bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sirtuin 6 expression in colorectal adenocarcinoma
Authors: Abdelhafez Dalia N. , El Nemr Reham S. , Mouhammed Heba H.M. 
Published: February 2023

Background
Sirtuin 6 (SIRT6), a NAD+-dependent deacetylase SIRT6 has been demonstrated to inhibit tumor development in a variety of cancers. Colorectal carcinoma is a difficult malignancy with high morbidity and mortality rates. However, it is unknown if SIRT6 has a direct role in colon carcinogenesis or what the underlying mechanism is.

Aim and objectives
The aim of this work was to study the expression of SIRT6 in colorectal carcinoma and its correlation with other pathological prognostic factors to clarify the role of SIRT6 in colorectal cancer (CRC) and determine whether SIRT6 could be a potential new prognostic biomarker for patients with CRC.

Patients and methods
We studied the tissues of 40 CRC patients to see whether SIRT6 has a role in colon cancer. Tumor tissue sections have been stained with hematoxylin and eosin and immunostained for SIRT6.

Results
The clinicopathological features of all cases were studied and statistical correlations between SIRT6 expression and clinicopathological parameters were done showing significant relations between SIRT6 expression and both tumor size and distant metastases with P values equal to 0.042 and 0.016, respectively.

Conclusion
SIRT6 is thought to play a significant role in the tumorogenesis of cancer colon; larger studies of all cancer colon variants are recommended for further declaration of each role.
Impact of erector spinae plane block on the quality of recovery after lumbar spine decompression surgery: A comparative study between addicts and non-addicts
Authors: Amin Samar R. , Abdelfatah Fatma A. 
Published: February 2023

ABSTRACT

Background and Aims:
Acute pain management in drug addicts is a critical yet understudied topic. Drug addicts have a decreased pain threshold, impairing anaesthetic pain control. This study aimed to evaluate the postoperative quality of recovery in addicts and non-addicts after receiving erector spinae plane block (ESPB) with general anaesthesia.

Methods:
Sixty males, aged 18-60 years, with an American Society of Anesthesiologists physical status I/II, scheduled for elective lumbar decompression surgery, were divided into two equal groups. Group A included 30 addicts and group N included 30 non-addicts. Both groups received bilateral ultrasound-guided ESPB with 20 mL bupivacaine (0.25%) before induction of general anaesthesia. The primary outcome was comparison of the 24-hour postoperative quality of recovery (QoR-15) score. The secondary outcomes were time to first analgesic requirement, postoperative pain scores, morphine consumption, and adverse events.

Results:
The QoR-15 score was higher in group N (median = 128.5, interquartile range = 107-136) than in group A (118 [99-130]), indicating a better recovery in group N. The visual analogue scale pain score was lower in group N than in group A, especially in the first 12 hours postoperatively. Time to first analgesic request was significantly longer in group N than in group A (mean ± standard deviation: 8.67 ± 2.74 and 5.53 ± 1.64 hours, respectively, P =0.001), Morphine consumption was significantly higher in group A than in group N (9.62 ± 3.2 and 7.08 ± 2.57 mg, respectively, P =0.041).

Conclusion:
Drug addicts experienced decreased analgesic efficacy of ESPB compared to non-addicts, with comparable postoperative QoR-15 score following lumbar decompression surgery.
Quadratus lumborum block vs. transversus abdominis plane block in laparoscopic trans-abdominal pre-peritoneal repair of inguinal hernia in adults: A randomised controlled trial
Authors: Roy Avishek , Bhoi Debesh , Chhabra Anjolie , Mohan Virender K. , Darlong Vanlalnghaka , Prasad Ganga 
Published: February 2023

ABSTRACT

Background and Aims:
Laparoscopic trans abdominal preperitoneal (TAPP) repair of hernia is one of the most commonly performed surgeries and may cause significant postoperative pain. Among different truncal block techniques, quadratus lumborum (QL) and transversus abdominis plane blocks (TAP) are used during this abdominal surgery. We aimed to investigate whether, bilateral QL block by trans-muscular approach provided better analgesia as compared to posterior TAP block in these patients.

