bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term cognitive impairment, psychological disorders, and functional limitations in COVID-19 survivors: A 2-year follow-up at a tertiary care hospital in Bengaluru
Authors: Shivamadhu Shivani , Ram V Ananth , Singh Hemendra , Raj Madhu P , Thyagaraj Vijayashree 
Published: January 2025

Abstract

Introduction:
Given the COVID-19 pandemic, a significant number of patients experience postacute/long COVID-19. Neurological manifestations, possibly stemming from direct viral effects or systemic inflammation, are increasingly recognized. The current study aimed to better understand the psychological, cognitive, and functional outcomes of COVID-19 survivors 2 years postdischarge.

Materials and Methods:
This analytical cross-sectional study included 98 COVID-19 survivors aged ≥18 years, referred to a post-COVID-19 clinic, and informed consent was procured. After administering a semi-structured interview constituting sociodemographic details, treatment profile, and validated assessment tools, subjects were categorized based on anxiety, depression, cognitive failure, and functional disability scores accordingly.

Results:
The median age of participants was 55 years, with 58.2% being male. The median hospital stay was 13 days, and 27.6% required intensive care unit care. Anxiety, depression, and functional disability were prevalent in 22.1%, 25.3%, and 60% of participants, respectively. The median scores of the domains of cognitive failure, i.e., forgetfulness, distractibility, and false triggering among the subjects were 6, 5, and 6, respectively, out of the highest possible score of 32. Depression and functional disability were more common in those over 45 years, with lower education, and unemployed (P < 0.01). Increased anxiety (P < 0.01) was seen associated with longer hospital stays. Patients aged above 45 years had significantly higher scores of depression, cognitive failure, and anxiety. Depression and cognitive issues were associated with lower education and unemployment which correlated positively with anxiety and forgetfulness.

Conclusion:
Due to the significant correlation of certain sociodemographic and treatment factors with depression, anxiety, and domains of cognitive failure, early identification and treatment of the same through specialized clinics are crucial.
Post hematopoietic stem cell transplant (HSCT) outcomes in pediatric intensive care unit, experience from a referral center for cellular therapy and hematopoietic stem cell transplantation
Authors: AlAbdullah Hussain , Alanzi Fawaz , Alhuthil Raghad , Alshaibani Tahani , AlBeeshi Nourah , Alqahtani Ali , Alabdulsalam Moath , Alayed Tareq , Alturki Abdullah , Alofisan Tariq , Aljofan Fahad 
Published: January 2025

Background
Patients who underwent hematopoietic stem cell transplantation (HSCT) are considered at high risk for pediatric intensive care unit (PICU) admission. Therefore, this study aimed to assess outcomes and mortality-related risk factors among pediatric HSCT recipients admitted to the PICU.

Methods
This retrospective cohort study was conducted at a Saudi Arabian tertiary care center and involved pediatric patients (aged 4 weeks to 14 years) who underwent HSCTs between January 2015 and December 2019 and were admitted to the PICU.

Results
Of the 173 pediatric HSCT recipients admitted to the PICU, 65.3% were admitted for respiratory failure. Graft-versus-host disease and chronic infections affected 48.6% and 71.7% of the cases, respectively. Pulmonary hemorrhage and veno-occlusive disease occurred in 15.0% and 32.4% of the patients, respectively. Ventilation and inotropic support were administered to 79.8% and 41.0%, respectively. Acute kidney injury (AKI) occurred in 47.4% of the patients, of which 23.2% required continuous renal replacement therapy/hemodialysis. The PICU survival rate was 59.0% (102/173), and the mortality rate was 41.0% (71/173). In the univariate analysis, chronic infection, pulmonary hemorrhage, ventilation, inotropic support, AKI, higher PRISM III score, and prolonged PICU stay were associated with mortality (P < 0.05). In the multivariable analysis, only prolonged PICU stay (P = 0.016), AKI (P = 0.040), inotropic support (P < 0.001), and ventilation (P = 0.017) showed potential association with mortality.

Conclusion
Early recognition and targeted interventions for these complications are crucial for improving outcomes in this vulnerable population. More research is needed to validate these findings and optimize care practices for HSCT recipients in the PICU setting.
Incidence, distribution, and patient characteristics of childhood cancer in Jordan: an updated population-based study
Authors: Baddourah Ranya , Baddourah Dana , Alsweedan Dalia , Al Sheyyab Mahmoud , Nimri Omar F. , Alsweedan Suleiman 
Published: January 2025

Background and Objectives
The most recent study on pediatric cancer epidemiology in Jordan was published in 2003. This study aims to provide updated epidemiological data for local clinicians, policymakers, and international physicians interested in Middle Eastern patient populations.

