bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Efficacy and Safety of Anticoagulation Therapy in the Management of Patients with Concurrent Pulmonary Embolism and Atrial Fibrillation: A Systematic Review and Meta-Analysis
Authors: Laraib Aurangzeb  , Jawad Ahmad  , Aimen Zeb  , Qazi Muhammad Farooq Wahab  , Muhammad Ayub  , Aibad Ahmed Afridi  , Hamad Qasim  , Haroon Tahir  , Ijaz Hussain  , Shah Faisal Khan  , Muhammad Amin Noor  , Zahid
Published: January 2025

Background: Management of anticoagulation in patients with both pulmonary embolism (PE) and atrial fibrillation (AF) can be difficult. They also continue to be at a higher risk of embolic events including stroke and recurrent pulmonary embolism, but at the same time remain at a high risk of bleeding secondary to anticoagulation. Management of this dual diagnosis complicates the administration and dosing of anticoagulant medications with the dual aim of preventing thromboembolic events while at the same time not increasing the risk of haemorrhage. Objectives: The current meta-analysis and systematic review was designed to compare and assess the effectiveness and safety of DOACs compared to warfarin in individuals with both PE and AF with reference to TE, stroke risk, and bleeding. Methods: A PubMed, Cochrane Library, and Scopus search was performed for all articles comparing different anticoagulation regimes in the patients with both PE and AF. Inclusion criteria were RCTs and cohort studies of patients from 2010 to 2023. Meta-analysis used fixed/fixed or random/random models and efficacy and safety outcomes were estimated by RR and 95% CI. Results: DOACs were also reported to prevent recurrent PE (RR = 0.58, 95% CI [0.40–0.85]) and ischemic stroke (RR = 0.58, 95% CI [0.35–0.93]). Furthermore, DOACs was associated with less major bleedings (RR = 0.52; 95% CI [0.32–0.85] and intracranial hemorrhage (RR = 0.30; 95% CI [0.11–0.83]. Conclusion: Certain DOACs are superior to warfarin in the treatment of anticoagulation in patients with both PE and AF making the use of DOACs a possible pathway towards the management of both thromboembolic events and bleeding complications. These findings add credence to the general use of DOACs over the current traditional treatment in this high-risk group.
Frequency and its Associated Factors of Proteinuria Among Women having Preeclampsia with Hypertensive Disorders in Pregnancy at Khyber Teaching Hospital (KTH) Peshawar
Authors: Asma Ambareen  , Tayyaba Mazhar  , Ateeq Ur Rehman  , Sania Nosheen  , Farid Hussain
Published: January 2025

Background: Hypertensive disorders during pregnancy pose substantial risks to both maternal and fetal health. Preeclampsia, characterized by new-onset hypertension and proteinuria, represents a significant global health concern with varying regional prevalence. Objective: This study aims to address the critical knowledge gap regarding the frequency and associated factors of proteinuria among women with Preeclampsia and Hypertensive Disorders in Pregnancy. Materials and Methods: In this cross sectional study, the gestational age was determined by either dates or first-trimester scans. Blood pressure measurements were taken, and Preeclampsia was diagnosed using established criteria. Urine samples were collected and analyzed for proteinuria. Patients were further screened for systemic lupus erythematosus and diabetes mellitus. Exclusion criteria included multiple pregnancies, chronic hypertension, renal disease, and chronic diabetes mellitus. Data were analyzed using SPSS version 22, and statistical significance was set at p ≤ 0.05. Results: Of the 137 participants, 54 (39.4%) were primiparous, and 83 (60.6%) were multiparous. The average age was 31.26 years with a range of 17-45 years. Proteinuria was detected in 26 (18.98%) patients. Proteinuria prevalence did not significantly vary by age group. However, its occurrence was notably higher in severe hypertensive patients (46.2%) and those with comorbidities such as diabetes (58.1%) and systemic lupus erythematosus (100%). Parity did not emerge as a decisive factor. Conclusion: Approximately 19% of the studied participants exhibited proteinuria, emphasizing the need for vigilant management and targeted interventions for high-risk pregnancies. While age showed limited influence, the severity of hypertension strongly correlated with proteinuria. Comorbidities, especially diabetes and systemic lupus erythematosus, significantly elevated the risk. Parity, however, did not emerge as a decisive factor.
Investigation the Antioxidant Features and Therapeutic Potential of Onion Peel Husk on Elevated Liver Enzymes with Induced Liver Fibrosis in Male Albino Rats
Authors: Kiran Aslam  , Qura-tul-ain  , Aqsa Farooq  , Maham Saeed  , Hafiza Nimra Mukhtar  , Arooj Fatima  , Sidra Habib  , Menahil Azmat
Published: January 2025

