bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and risk factors associated with long COVID symptoms in children and adolescents in a southern province of Vietnam
Authors: Linh Huynh Ngoc , Tan Nguyen The , Thu Le Thi Minh , Loan Nguyen Tu , Uyen Nguyen Thi To , Trang Le Thanh Thao , Nam Truong Thanh , Phu Doan Hoang 
Published: March 2024

Objective:
To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.

Methods:
This study applied a cross-sectional approach within community settings in a southern province of Vietnam. A structured questionnaire featuring socio-demographic information and common long COVID symptoms was employed. Phi correlation coefficients assessed associations among pairs of long COVID symptoms. Additionally, multivariable logistic regression models were performed to investigate the risk factors of long COVID in recovered COVID-19 children and adolescents.

Results:
Among 422 participants, 39.3% reported long COVID symptoms, with a prevalence of 45.2% (SD=0.5) in children and 22.2% (SD=0.4) in adolescents. Common symptoms reported were cough 34.6% (SD=0.5), fatigue 20.6% (SD=0.4), shortness of breath 10.9% (SD=0.3), and lack of appetite 6.6% (SD=0.3). Concerning risk factors of long COVID, a higher risk was observed among demographic groups, including girls (OR 1.25, 95% Cl 1.15-1.37; P<0.001, reference: boys), children compared to adolescents (OR 1.24, 95% CI 1.12-1.37; P<0.001), overweight individuals (OR 1.14, 95% CI 1.02-1.27; P=0.018, reference: healthy weight), and participants without any COVID-19 vaccination (OR 1.36, 95% CI 1.20-1.54; P<0.001), or have received only one single dose (OR 1.35, 95% CI 1.10-1.64; P=0.004) compared to those who have received two doses. Besides, patients with a COVID-19 treatment duration exceeding two weeks also had a higher risk of long COVID (OR 1.32, 95% CI 1.09-1.60; P=0.003) than those who recovered less than seven days.

Conclusions:
The insights from this study provide crucial guidance for predicting the factors associated with the occurrence of long COVID in pediatric patients, contributing to strategic interventions aimed at mitigating the long COVID risks among children and adolescents in Vietnam.
Dengue hemorrhagic fever with rectus sheath hematoma: A case report
Authors: Bhattacharjee Boudhayan , Patel Hardik , Karad Rucha , Teja Vasireddy , Mondal Agnibho , Haldar Soumendra Nath , Saha Bibhuti 
Published: March 2024

Rationale:
Acute pain is a medical emergency that requires prompt abdominal evaluation and management. Dengue, a mosquito-borne arboviral infection, can lead to complications such as acute abdominal pain.

Patient concerns:
A 72-year-old hypertensive female presented with high-grade intermittent fever with chills and rigors for four days. She was diagnosed with dengue fever (NS1Ag-reactive) the day before admission. A contrast-enhanced computed tomography of the abdomen showed a hematoma along the rectus sheath which was managed conservatively as per surgical opinion.

Diagnosis:
Dengue hemorrhagic fever with rectus sheath hematoma.

Interventions:
Blood transfusion and fluid therapy.

Outcomes:
Ten days after discharge, the patient reproted no pain in the right iliac fossa and the size of the hematoma was significantly reduced.

Lessons:
Although it is rarely seen as a cause of acute abdomen, complaints of adnominal pain should never be ignored in critical or convalescent phase of dengue fever. Radiological investigations should be promptly conducted as hematoma is often difficult to be diagnosed clinically. Delay in diagnosis of rectus sheath hematoma can be fatal.
Hellebrigenin induces apoptosis by triggering cellular inhibitor of apoptosis 1 and Jun N-terminal kinase pathway in melanoma cells
Authors: Shieu Mu-Kuei , Chuang Yi-Ching , Ho Hsin-Yu , Lin Chia-Chieh , Lo Yu-Sheng , Hsieh Ming-Ju 
Published: March 2024

Abstract

Background:
Melanoma, the malignancy of melanocytes, is the most fatal form of skin cancer. Although various interventions are currently available, advanced stages of melanoma are still associated with a risk of metastatic recurrence.

Objectives:
The present study examined the anticancer activity of hellebrigenin, a natural product extracted from toad skin.

