bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethnobotanically important plants with piscicidal properties used for traditional fishing in Chirang district of Assam, Northeast India
Authors: Narzary Pratibha , Basumatary Nelson , Dayami Heikham , Khangembam Bronson Kumar
Published: December 2023

The use of certain plant species in traditional fishing for their piscicidal or stupefying effect is widespread among many fishing communities in northeast India. Plant poisoning is one such traditional method for fishing practised in the Chirang district of Assam in northeast India. This paper identifies six different species of plants (Polygonum hydropiper, Spilanthes paniculate, Parthenium hysterophorus, Alistonia scholaris, Albizia procera, Ageratum conyzoides) belonging to four different families (Asteraceae, Apocynaceae, Fabaceae and Polygonaceae) which are used as natural poison for capturing fishes in the study area. Maximum number of species (50%) was recorded in family Asteraceae while the remaining families recorded one species each. The most common mode of application was in the form of a grounded paste or an aqueous extract while in some cases the raw plant itself were used. All of these plant toxins were reported to probably affect the swimming and respiration of the fish on application. However, detail mechanism of their toxic action needs to be evaluated fully. This study has identified some potent natural piscicidal plants which may be further investigated for widespread application in aquaculture and allied industry.
In Vitro Antioxidant Activity and GC-MS Analysis of Sesbania grandiflora (L.) Pres. Leaves
Authors: Ambastha Surabhi , Sharan Latika
Published: December 2023

Sesbania grandiflora (L.) Pres. is a member of the Fabaceae family. In the DPPH antioxidant assay ethanol excerpts of August plant leaves scavenge more free radicals at volumes of 5 to 20 µl i.e., 16.33%, 19.88%, 23.07% & 27.59% as compared to other two solvents such as acetone and water. In the CUPRAC antioxidant assay ethanol excerpts also scavenge more free radicals at concentrations of 2, 3 4 and 5 µg/1000µl i.e., 5.15%, 8.68%, 13.82% & 17.17 as compare to the other two solvents such as acetone and water. In GC-MS analysis 42 compounds are pointed out by chromatogram image. Out of 42 compounds 15 compound are antioxidant in nature such as 1-Tetradecene, 1-HEXADECENE, 1-OCTADECENE, 1-Nonadecene, Phytol, DOCOSANE, 1-HYDROXY-2,2,6,6-TETRAMETHYL-3-(1-PIPERIDINY, Pentatriacontane, 1-Heptacosanol, Stigmasterol, 9,19-Cyclolanostan-3-ol, 24-methylene-, (3.beta.)-, Neophytadiene, n-Hexadecanoic acid, .alpha.-Tocospiro B & Squalene which justify these plant leaves are antioxidant in nature. 8 antimicrobial compounds; 1-Tetradecene, 1-HEXADECENE, 8-Pentadecanone, 1-Nonadecene, DOCOSANE, Squalene, n-Hexadecanoic acid & Heneicosane, 5 anti-inflammatory compound; Neophytadiene, n-Hexadecanoic acid, Phytol, .alpha.-Tocospiro B & Stigmasterol, 4 anticancer compound; 1-OCTADECENE, Vitamin E, .gamma.-Sitosterol & Squalene, 1 anti-neuropathic cholesterolytic compound: MOME INOSITOL, 2 antitumor compound; .beta.-Amyrin & .alpha.-Amyrin and 4 antidiabetic compound; .gamma.-Sitosterol, Vitamin E , .alpha.-Tocospiro B & 9,19-Cyclolanostan-3-ol, 24-methylene-, (3.beta.)- are also identified which shows these plant is immense potential to make an individual place on medical science for production of plant based medicine. The main manifesto of this investigation is to find out Phyto-therapeutic antioxidant which has extreme benefits and limited or no side effects.
Regulatory effects of prolactin in amphibians
Authors: Dey Suvajit , Karar Atindra
Published: December 2023

Prolactin (PRL) is a protein hormone of the anterior pituitary and has a diverse role in different aspects of amphibian life - in courtship, reproduction, larval development and in other physiological functions. The expression of PRL receptor mRNA is reported in skin, gill, liver, gut, kidney, gonads and many other organs of different groups of amphibians. PRL stimulates growth and inhibits the metamorphosis of larvae of several species of amphibians. PRL causes seasonal changes in sex accessory structures and secondary sexual characteristics. PRL affects metabolic regulation and suggests phylogenic conservation of its receptors. Plasma PRL concentration changes during the annual reproductive cycle in many amphibians. In courtship behavior of newt, PRL also induces the synthesis of the newt courtship pheromones. PRL acts on skin and its function is also associated with water drive in amphibians. PRL causes water retention in amphibians. PRL acts centrally or peripherally to induce the courtship behavior. The key goal of the paper is to understand the roles of PRL in various aspect of amphibian life, like in aspects of morphology, behaviour, physiological functions and how PRL interfere amphibian life in presence and absence of other chemical and biological factors.
Efficacy and safety of denosumab treatment for Korean patients with Stage 3b–4 chronic kidney disease and osteoporosis
Authors: Kim Jin Taek , Kim You Mi , Jung Kyong Yeun , Choi Hoonsung , Lee So Young , Kim Hyo-Jeong
Published: December 2023

