bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compromised dynamic cerebral autoregulation is a hemodynamic marker for predicting poor prognosis even with good recanalization after endovascular thrombectomy
Authors: Ran Liu , Wang Pingping , Chen Hongxiu , Li Na , Zhou Fubo , Zhao Wenbo , Ma Qingfeng , Xing Yingqi 
Published: March 2024

Abstract:

PURPOSE:
In patients undergoing endovascular thrombectomy (EVT) with acute ischemic stroke (AIS), dynamic cerebral autoregulation (dCA) may minimize neurological injury from blood pressure fluctuations. This study set out to investigate the function of dCA in predicting clinical outcomes following EVT.

METHODS:
43 AIS of the middle cerebral or internal carotid artery patients underwent with EVT, and 43 healthy individuals (controls) were enrolled in this case control research. The dCA was evaluated using transcranial Doppler 12 h and five days after EVT. The transfer function analysis was used to derive the dCA parameters, such as phase, gain, and coherence. The modified Rankin scale (mRS) at 3 months after EVT was used to assess the clinical outcomes. Thefavorable outcome group was defined with mRS ≤2 and the unfavorable outcome group was defined with mRS score of 3–6. Logistic regression analysis was performed to determine the risk factors of clinical outcomes.

RESULTS:
A significant impairment in dCA was observed on the ipsilateral side after EVT, particularly in patients with unfavorable outcomes. After 5 days, the ipsilateral phase was associated with poor functional outcomes (adjusted odds ratio [OR] = 0.911, 95% confidence interval [CI]: 0.854–0.972; P = 0.005) and the area under the curve (AUC) (AUC, 0.878, [95% CI: 0.756–1.000] P < 0.001) (optimal cutoff, 35.0°). Phase change was an independent predictor of clinical outcomes from 12 h to 5 days after EVT (adjusted OR = 1.061, 95% CI: 1.016–1.109, P = 0.008).

CONCLUSIONS:
dCA is impaired in patients with AIS after EVT. Change in dCA could be an independent factor related to the clinical outcomes.
Impacts of futile reperfusion and reperfusion injury in acute ischemic stroke
Authors: Elmadhoun Ahmed , Wang Hongrui , Ding Yuchuan 
Published: March 2024

Abstract:
Acute ischemic stroke (AIS) remains to be a challenging cerebrovascular disease. The mainstay of AIS management is endovascular reperfusion therapy, including thrombectomy and thrombolysis. However, ineffective (futile) reperfusion (FR) or reperfusion injury (RI) can be seen in a significant number of patients undergoing reperfusion strategy. In this article, we discuss two clinically relevant concepts known as “time window” and “tissue window” that can impact the clinical outcome of reperfusion therapy. We also explore patient risk factors, leading to FR and RI as well as an emerging concept of “no-reflow phenomenon” seen in ineffective reperfusion. These fundamental concepts provide insight into the clinical management of AIS patients and provide references for future research.
Different techniques for identification of facial nerve during superficial parotidectomy
Authors: Kamel Peter Victor , Ahmed Ahmed Saad , Imam Usama Saeed , Ahmed Ahmed Safaa , El Prince Sayed Sherif 
Published: March 2024

BackgroundParotidectomy is a common surgical procedure for the treatment of benign and malignant lesions of the parotid gland. Identification of the facial nerve trunk is essential during surgery of the parotid gland to avoid facial nerve injury. A comprehensive knowledge of its anatomy and meticulous dissection are the keys for the identification of the facial nerve trunk and its branches.AimTo compare between the traditional antegrade parotidectomy and retrograde in identification of facial nerve during superficial parotidectomy, determination the best anatomical landmark, the time of exploration of facial nerve, outcomes, facial nerve complication, duration of surgery, patient satisfaction as well as other complications.MethodsTwelve patients who were diagnosed with having parotid gland neoplasms, and had undergone superficial Parotidectomy were recruited and assessed for eligibility at General Surgery Department, Beni-Suef University Hospital. Patients were divided according to the surgical technique into two equal groups, group A (the antegrade dissection group), and group B (the retrograde dissection group), follow-up was 6 months.ResultsThere was no statistically significant differences between both groups regarding pain, paresthesia and pathology postoperation (Pvalue>0.05). Longer mean operation time was observed in the antegrade dissection group in comparison with the retrograde dissection group (2.06±0.75 and 1.61±0.31 h, respectively), which was statistically insignificant (Pvalue>0.05). There was a statistically significant increase in facial nerve injury among patients in the antegrade dissection group in comparison with the retrograde dissection group (Pvalue=0.046). There was no statistically significant difference between techniques regarding hospital stay duration and complications three months postoperation (Pvalue>0.05).ConclusionRetrograde facial nerve dissection technique is better than the classical antegrade technique in the superficial parotidectomy within this study.
Evaluation of the Results of Reconstruction of Medial Patellofemoral Ligament in the Treatment of Recurrent Patellar Instability Using Hamstring Autograft by Dual Patella Docking Technique
Authors: Bayomy ElSayed Mahmoud , Atallah Ahmed Taha , Al-Ashhab Mohamed Ebrahim , Aeltraigy Shareef Abd Elmoneim 
Published: March 2024

