bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unraveling belly dancer’s dyskinesia and other puzzling diagnostic contortions: A narrative literature review
Authors: Rissardo Jamir Pitton , Vora Nilofar Murtaza , Tariq Irra , Batra Vanshika , Caprara Ana Letícia Fornari 
Published: June 2024

Abstract:Belly dancer’s dyskinesia (BDD) is characterized by involuntary abdominal wall movements that are rhythmic, repetitive, and dyskinetic. The present study aims to review BDD’s etiology, pathophysiology, and management. We searched six databases to locate existing reports on BDD published from 1990 to October 2023 in electronic form. A total of 47 articles containing 59 cases were found. The majority of the patients affected by BDD were female, accounting for 61.01% (36/59) of the cases. The mean and median ages were 49.8 (standard deviation: 21.85) and 52 years (range: 7–85), respectively. The BDD was unilateral in only 3.38% (2/59). The most commonly reported causes associated with BDD were 17 idiopathic, 11 drug-induced, 11 postsurgical procedures, 5 pregnancies, and 4 Vitamin B12 deficiencies. BDD is a diagnosis of exclusion, and other more common pathologies with similar presentation should be ruled out initially. Differential diagnostic reasoning should include diaphragmatic myoclonus, cardiac conditions, truncal dystonia, abdominal motor seizures, propriospinal myoclonus, and functional or psychiatric disorders.
Effect of emotions on learning, memory, and disorders associated with the changes in expression levels: A narrative review
Authors: Johnson Jaivarsini 
Published: June 2024

Abstract:
Emotions, in general, have no scientific definition. Emotions can be denoted as the mental state because of the neurophysiological changes. Emotions are related to mood, personality, temperament, and consciousness. People exhibit different emotions in different situations causing changes in cognitive functions. One of the major cognitive functions is the ability to learn, to store the acquired information in the parts of the brain such as the hippocampus, amygdala, cortex, and cerebellum. Learning and memory are affected by different types of emotions. Emotional responses such as fear, depression, and stress have impaired effects on cognitive functions such as learning and memory, whereas optimistic and happy emotions have positive effects on long-term memory. Certain disorders have greater effects on the regions of the brain which are also associated with synaptic plasticity and Learning and Memory(LM). Neuroimaging techniques are involved in studying the changing regions of the brain due to varied emotions and treatment strategies based on the changes observed. There are many drugs, and in advancements, nanotechnology is also utilized in the treatment of such psychiatric disorders. To improve mental health and physical health, emotional balance is most important, and effective care should be provided for people with less emotional quotient and different types of disorders to inhibit cognitive dysfunctions. In this review, emotions and their varied effects on a cognitive function named learning and memory, disorders associated with the defects of learning due to emotional instability, the areas of the brain that are in control of emotions, diagnosis, and treatment strategies for psychiatric disorders dependent on emotions are discussed.
Restoring brain health: Electroacupuncture at GB20 and LR3 for migraine mitigation through mitochondrial restoration
Authors: Luo Jianchang , Feng Liyao , Wang Luodan , Fang Zhenyu , Lang Jiawang , Lang Boxu 
Published: June 2024

Abstract:

BACKGROUND:
Electroacupuncture (EA) is a promising alternative therapy for migraine, with mitochondrial dysfunction hypothesized as a pivotal mechanism in migraine pathophysiology. This research endeavors to investigate the therapeutic potential of EA in addressing migraines and shed light on the associated mechanisms linked to mitochondrial anomalies.

MATERIALS AND METHODS:
Migraine in rats was induced by 10 mg/kg nitroglycerin, followed by 2/15 Hz EA treatment at GB20 and LR3. Nociceptive behavior was recorded via a camera and analyzed using EthoVision XT 12.0 software. The hind-paw withdrawal threshold was assessed using the von Frey test. We assessed the levels of calcitonin gene-related peptide (CGRP), nitric oxide (NO), and endothelin (ET) – key parameters in migraine pathophysiology using immunohistochemistry and enzyme-linked immunosorbent assay. Mitochondrial morphology in brain tissues was observed through transmission electron microscopy. Reactive oxygen species (ROS) level in mitochondria was measured by flow cytometry. The levels of PINK1 and Parkin were assessed using Western blot analysis.

