bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Leg Length Discrepancy in Hip Arthroplasty Patients: What is the Amount a Patient Can Accept Without a Limp? How to Avoid Medical-Legal Issues
Authors: Massoeurs S. J. , Leahey J. L. , Elnagar Islam , Leighton Peter , Leighton R. K.
Published: November 2024

Introduction: Leg length discrepancy (LLD) following total hip arthroplasty (THA) is a common occurrence that can spoil an otherwise excellent clinical outcome1,2 as well as have medical-legal ramifications3. Scientifically, the amount of LLD that is clinically significant in THA patients is not well established4,5. The purpose of this study was to determine the relationship between static leg length discrepancy (SLLD) and dynamic leg length discrepancy (DLLD) in total hip arthroplasty patients. We also investigated the correlation between various methods of static leg length discrepancy measurement. Methods: Static leg length was measured by three methods: tape measure from anterior superior iliac spine to medial malleolus, inclinometer (spirit level) measured with the sacrum for flexion of lumbar spine with the knees extended, ortho-roentgenogram. Participants were assessed for dynamic leg length discrepancy during walking using an inertial measurement unit (IMU). The IMU consisted of three tri-axially arranged accelerometers applied to the lumbar region of the spine in order to measure the centre of mass excursion in three dimensions. Data are recorded at 200 Hz for a maximum of 20 seconds. Each participant completed nine gait tests: four walks with modified shoe lifts applied in random order to the operative or non-operative sides of the THA group or alternate sides on controls, and a normal walk with no lift applied to either side. Lift heights were 0.2 cm, 1.2 cm, 2.2 cm, and 3.2 cm Results: Data from the inertial measurement unit was plotted in two dimensions to illustrate dynamic leg length discrepancy. A control with no lift and basically equal leg lengths showing a nice shift and equal heights of the Anterior Superior Iliac Crest (ASIS). A patient with a 1.2 cm lift on the right side, indicates a dynamic leg length discrepancy of 1 cm. A patient with 3.2 cm of lift on the right side, measures a 2.75 cm leg length discrepancy dynamically. Conclusion: Dynamic leg length discrepancy of less than one centimeter is rarely detected by the patient and is quite easily adapted to with a small lift in the other shoe of 80% of the inequality. Dynamic leg length discrepancy of greater than one centimeter (static leg length discrepancy greater than 1.2 cm) usually provides a patient with enough discrepancy that a limp is perceptible. This study emphasizes the need to do careful leg length measurements when performing total hip arthroplasty
Biventricular Reverse (Inverted) Takotsubo/Stress Cardiomyopathy in a Male Patient
Authors: Florea Victor , Malik Awais , Prasad Abhiram
Published: November 2024

This report describes the rare occurrence of biventricular reverse takotsubo cardiomyopathy in a male patient who accidentally rolled his tractor trapping his right leg and left chest for 8 hours before being found. At admission, laboratory studies were remarkable for elevated serum troponin, creatine kinase and lactate levels and for acute kidney injury with hyperkalemia and metabolic acidosis. An echocardiogram demonstrated severe biventricular systolic dysfunction with relative preservation of contractility at the apex of both ventricles. Cardiac catheterization showed mild coronary atherosclerosis. The patient was critically ill and hypotensive, requiring vasopressor support and intravenous fluid replacement. He later became anuric with refractory acidosis and hyperkalemia from acute kidney injury due to rhabdomyolysis. Renal replacement therapy was initiated. The patient ultimately expired to multi-system organ failure. Reverse biventricular takotsubo cardiomyopathy is a rare variant of stress cardiomyopathy. Our case suggests that it likely occurs in the setting of a major physical trigger and is associated with severe hemodynamic compromise requiring intensive management, and associated with poor outcomes.
Integration of Teleradiology and Artificial Intelligence: Opportunities and Challenges
Authors: Kalyanpur Arjun , Mathur Neetika
Published: November 2024

Over the past few decades, radiology has become an increasingly important part of diagnosis and healthcare delivery in general, and correspondingly the burden on radiologists continues to increase with greater imaging volumes and stringent reporting turnaround time expectations, resulting in radiology reporting delays and errors. To bridge the gap, teleradiology has played an important role over the past two decades, but given the mismatch between the dramatically increased utilization of radiologic imaging and the relatively constant number of trained radiologists entering practice, additional solutions are necessary. Teleradiology and Artificial Intelligence have exceptional synergies from the perspective of both being technology enabled healthcare delivery mechanisms that address the same fundamental issue of radiologist shortages. These synergies lead to a multiplier effect in terms of Teleradiology enabling Artificial Intelligence algorithms to be deployed at scale globally over a short time frame to rapidly achieve greater impact than either solution can individually. This article will review the opportunities whereby Artificial Intelligence can further enhance Teleradiology practice, as well as explore the challenges that exist at this time that may potentially delay this process of integration.
The Importance of Non-Governmental Organizations in Response to the Corona Virus Pandemic in Rural Mozambique: A Case Study
Authors: Panos Angelea , Panos Patrick
Published: November 2024

