bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting macular hole surgery outcomes: Integrating preoperative OCT features with supervised machine learning statistical models
Authors: Venkatesh Ramesh , Gandhi Priyanka , Choudhary Ayushi , Sehgal Gaurang , Godani Kanika , Darade Shubham , Kathare Rupal , Hande Prathiba , Prabhu Vishma , Chhablani Jay
Published: December 2024

Purpose:

To evaluate various supervised machine learning (ML) statistical models to predict anatomical outcomes after macular hole (MH) surgery using preoperative optical coherence tomography (OCT) features.

Methods:

This retrospective study analyzed OCT data from idiopathic MH eyes at baseline and at 1-month post-surgery. The dataset was split 80:20 between training and testing. XLSTAT® statistical software (Lumivero, USA) was used to train different ML models on 10°CT parameters: prefoveal posterior cortical vitreous status, epiretinal membrane, intraretinal cysts, foveal retinal pigment epithelium hyperreflectivity, MH basal diameter, MH area (MHA), hole-forming factor, MH index, tractional hole index, and diameter hole index. The most effective statistical model was identified and was further assessed for accuracy, sensitivity, and specificity on a separate testing dataset.

Results:

Six ML statistical models were trained on 33,260°CT data points from 3326°CT images of 308 operated MH (300 patients) eyes. Following training and internal validation, the random forest (RF) model achieved the highest accuracy (0.92), precision (0.94), recall (0.97), and F-score (0.96), and lowest misclassification rate. RF model identified the MHA index as the best predictor of post-surgical anatomical success. Following external testing, the RF model confirmed the highest accuracy and lowest misclassification rate (8.8%).

Conclusion:

ML-based statistical models can be used to predict MH status after surgery. The RF model was the most accurate ML model, and the MHA index was the best predictor of postoperative hole closure after surgery based on preoperative OCT parameters. These predictions may help with future surgical planning for MH patients.
Insights into the systemic risk factors associated with diabetic retinopathy in the Indian population: A comprehensive systematic review and meta-analysis
Authors: Favas KT Muhammed , Niveditha Mamidi , Yoosuf Beema T , Bhukya Manideep , Gupta Parul Chawla , Dutta Pinaki , Bansal Dipika
Published: December 2024

Diabetic retinopathy (DR) is a predominant cause of vision impairment globally. Understanding risk factors is crucial for effective planning. The aim of this study is to comprehensively investigate the risk factors in the Indian population contributing to the increased incidence of DR, which is a potentially sight-threatening complication among diabetic individuals. A comprehensive literature search was done on PubMed, Embase, and Google Scholar databases for epidemiological studies reporting risk factors in the adult Indian population in the English language. Joanna Briggs Institute’s (JBI) critical appraisal tools were used to assess the quality of the included studies. Analysis was performed using R studio. I2 statistic was used for the assessment of heterogeneity. Results are expressed as odds ratio (OR) and standardized mean difference (SMD) along with a 95% confidence interval (CI). Overall, 20 studies enrolling 4,12,421 patients with 1,04,104 DR-positive and 3,08,317 DR-negative adults were analyzed. Being male (OR: 1.38, 95% CI: 1.11–1.72), intake of insulin (OR: 2.05, 95% CI: 1.02–4.14), higher HbA1c levels (MD: 0.50, 95% CI: 0.06–0.94), higher random (MD: 0.32, 95% CI: 0.10–0.55), and fasting blood glucose levels (MD: 0.51, 95% CI: 0.10–0.93) were found to be significantly associated with increased risks of DR among diabetic patients, while age, body mass index, hypertension, lipid profile, and smoking status did not indicate any association with DR. Good glycemic control remains the most important modifiable risk factor to reduce the risk of progression of DR and vision loss.
Liquid chromatography/tandem mass spectrometric characterization of Rhodotorula mucilaginosa GMM natural pigment and its synergistic antitumor effect with γ-radiation: in-vitro and in-vivo study
Authors: Ibrahim Ghada S. , Hassan Amal I. , Mahmoud Manal G. , Asker Mohsen M.S. , Marzouk Mohamed
Published: December 2024

Background/aim

Recently, there has been a marked increase in interest toward using microbial resources, especially yeast, to synthesize carotenoids. Ovarian cancer is a major health problem worldwide, as it is the most frequently diagnosed form of cancer in women and contributes significantly to cancer-related deaths. Yeast carotenoids are currently under evaluation for cost-effective and nonhazardous drugs derived from natural products. The principal objective of this study is to evaluate the natural pigment produced from Rhodotorula and characterize it by liquid chromatography-mass spectrometric and to evaluate the ability of its synergistic antitumor effect with γ-radiation.

Materials and methods

A new pigmented yeast was isolated from yogurt and identified. The pigment was characterized and studies of its biological activities were conducted. The isolate was defined as Rhodotorula mucilaginosa GMM with accession number OQ120277 by 18 S rDNA, and the pigment was characterized by liquid chromatography-mass spectrometric. Combining γ-radiation with a carotenoid pigment was also tested for its synergistic anticancer properties in CAOV-3 and HEK-293 cell lines and in experimental mice bearing solid tumors. BAX, BCL2, P53, MMP2, MMP9, caspase-3, and caspase-9 were measured using ELISA techniques.

