bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustained Alleviation of Autoimmunity by Activating α2B-adrenergic Receptors
Authors: Viswanath Veena , Mistry Shruti , Cabrera-Ghayouri Sara , Leang Ronika , Frail Don , Donello John , Gil Daniel
Published: June 2024

Catecholamines binding to α- and β-adrenergic receptors on immune cells have recently been shown to play an important role in regulating immune responses. Although α2-adrenergic receptors are known to modulate the immune response in different ways, the therapeutic exploration of their utility has been limited by the lack of agonists selective for the three α2-adrenergic subtypes. We report in this study the identification of the agonist AGN-762, which activates α2B- and α2C-adrenergic subtypes, but not the α2A subtype. We show that AGN-762 reduced clinical disease in an experimental autoimmune encephalitis model of autoimmune disease via direct or indirect effects on T regulatory cells. The activity of AGN-762 was abrogated by depletion of T regulatory cells, which express the α2B-adrenergic receptor. Furthermore, a drug-induced shift to an anti-inflammatory phenotype was demonstrated in immune cells in the spleen of drug-treated experimental autoimmune encephalitis mice. AGN-762 does not display sedative and cardiovascular side effects associated with α2A subtype agonists. Immune modulation by selective α2-adrenergic agonists represents a novel, to our knowledge, approach for treating autoimmune disease.
Transcription Factor Activity Regulating Macrophage Heterogeneity during Skin Wound Healing
Authors: Zandigohar Mehrdad , Pang Jingbo , Rodrigues Alannah , Roberts Rita E , Dai Yang , Koh Timothy J
Published: June 2024

Monocytes and macrophages (Mos/Mϕs) play diverse roles in wound healing by adopting a spectrum of functional phenotypes; however, the regulation of such heterogeneity remains poorly defined. We enhanced our previously published Bayesian inference TF activity model, incorporating both single-cell RNA sequencing and single-cell ATAC sequencing data to infer transcription factor (TF) activity in Mos/Mϕs during skin wound healing. We found that wound Mos/Mϕs clustered into early-stage Mos/Mϕs, late-stage Mϕs, and APCs, and that each cluster showed differential chromatin accessibility and differential predicted TF activity that did not always correlate with mRNA or protein expression. Network analysis revealed two highly connected large communities involving a total of 19 TFs, highlighting TF cooperation in regulating wound Mos/Mϕs. This analysis also revealed a small community populated by NR4A1 and NFKB1, supporting a proinflammatory link between these TFs. Importantly, we validated a proinflammatory role for NR4A1 activity during wound healing, showing that Nr4a1 knockout mice exhibit decreased inflammatory gene expression in early-stage wound Mos/Mϕs, along with delayed wound re-epithelialization and impaired granulation tissue formation. In summary, our study provides insight into TF activity that regulates Mo/Mϕ heterogeneity during wound healing and provides a rational basis for targeting Mo/Mϕ TF networks to alter phenotypes and improve healing.
Parenting experiences of marriage immigrant women in South Korea during the COVID-19 pandemic: a descriptive phenomenological study
Authors: Ko Eunjung , Kim Hyun Kyoung
Published: June 2024

Purpose: This study aimed to investigate the experiential meaning of child-rearing for marriage immigrant women in Korea in the context of the coronavirus disease 2019 (COVID-19) pandemic.Methods: Using the hermeneutic descriptive phenomenology framework developed by Colaizzi, 10 marriage immigrant women rearing preschool and school-age children were invited through purposive and snowball sampling from two multicultural support centers in Korea. The participants were rearing one or two children, and their original nationalities were Vietnamese, Japanese, Cambodian, and Chinese. Individual in-depth, face-to-face, semi-structured interviews were conducted from September 1 to November 30, 2021. We extracted significant statements from the transcripts, transformed these into abstract formulations, and organized them into theme clusters and themes to authentically capture the essence of the participants’ subjective experiences.Results: Four theme clusters with 14 themes were derived. The four theme clusters identified were “navigating child healthcare alone,” “guilt for not providing a social experience,” “worry about media-dependent parenting,” and “feelings of incompleteness and exclusion.” This study explored the perspectives of mothers raising children as marriage migrant women who experienced physical and emotional health crises due to the COVID-19 pandemic.Conclusion: The findings underscore that marriage immigrant women encountered heightened challenges in managing their children’s health and well-being during the COVID-19 pandemic due to linguistic and cultural barriers limiting access to healthcare and information. Additionally, these women experienced considerable emotional stress from perceived inadequacies in providing a holistic social and developmental environment for their children under extensive social restrictions.
Psychometric testing of the Chinese version of the Perinatal Infant Care Social Support tool: a methodological study
Authors: Yi Feiyan , Ahn Sukhee , Park Miyeon
Published: June 2024

