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Exploring the Perspective of Oral Microbiome Studies in PubMed Database: A Bibliometric Appraisal

Dagli N, Sinha S, Haque M, Kumar S

Cureus, 2024 Feb;16(2):e53824.
PMID: 38332998 DOI: 10.7759/cureus.53824

This research aims to postulate an exhaustive sketch of the current research background on the oral microbiome to emphasize prevailing research trends. On November 25, 2023, a digital exploration was conducted on the PubMed platform. The search strategy employed was- '(Microbiome, Microbiota, Microorganisms, Bacteria, Virus, Fungi) AND (Oral, Dental, Saliva, Plaque, Gingival Crevicular Fluid)'. Inclusive criteria comprised review articles, clinical trials, and meta-analyses. The Biblioshiny app and VOSviewer software were used to create and visualize bibliometric maps for network, thematic, and factorial analyses. The PubMed database search unveiled 215,068 published research studies on the oral microbiome, indicating a fluctuating publication pattern with an all-embracing mounting trajectory. Notably, there was a substantial increase in publications in 2020 and 2021, succeeded by a marked decline in 2022 and 2023. Sichuan University and the International Journal of Molecular Sciences emerged as the most prolific contributors among organizations and relevant sources. Keyword analysis revealed a research emphasis on the COVID-19 pandemic and the SARS-CoV-2 virus since 2019. Thematic mapping categorized key terms into motor, primary, niche, and emerging themes. The emerging terms identified are viral immunogenicity, antibodies, and vaccines, which support the revelation that COVID-19 and related terms will be the most pertinent subjects in oral microbiome studies in the future. Factorial analysis delineated the relationships between topics and subtopics in this domain.
Fulltext Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now

Chowdhury K, Ahmad R, Sinha S, Dutta S, Haque M

Cureus, 2023 Feb;15(2):e35154.
PMID: 36819973 DOI: 10.7759/cureus.35154

Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.
Fulltext Constipation: A Pristine Universal Pediatric Health Delinquent

Chowdhury K, Sinha S, Kumar S, Haque M, Ahmad R

Cureus, 2024 Jan;16(1):e52551.
PMID: 38249647 DOI: 10.7759/cureus.52551

Constipation suffered by children is a global public health problem. Functional constipation (FC) brings about deteriorating effects in the children's lives who suffer from it. The risk factors for the development of constipation include the consumption of a diet low in fiber and high in calories (such as the consumption of fast food), a sedentary lifestyle with a lack of exercise, a family history of constipation, and emotional and psychological stress endured by children in their families. It is one of the most common causes of stomachaches in children. FC may lead to fecal incontinence (FI), anal fissures, recurrent urinary tract infections (RUTI), and enuresis in children. Severe constipation may result in stool becoming rock-hard and inflexible in the rectum, which is clinically identified as fecal impaction. It is imperative to perform clinical evaluation and treatment, including pharmacological (the use of stimulant and osmotic laxatives) and non-pharmacological (education, changes in diet, intervention to promote positive behavior and address any emotional issues, toilet training, and physiotherapy for the pelvic floor) interventions. In the case of refractory patients, neuromodulation, the irrigation of the anal canal, and surgical management may be needed. It is essential to lead a healthy, stress-free lifestyle with plenty of exercise and a balanced diet rich in fiber (such as fruits and vegetables) so children can have regular bowel habits and thrive.
Fulltext Thalassemia: A Review of the Challenges to the Families and Caregivers

Yousuf R, Akter S, Wasek SM, Sinha S, Ahmad R, Haque M

Cureus, 2022 Dec;14(12):e32491.
PMID: 36523854 DOI: 10.7759/cureus.32491

Thalassemias are a group of congenital hemoglobin (Hb) disorders distinguished by dwindling or total curtailment of production of one or more globin chains of hemoglobin tetramers, ensuing in unrestrained destruction of red blood cells (RBC) that causes severe anemia. The severity of the disease often remains immensely variable. Children with thalassemia suffer from the disease's consequences and treatment complications. The disease also causes a negative impact on family members, who suffer mentally, socially, financially, and even physically. In this review, we highlight the challenges experienced by the family and caregivers; for instance, repeated blood transfusion as the dominant origin of tissue casualty, morbidity, and fatal clinical outcomes. Treatment modalities regarding thalassemias were not successful until the inception of bone marrow transplantation and gene therapy.
Fulltext Electrolyte Imbalance Among Bangladeshi Patients With COVID-19

Sharmin Moutushi S, Akter T, Haq MA, Ahmad R, Sinha S, Adnan N, et al.

