bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of higher serum follicle-stimulating hormone levels with successful microdissection testicular sperm extraction outcomes in nonobstructive azoospermic men with reduced testicular volumes
Authors: Song Ming-Zhe , Ye Li-Jun , Xiao Wei-Qiang , Huang Wen-Si , Wen Wu-Biao , Dai Shun , Lai Li-Yun , Peng Yue-Qin , Wu Tong-Hua , Sun Qing , Zeng Yong , Cai Jing 
Published: December 2024

Abstract
To investigate the impact of preoperative serum follicle-stimulating hormone (FSH) levels on the probability of testicular sperm retrieval, we conducted a study of nonobstructive azoospermic (NOA) men with different testicular volumes (TVs) who underwent microdissection testicular sperm extraction (micro-TESE). A total of 177 NOA patients undergoing micro-TESE for the first time from April 2019 to November 2022 in Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital, Shenzhen, China) were retrospectively reviewed. The subjects were divided into four groups based on average TV quartiles. Serum hormone levels in each TV group were compared between positive and negative sperm retrieval subgroups. Overall sperm retrieval rate was 57.6%. FSH levels (median [interquartile range]) were higher in the positive sperm retrieval subgroup compared with the negative outcome subgroup when average TV was <5 ml (first quartile [Q1: TV <3 ml]: 43.32 [17.92] IU l−1 vs 32.95 [18.56] IU l−1, P = 0.048; second quartile [Q2: 3 ml ≤ TV <5 ml]: 31.31 [15.37] IU l−1 vs 25.59 [18.40] IU l−1, P = 0.042). Elevated serum FSH levels were associated with successful micro-TESE sperm retrieval in NOA men whose average TVs were <5 ml (adjusted odds ratio [OR]: 1.06 per unit increase; 95% confidence interval [CI]: 1.01–1.11; P = 0.011). In men with TVs ≥5 ml, larger TVs were associated with lower odds of sperm retrieval (adjusted OR: 0.84 per 1 ml increase; 95% CI: 0.71–0.98; P = 0.029). In conclusion, elevated serum FSH levels were associated with positive sperm retrieval in micro-TESE in NOA men with TVs <5 ml. In men with TV ≥5 ml, increases in average TVs were associated with lower odds of sperm retrieval.
Retinal optical coherence tomography changes as biomarkers for Parkinsonism duration and severity in the Kashmiri population
Authors: Mohammad Irtiqa , Rashid Sabia , Sanie Bashir A. , Ashraf Shubana , Raina Adnan F. 
Published: December 2024

Abstract

BACKGROUND:
Parkinson’s disease (PD) is a progressive neurodegenerative disorder with motor and non-motor symptoms, including visual disturbances. The retina, being an extension of the central nervous system, may serve as a potential biomarker for PD and related disorders.

AIMS AND OBJECTIVES:
To evaluate retinal morphological changes using optical coherence tomography (OCT) in patients with PD and atypical parkinsonian syndromes and to correlate these changes with disease duration and severity.

METHODS:
This cross-sectional study included 50 parkinsonian patients (37 idiopathic PD, 5 multiple system atrophy [MSA], 4 corticobasal degeneration [CBD], 4 progressive supranuclear palsy [PSP]) and 50 age-matched healthy controls. Retinal parameters, including central macular thickness, macular volume, ganglion cell layer–inner plexiform layer (GCL–IPL) complex thickness, inner plexiform layer to outer nuclear layer (IPL–ONL) thickness, and retinal nerve fiber layer (RNFL) thickness, were assessed using OCT.

RESULTS:
The mean central macular thickness was significantly lower in cases (229.10 ± 36.61 μm) compared to controls (271.67 ± 19.03 μm) (P < 0.001). Macular volume was also lower in cases (8.91 ± 0.90 mm³) versus controls (9.21 ± 0.52 mm³) (P = 0.01). The GCL–IPL complex thickness (57.98 ± 20.22 μm vs. 86.93 ± 6.51 μm), IPL–ONL thickness (165.45 ± 13.74 μm vs. 174.06 ± 7.78 μm), and RNFL thickness (75.10 ± 23.12 μm vs. 94.51 ± 7.57 μm) were significantly lower in cases compared to controls (P < 0.001). Progressive supranuclear palsy patients had the lowest central macular thickness, macular volume, and GCL–IPL complex thickness, while corticobasal degeneration patients had the lowest IPL–ONL thickness, and multiple system atrophy patients had the most reduced RNFL thickness.

