bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Paroxetine Causing Me Nightmares?
Authors: Bhardwaj Akansha , Gupta Dimple , Prakash Rashmi , Jose Nimmi 
Published: March 2024

Abstract
Paroxetine is a commonly used drug in psychiatric settings for disorders such as major depressive disorder, obsessive-compulsive disorder, social anxiety disorder, generalized anxiety disorder, panic disorder, premenstrual dysphoric disorder, and posttraumatic stress disorder. However, this drug comes with its own series of adverse effects, including dry mouth, drowsiness, constipation, sexual side effects, etc. In our case study, we wish to highlight a case of depression who developed a rarely documented side effect of serial nightmares after prescribing paroxetine. On cross-tapering it with sertraline, her nightmares gradually resolved with no deterioration of depressive symptoms. By reporting this case, we wish to emphasize on this potential side effects of paroxetine which should be kept in mind while choosing this agent. Such reporting is important as this rare side effect could be confused with other clinical pictures, thereby affecting management. It also helps us enhance our knowledge of how selective serotonin reuptake inhibitors can lead to the development of nightmares.
A Study of Delirium in a Tertiary Care Hospital in Ahmedabad City of Gujarat
Authors: Patel Devanshi M. , Lakdawala Bhaveshkumar M. , Chokshi Vaishal D. 
Published: March 2024

Abstract

Background:
There are many risk factors for the development of delirium. According to the definition given by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, delirium is defined as “disturbances in attention and awareness over a short period of time, representations of changes from baseline attention, and awareness with a tendency to fluctuate over a period of time.”

Aim:
The aim of the study was to assess the prevalence of risk factors among patients of delirium in a tertiary care hospital.

Materials and Methods:
A cross-sectional study was conducted among patients of delirium in a tertiary care hospital of the city of Ahmedabad using the Confusional Assessment Method-Severity scale and sociodemographic questionnaire. A total of 100 patients were recruited in the study. The analysis was done using Microsoft Excel 2019.

Results:
In the study, we found that the majority of patients of delirium were of age >65 years, males, suffering from cerebrovascular illness, and having dementia. It was reported from the study that the majority patients of delirium were admitted to the intensive care unit and having a prolonged hospital stay.

Conclusions:
Identification of risk factors and early intervention can have better outcomes in patients suffering from delirium and lead to better prognosis.
Modern View on Potentials of Forensic Pharmaceutical and Pharmacological Expertise
Authors: Vazhnichaya Elena M. , Deviatkina Nataliia M. 
Published: March 2024

Abstract
The great number of drugs and their variety have increased the potential of therapy but increased the risks of crimes related to the production, sale, and use of medicines. The prosecution of such crimes requires pharmaceutical or pharmacological expertise. The development of forensic pharmacy and forensic pharmacology is relevant and needs consideration of their modern capabilities. The purpose of the work is to analyze literature data on the scientific basis of forensic pharmaceutical and pharmacological expertise and their modern possibilities. The texts of articles, book chapters, and websites were studied using keywords relevant to the purpose of the review. It is shown, that modern forensic pharmaceutical expertise is a separate type of expertise that focuses on the study of drugs and documents that regulate the production, distribution, and quality of medicines. It uses the latest analytical methods of pharmacy. A pharmacologist analyzes body fluids and tissues and interprets the resulting data to help courts and investigators assess the role of a drug in the person’s behavior, illness, injury, or death. The range of issues included in the pharmacological examination is fully within the competence of the forensic medical examination, which can be appointed in civil cases or criminal proceedings connected with harm to health or death. Forensic pharmacology is not the same as forensic toxicology or pharmacovigilance and requires a separate approach based on purely pharmacological knowledge.
Nonmetric Traits in Permanent Teeth as Clues to Ethnicity in Vidarbha Subpopulation to Aid Forensic Profiling: Pilot Study
Authors: Sadhwani Vaishali Amarlal , Prakash Nilima , Pradeep G. L. , Patil Rekha , Khivsara Shubhechha Anand , Khan Sabiha Mokashi 
Published: March 2024

Abstract

Introduction:
Nonmetric dental traits have a crucial role in ethnic classification of populations that help in forensic racial identification. Many studies have demonstrated the differences in the expression and frequency of dental traits between various ethnic groups for ancestry determination in the context of forensic dental anthropology. The present study is an attempt to assess the frequency and variation in nonmetric traits for establishing ethnicity in the Vidarbha subpopulation.