Cureus, 2023 Feb;15(2):e35352.
PMID: 36860825 DOI: 10.7759/cureus.35352

Introduction Infection with SARS-CoV-2 begins in the lower respiratory tract, but COVID-19 often involves the renal system, resulting in serum electrolyte imbalance. Monitoring serum electrolyte levels and parameters of liver and kidney function is essential to understand disease prognosis. Objectives This study aimed to determine the effect of imbalances in serum electrolytes and other parameters on COVID-19 severity. Material and method This retrospective study comprised 241 patients, ages 14 years and older, including 186 patients who were moderately affected and 55 who were categorized as severely affected by COVID-19. Serum electrolytes (sodium (Na+), potassium (K+), and chloride (Cl-)) and biomarkers of kidney and liver function (creatinine and alanine aminotransferase (ALT)) were measured and correlated with disease severity. This research was conducted among admitted patients of Holy Family Red Crescent Medical College Hospital designated into two groups based on retrospective hospital records. Individuals with moderate illness had evidence of lower respiratory tract infection (cough, cold, breathless, etc.) during clinical assessment or imaging (chest X-ray and computed tomography (CT) scan of the lungs) and have an oxygen saturation by pulse oximetry (SpO2) ≥ 94% on room air at sea level. The severely ill group involved individuals with SpO2 ≤94% on room air at sea level and respiratory rate ≥ 30 breaths/minute, and critically ill patients are those who needed mechanical ventilation or required intensive care unit (ICU) care. This categorization was based on the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines (https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/). Results Average Na+ and creatinine increased by 2.30 parts (95% confidence interval (CI) = 0.20, 4.81, P = 0.041) and 0.35 units (95% CI = 0.03, 0.68, P = 0.043) in severe cases compared with moderate cases. Older participants had relatively Na+ lowered to -0.06 parts (95% CI = -0.12, -0.001, P = 0.045), significant Cl- reduction by 0.09 units (95% CI = -0.14, -0.04, P = 0.001), and ALT by 0.47 units (95% CI = -0.88, -0.06, P = 0.024), whereas serum creatinine was increased by 0.01 parts (95% CI = 0.001, 0.02, P = 0.024). The creatinine and ALT of COVID-19 participants were significantly higher in males by 0.34 units and 23.2 units, respectively, compared with females. In severe COVID-19 cases compared with moderate cases, the risks of hypernatremia, elevated chloride levels, and elevated serum creatinine levels were increased by 2.83-fold (95% CI = 1.26, 6.36, P = 0.012), 5.37-fold (95% CI = 1.90, 15.3, P = 0.002), and 2.00-fold (95% CI = 1.08, 4.31, P = 0.039), respectively. Conclusion Serum electrolyte and biomarker levels can serve as good indicators of the condition and disease prognosis of patients with COVID-19. Our purpose in this study was to determine the association between serum electrolyte imbalance and disease severity. We collected data from ex post facto hospital records and did not intend to assess the mortality rate. Consequently, this study expects that the prompt diagnosis of electrolyte disparity or disturbance possibly minimizes COVID-19-related morbidity and mortality.
Histological Study on the Thickness of Gray Matter at the Summit and Bottom of Folium in Different Age Groups of Bangladeshi People

Nitu NS, Sultana SZ, Haq A, Sumi SA, Bose SK, Sinha S, et al.