Materials and Methods
We analyzed data from the Jordanian National Cancer Registry for pediatric patients (ages 0–18) diagnosed between 2000 and 2017, classified according to the International Classification of Childhood Cancer, third edition.

Results
Our cohort comprised 7639 patients. The mean age at diagnosis was 8.68 years, with a male-to-female ratio of 1.4 and an annual incidence rate of 191 per million population. We identified significant differences in cancer distribution between Jordan and neighboring Middle Eastern countries, as well as regional discrepancies in the number of diagnosed childhood cancer cases. A comparison of cancer incidence between 1996–1998 and 2000–2017 in Jordan was conducted. Our findings align with established trends, such as the correlation between the male-to-female cancer incidence ratio and GDP per capita.

Conclusion
This study provides the latest organized and accessible data on childhood malignancies in Jordan.
Prevalence of depressive disorder in asthma patients as seen in an outpatient facility of a tertiary care hospital in Kashmir, India
Authors: Wani Chandni , Mushtaq Mehvish , Shah Naveed Nazir , Dar Shabir Ahmad , Hussain Arshad 
Published: January 2025

Abstract

INTRODUCTION:
Globally, the prevalence of depression in individuals with bronchial asthma has been determined to be 9%. A significantly higher proportion of bronchial asthma patients, namely 28%, experience psychiatric morbidity compared with the national average of 14% in the general population. This study was conducted at a specialized tertiary care hospital dedicated to respiratory diseases, to assess the prevalence of depression in patients diagnosed and treated for bronchial asthma.

MATERIALS AND METHODS:
A total of 126 confirmed cases of bronchial asthma who were on regular follow-up care at our outpatient department were included in this study. Depression was diagnosed by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria utilizing the Mini-International Neuropsychiatric Interview (MINI English version 7.0.2).

RESULTS:
Out of 126 patients, 52 were males and 74 were females. In the 15–29 years age group, three patients (16%) exhibited symptoms consistent with the criteria of major depressive disorder (MDD). Among the 30–45 years age group, 6 out of 34 patients (17.6%) had MDD. The majority of patients fell into the 46–60 years age group, with 9 out of 67 patients (13.4%) having MDD in the said age group. Our study revealed that 15% of asthma patients attending our outpatient department were diagnosed with MDD.

CONCLUSION:
Given the significant impact of asthma and depression on the quality of life (QoL) of patients, as well as the burden these conditions impose on healthcare facilities even if not coexist in an individual, it is crucial for researchers to assess asthma patients for psychiatric comorbidities. This will not only lead to improved QoL for the patients but also ensure the appropriate allocation of healthcare resources.
Use of casirivimab and imdevimab to prevent progression to severe COVID-19
Authors: Shahnawaz Mir , Hussain Tajamul , Firdous Naeem , Yousoof Mohammad , Gundroo Hafsa M. , Sharma YashPal , Shah Naveed Nazir 
Published: January 2025

Abstract

BACKGROUND:
Advanced age and the presence of comorbid illnesses increase the risk of disease progression and death in patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Several neutralizing antibodies against SARS-CoV2 have been developed for the management of mild to moderate coronavirus disease 2019 (COVID-19) at risk of disease progression. This study aimed to evaluate the effect of a combination of casirivimab and imdevimab (REGN-COV2) on disease progression/hospitalization in mild-to-moderate COVID-19.

MATERIALS AND METHODS:
It is a prospective interventional study, patients with mild-to-moderate COVID-19 were included in the study. The illnesses with risk factors for disease progression were divided into two groups, one who received a combination of casirivimab and imdevimab (REGN-COV2) cocktail and the other who received usual care. The primary outcome of the study was a comparison of disease progression or hospitalization on day 14 after treatment. Secondary outcomes included viral clearance, mortality, and effect on proinflammatory markers.

