bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Pharmacological Pain Relief Methods on Birth Experience:
A Systematic Review and Meta-Analysis
Authors: Ghanbari-Homaie Solmaz , Hasani Sonia , Pourfathi Hojjat , Mirghafourvand Mojgan 
Published: January 2021

Background:
The use of pharmacological pain relief methods during labour is increasing, however there is no
clear evidence that pharmacological interventions can also improve women’s satisfaction with birth experience.

Objective:
To assess the effectiveness of pharmacological interventions on women's satisfaction with birth experience
(primary outcome) and satisfaction with the received method (secondary outcome).

Methods:
We searched databases in English (MEDLINE, Cochrane Library, Embase, ProQuest, Scopus and Web of
Science) and Persian languages (SID and Magiran) from inception until April 30, 2018 for clinical trials that
pharmacological pain relief methods were compared with standard or routine cares, or non-pharmacological methods. The
evaluation of studies in term of risk of bias was conducted using the Cochrane Handbook. Meta-analysis results were
reported as OR and 95% confidence interval. In meta-analysis, subgroup analysis was performed based on the type of
intervention. Due to the heterogeneity of over 30%, random effect was reported instead of the fixed effect. The heterogeneity
was evaluated using I2, T2 and Chi2. The evaluation of the quality of the studies was also examined using the Grading of
Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach.

Results:
The results of 7 studies with low-quality in meta-analysis, showed that pharmacological methods significantly
improved satisfaction with birth experience (OR = 2.99; 95% CI: 1.37 to 6.52; P = 0.006). However, meta-analysis of
subgroups showed that only inhalation of Entonox gas (OR = 6.51; 95% CI: 3.47 to 12.22; P < 0.001), in contrast to epidural
analgesia (OR = 1.19; 95% CI: 0.62 to 2.27; P = 0.60) and Hyoscine injection (OR = 2.58; 95% CI: 0.93 to 7.20; P = 0.07)
significantly improved satisfaction with birth experience.

Conclusion:
Pharmacological interventions such as epidural, although introduced as one of the effective methods for pain
relief, may not provide women with satisfaction with birth. However, more studies with precise methodology, high sample
size, and standard tools should be performed to more accurately investigate the effect of pharmacological interventions on
birth experience.
Complete Uterine Rupture a Stigma for Modern Obstetrics: An Observational Study
Authors: Kumar Naina , Yadav Ashu 
Published: January 2021

Aims::
To know the maternal and perinatal outcome in women with complete uterine
rupture.

Background:
Uterine rupture is a catastrophic obstetric event associated with high maternal, perinatal
morbidity, and mortality.

Objective:
The present study was conducted to know prevalence, risk factors, presentation, the
maternal, perinatal outcome in women with complete uterine rupture.

Methods::
Present retrospective observational study was conducted on 31 women admitted to the
Obstetrics ward of the rural tertiary center of Northern India with complete uterine rupture between
January 2016 and December 2018 after Institutional ethical committee approval and informed written
consent from participants. Data included socio-demographic parameters, gestation, predisposing
factors, clinical features, site of rupture, associated bladder injury, need for hysterectomy, perinatal,
and maternal outcome. Statistical analysis was conducted using Statistical Package for the Social
Sciences software version 22.0.

Results::
Of the total of 9,156 deliveries during the study period, 31 women had a uterine rupture,
indicating the prevalence of 0.34%. Of all 21(67.7%) women had an unscarred uterine rupture, and
10(32.3%) scarred uterine rupture. The majority cases were un-booked (77.4%), multiparous
(90.3%), and term at gestation (66.7%), with an average age of all cases as 26.97±3.73 years. The
most common risk factor was injudicious use of oxytocic (29.0%) and previous cesarean section
scar (22.6%). The most common site of unscarred uterine rupture was the lower uterine segment
(26.7%) and in the scarred uterus, the site of previous cesarean section (26.7%). Eight (25.8%)
women had bladder injury. Total 24 (77.4%) fetuses were stillborn. Seventeen (54.8%) women
needed hysterectomy as a lifesaving procedure, and three (9.7%) succumbed to death despite all
resuscitative measures.

