bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proof-of-Principle for AVM Embolization Complications Caused by the Proximal Occlusion Technique Using Onyx
Authors: Zhang Huachen , Liang Shikai , Lv Xianli 
Published: September 2022

Abstract
To analyze the complications of the standard proximal plug technique in arteriovenous malformations (AVMs) embolization by Onyx and promote ante-grade drifting technique for AVM embolization. Seven publications reporting complications of AVM embolization by Onyx were identified and reviewed. Render descriptive statistics regarding causes of ischemic and hemorrhagic complications within 1 month following treatment were provided. A novel Onyx injection technique was proposed to overcome these problems. All reported transarterial Onyx AVM embolizations were conducted by employing the proximal plug technique. Causes of complications elicited by utilizing this strategy may generally be attributed to long-fluoroscopy and long-procedure times, embolisate reflux across a considerable extent of the vessel, catheter entrapment, extravasation of Onyx from the arterial lumen, catheter transgression through the arterial wall, the use of an Onyx volume exceeding, and venous occlusion preceding arterial feeder shutdown. Complications occurring during the course of attempts at embolizing AVMs utilizing Onyx constitute unfortunate causes of patient morbidity resulting from this conventional technique. We suggest that institution of a novel “ante-grade drifting technique” for Onyx injection may avoid these commonly elicited deficits. The proximal plug technique has a series of drawbacks that lead to serious adverse outcomes of AVM embolization. The Onyx embolization technology for AVM could be updated to improve clinical outcomes.
Occipital Interhemispheric Transtentorial Approach for Tumors of Posterior Third Ventricular Region
Authors: Sai Kiran Narayanam A. , Vidyasagar Kanneganti , Srinivasa Rakshith , Sivaraju Laxminadh , Raj Vivek , Furtado Sunil V. , Thakar Sumit , Aryan Saritha , Mohan Dilip , Hegde Alangar S. 
Published: September 2022

Abstract

Background:
Controversies exist regarding the ideal surgical approach for tumors in posterior third ventricular region (PTV).

Objective:
To evaluate the results of occipital interhemispheric transtentorial (OITT) approach for tumors in PTV.

Materials And Methods:
Thirty-three patients underwent surgery via OITT approach for PTV tumors at Sri Sathya Sai Institute of Higher Medical Sciences during the study period of 5 years (June 2011–May 2016). Ideal trajectory for OITT approach was determined by neuronavigation. Endoscope was used for removing any residual lesion at the blind spots.

Results:
Postoperative magnetic resonance imaging (MRI) performed in all the patients revealed gross total or near-total (>95%) excision of tumor in 31 patients (93.9%). Preoperative neurological deficits improved either completely or significantly following excision of the tumor in 73.3% (11/15) of the patients. Outcome was good (modified Rankin scale ≤2) at discharge in 93.9% (31/33) and at a final follow-up of 3 months or more in 96.8% (30/31) of the patients. None of the patients died during the postoperative period. Complications included upgaze palsy (transient- 6.1% [2/33], persisting- 3% [1/33]), visual field defects (transient- 3% [1/33], persisting- 3% [1/33]), transient third nerve paresis (1/33-3%), transient hemiparesis (1/33-3%), operative site hematoma (1/33-3%), small posterior cerebral artery (PCA) territory infarct (1/33-3%), and small venous infarct (1/33-3%). At least one follow-up MRI could be performed in 23 patients. Final follow-up MRI revealed no recurrence or increase in the size of the residual lesion compared to postoperative images in 20 patients (20/23-87%) and large recurrence in 3 patients (3/23-13%) with high-grade lesions.

Conclusion:
Gross total/near-total excision can be performed in majority of the PTV tumors through OITT approach with minimal morbidity and mortality.
Correlation of Preoperative Functional Magnetic Resonance Imaging (fMRI) with Intraoperative Cortical Stimulation in Surgeries of Eloquent Brain Lesions
Authors: Chawla Pawan , Misra Basant K , Udani Vrajesh , Desai Neelu , Gupta Santosh 
Published: September 2022

Abstract

Background:
Direct Cortical Stimulation (DCS) represents the gold standard for mapping of eloquent brain cortex. However, DCS is an invasive and time-consuming procedure. fMRI has become a useful tool to delineate motor and sensory eloquent cortex from the areas of planned neurosurgical resection. In our study, we will be studying the reliability of preoperative imaging when compared with the intraoperative DCS.

