bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptoms and Risk Factors of Carpal Tunnel Syndrome among Schoolteachers in Al-Ahsa, Saudi Arabia: A Cross-sectional Study
Authors: Aldehailan Khawlah Salman , Alhubail Fatimah Muhanna , Almukhaimar Sara Khalid , Wutayd Haya Fayez , Alshehri Razan Ali , Almukhaimar Noof Khalid , Almuslim Nora Isa
Published: July 2024

Context:

Carpal tunnel syndrome (CTS) is caused by compression of the median nerve as it travels through the carpal tunnel into the wrist. It is the most common peripheral mononeuropathy and accounts for a large proportion of occupational upper extremity disorders. Teaching is an occupation associated with musculoskeletal disorders.

Aims:

This study aimed to investigate the prevalence of CTS symptoms and related risk factors among schoolteachers in Al-Ahsa.

Settings and Design:

A cross-sectional study was conducted on schoolteachers in Al-Ahsa, Saudi Arabia, during 2023.

Subjects and Methods:

We distributed the Boston Carpal Tunnel Questionnaire to the teachers’ groups through social media in the form of an online questionnaire, and we visited schools to encourage participation.

Statistical Analysis Used:

Data were analyzed using the Statistical Package for the Social Sciences. P < 0.05 was considered statistically significant.

Results:

Our study included 619 schoolteachers. The syndrome symptoms were present in 71.1% of individuals, and functional disruption was present in 52.7%. The likelihood of exhibiting the symptoms is increased by being female, not participating in sports, having a chronic illness, writing for more than 4 h, and having symptoms in both hands.

Conclusions:

We found a comparatively high percentage (71.1%) of the syndrome symptoms among schoolteachers working in Al-Ahsa, Saudi Arabia, which suggests that any signs of CTS in schoolteachers should be evaluated to ensure proper diagnosis and treatment.
A Prospective Study of Contracture of the Finger and its Management in a Tertiary Care Center
Authors: Shukla Brijesh Kumar , Naithani Neeraj , Kumar Amit , Mishra Ritambhara
Published: July 2024

Background:

When the range of motion between two finger segments, both active and passive, is restricted, finger contracture occurs. The aim of this study is to investigate the best procedure to eliminate finger contracture and the functional and esthetic results of the different surgical procedures.

Materials and Methods:

A total of 31 patients with soft-tissue abnormalities of the hand were included in this prospective study. They underwent either contracture removal with K-wire and skin grafts or various flap procedures in the department of plastic surgery. Complaints of stiffness and discomfort were classified into five categories: none, mild, moderate, marked, and severe. The difficulty a person had in picking up objects, grasping, writing, etc., was used to determine the degree of disability. Absenteeism from work and surgical site infections were also recorded.

Results:

The mean age was 20.25 years, with a mean age of 23.05 for men and 15.83 for women. Overall, most cases occurred in the age range of 3–10 years. For K-wire surgery with skin grafting, the typical time off work was 24 days. The average recovery time ranged from 15.2 days for skin grafts to 16.9 days for tenolysis, 28.33 days for groyne flaps, and 41 days for abdominal flaps. Of all cases, 12 (38.00%) had a fair result, 10 (31.04%) had a moderate result, and 9 (30.96%) had an excellent result.

Conclusion:

The most feasible method for treating these situations, which offers the greatest potential for a functional and cosmetic result, is contracture reduction with skin grafting.
Evaluation of Surface Roughness and Microhardness of Bulk-fill and Nanohybrid Composite after Exposure to Different Beverages at Various Time Intervals – An In vitro Study
Authors: Bengal Sachin , Badole Gautam P. , Shenoi Pratima R. , Kubde Rajesh , Shahu Shriya
Published: July 2024

Aim:

The aim of the study was to compare the surface roughness and microhardness of bulk-fill composite and nanohybrid composite resin after exposure to three different beverages at different time intervals.

Methodology:

In this study, 60 composite discs each for bulk fill and nanohybrid, of dimensions 10 mm × 2 mm were made. Both composites were randomly divided into four subgroups, i.e., 15 samples each for artificial saliva, tea, coffee, and soft drinks which were further subdivided into five samples for three time intervals. Composite resin discs were immersed in beverages for 4 min in 24 h for 7, 15, and 30 days. All samples were evaluated for surface roughness and microhardness before and after immersion.

Results:

Both the composites showed a significant increase in surface roughness in all the beverages with maximum change in surface roughness observed in nanohybrid composite resin immersed in soft drinks. Furthermore, the microhardness of both the composites was decreased significantly in all beverages with maximum change in microhardness observed in nanohybrid composite resin immersed in soft drinks.

Conclusions:

Bulk-fill composite resin has better resistance to surface roughness and higher microhardness as compared to nanohybrid. Furthermore, acidic beverages highly affect the physical properties of both composite resins for longer periods.
Demographic Characteristics and Functional Outcome in Posterior Circulation Strokes
Authors: Shahid Rizwana
Published: July 2024

Introduction:

The constantly increasing incidence of stroke in Saudi Arabia substantiates an urgent need to elucidate underlying risk factors and etiologies. In terms of improving outcomes, the predictors of functional outcomes need to be identified as well. As posterior circulation strokes (PCS) have not been studied in detail, the current study aimed to identify the risk factors, etiology, and predictors of outcome in PCS.