RESULTS:
A total of 169 patients with mild-to-moderate COVID-19 illness with risk factors for disease progression were included in the study. About 85 patients (50.3%) as cases received REGN-COV2 whereas 84 (49.7%) as control received usual care only. Hospitalization or progression of disease was significantly lower in patients who received REGN-COV2 than in the usual care only [14.12% vs. 27.38%; relative risk (RR) = 0.51, 95% confidence interval (CI) = 0.27−0.95, P = 0.03]. Time taken for viral clearance was again lower in intervention group [median = 9 days, interquartile range (IQR) = [8–11] vs. median =13 days, IQR [10–14], P < 0.001] as was serum levels of C-reactive protein (CRP) and interleukin (IL)-6 significantly reduced in patients who received REGN-COV2 [CRP, median = 11.5 (5.75–34) to 4 (2–9), P = 0.001 and IL-6, median 10 (4–23.5) to 3 (2–7), P = 0.001]. Three patients in the usual care group died due to worsening respiratory failure compared with none in the REGN-COV2 group. Only minor adverse events were noticed in 8.2% (n = 7) patients in the REGN-COV2 group with no life-threatening events observed.

CONCLUSION:
In mild-to-moderate COVID-19 patients at high risk of disease progression REGN-COV2 treatment significantly reduced progression of disease and hospitalization without significant adverse events.
Forensic botany: Unraveling crimes with nature’s clues
Authors: Khan Aymaan , Bashir Khalid , Rashid Arsalaan F. , Khan S. Muhammad Salim , Janan Mariya 
Published: January 2025

Abstract
Forensic botany harnesses the characteristics of plant materials to yield vital insights in criminal investigations, linking suspects to crime scenes and unraveling details about criminal events. This review delves into various applications of forensic botany, including pollen analysis, diatom examination, mycology, and bryology, which play critical roles in forensic inquiries. Despite its significant potential, forensic botany remains underutilized in practical forensics. By synthesizing the existing research, identifying gaps, and suggesting future research directions, this review emphasizes the crucial role of botanical evidence in forensic science.
Comprehensive Ayurveda Management of Achalasia Cardia: Clinical Insights from a Case Report
Authors: Urvashi Patel , Anup Thakar , Rita Khagram , Hitesh Ghetiya 
Published: January 2025

Abstract

INTRODUCTION:
Achalasia Cardia (AC) is a rare esophageal motility disorder marked by the loss of inhibitory neuronal function, leading to impaired relaxation of the lower esophageal sphincter (LES) and absence of normal esophageal peristalsis, which disrupts coordinated swallowing. Achalasia has been regarded as an uncommon disorder with an annual incidence of approximately 1.6 cases per 1,00,000 individuals and a prevalence of 10 cases per 100,000 individuals. Treatment options for AC aim to reduce lower esophageal sphincter (LES) pressure and alleviate symptoms, utilizing pharmacologic therapies like calcium channel blockers and nitrates, endoscopic botulinum toxin injections, pneumatic dilation, or surgical interventions.

PATIENT INFORMATION:
A 42-year-old female presented to the Panchakarma OPD with a confirmed diagnosis of AC for the past four years. Her chief complaints included difficulty swallowing (dysphagia), regurgitation of food, excessive belching, a burning sensation in the chest and abdomen, occasional chest pain associated with food intake, and intermittent episodes of vomiting. The patient reported undergoing surgical intervention previously; however, it did not result in significant symptomatic relief.

THERAPEUTIC INTERVENTIONS:
The patient was managed with comprehensive Ayurvedic therapy, targeting the symptoms attributed to Vata impairment. Virechana Karma (therapeutic purgation), a Panchakarma procedure, was administered to facilitate Vatanulomana (normalization of the downward movement of Vata). Nasya Karma (nasal administration) was also performed for Vata Shamana. Orally, Shankha Vati 1 Tab (250 mg) twice a day and Avipattikara Choorna 3 gm with Madhu (honey) twice a day were administered during the treatment.

RESULTS:
This comprehensive therapeutic approach from May 6 to August 25 resulted in significant improvements in symptoms such as regurgitation, difficulty in swallowing (dysphagia), and change in esophageal motility and esophageal muscle tone. The patient was monitored and followed up for three months under the prescribed Ayurvedic regimen, during which consistent symptomatic relief was observed.

CONCLUSION:
The outcomes indicate the potential of Ayurvedic interventions, including Panchakarma, in producing symptomatic improvement in AC.
A “Sage on the Stage” to a “Guide on the Side”: Flipping the Conventional Classroom
Authors: Gosavi Manasi A. , Hungund Bhagyashri , Ratnakar Ashwini V. , Kangle Ranjit 
Published: January 2025

ABSTRACT

Background:
In the constantly changing field of medical education, it is imperative for educators to adopt newer methods of teaching-learning. Flipped classroom [FC] is a student-centric method where the students gain knowledge outside the classroom with class time being used for application of knowledge. There is paucity of data about the use of FC’s for teaching pathology.

