bluuebunny/crossref_metadata_2025 huggingface dataset:
Does maternal hyperoxygenation have any effect on the fetal circulatory system in normal growth and late-onset IUGR fetuses?
Authors: ar Deniz , Bakhshaliyev Nijad , Yozgat Can
Published: October 2023

Abstract
Objective: maternal hyperoxygenation (MHO) has been recommended as an alternative treatment for fetuses with IUGR. We wanted to evaluate the effect of MHO treatment on ductus venosus (DV) and pulmonary vein (PV) doppler flow measurements in fetuses with late-onset IUGR.
Materials and Methods: A total of 63 pregnant women were enrolled in the study (32 pregnant women diagnosed with IUGR and 31 women with normal growth). The control group comprised 31 randomly selected age-matched and gestational-age-matched healthy pregnant women who presented to the antenatal clinic on the exact dates as the women in the study group.
Results: In the IUGR group, MHO significantly increased the PI value of DV (0.50 (0.40, 0.58) to 0.62 (0.60, 0.65). p<.001). The DV-S, DV-D, and S/a values of the DV increase significantly for the IUGR group. DV- a value of DV decreased significantly from 52.00 (49.25, 52.75) to 41.50 (38.50, 42.75) p<.001. Comparison of Doppler findings in healthy fetuses before and after oxygen inhalation did not change significantly. Also, The PI value in the PV did not change significantly following maternal hyper oxygenation in the In the IUGR group (pre-O2: 0.80 (0.73, 0.88) and post-O2: 0.80 (0.70, 0.90)).
Conclusion: We detected a statistically significant increase in both DV and PV blood flow during MHO administration in late-onset IUGR fetuses. Since increased DV and PV blood flow is associated with increased cardiac output, we think that it will reduce foetal hypoxia in fetuses with IUGR.
A visual and bibliometric analysis of Parkinsons disease biomarker research
Authors: inpolat Havva , Akar Ali
Published: October 2023

Objectives: Biomarker research in Parkinsons lacks a systematic bibliometric review, despite a growing body of bibliometric studies. This study aimed to analyze publications on biomarkers that may play an important role in the diagnosis and treatment of Parkinsons disease.
Materials and Methods: In the study, bibliometric methods were used to analyze the related research in depth. Data were obtained from the Web of Science Core Collection database. Specific keywords consisting of MeSH terms were used as search criteria. The search was conducted in English and the type of publication was selected as article. Microsoft Excel, VOS viewer and the visualization and analytical capabilities of the Biblioshiny R package were used in the analysis, providing a versatile approach to achieve the study objectives.
Results: A total of 461 articles on Parkinsons disease biomarkers published between 2002 and 2023 in 170 journals met the criteria and were analyzed. Regarding publications and citations, the year 2022 stood out. Each document had an average of 6.28 co-authors. The main contributing countries were the United States, China and Italy, with a global co-authorship rate of 30.8%. Notable institutions included the University of Washington, Ruhr University Bochum and the Paracelsus Elena Clinic. "Journal of Neurochemistry," was the journal with the most publications. Through their total link strength, prominent terms such as "Parkinsons disease", "biomarker" and "alpha-synuclein" showed significant occurrences and thematic relevance.
Conclusion: The present study presents the inaugural bibliometric evaluation of biomarkers in Parkinsons disease. The gradual increase of papers since 2012 indicates persistent scholarly interest and foretells continued significance over the following ten years. Future research will be aided by the study's depiction of biomarker patterns, which provides insightful information. The term "Alpha-synuclein" stood out, highlighting its relevance in our research.
Human mesenchymal stem cell secretome lowers caspase-3 levels and apoptosis in hepatocytes of cholestatic rats
Authors: Purwanto Naufal , Susilaningsih Neni , Budiono Bernardus , Maharani Nani , Riwanto Ignatius
Published: October 2023

Liver cirrhosis is ranked 15th as a cause of morbidity and is ranked 11th as a leading cause of mortality in the world. Definitive therapy is liver transplantation, but it is constrained by difficulties in finding a transplant donor Hu MSCs cell-based therapy can help liver regeneration directly, through hepatogenic differentiation, or indirectly through the paracrine secretome. This study aims to determine the effect of Human Mesenchymal Stem Cell Secretome administration on caspase 3 levels and apoptotic hepatic cell count in a rat model with cholestasis after choledochal duct ligation receiving standard UDCA (Urso Deoxy Cholid Acid) therapy. Twenty-four male Wistar rats were subjected to a choledochal duct ligation and were included in this randomized experimental study. After surgical intervention, all rats were randomly assigned into 4 group; control, administration of UDCA, Hu MSC-S, and a combination of UDCA and Human Mesenchymal Stem Cell Secretome for 4 weeks. Caspase-3 levels were assessed from the blood sample, while the apoptosis of hepatocyte evaluated using histopathologic examination of the liver. Caspase-3 levels was significantly lower in the UDCA and Human Mesenchymal Stem Cell Secretome treated groups (6.23 ± 0,30), compared to the UDCA (8.77 ± 0.55) and Human Mesenchymal Stem Cell Secretome alone (7.30 ± 0.42) (ANOVA p < 0,05). The apoptosis of hepatocyte was significantly lower in the combination group (8,88 ± 5,46) compared to the UDCA (29,00 ± 4,52) and Human Mesenchymal Stem Cell Secretome alone (20,83 ± 4,14) (ANOVA p < 0,05). In conclusion, addition of Human Mesenchymal Stem Cell Secretome to UDCA lowered caspase-3 levels and apoptotic cell count in rats with hepatic cholestasis after choledochal duct ligation and better compared to each alone.

