bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Neural Network-based Handheld Diagnosis System for Autism Spectrum Disorder
Authors: Khullar Vikas , Singh Harjit P , Bala Manju
Published: April 2021

Objective:

The aim of the present work was to propose and implement deep neural network (DNN)-based handheld diagnosis system for more accurate diagnosis and severity assessment of individuals with autism spectrum disorder (ASD).

Methods:

Initially, the learning of the proposed system for ASD diagnosis was performed by implementing DNN algorithms such as a convolutional neural network (CNN) and long short-term memory (LSTM), and multilayer perceptron (MLP) with DSM-V based acquired dataset. The performance of the DNN algorithms was analyzed based on parameters viz. accuracy, loss, mean squared error (MSE), precision, recall, and area under the curve (AUC) during the training and validation process. Later, the optimum DNN algorithm, among the tested algorithms, was implemented on handheld diagnosis system (HDS) and the performance of HDS was analyzed. The stability of proposed DNN-based HDS was validated with the dataset group of 20 ASD and 20 typically developed (TD) individuals.

Results:

It was observed during comparative analysis that LSTM resulted better in ASD diagnosis as compared to other artificial intelligence (AI) algorithms such as CNN and MLP since LSTM showed stabilized results achieving maximum accuracy in less consumption of epochs with minimum MSE and loss. Further, the LSTM based proposed HDS for ASD achieved optimum results with 100% accuracy in reference to DSM-V, which was validated statistically using a group of ASD and TD individuals.

Conclusion:

The use of advanced AI algorithms could play an important role in the diagnosis of ASD in today's era. Since the proposed LSTM based HDS for ASD and determination of its severity provided accurate results with maximum accuracy with reference to DSM-V criteria, the proposed HDS could be the best alternative to the manual diagnosis system for diagnosis of ASD.
Deep Brain Stimulation for Treatment of Refractory Epilepsy
Authors: de Oliveira Tatiana V , Cukiert Arthur
Published: April 2021

Background and Introduction:

Deep brain stimulation (DBS) has been increasingly used in the treatment of refractory epilepsy with remarkable safety. Experimental data demonstrated that electric current could modulate distinct brain circuits and decrease neuronal hypersynchronization seen in epileptic activity. The ability to carefully choose the most suitable anatomical target and precisely implant the lead is of extreme importance for satisfactory outcomes.

Objective:

This video aimed to explore the targeting of the three most relevant nuclei in the treatment of refractory epilepsy.

Technique:

Through a step-by-step approach, this video describes the surgical planning for DBS implantation in the anterior nucleus of the thalamus (ANT), the centromedian nucleus of the thalamus (CM), and the hippocampus (HIP).

Conclusion:

Each of the discussed targets has its own pearls and pitfalls that should be considered for an adequate lead placement. Accurate planning of the surgical procedure is essential for achieving optimal results.
Simple Indigenous Two-Point Discrimination Testing Device
Authors: Agarwal Pawan , Mukati Prachir , Kukrele Rajeev , Sharma Dhananjaya
Published: April 2021

Background:

Measurement of two-point discrimination (2-PD) is used in clinical practice to evaluate the severity of nerve injuries, neuropathy, and recovery of patients following nerve repair. Commercially available 2-PD testing devices are costly and therefore not available everywhere.

Methods and Material:

We made an economical indigenous 2-PD testing device from off-the-shelf components and tested its efficacy in volunteers.

Statistical Analysis:

The data were analyzed using Minitab Statistical Software Version 17.0 and Kappa statistics were used in the assessment of agreement between two devices.

Results:

A total of 30 (23 men, 7 women) subjects were included in the study. There was good agreement between the measurements of static 2-PD with the two different test devices: from fair (Kappa = 0.408, P = 0.018) to strong (Kappa = 0.618–0.795, P = 0.000).

Conclusions:

This device is simple to make, very economical, and obtains accurate 2-PD measurements.
Ischemia Modified Albumin and miR-126 Play Important Role in Diagnosis of Posterior Circulation Transient Ischemic Attack and Prediction of Secondary Cerebral Infarction
Authors: Lidong Ding , Zhanghong Xiao , Huawu Mao , Xiaofang Hang , Junhua Guo , Kaifu Ke , Jue Chen
Published: April 2021

Background:

Transient ischemic attack (TIA) is a super warning for cerebral infarction stroke, thus probe of sensitive biomarker for TIA diagnosis and prognosis can contribute to make an optimal intervention plan.

Objective:

This study was conducted to explore the value of ischemic modified albumin (IMA) and microRNA-12miR-126 on the diagnosis of posterior circulation TIA and the prediction of secondary cerebral infarction.

Study Design:

This study was conducted as a longitudinal prospective research.

Methods:

The levels of serum IMA and miR-126 at 3h, 6h and 12h after TIA onset were analyzed in 106 patients, then the predictive value of IMA and miR-126 for secondary cerebral infarction were tested.

Results:

A significant increase of serum IMA and a decrease of miR-126 were observed after TIA onset (P = 0.000),simultaneously a significant negative correlation was found between serum IMA for 3 h and miR-126 for 12 hr=-0.401, P = 0.000. Both IMA and miR-126 were significant associated with the secondary cerebral infarction.

Conclusion:

Early detection of IMA and miR-126 is of great value in diagnosing posterior circulation TIA and predicting the secondary cerebral infarction.
Differential Characteristics of Ischemic and Hemorrhagic Stroke in Patients with Cerebral Small Vessel Disease
Authors: Bernal Mireia , Escarcena Paula , Arboix Adrià , García-Eroles Lluis , Vergés Enric , Díez Laura , Massons Joan
Published: April 2021

Background:

Small vessel disease (SVD) is the underlying anatomical substrate for both lacunar infarction and subcortical hemorrhage.

