bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tongue and teeth hyperpigmentation in etoposide, prednisolone, vincristine, and cyclophosphamide regimen in the treatment of cutaneous lymphoma
Authors: Morabad Soumya Shivalingappa , Khan Zahed Ullah , Gad Richa , Kallur Nikitha , Madhabhavi Irappa Vithoba , Shalavadi Mallappa Hanumanthappa , Mangannavar Chandrashekhar Venkaraddi 
Published: May 2024

Abstract:
Cutaneous extranodal non-Hodgkin lymphoma is a rare cancer and chemotherapeutic agents like etoposide, vincristine and cyclophosphamide are the drug of choice, which rarely cause hyperpigmentation in skin and nails. However, herein we present a case of hyperpigmentation that was seen in tongue and even in teeth. The hyperpigmentation of the tongue and teeth occurred shortly after the initiation of chemotherapy. Hyperpigmentation was self-limiting and rectified in a week without need of any pharmacological, surgical, or lifestyle interventions.
Materiovigilance of unidirectional barbed and poliglecaprone 25 nonbarbed sutures used for intraoral incision closure
Authors: Deo Jaspreet Kaur , Rehan Harmeet Singh , Mehra Pravesh 
Published: May 2024

INTRODUCTION:
The adverse events of sutures used for the closure of surgical incisions influence clinical outcomes. Literature on the safety profile of the application of unidirectional barbed sutures in oral and maxillofacial surgery is scarce. Hence, focused materiovigilance was done to monitor and compare the adverse events of unidirectional barbed and poliglecaprone 25 nonbarbed sutures for intraoral incision closure.

METHODS:
In a prospective randomized comparative study, 64 patients requiring intraoral incision closure were randomized to receive either unidirectional barbed or poliglecaprone 25 nonbarbed sutures. Postoperatively, patients were monitored for any adverse events for 15 days. Causality association of adverse events with sutures was done using the European Commission directives on safety reporting of medical devices.

RESULTS:
Adverse events observed with unidirectional barbed suture were suture extrusion (n = 7; 21.875%) and suture discomfort (n = 3; 9.375%). While subjects who received poliglecaprone 25 suture experienced suture discomfort (n = 6; 18.75%) and knot unraveling (n = 2; 6.25%). The number of adverse events in both groups was statistically comparable (P = 0.78). Causality assessment of adverse events was probable for suture extrusion and discomfort with nonbarbed and barbed sutures, while it was possible for knot unraveling for nonbarbed sutures.

CONCLUSION:
Both types of study sutures were associated with minor severity adverse events when used for the closure of intraoral surgical incisions. Suture extrusion had a probable causal association with barbed suture. Knot unraveling was possibly associated with the nonbarbed suture. Both types of suture materials were equally safe in oral and maxillofacial intraoral surgical incision closure.
Cost-minimization analysis of escitalopram, fluoxetine, and amitriptyline in the treatment of depression
Authors: Salian Harshit Hemant , Raghav M. V. , Rawat Vikram Singh , Divakar A. 
Published: May 2024

INTRODUCTION:
Escitalopram, fluoxetine, and amitriptyline are the drugs commonly used in the treatment of depression. The pharmacoeconomic evaluation of these drugs becomes relevant as they are prescribed for a long period of time, and depression causes a significant economic burden. The cost-minimization study would contribute to bringing down the annual treatment costs, leading to better medication adherence and ultimately better patient outcomes.

MATERIALS AND METHODS:
All drug prices are mentioned in Indian National Rupee (INR). All expenses are based on 2022 pricing. No cost discounting was used because all expenditures were calculated over a year. We considered hypothetical scenarios where the patient was prescribed the lowest possible dose for depression, an equivalent antidepressant dose, a defined daily dose, and the maximum acceptable therapeutic dose for depression.

RESULTS:
Annual average treatment costs of amitriptyline, escitalopram, and fluoxetine in patients with depression at baseline with equivalent dosing as mono-drug therapy were 2765.53, 2914.78, and 1422.72 rupees (INR), respectively. Savings were high when the patient was shifted to fluoxetine from either escitalopram or amitriptyline. The savings from switching to fluoxetine were 50.66% and 56.42% from escitalopram and amitriptyline, respectively.

