school children in endemic fluoride areas of Haryana (India) for a period of six months. Dental fluorosis was recorded by the Thylstrup-Fejerskov index (TF index) given by Thylstrup A, Fejerskov O. Data entry and analysis were performed using Statistical Package of Social Sciences (SPSS) software version 18.0. Chi square test was used to find association between TFI scores and gender, age categories. The level of significance was set at 0.05. Prevalence of dental fluorosis (TFI) reached 96.6% with most children falling in TFI score 2, 3, 4 and 5 categories. Mean TFI score of study population was found to be 3.19 ± 1.551. There was significant difference found between gender and prevalence of dental fluorosis (P = 0.00). Our findings showed the increased prevalence of dental fluorosis in endemic fluoride areas with mild to moderate level of dental fluorosis.
Lakshanika Yogesh, Nalini Aswath
Indian Journal of Dental Research, Volume 32, pp 69-73; https://doi.org/10.4103/ijdr.ijdr_18_18

Abstract:
An individual's risk towards development of cancer depends not only on environmental factors or extrinsic exposure to carcinogens but also on individual's genetic susceptibility. To determine two genetically established parameters such as prevalence of GSTM1 null polymorphism and analysis of Palmar dermatoglypics (PD) in patients with Oral Leukoplakia (OL) and Controls. Group I (cases) 30 patients with established histopathological diagnosis of OL and Group II (controls) 30 patients without any habits of tobacco, alcohol usage and without OL were selected. After informed consent, the palm prints were recorded using a Canon PIXMA MP250 scanner and 2 ml of blood was collected and transported under cold cycle and taken for evaluation of GSTM1 null polymorphism using Multiplex PCR. There exists a highly significant difference in GSTM1 null polymorphism (p-0.002), Finger ridge patterns (arches- p-0.027, loops p-0.001, whorls p-0.001), hypothenar pattern (p-0.015), ATD angle (p-0.001), AB count (p-0.007) between cases and controls. Similarly, when analysing the GSTM1 null polymorphism with PD among cases, there exists a significant association between loops (p-0.001), AB count (p-0.058) and hypothenar pattern (p-0.076), respectively 43% of OL cases had alteration in both which implies that those patients are at a higher risk of developing cancer. Not all patients who smoke or chew tobacco develop cancer. This could probably be due to the individual's genetic susceptibility. Environment gene interactions, in the form of GSTM1 polymorphism, and carcinogenesis, share links that can help in the prediction of risk for oral cancer development, and use of such markers can aid in prediction of oral cancer susceptibility in exposed individuals. Palm prints once formed do not change throughout life and are not influenced by environment. It can also serve as genetic markers to predict the risk of occurrence of oral cancer.
Farhin A Katge, Devendra P Patil, Pooja J Khakhar, Manohar S Poojari, Paloni B Koticha
Indian Journal of Dental Research, Volume 32, pp 51-55; https://doi.org/10.4103/ijdr.ijdr_613_18

Abstract:
Dental trauma is a serious oral health problem that can impair function and aesthetics, which affects the overall quality of life in children. The aim of the present study was to identify the level of knowledge and awareness of school teachers regarding emergency management of dental trauma in school children of Navi Mumbai. The second objective was to correlate it with demographic characteristics and evaluate the need for oral health education programs for teachers. The present study is a cross-sectional survey and involved the completion of a self-administered anonymous questionnaire by teachers. A total of 559 school teachers of primary and secondary sections completed the questionnaire comprising 19 questions. These included demographic data, knowledge regarding teeth most frequently affected by trauma, immediate action to be taken, awareness about storage media and the use of mouth guards. The questionnaire also assessed the willingness of teachers to participate in future training programs on dental trauma management. Data were statistically analysed using Chi-square test for any correlation. Among 559 school teachers who completed the questionnaire, 75.3% were females and 24.7% were males. Merely 6.6% of them agreed to have received prior training in dental trauma management. The majority of teachers (87.5%) were willing to attend training programs on dental trauma management. The knowledge and awareness of school teachers about dental trauma management and storage media for avulsed teeth is poor. Overall, they have a fair knowledge of dental trauma management in school children.
Suman Mukherjee, Sushama R Galgali
Indian Journal of Dental Research, Volume 32, pp 44-50; https://doi.org/10.4103/ijdr.ijdr_534_19

