bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of combined treatments in patients with retinal arterial macroaneurysm
Authors: Wang Chenghu , Cao Guofan , Xu Xiangzhong , Wang Jian , Zhang Shu 
Published: November 2021

Purpose:
To evaluate the outcome of the combined approach between intravitreal ranibizumab (IVR) and focal laser photocoagulation (FLP) in the treatment of symptomatic retinal arterial macroaneurysm (RAM).

Methods:
A total of 10 patients were included in this clinical case series report. They were diagnosed with symptomatic RAM (one eye in each) and assessed by a comprehensive ophthalmologic examination, including fluorescein angiography (FA), optical coherence tomography angiography (OCT-A), and indocyanine green angiography (ICGA). All patients were treated with an IVR followed by an FLP 2 weeks later. If necessary, a second IVR was given 1 month after the first one (or 2 weeks after the first FLP), which was followed by a second FLP treatment 2 weeks later in the needed cases. All cases were followed up for 6 months after the last treatment.

Results:
Both the retina hemorrhage and edema were resolved by the treatment. No ocular and/or systemic side effects were evident, and no recrudescence of RAM was seen within the 6 months of follow-up.

Conclusion:
The combined treatment of IVRs and FLPs was successful in the management of symptomatic RAM.
The artificial iris – Analysis of various implantation techniques after ocular trauma
Authors: Krishnan V Murali , Todorova Margarita G , Wiechens Burkhard , Valmaggia Christophe , Varde Meghana A 
Published: November 2021

Purpose:
The aim of this study is to analyze the outcome of various techniques for a custom-made iris prosthesis implantation as part of reconstructive anterior segment surgery following traumatic aniridia.

Methods:
This retrospective interventional study was done for 6 eyes that received an artificial iris as secondary reconstructive measure for photophobia and unsatisfactory vision following initial globe repair. Different implantation techniques were employed. These included simple sulcus implantation, implantation of a composite (iris prosthesis with attached intraocular lens) implant, and combinations with phacoemulsification, vitrectomy, and penetrating keratoplasty.

Results:
In all cases, the artificial iris was implanted successfully. In the follow-up period (1–48 months), postoperative complications included rhegmatogenous retinal detachment, prolonged intraocular inflammation, and corneal transplant decompensation due to graft rejection. There was no case of secondary glaucoma. Complications could be managed successfully. All patients showed improved best-corrected visual acuity and were satisfied with functional and cosmetic results.

Conclusion:
This case series highlights the different implantation techniques for reconstruction of the anterior segment after ocular trauma. The versatility of the custom-made iris implant accounts for a wide range of applications and the foldable material reduces the need for large incisions in the already traumatized eye.
Elliptical versus circular flap configuration in myopic eyes undergoing femtosecond laser in situ keratomileusis surgery: A contralateral eye study
Authors: Gupta Amit , Thakur Anchal , Gupta Suruchi , Malhotra Chintan , Kulshrestha Ashish , Choudhary Tripti 
Published: November 2021

Purpose:
To study whether a customized elliptical flap configuration offers any visual, refractive, or biomechanical advantage over the “conventional” circular flaps in patients undergoing myopic laser in situ keratomileusis (LASIK).

Methods:
A prospective interventional contralateral eye study was undertaken enrolling 290 eyes of 145 myopic patients (≤−6.0D) undergoing LASIK, wherein the corneal flap was created in one eye using a customized elliptical flap configuration versus a conventional circular flap configuration in the other eye. Postoperatively, we compared the visual outcome, change in higher-order aberrations, corneal asphericity, and corneal biomechanics.

Results:
The visual outcomes, including higher-order aberrations, were comparable between the two groups. Changes in spherical aberration (mean: 0.234–0.331 versus 0.234–0.42; P = 0.644), corneal asphericity (−0.32–0.34 versus − 0.34–0.45; P = 0.42), corneal hysteresis (9.35–7.33 versus 9.4–6.71, P = 0.489), corneal resistance factor (9.71–7.40 versus 10.38–6.9, P = 0.181) were comparable between the elliptical and circular groups, respectively.

