bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of Dielectric Properties and Structural Changes in XLPE Composite Insulation of Covered Conductor due to Thermal Aging
Authors: Camalov Mehti , Bagirli Elmir , Aliyev Hikmet
Published: March 2024

Investigating the dielectric characteristics and structural alterations in XLPE composites, commonly employed in the insulation of covered conductors, stands as a pivotal research focus. In this study, we examined the variation in dielectric loss (tanδ) concerning frequency and voltage, influenced by thermal aging in XLPE insulation. To achieve this, the samples underwent aging at 120°C for six periods, a total of 450 hours. Furthermore, we conducted PD tests, FTIR, and SEM assessments on the insulation both before and after the aging process. A comprehensive analysis of the material's property changes during thermal aging was performed by comparing the PD test results with the tanδ measurements. In order to delve deeper into the interpretation of these findings because of thermal aging, we explored both internal and surface structural modifications, which directly impact tanδ and PD values, utilizing FTIR and SEM techniques.
Investigations on Varying Compositions of Nylon 6 Polymer Matrix Composites for Wear Reduction in Application to Gears
Authors: Karthi V , Raj N. Mohan , Baskaran J
Published: March 2024

In power transmission systems, gears are the most essential parts. Gear failure would happen at any regular working cycles and it must be avoided with special care. The mode of failure suggests that optimum material and suitable post processing has to be done. Industry demands more efficient, reliable, and lightweight gears. Hence more efficient, reliable, and lightweight gears must be developed and manufactured. Eventhough lot of investment is being done on research and implementing new technologies while manufacturing gears, stills some failures is arised. Many physical factors, including the inappropriate materials composition, may induce gear failure. In this paper, some typical diverse materials, like nylon 6 and glass fibers are mixed with various volume proportions to enhance wear resistance and improve gear’s life. Polymer gears developed in this study offer more superior life than pure nylon gears. All the prepared specimen samples are tested to a variety of studies including Tensile, Compression, Flexural, Impact, TGA and Wear tests. Depreciation is not reducing low, however. 90% nylon 6 + 10 % Glass fiber to 10% nylon 6+ 90Glass fiber 10 % Nylon 6 has mixed for investigation. Based on the investigation, 70% of Nylon 6 + 30% glass fiber has high strength, low wear, and high wear resistance.
Steel Boiler Tube with HVOF Coating: Peculiarity and Interfacial
Authors: Mohan P. , Ram K. Hari , Jenaris D.S. , Abraham D.S. Manoj , Raj R. Rethan
Published: March 2024

In this research, a NiCrMoFeCoAl-30%Cr3C2 composite finish was deposited using an HVOF technique on the T22 bare steel. Cr3C2 coatings provide excellent durability and corrosion resistance. When manufacturing homogenous and dense Cr3C2 layers with decreased as-deposited greater hardness, surface roughness, and enhanced quality corrosion resistance, high-velocity oxy-fuel spraying with suspension feedstock has been a viable choice. Scanning electron microscopy with energy dispersive spectroscopy and X-ray diffraction have been used to examine the specimen's microstructure. Coating properties such as thickness, microhardness, and porosity were measured.
Analyze the Seed Quality of Capsicum annum (Clv. GROSSUM) by Maintaining an Optimum Number of Fruits Load in the Plant
Authors: Dilrukshi W. M. D. , Dahanayake N. , Balasooriya A. S. , Priyadarshana U.
Published: March 2024

Capsicum annum, commonly known as bell pepper, belongs to the Solanaceae family, specifically the Grossum Group. Various cultivars of this plant yield fruits in diverse colors, such as red, yellow, orange, green, white, and purple. The quality of Capsicum annum seeds is closely tied to the quantity of fruits produced. It was observed that as the number of fruits per plant increases, the seed quality tends to decrease. The primary objective of this study was to examine the relationship between seed quality and the number of fruits per plant. Awareness of the optimal fruit yield achievable with high-quality seeds can reduce the cost associated with hybrid seed production. The study utilized fruit development in plants as the treatment, with fruit load categories ranging from 8–9 fruits/plant to more than 18 fruits/plant. A completely randomized design with ten replicates was employed, and hand pollination of Capsicum annum exhibited a success rate of 75–80%. Various parameters, including the dry weight of seeds per pod, seed number per pod, seed volume, dry weight of 1000 seeds, seed germination, and viability percentage, were recorded. While the number of seeds per pod, seed germination, and viability percentage remained unaffected by the fruit load of plants, other selected parameters were influenced. The seed volume was recorded as the number of seeds per gram, with the lowest value considered the best. The treatment with 13–15 fruits/plant demonstrated the highest number of fruits and the best seed quality. Observations indicated the following values for this treatment: dry weight of seed per pod (0.533g), seed number per pod (86 seeds), seed volume (147 seeds), dry weight of 1000 seeds (7.45g), seed germination percentage (85%), and viability percentage (86.33%). For Capsicum annum (Cultivar: Grossum), it is recommended to maintain 13–15 fruits per plant in a greenhouse setting to ensure the production of high-quality seeds.
Pyronaridine combined with diminazene aceturate inhibits Babesia in vitro and in vivo
Authors: El-Sayed Shimaa Abd El-Salam , Sayed-Ahmed Mohamed Z. , Ali Shaimaa Ahmed Awad , Alsadaan Nourah , Alam Nawazish , Alkhoudary Mahmoud S. , Igarashi Ikuo , Rizk Mohamed Abdo
Published: March 2024

Objective:

To evaluate the combination therapy of pyronaridine tetraphosphate and diminazene aceturate against Babesia in vitro and in vivo.