Aim:

To assess predictive factors of ischemic or hemorrhagic stroke in patients with cerebral SVD.

Materials and Methods:

Prospective hospital-based stroke registry (“The Sagrat Cor Hospital of Barcelona Stroke Registry”) in an acute-care teaching hospital in Barcelona, Spain. From 4597 acute stroke patients included in the stroke registry over a 24-year period, 440 cases of lacunar stroke and 210 of subcortical intracerebral hemorrhage were selected. Demographics, clinical characteristics, risk factors, and early outcome were compared. Predictors of lacuna versus subcortical hemorrhage were assessed by multivariate analyses.

Results:

In a logistic regression model based on demographics, risk factors, clinical features and outcome, dyslipidemia (odds ratio [OR] 2.06 (95% confidence interval (CI) 1.17-3.62) and diabetes (OR 1.97, 95% CI 1.19–3.26) were independent risk factors for lacunar infarction. Anticoagulation therapy (OR 0.05, 95% CI 0.01–0.28), sudden onset (OR 0.51, 95% CI 0.33–0.78), motor symptoms (OR 0.44, 95% CI 0.26–0.76), headache (OR 0.23, 95% CI 0.12–0.41), altered consciousness (OR 0.10, 95% CI 0.05–0.21), respiratory complications (OR 0.19, 95% CI 0.08–0.46), and in-hospital death (OR 0.08, 95% CI 0.02–0.36) were predictors of subcortical hemorrhage.

Conclusion:

Identification of differential clinical and prognostic profile between ischemic and hemorrhagic consequences of underlying cerebral SVD is useful for risk stratification in the current process pursuing precision medicine.
A Case of Possible IgG4-Related Disease with Bilateral Optic Neuropathy and Bilateral Hippocampal Bleed
Authors: Gogineni Sujana , Mehta Anish , Shah Arjun Gaurang , Kumar Selva , Nagappa HH , Pradeep R , Javali Mahendra , Acharya Puroshottam , Srinivasa Rangasetty
Published: April 2021

IgG4-related disease (IgG4-RD) is a multisystem inflammatory disorder. The diagnosis requires consideration of clinical, radiographic, serological, and pathological evidence. Neurological involvement by IgG4-RD is relatively uncommon and is being increasingly recognized and reported with hypertrophic pachymeningitis and hypophysitis as the most frequent manifestations. IgG4-related involvement of brain parenchyma is rare, but isolated case reports exist. Here, we report a case of a young boy who presented to us with bilateral optic neuropathy and bilateral hippocampal bleed-related neurological involvement in a possible IgG4-RD, a rare entity.
Isolated Cervical Pain Revealing a Common Carotid Artery Dissection in a Child Following a Minor Trauma
Authors: Messelmani Mariem , Akkari Manel , Souissi Wala , Mrissa Ridha
Published: April 2021

Background:

Cervical artery dissections are not exceptional in the pediatric population. Typically, it affects the internal carotid artery or the vertebral artery. To our knowledge, this is the first case of common carotid artery (CCA) dissection in a child.

Case:

We present a case of a 7-year-old-boy admitted to our neurology department complaining of cervical pain after a minor neck trauma. The neurological examination was normal. The ultrasound showed a mural hematoma with an intimal flap. The magnetic resonance angiography revealed an irregular segment of the left CCA just before its bifurcation. The diagnosis of an acute dissection on the left CCA was confirmed and antiplatelet therapy was started.

Conclusion:

The diagnosis of cervical artery dissections remains a challenge because of its variable clinical presentation. It should be suspected in the context of neck trauma and treatment should be initiated rapidly to reduce the risk of ischemic stroke.
Basal Cisternostomy - A Microsurgical Cerebro Spinal Fluid Let Out Procedure and Treatment Option in the Management of Traumatic Brain Injury. Analysis of 40 Consecutive Head Injury Patients Operated with and without Bone Flap Replacement Following Cisternostomy in a Tertiary Care Centre in India
Authors: Parthiban Jutty K B C , Sundaramahalingam Shanthanam , Rao J Balaparameswara , Nannaware Vaishali Pralhad , Rathwa Vishnu Najarubhai , Nasre Vaibhav Yogesh , Prahlad Shantigrama Thirumalachar
Published: April 2021

Background:

Decompressive craniectomy (DC) is considered the gold standard blanket surgical procedure for all medically intractable cerebral oedema in Traumatic Brain Injury (TBI). It's only proven fact is that it reduces Intra Cerebral Pressure (ICP) by providing space for the oedematous brain. Attempts are being made to find additional or alternative procedures to improve outcomes in TBI. Basal Cisternostomy is one such technique proposed to bring such a change in world literature.

Aim:

To analyse the validity of Basal Cisternostomy in TBI patients

Materials and Methods:

A total of 40 patients who underwent Basal Cisternostomy (BC) in TBI admitted in the senior author's unit between January 2016 and April 2019 were analysed retrospectively. All surgeries were performed by single surgeon with microsurgical expertise. Outcome was assessed according to Glasgow outcome scale (GOS). Results were analysed using SPSS software.

Results:

In severe TBI, Basal Cisternostomy group showed 77.8% favourable outcome while Decompressive Craniectomy in addition to Basal Cisternostomy group showed 72.7% only. While favourable GOS was seen in 82% (33/40), the unfavourable outcome was noticed in 12.5% (5/40) and death in 5% (2/40) in this series. Hydrocephalus was seen in 12.5% (5/40). Patients operated earlier from the time of injury showed better results than those who got operated later irrespective of severity of neurological status. ICU stay and hospital stay duration and its validity could not be assessed.

