bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Neurological Disorders
Authors: Sarangi Sudhir Chandra , Sopory Pranav , Reeta KH 
Published: April 2021

Introduction:
Chronic neurological diseases are a major cause of mortality and morbidity in the world. With increasing life expectancy in the developing world, the incidence and prevalence of these diseases are predicted to rise even further. This has also contributed to an increase in disability-adjusted life years (DALYs) for noncommunicable diseases. Treatment for such diseases also poses a challenge with multiple genetic and epigenetic factors leading to a varied outcome. Personalization of treatment is one way that treatment outcome/prognosis of disease can be improved, and pharmacogenomics plays a significant role in this context.

Methodology:
This article reviewed the evidence pertaining to the association of genetic and epigenetic markers with major neurological disorders like multiple sclerosis (MS), Alzheimer's disease (AD), and Parkinson's disease (PD), which are a major source of burden among neurological disorders. Types of studies included are peer-reviewed original research articles from the PubMed database (1999–2018).

Results:
This study compiled data regarding specific genetic and epigenetic markers with a significant correlation between the clinical diagnosis of the disease and prognosis of therapy from 65 studies. In a single platform, this review highlights the clues to some vital questions, such as why interferon beta (IFN-β) therapy fails to improve symptoms in all MS patients? why cholinesterase inhibitors fail to improve cognitive impairment in a subset of people suffering from AD? or why some individuals on levodopa (L-DOPA) for PD suffer from side-effects ranging from dyskinesia to hallucination while others do not?

Conclusion:
This article summarizes the genetic and epigenetic factors that may either require monitoring or help in deciding future pharmacotherapy in a patient suffering from MS, AD, and PD. As the health care system develops and reaches newer heights, we expect more and more of these biomarkers to be used as pharmacotherapeutic outcome indicators.
Bilateral Posterior Nasoseptal Flap – Double Breasting Technique
Authors: Srinivasa Rakshith , Chandrakiran C , Luckose Rini 
Published: April 2021

Background and Introduction:
The success of endoscopic skull base surgery is largely based on the effective repair of the skull base defect. A pedicled nasoseptal flap (NSF), described by Hadad-Bassagateguy is the workhorse of contemporary endoscopic skull base repair. We describe a modification in the technique, “double breasting technique,” using the bilateral posterior NSF for skull base repair.

Objective:
In this video article, we describe the technique of harvesting bilateral posterior nasal septal flaps and overlaying the flaps in a double breasting technique to cover the skull base defect. The posterior NSF can be used to cover medium to large skull base defects effectively.

Surgical Technique:
A 40-year-old female patient presented with headache and decreased vision for 2 months. MRI with gadolinium showed a sellar suprasellar lesion with chiasmal compression. Visual field charting showed bitemporal hemianopia. She underwent endoscopic transnasal transsphenoidal surgery (binostril approach) and complete excision of tumor. Intraoperatively, there was evidence of arachnoid breach with high flow cerebrospinal fluid (CSF) leak. Sella was repaired with fat, fascia, fibrin glue, and overlaid with the bilateral posterior NSF in a double breasting technique, as described in the video.

Results:
The skull base repair was successful, with no CSF leak postoperatively.
Effects of Tempol on Epileptic Activity in Picrotoxin-Induced Epilepsy in Rats
Authors: Pinar Neslihan 
Published: April 2021

Introduction:
Epilepsy is a common neurological disease, although its etiology and pathophysiology are not yet fully understood. Oxidative stress plays a key role in the pathogenesis of many neurological diseases, including epilepsy, and there have been many studies reporting that antiepileptic medicines with neuroprotective and antioxidant activity inhibit free oxygen radicals. This study evaluates the effects of tempol on epileptic activity through behavioral parameters in acute picrotoxin (Ptx) models.

Materials and Methods:
This experimental study was conducted on 42 adult male Wistar Albino rats weighing 450–500 g. Ptx (2.5 mg/kg) was injected i.p. as a single dose and observed for one hour to establish the acute Ptx model. Following injection, the animals were observed for 30 min in glass observation cages measuring 35 cm x 35 cm x 35 cm.

Results:
In picrotoxin-induced epilepsy, the total number of seizures and the total duration of seizures were decreased significantly with Ptx + tempol 100 mg/kg and Ptx + Tempol 150 mg/kg. The seizure phases were reduced significantly by Ptx + tempol 150 mg/kg (P < 0.05).