Materials and Methods:
Two batches of MBBS Phase II students were enrolled. The first batch underwent a flipped classroom. Students were given pre-class material followed by in-class activities like case scenarios to prompt in-depth discussion. Feedback was collected about the flipped class. Another batch of MBBS students was subjected to conventional classroom teaching. Both batches were administered pre- and post-tests.

Results:
In the flipped class, the mean post-test score was higher by 2.26 ± 3.11 and this value was statistically significant. There was a statistically significant increase in number of students acquiring A or B grade. A greater number of students got upgraded to A grade in post-test after attending flipped class as compared to conventional class. 50.6% students felt that flipped class helped in understanding key concepts.

Conclusion:
Flipped classrooms are a unique and student-centric method of teaching where the role of a teacher shifts from being a “Sage on the stage” to a “Guide on the Side.” Strategic planning on the part of the instructors and adequate preparation on the part of the students is vital. Flipped classroom had a more positive influence on high achievers.
Incidence and Risk Factors for Retinopathy of Prematurity (Rop): A Prospective Follow-up Study from Sub-himalayan Union Territory (UT) of India
Authors: Gupta Riya , Gupta Satish K. , Gupta Rajiv K. , Gupta Surbhi , Mahajan Richa , Kumari Rashmi , Langer Bhavna 
Published: January 2025

ABSTRACT

Purpose:
The study was aimed to elucidate the incidence and associated risk factors for Retinopathy of Prematurity (ROP) in new-born babies in a tertiary care teaching hospital in North India.

Methods:
The present study was a prospective follow-up study involved in the screening of new-born babies who are at risk of developing ROP conducted in the Ophthalmology department of a teaching hospital in Jammu district, India.

Results:
During the course of the present study, 199 infants were screened and 13 were found to be having ROP. Incidence of ROP thus was 6.53%. Univariate analysis revealed that neonatal factors like birth weight, O2 supplementation >5 days, patent ductus arterious, sepsis and apnoea of prematurity were significantly associated with ROP (P < 0.05). C-PAP and mechanical ventilation (>5 days) were the only significant predictors for ROP on multivariate logistic regression.

Conclusion:
A relatively low incidence of ROP was observed with neonatal risk factors more significantly associated with ROP. The prevention of pre-term births and sustaining the gains in neonatal care should go a long way to reduce the incidence of ROP in infants.
Period Prevalence and Determinants of Antara Injectable Contraceptive use among Women of Reproductive Age Group in a Tribal Village of Dadra and Nagar Haveli
Authors: Solanki Preeti , Bariya Bhaveshbhai R. , Mahyavanshi Darshankumar 
Published: January 2025

ABSTRACT

Background:
Antara injectable contraceptive is a safe, low-cost, reversible, and highly effective contraceptive method. The objectives of the study were to estimate the period prevalence of injectable contraceptive use and its determinants among women of reproductive age group in a tribal village of Dadra and Nagar Haveli (DNH), India.

Materials and Methods:
A cross-sectional study was conducted at two sub-centers, and women of reproductive age groups were selected using a simple random sampling method. Data was collected about sociodemographic details, obstetric history, knowledge, and perceptions about Antara injection and its practice among Antara users. Mean, median, and proportion were used for quantitative variables, whereas qualitative attributes were presented by proportion. To find out the predictors of injectable contraceptive use, binary logistic regression was applied, taking injectable contraceptive use as the dependent variable.

Results:
The study participants had a mean age of 31.8 years (standard deviation: 7.1). The majority of them were homemakers (94%) and had received primary education (47.4%). Among the total 325 participants, only 15 women had used Antara injectable in the last year, resulting in a period prevalence of 4.6%. Most of the women who discontinued injectable contraceptives (80%) cited irregular bleeding as the reason. Multiple logistic regression revealed that age, type of family, and knowledge about the interval between two doses were determinants of injectable contraceptive use.

