bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toxic and trace elements in scalp hair samples of Egyptian children with multiple sclerosis: a case–control study
Authors: Abdulhai Eman A. , Abdelrazik Eman 
Published: December 2024

Background
Heavy metals and trace elements are considered as environmental pollutants that pose serious risks to public health as they are nonbiodegradable and remain in the ecosystem. It has been documented that they are neurotoxic, and their levels in hair samples can be used as a biomarker of exposure, indicating their levels in soft tissues. Multiple sclerosis (MS) is considered one of the most common chronic neurodegenerative diseases. Its pathogenesis is complex and multifactorial, and there is interaction between genetic and environmental factors.

Aim
The aim of this study is to compare the levels of some heavy metals and trace elements in hair samples of children with MS with those of healthy controls to investigate their possible association with the onset of MS.

Patients and methods
A total of 30 children with MS and 30 healthy children were investigated. Using inductively coupled plasma atomic emission spectrometry, we analyzed 21 elements in hair samples from MS patients and a healthy control group.

Results
Zn, Cr, Ba, Mg, Mn, Se, Sr, and V were significantly higher in hair samples from children with MS. While Hg, B, and As were only detected in cases, there was no significant difference in the level of Al, Ag, Ca, Cd, Cu, Fe, Ni, Pb, P, and Na between cases and controls.

Conclusion
Zn, Cr, Ba, Mg, Mn, Se, Sr, and V were significantly higher in hair samples from children with MS. There was no significant difference in levels of Al, Ag, Ca, Cd, Cu, Fe, Ni, Pb, P, and Na between cases and controls.
Study of the incidence of intraventricular hemorrhage in preterm babies in Damanhour medical national institute’s neonatal intensive care unit
Authors: El-touny Eman M. , Hassan Mohamed F. , Khamis Gamila S. , Ayad Ashraf M. , El Bedawy Neveen M. 
Published: December 2024

Purpose
To study the incidence of intraventricular hemorrhage (IVH) and its predictors among premature neonates admitted to Neonatal Intensive Care Unit (NICU) and also to look for the mortality rate due to IVH.

Patients and methods
This retrospective cohort study was conducted on 80 preterm babies with a gestational age (GA) of less than or equal to 36 weeks. They were divided after obtaining cranial ultrasound imaging into study group (16 preterm babies with IVH) and a control group (64 preterm babies without IVH), both groups were then compared in terms of maternal history such as age, Gravida Para Scoring, preterm siblings, incidence of preeclampsia/eclampsia, type of delivery.
Preterm data and IVH predictors such as GA, sex, birth weight (BW), Down Score, use of mechanical ventilation (MV), apnea, pneumothorax, thrombocytopenia, jaundice, hypoxia, early onset sepsis, hypotension, seizures, jaundice, Patent Ductus Arteriosus, metabolic diseases, blood diseases were compared. Mortality rates were also compared between the two groups.

Results
The incidence of IVH among total neonates was 20%, significant differences were observed between the two groups regarding to GA and BW, mechanical ventilation, apnea, hypotension/shock, seizures. The mortality rate was 56.3% in the IVH group and 20.3% in the control group. Moreover, when multivariate logistic regression analysis for the variables affecting IVH was performed; only seizures showed significant outcomes.

Conclusion
Prematurity and low BW are significant risk factors for IVH. Seizures were strongly linked to the incidence of IVH. Prevention of preterm birth, prenatal and postnatal care are mandatory to prevent IVH and its complications.
Fibrosis-4 and Ultrasonography Assessment of Metabolic Dysfunction-associated Steatotic Liver Disease: A Cross-sectional, Observational Study
Authors: Eva Israt Zerin , Qureshi Nazmul Kabir , Ferdous Chandina , Afrooz Farhana , Jahan Dilruba Nusrat , Samad M. A. 
Published: December 2024

ABSTRACT

Introduction:
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease, has now emerged as endemic. Fibrosis-4 (FIB-4) can grade the risk of evolving liver fibrosis utilizing inexpensive easily available parameters, and ultrasonography (USG) is the attainable initial imaging modality to detect the presence of MASLD. This study aimed to determine the prevalence and grades of MASLD along with fibrosis risk stratifications according to the FIB-4 index among the urban diabetic population of Bangladesh.

