bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autologous Serum Therapy in Recalcitrant Chronic Spontaneous Urticaria: Experience from Three Dermatology Clinics in Malaysia
Authors: Ting Pao Lin Ingrid , Ghazali Nurul Izyan , Teo Yan , Lai Siaw Ling , Bakhtiar Mohammed Faizal , Tang Min Moon 
Published: October 2024

Abstract
Autohemotherapy is a commonly used treatment for recalcitrant chronic urticaria in some countries. Herein we report our experience using autologous serum therapy in eight patients with recalcitrant chronic spontaneous urticaria. Autologous serum therapy was initiated weekly for nine weeks followed by every fortnightly. Urticaria Activity Score (UAS) 7, Dermatology Life Quality Index (DLQI), and reduction of antihistamine usage were used to assess the treatment response. Eight patients (age range: 25–76 years old; four females and four males) had one to ten years of duration of recalcitrant chronic spontaneous urticaria. All failed to respond to high doses of second-generation antihistamines and five to immune-modulating agents. Three did not respond to omalizumab. At week nine, the reduction of UAS7 ranged from 76.2% to 100%. There was more than an 80% improvement in DLQI in all patients. The number of wheals seemed to be reduced first followed by pruritus. Three patients had stopped antihistamines by week eight of treatment. No adverse events were reported in all eight patients. Autologous serum therapy may serve as an alternative treatment for recalcitrant chronic spontaneous urticaria. Apart from the practicality, which requires frequent clinic visits, venipuncture, and centrifugation, it is cheap and effective with minimal adverse events.
Role of Probiotic in Vulvovaginal Candidiasis: A Randomised Controlled Non-blinded Trial from India
Authors: Thekho Apaopa Jemima , Mendiratta Vibhu , Garg Taru , Kaur Ravinder , Yadav Vidya 
Published: October 2024

Abstract

Background:
Vulvovaginal candidiasis (VVC) is a prevalent form of vaginitis, and most patients show improvement when treated with antifungal medications. However, recurrence may affect a minority. It has been found through previous research that the concomitant utilisation of probiotics during acute VVC leads to early relief of symptoms and signs and offers a preventive measure against recurrences.

Objectives:
This study aimed to assess the efficacy of the combination of oral probiotics with conventional antifungal treatment as compared to conventional antifungal treatment alone.

Methods:
Sixty patients who were newly diagnosed with VVC were enrolled in a randomised controlled trial. They were divided into two groups. Group A included 30 cases treated with conventional antifungal medication (oral fluconazole 150 mg single dose), while Group B included 30 cases treated with conventional antifungal medication (oral fluconazole 150 mg single dose) alongside oral probiotic capsules (Lactobacillus rhamnosus, L. crispatus, L. gasseri, L. jensenii) for 2 months. The clinical and mycological findings were recorded before and after treatment. The relapse rate and side effects were recorded during the period of our study.

Results:
No significant difference between the clinical cure rate, mycological cure, and relapse rate was seen between the two groups. (P < 0.05). However, a larger proportion of patients in Group B (97%) achieved complete remission compared to Group A (90%). No side effects were noted in either of the groups.

Conclusion:
Based on the findings, it can be concluded that the addition of probiotics to conventional antifungal treatment led to better rates of clinical and mycological cure and a lower likelihood of relapse compared to conventional antifungal treatment alone.
Verruciform Xanthoma Presenting Within an Ear Piercing
Authors: Myers Hannah E. , Rangarajan Subhapradha , Roberts Michael , Buckley Christopher , Hammel Josh 
Published: October 2024

Abstract
Verruciform xanthomas are rare lesions affecting 0.025-0.5% of the population. They present as an asymptomatic, slow growing solitary lesion on the oral mucosa. Commonly misdiagnose as squamous cell carcinoma, verruca vulgaris, leukoplakia, and lichen planus. Presented is a 22 year old male with a painful verruciform xanthoma on the posterior ear lobe in a prior ear piercing.
Seronegative and Low Seropositive Treatment-Naive Secondary Syphilis in India: A Cross Sectional Study
Authors: Ghosh Aparajita , Panda Saumya , Bhattacharyya Surjyamukhi 
Published: October 2024

