Research Article
Open Access
Effectiveness of Tobacco Cessation Counseling in Primary Care Settings: A Prospective Observational Study
Dr. Nagabhushan D ,
Dr. Sreelatha.N
Pages 111 - 115

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Abstract
Background: Tobacco use remains one of the most preventable causes of morbidity and mortality worldwide. Primary care settings offer an ideal platform for delivering brief cessation interventions, yet evidence on their real-world effectiveness in low- and middle-income countries remains limited. Objective: To evaluate the effectiveness of structured tobacco cessation counseling using the 5A's framework in primary health care centers and to identify factors associated with successful cessation at 6-month follow-up. Methods: A prospective observational study was conducted across 4 primary health centers over 12 months. A total of 320 tobacco users were enrolled and received structured counseling at baseline, 1 month, and 3 months. Primary outcome was self-reported tobacco abstinence at 6 months, validated by exhaled carbon monoxide measurement. Multivariate logistic regression identified independent predictors of cessation. Results: At 6-month follow-up, 38.4% (n=123) of participants achieved tobacco abstinence. Cessation rates were significantly higher among participants who received all three counseling sessions (52.1% vs. 21.3%, p<0.001). Older age (OR=1.04, 95% CI: 1.01-1.07), higher education (OR=2.31, 95% CI: 1.44-3.71), strong motivation to quit (OR=3.12, 95% CI: 1.89-5.14), and absence of household tobacco users (OR=2.08, 95% CI: 1.27-3.41) were independent predictors of successful cessation. Conclusion: Structured 5A's-based cessation counseling in primary care settings significantly reduces tobacco use. Multi-session counseling, tailored to individual motivation and social context, should be integrated into routine primary care practice.
Research Article
Open Access
Optimizing Outcomes in Lower Limb Amputation: Operative Strategies, Pain Control, and Rehabilitation
Dr. Lokesh Kumar ,
Dr. Rajendra Prasad P ,
Dr. V. Suresh Kumar ,
Dr. T. Suresh Kumar
Pages 104 - 110

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Abstract
Background: Lower limb amputation remains a major surgical intervention worldwide, most commonly resulting from trauma, vascular disease, diabetes, and infection. Despite advancements in surgical care, postoperative pain, functional disability, and psychosocial distress remain prevalent. Objective: This study aimed to analyze operative strategies, pain management protocols, and rehabilitation outcomes in patients undergoing lower limb amputations during the research period. Methods: A retrospective observational study was conducted from July to December 2018, including patients undergoing major lower limb amputation. Data were collected on surgical techniques, perioperative pain control, and rehabilitation outcomes. Results: Seventy-five patients were included. The most common indication was peripheral vascular disease (46.7%). Myoplastic closure techniques were associated with reduced wound complications. Regional anesthesia combined with systemic analgesia improved early mobilization scores. Multidisciplinary rehabilitation, including physiotherapy and psychological support, significantly improved prosthetic adoption rates. Conclusion: Optimizing surgical techniques, multimodal pain management, and structured rehabilitation programs leads to improved outcomes in lower limb amputees.
Research Article
Open Access
Awareness, Attitudes, and Self-Medication Practices toward Acne Management among Health-Science Students: A Cross-Sectional Study
Padma P ,
A. Gnaneshwar Rao
Pages 95 - 103

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Abstract
Background: Acne vulgaris is a prevalent dermatological disorder affecting up to 90% of adolescents and young adults worldwide. Despite being medically manageable, misconceptions about acne and its treatment persist, particularly among university students. Easy accessibility of over-the-counter (OTC) medications, social-media influence, and perceived self-competence contribute to irrational self-medication. Understanding the awareness, attitudes, and self-treatment behaviors among health-science students is essential to inform targeted educational interventions. Aim: To assess the level of awareness, attitudes, and self-medication practices related to acne management among undergraduate medical, dental, nursing, and paramedical students in a tertiary-care university in South India. Methods: A descriptive cross-sectional study was conducted among 284 undergraduate students selected using stratified random sampling across four professional streams. Data were collected using a validated, self-administered questionnaire comprising sections on demographic details, knowledge of acne etiology and treatment, attitudes toward acne, and self-medication behaviors. Descriptive statistics summarized frequency distributions, while Chi-square tests assessed associations between awareness levels and self-medication. A p-value <0.05 was considered statistically significant. Results: The mean age of participants was 20.9 ± 1.8 years, with 62.7% females. Overall, 79.9% recognized acne as a medical condition, yet only 32.4% were aware of the antibiotic-resistance risk. Nearly 43.7% reported self-medication, most commonly using topical antibiotics (37.9%) and steroid creams (29.0%), predominantly influenced by social media and peer advice. A significant inverse relationship was observed between awareness and self-medication (p = 0.002). Conclusion: Despite adequate general awareness about acne, substantial gaps remain in understanding rational therapy and drug safety. High self-medication rates among health-science students emphasize the need for structured dermatology education, digital-health literacy programs, and stricter regulation of OTC acne products to promote safe and evidence-based self-care practices.
Research Article
Open Access
Impact of Uric Acid on Chronic Liver Disease: Relationship with Hepatic Encephalopathy and Liver Function Tests
Vadlamani Venkateshwar Rao
Pages 90 - 94

