bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective, Randomized, Open-Label, Blinded End Point, Two-Arm, Comparative Clinical Study to Evaluate the Efficacy and Safety of a Fixed Ayurvedic Regimen (FAR) as Add-on to Conventional Treatment in the Management of Mild and Moderate COVID-19 Patients
Authors: Gupta Arun , Vedula Sasibhushan , Srivastava Ruchi , Tamoli Sanjay , Mundhe Narendra , Wagh D N , Batra Sanjay , Patil Manoj , Pawar Hiren Baburao , Rai Rajiva K 
Published: February 2023

Background:
The traditional healthcare systems are being avidly looked into in the quest for effective remedies to tackle the menace of COVID-19 pandemic.

Objective:
This was a prospective randomized, controlled open-label, blinded end point (PROBE) study to evaluate the efficacy and safety of a fixed ayurvedic regimen (FAR) as an add-on to conventional treatment/standard of care (SOC) in the management of mild-to-moderate COVID-19 infection.

Methodology:
A total of 68 patients were recruited who consumed either FAR + SOC (n = 35) or SOC only (n = 33) for 28 days. Primary outcomes assessed were mean time required for clinical recovery and proportion of patients showing clinical recovery between the groups. Secondary outcomes assessed included mean time required for testing SARS-CoV-2 negative, change in clinical status on World Health Organization (WHO) ordinal scale, number of days of hospitalization, change in disease progression and requirement of oxygen/intensive care unit admission/ventilator support/rescue medication, health status on WHO quality of life (QOL) BREF and safety on the basis of occurrence of adverse event/serious adverse event (AE/SAE) and changes in laboratory parameters.

Results:
Patients consuming FAR as an add-on SOC showed faster clinical recovery from the day of onset of symptoms by 51.34% (P < 0.05) as compared to SOC group. A higher proportion of patients taking FAR recovered within the first 2 weeks compared to those taking only SOC. It was observed that 5 times more patients recovered within 7 days in FAR group when compared to SOC (P < 0.05) group. An earlier clinical recovery was observed in clinical symptoms such as sore throat, cough, loss of taste and myalgia (P < 0.05). Improvement in postclinical symptoms such as appetite, digestion, stress and anxiety was also obs served to be better with the use of FAR. Requirement of rescue medications such as antipyretics, analgesics and antibiotics was also found to be reduced in the FAR group (P < 0.05). FAR showed a significant improvement in all the assessed domains of QOL. None of the AEs/SAE reported in the study were assessed to be related to the study drugs. Further, FAR did not produce any significant change in the laboratory safety parameters and was assessed to be safe.

Conclusion:
FAR could be an effective and safe add-on ayurvedic regimen to standard of care in the management of mild and moderate COVID-19 patients. CTRI number: CTRI/2020/09/027914.
Melatonin–Caffeine Combination Modulates Gamma Radiation-induced Sperm Malformations in C57BL/6 Male Mice at Sublethal Dose of Gamma Radiation
Authors: Kushwaha Ritu , Nishad Dhruv K. , Bhatnagar Aseem , Khar Roop Krishen 
Published: February 2023

Aims:
The aim of this study was to assess the protective effect of the melatonin–caffeine combination against γ radiation-induced alterations in the morphological characteristics of sperms.

Settings and Design:
C57BL/6 male mice (n = 30) were randomly divided into five groups: control, radiation (2 Gy), melatonin (100 mg/kg body wt.) + radiation (2 Gy), caffeine (30 mg/kg body wt.) + radiation (2 Gy), melatonin–caffeine (100–30 mg/kg body wt.) + radiation (2 Gy).

Materials and Methods:
All the mice were sacrificed 24 h postirradiation, and cauda epididymis was collected. In this study, sperm concentration along with any abnormality in their morphology (amorphous heads, pinheads, hookless, coiled tails, midpiece defect, and tail-less) was observed in the control and treatment group of animals.