Keywords: Mesenchymal Stem Cell Secretome, Capsase-3, Apoptotic Cell, Liver Regeneration, Cholestasis
Indoor Aeroallergen Sensitization and Associated Factors in Hospitalized Children with Asthma Exacerbations
Authors: Thao Nguyen , Kien To , Tuan Tran , Duc Nguyen , Hoang Phan , Vu Le
Published: October 2023

Background: Allergic asthma represents the most popular phenotype of childhood asthma and is characterized by eosinophilic airway inflammation associated with specific immunoglobulin E (IgE) antibodies sensitization to various allergens, as evidenced by serology or skin prick test.2 Sensitization to indoor aeroallergens is associated with severe asthma and severe asthma exacerbations. Objective: This study aimed to identify the prevalence of aeroallergen sensitization and its associated factors in children with an asthma exacerbation in Vietnam. Methods: A cross-sectional study was conducted at Children’s Hospital 1, Ho Chi Minh City (HCMC). Children who were aged 3 to 15 and admitted to the hospital with moderate or severe asthma exacerbation were recruited to the study. Data was collected from interviews and medical records. SPT was used to identify aeroallergen sensitization. The association between school-age, living area, and passive smoking with the odds of aeroallergen sensitization was assessed using a multivariable logistic regression. Results: The prevalence of aeroallergen sensitization was 82.6% and this figure in school-age children was higher than that in preschool-age ones (93.8% vs 72.1%, p=0.001). School-age, living in HCMC, and passive smoking significantly increased the odds of aeroallergen sensitization in asthmatic children with adjusted OR [95%CI] as 6.9 [2.1-23.3], 4.1 [1.5-11.5], and 2.9 [1.0-8.4], respectively. Asthmatic children with aeroallergen sensitization required more hours to resolve an asthma exacerbation than those without (22.4 vs 15.2, p=0.006). Conclusion: Aeroallergen sensitization was common in hospitalized children with moderate or severe asthma exacerbation. It is necessary to establish environmental policy and screening practices of aeroallergen sensitization to improve the quality of asthma management for Vietnamese children.
A Single-Center Experience on the Treatment Outcomes of Patients with COVID-19-Pleural Disorders: Lessons for the Future
Authors: Pasalic Alma , Pilav Ilijaz , Maric Veljko , Kadic Kenan , Dapcevic Meho , Hadzismailovic Ademir , Pilav Alen , Ademovic Enisa , Custovic Orhan
Published: October 2023

Background: Pleural disorders in novel coronavirus disease 2019 (COVID-19), responsible for the deaths of more than 6.7 million people worldwide, are relatively uncommon and underappreciated findings. The severity of the pleural disease in these patients correlates with the treatment outcome and overall prognosis. Objective: We aim to review our experience with treatment modalities and prognosis in 45 patients with COVID-19, who were treated at our Clinic between April 2020 and October 2021. Methods: We conducted a retrospective, single-center, cross-sectional study. Demographic data, the type of thoracosurgical intervention(s), and treatment outcome for 45 patients included in this study were recorded for every patient. We analyzed the type and number of treatment modalities according to the pleural disorder, and the outcome of the treatment. Results: Pneumothorax was the most common COVID-19-related pleural disorder, followed by the pleural effusion. Tube thoracostomy was the mainstay of treatment, performed in 84.4% of patients with unilateral pleural complications. In total, 20% of our patients were on mechanical ventilation, and all of them had a fatal outcome. We found statistical significance in comparison to the percentage of fatal outcomes between patients treated with and without mechanical ventilation (p=0.000). Conclusion: COVID-19-related pleural disorders are prognostic markers of disease progression. Mechanically ventilated patients who require tube thoracostomy have an unfavorable prognosis.
The Correlation Between the D-Dimer Values and Anatomical Distribution of Pulmonary Embolism
Authors: Kristic Spomenka , Begic Amela , Zubovic Sandra , Basic Amila , Kuric Haris
Published: October 2023

Background: Pulmonary Embolism (PE) represents a life-threatening medical emergency that, given the serious complications, requires urgent application of anticoagulant therapy. In addition to other factors that are taken into account when choosing a therapy for treatment of PE, the anatomical distribution of thrombi is also considered–whether it is a central, lobar, segmental or subsegmental PE. D-dimer is an intermediate product of degradation of fibrin molecules and its values in the plasma are increased in the case of PE, but also in other diseases. Objective: To determine whether there is a difference in D-dimer values in subjects with different anatomical distribution of PE. Methods: The study included 100 subjects with diagnosed PE by using MSCT and/or V/P SPECT and with measured values of D-dimer. Results: Out of 100 subjects, PE was not diagnosed in 37 subjects, while 63 subjects PE was diagnosed. All subjects with diagnosed PE were divided into 3 groups regarding the anatomical localization of thrombus: lobar, segmental or subsegmental. Average D-dimer values were calculated for all 3 groups. Statistical analysis showed that there was no significant difference in D-dimer values between subjects with different anatomical distribution of PE. Conclusion: There is no significant difference in D-dimer values between subjects with different anatomical distribution od PE–lobar, segmental and subsegmental PE.
The Incidence of Acute Pancreatitis After Device Assisted Enteroscopy: a Systematic Review and Meta-analysis
Authors: MD Xiao , MD Hao , MD Le , MD Yong , MD Ye , MD Cheng
Published: October 2023

