bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight status influences the effect of hyperglycemia at admission on clinical outcomes after endovascular thrombectomy
Authors: Tang Tao , Zhao Xu-Sheng , Chen Zhong-Jun , Fan Tie-Ping , Thomas Aline M. , Zhao Man-Hong , Li Di , Li Shen 
Published: December 2024

BACKGROUND:
Insulin resistance is more prevalent in the overweight population, which can affect their glucose metabolism. This study explores whether weight status influences the relationship between admission hyperglycemia and outcomes after thrombectomy.

METHODS:
Four hundred and fifty-two patients with acute anterior circulation ischemic stroke undergoing thrombectomy were retrospectively analyzed. Hyperglycemia at admission was described as venous blood glucose ≥7.8 mmol/L and overweight as body mass index ≥24 kg/m2. The outcomes included the rates of functional independence (90-day modified Rankin Scale 0–2), symptomatic intracranial hemorrhage within 24 h after thrombectomy, and mortality at 90 days.

RESULTS:
Overall, hyperglycemia at admission decreased the likelihood of functional independence (adjusted odds ratio [OR] 0.50, 95% confidence interval [CI] 0.30–0.83, P = 0.008). Weight status modified the efficacy of admission hyperglycemia on functional independence (P = 0.022 for interaction). Hyperglycemia at admission was negatively associated with functional independence among overweight patients (adjusted OR 0.30, 95% CI 0.15–0.60, P = 0.001) but not among normal-weight patients (adjusted OR 1.13, 95% CI 0.48–2.70, P = 0.776). Weight status did not influence the efficacy of hyperglycemia at admission on mortality (P = 0.201 for interaction) or symptomatic intracerebral hemorrhage (P = 0.105 for interaction).

CONCLUSIONS:
Weight status influenced the effect of hyperglycemia at admission on functional independence after thrombectomy. Hyperglycemia at admission was related to functional independence among overweight patients but not among normal-weight patients. Our findings suggest tight control of glucose may be needed for overweight patients in the thrombectomy setting.
Prevalence of atrial fibrillation in ischemic stroke and associated risk factors: A hospital-based study in Indonesia
Authors: Nathan Theodore Amadeo , Wibowo Raisa , Sasongkojati Radhitya , Hartoko Budhi , Butarbutar Debora Theresia 
Published: December 2024

CONTEXT:
The prevalence of ischemic stroke increases each year. One such important factor is the presence of atrial fibrillation (AF), but data regarding this are scarce in Indonesia.

AIMS:
This study aimed to understand the prevalence of AF in ischemic stroke and its associated risk factors.

SETTINGS AND DESIGN:
A cross-sectional study was conducted from January 2021 to 2023 in Fatima Hospital, through medical records.

SUBJECTS AND METHODS:
Subjects were ischemic stroke patients aged ≥18 years. Additional data included demographic characteristics, congestive heart failure (CHF), hypertension, diabetes mellitus, stroke history, vascular disease, AF, dyslipidemia, Glasgow Coma Scale, and anticoagulant usage.

STATISTICAL ANALYSIS USED:
Data were analyzed using Chi-square, Fisher, Student’s t-test, Mann–Whitney, and logistic regression.

RESULTS:
Out of 148 subjects, AF was detected in 16 (10.8%). Among these, 14 (87.5%) had a CHA2DS2-VASc score of ≥2 and were given anticoagulant therapy. A higher proportion of subjects aged over 75 years was observed in the AF group (31.2% vs. 3.8%; P < 0.001). A similar pattern was seen with CHF and dyslipidemia (CHF: 56.3% vs. 8.3%; P < 0.000; dyslipidemia: 93.7% vs. 58.3%; P < 0.005). CHF and dyslipidemia increased the risk of AF by 27-fold (P = 0.001, odds ratio [OR]: 27.400) and 21-fold (P = 0.013, OR: 21.812), respectively.

CONCLUSIONS:
These findings underscore the importance of vigilant screening for AF in ischemic stroke, particularly in patients with CHF and dyslipidemia, to guide appropriate anticoagulation therapy and reduce the risk of recurrent stroke. This study was limited by its single-center design and small sample size. A larger, multicenter study is recommended.
Cerebral arterial collateral status, but not venous outflow profiles, modifies the effect of intravenous tissue plasminogen activator in acute ischemic stroke
Authors: Gencer Elif Sarionder , Yilmaz Ezgi , Arsava Ethem Murat , Gocmen Rahsan , Topcuoglu Mehmet Akif 
Published: December 2024

BACKGROUND:
The role of arterial collateral and venous outflow status on the response to intravenous tissue plasminogen activator (IV-tPA) has not been sufficiently clarified in acute major cerebral occlusions.

