bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Quality of Life Between Patients Undergoing Pharmacomechanical Catheter-Directed Thrombolysis Versus Conservative Management with Iliofemoro-Popliteal Deep-Vein Thrombosis
Authors: Yeramsetti SVR Krishna , Ghanwat Shrikant Pandurang , Sahu Tapish , Sheorain Virender , Grover Tarun , Parakh Rajiv 
Published: August 2021

Background:
Pharmacomechanical catheter-directed thrombolysis (PCDT) has revolutionized the treatment of acute deep-vein thrombosis (DVT). Assessment and comparison of quality of life (QOL) in patients treated with anticoagulation alone and PCDT need to be elaborated more in the context of better management of patients. The objective of this study was to compare and assess QOL using health-related QOL (HRQOL) which includes short form-36 (SF-36) and VIENES QOL/sym scoring systems in anticoagulation alone group and patients treated with PCDT.

Methods:
There were 130 consecutive patients presenting to our department with acute iliofemoro-popliteal DVT (IFPDVT) with <2 weeks duration treated between April 2018 and April 2019 were included in the study. Sixty-five patients received anticoagulation alone and the other 65 patients received PCDT along with anticoagulation. Patients were assessed at baseline, the 1st month, and the 6th month in terms of QOL, deep venous patency (DVP), and deep venous reflux (DVR).

Results:
There was a statistically significant difference between the two groups in terms of QOL at 1st and 6 months. Mean physical component score and mental component score were statistically significantly better in PCDT than the conservative group at 1 and 6 months, respectively (P = 0.001). Mean venous insufficiency epidemiological and economic study (VEINES) QOL and VEINES SYM scores were significantly better in PCDT group than conservative group at 1 and 6 months, respectively (P = 0.001).

Conclusion:
QOL, DVP, and DVR are significantly better when PCDT is offered as an initial option when compared to anticoagulation alone. HRQOL (SF 36 and VEINESQOL/SYM score) should be considered as an outcome measure in clinical studies on patients with IFPDVT along with other comparison parameters with respect to QOL. However, long-term follow-up is required to establish the superiority of PCDT in IFPDVT patients.
Outcomes with Aspirin and Clopidogrel Versus Aspirin and Rivaroxaban in Infrainguinal Endovascular Revascularization for Critical Limb Ischemia
Authors: Nishan B , Hudgi Vishal , Siva Krishna K , Ahsan V P , Rodney Roshan , Raj K B 
Published: August 2021

Background:
The purpose of the study was to assess the benefits of dual antithrombotic therapy in the management of peripheral arterial disease in Indian population.

Methods:
We conducted a prospective review of patients on dual antithrombotic therapy who underwent infra-inguinal endovascular revascularisation at JIVAS for 18 months.

Objectives:
To study the outcomes with aspirin + clopidogrel (CA) versus aspirin + rivaroxaban (RA) after infrainguinal endovascular revascularization for critical limb ischemia. The main objective was to assess primary patency of vessel after endovascular revascularization. The secondary objectives were to study limb salvage, major adverse limb events (MALEs), major adverse cardiac events (MACEs), bleeding events (major and minor), and wound healing.

Results:
In the present study, a total of 104 patients underwent infrainguinal revascularization and fulfilled the inclusion criteria, of which 48 received RA and 56 received CA. The mean age was 49.8 years with no significant differences in the baseline demographics and comorbidities between the two groups. The primary objective of vessel patency was assessed measuring the ankle brachial index which was 0.91 in the RA group and 0.96 in the CA group and remained the same on follow-up till 6 months and mean trans cutaneous oxygen pressure of around 34 in both the groups. There was no significant difference in the incidence of MALE (2.1% in RA vs. 7.1% in CA;P= 0.2), MACE (6.3% in RA vs. 10.7% in CA;P= 0.4), wound healing (81% RA vs. 75% CA;P= 0.4), safety parameter of bleeding (6.3% RA vs. 3.6% CA), creatinine, and liver function tests (LFT) during the study period.

