bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Functional Outcome Following Left Hemispherotomy in Adults and Pediatric Participants with Fmri Analysis
Authors: Girishan Shabari , Chaudhary Kapil , Samala Raghu , Agarwal Mohit , Kumaran Senthil , Doddamani Ramesh , Wadhawan Ashima Nehra , Ramanujam Bhargavi , Chandra Sarat P , Tripathi Manjari 
Published: September 2022

Abstract

Background and Objective:
Hemispherotomy surgery in adults is shrouded in doubts regarding the functional outcome. The age at surgery alone should not be the deciding factor for surgery. Language paradigms were used in functional magnetic resonance imaging (fMRI) to confirm the role played by the age at the onset of seizures to predict the postoperative functional outcome. The objective of the study was to formulate an optimal strategy for patient selection for the left-sided hemispherotomy in adults, based on functional outcome analysis.

Materials and Methods:
A retrospective analysis of 20 participants (age at surgery 1–26 years) who underwent left hemispherotomy (over a 5-year period) was conducted. The language and motor functional assessments of 18 participants (13 pediatric and five adult participants; attrition of participants- two) were recorded at presentation and during follow-up visits. After approval was obtained from the Institutional Ethics Committee, 13 cooperative participants (eight pediatric and five adult participants) underwent language fMRI. Motor fMRI with both active and passive paradigms was done in 16 participants.

Results:
All 18 participants with a mean follow-up of 24 months had class I seizure-free outcome. Of these 18, five were adults (mean age = 21 years, range: 18–22 years) and 13 were in the pediatric age group (mean age = 8 years, range: 2–15 years). Postoperatively, four adults retained both verbal fluency and language comprehension at a mean follow-up period of 38 months (range: 24–48 months). Their pre- and post-op language fMRI showed word generation and regional activations for semantic comprehension in the right hemisphere. The motor area activations were seen in the right hemisphere in two and in the left hemisphere in two participants. Among the pediatric participants, four (group I [n = 4/13]) who had good language outcome showed activations in the right hemisphere. In two participants (group II [n = 2/13]) who deteriorated postoperatively, the activations were in the left hemisphere. Five participants (group III [n = 5/13]) who retained the telegraphic language postoperatively had bilateral activations of semantic comprehension areas in fMRI. All 13 pediatric participants had motor area activations seen in the left hemisphere, similar to controls.

Conclusion:
Left hemispherotomy can be advised to adults with comparably good postoperative language and motor outcome as in the pediatric age group, provided the weakness is acquired perinatally or below the age of 7 years. The fMRI is a valuable tool to aid in patient selection.
Diagnostic Value of Micro-Bubble Transcranial Doppler Combined with Contrast Transthoracic Echocardiography in Cryptogenic Stroke Patients with Patent Foramen Ovale
Authors: Lu Jianping , Li Jinguo , Huang Huapin , Ye Qinyong 
Published: September 2022

Abstract

Background:
In recent years, increasing attention has been paid to cryptogenic stroke (CS) caused by the patent foramen ovale (PFO).

Objective:
This study aims to evaluate the value of microbubble transcranial Doppler (MB-TCD) combined with contrast transthoracic echocardiography (cTTE) in the diagnosis of cryptogenic stroke patients with PFO.

Materials and Method:
From January 2014 to January 2019, patients who suffered from CS were recruited and divided into the cTTE group and MB-TCD combined with cTTE group. All patients were further checked by transesophageal echocardiography (TEE).

Results:
A total of 130 patients accepted cTTE examination, and 109 patients accepted MB-TCD combined with cTTE. In the group, 52 of the 54 positive patients were finally confirmed by TEE with PFO, and 12 of the 76 negative patients were finally confirmed by TEE with PFO. In combined group, 50 patients were negative on both two examination (Negative group), 54 were positive on both two examination (Positive group) and finally confirmed by TEE indeed with patent foramen ovale (PFO), while remaining five (5) patients were positive only on MB-TCD (Suspected group). After checked by TEE, three (3) of five patients with MB-TCD positive were confirmed by TEE indeed with PFO. The sensitivity, specificity, positive likelihood ratio (+LR), and Youden's index of cTEE in diagnostic of cryptogenic stroke patients with PFO were 81.25%, 96.97%, 26.82 and 0.78, respectively, and these for MB-TCD combined with cTTE were 100%, 96.15%, 25.97 and 0.96, respectively. MB-TCD medium can sensitively discover PFO in cryptogenic stroke patients with 100% sensitivity and a missdiagnosis rate of 0.