Methods:
Two types of metastatic melanoma cell lines, A2058 and HMY-1, were selected.

Results:
The findings revealed that hellebrigenin had cytotoxic effects on the two melanoma cell lines by triggering apoptosis: hellebrigenin activated cell arrest during the G2/M phase and downregulated regulators’ expression (e.g., cyclin-dependent kinase [CDK] 1, CDK 4, and cyclins E1, E2, A2, and D3). In intrinsic and extrinsic pathways of apoptosis, hellebrigenin activated the expression of the proapoptotic proteins t-BID, Bak, poly-ADP-ribose polymerase, Fas-associated death domain protein, death receptors 5, and cleaved caspases 3, 8, and 9; it also reduced the expression of the antiapoptotic proteins Bcl-2 and Bcl-xL. Mitochondrial membrane depolarization and cell nucleus condensation were also observed. In addition, human apoptosis arrays revealed that hellebrigenin inhibited the expression of cellular inhibitor of apoptosis 1, which is crucial for blocking cell apoptosis. Regarding upstream signaling activity, hellebrigenin suppressed the phosphorylation of the Jun N-terminal kinase 1/2 pathway in both melanoma cell lines.

Conclusion:
Overall, hellebrigenin can be used as a potential anticancer agent in clinical settings for treating the advanced stages of melanoma.
A Study on Early Surgical Complications in Renal Transplant Recipients
Authors: Prakash J. V. S. , Thiruvarul P. V. , Natarajan V. , Vetrichandar S. , Arasi K. V. , Paranjothi Arun Kumar , Dhineshkumar P. 
Published: March 2024

Introduction:
Renal transplantation is one of the most effective treatment measures in patients with end-stage renal disease to improve their quality of life. However, postoperative surgical complications can be seen in 15% to 17% of cases, with significant morbidity in earlier periods. This study aims to study the incidence, presentation, and management of various surgical complications within 2 months of renal transplantation.

Materials and Methods:
This retrospective descriptive study included data from hospital records of 236 recipients who underwent renal transplantation from 2015 to 2022 at our institute. In addition, salient characteristics of the donors were also noted. Recipients whose hospital records were not available were excluded from the study. Surgery-related complications within 2 months of renal transplantation in recipients and their management were studied.

Results:
Of 236 cases of renal transplantation, 182 cases were live-related renal transplantation recipients, and 54 were deceased donor renal transplantation recipients. Surgical complications such as posttransplant urine leak in three patients, lymphocele in two patients, graft renal vein thrombosis in three patients, and anastomotic site pseudoaneurysm in one patient occurred. The overall incidence of early surgical complications in our study is 3.81%. The study reports the successful management of all these nine patients with necessary intervention.

Conclusion:
The early diagnosis of postoperative complications is essential for reducing mortality and preserving graft function.
The Impact of Screening for BK Virus Infection on the Incidence of BK Virus Nephropathy in Kidney Transplant Recipients: A Single-center Experience
Authors: Sejpal Kapil Navin , Sivakumar Reddi , Kumar Mattewada Navin , Ganesh Rajesh Nachiappa , Srinivas B. H. , Gochait Debasis , Priyamvada P. S. , Haridasan Satish , Parameswaran Sreejith 
Published: March 2024

Introduction:
Kidney allograft survival has increased significantly in the past few decades. However, the more potent immunosuppression has also resulted in a higher incidence of infections including BK virus nephropathy (BKVN). The profile of kidney transplant (KT) recipients including age, basic kidney disease, comorbidities, dialysis vintage, and type of kidney donor in India is different from that of high-income countries. There are very few studies on the incidence and outcomes of BKVN from India. We studied the incidence, clinical features, and the impact of a screening strategy on patients with BKVN at our center.

Materials and Methods:
This was a single-center retrospective record-based study. We screened the medical records of all KT recipients at our center from March 2012 to December 2020 for patients who were diagnosed with BKVN. We compared the incidence of BKVN before and after the implementation of a proactive screening strategy in 2017.

Results:
From March 2012 to December 2020, a total of 212 KTs were performed at our center. Twenty-eight patients were diagnosed to have BKVN at this time. The incidence of BKVN in our study was 13.2%. The incidence of BKVN before routine screening was initiated at our center was 11.3% whereas it was 13.6% after routine screening was initiated. Graft loss from BKVN was 7.14%.

