bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Ivermectin among COVID-19 patients: A Randomized Controlled Trial
Authors: Umar Muhammad , Shahid Rizwana , Khan Muhammad Mujeeb , Hayat Uzma , Nadar Ayesha , Afzal Sheema 
Published: October 2022

Objectives: To determine the effectiveness of Ivermectin among COVID-19 patients in terms of mortality and biochemical / hematological attributes.
Materials and Methods: A Randomized Controlled Trial (RCT) was carried out in Department of Infectious Diseases (DID) of Holy Family Hospital Rawalpindi during March 2021 through concurrent parallel study design. Apart from seeking Ethical approval for this research, DID was also licensed from Drug Regulatory Authority of Pakistan (DRAP) for this trial. Total 90 PCR positive COVID-19 patients were enrolled in this study via 1:1 randomization in experimental and control group without blinding. The control group received Standard of Care (SOC) starting from day 1 while experimental group was given SOC along with Ivermectin (200µg/kg) for 5 days. Study participants were assessed on day 0, 4, 7 and 10 for general symptoms through physical examination, blood oxygen saturation and diverse hematological and biochemical indicators in addition to adverse events. Data analysis was done by means of SPSS version 25.0. and Microsoft Excel 2010. Mean ± SD for age, length of hospital stay and time to PCR negativity were calculated. Independent sample t-test was applied to determine the mean difference in age, duration of hospital stay, time to PCR negativity, SpO2, oxygen supply, serum Hemoglobin, TLC, platelet count, Clinical Severity Score (CSS), urea and creatinine levels of both groups. The difference in secondary outcome (expiry / discharge) of both groups was compared by means of chi-square test. P-value ≤ 0.05 was considered significant. 95% Confidence Interval was also computed. Relative Risk (RR) was also measured to verify the effectiveness of Ivermectin in COVID patients
Results: Males constituted the majority (56.7%) of our study participants. Statistically insignificant difference in mean age (P = 0.42) and mean length of hospital stay (P= 0.32) between experimental and control group subjects was observed. Mean time to PCR negativity was reported to be significantly less (P= 0.002) in experimental group. Significant improvement was seen in PCR negativity (P<0.05), mean Clinical Severity Score (CSS) (P0.02), mean hemoglobin level (P=0.03) and mean platelet count (P=0.03). Difference in health outcome of both groups was determined to be statistically insignificant (P<0.2, 95% CI (-0.20 – 0.12)). Relative Risk of 0.8 proved the protective effect of Ivermectin in COVID.
Conclusion: Ivermectin was quite effective in reducing mortality and improving the health outcome in COVID-19 patients.
Conventional Cold steel and Modern technique BiZact LigaSure for tonsillectomy: A comparative analysis
Authors: Saleem Muhammad , Alamgir Ashar , Ali Syeda Jamila , Hyder Hafiz Sajjad , Bibi Sarwat , Tabassum Sumara 
Published: October 2022

Introduction:
One of the bulk number of operations carried out at otorhinolaryngology department across globe is Tonsillectomy. With the advent of refined surgical tools along with surgical approaches, the conventional methods are now taken over by these new interventions. The study aims to explore the use and advantages of BiZact LigaSure tonsillectomy as compared to the old conventional method.
Material & Methods:
A comparative study was conducted using non-probability purposive sampling technique at Aziz Fatimah Hospital, Faisalabad. 100 participants were divided in two groups. Group A (50 patients) underwent BiZact LigaSure tonsillectomy and Group B (50 patients) with conventional cold steel method. Per-operative variables such as Blood loss and Operative time and Post-operative variable such as Pain was assessed. The data was analyzed in SPSS 20 using independent t- test.
Results:
The mean age in group A and B was 12, 12 respectively. The blood loss calculated in Group A patients undergoing BiZact LigaSure tonsillectomy was 0.390.15 ml and in Group B 15.92.65 ml. The mean operation time in group A and B was calculated as 4.260.66 and 32.385.56. Both of these variables were recorded as highly significant as the P value = 0.000. Pain was assessed using the VAS pain scale. Post-operative pain variable was also recorded as highly significant variable.
Conclusion:
The study concludes that BiZact ligaSure tonsillectomy is more effective and safe procedure than the conventional cold steel method. This new intervention significantly reduces the blood loss during surgeries, operative time and post-operative pain.
Spectrum of Complications in Children with Moderate to Severe DKA Admitted in Pediatric Intensive Care Unit of a Tertiary Care Hospital
Authors: Aslam Ambreen , Sultana Nighat , Sarwar Muhammad , Jamil Anila , Kausar Fareeha , Waqar Umer 
Published: October 2022

