bluuebunny/crossref_metadata_2025_split huggingface dataset:
Air Pollution and Cerebrovascular Disorders with Special Reference to Asia
Authors: Taimuri Bushra , Lakhani Sohail , Javed Maryam , Garg Divyani , Aggarwal Vasundhara , Mehndiratta Man Mohan , Wasay Mohammad 
Published: September 2022

Background:
Among the primary environmental issues affecting global health, air pollution is considered the leading cause of concern. Globally, around 800,000 deaths were attributed to air pollution according to WHO. Evidence suggests that there has been a strong association of air pollution with stroke. Approximately, 25% of stroke mortality was due to air pollution according to a study in 2013.

Objective:
The aim of this review was to analyze the association between stroke, intracerebral hemorrhage, and subarachnoid hemorrhage and air pollution and its burden globally with a special focus on South Asia along with its association with the COVID-19 pandemic.

Results:
There is growing research data linking air pollution to cardiovascular disorders including stroke. Short-term and long-term air pollution exposures have been shown to increase stroke incidence in epidemiological data. Air pollution, both gaseous and particle, show a strong and tight temporal relationship with stroke hospitalizations and death. The link between ICH and SAH to air pollution is less strong and less well studied as compared to ischemic stroke. Stroke and air pollution both are highly prevalent in South Asia. It is possible that the high prevalence of stroke in south Asia may be linked to the high frequency of air pollution in addition to other conventional risk factors. Decreased stroke admissions and mortality and reduced cardiovascular mortality reported during coronavirus disease 2019 (COVID) lockdown may be attributable to decreased levels of air pollution.

Conclusion:
Even though air pollution poses a significant threat to human health, a great number of countries still fail to achieve internationally agreed air quality standards. Air pollution should be recognized among the most significant controllable risk factors for cardiovascular and cerebrovascular disease prevention and treatment.
Access to pain medicines and follow-up consultation after radiofrequency ablation for trigeminal neuralgia during the COVID-19 pandemic
Authors: Ramaprasannakumar Shwethashri Kondavagilu , Karan Nupur , Pruthi Nupur , Kamath Sriganesh 
Published: September 2022

Background:
In the recent coronavirus disease 2019 (COVID-19) pandemic, follow-up of patients with trigeminal neuralgia post radio-frequency ablation (RFA) of the Gasserian ganglion was restricted because of closure of pain clinic services (PCSs) at our institution, travel restrictions, and fear of contracting COVID-19 infection by hospital visit. Periodic follow-ups are a must in this group of patients. Because the access to pain medications and consultations remained restricted, we tried identifying the factors predisposing to these difficulties in patients.

Methods:
We had contacted patients telephonically, who underwent RFA at our institution in the past 5 years as the PCS had not re-started to follow up with in-person consultation. Demographics, socio-economic factors, clinical factors, literacy status, distance to the health care system, and current health status were noted. Collected data were analyzed descriptively, and correlations were calculated between the predictors for difficulty in follow-up to access the medications and consultations.

Results:
Out of 121 patients who underwent RFA in the past 5 years, 73 were accessible on phone. Of these, 42.46% (31/73) patients had difficulty in accessing either medications or consultation. The literacy status of the patient was the strongest predictor (0.044) with a negative correlation (-1.216). Difficulty in accessing PCS was associated with a poor health status (p-0.032) and higher pain scores (0.066).

Conclusion:
Along with the clinical factors, we have to overlook other factors in predicting difficulty to access PCS in trigeminal neuralgia patients post the RFA status. Difficulty in access to pain medicines and/or consultations was associated with a poor health status and higher pain scores.
Ketamine as the main analgesic agent during analgesia-based sedation for elective colonoscopy – A randomised, double-blind, control study
Authors: Kovačević Mirza , Rizvanović Nermina , Adilović Adisa Šabanović , Smajić Jasmina , Sijerčić Selma 
Published: September 2022

Aim:
The aim of the study was to compare the analgesic effects of ketamine over fentanyl combined with propofol in analgesia-based elective colonoscopy with purpose of patient safety and satisfaction.

Methods:
This is a double-blinded prospective randomized controlled trial. Ninety patients were included and randomized to either fentanyl-propofol (Group FP, n: 30), ketamine-propofol (Group KP, n: 30) or propofol-control group (Group C, n: 30). Group FP patients received fentanyl and propofol, Group KP received ketamine and propofol and Group C, propofol. In all groups, incremental doses of propofol were used to maintain a Ramsay sedation score (RSS) of 5. Respiratory depression and hemodynamic parameters were monitored for the first minute and every 5 min during endoscopy. Fifteen minutes after the procedure, the degree of pain was assessed using a visual analog scale (VAS), the quality of recovery according to the Aldrete score (ARS), complications during and after the procedure and additional doses of propofol were recorded.

Results:
Mean arterial pressure (MAP) at 5 and 30 min (p < 0.05), heart rate (HR) at 15, 25 and 30 min (p < 0.05) and peripheral oxygen saturation (SpO2) at 30 min (p < 0.05) were statistically significant for Group FP. Desaturation (*p = 0.033), and weakness (*p = 0.004) was also significant for Group FP at 20, 25 and 30 min (p < 0.05). Pain was lower assessed for the Group KP according to the VAS (**p = 0.025).