Introduction/Importance: In response to the overwhelming public health demands of the COVID-19 pandemic, many communities were not served due to the shortage of medical supplies and access to healthcare, particularly in developing countries. Consequently, the WHO began an initiative to engage the “untapped resources” of Civil Society Organizations (CSOs)/Non-Governmental Organizations (NGOs) working within various developing and underserved countries. In order to better prepare for future public health emergencies, it is critical to assess the experiences of CSOs/NGOs in responding to the COVID-19 pandemic in partnership with marginalized communities. Objectives of Study: The primary research objectives of this study were (1) Document the challenges that the frontline NGO/community partnerships faced in responding to rural villages’ needs associated with COVID-19 within Mozambique, (2) Document the frontline NGO/community partnership responses in addressing rural villages’ needs associated with COVID-19 in rural Mozambique. Background: This case study examines the NGO Care-for-Life (CFL) within its partnership with rural villages in Mozambique in response to COVID-19. Care-for-Life is one of the few formally recognized NGOs in Mozambique that takes a holistic approach to community development in rural villages. Methods: Data for this study was collected using qualitative methods, including in-depth interviews (26), focus group discussions (5), household surveys, and non-participation observation. Results: Based on household surveys, villages with the CFL/community partnership experienced an approximate 4% increase in overall deaths during the pandemic, while surrounding villages without an NGO/community partnership experienced an approximate 15% increase in overall deaths. The general findings strongly suggest that NGO/CSO/community partnerships can have a significant impact on a community’s ability to respond to a public health emergency. Conclusions: The results of this case study suggest that the use of CSOs/NGOs during a crisis can enhance public health responses in emergencies such as pandemics.
Implementation of Machine Learning to Improve Implantable Cardioverter-Defibrillator Detection Algorithms
Authors: Newell Samuel , Callaway Trenton , Adabag Selçuk , Tolkacheva Elena
Published: November 2024

Background: Sudden cardiac death is a leading cause of death in the US and globally. Implantable cardioverter-defibrillators (ICD) prevent this through electrical therapy, but inappropriate therapy for non-life threatening heart rhythms remains pervasive. Objective: The goal of this study was to improve upon current ICD discrimination algorithms by using supervised machine learning techniques on an annotated database of ICD electrograms (EGM) preceding therapy to discriminate between appropriate (App) or inappropriate (InApp) therapies. Methods: A total of 54 EGMs of therapy events adjudicated by cardiologists were digitized from 49 cases. The signals were analyzed within either a single long window, or four short overlapping windows preceding therapy. The discrimination between App and InApp therapies was done using EGMs recorded over specific windows by separately calculating RR-based and nonlinear dynamic (NLD) based metrics, and creating RR- and NLD-scores, respectively. Linear and quadratic discriminant analysis (LDA and QDA) were then used on the obtained RR- and NLD-scores to predict the App or InApp therapy. These results were then compared to the App and InApp designation by cardiologists. Error rates based on incorrect classifications were used to evaluate the performance of both techniques. Results: We demonstrated that the optimal windows for LDA and QDA can both greatly improve upon modern error rates, with our QDA error going as low as nearly 2% when using an optimal window, as compared to the errors up to 25% found in recent studies. Despite QDA having a lower overall error across all windows, the QDA error came mostly from more dangerous false negatives, whereas the majority of LDA error came from less dangerous false positives. Conclusions: This novel strategy shows promise for use in retrospective discrimination of inappropriate and appropriate ICD therapy events and could improve real time decision making algorithms in ICDs. Additional studies should be completed to assess its utility in real time decision making and case adjudication.
Diagnostic strategy to distinguish non-neoplastic masses of the pancreas from pancreatic cancer
Authors: Mack Sahar , Chartier Suzanne , Frossar Jean- Louis
Published: November 2024

Background: Pancreatic cancer presents a significant challenge in oncology due to its aggressive nature and poor prognosis. Obtaining an accurate diagnosis can be difficult because of the presence of mimicking masses, which may correspond to chronic pancreatitis, pancreatic neuroendocrine tumors, pancreatic pseudocysts, autoimmune pancreatitis, or primary pancreatic lymphomas. The aim of this paper is to understand the distinctive features of these diseases in order to guide appropriate management and improve patient outcomes. Methods: This article reviews the clinical presentation, diagnostic modalities, and differential diagnosis of pancreatic cancer and its mimicking masses. Results: Pancreatic cancer often presents with nonspecific symptoms such as abdominal pain, weight loss, and jaundice. It requires a multidisciplinary diagnostic approach that includes clinical evaluation, imaging, laboratory tests, and, when possible, histological samplings. Mimicking masses such as chronic pancreatitis exhibit overlapping symptoms and imaging features with pancreatic cancer, making histopathological evaluations essential for differentiation. Pancreatic pseudocysts may mimic cancer on imaging but lack malignant potential, often resolving spontaneously or requiring a minimally invasive drainage procedure. Pancreatic neuroendocrine tumors, characterized by hormone secretion and distinct histological patterns, require specialized imaging modalities and tissue biopsy for accurate diagnosis. Autoimmune pancreatitis and primary pancreatic lymphomas present diagnostic challenges due to their autoimmune and lymphoproliferative symptoms, respectively, necessitating a combination of serological, histopathological, radiological and molecular analyses to obtain a definitive diagnosis. Conclusion: Multidisciplinary approach integrating clinical expertise, advanced imaging techniques, and molecular diagnostics are crucial to diagnose pancreatic cancer and its mimicking masses. A good understanding of distinctive features can help for an accurate diagnosis and guide optimal management strategies. Continued research efforts are warranted to enhance diagnostic precision, identify novel biomarkers, and improve therapeutic outcomes for patients affected by these challenging conditions.
Insulin Impact in Glaucoma Neurodegeneration and Vascular Dysfunction
Authors: Boudghene Amine , Bouabdallah Abderrazak , Belbachir Kaoutar
Published: November 2024

