bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of Maternal Serum Ischemia-modified Albumin and Ischemia-modified Albumin Ratio in Uncomplicated and Complicated Pregnancy
Authors: Sethi Harleen Kaur , Kumar Ajay , Thomas Maria , Mandrelle Kavita 
Published: July 2024

Abstract

Introduction:
The maternal and fetal outcomes are poorer in pregnancies associated with obstetric complications. A newly recognized marker of hypoxia, serum ischemia-modified albumin (IMA), which serves as an early predictive marker of myocardial infarction in the emergency department, is now being studied in obstetric complications of pregnancy.

Aims and Objectives:
(1) To study the levels of maternal serum IMA in the early 2nd trimester (12–20 weeks) to predict the occurrence of uncomplicated and complicated pregnancy post 20 weeks of gestation. (2) To evaluate the IMR ratio (IMAR) (serum IMA-to-human serum albumin ratio) and its significance in the obstetric complications of pregnancy.

Methodology:
This prospective cohort study was conducted on 150 antenatal women with gestational age from 12 to 20 weeks. A complete detailed history of all participants was taken and they were followed up to the time of delivery for the specific complications (i.e., pregnancy-induced hypertension [PIH], preeclampsia, eclampsia, and gestational diabetes in mother and stillbirth, preterm birth, and fetal growth restriction [FGR] in the fetus) that developed during pregnancy. IMA levels and IMA ratio were obtained and correlated with the development of the defined complications of pregnancy. The data were recorded, tabulated, and subjected to statistical analysis.

Results:
A significant relationship between IMA value and the incidence of PIH, preeclampsia, and eclampsia and between IMAR value and the incidence of preeclampsia and eclampsia was seen among the study population (P < 0.05). We observed that IMA and IMAR values were higher in women who did not have any fetal complications than in women who had fetal complications, namely, stillbirth, preterm birth, and FGR. However, this difference was not significant (P > 0.05).

Conclusion:
Serum IMA and IMAR levels were higher in women with PIH, preeclampsia, and eclampsia. The most common pregnancy outcome was small for gestation age. No significant link was found between serum IMA levels or IMAR and the severity of eclampsia, gestational diabetes, stillbirth, preterm, and FGR.
An Evaluation of Retention of Complete Denture Bases Made with a “Modified Single-stage Impression” Technique Using a Heat-moldable Tray
Authors: Kurian Nirmal , Kaur Ravneet , Kaur Mankamal , Daniel Angleena Y. , Wadhwa Samiksha , Grewal Ishmeet Kaur 
Published: July 2024

Abstract

Aim:
Although most dental schools teach complete denture definitive impression techniques consisting of secondary impressions in border-molded custom impression trays, it has been found that later, graduates in clinical practice abandon this step because of its complexity and attempts to seek easier alternatives. To simplify two-stage techniques, single-step border molding with elastomeric impression materials and light-cured resin materials has gathered acceptance among clinicians. The study aims to evaluate the retention of record bases made with a modified single-stage impression technique that uses elastomeric impression material in a heat moldable tray with modeling compound as material for border molding.

Settings and Design:
This was an in vivo preliminary cohort study.

Materials and Methods:
Thirteen completely edentulous patients requiring complete dentures were included in the study. A traditional two-stage impression was made using custom trays fabricated over diagnostic casts and further border molding done with a modeling compound, and the final impression was made to use zinc oxide–eugenol impression material. Additionally, a modified single-stage impression technique using heat moldable impression trays was made. Master casts from each technique were made, and further record bases were made on each master cast. Wire loops were adapted on the palatal aspect of record bases. The retention of each record base was evaluated using a force gauge.

Statistical Analysis:
The Kolmogorov–Smirnov test was used to analyze the normality of variables and later Wilcoxon signed-rank test was applied.

Results:
The double-stage technique exhibited retention values in the range of 0.6–66.7 units, whereas the single-stage technique showed a range of 0.15–78.55. The tests showed no significant difference between double-stage and single-stage techniques (P > 0.05).

