bluuebunny/crossref_metadata_2025 huggingface dataset:
Incontinentia Pigmenti: A Series of Six Cases with Isolated Cutaneous Involvement
Authors: Katakam Bhumesh K. , Gurram Narsimha Rao Netha , Chintagunta Sudharani , Dhabal Arunima
Published: March 2024

Incontinentia pigmenti (IP) is a rare multi-system genetic disorder mostly affecting females. It presents primarily with cutaneous lesions but is often associated with dental, ocular, neurological, musculoskeletal, and cardiovascular abnormalities. We report a series of one male and five female infants with IP having isolated cutaneous involvement at the time of presentation. In such cases, timely diagnosis of the condition, followed by systemic evaluation and long-term periodic follow-up, is imperative to detect and treat more serious systemic manifestations at an early stage.
Is Atopic Dermatitis a Risk Factor for Thyroid Autoimmunity? – A Cross-Sectional Study from a Tertiary Care Center in India
Authors: Mendiratta Vibhu , Himadri Himadri , Verma Damini , Aggarwal Meenakshi , Yadav Jyoti
Published: March 2024

Background:

Because of the counter-regulation of Th1 and Th2 cells, Th1-type autoimmune diseases like thyroid autoimmunity and Th2-mediated allergic diseases like atopic dermatitis (AD) should occur in mutually exclusive populations. However, thyroid autoimmunity has been associated with chronic urticaria, and atopy is considered a cause of both AD and urticaria.

Objectives:

To assess the frequency of thyroid autoimmunity in children with AD and to study the correlation between the clinical severity of AD using the SCORing Atopic Dermatitis (SCORAD) score, and biochemical parameters of serum immunoglobulin E (IgE), absolute eosinophil count, and vitamin D levels.

Materials and Methods:

A hospital-based cross-sectional study was conducted, recruiting children (0–18 years) with AD. Patients on drugs affecting thyroid dysfunction and those with sick euthyroid syndrome or an immunodeficiency disorder were excluded. Clinical severity was assessed using SCORAD, and the thyroid profile, anti-thyroid peroxidase antibodies, antinuclear antibody (ANA), absolute eosinophil count, serum IgE, and vitamin D levels were measured.

Results:

Thyroid autoimmunity was diagnosed in 18.9% (10/53) of children. There was a significant correlation between SCORAD and serum IgE (r = 0.432, P = 0.002) and absolute eosinophil count (r = 0.575, P = <0.001). There was a negative correlation between SCORAD and vitamin D levels (r = -0.373, P = 0.006).

Conclusions:

Thyroid autoimmunity may be associated with AD, and a high index of suspicion is essential. Vitamin D also should be supplemented in children with AD as it is frequently found to be low, especially in severe cases. Multi-center case-control studies are required to determine the prevalence of thyroid autoimmunity in children with AD.
Nail Society of India Recommendations for Treatment of Onychomycosis in Special Population Groups
Authors: Mahajan Khushbu , Grover Chander , Relhan Vineet , Tahiliani Sushil , Singal Archana , Shenoy Manjunath M. , Jakhar Deepak , Bansal Shikha
Published: March 2024

Onychomycosis (OM) is a difficult-to-treat condition, especially considering the limited armamentarium of antifungal drugs, need for prolonged treatment, and poor compliance. This problem is further confounded while treating OM in special populations such as children, elderly, immunosuppressed patients, pregnant or lactating women, and patients with chronic liver or kidney disease. In the absence of standardized treatment guidelines, the antifungal therapy is either withheld or compromised, as it is largely governed by personal preferences or based on anecdotal reports. Hence, an expert group of the Nail Society of India worked towards drafting guidelines based on established literature and inputs from experts, with practical recommendations for the treatment of onychomycosis in special population groups. An extensive analysis of available English language literature on onychomycosis in special populations, published during a 10-year period (2014–2023 until date) was done. The available studies and reports were evaluated, cross-references read, and evidence compiled, graded, and discussed by the expert group to derive consensus recommendations for practice. The evidence and recommendations based on it are presented in a narrative format to guide treatment choices when dealing with population groups with special considerations.
Exogenous Progestogen Hypersensitivity and its Increasing Association with Assisted Reproductive Techniques (ART)/in vitro Fertilization (IVF)
Authors: Sashidhar Nivedita , Mysore Venkataram , Thejavathy G. V.
Published: March 2024

Progestogen hypersensitivity (PH) also known as autoimmune progesterone dermatitis is a rare clinical entity that may be triggered by endogenous progesterone (menstrual cycles and pregnancy) or exogenous progestin exposure (examples: contraceptive medicines, in vitro fertilization treatments). It is a poorly recognized syndrome due to its heterogeneous clinical presentation. The pathomechanism of PH is believed to be primarily IgE mediated but less commonly other immune responses may be involved. Management is usually focused on symptomatic control with medications. Recently, with the increasing use of exogenous progestins for in vitro fertilization more cases of hypersensitivity to exogenous progestins have been reported. Progesterone is an essential drug in the luteal phase support improving chances of implantation and pregnancy rates, and hence, PH is an important and difficult challenge to manage in these patients. Because patients require IVF and there is no alternative to progesterone, desensitization is suggested as an approach to endure fertility treatments and provides symptom control in refractory cases. Here, we will review the different aspects of PH.
Panchakarma and Satvavajaya chikitsa in the management of Pittodara caused by fast food addiction: A case report
Authors: Huilgol Pooja , Grampurohit Pradeep L.
Published: March 2024