Aim:
The aim of the study was to assess the frequency and variation of nonmetric traits in permanent teeth for establishing ethnicity in the Vidarbha subpopulation.

Materials and Methods:
Participants of the Vidarbha subpopulation were selected by random sampling method. Molars, premolars, and incisors were evaluated for frequency of nonmetric traits, and variations were graded according to Dentoanthropological System of State University of Arizona criteria. Descriptive statistics, Chi-square test, and Student’s t-test were used for analysis of data.

Results:
The most common occlusal morphology in mandibular first and second molar was 5 cusp and 4 cusp, respectively, with the “+” groove pattern. Cusp 3 and cusp 4 were observed frequently in the maxillary molars. One lingual cusp was most commonly seen in mandibular premolars show while incisors showed faint shoveling.

Conclusion:
Our study concludes that nonmetric traits were present and showed variation in permanent maxillary and mandibular teeth among the Vidarbha subpopulation. Cusp 5 and Cusp 4 in first and second mandibular molars, respectively, groove pattern “+” and grade 1 protostylid were the most frequent grades observed in permanent mandibular molars. One lingual cusp was most commonly seen in mandibular premolars and faint shoveling was a notable feature in incisors of this population.
A Case Report of Pulmonary Alveolar Proteinosis with Associated Opportunistic Infection of Pneumocystis jirovecii and Molluscum Contagiosum
Authors: Patel Sapna , Gurumurthy Deepika , Rani Smitha , Devi Sheela 
Published: March 2024

Abstract
Pulmonary alveolar proteinosis (PAP) is an idiopathic rare diffuse pulmonary disease, first described in 1958 by Rosen et al. Its estimated prevalence is about 1 in 3.7–6.9 × 106 with a male: female ratio of 1:1–2:1. Majority of the patient’s age ranges between 20 and 50 years. PAP on microscopy is characterized by the presence of massive insoluble, amorphous, phospholipid-rich protein deposits in the bronchial and alveolar cavities. Most patients with acquired PAP present with cough and exertional dyspnea. It has been studied that there is increased risk of superinfection in PAP with opportunistic organisms like pneumocystis and vice versa. Definitive diagnosis of Pneumocystis jirovecii pneumonia rests on the demonstration of the organism within the alveoli by special stains like Grocott Methenamine Silver stain. Molluscum contagiosum (MC) is a common superficial skin infection caused by the poxvirus. MC is characterized by painless papules commonly seen in children and immunocompromised individuals. Here, we present a 34-year-old female who had complaints of severe difficulty in breathing and was brought dead to our hospital. On external examination, she had multiple warts over chest, abdomen, and over genitalia. Internal examination was unremarkable. Specimens of kidney, lung, and skin biopsy of genital warts sent for histopathological examination revealed acute tubular necrosis, P. jirovecii with PAP, and MC respectively.
Pattern of Clinical and Laboratory Presentation of Cerebral Malaria among Children in Nigeria
Authors: Jegede Tolulope O. , Oseni Saheed B. , Okeniyi John A. O. , Kuti Bankole Peter , Adegoke Samuel A. , Salau Qasim A. , Bello Emmanuel Olaseinde , Jegede Temitope Oyinlola , Kareem Abiodun John , Oyelami Oyeku A. , Samuel Ibitoye Bayode , Oluwatuyi Korede O. , Ekogiawe Foluwakemi T. , Obasohan Stanley E. , Abazu Ikechukwu S. , Babalola Emmanuel O. 
Published: March 2024

Abstract

Introduction:
Cerebral malaria (CM) is the most lethal form of severe malaria with high case fatality rates. Overtime, there is an inherent risk in changing pattern of presentation of CM which, if the diagnosis is missed due to these changing factors, may portend a poor outcome. Variations in the pattern of clinic-laboratory presentations also make generalization difficult. This study was, therefore, set out to report the pattern of clinical and laboratory presentation of CM