CONCLUSION:
This study demonstrates significant retinal morphological changes in parkinsonian patients, suggesting the potential use of the retina as a biomarker for PD and related disorders. Patients with PSP exhibited the most pronounced retinal changes, indicating diagnostic value. Further large-scale studies are warranted to establish the clinical utility of OCT in the management of these neurodegenerative conditions.
Olfactory dysfunction as a diagnostic and prognostic marker for movement disorders
Authors: Peyvandi Aliasghar , Khoshsirat Shahrokh , Bazgir Narges , Zaker Amirreza , Tahvildari Azin , Niknazar Somayeh , Mohammadi Sara , Salari Mehri 
Published: December 2024

Abstract
Olfactory dysfunction (OD) is a common nonmotor symptom observed in several movement disorders. The severity and pattern of olfactory impairment vary among these conditions. Notably, olfactory impairment often precedes the clinical diagnosis of movement disorders by several years, yet it remains frequently unrecognized by patients and physicians until formal olfactory tests are undertaken.
This review focuses on exploring OD across various movement disorders. A systemic search strategy incorporating key terms such as movement disorders, dystonic disorders, tic disorders, parkinsonian disorders, parkinsonism, ataxia, essential tremors, drug-induced akathisia, and olfaction disorders was employed to query databases including Embase, Scopus, and PubMed. After excluding irrelevant articles, 99 studies were selected for comprehensive review.
OD is a persistent feature across all movement disorders, with the exception of pseudo supranuclear palsy. Among these conditions, olfactory impairment is much more frequent and severe in patients with Parkinson’s disease.
Incorporating olfactory testing into the diagnostic evaluation of at-risk individuals or patients with established movement disorders is recommended. These olfactory tests offer a practical, cost-effective, and convenient diagnostic tool that may aid in the early identification and management of these conditions.
Binucleated Neuron as a Potential Histologic Marker of Neuroregeneration in Rat Sciatic Nerve Injury Model
Authors: Pryambodho Pryambodho , Dilogo Ismail Hadisoebroto , Tantri Aida Rosita , Aman Renindra Ananda , Senapathi Tjokorda Gde Agung , Ramli Yetty , Siregar Nuryati Chairani , Widyahening Indah Suci , Dewi Fitriya Nur Annisa 
Published: December 2024

Abstract

Background:
The rat sciatic nerve injury model is one of the most studied models for peripheral nerve injury. Mesenchymal stem cells (MSCs) are known to induce neuroregeneration in this rat model. The most common methods to quantify neuroregeneration in peripheral nerves include histomorphometric analysis of axonal count, length, and mean axonal area. However, histomorphometric analysis remains vague for dorsal root ganglion (DRG). It is known that binucleated neurons (BNs) are present in normal rat populations, increase following the transplantation of bone marrow-derived cells into the cerebellum, and disappear with inflammation. We propose a new potential histologic marker as a probable alternative to conventional axonal histomorphometric analysis for DRG in the Sprague Dawley rat sciatic nerve injury model.

Materials and Methods:
A total of 32 Sprague Dawley rats were involved in this study, 30 rats were subjected to sciatic chronic constriction injury (CCI) to develop a neuropathic pain model. The rats were randomized into two groups, which received intrathecal normal saline injection (NSI) or stem cell injection (SCI). Human MSCs were intrathecally delivered using ultrasound-guided injection, 7 days after ligation (D7). Samples of DRG were obtained from normal rats (n = 2), from both groups on day 0 (D0), day 14 (D14), and day 28 (D28) post-CCI, analyzing DRG structures of BN.

Results:
CCI causes neuropathic pain, confirmed using Von Frey at D7, D14, and D28. Histologically, neuroregeneration was observed starting from D14 and D28. Histomorphological analysis revealed BN present exclusively in the SCI group compared with the NSI group.

Conclusion:
BN may serve as a potential marker for early neuroregeneration in rat sciatic nerve injury models.
Analgesic Efficacy of Combined Adductor Canal and Popliteal Plexus Blocks Versus Adductor Canal Block Alone in Arthroscopic Knee Surgery: A Prospective, Double-Blinded, Randomized Trial
Authors: Behery Ghada Magdy , Fattoh Nadia Hassan , Abduallah Mohammad Ali Mohammad , Shaban Shimaa Elsaied Ibrahim 
Published: December 2024

Abstract

Background:
The currently accepted standard for improving knee stability and function is anterior cruciate ligament reconstruction (ACLR). This study aimed to assess the postoperative analgesic efficacy of combining adductor canal (AC) and popliteal plexus blocks (PPB) to that obtained by using AC block (ACB) alone in arthroscopic ACLR.

