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Orthodontic intrusion is a common treatment approach in managing orthodontic esthetic and functional problems. Intrusion often constitutes an integral part of orthodontic treatment in order to improve sagittal and vertical incisor relationships. In this article we are trying to review all the appliances in a manner of their evolution, beginning from removal appliances used initially, discussing role of functional appliances, head gears, intrusion arches, implants, magnets and surgical procedures etc. in treatment of intrusion.
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This review article provides information on the role of clinical research site (CRS) Pharmacies in supporting the division of AIDS (DAIDS)-sponsored clinical trials at the CRS, their legislative framework, and how they differ from community pharmacies. These pharmacies are relatively few, and little information is available about their operation, setup, and requirements in low-and middle-income countries (LMICs). The information in this article is pertinent to pharmacy associations and regulators who formulate policies and guidelines and to pharmacy professionals eager to enhance their skills and competencies through knowledge sharing to improve the quality of healthcare services. Moreover, this information is relevant in establishing a CRS pharmacy and understanding its interaction with various administrative and financial institutions. This article provides information on how CRS pharmacies achieve uninterrupted power supply for investigational medicinal products (IMP) throughout the year, the sponsor and regulatory requirements for the CRS pharmacy and the processes for IMP shipment, from its dispensation to the study participants. The article also provides information on quality control and assurance processes for maintaining a CRS pharmacy. CRS pharmacies in LMICs have unique requirements, operations, services, and setups, and regulatory authorities must develop policies and guidelines that align with these distinct features. More so, leveraging the existing CRS pharmacies to disseminate skills and knowledge to trainees, community pharmacies, and other medicine outlets can significantly enhance the quality of health services delivered to the community.
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Background: In today's competitive industrial landscape, companies are focusing on developing diverse product portfolios to maintain a competitive edge. This trend has led to the adoption of product portfolio strategies aimed at enhancing customer satisfaction and optimizing resource utilization. Methods: This study introduces a model to enhance the design of weather radar products by integrating DEMATEL and Goal Programming (GP). The methodology involves identifying key indicators of variety in weather radar design, assessing component interdependencies, and determining component weightage for optimal functionality and cost-effectiveness. Results: The DEMATEL and GP approach proved effective in optimizing the product family structure for weather radar systems. Key results include the identification and prioritization of variety indicators, evaluation of component interdependencies, and determination of component weightage, resulting in a more precise and operational design. Conclusions: The proposed model for weather radar variety enhances customer satisfaction, meets market demands, and addresses the challenges of dynamic customer needs. This methodology offers valuable insights into managing product variety and complexity, enabling designers to quickly adapt to evolving customer requirements.
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Background: With the rapid advancement of machine learning technology, there is a growing interest in integrating it into IoT systems for enhanced functionality. In this study, we propose a SMART Weight Machine system designed to detect, weigh, and price various objects using machine learning techniques. Methods: Our system utilizes TensorFlow, a machine learning framework, in conjunction with Raspberry Pi for object recognition. Image processing is performed locally on the Raspberry Pi for efficient detection. The system also incorporates MySQL for database management and a WebApp developed using PHP and Laravel for the user interface. Results: Through our implementation, we achieved significant improvements in speed and accuracy. TensorFlow's compatibility with microcontroller devices like Raspberry Pi enabled swift processing, resulting in a 96% accuracy rate for object detection during our evaluation. Conclusions: The SMART Weight Machine system demonstrates promising potential for real-world applications. Moving forward, rigorous testing and quality assurance will be conducted to ensure the reliability and accuracy of the system during the development phase.