Fast food is often consumed not as a requirement for hunger but to continuously satiate the taste buds with appealing flavors, which creates an addictive behavior. This addiction represents “Asatmendriyartha samyoga” (~improper use of sensory organs) of Rasanendriya (~sensory faculty of tongue). Toxins present in fast food can act as Dushivisha (~artificial poison) and Garavisha (~combination of non-poisonous substances) leading to Udara roga (~diseases of the abdomen). The present case followed a typical presentation of Pittodara (~Udara roga due to Pitta dosha) in a 19-year-old female, who was habituated to fast-food consumption. The patient had developed pain in the abdomen, and yellowish discoloration of eyes, urine, and stools for two weeks. Fever was the first symptom to develop followed by vomiting, causing severe weakness. The contemporary diagnosis had suspected the case to be an acute liver failure, requiring a liver transplantation. Based on Nidana (~etiology), Samprapti (~pathogenesis), and Lakshanas (~symptoms), the case was diagnosed as Pittodara. Considering the Vaya (~age), Bala (~physical endurance), Agni (~digestive/metabolic factors), and Satva (~psychic condition) of the patient, Dosha nirharana chikitsa (~evacuation of accumulated toxins), and Shothahara chikitsa (~reduction of inflammation and swelling) were planned through Nitya virechana (~therapeutic purgation on daily basis) by Gandharva hastadi eranda taila, Nasya (~medication through nasal route) with Gudanagara, Parisheka (~therapeutic streaming) with Dashamoola kwatha and Udaralepa (~application of medicated paste over abdomen). The patient was provided counseling along with specific advice on a planned diet and daily routine. A combination of Yukti vyapashraya (~logic-based treatment) and Satvavajaya chikitsa (~subjugation of mind/counsel) resulted in the reduction in yellowish discoloration of eyes, bilirubin levels, abdominal girth, pedal edema, and pain per abdomen. This case depicts the hazards of fast-food addiction among the young population, the utility of Panchakarma chikitsa in treating liver disorders, and the need for social policies to control the growth of fast-food outlets in India.
The versatile and minimally invasive mini and narrow diameter implants: A case series
Authors: Krishna Ravishankar , Midhula V. , Lanka Hima Bindu , Agarwal Shobhit
Published: March 2024

The awareness and demand for implants as a treatment option have put the onus on the dentist to adapt to the patient’s requirements. Standard diameter implants cannot be placed in all situations due to limited bone volume, altered systemic status of patients, or financial constraints. Mini and narrow-diameter implants may be a reliable alternative in such circumstances. They have demonstrated good success and survival rates for the replacement of maxillary lateral incisor, mandibular anterior teeth, maxillary or mandibular posterior teeth when the occlusal load is favorable, and maxillary or mandibular overdentures. Splinting these mini implants has been shown to decrease the stresses on the bone and improve the load-bearing capacity. The three cases described here validate the usefulness of mini implants where standard diameter implants were not feasible.
Comparison of the effects of opioid-free anesthesia (OFA) and opioid-based anesthesia (OBA) on postoperative analgesia and intraoperative hemodynamics in patients undergoing spine surgery: A prospective randomized double-blind controlled trial
Authors: Rani Ugrani S. , Panda Nidhi B. , Chauhan Rajeev , Mahajan Shalvi , Kaloria Narender , Tripathi Manjul
Published: March 2024

Background:

Opioids form the basis of perioperative pain management but are associated with multiple side effects. In opioid-free anesthesia (OFA), several non-opioid drugs or neuraxial/regional blocks are used as substitutes for opioids. Ketamine, a N-methyl-d-aspartate antagonist, provides intense analgesia. However, there is a shortage of literature on the effects of ketamine-based OFA on hemodynamics (HD) and postoperative analgesia in patients undergoing thoracolumbar spine surgery.

Materials and Methods:

This prospective randomized controlled trial included 60 adult patients. The patients in Group OFA (n = 30) received OFA with ketamine and ketofol (1:5) infusion, and those in Group OBA (n = 30) received opioid-based anesthesia (OBA) with fentanyl and propofol infusion. The postoperative pain-free period, pain scores, rescue analgesia, intraoperative HDs, and postoperative complications were assessed.

Results:

The mean pain-free period in Group OFA (9.86 ± 1.43 hr) was significantly higher than that in Group OBA (6.93 ± 1.93 hr) (P = 0.002). During the postoperative 48 hours, the total requirement of fentanyl was considerably lower in Group OFA (P < 0.05). There was a significantly higher incidence of hypertension in Group OFA (46%) and hypotension (43%) in Group OBA (43%), respectively. Postoperative nausea vomiting (PONV) was more common in Group OBA at the 2nd and 6th hr (P = 0.046 and P = 0.038)

Conclusion:

