bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial activity, toxicity and retrospective clinical effectiveness of Kantinka BA and Kantinka Herbaltics, two multi-component-herbal products used in the management of infectious diseases in Ghana
Authors: Turkson Bernard K. , Nkrumah Desmond , Nketia Reinhard  Isaac , Ofori Agyemang Alfred , Amponsah Isaac Kingsley , Tetteh Accam Burnett , Mensah Merlin L.K. , Boateng Yvonne
Published: September 2024

There is an upsurge in the incidence of persons living with infectious diseases and their associated symptoms. Also, there is increased resistance and high cost of available synthetic antimicrobial therapeutic agents. This calls for screening candidate herbal products to examine the risk-to-benefit ratio for users. Moreover, there are inadequate proven scientific studies to assess the quality, effectiveness, and toxicity of herbal products that traditional medicine practitioners in Ghana commonly use for the management of infectious diseases such as those caused by Neisseria gonorrhoeae, Candida albicans and the symptomatic management of symptoms associated with infections like cough, skin infections among others and gastritis. Kantinka BA and Kantinka Herbaltics, two multicomponent herbal products, have been used to manage the above-mentioned disease conditions.
The study aims to evaluate the in vitro antibacterial activity, assess the retrospective clinical effectiveness (clinical responses; the disappearance of presenting signs and symptoms associated with infections, gastritis), and the quality and toxicity of Kantinka BA and Kantinka Herbaltics. The products are registered by the Food and Drugs Authority (FDA).
Data on 200 patients who were diagnosed with infectious diseases such as Human Immunodeficiency Virus (HIV) / Acquired Immunodeficiency Syndrome (AIDS) and associated symptoms from January 2018 to June 2018 was obtained from the Adom Herbal Clinic, and the Tafo Government Herbal Medicine Records Unit was assessed. The antibacterial activity of the products was evaluated using the HT-SPOTi method. Phytochemical screening, microbial load, and pH were carried out according to standard procedures. Acute toxicity was carried out according to the Organization for Economic Cooperation and Development (OECD) guideline 425. Phytochemical screening, pH, and microbial load have been established for both products.
Binding toxicity studies revealed that the products are non-toxic at a 2000 mg/kg dose. The two products exhibited antimicrobial activities against the test organisms with Minimum Inhibitory Concentration (MIC) and Minimum Lethal Concentration (MLC) determined for Kantinka BA and Kantinka Herbaltics as 5% and 10% and <80, respectively, against C. albicans and N. gonorrhoeae - the signs and symptoms associated with infections disappeared during the management period.
The products are safe and may effectively manage some infectious diseases and associated symptoms.
Speck: a traditional culinary specialty from the Italian Alps. A microbiological, molecular and chemical evaluation
Authors: Colorio Stefano , Precazzini Francesca , Stella Martina , Rabini Michela , Paolazzi Gloria , Oberkalmsteiner Evelin Elke , Borghi Mara , Bettini Astrid , Tavella Alexander
Published: September 2024

South Tyrol is the northernmost Italian province; its history, geography, and closeness to other European countries, such as Austria and Switzerland, have influenced both culture and food production. Among the South Tyrolean culinary specialties, a type of dry-cured ham called Südtiroler Speck/Speck Alto Adige (Speck) plays a relevant role and has gained increasing significance both on a national and international level over the last 2 decades. Despite it being a common culinary product in Italian and international markets, there is not much published data regarding the microbiological and chemical features of Speck. This study describes the analytical results obtained during a period of 7 years, during which the main pathogens and contaminants were considered.
Bioethics and Politics
Authors: Sgreccia Elio
Published: September 2024

Bioethics is at a significant turning point: from university chairs, where it has just appeared, it is about to move into political and parliamentary arenas. It is actually a hairpin turn or a return to the political arena. It is well known that bioethical reflection was born after the Nuremberg trial to give theoretical substance to the proclamations of some of the main ‘human rights’ that were gradually being formulated, starting with the ‘Universal Declaration of Human Rights’ by the UN on 10 December 1948, just 40 years ago: the right to life, to physical integrity, to the protection of health, for every man, of every culture and religion, together with the other rights to freedom, association, culture, etc., which are the cultural heritage of every free society. which are the cultural heritage of every free and worthy society.
Legal and deontological reflections in the ‘Instruction on respect for nascent human life and the dignity of procreation’.
Authors: Lega Carlo
Published: September 2024

On 22 February 1987, the Congregation for the Doctrine of the Faith issued a document, signed by Cardinal J. Ratzinger, entitled: ‘Instruction on Respect for Human Life in Birth and the Dignity of Pro-creation’, in which the ethical values and fundamental rights of the human person are emphasised with particular reference to the various aspects of nascent life. In these notes we shall briefly dwell on those that are of special interest to law and medical ethics
The legal issue of prenatal diagnosis
Authors: Auletta Tommaso
Published: September 2024

Medical interventions concerning the embryo, such as those involving genetic engineering and, more generally, sperirrientation, artificial insemination, as well as prenatal diagnosis, give rise to a legal problem, the treatment of which requires a preliminary, albeit general, identification of the position recognised by the legal system for the unborn child.
The image of the family in the document ‘The Gift of Life
Authors: Ruini Camillo
Published: September 2024

Not available.
Electronic cigarettes: a harm reduction option for smokers?
Authors: Ashraf Hamza , Ashfaq Haider
Published: September 2024

Dear Editor,An electronic cigarette or electronic nicotine delivery system is a tobacco-free device powered by a battery. It usually contains a solution of nicotine, flavorings, and various chemicals, some of which may carry potential risks...
Morphologic Response in Femoral Cartilage During and After 40-Minute Treadmill Running
Authors: Lee Jinwoo , Lim Junhyeong , Park Sanghyup , Kim Sojin , Park Jihong
Published: September 2024

Context

It is unclear whether the response in femoral cartilage to running at different intensities is different.