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Background: Nurses are important health caregivers in Bangladesh. They help to improve health-facilities every day and reach it to helpless people. This study aimed to assess the responsibilities of professional nurses in public health hospitals. Methods: The descriptive cross-sectional study conducted at Rajshahi Medical College (RMCH), Bangladesh from 18 September 2018 to 19 February 2019 included 300 individuals with following inclusion and exclusion criteria. A pre-tested questionnaire was used as a tool for data collection. Results: Majority of participants age range of 31-40y 46.33%, 41-50y 27%, 20-30y, and 51-60y 19% and 7.67%, respectively. Moreover, Female are 96.33% and males constitute only 7.74%. Based on religion, Muslim 87%, Hindu 10%, Christian 1.67%, and Buddhist 1.33%. Beginning of education, diploma was compared to very few with advanced training for instance Master's and Ph.D. 38.67% nurses were 1-5 years of experience. But only 11 had ?21 years of experience. A significant portion, 48.02%, had a good level of assessment of patients and 36.67% of individuals excelled at a high level of proficiency. While only 2% showed an inferior level of patient assessment. Improvement of quality care, the majority of respondents 48.33% good, 17.67% excellent, 21.67% average, and 3.33% poor quality care. Conclusions: Nurses are the key element of the healthcare system. The study outcomes showing their best to provide quality service despite of lack of resources. If the responsible authority has a deep look at this domain, in the future they could make a role model in Bangladesh.
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Background: Cervical cancer is a common gynecological malignancy and public health problem that can be prevented, but the utilization of screening is just 2.6%-5% in India. Healthcare providers mainly nursing personnel are crucial and play a vital role in raising awareness and educating the public about implementation of low-cost cervical cancer screening approaches in low-resource settings. Objectives were to determine baseline information about knowledge of cervical cancer and explore attitude and practice of pap smear screening among staff nurses. Methods: The questionnaire containing mostly recognition and some recall type questions about demographics, knowledge about cervical cancer, its risk factors, screening techniques, attitudes towards cervical cancer screening and its practices and their knowledge was tested. Results: Analyses of knowledge showed that majority of nurses recognized the risk factors and symptoms associated with carcinoma of cervix. A considerable lack of knowledge was observed on the treatment of cervical cancer but a significant portion of nurses knew about prevention. A positive attitude was observed on all aspects of cervical cancer and its prevention. Conclusions: This study demonstrates a good knowledge and positive attitude about carcinoma of cervix and its prevention amongst the nurses which plays a key role in the campaign to prevent cervical malignancy. Poor practice seen in this study emphasizes the need to translate the awareness to practice. Easier availability of HPV testing and better distribution of HPV vaccine is paramount to successfully prevent cervical cancer in future.
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Background: Many men with penile injuries opt out of medical treatment for ethical or psychological reasons, which means the true incidence is likely substantially lower than reported. Urgent medical attention is usually required for acute penile illnesses, which are rare but serious. A vascular, viral, or trauma-related event is usually to blame. Methods: The study was carried out at Narayana medical college in Nellore for a duration of two years, from January 2022 to April 2024.There were four groups vascular group with priapism and spontaneous penile gangrene (n=9) and those with penile fractures, degloving injuries, amputations, and entrapment (n=16) were part of the infected group, whereas patients with penile myiasis were part of the trauma group. The last group consisted of four patients who had paraphimosis. Results: The results showed that 60% of patients who had penile fractures within 6 hours presented for treatment. Every single patient has a torn tunica and one of them even has urethral involvement. Idiopathic causes 62.5% of the eight cases of priapism, and 37.5% of patients presented within six hours. Aspiration with intra-cavernous phenylephrine was the. If they fail to respond, employ the grey hack and water shunt techniques. Conclusions: The incidence of penile injuries is underreported; patients may appear to healthcare providers far later than necessary, and this is largely attributable to psychological and ethical factors, such as shame and fear. However, early and rapid management led to better outcomes.
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Background: Snake bite is a common acute medical emergency faced by rural populations in tropical and subtropical countries. In India, a large proportion of snake bites occur when people are working barefoot in the fields or while walking at night. More than 2,000 species of snakes are known worldwide, of which around 400 are poisonous. These snakes belong to the families Elapidae, Viperidae, Hydrophiidae and Colubridae. Methods: A prospective was done at medicine department of SDH Sawantwadi, Sindhudurgh. Study duration was 3 months (May 2023 to July 2023). Study population included all cases admitted in SDH Sawantwadi with history of snake bite. Sample size was 50. Results: Majority of cases found in the age group of 18-30 years 19 cases (38%) followed by 9 cases in 31-45 age group, 12 in 46-60 age group and 10 cases in 61 and above group. Majority of patients with history of snake bite were males contributing 27 (54%). Snake bites were more common in males as compared to females 23 (46%). 14% snake bite cases have activated partial thromboplastin time (APTT) >30 seconds, 10% of snake bite cases had prothrombin time (PT) >15 sec, 30% had platelet count <100000, increased leucocyte count >11000 was seen in 22% cases and 12% victims showed whole blood clotting test (WBCT) >20 minutes. Clinical outcome was 90% discharged after treatment and 10% death during treatment. Correlation between PT and clinical outcome is significant at p<0.5. Conclusions: Association between PT and mortality among snake bite patients was statistically significant.
