bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of exosomes in false-positive COVID-19 PCR tests: Non-specificity of SARS-CoV-2-RNA in vivo detection explains artificial post-pandemic peaks
Authors: Igor Khmelinskii , Peter Stallinga , Leslie V Woodcock
Published: February 2024

Background: The COVID-19 pandemic priorities have focused on prevention by detection and response. National governments’ prevention response decisions are based upon detection statistics from PCR (polymerase chain reaction) tests that are used to define numbers of (i) COVID-19 infected persons, (ii) COVID-19 hospitalisations, and (iii) COVID-19 deaths. These statistics assume a priori that PCR tests are nigh 100% true detectors of COVID-19 infections. Here we will provide an alternative interpretation, along with the compelling evidence, that false positives have distorted to some degree the statistics of the primary outbreaks, and account for almost the whole of the 2nd and subsequent apparent COVID-19 outbreak peaks in various countries. Methods: We extract from the published literature on PCR-test outcomes graphical data that reveals the evidence for a very large percentage of false positive results. We review the role of exosomes in the immune response to all respiratory viral infections and its effect on PCR tests. We hypothesise that exosomes, triggered by all viral respiratory infections, are largely responsible for positive outcomes from PCR tests for COVID-19. We test our alternative interpretation for consistency with the empirical epidemiological trends as published by the World Health Organization (WHO). The Scientific Method is used to direct our research efforts. Findings: We find that PCR testing data for the second and following waves of the COVID-19 pandemic indicate that these waves are mainly artefacts of false-positive results. We find that this interpretation provides a more consistent explanation of the known epidemiology of COVID-19 than the hitherto consensus notion of extremely contagious and rapidly mutating viruses. Interpretation: The RNA (ribonucleic acid) code detected in PCR tests, previously attributed to SARS-CoV-2, belongs instead to a respiratory-virus-induced immune system response by human cells that liberate exosomes, and that vitiate PCR test results. PCR tests have zero specificity in vivo due to the exosome RNA. PCR tests exhibit excellent specificity in vitro on pure samples of other respiratory viruses. The low success rate of vaccines in preventing COVID-19 is explained by the inexact identification of the SARS-CoV-2 RNA.
Clerodendrum bungei an Ornamental Plant with Several New Records Outside of Parks and Gardens in Türkiye
Authors: Coşkunçelebi Kamil , Terzioğlu Salih
Published: February 2024

Clerodendrum bungei (Lamiaceae) is a deciduous shrub that occurs both within its native Asian range and beyond to temperate and tropical regions around the world as a result of both unintentional and intentional introductions for ornamental uses. Although it was listed as an ornamental plant in parks and gardens of Türkiye, this paper presents a list of 55 records including 47 new records of C. bungei outside parks and gardens of Black Sea Region. The new list includes 11 records from Artvin, 10 from Rize, 8 from Trabzon, 14 from Giresun, 3 from Ordu, and 1 from Samsun. The rapid increase in the number of new localities outside gardens and parks of Türkiye in the last 10 years shows that the species will become an invasive alien species in this region shortly. So, it will outcompete native plant species and impact habitat values, thus it is important to closely monitor the populations outside parks and gardens in this region and should take the necessary precautions for local farmers and administrations.
Role of pembrolizumab in relapsed Hodgkin lymphoma patients
Authors: Hladkykh Dmytro M. , Oleshko Victoria , Berladir Nataliya
Published: February 2024

About 10–15% of patients with early-stage and 15-30% with relapsed Hodgkin lymphoma after primary conventional treatment. Despite the approval of novel therapies, autologous stem cell transplantation (ASCT) remains the standard of care in these patients. However, up to half of transplanted individuals may relapse. Pembrolizumab is an FDA-approved monoclonal antibody directed against programmed cell death protein 1 (PD-1), it has received approval for the treatment of solid cancer and showed increased progression-free survival in high-risk patients with relapsed Hodgkin lymphoma receiving autologous stem cell transplantation. This study aims to investigate the role of relapsed Hodgkin lymphoma after using Pembrolizumab. This study was conducted for 80 patients with relapsed Hodgkin lymphoma who received Pembrolizumab and 50 patients had completed treatment with 40% complete response. In conclusion, Pembrolizumab showed a good response in patients with relapsed Hodgkin lymphoma.
The effectiveness of early administration of antifibrotic therapy as a reflection of properly organized medical care for patients with progressive pulmonary fibrosis
Authors: Ignatova G. L. , Antonov V. N. , Blinova E. V. , Belsner M. S.
Published: February 2024

The issues of organization of medical care and early administration of antifibrotic therapy in patients with progressive fibrotic phenotype require in-depth study and implementation in real clinical practice.

The aim of this paper is to provide a rationale for the early administration of antifibrotic drugs in patients with various forms of interstitial lung disease.

Results. The article addresses organizational issues in the medical care for interstitial lung disease with a progressive fibrotic phenotype. Topical epidemiological problems are also addressed, in particular the high mortality rate in this disease. The main risk factors of the disease are considered. Diagnostic markers for the fibrosis progression are analyzed. Data from large-scale studies on the early initiation of antifibrotic therapy and its effect on disease outcomes are presented.

