bluuebunny/crossref_metadata_2025 huggingface dataset:
The cytotoxic and antiproliferative properties of ruthenium nitrosyl complexes and their modulation effect on cytochrome P450 in the HepG2 cell line
Authors: Klyushova L.S. , Vavilin V.A. , Grishanova A.Yu.
Published: February 2024

Ruthenium nitrosyl complexes are actively investigated as antitumor agents. Evaluation of potential interactions between cytochromes P450 (CYPs) with new compounds is carried out regularly during early drug development. In this study we have investigated the cytotoxic and antiproliferative activities of ruthenium nitrosyl complexes with methyl/ethyl esters of nicotinic and isonicotinic acids and γ-picoline against 2D and 3D cultures of human hepatocellular carcinoma HepG2 and non-cancer human lung fibroblasts MRC-5, assessed their photoinduced activity at λrad = 445 nm, and also evaluated their modulating effect on CYP3A4, CYP2C9, and CYP2C19. The study of cytotoxic and antiproliferative activities against 2D and 3D cell models was performed using phenotypic-based high content screening (HCS). The expression of CYP3A4, CYP2C9, and CYP2C19 mRNAs and CYP3A4 protein was examined using target-based HCS. The results of CYP3A4 mRNA expression were confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR). The ruthenium nitrosyl complexes exhibited a dose-dependent cytotoxic effect against HepG2 and MRC-5 cells. The cytotoxic activity of complexes with ethyl isonicotinate (1) and nicotinate (3, 4) was significantly lower for MRC-5 than for HepG2, for a complex with methyl isonicotinate (2) it was higher for MRC-5 than for HepG2, for a complex with γ-picoline (5) it was comparable for both lines. The antiproliferative effect of complexes 2 and 5 was one order of magnitude higher for MRC-5; for complexes 1, 3, and 4 it was comparable for both lines. The cytotoxic activity of all compounds for 3D HepG2 was lower than for 2D HepG2, with the exception of 4. Photoactivation affected the activity of complex 1 only. Its cytotoxic activity decreased, while the antiproliferative activity increased. The ruthenium nitrosyl complexes 1–4 acted as inducers of CYP3A4 and CYP2C19, while the complex with γ-picoline (5) induced of CYP3A4. Among the studied ruthenium nitrosyl complexes, the most promising potential antitumor compound is the ruthenium compound with methyl nicotinate (4).
McCarthyism and American Cold War Ideology in Irish-American Autobiographical Writing
Authors: Perez Alvarez Andrea
Published: February 2024

This article explores the various ways in which the protagonist of Frank McCourt’s autobiographical account ’Tis, A Memoir confronts the McCarthyite proceedings and their unsettling consequences at times of utmost conservatism in America. It addresses his negotiation of an ultimately alienated ethnic identity, arguing that the protagonist’s fractured self not only reflects the slippery ground upon which McCarthyite practices are founded, but is also brought about by it. Beyond this analysis, however, the article is set to problematize the very status of McCourt’s autobiographical writing by assessing the memoir’s narrative codes in association with its content and purported readership. Specifically, the proposal evaluates the fictional strategies on which it is constructed, as well as the inconsistencies inherent in the narrative depiction of the character’s partial assimilation into an eventual Irish-American national identity. The proposal ultimately assays McCourt’s memoir as a product and reworking of the ideological tenets characteristic of McCarthyism and the early Cold War period.
Saroyan’s “The Black Tartars”
Authors: Aguilera Linde Mauricio D.
Published: February 2024

This article offers an examination of William Saroyan’s stance on nationalism through the analysis of “The Black Tartars” (1936), a story built on the technique of embedding which shows, through the layering of stories, two distinct models: one based upon primordialist notions of race; the other resting on the principle of ethnolinguistic homogeneity and resulting in the birth of the modern nation-state. By examining the dialogicity implicit in the frame narrative, I propose to examine Karachi’s tale as an example of “parodic skaz” which stands at odd with the author’s ideology and operates as a concave mirror reflection of the tragic fate hovering over stateless minorities.
Prevalence and patterns of thyroid dyfunction in chronic kidney disease patients in a tertiary hospital in southern Nigeria
Authors: Gomba Victoria E. , Unachukwu Chioma , Chinenye Sunny
Published: February 2024

Background: Several studies have identified that a decline in renal function as occurs in chronic kidney disease (CKD) is associated with thyroid dysfunction among other endocrine disorders. The prevalence and pattern of thyroid dysfunction in CKD patients in our environment is however not known. This study aimed to determine the prevalence and pattern of thyroid dysfunction in dialysis naïve CKD patients in a tertiary hospital in Southern Nigeria.
Methods: This was a cross sectional study involving 100 participants with established CKD and 100 age and sex matched healthy controls. Relevant data were collected using an interviewer based questionnaire. Samples collected from the participants were assayed for fT3, fT4, TSH and serum creatinine. Analyses was done using version 25 of the SPSS software at a 95% confidence interval and a p value of <0.05 was considered statistically significant.
Results: There were 93 males and 107 females with mean ages of 46.3±15.9 and 45.7±14.9 years for the CKD and control participants respectively (p=0.7587). The prevalence of thyroid dysfunction was 45% in the CKD group and 4% in the control group. Sick euthyroid syndrome was the commonest form of thyroid dysfunction (23%), followed by subclinical hypothyroidism (14%). Thyroid dysfunction increased with increasing severity of CKD but this was not statistically significant.
Conclusions: Thyroid dysfunction is highly prevalent in dialysis naive CKD patients.  Further studies need to be carried out to determine risk factors and evaluate the impact of treatment in these patients following which a guideline for screening and management can be developed.
Changing trends in cardiovascular risk factors among adults in southern Nigeria
Authors: Nwafor Chibuike E. , Edeogu Julius , Rosemary Stanley O. , Enyichukwu Blessing Chinaza , Agbamoro Jovita
Published: February 2024