Cureus, 2023 Jul;15(7):e42103.
PMID: 37476298 DOI: 10.7759/cureus.42103

Context The cerebellum is a part of the hindbrain and consists of cortical gray matter (GM) at the surface and a medullary core of white matter (WM). The GM contains a cell body of neurons that helps process and transmit any command type through nerve fibers found in the WM. The main functions of GM in the central nervous system empower persons to control motor activity, recollection, and passion. So, this research aims to assess the thickness of GM at the summit and bottom of folia by histologically studying the cerebellum cortex. Methods The collection of data was a descriptive type of cross-sectional study. The method was the purposive type. This study was conducted from August 2016 to March 2017, and the research was carried out at Mymensingh Medical College's Department of Anatomy, Bangladesh. Specimens containing cerebellum were preserved from Bangladeshi cadavers according to sexes and ages ranging in years. We chose fresh specimens from people who died within the last 12 hours and preserved them in 10% formol saline. The size of the tissue that was collected for the histological study was not more than 2 cm2 and not more than 4-5 mm thick. Then the tissue was placed in 10% formol saline. This fluid was used for quick fixation and partial dehydration of the tissue. After dehydration, each tissue segment is processed for infiltration and embedding separately. Every section was stained with hematoxylin and eosin stain (H&E) before being coated with dibutyl phthalate polystyrene xylene (DPX) coverslips on slides. Result The mean (±SD) thickness of GM at the summit of folium was 886.2±29.7µm in Group A, 925.2±25.9µm in Group B, 912.7±22.3µm in Group C, and 839.9±40.7µm in Group D. Mean (±SD) GM thickness at the bottom of the fissure was 395.6±12.2 µm, 403.9±26.0µm, 380.4±23.4 µm, and 375.8±28.8 µm in Groups A, B, C, and D respectively. Conclusion The thickness of the cortex is an essential factor in the normal development process, and it was similar in the current study. Normal aging, Alzheimer's disease, and other dementias cause reduced GM which makes the cortical sheet thin. Huntington's disease, corticobasal degeneration, amyotrophic lateral sclerosis, and schizophrenia are all examples of neurological disorders. Cortical thinning is typically locally localized, and the progression of atrophy can thus disclose much about a disease's history and causal variables. The present study correspondingly found that GM was reduced after the age of 50 years onward. Furthermore, longitudinal investigations of cortical atrophy have the potential to be extremely useful in measuring the efficacy of a wide range of treatments.
Fulltext The Protective Effect of Oxitard on Sperm Function and Antioxidant Status in Rats Exposed to Swimming Stress

Prashad SV, Prajapati K, Moharir G, Ojeh N, Sinha S, Kumar S, et al.

Cureus, 2023 Jun;15(6):e40381.
PMID: 37325690 DOI: 10.7759/cureus.40381

BACKGROUND: Infertility is a significant public health issue, but its impact on quality of life and treatment efficacy is limited. Modern medicine lacks safe and effective drugs for male infertility, while traditional medicine has explored herbal extracts like Oxitard, which contains multiple extracts and oils. This study aimed to investigate the effects of Oxitard on male rats exposed to swimming (SW) stress.
METHODS: Albino rats weighing 220-250 g were divided into five groups: control, SW stress, and SW treated with Oxitard at low, medium, and high doses of 250, 500, and 750 mg/kg/day, respectively. The rats were subjected to SW stress for 15 days and then assessed for body weight, reproductive organ weight, testosterone, antioxidant status, sperm function, and histological changes in the testes, seminal vesicles, and vas deferens.
RESULTS: The results showed that SW stress significantly reduced body weight, seminal vesicle weight, testosterone levels, superoxide dismutase (SOD), catalase (CAT), sperm count, sperm motility, sperm viability, and significantly increased malondialdehyde (MDA) levels. The testes of the SW-stress group rats also showed a significant decrease in spermatogenesis and the number of seminiferous tubules containing sperm. In contrast, treatment with Oxitard, especially at the highest dose, demonstrated potent free radical scavenging activity, recovering antioxidant status, and sperm function.
CONCLUSION: SW stress led to decreased sperm function, antioxidant status, and increased lipid peroxidation (LPO) in male rats. Oxitard treatment, particularly in high doses, showed a potential role as a free radical scavenger in treating oxidative stress (OS)-associated male infertility. Further studies are needed to investigate the individual components of Oxitard and conduct clinical trials in human subjects.
Fulltext Metformin: A Review of Potential Mechanism and Therapeutic Utility Beyond Diabetes

Dutta S, Shah RB, Singhal S, Dutta SB, Bansal S, Sinha S, et al.

