bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early and midterm results of Cook Formula stent in children with right heart disease: A single-center experience
Authors: Girija Haritha , Muthukumaran Chinnasamy Sivaprakasam , Ganesan Rajaguru , Ramkishore Sankarakuttalan , Arun Vijay , Mahitha Vellusamy , Solomon Neville , Vaidyanathan Swaminathan 
Published: December 2024

ABSTRACT

Background:
Branch pulmonary artery (PA) stenosis must be addressed early to prevent right ventricular scarring and establish lung blood flow. Balloon-mounted stents are more useful in managing right ventricular outflow tract (RVOT) obstruction and PA stenosis.

Materials and Methods:
We studied the clinical and angiographic data of children with congenital heart disease who underwent stenting for RVOT obstruction and branch PA stenosis using the Formula stent (Cook Medical, Limerick, Ireland) between 2018 and 2024 in a tertiary pediatric cardiac center in southern India.

Results:
Our patient cohort included 65 patients with a median age of 3 years (range: 3 months to 17 years). The median weight of patients was 11.5 kg (4.8–60.4 kg), with 40% weighing <10 kg. Out of the 87 stents implanted, four stents were implanted in RVOT, while the rest were branch PA stenting. The median stent length was 20 mm (12–60 mm), and the median stent diameter was 10 mm (5–10 mm). All stents were deployed using 5Fr to 8Fr sheaths or guiding catheters. The median procedure time was 62 min (20–170 min), with a median fluoroscopy time of 15 min (4–110 min). A total of 17 (19%) stents in 14 patients required further dilatation at a mean interval of 25 ± 4 months from the time of stenting. Ballooning resulted in an increase in diameter from 7.8 ± 2.2 mm to 10.2 ± 1.7 mm. Right ventricular systolic pressure had reduced from 70.3 ± 8 to 40.1 ± 1 mmHg after balloon dilatation in patients with a biventricular heart.

Conclusion:
The Formula stent provides a comprehensive stent size option, requiring smaller sheaths, reduced procedural time, minimum complications, and an acceptable rate of reinterventions.
Combining High Protein Intake with Early Physical Exercise During Critical Illness to Maintain Muscle Mass in Intensive Care Unit Patients: A Prospective, Randomized Controlled Study
Authors: Opoda Asmaa Badr Eldin , Soliman Sohair Moustafa , Fayad Mona Blough El Mourad , Abdulrahim Taysser Mahmoud 
Published: December 2024

Abstract

Background:
Muscle wasting and weakness are frequent findings in critically ill patients and are associated with worse short- and long-term outcomes. We aimed to assess the efficacy of combined high protein intake with early physical exercise on the rectus femoris (RF) muscle cross-sectional area (CSA) assessed by ultrasound in a patient undergoing mechanical ventilation in the intensive care unit (ICU).

Patients and Methods:
This randomized controlled study was carried out on 70 mechanically ventilated patients of both genders aged 18–60 years old. Patients were randomly allocated into two groups; Group Ι received protein in a dose (1.2 g/kg/day) in addition to usual ICU physical exercise intervention, and Group ΙΙ received protein in a dose of 2 g/kg/day in addition to the physical exercise intervention.

Results:
The measurements of CSA at day 20 and day 30 were significantly improved in Group Π compared to Group Ι (P = 0.012 and 0.007, respectively). The measurements of muscle thickness of the RF muscle at day 20 and day 30 were significantly improved in Group Π compared to Group Ι (P < 0.001). The CSA and muscle thickness of the RF muscle showed no significant differences at baseline, day 5, and day 10. There was a significant decrease in the length of ICU stay and the incidence of infection in Group Π as compared to Group Ι (P = 0.030 and 0.029, respectively).

Conclusions:
Early protocolized physical therapy along with high protein nutritional supplementation in critically ill, mechanically ventilated patients attenuated the decrease in the CSA and thickness of the RF muscle when compared to standard medical care and standard protein supplementation.
A Comparison Between the Effects of Peribulbar and Sub-tenon Blocks Combined with General Anesthesia on the Incidence of Oculocardiac Reflex during Pediatric Strabismus Surgery: A Double-Blinded Randomized Control Study
Authors: Fathy Shymaa , Hanna Maha Gamil , Abdallah Nasr Mahmoud , El Waraky Sarah Maher , Bassyouni Essam El-Din Zaki , Shoukat Hany Mohammed El-Hadi 
Published: December 2024

Abstract

Background:
Pediatric strabismus surgeries have frequently been linked to the occurrence of oculocardiac reflex (OCR). This study aimed to assess the efficacy and safety of peribulbar and sub-tenon blocks on the occurrence of OCR during pediatric strabismus surgeries.