Background: Globally, cardiovascular diseases (CVDs) cause 17.9 million deaths yearly. In nations like Nigeria, diabetes, hypertension, and obesity, coupled with modifiable behaviors such as physical inactivity, unhealthy diet, smoking, and alcohol use, are rising. This study focused on assessing the evolving prevalence and distribution of CVD risk factors among adults in southern Nigeria.
Methods: This cross-sectional study, conducted in Port Harcourt, Rivers state, was part of world heart day celebrations over three years (September 2019-September 2023). 309 adults participated, undergoing screening for blood pressure, fasting blood glucose, lipid profile, and body mass index calculated from weight and height measurements.
Results: Over three years, 309 subjects (mean age 46.63±12.03) were studied, with 53.40% females and 46.28% males. Most cardiovascular risk factors occurred in the 41-50 age group. Hypertension rose from 65.63% (2019) to 75.29% (2023), dipping to 64.79% (2022). Obesity decreased from 29.69% (2019) to 24.71% (2023), rising to 30.99% (2022). Diabetes increased from 23.44% (2019) to 27.59% (2023), decreasing to 19.71% (2022). Total cholesterol rose from 1.56% (2019) to 2.9% (2023). High LDL increased from 3.12% (2019) to 12.7% (2023). Low HDL and high TRIG decreased from 2019 to 2023.
Conclusions: From 2019 to 2023, cardiovascular risk factors like hypertension, obesity, diabetes, and dyslipidemia increased, with a slight fluctuation in 2022. Heightened awareness and preventive measures against adult CVD risk factors are imperative. National education on risk factors is vital for individuals to monitor their blood pressure, weight, cholesterol, and blood sugar levels.
A cross-sectional Study on lifestyle factors influencing gastritis and dyspepsia among international students’ faculty of medical university
Authors: Zoya Petrovna Lemeshevskaya , Liyanage L. R. Sathisha Deshan , Rajendrakumar Patel Grishma , Rilwan Maryam Mohamed
Published: February 2024

Background: Gastritis is the syndrome associated with the inflammation of the stomach epithelium. Age, dietary pattern, health issues, level of stress, the existence of any other gastrointestinal symptoms, smoking, use of alcohol, and use of over-the-counter medication were considered extraneous variables. The purpose of this study was to determine the lifestyle characteristics that predispose to gastritis among the international students of Grodno State Medical University, Belarus and the results were closely and meticulously analyzed.
Methods: A descriptive survey strategy was used to evaluate the variables associated with gastritis. A simple random approach was chosen for this research. Data was collected with the help of a questionnaire in the format of an online Google form and recorded. Responses from 211 respondents mostly aged 18 to 29 years old were collected. The survey focused on gastritis and its connection to lifestyle factors like smoking, stress, and eating patterns.
Results: The frequency value for the consumption of processed food was the highest above all with regards to dietary habits in this study followed by consumption of fibrous food, having carbonated drinks, frequency of having coffee/tea per day, and general stress level with their daily workload as well as evidently due to consumption of spicy food.
Conclusions: This study demonstrates that the incidence of gastritis among the respondents was multifactorial.
Examining folic acid intake: a cross-sectional study of pregnancy-related practices
Authors: Khan Muhammad M. , Saad Muhammad , Syed Muhammad R. , Siddiqui Farina F. , Siddiqui Aisha R. , Rajput Maisam A. , Siddiqui Noor-us-Sahar , Sanaullah Ifrah , Gul Laraib , Ahmad Muhammad
Published: February 2024

Background: Folic acid supplementation during the periconceptional period is critical in preventing neural tube defects (NTDs) in the developing fetus. In Pakistan, a profound lack of awareness is seen regarding preventable pregnancy-related illnesses and the consequential high maternal and fetal mortality and morbidity rates. However, data from the surveys in the region of Sindh lacks inquiries regarding the baseline characteristics of the surveyed participants. Therefore, this study endeavoured to address this gap.
Methods: Between October 2022 and April 2023, a cross-sectional study was conducted at two major tertiary care hospitals in Hyderabad and Jamshoro, Pakistan. A total of 374 participants, chosen by non-probability consecutive sampling, comprised the sample size. The association of demographic variables and knowledge, attitude, and practice of consumption of folic acid during pregnancy was determined using the χ2 test. A p value of less than 0.5 was considered statistically significant.
Results: The mean age of the participants was 26.4±5.7 years. A total of 199 (53.20%) participants were literate, compared to 175 (46.79%) participants who were illiterate. Literate women fared better than illiterate women in all the metrics with a p-value of <0.001 and a Pearson correlation coefficient (r) of >0.7. Moreover, folic acid was consumed by only 38% of pregnant women during the periconceptional period.
Conclusions: A substantial lack of knowledge regarding folic acid was found in the surveyed sample, significantly more marked in the illiterate faction. Additionally, the practice was rather unsatisfactory. However, the attitude remained encouraging.
Association of liver function tests with severity of disease in patients with COVID-19
Authors: Ipek Serkan , Gelgec Sule Ayse , Turker Gamze , Aydin Catakli Serra
Published: February 2024

