bluuebunny/crossref_metadata_2025_split huggingface dataset:
Giant Bilateral Angiomyolipoma Associated with Tuberous Sclerosis of Bourneville: Exceptional Case and Therapeutic Dilemma
Authors: Mahmoud Benatta 
Published: November 2021

Angiomyolipoma (AML) is a mesenchymal tumour composed of variable proportions of adipose tissue and vascular and smooth muscle elements. It can cause potentially life-threatening complications.
This report aims to describe a bilateral angiomyolipoma associated with tuberous sclerosis of Bourneville; the second aim is to discuss the treatment modalities of this disease.
A 51-year-old woman with abdominal mass and characteristic triad: Epilepsy, mental retardation and skin lesions (adenoma) (Fig. 1), with no notion of hematuria or abdominal pain, abdominal ultrasonography and computed tomography showing bilateral renal masses of 28.4×17 cm on the left kidney and 22× 11.7 cm on the right, respectively (Fig. 2-3). Serum creatinine was 13.4g/l.
Body-scan imaging finds cardiac rhabdomyoma (Fig. 4) and brain calcifications (Fig. 5). the patient underwent surveillance with scan imaging every month, and at the last control, she was asymptomatic, serum creatinine was still normal. The management of giant bilateral AML is a complex and multifactorial decision. Patients can knowingly choose an active surveillance program, even with giant AML, but the economic situation and mental status can limit the therapeutic choice.
Evaluative Study of River Birim in Denkyembuor, Ghana, Using Water Quality Indices
Authors: Samlafo Victus Bobonkey , Adakwah Desmond 
Published: November 2021

Aim: To evaluate water quality of the river Birim after a two-year ban as a result of illegal mining activities in the catchment areas of the river.
Methodology: Samples were taken during wet and dry seasons in acid-washed plastic containers. Two water quality indices were adapted for the river under study and used in the evaluation. These were Water Quality Index (WQI) and Heavy Metal Pollution Index (HPI). Twelve physicochemical parameters, such as pH, turbidity, conductivity, total suspended solids, total dissolved solids, total hardness, alkalinity, sulphate, phosphate, nitrate, Fluoride, and chloride which were life-threatening and generally acceptable in water quality were used to evaluate the water quality index. The computed WQI was 439.168, which fell within the unfit for drinking category with turbidity and total suspended solids positively influencing the index. Iron, (Fe), As, Mn, and Hg were used to evaluate HPI, with an index value of 39.49, which was excellent considering a critical value of 100 set, below which the water is fit for good drinking water.
Conclusion: Except for heavy metal pollution, the river Birim is unfit for drinking without chemical treatment and that, the two-year ban on artisanal small-scale mining was not enough for the river to recover fully from previous pollution episodes and hence did not have any impact on water quality of the river Birim.
Isolation, Chemical Characterization, Evaluation of Analgesic and Anti-Inflammatory Activities of Triterpenoids from the Tubers of Raphionacme vignei E. A. Bruce (Apocynaceae)
Authors: Diatta Diarra , Camara Mamadou  Fodé , Sène Madièye , Yao-Kouassi Philomène akoua , Barboza Firmin Sylva , Gassama Abdoulaye , Lavaud Catherine , Sy Guata Yoro 
Published: November 2021

Raphionacme vignei E. A. Bruce (Apocynaceae) is a plant of the traditional African pharmacopoeia, whose parts are used in the treatment of various pathologies. Water-soaked R. vignei tubers are edible. The objective of this study was to isolate triterpenoids from the acetonic extract of R. vignei tubers, evaluate the analgesic and anti-inflammatory activities of each molecule. The isolated compounds, characterized by NMR and mass spectrometry, is composed of six triterpenoids: beta-amyrin dodecanoate 1(DDQ1), lupeol dodecanoate 2(DDQ2), beta-amyrin acetate 3(DDQ3), lupeol acetate 4(DDQ4), luepol 5(DDQ5) and β-sitosterol 6(DDQ6). These molecules (DDQ2, DDQ3, DDQ4, DDQ5, DDQ6) are anti-inflammatory in carrageenan induced rat paw edema, with better anti-inflammatory power for DDQ2 and DDQ4, which would be related to the presence of acetate function and cycle E. DDQ2 and DDQ4 are also analgesic in acetic acid induced contortions and the removal test of rat tail on the heating plate. The analgesic action of DDQ2 and DDQ4, superior to that salicylic acetyl acid, identical to that morphine, suggests a central action of these two molecules. The potent analgesic effect of DDQ2 and DDQ4, could be attributed to the presence of cyclopentane and isoprene substitution in position 19 of the lupane family. DDQ2 and DDQ4 represent a potential for the synthesis of structural analogues with analgesic and/or anti-inflammatory properties.
New, Emerging, Re-Emerging Tropical Infectious and Non-Communicable Diseases Persistent to the Climate, Landscape, and Environmental Changes on the Grounds of the Urbanizations, Industrializations, and Globalisation
Authors: Palaniyandi Masimalai 
Published: November 2021