Purpose: This study aimed to translate the Perinatal Infant Care Social Support (PICSS) instrument into Chinese and to verify the reliability and validity of the translated version.Methods: This study used a cross-sectional design to examine the reliability and validity of the Chinese version of the PICSS (C-PICSS). A cohort of 150 first-time mothers in China participated, attending hospital follow-up care at 6 weeks postpartum. Data were collected after obtaining informed consent from the mothers.Results: The majority of mothers were aged between 20 and 29 years, with a mean age of 26.25 (±3.90) years. An item analysis of the 19 items in the C-PICSS showed that all items had an item-total score correlation above 0.2. This resulted in a Kaiser-Meyer-Olkin value of 0.92 and a significant Bartlett’s test of sphericity (χ2=1,778.65, p<.001), confirming the suitability of the data for factor analysis. Correlation analyses revealed a strong positive relationship between infant care social support and general social support (r=.62, p<.001), and a negative relationship between infant care social support and postpartum depression (r=–. 38, p<.001). Higher scores for infant care social support were associated with reporting positive relationships with their husbands (t=3.72, p<.001) and high levels of spousal involvement (t=4.09, p<.001). In terms of structural support, spouses were identified as the primary source.Conclusion: The research results indicate that C-PICSS is reliable and valid as an indicator of social support for infant care among Chinese mothers.
Prevalence of pre-obesity and above and its associated factors in adult women: an analysis of the 2020 Korea National Health and Nutrition Examination Survey
Authors: Chae Hyunju
Published: June 2024

Purpose: This study was conducted to determine the prevalence of pre-obesity (overweight) and above in adult women and to identify associated factors.Methods: Data were obtained from the eighth Korea National Health and Nutrition Examination Survey (KNHANES VIII-2), conducted in 2020. The sample comprised 2,288 women aged 19–64 years who participated in the KNHANES VIII-2. Data were analyzed using complex sample design analysis with SPSS version 20.1.Results: The prevalence of pre-obesity and above among adult women was 46.5%, with 18.6% classified as having pre-obesity and 27.9% as having obesity. A higher prevalence of pre-obesity and above was observed in women aged 50–59 years (odds ratio [OR]=1.67, p=.019) or 60–64 years (OR=1.80, p=.029); women whose highest educational attainment was high school (OR=1.28, p=.018) or middle school or less (OR=1.60, p=.017); those in middle-income households (OR=1.55, p=.005); those engaging in muscle-strengthening activities less than 2 days per week (OR=1.37, p=.019); and those sleeping less than 6 hours per night during the week (OR=1.37, p=.025).Conclusion: As nearly half of all adult women have either pre-obesity or obesity, prevention and management strategies must target both groups. Interventions should be prioritized for women in their 50s and older, as well as those with low education or income levels. Additionally, receiving adequate sleep of 7 hours or more and engaging in muscle-strengthening activities at least 2 days per week are important components of obesity management.
GLP-1 Receptor Agonist
Authors: Chung Seung Min
Published: June 2024

Glucagon-like peptide-1 (GLP-1) is an incretin hormone secreted by food intake from L cells of the ileum. GLP-1 contributes to blood glucose control through three main mechanisms: promoting glucose-dependent insulin secretion from pancreatic beta cells, suppressing glucagon hypersecretion from pancreatic alpha cells, and delaying gastric emptying time. GLP-1 receptor agonists (RAs) have been developed for administration twice daily, once daily, and once weekly as subcutaneous injection formulation and as a daily oral formulation. GLP-1 RAs have benefits in reducing glycated hemoglobin, weight, and blood pressure, as well as in managing lipid profiles. Additionally, some GLP-1 RAs have demonstrated cardiovascular benefits. Therefore, the guidelines recommend GLP-1 RA treatment of type 2 diabetes patients with preexisting atherosclerotic vascular disease. GLP-1 RA may also improve renal outcomes. The most frequently reported side effects of GLP-1 RA are gastrointestinal symptoms, which can be minimized by gradually starting treatment at a low concentration and then increasing to the final dosage. Considering the efficacy, administration frequency, and cost of each GLP-1 RA treatment, it can be selected as monotherapy or in combination with oral hypoglycemic agents and basal insulin in free or fixed dose formulation.
GLP-1/GIP Receptor Agonists: Mechanism of Action of Tirzepatide
Authors: Oh Tae Jung
Published: June 2024

Tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has demonstrated remarkable effectiveness in lowering glucose levels and reducing weight in the SURPASS and SURMOUNT trials. However, its mechanism of action in vivo remains incompletely understood. Although pancreatic beta cell express both GLP-1 and GIP receptors, the insulinotropic effect of GIP is attenuated under hyperglycemic conditions. Tirzepatide may enhance the role of GLP-1 and potentially restore the insulinotropic effect of GIP. Furthermore, the expression of GIP receptors in adipose tissue suggests that tirzepatide may directly impact adipose tissue function, contributing to its ability to regulate hyperglycemia and obesity. Despite these insights, the precise mechanism of action of tirzepatide remains unknown, as its unprecedented effects cannot be solely attributed to reduced food intake. Further research is warranted to fully comprehend the therapeutic potential of this agent.
Analgesic and anti-inflammatory activity of Cotinus coggygria Scop. extracts in vivo
Authors: Lu Kai , Yang Chong-Yu , Yan Zhao-Hong
Published: June 2024

Objective:

To assess the analgesic and anti-inflammatory effects of standardized extract of Cotinus coggygria (C. coggygria) in different animal models.

Methods:

C. coggygria extracts (25, 50, and 100 mg/kg) were administered to rats and mice (n=6) during hot plate, tail-flick, acetic acid-induced writhing, and formalin tests to determine its analgesic efficacy. The anti-inflammatory activity of C. coggygria extracts was evaluated by histamine and carrageenan-induced paw edema, cotton pellet-induced granuloma, and acetic acid-induced peritoneal capillary dye leakage tests.