Objective

To examine the acute patterns of deformation and recovery in femoral cartilage thickness during and after running at different speeds.

Design

Crossover study.

Setting

Laboratory.

Patients or Other Participants

A total of 17 healthy men (age = 23.9 ± 2.3 years, height = 173.1 ± 5.5 cm, mass = 73.9 ± 8.0 kg).

Intervention(s)

Participants performed a 40-minute treadmill run at speeds of 7.5 and 8.5 km/h.

Main Outcome Measure(s)

Ultrasonographic images of femoral cartilage thickness (intercondylar, lateral condyle, and medial condyle) were obtained every 5 minutes during the experiment (40 minutes of running followed by a 60-minute recovery period) at each session. Data were analyzed using analysis of variance and Bonferroni- and Dunnett-adjusted post hoc t tests. To identify patterns of cartilage response, we extracted principal components (PCs) from the cartilage-thickness data using PC analysis, and PC scores were analyzed using t tests.

Results

Regardless of time, femoral cartilage thicknesses were greater for the 8.5-km/h run than the 7.5-km/h run (intercondylar: F1,656 = 24.73, P < .001, effect size, 0.15; lateral condyle: F1,649 = 16.60, P < .001, effect size, 0.16; medial condyle: F1,649 = 16.55, P < .001, effect size, 0.12). We observed a time effect in intercondylar thickness (F20,656 = 2.15, P = .003), but the Dunnett-adjusted post hoc t test revealed that none of the time point values differed from the baseline value (P > .38 for all comparisons). Although the PC1 and PC2 captured the magnitudes of cartilage thickness and time shift (eg, earlier versus later response), respectively, t tests showed that the PC scores were not different between 7.5 and 8.5 km/h (intercondylar: P ≥ .32; lateral condyle: P ≥ .78; medial condyle: P ≥ .16).

Conclusions

Although the 40-minute treadmill run with different speeds produced different levels of fatigue, morphologic differences (<3%) in the femoral cartilage at both speeds seemed to be negligible.
Self-care practices among professional nurses employed in primary health care clinics
Authors: Nkabinde-Thamae George J. , Downing Charlene
Published: September 2024

Background: Professional nurses typically promote and advocate self-care practices to their patients to achieve better health outcomes, but rarely engage in these practices themselves.Methods: A qualitative, descriptive phenomenological approach was used in this study. Ten professional nurses employed in different primary health care facilities were purposively sampled. Semi-structured interviews were conducted to collect data, which were analysed using Colaizzi’s data analysis strategy, and data saturation was reached.Results: Two themes were identified. Theme 1: the participants expressed that internal and external factors compromised self-care practices, such as subconscious self-neglect, insufficient resources, and a depressed economy, which encouraged them to work extended hours. Theme 2: participants’ holistic well-being was compromised, as they neglected their mental well-being.Conclusion: Self-care practices among professional nurses seem unachievable. The extent of this population’s self-care neglect was evident during the coronavirus disease 2019 (COVID-19) pandemic when professional nurses globally gave of themselves relentlessly.Contribution: This is the first study conducted on the topic in the City of Ekurhuleni, and the findings will provide relevant stakeholders with a directive on what strategies, policies, and guidelines to develop and implement to make self-care practices attainable for professional nurses.
Use of Electroconvulsive Therapy in a Patient with a Permanent Cardiac Pacemaker
Authors: Grover Sandeep , Jagota Gopika , Swer Sankie B.
Published: September 2024

There is limited information on the use of electroconvulsive therapy (ECT) in patients having a cardiac pacemaker. The aim of the study was to present a case of an older woman with an implanted permanent cardiac pacemaker who presented with recurrent catatonia in the background of recurrent depressive disorder, a current episode of severe depression with psychotic symptoms, and managed with ECT. A 65-year-old female patient presented with catatonia in the background of severe depression with psychotic symptoms and marked cachexia to the emergency services for management of catatonia. Initially, she was managed with lorazepam, with which she showed improvement in catatonia. However, after 2 weeks, there was a worsening of catatonia and resultantly she was considered for ECT. In addition, she was treated with venlafaxine 150 mg/day and olanzapine 5 mg/day. She maintained well for a year, she again developed depressive, psychotic symptoms, suicidal ideations, and catatonic symptoms in the form of mutism, rigidity, negativism, and staring. Her medications were increased to tablet escitalopram 20 mg/day and tablet olanzapine 10 mg/day, but her symptoms kept worsening. The lorazepam challenge test done during this time was negative, and she was readmitted to the inpatient unit. Her medications were changed to tablet dosulepin, and she again received 15 effective ECTs. The patient was discharged on tablet dosulepin 112.5 mg/day and olanzapine 10 mg/day and maintained well for the next 6 months, i.e., until the last follow-up. ECT can be given safely in patients with depression having cardiac pacemakers with close monitoring of the cardiac parameters during ECT.
Unraveling the Spectrum of Deliberate Self-harm and Survivors of Suicide
Authors: Ramanathan Barath , Vijayan Souganya , Sivakumar Perarul , Selvaraj Arun
Published: September 2024

Introduction:

Among people who attempt suicide, some may have intent to die and some may not. At present, there are not many studies that have compared clinical profiles based on the intent of the attempt of suicide, i.e., low-intent group (deliberate self-harm [DSH]) and high-intent group (suicide survivors). Our study aims to compare the psycho-socio-demographic profile between DSH and suicide survivors.