Abstract:
(1) To assess the risk of Obstructive Sleep Apnea (OSA) using a pre-designed questionnaire; (2) To assess the periodontal parameters like pocket probing depth (PPD) and clinical attachment loss (CAL) in the study subjects and (3) To determine the association between the shared risk factors of OSA and periodontitis. Periodontitis is a microbially associated, host-mediated inflammatory disease that results in the loss of periodontal attachment. It has multifactorial etiology and has been linked to an array of systemic diseases. Though both periodontitis and obstructive sleep apnoea (OSA) share some common risk factors, the insight into the hypothetical speculative link remains vague. This study intended to probe into the association between periodontitis and OSA. A cross-sectional study was conducted on 250 subjects. The subjects were explained the nature of the study and written informed consent was obtained for participation in the study. The patients were administered a STOP-BANG questionnaire following which the periodontal parameters were recorded. The data obtained was analyzed by descriptive and inferential statistics. A statistically significant increase in PPD and CAL scores were seen with the increase in OSA scores. A significant moderate positive correlation was found between OSA scores and PPD [r = 0.58, P < 0.001] and CAL [r = 0.55, P = 0.001]. Males were at increased risk for OSA and periodontitis. Age, hypertension and BMI which are the risk factors for periodontitis were also significantly higher in subjects at high risk for OSA. This study found a moderate positive association between periodontitis and OSA.
Vikram Simha Bommireddy, Viswa Chaitanya Chandu, Harish Chowdary Kommineni, Anu Vijaykumar, Srinivas Ravoori, Gayathri Spandana Neeli
Indian Journal of Dental Research, Volume 32, pp 35-38; https://doi.org/10.4103/ijdr.ijdr_111_20

Abstract:
The regard for dentistry as a profession has been declining over the recent years in light of the increasing number of dental students graduating per year with negligible improvement in the utilization of oral health care services. In this context, it is important to document the perceptions and apprehensions of the current dental students as these feelings would have an influence on the roles they assume as dentists in future. With this background, this study attempts to document the willingness of dental students from three South Indian states to re-choose dentistry given an opportunity. This cross-sectional survey was conducted among house surgeons from 12 dental institutions, 4 each from the southern Indian states of Andhra Pradesh, Telangana, and Tamilnadu. The semi-structured questionnaire used in this study consisted of five primary questions along with details on the participants' gender, type of admission. It aimed at documenting the willingness to re-choose dentistry given an opportunity, and the reasons for their willingness or otherwise. A total of 822 students constituted the final sample. SPSS version 20 software was used to analyse the data. Majority of the study participants were from Tamil Nadu, not reported dentistry as their primary career choice, and demonstrated reluctance in re-choosing dentistry given an opportunity. A significantly higher percentage of dental students from Tamil Nadu reported dentistry as their first professional choice. This observation persisted in the response of students for the question on their willingness to re-choose dentistry. The study results demonstrate the declining interest and regard for dentistry among the current dental students with nominal variations between students from the three South Indian states.
Archana B More, Anisha Rodrigues, Bhakti J Sadhu
Indian Journal of Dental Research, Volume 32, pp 23-26; https://doi.org/10.4103/ijdr.ijdr_711_18