Conclusion:

Basal Cisternostomy is an effective procedure in Traumatic Brain Injury patients that not only improves outcome but also reduces the need for Decompressive Craniectomy as a blanket procedure and thus avoiding its associated complications.
Bone Wax as an Intra-Cavitary Fiducial for Intra-Operative Magnetic Resonance Imaging Guided Resections of Eloquent Cortex Glioma
Authors: Arumalla Kirit , Deora Harsh
Published: April 2021

Background:

The extent of resection of eloquent cortex low-grade glioma is improved by intraoperative magnetic resonance imaging (IOMRI) which is faced with challenges such as difficulty in automated registration after the MRI and prolongation of operative time.

Objective:

We describe an easier and foolproof method of resection using bone wax as fiducial.

Surgical Procedure:

A young male with right-frontal low-grade glioma anterior and superficial to the motor fibers was operated using IOMRI and awake craniotomy under neuromonitoring. Motor cortex mapping using phase reversal and continuous motor evoked potential (MEP) monitoring was used initially followed by continuous sub-cortical suction stimulation for deeper decompression until stimulation was seen. Bone wax in a triangular shape was placed at the suspicious margin and IOMRI was done.

Results:

The tumor residue was seen anterior and deeper to the bone wax and removed subsequently.

Conclusion:

The use of bone wax as a fiducial can aid in IOMRI-guided resection of eloquent cortex glioma in awake patients.
Anomalous Vertebral Artery During Cranio Vertebral Junction Surgery Using DCER (Distraction, Compression, Extension, and Reduction)
Authors: Chandra P S , Ghonia Raj , Singh Simranjeet , Garg Kanwaljeet
Published: April 2021

Introduction:

Vertebral artery (VA) may run an anomalous course in congenital craniovertebral junction anomalies. Anomalous VA, though rare, is challenging to handle. An anomalous VA can get injured during exposure of craniovertebral junction, even in the experienced hands.

Objective:

The objective of this article was to describe the technique of repairing the VA in case of its damage during exposure in the craniovertebral junction (atlantoaxial dislocation [AAD] with basilar invagination [BI]).

Procedure:

The authors describe a case of VA artery injury in a case of severe BI & AAD, which was anomalous and coursing over the joints. Following the repair of injured VA, we proceeded with the surgery (distraction, compression, extension, and reduction [DCER]).

Conclusion:

To avoid injury, it is important to always perform a CT 3-D angiogram, perform meticulous dissection under the microscope while exposing the joints, use variable impedance bipolar to control venous bleeding and always expose the side with non-dominant VA first.
Interleaved Stimulation for Freezing of Gait in Advanced Parkinson's Disease
Authors: Zafar Syed M , Rajan Roopa , Krishnan Syam , Kesavapisharady Krishnakumar , Kishore Asha
Published: April 2021

Background:

Freezing of gait (FOG) is a disabling and refractory symptom of advanced Parkinson's disease (PD). Interleaved stimulation (ILS) is a novel paradigm which may benefit axial symptoms of PD.

Objectives:

To assess the effect of ILS on FOG in patients unresponsive to conventional subthalamic nucleus (STN) stimulation.

Methods:

19 PD patients receiving subthalamic stimulation and experiencing FOG at both conventional (130–150Hz) and low frequency (60Hz) stimulation were given ILS. The primary outcome measure was the UPDRS part III gait score (item 29) at 3 months after ILS. A subset of patients was tested with the stand–walk–sit (SWS) test, 30 min after ILS.

Results:

The mean UPDRS part III gait score (baseline: 1.8 ± 0.6) improved at 30 min (1.1 ± 0.8, P = 0.017) and remained improved at 3 months (1.2 ± 0.8, P = 0.048). FOG episodes reduced during SWS test (P = 0.041).

Conclusions:

ILS of STN through two adjacent contacts provided significant short-term beneficial effects on FOG.
Microencephaly in macrocephaly
Authors: Agarwal Ayush , Garg Divyani , Agarwal Sangeeta
Published: April 2021

Glutaric aciduria type 1 is an autosomal recessive disorder caused by mutations in GCDH gene on chromosome 19 leading to the deficiency of glutaryl-CoA dehydrogenase which causes an abnormal metabolism of lysine, hydroxylysine and tryptophan with resultant accumulation of glutaric acid and 3-hydroxy glutaric acid. Usual presentations include macrocephaly with recurrent dystonic episodes, along with developmental regression. The diagnosis is based on characteristic magnetic resonance imaging finding of widening of sylvian fissures and urinary tandem mass spectroscopic analysis of excess glutarylcarnitine and hydroxyglutaric acid. Management includes lysine-free diet and carnitine supplementation.
Incidence of colorectal cancers in India
Authors: Asthana Smita , Khenchi Rubal , Labani Satyanarayana
Published: April 2021

A number of studies on population-based cancer registries (PBCRs) data have been reported from India about various cancers. However, updated status of colorectal cancer is not available in literature. The objective is to provide an overview of age-specific and age-adjusted colorectal cancer incidence reported in 27 PBCRs in India. Secondary data on age-specific and age-adjusted rates of incidence rate, the lifetime risk of the disease was computed using cumulative risk and a number of cases for all ages (0–75 years), were collected from the report of the National Cancer Registry Program 2012-2014 in 27 population-based control registries. The annual incidence rates (AARs) for colon cancer and rectal cancer in men are 5.36 and 5.17/100,000, respectively. The AAR for colon cancer in women is 4.3/100,000. Males were comparably at higher risk than females. The maximum lifetime risk of developing colon cancer ranged from 167 to 500 females and lifetime risk of developing rectum cancer ranged from 100 to 353 in males. The risk of colorectal cancers was high amongst the Northeast population followed by South regions of India. The management of colon and rectal cancer cases and screening could serve to control the disease.
Efficacy of Antibacterial Sealant to Prevent Microlekage at the Implant Superstructure Interface – An In vivo Study
Authors: Nayak Aishwarya , Nadiger Ramesh , Bhat Kishore , Ingalgi Preeti , Kulkarni Raghvendra
Published: April 2021

Objective:

The aim of this study is to evaluate the efficacy of antibacterial sealants to prevent microleakage at the implant superstructure interface.

