bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post–COVID-19 autoimmune hypoglycemia: A case report
Authors: Alabbood Majid , Chamberlain Michael 
Published: May 2024

ABSTRACT
Insulin autoimmune hypoglycemia is characterized by insulin autoantibodies causing initially hyperglycemia followed by hypoglycemia. The authors describe a case of a patient who presented with recurrent episodes of severe hypoglycemia 1 month after COVID-19 infection. Blood glucose monitoring during admission revealed postprandial hyperglycemia ranging from 15 to 18 mmol/L followed by severe hypoglycemic episodes. His insulin at the time of hypoglycemia (blood glucose level 1.5 mmol/L) was 255 mU/L (3–25 mU/L). C-peptide was 3.3 nmol/L (0.3–1.4 nmol/L), and β-hydroxybutyric acid was 0.06 mmol/L (<0.27 mmol/L). The anti-insulin antibodies level elevated at 403 U/mL (<0.5 U/mL). A diagnosis of post–COVID-19 autoimmune hypoglycemia was performed, and the patient was started on high-dose prednisolone 60 mg/day with gradual tapering over 3 months. Metformin and acarbose were also started to treat hyperglycemia. On follow-up after glucocorticoid cessation, blood glucose profile stabilized with no hypoglycemia or hyperglycemia. This is the fourth case report written in the literature.
COVID-19-induced Stress in Health-care Workers: Effect of 8-week Common Yoga Protocol on Autonomic Function and Inflammatory and Oxidative Stress Markers
Authors: Sharma Vivek Kumar , Kathrotia Rajesh , Barde Pradip B. , Sharma Gaurav , Chitturi Vinay , Parmar Naresh , Dhruva Gauravi , Kavathia Ghanshyam 
Published: May 2024

Background:
COVID-19 pandemic posed a huge stress on health-care givers affecting their physical and mental health. Wellness strategies like yoga can improve flexibility, resilience, and outlook.

Aim:
The present study explored the effect of 8-week standard common yoga protocol (CYP) intervention on autonomic functions, emotional stress, oxidative stress, and inflammation markers in the nurse group of health-care givers.

Materials and Methods:
It is a randomized controlled trial where 50 nurses underwent CYP and 50 participated as controls. Anthropometric parameters, cardiovascular parameters, autonomic function including time and frequency domain parameters, biochemical parameters, and psychological stress using the questionnaire were assessed before and after 8-week CYP.

Results:
Total 88 nurses completed the study with 42 and 46 participants, respectively, in the CYP and control groups. CYP intervention resulted in a significant reduction in cardiovascular parameters systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, and rate pressure product (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.002, respectively), perceived stress score and Depression, Anxiety, and Stress Scale psychological variables of depression, anxiety, and stress, and serum lipid parameters compared to the control group. CYP significantly increased total power, low frequency, high frequency, root mean square of successive differences between adjacent NN intervals, change in successive normal sinus (NN) intervals exceeds 50 ms, and pNN50% (P < 0.001, P = 0.006, P = 0.006, P = 0.039, P < 0.001, and P = 0.013, respectively) suggesting improved resting autonomic modulation and parasympathodominance due to higher vagal efferent activity. There were significant reductions in serum cortisol, tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6 in both the groups. Serum telomerase significantly reduced (P = 0.024) and total antioxidant capacity (P = 0.036) increased in the CYP group post intervention.

Conclusion:
CYP intervention was beneficial in improving psychophysiological, autonomic, and biochemical profile of the nurse group of health-care workers.
Heart–brain Rhythmic Synchronization during Meditation: A Nonlinear Signal Analysis
Authors: Anurag Shrivastava , Singh Bikesh Kumar , Krishna Dwivedi , Prasanna Krishna , Deepeshwar Singh 
Published: May 2024

Background:
Heart–brain synchronization is the integration of mind, body, and spirit. It occurs when the electrical activity of the heart and brain is synchronized. In recent years, there has been mounting curiosity to investigate the effects of meditation on heart–brain synchronization with respect to mental and emotional health and well-being. The current investigation aims to explore the rhythmic synchronicity between the brain and the heart during heartfulness meditation (HM) practice.