Conclusion. The main reasons for early initiation of therapy in a progressive fibrotic phenotype are presented: an unfavorable prognosis, an unpredictable course, a progressive decrease in forced vital capacity, and the association of changes in FVC with an increase in mortality. Using the Chelyabinsk region as an example, a model of care for patients with interstitial lung diseases is considered, with a brief analysis of the effectiveness of antifibrotic therapy, its early initiation and the impact on mortality in patients with this disease.
Effect of hydrogen inhalation on cardiovascular and interstitial components of pulmonary hypertension in rats
Authors: Kuropatkina T. A. , Gufranov K. F. , Sychev F. Yu. , Artemieva M. M. , Bondarenko G. N. , Esaulenko D. I. , Samoylenko T. V. , Shyshkina V. V. , Medvedeva N. A. , Medvedev O. S.
Published: February 2024

Hydrogen is known to have selective antioxidant properties. It binds highly reactive hydroxyl radicals. The pathogenesis of the monocrotaline animal model of pulmonary hypertension is associated with oxidative stress and leads to all the symptoms of pulmonary hypertension (PH) and interstitial lung disease (ILD) associated with hypertension.

The aim of this work was to study the effect of 4% hydrogen inhalations on the symptoms of PH and ILD in rats.

Methods. To model monocrotaline-induced pulmonary hypertension (MCT-PH), two groups of animals received a single subcutaneous injection of monocrotaline (MCT) on day 1. The control group was injected subcutaneously with MCT solvent only. The animals receiving MCT were further divided into 2 subgroups. Subgroup 1 rats breathed room air and subgroup 2 rats breathed a mixture of room air and 4% hydrogen. The regular inhalations continued until day 21. On day 21, hemodynamic parameters were measured under urethane anesthesia, the heart and its components and the lungs were weighed, and lung tissue was preserved for morphological study.

Results. The inhalation had no effect on the main cardiovascular symptoms of PH, but a positive effect on the state of the connective tissue of the lungs affected by PH was shown. The mast cell response was reduced both quantitatively and functionally. There was a decrease in tryptase expression by mast cells, with predominance of the forms without signs of degranulation. TGF-β secretion was also significantly reduced and visualized by immunopositive cells in alveolar cellular structures and vessel walls.

Conclusion. Inhalation of 4% hydrogen reduces inflammation and fibrosis of lung tissue during the development of MCT-PH.
Lymphangioleiomyomatosis: X-ray morphological comparisons
Authors: Samsonova M. V. , Timofeeva A. S. , Pakhomov P. V. , Pershina E. S. , Cherniaev A. L. , Makarova M. A. , Cherniak A. V.
Published: February 2024

Lymphangioleiomyomatosis (LAM) is a rare, slowly progressing disease characterized by a tumor-like overgrowth of smooth muscle fibers in the interstitial lung tissue, around blood and lymph vessels, bronchi, bronchioles, in lymph nodes. The disease has mainly been described in women of childbearing age, with a mean age of diagnosis of about 35 years.

Methods. This retrospective, cohort study included 16 patients who were diagnosed with LAM at the age of 17 – 53 years (Me – 39, HQ – 42.5, LQ – 30.5). The calculation of the volumetric area of cystic lesion in the entire volume of the lungs was carried out using the GE aws 3.2 Thoracic VCAR software. To assess the area of cystic lesion on histological sections, we calculated area of cystic formations, in the walls of which smooth muscle nodules were found. For statistical analysis, the Kolmogorov–Smirnov test, the Mann – Whitney U-test (p < 0.05), and the Spearman correlation analysis were used.

Results. Morphometric analysis of histological preparations of the lungs showed no statistically significant difference between women of young age and older age. A correlation was found between the volumetric area of cystic lesion on CT and FEV1 (correlation coefficient = –0.886). Baseline median area of cysts was larger in patients who later deteriorated, while condition of patients with a smaller area of cysts remained stable (2.677 vs 1.119 mm2  correspondingly).

Conclusion. The volumetric area of cystic lesions in LAM correlates with functional parameters. The size of cysts in LAM may determine the prognosis of the course of the disease, because the formation of larger cysts is an unfavorable prognostic factor that increases the risk of developing pneumothorax.
Mitochondria as a key target of molecular hydrogen
Authors: Nesterov S. V. , Rogov A. G. , Vasilov R. G.
Published: February 2024

The aim of the work was to systematize the data on the biologically significant effects of molecular hydrogen to uncover the mechanisms of its effect on the human body. The paper analyzes the literature on the effect of molecular hydrogen administered in the form of inhalation and hydrogenenriched water on the human body, on laboratory mammals (rats, mice), and on model cell systems in vitro. As a result, a mechanism has been proposed according to which, in addition to the already known effect of hydrogen in neutralizing highly reactive oxygen species, there is at least one other group of molecules that are the target of molecular hydrogen in the body. These are the porphyrins, which are part of the hemoproteins, in particularly the cytochromes of the mitochondrial respiratory chain. In the presence of high concentrations of carbon dioxide, which is formed in the tricarboxylic acid cycle in the mitochondrial matrix, hydrogen damages some of the hemes as a result of covalent binding of the CO group to them. At low doses of hydrogen, this causes a moderate decrease in mitochondrial potential and stimulates the adaptive response of the body, including activation of the transcription factor Nrf2, expression of the heme oxygenase and antioxidant defense enzymes, mitophagy, and renewal of the mitochondrial population in the cell.