Conclusion:
Tempol 100 mg/kg and tempol 150 mg/kg are found to be effective in epilepsy models caused by Ptx, with tempol 150 mg/kg found especially to be more effective.
Auditory Temporal Ordering in Patients with Medial Temporal Lobe Epilepsy with and without Hippocampal Sclerosis
Authors: Rajasekaran Aravind K , Shivashankar Nagarajarao , Sinha Sanjib , Saini Jitender , Subbakrishna Doddaballapura K , Satishchandra Parthasarathy 
Published: April 2021

Context:
Temporal lobe epilepsy can affect central auditory processing (CAP) skills. Auditory temporal ordering (ATO) is a CAP skill that can be evaluated using duration pattern test (DPT).

Aim:
The aim is to evaluate ATO in patients with medial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (MTLE + HS) and without hippocampal sclerosis (MTLE-HS) and in their subgroups.

Settings and Design:
It was a prospective cross-sectional behavioral observational study conducted in a tertiary neuropsychiatric hospital.

Subjects and Methods:
The subjects were patients with refractory MTLE (N = 100), comprising 50 “MTLE + HS” patients and 50 “MTLE-HS”. Age-range matched normal healthy subjects (n = 50) formed the control group. Both groups were administered duration pattern test (DPT).

Statistical Analysis Used:
Analysis of variance (ANOVA) with post hoc analysis, Dunnett's two-sided and Bonferroni, paired sample t-test, Pearson's correlation, and independent t-test.

Results:
The clinical groups performed significantly poorer than the control group, and however, did not differ significantly between them. The age at onset and the duration of the seizures did not have significant relation with the test measures.

Conclusions:
Patients with “MTLE + HS” as well as those with “MTLE-HS” and their respective subgroups revealed abnormal ATO indicating CAP dysfunction.
Acute Leucoencephalopathy with Restricted Diffusion in Children – A case series
Authors: Kamate Mahesh , Detroja Mayank , Hattiholi Virupaxi 
Published: April 2021

Objective:
To study the clinico-radiological profile of children with acute leukoencephalopathy with restricted diffusion.

Methods:
A retrospective chart review of children with acute leukoencephalopathy with restricted diffusion was done from July 2015 to July 2018. The clinical details, neuroimaging findings, sequelae, and the final outcome on modified Rankin Score were analyzed.

Results:
Sixteen children with a mean age of 4.4 years were diagnosed with acute leukoencephalopathy with restricted diffusion. All, except one, had fever, seizure, and altered sensorium. The median duration of hospital stay was 3 weeks. Only one out of 16, had biphasic clinical picture that is characteristic of acute encephalopathy with biphasic seizures and restricted diffusion. Magnetic resonance imaging showed restriction diffusion in all. While it was symmetric in 13 children, in 3 children it was asymmetric, and in 2 children there was patchy involvement. Seven children (43.7%) had post-encephalopathic epilepsy. While complete neurological recovery was seen in 2 children, behavioral problems like hyperactivity in 10 (62.5%), speech problems in 8 (50%), and cognitive delay in 3 (18.8%) children were noted.

Conclusion:
Acute leukoencephalopathy with restricted diffusion is emerging as an important cause of acute encephalopathy in children with a protracted course and long-term sequelae such as cognitive impairment and refractory postencephalopathic epilepsy.
Comparison of the Solitaire and Trevo Stents for Endovascular Treatment of Acute Ischemic Stroke
Authors: Baek Jin Wook , Heo Young Jin , Kim Sung Tae , Seo Jung Hwa , Jeong Hae Woong , Kim Eung-Gyu 
Published: April 2021

Aims:
Limited studies have compared the effectiveness of Solitaire and Trevo stentrievers for endovascular thrombectomy to achieve recanalization and improve functional outcomes of patients with acute ischemic stroke. Therefore, we compared the safety and efficacy of the two stents during endovascular thrombectomy for patients with acute ischemic stroke.

