bluuebunny/crossref_metadata_2025_split huggingface dataset:
IJCM_299A: Clinical profile of patients with dengue: a cross-sectional study from a tertiary care hospital, Karnataka
Authors: Nivetha S , Kumar Ashwini , Saravu Kavitha , Eshwari K 
Published: April 2024

Background:
Dengue fever (DF) are among the most important mosquito- borne diseases of the Indian subcontinent and have become a major global public health concern. Its clinical manifestations of which vary from influenza- like illness (DF) to life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The purpose of the study was to find out the mode of presentation, biochemical profile and complications of Dengue cases in an apical level.

Objectives:
1. To identify socio-demographic characteristics and clinical features; 2. To document the disease specific management and outcomes

Methodology:
A cross-sectional study of admitted patients was conducted in the department of medicine and Infectious Diseases over a period of 9 months (15/2/2023 -15/11/2023). Patients aged above 18 years with serology proven (nonstructural protein 1 [NS1]/dengue immunoglobulin M [IgM]) DF were included in this study. Their Socio demographic Details, clinical and laboratory data was recorded and analyzed.

Results:
Preliminary Results: Out of 125 cases, - 89 (71.2 %) patients were males and 36 (28.8%) were females. - The most common presentations were fever (96%) followed by Nausea/vomiting (40%), Headache (35%) and myalgia (31%). - Dengue NS1 and IgM antibodies were positive in 87.3% and 88.12% of the patients, respectively. - the incidence of DF, DHF, and DSS was 87.2, 11.2, and 1.6% respectively. - Shock, bleeding, and elevated serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase levels predicted adverse outcome.

Conclusion:
DF can present with a spectrum of clinical manifestations ranging from mild self-limiting illness to severe fatal disease. It can have varied and multi-systemic manifestations which can go unrecognized. Continuous seroepidemiological surveillance is essential to control outbreak and minimize morbidity and mortality.
IJCM_61A: Prevalence of Domestic Violence Among Married Women in urban and rural field practice area of RIMS, Raichur
Authors: Radha K. Jeeva , Neelopant Sushrita , Kirte Rahul C. , Basagoudar Shashidhar. S. 
Published: April 2024

Background:
Domestic violence (DV), being a widespread public health issue affecting women globally, is still being neglected and women remain silent sufferers and suffer from physical, mental, sexual and reproductive health consequences which further affects well-being of her family. It also leads to increased risk of child abuse. Women being considered as weaker sex, gender bias and male dominance resulted in mistreating women and victimizing them and remains unreported in many areas.

Objective:
To estimate prevalence of domestic violence among married women. €¢ To compare prevalence of domestic violence in urban and rural areas. €¢ To find out factors associated with prevalence of domestic violence.

Methodology:
Cross sectional study, 3 months duration in married women residing in field practice areas of RIMS, Raichur. Least prevalence found in a study having 28%. Using the formula N = Z2pq/ d2 sample size calculated as 257. Almost population of UHTC, RHTC and PHC are similar, equal number of samples (86) taken from all 3 areas. Community consent obtained from representatives, Home visits were made, informed oral consent obtained, face to face interview done using pre-designed, pre-tested questionnaire. Statistical analysis done using SPSS, means and standard deviations calculated. Chi square test used to calculate the associations.

Results:
Prevalence of DV is 33.3% and 16% of them are currently experiencing domestic violence. 36.4% of rural participants have experienced DV compared to 21.2% in urban participants & these differences were statistically significant as indicated by p value of 0.037. Factors such as religion, caste, type of family, education of female, spousal education, spousal occupation, alcohol consumption by husband, smoking habit of husband, history of parental abuse in spousal family, etc.. are associated with domestic violence.