Conclusion:
We evaluated the usefulness of a customized elliptical flap configuration for performing LASIK surgery. Our data suggests that elliptical flaps may be associated with superior visual and biomechanical performance compared to circular flaps. This is certainly relevant in eyes with “borderline” pre-LASIK profile to improve patient satisfaction and safety after surgery.
Phylodynamic Pattern of Genetic Clusters, Paradigm Shift on Spatio-Temporal Distribution of Clades, and Impact of Spike Glycoprotein Mutations of SARS-CoV-2 Isolates from India
Authors: Sivasubramanian Srinivasan , Gopalan Vidya , Ramesh Kiruba , Padmanabhan Padmapriya , Mone Kiruthiga , Govindan Karthikeyan , Velladurai Selvakumar , Dhandapani Prabu , Krishnasamy Kaveri , Kitambi Satish Srinivas 
Published: November 2021

Introduction:
The COVID-19 pandemic is associated with high morbidity and mortality, with the emergence of numerous variants. The dynamics of SARS-CoV-2 with respect to clade distribution is uneven, unpredictable and fast changing.

Methods:
Retrieving the complete genomes of SARS-CoV-2 from India and subjecting them to analysis on phylogenetic clade diversity, Spike (S) protein mutations and their functional consequences such as immune escape features and impact on infectivity. Whole genome of SARS-CoV-2 isolates (n = 4,326) deposited from India during the period from January 2020 to December 2020 is retrieved from Global Initiative on Sharing All Influenza Data (GISAID) and various analyses performed using in silico tools.

Results:
Notable clade dynamicity is observed indicating the emergence of diverse SARS-CoV-2 variants across the country. GR clade is predominant over the other clades and the distribution pattern of clades is uneven. D614G is the commonest and predominant mutation found among the S-protein followed by L54F. Mutation score prediction analyses reveal that there are several mutations in S-protein including the RBD and NTD regions that can influence the virulence of virus. Besides, mutations having immune escape features as well as impacting the immunogenicity and virulence through changes in the glycosylation patterns are identified.

Conclusions:
The study has revealed emergence of variants with shifting of clade dynamics within a year in India. It is shown uneven distribution of clades across the nation requiring timely deposition of SARS-CoV-2 sequences. Functional evaluation of mutations in S-protein reveals their significance in virulence, immune escape features and disease severity besides impacting therapeutics and prophylaxis.
Knowledge, Attitude, and Practices Associated with Type 2 Diabetes Mellitus among Patients Attending a Tertiary Health Facility in North-East Nigeria
Authors: Maiyaki Tanko Fisak , Odjimogho Stella , Okandeji-Barry Oghenenioborue Rume , Agofure Otovwe , Enoch Musa 
Published: November 2021

Background:
Poor management of diabetes mellitus (DM) has resulted in increased morbidity and mortality among patients. Likely factors contributing to this trend include inadequate knowledge, attitude, and diabetes management practices among patients.

Aim:
This study was therefore designed to assess the knowledge, attitude, and practices associated with type 2 DM in patients attending Federal Medical Center, Jalingo Taraba State.

Materials and Methods:
The study was a cross-sectional study carried out among 286 type 2 diabetes patients selected purposively. A validated questionnaire was used to collect the data, and it comprised of four sections, namely sociodemographic characteristics, knowledge of DM, attitude toward DM, and DM management practices. The collected data were entered into IBM SPSS 23.0 and were analyzed using the descriptive and inferential statistics with the level of significance set at 0.05.

Results:
Most of the respondents 104 (35.62%) were aged 50–59 years and 163 (55.8%) were females. Besides, 89.0% of the respondents demonstrated good knowledge of DM, whereas 56.8% exhibited good attitude toward DM and 81.8% demonstrated good DM management practices. Knowledge of DM showed a significant association with attitude and practice of DM management (P < 0.05).

Conclusion:
Knowledge, attitude, and practice remain vital in the management of DM and prevention of complications. Therefore, more efforts must be channeled into improving and sustaining the knowledge, attitude, and practices of patients to improve their quality of life.
Postweaning Administration of Aqueous Leaf Extract of Gongronema latifolium May Improve Obesity Indices in Young Adult Offspring
Authors: Amadi Okekem , Adeniyi Deborah B. , Katchy Nkiru A. , Nwannadi Vivian , Ugwu Princewill Ikechukwu , Ugwu Sandra Ugonne , Iloabachie Chioma R. , Emelike Chinedum U. , Chukwu Odochi O. , Iyare Cordilia O. 
Published: November 2021

Introduction:
Metabolic diseases are multifactorial resulting from genetic, physiological, behavioral, and environmental influences. Genetic influence alone does not suffice to explain the rate at which these diseases have increased. Diet manipulations during critical developmental periods have been used to identify their contribution to obesity and diabetes development in offspring. Gongronema latifolium (GL) has been used for many generations for medicinal and nonmedicinal purposes. The leaves of GL are primarily used as spice and vegetable in traditional folk medicine.