PATIENTS AND METHODS:
A total of 130 patients (mean age: 71 years; 73 females) with acute middle cerebral artery M1/M2 segment or terminal internal carotid artery occlusion treated solely with IV-tPA were analyzed. Regional leptomeningeal score (rLMC) was used for cerebral arterial collateral scoring, and the cortical vein opacification score (COVES) and modified Prognostic Evaluation based on Cortical vein score difference In Stroke (PRECISE) superficial and deep scores were used for venous outflow profile. Exploratory logistic models for response to IV-tPA [positive response: National Institutes of Health Stroke Scale (NIHSS) decrease 4 (or decrease to 0) at 24 h; dramatic response: NIHSS decrease ≥8 (or decrease to 0 or 1)], functional outcome (modified Rankin’s score 0–1 as “excellent” and 0–2 “good”) and tPA-associated hemorrhagic transformation were constructed.

RESULTS:
IV-tPA efficacy was positive in 47% and dramatic in 32%. Dramatic response was linked to better arterial collateral status (exp[B] =1.115 [95% confidence interval (CI), 1.016–1.223]). Excellent outcome was noted in 26% and good in 45%. One-point increase in rLMC score independently increased good prognosis (exp[B] =1.209 [1.034–1.412]). Patients with good prognosis had higher (by 0.5 points) modified PRECISE deep score (P = 0.047) and less frequent nonsufficient modified PRECISE deep score (0–2) (P = 0.017) in univariate analyses. However, these associations failed to survive in multiple regression. Any type tPA-associated cerebral hemorrhagic transformation was observed in 23% and parenchymal hemorrhage type 2 in 5.4%. While rLMC score showed a borderline strength correlation to hemorrhage (exp[B] =0.899 [95% CI, 0.808–1.001]), outflow scores not.

CONCLUSION:
While arterial collateral status modifies the effect of tPA in acute anterior circulation major artery occlusions, venous outflow capacity is not so critical.
Ethical Pitfalls in Scientific Publishing
Authors: Thulasingam Mahalakshmy , Karthikeyan Bindhya 
Published: December 2024

Abstract
Ethical integrity is crucial for scientific research and publishing. The four ethical principles of research are autonomy, beneficence, nonmaleficence, and justice. These ethical standards must be followed to ensure trust in the scientific inquiry process and to guarantee that the research benefits society or the scientific community. However, the rapid growth and competitive nature of scientific publishing have led to numerous ethical pitfalls. Evidence suggests that a considerable proportion of scientists engaged in questionable research practices while 1 in 50 acknowledged having either fabricated or falsified data at least once in their career. This article explores the common ethical pitfalls in scientific publishing, with respect to authorship issues, plagiarism, data fabrication, challenges in peer review, conflicts of interest, duplicate publication, and predatory journals. The article aims to provide insight into the best practices to maintain scientific integrity and offers recommendations for best practices in scientific publishing.
Quantitative and qualitative assessment of evaporative dry eye post intense pulsed light therapy, a prospective study
Authors: Patwardhan Sourabh D , Sangle Ankita , Patwardhan Nidhi S , Mane Seema 
Published: December 2024

Abstract

Purpose:
This study aimed to determine the effect of intense pulsed light (IPL) treatment on meibomian gland disease.

Settings and Design:
This is a prospective interventional study.

Methods:
Seventy eyes of patients with dry eye disease undergoing three sessions of IPL therapy, 15 days apart, were included. Each patient completed the dry eye questionnaire (SPEED) for symptomatic assessment. Dry eye evaluation tests were performed, including Schirmer’s 1 test, meiboscopy, noninvasive tear break-up time (NIBUT) and interferometry. These tests were repeated before each IPL session.

Statistical Analysis Used:
Data analysis was performed using IBM SPSS Statistics software (Version 20, Inc., Chicago, Illinois, USA). To Kolmogorov–Smirnov test was used to assess the normality of the variables. The Chi-square test was applied for statistical analysis. Level of significance was set at p ≤ 0.05.

Results:
The mean symptom score from the dry eye questionnaire (SPEED) showed a significant reduction of 24.5% (p < 0.001) in symptoms. Schirmer’s 1 test showed an improvement of 16.43% on day 15 and 40.13% on day 45. Meiboscopy grade improved by 13.54% on day 45. NIBUT improved from 53.29% on day 15 to 135.53% on day 45. Interferometry showed an improvement of 58.91% on day 45.