Results

The maximum production of total carotenoids was 2.99 g/l. Pigment extract constituents exhibited 12 major compounds during its identification. Their structures can be sorted as 8 tetra, and 3 triterpenoidal carotenes (astaxanthin, 4,4’-E-diapophytoene, torularhodin, 1,2,1’,2’-tetrahyroxylycopene, E-β-apo-8’-carotenal, 10’-apo-E-β-caroten-10’-ol, β-carotene, torulene, echinenone, 1,2,1’,2’-tetrahyroxy dihydrolycopene, and α-canthaxanthin). The pigment exhibited DPPH scavenging activity, and the combination of natural pigment and radiation therapy showed a significant reduction (P<0.05) in the levels of matrix metalloproteinases (MMP2, MMP9), and significant increases (P<0.05) in the levels of tumor protein p53, Bax and caspases-3 and caspases-9 in CAOV-3 cell lines and mice bearing solid tumors.

Conclusion

The natural pigment produced by yeast fermentation in this study exhibited a potential antitumor efficacy when combined with radiation in cell lines and against Ehrlich solid tumors.
Tibial scoring as a predictor for amputation-free survival in critical limb ischemic patients
Authors: Sadek Yehia K. , El Emam Sameh El Sayed , Mohamed Ahmed K.
Published: December 2024

Background/aim

Evaluating the risk of amputation in patients with peripheral arterial disease (PAD) is essential. A critical Limb Ischemic patient (CLI) is known as end stage of PAD. Creating novel approaches to pinpoint high-risk patients would allow for targeted treatments and support specialized clinical trials focused on limb preservation. This study’s objective is to evaluate tibial adversity and scoring for risk of lower extremity amputation in critical limb ischemic patients (CLI).

Patients and methods

This study is a prospective study carried out on 30 patients with symptomatic lower extremity PAD in Al-Zahraa University Hospital from February 2023 to January 2024 interval. All patients were assessed by hemodynamics study and multislice noncontrast CT and tibial angioplasty according to inclusion and exclusion criteria. The patients followed up at day 1 and 3 and 6 months.

Results

Patients with CLI exhibited significant high (p < 0.05) tibial artery calcification scores, which were linked to increased limb ischemia levels, with high risk for amputation compared to traditional risk factors. 26 patients were amputation free rate and only 4 patients were done major amputation. Nonmodifiable risk factors correlated with elevated tibial artery calcification scores.

Conclusions

The present study indicated that tibial scoring independently predicts the risk of lower extremity amputation, even when considering other risk factors in patient with CLI. Increasing calcium scores are associated with greater PAD severity.
Identifying clinical phenotypes for hospitalized patients with chronic obstructive pulmonary disease acute exacerbation
Authors: Mamdoh Mayar , El Nady Mohamed A.H. , Assal Hebatallah H. , Saad Gihan , Eldin Amira I.A. , Soliman May S. , Elkholy Amani A. , Haddad Sara E.E. , Soliman Noha S. , Hamdy Gehan
Published: December 2024

Background/aim

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is common and has clinical consequences, such as a decline in quality of life, reduction in lung functions, hospitalization, and death. This study aims to assess the clinical phenotyping of hospitalized patients with AECOPD, and the correlation between the phenotype of Chronic Obstructive Pulmonary Disease (COPD) exacerbation and clinical outcome.

Patients and methods

This is a prospective cross-sectional study which included thirty- nine patients from the Chest diseases department, Faculty of Medicine, Cairo University. Each patient was subjected to full history taking, clinical examination, plain chest radiography, bacterial culture, viral polymerase chain reaction, modified medical research council dyspnea scale, and COPD assessment test.

Results

Most of our patients were males (92.3%), mean age was 65.33±9.73 years, 92% of the study populations were smokers and the mean BMI was 25.94±5.04 kg/m2. Four phenotypes were identified as bacterial, viral, co-infection, and noninfectious. Regarding the clinical outcome, the viral phenotype had the highest ICU admission rate (58.3%), while the co-infection phenotype had the highest mean duration of hospital stay (18.13±16.8 days), and in-hospital mortality of 37.5%.

Conclusion

Clinically important differences in outcomes suggest that a phenotyping strategy based on etiologies can enhance AECOPD management.
Melittin ameliorates schistosomiasis-induced liver fibrosis by suppressing signal transducer and activator of transcription 3 and nuclear factor kappa B
Authors: Rozik Ola I. , Hussein Manal M. , El-elebiarie Ahmed S. , Nady Soad
Published: December 2024

Background/aim

Liver fibrosis is a persistent inflammatory liver disorder that contributes to a wide variety of conditions, including schistosomiasis. There is no approved therapy for liver fibrosis to date; therefore, finding effective therapeutic targets is a crucial need. There are several studies on natural products, such as bee venom and its bioactive substances like melittin (MEL), for the treatment of inflammatory disorders. The therapeutic effect of MEL in a BALB/c mouse model of Schistosoma
mansoni-induced liver fibrosis was studied in this research.

Materials and methods

Forty-eight male BALB/c mice were classified into six groups (eight mice each): a healthy control group and five groups infected subcutaneously with cercariae of S. mansoni. The infected groups were classified into the infected control group, the Praziquantel (PZQ)-treated group, and three MEL-treated groups that received three different doses (0.1, 0.2, and 0.3 mg/kg, respectively) for 14 days. Hepatic granuloma index (GI) was measured in each experimental mouse, and serum tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), interleukin-10 (IL-10), and immunoglobulin E were measured by ELISA techniques. Additionally, expressions of signal transducer and activator of transcription 3 (STAT3) and nuclear factor kappa B (NF-κB) were assessed in splenocytes. Moreover, histopathology of the liver and spleen were also investigated.