Abstract
The non-treponemal tests like VDRL and RPR hold an important place in the diagnosis of syphilis. In many countries, these tests are used for screening, with positive results being subsequently confirmed by treponemal or specific tests like TPHA or FTA-ABS. Recent observations of low-titer VDRL or RPR positivity (<1:8) or negative results in patients with clinically active syphilis are becoming a cause for concern especially in the backdrop of a resurgence of the disease. Such a scenario might undermine the usefulness of VDRL or RPR as effective screening test and for treatment monitoring. We studied the titers of non-treponemal serological test (VDRL) in non-HIV-positive, untreated cases of secondary syphilis (diagnosed clinically and confirmed serologically with specific treponemal tests like TPHA or FTA-ABS). It was an OPD-based cross-sectional study, which included patients presenting with muco-cutaneous lesions suggestive of secondary syphilis, confirmed serologically with positive specific treponemal tests, who were seronegative for HIV1 and 2 and had not received treatment with injectable benzathine penicillin. Their VDRL titers were noted. Information regarding duration of lesions and any previous genital ulcer was obtained, and additional information was sought regarding any medications taken during the last two months. Nineteen patients (12 males, 4 females, and 3 transgender individuals) between the ages of 18 and 46 years were included in the study. Ten of these cases (52.63%) had a VDRL titer of less than 1:8 (non-reactive in 5 patients, titer of 1:4 in 5 patients). Among the remaining nine cases, a titer of 1:8 was observed in six, 1: 16 in two, and 1:32 in one case. Our observations raise concerns regarding the possibility that a significant number of patients with active syphilis and potential to transmit the disease are being left untreated because of low or negative titers in the screening tests. This may account for the slow resurgence of syphilis as documented by increase in case rates and incidence of congenital syphilis in different parts of the world.
miRNA: The Next Frontier in Dermatology Research and Therapeutics
Authors: Sil Abheek , Chakraborty Disha 
Published: October 2024

Abstract
Engagement of microribonucleic acids (miRNA) in the regulation of cutaneous cellular health and diseases is a rapidly advancing niche in dermatology basic research. miRNAs have been identified to play a key role in the pathogenesis of various cutaneous inflammatory, autoimmune and neoplastic conditions, among others. In addition, their purported role as therapeutic targets and biomarkers in diseased conditions harbours exciting news for the approaching years in clinical research. The current review outlines the possible translational role of miRNA in skin health and diseases (encompassing pathogenesis, diagnosis, biomarkers and therapy) from bench to bedside.
Combination Therapy for Post-Kala-Azar Dermal Leishmaniasis: A Literature Review of Current Evidence
Authors: Kumari Alka , Siddiqui Niyamat A. , Kumari Sweta , Murti Krishna , Kumar Rishikesh , Pandey Krishna , Padmakar Somanaboina , Pal Biplab 
Published: October 2024

Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is a neglected skin disease that has tremendous epidemiological significance as a reservoir of Leishmania parasites. Relapse, drug resistance, non-compliance to prolonged treatment, poor health-seeking behaviour, along with limited therapeutic options pose a significant impact on the management of PKDL. In this study, we aimed to review the efficacy, safety and tolerability data of combination therapies for PKDL in the published literature. We have also described patients’ compliance with treatment and associated co-infections in PKDL. A comprehensive literature search was conducted in PubMed, Scopus and Google Scholar to identify the relevant articles. A total of nine studies were eligible for inclusion in this review. Drug combinations used in India were miltefosine-liposomal amphotericin-B, miltefosine-paromomycin, miltefosine-amphotericin-B, sodium stibogluconate (SSG)-immunotherapy and SSG-rifampicin. However, in Sudan, except one, all studies have used SSG-based combinations viz. SSG-rifampicin, SSG-paromomycin and SSG-immunotherapy. The efficacy and safety of miltefosine in combination with liposomal amphotericin-B as well as conventional amphotericin-B were found to be excellent in a limited number of patients. These combinations are said to have better patient compliance and shorter treatment duration. Another combination of miltefosine and paromomycin was found to be satisfactory with a final cure rate of 83.3%. SSG in combination with paromomycin had a good clinical outcome among severe PKDL patients in Sudan, though pain at the injection site was experienced by all patients. There is a lack of data on combination therapies for PKDL through large-scale randomised controlled trials (RCTs). Therefore, multicentric randomized controlled trials with a sufficiently large sample size are urgently needed to verify the efficacy, safety, and other advantages of combination therapies for PKDL. With the availability of liposomal amphotericin-B, miltefosine and immunotherapy, clinical management of PKDL appears promising.
Recognizing the impact of Samyoga Viruddha in clinical practice: A case report on Ayurvedic management of chronic urticaria
Authors: Jangid Sushil Kumar , Chhatbar Disha K. , Solanki Varsha R. 
Published: October 2024

BACKGROUND:
The Ayurvedic concept of Samyoga Viruddha addresses the significant health risks associated with incompatible mixtures of substances, including food components, medications, and environmental factors. This concept is pivotal in understanding how these combinations can disrupt Doshic balance, leading to various health issues.