Conclusion:
In analgesia-based colonoscopy, ketamine provides appropriate analgesia and less incidence of complications compared to fentanyl.
Continuous local anesthetic wound infusion
Authors: AlFaraj Ahmed , AlFaraidy Mona , AlZaher Zaki , Al Wosaibai Adnan , AlShabeb Abduladem K. , AlHashim Hussain , AlKhulaif Zainab 
Published: September 2022

Introduction:
Opioids are commonly used to control acute postoperative pain but their usage is associated with significant complications and the potential of addiction. This study was designed to assess the effect of a Continuous Local Anesthetic Wound Infusion Catheter (CLAWIC) on pain score and as an opioid-sparing agent in patients undergoing elective mastectomy.

Method:
The search was done using all patients' record from February 2013 to February 2018. The data were collected through the acute pain service database, operation room lists, surgical site infection database, acute pain service sheet, and anesthesia sheet. The patients inclusion criteria were adults who underwent elective mastectomy surgery at King Fahad Specialist Hospital. Patient age, sex, weight, and height were also recorded.

Result:
The opioid use intraoperatively and postoperatively was significantly lower in the CLAWIC than in the control group. Also, accumulative opioid use was significantly lower in the CLAWIC group. From transfer to the PACU until 48 hours postoperatively, the percentage of patients requiring opioids was significantly lower in the CLAWIC group. After 48 hours, there was no difference in opioid use between the two groups. Visual Analog Scale (VAS) pain scores were significantly lower in the CLAWIC than in the control group.

Conclusion:
CLWIC showed opioid-sparing effects following mastectomy, as shown by a significantly lower mean opioid dose and a lower percentage of subjects needing opioid analgesia. The procedure is easy to perform and relatively safe. CLWIC could reduce opioid consumption while maintaining good postoperative pain control.
Expression of chemotaxis in regulators of tissues of exudative lesions of Reinke’s space
Authors: Kovalev Michael A. , Davydovа Evgeniya V. 
Published: September 2022

Exudative tumor-like neoplasms of the Reinke space in vocal folds are widespread in the population, more often among representatives of vocal professions, e.g., actors, singers, teachers, lecturers and represent a serious medical and social problem. In pathogenesis of such neoplasms, a key role is given to chronic phonotrauma, intoxication during smoking against the background of the nearly complete absence of lymphatic drainage in the Reinke space. Cellular factors of tissue and immune homeostasis are of great importance in morphogenesis of this disorder. Switching of immune responses aimed at maintaining tissue homeostasis is accompanied by increased production of pro-inflammatory cytokines, as well as chemotaxis regulators and growth factors. The aim of our work was to study the levels of chemokines (MIP-1, MIP-1, MIP-3, fractalkine, IL-8, I-TAC) in the tissues of exudative lesions from the Reinkes space (EPPR).
Forty tissue samples of exudative lesions from Reinkes space, in particular, vocal fold polyps, vocal nodules and neoplasms presenting as Reinkes edema were taken as biological material for the study. The samples were taken intraoperatively when the neoplasm was removed, using an Olympus TYPE 150 fiber bronchoscope (Germany) using an integrated Lumenis Acu Pulse CO2 laser (Israel). The content of chemokines was determined in the supernatants of the tissues homogenates, using multiplex analysis with MAGPIX-100 immunoanalyzer (Bio-Rad, USA). Statistical processing was carried out using Statistica 10.0 for Windows software package. The results are presented as medians (Q0.25-Q0.75).
Chronic phonotrauma and/or exposure to toxic factors leads to increased permeability of the vascular endothelium, tissue edema and activation of cells involved in tissue and immune homeostasis, e.g., fibroblasts, monocytes, endotheliocytes. The study of the chemokine expression in the tissues of various exudative lesions of Reinkes space enabled us to reveal the following features: (1) predominance of the CXC-chemokine content produced mainly by fibroblasts in dense neoplastic tissues, thus reflecting participation of the latter in the genesis of this pathology. (2) In the tissues of soft neoplasms with large proportion of liquid component, we have revealed increased concentrations of SS-chemokines and fractalkine. The latters are produced mainly by macrophages and endotheliocytes, thus, probably, reflecting a predominant role of these cells in development of myxoid polyps and Reinkes edema.
Effect of Pregnancy on Bone Age
Authors: KAYA Kenan , ÖZESEN Toygün Anıl 
Published: September 2022