Objectives:
The aim of this study was to assess the reliability of fMRI by comparing it with DCS.

Methods and Materials:
Thirty patients with eloquent cortex lesions were admitted. Preoperative fMRI sequences were loaded into a neuro-navigational system. Intraoperative motor mapping was done by DCS. The location of all cortical stimulated points was correlated with the cortical functional structures. Based on it, specificity, sensitivity, positive predictive value, negative predictive value of fMRI was calculated. Preoperative and postoperative Karnofsky score and MRC grading was then noted.

Results:
Concordance between fMRI and DCS was noted in 26 cases. Overall mean sensitivity, specificity, positive and negative predictive value of fMRI as compared to DCS was 95%, 92.48%, 85.56%, and 96.08%, respectively. Preoperative and Postoperative Karnofsky score stayed same in most of the cases [25/30].

Conclusions:
DCS remains the gold standard for mapping eloquent cortex in-spite of its invasiveness, side effects such as seizures and cost concerns. Although fMRI cannot replace DCS, it can guide and increase the efficacy in resection, select high-risk patients for intraoperative monitoring, help in preoperative stratification of risk counseling and preservation of neurological status in eloquent brain lesions.
Temporal Lobe Encephalocele with Epilepsy in A Young Female
Authors: Thottiyil Jasica J , Prasad Arun , Dutta Durllav J , Anand Rajeev , Panikar Sujith A N S , Nadarajah Jeyaseelan , George Sabin 
Published: September 2022

Abstract
Idiopathic intracranial hypertension (IIH) is typically described in a middle-aged female and present with symptoms of headache, transient visual obscuration, photophobia, diplopia, rarely with pulsatile tinnitus. Seizure as a sole manifestation is very rare. Here we present a case of a young non-obese female with epilepsy, and imaging revealed temporal lobe encephalocele with typical imaging features of IIH. She underwent further workup, which confirmed the diagnosis of idiopathic intracranial hypertension.
Evaluation of Progesterone Receptor Antagonist and Maxi-K Channel Agonist as Neuroprotective in Feeney's Weight Drop Model of TBI
Authors: Kumar-M Praveen , Rajput Rohit , Ralta Arti , Quintans-Júnior Lucindo J , Gutierrez Stanley J C. , Barbosa-Filho Jose Maria , Shekhawat Devendra , Radotra B D , Gupta S K , Medhi Bikash 
Published: September 2022

Abstract

Background:
Neuroprotection in traumatic brain injury (TBI) is an unmet medical need.

Objective:
We evaluated two agents, aglepristone (progesterone receptor antagonist) and N-salicyloyltryptamine (STP) (activator of Maxi-K channel in GH3 cells), for neuroprotection in Feeney's weight drop model of TBI.

Material and Methods:
Forty-eight male Wistar rats were divided into six groups (n = 8 per group). A battery of six neurobehavioral tests was evaluated at the end of the first week (EO1W), second week (EO2W), and third week (EO3W). In addition, histopathological and immunohistochemistry (BAX, Bcl-2, and M30 Cytodeath) tests were performed at EO3W.

Results:
Aglepristone at 10 mg/kg showed significant neuroprotection compared to control as assessed by Rota-rod test at EO1W, VEFP right paw and 28-point neurobehavioral test at EO2W, MWM test at EO3W, and positive histopathological and IHC findings. Aglepristone at 20 mg/kg showed negative results as assessed by BAX expression, downregulation of Bcl-2, and positive M30 Cytodeath, thereby suggesting toxicity at higher doses. STP 100 mg/kg showed modest neuroprotective activity but failed to show a dose-response relationship at a dose of 50 mg/kg.