Results:

C. coggygria extracts (50 and 100 mg/kg) significantly alleviated thermal and chemical-induced pain in rodents (P<0.05). It also demonstrated notable anti-inflammatory properties by mitigating histamine and carrageenan-induced paw edema, granuloma deposits, and vascular permeability (P<0.05). Moreover, C. coggygria extracts remarkably reduced TNF-α, IL-1β, IL-6, COX-2, and oxidative stress in rat paws (P<0.05). Carrageenan-induced histological aberrations in hind paw tissues were effectively (P<0.05) mitigated by treatment with C. coggygria extracts.

Conclusions:

C. coggygria Scop. extracts show analgesic and anti-inflammatory effects via inhibition of COX-2 and inflammatory and oxidative mediators.
Antimicrobial, antibiofilm, angiogenesis, anti-inflammatory, and wound healing activities of zinc nanoparticles green synthesized using Ferula macrecolea extract
Authors: Alnomasy Sultan F.
Published: June 2024

Objective:

To assess the antimicrobial, antibiofilm, anti-inflammatory, angiogenic, and wound healing activities of zinc nanoparticles (ZNPs) green synthesized using Ferula macrecolea extract.

Methods:

The green synthesis was conducted using the precipitation method. Then, the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum biofilm inhibition concentration 50% (MBIC50) of ZNPs against Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) were evaluated. The effects of ZNPs on the gene expressions of Staphylococcus spp. [intracellular adhesion A (icaA) and D (icaD)] and P. aeruginosa (rhlI and rhlR) were investigated using quantitative real-time PCR. In addition, the effects of ZNPs on wound healing, angiogenesis, and anti-inflammatory markers were assessed.

Results:

The green-synthesized ZNPs demonstrated significant antimicrobial efficacy against S. aureus and P. aeruginosa. The biofilm formation in S. aureus and P. aeruginosa was also inhibited by ZNPs with MBIC50 values of 3.30 μg/mL and 2.08 µg/mL, respectively. Additionally, ZNPs downregulated the expression of biofilm-related genes icaA, icaD, rhlI, and rhlR in the tested bacteria. They also demonstrated promising in vitro wound healing effects by promoting fibroblast cell proliferation and wound closure in a dose-dependent manner. A significant increase in the expression of HLA-G5 and VEGF-A genes as well as a marked decrease in the expression of NF-κB, IL-1β, and TNF-α genes were observed in cells treated with ZNPs compared to the control group (P<0.05).

Conclusions:

ZNPs display promising antibacterial effects against S. aureus and P. aeruginosa and wound-healing effects by inhibiting biofilm formation, inducing angiogenesis, and reducing inflammation. However, further studies must be conducted to specify the accurate mechanisms of action and toxicity of ZNPs.
Management of Secondary Caries in Primary Molars Using Silver Diamine Fluoride: An In-Vitro Study
Authors: Felemban Osama M. , Swead Arwa A. , Farsi Deema J. , Bagher Sara M. , Bagher Amina M. , Farsi Najat
Published: June 2024

Introduction: We aimed to evaluate the effects of 38% silver diamine fluoride (SDF) application on the progression of secondary caries (SC) around resin-based composite (RBC) restoration margins in extracted human primary molars compared to 2.5% fluoride varnish (NaF) with hydroxyapatite and no intervention. Methods: Standardized box-shaped cavities were prepared on 30 primary teeth and restored with RBC restorations. The teeth were thermo-cycled and then immersed in a demineralizing solution for 10 days. The baseline volumes of the demineralized lesions were measured using Micro-CT (first evaluation). Next, the teeth were randomly divided into three equal groups of 10 teeth: the experimental group (38% SDF), the positive control group (2.5% NaF varnish with hydroxyapatite), and the negative control group (no intervention). All teeth were immersed again in the demineralizing solution for 10 days, followed by a second micro-CT evaluation. Results: There was a statistically significant difference in the rate of change of demineralization areas between the three groups (p < 0.001). The SDF group showed the least change in the mean volume of the demineralization area between the baseline and after the second exposure (3.4 ± 0.94 mm3) compared to NaF (4.85 ± 1.97 mm3) and the negative control groups (8.78 ± 2.03 mm3). Conclusion: SDF was effective in managing primary molars with SC around resin-based composite restorations.
Assessment of Cytological Changes of Oral Mucosa in the Patients with Gastroesophageal Reflux Disease: An Analytical Cross-Sectional Study
Authors: Torabinia Nakisa , Samim Firoozeh , Khatoonabadi Samane , Motamedi Alireza , Badri Parvaneh , Keshani Forooz
Published: June 2024

Introduction: This study aims to investigate cytological changes of oral mucosa in patients with gastroesophageal reflux disease (GERD). Methods: In this cross-sectional study, 25 patients with GERD and 25 healthy persons underwent buccal mucosa brush biopsy for cytological assessment. The observed cellular changes were categorized(14) as Class I: normal; Class II: atypical; Class III: intermediate; Class IV:suggestive of cancer; Class V: positive for cancer. Results: All 50 participants (mean age 39.9± 11.8, 24 male) completed the study and were included in statistical analysis. Ordinal logistic regression (overall model test p<0.001) showed GERD was a significant predicator for cytological changes of the oral mucosa (p<0.001). Age and gender were not significant predicators (p˃0.05). Conclusion: GERD is associated with cellular alterations in the buccal mucosa, which can be detected by cytology. The most common outcomes were nuclear hyperchromatism and grade II cellular changes.
Changes of plasma cytokines content in Graves’ orbitopathy patients, could be potential markers
Authors: Fu Ying , Zhang Yuanyuan , An Yaxin , Cao Bin , Zhao Dong
Published: June 2024

Aims:

The purpose of this study was to detect potential cytokines markers involved in the Graves’ orbitopathy (GO).