Methods:

This retrospective study included the data for 138 patients with PCS. Demographics, risk factors, clinical signs/symptoms, etiology, and outcome at discharge and 3-month follow-up were recorded. Factors associated with outcomes were identified, and the difference was ascertained using Chi-square, odds ratios, and 95% confidence intervals.

Results:

The mean participant age was 58 ± 14.8 years with 73% being males. The mean arrival time was 26.5 ± 31.6 h; with a mean National Institute of Health Stroke scale (NIHSS) score of 7.2 ± 5.6. Motor deficit and dysarthria were the most common presentations. Twenty percent of patients received intravenous recombinant tissue plasminogen activator, whereas endovascular thrombectomy was performed in 9 (6.5%). Follow-up outcome at 3 months was available in 113 (81.8%). Male sex, baseline modified Rankin scale of <2, low baseline NIHSS, and stable or improvement in baseline NIHSS during 24 h of admission were documented as predictors of a good outcome, whereas history of atrial fibrillation and prior stroke, high NIHSS at admission and worsening of symptoms during 24 h of admission, as well as bilateral body involvement were associated with poor outcome.

Conclusion:

The functional outcomes and the predictors of functional outcomes did not differ from the previously published literature; however, significant differences were observed in the risk factors and etiological profile in our population. These differences are of potential interest to the researchers and clinicians, as they carry important therapeutic and prognostic implications and need to be verified through large prospective studies.
A Conundrum to Decode the Proficiency of Urban Schoolteachers in Screening Learning Disabilities
Authors: Dani Akanksha , Pusdekar Yamini , Deshmukh Vishwajit
Published: July 2024

Introduction:

It is estimated that nearly 5%–10% of Indian schoolchildren have hidden problems, with about 80%–85% of them having dyslexia. Failing to diagnose and address learning disabilities on time can lead to adverse outcomes, such as school dropouts and mental health issues. In this context, the study was designed to assess educators’ knowledge regarding LD, its detection, and provisions for its management.

Methods:

A cross-sectional study was conducted in 10 randomly selected English, Hindi, Marathi, and Urdu medium schools under Brihanmumbai Municipal Corporation from June 2018 to December 2019. The study participants were primary, upper primary, and high schoolteachers whose knowledge and practices regarding LD were assessed using a validated questionnaire.

Results:

From the ten selected schools, 150 teachers were interviewed. The knowledge regarding LD was poor, with only 26.67% of the teachers expressing the inability of the child to learn in only one particular tenet of their studies as a learning disability, which was incorrect. Nearly 24.67% of the teachers expressed the correct opinion that children who had problems with two or more learning domains were found to have LD. Most of them were unaware of the provisions for children with LD. The most common factors influencing learning disability among children were the environment at home (approximately 40%), followed by health and frequent illness of a child (28.67%).

Conclusion:

LD criteria, screening, provision, and referral should have been better understood by schoolteachers. Most of their expertise came from teacher training programs. Teachers closely study their pupils and can spot even modest changes in academic performance or behavior, making them the first screening medium for learning disabilities. Therefore, teachers must be trained to recognize LD and informed about available services such as urban rehabilitation centers for children with LD.
Comparative Analysis of Multidimensional Learning Tools in Anatomy: A Randomized Control Trial
Authors: Rani Sudha , Gupta Govind Kumar , Chakraborty Ratnajeet , Kumar Tushar , Kumar Mani Kishlay , Das Anil Kumar , Shekhar Shashank
Published: July 2024

Introduction:

Anatomy teaching has traditionally been based on dissection. However, reduced hours in total and laboratory hours in gross anatomy along with a dearth of cadavers have ensued the search for a less time-consuming tool.

Materials and Methods:

The study was conducted in the Department of Anatomy in Sheikh Bhikhari Medical College, Hazaribag. A total of 282 medical students were taught gross anatomy, using three different learning modalities: dissection (n = 95), plastic models (n = 94), and three-dimensional (3D) anatomy software (n = 93). The knowledge of the students was examined by 100 multiple-choice question (MCQ) and tag questions followed by an evaluation questionnaire.

Results:

When performance is considered, the dissection and 3D group performed better than the plastic models group in total, MCQs, and tag questions. In the evaluation questionnaire, dissection performed better than the other two modalities. Moreover, dissection and 3D software emerged as superior to the plastic models group.

Statistical Analysis:

All data were analyzed using the one-way ANOVA and t-test. Group-based analysis by ANOVA and gender-based analysis were done by Student’s t-test. A comparison of students’ perceptions was done by Kruskal–Wallis H-test.

Conclusion:

Dissection remains a favorite with students and accomplishes a significantly higher attainment of knowledge. Plastic models are less effective but are a valuable tool in preparation for cadaveric laboratories.
Study of Body Composition by Biphotonic X-ray Absorptiometry in a Moroccan Female Population, an Indicator of Obesity?
Authors: Toufik Hamza , Majjad Abderrahim , Ghassem Mohammed Ahmed , Djossou H. J. , Sadni Siham , Achemlal L. , Bezza Ahmed , El Maghraoui Abdellah
Published: July 2024

Introduction:

Our purpose was to study the body composition in a healthy female Moroccan adult group, and to help physicians to evaluate nutritional status.

Materials and Methods:

Five hundred and nineteen healthy women aged from 20 to 80 years were included in the study. Bone mineral density at the hip and lumbar spine and the body composition parameters were measured by dual-energy X-ray absorptiometry: fat mass (FM), fat-free mass (FFM), and percentage (%) of body fat. The FFM index (FFMI) and the FM index (FMI) were calculated. We analyzed the population by age and body mass index (BMI) defined groups.

