Background:Metacarpal and phalangeal fractures are common upper limb injuries that significantly affect hand function. Surgical fixation using Kirschner wires (K-wires) and mini-plates is widely practiced, but their comparative effectiveness in terms of functional recovery and postoperative analgesic requirements remains debated. Aim:To compare functional outcomes and postoperative analgesic requirements in patients undergoing K-wire versus mini-plate fixation for metacarpal and phalangeal fractures. Methodology:A prospective comparative study was conducted on 50 adult patients with unstable metacarpal or phalangeal fractures. Patients were divided into two groups: Group A (K-wire fixation, n = 25) and Group B (mini-plate fixation, n = 25). Outcomes assessed included total active motion (TAM), visual analog scale for pain, time to union, and analgesic requirements. Follow-up was conducted at 1, 3, 6, and 12 months. Results:Both groups showed progressive improvement. K-wire fixation demonstrated significantly better TAM at 12 months (54.70 ± 10.94 vs 28.09 ± 5.62; P < 0.001). Mini-plate fixation showed faster fracture union. Analgesic requirements were higher in the mini-plate group during the early postoperative period. Complication rates were comparable. Conclusion:K-wire fixation offers superior long-term functional outcomes and reduced analgesic requirements, whereas mini-plate fixation provides earlier fracture stability and faster union. Implant selection should be individualized.
Background:Cyberbullying is an emerging public health issue among adolescents, associated with psychological consequences such as anxiety, depression, and sleep disturbances, often requiring clinical and pharmacological management. Preventive educational interventions may improve knowledge, awareness, and sensibility, thereby reducing mental health burden. Aim:To evaluate the effectiveness of a contemplated nursing intervention on knowledge, awareness, and sensibility regarding cyberbullying and its mental health consequences among adolescents. Methods:A true experimental design was conducted among 20 adolescents (13-17 years) in selected schools in Coimbatore, India. Participants were randomly assigned to experimental (n = 10) and control (n = 10) groups, each subdivided to minimize contamination. Pre- and post-tests were administered using standardized tools. The experimental group received an eight-week nursing intervention involving mobile-based modules and vignette discussions. Data were analyzed using descriptive and inferential statistics (P < 0.05). Results:Post-intervention, the experimental group showed significant improvements in knowledge (mean difference 6.3), awareness (16.6), and sensibility (6.3), with all participants achieving adequate or high levels. Control groups showed minimal change. Significant inter-group differences were observed (P < 0.05). No association was found between pre-test scores and demographic variables. Participants also demonstrated improved understanding of psychological consequences and treatment options, including counseling and Selective Serotonin Reuptake Inhibitors (SSRIs). Conclusion:The intervention effectively enhanced adolescents' understanding of cyberbullying and its mental health impact. Such programs may reduce psychological morbidity and future reliance on pharmacological management. Larger studies are recommended.
Background:Diabetic nephropathy (DN) is a leading microvascular complication of diabetes and a major cause of end-stage renal disease. Conventional biomarkers such as albuminuria fail to detect early renal injury. MicroRNA-377 (miRNA-377) has emerged as a potential epigenetic regulator involved in renal fibrosis and extracellular matrix accumulation. Aim:To evaluate circulating miRNA-377 expression across different stages of DN and determine its diagnostic utility. Methods:This analytical cross-sectional study included 132 participants categorized into healthy controls (n = 35), type 2 diabetes mellitus (T2DM) with normoalbuminuria (n = 32), microalbuminuria (n = 32), and macroalbuminuria (n = 33). Plasma miRNA-377 expression was quantified using reverse transcription polymerase chain reaction (RT-PCR) and analyzed by the Livak method. Clinical, biochemical, and renal parameters were assessed. Statistical analysis included ANOVA, Spearman correlation, receiver operating characteristic (ROC) curve, and multinomial regression. Results:miRNA-377 expression showed significant upregulation in microalbuminuria (P = 0.022) and macroalbuminuria (P = 0.014). It demonstrated strong correlation with urinary albumin-to-creatinine ratio (UACR) (r = 0.510, P < 0.001) and moderate correlation with HbA1c (P = 0.04). ROC analysis showed good diagnostic performance (area under the curve [AUC] =0.811). Multinomial regression confirmed miRNA-377 as an independent predictor of DN progression. Conclusion:Circulating miRNA-377 is significantly associated with DN severity and may serve as a promising non-invasive biomarker for early detection and disease stratification.