Conclusion:
Both the antithrombotic regimens can be considered safe and efficacious in the postoperative management of patients undergoing infrainguinal revascularization; with maintenance of primary patency, comparable wound healing, incidence of MALE and MACE, and safe with no bleeding; and no impairment in the serum creatinine and LFTs during follow-up.
Factors Affecting the Long Term Patency of Arteriovenous Access for Hemodialysis
Authors: Gangadharan Ashwini Naveen , Prasad Rajendra Basavanthappa , Anandasu Ranjith Kumar , Vardhan J P , Ramswamy Chandrashekar Anagavalli , Desai Sanjay C , Maruthu Pandian Adharsh Kumar , Mitta Nivedita , Kumar Hemanth 
Published: August 2021

Objective:
The objective of the study was to analyze and evaluate the possible factors in the long-term patency of arteriovenous (AV) access for hemodialysis (HD).

Materials and Methods:
This was a cross-sectional study recruiting patients from January 2019 to December 2019. All patients who have a working HD vascular access, either AV fistula (AVF) or AV graft which has been working for at least 2 years were included and collected demographic data along with other parameters such as timing of creation, interventions, dialysis sessions, and antiplatelet therapy among others.

Results:
We included 81 patients with AV access patent more than 2 years; 22.5% were aged >65 years, 39.6% were diabetic, 68.5% were hypertensive, and 26.1% had vascular disease. Analysis revealed that the patient factors such as current tobacco usage and side of creation and technical factors such as maturation time, number of dialysis sessions, and single-center dialysis have a significant effect on the patency of the AV access, while the factors such as past tobacco usage, diabetes, hypertension, use of jugular catheter before access creation, and cannulation technique could not establish any statistical effect on the patency of AV access.

Conclusion:
There is a complex interaction of factors that may affect the patency of an individual AV access. These need to be carefully considered when selecting surgical site or technique, adjuvant treatments, and follow-up protocols for AVFs.
Hybrid and Percutaneous Salvage of a Thrombosed Native Arteriovenous Fistula
Authors: Agarwal Rahul , Atreyapurapu Viswanath , Sharma Pritee , Yerramsetty Vamsi Krishna , Burli Pradeep , Atturu Gnaneswar , Gupta Prem C 
Published: August 2021

Context:
Outcomes of salvage procedures for thrombosed native arteriovenous fistulas (AVFs) are studied.

Aims:
The aim of this study is to assess the short- to mid-term results of percutaneous and hybrid approaches used for salvage of thrombosed native AVF.

Settings and Design:
This study design was a single-center, descriptive, prospective study.

Materials and Methods:
All patients undergoing hybrid or percutaneous salvage procedure between July 2018 and September 2019 were included in the study. Patient demographics, clinical, and operative details and follow-up data at 1 year were collected from a prospectively maintained database and subjected to statistical analysis. Salvage procedure selection and techniques were studied.

Statistical Analysis:
Chi-square test and Fisher's exact test.P< 0.05 was considered statistically significant.

Results:
Out of 135 patients undergoing salvage procedure during the study period, 85 patients were included in the study based on inclusion and exclusion criteria. The age of the study population ranged from 18 to 75 years with a mean of 53.33. 75.3% (n = 64) were males. Seventy-seven (90.58%) patients were hypertensive, 45 (52.94%) were diabetic, and 22 (25.88%) had coronary artery disease. The mean time to procedure from the failure of AVF was 8.22 days. The most common type of AVF was brachiocephalic (45.88% [n = 39]), followed by radiocephalic (36.47% [n = 31]) and basilic vein transposition (BVT) (17.64% [n = 15]). Stenotic sites were juxta anastomotic in 42 (49.41%), cephalic arch or axillary swing segment (for BVT) in 28 (32.94%), and intervening segment in 54 (63.52%). Sixty patients underwent hybrid salvage and 25 underwent percutaneous salvage procedure. Technical success was 88.23% on table and 83.53% at 24 h. Primary, primary assisted, and secondary patency was 67.86%, 82.14%, and 89.29% at 6 months and 50%, 68.75%, and 83.33% at 12 months. Anastomotic thrombosis was associated with significantly high technical failure (35.7% vs. 12.67%,P= 0.049).