Background: The diagnosis of small bowel diseases is challenging and device assisted enteroscopy (DAE) is a technique for visualizing the entire small bowel. DAE is considered as a safe procedure and the reported rate of adverse events associated with DAE in the literature is low. Objective: The present study tried to investigate the actual incidence of AP after DAE with a systematic review and meta-analysis of available relevant studies. Methods: Studies were searched through the PubMed, EMBASE, and Cochrane library databases. The following data were extracted from all eligible studies: author, country, publication year, publication type, study design, type of DAE used, route of DAE, number of patients with AP after DAE, and number of patients with hyperamylasemia after DAE.A random-effects model with RStudio version 4.2.0 was performed in all analyses. Heterogeneity was assessed using the I2 test. The risk of bias was assessed by the Newcastle-Ottawa Scale criteria and the publication bias was assessed by the Egger test. Results: Twenty three studies involving a total of 11145 patients were included in the analysis. The overall, pooled AP rate after DAE was 1% (95% CI:0-1%). There was significant heterogeneity among the studies (I2 = 65%; P < 0.01).The pooled AP rate was 1% (95% CI:0-2 %)in peroral route group. The pooled proportion of patients having hyperamylasemia after DAE was 29% (95% CI: 16-46%).Among the patients who had hyperamylasemia AP were identified in 2% (95% CI: 0-6%) of patients. Conclusion: The incidence of AP after DAE is about 1%. Hyperamylasemia is a common change in the patients undergoing DAE and only 2% of the patients with hyperamylasemia present with AP.
Epidemiology, Etiology, Timing and Severity of Open Fracture - a Five Years Review From a Tertiary Trauma Center, Eastern Province, Saudi Arabia
Authors: Alhavas Abdulaziz , Alghamdi Mohannad
Published: October 2023

Background: Open fractures are severe injuries resulting from the bone breaking through the skin, and they have a negative impact on patients' physical, mental, and financial well-being as well as that of the healthcare system. The incidence of open fractures varies globally. These injuries can lead to prolonged disability, increased healthcare costs, and psychological distress. The Gustilo-Anderson classification system is used to classify open fractures into three categories which surgeons use as an index for the severity of an injury and as a prognostic tool. Management involves a multidisciplinary approach, focusing on preventing infection, promoting wound healing, and restoring function. Objective: The objective of this study is to provide statistics on the epidemiology of open fractures presented to the emergency department to be used later to create management protocols. Methods: This 5-year retrospective observational analysis of open fracture patients at King Fahad Hospital, a tertiary trauma care institute in Alkhobar from 2018-2023, aimed to understand socio-demographics, injury mechanisms, fracture patterns, and timing. Data were collected electronically, and found 373 cases which were reviewed, and only 138 open fractures fit our inclusion and exclusion criteria and were added to the study. Results: The study analyzed 138 openly fractured bones in 132 patients aged 2 to 68. Most bones affected were in the lower extremities, the most common being the forefoot bones. The most common mode of injury was a motorbike, followed by MVA. The most common Gustilo type was type 2, with no significant correlation between gender and severity. Musculoskeletal system injury was the highest associated system. Furthermore, we observe a slight increase in cases in Winter/Fall weather seasons. Conclusion: Total amount of 84.8% of patients with open fractures are men, compared to 15.2% of women. The average age of patients is 25.6 ± 15.6 years. Motorbike accidents, then MVA, are the two leading causes of open fractures. Weather seasons, especially in fall and winter, may also contribute to an increase in open fractures. We found that type 2 is the most common Gustilo type among the injured bones (59.1%).
Comparison of Three Fall Risk Assessment Tools in Community-Dwelling Saudi Elderlies
Authors: Alharbi Ahmad
Published: October 2023

Background and Aims:
Falls are common in the elderly population. The Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and Five Times Sit-to-Stand Test (5xSTS) are evidence-based clinical performance-based measurements of the risk of falls among elderlies. This study aimed to compare the validity of these assessment tools in predicting falls in community-dwelling elders in Saudi Arabia. Moreover, the cut-off point, sensitivity, specificity, and post-test accuracy percentage for these assessment tools were determined.
Methods:
One hundred fourteen ambulatory community-dwelling individuals aged 65 or older were recruited for this study. Demographic information and a history of falling were collected before all participants were assessed with BBS, TUG, and 5xSTS.
Results:
The BBS was sensitive to group differences between fallers and non-fallers (P = 0.0001). Results from the receiver operating characteristic curve analyses showed that the accuracies of the BBS and TUG at classifying participants with and without a fall history were high-to-moderate (area under the curve [AUC], 0.73 and 0.71, respectively). In contrast, the accuracy of the 5xSTS for the same was low (AUC, 0.67). The cut-off points for the BBS, TUG, and 5xSTS were 42, 20, and 34 seconds, respectively. The highest post-test accuracy was that of the BBS at 84.39%, followed by that of the TUG at 68.05%, and 5xSTS had the lowest accuracy at 25.29%.
Conclusions:
The BBS was a sensitive tool to distinguish fallers among community dwelling elderly as compared to TUG and 5xSTS tests.
Knowledge and Perception Towards The Keto Diet Among The General Population in Baghdad City, Iraq
Authors: Hasan Tiba , Taher Taqi , Ghazi Hasanain , AbdalQader Mohammed
Published: October 2023

