bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asleep surgery for deep brain stimulation of the globus pallidus internus in pediatric dystonia associated with KMT2B mutation
Authors: Nurimanov Chingiz , Menlibayeva Karashash , Aidarov Seitzhan , Mammadinova Iroda , Nurakay Nurtay 
Published: August 2024

Abstract
Pediatric dystonia refers to the onset of dystonia before the age of 21 years. Accurate diagnosis through genetic testing and precise electrode placement may significantly improve motor symptoms and quality of life of patients with gene-associated dystonia. This report presents a rare KMT2B-related dystonia case managed with bilateral pallidal deep brain stimulation (DBS) in an 8-year-old girl. The patient presented with muscle contractions on the distal parts of the lower limbs, speech impairment, and myoclonic jerking movements. Genomic sequencing identified a heterozygous mutation in the KMT2B gene (617284 on chromosome 19p13). In this case, DBS of the globus pallidus internus was performed under general anesthesia. Six months post-surgery, the Burke–Fahn–Marsden scale scores indicated a 46% improvement, and the scores for the Unified Dystonia Rating Scale and Global Dystonia Severity Rating Scale showed 50% and 28% improvements, respectively. Accurate diagnosis of KMT2B-related dystonia holds significant value in terms of guiding appropriate treatment as the disease is responsive to DBS surgery targeting the globus pallidus internus. This case illustrates the benefits of DBS in pediatric patients and its role in advancing surgical interventions for dystonia.
Onconeural antibody-associated cerebellar ataxia: An analysis
Authors: Mahale Rohan , M Sandeep , Mahadevan Anitha , Kamble Nitish , Holla Vikram , Pal Pramod K. , Yadav Ravi 
Published: August 2024

Abstract

BACKGROUND:
Cohort-based studies on onconeural antibody-associated cerebellar ataxia (CA) investigating the immunological and radiological spectrum as well as functional outcomes are limited.

OBJECTIVE:
To study the clinical, radiological, and immunological spectrum, as well as the treatment profile and outcomes, of onconeural antibody-associated CA.

METHODS:
A retrospective descriptive analysis was performed for a cohort of patients who presented with CA and had positive onconeural antibodies in serum. The clinical, radiological, and immunological spectrum and the treatment profile and outcomes of the patients were analyzed.

RESULTS:
Thirty-two patients were diagnosed with onconeural antibody-associated CA and were selected for our analysis. Eighteen patients (56%) had anti-Yo, seven (22%) had anti-Zic4, four (12.5%) had anti-CV2/CRMP5, two (6.25%) had anti-Hu, and one had anti-PCA-2 antibodies. The median duration of illness was 4 months (interquartile range (IQR): 3–6 months). Twenty-eight patients had pancerebellar syndrome. The mean score of the Scale for the Assessment and Rating of Ataxia (SARA) was 23.9 ± 5.2 (range: 16–34; median: 26). Bilateral cerebellar atrophy was observed in 24 patients (75%). Four patients with anti-Yo antibodies had breast lesions on screening at the time of admission. Two patients with anti-Yo antibodies had carcinoma ovary at 1-year follow-up. The median modified Rankin scale (mRS) score at admission was 4. Twelve patients underwent a 6-month follow-up (37%) and eight had a 1-year follow-up. Favorable outcomes (mRS scores ≤ 2) were observed in five patients (42%), whereas poor outcomes were observed in seven patients (58%).

CONCLUSION:
CA was most commonly caused by anti-Yo antibodies, followed by anti-Zic4 antibodies. Patients with anti-Zic4 antibodies had the lowest mean SARA score and the most favorable functional outcome. Patients with anti-Yo had poor functional outcomes with immunotherapy.
Burden of non-motor symptoms in Parkinson’s disease and atypical parkinsonism syndromes: A single-center cross-sectional comparison study
Authors: Barad Narendra , Asole Dnyaneshwar , Thakre Mahendra , Sankhla Charulata 
Published: August 2024

Abstract

BACKGROUND:
Non motor symptoms (NMS) in idiopathic Parkinson’s disease (IPD) and atypical Parkinsonism (APD), are common. There are very few Indian studies addressing the frequency and burden in APD. Hence, this study aimed to investigate the frequency and burden of NMS in Indian patients with APD, compared with IPD and controls.

OBJECTIVES:
1) To examine the clinical characteristics and burden of NMS in patients with APD, 2) To compare the frequency, and burden of NMS between typical and atypical Parkinsonism.