Methods:
This was a cross-sectional study among children aged 6 months to 14 years admitted with a diagnosis of CM as defined by the World Health Organization criteria. A pretested pro forma was filled, and detailed neurological examination and laboratory (biochemical, microbiology, and hematology) investigations were done. P <5% was considered statistically significant

Results:
Sixty-four children were recruited with a mean age of 34.9 ± 24.9 months and a male-to-female ratio of 1.9:1. There were 87.5% of under-five children. Fever (96.9%) was the major presenting feature closely followed by convulsions (92.2%). Convulsions were mainly generalized (94.9%) and multiple (76.5%). Profound coma (Blantyre coma score of 0) was present in 12.5% of cases, and the leading features on examination were fever (84.4%) and pallor (75.0%). Retinal vessel whitening (48.4%) was the most common funduscopic abnormality. Metabolic acidosis (47.9%), severe anemia (14.1%), hyperglycemia (17.2%), and hypoglycemia (7.8%) were seen among the children. Few (1.6%) had hyperparasitemia and bacteremia (3.2%)

Conclusion:
Early recognition of the clinical presentation and prompt management may improve the outcome of cerebral malaria.
Comparison of Waterlow and Braden scores for predicting pressure ulcer development in intensive care unit patients: A prospective observational cohort study
Authors: Kumar Pankaj , Dinesh C. 
Published: March 2024

Abstract

Background and Objectives:
Intensive care unit (ICU) patients are highly vulnerable to the development of pressure ulcers (PUs). Risk score scale that would efficiently predict the formation of PU in such patients includes the Waterlow Scale and the Braden Scale. Our objective was to determine the cutoff values of these scores for predicting PU formation in the ICU.

Materials and Methods:
A prospective observational study was conducted in the ICU of tertiary care center with 74 admitted patients. Inclusion criteria were Braden score ≤18 and Waterlow score >15 at admission to ICU and without preexistent ulcer. Assessment was done at 24-h intervals, after admission using Braden and Waterlow Scales till the patient reached a predefined endpoint development of PU, discharge, or transfer from ICU or death.

Results:
Thirty-nine patients developed PUs during their ICU stay. Waterlow score on the penultimate day for those who developed ulcers had a lower coefficient of variance (13.30) and greater area under receiver operating characteristic (0.977) than that of Braden (14.20; 0.888). A Waterlow score >20 (sensitivity 97.4%, specificity 88%, and accuracy 93.75%) and Braden score of <12 (sensitivity 97.4%, specificity 60%, and accuracy 82.81%) were predictors of impending ulcer formation in ICU patients.

Conclusion:
A Waterlow score >20 (19.5) may be taken as a cutoff for predicting impending ulcer formation for ICU patients. Whenever Braden scores are used instead of Waterlow, a cutoff of <12 (12.5) is indicative of higher chances of ulceration.
Role of sonoelastography and thyroid imaging reporting and data system in assessment of thyroid nodules
Authors: Elewa Eman M.S.A. , Hassan Rawhia T. , Amer Talal A. 
Published: March 2024

Background
Thyroid nodules are very common and may be observed at ultrasound (US) in 50% of adult population. US elastography is a noninvasive technique for evaluating thyroid nodules to decrease the number of tissue biopsies. Thyroid imaging reporting and data system (TIRADS) is the assessment of risk stratification of thyroid nodules using a score.

Patients and methods
This cross-sectional study was carried out on 100 patients with 146 thyroid nodules. The study was conducted in the period from October 2018 to October 2020 at the Radiology Department and approved by the Ethics Committee, and all patients gave their informed consent before inclusion in the study. Results were collected and then analyzed using a specialized computer statistical program.

Results
We found 124 (84.9%) benign nodules and 22 (15.1%) malignant nodules. The accuracy of elastography color score in detection of malignancy was found to be 95.1%, 89.7% for strain ratio, and 88.4% for TIRADS.