Results:

The mean age of the population was 53.14 ± 13.69 years with an average BMI of 29.30 ± 5.04 kg/m2. Means of FM and FFM were 33.93 ± 9.18 kg and 36.91 ± 5 kg, respectively, with FM and FFMI of 13.65 ± 3.66 kg/m2 and 14.85 ± 1.91 kg/m2, respectively. The % FM, FFM, and their corresponding indices increased with age; a statistically significant difference was observed between the 20 and 39 age categories and the two other categories. The BMI category analysis showed that FFMI and FMI increased in obese women with a statistically significant difference between the four groups. Age and BMI were correlated significantly with the different parameters.

Conclusion:

This is the first Moroccan study to present body composition indexes in healthy Moroccan female adults. These reference values may be useful for the clinical evaluation of body composition and nutritional status.
Promoting and creating feel-good positive experience among voluntary blood donors: An eight-step guide
Authors: Mittal Siddharth , Muthukumaravel P. J. , Tripathi Parmatma Prasad , Gupta Anubhav , Mandal Saptarshi , Sharma Suresh K , Chandra Tulika
Published: July 2024

The safest way to meet our nation’s blood needs is through regular, repeat, voluntary, nonremunerated donors, as recommended by the National Blood Transfusion Council. While several innovative methods are needed to draw in and keep these willing blood donors, optimization of the fundamental donation procedures can guarantee a positive and pleasant experience for them and improve donor retention. To provide a steady and secure blood supply, we emphasize on eight step-by-step guidelines in this article to address the positive blood donation experience and assure donor comfort and safety.
Knowledge, Attitude, and Perceived Barriers of Arteriovenous Fistula among Chronic Kidney Disease Patients Attending a Tertiary Care Center
Authors: Deepthi Vasanth , Anil R , Avinash Prabhu
Published: July 2024

Introduction:

Chronic kidney disease (CKD) affects 11% of the adult population worldwide. Hemodialysis (HD) therapy can be through either arteriovenous fistula (AVF), arteriovenous graft, or central venous catheter. Although AVF has better outcomes, many factors are responsible for its underutilization.

Materials and Methods:

A cross-sectional study was conducted in a tertiary care hospital among all adult patients diagnosed with CKD registered in the nephrology outpatient department for 3 months. The patients were subjected to a structured questionnaire. The questionnaire consisted of four parts, namely sociodemographic details, patients’ knowledge regarding AVF, attitude toward AVF, and perceived barriers toward the procedure. Data were analyzed using SPSS V-21. Demographic and knowledge data were summarized by calculating means and standard deviation. Attitudes and perceived barriers were analyzed as categorical variables. Association between categorical variables was done using the Chi-square test.

Results:

The mean age of the study participants was 52.24 (±15.47) years. The major cause of end-stage renal disease was hypertension (35.3%). Adequate knowledge was found to be among 79.8% of patients; which was significantly associated with patients who had dialysis session >150 times and who underwent AVF. 65.5% of patients would recommend AVF to others who are undergoing HD. Fear of needles (18%) was found as a major barrier to undergoing AVF.

Conclusion:

A systematic health education regarding the advantages of AVF over other VA methods can be done before initiating HD which can reduce the perceived barriers. This will aid in increasing the acceptance of AVF procedure among CKD patients.
An Uncoventional Technique: Outflow Vein Tributary access for Central Vein and Cephalic Arch Angioplasty in Dysfunctional AVF
Authors: Amullya KR , Muralikrishna N , Vinay K S , Gheewala Umesh Satish , Palanisamy Poornima , Vidyasagar Radhika , Sravan C P S. , Davu Narendra Babu , Sony Jithin , Gupta Veerabhadra
Published: July 2024

Introduction:

Central venous stenosis (CVS) is a significant and frequently encountered problem in managing hemodialysis (HD) patients. Venous hypertension, often accompanied by severe symptoms, undermines the integrity of the HD access circuit. In CVS, dialysis through an arteriovenous (AV) fistula is usually inefficient, with high recirculation rates and prolonged bleeding after dialysis. Interventions for central vein stenosis in patients with AV access are typically performed with a direct puncture of the fistula outflow vein or taking access from the femoral vein, jugular vein, axillary vein, and basilic vein. Commonly encountered complications with taking access from the fistula vein-puncture site bleeding, hematoma, pseudoaneurysm, thrombosis of arteriovenous fistula; complications noted with femoral vein access are groin hematoma, lower limb deep-vein thrombosis, need for patient immobilization, and groin compression. An alternative approach is to use the outflow vein tributary, such as the cephalic vein tributary, as an access to avoid these potential complications.

Aim and Objective:

The objective of this study was to evaluate the feasibility and clinical outcomes of central vein and cephalic vein arch angioplasty, utilizing an outflow vein tributary as access, for managing symptomatic CVS in dialysis patients with upper limb vascular access and significant ipsilateral limb edema.

Methodology:

In a Prospective interventional study conducted at 2 Tertiary care Institutes between 2022 and 2023, a total of 34 patients underwent central vein and cephalic arch angioplasty utilizing an outflow vein tributary as access. Follow-up duration varied among patients.

