bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of co-morbid insomnia and obstructive sleep apnoea
Authors: Thorve Swapnil Manaji , Yadav Manish , Kamath Anjali Arvind , Nair Jairaj Parmeswaran 
Published: July 2024

ABSTRACT

Introduction:
The coexistence of insomnia and obstructive sleep apnea (OSA) poses a complex and challenging clinical scenario, commonly referred to as comorbid insomnia and OSA (COMISA). The bidirectional relationship between these two sleep disorders is explored, illuminating how the presence of one can exacerbate the severity and manifestations of the other. We under took this study to understand the prevalence of COMISA in Indians which is never studied.

Aim:
To study the prevalence of COMISA in tertiary hospital in India.

Methods:
All OSA patients diagnosed with polysomnography were interviewed with insomnia severity index. Patients having score of more than 15 were considered to have insomnia. Demographic factors, clinical and physical examination and polysomnography values were noted.

Results:
25% of 64 patients were diagnosed to have COMISA. Female gender, BMI, and STOP BANG score had positive association with COMISA, whereas age was not associated with increased risk.

Conclusion:
COMISA can be more complex to diagnose and manage than insomnia or OSA alone. The symptoms and mechanisms of each condition have synergistic effect and is a barrier to treating COMISA.
Evaluation of Apo A IV and Haptoglobin as Potential CSF Markers in Patients with Guillain-Barre´ Syndrome: A Cross-Sectional Study
Authors: Tiwari Rajlaxmi , Saharia Gautom K , Bhoi Sanjeev K , Mangaraj Manaswini 
Published: July 2024

Background:
Brain- and blood-derived protein analysis in the cerebro-spinal fluid (CSF) in various studies performed abroad found that some proteins and their isoforms were altered significantly in Guillain-Barre´ syndrome (GBS) patients in comparison to controls. However, data are lacking in India with respect to the blood- or brain-derived proteins in patients of GBS.

Objective:
This study aimed to identify the role of apolipoprotein A IV (Apo A IV) and haptoglobin as potential protein markers in CSF of patients with GBS in our population.

Materials and Methods:
The study comprised 28 participants where 12 confirmed cases of GBS and 16 control subjects admitted for non-infectious neurological disorders were recruited after obtaining approval from the Institutional Ethics Committee. CSF glucose, protein, and adenosine deaminase were analyzed using an autoanalyzer. The concentrations of Apo A IV and haptoglobin were estimated with enzyme-linked immuno-sorbent assay (ELISA) kits.

Results:
The CSF protein concentrations of cases were higher as compared to controls. The concentrations of haptoglobin and Apo A IV were higher in the confirmed cases of GBS as compared to the control subjects, and this difference was found to be significant. The receiver operating characteristic curve analysis for haptoglobin revealed that the area under the curve (AUC) was 0.867 (95% CI: 0.732–1.001), with a sensitivity of 83.8% and a specificity of 63.3%. The AUC for Apo A IV was 0.883 (95% CI: 0.758–1.009), with a sensitivity of 91.7% and a specificity of 73.3%.

Conclusions:
Haptoglobin along with Apo A IV can emerge as a potential biochemical marker in CSF for the diagnosis of GBS.
Clinicopathological Features of Amyloid Neuropathy: A Four Decade Experience
Authors: Unchagi Asha , Rao Shilpa , Nagappa Madhu , Nandeesh Bevinahalli N. , Yasha Thagadur Chickabasavaiah , Taly Arun B , Mahadevan Anita 
Published: July 2024

Background:
Peripheral neuropathy is one of the manifestations of primary or familial amyloidosis. Published studies from India are limited.

Materials and Methods:
We reviewed the clinical and pathological features of amyloid neuropathy diagnosed at our Institute over the last 39 years.

Results:
Fifty-five cases of amyloid neuropathies were diagnosed between 1981 and 2019, constituting 0.28% of peripheral nerve biopsies (55/19,081). Age at presentation ranged from 24 to 81 years (mean—48 years) with male preponderance [M:F = 3.58:1]. Duration of symptoms at presentation varied from 3 months to 10 years (mean—2.31 years). Majority presented with small fiber neuropathy (85%). Pure sensory symptoms predominated in 23%, while 72% had sensorimotor neuropathy and 35.8% had autonomic involvement, with isolated autonomic failure in one patient. Amyloid neuropathy was clinically suspected in 22.6% of nonfamilial cases. Familial amyloid neuropathy was suspected in eight patients. Genetic testing detected ATTR and gelsolin mutation in one each of tested patients. Nerve biopsies revealed characteristic birefringent amyloid deposits stained mahogany brown by Congo red predominantly surrounding endoneurial microvessels (34.5%), also in perineurium and epineurium in 25.45% cases. Preferential loss of small diameter myelinated fibers was noted. Axonal degeneration or regeneration was conspicuously absent.

