International Journal of Medical Science and Dental Research

Volume 7 Issue 1 (January-February 2024)

    • Correlation and Prediction Value of Glycemic Control (Hba1c) and Duration of Diabetes Mellitus on Cognitive Impairment
      Diabetes mellitus is a disease characterized by hyperglycemia and disorders of carbohydrate, fat and protein metabolism which are associated with absolute or relative deficiencies in insulin action or secretion. There are many insulin receptors in the brain. Some have a role in glucose transport, and some are thought to have a role in cognitive processes.
      Objective: This study aims to determine the correlation and predictive value of glycemic status and duration of suffering from DM on impaired cognitive function.
      Method: Observational analytical study with a cross sectional design involving 100 research subjects with type 2 DM who met the inclusion criteria. Subjects were categorized into groups with controlled (HbA1c ≤7%) and uncontrolled (HbA1c ≥7%) glycemic status. Cognitive function was assessed using the Indonesian version of the Montreal Cognitive Assessment (Moca-Ina). Results: There was a significant relationship between HbA1c levels and impaired cognitive function (p=0.000) and there was a significant relationship between the duration of suffering from DM and cognitive function. (p=0.001). HbA1c levels were significantly positively correlated with the Moca-Ina score (p=0.000) (R= -1.044), apart from that, the duration of suffering from DM was also significantly correlated with the Moca-Ina Score (p =0.001) (R=-7.752). In the ROC curve analysis, it was found that the area under the curve (AUC) of Hba1c was 96.3% with a cut off value of 7.5% and sensitivity of 89.71%

      Keywords:: Glycemic Control, HbA1c, Diabetes Mellitus, Cognitive Impairment

    • A Case Study on Cough Syncope
      Cough syncope is also known as laryngeal vertigo. It is a syndrome occurring with forcefulcoughing caused by a heightened reaction to a strong cough, Chiarimalformation or unusually sensitive heart-depressor response to Valsalva. Characterized by paroxysmal cough, facial congestion, cyanosisandloss of consciousness.we found this case of cough syncope in a 60years male patient presented with dry cough for5 days associated with throatpain,fever for3 days low grade relived on medication, SOB, loss of consciousness 3 episodes each lasting 30sec immediately after severe cough then spontaneously regain consciousness. Based on the subjective, objective and laboratory investigation patient must be diagnosed with cough syncope and treated with conservative management that includesantibiotics, antacids, antiemetic, mucolytic agents, bronchodilators, and antitussivesand the patient was recovered after 3 days.

    • A Comprehensive Review on Kidney Stones, Its Treatment and Recent Advancement
      Kidney stones are very common in India and other underdeveloped countries. In wealthy countries, kidney stones afflicted 10% to 12% of the population. The vast majority of people develop kidney stones later in life. The most common sort of stone seen in both men and women is kidney stones. Kidney stones are caused by a variety of factors, one of which is obesity. Kidney stones are caused by calcium oxalate crystals, a high level of uric acid, and a lack of citrate in the body. Foods high in oxalate, such as cucumber, green peppers, and beetroot, are recommended since a minor reduction in urinary oxalate has been associated to a significant reduction in the development of calcium oxalate stones. Spinach, soya bean, chocolate, rhubarb, popcorn, should all be avoided.The kidneys, ureters, and urethra are the main targets of kidney stones. More importantly, kidney stones are a recurrent condition with a lifetime recurrence risk of up to 50% according to calcium oxalate crystals. Calcium oxalate kidney stones are the most common stone seen in India. There is a higher danger of acquiring heart diseases as a result of kidney stone disorders, which are currently being discovered in India and around the world. This overview looks at the history of kidney stones, the different forms, and the medications used to prevent them, as well as future therapeutic directions. Original and review investigations found kidney stones, as well as their diagnosis and therapy.

      Keywords: calcium oxalate crystals, uric acid stones, surgical treatment, Recent Advancement

      Deep vein thrombosis(DVT) is a life threatening condition characterised by formation of thrombus in the deep veins of pelvis or legs including calf , femoral and popliteal veins which leads to swelling of one (or) both legs associated with throbbing pain usually in calf or thigh, swollen veins. Males are mostly affected than females, it increases with age and accounts 1 in 10000 persons per year.DVT is mostly caused due to hereditary (mutations in the prothrombin gene), acquired (oral contraceptives secondary to cancer, pregnancy, haemophilic treatment) and idiopathic. Apart from these elements, factors that can cause DVT are hypercoagul ability, stasis and endothelial injury.DVT was diagnosed by USG, D-Dimer, MRI, Contrast venography and treated with LMWH,Vit-K antagonists, Thrombolytics. A 12years old female child with chief complaints of left lower limb swelling since 10days associated with pain, unable to walk since morning, H/O trouble in walking from past 10 days and is progressive in nature.H/O using tab ovral-L since 3months for puberty menorrhagia. Child underwent left lowerlimb Doppler study, impression was found to beacute left lower limb DVT extending proximally up to the bilateral common iliac veins. Varicose veins in great saphenous territory. Mild subcutaneous oedema in the thigh, leg, foot and ankle regions. Patient Hb and RBC were below normal, INR was increased to 1.18(0.92-1.09).child was treated with LMWH, antibiotics, antiemetics, analgesics, antacids, foot elevation. The patient lower limb swelling was reduced within 5 days and got discharged.

      Keywords: DVT-Deep vein thrombosis, LMWH- Low molecular weight heparin, endothelial injury,stasis, hypercoagul ability.

    • Comparative Evaluation of Vicryl (Polyglactin 910) and Qubix -PDX suture (Polydioxanone) for tensile strength and microbial adhesion-An invitro study
      A surgical suture is a medical device used to hold tissues together and approximate wound edges after an injury or surgery. Appropriate sutures require specific physical properties such as tensile strength, dimensional stability. lack of memory, knot security and sufficient flexibility to avoid damage to the oral mucosa. Though sutures have a significant role in wound healing they act as a habitat for micro-organisms that can eventually lead to surgical site infection Hence the present study is conducted to assess the tensile strength and microbial adhesion of Vicryl and Qubix -PDX sutures.

      Keywords: Knotless suture, Vicryl suture ,Tensile strength

    • Predetermined Doses of Crystalloid Preload With Crystalloid Coload For Prevention of Hypotension in Parturients Undergoing Caesarean Section Under Subarachnoid Block
      The issue of hypotension following induction of subarachnoid block remains a long standing major area of clinical research. Several studies have been carried out to find lasting solution to this burden, but results are still not quite rewarding. To determine whether predetermined crystalloid coloading will improve maternal haemodynamic control provided by predetermined crystalloid preloading during subarachnoid block for women who undergo caesearean section under subarachnoid block Two hundred women scheduled for emergency caesearean section under subarachnoid block were recruited for the prospective observational study. All the parturients received 1 litre normal saline within 15 minutes before induction of spinal anaesthesia, then had another 1 litre normal saline infusion within 15 minutes following induction of subarachnoid block. Maternal haemodynamics, total rescue fluid and ephedrine used were documented. Incidence of hypotension was 5% among patients who had this combination of crystalloid loading. Among the ten patients who had hypotension, five of them were corrected with fluid. The remaining parturients were corrected with 3mg of ephedrine each. predetermined combination of crystalloid preload in conjunction with predeterminedcoload can be used in the prophylactic method of managing spinal-induced hypotension in women undergoing caesarean section under subarachnoid block.

      Keywords: caesarean section, hypotension, preload, preload-coload, spinal anaesthesia

    • Case Study on A 55-Years old Male With Accelerated Hypertension With Epistaxis
      Accelerated hypertension is characterized by extreme rise of systolic blood pressure (BP) (greater than 180 mm Hg) and diastolic BP (over 130 mm Hg at the time of diagnosis) characterised by renal stenosis, narrowing of aorta, irregular usage of anti- hypertensive, pre-eclampsia, autoimmune disorders which accompanied, by bilateral retinal bleeding, nasal bleed, headache, blurred vision, seizures, confusion and irregular heartbeat. About 1-2 cases per 100,000 people have been reported annually in the United Kingdom, over the past 5 decades. And it is mainly assessed by repeated sphygmomanometer readings, ECG, MRI of brain, RFT and serum electrolytes. Accelerated hypertension is primarily treated with labetalol (beta-blocker), nicardipine (calcium channel blocker) and other class of drugs include ACE inhibitors, diuretics and angiotensin receptor blockers. We came across a case of55-years-old male presents in emergency ward with chief complaints of nasal bleed since 4am in the morning. History of excessive sneeze since 1 month.Patient blood pressure was raised by 210/110 mmHg, and provisionally diagnosed as hypertensive urgency with epistaxis. On day 2 and day 3 patient experienced epistaxis, BP was found to be 160/100 mmHg. Patient underwent 2D echo, USG of abdomen, nasoscopy, CT of head and brain, RFT and CUE. Patient was treated with beta-blockers, anti-fibrinolytic, calcium channel blockers, angiotensin-II receptor blocker and nasal decongestant.The final diagnosis was found to be Accelerated Hypertension with Epistaxis. On day 5 patient vitals was stable and got discharged in stable condition.

      Keywords: Accelerated Hypertension, Epistaxis, Sphygmomanometer, Labetalol, Nicardipine

    • Case Study on Young Male With Myocarditis with Cardiogenic Shock With IWMI
      Myocarditis is a condition characterized by the inflammation of the heart muscles leading to decreased cardiac output. The destruction of myocyte from acute injury results in triggering the innate and humoral immunity systems resulting in long-term cardiac damage, contributing to left-ventricular dilatation and cardiac failure. The clinical manifestations includes fever, myalgias, chest pain, heart palpitations, dyspnoea, fatigue etc. The etiological factors such as infectious and non-infectious agents like viruses, bacteria, protozoa, fungi, toxins, physical conditions may cause myocarditis. A 25 years male patient was presented with complaints of epigastric pain, dyspnoea on exertion since 3 days. H/O fever with chills since 3 months, vomitings (4 episodes), neck pain, generalized weakness, diarrhoea (4-5 episodes). The patient was hypotensive and the ejection fraction was dropped to 15%. Troponin-I levels were elevated. The ECG was abnormal. Serum electrolytes analysis was abnormal. The patient was treated with inotropic agent, vasopressor, antibiotics, antiplatelets, anticoagulants, statins and diuretics. The ejection fraction was improved to 55% and the patient was discharged in a stable condition.

      Keywords: Myocarditis, Cardiac Output, Ejection Fraction, Troponin

    • Wireless Music Control Using Gesture Implementation
      This research article focuses on how gesture recognition technology can be used in wireless music controllers to improve accessibility for people with visual impairments. With over 7 million blind or visually impaired persons in the United States alone and an estimated 2.2 billion people worldwide suffering from vision impairment or blindness, there is an urgent need for creative solutions to raise the accessibility and quality of life for those who are visually impaired. The subject of gesture detection research is booming as a result of developments in game apps and other technologies for smartphones, computers, notebooks, and other portable devices. Originally, the gesture recognition system was built around a wearable hand glove-based sensor, but the cost of production was too high. Sensors based on camera vision are employed nowadays because of their simplicity and convenience of use. Any specific hand, facial, or body pattern or movement used to convey meaning in sign language is referred to as a gesture. Additionally, gestures can be expressed by the placement and combination of still hands. Multiple hand positions can be used to illustrate a continuous motion, whereas one hand position might be used to suggest a stance. To be more specific, the research focuses on volume control by hand gestures using MediaPipe and OpenCV, which is consistent with the broader objective of gesture recognition technology. Using the webcam camera to interpret video, the process involves recognizing hand gestures, particularly those made with the tip of the index finger, and dynamically altering the device's volume in response. The project achieves its objectives with the use of crucial libraries such as MediaPipe, OpenCV, Pycaw, and NumPy. In order to adjust the volume, the camera on the device must first recognize hand landmarks, namely the points that represent the base of the palm and the tip of the index finger. The distance between these points is then used as a proportional measure.