Conclusion:
There is a need to provide correct information and counseling before starting injectable contraceptives and during follow-up visits to increase the uptake of Antara injection among women of the reproductive age group.
Overweight in mediating the association between depression and new-onset diabetes: A population-based research from Health and Retirement Study
Authors: Zhang Zi-Hao , Yue Shuo-Ying , Su Meng , Zhang Hong-Lu , Wu Qing-Cui , Li Zhi-Lin , Zhang Nai-Jian , Hao Zhi-Yi , Li Man , Huang Hui-Jie , Ma Jun , Liu Yuan-Yuan , Wang Hui 
Published: January 2025

BACKGROUND
Several studies have suggested a close link between depression, overweight, and new-onset diabetes, particularly among middle-aged and older populations; however, the causal associations remain poorly understood.
AIM
To investigate the role of overweight in mediating the association between depression and new-onset diabetes in middle-aged and older populations.
METHODS
Data of 9426 individuals aged ≥ 50 years from the 1998-2016 Health and Retirement Study database were analyzed. Weighted logistic regression was employed to obtain odds ratios (ORs) and 95% confidence intervals (95%CIs) for depression and new-onset diabetes in the middle-aged and older populations. Mediation analysis and the Sobel test were used to test the mediating effects of overweight between depression and the risk of new-onset diabetes.
RESULTS
New-onset diabetes was identified in 23.6% of the study population. Depression was significantly associated with new-onset diabetes (OR: 1.18, 95%CI: 1.03-1.35, P value: 0.014). Further adjustment for overweight attenuated the effect of depression on new-onset diabetes to 1.14 (95%CI: 1.00-1.30, P = 0.053), with a significant mediating effect (P of Sobel test = 0.003). The mediation analysis demonstrated that overweight accounted for 61% in depression for the risk of new-onset diabetes, with overweight having a partially mediating role in the depression-to-diabetes pathway.
CONCLUSION
New-onset diabetes was not necessarily a direct complication of depression; rather, depression led to behaviors that increase the risk of overweight and, consequently, new-onset diabetes.
Effects of glycemic indicators on early neurological outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis
Authors: Duan Zuo-Wei , Li Zhi-Ning , Zhai Yu-Jia , Liu Teng-Fei , Zhang Cui-Cui , Hu Ting , Wei Xiu-E , Rong Liang-Qun , Liu Hai-Yan 
Published: January 2025

BACKGROUND
Stress hyperglycemia (SH) is a common phenomenon that is present in about 50% of patients with acute ischemic stroke (AIS). It is thought to be a main risk factor for poor functional outcome among patients with AIS undergoing intravenous thrombolysis (IVT).
AIM
To investigate the predictive value of glycemic indicators for early neurological outcomes (ENOs) in patients with AIS treated with IVT.
METHODS
We retrospectively reviewed a prospectively collected database of patients with AIS who underwent IVT at the Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, between January 2017 and June 2022. ENO included early neurological improvement (ENI) and early neurological deterioration (END), defined as a decrease or increase in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 24 hours after IVT. We analyzed the associations between glycemic indicators [including admission hyperglycemia (AH), fasting blood glucose (FBG), and SH ratio (SHR)] and ENO in all patients and in subgroups stratified by diabetes mellitus (DM).
RESULTS
A total of 819 patients with AIS treated with IVT were included. Among these, AH was observed in 329 patients (40.2%). Compared with patients without AH, those with AH were more likely to have a higher prevalence of DM (P < 0.001) and hypertension (P = 0.031) and presented with higher admission NIHSS scores (P < 0.001). During the first 24 hours after IVT, END occurred in 208 patients (25.4%) and ENI occurred in 156 patients (19.0%). Multivariate mixed logistic regression analyses indicated that END was independently associated with AH [odds ratio (OR): 1.744, 95% confidence interval (CI): 1.236-2.463; P = 0.002]. Subjects were classified into four groups representing quartiles. Compared with Q1, patients in the higher quartiles of SHR (Q2: OR: 2.306, 95%CI: 1.342-3.960; P = 0.002) (Q3: OR: 2.284, 95%CI: 1.346-3.876; P = 0.002) (Q4: OR: 3.486, 95%CI: 2.088-5.820; P = 0.001) and FBG (Q3: OR: 1.746, 95%CI: 1.045-2.917; P = 0.033) (Q4: OR: 2.436, 95%CI: 1.476-4.022; P = 0.001) had a significantly higher risk of END in the overall population. However, none of the glycemic indicators were found to be associated with ENI in patients with or without DM.
CONCLUSION
Our study demonstrated that glycemic indicators in patients with stroke treated with IVT were associated with the presence of END rather than ENI during the first 24 hours after admission.