Conclusion
Adding elastography examination and TIRADS score to the routine thyroid US will be of high diagnostic value in detection of malignancy.
Transforaminal lumbar interbody fusion in degenerative spondylolisthesis
Authors: Dawood Ahmed M. , Abdel Baky Gad R. , Soliman Hany A.G. 
Published: March 2024

Introduction
Spinal fusion surgery is a common technique used to treat degenerative lumbar pathologies including disc herniation with instability, spinal stenosis, and degenerative spondylolisthesis (DS). Minimally invasive transforaminal lumbar interbody fusion (TLIF) is a common surgical procedure for treatment of DS.

Aim
We aimed to assess the outcomes of TLIF in DS.

Patients and methods
This study was conducted on 15 patients treated for DS treated with TLIF. A written informed consent was taken from all participants after proper explanation of the study. The study assessed perioperative results related to the operative procedure such as blood loss, operation time, hospital stay, and complications. Oswestry Disability Index (ODI) questionnaire was filled for functional evaluation, and the visual analog scale was used to assess pain preoperatively and postoperatively.

Result
A total of 15 cases were included. The mean age of the included cases was 53.67 years, the mean BMI was 26.73, 53.3% of cases were female, and 33.3% of patients were smokers. There was a significant decrease in visual analog scale ODI after operation. Regarding complications, 73.3% had no early complications but 13.3% had wound infection and 6.7% had positioning neuropathy and postoperative hematoma. Late complications were founded in 33.3% in the form of adjacent segment disease in 13.3%, arthrodesis in 13.3%, and fusion failure in 6.7%.

Conclusion
This study shows that TLIF is an effective procedure in surgical management of DS. The TLIF gives better results regarding reduction of low back pain and leg pain, as well as reduction in ODI score in early follow-ups and similar results in late follow-ups.
Comparative study between preoperative ketamine bolus dose versus ketamine bolus plus infusion for perioperative analgesia in orthopedic surgery
Authors: Abdullatif Esraa B. , Amin Mohamed A. , Lotfy Soad A. 
Published: March 2024

Background and aim
Postoperative pain severity depends on patient factors, anesthesia-related factors, and type of surgery. Pain after orthopedic surgery has been found to be immediate and severe, which necessitates more attention for its management. The aim of this study was assessment of the effectiveness of intravenous ketamine to provide postoperative analgesia after orthopedic surgery. This randomized double-blind study had been performed in Al-Zahraa University Hospital from December 2019 to October 2020.

Patients and methods
A total of 75 patients subjected to major orthopedic surgery were registered in the study. The patients had been randomly assigned into three equal groups (control, bolus, and bolus with infusion groups) to receive intravenous ketamine bolus dose alone (0.3 mg/kg) (bolus group); ketamine bolus (0.3 mg/kg) plus infusion (5 µg/kg/min), which terminated at the end of operation (bolus with infusion group); or placebo in the form of normal saline (control group). Visual analog pain scale score, postoperative 24 h morphine requirements, time to first analgesic requirement, and postoperative adverse effects were recorded and compared.

Results
Postoperative visual analog pain scale score and total morphine requirements were significantly less in bolus with infusion group, followed by bolus group, whereas the highest score and requirements were in control group. Regarding the time to first analgesic requirement, there was a statistically significant increased time to first analgesic in bolus with infusion group, followed by bolus group, whereas the shortest time was in control group, and there were nonsignificant differences among groups regarding postoperative complications.

Conclusion
Ketamine bolus dose alone before skin incision or followed by infusion had the capability of decreasing postoperative pain and total analgesic requirement and increasing the time to first analgesic requirement after orthopedic surgery, with superiority of ketamine bolus dose plus infusion without increasing the incidence of adverse effects.
Role of calponin 1 and cervical length measurement in predicting preterm labor
Authors: Youssry Lamiaa M. , Effat Doaa M. , Zaid Nesreen H. 
Published: March 2024

Background
Birth at less than 37 weeks of gestation is considered preterm, which is 11% of all live births. Most of symptomatic women who have preterm birth before 32 weeks of gestation are transferred to a tertiary referral center and receive treatment. However, 80–95% will not deliver within 7 days after admission, and 50% of these are delivered at term.

Aim
To decide whether serum calponin 1 level when combined with measurement of the cervical length may be used as a biomarker for prediction of delivery within 24 h in threatened preterm labor (PTL) pregnancies between 24 and 34 weeks of gestation.