Abstract:
Tobacco smoking is the leading cause of preventable premature mortality in the world. Smoking is also detrimental to oral health, causing unaesthetic tooth staining, bad breath, periodontal diseases, impaired healing of wounds, increased risk of dental implant failure, precancerous conditions and oral cancer. To assess the awareness of the effects of smoking on oral health among smokers in Mangalore city and to assess the smoker's willingness to quit smoking. Cross-sectional study. Data was collected from 140 participants. A cross sectional study was conducted using a self-administered questionnaire to determine the sociodemographic characteristics, awareness about the effects of smoking on oral health and their willingness to participate in smoking cessation programs and to quit smoking. There was statistically significant difference found in the level of awareness of the smoking effects on oral cancer, on tooth staining and dental implants. However, it was observed that the upper socioeconomic class showed a comparatively higher level of awareness than the other classes. No significant differences were found in the level of awareness of the smoking effects on gum disease and on wound healing. One hundred and thirteen individual out of 140 expressed their willingness to quit smoking and also 78 respondents showed a positive attitude toward participation in cessation programs. Participants in this sample had some knowledge about the effects of smoking, but were not much aware of its effect on dental implants, requiring further education.
Puneet Bhardwaj, Zoya Chowdhary, Vandana Sharma, Ravi Ladani, Sonamben Kishorchandra Modi, Sudhanshu Bhardwaj, Kasper D Hundal
Indian Journal of Dental Research, Volume 32, pp 15-22; https://doi.org/10.4103/ijdr.ijdr_566_18

Abstract:
The metabolic syndrome has become one of the major public-health challenges worldwide which include diabetes, prediabetes (raised blood glucose level), abdominal obesity, high cholesterol level, and high blood pressure. Periodontitis is described as a multi-factorial irreversible and cumulative condition and, is also the sixth complication of diabetes. Areca nut chewing has already been linked with the development of various cancers, and more recently with metabolic syndrome. Therefore, the purpose of the study is to investigate the association of periodontal inflammatory conditions among gutka chewing with and without prediabetes patients. There are about 50 pre-diabetic and 50 healthy patients, both males and females with the age range of 18 years to 45 years, were included in the study. They were then divided into 4 groups based upon gutka chewers and non-chewers i.e., pre-diabetic gutka chewers (PDC), pre-diabetic non-chewers (PDNC), healthy gutka chewers (HC), and healthy non-chewers (HNC). A complete demographic data was obtained along with clinical and radiographic parameters i.e. plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), marginal bone loss (MBL) were recorded. A statistical analysis was performed and Bonferroni adjustment post hoc test was performed for multiple comparisons. The overall results suggested that the clinical periodontal parameters i.e., PD, PI, SBI and radiologic parameters i.e., MBL are significantly higher in prediabetes chewers compared with healthy chewers and healthy non chewers. The periodontal inflammatory conditions are worse in gutka chewers compared to non-chewers in healthy and pre-diabetic patients, concluding that the severity of periodontal inflammation is governed by hyperglycemia when compared to habitual gutka usage.
Sonu Singh Ahirwar, Sunil K Snehi, M K Gupta
Indian Journal of Dental Research, Volume 32, pp 8-14; https://doi.org/10.4103/ijdr.ijdr_298_19

Abstract:
Dental caries is a chronic and multifactorial disease mainly caused by microorganisms that are accumulated on soft and hard tissues of oral cavity. Lactobacillus is one of that kind, produces acid after metabolic breakdown of dietary sugar and reduces the pH of oral environment, resulting in teeth demineralisation or dental caries. The present study focuses on the distribution and characterisation of lactobacilli in the oral cavity of children which are associated with dental caries formation. Total 116 swab samples were collected from different age groups of children by swabbing the caries surface of teeth. Physiological, morphological and biochemical characteristics of Lactobacillus were analysed. Whole cell protein profiling using SDS-PAGE was also performed for their characterisation. Molecular characterisation of selected isolates was done using 16S-rRNA sequencing for identification. Total 269 isolates were successfully isolated and identified by physiological and biochemical tests according to Bergey's Manual Systematic Bacteriology, which belongs to the seven species of Lactobacillus i.e., L. acidophilus, L. casei, L. delbrueckii, L. helveticus, L. plantarum, L. rhamnosus, L. salivarius. All the isolates were further differentiated by whole cell proteins profiling and species level identification was done by 16S-rRNA gene sequencing method. The present study, suggested that the occurrence of the species of Lactobacillus changes with the age of the individual, but L. rhamnosus (20.54%) and L. acidophilus (18.21%) were abundantly found in age group of 3-12 yr which could be the possible causative agent of dental caries formation in the children of Central India.
, Syeda Khadija Fatima, Haissan Iftikhar, Fatima Mir
Lung India : Official Organ of Indian Chest Society, Volume 38, pp 326-329; https://doi.org/10.4103/lungindia.lungindia_589_20