Historical records evidenced of urban landscape changes, and environmental transitions brought by the improper growths and urban development’s of the urbanisation and industrialization in the developing countries, especially in India, significantly chaotic urban sprawl and industrial growths, and the development of its allied activities for the recent decades, invites new, emerging, re-emerging, and triggers the tropical infectious diseases including vector borne diseases (VBD) as well non-communicable diseases. Urban sprawl has a multiplier effect of growth of unplanned a crowded housing, and industrialization has an impact on the urban landscape with commercial and market development, and roads over large expanses of urban land while little concern for appropriate urban planning. The union government of India is launching to promote 100 mega smart city projects / metropolitan / urban agglomeration across the nation for betterment of the standard of living infrastructure facilities by 2030. The large scale urban landscape architectural changes, land use / land cover changes, environmental transitions, and micro climatic changes in the heart of the urban landscape, and its fringe areas on the consequence of built-up structures, construction of roads transport networks, drainages, commercial buildings, human dwellings, educational buildings, legal and medical health services, income tax professionals, small scale to large scale industries, etc., The census of India, reports highlighted that people mass movements / migration from rural to the urban, and small towns to mega cities are notably accelerating trends for the recent decades mainly for the purposes of occupation, education, trade and commerce, and professional services, generally reasons for male migration, and marriage is the absolute reason for female adults migration. The spatial and temporal aspects of malaria and dengue has been declining trends in rural settings, however, it has been accelerating trends in the urban settings due to the urban buoyant migrants. Urbanization and industrialization effect on urban landscape environment leads to breakdown of sanitations, water-borne diseases associated with inadequate and unsafe drinking water supply, tendency to use metal, plastic, and mud pots water storage containers, discarded domestic waste misshapen to vector breeding habitats containers, urban heat island, garbage waste disposal, liquid waste from dwellings, and industries, air pollution (dust, pollen and spores suspended as particles, Sulphur Dioxide-SO2, nitrogen oxides-NO, Carbonate-CO3, depletion of Oxygen O2, Ozone-O3, Methane Gas- CH₄, Lead- Pb, Mercury- Hg etc.,), exonerated by the industries and urban transport emissions, modern transport / shipping goods and services, and collectively hazard to human health through erratic infectious diseases and vector borne diseases immediately.
Impact of Surgery in De Novo Metastatic Breast Cancer after Systemic Disease Control
Authors: Soomro Rufina , Khokher Afsheen Javaid , Zahid Naila 
Published: November 2021

Background: Systemic chemotherapy is the standard of care for patients with metastatic breast cancer, with an undecided role in surgery. Limited data is available for the role of surgery on the overall survival of stage 4 breast cancer regarding luminal subtypes of patients. This is a retrospective data analysis comparing overall survival benefit and disease-free survival in stage IV breast cancer after systemic treatment and systemic disease control concerning luminal classification in the last five years.
Method: Patients who had surgery and no surgery after systemic treatment and disease control were compared for 5 years overall survival as the primary endpoint and disease-free survival as the secondary endpoint. The survival benefit was also compared regarding tumor biology (ER/PR, HER2 status).
Results: Data included 421 patients, 237 in surgery and 184 in no surgery group. At one year survival for surgery performed and not performed was not significant. Five-year overall survival for surgery performed and not performed was 84.4% and 74.5%. A statistically significant difference in survival rates was observed (p<0.0001). The mortality rate was 15.6% in surgery performed and 25.5% in the no-surgery group which showed a significant difference among the two study groups (p=0.011). We found statistically significant differences in luminal B (p=0.004) and triple-negative breast cancer patients (p=0.001) for survival rates in surgery performed and not performed groups.
Disease-free survival has shown no significant difference in surgery performed and not performed group in 1, 2, and 5 years follow-up.
Conclusion: Surgery has a positive impact on overall survival in Stage 4 patients with systemic disease control even in high-risk luminal B, Her 2 Positive, and triple-negative breast cancer patients. There was no significant difference observed in disease-free survival who were operated on or not. However, there was no local recurrence in the operated group.
A Synthetic Chrono Genetic Therapy Gene for Consecutive Drug Delivery
Authors: Anosh Maryam , Majeed Zukhruff , Qamar Nida 
Published: November 2021