Background and Aims:
The ketogenic diet or keto diet (KD) is a recently used diet regime by a lot of the population for weight loss. The purpose of this study was to examine the general population’s knowledge and perceptions regarding the KETO diet in Baghdad, Iraq.
Methods:
This study included 203 respondents who completed an internet-based survey. A questionnaire adopted from a previous study was used to assess the knowledge and perception of the respondents.
Results:
Almost all the participants (98.5%) had heard of the ketogenic diet, 41.8 percent were currently following it, and 26% had tried it before. The longest time spent following the keto diet was one month (26%), and 44.3% of participants admitted to taking supplements while on the diet. Around half of the respondents (44.8%) said that the keto diet helped them lose weight and keep it off. In general, most of the participants had good knowledge of the keto diet, except for 2 parts, nutritional ketosis, and long-term studies on the keto diet effect, where the majority answered don’t know (70.9%, 43.3%) respectively. In terms of perception, around half of the respondents (42.8%) agreed that the keto diet should only be prescribed by doctors or nutritionists, while 40.0% disagreed that the keto diet is safe to follow for the long term.
Conclusions:
In conclusion, nowadays the ketogenic diet is a very popular weight loss diet, especially among young adults; however, more health promotion and education are required especially about long-term side effects of it.
Knowledge of Tonsillectomy Indications among Primary Healthcare Physicians in Riyadh, Saudi Arabia
Authors: Alotaibi Fahad
Published: October 2023

Background and Aims:
Tonsillectomy is a common procedure in children and adults. Despite its popularity, many physicians still need to be adequately educated regarding the indications for tonsillectomy. Recurrent tonsillitis is the most common indication in which primary care physicians seek consultation from otolaryngology. This study aimed to assess the knowledge of indications for tonsillectomy among primary healthcare physicians in Riyadh, Saudi Arabia.
Methods:
This cross-sectional study was conducted between March and August 2022, with a sample size of 100 male and female primary healthcare physicians in Riyadh, Saudi Arabia. A questionnaire on demo¬graphic data, clinical practice and exposure, and basic knowledge of current tonsillectomy indications was administered to the participants, and data were analyzed.
Results:
Of the 73 primary care providers included in the study, almost 70% had an average-to-poor knowledge of tonsillectomy indications. Women had better knowledge than men.
Conclusions:
The results of the present study indicate that primary healthcare physicians’ knowledge regarding adenotonsillectomy indications is still inadequate. Enrichment of the otolaryngology teaching at medical school and in residency programs is essential for optimization of the primary care delivered to patients.
Screening Strategies for the Detection of Breast Cancer: Correlating Knowledge and Practice of Women in Eastern Saudi Arabia
Authors: Jalal Sahbanathul
Published: October 2023

Background and Aims:
Breast cancer is the most common cancer worldwide. It represents 30.1% of other diagnosed female cancers as per the cancer incidence report of Saudi Arabia (2015). The highest incidence of breast cancer was observed in the eastern province region. Breast self-examination (BSE) and mammograms are helpful to detect breast cancer at the earliest. This study aimed to determine the knowledge and practices of women about breast cancer screening.
Methods:
A cross-sectional study was conducted to assess the knowledge and practices of women attending primary healthcare centers (PHC) in eastern Saudi Arabia regarding breast cancer screening. Data was collected from women who were aged 20 years and above through direct interviews using a validated questionnaire and it was analyzed using SPSS. Frequency distributions and chi-square tests were used to describe the demographic data and associate the variables respectively, with (p<0.05) normality.
Results:
Out of 428 women, 62% were 41-60 years old, and most of them (84%) were married. Around 29% were unaware of breast cancer screening, 72% of women never did BSE, and 86% reported that they never had a mammogram. There was a significant association found between knowledge and age and education (p < 0.05). A positive correlation was found between knowledge of BSE and mammogram (p < 0.05).
Conclusions:
Even with the provision of free health services in Saudi, the practice of breast cancer screening was unsatisfactory. This alarm the focus to make awareness campaigns. The importance of early detection of breast cancer must be emphasized in every PHC centers continually.
Door to Needle Time in Acute Ischemic Stroke Patients before and after Initiation of Quality Improvement Project - Single Local Centre Experience
Authors: Alshanqiti Mahmoud , Alqahtani Mohammed , Alharbi Naif , Alwadai Mohammed , Asiri Muhannad , Alqahtani Saeed , Alguthmi Mosab , Ogran Saeed , Almansour Mohammed , Bajunaid Khalid , Alzahrani Saeed
Published: October 2023