Conclusion:
The combination of MB-TCD and cTTE can improve the sensitivity and specificity of PFO diagnosis in cryptogenic stroke patients. MB-TCD medium also had high sensitivity and specificity.
Sural Sensory Nerve Action Potential
Authors: Jain Rajendra S. , Kumar Kamlesh 
Published: September 2022

Abstract

Objectives:
This study was done to obtain the reference data for the sural SNAP amplitude and latency at distances of 14, 12, and 10 cm from the active recording electrode in Indian healthy subjects for different age groups.

Material and Methods:
Two hundred forty-four healthy subjects (18–80 years) were included in this cross-sectional study. Subjects were divided into six groups according to age. Sural SNAP was recorded antidromically stimulating at three sites (14, 12, and 10 cm from the recording electrode). The quantitative variables were expressed as Mean ± SD/Median (IQR) and compared using t test/ANOVA. Transformed data for amplitude were analyzed with the use of paired t test. P < 0.05 was considered statistically significant. SPSS version 20.0 software was used for statistical analysis.

Results:
Mean age of included subjects was 43.28 years. Maximum leg girth was at 14 cm. Analysis showed a significant difference in the leg girth at all three sites (P < 0.001). Sural SNAP latency at each stimulating site was compared in different age groups, no significant difference was found between groups (P = 0.19). Maximum amplitude was in the 18–30-years age group and amplitude was minimum in the 71–80-years age group (4.34 and 2.79, respectively). The difference in the amplitude recorded in the different age groups was found to be statistically different (P < 0.001). The difference in the amplitude recorded at each site was found to be statistically different (P < 0.001).

Conclusion:
This is the first study with a large sample size (244 subjects) to provide age-stratified reference data for SNAP in the Indian population by using three sites of stimulation at distances of 14, 12, and 10 cm from the recording electrode. This study shows that sural SNAP amplitude varies with the age of the subject and distance from stimulation.
Correlation of Obesity and Serum Vitamin D Levels with Sperm DNA Integrity, Sperm Quality, and Sperm Viability in Normozoospermia Men
Authors: Pooladi Marziyeh , Sharifi Mohammadreza , Abbasi Yusef , Dashti Gholam Reza 
Published: September 2022

Background:
Obesity, Vitamin D (VD) deficiency, and infertility are important ubiquitous issue; however, the association of obesity and serum VD levels with abnormal sperm is unclear and inconclusive. The current study investigated the correlation of obesity and serum VD levels with sperm DNA integrity and sperm parameters in normozoospermia men.

Materials and Methods:
Semen and blood samples from 64 men were divided into two groups: obese and nonobese men based on body mass index (BMI). Sperm motility and viability were determined by computer-aided sperm analysis and eosin-nigrosin staining. DNA fragmentation, determined by sperm chromatin dispersion method. VD concentrations were assessed by the Elisa technique.

Results:
Serum concentration of VD levels in the obese group was significantly lower than nonobese men (P < 0.05). Sperm motility was significantly reduced in the obese group in comparison to nonobese (P < 0.05). Rapid progressive motility was statistically lower in obese men compared with the nonobese group (P < 0.05). Sperm count and morphology were not statistically significant in both groups. Sperm viability in the nonobese group was significantly decreased in comparison to obese group (P < 0.05). DNA integrity was significantly higher in the obese group as compared with nonobese (P < 0.01).