Abstract:
The function of Vitamin D in preventing inflammation and infection has been studied previously for different pathologies in different populations globally. Relationships between serum Vitamin D levels and its effect on pulmonary exacerbations in the cystic fibrosis (CF) population are not well studied in our part of the world. Therefore, we aimed to ascertain the Vitamin D status in pediatric and adolescent CF patients and its association with pulmonary exacerbations. A retrospective study was conducted at The Aga Khan University Hospital from 2015 to 2018. Patients of CF with sweat chloride value >60 mmol/l and who had at least one measurement of 25 hydroxy Vitamin D (25 OHD) were included in the study. Annual serum Vitamin D levels were documented for enrolled patients and their past 1-year data were analyzed for pulmonary exacerbations, average length of stay, and tracheal/airway colonization with organisms. 69 patients were included in the study. 28 patients (40.57%) were found to be Vitamin D deficient, 22 patients (31.88%) were Vitamin D insufficient and 19 patients (27.53%) were labeled as Vitamin D insufficient. The average number of exacerbations per year was significantly high in Vitamin D deficient group (3.71 ± 0.96) in comparison with insufficient (3.18 ± 1.09) and sufficient groups (2.26 ± 0.93) (P < 0.001). Vitamin D deficiency is related to an increased number of annual pulmonary exacerbations and pseudomonas infections.
Rakesh K Chawla, Aditya Chawla, Gaurav Chaudhary, Madhav Chawla, Manoj Sareen
Published: 15 July 2021
Lung India, Volume 38, pp 394-395; https://doi.org/10.4103/lungindia.lungindia_706_20

Rohit Munagala, Pranjal Mishra, Atul Lodh, Dhairya Shukla, , Varsha Taskar, Jayanth Keshavamurthy
Published: 15 July 2021
Abstract:
A 53-year-old African American male smoker presented with epigastric pain, tarry stools, and laboratory results indicative of acute pancreatitis. Chest X-ray showed a right perihilar mass with pleural effusion. Computed tomography scan showed multiple large right paratracheal and hilar nodes with internal calcification. The patient underwent a fiberoptic bronchoscopy with biopsies which were negative for malignancy. Mediastinoscopy was performed and revealed amyloidosis. Evaluation for multiple myeloma showed elevated kappa and lambda light chains and diffuse polyclonal gammopathy, but there was no monoclonal spike on serum protein electrophoresis. Bone marrow and abdominal fat pad were negative for amyloid, and the patient continues to lack chronic underlying systemic disease with no symptoms on cardiac or pulmonary examination.
, Karan Madan, Anant Mohan, Ashu Seith Bhalla, Pawan Tiwari, Vijay Hadda
Published: 15 July 2021
Lung India, Volume 38, pp 387-388; https://doi.org/10.4103/lungindia.lungindia_918_20

Christopher M Walker, Christine Y Zhou,
Published: 15 July 2021
Abstract:
Nontuberculous mycobacterial infection, particularly Mycobacterium avium complex (MAC), which is also known as Lady Windermere syndrome usually presents with chronic cough, typically seen in elderly caucasian women who chronically suppress the normal cough reflex. Computerized tomography of the chest in patients with MAC infection can present as a tree in bud nodules, pulmonary nodules, cavity, or consolidation. However, other coexisting diseases such as lung cancer should be kept in mind while investigating these radiographic changes in patients with suspected MAC infection, more so if they have underlying risk factors for malignancy. We present a patient with suspected MAC infection who had co-existing lung adenocarcinoma.
Naveen Kumar, Prabhat Singh Malik, Sachidanand Jee Bharati, Mukesh Yadav, Deepali Jain,
Lung India : Official Organ of Indian Chest Society, Volume 38, pp 338-342; https://doi.org/10.4103/lungindia.lungindia_725_20