Materials and Methods:

It was a cross-sectional study. A total of 100 patients were recruited for the study. The data were collected on sociodemographic variables, psychiatric disorders, suicide intent, anxiety, and depression. Grouping was done using Beck’s suicide intent as the determining dimension. The DSH and suicide survivors were defined by the psycho-socio-demographic characteristics of the patients.

Results:

Two groups with different traits emerged in aspects of age, gender, education, occupation, employment, residence, method of attempts, family history of suicide, physical illness, psychiatric diagnosis, well-being, hopelessness, depression, and anxiety scores, which showed statistically significant difference (P < 0.05) in the study.

Conclusions:

DSH and suicide survivors exhibit notable distinctions in their psycho-socio-demographic and clinical profiles.
The Impact of Intraoperative Hyperlactatemia on Weaning from Cardiopulmonary Bypass in Patients Undergoing on-Pump Coronary Artery Bypass Grafting Surgery: An Observational Study
Authors: Tawadros Pierre Zarif , Mustafa Mahmoud Mohamed , Ibrahim Amr Abdelmonem , El-Masry Hadi , Al-Tantawy Mostafa A.
Published: September 2024

Background:

Hyperlactatemia after cardiac surgery is common. However, the association and the implications of hyperlactatemia on the prognosis after cardiopulmonary bypass (CPB) remains controversial. This study investigated the associations between early-onset hyperlactatemia and the need for doses of inotropes and vasopressors during weaning from CPB, hemodynamic stability after weaning from CPB, and the duration of postoperative mechanical ventilation.

Patients and Methods:

This prospective cohort study included 300 patients who underwent elective on-pump coronary artery bypass grafting (CABG) surgery and had normal systolic function >55%. Serum lactate levels were measured 1 h before induction, upon initiation of CPB, after removal of aortic cannula and on admission to the intensive care unit (ICU). Patients were divided into two groups: patients with lactate levels <4 mmol/L (Group N) and those with lactate levels ≥4 mmol/L (Group H).

Results:

Patients with hyperlactatemia constituted 20.7% of the study population. The number of patients who required adrenaline and noradrenaline administration upon weaning from CPB, as well as the doses of these drugs, were significantly higher in Group H (P < 0.001). Arterial blood pressure levels after weaning from CPB and upon admission to the ICU were significantly lower in Group H patients (P < 0.001). The duration of post-operative mechanical ventilation was longer in Group H patients (P < 0.001).

Conclusion:

Early-onset hyperlactatemia was associated with worse outcomes after CABG surgery. There was difficult weaning from CPB with increased inotrope and vasopressor drug support, early post-operative hemodynamic instability, and a prolonged duration of post-operative mechanical ventilation.
Establishment and validation of glioma patient-derived organoid models
Authors: Wang Anqi , Xie Xiangtong , Hao Lu , Li Xuetao , Huang Yulun , Wang Zhimin
Published: September 2024

Background and Aim:

Glioma is one of the most prevalent and refractory brain cancers with a high recurrence rate. Current limitations of experimental in vitro models include their inability to remodel the heterogeneity of the parental tumors and their incapacity to effectively reflect antitumor effects and mechanisms observable in vivo. Organoid models, as a new technology developed in recent years, can preserve the histological characteristics, cellular diversity, and gene expression of parental tumors to the fullest extent, thereby delivering more reliable data. This study intends to construct a simple organoid model developed from glioma patient material.

Materials and Methods:

Glioma samples were taken intraoperatively and cultured in the organoid medium using a continuous horizontal shaker. Sample collection and scientific research were authorized and approved by the Ethics Committee of Kowloon Hospital, China (Approval No. KY-2021-007). Immunofluorescence was applied to identify CD31 and Sox2 protein expression in the organoid model. The differences between primary glioblastomas and transplanted organoid tumors were analyzed by hematoxylin and eosin (H and E) staining. Immunohistochemistry (IHC) and Western blot assay were used to analyze the Sox2, Ki67, and CD31 protein expression levels.

Results:

The success rate of establishing organoid models was 90.9% in the primary glioblastomas, 75.0% in the WHO Grade III gliomas, and 42.9% in the Grade I–II gliomas. Immunofluorescence demonstrated that in vitro cultured organoids expressed CD31 and Sox2. Similarly, IHC and Western blot assay showed that orthotopically transplanted organoid tumors could exhibit high expressions of Sox2, Ki67, and CD31. There were no significant differences regarding the pathological features of primary glioblastomas and glioma organoid model as judged by H and E staining.