Conclusion::
Hence, complete uterine rupture is common in rural areas and is serious obstetric emergency with high
perinatal, maternal morbidity and mortality. Other: As most of the cases of complete uterine rupture occur in unbooked
women, hence, motivating all antenatal women for regular antenatal visits can prevent the dreadful condition to a large
extent, thereby saving many maternal and fetal lives.
Magnetic Resonance Imaging Assessment of Radial Scars/complex Sclerosing Lesions of the Breast
Authors: Bargallo Xavier , Ubeda Belen , Ganau Sergi , Gonzalez Blanca , Macedo Miguel , Alonso Inma , Oses Gabriela , Vidal Maria , Santamaria Gorane 
Published: January 2021

Purpose:
To describe the magnetic resonance characteristics of radial scars/complex
sclerosing lesions (RS/CSL) of the breast using the current BI-RADS lexicon. To investigate the
value of diffusion weighted imaging to predict malignancy.

Patients and methods:
From 2010 to 2017, we have found 25 women with architectural distortion
at mammography who underwent surgical resection with a final hystopathologic report of RS/CSL.
For the description of MRI findings, we adhered to BI-RADS classification (5th edition).

Results:
The final pathological diagnosis was: “pure” RS/CSL in 7 cases (28%), RS/CSL with associated
high risk lesions in 12 (48%) and 6 cases (24%) were associated with malignancy.
Magnetic resonance findings: four of 25 negative or focus. Five of 25 mass enhancement: irregular,
non circumscribed spiculated mass with heterogeneous or rim enhancement and most with type II
curves. Sixteen of 25 non mass enhancement: focal or linear distribution and heterogeneous internal
enhancement most with type I curves. Six of 25 had cancer associated with the complex sclerosing
lesion. All six showed non-mass enhancement.
Two cases with invasive breast carcinoma had ADC values under 1.15 x10−3 mm/s while most of
the rest had the values above.

Conclusion:
Most RS/CSL showed enhancement at MR. The predominant pattern was a non-mass,
focal, heterogeneous internal enhancement with type 1 curves. All cases with associated cancer
showed non mass enhancement. Invasive breast cancers had ADC values < 1.15 10-3 s/mm2.
Effect of Quantitative and Semi-quantitative Elastography Methods for the Management of Borderline Lesions on Ultrasonography
Authors: Aksoy Direnç Özlem , Yildiz Seyma , Atasoy Bahar , Alkan Alpay , Kandemirli Sedat Giray , Cingöz Mehmet 
Published: January 2021

Background:
Elastography (strain or shear-wave) is a method that estimates tissue stiffness.

Introduction:
Our aim in this study to evaluate the quantitative and semi-quantitative ultrasound elastography methods for
diagnosis of category BI-RADS 4a and BI-RADS 3 lesions, which are borderline for biopsy and follow-up.

Material and Methods:
175 consecutive women with 193 ultrasound-visible breast lesions were
classified on Conventional B-mode Ultrasonography (CUS) according to the BI-RADS scoring system.
Quantitative and semiquantitative values from ultrasound elastography in the form of strain
Elastography Ratio (SER), shear Wave Elastography (SWE) and Shear Wave Elastography Ratio
(SWER) were obtained. The lesions categorized as BI-RADS 4a and BI-RADS 3 on ultrasound
were subsequently re-categorized according to the elastography values.

Results:
Except for the 13 BI-RADS 2 lesions, the remaining 180 lesions were biopsied. Pathology
showed 83 lesions to be benign and 97 to be malignant. The sensitivity and specificity of the CUS
were 96.9% and 75.0%, respectively with an accuracy of 86.0%. Cut-off points calculated based on
ROC curves were 56.8 kPa for SWE, 3.53 for SWER and 3.81 for SER. When we downgraded BIRADS
4a lesions based on elastography results, the specificity (CUS+SER 96.9%, CUS+SWE
91.7%, and CUS+SWER 90.6%) and the accuracy (CUS+SER 95.3%, CUS+SWE 92.7%, and
CUS+SWER 92.2%) were shown to be better than CUS. When we upgraded BI-RADS 3 lesions
based on elastography results, the sensitivity of combined sets of SWE (99,0%) and SWER
(100,0%) was better than CUS.