Materials and Methods:
A randomized, double-blinded trial was conducted with 120 children (ASA I/II) scheduled for strabismus surgery. Patients were randomized into three groups: control (intravenous paracetamol 15 mg/kg), sub-tenon (0.08 mL/kg of 0.5% bupivacaine), and peribulbar (0.25 mL/kg of a 1:1 mixture of 0.5% bupivacaine and 2% lidocaine). The study assessed the incidence rate of OCR as well as the time of occurrence of OCR after induction, hemodynamic variables, postoperative pain and analgesic requirements, the incidence of postoperative vomiting (POV), complications resulting from the orbital regional anesthesia, and total intraoperative atropine requirements.

Results:
The OCR incidence did not differ significantly between groups. Twenty-three patients (57%) in the sub-tenon group, 14 patients (35%) in the peribulbar group, and 14 patients (35%) in the control group experienced OCR (P = 0.063 and 0.201). All OCR cases were treated with atropine. Pain scores at 4 h post-surgery were significantly higher in the sub-tenon and peribulbar groups compared to the control group (P = 0.001 and 0.041, respectively). The sub-tenon group had one case of POV, whereas the control group had five cases (P = 0.025).

Conclusion:
Both sub-tenon and peribulbar blocks effectively reduced POV and analgesic requirements in pediatric strabismus surgery, but did not prevent the occurrence of OCR.
Factors Contributing to Prolonged Time to Extubation After Sevoflurane Anesthesia in Pediatric Patients who Underwent Strabismus Surgery: A Retrospective Study
Authors: Kim Kyung Mi , Lee Ki Hwa , Park Jae Hong , Kwon Ji Yeon , Park Yei Heum , Kim Jae Hwan 
Published: December 2024

Abstract

Background:
Rapid and smooth emergence is a crucial factor in the recovery of pediatric patients, especially after short ambulatory surgery. However, the factors contributing to the recovery time in pediatric patients after sevoflurane anesthesia have not yet been established. The present study evaluated the underlying factors affecting prolonged extubation time after sevoflurane anesthesia administration.

Materials and Methods:
Data were collected retrospectively from pediatric patients who underwent strabismus surgery between January 2011 and December 2020. Variables affecting time to extubation, including patient-related, anesthesia-related, and procedure-related factors, were investigated for univariate logistic and multivariate logistic regression analyses.

Results:
Overall, 459 patients were included in the final analysis. In the univariate analysis, the timing of fentanyl administration (P = 0.001), fentanyl dosage (P = 0.036), and operation/anesthesia duration ratio (P < 0.001) was found to prolong the extubation time significantly. Multiple logistic regression analysis that included intraoperative factors showed that late IV fentanyl administration (odds ratio [OR] = 3.051; 95% confidence interval [CI] = 1.830–5.086), use of a high (>1 µg/kg) fentanyl dose (OR = 2.61; 95% CI = 1.383–4.910), and a low operation/anesthesia duration ratio (OR = 0.92; 95% CI = 0.904–0.945) were associated with late recovery time.

Conclusion:
Late fentanyl administration, use of a high fentanyl dose, and a low operation/anesthesia duration ratio are potential risk factors for prolonged extubation time after sevoflurane anesthesia administration in pediatric patients.
Evaluation of Periodontal Wound Healing with Human Placental Extract as an Adjunct to Scaling and Root Planing – A Randomized Controlled Clinico-Histological Trial
Authors: Garapati Sahithi , Malgikar Suryakanth , Palaparthy Raja Babu , Sistny Vidya Sagar , Gooty Jagadish Reddy , Guntakandla Vikram Reddy 
Published: December 2024

Abstract

Aim:
The present study is aimed to assess the clinical and histological evaluation of human placental extract (Placentrex®) as an adjunct to scaling and root planing in Stage III Grade A periodontitis.

Methods:
Forty sites in twelve, stage III Grade A periodontitis patients, were randomly assigned into Group I (Test) and Group II (Control). Plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded, and curettage samples were collected in both groups for histological evaluation of collagen density (pixels) at baseline and one month.