Conclusions:

This study presents a simple in vitro organoid model established from glioma patient samples. The success rate of constructing an organoid model is correlated with the degree of glioma malignancy. The established organoid model displays original model properties and simplifies the development of new experimental platforms that can support preclinical glioma treatment studies.
Combination Therapy of Oral Tofacitinib with Phototherapy in Severe Pediatric Atopic Dermatitis
Authors: Pramanik Ananya , Panda Maitreyee , Madhual Subhasree , Asritha C. V. V.
Published: September 2024

Atopic dermatitis (AD) is an itchy skin condition commonly seen in children. It is usually controlled with emollients and topical corticosteroids, but severe cases require systemic management. Tofacitinib is a promising molecule tried in various inflammatory dermatoses. It suppresses the expression of cytokines and improves the skin barrier function. Phototherapy is a second-line treatment modality in AD. Here, we describe a case report of a 6-year-old child of severe AD with predominantly lichenified lesions not responding to the conventional first-line therapeutics and cyclosporine. A combination therapy of tofacitinib with narrow-band ultraviolet B phototherapy (NB-UVB) was tried with impressive results in terms of symptomatic relief of pruritus and significant reduction in lichenification of the lesions.
Role of Steroids in Paint Thinner Induced Chemical Pneumonitis
Authors: Indhu S , Kalaimani S , Harish Sabarigrivasan , Ramalingam Gogulakrishnan
Published: September 2024

Paint thinners are organic hydrocarbons that contain a mixture of chemicals such as acetone, toluene, and xylene. Thinner poisoning is most common in children due to accidental ingestion. Acute poisoning can lead to various systemic manifestations such as chemical pneumonitis, arrhythmia, dermatitis, and metabolic acidosis. Chronic toxicity leads to encephalopathy and weakness. Usually, management of chemical pneumonitis following hydrocarbon aspiration is symptomatic and the role of steroids is controversial. We report the case of a 47-year-old female who presented with ingestion of paint thinner with suicidal intention and developed chemical pneumonitis. She was initially managed symptomatically but due to persistent symptoms, was started on intravenous steroids and antibiotic. The patient showed symptomatic and radiological resolution.
Correlation between Respiratory Symptoms Questionnaire and Pulmonary Function Test in Chronic Obstructive Lung Disease Patients: A Tertiary Care Hospital Study
Authors: Chandrasekaran Srinidhi , Sreenivasan Vadivelu , Verma Ghanshyam
Published: September 2024

Objective:

This study aimed to investigate the correlation between respiratory symptoms assessed by the Respiratory Symptoms Questionnaire (RSQ) and pulmonary function test (PFT) results in patients diagnosed with chronic obstructive pulmonary disease (COPD) at a tertiary care hospital.

Methods:

This analytical, cross-sectional study was conducted at Sree Balaji Medical College and Hospital, Chennai, involving 130 COPD patients presenting with symptoms of breathlessness, chronic cough, and wheeze. Data collection instruments used were: (1) RSQ: The RSQ was utilized to assess respiratory symptoms, including breathlessness, cough, and wheeze, (2) PFT: PFT assessments, including spirometry, were performed to measure lung function impairment objectively. Participants completed the RSQ under supervision, followed by PFT assessments conducted by trained respiratory technologists using standardized procedures.

Results:

Descriptive statistics were computed for demographic variables and questionnaire scores. Pearson correlation analysis was employed to assess the association between respiratory symptoms measured by RSQ and PFT parameters. The Chi-square analysis determined the overall association between symptom scores and PFT results across the COPD severity groups. Significant correlations were observed between severe COPD and St. George’s Respiratory Questionnaire, moderate COPD and Clinical COPD Questionnaire, and moderate-to-severe COPD and COPD Assessment Test (P < 0.05). Nonsignificant correlations were found between mild COPD and symptom scores (P > 0.05). The Chi-square analysis confirmed a strong association between respiratory symptoms and PFT results (P = 0.04).

Conclusion:

This study highlights the importance of comprehensive symptom assessment alongside the objective measures of lung function in COPD management. Integrating tools such as RSQ with PFTs enables clinicians to obtain a holistic understanding of patients’ disease status and tailor treatment strategies accordingly.
Impact of Mild Gestational Diabetes Mellitus on Maternal and Fetal Liver Histopathological Alterations
Authors: Khales Sahar Ardalan , Mafinezhad Asghar , Golalipour Masoud , Roshandel Gholamreza , Ghafari Soraya , Golalipour Mohammad Jafar
Published: September 2024

Background:

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications that can affect the organ systems of the body in both the mother and fetus. This study aimed to determine the impact of mild GDM on maternal and fetal liver histopathological alterations.

Materials and Methods:

In this experimental study, 20 pregnant Wistar rats were randomly allocated in control and diabetic groups. Mild hyperglycemia was induced by intraperitoneal injection of streptozotocin (40 mg/kg body weight) on the 5th day of gestation. The control group received an equal volume of citrate buffer. The diabetic state was confirmed by a blood glucose level of 120–300 mg/dL. Maternal and fetal liver samples were obtained on day 19 of gestation and stained with hematoxylin and eosin for histopathological investigation.

Results:

Liver sections of diabetic dams exhibited edematous hepatocytes and scattered pyknotic and necrotic cells with dilated sinusoids and congested central veins. The portal tracts showed the proliferation of bile ducts with mild chronic inflammatory cells infiltrating together with fibrosis beyond the limited plate which extends to the central vein (porto-central fibrosis). Liver sections of their fetuses revealed edematous hepatocytes with increased necrotic cells, with pyknotic nuclei, dilatation of the hepatic sinusoids, and their central veins. There was also a relative increase in megakaryocytes, which promoted fibrosis and distorted vascular beds of the hepatic tissue. The portal tracts also showed bile duct proliferation.