Conclusions:
A combination of open and endovascular procedures to salvage thrombosed native AVF's is feasible and is associated with good short- and mid-term patency. A thrombosed anastomosis in a failed AVF decreases the success rate of salvage procedures.
The effect of alendronate on lipid profile of postmenopausal women with osteopenia and prediabetes
Authors: Karimifard Maryam , Aminorroaya Ashraf , Amini Massoud , Kachuie Ali , Feizi Awat , Yamini Sima Aminorroaya , Alijanvand Moluk Hadi 
Published: August 2021

Background:
Prediabetes is a high-risk state for developing diabetes at an annual rate of 5%–10%. Early intervention can prevent further complications, including metabolic syndrome. Bisphosphonates are commonly used for osteoporotic postmenopausal women. The purpose of this study was to assess the effects of bisphosphonates on lipid profile including triglyceride (TG), total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) of prediabetic postmenopausal women with osteopenia.

Materials and Methods:
In this triple-blind randomized controlled trial, sixty prediabetic, postmenopausal women with sufficient Vitamin D and osteopenia, aged 45–60 years, were randomly enrolled in two groups of intervention (receiving 70-mg alendronate for 12 weeks [duration for maximum metabolic effect of bisphosphonates], n = 30) and control (receiving placebo, n = 30) according to a randomized block procedure of size 2 and 1:1 allocation ratio. The primary outcome of the study, the lipid profile, was evaluated before and after the interventions. The effect of the intervention was assessed using analysis of covariance.

Results:
The lipid profiles showed no significant differences to the mean values at the baseline in both the groups (all P > 0.05). At the end of the study, the differences between the groups were not significant for 25(OH) D3 (mean difference: −11.09, 95% confidence interval: −32.43–10.25), T (4.19, −30.58–38.97), cholesterol (8.13, −13.07–29.33), LDL-cholesterol (5.07, −10.18–20.31), and HDL-cholesterol (−0.86, −6.04–4.31) when the baseline values and confounders were adjusted (all P > 0.05).

Conclusion:
No statistically significant difference was detected in the serum lipid profile of prediabetic postmenopausal women with osteopenia as a result of alendronate intervention. More studies with larger sample sizes and longer intervention periods are recommended.
Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy
Authors: Alvandipour Mina , Tavallaei Mehdi , Rezaei Fatemeh , Khodabakhsh Hamed 
Published: August 2021

Background:
Pain is the most common postoperative complication of hemorrhoidectomy. We evaluated the effectiveness of intrasphincteric Botox injection on posthemorrhoidectomy complications including pain reduction and wound healing.

Materials and Methods:
In this randomized, double-blind clinical trial, patients with Grades 3 or 4 symptomatic hemorrhoids who underwent open (Milligan-Morgan) hemorrhoidectomy were enrolled. The experimental group received intrasphincteric Botox injection during hemorrhoidectomy, while the controls received normal saline injection. Hemorrhoid grades, constipation status, history of hemorrhoidectomy, duration of operation, pain at rest and after defecation in six follow-up periods (6, 12, 24, and 48 h and 7 and 14 days after operation), wound healing (during follow-up after discharge with a 2-week period), analgesic use, and Botox side effects were evaluated and compared in the two experimental and control groups.

Results:
In this trial, 34 and 33 patients were randomly allocated in the experimental and control groups, respectively. Operation time was significantly higher in Botox group (P = 0.009). Mean dose of analgesics use in Botox was significantly lower (P < 0.001). Rate of wound healing during follow-ups was significantly higher in Botox group in the fifth follow-up (P = 0.009). Frequency of urinary retention (P = 0.02) and moderate itching (P = 0.01) was significantly higher in placebo than Botox group. Mean of postoperative pain at rest in Botox group was significantly lower at 12th, 24th, and 48th h and 7th and 14th days after operation (P < 0.01). Mean of postoperative pain in Botox group was significantly lower at 3rd to 5th defecation (P < 0.01).

Conclusion:
Our findings indicated that a single-dose injection of Botox during Milligan-Morgan hemorrhoidectomy is associated with less postsurgical pain at rest and during defecation and improved wound healing. It is suggested that it is a safe and effective procedure during hemorrhoidectomy regarding the procedure-related complications.
Comparison of the effects of dexmedetomidine and propofol in reducing recovery agitation in pediatric patients after ketamine procedural sedation in emergency department
Authors: Azizkhani Reza , Kouhestani Soheila , Heydari Farhad , Esmailian Mehrdad , Feizi Awat , Khalilian Gourtani Bahar , Safavi Mohammadreza 
Published: August 2021

Background:
Ketamine has been a safe and effective sedative agent commonly used for painful pediatric procedures in the emergency department (ED). This study aimed to compare the effect of dexmedetomidine (Dex) and propofol when used as co-administration with ketamine on recovery agitation in children who underwent procedural sedation.