Results:
Significant reduction in PI and GI was observed within the groups at baseline and one month. Probing pocket depth at the end of one month was 3.55 ± 0.83 in Group I and 2.50 ± 0.83 in Group II. The gain in clinical attachment level was 2.55 ± 0.83 in Group I and 1.65 ± 0.59 in Group II. PPD and CAL are better in Group I but could not reach statistical significance. Collagen density (pixels) at the end of one month histologically was 2884.9 ± 1386 in Group I and 447.9 ± 244.6 in Group II which were statistically significant (P < 0.05*).

Conclusions:
Local drug delivery of human placental extract played a significant role in managing Stage III Grade A periodontitis, especially as an adjunct to scaling and root planing.
Staining Efficacy of Zingiber Officinale and Curcuma Longa as a Natural Alternative to Eosin - A Comparative Study
Authors: Prajapati Mitul , Shah Monali , Ranginwala Amena , Bhojak Hiren , Nayak Saurabh , Agarwal Prakhar 
Published: December 2024

Abstract

Introduction:
Synthetic dyes are expensive, allergic, and health hazardous to the human health and deleterious to the environment. In this era, the use of ecofriendly and biodegradable material has gained interest worldwide. Eosin is the widely used synthetic dye in histopathology. Zingiber officinale (ginger) and Curcuma longa (turmeric) contain polyphenolic compounds and several colouring compounds, which impart colour.

Aims and Objectives:
To compare the staining efficacy of ginger and turmeric dyes by observing the nuclear staining, cytoplasmic staining, overall histologic appearance, intensity, and contrast.

Material and Methods:
The fresh rhizomes of Zingiber Officinale (Z. Officinale) and Curcuma longa (C. longa) were collected, and dye preparations were done by dissolving dried powder of both extracts into 70% alcohol, which was used to stain the sections of 10 cases of oral submucous fibrosis. Stained slides were evaluated by the independent observer using the various parameters like nuclear, cytoplasmic staining, overall histologic appearance, intensity, and contrast of staining. Statistical significance was done by using Chi-square test.

Result:
Z. officinale showed better staining efficacy compared to C. longa. Z. officinale The cytoplasm of the cell and connective tissue components is stained with pale eosin by Z. officinale and by C. longa, with a yellow to golden yellow color. There was no statistically significant difference seen in nuclear staining (P = 0.133), and a significant difference was seen in cytoplasmic staining (P = 0.0008), overall histologic appearance (0.00001), staining intensity (P = 0.0258), and contrast (P = 0.012).

Conclusion:
Z. officinale showed better staining than C. longa and can be used as a natural safe alternative to the eosin in haematoxylin and eosin staining method.
The Relationship between Chewing Betel Habit and Periodontal Disease in an Indonesian Village Community - An Evaluative Study
Authors: Nurdin Nurdin , Imran Herry , Nur Arnela , Keumala Cut R. , Nasri Nasri , Reca Reca 
Published: December 2024

Abstract

Background:
The habit of chewing betel has some very adverse effects due to the use of lime in the betel leaf, which causes an alkaline atmosphere in the mouth, leading to the buildup of calculus.

Aim:
The purpose of this study was to determine the relationship between betel nut habit and periodontal disease in the community of Gampong Kampung Blang, Blang Bintang District, Aceh Besar Regency.

Methods:
The type of research used in this study is an analytic Cross-Sectional design, which is a research design by making observations or measurements at a certain time. The sampling technique in this study was to use the Tro Yaname and Slovin opinion formula through Proportional Random Sampling, so that a sample of 89 people was obtained. This research was conducted starting 23 January 2023. Data analysis using statistical tests Chi-square statistical tests (α = 0.05).

Results:
The results showed that the respondents brushed their teeth well (51.7%), and periodontal disease in the community found tartar (33.7%). The results of statistical tests show a relationship between the habit of whisking to periodontal disease in the community which a P value was obtained (0.003 < 0.05).

