bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of vitamin D and antioxidant enzyme levels in patients with delirium tremens: A case control study
Authors: Deka Kamala , Rabha Anju Moni , Roy Mainak 
Published: December 2024

Background:
Global alcohol consumption poses a serious threat to humankind. It is estimated that between 5% and 7% of Indian adults struggle with alcohol abuse. Alcoholism is associated with a number of disorders, impacting different organ systems and nutritional status, including symptoms of withdrawal that can vary in severity from moderate symptoms to delirium tremens (DT). An increase in oxidative stress in the body is linked to alcohol withdrawal.

Aim:
This study aimed to evaluate the role of vitamins with antioxidant properties on oxidative stress caused by the severe alcohol withdrawal state.

Materials and Methods:
60 patients with DT and 30 control subjects were recruited using a purposive sampling method. They were evaluated for liver function test, antioxidant enzyme superoxide dismutase, glutathione peroxidase, and serum vitamin D level on day 0, day 14 and on day 0 of treatment for patients and controls, respectively.

Results:
The mean age of the study group was 41.12 years. The mean duration of substance use while coming for treatment was 22 years. Means of liver function test were found to be aspartate transaminase (AST) 196 IU/L, alanine transaminase (ALT) 71 IU/L, and alkaline phosphatase (ALP) 143 IU/L of patients on day 0 of evaluation. When comparisons of liver enzymes and antioxidant enzymes were conducted between cases and controls on day 0, significance was found. Further comparison of day 0 and day 14 levels of liver enzymes and antioxidant enzymes also had shown significant differences. However, no significant correlation was found with vitamin D level and liver enzyme, antioxidant enzyme level.

Conclusion:
Oxidative stress evaluated via antioxidant enzyme was found to be at a higher level in patients with DT than in patients with mild withdrawal symptoms. This study has shown an association between antioxidant enzymes with severity of withdrawal; however, no such association with vitamin D level was found.
Correlation of severity of alcohol dependence with liver dysfunction (by transient elastography) in freshly diagnosed cases of alcohol dependence syndrome
Authors: Madhusudhan Guggilla , Singh Kartikeya R , Panda Om , Patra Priyadarshee 
Published: December 2024

Background:
Alcohol-related liver disease contributes significantly to global mortality and healthcare costs, underscoring the urgency of early detection and non-invasive diagnostic tools such as transient elastography.

Aim:
This study aimed to investigate the correlation between the severity of alcohol dependence syndrome (ADS) and liver dysfunction assessed via transient elastography in newly diagnosed patients.

Materials and Methods:
From October 2019 to September 2021, a cross-sectional observational study was conducted on 58 inpatients diagnosed with ADS according to International Classification of Diseases-10 criteria. The severity of alcohol dependence was assessed using the Severity of Alcohol Dependence Questionnaire (SADQ), serum biochemical markers, and liver stiffness measured by transient elastography within 96 hours of admission and again after four weeks of enforced abstinence. Data were analyzed using Statistical Package for Social Sciences, with descriptive statistics applied to socio-demographic and clinical data. Paired t-tests compared biochemical markers, and Spearman rank correlation analyzed the relationship between SADQ scores and liver stiffness at admission and after abstinence.

Results:
Initial SADQ scores indicated moderate alcohol dependence in 55% of participants. According to Alcohol Use Disorders Identification Test, 38% had a medium-to-severe risk of harmful alcohol consumption. Liver fibrosis assessment showed that 63.8% had no or mild fibrosis on day 1, increasing to 81.0% by day 28. Moderate to advanced fibrosis (measured above 7.5 kilopascal) decreased from 8.6%, 12.1%, and 15.5% on day 1 to 3.4%, 5.2%, and 10.3% on day 28, respectively. There was a statistically significant (P < 0.05) reduction in serum biochemical markers and mean liver stiffness after four weeks of abstinence.