Conclusions:
The single-stage technique using heat moldable trays with elastomeric impression material and modeling compound as a material for border molding can produce denture retention compared to the conventional technique that uses a two-step impression technique. The use of the modified single-stage technique can additionally save an extra appointment for patients, although it is better to use such a technique as an advanced impression technique and not as a training technique for beginners or students, as the material cost is substantially higher than the conventional two-stage technique.
Functional, Oncological, and Radiological Outcomes Following Safe Surgical Dislocation for the Treatment of Locally Aggressive Proximal Femoral Lesions
Authors: John Justin G. , Shreemal Bhim Bahadur 
Published: July 2024

Abstract

Study Type:
Retrospective cohort study.

Background and Purpose:
Locally aggressive lesions of the proximal femur represent a spectrum of pathologies in the younger age group, which result in large defects. Safe surgical dislocation (SSD) is one of the viable surgical approaches to achieve optimal visualization and clearance of tumor. This study looks at the functional, oncological, and radiological outcomes following SSD for the treatment of locally aggressive proximal femoral lesions.

Materials and Methods:
A retrospective study was done in Orthopedics Unit 3 at our tertiary care center between 2015 and 2021 on patients who underwent SSD for the treatment of biopsy confirmed locally aggressive proximal femur lesions. The inclusion criteria were age more than 15 years, with biopsy confirmed symptomatic locally aggressive lesions of the proximal femoral region with a minimum 1 year follow-up. The clinical parameters were reduction in pain, restoration of hip movements, abductor strength, and ability to weight bear and resumption of activities of daily living. Graft consolidation, status of implant, local recurrence, trochanteric nonunion, and appearance of avascular necrosis included as radiological parameters. The functional parameters were assessed through the modified Musculoskeletal Tumor Society Score and the nonarthritic Young Hip Score.

Results:
Ten cases of biopsy-proven proximal femoral lesions (out of 15 such cases) fulfilling the inclusion criteria were enrolled. All ten underwent intralesional excision/extended curettage of lesion, followed by auto/allograft reinforcement to fill the defect and internal fixation using SSD as surgical approach. The choice of graft and fixation method was based on surgeon’s preference. Functional and radiographic assessment was done on follow-up, with an average follow-up of 13 months (range 12–14 months). The mean nonarthritic Young Hip Score improved from 49 (±8.96) preoperatively to 85.4 (±11.95) at the time of review, and the modified Musculoskeletal Tumor Society Score improved from a mean of 23.3 (±0.83) preoperatively to 28.4 (±1.07) at the time of review. There was no tumor recurrence and avscular necrosis at the time of follow-up. Allograft consolidation was seen in 8 out of 10 cases at the time of review.

Conclusion:
SSD is an excellent approach to achieve optimal tumor clearance. Good functional and radiological outcomes are seen if adequate tumor clearance is obtained and reconstruction with stable internal fixation is achieved. Tumor recurrence and avascular necrosis were not noted in any of the cases at 1-year (intermedial) follow-up.
Post liver transplant refractory dyslipidemia
Authors: Thulasidass Kumar , Varghese Joy , Premkumar Dinu Abirami 
Published: July 2024

ABSTRACT
A 53-year-old male presented with intractable pruritus and jaundice. He underwent liver transplantation for liver cirrhosis a year prior to the current presentation. Post-transplantation, he developed diabetes mellitus. He experienced an episode of early acute graft rejection, 2 months after transplantation, which was successfully treated. Subsequently, about a year after transplantation, he developed chronic graft rejection. He was treated with everolimus and prednisolone. Incidentally, he was found to have elevated blood cholesterol, triglycerides, and low density lipoprotein (LDL) levels. The lipid levels were significantly higher than those commonly encountered in post-liver transplant patients. Dyslipidemia was treated with maximum dose of high-intensity statin, ezetimibe, and fenofibrate. However, there was not much reduction in lipid levels, indicating resistance to treatment. Subsequently, injection evolocumab 140 mg subcutaneously was added, administered once every 2 weeks. Following that, after only three doses of injection, there was about 65% reduction in the LDL level, which sustained at lower levels with continued treatment using evolocumab. Evolocumab was proven to be highly effective in reducing lipid levels in post-liver transplant patients who are refractory to treatment with conventional lipid-reducing medications.
Multiple congenital anomalies in a late-preterm neonate: A case of possible carbimazole embryopathy
Authors: Ahmadu Ibrahim , Abubakar Muhammad Shakur , Mustapha Hauwa Umar , Chibiyayi Hamisu Musa , Gurama Kabiru Ibrahim , El-Yakub Firdausi Aliyu , Aliyu Ibrahim , Asani Mustafa O. 
Published: July 2024