Drug Des Devel Ther, 2023;17:1907-1932.
PMID: 37397787 DOI: 10.2147/DDDT.S409373

Metformin has been designated as one of the most crucial first-line therapeutic agents in the management of type 2 diabetes mellitus. Primarily being an antihyperglycemic agent, metformin also has a plethora of pleiotropic effects on various systems and processes. It acts majorly by activating AMPK (Adenosine Monophosphate-Activated Protein Kinase) in the cells and reducing glucose output from the liver. It also decreases advanced glycation end products and reactive oxygen species production in the endothelium apart from regulating the glucose and lipid metabolism in the cardiomyocytes, hence minimizing the cardiovascular risks. Its anticancer, antiproliferative and apoptosis-inducing effects on malignant cells might prove instrumental in the malignancy of organs like the breast, kidney, brain, ovary, lung, and endometrium. Preclinical studies have also shown some evidence of metformin's neuroprotective role in Parkinson's disease, Alzheimer's disease, multiple sclerosis and Huntington's disease. Metformin exerts its pleiotropic effects through varied pathways of intracellular signalling and exact mechanism in the majority of them remains yet to be clearly defined. This article has extensively reviewed the therapeutic benefits of metformin and the details of its mechanism for a molecule of boon in various conditions like diabetes, prediabetes, obesity, polycystic ovarian disease, metabolic derangement in HIV, various cancers and aging.
Fulltext Iontophoresis-Infused Deep Topical Anesthesia and Injectable Local Anesthesia for Dental Procedures Among Pediatric Patients: Performances and Consequences

Mistry H, Fernandes S, Haq MA, Bafna Y, Bhatt R, Sinha S, et al.

Cureus, 2023 Aug;15(8):e43748.
PMID: 37600432 DOI: 10.7759/cureus.43748

INTRODUCTION: Exploring routes of needle-free anesthesia has drawn particular attention to the iontophoretic technique. Iontophoresis has a wide range of applications in dentistry, treating hypersensitivity, oral ulcers, non-invasive procedures of deep topical anesthesia, etc. Hence, this research was performed for a comparative assessment of topical anesthesia spray infused via iontophoresis and local anesthesia (LA) infiltration for dental procedures among 5-12-year-old patients.
MATERIALS AND METHODS: A split-mouth, randomized clinical trial was undertaken over two years among study subjects aged 5 to 12 years. They were randomly assigned to one of two groups: the first (Group A - iontophoresis group) received topical anesthesia spray (Lidayn®; Pyrax Polymers, Roorkee, India) applied by iontophoresis, and the second (Group B - LA infiltration group) received local infiltration of 2% lignocaine solution (LignoTer®; Lusture Pharma, Ahmedabad, India), where primary teeth extraction or pulpectomy was performed. The Wong-Baker Facial Pain Rating Scale (WBFPRS) was used for a subjective assessment immediately following anesthesia.
RESULTS: The mean value of current intensity for the extraction procedure was 9.43±0.95 mA, and the duration of application was 1.85±0.80 minutes. The mean value of current intensity for pulpectomy was 9.07±1.34 mA, and the time was 2.40±0.74 minutes. In inter-group comparison, WBFPRS scores were lower in Group A (1.96±1.64) compared to Group B (3.62±1.11), which was statistically significant with p=0.001.
CONCLUSION: Compared to local infiltration, iontophoresis as a non-invasive approach for topical anesthesia was more well-received by pediatric patients.
Clinical and Radiographic Evaluation of Autologous Platelet-Rich Fibrin With or Without Demineralized Bone Matrix in the Treatment of Grade II Furcation Defects

Patel B, Joshi S, Nagrani T, Girdhar GA, Patel H, Sinha S, et al.

Cureus, 2023 Aug;15(8):e44394.
PMID: 37654905 DOI: 10.7759/cureus.44394

Introduction This study aims to differentiate the employment of demineralized bone matrix (DMBM; Osseograft, Advanced Biotech Products (P) Ltd, Chennai, India) and platelet-rich fibrin (PRF) alone to a composite graft consisting of both materials in the surgical actions toward the anomalies of the human periodontal furcation imperfection. Methods In a split-mouth study, 30 patients with mandibular molars affected by the furcation were allocated without conscious choice to test (PRF + DMBM, n = 30) or control (PRF, n = 30) categories. At the starting point, three months after surgery, and six months later, the following modifiable factors were evaluated: probing pocket depth (PPD), full-mouth plaque scores, full-mouth gingival scores, radiographic defect depth, relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). Results Results at three and six months demonstrated substantial differences between baseline values for both treatment methods in clinical and X-ray imaging appraisal. Nonetheless, the PRF/DMBM group manifests statistically significantly soaring changes observed in comparison to the PRF group. Overall, the probing depth (PD) in the test site was significantly lower than that in the control site, showing a reduction of 68% (95% CI=41%, 95%, p<0.001). Conclusion Clinical indications significantly improved with PRF and DMBM combined instead of PRF alone. On radiographs, the test group also showed higher bone fill.
Fulltext Use of Injectable Platelet-Rich Fibrin Accompanied by Bone Graft in Socket Endurance: A Radiographic and Histological Study

Nagrani T, Kumar S, Haq MA, Dhanasekaran S, Gajjar S, Patel C, et al.