Conclusions:
The study underscores that the greater severity of alcohol dependence correlates with more pronounced liver function impairments and stiffness. Transient elastography indicated significant liver fibrosis in actively drinking patients, with notable improvement after one month of abstinence.
The child and adolescent patient’s profiles and usefulness of instant collaborative video consultations of tele-psychiatrists with primary care doctors
Authors: Madegowda Rajendra K , Nirisha P Lakshmi , Sabhahit Gajanan Ganapati , Manjunatha Narayana , Kumar Channavaeerachari Naveen , Math Suresh Bada 
Published: December 2024

Background:
The Tele-Medicine Center at the National Institute of Mental Health and Neurosciences, Bengaluru, organized module-based capacity-building training courses for in-service primary care doctors (PCDs) with MBBS degree. The objective was to bolster the coverage of the National Mental Health Program services and diminish the treatment gap in the region. As part of this training, an instant collaborative video consultation (i-CVC) module allowed PCDs to engage in live, real-time video consultations with tele-psychiatrists at NIMHANS to discuss their patients’ cases. Approximately 7% of the i-CVC cases focused on child and adolescent psychiatric disorders.

Aim:
Aim of this study is understand the profiles of child and adolescent patients and usefulness of instant collaborative video consultations of tele-psychiatrists with primary care doctors.

Materials and Methods:
This study delved into data from 41 children and adolescents’ (aged 10–17 years) i-CVC module case proformas. It examined six predefined learning themes highlighted by PCDs and evaluated patientprofiles, along with diagnostic agreement between PCDs and tele-psychiatrists.

Results:
Among the 41 patients, there were 19 males (46.3%) and 22 females (53.7%), aged between 10 and 17 years. The study identified six key learning themes: clinical assessment, identification and diagnosis, counseling for children and parents, pharmacotherapy, and legal aspects. Emotional disorders were noted in 12 patients (29.3%), developmental disorders in eight patients (19.5%), psychotic disorders in eight patients (19.5%), and behavioral disorders in three patients (7.3%). Pharmacotherapy was initiated for five patients (12.2%), while 23 patients (56.1%) received counseling, and 13 patients (31.7%) received both treatments.

Conclusion:
Diagnostic agreement between PCDs and tele-psychiatrists was observed in 25 cases (61%). This study represents the first evaluation of the collaborative i-CVC module aimed at training PCDs in child and adolescent psychiatry in India. The 61% diagnostic agreement suggests the feasibility of PCD training. These findings underscore the pressing need for an Indianized, point-of-care manual in child and adolescent psychiatry to train PCDs throughout India.
Correlation of Preoperative Hippocampal Volume Measured with Magnetic Resonance Imaging and Emergence from General Anaesthesia in Elective Neurosurgical Patients: An Observational Study
Authors: Kalgudi Pramod , Bharadwaj Suparna , Chakrabarti Dhritiman , Bhadrinarayan V , Uppar Alok M. , Prasad Chandrajit 
Published: December 2024

Background and Objectives:
The electrophysiological process of emergence from general anesthesia (GA) commences from deeper structures of the brain rather than the cortex. The phylogenetically old parts of the brain (hippocampus) are the first to recover during emergence. Study objectives were to evaluate and predict the effect of preoperative hippocampal volume (HV) measured using MRI with emergence from GA and delayed extubation in patients undergoing elective neurosurgical procedures.

Methods:
Patients aged 18-65 years of age scheduled for elective neurosurgical procedures under GA with GCS = 15 were recruited into the prospective cohort. Those who underwent excision of the hippocampus, amygdala, and temporal lobe pathology were excluded. Bilateral HVs and total brain volume were measured preoperatively using MRI brain. GA was induced by thiopentone, fentanyl, and vecuronium and maintained with sevoflurane. At the end of the surgery, sevoflurane was turned off, and a fresh gas flow of 6 L min-1 oxygen was set, allowing patients to wake up by “no contact technique.” Time elapsed from turning off sevoflurane till the onset of different phases of emergence was measured. The patterns of emergence were assessed using GCS and Riker Sedation-Agitation Scale.

Results:
The complete data of 125 patients of 1192 screened for recruitment were analyzed. The median time for extubation was 13 minutes (IQR 9-16). The average bilateral standardized HV had a statistically significant negative correlation with the time to extubation (r = -0.185; P = 0.039). Average of bilateral standardized HV <2097 mm3 predicts delayed extubation with a specificity: 70.7%, sensitivity: 51.2% and AUC: 0.672, CI 0.524-0.724. Standardized dominant HV <1925 mm3 also predicts delayed extubation with specificity: 78%, sensitivity: 46.4% and AUC: 0.635, CI 0.533-0.738.