Methods:
This cross-sectional observational study was performed at National Healthcare Network Uttara, Dhaka, Bangladesh, from November 2022 to October 2023 with ethical clearance among nonpregnant adults having type 2 diabetes mellitus, aged 18 years to ≤74 years. The presence of MASLD with grading was ascertained by USG of the hepatobiliary system, and the fibrosis risk score was calculated according to the FIB-4 index.

Results:
Overall, 167 subjects were studied (male-to-female ratio of 1:1.7). USG revealed that 94.6% had fatty changes in the liver, among them 37.7% had Grade 1, 48.5% had Grade 2, and 8.4% had Grade 3 fatty changes. Risk stratification by the FIB-4 index revealed that 65.3% had low risk, 31.7% indeterminate risk, and 3.0% high risk for hepatic fibrosis. Most subjects in the indeterminate and high-risk group had HbA1c% ≥7 than the low-risk group for fibrosis. The study found that 41.9% of patients were overweight, 47.3% were obese, and central abdominal obesity was seen in 85.6% of patients.

Conclusion:
This study revealed a considerable prevalence of MASLD, with varying degrees of liver fibrosis among the diabetic population. Case-finding strategies using USG and noninvasive tests (such as FIB-4) should be applied to rule out or in advanced fibrosis.
Safe Implementation of Robotic Surgery for Gynecologic Diseases at a Tertiary Center: Retrospective Analysis of 149 Cases and Review of the Literature
Authors: Yoshimura Takuma , Nishio Hiroshi , Sakai Kensuke , Nogami Yuya , Hayashi Shigenori , Yamagami Wataru 
Published: December 2024

Abstract

Objectives:
The initial learning curve is a barrier to introducing robotic surgery. Evidence regarding appropriate simulation programs that allow for a smooth introduction of gynecological robotic surgery remains limited.

Materials and Methods:
We retrospectively analyzed 149 patients who underwent robotic surgery for gynecologic diseases. Before their first procedure, the surgeons completed a robotic surgery training program. Assistant surgeons also completed simulation programs, including setup procedures and manipulation of the robotic arm.

Results:
The mean (± standard deviation) operative, setup, and console times were 170 ± 54 min, 22 ± 8 min, and 126 ± 51 min, respectively. No patient required blood transfusion or conversion to laparoscopy or laparotomy. Patients undergoing surgery by the same surgeon were divided into three groups (first-third, middle-third, and last-third of patients undergoing surgery) to assess chronological changes. No statistically significant differences were found between the operative and console times among these groups. The setup times for the middle and last third of patients were 20 ± 7 min and 18 ± 7 min, respectively, which were statistically significantly shorter than those for the first third of patients. No significant differences in the operative and console times done by five physicians who completed programs were observed between the first 75 and the latter 74 procedures; however, the setup times of the latter 74 procedures were significantly shorter than those of the first 74 procedures (25 ± 9 min vs. 19 ± 6 min; P < 0.001).

Conclusion:
The setup time was influenced by clinical experience. An appropriate simulation program allowed a safe implementation of robotic surgery.
The Impact of Oxidized Regenerated Cellulose Application during Cystectomy and Drainage in Endometrioma Patients: A Retrospective Cohort Study
Authors: Marwali Luky Satria , Setiawan Marcel Ezra , Emeraldi Malvin , Asadi Agus Surur , Putera Aditya Rangga , Puspitasari Rany Ayu 
Published: December 2024

Abstract

Objectives:
This study aims to determine the impact of oxidized regenerated cellulose (ORC) during cystectomy and drainage on recurrence and ovarian reserve.

Materials and Methods:
Women aged 18–45 years with endometrioma (pathologically confirmed) who underwent conservative laparoscopy surgery (cystectomy and drainage) using ORC at Fatmawati General Hospital Jakarta, Indonesia, were included in this study. All surgeries were done by complete excision of all endometriosis lesions (especially for excision of deep infiltrating endometriosis and adenomyosis resection). All patients were followed up for 1 year, and the recurrence rate and postoperative anti-Mullerian Hormone (AMH) were evaluated.

