bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol of a randomized controlled study to evaluate the efficacy of Shwadanshtradi Taila Abhyanga in pain management of Janusandhigata Vata vis-à-vis knee osteoarthritis
Authors: Raut Manoj , Mandalkar Pramod , Bhabad Pradeep , Wagh Anil , Mundada Pallavi , Singhal Richa
Published: October 2024

BACKGROUND:

Knee osteoarthritis (OA) is one of the leading causes of disability globally and is generally managed by various pharmacological modalities like analgesics, supplementations, intra-articular injections, physiotherapy, and self-management strategies. Ayurveda offers numerous interventions for the management of symptoms of OA. Abhyanga (massage with oil) is one of the clinically effective modalities for pain management in Janu Sandhigata Vata which is similar to the presentation of OA. However, the effect of Abhyanga with Shwadanshtradi Taila alone (without any internal medication), in reducing the severity of pain due to knee OA, in a specified duration, needs to be evaluated.

OBJECTIVE:

To evaluate the efficacy of Abhyanga with Shwadanshtradi Taila for seven days in relieving pain due to Janusandhigata Vata vis-à-vis knee OA.

MATERIALS AND METHODS:

This study is a single center, prospective, parallel arm, exploratory, single-blind, and randomized controlled clinical trial. Patients aged 35–70 years with persistent knee pain, morning stiffness under 30 min, and suspected or diagnosed unilateral or bilateral knee OA, those who are not taking regular anti-inflammatory/analgesic drugs or are not finding satisfactory relief with conventional treatments, are being included in the study. A total of 62 participants fulfilling the selection criteria will be enrolled in the study and allocated randomly to one of the two study arms. Participants are administered either Shwadanshtradi Taila or Tila Taila for Abhyanga (external oil massage) on the affected Janu Sandhi (knee joint) twice daily for seven days. The outcomes of the study include the severity of pain assessed by the visual analog scale (VAS) and change in functional disability assessed by the WOMAC scale and improvement in symptoms of Janu Sandhigata Vata. The outcomes are assessed at baseline, 7th day and 14th day.

DISCUSSION:

The outcomes of this study will inform about the efficacy of Abhyanga in the management of symptoms especially pain of knee OA in a specified duration of seven days without any internal medication. The study can generate leads for larger studies to prove the effectiveness of this simple and commonly practiced Ayurveda procedure in pain management in various musculoskeletal painful conditions.
Ayurveda interventions in the management of avascular necrosis of femoral head: A case report
Authors: Therokar Sagar , Aswathy Y. S. , Anandaraman P. V. , Dharmarajan Prasanth
Published: October 2024

Avascular necrosis (AVN) of the femoral head is a progressive degenerative disease caused by an interruption of blood supply to the femoral head. Due to the similarity in its signs and symptoms, it can be correlated with Asthimajjagata Vata. According to Ayurveda, Vata, Pitta, and Raktadosha play an important role in the etiopathogenesis of AVN along with Asthi (~bones) and Majja Kshaya (decline in bone marrow). This case report highlights the outcomes of a customized Ayurveda treatment protocol for the management of Asthimajjagata Vata. A 42-year-old male patient, occasionally alcoholic, approached the outpatient department of the Ayurveda tertiary care hospital with pain and stiffness in both hip joints and difficulty in walking, sitting, and performing routine activities for about 6 months. Magnetic resonance imaging findings were suggestive of bilateral AVN (left > right, Ficat–Arlet stage 2). The patient was admitted to the inpatient department for 27 days and underwent Panchakarma procedures, including Rukshana (dehydrating therapy), Snehana (oleation), Virechana (therapeutic purgation), Patra Pinda Sweda (fomentation with bolus), and Basti Karma (therapeutic enema), along with Shamana Aushadha (internal medications). As a result of the treatment protocol, there was a marked improvement in the Harris Hip Score from 76 to 85, the Oxford Hip Score from 30 to 37, and the range of motion of the hip. Along with reduced pain (Visual Analog Scale score) from 8 to 3, the quality of life of the patient also improved, as assessed by the Short Form Health Survey-12 (physical component summary from 28.93 to 56.28 and mental component summary from 40.32 to 56.92). Based on these encouraging results, it can be presumed that a customized Ayurveda treatment protocol adopted in the management of AVN is promising.
Management of Guillain–Barre Syndrome through Basti (Medicated Enema) and Composite Ayurveda Treatment: A Case Report
Authors: Nakanekar Amit , Khobarkar Punam
Published: October 2024

BACKGROUND:

Guillain–Barre syndrome (GBS) is a condition characterized by polyradiculoneuropathy associated with an immune-mediated response. Conventional therapies such as intravenous immunoglobulins and plasma exchange have been used to manage this condition, but they often result in unpleasant clinical and electrophysiological outcomes. The present case report describes traditional Ayurveda treatments, specifically Basti (medicated enema) and composite Ayurveda treatment, used to manage GBS. This report aims to provide insights into the effectiveness of traditional Ayurvedic treatments in managing GBS.