Conclusion:
Neurosurgical patients with larger average HV might lead to early extubation, vocalization, and faster gaining of orientation after GA.
Tranexamic Acid in Symptomatic Chronic Subdural Hematoma in the Absence of Surgical Intervention
Authors: Nayak Raghavendra , Pai Ashwin , Anand Arjun , Sunder Geeta , Gangachannaiah Shivaprakash 
Published: December 2024

Background:
Standard treatment for symptomatic chronic subdural hematoma (CSDH) is a burr-hole evacuation. However, in patients in whom surgical evacuation carries a very high risk, we do not have an established practice guideline.

Objective:
To analyze the outcome of symptomatic CSDH treated only by tranexamic acid.

Material and Methods:
A total of 22 admitted patients with symptomatic chronic subdural hematoma from 2018 to 2019 were included in the study. All patients were managed conservatively with oral tablet tranexamic acid 250 mg thrice daily till the resolution of hematoma. Patients were followed up every month with CT scan brain. Data regarding the volume of hematoma, resolution of hematoma, and recurrence of hematoma were anonymized and analyzed.

Results:
The median duration of treatment was 60 days (range 30–98). The median volume of hematoma before the initiation of the therapy was 74 ml (range 66–96), and it was reduced to 2 ml after the therapy with tranexamic acid. The median midline shift before the initiation of the therapy was 15 mm (range 10–20), and it was zero in all patients following the treatment. There was no progression or recurrence of hematoma in any one of patients. No major complications (thromboembolic events) due to the use of tranexamic acid were seen in any patient.

Conclusion:
Even symptomatic patients with chronic subdural hematoma can be effectively managed with tranexamic acid when the surgical drainage is risky or not possible. It can be used as an alternative to surgery when there is no immediate threat to life.
Olfactory Evoked Potential Monitoring: Technical Note and Challenges Faced
Authors: Karre Bujji , Sasidharan Gopalakrishnan M. 
Published: December 2024

Background and Aim:
Despite the sustained progress in the realm of intraoperative neurophysiologic monitoring of the nervous system, little progress has been achieved in monitoring the olfactory pathway. Loss of olfactory function due to retraction-induced physical damage during operations has ill-appreciated negative consequences for the patients and is often underreported. Improvements in this area of neuromonitoring require a revisit of the technical challenges. We aim to describe the method to construct flexible, bipolar silver ball electrodes to stimulate the olfactory mucosa during cranial neurosurgery and suggest ways to overcome the challenges in eliciting olfactory evoked potentials.

Materials and Methods:
We analyze the potential difficulties in routinely eliciting olfactory evoked potential in neurosurgical operations and summarize ways to overcome them. We also describe the construction of a simple electrical stimulator electrode for the olfactory mucosa, its application, and potential recording sites in an effort to detect the potential during cranial neurosurgery.

Results:
We created flexible, insulated bipolar silver electrodes and placed them atraumatically on the olfactory mucosa under endoscopic guidance, bilaterally, in 22 patients. We obtained an optimal position in less than 10 minutes in most cases. We also summarize the challenges faced and potential paths to overcome them.

Conclusions:
Though electrical stimulation of the olfactory mucosa using custom-made silver electrodes is possible and takes little time to place them as part of an intraoperative neurophysiologic monitoring setup, detecting the minute potential remains elusive.
Machine Learning–Based Model for Prediction of Post-Stroke Cognitive Impairment in Acute Ischemic Stroke: A Cross-Sectional Study
Authors: Zhang Junqin , Kong Zhaohong , Hong Songlin , Zhang Zhentao 
Published: December 2024

Background and Objective:
Early identification of post-stroke cognitive impairment (PSCI) is an important challenge for clinicians. In this study, we aimed to build a machine learning–based prediction model for PSCI and uncover potential risk factors to support clinical decision-making.

Materials and Methods:
We collected features of 96 patients with acute ischemic stroke and measured cognitive impairment using the Mini-Mental State Examination. Three common machine learning algorithms, including support vector machine, Gaussian naive Bayes, and logistic regression, were used to build clinical prediction models for PSCI. The area under the receiver operating characteristic curve (AUROC), specificity, sensitivity, negative prediction value, positive prediction value, accuracy, and model fitting effect were used to evaluate the predictive performance of the models and further determine the clinical prediction rules.