Aim:
The aim of the study is to investigate the effect of postweaning consumption of aqueous leaf extract of GL on obesity indices in young adult offspring.

Materials and Methods:
Adult female Wistar rats were used and pregnancy was achieved by introducing matured male Wistar rats of proven fertility at the ratio of two females to one male during proestrus. At the day of delivery, adult female rats were randomly divided into two groups; Group I (normal control) and Groups II–IV (GL extract-treated group). The offspring of the different maternal groups also assumed their mothers' group. Group I was the normal control group while Groups II–IV were given 100, 200, and 400 mg/kg of GL extract, respectively. At postnatal day (PND), 21 offspring were weaned from their mothers and assumed the group of their mothers till PND 42. Parameters such as body weight, body mass index (BMI), waist circumference, body weight-waist circumference ratio, insulin level, liver enzymes (ALT, ALP, and AST), and oral glucose tolerance were assessed in the experimental animals.

Results:
There was a significant decrease in anthropometric indices (body weight, BMI, waist circumference, body weight-waist circumference ratio) and serum ALT, ALP, and AST levels in the young adult offspring of the GL extract group. However, there was a significant (P < 0.05) increase in insulin level in offspring whose mothers consumed GL extract when compared to the values of the normal control.

Conclusions:
This study showed that postweaning consumption of GL had significant effects on anthropometric indices, hepatoactivity, insulin sensitivity, and blood glucose level.
Effect of Administration of Flavonoid-Rich Extract from Hibiscus sabdariffa to Lactating Rats on Plasma Glucocorticoid, Leptin, and Postnatal Growth of Offspring
Authors: Ugwu Sandra Ugonne , Adeniyi Deborah B. , Katchy Nkiru A. , Nwannadi Vivian , Ugwu Princewill Ikechukwu , Amadi Okekem , Iloabachie Chioma R. , Emelike Chinedum U. , Chukwu Odochi O. , Iyare Cordilia O. 
Published: November 2021

Introduction:
Flavonoids are a group of natural substances with variable phenolic structures well-known for their beneficial effects on health. Flavonoids are now considered an indispensable component in a variety of nutraceutical, pharmaceutical, medicinal, and cosmetic applications because of their anti-oxidative, anti-inflammatory, anti-mutagenic, and anti-carcinogenic properties coupled with their capacity to modulate key cellular enzyme function.

Aim:
This study was aimed at investigating the effect of administration of flavonoids from Hibiscus sabdariffa (HS) to lactating rats on plasma glucocorticoids, leptin, and postnatal weights of the offspring.

Materials and Methods:
Forty pregnant female Sprague − Dawley rats weighing 150 g–200 g were used for this study. Flavonoids were extracted from HS following standard procedures. On the day of delivery, the rats were divided basically into four groups of 10 dams per group. Group A received tap water; Group B received low dose of flavonoid (5 mg/kg body weight daily); Group C received medium dose of flavonoid (10 mg/kg body weight daily); and Group D received high dose of flavonoid (20 mg/kg body weight daily). Flavonoid administration commenced on day 1 of lactation and ended at weaning. Dams from each group had their blood withdrawn from the orbital sinus on days 1, 7, and 21 for assay of plasma glucocorticoids and leptin. Food intake of the dams and body weight of the offspring was measured.

Results:
There was a progressive dose-dependent decrease (P < 0.05) in maternal plasma glucocorticoids and leptin with the most decrease seen in the high dose group and PND 21. Low dose flavonoid caused a progressive decrease in maternal food consumption when compared with the control group (P < 0.05). Low dose extract caused a progressive decrease in the body weight of the offspring, whereas the high dose caused a progressive increase in the body weight of the offspring (P < 0.05).

Conclusion:
Flavonoids from HS caused a progressive decrease in glucocorticoids and leptin with a resultant progressive increase in maternal food intake and body weights of the offspring.
Melatonin and Vitamin C Modulate Cassava Diet-Induced Alteration in Reproductive and Thyroid Functions
Authors: Maliki Oloruntobi Oluwasegun , Alagbonsi Abdullateef Isiaka , Ibitoye Comfort Moyinoluwa , Olayaki Luqman Aribidesi 
Published: November 2021

Background:
Cyanide, present in cassava, causes adverse effects on the thyroid and male reproductive functions and its poisoning generates free radical and oxidative stress. Melatonin and Vitamin C are antioxidants that improve conditions associated with oxidative stress.

Aims and objectives:
We evaluated the effects of melatonin and/ or Vitamin C on body weight, thyroid functions, and reproductive parameters in cyanide-enriched cassava-fortified diet (CD)-treated rats and their possible mechanisms of actions.