Chronotherapy, the delivery of therapeutic interventions personalized to patient's circadian rhythms, has shown enhanced therapeutic efficacy and reduced side effects. Patients exhibit diurnal changes in cytokines in rheumatoid arthritis that lead to inflammatory flares and enhanced disease severity in the early morning. There has been important work showing the administration of anti-inflammatory treatments in the early morning, immediately before the inflammatory flare, in reducing symptoms of RA. Using synthetic biology, we developed chronotherapy-based gene chromogenic therapies that produce our prescribed transgene downstream of the core circadian clock component, Per2. We transduced these lentiviral chromogenic therapies into murine-induced pluripotent stem cells and developed tissue-engineered cartilage as our model system for timed drug delivery. Our anti-inflammatory chromogenic could produce interleukin-1 receptor antagonist (IL-1Ra) in an oscillatory manner tracking with circadian rhythms in vitro. Additionally, the tissue-engineered pellets could entrain host circadian rhythms when implanted into mice and produce different levels of IL-1Ra in the serum at other times of the day. The chromogenic synthetic gene provides a novel cell therapy driving by the circadian clock for controlled biologic delivery at prescribed times of the day.
Surgical Site Infection in a Tertiary Care Teaching Hospital
Authors: Kartthick V. , Sudarshan P. B. 
Published: November 2021

Introduction: Surgical site infections [SSIs] are the Third most common nosocomial infections, According to the National Nosocomial Infections Surveillance, patients who are hospitalized account for 15 to 18 percent of all nosocomial infections .increased mortality and morbidity rates associated with Surgery.
Surgical wounds are divided into four categories: clean, clean-contaminated, contaminated and dirty wounds.
Materials and Methods: This was a retrospective study, done throughout for two years period, from June 2018 to May 2020 .785 patients underwent surgery in the Dept. of General Surgery in Saveetha Medical College and Hospital, Thandalam.
Were taken as part of this study. Elective surgical procedures were performed on 495 patients. And 290 were taken to the hospital for emergency treatment. An in-depth examination of these cases was conducted, taking into account the date of admission, clinical features, history, types of surgery [emergency or elective], pre-operative preparation, drain used, and its type and postoperative findings.
Results: Surgical Site Infections were found in 58 cases out of 785 surgeries. In elective clean and contaminated patients, the overall postoperative SSI rate is 4.34 percent of all cases, whereas emergency cases account for 12.41 percent. According to the research, that the most prevalent type of surgical site infection is superficial surgical site infection accounting for 72.1 percent of all SSIs in elective cases and 61.11 percent in emergency cases, and deep surgical site infection accounting for 23.25 percent of elective cases and 30.55 percent of emergency cases.
Conclusion: The most common bacteria found in elective surgical wounds are E. coli. Proteus mirabilis is the most prevalent organism isolated from emergency surgical wounds. A shift in the pre-operative period antibiotics may even diminish the occurrence. Pre-existing medical conditions like diabetes mellitus wound type, operation time, emergency procedures, and wound contamination all had a significant impact on the development of surgical site infection.
A Comparative Study to Assess the Knowledge of Anemia among School Children in Selected Urban and Rural Schools of Bilaspur, Chhattisgarh
Authors: D. Masih Shailvina , Linson C. C. 
Published: November 2021