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Abstract
Introduction Chronic liver disease (CLD) is a global health concern, characterized by the progressive deterioration of liver function due to various etiologies, such as chronic viral hepatitis, alcohol abuse, and non-alcoholic fatty liver disease (NAFLD). The progression of CLD often leads to cirrhosis, a condition where liver architecture is extensively damaged, resulting in complications such as portal hypertension, ascites, and hepatic encephalopathy (HE). Hepatic encephalopathy, in particular, is a Significant neuropsychiatric complication associated with liver failure, manifesting as a spectrum of cognitive dysfunction ranging from subtle changes in mental state to deep coma. Materials And Methods This is a Prospective, Cross-sectional study and Observational study was conducted in the Department of General Medicine and OBGY, JIIU’s Indian Institute of Medical Science and Research. After approval from institutional ethical committee, was carried out for 18 months duration and 150 adult patients aged >18 years of either gender who were diagnosed with Chronic liver disease on the basis of clinical, radiological and biochemical investigation presenting to the OPD were included. Informed written consent was obtained from all patients satisfying the inclusion criteria after explaining the study protocol in detail. Results The present study was conducted on 150 patients. The age distribution ranged between 20 and 80 years. The mean age of the patients was 52.3 ± 11.4. In the present study, out of the 150 patients, 105 (70%) were males and 45 (30%) were females with chronic liver disease of various causes, diagnosed clinically and substantiated by imaging studies. In more than half of the patients, i.e., in 79 (52.7%) patients, alcohol was identified as a major cause of chronic liver disease, followed by Hepatitis B in 34 (22.7%) patients. Other causes accounted for chronic liver disease in 35 (23.3%) patients, with one case each of Wilson’s disease and autoimmune disease as a cause of chronic liver disease. Conclusion The serum UA level is associated with the development of cirrhosis and the presence of elevated serum liver enzymes after adjustments for important causes and risk factors of chronic liver disease.
Research Article
Open Access
The role of oral medicine in the management of patients with dementia- A systematic review
Abdullah Abdullaziz Al-Mutairi,
Ibrahim Saleh Alowayyed,
Abdullah Ibrahim Albarkheel
Pages 73 - 83

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Abstract
Background- Dementia, a progressive neurological condition, poses significant challenges for healthcare systems worldwide. Beyond cognitive decline, it profoundly impacts oral health due to patients' reduced ability to maintain hygiene, contributing to systemic complications such as pneumonia and malnutrition. Despite the growing recognition of this relationship, the role of oral medicine in dementia management remains underexplored. This is a systematic review that was conducted to assess the outcome of oral medicine interventions on oral health, cognitive outcomes, and systemic health in patients with dementia. Methods- A comprehensive systematic review was conducted in line with PRISMA guidelines. Cross-sectional studies and clinical trials on oral health interventions in dementia patients were searched on six databases using Boolean operators and MeSH keywords. The studies meeting the predetermined inclusion criteria were assessed for quality by applying Cochrane's RoB 2.0 and the AXIS tool. Data pertaining to intervention details, outcomes, and statistical significance were drawn out and analyzed. Results- Seven studies consisting of randomized controlled trials and cross-sectional surveys were included in the review. Some interventions, such as caregiver-assisted oral care, professional dental practices, and oral exercises showed the results to be significant improvement for oral health outcomes, such as changes of Oral Health Assessment Tool (OHAT) score that showed decreases (Wald χ² = 29.02, p <0.001) and Maximum Tongue Pressure (MTP) with interaction effects observed via generalized estimating equations (p < 0.05). Cognitive results, as measured by the Mini-Mental State Examination (MMSE), were all significantly improved at 6 and 12 months postintervention (p < 0.05). The systemic outcomes as captured were decreased incidence of pneumonia (p < 0.05) and increased sensitivity to cough reflex (odds ratio = 5.3, 95% CI 1.7–16.0, p < 0.005). Conclusion- This systematic review discovered that medical interventions in orodental diseases were effective in enhancing oral health and minimizing systemic complications in patients with dementia. Additionally, specific approaches had promise in preventing the deterioration of cognitive function. These results highlight the importance of oral medicine as a core treatment component for dementia care, requiring more general application in care delivery.
Research Article
Open Access
Functional Outcome Between Peroneus Longus Vs Hamstring Graft in An ACL Reconstruction under spinal anesthesia
Shirish Kumar Talakanti,
P. Surendranath Reddy
Pages 68 - 73

