bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Yoga Intervention on Psychological Symptoms, Health-Related Quality of Life, and Cardiovascular Risk Factors in People with Coronary Artery Disease: A Systematic Review and Meta-Analysis
Authors: Neto Mansueto Gomes , Saquetto Michelli Bernardone , Roever Leonardo , Carvalho Vitor Oliveira 
Published: May 2024

Background:
Whether yoga is effective in the cardiac rehabilitation of people with coronary artery disease (CAD) remains controversial.

Objective:
The aim of this study was to investigate the effects of yoga intervention on psychological symptoms, health-related quality of life (HRQoL), and major cardiovascular risk factors in people with CAD.

Methods:
We searched MEDLINE/PubMed, Cochrane, EMBASE, and Physiotherapy Evidence Database (from the earliest date available to July 2023). Mean difference (MD), standardized MD (SMD), and 95% confidence interval (CI) were calculated.

Results:
Seventeen studies, with 5,698 patients, met the study criteria. Compared to control (no exercise), yoga resulted in improved depression MD −0.83 (95% CI: −1.35 to −0.31), stress MD −3.83 (95% CI: −4.8 to 2.86), HRQoL SMD 1.48 (95% CI: 0.55 to 2.4), major cardiovascular risk factors (peak VO2 MD 1.7 mL/kg/min [95% CI: 0.2 to 3.3], systolic blood pressure MD −3.2 mmHg [95% CI: −5.9 to −0.5], and diastolic blood pressure MD −2.42 mmHg [95% CI: −4.08 to −0.76]).

Conclusions:
Yoga was effective in the improvement of psychological symptoms, HRQoL, and cardiovascular risk factors.
Spatial analysis of animal bites in Iran (2015-2020): A cross-sectional study
Authors: Amiri Hoda , Yazdanparast Khadijeh , Pourkhosravani Mohsen , Rastegar Maryam 
Published: May 2024

Objective:
To investigate the distribution pattern of animal bites in Mirjaveh, Iran from 2015 to 2020.

Methods:
The data on animal bites were collected from the Department of Infectious Diseases, the provincial health center. Monthly climatic data on precipitation and temperature during the study period were also collected. The correlation between incidence and temperature, precipitation rate, land type, and altitude was also analyzed.

Results:
The results showed that men were more affected by animal bites than women (76.4%, P<0.001), and the highest incidence rate occurred in the age group of 5-19 years. The incidence rate of animal bites was found to be correlated with temperature and altitude. An increase in temperature was associated with a rise in the incidence rate of animal bites. The number of animal bites increased until 2019, possibly due to an increase in the number of dogs in the area.

Conclusions:
Targeted interventions should be implemented to reduce the incidence of animal bites, particularly among children, housewives, and students. Improving access to appropriate treatments, increasing public awareness of the hazards of animal bites, and increasing the number of vaccinated dogs in the area are essential strategies to be considered.
Molecular investigation of exoU and exoY virulence genes in Pseudomonas aeruginosa collected from hospitalized patients in North of Iran: A descriptive-analytical study
Authors: Moradi Ahmad Reza , Gholami Mehrdad , Davoodi Lotfollah , Hajilou Negar , Goli Hamid Reza 
Published: May 2024

Objective:
To investigate the frequency of exoU and exoY genes in patients with Pseudomonas aeruginosa infection.

Methods:
In this study, 100 clinical isolates of Pseudomonas aeruginosa were collected from patients hospitalized in educational- therapeutic hospitals and were identified using standard microbiological tests. Then, the antibiotic resistance pattern of the isolates was determined by the disk agar diffusion method. The bacterial DNAs were extracted by the alkaline lysis method. Finally, the presence of exoU and exoY genes was evaluated by the PCR test.

Results:
In this study, 47%, 72%, 29%, 39%, 40%, and 44% of the isolates were non-susceptible to piperacillin, aztreonam, ceftazidime, imipenem, tobramycin, and ciprofloxacin, respectively. In addition, 95% and 93% of the clinical isolates carried the exoU and exoY genes. Blood and fecal isolates had both virulence genes, while only one wound isolate had neither genes. Meanwhile, all urinary isolates contained the exoY gene and only one isolate lacked the exoU gene. Also, 88 isolates simultaneously had both exoU and exoY genes.