Methods:
Forty adult patients with American Society of Anesthesiologists physical status I and II, undergoing inguinal hernia repair were randomized to receive either QL or TAP block, with 20 mL of 0.25% ropivacaine bilaterally. The primary objective of the study was to compare the total fentanyl consumption (in μg) within 24 hours postoperatively. The secondary objectives studied were dermatomal spread, quality of recovery at discharge and at 3 months postoperatively.

Results:
There was a significant reduction in total 24-hour fentanyl consumption (552 ± 229.56 vs 735.5 ± 264 μg, P =0.01) in the QL group, with longer duration of analgesia [282.5 ± 89.9 min group TAP vs. 354.8 ± 107 min QL, (mean difference -72.34,95% confidence interval -135.516 to -9.024), P =0.03], as compared to TAP group. At T8 and T9 dermatomes, greater proportion of patients in the QL group attained analgesia. Quality of Recovery at 24 hours and at 3 months of follow-up were comparable.

Conclusion:
QL block provided better perioperative analgesia than TAP block, in patients undergoing laparoscopic hernia repair. It also leads to greater dermatomal spread but without any decrease in the incidence of chronic pain at 3 months postoperatively.
Correlation of transcranial Doppler based parameters with computed tomography assessed cerebral oedema score in patients with traumatic brain injury: A prospective observational study
Authors: Ammar Mona A , Abdelmoneim Wael , Abdalla Waleed 
Published: February 2023

ABSTRACT

Background and Aims:
Cerebral oedema and increased intracranial pressure are associated with poor neurological outcomes in traumatic brain injury (TBI). This study aimed to examine the correlation between transcranial doppler (TCD) derived indices and computed tomography assessed cerebral oedema score in patients with TBI.

Methods:
This prospective observational study was conducted between April 2021 and December 2021 after approval from the University Research Ethics Committee (R75/2021) and registration with the clinicaltrials.gov (NCT04834453). Cerebral oedema on computed tomography (CT) imaging of the brain was scored as (0 = no cerebral oedema, 1 = mild cerebral oedema, 2 = moderate cerebral oedema, and 3 = severe cerebral oedema). The daily neurological assessment was performed using Glasgow coma scale score. TCD-based parameters, mean flow velocity (MFV), and pulsatility index (PI) in middle cerebral arteries were simultaneously obtained.

Results:
There was a significant negative correlation between MFV and cerebral oedema score (r = - 0.840, P <.001) and a significant positive correlation between PI and cerebral oedema score (r = 0.825, P <.001) on the seventh day of assessment. Significant differences were noted in MFV [53.17 ± 7.52 cm/s vs. 34.55 ± 3.35 cm/s] and PI [1.02 ± 0.16 vs. 1.46 ± 0.07] in patients with improvement and no improvement in cerebral oedema after seven days of TBI management.

Conclusion:
Bedside assessments of TCD-based parameters of MFV and PI correlate well with CT-based assessment of cerebral oedema in patients with TBI.
Evaluation of efficacy and safety of a single dose Tranexamic acid in reducing blood loss during colorectal cancer surgery. A randomised, placebo controlled, double-blinded study
Authors: Shaker Ehab H , Fayek Ehab S , Elrawas Mai M 
Published: February 2023

ABSTRACT

Background and Aims:
Colorectal cancer surgeries are commonly performed nowadays. They are considered as extensive procedures requiring perioperative blood transfusion in 32% to 68% of cases. The objective of this study was to evaluate the anti-haemorrhagic effects and safety of a single dose of tranexamic acid in such surgeries.

Methods:
Sixty patients scheduled for colorectal cancer surgeries were randomly assigned (TA) into two equal groups. Group TA received 10 mg/kg tranexamic acid in 100 ml of 0.9% NaCl immediately following induction of anaesthesia and control group received 100 ml 0.9% NaCl. The primary outcome was total blood loss reduction. The secondary outcomes were total number of patients requiring blood transfusion and occurrence of any thromboembolic events within 30 days after surgery.