Methods:

Bioinformatic analysis was performed using atom pair fingerprints. An in vitro combination test was performed against Babesia bovis and Theileria equi. Moreover, the in vivo chemotherapeutic efficacy of pyronaridine tetraphosphate in combination with diminazene aceturate was investigated against the growth of Babesia microti in mice using a fluorescence inhibitory assay.

Results:

Pyronaridine tetraphosphate and diminazene aceturate exhibited nearly similar molecular weights. The in vitro combination of pyronaridine tetraphosphate and diminazene aceturate was synergistic on Babesia bovis and additive on Theileria equi. In addition, 5 mg/kg pyronaridine tetraphosphate combined with 10 mg/kg diminazene aceturate inhibited Babesia microti growth significantly compared with those observed after treatment with 25 mg/kg diminazene aceturate alone from day 6 post treatment to day 12 post treatment. The combination therapy also normalized the hematological parameters of infected mice.

Conclusions:

An oral dose of pyronaridine tetraphosphate combined with a subcutaneous dose of diminazene aceturate inhibits Babesia in vitro and in mice, suggesting it might be a new paradigm for the treatment of babesiosis.
Characteristics of hospitalized patients with confirmed COVID-19 and their hospital management
Authors: Indrawati Lely , Tjandrarini Dwi Hapsari , Sulistiyowati Ning , Afifah Tin , Paramita Astridya , Senewe Felly Philipus , Dewantara Pandji Wibawa
Published: March 2024

Objective:

To determine the risk factors of mortality among hospitalized COVID-19 patients.

Methods:

This retrospective study used hospitalization records collected by the Indonesia Health Social Security Administrator Agency (Badan Penyelenggara Jaminan Sosial Kesehatan-BPJS Kesehatan). A total of 38277 eligible patients with confirmed COVID-19 were analyzed. The dependent variable of the study was the discharge status (death or recovery) of COVID-19. Independent variables were history of morbidity and disease-related occurrence, type of room health facilities, length of stay and demographic variables (sex, age). The analyses use bivariate and multivariate logistic regression to determine the dominating variable associated with all these variables.

Results:

Of the 38 277 inpatients with PCR-confirmed COVID-19, 31051 (81.1%) were discharged and 7226 (18.9%) died. Risk of death was positively associated with older age (aOR 5.74, 95% CI 4.20-7.87 for 19-64 years old; aOR 13.75, 95% CI 9.99-18.92 for 65 years above), male sex (aOR 1.13, 95% CI 1.07-1.19), treated in ICU without ventilator (aOR 5.84, 95% CI 5.41-6.30) and had comorbid respiratory diseases (aOR 5.39, 95% CI 4.93-5.90), but negatively associated with hospital stay of 15 days or longer (aOR 0.39, 95% CI 0.36-0.43).

Conclusions:

COVID-19 related death during hospitalization was associated with duration and type of treatment, and existing medical condition among the inpatient individuals during COVID-19 pandemic in DKI Jakarta. The findings of the study suggest importance of appropriate and timely medical intervention and care.
Epidemic management in a measles outbreak in 2023, the return of vaccine–preventable diseases: A single center, retrospective observational study
Authors: Tuncay Sevgi Aslan , Akkoc Gulsen , Yilmaz Seyhan , Parlak Burcu , Erdemli Pinar Canizci , Isik Aylin Dizi , Aytac Didem Buyuktas , Capar Meryem Cagla Abaci , Kadayifci Eda Kepenekli
Published: March 2024

Objective:

To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.

Methods:

This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023, at Marmara University Pendik Training and Research Hospital. The effects of vaccination status and underlying disease on the clinical course, treatments, and complications were evaluated.

Results:

In total, 117 patients were enrolled in the study with a median age of 80 months (IQR: 32.5-125.0). Twelve patients with contact history were asymptomatic and had an underlying disorder, and intravenous immunoglobulin was given to them for post-exposure prophylaxis. Fifty-one patients had confirmed measles diagnosis. Ribavirin treatment was given to three patients (a newborn, a girl with rhabdomyosarcoma, and a healthy boy) with respiratory distress. Seventy-eight percent of confirmed measles cases were unvaccinated, and all hospitalized cases were unvaccinated or under-vaccinated. Four full-vaccinated children had confirmed measles infection. Measles PCR from nasopharyngeal swabs was negative in all of them, and their diagnosis was established with anti-measles IgM positivity.

Conclusions:

The measles vaccine is the most effective way to protect from measles and measles-related complications. Although measles can also occur in fully vaccinated patients, the disease is milder than in unvaccinated patients. Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.
Prevalence and risk factors associated with long COVID symptoms in children and adolescents in a southern province of Vietnam
Authors: Linh Huynh Ngoc , Tan Nguyen The , Thu Le Thi Minh , Loan Nguyen Tu , Uyen Nguyen Thi To , Trang Le Thanh Thao , Nam Truong Thanh , Phu Doan Hoang
Published: March 2024

Objective:

To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.

Methods:

This study applied a cross-sectional approach within community settings in a southern province of Vietnam. A structured questionnaire featuring socio-demographic information and common long COVID symptoms was employed. Phi correlation coefficients assessed associations among pairs of long COVID symptoms. Additionally, multivariable logistic regression models were performed to investigate the risk factors of long COVID in recovered COVID-19 children and adolescents.