Conclusions:
High prevalence of exoU and exoY genes in this region indicates a significant role of type III secretion system in pathogenesis of Pseudomonas aeruginosa. The type III secretion system may be a suitable target to reduce the pathogenicity of this bacterium.
Death from caustic ingestion: A case report
Authors: Koh Shao Hui , Tan Jacqueline C. L. 
Published: May 2024

Rationale:
Acute caustic ingestion from suicidal intent is not usual in emergency departments in developed countries. One of the substances commonly ingested by suicidal patients, phosphoric acid, tends to cause multi-system derangements.

Patient’s Concern:
A 41-year-old male patient presented with complaints of throat discomfort, severe generalized abdominal pain, and multiple episodes of hematemesis after ingesting a restroom cleaning solution.

Diagnosis:
Poisoning by acute caustic ingestion (containing <30% phosphoric acid and <4% ethylene glycol).

Interventions:
The patient was administered 50 mL of 8.4% sodium bicarbonate solution followed by an isotonic sodium bicarbonate solution running at 500 mL/h, a hyperkalemia kit, ceftriaxone, metronidazole, omeprazole, and atropine. The patient then underwent urgent hemodialysis.

Outcomes:
The patient suffered gastrointestinal bleeding as a result of local caustic injury. In addition, his course of illness was complicated by severe acidemia from high anion gap metabolic acidosis and deranged electrolytes (hyperphosphatemia, hyperkalemia, and hypocalcemia). He developed multi-organ failure and eventually demised.

Lessons:
The clinician needs to be mindful of the multi-system complications arising from such a caustic ingestion. These patients need to be monitored closely for deterioration, and have prompt management of the various arising complications, to reduce the high morbidity and mortality associated with this condition.
Does Age Influence the Functional Recovery after Infant Pyeloplasty?
Authors: Tharanendran Heera , Sundararajan Lakshmi , Babu Ramesh , Arunachalam Pavai 
Published: May 2024

ABSTRACT

Purpose:
The purpose was to study the correlation between age at surgery and functional recovery after infant pyeloplasty.

Materials and Methods:
All infants who underwent pyeloplasty were analyzed retrospectively in this multicenter study. Anteroposterior diameter (APD) >2 cm, split renal function (SRF) <40%, and Society of Fetal Urology (SFU) grade 3–4 were surgical indications. Based on the age at pyeloplasty, they were divided into Group 1 (1–3 months) and Group 2 (4–12 months). APD and SRF were compared before and after surgery in both groups. The fractional recoverable function (post-SRF-pre-SRF)/(50-pre-SRF) ×100 was correlated with age.

Results:
Fifty-one infants underwent pyeloplasty (mean age: 1.6 months – Group 1 and 7.2 months – Group 2). The mean APD decreased from 3 cm to 1.2 cm in Group 1 while 2.8 cm to 2 cm in Group 2 (P = 0.001). The mean SRF increased from 32.28% to 42.81% in Group 1 while 31%–34.18% in Group 2. SRF recovery was significantly higher in Group 1 compared to Group 2 (P = 0.001). Regression analysis showed a weak negative correlation (r = −0.2792) between age at surgery and renal function improvement.

Conclusion:
Functional recovery after pyeloplasty is better when done earlier (1–3 months), as this gives the growing kidney the best opportunity to recover.
Liver Histopathology in Pediatric Patients with Choledochal Cyst
Authors: Mayank Kumar , Choudhury Subhasis Roy , Singh Smita , Sarin Yogesh Kumar 
Published: May 2024

ABSTRACT

Aim:
The aim is to study the various histopathological changes in the liver in pediatric patients with choledochal cyst (CC) and correlate with the presentation and type of cyst.

Methods:
In a prospective observational study including all pediatric patients who underwent CC excision, histopathological changes of the liver in the form of cholestasis (CHS), portal inflammation (PI), bile duct proliferation (BDP), and fibrosis were studied and graded using a scoring system. They were analyzed in relation to age, sex, symptoms, and type of the cyst.

Results:
All 30 patients of CC showed various degrees of histopathological changes in the liver in the form of CHS, PI, BDP, and liver fibrosis. Patients <1 years had 9/13 (69.2%) cystic variety and those >1 years had 17/17 (100%) fusiform variety of CC (P < 0.001). Patients <1 years frequently presented with jaundice and hepatomegaly and those >1 years presented with pain abdomen (P < 0.002). Higher grades of liver fibrosis and BDP were seen in the cystic variety compared to the fusiform variety (P < 0.001). However, no significant association was found with CHS and PI (P > 1.23).