OFA with ketamine and ketofol provided adequate postoperative analgesia with a lower incidence of PONV after spine surgery. However, hypertension in the ketamine group and hypotension in the propofol group required fine titration of the infusion rate of drugs during the intraoperative period.
Enhanced recovery after cardiac surgery: A literature review
Authors: Navas-Blanco Jose R. , Kantola Austin , Whitton Mark , Johnson Austin , Shakibai Nasim , Soto Roy , Muhammad Sheryar
Published: March 2024

Enhanced recovery after cardiac surgery (ERACS) represents a constellation of evidence-based peri-operative methods aimed to reduce the physiological and psychological stress patients experience after cardiac surgery, with the primary objective of providing an expedited recovery to pre-operative functional status. The method involves pre-operative, intra-operative, and post-operative interventions as well as direct patient engagement to be successful. Numerous publications in regard to the benefits of enhanced recovery have been presented, including decreased post-operative complications, shortened length of stay, decreased overall healthcare costs, and higher patient satisfaction. Implementing an ERACS program undeniably requires a culture change, a methodical shift in the approach of these patients that ultimately allows the team to achieve the aforementioned goals; therefore, team-building, planning, and anticipation of obstacles should be expected.
Remote ischemic preconditioning and cognitive dysfunction following coronary artery bypass grafting: A systematic review and meta-analysis of randomized controlled trials
Authors: Siburian Reynold , Fadillah Rizki , Altobaishat Obieda , Umar Tungki Pratama , Dilawar Ismail , Nugroho Dimas Tri
Published: March 2024

Introduction:

Postoperative cognitive dysfunction (POCD) is a common neurological issue following cardiopulmonary bypass (CPB)-assisted heart surgery. Remote ischemic preconditioning (RIPC) increases the tolerance of vital organs to ischemia/reperfusion injury, leading to reduced brain injury biomarkers and improved cognitive control. However, the exact mechanisms underlying RIPC’s neuroprotective effects remain unclear. This systematic review aimed to explore the hypothesis that RIPC lowers neurocognitive dysfunction in patients undergoing CPB surgery.

Method:

All relevant studies were searched in PubMed, ScienceDirect, EBSCOhost, Google Scholar, Semantic Scholar, Scopus, and Cochrane Library database. Assessment of study quality was carried out by two independent reviewers individually using the Cochrane Risk of Bias (RoB-2) tool. Meta-analysis was performed using a fixed-effect model due to low heterogeneity among studies, except for those with substantial heterogeneity.

Results:

A total of five studies with 1,843 participants were included in the meta-analysis. RIPC was not associated with reduced incidence of postoperative cognitive dysfunction (five RCTs, odds ratio [OR: ] 0.79, 95% confidence interval [CI]: 0.56–1.11) nor its improvement (three RCTs, OR: 0.80, 95% CI: 0.50–1.27). In addition, the analysis of the effect of RIPC on specific cognitive function tests found that pooled SMD for RAVLT 1-3 and RAVLT LT were −0.07 (95% CI: −0.25,012) and −0.04 (95% CI: −0.25–0.12), respectively, and for VFT semantic and phonetic were −0.15 (95% CI: −0.33–0.04) and 0.11 (95% CI: −0.40–0.62), respectively.

Conclusion:

The effect of RIPC on cognitive performance in CABG patients remained insignificant. Results from previous studies were unable to justify the use of RIPC as a neuroprotective agent in CABG patients.
Use of bispectral index for detection of partial cerebral hypoperfusion during cervical spine surgery: A case report
Authors: Suzuki Hiroaki , Doi Kazuki , Asai Takashi
Published: March 2024

The BIS value may decrease by cerebral hypoperfusion. We report a case in which the BIS value suddenly decreased during cervical spine surgery, which led us to find cervical screws compressing the vertebral arteries. In a 79-year-old man undergoing cervical spine surgery, the BIS suddenly decreased from about 40 to 10-20, about 4 h after the start of surgery. Intraoperative 3-dementional computed tomography indicated that both the two tips of cervical screws inserted in the 6th cervical vertebra were within bilateral transverse foramens. These cervical screws were removed, and the BIS increased immediately. The cervical screws were re-inserted again thorough the same vertebra into the bilateral transverse foramens, and the BIS decreased immediately. Postoperatively, cerebral hypoperfusion due to compression of bilateral vertebral arteries by two cervical screws was identified. The BIS may be a useful to detect cerebral hypoperfusion due to compression of the vertebral artery by a cervical screw.
Airway management of postburn neck contracture in pediatric patient – A challenge for anesthesiologist!
Authors: Ramesh Athira , Gupta Kewal K. , Deep Gagan , Singh Amanjot
Published: March 2024

Pediatric difficult airway management is more challenging for an anesthesiologist due to anatomical and physiological differences as compared to adults. Moreover, the familiarity with the use of difficult airway equipment in adults does not equate to proficiency for the same in children. So, here we are presenting the management of a unique case of a difficult airway due to postburn neck contracture in a 4-year-old child, which was managed successfully with the help of a video laryngoscope after the failure attempt with a flexible fiberoptic bronchoscope.
The association between different anesthetic techniques and outcomes in patients undergoing transfemoral aortic valve replacement
Authors: Abuzaid Ahmad , AbdelAal Ibrahim , Galal Ahmed
Published: March 2024

Background:

There is an increasing number of patients undergoing transfemoral aortic valve replacement (TAVR) with sedation. There is limited data assessing the efficacy and safety of the different types of sedative drugs. The objective was to compare two sedation techniques with regard to the need for vasoactive support, respiratory support, rate of conversion to general anesthesia (GA), common perioperative morbidities, intensive care unit (ICU) stay, and in-hospital mortality.