Materials and Methods:
The study was performed on 45 healthy volunteers who were categorized into three equal groups: long-term meditators (LTMs), short-term meditators (STMs), and nonmeditators (NMs). The electroencephalogram (EEG) signals were recorded to measure the prefrontal activity, and electrocardiogram (ECG) signals were recorded to measure the cardiac activity. The data were recorded in four states: baseline, meditation, transmission, and posttransmission. The detrended fluctuation analysis (DFA) method was used for the analysis of EEG and ECG signals.

Results:
The result indicates that DFA values of EEG and ECG declined during meditation and transmission states as compared to pre- and postmeditation states. Significant results were obtained for the LTM group in all the states. A positive correlation was also observed between DFA of the heart and brain for the LTM group and no significant correlations were observed for the STM and NM groups.

Conclusion:
The shreds of evidence suggest that heart–brain synchronization facilitates mental and emotional stability. HM practice has the potential to regulate the fluctuation of the mind. Regular meditation practice may result in physiological synchrony between cardiac and neural behavior, which can be considered a quality index for meditation practice.
Phosphaturic mesenchymal tumor: Clinicopathological features with outcomes in 10 patients with review of literature
Authors: Parameshwar Vivek C. , Rekhi Bharat , Duggad Ashwini , Ramadwar Mukta 
Published: May 2024

ABSTRACT

Background:
Phosphaturic mesenchymal tumors (PMTs) are rare mesenchymal tumors, associated with long-standing, non-specific but often debilitating symptoms in the affected patients. These tumors display characteristic histopathological features and in case, identified timely, can be a boon for patients, given an excision is completely curative.

Aims:
To evaluate the clinical and histopathological features of 10 PMTs, diagnosed at our institution, along with clinical outcomes in those patients.

Materials and Methods:
This was a retrospective study, wherein 10 PMTs, diagnosed from January 2013 to July 2022, were included.

Results:
The average age at the time of diagnosis was 40 years with an M:F ratio of 4:1. Clinical features included lumps, weakness, bone pain, difficulty in moving and walking, and pathologic fractures. The biochemical analysis showed normal serum calcium levels (average = 9.5 mg/dL), with low serum phosphorus (average = 2.2 mg/dL) and raised serum fibroblast growth factor 23 (FGF23) levels, in all the cases, wherever available. On histopathology, all tumors showed cells arranged in a hemangiopericytomatous pattern, including oval to short spindle forms. Multinucleate giant cells were present in nine tumors, and characteristic “grungy calcifications” was observed in eight tumors. Prominent pseudo cystic spaces were seen in eight tumors. A significant number of mitotic figures and tumor necrosis were not seen in any tumor. In five cases where follow-up was available, there was complete resolution of symptoms post-resection with no recurrence or metastasis. All those patients were free of disease until the last follow-up.

Conclusion:
This constitutes the first largest comprehensive study on these rare tumors from our country. PMTs can be diagnosed based on certain histopathological features and correlation with clinicoradiological and biochemical findings. These are invariably benign neoplasms. Patients are relieved of their debilitating symptoms after adequate surgical tumor resection. Therefore, their correct and timely diagnosis is crucial.
Synchronous multiple myeloma and lung adenocarcinoma: A clinical series
Authors: Ye Fang , Wang Huan , Li Ningning , Liu Aijun , Chen Wenming 
Published: May 2024

ABSTRACT

Background:
Multiple myeloma (MM) is characterised by an increased number of monoclonal immunoglobulin-producing plasma cells that malignantly grow in the bone marrow. Lung cancer is one of the most common malignancies and at the advanced stage may become metastatic to the bone. Rarely, MM and lung cancer are synchronously present in the same patient.

Materials and Methods,

Results:
In this report, we describe five cases of MM synchronous with lung adenocarcinoma including λ light chain in three cases and ϰ light chain in two cases. Two patients achieved complete remission, and no progression was seen in two patients.

Conclusion:
In conclusion, synchronous MM and lung adenocarcinoma are clinically rare, and diagnosis should be made scrupulously based on morphology, immunology, cytogenetics, molecular biology and biopsy pathology.
Incidence of Clostridium difficile Infection Detected by Premier Toxin A and B Enzyme Linked Immunosorbent Assay and Underlying Risk Factors in Patients Admitted to a University Hospital in Northern India
Authors: Kar Mitra , Kumar Awadhesh , Tiwari Ritika , Tejan Nidhi , Sahu Chinmoy , Jain Mudra , Patel Sangram Singh , Goyal Urvashi , Ghoshal Ujjala 
Published: May 2024

Background:

Clostridium difficile is a toxin-producing, Gram-positive, spore-forming anaerobic Bacilli isolated from air, water, soil, and human and animal feces. This study was performed to recognize the incidence of C. difficile infection (CDI) at this center by detecting toxigenic C. difficile using Premier Toxin A and B Enzyme linked immunosorbent assay (ELISA) from stool samples.