Materials and Methods:
This study included 130 patients who underwent endovascular thrombectomy using either the Trevo (n = 51) or the Solitaire (n = 79) stent for anterior circulation acute ischemic stroke. Recanalization was classified using thrombolysis in cerebral infarction (TICI) grading. Efficacy and safety of the devices during endovascular thrombectomy were analyzed by evaluating the rate of good recanalization after the first pass, clot retrieval rate, final recanalization grade, use of rescue treatment, recanalization time, and hemorrhagic and thromboembolic complications.

Results:
Overall, good recanalization (TICI grades 2b and 3) was achieved (Solitaire: n = 57, 72.2%; Trevo: n = 46, 90.2%) (P = 0.01). The rate of good recanalization after the first pass and clot retrieval rate were similar between groups; however, the use of rescue treatment was more frequent in the Solitaire group. Recanalization time was shorter in the Trevo group. The good clinical outcome rate was higher in the Trevo group but not statistically significantly. The rates of symptomatic hemorrhage and thromboembolism were not significantly different between groups.

Conclusion:
The Trevo stent achieved more successful recanalization with less need for rescue treatment and less time for recanalization than the Solitaire stent. There was no statistically significant difference in the clinical outcomes.
eNeuroIntensive Care in India
Authors: Haranath Sai P , Ganapathy Krishnan , Kesavarapu Subba R , Kuragayala Swarna D 
Published: April 2021

Background:
As ICU consultants in smaller hospitals may not be familiar with neurocritical care and with current travel restrictions due to the COVID-19 pandemic, one needs to relook at how neurocritical care can be provided.

Objective:
This article reviews the authors' experience of providing remote neurointensive care, from a non-specialist ICU over a 16-month period.

Material and Methods:
61 neuro consultations were provided for 56 patients admitted in remote ICU's, including five repeat consultations. Most teleconsultations were from three rural hospitals. The central command center has monitored remote patients with neurological conditions, in 23 ICUs.

Results and Conclusions:
Providing real-time virtual neuro intensive advice to ICU's in smaller cities even without dedicated neuro-intensive units is feasible in India. eNeuroIntensive care is particularly necessary in the current “New Normal” era.
An evaluation of horizontal equity in surgical care for gallstone disease in a Caribbean country
Authors: Mahabir Avidesh Haresh , Ramkissoon Solange CK , Thomas Dexter A. , Cawich Shamir O. , Naraynsingh Vijay , Dapri Giovanni 
Published: April 2021

Background:
The aim of this study was to identify social injustice by evaluating horizontal equity (allocation of similar resources to patients with the same clinical needs) in surgical care for gallstone disease in a Caribbean Country.

Methods:
We compared access to laparoscopic cholecystectomy (LC) for gallstone disease between a fee-for-service (private) and a government-funded (public) health-care system between 1st January and 31st August, 2018. We defined a prolonged waiting time as an interval of >90 days between the index diagnosis and LC. The data were examined using SPSS v23.

Results:
Ninety-nine patients underwent LC in public (60) or private (39) hospitals. There was a significantly longer mean waiting time in public hospitals (336.4 ± 647.9 days vs. 20.2 ± 25.5 days; P 0.002) and significantly more hospital readmissions while awaiting LC (72% vs. 0%). In the public hospital system, fewer patients had ambulatory operations (8.4% vs. 51.3%; P < 0.00001) and the mean duration of operation was longer (2.4 ± 0.88 vs. 0.92 ± 0.34 h; P < 0.0001). There were no differences in morbidity or mortality between the health-care systems. Thirty-eight patients had prolonged waiting times due to: long pre-existent waiting lists (13), consumables out of stock (10), equipment malfunction (6), patient request (3), pre-operative Endoscopic retrograde cholangiopancreatography (2), unspecified (2) and anaesthetic optimisation (1). One patient in the private hospital had a delay >90 days while awaiting insurance pre-authorisation.

Conclusion:
Horizontal inequity exists between the health-care systems. There is room for improvement through increased accountability for administrators, better resource allocation, proper equipment maintenance schedules and efforts to reduce waiting lists.
The Impact of Kobasa and Maddi Hardiness Model on Stress and Hardiness of Iranian Pediatric Nurses
Authors: Sadeghpour Masoumeh , Fereydooni-Moghadam Malek , Namnabati Mahboobeh 
Published: April 2021

Background:
Pediatric nurses, who take care of ill children and interact with their exhausted and anxious parents, face more challenges for which some strategies must be considered to reduce tensions and improve mental health. This study was conducted to examine the effect of Kobasa and Maddi hardiness model on hardiness and perceived stress among nurses in pediatric units of a hospital in Isfahan – Iran in 2018.