Materials and Methods:

We measured 25 plasma cytokines using label-free quantitative proteomic analysis in the pilot cohort. In validation cohort, NORCH3, TBP, α-enolase (ENO1), GPX3, ORM1, extracellular matrix protein-1 (ECM1), SERPINE, IGF1, IGKV1, and SPARC were validated using ELISA kits. We used label-free liquid chromatography–mass spectrometry/MS (LC–MS/MS) quantitative proteomic to analyze plasma cytokines content of Graves’ disease and GO patients.

Results:

The validation cohort showed that the concentrations of ECM1, ENO1, and GPX3, (244.4276 pg/ml, 4.361807 ng/ml, and 17.72794 pmol/ml, respectively) were significantly lower in GO patients samples than those in Graves’ patients (257.3197 pg/ml, 4.601592 ng/ml, and 21.33118 pmol/ml, respectively). Both univariate and multivariate logistic analyses indicated that GPX3, ECM1, and ENO might be predictors of Graves’ ophthalmopathy. A receiver-operating characteristic curve with an area under the curve of 0.938, a sensitivity of 84.4%, and a specificity of 90.5% underscored the applicability of this method.

Conclusions:

ECM1, ENO1, and GPX3 were associated with the presence of the GO group and may be good biomarkers that play an important role in the pathogenesis of GO.
Prevalence of anemia in Somalia: A systematic review and meta-analysis of 3988 participants
Authors: Nageye Yahye Ahmed , Mude Abdirasak Sharif Ali , Bello Kizito Eneye
Published: June 2024

The incidence of anemia in Somalia is of medical concerns, especially among neonates and pregnant women. Despite the available intervention of the government to provide iron-based supplement, the associated morbidity of anemia in Somalia is still of medical relevance. This systematic review and meta-analysis were conducted to provide detailed information on the prevalence of anemia in Somalia. A systematic search for articles describing the prevalence of anemia within Somalia was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A meta-analysis was performed on our eligible studies using the random effect model. Our search returned 13 eligible articles involving 3988 participants within Somalia. There was a relative high prevalence of anemia in Somalia in this study 39.7% (95% CI: 26.3–53.1; I2=99.26%, P≤ 0.001). A higher proportion of these cases was from pregnant women. Cross-sectional study designs had more incidence of anemia 39.8% (95% CI: 29.0–51.7) than retrospective studies 29.2% (95% CI: 17.0–45.3) in this review. There was a variation in the distribution of anemia in relation to the publication years at P< 0.001. Evidence from this study reveals that there is a high prevalence of anemiain Somalia and effort toward strategic treatment should be prioritized.
Assessment of Indoor Particulate Matter and Teacher’s Perceived Indoor Climate in Government Schools of Bilaspur District, Chhattisgarh, India: A Cross-Sectional Study
Authors: Pritwani Sabhya , Devasenapathy Niveditha
Published: June 2024

Context:

Indoor air pollution (IAP) affects the long-term health, cognitive growth, and academic performance of children. Since children spend most of their time at school, quantifying IAP in classrooms is an important parameter for air pollution.

Aim:

To assess the average particulate matter (PM) levels inside and outside of classrooms along with their associated factors and teacher’s perceived indoor climate.

Setting and Design:

Cross-sectional survey in nine government-run schools.

Methods and Material:

PM2.5 and PM10 were measured inside the classroom and outdoors simultaneously during summers, using an Atmos monitor for two consecutive days, along with several school and classroom characteristics. Perception about indoor air quality was captured from teachers (n = 15) using a validated questionnaire.

Statistical Analysis:

Mean values of PM using mixed effect linear regression. Perceived indoor air quality is presented using percentages.

Results:

Mean indoor PM2.5 and PM10 was 52.5 µg/m3 and 65 µg/m3. Indoor and outdoor PM levels were highly correlated, but the indoor-outdoor ratio of PM concentrations was more than 1. Teachers were mostly bothered by dust, dirt, and noise in the schools.

Conclusion:

Indoor air quality was higher than World Health Organization (WHO) standards but within the national standards. Need further research to find the exact cause for higher indoor PM levels compared to outdoor PM levels.
Impact of Health Care Management Workshops on the Health-Seeking Behavior of Traffic Police in Bhubaneswar
Authors: Joseph Abba E. , Singh Vaishali , Herlekar Mihir , Sahoo Kalpana , Kanungo Srikanta , Mishra Puspanjali , Balaram Rajashree
Published: June 2024

Background:

Sustainable development goals (SDGs) 3.9.1 and 11.6.2 call for a reduction in deaths and illnesses from air pollution, improving the air quality of cities. The above goals motivate us to organize workshops to improve the health of traffic police, who bear the brunt of air pollution. The paper examines the effect of workshops on the health-seeking behavior of the traffic police in Bhubaneswar city.

Methods:

The study conducted two workshops as a quasi-experimental, single-group study at an academic institution in Bhubaneswar. It included 20 traffic police officers (11 male and 9 female). The Kirkpatrick 4-level model was used to assess the effectiveness of the workshops. A paired t-test was used to compare pre- and postworkshop scores.