METHODS:
A case study was conducted involving a 38-year-old male patient who presented with symptoms of intense itching, rashes, heartburn, dyspepsia, and abdominal heaviness. During history taking, it was revealed that the patient had recently consumed milk with meals followed by an over- the-counter pain reliever for a severe headache. As per Ayurvedic principles, this combination is considered incompatible and was believed to have destabilized the Pitta and Kapha Doshas, leading to the observed symptoms.

RESULTS:
The patient’s symptoms were successfully managed through a combination of Virechana (medication-induced purgation) and Shamana therapy (pacification of vitiated Doshas). The treatment effectively alleviated hyperacidity, poor digestion, fatigue, and urticaria, demonstrating the practical application of Ayurvedic principles in addressing Doshic imbalances.

CONCLUSION:
This case study illustrates the importance of recognizing and avoiding Samyoga Viruddha in clinical practice. By adhering to harmonious combinations, healthcare professionals and individuals can mitigate the adverse effects of incompatible substances, thereby promoting better health and vitality. The case also highlights the efficacy and affordability of Ayurvedic treatments like Shodhana and Shamana Chikitsa in managing conditions such as chronic urticaria.
Development of Amla Nutri-bar: Proximate analysis, gallic acid quantification and its validation through HPTLC, and spectroscopy
Authors: Mehere Nikhil , Kaushik Shreshtha , Upadhyay Mohit Kumar , Singh Divyani , Yadav Pramod , Galib R. 
Published: October 2024

BACKGROUND:
“Ayush Ahara” confluences advanced food technology with Ayurveda to develop dietary products rooted in traditional medicine. Here, Amla (Indian gooseberry), a medicinal fruit well-known for its health benefits, was used to develop a novel dietary product—Amla Nutri-bar (ANB). Furthermore, this research aims to substantiate its therapeutic potential through quality control analysis.

METHODS:
Three batches of ANB were prepared at the pharmaceutical laboratory, All India Institute of Ayurveda, New Delhi, India. These were evaluated for sensory attributes using a 9-point hedonic scale and underwent physicochemical, phytochemical, total phenolic content, chromatographic, and spectroscopy assays.

RESULTS:
The sensory evaluation indicated positive feedback, with an overall acceptability score of 8, followed by taste and flavor rated at 7 Physiochemical constants included pH: 2.2, moisture: 11.48%w/w, total ash: 0.17%w/w, water-soluble extractive value: 88.4%w/w, and alcohol-soluble extractive value: 56.65%w/w. Phytochemical screening revealed that the product is rich in flavonoids, tannins, and alkaloids. Nutritional composition per 100 g had energy: 373.76 kcal, proteins: 1.61%, carbohydrates: 88.59% by wt, dietary fiber: 2.72 g, total fat: 1.44%, vitamin C: 300.11 mg, vitamin A: 71.23 pg, iron: 5.63 mg, calcium: 126.69 mg, and potassium: 103.57 mg. Total phenolic content was 4.95 mg gallic acid equivalents/g, with gallic acid quantified at 270.4 μg/100 mg employing a validated high-performance thin layer chromatography method. Fourier transform infrared spectroscopy analysis showed the presence of alcohol, phenol, and alkanes. All the tested pesticide residues were found below detection limits.

CONCLUSION:
ANB can be a food product that is, not delicious only but can also contribute significantly to overall health and well-being.
Ethnic fermented foods and beverages used by the tribal communities of Papum Pare and Lower Subansiri districts of Arunachal Pradesh, India
Authors: Bhardwaj Yashpal , Yehi Taba , Yugandhar Pulicherla , Srinivasulu Cheemanapalli , Meher Sudhanshu Kumar , Gammi Lemmem , Nagayya Shiddamallayya , Bhuyan Gurucharan , Tripathi Ashish Kumar 
Published: October 2024

BACKGROUND:
The North-Eastern Region of India, with its diverse ethnic culture and rich wild edible plant resources, has a long tradition of consuming fermented foods and beverages. This study attempts to document the traditional fermented food and beverages prepared by the tribal communities residing in Papum Pare and Lower Subansiri districts of Arunachal Pradesh India.