Abstract:
The incidence of lung cancer with chest wall (CW) involvement is approximately 5%. Surgical resection with tumor-free margin is the mainstay of the treatment but these patients generally require multimodality management. CW resection for lung cancer is a complex procedure and requires a balance of radical oncological resection and reconstruction. Herein, we shared an experience of primary lung cancer with CW involvement. Outcome analysis of a prospectively maintained lung cancer database was done for the patients having primary lung cancer with CW involvement. All the patients underwent radical surgical resection of the primary tumor along with the CW. Among the 208 patients undergoing surgery for non-small cell lung cancer, 20 (9.5%) were found to have CW involvement radiologically. The most common symptom was chronic cough. A total of 11 patients received neoadjuvant chemotherapy (NACT) and the rest were taken for upfront surgery. Six patients had a partial response to NACT and none of them had tumor progression during the chemotherapy. All the patients underwent en bloc resection of the CW with anatomical resection of lung and systematic mediastinal lymphadenectomy. The mean duration of surgery was 199 min and the average blood loss was 560 ml. Reconstruction was done with a combination of prosthetic mesh and pedicled muscle flap. Median disease-free and overall survivals were 21 and 26 months, respectively. Radical resection with reconstruction is required for optimal long-term oncological and functional outcomes for NSCLC with CW involvement.
, Mana A. Almuhaideb, Meshari A. Alzahrani, Abdulaziz M. Althunayan, Raed M. Almannie
Published: 14 July 2021
Urology Annals, Volume 13, pp 272-276; https://doi.org/10.4103/ua.ua_146_20

Abstract:
Prospective urology applicants in Saudi Arabia must go through a rigorous matching process. Defining which aspects of an applicant's portfolio or interview will get them matched is difficult. Our objective is to provide information on which aspects of an application are the most important. In this cross-sectional study, an electronic survey was sent out to all urology program directors (PD). The survey included 27 items from an application that were rated by the respondent using a 5-point Likert scale. Twenty-three urology PD completed the survey (79.3% response rate). Most of the PD subspecialized in endourology and minimally invasive surgery. The three most important aspects as perceived by all responding PD were as follows: performance during rotation at the respondent's centre, publications in urology, and the total number of electives in urology. The three least important factors were as follows: presentations in fields other than urology, recommendation letters from nonurologists, and quality reference letters from nonurologists. Performance during rotations has been shown in our and other studies to be one of the most important factors in an application. Surveying PD on what they value the most in an applicant, provides valuable information and more transparency regarding the match processes. We also recommend that our colleagues from different specialties conduct similar studies.
Abdulmalik M. Addar, Ahmed Nazer, Abdulmalik Almardawi, Naif Al Hathal, Said Kattan
Published: 14 July 2021
Urology Annals, Volume 13, pp 268-271; https://doi.org/10.4103/ua.ua_53_20

Abstract:
Varicocele is detected in 35%–50% of men with primary infertility and up to 81% with secondary infertility. Various studies have shown that varicocele is related to testicular hypotrophy and impaired spermatogenesis. The effect of varicocelectomy in mild-to-moderate male factor infertility has been well reported. However, only a few studies addressed the impact of varicocelectomy in severe oligospermia. We included 45 patients with severe oligospermia ( 0.05). Four patients (8.9%) were found to have azoospermia after a 6-month follow-up. In these four patients who turned azoospermic had count 6 months). The magnitude of improvement after microsurgical varicocelectomy for severely oligospermic patients is less profound than reported in mild male factor infertility.
Manidip Pal, Ranita Roy Chowdhury, Soma Bandyopadhyay
Published: 14 July 2021
Urology Annals, Volume 13, pp 263-267; https://doi.org/10.4103/ua.ua_52_20