Results

S. mansoni-infected mice showed significant (P<0.05) increases in the pro-inflammatory mediators and upregulate expression of STAT3, and NF-κB compared with the healthy group. MEL exhibited potent anti-inflammatory effects, as evidenced by significant (P<0.05) inhibition of the elevated pro-inflammatory cytokines, including TNF-α and IL-17, as well as immunoglobulin E levels and hepatic GI, while the anti-inflammatory IL-10 was significantly (P<0.05) increased. In addition, MEL treatment significantly (P<0.05) inhibited the expression of STAT3 and NF-κB in splenocytes compared with healthy mice. The most positive effects were associated with MEL were observed at the maximum dose.

Conclusion

According to the findings of this study, MEL alleviates the degree of hepatic inflammation in a mouse model of S. mansoni-induced liver fibrosis by modulating inflammation through suppression of STAT3 and NF-κB.
The relation of MEFV gene variants to clinical phenotype and selected laboratory markers in Egyptian patients with familial Mediterranean fever
Authors: El-Bassyouni Hala T. , Eldeen Ghada Nour , Sokkar Mona F. , Taher Mohamed B. , Sayed-Ahmed Mohammed M. , Salama Iman I. , Raslan Hala M.
Published: December 2024

Background/aim

Familial Mediterranean fever (FMF) is an autoinflammatory disease, with a high prevalence in the Mediterranean region. It is brought out by variants in the MEFV gene. The present goal is to describe the demographic, clinical features, and MEFV gene variants among Egyptian FMF patients and to explore the relation of MEFV variants with clinical features and selected laboratory markers.

Patients and methods

The present study enrolled 302 patients with FMF from both sexes with a mean age 18.01±8.73 years. Patients were recruited from the Clinical Genetic Clinic, Medical Research Centre of Excellence, National Research Centre, Cairo, Egypt, during the period from 2021 to 2023. All patients were subjected to complete history taking, clinical evaluation, and laboratory investigations. C-reactive protein, serum amyloid A (SAA) protein and vitamin D were measured using enzyme-linked immuno-sorbent assay technique, while erythrocyte sedimentation rate was measured by Westergren method. In addition, MEFV genetic variants were investigated using a real-time PCR genotyping assay and direct sequencing of exon 2 and exon 10 of the MEFV gene.

Results

The average age of FMF cases was 18.01±8.73 years (with a range between 2 and 34 years), and the female/male ratio was 1.07. The most prevalent symptoms were abdominal pain, fever, and arthritis. Genotyping of the MEFV gene demonstrated that 215 (71.2%) patients were heterozygotes, 26 (8.6%) patients were compound heterozygotes and 12 (4.0%) patients were homozygotes, while 49 (16.2%) patients had no detected mutation. p. Met 694Ile was the most common MEFV variant (36.7%), followed by p. Met680Ile (21.5%), p.Val726Ala (9.6%), p.Glu148Gln (8.94%), and p.Met694Val (7.94%). There was no significant variation in clinical manifestations between different MEFV gene variants. The level of SAA protein was higher in FMF patients carrying the Met694Val variant, while carriers of the p. Glu148Gln variant showed lower erythrocyte sedimentation rate, SAA, and higher serum vitamin D.

Conclusion

The most commonly encountered MEFV gene variants among our Egyptian FMF cases were p. Met694Ile followed by p. Met680Ile. No phenotype-genotype association was observed. The p. Met694Val variant could be a possible risk factor for developing amyloidosis. Investigating the whole MEFV gene is recommended to fully understand the molecular background of FMF cases and properly establish a good correlation with the variable phenotypes.
Assessing the Clinical Impact of Emergency Physician-performed Ultrasound-guided Peripheral Nerve Blocks in a Level 1 Trauma Center: A Retrospective Analysis
Authors: Bhoi Sanjeev , Gopinath Bharath , Khandelwal Utkarsh , Nayaka Rakesh , Bhaskararayuni Jyothiswaroop , Gupta Devansh , Srivastava Ayush , Anshu Anisha , Katyal Aaditya , Sinha Tej Prakash
Published: December 2024

Introduction:

Effective pain management is crucial in the emergency department (ED), particularly for trauma patients. Ultrasound-guided regional analgesia (UGRA) has emerged as a promising technique for acute pain relief. The objective of this study is to describe the various UGRA performed and assess their effectiveness among trauma patients in our Level 1 Trauma Center ED over the past 2.5 years.

Methods:

Data from 485 trauma patients who underwent UGRA over 2.5 years were analyzed retrospectively. The primary outcome was the median Defense and Veterans Pain Rating Scale (DVPRS) reduction at 30 min and 1 h after nerve block administration. Patient characteristics, types of nerve blocks administered, procedural details, and outcomes were also noted. Statistical analysis was performed to determine the median reduction in pain scores and evaluate the success of UGRA.

Results:

UGRA demonstrated a significant reduction in pain scores, with a median DVPRS decrease from 9 (interquartile range [IQR]: 9–10) preprocedure to 4 (IQR: 2–5) at 30 min and 1 (IQR: 0–2) at 1 h postprocedure. Sixteen types of nerve blocks were administered in our ED, with the serratus anterior block (n = 91) and fascia iliaca compartment block (n = 58) being the most common. Pain relief was the most common indication for block administration. A higher volume was injected for plane blocks compared to nerve-specific blocks. No complications or failed blocks were reported.