Background and Aims:
Thrombolysis has been shown to improve stroke outcomes by reducing disability, particularly when administered early. Lowering the door-to-needle time (DNT) for administering intravenous thrombol¬ysis (IVT) is an important objective for improving the quality of acute stroke care. This study aims to compare DNT before and after implementing the code stroke pathway protocol.
Methods:
The study evaluated the impact of a quality improvement project, Code Stroke, on acute ischemic stroke patients at King Fahd General Hospital in Jeddah, Saudi Arabia, September 2019 to April 2020, using a retrospective record-based analysis, with data extracted using a standardized format and cat¬egorized into pre and post code groups.
Results:
81 stroke patients were reviewed, with 47 in the pre-code group and 34 in the post-code group. The re¬ported tPA DNT time was less than 60 minutes in only 8.5% of patients before the implementation of stroke code activation, compared to 55.9% after implementation (p=.001). Incidence of symptomatic hemorrhagic transformation was 8.6%. Post-code group had a lower median length of hospital stay (8 days) compared to the pre-code (13 days), with a marginal trend towards statistical significance, and half of the post-code group patients had a modified Rankin Scale of 0-2 compared to one third of the pre-code group at three months of discharge.
Conclusions:
The Code Stroke project resulted in a significant reduction in DNT, improved functional outcomes, and a reduction in hospital length of stay, but the incidence of symptomatic intracranial hemorrhage and in-hospital mortality rates were slightly higher than expected, requiring continued improvement efforts.
Exercise Training’s Impact on Multifidus Muscle Thickness in Patients with Lower Back Pain: A Systematic Review
Authors: Qahtani Mazen
Published: October 2023

Various previous studies showed that there is involvement of multifidus muscle in lower back pain patients. Atrophy of lumbar multifidus is commonly witnessed among LBP patients. However, there is a lack of scientific findings regarding the training of this muscle. It is still unknown what changes are caused in the multifidus by such training methods. Therefore, the aim of this review is to explore the impact of various training techniques on the thickness of the multifidus muscle in patients with chronic or nonspecific back pain. Various international databases like Google Scholar, Scopus Elsevi¬er, Web of Science, and PubMed were searched by using a combination of keywords like “Exercise”, “Multifidus”, “Thickness” and “Lower Back Pain”. PEDro scoring was used for the assessment of the quality of included RCTs in the present review. It was found that there are few studies that showed improvement in the thickness of lumbar muscles due to different types of training but without investigating lumbar multifidus specifically. Isokinetic training and core stabilization exercises have been found to improve the thickness and symmetry of the multifidus muscle, as well as aid in muscle atrophy recovery. Isokinetic exercises and core-strengthening routines have been shown to enhance the multifidus muscle’s thickness and symmetry, and also assist in reversing muscle atrophy. It can be used to improve the knowledge of physical therapists and LBP patients who are suffering from chronic or nonspecific back pain.
Association of metabolic status with serum orexin levels in young females
Authors: Jain Shikha , Goel Amit , Gupta Vani , Jain Ajay
Published: October 2023

Background: Metabolic syndrome has always been linked with obesity and a sedentary lifestyle due to induction of metabolic derangements. Orexin A and B are recently discovered hypothalamic neuropeptides. Orexin A regulates appetite, food intake, and energy expenditure.

Aims and Objectives: Metabolic fuel detectors regulate energy balance at peripheral and central levels. The aim of this study is to assess association of serum orexin levels with metabolic risk markers in women of reproductive age group (RAG).

Materials and Methods: The study was conducted in the campus of King George Medical University (KGMU), Uttar Pradesh, Lucknow, INDIA. One hundred and fifty apparently healthy women of RAG, that is, 20–40 years of age were randomly selected. Fasting serum orexin and serum insulin levels were measured using enzyme-linked immunosorbent assay and weight, body mass index (BMI), fasting blood glucose, lipid profile, and blood pressure were estimated in women.

Results: The results show that serum orexin levels have significant positive correlation with fasting blood glucose, weight, BMI, and waist circumference along with a weak negative correlation with serum insulin level.

Conclusion: In the present study, serum orexin levels significantly correlate with weight, BMI, fasting blood glucose, and weak negative correlation with serum insulin levels. Serum orexin levels did not correlate with the lipid profile of women of RAG.
Assessment of cognitive function using the Montreal cognitive assessment test and its association with glycemic control in diabetes mellitus patients
Authors: K Sakthi , Ramamoorthy Shanthimalar , N Vijayalakshmi , Palaniswamy Sathya
Published: October 2023

Background: Diabetes mellitus (DM) is associated with decreased performance on cognitive domains. Diabetic patients have poor memory and attention. Cognitive dysfunction has emerged as significant morbidity of DM nowadays. Cognitive function can be screened rapidly by Montreal cognitive assessment test (MoCA).

Aims and Objectives: The objective of this study was to study the effect of blood glucose levels and diabetic duration on MoCA score in diabetic patients.

Materials and Methods: DM patients of both type 1(30) and type 2(30) from NCD clinic were selected as cases. Thirty persons with good health from master health checkup were selected as controls. Cognitive function was assessed in all the participants with MoCA after getting informed consent. Fasting and postprandial blood sugars were assessed with 2 mL of venous blood.

Results: The mean MoCA score has decreased among diabetic cases than controls. Among cases, T1DM has decreased mean MoCA score than T2DM. Fasting blood sugar (FBS), post prandial blood sugar (PPBS), and diabetic duration were found to be correlated negatively with the score obtained in MoCA in controls and T1DM cases. In T2DM cases, FBS and PPBS were found to be correlated negatively with the score obtained in MoCA, but weak positive correlation was found between duration and MoCA score.