Results:
Intraoperative and total blood loss were lower in TA group compared to the control group (P = 0.010, 0.003, respectively) while postoperative blood loss was comparable between both groups. The need for blood transfusion was lower in TA group (P = 0.038). Number of blood units transfused was also lower in TA group. Mean arterial blood pressure, serum creatinine and urine output in first 24 h postoperatively were comparable between both groups. Haemoglobin level in the first postoperative day was higher in TA group (P = 0.002), but was comparable between the groups at 2 weeks preoperative and from second up to fifth day postoperatively.

Conclusion:
A single dose of TA administered between induction and start of surgical procedure may reduce total blood loss and need of transfusion in colorectal cancer surgeries without any serious adverse effects.
A comparative study of 10% lidocaine spray versus eutectic mixture of 2.5% lidocaine and 2.5% prilocaine (EMLA) to attenuate pain of peripheral venous cannulation in children: A prospective randomized control trial at a tertiary care centre
Authors: Kulkarni Malavika M. , Patil Anirudh T. , Sinha Shweta 
Published: February 2023

ABSTRACT

Background and Aims:
Eutectic mixture of local anesthetics (EMLA) (2.5% lidocaine and 2.5% prilocaine) cream is the commonly used topical anesthetic for painful intradermal procedures. Topical 10% lidocaine spray has successfully been used to anesthetize mucosal surfaces. Owing to its skin penetrative properties, this study was conducted to compare dermal analgesia between 10% lidocaine spray and EMLA cream for intravenous (IV) cannulation in children.

Methods:
In this prospective single-blind randomized study, ninety-nine Paediatric patients were assigned into Group A (number(n) =51) with Lignocaine 10% spray applied 10 minutes and Group B (n = 48) EMLA cream applied 1 hour prior to cannulation. Vital signs were recorded before, during, and after the procedure. The primary objective of the study was assessment of severity of pain during IV cannulation using 10 cm visual analogue scale (VAS). Secondary objectives such as ease of cannulation and adverse effects were also noted.

Results:
All cannulations were performed in the first attempt with no adverse effects in both lidocaine group and EMLA group. The median (interquartile range) VAS score was 2 cm (1 to 3) in both the groups with a P value of 0.58.

Conclusion:
Topical 10% lidocaine spray applied ten minutes before venous cannulation is as effective as EMLA cream applied an hour before cannulation in children in providing dermal analgesia for intravenous cannulation with an added advantage of rapid onset of action in the former group.
Challenges and opportunities in the implementation of competency-based medical education – A cross-sectional survey among medical faculty in India
Authors: Gopalakrishnan Shivkumar , Catherine A. Precilla , Kandasamy Sangeetha , Ganesan Harissh 
Published: February 2023

BACKGROUND:
In India, competency-based medical education (CBME) is gaining foothold to transform the medical student into a doctor fulfilling community and societal needs. With that end in view the teaching faculty are getting sensitized and trained by the National Faculty Development Program (FDP). We aimed to assess the awareness about FDP among teaching faculty in medical colleges and study the attitude and perceived barriers to implementation of CBME.

METHODOLOGY:
A cross-sectional, electronically distributed, questionnaire-based study was conducted among medical faculty in India. The questionnaire identified participants’ awareness, attitude, and perceived barriers to CBME. Descriptive analysis was employed for continuous variables and internal comparison employing Chi-square test with α <0.05 for statistical significance.

RESULTS:
Among 251 participants 90.2% faculties from private institutes had undergone FDP as against 71% from Government sector (P = 0.008). We observed that 92.4% were aware, 80.2% had undergone Curriculum Implementation Support Program and 95.2% did agree that CBME will improve the medical education system. Major challenges perceived were high student to faculty ratio (67.7%), ill developed infrastructure (41.4%) and difficulties in assessment (41.1%). The popular solutions suggested were to increase faculty strength (73.7%), improve infrastructure (69.3%), extra remuneration (35.9%) and increase administrative support (30.7%). There was significant difference of opinions between teaching faculty of government and private sector (P = 0.017).