Conclusion. Molecular hydrogen is an adaptogen that causes mitochondrial hormesis – the renewal and strengthening of the body’s bioenergetic and antioxidant systems.
Influence of adipocytokines on the bronchopulmonary system in abdominal obesity
Authors: Khudiakova A. D. , Ragino Yu. I.
Published: February 2024

Pathogenesis of chronic lung diseases is assumed to involve systemic inflammation factors, as well as hormone-like substances adipokines produced by adipose tissue, which is an independent endocrine organ. Adipokines cause systemic inflammation under the influence of hypoxemia due to obesity and associated respiratory disorders such as obstructive sleep apnea syndrome, chronic obstructive pulmonary disease, hypoventilation syndrome, etc. However, the influence of specific adipocytes on the development and course of bronchopulmonary diseases remains unclear.

Purpose of this review was to evaluate the contribution of some adipocytokines to the development of bronchopulmonary conditions against abdominal obesity. We collected data on adiponectin, adipsin, lipocalin-2, interleukin 6, insulin, glucagon, leptin, monocyte-chemoattractant protein type 1, tumor necrosis factor-α, amylin, glucose-dependent insulinotropic polypeptide, ghrelin, and pancreatic polypeptide in patients with abdominal obesity and bronchopulmonary disorders.

Conclusion. The presented data confirm that hormone-like substances produced by adipose tissue make a significant contribution to the severity of respiratory disorders.
“Ground glass opacity” sign in lung diseases: nuances of radiological diagnosis and correct interpretation
Authors: Karpova A. A. , Sergeev N. I. , Nikitin P. A. , Solodkiy V. A. , Kotlyarov P. M. , Nudnov N. V. , Tsallagova Z. S. , Soldatov D. G.
Published: February 2024

“Ground glass opacity” (GGO) sign is one of the most common radiological symptoms of lung diseases that has become the focus of discussion by the general medical community during the pandemic of COVID-19. Non-specificity of GGO and the variety of diseases accompanied by this sign hinder the correct interpretation and differential diagnosis.

The purpose of this review is to study the differential diagnostic features of GGO detected by multispiral computed tomography in various lung diseases.

Conclusion. Knowledge of the features of GGO CT-pattern in various lung diseases significantly facilitates the interpretation of the imaging results and speeds up the differential diagnosis.
Plastic bronchitis with the development of atelectasis and bronchiectasis during a long course of bronchial asthma
Authors: Molodtsova V. P. , Dvorakovskaya I. V. , Dvoretskaya M. A. , Sobchenko S. A. , Akopov A. L.
Published: February 2024

Plastic bronchitis (PB) is a recurrent inflammation of the bronchi, characterized by the formation of fibrin-rich rubber-like secretions that obstruct the airways.

Aim. The authors present a rare case of PB in a 67-year-old woman who had been receiving treatment for bronchial asthma for 20 years. This case was complicated by the development of persistent atelectasis and saccular bronchiectasis of the left lower lobe requiring surgical treatment.

Conclusion. Removal of the rubbery contents of the bronchi by bronchoscopy provides a temporary effect only. Surgical treatment is advisable with a progressive course of the disease.
Questionnaire-based assessment on knowledge, attitude and practice of fixed-dose combination in medical undergraduates of a tertiary care teaching hospital, Kanpur
Authors: Kushwaha Virendra , Agrawal Pooja , Sahu Alpana , Pushkar Pushpendra , Khan Nasreen F. , Vekaria Harsh
Published: February 2024

Background: Aim was to assess knowledge, attitude and practice of second-year medical undergraduates towards FDC.
Methods: A cross-sectional questionnaire-based study was conducted among second-year medical undergraduates of GSVM, medical college, Kanpur in the form of a pre-test, and after sensitizing the students about FDC, the same questionnaire was given as a post-test.
Results: A total of 251 students, 157 students participated in the pre-test and 140 participated in the post-test. The percentage of male students in pre and post-test were more (58% and 61.4%) compared to female students (42% and 38.6%). After conducting a post-test survey, there is a significant improvement in knowledge and attitude toward FDC.
Conclusions: The inclusion of FDC in the undergraduate curriculum is a good initiative by NMC but there is a need to conduct more CME, symposiums, and workshops in medical colleges to update the knowledge regarding FDC among medical undergraduates.
Medication error in general medicine department of tertiary care Koshi Zonal hospital in Nepal
Authors: Mustafa Mohammad , Adhikari Kajiram , Shah Anil K. , Alam Kadir , Jha Rajesh , Sarraf Deependra P.
Published: February 2024