Background/Aims: We evaluated the efficacy and safety of denosumab treatment in severe chronic kidney disease (CKD) patients with osteoporosis. We also investigated whether the treatment affects the coronary artery calcifications.Methods: Twenty-seven postmenopausal women with Stage 3b–4 CKD and osteoporosis were enrolled. Twenty patients received denosumab plus calcium carbonate and vitamin D, and seven controls received calcium carbonate and vitamin D for 1 year. Dual-energy X-ray absorptiometry and coronary artery calcium (CAC) scoring computed tomography were performed before and after treatment. Hypocalcemic symptoms and serum calcium levels were evaluated.Results: After 1 year of treatment, the percent changes of femur neck (3.6 ± 3.2% vs. -0.7 ± 4.4%, p = 0.033) and total hip (3.4 ± 3.8% vs. -1.9 ± 2.1%, p = 0.001) bone mineral density (BMD) were significantly increased in the denosumab treated group compared to the control group. However, the percent change of lumbar spine BMD did not differ between two groups (5.6 ± 5.9% vs. 2.7 ± 3.9%, p = 0.273). The percent change of bone alkaline phosphatase was significantly different in the denosumab-treated group and control group (-31.1 ± 30.0% vs. 0.5 ± 32.0%, p = 0.027). CAC scores did not differ between groups. No hypocalcemic events occurred in both groups.Conclusions: If carefully monitored and supplemented with calcium and vitamin D, denosumab treatment for 1 year provides significant benefits in patients with Stage 3b–4 CKD and osteoporosis. However, denosumab treatment did not affect coronary artery calcifications in these patients.
Bifurcation analysis of a two–dimensional p53 gene regulatory network without and with time delay
Authors: Du Xin , Liu Quansheng , Bi Yuanhong
Published: December 2023

In this paper, the stability and bifurcation of a two–dimensional p53 gene regulatory network without and with time delay are taken into account by rigorous theoretical analyses and numerical simulations. In the absence of time delay, the existence and local stability of the positive equilibrium are considered through the Descartes' rule of signs, the determinant and trace of the Jacobian matrix, respectively. Then, the conditions for the occurrence of codimension–1 saddle–node and Hopf bifurcation are obtained with the help of Sotomayor's theorem and the Hopf bifurcation theorem, respectively, and the stability of the limit cycle induced by hopf bifurcation is analyzed through the calculation of the first Lyapunov number. Furthermore, codimension-2 Bogdanov–Takens bifurcation is investigated by calculating a universal unfolding near the cusp. In the presence of time delay, we prove that time delay can destabilize a stable equilibrium. All theoretical analyses are supported by numerical simulations. These results will expand our understanding of the complex dynamics of p53 and provide several potential biological applications.
Estimation of spatiotemporal travel speed based on probe vehicles in mixed traffic flow
Authors: Kim Jongho , Kim Woosuk , Ko Eunjeong , Kang Yong-Shin , Kim Hyungjoo
Published: December 2023

Conventional fixed traffic detectors are limited to their installed locations and are unable to collect general traffic information or monitor microscopic traffic flows. Mobile detectors overcome spatial constraints by allowing the vehicle to act as a detector and can observe microscopic traffic flows by collecting high-resolution trajectory data from individual vehicles. The objective of this study is to estimate spatiotemporal traffic information based on the autonomous driving sensor headway distance and to calculate the appropriate spatiotemporal interval according to the sampling rate. First, individual vehicle trajectory data was collected, and a traffic information estimation was established. Travel speed was calculated based on generalized definitions, and its estimation and errors were analyzed. In addition, the appropriate spatiotemporal interval according to cell size, time interval, and sampling rate was analyzed. The analysis demonstrated that the estimation accuracy was improved by cell size, time interval, and sampling rate. Based on this, the appropriate time and space to minimize the error rate were calculated considering the sampling rate. When the sampling rate was 40% or more, the error rate was 5% or less in all time and space; however, error rate differences occurred in several cases at sampling rates below 40%. These results are anticipated for efficient management of collecting, processing and providing traffic information.
A study on the static behavior of functionally graded I-shaped beams
Authors: Loja M.A.R. , Carvalho André , Barbosa Ines C.J.
Published: December 2023

Functionally graded materials are well-known for their ability to minimize abrupt stress transitions that are typical of laminated composites, as well as for being very suitable to operate in adverse high-temperature environments. They can act as thermal barriers if a proper selection of the constituent materials is considered. These materials and structures have attracted the attention of many researchers; however, previous research efforts have been focused on the systematic study of rectangular-shaped cross-section profiles. The use of beams characterized by other cross-sections, which are commonly used in metallic construction, may benefit from the continuous, smooth materials mixture that is typically found within functionally graded composites. Hence, this work aims to investigate the behavior of symmetrical, I-shaped, cross-section beams made from these advanced composites by performing a set of parametric analyses. These beams are modeled after solid finite elements to be able to describe the materials mixture evolution through the beam thickness with greater detail. Thick and moderately thick beams are submitted to static loading while considering different boundary conditions, and their linear static behavior is analyzed. As expected, the stress profiles are highly influenced by the materials' mixture profiles. Significant shear stress was found in the I-shaped cross sections.
Design and experimentation of sampled-data controller in T-S fuzzy systems with input saturation through the use of linear switching methods
Authors: Kim YeongJae , Lee YongGwon , Lee SeungHoon , Selvaraj Palanisamy , Sakthivel Ramalingam , Kwon OhMin
Published: December 2023