Results:

Among 422 participants, 39.3% reported long COVID symptoms, with a prevalence of 45.2% (SD=0.5) in children and 22.2% (SD=0.4) in adolescents. Common symptoms reported were cough 34.6% (SD=0.5), fatigue 20.6% (SD=0.4), shortness of breath 10.9% (SD=0.3), and lack of appetite 6.6% (SD=0.3). Concerning risk factors of long COVID, a higher risk was observed among demographic groups, including girls (OR 1.25, 95% Cl 1.15-1.37; P<0.001, reference: boys), children compared to adolescents (OR 1.24, 95% CI 1.12-1.37; P<0.001), overweight individuals (OR 1.14, 95% CI 1.02-1.27; P=0.018, reference: healthy weight), and participants without any COVID-19 vaccination (OR 1.36, 95% CI 1.20-1.54; P<0.001), or have received only one single dose (OR 1.35, 95% CI 1.10-1.64; P=0.004) compared to those who have received two doses. Besides, patients with a COVID-19 treatment duration exceeding two weeks also had a higher risk of long COVID (OR 1.32, 95% CI 1.09-1.60; P=0.003) than those who recovered less than seven days.

Conclusions:

The insights from this study provide crucial guidance for predicting the factors associated with the occurrence of long COVID in pediatric patients, contributing to strategic interventions aimed at mitigating the long COVID risks among children and adolescents in Vietnam.
Dengue hemorrhagic fever with rectus sheath hematoma: A case report
Authors: Bhattacharjee Boudhayan , Patel Hardik , Karad Rucha , Teja Vasireddy , Mondal Agnibho , Haldar Soumendra Nath , Saha Bibhuti
Published: March 2024

Rationale:

Acute pain is a medical emergency that requires prompt abdominal evaluation and management. Dengue, a mosquito-borne arboviral infection, can lead to complications such as acute abdominal pain.

Patient concerns:

A 72-year-old hypertensive female presented with high-grade intermittent fever with chills and rigors for four days. She was diagnosed with dengue fever (NS1Ag-reactive) the day before admission. A contrast-enhanced computed tomography of the abdomen showed a hematoma along the rectus sheath which was managed conservatively as per surgical opinion.

Diagnosis:

Dengue hemorrhagic fever with rectus sheath hematoma.

Interventions:

Blood transfusion and fluid therapy.

Outcomes:

Ten days after discharge, the patient reproted no pain in the right iliac fossa and the size of the hematoma was significantly reduced.

Lessons:

Although it is rarely seen as a cause of acute abdomen, complaints of adnominal pain should never be ignored in critical or convalescent phase of dengue fever. Radiological investigations should be promptly conducted as hematoma is often difficult to be diagnosed clinically. Delay in diagnosis of rectus sheath hematoma can be fatal.
Effect of Surface Treatments with Plasma and Chemical Bond on Shear Bond Strength of Acrylic Denture Teeth to Flexible and Heat-Cured Denture Base Material: An In Vitro Study
Authors: Abood Ghazwan A. , Mohammed Ali A. , Abdullah Zainab S. , Fatalla Abdalbseet A.
Published: March 2024

Introduction: We aimed to evaluate the shear bond strength of acrylic denture teeth to flexible and heat-cured denture base material after surface treatments with argon plasma, chemical bonding agent (PALFIQUE universal), and combination. Methods: A total of 80 incisor acrylic denture teeth were treated with a argonplasma, chemical bond (PALFIQUE universal bond), and a combination with 10 samples for each group. The neck (gingival portion) of teeth was cut at a 45° angle, and the teeth were attached to heat-cured acrylic resin and flexible denture base material. All the specimens were stored in artificial saliva for 7 days in an incubator (37 °C). A shear bond strength test was conducted using an Instron universal testing machine. Data were analyzed by the analysis of variance (ANOVA) and the Tukey’s honest significant difference post hoc test using R 4.2.3. Results: A statistically significant difference was found among study groups regarding the type of base, surface treatment with bond, plasma, and combination of bond and plasma (P < 0.00). The Tukey’s test showed that in a heat-cured base, the difference between the control and surface treatment with bond was not significant (P > 0.05). Also, in the flexible base group, the difference between the control and surface treatment with plasma was not significant (P = 0.162). Conclusion: In heat-cured denture-base group, the shear bond strength increased significantly with the combination of surface treatment with argon plasma and a chemical bonding agent (PALFIQUE universal). In the flexible denture-base group, the shear bond strength increased significantly with use of a surface treatment with a chemical bonding agent (PALFIQUE universal).
Hellebrigenin induces apoptosis by triggering cellular inhibitor of apoptosis 1 and Jun N-terminal kinase pathway in melanoma cells
Authors: Shieu Mu-Kuei , Chuang Yi-Ching , Ho Hsin-Yu , Lin Chia-Chieh , Lo Yu-Sheng , Hsieh Ming-Ju
Published: March 2024

Background:

Melanoma, the malignancy of melanocytes, is the most fatal form of skin cancer. Although various interventions are currently available, advanced stages of melanoma are still associated with a risk of metastatic recurrence.

Objectives:

The present study examined the anticancer activity of hellebrigenin, a natural product extracted from toad skin.

Methods:

Two types of metastatic melanoma cell lines, A2058 and HMY-1, were selected.