Materials and Methods:
A retrospective study was performed in the department of microbiology for 1 year from January 1, 2022 to December 31, 2022. All data were extracted from ward files, hospital electronic records, and laboratory registers. Statistical analysis was aided by the software program IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA).

Results:
We included 788 stool samples from patients with suspected CDI. The incidence of CDI at our center was 15.73% (124/788, 15.73%) based on C. difficile toxin positivity by Premier Toxin A and B ELISA. The mean age of patients was 37.83 ± 20.82 years with a male predominance (78/124, 62.9%). Patients with hypertension, and Type 2 diabetes mellitus (DM) patients were significantly associated with patients without inflammatory bowel disease. Pseudomembranous colitis was significant in patients not receiving appropriate antibiotics. Among underlying comorbidities, Type 2 DM, chronic kidney disease, patients undergoing hemodialysis, and solid organ transplant patients were significantly associated with patients not receiving appropriate antibiotics. The length of hospitalization was significantly prolonged in the cohort not receiving appropriate antibiotics.

Conclusion:
We have demonstrated the rate of CDI and associated risk factors to guide clinicians in implementing appropriate treatment to reduce the length of hospitalization in these patients.
A Cross-Sectional Study of the Olfactory Fossa in Delta State, Nigeria
Authors: Ominde Beryl Shitandi , Ikubor Joyce Ekeme , Iju Wilson Josiah , Igbigbi Patrick Sunday 
Published: May 2024

Introduction:Evaluation of the olfactory fossa (OF) before endoscopic sinus surgery is important in minimizing inadvertent penetration into the anterior cranial fossa. This study assessed the depth of the OF using computed tomography (CT) images of adult Nigerians.Materials and Methods:Cranial CT images were obtained from the database of the radiological unit of a referral center in Delta State, Nigeria, after ethical clearance. The images belonged to 137 female and 199 male adults aged ≥20 years. The depth of OF was measured as the perpendicular distance between the cribriform plate (CP) inferiorly to the superior end of the lateral lamella of the CP on coronal sections. The fossae were classified as Keros Type I (0.1–0.39 cm), Type II (0.4–0.79 cm), and Type III (>0.8 cm). Data collected were analyzed using the Statistical Package for the Social Sciences version 23. Side and gender comparisons of the depth were evaluated using the Student'st-test, while the variations in the OF types were assessed using the Chi-square test. These comparisons were regarded significant whenP< 0.05.Results:The mean OF depth was larger in males (0.543 ± 0.183 cm) than in females (0.527 ± 0.169 cm) (P= 0.018). The prevalence of symmetrical (64.9%) and asymmetrical (35.1%) OF showed significant sex differences (P< 0.05). Type II OF was the most common (77.2%), followed by Type I (15.8%) and Type III (7%).Conclusion:The presence of the deep (Type III) and asymmetric OF in the patients studied emphasizes the importance of their preoperative radiological identification to minimize complications.
Clinical Course and Outcome of Stroke Patients at a Tertiary Health Care Center during SARS-COV-2 Pandemic in North India
Authors: Atam Virendra , Kumar Satish , Rahul Kumar , Kumar Bhupendra , Gupta Harish , Sonkar Satyendra Kumar , Patel Munna Lal , Kumar Amit , Singh Anshu , Yadav Ambuj 
Published: May 2024

Background:
SARS-COV-2 is primarily a respiratory illness. However, beyond respiratory illness and associated acute and long-term medical complications, it manifests as stroke, including acute ischemic stroke and hemorrhagic stroke. Clinical evidence reported the occurrence of both venous and arterial thromboembolic complications in SARS-COV-2 positive patients due to hypercoagulable state, hyperinflammatory response, cardiomyopathy, and endothelial inflammation.

Materials and Methods:
This is a retrospective, single-center cohort study, which includes confirmed SARS-COV-2-positive patients hospitalized between March 2021 and February 2022. Clinical and biochemical data were analyzed. Noncontrast computed tomography of the brain was performed to assess the area and type of stroke.