Conclusions:
Histopathological changes in the liver of varying grades are seen in all patients of CC. Patients of CC <1 year presented frequently with jaundice, had the cystic type, and had a higher degree of liver damage on histopathology.
Acellular Bovine Pericardial Patch for Difficult Abdominal Closure in the Pediatric Population: Our Experience with Review of Literature
Authors: Karmakar Debalina , Basu Kalyani Saha , Basu Syamantak , Chakrabarty Saikat , Saha Koushik , Ghosh Dipak 
Published: May 2024

ABSTRACT

Aims:
Closure of congenital body wall defects in children can be a challenging task for the pediatric Surgeon. Biological prosthesis has been increasingly used for high-risk wound closure in adult patients with excellent outcomes and use in the pediatric population has also been reported. Here, we aim to study the outcome of abdominal wound repair with a tissue-engineered acellular bovine pericardial patch.

Methods:
Over a period of 21 months, a total of 15 children had undergone abdominal wound repair with bioprostheses, i.e., bovine pericardial patch at our institute. Patient demographics, cause of defect, an indication of patch use, rate of infection, postoperative recovery, recurrence, and outcome were studied.

Results:
A total of 15 patients underwent abdominal wall closure with acellular bovine pericardial patch. Nine out of 15 patients were neonates, of whom five had gastroschisis, two had a congenital diaphragmatic hernia, and two had ruptured omphalocele major. Of the rest 6 patients, 2 were patients of bladder exstrophy, 2 were older children of congenital diaphragmatic hernia with incisional hernias, and 2 were older children with omphalocele major. Out of the five patients with gastroschisis, two died during the early postoperative period due to sepsis. The wound healed in the rest 13 patients with mild skin dehiscence in two patients. Only one child had a recurrence.

Conclusion:
Reconstruction with acellular bovine pericardial patch is a viable option in children with high-risk abdominal wounds as it allows tensionless repair with excellent healing and minimal complications. Recurrence, if any, may disappear with time as remodeling of the prosthesis occurs along with the growth of the body wall of the child.
Safety and Efficacy of Enhanced Recovery after Surgery Protocol in Pediatric Patients Undergoing Hepato-Pancreatico-Biliary Surgery: A Prospective Randomized Control Study
Authors: Kanneganti Pujana , Verma Anju , Mandelia Ankur , Upadhyaya Vijai Datta , Kumar Basant , Kumar Tarun , Agarwal Nishant , Kannojia Ashish 
Published: May 2024

ABSTRACT

Introduction:
Enhanced recovery after surgery (ERAS) is a multidisciplinary approach to optimize patient care. The goal of this approach is to reduce the body’s reaction to surgical stress by optimizing the perioperative nutritional status, promoting analgesia without opioids, and early postoperative feeding. In pediatric patients, very limited literature is available for the application of ERAS protocol. This study was done to evaluate the application of ERAS protocol in pediatric hepatobiliary and pancreatic patients.

Materials and Methods:
This is a randomized prospective study conducted over a period of 2 years at a tertiary center in North India. A total of 40 hepatobiliary and pancreatic patients who were willing to participate in the study were included in the study. Patients were randomized by computer-generated method and data were collected regarding demography, clinical diagnosis, preoperative and postoperative workup, and peri-operative care including analgesia, pain scores, postoperative recovery, hospital stay, and complications. These patients were followed for 6 months postoperatively and the results were evaluated using SPSS software.

Results:
The study included 20 patients each in both the conventional and ERAS group with median ages of 11.5 years and 7.1 years, respectively. The data analysis showed that the ERAS group of patients had better outcomes in terms of hospital stay and drain removal time with significant statistical differences. Pain scores and complications are almost the same in both groups.

Conclusion:
Principles of ERAS can be safely applied in pediatric patients undergoing major surgery in the present era of emerging infections and also increasing patient burden without morbidity.
Orthodontic treatment in adults: Challenges, outcomes, and factors affecting compliance and satisfaction
Authors: Pattanaik Snigdha , Veeraraghavan Vishnu Priya , Dasari Arun Kumar , Patil Santosh R. , Alzahrani Saeed G. , Fareed Mohammad 
Published: May 2024

BACKGROUND:
The demand for orthodontic treatment among adults has witnessed a substantial rise in recent years. This study aims to explore the complexities of adult orthodontics, focusing on challenges faced, treatment outcomes, and the influence of factors such as age, gender, and education on patient compliance and satisfaction.

