bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plurihormonal pituitary neuroendocrine tumor causing acromegaly with subclinical Cushing’s disease
Authors: Nachankar Amit S. , Shekhawat Vikram Singh , Modi Sachin , Sharma Mandeep , Kumar Ashish , Santosha Mantha 
Published: September 2024

ABSTRACT
Macrosomatotropinoma is the most common cause of acromegaly. Plurihormonal pituitary neuroendocrine tumor causing acromegaly often has growth hormone (GH) and prolactin excess. Here, we present a case of acromegaly with adrenocorticotrophic hormone (ACTH) excess due to macrosomatocorticotropinoma. A 32 years old man presented with left-sided progressive painless loss of vision. Clinically, he had acromegaloid features with overt diabetes mellitus (DM) without any discriminatory features of Cushing’s disease or hypertension. The hormonal evaluation revealed elevated insulin-like growth factor 1 with nonsuppressible GH and elevated plasma ACTH. Overnight, the dexamethasone test was nonsuppressible but the low-dose dexamethasone test was suppressible. Magnetic resonance imaging showed pituitary macroadenoma with optic chiasmal compression. Perimetry revealed left anopia. He underwent endoscopic transnasal transsphenoidal resection of macrosomatotropinoma with full recovery of vision. Immunohistochemistry confirmed pleurihormonal (GH and ACTH) pituitary adenoma. Postoperatively, his secondary DM is well controlled on oral antidiabetic agents. He underwent gamma knife surgery for residual lesion and is presently on long-acting somatostatin receptor ligand octreotide for active acromegaly. This is an extremely rare case of overt acromegaly with subclinical Cushing’s disease due to plurihormonal macrosomatocorticotropinoma. A total of 25 similar cases have been recorded in world literature to date. In the presence of GH–ACTH excess, signs of acromegaly are often clinically dominant and Cushing’s disease is usually but not always silent.
Catecholamine-Secreting Adrenal Myelolipoma in the Absence of Hypertension: A Rare Case Report
Authors: Jain Abhinay , Daksh Seema , Ranjan Karishma , Tanveer Nadeem , Mangla Pragya , Raizada Nishant , Madhu Sri Venkata 
Published: September 2024

ABSTRACT
Adrenal myelolipoma (AML) is a benign neoplasm of the adrenal gland composed of fat and myeloid components. Most of these tumors are asymptomatic and non-secretory. We describe the case of a 22-year-old female who was being evaluated for right abdominal flank pain. She was detected with a 7.1 × 5.2 cm right adrenal mass with −55 mean HU on computed tomography (CT) scan, suggestive of myelolipoma. Her 24-hour urine normetanephrine level was elevated. Regular blood pressure monitoring was carried out, but she was normotensive. Right-sided unilateral adrenalectomy was performed. Histopathologic analysis confirmed the diagnosis of adrenal myelolipoma. Urine normetanephrine levels normalized post-surgery. Very few cases of catecholamine secretion by AML have been described in the literature. All of these cases had hypertension. To the best of our knowledge, this will be the first case reporting catecholamine secretion by AML in a normotensive patient.
Thoracic Epidural Anesthesia with Ipsilateral Interscalene Nerve Block for Modified Radical Mastectomy in Patients with Cardiorespiratory Compromise: A Prospective Feasibility Case Series
Authors: Jain Amrita , Shah Pratibha Jain , Ayalasomayajula Sashank 
Published: September 2024

Abstract
Modified radical mastectomy (MRM) is the most common surgical procedure performed for breast carcinoma. It is usually performed under general anesthesia (GA), which becomes challenging in patients with respiratory compromise and multiple comorbidities. Thoracic epidural anesthesia is adequate for simple mastectomies, and when combined with ipsilateral interscalene nerve block, it provides adequate anesthesia for MRM, which involves axillary lymph node (LN) dissection in an outstretched arm that can be a discomfort to the patient. We describe our experience of giving thoracic epidural anesthesia with ipsilateral interscalene brachial plexus block (IBPB) in ten patients posted for MRM. A thoracic epidural was introduced under local anesthesia at T6-T7 intervertebral space and ultrasonography (USG)-guided ipsilateral IBPB was given. A satisfactory anesthetic effect was proved by the absence of tactile sensation over the operative mammary region and axilla within 30 min. This case series demonstrated that combined thoracic epidural anesthesia with ipsilateral IBPB can be used very efficiently in patients posted for MRMs without the need for GA.
Early Outcome of Percutaneous Cooled Radiofrequency Ablation in Degenerative Lumbar Facet Arthropathy and Sacroiliac Dysfunction with Associated Comorbid Illness: A Prospective Observational Study
Authors: Shamim Parvez , Ahmed Abrar , Mullick Joydeep 
Published: September 2024

Abstract

Study Design:
This was a prospective observational study.