Cureus, 2023 Oct;15(10):e46909.
PMID: 37841989 DOI: 10.7759/cureus.46909

Background Ridge preservation became a crucial dental health issue and strategy to keep away from ridge defacement after post-tooth loss. The recent scientific evolution of platelet-rich fibrin (PRF) comprises a parenteral formulation of PRF. The combined allograft for socket preservation gives benefits. In this study, bone allografts, demineralized freeze-dried bone allografts (DFDBA) and freeze-dried bone allografts (FDBA) are used in a 30:70 ratio alone or in combination with injectable PRF (I-PRF) for socket preservation. Methods This study is a radiographic and histological examination conducted on 60 participants aged between 19-65 years. Participating patients agreed voluntarily that they would not bear any fixed prosthesis for the next nine months and plan for implanted teeth placement, including multi-rooted mandibular molars denticles. Both groups received atraumatic extraction; then, the socket was preserved with bone allograft alone in the control group and bone allograft mixed with I-PRF, forming sticky bone, in the experimental group. Clinical, radiological, and histological assessments were taken at the inception stage, three months, six months, and nine months. A multivariate regression model and a generalized estimating equation (GEE) model were used to analyse the effects of these changes on outcomes. Results In all the parameters, the test group indicated a good amount of bone growth with increasing intervals of time for bone height radiographically with statistically significant difference present (p<0.05) and histologically after nine months when socket site grafted with bone graft in combination with I-PRF. Conclusion This study's results demonstrated that I-PRF possesses the potential to regenerate and heal in the tooth-extracted socket. This study further recommends the implementation of I-PRF in safeguarding and conserving the raised rim of the tooth. Future research should take place on the osteogenic capability of I-PRF in more comprehensive ridge accession surgical procedures and additional expanding and improving capacities in periodontal reconstruction.
Fulltext The Laboratory and Clinical Perspectives of Magnesium Imbalance

Ab Rahim SN, Nordin N, Wan Omar WFA, Zulkarnain S, Kumar S, Sinha S, et al.

Cureus, 2023 Dec;15(12):e49835.
PMID: 38045630 DOI: 10.7759/cureus.49835

Magnesium (Mg2+) is a predominantly intracellular cation that plays significant roles in various enzymatic, membrane, and structural body functions. As a calcium (Ca2+) antagonist, it is imperative for numerous neuromuscular activities. The imbalance of body Mg2+ concentration leads to clinical manifestations ranging from asymptomatic to severe life-threatening complications. Therefore, the contribution of Mg2+ measurement regarding various laboratory and clinical aspects cannot be ignored. Mg2+ is often described as the forgotten analyte. However, its close relationship with body potassium (K+), Ca2+, and phosphate homeostasis proves that Mg2+ imbalance could co-exist as the root cause or the consequence of other electrolyte disorders. Meanwhile, several preanalytical, analytical, and postanalytical aspects could influence Mg2+ measurement. This review highlights Mg2+ measurement's laboratory and clinical issues and some analyte disturbances associated with its imbalance. Understanding this basis could aid clinicians and laboratory professionals in Mg2+ result interpretation and patient management.
Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

Nordin N, Ab Rahim SN, Wan Omar WFA, Zulkarnain S, Sinha S, Kumar S, et al.

Cureus, 2024 Mar;16(3):e57243.
PMID: 38559530 DOI: 10.7759/cureus.57243

The accuracy of diagnostic results in clinical laboratory testing is paramount for informed healthcare decisions and effective patient care. While the focus has traditionally been on the analytical phase, attention has shifted towards optimizing the preanalytical phase due to its significant contribution to total laboratory errors. This review highlights preanalytical errors, their sources, and control measures to improve the quality of laboratory testing. Blood sample quality is a critical concern, with factors such as hemolysis, lipemia, and icterus leading to erroneous results. Sources of preanalytical errors encompass inappropriate test requests, patient preparation lapses, and errors during sample collection, handling, and transportation. Mitigating these errors includes harmonization efforts, education and training programs, automated methods for sample quality assessment, and quality monitoring. Collaboration between laboratory personnel and healthcare professionals is crucial for implementing and sustaining these measures to enhance the accuracy and reliability of diagnostic results, ultimately improving patient care.
Red Cell Distribution Width and Mean Corpuscular Volume Alterations: Detecting Inflammation Early in Occupational Cement Dust Exposure

Ahmad R, Haq MA, Sinha S, Lugova H, Kumar S, Haque M, et al.

Cureus, 2024 May;16(5):e60951.
PMID: 38784687 DOI: 10.7759/cureus.60951

Introduction Cement dust emitted during cement manufacture consists of toxic components. Occupational cement dust exposure may cause inflammation in the human body, which may be detected early by observing changes in blood parameters such as red blood cell distribution width (RDW) and mean corpuscular volume (MCV). Objectives The study aims to observe the effect of occupational cement dust exposure on RDW and MCV. Methods This study was performed in the Department of Physiology of Dhaka Medical College, Dhaka, Bangladesh, and a factory in Munshiganj, Bangladesh, from September 2017 to August 2018. Ninety-two participants between 20 and 50 years were included (46 subjects were occupationally exposed to cement dust, and 46 were not exposed to cement dust). A pre-designed questionnaire was used for data collection. An independent sample t-test was used to analyze basic information, such as blood pressure and BMI. The multivariate regression model was used to analyze the effect of cement dust exposure on the study group. The impact of cement dust exposure duration was analyzed using the multivariate regression model. The level of significance was p < 0.05. The statistical analysis was performed using STATA-15 (StataCorp, College Station, TX), and the graphical presentation used GraphPad Prism v8.3.2. Results The cement dust-exposed participants had a significantly higher value of MCV by 1.19 fi (95% CI = 0.02, 4.84; p = 0.049) and a 5.92% increase in RDW (95% CI = 5.29, 6.55; p < 0.001) than that of the control group. Conclusion The study reveals that exposure to cement dust causes significant changes in RDW and MCV. These changes may indicate hemolysis due to inflammation.
Fulltext Unmasking the Hidden Burden: A Delayed Diagnosis of Leprosy Patients With Grade 2 Disability and Its Effects on the Healthcare System in Bangladesh

Sinha S, Haq MA, Ahmad R, Banik S, Kumar S, Haque M

Cureus, 2024 Apr;16(4):e58708.
PMID: 38651088 DOI: 10.7759/cureus.58708

Introduction Leprosy remains a significant cause of preventable disability worldwide. Early diagnosis and treatment of leprosy are critical not only to stop its spread but also to prevent physical and social complications and reduce the disease burden. Objectives The study aims to evaluate the factors that lead to a delayed leprosy diagnosis. Methods This study was conducted in the outpatient departments of Leprosy Control Institute and Hospital, Dhaka, Bangladesh, and at Medical College for Women and Hospital, Dhaka, Bangladesh, from March 2023 to June 2023. A total number of 252 male (148) and female (104) patients were selected with any sign of leprosy, including disability, age ranging from 15 to 74 years. Data was collected in a pre-designed structured questionnaire by the researchers. To assess the risk of independent exposures of Grade 2 leprosy disabilities, we used a logistic regression model. A chi-square test showed the association between significant effects and leprosy disabilities. A p-value of 0.05 was considered as significant. For statistical analysis, STATA version 15 (StataCorp LLC, College Station, Texas, USA) was used. Results The study participants exhibited a higher percentage of disability, with a rate of 25.8% for Grade 2 disabilities. In addition to this, males represented a more considerable proportion, 58.7%, than females among leprosy and disability patients across all levels of disability. In our study, lack of money and painless symptoms showed a significant association (p<0.001) with Grade 2 disability. Conclusion The study reveals that Grade 2 disabilities are more common in males and are particularly prevalent in lower socioeconomic groups.
Type 2 Diabetes Mellitus and Cardiometabolic Prospects: A Rapid Narrative Review

Chowdhury K, Sinha S, Ahmad R, Lugova H, Mehta M, Kumar S, et al.

Cureus, 2024 Jul;16(7):e65808.
PMID: 39092382 DOI: 10.7759/cureus.65808

Cardiometabolic syndrome (CMS), type 2 diabetes mellitus (T2DM), and cardiovascular diseases are among the major altruists to the international liability of disease. The lifestyle and dietary changes attributable to economic growth have resulted in an epidemiological transition towards non-communicable diseases (NCDs) as the leading causes of death. Low- and middle-income countries (LMICs) bear a more substantial disease burden due to limited healthcare sector capacities to address the rapidly growing number of chronic disease patients. The purpose of this narrative review paper was to explore the interrelationships between CMS, T2DM, and cardiovascular impairments in the context of NCDs, as well as major preventative and control interventions. The role of insulin resistance, hyperglycemia, and dyslipidemia in the pathogenesis of T2DM and the development of severe cardiovascular impairments was highlighted. This paper elaborated on the pivotal role of lifestyle modifications, such as healthy diets and physical activity, as cornerstones of addressing the epidemics of metabolic diseases. Foods high in calories, refined sugar, red meat, and processed and ready-to-eat meals were associated with an amplified risk of CMS and T2DM. In contrast, diets based on fruits, legumes, vegetables, and whole grain, home-cooked foods demonstrated protective effects against metabolic diseases. Additionally, the role of a psychological and behavioral approach in addressing metabolic diseases was highlighted, especially regarding its impact on patient empowerment and the patient-centered approach to preventative and therapeutic interventions.
Fulltext The Impact of Saline Water on Women's Health in the Coastal Region of Bangladesh: Special Attention on Menstrual Hygiene Practices

Sinha S, Ahmad R, Chowdhury K, Ferdaus F, Banik S, Mehta M, et al.

Cureus, 2024 Aug;16(8):e67032.
PMID: 39157000 DOI: 10.7759/cureus.67032

Introduction Salinity intrusion is the most common global concern along coastlines, but it can happen inland also. The lack of freshwater is the primary issue affecting the coastal areas. Many health problems are prevalent among the inhabitants due to their frequent use of salted water. The health of women living along the coastline is getting progressively compromised due to salinity intrusion. Objectives The study aims to determine menstrual health practices and other health problems faced by women in the coastal region of Bangladesh. Methods The study was conducted using a survey research design from May 2023 to October 2023 on rural women aged 18 to 45 years, who lived in the Bangladeshi village of Koyra Upazila in the Khulna district. The sample size of the study was 101. Open- and closed-ended questions from a planned interview schedule were used to gather primary data. Additional information from appropriate sources, e.g., newspapers, publications, and books, was utilized to enhance the comprehensiveness of statistical analysis and support rationality. A p-value of 0.05 was considered significant. Statistical analysis was performed using STATA version 15 (StataCorp LLC, College Station, TX). Results Menstrual hygiene practices showed a higher prevalence of using fabric rags and reusing them after rinsing them in salt water (72.3%) than sanitary pads (25.7%). It was observed that the risk of diarrhea among tubewell water and rainwater users was significantly lowered by 0.25 times (95% CI = 0.06, 0.99; p = 0.049) and 0.06 times (95% CI = 0.01, 0.43; p = 0.005), respectively, compared to pond water users. Conclusion Salinity has a significant impact on the livelihoods and health of coastal women. The village women are unaware of the health risks of excessive saline water use. Establishing an adequate supply of freshwater reservoirs for the entire community throughout the year is an alternative for women to use as a source of water for hygiene necessities.
Fulltext Classic and Current Opinions in Human Organ and Tissue Transplantation

Oli AN, Babajide Rowaiye A, Adejumo SA, Anazodo FI, Ahmad R, Sinha S, et al.

Cureus, 2022 Nov;14(11):e30982.
PMID: 36337306 DOI: 10.7759/cureus.30982

Graft tolerance is a pathophysiological condition heavily reliant on the dynamic interaction of the innate and adaptive immune systems. Genetic polymorphism determines immune responses to tissue/organ transplantation, and intricate humoral and cell-mediated mechanisms control these responses. In transplantation, the clinician's goal is to achieve a delicate equilibrium between the allogeneic immune response, undesired effects of the immunosuppressive drugs, and the existing morbidities that are potentially life-threatening. Transplant immunopathology involves sensitization, effector, and apoptosis phases which recruit and engages immunological cells like natural killer cells, lymphocytes, neutrophils, and monocytes. Similarly, these cells are involved in the transfer of normal or genetically engineered T cells. Advances in tissue transplantation would involve a profound knowledge of the molecular mechanisms that underpin the respective immunopathology involved and the design of precision medicines that are safe and effective.
Fulltext Anesthetic Effect of 2% Amitriptyline Versus 2% Lidocaine: A Comparative Evaluation

Patel N, B Urolagin S, Haq MA, Patel C, Bhatt R, Girdhar G, et al.

Cureus, 2023 Aug;15(8):e43405.
PMID: 37581201 DOI: 10.7759/cureus.43405

Introduction A common dental problem is the fear of pain during needle prick for giving local anesthesia (LA). The needle prick pain during dental procedures often varies with sex and age. Perception of pain depends on various factors, which can be psychological and biological. This perception of pain may change the behavior of patients toward dental treatments. Traditionally, lidocaine gel formulation was utilized before the parenteral dosage form. The lidocaine gel formulation is considered the drug of choice for LA in dental surgery. Currently, amitriptyline has been utilized in dental practice because of its beneficial pharmacology. Hence, the present study has been undertaken to compare the anesthetic ability of amitriptyline as an intraoral topical anesthetic agent with lidocaine gel. Methods This study was a comparative clinical study between two medications' anesthetic properties. This study included 120 patients indicated for bilateral orthodontics (the subdivision of dentistry that emphasizes identifying necessary interventions for the malocclusion of teeth) procedures. All the subjects were divided into amitriptyline and lidocaine groups. Both anesthetic gels were applied at separate sites before the injection of LA. The time of the onset of anesthesia was noted and analyzed. Patients were selected on the basis of inclusion and exclusion criteria. Individuals aged 18 to 30 years who were systemically healthy and orthodontically indicated for bilateral premolar extraction were included in this study. Again, patients with a history of neurological disorders and allergies to amitriptyline and lidocaine were excluded from the current study. Results Significant differences emerged between groups at five and 10 minutes, with amitriptyline-induced partial numbness (36.7% and 6.7%). At 40 and 45 minutes, both groups showed varied partial and complete numbness, with amitriptyline leading to partial recovery (23.3% and 73.3% complete numbness, 23.3% partial recovery) and lidocaine resulting in partial recovery (81.7%). When comparing the visual analog scale (VAS) scores, both groups exhibited a similar simultaneous effect at 15 minutes. Nonetheless, amitriptyline displayed significantly lower scores at 25 and 35 minutes (p < 0.001) in comparison to lidocaine. Similar observations were made when controlling for pain intensity. Conclusion It was concluded that amitriptyline holds both anesthetic and analgesic properties. Nevertheless, this study was unable to generalize the study findings because of the small sample size and being a single-center study. However, the VAS scores of anesthetic and analgesic pharmacodynamics properties of amitriptyline were statistically significantly lower than lidocaine, particularly at 25 and 35 minutes. Additionally, amitriptyline-induced anesthetic and analgesic pharmacology, especially pharmacokinetics properties, depends on the location and pattern of pain.
Fulltext The Relationship Between Serum Anti-Müllerian Hormone and Basal Antral Follicle Count in Infertile Women Under 35 Years: An Assessment of Ovarian Reserve

Islam UN, Begum A, Rahman F, Haq MA, Kumar S, Chowdhury K, et al.

Cureus, 2023 Dec;15(12):e50181.
PMID: 38077683 DOI: 10.7759/cureus.50181

Introduction Estimating ovarian reserve has been the cornerstone of designing treatment plans for female infertility over the last few years. The most reliable biomarker for assessing female fertility is the antral follicle count (AFC). Also, the anti-müllerian hormone (AMH) is a sensitive test for predicting ovarian reserve and is precisely associated with AFC value. Objective The study aimed to investigate the relationship between serum AFC and AMH levels. Methods This cross-sectional type of observational study included 101 healthy infertile women aged 20-35 years and with low serum AMH. The mean difference in basal AFC among different age groups was evaluated using an independent sample t-test, revealing no significant difference. A multiple regression model was used to assess the association between serum AMH, and other factors related to demographics and other aspects of infertile women with basal AFC. Results The mean age of infertile women in our study was 30.7±3.69, and 29.7% of females had secondary infertility. The highest ovarian reserve was notable among the group 20-25 years, and the lowest follicular volume was observed in the 31 to below 35 years. Multiple regression analyses revealed that serum AFC and AMH had a strong positive association with basal ovarian volume. Additionally, every one-unit surge in AFC and AMH was statistically significant (p<0.05) and concomitant increases with 0.45 cc and 3.98 cc in basal ovarian volume, respectively. Conclusion The AMH and AFC strongly associate with basal ovarian volume, which declines as age progresses.

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