Results:
In this study, the logistic regression model showed the best performance with an AUROC of 0.86, which was higher than the values of the other two models. Moreover, the logistic regression model showed high sensitivity (0.82), specificity (0.83), negative prediction value (0.88), positive prediction value (0.75), and accuracy (0.83). This work identified the top nine factors in importance ranking as predictors of PSCI. Among them, age and urine glucose were significantly associated with PSCI (P < 0.05).

Conclusions:
Machine learning algorithms may be useful in the prediction of PSCI, especially logistic regression algorithms. In the present study, aging and hyperglycemia were independent risk factors for PSCI, and the cognition of such patients should be carefully addressed in clinical practice screening work.
Clinical, laboratory, and electrophysiological presentations and treatment modalities in Guillain–Barré syndrome: A prospective study
Authors: Singh Anshu Man , Sawardekar Vinayak M. , Jaiswal Amit , Kale Maithilee M. 
Published: December 2024

INTRODUCTION:
Guillain–Barré syndrome (GBS) is a rare autoimmune disorder causing acute inflammatory demyelinating polyneuropathy (AIDP), leading to muscle weakness, paralysis, and respiratory failure.

MATERIALS AND METHODS:
This single-center, prospective study was performed in the department of medicine of a tertiary care institute over a period of 18 months with 6 months of follow-up. This study enrolled 50 patients diagnosed with GBS. We analyzed medical records, clinical presentation, laboratory results, electrophysiological findings, and treatment modalities.

RESULTS:
This study enrolled 50 patients diagnosed with GBS, the mean age of patients was 38.5 ± 17.02 years, and males were predominant (70%). Quadriparesis was the most common motor complaint presented in 80%, whereas tingling and numbness were the most common sensory complaint (70%); 4% of patients had bowel and bladder involvement. Excessive sweating was the most common autonomic disorder, found in 44 (88%) patients. In a nerve conduction study, AIDP was the most common subtype seen in 28 (56%) patients; acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN) were seen in 11 (22%) patients each. In patients with AIDP, distal latency prolongation was the most common findings (86%), while in AMAN and AMSAN, a decrease in CAMP was the most prevalent finding. Ventilatory support was needed in 18 (36%) patients enrolled in the study. Mortality was reported in 8 (16%) patients. In AMAN-AMSAN variants, IV Ig therapy appeared to have better outcomes at 6 months as compared to plasma exchange therapy.

CONCLUSION:
This study provides valuable insights into the clinical, laboratory, and electrophysiological features of GBS and highlights the effectiveness of IVIG as a treatment modality. Early recognition and treatment are crucial for optimal outcomes in GBS patients.
To study socioclinical profile of COVID-19 among health-care workers of tertiary care COVID-19 hospital in the year 2021–2022
Authors: Sharma Shweta , Gupta Abha , Singh Gaurav , Jain Seema , Malik S. K. K. 
Published: December 2024

INTRODUCTION:
COVID-19, caused by SARS-CoV-2, emerged in December 2019 and swiftly became a pandemic by March 2020. Health-care workers (HCWs) face a high risk of infection. Previous epidemics such as SARS, Ebola, and Middle east respiratory syndrome (MERS) highlight these risks. As of January 22, 2021, there were 96.2 million cases and 2 million deaths globally. In India, there were 10.6 million cases and 153,000 deaths by that date. Protecting HCWs and implementing preventive measures in health-care settings are urgent.

AIM AND OBJECTIVE:
The aim of this study was to study socioclinical profile of COVID-19 among health-care workers of tertiary care COVID-19 hospital in the year 2021–2022.

MATERIALS AND METHODS:
A cross-sectional study at LLRM Medical College (June 2021–June 2022) focused on COVID-19 positive HCWs. Inclusion criteria included HCWs aged 20–50 affiliated with the medical college. Exclusion criteria covered those outside this age range, COVID-19 negative cases, and individuals with diabetes, hypertension, or known respiratory illnesses, ensuring a specific study cohort.