Objectives:
We report clinical outcomes in a clinical study of patients treated with cooled radiofrequency ablation for chronic back pain associated with lumbar facet arthropathy with sacroiliac dysfunction (unilateral as well as bilateral) associated with multiple medical comorbidities.

Summary of Background Data:
A clinical study was conducted on patients with lumbar facet arthropathy with sacroiliac dysfunction. A significant difference was observed postprocedure during periodical follow-ups.

Materials and Methods:
A prospective observational study of 56 patients suffering from lumbar facet arthropathy with sacroiliac joint dysfunctions was conducted at Apollo Multi-Speciality Hospital, Kolkata, from July 2022 to July 2023 over 1 year. Inclusion criteria are chronic low back pain with degenerative lumbar facet arthropathy with sacroiliac dysfunction with sacroiliitis and patients with failed back syndrome which fails on conservative management for at least 3 months in more than 30-year-old patients. The outcome assessment of all patients was done by the Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) scores and followed up for 0, 1, 3, and 6 months and 1 year.

Results:
We found significant relief in pain with a significant statistical difference on subsequent follow-up over 6 months to 1 year using VAS and ODI scores. We did not get any major complications in our study despite elderly patients with multiple medical comorbidities.

Conclusion:
Cooled radiofrequency significantly improves the pain associated with lumbar facet arthropathy with sacroiliac dysfunction with promising results.
Headache Due to Spontaneous Intracranial Hypotension Treated with Cervical Epidural Blood Patch
Authors: Mutha Sandeep , Manohar Manas , Mahazoom MV , Phalgune Deepak 
Published: September 2024

Abstract
Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid and it is characterized by an orthostatic headache without a history of trauma or dural puncture. Epidural blood patches have been regarded as the mainstay of therapy for SIH, often providing instantaneous relief of symptoms in 90% of cases regardless of the site of the leak. We present a rare case report of an epidural leak treated with a cervical epidural blood patch.
Innovative Approaches to Severe Intractable Cancer Pain Due to Malignant Psoas Syndrome
Authors: Turkoz Ayda , Kangarli Nigar , Tepe Gulpınar 
Published: September 2024

Abstract
Malignant psoas syndrome (MPS) is associated with proximal lumbosacral plexopathy and is characterized by severe intractable pain, despite multimodal medical treatment. Spinal dexmedetomidine and lumbar sympathetic nerve block in combination with pulsed radiofrequency (PRF) are rarely performed for intractable lumbosacral plexopathy pain. We present a combination of spinal dexmedetomidine lumbar sympathetic nerve block and caudal-epidural PRF in the management of MPS, refractory to medical and physical treatment. A 49-year-old female with recurrent lung adenocarcinoma was admitted with shooting pain on the right side over the psoas muscle with irradiation into the right groin and weakness of quadriceps at motion. She was managing her pain with a number of opioids, including oxycodone, morphine, fentanyl, and intramuscular meperidine. The total oral morphine equivalent opioid dose equaled 460 mg. At the first admission, we successfully palliated pain with spinal dexmedetomidine and simultaneously reduced the patient’s opioid addiction. On the second admission, lumbar sympathetic nerve block at L3 with additional caudal-epidural PRF led to a significant reduction in her thigh pain visual analog scale (VAS) score to 1–2/10. In addition, improvement in quadriceps functionality and sleep quality, along with a remarkable reduction in analgesic medicine doses, earned patients high satisfaction. Our patient passed away 6 months later with average VAS severity of 4/10. Spinal dexmedetomidine, caudal-epidural PRF, and lumbar sympathetic nerve block should be added as a therapeutic option to the treatment guidelines for the management of MPS, acquired due to lumbosacral plexopathy.
Preventive Effects of Crocin, a Key Carotenoid Component in Saffron, Against Nicotine-Triggered Neurodegeneration in Rat Hippocampus: Possible Role of Autophagy and Apoptosis
Authors: Gholami Mina , Klionsky Daniel J. , Motaghinejad Majid 
Published: September 2024