Conclusion:

This study describes 16 different UGRA that can be performed by emergency physicians (EPs) in ED for trauma patients. UGRA is effective in providing substantial pain relief for trauma patients in the ED. UGRA performed by EPs offers a safe and feasible approach for managing acute pain in the ED.
Utilisation of Cryopreserved Gametes in Cancer Patients who Underwent Fertility Preservation
Authors: Gunasheela Devika , Ashwini N. , Saneja Yoshita , Deepthi D
Published: December 2024

ABSTRACT

Background:

Cancer treatments such as chemotherapy and radiotherapy often compromise fertility by damaging gonadal function, creating a critical need for fertility preservation options. Despite advancements in fertility preservation techniques, there is a significant lack of research focused on their application in Asian cancer patients and their utilisation remains underexplored in this population.

Aim:

This study aims to evaluate the utilisation rates and outcomes of cryopreserved gametes in cancer patients who underwent fertility preservation before their cancer treatment.

Settings and Design:

This retrospective study was conducted at our hospital from January 2003 to May 2023. It investigated the utilisation of cryopreserved gametes in 557 male patients aged 15–50 years and 39 female patients aged 15–40 years who opted for fertility preservation before chemotherapy or radiotherapy.

Materials and Methods:

Data were retrospectively collected, including patient demographics and fertility preservation outcomes. Various fertility preservation methods were employed based on patient suitability and availability. Participants were surveyed to identify reasons for non-utilisation of cryopreserved gametes. All data were collected and analysed following institutional ethical guidelines.

Statistical Analysis Used:

Descriptive statistics were used to calculate utilisation rates and report clinical pregnancy and live birth rates. Reasons for non-usage were categorised into mortality, spontaneous pregnancies, financial constraints and social factors.

Results:

Out of 596 participants, only 11 utilised their cryopreserved gametes, yielding a utilisation rate of 1.8%. Among those who used their gametes, clinical pregnancy rates were 66.66% for males and 50% for females, with live birth rates of 33.33% for males and 50% for females. Non-usage was primarily due to mortality, spontaneous pregnancies, financial constraints and social issues.

Conclusion:

The utilisation rate of cryopreserved gametes was low at 1.8%. Challenges such as mortality, financial constraints and social factors highlight the need for improved counselling and a refined approach to fertility preservation, ensuring services better align with patients’ future needs.
Yoga: As a Transformative Approach to Addressing Male Infertility and Enhancing Reproductive Health in Men: A Narrative Review
Authors: Yadav Anjali , Tiwari Prabhakar , Dada Rima
Published: December 2024

ABSTRACT

Infertility presents multifaceted challenges that encompass both physical and emotional burdens. Yoga, as a comprehensive system of mind–body medicine, serves as an effective intervention for managing male factor infertility, a complex lifestyle disorder with significant psychosomatic elements. This review explores the transformative role of yoga in addressing both the emotional and physical dimensions of infertility. By incorporating physical postures, breath control and meditation, yoga promotes emotional well-being and enhances reproductive health by improving the integrity of nuclear and mitochondrial genomes as well as the epigenome. In addition, yoga contributes to maintaining sperm telomere length through the regulation of seminal free radical levels and increased telomerase activity, which are crucial for optimal embryo cleavage and the development of high-quality blastocysts. Integrating yoga as an adjunctive therapeutic approach fosters a supportive intrauterine environment and facilitates physiological homoeostasis, thereby increasing the likelihood of successful fertilisation and implantation. Gentle asanas and flowing sequences promote relaxation, alleviate tension and cultivate emotional stability, while meditation aids in emotional healing and resilience during the infertility journey. Specific asanas, such as Baddha Konasana (bound angle pose), Bhujangasana (cobra pose) and Sarvangasana (shoulder stand), stimulate reproductive organs, enhance blood circulation and regulate hormone production. Pranayama techniques further support endocrine balance and overall vitality. Moreover, yoga provides a non-invasive strategy for managing fertility-related conditions leading to improved reproductive health and overall well-being. This review aims to elucidate the comprehensive role of yoga in improving male infertility, focusing on its impact on sperm nuclear and mitochondrial genomes, the epigenome and telomere health. In addition, it underscores the importance of self-care, open communication and shared experiences with partners. Practicing yoga regularly supports psychosocial well-being, promotes holistic healing, enhances physical and mental health and probably helps in improving reproductive health, thereby fostering resilience and self-efficacy throughout the journey of fertility and reproduction.
Assessment of Thyroid Auto-antibodies in Euthyroid Infertile Women with Polycystic Ovarian Syndrome - A Cross-sectional Analytical Study
Authors: Anusha K. H. , Thyagaraju Chitra , Nandeesha H
Published: December 2024

ABSTRACT

Background:

Thyroid auto-antibodies could be one of the many causes of infertility in women, especially with polycystic ovarian syndrome (PCOS) with a prevalence of 5%–15%. Patients with anti-thyroid antibodies have shown significantly lower fertilisation rates, implantation rates, lower pregnancy rates and increased risk of first-trimester abortions when compared with those without anti-thyroid antibodies.

Aim:

The aim of the study was to assess the prevalence of thyroid auto-antibodies in euthyroid infertile women with PCOS and to compare the prevalence of thyroid autoantibodies in euthyroid infertile women with PCOS and without PCOS.

Settings and Design:

This is a cross sectional analytical study involving 132 Infertile women with and without PCOS visiting the department of OBG in a tertiary care center. The study was conducted for period of 2 years.