CONCLUSION:
The choice of an antidepressant depends on multiple aspects, among which the cost of treatment plays a crucial role. Among the drugs compared, fluoxetine seems to offer greater value for money. The study emphasizes that selective serotonin reuptake inhibitors are the most commonly prescribed antidepressants not only because of their favorable pharmacological profile but also because of their affordability.
Simultaneous determination of lactulose, sucrose, sucralose, and mannitol using high-performance liquid chromatography-refractive index to estimate intestinal permeability in patients with active ulcerative colitis
Authors: Sarotra Pooja , Dutta Usha , Gupta Hina , Ravindranathan Kartha K P , Kochhar Rakesh , Prakash Ajay , Sarma Phulen , Shah Jimil , Medhi Bikash 
Published: May 2024

OBJECTIVES:
The intestinal permeability (IP) of sugars and their derivatives has been widely used to assess mucosal damage in gastrointestinal diseases. Ulcerative colitis (UC) is a recurring and relapsing disease that causes inflammation of the gut. IP of sugars can be evaluated and correlated with the flare of UC.

MATERIALS AND METHODS:
A prospective study was conducted on 91 patients with active UC at the tertiary care center in North India. Mayo grading system assessed disease activity, and IP was assessed by measuring sucrose, lactulose, mannitol, and sucralose in urine samples from UC patients. A high-performance liquid chromatography (HPLC) method to detect all of these sugars simultaneously using a refractive index detector was developed and further validated in patients with UC.

RESULTS:
The analytical recovery rate of the tested sugars ranged from 95% to 146% in the urine matrix. The limit of detection and limit of quantification were 78.838 mg/L and 262.79 mg/L for sucrose, 84.994 mg/L and 283.31 mg/L for lactulose, 74.789 mg/L and 249.30 mg/L for mannitol, and 50.908 mg/L and 169.69 mg/L for sucralose.

CONCLUSION:
The standardized HPLC method is sensitive and suitable for the simultaneous detection and determination of different sugar moieties in the urine sample. Patients with UC can be evaluated indirectly for the flare by estimating the recovery rate of sugars through gut permeability. The procedure is noninvasive and thus improves the quality of life of chronically ill patients.
Evaluation of mechanism(s) of action underlying the antioxidant and antiulcer activity of Sesamum indicum leaves extract in experimental rats
Authors: Shivam  , Chandra Phool , Sachan Neetu 
Published: May 2024

OBJECTIVE:
The current study aimed to estimate phytochemical screening, in vitro antioxidant activity, and gastroprotective activity of Sesamum indicum Linn ethanolic extract.

MATERIALS AND METHODS:
The current study was held out by ulceration induced by pylorus ligation and indomethacin-induced ulcer screening models in Wister albino rats. The screening of antiulcer activity of ethanolic extract of S. indicum leaves (EESIL) at the different amounts (100, 200, and 400 mg/kg; per orally for 7 days) was compared with omeprazole as a usual antiulcer drug. Additional parameters such as gastric content, pH, total acidity, pepsin activity ulcer score, free acidity, ulcer index (UI), % inhibition of ulcers, mean mucin, pepsin content, and total protein content were observed.

RESULTS:
In the pylorus ligation model, the pepsin activity free acidity, pepsin content, UI, total acidity, ulcer score, total protein content, and percentage ulcer inhibition were considerably decreased (P < 0.05 and P < 0.01), and mean mucin and gastric content pH extensively elevated (P < 0.05 and P < 0.01) in EESIL tested groups in the comparison of the control group. Doses (100, 200, and 400 mg/kg p.o.) of EESIL showed dose-reliant gastro protective outcomes, a considerable (P < 0.05 and P < 0.01) decrease in gastric parameters as UI and ulcer score and induction in gastric pH and percentage inhibition of ulcer compared with the control group.

CONCLUSION:
Antioxidant, anti-Ulcer, EESIL, and EESIL show antioxidant activity at different concentration. The fallout of the study indicated that the EESIL had improved antiulcer potential due to the decrease in offensive factors and increase in defensive factors.
Intraperitoneal Instillation of Bupivacaine and Hydrocortisone for Postoperative Analgesia in Laparoscopic Cholecystectomy Under Spinal Anaesthesia – A Prospective Randomized Study
Authors: Kshirsagar Rajabhau , Kuttarmare Shital Mahendra , Bhalerao Pradnya Milind , Kshirsagar Sujit Jagannath 
Published: May 2024

Background:
Laparoscopic cholecystectomy is a minimally invasive procedure requiring less hospital stay and early mobilization as compared to open procedure. The aim of our study was to compare the efficacy of intraperitoneal instillation of hydrocortisone with bupivacaine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy under spinal anesthesia.