Liver inflammations and fibrosis can be due to liver injury. In liver fibrosis, inflammations which trigger myofibroblasts in the liver release extracellular matrix proteins that produce fibrous scar. There exist a number of plants which are helpful in regulating the malfunctioning of liver enzymes in liver fibrosis. Onion peel contains quercetin which is effective against the management=nt of malfunctioning liver enzymes. 15 albino male subjects were induced with liver fibrosis using carbon tetrachloride injection to investigate their elevated liver function enzymes when given different doses of red onion peel. The serum level of alanine transaminase and aspartate transaminase enzymes were investigated. While members of treatment groups I (T1) and II (T2) received ROP powder in encapsulated quantities of 150 mg and 300 mg per kilogram of body weight, respectively, for 15 days, members of the control group (T0) received no therapy. Onion peel powder can be useful in treating malfunctioning liver enzymes in caused liver fibrosis, as seen by the significant decrease in liver enzymes seen in treatment groups. All results were taken significantly at p<0.05.
Integrating Eco-Innovation with AI: Reimagining Non-Heritage Cultural Product Design through Sustainable Technological Interventions.
Authors: Ghaith Kholoud
Published: January 2025

This study investigates how Artificial Intelligence (AI) and eco-innovation could revolutionize non-heritage cultural product design, primarily through modern furniture and related industries. It aims to address the growing demand for durable and culturally adaptive products in contexts where historical preservation rules are not applicable, allowing for greater openness to innovation. The mixed-methods study draws on qualitative data (interviews with designers, AI engineers, and sustainability practitioners) and quantitative sustainability data (material efficiency, waste minimization, lifecycle length). The findings underscore the pivotal role of AI in eco-innovation processes, leveraging advanced solutions such as lifecycle management systems, predictive analytics, and adaptive design paradigms. These technologies also reduce waste materials by up to 30% in some sectors, optimize energy use, and boost the lifecycles of products by 25% (see example cases). Apart from being environmentally friendly, AI also raises the cultural value of non-heritage goods by considering society and regional tastes, which enables designers to develop flexible goods that reflect today’s consumer values and are environmentally sustainable. This fusion of environmental and cultural flexibility makes non-heritage products key players in a sustainable future. The paper’s outputs include the creation of a conceptual framework for AI and eco-innovation integration that gives designers pragmatic tips on using AI tools in the context of sustainable product design. It also defines methods for industry stakeholders to leverage AI across the production workflow and recommendations for policy measures to foster adopting a sustainable AI system with incentives and standardized standards. Drawing a parallel between theoretical thinking and application, this work underlines AI’s potential to transform cultural product sectors, paving the way for more widespread sustainable development in non-heritage design sectors.
DropletCoin DropletCoin: Pioneering Sustainable AI and Emerging Technologies through Blockchain Innovation
Authors: Moodley Tyrone
Published: January 2025

DropletCoin represents an innovative fusion of blockchain technology and renewable energy solutions, targeting the substantial energy demands of AI and emerging technologies. This paper presents the UMD v3.0 IoT device, designed for logging solar energy production, and its seamless integration with the Dandelion Blockchain for efficient data capture and processing. By utilizing tokenized energy credits and IoT-based monitoring, DropletCoin enables decentralized, carbon-neutral AI computing networks. Findings reveal a 30% reduction in energy costs and a 40% decrease in carbon emissions in smart city applications.
Generic Multi-Agent AI Framework for Weighted Dynamic Corridor Price Optimisation
Authors: Kurz Walter
Published: January 2025

The objective of this analysis is to address the challenges encountered by pricing systems in managing real-time market dynamics. This study presents a fundamental theoretical framework focused on taxonomy and ontology for a domain-specific multi-agent artificial intelligence (AI), serving as an internal price advisor to optimize pricing strategies for products and services. The system is designed to function in conjunction with other corporate AI systems and an Enterprise Resource Planning System (ERP). The ERP serves as a high-quality data foundation, and several other internal and external sources can provide essential data with varying quality. Methods: The proposed AI model builds upon the Weighted Dynamic Corridor Price Optimization framework, which integrates cost-plus and value-based pricing methodologies within a non-linear price corridor bounded by lower and upper thresholds. In the context of supply chain integration, fully-cooperative pricing models can apply Nash equilibrium to enhance supply chain profitability, whilst semi-cooperative models mitigate information asymmetry through the principal-agent theory. The findings from the theoretical analysis of the generic industry- and product-agnostic multi-agent AI system suggest the system’s potential capacity for dynamically computing optimal prices. A generative AI module could facilitate real-time decision-making, enabling sales teams and similar stakeholders to simulate scenarios and refine pricing strategies. In conclusion, the proposed AI system should be capable of delivering adaptive, context-aware, and data-driven recommendations. Depending on its application, the AI system could become very complex, susceptible to errors, and require significant maintenance. Future research should focus on customizing the proposed AI system for specific industries and product categories and validating its applicability through empirical research.
Contribuciones de los sistemas de información geográfica (SIG) en la planificación urbana sostenible
Authors: Sarango-Ordóñez Jhandry Patricio
Published: January 2025

