bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study of the Clinical Characteristics and Severity of Amyotrophic Lateral Sclerosis from North India
Authors: Mani Vinita Elizabeth , Thomas Justin 
Published: May 2024

Introduction:
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease, and severity of disease at presentation decides prognosis and therapeutic options. We aimed to study the clinical characteristics and severity of ALS, and establish a correlation between King's ALS clinical staging and revised ALS Functional Rating Scale (ALSFRS-R) scores.

Materials and Methods:
All patients with clinically definite ALS presenting to the outpatients clinic of a tertiary care institute in North India were included. Their demographic and risk factor profiles were noted, and patients were categorized according to King's ALS clinical staging and ALSFRS-R scores. Correlations between the two scores were done using appropriate statistical tests. All data were analyzed using IBM SPSS version 26 for Macintosh.

Results:
Sixty-three patients with clinically definite ALS were included; of which 42 (66.7%) were male, with a sex ratio of 2:1. The mean duration of symptoms was 11.9 ± 6.6 months (range 3–24 months). Forty-five patients (71%) had limb-onset, and 18 (29%) had bulbar-onset ALS. The mean ALSFRS-R score was 36.5 ± 6.3 (range 16-48), and the scores were significantly lower in females (33.76 ± 5.60 vs. 37.81 ± 6.31; P = 0.01). On correlating the King's ALS clinical staging and ALSFRS-R scores, we found a score of >41 on ALSFRS-R was predictive of Stage 1, 34–41 of Stage 2, and 16–34 of Stage 3 disease.

Conclusions:
ALS has a male preponderance, but females present with more severe symptoms. There is a definite correlation between King's ALS clinical Stages 1-3 and ALSFRS-R scores.
Impact Evaluation and Cost–Benefit Analysis of Remote Orthopedic Consultation Methods in a Low-Resource Health-Care Setting
Authors: James Deeptiman , Kurian Nirmal , John Arun , Verghese Viju Daniel , Cherian Vinoo Mathew 
Published: May 2024

Background:
Geographic barriers, inadequate infrastructure, and large-scale logistics severely limit telemedicine and e-health systems' ability to make orthopedic care accessible to masses in rural centers. With <1% of the registered hospitals in our country connected through telemedicine, novel alternatives are necessary for effective remote consultation in low-resource health-care settings.

Materials and Methods:
A retrospective cohort analysis to compare the impact of “e-mail and telephone-” and “WhatsApp-” assisted remote orthopedic consultations (ROCs) on surgical decision-making and outcome of complex orthopedic conditions treated at a remote location hospital in Central India was conducted by assessing the response time, clarity, peer review accessibility, cost-effectiveness and functional outcome parameters (Visual Analog Score [VAS] and Single Assessment Numerical Evaluation [SANE]), complication rates, and duration of hospital stay. Unpaired t-test was used for statistical analysis.

Results:
Forty-eight patients were included in the study. Remote consultation was carried out through “e-mail and telephone” for 17 patients and through “WhatsApp” for 31 patients. “WhatsApp-” assisted remote consultation enabled quicker response (P < 0.0001), ensured nonambiguity (P < 0.0001), was cost-effective, and facilitated more peer review (P < 0.0001). Mean VAS and SANE scores reflected better outcome in the “WhatsApp-” assisted remote consultation (P < 0.0001), but hospital stay and complication rates were higher in this group.

Conclusions:
“WhatsApp-” assisted ROC had a higher impact and was cost-effective in management of complex orthopedic conditions in the low-resource setting.
Association of herpes zoster with dementia: A systematic review and meta-analysis with GRADE assessment
Authors: Lin Huang-Shen , Lin Yu-Sheng , Tsai Yu-Shiun , Chang Pey-Jium , Chi Ching-Chi 
Published: May 2024

Abstract

Background:
Herpes zoster (HZ) is the reactivation of varicella zoster virus predominantly affecting individuals aged over 50 years. Dementia is a prevalent age-related condition. The association between HZ and dementia was under dispute.

Objectives:
The objective of this study was to evaluate the evidence on the association of HZ with dementia.