MATERIALS AND METHODS:

In this case, the patient presented with complaints of tingling and numbness in the bilateral upper and lower limbs for 2 months, weakness in bilateral upper and lower limbs for 1 month, inability to stand and walk, pain in the lumbar region, intermittent constipation, and dysphagia since 1 month. The patient was diagnosed with Guillain–Barre syndrome based on clinical findings, electromyography, and nerve conduction velocity test (EMG-NCV). He received treatment from a private hospital, but his symptoms were aggravated, so he was referred to Government Ayurveda Hospital Nagpur for further clinical management. Plasma transfusion was done at PVT Hospital 15 days before. He was treated based on the treatment principles of Vatavyadhi Chikitsa, Vata Dosha Upkram, and Santarpan Chikitsa. The primary goals of the therapy were to nourish the bodily tissues (Santarpan) and pacify the Pitta Dosha (Pittaghna).

RESULTS:

The patient’s electromyography and nerve conduction velocity test (EMG-NCV) results showed acute demyelinating sensorimotor polyneuropathy involving both the upper limbs and lower limbs. Compared to before treatment, EMG-NCV studies showed definite improvement in compound motor action potential (CMAP) amplitudes more prominently in upper limbs after 4 months of therapy. The muscle power grade increased from 0 to 5, indicating a significant improvement. The bedridden patient can walk alone after the completion of treatment.

CONCLUSION:

This case study reveals that Ayurvedic treatment has the potential for significant recovery in GBS instances.
Cranioplasty Approaches for Cranial Defects: A Case Series
Authors: Manoharan P. S. , Koppolu Sai Kiran , Abraham Sonia , Mathew Jitin
Published: October 2024

Cranial defects are commonly caused due to road traffic accidents, tumor, postneurosurgery, or congenital deformities. Protection of the cranial structures, maintaining cerebrospinal fluid dynamics, and esthetics are some of the prime considerations while restoration of such defects. The use of autograft or allograft materials such as bone from a self or another donor site from ribs, ilium, tibia, scapula, and fascia and procedures such as split-thickness cranioplasty were carried out in the past. However, in larger defects, alloplastic materials such as celluloids, methyl methacrylate, hydroxyapatite, polyethylene, silicone, and metals such as titanium, aluminum, and stainless steel, were used for restoration. Irrespective of the material of choice, it is desirable of the prosthetic material to demonstrate low thermal conductivity, optimal strength, low infection rate, longevity, close adaptation to the defect, and fixability with plates to adjacent bone. Before digital imaging, conventional impressions were made, and approximations were done to fabricate cranial plates. With the advent of digital technology and bone imaging techniques with alongside the development of printed and milled materials, accurate cranial prosthesis can be fabricated. We cannot disregard conventional techniques as these are still used in places where access to digital technology is limited and also for patients who cannot afford the cost incurred with digital technology. The case series presents one case, which was fabricated with a conventional method, and two cases with two different approaches using digital technology. The paper aims to present various advantages, limitations, and nuances needed while the fabrication of such a prosthesis with these three methods.
Clinical XLNet-based End-to-End Knowledge Discovery on Clinical Text Data using Natural Language Processing
Authors: Pagad Naveen S. , Nijalingappa Pradeep , Chakrabarti Tulika , Chakrabarti Prasun , Thangaraju Pugazhenthan
Published: October 2024

A modern framework for assessing patient histories and conducting clinical research has been developed as the number of clinical narratives evolves. To discover the knowledge from such clinical narratives, clinical entity recognition and relation extraction tasks were performed subsequently in existing approaches, which resulted in error propagation. Therefore, a novel end-to-end clinical knowledge discovery strategy has been proposed in this paper. The clinical XLNet was used as a base model for handling the discrepancy issue. To predict the dependent clinical relation association, the multinomial Naïve Bayes probability function has been incorporated. In order to improve the performance of the proposed strategy, it takes into account entity pairs presented consecutively through the multi-head attention layer. Tests have been conducted using the N2C2 corpus, and the proposed methodology achieves a greater than 20% improvement in accuracy over existing neural network-based and transformer-based methods.
Right Ventricular Outflow Tract Perforation and Stenting for a Premature Neonate with Pulmonary Valve Atresia and Double Outlet Right Ventricle
Authors: Hussein Mohammed Rasool , Abed Maysam Yousif , Akram Nabeeha Najatee
Published: October 2024

Pulmonary valve atresia (PVA) is a fatal pediatric cardiac condition and commonly associated with other anomalies such as double outlet right ventricle (DORV). There is a disagreement over the best surgical strategy for treating PVA in conjunction with DORV. Prematurely born neonates are considered high-risk group for early pulmonary artery shunt surgery as the staged repair is found to be associated with higher interstage mortality, while the primary repair may lead to frequent postrepair reinterventions due to the presence of associated developmental anomalies. In this report, we present the successful results of using percutaneous transcatheterization in a high-risk patient; a 6-h premature neonate who had DORV, PVA with other anomalies including situs inversus, levocardia, D-malposed great arteries without patent ductus arteriosus. This rapid interventional catheterization offered to the neonate has an immense advantage of lifesaving and the protection against the remolding effect on the right ventricle that usually develops when waiting for the palliative procedures or surgery to take place.
Morphometric Assessment of the Piriform Aperture and Its Clinical and Forensic Applications
Authors: Ominde Beryl Shitandi , Ikubor Joyce Ekeme , Jaiyeoba-Ojigho Jennifer Efe , Omoro Orovwoghene Faithful , Igbigbi Patrick Sunday
Published: October 2024

Background:

The piriform aperture (PA) is a midface structure that forms the anterior skeletal boundary of the nose. It is highly variant due to its physiological adaptations to the climate. Its variations are useful in forensic identification and reconstructive surgeries of the face. This study aimed at determining the PA’s dimensions and their accuracy in sex determination.