Abstract:
At the initial management of overactive bladder (OAB) syndrome urge suppression technique along with other behavioural modification could be a good option. Prospective experimental study conducted between 2015 and 2019. Women complaining of OAB were enrolled. Three-day bladder diary and patient global impression of severity (PGI-S) scale were evaluated at baseline. Then, the women were asked to perform the urge suppression technique whenever urgency occurred. She stopped moving, sat down and started squeezing the pelvic floor muscle quickly and tightly about ten times without full relaxation in between squeezes. After that, she did something to distract her mind. Once urgency disappeared, she proceeded to the toilet. If urgency reappeared, she stopped moving and repeated the same thing. Only on relax mood she entered toilet. Modified fluid consumption was - total daily requirement divided into three parts and two-third of that was taken from morning to lunch. The remaining one-third was divided again in three parts and two-third of that was taken before evening. Rest few amount was taken from the evening till waking up the next morning. After 3 months, 3-day bladder diary and patient global impression of improvement (PGI-I) scale assessed the improvement. Ninety-one women ultimately completed the study. Frequency and nocturia were reduced. Seventy-six women had improvement of their urgency sensation (P < 0.001), whereas urgency urinary incontinence reduction was statistically not significant (P > 0.05). PGI-I scale showed that 51.6% felt that either they were very much better or much better. Urge suppression and modified fluid consumption is good adjunct in female OAB management.
Khalid Alrabeeah, , Ali Alothman, Saad Abu Melha, Abdullah Alkhayal
Published: 14 July 2021
Urology Annals, Volume 13, pp 254-257; https://doi.org/10.4103/ua.ua_129_20

Abstract:
Microdissection Testicular Sperm Extraction (micro-TESE) is a surgical method used for retrieving sperm from men with non-obstructive azoospermia. Clomiphene citrate (CC) is a selective estrogen receptor modulator (SERM) that stimulates luteinizing hormone (LH) and follicle-stimulating hormone (FSH) production. It is believed that treating patients with CC prior to micro-TESE increases the chance of sperm retrieval. This retrospective study was conducted in a tertiary care center in Riyadh, Saudi Arabia and included all patients who underwent Micro-TESE from August 2015 to November 2018. Data related to the pre-surgery hormonal levels, testicular volume, and associated genetic abnormalities were collected. chi-square and t-test were used to compare variables. A p-value of less than 0.05 was considered significant. A total of 122 patients were included in this study, with 30.0% (n=37) treated with CC. The overall sperm retrieval rate was 44.3%. Micro-TESE results were not statistically affected by age, testosterone levels, Klinefelter syndrome, or taking CC. However, higher testicular volumes and lower LH and FSH levels had more positive micro-TESE results. In conclusion, Micro-TESE results were not affected by CC, age or testicular volume.
Moataz Sait, Abdullah Aljarbou, Raed Almannie,
Published: 14 July 2021
Urology Annals, Volume 13, pp 243-253; https://doi.org/10.4103/ua.ua_42_20

Abstract:
The aim of this study is to assess the knowledge, attitude, and perception pattern of contraception and family planning among males in Saudi Arabia. A cross-sectional study was conducted using a self-administered questionnaire. Study sample were Saudi males who presented to the urology clinics in one tertiary center. Beside demographic data, we evaluate the responders’ knowledge about types of contraceptive methods, usage of one or more methods, reasons for using contraceptives, knowledge of contraception complications, awareness of religious opinion on contraception, the ideal number of children, and birth interval between them. Statistical analysis was performed using the Chi-square and Fisher's exact tests. A value of P < 0.05 was considered statistically significant. Two hundred and forty-three subjects filled the questioner. The participants’ mean age was 42.7 years (range, 19–81); 227 (93.4%) were married. The majority of the participants were aware of the concept of contraception (79%). However, only 54% of the cohort reported using at least one type of contraception. A high percentage of the participants wanted a limited number of children with longer birth intervals. Many factors are responsible for increasing awareness and practice of contraception, additionally; there is limited knowledge and practice regarding male contraception, particularly vasectomy. Withdrawal technique and oral contraceptive pills for females were the most commonly used contraceptive methods for Saudi family planning. The most common reason for using birth control methods was having a lot of children. More than two-thirds of males believed that birth control methods are not prohibited by Islamic law. Younger age, shorter duration of marriage, governmental employee, less number of children, higher education degree, and higher monthly income had higher impact on contraception awareness and utilization. Couples still prefer noninvasive methods for contraception. Despite the relatively low use of contraceptive methods, particularly the male methods, the majority of the participants know about contraception. Efforts to advocate and promote the effective use of reproductive and sexual health services among newly married couples are warranted.
Rahul Gupta, Arti Mahajan, Sunana Gupta, Suhail Masood
Published: 14 July 2021
Urology Annals, Volume 13, pp 258-262; https://doi.org/10.4103/ua.ua_51_20

