bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of bone turnover markers in screening low bone mineral density and their relationship with fracture risk in the postmenopausal period
Authors: Mobasseri Majid , Tarverdizadeh Nahid , Mirghafourvand Mojgan , Salehi-Pourmehr Hanieh , Ostadrahimi Alireza , Farshbaf-Khalili Azizeh 
Published: June 2023

Background:
Using bone turnover marker (BTM) monitoring to identify “quick losers” who may develop osteoporosis in the coming years is one of the main challenges in clinical practice. This study was implemented to examine the association of BTMs with bone mineral density (BMD) as well as to determine their relationship with the fracture risk assessment tool (FRAX) in women in the postmenopausal period.

Materials and Methods:
This study was observational cross-sectional research that was done on women between the ages of 50 and 65 who were in the postmenopausal period. A dual-energy X-ray absorptiometry was applied to select 120 eligible women with normal BMD and 120 women without normal BMD. BTMs were assessed using enzyme-linked immunosorbent assay. Osteoporosis's Odds Ratio (OR) was estimated using a confounder-adjusted logistic regression model. The area under curve was calculated for the differentiation of low BMD in the postmenopausal period through receiver-operator characteristic (ROC) curves. To assess the probability of major osteoporotic fracture and hip fracture for the future 10 years, FRAX was applied.

Results:
Higher serum osteocalcin (OC) (OR: 1.134, 95% confidence interval [CI]: 1.086–1.184), osteopontin (OP) (OR: 1.180; 95%CI: 1.105–1.261), and alkaline phosphatase (ALP) (OR: 1.007; 95%CI: 1.001–1.144) concentrations were potential risk factors for developing low BMD in women after menopause. The area under curve (AUC) (95%CI) for OC, OP, and ALP was 0.75 (0.668–0.8130), 0.75 (0.685–0.812), and 0.602 (0.524–0.670), respectively. ROC analysis indicated that at the cut-off point of 16.28 ng/mL, sensitivity and specificity were 70.3% and 70.9%, respectively, for OC. Furthermore, at the cut-off point of 28.85 ng/mL, the sensitivity of 70.3% and specificity of 66.6% were obtained for OP. The serum OC and OP were significantly related to hip and major osteoporotic fractures (P < 0.05).

Conclusion:
The higher serum concentration of OC, OP, and ALP had significant associations with lower BMD. These BTMs can be complementary tools and helpful in the postmenopausal period as measures for screening of bone loss and possible bone fracture.
Reference values for ductus venosus Doppler velocity indices between 11 and 13+6 weeks of gestation: A single-center prospective study in Iran
Authors: Hajiahmadi Somayeh , Adariani Alireza Rezaei , Amini Ehsan , Rasti Sina 
Published: June 2023

Background:
This study aimed to investigate reference Doppler velocimetry indices (DVIs) of the fetal ductus venosus (DV) during 11–13 + 6 gestational weeks.

Materials and Methods:
In a prospective observation over referrals to a single tertiary care center in a 2-year interval, normal singleton pregnancies with fetal crown-rump lengths (CRLs) of 43–80 mm were examined by a single experienced sonographer for their DV pulsatility index (DVPI), DV resistance index (DVRI), and S-wave maximum velocity/A-wave minimum velocity (S/A ratio). Multinomial and quantile regression functions were used to analyze the effect of gestational age (estimated by CRL) on reference values (5th and 95th percentiles of the distribution in each gestational day/week). P < 0.05 was considered significant.

Results:
Over a sample of 415 participants with a mean/median gestational age of 12 + 1 weeks, no significant correlations were found between the CRL and DVIs using multinomial regression functions (linear model best fitted for all [DVPI: B coefficient = 0.001, P = 0.235] [DVRI: B coefficient = 0.001, P = 0.287] [DV S/A: B coefficient = 0.010, P = 283]). Quantile regression analyses of DVIs' reference values were nonsignificant across the CRL range except for the DVRI ([5th regression line: coefficient = −0.004, P = 0.018] [95th regression line: coefficient = −0.001, P = 0.030]).