Conclusion: Our study concludes an association between FBS, PPBS, and duration of diabetes with MoCA score in diabetic patients of both types. Strict glycemic control and regular screening for cognitive dysfunction can prevent dementia.
Knowledge and practicing pattern of patients following oral anticoagulant therapy in a tertiary health-care center
Authors: Shareef Fateen , Wasay Mohammed , Fatima Azha , Shaheen Shaik , P Sri , Fatima Arooba , Farooqi Mohammed , Mohiuddin Mohammed
Published: October 2023

Background: Oral anticoagulant therapy is frequently used for the diagnosis, treatment, and prevention of heart diseases. Oral anticoagulants need to be constantly managed when used long term and outside of a hospital setting since they have a restricted therapeutic index. Oral anticoagulants have been associated with a number of issues, including bleeding. Patients’ health can be enhanced by educating patients about their oral anticoagulant therapy which can enhance long-term adherence to the therapy.

Aims and Objectives: The objective was to evaluate how well oral anticoagulant therapy users comprehended the drug, in addition to providing the patients with the appropriate education.

Materials and Methods: This cross-sectional study was conducted on 200 patients on oral anticoagulant therapy in a tertiary care hospital. A standardized questionnaire was circulated to 200 patients and institutional ethical approval was taken before the study. Data were evaluated using Statistical Package for the Social Sciences software. Descriptive analysis and Chi-square tests were used for data analysis. For significance P ≤ 0.05 was considered.

Results: The majority (36.5%) were from 61 to 70 years of age group with a high percentage (59.5%) of male gender. Most (46%) of the patients were from the middle class with graduation (49%), and mostly receiving >1 year (55.5%) of anticoagulant therapy as treatment. The predominant age group (71–80 years) has shown good knowledge and practice pattern significantly, (P = 0.001), and the predominant duration of anticoagulant therapy (>1 year) showed very good knowledge and practice pattern significantly, (P = 0.001).

Conclusion: In this study, patients on oral anticoagulant therapy had limited knowledge of a good practicing pattern. More effective strategies focusing on patient knowledge and practicing patterns need to be implemented to optimize oral anticoagulant medication, improve patient outcomes, and reduce associated side effects.
Demographic profile and outcomes in hospitalized COVID-19 patients in a tertiary care teaching hospital
Authors: Malhotra Shruti , Beg Mirza , Bawa Shalu , Vishnoi Arpit , Rawat Jagdish , Varma Amit , Huidrom Sangeetha
Published: October 2023

Background: Coronavirus disease-19 (COVID-19), a novel viral infection has proved to dismantle the lives of people worldwide and has inflicted a major health crisis making it crucial to study its demographic and outcome profile to safeguard the future generations to the best of our capabilities.

Aims and Objectives: The objective of this study was to analyze observational outcomes of the hospitalized COVID-19 patients.

Materials and Methods: Study was conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun from October 1, 2020, to September 30, 2021, after approval from the Institutional Ethics Committee. It was a cross-sectional, open-label, and retrospective study that included hospitalized COVID-19 patients confirmed by reverse-transcription polymerase chain reaction testing. Records of patients were obtained with permission from concerned authorities. Appropriate statistical tools were used for analysis. P ≤ 0.05 was considered statistically significant.

Results: Records of 606 hospitalized COVID-19 patients were analyzed and indicated that 359 (59.24%) patients were male and 247 (40.76%) were female. The male: female ratio is 1.45:1. The majority of the patients 228 (37.62%) belonged to age group of 46–60 years. Two hundred and seventy-one (44.72%) patients suffered from associated comorbidities of which diabetes mellitus 87 (32.10%) followed by hypertension 70 (25.83%) were most common. 217 (35.81%) patients required oxygen support. Of 86(14.19%) reported deaths, 60 (69.77%) were male with statistically significant P-value belonged to age group of 61–75 years. Median length of stay of the patients was 7 days.

Conclusion: Majority of patients hospitalized were male and belonged to middle-aged group. Majority of mortalities were among males and belonged to elderly age-group. Most patients with comorbidities were from elderly age-group and diabetes being most common. Continued study on infectivity profile of infected individuals may contribute largely in assessment and formulation of various norms to fight the disease in the future.
Knowledge, attitudes, and practices among MBBS students about vaccination during the COVID-19 pandemic: A cross-sectional study
Authors: Kunnoor Nitin , Ambresh Ayyali , K Lohit , R Vidya
Published: October 2023

Background: The severe acute respiratory syndrome (SARS) coronavirus, also known as COVID-19, is a significant epidemic that has generated a rapidly spreading respiratory infectious disease responsible for SARS. The present study was designed to observe the knowledge, attitude, and practice of medical students on COVID-19 vaccines. The pandemic was tougher on medical students than ever before and now that they are vaccinated and have finally resumed outpatient department and ward posting it was necessary to understand student’s perspectives about vaccines.

Aims and Objectives: The aims and objectives of the study were to assess the knowledge, attitudes, and practices among MBBS students about vaccination during the COVID-19 pandemic.

Materials and Methods: Based on the medical students’ COVID-19 vaccination status, this qualitative investigation was carried out between May and July 2021. Online data on the COVID-19 vaccination were gathered using a self-administered, semi-structured questionnaire that was distributed to students throughout South India and was based on recommendations provided on the official website by the Ministry of Health and Family Welfare, Government of India. Approval from the institutional ethical committee was obtained before data collection.