Conclusion:
We conclude that domestic violence is mostly done by husband followed by mother-in-law and most common solution offered was to advice husband.
Detection of Molecular Variations at Androgen Receptor Gene in 46,XY Differences in Sex Development Cases
Authors: Marzuki Nanis S. , Kartapradja Hannie D. , Coutrier Farah N. , Wahyudi Irfan , Batubara Jose R.L. 
Published: April 2024

Abstract

Introduction:
One of the common causes of 46,XY differences in sex development (DSD) cases is androgen insensitivity syndrome. This X-linked recessive inherited condition is associated with pathological variations of the AR gene, leading to defects in androgen action. Affected 46,XY infants or individuals experience variable degrees of undervirilization and those with severe form will have female-like external genitalia. Therefore, they were more likely assigned and reared as females. The confirmatory molecular test is often needed due to similar clinical manifestations with other conditions causing 46,XY DSD. Since in our country, the molecular test for the AR gene is lacking, the study is conducted as a preliminary study to elaborate on the possibility of developing a molecular test for the AR gene in 46,XY DSD cases.

Methods:
Archived DNAs of 13 46,XY DSD cases were analyzed using polymerase chain reaction and direct sequencing for molecular defects in the AR gene. Clinical and hormonal data were collected and analyzed.

Results:
The study successfully amplified and visualized the eight exons of the AR gene and revealed two subjects carrying AR gene variants at exon 7. In the first case, 1.2-year-old boy carried heterozygous p.Gln825Arg, which has never been reported elsewhere, and the second subject, a 2.1-year-old girl with heterozygous p.Arg841His. Both subjects presented with severe undervirilization of external genitalia with external genitalia masculinization scores (EMS) of 1.5 and 3.

Conclusion:
In this series, two of 13 46,XY DSD cases carried variants at the AR gene, resulting in complete androgen insensitivity syndrome.
Clinical usefulness of nebulized dexmedetomidine for conscious sedation in daycare flexible bronchoscopy in Southern India
Authors: Antony Thomas , Acharya K. Vishak , Acharya Preetam Rajgopal , Kotian Himani , Kamath Sindhu 
Published: April 2024

Abstract

BACKGROUND:
Sedative agents used in bronchoscopy require trained personnel to administer and monitor the patient. This increases the procedure cost, duration, and inpatient stay. Inhalational administration of sedative agents can be a practical solution to the issue. Dexmedetomidine in the inhalational form could give results similar to the intravenous form without significant adverse events.

MATERIALS AND METHODS:
The study is prospective, randomized, and double-blinded study. Patients needing bronchoscopy were randomized to receive the nebulized form of either dexmedetomidine or saline (0.9%) before bronchoscopy. The study parameters are assessed and recorded before, during, and after bronchoscopy. Data collected are analyzed using the SPSS software.

DISCUSSION:
The side effects limit using commonly administered sedation agents in bronchoscopy, such as midazolam, fentanyl, and dexmedetomidine. The nebulized dexmedetomidine is safe with proven efficacy when compared to the placebo. Proceduralist-administered conscious sedation reduces the overall cost and shortens inpatient stays. Attenuation of hemodynamic parameters by dexmedetomidine could be an advantage for the physician in reducing an untoward cardiac event.

CONCLUSION:
Dexmedetomidine in the nebulized form improves the comfort of patients during the procedure. It blunts the pressure response during bronchoscopy and could be a safer and cost-effective agent in its nebulized form for conscious sedation in bronchoscopy. The study is approved by the institutional ethics committee (IEC KMC MLR 10-2021-310).
Neutralization antibody titer and change in 50% protection after the third dose of the COVID-19 vaccine
Authors: Mungmunpuntipantip Rujittika , Wiwanitkit Viroj 
Published: April 2024

Abstract

BACKGROUND:
The new COVID-19 variant outbreak is the present global public health problem. The omicron variant of SARS-CoV-2 has several subvariants and causes outbreaks worldwide. Because of the increasing genetic heterogeneity of SARS-CoV-2, it is expected that using COVID-19 immunization to prevent and control disease will be problematic.

AIM:
The aim of the study was to study neutralization of antibody titer and change in 50% protection after the third dose of the COVID-19 vaccine.

MATERIALS AND METHODS:
In this report, the authors determine the expected neutralization antibody titer against omicron subvariants and the change in 50% protection against infection after the third dose of the immunization.