Conclusion:
The incidence of BKVN at our center is higher than previously reported in India; however, the rate of graft loss is low. A proactive screening strategy using nucleic acid test may allow early detection of BKVN and may have a beneficial impact on graft outcomes.
Role of Platelet-rich Plasma in Unexplained Recurrent Implantation Failure – A Systematic Review and Meta-analysis of Randomised Control Trials
Authors: Kaur Harpreet , Meenu Meenakshi , Pandey Shivam , Chauhan Anil , Mangla Mishu 
Published: March 2024

ABSTRACT

Background:
Recurrent implantation failure (RIF) is a challenging clinical situation and various strategies have been tried to improve the pregnancy rate in RIF. Platelet-rich plasma (PRP), which is obtained from the autologous blood samples of a person and is multiple times richer in platelets and other growth factors helps improve endometrial receptivity.

Objective:
This study has been conducted to summarise the evidence and quality of evidence available so far regarding the role of PRP in cases of unexplained RIF.

Materials and Methods:
An electronic database search for randomised clinical trials comparing PRP against routine care in women with unexplained RIF was performed on PubMed, EMBASE, SCOPUS and Cochrane Central. Two independent reviewers conducted a literature search and retrieved data using the predefined eligibility criteria. Bias assessment was done using the Cochrane Collaboration Network Risk of Bias Tool version 2. The quality of evidence was determined and a summary of the findings table was prepared for individual outcomes using GRADEpro software.

Results:
We identified 1146 records, and after removing duplicates, 531 records were screened. Out of these, 22 studies reached full-text screening and nine studies were included in the final review. We are uncertain about the effect of PRP due to the very low quality of evidence and we have little confidence that the administration of PRP had any significant effect on improving the live birth rate in women with RIF (odds ratio [OR]: 7.32, 95% confidence interval [CI]: 4.54–11.81, I
2 = 40%). Similarly, the quality of evidence was low for the clinical pregnancy rate, so we are uncertain if the administration of PRP had any significant effect on the clinical pregnancy rate (OR: 3.20, 95% CI: 2.38–4.28, I
2 = 0%).

Interpretation:
The current review suggests that there may be some beneficial effects of PRP in women with RIF, but the quality of evidence is very low and we are uncertain of the benefit and have little confidence in these findings.

Limitations:
Limitations are the small sample size of most studies, a short follow-up period, non-uniformity in the definition of outcomes and very low quality of evidence.

Registration:
The protocol was registered on PROSPERO (CRD42021292209).
Serum Zinc Levels in Women with Polycystic Ovarian Syndrome are Lower as Compared to Those without Polycystic Ovarian Syndrome: A Cohort Study
Authors: Dhar Swati , Yadav Reena , Tomar Akash 
Published: March 2024

ABSTRACT

Background:
Zinc is an essential micronutrient, a vital stabiliser and a cofactor in many enzymes such as superoxide dismutase and phospholipase C and also acts as an antioxidant by protecting the sulfhydryl groups of different proteins and enzymes against free radicals. It is unclear if serum zinc levels are correlated with polycystic ovary syndrome (PCOS) and its pathophysiology, although relation between diabetes and insulin resistance has been established.

Aims:
This study aimed to investigate circulating serum zinc levels in PCOS subjects compared with non-PCOS subjects.

Settings and Design:
In this cohort study, PCOS subjects were compared with normal subjects aged between 18 and 35.

Materials and Methods:
All the included subjects underwent measurement of anthropometric parameters, fasting insulin, luteinising hormone, follicle-stimulating hormone, thyroid-stimulating hormone, prolactin, progesterone, oestrogen and serum zinc levels. These values were taken on days 2–5 of the menstrual cycle.

Statistical Analysis Used:
Univariate analysis and linear regression were performed for serum zinc levels and fasting insulin levels in PCOS subjects and non-PCOS subjects using SPSS (version 21) and Microsoft Excel (2019).