Materials and Methods:

A total of one hundred two women were enrolled in to the study. Sixty six women (66) had features of PCOS based on Rotterdam’s criteria and 66 women were controls without PCOS features. Detailed history and examination were done for all women after taking informed and written consent. Previous hospital records were collected along with all biochemical investigations. The blood sample was collected for hormonal levels and thyroid auto-antibodies (anti-thyroid peroxidase [TPO] and anti-thyroglobulin [TG]) were assessed by enzyme-linked immunosorbent assay. The antibody levels were compared between the two groups along with the other parameters.

Statistical Analysis Used:

Statistical tests were done using SPSS version 26. The Chi-square test or Fisher’s exact test would be used to study the association of categorical data like the presence of hirsutism, acne, etc. The association of independent variables with outcome variables was assessed using Chi-square. The P < 0.05 was considered significant with a confidence interval of 95%.

Results:

Anti-TPO antibody levels were found to be elevated in 25.4% of the PCOS group in comparison to only 3% of the non-PCOS group. Anti-TG antibodies of >100 U/mL were seen in 23 patients (34.3%) in PCOS group in comparison to two patients (3%) in non-PCOS group (P = 0.001). Both the antibodies (anti-TPO and anti-TG) were present in 21.2% of the PCOS group and 1.5% of the non-PCOS group.

Conclusion:

Women with PCOS were found to be 11 times more likely to have anti-TPO antibodies and 20 times more likely to have anti-TG antibodies compared to non-PCOS women. This heightened prevalence of anti-thyroid antibodies suggests that testing for these antibodies may be warranted in women with PCOS, even if they have normal thyroid function. However, further studies with larger sample sizes are needed to validate these findings.
Self-gripping mesh in laparoscopic inguinal hernia repair: A comparative study about surgical time, post-operative pain and recurrence
Authors: Aragone Lucía , Pasquini Mariana Toffolo , Croceri Raul , Medina Pablo , Pirchi Daniel
Published: December 2024

Introduction:

In laparoscopic inguinal hernia repair (LIHR), fixation means for meshes (FMMs) are commonly used to reduce hernia recurrence risk. Their use may result in post-operative pain (PP) and may even increase surgical time (ST). Recently, self-gripping meshes (SGMs) have been developed, which leave aside fixation devices; they could potentially reduce PP and even decrease ST. Our primary outcome was to compare ST, PP and recurrence rates in LIHR using SGM versus FMM.

Patients and Methods:

A comparative retrospective study with prospective case registry was conducted. All patients who underwent LIHR with transabdominal pre-peritoneal approach from January to December 2022 in a high-volume centre were analysed. Patients were divided into two groups according to the type of mesh used in surgery (SGM vs. FMM). Demographic variables, hernia type and size, mesh type and size, ST, PP, recurrence and other morbidities were compared between the groups.

Results:

A total of 411 LIHRs were performed during the period, of which 283 were included in the study. Of these, 234 patients were repaired with FMM and 49 with SGM. ST had a statistically significant reduction in the SGM group (P = 0.0004) with a mean time of 58.9 min (±13.6), compared to 68.1 min (±18.9) for the FMM group. A trend towards lower PP in the SGM group was noted (P = 0.08). No recurrences were found in the SGM group with a median follow-up of 18 months (interquartile range: 3).

Conclusions:

SGMs have proven to be a safe, efficient and fast for LIHR in our series. They are a feasible alternative for LIHR, reducing ST and potentially reducing PP. Prospective randomised trials are needed to confirm this trend, along with a longer follow-up period to determine potential advantages in terms of recurrences.
Outcomes following laparoscopic adrenalectomy: Experience of more than two decades at a tertiary care centre
Authors: Bansal Virinder Kumar , Asuri Krishna , Singh Deepti , Agarwal Keshav , Dixit Raghunandan , Prakash Om , Kumar Subodh , Subramaniam Rajeshwari , Ramachandran Rashmi , Tandon Nikhil , Misra M. C.
Published: December 2024

Introduction:

Laparoscopic transperitoneal adrenalectomy was first described by Gagner M et al. Here, we present our experience of more than two decades of laparoscopic adrenalectomy performed in a single surgical unit at a tertiary care centre.

Patients and Methods:

A prospectively collected database of patients undergoing laparoscopic adrenalectomy from December 1994 to May 2020 was analysed retrospectively. The demographic profile, details of clinical workup and laboratory parameters were recorded in a pre-structured pro forma. Functional workup and anatomical imaging were performed for all the patients. Patients were taken up for surgery after adequate pre-operative optimisation using a multidisciplinary approach. All the patients were operated by a single surgical team of experienced laparoscopic surgeons.

Results:

A total of 158 patients underwent laparoscopic transperitoneal adrenalectomy. The majority patients were females (64.5%). The median tumour size was 5 cm (range, 1–18 cm). The diagnosis in the majority of the patients was pheochromocytoma (56.3%). The mean operative time was 80 min (range: 45–210 min). The most common complication was bleeding in 6 (3.7%) patients, which required laparotomy. The median duration of post-operative hospital stay was 3 days (range: 1–13). There was no 30-day mortality. The mean follow-up period was 15 months (range: 6–72 months), during which two patients developed local recurrence.