ABSTRACT
The use of carbimazole in the treatment of hyperthyroidism in pregnant women is associated with several congenital anomalies, especially when used during early pregnancy. Some of the reported congenital anomalies include aplasia cutis congenita, choana/esophageal atresia, facial dysmorphism, and cardiovascular/gastrointestinal anomalies. We report the case of a 17-day-old late-preterm neonate who presented with complaints of difficulty in breathing, darkening of the lips/extremities, and abnormal facies observed since birth. The mother had been on tablet carbimazole 20 mg daily for the treatment of hyperthyroidism until the fifth week of gestation from the time she was confirmed to be pregnant. Physical examination and further evaluations revealed multiple congenital anomalies, including facial dysmorphism, bilateral arthrogryposis of the lower limbs, micropenis, complex congenital heart disease, and intestinal obstruction. This case report, therefore, highlights the need to avoid the use of imidazole derivatives such as carbimazole during the pre-conception period as well as in the first trimester of pregnancy.
Sellar and supra-sellar glioma masquerading as a pituitary macroadenoma
Authors: Baruah Mintu Mani , Jha Vivek , Prasad Trupti Nagendra , Konsam Biona Devi , Das Liza , Chatterjee Debajyoti , Singh Paramjeet , Dutta Pinaki 
Published: July 2024

ABSTRACT
We present a rare case of glioma presenting as a sellar suprasellar mass in a 44-year-old male. He presented with a 6-month history of significant weight loss and erectile dysfunction and a 2-month history of bilateral decrease in vision. Clinically, he had bitemporal hemianopia. He had secondary hypogonadism without the involvement of another hormonal axis. Contrast-enhanced MRI sella suggested an ill-defined mass in the suprasellar region involving the medial temporal lobe, hippocampus, and infiltration of the optic chiasma and hypothalamus, further extending into the sella. The diagnosis was confirmed by biopsy of the lesion and using immunohistochemistry. The patient underwent chemoradiotherapy (CRT) with significant clinical and radiological improvement. Our report emphasizes the challenges in diagnosing and the importance of pathologic examination.
Doughnut capsulorhexis: Pioneering advancements in cataract surgery to sidestep Argentinian flag sign
Authors: Kumar Badri Praveen , Ramesh Shruthy Vaishali , Ramesh Prasanna Venkatesh 
Published: July 2024

Background:
For a successful capsulorhexis, it is crucial to use controlled centripetal and tangential vector forces in the rhexis border to counteract the centrifugal forces of the zonular component. Unfortunately, in hypermature cataracts, these maneuvers do not prove successful due to the raised intralenticular pressure, leading to an Argentinian flag sign. Among several techniques, this method of doughnut capsulorhexis is one such technique to perform successful capsulorhexis in cases with high intralenticular pressure.

Purpose:
In this video, we highlight this new method of capsulorhexis to prevent undue capsule-related complications in hypermature cataracts, as this plays a crucial role in successful surgical outcomes.

Synopsis:
The lens capsule usually experiences centrifugal vector forces exerted by the zonules, but in hypermature cataract cases, there is an additional factor of raised intralenticular pressure. In such cases, the attempts to make a 5 mm capsulorhexis might lead to the propagation of the rhexis to the periphery due to the combined mechanism of the two vector forces. Therefore, the technique of performing a smaller 2 to 3 mm rhexis is performed. This reduces the centrifugal force involved and prevents undue extension of the rhexis. Following this, decompression of the capsular bag is performed by aspirating the liquefied cortex using a bimanual irrigation and aspiration cannula, followed by controlled extension of the rhexis using a cystitome, which is performed for a successful surgical outcome. The second knick is made parallel to the first rhexis,1 mm away from the rhexis border, and a flap is raised. The rhexis can either be completed using a cystitome or a microrhexis forceps.

Highlights:
This technique does not require any additional instrumentation or training. It can be performed using the cystitome and microrhexis forceps. Surgeons of all calibers can efficiently perform it. This series of videos shows the successful outcome of continuous curvilinear capsulorhexis using the Doughnut method.