Conclusion:
The study shows that progesterone receptor antagonists have neuroprotection at lower doses and toxicity at higher doses.
Gender Differences in Perceived Stress among Neurosurgeons
Authors: Jagetia Anita , Vaitheeswaran Krishna , Mahajan Mahesh , Dholakia Binita , Devi B Indira 
Published: September 2022

Abstract

Purpose:
Surgeons are subjected to enhanced levels of work-related stress and women are likely to face unique challenges due to sub-optimal representation. The present study was conceived with a primary objective to study the gender differences faced by surgeons and neurosurgeons in particular. The secondary objective was to assess the correlation between the various stress inducers and busters of normal working and daily life and the mental state of neurosurgeons.

Methods:
The study was a cross-sectional, multi-centric study in which a structured questionnaire was sent to neurosurgeons through various neurosurgical forums of the country. A total of 93 complete responses were included in the study. The questions were broadly divided into four themes, demographic working data, stress inducers, stress busters, and questions to reflect the mental state of the respondent.

Results:
There were 74 males and 19 females in the study, with an average age of 39.34 ± 8.57 years. Statistically significant gender differences were noted in rating the out-patient department (OPD) hours, lectures and seminars, performing and assisting surgeries, attending conferences and working in the intensive care unit (ICU), with women scoring lower than men for these activities. There were no significant gender differences in the mental state of the respondents. A strong correlation was found between scoring for performance and assisting of surgery and the mental state questions, and a strong negative correlation was noted between music, playing games, going to the gym, practicing yoga and the mental state questions, indicative of a protective effect.

Conclusions:
There was no significant gender differences in the perceived stress levels among neurosurgeons. Women appeared more comfortable with certain normal activities of working. A strong negative correlation was reported for activities such as music, playing games, yoga, and going to the gym, indicating a protective effect.
Comparison of Periodic in-Person and Remote Visits via Smartphone Applications during COVID-19 Pandemic in Clinical Follow-up of Range of Motion in Patients with Distal Radius Fracture
Authors: Sabbaghzadeh Amir , Bonakdar Sona , Khoshkholghsima Maryam , Moshirpour Melina , Gorji Mona , Gholipour Morteza 
Published: September 2022

Background:
Wrist function has a significant impact on quality of life, which is why restoring normal wrist movement after surgery is so important. Due to the COVID-19 pandemic, and the restrictions imposed on “face-to-face” visits, using smartphones has become more important in tracking patients. The main purpose of this study was to determine the accuracy of telemedicine in following up patients who had undergone distal radius fracture operation.

Materials and Methods:
From February to October 2020, 126 patients between 20 and 60 years old were randomly selected at our orthopedic trauma center. All patients were visited in person by an orthopedic surgeon in the morning (control group) and again all of them were visited online via smartphone in the evening by another orthopedic surgeon (case group). Both visits were done at regular intervals in the 2nd, 6th, and 12th weeks after surgery. Patients were evaluated for extremity function outcomes and joint range of motion.

Results:
The two groups were similar in terms of mean Patient-Rated Wrist Evaluation score and Disabilities of the Arm, Shoulder, and Hand score and did not show a statistically significant difference (P < 0.05). There was no significant difference in wrist range of motion measurements between the two groups (in-person visits and smartphone visits) during the follow-ups (P > 0.05).

Conclusion:
Changes in wrist range of motion after surgery can be assessed with high accuracy using smartphone applications and this method can be considered as a proper alternative to frequent in-person visits to evaluate postsurgical wrist condition.
Intoxication-Related Deaths in a Poisoning Center in Isfahan
Authors: Dorooshi Gholamali , Meamar Rokhsareh , Kalantar Kamran , Amini Zahra 
Published: September 2022

Background:
The aim of this study was to investigate the frequency of poisoning mortality in the 5-year period of 2014–2019 in Isfahan Khorshid Hospital, Iran.

Materials and Methods:
This study is a cross-sectional descriptive analytical study, which was performed in 2020. The demographic and clinical data about the patients were extracted from the patients’ files and were then analyzed.