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Background: Restoration of the skin barrier after wounding prevents infection, and minimises wound contraction, cosmetic disfigurement and volume depletion. Skin grafting represents an effective solution for large skin defects. Optimum care for donor-site wounds should promote wound healing cost-effectively while preventing complications like pain, infection, and scarring. Healthcare professionals use various dressings and topical agents, but there is no ideal dressing. In our study, we aim to compare the efficacy of chlorhexidine coated tulle gras (CTG) and polyurethane adhesive film (Opsite) in managing donor site wounds in split skin grafts. Methods: This study was conducted at the Department of Surgery, Lokmanya Tilak Municipal Medical College, a teaching hospital and tertiary care centre in Mumbai, from September 2012 to December 2014, following a prospective observational design, with a sample size of 50 patients. Results: The study subjects were predominantly in the 20-30 age group (36.0%) and mostly male (72.0%). The Opsite group reported significantly higher comfort scores (56.0%) compared to the CTG group (36.0%, p=0.002). Healing time was significantly shorter in the Opsite group (7.36�7 days) compared to the CTG group (9.52�39 days, p=0.001). Pain scores were significantly lower in the Opsite group at all observed times. Deviations like soakage and slippage were frequent in the Opsite group (76.0% and 56.0%, respectively). Conclusions: Opsite has advantages over CTG viz. faster healing and re-epithelization, decreased pain, and greater comfort. However, soakage and exudate formation are seen with Opsite.
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Background: Type 2 diabetes mellitus (T2DM) is a prevalent condition, with a significant burden in India, affecting approximately 74.2 million individuals. Vildagliptin, a selective dipeptidyl peptidase 4 (DPP-4) inhibitor, is approved globally for monotherapy and combination therapy. Recently, it became available as a generic product, which increased its accessibility to patients. This study aimed to assess the knowledge, attitude, and practice (KAP) regarding vildagliptin and its combination in T2DM management. Methods: A pan-India cross-sectional KAP survey was conducted from February 2022 to March 2023. The survey utilized a specially designed questionnaire focusing on various aspects of vildagliptin treatment. A total of 1,440 healthcare professionals (HCPs) with recognized qualifications and experience in diabetes management participated. Descriptive statistics were employed for data analysis. Results: HCPs reported initiating Vildagliptin monotherapy at an HbA1c 6.5-7.5%, while combination therapy with vildagliptin and metformin at HbA1c 7-8%. Vildagliptin was primarily preferred as an add-on to metformin. Inadequate HbA1c control with existing therapy emerged as the primary trigger for switching to vildagliptin and metformin combination. Treatment-na飗e T2DM patients with HbA1c 1.5% above target and those uncontrolled on metformin monotherapy or dual therapy were reported to benefit most from combination therapy. Combination therapy was reported to result in a glycemic reduction of 1.0-1.5%. HCPs perceived vildagliptin better than other DPP4 inhibitors due to its efficacy in reducing HbA1c and a lower risk of hypoglycemia. Conclusions: The KAP survey highlights the value Indian HCPs place on the effectiveness and tolerability of vildagliptin and their attitudes and practices in its use, highlighting its clinical utility in routine practice.