Video Link:
https://youtu.be/x0dTklOaMqg
Risk Factors of Impediment of the Early Childhood Development in Rural Bengal
Authors: Chattopadhyay Nandita , Mitra Kaninika , Basu Swati , Pal Ranabir , Ghosh Amrita 
Published: July 2024

Abstract

Background:
Early childhood development (ECD) is the foundation of future life starting from conception and depends on biological and environmental factors. Seventy-four percent of these children reside in villages; many are underserved and marginalized. Enabling young children to achieve their full developmental potential is a requisite for sustainable development, but globally, 43% of children are still at risk to do so. The problem of ECD is grave for underprivileged rural population in India.

Objectives:
The objective of the present study was to identify the key risk factors that are prevalent in a marginalized rural community in West Bengal and to observe the impact of these impeding factors on ECD, thereby helping in priority setting in service delivery to optimize ECD promotion.

Methods:
In this community-based cross-sectional observational study, a random sample survey of 609 households with children 0–6 years was conducted in Purulia district, West Bengal, India, using a Multiple Indicator Cluster Survey III-based questionnaire followed by data analysis.

Results:
Lack of stimulatory home environment, poor learning opportunities, and inadequate responsive parental care were major hindrances. The cumulative effect of multiple other health and hygiene factors was also hindering ECD. Most factors were strongly influenced by poor maternal education.

Conclusion:
Education of caregivers, especially parents by dedicated health workers on early learning opportunities, showed the path of applied sciences in pediatric clinical practice. To modulate socioeconomic adversities with responsive parental care, ECD can be fostered.
Transcranial Doppler Sonography in Acute Viral Encephalitis with Special Reference to Dengue Encephalitis
Authors: Verma Nagendra Pratap , Verma Rajesh , Chakraborty Rajarshi , Garg Ravindra Kumar , Malhotra Hardeep Singh , Sharma Praveen Kumar , Kumar Neeraj , Uniyal Ravi , Pandey Shweta , Rizvi Imran 
Published: July 2024

Abstract

Introduction:
Acute viral encephalitis syndrome including dengue encephalitis (DE) is an important tropical illness with a guarded prognosis. The cerebral blood flow may be affected in acute viral encephalitis. Transcranial Doppler (TCD) sonography can quantitatively determine intracranial vascular flow dynamics in acute viral encephalitis.

Aim:
We aimed to investigate the intracranial blood flow characteristics in patients with DE and compare with nondengue acute viral encephalitis patients.

Materials and Methods:
In this prospective study, all the cases of acute viral encephalitis including dengue were enrolled over 18 months and followed up at 3 months. TCD was performed to determine the mean velocity pulsatility index (PI) and resistive index (RI) across the middle cerebral artery, anterior cerebral artery, posterior cerebral artery (PCA), vertebral artery, and basilar artery and compared it among dengue versus nondengue group as well as outcome at 3 months.

Results:
Out of 39 patients, 19 were diagnosed with DE, whereas 20 patients suffered from the nondengue group. The elevated PI and RI in the left PCA were found to statistically significant (P = 0.001 and 0.008, respectively) in the DE group. There was no significant difference in any other TCD indices in any other vessel among both the groups. In addition, an initial low Glasgow Outcome Scale (GOS) and higher brain imaging abnormality were significantly associated with poor GOS of <5 in both the groups.

Conclusion:
An elevated PI and RI of PCA could be an important initial TCD parameter in DE. TCD parameters did not affect the outcome of acute viral encephalitis.
Treatment of Hyperuricemia with Thlaspi Bursa Pastoris 6CH: A Randomized, Open-Label, Equivalence Trial
Authors: Bhar Koushik , Uchat Usha Ghelani , Nayak Chintamani , Saha Sangita , Misra Pankhuri , Ghosh Priyanka , Singh Navin Kumar , Koley Munmun , Saha Subhranil 
Published: July 2024

Abstract

Background:
Hyperuricemia (HU) remains a priority research area in every medical science, including complementary and alternative medicine interventions and homeopathy; however, the research evidence is limited. In homeopathy, Thlaspi bursa pastoris (TBP) is considered to be a potential treatment option in HU.

