bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unveiling mental health perspectives: Insights from key stakeholders including primary healthcare providers in a tribal District of Gujarat
Authors: Nagar Shashwat , Patel Hirenkumar B. , Nagar Noopur , Gamit Gaurangi , Godara Naresh 
Published: February 2025

ABSTRACT

Context:
Mental disorders impact over 25% of people worldwide, with a prevalence of 14.9% in India, higher in rural (17.1%) than urban (12.7%) areas. Effective treatment is limited, particularly in low- and middle-income countries. Integrating mental health into primary care and understanding stakeholder knowledge gaps are essential to improving services and reducing stigma.

Objectives:
This study qualitatively assessed the perspectives of primary healthcare providers and key stakeholders, such as PRI members, regarding common mental disorders in tribal and remote areas.

Materials and Methods:
Fourteen in-depth interviews were conducted with primary care physicians, private practitioners, and PRI members, following written consent for audio recording. Two talukas were randomly selected, and two PHCs from each were chosen for data collection. Content analysis was used to identify themes and codes from the interview transcripts.

Results:
Interviews revealed varied perspectives on mental health. PRI members demonstrated limited understanding, often attributing mental disorders to supernatural causes or stress, and preferred traditional healers. They recommended increased involvement of NGOs and enhanced awareness. Primary care providers highlighted the need for better training, mental health OPDs, and improved access to treatment and medications, noting shortages in government facilities.

Conclusions:
Key themes included limited mental health knowledge, reliance on faith healers, and a need for enhanced training and awareness. Recommendations include improving mental health education, establishing dedicated clinics, increasing professional availability in rural areas, and shifting community attitudes through awareness campaigns and local volunteer training. Effective implementation requires robust government support and NGO collaboration.
Evaluating the causes associated with false positive Galactomannan assay in suspected cases of respiratory fungal infections
Authors: Garg Parul , Suyal Shipra , Deepak Desh , Hembrom Sneha , Chauhan Ankit K. , Kaur Nirmalajit , Malhotra Shalini 
Published: February 2025

ABSTRACT

Introduction:
The circulating GM antigen is considered an important and reliable biomarker according to the European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSG) guidelines. However several possible causes of false-positive reactions have been reported, including intake of certain antibiotics, cross-reactivity with other fungi (e.g. Histoplasma capsulatum, Alternaria spp., Candida spp, and Fusarium spp etc), food (Carba beans and fava beans) and food supplements. In this context, the occurrence of false-positive results may lead to an unjustified invasive investigation and anti-fungal therapy.

Purpose:
The study was conducted to analyse of causal association of false positive galactomannan factors.

Material and Methods:
BAL samples from suspected respiratory tract infections were submitted for direct microscopic examination, GM detection and fungal culture.

Results:
Out of a total of 530 patients, 70 patients were in the case group (False positive GM) and 50 were in the control group (True positive). The average GMI of the case group was 2(1-4.2). and control group was 1.8(1-3.5). At a cut-off index of >1 false positive galactomannan results were observed maximum in patients who received Amoxiclav(48.5%), Piperacillin-tazobactam(33.3%), Amoxicillin(12.5%) followed by Meropenem(8.3%). The results showed a significant association(p-value <0.001) with false positive GM.. Other fungal agent colonization also had a higher GM index in the BAL sample but it is difficult to comment on association as the odds ratio was low (0.187). The odds were also lower (0.167) in dietary history to get false positive results and similarly with those on dietary supplements, but in contrast to these findings it was seen that the odd ratio was higher in patients suffering from tuberculosis(3.777) which can be attributed to increased colonization of aspergillus in TB patients.

Conclusion:
Galactomannan is the key biomarker of whether to start antifungal therapy for patients with IA and a higher mortality risk. Test results should be critically interpreted in the clinical context concerning potential causes of false-positive findings, especially with concomitant Piperacillin-tazobactam and amoxiclav use, other fungal infections and dietary history to prevent unnecessary antimycotic treatment.
Evaluation of different concentration techniques for microscopic diagnosis of protozoa and helminths in stool samples of children
Authors: Agarwal Krati , Mishra Shailja , Singh Parul , Sharma Rahul , Rukadikar Atul R , Hada Vivek , Mohanty Aroop 
Published: February 2025

ABSTRACT

Introduction:
Intestinal parasitic infections (IPIs) are prevalent among children in developing countries, particularly in tropical and subtropical regions. These infections significantly impact physical and intellectual development and exacerbate nutritional deficiencies in early childhood.