Introduction: Diabetic Ketoacidosis (DKA) is the major source of mortality and morbidity in type 1 Diabetes Mellitus. Cautious fluid resuscitation, insulin and electrolyte replacement along with observation for complications is the mainstay of treatment. Early identification of complications lead to better management and outcome.
Objective: To find out the complications of moderate to severe DKA in pediatric patients admitted in Pediatric Intensive Care Unit (PICU).
Methods: Cross-sectional Study was conducted in PICU of University of Child Health Sciences & The Children’s Hospital, Lahore from Jan, 2015 to Dec, 2018.Data was collected from retrospective records of patients admitted in PICU. All patients with moderate/severe DKA were included. Patients with developmental delay were excluded. Data was analyzed using SPSS version 25. Chi-square test was used to find out p-value.
Results: A total of 152 patients with moderate/severe DKA were included in the study, having mean age of 7.86 ± 4.06 years. Most patients 42% (n=64) were more than 10 years of age. Mean weight of the children was 19.89 ± 8.70 kg. Majority 59% (n= 89) were of new onset diabetes. Severe DKA was seen in 74% while moderate DKA in 26% patients. The complications seen were: hypokalemia 33% (n=50), cerebral edema 28% (n=42), hypernatremia 18% (n=27), hyponatremia 8% (n=12) and acute kidney injury (AKI) in 7% (n=11). Survival rate was 85% while mortality rate was 15%.
Conclusion: Hypokalemia and cerebral edema were the most common complications observed. Complications were more common in those patients who presented with DKA in first presentation.
Key words: complications, DKA severity, children, PICU.
One-off and Repeating Fast Radio Bursts: A Statistical Analysis
Authors: Chen Hao-Yan , Gu Wei-Min , Sun Mouyuan , Yi Tuan 
Published: October 2022

Abstract
According to the number of detected bursts, fast radio bursts (FRBs) can be classified into two categories, i.e., one-off FRBs and repeating ones. We make a statistical comparison of these two categories based on the first FRB catalog of the Canadian Hydrogen Intensity Mapping Experiment Fast Radio Burst Project. Using the Anderson–Darling, Kolmogorov–Smirnov, and Energy statistic tests, we find significant statistical differences (p-value < 0.001) in the burst properties between the one-off FRBs and the repeating ones. More specifically, after controlling for distance, we find that the peak luminosities of one-off FRBs are, on average, higher than the repeating ones; the pulse temporal widths of repeating FRBs are, on average, longer than the one-off ones. The differences indicate that these two categories could have distinct physical origins. Moreover, we discuss the subpopulations of FRBs and provide statistical evidence to support the existence of subpopulations in one-off FRBs and in repeating ones.
Evaluation of risk factors and diseases associated with metabolic and atherosclerotic disorders in different abdominal fat distribution patterns assessed by CT-scan
Authors: Ehsanbakhsh Alireza , Abadi Javad Mohamadi Taze , Khorashadizadeh Nasrin , Darabi Azadeh 
Published: October 2022