Neurodegeneration in glaucoma remains a significant challenge, even with efforts to lower intraocular pressure (IOP). Many patients continue to experience visual field loss. This review will highlight the role that insulin signalling plays in neurodegeneration and also in vascular dysfunction. Neurodegeneration glaucoma and Alzheimer's disease (AD) share many identical characteristics, deposits of beta-amyloid, cell apoptosis, Tau hyperphosphorylation, NFT formation, and mitochondrial dysfunction with elevated OS. Vascular autoregulation in glaucoma is abnormal with a high level of endothelin-1 (ET-1) and impaired nitric oxide (NO) signaling. There is insulin resistance by an increase of serine of insulin receptor -1 phosphorylation (p(ser)IRS-1) instead of tyrosine –IRS-1 phosphorylation (p (Tyr) IRS-1) causing alteration in insulin signaling. C-peptide presence in the brain and insulin detection in neuron culture reinforce the evidence of insulin central secretion. In this review, we will see the capacity of insulin intravitreal injection to promote visual function, restore the balance between NO/ET-1 secretions, and ameliorate neurite outgrowth and function.
Risk of COVID-19 reinfection and its severe complications in adults treated with long-term opioids for chronic non-cancer pain
Authors: Tuan Wen-Jan
Published: November 2024

Since December 2019, over 770 million cases and over 6.9 million deaths attributed to SARS-CoV-2 infection have been reported globally. 1 The pandemic has disproportionately affected populations impacted by chronic health issues, including people with chronic non- cancer pain. 2,3 Research has shown the COVID-19 pandemic increased the burden of chronic pain, with worsened social isolation, economic stress, anxiety, and disrupted access to pain management contributing to this distress. 2,4,5 Pharmacological treatments, including long-term opioid therapy (LTOT), are a part of standard of care in chronic non-cancer pain, 6,7 with an increase in opioid medication use for managing chronic pain noted likely in compensation for stopping physical/psychological treatments due to the pandemic.
Adult Day Center Use among Older Mexican Americans with Dementia in California and Texas
Authors: L. Angel Jacqueline
Published: November 2024

Background. Dementia is one of the most common causes of disability and dependence in the world and is a frequent reason that older people require supportive living arrangements. Providing such arrangements on a broad scale will require a broad public dialogue and insights from social science, especially with respect to the neediest, who suffer from a profound gap in access to care. New and innovative social policy, in line with Recommendation #10 of the European Society of Medicine Policy Framework Reducing the Burden of Neurodegenerative Diseases in Europe and Beyond, is vital. The current study offers insights based on dementia care for Latinos in California and Texas, a population with a high incidence of the disease and few low access to resources. Objective. This study investigates how a growing number of Latino families use adult day care services. We focus on California and Texas, the two states with the largest Latino populations of Mexican origin with dual-eligible (Medicare and Medicaid) beneficiaries. Methods. We employ the 2015 Hispanic Established Epidemiologic Studies of the Elderly to compare the socioeconomic characteristics of Mexican Americans 80 and over who are day care service users living with and without dementia in both states (n = 406). Logistic regressions are used to determine the likelihood of participation in adult day care programs in both states by insurance status. Results. Compared to California, restrictive income eligibility requirements in Texas limit participation in adult day care despite a higher need for care. Multivariate analyses reveal that foreign-born dual-eligibles in Texas are particularly dependent on family, to provide dementia caregiving in comparison to the native born; they do not report using adult day health services. Conclusion. The paper ends with a discussion of viable policy options for promoting equity in access to affordable and sustainable adult day health centers as well as other community-based long-term care services in Texas and California. A multi-faceted approach is necessary and must involve all levels of government, as well as private and charitable organizations.
The Role of Inclusivity in DEI Initiatives: Cultivating an Inclusive Clinical Learning Environment for All
Authors: Smith Teresa , Esmay Katherine , Terhune Esmay , Caniano Donna
Published: November 2024