Materials and Methods:
Thirty male rats were divided into six groups (n = 5 each): Group I – Control, Group II – Melatonin, Group III – Vitamin C, Group IV – CD, Group V – CD + Melatonin, and Group VI – CD + Melatonin + Vitamin C. The control received normal saline, while melatonin and Vitamin C groups were dosed orally at 15 mg/kg melatonin and 100 mg/kg Vitamin C, respectively, CD group was fed with 40% cassava-fortified diet only, while other groups received the combination of the treatments.

Results:
In CD-treated rats, the sperm parameters were not affected but sperm count was insignificantly increased by melatonin, while melatonin + Vitamin C significantly increased all semen parameters. Neither CD only nor co-administration with melatonin and/or Vitamin C affected plasma luteinizing hormone and testosterone. The CD increased triiodothyronine (T3), but the increase was abolished by melatonin. Moreover, the CD increased thyroxine (T4), which was neither affected by melatonin alone nor its combination with Vitamin C. The levels of thyroid-stimulating hormone were not different across all treatment groups. The CD increased the thiocyanate, which was ameliorated by melatonin but abolished by combination of melatonin and Vitamin C. The CD also decreased the total antioxidant capacity level, which was abolished by melatonin. The CD increased weight gain, thyroid hormone, and oxidative stress but had no effect on semen parameters and reproductive hormones.

Conclusion:
Melatonin and Vitamin C attenuate the effects of CD on weight, thyroid hormones, and oxidative stress.
Outcomes of Starting Low-dose Pazopanib in Patients with Metastatic Renal Cell Carcinoma Who Do Not Meet Eligibility Criteria for Clinical Trials
Authors: Akatsuka Jun , Kimura Go , Obayashi Kotaro , Tsutsumi Kotaro , Yanagi Masato , Endo Yuki , Takeda Hayato , Hayashi Tatsuro , Toyama Yuka , Suzuki Yasutomo , Hamasaki Tsutomu , Yamamoto Yoichiro , Kondo Yukihiro 
Published: November 2021

Purpose:
Eligibility for clinical trials is very strict and only patients who satisfy various criteria can enter trials. The individual use of pazopanib has not been adequately investigated. An optimal administration regimen for pazopanib in “real-world” patients with metastatic renal cell carcinoma (mRCC) is required. Our purpose was to determine the tolerability and efficacy of first-line pazopanib with a low starting dose in patients with mRCC who were ineligible for clinical trials.

Materials and Methods:
This study included patients with mRCC who underwent treatment with first-line pazopanib and were previously excluded from clinical trials because they did not meet the inclusion criteria. A 400 mg pazopanib starting dose is used routinely in patients with mRCC; if tolerated, dose escalation up to 800 mg may occur.

Results:
We identified 18 patients with mRCC who received first-line pazopanib and were previously determined ineligible for clinical trials. Pazopanib dose was escalated in 12 patients (66.6%), to 600 mg/day in 8 patients (44.4%) and to 800 mg/day in 4 patients (22.2%), and was not escalated in 6 patients (33.3%). In 3 patients (16.7%), pazopanib was discontinued owing to intolerability. The most common frequent adverse event was elevated alanine aminotransferase levels in 6 patients (33.3%), followed by a decreased platelet count in 5 patients (27.8%) and anorexia in 5 patients (27.8%). Partial response was seen in 5 patients (27.8%) and stable disease in 10 patients (55.6%); median progression-free survival was 11.9 months (95% confidence interval: 6.3–28.7 months).

Conclusion:
Our data indicated that a low starting dose of 400 mg pazopanib did not negatively affect treatment tolerability and efficacy in patients with mRCC ineligible for clinical trials. We found that lower starting doses may lead to better results. Additional studies are needed in a larger cohort and longer follow-up to attain authentic outcomes.
Do Transperitoneal and Retroperitoneal Hand-Assisted Laparoscopic Nephroureterectomy have Different Effects on Intravesical Recurrence?
Authors: Hu Che-Yuan , Huang Chao-Yuan , Huang Kuo-How , Tai Huai-Ching , Lin Yung-Ming , Tai Ta-Yao 
Published: November 2021

Objectives:
Some studies have shown that in patients with upper tract urothelial carcinoma (UTUC) who have undergone hand-assisted laparoscopic nephroureterectomy (HALNU), the narrow working space and inevitable manipulation that occurs during the retroperitoneal approach (RP-HALNU) enhances tumor cell seeding in the bladder mucosa. This study was an attempt to investigate the differences in intravesical recurrence between transperitoneal HALNU (TP-HALNU) and RP-HALNU.

