bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of ketofol (ketamine and propofol) and etomidate in electro convulsive therapy
Authors: Joshi Chhaya P , Thapisrija  , Ayyanagouda Basavaraja , Mutalik Narayan , Hulakund Shivanand Y. , Jalapati Harini 
Published: August 2023

Background and Aims:
Electroconvulsive therapy (ECT) is the most effective treatment modality for severe and medication-resistant psychiatric disorders. ECT provokes generalized tonic-clonic seizures. Induction of optimal seizures (duration of motor seizures >15 s) is considered as an important goal during the ECT procedure. We compared ketofol and etomidate as induction agents in ECT with respect to the seizure duration and seizure threshold as there is less information available in the literature.

Methods:
One hundred and twenty patients posted for ECT were randomized into two groups. Group A received ketofol 1:1 (ketamine 0.5 mg/kg + propofol 0.5 mg/kg), while as Group B received etomidate 0.2 mg/kg. After administration of the muscle relaxant (succinylcholine 0.5 mg/kg) ECT was delivered. The primary outcome was seizure duration, and secondary outcomes such as seizure threshold, hemodynamic parameters, recovery profile, and any complications were noted. Motor seizure duration was recorded as the time interval between starting of the seizure episode until the cessation of tonic-clonic motor activity in the isolated upper limb. Data were entered in MS-Excel and analyzed in SPSS V22. Descriptive statistics were represented with percentages, and parametric data were represented with mean with standard deviation. The statistical analysis was carried out using the Chi-square test, independent t-test. A Probability (P) value <0.05 was considered statistically significant.

Results:
There was a statistically significant difference in seizure duration between two groups with Group A having less meantime 38 ± 14.9 s compared to Group B 45.3 ± 17.5 s with P = 0.014. Seizure threshold, hemodynamic parameters, recovery profile, and complications except myoclonus were not statistically significant between the two groups.

Conclusion:
Etomidate has the definite advantage of longer seizure duration compared to ketofol, and hence, etomidate is a better induction agent in patients with psychiatric disorders undergoing ECT.
A randomized, double-blinded comparative study of phenylephrine infusion and norepinephrine infusion for the prevention and treatment of spinal anesthesia-induced hypotension in elective and emergency cesarean deliveries
Authors: Berawala Payal Kalpesh , Mehta Sanket Hirenbhai , Chaudhari Madhavi Sanjay , Shinde Mayur Kiran 
Published: August 2023

Context and Aims:
Among vasopressors used to treat postspinal hypotension (PSH) in cesarean sections (CS), phenylephrine (PE) is the preferred drug at present but reflex bradycardia and thus reduction in cardiac output still pose a concern. Norepinephrine (NE), with its better pharmacological properties, may be a better alternative to overcome this risk. Hence, we did this study intending to compare both the drugs.

Materials and Methods:
A double-blinded, randomized, controlled trial (RCT) was carried out on 70 patients, 35 in each group-group P (PE) and group N (NE) undergoing CS, to compare and evaluate the efficacy of both drugs for preventing and treating PSH. Patients in Group P and Group N were given intravenous infusion of PE at the rate of 50 μg/min and NE at the rate of 2.5 μg/min, respectively, after the intrathecal injection of bupivacaine. The number of intermittent bolus doses required, heart rate, and mean arterial pressure (MAP) at predefined intervals were noted.

Results:
The incidence of hypotension calculated from the number of bolus doses required was lower in Group N than in Group P for the initial 15 min (P < 0.05). The incidence of bradycardia and vomiting was higher in Group P but were not statistically significant, while the incidences of nausea (P = 0.004) and oxygen requirement (P = 0.03) were statistically significantly higher in Group P.

Conclusion:
This study suggests that NE infusion is superior to PE infusion when used in the potency ratio of 20:1, to prevent and treat PSH in CS, with a lesser number of side effects.
Serum serotonin level as a predictor of presence of gastroesophageal varices in patients with liver cirrhosis
Authors: Adam Tasnim F. , Abdelsamea Mahmoud Z. , Abd-Elsalam Sherief M. , Elserougy Hesham A. , Wasfy El Sayed Ahmed 
Published: August 2023

Background
Portal hypertension is one of the most important complications of liver cirrhosis, leading to the development of esophageal varices (OV). Variceal bleeding carries high morbidity and mortality. The frequency of varices in patients with cirrhosis is unfixed, extended from 24 to 80%; therefore, endoscopic examination of all cirrhotic patients would lead to unnecessary additional burdens to endoscopic units.