CONCLUSION:
Most of the medical faculty are aware of the need and have acquired a positive attitude towards enforcement of CBME. However, significant barriers do exist in the form of manpower and resources which need to be addressed.
A review on attraction factors of science and technology parks to firms in health sector
Authors: Mohammadzadeh Abbas , Javanmard Shaghayegh Haghjooy 
Published: February 2023

BACKGROUND:Over the past few years, a rapidly growing number of science and technology parks (STPs) in health sector have emerged across the world. There has been little discussion in the literature to show how STPs could make an attractive environment to absorb and retain potential firms. This is even more challenging for specialized STPs in health sector. The aim of this study is to identify the attractive factors for firms in a STP in health sector.MATERIALS AND METHODS:A scoping review method was undertaken to review the literature on seven databases (ScienceDirect, Scopus, ProQuest, Google Scholar, EconPapers, PubMed, and ISI Web of Science) for peer-reviewed articles published until 2019. The search results were screened against the inclusion of criteria to ensure they met the objectives. The eligible papers were then assessed on the basis of the full text, and finally the results were extracted.RESULTS:The attractive factors for firms and talents in multidimensional STPs and those in health sector are extracted and summarized. The attractive factors of multidimensional STPs, which includes health sector firms, and those specialized in health sector are summarized in three main categories; factors created by government and universities, and factors related to STP policies and those expected by the firms.CONCLUSION:To make STPs attractive for firms in health sector, there is a list of factors that are required to be done not only by STP itself, but also by the national and local government and industries. It is important to consider the factors that are expected by the firms to be implemented. The results of this study suggest that making STPs attractive for health sector firms needs close collaboration between government, universities, related industries, and STPs all together.
Quality of life and empowerment among women
Authors: Kundu Purnima , George Linu Sara , Yesodharan Renjulal 
Published: February 2023

BACKGROUND:
Few women in history were respected by society because of their contributions to the field of science, arts, politics, and so on, but in general, women are deprived of their rights and being refrained from decision-making in major areas of individual and family life. This research tried to investigate the degree of empowerment and quality of life (QOL) of the women to find out the relationship between empowerment and QOL of women.

MATERIALS AND METHODS:
An exploratory survey was carried out among 210 purposively selected married women aged between 20 and 49 years in a selected municipality area of West Bengal. Data were obtained by one-to-one interviews using Women Empowerment Interview Schedule and WHOQOL Scale BREF.

RESULTS:
The mean total QOL score of the women was found as 98.59 ± 13.61. The transformed scores in the physical, psychological, social relation, and environmental domains were 74.92 ± 14.97, 66.58 ± 15.78, 81.00 ± 18.07, and 65.28 ± 17.99, respectively. The degree of empowerment was calculated as 64.71 ± 6.79. Among the women, 5% had poor, 62% had medium, and 33% had a high degree of empowerment. A weak positive correlation (r = 0.325, P = 0.001) was found between QOL and empowerment. Significant associations were established between empowerment and education (Fisher's exact = 13.975 [0.007]) and education gap with husband (Fisher's Exact = 8.68, P 0.069). Multiple regression analysis between empowerment dimensions and QOL shows that personal or family dimensions, including health, are a significant predictor for the QOL (P < 0.01).

CONCLUSION:
Most of the women had medium degree of empowerment. Increased degree of empowerment improves their QOL of women. Women should be aware of their rights that can enhance the empowerment in different dimensions of life.
Exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit
Authors: Najafi Marzieh , Mohammadzadeh Hakimeh , Heydarian Nasrin , Rostami Mohammad , Ebadi Fard Azar Tooba , Mahmoodi Fatemeh , Chaboksavar Fakhreddin , Garmaroudi Gholamreza 
Published: February 2023

BACKGROUND:
Satisfaction of patients is among the top priorities of health-care providers. Meeting with families is essential for patients who are admitted to various wards, although it has been restricted for many reasons such as its impact on physiologic indicators. This present research study aimed to exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit.

MATERIALS AND METHODS:
This study was a nonrandomized clinical trial with a control group conducted in the cardiac care unit ward of Hamadan's Ekbatan Hospital. Sixty patients with acute myocardial infarction were chosen through convenient sampling and assigned to intervention (planned meeting) and control (routine meeting) groups in a nonrandomized manner. Data were collected by a researcher-made questionnaire of patient satisfaction and the observatory checklist of physiologic indicators and then analyzed in IBM SPSS Statistics v23.