Results:

Thirteen traffic police officers rated the workshop sessions as excellent. The score before the workshop ranged from zero to three, with a mean (standard deviation [SD]) of 2.81 (1.0). The postworkshop score had a minimum to maximum score of three to five with a mean (SD) of 4.41 (0.7) (P < 0.005). The effect size dcohen (confidence interval [CI]) was 1.87 (3.27–4.71). The mean (SD) of absolute and relative gain was 1.6 (1.0) and 0.93 (1.02), respectively. All 20 traffic police officers showed improvement in health-seeking behavior. The significant lifestyle changes after the workshops ranged between 5% and 75%.

Conclusion:

The test scores indicated statistically significant improvement as the P value recorded was smaller than 0.05. This concludes that the improvement in understanding of the session was statistically significant because of the training imparted.
Depression, Anxiety and Stress Symptoms among Afghan Healthcare Workers: A Cross-Sectional Analytical Study
Authors: Samsoor Ali Ahmad , Stanikzai Muhammad Haroon
Published: June 2024

Background:

Decades of conflict and cycles of disasters in Afghanistan have caused enormous impacts on health, the economy, and even national security.

Objectives:

We aimed to assess the levels of depression, anxiety, and stress symptoms and their determinants among Afghan healthcare workers.

Methods:

A cross-sectional study of 830 Afghan healthcare workers working in public and private hospitals was conducted between May and July 2021. We employed a non-probability sampling method to select our subjects. The questionnaire was composed of sections on sociodemographic information, working conditions, and Depression, Anxiety, and Stress Scale-21 (DASS-21). Multivariable linear regression models were fitted using SPSS 21 to identify determinants of mental health symptoms among Afghan healthcare workers at a 5% significance level.

Results:

Of all participants, 52.3% (435) had symptoms of depression, 48.8% (405) anxiety, and 46.9% (389) stress. The likelihood of mental health symptoms was higher among those who worked in an urban setting (P = 0.001), were physically inactive (P = <0.001), had a decrease in income or an unpaid salary in the past six months (P = <0.001), thinking of leaving Afghanistan (P = <0.001), had medical comorbidity (P = <0.001), and being single (P = 0.048)].

Conclusion:

This study highlights the important findings about the psychological health of healthcare workers in Afghanistan. These findings suggest rapid, actionable, and locally relevant interventions to assure potential improvements in working and living conditions for the health staff.
Occupational Fatigue and Its Relationship with Musculoskeletal Disorders and Heat Stress among the Workers of Summer Crops in Southeast Iran in 2021
Authors: Sharif Sanaz , Hasheminejad Naser , Sharifi Hamid , Tahernejad Somayeh , Mohammadian Mostafa
Published: June 2024

Aims:

This research aimed to evaluate work fatigue and its relationship with musculoskeletal disorders (MSDs) and heat stress (WBGT) among greenhouse workers in Jiroft County, southeast Iran.

Materials and Methods:

This cross-sectional study was carried out between September 2021 and February 2022 among 150 workers in summer crop greenhouses. Data were collected by a demographic questionnaire, the Swedish occupational fatigue inventory (SOFI-20), and the Nordic musculoskeletal questionnaire (NMQ), and wet bulb globe temperature (WBGT) was measured as per ISO 7243. The collected data were analyzed by the χ2 test, logistic regression, and multivariable linear regression in the Stata 17.0 software.

Results:

The results showed a higher total fatigue score among the studied workers (mean = 100.71 out of 200). Among the fatigue dimensions, the three dimensions of lack of energy, physical discomfort, and physical exertion had the highest scores of 27.28, 26.71, and 25.71, respectively. The highest rate of MSD prevalence was in the back (54.7%), neck (50.7%), and shoulders (49.3%). Based on ISO 7243, the mean WBGT was beyond the allowed level for most tasks for greenhouse workers. There was a statistically significant relationship between occupational fatigue with MSDs and WBGT.

Conclusion:

Given the relatively high score reported for fatigue and its relationship with MSDs and heat stress, it is recommended to conduct further and more applied studies to investigate the approaches to alleviating heat stress and physical ergonomic risk factors in greenhouses in this occupational group.
Two-Year Follow-up of Necrotic Herpetic Retinopathy in a Renal Transplant Recipient
Authors: Sivagnanam Harish , Kumar P. K. Senthil , Palaniselvam Shankar , Viswanathan Ramasubramanian
Published: June 2024

Visual disturbances are common in patients who received renal transplant. Visual acuity is reduced in 60% of renal transplant patients after 10-year posttransplant. The most common causes are cataracts, diabetic retinopathy, and hypertensive retinopathy. However, infectious causes of visual loss are rare and most commonly associated with cytomegalovirus and toxoplasmosis infections. Here, we report a 32-year-old male who developed visual loss 6 months after receiving a live-related kidney transplant. The patient had a history of varicella infection in the immediate posttransplant period. The visual loss was secondary to acute retinal necrosis probably secondary to a Varicella infection. This rare manifestation is even more unique in a posttransplant scenario which is usually associated with progressive outer retinal necrosis. The patient had developed irreversible visual loss secondary to the retinal necrosis. Here, we report this rare association as well as 2-year ophthalmological follow-up of this patient.
Mucormycosis-Associated Colon Perforation in the Early Postrenal Transplant Period
Authors: Sivagnanam Harish , Kumar P. K. Senthil , Velu Kannan Bhaba , Viswanathan Ramasubramanian
Published: June 2024

