bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Sleep Disturbances on Mental Health in Patients with Restless Legs Syndrome
Authors: Olgun Hülya , Yazar Tamer , Çakmak Berna B , Arıcı Yeliz K 
Published: August 2023

Background and Objective:
In our study, we aimed to evaluate the sleep disturbances of patients diagnosed with restless legs syndrome (RLS) regarding their mental health according to the severity of the disease.

Materials and Methods:
The study included 166 patients diagnosed with RLS and 161 healthy controls in the same age interval as patients. Sleep disturbances of patients were defined with the “personal information form” (PIF) prepared by the researchers, while the mental health status of patients was defined with the “Brief Symptom Inventory” (BSI).

Results:
All RLS patients had an increase in BSI subscale points, with a positive correlation to disease severity, and subscale points were significantly higher than the control group (p < 0.05). Those with the “frequent waking” problem had higher BSI subscale points compared to those without the problem (p<0.01 or 0.001). Those with “waking with respiratory distress,” “daytime sleepiness,” “very early waking,” and “sleep disorder” problems had statistically significantly high BSI subscale points for all subscales, apart from hostility, compared to those without these problems (p<0.01 or 0.001).

Conclusion:
It is considered that assessment of sleep disturbances causing disrupted quality of life and mood disorders is beneficial for the treatment of patients with RLS. Our study data appears to be related to the result that sleep disturbances and mental health disruptions might be associated with the disease severity among RLS patients.
Is Asterion a Reliable Surgical Landmark for the Transverse and Sigmoid Sinus Junction in Indian Skulls?
Authors: Rohilla Swati , Singh Seema , Sudheer Arava Harisha Kusuma , Tamang Shradha , Rani Neerja , Gurjar Hitesh Kumar , Shariff Ahmadulla 
Published: August 2023

Background:
Asterion is the junction of lambdoid, parietomastoid, and occipitomastoid sutures. In traditional anatomy teaching, it is believed that asterion sits over the transverse-sigmoid sinus junction (TSSJ). It is a significant surgical landmark for the placement of a burr hole in the retrosigmoid approach.

Objective:
The purpose of this study was to evaluate the asterion's accuracy as a TSSJ-specific external surgical landmark in the Indian population.

Materials and Methods:
16 human dried skulls were obtained from the Department of Anatomy, AIIMS, New Delhi. The point of TSSJ was taken between the two lips and just posterior to the entry of the superior petrosal sinus. Asterion internally was localized with the help of a geometrical divider. The x- horizontal/ anterior and y- vertically superior (+)/ inferior (-) distances were measured from asterion (internally) to the TSSJ by a digital vernier caliper.

Results:
The mean horizontal distance (x) of the left side asterion & TSSJ was 10.3±1.0mm whereas the vertical distance (y) ranged between +2 to -4.3 mm. The mean horizontal distance (x) of the right side asterion & TSSJ was 13.5±1.4mm whereas the vertical distance (y) ranged between +3 to -4.2 mm.

Conclusion:
Asterion is not a reliable landmark for TSSJ in Indian skulls. The TSSJ with respect to asterion was found on average 10mm and 13.5mm anterior on the left and right side respectively, and mostly inferior (average 4.2mm) in 75% of the skulls. The TSSJ was closer to the asterion on the left side in comparison with the right side. However, further studies with a larger sample size will be needed to evaluate the population-specific relation of asterion with the TSSJ.
Real-Life Disability-Adjusted Life Years (DALY) Capture the Disability of Epilepsy Better from an Individual's Perspective
Authors: Sumedha Maturu Mohan V. , Thomas Sanjeev V. , Sarma P Sankara , Arjun S 
Published: August 2023

Background and Objective:
For 1.3 billion population in India, there are only scarce reports on disability of epilepsy using disability-adjusted life year (DALY) as a measure. Our objective was to estimate DALY using real-life data over a period of time for a cohort of people with epilepsy (PWE) admitted to an Epilepsy Monitoring Unit (EMU) of a tertiary care epilepsy center.

Materials and Methods:
We ascertained survival status as on December 31, 2016 of all eligible admissions to the EMU between 01/01/2005 and 12/31/2015. We examined the medical records of randomly selected 200 of the 1970 survivors and all the expired PWE (n = 40) for clinical characteristics. The cumulative real-life DALY (cr-DALY) for individual was calculated as the sum of the years lost to disability (YLD) and the years of life lost (YLL). Annual population-based DALY (p-DALY) was estimated from the cr-DALY, total patient-years of follow-up, and regional population prevalence.