Introduction: Obesity is defined as an increase in body fat composition.
Aim: The purpose of our study was to evaluate metabolic risk factors and diseases in different patterns of abdominal fat distribution.
Materials and methods: This is a cross-sectional study. Among patients aged 15 to 65 years who have had no significant weight loss in the past year and were referred to the Radiology Department to perform an abdominal CT-scan, the visceral and subcutaneous fat area (VFA and SFA) with Hounsfield units -30 to -190 (±2 SD) was calculated at the umbilical level. Based on the VFA and SFA, patients were stratified into four groups, group 1: V(+)S(+); group 2: V(+)S(-); group 3: V(−)S(+); group 4: V(−)S(−). The following parameters were assessed in the groups: anthropometric parameters including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist to hip ratio (WH); laboratory parameters, including fasting blood glucose (FBG), lipids profile (TG, LDH, LDL, and total cholesterol), creatinine, and liver enzymes (AST, ALT). Additionally, sensitivity, specificity, positive predictive value (PPV), and negative predictive value of study variables were assessed in predicting group 1.
Results: The study included 180 individuals (mean age 50±14 years, range 15-65 years). Group 1 was the most, and group 2 was the least prevalent pattern of abdominal fat distribution. Most females (75%) had high percentage of subcutaneous fat tissue. There was a significant association between the abdominal fat distribution pattern and BMI, WC, WHtR, TG, LDL, HDL, total cholesterol, FBG, diabetes, and metabolic syndrome (p&lt;0.05).
Conclusions: Most of the metabolic factors, including BMI, WC, lipid profile, and FBG, as well as metabolic syndrome, diabetes, and impaired glucose tolerance, were highly correlated with group 1. However, most of the individuals in group 1 were normal according to the factors mentioned above. Therefore, there is a gap between the main definition of obesity (increasing body fat mass) and parameters that calculated obesity and metabolic disorders.
THE GROWING ROLE OF THE BH3 MIMETIC DRUG VENETOCLAX IN THE THERAPY OF ACUTE MYELOID LEUKEMIA
Authors: Pelosi Elvira , Castelli Germana , Testa Ugo 
Published: October 2022

In spite recent progresses, acute myeloid leukemia (AML) remains a disease associated with poor prognosis, particularly in older AML patients unfit to tolerate intensive chemotherapy treatment. The development and introduction in therapy of the drug Venetoclax, a potent BH3 mimetic targeting the antiaopoptotic protein BCL-2, inducing apoptosis of leukemic cells, has shown to be a promising treatment for newly diagnosed, relapsed and refractory AML patients ineligible for induction chemotherapy. Combination treatments using Ventoclax and a hypomethylating agent (azacytidine or decitabine) or low-intensity chemotherapy have shown in newly diagnosed patients variable response rates, with highly responsive patients with NPM1, IDH1-IDH2, TET2 and RUNX1 mutations and with scarcely responsive patients with FLT3, TP53 and ASXL1 mutations, complex karyotypes and secondary AMLs. Patients with refractory/relapsing disease are less responsive to Venetoclax-based regimens.
However, in the majority of patients the responses have only a limited duration and development of resistance is frequently observed. Understanding mechanisms of resistance is of crucial importance for the development of new strategies and identification of rational drug combination regimens. In this context, two strategies seem to be promising: (i) triplet therapies based on the combined administration of Venetoclax, a hypomethylating agent (or low-dose chemotherapy) and an agent targeting a specific genetic alteration of leukemic cells (i.e., FLT3 inhibitors in FLT3-mutated AMLs) or an altered signaling pathway; (ii) combination therapies based on the administration of two BH3 mimetics (i.e., BCL-2 +MCL-1 mimetics) and a hypomethylating agent.
Diversity of coronaviruses in wild and domestic birds in Vietnam
Authors: Marchenko Vasily Y. , Kolosova Natalia P. , Danilenko Alexey V. , Bragina Maria K. , Nhai Tran Thi , Ryzhikov Alexander B. 
Published: October 2022

Objective:
To investigate the genetic diversity of coronaviruses in wild and domestic birds in the bird park and live poultry markets of Ca Mau province in Vietnam in 2020.

Methods:
A total of 228 samples (121 from wild birds and 107 from poultry) were collected in the territory of Ca Mau province of Vietnam in 2020. The avian samples were tested for the presence of the four genera of coronaviruses using reverse transcription and nested PCR. Molecular genetic analysis using targeted NGS sequencing of RdRp gene was performed for 29 representative samples (12 samples from wild birds and 17 from poultry). Phylogenetic analysis was performed using the neighbour joininig method with 1000 bootstrap replications using MEGA X software.

Results:
Among wild birds, 21.5% samples were positive for the genetic material of coronaviruses and 38.3% samples were positive for coronaviruses among poultry. Genetic analysis of the partial sequence of RdRp gene from representative samples revealed that wild birds were carriers of gammacoronaviruses and deltacoronaviruses. Among poultry, three genotypes of infectious bronchitis virus (QX, Mass and Q1) were detected in chickens, with QX genotypes being predominant, and viruses of DCoV group were detected in domestic ducks. There was no detection of alphacoronaviruses or betacoronaviruses in the studied birds.