Materials and Methods:
Sixty patients were enrolled in this prospective randomized study. Patients either received 0.125% bupivacaine (Group B) or 0.125% bupivacaine with 100 mg hydrocortisone (Group H) through intraperitoneal drain at the end of surgery. Pain was evaluated every two hourly using the Visual Analog Scale (VAS) for 24 h. Analgesics were required during this period and the presence of shoulder pain was also noted.

Results:
Patients in the hydrocortisone group had lower pain scores (2.17 ± 0.47) compared to the bupivacaine group (3.51 ± 1.10). This difference in the mean VAS score was statistically significant (P < 0.01). Similarly, patients requiring rescue analgesia were 60.86% in Group B and 39.14% in Group H and were statistically significant. Time for rescue analgesia was longer in Group H as compared to Group B.

Conclusion:
Intraperitoneal bupivacaine and hydrocortisone decrease pain and analgesic requirements more effectively than bupivacaine alone after laparoscopic cholecystectomy without causing significant adverse effects.
Subcutaneous Platelet Rich Plasma Therapy for Management of Hyperalgesia in Complex Regional Pain Syndrome
Authors: Rout Aradhana , Thakur Kamparsh , Choubey Amit Kumar 
Published: May 2024

Objectives:
Complex regional pain syndrome (CRPS), which usually develops after a traumatic event, often has a debilitating effect on the quality of life. Treatment is multidisciplinary and is based primarily on pain relief. Due to the symptoms of hyperalgesia and allodynia in patients with CRPS, dermatology opinion is often seeked. CRPS is a difficult disorder to treat and platelet-rich plasma (PRP) is a potential treatment modality for pain relief in this debilitating illness. We aimed to investigate the role of subcutaneous PRP for relief of hyperalgesia in patients with CRPS.

Materials and Methods:
A comparative prospective study of 15 male patients with CRPS diagnosed clinically by the Budapest criteria and radiologically by magnetic resonance imaging was enrolled for the study. PRP was injected subcutaneously at biweekly interval for 8 weeks and the results were assessed clinically by neuropathic pain score (NPS) score. The patient satisfaction was noted at baseline, 4 weeks, and 8 weeks. Patients were followed up for 3 months to assess the increase or decrease in hyperalgesia after stopping PRP. ANOVA was used with the Bonferroni correction for NPS score at various time interval. P ≤ 0.05 is considered statistically significant.

Results:
Numeric Rating Scale score showed statistically significant improvement at end of the study as compared to the baseline. Patients also had improvement in range of motion which was assessed at every visit. A few patients had mild redness and burning postprocedure which resolved spontaneously after a few hours.

Conclusions:
From this study, we concluded that subcutaneous PRP shows a significant reduction of hyperalgesia associated with CRPS.
Hypothalamus-pituitary-adrenal axis (HPA axis) suppression with inappropriate use of steroids in recalcitrant dermatophytosis – A cross-sectional study
Authors: Kaur Tanureet , Bassan Manbir S. , Bisht Manisha , Kumar Nitish , Saini Poonam , Hazarika Neirita 
Published: May 2024

ABSTRACT

Background:
Improper use of over-the-counter (OTC) steroid medication has been linked to recalcitrant dermatophytosis. There is proven evidence of HPA axis suppression by the use of long-term oral steroids. This study aims to determine the prevalence and pattern of inappropriate OTC steroid use and its effects on the hypothalamus-pituitary-adrenal (HPA) axis in adults with recalcitrant dermatophytosis.

Materials and Methods:
This cross-sectional study of 2 months was conducted in a hospital setting and included patients of recalcitrant dermatophytosis with a history of OTC steroid use. Clinico-demographic details and basal serum cortisol levels were recorded in all and analyzed.