Results:
Radiation exposure (2 Gy) considerably decreases the sperm count when compared with the control group. However, pretreatment with melatonin and melatonin–caffeine combination before gamma irradiation increased the sperm count (P < 0.05), but with caffeine alone could not produce a significant difference. The higher rate of abnormal sperms was observed in the γ-irradiated mice when compared with the control group (P < 0.05). Besides, the numbers of sperm that are hookless and coiled tails were significantly increased after irradiation. Melatonin significantly reduced the number of sperm with amorphous heads and coiled tails. Melatonin–caffeine combination further reduced sperm malformations when compared with the melatonin + 2 Gy radiation and caffeine + 2 Gy radiation group.

Conclusions:
This study suggests that caffeine exerts a protective effect when given in combination with melatonin against gamma irradiation in sperms of C57BL/6 mice and could be a potent combination for the development of radioprotector.
Serum Metabolic Disturbances Associated with Acute-on-chronic Liver Failure in Patients with Underlying Alcoholic Liver Diseases
Authors: Kumar Umesh , Sharma Supriya , Durgappa Manjunath , Gupta Nikhil , Raj Ritu , Kumar Alok , Sharma Prabhat N. , Krishna V. P. , Kumar R. Venkatesh , Guleria Anupam , Saraswat Vivek A. , Pande Gaurav , Kumar Dinesh 
Published: February 2023

Objectives:
Acute-on-chronic liver failure (ACLF), which develops in patients with underlying alcoholic liver disease (ALD), is characterized by acute deterioration of liver function and organ failures are secondary to that. The clear understanding of metabolic pathways perturbed in ALD-ACLF patients can greatly decrease the mortality and morbidity of patients through predicting outcome, guiding treatment, and monitoring response to treatment. The purpose of this study was to investigate the metabolic disturbances associated with ACLF using nuclear magnetic resonance (NMR)-based serum metabolomics approach and further to assess if the serum metabolic alterations are affected by the severity of hepatic impairment.

Materials and Methods:
The serum-metabolic profiles of 40 ALD-ACLF patients were compared to those of 49 age and sex-matched normal-control (NC) subjects making composite use of both multivariate and univariate statistical tests.

Results:
Compared to NC, the sera of ACLF patients were characterized by significantly decreased serum levels of several amino acids (except methionine and tyrosine), lipid, and membrane metabolites suggesting a kind of nutritional deficiency and disturbed metabolic homeostasis in ACLF. Twelve serum metabolic entities (including BCAA, histidine, alanine, threonine, and glutamine) were found with AUROC (i.e., area under ROC curve) value >0.9 suggesting their potential in clinical diagnosis and surveillance.

Conclusion:
Overall, the study revealed important metabolic changes underlying the pathophysiology of ACLF and those related to disease progression would add value to standard clinical scores of severity to predict outcome and may serve as surrogate endpoints for evaluating treatment response.
A Narrative Review of Antiviral Drugs Used for COVID-19 Pharmacotherapy
Authors: Kumar Subodh , Saurabh Manoj K. , Maharshi Vikas , Saikia Dibyajyoti 
Published: February 2023

Purpose:
A number of research articles has been published evaluating safety and efficacy of drugs against COVID-19. This study was undertaken to collate and review the information regarding common proposed anti- viral drugs for easy reference.

Methods:
The literature was search was done using terms like severe acute respiratory syndrome or SARS-CoV-2 or 2019-nCoV or SARS-CoV or COVID-19 in combination with drugs or treatment or pharmaco-therapy using PubMed and google scholar to identify relevant articles.

Results:
Despite showing good early results, hydroxychloroquine and lopinavir-ritonavir has not shown clinical benefit in randomized controlled trials. However lopinavir in combination with other drugs specially interferon is being investigated. Remdesivir has shown positive effect in terms of clinical improvement and continued to being investigated alone or in combination with other drugs. Favipiravir has shown mixed results and more data from adequately powered study is needed to prove its efficacy.