Aim
The aim of the study was to evaluate the serum serotonin level as a noninvasive predictor of presence of gastroesophageal varices in patients with liver cirrhosis.

Patients and methods
The study was performed on 60 cirrhotic patients recruited from the endoscopy unit of Tropical Medicine and Infectious Diseases Department in Tanta University Hospitals. In addition, 20 physically fit participants served as a control group within the period between April 2020 and April 2021.

Results
Serum serotonin is significantly increased in cirrhotic patients with varices. Serum serotonin correlated well with severity of liver insult in patients with cirrhosis assessed by Child, Model for End Stage Liver Disease, fibrosis-4, and aspartate aminotransferase/platelet ratio index scores as well as OV grade.

Conclusion
Serum serotonin had a good power of prediction for development of OV.
The possible association between blood level of free cholesterol and the severity of steatosis in patients with nonalcoholic fatty liver disease
Authors: Elsawy Abdallah A. , Hodeib Hossam , Selim Ahmed F. , Sarhan Mohamed E. , Elhadidy Ahmed A. , Sameir Heba M. , Selim Amal , Tawfik Mohamed A. 
Published: August 2023

Background
The global rising prevalence of nonalcoholic fatty liver disease (NAFLD) highlights the need to understand the risk factors related to its pathogenesis and its related complications. NAFLD is mediated by lipotoxicity that results from an imbalance in hepatic lipid metabolism. Emerging evidence suggests that lipotoxicity mediated by hepatic free cholesterol (FC) overload may result in steatohepatitis. Lipotoxicity is not only associated with the pathogenesis of NAFLD, but also related to increased risk of atherosclerosis and cardiovascular complications, the main leading causes of mortality in NAFLD.

Aim
The study tried to clarify the possible association between serum levels of FC and the severity of hepatic steatosis in NAFLD.

Patients and methods
This cross-sectional study included 120 participants, who proved to have different stages of hepatic steatosis using elastography with controlled attenuation parameter (CAP). The correlations between different lipid parameters as well as serum FC levels and CAP values of hepatic steatosis for all participants were assessed using multivariate linear regression analysis.

Results
The most independent significant lipid parameters associated with CAP values were FC, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (P<0.001 for all). Moreover, the discriminately performance of those parameters as risk factors for steatosis using receiver operating characteristics showed an area under the curve of 0.991, 0.957, and 0.861, respectively, with a significant performance (P<0.001 for all).

Conclusion
We could conclude that increased serum levels of FC along with increased levels of low-density lipoprotein cholesterol and decreased levels of high-density lipoprotein cholesterol have significant correlations to the increased severity of hepatic steatosis in NAFLD.
The potential role of omega-3 on the effect of the energy drinks on testis of adult male albino rats: a histological and immunohistochemical study
Authors: Maksoud Mangoud Rana A.K.A. , El-Aziz El-Deeb Safwat A. , El-Khalek Mahdy Amal A. , El-Hanafy Hend A.M. 
Published: August 2023

Background
Consumption of energy drinks rich in caffeine has increased between individuals. Health problems related to caffeine such as reproductive diseases have occurred.

Aim
The objective of this work was to study the potential role of omega-3 on the effect of energy drinks on the testis of adult male albino rats.

Material and methods
A total of 40 adult male albino rats were used in this study. Rats were divided into four main groups: control group (I) included 10 rats that received no treatment for the same periods as the experimental animals; omega-3 group (II) included 10 rats that received 300 mg/kg body weight of omega-3 orally using a gastric tube once daily for 3 months; energy drink group (III) included 10 rats that received 1.07 ml/100 g body weight of energy drink orally using a gastric tube once daily for 3 months; and energy drink and omega-3 group (IV) included 10 rats that concomitantly received both energy drink and omega-3 at the same dose, route, and duration as groups II and III. Testicular specimens were subjected to histological and immunohistochemical examinations. The data were analyzed statistically.