Conclusion:

The advantages of laparoscopic surgery are well established and have been extensively explored for the management of adrenal lesions. A multidisciplinary approach to management, consisting of endocrinologists, surgeons and anaesthesiologists is preferred. Pre-operative evaluation, optimisation and accurate selection of patients are crucial for successful laparoscopic adrenalectomy.
Simultaneous treatment with benralizumab and ustekinumab in a patient with severe asthma and ulcerative colitis
Authors: Carriera Lorenzo , Barone Roberto , Ielo Simone , Coppola Angelo
Published: December 2024

The burden of autoimmune diseases is rising worldwide. The expansion of the population of patients eligible for severe asthma biological therapy we are seeing in clinical practice could lead to the simultaneous use of different monoclonal antibodies. We present the case of biological combination therapy with ustekinumab and benralizumab in a patient with ulcerative colitis and severe eosinophilic asthma. The patient, already undergoing biological treatment for colitis, began to suffer from uncontrolled severe asthma. Since benralizumab was administered, the patient has not experienced any exacerbations requiring oral corticosteroids, emergency department visits, or hospital admissions, and the control of asthma symptoms and respiratory function considerably improved. Twelve months after the initiation of the combination, both diseases are well controlled, without any side effects or blood test abnormalities. To our knowledge, this is one of the first reported cases of patients simultaneously receiving a combination of biological therapy for ulcerative colitis and asthma.
Scientometric analysis of Mycobacterium tuberculosis revaccination: Dynamics, impact and analysis of collaborative networks
Authors: Vieira Luis Roberto Checa , Dávila Aylén Solange Vásquez , Mayta-Tovalino Frank
Published: December 2024

Background:

Mycobacterium tuberculosis (M. tuberculosis) is an infectious disease that remains a significant global health problem. Despite efforts to reduce the disease, the disease remains prevalent in many parts of the world. This study aims to analyse the dynamics, impact and analysis of collaborative networks in revaccination against M. tuberculosis through a scientometric study in Scopus (2018–2024).

Methods:

This study is retrospective, descriptive and observational, and everything was carried out with a scientometric approach in which the unit of analysis was all publications in journals indexed in the Scopus database between 2018 and 2024, without language limitation. To collect the articles, an advanced search strategy was carried out in the Scopus database. Specific search criteria were defined using combinations of key terms such as ‘revaccination’ and ‘M. tuberculosis’, articulated through Boolean operators to optimize the relevance of the results.

Results:

The most productive institution was the University of Cape Town, while University College London had the highest citation impact. Frontiers in Immunology was the most productive journal, with Nature Communications having the highest citation count. The Hatherill Mark was the most prolific author with 17 publications, although the highest h-indexes did not necessarily correspond to the most productive authors. An increase in the number of publications was observed, peaking in 2020 at 52 publications. In terms of collaboration, strong networks were identified between countries such as the United States, the United Kingdom and China, with authors such as Hatherill Mark and Scriba Thomas J. occupying central positions in these networks.

Conclusions:

This scientometric analysis highlights the growing interest in tuberculosis revaccination, with an increase in scientific production and international collaboration. However, the variability in the quality of publications emphasizes the need to promote high-quality research and innovative strategies to improve global health.
A Case Series of Adult Measles from a Tertiary Care Hospital in North India
Authors: Selvam Suresh , Dhibar Deba Prasad , Singh Harpreet , Suri Vikas , Sharma Vanita , Goyal Kapil , Selvamani Srinivasan , Singh Mini P. , Bhalla Ashish
Published: December 2024

Measles or rubeola is caused by an enveloped single-stranded RNA virus belonging to the genus Morbillivirus in the Paramyxoviridae family. Here, we present five adult measles patients. The laboratory confirmation of measles by serology/polymerase chain reaction (PCR) was carried out in the National Measles Laboratory as per WHO standard operating procedure at the Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. All of the patients presented with prodromal fever with rash. Diffuse erythematous maculopapular rash in a centrifugal manner was present. Measles was diagnosed based on clinical examination findings and positive serology or PCR reports from throat swab specimens. Two patients had a history of exposure; other patients denied any exposure. All of the patients were admitted and managed conservatively in the isolation ward during the period of infectivity.
Gastrointestinal Manifestations and Prognostic Factors for Severe Dengue in Thai Children
Authors: Setrkraising Kittiya , Kittitrakul Chatporn
Published: December 2024