RESULTS:
EA at GB20 and LR3 decreased nociceptive behaviors (resting and grooming) and increased exploratory and locomotor behaviors in migraine rats. The hind-paw withdrawal threshold in migraine rats was significantly elevated following EA treatment. Post-EA treatment, levels of CGRP and NO decreased, while ET level increased, suggesting an alteration in pain and vascular physiology. Notably, EA treatment mitigated the mitochondrial damage and reduced ROS level in the brain tissues of migraine rats. EA treatment upregulated the expression of PINK1 and Parkin in migraine rats.

CONCLUSION:
EA at GB20 and LR3 may treat migraine by alleviating PINK1/Parkin-mediated mitochondrial dysfunction.
Perception of MBBS Students to the New Competency-based Medical Education Curriculum in a Tertiary Care Hospital in North East India
Authors: Thakuria Bhaskarjyoti , Bordoloi Purnima , Pathak Pradumna 
Published: June 2024

Objectives:
The objective of the study was to assess the knowledge, experience, and perception of the students of our institute toward the newly implemented competency-based medical education (CBME) curriculum.

Materials and Methods:
A prospective, cross-sectional study was conducted among the Phase II Students of Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam. A self-administered feedback questionnaire was used for the study after acquiring written informed consent from the students. The responses to the questions were based on the knowledge, attitudes, and perspectives of the students and were assessed on a 3-point Likert scale.

Results:
The questions were categorized under four broad headings. Under the first category, 49.3% were in assent as to their general awareness of the new curriculum and its structure and in agreement as to the changes proposed by it. In the second category, 55.7% were in agreement as to the beneficial effects of early clinical exposure and problem-based learning. 51.7% of the students in the next category were in agreement on the role of vertical and horizontal integration in the new curriculum in making them understand the topic better. Finally, 55.2% of Phase II students were in agreement on the importance of attitude, ethics, and communication and the role of assessment to improve the learning of the students.

Conclusion:
As we got positive responses from most of the students, we can conclude that CBME is the need of the hour. The few negative and equivocal responses indicate the challenges to be considered while implementing CBME.
Primary Radical Extended Sinus Surgery for Management of Extensive Allergic Fungal Rhinosinusitis
Authors: Sara Katti Blessi , Vediappan Rajan Sundaresan , Prabaakharan J. , Thomas Regi 
Published: June 2024

Introduction:
Allergic fungal rhinosinusitis (AFRS), a subset of sinusitis secondary to hypersensitivity, is clinically similar to chronic rhinosinusitis with nasal polyp but histologically different with rich eosinophils and Charcot Leyden crystals. Since the primary pathology in AFRS is immune mediated, the recurrence rates are high. In this study, we describe the application of radical extended sinus surgery (RESS) as the surgical technique with the usage of postoperative high-volume steroidal nasal irrigation and short-term oral steroid therapy – a threefold strategy – for the prevention of recurrence of this disease.

Materials and Methods:
A retrospective surgical chart audit of patients diagnosed with AFRS and treated between January 2012 and December 2019 was done. The clinical findings and postoperative outcomes performed by a single senior surgeon in a tertiary referral institution were extracted and analyzed.

Results:
Of the 17 patients, 88% of patients were immunocompetent and Lund Mackay (LM) of 24, 16 patients had Grade 3 nasal polyps, except one with Grade 1 nasal polyps and an LM score of 8. All patients underwent RESS and received postoperative high-volume topical steroid irrigation with oral steroids in the immediate postoperative period and on follow-up, if recurrence was noted, none required revision surgery.

