bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microwave ablation after VATS in patients with multiple pulmonary nodules
Authors: Cui Xiangyu , Zhao Jinglan , Lu Ruizhen , Sui Yingzhong , Shao Changqing , Zhang Zhixue , Chen Jun 
Published: October 2024

ABSTRACT

Background:
The management of residual nodules after video-assisted thoracoscopic surgery (VATS) for multiple pulmonary nodules (MPNs) is challenging. Microwave ablation (MWA), which is highly repeatable and minimally invasive, has garnered widespread attention in the treatment of MPNs.

Methods:
Ninety-one patients with MPNs who underwent VATS for resection of high-risk nodules followed by MWA for residual nodules were examined. Clinical efficacy and complications were assessed. The primary end points were MWA success rate and complete ablation rate. Secondary end points were local progression-free survival (LPFS), overall survival (OS), and complications.

Results:
MWA was successfully completed in all patients. Mean tumor diameter, ablation time, and ablation output power were 0.81 cm, 3.4 minutes, and 39 W, respectively. LPFS was 100% at 3, 6, 12, and 24 months, respectively. OS was 100% at 12 and 24 months, respectively. No intraoperative or postoperative deaths occurred. Complications with MWA were infrequent. Pneumothorax was most common, occurring in 31 patients (34.07%); among these, seven (7.69%) required closed thoracic drainage. Pleural effusion occurred in six patients (6.59%), hydropneumothorax in five (5.49%), and pneumonia in three (3.30%). The pain level after MWA was moderate-to-severe in 29 patients (31.87%).

Conclusion:
MWA is safe and feasible for treating residual nodules in patients with MPNs who have undergone VATS. The incidence of complications was low, and most complications were mild.
Senile patient, no medical history: Hexdrive ingestion during implant placement
Authors: Srivastava Nikhil , Swaroop Chouduri Sai , Shetty Akshay , Bagga Vivek , Rishi Diljith , Kakkar Pragati 
Published: October 2024

ABSTRACT
While rare, the ingestion of foreign bodies is a potential occurrence in dentistry, particularly during routine implant procedures if adequate precautions are not taken. Such incidents can lead to severe complications, including intestinal perforation. Confirmation of the presence or absence of a foreign body is crucial and is typically achieved through radiographs, enabling accurate diagnosis and subsequent treatment. The key to preventing such instances lies in obtaining a proper case history and ensuring the correct positioning of the patient. In general, instruments entering the gastrointestinal tract often pass without symptoms, and surgical intervention is rarely necessary. However, when indicated, a surgical approach may be required for instrument removal. Therefore, a precise diagnosis is essential to avoid unnecessary surgical interventions. This article aims to highlight a case involving the accidental ingestion of a hexdrive by a senile patient.
Efficacy of oral alprazolam in the management of perioperative anxiety in dental implant surgeries: A randomized controlled study
Authors: Ahmed Fazeel , Shetty Akshay D. , Krishnakumari Aparna Melethu , Ahmed Nida , Imran Mohammed , Chandrashekhar V 
Published: October 2024

ABSTRACT

Objectives:
Surgical anxiety has emerged as a major limitation of implant surgery impeding its emergence as a leading choice of rehabilitation. It also triggers a series of physiological, emotional, and cognitive responses which adversely affects treatment outcomes and postoperative management. Hence, this study was designed specifically to address anxiety in patients undergoing dental implant surgeries.

Materials and Methods:
This study included 54 partially edentulous patients requiring single-implant rehabilitation. The patients were randomly assigned to the test group (Alprazolam group) and control group (Placebo group). Twenty-seven patients (test group) received Alprazolam 0.5 mg as a preemptive anxiolytic and 27 patients (control group) received a multivitamin tablet as placebo 1 h before implant surgery. Heart rate, blood pressure and respiratory rate of patients were measured to access the activation of sympathetic nervous system.

Results:
Oral administration of Alprazolam 1 h before the procedure showed significant reduction in preoperative anxiety in patients undergoing surgical placement of dental implants.

Conclusion:
Anxiolytic effect of Alprazolam mediated by binding to the alpha 1 subunit of GABA A receptor enhances the inhibitory effect on the nervous system. Preoperative administration of alprazolam 0.5 mg h prior, conceivably be standardized for management of surgical anxiety.
Pregnancy-induced Hypertension: What Are the Associated Factors in Rural Areas? A Study from Rural Dehradun, Uttarakhand
Authors: Dhinwa Manisha , Aggarwal Pradeep , Singh Mahendra , Bahurupi Yogesh Arvind , Sharma Nandita 
Published: October 2024

Abstract

Background:
Pregnancy-induced hypertension (PIH) is a major significant cause of adverse pregnancy outcomes – mortality and morbidities in both mother and foetus.