Conclusion:
VD deficiency in the obese group showed decreased sperm motility, increased DNA damage, and viability. Adverse consequences of obesity and the possible effect of BMI infertility treatment must be discussed with counseling couples interested in assisted reproductive techniques outcomes, especially in men without any unknown cause.
Supporting Resident Wellness Through Reflection on Professional Identity
Authors: Toubassi Diana , Forte Milena , Herzog Lindsay , Roberts Michael , Schenker Carly , Waters Ian , Bearss Erin 
Published: September 2022

Background:
Interventions to address distress among medical trainees often include reflective practice, as well as peer support. Few, however, have emphasized the role of professional identity formation, increasingly recognized as critical to wellness. The structural aspects of curricular interventions have also received little attention. A novel curriculum was therefore designed and evaluated with the goal of understanding how best to support resident wellness through reflection on professional identity.

Materials and Methods:
The curriculum consisted of 8 2-hour sessions, each focusing on a theme commensurate with residents’ professional identity at the time of its delivery. Two Family Medicine sites at the University of Toronto participated, with residents divided into small groups by residency year. Qualitative data were collected through feedback forms, and resident and faculty focus groups, transcripts of which were subjected to pragmatic thematic analysis.

Results:
Four major themes were developed relating to 1) the curriculum's ability to support resident wellness, 2) the importance of protecting reflection, 3) the impact of participants’ professional developmental stage, and 4) the critical role of facilitators.

Conclusions:
A curriculum encouraging reflection on professional identity appears to support resident wellness. To optimize impact, structural factors such as robust curricular integration, confidentiality and group member continuity, require care.
An Evaluation of Anxiety Disorder and Emotion Regulation Difficulty in Children and Adolescents with Alopecia Areata
Authors: Miniksar Dilşad Yıldız , Çölgeçen Emine , Cansız Mehmet Akif 
Published: September 2022

Context:
The relationship between alopecia areata (AA) and emotion regulation difficulty has not yet been fully explained.

Aims:
The aim of the study was to investigate the levels of anxiety and emotion regulation difficulty in children diagnosed with AA.

Settings and Design:
This case-control study was done in the university setting.

Methods:
Behavioral tests measuring anxiety and emotion regulation difficulties, and the measures assessing AA severity were applied to 32 AA patients consulted at Dermatology Clinic of Yozgat Bozok University. A control group was formed of 36 healthy children.

Statistical Analysis Used:
Kolmogorov-Smirnov normality test, Mann-Whitney U test and Pearson's and Fisher's Chi-square tests and Spearman's correlation test.

Results:
Evaluation was made of a total of 68 subjects (32 patients, 36 healthy subjects). The Difficulties in Emotion Regulation Scale (DERS)-total score and the DERS-clarity subscore were statistically significantly higher in the control group than in the patient group (P = 0.021, P = 0.003, respectively). No significant difference was determined between the two groups in respect of anxiety levels. No correlation was determined between disease severity and the scales. It was determined that as disease duration increased, so the DERS-non-acceptance subscale score increased, and with an increase in age, the SAI score of the AA patients increased. The DERS-impulse subscale score was seen to be statistically significantly higher in the boys with AA than in girls (P = 0.030).

Conclusions:
The results of this study showed that a visible, chronic, recurrent disease such as AA is not always seen with high psychiatric comorbidity and that together with the presence of the disease, patient age and disease duration are also important. It can be considered that AA may have been affected by the location, time and conditions of the study.
Use of Complementary and Alternative Medicine among Patients with Acne Vulgaris and Factors Perceived to Trigger the Disease
Authors: Kayıran Melek Aslan , Karadağ Ayşe Serap , Alyamaç Gökçen , Cemil Bengü Çevirgen , Demirseren Düriye Deniz , Demircan Yuhanize Taş , Aksoy Hasan , Kılıç Sevilay , Yüksel Esma İnan , Kalkan Göknur , Aksaç Sema Elibüyük , Kutlu Ömer , Kakşi Sümeyye Altıntaş , Aktürk Aysun Şikar , Solak Sezgi Sarıkaya , Yazıcı Serkan , Özden Hatice Kaya , Koska Mahmut Can , Uzunçakmak Tuğba Kevser , Ataseven Arzu , Işık Begüm , Alpsoy Erkan 
Published: September 2022

Background:
Acne vulgaris (AV) is among the common skin diseases for which patients refer to complementary and alternative medicine (CAM).