Results:
The cr-DALY per PWE was 17.63 (generalized seizures only). The cr-DALY increased by 23.7% when all seizure types were considered (23.12). PWE with epilepsy onset <10 years of age, focal epilepsy (particularly, extratemporal lobe epilepsy), and premature death had significantly higher cr-DALY. Those who underwent surgery for epilepsy or achieved remission had significantly lower cr-DALY. The computed p-DALY was 583/1,00,000 population (generalized epilepsy contributed 165/1,00,000 population; focal epilepsy contributed 418/1,00,000 population).

Conclusion:
Our study had identified, for the first time, several determinants that reduced DALY significantly. Real-life DALY, rather than prevalence-based DALY, captures the cumulative disability of affected individuals. Epilepsy leads to loss of 23 years of disability-adjusted life span for the affected person. This can be extrapolated to substantial economic benefits.
Effects of Vitamin D on Migraine
Authors: Das Saibal , Roy Ayan , Behera Sapan Kumar , Selvarajan Sandhiya , Kamalanathan Sadishkumar , Sahoo Jaya Prakash , Nair N Sreekumaran 
Published: August 2023

Objective:
The aim of this study was to evaluate the difference in mean serum 25-hydroxy vitamin D level between migraineurs and nonmigraineurs, the association between hypovitaminosis D and migraine, and the effects of oral vitamin D supplementation on migraine-related symptoms as compared to placebo.

Methods:
Relevant databases were searched for observational studies and randomized-controlled trials (RCTs) which evaluated the difference in mean serum 25-hydroxy vitamin D level between migraineurs and nonmigraineurs; the association between hypovitaminosis D and migraine; and the effects of vitamin D supplementation on migraine-frequency, duration, and severity. Pooled mean difference and odds ratio were calculated (random-effects model, RevMan version 5.3).

Results:
Ten observational studies and two RCTs were included. The serum 25-hydroxy vitamin D level in the migraineurs was significantly lower than that in the nonmigraineurs [mean difference − 4.44 ng/mL (95% CI: −6.11, −2.77)] (low-GRADE evidence). Hypovitaminosis D was found to be significantly associated with migraine [OR: 1.95 (95% CI: 1.07, 3.58)] (low-GRADE evidence). As compared to placebo, oral vitamin D supplementation significantly reduced the monthly migraine-frequency [mean difference: −2.20 (95% CI: −3.04, −1.36)]

,
although it did not reduce the migraine-duration [mean difference: −16.00 hours per month (95% CI: −42.77, 10.76)] and migraine-severity score [standardized mean difference: −0.23 (95% CI: −0.79, 0.32)] (moderate-GRADE evidence).

Conclusion:
Serum 25-hydroxy vitamin D level was significantly lower in the migraineurs than that in the nonmigraineurs, and hypovitaminosis D was significantly associated with migraine. Oral vitamin D supplementation significantly reduced migraine-frequency, but not its duration and severity.
Comparison of the Degree of Expanded Spinal Canal Area between the Hinge-Side Area and the Open-Side Area in Cervical Open-Door Laminoplasty
Authors: Doi Kazuma , Mizuno Junichi , Ohara Yukoh , Tani Satoshi 
Published: August 2023

Background:
There have been reports on the significant canal cross-sectional area (CSA) expansion difference between pre- and post-operation, but no comparison of CSA expansion between the hinge-side area (Area H) and the open-side area (Area O) has been reported. This study aimed to measure the spinal CSA expansion between Area H and Area O retrospectively after open-door laminoplasty using new titanium spacers and evaluated this common decompression procedure's effectiveness.

Materials and Methods:
This study included 27 patients diagnosed with cervical spondylotic radiculopathy or myelopathy, ossification of the posterior longitudinal ligament, and developmental canal stenosis from February 2021 to October 2022. The CSA difference between pre- and post-cervical laminoplasty (C4–C6 levels) was measured with cervical transverse computed tomography scan images. The CSA difference in Area H and Area O between pre- and post-laminoplasty was similarly calculated.

Results:
The spinal canal areas of each segment after open-door laminoplasty were significantly enlarged (P < 0.05). Area O was also significantly enlarged compared to that of Area H (P < 0.05).