Many U.S. academic medical centers, medical societies, and accreditation bodies are committed to continuing initiatives of recruiting a diverse workforce. It is this focus of DEI that is often weighted towards diversity recruitment within undergraduate and graduate medical education. These recruitment initiatives result in an influx of an underrepresented in medicine (UIM) physician workforce into clinical learning environments that may not reflect inclusivity. The authors provide a brief introduction to the topic of inclusion, discuss its importance in the clinical environment, and suggest ways that medical education leaders can incorporate the tenets of inclusion into their curriculum and training. There are harms to having an exclusionary clinical learning environment that impact the clinical performance and well-being of all learners, particularly those coming from UIM backgrounds. There are also clear benefits to creating inclusion practices, however, there must be intention and strategic planning to work towards solutions to creating a safe, inclusive environment for all.
REVIEW ARTICLE Review of Glucagon-Like Peptide 1 and Glucose-Dependent Insulinotropic Polypeptide Agonists for Treatment of Adult Obese Patients with Obstructive Sleep Apnea
Authors: Seda Gilbert
Published: November 2024

Although there are multiple risk factors for obstructive sleep apnea, obesity is a significant actionable risk factor that is increasing worldwide. Studies have shown that weight loss whether through bariatric surgery or medications is associated with improvement in obstructive sleep apnea severity. This review summarizes the underlying mechanisms of glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide receptor agonists pertaining to weight loss and then summarizes the studies which show beneficial effects on weight loss in obese adults with or without diabetes. We then review the available studies showing a reduction in obstructive sleep apnea severity in adult patients with obesity primarily through weight reduction. Potential limitations and implications of treatment with these medications for obstructive sleep apnea will be reviewed.
TeleHD: Establishing feasibility, validity, and value of telemedicine in Huntington’s disease
Authors: Deliz Juan , Lancki Nicola , Bega Danny , Larson Danielle
Published: November 2024

Objective: To demonstrate the feasibility of conducting telemedicine visits, establish the validity and reliability of tele-administered motor/non-motor assessments, and determine the satisfaction of virtual visits for individuals with Huntington disease (HD). Background: Telemedicine has become a prevalent method for patients to interact with their healthcare providers. Patients with HD often cite time and travel burden as significant barriers to receive care in HDSA centers of excellence. TeleHD studied the applicability of telemedicine in a specialized HD clinic at a large urban center. Methods: Individuals aged 18 to 70 with genetically confirmed HD, MoCA score >26, and a smartphone or computer were enrolled. Participants completed 2 pairs of in-person clinic and televisits 1 month apart, completing all 4 visits within a 9-month time frame. Validity of tele-administered composited Unified Huntington's Disease Rating Scale (UHDRS) component of Total Motor Score (TMS), Total Functional Capacity (TFC) Score, Symbol Digit Modalities Test (SMT), and Stroop Color and Word Test (SCWT) was assessed by measuring the strength of the association with clinic-administered scales using Pearson correlation coefficients. Intraclass correlation coefficients (ICC) were calculated to assess cross-sectional reliability and agreement between in-person and tele-administered scales. The value of televisits was assessed with a Satisfaction Survey and Resource Utilization Survey. Results: Thirty-one participants were enrolled. 55% completed all study visits. The cross-sectional correlations for TMS and mTMS at visits 1 and 2 were very high (r=0.95 and r= 0.98), respectively with p<0.01. Similarly high correlations were observed for cognitive tests including TFC, SWRT Word and Color and SDMT (r >0.8, p<0.01), but were lower for Color-Word and Interference. ICCs showed excellent agreement for TMS and mTMS, TFC, SCWT-Color, SCWT-Word, and SDMT. Ten participants completed the satisfaction and utilization surveys. Conclusions: The results failed to meet the pre-defined measure of feasibility (80% completion of both telehealth visits). Nonetheless, there was evidence of strong validity and reliability of tele-administration of multiple assessment scales, including administered modified TMS, TFC scale, and cognitive assessments SWCT and SDMT. Respondents to the satisfaction and utilization surveys (N=10) were either satisfied or very satisfied with televisit convenience, comfort, and care.
Impact of the United States Supreme court Dobbs versus Jackson Health Women’s Organization Decision on Abortion Curricula in United States Medical Schools
Authors: Famy Alyssa , Fleming Angela , Baecher-Lind Laura , Bhargava Rashmi , T. Chen Katherine , Morgan Helen , Morosky Christopher , Royce Celeste , Schaffir Jonathan , Sims Shireen , Sutton Jill M. , Sonn Tammy , Education The Undergraduate
Published: November 2024

This study investigated the effect of the reversal of Roe versus Wade, with the 2022 United States (U.S.) Supreme Court Dobbs1 decision, on medical school reproductive health curriculum in U.S. An electronic survey was distributed to 248 U.S. medical school obstetrics and gynecology clerkship directors in March 2023 to assess faculty demographics, reproductive health topics included in medical school curriculum and challenges in abortion education after Dobbs. One hundred forty-eight faculty completed the survey (60% response rate) from 40 states and the District of Columbia; 45% of respondents were from states with abortion restrictions in the first and second trimesters. There were no significant changes in curricular content during the months following Dobbs. Thematic analysis of text responses indicates concerns about legal implications of teaching, state audits and restrictions on materials, as well as limits on abortion education in medical schools in states with restrictive abortion laws, even prior to Dobbs. PRECIS: In the months following the Dobbs decision, there was no change in abortion curricula in pre-clerkship courses or Obstetrics and Gynecology clerkship in U.S. medical schools.
Adolescents who Promote Family Discussion about Organ Donation may Influence Kidney Donation Rate
Authors: Trompeta Dr. Joyce
Published: November 2024