Conclusion:
Based on the results of the study, it can be concluded that there is a relationship between the habit of whisking and periodontal disease in the community.
Evaluation of plasma progranulin level in patients with newly diagnosed chronic lymphocytic leukemia and its correlation with clinical stages, hematological parameters, and B2-microglobulin
Authors: Mohammed Zahra Q. , Al-bayaa Israa M. 
Published: December 2024

Abstract

BACKGROUND:
With a high degree of intratumoral and interpatient heterogeneity, chronic lymphocytic leukemia (CLL) is a malignant lymphoproliferative illness characterized by the accumulation of defective B lymphocytes in the blood and lymphoid tissues. A multifunctional glycoprotein released by the body, progranulin (PGRN) is linked to inflammation, repair, development, and carcinogenesis. As a prognostic indicator, PGRN was discovered to be elevated in a large number of solid tumors and a small number of hematological malignancies.

OBJECTIVES:
The objective of the study was to assess the plasma PGRN level in newly diagnosed CLL patients in comparison to healthy controls and to establish a correlation between it with plasma beta-2 microglobulin (β2M), hematological parameters, and disease stage.

PATIENTS, MATERIALS, AND METHODS:
From October 1, 2022, to March 1, 2023, 50 newly diagnosed CLL patients visited the Baghdad Teaching Hospital on the Medical City campus. This cross-sectional study was conducted. The diagnosis was made using immunophenotyping by flow cytometry and morphology, with a control group of 30 healthy people. PGRN and β2M plasma levels were assessed using an enzyme-linked immunosorbent assay.

RESULTS:
A (P = 0.001) indicated a statistically significant difference in plasma PGRN level between the patients’ median of 5.62 ng/mL and the control groups’ median of 2.37 ng/mL. The Binet staging system revealed that there was a significant difference with regard to absolute lymphocyte count, smudge cell percentage, and plasma β2M (P = 0.01, 0.001, 0.049), respectively, but there was no statistically significant difference between the stages with regard to age and plasma PGRN level (P = 0.35, 0.9). With a P = 0.046, PGRN demonstrated a strong positive correlation with β2M.

CONCLUSIONS:
Compared to healthy controls, patients with CLL showed higher levels of PGRN. The other poor prognostic sign, β2M, and the high PGRN levels at baseline correlate well; however, no difference was found when comparing the levels at later stages of the disease.
Beclin-1 as a potential prognostic marker in correlation with E-cadherin in oral lichen planus and oral squamous cell carcinoma: an immunohistochemical analysis
Authors: Shalash Heba N. , Hussein Radwa R. , Seragel-Deen Fatma 
Published: December 2024

Background/aim
Oral lichen planus (OLP) is a chronic, unexceptional, frequent disease of inflammatory origin, autoimmune background with unspecified etiology. Also it has been regarded as an oral potentially malignant disorder and reflects the potential hazard of malignant transformation into oral squamous cell carcinoma (OSCC). Beclin-1 happens to be one of the proteins regulating autophagy, where its dysfunction has been involved in various disorders. The function of Beclin-1, as per a marker for autophagy, still needs to be verified in oral premalignant lesions and their progression to OSCC. E-cadherin is an integral intercellular epithelial component responsible for intercellular adhesion, in which its down-expression denotes diminished cellular adhesion and propensity for invasion. Our work aimed to explore the levels of Beclin-1 and E-cadherin in erosive and nonerosive OLP and OSCC to assess the possible role of autophagy in the pathogenesis of OLP and estimate the malignant potential in each OLP type.

Materials and methods
This retrospective study was carried out in the pathology unit Ain Shams University Specialized Hospital. Sixty formalin-fixed paraffin-embedded tissue blocks, along with their clinicopathologic records, were retrieved from the archives of the Department of Oral Pathology, Faculty of Dentistry, Ain Shams University, Egypt. They were classified into three groups (20 each) as follows: group 1: the negative control group; group 2: comprised OLP cases, subdivided into two groups (10 each): group 2A, the erosive type and group 2B, the nonerosive type and group 3: comprised the OSCC cases, subdivided into two groups (10 each): group 3A, well-differentiated OSCC and group 3B, moderately differentiated OSCC. Immunohistochemistry was utilized to assess the expression levels of both Beclin-1, as a marker of autophagy and E-cadherin, as a marker of invasiveness and aggressiveness, to validate the malignant transformation potential.

Results
The present result obtained significant increases (P<0.05) in the levels of Beclin-1in a group of patients with OLP, the erosive type (G2A), and both groups of OSCC cases (G3A and B), while G3B was the highest level. Regarding E-cadherin, a significant decrease (P<0.05) was found in their levels in all groups of OLP and OSCC cases, compared to the control group; however group G3B exhibited the lowest reduction. Correlation between Beclin-1 and E-cadherin revealed an insignificant correlation between the two markers in all groups, except a significant negative correlation (r=−0.9, P<0.03) was found in a group of OLP patients with erosive type.