Materials and Methods:

Around twenty patients were selected after a thorough investigation with lower missing teeth (1st and 2nd premolars 1st and 2nd molars) by inclusion criteria. The patients were divided into two groups Group A (10 patients)– Control group and Group B (10 patients)-test group. The implants were placed with proper surgical protocol in all the patients except that in the test group antibacterial sealant was used before putting the coverscrew. The implants were allowed to osseointegrate for 3 months after which swabs were collected from the interior of the implant once the cover screw was removed. The swabs collected from all the patients were immediately transported to the microbiology laboratory by placing in 1 ml of phosphate buffered saline. The swabs were inoculated on brain heart infusion and McKonkeys medium and processed for routine culture and sensitivity. The identification of the isolates was done by standard microbiological methods. The data thus obtained were subjected to statistical analysis using t-tests for equality.

Results:

Microbial growth was found in both the groups, but lesser variation in colony-forming units was observed in the test group where antibacterial sealant was used.

Conclusions:

It was concluded that in spite of using antibacterial sealants; some amount of microleakage was still observed.
Scoping Review on the Concept of Patient Motivation and Practical Tools to Assess it
Authors: Hosseini Fatemeh , Alavi Negin Masoud , Mohammadi Eesa , Sadat Zohreh
Published: April 2021

Background:

In this scoping review, the concept of patients' motivation and the tools that have been designed to measure this concept in clinical settings are presented.

Materials and Methods:

Arksey and O'Malley's framework was used in conducting the current scoping review. Google Scholar, PubMed, Scopus, and Web of Science databases were searched for relevant English articles published between January 1995 and January 2020 using the keywords motivation and tool, and their synonyms. Out of 2820 articles, 34 articles were chosen and were entered into the final analysis. Definitions of patients' motivation were determined using Kyngäs et al., content analysis method.

Results:

The findings showed that new tools had been developed in 38% of the studies and other studies had revised or translated existing questionnaires. Moreover, 62% of the tools were used to measure patient motivation in mental disorders. Most of the studies did not clearly define the concept of patient motivation in the clinical environment. The findings of content analysis outlined the 3 categories of motivation determinant factors, decisions, and behaviors that determine overall levels of motivations and its consequences.

Conclusions:

Motivation is a dynamic concept and is a result of internal and external motives that lead to decisions and behaviors. There are limited tools for measuring motivation in clinical settings. This addresses the need to design specific tools in various diseases, especially chronic diseases. By the concept defined in this study, it is possible to design a short tool with general application that can be used in all diseases.
Comparing the Effectiveness of Sexual Counseling Based on PLISSITand BETTER Models on Sexual Selfdisclosure in Women with Sexual Problems after Childbirth
Authors: Karimi Farzane , Babazadeh Raheleh , Roudsari Robab Latifnejad , Asgharipour Negar , Esmaily Habibollah
Published: April 2021

Background:

Sexual self-disclosure is one of the factors that affect sexual satisfaction. The aim of this study was to assess the efficacy of individual therapy using the Bring up, Explain, Tell, Timing, Educate, and Record (BETTER model) in comparison to individual therapy using the Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT model) in terms of increasing sexual self-disclosure in women with sexual problems after childbirth.

Materials and Methods:

This randomized trial was conducted in 2017 in Mashhad, Iran. 80 women with sexual problems within 4 weeks to 6 months after childbirth were randomized into two equal groups and received the interventions in 2 sessions of 60–90 minutes. The research instruments included a demographic questionnaire, the Female Sexual Function Index (FSFI) and Hulbert sexual self-disclosure index. Changes in mean (SD) scores of sexual self-disclosures between groups were assessed before and 4 weeks after the intervention and the results (mean changes) were compared between groups. The data analysis was conducted using independent t-test, paired t-test, Chi-square, analysis of covariance (ANOVA), and Mann-Whitney U test in SPSS (p < 0.05).

Results:

In the PLISSIT group, the mean (SD) sexual self-disclosure score at baseline was 43.80 (9.50) and after 4 weeks was 51.60 (8.30). In the BETTER group, at baseline and after 4 weeks the mean (SD) sexual self-disclosure score was, respectively, 44.10 (10.30) and 55.60 (8.20) (Z = -2.5, p = 0.013).

Conclusions:

The findings confirm the effectiveness of the BETTER counseling model in increasing sexual self-disclosure after childbirth.
Experiences of Family Caregivers of Patients with Borderline Personality Disorder of Social Stigma
Authors: Meshkinyazd Ali , Bordbar Mohammadreza Fayyazi , Heydari Abbas
Published: April 2021

Background:

Social stigma is the most common and challenging burden of care on the family of people with Borderline Personality Disorder (BPD) In Iran, despite the cultural and social influences, this issue has been less studied. Therefore, present study was conducted to determine the lived experiences of caregivers of patients with BPD of social stigma.