Conclusions:
Coronaviruses of genera Gammacoronavirus and Deltacoronavirus were detected in wild birds. A high percentage of infectious bronchitis virus was detected in poultry. Thus, there is a need for broader surveillance of coronaviruses in birds, which can be used for evaluation of diversity, evolution and distribution of coronaviruses in Vietnam. Continuous surveillance of coronaviruses circulation in wild and domestic animals is necessary for implementing strategic measures for poultry and domestic animal protection and for evaluation of possible risk of circulating coronaviruses to human health.
The Pros and Cons of Using Elderberry (Sambucus nigra) for Prevention and Treatment of COVID-19
Authors: Asgary Sedigheh , Pouramini Alireza 
Published: October 2022

Background:
The novel severe acute respiratory syndrome coronavirus 2 emerged in 2019. Health-care systems around the world are looking for alternative prevention and treatment remedies. Herbal supplements are popular among consumers as a complementary method to prevent and treat illnesses. One of them is Sambucus nigra.

Methods:
We searched for related articles in Scopus, Web of Science, PubMed, Google Scholar, and the Directory of Open Access Journals using the following keywords: elderberry, S. nigra, and COVID-19.

Results:
Elderberry has antiviral properties due to its ability to modulate inflammatory cytokines. The current evidence suggests elderberry is appropriate for the prevention and initial treatment of viral disease. Concerns have been raised that elderberry may overstimulate the immune system, increasing the risk of a cytokine storm. There is not yet enough evidence to support this claim.

Conclusions:
For COVID-19 patients, further research is required since elderberry may provoke a cytokine storm if administered therapeutically.
Higher Dose of Dexmedetomidine Infusion Provides Better Oxygenation and Lung Mechanics in Obese Patients Undergoing Laparoscopic Cancer Surgeries
Authors: Hassan Mohamed Elsayed , Wadod Mohamed Alfattah 
Published: October 2022

Background:
As a result of the growing international prevalence of overweightness, following then, the proportion of obese people undergoing major surgery increased. Both obesity and laparoscopic cancer surgeries had physiological effect on the respiratory system. Various studies have shown that Dexmedetomidine improves both lung compliance and oxygenation. The goal of the work to compare the effect of two various doses of dexmedetomidine infusion intraoperative on the oxygenation and lung mechanics in obese underwent laparoscopic cancer surgeries.

Materials and Methods:
This randomized double-blinded, trial was performed on 70 cases who underwent laparoscopic pelviabdominal cancer surgery. Cases were categorized into 2 equal groups. Group A: was given 1 μg/kg body weight dexmedetomidine then 0.5 μg/kg/hour, and group B: received 0.5 μg/kg body weight then 0.3 μg/kg/hour. Dexmedetomidine was administered as a bolus following intubation, then infusion till the end of surgery. Arterial blood gases and lung mechanics were measured at baseline, 30, 60, 90,120 min, and end of surgery.

Results:
PaO2/FiO2 ratio at 90min, 120min, and the end of surgery and delta PaO2/FiO2 were significantly increased in group A than in group B (P = 0.045, 0.048, and 0.047, respectively). Dynamic compliance at 120 min and at end of surgery were significantly increased in group A in comparison to group B (P = 0.047 and 0.04, respectively).

Conclusions:
Dexmedetomidine at a higher dose provides better oxygenation, dynamic compliance, lower dead space in obese laparoscopic cancer patients.
Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
Authors: Nabi Umer Un , Rafi Asma , Maqbool Muzaffar , Shah Parvaiz Ahmad 
Published: October 2022

Background:
Inception of emergency medicine as a specialty in India is on a rise. Data on the accuracy of diagnosis made in emergency rooms in India is scarce and with varied results with especially no such data available from our part of the country.

Aim:
The aim of this study was to evaluate the discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and outcome. This study was an observational prospective study.

Materials and Methods:
Patients were categorised as per the International Classification of Diseases – Version 10. A total of 2000 patients were enrolled in the study. The patients were followed from admission to discharge. Data were categorised into two major groups – 'Concordant' diagnosis and 'Discordant' diagnosis. Univariate analysis was performed using SPSS version 20.0.