Conclusions:
The various investigative tests demonstrated both qualitative and quantitative improvements in dry eye disease, and patients reported symptomatic relief. The effects of IPL therapy, in terms of symptomatic relief, continued to improve with each session. The quality of the tear film also improved progressively. IPL therapy is a potential therapeutic option for MGD.
Outcomes of non-penetrating deep sclerectomy combined with mitomycin C in advanced open-angle glaucoma in Indian eyes
Authors: Maheshwari Devendra , Goyal Rinkal , Pillai Madhavi Ramanatha , Gupta Shivam , Chautani Drishti , Ramakrishnan Rengappa 
Published: December 2024

Purpose:
To assess the safety and efficacy of non-penetrating deep sclerectomy (NPDS) in advanced open-angle glaucoma patients.

Design:
Retrospective observational study.

Methods:
Forty-two eyes of 38 patients with advanced glaucoma who underwent NPDS surgery combined with mitomycin-C with or without phacoemulsification were evaluated for up to 12 months at a tertiary eye care center in South India. Patients with intraoperative perforation of the trabeculo-Descemet membrane who did not meet the follow-up criteria were excluded. The primary outcome measured was intraocular pressure (IOP) reduction postoperatively on day 1, week 2, and months 1, 3, 6, and 12. The secondary outcomes measured were the need for antiglaucoma medications (AGMs), postoperative complications, and interventions.

Results:
Patients enrolled had a mean age of 61.08 ± 10.2 years. There was a statistically significant reduction (P < 0.001) of IOP from 29.48 ± 10.89 mmHg (baseline) to 11.58 ± 6.29, 11.90 ± 5.99, 13.60 ± 7.06, 14.03 ± 8.00, 13.94 ± 4.65, and 13.19 ± 3.29 mmHg at day 1, week 2, and months 1, 3, 6, and 12, respectively. The number of AGMs reduced from 3.14 ± 1.03 preoperatively to 1.85 ± 0.83 at 12 months postoperatively (P < 0.001). Nd: YAG laser goniopuncture was done in 21.4%, bleb needling in 11.9%, and one patient underwent 260° trabeculotomy after NPDS. There were no cases of choroidal detachment or wipeout.

Conclusion:
NPDS with or without phacoemulsification has good safety for managing advanced open-angle glaucoma.
Real-world use of integrated intraoperative OCT in pediatric cataract
Authors: Kaur Savleen , Sukhija Jaspreet , Nischal Ken K 
Published: December 2024

Purpose:
To study the utility of integrated intraoperative OCT (i2OCT) in pediatric patients with cataracts in the real world.

Methods:
It was a retrospective case series. We included patients aged 0–12 years with unilateral or bilateral cataracts who underwent cataract surgery or membranectomy for visual axis opacification between July 2022 and December 2023, where intraoperative OCT was used. We matched the clinical data with i2OCT images and tried to identify any useful information i2OCT provided. Intraoperative notes were reviewed to analyze any changes in the surgical plan or steps after doing i2OCT.

Results:
The mean age of the children undergoing surgery was 5.9 ± 2.4 years (range: 6 months–9 years). OCT provided valuable insights into the anterior, posterior capsule, and vitreolental surface morphology. The surgical decision was modified in 10 cases after doing the intraoperative OCT (31.3%).

Conclusions:
The study adds to the database of pediatric patients imaged using i2OCT in the real world. i2OCT complements the preoperative examination and aids intraoperative decision-making in cases of white cataracts with excellent real-time delineation of the vitreolental interface in children.
miR-124, miR-126-3p, and miR-200b: Potential therapeutic targets for VEGF-mediated complications in proliferative diabetic retinopathy
Authors: Akaray Irfan , Ozal Sadık Altan , Sancar Hilal , Ozal Ece , Ayaz Lokman 
Published: December 2024

Abstract

Introduction:
This study aimed to investigate alterations in intravitreal microRNA and vascular endothelial growth factor (VEGF) levels in patients with proliferative diabetic retinopathy (PDR) as these factors are implicated in PDR pathogenesis.

Methods:
Fifty-two participants, including 26 patients with PDR and 26 controls without diabetes, were included in this study. VEGF levels were assessed using ELISA, and seven microRNAs (miRNAs) (miR-19a, miR-20b, miR-27a, miR-124, miR-126-3p, miR-146a, and miR-200b) were analyzed using quantitative real-time PCR.