Dengue infection poses a significant public health challenge in tropical countries. In Thailand, children ages 5–14 years are among the groups with the highest incidence of dengue. This study aimed to determine the prevalence of gastrointestinal (GI) manifestations in children with dengue infection and assess prognostic factors for severe dengue. We reviewed the medical records of children ages 0–14 years who were hospitalized with a diagnosis of dengue infection between 2019 and 2022 at Charoenkrung Pracharak Hospital in Bangkok, Thailand. Dengue severity was classified according to the 2009 WHO dengue guidelines. Clinical manifestations and laboratory data were analyzed for their association with severe dengue using a logistic regression model. The study included 556 dengue cases, with 48 cases (8.6%) classified as severe dengue. The mean age (SD) of patients was 9.9 (3.7) years. The most common GI symptoms were anorexia (91.7%) and vomiting (57.6%) followed by abdominal pain (38.3%), and diarrhea (33.3%). GI bleeding was found in 3.2% of patients. Hepatomegaly and ascites were found in 20.9% and 2.9% of patients, respectively. Acute liver failure and acalculous cholecystitis were found in 0.4% and 0.2% of patients, respectively. Children younger than 5 years of age exhibited a lower prevalence of vomiting and abdominal pain compared with older children, making the diagnosis of dengue more challenging. Vomiting, ascites, aspartate aminotransferase >450 U/L, and serum albumin <3.5 g/dL were significantly associated with severe dengue infection. Children with dengue infection presenting any of these factors should be closely monitored for severe dengue.
Adding Virome Capture Metagenomic Sequencing to Conventional Laboratory Testing Increases Unknown Fever Etiology Determination in Bamako, Mali
Authors: Koné Amadou , Kané Fousseyni , Neal Aaron , Konate Issa , Coulibaly Bintou , Dabitao Djeneba K. , Diarra Bassirou , Sanogo Ibrahim , Sarro Yeya Dit Sadio , Coulibaly Tenin A. , Diallo Dramane , Samake Seydou , Dicko Ilo , Diallo Mountaga , Diarra Ayouba , Coulibaly Mamadou D. , Keita Daouda , Coulibaly Nadié , Koloma Isaac , Perou Mamadou , Diarra Hawa Boukary , Cisse Boubacar Elmadane , Togo Antieme Combo Georges , Coulibaly Gagni , Traoré Fah Gaoussou , Sanogo Moumine , Diakité Mahamadou , Aboulhab Jamila , Akpa Esther , Fouth-Tchos Karine , Shaw-Saliba Kathryn , Collins John , Lu Xiang-Jun , Nischay Mishra , Wickiser J. Kenneth , Briese Thomas , Lipkin W. Ian , Chen Ray Y. , Doumbia Seydou , Dao Sounkalo
Published: December 2024

Unexplained fever poses significant diagnostic challenges in resource-limited settings like Bamako, Mali, where overlapping endemic diseases include malaria, HIV/AIDS, yellow fever, typhoid, and others. This study aimed to elucidate the infectious etiologies of acute febrile illnesses in this context. Acute febrile patients of any age were enrolled after informed consent or assent. Baseline clinical and demographic data were collected, and samples were analyzed by using rapid diagnostic tests, reverse transcriptase polymerase chain reaction, ELISA, and virus-targeted metagenomic sequencing (virome capture sequencing platform for vertebrate viruses [VirCapSeq-VERT]). Among 108 enrolled subjects, most were male (51.9%) and under 15 years old (56.5%). Measles virus was identified in 39.8% of cases, primarily among children. Other findings included Plasmodium spp. (12%), Salmonella spp. (13%), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; 8.7%). The virome capture sequencing platform for vertebrate viruses was used for 101 subjects, corroborating many routine test results and identifying additional cases of measles virus (1), SARS-CoV-2 (5), and numerous other agents. Notably, nearly all subjects showed evidence of herpesviruses (90%) and anelloviruses (98%). Hemorrhagic fever viruses were not observed. With the inclusion of VirCapSeq-VERT, identifiable pathogens were found in 79.6% of cases, leaving 20.4% without a clear etiology. The identification of more than one concurrent pathogen was common (41.5%). Integrating metagenomic sequencing with routine laboratory diagnostic testing enhances the detection of pathogens in acute febrile illnesses, highlighting its potential value in identifying infectious etiologies in resource-limited settings.
Latinska šola v Rušah, ruški Romul Luka Jamnik, Gesta Romanorum in izgubljena igra De Joviniano imperatore mire correcto
Authors: Movrin David
Published: December 2024

Verske igre v Rušah, naselju zahodno od Maribora, o katerih v povezavi z latinsko šolo (1645-1760) poroča latinska kronika Jožefa Avguština Mezneriča z naslovom Notata Rastensia antiquissimis documentis desumpta et variis fide humana dignis autographis synoptice descripta, sodijo med danes izgubljene začetke dramskega dogajanja na Slovenskem. Uvedel jih je nadarjeni Luka Jamnik, krajevni duhovnik in spodbujevalec kulturnega dogajanja, v kroniki imenovan kar »ruški Romul«. Leta 1680 je začel prirejati vsakoletne igre po zgledu jezuitskih šolskih »komedij«, actio comica. Redne letne predstave na čast Devici Mariji so vsak začetek septembra, ob prazniku Marijinega imena, potekale vse do leta 1722, vendar se zaradi kasnejšega požara ni ohranilo nobeno besedilo.
Članek prinaša prvi poskus rekonstrukcije ene od takratnih predstav, izgubljene igre z dozdevno antičnim motivom o cesarju Jovinijanu, čudežno napeljanem k spreobrnitvi, De Joviniano imperatore mire correcto, iz leta 1706. Na podlagi dveh literarnih virov, enega iz zbirke Gesta Romanorum in drugega iz dela Summa theologica dominikanca Antonina iz Firenc, predstavi okvirno dramsko dogajanje; nato pa z zbirko kar šestih perioh, »gledaliških listov«, ohranjenih od primerljivih šolskih predstav tistega časa, zariše tudi horizont možnih variacij, kot so jih takrat igrali po evropskih odrih.
Hkrati prikaže obravnavo tega motiva, znanega kot ATU 757, »Kazen za cesarjevo ošabnost«, v vrsti drugih izročil, od njegovih korenin iz svetopisemske zgodbe o kralju Nebukadnezarju (Dan 3,31–4,34) prek avtorjev, kot so bili Herrand Wildonski, Geoffrey Chaucer, Hans Sachs, William Morris in Henry Wadsworth Longfellow, vse do sodobne opere iz 20. stoletja, ki sta jo napisala Josef Tal in Israel Eliraz. V tej luči je uprizoritev v Rušah leta 1706 mogoče razumeti kot enega vsakoletnih vrhuncev kulturnega življenja v regiji, s katerim so mladi izobraženci množico več tisoč gledalcev seznanili s kompleksnim in duhovno ter družbeno provokativnim motivom iz zakladnice evropskega literarnega izročila.
Iz gledališke zgodovine: Liebe kann alles oziroma sezona 1833/34 na ljubljanskem stanovskem odru
Authors: Smolej Tone , Žigon Tanja
Published: December 2024