Conclusion:
Amyloid neuropathy is uncommon (0.28% of nerve biopsies in our series). Nerve biopsy is essential for the diagnosis. We report our experience of amyloid neuropathy and underscore the importance of making an assiduous search for amyloid deposits in the appropriate setting. Awareness of this entity is important for early diagnosis in the light of emerging therapeutic advances.
Two-Point Discrimination for Upper Extremity and Face in Healthy Young Adults: A Cross-Sectional Study
Authors: Seyyar Gulce Kallem , Aras Ozgen , Aras Bahar , Turkmen Utku 
Published: July 2024

Background and Aim:
The threshold values of two-point discrimination (TPD) provide a numerical measure of tactile acuity. Normal reference values are needed to decide whether sensory variability is within normal sensorial limits. The study aimed to determine the upper extremity and face threshold values in healthy young adults.

Materials and Methods:
Static TPD thresholds of 67 healthy young adults aged 18–35 years were assessed. Eight skin areas in the face and upper extremity on the dominant side were assessed using a “method of limits” approach with an aesthesiometer. Differences between genders were examined with the Mann–Whitney U test. The Spearman correlation analysis investigated the relationship between age and TPD measurements.

Results:
TPD values ranged between 4.66 and 19.16 mm and 1.33-68.66 mm in the face and upper extremity, respectively, in the participants with a mean age of 23.83 ± 4.66 years. Fingertips and the area over the lateral mandibula showed the greatest sensitivity. The threshold values of TPD showed both interindividual and intraindividual variability. There was no statistical difference in the TPD values according to gender in any of the measured areas, and there was no relationship between age and TPD test values.

Conclusions:
The threshold values of TPD have clinical applicability in various diseases affecting the sensation of the upper extremity and/or face. These data may help the detection of early sensory loss.
Incidence of Rebleed Following Cerebrospinal Fluid (CSF) Drainage in Poor Grade Subarachnoid Hemorrhage: An Institutional Experience
Authors: Sawarkar Dattaraj P. , Singh Pankaj K. , Nandish HS , Sharma Rajeev , Kedia Shweta , Meena Rajesh , Kumar Rajinder 
Published: July 2024

Background:
The outcome of poor grade subarachnoid hemorrhage (SAH) is dismal. Some of these patients need cerebrospinal fluid (CSF) drainage procedure for the hydrocephalus and intraventricular hemorrhage (IVH) which may precipitate rebleeding. However, aneurysmal rebleed following CSF drainage procedure is controversial.

Objective:
Our study aimed at analyzing the effect of CSF drainage procedure on aneurysmal rebleeding.

Material and Methods:
We retrospectively analyzed the records of all the consecutive patients diagnosed with poor grade aneurysmal SAH over three year period. Patients initially requiring either external ventricular drainage (EVD) or lumbar drain (LD) were included in the study group, and the rest (not requiring drainage) were included in the control group. Rebleeding was confirmed on computed tomography. The factors affecting rebleeding were analyzed.

Results:
Overall 194 patients with poor grade SAH were enrolled in the study (91 males: 103 females; mean age: 50.6 years). The study group had 91 patients (83 EVD and 8 LD) while 103 patients were in the control group. Posterior circulation aneurysms, poor grade SAH, hydrocephalus, and IVH were more common in the study group P < 0.001. The rebleeding rate was 7.6% in the study group and 8.7% in the control group. On univariate analysis size >1 cm, multiplicity, multilobularity, vasospasm, and CSF drainage were significant risk factors for rebleeding (P < 0.001). On multivariate analysis aneurysm size >1 cm, CSF overdrainage >250 ml/day were significantly associated with risk of rebleeding.

