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Background Enterococcus , once benign intestinal flora, has transformed into formidable nosocomial pathogens as a result of the accelerated emergence of antibiotic resistance represents a major global health challenge, particularly within hospital settings. Enterococcus has grown more prevalent in nosocomial infections, such as urinary tract infections (UTIs), surgical site infections (SSIs) and bacteremia. The potential emergence of vancomycin-resistant Enterococcus  (VRE) strains further complicates treatment choices for multi-drug resistant (MDR) infections. This study evaluated the magnitude of Enterococcus infections and their antibiotic resistance patterns in a tertiary care hospital. Material and methods A laboratory-based cross-sectional study was conducted from January 2023 to December 2023 (one year) at Krishna Hospital & Medical Research Centre, Karad, India. A total of 189 enterococcalisolates were identified from various clinical specimens, including urine, blood, pus, and other samples. These isolates were subjected to identification and antimicrobial susceptibility testing using the automated VITEK 2 (bioMérieux SA, Marcy-l'Étoile, France) system. VanA and VanB phenotypes were detected based on minimum inhibitory concentration (MIC) values using the VITEK 2 Advanced Expert System (AES) system (bioMérieux SA). Statistical analysis was done using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 21.0, Armonk, NY). Results Among 189 culture-positive enterococcal isolates, the majority were obtained from urine 144 (76%), followed by blood 17 (9%), pus 12 (6%), etc. A larger proportion of these isolates were from female patients 97 (51%) aged over 60 years. A substantial proportion of these isolates originated from in-patient departments (IPD) 178 (94.2%) with intensive care units contributing the highest number 114 (60%) and out-patient departments (OPD) 11 (5.8%). The highest prevalence of infection was observed among patients with a hospital stay of 8 to 14 days (32.3%). E. faecium (57.7%) and E. faecalis (39.6%) were the predominant species with E. faecium displaying significant resistance to benzylpenicillin (96%) and nitrofurantoin (94%) whereas E. faecalis showed higher resistance to high-level gentamicin (80%). E. gallinarum (1.6%)showed complete resistance to benzylpenicillin (100%) and moderate resistance to nitrofurantoin (67%), and high-level gentamicin (67%). Conversely, E. durans showed complete resistance (100%) to both nitrofurantoin and benzylpenicillin. Among 31 VRE isolates, 16 (52%) showed the VanA and 15 (48%) showed the VanB phenotype. Conclusion Antimicrobial resistance among E. faecium and E. faecalis , particularly to benzylpenicillin, high-level gentamicin and nitrofurantoin along with the emergence of resistant species like E. durans and E. gallinarum underscores the urgent need for vigilant antimicrobial stewardship and continuous surveillance of the growing threat of MDR enterococci in clinical settings., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, Krishna Institute of Medical Sciences (KIMS) issued approval KVV/IEC/05/2024 under protocol number 338/2023-2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Hota et al.)

Digital smile designing (DSD) is a concept of dentistry which combines the old and the new and becomes a different world in the world of smile aesthetics and functionality. Dental aesthetics is not just a cosmetic issue but a multidimensional part of oral health that has a great impact on psychological well-being, social life, functional capabilities, and, hence, the quality of life. To put it simply, the recognition of its significance stresses the necessity of complete dental care which is the one that combines beauty and function as well as health. This systematic review aims to analyze the recent use and patient satisfaction of DSD and to show the recent advances in DSD. A thorough literature search was conducted across the online databases for articles about the implementation of digital smile analysis in dentistry. The articles that were published between 2013 and 2023 on DSD were selected which included randomized and non-randomized trials and observational studies covering the effectiveness, advantages, and patients' opinions about the treatment. The National Institutes of Health tool was applied for bias assessment. Ten studies were selected to address the use of DSD in dentistry based on the inclusion criteria. The findings from these studies suggest that DSD is useful in improving communication, reducing working time, minimizing errors, enhancing patient satisfaction, and providing clinical adequacy for final prosthetic pieces, indicating the usefulness of this approach in dental procedures. Smile designing using digital technologies has the potential to improve dental aesthetics and treatment procedures while showcasing their reliability and clinical effectiveness., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jain et al.)

When considering dental restorations, the use of fixed partial dentures is one of the most widely accepted treatment options. In the past, fabrication was done using traditional techniques and the conventional workflow was by far the popular method; however, nowadays digital workflows are being used as a means to produce the prosthesis. This systematic review aims to compare the workflows by considering their respective qualities, such as precision, efficiency, cost-effectiveness, and clinical performance. A complete search has been carried out to incorporate any relevant studies published between the years 2012 and 2023 in databases such as Scopus, Web of Science, PubMed, ScienceDirect, and Cochrane Library. Two independent reviewers screened articles for inclusion and assessed the studies' methodological quality rating via the NIH Tool. A total of 22 relevant articles were reviewed after a systematic search strategy. The main outcome of the review was digital workflows were found to reduce working time, eliminate the selection of trays, minimize material consumption, and enhance patient comfort and acceptance. The studies also showed that digital workflows resulted in greater patient satisfaction and higher success rates than conventional workflows. Workflows for digital dentistry demonstrated to be better than traditional ones due to the cost-effectiveness, accuracy, and time optimization for the fabrication of fixed prostheses., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mahato et al.)