Results: A total of 296 medical students participated in the study. The mean age of participants was 20.5 ± 1.3 years. Out of which 57.40% were men and 42.60% were women. The majority of 97.30% medical students consider that vaccination is required; 84.80% of medical students are vaccinated and 15.20% of them are not yet vaccinated pain at the site of injection, body ache, headache, and fever appears to be the major side effects of COVID-19 vaccination whereas loss of consciousness, and allergy occurred among the least population.

Conclusion: This study examined medical students of South India’s attitudes, beliefs, experiences, reactions, and feelings regarding the COVID-19 vaccine acceptance and perception. We found that the opinion on the vaccine’s safety, doses of the vaccine to receive, vaccine safety with some side effects, and the possibility of getting coronavirus disease after vaccination are significant positive factors influencing the acceptability in medical students.
Investigation of Causes and Characteristics of Monsoon Extremes in Pakistan: A Case Study for Summer Monsoon 2022
Authors: H. Shah Syed Muzzamil , Qureshi Haris U. , Yassin Mohamed A. , Abba Sani I. , Mustaffa Zahiraniza
Published: October 2023

Apart from the long-term changes in the normal weather patterns, the occurrence of short-lived extreme meteorological events has also emerged as a major consequential aspect of global climate change. Pakistan being listed among the most susceptible nations to the changing global climate patterns has witnessed an increasing frequency of extreme summer monsoon rainfall events during the past decades. This study was conducted to comprehensively investigate the major meteorological factors that lead to the extreme summer monsoon precipitation in Pakistan in 2022. The results obtained from the study showed that in April 2022, Balochistan observed 1.5 to 6 °C, Sindh observed 2 to 4 °C, while Punjab and KPK observed 3 to 5.5 °C above normal temperatures (1961-2010). In May, Sindh and Balochistan observed 1 to 3.5 °C above normal temperature, consequently causing intense low-pressure conditions over the area. In April 2022, about 1 to 2.5 mb below normal air pressure was found in Sindh and Balochistan, while in May, about 1 to 3 mb below normal pressure was found over the area. The summer monsoon 2022 analysis showed that in July, about 0.2 to 4 mb above normal vapor pressure was found in Sindh and Balochistan, while Punjab reported 1 to 5 mb above normal vapor pressure. In August, Balochistan and Sindh recorded 1 to 5 mb, while Punjab recorded 1.5 to 5 mb above normal vapor pressure. Further, the extreme monsoon precipitation was more concentrated in Sindh and Balochistan, as compared to the other provinces. In July 2022, Sindh received 307 %, Balochistan received 450 %, while Punjab received 116% above normal rainfall. In August, Sindh received the highest rainfall (+726% above normal) followed by Balochistan with the rainfall departure as +590%. Conclusively, it was established that the unusual pre-monsoon heating over the arid plains in Sindh, Balochistan and southern Punjab resulted in the development of intense trough over the area, that pulled excess moisture from the Indian ocean, causing high vapor pressures
Serum alpha-fetoprotein level (> 10,000 U/mL) is a marker of hepatocellular carcinoma: A case study
Authors: Panda Prasan Kumar
Published: October 2023

Hepatocellular Carcinoma (HCC) development in young adults is strongly multifactorial. Important risk factors for the same are smoking, alcohol abuse and hepatitis C virus (HCV) infection at an early age. However, suspecting HCC is enigmatic at early age in which biochemical marker may aid in identifying such patients. In this article, we describe an unusual case of a 27-years-old male who presented with complaints of vague right upper abdominal fullness, non-bilious, non-projectile vomiting, loss of appetite, and significant weight loss for the past 2 months. On examination, there was firm, non-tender hepatomegaly. Patient had normal liver enzymes with very high alpha-fetoprotein (AFP) level (> 10,000 U/mL). Ultrasoundabdomen suggested hetero-echoic lesion in liver along with chronic kidney disease (CKD) changes. The triple phase CT of the abdomen showed a liver mass with arterial enhancement and delayed washout suggestive of HCC. Chronic HCV infection was confirmed with high RNA titres (> 50,000 IU/mL). Patient was diagnosed as HCC at an early stage, which allowed for timely initiation of treatment. This early age onset of HCC in a young adult may be due to multiple factors such as HCV infection, alcoholism, cirrhosis, and CKD. This single case study confirms that alcohol-induced liver injury increases the risk of developing early age HCC in persons infected with HCV and complicated with CKD. And AFP measurement helps inearly identification of HCC, especially at such high level > 10,000 U/mL.
Improving Audit Quality by Using Increased Auditor Ethics
Authors: Helvira Putri Nabila Felby , Yusup Maulana
Published: October 2023

The objective of this study is to investigate the ethical approaches employed by auditors in order to improve the overall quality of audits. The study utilizes a qualitative research methodology. The individuals chosen for interviews consist of the Head of Department, Auditors, as well as functional and non-structural officials from a regional examination office located in Bandung City. The results obtained from the conducted research demonstrate that Audit Ethics positively influence the quality of audits, which can be classified as either moderately satisfactory or not yet reaching optimal levels. Consequently, the structural authorities have enhanced the optimization of ethical strategies aimed at enhancing audit quality. However, they need to gain familiarity with the evaluation and measurement of auditors' performance and the conduct of such evaluations or measurements. To achieve proficiency and excellence, auditors must consistently execute their responsibilities in a professional manner and adhere to the prescribed code of ethics. This commitment ensures unbiased outcomes that furnish valuable information to the pertinent organization.
Detection of Authentication of Meat Products by Low Cost Closed-tube Molecular Methods
Authors: Laliotis George P. , Batrinou Anthimia , Giannakourou Maria , Tsakali E. , Letsiou Sophia , Halvatsiotis Panagiotis , Akkermans Simen , Impe Jan Van , Maragou Niki C. , Houhoula Dimitra
Published: October 2023