Materials and Methods:
In this prospective, randomized, and double-blind clinical trial, 93 children aged between 3 and 17 years with American Society of Anesthesiologists Class I and II undergoing short procedures in the ED were enrolled and assigned into three equal groups to receive either ketadex (Dex 0.7 μg/kg and ketamine 1 mg/kg), ketofol (propofol 0.5 mg/kg and ketamine 0.5 mg/kg), or ketamine alone (ketamine1 mg/kg) intravenously. Incidence and severity of recovery agitation were evaluated using the Richmond Agitation-Sedation Scale and compared between the groups.

Results:
There was no statistically significant difference between the three groups with respect to age, gender, and weight (P > 0.05). The incidence of recovery agitation was 3.2% in the ketadex group, 22.6% in the ketofol group, and 22.6% in the ketamine group (P = 0.002, children undergoing short procedures were recruited). There was a less unpleasant recovery reaction (hallucination, crying, and nightmares) in the ketadex group compared with the ketofol and ketamine groups (P < 0.05). There was no difference in the incidence of oxygen desaturation between the groups (P = 0.30).

Conclusion:
The co-administering of Dex to ketamine could significantly reduce the incidence and severity of recovery agitation in children sedated in the ED.
Genetic and biochemical studies of hepatic carcinoma in the Egyptian population
Authors: Elkhoudary Amany F , Elmougy Rehab , Elsaid Afaf , Wahba Yahya , Abdel-Aziz Abdel-Aziz F 
Published: August 2021

Background:
Hepatocellular carcinoma (HCC), a deadly malignancy of the liver, is considered the third leading reason behind cancer deaths. It is more frequent in men than in women of ages above 50. Liver disease, leading to liver cirrhosis (LC), is mostly caused by alcoholism abuse, reaction diseases of the liver, or viral hepatitis B or C infection. Interleukin-6 (IL-6) is considered an effective pro-inflammatory cytokine, which plays a crucial role in the host defense mechanism. Its level is higher in HCC patients than in LC cases, indicating that tumor cells increase the production of cytokines. The X-ray repair cross-complementing group 1 (XRCC1) gene is a major DNA repair gene. It acts as a scaffold of various activities that are concerned in the repairing method by interacting with components of base excision repair. This study aims to measure the serum concentrations of IL6 and C-reactive protein (CRP) and investigate whether XRCC1 Arg194Trp and Arg399Gln polymorphisms are related to HCC disease.

Materials and Methods:
Whole-blood DNA was extracted from 123 HCC patients and 123 healthy volunteers. Tetra-primer amplification refractory mutation system was performed in the detection of XRCC1 Arg399Gln and Arg194Trp polymorphisms.

Results:
Serum concentration levels of IL-6 and CRP are significantly higher in patients with HCC than in control subjects. The allelic and genotype frequency distributions of XRCC1 (Arg399Gln and Arg194Trp) are significantly increased in HCC cases compared to healthy volunteers.

Conclusion:
Arg/Gln, Arg/Trp, Gln/Gln, and Trp/Trp genotypes are associated with higher risk HCC than the Arg/Arg genotype.
Serum pancreatic enzymes and imaging in paediatric acute pancreatitis
Authors: AlEdreesi Mohammed H. , AlAwamy Mohammed B. 
Published: August 2021

Background:
In acute pancreatitis (AP), serum amylase, lipase and imaging help establish a diagnosis with recognised lipase superiority. Recent literature has debated serum amylase testing and proposed its elimination, but little is known about the diagnostic role of simultaneously measured serum amylase levels in patients with non-diagnostic lipase. This study examined the contribution of pancreatic enzymes and imaging and the role of simultaneously measured serum amylase in children with non-diagnostic serum lipase.

Methods:
Retrospective medical records review of children aged <18 years with a verified discharge diagnosis of first-attack AP between January 01, 1994, and December 31, 2016.