The aim of the research was to assess the knowledge and prevalence of anemia among rural and urban school children. A quantitative approach was used for the present study. The study population wasthe school children, 9-14 years of age studying in 6th to 9th standard of rural and urban schools of Bilaspur, Chhattisgarh. The sample size consisted of 50 children from urban and 50 children from rural school. The objectives of the study were to assess the knowledge of anemia among children in urban and rural school. Compare the knowledge of anemia among children in urban and rural school. To find out the association between knowledge and selected demographic variables. Among the urban school children 14(28%) had inadequate knowledge, 26(52%) had moderately adequate knowledge, and, 10(20%) were having adequate knowledge. Among the rural school children 35(70%) had inadequate knowledge, 12(24%) had moderately adequate knowledge, and 3(6%) had adequate knowledge. There is significant difference in the level of knowledge regarding Anemia among urban and rural school children. There is significant association between knowledge of urban school children and occupation of mother.
There is significant association between knowledge of rural school children and educational qualification of father.
To Determine the Frequency of Thrombocytopenia in Pre Eclamptic Presented at Isra University Hospital
Authors: Khatoon Hafiza , Ahmed Rukhsana , Naz Ambreen , Mushtaq Nousheen , Irfan Asma , Safia . 
Published: November 2021

Objective: To determine the frequency of thrombocytopenia in pre-eclamptic women presented at Isra University Hospital Hyderabad.
Patients and Methods: This cross sectional descriptive study of six months study was conducted at Isra university hospital from April 2019 to September 2019. All the patients between ≥18 - 45 years of age diagnosed preeclampsia were admitted and evaluated for thrombocytopenia.
Results: During six month study period, total of 177 patients with preeclampsia were evaluated for thrombocytopenia. The majority of patients were from urban areas 125/177 (70.6%). The mean ±SD for maternal and gestational age of the preeclamptic patient was 32.75±8.85 and 28.75±7.63 whereas the mean platelet count was 93200±10.74 respectively. The majority of the patients were 21-30 years of age (54.8%) and the finding was statistically significant with gestational age [p=0.002]. The thrombocytopenia was observed in 99/177 (55.9%) and is statistically with relation to maternal age, gestational age and parity while in context to gravida and duration of disease it is non significant.
Conclusion: A significantly high frequency of thrombocytopenia (55.9%) was recorded in the patients with preeclampsia and is statistically with relation to maternal and gestational age and parity.
Comparison of Dexamethasone and Ondansetrone Use in Prevention of Post-operative Nausea and Vomiting
Authors: Alam Shakil , Rashid Haris , Khan Sagufta , Ali Mir Arsalan , Haseeb Obaidul , Sidhwani Santosh Kumar 
Published: November 2021

Background: PONV remained the common cause of patient’s discomfort after anaesthesia 30% in all post-surgical patients and 80% in high-risk patients. With other common and serious complications of surgeries vomiting and nausea remained unpleasant trigger for patients who underwent the surgeries that prolongs the hospital stay and also leads to recurrent admissions. Therefore in this study we want to compare the effectiveness of pre-operative single-dose dexamethasone versus ondansetron in reducing post-operative nausea and vomiting after laparoscopic surgeries.
Methods: Patients admitted for laparoscopic procedures at Ziauddin Hospital North site were recruited for this quasi-experimental study. All consecutive patients were assigned to one of the two groups (1 or 2) using computer generated simple randomised numbers and given either of the two treatments: single dose dexamethasone (5-8mg) or ondansetron (4mg). Researcher assessed post-operative nausea and vomiting at thirty minutes, two, four, eight, and twenty-four hours after the procedure. For statistical association the chi-square test and independent t-test were applied. Significant was defined as a P-value of less than 0.05.
Results: The mean age of patients was 42.9±16.6years with mean weight of 62.9±8.8 kilograms. All the operation performed as laparoscopic and common procedure was cholecystectomy (72/98: 73.5%), followed by appendectomy (17/98: 17.3%). Patients with ondansetron had more episodes of vomiting after 30 minutes of laparoscopic surgery. In addition, we discovered a correlation between the two groups' nausea episodes 30 minutes after surgery. After 30 minutes of laparoscopic surgery, patients who took ondansetron reported more nausea episodes.
Conclusion: Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic surgery.
Combined Effect of Walking and Vitamin D Intake on Patients with Heart Failure
Authors: Usama Javed Muhammad , Mustafa Tanzeel ur Rehman , Shah Sharoz Mukhtar , Babar Iza , Iqtidar Fatima Maham , Arslan Babar Muhammad 
Published: November 2021