Background: Medication errors are the leading cause of patient harm, injuries and even death in hospitalized patients. It endangers patient safety and also increases the cost of treatment leading to enhanced financial burden to the individuals and the community as well. The study was aimed to determine the pattern of occurrence of medication errors.
Methods: A cross-sectional study was conducted in 188 hospitalized patients in medical ward at a Zonal Hospital. Medication errors were identified and categorized by reviewing the cardex. The data were analyzed to determine the cause of medication errors including rates of harm to patients. The descriptive statistics frequency and percentage were calculated using Microsoft Excel 2007. The findings were presented as tables and graphs.
Results: A total of 985 medication errors were found in 650 (38.3%) drugs prescribed in 177 (94.1%) patients. Approximately 72.9% of the errors reached the patients and 32.39% of the errors were harmful. The most common observed errors were administration errors (41.6%) followed by prescribing errors (36.5%), transcription errors (14.3%) and monitoring errors (7.5%). Omission of prescribing information (63.88%) and wrong dosing schedule (34%) were the most common type of prescribing and transcription errors respectively. Omission of dosages administration (57.32%) to patients was the most common types of administration error. All types of medication errors were highest in the alimentary tract and metabolism class of drugs (32.39%).
Conclusions: Medication errors were associated with the majority of hospitalized patients signifying the requirement of immediate preventive strategies and policies to ensure patient safety.
Assessment of minimum inhibitory concentration to vancomycin, tigecycline, linezolid, daptomycin, ceftaroline and mupirocin against methicillin resistant Staphylococcus aureus clinical isolates by antibiotic gradient strips
Authors: N. Aparna , P. R. Devipriya , N. Shilpa , Premanandan Fashna , K. B. Anusree , Sathar Saliha , Kumar K. S. Harish
Published: February 2024

Background: Staphylococcus aureus infections are one of the most common and serious hospital-acquired infections seen in developing countries. Methicillin resistant Staphylococcus aureus (MRSA) is an important human pathogen and normally colonized in body parts including skin, nose, perineum and throat. MRSA is resistant not only to all β-lactam groups but also other antibiotics including aminoglycosides, tetracycline and macrolides. In the present study the efficacy of agents used in the management of MRSA infections was determined by antibiotic gradient testing.
Methods: A total of 60 clinical isolates of MRSA strains were collected from various diagnostic labs in central Kerala. Clinical isolates were reconfirmed as MRSA by gram staining, yellow-coloured colonies on mannitol salt Agar (MSA). Antibiotic susceptibility testing was done by disc diffusion method as recommended by CLSI guidelines. S. aureus isolates resistant to cefoxitin (30 µg) was identified as MRSA. Antibiotic gradient testing was performed to determine the MIC of vancomycin, tigecycline, linezolid, daptomycin, ceftaroline and mupirocin against MRSA isolates.
Results: All the 60 MRSA isolates tested were sensitive to vancomycin, tigecycline, linezolid, daptomycin, ceftaroline and mupirocin (100%) and none of the MRSA isolates show resistance. 
Conclusions: Results of present study indicates that these agents may be used alongside vancomycin in management of infection caused by MRSA.
Evaluation of orphan drug therapies and associated monitoring guidelines
Authors: Bhavadharini Pandiarasu , A. Samath Suhaina , Ali Jabarulla Mohamed
Published: February 2024

Orphan drugs, designed for the treatment and prevention of rare medical conditions known as orphan diseases, are infrequently accessible due to their high costs and limited research. The prevalence of rare diseases varies across countries based on population demographics. The Food and Drug Administration (FDA) has approved over 770 drugs with 77 designations for orphan status. Some of these drugs, often discovered by the pharmaceutical industry, are both highly valuable and expensive. When using orphan drugs, specific parameters need to be monitored. Therapeutic monitoring should align with the patient's physical condition and the severity of the disease. This article aims to comprehensively examine the development of orphan drugs and their monitoring protocols.
Comparing the Bacterial Flora of Insectary and Filed Strains of Supella longipalpa (Blattaria: Ectobiidae) and their Antibiotic Resistant Pattern in Qom Province, Central Iran
Authors: Veysi Arshad , Kababian Majid , Khalifeh Gholi Mohammad , Godini Kazem , Vatandoost Hassan , Saghafipour Abedin
Published: February 2024

Background: Cockroaches play a role in the mechanical transmission of microbial pathogens. This study was designed to determine the isolated bacteria and their susceptibility to conventional antibiotics from brown-banded cockroach, Supella longipalpa, in Qom province, central Iran.
Methods: In this cross-sectional study, brown-banded cockroaches were bred in an insectary and caught from hospitals of Qom. The samples were taken from the surface and alimentary canal and then cultured on microbial culture media; next, grown specimens were identified using differential culture media. Finally, after performing diagnostic tests and identifying the bacteria species, their susceptibility to various antibiotics was evaluated.
Results: A total of 120 adult cockroaches from the insectary and hospitals were included in the study. Ten bacterial genera were found; nine were Gram-negative and one was Gram-positive. The genus Klebsiella, Enterobacter, Staphy­lococcus, Citrobacter and Hafnia were isolated only from the hospital strain. On the other hand, Pseudomonas and Escherichia from both groups and other species such as Salmonella, Proteus and Shigella were isolated only from la­boratory strains. The highest antibiotic resistance among Gram-positive cocci and Gram-negative bacilli were 100.0% and 98.1% for ampicillin and Ceftazidime, respectively.
Conclusion: The results of this study showed that various pathogenic bacteria harbored by brown-banded cockroaches. Moreover, it was found that most of these bacteria belong to the Enterobacteriaceae family, which can be pathogenic and thus threaten human health.
Distal Radius Volar T Plate Versus Distal Clavicle Pre-Contoured Locking Plate in Neer 2b Distal Clavicle Fractur: A Randomized Controlled Trial
Authors: Mehrvar Amir , Zandi Reza , Okhovatpour Mohammad Ali , Sarlak Shahab , Minator Sajjadi Mohammadreza , Ehsani Akbar , Ahmadi Abdashti Ahmadreza
Published: February 2024