Results:
Among all the included 703 patients with SARS-COV-2, 42 patients developed stroke. SARS-COV-2 patients who developed stroke were older and had multiple comorbidities. Patients had higher quick sequential organ failure assessment (qSOFA) score on hospitalization (P < 0.05), higher in-hospital mortality, and had poor clinical outcomes (P < 0.0001). In multivariate regression analysis, there were higher odds of in-hospital mortality linked with higher qSOFA scores (odds ratio 4.47, 95% confidence interval 1.21–16.5; P = 0.025). SARS-COV-2 patients developing stroke had high total leukocyte counts, high neutrophil counts, low platelet counts, low lymphocyte counts, raised C-reactive protein, raised ferritin levels, raised interleukin-6, raised fibrinogen, and D-dimer as compared to those without stroke.

Conclusion:
Patients with SARS-COV-2 who developed stroke had more severe clinical symptoms, poor clinical outcomes, and higher in-hospital mortality rates compared to those without stroke.
Novel Curved Tongue Depressor for the Easier Insertion of Supraglottic Airway Devices
Authors: Sarbadhikari Sohini , Sarbadhikari Anindya 
Published: May 2024

Background:
The i gel™ is a single use supraglottic airway management device used in anesthesia delivery. However, the insertion of the i gel™ has been associated with challenges, particularly related to the tongue obstructing the procedure. Currently available straight tongue depressors designed for awake patients in a sitting position are ineffective for unconscious or anesthetized patients who lack tongue control. Anesthetists resort to using fingers to control the tongue, leading to drawbacks such as messiness, injury risks, and hygiene concerns.

Aims and Objectives:
To address these issues, a curved tongue depressor has been proposed.

Materials and Methods:
Unlike conventional flat tongue depressors, the curved design conforms to the natural shape of the tongue, offering better control. This tongue depressor is specifically shaped to gently push the tongue, facilitating smooth i gel™ insertion without adversely affecting oral structures.

Results:
The dimensions are aligned with the i gel™, and the prototype’s curvature resembles a Macintosh laryngoscope blade 3.

Conclusions:
This study highlights the need for an alternative solution to effectively depress the tongue, ensuring hygiene and minimizing injury risks during airway management procedures.
The Impact of COVID-19 Pandemic on the Mental Health of Health-Care Workers in India
Authors: Gopichandran Lakshman , Choudhary Mamta , D'Souza Preethy , Venkatesan Latha , Srinivasan Muthuvenkatachalam , Anupama D. S. , Kumar Nand , Rai Sanjay K. 
Published: May 2024

Background:
Public health emergencies are known to affect mental health and well-being at the individual (anxiety, loneliness) and societal level (income loss, reduced access to services). The socioeconomic and health-care impacts of the COVID-19 pandemic are unprecedented with worldwide economic loss, closure of business activities, travel restrictions, social distancing, quarantine and isolation, fear of shortage of basic needs, and rapid spread of mental health problems.

Materials and Methods:
Qualitative phenomenological research with the overall aim to explore the psychological impact of the COVID-19 pandemic among healthcare workers in India was undertaken in a selected tertiary care hospital, in India. Qualitative in-depth interview was conducted to elucidate the mental health issues and problems of healthcare workers as experienced by them. We used phenomenological methodology to conduct in-depth face-to-face interview to focus on individual versions of experience combined with thematic analysis techniques for analyzing and framing the research data. Thematic analysis was carried out on data collected from 29 healthcare workers from different disciplines such as doctors, nurses, laboratory technician, paramedics, and operation theatre technicians.

Results:
Health-care workers reported various psychosocial issues and problems that they have experienced from the onset of COVID-19. From the analysis, we have generated three overarching themes, each with five subthemes.

Conclusion:
The study concludes that the health-care workers exposed to pandemic situation are vulnerable for a range of mental health issues from distress to sleep disturbances, fear and anxiety to social isolation and stigma, and loss of hope to helplessness.
Religiosity and Religious Coping among Outpatients with Schizophrenia
Authors: Inechi McDonald C. , Onu Justus U. , Achor Justin U. , Ubochi Vincent N. 
Published: May 2024

Background:
There are burgeoning data on the beneficial and deleterious effects of religion on health, especially, mental health worldwide. This complex relationship between religious variables and outcome in patients with schizophrenia is yet to be robustly explored among Africans. This study aimed to determine the relationship between religious variables (i.e., religious coping and orientation) and outcome variables (e.g., disease severity and psychosocial functioning).