Methods:
We conducted a systematic review and meta-analysis to evaluate the risk of dementia in individuals with a history of HZ compared to those without such a history. We searched PubMed, Embase, Medline, and Cochrane Library for studies published up to February 24, 2024. The risk of bias of studies was examined by the Newcastle–Ottawa Scale. A random effects model meta-analysis was performed to calculate the pooled hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses on Alzheimer’s disease (AD), vascular dementia (VD), and cranial nerve involvement of HZ were executed. We used the GRADE methodology to assess the certainty of evidence.

Results:
We included seven cohorts and two case–control studies involving 3,550,251 subjects. The risk of bias of included studies was generally low. The meta-analysis found no association of HZ with dementia (pooled HR 1.00, 95% CI 0.94–1.07 for cohort studies; pooled OR 1.05, 95% CI 0.84–1.30 for case-control studies), with the certainty of evidence being very low. Subgroup analyses for AD, VD, and cranial never HZ also revealed no significant differences (pooled HR being 0.99, 95% CI 0.89–1.09; 1.04, 95% CI 0.85–1.27; and 1.36, 95% CI 0.76–2.43, respectively).

Conclusion:
The current evidence does not support an association of HZ with dementia.
Modeling Causes and Extent of Negligence of Occupational Accidents Assessed by Labor Office Inspectors and Official Experts of the Judiciary
Authors: Yazdi Maryam , Zeverdegani Sara Karimi , Amirkhani Reza , Rismanchian Masoud 
Published: May 2024

Aim:
The purpose of this study was to model the causes and negligence of occupational accidents assessed by labor inspectors and justice official experts of Isfahan province from the perspective of health, safety, and environment management.

Materials and Methods:
This is a descriptive-analytical cross-sectional study that was conducted cross-sectionally to determine the causes of occupational accidents in some industries and workshops in Isfahan province. Data collection was by census, which after reviewing all cases, finally 367 cases completed by inspectors of the labor and justice official experts of Isfahan province have been reviewed.

Results:
The results showed that regarding the injured person's negligence percent, the least agreement was related to the opinion of the inspector and the opinion of the 7-member panel (intra-class correlation coefficient = 31.5%) and then the lowest agreement was related to the opinion of the inspector with the opinions of 3- and 5-member panels. There is a high level of agreement among all groups to determine the percentage of negligence for the contractor (>60%). There was no statistically significant difference between the 3-member and 5-member staff in any of the potential causes of the accident (P > 0.05). This disagreement is seen in 40% of cases. The results showed that the disagreement between the 3-member and the 5-member panels is 27%. The rate of disagreement between the 5-member and 7-member panels is 10%.

Conclusion:
Based on the results, people who have more work experience receive less negligence percentage. However, if the injured person has a higher work experience in the current job, the accident occurred with a higher percentage of negligence.
Evaluation of the Performance of Two Types of Low Volume High Velocity Ventilation Systems for the CO2 Welding Process
Authors: Sabzehali Saeid , Rismanchian Masoud , Feizi Awat 
Published: May 2024

Abstract

Aim:
Millions of workers worldwide are exposed to the complications of fumes and gases welding process. This study aimed to evaluate the performance of two types of hoods installed on CO2 welding torch in a low volume high velocity (LVHV) ventilation system to control its pollutants.

Materials and Methods:
Two designs of slots and bell-shaped hoods were designed with an inner diameter of 46 and 37 mm, respectively. To determine the efficiency of the studied hoods, personal sampling at the source of pollutant production (at a distance of 15 cm from the tip of the torch), was performed by the National Institute of Occupational Safety and Health Method No. 7302. The concentration of iron metals, manganese, and total chromium was measured and analyzed when the LVHV ventilation system was on and off.

Results:
The two designed hoods, showed different efficiencies against the studied metals. The highest efficiency obtained was related to manganese metal in the bell-shaped hood with an average of 84.92%, and the lowest efficiency was related to chromium metal in the slot hood with an average of 13.39%. Optimal exhaust flow rate ventilation obtained for low volume – high-velocity ventilation system was 14 m3/h.