Abstract

Background:
Recurrent patellar instability can significantly affect a patient’s life quality. This study evaluated the results of medial patellofemoral ligament (MPFL) reconstruction in the recurrent patellar instability treatment using hamstring autograft by dual patellar docking technique.

Materials and Methods:
This prospective study was performed on 20 recurrent patellar instability patients. Magnetic resonance imaging and computed tomography scans were performed to confirm MPFL tear and assess the tibial tubercle-trochlear groove distance. Various clinical and radiographic evaluations were performed preoperatively. The surgical technique involved diagnostic arthroscopy, graft preparation, patellar preparation, graft passage, femoral tunnel preparation, and graft fixation.

Results:
Postoperatively, a substantial progression was observed in the International Knee Documentation Committee score, Kujala score, Cincinnati score, and Lysholm score compared to preoperative values (P < 0.001). In addition, the postoperative measurements of patellar tilt angle and patellar congruence angle were significantly lower than their respective preoperative values (P < 0.001). All 20 (100%) patients had negative findings in the postapprehension test, indicating improved stability. In the postcompression test, 3 (15%) patients showed positive results, whereas 17 (85%) patients had negative results. In terms of complications, 2 (10%) patients experienced patellofemoral pain, 1 (5%) patient had residual patellar translation without dislocation, 1 (5%) patient had limited flexion, and the majority of patients (16, 80%) had no complications.

Conclusions:
MPFL reconstruction with patellar docking yielded good results with Kujala and Lysholm, as well as adequate, satisfactory congruence angles for most patients. This procedure has exhibited a high success rate in addressing patellofemoral instability.
Genu Recurvatum in Total Knee Arthorplasty: A Review
Authors: Gaitán-Lee Hernando , Correa Willy Paul Stangl , Herrera Willy Paul Stangl , Villegas Julio Cesar Palacio , Nalus Felipe Guzmán , Gaitán-Duarte Hernando 
Published: March 2024

Abstract
Genu recurvatum is a rare knee deformity that can be linked with osteoarthritis. The main causes of this deformity include neuromuscular disorders, rheumatoid arthritis, inverted tibial slope, or conditions associated with coronal deformities such as genu valgum. In cases of end-stage knee osteoarthritis, total knee arthroplasty is the indicated management to reduce pain and improve functionality and quality of life. Genu recurvatum is associated with an imbalance in the flexion and extension gaps, which is why it is necessary to have important considerations in the preoperative evaluation, implant selection, and surgical technique. We conducted a review in electronic databases including MEDLINE, EMBASE, and LILACS from 1990 to June 28, 2023. Two authors independently reviewed the titles and abstracts to identify studies that met the inclusion criteria. Thirty-four literature sources were included to address our inquiries. Results are presented in a narrative format, focusing on the design and study population for each specific research question. Genu recurvatum is a rare knee deformity which needs special considerations. Accurate assessment of the deformity magnitude and quadriceps weakness is crucial during the preoperative evaluation. The choice of implant should be tailored to the individual patient’s characteristics. Surgical technique plays a critical role in achieving soft tissue and gap balance. Literature highlights an increased incidence of complications associated with this deformity, particularly in cases of poliomyelitis. Navigation and robotics offer promising alternatives to enhance surgical precision and appear to show a lower recurrence rate.
Scimitar Syndrome with Acquired Cardiac Disease: A Once-in-a-blue-moon Occurrence
Authors: Tammiraju Iragavarapu , Bhupathi Meghana 
Published: March 2024