Conclusion:
Ventricular drainage is essential to relieve acute hydrocephalus and drain IVH in SAH and we found no significant association between CSF drainage and rebleeding. However, rapid overdrainage of CSF can lead to aneurysm rupture, hence controlled controlled CSF drainage should be undertaken.
Comparison of Change in the Pulsatility Index before and after Ventriculoperitoneal Shunt Surgery in Adult Patients with Hydrocephalus
Authors: Deepak G. P. , Pandia Mihir Prakash , Dube Surya Kumar 
Published: July 2024

Background and Aim:
In hydrocephalus patients, after ventriculoperitoneal (VP) shunt, decrease in pulsatility index (PI) correlates with decrease in ventricle size. Also, increase in PI is noted in obstructed or malfunctioning VP shunts. However, previous studies were either done in infants and children or included patients of all age groups. Our aim was to compare PI before and after successful VP shunt surgery in adult patients and also the trend of transcranial Doppler (TCD) parameters for 3 days after surgery.

Materials and Methods:
A prospective, observational study was done in 20 adult patients undergoing VP shunt. Clinical features, vitals, Evans index, and TCD parameters were noted in the preoperative period. A computed tomography (CT) head was repeated 4–6 h after surgery, and the position of ventricular end of shunt was confirmed and Evans index was calculated. The vitals and TCD parameters were noted at same time and for the next 2 days. Repeated measures analysis of variance (ANOVA) and paired t-test were uses for statistical analysis.

Results:
A total of 18 patients were included for statistical analysis. The mean preoperative PI was 1.19 ± 0.24 and the postoperative PI after surgery was 0.97 ± 0.17, 0.97 ± 0.23, and 0.94 ± 0.21 (P = 0.0039) on postoperative day (POD) 1 (POD1), POD2, and POD3, respectively. The mean preoperative value of Evans index was 0.37 ± 0.06 and there was statistically significant (P = < 0.001) reduction to 0.33 ± 0.07 after VP shunt surgery. The change in PI and change in Evans index were found to be positively correlated (r = 0.34 and P = 0.0013).

Conclusions:
The decrease in PI after VP shunt surgery correlates with decrease in ventricular size. Any increase in PI in the postoperative period should raise the suspicion of malfunctioning of VP shunt.
An Incidental Study of the Effects of COVID-19 Lockdowns on the Muscle Strength of Patients with Postpolio Syndrome: Do These Patients Need a Break?
Authors: Tanigor Goksel , Cinar Ece , Darilgen Atinc , Kancay Mustafa Sedat , On Arzu Yagiz 
Published: July 2024

ABSTRACT

Introduction:
This study was designed before the emergence of the COVID-19 pandemic, to assess the annual changes in muscle strength in relatively young Turkish people with postpolio syndrome (PPS). After we completed the baseline measurements, the COVID-19 pandemic emerged and lockdowns followed right after. Thus, the purpose of the study turned to how these lockdowns, which induced a sedentary lifestyle, have affected muscle strength in participants with PPS compared to healthy controls.

Materials and Methods:
This study included 49 hip joints (21 PPS vs. 28 healthy controls) and 51 knee joints (23 PPS vs. 28 healthy controls). Concentric isokinetic testing of bilateral hip and knee muscles was performed in all participants with PPS and controls just before the outbreak of the COVID-19 pandemic. The measurements were repeated after 1 year of lockdowns.

Results:
Perceived physical activities were reported to be decreased by 35.9% and 32.2% in participants with PPS and controls, respectively. No significant changes were observed in muscle strengths, and these changes did not differ between PPS and healthy controls.

Conclusion:
This is the first and possibly the only study to show that the muscle strengths of participants with PPS did not change significantly during 1 year of physical restraints due to the COVID-19 pandemic. These findings may support the basic principle in the rehabilitation of participants with PPS, which includes conserving energy and avoiding the overuse of muscles. However, more data from studies with a larger number of participants and longer follow-ups, which will hopefully never happen again in a situation like this, are required to draw a conclusion.
The effect of Dracocephalum subcapitatum hydroalcoholic extract on dexamethasone-induced hyperlipidemic rats
Authors: Safaeian Leila , Yazdiniapour Zeinab , Hajibagher Sara , Bakhtiari Zohreh , Karimian Paridokht 
Published: July 2024

Background and purpose:
Recent data show the antihyperlipidemic activities of some plants belonging to the genus Dracocephalum. In this study, the effects of hydroalcoholic extract of D. subcapitatum (O. Kuntze) Lipsky aerial parts were evaluated in a model of hyperlipidemia induced by dexamethasone.