      Keywords: Hand Gesture Recognition, Mediapipe, Human-Computer Interface, Wireless Volume Control

    • Comparison of the Effects of Different Doses of Acetylsalicylic Acid on Thromboxane B2 According to Gender
      Purpose: It is a basic drug with proven antiaggregant and antiplatelate activity in atherosclerotic heart diseases, especially coronary heart disease.Although there are different views on the ideal dose, we aimed to determine whether aspirin (ASA), which we have tried to show its efficacy even at very low doses, creates a difference in efficacy in males and females at very low doses, and therefore we wanted to determine the lowest dose depending on gender.
      Method:In this study, 21 female and 19 male patients who applied to the General Internal Medicine Department of ŞişliEtfal Hospital were included.The patient groups included in the study were divided into four groups consisting of 10 patients each receiving 20mg, 40mg, 80mg and 150mg.Blood samples were taken for serum thromboxane (Tx) B2 examination from all patients before ASA. Then, after 14 days of ASA use, blood samples were taken from the patients again for the second time to detect TXB2 decrease.TxB2 levels were determined by ELISA using acetylcholinesterase and Elimin reagent.
      Findings:The effects of TXB2 formation were similar in all groups, including 20 mg ASA.This similarity was the same between female and male patients and no statistical significance was found between both genders.In both males and females, the 20 mg ASA dose resulted in the same reduction in TXB2 as the other doses. Statistically, there was no difference between all groups. TXB2 formation was similar at all doses.No statistical significance was found between all groups in TXB2 formation after treatment.
      Discussion:The metabolism of some drugs may differ between males and females, especially at very low doses.In our study, we found that the efficacy of a very low ASA dose of 20 mg decreased TXB2 formation at similar and identical rates in both genders. We consider that the use of low dose ASA will be more beneficial in terms of side effects and because it does not cause prostocyclin inhibition.

      Keywords: Antiaggregation ,Acetyl salicylic acid, Prostoglandin, Prostocyclin, Thromboxane

    • Perception on the use of Nitrous Oxide Inhalational Sedation (NOIS) in pediatric dental practice among dental interns in colleges of Mangalore: A Cross Sectional Study
      Aim: The present study aims to assess the perception on the use of nitrous oxide inhalation sedation among dental interns.
      Materials and Methods: The cross-sectional questionnaire survey was conducted among interns from 5 dental colleges located in and around Mangalore city. Questionnaire was prepared using Google forms and circulated among the participants via social media (WhatsApp). Data from Google forms was entered into excel sheets and SPSS 23 software was used for inferential analysis.
      Results: The results of the present study show that almost all participants were aware of the types of sedation used in dental practice. A large proportion (98.1%) of participants were aware of the use of NOIS in dental practice and 72.6% participants somewhat agreed that it was effective. Knowledge on NOIS was acquired from undergraduate curriculum for a majority (94.3%).Regarding the barriers in the way of NOIS use; most participants answered the reason to be a lack of training (75.5%) and 76.4% participants believed that NOIS should be a mandatory component of undergraduate curriculum.
      Aim: NOIS use among dentists requires hands-on training and this should be incorporated into the dental curriculum. This can help increase student confidence levels and preparedness while also ensuring patient safety

      Keywords: Behavior Management, Dental students, Inhalation sedation, Nitrous oxide, Pediatric dentistry

    • Comparison between Immediate and Traditional Dental Implantation Methods: an Overview on Surgical Success and Failures."
      Background: An immediate dental implementation proved to be beneficial on the classic method, however, immediate this method may also lead to a higher implant failure.
      Objective: to compare the negative and positive between immediate and traditional dental implantation methods.
      Methods:a systematic search was conducted peer reviewed publications of any research of immediate and traditional dental implantation methods via Medline, PubMed and Google scholar. Studies were included in the overview based on study characteristics, design and findings.
      Results: the negative and positive between immediate and traditional dental implantation methods were presented including the indications, contraindications, and limitations.
      Conclusion: evidence available indicates that the immediate dental implantation method has been studied extensively and proved as a successful procedure that may benefit patients. However, careful considerations are needed to ensure implant success and final esthetic outcomes.
      Recommendations: further researches should investigate the predicted factors that make both immediate and traditional dental implantation methods fail or success.

      Keywords: Immediate dental implant, traditional dental implant, comparation, success.