Materials and Methods:
For elective arthroscopic ACLR, 110 male and female patients with American Society of Anesthesiologists physical status I or II, aged from 21 to 50 years, were randomly assigned to a double-blind, prospective trial. Patients were divided into two equal groups and given either ACB (15 mL of 0.25% bupivacaine) and PPB (15 mL of 0.25% bupivacaine) or ACB alone. Outcome parameters were 24-h morphine consumption, time-to-first rescue analgesia, and postoperative pain.

Results:
Group I used less morphine (6.45 ± 1.8 vs 11.22 ± 1.7 mg, P < 0.001) and required less time-to-first rescue analgesia (14.49 ± 2.27 vs. 13.64 ± 1.77 min, P = 0.030). At 12, 18, and 24 h, Group I had significantly lower postoperative pain scores (P = 0.007, 0.010, and 0.012, respectively) than Group II. Additionally, Group I also exhibited significantly less required time to be able to stand, walk, and exercise compared to Group II (P = 0.002, 0.013, and 0.035, respectively).

Conclusion:
ACB combined with PPB resulted in reduced morphine consumption, required less time-to-first rescue analgesia, exhibited lower postoperative pain scores, and required less time to rehabilitate compared to ACB alone.
Atraumatic Massive Left-sided Bochdalek Hernia in Adulthood: A Case Report
Authors: Ismail Muhamad Aizuddin Bin , Zainy Rhendra Hardy Mohamed , Adnan Syafiqah Binti 
Published: December 2024

Abstract
Bochdalek hernia, a rare congenital anomaly of the diaphragm, typically manifests in the pediatric population but can also occur in adults. In the adult population, it presents unique challenges in airway management due to the potential displacement of abdominal organs into the thoracic cavity, resulting in compromised respiratory function. We report the case of a 61-year-old male with a massive left-sided Bochdalek hernia, presenting with upper abdominal pain. Imaging revealed an 8.7-cm defect in the left diaphragm, resulting in herniation of the abdominal viscera into the thoracic cavity, causing a mediastinal and tracheal shift. Emergency surgical repair was conducted, requiring careful airway management, including the use of a bronchial blocker (BB) for lung isolation to safely reduce the herniated organs into the abdominal sac and repair the diaphragmatic defect. Though rare, the incidence of Bochdalek hernia in adults necessitates specific considerations for airway management due to its anatomical complexities and potential for respiratory function compromise. Successful management highlights the need for thorough preoperative planning and inter-team communication in such complex scenarios. This case demonstrates the challenges and critical considerations in managing adult Bochdalek hernia, emphasizing the importance of tailored airway management strategies and coordinated care to optimize patient outcomes in such rare disease cases.
A Comparative Double-blind Study to Evaluate the Efficacy of Coconut Water and Honey as Cytological Fixatives for Oral Smears
Authors: Bordoloi Bharadwaj , Tandon Aanchal , Goswami Arunima , Roy Debojyoti , Srivastava Abhinav , Sharma Apoorva 
Published: December 2024

Introduction:
Ninety-five percent ethanol is the routinely used and standard cytological fixative. However, commercially available ethanol is expensive and not freely available in some institutions. There is always a search for an ideal alternative.

Aim and Objective:
In the present study, we evaluated 100% coconut water (CW) and 30% aqueous honey solution as cytological fixative at different time points and compared them with routinely used spray fixative of ethanol.

Materials and Methods:
Oral smears were prepared from 30 healthy volunteers, and a total of 270 smears were prepared. From each volunteer, 9 smears were prepared. One smear was fixed in ethanol, four smears were fixed in 100% CW and four in 30% aqueous honey solution. Of the four smears fixed in CW or honey, one smear was fixed for 15 min, one for 30 min, one for 45 min, and one for 1 h, respectively. The slides were dried and then the smears were stained with Papanicolaou staining. Slides were evaluated by two independent observers who were blinded to the procedures. The following parameters were evaluated – nuclear staining, cytoplasmic staining, cell morphology, clarity of staining, and uniformity of staining. Statistical analysis was done using post hoc pairwise comparison, and P < 0.05 was considered to be statistically significant.

Results:
The results of the study showed that fixation with 30% aqueous solution of honey or 100% CW for more than 15 min yields useful and evaluable results.

Conclusion:
These readily available materials can be used as alternatives of alcohol in oral cytology.
Surgeon’s perceptions and preferences in the management of idiopathic macular hole
Authors: Kumawat Devesh , Dave Vivek Pravin , Venkatesh Pradeep , Shanmugam Mahesh P , Nagpal Manish , Gupta Vishali , Bhende Pramod S , Babu Naresh , Narayanan Raja , Shroff Daraius ,   The Macular Hole Survey Study Group
Published: December 2024

Purpose:
The management of idiopathic macular holes (iMH) has evolved over time with various modifications in surgical approach. The study aimed to survey the surgeons’ preferences in the management of iMH in current times.