The incidence of colon perforation in the posttransplant period is 1.3% based on various single-center studies. We report the case of a 32-year-old male, a known case of chronic kidney disease and end-stage renal disease who received a live-related ABO-compatible transplant. The patient was started on tacrolimus, mycophenolate mofetil, and steroids; no induction was given. The patient had a delayed graft function, and his creatinine was persistently high. Hence, a biopsy was done on postoperative day 4, which revealed an acute tubular injury with features of calcineurin inhibitor toxicity. His tacrolimus dose was reduced and his output improved until day 13, after which his renal function worsened. The repeat tacrolimus level was low. Hence, the patient was started on pulse steroids and discharged after the patient improved symptomatically (discharge creatinine: 2.1). The patient was readmitted 3 days after discharge with severe abdominal pain. The patient’s blood pressure was 90/30 mmHg; he was drowsy and tachypneic. His abdomen was distended. Computed tomography of the abdomen revealed pneumoperitoneum, and the patient was subjected to an explorative laparotomy. There was colonic perforation. The peritoneum and colon revealed multiple punched-out lesions and a right hemicolectomy was done. A biopsy revealed suppurative inflammation involving all three layers with multiple giant cells, and tissue staining revealed ribbon-like aseptate hyphae with 90° angulation suggestive of mucormycosis. The patient expired in the immediate postoperative period. The final diagnosis of mucormycosis-associated colon perforation was made. Only one such case has been reported previously.
Technical Challenges in Simultaneous Living Donor Liver Transplantation and Domino Orthotopic Liver Transplantation
Authors: Somasundaram Soundappan , Christopher Pradeep Joshua , Ahuja Ankit , Motati Harshini , Kasi Vigneshwaran , Prabhakaran S. , Doraiswamy Raghunath , Ganesan Dhivahar , Singla Punit , Sambandam Swaminathan , Natesan Anand Vijai
Published: June 2024

Liver transplantation is the ideal treatment of choice for Familial amyloid polyneuropathy (FAP). It is known that during transplantation surgery, this explant liver which will be removed from amyloid patient can be used as a domino graft for another suitable recipient. Even after successful results of domino liver transplantation in deceased donation setting this procedure is always seen with a fear of putting both the recipients at risk due to technical challenge. With living donor as the liver donor for the amyloid patient, the challenges faced are even higher. Only few centres have done similar surgeries and there are no standard guidelines for the same. The anatomical prerequisites, technique, and indications of domino orthotopic liver transplant (D-OLT) in live donation settling are still evolving. We here report a case of live donor liver transplant from a 38 year old with a Right lobe graft for a 40 year old with FAP along with D-OLT for a 52 year old with HBV related decompensated chronic liver disease with HCC. We have described the technical challenges and learnings in our first case which is one of few cases done in the Indian Subcontinent.
Immediate Recurrence of Genetic Focal Segmental Glomerulosclerosis PostKidney Transplant
Authors: Subramani Vignesh , Venkatasubramanian Vaishnavi , Sethi Jasmine , Sekar Aravind , Patil Shivakumar S S , Kenwar Deepesh B , Singh Sarbpreet , Sharma Ashish , Nada Ritambhra
Published: June 2024

Recurrent focal segmental glomerulosclerosis (FSGS) after kidney transplantation is a serious concern with poor allograft outcomes. Possible circulating permeability factors are postulated as pathogenetic factors leading to recurrence. Genetic FSGS is said to have a negligible risk of posttransplant recurrence. Here, we describe an unfortunate patient of genetic FSGS (pathogenic genetic variant) who had a recurrence within hours after transplant and presented with a sudden onset of anuria. The patient did not respond to plasma exchange and subsequently underwent allograft nephrectomy.
Pediatric Liver Transplantation Secondary to Hepatoblastoma without the Use of a Kehr’s T Tube
Authors: Ruiz Mauricio Alejandro Saldaña , Saldívar Mauricio Linnery Rendón , Maldonado Héctor Fernando Sánchez , Treviño Guillermo Alberto Álvarez
Published: June 2024

Hepatoblastoma has a PRETEXT staging depending on the degree of hepatic involvement; stage IV is an indication for transplantation. At the same time, it has sought to reduce the occurrence of posttransplant complications by not using a Kehr’s T tube during the choledocho-choledochostomy, obtaining interesting results. A 16-month-old girl diagnosed with a PRETEXT IV hepatoblastoma, who received four courses of chemotherapy (CTX) with cisplatin plus doxorubicin, after she received a liver transplant and during surgery it was decided not to use a Kehr T-tube. She remained stable and had a favorable evolution, leaving on day 19 posttransplant. One month later, she received two cycles of adjuvant CTX with CAV scheme. Currently, she is free of disease. Even though the technique of choice is hepaticojejunostomy, it was decided to perform a choledocho-choledochostomy without a Kehr’s T tube, without the development of complications. Results in the literature show that the use of this technique prevents the appearance of complications in up to half of the cases, compared to when the tube is used.
A Rare Malignancy Postrenal Transplantation – The Dark Side of Success
Authors: Giri Kajaree , Sahay Manisha , Ismal Kiran Mai , Kavadi Anuradha
Published: June 2024

Solid organ transplant patients are at an increased risk of developing various types of malignancies. Herein, we have reported the case of a 32-year-old male patient, who presented with a nodular mass in the left shoulder 4 months after undergoing deceased donor renal transplantation. Local excision and biopsy were performed which revealed a malignant spindle cell tumor. Immunohistochemistry revealed S100 faint nuclear positivity in a few cells, CD34 positive, Ki67 1% low, and SMA negative suggestive of low-grade fibroblastic origin spindle cell tumor. This is a rare low-grade sarcoma with a high rate of local recurrence, rarely leading to amputation. Metastasis to the lungs and liver has been seldom reported. Our patient had local recurrence twice posttransplant for which he underwent wide local excision.
En bloc Kidney Transplant – A Surgical Illustration and Clinical Experience from a Tertiary Care Hospital in South India
Authors: Reddy Govardhan Krishan , Shetty Shashank , Panchangam Vidyashankar , Viswanathan Akila , Patil Vinay
Published: June 2024