Materials and Methods:
This hospital-based cross-sectional study, conducted at AIIMS, Gorakhpur, from July to December 2023, involved 110 children aged six months to five years with diarrhea. The study compared the diagnostic performance of routine wet mount examination and stool concentration techniques (Formol-Ether Acetate Concentration [FAC] and Formal-Ether Concentration [FEC]) for identifying intestinal parasites.

Result:
FAC detected parasites in 75% of cases, FEC in 62%, and wet mount in 41%. Protozoan infections were predominant, with Blastocystis hominis, Entamoeba coli, Entamoeba histolytica, and Giardia lamblia being the most common. Dual infections were better detected by concentration methods.

Conclusion:
The study highlighted the higher sensitivity of FAC over FEC and wet mount techniques. Environmental, socioeconomic, and geographical factors influenced the prevalence and distribution of IPIs. The study emphasizes the need for improved public health measures, including health education, safe water, and sanitation facilities. The formol–ether acetate concentration technique is recommended for its higher recovery rate, safety, and feasibility in rural settings, requiring minimal infrastructure.
The association between sociodemographic characteristics and knowledge about oral cancer in the Western Region of Saudi Arabia
Authors: Merdad Mazin , Alqutub Abdulsalam , Alharbi Abdullah F. , Nujoom Mohammed A. , Ali Kanawi Hala M. , Awadh Mohammed , Aljehani Zuhair H. , AlSharif Sarah M. , Alqutub Taher 
Published: February 2025

ABSTRACT

Background:
Oral cancer (OC) is the third most common malignancy in Saudi Arabia, following leukemia and lymphoma. Early detection of this disease is impacted by knowledge of OC. This study aimed to evaluate public awareness of OC in the Western Region of Saudi Arabia and investigate how demographic background characteristics influence this knowledge.

Methods:
In this cross-sectional study, a web-based questionnaire was distributed in a random multistage pattern between September 2023 and December 2023. The questionnaire was designed to measure knowledge levels of OC. A logistic regression model was used with demographic background variables as independent variables and knowledge of OC as the dependent variable.

Results:
Of 389 participants, only half were aware of OC (52.4%). Most participants (56%) had poor knowledge of OC, 37.3% had a moderate level of knowledge, and only 6.7% had good knowledge about OC. On multivariate analysis, higher level of education [(odds ratio (OR = 1.53; 95% confidence interval (CI): 1.27–1.79; P < 0.0001)], higher salary (OR = 1.29; 95% CI: 1.08–1.49; P < 0.0001), and being a female (OR = 1.28; 95% CI: 1.09–1.46; P = 0.011), were positively associate with the general knowledge of OC.

Conclusion:
Nearly one in every two residents in the western region of Saudi Arabia has never heard of OC. Most of the participants had poor knowledge of OC. Socioeconomic factors, including income and educational level, were the most prominent factors affecting the general understanding of OC. Community-level educational programs focusing on high-risk groups could increase awareness about OC and improve public health.
Perception of medical students about family medicine in Karachi, Pakistan: Medical students’ perception about family medicine
Authors: Asad Munazza , Khan Unab I. , Arshad Anum 
Published: February 2025

ABSTRACT

Objectives:
To assess the perceptions of medical students about Family Medicine (FM) as a career choice and to examine if exposure to FM in undergraduate medical curriculum is associated with a positive perception of FM.

Study Design:
Cross-sectional study.

Place and Duration:
The study was conducted in four medical universities of Karachi out of which two were public and two were private sectors. From July 2021 to January 20 22.

Methodology:
The investigator administered a structured questionnaire in person to the participants. Quantitative data was collected, and descriptive statistics were computed. Association between exposure to FM and perceptions about FM was compared using Chi-squared test. A P value of < 0.05 was considered as significant.

Results:
A total of 300 students were included; 116 (38.7%) were male. The mean age of participants was 22.8 (±1.7) years. Most (79%) of the participants had a positive perception of FM. Exposure to FM in the undergraduate curriculum (UGC) played a significant role in improving perception, and 80.6% of exposed participants were found to have positive perception. However, there was no association between participants’ preference for choosing FM as their career and exposure to FM (not exposed: 35 (31%) vs. exposed: 52 (28%); P = 0.598).