Conclusion:

This study highlighted the adverse effects of uncontrolled mild GDM on liver structure in rat dams and their fetuses.
Radiological Characteristics of the Interlaminar Foramen in Patients with Herniated Lumbar Disc: Implications for Interlaminar Lumbar Endoscopic Discectomy
Authors: Thanh Vo Van , Tien Nguyen Le Bao , Thanh Dao Xuan , Tu Ngo Thanh , Luc Nguyen Viet , Phong Pham Hong , Long Nguyen Vu Cong Bao , Dung Le Thanh , Son Dinh Ngoc , Long Nguyen Hoang , Cuong Vu Van , Hung Do Manh , Thach Nguyen Van , Nghia Nguyen Duc , Thuong Le Manh , Loc Tran Quang
Published: September 2024

Background and Objectives:

While interlaminar endoscopic discectomy has gained prominence as an effective treatment for lumbar disc herniation, there remains a paucity of research investigating the correlation between the radiological features of the interlaminar window and the intra-operative indications and techniques. This study aims to delineate several indices of a patient’s radiological characteristics of the interlaminar window and their corresponding relationships.

Subjects and Methods:

We measured parameters of interlaminar foramen using optimized coronal oblique projection computed tomography images. Measurements were conducted at the L2, L3, L4, and L5 levels.

Results:

As we descended from the L2-3 to the L5-S1 levels, we observed that the transverse interlaminar diameter increased from 14.04 ± 2.24 mm to 24.82 ± 3.41 mm. The superior angles of the interlaminar windows increased from 46.96° ± 11.30° to 97.53° ± 17.94°. The interlaminar height declined from 9.43 ± 1.95 mm to 8.79 ± 2.38 mm, while the interpedicular distance expanded from 18.30 ± 3.18 mm to 29.36 ± 3.22 mm.

Conclusions:

The morphology of the interlaminar windows transitions from a vertically elongated shape to a horizontally flattened form as we move downward along the spine. This transformation should be taken into consideration during the intraoperative planning and execution of interlaminar endoscopic discectomy procedures.
Prevention of Neuronal Damage in Brains of Chronic Stress-induced Male Wistar Rats Administering Centella asiatica (L) Urban
Authors: Jagadeesan Saravanan , Gopalakrishna Prarthana Kalerammana , Sura Sreenivasulu , Karikalan Barani , Dandala Krishna Chaitanya Reddy , Ravindranadh Gandrakota , Moklas Mohamad Aris Mohd , Vishnumukkala Thirupathirao
Published: September 2024

Introduction:

Physiological and psychological response of an organism to repetitive stimulus leads to chronic stress which results in depression. This affects the neuro-endocrine axis causing hypersecretion of glucocorticoids which damages the hippocampal neurons in brain through oxidative stress. The body responds by producing Catalase (CAT) an antioxidant found on peroxisomes, which splits the hydrogen peroxide produced by oxidative stress into water and oxygen which are nontoxic, thus offering a protective effect. The synaptic function of the hippocampal neurons is dependent on acetylcholinesterase (AChE) and oxidative stress affects the levels of AChE. The available anti-depressants have the late onset of action and increased toxicity. Centella asiatica (CA), an herb with neuroprotective properties, is known as neuro-tonic and has less toxicity and has been used in ancient traditional medicines. This study aims to examine the neuroprotective effects of crude extract of CA on hippocampal neurons using Nissls stain and levels of AChE and expression of mRNA CAT in the brain tissues of chronic unpredictable mild stress (CUMS)-induced male Wistar rats.

Materials and Methods:

Thirty-six Male Wistar rats aged 8–10 weeks were held in six groups. One group assigned as control, whereas the other groups were administered CUMS by various stressors, namely restrain, forced swimming in cold water, overnight food and water deprivation, wet bedding, cage tilt at 45°, tail pinching, overcrowding the cages, and change of cage mates randomly for a period of 64 days. One of the stress-induced groups was retained as model group and others were administered crude extracts of CA at the doses of 200, 400, 800, and fluoxetine (Flx) 10 mg/kg body weight. At the end of 64 days, the rats were euthanized and the brain tissue was collected for Nissls staining of the hippocampus, measure levels of AChE using ELISA and expression of mRNA CAT levels using RT-PCR.

Results:

The rats of the model group exhibited reduced number of viable neurons in the hippocampus as observed in Nissls stain, reduced levels of AChE, and reduced expression of mRNA CAT in the brain tissue while the rat groups receiving CA showed increase in the number of viable neurons, increase in level of AChE, and increase in the expression of mRNA CAT in the brain tissues. The results were comparable to that of Flx.

Conclusion:

CA effectively attenuates CUMS-induced neuronal loss in the hippocampus of the rat’s brain, normalizes AChE levels, and also the expression of mRNA CAT antioxidant levels. CA could be used in the long-term prevention of chronic stress-induced depression.
Accessory Abductor Pollicis Longus: An Anatomical Case Report
Authors: Kaur Amarjeet
Published: September 2024

An accessory abductor pollicis longus (APL) tendon is present in more than 80% of people, but a separate muscle belly is present in only 20% of people. The present article documented the atypical anatomical variation of APL found during routine dissection. The muscle had three bellies and three tendons with unique bifurcation and attachments in the right upper limb of a 52-year-old male cadaver. The variation of APL is clinically important for surgeons doing flap surgeries, tendon transfer, for surgeons dealing with De Quervain’s tenosynovitis, and in any operative procedure involving the forearm and hand. Multiple APL tendons can be regarded as a functional advantage since injured tendons can be compensated by healthy ones. In addition, knowledge of the anatomy of the area is essential for treating this condition surgically by performing a tendon release after conservative treatment has failed.
Postoperative Delirium in Adult Patients Undergoing Surgery: A Prospective Observational Study in a Peripheral Hospital in the Southern Region of India
Authors: Karan Basavaraj , Ravi Parli Raghavan (Retd)
Published: September 2024

Introduction:

Delirium is one of the most deleterious complications in the postoperative period. The incidence of it in the Indian rural population undergoing surgery is not well studied.