Results:
The number of deaths due to poisoning in the study period was 264, and the mean age of the deceased was 42.33 ± 20.097. One hundred and ninety-three (73.1%) patients were male. The frequency of deaths in the poisoning ward was 0.84%. The causes of death were accidental overdose (73, 26.9%), suicide (155, 63.2%), accidental use (18, 7.3%), and homicide in one patient. The mean age, time between exposure of toxin until death and history of addiction, substance use, and suicide in men patients was significantly higher than women (P < 0.05), however, such significant results were observed in married when compared with single patients. The differences between the two genders based on the type of toxic substance were statistically significant (P < 0.001). The most common causes of death were pesticides poisoning (n = 121), especially paraquat (n = 48) and Aluminum phosphide (n = 45), and multidrug poisoning (n = 48).

Conclusion:
In this study, we showed that the death rate due to poisoning in our center was lower than other centers. The highest number of poisoning was in men as well as married patients. It is also recommended that more serious educational and preventive strategies should be used in this regard.
Evaluation of the association between nasopharyngeal depth and respiratory complications after cleft palate surgery in children between 9 and 18 months old
Authors: Shahhosseini Sedighe , Shafa Amir , Saadati Mohammadali , Omid Mohammad , Memarzadeh Mehrdad , Montasery Mohammad 
Published: September 2022

Abstract

Background:
Considering the incidence of respiratory complications after cleft lip and palate surgery and its significance in the survival of children undergoing the mentioned surgery, the present study was performed to evaluate the association between the nasopharyngeal depth and the incidence of respiratory complications after cleft palate surgery.

Materials and Methods:
The present cross-sectional study was performed on 222 children who aged 9–18 months and were the candidates for cleft palate surgery. After performing general anesthesia and implanting mouth gag and before surgery, the nasopharyngeal depth and the cleft palate width were measured with a calibrated ruler and an ophthalmic caliper, respectively. At the end of the surgery and after extubation, the incidence of respiratory complications such as respiratory distress, laryngospasm, bronchospasm, and need for intubation was recorded.

Results:
The nasopharyngeal depth in children with respiratory complications with a mean of 7.57 ± 3.12 mm was significantly less than that of children without respiratory complications with a mean of 10.82 ± 2.14 mm (P < 0.001). The nasopharyngeal depth of ≤8 mm with a sensitivity of 80% and a specificity of 89.60% had a significant predictive value in the incidence of respiratory complications (P < 0.001).

Conclusion:
According to the results of the present study, it seems that the nasopharyngeal depth of ≤8 mm can make the incidence of respiratory complications more likely. Therefore, considering the simplicity and convenience of measuring the nasopharyngeal depth and the cleft palate width, it is suggested to perform further studies to evaluate the anatomy of palate before this surgery using the employed method and address its association with respiratory complications.
How to Predict the Diagnosis of Cutaneous Leishmaniasis in a Non-Endemic Region
Authors: Altinel Yuksel , Tas Betul 
Published: September 2022

Background:
Cutaneous leishmaniasis (CL) is a parasitic infection transmitted by the female sandfly, which has limited knowledge in non-endemic areas.

Aims:
To predict the epidemiological and clinical characteristics of CL cases on treatment during the period of Syrian refugees’ settlement.

Methods and Material:
The epidemiological and clinical data of 81 patients with CL who were admitted to the Istanbul Bagcilar Research and Training Hospital between March 2010 and April 2017 were conducted as a retrospective cohort study. A logistic regression analysis was performed.

Results:
Most detected demographics were Syrians (n = 56, 69.1%), ages <= 18 (n = 37, 45.7%), males (n = 49, 60.5%), elementary-school graduates (n = 35, 43.2%), and $500–750 income (n = 42, 51.9%). Most detected clinical characteristics were head/neck location (n = 38, 46.9%), acute-dry localized type (n = 71, 88%), crusted-papule (n = 79, 97.5%), and two lesions (n = 29, 35.8%). Means for age, family population, and session were 25.28 ± 20.90, 7.04 ± 2.03, and 11.27 ± 3.52, respectively. Majority of patients were admitted in 2014 and June. Significant factors by age were location, lesion type/number, and disease-duration. Lesion number ≥10, ages ≥41, crusted-nodule, cicatrix, and dissemination increased in session numbers, whereas crusted-nodule showed significant predictivity (P = 0.01).