METHODS:
The study had total 114 participants, with 42 APD, 44 IPD patients meeting the standard diagnostic criteria and 28 age and sex matched healthy controls. The Non-Motor Symptoms scale (NMSS) was used to assess the frequency and burden of non-motor symptoms associated with parkinsonian disorders.

RESULTS:
The frequency and burden of NMS, across all domains, are highest (p < 0.05) in patients with atypical Parkinsonism compared to those with IPD and the control group. In the APD group, the most common NMS reported was sexual dysfunction (85%), followed by urinary urgency (72.5%), fatigue, lack of motivation, and nocturia (67.5%). The most common NMS reported in IPD patients were sexual dysfunction (81%), fatigue (70.45%), and constipation (68.18%). Restless legs symptoms were significantly more prevalent in the IPD group (p ≤ 0.05). The mean total NMS score was also significantly higher in APD patients (p ≤ 0.05).

CONCLUSION:
The frequency and burden of NMS, across all domains, are higher in patients with APD group.
Efficacy and safety of ciprofol versus propofol for induction of general anaesthesia or sedation: A systematic review and meta-analysis of randomised controlled trials
Authors: Saeed Abdallah , Elewidi Mariam , Nawlo Ahmad , Elzahaby Amr , Khaled Asmaa , Othman Abdalla , Abuelazm Mohamed , Abdelazeem Basel 
Published: August 2024

Background and Aims:
Propofol has been used in medical practice as an anaesthetic drug for producing and sustaining general anaesthesia due to its advantages. However, it also has drawbacks, including injection-related discomfort. Recently, ciprofol has emerged as a promising anaesthetic drug that may overcome many drawbacks associated with propofol. In this systematic review and meta-analysis, we assess the efficacy and safety of ciprofol compared to propofol in different anaesthesia procedures.

Methods:
The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42023458170). Central, PubMed, EMBASE, Scopus and WOS were searched for English literature until 26 February 2024. Meta-analysis was performed using RevMan. The risk of bias was assessed using the RoB 2.0 tool. Results were reported as risk ratios (RRs), mean differences (MDs) and 95% confidence intervals (CIs).

Results:
Nineteen randomised controlled trials were included in our analysis, with 2841 participants. There was no difference between ciprofol and propofol in the success rate of endoscopy (RR: 1.01, 95% CI: 0.99, 1.02; P = 0.44), while ciprofol showed a significant increase in the success rate of general anaesthesia/sedation (RR: 1.01, 95% CI: 1.00, 1.02; P = 0.04). Ciprofol showed significantly lower pain on injection (RR: 0.14, 95% CI: 0.09, 0.22; P < 0.001), lower adverse events (RR: 0.80, 95% CI: 0.69, 0.92; P = 0.002) and higher patient satisfaction (standardised mean difference (SMD): 0.36, 95% CI: 0.24, 0.48; P < 0.001).

Conclusion:
Ciprofol exhibited a comparable efficacy to propofol in inducing general anaesthesia and sedation with fewer adverse events, less pain on injection and higher patient satisfaction. These collective findings may suggest that ciprofol can be used as an alternative drug to ensure effective general anaesthesia/sedation induction in the future.
Comparison of aprepitant versus ondansetron for prevention of postoperative nausea and vomiting: A systematic review and meta-analysis with trial sequential analysis
Authors: Singh Madhusudan P. , Gurunthalingam Meenalotchini P. , Gupta Ayushee , Singh Juhi 
Published: August 2024

Background and Aims:
Postoperative nausea and vomiting (PONV) is a common complication after surgery. Preventing PONV in high-risk patients often requires a multimodal approach combining antiemetic drugs with diverse mechanisms. While aprepitant, a neurokinin-1 receptor antagonist, is recognised as highly effective for PONV prevention, uncertainties remain regarding its effectiveness.

Methods:
This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The analysis assessed the effectiveness of aprepitant (A), aprepitant plus ondansetron (AO) and aprepitant plus dexamethasone and ondansetron (ADO) in preventing PONV compared to ondansetron alone (O) or in combination with dexamethasone (DO).