Aims:
The present study aims to determine the prevalence of PIH and its associated factors among pregnant women attending antenatal care in rural field areas of a tertiary care hospital in Uttarakhand.

Patients and Methods:
A cross-sectional study was conducted on pregnant women-seeking antenatal services from January 2020 to October 2020 at three sub-centres (Raiwala, Pratit Nagar and Haripur Kala) of the Primary Health Centre (Raiwala) after giving informed consent. A sample size of 113 was calculated and included in our study. A pre-tested structured schedule was used to interview the study participants after a pilot test. Blood pressure was determined using an average of three measurements, and some clinical and laboratory findings were reviewed from medical records; these were mainly the mother-child protection card. Data were presented as frequency, percentage frequencies and the results are presented with the table. Fisher’s exact statistics were calculated for the association with pregnancy-induced hypertension, and logistic regression was performed to identify independent predictors. P <0.05% was considered statistically significant.

Results:
The prevalence of PIH among total study participants in Dehradun District, Uttarakhand, was 6.2% (95% confidence interval [CI], 1.8%–10.6%). The majority of respondents were noted in ≤ 30 years of age group (91.15%), followed by > 30 years of age group (8.84%). In univariate regression, factors such as age, pre-term birth, abortion, pedal oedema, blurred vision, proteinuria, present history of gestational diabetes mellitus, present history of diabetes, present history of other morbidities, past history of diabetes, past history of other morbidities, i.e. surgeries, otitis media, obesity and thyroid, family history of hypertension and family history of diabetes were associated with pregnancy-induced hypertension. In multivariate logistic regression, maternal age (adjusted odds ratio AOR = 18.29, 95 CI% =2.3–141.4, P = 0.005*), pre-term birth (AOR = 61.7, 95% CI = 3.5–1071.3, P = 0.005*), (proteinuria AOR = 8, CI = 0.80–79.6, P = 0.006*), gestational diabetes (AOR = 19.9, CI = 2.9–133.06, P = 0.002*), history of other morbidities (AOR = 13.4, 95% CI; 1.7–106.5, P = 0.014*) and family history of diabetes (AOR; 8.7, 95% CI = 1.7–43.3, P = 0.008*) were found as the predictor factors for developing PIH.

Conclusions:
Early detection and treatment of pregnancy-induced hypertension and risk factors in pregnant women by healthcare professionals and policy-makers at the community level should be strengthened.
The Effect of Magnesium Sulfate plus Ketorolac versus Morphine plus Ketorolac on Pain Relief in Patients with Renal Colic: A Double-blind Randomized Clinical Trial
Authors: Mardani Hosseinali , Isfahani Mehdi Nasr , Abootalebi Alireza 
Published: October 2024

Background:
It seems that magnesium sulfate (MgSO4) can be useful in reducing acute pain caused by stone passing through the ureter by reducing ureteral smooth muscle contractions.

Aim:
This study aimed to evaluate the effect of MgSO4 plus ketorolac versus morphine plus ketorolac on pain relief in renal colic.

Methods:
The present double-blind randomized clinical trial was performed on 70 patients with renal colic divided into two groups. Patients in the first group received 30 mg intravenous ketorolac plus 5 mg intravenous morphine while patients in the second group received 30 mg/kg MgSO4 plus 30 mg intravenous ketorolac. Then, patients’ hemodynamic parameters and pain scores were evaluated before and 20, 40, and 60 min after the intervention.

Results:
Within 60 min of administration, systolic blood pressure was significantly reduced in the morphine plus ketorolac group (P < 0.001) while there was no significant change in the MgSO4 plus ketorolac group in this regard (P = 0.576). In addition, the patients’ mean pain scores were not significantly different between the two groups in any of the studied times (P > 0.05).

Conclusion:
Given that the addition of MgSO4 to ketorolac, as compared with the addition of morphine (as a drug) to ketorolac, has been associated with fewer complications and greater stability of hemodynamic parameters, it can be stated that the use of MgSO4 as an adjunct can be a good choice for further pain relief in patients with contraindications for drug administrations.
Ficus carica Puree Exerts a Higher Antioxidative Profile in Hypoxic Lungs after Intermittently Inducing Hypoxia in Sprague–Dawley Rats
Authors: Fitri Ayu Tiara , Meliala Andreanyta , Widyawati Dwi , Narwidina Paramita , Siswanto Siswanto , Sumarno Yogi Tri 
Published: October 2024

Background:
The body produces more hypoxia-inducible factor and reactive oxygen species in response to hypoxic situations because they cause unbalanced oxygen levels. Ficus carica provides numerous benefits because of its high antioxidant and mineral content. Nevertheless, the mechanism by which F. carica consumption confers this protective benefit remains incompletely understood.