Materials and Methods:

The PA’s dimensions were retrospectively examined using 336 (199 males and 137 females) adult cranial computed tomography images in the database of the radiology unit of a university teaching hospital in Delta State, Nigeria, following institutional authorization. The aperture’s index was calculated as a ratio of height to width. The data were analyzed using Statistical Package for the Social Sciences Version 23. The sexual dimorphism in the parameters was assessed using an independent t-test. Association among the continuous variables was analyzed by Pearson’s correlation test. P = 0.05 was considered statistically significant. The percentage accuracy for correct sex prediction was assessed using the discriminant function analysis.

Results:

A significant relationship between dimensions with sex was observed (P < 0.05). The width of the aperture was the best sex-discriminating parameter (70.2%). The overall accuracy for sex discrimination using the aperture’s dimensions was 75.0%.

Conclusion:

This study provides the standard ranges for the PA’s width and height, valuable for surgical planning. These dimensions were sexually dimorphic and demonstrated an acceptable overall accuracy of correct sex allocation (75%). Consequently, this aperture may be utilized as a supplementary tool in conjunction with other methods for sex determination within studied population.
Proboscis Lateralis of the Nose
Authors: Swain Santosh Kumar
Published: October 2024

Proboscis lateralis (PL) of the nose is a very uncommon craniofacial anomaly characterized by a rudimentary tubular nose-like structure seen a little away from the midline of the face. It may be associated with other anomalies such as heminasal aplasia, mental retardation, callosal agenesis, microphthalmia, heminasal hypoplasia, and atypical clefting syndrome. Patients with this congenital craniofacial malformation need proper evaluation with the help of a computed tomography scan to assess the growth of facial and skull bones. The esthetic aspects and psychological problems are often a concern for patient’s families. The cartilaginous part or bony support of the nose can be reconstructed following proper growth of the face. Here, we presented a male neonate of 15 days with PL of the nose. There was no evidence of cleft lip or cleft palate. Parents were counseled for staged repair at an early age to avoid anxiety and to allow proportionate growth of the nose and face.
Microbial keratitis at a single tertiary eye care in Andhra Pradesh: A 12-year analysis of microbiological profile and in vitro susceptibility of bacterial isolates
Authors: Madduri Bhagyasree , Mohan Nitin , Fernandez Merle , Joseph Joveeta
Published: October 2024

CONTEXT:

Microbial keratitis is a potentially vision-threatening emergency that demands prompt diagnosis and treatment to ensure better vision recovery. Empirical use of broad-spectrum antimicrobial therapies is often the primary treatment modality, which is then tailored according to clinical response, cultured organisms, and their sensitivities. Since the spectrum of microbial agents associated with corneal ulcers is wide and varies from one geographical location to another, it is imperative that local microbial trends and susceptibility patterns are analyzed to enable better care in the management of these patients.

AIMS:

The aim of the study was to report the microbiological profile and in vitro drug susceptibility patterns of bacterial isolates obtained from patients with microbial keratitis in a single tertiary center in Andhra Pradesh over 12 years.

METHODS:

Microbiology records of culture-positive microbial keratitis that underwent a diagnostic corneal scraping and cultures from the years 2010 to 2021 were reviewed. Trends in bacterial and fungal etiology along with the antibiotic susceptibility profile of bacteria were analyzed.

STATISTICAL ANALYSIS USED:

Frequency distribution was obtained, and percentages were calculated.

RESULTS:

Of the 8529 microbial keratitis samples, 3581 corneal scrapings were culture positive which included Gram-positive bacteria (1054/3581, 29.4%), Gram-negative bacteria (476/3581, 13.2%), fungi (2051/3581, 57.2%), and parasites (369/3581, 10.3%). The most common fungal isolate was Fusarium species (557/1748, 31.8%) followed by Aspergillus flavus (495/1748, 28.3%). Similarly, the most common Gram-positive bacteria included Streptococcus pneumoniae (297/891, 33.3%) and Staphylococcus species (213/891, 23.9%), and the most common Gram-negative bacteria was Pseudomonas aeruginosa (294/403, 72.9%). Overall susceptibility patterns showed that Gram-positive bacteria were susceptible to vancomycin (92%), cefazolin (88%), and chloramphenicol (86%), while Gram-negative bacteria were most susceptible to gentamicin and amikacin (81%). The susceptibility to amikacin and gentamicin increased significantly from 71% in 2010 to 92% in 2021 and 74% in 2010 to 92% in 2021, respectively. In comparison, the susceptibility of fluoroquinolones for both Gram-positive and Gram-negative bacteria did not show any significant change over the study period.

CONCLUSIONS:

The prevalence of fungal and bacterial keratitis has remained unchanged over the years. This study reinforced that fluoroquinolones and vancomycin continue to be good empiric therapies for treating bacterial keratitis in Andhra Pradesh.
Correlation of optic nerve on magnetic resonance imaging with visual acuity in children with cerebral visual impairment
Authors: Samvedya Veenish , Smitha K. S. , Mahesh Kamate , Virupaxi Hattiholi
Published: October 2024

AIM:

The aim of the study was to correlate the optic nerve dimensions at various locations on magnetic resonance imaging (MRI) with the visual acuity of children with cerebral visual impairment (CVI).