Materials and Methods:

Eight hundred and fifteen patients coming for surgery in a peripheral Indian hospital in the southern part of the country were taken up for an observational study. All patients who had a Mini-Mental State Examination (MMSE) score of above 25 were taken into the study, postoperatively confusion assessment method was used to assess the delirium. Patients were followed up for 7 days. Various modifiable and nonmodifiable risk factors were studied using SPSS (version 26.0) for statistical analysis.

Results:

Six out of 815 (0.73%) patients had postoperative delirium (POD). The average age of the population was 43 ± 12.61. All six patients were above the age of 60 years. POD was found statistically significant with higher grades of the American Society of Anaesthesiologists, long duration of surgery and anesthesia, more fluid transfusion and blood loss, and sevoflurane in comparison to desflurane.

Conclusion:

Preoperative screening with MMSE and reducing the modifiable risk factors can be used to strategize providing anesthesia care for the surgical population. The risk factors are almost the same in the rural population in comparison to the known risk factors for the development of POD.
Exploring the Uncommon: A Series on Dermatofibrosarcoma Protuberans with Rare Locations, Unusual Sites of Metastasis, and Their Close Mimics
Authors: Goyal Neeti , Singh Shamresh , Sharma Pragya , Mishra Prabha Shankar , Kapoor Umesh , Singhal Paresh , Singh Sankalp , Singh Navdeep , Singh Vikram , Sharma Dushyant
Published: September 2024

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, slowly growing soft-tissue tumor that involves the dermis, subcutaneous fat and very rarely involves, muscle and deep fascia. It is locally aggressive and an intermediate-grade fibroblastic neoplasm that rarely metastasizes. It is important to know about this entity as it is locally aggressive and has a higher rate of transformation into fibrosarcoma which has an aggressive growth pattern and frequently metastasizes. Apart from this, there are diagnostic challenges, especially in small biopsies, where they resemble other spindle cell neoplasms. This article reviews the clinical and histological features of DFSP as well as possible pitfalls in their diagnosis and how to resolve them. Diagnosed cases of DFSP were retrieved from pathology archives. Their locations and histopathological features along with Immunohistochemistry (IHC) features were reviewed. Our study identified 26 cases of DFSP for 5 years from January 2019 to January 2024 in a tertiary care hospital. The age of study subjects was in the range of 11–70 years. Male:female ratio was 1.30:1. The most common site was shoulder (n = 5). Immunohistochemistry (HC) was performed in cases with diagnostic dilemmas and cases of high-grade transformation. The aim of this study was to perform a retrospective analysis of histopathological features of DFSP to distinguish it from other mimics and emphasize its local aggressiveness, reoccurrence, and rare site of metastasis, especially in cases with fibrosarcomatous transformation. The careful histomorphological examination particularly in smaller biopsies can be challenging, especially in peripheral laboratories and in resource-limited settings.
A Descriptive Study to Determine Prescription Compliance of Dispensary in a Polyclinic Outpatient Department of a Tertiary Care Hospital
Authors: Kumar M. Vinodh , Sahran Deepti , Yadav Sanjay , Bhatti Archana , Garg Neeraj , Jithesh V.
Published: September 2024

Introduction:

The nonavailability of medicines is a multifactorial problem in India, and several factors contribute to it. The nonavailability of medicines in public health facilities has severe consequences for the health and well-being of the population, particularly the poor and marginalized communities. Patients who rely on public health facilities are often unable to afford the high cost of drugs in private pharmacies and must turn to government-run facilities for their medical needs. When medicines are not available in these facilities, patients are forced to either go without treatment or seek treatment from unlicensed providers. This study aimed to determine prescription compliance of a dispensary in a polyclinic outpatient department (OPD) of a tertiary care hospital.

Materials and Methods:

The study was a descriptive cross-sectional study. Data collection spanned over 3 months, involving 1660 prescription slips of patients and from various records and documents of the facility. Data were analyzed in MS Excel and descriptive statistics were computed.

Results:

The study was conducted at the OPD of a tertiary care hospital from December 1, 2022, to February 28, 2023. Prescription compliance, assessed over the 3 months, reflects the availability of prescribed medications at the dispensary throughout the research duration. The findings revealed a combination of full compliance at 58.33% and partial compliance at 41.67%. A full compliance rate of 58.33% means that about 58.33% of all prescribed medications were fully available, meeting the requirement for complete compliance. On the other hand, a partial compliance rate of 41.67% shows that approximately 41.67% of prescribed medications were only partly available, showing partial compliance. This information highlights the different levels of medication availability seen in the health-care facility during the study time.