Design:
Cross-sectional descriptive survey.

Methods:
A 12-item questionnaire addressing the key aspects of iMH management was sent, between October 2022 to November 2022, by personal correspondence to 104 vitreoretinal specialists, actively practicing and performing iMH surgeries at various institutes in India. The responses were gathered till January 2023 and analyzed as per appropriate statistical methods.

Results:
Ninety-one retina specialists responded to the survey (response rate of 87.5%) with a median annual surgical load of 30 cases (range: 5–150). Most respondents had similar views on patient selection, combined phaco-vitrectomy, internal limiting membrane (ILM) staining, ILM peel initiation and propagation, tamponade, postoperative positioning, and prognostic factors. The preferred approach for peel initiation was “pinch and peel,” but “scrape and peel” was equally recommended for beginners. Most respondents considered iMH >600 microns in size as large and used additional surgical maneuvers for large and failed cases such as ILM flap, large flap, macular detachment, platelet-rich plasma application, and amniotic membrane graft. The three most important visual prognostic factors were duration, preoperative vision, and MH size.

Conclusions:
The practice of surveyed surgeons performing iMH surgery was uniform in several aspects. There is a need to create consensus on the preferred ILM peel technique among trainee surgeons, revisit the iMH size classification, and standardize the surgical approach as per hole size and characteristics.
Profile and outcomes of retinal artery occlusion: The underrealized need to expedite presentation
Authors: Kadam Yogita , Das Anthony V , Narayanan Raja , Balakrishnan Neelima , Telukunta Praneet , Takkar Brijesh 
Published: December 2024

Purpose:
To evaluate the clinical profile of retinal artery occlusion (RAO) and impact of presentation on visual outcomes.

Design:
A retrospective analysis of case files of 3070 patients with RAO was performed using electronic medical records.

Methods:
Demographic data were analyzed using descriptive statistics. The differential distribution of risk factors of RAO with age was studied. Time to presentation and treatment effects were assessed using multivariate regression. Interaction plots were drawn to assess the impact of risk factors on outcomes.

Results:
Central RAO was the most common type (n = 2443, 77.11%), followed by branch RAO (n = 500, 15.78%), while combined retinal vascular occlusion and cilio-RAO were rare. Most of the patients (71.40%) were male and had unilateral (96.81%) affliction. Almost half presented within the fifth (24.85%) and sixth (21.4%) decades of life. Hyperhomocysteinemia had a higher association (1.95, P = 0.0019) with younger patients (<40 years), while hypertension (3.64, P < 0.001), diabetes mellitus (DM; 4.18, P < 0.001), and coronary artery disease (CAD) (4.26, P = 0.002) were significantly commoner in older patients. CAD (5.1%) and cerebrovascular disease (0.6%) were detected after ocular presentation in some patients. Embolus, though detected rarely (1%), was associated (60%) with serious systemic disorders. Early presentation (<6 h) was associated with better visual outcomes (mean log of minimum angle of resolution 1.8 ± 1.3 vs. 2.1 ± 1.3, P = 0.032). Neovascular glaucoma (2.14% overall) was twice more common in DM (P < 0.0004) and led to further vision loss. Visual improvement occurred in 10% of patients over follow-up.

Conclusion:
RAO occurs slightly earlier compared to coronary and cerebrovascular disorders and can precede their detection. Associated risk factors vary with the age of presentation. Presentation within 6 h needs facilitation for better outcomes and management.
The association of cytokine levels and postnatal factors with retinopathy of prematurity
Authors: Yazib Syatirah Abu , Choo May May , Khaliddin Nurliza , Ong Christine PY , Choo Yao Mun , Kamar Azanna Ahmad , Lingam Gopal G , Kamalden Tengku A 
Published: December 2024

Purpose:
Prematurity has been known to trigger several cellular pathways, leading to the clinical occurrence of retinopathy of prematurity (ROP). This study compared the levels of a panel of serum cytokines in premature infants with and without ROP.

Methods:
This is a prospective observational study. Premature infants at 36–38 weeks’ gestational age were recruited, their clinical data recorded, and serum samples collected and assayed for 18 cytokines. Based on follow-up examinations, patients were divided into two groups: No ROP and ROP. The ROP group was further divided into two subgroups: non-vision-threatening ROP (non-VTROP), and vision-threatening ROP (VTROP).