Materials and Methods:

This qualitative study was performed at Ibn Sina hospital in Mashhad, Iran from 2017 to 2019. Participants were selected by purposive and snowball sampling method. Data were collected through semi-structured interviews. Data saturation was achieved after 16 interviews. Finally, the data were analyzed by the method proposed by Diekelmann (1989).

Results:

In data analysis, one main theme and two sub-themes emerged. The main themes include Black shadow. Two sub-themes consisted of society dagger and secrecy. The sub-theme of society dagger included the two common meanings (inner turmoil in response to the stigma of others and weakening of family status among relatives and acquaintances). The sub-theme of secrecy comprised of the three common meanings (concealment of disease, hide hospitalization, and seclusion).

Conclusions:

An understanding of the experience of family stigma can lead to the development of supportive strategies to manage this problem among caregivers of patients with BPD. Nurses can support caregivers by offering them opportunities to discuss how stigma is disrupting their caregiving roles. They can also support the caregivers in negotiating the experienced social and emotional distress and when necessary, refer them to the other members of healthcare teams.
The Effect of Exposure to Rubber Production Emissions and Physical Activity on Pulmonary Function Indices among Tyre Manufacturing Employees in Iran
Authors: Rafeemanesh Ehsan , Esmaily Habibollah , Ahmadi Fatemeh , Sardar Mohammadali , Ghooshchi Golnoosh
Published: April 2021

Background:

Exposure to rubber production emissions can cause respiratory problems. There is some evidence that physical activity might have protective effects against respiratory obstruction.

Aims:

This study, was investigated the effect of physical activity on potential respiratory damages induced by the exposure to rubber production chemicals.

Methods:

This cross-sectional study was carried out during 2019 on the staff of a rubber manufacturing company in Khorasan, Iran. Employees of a rubber manufacturing company were recruited in this cross-sectional study (n = 385), and were classified into exposed (n = 266) and unexposed (n = 119) groups. Baecke Physical Activity Questionnaire (BPAQ) was used to assess the level of physical activity. Logistic regression was used to evaluate the effects of exposure, physical activity and confounding variables on pulmonary function test (PFT) results.

Results:

Work, leisure time and total physical activity scores were significantly higher in exposure group compared with control group subjects. Although no significant differences were observed between the exposure and control groups in most spirometric parameters, FEF25-75 was significantly lower in the exposure group (P = 0.035). Abnormal PFT was observed in 93 participants (24.2%) and in the multivariate model was significantly associated with exposure (OR = 1.80, CI95: 1.01-3.22) and age (OR = 1.08, CI95: 1.02-1.14) but not physical activity score.

Conclusion:

Exposure to rubber manufacturing chemicals nearly doubles the odds of abnormal PFT, and the self-reported level of physical activity had no protective effect against these occupational hazards.
Pulsed Radiofrequency Lesioning of the Lumbosacral Dorsal Root Ganglion in a Patient with Lumbosacral Plexopathy due to Locally Advanced Pelvic Liposarcoma
Authors: Murugesan Anand , Daivam Indumathi , Nangia Sapna , Burela Nagarjuna , Panda Pankaj Kumar , Raghuraman M. S.
Published: April 2021

Neoplastic lumbosacral plexopathy can be associated with pelvic malignancies where patients present with severe lumbosacral radicular pain (LSP) involving the lower extremities, leading to weakness of the affected limb. We hereby report the case of a 34-year male who presented with pain in low back radiating to left lower limb for the past 2 months. MR imaging, histopathological examination after debulking surgery confirmed it as a liposarcoma involving the anterior aspect of the left side of sacrum extending toward left neural foramina of S1-S2, left greater sciatic notch and left piriformis muscle. As the LSP was refractory to previous neuropathic medications it was planned to perform pulsed radiofrequency lesioning (PRFL) of lumbosacral Dorsal root ganglion (DRG) from L3 to S1 before further oncological management. Each DRG was treated with PRFL at 42°C for 120 s. Postprocedure, the patient had a satisfactory pain relief and underwent further oncological management.
Magnetic Resonance Imaging Scan of the Dimensions of Normal Lumbar Intervertebral Foramina - An Observational Study
Authors: Mallick Santanu P.
Published: April 2021

Background:

Intervertebral foramen (IVF) is an oval, round, or inverted teardrop shaped bilateral fibro osseous window throughout the entire vertebral column through which neurovascular structures pass. The lumber canal stenosis due to variations of narrowing of intervertebral foramina causes compression of exiting spinal nerve or other foraminal components, for which normal IVF dimensions must be known and understood thoroughly.

Aims and Objectives:

Although computed tomography scan remains very effective in the evaluation of osseous tissues, but being a fibro osseous canal, intervertebral foramina can be better evaluated by magnetic resonance imaging (MRI) scan for superior resolution.

Materials and Methods:

Normal morphometric database of right and left lumber IVF of 195 normal adult males (96) and females (99) from different age groups (20–69 years) has been taken to draw conclusions from the data relevant to clinical practice and future research. MRI scan in the sagittal plane gives a complete view of the fibro osseous canal, whereas horizontal imaging (axial view) does not demonstrate the entire IVF on a single image. That's why all the measurements were taken from the sagittal plane.

Results:

All the values are evaluated with the subjects' age, sex, weight, height, and also with the left versus right sides. The development of this normal database should further allow for more meaningful evaluation of the dimensions of the IVFs in pathologic states. Although diagnosis can be suspected from the history and physical findings, knowledge of the specific anatomy of this clinically significant area with radiological support is very important in the differential diagnosis which helps in proper management.