Introduction: Traditionally, radiographs were used to assess the working length of root canals. However, the use of Electronic Apex Locators (EAL) may be a non-invasive alternative. This study aimed to evaluate the accuracy of the electronic apex locator (EAL) compared to radiographic measurements in determining the working length of root canals., Method: The study assessed the performance of EALs in different scenarios, including the presence of blood and pulp tissue, the use of ethylenediaminetetraacetic acid (EDTA), sodium hypochlorite (NaOCl) as an irrigant, and post-instrumentation with normal saline. An electronic apex locator (DTE DPEX-V; Woodpecker, China) was used alongside traditional radiographs to measure the working length in 144 root canal treatments. Bland-Altman analysis was used to compare the measurements between EAL and radiographs using Jamovi software, v2.4.8 (https://www.jamovi.org/)., Result: The findings revealed strong correlations between EAL and radiographic measurements across all testing environments, with Pearson's correlation coefficients ranging from 0.944 to 0.998. The Bland-Altman analysis suggests bias; the average difference was negative and close to zero (Pulp: -0.354, EDTA: -0.0972, NaOCl: -0.0382, Saline: -0.0139) when EAL measurements were compared to radiographic measurements., Conclusion: The working length measurement of root canals using an electronic apex locator such as DTE DPEX-V is comparable to traditional radiographic measurements. The use of irrigants improves the measurement. The EAL has the potential to be an alternative to the invasive radiograph for root canal length measurement., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bhagat et al.)

Objective The primary objective of this study was to evaluate the feasibility of performing retropubic mid-urethral transvaginal tape (TVT) with self-tailored ordinary polypropylene mesh (STOM) under sedation and local anesthesia in female patients with stress urinary incontinence (SUI). The second objective was to evaluate perioperative and immediate postoperative complications, success rates, and cost-effectivity. Materials and methods Forty-two subjects treated for stress urinary incontinence using STOM under local anesthesia were reviewed. Pre- and postoperative evaluation included assessment of valid questionnaires such as the urogenital distress inventory (UDI) and medical, epidemiologic, and social aspects of aging incontinence questionnaire (MESA), uroflowmetry in all cases, and urodynamics in some instances. Success rates and complications were compared with published studies. Results The mean operating time was 27 mins, and the median visual analog scale (VAS) score at 12 hours was three. Postoperative MESA and UDI scores had significant improvement. The mean hospital stay was 18 hours. Mean preoperative and postoperative Q max had no significant difference. With a mean follow-up of 27.32±3.29 months, the cure was seen in 38 patients (90.4%), improvement in three patients (0.07%), and failure in one patient (0.02%). Mesh-related complications (extrusion) occurred in one patient. The sling cost was reduced from approximately $500 (Gynecare TVT sling; Ethicon Inc., Somerville, NJ, USA) to $12.44 (Ethicon 15 x 7.6 cm Prolene (polypropylene mesh); Ethicon Inc., Somerville, NJ, USA) in our study. Conclusion Performing TVT with STOM under sedation and local anesthesia as a daycare procedure was feasible and cost-effective, has a high success rate, and was associated with minimal complications. It should be considered in developing countries with vast patient burdens, such as India., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kalra et al.)

The emergence of autologous platelet-rich plasma (PRP) therapy reflects a break-through for infertile patients with premature ovarian failure. To study the efficacy of intra-ovarian infusion of autologous PRP on the improvement of ovarian reserve parameters and the subsequent artificial reproductive technique (ART) cycle outcomes in infertile women with poor ovarian reserve or premature ovarian insufficiency, a systematic search in electronic databases like Medline (through PubMed), Embase, Scopus, Web of Science, and Cochrane was done using relevant search terms. Except for case series, case reports, and review articles, all other types of studies, those evaluated for the effects of intra-ovarian infusion of PRP in subfertile women for decreased ovarian reserve (DOR) or premature ovarian insufficiency (POI) were included in our systematic review. The data were extracted from each eligible study and cross-checked by two authors. Intra-ovarian PRP infusion appears to be effective in ovarian rejuvenation, and the results of the subsequent intracytoplasmic sperm injection (ICSI) cycle are encouraging. PRP intervention was found to be beneficial in terms of an improvement in ovarian reserve parameters (increase in serum anti-mullerian hormone or antral follicle count or decrease in serum follicular stimulating hormone). ICSI cycle performance in terms of the total number of oocytes retrieved, number of two-pronuclei embryos, fertilization rate, number of cleavage stage embryos, number of good quality embryos, and cycle cancellation rate were found to be improved after intra-ovarian PRP infusion as compared to their previous cycle without PRP infusion., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Panda et al.)