Conclusion:
Reference values for DVPI, DVRI, and DV S/A ratios were established as 0.80–1.39, 0.62–0.88, and 2.57–6.70, respectively. Future meta-analyses and multicenter studies are required to incorporate DV DVIs into an updated universal version of the practice.
Content analysis of papers published in Malaysian Journal of Movement, Health and Exercise (MoHE) between 2013 and 2022
Authors: Hashim Roosfa 
Published: June 2023

Background:
There are several scientific journals in the field of sports science that have been published in Malaysia. One of these journals that has been published regularly is Malaysian Journal of Movement, Health and Exercise (MoHE).

Aims and Objectives:
The purpose of this study was to analyse the development trends of subjects studied and published in MoHE between 2013 and 2022.

Materials and Methods:
A total of 174 articles published in 18 issues of MoHE between 2013 and 2022 were analysed. This study was conducted quantitatively by tracking the highest percentage of various subfields that have been published in MoHE. Therefore, the focus of this study is on the keywords listed at the end of each abstract for articles that have been published in MoHE.

Results:
This study found that MoHE has become a popular platform for researchers in the field of sports science to publish their research findings. Several subjects and important subtopics in the field of sports science have been identified as the focus of papers published in the MoHE.

Conclusion:
This study has proven that MoHE has been accepted as a platform for scientific debate and discussion in the field of sports science.
Response Pattern and Risk Factor of Relapse in Children with First Attack Idiopathic Nephrotic Syndrome
Authors: Shanta Shamsun Nahar , Begum Afroza , Uddin Golam Muin , Roy Ranjit Ranjan , Huque Syed Saimul , Jesmin Tahmina , Mamun Abdullah-Al , Sharmim Mst Shanjida , Khan Ashiqur Rahman 
Published: June 2023

Background:
Most patients with idiopathic steroid-sensitive nephrotic syndrome have frequent relapses. So, it is very important to find out such children who are prone to develop frequent relapses. The objective of this study is to find out the predictors of relapse.

Materials and Methods:
This prospective longitudinal study was carried out in the Department of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from September 2015 to August 2016. A total of 110 patients of idiopathic nephrotic syndrome (INS) with the initial attack, aged 1–18 years, were enrolled in this study. All patients were treated with prednisolone 60 mg/m2/day, single morning dose for 6 weeks, followed by 40 mg/m2 every alternate day for another 6 weeks. Among 110 patients, seven patients were lost during follow-up, and six patients were excluded from this study due to unresponsive to oral prednisolone 60 mg/m2/day within 4 weeks. The remaining 97 were analyzed and followed up.

Results:
Among them, 59 (60.9%) were males, 38 (39.1%) were females, with a male:female ratio of 1.5:1. Twenty-nine (29.9%) children had no relapse, 24 (24.7%) had infrequent relapse, and 44 (45.3%) had frequent relapse. Children responding between 2 and 4 weeks after the start of treatment had a more chance of relapse (P = 0.002) than those who responded less than 1 week. Children with INS who had respiratory tract infection at onset had 4.4 times more chance of relapse. Children with low serum albumin (<15 g/L) at onset had 2.1 times more chance of relapse.

Conclusions:
There was significant correlation of INS associated with male sex, delayed response to steroid treatment, respiratory tract infection at onset, and severe hypoalbuminemia with more relapse.
Steroid-Resistant Nephrotic Syndrome in Children
Authors: Roy Ranjit Ranjan , Sultana Nadira , Jesmin Tahmina , Mamun Abdullah Al , Kakon Kaosary Khan , Akbar Romana , Sharmim Mst Shanjida , Huque Syed Saimul , Uddin Golam Muin , Begum Afroza 
Published: June 2023

Background:
Nephrotic syndrome (NS) is the most common glomerular disease in childhood. With corticosteroids, 80%–85% of children achieve remission, although 10%–15% remain refractory or develop steroid resistance in NS. Steroid-resistant nephrotic syndrome (SRNS) management is difficult due to its varied etiology, frequent lack of remission induced by immunosuppressive treatment, and consequences including drug toxicity, infections, thrombosis, end-stage kidney disease, and recurrence following renal transplantation. Renal histology and genetic mutation play an important role in the management of SRNS. Calcineurin inhibitor (CNI) is the first-line drug of SRNS. In CNI-resistant and multidrug-resistant cases, rituximab and newer drugs are a good option. There is a 35%–50% chance of developing chronic kidney disease (CKD) in SRNS, and supportive measures are required in that case. Few studies have described clinical characteristics, renal biopsy patterns, and treatment outcomes in Bangladeshi children with SRNS. This study evaluated the clinical characteristics at diagnosis, histological pattern, immunosuppressive therapy, and patient outcomes after immunosuppressive medication.