Methods:

A retrospective chart review study conducted among patients who underwent TAVR at a specialized cardiac center between January 2016 and December 2019. Data collection included patient diagnosis, preoperative comorbidities, intraoperative outcomes, and postoperative outcomes.

Results:

A total of 289 patients received local anesthesia; 210 received propofol infusion and 79 received a mixed propofol-ketamine infusion (Ketofol). The average age was 75.5 ± 8.9 years and 58.1% of the patients were females. Comparing propofol and ketofol groups, 31.2% and 34.2% of the patients required drug support, 7.6% and 6.3% required conversion to GA, 46.7% and 59.5% required respiratory support, respectively. These intraoperative outcomes were not significantly different between groups, P = 0.540, P = 0.707, and P = 0.105, respectively. In-hospital 30-day mortality in propofol and ketofol groups were 1.9% and 3.8%, respectively, P = 0.396. In both groups, the median post-procedure coronary care unit stay was 26 hours while post-procedure hospital stay was 3 days.

Conclusions:

There were no significant differences in perioperative or postoperative outcomes in TAVR patients receiving either propofol or ketofol. Propofol infusion, either alone or with ketamine, is reliable and safe, with minimal side effects.
Torsion of the inferior vena cava: An unprecedented variant of post-pneumonectomy syndrome
Authors: Aleixo Raul C. , Oliveira Bruna C. , Drumond André L. V. , Delgado Marina Ayres
Published: March 2024

Post-pneumonectomy syndrome (PPS) is a rare complication after pneumonectomy defined by mediastinum shift toward the vacated pleural space with compression of the distal trachea or mainstem bronchi, resulting in dyspnea. This report describes a 32-year-old woman who presents with limiting symptoms of progressive dyspnea and chest pain 2 years after a right pneumonectomy. In computed tomography scan, there was no evidence of airway compression but suggested torsion of the inferior vena cava with preload compromise, confirmed during the surgical mediastinum repositioning using a transesophageal echocardiography-guided approach. This case report presents this unprecedented variant of PPS syndrome, highlighting the diagnostic and peri-operative management challenges.
Tolerance to preoperative placement of electrodes for neuromuscular monitoring using the Tetragraph™
Authors: Espinal Leah M. , Kalsotra Sidhant , Rice-Weimer Julie , Kitio Sibelle A. Yemele , Tobias Joseph D.
Published: March 2024

Background:

Quantitative train-of-four (TOF) monitoring has recently been shown to be feasible in infants and children using a novel electromyography (EMG)-based monitor with a pediatric-sized self-adhesive sensor. However, placement of the sensor and initiation of TOF monitoring may require additional time in the operating room (OR), delaying workflow and the time to induction of anesthesia. The current study evaluates the feasibility of placing the self-adhesive sensor in the preoperative holding area in pediatric patients before arrival to the OR.

Methods:

Consented pediatric patients undergoing inpatient surgery requiring the administration of NMBAs were enrolled. The EMG electrode was placed along the ulnar nerve on the volar aspect of the distal forearm to provide neurostimulation. After the induction of anesthesia, monitoring was initiated and TOF recording started before the administration of the NMBA. A Likert score (0-10) was used to assess ease of placement, tolerability of the monitor during the preoperative period, and its ability to generate a recorded response in the OR.

Results:

The final study cohort included 40 patients with a median age of 3.7 years. Fourteen patients (35%) pulled off the sensor before arrival to the OR and 26 patients (65%) arrived at the OR with the sensor intact and functioning. Older children were more likely to maintain the sensor until arrival to the OR compared to younger patients (median age of 5.24 versus 1 year, P = 0.0521). A median age of 3.7 years correlated with an 80% chance of arriving in the OR with the sensor intact. Application ease and tolerance of the sensor were higher in the group that maintained the sensor until OR arrival.

Conclusion:

In patients more than 4 years of age, placement of the self-adhesive sensor for EMG-based TOF monitoring may be feasible. However, in younger patients, additional interventions may be required to achieve a similar success rate.
Surgical management of COVID-19 associated Mucormycosis with adjuvant systemic antifungal therapy
Authors: Elsaadany Wesam H. , Sheta Mona S.
Published: March 2024

Purpose

This study aimed to evaluate clinically and radiographically the patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis managed with surgery and simultaneous systemic antifungal therapy.

Patients and methods

This is an interventional study included 20 cases with COVID-19-associated mucormycosis and they were managed with aggressive surgical debridement and systemic antifungal therapy after controlling of underlying systemic disease. the patients were followed clinically and computed tomography scan for 6 months.

Results

The cases were with only nasal/sinus involvement in 15 (75%) cases followed by two (10%) cases with rhino-orbital, and rhino-orbito-cerebral was seen in three (15%) patients, with reported mortality rates of about 10% (two cases). All cases had a history of taking steroids for COVID treatment. All patients had diabetes mellitus with high glucose levels except one case had heart disease. After 6 months, all patients had adequate soft tissue healing with normal color and texture without any signs of recurrence of infection. Computed tomography scan showed adequate bone healing without any evidence of recurrence of disease.