Conclusion:

The assessment identifies major hurdles impeding the availability of drugs in health-care institutions, including inadequate forecasting, insufficient ordering practices, and absence of audit mechanisms through review of records. Possible solutions involve establishing uniform protocols for procurement and distribution, educating staff on inventory control, and integrating IT-driven supply chains. Essential infrastructure upgrades and workforce development are imperative for lasting enhancements in drug accessibility, pivotal for realizing universal health coverage in India.
Why You Should Attend the Rural Health Conference: A Unique Opportunity for Learning and Collaboration
Authors: Kumar Pratyush
Published: September 2024

Rural health care faces a distinct set of challenges compared to urban areas. Attending a rural health conference can provide invaluable resources and connections to tackle these specific issues and improve the health of rural communities. While limitations exist, the valuable knowledge, connections, and inspiration gained at a rural health conference can significantly benefit your career and the health outcomes of your community. Explore cost-saving strategies, seek support from your employer, and prioritize attending conferences that align with your professional goals.
Assessment of Right Ventricular Functions in Patients with Rheumatoid Arthritis by Tissue Doppler Imaging and 2D Speckle-Tracking Echocardiography
Authors: Sahib Hussein Faiz , Al-Mamoori Ali Jaber , Saeed Hassanain M.
Published: September 2024

Background:

Advanced echocardiographic techniques play a crucial role in evaluating right ventricular function and providing valuable information for the management of rheumatoid arthritis (RA)-related cardiovascular complications.

Objectives:

To investigate early signs of right ventricle dysfunction in patients with RA using tissue Doppler imaging and two- dimensional speckle-tracking echocardiography (GLS).

Materials and Methods:

This case–control study examined cardiac changes in 50 RA patients compared to 50 healthy controls. Echocardiography and anthropometric measurements were used to assess ejection fraction, ventricle systolic and diastolic function, and myocardial strain.

Results:

The study examined socio-demographic characteristics and echocardiographic parameters in RA patients (N = 50) compared to controls. RA patients had a mean age of 48.28 ± 11.06 years, with 74.0% females. No significant differences in age, BMI, and body surface area between RA patients and controls. There were no significant mean differences between the two study groups according to ejection fraction. There is a significant difference in right ventricular systolic function (TAPSE, S^ velocity, and MPI) observed in RA patients. There is a significant difference in right ventricular diastolic function (E/A ratio, IVRT) observed in RA patients. Global longitudinal strain (GLS) was also significantly reduced. The treatment strategy (single vs. combination therapy) did not significantly affect echocardiographic parameters. The findings emphasize the importance of monitoring cardiac health in RA patients. RA patients show cardiac function alterations, particularly in right ventricular systolic function (TAPSE, S^, and MPI), right ventricular diastolic function (E/A ratio, IVRT), and global function (GLS).

Conclusion:

Monitoring cardiovascular health in RA patients is crucial. Treatment regimens (combination or monotherapy) did not significantly affect the measured echocardiographic parameters.
Estimation of IL-8 and TNF-α Levels in Pediatric Diarrhea Patients Infected with Enterohemorrhagic E. coli O157:H7
Authors: AL-Isawi Safaa A. , Alsultany Shaimaa Jassim
Published: September 2024

Background:

Verotoxins are bacterial virulence factors produced by E. coli O157:H7, transmitted by the fecal-oral route.

Objectives:

The aim of this article was to diagnose E. coli O157:H7 which causes diarrhea and sometimes develops into HUS, which considers pig health problems and estimates the levels of interleukin (IL)-8 and tumor necrosis factor (TNF)-α in the sera of pediatric patients infected with Enterohemorrhagic E. coli compared to the control group.

Materials and Methods:

Stool and blood samples were collected from 421 pediatric patients with diarrhea, ranging in age from birth to 13 years old, from March to October 2022. Samples were collected from Al Noor Teaching Hospital, Babylon Hospital for Pediatric and Gynecology, Hilla, Iraq. E. coli O157:H7 was cultured on eosin methylene blue (EMB) and Sorbitol MacConkey agar (SMA), confirmed by biochemical test and cultured on HiCrome E. coli O157:H7 selective medium which was an agar base supplemented with cefixime tellurite agar. Serum from 30 pediatric diarrhea patients infected with E. coli O157:H7 compared with 30 healthy children as control group used to determine serum levels of IL-8 and TNF-α by sandwich ELISA.

Results:

The results revealed that out of the total 421 samples used in this study, E. coli O157H:7, represented 7% (30 of 421) stool samples. This 30serum samples of infected children as well as 30 samples from healthy children subjected to the estimate serum level of IL-8 and TNF-α which record significant differences P ≤ 0.01 and P ≤ 0.05 to this cytokines in different age group; the mean of IL-8 level was 283.62 ± 17.8 pg/mL (7–9 years), and the mean of TNF-α was 208.62 ± 28.7 pg/mL (10–13 years) comparative with the control group of 80.58 ± 15.4pg/mL and 32.50 ± 7.5 pg/mL, respectively, and also result showed an increased mean level of IL-8 than TNF-α in the male comparative with female 195.19 ± 10.4 pg/mL and 159.05 ± 12.4 pg/mL, respectively, comparative with the control group. The result showed no significant differences in IL-8 and TNF-α between watery diarrhea (192.43 ± 24.3 pg/mL and 136.05 ± 20.4 pg/mL) and bloody diarrhea (189.02 ± 22.5 pg/mL and 123.80 ± 13.5 pg/mL), and also result showed significant increase of mean sera level of IL-8 than TNF-α in formula feeding children comparative with breastfeeding children (187.87 ± 19.5 pg/mL and 119.93 ± 17.4 pg/mL, respectively).