In this study, the stability and stabilization analyses are discussed for Takagi-Sugeno (T-S) fuzzy systems with input saturation. A fuzzy-based sampled-data control is designed to stabilize the T-S fuzzy systems. Based on the Lyapunov method and some integral inequality techniques, a set of sufficient conditions is obtained as linear matrix inequality (LMI) constraints to guarantee the asymptotic stability of the considered system. In this process, the linear switching method is utilized to design a controller that is dependent on the membership function, and an integral inequality is utilized. Additionally, determination of the controller parameters is achieved by resolving a series of LMI constraints. The effectiveness of these criteria is demonstrated through a real system that is modeled by the T-S system.
Photovoltaic power prediction based on dilated causal convolutional network and stacked LSTM
Authors: Tian Chongyi , Lin Longlong , Yan Yi , Wang Ruiqi , Wang Fan , Chi Qingqing
Published: December 2023

Due to the crucial role of photovoltaic power prediction in the integration, scheduling and operation of intelligent grid systems, the accuracy of prediction has garnered increasing attention from both the research and industry sectors. Addressing the challenges posed by the nonlinearity and inherent unpredictability of photovoltaic (PV) power generation sequences, this paper introduced a novel PV prediction model known as the dilated causal convolutional network and stacked long short-term memory (DSLSTM). The methodology begins by incorporating physical constraints to mitigate the limitations associated with machine learning algorithms, thereby ensuring that the predictions remain within reasonable bounds. Subsequently, a dilated causal convolutional network is employed to extract salient features from historical PV power generation data. Finally, the model adopts a stacked network structure to effectively enhance the prediction accuracy of the LSTM component. To validate the efficacy of the proposed model, comprehensive experiments were conducted using a real PV power generation dataset. These experiments involved comparing the predictive performance of the DSLSTM model against several popular existing models, including multilayer perceptron (MLP), recurrent neural network (RNN), long short-term memory (LSTM), gated recurrent unit (GRU), stacked LSTM and stacked GRU. Evaluation was performed using four key performance metrics: Mean absolute error (MAE), mean squared error (MSE), root mean squared error (RMSE) and R-squared (R2). The empirical results demonstrate that the DSLSTM model outperforms other models in terms of both prediction accuracy and stability.
Effects of Electroacupuncture Combined with Acupoint Catgut Embedding on Gastrointestinal Motility and Gastrointestinal Hormones in Rats with Functional Dyspepsia
Authors: Yu Hui , Deng Huiqian , Zhou Wei , Liang Zhenling
Published: December 2023

Electroacupuncture (EA) or acupoint catgut embedding (ACE) plays a therapeutic role in functional dyspepsia (FD). Herein, we aimed to elucidate the influences of EA combined with ACE on gastrointestinal motility and gastrointestinal hormones in rats with FD. Sprague–Dawley rats were randomized into the control group, model group, EA group, ACE group, and EA + ACE group (n = 10). Except for the control group, the rats in all groups were modeled by combining neonatal iodoacetamide gastrogavage and modified tail-clamping stimulation. The rats were treated with different treatments according to their groups. The rats were observed for changes in general behavior, body weight, food intake, and paw mechanical pain threshold. Gastric emptying rate (GER) and intestinal propulsive ratio (IPR) were measured in each group, and serum gastrointestinal hormone (motilin [MTL], leptin, gastrin [GAS], vasoactive intestinal peptide [VIP], calcitonin gene-related peptide [CGRP], and somatostatin [SS]) levels, oxidative stress factors (superoxide dismutase [SOD] and malondialdehyde [MDA]) and 5-hydroxytryptamine (5-HT) levels were also measured. Decreased mean body weight, paw mechanical pain thresholds, food intake, and GER and IPR were found in rats of the model group in comparison to the control group. Serum MTL, GAS, SS, and SOD levels were reduced, and serum leptin, VIP, CGRP, MDA, and 5-HT levels were increased in rats of the model group in comparison to the control group. Elevated mean body weight, paw mechanical pain threshold, food intake, GER and IPR, and serum MTL, GAS, SS, and SOD levels, and reduced serum leptin, VIP, CGRP, MDA, and 5-HT levels were observed in rats of the EA, ACE, and EA + ACE groups relative to the model group. EA combined with ACE treatment was more effective than the EA or ACE treatment alone. EA combined with ACE treatment improves gastrointestinal motility and gastrointestinal hormone levels, promotes food intake, and reduces visceral hypersensitivity in FD rats.
Long Non-Coding RNA NBR2 Suppresses the Progression of Colorectal Cancer by Downregulating miR-19a to Regulate M2 Macrophage Polarization
Authors: Yang Xiaoting , Luo Ye , Li Mengying , Jin Zhan , Chen Gao , Gan Chunchun
Published: December 2023