The article reviews the contributions of Geographic Information Systems (GIS) in sustainable urban planning, highlighting their relevance in resource management and informed decision making for the development of resilient cities. Through a literature review, we analyze studies that show how GIS facilitate the optimization of water and energy distribution, the identification of risk areas, and the planning of transportation and waste collection routes. These systems allow the integration of geospatial data in real time, facilitating decision making that promotes sustainability. However, GIS implementation faces significant challenges, such as lack of up-to-date data, high costs, and the need for trained personnel. Overcoming these barriers is fundamental to maximize the potential of GIS in urban contexts, especially in areas with economic and technical constraints. In conclusion, GIS are strategic tools for achieving sustainable urban development, although their optimal application requires improvements in data infrastructure and professional training in geospatial technology.
Impacto de la Contaminación Plástica en los Ecosistemas Marinos y su Panorama Actual
Authors: Alcázar-Espinoza Javier Alexander
Published: January 2025

Plastic pollution in the oceans represents a significant threat to marine biodiversity and coastal ecosystems. This study analyzes the effects of microplastics and plastic debris, focusing on their impact on species at different trophic levels and ecosystem health. Through a comprehensive review of scientific literature from databases such as Scopus and Web of Science, recent research on the toxicological consequences of plastics and possible solutions were selected. The results show that microplastics are ingested by a wide variety of organisms, causing digestive blockages, cell damage and reproductive alterations, as well as serving as vectors of chemical contaminants. Although current policies have been successful in reducing the use of single-use plastics, the lack of adequate recycling and composting infrastructure limits the effectiveness of these measures. The study concludes that coordinated global action, with emphasis on the transition to a circular economy and the development of innovative technologies, is required to mitigate the devastating impacts of plastic pollution in the oceans.
Análisis de la efectividad de las terapias biológicas en enfermedades autoinmunes
Authors: Villa-Feijoó Amarilis Liseth
Published: January 2025

Biological therapies have revolutionized the treatment of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, by significantly improving patients' symptoms and quality of life. The aim of this study was to analyze its effectiveness by means of a literature review in recognized databases. A documentary analysis was carried out based on strict inclusion and exclusion criteria, focusing on articles published in the last ten years on clinical efficacy, safety profile and associated costs. The findings highlight an improvement in inflammatory parameters and the induction of sustained remissions in a considerable number of patients, although with variations in therapeutic response. Regarding the safety profile, adverse events such as infections and metabolic alterations were identified, highlighting the need for continuous monitoring. Despite their efficacy, the high cost limits their accessibility, which poses ethical and economic challenges. In conclusion, biological therapies are essential for the management of these diseases, but require more equitable and personalized strategies that optimize their positive impact and reduce their limitations
La importancia del autocuidado en el ejercicio profesional de la enfermería
Authors: López-Cudco Leidy Liceth
Published: January 2025

Self-care is essential in the nursing profession due to the high physical, emotional and mental demands associated with this work. This article aims to analyze the factors that hinder and promote self-care, as well as their impact on the health of professionals and the quality of patient care. Through an exhaustive literature review, data were collected from recent studies published in recognized academic databases, using rigorous inclusion and exclusion criteria. The results showed that long working hours, lack of institutional resources and an organizational culture focused on productivity are significant barriers to the implementation of self-care. However, wellness programs, organizational support and continuous training were identified as key facilitators to overcome these limitations. The analysis shows that self-care improves nurse-patient interaction, strengthens staff resilience and decreases medical errors. In conclusion, self-care should be considered a priority in institutional policies to ensure sustainable work environments and quality health care
Evaluación del impacto ambiental de los sistemas intensivos de producción animal según la literatura reciente
Authors: Tipan-Torres Cristhian
Published: January 2025

The intensification of animal production systems in recent decades has made it possible to satisfy the growing world demand for meat products, but has also generated significant environmental challenges. This study aims to review the environmental impacts of these systems, exploring areas such as greenhouse gas (GHG) emissions, soil and water contamination, and high resource consumption. A literature review was conducted in academic databases, focusing on recent studies on these issues. The results show that intensive systems are responsible for high CO₂, CH₄ and N₂O emissions, contributing to climate change. There is also a high demand for water and land for growing fodder crops, which drives deforestation, in addition to inadequate waste management practices that affect air quality and public health. The discussion highlights the urgency of implementing more sustainable technologies in waste treatment and natural resource management to mitigate these impacts. In conclusion, the transition to more responsible and sustainable production practices is fundamental to reduce the environmental impact of intensive livestock production.
Análisis Comparativo en los Procesos de Soldadura en la Industria Naval: Caso Experimental de Soldadura por Arco Eléctrico SMAW, GMAW, GTAW y FCAW
Authors:   Facultad de Ingeniería Industrial, Universidad de Guayaquil, Guayaquil 090514, Ecuador., Castro Jonathan , Espinel Francisco , Castro-Verdezoto Pedro
Published: January 2025