Materials and Methods:
Participants were 57 nurses selected from the staff of pediatric units. They were randomly assigned to intervention and control groups. Data collection was done by means of Kobasa Hardiness Inventory and perceived stress scale. The intervention group attended educational and exercise sessions for 3 months. Data were analyzed through descriptive (frequency, mean, and standard deviation) and analytical (Chi-square, Fisher exact test, Mann–Whitney, and t-tests) statistics.

Results:
Results of study revealed that before the intervention, the mean scores of hardiness and perceived stress of nurses were not significant. However, significant differences were observed after the intervention for hardiness and perceived stress (t2,98
p < 0.004, t2,4
p < 0.02), respectively. The mean (SD) hardiness score in the intervention group increased from 65.06 (9.11) to 71.27 (7.44), whereas mean perceived stress score decreased from 26.54 (7.59) to 22.55 (8.39) after the intervention.

Conclusions:
The implementation of Hardiness Kobasa and Maddi Model increased hardiness and decreased perceived stress of the nurses. Thus, nursing managers may implement the Kobasa and Maddi hardiness model before initiating their job and during continuing education.
The Process of Managing the Children with Type 1 Diabetes in the Family
Authors: Sanjari Mahnaz , Peyrovi Hamid , Mehrdad Neda 
Published: April 2021

Background:
Diabetes is a disease that affects all family members. Parents of children with type 1 diabetes are always concerned about all aspects of children's life. The aim of this study was to elucidate the process of managing children with diabetes in the family.

Materials and Methods:
This is a qualitative grounded theory of a doctoral dissertation, which was done on 2016. The 18 participants were selected through purposive and theoretical sampling until data saturation. The main participants in this study included parents, siblings, and children with type 1 diabetes. The data was gathered by semi-structured interviews as well as field notes and memos. Data analysis was done concurrently with data collection in four levels, including data analysis for concept and contex, bringing the process into the analysis, and integration of categories according to Corbin and Struss (2008). Core category appeared at the end of integrated categories.

Results:
“The family with diabetes in the child's diabetes orbit” as a core category contains the process of managing children with diabetes within the family, which included three main subcategories, including “entering into the diabetes orbit”, “movement into the diabetes orbit”, and “living into the diabetes orbit”.

Conclusions:
The family through the concept of “The family with diabetes in the child's diabetes orbit “as a main concern of families with diabetes suffering diabetes attempt to select and practicing appropriate strategies and manage diabetes and children with diabetes.
Thyroid-Stimulating Hormone and Free Thyroxine Alterations in Subjects with Occupational Hearing Loss
Authors: Ranjbar Nastaran , Arefi Hossein Namvar , Maarefvand Mohammad , Pourbakht Akram , Shahbazi Ali 
Published: April 2021

Context and Aim:
Occupational hearing loss (OHL) is caused by exposure to industrial noise. Alterations in the thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels are related to hearing loss. The purpose of this study is to investigate the TSH and FT4 level alterations in OHL.

Methods and Material:
Among 428 subjects, 144 male workers with normal hearing (NH), noise-induced hearing loss (NIHL), and high tone loss (HTL) (N = 48 in each group) were included in this study. All the subjects had normal TSH and FT4 levels.

Results:
The TSH level is higher in the HTL and NIHL groups in comparison to NH, but it is only significant in the HTL group. The FT4 level is significantly lower in the NIHL group; however, the lower FT4 level in the HTL group is not significant when compared to the NH group.

Discussion:
The NIHL group may turn into the HTL group over time. This process could be monitored by alteration in their TSH and FT4 levels.

Conclusions:
Alterations in the TSH and FT4 levels could be considered as a pathophysiology for OHL. More research is required to investigate the electrophysiological, physiological, and histological correlations of TSH and FT4 and different types of hearing loss caused by noise exposure.
A Diagnostic Assistant Tool for Work-Related Low Back Pain in Hospital Workers
Authors: Saengdao Oopara , Surasak Buranatrevedh , Jayanton Patumanond 
Published: April 2021

Aims:
The study objective was to develop a clinical risk score to assist occupational medicine physicians in diagnosing hospital workers’ occupational lower back pain (LBP).