Conclusion:
The rate of false-negative biopsies can be decreased with the combined use of elastography
and ultrasonography.
Chest Radiograph (CXR) Manifestations of the Novel Coronavirus Disease 2019 (COVID-19): A Mini-review
Authors: Chan Wai Yee , Hamid Marlina Tanty Ramli , Gowdh Nadia Fareeda Muhammad , Rahmat Kartini , Yaakup Nur Adura , Chai Chee Shee 
Published: January 2021

Background:
Coronavirus disease 2019 (COVID-19) is highly contagious and has
claimed more than one million lives, besides causing hardship and disruptions. The Fleischner Society
has recommended chest X-ray (CXR) in detecting cases at high risk of disease progression, for
triaging suspected patients with moderate-to-severe illness, and for eliminating false negatives in areas
with high pre-test probability or limited resources. Although CXR is less sensitive than real--
time reverse transcription-polymerase chain reaction (RT-PCR) in detecting mild COVID-19, it is
nevertheless useful because of equipment portability, low cost and practicality in serial assessments
of disease progression among hospitalized patients.

Objective:
This study aims to review the typical and relatively atypical CXR manifestations of COVID-19 pneumonia in a
tertiary care hospital.

Methods:
The CXRs of 136 COVID-19 patients confirmed through real-time RT-PCR from March to May 2020 were
reviewed. Literature search was performed using PubMed.

Results:
A total of 54 patients had abnormal CXR whilst the others were normal. Typical CXR findings included
pulmonary consolidation or ground-glass opacities in a multifocal, bilateral peripheral or lower zone distribution, whereas
atypical CXR features comprised cavitation and pleural effusion.

Conclusion:
Typical findings of COVID-19 infection in chest computed tomography studies can also be seen in CXR.
The presence of atypical features is associated with worse disease outcome. Recognition of these features on CXR will
improve accuracy and speed of diagnosing COVID-19 patients.
Phytochemical Investigation of Phenolic Constituents and In vitro Evaluation of Antioxidant Activity of Five Algerian Propolis
Authors: Bouaroura Amina , Segueni Narimane , Erenler Ramazan , May Abdghani , Bensouici Chawki , Akkal Salah , Rhouati Salah 
Published: January 2021

Background::
Algerian propolis has gained interest in the last recent years. Many researches
concerning both its biological effects and chemical composition were performed.

Objective::
The present study was designed to investigate the chemical composition in particular
phenolic compounds and the antioxidant activity of five Algerian propolis collected from different
geographical parts of the Algerian north namely: Constantine (CN), Boumerdes (BN), Mila (MN),
Tebessa (TN) and Guelma (GN).

Method::
Propolis extracts were obtained using solvents of varying polarity: petroleum ether, chloroform,
ethyl acetate and finally methanol. Phenolic compounds were determined by liquid chromatography-
tandem mass spectrometry (LC-MS/MS). In addition, total flavonoid and phenolic contents
were also determined. Antioxidant activity was investigated using five complementary tests
namely: DPPH., ABTS.+ assays for radical-scavenging activity, β-carotene-linoleic acid assay for
lipid peroxidation activity, CUPRAC and FRAP assays for reduction capacity.

Results::
The main phenolic compounds detected in the present study were caffeic, p-coumaric, cinnamic
and chlorogenic acids as well as naringenin and kampferol. Among the tested extracts, ethyl
acetate and methanol extracts exhibited the highest phenolic and flavonoid contents and the
strongest antioxidant activity. Propolis of Constantine was the most active one.

Conclusion::
Our results suggest the potential use of Algerian propolis as a natural source of bioactive
compounds with antioxidant activity.
Evaluation of the Pharmacological Properties of Piscine Venoms from both Lionfish (Pterois) and Stonefish (Synanceja)
Authors: Ramalingam Karthikeyan 
Published: January 2021

Background::
For the past 70 years, the focus of research is on the search for poisons and toxins
found in venomous and poisonous organisms, purely directed towards the pharmacological properties
of the toxins. In the research of finding novel compounds in pharmaceutical research, the identified
source was the piscine venom.

Objective::
The Scorpaenidae family was considered the most venomous of all. The toxins isolated from
stonefish and lionfish are responsible for the effects caused in cardiovascular and neuromuscular systems
and also for causing cytolytic activities. The main objective of the review is to study the mechanism of
the stonefish venom and portray its benefits in the field of drug discovery.

Methods::
A study on the mechanism of stonefish venom was carried out by inducing cardiovascular endothelium.
The release of neurotransmitter signals thus leads to the depolarisation of cell membrane by
the formation of pores in the cell membrane in the neuromuscular system of rabbits, porcine artery, mice
and rats. Lionfish venom in cross-reactivity with the results evolved from a stonefish venom activity. The
presence of enzymatic hyaluronidases in the primary structures of lionfish has evolved from stonefish and
their anticancer potential has also been demonstrated for the benefits of drug discovery as they possess
biological and chemical activity.

