bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Marrow Metastasis in Nonhematological Malignancies: A Study from Tertiary Care Center
Authors: Singh Anurag , Rawat Shalini , Kushwaha Rashmi , Jain Mili , Verma Shailendra Prasad , Verma Nishant , Singh Uma Shankar 
Published: February 2024

Introduction:
Metastatic cancer presents a treatment challenge to clinicians, particularly for patients with bone marrow infiltration. For tumor staging, therapy selection, and prognosis risk stratification, the status of the bone marrow should be known for the presence or absence of metastasis. The study aimed to evaluate the hematological findings and comprehensive analysis of bone marrow in cases of nonhematological malignancies with bone marrow metastasis.

Materials and Methods:
This retrospective study comprised a record retrieval of the departmental archives for the past 6 years. A total of 331 patients with nonhematological malignancies were found, of whom 31.42% (104/331) showed bone marrow metastasis. An integrated clinical approach with bone marrow examination findings and immunohistochemistry whenever necessary was used to achieve a definitive diagnosis of bone marrow metastasis.

Results:
Among the study population, 31.42% (104/331) of patients had nonhematological malignancies that metastasized to the bone marrow. Most of the patients with bone marrow metastasis had anemia, which was found in 77.88% (81/104) of the cases. Leukoerythroblastic reaction was noted in 31.73% (33/104) of the cases, and thrombocytopenia was found in 25% (26/104) of the cases. The most common malignancy with bone marrow metastasis in adults was prostatic adenocarcinoma (28.1%) (9/32) and in pediatric cases, neuroblastoma (53.9%) (52/98).

Conclusions:
It is essential to diagnose nonhematological malignancies that have metastasized to the bone marrow since this necessitates tumor staging, therapy selection, and prognosis risk stratification. To conclude, not a single hematological parameter is predictive of bone marrow metastasis; however, unexplained anemia, a leukoerythroblastic blood picture, and thrombocytopenia in peripheral blood should raise suspicion for bone marrow metastasis in cases of nonhematological malignancies.
Positivity of Interferon-Gamma Release Assay among Foreign-Born Individuals, Tokyo, Japan, 2015–2017
Authors: Miyake Satoshi , Endo Masayuki , Ikedo Keiko , Kayebeta Aya , Takahashi Ikumi , Ota Masaki 
Published: February 2024

Background:
The aim of this study is to analyze interferon-gamma release assay (IGRA) data of foreign-born individuals in Japan derived from tuberculosis (TB) contact investigations.

Methods:
A contact with a TB patient was considered to have occurred when an individual had contact with a TB patient for more than 8 h indoors. This is a retrospective cohort study, and all the TB contacts tested with IGRA during the contact investigations conducted by the Shinjuku city Health Office from 2015 through 2017 were enrolled.

Results:
A total of 880 foreign-born contacts were investigated. The IGRA positivity of the contacts from China and Viet Nam were both 5.1% (95% confidence intervals [CIs]: 3.2%–7.8% and 2.4%–9.5%, respectively), whereas that from Nepal and Myanmar were 24.4% (95% CI: 16.0%–34.6%) and 23.3% (95% CI: 9.9%–42.3%), respectively. Multiple logistic regression analysis showed that the risk factors were smear status of the index patient (1+: adjusted odds ratio [aOR]: 6.2, 95% CI: 1.2–30.5, smear status 3+: aOR: 14.3, 95% CI: 1.7–118.2), age of the contact (aOR: 1.1, 95% CI: 1.0–1.1 for 1 year increment), and being born in Nepal (aOR: 5.6, 95% CI: 2.8–11.2) and Myanmar (aOR: 4.3, 95% CI: 1.4–13.0), compared with China as reference.

Conclusions:
In contact investigations involving foreign-born individuals, local health offices should carefully consider the composition of the TB contacts and expand the focus of the investigation, if deemed necessary.
Chronotype and Its Relationship with Sleep Quality among Professional Students at Indian University
Authors: Khan Moazzam Hussain , Sharma Saurabh , Saleem Mohammad 
Published: February 2024

Context:
Chronotype varies from one individual to others and thus results in individual difference in physical performance and quality of sleep.

Aims:
This study’s goal was to determine the chronotype and its relationship to sleep quality in university-level professional students.

Settings and Design:
This was a cross-sectional survey of professional students at university level.

Subjects and Methods:
A total of 240 students completed the Horne and Ostberg morningness–eveningness questionnaires (MEQs) to determine their chronotype and Pittsburgh Sleep Quality Index (PSQI) to determine the quality of sleep at university students.

Statistical Analysis:
The data were analyzed with Spearman’s correlation test and Chi-square test.

Results:
A total of 240 students, 72 (30%) females and 168 (70%) males, participated in this study (age 18–28 years): 137 (57.1%) intermediate types, 75 (31.3%) morning types, and 28 (11.7%) evening types. Morning typology was more common among Indian males. In terms of MEQ typology, there was no discernible gender difference (P = 0.06 > 0.05). A noteworthy inverse relationship has been observed between the chronotype score (MEQ) and the sleep quality (PSQI) (rho = −0.15). It was noted that 10.4% of individuals had poor sleep quality.

Conclusion:
The majority of Indian university professionals are of the intermediate type, and it appears that Indian students, particularly males, are slightly more likely to be morning type than people from some Western societies. Evening chronotype students have poor quality of sleep.
Online gaming motives, family relationships, and personality among Indian youth
Authors: Ajith SJ , Narayanan Gitanjali , Sharma Manoj Kumar , Anand Nitin , Vishwakarma Akash 
Published: February 2024

Background:
Youth involvement in gaming has become an important concern for mental health professionals due to its significant impact on functionality and relationships. However, the gaming motives and associated family relationships and personality traits in the Indian context are poorly understood.

Aim:
The study examined problematic online gaming, including Internet gaming disorder in connection to gaming motives and personality, especially as they impact family relationships among Indian youth.

Materials and Methods:
The study consisted of 179 participants (86 males; 93 females) with the age range of 18–25 years who were involved in Internet gaming in the last 1 year. The subjects were recruited using an online survey. Tools used were brief and included the Gaming Usage Questionnaire, Internet Gaming Disorder Scale-Short-Form, Motivation for Online Gaming Questionnaire UCLA Loneliness Scale, Sheehan Disability Scale, Brief Family Relationships Questionnaire, and MINI International Personality Item Pool.

Results:
The mean age of the participants was 21.99 ± 2.202 years. A stepwise multivariate regression analysis indicated that escape and competition motives, low cohesion in family relationships, low level of conscientiousness, and low level of intellect/imagination contributed to problematic gaming behaviors.

Conclusions:
The study established a relationship between gaming motives and both internal and external factors associated with problematic online gaming. Generalizing the findings across a larger youth population would help in developing informed preventive measures to reduce the risk of developing a gaming disorder.
Prevalence of internet addiction and its relationship with insomnia, depression, anxiety, and stress among medical students of a tertiary care medical institute of Eastern India
Authors: Rani Shreya , Sinha Niska , Kumar Rajesh 
Published: February 2024

Background:
Internet has become an integral part of our daily lives but as the use of internet is increasing, it is important to be aware of the prevalence, context, and impact of its addiction on sleep and the presence of anxiety, depression, and stress in our lives.

Aim:
To assess the prevalence of internet addiction and its association with insomnia, depression, anxiety, and stress among medical students in a tertiary care medical institute in Eastern India.

Materials and Methods:
A descriptive cross-sectional questionnaire-based study with a purposive sampling method was conducted among 420 undergraduate medical students of different professional years. Out of 420 medical students, 413 students who gave consent and returned complete performa were taken in the study using a semi-structured performa for sociodemographic details, Young’s Internet Addiction Test, Insomnia Severity Index, and Depression Anxiety Stress Scale.

Results:
We found 31.2% of students had internet addiction, 24.2% had clinical insomnia, 58.1% had stress, 68.8% had anxiety, and 64.6% had depression. Potential internet addiction was significantly related to average screen time, insomnia, stress, anxiety, and depression.

Conclusions:
Internet addiction is prevalent among medical students affecting sleep, anxiety, depression, and stress, which needs urgent preventive strategies.
Ayurvedic management of Mootrashmari: A case report
Authors: Rana Deeksha , Sharma Meenakshi , Mandal Sisir Kumar , Agarwal Vivek 
Published: February 2024

Abstract
Urolithiasis is a urological disorder affecting about 12% of the world’s population. It results in recurrent urinary tract infections (UTI). The disease Mutrashmari is Kapha Pradhan Tridoshajavyadhi formed in Mutravahastrotasa (the urinary system). It is one among Asta-Mahagadha (eight fatal conditions) showing its severity. In the present case report, a 22-year-old female patient has complaints of acute pain and tenderness in the left and right iliac region, fever, burning micturition, and nausea. In Ayurveda, the condition corresponds to Mutrashmari. Classical holistic approach including Shamana Chikitsa with Varunadikashyam, Hazrulyahud Bhasma, and Cystone syrup for 6 months period was employed in this case. All the symptoms were relieved within 2 months of intervention and ultrasonography of abdomen was done after 6 months, which revealed no evidence of calculus. The case proved the potential of ayurvedic interventions in such renal calculus cases where the patient was advised nephrolithotomy by the allopathic physicians. The uniqueness of the case was that she got relief in not only objective and subjective parameters but no relapse of calculus and UTI was seen even after 1 year without taking the treatment. The findings of the case also suggested that the classical approach has enough potential in the management of large renal stones (> 6.5 mm) without any surgical intervention.
Acute encephalitis syndrome
Authors: Patnaik Sibabratta , Kamath Shrishu R. , Jain Mukesh Kumar 
Published: February 2024

Abstract
Acute encephalitis syndrome (AES) is a serious disorder characterized by the sudden onset of inflammation in the brain, which may lead to life-threatening clinical situations. This syndrome encompasses a range of neurological disorders, including, but not limited to, viral and bacterial infections, toxins, and metabolic causes. It includes a wide array of spectrum of diseases, and diagnosis is based on clinical symptoms and a wide range of investigations. Treatment is usually symptomatic, and in some instances, definitive treatment is available. Long-term sequelae of AES can include cognitive deficits, behavioral changes, motor impairments, and epilepsy. Rehabilitation and supportive care are often necessary.
Hemodynamic assessment and management of septic shock in children
Authors: Ranjit Suchitra , Natraj Rajeswari 
Published: February 2024

Abstract
The three main pathophysiologic contributors to septic shock include varying combinations of hypovolemia (relative > absolute), vasoplegia, and myocardial dysfunction. The three pillars of hemodynamic support include fluid boluses (FBs), vasopressors ± inotropic agents. The three goals of hemodynamic resuscitation include an adequate cardiac output (CO)/clinical perfusion markers, pressure parameters (adequate mean arterial pressure [MAP] and diastolic blood pressure [DBP]) for organ perfusion, and avoiding congestion (worse filling) parameters. Fluid bolus-induced CO improvements are variable (33%–50%) and ill-sustained on account of sepsis-mediated glycocalyx injury. A pragmatic approach is to administer a small bolus (10 mL/kg over 20–30 min) as a test and judge the response based on clinical perfusion markers, pressure parameters, and congestive features. Vasoplegia is characterized by low DBP, which is a major contributor to hypotension in septic shock; furthermore, FBs may exacerbate vasoplegia. A strategy of restricted FB with early low-dose norepinephrine (NE) (0.05–0.1 µg/kg/min) can be helpful. NE has press or effects and also mild inotropy and can be a useful first-line vasoactive even in patients with mild-moderate septic myocardial dysfunction (SMD) to maintain adequate coronary perfusion and DBP while minimizing tachycardia. Severe SMD may benefit from additional inotropy (epinephrine/dobutamine). Except vasopressin, most vasoactive drugs may safely be administered via a peripheral route. The lowest MAP (5th centile for age) may be an acceptable target, provided that end-organ perfusion and organ function (mentation and urine output) are satisfactory. An individualized rather than protocolized approach combining the history, physical examination, laboratory analyses, available monitoring tools, and re-assessments can improve outcomes.
Utility of pediatric early warning score at emergency room in predicting the level of care required for next 48 h: A single-center, prospective, observational study
Authors: Parwaiz Anas , Agrawal Nitika , Gupta Alpa , Simalti Ashish , Kedarnath Manju 
Published: February 2024

Abstract

Background:
Pediatric scores such as the Pediatric Early Warning Score (PEWS) are based on parameters available at the bedside. The aim of this study was to assess the utility of PEWS to determine the need for critical care support within the next 24–48 h. this study aimed to see if PEWS could predict a suitable level of care, namely ward, high-dependency unit (HDU), or pediatric intensive care unit (PICU).

Subjects and Methods:
It was a prospective observational study and a convenient sample method was used with children of age groups from 1 month to 18 years, coming to the pediatrics department being the subject. We correlated the level of care at admission and also after 48 h with PEWS at the time of admission of children already intubated, children on inotropes at the time of admission, children with surgical illness, and children admitted only for procedure/procedural sedation were excluded from this study. The Brighton PEWS was used to calculate PEWS.

Results:
A total of 953 patients were enrolled in this study. In this study, the likelihood of admission to PICU correlated well with PEWS above 6 with a positive predictive value of 56% and a negative predictive value of 99.43%.

Conclusions:
The admission PEWS can be used as an effective tool for deciding the level of care area. Score <3 admission PEWS can be kept at the ward, while >3 score at HDU/PICU where frequent periodic monitoring should be done.
Peri vesical and retroperitoneal vascular injury following pd catheter insertion in a child: An unusual occurrence
Authors: Srinivasan Shreyas , Singh Akhand Pratap , Kiran Chimmani Sai , Peters Nitin James 
Published: February 2024

Abstract
Peritoneal dialysis (PD) is an important modality of renal replacement therapy (RRT) in children in the acute setting. Despite the favorable outcomes of RRT, PD catheter insertions have various complications that may be related either to variations in procedural technique or infections. We report a case of a child with massive retroperitoneal and intra-abdominal bleeding secondary to injury to the inferior epigastric arterial arcade, near the urinary bladder following the insertion of a PD catheter.
Comparison of bedside risk assessment scores to predict the outcome of patients with acute febrile illness admitted to pediatric intensive care unit: A single-center prospective observational study
Authors: Alam Shahzad , Mazahir Rufaida , Agarwal Deepika 
Published: February 2024

Abstract

Background:
Acute febrile illness (AFI) is the most common presentation in the pediatric emergency room, and bedside risk assessment scores are very useful to identify those at risk. This study aimed to evaluate the predictive validity of quick Sequential Organ Failure Assessment (qSOFA), quick Pediatric Logistic Organ Dysfunction-2 (qPELOD-2), Liverpool qSOFA (LqSOFA), and Pediatric Early Warning Score (PEWS) to predict the outcome of patients with AFI admitted to the pediatric intensive care unit (PICU).

Subjects and Methods:
This prospective observational study included children under the age of 18 years admitted to PICU. A thorough history and examination was performed in the ER, and the qSOFA, the qPELOD-2, the LqSOFA, and the PEWS scores were calculated. The primary outcome was inhospital mortality. The capacity of the scores to predict outcome was evaluated for calibration (using Hosmer–Lemeshow adaptation of the Chi-square test) and discrimination (using receiver operating characteristic [ROC] curve). The scores were compared for any significant difference using z-statistics.

Results:
The study included 239 patients with the most common diagnosis of dengue fever. The overall mortality rate in the study was 8.4%. On the calibration of the models, all the scores showed a good fit to predict mortality. On discrimination by ROC curve, the LqSOFA score and PEWS had the best area under the curve for ROC curve (AUC-ROC) (0.913), followed by the qSOFA score (0.859). On comparing the AUC-ROC curve, no statistically significant difference was found between the scoring systems to predict mortality.

Conclusions:
Bedside risk stratification scores are a simple and convenient tool to identify patients at risk for mortality and assess prognosis. No single assessment tool was found superior to others.
Correlation of dental caries severity with physical properties of saliva in connection with nutrition status among a group of adolescent
Authors: Yousif Sarah Hikmat , Qasim Alhan Ahmed 
Published: February 2024

Abstract

Background:
One of the most common oral health problems in the world, dental caries, is a multifactorial sickness. Interactions between saliva, fermentable carbohydrates, acid-producing bacteria, and several host factors cause it.

Objective:
This study was conducted among a group of adolescents to evaluate the correlation of dental caries severity with the physical properties of saliva in connection with nutrition status among a group of adolescents.

Materials and Methods:
In total, 90 teenagers of both genders, aged 15, participated in the current observational (comparison) study. The participants were split into two groups: 60 had previously had caries (the study group) and 30 had not (the control group). Adolescents with diverse caries experiences were separated into two groups in accordance with World Health Organization (WHO) recommendations from 2013: 30 of them had moderately carious (1–3) teeth, and 30 had severely carious experiences (Decay-Missing-Filled Teeth [DMFT] > 10). Caries’ experience was measured using the DMFT Index. Weight, height, and body mass index (BMI) measurements were used to determine nutritional status. Based on their BMI, adolescents were categorized as having a healthy weight, being at risk of becoming overweight, or being overweight.

Results:
The current study’s findings show that both salivation rate and salivary and potential of hydrogen (pH) mostly decrease within nutritional status and caries severity groups but with no significant difference except in the total sample in salivation rate among nutritional status, its result is significant; also, there is a significant result between healthy and overweight in salivary flow rate, whereas other results are not significant.

Conclusion:
This study concluded that obesity is one of the factors responsible for deranged salivary parameters, that is, diminished stimulated salivary flow rate, buffer capacity, and salivary pH, which in turn has an adverse effect on oral health.
The role of methylenetetrahydrofolate reductase gene polymorphisms hypercoagulable status of coronavirus disease
Authors: Taha Ibraheem Kais , Mahmood Ibrahim Abdulla , Al-Mayah Qasim S 
Published: February 2024

Abstract

Background:
Hypercoagulation is a hallmark in coronavirus disease (COVID-19). The activity of the enzyme methylenetetrahydrofolate reductase (MTHFR) determines homocysteine levels, and polymorphisms in the enzyme’s gene can influence the enzyme activity with a consequence of hypercoagulability in patients with COVID-19.

Objectives:
To investigate the association of two single nucleotide polymorphisms (SNPs) in the MTHFR gene with hypercoagulability status in COVID-19.

Materials and Methods:
This is a retrospective cross-sectional study, which included 90 patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with variable severity. Patients were classified according to D-dimer level at admission into two groups: with and without hypercoagulability. Nucleic DNA was extracted from leukocytes and gene fragments corresponding to C677T and A1298C MTHFR gene were amplified and genotyped using allele specific polymerase chain reaction.

Results:
Hypercoagulation was reported in 42.22% of the patients. The mutant homozygous genotype (TT) was more frequent among hyper - than normocoagulable patients (13.6% vs. 1.92%) with a significant difference (odds ratio [OR] = 9.28, 95% confidence interval [CI] = 1.02–84.78, P = 0.048). Furthermore, T allele was more common among hyper- than normocoagulable patients (28.95% vs. 13.46%) with a significant difference (OR = 2.62, 95% CI = 1.24–5.5, P = 0.012). In contrast, the SNP A1298C had no significant impact.

Conclusions:
The TT genotype and T allele of C677T polymorphism but not A1298C in cMTHFE gene could be considered a risk factor for the hypercoagulable status in COVID-19.
Serological detection of hepatitis B virus e antigen and TNF-α in a dialysis patient
Authors: Abed Aneeda Khraibet , Alkhafaji Zaytoon A , Abood Ali Jaber 
Published: February 2024

AbstractBackground:The hepatitis B virus (HBV) is responsible for all forms of hepatitis (occult HBV infection [OBI]) endangering the health of the public. The growth, division, and activity of immune cells are governed by chemical mediators called cytokines. Evidence suggests that inadequate immune responses contribute to the persistence of HBV.Objectives:The goal of this study was to determine the prevalence of hepatitis B e antigen (HBeAg) among HBV surface antigen-positive (HBsAg+) persons by analyzing the association between age and gender and the severity of HBV infection.Materials and Methods:Seventy-two individuals from August 2022 to November 2022 were hired: a total of 35 healthy participants and 37 persons with acute or chronic HBV infection. Healthy controls and research participants ranged from 20 to 80 years old, and all of them were analyzed using serum samples (3 mL). The levels of HBV, tumor necrosis factor-alpha (TNF-α), and HBeAg in the blood were determined using enzyme-linked immunosorbent assay (ELISA).Results:37 affirmatives out of 72 Using a double-antibody sandwich ELISA, we determined that our HBV participants met the inclusion criteria. The findings of the HBsAg ELISA Kit indicated that the prevalence of HBsAg was greatest in those 35–49 years old (32.5%) and lowest in those 20–34 years old (21.6%) and 50–64 years old (21.6%). The HBsAg ELISA Kit result showed that the 37 patients who tested positive for HBsAg, 22 were female (59.5%), and 15 were male (40.5%). This suggests that the prevalence of HBsAg infection is higher in females than in males. Dialysis patients have been shown to have increased levels of HBeAg and TNF-α.Conclusions:Patients in Babylon province with chronic HBV had significantly higher than average levels of HBeAg and TNF.