Conclusion:

Therefore, it is really convincing that, with regard to morphometry of the spine by means of MRI, the future is very promising.
A Prospective Observational Study to Assess Drug Aberrant Behaviours in Chronic Pain Patients on Gabapentinoids
Authors: Berwertz Martyna , Das Sangeeta , Raj John Michael
Published: April 2021

Aim:

The aim is to explore whether addiction or drug aberrant behavior exists among patients being treated with pregabalin or gabapentin in our outpatient service.

Methods:

A self-administered questionnaire, the current opioid misuse measure (COMM) was distributed to all patients attending the outpatient service. They filled this voluntarily with maintenance of complete anonymity and confidentiality. Statistical analysis was conducted using the SPSS software.

Results:

A total of 52 questionnaires were received. Twenty-one patients were on gabapentin and 19 on pregabalin. Eighty percent of the patients had little or no benefit and yet an attempt to taper the doses was made only in 37.8% patients. About 56.9% patients had COMM scores above 9, the cut off value for detecting drug abuse/misuse. The COMM scores showed a positive association with the dose magnitude of gabapentin (P = 0.006) but not pregabalin. They also showed a significant positive correlation with the duration of treatment with pregabalin (P = 0.000). The Mann–Whitney U-test showed that the COMM scores were significantly higher in the pregabalin group (P = 0.022).

Conclusions:

Our findings suggest gabapentinoids do carry a potential risk of addiction. Pregabalin more than gabapentin may have a potential for drug aberrant behavior. We must regularly review patient's doses and duration of treatment. Large scale studies are needed to validate the findings. Setting up of national pharmacovigilance databases may be the way forward in preventing a potential drug abuse problem.
The effect of variation of tetrahydropentagamavunon-0 concentration in lotion and emulgel formula toward acute dermal irritation study
Authors: Ritmaleni  , Susilo Putri Dina Suci , Wulandari Tia , Zulkarnain Abdul Karim , Murrukmihadi Mimiek
Published: April 2021

Tetrahydropentagamavunon-0 (THPGV-0) is a curcumin metabolite analog which known has a higher antioxidant activity than Vitamin E. This compound has been formulated in lotion as antiaging cosmetics, but the irritation effect is unknown yet. This study aims to analyze the effect of variation of THPGV-0 concentration in lotion and emulgel formula toward acute dermal irritation. The concentrations of THPGV-0 varied to 0.1%, 0.2%, and 0.4% in lotion/emulgel and tested for their physical properties such as organoleptic, homogeneity, pH, spreadability, and adhesion. Acute dermal irritation test is done in accordance with the In vivo Nonclinical Toxicity Test Guidelines by the Indonesian Food and Drug Administration (BPOM). This study showed that Primary Irritation Index (PII) value concentrations of 0.1%, 0.2%, and 0.4% THPGV-0 in lotion formula are 0.014, 0.014, and 0.028 (close to 0) and in emulgel formula are 0.08 at concentration of 0.1%, 0.33 at concentration of 0.2%, and 0.25 at concentration of 0.4%. PII of 0.1%, 0.2%, and 0.4% THPGV-0 in lotion and emulgel is included in negligible irritation response. Hence, the both of THPGV-0 formula in lotion and emulgel are considered safe to use on skin according to this study.
Rhaponticin contained Rheum officinale root extract improved Postmenopause symptom of Ovariectomized Rat
Authors: Bahtiar Anton , Setyowati Herlina Tri , Mahanani Retno Rela , Wati Azizah , Arsianti Ade , Fadilah Fadilah
Published: April 2021

Postmenopausal women have decreased levels of the hormone estrogen. Reduced estrogen levels will often involve many symptoms that reduced quality of life. This research aims to analyze the effects of Rheum officinale root extract on postmenopausal model rats. To this end, thirty rats underwent ovariectomy (OVX) surgery and six rats were operated without having their ovaries removed. The OVX was confirmed by body weight–uterus weight ratio and a vaginal swab. Six groups of the rats were performed: SHAM group and negative control groups are given vehicle; the positive control was assigned tamoxifen; and the extract has been given three doses 7, 35, and 175 mg/200 g BW, respectively, for 30 days. The calcium content of bone ash was measured using atomic absorption spectrophotometer. Blood pressure was evaluated using CODA®, and the metabolites in the blood were assessed using gas chromatography–mass spectrometry (MS) and high-performance liquid chromatography. As a result, using ultra-performance liquid chromatography (UPLC)-MS, we found that the extract's major component was rhaponticin and its metabolites. The bone calcium levels increased with increasing doses of the extract. In the OVX group, the bone calcium content was decreased significantly 51.56% ± 8.9% g compared with the SHAM group 62.97% ±5.6% g, and the administration of Rheum extract could restore the calcium content of the bone to become 69.27% ± 3.8% g. From the above data, we concluded that Rheum root extracts contain astrigin, rhaponticin, rhapontigenin, and desoxyrhaponticin. Rheum root extract could improve calcium content and lipid profiles of OVX rats by stimulation osteoblastogenesis. Rheum root extracts could control the blood pressure of OVX rats by reducing lipid profiles.
Anti-inflammatory activity and chemical constituents of red limestone
Authors: Duangyod Thidarat , Rujanapan Narawadee , Champakam Sorraya , Charoensup Rawiwan
Published: April 2021