Este estudio evalúa cómo el amperaje y el grosor del material afectan la resistencia y calidad de las soldaduras en la industria naval. Se realizaron pruebas destructivas (tracción e impacto) y no destructivas (ultrasonido y líquidos penetrantes) con diferentes combinaciones de parámetros en los procesos de soldadura SMAW, GMAW, GTAW y FCAW. Los resultados muestran que el grosor del material y el tipo de soldadura son los factores más influyentes en la calidad de las uniones. El proceso FCAW demostró un rendimiento superior en resistencia de tracción, alcanzando hasta 450 MPa en materiales de 10 mm y 12 mm de espesor. Aunque el amperaje varió entre 185 A y 200 A, su impacto fue menor en comparación con el grosor del material y el tipo de soldadura. El estudio concluye que la selección del método de soldadura y los parámetros operativos deben ajustarse a las necesidades específicas de la aplicación naval, ofreciendo recomendaciones para optimizar estos procesos y mejorar la eficiencia y calidad en la industria naval.
Análisis y propuesta de estrategias de logística inversa para el aprovechamiento de plásticos residuales
Authors:   Facultad de Ingeniería Industrial, Universidad de Guayaquil, Guayaquil 090112, Ecuador., Povea Fabián , García Angel
Published: January 2025

En este artículo presenta una propuesta de estrategias de logística inversa basadas en incentivos operativos y logísticos, para el aprovechamiento de plásticos residuales. Para esto emplea el método analítico con el fin de descomponer el tema por partes y realizar una examinación de las variables de estudio. Entre los resultados, muestra una generación aproximada de 545 960.84 toneladas de desechos sólidos en el año 2022 y aproximadamente 1 495.78 toneladas al día. A partir de esto, pudo determinar un aproximado de los residuos plásticos generados correspondiente a 179.54 toneladas de desechos plásticos producidos en la parroquia Tarqui ciudad de Guayaquil, Ecuador. Por consiguiente, se propone la implementación de un sistema de logística inversa en base a el ofrecimiento de incentivos para promover la participación de la comunidad, estableciendo indicadores de desempeño para monitorear y evaluar la efectividad de las estrategias implementadas. En conclusión, el estudio permitió realizar un análisis teórico sobre casos de aplicación de logística inversa, identificar los desechos sólidos y plásticos producidos y proponer estrategias para el aprovechamiento de este material.
Effect of Creative Leadership on Innovative Work Behavior Mediated by Employee Creativity and Innovative Culture in Advertising and Media Industry
Authors: Zaidi Ambreen , Malik Fozia , Iqbal Sana
Published: January 2025

Aim of the Study: This study investigates the effect of creative leadership on innovative work behavior (IWB), emphasizing the mediating roles of employee creativity and innovative culture.
Methodology: Utilizing a quantitative research design, data was collected through snowball sampling and an online questionnaire distributed via social media platforms such as WhatsApp, Instagram, and Facebook to Advertising and Media Industry of Pakistan.
Findings: The analysis, conducted using SPSS and Hayes' Process Macro, involved 199 respondents and revealed that creative leadership significantly impacts IWB both directly and indirectly through the mediating effects of employee creativity and innovative culture. The findings underscore the importance of creative leadership in enhancing employee creativity by providing necessary support and resources, thereby promoting IWB. Additionally, creative leadership fosters an innovative culture that further mediates the relationship between leadership and IWB.
Conclusion: These insights are critical for organizational leaders aiming to cultivate a culture of innovation by focusing on creative leadership and the development of both employee creativity and innovative culture. However, the study's reliance on snowball sampling and a predominantly sample from one industry limits the generalizability of the findings. Future research should include a more diverse and larger sample and explore these dynamics across different cultural and organizational contexts.
Exploring the Impact of Exposure to Social Networking Sites on Climate Activism among University Students: A Case of Islamabad, Pakistan
Authors: Younis Naheed , Ahmed Aqeel
Published: January 2025

Aim of the Study: This cross-sectional, correlational research explores the relationship between the exposure to social networking sites and climate activism among the Islamabad-based Pakistani university students.
Methodology: The quantitative survey study employed simple random sampling to collect data from a sample of 376 students. Two standardized scales, validated by the exploratory factor analysis, with the scale for Exposure to Social Networking Sites explained 63% of the variance, and the scale for Climate Activism exhibited 57% of the variance. The reliability analysis reflected strong internal consistency with Cronbach alpha (α) values 0.85 and 0.91 respectively.
Findings: The findings of the study demonstrated a moderate positive correlation between exposure to social networking sites and climate activism (r = 0.457), with the independent variable significantly predicting climate activism (R² = 0.320). The application of independent sample t-test showed that female university students scored higher than their male counterparts on the variables of social networking sites and climate activism, whereas the academic qualification did not depict significant impact.
Conclusion: The study underscored the role of social media in promoting awareness and advocacy among the Pakistani university students on climate change, stressing the potential of these sites for environmental awareness and activism.
Diversity of Fungi in the Mount Rinjani National Park Kembang Kuning Resort, Jeruk Manis Village, Sikur District, East Lombok Regency
Authors: Dzakwan Army Fawwaz  , Tina Warasari  , Ernawati  , Yulia Nurhaliza  , Yuni Sucitawati  , Ervina Titi Jayanti  , Baiq Muli Harisanti  , Sri Nopita Primawati
Published: January 2025