Results:

The findings revealed that hellebrigenin had cytotoxic effects on the two melanoma cell lines by triggering apoptosis: hellebrigenin activated cell arrest during the G2/M phase and downregulated regulators’ expression (e.g., cyclin-dependent kinase [CDK] 1, CDK 4, and cyclins E1, E2, A2, and D3). In intrinsic and extrinsic pathways of apoptosis, hellebrigenin activated the expression of the proapoptotic proteins t-BID, Bak, poly-ADP-ribose polymerase, Fas-associated death domain protein, death receptors 5, and cleaved caspases 3, 8, and 9; it also reduced the expression of the antiapoptotic proteins Bcl-2 and Bcl-xL. Mitochondrial membrane depolarization and cell nucleus condensation were also observed. In addition, human apoptosis arrays revealed that hellebrigenin inhibited the expression of cellular inhibitor of apoptosis 1, which is crucial for blocking cell apoptosis. Regarding upstream signaling activity, hellebrigenin suppressed the phosphorylation of the Jun N-terminal kinase 1/2 pathway in both melanoma cell lines.

Conclusion:

Overall, hellebrigenin can be used as a potential anticancer agent in clinical settings for treating the advanced stages of melanoma.
Collapsing Glomerulopathy in a Patient with Tuberculosis and Poncet’s Disease
Authors: Alam Tayyibah Shah , Kumar Vinod , Thomas Joe , Shenoy Nayantara , Philips Geetha
Published: March 2024

A 39-year-old woman presented with inflammatory polyarthritis, low-grade fever, progressive pedal edema, and frothy urination of three weeks duration. She had nephrotic range proteinuria and elevated creatinine. Kidney biopsy showed collapse of capillary tuft in the glomeruli and proliferation, hyperplasia, and hypertrophy of the overlying podocytes suggestive of collapsing glomerulopathy. Histology of the cervical lymph node showed necrotizing granulomatous inflammation suggestive of tuberculosis. With all other possible causes of polyarthritis ruled out, a diagnosis of Poncet’s disease—a form of polyarthritis observed in patients suffering from an active form of extrapulmonary tuberculosis (TB)—was considered. Association between TB lymphadenitis and collapsing glomerulopathy (CG) is very rare, and the patient had partial remission of the disease after being started on anti-tuberculosis therapy (ATT) along with steroids.
Nephrotic Syndrome and Posterior Reversible Encephalopathy Syndrome as Clinical Presentations of Gemcitabine-Induced Thrombotic Micro-Angiopathy
Authors: Jha Vijoy Kumar , Akal Ramanjit Singh , Mahapatra Debasish , Sharma Alok , Singh Bhanu Pratap , Arora Rahil
Published: March 2024

Gemcitabine-induced thrombotic micro-angiopathy (GiTMA) is a very rare pathology of micro-vascular occlusion with a poor prognosis. In this case report, we present a young male with pancreatic carcinoma who received gemcitabine as adjuvant chemotherapy and developed thrombotic micro-angiopathy (TMA) manifesting as nephrotic syndrome with renal dysfunction and posterior reversible encephalopathy syndrome (PRES). The case was successfully managed with discontinuation of the drug and conservative management. The pathogenesis of GiTMA might be direct endothelial dysfunction with consequent activation of the clotting system. The role of plasma exchanges and monoclonal antibodies is unclear in drug-induced TMA.
Successful Reversal of Refractory Posttransplant Thrombotic Microangiopathy with Eculizumab
Authors: Chaudhary Satish , Sharma Reetesh , Gupta Saumya , Paikra Sita , Gupta Mohit , Upadhyay Bal K. , Sharma Alok , Sethia Rajiv K.
Published: March 2024

Posttransplant thrombotic microangiopathy (PT-TMA) can be caused by calcineurin inhibitors (CNIs), ischemic injury, infections, or antibody-mediated rejection (ABMR). Delayed recognition can result in allograft loss. We describe the first reported case of successful reversal of refractory PT-TMA with eculizumab in India. It highlights the importance of prompt diagnosis and benefit from an early initiation of eculizumab therapy in refractory cases.
Obesity in Renal Transplantation
Authors: Gadwal Shankar , Madipalli Ravi Tej , Sharma Sourabh , Raju Sree Bhushan
Published: March 2024

Obesity has surged as a formidable global public health concern, with its prevalence nearly tripling over the past 40 years. Concurrently, the burden of kidney disease remains substantial, with obesity emerging as a significant risk factor. Transplantation is a life-saving intervention for patients with end-stage kidney disease living with obesity. However, it introduces a dual-edged sword, decreasing the risk of mortality related to dialysis while still leaving cardiovascular disease as one of the leading causes of death in transplant recipients. The relationship between obesity and transplantation is a multifaceted challenge demanding concerted efforts from health-care providers, researchers, and policymakers to navigate. While transplantation offers hope and improved quality of life for many, the weight of obesity cannot be underestimated. This review provides a comprehensive assessment of the intricate interplay between obesity and transplantation, with a particular focus on kidney transplantation. Through this review article, we want to reiterate the critical role of weight management, lifestyle modifications, and medical interventions in optimizing transplantation outcomes for individuals with obesity. By comprehensively addressing these issues, we aim to contribute to the development of a holistic approach that minimizes the risks while maximizing the benefits of transplantation for this vulnerable population.
A Study on Early Surgical Complications in Renal Transplant Recipients
Authors: Prakash J. V. S. , Thiruvarul P. V. , Natarajan V. , Vetrichandar S. , Arasi K. V. , Paranjothi Arun Kumar , Dhineshkumar P.
Published: March 2024

Introduction:

Renal transplantation is one of the most effective treatment measures in patients with end-stage renal disease to improve their quality of life. However, postoperative surgical complications can be seen in 15% to 17% of cases, with significant morbidity in earlier periods. This study aims to study the incidence, presentation, and management of various surgical complications within 2 months of renal transplantation.