METHODS:
A multi-dimensional approach was employed, combining a review of clinical records with structured patient surveys. Descriptive statistics summarized demographic characteristics, treatment duration, and orthodontic problems addressed. Inferential statistics included Pearson correlation, Chi-squared tests, and analysis of variance to examine age compliance, gendersatisfaction, and education-orthodontic problem relationships. Qualitative analysis enriched findings, and statistical software facilitated data processing.

RESULTS:
The analysis revealed a statistically significant negative correlation between age and compliance (r = -0.28, P < 0.05), indicating that younger participants demonstrated higher compliance rates. Gender emerged as a significant factor influencing patient satisfaction (P = 0.024), with females reporting notably higher levels of satisfaction than males. Furthermore, participants with advanced education levels (Master’s/Ph.D.) were significantly more likely to have orthodontic issues related to malocclusion (P = 0.041).

CONCLUSION:
The study provides an insight into the multi-dimensional aspects of adult orthodontics, recognizing the challenges, compliance, and satisfaction levels. Tailored approaches considering age, gender, and education are essential. This research contributes to a deeper understanding of orthodontic treatment in adults and its potential implications for enhanced patient care.
Assessment of salivary tumor necrosis factor-alpha level in the initial stages of treatment with fixed appliances and clear aligners
Authors: Hassan Sarfraz , Shetty Mukul , Shetty Shravan , Naik Roopak 
Published: May 2024

OBJECTIVES:
To assess and compare the tumor necrosis factor-alpha (TNF-α) levels in saliva samples during the initial stages of orthodontic treatment with fixed orthodontic appliances (FAs) and clear aligners (CAs).

MATERIALS AND METHODS:
This longitudinal study comprised 40 patients (22 males, 18 females, mean age 22 ± 7 years) who were categorized into two equal-sized groups. Group A comprised 20 patients treated with FA, and Group B comprised 20 patients treated with CA. Unstimulated saliva was collected before the intiation of treatment and then collected again after the placement of the FA/CA at 24 hrs, 7th day, and on the 21st day in both groups. TNF-α levels were determined through ELISA.

STATISTICAL ANALYSIS:
The data were subjected to statistical analysis. For intragroup comparison of TNF-α at different time points, the Wilcoxon matched-pairs signed-rank test was used, and for intergroup comparison of FAs and CAs at different time points, the Mann–Whitney U test was used.

RESULTS:
TNF-α levels in the saliva increased significantly at 24 hours, followed by a decline on the 7th day and 21st day in both groups. Changes in TNF-α levels were significantly higher in the FA group than those in the CA group at different time points.

CONCLUSION:
This study showed that the salivary TNF-α levels increased significantly during the initial stages of FA and CA treatment at different time points. The mean salivary TNF-α level in both FA and CA groups increased significantly at 24 hours, followed by a decline on the 7th day and then on the 21st day. There was a significant difference between the FA and CA treatment, where the CAs showed a significantly low level of TNF-α in saliva at different intervals of time when compared to the FAs.
SEXISM IN FLANNERY O'CONNOR'S “WISE BLOOD”
Authors: Gebreen Hayder , Jawad Mustafa Talib 
Published: May 2024

This research paper aims to explore the theme of sexism, particularly within Flannery O'Connor's novel “Wise Blood”. Historically, societies have upheld a patriarchal structure where men were considered the standard while women were viewed as exceptions. For instance, Aristotle famously asserted that women were inferior to men but superior to slaves, elevating men as the epitome of human perfection. Despite progress over time, deep-seated prejudices against women have persisted, manifesting in various forms such as sexual harassment and domestic violence. Consequently, sexism permeates multiple aspects of life, not confined to any single domain. In recent years, there has been a notable increase in women's educational attainment, with more females attending college and graduating with degrees in traditionally male-dominated fields like the sciences. However, despite these advancements, disparities persist, with fewer women pursuing careers in areas such as science and academia. Numerous factors contribute to perpetuating sexism, including societal expectations surrounding motherhood and family commitments, early socialization patterns that shape interactions between genders, institutional barriers within certain fields, and even conjectures rooted in biological differences. This paper endeavors to examine these multifaceted aspects of sexism in both literature and contemporary society.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0787/a.php" alt="Hit counter" /></p>
EMPAIA International e. V.: Pioneer in Digital Pathology
Authors: Hufnagl Peter , Müller Helmo , Zerbe Norman 
Published: May 2024