MATERIALS AND METHODS:

A 1-year cross-sectional study was conducted in a tertiary care hospital involving 60 children aged 1 to 12 years diagnosed with CVI but without ocular pathologies. Visual acuity was evaluated using teller acuity cards (TACs). MRI of the brain and orbit was performed using three-dimensional high-resolution, volumetric heavily T2-weighted sequences to screen for brain pathologies and measure optic nerve dimensions at two locations. The correlation between visual acuity and optic nerve dimensions was analyzed. The Chi-square test was employed to assess significance using SPSS software.

RESULTS:

In our study, 64% (n = 38) of the participants were children under 3 years of age. The severity and characteristics of CVI influenced visual functioning at different ages. As children with CVI grew older and moved from Phase I to Phase III, the proportion with very low visual acuity significantly decreased from 85.2% in Phase I to 22.2% in Phase III and from 63.2% in the <3-year age group to 18.2% in more than 5-year age group. No direct correlation was found between optic nerve dimensions and visual acuity but optic disc changes such as optic disc pallor significantly correlated with low visual acuity.

CONCLUSION:

Our findings suggest that there may not be a direct correlation between optic nerve dimensions and visual acuity in children with CVI. However, optic disc changes do correlate with visual acuity, but optic disc changes alone are not a criterion for assessing visual function. Additionally, our study highlights the significance of a combined assessment by a neuro- ophthalmologist and neuro-pedaitrician in children with CVI.
Carotid-cavernous fistula due to contralateral orbital trauma
Authors: Namitha V. G. , Neena R. , Jayadevan E. R.
Published: October 2024

Direct carotid cavernous fistula is an abnormal arterio-venous connection from the carotid artery to the cavernous sinus (CS), resulting in high-pressure arterial blood entering the low-pressure venous CS. Most often, it occurs posttrauma and presents with ipsilateral orbital signs. In this report, we describe the case of a 54-year-old man, who presented with a late-onset right-sided red eye and diplopia following contralateral (left sided) orbital trauma (road traffic accident 7 months ago). Ocular examination revealed signs of Lateral rectus palsy, axial proptosis, and elevated intraocular pressure with dilated episcleral vessels in the right eye. Clinical findings were consistent with the diagnosis of right-sided direct CCF. To our surprise, digital subtraction angiogram revealed a left CCF with prominence of signs on the contralateral side. He underwent near-total endovascular coiling of the fistula, with initial aggravation of symptoms followed by near-total resolution.
Evisceration and ocular prosthetic implantation following endovascular coiling for the management of endophthalmitis in a long-standing post-traumatic unilateral carotid-cavernous fistula: A case report and review of the literature
Authors: Thrishulamurthy Chinmayee J. , Ahmed H. Shafeeq , Pendharkar Hima , Kusuma M. J.
Published: October 2024

Carotid-cavernous fistula (CCF) is a rare condition involving an abnormal communication between the carotid artery and the cavernous sinus. We present a unique case of posttraumatic unilateral CCF initially misdiagnosed as a corneal melt with iris prolapse and orbital cellulitis. The patient, a 25-year-old male, experienced swelling, bleeding, and sudden vision loss in the affected eye following a fall. Imaging confirmed a direct CCF, and the patient underwent endovascular coiling, evisceration, and prosthetic replacement. Partial loss of levator palpebrae superioris muscle function was observed postprocedure. This case underscores the diagnostic challenge of CCF and highlights the significance of early and accurate diagnosis for appropriate management.
Branch retinal artery occlusion in a young patient with Mayer-Rokitansky-Küster-Hauser type 2 syndrome
Authors: Bedwal Anita , Banerjee Mousumi , Rewri Parveen
Published: October 2024

Retinal vascular occlusions are rare in young people, and any occlusion warrants an extensive clinical evaluation to establish the etiology. Cardiac malformations are a source of embolism. We present a case of atrial septal defect (ASD) in a patient with type II Mayer-Rokitansky-Küster-Hauser syndrome, leading to unilateral branch retinal arterial occlusion (BRAO) in a young woman. A 21-year-old woman presented with sudden, painless, blurring of vision, and a superior visual field defect in her right eye. A fundus examination confirmed the BRAO diagnosis. Ocular and systemic evaluation revealed primary amenorrhea, ASD, ectopic kidneys, and pelvic cyst. Any vascular occlusion in a young patient must be thoroughly evaluated, including a detailed systemic history.
Impact of neuro-optometric rehabilitation on adult oculomotor challenges – A systematic review
Authors: Jose Judy , George Bincy M. , Bhandary Sulatha V. , Jasti Dushyanth Babu
Published: October 2024

Neuro-optometric rehabilitation has a broad range of potential rehabilitative applications in neurological and developmental conditions affecting the eye. There is a dearth of evidence supporting its effectiveness, especially in adults. To address this issue, we systematically reviewed literature published in English between January 2000 and June 2022, obtained from search engines such as PubMed, EMBASE, Scopus, and CINAHL, using keywords including “neuro optometry,” “rehabilitation” or a related term, and “oculomotor problem” or “neurological problem” or a related term. Duplicates were eliminated through Mendeley software, and the quality of the selected studies was evaluated using JBI’s critical appraisal tools. Two authors independently reviewed six full-text articles. Relevant data were extracted to Microsoft Excel, and a third author reviewed it. Any uncertainties were resolved through consultation with the last author. Selected studies included adults who had oculomotor problems resulted either from traumatic brain injury/stroke/cerebrovascular accidents and managed with various rehabilitative therapies. Office-based, home-based, or combination therapies with duration ranging from 8 to 12 weeks with the frequency of 2–5 sessions/week were found effective in managing oculomotor problems in adults. However, there is a need for more clinical studies with a larger sample size in this regard.
The patterns and correlates of tobacco use in patients with schizophrenia: A cross-sectional study from North India
Authors: Yadav Shri Krishna , Dalal Pronob Kumar , Datta Manjistha , Pant Sanju , Kar Sujita Kumar
Published: October 2024

BACKGROUND:

Schizophrenia is a severe mental illness that is attributed to significant morbidity. Tobacco use is widespread among patients with schizophrenia. The purpose of this research was to evaluate the patterns and correlates of tobacco use in patients with schizophrenia.