RESULTS:
The change due to subvariant B.4 or B.5 is substantially higher than that due to the other subvariants. The efficacy of using viral vector vaccine boosters is questionable since viral vector COVID-19 boosters fail to generate enough antibodies to achieve the mean convalescent plasma level.

CONCLUSION:
Higher antibody levels than the typical convalescent level and that needed for half protective property are still possible with the mRNA vaccine booster shot. In addition, compared to the half-dose regimen, the full-dose regimen produces a higher antibody level. As a booster shot, the mRNA COVID-19 vaccine is recommended.
Off-target effect of high-dose sildenafil on adenosine 5’- diphosphate and collagen-induced platelet activation through mitogen-activated protein kinase pathway in treated BALB/C mice and in vitro experiments: A preliminary study
Authors: Balaji Sudharshanan , Patnaik Yash Raj , Surin William Rasican 
Published: April 2024

Abstract
Sildenafil, a common over-the-counter pill often self-administered at high doses for erectile dysfunction, has been reported to rarely cause prothrombotic events and sudden cardiac death in a few case reports. Therefore, we investigated the in vitro and in vivo effect of sildenafil treatment and dosage on platelet activation and mitogen-activated protein kinase (MAPK) phosphorylation. BALB/C mice were segregated into four groups, each having four mice each (control, low [3.25 mg/kg], medium [6.5 mg/kg], and high [13 mg/kg] sildenafil), and after the treatment, blood was drawn from each mouse and washed platelets prepared. Washed platelets were incubated with CD41 PE-Cy7 and Phospho-p38 MAPK PE antibodies and analyzed using a flow cytometer for platelet activation and adenosine 5’- diphosphate (ADP)/collagen-induced MAPK phosphorylation. Washed platelets obtained from the venous blood of 18 human volunteers, were incubated with PAC-1 FITC and Phospho-p38 MAPK PE antibodies, and platelet activation (ADP and collagen), followed by flow cytometry analysis. There was a significant increase in both platelet activation as well as MAPK phosphorylation in the presence of collagen in the high-dose (13 mg/kg) sildenafil group (P = 0.000774). Further, increased platelet activation was observed in samples that were treated with high-dose sildenafil as compared to the untreated samples (P < 0.00001). These studies show the risk of prothrombotic episodes in patients on high-dose sildenafil (100 mg), in those with even mild endothelial dysfunction due to ADP, and collagen-induced platelet activation through MAPK phosphorylation, which was not seen in the low-and intermediate-dose cohorts.
Prescription-based cost analysis of medicines for cardiovascular risk factors at Indian Council of Medical Research-Rational Use of Medicine Centre Hospitals of India
Authors: Chugh Preeta Kaur , Gupta Pooja , Wasan Himika , Tripathi C. D. , Chandy Sujith J. , Ranjalkar Jaya , Bright Heber Rew , Badyal Dinesh Kumar , Samuel Madhulika Peter , Jhaj Ratinder , Banerjee Aditya , Joshi Rupa , Medhi Bikash , Prakash Ajay , Kamat Sandhya , Tripathi Raakhi , Shetty Yashashri , Parmar Urwashi , Dikshit Harihar , Mishra Hitesh , Roy Sukalyan Saha , Kumar Rajiv , Chatterjee Suparna , Bhattacharya Manjari , Samanta Kalyan , Trivedi Niyati , Shah Prashant , Chauhan Janki , Ramasamy Raveendran , Mathaiyan Jayanthi , Gauthaman Jeevitha , Kaushal Sandeep , Jain Samriti , Arora Shalini , Gupta Kanchan , Cherian Jerin Jose , Chatterjee Nabendu Sekhar , Kshirsagar Nilima Arun 
Published: April 2024

Abstract

OBJECTIVES:
India has taken several initiatives to provide health care to its population while keeping the related expenditure minimum. Since cardiovascular diseases are the most prevalent chronic conditions, in the present study, we aimed to analyze the difference in prices of medicines prescribed for three cardiovascular risk factors, based on (a) listed and not listed in the National List of Essential Medicines (NLEM) and (b) generic and branded drugs.