Result:
Of a total of 103 patients, 59.22% (n = 61/103) were males, and the mean duration of steroid abuse was 17.78 months. About 48.54% (n = 50/103), 3.88% (n = 4/103), and 47.57% (n = 49/103) patients reported the use of topical steroids, oral steroids, and both oral and topical steroids, respectively. Among all the topical steroid users (n = 99), clobetasol propionate 48.48% (n = 48/99), while among oral steroid users (n = 53), prednisolone 45.28% (n = 24/53) were the most commonly used agents, respectively. The morning serum cortisol levels (8–9 AM) were found to be decreased in 42.7% (n = 44/103), with a mean value of 44.28 ± 17.34 μg/dL.

Conclusion:
Improper OTC steroid use in recalcitrant dermatophytosis leads to HPA axis suppression. This highlights the need for intervention from apex health officials.
Impact of the heartfulness program on stress and sleep among healthcare professionals: Pre experimental study
Authors: Kumar Deepak , Rohilla Kusum K. , Gupta Pratima , Kalyani Vasantha C. , Kumar Rajan 
Published: May 2024

ABSTRACT

Background:
Healthcare professionals (HCPs) worldwide suffer from stress and poor sleep and the COVID-19 pandemic has further raised these issues. This study sought to determine whether HCPs had reduced stress and increased sleep quality while participating in a heartfulness meditation program.

Subjects and Methods:
For a 2-month (8 weeks) heartfulness meditation program, we included 41 individuals in a prospective one-group pretest post-test intervention design from February 2023 to April 2023. Scores on the Perceived Stress Scale and Pittsburgh Sleep Quality Index were gathered at baseline and 8 weeks. Forty-one (76%) of the 54 participants completed this study for 8 weeks.

Results:
Results showed a substantial decline in stress (preintervention mean ± standard deviation [SD] = 20.54 ± 4.46; postintervention mean ± SD = 18.42 ± 6.14; t-value = -1.947 [0.05*]) and improvement in sleep quality (preintervention mean ± SD = 6.63 ± 3.82; postintervention mean ± SD = 5.29 ± 2.44) among HCPs after following this 8-week heartfulness meditation program. In the end, a substantial decrease in perceived stress score and an improvement in the sleep quality index was found.

Conclusion:
Additionally, practicing heartfulness meditation may aid in developing the traits of empathy, acceptance, and inner serenity. We draw the conclusion that more extensive research is required to fully understand the impact of heartfulness meditation practice.
Vitamin B12 and homocysteine in patients with major depressive disorder
Authors: Harikaran S , Basu Sharbari , Mukherjee Moushumi P. , Kar Rakhee , Nair Sreekumaran , Priyadarssini M 
Published: May 2024

ABSTRACT

Background:
Alterations in the level of neurotransmitters are evident in patients with major depressive disorder (MDD). Vitamin B12 mediates the synthesis of neurotransmitters, and hence, vitamin B12 deficiency could be associated with depression.

Aims and Objectives:
To assess the levels of serum vitamin B12, homocysteine (Hcy), and haematological profiles in patients of MDD.

Materials and Methods:
Fifty-nine patients with MDD were recruited based on ICD-10 criteria. Severity of depression was assessed by HAM-D scale. Vitamin B12, Hcy levels, and haematological profiles were analysed.

Results:
Vitamin B12 was deficient or depleted in all patients with MDD. The median level of vitamin B12 in serum was 164.2 pg./ml and significantly lower in patients with severe MDD. The mean value of Hcy was 18.34 μmol/L, which was high compared to the normal reference range. The red cell distribution width (RDW-CV) varied significantly between the three groups of MDD patients. Patients consuming non-vegetarian food had a significantly higher median value of serum vitamin B12.

Conclusion:
Vitamin B12 deficiency is found in patients with MDD and varies inversely with severity of MDD. Hcy is found to be higher in patients with MDD. The manifestation of depressive symptoms precedes the more commonly known haematological manifestations of vitamin B12 deficiency in this study.
Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial
Authors: Sinha Nutan , Rajbhar Sarita , Thakur Pushpawati , Agrawal Sarita , Singh Vinita 
Published: May 2024

ABSTRACT

Background:
Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of maternal deaths, making it the leading direct cause of maternal death. PPH has been identified in more than two-thirds of reported hemorrhage-related deaths, causing 38% of maternal deaths in India. Tranexamic acid, an antifibrinolytic, has been used to control bleeding after PPH is identified.