Conclusion
Beclin-1 could potentially be an important prognostic marker in OLP and OSCC. Low levels of E-cadherin expression in erosive OLP indicate greater potential for invasiveness, migration capability and a higher tendency to malignant transformation, which was found comparable to OSCC.
Assessment of obesity indices and disease severity in male patients with obstructive sleep apnea: a cross-sectional study
Authors: Gharib Ahmed , Elsheikh Mai S. , El-Hinnawy Yasmine H. , Hamdy Gehan 
Published: December 2024

Background/aim
Obstructive sleep apnea (OSA) is associated with multiple chronic conditions and increased risks of complications and mortality. The relationship between OSA and obesity is complex but increased body fat is widely recognized as a major risk factor for OSA. This work aims to determine the cut-off values of the body mass index (BMI), waist to hip ratio (WHR), neck circumference (NC) that can be used to predict the occurrence of OSA and its severity.

Patients and methods
This observational cross-sectional study included 241 Egyptian male patients, complaining from symptoms of OSA. The patients were subjected to measurements of obesity indices and underwent polysomnography to confirm the diagnosis of OSA according to the recommended guidelines for the manual scoring of respiratory events.

Results
The present study exhibited a significant association between BMI, WHR and NC with different polysomnographic parameters. BMI, NC, and WHR were the most significant predictors of OSA (P<0.05). Cutoff values reported 34.35 kg/m2 for BMI with 73.2% sensitivity and 69.4% specificity, while for NC reported 42.5 cm with 68.3% sensitivity and 75.5% specificity, and for WHR exhibited 1.0259 cm, with 59.9% sensitivity and 65.3% specificity. The severity of OSA in male sex was associated with older age, increased BMI, NC, WHR. The severity of OSA was also associated with decreased O2 saturation and higher Desaturation index, Arousal index, and snoring index.

Conclusion
Increased BMI, NC, and WHR were the most significant predictors of OSA and correlated with the severity of the disease in male patients.
DNA methylation of leptin before and after weight loss intervention program among sample of Egyptian obese females: Epigenetic approach in obesity
Authors: Hassan Nayera E. , El-Masry Sahar A. , Zarouk Waheba A. , Mehanna Nayra S. , Mosaad Rehab M. , Kobesiy Maha M , Kishta Mohamed S. , Selim Mohamed , Afify Mahmoud A.S. , Alian Khadija , Khalil Aya , Aboud Heba T. 
Published: December 2024

Background/aim
Obesity phenotype results from interactions between epigenotype and genotype. DNA methylation constitutes the most relevant epigenetic mechanism that regulates gene expression in human cells. Leptin (LEP) has a promoter region that presents CpG (CG dinucleotide repeats) islands which may undergo a methylation process. The DNA methylation process could be influenced by nutrition and alter adipocyte LEP gene expression. This study aimed to investigate whether the LEP gene promoter could be epigenetically modified by dietary weight reduction intervention and whether these changes affect its circulating level which may be involved in regulating the expression of the LEP gene in obesity.

Patient and methods
A total of 82 obese females were prescribed 3 months weight loss program. Fifty-eight women with a mean age of 41.62±10.70 years and a mean baseline BMI of 38.32+ 4.01 kg/m2 completed this longitudinal follow-up intervention study. Epigenetic mark, baseline and endpoint anthropometric, and laboratory parameters were assessed. Therefore, the methylation of the promoters of the LEP gene, using methylation-specific PCR, and measuring LEP levels before and after the dietary intervention program, and after bisulfite modification were investigated.

Results
After successful weight loss in obese females, Leptin receptor (LEPR) promoter methylation patterns had significantly higher values, and serum LEP levels had significantly lower values compared with before the dietary intervention program (P<0.05). Among the obese females with BMI equal to or more than 40 kg/m2the most increased variable was LEP promoter methylation (↑10.2%), while among the obese females with BMI less than 40 kg/m2, it increased by ↑1.7%. Among both groups of obesity, the most decreased variable was LEP (↓94.7% and ↓89.4, respectively).

Conclusion
These results support the assumption that in obesity, there is a link between LEPR methylation and LEP blood levels. The epigenetic profile of LEP gene could be affected by serum LEP via feedback regulation.