Conclusions:
A three-fold strategy is beneficial in the management of AFRS-RESS followed by oral steroids during the immediate postoperative period along with long-term topical high-volume steroid nasal irrigation.
The Real-world Experiences of Abemaciclib for Estrogen Receptor-positive Human Epidermal Growth Factor Receptor-negative-2 Metastatic Breast Cancer – Sharing from a Single Institute in Southern Taiwan
Authors: Tsai Jui-Hung , Lee Kuo-Ting 
Published: June 2024

Abstract

Background:
CDK 4/6 inhibitor (CDK4/6i) is the first-line therapeutic drug to treat ER-positive (ER+) HER2-negative (HER2 -) metastatic breast cancer (MBC) now. We have three CDK4/6i: Palbociclib, Ribociclib, and Abemaciclib. In the long-term follow-up study, there are some different results among the three CDK4/6i. Some real-world reports demonstrated some patients would have clinical benefits from Abemaciclib in the ER+ HER2- metastatic BC patients who had priorly received the other CDK 4/6 inhibitor (Palbociclib). In Taiwan, Abemaciclib is the third available CDK 4/6 inhibitor behind the other two CDK4/6i. However, Abemaciclib was not reimbursed in ER+ HER2- MBC by Taiwan Health Insurance until now. Most doctors in Taiwan have the less therapeutic experiences for Abemaciclib. In this article, we would share the clinical experiences for the first thirteen patients who were prescribed with Abemaciclib to treat ER+ HER2- MBC.

Materials and Methods:
This chart review study was conducted from January 1, 2020, to May 31, 2023. We reviewed the medical charts at National Cheng Kung University Hospital (NCKUH) and identified 13 patients who had received abemaciclib treatment for ER+ HER2− MBC. The study was approved by the Institutional Review Board at NCKUH (approval number: B-ER-112-220). All of the 13 patients were treated with abemaciclib (150 mg twice daily initially), in combination with other anti-cancer medications. We recorded the clinical parameters, including sex, age, treatments in neoadjuvant/adjuvant setting, metastatic sites, other prior CDK4/6i therapy, treatment lines of abemaciclib in the metastatic setting, survival period before abemaciclib treatment, time to treatment failure for abemaciclib, causes of abemaciclib discontinuation, dose reduction, and adverse effects (AEs) related to abemaciclib.

Results:
Up to the cut-off date (May 31, 2023), four (4/13) patients were still receiving therapy and nine patients (9/13) had discontinued abemaciclib therapy. Five (5/9) patients discontinued abemaciclib due to disease progression (PD), and two (2/9) patients interrupted abemaciclib treatment due to personal reasons. Two (2/9) patients stopped abemaciclib early because of AEs, and one patient died due to PD. The time to treatment failure for abemaciclib ranged from 1 to 41 months (average: 19.2 months, median: 14 months). AEs were noted in 12 patients (no recording in one patient), of which diarrhea (10/12), anemia (4/12), and neutropenia (3/12) were the most common.

Conclusion:
According to our real-world data, Abemaciclib is effective and safe for the ER+ HER2- metastatic BC cancer patients who they were heavily treated.
Acute Abdominal Presentation of Enteropathy Intestinal T-cell Lymphoma: A Rare Case Report
Authors: Chio U-Chon , Wu Yi-Hung , Siow Tiing-Foong , Chen Kuo-Hsin 
Published: June 2024

Abstract
Intra-abdominal hollow organ perforation is a critical condition that requires immediate intervention. There are various causes of small bowel perforation, including benign diseases, iatrogenic procedures, and perforation associated with tumors. However, preoperative imaging alone is often insufficient to determine the underlying cause. In this report, we present a unique case involving a malignant neoplasm of the small intestine resulting in bowel perforation.
Changes in the Cutaneous Nerve Fiber Staining and Distribution of PGP9.5 in Clinically Uninvolved Skin in Leprosy Patients after Completion of Multidrug Therapy and Assessing PGP9.5 as a Marker of Treatment Response
Authors: Thakur Vishal , Narang Tarun , Bishnoi Anuradha , Dhawan Garima , Sharma Ankur , Saikia Uma Nahar , Razmi T Muhammad , Dogra Sunil , Handa Sanjeev , Modi Manish 
Published: June 2024

Abstract

Background:
Subclinical involvement of nerves may sometimes be present much before the overt clinical manifestations become apparent. Protein gene product (PGP) 9.5, a ubiquitin-C-terminal hydrolase, has been widely used as a marker to study the involvement of peripheral nerve fibers in many diseases.