Conclusion

The diagnosis of mucormycosis should be done early. Aggressive surgical debridement with simultaneous systemic antifungal therapy is necessary for adequate management of disease.
Evaluation of different remineralizing agents on microhardness and surface roughness of bleached enamel
Authors: Elminofy Khloud Mohamed , Hasan Mostafa M. A. , Shebl Eman A. E.
Published: March 2024

Purpose

To evaluate remineralization efficacy of self-assembling peptide (Curodont) and sodium calcium phosphosilicate (Novamin) on bleached teeth.

Materials and methods

Twenty freshly extracted human premolars were selected, roots were separated, and crowns were impregnated in acrylic resin then kept in artificial saliva. Specimens were randomly divided into two equal groups (10 specimens for each group). Group 1 specimens were bleached and treated with Curodont and group 2 specimens were bleached and treated with Novamin. Enamel microhardness and surface roughness changes were measured for both groups using Vickers hardness testing machine and Surface Profile Gage (Positector), respectively.

Results

Bleaching increased enamel surface roughness value (0.6 ± 0.10 μm) more than the baseline value (0.3 ± 0.09 μm) and decreased enamel microhardness (239.4 ± 5.33 MPa) compared to unbleached group (334.9 ± 4.26 MPa). After remineralization with Curodont, surface roughness decreased (0.4 ± 0.06 μm) and microhardness increased (300.3 ± 5.92 MPa) while after remineralization with Novamin surface roughness slightly decreased (0.5 ± 0.08 μm) and enamel microhardness slightly increased (252.8 ± 7.35 MPa). Spearman’s correlation test revealed an inverse relationship between surface roughness and microhardness after bleaching (r
s=−0.177, −0.818) for groups 1 and 2, respectively, and a strong correlation between surface roughness and microhardness after treatment with Curodont and Novamin as whenever surface roughness decreased, microhardness increased (r
s=−0.921, P < 0.001) in group 1 and (r
s=−0.855, P < 0.002) in group 2.

Conclusion

Both Curodont and Novamin have a reasonable potential to remineralize bleached teeth by increasing enamel microhardness and decreasing surface roughness. However, Curodont is better than Novamin in the remineralization effect.
Evaluation of fetuin-A and high-sensitivity C-reactive protein levels in gingival crevicular fluid in periodontitis diabetic and nondiabetic patients: an observational diagnostic accuracy study
Authors: Fahmy Maha A.K. , Shaker Olfat G. , Elbanna Riham M.H. , Tarrad Nayroz A.F.
Published: March 2024

Introduction

Periodontitis is one of the most common chronic inflammatory diseases worldwide although its pathogenesis is still unclear. Diabetes complicates periodontitis changing its grade as a modifying factor. Gingival crevicular fluid (GCF) is regarded now as an important biological fluid especially in periodontal diseases. Hence, the aim of this study was to compare and correlate GCF fetuin-A and high-sensitivity C-reactive protein (hs-CRP) levels in nondiabetic periodontitis patients and diabetic periodontitis patients with healthy participants revealing their possible role in periodontal disease diagnosis.

Patients and methods

Thirty periodontitis stage III grade B/C patients categorized into two groups according to whether having diabetes mellitus or not were compared to 15 systemically and periodontally healthy participants. Clinical parameters were recorded. Assessment of GCF levels of fetuin-A and hs-CRP were done utilizing an enzyme-linked immunosorbent assay kit. Receiver operating characteristic curve was performed revealing sensitivity, specificity, predictive value, and diagnostic accuracy of both markers.

Results

GCF fetuin-A levels showed statistically significant difference between the three groups (P < 0.001) with the highest level in healthy group followed by the nondiabetic periodontitis group then the diabetic periodontitis group. While for hs-CRP level, it showed significantly higher results in nondiabetic periodontitis group and the diabetic periodontitis group than in healthy group with no statistically significant difference between both periodontitis groups.

Conclusions

Both markers have diagnostic ability in discriminating periodontitis against healthy individuals. However, the diagnostic ability in discriminating diabetic patients with periodontitis against nondiabetic periodontitis patients, fetuin-A showed outstanding ability, while the ability of hs-CRP was acceptable.
Multicomponent reactions of cyanoacetanilide derivatives: Synthesis of coumarin and quinoline derivative and evaluations of their cytotoxicity
Authors: M. Mohareb Rafat , K. Zahran Magdy , R. Maghraby Hager , E.M.  Abdallah Amira
Published: March 2024

In this study, several fused heterocyclic systems involving tetrahydrobenzopyrans 7a-i and tetrahydrobenzopyridines 9a-i were synthesized. The reactions proceed via a multicomponent reaction of different aromatic aldehydes, cyanoacetanilide derivatives, and cyclohexane-1,3-dione. All the produced compounds were tested for their anticancer activity by using six cancer cell lines such as A549, HT-29, MKN-45, U87MG, SMMC-7721 and H460 utilizing foretinib as the positive control and the standard MTT assay in vitro. The results indicated that many synthesized derivatives were the most potent towards all the cancer cell lines used, six compounds 7e, 7f, 9b, 9d, 9e, and 9g   showed the highest potency. The results obtained in this work enhance further investigations in the future.