Background: The purpose of the current study was to compare the clinical and radiographic outcomes of distal radius volar T plate and pre-contoured locking plate in distal clavicle fracture.
Methods: A total of 60 patients with Neer 2b distal clavicle fracture were included in this study and underwent open reduction and internal fixation (ORIF) between March 2019 and November 2020 via two different plates, distal radius volar T plate and distal clavicle pre-contoured locking plate. All patients were followed at least two years post-operative. Union rate, time to union, need to device removal, and Constant-Murley score (CMS) were assessed among them.
Results: In all patients, the bony union was achieved without wound-related complications. The mean time to union in distal radius volar T plate group was 3.3 ± 0.6 months and in the pre-contoured locking plate group was 3.6 ± 0.7 (P = 0.14). The mean CMS was 93.1 ± 2.2 and 92.1 ± 2.5 in T plate group and pre-contoured plate group, respectively (P = 0.09). Five cases with T plate and eight cases with pre-contoured plate were candidates for device removal (P = 0.53).
Conclusion: Distal radius volar T plate could be a reasonable choice to manage Neer 2b distal clavicle fracture as it restores functional range of motion (ROM) with excellent bone union and without the necessity of device removal, besides its economical price.
Assessment of Forward Head Posture in Information Technology Employees with Neck Pain: A Cross-Sectional Study
Authors: Mohapatra Subrat , Ganesh Anantharamakrishnan , Zion Nego
Published: February 2024

Background: Neck pain is the most common complaint that we deal with in orthopedics, most of which are information technology (IT) professionals. These individuals have vocational mismanagement which leads to high incidence of forward head posture (FHP).
Methods: A cross-sectional study was carried out from January 2019 to June 2019 during which a total of 300 patients were taken into study. Clinical assessment of neck pain, head posture, range of motion (ROM), and radiological assessment of craniovertebral angle (CVA) and anterior head translation (AHT) was done.
Results: Out of 300 patients, the majority of the patients were men. On average, men used computers for 9.6 hours compared to 9.2 hours for women. The average CVA was higher in women (58.8). The average AHT was more in men (22.9).
Conclusion: As compared with the previous literature, our study showed that 84.3% of male and 92.91% of female participants had FHP. CVA was lower, while AHT was higher in both groups than the usual range. The mean AHT in our sample was 18.8 mm, which was found to be aberrant in the prior research studies. In our study, we have found a negative correlation between the CVA and AHT, resulting in FHP, which can furthermore lead to early changes of cervical spondylosis in IT employees, probably due to long hours of desktop usage resulting in fixed postural habit.
Intravenous Injection of Tranexamic Acid in Patients with Pelvis or Acetabulum Fractures to Reduce Blood Loss: A Double-Blind, Randomized, Controlled Trial
Authors: Zandi Reza , Yousefi-Hajivand Esmaeel , Manafi-Rasi Alireza , Minator Sajjadi Mohammadreza
Published: February 2024

Background: Despite their low incidence, pelvis and acetabular fractures have a high mortality rate due to extensive hemorrhage. Tranexamic acid (TXA) is an antifibrinolytic drug that inhibits the production of plasminogen. The aim of the current study is to evaluate the safety and efficacy of TXA use for blood loss reduction and the need for blood transfusion in patients with fractures of the pelvis or acetabulum.
Methods: 108 patients were recruited from two tertiary care hospitals and assigned evenly either to the intervention (TXA) or the control group. TXA group received 15 mg/kg TXA 30 minutes before the fracture reduction and fixation surgery. The number of transfused blood units before, during, and after the surgery was recorded. Blood loss was assessed by calculation of estimated blood loss (EBL), collected blood with drain, collected blood with suction, and weight of the used gauzes during the surgery. The time between fracture occurrence and the surgery, the duration of the surgery, and the days of admission were assessed.
Results: The mean age was 39.49 ± 15.81 years, and 69.4% were women. 6 patients had pelvic, and 102 patients had acetabulum fractures. The duration of the surgery was not significantly different. The time gap between the reconstructive surgery and fracture occurrence was significantly higher in the TXA group (P = 0.032). The mean postoperative hospitalization time was significantly lower among TXA group patients (P = 0.037). The mean hemoglobin (Hb) in the TXA group was significantly higher, postoperatively (P = 0.028). The mean EBL, the blood volume collected by suction or drain, the weight of the consumed gauze during the surgery, and the number oftransfused blood units were significantly lower in the TXA group. The transfusion rate was significantly lower in patients with a shorter time gap between fracture occurrence and reduction surgery (P = 0.021).
Conclusion: TXA can decrease blood loss, the transfused blood units during and after the operation, and hospital admission days. Moreover, it did not increase the chance of pulmonary thromboembolism (PTE) or deep vein thrombosis (DVT) in the patients receiving TXA; thus, it can be assumed as a safe and efficient drug in patients with acetabulum or pelvis fractures.
Comparative Analysis of Dilute Povidone Iodine (Betadine) versus Normal Saline in Bilateral Knee Joint Replacement Surgery: A Retrospective Cohort Study
Authors: Shahbazi Pezhman , Ghorbani Amjad Gholamreza
Published: February 2024