Patients and Methods:
From 1999 to 2011, a total of 197 patients with UTUC were enrolled. After excluding those with a previous history of bladder cancer, 170 patients were analyzed. Sixty-five of these underwent RP-HALNU, and 105 of these underwent TP-HALNU. The median follow-up periods were 39.2 and 46.2 months. Tumor location was divided into three groups: In the renal pelvis, in the ureter, and in both the renal pelvis and ureter.

Results:
There was no significant difference in the intravesical recurrence rate in relation to the different surgical approaches (P = 0.10), but tumor location in both the renal pelvis and ureter significantly increased the risk (hazard ratio [HR] = 3.11, P = 0.01). In addition, advanced T stage (HR = 9.63, P < 0.01) was the only significant risk factor related to death.

Conclusions:
In patients with UTUC, tumor location in both the renal pelvis and ureter determined higher susceptibility to intravesical recurrence. However, different surgical approaches to HALNU were not a significant risk factor for intravesical recurrence.
An Observational Study on the Efficacy of Mirabegron in Medical Expulsive Therapy of the Lower Ureteric Calculus
Authors: Chatterjee Souvik , Jalan Vishal , Pal Dilip Kumar 
Published: November 2021

Purpose:
Medical expulsive therapy (MET) is used in lower ureteric calculus to reduce symptoms, to facilitate passage, and to decrease the requirement of endourological surgical interventions. Alpha-blockers, spasmolytics, and calcium channel blockers have been shown to be effective in clinical trials. Beta-3 receptor stimulation in the ureter has been shown to decrease the intraluminal pressure. Thus, Mirabegron, beta 3 receptor agonist, can be thought as alternative MET agent.

Materials and Methods:
We have done prospective observational study to see the efficacy of mirabegron for MET of lower ureteric calculus ≤10 mm in size. Patients were divided into two groups: Group A (n = 50) received diclofenac 50 mg twice daily for 5 days then on demand for 4 weeks and Group B (n = 50) received diclofenac 50 mg twice daily for 5 days than on demand and mirabegron 50 mg daily for 4 weeks. Patients were followed up weekly with clinical examination, ultrasound screening of kidney, ureter, and bladder (KUB) and noncontrast computed tomography scan KUB after the 28th day of therapy.

Results:
We found that the passage of stone is significantly higher in mirabegron group (Group A: 68% and Group B: 92%; P < 0.05), and this effect is also statistically significant for stones <7 mm size (Group A: 73.91%, Group B: 96.96%, P = 0.01026). Duration of stone expulsion in Group A: 20.29 ± 5.512 days and Group B: 10.65 ± 4.294 days (P = 0.00001) and the relief of storage symptoms are earlier in mirabegron group (Group A: 16.28 ± 5.65 days and Group B: 6.2 ± 2.58 days, P = 0.00001).

Conclusion:
Our study reveals that Mirabegron is effective for the treatment of lower ureteric stones ≤10 mm size, especially for stone of size <7 mm and it improves the storage symptoms in these patients.
The Effectiveness and Durability of Ureteral Tumor Stent, the National Taiwan University Hospital Experience
Authors: Hung Shih Chun , Chiang I. Ni , Huang Chao Yuan , Pu Yeong Shiau 
Published: November 2021

Purpose:
We reviewed the clinical experience of using the ureteral tumor stent (Bard®, angiomed UROSOFT) in the National Taiwan University Hospital. We focused on the efficacy and durability of the ureteral tumor stent.

Materials and Methods:
We collected the patient data from April 2013 to 2014. A total of 94 patients with 157 ureteral units which received ureteral tumor stent in the National Taiwan University Hospital were enrolled. We analyzed the effectiveness according to the hydronephrosis grading. The durability was counted if it did not match any of the failure criteria including the following: 1. Hydronephrosis upgrade, 2. Serum creatinine elevated over 150% of baseline, 3. Ipsilateral percutaneous nephrostomy insertion or failure to remove it after antegrade insertion, and 4. Replacement due to clinically significant symptoms.

Results:
In general, 65% hydronephrosis downgrade, 25% remained stationary without severe hydronephrosis, while only 10% deteriorated or remain severe hydronephrosis. The median durability was 6.8 months. The bacteriuria and size of the ureteral tumor stent were the significant factors about the durability in single variant analysis.

Conclusion:
The ureteral tumor stent would improve the obstructive uropathy and persist functional for an average period over half a year.