Results:

During a 1-year period, a total of 34 patients (20 male and 14 female) underwent interventions for central vein stenosis using a tributary of the outflow vein as an access. These interventions encompassed lesions in the SVC, innominate vein, subclavian vein, cephalic arch, and multisegmental disease. The technical success rate for endovascular treatment stood at 88%. However, in four patients, we encountered difficulties in crossing the lesion despite employing additional access from the great saphenous vein (GSV). Notably, in 23 cases, the entire procedure was successfully completed using access from the tributary vein, whereas in seven patients, supplementary access was obtained from the right GSV. Importantly, none of the patients experienced access site complications.

Conclusion:

The use of tributary veins as access allows for the use of wide bore sheaths without encountering complications when addressing central vein pathology. Our findings indicate that employing outflow vein tributaries as access for endovascular treatment is both safe and effective in managing central venous disease.
Management of Ballistic Injuries Affecting the Limbs at the University Hospital of Tengandogo, Burkina Faso, West Africa
Authors: Sawadogo Adama , Bazongo Moussa , Doamba Rodrigue Namekinsba , Sawadogo Youssouf , Tamboura Yacouba , Belem Farid Pingwinde , Nare Youssouf , Sanou Alain , Sanou Adama
Published: July 2024

Introduction:

Limb arterial injuries are serious clinical conditions that can lead to amputation or death. In Burkina Faso, there is a rise in gun shooting since 2016 because of armed conflict. In this study, the authors report the management of limb arterial injuries that occurred in ballistic traumas.

Patients and Methods:

From January 1, 2019, to December 31, 2022, 15 patients (14 males and 1 female) consecutively underwent operative management of limb arterial injuries at the University Hospital of Tengandogo. The mean age was 29.9 years old (17–55). Outcomes were defined according to intensive care unit stay time and postoperative morbidity and mortality.

Results:

Hospital admission after 6 h represented 93.7%. Unstable hemodynamic status was noted in 40%. Upper limbs arteries were more injured (60%) and these included false aneurysms (9) and complete arterial cut (6). Revascularization techniques consisted of direct suture in eight cases and prosthetic grafting in seven cases. Postoperatively, five patients presented complications: two superinfections, two skin necrosis, and one limb paresis. Amputation and mortality were nil.

Conclusion:

The management of ballistic arterial trauma to the limbs is late in our context. Circumstances are dominated by combat injuries and the militaries are more affected. However, a good indication for revascularization and rigorously executed technique can save the limbs.
A Rare Case of Painful Thrombosed Great Saphenous Vein Aneurysm in a Young Male
Authors: Aryala Shalini , Madavan Praveena , Singh Devender
Published: July 2024

Primary venous aneurysms are uncommon solitary dilatation of a vein that can occur throughout the venous system. Superficial venous aneurysms of the lower extremities are more often reported as esthetically displeasing bulges or incidental findings and are asymptomatic. A painful primary venous aneurysm is an extremely rare clinical entity. We report a case of painful thrombosed venous aneurysm of the great saphenous vein in a young male and managed surgically.
Comparison of Longitudinal and Transverse Transperitoneal Incisions in Abdominal Aortic Surgery: A Retrospective Analysis
Authors: Gupta Aditya , Pandey Ashutosh Kumar , Manchikanti Sriram , Sun Neelamjingbha , Pitchai Shivanesan
Published: July 2024

Objective:

Patients with abdominal aortic aneurysm (AAA) may be treated with endovascular intervention or open surgical repair. Despite the possibility of a retroperitoneal approach for open surgery, many surgeons prefer a transperitoneal approach. Transperitoneal aortic exposure may be done by longitudinal or transverse incisions. Transverse incisions are thought to be less painful and have less perioperative complications as compared to longitudinal midline incisions, but the reports to this effect are not conclusive. To address the lack of data comparing perioperative outcomes in aortic surgery incisions, our center conducted a retrospective study. Our aim was to generate concrete evidence regarding the choice of incision and its impact on surgical outcomes, filling a crucial gap in existing knowledge.

Materials and Methods:

Fifty-two consecutive cases were selected from our institute’s database who underwent elective open AAA repair, with 26 cases each in longitudinal and transverse incision group. Data were analyzed to compare the effects of type of incision for abdominal aortic surgery on the duration of ventilatory requirements and intensive care unit (ICU) stay, postoperative ileus, perioperative analgesia requirement, and the duration of hospital stay in these patient groups.

Results:

Baseline characteristics and comorbidities of the study population were comparable. Postoperative hospital stays were notably shorter for patients with transverse incisions than those with longitudinal incisions. The transverse incision group also exhibited a statistically significant reduction in postoperative ileus development. However, no significant differences were observed between the two study groups in terms of ventilatory requirements, postoperative analgesia needs, and ICU stays.

Conclusion:

The ongoing discourse in the literature surrounding the incision choices find support in our study, indicative of advantages of transverse incisions that include lower postoperative ileus and shorter hospital stays. However, no clear benefits were observed regarding postoperative ventilation and analgesic requirements. Study limitations underscore the necessity for future prospective research with larger samples and longer follow-ups, yet the findings suggest that transverse incisions may offer improved perioperative outcomes, potentially easing financial strains on patients and health-care systems through reduced hospitalization durations.
Physical characteristics of quercetin pulmospheres using combination of alginate-carrageenan: Effect of polymer concentration
Authors: Hariyadi Dewi Melani , Fawwaz Lubby Razan , Fattah Abdul , Purwanti Tutiek , Erawati Tristiana
Published: July 2024