Conclusion:
Location, lesion type/number, and disease duration may change by age in CL cases, whereas the presence of a crusted nodule may have a predictive effect on the number of treatment sessions.
Hemostatic and Coagulation Profile in Psoriasis
Authors: Mir Mubashar M , Dogra Devraj , Koul Kuldeep K 
Published: September 2022

Context:
Psoriasis is a chronic inflammatory dermatosis associated with an increased risk of cardiovascular disease and atherothrombosis.

Aims:
This study was conducted to assess the levels of various hemostatic and coagulation parameters in psoriasis and their correlation with disease severity.

Settings and Design:
This was a hospital-based observational study.

Methods and Material:
Seventy-five patients with psoriasis and seventy controls were included in the study. History taking, clinical examination, and calculation of Psoriasis Area and Severity Index (PASI) were done. Blood analysis for Platelet count (PC), mean platelet volume (MPV), Vitamin B12, Thrombin Time (TT), Prothrombin time (PT) and Activated partial thromboplastin time (APPT) were done in both groups.

Results:
MPV which is a marker of inflammation and platelet activation was significantly increased in cases and positively correlated with the disease severity. Vitamin B12 is an important cofactor in homocysteine (Hcy) metabolism and correlates inversely with serum Hcy which is a known atherothrombotic marker. Vitamin B12 levels were significantly decreased in the cases with a significant negative correlation between Vitamin B12 level and PASI. There was also a significant decrease in serum level of PT, aPTT and TT in cases as compared to controls; however they showed no significant correlation with PASI.

Conclusions:
Inflammation in psoriasis may drive the process of abnormal platelet activation and coagulation abnormalities thus predisposing psoriatic patients to an atherothrombotic state and increasing the cardiovascular risk in psoriatic patients.
Predictors of Quality of Life in Adults and Adolescents with Acne
Authors: Yıldırım Fatmaelif , Mert Başak , Çağatay Enis Yilmaz , Aksoy Berna 
Published: September 2022

Background:
Acne is becoming more prevalent in adults, particularly women across the globe. Although previous studies have compared clinical and epidemiologic characteristics of adolescent and adult acne, an adequate understanding of the quality of life (QoL) of adult acne patients and associated comorbidities are still lacking.

Objectives:
We sought to compare the differences between adolescent and adult patient groups, regarding gender, socio-clinico-demographic factors, and comorbid associations, as well as their relatedness with life quality.

Methods:
This is a cross-sectional study with 1013 acne patients. Data on the severity, onset and location of acne, sex, family history of acne, smoking and alcohol habits, medication history, presence of seborrhea, and other comorbidities were collected. We employed the classification used by the American Academy of Dermatology for assessing acne severity. To assess the QoL in the patients, the Dermatology Life Quality Index (DLQI) score was used.

Results:
Of the 1013 patients included in this study; 380 (female: 333, male: 47) were adult, and 633 (female: 535 and male: 98) were adolescent cases. The median total DLQI scores of adult and adolescent groups were not significantly different. Our results showed that factors such as age, gender, duration, body mass index, family history, and psychiatric disorders exhibited no impact on QoL in both adolescents and adults. Age of onset was correlated with DLQI scores in the adult group. The main influencers of DLQI in the adult group were allergic disorders, hormonal imbalances, and previous treatment history. Besides, major influencers in adolescent patients were acne severity, acne location, hirsutism, hyperseborrhea, premenstrual exacerbation, menstrual irregularities, previous treatment history, and smoking.

Conclusions:
The findings of our current study have shown that DLQI has been influenced by different factors in adolescents and adults that should be kept in mind.