Background: We aimed to investigate the association of liver function tests with disease severity at admission and during hospitalization in patients with coronavirus disease 2019 (COVID-19).
Methods: Blood tests of patients who were hospitalized due to COVID-19 were retrospectively analyzed. Liver tests included serum aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin, and albumin. Besides these, C-reactive protein and ferritin were also analyzed in the study. Levels of these tests at admission and peak levels during hospitalization were then recorded. Severe COVID-19 infection was defined as the reason for ICU admission. Both the associations of the levels of liver tests at admission and peak levels during hospitalization with severe disease were evaluated.
Results: The study included a total of 602 patients, and 127 (21.1%) of the patients were hospitalized in the ICU. In our study, only albumin level abnormality was significantly associated with severe disease in COVID-19 patients at admission. However, during hospitalization, a significant association was found between severe disease and abnormal AST, ALT, GGT, T.BIL, albumin, and ferritin levels. During hospitalization, it was also observed that the rates of severe disease cases increased as AST, ALT, GGT, and T.BIL levels increased.
Conclusions: Abnormal liver function tests may be a predictor for severe disease in patients with COVID-19. It is therefore important to monitor liver function tests in hospitalized patients.
Evaluation of adaptive capabilities of students of different nationalities: cross sectional study
Authors: Varsha Priyadarshani Mohotti Gedara Weerakoon Mudiyanselage , Wattaladeniya Poorna Gayan , Dzmitry Karnialiuk , Anbalagan Shailesh , Kalna Munasinghe Owini
Published: February 2024

Background: The autonomic nervous system actively regulates the body's reactions to various external and internal factors, ensuring physiological balance in a person. Advances in information technology now allow for a dependable and non-intrusive examination of this system through an in-depth analysis of heart rate variability. This approach is not only a recognized instrument in cardiac studies but is also growing in its utilization for numerous clinical purposes. This overview details the foundational theories and practical uses of this evolving method. The purpose of the study is to study the adaptive reserves and indicators of autonomic regulation in students of different nationalities.
Methods: We conducted a cross sectional study of 110 students studying in Grodno State Medical University using photoplethysmography method via an app “Pulse HRV”during the period of December 2022- February 2023. The students were grouped into three groups: Group 1 being southeast Asian students, group 2 being Nigerian students and Group 3 being Belarussian students.
Results: As a result of the analysis, it was found that AP in group 2 was significantly different from groups 1 and 3. At the same time endurance coefficient was above norm in all groups, which indicated a weakening of the cardiovascular system, while in students from group 2 it was significantly less than in groups 1 and 3.
Conclusions: Students from Nigeria have significantly higher adaptive reserves than students from Belarus and Southeast Asia, which may be due to the prevalence of increased tone of the parasympathetic nervous system.
Role of histopathological and microbiological investigations for a definitive diagnosis of benign sinonasal masses: a tertiary care institute study
Authors: Maan Arvinder Singh , Bhagat Ruchika , Navneet
Published: February 2024

Background: This research aimed to study the clinical presentation of various sino nasal masses (SNM), to study the importance of Histopathological and microbiological investigations in making diagnosis of SNM and to study the correlation between clinical, radiological, histopathological, and microbiological findings of SNM.
Methods: In the present study 50 patients attending the ENT outpatient department with clinical evidence of nasal mass were selected based on inclusion and exclusion criteria. Patients were examined clinically and radiologically followed by surgical intervention. Histopathological and microbiological examination was done to make a definitive diagnosis.
Results: Majority of cases were from 21-40 years age group (66%) with male preponderance. Nasal obstruction was most common symptom 45 (90%) followed by nasal discharge 43(86%). On histopathology highest incidence was of inflammatory polyps 22 (44%) followed by allergic polyps 14(28%) and non-invasive fungal sinusitis (NIFS) 11 (22%) respectively. Microscopically in KOH, fungal elements, yeast and hyphae were seen in total 11 (22%) cases and with SDA, Aspergillus niger was seen in 7 (14%) cases, Candida albicans in 3 (6%) and both in 1 (2%) case. Correlation of provisional diagnosis with HPE was found to be highly significant.
Conclusions: It was observed that histopathological and microbiological examination is irreplaceable as both are the “GOLD STANDARD” for making a definitive diagnosis.
Understanding motivators and barriers for yoga practice in obese and non-obese individuals
Authors: Telles Shirley , Gupta Shivam K. , Sharma Sachin K.
Published: February 2024

Background: Yoga is a comprehensive lifestyle intervention which has been used for weight management by overweight and obese. Yoga is also used as therapy for various other ailments by both obese and non-obese individuals. However, the motivators and barriers of yoga in obese persons compared to non-obese has not been reported.
Methods: The present cross-sectional comparative control trial included 200 participants of both sexes aged between 13 and 80 years. Of these, 102 were obese and 98 were non-obese. Data were analyzed using Chi-square test.
Results: The most common motivators for yoga were: reducing symptoms of illness (35% for obese versus 21.73% for non-obese), pain relief, (21% for obese versus 10.86% for non-obese) and lifestyle changes (9% for obese versus 10.86% for non-obese). The most common barriers for yoga were: no time (29.54% for obese versus 42.25% for non-obese), physical incapability of practicing yoga (18.18% for obese versus 16.9% for non-obese) and tiredness (15.9%) for obese and no interest/motivation (15.49%) for non-obese.
Conclusions: The motivators to yoga for obese are comparable to non-obese with obese use yoga more frequently for “reducing symptoms of illness”. Also, the barriers to yoga are comparable to obese with normal weight for “no time”.
Sonomammographic and sonoelastographic evaluation of benign and malignant breast lesions and its correlation with fine needle aspiration cytology
Authors: Gour Khushboo , Mallik Rikta , Mondal Anisha , Mondal Abhishek
Published: February 2024