Indonesia is the second country with the highest number of tuberculosis (TB) cases in the world and the first in Southeast Asia, according to WHO Global Report 2020. Quercetin has been tried as an alternative therapy and was found effective. This study aims to optimize quercetin pulmospheres using combination polymers and study its characteristics as an inhalation delivery system. Combination polymers provide the advantages of safe, mucoadhesive, and compact pulmospheres. Pulmospheres were made as formula F1, F2, and F3 (polymer ratios of 1:1, 1:2, and 1:3), respectively. Pulmospheres were made with quercetin 0.2%, alginate-carrageenan (total concentration of 1.8%), and CaCl2 0.5 M. Characterization of particle size, morphology, moisture content (MC), yield, drug loading, and entrapment efficiency (EE) were conducted. The yield range was from 83.89 to 86.30% ± 4.59%. MC range was from 4.23 to 5.12% ± 0.05%. Particle size was <3 µm (between 2.19 and 2.76 ± 0.149 µm), spherical shape and smooth surface. EE range was 60.69% ± 4.45% to 77.86% ± 1.74% and the drug loading range was 1.66–2.09% ± 0.15%. F2 formula with a polymer ratio of 1:2 was the best quercetin pulmospheres. Potential pulmospheres will then be recommended for in vitro release and in vivo study.
Evaluation of the methanol extract of BaiYangJie: Toxicology and protective effect against acute kidney injury
Authors: Li Jiaxin , Zhou Lingjuan , Wang Jinhui , Zhang Lixia , Xia Bin , Li Guang , Ren Jiahui , Li Jiacheng
Published: July 2024

BaiYangJie (BYJ) is a terrestrial perennial plant commonly used as a Dai medicine and has therapeutic effects on liver and kidney diseases. Cisplatin (CP), a chemotherapy drug, has good therapeutic effects but causes many side effects, including nephrotoxicity. This article investigated the toxicology of the methanol extract of BYJ (ME-BYJ) and its protective effect on CP-induced acute kidney injury (AKI) through pharmacological experiments. The results showed that the treated mice had no toxicological symptoms and no anatomical, physiological, or histological abnormalities. The BYJ-high-dose group showed significantly attenuated CP-induced AKI. It is concluded that ME-BYJ has the most significant protective effect on AKI at a dose of 8 g/kg and BYJ was not toxic.
Potential antioxidant and antiradical agents from Allium ascalonicum: Superoxide dismutase and density functional theory in silico studies
Authors: Ajiati Dwipa , Sumiarsa Dadan , Amin Meiny Faudah , Kurnia Dikdik
Published: July 2024

Antioxidants are compounds that can inhibit excessive free radical reactions in the body. Excessive free radicals can cause system imbalances in the body which can trigger oxidative stress and cause serious illness. The limitations of antioxidants in the body can be overcome by consuming safe natural additional antioxidants that can be obtained from natural products. Isolating compounds of Allium
ascalonicum leaves as antioxidant and antiradical agents in inhibiting excessive free radicals by in vitro and in
silico. The extracted compounds were purified by column chromatography. The compounds obtained were then characterized using ultraviolet, infrared, NMR, and mass spectrometry. Determination of antioxidant activity was carried out by in
vitro using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and the non-enzymatic superoxide dismutase (SOD) methods. The in
silico study used the density functional theory (DFT) calculation method with global descriptive parameters (GDP), donor acceptor map (DAM), and frontier molecular orbitals (FMO) analysis. Three compounds have been isolated, of which compound 1 is a new compound. In the DPPH method, compound 1 has more strong antioxidant activity than others, as well as in the non-enzymatic SOD method. Whereas, in the DFT calculation shows that compound 1 has the best reactivity and stability between other compounds and was categorized as the best antiradical. Compound 1 has the highest antioxidant activity compared to the other compounds by in
vitro both the DPPH and non-enzymatic SOD methods. In
silico, compound 1 has the potential as the best antiradical.
Genetic analysis: therapeutic drug monitoring of metformin and glimepiride on diabetic patients’ plasma including genetic polymorphism
Authors: Ibrahim Areen , Odeh Mohanad , Mallah Eyad , Abu-Qatouseh Luay , Awaad Ahmad Abu , Ahmad Mohammad I. A. , Shdifat Amjad , Saleh Soadad , Al Hyari Muwafaq , Khadra Ibrahim , Omari Khaled W. , Arafat Tawfiq
Published: July 2024

Diabetes is a widespread disease that needs to be controlled. Therapeutic monitoring of drugs is very helpful in maintaining desirable doses. To study a correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Determine drug levels using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) tool. A validated LC-MS/MS method was developed to determine metformin and glimepiride levels in human plasma. DNA extraction was performed using Jena Bioscience’s Blood DNA preparation, in which a column kit was used to extract DNA for genetic polymorphism. The investigation was carried out using both medications in type 2 diabetes patients alongside the genetic polymorphism. One hundred and six patients were assessed. The prevalence of homozygosity for SULT1A1 and wild-type CYP2D6 * 4 were 72.6% and 73.6%, respectively. After adjustment for daily intake of metformin, three patients out of five with the highest levels of metformin had no homozygosity (SULT1A1 genotype). Statistically, variables that demonstrated an insignificant correlation with the level of metformin were body mass index (rs (87) = 0.32, P = 0.011) and age (rs (87) =0.26, P = 0.017). The homozygous (SULT1A1 genotype) correlation was moderate (rs (87) =0.21, P = 0.052). According to the findings, patients with the wt/wt CYP2D6 genotype had considerably greater levels of endoxifen than those with the v/v CYP2D6 genotype. The study’s results reported a probable correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Genotype-guided drug therapy may provide a novel contribution to maximize drug efficacy and/or minimize toxicity.
Botanical and pharmacognostic investigation of Strobilanthes kalimantanensis
Authors: Prabowo Wisnu Cahyo , Kuncoro Hadi , Irawan Budi , Kusuma Sri Agung Fitri , Susilawati Yasmiwar
Published: July 2024