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Background: Overactive bladder (OAB) is identified by urinary urgency, with or without urgency urinary incontinence, typically accompanied by increased daytime urinary frequency and nocturia, in the absence of proven infection or other evident pathology. Methods: A cross-sectional, observational, questionnaire-based knowledge, attitude, and practice (KAP) survey was conducted across India from January 2022 to July 2023 to understand OAB therapy through 14 multiple朿hoice questions containing questionnaire shared with 1, 029 healthcare professionals (HCPs), including urologists, surgeons, nephrologists, and consulting physicians. Results: The HCPs see 10-20% of patients daily in clinical practice, wherein 5-10% are females. Patients usually consult general practitioners first and then other specialists. Although anticholinergics are commonly used in the management of OAB, HCPs reported that side effects (57%) and the high cost of therapy (43%) were mainly responsible for discontinuing anticholinergics. Mirabegron was preferred by 67% of HCPs in the treatment of these patients. Mirabegron is also preferred as a first-line treatment by all HCPs in this survey. It is prescribed for 6-12 months, has a response rate of >75% in clinical practice, and offers a more favourable side-effect profile compared to anticholinergics. In cases where patients do not respond to anticholinergics or experience treatment failure, a combination therapy of mirabegron and solifenacin is preferred. Conclusions: The survey highlights the use of mirabegron as a first-line treatment for OAB, its better side-effect profile, and its role in combination therapy with solifenacin for patients unresponsive to anticholinergics, ultimately improving the quality of life of patients.
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Background: Magnesium sulphate (MgSO4) is the most popular anti-convulsant drug for treatment of eclampsia. Pritchard regimen is the most widely used regime worldwide where maintenance dose of MgSO4 is administered for 24-hour after delivery or last fit (whichever is later). As the duration of MgSO4 therapy increases, the incidence of adverse effects also increases. Therefore, the present study has been conducted to compare the maternal outcome with decreased duration of MgSO4 therapy for 12-hour with that of 24 hours for patients with eclampsia. Methods: It was an experimental study which was performed as a single centered, open labelled hospital based randomized control trial. It was conducted for 2 years (December 2019 to November 2021) among the patients of eclampsia admitted at department of obstetrics and gynaecology, AGMC and GBPH. Results: No cases of recurrent seizures in either group with additional benefit of lesser adverse effect of toxicity of MgSO4 in the 12-hour group. Conclusions: In the present study, it has been seen that 12-hour MgSO4 maintenance therapy is as efficacious as standard 24 hours therapy in controlling seizure as there was no case of recurrent seizure in either group.
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Background: Reproductive health (RH) communication between mothers and adolescent girls is critical for fostering knowledge and healthy behaviors. This communication varies significantly between urban and rural settings due to different socio-cultural contexts and access to information. The aim of this study was to compare RH communication with mothers between urban and rural adolescent girls. Methods: This cross-sectional comparative study was conducted from January to December 2020 in Mithapukur upazila (rural) and Rangpur city (urban) in Bangladesh. A total of 112 adolescent girls aged 14 to 17 from class 9 and 10 were interviewed, with 56 girls from each area. Results: Socio-demographic characteristics were similar in both groups. In both urban and rural areas, 67.9% of respondents communicated with their mothers about RH, while 32.1% did not. In the past six months, 58.9% of urban and 57.1% of rural girls had no RH discussions. Menstruation and pubertal changes were the most common topics in both areas, while other RH topics were less frequently discussed. Discussions often began at the onset of menstruation or between ages 9-12, with some starting during high school entry or initiated by the girls themselves, though 32.1% in both areas had not started discussions. The majority were only informed about necessary RH parts. Conclusions: The results of this study demonstrate that RH communication among urban adolescent girls was higher as compared to the rural adolescent girls.
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Background: To effectively manage diabetes, it is crucial to achieve optimal glycemic control by ensuring that A1C levels remain below 7.0%. This study aimed to investigate the impact of Nigella sativa oil (black seed oil, BSO) on glycemic control in alloxan-induced diabetic Wistar rats. Methods: Forty (40) male Wistar rats weighing 200-250 gm were randomly allocated into eight (8) groups of five (5) animals per group. Group 1 received normal saline as the normoglycemic control, while groups 2 to 8 were given alloxan monohydrate to induce hyperglycemia, following the method of Osikwe et al. Following the induction of hyperglycemia, group 2 received normal saline, group 3 received 200 mg/kg of metformin, group 4 received 2 mg/kg of glimepiride, group 5 received 2.5 ml/kg of BSO, group 6 received glimepiride and BSO, group 7 received metformin and BSO, and group 8 received BSO, glimepiride, and metformin. Results: The results showed that BSO significantly reduced fast blood glucose levels compared to the diabetic control group (p<0.05), lowered glycosylated hemoglobin to <7%, and improved pancreatic beta cell function. Conclusions: Black seed oil reduces fasting blood glucose, exhibits synergism with glimepiride, and improves pancreatic beta-cell function in alloxan-induced diabetic Wistar rats.