The recently founded association EMPAIA International e. V. is a pioneer in collaboration and innovation in digital and computational pathology. Continuing the work of the EMPAIA project (2019–2023), which received public funding from the German Federal Ministry for Economic Affairs and Climate Action, the association brings together a broad range of stakeholders to accelerate progress in AI-assisted diagnostics. With its clear focus on standardization, advocacy, and promoting innovation, EMPAIA International plays a leading role in shaping the future of digital pathology.
Influence of Clinician-Related Factors on Adherence to the American Heart Association Guidelines for Acute Coronary Syndrome among Clinicians at Kenya Ports Authority Clinics in Mombasa, Kenya
Authors: Mailu Mary , Shariff Nilufa , Mbugua Ruth 
Published: May 2024

Purpose: The aim of the study was to assess influence of clinician-related factors on adherence to the American heart association guidelines for acute coronary syndrome among clinicians at Kenya Ports Authority clinics in Mombasa, Kenya.
Methodology: A descriptive cross-sectional study involving quantitative methods of data collection was adopted. An interviewer administered questionnaire was used for data collection. The study was carried out in Kenya Ports Authority clinics in Mombasa, Kenya. The target population was 106 clinicians attending to patients who present with Acute Coronary Syndrome at the KPA clinics in Mombasa. A census method was used to determine the study participants. The sample size was made up of a hundred and six participants. The clinicians who consented to participate in the study were included while those who were on sick off, leave or who recently joined the clinic were excluded. Pretesting of the study tool was done at the Kenya Pipeline Clinic Mombasa. Data analysis was done using Statistical Package for Social Sciences version 25 and presented via tables.
Findings: The study results showed that at 95% level of confidence (ρ-value = 0.05%), there was a significant association between gender (ᾳ=0.025), work experience (ᾳ=0.016), job cadre (ᾳ=0.014) and training received (ᾳ=0.022) on adherence to the American Heart Association Guidelines for Acute Coronary Syndrome among clinicians at Kenya Ports Authority clinics in Mombasa, Kenya. The association was insignificant between age (ᾳ=0.178), education level (ᾳ=0.439) and specialization (ᾳ=0.489) on adherence to the AHA guidelines.
Unique Contribution to Theory, Practice and Policy: The study recommends that the KPA management should increase the medical budget to ensure availability of adequate resources for ACS patient management. These resources include adequate staffing, medication, equipment, and staff training costs. The clinic management should ensure that medications such as aspirin, morphine and nitroglycerine are readily available and accessible at patients care points. The KPA clinic management to formulate a simple algorithm that outlines the steps to be taken when managing ACS patients. The study recommends that the clinics should assess their equipment reqularly for maintenance controls to ensure efficiency. The study further recommends random assessments and post care audits to assess the adherence to ACS guidelines among clinicians. Training associated with adherence to the AHA guidelines and as such, KPA should continue offering training and education on the latest AHA guidelines for ACS to ensure updated guidelines for practice.
Patala the layers of Eye - basis of all eye disorders in Ayurveda a critical review.
Authors: Sharma Himani , Mehar Kapil , Tripathi Ankur , Bavalatti Narayan , Kundal Pankaj , Sharma Swati 
Published: May 2024

Ayurveda is a science that is discovery oriented and explore fundamental theory as scientific facts. With time these facts have been illustrated by the founding fathers of Ayurveda. Ayurvedic dogma have elucidated Netra Rachna Sharir and Kriya Sharir in a beautiful descriptive manner, still there is need of exploring the terminologies for proper understanding of pathogenesis of Netra Rogas and their managements so that implementation of Ayurvedic concepts in eye disease can be done. Acharya sushruta elucidated the Netra Sharira into three distinct part called as Mandala, Sandhi and Patala. In this literary research paper we have tried to establish alliance of Netra Patalas according to their anatomical position in eye and pathology.