Results:
Serum zinc levels in the PCOS group were lower than in the control group (P = 0.012). Fasting insulin levels in the PCOS group were higher than in non-PCOS subjects (P = 0.001). We found a negative correlation between zinc and fasting insulin (r = −0.580, P < 0.0001) in the normal group and (r = −0.332, P = 0.019) in the PCOS group. A positive correlation was found between body mass index (BMI) and fasting insulin levels in both the PCOS group (r = 0.227, P = 0.112) and normals (r = 0.612, P < 0.0001). A negative statistically significant correlation between BMI and zinc in both the PCOS group (r = −0.378, P = 0.007) and the non-PCOS group (r = −0.7452, P < 0.0001) was seen.

Conclusion:
The data suggest that serum zinc levels were found to be lower in PCOS subjects as compared to normal controls and evaluation of these levels may indicate that zinc has a vital role in PCOS pathophysiology.
Morphology of Coracoacromial Ligament and its Role in Biomechanics of Shoulder Joint along with its Surgical Significance
Authors: Sonje Preeti Dnyandeo , Shinde Amol Ashok , Bose Aditya , Kanesker Neelesh Subash , Vatsalaswamy P. 
Published: March 2024

Abstract

Background:
The coracoacromial ligament is a triangular band, which extends between the coracoid process and the acromion. This ligament, along with the coracoid process and the acromion, forms arch above the humeral head which protects the head of the humerus during abduction. It is important for gleno humeral stability. Coracoacromial ligament may be composed of two strong marginal bands with thinner centre.It may be present in the form of a thick anterolateral bundle and a posteromedial bundle, with a triangular base. Anatomic variants are frequently seen .Sometimes it is Y-shaped, quadrangular and may be straight in shape. Release of Coracoacromial ligament for the treatment of shoulder impingement syndrome has been suggested in surgeries.

Aim and Objectives:
Aim of the present study is to study the different types of coracoacromial ligament. Cadaveric study was helpful for identifying the types of normal coracohumeral ligaments.

Methodology:
Fifty upper limbs were procured from the cadavers. Cadavers were embalmed and in 10% formalin. Inclusion criteria for study were intact shoulder joint. Exclusion criteria were disarticulated shoulder joint. Dissection was carried out as per steps given in Cunningham dissecting manual. As dissection of upper limb was already done by undergraduate students, skin was reflected and deltoid was exposed. For further dissection the anterior and middle fibers of deltoid muscle were cut Superior surface of coracoid process and acromion process were exposed to visualised the coracoacromial ligament.

Results:
Meticulously dissected upper limbs were observed to determine various shapes of CAL. Trapezoid, rectangular, Y shaped, bipartite and tripartite type of choracoacromial ligaments were observed.

Conclusion:
Advances in understanding Coracoacromial ligament through research outcomes will contribute more to intraoperative decision making for arthroscopic surgeons.
Comparison of Flipped Classroom Versus Traditional Didactic Lectures among Medical Students: A Mixed Method Study
Authors: Nanjundaiah Komala , Anuradha H. V. 
Published: March 2024

Abstract

Background:
Didactic lectures are one of the commonly used instructional methods used for curriculum delivery in medical colleges. These lectures have a limited scope for interactions. Flipped classroom constitutes both an instructional approach and a form of blended learning, designed to enhance student engagement and comprehension. This intentional shift to a learner-centric model allocates initial exposure to new subjects beyond traditional classroom settings, thus enabling classroom time to be dedicated to in-depth exploration of topics, fostering significant learning experiences. Hence, a study was conducted to compare the academic scores of students taught in the flipped method versus traditional classroom and to assess the perception of students regarding the flipped classroom.

Methodology:
One hundred students were divided into two Batches A and B of 50 students each. Topic one was taught, by the flipped classroom method for Batch A and by the traditional method for Batch B. Topic two was taught by flipped classroom for Batch B and Batch A had traditional class. A multiple-choice question test was done for all the batches at the end of the classes. Perception of students regarding flipped classrooms was assessed through a prevalidated questionnaire on a Likert scale.

Results:
The mean value of the academic scores of the tests conducted was higher after flipped classroom sessions compared to traditional teaching sessions with a significant P < 0.001. Analysis of the open-ended questions revealed that the flipped class had advantages of in terms of better student involvement.