There is a global shortage of transplantable organs, especially in a resource-limited country like India. Deceased pediatric donors provide an excellent opportunity to expand the donor pool. Herein, we report a rare case of multi-organ harvesting from a 3-year-old brain-dead donor, where both the kidneys were transplanted en bloc to an adult male recipient and the liver to a 4-year-old male child. This case report provides the surgical steps and our experience.
Outcomes and Complications of Donor and Recipient of Renal Transplantation: An Experience from Tertiary Care Center – A Retrospective Observational Study
Authors: Punia Sahil , Sadasukhi Nripesh , Sadasukhi Trilok Chand , Gupta Hoti Lal , Gupta Manish , Sharma Ashish
Published: June 2024

Introduction:

Kidney transplantation has emerged as a preferred method for improving survival and quality of life for patients with end-stage renal disease in comparison with dialysis. Living donation provides a better patient and allograft survival when compared with deceased-donor transplantation, specifically when the live donor transplant is accomplished before the onset of dialysis. The present study aimed to create and add data for the long-term survival, complications occurred in donor as well as in recipient both in single study in India.

Materials and Methods:

We performed a retrospective cohort study of all adult patients undergoing renal transplantation. Data on kidney transplantation and operative variables, as well as follow-up data, were obtained retrospectively from the Internal Medical Record Department. The primary outcomes examined were both donor and recipient and graft survival after 2 years and 5 years. Secondary outcomes included the presence of acute rejection and delayed graft function, as well as the rate of postoperative complications.

Results:

A total of 500 donors and 500 recipients participated in the research overall. The mean warm ischemia time was 3.1 ± 1.4 min and cold ischemia time was 44.3 ± 23.4 min. Surgical complications were encountered in 32.8% (164/500) of patients. The 2-year and 5-year graft survival rates were 90.2% and 84.8%, respectively.

Conclusion:

Our patients’ rate of complications was not greater than that noted in the previous publications. A thorough and meticulous medical assessment of the donor and recipient is required, as well as a rigorous and responsible evaluation of the indications.
Pediatric Transplant Experience from a Single Center in South India
Authors: Siddini Vishwanath , Khan Mohammed Fahad , Ravitej S. , Babu Kishore , Ballal H. Sudarshan
Published: June 2024

Background and Objective:

Pediatric renal transplantation is a life-saving procedure for children with end-stage renal disease. This study aims to analyze the outcomes of pediatric renal transplants at our center, focusing on patient demographics, donor sources, surgical techniques, posttransplant complications, graft survival, and rejection rates.

Methodology:

A retrospective analysis was conducted on 43 pediatric kidney transplant recipients. Data on recipient age, gender, donor type, pretransplant dialysis, donor characteristics, surgical techniques, native kidney disease, induction therapy, maintenance immunosuppression, posttransplant infections, graft survival, and rejection episodes were collected and analyzed.

Results:

We performed 43 pediatric kidney transplants in total. The average age was 13.7 years (±3.81), with 8 (18.6%) being under the age of ten, 11 (25.6%) being between the ages of eleven and fourteen, and 24 (55.8%) being between the ages of fifteen and eighteen. There were 43 recipients: 27 males and 16 females. There were four (9.3%) deceased donor renal transplants and 39 (90.7%) live-related kidney transplants. Right internal iliac artery and right external iliac vein anastomosis were found in 32 (74.4%) cases, right external iliac artery and right external iliac vein in 9 (20.9%), right common iliac artery and right common iliac vein in 1 (2.3%), and right common iliac and right internal iliac in 1 (2.3%). Induction was used in 27 recipients (62.8%). Graft survival was seen at 1 year in 42 (97.7%) patients and at 5 years in 34 (81%). Biopsy-proven rejection occurred in 22 (51.2%) of the recipients, with antibody-mediated rejection occurring in 8 (18.6%) and cellular rejection occurring in 22 (51.2%). Graft loss was caused by acute cellular rejection in three (23.1%) cases, graft pyelonephritis in 2 (15.4%), and an unknown cause in 2 (15.4%). There were no significant connections with antibody-mediated rejection.

Conclusion:

Our study provides valuable insights into the outcomes of pediatric renal transplantation at our center. Despite the challenges of graft rejection and posttransplant infections, favorable graft survival rates were achieved. Cellular rejection emerged as a significant risk factor for graft survival, highlighting the importance of effective immunosuppressive management. Our findings emphasize the need for close follow-up, infection control measures, and individualized immunosuppressive strategies to optimize long-term outcomes in pediatric renal transplant recipients. Further research is warranted to refine protocols and address the specific needs of this vulnerable patient population.
Early Liver Retransplantation in a Pediatric Patient with Biliary Atresia and Treatment of Complications
Authors: Ruiz Mauricio Alejandro Saldaña , Flores José Guillermo Martínez , Alonso Federico Ortiz , Brito Liliana Sayuri Tapia
Published: June 2024