Colorectal cancer (CRC) is a malignant tumor of the gastrointestinal tract that significantly impacts the health of patients and lacks promising methods of diagnosis. Tumor-associated macrophages (TAMs) are involved in CRC progression, and their function is regulated by long non-coding RNAs (lncRNAs). The lncRNA NBR2 was recently reported as an oncogene, whose function in CRC remains uncertain. The present study aimed to investigate the biological function of lncRNA NBR2 in the progression of CRC and its underlying molecular mechanisms. Ten pairs of clinical CRC and para-carcinoma tissues were collected to determine the expression levels of lncRNA NBR2 and miR-19a, and the polarization state of TAMs. Quantitative reverse transcriptase-polymerase chain reaction was used to evaluate the expression of miR-19a, and western blotting was used to determine the expression levels of tumor necrosis factor-α, human leukocyte antigen-DR, arginase-1, CD163, CD206, interleukin-4, AMP-activated protein kinase (AMPK), p-AMPK, hypoxia-inducible factor-1α (HIF-1α), protein kinase B (AKT), p-AKT, mechanistic target of rapamycin (mTOR), and p-mTOR in TAMs. The proliferative ability of HCT-116 cells was detected using the CCK8 assay, and the migratory ability of HCT-116 cells was evaluated using the Transwell assay. The interaction between lncRNA NBR2 and miR-19a was determined using the luciferase assay. The lncRNA NBR2 was downregulated and miR-19a was highly expressed in CRC cells, accompanied by a high M2 polarization. Downregulated miR-19a promoted M1 polarization, activated AMPK, suppressed HIF-1α and AKT/mTOR signaling pathways, and promoted antitumor properties in NBR2-overexpressed TAMs, which were all reversed by the introduction of the miR-19a mimic. LncRNA NBR2 was verified to target miR-19a in macrophages according to the results of the luciferase assay. Collectively, lncRNA NBR2 may suppress the progression of CRC by downregulating miR-19a to regulate M2 macrophage polarization.
Anti-Oncogenic Mechanism of KLF17 in Colon Cancer by Repressing Cell Migration and Invasion via FHL1 Upregulation
Authors: Yi Shengen , Luo Ming , Peng Yanjin , Chen Yong , Yu Dan
Published: December 2023

Colon cancer is a disease with high prevalence worldwide. This study sought to investigate Kruppel-like factor 17 (KLF17) mechanism in the development of colon cancer through four-and-a-half-LIM domain protein 1 (FHL1). In colon cancer cells, KLF17 and FHL1 expression was detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blot. After gain- and loss-of-function experiments in colon cancer cells, cell proliferative, invasive, and migrating abilities were tested by cell counting kit-8, transwell, and scratch assays, respectively. The expression of epithelial–mesenchymal transition (EMT)-related genes, E-cadherin, N-cadherin, and Vimentin, was measured by RT-qPCR and Western blot. Chromatin immunoprecipitation and dual-luciferase reporter gene assays were performed to detect the binding of KLF17 and the FHL1 promoter. Finally, a transplantation tumor model in nude mice was established for in vivo validation. Mechanistically, KLF17 facilitated FHL1 transcription by binding to the FHL1 promoter. KLF17 or FHL1 upregulation suppressed the colon cancer cell proliferative, invasive, and migrating capacities, accompanied by elevated E-cadherin expression and diminished N-cadherin and Vimentin expression. Furthermore, FHL1 silencing abrogated the repressive impacts of KLF17 upregulation on colon cancer cell EMT, proliferative, invasive, and migrating capabilities. Furthermore, KLF17 augmented FHL1 expression and curtailed the growth of transplanted tumors in nude mice. Conclusively, KLF17 promoted FHL1 transcription, thereby impeding the invasion, migration, and EMT of colon cancer cells.
Unmasking of central diabetes insipidus on initiation of glucocorticoid replacement therapy in a patient with panhypopituitarism
Authors: Maldar Aasim N. , Shah Nishitkumar F. , Chauhan Phulrenu H.
Published: December 2023

Hypopituitarism is commonly seen after sellar surgery for pituitary adenoma. Hypocortisolism and diabetes insipidus can be a part of hypopituitarism. Rarely, diabetes insipidus can be unmasked on initiating treatment for hypocortisolism. A 62-year-old female with a history of trans-sphenoidal decompression surgery 9 years ago for non-functioning pituitary adenoma, was diagnosed to have developed panhypopituitarism on the present evaluation. The patient was started on prednisolone replacement, following which central diabetes insipidus was unmasked after 7 days. Thus, hypopituitarism may develop gradually over years after trans-sphenoidal surgery, and the patient may not manifest symptoms of hormone deficiencies. Diabetes insipidus may be masked by adrenal insufficiency, and the same can manifest after the initiation of glucocorticoid therapy.
Is fasting necessary for thyroid-stimulating hormone estimation? Role of analytical and biological variation in the interpretation of results
Authors: Kumari S. Jaya , Abraham Manu , Ayyar Vageesh
Published: December 2023

Background:

There are varied reports on the effect of sample timing on thyroid-stimulating hormone (TSH) interpretation and its role in under- or over-diagnosing subclinical hypothyroidism. This study was undertaken to evaluate the difference in consecutive values of TSH in fasting and post-prandial samples and interpret the clinical relevance of the difference obtained using parameters such as measurement uncertainty (MU) and reference change value (RCV) which are based on analytical and biological variations.

Methods:

The fasting and post-prandial TSH were evaluated in 30 paired specimens of apparently healthy individuals. TSH was analysed using chemiluminescence technology. MU was calculated from 6-month cumulative internal quality control data, and RCV was obtained from the published literature.