Materials and Methods:

This retrospective descriptive study included data from hospital records of 236 recipients who underwent renal transplantation from 2015 to 2022 at our institute. In addition, salient characteristics of the donors were also noted. Recipients whose hospital records were not available were excluded from the study. Surgery-related complications within 2 months of renal transplantation in recipients and their management were studied.

Results:

Of 236 cases of renal transplantation, 182 cases were live-related renal transplantation recipients, and 54 were deceased donor renal transplantation recipients. Surgical complications such as posttransplant urine leak in three patients, lymphocele in two patients, graft renal vein thrombosis in three patients, and anastomotic site pseudoaneurysm in one patient occurred. The overall incidence of early surgical complications in our study is 3.81%. The study reports the successful management of all these nine patients with necessary intervention.

Conclusion:

The early diagnosis of postoperative complications is essential for reducing mortality and preserving graft function.
Rare Association of Donor-specific Antibody-negative Antibody-mediated Rejection with Segmental Thrombosis and Infarction
Authors: Nanda Aneesh , Kumar Jitendra , Katiyar Varun Kumar , Joshi Saurabh
Published: March 2024

Arterial thrombosis occurs in <1% of kidney transplant patients. Most cases arise early in the postoperative period following technical problems. However, it can be delayed until after the 1st week. In contrast to total graft thrombosis, segmental thrombosis is uncommonly recognized. Although some reports suggest acute rejection as the cause of graft thrombosis, segmental thrombosis with infarction secondary to rejection has not been reported. Here, we present a case of donor-specific antibody-negative antibody-mediated rejection associated with segmental thrombosis and infarction.
The Impact of Screening for BK Virus Infection on the Incidence of BK Virus Nephropathy in Kidney Transplant Recipients: A Single-center Experience
Authors: Sejpal Kapil Navin , Sivakumar Reddi , Kumar Mattewada Navin , Ganesh Rajesh Nachiappa , Srinivas B. H. , Gochait Debasis , Priyamvada P. S. , Haridasan Satish , Parameswaran Sreejith
Published: March 2024

Introduction:

Kidney allograft survival has increased significantly in the past few decades. However, the more potent immunosuppression has also resulted in a higher incidence of infections including BK virus nephropathy (BKVN). The profile of kidney transplant (KT) recipients including age, basic kidney disease, comorbidities, dialysis vintage, and type of kidney donor in India is different from that of high-income countries. There are very few studies on the incidence and outcomes of BKVN from India. We studied the incidence, clinical features, and the impact of a screening strategy on patients with BKVN at our center.

Materials and Methods:

This was a single-center retrospective record-based study. We screened the medical records of all KT recipients at our center from March 2012 to December 2020 for patients who were diagnosed with BKVN. We compared the incidence of BKVN before and after the implementation of a proactive screening strategy in 2017.

Results:

From March 2012 to December 2020, a total of 212 KTs were performed at our center. Twenty-eight patients were diagnosed to have BKVN at this time. The incidence of BKVN in our study was 13.2%. The incidence of BKVN before routine screening was initiated at our center was 11.3% whereas it was 13.6% after routine screening was initiated. Graft loss from BKVN was 7.14%.

Conclusion:

The incidence of BKVN at our center is higher than previously reported in India; however, the rate of graft loss is low. A proactive screening strategy using nucleic acid test may allow early detection of BKVN and may have a beneficial impact on graft outcomes.
A Rare Case of Pelvic Lipomatososis in a Cadaveric Renal Transplant Recipient
Authors: Viswanathan Akila , Reddy Govardhan , Panchangam Vidyashankar , Shetty Shashank , Patil Vinay , Tonshal Sanjeev , Srinivas Rohit K. , Kumar R. Sunil
Published: March 2024

A middle-aged male with end-stage renal disease underwent cadaveric transplantation. Intraoperatively, a large mass was seen in the pelvis surrounding the vessels, native ureter, and bladder. Ultrasound showed echogenic fatty tissue in the pelvis suggestive of pelvic lipomatosis vessels were dissected, layers were separated with a lot of difficulty. The urinary bladder could not be defined. Hence, ureteroureterostomy was done and a DJ stent was placed. The patient had immediate graft function and attained a nadir creatinine of 0.6 mg/dl on postoperative day 6.
Salvage of a Transplanted Kidney following Immediate Renal Artery Narrowing
Authors: Nerli Rajendra B. , Saldanha Richard , Jogula Abhinay , Ghagane Shridhar C. , Vernekar Ritesh , Kadeli Vishal , Dixit Neeraj S. , Rai Shreyas , Bokare Ashwin , Setya Nishant
Published: March 2024

Renal transplantation is considered the preferred treatment method for chronic renal failure. Early graft failure caused by transplant renal artery narrowing/stenosis is a common vascular complication after kidney transplantation. The classic symptoms include refractory hypertension, a decline in graft function, and fluid retention. Color Doppler sonography plays an important role in the diagnosis of renal artery narrowing; however, allograft artery angiography remains the gold standard. We report on a case of cadaveric donor renal transplantation, wherein the urine output markedly decreased within 7 h of transplantation due to renal arterial narrowing and the efforts that were made to salvage the kidney.
Tacrolimus-induced Sinusoidal Obstruction Syndrome after Liver Transplant: A Report of a Rare Case
Authors: Durairaj Parthiban , Senthil M. , Bharathan Anand , Mariappan M.
Published: March 2024