Conclusions:
Many drugs which showed positive effect in initial studies could not replicate the same benefit in large randomized controlled trials. There is need to evaluate efficacy and safety of drugs based on high quality evidence before allowing it to be used in general population.
Microalbuminuria and its Association with Adverse Pregnancy Outcome in a Tertiary Health Centre in Nigeria
Authors: Afolabi-Oboirien Khadijat Omodunni , Panti Abubakar Abubakar , Tunau Karima Abubakar , Ukwu Aaron Eze , Abdulrahman Muhammad Bashir , Garba Jamila Abubakar 
Published: February 2023

Background:
Adverse pregnancy outcomes occur more commonly in developing countries and are still prevalent in our sub-region. Microalbuminuria is a marker of endothelial dysfunction and has been proposed as an aetiological factor in the development of some adverse pregnancy outcomes such as pre-eclampsia, intrauterine growth restriction (IUGR) and pre-term labour.

Aim:
The aim is to determine the prevalence of microalbuminuria and its association with adverse pregnancy outcomes.

Methods:
This was a prospective cross-sectional study with follow-up amongst women in early pregnancy presenting at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Three hundred and thirty women with singleton pregnancy at gestational age <20 weeks, blood pressure <140/90 mmHg, normal fasting blood sugar and normal renal function were recruited. Those with a history of hypertension, diabetes mellitus, chronic kidney disease, sickle cell anaemia were excluded, multiple pregnancies, urinary tract infection or positive dipstick proteinuria at first contact were excluded. They were recruited consecutively and a structured interviewer-administered questionnaire was completed. Single-spot urine analysis for albumin was performed. The women were followed up to the time of delivery and the puerperium and any adverse outcome were documented.

Results:
The prevalence of microalbuminuria was 58.4%. The maternal and foetal adverse outcomes such as hypertensive disorders of pregnancy, pre-mature rupture of membrane, IUGR, preterm birth and stillbirth occurred more amongst the women with microalbuminuria. However, there was no statistically significant association between microalbuminuria and having these adverse outcomes (P > 0.05).

Conclusion:
There was a high prevalence of microalbuminuria amongst healthy pregnant women and pregnancy complications occurred more frequently in women with microalbuminuria than in those without. However, this association was not sufficient to predict adverse outcomes in pregnancy.
Current Epidemiology of Histoplasmosis in Nigeria
Authors: Ekeng Bassey Ewa , Davies Adeyinka Afolake , Osaigbovo Iriagbonse Iyabo , Emanghe Ubleni Ettah , Udoh Ubong Aniefiok , Alex-Wele Mary Adanma , Adereti Oluwaseun Chinaza , Oladele Rita Okeoghene 
Published: February 2023

Introduction:
Histoplasmosis commonly occurs in the advanced HIV disease population and also in immunocompetent individuals. Previous reviews and recent studies highlight several cases of histoplasmosis reported in Nigeria. We aimed to describe the current epidemiology of histoplasmosis in Nigeria and the need for active surveillance in the at-risk populations.

Methods:
Literature searches for all publications on histoplasmosis in Nigeria were performed using online databases including Google scholar, PubMed and African Journal online. The following search terms: 'histoplasmosis' and 'Nigeria', AND/OR 'Histoplasma and Nigeria' were used. No limitations on the date or other search criteria were applied, to avoid the exclusion of articles on histoplasmosis in Nigeria. All publications on histoplasmosis outside Nigeria were excluded.

Results:
Our review identified a total of 231 cases of histoplasmosis reported from Nigeria: 128 were from individual case reports and case series while 103 were cases from two observational studies. Of the 231 cases, 97 (42.0%) were from South West Nigeria, 66 (28.6%) were from South-South Nigeria, 24 (10.4%) were from North West, 22 (9.5%) from North Central Nigeria, 17 (7.4%) from South East Nigeria and 5 (2.2%) from the North East. Based on Nigeria's current population size of 216,953,585 the burden of histoplasmosis per 100,000 inhabitants was estimated to be 0.1%. The sheer number of cases detected in recent observational studies compared with individual case reports and series reported over a longer duration of 6 decades suggests gross under-reporting of histoplasmosis in Nigeria.