Results:

The study showed that fasting TSH levels were higher than post-prandial TSH. However, 90% of the difference observed between the pairs at lower concentrations of TSH was within laboratory MU, and 100% of the difference observed at higher concentrations of TSH was within the MU. When the difference obtained was compared with RCV (which includes both analytical and intra-individual variations), the difference was within the RCV across all concentrations.

Conclusions:

Although TSH values in the fasting specimens were higher than the post-prandial samples, a comparison of the difference obtained with MU and RCV shows that the difference was well within these parameters and hence less likely to be a clinically significant difference. Thus, the RCV of analytes may be used as a guide in the interpretation of consecutive samples or serial measurements of analytes.
Anterior urethral valve with diverticulum in an adolescent
Authors: Krishanppa Deepak , Mhaske Sunil , Ranjan Pratyush , Sabale Vilas , Satav Vikram , Pothula Pavan , Singh Siddharth Jai , Rayee Tabish , Asabe Shashikant
Published: December 2023

The anterior urethral valve (AUV) is a rare cause of obstructive uropathy in children; they are much rarer than posterior urethral valves. A 13-year-old male presented with obstructive and irritative lower urinary tract symptoms (LUTS). On urethrocystoscopy, an AUV with a diverticulum was noted in the ventral surface of the urethra. It was ablated endoscopically using the holmium laser. Postoperatively, the patient voided successfully without any immediate complications. AUV with diverticulum may occur in adolescents. Endoscopic holmium laser ablation of the valve and the diverticulum is associated with good outcome.
Dual primary malignancies in gynaecological cancers
Authors: Gupta Sweety , Bachheti Yamini , Chophy Atokali , Chakravarty Abhishek , Gupta Manoj
Published: December 2023

The occurrence of second primary malignancy (SPM) in a diagnosed case of a cancer patient and also in a cancer survivor is not very uncommon. We report the occurrence of double malignancies in 9 patients with gynaecological cancers. Three patients had gynaecological index malignancy (1 endometrium and 2 cervix); 7 had second malignancy as gynaecological (3 endometrium, 2 ovary, 1 each cervix and vulva). Three had synchronous, 6 had metachronous malignancies; 1 patient had multiple gynaecological malignancies. Primary index malignancies were treated with radical intent (n=8), except for one patient with gallbladder cancer with liver metastases and simultaneous ovarian cancer was treated by palliative chemotherapy. Second primary tumours were managed with radical intent in six and palliative intent in three patients.
Prevalence and major contributing factors predicting the 10-year risk for cardiovascular disease in post-menopausal women based on the Framingham Risk Score
Authors: Paul Steve , Ajith Thekkuttuparambil Ananthanarayanan , Jose Swetha Elizabeth
Published: December 2023

Background:

Framingham risk score (FRS) for cardiovascular disease (CVD) initiates preventive medication to reduce the future CVD risk. This study aimed to evaluate the prevalence and the significant contributors to predict the 10-year risk for CVD amongst post-menopausal women using FRS-CVD score.

Methods:

This cross-sectional study was designed amongst post-menopausal women (5080 years) lacking typical angina pectoris symptoms. Age, gender, systolic blood pressure (SBP), total and high-density lipoprotein (HDL)-cholesterol, smoking status, treatment for hypertension and diabetes were collected from the patients’ records. As per the FRS, risk for CVD was categorised as high (≥20%) and low/intermediate (≤19.9%).

Results:

Of the 50 subjects included in the study (mean age 63.8 ± 7.5 years), 30 (60%) showed low/intermediate risk and 15 (30%) showed high risk for CVD. Age (P < 0.0002) and SBP (P < 0.0001) were significantly different between the groups. No significant difference in total/HDL-cholesterol and diabetes mellitus was found between the groups. Of the 50 patients, 23 (46%) (13/15 in the high-risk group, P = 0.0002) were undergoing hypertension treatment. Multiple logistic regression analysis showed that age (P = 0.0058, 95% confidence intervals [CI]: 1.0638–1.4395) and hypertension (P = 0.0007, 95% CI: 5.2369- 476.8816) were independent contributing factors for 10-year CVD high risk.

Conclusion:

Thirty per cent of post-menopausal women showed a 10-year CVD high risk. Age and blood pressure were significant contributing factors for high risk. As the age advances, periodic check-up of blood pressure is inevitable to reduce CVD risk.
An interesting case of gastric adenocarcinoma presenting as bicytopenia in young adult
Authors: Bhagath Dinesh Chandra , Kolia Vaishnavi , Shetty Mallikarjuna , Uppin Shantveer G.
Published: December 2023

A 28-year-old male with no prior comorbidities came with chief complaints of loss of weight for 4 months, generalised weakness for 1 month and blackish discolouration of stools for 20 days. On general examination, pallor present; rest of the physical examination was normal. Laboratory investigations showed low haemoglobin (4.8 g/dL) and platelet count (10,000/mm3). Atypical cells were present in the peripheral blood smear and accounted for 4%. packed red blood cells and platelet-rich plasma transfusions were given. As the blood counts were not improving, bone marrow aspiration and biopsy were done which showed metastatic signet-ring cell carcinoma. In view of melaena, endoscopy was done, which showed carcinoma stomach with active bleeding. The patient was diagnosed to have metastatic signet-ring cell adenocarcinoma with bone marrow metastasis. In view of the advanced nature of disease, the patient was given palliative and supportive treatment.
A comparative study evaluating the role of nasogastric tube following ileostomy reversal surgery
Authors: Khatana P. S. , Kumar Jitendra , Kumar Rajeev Ranjan , Khemka Siddharth , Gupta Shardool Vikram
Published: December 2023

Background:

Nasogastric tube (NT) is commonly used following abdominal surgeries with a belief that it will decompress the bowel and prevent complications such as abdominal distension and post-operative nausea and vomiting. However, many studies have now reported that the use of a NT after abdominal surgery is not only unnecessary but also can be harmful to the patient.