Background: Breast cancer affects 25.8% of women worldwide. Mammography and ultrasound have sensitivity, but invasive breast biopsies and aggressive biopsies are essential. Sonoelastography is a non-invasive imaging method that can measure tissue stiffness related to different pathologic conditions, such as cancer. Objective is to assess the diagnostic accuracy of sonomammography and sonoelastography in diagnosing breast lesions as benign or malignant in correlation with fine needle aspiration cytology (FNAC) as gold standard.
Methods: This study was conducted on 52 female patients with breast mass and sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), kappa and p value of conventional gray scale ultrasound and ultrasonography (USG) elastography were calculated and compared with that of FNAC. Ultrasound was performed using grayscale and elastography mode on GE LOGIQ P9 ultrasound equipment with a 7-12 MHz linear-array transducer. All cases with breast lesions identified on ultrasound elastography underwent FNAC.
Results: The sensitivity, specificity, PPV, NPV of sonoelastography were 78.5, 94.7, 84.6, 92.3 with kappa 0.75 and p value <0.0001. Similarly, sensitivity and specificity for strain ratio were 85.7 and 97.4, and that for size ratio were 85.7 and 100 respectively. These results are comparable to or better than results for conventional ultrasound.
Conclusions: Breast elastography makes it easier to classify BIRADS 3 category lesions which are benign but still confused as malignant on conventional USG. BIRADS category 3 and 4 lesions with benign findings on sonoelastography can be downgraded to category 2 and 3 respectively thus reducing the number of false positive malignancy cases and biopsy.
Expert opinion on the clinical use and benefits of liposomal iron in the treatment of anemia in Indian settings
Authors: S. Manjula , M. Krishna Kumar
Published: February 2024

Background: Several studies have reported the effectiveness and safety of liposomal iron in increasing hemoglobin levels and correcting anemia. However, there was a dearth of information regarding the prescription pattern of physicians regarding its use and advantages in the actual practice. The present survey-based study aims at gathering clinicians' perspectives regarding the clinical use and benefits of liposomal iron in the treatment of anemia in Indian settings.
Methods: This cross-sectional study used a 19-item questionnaire to gather insights from specialists across different Indian settings regarding their perspectives on anemia and liposomal iron.
Results: Out of 124 participants, 77% opined that liposomal iron was highly bioavailable, achieves much higher plasma iron concentration, and bypasses the extremely restrictive, normal intestinal barriers. Oral liposomal iron was preferred by 77% of clinicians for the rapid increase in hemoglobin level and 99% of clinicians reported improved patient compliance with liposomal iron therapy for anemia. According to 50% of clinicians, oral liposomal iron was effective in non-hemodialysis dependent chronic kidney diseases and 87% of clinicians reported that patients without CKD needed oral liposomal iron. Half of the respondents reported a significant increase in Hb with liposomal iron in both dialysis and non-dialysis patients.
Conclusions: The survey participants reported that liposomal iron treatment for anemia was beneficial in treating both CKD and non-CKD patients. The survey findings have corroborated the advantages of liposomal iron for treating anemia such as increased bioavailability, rapid and effective increase in Hb level, better patient compliance and tolerability, decreased side effects, cost-effectiveness, and flexible dosing.
A study on the symptoms, sleep quality and cognitive function of the women during menopause
Authors: S. H. Fiza , N. Manaswi , Preman Pavithra , Hari Gopika , Kalyan Pavan , Sajan Tesmi
Published: February 2024

Background: Menopause is the time that marks the end of your menstrual cycle. It is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. The primary objective of the study was to evaluate the pattern of symptoms among women during menopause. The secondary objective was to assess the sleep quality and cognitive function of the women during menopause and to create awareness and educate rural women regarding menopause.
Methods: A cross-sectional observational study was carried out in and around B. G. Nagar, Nagamangala, Mandya for 6 months.
Results: A total of 504 women were enrolled in the study. Out of 504, 224 (44.4%) participants come under perimenopause, 117 (23.31%) participants come under perimenopause and 163 (33.34%) participants comes under post menopause. After filling out the questionnaire it was observed that there was a decline in cognitive function of postmenopausal women along with poor sleep quality. When the age group of the participants was compared with the different symptoms of menopause a significant relation was found between the age category of the participants and the somatic symptoms. A significant relation was found between the sexual activity and with the somatic symptoms (p=0.00**), psychological symptoms (p=0.00**) and urogenital symptoms (p=0.00**) of the participants.
Conclusions: As women passes from premenopausal to perimenopause to post menopause menopausal symptoms were increased. The menopausal transition and postmenopausal years are associated with significant symptoms.
Assessment of bacteriological profile and wound infection in open and laparoscopic gall bladder surgery
Authors: Raja Faizan , Gani Mubashir , Illahi Mir Fazil , Rather Ajaz Ahmad
Published: February 2024