METHODS:
Field surveys were conducted in the villages and market areas of two districts of Arunachal Pradesh. In this study, face-to-face interviews were organized with the local inhabitants, and data were collected in a semi-structured questionnaire format. The documented fermented foods were meticulously categorized into different categories based on the ingredients involved in the preparation of each food recipe. During the documentation process, demographic data and details such as the local names of the recipes, ingredients, plant used, the local name of plant used, plant parts, shelf life, and a detailed step-by-step recipe preparation procedure were recorded.

RESULTS:
A total of 16 different fermented food products/dishes made up of bamboo shoots, soybean, and meat were documented along with six different local beverages made up of Oryza sativa L., Eleusine coracana (L.) Gaertn., and Zea mays L. These fermented foods were not only consumed within households but were also commercialized in local markets generating revenue for local people.

CONCLUSION:
This study underscores that the ethnic communities of Arunachal Pradesh are utilizing plant resources in various forms. This research provides baseline data, which can serve as a valuable resource for, researchers, policymakers, and food enthusiasts interested in understanding and exploring the culinary traditions and nutritional potential of ethnic fermented food and beverages.
Artificial Neural Network-based Model for Predicting Cardiologists’ Over-apron Dose in CATHLABs
Authors: Fardid Reza , Farah Fatemeh , Parsaei Hossein , Rezaei Hadi , Jorat Mohammad Vahid 
Published: October 2024

Aim:
The radiation dose that cardiologists receive in the catheterization laboratory is influenced by various factors. Handling high-stress tasks in interventional cardiology departments may cause physicians to overlook the use of dosimeters. Therefore, it is essential to develop a model for predicting cardiologists’ radiation exposure.

Materials and Methods:
This study developed an artificial neural network (ANN) model to predict the over-apron radiation dose received by cardiologists during catheterization procedures, using dose area product (DAP) values. Leveraging a validated Monte Carlo simulation program, we generated data from simulations with varying spectra (70, 81, and 90 kVp) and tube orientations, resulting in 125 unique scenarios. We then used these data to train a multilayer perceptron neural network with four input features: DAP, energy spectrum, tube angulation, and the resulting cardiologist’s dose.

Results:
The model demonstrated high predictive accuracy with a correlation coefficient (R-value) of 0.95 and a root mean square error (RMSE) of 3.68 µSv, outperforming a traditional linear regression model, which had an R-value of 0.48 and an RMSE of 18.15 µSv. This significant improvement highlights the effectiveness of advanced techniques such as ANNs in accurately predicting occupational radiation doses.

Conclusion:
This study underscores the potential of ANN models for accurate radiation dose prediction, enhancing safety protocols, and providing a reliable tool for real-time exposure assessment in clinical settings. Future research should focus on broader validation and integration into real-time monitoring systems.
Effect of Kaishora Guggulu and Madhusnuhi Rasayana in the management of gout (Vatarakta): An open-label single-arm prospective study
Authors: Panda Purnendu , Bhuyan Guru Charan , Rao Meda Mrutyunjaya , Yadav Babita , Sharma Bhagwan Sahai , Khanduri Shruti , Rana Rakesh Kumar , Srikanth Narayanam 
Published: October 2024

Abstract

BACKGROUND:

Vatarakta, also known as Adhayavata, is attributed to diverse etiological factors, such as imbalanced dietary practices, occupational factors, sedentary lifestyles, and environmental influences. The symptomatology of Vatarakta resembles that of gout in contemporary medicine. While nonsteroidal anti-inflammatory drugs), colchicine, and corticosteroids are used in acute management in conventional treatment, there is a growing recognition of the need for safer and more effective alternatives. Ayurvedic formulations, such as Kaishora Guggulu (KG) and Madhusnuhi Rasayana (MR) are used commonly in clinical practice for similar conditions, and they can be potentially validated for their therapeutic potential in gout.

OBJECTIVES:
The study was designed to evaluate the therapeutic effect and safety of Ayurvedic formulations: KG and MR in the management of Vatarakta (gout).