Abstract:
Introduction: In this study, we retrospectively evaluated the outcomes of flexible uretrorenoscopy (fURS) for removal of solitary renal stones sized up to 15 mm. We evaluated the data of 115 patients who underwent fURS at our unit between Jan 2018 and Dec 2019. All fURS were performed by a single surgeon using Flex-2 flexiscope. Ureteral Access sheath (UAS) of size 9/11 fr was used in all patients. Stones were fragmented using 20 watts laser. Few fragments were retrieved using Nitinol zero tip basket for assessment of the passability of remaining dust and sent for stone analysis. Data pertaining to demographic characteristics, stone size, stone site, operative time, intra and post operative complications were retrieved from the records. Of the 115 patients who underwent fURS, 71 (61.7%) were male and 44 (38.2%) were female. Average age of patients was 32.9±8.9 years; the average body mass index was 22.9±3.9 kg/m2. Average size of the stone was 11.0±1.5 × 10.2±1.3 mm. The stone free rates at the end of 3 weeks and 3 months were 97% and 99%, respectively. fURS is an effective minimally-invasive procedure for removal of single stones up to 15 mm in size. We observed minimal morbidity rates and acceptable stone free rates in our series.
Mayank Jain, , M. Nagabhushan, R. Keshavamurthy
Published: 14 July 2021
Urology Annals, Volume 13, pp 226-231; https://doi.org/10.4103/ua.ua_10_20

Abstract:
PCNL is the treatment of choice for renal stones. But wide array of complications due to larger tract size(>20 Fr) has lead to development of improved techniques like miniPCNL( 51.58 min; p=0.003), lesser radiation exposure (p=0.012), shorter hospital stay (p =0.15), lesser blood loss and lesser post operative pain on POD1 and POD2 (p =0.005, p=0.001 respectively). RIRS group patients sufferred more post op complications (p=0.03 )of which urosepsis was most common. Stone free rate is significantly better(p =0.003) in miniPCNL group on POD1 , while SFR's at 1 month (miniPCNL-90% and RIRS -85%) and 3 month (miniPCNL- 92.5% and RIRS -87.5%) was better in miniPCNL group, but statistically insignificant.On subgroup analysis SFR in lower pole calculus was better in miniPCNL group at 1month and 3 month (p=0.008). Second intervention for stone clearance was required in 3 patients of miniPCNL and 5 patients of RIRS, out of which 4 had lower pole stone.No significant differnce was found in quality of life in both groups at 1 month. MiniPCNL is a better treatment modality for higher single step stone free rate, shorter operative time and fewer postop complication. RIRS has SFR slightly less than miniPCNL but has less radiation exposure and much less post operative pain. There is no significant difference in quality of life in both groups.
, Awatif Alanazi, Abdulmohsin Afaddagh, Samir Eldahshan, Mohammed Alshayie, Ahmad Alshammari
Published: 14 July 2021
Abstract:
Renal cell carcinoma (RCC) in children is relatively uncommon, especially in the absence of syndromes or hereditary diseases. Duplex kidney – as a common congenital anomalies in children – is usually insignificant with no serious impact or known risk of tumor association. Herein, we report a 5-year-old girl who presented with gross hematuria and a right renal mass in duplex system identified on computed tomography. Radical nephrectomy was performed; the patient was diagnosed with Xp11 translocation RCC and no other modalities of treatments were needed over 3-month follow-up.
, Ahmed Ali
Published: 14 July 2021
Abstract:
Bladder endocervicosis describes the ectopic presence of endocervical tissue within the bladder. It is a rare condition with an unclear aetiology. We report the case of a 29-year-old woman who presented with bladder endocervicosis during her first pregnancy with recurrence during her second pregnancy. On both occasions, the patient was treated with transurethral resection and the lesion recurred. This is the first case in the literature of bladder endocervicosis presenting during pregnancy and suggests a hormonal stimulus is important in its development.
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