Conclusion:
Area O was more enlarged than Area H, and both sides were statistically enlarged after open-door laminoplasty.
Diffusion Restriction in Bilateral Thalami
Authors: Shaik Reshma S , Manorenj Sandhya , Marupaka Sravan K. , Ara Tasneem 
Published: August 2023

Background:
Bilateral thalamic infarction, especially the medial thalamus, has been characteristically described in the artery of Percheron (AOP) affection. However, bilateral thalamic restriction has been described in many entities beyond the AOP infarction.

Objective:
Here we describe a case series (three cases) with infection as an etiology for bilateral thalamic lesions in the topographic distribution of the AOP from a tertiary care center in tropical India.

Materials and Methods:
Case series during a 1-year period collecting cases with bilateral thalamic diffusion restriction on MRI who did not have thalamic infarcts and their outcomes.

Results:
Bilateral thalamic lesion can occur in both bacterial and viral infections such as tuberculosis, dengue, and SARS-COV-2. Thus, we intend to add infections as one of the etiologies in the ever-expanding list of conditions that produce bilateral thalamic restriction.

Conclusions:
All the acute symmetric thalamic lesions are not always secondary to vascular insult. Accurate assessment and prompt diagnosis can prevent unnecessary delays in treatment. To our knowledge, this is the first case series in the literature that throws light on the bilateral thalamic lesions in the topographic distribution of the AOP secondary to infections in a tropical country like India.
Evaluation of Invasive Tumour Front in Primary and Secondary Oral Squamous Cell Carcinoma – A Reliable Prognostic Parameter
Authors: Joshi Hemal , Parikh Neelampari , Nandini C , Bhatt Garima , Jain Sandeep , Parmar Ashwini 
Published: August 2023

Introduction:
Oral squamous cell carcinoma (OSCC) is the most common malignant epithelial neoplasm affecting the oral cavity. Recent work indicates that morphological and molecular characteristics of tumour cells at invasive tumor fronts (ITF) underlie the biological aggressiveness of OSCC. The aim of the study was to compare the pattern of invasion (POI) (Type I to V) at tumour–host interface in 150 primary and 50 secondary OSCC cases.

Materials and Methods:
Both pre-dominant POI and worst POI was evaluated in all cases. Pre-dominant pattern of invasion and worst pattern of invasion (WPOI) were compared with Broder's grading system. Statistical analysis was done using a statistical software package (SPSS) and Fisher's exact test.

Results:
Results showed that the WPOI pattern also moves towards higher scores as the grade increases.

Conclusion:
We thus conclude that POI could serve as an individual prognostic marker irrespective of the histologic differentiation of the tumour.
Disability assessment in the persons with schizophrenia: Inter-rater agreement and correlation between self-, proxy-, and interviewer-rated versions of the World Health Organization Disability Assessment Schedule 2.0
Authors: Paul Fayaz Ahmad , Ali Arif 
Published: August 2023

Abstract

Background:
Schizophrenia has been described as the most disabling mental disorder, and patients with schizophrenia have been said to be disabled mostly in occupation, sexual relation, self-care, and social relationship domains.

Aim:
The present study aimed at assessing disability through self-, proxy-, and interviewer-rated versions of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 among persons with schizophrenia.

Materials and Methods:
The study was cross-sectional. Thirty samples of patients with schizophrenia as per the International Classification of Diseases-10 criteria were selected using a consecutive sampling technique. Patients above 18 years of age with a total duration of illness of at least more than 2 years were included in the study. The study was conducted at the Outpatient Department of Mental Health Institute and Department of Psychiatry, Government Medical College and Hospital Sector 32, Chandigarh, India.

Results:
The overall inter-rater reliability in schizophrenia was 0.599 (0.395–0.767), indicative of moderate reliability. Domains, namely, getting along with people (0.803) and life activities of household (0.854) had a good reliability, whereas domains such as cognition (0.681), mobility (0.616), self-care (0.636), life activities at school/work (0.664), and participation in the society (0.753) indicated a moderate reliability.

Conclusion:
There was no significant difference among the self, proxy, and interviewer assessments for most items. This study highlighted the fact that service users can also carry out an objective self-assessment of disability, thus upholding the principles of advanced directives as envisaged under the Mental Health Care Act, 2017.
Assessment of mental health among hospital-discharged patients of COVID-19 in North India: A cross-sectional study
Authors: Kour Preeti , Singh Manmeet , Sahni Bhavna 
Published: August 2023

Abstract

Background:
Psychological impact of COVID-19 is an emerging area of interest among researchers worldwide. We aimed to study the prevalence of anxiety and depression among COVID-19 survivors and its association with individual characteristics including demographic variables.