Aim and Objectives:
To evaluate the change in cutaneous nerve fiber staining and distribution from pre-treatment and post completion of multidrug therapy through the expression of PGP9.5 and to assess PGP9.5 as a marker of treatment response.

Materials and Methods:
In this prospective single-center observational study, skin biopsy was taken in patients with leprosy, having areas of nerve function impairment (NFI), based on findings of nerve conduction studies (NCSs), but not having lesions or impaired tactile or thermal impairment clinically. The thin nerve fiber density in the clinically normal skin in areas supplied by nerve showing changes of sensory neuropathy was evaluated to study the density of the fibers. A second biopsy was taken at the end of treatment from a site near the previous site to assess the changes in intra-epidermal nerve fiber staining and distribution.

Results:
Thirty-three patients were recruited in the present study (24 males and 9 females). Pre-treatment, 27 patients had abnormal NCSs, while six patients did not have any evidence of neuropathy on NCSs. Staining for nerve fibers using PGP9.5; in the epidermis was positive in five patients pre-treatment and 11 patients post treatment (P = 0.181). Staining in the dermis revealed positivity in 14 pre-treatment, which increased to 18 post treatment (P = 0.342). Adnexae showed positivity in five patients pre-treatment and increased to 17 post treatment (P = 0.005).

Conclusion:
A reduced PGP9.5 staining in the epidermal, dermal, and adnexal regions was seen in leprosy patients, which improved post treatment. Thus, PGP9.5 may serve as a marker of NFI and treatment response.
A Verrucous Plaque Healing with Cribriform Scarring
Authors: Meena Akshay , Mehta Hitaishi , Chaterjee Debajyoti , De Dipankar 
Published: June 2024

Abstract
Lupus vulgaris manifests with diverse clinical presentations, although the typical pattern involves a plaque that extends at one end and heals at the other, leaving behind characteristic atrophic scarring. Cribriform scarring is classically described after the healing of ulcerative pyoderma gangrenosum. In this case report, we present a noteworthy instance of lupus vulgaris that exhibited healing accompanied by cribriform scarring.
Efficacy and Safety of Topical Tofacitinib for the Treatment of Alopecia Areata
Authors: Chikhalkar Siddhi B. , Prasanna Swati , Vishwanath Tejas 
Published: June 2024

Abstract

Background:
Alopecia areata (AA) is an autoimmune disease of the hair follicles. Although some cases resolve spontaneously, many patients require some form of treatment, including corticosteroids and vitamin D analogues, among others. Cytokine signaling in autoimmune disorders and their inhibition have been the prime objective in therapeutic research over the past few years. Janus kinase inhibitors such as tofacitinib have shown efficacy in the treatment of AA. The present study aimed to evaluate the efficacy of a novel formulation of topical tofacitinib compared to vehicle in patients with AA.

Materials and Methods:
A prospective, non-blinded, intrasubject vehicle-controlled study was conducted in patients with AA for a total duration of 6 months. A 2% tofacitinib citrate ointment was compounded in the pharmacy. Tofacitinib tablets (5 mg) were crushed and mixed in white soft paraffin to produce 2% ointment. A thin layer of this ointment was applied to the treatment patch, while the control patches received the application of the vehicle twice daily. Both patches in each patient were evaluated for percentage change in severity of alopecia tool [SALT] score after 24 weeks as the primary outcome. This was graded as excellent response (>50% improvement), intermediate response (25–50%), mild response (5–25%), and no response (<5% improvement). Trichoscopy and hair pull test were evaluated as secondary outcomes.

Results:
The present study included 30 patients with AA having a median age of 27 years. Among 30 patients, 40% achieved excellent response (>50% change in the SALT score) over six months of treatment. The mean SALT score was significantly reduced from baseline to six months of treatment (mean [95% CI]: 4.3 [1.9–6.3]; P = 0.001). The control patch had substantially higher positive results in the final hair pull test, indicating disease activity (Treatment: 10% vs. Control: 86.7%, P < 0.001). Compared to the control patch, the prevalence of upright hair (10.0% vs. 80.0%) and terminal hair (3.3% vs. 70.0%) were significantly higher in the treatment patch (P < 0.001). No serious adverse effects were reported during the study duration.