N/A
Empowering Underrepresented Researchers Through Effective Writing Support
Authors: Elliott Bethtrice , Mehravaran Shiva , Hohmann Christine
Published: November 2024

Background: Effective writing support is crucial for enhancing research competitiveness, particularly at Historically Black Colleges and Universities (HBCUs), where faculty face significant challenges such as high teaching loads and limited research resources. These barriers often hinder research productivity, particularly in biomedical and STEM fields, which are critical for addressing health disparities. To address these challenges, Morgan State University, a midsize HBCU, implemented a series of grant-writing workshops (GWWs) and Scientific Writing Accountability Groups (SWAGs) to enhance faculty research capabilities. Aims: The goal of this study was to assess their effectiveness in terms of increasing writing confidence among participants and increasing grant submission rates and research productivity among early-career and tenure-stream faculty. The workshops were particularly focused on helping faculty develop competitive NIH-style research proposals. Methods: The GWWs and SWAGs provided structured, hands-on coaching for proposal and manuscript writing. The GWWs focused on teaching key grant-writing skills, such as formulating research questions, designing studies, and writing proposals. Meanwhile, the SWAGs supported ongoing writing accountability, encouraging participants to develop consistent writing habits and providing peer feedback. Participants’ progress was assessed through pre- and post-workshop surveys that measured confidence in writing tasks, as well as tracking grant submissions and funding outcomes. Results: Since 2019, five series of GWWs and four SWAG sessions have been held, leading to significant gains in self-efficacy and productivity. Participants in the GWWs reported improved confidence in tasks such as formulating research questions, conducting literature reviews, and writing proposals. Those involved in accountability groups reported improved writing habits and progress on manuscripts, grants, and other academic projects. Overall, these programs contributed to a 78% grant submission rate among attendees, compared to 55% for non-attendees. A total of 174 proposals were submitted, resulting in over $84 million in funding. Conclusion: The workshops and accountability groups were highly effective in enhancing faculty research productivity and grant success. These initiatives demonstrate the value of providing structured writing support at under-resourced institutions, particularly HBCUs, to build a more competitive and diverse research workforce. The success of these programs highlights the potential for similar models to be implemented at other minority-serving institutions to address health disparities and foster academic excellence.
Effects of the COVID-19 Pandemic in Patients with Systemic Autoinflammatory Diseases. An international survey
Authors: Nazzar S , Moorthy L. , Tousseau Jennifer , Lapidus Sivia , Mansfield Leanne , Twilt Marinka , Schulert Grant , Gutierrez Maria , Angevare Saskya , Durrant Karen , Dedeoglu Fatma
Published: November 2024

Background: Early in the COVID-19 pandemic it was recognized that individuals who had worse prognoses had hyperinflammatory reactions associated with SARS CoV-2. This was worrisome for patients with systemic autoinflammatory diseases (SAID) who already have episodic hyperinflammation at baseline. Aim: To assess the effects of the COVID-19 pandemic and SARS CoV-2 infection on patients with SAID. Methods: An anonymous survey developed on the Survey Monkey platform was distributed online through social media and support groups of patients with SAID between January 20th and May 17th of 2021. Results: We analyzed 484 surveys that conveyed data from 593 patients with SAID. Seventy-four percent of the surveys were answered in the United States, US territories, and Canada (n=360/484) and the rest from other countries. Sixty percent (n=330/547) of patients with SAID did not experience changes in the frequency of flares during the first year of the pandemic. Ten percent (n=52/545) of patients had presumed or confirmed COVID-19. Of those, 81% (n=42/52) had mild and moderate symptoms and 4 were hospitalized. Thirty-one percent (n=16/52) experienced flares during or after the infection and 40% (n=21/52) reported post-COVID manifestations. The individuals who had moderate symptoms or were hospitalized for COVID-19 were more likely to report post-COVID manifestations, OR 5.25 (95%CI 1.57-17.6, p=0.0072). Post-COVID integumentary manifestations occurred after asymptomatic and mild COVID-19 whereas neurologic manifestations occurred after acute COVID-19 with moderate symptoms or requiring hospitalization. Conclusion: During the COVID-19 pandemic, over half of patients with SAID did not experience changes in the frequency of flares despite a decreased exposure to environmental triggers. Few individuals with SAID required hospitalization for COVID-19. The presence and type of post-COVID manifestations were associated with the severity of acute COVID-19 in patients with SAID.
Investigation of the Relationships Between Digital Games and Neuropsychological Test Scores and Cognitive Functions
Authors: Gunuc Selim , Koylu Ersin
Published: November 2024