Background: One of the proposed methods to reduce the risk of infection after joint replacement is the use of disinfectant solutions at the end of the surgery. Differing results have been reported regarding the effects of diluted povidone-iodine (betadine) washing solution and normal saline in reducing the risk of periprosthetic joint infection (PJI). The purpose of this retrospective cohort study is to compare the outcomes of diluted betadine solution with normal saline in bilateral knee replacement surgery.
Methods: Patients who were referred to Ba’ath Hospital, Hamedan, Iran, from 2019 to 2021 for bilateral knee joint replacement were included. For each patient, one knee was washed with diluted betadine (35%), and the other with normal saline for 3 minutes before closing the wound. Demographic information, risk factors, and the rate of PJI three months after the surgery were collected and analyzed.
Results: Out of 320 patients, 177 (55.3%) were women, and the most common underlying disease was type 2 diabetes with a frequency of 20.0%. Out of 640 operated knees, 17 cases (2.7%) of PJI occurred after surgery, of which 11 (4.3%) were washed with normal saline (P = 0.326). The multivariate regression analysis showed that being male (P = 0.028), diabetes (P = 0.030), high blood pressure (P = 0.019), and an increase in each body mass index (BMI) unit (P = 0.030) increased the chance of infection.
Conclusion: Intraoperative irrigation with diluted betadine solution in bilateral knee replacement surgery can reduce the risk of infection, especially in patients with underlying diseases and obesity.
On Robotic Surgery in Knee Arthroplasty: Beginning of a New Era
Authors: Sherafat Vaziri Arash , Javidmehr Sina , Vosoughi Fardis , Babaei Nejad Erfan , Same Kaveh
Published: February 2024

During the past two decades, the use of robotic arms in knee arthroplasty has changed from a concept to a reality. These systems promise precision and accuracy while shortening the required learning curve. Although still largely in the early stages, there are currently several commercially available platforms with varying degrees of flexibility. The available models can be classified into several categories based on their mode of operation (whether the system requires imaging input) and degree of autonomy. The present study aimed to review the existing body of literature and provide an outlook of the current landscape. The strengths and weaknesses of the implementation of such systems in knee arthroplasty are also discussed.
Calcific Myonecrosis of Tibialis Anterior in a 76-Year-Old Man with Foot Drop
Authors: Saini Naresh Kumar , Sharma Anamendra
Published: February 2024

Background: Calcific myonecrosis is a rare entity that is considered a sequela of chronic compartment syndrome. A fusiform mass with central liquefaction and peripheral calcification replaces the affected muscle unit.
Case Report: We are presenting a case of calcific myonecrosis of the tibialis anterior in a 76-year-old man. Although the mass was present for several years, the patient recently developed leg pain and foot drop. After radiological and histopathological diagnosis, patient was treated with surgical excision of the mass.
Conclusion: Although calcific myonecrosis is a benign condition, due to the pressure effect on surrounding structures, it may be a source of leg pain and foot drop. Cortical erosion and scalloping of underlying major bone may be reasons for extremity pain. To relieve pain, alleviate pressure effect, and prevent pathological fracture of the underlying bone, complete surgical excision of the lesion is essential.
Frequent Request of Injectable Biperiden in a Young Patient with Uncommon Neck Deviation and History of Neurodevelopmental Disorder
Authors: Kiani Reza , Jalali fard Hamid , Reza Bidaki Reza x
Published: February 2024

Introduction: Malingering is a differential diagnosis in the field of medical disorders, especially in the field of forensic medicine. In medicine, malingering is when a person imitates a medical or psychiatric disorder with external motivations to gain financial gain or avoid social or occupational duties. In some cases, diagnosing a medical or psychological condition from malingering can be challenging and difficult. In this case report, a patient with a history of multiple hospitalization, neurodevelopmental disorders, and intellectual disability requested to receive injectable Biperiden due to aggression, irritable mood, and neck deviation, and in order to receive it, he deliberately showed neck dystonia. This report aimed to discuss on a neuropsychiatric symptom, after which the patient requested a drug injection to resolve it, in order to differentiate possible diagnoses such as drug complication, factitious disorder, and functional neurological symptom disorder. On the other hand, during the recent searches of similar texts, conflicting results and suggestions have been presented.
Genetic Causes of Familial Adenomatous Polyposis (FAP), Risk Factors and Clinical Outcomes
Authors: Mehdi Heidari Mohammad , Aqhda Elham Afkhami , Tahmasebi Maryam , Khatami Mehri , Ardakani Zahra Shaker
Published: February 2024

Introduction: Familial adenomatous polyposis (FAP) is a hereditary disorder that is the most common colon cancer syndrome in an autosomal dominant form. At first, germline mutations in the APC gene (adenomatous polyposis) were identified as the main genetic factor causing FAP, but during subsequent studies, the human MutY (MYH) gene with an autosomal recessive pattern was also identified as the factor causing this disease, which is commonly referred to as MutYH-dependent apoptosis (MAP). FAP and MAP present with an early onset of hundreds of adenomatous polyps in the colon, at a median age of 35–40 years, and are associated with a significantly increased risk of colon cancer (CRC). In some other patients, gastrointestinal polyps, congenital hypertrophy in the retinal pigment epithelium, desmid tumors, and extracolonic malignancies are seen. The common treatment method in patients is through endoscopic and surgical methods. However, the patients with FAP and their relatives should receive appropriate genetic counseling. The purpose of this review article was to describe and investigate the clinical aspects and genetic diseases of FAP and MAP. For this purpose, the latest articles related to FAP genetic disease were selected by searching Google Scholar and PubMed sources.
Conclusion: Despite the progress made in discovering the molecular mechanisms of FAP, its genetic factors are still not fully understood. A deeper understanding of the molecular biology and genetics of this disease can lead to healthy therapies that can be used to rezone intestinal polyps and neoplastic malignancies and be a new target for future treatment.
Mental Adjustment to Cancer and its Effect on the Quality of Life of Women with Breast Cancer
Authors: Fallah Bahare , Fathi Fatemeh , Fallahfaragheh Ahmad Reza , Nasiriani Khadijeh , Mehrabbeik Akram
Published: February 2024