MATERIALS AND METHODS:
Outpatient prescriptions for diabetes mellitus, hypertension, and dyslipidemia were retrospectively analyzed from 12 tertiary centers. The prices of medicines prescribed were compared based on presence or absence in NLEM India-2015 and prescribing by generic versus brand name. The price was standardized and presented as average price per medicine per year for a given medicine. The results are presented in Indian rupee (INR) and as median (range).

RESULTS:
Of the 4,736 prescriptions collected, 843 contained oral antidiabetic, antihypertensive, and/or hypolipidemic medicines. The price per medicine per year for NLEM oral antidiabetics was INR 2849 (2593–3104) and for non-NLEM was INR 5343 (2964–14364). It was INR 806 (243–2132) for generic and INR 3809 (1968–14364) for branded antidiabetics. Antihypertensives and hypolipidemics followed the trend. The price of branded non-NLEM medicines was 5–22 times higher compared to generic NLEM which, for a population of 1.37 billion, would translate to a potential saving of 346.8 billion INR for statins. The variability was significant for sulfonylureas, angiotensin receptor blockers, beta-blockers, diuretics, and statins (P < 0.0001).

CONCLUSION:
The study highlights an urgent need for intervention to actualize the maximum benefit of government policies and minimize the out-of-pocket expenditure on medicines.
Tumor-targeted gypenoside nanodrug delivery system with double protective layers
Authors: Lai Zongqiang , Bai Facheng , Pu Tao , Li Jun , Wu Lining , Zhou Zhou , Yang Nuo 
Published: April 2024

ABSTRACT

Objectives:
Gypenoside (Gyp) is easily degraded in the gastrointestinal tract, resulting in its low bioavailability. We aimed to develop a tumor-targeted Gyp nanodrug delivery system and to investigate its antitumor effect in vitro.

Materials and Methods:
We used Gyp as the therapeutic drug molecule, mesoporous silica (MSN) and liposome (Lipo) as the drug carrier and protective layers, and aptamer SYL3C as the targeting element to establish a tumor-targeted nanodrug delivery system (i.e., SYL3C-Lipo@Gyp-MSN). The characteristics of SYL3C-Lipo@Gyp-MSN were investigated, and its drug release performance, cell uptake, and antitumor activity in vitro were evaluated.

Results:
A tumor-targeted Gyp nanodrug delivery system was successfully prepared. The SYL3C-Lipo@Gyp-MSN was spherical or ellipsoidal; had good dispersion, which enabled it to specifically target and kill the liver tumor cell HepG2; and effectively protected the early leakage of Gyp.

Conclusions:
We have established a tumor-targeted nanodrug delivery system that can target and kill liver cancer cells and may provide a strategy for preparing new nanodrug-loaded preparations of traditional Chinese medicine.
Activation of M2 macrophage autophagy by rapamycin increases the radiosensitivity of colorectal cancer xenografts
Authors: Shao Lening , Wu Yongyou , Cao Jianping , Zhong Fengyun , Yang Xiaodong , Xing Chungen 
Published: April 2024

ABSTRACT

Background:
Tumor-associated macrophages (TAMs) are intimately involved in cancer radiochemotherapy resistance. However, the mechanism by which macrophages affect radiosensitivity through autophagy remains unclear. The purpose of our study was to investigate how activating autophagy in type-II macrophages (M2) by using rapamycin (RAP) would affect the radiosensitivity of colorectal cancer (CRC) xenografts.

Materials and Methods:
A nude mouse CRC model was established by injecting LoVo CRC cells. After tumor formation, supernatant from M2 cells (autophagy-unactivated), autophagy-activated M2 cells, or autophagy-downregulated M2 cells was injected peritumorally. All tumor-bearing mice were irradiated with 8-Gy X-rays twice, and the radiosensitivity of CRC xenografts was analyzed in each group.