Materials and Methods:
The study was a cross-sectional study done at the Federal Neuropsychiatric Hospital, Enugu, Nigeria. A total of 422 outpatients who met the stringent criteria for schizophrenia were recruited into the study over a study period of 18 weeks. Standard instruments were used to measure religious coping (Brief Religious Coping-Brief—RCOPE), religious orientation (Religious Orientation Scale-Revised—ROS-R), disease severity (The Brief Psychiatric Rating Scale), and psychosocial functioning (Social and Occupational Functioning Assessment Scale). A multivariate linear regression analysis was used to determine the religious variables that predicted disease severity and psychosocial functioning.

Results:
Religiosity and religious coping variables were not significant predictors of symptom severity among patients with schizophrenia. However, negative religious coping was a significant predictor of poor psychosocial functioning (t = −2.23, P = 0.02, β = −0.28), whereas high score in intrinsic religiosity was a predictor of good psychosocial functioning (t = 3.32, P = 0.001, β = 0.27).

Conclusion:
Findings from this study support the vast majority of research that suggests that religiosity and religious coping have diverse effects on clinical and functional outcomes.
In silico Characterization of Predominant Genes Involved in Early Onset of Alzheimer's Disease
Authors: Sachdeva Punya , Ahmad Faizan 
Published: May 2024

Objective:
Alzheimer's disease (AD) is a predominant neurodegenerative disorder and one of the most prevalent forms of dementia, affecting 35 million people worldwide. The neuropathologic characteristics of this disorder show extracellular aggregation of amyloid plaques composed of amyloid-beta (Aβ) peptides and the presence of hyperphosphorylated tau protein leading to the formation of neurofibrillary tangle inside the neurons. Some of the significant clinical presentations of AD patients include memory decline, trouble in speech, personality alterations, gait imbalance, and mood changes. A tremendous core of genetics is involved in the prevalence of AD. The three vital genes such as amyloid precursor protein (APP), presenilin-1 (PSEN1), and presenilin-2 (PSEN2) have a definite association with AD. The objective of this study was to characterize these genes, which are immensely relevant in health-care practices and the formation of personalized medications.

Materials and Methods:
The characterization of genes has been done using several databases such as the National Center for Biotechnology Information, GeneCards, Human Protein Atlas, tissue expression database, and protein modeling server – Swiss-model.

Results:
As a result, we got the genomic and subcellular location of genes. Furthermore, we got the expression concentration of proteins in tissues, three-dimensional protein structures using amino acid sequences, string connection with various proteins, features of genes, and the protein encoded by it.

Conclusion:
We reach the conclusion that protein expression of APP is high in the brain, spinal canal, liver, lungs, and small and large intestine. PSEN1 concentration of expression is high in the brain and spinal, whereas PSEN2 concentration of expression is high in the liver, lungs, brain, and intestine.
A case–control study to evaluate the role of mean platelet volume and platelet distribution width in acute ischemic stroke
Authors: Sundari Meenatchi , Hanifah Mohamed , Kotasthane Dhananjay S. , Jayasingh K. 
Published: May 2024

Background:
Ischemic stroke is known to be one of the foremost causes of long-term disability and death, and platelets play a pivotal role in its pathophysiology. However, the platelet indices having a role in ischemic stroke are not routinely reported in the available literature.

Objective:
The objective of the study was to evaluate the potential role of mean platelet volume (MPV) and platelet distribution width (PDW) in the development of ischemic stroke, especially in the South Indian region.

Materials and Methods:
This case–control study was conducted on 80 patients who were broadly divided into two groups: the case group (patients with ischemic stroke) and the control group (patients without ischemic stroke). Platelet indices were measured using Mindray BC-5200 auto hematology analyzer, and the results were analyzed using Student's t-test and Wilcoxon rank-sum Test.

Results:
There was a statistically significant difference (P < 0.001) in the MPV and PDW values between the two groups. The difference between the area under the curve for both MPV and PDW was also found to be statistically significant (P < 0.001) in the receiver operating characteristic curve. However, the differences in the values of MPV and PDW across different age groups, genders, and various comorbid conditions were not found to be significant.

Conclusion:
The elevated platelet indices may be associated with the development of ischemic stroke. The MPV and PDW can be prospective biochemical markers for predicting the onset of ischemic stroke.