Tacrolimus-induced hepatic sinusoidal obstruction syndrome (HSOS) is a rare complication after a solid organ transplant, especially in liver transplantation (LT) recipients. Nevertheless, the consequence of HSOS could result in severe liver or renal failure and even mortality. Most of the previous reports diagnosed HSOS with the help of liver biopsy, and the treatment remains a withdrawal of causative agent. In this study, we report a case of tacrolimus-induced HSOS after LT. Initially, HSOS was suspected based on typical symptoms including ascites, weight gain, and hepatomegaly. Further, the features of typical patchy enhancement of liver parenchyma on the venous phase of contrast-enhanced computed tomography (CECT) confirmed the diagnosis of HSOS. After replacing tacrolimus with cyclosporine, there was a complete resolution of ascites and clinical symptoms, which was confirmed again with repeat CECT showing normal enhancement of liver parenchyma. Tacrolimus-induced HSOS is a rare complication. Timely diagnosis of HSOS is based on clinical symptoms and typical radiological findings. Tacrolimus withdrawal remains the only effective treatment.
Role of Platelet-rich Plasma in Unexplained Recurrent Implantation Failure – A Systematic Review and Meta-analysis of Randomised Control Trials
Authors: Kaur Harpreet , Meenu Meenakshi , Pandey Shivam , Chauhan Anil , Mangla Mishu
Published: March 2024

ABSTRACT

Background:

Recurrent implantation failure (RIF) is a challenging clinical situation and various strategies have been tried to improve the pregnancy rate in RIF. Platelet-rich plasma (PRP), which is obtained from the autologous blood samples of a person and is multiple times richer in platelets and other growth factors helps improve endometrial receptivity.

Objective:

This study has been conducted to summarise the evidence and quality of evidence available so far regarding the role of PRP in cases of unexplained RIF.

Materials and Methods:

An electronic database search for randomised clinical trials comparing PRP against routine care in women with unexplained RIF was performed on PubMed, EMBASE, SCOPUS and Cochrane Central. Two independent reviewers conducted a literature search and retrieved data using the predefined eligibility criteria. Bias assessment was done using the Cochrane Collaboration Network Risk of Bias Tool version 2. The quality of evidence was determined and a summary of the findings table was prepared for individual outcomes using GRADEpro software.

Results:

We identified 1146 records, and after removing duplicates, 531 records were screened. Out of these, 22 studies reached full-text screening and nine studies were included in the final review. We are uncertain about the effect of PRP due to the very low quality of evidence and we have little confidence that the administration of PRP had any significant effect on improving the live birth rate in women with RIF (odds ratio [OR]: 7.32, 95% confidence interval [CI]: 4.54–11.81, I
2 = 40%). Similarly, the quality of evidence was low for the clinical pregnancy rate, so we are uncertain if the administration of PRP had any significant effect on the clinical pregnancy rate (OR: 3.20, 95% CI: 2.38–4.28, I
2 = 0%).

Interpretation:

The current review suggests that there may be some beneficial effects of PRP in women with RIF, but the quality of evidence is very low and we are uncertain of the benefit and have little confidence in these findings.

Limitations:

Limitations are the small sample size of most studies, a short follow-up period, non-uniformity in the definition of outcomes and very low quality of evidence.

Registration:

The protocol was registered on PROSPERO (CRD42021292209).
Serum Zinc Levels in Women with Polycystic Ovarian Syndrome are Lower as Compared to Those without Polycystic Ovarian Syndrome: A Cohort Study
Authors: Dhar Swati , Yadav Reena , Tomar Akash
Published: March 2024

ABSTRACT

Background:

Zinc is an essential micronutrient, a vital stabiliser and a cofactor in many enzymes such as superoxide dismutase and phospholipase C and also acts as an antioxidant by protecting the sulfhydryl groups of different proteins and enzymes against free radicals. It is unclear if serum zinc levels are correlated with polycystic ovary syndrome (PCOS) and its pathophysiology, although relation between diabetes and insulin resistance has been established.

Aims:

This study aimed to investigate circulating serum zinc levels in PCOS subjects compared with non-PCOS subjects.

Settings and Design:

In this cohort study, PCOS subjects were compared with normal subjects aged between 18 and 35.

Materials and Methods:

All the included subjects underwent measurement of anthropometric parameters, fasting insulin, luteinising hormone, follicle-stimulating hormone, thyroid-stimulating hormone, prolactin, progesterone, oestrogen and serum zinc levels. These values were taken on days 2–5 of the menstrual cycle.

Statistical Analysis Used:

Univariate analysis and linear regression were performed for serum zinc levels and fasting insulin levels in PCOS subjects and non-PCOS subjects using SPSS (version 21) and Microsoft Excel (2019).

Results:

Serum zinc levels in the PCOS group were lower than in the control group (P = 0.012). Fasting insulin levels in the PCOS group were higher than in non-PCOS subjects (P = 0.001). We found a negative correlation between zinc and fasting insulin (r = −0.580, P < 0.0001) in the normal group and (r = −0.332, P = 0.019) in the PCOS group. A positive correlation was found between body mass index (BMI) and fasting insulin levels in both the PCOS group (r = 0.227, P = 0.112) and normals (r = 0.612, P < 0.0001). A negative statistically significant correlation between BMI and zinc in both the PCOS group (r = −0.378, P = 0.007) and the non-PCOS group (r = −0.7452, P < 0.0001) was seen.