Patients and methods
This is a prospective cohort study that was conducted at Al Azhar University Al-Zahraa Hospital within 1 year and included 50 pregnant women with threatened PTL between 24 and 34 weeks of gestation. Pelvic ultrasound and serum calponin 1 level were done for all cases.

Results
Calponin 1 level was significantly higher in women who delivered within 24 h (P=0.003). The cutoff value of calponin 1 level was 1.08 ng/ml, with 95.2% sensitivity and 100% specificity (area under curve: 0.986, confidence interval: 0.955–1.018). There was a significant positive correlation between cervical length and delivery interval (r=0.543, P=0.001). Cervical length less than or equal to 2.56 cm was 89.2% sensitive and 100% specific to identify delivery within 24 h (area under curve: 0.886, confidence interval: 0.865–1.011). There was a significant negative correlation between cervical length and calponin 1evel (−4.244, P<0.001).

Conclusion
Serum calponin 1 level and cervical length measurement can be used for predicting PTL in threatened pregnancies.
Subarachnoid versus intravenous dexmedetomidine and fentanyl for minimizing stress response in laparoscopic cholecystectomy
Authors: Abdalla Mofeed 
Published: March 2024

Background
The magnitude of stress response depends on several factors such as duration and intensity of surgical trauma, patient's age, surgical method, anesthetic technique, blood loss, and postoperative pain.

Aim of the work
The aim of this work was to study the effect of intravenous versus intrathecal dexmedetomidine and fentanyl on stress response during laparoscopic cholecystectomy.

Patients and methods
Sixty patients fulfilling the inclusion criteria who were undergoing laparoscopic cholecystectomies were randomly assigned to receive either intravenous fentanyl and dexmedetomidine (group I) or intrathecal fentanyl and dexmedetomidine (group II). Mean arterial blood pressure and heart rate were recorded before induction of anesthesia (T0), 5 min after intubation (T1), 30 min after start of surgery (T2), at skin closure (T3), 6 h postoperatively (T4), and 24 h postoperatively (T5). The number of patients who required intraoperative intravenous fentanyl and total intraoperative fentanyl consumption (µg), and the number of patients who required intravenous morphine at the end of surgery were recorded. Visual analogue scale and total postoperative morphine consumption (mg) at the end of surgery (M0), and at 6, 12, 18, and 24 h (M1, M2, M3, and M4, respectively) were recorded. Blood interleukin-6, cortisol, and glucose were measured before anesthesia (F0) and after recovery (F1). Postoperative complications were recorded.

Results
Heart rate and mean arterial blood pressure were statistically lower in group II at T2 and T3. The number of patients requiring intraoperative intravenous fentanyl and total intraoperative fentanyl consumption (µg), and the number of patients requiring intravenous morphine at the end of surgery were statistically lower in group II. Visual analogue scale and postoperative morphine consumption (mg) were statistically lower in group II at M0 and M1. Blood cortisol and blood glucose level were statistically lower in group II at F1. There were no statistical differences as regards complications.

Conclusion
Apart from lowering heart rate and BP, intrathecal dexmedetomidine and fentanyl was superior to intravenous dexmedetomidine and fentanyl, wherein it lowered pain score and analgesic consumption with attenuation of stress response.
The added value of digital breast tomosynthesis over digital mammography in evaluation of suspicious breast lesions
Authors: Abdullah Riham A.S. , Oun Abdel A.K. , Ahmed Abdullah H. 
Published: March 2024

Background
Breast cancer is the most frequent cancer among women worldwide and also in Egypt and causes the greatest number of cancer-related deaths among women. Mammography remains the method of choice for breast imaging. In the field of mammography, significant technical improvements have been realized, mainly owing to the introduction of digital mammography (DM) and digital breast tomosynthesis (DBT).

Aim
To determine the added value of DBT over DM in evaluation of suspicious breast lesions.

Patients and methods
A total of 50 female patients who had breast lumps or positive findings in screening by mammography were included.

Results
The study population was 50 female patients. They were subjected to imaging by DM and DBT. The study reveals that DBT has a superior role in assessment and characterization of suspicious breast lesions over DM.

Conclusion
DBT showed higher sensitivity and specificity and diagnostic accuracy over DM.