Materials and Methods:
All the records of children (1–18 years old) with idiopathic NS who had been followed up in the Pediatric Nephrology Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), from January 2019 to December 2021 were reviewed retrospectively.

Results:
Among 606 NS cases during the study period, 90 cases (14.85%) were SRNS. Males comprised 70% of the population, whereas females made up 30%. The mean age at the time of diagnosis was 76.21 ± 51.55 months. Hematuria was found in 35.5% of cases, hypertension in 40.8%, and impaired renal function in 34.2% at the time of presentation. Children had primary resistance in 65.7% of cases. Biopsy report was found in 65 cases. The most common histopathological pattern were minimal change disease (MCD) (43.08%) and focal segmental glomerulosclerosis (FSGS) (38.46%). Complete remission was achieved in 66% of cases, and 14% developed CKD. Renal impairment and mesangioproliferative glomerulonephritis (MesPGN) increased the risk for CKD. Patients who received CNI or CNI and mycophenolate mofetil had a higher rate of complete remission.

Conclusion:
Hypertension and hematuria were prevalent in SRNS children. Most lesions were MCD. CNI or combination therapy remissioned more children. Renal impairment at presentation and non-MCD lesion increased CKD risk (FSGS and MesPGN). Long-term follow-up is needed to confirm poorer renal survival.
Role of transcranial Doppler ultrasound as a predictor of outcome in severe traumatic brain injury and its correlation with full outline of unresponsiveness score
Authors: El-Morsy Amr A. , Dahroug Amr H. , Elfaham Ahmed A. 
Published: June 2023

Intro
duction Traumatic brain injury (TBI) is a major public health problem. It is considered to be one of the leading causes of death and disability worldwide. After TBI, cerebral blood flow (CBF) becomes extremely low approaching ischemic thresholds. Concurrently, CBF velocities become strongly correlated to CBF itself post injury. Identification of such hemodynamic disturbances can be used to predict outcome in severe TBI when measured immediately postinjury using transcranial Doppler (TCD). TCD permits noninvasive assessment of different CBF velocities as well as pulsatility index (PI). Abnormal measurement of such indices is believed to correlate to poor outcome.

Objective
The aim of this work was to assess the predictive value of early TCD in patients with severe TBI and to correlate different TCD measurements with full outline of unresponsiveness (FOUR) score.

Patients and methods
In total, 74 patients with severe TBI, according to Glasgow Coma Scale (GCS), underwent TCD within 24 h posttrauma. Middle cerebral artery (MCA) velocities and pulsatility index (PI), as well as other clinical and neuroimaging data, were recorded and accordingly patients were divided into three groups: patients with normal TCD measurements, patients with hypoperfusion, and patients with vasospasm. Hypoperfusion was defined by meeting two out of three criteria: mean flow velocity of MCA less than 35 cm/s, end-diastolic velocity of MCA less than 20 cm/s, and PI more than 1.4. Vasospasm was defined as mean flow velocity more than 120 cm/s. Outcome was evaluated using the Glasgow Outcome Scale Extended at 3 months, as well as in-hospital mortality. TCD measurements were also correlated to GCS and FOUR score.

Results
There was a significant correlation between PI and Glasgow Outcome Scale Extended at 3 months. There was also significant correlation between PI and mortality. Strong negative correlation was recognized between PI and FOUR scores. Patients with hypoperfusion showed worst GCS and FOUR score and patients with vasospasm group showed worst Acute Physiology and Chronic Health Evaluation II score between all groups.