Results:
On univariate analysis, among the clinical parameters, gestation age, birth weight, duration of invasive ventilation, and duration of stay in neonatal intensive care unit (NICU) were found to be significant. The univariate analysis also showed an association between raised levels of VEGF-D and IL-8 in the VTROP group. Multiple logistic regression indicated that gestation age was a significant risk factor across all subgroups. Additionally, VEGF-D levels were found to be significantly associated with VTROP.

Conclusion:
Higher VEGF-D levels are associated with an increased risk of severe ROP that requires treatment and could potentially be used as a biomarker.
12-month outcomes of ziv-aflibercept for neovascular age-related macular degeneration in eyes previously treated with aflibercept
Authors: Kheir Wajiha J , Hassoun Mahdi , Hamam Rola N , Bashshur Ziad Fayez 
Published: December 2024

Purpose:
To investigate the 12-month outcomes of ziv-aflibercept for neovascular age-related macular degeneration (nAMD) in eyes previously treated with aflibercept.

Methods:
Retrospective chart review of patients with nAMD previously treated with aflibercept for at least 12 months and subsequently transitioned to ziv-aflibercept between January 1, 2019, and December 31, 2022, for a period of at least 12 months. Participants were identified, and their clinical and imaging information was extracted from our electronic health records system. Data on best corrected visual acuity (BCVA), intraocular pressure, injection intervals, central retinal thickness (CRT), volume cube presence of subretinal fluid (SRF), and intraretinal fluid (IRF) were obtained. Main outcome measures included changes in BCVA, injection intervals, CRT, SRF, and IRF before and after 12 months of ziv-aflibercept treatment.

Results:
Fifty-four eyes of 44 patients were included in the study. After 12 months of ziv-aflibercept treatment, BCVA decreased by 0.84 ETDRS letters (P = 0.424) compared to BCVA at the last visit prior to conversion from aflibercept. Injection intervals decreased by 1.18 weeks (P = 0.489). CRT significantly decreased by 15.66 µm (P = 0.005). SRF was present initially in 31.5% of eyes and decreased to 22.2% (P = 0.125). IRF was present initially in 42.6% of eyes and decreased to 35.2% (P = 0.219).

Conclusion:
Ziv-aflibercept demonstrated effectiveness in maintaining treatment outcomes in nAMD eyes previously treated with aflibercept. The treatment was well-tolerated with no reported adverse events. Ziv-aflibercept may be a cost-effective alternative and a potential solution to the financial burden associated with conventional anti-VEGF agents.
Scleral buckling in retinal detachment due to retinal dialysis – A vitreoretina fellow’s perspective
Authors: Balaji Akshaya , Verma Saurabh , Shaikh Nawazish , Azad Shorya V , Kumar Parmanand , Chawla Rohan , Kumar Vinod 
Published: December 2024

Purpose:
To analyze the efficacy of scleral buckling in the hands of vitreo-retina (VR) fellows under training in eyes with retinal detachment associated with retinal dialysis and analyze the patient and retinal characteristics in these eyes.

Methods:
We carried out a retrospective consecutive case review at a tertiary eye care center in North India. Records of all the patients who had undergone scleral buckling (SB) for retinal dialysis-associated rhegmatogenous retinal detachment by VR fellows (with less than 2 years’ experience) between January 2017 and January 2020 were reviewed.

Results:
Fifty-three eyes of 53 patients with a mean age of 20.77 years were analyzed. Of the patients, 73.58% were males. History of eye trauma was present in 71.69% patients. A total of 21 residents operated these 53 eyes. SB was able to achieve retinal attachment in a single surgery in 84.9% (45/53) eyes. Mean preoperative best corrected visual acuity was 1.9 ± 1.05 log of minimum angle of resolution (logMAR), which improved postoperatively to 1.07 ± 0.72 logMAR (P < 0.001). Surgical success rate was 85.71% (24/28) in eyes with no proliferative vitreoretinopathy (PVR), 66.66% (2/3) in eyes with PVR-A, 91.66% (11/12) in eyes with PVR-B, and 80% (8/10) in eyes with PVR-C1. Fifty-two eyes had a single dialysis and one eye had two separate dialysis. Six eyes had giant retinal dialysis (dialysis greater than 3 clock hours) and all were due to trauma. Five patients had retinal dialysis in the fellow eye and were diagnosed with bilateral idiopathic retinal dialysis.

Conclusion:
Scleral buckling is a safe and effective management for retinal dialysis retinal detachment even in the hands of VR fellows under training.