Mount Rinjani National Park is one of the ecosystems with mountain rainforest and savanna types located on Lombok Island, West Nusa Tenggara with a variety of fungal diversity. This research was conducted in the Jeruk Manis area, this area is one of the many areas included in the Mount Rinjani National Park. This study aims to observe the diversity of fungi in the Mount Rinjani National Park area. The research was conducted from 08.00 - 10.00 WITA. The method used in this study is the exploration method. The exploration method is one method where researchers conduct direct exploration in the Jeruk Manis TNGR (Mount Rinjani National Park) area. Fungi are eukaryotic organisms that do not have chlorophyll, grow as hyphae, have cell walls containing chitin, are heterotrophic, absorb nutrients through their cell walls, excrete extracellular enzymes into the environment through spores, and reproduce sexually and asexually. Ganoderma lucidum, also known as reishi or lingzhi, is a fungus that has long been used in traditional medicine in Asia. Neofevolus alveolaris is a wood fungus that grows saprophytically in forests. Stereum hirsutum is a fungus that is usually found on dead wood in forests. Ramariopsis kunzei  is a fungus that has a body shape that resembles a cone-shaped mushroom with a yellow or orange color. Entoloma abortivum, also known as the "lobster mushroom", is a unique fungus because it is the result of parasitism on other fungi, namely Russula or Lactarius fungi. Baeospora myosura is a fungus that is usually found in forests, growing saprophytically on decaying organic matter such as leaf litter or dead wood.
Ecology And Habitat Characteristics Of The Yellow-Crested Cockatoo (Shulpurea cockatoo) In The Tanjung Pasir Area, Taman Buru, Moyo Island, Indonesia
Authors: Muhammad Yul Fikry  , Kayla Al Khansa Munthe  , Dzar Al Ghifari  , Muhammad Abdul Rokhim  , Hafizh Haritsah
Published: January 2025

This study examines the habitat and ecological characteristics of the Yellow-crested Little Cockatoo (Cacatua sulphurea) on Moyo Island, West Nusa Tenggara, to identify the types of trees used as habitats and conditions that affect the existence of the population. Data were collected through direct observation, in-depth interviews, and measurements of tree characteristics. The results of the study showed that this bird perches on Binong (Alstonia angustiloba) and Asam (Tamarindus indica) trees, with a preference for large-diameter trees and irregular crowns. Trees with a diameter of 53 cm to 220 cm and a height of 4 to 23 meters above ground level have proven to be an ideal perch for the yellow-crested cockatoo (Cacatua sulphurea).The large diameter of the tree provides a large surface for perching, while the sufficient height allows the bird to have a wider view of the surrounding environment. This suggests that the choice of a perch by a cockatoo is influenced not only by the size of the tree, but also by the ecological function offered by the tree. However, this bird population is threatened by habitat destruction due to forest encroachment and land conflicts. This study provides important insights into the habitat conservation of the Yellow-crested Little Cockatoo and emphasizes the need for more intensive conservation efforts to protect this species from extinction and maintain the balance of the Moyo Island forest ecosystem.
Intraspecific Competition for Beans and Corn in the Green House of IPB University Bogor, West Java
Authors: Taufik Arianto  , Firman Ali Rahman  , Muhammad Shohibul Ihsan  , Hasan Basri  , Sulistijorini
Published: January 2025

This study aims to analyze the intraspecific competition between peanuts (Arachis hypogaea) and corn (Zea mays) in a controlled environment in the Green House IPB University, Bogor, West Java. Intraspecific competition occurs when individuals of the same species compete with each other for limited resources, such as light, water, and soil nutrients. This study was conducted using a factorial experimental design, involving various levels of planting density in each species. The observed parameters include plant growth, biomass, competition index, and crop yield. The results showed that the interaction between peanuts and corn under intraspecific conditions affected the efficiency of resource use as well as the yield of each plant. These findings provide important insights for the management of mixed cropping patterns, especially in sustainable agricultural systems that prioritize land and resource use efficiency.
Challenges in the Delivery of Social Services in Pakistan
Authors: Shah Dr. Zahir
Published: January 2025

This package of interlinked issues threatens the sustainability, accessibility, and effectiveness of social services in Pakistan. Challenges such as economic constraints, demographic changes, technological advancements, political and policy uncertainty, social and cultural factors, environmental factors, manpower-related issues. There are economic factors relating to shortages in funding and inefficiency in the capacity for providing basic services. There is an aging population, and the people are increasingly living in urban settings. Such factors demand responsive solutions. Technical innovations provide service delivery opportunities but also bring concerns over equity and data security. Poor policies and political instability dent governance in the social services, while societal inequalities and cultural practices make access unfair. Resource scarcity and climate change are critical environmental factors posing threats to vulnerabilities. Workforce challenges such as scarcity, burnout, and poor preparation present barriers to meeting increased demands. Ethical and legal aspects create barriers in decision-making on confidentiality, informed consent, and resource use. The research findings suggest the need for multi-dimensional and collaborative work to address these issues. It focuses on sustainable funding models, cultural competence, technological oversight, workforce development, and ethical governance to strengthen the resilience and adaptability of social services in Pakistan.
In vitro analysis of thimerosal genotoxicity and cytotoxicity effect
Authors: Mirela Mačkić-Đurović  , Dzenana Klepo  , Amina Aščerić  , Dunja Rukavina  , Izeta Aganović-Mušinović
Published: January 2025