RESULTS:
The total mean score of satisfaction did not significantly differ between the two groups (P = 0.921). The satisfaction of patients for “the conduct of visitors” was significantly higher in the intervention group (P = 0.005). During the study, no meaningful difference was found between the two groups for physiologic indicators (P > 0.05), while these indicators, except for blood O2 saturation, were meaningfully increased in the control group during routine meetings (P < 0.05).

CONCLUSION:
Planned meetings did not promote total satisfaction of patients with meetings, but improved some aspects of satisfaction, such as the conduct of visitors. The planned meeting is recommended as an alternative for a routine meeting, as it did not affect the physiologic indicators of patients in the intervention group.
Psychometric properties of the Persian version of the “Intergenerational relationship quality scale for aging parents and their children”
Authors: Torabian Maryam , Fadayevatan Reza , Zanjari Nasibeh , Foroughan Mahshid , Harouni Gholamreza Ghaedamini 
Published: February 2023

BACKGROUND:
Investigating the status of intergenerational relationships of elderly parents with their adult childen is very important in examining issues related to the status of the elderly such as well being and quality of life and other aspects of elderly life. Giveeen the significance of the topic, the current study aimed to examine the psychometric properties of the Persian version of “Intergenerational Relationship Quality Scale for Aging Parents and Their Children” (IRQS-AP).

MATERIALS AND METHODS:
A total of 463 community-dwelling elders (aged 60 years or older) in Tehran participated in this study through multistage cluster sampling method. To investigate reliability, the construct and convergent validity of the IRQS-AP, confirmatory factor analysis (CFA), and interclass correlation coefficient were done.

RESULTS:
The content validity index was 0.84 for the entire tool. In the CFA, we found the instrument had a four-factor structure and adequate internal consistency. The scale had a significant and positive correlation with the two measures of loneliness and depression. Furthermore, Cronbach's alpha was estimated at 0.77, and the high value of the interclass correlation was 0.82.

CONCLUSION:
The IRQS-AP is a valid and reliable scale that can be used to examine the status of intergenerational relationship quality in Iranian elder population.
Role of Guided FNA in Gallbladder Cancer
Authors: Goyal Surbhi , Prasad Garima , Chaudhary Dimple , Sakhuja Puja , Srivastava Siddhartha , Aggarwal Anil K. 
Published: February 2023

Background:
A majority of the patients with gall bladder cancer (GBCa) present at an advanced stage and have poor survival. The aim is to retrospectively study the role of guided FNA in the diagnosis of GBCa in a superspecialty institute and to describe the cytomorphologic spectrum of gall bladder (GB) lesions in the North Indian population.

Materials and Methods:
All suspected cases of GBCa who underwent guided FNA from the primary GB mass or metastatic liver space-occupying lesion from 2017 to 2019 were included. The aspirate smears were retrieved and analyzed for cytomorphological features independently by two cytopathologists. The neoplastic lesions were classified according to the WHO 2019 classification.

Results:
Of 489 cases, fine needle aspiration cytology (FNAC) was diagnostic in 463 cases (94.6%), of which 417 (90.1%) were positive for malignancy, 35 (7.5%) were inflammatory, and 11 (2.4%) were inconclusive for malignancy. Adenocarcinoma not otherwise specified (NOS) was the most common type seen in 330 cases (79.1%) and 87 (20.9%) were unusual variants. These included papillary adenocarcinoma (22, 5.2%), mucinous adenocarcinoma (12, 2.8%), signet ring carcinoma (2,0.4%), adenosquamous carcinoma (8, 1.9%), squamous cell carcinoma (10, 2.4%), neuroendocrine neoplasms (7, 1.7%), undifferentiated carcinoma (24, 5.7%) and non-Hodgkin lymphoma (2,0.4%), respectively. Immunohistochemistry on the cell block confirmed the diagnosis wherever possible. Histopathology was discordant in 5 out of 33 cases.

Conclusion:
Guided FNAC is a sensitive investigation that plays a crucial role in confirming the diagnosis and deciding the further treatment options in advanced-stage GBCa patients. The uncommon variants of GBCa can be reliably categorized on cytology.