Limitations:
Sample size was small and the followup was not long enough to study the full effects of tofacitinib, as well as maintenance of remission or relapse after discontinuation.

Conclusion:
Topical tofacitinib proved to be an efficacious and well-tolerated treatment modality for AA with no adverse effects reported during this study.
Teachers’ knowledge about communicable disease control at primary schools in Mosul City: A cross-sectional study
Authors: Ayed Alaa Yousif , Younis Nasir Muwfaq , Ahmed Mahmoud Mohammed 
Published: June 2024

Introduction:
In emergency situations, particularly complicated ones including the collapse of health services and disease control programs, a major cause of mortality and morbidity is limited access to health care and communicable diseases. The aim of the study is to assess the primary school teachers’ knowledge of communicable illness control in Mosul City.

Materials and Methods:
A descriptive cross-sectional study design was employed, utilizing a purposeful sample of 149 teachers. The study was carried out at Mosul City primary schools in the first quarter of 2024. A survey was made specifically for this purpose. It was made up of two parts. The data were analyzed using SPSS version 26.

Results:
Findings of the current study showed that 7 (4.7%) teachers only had excellent knowledge of communicable disease prevention and control, while the majority of teachers, 105 (70.5%), had poor knowledge of these topics.

Conclusion:
The majority of elementary school teachers in Mosul City lack sufficient information on managing communicable diseases. The study advised the essential to work with the Ministry of Health and Environment to implement educational programs on communicable diseases and preventive measures to raise their level of awareness regarding the prevention and control of communicable illnesses.

The following core competencies are addressed in this article: Medical knowledge, Practice-based learning and improvement, Systems-based practice.
Evaluation of the effects of different mouthwashes, acidic soft drinks, and herbal teas on shear bond strength of orthodontic stainless steel brackets: A stereomicroscopic study
Authors: Adika Sandeep , Venkata Kalyan Vikram , Raiyan Mohammed , Aafaque Syed , Dawood Tazeen , Sivanandam Muruganandam , Babu J. Suresh , Swarnalatha C. , Nayyar Abhishek Singh 
Published: June 2024

Background:
Premature debonding of brackets often turns out into orthodontic treatment failures and actual treatment delays. The aim of the present study was to evaluate the effects of different mouthwashes, acidic soft drinks, and herbal teas on the shear bond strength of metal (stainless steel) brackets used in orthodontic practice.

Materials and methods:
For the present study, 100 therapeutically extracted healthy premolar teeth with sound enamel surface were collected from patients who were scheduled for orthodontic treatment. The select teeth were cleansed, whereas the dried enamel surface was etched with 38% phosphoric acid for 15 s following which orthodontic stainless steel brackets (MBT 0.022 SLOT) were bonded with the help of composite resin (3M Unitek Transbond XT Light Cure Adhesive). The prepared teeth were divided into four groups depending on exposure to different mouthwashes, acidic soft drinks, and herbal teas. The shear bond strength values of the specimen were measured using a universal testing machine, whereas debonded surfaces were observed under a stereomicroscope. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) version 18.0 (SPSS Inc., Chicago, IL, USA). One-way analysis of variance and Tukey’s multiple post hoc procedures were used for statistical analysis. P <0.05 was considered statistically significant.

Results:
The results obtained in the present study suggested that the highest mean shear bond strength observed was in case of Group II specimen with a mean value of 11.83 ± 1.92 MPa, whereas the least shear bond strength was observed in case of Group III specimen with a mean value of 10.33 ± 1.31 MPa, with the results being statistically significant (P = 0.014).

Conclusions:
Within the limitations of the present study, it was concluded that comparatively lesser/weaker shear bond strength values were observed in case of specimen belonging to Group III, wherein among the 30 teeth belonging to Group III, 12 teeth showed shear bond strength value of 9 MPa which was the lowest in the study.

The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge.