bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Cognitive Behavioral Therapy on Insomnia in Patients with Schizophrenia: A Randomized Controlled Trial
Authors: Chaurasia Neha , Dhyani Mohan , Garg Shobit , Mishra Preeti 
Published: March 2024

Abstract

Background:
Insomnia is a common feature of schizophrenia. Patients with schizophrenia also encounter the problem of insomnia, which impairs their cognitive functioning, quality of life, mental well-being, and functional recovery. Studies support pharmacological treatment of insomnia with certain drugs; however, these hypnotic medications also have adverse effects. There are no grounded recommendations about insomnia treatment in this clinical setting and research in nonpharmacological areas is sparse. To the best of our knowledge, this is the first study to see the effect of cognitive behavioural therapy for insomnia (CBT-I) in schizophrenia patients in an Indian population.

Aims:
To evaluate the effects of CBT-I in schizophrenia patients.

Materials and Methods:
It is a randomized controlled study. Forty schizophrenic patients were recruited and were randomly allocated into two groups. The CBT-I group (n = 20) received four sessions of CBT-I in addition to treatment as usual, whereas the control group (n = 20) received. no additional intervention. The Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) were administered at baseline, week 4, and week 8.

Results:
Both the groups showed significant time–group interactions on the ISI and PSQI. Post hoc testing showed that, compared to the control group, the CBT-I group showed significant reductions in ISI at both week 4 and week 8.

Conclusion:
CBT-I was effective for reducing insomnia symptoms in patients with schizophrenia and the effect lasted for 4 weeks after the intervention.
Diabetes Mellitus, Obesity, and Metabolic Dysregulation as Risk Factors for Metabolic Dysfunction-Associated Steatotic Liver Disease
Authors: Sridhar Janavi , Muthukrishnan Manasa , Pranavi Annadata Shanmukh , Karthikeyan Mu , Venkataraman Jayanthi , Jain Mayank 
Published: March 2024

Background and Aim:
New nomenclature defines metabolic dysfunction-associated steatotic liver disease (MASLD) as hepatic steatosis with at least one of the following, i.e., type 2 diabetes mellitus, obesity, and metabolic dysregulation. This study aimed to determine the risk factor profile of individual components of MASLD.

Methods:
Three hundred and forty-one patients attending the master health checkup between October 2022 and December 2022 at two centers were screened for fatty liver (FL) and assessed for three metabolic states: type 2 diabetes mellitus (T2DM), overweight/obesity (body mass index [BMI] ≥23 kg/m2), and metabolic dysregulation (Asia Pacific Association Study for Liver [APASL] criteria: 3 of the 5 criteria), i.e., waist circumference (WC) ≥90 cm (men); 80 cm (women); blood pressure >130/85 mm Hg, triglyceride (TGL) >150 mg/dL, high-density lipoprotein <40 mg/dL (men); <50 mg/dL (women), prediabetes (blood sugar [fasting] 100≤ to ≤125 mg/dL, or postprandial 140≤ to ≤199 mg/dL, and glycated hemoglobin 5.7≤ to ≤6.4%.

Results:
Of the 190 patients with FL, 172 patients had metabolic dysfunction (90.5%), 164 had raised BMI (86.3%), and 69 had diabetes (36.3%). MeS in combination with high BMI was present in 97 patients (51.1%) and all three were present in 52 (27.4%). Twenty-three patients (12.1%) had lean type MASLD, i.e., BMI <23 kg/m2. In the absence of FL (151 patients), 104 patients (54.7%) had MeS, 34 (22.5%) had T2DM, and 91 (60.3%) had raised BMI. Significant contributors to MAFLD were overweight/obese BMI ≥23 (odds ratio [OR]: 4.16), WC (men) (OR: 5.61), diabetes mellitus (OR: 1.96), and elevated S. TGL levels (OR: 4.77).

Conclusion:
Diagnosis of MASLD based on the presence of definite indicators of metabolic dysfunction can aid in the identification of at-risk patient groups and thereby tailor management in these patients.
The Determination of Heritability in palatal Rugae Pattern among Parents and their Off-Springs in Western India – A Cross-sectional Study
Authors: Bhatnagar Aishwarya , Arya Sugandha , Kumar Jyothi S , Arya Aishwarya , Morya Kailash Chandra , Baroopal Sudhir 
Published: March 2024

Abstract

Background:
Palatal rugae are asymmetrical elevations present on hard palate and are significant due to their uniqueness, stability and thus, aid in forensic identification.

Objective:
The objective is to determine palatal rugae morphology between parents and their offsprings and to determine their genetic inheritance.

Materials and Methods:
This randomized controlled cross-sectional single-blinded study was conducted on 50 families (randomly selected) who visited Vyas Dental College and Hospital. A total of 150 maxillary study models were examined and rugae were delineated and shape, size, and pattern of rugae were recorded.

Results:
Weak but significant correlation was seen in the nonspecific and angular type of palatal rugae between child and mother and child and father as P < 0.05. Matching with either or both of their parent was seen for curved, wavy, divergent, straight, horseshoe, angular, and nonspecific type of rugae with the higher % of wavy pattern matching (52% with mother and 54% with father). A considerable number of samples showed high heritability of primary and secondary rugae from both parents, but more predominantly to their mothers (branched, nonspecific, and straight).

Conclusion:
Both environmental and genetic factors can influence the rugae pattern. Further, studies should be conducted on a larger sample size to get more significant results.
Comparison of the Anatomy and Adaptability of Reconstructed Teeth with Natural Teeth: An Innovative Approach in Forensic Dentistry
Authors: Supraja S , Tejaswi P M , Manyam Ravikanth , Pasupuleti Mohan Kumar , Swetha P , Budumuru Ramesh Kumar 
Published: March 2024

Abstract

Background:
Forensic tooth reconstruction is the technique of reconstructing the morphology of a missing tooth from the intra-alveolar morphology of dental sockets from skeletal remains.

Aims and Objectives:
The aim and objective of the study are to compare and investigate whether the anatomy and adaptability of reconstructed teeth simulate with the natural tooth and to investigate whether the dental materials have potential in reconstruction of teeth.

Materials and Methods:
An in vitro experimental study was undertaken on a human mandible. According to the Fédération Dentaire Internationale, charting will be done based on the number of teeth present. The entire study will be conducted in three phases using dental materials. Phase 1 comprised preparation for negative replica, where an impression will be taken, Phase 2 comprised preparation of a positive replica or cast, and Phase 3 comprised tooth reconstruction using the flowable composite.

Results:
The specimen tooth (which had been taken from its socket) and the newly constructed tooth were compared, and when the length of the newly constructed root was measured using digital vernier calipers, there was a disparity of 0.5–1 mm. The cone-beam computed tomography radiographs demonstrated the necessary flexibility.

Conclusion:
The present study demonstrated that dental information can be obtained even when teeth are absent postmortem by making an attempt to recreate the teeth using dental materials while documenting the intra-alveolar anatomy of the dental root socket.
Morphometric Study of the Mastoid Process and its Role in Sex Differentiation: A Nigerian Computed Tomography Study
Authors: Ominde Beryl Shitandi , Igabari John N. , Ikubor Joyce Ekeme 
Published: March 2024

AbstractBackground:The mastoid process can be utilized in forensic identification due to its resistance to alterations and population variations in its morphology. The study investigated the role of mastoid parameters in the determination of sex in a Nigerian population.Aims and Objectives:The aim of this study was to determine the gender differences in measurements of the mastoid process. Furthermore, the study aimed at assessing the percentage accuracy of using the mastoid variables in sex discrimination.Materials and Methods:This cross-sectional study used computed tomographic images of the brain, stored in the radiology unit of a referral hospital in Delta State, Nigeria. Permission was granted by the hospital’s Ethics Board. The measurements of the mastoid process were taken on images of 310 patients (170 males and 140 females) aged 20–80 years. Data were summarized using means and standard deviations. Gender, side, and age group comparisons were assessed using the independentt-test, pairedt-test, and analysis of variance, respectively. The association between variables was probed using Pearson’s correlation test. The discriminant function analysis was used to determine the accuracy of correct sex allocation. The probability value was set at <0.05.Results:All the measurements were larger in males than in females (P< 0.05). All except the conventional height, oblique sagittal diameter, and mediolateral inclination angle showed significant differences between age groups (P< 0.05). The true height and oblique coronal diameter showed a significant positive correlation with age (0 <r< 0.05) (P< 0.05). The lateral intermastoid distance was the best sex-discriminating variable (89.4%). Using all nine variables, the accuracy of sex prediction was 89.7%.Conclusion:The sexually dimorphic mastoid dimensions can collectively be used for sex determination with acceptable accuracies, in cases where only the fragmented parts of the temporal bone are available in Delta State, Nigeria.
An Autopsy and Histopathology-based Study to Ascertain the Cause of Death of Brought Dead Cases
Authors: Bandyopadhyay Chandan , Paul Prabir Chandra , Chakraborty Prabhas Chandra 
Published: March 2024