Experimental approach:
The extract was prepared by maceration method and its total phenolic content was determined. Seven groups of 6 Wistar rats were used as follows: group 1 (normal control) received vehicle; group 2 (extract control) treated only with 200 mg/kg D. subcapitatum; group 3 (hyperlipidemia control) received dexamethasone (10 mg/kg/day, subcutaneously); group 4 (reference) received dexamethasone and atorvastatin (40 mg/kg, orally), and groups 5-7 (test groups) received dexamethasone and simultaneously treated orally with 50, 100, or 200 mg/kg D. subcapitatum. All treatments were done for 1 week. Serum lipid profile, fasting blood glucose, malondialdehyde concentration, and liver histopathology were examined.

Findings/Results:
Total phenolic content was 77.34 ± 4.9 mg/g as gallic acid equivalent. Treatment with D. subcapitatum (200 mg/kg) meaningfully declined triglycerides, total cholesterol, low-density lipoprotein, very low-density lipoprotein, blood glucose, alanine aminotransferase, aspartate aminotransferase, and malondialdehyde levels, and alleviated hepatic steatosis in dexamethasone-induced dyslipidemic rats.

Conclusion and implications:
Findings of the current study suggest that D. subcapitatum may be effective in the management of hyperlipidemia. Further studies are necessary to determine the clinical efficacy of this treatment and to understand the underlying mechanisms responsible for its ability to lower lipid levels.
The enhancement of M13 phage titration by optimizing the origin of replication
Authors: Darvishali Mohammad Hossein , Fadaie Mahmood , Khanahmad Hossein 
Published: July 2024

Background and purpose:
M13KO7, a modified M13 phage variant, carries the p15A replication origin and Tn903 kanamycin resistance gene. This study aimed to optimize M13KO7's replication by substituting the p15A origin with the higher-copy pMB1 origin (500-700 copy numbers).

Experimental approach:
A 6431-nucleotide fragment from the M13KO7 plasmid lacking the p15A replication origin and kanamycin resistance gene was amplified using a long polymerase chain reaction (PCR). The modified M13AMB1 plasmid was created by adding adenine to the 3’ ends of this fragment and ligating it to the pMB1-containing fragment using T/A cloning. Afterward, to prepare the phage, pM13AMB1 was transformed into E. coli TG1 bacteria, and then, using the PEG-NaCl precipitation, the modified phage was propagated. The modified phage titer was determined utilizing the serial dilution and the qPCR methods, compared with the M13KO7 phage.

Findings/Results:
The results showed that in the serial dilution method, the titers of modified phage and M13KO7 phage were 4.8 × 1014 and 7 × 1012 pfu/mL, respectively. Besides, the phage titer calculated by the qPCR method for the modified phage was equal to 1.3 × 109 pfu/mL, whereas it was 4.08 × 108 pfu/mL for the M13KO7 phage.

Conclusion and implications:
This study provides evidence that replication origin replacement led to a significant increase in phage titers. It highlights the importance of replication optimization for molecular biology applications.
The enemy at the gate: Botulism
Authors: Taşkın Ömer , Akpınar Ayça Açıkalın 
Published: July 2024

Abstract
Botulism, caused by Clostridium botulinum, continues to pose a significant threat to public health. This review explores the historical context and contemporary relevance of botulism, emphasizing its potential lethality and evolving medical applications. In recent years, the use of botulinum toxin in medical procedures, particularly in cosmetic and therapeutic applications, has increased the risk of iatrogenic botulism. The rise in iatrogenic cases underscores the importance of vigilance among health-care providers, especially those in emergency departments, where prompt diagnosis and intervention are critical. This review underscores the necessity for health-care professionals to consider botulism in the differential diagnosis of patients presenting with relevant symptoms, given the potential severity of the condition.
Assessment of Macular Thickness in Different Grades of Myopia: An Optical Coherence Tomography Study in a Rural Tertiary Care Hospital
Authors: Pooja H. V. , Devarmani Suman 
Published: July 2024