Under a hidden waterfall in the interior of the tropical rainforest of East Kalimantan, a new medicinal plant that produces essential oil (EO) was found with the name Strobilanthes
kalimantanensis. The aim was to investigate the botanical and evaluate the pharmacognostic characteristics of S.
kalimantanensis leaves from East Kalimantan, Indonesia. Pharmacognostic studies can provide recommendations for establishing quality control standards or guidelines for cultivating, harvesting, and processing S.
kalimantanensi
s to ensure the consistent and reliable quality of medicinal products. Characteristic methods of S.
kalimantanensis leaves include botanical macroscopic, fluorescence, physicochemical, and phytochemical evaluation. The plant characteristics of this plant are similar to S.
kunthia and S.
reptans but can be differentiated in the leaves and flowers. Fluorescence assay with sodium hydroxide 5% shows unique characteristics of secondary metabolites based on their ability to form dark green with black precipitate in Ultraviolet 365 nm. The physicochemical characteristics showed yield, water content, water-soluble, ethanol soluble, total ash value, and acid-insoluble ash. Phytochemicals showed the presence of alkaloids, polyphenols, terpenoids, and EO containing 23% trans-anethole. This evaluation report details the chemical composition, identity, and safety of S.
kalimantanensis leaves.
Dengue in Pregnancy
Authors: Wankhede Alice , Taksande Vaishali , Mahakarkar Manjusha , Jawade Switi , Khewale Dharti
Published: July 2024

Dengue is the most common virus-borne illness transmitted by mosquitoes. Globally, the incidence of dengue increased from 30,668,000 in 1990 to 56,879,000 in 2019. It is a significant issue for global public health, especially in the subtropical and tropical regions. Over 2.5 billion people live in regions where there is a 40% chance of getting dengue virus as reported by the World Health Organization. Tropical regions are been more frequently visited by pregnant women and adults of reproductive age. Consequently, they are being exposed to particular arboviral illnesses like dengue, which may affect both current and future pregnancies. A 24-year-old primigravida with 35 + 2 weeks gestational age was referred to the hospital with eclampsia with thrombocytopenia with dengue IgM positive (mildly) in the emergency department. An emergency lower-segment cesarean section was performed. A 2 kg of male baby was delivered. The patient received conservative care for 10 days, and after that, she was discharged with her baby. There are more incidences of infection during pregnancy, due to the rising occurrence of dengue during adulthood. Conservative therapy should be used, if there are no complications. Early detection and treatment are necessary for dengue during pregnancy. Any pregnant lady with a fever during an epidemic requires a high degree of clinical suspicion. The lack of evidence-based data about the treatment of dengue, especially for pregnancy, necessitates further research.
Maximize Workplace-Based Learning Through Application of Learning Theories
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: July 2024

Workplace-based learning refers to a learning experience that enables medical students to acquire knowledge and skills via supervised application of their professional roles in authentic workplace settings. The learning triad in workplace learning comprises patients, medical students, and doctor–teacher. The success and effectiveness of workplace-based learning will eventually be determined by the kind of interaction and relationship between these stakeholders. There are three components of workplace learning, namely task, context, and learner. Learning theories occupy a special place in not only determining how people learn but also laying down the platform for medical educators to facilitate learning among medical students. To conclude, workplace-based learning is a crucial and indispensable component of medical undergraduate training. Acknowledging the merits of the same, it is crucial that it needs to be strengthened in each of the medical colleges. Further, awareness about learning theories and the application of the same for facilitating learning among medical students in workplace settings can prove to be instrumental, and thus medical educators should always work on the similar lines.
Diagnostic Value/Accuracy of Diffusion-weighted Magnetic Resonance Imaging in Low-grade Glioma: Systematic Review
Authors: Pavanan Asish , Kashikar Shivali , Parihar Pratapsingh Hanumansingh
Published: July 2024

Tumor grading plays a decisive role in glioma classification, which impacts the treatment strategy and prognosis of the patient. Diffusion weighted imaging (DWI) technique is a noninvasive technique used in tumor grading. This study explores whether DWI can be effectively used in tumor grading and the identification of low-grade glioma (LGG) by analyzing apparent diffusion coefficient (ADC) values. Publicly available English databases, PubMed and Google Scholar, were queried from 2015 to 2021. We mined a total of 465 research documents; of which nine articles were selected based on the inclusion and exclusion criteria. The overall findings show cutoff threshold min ADC values with higher b value playing a significant role in the differentiation of high-grade gliomas and LGGs, tumor grading, and determining tumor progression and stability. This systematic review suggests the development of unified DWI imaging parameters with better sensitivity and specificity for grading LGG tumors.
Retroperitoneal Angioleiomyoma: An Extremely Rare Case Report
Authors: Chandanwale Shirish Sahebrao , Raj Akshi , Kundlia Aakriti , Kambale Tushar
Published: July 2024