This study aimed to examine the relationships between digital games and neuropsychological test scores (card sorting, verbal memory and digit span tests). The study was designed using the descriptive cross-sectional research method. Data were collected from a total of 117 volunteering university students at a state university. Of all the participants, 66.9% of them were women, and 33.1% were men. The mean age of the participants was calculated as 21.3 years. In the study, demographic variables were determined, and data on games were collected from the participants. In addition within the scope of neuropsychological tests, Wisconsin Card Sorting Test, Öktem Verbal Memory Processes Test and Digit Span Test were used. The results of the study revealed that the neuropsychological test scores did not show a significant difference in terms of digital game players/non-players and game types.
The Revolutionary Role of GLP-1 Agonists and SGLT-2 Inhibitors in Managing Diabetes and Chronic Kidney Disease in Liver Transplant Recipients
Authors: Chakkera Shankar , Carey Elizabeth
Published: November 2024

Successful liver transplant is the only life-saving intervention for patients with end-stage liver disease, but post-transplant complications, particularly diabetes mellitus and chronic kidney disease, significantly compromise both patient and graft survival. These complications not only heighten clinical and economic burdens but also worsen long-term outcomes due to the rising prevalence of metabolic syndrome, which predisposes many liver transplant recipients to metabolic dysfunctions like diabetes and chronic kidney disease. Additionally, metabolic syndrome is a key driver of Metabolic Associated Steatotic Liver Disease, a leading cause of liver failure and a growing indication for liver transplantation worldwide. While liver transplantation resolves end stage liver disease, it fails to address the underlying metabolic challenges, such as pre-existing or post-transplant diabetes and chronic kidney disease. The use of calcineurin inhibitors ,a cornerstone of immunosuppression, exacerbates these issues by disrupting glucose metabolism, increasing insulin resistance, and causing pancreatic beta-cell dysfunction, which further contributes to post-transplant diabetes mellitus. Post-transplant diabetes mellitus is associated with increased morbidity, mortality, and graft rejection, underscoring the need for improved management strategies. Emerging therapies, such as GLP-1 receptor agonists and SGLT-2 inhibitors, have shown promise in mitigating the effects of diabetes and chronic kidney disease in non-transplant populations. These agents offer potential benefits for liver transplant recipients by improving glycemic control, promoting weight loss, and offering renal protection. However, their application in liver transplantation remains underexplored, with limited clinical data available. This review explores the pathogenesis of diabetes and chronic kidney disease in liver transplant recipients, the challenges posed by current immunosuppressive regimens, and the potential role of GLP-1 agonists and SGLT-2 inhibitors in improving patient and graft outcomes. Future research is essential to optimize post-transplant care and reduce the burden of metabolic complications in liver transplant recipients.
A patient with Tuberculous para-valvular leak and tuberculous hepatic abscesses treated conservatively with anti-tuberculous medication without the need for surgical intervention. “Case report”
Authors: Tayeb Areeg , Ahmed Mohammed , Abdelrahim Walid
Published: November 2024

Introduction: We report a case of a young lady with rheumatic heart disease who underwent mechanical prosthetic mitral valve replacement and tricuspid valve repair. The case was complicated after one year by multi system tuberculous abscesses, para-valvular leak and hemolytic anemia. Case summary: The case started one year following mechanical prosthetic mitral valve replacement, and after contact with a tuberculous patient. The lady developed, sterile pyuria, two tuberculous hepatic abscesses, and a big pelvic tuberculous abscess. She first needed percutaneous drainage for the pelvic abscess followed by laparotomy and surgical drainage after recurrence. The case was complicated by Para-valvular leak in the prosthetic mitral valve detected by Transoesophageal echocardiography as well as refractory hemolytic anemia needing multiple transfusions. She required six months of anti-tuberculous therapy for the hemolysis to stop. Treatment continued for a total of one year of anti-tuberculous therapy. The patient restored normal valve dynamics and hematological parameters without the need for surgical intervention for the para-valvular leak. Conclusion: We report this case to show that small tuberculous para-valvular leak and hemolytic anemia as well as tuberculous hepatic abscesses can be treated medically as an alternative option to the well-known and recommended surgical indication. We also confirm delayed healing of the abdominal surgical wound due to tuberculosis.
Laboratory Manual of Immunohistochemistry
Authors: Gogoi MD Dr. Gayatri
Published: November 2024

Immunohistochemistry (IHC) is an indispensable ancillary technique for tissue diagnosis which enhance, support to correlate and to confirm histopathology report in great variety of situations. No histopathologist will fully affirm a case of soft tissue tumours origin unless supported by immunohistochemical markers study. There are automated solutions available for high case load hospitals but it is costly and not sustainable for all laboratory set ups due to lack of affordability and lower number of histopathology sample load.

So economically viable and sustainable solution for small laboratory or educational institutions for academic/training purpose is a manual method of immunohistochemistry. Exclusive and detailed training and meticulous technical skill of laboratory procedure can ensure good immunohistochemistry (IHC) result which can be undertaken by technical staffs and PGTs for thesis purpose.