Abstract

Background:
Nicotine is a behavioral stimulant that in high doses, through the neuro-inflammatory and oxidative stress pathway, can induce apoptosis and autophagy leading to cell death. Previous data indicate that crocin has neuroprotective properties. The aim of the current study is to investigate crocin’s neuroprotective effects against nicotine-triggered neuro-inflammation, apoptosis, and autophagy in rat hippocampus.

Methods:
Seventy adult male Wistar rats were divided into the following seven groups: Group one received normal saline (0.2 ml/rat), group two was treated with nicotine 10 mg/kg intraperitoneally, groups 3 to 6 were treated simultaneously with nicotine and crocin (10, 20, 40, and 80 mg/kg, intraperitoneally), group 7 was treated with crocin-alone (80 mg/kg, intraperitoneally). The period of the mentioned agent administration was 21 days. On the 22nd day, an open field test (OFT) was used for evaluation of anxiety and motor activity changes. Inflammatory and oxidative stress factors and also apoptosis and autophagy biomarkers were evaluated.

Results:
All mentioned doses of crocin could decrease the nicotine-induced OFT behavioral changes. Crocin also could decrease levels of hippocampal TNF/TNF-α (tumor necrosis factor), IL1B/IL-1β (interleukin 1 beta), oxidized glutathione (GSSG), unphosphorylated and phosphorylated forms of JNK, BECN1 (beclin 1), BAX (BCL2 associated X, apoptosis regulator), and phosphorylated/inactive forms of BCL2 (BCL2 apoptosis regulator) in nicotine-dependent rats. Crocin treatments also caused increases in the reduced form of glutathione (GSH) content and activity of CAT (catalase) and mitochondrial complex enzymes in nicotine-addicted subjects.

Conclusions:
Crocin can modulate JNK-BCL2-BECN1 or JNK-BCL2-BAX signaling pathways and reduce neuronal oxidative stress, neuro-inflammation, and mitochondrial respiratory chain enzymes and exert neuroprotective effects against nicotine-induced neurodegeneration.
Development and psychometric testing of an instrument for team-based learning assessment
Authors: Mojtahedzadeh Rita , Mohammadi Aeen , Kolahdooz Sima , Parmelee Dean X. , Hassanzadeh Gholamreza 
Published: September 2024

BACKGROUND:
In team-based learning (TBL), students actively participate in the learning process and are responsible for their learning through preclass studying and team work with other classmates. Evaluation of the TBL method by students provides information for its better implementation. Due to extensive use of TBL method in medical curriculum at medical universities, we aimed to develop a questionnaire for its evaluation from the viewpoints of students.

MATERIALS AND METHODS:
This mixed-method cross-sectional study with a Qual-Quan design was conducted on 168 medical students in the basic sciences stage of their studies. We evaluated students’ satisfaction with this teaching method and its effectiveness by semistructural in-depth individual interviews until data saturation (12 interviews). We performed content analysis of the interviews and designed the questionnaire. Psychometric characteristics of the questionnaire were assessed in terms of content validity, test-retest reliability, internal consistency, and construct validity through explanatory factor analysis.

RESULTS:
The final tool was a 25-item questionnaire (reliability = 0.87 and α = 0.93) with five components of “learning enhancement,” “satisfaction,” “technical aspects,” “teacher’s capabilities,” and “appropriate testing.” Explanatory factor analysis showed that 64.68% of total variances were explained by these five components.

CONCLUSION:
In addition to academic performance outcomes, a successful instructional strategy should generate positive experiences for the learner. This study has created an assessment tool to be part of an evaluation process of the effectiveness of TBL in a given curriculum for medical students.
A cross-sectional study to estimate the prevalence of eating disorders and ascertain factors for eating disorder risk among senior college students in a metropolitan city
Authors: Hadaye Rujuta S. , Rahini S 
Published: September 2024

BACKGROUND:
Eating disorders are more prevalent in Western countries and their prevalence is on the rise in India, mainly due to peer pressure and the influence of media. However, research on eating disorders is limited in India. The aim of this study is to estimate the prevalence of eating disorders among senior college students and to ascertain factors for eating disorder risk.