Results:
Five hundred and fifty-three (27.65%) patients had a final diagnosis in ward discordant from the initial diagnosis in the medical emergency room. The frequency of discrepancy was highest for the genitourinary system (39%) and relatively low for neoplasm (16%). The average length of hospital stay in the concordant group of patients was 5.15 days, whereas it was 7.05 days in the discordant group (P = 0.003). There was a statistically significant increase in percentage mortality in patients when initial and final diagnoses did not match (P = 0.0005).

Conclusions:
A diagnostic discrepancy of 27.65% occurred between admission diagnosis in the medical emergency room and final diagnosis in ward. The diagnostic discrepancy resulted in a significant increase in the length of hospital stay and mortality.
Study of changes in pre-existing against-the-rule astigmatism after temporal manual small-incision cataract surgery using frown, straight, and smile incisions
Authors: Soumya H V , Yadav Prashansa , Prabhakar S K 
Published: October 2022

Purpose:
To assess the change in the amount of astigmatism caused by frown, straight, and smile incision in patients with pre-existing against-the-rule (ATR) astigmatism of more than and equal to 1 diopter

Methods:
This is a prospective, comparative study conducted over 18 months on 60 patients. Twenty patients were allocated to each incision using simple random sampling. Demographic details, best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segment evaluation, and A-scan were done. An average of three measurements of K horizontal (Khavg), K vertical (Kvavg), and difference between the two (Khavg − Kvavg) were taken using manual keratometry. All surgeries were performed by a single surgeon. All the data analyses were performed by using IBM Statistical Package for the Social Sciences (SPSS) version 20 software. Frequency distribution and cross tabulation were performed to prepare the tables.

Results:
In frown incision, Khavg − Kvavg was significantly decreased on day 45 from the preoperative value (P < 0.001), followed by straight incision (P < 0.001), and smile incision (P < 0.001). Maximum decrease was observed in frown incision (49.15%) followed by straight (37.75%) and smile (28.57%) incisions.

Conclusion:
Our results are consistent with reduction of pre-existing ATR astigmatism with temporal incisions, and frown incision seems to be the best approach.
Long-term outcomes of small-incision cataract surgery in patients with uveitis
Authors: Bhargava Rahul , Pandey Kankambari , Mehta Bhavya 
Published: October 2022

Purpose:
To evaluate the long-term outcomes of manual small-incision cataract surgery (MSICS) in eyes with uveitis.

Methods:
Patients who underwent MSICS for uveitic cataract from 2009 to 2019 were retrospectively evaluated. Visually significant cataract and presence of less than five cells per high-power field in the anterior chamber for a minimum of 3 months were the prerequisites for surgery. Patients with follow-up less than 9 months were excluded.

Results:
After exclusion, 283 eyes of 264 patients were evaluated. The mean age of patients was 44.3 ± 11.3 years. The mean follow-up duration was 22 ± 11.5 months. The mean surgical time was 11.2 ± 3.2 min. One hundred and seventy-two eyes (60.8%) had anterior uveitis, 78 (27.5%) had posterior uveitis, and 33 (11.7%) had panuveitis. At the final follow-up, 253 eyes (88.4%) had corrected distance visual acuity (CDVA) better than 0.6 log of minimum angle of resolution (LogMAR) unit. The final endothelial cell counts were significantly (analysis of variance [ANOVA], P = 0.001) lower in eyes with human leukocyte antigen (HLA)-B27–associated uveitis and in eyes with idiopathic anterior uveitis. Patients on systemic corticosteroids had significantly better (P = 0.031) final visual acuity than those without preoperative corticosteroids. Recurrent uveitis (43.8%), Posterior capsule opacification (PCO) (19.4%), glaucoma (8.5%), cystoid macular edema (CME; 13.5%), and Epiretinal membrane (ERM) (5.6%) were the frequent complications. A significantly worse (ANOVA, P = 0.001) visual prognosis was seen in patients with Vogt–Koyanagi–Harada disease (VKH), sarcoidosis, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and serpiginous choroiditis.

Conclusion:
MSICS is safe in most cataracts due to uveitis and results in improvement in CDVA at 9 months. Posterior capsule opacification, macular edema, persistent uveitis, etiology of uveitis, and use of preoperative steroids significantly influenced the visual outcome.