Conclusion:
In general, the bell-shaped hood with 75.34% efficiency had better performance in eliminating welding fumes than the slot-shaped hood, which is due to the physical form of the hood. Therefore, the shape of the hood, distance of the hood from the point of electric arc and exhaust flow rate at the hood opening, are important factors in the design and efficiency of a low volume - high-velocity ventilation system.
Assessing the Knowledge and Attitude of Residents of an Urban Community in Relation to Health Performance of Housing in Kermanshah, Iran
Authors: Nafez Amir Hossein , Rajati Fatemeh , Rahimi Shoeib 
Published: May 2024

Aim:
The aim of this study was to investigate the knowledge and attitude of the staff of a university of medical sciences about housing health in Kermanshah, Iran.

Materials and Methods:
For this cross-sectional descriptive-analytical study, based on Morgan Table 100 people were randomly selected and knowledge and attitudes about housing health were assessed based on a researcher-made questionnaire in 2017. The obtained data were analyzed using SPSS software version 18 and paired t-test on Likert scale.

Results:
A total of 100 employees were studied, more than half of them (60%) were female and more in the group of 20–29 years. The mean scores of knowledge and attitude of the target group regarding housing health were 18.35 and 78.00, respectively. The mean score of knowledge in men and women is significantly different (P < 0.001). However, the attitude scores of the two groups were not statistically significant (P = 0.15). Although knowledge of housing quality was reasonable among respondents, the method of disposing of sanitary waste and housing maintenance was poor. The highest score of women's attitude was related to the groups with diploma and/or associate degree and the highest score of knowledge and attitude in men was related to the groups with bachelor's degree or higher.

Conclusion:
This study showed that people with higher education have better knowledge and attitudes about housing health than people with lower education. However, more research is needed to fully understand the link between housing and adverse health outcomes.
Fragility fracture as the first presentation of Cushing’s disease
Authors: Ghosh Jayaditya , Arjunan Durairaj , Aggarwal Piyush , Pal Rimesh , Walia Rama , Singh Harmandeep , Bhadada Sanjay Kumar 
Published: May 2024

ABSTRACT
Cushing’s syndrome (CS) is a state of glucocorticoid excess with its effect on all the systems of the body. Steroids are known to affect bone health, leading to altered bone microarchitecture. Patients of CS are at increased risk for the development of fracture but fracture as the initial presentation of CS is relatively uncommon. Here, we describe a 31-year-old female who presented with pain in the bilateral hip joint and was found to have a fracture in the right neck of the femur. Though she did not have the classical features of CS, she had striae in the bilateral thigh region. On evaluation, she had a pituitary microadenoma with cortisol dynamics suggestive of Cushing’s disease. The F-18 Fluoride positron emission tomography scan was done, which showed multiple areas of uptake suggestive of fracture. She underwent transsphenoidal surgery and later gamma knife radiotherapy due to the persistence of the disease even after surgery.
Effect of Various Lengths of Respiration on Heart Rate Variability during Simple Bhramari (Humming)
Authors: Trivedi Gunjan Y. , Kathirvel Soundappan , Sharma Kamal , Saboo Banshi 
Published: May 2024

Background:
Heart rate varies during breathing and the heart rate variability (HRV) facilitates the autonomic homeostatic capacity. The maximum HRV was observed at around 10 s of prolonged respiration as per HRV biofeedback literature. However, there is a gap in understanding the variations in HRV by different respiration lengths during simple Bhramari practice.

Objective:
To assess the effect of various respiration lengths (8, 10, 12, and 14 s) on HRV during the simple Bhramari (humming) practice.

Methodology:
A total of 118 individuals (67 males, 51 females) signed up for the study based on convenience sampling at a wellness center. A randomized (simple permutation) within-subject crossover design with repeated measures was used to measure their HRV during the simple Bhramari practice. The results were analyzed with one-way ANOVA and paired samples t-test.

Results:
The results indicate that, unlike the 10 s of respiration during HRV biofeedback breathing, maximum HRV during humming happens between 12 and 14 s of long breathing.

Conclusions:
The unique findings of the study demonstrate the maximization of HRV between the respiration lengths of 12 and 14 s. Future work should explore expanding the research to a broader group of participants, including individuals with chronic conditions and other demographic variables and mantra chanting.
Breath Phase Durations, Affect, and Attention: A Pilot Randomized Crossover Trial
Authors: Telles Shirley , Sharma Sachin Kumar , Kumar Ankur , Gandharva Kumar , Balkrishna Acharya 
Published: May 2024

Objectives:
Previously, yoga volitional breathing with low inspiration to expiration ratios (i/e) (as in bhramari pranayama) improved cognition and reduced state anxiety. This study compared the effects of low, high and equal i/e ratio breathing on affect and attention.