MATERIALS AND METHODS:
The study was conducted as an open-label single-arm prospective trial at the Central Research Institute for Hepatobiliary Disorders, Bhubaneswar, Odisha, India. A total of 68 patients meeting the diagnostic criteria for primary gouty arthritis set by the American College of Rheumatology were screened according to the selection criteria, with 55 ultimately participating in the study. The treatment protocol consisted of administering KG (1000 mg) and MR (10 g) twice daily after meals with lukewarm water for 12 weeks, followed by a 2-week follow-up period, without intervention. Clinical outcomes included evaluating changes in various parameters, including clinical assessment, 36-item Short Form Health Survey (SF-36) health survey score, patient’s global assessment score, physician global assessment score (Visual Analog Scale) score for pain, and serum uric acid levels from baseline to the 84th-day visit of the study.

RESULTS:
After 84 days of the study, statistically significant changes were found in clinical symptoms, joint pain, and SF-36 health survey parameters, including physical functioning, emotional well-being, social functioning, and general health (P < 0.0001). The mean serum uric acid at the baseline was 7.39 ± 0.55, which reduced to 5.35 ± 1.48 after treatment, which was significant (P < 0.0001). During the trial period, no adverse events were reported.

CONCLUSION:
Despite variations in demographics, such as gender, socioeconomic status, age groups, Prakriti, and geographic region, Ayurveda treatment exhibited a significant response, accompanied by a notable reduction in serum uric acid levels. The absence of adverse reactions throughout the trial period further supports the safety profile of these formulations. These positive outcomes advocate for the use of KG and MR in gout treatment regimens, offering patients a well-tolerated and beneficial therapeutic option.
Cardiac Myosin-binding Protein-C as a Biomarker in the Early Diagnosis of Acute Coronary Syndrome and Differentiation of Its Types
Authors: Hussein Ali Abdul Rasool , Issa Abdulkareem Hamadi , Al Shareeifi Abbas Naji Muslem 
Published: October 2024

Abstract

Background:
Coronary heart disease (CHD) is primarily caused by atherosclerotic lesions within the intima of coronary arteries and acute coronary syndrome (ACS) is the main acute clinical manifestation of CHD. The ACS is manifested in one of three subtypes and it is the leading cause of mortality worldwide. The three subtypes of ACS include: acute myocardial infarction (MI) with the electrocardiogram (ECG) presenting ST-segment elevation (STEMI), MI with no ST-segment elevation on ECG (NSTEMI), and the third subtype is unstable angina (UA). The early diagnosis of is important in decreasing morbidity and mortality in ACS patients.

Objective:
To investigate the role of serum level of cardiac myosin-binding protein-C (cMyC), compared with high-sensitivity cardiac troponin-I (hsCTn-I) in the early diagnosis of ACS and differentiation of its subtypes.

Materials and Methods:
One hundred and twenty patients (72 males and 48 females), aged ≥30 years selected from those who were admitted to emergency department (ED) of Al-Yarmouk teaching hospital and diagnosed with ACS by cardiologists. The duration between the onset of chest pain and admission to ED should not exceed 3 h in any cohort. Apparenty healthy subjects as controls group for the study were recruited from those who had no current illness, particularly CHD, no other systemic disease and each had a normal ECG. For each study subject, cMybp-C and hsCT-I serum levels on admission were measured using the enzyme-linked immunosorbent assay kits. For each ACS patient, serum level of hsCTn-I level was measured 3 h after admission.

Results:
The comparison of cMybp-C levels among study groups revealed an overall significant difference and on paired comparison of study groups, the cMybp-C mean level was significantly higher in each ACS subgroup than in controls group (P < 0.001), except in UA subgroup versus controls group. The cMybp-C levels showed a significant positive correlation with hsCT-I levels on admission in STEMI and NSTEMI subgroups but not in UA subgroup. The cMybp-C levels also showed a significant positive correlation with hscT-I levels 3 h after admission in STEMI and NSTEMI subgroups but not in UA subgroup. On receiver operating characteristic curve analysis, the cMybp-C level had a better diagnostic accuracy than hscTn-I on admission in differentiation of patients with “STEMI or NSTEMI” from those with UA or from controls.

Conclusion:
Serum cMybp-C mean level is significantly higher in ACS patients with STEMI and NSTEMI than in controls and the increase was more significant than hsCTn-I mean level on admission, so it could help the early diagnosis of ACS patients. The serum levels of cMybp-C also had a better diagnostic accuracy than hsCTn-I on admission in differentiation of ACS patients with STEMI or NSTEMI from those with UA or from controls.