Introduction: Breast cancer has been recognized as the most common malignancy in women during the last 10-15 years. Quality of life is the result of several physical and psychosocial effects. The result of this study was conducted to investigate the strategies of mental adjustment to cancer and its impact on the quality of life of breast cancer patients.
Methods: This descriptive-correlational study was conducted on 240 breast cancer patients using simple random sampling who were referred in Shahid Ramezanzadeh Radiotherapy Center, Yazd, Iran, from April to October 2021. Data collection tools were standard quality of life questionnaires (EORTC QLQ-C30) and Mini-Comparison of Mental Adaptation to Cancer (Mini-MAC). Data were analyzed using t-test, correlation and regression in SPSS version 16 software.
Results: The mean age of patients was 44.77(±11.00) years. There was a significant and negative correlation between quality of life and Helplessness hopelessness (r= -.795, p<0.001) and anxious preoccupation (r= -.705, p<0.001). Quality of life was significantly and positively correlated with fighting spirit (r= .368, p<0.001) and cognitive avoidance (r= .364, p<0.001) and Fatefulness(r= .155, p<0.05). In general, cancer coping strategies explained 59% of the quality of life variation in breast cancer patients.
Conclusion: In order to improve the quality of life of patients, it is necessary to teach them adaptive strategies to adjust with cancer, such as fighting spirit and cognitive avoidance.
Comparison of the Effect of Eight Weeks Aerobic and Combined Exercise on Some Hemodynamic Indicators in Middle-Aged Male Patients Undergoing Coronary Artery Bypass Graft Surgery
Authors: Doulatyari Peyman Kaikhosro , Hosseinpour Delavar Sedigheh , Ghahramani Mehran , Rouzbahani Mohammad
Published: February 2024

Introduction: Exercise training by modulating blood pressure and heart rate have a protective role for middle-aged cardiac patients. Aim of this study was to compare the effect of eight weeks of aerobic and combined exercise on some hemodynamic indicators in middle-aged male patients undergoing coronary artery bypass graft surgery.
Methods: In this clinical trial, a sample of 30 middle-aged men who underwent coronary artery surgery in 2023 were enrolled after meeting predetermined eligibility criteria and randomized for participation. They were divided into three aerobic (n=10), combined (n=10) and control (n=10) groups. The individuals of the 2 intervention groups performed selected aerobic and combined exercises (with an intensity of 55 - 75% of the maximum heart rate, for 60 minutes) for 8 weeks, 3 sessions per week. Blood pressure, heart rate and peripheral oxygen saturation (SpO2) were measured before and after the intervention. The parametric paired sample t-test, one-way ANOVA test and Tukey's Test were used to examine differences at a significance level of P ≤ 0.05.
Results: The effect of aerobic exercises on systolic blood pressure (P=0.036), diastolic blood pressure (P=0.040) and heart rate (P=0.013) was significant and caused a decrease in these indicators, but the decrease in the combined group was not significant (P>0.05). The intergroup effect difference was not significant (P>0.05). In both aerobic (P=0.000) and combined (P=0.007) groups, the peripheral oxygen saturation has increased significantly and intergroup mean difference was significant (P=0.004).
Conclusion: It seems that aerobic and combined exercises as a helpful intervention strategy to improve hemodynamic indicators, make the patient more adaptable to the conditions after coronary artery bypass graft surgery.
Sanitation Knowledge and Practices of Malaysian Food SMEs: Addressing Current Issues and Readiness in Acceptance of Green Sanitation Technology
Authors: Khalid Nurul Izzah , Jalil Noor Ashikin , Ab. Aziz Norashikin , Harun Maizatul Mardiana , Taip Farah Saleena , Mahmud Ab Rashid Nor-Khaizura , Sobri Shafreeza , Yusof Yus Aniza
Published: February 2024