Material and Methods:
Affect, vigor and attention were assessed in forty healthy participants (group mean age± SD; 22.58±3.83; M:F= 2.33:1) while breathing with three different i/e regulated by a visual metronome on separate days viz., (i) low i/e (28:72), (ii) equal i/e (50:50), (iii) high i/e (72:28) compared to control, without conscious breath modification. Assessments were: (i) brief mood introspection scale (BMIS), (ii) global vigor and affect scale (GVAS), (iii) Spielberger's state trait anxiety inventory-state (STAI-S) and a six letter cancellation test to assess sustained attention. Data were analyzed with repeated measures analysis of variance with Bonferroni adjusted post-hoc tests.

Results:
Pleasant feelings increased after low and equal i/e. Low i/e also increased positive feelings whereas equal i/e decreased scores in the cancellation test for sustained attention. All three breathing practices and the control session decreased state anxiety and increased vigor. High i/e breathing alone did not decrease negative feelings. For all the breath ratios the breath frequency cue was set at twelve breaths per minute.

Conclusion:
In summary, varying breath phase ratios influenced positive and pleasant feelings but did not influence state anxiety or vigor. Understanding the mechanisms underlying the findings would be improved with concurrent physiological assessments.
Evaluation of the histopathological spectrum of skin biopsies in patients with chronic kidney disease: A single-center experience
Authors: Fathaddin Amany A 
Published: May 2024

ABSTRACT

Background and Aim:
Patients with chronic kidney disease (CKD), particularly those with end-stage renal disease (ESRD), frequently experience skin problems. Here, we present and discuss the histopathology results of skin biopsies performed on renal patients at our facility.

Materials and Methods:
We retrospectively reviewed all histopathological reports and slides of skin biopsies taken from CKD patients for the last 5 years at the Pathology Department of King Saud University Medical City, King Saud University in Riyadh.

Design:
This is a retrospective cross-sectional study.

Results:
Patients were 19 (43.2%) males and 25 (56.8%) females, with a mean age of 53.4 19.8 years. Diabetic nephropathy, hypertensive nephropathy, and lupus nephritis were the three most common kidney pathologies (59.1%, 11.4%, and 11.4%, respectively). Seventeen patients (38.5%) were receiving hemodialysis. Acquired perforating collagenosis (APC), which was observed in 16 (36.4%) of our patients, was the most prevalent skin pathology, followed by bullous drug reactions in nine (20.5%), leukocytoclastic vasculitis (LCV) in eight (18.2%), calciphylaxis in six (13.6%), and prurigo nodularis in five (11.4%) patients. Erythematous plaques and papules were the most prevalent skin conditions at the time of presentation in 12 patients (27.3%), followed by pruritus in six (13.6%) and ulcerations in six (13.6%) patients. Collected data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26.0.

Conclusion:
A spectrum of skin conditions may be seen in CKD patients. The quality of life of CKD patients will be significantly improved by identifying and managing these conditions. Pathologists’ familiarity with this spectrum is important, as a correct histopathologic diagnosis will lead to a better outcome.
The teaching pathologists association of Mumbai: A legacy that lives on
Authors: Deshpande Jaya , Binayke Rachana , Kandalkar Bhuvaneshwari , Khare Manisha 
Published: May 2024

ABSTRACT
The Teaching Pathologists Association of Mumbai was started by two doyens of pathology, Dr V. R. Khanolkar and Dr. P. V. Gharpure. They were the heads of the departments of pathology at Seth G S Medical College and Grant Government Medical college. The first meeting of the association was held in July 1935 at the Grant Medical College. The idea of the meetings was to know about the work done in other institutes and was attended by staff and students of these institutes. Soon Haffkine Institute joined, followed by Tata Memorial Hospital, TN Medical College, and Lokmanya Tilak Medical College in the late 1960s, with the latest entrant being HBT Medical College in 2023. The meetings that started in 1935 have continued till date (2023) with over 500 meetings being conducted so far. The nature of the meetings was in the form of a presentation by a postgraduate or faculty member. It was left to the discretion of the head of the department. This has been a unique association with no formal office bearers and runs purely on the understanding and cooperation of the senior teachers of these institutes. It has nurtured the spirit of mutual cooperation among the various medical institutes in Mumbai with the exchange and sharing of views and material. This article describes the beginning and subsequent growth of this association, the likes of which are yet to be seen elsewhere.
Evaluation of the significance of tumor stromal patterns and peri-tumoral inflammation in head and neck squamous cell carcinoma with special reference to the Yamamoto–Kohama classification
Authors: Bhuyan Geet , Hazarika Prabir , Rabha Anju M. 
Published: May 2024