Conclusion:

The data suggest that serum zinc levels were found to be lower in PCOS subjects as compared to normal controls and evaluation of these levels may indicate that zinc has a vital role in PCOS pathophysiology.
Morphology of Coracoacromial Ligament and its Role in Biomechanics of Shoulder Joint along with its Surgical Significance
Authors: Sonje Preeti Dnyandeo , Shinde Amol Ashok , Bose Aditya , Kanesker Neelesh Subash , Vatsalaswamy P.
Published: March 2024

Background:

The coracoacromial ligament is a triangular band, which extends between the coracoid process and the acromion. This ligament, along with the coracoid process and the acromion, forms arch above the humeral head which protects the head of the humerus during abduction. It is important for gleno humeral stability. Coracoacromial ligament may be composed of two strong marginal bands with thinner centre.It may be present in the form of a thick anterolateral bundle and a posteromedial bundle, with a triangular base. Anatomic variants are frequently seen .Sometimes it is Y-shaped, quadrangular and may be straight in shape. Release of Coracoacromial ligament for the treatment of shoulder impingement syndrome has been suggested in surgeries.

Aim and Objectives:

Aim of the present study is to study the different types of coracoacromial ligament. Cadaveric study was helpful for identifying the types of normal coracohumeral ligaments.

Methodology:

Fifty upper limbs were procured from the cadavers. Cadavers were embalmed and in 10% formalin. Inclusion criteria for study were intact shoulder joint. Exclusion criteria were disarticulated shoulder joint. Dissection was carried out as per steps given in Cunningham dissecting manual. As dissection of upper limb was already done by undergraduate students, skin was reflected and deltoid was exposed. For further dissection the anterior and middle fibers of deltoid muscle were cut Superior surface of coracoid process and acromion process were exposed to visualised the coracoacromial ligament.

Results:

Meticulously dissected upper limbs were observed to determine various shapes of CAL. Trapezoid, rectangular, Y shaped, bipartite and tripartite type of choracoacromial ligaments were observed.

Conclusion:

Advances in understanding Coracoacromial ligament through research outcomes will contribute more to intraoperative decision making for arthroscopic surgeons.
Comparison of Flipped Classroom Versus Traditional Didactic Lectures among Medical Students: A Mixed Method Study
Authors: Nanjundaiah Komala , Anuradha H. V.
Published: March 2024

Background:

Didactic lectures are one of the commonly used instructional methods used for curriculum delivery in medical colleges. These lectures have a limited scope for interactions. Flipped classroom constitutes both an instructional approach and a form of blended learning, designed to enhance student engagement and comprehension. This intentional shift to a learner-centric model allocates initial exposure to new subjects beyond traditional classroom settings, thus enabling classroom time to be dedicated to in-depth exploration of topics, fostering significant learning experiences. Hence, a study was conducted to compare the academic scores of students taught in the flipped method versus traditional classroom and to assess the perception of students regarding the flipped classroom.

Methodology:

One hundred students were divided into two Batches A and B of 50 students each. Topic one was taught, by the flipped classroom method for Batch A and by the traditional method for Batch B. Topic two was taught by flipped classroom for Batch B and Batch A had traditional class. A multiple-choice question test was done for all the batches at the end of the classes. Perception of students regarding flipped classrooms was assessed through a prevalidated questionnaire on a Likert scale.

Results:

The mean value of the academic scores of the tests conducted was higher after flipped classroom sessions compared to traditional teaching sessions with a significant P < 0.001. Analysis of the open-ended questions revealed that the flipped class had advantages of in terms of better student involvement.

Conclusions:

Flipped classroom can be an effective student-centered teaching strategy when properly planned and implemented for higher education. In medical colleges, it can be incorporated as one of the teaching–learning methodologies to teach must know topics.
A Comparative Study of Morphometric Parameters of Knee Using Magnetic Resonance Imaging in Different Population Groups
Authors: Prithishkumar Ivan James , Paul Hephzibah , Punekar Abdul Samad , Lakshmanan Jeyaseelan , Albelooshi Ali
Published: March 2024

Background:

The design of majority of commercially available knee implants has their basis on data obtained from the European population. Anthropometric research has demonstrated a difference in the shape and size of proximal tibia and distal femur between the genders and ethnic groups. Underfit or overhang of prosthetic components can result in poor clinical and functional outcomes with need for revision. This study compares the dimensions of the knee in multiple racial groups to observe if significant racial and gender differences occur.

Methodology:

Morphometric parameters of the knee of adult patients (>18 years) in four population groups (Native Emirati, East Asian, Indian, and Caucasian) were measured using magnetic resonance imaging. Knee parameters were obtained from 368 patients (179 females and 189 males).

Results:

Males have larger femoral and tibial parameters compared to females (P < 0.01). For any specified anteroposterior length of knee, females demonstrate narrower mediolateral widths compared to males. Significant differences exist in knee parameters between the racial groups in both genders (P < 0.01).