Background: Thimerosal is an organomercury compound with high mercury content. Thimerosal is located in the market as an effective bacteriostatic in a series of pharmaceutical products, ophthalmic and nasal products, immunoglobulin preparations, and as a preservative in vaccines.
Aims and Objectives: Since it is a compound with living content, this study aimed to examine the genotoxic and cytotoxic potential of thimerosal in human lymphocytes culture.
Materials and Methods: We used chromosome aberration analysis and cytokinesis-block micronucleus cytome (CBMN-Cyt) assay to test its genotoxic and cytotoxic potential in human lymphocyte culture.
Results: Results showed that the frequency of structural chromosome aberrations and CBMN-cyt assay was significantly increased in treated cultures (1 μg/ml and 0.5 μg/ml) compared to the negative control.
Conclusion: Obtained results and statistical analysis show that thimerosal is genotoxic and cytotoxic in human lymphocytes in tested concentrations.
Comparison of intravenous ketamine hydrochloride plus dexmedetomidine hydrochloride and ketamine hydrochloride plus midazolam hydrochloride in procedural sedation for short surgical procedures: A prospective randomized double-blind study
Authors: Dilip Kothari  , Seethal Ann Sunny  , Anjali Bansal
Published: January 2025

Background: The growing popularity of ambulatory anesthesia has led to the development of newer drug regimens and combinations. We decided to compare the effects of ketamine plus dexmedetomidine versus ketamine plus midazolam in procedural sedation.
Aims and Objectives: The present study aimed to compare the effects of ketamine plus dexmedetomidine versus ketamine plus midazolam on the adequacy of anesthesia, level of sedation and analgesia, hemodynamic and respiratory parameters, recovery time, and post-operative side effects in short surgical procedures.
Materials and Methods: Hundred adult patients were randomized into two groups: Group KD: A bolus dose of Dexmedetomidine 1 mcg/kg in 100 ml NS over 10 min and Group KM: A bolus dose of Midazolam 0.05 mg/kg in 100 ml NS over 10 min. Both groups received bolus dose of Ketamine 1 mg/kg at the start of the procedure. Level of sedation, adequacy of anesthetic technique, hemodynamic parameters, time for rescue analgesia, post-operative recovery time, and complications was measured.
Results: In Group KD 7 (14%) patients and in Group KM 13 (26%) patients had inadequate anesthesia. A significant reduction in pulse rate (P<0.001) was observed in Group KD as compared to Group KM. MAP between the two study groups showed a statistically significant reduction in Group KD as compared to Group KM (P<0.05). Time for first rescue analgesia was delayed in Group KD (70.20±14.35) compared to that of Group KM (49±4.73) (P=0.000). Four (8%) patients in Group KD and 11 (22%) patients in Group KM had post-operative nausea and vomiting.
Conclusion: Dexmedetomidine-ketamine combination is a good and safe alternative agent for procedural sedation in patients undergoing short surgical procedures.
A clinico epidemiological study of cut throat patients – An observational retrospective study at tertiary care hospital in Jharkhand, India
Authors: Md. Noman Alam  , Sandeep Kumar  , Md. Anas
Published: January 2025

Background: Cut throat injury is an incised wound in the neck that may be superficial or deep and is usually caused by sharp objects. These wounds may be from homicide, suicide, or accidental.
Aims and Objectives: The purpose of this study was to assess cut throat injury in terms of age, sex, site of injury, and triggering factors for suicidal cut throat injury.
Materials and Methods: This retrospective study was carried out in the Department of ENT, Rajendra Institute of Medical Sciences. The study included 35 cut throat patients who were admitted and managed in the ENT department. Data were analyzed with detailed history as age, sex, cause, site of injury, sociodemographic pattern, and history of substance abuse, psychiatric problem, and duration of hospital stay.
Results: Out of 35 patients, 32 were male and three were female. The majority of the patients 21 (60%) were young adults. Causes of cut throat were suicidal 77.14% followed by homicidal 20%. The majority of patients had Zone II injuries. In general, the patients belonged to the lower middle socioeconomic class. About 77.8% of patients with suicidal cases were found to be addicted to one more substance and 22.2% were having some psychiatric illness. The most common substance abuse was indigenous rice beer Hadia mahua.
Conclusion: Young adults of the low socioeconomic class were most vulnerable to cut throat injury with a majority having zone II injury. Suicide was the most common cause with substance abuse proving to be a major provoking factor in addition to unemployment, illiteracy, and poverty.
Prevalence of concomitant pulmonary tuberculosis in patients with newly diagnosed silicosis in a tertiary care center in South India
Authors: Navaneethakrishnan Muthulakshmi  , Saravanavasan Rajendran  , Kannan Muthuraman Alagappan
Published: January 2025