Results
Group III showed disturbed normal histological architecture of the testicular structure, but group IV omega-3 resulted in preservation of the normal histological architecture. Moreover, the cyclooxygenase 2 immune stain and the statistical analysis confirm these results.

Conclusion
There is a correlation between omega-3 and reduction of the testicular damage induced by energy drinks in adult male albino rats. Omega-3 leads to protection of the testis.
Amniotic membrane transplantation with intra-stromal Voriconazole versus amniotic membrane transplantation with argon laser photocoagulation for treatment of resistant fungal keratitis
Authors: Khater Mohammad M. , Sharaf Amr F. 
Published: August 2023

Background
Fungal keratitis is a serious problem that may affect vision. Many procedures like argon laser, voriconazole injection, and amniotic membrane transplantation (AMT) may be used to control infection.

Aim
To compare between intrastromal voriconazole injection with AMT and argon laser photocoagulation with AMT as treatment for fungal keratitis.

Patients and methods
Mycotic keratitis cases were divided in two groups, with 15 cases each. In one group, intrastromal voriconazole injection and AMT in the same setting was done, and in the other group, argon laser photocoagulation and AMT in the same setting was done. The studied cases included 21 cases with mixed infection and nine cases were pure fungal keratitis according to culture results. In the voriconazole group, intrastromal injection followed by AMT was done, whereas in the argon group, the corneal ulcer was irradiated with argon after fluorescein staining followed by AMT in the same settings.

Results
Healing was achieved in both groups in 2–6 weeks in all cases. Less than 50% of cases of the voriconazole group healed by the third week, whereas 80% of cases of the argon laser group healed by the third week. Vision was increased in four (26.7%) patients in the voriconazole group, whereas in six (40%) cases in the argon laser group.

Conclusions
Argon laser with AMT gives better results than intrastromal voriconazole injection with AMT for the treatment of resistant mycotic keratitis.
Fetal main pulmonary artery Doppler and prediction of lung maturity
Authors: Kandil Safaa A. , Elshafey Rasha A. , Eltokhi Hesham M. , Eldeeb Basma S. 
Published: August 2023

Background
Respiratory distress syndrome (RDS) in newborns occurs owing to surfactant deficiency. Decrease in quantity and quality of surfactant in lungs results in diminished surfactant activity. It affects not only preterm neonates but also term ones. RDS is a serious condition as it can lead to many neonatal comorbidities and even death. Doppler ultrasound is a noninvasive tool used for assessment of fetal biometry, so Doppler of pulmonary artery can be used safely in assessment of fetal lung maturity.

Aim
The purpose of our study was to assess the significance of fetal pulmonary artery Doppler in predicting lung maturity.

Patients and methods
A total of 50 pregnant women participated in this study with gestational age ranging from 34 to 39 weeks who were referred to the Diagnostic Radiology Department at Tanta University Hospitals during the period between December 2019 and December 2021.

Results
From the 50 pregnant women included in this study, six fetuses developed RDS. The greatest correlation was found with acceleration time/ejection time (AT/ET) ratio and resistive index (RI) with high sensitivity and specificity (P=0.000 and P<0.001, respectively). A cutoff value AT/ET less than 0.297 and RI more than 0.889 predicted RDS with sensitivity of 94.8 and 89.1%, respectively, and specificity of 83.5 and 78.2%, respectively.

Conclusion
Neonatal RDS can be predicted by pulmonary artery AT/ET ratio and RI with high sensitivity and specificity.
Endostatin level in coronavirus patients: a prospective study
Authors: Zahra Ahmed M.K. , Abd-Elall Mohamed , Hantera Mohamed , Sakran Alaa , Zahra Mohamed K. 
Published: August 2023

Background
Endostatin is a protein linked to the C-terminal of collagen in the basement membrane of endothelial cells. It functions as an antiangiogenic protein. It inhibits endothelial proliferation, migration, and tube formation. Studies have observed that it downregulates endothelial-signaling pathways of proangiogenic activity as well as upregulates the angiogenic gene.

Aim
This work was designated to explore the levels of endostatin in coronavirus disease 2019, trying to investigate its role as a prognostic marker.