Pediatric liver transplantation is the main therapeutic modality for patients with liver cirrhosis secondary to biliary atresia. Unfortunately, approximately 22% will require a retransplantation. We present the case of a 15-month-old male patient diagnosed with biliary atresia, who received a liver transplant, which was complicated with hepatic artery thrombosis. For this reason, he received a retransplantation. Afterward, he had gastric varices and portal vein stenosis, which were resolved successfully by interventional radiology. Currently, liver with normal function, and adequate psychomotor development. It is very important to quickly identify and manage biliary atresia and to be aware of early and late complications of transplantation; once identified, it is necessary to perform the appropriate treatment for complications to avoid fatal outcomes.
Admission and respiratory outcomes of late preterm infants in the setting of high cesarean section deliveries: A single center retrospective analysis
Authors: Khasawneh Wasim , Sindiani Amer , Alsheyab Safa
Published: June 2024

Background

Late preterm infants (LPIs) account for most preterm births and are at high risk of developing prematurity-related morbidities. Due to the increasing rate of cesarean section delivery, it is expected that more LPIs with respiratory complications will be admitted to neonatal intensive care units (NICU).

Objectives

To assess the rate of NICU admission and respiratory complications among LPIs and to compare their outcomes based on the mode of delivery.

Patients and Methods

The list of all LPIs who were admitted in the period 2015–2020 was reviewed. Data collected about demographic characteristics, delivery information, NICU admission, respiratory complications, respiratory support, length of stay, and readmission. Infants were classified according to their mode of delivery into: vaginal delivery group (VD) and cesarean section group (CS).

Results

Out of 2236 LPIs included, 321 (14%) were born at 34-week gestation, 1137 (51%) were males. 1243 (56%) were admitted to NICU. The CS group comprised 77% (1719) while the VD group 23% (517).

Compared to the VD group, infants in the CS group had a higher rate of NICU admission (57.1% vs. 50.7%, P = 0.006), respiratory distress syndrome (RDS) (22% vs. 17%, P = 0.000), and transient tachypnea of newborn (TTN) (17% vs. 11%, P = 0.019). Also, more babies in the CS group received CPAP (36.2% vs. 24.6%, P = 0.000) and surfactant therapy (6.6% vs. 4.6%, P = 0.02). After logistic regression analysis, CS remains an independent factor for NICU admission (OR 1.3, 95% confidence intervals [CI] 1.1–1.6, P = 0.01), respiratory complications (OR 1.6, 95% CI 1.2–2.2, P = 0.001), CPAP requirement (OR 1.6, 95% CI 1.3–2, P = 0.000), and a longer length of stay > 3 days (OR 1.5, 95% CI 1.2–1.8, P = 0.000).

Conclusion

The rate of CS delivery among late preterm gestation is very high and alarming. CS delivery of LPI increases the rate of NICU admission, respiratory complications, and the need for respiratory support.
Evaluation of Clinical Efficacy and Patient Compliance of Interdental Floss as an Adjunct to Toothbrushing for Control of Dental Plaque: A Comparative Study
Authors: Chipre Sanyukta Rajesh , Shah Monali
Published: June 2024

Introduction:

Good oral hygiene is vital for overall health, and interdental floss is a key tool for maintaining a healthy mouth by removing plaque and food particles from between teeth. However, the success of floss depends on patient compliance, which is crucial for its effectiveness. The aim of this study was to assess the clinical efficacy and patient compliance after dental health education of interdental floss when used alongside toothbrushing for dental plaque control.

Materials and Methods:

A prospective observational comparative study was conducted, involving 52 participants randomly divided into toothbrush and dental floss (TB + DF) and toothbrush (TB) groups. The participants underwent professional prophylaxis, and interdental floss education was provided to the TB + DF group.

Results:

Results showed significant differences between the groups at 7 days and 1 month, favoring the floss group in terms of approximal plaque index. However, the toothbrush group exhibited better outcomes for interdental bleeding at 7 days. Patients’ perceptions of cleaning capacity, comfort, and Visual Analog Scale scores were also evaluated. While no significant difference was observed in cleaning capacity perception at 7 days, the floss group showed significantly better results at 1 month. Comfort favored the floss group at both time points.

Conclusion:

This study highlights the importance of dental health education in improving compliance and underscores the efficacy of interdental floss in conjunction with toothbrushing for comprehensive plaque control.
Grahonmada or Bhutonmada: Ayurvedic Psychiatric and Neuropsychiatric Conditions
Authors: Gupta Kshama , Mamidi Prasad
Published: June 2024

BhutonmadaorGrahonmadais a psychiatric illness explained in classicalAyurvedictexts. It is characterized by unknown or idiopathic manifestation. It is an underexplored entity inAyurvedic psychiatryover the years with lack of scientific evidence.Bhutonmadais often misunderstood and surrounded by several myths and misconceptions such as “BhutasorGrahasare demons and they afflict an individual and produce a psychiatric illness.” Despite the growing recognition of psychological health as a global concern, there remains a significant scarcity of research available onBhutonmada/Grahonmada. The aim and objective of the present narrative review is to summarize and synthesize the existing research works onBhutonmada/Grahonmadaand also to evaluate the overall state of knowledge and practice onGrahonmada/Bhutonmada. AlthoughBhutonmadais considered an unknown or idiopathic entity, various predisposing (vulnerable personality traits), precipitating (Chidra Kalaas), and perpetuating factors (PragnaparadhaandKarma) are described inAyurvedictexts.Bhutonmadashave a wide variety of clinical presentations and they represent various psychiatric and neuropsychiatric conditions.Bhutonmadasare not demonic possessions; rather, they do represent various psychiatric illnesses and further research is required in this direction.