Results:
Twenty patients were included in the cystectomy group and 19 in the drainage group. The researchers found the result was not significant (P = 0.622) in recurrence rate. AMH was decreased from 3.0 ± 1.8 to 2.1 ± 1.5 in cystectomy with ORC group. Conversely, AMH decreased from 1.4 ± 1.25 to 1.1 ± 0.9 in the drainage with ORC group. The reduction of AMH level was more significant in the cystectomy group (P = 0.002) than in the drainage group (P = 0.124).

Conclusion:
Cystectomy with ORC significantly reduces ovarian reserve. Drainage followed by insertion of ORC to the cyst cavity can be an option to maintain ovarian reserve with a risk of recurrence that is not significantly different from cystectomy.
Internal and Surgical Ablations of Ventricular Arrhythmia and Bundle Branch Reentry Ventricular Tachycardia
Authors: Chen Hongwu , Chen Minglong 
Published: December 2024

Abstract
Catheter ablation is a crucial therapeutic approach for managing ventricular arrhythmias (VAs), offered improved outcomes over the last few decades. The strategy’s efficacy and safety have seen consistent enhancements, benefiting patients both with and without structural heart disease. Combining endocardial and epicardial ablation has proven valuable, particularly in nonischemic cardiomyopathy, myocardial infarction, arrhythmogenic right ventricular cardiomyopathy, and certain epicardially originating focal VAs. However, despite these advancements, some VAs remain refractory, leading to life-threatening electrical storms and increased mortality rates. Surgical epicardial ablation has emerged as a promising alternative for managing such challenging cases. Bundle branch reentrant ventricular tachycardia (VT), a specific form of sustained monomorphic VT, involves a reentry circuit comprising the distal His-Purkinje system, left and right bundle branches, and the proximal ventricular septum. This review underscores the significance of comprehending the underlying substrate in VAs necessitating internal and surgical ablation, particularly in the context of bundle branch reentrant VT. The discussion encompasses mapping strategies, clinical prognosis, and the identification of optimal ablation techniques. Through this comprehensive examination, clinicians can better navigate the complexities of VA management, ultimately improving patient outcomes.
Evaluation of Analgesic Effects of Different Doses of Vitamin D3 in Two Animal Models of Pain in Swiss Albino Mice
Authors: Dhorajiwala Shakeeb Siraj , Nerurkar Rajan P. , Singh Kanchan R. 
Published: December 2024

Background and Objective:
Pain is the most common symptom compelling an individual to seek medical attention. The use of Vitamin D3 for nociceptive and inflammatory pain is highly debated. Therefore, this study was undertaken to compare three daily doses (15/30/60 μg/kg) and a single high dose of Vitamin D3 (260 μg/kg) to standard drugs, namely tramadol and diclofenac in two most resorted pain-models in mice.

Materials and Methods:
Thirty-six Swiss-albino mice were divided into six groups of six mice each. The experiment was conducted using hot plate and writhing test. Same groups of mice were reused after suitable wash-out period. Groups were dosed with 0.25% carboxymethyl-cellulose (negative-control), a positive-control (tramadol for hot-plate and diclofenac for writhing-test). Injection Vitamin D3 was given in three daily doses of 15/30/60 μg/kg. Single dose of 260 μg/kg of Vitamin D3 was also tested. Latency period (LP), percent of maximal-possible-antinociceptive-effect (%MPE), mean number and percentage inhibition of writhes were the parameters evaluated to compare analgesic effect. Data were analyzed using paired t-test, analysis of variance (ANOVA)/Kruskal–Wallis/Friedman’s-ANOVA, and repeated-measures ANOVA with post hoc Dunnett’s tests.

Results:
In hot-plate method, 60 and 260 μg/kg of Vitamin D3 raised mean LP when compared to baseline and negative control and all groups recorded higher percentage MPE values when compared to negative control. In writhing test, 15-, 30-, and 60 μg/kg/day showed analgesic effect in comparison to negative control. However, 15 and 30 μ/kg/day of Vitamin D3 contradicted its responses when assessed through different parameter.