Conclusion:
Histoplasmosis is not an uncommon clinical entity in Nigeria. Histoplasmosis case finding should be improved by training and retraining healthcare professionals and providing much-needed diagnostic capacity and infrastructure across health facilities in Nigeria.
Pengaruh Legalitas Usaha, Packaging produk dan Labelisasi Halal MUI terhadap Peningkatan Volume Penjualan Produk, Usaha Mikro Kecil Menengah (UMKM) Di Kecamatan Cilacap Selatan Kabupaten Cilacap
Authors: Akim Hakim 
Published: February 2023

The purpose of this study 1. To find out the effect of business legality on sales volume of micro, small and medium enterprise products (MSMEs) in South Cilacap District, Cilacap Regency. 2. Changing the effect of product packaging on sales volume for micro, small and medium enterprise (MSMEs) products in Cilacap Selatan District, Cilacap Regency. 3. Changing the effect of the MUI Halal Labeling on sales volume of micro, small and medium enterprise (MSMEs) products in South Cilacap District, Cilacap Regency. 4. Changing the effect of business legality, Product Packaging and MUI Halal Labeling on sales volume of micro, small and medium enterprise (MSMEs) products in South Cilacap District, Cilacap Regency.In this study using quantitative methods with the type of associative research. The sampling technique uses saturated sampling techniques. The data used is primary data. The data collection technique used a questionnaire which was distributed to 47 MSMEs in the South Cilacap District. Methods of data analysis in research, using the classical analysis assumption test, t test, f test multiple linear regression and terminationThe results of this study indicate that (1) business legality, Product Packaging and Halal Labeling have a positive and significant effect on sales volume for micro, small and medium enterprise (MSMEs) products in South Cilacap District, Cilacap Regency. (2) Product packaging has a positive and significant effect on sales volume for micro, small and medium enterprises (MSMEs) in Cilacap Selatan District, Cilacap Regency Keywords: Business Legality, Product Packaging, MUI Halal Labeling and Increasing Product Sales Volume
Suture-mediated closure devices for percutaneous endovascular abdominal aneurysm repair
Authors: Szpotan Tomasz , Czernik Maciej , Majos Agata 
Published: February 2023

PurposeEndovascular procedures such as endovascular aneurysm repair or transcatheter aortic valve implantation have become very common because of reduced patient traumatisation and the ability to use shorter or local anaesthesia. In these procedures large-bore sheath devices are used. Access with percutaneous closure is an alternative method to surgical cutdown in groins. The aim of the study was to assess the correlation between sheath size and unsuccessful haemostasis. In addition, the effectiveness of haemostasis after a percutaneous procedure and the number and type of complications were evaluated.Material and methodshere were 202 patients included in the study. Patients with abdominal aortic aneurysm were qualified to percutaneous aortic stentgraft implantation with Perclose Proglide preclosure technique.ResultsThere were 384 access sites performed with 12F to 22F sheaths during aortic stentgraft implantation with Perclose Proglide (Abbott Vascular, Santa Clara, CA, USA) preclosure technique. High effectiveness of haemostasis (98%), low percentage of short- and mid-term complications (2.6%), and infinitesimal number of surgical conversions (<i>n</i> = 5) were stated in the study. There was no correlation between diameter of used introducer sheath and lack of haemostasis observed (Fisher-Freeman-Halton test; <i>p</i> = 0.122). No relationship between diameter of introducer sheath and number of closure devices was observed (<i>x<sup>2</sup></i> = 2.436; df = 5; <i>p</i> = 0.786).ConclusionsLarge-bore device percutaneous procedures with closure devices are effective and safe. High effectiveness of haemostasis (98%) was observed in the study group, with a low percentage of complications (2.6%). There was no correlation between size of the vascular access and the lack of haemostasis found in the study.
Predicting ocean-induced ice-shelf melt rates using deep learning
Authors: Rosier Sebastian H. R. , Bull Christopher Y. S. , Woo Wai L. , Gudmundsson G. Hilmar 
Published: February 2023