Abstract
Scimitar syndrome (SS) is a rare congenital anomaly characterized by various abnormalities observed in both children and adults, primarily involving partial anomalous pulmonary venous drainage from the right lung to the inferior vena cava and right lung hypoplasia. It is also known by alternative names such as congenital venolobar syndrome, Halasz syndrome, mirror-image lung syndrome, hypogenetic lung syndrome, and vena cava bronchovascular syndrome. The clinical presentation of this syndrome varies widely, ranging from asymptomatic cases to severe forms. Surgical intervention is typically required for severe cases, and the diagnosis relies predominantly on imaging studies. We present two instances of SS: one involving a patient with underlying rheumatic heart disease scheduled for valve replacement surgery and the other as an incidental finding in an asymptomatic individual, managed through medical means.
The Effect of Obesity on Severity of Asthma: An Observational Prospective Study from Pakistan
Authors: Shahid Sara , Alqahtani Saad S. , Bajwa Mishal , Rashid Mahnoor , Sana Anosh , Bajwa Amna , Ali Abdul N. , Ariffin Ahmad K. , Mahmood Mahgull , Ahmed Fahad , Mustafa Muhammad Abid 
Published: March 2024

ABSTRACT

Objective:
The current research study aimed to access the relationship between obesity and asthma exacerbations and severity among adult patients at the outpatient section of a federal hospital (PIMS) in Islamabad, Pakistan.

Methods:
A cross-sectional research study was carried out on 207 asthma adult patients belonging to different areas and ethnic groups from the country. The study setting was the PIMS hospital, which attracts patients from all over the country due to its facilities and cost-effective treatments. The body mass index (BMI) of asthma patients was calculated using the heights and weights of the study subjects. However, the pulmonary functions were calculated using a computerized spirometer i-e Spirolab III S/N 303681 in line with Winspiro PRO 7.1.version software. It presents the patient’s forced vital capacity that expires in the first second of expiration to full (FEV1) in comparison to forced vital capacity (FVC) ratio, that is, Tiffeneau–Pinelli index was also recorded to determine the asthma severity.

Results:
According to recent surveys, the overall prevalence of patients with overweight and obesity was 29.0% and 23.7%, respectively. A Chi-square test was used, and a statistically significant relationship was observed between BMI and asthma severity (P
< 0.001). The adult obese female patients presented poor pulmonary functions. The average FEV1/FVC ratio presented significant variance among four different categories of BMI with P < 0.05. This difference was due to the normal BMI category as the Tiffeneau–Pinelli index, that is, FEV1/FVC in the normal BMI group was significantly lower as compared to that in underweight and obese patients.

Conclusion:
The study subjects presented raised asthma severity in accordance with the raised BMI. Obese patients presented comparatively raised asthma exacerbations. Moreover, a statistically significant association of gender difference was observed between obesity and asthma severity. It was concluded that adult asthmatic women with obesity presented raised asthma severity as compared to adult asthmatic males.
A Cross-sectional Survey-based Study of Knowledge, Attitude, and Practice Towards Uses of Cosmetics and Cosmetovigilance in India
Authors: Siddiqui Almass , Ali Nida , Pandey Arushi , Ali Mohammad Daud , Haider Nafis , Khan Mohammed Zaafar , Iqbal Zeenat , Mirza Mohd. Aamir , Alharthi Sitah , Ansari Md Salahuddin , Mustafa Gulam , Ahmad Sarfaraz 
Published: March 2024

ABSTRACT

Background:
In India, the cosmetics industry has expanded significantly because of changing lifestyles and increased awareness. In terms of earning the most money from the personal care and cosmetics industry in 2021, India is ranked fourth globally. Many cosmetics sold in India include ingredients that cannot be used on humans.

Objective:
To assess knowledge, attitudes, and practice toward the uses of cosmetics and cosmetovigilance in India.

Methods:
A cross-sectional study was conducted, from April to May 2022, among the general population living in the Delhi NCR region, India. Study questionnaires (printed and survey link) were distributed in public as well as at workplaces for the survey.

Results:
Around 268 (54.78%) females and 223 (45.21%) males participated in the survey. Amongst the total respondents - 407 (83%) agreed that they are using cosmetic products on a daily basis, females 229 (85.44%), being the majority users compared to males 178 (80%), with a significant P value = 0.011. Most of the people reported side effects of shampoos - 7.13% (hair fall, hair thinning, dryness of the scalp, itching), followed by allergic reactions to moisturizers - 5.70%.

Conclusion:
Because of the right safety and effectiveness mentorship of cosmetics, regulatory agencies and stakeholders should adopt this broadly. Cosmetovigilance needs to be put into practice.
Validation of R/S-Warfarin Analysis Method in Human Blood Plasma Using HPLC with Fluorescence Detection and its Application to Patient Samples
Authors: Putriana Norisca Aliza , Rusdiana Taofik , Rostinawati Tina , Nurfuadah Ilma 
Published: March 2024

ABSTRACT

Context:
Warfarin is extensively used for venous thromboembolism and other coagulopathies. In clinical settings, warfarin is administered as a mixture of S-warfarin and R-warfarin, and both enantiomers are metabolized by multiple cytochrome P450 enzymes into many hydroxylation metabolites. Validation of analysis method and estimation of warfarin plasma levels are important, especially in narrow-index drugs such as warfarin.

Aims:
This study aimed to obtain a validated method for analyzing warfarin in patient plasma according to the European Medicines Agency (EMA) guidelines.

Materials and Methods:
A total of 77 patients were enrolled in this study. Five millimeters of venous blood was collected using sodium ethylenediaminetetraacetic acid (EDTA) tubes for pharmacokinetic analysis. Samples were prepared by the protein precipitation technique using acetonitrile. The optimum conditions for the analysis of warfarin in human plasma were tested using fluorescence detector (FLD) high-performance liquid chromatography (HPLC) with Chiralcel OD-RH column (4.6 × 150 mm i.d., 5 μm), Chiralcel OD-RH guard column (4.0 × 10 mm, 5 μm), and a column temperature of 45°C. The mobile phase used was acetonitrile: phosphate buffer pH 2 (40:60), with an isocratic flow rate of 1 ml/min and an injection volume of 20 μl. Excitation and emission wavelengths were 310 and 350 nm (warfarin) and 300 and 400 nm (griseofulvin). The retention time of griseofulvin was 6–7.5 minutes; R-warfarin was 10–11.5 minutes; and S-warfarin was 14–16 minutes.

Results:
The result of this validation obtained the optimum conditions. This method yielded the limit of detection (LOD) values of 0.0674 ppm (R-warfarin) and 0.0897 ppm (S-warfarin). The limit of quantification (LOQ) values were 0.225 ppm (R-warfarin) and 0.298 ppm (S-warfarin). Linearity existed at concentrations of 0.2–3 ppm with the line equation y = 0.0705x + 0.0704 with R² = 0.978 for R-warfarin and y = 0.0513x + 0.0297 with R² = 0.9924 for S-warfarin. At least 75% of the seven concentrations met the reverse concentration requirements, which were below ± 15%. This method met the requirements of accuracy and precision within and between runs, selectivity, and carryover where the %RSD and %diff values were below ± 15%. The mean plasma concentrations of R-warfarin and S-warfarin were found to be 0.76 ± 1.87 (SD) μg/ml and 0.59 ± 0.81 (SD) μg/ml, respectively. The mean standard dose group plasma concentration from the analysis of 77 samples was 0.68 ± 0.61 μg/mL for R-warfarin and 0.52 ± 0.42 μg/mL for S-warfarin.

Conclusions:
Based on these results, this analytical method can be declared valid and can be used for sample measurement in warfarin pharmacokinetic studies.
Survival after Trastuzumab Therapy in Patients with Locally Advanced or Metastatic HER2-Positive Gastric or Gastroesophageal Junction Cancer: A Meta-Analysis of Randomized Controlled Trials
Authors: Ali Mohammad D. , Al-Matouq Jenan A. , Ahmad Ayaz , Patel Munfis , Alshnbari Afnan S. , Alhussini Sara H. , Almozien Sara F. , Alowaywi Ghadeer A. , Kannan Latha S. 
Published: March 2024

ABSTRACT

Background:
In the Trastuzumab for Gastric Cancer study, it was found that trastuzumab combined with doublet chemotherapy (fluoropyrimidine and platinum) was the gold-standard treatment for gastroesophageal adenocarcinoma (GEA) that was locally advanced, unresectable, or metastatic (HER2+).

Materials and Methods:
We performed a meta-analysis of randomized phase II/III studies testing trastuzumab in combination or alone.

Results:
This meta-analysis’s findings involved 2048 patients in total. The treatment arm and hormone receptor status were used to stratify the combined HR. Overall, the PFS (Random model) HR [0.80] and 95% confidence intervals (CI) [0.68-0.95] were significantly higher for regimens containing trastuzumab, fluoropyrimidine, and platinum compared to regimens containing fluoropyrimidine and platinum.