This article presents a fragment of Slovene theatre history, focusing on performances on the stage of the German-language Theatre of the Carniolan Provincial Estates (Ständisches Theater) in Ljubljana during its 1833/34 season. The introductory part describes Amalie Maschek, an opera singer with extensive experience in theatre practice, who was then directing the Ljubljana stage, followed by a detailed description of the season’s repertoire. The focus is exclusively on the dramatic pro­ductions, and not on the opera performances. The article shows that the theatre’s repertoire, which included romantic rescue plays, classic comedies, vaudeville comedies (comédie-vaudeville), and magical fairy tales, was not far behind the Viennese and even Parisian productions of the first half of the nineteenth century and that the audience in Ljubljana could often see the plays just a few years after their premiere.
La importancia de la lectura para el campo literario
Authors: Pregelj Barbara
Published: December 2024

El objetivo principal de este capítulo es reflexionar sobre una herramienta tradicional de la comunicación literaria, la lectura, desde la perspectiva del constructivismo radical y los estudios sistémicos de literatura. Según el constructivismo radical (Francisco Varela, Humberto Maturana, 1984), el significado del texto no es sino mero resultado de operaciones cognitivas de cada uno de sus lectores y lectoras, lo cual convierte la lectura en un instrumento de polinterpretación. La ciencia empírica de la literatura (Siegfried J. Schmidt, 1995; Marijan Dović, 2004; Urška Perenič, 2010) pondera sus múltiples (y también contradictorias) formas (ideas, expresiones, significados) que dejan de ser propias de un solo texto literario para convertirse en una característica del sistema mismo, constitutiva y propia de todos y cada uno de sus componentes. El dinámico y complejo proceso de construcción de significados de un texto literario viene multiplicado tanto por tres niveles del funcionamiento del sistema literario (el de la producción, el de la distribución y el de la recepción y reproducción), como también por la multiplicación que dentro de los mismos sucede a través de cada uno de sus agentes. Son ellos los que hacen posible que un manuscrito se convierta en un libro y llegue a las manos de sus diferentes lectores.
Evando Nascimento y Alberto Giordano (2021). La literatura fuera de sí
Authors: Forace Virginia P.
Published: December 2024

La literatura fuera de sí, de Evando Nascimento (1960-, Camacã, Bahia, Brasil) y Alberto Giordano (1959-, Rufino, Santa Fe, Argentina), pertenece a la colección de Bulk Editores y Nube Negra “Discusión”, dirigida por el propio Giordano. En el libro, se presenta el ensayo de Nascimento «Para un concepto de literatura en el siglo XXI: expansiones, heteronomías, desdoblamientos», presentado inicialmente en el seminario internacional «El lugar de la Literatura en el siglo XXI» (2015) y que cuenta con una versión publicada en español en el volumen colectivo homónimo (Ediciones Universitarias de Valparaíso, 2016). De la misma forma, el ensayo de Giordano, «¿A dónde va la literatura? La contemporaneidad de una institución anacrónica», había sido socializado en el encuentro de los miembros del PIP Conicet denominado «La resistencia a la teoría en la crítica literaria en Argentina. Algunos episodios desde 1960 hasta la actualidad» (2015), y publicado luego en el dossier «Fin y resistencia de la teoría», dirigido por Judith Podlubne (El Taco en la Brea, 2017). Lo interesante de la propuesta del libro, entonces, no es tanto la novedad de los textos, sino el diálogo que se visibiliza entre dos críticos contemporáneos, uno brasileño y otro argentino. Sus reflexiones fueron pensadas en contextos diversos (un seminario internacional y una reunión de grupo de investigación), pero dan cuenta de las preocupaciones similares que atravesaban ambos grupos y que, de hecho, señalan un momento particular en los estudios críticos sobre la literatura y el arte.
Literature and work
Authors: Gallego Cuiñas Ana , Sánchez Abselam Samir
Published: December 2024

The paper aims to analyze a growing figure in Spanish-language literature – the independent writer-editor, using the case of the Argentine avant-garde writer and independent editor Damián Tabarovsky. The paper is structured in two sections of analysis that seek to provide a comprehensive view of a complex issue involving both writing and publishing. The first section critically examines the relationship between literature and work, questioning Bernard Lahire’s sociology of literature by introducing notions such as “recognition” or “valorization.” The second part uses the example of Damián Tabarovsky and Mardulce Editora to simultaneously consider Tabarovsky’s aesthetics and politics of aesthetics on the one hand, and the editorial poetics of Mardulce on the other, aiming to offer insights into the impact the Argentine writer-editor had on the literature of his time.
La literatura del siglo XXI en español: producción, distribución y recepción
Authors: Santiago Gemma , Geršak Marija Uršula , Šabec Maja
Published: December 2024

El título de este número temático, La literatura del siglo XXI en español: producción, distribución y recepción, abre un ambicioso espacio de reflexión donde se han congregado trabajos sobre la literatura escrita en español, que cuestionan el canon literario y que, a través de la relectura y de la visibilización de áreas que hasta hace poco habían sido periféricas, muestran acercamientos literarios divergentes.