Aim:
This study aimed to evaluate how F. carica puree (FCP) can affect the antioxidant enzyme activity and malondialdehyde (MDA) levels in the lung by mitigating the effects of intermittent hypoxia (IH).

Methods:
Thirty Sprague–Dawley rats were divided into five groups: negative control (NC), untreated; positive control (PC), treated with aquadest; FCP1; FCP2; and FCP3, which received FCP at doses of 1.25, 2.5, and 5 mL/200 g body weight. The treatment was administered for 4 weeks before inducing IH (10% O2 and 90% N2) into all groups (except NC) for 4 h for 7 days. Furthermore, hemoglobin (Hb) level, lung MDA level, and lung superoxide dismutase (SOD) enzyme activity were assessed.

Results:
The Hb level did not exhibit a significant increase under IH conditions. Conversely, the PC group exhibited the least activity of lung antioxidant enzymes and the highest lung MDA levels. In addition, the FCP intervention group exhibited lower MDA levels than the PC group and ameliorated relative lung weight loss.

Conclusion:
All FCP intervention groups showed lower MDA levels and higher SOD levels compared to the PC group, suggesting that FCP could mitigate the effects of hypoxia in rat lungs.
Diagnosis of Autism in Children Based on their Gait Pattern and Movement Signs Using the Kinect Sensor
Authors: Yazdi Shabnam Akhoondi , Janghorbani Amin , Maleki Ali 
Published: October 2024

Abstract

Background:
Autism spectrum disorders are a type of developmental disorder that primarily disrupt social interactions and communications. Autism has no treatment, but early diagnosis of it is crucial to reduce these effects. The incidence of autism is represented in repetitive patterns of children’s motion. When walking, these children tighten their muscles and cannot control and maintain their body position. Autism is not only a mental health disorder but also a movement disorder.

Method:
This study aims to identify autistic children based on data recorded from their gait patterns using a Kinect sensor. The database used in this study comprises walking information, such as joint positions and angles between joints, of 50 autistic and 50 healthy children. Two groups of features were extracted from the Kinect data in this study. The first one was statistical features of joints’ position and angles between joints. The second group was the features based on medical knowledge about autistic children’s behaviors. Then, extracted features were evaluated through statistical tests, and optimal features were selected. Finally, these selected features were classified by naïve Bayes, support vector machine, k-nearest neighbors, and ensemble classifier.

Results:
The highest classification accuracy for medical knowledge-based features was 87% with 86% sensitivity and 88% specificity using an ensemble classifier; for statistical features, 84% of accuracy was obtained with 86% sensitivity and 82% specificity using naïve Bayes.

Conclusion:
The dimension of the resulted feature vector based on autistic children’s medical knowledge was 16, with an accuracy of 87%, showing the superiority of these features compared to 42 statistical features.
Evaluation of the Activity of Vogt–Koyanagi–Harada Disease; A Comparison of Indocyanine Green Angiography Scoring, Enhanced Depth Imaging Optical Coherence Tomography, and Choroidal Vascularity Index
Authors: Fadakar Kaveh , Rezaii Keivan , Niktinat Hanieh , Roohipourmoallai Ramak , Mahmoudi Tahereh , Tuli Sonal , Ahmadi Amin , Pour Elias Kalili , Pahlaviani Fatemeh Golsoorat , Mahdizad Zahra , Davoudi Samaneh , Zarei Mohammad , Ebrahimiadib Nazanin 
Published: October 2024

Abstract

Purpose:
To investigate the correlation between choroidal biomarkers using enhanced depth imaging optical coherence tomography (EDI-OCT) and indocyanine green angiography (ICGA) scoring for monitoring the activity of Vogt–Koyanagi–Harada (VKH).

Methods:
Patients who were not in the acute phase of VKH were recruited. Simultaneous EDI-OCT and ICGA were captured in seven patients only at baseline, in six patients at the 3-month follow-up, and in two patients at both the 6- and 9-month follow-ups. Subfoveal choroidal thickness (SFCT), subfoveal choroidal area (SFCA), and choroidal vascular index (CVI) were measured on EDI-OCT using FIJI software and a denoising system. ICGA scoring was performed.