Patients and methods
Patients with positive PCR for SARS-CoV-2 were divided into two groups (survivors and nonsurvivors). Computed tomography chest was for each patient. The nonsurvivor group comprised 19 patients and the survivor group had 31 patients. In addition, 50 normal volunteers participated in this study and served as a control group. Serum endostatin was measured by ELISA and was compared with other measured laboratory parameters.

Results
Endostatin was statically increased in nonsurvivors than both survivors and normal volunteers (P
1=0.007, P
2=<0.001). However, this significant increase was still observed in survivors on comparing with normal individuals. There was a correlation between endostatin and different parameters in coronavirus disease 2019 patients.

Conclusion
The high level of endostatin in this prospective study and its correlation with laboratory makers and clinical manifestations leads us to consider it as a valuable prognostic factor. Moreover, it can predict mortality and severity of patients. It was important to conduct a study on large scale to confirm this value.
Cardiac dysrhythmia in drug-resistant epileptic children
Authors: ElNawasany Mohamed A. , Basiouny Mohamed A. , Khalfallah Mohamed , ElGammal Tarek M. 
Published: August 2023

Background
Drug-resistant epilepsy is one of the most common neurological conditions associated with high mortality and morbidity rates.

Aim
To assess heart rate variability among drug-resistant epileptic children.

Patients and methods
This observational cross-sectional case–control study included 60 epileptic children. Cases were assigned into two equal groups: group 1 (drug-resistant group) included children presented with drug-resistant epilepsy and group 2 (control group) included cases with controlled primary epilepsy who achieved sustained seizure freedom for at least 6 months on one antiepileptic drug, matched with the patient group regarding age and sex. All patients were subjected to history taking and clinical and radiological investigations including computed tomography (CT) and/or MRI and electroencephalogram (EEG) monitoring. ECG monitoring was using Holter ECG.

Results
MRI, EEG, and ECG abnormalities are significantly more common in drug-resistant epilepsy. Interictal tachycardia was the most prevalent abnormality among group I (93.3%). ECG structure was abnormal in 33.3% in group I, in the form of prolonged QTc interval, ST segment abnormalities, P wave dispersion, and T wave alternans. Tachycardia associated with prolonged QTc interval was present in patients with focal or temporal EEG abnormalities, and patients with multifocal EEG abnormalities.

Conclusion
ECG monitoring is important in drug-resistant epileptic children to detect any autonomic changes occurring in the heart either ictally or interictally. Heart rate is significantly higher and RR interval is significantly shorter ictally than interictally. Careful monitoring of these changes may help in predicting the risk of sudden unexpected death.
Evaluation of antagonistic activity of an Egyptian probiotic Lactobacillus plantarum against bacteria isolated from ready-to-eat meat products
Authors: Radwan Aya G. , El Naghy Wageih S. , Shahbab Abeer A. , Hassan Aziza M. 
Published: August 2023

Background
The increase in the incidence of antibiotic-resistant pathogens calls for strenuous efforts to substitute the administration of antibiotics with the use of probiotics.

Aim
The aim of the study was to evaluate the bacterial contamination of ready-to-eat meat products in Tanta city, determine the antibiotic susceptibility of the isolates, determine in vitro antagonistic effect of a probiotic Lactobacillus plantarum (L. plantarum) against isolates, and compare this effect with the inhibitory effect of the commonly used antibiotics.

Materials and Methods
The samples were collected in stomacher packs, homogenized, and serially diluted. Identification of pathogenic bacteria was done via standard microbiological methods. Antibiotic-sensitivity tests were done by disk-diffusion method. The results were compared with the inhibitory effect of L. plantarum done by well-diffusion and overlay methods.

Results
The total rate of bacterial contamination of the collected samples was 72/90 (80%), while the contamination rates from good sanitation-state (GS) outlets and poor sanitation-state (PS) outlets were 27/37 (72.9%) and 45/53 (84.9%), respectively. The most isolated bacteria were Escherichia coli (E. coli) (29%) followed by Staphylococcus aureus (21%). L. plantarum showed inhibitory effect against both Gram-positive and Gram-negative isolates. Its activity was maximum against E. coli and least for Klebsiella spp. in both well-diffusion and overlay methods.