Background: Long-term exposure to silica dust makes people prone for silicosis which raises the risk of the individual in developing pulmonary tuberculosis (PTB). Silicosis is a progressive lung disease characterize with shortness of breath, cough, fever, and bluish skin, caused due to inhalation of crystalline silica dust found in abundance in sand, rock, and quartz.
Aims and Objectives: The disease is known to effect the functioning of macrophages making it unable to defend mycobacterium species, thus allowing the bacterium to invade and develop tuberculosis.
Materials and Methods: A retrospective cross-sectional study is carried out to estimate the prevalence of PTB in newly diagnosed silicosis patients at Madurai Medical College, Madurai, Tamil Nadu. All the patients who got registered in Occupational Lung Diseases Registry from January 2016 to December 2021 are included in the study. Silicosis patients tested positive on sputum CBNAAT are considered as silicotubercular patients, whose prevalence is calculated.
Results: Our study included a total of 54 subjects (90.8% males and 8.2% female) with mean SD age of 38±6.7 years ranging from 26 to 53 years. Of which 22 patients, 40.7% tested positive for Mycobacterium tuberculosis (MTB) on sputum CBNAAT. The prevalence of MTB in among silicosis patients was found to be 40.7%.
Conclusions: Association of TB and silicosis is very strong with the prevalence of TB among silicosis patients as 40.7%. Our study also observed the male sex and elder age as elevated risk of developing silicotuberculosis. All the people getting exposed to silica dust need to be educated in the usage and usefulness of protective equipment.
Prevalence of prehypertension, hypertension, stress, anxiety among undergraduate medical students, and its association with cognitive failure: A cross-sectional study
Authors: Vineeta Chadha  , Swarna Rastogi  , Sampa Choudhury  , Madhu Chaudhary  , Harvir Singh Sodhi  , Qazi Rais Ahmad
Published: January 2025

Background: Research shows that both hypertension and prehypertension accelerate the decline in standardized global cognitive performance. Two important risk factors for development of elevated BP are stress and anxiety. Hence, the study also focuses on assessing stress and anxiety in undergraduate medical students using validated questionnaires.
Aims and Objectives: Hypertension and prehypertension are on a rise in undergraduate medical students and are proposed to accelerate cognitive failure. This study aims to provide prevalence of hypertension, prehypertension, anxiety, stress, and its association with cognitive failure among 1st year medical students in a medical college in North India.
Materials and Methods: The study is a cross-sectional study conducted in the Department of Physiology of a Medical College on 1st year medical students. Google form was given to the whole batch of 150 medical students. Out of them, 111 students voluntarily participated. Hence, we have included them in our study. Standard questionnaire prescribed by Cohen et al., Spitzer et al., and Broadbent et al., for stress, anxiety, and cognitive failure respectively was given to students. Google documents were used as a platform to create online questionnaires that were automatically posted through a unique URL. Password protected access to URL link and a unique study ID gave students round the clock access. Unique study ID ensured confidentiality of all self-reported data. Student’s response was secured using a “cloud” database, where data were automatically sorted, scaled, and scored by custom Excel formulas. Blood pressure of all the students was measured and a Google form consisting of items from these three questionnaires was filled by the students. Data were organized and statistically analyzed by Chi-square test.
Results: In the present study, the prevalence of prehypertension was 46.8% and hypertension was 7.2%. Perceived stress score was moderate in 71.2% of subjects and high in 10.8% of subjects. Moderate-to-severe anxiety was recorded in 21.6% of students. Cognitive failure score was high (>43) in 24.3% of students. A Chi-square test of independence was performed to examine the relation between blood pressure and cognitive failure. Relationship between these variables was significant X2 (1, n=111)=7.08, P=0.029. Patients with hypertension are likely to develop cognitive failure than those with normal blood pressure.
Conclusion: The prevalence of prehypertension and hypertension is rising in medical students. Anxiety and stress being the major causes need to be addressed so as to maintain cognitive well-being of the undergraduate medical students.
Ischemic cerebrovascular event amidst coagulopathy in snake venom envenomation: A case report
Authors: Sriman Narayan Reddy  , Kamalesh Tagadur Nataraju  , Suman Gowdru Rajkumar  , Sai Shashank Moota
Published: January 2025

This case report highlights the necessity to have in consideration about the ischemic complications post snake envenomation along with the traditional hemmorhagic events. We report a case of 28-year-old male who developed ischemic cerebral vascular accident post snake envenomation. The manifestations of snakebite may cause severe and sometimes fatal thrombotic or hemorrhagic sequelae. Some of these venom constituents and the mechanisms by which cerebral infarction have been discussed here. Physicians should also take into consideration that snake bite may cause both procoagulant and anticoagulant state. Complications can be prevented by prior identification of the snake bite and early administration of anti-snake venom.
Cytomorphological overview of fine-needle aspiration breast utilizing the International Academy of Cytology – Yokohama system of reporting
Authors: Manjusha Punjaji Tambse  , Dhiraj Bapu Nikumbh  , Samruddhi Sudhir Thakare  , Shalaka Deepak Tupkari
Published: January 2025