KEY WORDS: Multi-component reactions, Cyanoacetanilide, Pyran, Pyridine, Cytotoxicity

Bull. Chem. Soc. Ethiop. 2024, 38(3), 739-750.                                                            

DOI: https://dx.doi.org/10.4314/bcse.v38i3.15
Nigeria and the culture of recycling old leaders, its effect on her economic advancement and nation building in the 21st Century; A critical examination
Authors: Akonye Enyioma Joseph , Chukuemeka Emmanuel , Uchechuku Anthony Nwobi , Nnaeto Japhet Olusadum , Obike Hilary Nwokoma , Onele Sunday , Amulu Sampson Obum
Published: March 2024

Recycling old leaders in Nigeria politics has been a problem to the Nigeria people in recent time as the country has the habit of recycling old leaders who are between 87 years and 90 years who has nothing good again to offer the country, while the youths are there without any hope. This paper explores Nigeria political system and the culture of recycling old leaders, and its effects on her economic advancement/development and Nation building in the 21st Century. The theory used to analyze the paper was Modernization Theory, while the methodology for data collection was secondary sources like; books, newspapers, journal articles, and internet source materials, among others. The research findings on the subject matter implicated ethnic politics, sit tight syndrome and greed, among others. These manifested in economic backwardness/stagnation, relegating citizens’ backward, disunity, killing of initiatives and discouragement of ideas on nation building and economic advancement, as well as ethnic politics, encourages corruption and nepotism. Based on the findings, the paper suggests constitution review, age limit for the political office seeker, power rotation, youth active participation in politics by joining a political party, overhauling the system and condition of service for every political office seeker.
Cost of governance and human development in Enugu State
Authors: Nwobodo Florence Ngozi
Published: March 2024

The study appraised the Cost of governance and Human Development in Enugu State. To achieve these objectives, three research questions were raised while three hypotheses were stated. This study adapted a descriptive survey research design. The study employed secondary and primary sources of data. The population of the study was 1106681. Taro Yamane formula was used to determine the sample size of 400. The collected data was analysed through the use mean score. The z-test analysis technique was applied in testing the hypotheses. The findings revealed that Cost of governance significantly and negatively affected the literacy rates in Enugu State, that cost of governance had a significant negative effect on life expectancy rate in Enugu State and that Cost of governance significantly and negatively affect skill acquisition in Enugu State. The study concluded that cost of governance undermine human development in Enugu State. Notwithstanding to the fact that Human capital development is a critical component of sustainable economic growth and societal progress. The study recommended for prioritizing investments in education, healthcare, and skills development is essential. Allocating adequate funds to these sectors will contribute to the creation of a robust and skilled workforce, fostering human capital development.
Assessment of the UNDP’s humanitarian assistance programme on community development in Lagos State, Nigeria
Authors: Ebenezer Adewole Ajayi , Ogunlela Yemisi , Nwogbo David C. , Zakari Musa
Published: March 2024

The study appraised the United Nations Development Programme (UNDP)’s intervention programmes on community development in Lagos State. Multiple regression analysis, using ordinary least square (OLS) techniques of data analysis will be used to test Hypotheses. OLS techniques of data analysis constitute inferential statistics. The hypotheses will be tested at 5% (percent) level of significance. Finding suggests that UNDP’s humanitarian assistance programme does not significantly enhance community development in the selected communities in Lagos state. The study also revealed that UNDP’s empowerment programme does not significantly enhance community development in the selected communities of Lagos State. The findings of this study highlight the non-positive impact of UNDP programmes on community development in selected communities in Lagos State. Building upon these insights, the following comprehensive recommendations are provided for consideration by UNDP development Partner. UNDP, in collaboration with relevant governmental and non-governmental agencies, should reinforce humanitarian assistance programs. Emphasis should be placed on the development of long-term strategies that address the root causes of socio-economic challenges, ensuring sustained positive impacts on community development. UNDP's women empowerment programmes should be expanded and tailored to address specific challenges faced by women in the selected communities. Efforts should include capacity-building initiatives, promoting entrepreneurship, and fostering gender equality to empower women as key contributors to community development.
Periscoping E-Governance in Nigeria: Matters Arising
Authors: Ebele Nwafor Angela , Chibugo Afuecheta Edigth , Benedicta Umetiti Chidinma
Published: March 2024

The technological trends of our changing world, has changed the world into a global village where every nation including Nigeria is  striving to attain a high level of electronic governance, which revolves around the use of information and communication technology to  deliver technology market in Africa, yet in spite of this, the country is still ranked low in the provision of e-government services to its  citizens. The paper is adopted content analysis technique. The study also evaluated the parameter of E-governancebased on the laid  down guidelines by the United Nations Global E-government Readiness Report. The paper identified and addressed the obstacles and  benefit of e-governance. The paper therefore recommends that Nigeria government should create enabling environment where maintenance culture will be an accepted ethic or norm in public life; there should be effective implementation of ICT at all levels of  education in both urban and rural areas and Principle of the rule of law must be upheld to promote equality before the law.
Biomechanical and physical properties selection of Ti-Ha-CaCO3 biocomposite prostheses for replacement of bone atrophy
Authors: Ibrahim H. K. , Abolarin M. S. , Abdulrahman A. S. , Adedipe O. , Okoro U. G.
Published: March 2024