Conclusion
The presence of pathogenic bacteria in ready-to-eat products is a great public health issue; also, this research supports the promising use of the tested L. plantarum and its products as antimicrobial agents against foodborne pathogen.
Perineural and Lymphovascular Invasion as Histologic Predictors of a 5-Year Local Recurrence After Curative Resection of Stages II and III Rectal Cancer
Authors: Behboudi Behnam , Ahmadi-Tafti Seyed M. , Heidari Mostafa , Fazeli Mohammad S. , Kazemeini Alireza , Keshvari Amir , Heirani-Tabasi Asieh , Poursalehian Mohammad , Notash Aidin Yaghoubi , Keramati Mohammad Reza 
Published: August 2023

Background:
Distinguishing predictors of local recurrence after surgery is important following curative resection of rectal cancer.

Objectives:
This study aimed to evaluate the correlation between perineural and lymphovascular invasion with local recurrence after curative resection of rectal cancer.

Design:
Prospective Cohort Study.

Patient and Methods:
Patients with stages II and III rectal cancer operated on between January 2011 and December 2015 were included. Data including demographic information and pathologic characteristics of the primary tumor, including perineural and lymphovascular features, were collected. The patients were followed-up for at least 5 years for any evidence of tumor recurrence.

Main Outcome Measure:
Perineural invasion (PNI) and Lymphovascular invasion (LVI).

Sample Size:
202 patients (including 77 women and 125 men).

Results:
PNI and LVI were found in the histologic features of the tumors of 34 (16.8%) and 56 (27.7%) patients, respectively. 85.3% of the patients with PNI and 67.9% with LVI had developed recurrence within 5 years after curative surgery. Twenty-four patients had concurrent PNI and LVI, which showed a recurrence rate of 87.5%.

Conclusion:
This study found a significant correlation between tumor recurrence and PNI or LVI in male patients with stage II or III rectal cancer. In addition, a significant relationship was found between PNI and tumor recurrence in female patients; however, there was no significant correlation between LVI and tumor recurrence in these patients.

Limitations:
Limited sample size.

Conflict of Interest:
The authors have no conflict of interest to declare.
Prevalence of Soil-Transmitted Helminths at Baseline and after Albendazole Treatment in the School-Age Children of Forcibly Displaced Myanmar Nationals in Bangladesh
Authors: Noor Zannatun , Hossain Biplob , Khan Shaila Sharmeen , Kabir Mamun , Bhuiyan Abu Toha Md Rezuanul Haque , Alam Mohammad Shafiul , Faruque Abu Syed Golam , Haque Rashidul 
Published: August 2023

ABSTRACT.
The forcibly displaced Myanmar nationals (FDMNs) known as Rohingya refugees are the largest group of stateless individuals globally. According to the emergencies humanitarian actors at the United Nations Office for the Coordination of Humanitarian Affairs, the worldwide refugee crisis involving FDMNs is intensifying at the fastest rate in history. Growing public health demands are being exacerbated by current difficulties in addressing poor access to health services, severe food shortages, and a lack of adequate housing. Infectious diseases constitute a major public health emergency in this vulnerable population. A study was carried out in FDMN children to investigate common soil-transmitted helminth (STH) infection at the time of enrollment and prospectively followed-up to 12 months after 2 doses albendazole treatment. At baseline, the prevalence of STH infection with at least one species was found to be 91.7% and 87.3% for Kato–Katz (KK) and quantitative polymerase chain reaction (qPCR) methods, respectively. Similarly, for follow-up children, the overall infection rate was 95.3% and 91.5%, respectively. Trichuris trichiura was the most predominant STH infection by both KK (baseline 87%, follow-up 89.1%) and qPCR (baseline 77.5%, follow-up 82.9%). The overall prevalence of stunting in the children was 37.8% at baseline and rose to 51.3% at 12 months. Alpha-1 antitrypsin (r = 0.13, P = 0.01) and myeloperoxidase (r = 0.12, P = 0.01) levels showed a positive correlation with Aascaris lumbricoides egg count per gram at baseline. An in-depth investigation is urgently needed to identify the underlying protective measures and the root cause of STH infections to improve the health of FDMN children.