Results:
In the analysis of 12 studies involving 2729 patients, aprepitant demonstrated significant efficacy in preventing PONV compared to ondansetron alone (A versus [vs.] O: PONV incidence 12.5% vs. 28.5%, relative risk [RR] = 0.45, P < 0.001; complete response rate 55.97% vs. 50.35%, RR = 1.13, P = 0.010). The combination of aprepitant with ondansetron (AO) also showed a significantly lower incidence of PONV compared to ondansetron alone (11.3% vs. 26.8%, RR = 0.43, P < 0.001) and a higher complete response rate (38.1% vs. 26.84%, RR = 1.41, P = 0.020). In addition, ADO significantly reduced PONV incidence compared to DO (ADO vs. DO: 13.63% vs. 35.38%, RR = 0.38, P = 0.006).

Conclusion:
Aprepitant, whether used alone or in combination with ondansetron or both ondansetron and dexamethasone, consistently outperforms ondansetron in achieving a complete response as it lowers vomiting rates and reduces the need for rescue therapy during the crucial 24–48-h postoperative period.
A randomised controlled trial to compare the occurrence of postoperative nausea and vomiting in early versus conventional feeding in children undergoing daycare surgery under general anaesthesia
Authors: Singh Ranju , Huligeri H Santoshkumar , Singh Pooja 
Published: August 2024

Background and Aims:
The time paediatric patients should resume oral intake after surgery is still ill-defined. No specific evidence suggests that the usual practice of postoperative fasting of 4–6 h to reduce postoperative nausea and vomiting (PONV) is beneficial. The primary objective of this study was to assess the occurrence of PONV with early oral feeding compared to conventional feeding in children undergoing daycare surgery under general anaesthesia.

Methods:
A randomised controlled trial was conducted in 300 children undergoing daycare surgery under general anaesthesia. Children were randomised into the early feeding group (Group EF, n = 150) or the conventional feeding group (Group CF, n = 150). Group EF received carbohydrate-containing oral fluids when the child demanded feed in the postoperative period. Group CF received oral fluids 4 h post-anaesthesia. All patients were monitored for occurrence of PONV, postoperative pain, duration of hospital stay and parental satisfaction. The incidence of PONV was compared using the Chi-squared test, while other continuous variables were compared using the Student’s t-test.

Results:
Both groups were comparable regarding PONV (12% in Group EF vs. 18.7% in Group CF, P = 0.109). The Face, Legs, Activity, Cry, Consolability scores were significantly lower in Group EF at 0 min (P = 0.011), 30 min (P = 0.001) and 1 h (P < 0.001). Patients in Group EF had a significantly shorter duration of hospital stay, that is, 6.31 [standard deviation (SD): 3.52] [95% confidence interval (CI): 1.45–12.24] h in EF versus 10.13 (SD: 2.99) (95% CI: 5.12–16.33) h in CF (P < 0.001). Parents of the children in Group EF had significantly better parental satisfaction scores (P < 0.001).

Conclusion:
Early postoperative feeding in children undergoing lower abdominal, non-gastrointestinal surgery under general anaesthesia does not increase the incidence of PONV.
Comparison of two techniques of administering the Valsalva manoeuvre in patients under general anaesthesia: A randomised controlled study
Authors: Shah Shagun B. , Chaudhary Vineet , Chawla Rajiv , Hariharan Uma , Ghiloria Neha , Dubey Jitendra Kumar 
Published: August 2024

Background and Aims:
Surgeons often request a Valsalva manoeuvre (VM) at the end of surgery (head–neck surgery, craniotomy) to check haemostasis and to unmask covert venous bleeders. We aimed to compare an anaesthesia machine-generated objective technique for delivering VM under pressure-control (PC) mode with the traditional subjective technique of delivering VM in manual mode.

Methods:
This randomised controlled study included 60 adult patients randomised to manual (Group M) and controlled ventilation (Group C) groups. Our primary outcome measure was internal jugular vein (IJV) diameter at pre-determined time points (T0 = baseline, T1 = VM initiation, T2 = 20 s after VM initiation, T3 = immediately after VM release, and T4 = 1 min, T5 = 2 min and T6 = 5 min post-VM release). Secondary outcome measures included mean arterial pressure (MAP), heart rate, time to desired plateau airway pressure, number of patients with bleeders unmasked and surgeon satisfaction. Independent/paired sample t-tests were applied. Results are expressed as mean (standard deviation), mean difference (95% confidence interval), dotted box–whisker plots and trendlines. P <0.05 is considered statistically significant.