Conclusion:

The finding of this study suggested that increased levels of IL-8 and TNF-α are present in all age groups, in male comparative with female, and also in pediatric diarrhea feeding by formula than breastfeeding and no differences of this cytokine according to consistency of diarrhea. These results contribute to using the immune profile as a serological marker for diagnosing diarrhea caused by E. coli O157:H7 in comparison with the control group.
Physiological and Histological Effects of Flaxseed Oil on the Liver and Heart Muscle
Authors: Alaubody Nehaya M. T. , Al-Mousawi Zainab A. H. , Abdulwahid Ahmed Badr , Khudair Zainab Waheed
Published: September 2024

Background:

Flaxseeds are the focus of medical nutrition due to their potential benefits for human health. Flaxseed oil is rich in unsaturated fatty acids and has many biological effects.

Objective:

This study aimed to assess the effects of flaxseed oil on lipid profile, liver, and heart.

Materials and Methods:

One hundred mice were randomly divided into 10 groups: 10 mice for each group (either male or female). Ten males and 10 females served as control groups, group 1 received flaxseed oil orally (60 mg/kg body weight/day). Twenty of them (10 of each gender) were treated for 1 week and another 20 mice (10 of each gender) were treated for 2 weeks. In the same way, group 2 was divided and treated with 120 mg/kg/day. Measurements of serum lipid profile, serum lactate dehydrogenase, serum total protein, and albumin were performed along with histological examination of the liver and heart.

Results:

The comparative data showed that there were statistically significant decreases in total cholesterol, low-density lipoprotein (LDL), serum albumin, and total protein levels. There were also statistically significant increases in levels of very low-density lipoprotein (VLDL), triglycerides, high-density lipoprotein (HDL), and lactate dehydrogenase enzyme. Histological examination revealed striking histological changes in the liver and heart.

Conclusion:

Consumption of flaxseed oil reduced total cholesterol and LDL levels and increased the levels of VLDL, triglycerides, HDL, and lactate dehydrogenase enzyme. Flaxseed oil in high doses causes damage to the liver and heart muscle.
Estimation of Programed Death Ligand_1 Concentrations in Serum and Tissue Among Iraqi Breast Diseases
Authors: Huadi Noor AL_huda Razakh , Abd Frial G. , Mohsen Liqaa Y.
Published: September 2024

Background:

A programed death ligand L1 is the particular PD-1 ligand that is primarily found in lymphoid, epithelial, and myeloid cells. In order to activate the PD-1/PD-L1 pathway, which suppresses the production of cytokines and controls immune function, PD-1 must bind to PD-L1.

Objectives:

Estimating the concentration of PDL_1 in serum and breast tissue of patients with breast tumors.

Materials and Methods:

Case–control study included 100 women (17–60 years old) undergoing breast surgery at Babylon Province’s Al-Hilla Teaching Hospital and Al-Fayhaa Al Ahly Hospital provided blood and breast tissue samples. Hospital histology lab performed histological confirmation of breast diseases, including benign and malignant tumors. Twenty blood samples were taken as controls from women and men who appeared to be in good health. The enzyme-linked immunosorbent assay was used to determine PDL_1 in both patient and control serum and in the cell supernatant from the patient’s breast tissues.

Results:

The mean level of PDL_1 in serum of patient was 549.37 ng/L while control was 594.22 ng/L with found significant differences where P value was 0.05. While tissue of patients was 464.97 ng/L. The results appeared concentrations of PDL-L1 were significantly higher in serum compared with tissues at P ≥ 0.05. The results found no significantly differences in concentrations of PDL_1 among types of diseases in sera of patients except in fat necrosis patients. Perhaps as a result of our small sample size, the difference in PD-L1 expression between the various subtypes was not statistically significant.

Conclusion:

This study found concentration of PDL-1 decreased with primary breast diseases and it might be diagnostic marker.
The Impact of Sitagliptin on Sodium Valproate-Induced Autism in a Mouse Model
Authors: Abbas Ahmed Sudan , Selman Selman Mohammed , Mahrath Alaa Jafear
Published: September 2024

Background:

Autism spectrum disorder (ASD), a neurodevelopmental disease, is described by problems with social interaction and communication that arise at an early age. The only approved drugs for the treatment of ASD are risperidone and aripiprazole.

Objectives:

The aim of the article is to explore the potential therapeutic effects of sitagliptin on the induced offspring model of autism. Also, to evaluate the effect of sitagliptin on interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α).

Materials and Methods:

We induced the disorder in mice by injecting pregnant mice with sodium valproate (600 mg/kg). Prenatal sodium valproate–exposed mice were split into four different groups, with two experimental groups taking sitagliptin (10 mg/kg and 15 mg/kg) and risperidone (1 mg/kg), and a control group receiving normal saline. Behavioral tests, including social interaction assessments were divided into three phases: habituation, familiarization, and testing, and lasted for 15 min, were conducted on postnatal day 65; also, anti-inflammatory marker assessments like TNF-α and IL-6 were conducted on postnatal day 66.

Results:

The study found that sitagliptin significantly improved behavioral disorders (social communication) and reduced neuro-inflammation in the brain. Sitagliptin therapy forcefully enhanced the cognitive function of ASD mice by regulating neurogenesis that could be connected with the powerful antioxidant and anti-inflammatory actions that sitagliptin possesses.

Conclusion:

Sitagliptin showed potent anxiolytic and anti-inflammatory properties that improved behavioral activities in the mice. These findings suggest that sitagliptin could be promising a potential treatment option for individuals with ASD.