Results:
The mass, volume, and microvessel density (MVD) of tumors in the autophagy-unactivated M2 group significantly increased; however, supernatant from M2 cells that were autophagy-activated by rapamycin significantly decreased tumor weight, volume, and MVD compared with negative control. Combining bafilomycin A1 (BAF-A1) with RAP treatment restored the ability of the M2 supernatant to increase tumor mass, volume, and MVD. Immunohistochemical and Western blot results showed that compared with the negative control group, supernatant from M2 cells that were not activated by autophagy downregulated the expression of Livin and Survivin in tumor tissues; activation of M2 autophagy further downregulated the protein levels.

Conclusions:
Therefore, autophagy-activated M2 supernatant can downregulate the expression of the antiapoptotic genes Livin and Survivin in CRC xenografts, improving the radiosensitivity of CRC by inducing apoptosis in combination with radiotherapy and inhibiting the growth of transplanted tumors.
Intracerebral Aneurysms in the Young: Institutional Series and Review of Literature
Authors: Menon Girish , Srinivasan Siddharth , Kanneganti Yasaswi , Nair Rajesh , Hegde Ajay 
Published: April 2024

ABSTRACT

Introduction:
Intracranial (IC) aneurysms in the paediatric population are uncommon. The natural history, clinical presentation and clinical outcome of children with IC aneurysms are different from their adult counterparts. We analyse our hospital database for IC aneurysms in children <20 years and present our findings.

Materials and Methods:
A retrospective review of case records of patients less than 20 years admitted with IC aneurysm was conducted at our institute. Details of clinical presentation, treatment provided and outcome were obtained from the case records.

Results:
Ten children were admitted with IC aneurysms. The mean age of presentation was 16.5 ± 3.43 years (9–20 years). While 90% were spontaneous in presentation, one case was post-traumatic. Nine patients underwent treatment for their aneurysm in the form of microsurgical clipping. Subarachnoid haemorrhage with intracerebral haemorrhage was the most common mode of presentation. Outcome was good in 80% and poor in 20% of patients. One patient succumbed to the illness before treatment.

Conclusion:
IC aneurysms in the young are represent a small subset of patients with aneurysms. IC aneurysms in the young represent a small subset of patients with aneurysms predominantly located in the anterior circulation. Micro-surgical treatment provides excellent outcomes in these patients.
Study of Microsurgical Anatomy of Middle Cerebral Artery in Human Cadaveric Brain
Authors: Gupta Vishnu , Jha Deepak Kumar , Gosal Jaskaran Singh , Dixit Shilpi Gupta , Nayyar Ashish Kumar , Ghatak Surajit 
Published: April 2024

ABSTRACT

Background:
Micro-dissection of cadaver specimens is the base, on which our knowledge of the intricate anatomy of the human brain. Microsurgical anatomy of middle cerebral artery (MCA) is of particulate interest to neurosurgeons as it is the largest and most complex arterial system of the brain. Although various studies have been done on MCA, no such study has been done taking into consideration large sample size of the Indian population. This study will be advantageous in improving knowledge of MCA and its variations. This will prove useful for neurosurgeons in performing microsurgeries.

Objective:
A study of the microsurgical anatomy of the MCA in human cadaveric brain; comparison of the findings with the existing studies and implication of these finding in micro-neurosurgical procedures.

Materials and Methods:
Sixteen formalin-fixed cadaveric brains, that is, 32 vessels from its origin from the internal cerebral artery to M1 segment with respect to diameter, length and branching pattern were studied under high magnification (operating microscope) and the data compared with literature.

Results:
The mean length of M1 was 24.1 ± 11 mm with the outer diameter of 3.1 ± 08 mm. An average number of perforators pre-bifurcation was 7 and post-bifurcation was 3. The pattern of branching of the main trunk was bifurcation (70%), trifurcation (20%) and tetrafurcation (10%), and amongst this, inferior trunk dominance was seen in 70%. An average number of early cortical branch was 3.

Conclusion:
The knowledge of anatomy of MCA and its variations is important for neurosurgical residents’ training and neurosurgeons dealing with MCA aneurysm management or bypass surgeries.