Materials and Methods:
Antenatal women admitted for elective cesarean section were randomized into two arms: the case group (received one gram of tranexamic acid 20 min prior to skin incision) and the control group (received a placebo), each group consisting of 36 participants. Clinical Trials Registry – India (CTRI) registration number – CTRI/2021/02/031579.

Results:
The mean (±standard deviation [SD]) intraoperative blood loss in the case group was 241.25 (±67.83) mL, and in the control group, it was 344.92 (±146.67) mL (P = 0.001), while postoperative blood loss did not differ significantly between the groups (P = 0.1470). In terms of the difference in hemoglobin, there was a significant difference between the two groups (P = 0.001). No significant maternal or neonatal side effects were found.

Conclusion:
Preoperative tranexamic acid, when given in elective cesarean section, significantly reduces intraoperative blood loss.
Medical doctor’s perception of artificial intelligence during the COVID-19 era: A mixed methods study
Authors: Dongre Ashwini S. , More Sandeep D. , Wilson Vidhya , Singh R. Jai 
Published: May 2024

ABSTRACT

Background:
Artificial intelligence (AI) has led to the development of various opportunities during the COVID-19 pandemic. An abundant number of applications have surfaced responding to the pandemic, while some other applications were futile.

Objectives:
The present study aimed to assess the perception and opportunities of AI used during the COVID-19 pandemic and to explore the perception of medical data analysts about the inclusion of AI in medical education.

Material and Methods:
This study adopted a mixed-method research design conducted among medical doctors for the quantitative part while including medical data analysts for the qualitative interview.

Results:
The study reveals that nearly 64.8% of professionals were working in high COVID-19 patient-load settings and had significantly more acceptance of AI tools compared to others (P < 0.05). The learning barrier like engaging in new skills and working under a non-medical hierarchy led to dissatisfaction among medical data analysts. There was widespread recognition of their work after the COVID-19 pandemic.

Conclusion:
Notwithstanding that the majority of professionals are aware that public health emergency creates a significant strain on doctors, the majority still have to work in extremely high case load setting to demand solutions. AI applications are still not being integrated into medicine as fast as technology has been advancing. Sensitization workshops can be conducted among specialists to develop interest which will encourage them to identify problem statements in their fields, and along with AI experts, they can create AI-enabled algorithms to address the problems. A lack of educational opportunities about AI in formal medical curriculum was identified.
Professionalism among family medicine residents at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A cross-sectional study
Authors: Alsharef Malikah S. Al Ghalib , Almaramihi Waad S. , Almuhyawi Razan A. 
Published: May 2024

ABSTRACTBackground:The Saudi Commission for Health Specialties (SCHS) recently proposed the Saudi Meds Family Medicine (FM) 2020 program, which is based on CanMEDS-FM 2017 and includes a number of competencies. The purpose of this study is to evaluate the professionalism of FM residents who follow the modified curriculum of the SCHS.Materials and Methods:A cross-sectional study was conducted between June and August 2023 at King Abdulaziz University Hospital in Jeddah among FM residents from year 1 to year 3 and postgraduates from the FM residency program of both genders. For data collection, a structured self-administered web-based questionnaire adapted from CanMEDS was used.Results:A total of 45 FM residents responded, with the majority (73.3%) between the ages of 20 and 30 (77.8%), and 62.2% females. In terms of patient professionalism, 93.3% frequently/always demonstrated appropriate professional behavior and relationships in all aspects of practice; 62.2% frequently/always demonstrated a commitment to excellence in all aspects of practice. In terms of professionalism and societal commitment, 80% frequently/always demonstrated accountability to patients, society, and the profession by responding to societal expectations of physicians, and 86.6% frequently/always demonstrated a commitment to patient safety and quality improvement. In terms of professional commitment, 88.9% frequently/always fulfil and adhere to professional and ethical codes, standards of practice, and laws governing practice. In terms of self-commitment, it was discovered that 86.6% frequently/always demonstrated self-awareness and managed influences on personal well-being and professional performance. The majority (80%) managed personal and professional demands for a sustainable practice throughout the physician lifecycle, and 86.7% frequently/always promoted a culture that recognizes, supports, and effectively responds to colleagues in need.Conclusion:FM residents in Jeddah, Saudi Arabia, demonstrated acceptable levels of dedication to patients, society, profession, and self, indicating a high level of professionalism.