This publication briefly covers scope of IHC, applications in different diagnostic and prognostic situations. It also highlights how to trouble-shoot in failure of staining, inconsistent situations. It also throws light to ensure quality control in pre testing to during the testing procedure. To improve better understanding, one chapter is dedicated to interpretation of staining in different cellular components with photographs and application of common antibody panels. This handbook consists of practical aspects of IHC in a step-by-step manner so that laboratory professionals have ready to refer material available with them.

This is a guide book for trainee laboratory technology students (DMLT, B.Sc, M.Sc), Post Graduate students of Pathology as well as Practicing Laboratory Professionals of low resource laboratory.
Practical Book of Community Pharmacy and Management for the Students of D.Pharm 2nd Year
Authors: Gupta Dr. Revathi A , Pachore Archana , Mahajan Vinay
Published: November 2024

The "Practical Book of Community Pharmacy and Management" is designed to align with the Pharmacy Council of India's (PCI) syllabus, providing comprehensive guidance on the practical aspects of community pharmacy. Here's an overview of the key areas typically covered in such a book Understanding the role and importance of community pharmacy in the healthcare system, structured practical details to assess competency in various tasks and analysis and discussion of case studies to develop problem-solving skills. This practical book serves as a comprehensive guide for pharmacy students, providing the necessary skills and knowledge to excel in community pharmacy practice and management.
Paradigms in periorbital scar management
Authors: Sheoran Khushboo , Chawla Urmil , Srivastava Divya , Khurana Ashok Kumar , Maurya Rajender Prakash , Gupta Reena , Anand Neebha , Khurana Bhawna P , Yadav Deepshikha
Published: November 2024

Periocular scarring following surgery or trauma is of great aesthetic and functional concern and is difficult to predict. In today’s era, with increasing scientific knowledge and technological advances, both physicians and their patients are highly concerned with minimizing scar appearance as a rising number of patients feel disappointed with their scars and are frequently seeking help for functional and aesthetic improvement. Although various non-surgical and surgical treatment strategies are available it is still difficult to improve excessive scarring. Thus, the importance of thorough knowledge of eyelid anatomy and heal­ing mechanisms along with appreciation of wound closure techniques like placing the sutures at natural cosmetic subunit junctions and along relaxed skin tension lines (RSTLs) in order to achieve scar camouflage and to ensure decreased tension on the wound cannot be more emphasised. Periorbital area should be tackled by the oculoplasty surgeons in view of their distinct anatomy and close proximity to the eye.

Scars are commonly treated with a combination of non-surgical techniques, including watchful waiting, scar massage, pressure therapy, silicone gel sheeting, topical or intralesional injections, cryotherapy, laser therapy or radiotherapy. Surgical approaches include pincushioning debulking, direct scar excision, broken line closure techniques, scar lengthening procedures (Z plasty, V-Y/Y-V advancement) and scar excision with lid reconstruction. Mastery of this content is essential for consistent operative success. For good cosmetic and functional outcomes, scar revision techniques should be thoughtfully tailored to the individual and scar subtype.
Eye on impact: An analysis of blunt ocular trauma cases at a tertiary eye care centre in South India
Authors: Pani Sachidananda , Sharat Soumya , B Poornima Raj , l J Mohammed Sohai
Published: November 2024

This study investigates the epidemiology, injury mechanisms, and clinical features of blunt ocular trauma. It aims to assess the prevalence of these injuries and the extent of vision loss among patients at a tertiary eye care center in South India.

A retrospective observational study was conducted at a teaching hospital over four months, from June 2024 to September 2024. The study included 417 patients of all age groups who visited the outpatient department of a tertiary eye care center after experiencing blunt ocular trauma. Data were collected on the cause and circumstances of the injury, injury mechanism, clinical features, management, and visual outcomes.

This study included 417 patients, with the majority falling into the 21–30 year age group. Men had a higher rate of eye injuries than women, and the most common cause of injury was road traffic accidents (35.97%). The predominant type of ocular injury was closed globe injuries, with an incidence of 95.92%. Additionally, 17.2% of the patients required surgical intervention.

Most blunt ocular trauma is caused by road traffic accidents, followed by physical assaults, with young men being the most affected. This underscores the need for preventive measures, such as wearing helmets and avoiding driving under the influence of alcohol, to reduce the incidence of these injuries. Public awareness campaigns can play a vital role in promoting safety and protecting vulnerable populations.
Contact lens adoption and associated knowledge among the general population of South Gujarat, India
Authors: Varshney Ankitkumar Sanjaykumar , Thakor Kartik P , Patel Chetna Suresh , Chauhan Mahendrasinh Dolatsinh
Published: November 2024

: Contact lenses have emerged as a popular alternative to spectacles, offering users enhanced vision correction, cosmetic appeal, and improved quality of life. However, awareness of contact lens care, hygiene, and complications remains a concern, particularly in regions with limited access to proper education on lens use. This study aimed to assess the level of knowledge, awareness, and practices related to contact lens use among the general population of South Gujarat, India.

: A cross-sectional study was conducted using a structured online questionnaire administered to 1,500 participants. The questionnaire covered demographics, awareness of contact lens types, usage patterns, hygiene practices, and knowledge of potential complications. Data were analyzed using SPSS software, with chi-square tests used to determine statistical significance.