Background:Pharmacovigilance is crucial in the safety of drugs and it is here that adverse drug reactions (ADRs) are observed, especially in a tertiary care environment where polypharmacy is prevalent. This paper set out to assess the patterns of pharmacovigilance reporting and examine the nature of ADRs in a tertiary care teaching hospital. Methods and Materials:The study was prospective observational and was carried out after 12 months involving 250 patients with suspected ADRs. The sources of data included the spontaneous reporting forms, patient records, and laboratory results. The World Health Organization (WHO) causality assessment scale was used to determine ADRs. Descriptive statistics were presented in the form of mean ± standard deviation and percentages, and Chi-square and t-tests were used in the inferential statistics. Results:The average age of the patients was 47.8 (18.5) years, and the patients were mostly male (58%). The largest percentage of ADRs reported was in the medicine department (42%), then surgery (22) and pediatrics (16). The most commonly involved classes of drugs were antibiotics (36%) and antiepileptics (18%). Type A reactions were found in 64 percent of the cases, whereas Type B reactions were found in 36 percent. WHO causality assessment indicated that 52% of ADRs were possible, 34% probable, and 14% certain. ADRs were serious in 28% of the patients. Underreporting was observed and only 68 percent of ADRs were reported in writing. The incidence of ADRs was significantly greater in patients who were on polypharmacy (five or more drugs) than in those on fewer drugs (P = 0.01). Conclusion:The article identifies some gaps in pharmacovigilance reporting and presents the necessity to involve better awareness, training, and regular reporting systems to improve drug safety in clinical practice.
Postoperative pain following cardiac surgery remains a major challenge that can delay recovery, increase opioid use, and hinder rehabilitation. This systematic review evaluated mixed methods evidence on pharmacological pain management strategies and their integration with nursing care in adult patients undergoing cardiac surgery. A comprehensive search of PubMed, Scopus, Web of Science, CINAHL, and Google Scholar was conducted from database inception to December 2025 following PRISMA 2020 guidelines. Four mixed methods studies met the inclusion criteria. Pharmacological interventions included opioids, paracetamol, nonsteroidal anti-inflammatory drugs, gabapentinoids, ketamine, dexmedetomidine, and multimodal analgesic regimens. These approaches were associated with reduced postoperative pain, 15-38% lower opioid consumption, shorter intensive care unit stays, and improved rehabilitation. Qualitative findings emphasized patients' concerns regarding opioid dependence and sedation while highlighting the importance of nurse-led education and individualized pain assessment. Overall, multimodal opioid-sparing analgesic strategies integrated with patient-centered nursing care appear to enhance postoperative recovery after cardiac surgery, although further high-quality mixed methods research is required to strengthen the evidence.
Background:Inflammatory hip arthritis caused by conditions such as rheumatoid arthritis and ankylosing spondylitis leads to progressive joint destruction, severe pain, and disability. Total hip replacement (THR) is an effective surgical intervention; however, pharmacological factors such as disease-modifying anti-rheumatic drugs (DMARDs), and postoperative analgesic management may influence outcomes. Aim:To evaluate functional outcomes of THR in inflammatory hip arthritis and assess the influence of DMARD therapy and postoperative analgesic requirements. Methodology:A prospective observational study was conducted on 30 patients with inflammatory hip arthritis undergoing primary THR. Functional outcomes were assessed using Harris hip score (HHS), visual analogue scale (VAS), and range of motion. Data on perioperative DMARD use and postoperative analgesic requirements were recorded. Patients were followed for 12 months. Results:Mean HHS improved from 38.6 ± 7.2 preoperatively to 87.4 ± 6.8 at 12 months (P < 0.001). Mean VAS decreased from 8.1 ± 1.0 to 1.3 ± 0.6. Patients on optimized DMARD therapy demonstrated better functional recovery and lower postoperative pain scores. Increased analgesic requirement was observed during early postoperative periods, but reduced significantly over time. Conclusion:THR provides excellent functional improvement in inflammatory hip arthritis. DMARD optimization and effective analgesic management significantly influence postoperative recovery and patient outcomes.
Background:Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus and a major cause of morbidity and lower limb amputation. Effective pharmacological interventions that enhance wound healing are essential for DFU management. Topical insulin has been shown to promote cellular proliferation and angiogenesis, whereas medicinal honey possesses antimicrobial, anti-inflammatory, and tissue regenerative properties. Objective:To compare the effectiveness of topical insulin therapy and medicinal honey dressing in promoting wound healing among patients with DFU. Methods:A randomized controlled superiority trial with a four-group pre-test and post-test design was conducted among 120 patients with Wagner grade I and II DFU. Participants were allocated into four experimental arms (n = 30 each). Experimental arms I and III received topical insulin dressing, whereas experimental arms II and IV received medicinal honey dressing. Wound healing was evaluated using the Bates-Jensen Wound Assessment Tool (BWAT) before and after intervention. Results:Both interventions significantly improved wound healing scores (P < 0.001). In the insulin groups, the paired t-test values were 16.91 and 15.91, while the honey dressing groups showed greater improvement with t-values of 22.35 and 28.17. The post-test mean wound scores were significantly lower in the honey dressing groups compared to the insulin groups, indicating enhanced healing. Conclusion:Both topical insulin and medicinal honey dressing are effective pharmacological adjuncts for DFU management. However, medicinal honey dressing demonstrated superior efficacy in promoting wound healing among patients with diabetes mellitus.
Background:First-trimester bleeding is a common obstetric problem affecting nearly one-fourth of pregnancies, with causes ranging from benign conditions to serious complications. Ultrasonography, including grayscale and Doppler imaging, plays a key role in early diagnosis. Aim:To evaluate ultrasonographic findings in women presenting with first-trimester bleeding and assess the radiological profile on ultrasound. Materials and Methods:This descriptive cross-sectional study was conducted in the Department of Radiology, Aarupadai Veedu Medical College and Hospital, Puducherry. Eighty-eight antenatal women with vaginal bleeding and gestational age <14 weeks were evaluated using transabdominal and transvaginal ultrasonography. Fetal viability, crown-rump length, pregnancy location, placental position, uterine artery Doppler, and associated maternal or cervical factors were assessed. Data were analyzed using descriptive statistics and Chi-square test, with P < 0.05 considered significant. Results:Fetal cardiac activity was present in 83% of cases. Intrauterine pregnancies constituted 86.4%, while ectopic pregnancies accounted for 13.6%. Threatened abortion was the most common diagnosis (37.5%), followed by missed abortion (21.6%). Normal uterine artery Doppler findings were seen in 88.6% of cases, with no significant association between maternal age and pregnancy outcome (P = 0.761). Conclusion:Ultrasonography is an indispensable, non-invasive tool for evaluating first-trimester bleeding, facilitating accurate diagnosis and timely management.
Background:Zirconia crowns are increasingly popular due to their optical properties, minimal preparation, high strength, and biocompatibility. Aim:To evaluate the effect of silane alone and silane with subsequent heat treatment on the shear bond strength of translucent zirconia luted to a glass-reinforced core composite with universal resin cement. Materials and Methods:Thirty zirconia blocks (12 mm × 12 mm × 3 mm) were milled using a computer-aided design/computer-aided manufacturing machine and fully sintered from a zirconia blank. The specimens were divided into three groups based on the surface pretreatments performed-non-surface-treated group (Group 1), silanized group (Group 2), and silanized and heat-treated group (Group 3). Results:Shear bond strength was significantly influenced by silanization and heat treatment. Group 3 showed the highest shear bond strength, followed by Group 2, while Group 1 showed the least bond strength. Conclusions:Silanization with 1% silane significantly enhanced the bonding of composite resin to zirconia. Heat treatment further increased the bond strength of silane-pretreated zirconia.