Abstract. Through their role in buttressing upstream ice flow, Antarctic ice shelves play an important part in regulating future sea-level change. Reduction
in ice-shelf buttressing caused by increased ocean-induced melt along their undersides is now understood to be one of the key drivers of ice loss
from the Antarctic ice sheet. However, despite the importance of this forcing mechanism, most ice-sheet simulations currently rely on simple
melt parameterisations of this ocean-driven process since a fully coupled ice–ocean modelling framework is prohibitively computationally
expensive. Here, we provide an alternative approach that is able to capture the greatly improved physical description of this process provided by
large-scale ocean-circulation models over currently employed melt parameterisations but with trivial computational expense. This new method brings
together deep learning and physical modelling to develop a deep neural network framework, MELTNET, that can emulate ocean model predictions of
sub-ice-shelf melt rates. We train MELTNET on synthetic geometries, using the NEMO ocean model as a ground truth in lieu of observations to provide
melt rates both for training and for evaluation of the performance of the trained network. We show that MELTNET can accurately predict melt rates for a
wide range of complex synthetic geometries, with a normalised root mean squared error of 0.11 m yr−1 compared to the ocean
model. MELTNET calculates melt rates several orders of magnitude faster than the ocean model and outperforms more traditional parameterisations
for > 96 % of geometries tested. Furthermore, we find MELTNET's melt rate estimates show sensitivity to established physical relationships
such as changes in thermal forcing and ice-shelf slope. This study demonstrates the potential for a deep learning framework to calculate melt rates
with almost no computational expense, which could in the future be used in conjunction with an ice sheet model to provide predictions for large-scale
ice sheet models.
TINJAUAN YURIDIS TERHADAP TINDAK PIDANA MALPRAKTEK (Studi Putusan Nomor 109/Pid.Sus/2019/PN.Kbu)
Authors: Fikma edrisy Ibrahim , Ayu Anggraini Serli 
Published: February 2023

Malpraktik dapat diartikan sebagai setiap tindakan medis yang dilakukan oleh dokter atau oleh orang-orang di bawah pengawasannya, atau oleh penyedia jasa kesehatan yang dilakukan terhadap pasiennya, baik dalam hal diagnosis, terapeutik, atau manajemen penyakit, yang dilakukan secara melanggar hukum, kepatutan, kesusilaan, dan prinsip-prinsip profesional, baik dilakukan dengan kesengajaan, atau ketidakhati-hatian, yang menyebabkan salah tindak, rasa sakit, luka, cacat, kematian, kerusakan pada tubuh dan jiwa, atau kerugian lainnya dari pasien dalam perawatannya, yang menyebabkan tenaga kesehatan harus bertanggungjawab baik secara administrasi dan atau secara perdata dan atau secara pidana. maka yang menjadi masalah dalam penelitian ini yaitu Bagaimana Penerapan Hukum Pidana Matril Terhadap Pelaku Tindak Pidana Malpraktek Pada Putusan Nomor 109/Pid.Sus/2019/PN.Kbu, Bagaimana Pertimbangan Hakim Dalam Menjatuhkan Pidana terhadap Pelaku Tindak Pidana Malpraktek Pada Putusan Nomor 109/Pid.Sus/2019/PN.Kbu .