Conclusion:
Our study highlights the significant impact that exposure to Family Medicine (FM) in undergraduate medical education has on students’ perceptions of the specialty. While this exposure generally fosters a positive view of FM, it does not translate into a strong inclination to pursue FM as a career. The primary deterrent identified is the perception of low remuneration associated with the specialty, which remains a critical factor in specialty choice. Addressing these financial concerns may be key to encouraging more students to consider Family Medicine as a viable and rewarding career path.
Myofascial Pain Syndrome: A Ultrasound-Guided Erector Spinae Plane Diagnostic Block Followed by Hydrodissection
Authors: Gyawali Hari Prasad , Das Gautam 
Published: February 2025

Abstract
Myofascial pain syndrome is a common cause of chronic pain affecting the daily activities of patients. Different modalities of treatment are being tried in those patients. Ultrasound-guided erector spinae plane (ESP) block has increasingly been used for the treatment of chronic pain. We present a case of a 65-year-old male treated with ESP diagnostic block followed by hydrodissection with 5% dextrose for myofascial pain of the trapezius.
The Power of Brain Waves: Applications of EEG in Chronic Pain Management
Authors: Thappa Priya , Arora Prateek , Kukanti Chandini , Dey Samarjit , Meshram Tanvi , Kumar Ashutosh 
Published: February 2025

Abstract
Chronic pain affects millions globally, profoundly impacting quality of life and posing significant challenges for healthcare providers. Traditional methods of pain assessment often fall short in capturing the full spectrum of this complex condition. The electroencephalogram (EEG) is a noninvasive tool for graphing the brain’s electrical activity. With the evolution of technology, the utility of EEG has been extended beyond the helms of neurological conditions. It offers a promising avenue for understanding and managing chronic pain. This review explores the basics of EEG, its utility in chronic pain assessment, and its potential applications in clinical practice.
Radiofrequency Ablation for Treatment of Symptomatic Bertolotti’s Syndrome II B
Authors: Yadav Rupesh Kumar , Thakur Jay Prakash , Amatya Shishir Prasad , Sherpa Tshering 
Published: February 2025

Abstract
Bertolotti’s syndrome is a congenital anomaly characterized by lumbosacral transitional vertebra with low back pain and radiculopathy. It has an incidence of 4%–8% in patients with low back pain. Conservative treatments such as medications and physiotherapy have limited success. Directed steroid injection, radiofrequency ablation (RFA), endoscopic resection, and surgical resection are recognized treatment methods. In this case, we used RFA on a medial branch of L3 and L4 in the L4/L5 facet joint. The patient had complete pain relief in subsequent follow-ups.
Severe Lumbar Canal Stenosis Treated with Caudal Epidural Steroid Injection
Authors: Nepal Niru , Das Gautam , Mahapatra Sunaina , Nanda Subhamay 
Published: February 2025

Abstract
Lumbar canal stenosis (LCS) is usually due to degenerative conditions in the older age group. Patients with LCS commonly present with low back pain, radiating leg pain, and neurogenic claudication. Treatment options for severe canal stenosis are mostly surgical but alternative treatment can be caudal epidural steroid in those individuals who refuse surgery. We present a case of 69-year-old male with a complaint of low back pain with neurogenic claudication, severe canal stenosis diagnosis was made after magnetic resonance imaging positive finding who underwent caudal epidural steroid injection. The patient came for follow-up after 2 months with much improvement in claudication and back pain. This case highlights the treatment outcome with caudal epidural steroid in severe LCS.
Advancing high-throughput anti-HCV drug screening: a novel dual-reporter HCV replicon model with real-time monitoring
Authors: Chitsombat Kanokwan , Chimnaronk Sarin , Sa-ngiamsuntorn Khanit , Chomnawang Mullika Traidej , Thirapanmethee Krit 
Published: February 2025

Background and purpose:
Hepatitis C virus (HCV) infection is a global health concern due to its substantial impact on morbidity and mortality. The burden of diseases related to HCV continues to escalate, particularly as infections progress to late-stage liver conditions, resulting in hepatocellular carcinoma on a global scale. Direct-acting antivirals effectively target HCV replication; however, their unreasonable costs and adverse effects emphasize the need for accessible and efficient therapeutic alternatives with minimal side effects. The primary aim of this study was to devise an HCV replicon system featuring a dual-reporter mechanism to facilitate high-throughput screening of potential novel antiviral agents.