METHODS:

This was a cross-sectional study conducted on patients with schizophrenia visiting a tertiary care center in North India. Adult patients of schizophrenia who were adherent to antipsychotic treatment were evaluated for the pattern and severity of tobacco use with reference to sociodemographic and clinical characteristics.

RESULTS:

A total of 93 patients were enrolled in the study. The current prevalence of tobacco use was found to be 61.54% among the patients with schizophrenia, and the majority (65.6%) of them was tobacco chewers with initiation of tobacco use during the second to third decades of life. More than half the tobacco users had at least a moderate level of dependence and had a positive family history of tobacco use. Patients with moderate-to-severe tobacco dependence had more severe psychopathology of schizophrenia than those with mild-to-moderate levels of tobacco dependence.

CONCLUSION:

The prevalence of tobacco use is high among patients with schizophrenia, and the psychopathology of schizophrenia may have a bearing on tobacco use behavior.
A case report of mephentermine dependence with mephentermine-induced psychosis
Authors: Chintala Hamini , Goud Sripathi Santhosh
Published: October 2024

Mephentermine is a cardiac stimulant with sympathomimetic effects which can be abused for bodybuilding. Athletes usually consume mephentermine at the advice of their trainers or peers to increase their stamina to exercise. The most common adverse effects experienced by the users were dependence and psychosis, which developed among chronic users. We report a case of a 37-year-old male, a gym trainer with mephentermine use who presented with schizophrenia-like psychosis.
Coping strategies used by children and adolescents following disaster trauma: A review of associated factors and intervention options
Authors: Kar Nilamadhab
Published: October 2024

Children and adolescents are more vulnerable to disaster-related trauma. The specific aim of this paper was to review the coping strategies used by children and adolescents in the aftermath of disasters. The relationship of coping methods with psychological consequences were also explored, along with the effectiveness of specific strategies in dealing with traumatic experiences of disasters. A literature search of electronic databases, involving the keywords “coping,” “children” and “adolescents,” and “disaster” was done along with secondary searches of the cross references. It was evident that children and adolescents use a range of coping strategies, and a large proportion of them are helpful, while others could be detrimental to their mental health. Many children and adolescents cope with disaster trauma and are resilient. Facilitation of positive coping methods can be used as an intervention along with other supportive activities and as a part of other psychological interventions. Coping can be supported by family, nonprofessional caregivers, community, and clinicians. There is a research need to develop consensus about the terminologies and culture-specific coping assessments and to explore the short- and long-term effectiveness of interventions focused on coping.
Contagion of fear: Investigating the psychology and effects of mass hysteria
Authors: Pradhan Lopamudra , Sahoo Ashrumochan , Sahu Pallabi , Swain Sarada Prasanna , Pradhan Mrunmayee
Published: October 2024

Mass hysteria, or mass psychogenic illness (MPI), refers to the rapid spread of symptoms or behaviors within a group without an identifiable physical cause, often triggered by psychological and social factors. This case report details an outbreak of MPI, commonly known as mass hysteria, at a girls’ boarding school in central Odisha. The incident was triggered by a 12-year-old student, Miss A, who exhibited physical symptoms such as fainting, shaking, and abdominal pain. These symptoms quickly spread to almost 100 other students. Medical evaluations found no physical cause, confirming the psychogenic origin of the outbreak. Cultural beliefs in malevolent spirits and social contagion were key factors in the spread, especially among the young, impressionable students. This case highlights the psychological and social mechanisms behind MPI outbreaks and emphasizes the importance of addressing mental health and cultural beliefs when managing such incidents.
Unveiling childhood onset bipolar disorder: A hidden diagnosis behind posttraumatic stress disorder
Authors: Chhajed Rucha , Sahoo Ashrumochan , Dash Swoyamsiddha , Swain Sarada Prasanna
Published: October 2024

Childhood-onset bipolar disorder (BD) presents significant challenges in diagnosis and management, compounded by a lack of extensive research into its early precursors and comorbidities. Delayed recognition and treatment of BD are linked to a higher frequency of depressive episodes and poor long-term outcomes. This case report describes an adolescent misdiagnosed with posttraumatic stress disorder after her father’s death, presenting with mood dysregulation, self-harm, suicidal tendencies, and school dropout, with a history of sexual abuse. Upon further evaluation, Bipolar type I disorder, current episode mixed, was diagnosed. The case highlighted the need for comprehensive pharmacological, psychosocial, and psychoeducational interventions to improve treatment outcomes in childhood-onset BD.
Correlation between the Ocular Surface Disease Index and dry eye functional parameters measured with the OCULUS Keratograph 5M in a Hispanic population
Authors: Morales-Mancillas Nallely R. , Garza-Garza Lucas A. , Hernandez-Camarena Julio C. , Castrejón-Perez Gabriela , Valdez-García Jorge E.
Published: October 2024

Background:

The evaluation of dry eye disease (DED) and the ocular surface can be approached from patient-centered questionnaires, clinical scales using the slit-lamp microscope, and more recently innovative ophthalmological devices that allow for noninvasive tests. The OCULUS Keratograph 5M (K5M) is a device that allows for noninvasive measurement of ocular surface parameters.