Interpretation and Conclusion:
In hot-plate test, 60 and 260 μg/kg of Vitamin D3 showed significant analgesic effect; however, effects were not superior to tramadol. In writhing test, 15-, 30-, and 60 μg/kg/day showed significant analgesic effect which were not superior to diclofenac. Surprisingly, 15 and 30 μ/kg, on instances exhibited irritant effects.
The Role of CT Guidance in T2–T3 Sympathetic Block: Overindulgence or Essential Safety Measure?
Authors: Godase Kanchan , Page Nivedita , Bangar Kashinath , Gaikwad Charusheela 
Published: December 2024

Abstract
Pain management is crucial in health care, especially in India where chronic pain affects millions of individuals. This case report discusses a rural woman with left finger gangrene unresponsive to medical management. She was planned for computed tomography (CT)- guided T2–T3 sympathetic block but was deferred due to incidental finding of pericardial effusion. Further evaluation revealed that she had systemic lupus erythematosus (SLE). She was subsequently managed with an ultrasound-guided stellate ganglion block. This case outlines the importance of thorough preprocedural evaluation and highlights the advantages of CT guidance in preventing complications and facilitating proper intervention.
Chiari Malformation 1 with Syrinx? Do We Need to Fix It – Our Institutional Experience
Authors: Saranraj M. K. , Giridharan K. , Nathan G. Sudhakshina , Jacob Adrian Jamesraj , Mangaleswaran Balamurugan 
Published: December 2024

Abstract

Background:
Chiari malformation (CM) is a spectrum of disorders associated with impaired cerebrospinal fluid (CSF) circulation through the foramen magnum, often presenting with syringomyelia (SM). While foramen magnum decompression (FMD) is the widely accepted treatment, the role of C1-C2 fixation remains underexplored.

Objective:
This study aimed to evaluate the regression of syrinx and clinical outcomes in patients with CM undergoing FMD alone versus FMD combined with C1-C2 fixation.

Methods:
A retrospective analysis of 48 patients diagnosed with CM-1 and syringomyelia treated at our institution from January 2012 to January 2020. Patients were grouped based on surgical intervention: FMD alone (with or without duraplasty) or FMD + C1-C2 fixation. Outcomes were assessed using postoperative imaging and the Chicago Chiari Outcome Scale (CCOS).

Results:
FMD alone led to >50% syrinx regression in 74.3% of patients without duraplasty and 84.3% with duraplasty, averaging 8 months. FMD + C1-C2 fixation demonstrated >75% regression in 85.7% of cases within 2 months. Faster recovery and significant syrinx resolution were noted in the fixation group.

Conclusion:
The findings suggest that FMD + C1-C2 fixation may offer faster syrinx regression and clinical recovery in isolated CM-1 cases, questioning the routine need for duraplasty. Further studies are needed to validate these results.
Surgical Strategy for Type II Long Segment Giant Spinal Schwannomas – Case Series and Review of Literature
Authors: Sridhar Krish , Sridhar Ashwin 
Published: December 2024

Abstract

Background:
Schwannomas have been classified according to their size, extent, and invasiveness. The type II giant intraspinal schwannomas (T2GSS) which extend for more than two vertebral bodies longitudinally are rare tumors. The challenge in surgery is the length of these lesions.

Objective:
The author critically reviewed literature with a view to decide on an ideal surgical strategy for these tumors.

Material and Methods:
A retrospective study was performed of the authors’ cases to identify those which qualified to be T2GSS. An online search was conducted to identify previously published cases in English literature. These were then analyzed especially for surgical approach and results.

Results:
Four cases from the author and 13 cases from the literature formed the basis of the study. The majority involved the cervical spine (15/17). In 4 patients, the lesion extended into the foramen magnum. The average length of the tumors was 6.5 (range 4–13), with 9 tumors located anteriorly. The approaches used included laminectomy – 5/17, laminoplasty – 4/17, hemilaminectomy – 2/17, and anterior corpectomy – 2/17. The author used a unilateral minimal laminotomy in 4 patients. There were no intraoperative complications recorded. Postoperative morbidity included pseudomeningocele, residual tumor, and swan neck deformity.