Results:
PDR patients exhibited significantly higher miR-124 and miR-126-3p levels in the vitreous material compared to controls (P < 0.05). Conversely, miR-200b levels were significantly lower in the PDR group (P < 0.05). VEGF-A levels were markedly elevated in PDR patients compared with controls (P < 0.05). A nonsignificant positive correlation was found between miR-124 and miR-126-3p levels and VEGF levels (r = 0.361, P = 0.076 and r = 0.168, P = 0.422, respectively), whereas a nonsignificant negative correlation was observed between miR-200b and VEGF levels (r = −0.145, P = 0.488).

Conclusion:
Our study demonstrated a significant upregulation of miR-124 and miR-126-3p, along with a downregulation of miR-200b, in vitreous samples from patients with PDR, accompanied by elevated VEGF-A levels. These findings provide valuable insights into the pathogenesis of PDR. Further research is needed to evaluate the potential diagnostic and therapeutic implications of these molecular changes and to explore their viability as potential therapeutic targets.
Leber congenital amaurosis: A clinical and genetic study from a tertiary eye care center
Authors: Upadhyaya Abhishek , Padhy Srikanta Kr , Teja Nithin , Chattannavar Goura , Dutta Shreya , Pochaboina Venkatesh , Balasubramanian Jeyapoorani , Kannabiran Chitra , Takkar Brijesh , Bhate Manjushree , Jalali Subhadra , Parameswarappa Deepika C 
Published: December 2024

Abstract

Purpose:
To assess the clinical phenotypes and genetic mutations in patients with Leber congenital amaurosis (LCA) from a tertiary eye care center in India.

Design:
Retrospective observational study.

Methods:
The study includes patients with a clinical diagnosis of LCA who underwent genetic testing from January 2016 to December 2021. The clinical exome of the patients was analyzed by targeted next-generation sequencing. The genetic variants found were classified as per standard American College of Medical Genetics and Genomics (ACMG) criteria and ClinVar database.

Results:
There were 35 patients (19 females, 16 males) of LCA. Family history was positive in 29% (10/35) and a history of consanguinity was noted in 54% (19/35) of the patients. The mean presenting best-corrected visual acuity was 2.48 ± 0.59 logMAR. Retinal pigment epithelial abnormalities and macular involvement were seen in 83% (58/70) and 23% (16/70) of the eyes, respectively, at presentation. The most common causative genes for LCA in our cohort were: GUCY2D (20%, 7/35), CRB1 (14%, 5/35), RPE65 (11%, 4/35), RPGRIP1 (11%, 4/35), and LCA5 (9%, 3/35). Autosomal recessive inheritance was seen in 94% (33/35). Macular involvement at presentation was seen in CRB1 (3/5), NMNAT1 (2/2), and one each of RPE65, LCA5, and RDH12 patients. The genetic testing cost was reduced from 23,800 INR to 15,000 INR per test in the study duration.

Conclusions:
Genetic screening of LCA cases identified various genotypes, with GUCY2D being the most common. Increased awareness and reduced costs of genetic testing would benefit both patients and caregivers. With promising clinical trial outcomes, genotyping is crucial for better patient selection and treatment.
Role of azithromycin as an add-on therapy in children with acute asthma exacerbation: A randomized controlled trial
Authors: Tholia Chetna , Bhalla Kapil , Acharya Rohan , Pahwa Kumud , Yadav Dinkar 
Published: December 2024

Background
Asthma, a chronic inflammatory airway disease, commonly affects children worldwide. Acute asthma exacerbations significantly impact children’s health, growth, and quality of life, straining families. To improve symptom relief and quality of life, new treatment options are needed.

Objective
This study aimed to determine the effectiveness of azithromycin (AZI) as an add-on therapy to standard treatment in children aged 5–14 years experiencing acute asthma exacerbation.

Study Design
A prospective, open-label, randomized controlled trial was conducted.

Participants
Two hundred children presenting with acute asthma exacerbations were enrolled and divided into two groups (n = 100 each) using computer-generated randomization.

Intervention
The intervention group received oral AZI (10 mg/kg body weight once daily for 3 days) alongside standard therapy (inhaled β2-agonist, inhaled and/or systemic corticosteroids). The control group received standard therapy alone.

Outcomes
Both groups were assessed on day 4 for the proportion of patients experiencing relief from respiratory symptoms (cough, noisy breathing, chest discomfort, fast breathing, difficulty breathing) and any side effects. Quality of life was assessed using the MINIPQLQ score on day 14.

Results
The AZI group showed significantly better early symptom relief (cough, chest discomfort, noisy breathing, fast breathing, and difficulty breathing) on day 4 compared to the control group. Additionally, the AZI group demonstrated improved quality of life as measured by the MINIPQLQ score on day 14. No significant differences in lung function improvement (peak expiratory flow rate) or side effects were observed between the groups.