Materials and Methods:

The present article is a retrospective and observational study detailing the correlation of the OCULUS K5M surface parameters and the Ocular Surface Disease Index (OSDI) score. Patients of any gender and age attending a cornea and refractive surgery practice in an academic center underwent a full ophthalmological examination and tear meniscus height, tear breakup time, bulbar redness, meibography, and OSDI score measurement through the K5M.

Results:

One hundred and sixty-four eyes of 82 patients were included. The sample showed a female preponderance (78%) and a mean age of 49.45 years. When comparing the OSDI score with ocular surface parameters, a weak negative correlation was found with the tear meniscus height (Pearson coefficient: [ −0.229, P = 0.003]). There were no other statistically significant correlations between the K5M and the OSDI score. In addition, the meibomian gland dropout was significantly associated with increasing age, whereas conjunctivochalasis was associated with the female gender, increasing age and increasing OSDI score.

Conclusions:

The subjective symptoms of DED measured with OSDI score correlate only with tear meniscus height measured by the K5M in a Hispanic population. The detection of symptomatic DED patients through the K5M is incomplete in this population.
Short-term Effects of Crude Oil-polluted Soil on the Histomorphometry of the Femoral Cortex
Authors: Ese Oghenemavwe Loveday , David Orupabo Clinton , John Banigo Rebecca
Published: October 2024

Introduction:

Skeletal remains are crucial in most forensic case investigations. There is therefore need to study the process of bone degradation and distortion caused by environmental factors. The aim of the study is to determine the effect of burial in a crude oil-polluted soil on long bone histomorphometry.

Materials and Methods:

Fragments of 1-cm diameter sections of the mid-shaft of the femur were obtained from a cadaver and divided into three groups. Group A fragments were not buried (control), Group B fragments were buried in normal clay soil, and Group C fragments were buried in crude oil-polluted soil. The bone fragments were buried for a period of 5 weeks in a crude oil-polluted soil and normal soil of pH 5.30 and 5.75, respectively. Histological sections of the bones were prepared using the modified Frost’s method of bone preparation. Photomicrographs were taken using a Leica ICC50E photomicroscope at four different regions of the slides. An ImageJ software was utilized to analyze the micrographic details.

Results:

Quantitative analysis showed a reduction in the Haversian canal area (HCA) and Haversian canal diameter (HCD) in the samples of bone fragments buried in the crude oil-polluted soil compared to the control. The crude oil-polluted soil showed a mean HCA and HCD of 83.52 μm and 8.91 μm as against 153.23 μm and 16.01 μm for the control. There was no statistically significant difference (P > 0.05) in HCA and HCD between the control bones and those buried in normal and crude oil-polluted soil. The variation in number of osteons was observed to be nonstatistically significant for both bone samples exposed to crude oil and those not exposed.

Conclusion:

The result of this study shows that crude oil-polluted soil have little or no effects on bone histomorphometry for a short period of time. This should help guide forensic investigations.
The influence of weathering and pedogenesis on the geochemical record of Miocene marls and Plio-Quaternary sediments, Medvednica Mt., Croatia
Authors:   Department of Geology, Faculty of Science, University of Zagreb, Croatia, Gverić Zvonka , Tomašić Nenad ,   Department of Geology, Faculty of Science, University of Zagreb, Croatia, Durn Goran ,   Faculty of Mining, Geology and Petroleum Engineering, Zagreb, Croatia, Rubinić Vedran ,   Faculty of Agriculture, Zagreb, Croatia
Published: October 2024

The geochemical signature of weathering and pedogenesis in a temperate humid climate on two parent material types in the foothills of Medvednica Mt. was studied. Five soil profiles on Miocene marls and three sections of Plio-Quaternary (PlQ) proluvial sediments with overlying soil and weathered material were analyzed. The (clay) mineralogy of all profiles and sections had been determined in previous studies. The chemical composition of the samples was determined by inductively coupled plasma emission spectroscopy (ICP-OES) and inductively coupled plasma mass spectroscopy (ICP-MS). Poorly ordered Fe and Mn oxides were determined in the PlQ sediment and overlying soil samples by atomic absorption spectroscopy (AAS), after oxalate dissolution in the dark. The concentrations and element ratios were used to determine element enrichment/mobility and intensity of chemical weathering, material provenance, and to compare the geochemical signatures with previously obtained clay mineralogy results. Trace elements in the Miocene marls, including rare earth elements (REE), indicate the continental origin of the marl siliciclastic component, while more scattered geochemical data of the PlQ sediments reflect their proluvial/torrential nature. The mass transfer coefficient (τ) for major elements and element ratios of the Miocene marl profiles indicate chemical weathering and pedogenesis of lower intensity. The geochemistry of these samples shows homogeneity within the profiles. In the geochemical signature of the PlQ sections, a chaotic proluvial deposition of the material is visible, as well as the heterogeneity with the overlying soil and weathered material. Overall, the geochemistry results largely support the clay mineralogy of the samples and demonstrate how a multiproxy approach can help test hypotheses about past environments and provide valuable additional information for complex paleoenvironmental studies.
How to preserve the native or reconstructed esophagus after perforations or postoperative leaks: A multidisciplinary 15-year experience
Authors: Nachira Dania , Calabrese Giuseppe , Senatore Alessia , Pontecorvi Valerio , Kuzmych Khrystyna , Belletatti Claudia , Boskoski Ivo , Meacci Elisa , Biondi Alberto , Raveglia Federico , Bove Vincenzo , Congedo Maria Teresa , Vita Maria Letizia , Santoro Gloria , Petracca Ciavarella Leonardo , Lococo Filippo , Punzo Giovanni , Trivisonno Angelo , Petrella Francesco , Barbaro Federico , Spada Cristiano , D'Ugo Domenico , Cioffi Ugo , Margaritora Stefano
Published: October 2024