Background: Cholecystectomy is one of the most frequent types of abdominal surgery performed in the world. Generally, there is minimal risk of serious postoperative complications. One of the complications is Surgical Site Infection, which can be caused by bile leakage and intraoperative contamination.
Methods: This prospective study was conducted in department of General Surgery, SKIMS medical college Srinagar, from June 2020 to July 2023 comprising of 100 patients. All patients undergoing the procedure were observed for wound infection.
Results: A total of 100 patients were studied with female to male ratio of 2:3. The mean age was 50.24±12.25 with 54% elderly patients. The average hospital stay was 4.02±07. 88% subjects belonged to ASA II Category with Hypertension and hyperthyroidism as common comorbidity. 11 patients got wound infection including 9 from open cholecystectomy and 02 from laparoscopic cholecystectomy with most patients belonging to elderly age group. Wound culture was positive in 9 out of 11 subjects of open cholecystectomy. E. coli was seen to be a major causal bacterial agent. Bile culture was positive in 8 patients. Both genders were almost equally affected by wound infection. Meropenem, Ceftriaxone, Gentamicin and Amikacin showed the highest number of antibiotic sensitivities tested in case of wound cultures.
Conclusions: The prevalence of positive wound culture in uncomplicated laparoscopic cholecystectomy is low as compared to open procedure. Elderly age, co-morbid patients, patients who had history of jaundice, recent history of cholecystitis were at higher risk of wound infections.
Association of genetic and epigenetic modification in MTHFR gene with coronary artery disease patients in North Indian population
Authors: Ramteke Alka , Yadav Amita , Anbhule Amol Parshram , Bansal Anju , Bansal Sandeep
Published: February 2024

Background: Methylene tetra hydro folate reductase (MTHFR) gene polymorphism C677T (rs180113) and DNA methylation in promoter region of MTHFR gene may contribute to the development of coronary artery disease however the results have been inconsistent across studies with different populations, so the aim of our study is to explore the association of polymorphism in MTHFR gene and methylation in promoter region with coronary artery disease (CAD) and other risk factor (lipid profile, homocysteine, vitamin B12 and folic acid levels)  leading to CAD in of north Indian population.
Methods: Total 100 CAD patients and 100 healthy controls were enrolled in the study. Genotyping of rs1801133 SNP (C677T) is done by PCR-RFLP and DNA methylation study in promoter region by methylation specific PCR. Lipid profile analysis by automated chemistry analyzers, serum homocysteine, folic acid and vitamin B12 was assayed by ELISA.
Results: As per our finding the T allele (OR=3.03, 95% CI=1.74-5.27) and hyper methylation in promoter region of MTHFR increases the odds of coronary artery disease, (OR=3.05, 95% CI=1.7-5.6). Study participants with CT and TT genotype had significantly higher homocysteine (Hcy) (p=0.001), lower folic acid level (p=0.0), and HDL levels (p<0.0001) than those with CC genotype. The study subjects with hyper methylated promoter region have a significantly high homocystenemia levels (p=0.001).
Conclusions: The TT genotype of the MTHFR C677T gene polymorphism and hyper methylation in promoter region of MTHFR, is associated with CAD and can be useful in identification of new biomarkers, development of preventive and therapeutic strategies for CAD.
Effect on haemodynamic parameters following spinal anaesthesia in sitting versus left lateral position for lower segment caesarean section: a comparative study
Authors: Noorjahan  , Binarani Maharabam , M. Dhayanithy , Koyu Sophia , Lollen Lippi , K. Vigneshwaravibhava
Published: February 2024

Background: The percentage of caesarean deliveries carried out under spinal anaesthesia has greatly increased over the last 20 years. However, hypotension remains the most common complication of spinal anaesthesia.
Methods: The study groups divided into two, named group S and group L. The total sample size was 76, 38 patients in each group. All the patients were given 2 ml of hyperbaric bupivacaine (0.5%) in L3-4 midline intrathecal space in sitting position in group S, and in left lateral position in group L.
Results: The comparison of heart rate showed that there was less heart rate fluctuation in group S. Statistically significant difference in mean systolic and diastolic blood pressure was seen between the groups during 2nd to 6th minutes, with more stability in group S. The mean MAP was found to be statistically significant in between 2 to 6 minutes and after 25 minutes. The mean onset time of hypotension in the group S was 17.07±7.98 minutes and that in the group L was 11.54±4.66 minutes.
Conclusions: There were no significant differences in the time to reach sensory block level T6, degree of motor blockade (Bromage scale), neonatal outcome and complications in between the two groups. However onset of spinal anaesthesia is faster in the lateral position. Similarly hypotension is more in the left lateral position. The insignificant difference in block height could be because of adjustments in table position.
Effectiveness of polyhexamethylene biguanide dressings vs. platelet-rich plasma in diabetic foot ulcer: a pilot study of case series
Authors: Martínez-Mejorada Roerto , Rojas-Ortiz Jorge A. , López-Romero Sandra C. , Vázquez-Guerra Ximena C. , Gonzalez Gabriel Garcia
Published: February 2024