Red limestone is a mixture of turmeric (Curcuma longa L.) powder and limestone which is made from burning shells at high temperature. The yellow mixture turns to red color or deep orange because of the reaction between turmeric and calcium carbonate in limestone. Red limestone is traditionally used to treat many diseases such as abscess, cut wound and insect bite. The purpose of this study was to investigate anti-inflammatory activity and chemical constituents of red limestone. The chemical analysis of red limestone extract by liquid chromatography with tandem mass spectrometry revealed that red limestone consisted of alpha-turmerone and curcumanolide B as major components. These compounds were related with the chemical constituents in C. longa extract which is a main ingredient of red limestone. However, curcuminoids were not detected in red limestone extract. Cytotoxicity of red limestone extract was investigated. Macrophage cell lines (RAW 264.7) and human keratinocyte cell lines (HaCaT cells) were investigated cell viability using MTT assay. Red limestone extract was nontoxic to normal cells such as macrophage cells and human keratinocyte cells. Moreover, the inflammatory activity was detected nitric oxide (NO) secretion in RAW 264.7 cells. The result showed that the extracts inhibited NO in dose-dependent manner and IC50 was found to be 102.42 μg/ml. It suggested that red limestone extract had a potential for anti-inflammatory activity.
Acute toxicity test of kenikir leaf (Cosmos caudatus H.B.K) ethanolic extract on Wistar white male rats with fixed dose procedure method and its effect on histopathology of pancreatic cells
Authors: Herlina Herlina , Amriani Annisa , Sari Indah Permata , Apriani Elsa Fitria
Published: April 2021

In this study, acute toxicity of kenikir leaf (Cosmos caudatus HBK) ethanolic extract was conducted on Wistar white male rats with fixed dose procedure. The extraction method used was maceration using 70% ethanol. A dose of 2000 mg/kgBW was determined as the starting dose based on the preliminary test result. The rats used in the main test were divided into the normal group and the 2000 mg/kgBW dose group, each used five animals in each group. The results of the test showed that there were no deaths or toxic symptoms both of the normal group and the 2000 mg/kgBW dose group. The conducted preliminary test results a dose of 2000 mg/kgBW as the starting dose. Next, main test is done toward two groups of rats: Normal group and 2000 mg/kgBW dose group each consist of five animals. The main test results in neither deaths nor toxic symptoms from those groups. The range of toxic doses of kenikir leaf ethanolic extract that can cause acute toxicity is >2000 mg/kgBW, and hence, this experiment classified in the practically nontoxic category. Statistical analysis on effect to macroscopic organs of the liver, heart, and kidney showed no significance (P > 0.05) from kenikir leaf ethanolic extract. Average levels of biochemical parameters from the 2000 mg/kgBW group and the normal group were in the normal range. Ethanolic extract at a dose of 333 mg/kg BW does not cause severe pancreatic damage, and hence, it is considered safe for use as an antidiabetic.
An Update on Coronavirus Disease-19 Vaccines
Authors: Gupta Madhu , Kapoor Isha
Published: April 2021

Coronavirus disease-19 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in massive health and economic burden. There has been substantial morbidities and mortalities owing to its high transmission rate. Therefore, effective strategies for treatment and prevention are crucial. Vaccines offer a ray of hope for the prevention and controlling the spread. Various new technological platforms have been utilised for vaccine production. The current review provides a brief description of these platforms for vaccine production and an update on the available and upcoming COVID-19 vaccines, discussing their results and outcomes from different trial phases. We have also focused on COVID-19 vaccination drive in India, emergency use authorisation, other candidate vaccines in Indian landscape, and issues involved with their clinical use and current recommendations.
Functional Outcome of Intra-Articular Fracture of Distal End of Radius Treated by Open Reduction and Internal Fixation with Locking Distal Radius System
Authors: Chandan Kumar , Kumar Ravi , Ranjan Rahul , Amar Rohit
Published: April 2021

Background:

There is alays been a dilemma in the treatment of intra-articular distal radius fracture (DRF). Close reduction and cast application gives satisfactory result in extra-articular Distal Radial Fractures but there is alays been debate beteen open and close reduction in the intra-articular fracture. Hence, this study is to evaluate effectiveness of open reduction and internal fixation of intra-articular Distal Radial Fractures.

Materials and Methods:

This prospective observational study as carried out in the department of orthopedics, All India Institute of Medical Sciences, Patna, from August 2016 to March 2019. The patient ere included ho qualified the inclusion criteria. The included patient ere treated by open reduction and internal fixation ith distal radius plate. The outcome as assessed in term of anatomical variables (radial dorsal tilt, length, and angle), residual deformity, and subjective result evaluation using Sarmiento's modification of Lind Storm criteria. The complication if any as also noted.

Results:

This study included 30 cases of intra-articular DRF, 12 fractures of AO type B, and 18 fractures of AO type C. Anatomically, 24 patients (80%) had excellent restoration of anatomy, 4 patients (13%) had good restoration and 2 had fair (7%) restoration of anatomy. 93% of patients had excellent to good alignment of fragments and good reduction could not be achieved in 7% of patients resulting in fair or poor results. Functionally, 22 patients (73%) had excellent, 5 good (17%), and 3 patients had fair (10%) restoration of functions.

Conclusion:

Open reduction and internal fixation ith volar plate and scres fixation gives satisfactory (good to excellent) result in intra-articular Distal Radial Fractures.
Монотонная линейная связность чебышeвских множеств в трехмерных пространствах
Authors: Alimov Alexey Rostislavovich , Bednov Borislav Borusovich
Published: April 2021

Дается характеризация трехмерных банаховых пространств, в которых любое чебышeвское множество монотонно линейно связно. А именно, в трехмерном нормированном пространстве $X$ любое чебышeвское множество монотонно линейно связно, если и только если выполнено одно из следующих двух условий: любая достижимая точка единичной сферы пространства $X$ является точкой гладкости; $X=Y\oplus_\infty \mathbb R$ (т.е. единичная сфера пространства $X$ - цилиндр).
Библиография: 17 названий.
О $DA$-эндоморфизмах двумерного тора
Authors: Grines Vyacheslav Zigmuntovich , Zhuzhoma Evgenii Viktorovich , Kurenkov Evgeny Dmitrievich
Published: April 2021