BACKGROUND

Esophageal perforation or postoperative leak after esophageal surgery remain a life-threatening condition. The optimal management strategy is still unclear.

AIM

To determine clinical outcomes and complications of our 15-year experience in the multidisciplinary management of esophageal perforations and anastomotic leaks.

METHODS

A retrospective single-center observational study was performed on 60 patients admitted at our department for esophageal perforations or treated for an anastomotic leak developed after esophageal surgery from January 2008 to December 2023. Clinical outcomes were analyzed, and complications were evaluated to investigate the efficacy and safety of our multidisciplinary management based on the preservation of the native or reconstructed esophagus, when feasible.

RESULTS

Among the whole series of 60 patients, an urgent surgery was required in 8 cases due to a septic state. Fifty-six patients were managed by endoscopic or hybrid treatments, obtaining the resolution of the esophageal leak/perforation without removal of the native or reconstructed esophagus. The mean time to resolution was 54.95 ± 52.64 days, with a median of 35.5 days. No severe complications were recorded. Ten patients out of 56 (17.9%) developed pneumonia that was treated by specific antibiotic therapy, and in 6 cases (10.7%) an atrial fibrillation was recorded. Seven patients (12.5%) developed a stricture within 12 months, requiring one or two endoscopic pneumatic dilations to solve the problem. Mortality was 1.7%.

CONCLUSION

A proper multidisciplinary approach with the choice of the most appropriate treatment can be the key for success in managing esophageal leaks or perforations and preserving the esophagus.
New rabbit model for benign biliary stricture formation with repeatable administration
Authors: Sun Qiu-Yue , Cheng Yi-Ming , Sun Yu-Hui , Huang Jin
Published: October 2024

BACKGROUND

The treatment of benign biliary strictures (BBS) is a challenging clinical problem. At present, there is a lack of ideal models for the study of BBS treatment.

AIM

To develop a novel animal model of BBS to simulate studies on the processes and mechanisms in the human condition.

METHODS

A rabbit model of benign bile duct stricture was established by surgical injury of the bile duct. After removal of the gallbladder, a drainage tube was placed through the cystic duct at the stump, and a BBS model was induced by surgical injury at the lower end of the common bile duct.

RESULTS

Compared with the control group, the model rabbits showed gross jaundice, increased serum bilirubin, and decreased liver function. Cholangiography showed segmental bile duct stenosis in the model rabbits. Pathological staining showed inflammatory cell infiltration and fibrosis in the biliary tract of rabbits in the model group. This was consistent with the clinical manifestations of BBS. This model provided serology, imaging, pathology, and other aspects of BBS.

CONCLUSION

We have successfully established an animal model of benign stricture of the lower bile duct with repeatable administration, which is consistent with the clinical manifestations of BBS.
Does shear wave elastography technology provide better value for the assessment of perianal fistulizing Crohn’s disease?
Authors: Wu Jiong
Published: October 2024

Magnetic resonance imaging is the gold standard compared other clinical findings. But shear wave elastography technique combined with endoscopic ultrasound can evaluate the degree of fibrosis of fistula tissue in Crohn’s disease patients. This topic is highly relevant to the current discourse, especially for It shows a certain degree of innovation and practicality and is worthy of study and popularization.
Motorized spiral enteroscopy: A cautious step forward in technological innovation
Authors: Xiao Shu-Ping , Lin Hai , Chen Hong-Bin
Published: October 2024

With the continuous advancement in medical technology, endoscopy has gained significant attention as a crucial diagnostic tool. The introduction of motorized spiral enteroscopy (MSE) represents a significant advancement in the diagnosis and treatment of small bowel diseases. While there are safety concerns and a high reliance on the operator’s skills, MSE should not be disregarded entirely. Instead, it should be considered as a supplementary endoscopic technique, particularly in situations where conventional endoscopy proves ineffective. Through continuous research and technical optimization, MSE has the potential to become an important addition to the endoscopy toolbox in the future. We call on colleagues in the industry to work together to promote the improvement of MSE technology through continuous research and practice, with the aim to bring out its unique value in endoscopy while ensuring patient safety.
Systemic air embolism associated with endoscopic retrograde cholangiopancreatography: A case report
Authors: Li Jing-Hao , Luo Zhi-Kun , Zhang Yu , Lu Ting-Ting , Deng Yue , Shu Rui-Ting , Yu Hang
Published: October 2024

BACKGROUND

Endoscopic retrograde cholangiopancreatography (ERCP) is a key procedure for diagnosing and treating biliary and pancreatic disorders. Although effective, it carries risks, including rare but severe complications such as air embolism.