Aims and Objectives:
To investigate the approaches to CAM methods and factors believed to increase the disease in 1,571 AV patients.

Materials and Methods:
The sociodemographic characteristics of the patients and disease severity according to the Food and Drug Administration criteria were recorded. The Cardiff Acne Disability Index (CADI) was used to assess the impact of acne on the patient's life and the history of CAM use was noted. The patients also listed the factors that they thought worsened their disease and reported their gluten-free diet experiences.

Results:
Of all the patients, 74.41% had a history of using CAM methods. CAM use was significantly higher in women, patients with severe AV, those with a higher CADI score and non-smokers. As a CAM method, 66.37% of the patients reported having used lemon juice. The respondents most frequently applied CAM methods before consulting a physician (43.94%), for a duration of 0–2 weeks (38.97%). They learned about CAM methods on the internet (56.24%) and considered CAM methods to be natural (41.86%). The patients thought that food (78.55%) and stress (17.06%) worsened their disease. They considered that the most common type of food that exacerbated their symptoms was junk food (63.84%) and a gluten-free diet did not provide any benefit in relieving AV (50%).

Conclusion:
Physicians need to ask patients about their CAM use in order to be able to guide them appropriately concerning treatments and applications with a high level of evidence.
Efficacy, Safety and Quality of Life of Oxybutynin versus Aluminum Chloride Hexahydrate in Treating Primary Palmar Hyperhidrosis
Authors: Attallah Heba Shawky , El-Gilany Abdel-Hady , Youssef Youssef EL Bayoumy , Abdelshaheed Mohamed Elsaid , Sharaf Elshahat Farag Ahmed 
Published: September 2022

Background:
Palmar hyperhidrosis is characterized by excessive sweating beyond the physiological needs of the patient's body and the most frequent form is primary or essential. Different treatments protocols have been proposed to control or decrease sweating.

Aims and Objectives:
This study aimed to compare the efficacy and safety of oral oxybutynin versus topical aluminum chloride hexahydrate (ACH) in treating primary palmar hyperhidrosis. Also, to assess quality of life (QOL) as a measure of improvement of hyperhidrosis state.

Materials and Methods:
Patients were randomized using the block randomization with sealed envelope method into two treatment groups; oral oxybutynin group and topical ACH group. Hyperhidrosis Disease Severity Scale (HDSS) was used as a primary outcome measure to assess the efficacy of the drug in both groups. Clinical grading and the QOL were used as secondary outcome measures. The safety was evaluated by recording side effects in the follow-up visits.

Results:
HDSS, clinical grading and QOL score showed a statistically significant improvement in the oral oxybutynin groups. One week after stoppage of treatment, the symptoms recurred again in both groups with return of HDSS and QOL scores to pretreatment levels. The most common side effects were dry mouth (65.8%) and itching (65.0%) for oral oxybutynin group and topical ACH group; respectively.

Conclusion:
Treatment of primary palmar hyperhidrosis with oxybutynin is a good initial alternative for treatment given that it gives better results and much more improvement in QOL when compared to topical ACH. QOL questionnaire and clinical grading should also be considered as useful tools in the assessment of response to treatment.
Standard Patch Test Results and Clinical Relevance
Authors: Bilgic Aslı , Bozca Burcin Cansu , Subası Gülbin Yaşar , Dicle Özlem , Uzun Soner , Yılmaz Ertan , Alpsoy Erkan , Akman-Karakas Ayşe 
Published: September 2022

Background:
Allergic contact dermatitis (ACD) is a type IV hypersensitivity reaction, and The European Standard Series (ESS) Patch Test (PT) is widely used in determining the possible responsible allergens causing ACD. The dynamic nature of the industrial products, socioeconomic and environmental factors cause the frequency of common allergens to change over the years and among different regions.

Aims and Objectives:
This study aimed to retrospectively evaluate the results of ESS PT of our centre in the last decade, and determine the current spectrum of allergens and their clinical relevance.

Materials and Methods:
The data of patients who underwent ESS PT in our clinic between January 2010 and March 2020 were included in the study. The patient files were examined retrospectively. The clinical relevance was evaluated according to the COADEX system. Statistical analysis used: SPSS for Windows version 23.0 software program.