Abstract

Background and Objectives:
The cases of apparent natural deaths are encountered in the hospital casualties who are noted dead at the time of the first medical attention and as such are labeled as “Brought Dead.” These include the cases of sudden death, unexplained death, and unattended death. The cause of such deaths is reported in the literature to emanate principally from the cardiovascular system, though there are some documented geographical, racial, and other variations. In the present study, we endeavored to detect the cause of such natural deaths in terms of the disease and the organ system involved, in the deceased individuals of the contemporary Bengali population, with cases due to obvious unnatural causes being excluded.

Materials and Methods:
An observational, cross-sectional study with 105 (n = 105, male: 89, female: 16) study subjects of age group of 20–80 years, selected by systemic random sampling, from the brought dead subjects coming to the mortuary of the NRS Medical College and Hospital for medicolegal autopsy from April 2011 to March 2012, excluding cases having a history of the obvious unnatural event. Organ system-wise gross examination was done, followed by tissue sampling for histopathological examination. The case-wise findings were tabulated and analyzed for descriptive statistics using SPSS software.

Results:
In the present study, 89 cases were male (84.8%) and 16 cases were female (15.2%), which reflects a male: female ratio of 5.56:1. The dead bodies are mostly recovered from the footpaths (47 cases, 44%). Sixty-four (61%) cases are of known identity. In 54 cases out of 105 (51.4%), morbid pathology is detected in the respiratory system (RS), lobar pneumonia, and cavitary pulmonary tuberculosis being the most frequent disease entity, in both genders. Fifty-one years–sixty-five years is found to be the most commonly affected age group, in both genders.

Interpretation and Conclusions:
The present study shows that the most common organ system involved in brought dead cases is the RS, which is supported by a few Indian studies.
Risk Factors for Death among Hospitalized and Nonhospitalized Patients due to COVID-19 in a Triple International Border Municipality
Authors: Gordillo Erica Alves Ferreira , Andrade Rubia Laine de Paula , Hoare Ismael , Izurieta Ricardo , Zilly Adriana , Cicchelero Laiz Mangini , Kunkel Merielly , Gordillo Ernesto Valdes , Silva-Sobrinho Reinaldo Antonio , Campos Regiane Bezerra , Silva Rosane Meire Munhak 
Published: March 2024

Abstract

Introduction:
The severity of COVID-19 in the general population ranges from minimally symptomatic disease to critical illness, which may require hospitalization and progress to death

Methods:
A retrospective cohort study carried out with all positive cases of COVID-19 reported in the municipality of Foz do Iguaçu (PR) between the period from March 2020 to December 2021. Data were collected from Bank Notifies COVID-19 is the name of the information system that provides notifications by professionals of suspected and confirmed cases of the disease. Data were analyzed using descriptive statistical techniques and calculation of relative risk

Results:
24,647 confirmed cases were identified in the study; among these, 22,211 (90.1%) were not hospitalized and 2436 (9.9%) were hospitalized. Among the 2436 patients hospitalized for COVID-19, 947 (38.9%) died and 1489 (61.1%) recovered. Among the 22,211 outpatients, 93 (0.4%) died and 22,118 (99.6%) recovered. An association between death and the following characteristics was identified among the cases that were hospitalized: male gender, all age groups over 40 years, indigenous race/color, hospital staylength of more than 10 days,hospitalization in a Unified Health System (SUS) bed and in an Intensive Care Unit (ICU). According to the clinical characteristics of symptoms and comorbidities, the following prevailed:ities dyspnea, intercostal retraction, cyanosis, hypertension, diabetes, obesity, cardiovascular disease, smoking, lung disease, kidneydisease, neurological disease, neoplasia, and immunodeficiency. Among the cases that were not hospitalized, death was associated with: malegender, all age groups over 50 years, dyspnea, cyanosis, hypertension, diabetes, obesity, cardiovascular disease, kidney disease, neurological disease, neoplasia, and liver disease

Conclusions:
Older adults, male, and Caucasian people are commonly affected by COVID-19 and can evolve with aggravation when they have modifiable risk factors such as obesity and smoking, as well as nonmodifiable risk factors such as: cardiovascular disease, neurological disease, renal, hypertension, diabetes, and immunosuppression.
Repetitive transcranial magnetic stimulation in complex posttraumatic stress disorder: A case report
Authors: Dharwadkar Nitin P. 
Published: March 2024

Abstract
Complex posttraumatic stress disorder (cPTSD) represents a unique clinical phenomenon. It is marked by traditional PTSD symptoms coupled with emotional instability, unfavorable self-perception, and challenges in interpersonal relationships. While the diagnostic recognition of cPTSD remains debated, emerging evidence supports its unique profile and clinical significance. This study presents an instance involving a 30-year-old woman who has been clinically determined to have severe cPTSD, comorbid borderline personality traits, major depressive disorder, and fibromyalgia. The patient underwent 25 bilateral sessions of repetitive transcranial magnetic stimulation (rTMS) targeting prefrontal cortices. Comprehensive assessments using standardized scales were conducted pre- and post-rTMS treatment. Results revealed significant reductions in cPTSD symptoms (PTSD Checklist-5 scores decreased from 55 to 21) and reduced borderline personality symptomatology (the Zanarini Rating Scale for borderline personality disorder scores decreased from 9 to 4), alongside improvements in other areas. These findings suggest the potential utility of rTMS as an adjunctive intervention for cPTSD. Aligned with previous PTSD research, the study highlights the capacity of rTMS to mitigate cPTSD symptoms, comorbidities, and subjective distress. Nevertheless, further exploration with larger samples and extended follow-up is needed to substantiate and generalize these findings. This preliminary evidence underscores rTMS’s promise as a prospective therapeutic avenue for complex PTSD, offering hope for improved treatment strategies.
Acute liver failure: The medical management
Authors: Pandey Chandra Kant , Singh Monika , Saxena Sumi , Danish Mohammad , Khanna Ashish , Srivastava Tanushree 
Published: March 2024

Abstract
Acute liver failure (ALF) is a clinical condition caused by multiple factors, such as drugs, viruses, and vascular causes. It is defined as coagulopathy and encephalopathy occurring in a time span of <6 months in a healthy patient with no preexisting liver disease. ALF is classified as, hyperacute, acute, and subacute on the basis of the duration of development of encephalopathy since the initial appearance of jaundice. The management of ALF comprises the treatment of hepatic and extrahepatic organ system dysfunction. The early recognition and treatment of raised intracranial pressure are the prerequisite for better neurologic outcome and survival. The main pathogenetic factor in the development of ALF is ammonia, but the role of newer ammonia-lowering agents is not well established. Once intracranial hypertension sets in, hypertonic saline and mannitol are the first-line therapy. Only liver transplants have been promising to be effective in patients with poor prognostic factors. Thus, it is vital to identify the complications and appropriate usage of different prognostic models in segregating the patients who require medical management or liver transplant, which is the mainstay of therapy.
Rapid detection of polymyxin resistance among carbapenem-resistant enterobacteriaceae
Authors: Alkhawagah Sabah M. , Rehim Soad E.-B.A , El-Nasser Asmaa M. 
Published: March 2024

Background
Colistin is used currently as a last-line antibiotic for the treatment of infections caused by carbapenem-resistant Enterobacteriaceae (CRE). For colistin-susceptibility testing, the conventional methods are not reliable, and the standard broth microdilution (BMD) method is both laborious and time consuming. Therefore, there is an urgent need for a rapid diagnostic technique for identification of colistin resistance.

Aim
The aim was to report the prevalence of CRE among hospitalized patients, to evaluate the performance of the rapid polymyxin Nordmann/Poirel (NP) test for detection of polymyxin resistance among CRE, and to detect the mcr-1 gene among these isolates.

Patients and methods
A total of 300 samples were included. CRE isolates were isolated and subjected to BMD test, disk diffusion test, E-test, and rapid polymyxin NP test to detect colistin resistance. In addition, PCR assay was done to detect mcr-1 gene.

Results
Out of 300 different clinical samples, 132 Enterobacteriaceae isolates were obtained. The prevalence of CRE was 41.7% (55/132). The prevalence of colistin resistance among CRE isolates was 7.3% (4/55). Of the four colistin resistant isolates detected by the standard BMD, disk diffusion test and E-test detected 2 and 3 isolates as colistin resistant, respectively, giving low sensitivity (50 and 75%, respectively) and unacceptably high rates of very major errors (3.6 and 1.8%, respectively), whereas all four isolates were recorded as colistin-unsusceptible by the rapid polymyxin NP test, giving 100% sensitivity and specificity, with no very major errors. Only one isolate was detected as mcr-1 positive by PCR assay.

Conclusion
There is a high prevalence of CRE. Rapid polymyxin NP test is an accurate and rapid method for detection of colistin resistance. This research confirms the alarming spread of the plasmid-mediated mcr-1 gene among CRE.
Ultrasound biomicroscopy of sclerotomy sites after conventional and sutureless (23, 25 G) pars plana vitrectomy
Authors: Sokromy Ali A. , Aly Mona M. , Moustafa Tarek A. 
Published: March 2024

Purpose
To evaluate postoperative outcomes of transconjunctival sutureless pars plana vitrectomy (PPV), using ultrasound biomicroscopy (UBM), conventional PPV, and transconjunctival sutureless vitrectomy (TSV) sclerotomy sites were compared using UBM.

Patients and methods
A total of 30 patients underwent complete ophthalmological examination. Conventional PPV was performed following the same surgical techniques, and all TSV procedures were performed by one surgeon. The 20-, 23-, and 25-G vitrectomy systems were used, with 10 patients in each gauge. UBM examination was performed after 1–30 days following surgery to locate and document the sclerotomy sites.

Results
The 20, 23, and 25 G sclerotomies showed no statistical difference in site diameter at UBM. All patients had at least two diameters of the incision measured, and all wounds were constructed obliquely. The mean size of 20 G sclerotomy was 375.40±83.70 µm (range, 280.4–695 µm) and coefficient of variation was 0.21. The mean size of 23 and 25 G sclerotomy was 315.5±56.8 µm (range, 253.2–362.5 µm; coefficient of variation=0.26; P<0.556).

Conclusion
Postoperative UBM examination allowed the evaluation of the wound architecture and showed no statistical difference between conventional 20 G and TSV 23, 25 G sclerotomies.
Detection of carbapenem-resistant enterobacteriaceae isolates harboring OXA-48 gene in a clinical setting
Authors: Muhammad Doaa M. , Elkholy Emtethal El-Sayed M. , Elmadbouly Asmaa A. , Montasser Karim A. 
Published: March 2024

Background
Increasing frequency of blaOXA-48 gene, commonly identified in Enterobacteriaceae family, is alarming across the world. The poor hydrolytic profile of OXA-48 likely may obscure its detection in clinical isolates, complicating the treatment option.

Objective
To detect the prevalence of blaOXA-48 gene in carbapenem-resistant Enterobacteriaceae (CRE) isolates from patients in Al-Zahraa and Helwan University hospitals, Cairo, Egypt, and to compare the diagnostic performance of phenotypic tests for the detection of OXA-48-mediated carbapenem resistance.

Patients and methods
A total of 500 Enterobacteriaceae isolates were identified from different clinical specimens provided to the Microbiology Laboratory of Al-Zahraa and Helwan University hospitals, Cairo, Egypt. The identified isolates underwent antibiotic susceptibility testing. Phenotypic carbapenemase production was confirmed by the modified Hodge test, Carba Nordmann-Poirel test, and modified carbapenem inactivation method (mCIM), and the blaOXA-48 gene was detected using real-time PCR.

Results
Out of 500 Enterobacteriaceae isolates, 102 (20.4%) isolates showed resistance to one or more of carbapenems. Among these 102 CRE isolates, Klebsiella pneumoniae was the most common isolate. Carbapenemase production was detected in 67/102 (65.7%), 69/102 (67.6%), and 72/102 (70.1%) of isolates by modified Hodge test, Carba Nordmann-Poirel, and mCIM, respectively. Of the 102 CRE isolates, 74 (72.5%) harbored blaOXA-48 gene, and of them, 43 (58.1%) were K. pneumoniae, 25 (33.8%) were Escherichia coli, and 6 (8.1%) were Citrobacter.

Conclusion

blaOXA-48 gene was prevalent among Enterobacteriaceae isolates in the two hospitals, with more prevalence in K. pneumonia isolates. mCIM has the best performance in phenotypic detection of this resistance.