RESULTS AND OBSERVATION:
Among the 51 positive cases, the majority were aged 25–30 (60.8%) and male (56.9%), with statistical significance. This aligns with previous research indicating that most cases were in the 26–35 years of age group (43.1%) and predominantly female. Junior residents (52.9%) and interns (27.5%) were the most affected. Gastrointestinal (GI) symptoms were uncommon (21.6%), and 78.4% had normal oxygen saturation. Symptom severity correlated with age: mild symptoms in 56.7% (25–30 years), moderate in 70% (25–30 years), and severe in 100% (35–40 years).

CONCLUSION:
The study underscores the vulnerability of younger male HCWs and emphasizes the importance of monitoring and protection measures in health-care settings. This research sheds light on the demographics and symptom severity among HCWs affected by COVID-19 during the specified period.
Estrategias para la comprensión de múltiples textos históricos
Authors: Moreno de León Tomás A. , Rangel Castillo Liliana , Vega López Norma Alicia , De León Arellano Esperanza 
Published: December 2024

El objetivo de este artículo es reportar los efectos de una intervención diseñada para enseñar cuatro estrategias de evaluación de la fuente a partir de las credenciales del autor e integrar la información proveniente de diversas fuentes históricas. Para ello se empleó una metodología cuantitativa de diseño cuasi-experimental con un pre y dos postest en la que participaron dos grupos de estudiantes de secundaria (experimental: N = 28, control: N = 29). Los resultados señalan que el grupo que recibió la estrategia de enseñanza mostró mejorías estadísticamente significativas, tanto a corto plazo (un día después de la intervención) como a largo plazo (sesenta días después de la intervención). Estos hallazgos nos han permitido configurar cuatro perfiles lectores (Estratégico, Semi estratégico, Poco estratégico y Nada estratégico) que buscan ser una guía orientadora para quienes se enfrentan al reto de enseñar a evaluar fuentes. Así, en este artículo proporcionamos una descripción detallada de los desempeños de lectores estratégicos y de aquellos quienes no logran alcanzar este nivel. Estos últimos generalmente ignorados en los reportes de investigación.
Mechanisms for mathematical modelling: the study and research paths at university level
Authors: Barquero Berta 
Published: December 2024

This paper addresses the problem of integrating mathematical modelling into first-year mathematics courses at university level. Our research focuses on identifying mechanisms that facilitate the dissemination of mathematical modelling in university mathematics education. Within the framework of the anthropological theory of the didactic (ATD), our work over recent decades has focused on the design, implementation, and analysis of the study and research paths (SRP) as a teaching device persuading a double purpose: making students aware of the rationale of mathematical contents through the experience of modelling activities; and connecting these mathematical contents through a whole modelling process. We draw upon empirical findings from the implementation of an SRP on population dynamics withfirst-year students at university level, and its ‘migration’ to other university settings, to identify valuable mechanisms for integrating mathematical modelling into university institutions. More concretely, we analyse the mechanisms facilitating two central dialectics for the SRP and for modelling: the dialectics of questions and answers and that of media and milieu.Cet article aborde le problème de l’intégration de la modélisation mathématique dans les cours de mathématiques de première année au niveau universitaire. Notre recherche se concentre sur l’identification des mécanismes qui facilitent la diffusion de la modélisation mathématique dans l’enseignement des mathématiques à l’université. Dans le cadre de la théorie anthropologique du didactique (TAD), notre travail des dernières décennies s’est concentré sur la conception, la mise en œuvre et l’analyse des parcours d'étude et de recherche (PER) en tant que dispositif d’enseignement ayant un double objectif : faire prendre conscience aux étudiants de la logique des contenus mathématiques à travers l'expérience des activités de modélisation ; et relier ces contenus mathématiques à travers l’ensemble du processus de modélisation. Nous nous appuyons sur les résultats empiriques de la mise en œuvre d’un PER sur la dynamique des populations avec des étudiants de première année à l'université, et sa « migration » vers d’autres contextes universitaires, pour identifier des mécanismes qui paraissent pour la modélisation mathématique dans lesinstitutions universitaires. En particulier, nous analysons les mécanismes facilitant deux dialectiques centrales pour le PER et la modélisation : la dialectique des questions et des réponses et celle des médias et du milieu.