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Background: Smartphones have simplified our lives and become essential, yet excessive usage may lead to "smartphone addiction". Global youth smartphone addiction is a growing public health concern. Research examines smartphone addiction, depression, anxiety, and depression among university of Baghdad medical and non-medical students. Compare 2 student groups' smartphone addiction rates. Correlate smartphone addiction, anxiety, and depression. Methods: Comparative cross-sectional research included 383 university of Baghdad students from four colleges. The research included undergraduate university students for a random sampling. From March to June 2023, the smartphone addiction scale-short version (SAS-SV), Beck's depression inventory (BDI), Beck's anxiety inventory (BAI), and sociodemographic were self-reported. Results: This survey comprised 383 students, 188 (49.1%) from medical institutions and 195 (50.9%) from non-medical colleges. Their ages varied from 18-25, with a mean of 20.8�8 years. Most were 20-21 (37.9%) and 260 (67.9%) females. According to SAS-SV cutoffs, 45.17% of medical students and 39.5% of non-medical students were smartphone addicts. Depression affected 38.37% of individuals, ranging from mild (10.7%) to moderate (17.75%) to severe-very severe (9.92%). Survey revealed 50.65% had little anxiety, 31.07 moderate anxiety, and 18.28% severe anxiety. Smartphone addiction significantly correlated with anxiety (p=0.0001) and sadness (p=0.008). Smartphone addiction, anxiety (r=0.29), and depression (r=0.25), among research participants, were positively correlated. Conclusions: Smartphone addiction was common among study participants, with medical college students being more hooked than non-medical students. Smartphone addiction is correlated with anxiety and despair. Smartphone addiction predicted anxiety and despair.
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Background: Though stroke in the pediatric age group is not as common as in adults, it is now recognized as an important cause of morbidity and mortality in children. For proper management of childhood stroke, it is very important to know about the spectrum of clinical presentation, risk factors, and neuroimaging features that can affect the outcome following stroke. The aim of the study was to identify predictors of outcomes in children with ischemic stroke treated at a referral neuroscience hospital in Bangladesh. Methods: A one-year prospective cohort study was conducted at the department of pediatric neurology, national institute of neurosciences and hospital (NINS and H), Dhaka, from March 2021 to February 2022. It involved 42 consecutive pediatric ischemic stroke patients aged 1 month to 18 years. Post-operative outcomes were assessed clinically, biochemically, and with imaging at discharge, 1 month, and 6 months post-discharge using the PSOM scale. Statistical analysis was performed using SPSS version 23.0, with significance set at p<0.05. Results: In our pediatric ischemic stroke study (n=42), most patients (76.2%) were aged 1-5 years, with iron deficiency anemia (59.5%) as the predominant risk factor. Anterior circulation stroke was common (90.5%), and PSOM assessments showed 28.6% favorable outcomes at discharge, increasing to 76.2% at 6 months. Seizure, speech difficulty, altered consciousness, and CNS infection were linked to poorer outcomes (p<0.005). Conclusions: Childhood stroke poses significant morbidity, with variable neurological outcomes. Factors like seizure, speech difficulty, altered consciousness, and CNS infection predict poorer outcomes.
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Background: Coronary angiography often detects NOCAD. Stable angina or MI patients may have NOCAD, defined as less than 50% luminal diameter decrease by visual assessment on coronary angiography. The study was to determine the frequency of non-obstructive coronary artery disease in Al Hussain cardiac centre patients who underwent CAG and the differences in clinical presentation and associated morbidity between the two groups. Methods: Cross-sectional research was done at Karbala's al-Hussaini cardiac centre. CAG data from 167 IHD-like patients between January and May 2021. NOCAD 42 individuals (stenosis <50%) were compared to 125 obstructive CAD patients (?50% stenosis). Results: Between January and May 2021, 167 individuals received CAG for diagnostic, therapeutic, elective, or emergency purposes. The study included 113 (67.7%) men and 54 (32.3%) women. Patients had an average age of 56.52�.09 years, with a median of 58 years. Overall, 25.1% (n=42) of research participants had NOCAD. The frequency of INOCA was 29.4% and MINOCA 19.1%. Patients with NOCAD were younger than those with obstructive CAD (p<0.05). no significant gender, co morbidity, or clinical differences across groups. Conclusions: We believe this is the first report of prevalence, risk factors, and clinical aspects in karbalai patients' cardiac care centre in Iraq. NOCAD patients are younger and their medical history, clinical features, ECG, and serum troponin are difficult to distinguish from OCAD.