Background: Benign and malignant lesions of breast are one of the most common causes of palpable masses seen in women. Fine-needle aspiration cytology (FNAC) is the important modality of diagnosis of breast lumps. Previously, there were no uniform criteria for reporting breast FNAC. To overcome this problem, the newly designed system – International Academy of Cytology (IAC) – Yokohama system of reporting was implemented in 2016. The system offers a structured report to the patient.
Aims and Objectives: This study aims to categorize breast FNAC according to the IAC – Yokohama system of reporting, to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the test, and to analyze the cytomorphological spectrum of various breast lesions.
Materials and Methods: A total of 210 patients presenting with breast lump in cytology section were subjected to FNAC using a 22 gauge needle under all aseptic precautions. Detailed clinical history was taken. All cytology and histopathology examination slides (wherever available) were thoroughly studied. FNAC smears were reported using IAC – Yokohama system of reporting.
Results: In our study, benign category (C2) was most commonly seen in 73.33% of cases, followed by 10.48% of cases of atypical probably benign (C3), 2.38% of cases were reported as suspicious (C4), and 11.43% of cases were reported as malignant (C5). Cytohistopathological concordance was seen in 38 cases (88.4%) whereas five cases were reported as discordant. Sensitivity and specificity of the test for the diagnosis of malignancy were 81% and 100%, respectively. PPV was 100%. NPV was 90.90%. Diagnostic accuracy of the test was 93.47%.
Conclusion: The newer IAC – Yokohama system of reporting of breast FNAC is simple, has clear diagnostic criteria hence boost up the confidence as well has uniformity of reporting by cytopathologist, and increases the understanding and uniformity in assessment by the attending clinician which help in improving the communication between the pathologist and the treating clinician.
Comparative analysis of education environment perception of 1st and 2nd year MBBS students of medical college using Dundee ready education environment measure
Authors: Amita Rajesh Ranade  , Anita Jibhau Jadhav  , Smita Wagh
Published: January 2025

Background: The Dundee ready education environment measure (DREEM) inventory is a useful tool to identify the student’s perception of the educational environment at the medical colleges.
Aims and Objectives: This study aimed to evaluate and compare the perception of educational environment of 1st and 2nd year undergraduate medical students of SBH Government Medical College Dhule, using DREEM inventory.
Materials and Methods: Eighty-six students of 1st year and 92 students of 2nd year MBBS participated in this study. DREEM questionnaire was given to the students in a classroom after the scheduled routine teaching sessions by the teachers. Students were instructed to indicate best response for each item given in DREEM questionnaire. Statistical analysis was performed using Microsoft Excel.
Results: The mean score of 1st year student for each domain was comparatively higher than the score of 2nd year students. Items that have a mean score of 3.5 or over were considered to be real positive points. Items with a mean between 2 and 3 were aspects of the great concern that could be improve. Items with a mean of 2 or less indicate problem areas. The overall DREEM score was 141.96 (70.87%). However, there were no significant differences in the overall DREEM score of 1st and 2nd year students. The overall DREEM score of 1st and 2nd year students was 141.96 (70.87%). However, there were no significant differences in the overall DREEM score of 1st and 2nd year students.
Conclusions: DREEM is a useful tool to assess the educational environment and to give a clear indication of the education environment perception of medical students. The DREEM questionnaire reflects the realistic situation in medical colleges and can be utilized in a variety of situations to obtain baseline information.
Evaluation of anti-inflammatory activity of ethanolic extract of Derris brevipes (benth.) Baker leaves
Authors: Nesni M Makkar  , Veena R  , Sancy Mary Sam  , Jeena Ann John  , Sanitha Kuriachan
Published: January 2025

Background: Ethnopharmacological relevance: Derris brevipes (benth.) Baker is widely used as an anti-arthritic agent in traditional medicine.
Aims and Objectives: This study evaluated the anti-inflammatory activity of ethanolic extract of D. brevipes (EEDB) leaves, a member of the Leguminosae family in vitro and ex vivo.
Materials and Methods: The EEDB leaves of was screened for anti-inflammatory activities by protein denaturation analysis and proteinase inhibition analysis. Prednisolone was used as the standard. EEDB (at doses of 300 mg/kg and 600 mg/kg) was administered through the oral route. Ex vivo analysis was performed by estimating the expression of tumor necrosis factor-alpha (TNF-α) in collagen (chicken sternal collagen)-induced arthritis (CIA) in Sprague–Dawley rats using the reverse transcription polymerase chain reaction method. The data were analyzed using one-way analysis of variance, followed by Dunnet’s multiple comparison tests.
Results: Prednisolone (100 mcg/mL) and EEDB (600 mcg/mL) showed percentage inhibition of 80.32% and 80.04%, respectively, in protein denaturation assay. Similarly, prednisolone (600 mcg/mL) and EEDB (600 mcg/mL) showed 66.03% and 56.69% inhibition in the proteinase activity. Synovial tissue TNF-α levels showed a significant decrease in EEDB-treated groups and prednisolone-treated group compared to CIA control rats.
Conclusion: From this study, it was concluded that the D. brevipes leaf extract possesses anti-inflammatory activity, which explains its beneficial role in rheumatoid arthritis.