Methods:
One hundred and fifty COVID-19 survivors from a tertiary care hospital were contacted to collect information regarding anxiety and depression using the Generalized Anxiety Disorder-7 (GAD-7) scale and Patient Health Questionnaire-9 (PHQ-9). The Pearson’s Chi-square was used for univariate analysis of categorical variables. The Mann–Whitney test was used to check the significance between group medians.

Results:
21.3% of the survivors (n = 32) reported postdischarge COVID-19 anxiety. Mild, moderate, and moderately severe anxiety was reported by 17.3%, 3.3%, and 0.7% of the patients, respectively, on using the GAD-7 questionnaire. PHQ-9 revealed that 29.3% (n = 44) had depression. Minimal, mild, moderate, and moderately severe depression was reported by 19.3%, 24.0%, 2.0%, and 3.3% of the respondents, respectively. None of the survivors had severe anxiety or depression. In both the questionnaires, variation in median scores was statistically significant with age, whereas for GAD-7 scores, the difference in median scores was statistically significant only for gender. On analysis, age above 40 years was a statistically significant determinant for both anxiety (P = 0.041) and depression (P = 0.018) while male gender showed a statistically significant association in case of anxiety (P = 0.028). The correlation between age and respective scores and GAD-7 scores and PHQ-9 scores was also found to be significant (P < 0.001).

Conclusion:
These preliminary screening results provide convincing evidence of anxiety and depression among COVID-19 survivors, thus reiterating the need of timely detection and management of mental health issues through formulation of strategies to tackle the concurrent psychological comorbidities amid the ongoing pandemic.
Clinical patterns of cutaneous adverse drug reactions in tertiary care centre of central India: A cross-sectional study
Authors: Roge Rakesh P. , Mukhi Jayesh Ishwardas , Mamidwar Sudhir M. , Rokade Pallavi Rupkumar , Supekar Bhagyashree Babanrao 
Published: August 2023

Introduction:
Cutaneous adverse drug reactions (CADRs) are the most common adverse reactions attributed to drugs in which any type of skin reaction can be mimicked, induced, or aggravated.

Aim and Objectives:
To study the morphological patterns of various types of CADRs.

Materials and Methods:
It was a descriptive cross-sectional study carried out from November 2017 to September 2019, where medical records of diagnosed cases of CADRs were analyzed in a predesigned proforma with respect to demographic data, clinical features, treatment history (topical and oral), offending drug, temporal association with a skin eruption, investigations, and treatment outcome. Statistical analysis was done using mean, median, and proportion.

Results:
A total of 180 patients with CADRs were enrolled. There was a male preponderance with the mean age being 32.9 ± 2.9 years. The most common CADR reported was fixed drug eruption (n = 77). Steven Johnson syndrome was the most common (n = 7) severe cutaneous adverse reaction. The mean duration of latency was 6.2 (±8.61 days). Antimicrobial drugs accounted for most of the benign as well as severe CADRs (41.4%). Among all cases, 43.9% of patients had mild CADR and 16.7% had severe CADR. Causality assessment using the Naranjo adverse drug reaction probability scale, 70% had a possible association, 18.3% probable and 11.7% had a doubtful association.

Conclusion:
Early identification of CADR is important to reduce morbidity and mortality. Patient education is required to avoid self-administration of drugs and re-administration of the same offending drugs to prevent further morbidity. Immediate withdrawal of the culprit drug/drugs with adequate management can be lifesaving.
Evaluating the efficacy of apremilast combined with low-dose steroids versus combination of apremilast with low-dose steroids and low-dose aspirin for selected cases in the management of erythema nodusum leprosum: A pilot study
Authors: Patil Nitin Krishna , Bubna Aditya Kumar 
Published: August 2023

Background:
Erythema nodosum leprosum (ENL) is a reactional state observed in the lepromatous spectrum of leprosy. Currently, systemic steroids and thalidomide constitute the backbone of ENL therapy.

Aim:
The aim of this study was to evaluate the efficacy of apremilast as a standalone steroid-sparing drug for ENL and its combination with aspirin for selected cases.

Materials and Methods:
This was a pilot study on 10 patients having recrudescence of ENL following reduction of prednisolone dose to 20mg. Apremilast (30 mg twice daily) was administered to these patients as prednisolone was gradually tapered. The severity of ENL was evaluated based on the 16-item ENLIST ENL Severity Scale (EESS). If the EESS score reduced to zero with 20 mg of prednisolone following apremilast addition, patients were considered apremilast responsive. In case the EESS score reduced by> 50% then low-dose aspirin was added to the therapeutic regimen with gradual taper of steroids, and patients were accordingly evaluated. Those patients not responding to apremilast were labeled non-responders and were switched to thalidomide after appropriate investigations.