Results:
The data of 1037 patients [623 (60.1%) female, 414 (39.9%) male] were analysed. The mean age was 38.34 ± 14.55 years. The five most common allergens were nickel sulphate (23.1%), cobalt chloride (12%), potassium dichromate (9.5%), Fragrance mix II (7.3%) and balsam of Peru (5.7%). According to the COADEX coding system, current relevance was detected in 319 (49.3%) of 646 patients who had a positive reaction to any substance in the patch test.

Conclusion:
Our study showed that with increasing awareness in society, the tendency to avoid some well-known allergenic substances and consumer products causes changes in common allergens. These results prove the value of long-term surveillance of contact allergy.
CD68 expression in the placenta of gestational diabetic mothers: A case–control study
Authors: Gosain Ratna , Motwani Rohini , Anupama Hari 
Published: September 2022

ABSTRACT

Background:
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy and is the most common metabolic complication of pregnancy. Significant maternal and fetal complications can result from undiagnosed or inadequately treated GDM. Aim: To investigate the difference in the expression of the CD-68 marker in the Hofbauer cells (HCs) and their distribution within the villi in the placentas of diabetic and non-diabetic mothers.

Materials and Methods:
Sixty placentas were included in the study, 30 as controls and 30 from mothers with diagnosed GDM as cases. Full-thickness cross sections of placentas were obtained. Tissue processing was done, followed by haematoxylin and eosin (H&E). A study of CD68 markers (placental macrophages) was done using standard protocols of immunohistochemistry.

Statistical Analysis:
Frequencies and percentages of Hofbauer cells (HCs) found in case and control placental tissue were calculated. Student’s t-test was used to compare two groups using SPSS 13.0 software. When P is 0.0001, differences were considered statistically significant.

Results and Conclusion:
We studied the distribution and number of fetal macrophages (CD68+) in diabetic and non-diabetic placentas. The immunostained CD68+ cell count was identified to be significantly higher in the GDM placenta. In relation to fetal blood vessels in the villus stroma of the GDM placenta in comparison to control, CD68+ cells were found more frequently. This study shows a significant increase in the number of Hofbauer cells in the placenta of mothers with GDM in comparison to control (P < 0.0001). An increase in macrophages in these placentae might be related to the protective mechanism against inflammation. Further studies are required to investigate the mechanism in detail.
Comparison of Effects of Honey and 0.1% Triamcinolone Acetonide in the Management of Recurrent Aphthous Stomatitis - A Randomised, Single-Blind Study
Authors: Mhapuskar Amit A. , Thakare Shweta , Kale Isha P. , Karmarkar Pradnya , Hiremutt Darshan R Prasad , Jadhav Abhijeet 
Published: September 2022

Introduction:
Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease known to humans and are characterized by the development of painful, recurring solitary or multiple ulcers confined to the oral mucosa. RAS is often painful and worsens during drinking and talking.

Aim:
To evaluate and compare the effects of honey and 0.1% triamcinolone acetonide in patients with ulcers of recurrent aphthous stomatitis minor.

Materials and Methods:
Sixty patients having RAS minor were divided into two groups of 30 participants each by simple random sampling. Group A was treated with application of 0.5 ml of honey thrice a day for a week or until complete healing of the ulcer. Group B was treated with application of 5 g of 0.1% triamcinolone acetonide oral paste thrice a day for a week or until complete healing of the ulcer. For all the individuals, baseline parameters like the size of the ulcer, pain, and burning sensation were recorded on day 0, reassessment was done on day 4 and day 7, followed by statistical analysis.

Results:
The study showed that the reduction in the size of ulcers, VAS score for pain, and VAS score for burning sensation were similar in patients receiving honey as compared to patients receiving 0.1% triamcinolone acetonide. No adverse effects were reported in patients receiving honey, and there were mildly adverse reactions in some patients receiving 0.1% triamcinolone acetonide oral paste.

Conclusion:
Honey, a natural anti-inflammatory agent, seems to hold immense potential as an alternative medication for managing RAS minor ulcers. It has better patient compliance as compared to 0.1% triamcinolone acetonide.