: The study revealed that 60% of participants had some awareness of contact lenses, but only 30% demonstrated "extreme" awareness. Most participants used contact lenses for vision correction (65%), followed by cosmetics (30%). Adherence to recommended hygiene practices was variable, with only 56% consistently using contact lens solutions. Furthermore, 21% of users experienced discomfort while wearing lenses, and the dropout rate within the first six months was 28%.

: There are significant gaps in knowledge and adherence to contact lens care, especially among younger users. Educational interventions focusing on hygiene practices, replacement schedules, and proper lens care are crucial to reducing complications and improving user experience.
Outcomes and complications of cataract surgery using phacoemulsification in eyes with and without pseudo exfoliation syndrome
Authors: Sharma Malvika , Sharma Nancy , Khurana Dhruval Ashok , Reddy Sandeep
Published: November 2024

Cataract remains a significant cause of visual impairment globally, with pseudo exfoliation syndrome (PEX) posing additional challenges for cataract surgery. This study aimed to compare outcomes and complications in patients with and without PEX undergoing phacoemulsification for senile cataract.

A total of 70 patients were divided into two groups: PEX (Group 1) and non-PEX (Group 2). Surgical procedures were performed, and outcomes were evaluated.

Group 1 exhibited smaller pupil diameter and higher rates of advanced cataracts and intraoperative complications. Despite similar postoperative parameters, Group 1 showed increased inflammatory response and poorer initial visual recovery.

Tailored management strategies for PEX patients undergoing cataract surgery are warranted.
Effectiveness of coatings in reducing biofilm adhesion on arch wires: A systematic review
Authors: Chaudhari Rhujuta Vinayak , Jain Anchal Anil , Ravindranath V K  , Gheware Anjali , Mhatre Amol , Mhatre Amol
Published: November 2024

To evaluate the Effectiveness of coatings in reducing biofilm adhesion on arch wire.

A literature search was performed on PubMed, Medline, Google Scholar, and Science Direct to examine studies that compared the uncoated group of arch wires to those with nano coatings and assessed the anti-adherent property. After extracting the data from each study, two risk of bias assessment tools were employed and tabulated data was obtained.

8 Studies met the requirements for inclusion. For majority of the included articles, the risk of bias assessment indicated a low to moderate risk. The antibacterial properties of various nanoparticle coatings were examined and evaluated.

Regardless of patient compliance, a proper application of each type of coated arch-wire can help prevent white spot lesions and reduce bacterial aggregation around orthodontic attachments. Majority of the studies that made up this systematic review have a risk of bias grade of "fair." A meta-analysis was not feasible because of heterogeneity in the different coating techniques used to test the antibacterial property.
A comparative evaluation of the displacement and stress distribution of Kilroy spring, ballista spring and temporary anchorage devices during traction of palatally impacted canine using a 3 dimensional finite element analysis
Authors: Jena Sanghamitra , Maikhuri Bhumika , Sahoo Nivedita , Dash Bhagabati Prasad , Mohanty Biswaroop
Published: November 2024

The above study comprises a comparative evaluation of the displacement and stress distribution of Kilroy spring, Ballista spring and Temporary anchorage devices during traction of palatally impacted canine using a 3 dimensional finite element analysis. Palatally impacted canine is a common phenomenon occuring in around 8% of individuals. The Finite Element Analysis/Finite Element method (FEA/FEM) is the most intricate and dependable study that significantly revolutionized the world of dentistry and biomechanical research. Stresses and displacements can be precisely located using this type of numerical analysis. The orthodontist can better comprehend the physiological reactions that take place within the dentoalveolar complex because of the quantitative information it gives them.

A Cone Beam Computed Tomography (CBCT)scan of the maxilla was obtained from a patient who reported to the Department of Orthodontics and Dentofacial Orthopaedics after he satisfied the inclusion and exclusion criterion. Finite element 3-D models of Kilroy spring, Ballista spring, Cantilever spring, miniscrew, lingual button, 0.022-inch-slot brackets, 0.019x0.025-inch SS archwire, stainless steel bands with molar tubes were constructed using a three-dimensional computer-aided design program (SolidWorks 2017; Solid Works K.K., Tokyo, Japan). All these components were imported and individually assembled in the ANSYS Software (Version 2021 R2, ANSYS, Canonsburg, Pa) and stress analysis was carried out. On the basis of this study following conclusion were drawn: The maximum amount of impacted canine displacement, with initial simulation, wasobserved with Kilroy spring followed by Ballista spring and miniscrew assisted Cantilever spring and the maximum amount of displacement of adjacent teeth i.e. lateral incisor and 1st premolar is observed with Ballista spring followed by kilroy spring and miniscrew assisted Cantilever spring. Furthurmore stress concentration on the canine is highest in case of ballista spring followed by Kilroy spring and miniscrew assisted Cantilever spring. Over all, miniscrew assisted Cantilever spring can be an efficient treatment option for traction of a palatally impacted canine.