Diverse treatments, including polyhexamethylene biguanide dressings, have been explored for managing diabetic foot ulcers. Platelet-rich plasma, known for its potential in chronic wound healing, has demonstrated efficacy both in vivo and in vitro, with possible intralesional or topical application. However, research on the production costs of PRP is scarce. This study compares the effectiveness and financial implications of polyhexamethylene biguanide dressings versus Platelet-rich Plasma in the treatment of diabetic foot ulcers. Conducted at the General Hospital of Mexico from July to August 2019, this case series involved 8 patients, split equally between the two treatment groups. Weekly assessments showed consistent reductions in wound size in both groups. By the fourth week, 75% of patients achieved clinical healing. The PHMB group demonstrated a 75.13% reduction in wound size, compared to a 37.38% reduction in the PRP group. However, due to the small sample size, no statistical significance was found between wound size, healing time, and dressing type. This report suggests no clear relationship between treatment, healing duration, and wound diameter. Additionally, PRP did not show a clear financial advantage over PHMB dressings. Randomized control trials with sufficient sample sizes are required to demonstrate overall advantage for each therapy choice.
Multiple unilateral craniopathies (Guillain-Alajouanine-Garcin syndrome) resulting from a malignancy of the external auditory canal: a case report
Authors: Ang Kevin Royce G. , Rivera Ceferino L. , Almelor Francis A.
Published: February 2024

Garcin syndrome (or Gullain-Alajouanine-Garcin syndrome) was first described in the year 1926, as a paralytic unilateral cranial syndrome consisting of multiple cranial nerve palsies, without findings pointing towards increased intracranial pressure or long tract involvement. A 54-year-old female presented to us initially with ptosis and lateral rectus palsy of the right eye, later on, followed by progressive hearing loss on the right ear, right facial hemianesthesia, and progressive ipsilateral facial paralysis. A mass at the external auditory canal was seen during otoscopy, and a biopsy revealed squamous cell carcinoma. Contrast-enhanced neuroimaging also showed an enhancing mass lesion at the right skull base.
A case of recurrent achalasia cardia with sigmoid esophagus managed laparoscopically
Authors: Panalal Kanishka Harsh , Shrotriya Siddhant , Naik Suresh , Kulkarni Bahar
Published: February 2024

Recurrences of symptoms after the surgery for achalasia cardia are not uncommon. There are several causes of recurrences but the early recurrences are thought to be secondary either to incomplete myotomy or late recurrences due to fibrosis after the myotomy or megaesophagus. A laparoscopic approach is a standard method because of the obvious benefits for the patients. The extent of the myotomy and addition of fundoplication are debatable issue in the management of achalasia cardia but evidence suggests that some kind of fundoplication would be necessary after the complete division of lower esophageal sphincter. We present our experience in a case of recurrent achalasia, secondary to incomplete myotomy managed laparoscopically by extended myotomy and a Dors fundoplication.
A case report of severe hypertriglyceridemia induced acute pancreatitis managed with continuous insulin infusion
Authors: Thomas Joseph
Published: February 2024

31-year-old male, chronic alcoholic presented to the emergency room with epigastric pain, nausea and vomiting. On examination he was febrile, had abdominal distention with tenderness in the epigastric region. His lipase was elevated and computed tomography of abdomen showed evidence of acute pancreatitis. His past history was significant for chronic myeloid leukemia on imatinib and poorly controlled type 2 diabetes mellitus. Laboratory studies revealed elevated triglyceride levels (5254 mg/dl) and uncontrolled blood sugars (HbA1c-10.77%). Due to the severity of his pancreatitis presentation, he was admitted to the intensive care unit. He received aggressive intravenous fluid hydration and was started on continuous insulin infusion. He improved significantly with insulin therapy. His triglyceride levels decreased from 5254 mg/dl to 1891 mg/dl after 48 hours of initiating insulin therapy, by fifth day of admission triglycerides were below 500 mg/dl and was clinically better. He was discharged with a basal dose of insulin and fenofibrates. Intravenous insulin infusion is an effective, affordable, and accessible therapy for acute pancreatitis due to severe hypertriglyceridemia.
Exposing Nipah virus: an epidemiological study of another thread in Kerala, South India
Authors: Prakash Kartikay , Yadav Reetu , Tiwari Shashank
Published: February 2024

Bats spread the Nipah virus, which causes severe encephalitis and high mortality. Multiple reports have come from Malaysia, Bangladesh, Singapore, and India. Pteropus fruit bats are known to host the virus. The virus has caused four outbreaks in Kerala in the past quinquennium. Scholars believe the virus is indigenous to the state's bat population. Climate change, resource depletion, deforestation, natural terrain changes, farming, and industrialization all contribute to viral disease outbreaks. In this review, we will discuss the epidemiological background of the previous NiV outbreak. We will also examine the transmission method epidemic prevention and control strategies and possible causes of the outbreak. Four Nipah epidemics have occurred in Kerala in the past five years. Expert investigation suggests that the virus may be endemic in the state’s bat population. Kerala, India, has many bat species. In 2018, research found viral infections in the local fruit bat population. Traditionally, people eat fresh toddy or sap from trees, which can be polluted by bats carrying the Nipah virus. Kerala's healthcare system also closely monitors unexplained fevers for Nipah virus infections. The World Health Organisation and Indian Council of Medical Research found that the entire state is susceptible to Nipah virus infections. The virus is a major cause of encephalitis outbreaks, which have high mortality rates, mostly in Indo-Bangladesh.
Isolated and fistulized primary appendicular tuberculosis: when a great pretender disguises herself
Authors: Abbas Riyad
Published: February 2024