Background:Thyroid nodules are commonly detected with high-resolution ultrasonography. While most are benign, a significant minority are malignant, necessitating accurate risk stratification. Conventional ultrasound is sensitive but has limited specificity due to overlapping features. Aim:To assess the diagnostic accuracy of ultrasound elastography in thyroid nodules by correlating elastography findings with cytopathology. Materials and Methods:This analytical cross-sectional study included 100 patients (20-60 years) with thyroid nodules evaluated using B-mode ultrasound and TI-RADS classification. Shear wave elastography was performed to assess tissue stiffness. Nodules with suspicious features underwent ultrasound-guided FNAC, reported using the Bethesda system. Statistical analysis was done using SPSS v26.0, with significance set at P < 0.05. Results:The mean age was 39.16 ± 12.24 years, with female predominance. Most nodules were hypoechoic, and 22% were TI-RADS 5. Elastography identified 28% of nodules as stiff. Cytopathology showed 56% benign and 44% malignant lesions. A weak but statistically significant negative correlation was observed between elastography findings and cytopathology (P = 0.05). Conclusion:The combined use of ultrasonography, shear wave elastography, and cytopathology enhances thyroid nodule characterization. Elastography is a valuable adjunct to conventional ultrasound and FNAC, supporting improved risk stratification and clinical decision-making.
Background:Adolescent stress and compromised psychological well-being are emerging public health concerns with long-term neurobehavioral implications. Emotional intelligence (EI)-based interventions have shown promise but remain underutilized in structured school settings in India. Aim:To evaluate the effectiveness of a structured school-based EI program on stress reduction and psychological well-being among adolescents. Methods:A randomized controlled pilot study was conducted among 26 adolescents (13 experimental, 13 control) in a selected school in Coimbatore. Baseline and postintervention assessments were conducted using standardized tools: Students' Stress Rating Scale and Brief Psychological Well-being Scale. The intervention consisted of a structured EI training module delivered over multiple sessions. Statistical analysis included paired and unpaired t-tests and Chi-square tests. Results:Postintervention, the experimental group demonstrated a significant reduction in stress scores (t = 18.10, P < 0.05) and a significant improvement in psychological well-being (t = 21.42, P < 0.05) compared to controls. The intervention resulted in a 57% reduction in stress and a 44% improvement in well-being scores. Conclusion:The school-based EI program was highly effective in improving psychological well-being and reducing stress among adolescents. Integration of EI training into school curricula is recommended as a preventive mental health strategy.
Background:Antimicrobial resistance (AMR) is an increasing health issue worldwide with the intensive care unit (ICU) being the main place where the phenomenon has become common due to the high use of antibiotics. The purpose of the research was to study the pattern of antimicrobial prescribing and resistance of patients admitted at ICU in a tertiary care hospital. Materials and Methods:The case of a prospective observational study was carried out during 12 months with 200 patients in the ICU who received antimicrobial therapy. Demographic, antimicrobial prescription, indications, and microbiological culture report data were gathered and compared. Descriptive statistics were represented as mean, standard deviation, and percentages, and Chi-square and t-tests were used in the inferential analysis. Results:The average age of patients was 54.6 years, and there were 62 males. The empirical antibiotic treatment was started in 78% of the cases with the most common ones (42% and 36%, respectively) being carbapenems and piperacillin-tazobactam. Only 28% cases showed de-escalation that was culture sensitive. Isolates with multidrug-resistance were found in 39% with the most common being Acinetobacter baumannii (18) and Klebsiella pneumoniae (15). Carbapenems resistance was observed in 32% of the isolates. There was a considerable difference in mortality (34 vs. 18, P = 0.02) between patients who received inappropriate empirical therapy. Conclusion:The research paper indicates the common occurrence of empirical broad-spectrum antibiotic use and high resistance patterns in the ICU. Antimicrobial stewardship programs and following culture-directed therapy should be implemented to limit the increasing antimicrobial resistance.