Conclusions:
Flipped classroom can be an effective student-centered teaching strategy when properly planned and implemented for higher education. In medical colleges, it can be incorporated as one of the teaching–learning methodologies to teach must know topics.
A Comparative Study of Morphometric Parameters of Knee Using Magnetic Resonance Imaging in Different Population Groups
Authors: Prithishkumar Ivan James , Paul Hephzibah , Punekar Abdul Samad , Lakshmanan Jeyaseelan , Albelooshi Ali 
Published: March 2024

Abstract

Background:
The design of majority of commercially available knee implants has their basis on data obtained from the European population. Anthropometric research has demonstrated a difference in the shape and size of proximal tibia and distal femur between the genders and ethnic groups. Underfit or overhang of prosthetic components can result in poor clinical and functional outcomes with need for revision. This study compares the dimensions of the knee in multiple racial groups to observe if significant racial and gender differences occur.

Methodology:
Morphometric parameters of the knee of adult patients (>18 years) in four population groups (Native Emirati, East Asian, Indian, and Caucasian) were measured using magnetic resonance imaging. Knee parameters were obtained from 368 patients (179 females and 189 males).

Results:
Males have larger femoral and tibial parameters compared to females (P < 0.01). For any specified anteroposterior length of knee, females demonstrate narrower mediolateral widths compared to males. Significant differences exist in knee parameters between the racial groups in both genders (P < 0.01).

Conclusion:
Adult knee parameters show significant variation between the genders and racial groups showing strong evidence for a race- and gender-specific knee arthroplasty system.
Comparison of Nocturnal Blood Pressure Patterns between Parkinson’s Disease, Cerebrovascular, and Other Neurological Diseases
Authors: Yalap Eray , Öztürk Gizem , Özaltun Burak , Sorgun Mine Hayriye , Şengül Şule , Akbostancı M. Cenk , Işıkay Canan Togay 
Published: March 2024

Background:
The rise in average systolic blood pressure at night compared with daytime is called reverse dipping. Reverse dipping is one of the indicators of autonomic dysfunction in Parkinson’s disease (PD). Reverse dipping may increase cardiovascular mortality. We aimed to document nocturnal blood pressure patterns of patients with Parkinson’s Disease, cerebrovascular diseases, and other neurological diseases.

Method:
Patients who applied to the neurology department between 2012 and 2016 and had 24-h ambulatory blood pressure monitoring were enrolled. Patients without an MRI examination were excluded. Patients in the cerebrovascular disease group had ischemic stroke, transient ischemic attack, vascular parkinsonism, and/or vascular dementia. The patients who did not have PD or cerebrovascular disease were assigned to the other neurological diseases group. Nocturnal blood pressure patterns were examined and categorized into two as dipping/non-dipping and reverse dipping. Dipping/non-dipping and reverse dipping rates were compared between groups. The difference between the groups was evaluated using the chi-square test.

Results:
A total of 126 patients were enrolled, 59% (n:74) of them were female while 41% (n:52) were male. The median age was 62 (18 - 88) years. The rates of dipping, non-dipping, and reverse dipping were as follows; 5.3%, 57.9%, 36.8% in the PD, 37%, 40.7%, 22.2% in the cerebrovascular disease, and 37.5%, 51.2%, and 11.3% in the other neurological diseases group. The rate of reverse dipping was significantly higher in the PD group (p=0.024), while it was lower in other neurological disease group (p=0.029). The rates in the cerebrovascular disease group were not statistically different.

Conclusion:
Reverse dipping is an important yet unnoticed autonomic dysfunction feature which can increase cardiovascular mortality in PD patients.
Immunotherapy for food allergy: current proposals to improve safety and efficacy
Authors: Wan Wing Tung Crystal 
Published: March 2024

Abstract
This review mainly focuses on the novel approaches that improve the safety and efficacy of immunotherapies, namely SLIT [alone or as pre-treatment of oral immunotherapy (OIT)], epicutaneous immunotherapy (EPIT), combination of anti-IgE into OIT or sublingual immunotherapy (SLIT) and introduction of hypoallergenic allergens by modifying native food products (boiling, baking, etc.) or manufacturing recombinant proteins. Among these proposals, some are clinically proven safe such as the use of anti-IgE while some are still under preclinical trials such as the use of some newly developed recombinant food protein allergens. What is certain is that more preclinical and clinical reviews and trials would be required on all these proposals before they could be maturely, safely, and effectively promoted in the clinical settings for patients’ use.