Conclusion
PI, when measured within the first 24 h posttrauma, is considered a good predictor of mortality as well as functional outcome at 3 months. PI values were associated with moderate negative correlation with the severity of injury FOUR score.
Clinical experience with the use of inhaled isopropyl alcohol to treat nausea and vomiting: A narrative review
Authors: Amaya Sebastian , Kalsotra Sidhant , Tobias Joseph D. , Olbrecht Vanessa A. 
Published: June 2023

ABSTRACT
Isopropyl alcohol (IA) is a colorless, flammable organic compound that has been used in the manufacturing process of a wide variety of industrial and household chemicals. Inhalation of its vapor has been noted to potentially have antiemetic effects, which may be useful in the treatment of postoperative nausea and vomiting (PONV). However, given the varied study protocols and endpoints assessing its efficacy as antiemetic, clinical trials have yielded mixed results. If effective, inhalation of IA may be a cost-effective, readily available, and inexpensive therapy that can be used for the treatment of PONV with a low risk of adverse effects. The following narrative review explores the available information regarding the mechanism of action of IA in treating PONV, presents clinical information including possible mechanism of action and clinical applications, and reviews the published literature on its efficacy to treat nausea and vomiting with a focus on its use postoperatively. While early studies suggested that inhaled IA may be successful for the short-term treatment of PONV compared with placebo, subsequent studies both in and out of the operating room (OR) have reported conflicting results. In general, studies in the perioperative setting have provided some evidence to support the use of inhaled IA in alleviating or reducing the severity of PONV in adults. In particular, inhaled IA may have a more rapid onset compared with traditional antiemetic agents, but the clinical effect has generally been found to be short-lived. The results outside of the OR and perioperative setting have been somewhat more favorable, generally showing that inhaled IA reduces nausea and vomiting of various etiologies in adults in the emergency department setting. Similarly, it has been shown to reduce the need for rescue antiemetic agents in this area and thus may be considered a cost-cutting strategy with no reported adverse effects. The available literature suggests that inhaled IA may be considered a potential therapy to achieve rapid relief of PONV and assist in the management of nausea and vomiting in adult patients outside of the perioperative setting. There remain insufficient data to determine how inhaled IA may impact PONV in children. Given the mixed results and the limitations of the current studies, additional data are needed to draw firm conclusions regarding the utility of inhaled IA.
Anesthesiological management of Brugada syndrome patients: A systematic review
Authors: Cuttone Giuseppe , Martucci Gennaro , Napoli Ruggero , Tigano Stefano , Arcadipane Antonio , Pappalardo Federico , Sanfilippo Filippo 
Published: June 2023

ABSTRACT
Brugada syndrome (BrS) is a major risk factor for sudden cardiac death and ventricular tachyarrhythmias. Several drugs are contraindicated in patients with BrS, including some commonly administered drugs during anesthesia or in the perioperative period; however, there is still a paucity of evidence regarding BrS and common anesthetic pharmaceuticals. We conducted a systematic literature search (PubMed, updated October 10, 2022), including all studies reporting pharmacological management of BrS patients during anesthesia or intensive care, with a specific focus on proarrhythmic effects and possible pharmacological interactions in the context of BrS. The search revealed 44 relevant items, though only three original studies. Two randomized controlled studies were identified, one comparing propofol and etomidate for the induction of general anesthesia and one investigating lidocaine with or without epinephrine for local anesthesia; there was also one prospective study without a control group. The other studies were case series (n = 5, for a total of 19 patients) or case reports (n = 36). Data are reported on a total population of 199 patients who underwent general or local anesthesia. None of the studies evaluated BrS patients in the intensive care unit (ICU). We found the studies focusing on the pharmacological management of BrS patients undergoing general or local anesthesia to be of generally poor quality. However, it appears that propofol can be used safely, without an increase in arrhythmic events. Regional anesthesia is possible, and lidocaine might be preferred over longer-acting local anesthetics. Considering the quality of the included studies and their anecdotal evidence, it seems increasingly important to conduct large multicenter studies or promote international registries with high-quality data on the anesthesiological management of these patients.
Pulsed radiofrequency to stellate ganglion for brachial plexus injury-induced complex regional pain syndrome: A case series
Authors: Kumar Ajit , Bhandari Baibhav , Mahiswar Aditya , Sharma Ravi S. , Purohit Gaurav 
Published: June 2023