AbstractBackground:Myopia is a condition related to the refractive error that causes visual disability. Due to its high prevalence, it can contribute to complicated cataracts and related conditions such as primary open-angle glaucoma. The risks of retinal detachment, chorioretinal atrophy, pigmentary degeneration, vitreous degeneration and retinal breaks may increase with an increase in axial length and severity of myopia, among other long-term effects of high myopia. The aim of this study was to assess the role of macular thickness and myopia in non-invasive optical coherence tomography (OCT).Materials and Methods:This was a prospective, hospital-based observational study conducted for 18 months in a tertiary care centre in Karnataka. A total of 155 consecutive myopia patients aged ≥10 years attending the outpatient Department of Ophthalmology were included in the study. The data were analysed using the Statistical Package for Social Sciences (SPSS) for Windows, version 22.0 (SPSS Inc., Chicago).Result:The participants aged from 10 to 75 years with a female preponderance of 60%. The mean age of participants is 31.95 yrs. The majority of the patients had mild myopia (91.6%), compared with moderate (5.8%) and high (2.6%) myopia. The mean value of best-corrected visual acuity improved from 0.67 to 0.08 in high, 0.94 to 0.22 in mild and 0.71 to 0.26 in moderate myopia patients. The mean maximum retinal thickness was 472 micrometres, and the mean minimum retinal thickness was 178 micrometres.Conclusion:There is a high prevalence of mild myopia cases, especially at extremes of age. Myopia was more common among females. There was a significant difference among different classes of myopia with respect to uncorrected and best-corrected visual acuity. The parafovea was thinner and the fovea thicker among myopia.
Prognostic analysis of endovascular treatment for acute lower limb ischemia in patients older than 80 years of age
Authors: Li Dazhi , Xiao Yu , Liu Qing , Xu Jinyan , Yuan Liangxi 
Published: July 2024

BACKGROUND AND OBJECTIVES:
Current treatment strategies for elderly patients with acute lower limb ischemia (ALLI) have no definitive effect, and studies have reported no definitive prognostic factors that reflect poor outcomes among patients with ALLI. Therefore, reliable clinical indicators that can accurately predict outcomes and guide the choice of treatment options are needed. This study aimed to identify prognostic factors among the elderly patients who underwent endovascular treatment for ALLI.

DESIGN:
Retrospective.

MATERIALS AND METHODS:
From January 2011 to December 2020, 270 patients (281 limbs; 124 males; mean age: 84.8 years [range, 80–102 years]) underwent endovascular therapy for ALLI, including acute limb arterial embolism (191 limbs) and acute exacerbation of chronic ischemia (90 limbs). Factors identified through univariate analysis (P < 0.1) and other variables considered likely to have important prognostic value were tested in a logistic regression model for symptom improvement, major amputation, and all-cause mortality.

RESULTS:
The mean age of the patients was 84.8 years, 54.1% were female, and hypertension (69.0%) was the most common coexisting disease. Patients in the acute group exhibited higher rates of atrial fibrillation (45.5% vs. 24.4%; P = 0.001) and chronic renal failure (15.2% vs. 6.7%; P = 0.044) than the acute-on-chronic group. The acute group exhibited significantly higher plasma D-dimer levels than the acute-on-chronic group (1.59 vs. 1.06; P < 0.001). In the acute group, 145 (75.9%) limbs had preacute Rutherford Classification (RC) of Grade I. In the acute-on-chronic group, 47 (52.2%) limbs had symptom duration of 7–14 days, and 84 (93.3%) limbs were diagnosed with arteriosclerosis obliterans. Most patients opted for antiplatelet therapy, particularly those in the acute-on-chronic group. Multivariate logistic regression analysis revealed that onset time, hypertension, white blood cell (WBC) count, and lesion nature were independent factors for postoperative symptom improvement, whereas hypertension, WBC count, and preacute RC grade were independent factors for amputation at 3 months postoperatively.

CONCLUSIONS:
WBC count was a major risk factor for postoperative symptom improvement and amputation within 3 months among elderly patients; the higher the WBC count, the higher the risk for amputation. In addition, among patients >80 years of age, early surgery could significantly improve the prognosis of ALLI, regardless of the procedure used to restore blood supply.
Countering Nazism rehabilitation and Fascist ideology formation: history lessons and modern realities
Authors: Козаев Н.Ш. , Рясов Д.А. 
Published: July 2024

В статье исследуются ключевые аспекты Стратегии национальной безопасности России в контексте противодействия реабилитации нацизма и формированию фашистской идеологии. Предпринят анализ исторических факторов, обусловивших возникновение фашистской идеологии, а также основных мер по противодействию современным формам неофашизма. Сформулированы важные направления криминологического противодействия реабилитации нацизма и формированию нацистской идеологии.
The article considers key aspects of Russia’s National Security Strategy in the context of countering Nazism rehabilitation and fascist ideology formation. The authors analyze historical factors that led to the fascist ideology emergence, as well as the main measures to counteract modern forms of neo-fascism. The important directions of criminological counteraction to Nazism rehabilitation and Nazi ideology formation are formulated.