Angioleiomyoma (ALM) is a benign mesenchymal tumor arising from the smooth muscle cells of the vessel wall. Common sites include subcutaneous tissues of the lower extremities but can also be seen in unusual sites including the head-and-neck region, submandibular gland, uterus, ovary, and broad ligament. It is exceptionally rare in retroperitoneum. Local recurrence is extremely rare but known to occur. Imaging features are nonspecific. Differential diagnosis on the basis of radiological features is difficult. Definitive diagnosis requires histopathology examination. Angiomyolipoma and myopericytoma are considered close differentials on microscopy at retroperitoneal locations. Histopathological examination along with immunohistochemistry markers such as desmin and HMB-45 are required for definitive diagnosis. It is difficult to diagnose angioleiomoma preoperatively, considering its location, thereby we are tempted to present an extremely rare case of retroperitoneal ALM highlighting its diagnostic dilemma.
Effective Treatment of Recurrent Periapical Lesion Involving Multiple Teeth in a Pediatric Patient: A Rare Case Report with Review of Literature
Authors: Khan Mohammad Kamran , Jindal Mahendra Kumar
Published: July 2024

Nonsurgical endodontic therapy is usually advised as primary approach to treat the nonvital teeth with pulpal or periapical infection. However, in certain clinical scenarios and also owing to various factors, surgical modality of endodontics is eventually adopted to manage the recurrent or persistent pulpal or periapical infection and also to treat the failed cases of previously endodontically-treated teeth with conventional approach. In existing literature, there is deficiency of published case report articles regarding successful surgical endodontic management of recurrent pulpal/priapical signs and symptoms and also of failed cases of nonsurgical modality of endodontic therapy in growing pediatric patients. Hence, the present article describes the case report of the effective and successful clinical management of recurrent and failed case of conventional nonsurgical orthograde endodontic therapy by employing the surgical endodontic modality in an adolescent pediatric patient aged 13 years. The whole clinical procedure in step-wise manner has been described, and furthermore, the relevant contemporary endodontic techniques have been elucidated in context of the present case.
Ambulatory Flash Glucose Monitoring Device Detects Hypoglycemia and Time in Range in Children and Adolescents of Type 1 Diabetes Mellitus
Authors: Qamar Tooba , Awasthi Shally , Bhriguvanshi Arpita
Published: July 2024

Objective:

The mainstay of diabetes control and management is glucose monitoring (GM). Improving glycemic control and decreasing glycemic variability is important to prevent microvascular complications of diabetes. Adherence to GM is a challenge in pediatric type 1 diabetes mellitus (T1DM) patients. Furthermore, nighttime hypoglycemia (NTH) is a common complication of diabetes management; prevention and treatment of which is essential to improve quality of life. We aim to study the impact of flash GM device (FGMD) in detecting NTH and time in range (TIR) in children and adolescents of T1DM.

Materials and Methods:

This was a prospective observational study. Twenty children and adolescents of T1DM from North India, with mean age (range) of 7.15 years (3–13), were enrolled and applied FGMD. Episodes of NTH and average TIR were analyzed during one sensor application, i.e., 14 days.

Results:

The proportion of patients developing NTH after 14 days of insertion of device was 15 (75%) and 5 (25%) patients did not. The mean (standard deviation) duration of NTH in 24 h was 101.35 (136.02) min. The mean (range) percentage of TIR of our study subjects was 32.03% (0–61).

Conclusion:

Flash monitoring is a useful tool to improve adherence to GM, detecting hypoglycemia (diurnal and nocturnal) and TIR in children and adolescents with T1DM.
Laser Photobiomodulation as Noninvasive Therapeutic Modality in Pediatric Endodontics: A Comprehensive Review
Authors: Khan Mohammad Kamran , Sharma Divya Sanjay , Jindal Mahendra Kumar
Published: July 2024

Endodontics is evolving with modern innovations for conservatively managing the various dental problems involving pulpal or periradicular tissue of primary and permanent teeth. Lasers have been reported with favorable clinical evidence, particularly in tackling the endodontic problems effectively. Recently, the application of lasers in the form of photobiomodulation therapy or low-level laser therapy has been reported in many recent scientific studies/researches with successful results. Hence, this narrative review critically appraise the existing scientific literature and highlights the photobiomodulation technique of lasers as noninvasive therapeutic modality in different pediatric endodontic therapies or procedures (direct pulp capping, pulpotomy, noninvasive treatment of periapical lesion, regenerative endodontics, postendodontic pain management, etc.).
Socio-demographic Characteristics, Clinical Variables, the Role of Stressor and Phenomenology in Patients with Acute and Transient Psychotic Disorders in One of the Tertiary Care Centre of North India: A Cross-sectional Study
Authors: Singh Mahender , Sharma Dinesh Dutt , Garg Sunny , Sharma Devesh , Chauhan Alka
Published: July 2024

Background:

Acute and transient psychotic disorders (ATPDs) have benign course and takes place in the existence of noticeable and exceptionally traumatic stressors (direct temporal association between stressors and occurrence of ATPD) which necessitate clinical investigations. Stressors are also known to affect phenomenology and its content.

Aims and Objectives:

This study aims to study the socio-demographic characteristics, clinical variables, the role of stressors and phenomenology in ATPDs patients.

Methodology:

It is a cross-sectional and observational study. This study was done on 150 patients diagnosed on the basis of International Classification of Disease-10 diagnosis criteria of ATPDs after getting an informed consent from them. Patients’ information was recorded on socio-demographic and clinical profile sheet. Thereafter, Presumptive Stressful Life Event Scale and Positive and Negative Syndrome Scale (PANSS) scales were applied to assess the stressors and phenomenology, respectively.