CASE SUMMARY

We report a case of a 58-year-old man who developed extensive air embolism during ERCP. He previously underwent a Whipple procedure and experienced a sudden drop in vital signs and loss of consciousness. Immediate intervention with hyperbaric oxygen therapy and supportive care led to gradual recovery. Imaging confirmed widespread air embolism, which resolved with continued treatment.

CONCLUSION

Air embolism is a rare, critical complication of ERCP, especially in patients with prior surgery such as pancreaticoduodenectomy. Early detection and prompt treatment, including hyperbaric oxygen therapy, are crucial for favorable outcomes.
Cardiovascular and nonalcoholic fatty liver disease: Sharing common ground through SIRT1 pathways
Authors: Maiese Kenneth
Published: October 2024

As a non-communicable disease, cardiovascular disorders have become the leading cause of death for men and women. Of additional concern is that cardiovascular disease is linked to chronic comorbidity disorders that include nonalcoholic fatty liver disease (NAFLD). NAFLD, also termed metabolic-dysfunction-associated steatotic liver disease, is the greatest cause of liver disease throughout the world, increasing in prevalence concurrently with diabetes mellitus (DM), and can progress to nonalcoholic steatohepatitis that leads to cirrhosis and liver fibrosis. Individuals with metabolic disorders, such as DM, are more than two times likely to experience cardiac disease, stroke, and liver disease that includes NAFLD when compared individuals without metabolic disorders. Interestingly, cardiovascular disorders and NAFLD share a common underlying cellular mechanism for disease pathology, namely the silent mating type information regulation 2 homolog 1 (SIRT1; Saccharomyces cerevisiae ). SIRT1, a histone deacetylase, is linked to metabolic pathways through nicotinamide adenine dinucleotide and can offer cellular protection though multiple avenues, including trophic factors such as erythropoietin, stem cells, and AMP-activated protein kinase. Translating SIRT1 pathways into clinical care for cardiovascular and hepatic disease can offer significant hope for patients, but further insights into the complexity of SIRT1 pathways are necessary for effective treatment regimens.
Farklı Dozlarda Boldenon Uygulamasının Egzersiz Yaptırılan Sıçanların Bazı Uzun Kemikleri Üzerine Etkisi
Authors: Erdem Berkay , Lök Sefa
Published: October 2024

Bu çalışmanın amacı; farklı dozlarda boldenon uygulamasının egzersiz yaptırılan sıçanların Femur ve Humerus kemikleri üzerindeki etkisini incelemektir. Sıçanlar, Kontrol (K), Egzersiz (E), Boldenon1 (B1), Boldenon 2(B2), Boldenon + Egzersiz1 (BE1) ve Boldenon + Egzersiz2 (BE2) olarak 6 farklı gruba ayrıldı. E, BE1 ve BE2 gruplarındaki sıçanlara 6 hafta boyunca 1.5km/saat hızda olacak şekilde haftada 5 gün 45 dakikalık koşu egzersizi yaptırıldı. Buna ek olarak BE1 grubundaki sıçanlara haftada 1.25mg/kg, BE2 grubundaki sıçanlara ise haftada 5mg/kg dozda Boldenon intraperitoneal olarak verildi. B1 (1,25 mg/kg) ve B2 (5 mg/kg) gruplarındaki sıçanlara ise egzersiz yaptırılmadan sadece Boldenon uygulaması yapıldı. Altı haftalık çalışmanın ardından sıçanlardan alınan femur ve humerus kemiklerinin boy uzunlukları, corpus ve cortex kalınlıkları ve medullar çap ölçüleri incelendiğinde gruplar arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p>0,05). Mevcut çalışmada femur ve humerus kemiklerinin boy uzunlukları ortalamaları incelendiğinde Boldenon uygulaması yapılan B1, B2, BE1 ve BE2 gruplarındaki Femur ve Humerus kemiklerinin boy uzunlukları ortalamaları, K ve E gruplarındaki Femur ve Humerus kemiklerinin boy uzunlukları ortalamalarından daha kısa olduğu görüldü. Sonuç olarak, istatistiksel olarak anlamlı bir fark bulunmasa da Boldenon uygulaması yapılan tüm gruplardaki Femur ve Humerus kemiklerine ait boy uzunlukları diğer gruplara göre daha kısa ölçülmüştür. Bu nedenle Boldenon uygulamasının femur ve humerus kemiklerinin büyümesini durdurabileceği söylenebilir. Anabolik androjenik steroidlerin ekstremite kemikleri üzerine olan etkileri farklı sürede ve dozda uygulama yapılarak incelenmelidir.
Developing a Disaster Recovery Plan to Enhance Corporate Resilience and Ensure Business Continuity
Authors:   ]School of Information and Computer Sciences, University of the Cumberlands, Vallabhaneni Rohith , Veeramachaneni Vinod ,   School of Computer and Information Sciences, Colorado Technical University, USA
Published: October 2024

Disasters occur in the corporate operational environment. Earthquakes, floods, fires, and other unpredictable events that might disrupt company activities are among these calamities. The incidence of disasters in the workplace adds to unfavorable consequences. As a result, the construction of a disaster recovery plan becomes necessary for the firm to manage the bad consequences that may arise as a result of the unfavorable occurrences. With a disaster recovery strategy in place, a firm can sustain and swiftly restart normal operations. The firm's disaster recovery plan is a written document that outlines an efficient strategy for dealing with unforeseen and unmanageable catastrophes. Developing a disaster recovery strategy ensures the organization's survival by responding effectively to the present calamity.