Results:
Fifteen subjects with the median of 4-month follow-up were recruited. Forty-eight pairs of EDI-OCT and ICGA were investigated. In univariate analysis, ICGA scores were positively associated with SFCT, and SFCA, but negatively with CVI. The strength of correlation between ICGA scores and SFCT was strong (correlation coefficient: 0.91). In multivariate analysis, only SFCT remained significant (B: 2.4, 95% confidence interval: 1.9–3.0; P < 0.001).

Conclusions:
SFCT can be an acceptable representative of the subclinical inflammatory activity of VKH. As an alternative to ICGA, SFCT functions better than SFCA and CVI.
Deep Learning Algorithm for Keratoconus Detection from Tomographic Maps and Corneal Biomechanics: A Diagnostic Study
Authors: Quanchareonsap Wiyada , Kasetsuwan Ngamjit , Reinprayoon Usanee , Piyacomn Yonrawee , Wungcharoen Thitima , Jermjutitham Monthira 
Published: October 2024

Abstract

Purpose:
To develop an artificial intelligence (AI) approach for differentiating between normal cornea, subclinical, and keratoconus (KC) using tomographic maps from Pentacam (Oculus) and corneal biomechanics from Corvis ST (Oculus).

Methods:
A total of 1,668 tomographic (769 patients) and 611 biomechanical (307 patients) images from the Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital were included. The sample size was divided into the Pentacam and combined Pentacam-Corvis groups. Different convolutional neural network approaches were used to enhance the KC and subclinical KC detection performance.

Results:
AI model 1, which obtained refractive maps from Pentacam, achieved an area under the receiver operating characteristic curve (AUC) of 0.938 and accuracy of 0.947 (sensitivity, 90.8% and specificity, 96.9%). AI model 2, which added dynamic corneal response and the Vinciguerra screening report from Corvis ST to AI Model 1, achieved an AUC of 0.985 and accuracy of 0.956 (sensitivity, 93.0% and specificity, 94.3%). AI model 3, which added the corneal biomechanical index to AI Model 2, reached an AUC of 0.991 and accuracy of 0.956 (sensitivity, 93.0% and specificity, 94.3%).

Conclusions:
Our study showed that AI models using either anterior corneal curvature alone or combined with corneal biomechanics could help classify normal and keratoconic corneas, which would make diagnosis more accurate and would be helpful in decision-making for the treatment.
Correlation between Orbital Computed Tomography Scan Measurements and Clinical Enophthalmos in Acute Isolated Orbital Floor Fractures
Authors: Rajabi Mohammad Taher , Samadi Melika , Ghods Sepide , Rafizadeh Seyed Mohsen 
Published: October 2024

Abstract

Purpose:
To analyze the correlation between orbital computed tomography (CT) scan measurements including the fracture area (FA), the fracture location, the soft-tissue herniation volume (HV), the fractured orbital volume ratio (OVR) to the normal orbit, and the clinical enophthalmos in acute isolated orbital floor fractures.

Methods:
We enrolled 100 patients with acute isolated unilateral orbital floor fractures from May 2017 to January 2021. Based on the CT scan findings, we measured the FA, HV, OVR, and fracture site. We assessed enophthalmos using both clinical (CE) and radiographic (RE) measurements. Additionally, we investigated the correlation between CE and the measured parameters, along with the relationship between the pattern of diplopia and the fracture site.

Results:
We identified enophthalmos in 81% and diplopia in 78% of the patients with an acute blowout orbital floor fracture. CE was moderately correlated with the FA (R
2 = 0.4341, P < 0.001). CE was weakly correlated with the HV (R
2 = 0.2861, P = 0.04). Anterior fractures caused diplopia in both vertical gazes, but posterior fractures were mostly associated with diplopia in the up gaze. OVR was strongly associated with RE (R
2 = 0.663, P < 0.0001) and moderately associated with CE (R
2 = 0.4378, P < 0.0001). The univariate regression analysis also showed that OVR could significantly predict CE and RE.

Conclusions:
OVR surpasses other CT scan measurements such as FA and HV in the prediction of clinical enophthalmos. Thus, OVR could be utilized to estimate clinical enophthalmos at the time of presentation, especially when the acute clinical setting prohibits the proper clinical evaluation.
How Safe is Nd:YAG Laser Capsulotomy in Patients with Uveitis? Outcomes of a Long-Term Study
Authors: Rajpoot Mukesh , Nehra Harshraj , Sharma Vinod , Bhargava Rahul , Pandey Kanakambari , Mehta Bhavya , Kalra Gautam , Reddy P.L. Sireesha 
Published: October 2024

Abstract

Purpose:
To study the outcomes and complications of Nd: YAG laser capsulotomy in patients with uveitis.