Results:

Most of the patients were female and were between 15 and 35 years of age. Mean age of patients was 32.45 (standard deviation = 11.25) years. Majority of the patients were educated, married, and unemployed. A large amount of the patients belong to nuclear family and were resident of rural areas. Most of the patients presented within 2 weeks of the onset of the illness without any past or family psychiatric history. In 75% patients, stressors precede the onset of the illness. The average value of PANSS was higher in female. Sleep disturbances, delusions, hallucinations, poor rapport, lack of insight, and concrete thinking were the most commonly observed phenomenology in these patients.

Conclusions:

Maximum patients who developed the illness had psychological stressor/s in the past year (mainly before 2 weeks) of the onset of the illness. It helps to consider the person’s life events as a trigger for illness and make decisions regarding treatment accordingly.
Epidemiology of uveitis after tuberculosis in Taiwan – A nationwide population-based cohort study
Authors: Lin Chun-Ju , Hsu Alan Y. , Hsia Ning-Yi , Tien Peng-Tai , Yang Yu-Cih , Lai Chun-Ting , Bair Henry , Chen Huan-Sheng , Tsai Yi-Yu
Published: July 2024

PURPOSE:

Current reports on the risk of uveitis of all causes after tuberculosis (TB) diagnosis are lacking. Therefore, we sought to investigate the association between the diagnosis of TB and the subsequent risk of uveitis in Taiwan.

MATERIALS AND METHODS:

Data from the Taiwan National Health Insurance system were retrieved and patients with newly diagnosed TB between 2000 and 2012 were recruited. The endpoint of interest was the occurrence of uveitis. Patients without TB were randomly matched 4:1 to TB cases based on age, gender, index date, outpatient clinic visit, and index year. Univariate and multivariable Cox proportional regression analyses were performed to analyze the risk of uveitis among TB patients.

RESULTS:

A total of 6139 patients with TB and corresponding 24,555 matched control participants were recruited. The mean age was 52.9 ± 22.1 years old and 32.1% were male. The medium follow-up period was 5.81 ± 4.37 years and 7.16 ± 3.95 years in the TB and matched control cohorts. Our results showed that patients with TB had no significantly increased incidence of uveitis. After stratification by gender, age, and comorbidities, the relationship between TB and uveitis was found to be not significant. The cumulative incidence of uveitis was also found to be not significantly higher among the TB group (log-rank P = 0.84).

CONCLUSION:

Our nationwide population-based cohort retrospective study showed that the incidence of uveitis was not significantly higher among patients with TB. Future prospective and multicenter studies are warranted to confirm our findings.
Blobbed topological recursion of the quartic Kontsevich model II: $\mathrm{Genus}=0$ (with an appendix by Maciej Dołęga)
Authors: Hock Alexander , Wulkenhaar Raimar
Published: July 2024

We prove that the genus-0 sector of the quartic analogue of the Kontsevich model is completely governed by an involution identity which expresses the meromorphic differential

\omega_{0,n}

at a reflected point

\iota z

in terms of all

\omega_{0,m}

with

m\leq n

at the original point

z

. We prove that the solution of the involution identity obeys blobbed topological recursion, which confirms a previous conjecture about the quartic Kontsevich model.
The packing measure of the linear Gauss system
Authors: Tryniecki Rafał
Published: July 2024

For every

k \in \mathbb{N}

, let

f_{k}:[\frac{1}{k+1}, \frac{1}{k}] \to [0,1]

be decreasing, linear functions such that

f_{k}(\frac{1}{k+1}) = 1

and

f_{k}(\frac{1}{k}) = 0

,

k = 1, 2, \dots

. We define the iterated function system

S_{n}

by limiting the collection of functions

f_{k}

to first n, meaning

S_{n} = \{f_{k} \}_{k=1}^{n}

. Let

J_{n}

denote the limit set of

S_{n}

. Then,

\lim\limits_{n\to \infty}\mathcal{P}_{h_n}(J_{n}) = 2

, where

h_{n}

is the packing dimension of

J_{n}

and

\mathcal{P}_{h_n}

is the corresponding packing measure.
Remarks on complete Weingarten hypersurfaces in the Euclidean space
Authors: de Lima Eudes
Published: July 2024

In this paper, first we provide a classification result for a large class of complete rotational Weingarten hypersurfaces in the Euclidean space. Second, we prove sharp inequalities for the norm of the second fundamental form of a class of Weingarten hypersurfaces. We show that sharpness is attained by a cylinder of the Euclidean space.
Linking number obstructions to satellite homomorphisms
Authors: Lidman Tye , Miller Allison N. , Pinzón-Caicedo Juanita
Published: July 2024

We prove that satellite operations that satisfy a certain positivity condition and have winding number other than one are not homomorphisms. The argument uses the

d

-invariants of branched covers. In the process, we prove a technical result relating

d

-invariants and the Torelli group which may be of independent interest.
The parabolic quaternionic Calabi–Yau equation on hyperkähler manifolds
Authors: Bedulli Lucio , Gentili Giovanni , Vezzoni Luigi
Published: July 2024

We show that the parabolic quaternionic Monge–Ampère equation on a compact hyperkähler manifold has always a long-time solution which, once normalized, converges smoothly to a solution of the quaternionic Monge–Ampère equation. This is the same setting in which Dinew and Sroka (2023) prove the conjecture of Alesker and Verbitsky (2010). We also introduce an analogue of the Chern–Ricci flow in hyperhermitian manifolds.