Tuberculosis in all its forms remains a public health problem in Morocco, despite the efforts of the state in terms of prevention and treatment. Recently, there has been an increase in the number of extra-pulmonary forms of TB. Isolated appendicular localization is very rare, especially since intestinal localization is only ranked 6th among extra-pulmonary localizations. We report the case of a 39 year old female patient admitted for right iliac fossa (RIF) pain evolving for two months, the clinical examination on admission objective a digestive fluid outlet through a fistulous orifice at the level of the RIF; the abdominal CT scan found a plastron with the presence of a fistulous path between a digestive segment and the wall, the surgical exploration found a fistula between the body of the appendix and the wall, an appendectomy was done and the anatomopathological examination confirmed the tuberculosis origin. Our work sheds light on an often-misunderstood form of a well-known pathology.
Buffalo chest in a not so high fall: a case report
Authors: Gualter Maria , Gonçalves Inês , Lajut Leandro , Rouxinol Margarida , Dupont Margarida , Pinto-de-Sousa João
Published: February 2024

Bufallo chest refers to an anatomical variation characterized by an ongoing connection between the two pleural spaces, a unique feature found in these animals, since they possess a single pleural space due to an incomplete mediastinum. When this condition is found in humans, a unilateral chest trauma can cause bilateral pneumothorax. We reported a case of a 91 year old male who, after a fall resulting in right ribs fractures, presented at the emergency department with an extensive bilateral pneumothorax. We described clinical and imagiological features and our approach. This case demonstrates an unusual presentation of a rare anatomical anomaly.
A rare ectopic localization of pleomorphic adenoma of lip
Authors: Kumar Birbal , Gupta Balkishan , Mitra D. S.
Published: February 2024

This case report described a rare and unusual lesion found in a 68-year-old male, which was diagnosed as pleomorphic adenoma of the minor salivary glands in the upper lip. The tumor was a circumscribed, large firm mass, about 2 cm in diameter, characterized by slow growth. Complete excision was performed and the histopathologic analysis showed pleomorphic adenoma.
The relationship between energy intake with stunting and wasting among toddlers in Aertembaga subdistrict, Bitung city
Authors: Punuh Maureen I. , Akili Rahayu H. , Tucunan Ardiansa
Published: February 2024

Background: Stunting and wasting are forms of malnutrition that can occur in toddlers. Stunting and wasting can increase the risk of physical and cognitive growth retardation. One of the factors directly causing stunting and wasting is energy intake. The purpose of this study was to determine the relationship between energy intake with stunting and wasting in toddlers.
Methods: This study was a type of quantitative research with an analytical survey method using a cross-sectional design conducted in Aertembaga district, Bitung city. The sample taken was 205 respondents using purposive sampling technique and met the inclusion and exclusion criteria. Data were analyzed univariately and bivariately using the chi square statistical test.
Results: The percentage of stunted toddlers was 45.9%, not stunted was 54.1%. The percentage of toddlers with wasting was 8.3% and not wasting was 91.7%. Energy intake of toddlers in the sufficient category amounted to 35.6%, the less category amounted to 33.2% and the more category amounted to 31.2%.
Conclusions: There was an association between energy intake and stunting (p=0.005) and wasting (p=0.037) in toddlers. Optimization of stunting and wasting prevention programs is needed to reduce stunting and wasting rates among under-fives in Aertembaga sub-district, Bitung city.
The effect of thyroid disorders on obstetric and perinatal outcomes: an observational retrospective study in a tertiary care center of north India
Authors: Sharma Ankita , Pandita Kanik , Khajuria Utkarsha , Chowdhary Shazia
Published: February 2024

Background: The incidence of hypothyroidism in pregnancy is between 0.5-3.5%, hyperthyroidism occurs in about 0.2-0.4%. They are associated with various maternal-fetal complications.
Methods: This retrospective observational cohort study was conducted in SMGS Hospital, Jammu, India after ethical clearance. Admitted patients were included over a period of 1 year from January to December 2021. Inclusion criteria was women belonging to any period of gestation admitted to the labour room and woman with established thyroid disorder. Exclusion criteria was women on drugs influencing thyroid functions.
Results: 1641 (10.43%) of 15722 women had thyroid disorders. Hypothyroidism in 10.37% (8.99% subclinical and 1.37% overt) and hyperthyroidism in 0.06%. PPROM was seen in 5.9% subclinical, 2.7% overt hypothyroid, none of hyperthyroid group. 7% subclinical, 8.5% overt hypothyroid and 1/10 women in hyperthyroid group had GDM. Abruption seen in 2.5% subclinical, 1.7% overt hypothyroid and none in hyperthyroid. In subclinical group 3.2% had gestational hypertension, 5.2% had preeclampsia and 0.6% had eclampsia. In overt hypothyroid, 2.8% had gestational hypertension, 7.9% preeclampsia and 1.7% eclampsia. In hyperthyroid group, 1/10 had gestational hypertension, 1/10 had preeclampsia. 18.2% subclinical, 14.7% overt hypothyroid, 2/10 in hyperthyroid group had history of abortion. 7% subclinical, 9.6% overt hypothyroid and 0/10 hyperthyroid group had infertility. 25.8% babies born were abnormal in terms of less gestational age at birth, low birth weight, IUGR, low apgar and IUD. 16.5% babies that had low birth weight <2.5 kg.
Conclusions: The impact of thyroid disorders warrants routine screening for thyroid dysfunctions in all women in prenatal and antenatal period to predict and prevent adverse maternal-neonatal outcomes.
Alarming rise in vape smoking among teenagers in Pakistan: a call for action
Authors: Ameer Muhammad Hassan , Tariq Asma , Ali Haider
Published: February 2024