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Abstract
Background The anterior cruciate ligament in the knee is commonly prone to injuries. Reconstruction of this ligament with hamstring tendon has been time-tested but peroneus longus autograft is also gaining popularity. However, very limited literature is available comparing the two grafts. This study aims to compare the functional outcome and donor site morbidity between hamstrings and peroneus longus autograft in anterior cruciate ligament reconstruction. Methods: This prospective cohort study was conducted was conducted int he Department of Anaesthesia and Critical Care and Orthopaedics, Tertiary Care Teaching Hospital. Results: Patient was followed at 6 weeks, 3 and 6-months post operatively for clinical and radiological evaluation and results at end of 6 months were calculated by using IKDC and Lysholm knee score. The functional and radiological outcome is similar in both groups Conclusion: Autologous peroneus longus tendon can be used as a graft of choice in anterior cruciate ligament reconstruction which showed promising results without compromising on the ankle function. Its usage as an alternative source of the graft may be more useful in multi-ligament injuries of the knee joint
Research Article
Open Access
The digital era in dentistry
Pages 66 - 67

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Abstract
In our private practice we have recently began implementing more and more digital workflows, starting with photography, Digital Smile Design, and moving on to intraoral scanning and 3D printing. Yet I often wonder if entering the digital era is really a step forward. While the technological advance is undeniable, one may question the added value this really brings to our treatments. Because in the center of all our planning and treatment decision should be our patient. So is digital dentistry a real plus for our patients?
Review Article
Open Access
Contribution of genetic background in HIV elite controllers
Veronica Georgiana Preda,
* ,
Oana Săndulescu
Pages 62 - 65

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Abstract
Translational medical research is a rapidly developing field, bridging fundamental and clinical science. Implementation of this domain has become increasingly prominent during the past decades, leading to a better understanding of HIV infection, where molecular genetics and bioinformatic tools have been integrated into the clinical field. It has also significantly impacted the way HIV treatment is conducted, particularly in terms of preventing the hypersensitivity reaction to abacavir through the study of the HLA-B*57:01 allele. Moreover, new cohorts of long-term non-progressors have been identified and described, namely the elite controllers (ECs) and viremic controllers (VCs). Studies have revealed a potential protective mechanism allowing the suppression of HIV replication in the absence of ART, as being related to the presence of rare HLA alleles in their genome.
Case Report
Open Access
Frostbite in a tropical country: cryogenic freon hand burn
Muhammad Izzuddin Hamzan,
* ,
Zara Octavia Markos,
Ariffuddin Ishak,
Arman Zaharil Mat Saad
Pages 57 - 61

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Abstract
Introduction Frostbite usually occurs in cold weather countries due to the environment of extreme cold climate. Frostbite in a tropical country is a rare occurrence and all of the available cases described were due to chemical cryogenic elements as insulting agents. Freon is a widely used industrial r22 chemical refrigerant that can lead to severe cryoinjury of the skin. There were scanty published papers of Freon burn injury in the literature. Case report We present the first 2 such cases in Malaysia involving Freon injury to the hand – one treated conservatively while the other benefited from early excision and skin grafting. Each case was managed according to their individual presentations with a good outcome. Conclusions Freon burn is a serious ailment which can be linked with substantial morbidity. Appropriate pre-hospital intervention and definitive treatment are imperative to decrease tissue damage and optimize the outcome of the injured extremity.
Editorial
Open Access
Training for competence and quality in medical care
Pages 56 - 56

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Abstract
The medical field is updating and changing continuously, so permanent seeking of knowledge is essential for the medical staff: doctors as well as nurses. In this context, two years ago, we started designing a teaching and training program for Romanian physicians working in the field of infectious diseases, microbiology, epidemiology, molecular diagnosis, with the aim of training a total of 225 physicians, from different areas of Romania, such as: Bucharest, Covasna, Brasov, Mures, Alba, Constanța, Dâmbovița, Iasi, Bacau, Vaslui, Cluj, Gorj, Dolj, Timis and Arad, and 715 nurses from the same geographical area.