Penerapan Hukum Pidana Matril Terhadap Pelaku Tindak Pidana Malpraktek Pada Putusan Nomor 109/Pid.Sus/2019/PN.Kbu dapat diuraikan maka unsur ini telah terbukti kebenarannya menurut hukum, dengan demikian unsur “Tenaga Kesehatan Yang Menjalankan Praktik Tanpa Memiliki Izin Sebagaimana Dimaksud Dalam Pasal 46 Ayat (1) UU RI Nomor 36 Tahun 2014 Tentang Tenaga Kesehatan” telah terpenuhi.

Seharusnya kepada pemerintah khususnya tenaga kesehatan harus bisa mengecek izin praktik tenaga kesehatan, jangan sampai tenaga kesehatan yang melakukan praktik kesehatan tidak memiliki izin sehingga bisa dipertanyakan dan membuat permasalahan dikemudian hari, sehingga bisa mendapat hukuman. Adanya pembenahan terhadap pola hubungan antar stakeholders (dokter, perawat, bidan, rumah sakit, klinik, pasien) yang ada sehingga malpraktek bisa atau diminimalisir. pencegahan yang diberikan berupa adanya lembaga independen yang melakukan pembinaan dan pengawasan antar pemangku kepentingan tersebut bila terjadi malpraktek medis. Minimnya pengetahuan masyarakat akan kesehatan, dan kepercayaan masyarakat yang tinggi terhadap tenaga kesehatan menyebabkan masyarakat awam belum memahami perbuatan-perbuatan dan kesalahan tenaga kesehatan yang dapat dilaporkan sebagai dugaan malpraktek medis, sehingga masyarakat perlu mendapat sosialisasi dan pemberitahuan mengenai hak-hak dan kewajiban baik yang dilakukan oleh tenaga kesehatan maupun rumah sakit serta perlunya mendapat pendampingan hukum bila terhadap malpraktek medis yang menyebabkan kerugian pasien.
PERTANGGUNGJAWABAN RUMAH SAKIT ATAS PENGGUNAAN BARANG MEDIS HABIS PAKAI YANG DI REUSABLE TERHADAP PASIEN
Authors: Maryadi Maryadi 
Published: February 2023

Undang-Undang Dasar Negara Republik Indonesia Tahun 1945 menyinggung bahwa setiap orang memiliki hak hidup sejahtera lahir dan batin, bertempat tinggal, dan mendapatkan lingkungan hidup yang baik dan sehat serta berhak memperoleh pelayanan kesehatan. Penelitian ini akan disusun dengan menggunakan tipe penelitian yuridis empiris. Sumber data yang digunakan adalah data primer dan sekunder. Data primer peneliti mengacu terhadap data atau fakta-fakta dan kasus hukum yang diperoleh langsung melalui penelitian di lapangan termasuk keterangan dari responden yang berhubungan dengan objek penelitian dan praktik yang dapat dilihat serta berhubungan dengan obyek penelitian. Data sekunder dilakukan dengan cara studi kepustakaan. Data sekunder dalam penelitian ini meliputi: Bahan hukum primer, yang terdiri dari : Undang-Undang Dasar Negara Republik Indonesia 1945, KUHP, KUHAP, Undang-Undang Nomor 36 Tahun 2009 Tentang Kesehatan, Undang-Undang Nomor 44 Tahun 2009 Tentang Rumah Saki. Rumah sakit bertanggung jawab atas kelalaian yang ditimbulkan oleh tenaga medis dalam melakukan tindakan medis kepada pasien. Ditambah lagi dengan adanya doktrin Corparate Liability mengharuskan rumah sakit untuk bertanggung jawab secara hukum atas segala peristiwa yang terjadi di rumah sakit. Bentuk tanggung jawabnya adalah dengan mengganti kerugian kepada pasien yang telah dirugikan dengan adanya kelalaian yang dilakukan oleh tenaga medis. Perlindungan hukum yang dapat dilakukan oleh pasien ataupun keluarga pasien atas kelalaian tenaga medis dalam melakukan tindakan medis terhadapnya adalah dengan menyelesaikannya baik melalui litigasi maupun non-litgasi.