MATERIALS AND METHODS:
A cross-sectional study was conducted among 807 students attending 2 of the arts and science colleges in a metropolitan city (Mumbai) over a period of 12 months from June 2019 to June 2020. A predesigned case record form was used to collect information on sociodemographic profiles and other factors related to eating disorder risk. Eating Attitude test (EAT-26) was used as a screening test to find the prevalence of those at risk for eating disorders. Munich-ED quest was used for the diagnosis of the eating disorder.

RESULTS:
Data were analyzed using SPSS version 16.0. The Chi-square test was used to find the association of various factors with eating disorder risk. Our study found the overall proportion of eating disorder risk to be 42.25%. Among them, 19 (2.35%) individuals had night eating syndrome and 7 (0.86%) had binge eating syndrome as per DSM-5 criteria using Munich ED Quest. On logistic regression, we found fasting once or twice a week (OR: 2.916;95%CI: 1.524–5.574; P = 0.001), increase in duration of physical activities for more than 10 h a week (OR: 3.874; 95% CI: 2.200–6.821; P < 0.001), being commented for weight by friends/relatives (OR: 1.695; 95% CI: 1.244–2.309; P = 0.001), and thought of being overweight (OR: 1.763;95% CI: 1.178–2.639; P = 0.006) to be significantly associated with risk of eating disorders. The age group of 18–20 years (OR: 0.519;95%CI: 0.345-0.782; P = 0.002) was found to be at lower risk for eating disorders compared to the 22–24 year age group.

CONCLUSION:
Screening of students with a simple tool like EAT-26 would prove beneficial in the early identification of those at risk of eating disorders.
Correlation between moral distress and compassion fatigue in the emergency department nurses: A cross-sectional study from Ardabil Province, Iran
Authors: Karimollahi Mansoureh , Mazaheri Effat , Khangah Hassan Almaspoor , Pourhamzeh Sulmaz 
Published: September 2024

BACKGROUND:
Nurses working in the emergency department increasingly face moral distress due to the nature of their profession, negatively affecting their love and compassion toward the patient. Therefore, this study sought to determine the correlation between moral distress and compassion fatigue in the nurses of the emergency departments of the hospitals in Ardabil.

MATERIALS AND METHODS:
The current cross-sectional (descriptive correlational) study was conducted using consensus sampling. The study population comprised all nurses working in the emergency departments of hospitals in Ardabil in 2022. Data were gathered using two standard questionnaires, comprising compassion fatigue by Figley (2002) and moral distress by Hamric et al. (2012). The data were analysed using SPSS-20 software and descriptive and inferential statistics, including independent T-test, Pearson’s correlation coefficient, and one-way ANOVA.

RESULTS:
Moral distress was higher than average in governmental hospitals (2.12±0.58) and below average in private and social security hospitals (1.72±0.68). Besides, the nurses' compassion fatigue was lower than average in all studied hospitals (2.17±0.43). There was also a significant positive correlation equal to 0.29 between moral distress and compassion fatigue in emergency department nurses (P<0.01).

CONCLUSION:
According to the results, the higher the level of moral distress, the greater the compassion fatigue. The level of moral distress and its relationship with compassion fatigue reflects the impact of conditions causing moral distress on the quality of care and the necessity to prevent such conditions by providing appropriate solutions. Informing nurses about moral distress and its consequences and providing periodic counseling can contribute to its identification and control.
Effect of hypnosis on anxiety and blood pressure of pregnant women with preeclampsia: A double-blind controlled clinical trial study
Authors: Seitz Farzaneh , Pourasghar Mehdi , Hosseinnataj Abolfazl , Hoseinnezhad Seydeh Zeynab , Eshraghi Nooshin , Ganji Jila 
Published: September 2024