Conclusion::
This review depicts an overview of the pharmacological activities of lionfish venom in comparison
with the stonefish venom and their purpose of applications for future research in drug discovery.
Hydrophobic and Hydrophilic Film-Forming Gels for the Controlled Delivery of Drugs with Different Levels of Hydrophobicity
Authors: Nguyen Khanh T. , Tran Phuong H.L. , Ngo Hai V. , Tran Thao T.D. 
Published: January 2021

Background:
This study aimed to evaluate the effects of hydrophobic and hydrophilic Film-Forming
Gels (FFGs) on the controlled delivery of drugs with different levels of hydrophobicity.

Methods:
This evaluation was carried out by employing zein and polyvinylpyrrolidone as hydrophobic and
hydrophilic film-forming agents, respectively, in combination with hydroxypropyl methylcellulose functionalized
as a hydrogel basement at a ratio that had been optimized to achieve the fastest drying time. Free curcumin or
terbinafine hydrochloride was subsequently dispersed into blank FFGs to produce the final FFG formulations.

Results:
Although the extreme hydrophobicity of curcumin strongly limited its topical permeability compared to
that of terbinafine hydrochloride, zein FFGs clearly resulted in a favourable sustained release system for highly
hydrophobic drugs, such as curcumin. Moreover, polyvinylpyrrolidone would be highly effective for the
sustained release of a less hydrophobic drug, such as terbinafine hydrochloride. Analyses of the wettability,
surface morphology, chemical interactions and crystallinity of FFGs also helped to elucidate the mechanisms of
their drug release profiles.

Conclusion:
This fundamental finding is beneficial for further design studies on FFGs as sustained drug delivery
systems for topical drugs with a wide range of hydrophobicities.
The Efficacy and Safety of Additional Anti-HER2-Targeting Drugs in the Treatment of HER2-Positive Advanced Breast Cancer: A Meta-Analysis
Authors: Du Nannan , Chen Bangsheng , Shen Zefeng , Zhou Bin , Fu Xiaojun , Mao Danyi , Mao Feiyan , Ng Derry M. , Khadaroo Parikshit A. , Yang Lei 
Published: January 2021

Background:
HER2-positive breast cancer patients account for one-fifth of the total breast cancer population. Besides, more and
more anti-HER2-targeting drugs have appeared clinically.

Objective:
This study aimed to analyze the efficacy and safety of additional anti-HER2 (Human Epidermal
growth Factor Receptor 2)-targeting drugs in the treatment of HER2-positive advanced breast cancers.

Methods:
The following databases were searched for published articles containing data on the efficacy and safety of additional anti-HER2-
targeting drugs in HER2-positive advanced breast cancer from the time of their inception until December 2019: PubMed, Web of Science,
EBSCO, and Cochrane library. The primary outcomes were progression-free survival (PFS) and overall survival(OS).

Results:
The additional anti-HER2-targeting drugs significantly improved the PFS (HR: 0.66, p<0.001) and OS
(HR: 0.77, p<0.001) of HER2-positive advanced breast cancer patients. Regarding drug types, lapatinib was the
most effective (HR: 0.53, 95% Cl: 0.39-0.67, p<.001), followed by pertuzumab (HR: 0.72, 95% Cl: 0.55-0.89,
p=0.001). Trastuzumab was the least beneficial (HR: 0.87, 95% Cl: 0.31-1.44, p=0.594). Concerning treatment
regimen, first-line treatment (HR: 0.67, 95% Cl: 0.52-0.82, p<0.001) was more effective than non-first-line
treatment (HR: 0.82, 95% Cl: 0.71-0.94, p=0.004). The main Adverse Events (AEs) observed were diarrhea and
decreased ejection fraction.

Conclusion:
Additional anti-HER2-targeting drugs can improve long-term prognosis in HER2-positive advanced
breast cancers. Besides, they are associated with fewer AEs and are tolerable. Lapatinib is the most effective
drug, followed by pertuzumab, whereas trastuzumab is the least effective. Concerning treatment, we recommend
the use of anti-HER2-targeting drugs in first-line therapy of HER2-positive advanced breast cancers.
Design, Synthesis and Biological Evaluation of a Novel Series of Thiadiazole- Based Anticancer Agents as Potent Angiogenesis Inhibitors
Authors: Altuğ-Tasa Burcugül , Kaya-Çavuşoğlu Betül , Koparal Ayşe T. , Turan Gülhan , Koparal Ali S. , Kaplancıklı Zafer A. 
Published: January 2021

Background:
Thiadiazole has attracted a great deal of interest as a versatile heterocycle for the discovery
and development of potent anticancer agents. Thiadiazole derivatives exert potent antitumor activity
against a variety of human cancer cell lines through various mechanisms.