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Background: Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms among older males. Transurethral resection of the prostate (TURP) still remains the gold standard in the treatment of benign prostatic hyperplasia. However, its availability is not widespread in most public healthcare facilities across sub-Saharan Africa. This study was designed to describe and share our experience of TURP in a single centre. Methods: This is a retrospective evaluation of 64 patients who had TURP for bladder outlet obstruction secondary to enlarged prostate. The records of men who had TURP over a period of one year (January 2022-December 2022) were retrieved and reviewed. The pre-operative prostate specific antigen (PSA), pre-operative ultrasound measured size of prostate, resected weight of prostate, duration of surgery, duration of hospital stay, indication for TURP and complications were analysed. Results: Sixty-four patients had TURP done during the period under review. The age range was 50-90 years (mean 68.33), the pre-operative prostate gland weight was 76.78gm. The mean resected weight was 53.9gm. The pre-operative serum prostate specific antigen PSA had a minimum value of 1.5ng/ml and the maximum was 50.8ng/ml with mean value of 13.8ng/ml. The mean duration of surgery was 55.73 minutes and the mean duration of hospital stay was 3 days. The most common indication for TURP was lower urinary tract symptoms. We recorded four complications; capsule perforation, clot retention, hypotension and stress incontinence, 60 patients had no complications. Conclusions: Transurethral resection of the prostate is an effective surgical treatment for benign prostatic hyperplasia, it is associated notable improvement in the patient抯 quality of life and minimal complications.
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Background: Cesarean section is one form of surgical procedure involving incision of the abdominal and uterine walls, which poses a risk of postoperative pain. Pain is a common issue experienced by women after cesarean section, particularly within the first 48 hours. Uncontrolled pain can lead to physical and psychological complications such as postpartum depression and difficulties in infant care. Pain management may involve pharmacological therapy, but non-pharmacological alternatives such as relaxation therapy like guided imagery need to be explored, which can help reduce post-cesarean section pain. Methods: This study is experimental, utilizing a randomized controlled trial pre-test and post-test control group double-blind design. The research was conducted from July to September 2022. A simple randomized sampling technique was employed, with a sample size of 32 post-cesarean section patients divided into two groups: the treatment group (guided imagery and standard therapy) consisting of 16 patients, and the control group (standard therapy) consisting of 16 patients. Results: The study revealed a decrease in visual analogue score (VAS) scores by -2.875�619 with an effect size of 0.641 in the treatment group. The study had a significant impact with a p value of 0.000 (p<0.05). Conclusions: Guided imagery is effective in reducing the pain level of post-cesarean section patients.
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Background: Breast reconstruction can have a significant impact on the physical, emotional and psychological well-being of patients undergoing mastectomy. The type and timing of breast reconstruction influence the satisfaction index of reconstructed patients. Methods: A retrospective examination was carried out on patient records from 2016 to 2024 at general hospital of Mexico. The analysis encompassed 210 patients who underwent breast reconstruction during this frame time. The BREAST-Q questionnaire was administered in March 2024 and at various intervals during each patient磗 post-operative care. Patients were stratified according to multiple variables such as: oncological therapy, timing of reconstruction, type of reconstruction and educational attainment. Results: The average age of the participants was 50.3 years. In terms of reconstruction timing, 25.24% underwent immediate reconstruction, while 74.76% opted for delayed reconstruction. When it came to BMI, the average was 26.99 kg/m�. Regarding the type of flap used for reconstruction, the majority (82.86%) had a latissimus dorsi flap. The overall demonstrated a mean psychosocial well-being scale score of 76�6. Conclusions: Breast reconstruction goes beyond physical restoration; it can profoundly impact a patient's emotional recovery, self-image, and quality of life. By addressing not only the physical changes but also the emotional and psychological aspects of breast cancer treatment, reconstruction plays a vital role in helping patients move forward with confidence, resilience, and a sense of empowerment. Regardless of when we first contact the patient, it is always worthwhile to provide her with information and the option of reconstruction.