Methods:

This was a prospective and interventional randomised comparative study where patients undergoing elective ileostomy reversal (n = 120) were randomly divided into two groups: patients with (Group A), and without (Group B) the placement of the NT in the post-operative period (n = 60 each). Post-operative parameters like time to pass first flatus and stool, the first appearance of bowel sounds, length of hospital stay, post-operative hospital stay, post-operative complications such as pneumonia, fascial dehiscence, anastomotic leak, nausea, vomiting and need for tube insertion/reinsertion were recorded.

Results:

Mean time (post-operative days) for appearance of first bowel sounds (P < 0.0001), passing first flatus (P < 0.0001) and first stool (P < 0.0001) were significantly higher in Group A as compared to Group B (P < 0.0001). The mean duration of hospital stay (days) was also significantly higher in Group A compared to Group B (8.8 ± 1.5 Vs 5.5 ± 1). The proportion of patients who developed a chest infection in both Groups A and B was comparable.

Conclusions:

Use of a NT during the post-operative period after ileostomy reversal surgery does not provide any additional benefit and may be harmful in terms of early patient recovery.
N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein and ferritin in predicting the functional outcome in stroke patients
Authors: Sanober Arshi , Khan Siraj Ahmed , Afshan Jabeen Shaik , Dominic Sachin , Ahrar Shakeeb , Das Priyanka , Luqman Hajra , Kompella Saibaba S. S. , Sreedevi N. N. , Bhaskar M Vijaya , Mohammed Noorjahan
Published: December 2023

Background:

Biomarkers that predict the outcome of stroke are critical for treatment, considering them to be a valuable adjunct to routine clinical examination and imaging data.

Methods:

Thirty-one patients admitted with stroke along with 30 controls were included in the study. Patients were divided into ischaemic and haemorrhagic stroke groups based on radiological findings. The study group was evaluated within 48 h of symptom onset for clinical stroke severity (Scandinavian Stroke Scale [SSS] and National Institute of Health Stroke Scale). Functional status before the stroke (modified Rankin Scale [mRS]) and at discharge was evaluated. The association of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP) and serum ferritin concentrations with stroke severity and functional outcomes at discharge in acute ischaemic and haemorrhagic stroke patients.

Results:

The median NT-proBNP, hsCRP and ferritin serum concentrations were significantly high for cases when compared to controls (P < 0.05). However, serum concentrations of NT-proBNP, hsCRP and ferritin were not significantly different when ischaemic and haemorrhagic stroke patients were compared. HsCRP showed a negative correlation with SSS score on admission and showed a positive correlation with mRS at discharge. In multivariate adjusted regression models, hsCRP remained associated with worse functional outcomes at discharge.

Conclusions:

In acute stroke patients, elevated concentration of hsCRP is associated with greater clinical stroke severity and worse functional outcomes at discharge. Hence, it can be used along with computed tomography scan/magnetic resonance imaging for assessment of stroke severity.
Rare haematological complication of a rheumatological disease
Authors: Kumar Dhanavath Naik Arun , Naini Abhilash , Rajkumar Medigadda , Rohit Lagisetti , Rao Modugu Nageswara , Uppin Megha
Published: December 2023

A 16-year-old female presented with complaints of low-grade fever for 4 months associated with generalised weakness, loss of appetite, significant loss of weight and loss of hair. On examination, pallor was evident. Rest of the examination was normal. Initial investigations revealed haemoglobin of 7 g/dL, white blood cell count of 3000 cells/mm3 and platelet count of 25,000/mm3. Bone marrow biopsy revealed 30% cellularity, suggestive of hypoplastic marrow. Further investigations revealed anti-nuclear antibody (4+ homogeneous pattern and 2+ cytoplasmic pattern); anti-dsDNA antibody was positive, low complements. A diagnosis of hypoplastic anaemia secondary to systemic lupus erythematosus was made.
Management of Discoloured Maxillary Central Incisor with Intracoronal Bleaching
Authors: Haridas Harsha , George Sibin , Muliyar Sabir
Published: December 2023

Dentistry has an array of treatment options to harmonise a smile with discoloured teeth. Bleaching is an extremely promising option. Bleaching is a safe and conservative approach to tackle discolorations, hence gaining wider acceptance. Intracoronal bleaching of non-vital teeth involves the use of oxidising agents within the coronal portion of an endodontically treated tooth to remove tooth discolouration. The objectives of treatment are to reduce or eliminate discolouration, improve the degree of coronal translucency and alleviate present and prevent future adverse clinical signs or symptoms. The successful outcome depends mainly on the cause, correct diagnosis, case selection and proper application of bleaching technique.
Bioprinting: The Future of Maxillofacial Prosthetic Rehabilitation
Authors: Pranav A. G. , Madhavan Ranjith , Sheejith M. , Francis Nivea T.
Published: December 2023