Conclusions:
The results of this meta-analysis provide additional support for trastuzumab’s use in treating HER2-positive GEA, particularly in cases where the disease lacks a HER2+ receptor.
Melinjo Seeds (Gnetum gnemon L.) Antioxidant Activity and Cytotoxic Effects on MCF-7 Breast Cancer Cells: A Study Based on Tracing of Resveratrol Compound
Authors: Sukohar Asep , Iqbal Muhammad , Triyandi Ramadhan , Sahidin  
Published: March 2024

ABSTRACT

Introduction:
Breast cancer is one of the deadliest cancers worldwide. One of the polyphenols, namely, resveratrol, has been proven to have anticancer activity. Melinjo seeds which contain resveratrol need to be tested for their potential as an anti-breast cancer agent. This study aims to determine the antioxidant activity and cytotoxic effect of melinjo seeds based on solvent variations and resveratrol tracing.

Methods:
Extraction of melinjo seeds was performed using the soxhletation method. Antioxidant test was performed using the 2,2-diphenyl-1-picrylhydrazil method. The in vitro cytotoxic test was carried out using the microtetrazolium method. Cytotoxic test was carried out on MCF-7 breast cancer cells using a concentration range of melinjo seeds between 31,25 and 1000 μg/mL. Antioxidant and anticancer potentials are expressed in inhibitory concentration (IC)50 values. Resveratrol was traced using preparative high-performance liquid chromatography (Prep-HPLC).

Results:
Melinjo seed ethanol extract provided the largest total phenolics (126,154 ± 0,865 mg GAE/g sample) and total flavonoids (44,576 ± 0,611 mg QE/g sample) among all solvent fractions. The antioxidant activity of melinjo seeds from ethanol extract, n-hexane fraction, ethyl acetate fraction, and ethanol fraction was 263,307 ppm, 317,595 ppm, 160,878 ppm, and 181,159 ppm, respectively. The ethyl acetate fraction of melinjo seeds showed the strongest cytotoxic effect (94.6 μg/mL) among all extracts and solvent fractions. Prep-HPLC showed that the ethanol extract of melinjo seeds contained resveratrol, while the ethanol and ethyl acetate fractions of melinjo seeds were thought to contain resveratrol derivatives.

Conclusion:
The antioxidant activity of melinjo seeds showed a cytotoxic effect on MCF-7 cells, which varied based on solvent polarity and total phenolic and total flavonoid. The ethyl acetate fraction which is thought to contain resveratrol derivatives provides the most potent antioxidant activity and cytotoxic effect. These results indicate that melinjo seeds containing resveratrol and its derivatives have the potential for anticancer of the breast. Further studies are still needed in determining the structure of resveratrol compounds and their derivatives to ensure their biological activity and mechanism of action.
Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis
Authors: Liu Kai , Wu Chun-Xiao , Liang Hui , Wang Tao , Zhang Ji-Yuan , Wang Xiao-Tao 
Published: March 2024

BACKGROUND
Gastric cancer (GC) is the fifth most common type of cancer and has the fourth highest death rate among all cancers. There is a lack of studies examining the impact of liver metastases on the effectiveness of immunotherapy in individuals diagnosed with GC.
AIM
To investigate the influence of liver metastases on the effectiveness and safety of immunotherapy in patients with advanced GC.
METHODS
This retrospective investigation collected clinical data of patients with advanced stomach cancer who had immunotherapy at our hospital from February 2021 to January 2023. The baseline attributes were compared using either the Chi-square test or the Fisher exact probability method. The chi-square test and Kaplan-Meier survival analysis were employed to assess the therapeutic efficacy and survival duration in GC patients with and without liver metastases.
RESULTS
The analysis comprised 48 patients diagnosed with advanced GC, who were categorized into two groups: A liver metastasis cohort (n = 20) and a non-liver metastatic cohort (n = 28). Patients with liver metastasis exhibited a more deteriorated physical condition compared to those without liver metastasis. The objective response rates in the cohort with metastasis and the cohort without metastasis were 15.0% and 35.7% (P > 0.05), respectively. Similarly, the disease control rates in these two cohorts were 65.0% and 82.1% (P > 0.05), respectively. The median progression-free survival was 5.0 months in one group and 11.2 months in the other group, with a hazard ratio of 0.40 and a significance level (P ) less than 0.05. The median overall survival was 12.0 months in one group and 19.0 months in the other group, with a significance level (P ) greater than 0.05.
CONCLUSION
Immunotherapy is less effective in GC patients with liver metastases compared to those without liver metastasis.