Objective: Patients with heart failure may benefit from vitamin D treatment, according to new research (Congestive Heart Failure).
Methods: In our current nonrandomized clinical research, 43 individuals with dilated cardiomyopathy who did not exhibit substantial gains in physical functioning with optimum heart failure therapy were included. Twelve weeks of weekly vitamin D supplements (200,000 IU) were added to the heart failure therapy to help improve the patient's condition. On the other hand, researchers looked at how it affected the 6-minute walk distance and pro-BNP levels. To analyses the data, we utilized SPSS version 19. Accordingly, we utilized random samples t-tests to assess the substantial role of vitamin D supplementation on pre-intervention vitamin D level, 6-minute walk distance, and pro-BNP level, respectively. Significance was defined as an alpha value less than 0.01.
Results: Individuals in NYHA class II (66%) were the majority, while those in NYHA classes I, III and IV were represented by 18%, 8% and 5%, accordingly. Following 14 weeks of vitamin D treatment, the group's mean vitamin D level was increased from 17.596.57ng/ml at baseline to 32.974.65ng/ml (p0.0006). Pre-intervention mean distance travelled was 806382ft, however after the intervention it rose to 945392ft (p-value 0.07). While before the intervention, the mean per-BNP level of research participant was 1025-636, and after intervention, it had enhanced to 160-80--a statistically significant improvement (p=0.005).
Conclusion: According to a decline in blood pro-BNP characterized by an increase in six-minute walk distance, vitamin D administration decreases the intensity of heart failure.
Comparison of Efficacy between Intramuscular Diclofenac and Transdermal Diclofenac Patch for Postoperative Analgesia in Patients Undergoing Lower Limb Surgery Under Sub Arachnoid Block in Jawaharlal Nehru Medical College, Wardha, India
Authors: Modak Anjali , Kumar Harindanath S. 
Published: November 2021

Background: To compare the analgesic efficacy of transdermal Diclofenac patch (100 mg) with intramuscular Diclofenac sodium (75 mg) for postoperative analgesia and to know the side effects of transdermal Diclofenac patch.
Methods: 60 ASA I and II patients, of either sex, aged 15 and above, scheduled for lower limb surgery under subarachnoid block were included in the study. All were allocated randomly by computer generated randomization sheet into two groups of 30 each. Subarachnoid block was administered using 0.5% hyperbaric Bupivacaine. Participants in the study group were applied with a transdermal Diclofenac patch containing 100 mg of Diclofenac diethylamine at the beginning of the surgery. In the control group 75 mg of Diclofenac sodium was given intramuscularly half an hour before the end of surgery. Pain was assessed postoperatively using visual analogue scale. Injection Tramadol 2 mg was administered intramuscularly as rescue analgesia. The data obtained was analyzed using chi - square test and unpaired student’s ‘t’test.
Results: The mean time at which rescue analgesia was administered in the control group was 7 hours 28 min and in study group was 20 hours 6min.The time at which rescue analgesics were required in the study group was significantly prolonged (p<0.0001). The amount of Inj. Tramadol required as rescue analgesia in the control group was 189.33 mg. ± 16.38 mg. and in study group it was 97 mg. ± 7.24 mg and this was found to be statistically significant (p<0.0001). When the side effects were compared they were not significant.
Conclusions: Based on the results obtained we conclude that, the intraoperative application of 100 mg transdermal Diclofenac diethylamine patch significantly prolongs the time at which patient requires rescue analgesia without any significant side effects. Rescue analgesic requirement was also significantly lower in the study group.
Bio-Analytical Stability Studies of Nadolol Material
Authors: Veeraswami B. , Naveen V. M. K. 
Published: November 2021

The best practices of Bio-analytical stability studies on drug samples are very crucial and essential for the drugs development process as it specify the acceptancy, purity, efficacy, prediction of strength and quality of the drugs. The main objective of this stability studies on Nadolol the proposed approach of chromatographic separation was administered in isocratic way by using asymmetric C18 column of 40:60 percent of acetonitrile and 0.1% OPA at a flow rate of 1 ml/min is a quantitative measure for drug analysis in biological matrix for more reliable, selective, reproducible and sensitive. This stability study constituents several methods like Bench-Top, Auto-sampler, Freeze-Thaw, Dry-extract, Wet-extract, Short-term, long-Term stability studies at various intervals gave the complete stability information about these drugs. The results of these stability studies are accepted based on ICH guidelines represents this drug has a good stability under the present experimental conditions.