Доказывается, что в каждом гомотопическом классе непрерывных отображений двумерного тора, индуцирующих гиперболическое действие в фундаментальной группе и не содержащих растягивающих отображений, существует $A$-эндоморфизм $f$, неблуждающее множество которого состоит из притягивающего гиперболического стока и нетривиального одномерного сжимающегося репеллера, который является одномерной ориентируемой ламинацией, локально гомеоморфной прямому произведению канторова множества на отрезок. Более того, неустойчивое $Df$-инвариантное подрасслоение касательного пространства к репеллеру обладает свойством единственности.
Библиография: 23 названия.
Многообразия изоспектральных матриц-стрелок
Authors: Ayzenberg Anton Andreyevich , Buchstaber Victor Matveevich
Published: April 2021

Матрицей-стрелкой называется матрица с нулями вне главной диагонали, первой строки и первого столбца. В работе исследуется пространство $M_{\operatorname{St}_n,\lambda}$ всех эрмитовых матриц-стрелок размера $(n+1)\times (n+1)$, имеющих заданный простой спектр $\lambda$. Доказано, что это пространство - гладкое $2n$-мерное многообразие с локально стандартным действием тора, описана топология и комбинаторика его пространства орбит. При $n\geqslant 3$ пространство орбит $M_{\operatorname{St}_n,\lambda}/T^n$ не является многогранником, а значит, $M_{\operatorname{St}_n,\lambda}$ не является квазиторическим многообразием. Тем не менее на $M_{\operatorname{St}_n,\lambda}$ имеется действие полупрямого произведения $T^n\rtimes\Sigma_n$ и его пространство орбит диффеоморфно специальному простому многограннику $\mathscr B^n$, который получается из куба срезкой граней коразмерности 2. При $n=3$ пространство орбит $M_{\operatorname{St}_3,\lambda}/T^3$ является полноторием, граница которого разбита регулярным образом на шестиугольники, что позволило описать кольца когомологий и эквивариантных когомологий шестимерного многообразия $M_{\operatorname{St}_3,\lambda}$ и еще одного многообразия - его двойника.
Библиография: 32 названия.
Effect Of Laboratory Produced Xylanase From Aspergillus niger On Fibre Digestibility Of Rice Husk And Guinea Grass
Authors: Yousuf M.B. , Kolade I.O. , Adetitun D.O. , Arekemase M.O.
Published: April 2021

The efficacy of laboratory produced xylanase enzyme from Aspergillus niger on highly fibrous feeds and feedstuffs was investigated. Guinea grass (Panicum maximum) from grass hay and rice husk (Oryza sativa) from crop by-product characterised with high fibre content served as substrates (Feeds and Feedstuffs) for the experiment. The enzyme xylanase was prepared from Aspergillus niger (fungal extracts). The two substrates were treated with three levels of aqueous enzymes xylanase (0.02 ml/g, 0.04 ml/g, 0.08 ml/g). Substrate with no enzyme treatment (0 ml/g) served as control. Substrates were subjected to xylanase enzyme treatment at different time interval to determine the optimum incubation period for maximum fibre digestibility. Rice husk and guinea grass were analysed to determine the level of digestibility of fibre fractions such as crude fibre, hemicellulose, acid detergent fibre, neutral detergent fibre and lignin. The results indicate an improvement in fibre digestibility for rice husk and guinea grass treated with enzyme when compared with the control. There was no significant different in the fibre digestibility of substrate treated different levels of xylanase enzyme. Results obtained on the period of application showed no significant different across the time intervals (0 hr, 24 hr, 48 hr and 72 hr). The results therefore, suggest that optimum fibre digestibility could be obtained at level 0.02 ml/g of xylanase treatment at any time interval.Key Words: Aspergillus niger, Xylanase, Rice husk, Guinea grass, Laboratory
Assessment Of Labile Metals In Effluents From Lubricating Oil Company In Osogbo Osun State, Nigeria
Authors: Adeniji A.O , Olabanji I.O. , Oluyemi E.A.
Published: April 2021

Effluent and sediment samples were collected on seasonal basis, comprising of three months (August to October) in the wet season and three months (December to February) in the dry season from five points around a lubricating oil company in Osogbo - Nigeria. The sequential extraction method was used to respectively fractionate the sediment and effluent samples, then analyzed by Atomic Absorption Spectrophotometry (AAS) to determine concentrations of five heavy metals: Mn, Ni Co, Cd and Pb. Results showed that in wet season, higher concentration of Mn was found in exchangeable fraction, Ni  and Pb were more pronounced in carbonate bound fraction, Cd in Fe-Mn oxide fraction, while Co was more in residual fraction. In dry season, Pb was more concentrated in exchangeable fraction, Coin residual fraction, Mn in Fe-Mn oxide fraction, Cd in organic matter bound, while Ni was more concentrated in the carbonate fraction. In both seasons for sediment samples, Cd concentrations were found above the set limit by WHO. The speciation study of the effluent showed that, Mn, Co and Ni concentration were found more in Organic substances fraction in both seasons, Pb was more concentrated in free metal ion fraction in wet season while it was high in organic fraction in the dry season. Concentrations of all metals in the effluent samples in both seasons were above the maximum permissible limit for effluent. The high mobility factors of heavy metals in the sediment indicated that the metals were labile and bioavailable thereby making the soil and the living organisms vulnerable to possibility of high heavy metal bioaccumulation.Key Words: Heavy Metals, Speciation, Effluents, Sediment