Bioprinting is an additive printing process in which the bio-ink containing the extracellular matrix-like material with stem cells and active biomolecules is deposited in a precise location with the help of a computer-aided design (CAD) system. Three-dimensional (3D) bioprinting is a developing technology that is derived from the evolution of 3D printing. The ability to print biological tissues like traditional 3D plastic and metal printing has resulted in the birth of a new era of 3D printing and tissue engineering. It was originally defined as ‘organ printing’, and this process involves a CAD model, which aids in converting and designing the maxillofacial prostheses, and then, it is fabricated through printing by deposition of cells, biomaterials and biomolecules. Murphy and Atala described 3D bioprinting as ‘layer-by-layer precise positioning of biological materials, biochemicals and living cells, with spatial control of the location of functional components to fabricate 3D structures’. 3D bioprinting covers a broad range of bioprinting techniques that can be used to print tissue and organ models to help research drugs and potential treatments. The future is created in the present; bioprinting and its applications will change the outlook of dentistry. This article has illustrated the concepts, materials used, techniques, limitations and prospects of bioprinting, which helps in the fabrication of maxillofacial prostheses.
Children’s Experiences Using Various Appliances for Class II Malocclusion: A Cross-sectional Study
Authors: Suresh Kavya , Peedikayil Faizal C. , Kottayi Soni , Aravind Athira
Published: December 2023

Background:

Skeletal Class II correction is one of the most challenging malocclusions for a dental surgeon. The appliances used in their treatment have advantages and disadvantages regarding patient comfort. Therefore, the aim of this study was to evaluate the experiences of patients regarding the use of various removable appliances for Class II malocclusion.

Methodology:

Patients were divided into three groups regarding the type of orthopaedic appliance used, i.e. headgear, twin block and a combination of twin block with headgear. The subjects were given a questionnaire which consisted of 15 multiple-choice questions. The children answered the questions in a one-to-one session with the principal investigator in the presence of their parents. The data were collected and descriptive statistics were done, and P < 0.05 was considered statistically significant.

Results:

Out of 75 patients, 49 were undergoing treatment with headgear, 14 with twin block and 12 with a combination of twin block and headgear. Amongst these patients, toothache was observed in all patient groups. Pain in temporomandibular joint (TMJ) was found to be statistically significant (P = 0.0397) in subjects using twin block and twin block with headgear. Patients had difficulties during sleeping and speech also.

Conclusion:

This study has shown that pain of the teeth, jaw pain and sleep difficulties were the common problems encountered while using the appliances. The study also showed that patients had problems with pronunciation. TMJ pain was significant in patients using twin block and twin block with headgear.
Success Rates of Immediately Loaded Implants in the Maxilla – A 10-year Follow-up Study
Authors: Vidyadharan Arun Kumar , Cho Sang-Choon , Jinendra Anju , Rajeev Gayathri
Published: December 2023

Introduction:

To restore missing teeth in the mouth, dental implants are crucial. Total edentulism leaves the patient unable to chew, smile or communicate well, which can cause a psychological collapse in day-to-day activities. The objectives of this retrospective study were to report the 10-year success rates of patients with immediately loaded implants in the fully edentulous maxilla by measuring the bone level at the coronal/crestal aspect annually and also to determine the survival rates and complications of the full-arch prosthesis.

Materials and Methods:

Seventy-seven implants (Ankylos, Dentsply, Tulsa, OK, USA) were inserted and immediately loaded in 10 fully edentulous maxillae. Patients were rehabilitated with a cement-retained metal-reinforced provisional bridge of 10–12 units, and all implants were loaded on the same day of placement. At the 12-month follow-up and each year thereafter, the prostheses were removed, and a clinical evaluation of the peri-implant tissues and implant mobility was made for each implant. The age of the patients included in the study ranged between 45 and 77 years, with the average age being 61 years old. Radiographic bone levels were recorded post-loading at years 1–10 annually.

Results:

In the group of immediate loading with simultaneous augmentation, 19 of 47 implants had received vertical or horizontal augmentation due to insufficient ridge height or width. In the other group, none of the 30 immediately loaded implants received augmentation either before or simultaneous with implant placement. After a clinical and radiographic follow-up period of 12–130 months, none of these implants were lost, and the probing depths around the implants were within normal limits. None of the prostheses reported prostheses loosening, abutment screw loosening or abutment screw fracture. In one case, maxillary fixed full-arch cement-retained final prostheses had to be replaced due to a fracture of the prostheses framework, and in two cases had to be replaced due to extensive ceramic chipping; hence, the cumulative survival rate of the prostheses was 70% at the end of 10 years.