BACKGROUND:The risk is on the level of blood pressure, and blood pressure is one of the prominent characteristics of preeclampsia. The aim of this study is to assess the effect of hypnosis on the pressure and blood pressure of pregnant women with preeclampsia.MATERIALS AND METHODS:In this controlled clinical trial study, 44 pregnant women from 20 to 32 weeks referred to Shahid Akbarabadi Hospital in Tehran in 2022 were randomly assigned to two intervention and control groups. Hypnotherapy was conducted individually and online for five sessions. Evaluation of performance and blood pressure (primary outcome) was done using the DASS-21 questionnaire and sphygmomanometer before, during maintenance, and 4 weeks after the intervention. Twenty people in each group entered the analysis stage. Independentt-test, Chi-square, analysis of variance with repeated measures and mixed model were used, and effect size (Cohen’s D) was used to evaluate the strength of the intervention effect. The data were entered into the SPSS software version 22 and a significance level of 0.05 was considered.RESULTS:The results showed that the two groups did not differ in terms of background changes (P= 0.757). The score after the intervention decreased by 10.25 (P< 0.001) and the time 1 month after the intervention decreased by 9.93 (P< 0.001). The blood pressure after the intervention was reduced by 7.90 (P< 0.001) and the blood pressure 1 month after the intervention by 7.52 (P< 0.001).CONCLUSION:It is suggested to use hypnotherapy as a complementary treatment to reduce anxiety and preeclampsia symptoms.
Exploring empathy among undergraduate nursing students at universities in India and South Africa
Authors: Aranha Priya Reshma , Chacko Leena K. , Bimray Portia , Chipps Jennifer 
Published: September 2024

BACKGROUND:
Empathetic involvement is an essential ingredient in forming a therapeutic nurse–patient relationship, which would lead to more optimal patient care. It is one of the essential professional values possessed by nurses. This study aimed to assess empathy among nursing students at two universities on different continents.

MATERIALS AND METHODS:
This was a cross-sectional online questionnaire-based study conducted among the Bachelor of Science (BSc) nursing students at Yenepoya Deemed to be University (YU), India, and the University of the Western Cape (UWC), South Africa. A total of 377 students from India and 245 students from South Africa voluntarily took part in the study. The study participants were selected based on convenience sampling techniques. A sociodemographic proforma and the Jefferson Scale of Empathy were used to collect the data. An analysis of variance (ANOVA)/t-test was computed to compare the empathy between students at two universities. The level of significance was fixed at a probability of <0.05.

RESULTS:
On the statistical analysis, it was shown that respondents from both settings showed a higher level of empathy. Overall, students at UWC showed higher empathy scores than those at YU (P < 0.05). Empathy scores of students from UWC did not differ significantly based on their age, year of study, and ethnicity, whereas empathy scores showed significant differences for students from YU in terms of gender, year of study, and religion (P < 0.05).

CONCLUSION:
In this study, the majority of respondents from both settings showed a higher level of empathy. Though students demonstrated high level of empathy, nurse educators need to pay more attention to value training, during undergraduate education for preparing the nurses to work in today’s complex healthcare context.
Academic success of students with low socioeconomic status: Explanation and evaluation of a model with a mixed-methods approach
Authors: Seyyedmoharrami Iman , Kareshki Hossein , Kimiaei Seyed Ali , Bordbar Maryam 
Published: September 2024

BACKGROUND:
In this research, a model of factors affecting students’ academic success with low socioeconomic status (SES) was explained and evaluated.

MATERIALS AND METHODS:
A mixed-methods research design was used to explain academic success and evaluate it. From this point of view, the research was divided into two parts: grounded theory (GT) and structural equation modeling (SEM). For the qualitative part, semi-structured interviews were held with 49 students, parents, and teachers from Roshtkhar City, one of the less privileged areas of the department of education in Razavi Khorasan Province in Iran. In the second part, this model was tested using the multistage cluster random sampling method on 314 students from Roshtkhar City with the SEM method. The instrument used in the quantitative section was a researcher-made questionnaire whose validity and reliability have been confirmed.

RESULT:
It was found that the causal conditions had significant effects on the phenomenon of the academic positive perspective of students with low SES (β = 0.77), academic positive perspective on the implementation of academic success strategies in low SES areas (β = 0.6), context background on the implementation of strategies (β = 0.28), intervening conditions on the implementation of strategies (β = 0.12), and implementation of interactions and strategies of students with low SES on the consequences of academic success (β = 0.86). The phenomenon of academic positive perspective clarified the complexity of the academic success of students with low SES.

CONCLUSION:
The examined paradigm model can be a suitable model for the academic success of students with low SES.