Results:
Mean differences in diameter changes in IJV (in centimetres) in the mediolateral and anteroposterior directions between Group C and Group M were -0.136 (-0.227, -0.044) and -0.073 (-0.143, -0.002), respectively. VM in the PC mode produced more significant IJV dilatation (P = 0.004, P = 0.044). MAP at T0 and T1 was comparable. At T2 and T3, there was a more significant fall in MAP in Group C versus Group M (P = 0.018 and P = 0.021, respectively). At T4, T5 and T6, MAP was comparable.

Conclusion:
Performing VM in PC mode is a better technique based on IJV diameter, haemodynamics, bleeder unmasking and surgeon satisfaction.
Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis
Authors: Majage Siddhavivek , Ravikumar Rajathadri Hosur , Prasanna Mrudula , Chandramouli M , Datta Priyankar Kumar , Baidya Dalim Kumar 
Published: August 2024

Background and Aims:
Existing literature does not establish the superiority of the erector spinae plane (ESP) block or the thoracolumbar interfascial plane (TLIP) block in pain relief and reducing opioid consumption in lumbar spine surgeries. This systematic review and meta-analysis was aimed to discern their relative efficacy and safety.

Methods:
This meta-analysis included randomised controlled trials (RCTs) comparing ESP and TLIP blocks in lumbar spine surgeries. The primary outcome was 24-h opioid consumption, and secondary outcomes were visual analogue scale (VAS) scores at 1 h and 24 h and various complications. PubMed, Central Register of Controlled Trials, SCOPUS, EMBASE databases and cross-references were electronically searched. Two authors extracted data independently, cross-checked, and analysed them using RevMan 5.4. Binary outcomes were reported as odds ratios (OR), while continuous outcomes were presented as standardised mean differences (SMDs) accompanied by 95% confidence intervals (95% CIs).

Results:
Among 1107 articles, six RCTs (492 patients) were finally included. The ESP block demonstrated lower 24-h opioid consumption compared to TLIP [SMD -0.32 (95% CI: -0.50, -0.14); P < 0.001, I
2 = 83%]. At 1 and 24 h, ESPB yielded significantly lower VAS scores compared to TLIP [1 h: SMD -0.38 (95% CI: -0.57, -0.18); P < 0.001, I
2 = 83%; 24 h: SMD -0.57 (95% CI: -0.76, -0.37); P < 0.001, I
2 = 73%]. No significant difference was noted in adverse events.

Conclusion:
In comparison to the TLIP block, the ESP block has significantly lower 24-h opioid consumption and VAS scores at 1 and 24 h in patients undergoing lumbar spine surgery.
Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial
Authors: Kruc Anamarija , Lijovic Lada , Skrtic Matteo , Pazur Iva , Perisa Nikola , Radocaj Tomislav 
Published: August 2024

Background and Aims:
Carotid endarterectomy (CEA) is a common procedure conducted under regional anaesthesia, providing real-time cerebral function monitoring. Many different combinations of regional cervical blocks exist, and most offer adequate analgesia in intraoperative and postoperative recovery. This research compares a superficial cervical plexus block (SCB) alone and combined with an ultrasound (US)-guided carotid sheath block (CSB). The primary objective was to explore the length of the sensory block after combining SCB and CSB.

Methods:
Patients scheduled for nonemergency CEA surgery were randomised into two cohorts. The Subject group (28 participants) received US-guided CSB and SCB. The Control group (31 participants) received only an SCB. Both groups received 0.5% levobupivacaine (2 mg/kg) along with 2% lidocaine (2 mg/kg). The sensory block time and its initiation, analgesia and neutrophil-to-lymphocyte ratio (NLR) were recorded before and after the block. The numeric pain rating scale (NPRS) was used to evaluate analgesia every 2 h for 12 h post block. Analysis of variance, Mann–Whitney U or log-rank test was used to analyse the distinction of selected variables.

Results:
The demographic characteristics were comparable across the cohorts. The Subject group demonstrated a significantly accelerated onset of sensory block (P = 0.029) and an extended time to first analgesia (P = 0.003). The sensory block was also substantially extended in the Subject group (P = 0.040). Postoperative pain (NPRS ≥1) within the first 12 h was more recurrent in the Control group (P = 0.048). NLR showed minimal disparity between the groups (P = 0.125).

Conclusion:
Combining SCB and US-guided CSB effectively and safely extends postoperative analgesia for CEA surgery.
School-Based Anti-Bullying Program on Reducing Violence among High School Students in Indonesia: A Quasi-Experimental study
Authors: Talib Susi Tentrem Roestyati , Senan Dato’ C. Prathapa , Said Faridah Mohd , Pamungkas Rian Adi , Matualage Amestina , Susantie Niluh Gede 
Published: August 2024

Background and Objectives
Bullying is a form of aggression that has detrimental effects on the physical, emotional, and psychological well-being of youths. The study sought to investigate the impact of school-based anti-bullying initiatives on mitigating violence among high school students in Indonesia.