Experimental approach:
The full-length HCV genome (pJFH1) was used to construct an HCV replicon system. The glycoprotein regions (E1 and E2) were substituted with a red fluorescent reporter, mCherry, enabling visualization of protein synthesis within the replicon. In addition, an adjacent green fluorescent reporter, dBroccoli, was strategically introduced in proximity to the NS5B stop codon to serve as a reliable indicator of HCV replication activity by monitoring the fluorescence signals.

Findings/Results:
The findings of this study unequivocally validated the effectiveness of the novel HCV replicon system for transfecting Huh-7 cells. Furthermore, the replicon system demonstrated a concentration-dependent response to anti-HCV pharmaceutical agents including telaprevir and sofosbuvir.

Conclusion and implications:
These compelling results underscored the potential utility of the proposed HCV replicon system as an innovative model for the expeditious high-throughput screening of prospective anti-HCV agents within a short timeframe.
Levator surgery with and without tarsectomy for correction of fair-function congenital ptosis: A randomized controlled trial
Authors: Diab Mostafa M. , Taha Taha A. Ashraf , Abdelsattar Nada K. 
Published: February 2025

Abstract

PURPOSE:
The purpose is to compare the functional and cosmetic outcomes of levator resection with tarsoconjunctival mullerectomy (LR plus) versus modified LR (mLR) for correcting congenital ptosis with fair levator function (LF; 4–7 mm).

METHODS:
In this prospective, randomized, controlled, double-blinded trial, 34 children (aged 6–12 years old) with unilateral congenital ptosis and fair LF were randomized to LR plus (n = 16) or mLR group B (n = 18). Margin-reflex distance 1 (MRD1), LF, lagophthalmos, corneal staining (Miyata grading), eyelid crease, contour, and eyelash angle were assessed postoperatively at 1, 3, 6, and 12 months. Outcomes were graded by an independent observer.

RESULTS:
Both groups demonstrated significant postoperative MRD1 improvements. In the LR plus group, MRD1 increased from 0.56 ± 1.09 mm to 3.44 ± 1.15 mm (P < 0.001), and while in the mLR group, it improved from 0.89 ± 1.18 mm to 4.06 ± 0.94 mm (P < 0.001), with no significant intergroup difference. The mLR group showed significantly greater LF improvement at all-time points (P < 0.001), with a 12-month LF of 11.28 ± 2.16 mm versus 7.38 ± 2.09 mm in the LR plus group. The mLR group had less lagophthalmos, corneal staining (early follow-up), and better eyelid contour at 3, 6, and 12 months. Eyelash ptosis was more frequently observed in the LR plus group. Complications occurred in 3 (18.8%) patients in the LR plus (including exposure keratopathy, recurrence, and suture-related corneal abrasion) and in 1 (5.6%) patient in the mLR group (overcorrection).

CONCLUSION:
Both LR plus and mLR are effective for the correction of congenital ptosis with fair LF. However, mLR yielded in greater LF improvement, less postoperative lagophthalmos and corneal complications, and better eyelid contour. Therefore, mLR may be the preferred surgical technique for this condition.
Immunological landscape of hepatic alveolar echinococcosis: A bibliometric analysis
Authors: Tulading Aliya , Wu Jing , Zhang Yun-Fei , Mamuti Alimujiang , Azhati Yilizhati , Lv Chun-Hui , Tuersunmaimaiti Abudusalamu , Tuxun Tuerhongjiang 
Published: February 2025