Methods:
An open-label, randomized, equivalence trial was conducted comparing TBP with individualized homeopathic medicines (IHMs). Serum uric acid (SUA) was the primary outcome; Gout Assessment Questionnaire version 2.0 (GAQ-2) and Measure Yourself Medical Outcome Profile version 2.0 (MYMOP-2) were the secondary outcomes; all measured at baseline and after 6 and 12 weeks. Intention-to-treat analysis was carried out to detect noninferiority and group differences using unpaired t-tests and two-way repeated-measure analysis of variance (ANOVA).

Results:
There were no differences between the groups at baseline. Reduction in SUA after 6 and 12 weeks was similar between groups (P = 0.784). Group differences in the secondary outcomes were also nonsignificant (all P > 0.05). TBP revealed noninferiority against IHMs, both after 6 weeks and 12 weeks in SUA and MYMOP-2 profile scores, but not in GAQ2 scores. Sulfur and Calcarea carbonica were the most frequently prescribed medicines in the IHMs group. There were no harms or serious adverse events reported from either of the groups.

Conclusion:
TBP acted noninferior to IHM in HU and both appeared to be equally effective. Rigorous and larger trials are warranted.

Trial Registration:
This trial was registered in the Clinical Trials Registry – India (CTRI/2018/10/016174; UTN: U1111-1221-8000).
Central Serous Chorioretinopathy Following Symbicort Usage in a 69-year-old Female Patient
Authors: Khamkar Shakib , Rahman Suleman 
Published: July 2024

Abstract
Steroid inhaler usage is the cornerstone of asthma management. This case report describes the development of central serous chorioretinopathy (CSCR) in a 69-year-old female following the use of Symbicort for the management of asthma. The association between inhaled corticosteroids and CSCR is discussed, highlighting the need for awareness among health-care providers. Further research is necessary to establish the pathogenicity of this rare condition and alternatives for patients in whom inhaled corticosteroids are essential to the control of their long-term condition.
Subchronic oral toxicity assessment of Ayurvedic herbo-metallic formulation Mahalaxmi Vilas Rasa in Wistar rats
Authors: Patil Pankaj S. , Wagh Mayuri D. , Mohan Mahalaxmi , Pande Shishir P. , Kulkarni Rajshree A. , Kulkarni Abhay N. 
Published: July 2024

Abstract

BACKGROUND:

Mahalaxmi Vilas (MV) Rasa, a revered Ayurvedic herbo-metallic formulation, holds historical significance for its therapeutic potential. In light of its traditional use, a rigorous evaluation of its safety profile in Wistar rats is imperative for establishing its evidence-based safety. This study aims to contribute valuable insights to the scientific community and healthcare practitioners, facilitating informed decision-making regarding the integration of MV into contemporary medical practices. The findings hold relevance for advancing our understanding of Ayurvedic formulations in the context of safety and efficacy, fostering a bridge between traditional wisdom and modern scientific scrutiny.

METHODS:
In the present study, a total of 24 Wistar rats were randomly divided into four groups as one control vehicle and three dose levels of the test drug MV Rasa. The test drug was made into suspension in a vehicle (honey-to-water ratio, 2:3) and administered orally once a day for 90 consecutive days in three dose levels (51.36, 205.44, and 513.6 mg/kg). Clinical observations, body weight changes, and food and water consumption were noted during the study. Then, on the 91st day, rats were sacrificed humanely, and parameters, such as hematological, biochemical, relative organ weight, and histopathological changes, were studied.

RESULTS:
There was a significant decrease in water intake in high-dose group rats (513.6mg/kg) in the weeks 1, 3, and 4, as compared with control group rats, the observed effect was not treatment related. In addition, MV (51.36, 205.44, and 513.6 mg/kg) produced no significant alterations in any of the hematological and biochemical parameters, except for a significant increase in direct bilirubin in the moderate dose group (205.44 mg/kg). However, no considerable cellular changes were found in the organs analyzed.

CONCLUSION:

MV had no toxic effect in Wistar rats during this repeated dose oral toxicity (90 days) study, even at 10 times the therapeutic dose (513.6 mg/kg). This was evidenced by their normal behavioral, hematological, biochemical, and histopathological examinations.