I am writing to draw attention to a matter of great concern that demands our collective awareness and action: the alarming rise in vape smoking among teenagers in Pakistan. This disturbing trend poses a serious threat to the health and well-being of our young population, and it is imperative that we address this issue promptly in a comprehensive way.
MAPAS HISTÓRICOS DO RIO DE JANEIRO E OS “DESVALIDOS”
Authors: Silveira de Berredo e Silva Ana Luíza , Barcellos Gaspar de Oliveira Maria Dulce
Published: February 2024

Os “desvalidos” compõem uma categoria que integra os miseráveis, abandonados, desamparados e desprotegidos, incluindo pessoas pobres, viajantes, mendigos, alforriados e, em alguns casos, escravizados. Por ser um segmento social sem recursos, não tinham o privilégio de serem enterrados no interior das igrejas conforme costume da elite carioca até 1850, de modo que seus corpos eram relegados aos espaços públicos como os largos, campos e rocios da cidade do Rio de Janeiro, que deram origem aos cemitérios dos “desvalidos”. O artigo busca identificar esses locais a partir da análise de mapas históricos, documentação primária e secundária, bem como mostrar que mesmo com o apagamento histórico das fontes oficiais, a arqueologia revela informações enterradas na cidade.
QUANDO AS PALAVRAS FOGEM, AS FLORES FALAM: ESTUDO DOS RITUAIS E DAS PRÁTICAS FUNERÁRIAS NO CAMINHO DA ROCINHA, BAHIA
Authors: Lima Fabiane Lopes Pereira
Published: February 2024

A presente pesquisa baseou-se na análise dos rituais e práticas funerárias realizadas no Caminho da Rocinha, no município de Boninal, Bahia. Trata-se de um território subdividido em pequenos povoados – Marcelos, Areão Branco, Rocinha, Ministro e Cutia –, que formam um corredor com cemitérios particulares e sepulturas isoladas. Essa configuração desperta a atenção por sua disposição geográfica, ou seja, por conter as formas tumulares como atributos da paisagem rural. Com isso, o objetivo desta pesquisa é compreender os hábitos, crenças e visões de mundo de tais comunidades, considerando que estas continuam a exercer rituais e práticas funerárias que fogem aos padrões seguidos pela modernidade, como, por exemplo, enterrar os mortos em sepulturas isoladas nos próprios quintais, acatando seus últimos desejos na forma de ritualizar e materializar a morte. Trata-se de um estudo com caráter etnográfico multimetodológico: quali-quanti, descritivo e analítico, que utiliza a análise espacial, formal e simbólica como ferramentas para percorrer os caminhos que desvendam as singularidades socioculturais e que evidenciam os cemitérios como portadores de mensagens simbólicas, mediadores de relações sensíveis entre vivos e mortos, como produtos culturais do modo de vida no meio rural.
UMA PERSPECTIVA ARQUEOLÓGICA DAS PRÁTICAS DE ETERNIZAÇÃO DOS CORONÉIS DO RECÔNCAVO DA BAHIA
Authors: Moreira de Jesus Taiane
Published: February 2024

As construções funerárias são reflexo do imaginário coletivo das diversas concepções sociais; por vezes, têm o objetivo de representar e atuar na construção e perpetuação da memória social do morto. Entender a morte como o aniquilamento do ser era (e ainda é) inaceitável para muitas sociedades, a humanidade encontrou na arte funerária o dispositivo para suprir sua necessidade de continuidade. A partir da secularização dos cemitérios no século XIX, foi conferida aos túmulos a atribuição de eternizar os mortos; sendo assim, cada estrutura funerária se tornou constituída e nutrida de artefatos materiais e imateriais que buscam desenvolver a memória coletiva e, por conseguinte, a imortalidade do ser. Este trabalho realizou um estudo arqueológico sobre as práticas de eternização por meio da arte cemiterial, tomando como objeto de estudo as sepulturas dos coronéis do século XIX e XX, presentes nos cemitérios municipais das cidades de Cachoeira, São Félix, Muritiba, Cruz das Almas, Santo Antônio de Jesus e Nazaré, no Recôncavo Baiano. O trabalho foi desenvolvido por meio da abordagem da Arqueologia Histórica, mais precisamente da Arqueologia das práticas funerárias. A investigação se deu através de análises iconológica e iconográfica das sepulturas, juntamente com o histórico regional e biográfico dos coronéis. A partir da análise da arquitetura e dos atributos arquitetônicos dos jazigos, foram encontrados os vestígios necessários à investigação das práticas empregadas para a eternização dos coronéis, personagens da elite, de prestígio e de alta influência no cenário regional e nacional entre o período de 1889 a 1930. Os túmulos em são constituídos por diversas representações textuais e não textuais que buscam expressar os sentidos sobre a morte e a preservação da imagem social do morto, com destaque para a exposição da patente militar. Ao analisar tais estruturas, foi possível observar o panorama dos coronéis e sua atuação na região, como também as formas de dominação e adaptação desses homens no cenário mortuário.