BACKGROUND
Hepatic alveolar echinococcosis (HAE) is a chronic parasitic disease caused by the larval stage of Echinococcus multilocularis . Although significant research has been conducted on the pathogenesis and immunological aspects of HAE, comprehensive bibliometric analyses in this area are still lacking. This study sought to fill this gap by systematically analyzing the immunological literature on HAE using bibliometric methods.
AIM
To identify research trends, key contributors, and emerging developments and offer insights to guide future research in this field.
METHODS
Research articles on HAE published between 1983 and 2023 were retrieved from the Web of Science Core Collection database. A total of 319 articles were selected for bibliometric analysis, which was conducted using the CiteSpace and VOSviewer software. The analysis focused on key variables such as publication volume, authors, journals, countries, references, and keywords.
RESULTS
The analysis revealed a significant increase in research on HAE over the past four decades, particularly after 1995. China and Switzerland emerged as the leading countries in terms of publication volume, with Bruno Gottstein and Vuitton DA identified as the most influential authors in this field. Key research areas include the interaction between the pathogen and the host immune system, as well as advances in disease diagnosis and treatment strategies. The keyword co-occurrence analysis highlighted the primary themes and identified emerging trends within the research landscape.
CONCLUSION
This study provides a comprehensive framework for understanding HAE immunology and highlights research hotspots, future directions, key contributors, and the importance of international cooperation.
Early plasmapheresis in type 2 benign recurrent intrahepatic cholestasis: A case report and review of literature
Authors: Heyerick Lander , Dhondt Annemieke , Van Vlierberghe Hans , Verhelst Xavier , Raevens Sarah , Geerts Anja 
Published: February 2025

BACKGROUND
Benign recurrent intrahepatic cholestasis (BRIC) is a rare autosomal recessive liver disease, causing episodic cholestasis with intense pruritus. This case report highlights the effectiveness of early plasmapheresis as a therapeutic option for BRIC type 2, offering rapid symptom relief and early termination of cholestatic episodes. It contributes to the limited evidence supporting plasmapheresis as a treatment for BRIC flares resistant to conventional therapies.
CASE SUMMARY
A 43-year-old male with BRIC type 2 presented with fatigue, jaundice, and severe pruritus, triggered by a recent mild severe acute respiratory syndrome coronavirus 2 infection. Laboratory results confirmed cholestasis with elevated bilirubin and alkaline phosphatase. First-line pharmacological treatments, including cholestyramine and rifampicin, failed. Endoscopic nasobiliary drainage was ineffective, prompting initiation of plasmapheresis. This intervention rapidly relieved pruritus, with complete biochemical normalisation after 11 sessions. Two years later, a similar episode occurred, and early reinitiation of plasmapheresis led to symptom resolution within two sessions and biochemical recovery within two weeks. The patient tolerated the procedure well, with no adverse effects observed. Follow-up showed no signs of cholestasis recurrence.
CONCLUSION
Plasmapheresis is a safe and effective option for therapy-refractory BRIC type 2, particularly when initiated early in cholestasis.
Thyroid hormone, immunoglobin and complements for predicting hepatocellular carcinoma development in patients with hepatitis B virus-related liver cirrhosis
Authors: Tong Xue-Cheng , Liu Kai , Huang Ze-Yu , Zhang Xiu-Jun , Xue Yuan 
Published: February 2025

BACKGROUND
Hepatocellular carcinoma (HCC) surveillance is crucial for patients with compensated cirrhosis (CC) and decompensated cirrhosis (DC). Increasing evidence has revealed a connection between thyroid hormone (TH) and HCC, although this relationship remains contentious. Complements and immunoglobulin (Ig), which serve as surrogates of cirrhosis-associated immune dysfunction, are associated with the severity and outcomes of liver cirrhosis (LC). To date, there is a lack of evidence supporting the recommendation of TH, Ig, and complement tests in patients at high risk of HCC.
AIM
To assess the predictive value of TH, Ig, and complements for HCC development.
METHODS
Data from 142 patients, comprising 72 patients with CC and 70 patients with DC, were analysed as a training set. Among them, 100 patients who underwent complement and Ig tests were considered for internal validation. Logistic regression was employed to identify independent risk factors for HCC development.
RESULTS
The median follow-up duration was 32 (24-37 months) months. The incidence of HCC was significantly higher in the DC group (16/70, 22.9%) compared to the CC group (3/72, 4.2%) (χ ² = 10.698, P < 0.01). Patients with DC exhibited lower total tetraiodothyronine (TT4), total triiodothyronine (TT3), free triiodothyronine, complement C3, and C4 (all P < 0.01), and higher IgA and IgG (both P < 0.01). In both CC and DC patients, TT3 and TT4 positively correlated with alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyl transpeptidase (GGT). IgG positively correlated with IgM, IgA, ALT, and AST, while it negatively correlated with C3 and C4. Multivariable analysis indicated that age, DC status, and GGT were independent risk factors for HCC development.
CONCLUSION
The predictive value of TH, Ig, and complements for HCC development is suboptimal. Age, DC, and GGT emerge as more significant factors during HCC surveillance in hepatitis B virus-related LC.