Patient and Methods
This study employed a quasi-experimental design, including a pretest and post-test, with a non-equivalent control group. This study included a total of 160 high school students.

Results
The findings indicated that school-based anti-bullying interventions had a substantial impact on the attitudes and behaviors of the experimental group, who received the program, in comparison to the control group, who received the standard care provided by the school. Nevertheless, there was no notable disparity in students’ understanding of anti-bullying between the experimental group and the control group both before and during the implementation of the school-based anti-bullying program.

Conclusion
Ultimately, school-based anti-bullying initiatives have proven to be efficacious and have the potential to be widely deployed as a means of curbing violence within educational environments. Additional research is required to carry out randomized control trials in order to ascertain the efficacy of the program in different educational institutions.
The effect of kangaroo mother care on weight gain pattern in low birth weight premature babies at a tertiary care hospital
Authors: Deepak D. H. 
Published: August 2024

Abstract

Background:
Premature infants are at high risk of death. They need specialized incubatory care which is very costly and requires skilled workforce and specialized equipment. Kangaroo mother care (KMC) does the same job with no cost and does not require set-up as for incubatory care. It can prevent mortality and morbidity and also promotes bonding between mother and child.

Objective:
The objective of the study was to study the effect of KMC on weight gain pattern in low birth weight premature babies compared to incubatory care.

Materials and Methods:
A nonrandomized experimental study was carried out among 200 premature infants. They were divided into two groups of 100 each. Randomization was not done. One group was given KMC. The second group was given incubatory care. The weight of babies in both groups was measured with a digital weighing machine. Both groups were followed till the 9th day with a follow-up frequency of days – 1, 3, 5, 7, and 9. On each follow-up day, weight was recorded.

Results:
Both groups were comparable for gender, birth weight, and gestational age. In the KMC group, there was significant weight gain on day 2 compared to day 1 and on day 7 compared to day 6. But weight gain on day 3 compared to day 2 and on day 9 compared to day 8 was not significant. In the non-KMC group, there was significant weight gain on day 3 compared to day 2 and on day 9 compared to day 8. From 2nd day to 9th day, each day weight gain in the KMC group was higher compared to the non-KMC group.

Conclusion:
We conclude that the KMC significantly improved weight gain on a daily basis. The KMC also improved the weight gain compared to that of the non-KMC group. Hence, we recommend to create awareness among the community at all health-care levels and among health-care professionals on the benefits of KMC/the importance of KMC.
Alteration of ascending colon mucosal microbiota in patients after cholecystectomy
Authors: Fan Miao-Yan , Jiang Qiao-Li , Cui Meng-Yan , Zhao Meng-Qi , Wang Jing-Jing , Lu Ying-Ying 
Published: August 2024

BACKGROUND
Cholecystectomy is a successful treatment option for gallstones, although the incidence of colorectal cancer (CRC) has notably increased in post-cholecystectomy (PC) patients. However, it remains uncertain whether the altered mucosal microbiota in the ascending colon is related.
AIM
To investigate the potential correlation between gut microbiota and the surgical procedure of cholecystectomy.
METHODS
In total, 30 PC patients and 28 healthy controls underwent colonoscopies to collect mucosal biopsy samples. PC patients were divided based on their clinical features. Then, 16S-rRNA gene sequencing was used to analyze the amplicon, alpha diversity, beta diversity, and composition of the bacterial communities. Additionally, the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) database, sourced from the Kyoto Encyclopedia of Genes and Genomes, was used to predict the functional capabilities of the bacteria.
RESULTS
PC patients were comparable with healthy controls. However, PC patients older than 60 years had a distinct composition compared to those under 60 years old. Bacteroidetes richness was considerably higher at the phylum level in PC patients. Bacteroides , Parabacteroides , and Bilophila were more abundant in the PC group than in the control group. Furthermore, PC patients exhibited greater enrichment in metabolic pathways, specifically those related to lipopolysaccharide biosynthesis and vancomycin group antibiotic production, than controls.
CONCLUSION
This study indicated that the mucosal microbiota in PC patients was altered, perhaps offering new perspectives on the treatment possibilities for CRC and diarrhea following cholecystectomy.