Traditional prosthetic materials often lack the desired properties to mimic the mechanical behaviour of natural bone, leading to complications and reduced implant longevity. This study aims to conduct a biomechanical and physical properties selection analysis for biocomposite prostheses' suitable for replacing bone atrophy. This involves evaluating the mechanical properties of developed biocomposites with different structures (dense, porous and gradient) to ensure compatibility with the mechanical properties of bone. The radar chart was adopted to compare and evaluate the mechanical strength of various biocomposite implants and identify the most suitable prosthesis for load-bearing bone replacement. The study utilises powder metallurgy, scanning electron microscopy (SEM), and ImageJ software to produce and characterise the pore size distribution of the biocomposites, respectively. The findings of this study revealed the gradient and porous biocomposites exhibited desired mechanical properties with porosity of 20.67 and 27.72 % pore size up to 134 and 256 μm, compressive strength of 174 and 149.29 MPa and compressive modulus of 30.42 and 28.3 GPa respectively. The SEM analysis, coupled with pore size distribution and porosity percentage measurements, offers valuable information for designing and fabricating biomaterials with enhanced properties. The gradient biocomposite was identified to be the best sample for load-bearing bone replacements by the selection analysis because of its high compressive strength and low modulus, which is within the established cortical bone mechanical properties.
Exploring the mechanism of action of Tripterygium wilfordii Hook F in the treatment of rheumatoid arthritis based on network pharmacology and molecular docking
Authors: Luo Feng , Yuan Xue-Mei , Xiong Hong , Huang Cong , Chen Chang-Ming , Ma Wu-Kai , Yao Xue-Ming
Published: March 2024

Purpose: To determine the mechanism of action of Tripterygium wilfordii Hook F (TwHF) in the treatment of rheumatoid arthritis (RA) based on network pharmacology and molecular docking.

Methods: The active constituents and targets of TwHF were screened by searching the TCMSP, TCMIP, PharmMapper database, and BATMAN-TCM platform combined with oral bioavailability and drug-like analysis. The drug-component-target maps were drawn using the UniProt database and Cytoscape 3.9.0 software. The drug-target maps were searched in GeneCards, OMIM, TTD, PharmGKB, and DrugBank databases to obtain the predicted targets of RA, Venn diagrams were drawn to derive the common targets of TwHF components and RA and protein-protein interaction (PPI) network, GO enrichment as well as KEGG pathway analyses were performed. The potential binding activities between the active constituents of TwHF and the targets were predicted using molecular docking.

Results: Seven active components and 131 potential targets were found for TwHF while RA had 4,917 related targets. However, TwHF and RA had 87 common targets. The target genes obtained from the PPI network include tumor necrosis factor (TNF), p53 tumor protein (TP53) and vascular endothelial growth factor A (VEGFA). The GO enrichment and KEGG pathway analysis yielded 336 results and 121 signal pathways, respectively.

Conclusion: Tripterygium wilfordii Hook F therapy for RA may be a multi-component, multi-target and multi-signal pathway biological process, which may regulate VEGFA, TNF, TP53 and other targets and also exhibit anti-inflammatory and immunomodulatory functions amongst others. Future studies should determine the relationship of the identified targets in vivo to produce alternative treatments for RA.
Efficacy of calcitriol in the treatment of patients with renal osteodystrophy
Authors: Jiang Haitao , Tang Xiaoming , Zhang Cheng , Dai Jian , Lu Haiyuan
Published: March 2024

Purpose: To investigate the efficacy and prognosis of calcitriol in patients with renal osteodystrophy (ROD).

Methods: 60 patients with ROD admitted to The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, China between June 2020 and June 2021 were randomly grouped into control (n = 30) and study groups (n = 30). Patients in control group received routine management study group was treated with routine management plus calcitriol. The treatment duration was six months. Serological markers (parathyroid hormone (PTH), calcium (Ca), and phosphorus (Pi)), renal function indices (blood creatinine (SCr), urea nitrogen (BUN), and alkaline phosphatase (ALP)), as well as patients’ skeletal conditions of the spine, pelvis, and extremities were investigated. Additionally, postoperative complications and clinical efficacy were also evaluated.

Results: Study group showed significant improvement in serological markers compared to control group (p < 0.05). Also, study group had significantly reduced SCr, BUN, and ALP levels (p < 0.05) compared to control group. There was significantly reduced incidence of complications and better skeletal conditions in study group compared to control group (p < 0.05).

Conclusion: Calcitriol effectively mitigates blood-bone mechanism dysfunction and reduces the occurrence of complications in patients with ROD. However, factors such as Scr, Hb, and blood pressure affect the clinical efficacy of calcitriol on renal bone disease by mechanisms that will be investigated in the future.
Effect of modified Buyang huanwu decoction on hemorheology, myocardial remodeling, serum soluble CD40 ligand and serum soluble P-selectin in patients with acute myocardial infarctionafter percutaneous coronary intervention
Authors: Li Juanxia , Meng Fanhua , Li Xiaoxu , Zheng Xingrui , Shi Hua , Li Xiaolong , Zhao Haijun
Published: March 2024

Purpose: To investigate the effect of modified Buyang Huanwu decoction on hemorheology and myocardial remodeling in patients with acute myocardial infarction (AMI) after conventional percutaneous coronary intervention (PCI), and its relationship with serum levels of soluble CD40 ligand (sCD40L) and soluble P-selectin (sP-sel).