Conclusions:
The T2GSS is a rare tumor with this report being the first case series. The surgery for these tumors needs to take into account their longitudinal extent to avoid complications related to laminectomy. A unilateral posterior approach with minimal bone removal appears to be the appropriate strategy to be adopted along with good microsurgical techniques.
Aerobic and Wingate anaerobic capacities, range of motion and muscular performance of adolescent Malaysian male volleyball and sepak takraw players
Authors: Hidzir Haziaty Md. , Ooi Foong Kiew , Chen Chee Keong , Jawis Mohd Nidzam Mat , Asri Siti Nur Farhana , Abidin Muhammad Amrun Haziq , Samsudin Norsuriani 
Published: December 2024

Background:
The present study examined the differences in aerobic and anaerobic capacities, range of motion (ROM) and muscular performance among adolescent Malaysian male volleyball players, sepak takraw players and sedentary controls.

Methods:
Thirty adolescent Malaysian males (mean age: 14.2 [1.3] years) participated in this study. They were divided into three groups: sedentary control, volleyball and sepak takraw groups with 10 participants per group. The tests conducted were 20-m shuttle run, Wingate anaerobic, ROM, hand grip strength, back and leg strength, standing long jump and vertical jump tests. Statistical analysis was performed using one-way ANOVA and post hoc Bonferroni test.

Results:
Anaerobic capacity and hand grip strength were significantly higher in the volleyball group compared to the sepak takraw group. Sepak takraw group showed a significantly higher ROM in trunk extension and flexion than the volleyball group. Compared to the sedentary control group, the volleyball group showed significantly greater values in anthropometric measurements, estimated VO2max, anaerobic capacities, ROM during knee extension and muscular performance parameters. Meanwhile, the sepak takraw group demonstrated statistically significant higher values in aerobic capacity, ROM during knee extension, trunk flexion and extension and leg explosive power compared to the sedentary control group.

Conclusions:
Involvement in volleyball and sepak takraw training significantly enhances physical and physiological performance compared to a sedentary lifestyle. These results added new information on aerobic and anaerobic capacities, ROM and muscular performance of Malaysian male volleyball and sepak takraw players in the field of sport science.
Changes in gait characteristics amongst female collegiate students with different body mass index
Authors: Ghafar Rosniwati , Ramli Nur Rasyiqah , Zulkifli Erie Zuraidee , Lau Jiun Sien , Shah Muhamad Sharil Md , Fadzil Nor Adila Mohd 
Published: December 2024

Background:
Walking is an essential daily function, with variations in gait observed across different populations. Abnormal gait patterns can lead to health complications over time.

Aims:
The study aimed to investigate the differences in gait characteristics amongst collegiate students with varying body mass indices (BMIs).

Subjects and Methods:
Thirty-nine female students were divided into three BMI categories: underweight, normal weight and overweight. Participants performed three walking trials, with data captured using six cameras from the Qualysis motion capture system and analysed using Visual3D software.

Statistical Analysis:
An analysis of variance test and post hoc using the Tukey procedure were employed to compare the spatial-temporal and kinematic parameters amongst the three groups.

Results:

Post hoc analysis revealing statistically significant differences (P < 0.05) in stride width (0.14 ± 0.03) and stance time (0.65 ± 0.02) when compared to the overweight group for spatial-temporal data, this strategy is used to overcome the instability of the body which can be related to the muscle weakness. For kinematic data, post hoc analysis showed significant differences (P < 0.05) when compared to the overweight group for maximum values of internal rotation angle (8.60 ± 4.44) at the pelvis joint, abduction angle (−5.37 ± 4.24) at the hip joint, dorsiflexion angle (94.52 ± 2.16) at the ankle joint and toes-up angle (27.55 ± 5.22) at the foot joint.

Conclusion:
The study found that different BMI categories notably affect individual gait parameters, with the most significant changes observed in the overweight group. Increased body weight imposes additional loads on the body’s systems, with these changes becoming evident as early as the overweight stage which showed a significant deviation from a normal range. These changes increase the burden and will increase the risk of musculoskeletal pathology in the overweight group. This research highlights the importance of maintaining a normal weight to prevent future gait alterations and movement complications. The findings aim to increase awareness amongst the younger generation about the impact of body weight on gait and encourage proactive health measures to manage weight effectively.