Settings and Design:
A cross-sectional data collection design was conducted at Saraburi Hospital, Thailand.

Methods and Materials:
The sample consisted of 220 hospital workers who cared for patients and had LBP. They were assessed for the frequency of targeted activities (CPR, lifting, transferring patients) and other activities from work as well as ergonomic assessments, and diagnosed with LBP by three occupational medicine physicians.

Statistical Analysis Used:
Predicted factors of multivariable logistic regression were analysed to find clinical risk scores to help the diagnosis.

Results:
The physicians agreed on the diagnosis, based on ergonomic risk factors and their experiences that 86 persons have occupational LBP. A diagnostic assistant tool consists of six predictors: the duration of LBP, having LBP within the last 7 days, bending, twisting, lateral bending, and reaching. The scores predicted occupational LBP correctly with an AuROC of 90.0% (95% CI; 84.8–93.5%). The positive likelihood ratio for occupational LBP was 0 in the low risk category (<6 points) and 16.8 (95% CI; 8.0–35.6) in the high risk (>8 points).

Conclusions:
A diagnostic assistant tool is used to assist occupational medicine physicians in diagnosing hospital workers' occupational LBP.
A Comparative Retrospective Study of the Efficacy of Caudal Epidural with Manipulation Versus Ganglion Impar Block with Manipulation in Patients with Coccydynia
Authors: Govardhani Y , RamMohan G , Abhijith S , Savithri B 
Published: April 2021

Objective:
The objective of the study was to compare the effectiveness of caudal epidural with manipulation and ganglion impar block with manipulation in treating patients with coccydynia.

Materials and Methods:
In this retrospective study, patients (n = 60) were divided into two groups of 30 each. Group C (n = 30) received caudal epidural with transrectal manipulation, whereas Group G (30) received ganglion impar block with transrectal manipulation. Preprocedural and procedural Visual Analog Scale (VAS) scores for 10 days, 1, 3, and 6 months were recorded. Preprocedural painless sitting period and postprocedure painless sitting period in two groups were recorded.

Results:
Preprocedural VAS score was not statistically significant between the two groups (7.76 ± 0.63 vs. 7.6 ± 0.72; P = 0.16). There was no statistically significant difference in the VAS score after 10 days of the procedure in both the groups. Significant decrease in VAS score was observed in Group G than in Group C after 1, 3, and 6 months of the follow-up. The painless sitting period was increased in Group G than in Group C after 6 months of follow-up (79.33 ± 48.4 min vs. 144.16 ± 37.87 min; P < 0.0001). Recurrence was observed in six patients in Group C. No significant complications were observed in both the groups.

Conclusion:
Ganglion impar block with manipulation is more effective in improving pain sensation and painless sitting period in patients with coccydynia.
Molecular docking studies of α-mangostin, γ-mangostin, and xanthone on peroxisome proliferator-activated receptor gamma diphenyl peptidase-4 enzyme, and aldose reductase enzyme as an antidiabetic drug candidate
Authors: Mahmudah Rifa’atul , Adnyana I Ketut , Sukandar Elin Yulinah 
Published: April 2021

ABSTRACT
α-mangostin, γ-mangostin, and xanthone are some of the marker compounds found in mangosteen (Garcinia mangostana Linn.) whose activity on several treatment targets including toward the peroxisome proliferator-activated receptor gamma (PPAR-γ) receptors, diphenyl peptidase 4 (DPP-4) enzyme, and aldose reductase enzyme is unknown. Although this plant has been predicted to be used as an alternative antidiabetic treatment, it has been proven through several previous studies. This research study used three natural ligands (α-mangostin, γ-mangostin, and xanthone) whose training set was designed using Molecular Operating Environment and then compared them with several drugs on the market that are used in the treatment of diabetes mellitus. The docking molecular results showed that the α-mangostin and γ-mangostin compounds had activity toward PPAR-γ receptor, DPP-4 enzyme, and aldose reductase enzyme by showing almost similar affinity values when compared to the comparison ligands. Meanwhile, xanthone showed unfavorable results. This approach shows that α-mangostin and γ-mangostin are predicted to play a role as antidiabetic mellitus in mangosteen when viewed from these mechanisms.