Conclusion:

Adult knee parameters show significant variation between the genders and racial groups showing strong evidence for a race- and gender-specific knee arthroplasty system.
Primary Headaches and Sleep Disorders: Review of Literature about Comorbidity in Children and Adolescents
Authors: Basile Vittorio , Tittarelli Sara , Stella Nausica , Mazzone Luigi , Moavero Romina , Papetti Laura , Valeriani Massimiliano
Published: March 2024

Sleep disorders and primary headaches are frequent health problems in childhood, and they are often comorbid in an individual, linked by a mutual and complex relationship. This comorbidity is frequent and well documented, but the available literature is usually biased in favor of one aspect or another, mainly depending on the expertise of the authors. The aim of this article is to review existing literature on the comorbidity between primary headaches and sleep disorders in pediatric age and summarize the heterogeneous results. Our findings, involving a total of 12 studies and 16.474 subjects aged 2–18 years, indicate a bidirectional and strong relationship between headache and sleep disorders in childhood, with multiple associations between headache features and sleep disturbances. This can be explained by many common pathophysiologic pathways. Improving sleep quality could help to reduce migraine intensity and disability and vice versa.
Comparison of Nocturnal Blood Pressure Patterns between Parkinson’s Disease, Cerebrovascular, and Other Neurological Diseases
Authors: Yalap Eray , Öztürk Gizem , Özaltun Burak , Sorgun Mine Hayriye , Şengül Şule , Akbostancı M. Cenk , Işıkay Canan Togay
Published: March 2024

Background:

The rise in average systolic blood pressure at night compared with daytime is called reverse dipping. Reverse dipping is one of the indicators of autonomic dysfunction in Parkinson’s disease (PD). Reverse dipping may increase cardiovascular mortality. We aimed to document nocturnal blood pressure patterns of patients with Parkinson’s Disease, cerebrovascular diseases, and other neurological diseases.

Method:

Patients who applied to the neurology department between 2012 and 2016 and had 24-h ambulatory blood pressure monitoring were enrolled. Patients without an MRI examination were excluded. Patients in the cerebrovascular disease group had ischemic stroke, transient ischemic attack, vascular parkinsonism, and/or vascular dementia. The patients who did not have PD or cerebrovascular disease were assigned to the other neurological diseases group. Nocturnal blood pressure patterns were examined and categorized into two as dipping/non-dipping and reverse dipping. Dipping/non-dipping and reverse dipping rates were compared between groups. The difference between the groups was evaluated using the chi-square test.

Results:

A total of 126 patients were enrolled, 59% (n:74) of them were female while 41% (n:52) were male. The median age was 62 (18 - 88) years. The rates of dipping, non-dipping, and reverse dipping were as follows; 5.3%, 57.9%, 36.8% in the PD, 37%, 40.7%, 22.2% in the cerebrovascular disease, and 37.5%, 51.2%, and 11.3% in the other neurological diseases group. The rate of reverse dipping was significantly higher in the PD group (p=0.024), while it was lower in other neurological disease group (p=0.029). The rates in the cerebrovascular disease group were not statistically different.

Conclusion:

Reverse dipping is an important yet unnoticed autonomic dysfunction feature which can increase cardiovascular mortality in PD patients.
Immunotherapy for food allergy: current proposals to improve safety and efficacy
Authors: Wan Wing Tung Crystal
Published: March 2024

This review mainly focuses on the novel approaches that improve the safety and efficacy of immunotherapies, namely SLIT [alone or as pre-treatment of oral immunotherapy (OIT)], epicutaneous immunotherapy (EPIT), combination of anti-IgE into OIT or sublingual immunotherapy (SLIT) and introduction of hypoallergenic allergens by modifying native food products (boiling, baking, etc.) or manufacturing recombinant proteins. Among these proposals, some are clinically proven safe such as the use of anti-IgE while some are still under preclinical trials such as the use of some newly developed recombinant food protein allergens. What is certain is that more preclinical and clinical reviews and trials would be required on all these proposals before they could be maturely, safely, and effectively promoted in the clinical settings for patients’ use.
Optic disc morphology and interocular symmetry in children
Authors: Muñoz-Gallego Alicia , Rodríguez-Salgado Martín , López-López Cristina , Torres-Peña José L. , Ortueta-Olartecoechea Ana , De La Cruz Javier , Tejada-Palacios Pilar
Published: March 2024

PURPOSE:

The purpose of the study was to obtain a pediatric reference database for optic disc parameters and interocular symmetry. To ascertain factors that modify these parameters (age, spherical equivalent [SE], and sex).

METHODS:

This was a cross-sectional study. 90 patients aged 5–17 years fulfilled all the inclusion criteria. After a full examination including cycloplegic refraction, all patients underwent optical coherence tomography (OCT) of the papilla using the three-dimensional (3D) scan protocol of the Topcon 3D 2000 OCT device. We provide reference values for optic disc parameters in the pediatric population. We also retrieved interocular symmetry reference values for these parameters.

RESULTS:

The multivariate regression analysis did not reveal variations in any of the optic disc parameters associated with age, sex, or SE (all P ≥ 0.126). The 95th percentile limit for absolute interocular differences for the cup-to-disc area ratio was 0.24. The multivariate regression analysis revealed the absence of a correlation between asymmetry of the optic disc parameters and age, sex, and the interocular difference in SE (all P ≥ 0.105).

CONCLUSION:

Pediatric reference databases for optic disc parameters and ranges of normality for interocular symmetry provide key diagnostic support in diseases that affect the optic nerve.
Congenital superior oblique palsy in a patient with VACTERL association
Authors: Acar Zeynep , Yılmaz Tuğan Büşra
Published: March 2024

Different types of ophthalmological defects have been reported to be accompanying vertebral anomalies, anal atresia, cardiac malformations, tracheoesophageal fistula, renal anomalies, and limb anomalies (VACTERL) association. A 7-year-old girl with a history of VACTERL association presented with upward drifting of the left eye and anomalous head posture to the right side and was diagnosed with congenital fourth nerve palsy. We report the first case representing a combination of congenital fourth nerve palsy with VACTERL association.