ABSTRACT

Introduction:
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with 878,348 new cases. Cancer-associated fibroblasts (CAFs) are the predominant cell type in tumor stroma and are important promoters of tumor progression.

Objective:
The aim of the study was to evaluate the pattern of desmoplastic stromal reaction and peri-tumoral inflammatory infiltrate with the histological grade and clinical data.

Materials and Methods:
A total of 60 cases of HNSCC were included in the study. The hematoxylin and eosin (H and E)-stained sections from all cases were examined by two experienced pathologists for the grade, nature of stomal reaction (SR), peri-tumoral inflammatory infiltration, Yamamoto–Kohama classification grade, worst pattern of invasion (WPOI), depth of invasion (DOI), and other histopathological parameters. Correlation analysis was conducted using the Chi-square test. P-value less than 0.05 was considered statistically significant.

Results:
Immature SR was not observed in any of the well-differentiated squamous cell carcinoma (SCC) cases. However, one (3.7%) case of moderately differentiated SCC and two (28.6%) cases of poorly differentiated SCC showed signs of immature SR. In the case of the higher grades of the YK classification, specifically grades 4C and 4D, a more profound depth of tumor cell invasion, equal to or exceeding 10 mm, was evident in six (66.67%) and two (28.57%) cases, respectively. Additionally, among the seven (11.7%) cases classified as poorly differentiated carcinoma, three (42.85%) displayed a WPOI score of 5.

Conclusion:
SR and the tumor invasive pattern in HNSCC are related to prognosis and may indicate tumor aggressiveness.
Exploring the Physiological Effects of 1% Chloroprocaine in Subarachnoid Block: A Comparative Analysis
Authors: Kumari Poonam , Chourasia Priyanka , Hyanki Divya 
Published: May 2024

Background:
The use of subarachnoid block (SAB), a regional anesthesia technique, has increased with the rise of outpatient surgeries. 1% chloroprocaine, a rapid-onset local anesthetic, is commonly used due to its safety profile and suitability for day care surgeries. However, its specific physiological effects compared to other agents are not well understood. The aim of our study was to compare the physiological effects of 1% chloroprocaine and 0.5% (H) bupivacaine in SAB.

Methodology:
This randomized controlled study included 80 patients, regardless of gender, of age group 18–60 years, scheduled for elective infraumbilical surgeries. Patients were randomly assigned to two groups: Group A received 0.5% bupivacaine (10.5 mg), and Group B received chloroprocaine (40 mg). Key cardiovascular parameters such as heart rate, blood pressure, and oxygen saturation (SpO2) were monitored. The onset and duration of sensory and motor blockade were also assessed.

Results:
Hyperbaric bupivacaine administration resulted in a significant decrease in heart rate during the intraoperative period compared to chloroprocaine. However, there was no significant difference in heart rate between the two groups in the postoperative phase. The mean arterial pressure was significantly lower in patients receiving bupivacaine during both the intraoperative and postoperative periods. SpO2 levels did not differ significantly between the two groups. In terms of sensory block, 1% chloroprocaine showed a significantly faster onset, shorter time to readiness for surgery, and quicker regression to the S2 dermatome compared to bupivacaine. Patients receiving bupivacaine experienced a delayed onset, prolonged duration of motor block, and extended recovery time compared to those receiving 1% chloroprocaine.

Conclusion:
One percent chloroprocaine in SAB maintains cardiovascular function more effectively. It has a minimal impact on SpO2 and offers a rapid onset and shorter duration of sensory and motor blocks without transient neurologic symptoms. Therefore, 1% chloroprocaine is a safe and effective choice for patients undergoing SAB in outpatient surgeries.