Background:Traumatic brain injury (TBI) is a major cause of morbidity and mortality. Computed tomography (CT) is the first-line imaging modality in acute head injury; however, patients with altered neurological status may show normal CT findings. Magnetic resonance imaging (MRI), with superior soft-tissue contrast, can detect subtle intracranial injuries missed on CT. Aim:To evaluate the role of MRI in head injury patients with altered Glasgow Coma Scale (GCS) scores and normal CT findings. Materials and Methods:This hospital-based cross-sectional study was conducted in the Department of Radiology, Aarupadai Veedu Medical College and Hospital, Puducherry, from November 2023 to May 2024. Ninety-two patients aged 18-60 years with acute traumatic head injury, altered GCS, and normal CT brain findings were included. MRI was performed using a 1.5-T scanner with T1 Weighted Imaging (T1W), T2 Weighted Imaging (T2W), T2 Fluid Attenuated Inversion Recovery (T2-FLAIR), Diffusion Weighted Imaging (DWI), and Susceptibility Weighted Imaging (SWI) sequences. MRI findings were correlated with GCS scores. Data were analyzed using descriptive statistics and Chi-square test, with P < 0.05 considered significant. Results:MRI detected small contusions (81.5%), edema (80.4%), thin SDH (60.9%), microhemorrhages (48.9%), nonhemorrhagic DAI (46.7%), hemorrhagic DAI (34.8%), brainstem injury (41.3%), and thin SAH (28.3%). Hemorrhagic DAI, nonhemorrhagic DAI, microhemorrhages, and edema showed significant association with GCS scores (P < 0.05). Conclusion:MRI is an essential complementary modality in acute head injury with normal CT findings, improving diagnostic accuracy, prognostication, and clinical management.
Background:Supracondylar fractures of the humerus are among the most common pediatric elbow injuries. Percutaneous lateral pinning is widely used due to its safety profile and reduced risk of ulnar nerve injury. Postoperative pain management plays a crucial role in recovery, yet limited studies evaluate analgesic requirements alongside functional outcomes. Aim:To evaluate functional outcomes of percutaneous lateral pinning in pediatric supracondylar fractures and assess postoperative analgesic requirements. Methodology:A prospective study was conducted on 24 children aged 3-12 years with Gartland type II and III supracondylar fractures. All patients underwent closed reduction and percutaneous lateral K-wire fixation. Functional outcomes were assessed using Flynn's criteria, range of motion, and carrying angle. Postoperative analgesic use (paracetamol and ibuprofen) was recorded. Follow-up was conducted up to 6 months. Results:Excellent to good outcomes were observed in 100% of patients. Most patients (92%) achieved excellent results. Postoperative pain was higher during the initial 48 hour, requiring regular analgesics, but decreased significantly thereafter. No iatrogenic ulnar nerve injury or loss of reduction was observed. Conclusion:Percutaneous lateral pinning provides stable fixation with excellent functional outcomes. Effective postoperative analgesic management enhances recovery and patient comfort.
Background:Spinal anesthesia is a common technique for lower abdominal and limb surgeries, offering advantages such as rapid onset, and fewer systemic complications compared to general anesthesia. However, postoperative challenges including delayed wound healing, pain, impaired gastric motility, anxiety, and sleep disturbances remain prevalent. Standard pharmacological regimens (e.g., bupivacaine, paracetamol, tramadol, ondansetron, and pantoprazole) address these issues, but integrating structured nursing care pathways may optimize recovery. Aim:This pilot study aimed to evaluate the effectiveness of a structured nursing care pathway combined with standard pharmacological management on biophysiological (wound healing, pain, gastric motility) and psychological (anxiety, sleep quality) outcomes in patients undergoing spinal anesthesia. Methods:A quasi-experimental pre-test-post-test control group study was conducted among 20 patients undergoing spinal anesthesia (control = 10, experimental = 10). Both groups received standard pharmacological therapy, while the experimental group additionally received a structured nursing care pathway. Outcomes including wound healing, pain, gastric motility, anxiety, and sleep quality were assessed using validated scales and analyzed using descriptive statistics, t-tests, and Chi-square tests (P < 0.05). Results:The experimental group showed significant improvements in all outcomes post-intervention (P < 0.05), with between-group post-test differences favoring the experimental group (t-values ranging from 8.25 to 10.12; P < 0.05). For instance, wound healing scores improved from 7.12 ± 0.88 to 17.1 ± 1.24 in the experimental group, compared to minimal changes in controls. Conclusion:Integrating structured nursing care pathways with pharmacological management enhances postoperative recovery, reducing complications, and improving patient well-being. Larger randomized trials are recommended to confirm these findings.
Introduction:Information on the plasma ranges of prescribed voriconazole prophylactic and therapeutic drug levels among the patients with invasive fungal infections (IFIs) is sparsely documented from central India. Methods:This prospective observational database study was conducted over a period of 18 months at the ICMR Mycology Advanced Resource Center of a tertiary care hospital in central India. It included 25 voriconazole samples from 18 patients undergoing routine therapeutic drug monitoring (TDM). Clinico-mycological characteristics, target concentration ranges for prophylactic and therapeutic prescriptions, and clinical outcomes were evaluated among enrolled patients. Results:Out of the 25 samples, 8 (32%) were random and 17 (68%) were trough samples. 33.3% (6/18) had repeat samples sent for analysis. Out of the 18 patients enrolled, 10 (55%) received prophylactic, while 8 (44%) were received therapeutic doses of voriconazole. Overall mean concentration of voriconazole in trough samples was 3.93 μg/ml, and in random samples was 2.38 μg/ml. Both these values were within the normal range. Commonest drug-drug interaction (DDI), between proton pump inhibitor (PPI) use and voriconazole was evident in supratherapeutic voriconazole concentrations. With small sample size, exploratory nature of this study and without a multivariable analysis; the association of PPIs alone for supratherapeutic voriconazole concentrations cannot be established. Conclusion:The research highlighted notable pharmacokinetic variances between children and adults who received voriconazole, particularly concerning the rate of absorption, bioavailability, and metabolism. This study emphasizes the need for antifungal TDM in developing nations with resource limited settings in better understanding of IFI management.
Background:Extubation in difficult airways patients may provoke cough and laryngospasm. To reduce airway irritation after intubation, Blockbuster Intubating Laryngeal Mask Airway (BBILMA) is mainly used. Materials and Methods:Patients with difficult airway were divided into two groups with 20 patients in each. BBILMA was left inside the endotracheal tube even after extubation in the LT group. Mask airway was removed once the intubation was done in the ET group. Postoperative sore throat, cough, hoarseness, leak pressure, and hemodynamics were noted up to 48 hours in both the groups. Results:Both groups showed comparable demographics and extubation characteristics. Oropharyngeal leak pressures were almost similar-30.5 ± 5.4 (LT) and 28.8 ± 7.2 (ET). Fiberoptic scores were likewise comparable at 3.2 ± 0.7 (LT) and 3.1 ± 0.8 (ET). At 48 hours, the LT group reported cough in one patient and sore throat in four, with no hoarseness; the ET group reported cough in two patients, sore throat in four, and hoarseness in one. Conclusion:BBILMA does not increase postoperative throat discomfort when left in situ after extubation. Thereby, it is safe in difficult-airway cases.
Background:Coagulopathy is frequently encountered in patients with liver disease, trauma, anticoagulant therapy, and perioperative bleeding. Fresh Frozen Plasma (FFP) is widely used to correct coagulation abnormalities associated with elevated International Normalized Ratio (INR). However, plasma alone may not always provide optimal correction. Adjunct pharmacological agents such as vitamin K1 (phytonadione), prothrombin complex concentrate (PCC), tranexamic acid (TXA), and Recombinant Factor VIIa (rFVIIa) are increasingly used to improve coagulation outcomes. Objective:To evaluate the effectiveness of FFP transfusion and the role of adjunct pharmacological therapy in correcting elevated INR values. Materials and Methods:A prospective observational study was conducted in a tertiary care teaching hospital over a period of 1 year. Adult patients (≥18 years) receiving FFP transfusion for elevated INR (>1.5) due to bleeding or prophylaxis before invasive procedures were included (n = 120). Pre-transfusion INR values were compared with post-transfusion INR measured within 6-12 hours. Data on concomitant administration of vitamin K1, PCC, TXA, and rFVIIa were recorded. Exclusion criteria included congenital coagulation disorders, incomplete records, and out-of-hospital transfusions. Statistical analysis was performed using paired t-test and ANOVA for subgroup comparisons (P < 0.05 is significant). Results:The mean pre-transfusion INR was 3.15 ± 1.20, decreasing significantly to 1.96 ± 0.82 post-transfusion (P < 0.001). Subgroup analysis showed greater INR reduction with adjuncts: FFP + PCC (1.78 ± 0.60), FFP + vitamin K1 (1.32 ± 0.52), FFP + rFVIIa (1.65 ± 0.55), and FFP + TXA (1.05 ± 0.48) compared to FFP alone (0.80 ± 0.45; P < 0.01). Minor transfusion reactions occurred in 3.3% of patients. Conclusion:FFP significantly reduces INR in coagulopathy, with adjuncts like vitamin K1 and PCC enhancing correction. Rational integration of blood components and pharmacology optimizes outcomes and transfusion practices.
Background:Acute endodontic infections are among the most common dental emergencies requiring prompt pharmacological intervention alongside operative treatment. Variations in host response, drug metabolism, and microbial flora between children and adults necessitate tailored pharmacological strategies. Methods:A prospective observational study was conducted on 120 patients presenting with acute endodontic infections, divided into two groups: children (n = 60; age 6-12 years) and adults (n = 60; age 18-60 years). Patients were managed with standardized pharmacological protocols including antibiotics (amoxicillin or amoxicillin-clavulanate), analgesics (ibuprofen or paracetamol), and adjunctive therapy when required. Clinical outcomes, including pain reduction (Visual Analog Scale [VAS] score), swelling resolution, and need for antibiotic escalation, were assessed over 5 days. Statistical analysis was performed using independent t-test and Chi-square test. Results:Mean baseline pain scores were compared between children (7.8 ± 1.1) and adults (8.1 ± 1.3; P = 0.18). By day 5, pain reduction was significantly greater in adults (VAS: 1.2 ± 0.6) compared to children (1.8 ± 0.9; P = 0.004). Swelling resolution occurred in 91.7% of adults and 83.3% of children (P = 0.18). Antibiotic escalation was required in 10% of children and 5% of adults (P = 0.31). Adverse drug reactions were minimal in both groups. Conclusion:Pharmacological management of acute endodontic infections is effective in both children and adults; however, adults demonstrate faster symptomatic relief. Tailored dosing and close monitoring are essential in pediatric populations.
Background and Objectives:Blood culture is the "gold standard" for diagnosing bacteremia. This study evaluates the performance of shortened incubation cultures in pathogen identification (ID) and antimicrobial susceptibility testing (AST) using the VITEK®2 system. Material and Methodology:A prospective study was conducted from November 2021 to October 2022, focusing Gram-negative pathogens. Flagged blood-culture bottles subjected to Gram-stain and simultaneous microbial workup by conventional 24-h protocol and faster 3-4 h and 7-8-h methods. Results:The data analysis encompassed 207 Gram-negative pathogens, Escherichia coli being the most prevalent isolate at 39.6%. Overall essential-agreement rates were 95.7% and 95.0%, and categorical-agreement rates were 96.2% and 96.0% for the respective incubation periods. Conclusions:Rapid pathogen ID and AST of positive blood cultures using shorter incubation times on solid media can significantly reduce turnaround time.