Results:
First-attack AP was confirmed in 127 children (median age, 12.5 years). The sensitivity was 90.4%, 54.3%, 42.2% and 36.4% for lipase, amylase, contrast-enhanced computed tomography and ultrasonography (US), respectively. Combination US and lipase identified 96.6% of AP cases. Simultaneous amylase and lipase measurements in 125 children showed that either was ≥3× the upper limit of normal (ULN) in 95.2%, while both were <3× the ULN in 4.8% of cases. Nondiagnostic lipase was seen in 12 (9.6%) children, and diagnosis was based on amylase level ≥3× the ULN in six children and imaging in the other six.

Conclusions:
Serum amylase, serum lipase and imaging should continue for the conclusive diagnosis of AP in children. Simultaneous serum amylase measurement helped diagnose AP with non-diagnostic lipase.
Case Report: First Report of Disseminated Trachipleistophora hominis Infection in an AIDS Patient from Thailand
Authors: Siripaitoon Pisud , Seatamanoch Nirin , Brownell Narisa , Kongdachalert Switt , Hortiwakul Thanaporn , Phumee Atchara , Siriyasatien Padet 
Published: August 2021

ABSTRACT.
Microsporidial myositis caused by Trachipleistophora hominis is a life-threatening and emerging microsporidiosis among immunocompromised hosts. This article reports a case of disseminated microsporidiosis caused by T. hominis in southern Thailand. The patient had HIV and presented at the clinic with incapacitating muscle pain. She was diagnosed with disseminated microsporidiosis. Molecular identification revealed the sequence of 18S ribosomal RNA gene involving sequences sharing 99% nucleotide identity with T. hominis from an Australian patient. To our knowledge, this is the first study to report the detection of T. hominis microsporidia in an HIV patient in Thailand.
Pharmacy students’ experience of a novel government-funded experiential learning initiative: A mixed-method study (ACTp Study)
Authors: Jacob Sabrina Anne , Jebara Tesnime , Watson Margaret , Cunningham Scott , Power Ailsa , Boyter Anne C 
Published: August 2021

Background: In 2018, the Scottish Government made the Pharmacy Additional Cost of Teaching (ACTp) funding available to support the development of Experiential Learning (EL) in undergraduate pharmacy education. To inform the further expansion of EL in the pharmacy degree evaluation of new EL sites was required.
Aim and method: A mixed-methods study was undertaken to determine students’ perceptions of four new areas included in an EL pilot: primary care, out-of-hours, specialist sites, and remote and rural.
Results: There were 43 survey respondents (response rate 72%). Majority agreed the pilot had developed their clinical (n=28, 74%) and communication skills (n=31, 82%), and prepared them for future practice (n=30, 79%). One third felt the EL did not permit them to interact with patients. Focus group and interview participants were positive about their experience and the opportunity to experience new pharmacy roles in non-traditional settings. Many highlighted the lack of hands-on experience and facilitator feedback. Facilitator training and quality assurance of sites are warranted.
Conclusions: Future work should focus on assessment of and feedback for students, and interprofessional opportunities within EL.
Condições higiênico-sanitárias de lanchonetes/restaurantes fast-food no Brasil
Authors: Nascimento Regina Santos , Alves Lima Marcus Vinícius 
Published: August 2021

As mudanças ocorridas nas últimas décadas no estilo de vida da população, estimuladas pelo mercado capitalista de grandes empresas do ramo alimentício e influenciadas pela aglomeração populacional em grandes centros urbanos, promoveram uma ascensão do consumo extradomiciliar de alimentos e consequentemente a expansão de estabelecimentos do segmento fast-food. No entanto, a capacidade técnica dos profissionais dos estabelecimentos supracitados no que concerne à higiene não acompanhou a expansão, pois houve um concomitante aumento no percentual de doenças transmitidas por alimentos (DTA) no país. Como as informações sobre as condições de higiene de empreendimentos do tipo fast-food são ainda incipientes e fragmentadas, este trabalho teve como objetivo realizar uma análise sobre as condições higiênico-sanitárias de lanchonetes ou restaurantes do tipo fast-food no Brasil a partir de uma revisão narrativa de literatura. Foram avaliados trabalhos publicados, desde 1980, prospectados em diversas bases de dados. De forma holística, a análise dos resultados dos estudos ratifica que as condições higiênicas dos serviços do fast food são insatisfatórias e aponta à necessidade da realização de treinamentos continuados em boas práticas de manipulação de alimentos.