Conclusion:

These results seem to demonstrate that a maxillary fixed full-arch prosthesis that is supported by at least six to eight implants in uniform distribution, even with simultaneous grafting, allows good long-term success for immediately loaded implants.
Mid-term outcomes of microfragmented adipose tissue plus arthroscopic surgery for knee osteoarthritis: A randomized, active-control, multicenter clinical trial
Authors: Wu Cong-Zi , Shi Zhen-Yu , Wu Zhen , Lin Wen-Jun , Chen Wei-Bo , Jia Xue-Wen , Xiang Si-Cheng , Xu Hui-Hui , Ge Qin-Wen , Zou Kai-Ao , Wang Xu , Chen Jia-Li , Wang Ping-Er , Yuan Wen-Hua , Jin Hong-Ting , Tong Pei-Jian
Published: December 2023

BACKGROUND

Osteoarthritis (OA) is the most prevalent form of degenerative whole-joint disease. Before the final option of knee replacement, arthroscopic surgery was the most widely used joint-preserving surgical treatment. Emerging regenerative therapies, such as those involving platelet-rich plasma, mesenchymal stem cells, and microfragmented adipose tissue (MFAT), have been pushed to the forefront of treatment to prevent the progression of OA. Currently, MFAT has been successfully applied to treat different types of orthopedic diseases.

AIM

To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA (KOA).

METHODS

A randomized, multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang, China. Overall, 302 patients diagnosed with KOA (Kellgren-Lawrence grades 2-3) were randomized to the MFAT group (n = 151, were administered MFAT following arthroscopic surgery), or the control group (n = 151, were administered hyaluronic acid following arthroscopic surgery). The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the visual analog scale (VAS) score, the Lequesne index score, the Whole-Organ Magnetic Resonance Imaging Score (WORMS), and safety over a 24-mo period from baseline.

RESULTS

The changes in the WOMAC score (including the three subscale scores), VAS pain score, and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups, as well as when comparing values at the posttreatment visit and those at baseline (P < 0.001). The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group (P < 0.05). Furthermore, the WOMAC stiffness score, WOMAC function score, and Lequesne index score differed significantly between the groups at 12 and 24 mo (P < 0.05). However, no signiﬁcant between-group differences were observed in the WORMS at 24 mo (P = 0.367). No serious adverse events occurred in both groups.

CONCLUSION

The MFAT injection combined with arthroscopic surgery treatment group showed better mid-term clinical outcomes compared to the control group, suggesting its efficacy as a therapeutic approach for patients with KOA.
Peri-operative score for elderly patients with resectable hepatocellular carcinoma
Authors: Conticchio Maria , Inchingolo Riccardo , Delvecchio Antonella , Ratti Francesca , Gelli Maximiliano , Anelli Massimiliano Ferdinando , Laurent Alexis , Vitali Giulio Cesare , Magistri Paolo , Assirati Giacomo , Felli Emanuele , Wakabayashi Taiga , Pessaux Patrick , Piardi Tullio , di Benedetto Fabrizio , de'Angelis Nicola , Briceño Javier , Rampoldi Antonio , Adam Renè , Cherqui Daniel , Aldrighetti Luca Antonio , Memeo Riccardo
Published: December 2023

BACKGROUND

Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma (HCC), also in elderly population. Despite this, the evaluation of patient condition, liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality.

AIM

To identify new perioperative risk factors that could be associated with higher 90- and 180-d mortality in elderly patients eligible for liver resection for HCC considering traditional perioperative risk scores and to develop a risk score.

METHODS

A multicentric, retrospective study was performed by reviewing the medical records of patients aged 70 years or older who electively underwent liver resection for HCC; several independent variables correlated with death from all causes at 90 and 180 d were studied. The coefficients of Cox regression proportional-hazards model for six-month mortality were rounded to the nearest integer to assign risk factors' weights and derive the scoring algorithm.

RESULTS

Multivariate analysis found variables (American Society of Anesthesiology score, high rate of comorbidities, Mayo end stage liver disease score and size of biggest lesion) that had independent correlations with increased 90- and 180-d mortality. A clinical risk score was developed with survival profiles.

CONCLUSION

This score can aid in stratifying this population in order to assess who can benefit from surgical treatment in terms of postoperative mortality.
Drug induced autoimmune hepatitis: An unfortunate case of herbal toxicity from Skullcap supplement: A case report
Authors: Thakral Nimish , Konjeti Venkata Rajesh , Salama Fady William
Published: December 2023

BACKGROUND

The surge in traditional herbal dietary supplement (HDS) popularity has led to increased drug-induced liver injuries (DILI). Despite lacking evidence of efficacy and being prohibited from making medical claims, their acceptance has risen over sevenfold in the last two decades, with roughly 25% of United States (US) adults using these supplements monthly. An estimated 23000 emergency room visits annually in the US are linked to HDS side effects. NIH-funded research suggests HDS contribute to 7-20% of DILI cases, with similar trends in Europe—Spain reporting 2% and Iceland up to 16%. Patients with acute liver failure from HDS undergo liver transplantation more frequently than those from prescription medicines. Here we describe a case of drug-induced autoimmune hepatitis due to Skullcap supplements, this association appears to be the first documented instance in literature.

CASE SUMMARY

A middle-aged Caucasian woman, previously healthy, presented with sudden jaundice. Four months earlier, her liver enzymes were normal. She mentioned recent use of Skullcap mushroom supplements. Tests for chronic liver disease were negative. The first liver biopsy indicated severe resolving drug-induced liver injury. Despite treatment, she was readmitted due to worsening jaundice. Follow-up tests raised concerns about autoimmune hepatitis. A subsequent biopsy confirmed this diagnosis. The patient responded as expected to stopping the medication with improvement in liver enzymes.

CONCLUSION

This scenario highlights an uncommon instance of DILI caused by Skullcap supplements. It's crucial for hepatologists to recognize this connection due to the increasing prevalence of herbal supplements.