Methods:
This study retrospectively evaluated outcomes of Nd: YAG laser capsulotomy in 260 eyes of 260 patients with uveitis. The main indications for performing capsulotomy were a visually significant posterior capsule opacification (PCO) and inability to visualize the posterior segment. The presence of 5 or <5 cells per high-power field in the anterior chamber for a minimum period of 3 months was a prerequisite for capsulotomy.

Results:
The mean age of patients was 52.8 ± 11.3 (range, 38–75 years). The incidence of PCO in the study was 22.4%. The mean follow-up was 21.5 ± 11.3 months postcapsulotomy. The mean best-corrected visual acuity (BCVA) improved in 161 (62%) eyes after capsulotomy. The BCVA remained stable in 50 (19.3%) eyes due to preexisting ocular pathology involving the macular area. There was worsening of BCVA in 49 (18.8%) eyes. The main causes of worsening of BCVA were sustained intraocular pressure (IOP) elevation (n = 13%), cystoid macular edema (CME) (n = 8.5%), and retinal detachment (RD) (n = 2.7%), respectively. Ninety-one percent (n = 20) of patients with CME had exaggerated postlaser inflammation and recurrent uveitis. The presence of posterior vitreous detachment (PVD) and higher laser energy levels were significant risk factors for RD.

Conclusions:
Nd: YAG laser capsulotomy in patients with uveitis may be associated with complications. Inflammation and IOP should be well controlled before initiating laser capsulotomy. Capsulotomy should be performed with caution in patients with preexisting PVD.
Short-Term Outcomes of a Modified Safer Surgery Trabeculectomy Technique
Authors: Konuganti Prakriti Yagnam , Rajamani Muralidhar , Chaya Craig John , Ramamurthy Chitra 
Published: October 2024

Abstract

Purpose:
To determine the short-term outcomes of a modified Moorfields Safer Surgery System technique of trabeculectomy.

Methods:
This is a prospective interventional study. Trabeculectomy was performed according to the author’s modification of Moorfields Safer Surgery System. This method allows titrating the opening pressure of trabeculectomy by varying the side cuts, varying the ostium size, and adjusting the tightness of the sutures. Forty-four eyes of 43 patients were included. Main outcome measures include postoperative intraocular pressure (IOP), incidence of intra and postoperative complications, and success up to 6 months after surgery.

Results:
The mean preoperative and postoperative IOP at 6 months were 20.97 ± 7.93 mmHg and 12.69 ± 4.76 mmHg, respectively (n = 44). 70.5% of the patients had absolute success at 6 months, and the overall success was 88.6%. None of the patients had hypotony and there were no intraoperative complications noted. Forty-two out of 44 eyes (95.5%) had diffuse formed blebs without leak on the 1st postoperative day. The most common postoperative complication (13.6%) was a conjunctival leak that was detected on fluorescein staining. In all these patients, the anterior chamber was deep, and the bleb well formed. These leaks were resolved with conservative measures. Many of these leaks would have been missed if not intentionally looked for. Excluding this complication, we had a complication rate of 9.1%.

Conclusion:
The authors’ modification of the Moorfields Safer Surgery System technique may allow the surgeon to optimize aqueous flow through trabeculectomy while mitigating complications.
Topical Insulin for Neurotrophic-Related Epithelial Defects: Where do We Stand? A Systematic Review
Authors: Wouters Colette , Saelens Isabelle , Delbeke Heleen 
Published: October 2024

Abstract

Purpose:
To review the existing literature to evaluate the utility of insulin eye drops as a treatment for neurotrophic-related epithelial defects.

Methods:
A comprehensive literature search of Medline, Embase, and Web of Science and additional manual searches were conducted using relevant keywords. All articles published from January 2005 to January 2024 were examined. Studies on the use of topical insulin drops in neurotrophic epithelial defects were included.

Results:
A total of 16 articles were found relevant to be discussed in the review. All included patients had neurotrophic-related epithelial defects ranging from 3.8 mm2 to 144 mm2. After treatment with topical insulin, most of the epithelial defects showed a complete epithelialization. Various concentrations and types of insulin were used. The studies also varied in the type of vehicle used in the preparation of insulin drops. Two randomized controlled trials demonstrated that topical insulin drops were more effective than conventional treatment with artificial tears or autologous serum. All included studies, except for two, reported the absence of local or systemic side effects.

Conclusions:
Topical insulin is a promising and effective (adjuvant) treatment for neurotrophic keratopathy. It facilitates the healing of neurotrophic epithelial defects and offers many advantages over the current treatment options; insulin is widely available and it is relatively inexpensive. Topical insulin drops do not affect systemic blood glucose levels and are well tolerated. However, further investigation is needed.