Methods: After PCI, 80 patients seen from February 2021 to February 2022 in Shijiazhuang Fourth Hospital, China with AMI were enrolled in the study. Subjects were assigned to study and control groups. Control group received standard conventional medical treatments, while study group received modified Buyang Huanwu decoction, in addition to the same standard treatment, orally twice a day (morning and night) for 3 months). The effect of modified Buyang Huanwu decoction was determined by comparing the post-treatment clinical outcomes and levels of hemorheology indices and myocardial remodeling-associated indices (myocardial injury markers) in both groups of patients.

Results: The clinical outcome in study group was significantly better, and the hemorheology indices were significantly improved when compared to control subjects (p < 0.05). Serum levels of myocardial injury markers (cardiac troponin (cTnI), cardiac markers (CRP), and brain natriuretic peptide (BNP)), and inflammatory markers (sCD40L and sP-sel) in study group were significantly decreased to varying degrees, relative to control group (p < 0.05).

Conclusion: Modified Buyang Huanwu decoction reduces inflammatory marker levels, cardiac inflammatory response and myocardial remodeling, and improves the prognosis of AMI in patients after PCI. Therefore, it may be beneficial to develop other methods for treating acute myocardial infarction after percutaneous coronary intervention.
Efficacy and safety of combining ginkgolide diterpene glucosamine injection with dual antibodies in elderly patients with acute ischemic stroke
Authors: Wang Jiaqi , Tan Hong
Published: March 2024

Purpose: To investigate the clinical effects and safety of ginkgo biloba diterpene lactone glucosamine injection, combined with dual antibiotic therapy for acute ischemic stroke in elderly individuals within a hyper thrombolytic time window.

Methods: 100 elderly patients with acute ischemic stroke at Changsha First Hospital, Changsha, China from March 2022 to March 2023 were randomly and equally assigned to study and control groups (50 patients each). Study group received aspirin and clopidogrel, while control group received ginkgo biloba diterpene lactone glucosamine injection along with dual antibodies. Clinical efficacy, National Institutes of Health Stroke Scale (NIHSS) score, Instrumental Activities of Daily Living (IADL) score, cerebral hemodynamics, and safety were compared between the two groups.

Results: There was no significant difference in effective rate between the two groups (p > 0.05). However, following treatment, study group showed superior NIHSS and IADL scores compared to control group, with greater statistical significance as the disease progressed. Doppler ultrasound revealed that study group had smaller Pulsatility index (PI) values and larger mean cerebral artery blood flow velocity (Vm), and systolic value (Vs) compared to control group (p < 0.05). In study group, three adverse reactions were reported (gastrointestinal discomfort, abnormal liver/kidney function, and skin itching), whereas the control group experienced five adverse reactions (gastrointestinal discomfort, abnormal liver/kidney function, dizziness, and skin itching).

Conclusion: The combination of Ginkgo biloba diterpene lactone glucosamine injection and dual antibodies in elderly individuals with acute ischemic stroke within a super thrombolytic time window enhances intracerebral blood flow levels, effectively promotes neurological recovery, improves daily living abilities, and safety. Further research is needed to elucidate the exact pathways involved.
Efficacy of Kirin pill plus vitamin CE and coenzyme Q10 in the treatment of ovarian reserve hypofunction
Authors: Zheng Ling , Liu Kuo , Wang Yue , Mei Hui
Published: March 2024

Purpose: To investigate the efficacy of Kirin pill plus vitamin CE and coenzyme Q10 in the treatment of diminished ovarian reserve (DOR).

Methods: 145 patients with ovarian reserve hypofunction hospitalized in Xiangyang Central Hospital, Xiangyang City, China from March 2019 to March 2022 were recruited and assigned randomly to receive either vitamin CE and coenzyme Q10 (control group), or vitamin CE and coenzyme Q10 plus Kirin pills (study group). The parameters/indices determined include menstrual recovery, clinical efficacy, sex hormone and serum anti-mullerian hormone (AMH) levels, changes in the number of ovarian sinus follicles, and levels of CD3+, CD4+ and CD8+ T cell.

Results: There were no significant differences (p > 0.05) observed among baseline data, pre-treatment sex hormones, serum AMH, ovarian antral follicle count, CD3+, CD4+, and CD8+ T cell levels. After the intervention, administration of the Kirin pill resulted in significantly lower serum follicle stimulating hormone (FSH) and FSH/luteinizing hormone (LH), elevated AMH levels, and better LH and estradiol (E2) levels in patients compared to the administration of vitamin CE and coenzyme Q10 (control group). The study group also showed superior ovarian reserve function and more ovarian basal sinus follicles than the control group (p < 0.05).

Conclusion: Kirin pill plus vitamin CE and coenzyme Q10 treatment regimen optimizes the ovarian reserve function of patients with DOR infertility by improving basal sex hormones, menstrual cycle and menstrual volume, AMH and ovarian basal sinus follicle count. Further clinical trials are required prior to application in clinical practice.