Nowadays adulteration of meat products, especially of ground meat products which form an easy case scenario for implementing adulteration practices due to their structure and texture, emerges a critical issue of raised concern threatening fair trade, food quality and consumers’ health and protection. Food authentication testing is the tool to address this kind of fraud. There is several analytical methodologies applied for meat authentication targeting at different biomarkers and using a variety of analytical techniques. However, the applied methodologies should exhibit suitable performance characteristics such as reliability, sensitivity, reproducibility and availability in order to be fit for purpose. During the last 20 years, amplification tests have emerged as an important diagnostic tool, not only for clinical applications, but also for food quality and safety. It was urgent to develop molecular techniques fast and sensitive. The introduction of new DNA technologies has facilitated the ease and accuracy of of methods for fraud detection. The closed-tube methods of Loop-mediated isothermal amplification (LAMP) and Gold Nanoparticles linked with oligonucleotides used as molecular probes are well known for their robust and highly sensitive and specific amplification of target DNA. Moreover, these techniques are rapid, low-cost diagnostics and available on site. This review provides a comprehensive overview of the molecular methods developed that can be applied for investigating ground meat adul-teration and focuses on the advantages of the rapid closed tube methods that can yield color results interpreted with the naked eye. The application of such time- and cost-effective molecular tools in the food market is proposed to provide a first-level filter for meat adulterated products, serving as a complementary tool to the more in-depth -omics approach.
Chemical profile and biological properties of the essential oil of Rosemary leaves (Rosmarinus officinalis L.)
Authors: Quyen Pham Thi , Quoc Le Pham Tan
Published: October 2023

Rosemary leaf essential oil (RoEO) is extracted using steam distillation. The aim of study is to determine physicochemical characteristics of essential oil (EO), such as acid/saponification/esterification index, relative/absolute density, freezing point, and fragrance retention. The chemical composition of EOs was analyzed by gas chromatography-mass spectrometry (GC-MS) method and identified 50 volatile compounds, of which α-Pinene (33.76%), 1,8-Cineole (18.47%), and Levoverbenone (6.11%) constituted the highest proportions in EO. The antioxidant capacity (AC) of the EO was evaluated by 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging method with a half-maximum inhibitory concentration (IC50) of 425.473 mg/mL. In particular, antibacterial activity (AA) by the paper plate diffusion method for susceptibility testing to essential oil showed that RoEO strongly inhibited the growth of four tested bacterial strains (Staphylococcus aureus, Bacillus cereus, Salmonella typhimurium, and Escherichia coli). Perhaps, it is possible to apply RoEO in the food industry and other fields owing to the good properties of RoEO.
LexVEN
Authors: Ferin Maria , Gyllstad Henrik , Venagli Ilaria , Zordan Angelica , Kupisch Tanja
Published: October 2023

While there is growing awareness that knowledge of regional minority languages must be protected, assessing the vitality of such varieties is challenging due to the lack of assessment materials. Our contribution documents the creation and validation of LexVEN, a bimodal yes/no vocabulary task, with the purpose of assessing the proficiency of users of Venetan with receptive and/or productive skills. The materials will be freely available. The vocabulary items were validated in a survey with 161 speakers of Italian, of which 136 came from the Veneto area. We have relied on Classical Test Theory (CTT) and Item Response Theory (IRT) in validating test items, and we demonstrate correlations with self-reported measures of proficiency and language use. Given the absence of any other assessment tools of Venetan for cross-validation, we further collected speech samples from a subset of the Venetan participants with active proficiency whose proficiency was rated by native speakers of Venetan. We discuss the procedures within a validation framework, concluding that LexVEN is reliable as a proficiency assessment tool of Venetan.
Spatial Disparities in Human Development Index across the Districts of Pakistan: An ESDA Analysis
Authors: Ahmed Noor , Iqbal Khurshed , Naseebullah  , Muhammad Kasi Ameer
Published: October 2023

Pakistan is spatially a diverse state in terms of the location of its economic activities, and regional disparities in human development level have been a vital concern in its history. The article aims to analyze the distribution of the development index across 97 districts of Pakistan through exploratory spatial data analysis for periods 2004-05 and 2014-15. For this purpose, an augmented development index is constructed for measuring development levels across districts. The index consists of three sub-indexes of education, health, and household welfare level, with each index further consisting of five indicators. The findings of the study indicate positive global autocorrelation, thus indicating that a district with a high (low) is linked spatially with bordering districts that also have a high (low) Development level. The results also display the HH quadrant in the scatterplot of the development Index, which includes most districts of Punjab and KP, while LL illustrates a cluster of most districts from Interior Sindh and Balochistan for both the 2004-05 and 2014-15 periods. Overall, the findings demonstrate the twofold structure of Pakistan’s economic geography, as explained by most of the previous studies. Since the geography of development matters, it is recommended to reduce inequalities across districts by developing the social and economic institutions and infrastructure in Balochistan and Interior Sindh.