ABSTRACT
Brachial plexus injury (BPI) occurs commonly in young adults following trauma. This may result in the development of complex regional pain syndrome (CRPS) following injury, which is difficult to treat. We present a group of patients with CRPS secondary to BPI. These patients were managed with neuromodulation of the stellate ganglion (SG) with pulsed radiofrequency (PRF) and followed up for a period of 3 months to assess for pain relief and a decrease in the intake of medications after the intervention. PRF to SG was found to have significant pain relief lasting around three months.
Effect of total fasting hours on the overall quality of recovery after surgery: An observational study
Authors: Alsharkh Wejdan S. , Aljuaid Mohammad , Huda Anwar U. , Bawazir Atheer , Alharbi Abdullah , Alharbi Nouf 
Published: June 2023

ABSTRACT

Context:
Preoperative fasting is one of the pre-requisite for patients undergoing a surgery. Despite clear instructions, patients frequently fast for extended periods before elective surgeries. Longer periods of fasting may cause discomfort, thirst, hunger, and other physiological problems.

Aims:
To assess the quality of postoperative recovery among adult patients having different preoperative fasting hours by using the postoperative Quality of Recovery40 (QoR40) score.

Settings and Design:
This was an observational study that was conducted for adult patients undergoing elective surgery during four weeks between 19th September and 13th October 2022 at Security Forces Hospital Riyadh, Kingdom of Saudi Arabia.

Methods and Material:
We excluded pediatric patients, patients undergoing spine or neurosurgery, emergency cases, or local anesthesia cases. Non-probability convenient sampling technique was used in this study. The postoperative quality of recovery-40 (QoR-40) questionnaire was distributed among 200 patients.

Statistical Analysis Used:
All analyses were performed with Statistical Package for the Social Sciences software (SPSS) v25. Descriptive statistics (frequency, percentage, median, and IQR) were used for the questionnaire’s variables. The difference between the variables was analyzed using Kruskal-Wallis, and a P value <0.05 was considered statistically significant.

Results:
Out of 200 patients, 172 patients responded but 16 responses were excluded. A total of 156 adult patients’ responses were included in this study. The majority were female (53%), 31% were older than 45 years. More than 50% of patients reported fasting for more than 6 hours for drinking and more than 8 hours for eating. On the positive scale, the comfort score was significantly affected by the fasting hours for drinking (P value = 0.045). On the negative scale of the questionnaire, the emotions were significantly affected by fasting hours for both drinking (P value = 0.027) and eating (P value = 0.043).

Conclusions:
The study results showed better comfort for patients with lesser fasting hours for drinking. Moreover, the results strongly suggest the need of following the fasting guidelines without prolonging the fasting duration. However, further studies with larger sample sizes are recommended.
Predictive factors of success and failure for intravenous ketamine therapy in patients suffering from chronic neuropathic pain
Authors: Gargori Nezar M. B. , Alahwal Hazem , Vacheron Charles-Herve , Alam Farouq Mohammad A. 
Published: June 2023

ABSTRACT

Background:
Intravenous (IV) ketamine is used for chronic neuropathic pain refractory to other treatments. Administration of such a medication requires high-cost services while the result is not always satisfactory with a significant percentage of failure. Success and failure are related to some factors.

Method:
In this study, we aim to point the most responsive disease category to IV ketamine and the predictive factors for successful and failed treatment. Two hundred and sixty-nine patients out of 371 were included. Demographic, clinical, and therapy-related variables were retrospectively collected and then statistically analyzed using various descriptive and inferential methods. A few descriptive statistics are obtained for the variables depending on their nature (e.g., percentages for qualitative variables and means for quantitative variables). Furthermore, several inferential methods are considered to address some statistical points of interest, including, but not limited to, odds ratio interpretations via logistic regression as well as association and correlation analyses.

Results:
A significant association was found between the presence of intermittent pain pattern as well as the pain of chronic primary category and favorable response to IV ketamine while the history of previous analgesic interventions was significantly associated with a negative response.

Conclusion:
The identified factors can be used to prospectively study the efficacy of ketamine using selection criteria based on the observed results in our study to re-evaluate the percentage of responsiveness according to these new parameters.