Sanitation is crucial in the food industry, involving cleaning and disinfection processes to ensure facility cleanliness. This study examined sanitation knowledge and practices among small and medium enterprises (SMEs) in Malaysia's frozen meat sector. It also evaluated the acceptance of eco-friendly sanitation technology, specifically an electrolysis unit producing electrolyzed water. Data was collected through an open-ended online questionnaire using Google Forms. The questionnaire comprises demographic profiles, sanitation knowledge, sanitation program design knowledge, sanitation challenges, and the acceptance of integrating a green cleaner with the current sanitation program. Results show SME manufacturers possess sanitation knowledge but face implementation challenges due to absent sanitation programs, skilled labor shortage, hot water supply issues, difficulty cleaning narrow spaces in equipment, chemical storage, and budget constraints. Due to low-temperature operations, only 73 % of frozen meat industries use hot water for sanitation. Additionally, 45 % lack wastewater treatment, leading to chemical residue discharge into municipal drainage. SMEs show interest in electrolyzed water for its dual role as a cleaning and disinfecting agent. The technology's room-temperature efficacy and environmentally friendly degradation into salt and water appeal to SMEs. Adopting electrolysis sanitation technology is expected to significantly reduce costs by utilizing only salt, water, and electricity for electrolyzed water generation.
Smart Banjar: An ICT Adoption Framework to Enhance People's Welfare
Authors: Joni I Dewa Made Adi Baskara , Mokhtar Shamsul Anuar , Talip Bazilah A. , Permana I Putu Hendika
Published: February 2024

Economic development has slowed dramatically in several countries during the COVID-19 pandemic, like in Indonesia. Bali Province was one of the regions that was severely affected. Due to its reliance on the tourism industry, Bali had the most significant negative growth. It is time for Bali and other regions to develop the potential of a locally-based, sustainable, and resilient economy to enhance the people’s welfare. Improving the community’s welfare can be done with the synergy of various entities—the synergy created by integrating programs in Banjar with microfinance to develop microenterprises. The main objective of this research is to ascertain the framework’s dimensions and components. Furthermore, the relationships between these dimensions or elements have been determined. Based on the findings, the two primary objectives were completed. This procedure has produced the Smart Banjar framework as a theoretical solution to enhance people’s welfare. This research created the information communication technology (ICT) adoption framework that uses the TOE theory as its theoretical basis. The Advisory Board serves as the environmental context for formulating policies. The policy will regulate governance to realize the synergy between microenterprises, microfinance, and Banjar in the organizational context. ICT adoption, including ICT infrastructure, ICT services, and ICT literacy, will support and optimize the synergy. Further investigation is required to ascertain the Advisory Board's specific constituents. Additional studies are needed to implement ICT, obtain empirical evidence, and prove its ability to improve people's welfare.
The Effect of Probiotic-Induced Fermentation of Restaurant Waste on the Growth of Common Carp (Cyprinus carpio) Fry
Authors: Andriani Yuli , Anasih Rita , Iskandar  , Pratiwy Fittrie Mellyanawaty , Wiyatna Muhamad Fatah , Pratama Rusky I.
Published: February 2024

The study explores using the fermentation process to convert organic restaurant waste into fish feed, a promising solution for aquaculture. The aim is to determine the best type and dosage of probiotics for fermenting restaurant waste (FRWM) and evaluate their impact on common carp (Cyprinus carpio) fry growth. Three commercial probiotics (P1, P2, and P3) were used at an 8% concentration for fermenting the waste. The best result from the fermentation trial was tested as feed containing different FRWM proportions: 0% (TA), 10% (TB), 20% (TC), 30% (TD), and 40% (TE) with 30% protein content. The trial lasted 42 days, assessing waste chemical composition before and after fermentation, growth rate, amylase and protease activity, feed conversion, survival rate, and water quality. Results showed P1 was most effective, increasing FRWM protein content by 84.25% and reducing crude fiber and fat by 15.17% and 3.94%, respectively. TE (40% FRWM) yielded the best outcomes, with fry common carp achieving a 1.05% daily growth rate and a feed conversion ratio of 0.80, indicating efficient feed utilization. TC (20% FRWM) exhibited the highest survival rate at 88.33%. The inclusion of FRWM influenced amylase activity, increasing enzyme levels and improving feed efficiency and growth rate. In conclusion, using FRWM, fermented with P1 probiotics, showed significant improvements in its composition, leading to enhanced fish growth and feed utilization. The 40% FRWM diet demonstrated the best fish growth rate and feed conversion performance. These findings support using fermented restaurant waste as sustainable and nutritious fish feed in aquaculture.
Potential of Underutilized Sago for Bioenergy Uses
Authors: Fetriyuna Fetriyuna , Letsoin Sri Murniani Angelina , Jati Ignasius Radix A.P. , Purwestri Ratna Chrismiari
Published: February 2024

Sago is a plant that grows naturally in some areas in Southeast and South Asia. Despite having multiple advantages, the usage of the sago palm is primarily from its starch content and is commonly used as an alternative replacement for white rice and wheat flour, the two most prominent staple foods, in several regions. Additionally, people are now more aware of how the total area of sago forests has decreased as monoculture, cash crops, or other food crop development have replaced it. This condition may endanger the ecology and the sustainability of food diversity. To support the bioeconomy principles, various utilizations of sago by turning it into higher value-added biomass need to be explored. The paper aims to review the potential utilization of sago as biomass and bioenergy as a value-added product after processing it for food. A literature review method in Scopus and PubMed databases was used to answer the research objective. Sago palm can be converted into bio-energy resources like biomass-biogas, bioelectricity, bioethanol, and biohydrogen. Together with the advancement in the processing of sago starch, sago waste from bark, pulp, fiber, or hampas is transformed into different products, e.g., plywood and particle board, sago craft from sago bark and fiber; thus, sago waste or sago hampas is a prospective bioenergy commodity. In conclusion, sago provides advantages beyond food diversity, such as lowering household food insecurity and promoting sago's use for biomass and bioenergy.