Conclusion
The study suggests that adding AZI to standard treatment for children with acute asthma exacerbation leads to earlier symptom relief and improved quality of life without significant side effects.
Comparison of risk factors and maternal outcomes in placenta previa: Assessing the impact of the revised classification in the Indian context
Authors: Gupta Tanvi , Udupa Vinita , Yenuberi Hilda Grace , Rathore Swati , Mani Thenmozhi 
Published: December 2024

Abstract

Background:
Placenta previa, characterized by the implantation of the placenta in the lower uterine segment close to or over the internal os, is a significant obstetric condition associated with maternal morbidity and mortality. This study aimed to compare the risk factors and outcomes of women with low-lying placenta (LLP) and true placenta previa (TPP) based on the revised classification in the Indian context.

Materials and Methods:
A retrospective study was conducted on patients diagnosed with traditional placenta previa at a tertiary care hospital in Vellore, India, between January 2006 and December 2016. The revised classification was applied, categorizing patients into LLP and TPP groups. Risk factors, including age, gravida, parity, previous cesarean sections, and previous placenta previa, were analyzed. Maternal outcomes such as mode of delivery, peripartum hemorrhage, and postpartum complications were assessed.

Results:
Among 888 women diagnosed with traditional placenta previa, 353 had LLP and 535 had TPP. Older age and previous cesarean delivery were significantly associated with TPP. Symptoms at presentation differed between the two groups, with LLP patients experiencing abdominal pain and leaking per vaginum, whereas TPP patients primarily presented with bleeding per vaginum. TPP was associated with a higher rate of cesarean deliveries, operative interventions, estimated blood loss, and the need for adjunct procedures, including peripartum hysterectomy. In addition, TPP was linked to longer hospital stays and a higher likelihood of intensive care unit admission.

Conclusion:
The revised classification of placenta previa offers improved risk assessment and enhances obstetric management. Women with TPP are at higher risk for adverse maternal outcomes compared to those with LLP. This study provides valuable insights into the Indian context, helping clinicians better understand the implications of the revised classification and tailor interventions for optimal maternal care.
Association of Obstructive Sleep Apnea in Periodontitis Patients with and Without Type 2 Diabetes Mellitus: An Observational Study
Authors: Aishwaraya V. L. , Subramanian Sangeetha , Prakash P. S. G. , Appukuttan Devapriya , Crena Jasmine , Ramkumar Raksha 
Published: December 2024

Abstract

Aim:
The aim of this study was to evaluate the prevalence of Obstructive Sleep Apnea (OSA) within the general population and investigate its association with periodontitis in patients with and without Type 2 Diabetes Mellitus (T2DM).

Materials and Methods:
A total of 120 patients were enrolled and divided into three groups: Group A (control), consisting of patients with gingivitis; Group B, consisting of patients with periodontitis; and Group C, consisting of patients with both periodontitis and T2DM. Each group contained 40 participants. A detailed oral history was collected from all participants, including information on diabetes, smoking, and alcohol consumption. The Berlin questionnaire was administered to assess the risk of OSA. Baseline periodontal parameters were recorded for each participant.

Results:
Among the study groups, 52.5% of patients in Group B (periodontitis) and 82.5% in Group C (periodontitis with T2DM) were identified as having a high risk for OSA. Among smokers, 33% in Group B and 59% in Group C were at high risk for OSA, whereas only 8% of smokers in Group A exhibited a high risk. Additionally, 60% of individuals who consumed alcohol were categorized as high risk for OSA. Multivariate regression analysis showed a significant association between periodontitis and OSA risk, with the highest risk observed in individuals with both periodontitis and T2DM (P < 0.05).

Conclusion:
This study indicates that patients with periodontitis are at a significantly higher risk for OSA, with the risk elevated even further in patients with both periodontitis and T2DM. These findings underscore the need for heightened awareness and potential screening for OSA in individuals with periodontitis, particularly those with additional risk factors such as T2DM, smoking, and alcohol consumption. Early detection and referral for sleep studies can help mitigate the potential systemic impacts of untreated OSA, such as cardiovascular disease, hypertension, and metabolic disturbances. Additionally, clinicians should consider integrating screenings for OSA into routine periodontal care, particularly for patients with known risk factors. Longitudinal studies are needed to evaluate whether the treatment of periodontitis can improve OSA outcomes and whether early intervention for OSA can positively affect periodontal health and overall systemic health.