Results:
Out of 10 patients, 1 demonstrated complete clinical response with apremilast. In 5 patients the EESS score with apremilast had reduced by 50% or more; and following the addition of low-dose aspirin complete clinical cure was obtained. The remaining 4 patients were apremilast unresponsive.

Conclusion:
Apremilast may not be an effective standalone steroid-sparing drug for ENL in all patients. EESS scoring is a valuable tool in assessing treatment responses in all patients with ENL. Low-dose aspirin shows efficacy in those ENL patients demonstrating partial response to apremilast.
Silodosin as a medical expulsive therapy for distal ureteral stones
Authors: Ramadhani Muhammad Zaniar , Kloping Yudhistira Pradnyan , Rahman Ilham Akbar , Yogiswara Niwanda , Soebadi Mohammad Ayodhia , Renaldo Johan 
Published: August 2023

ABSTRACT

Introduction:
Tamsulosin is the most commonly used medical expulsive therapy (MET). However, it does not alleviate ureteral colic. It is important to develop MET that can reduce ureteral colic while maintaining a high stone clearance rate. Silodosin is an α1A adrenoceptor with high affinity and selectivity for the distal ureter, which may reduce ureteral colic and enable stone expulsion for distal ureteral stones. Therefore, we performed this systematic review and meta-analysis to evaluate the efficacy of silodosin as MET and its role in reducing ureteral colic among patients with distal ureteral stones.

Materials and Methods:
This research was conducted in accordance with the Cochrane Handbook for Systematic Review and Intervention, in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42021249003). A comprehensive literature search was performed in several databases including Medline, EMBASE, and Scopus up to July 2021 for randomized trials comparing silodosin with placebo for MET. RevMan 5.4 was used for data analysis.

Results:
A total of six randomized controlled trials were included in this analysis with a total of 907 patients. Our analysis revealed that the patients who received silodosin had significantly higher stone expulsion rate (SER) (odds ratio [OR] 3.33, 95% confidence interval [CI] 2.34, 4.76, P < 0.01), significantly shorter stone expulsion time (SET) (mean difference −3.79, 95% CI −4.51, −3.06, P < 0.01), and lower analgesic use (OR 0.4, 95% CI 0.23, 0.69, P < 0.01) compared to the group receiving placebo.

Conclusion:
Silodosin showed significantly higher SER, lower SET and lower analgesic use in patients with distal ureteral stones as compared to a placebo.
Continuous ambulatory peritoneal dialysis catheter insertion by open technique
Authors: Pahwa Mrinal , Singh Mahendra , Tyagi Vipin , Gupta Manu , Jain Saurabh , Chaddha Sudhir , Jauhari Harsha 
Published: August 2023

ABSTRACT

Introduction:
Continuous ambulatory peritoneal dialysis (CAPD) catheter placement is a part of renal replacement therapy. We describe our 20-year experience in using the open technique and assess its safety, efficacy, and outcome in the treatment of end-stage renal disease patients.

Methods:
In a retrospective study, we analyzed data of all patients who had a CAPD catheter placed using our open dissection technique using local anesthesia over the previous 20 years, with minimum 1 year of follow-up. Intraoperative data, postoperative data, and complications were noted.

Results:
A total of 1410 cases were included in the study. The mean duration of follow-up was 72 ± 18 months (range 12–120 months). The mean operative time was 19 ± 7.5 min and mean hospital stay was 3 ± 1 days. No major intraoperative complications were noted. We observed a peritonitis rate of 0.49 episodes/patient/year. The most common reason for permanent catheter removal was refractory peritonitis in 21%, followed by flow failure in 7%, and ultrafiltration failure in 6.5%. The death-censored technical survival rate was 94.3%, 83.2%, 75.9%, 69.2%, and 60.6% patients at 1 year, 2 years, 3 years, 4 years, and 5 years, respectively.

Conclusions:
The open dissection method of peritoneal dialysis catheter insertion using local anesthesia at well-experienced center is a simple, painless, and uncomplicated procedure with excellent outcomes. Optimal exposure, judicious use of energy source, and using appropriate technique provide good technical success rate with lesser complications.