    • Radiobiological risks in dental X-ray exposure, «personalized imaging» future of radioprotection strategies
      Introduction: Medical imaging plays an important role in dentistry. Low doses of ionizing radiation can increase the risk of longer term effects such as cancer. A sensitive approach to dental imaging is necessary considering age, gender and other individual radiation sensitivity-related factors.
      Material and methods: A search of PubMed, MEDLINE for a variety of articles, guidelines, reviews, was carried out.
      Results: The search led to 175 publications published between 2004 and 2024. Publication selection criteria were : knowledge of the dentist regarding radiation protection, ionising radiation and its effects, the possible correlation between dental X ray exposure and the cell damage, age and gender-specific radiation sensitivity, individual factor in the radiation respose, radiation protection guidelines.
      Conclusion: These review will contribute to a better understanding of X ray-induced genotoxic and cytotoxic effects, resulting in DNA damage. We propose the consept of «personalized imaging». In accordance with this concept, there is a need to consider the individual factor in the radiation response by taking age, gender and other individual radiation sensitivity-related factors into account. In this way, dentiste can be better evaluate radiation sensitivity and radiation-related disease risk and can contribute to improved radiation protection guidelines, which, will benefit the patient.

      Keywords: Dental imaging, optimization, radiation safety, radiobiological risks, x ray limitation

    • Sonographic Prevalence of Supraspinatus Tendinopathy In Naïve Patients Seeking Care From A General Practitioner Due To Shoulder Pain: A Strobe-Compliant Single –Center Cross-Sectional Study
      The general population experiences a high prevalence of shoulder pain during their lifetime (about 66.7%), and up to 3% of adults consults General Practitioner (GP). Rotator cuff anatomy is intricate, and a meticulous differential diagnosis is necessary to understand the underlying cause of pain: this could be linked to supraspinatus (SP) damage; however SP damage incidence is poorly understood in general practice. The goal of this study is to evaluate the prevalence of supraspinatus (SP) tendinopathy, and explore the association between SP damage and other rotator cuff pathologies using ultrasound shoulder scan (USS) in the general population presenting to a GP surgery with previously undiagnosed shoulder pain. On this basis, 39 patients were enrolled in this study, and USS was performed. Subscapularis (SC), supraspinatus (SS), infraspinatous- teres minor (IS-TM) complex, and biceps long head (BLH) tendons were investigated; moreover, presence of osteoarthritis (OA) signs (e.g. irregular bone profile, cartilage thinning) and joint effusion was also evaluated. Statistical parametric and not-parametric analysis were performed. RESULTS: We found that 65% of the cohort was affected by SP damage; furthermore, almost 90% of the cohort presented other cuff tendon related injuries, and 52% showed osteoarthritis signs ; finally, anatomical injury increased linearly with the age.

      Keywords: General Practice, Shoulder Pain, Supraspinatus damage

    • Gut microbiota and plasma amino acids profile connections in patients with coronary artery disease and atrial fibrillation
      The aim of our work to check the connections between gut microbiota composition and plasma amino acids profile in patients with coronary artery disease (CAD) and atrial fibrillation (AF). Materials and methods: 300 patients were divided into 3 groups: first (CAD) – 149 patients with CAD but without arrhythmias, second (CAD+AF) – 124 patients with CAD and AF paroxysm and control group – 27 patients without CAD and arrhythmias. Plasma AA level was detected by ion exchange liquid column chromatography method. 16-S rRNA sequencing checked gut microbiota composition. Results: The II group patients are characterized by a significant increase in Actinobacter Spp. and a decrease in Blautia Spp., Bacteroides Thetaiotaomicron;a significant increase in glutamate, branched-chain amino acids, Fishers’ ratio, and a decrease in glycine levels (P<0.05). Pathogenic species have such significant correlations: Streptococcus Spp. with tyrosine (r=0.301), phenylalanine (r=0.340), aromatic amino acids (r=0.345), Fishers’ ratio (r=0.319); Escherichiacoli with arginine (r=-0.331), serine (r=-0.337), valine (r=-0.332);(P<0.05). Probiotic species have such significant correlations: Bifidobacterium Spp. with glycine (r=0.505), Fishers’ ratio (r=-0.371); Blautia Spp. with ornithine (r=0.329), glycine (r=0.414), alanine (r=0.316); Eubacteriumrectale. with ornithine (r=0.379), glycine (r=0.467), alanine (r=0.384), Fishers’ ratio (r=0.418);(P<0.05).Conclusions: Plasma amino acids and gut microbiota are closely connected.

      Keywords: coronary artery disease, atrial fibrillation, amino acids, gut microbiota composition, gut microbiota metabolites.