Objective:
The goal of this work was to design and synthesize thiadiazole-based anticancer agents with anti-angiogenic activity.

Methods:
N-aryl-2-[(5-(aryl)amino-1,3,4-thiadiazol-2-yl)thio]acetamides (4a-r) were synthesized via the reaction
of 5-(aryl)amino-1,3,4-thiadiazole-2(3H)-thiones with N-(aryl)-2-chloroacetamides in the presence of potassium
carbonate. The compounds were investigated for their cytotoxic effects on three cancer (A549, HepG2,
SH-SY5Y), two normal (HUVEC and 3T3-L1) cell lines using MTT and WST-1 assays. In order to examine
whether the compounds have anti-angiogenic effects or not, HUVECs were cultured on matrigel matrix to create
a vascular-like tube formation.

Results:
Compounds 4d, 4m and 4n were more effective on A549 human lung adenocarcinoma cells than cisplatin.
The IC50 values of compounds 4d, 4m and 4n for A549 cell line were found to be 7.82 ± 0.4, 12.5 ±
0.22, 10.1 ± 0.52 μM, respectively when compared with cisplatin (IC50= 20 ± 0.51 μM), whilst their IC50 values
for HUVEC cell line were determined as 138.7 ± 0.84, 78 ± 0.44, 177.6 ± 0.2 μM, respectively after 48 h of the
treatment. The concentrations (10-20-50 μM) of compounds 4d, 4e, 4l, 4m, 4n, 4q and 4r were found to inhibit
vascular like tube formation.

Conclusion:
According to their anticancer and anti-angiogenic effects, compounds 4d, 4m and 4n may be potential
anticancer agents for further in vivo studies.
Therapeutic Potential of Polyphenols and their Nanoformulations in the Treatment of Colorectal Cancer
Authors: Khan Shaheer H. , Alhumaydhi Fahad A. , Khan Masood A. , Younus Hina 
Published: January 2021

Background:
Colorectal Cancer (CRC) ranks third among all cancer-related deaths around the
globe. Chemotherapy may prolong the survival of CRC patients to some extent, but its clinical use is associated
with grave side effects on overall health. Contrary to chemotherapy, the use of plant-derived therapeutic
molecules offered advantages because of their reduced toxicity. Polyphenol is a group of phytochemicals that
impart many therapeutic benefits in the treatment of diabetes, cardiovascular disease and cancer. Various signaling
pathways, including Wnt/β-catenin, MAPK/PI3K and TGF-β/Smad, play very important roles in the development
and progression of CRC. Polyphenols inhibit CRC progressions by modulating these signaling pathways
e.g. curcumin and resveratrol impede cancer cell proliferation by inhibiting Wnt signaling. Because of
their lower aqueous solubility, the therapeutic efficacy of polyphenols is not fully exploited. In order to increase
their bioavailability and efficacy, the nanoformulations of polyphenols have been formulated and investigated
against various CRC test models. The main objective of this review is to explore the potential roles of polyphenols
and their nanoformulations in the treatment of colorectal cancer.

Methods:
We used PubMed, Web of Science, ScienceDirect, Google Scholar and Scopus electronic databases
by searching the keywords: nanoparticles, polyphenols, colorectal cancer, cell signaling pathways. Mostly, the
articles were retrieved directly from the journals licensed to the library of Qassim University, Saudi Arabia.

Results:
Literature analysis has shown that the polyphenols contain several important bioactive compounds,
which showed potential effectiveness against CRC. Incorporating polyphenols into nanoparticles further enhanced
their bioavailability and efficacy. The findings from various studies demonstrated that polyphenol-nanoformulations
accelerated the apoptosis in CRC cells by upregulating the levels of caspases and Bax, whereas inhibiting
the CRC cell proliferation by downregulating the expression of Bcl-2 and ERK1/2.

Conclusions:
This review provides a valuable resource on the important anti-CRC role of polyphenols and their
nanoformulations. This review will expand our knowledge about the anti-CRC roles of polyphenols and their
mechanisms of action through the multiple cell signaling pathways.