Objective: Age estimation for forensic purposes has an important place among daily Forensic Medicine services. Although many factors affect skeletal development, hormonal factors are among the most influencing factors. With this study, it is aimed to contribute to the literature on this subject by detecting any changes in the development of bone age with the effect of hormonal changes during pregnancy.
Materials and Methods: Cases referred to our Çukurova University Forensic Medicine Polyclinic between March 2017 and March 2021 with the request of the forensic authorities to estimate the bone age, and who declared that the date of birth in their official documents was correct; gender, identity age, age at marriage, having children, the reasons for asking for age estimation, the claim at which age they were, the bone ages determined were recorded, and the evaluations of the cases were made according to the Greulich-Pyle and Gilsanz-Ratib Atlases.
Results: According to the bone age estimation examinations made, of the 70 cases included in the study in accordance with the criteria, 35 (50%) had children, 35 (50%) reported that they had no children and had never had a pregnancy. Consistently, it was observed that 9 (12.9%) cases were evaluated as larger than the population registry and 1 case was evaluated as younger than the population registry. It was determined that 7 cases whose bone age was found to be greater than the identification age were pregnant, 2 cases did not become pregnant, and 1 case who did not become pregnant among all cases was evaluated as younger than the population registry.
Conclusion: It is very important to evaluate the age estimation cases in an objective, standardized, multidisciplinary and careful way. For this reason, we suggest that diseases that may affect bone development, situations that may affect body development such as pregnancy, personal factors should be evaluated, and that it should be evaluated with a multidisciplinary approach consisting of radiology and forensic medicine physicians.
CRIMINALIZAÇÃO, DESASSISTÊNCIA E CONTROLE
Authors: Silva Júlio César Paiva e , Rosa Lucia Cristina dos Santos 
Published: September 2022

Historicamente, a hegemonia da política proibicionista no trato do consumo prejudicial de substâncias psicoativas redundou no estigma, na criminalização, controle e desassistência desse segmento, com alta incidência de marcadores das desigualdades sociais, sobretudo classe e raça. Utilizando a pesquisa bibliográfica como METODOLOGIA, este ensaio tem por OBJETIVO analisar alguns aspectos da organização do movimento de usuários de substâncias psicoativas no Brasil e as complicações causadas pela remanicomialização da Política de Saúde Mental, álcool e outras drogas que silencia vozes e descontrói as possibilidades de corresponsabilização. RESULTADO: Reorientações pautadas na desinstitucionalização da Saúde Mental e Redução de Danos acenaram para o reconhecimento da heterogeneidade dos usuários de SPA e proporcionaram o fortalecimento da organização política com o fomento da participação social na formulação e avaliação dos serviços de saúde mental. CONSIDERAÇÕES FINAIS: Observa-se que a remanicomialização intensifica a criminalização, a desassistência e o controle, dificultando a participação social e protagonismo do movimento de usuários de SPA.
Association Of Hepcidin (HAMP) Gene Polymorphism And Cytokines, Iron, And Hb Levels In Covid-19 Patients
Authors: H. Salem Mustafa , A. Jabir Ferdous , A. Jabir Ferdous 
Published: September 2022

Introduction: COVID-19 is a new type of coronavirus that infects humans and causes severe acute respiratory syndrome (SARS). Isolated in Wuhan City, China, in December 2019. Similar to discoveries relating to the coronaviruses that cause severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Levels of cytokines (Interleukin-6, Interleukin-1 β ), iron and hemoglobin changed during COVID-19 disease. Hepcidin is an iron regulatory protein that is encoded by the HAMP gene .
Material and Methods : Serum IL-6, IL-1 β , Hepcidin are measured by an ELISA kit and Iron ,UIBC , TIBC are measured by colorimetric methods. The genotyping was done by the ARM-PCR technique with a specific set of primers.
Results : The difference in Hb and serum iron levels, UIBC, TIBC, IL-1, IL-6, and Hepcidin conc. between the patient and recovery groups is statistically significant at P≤ 0.05 . No significant difference between the two groups in hepcidin gene polymorphism because of Polymorphisms of the hepcidin gene appeared in the two groups (in most samples).
Conclusions: The persons involved in this study are (most of them) heterozygous, and this indicates the presence of the mutation allele in the two groups , and it may be one of the reasons for the deficiency in hepcidin that appeared in this study.
Frequency Of Hysterosalpingography Findings In Females Presenting With Infertility In Gujrat
Authors: Ahmad Mubashar Burhan , Zulfiqar Taiba , Ali Abid , Rashid Ali 
Published: September 2022

Background: Infertility is a gynecological illness which has clinical, financial and psychological consequences that affects 1.3% to 25.7% of couples throughout the world. Hysterosalpingography is a typical imaging technique used in gynecological practice to diagnose infertility in women.
Aim And Objective: The objective of our study was to evaluate the frequency of Hysterosalpingography findings in females presenting with infertility in Gujrat.
Methodology: The prospective cross sectional study was carried out at X-Ray unit in Azeem Ultrasound & Digital X-Rays center, Gujrat, Pakistan. A total of 90 females patients with infertility were enrolled in present study. The duration of this research work was from February 2022 to May 2022. The data was gathered using a predesigned questionnaire form.. Statistical Package of Social Sciences was used to analyze the data. Frequency of different findings was found out. These were then graphically portrayed in the form of tables and graphs.
Results : We observed 90 female patients out of which 72 (80%) patients found to be normal. In 18 (20%) patients fallopian tube blockage was diagnosed. Out of 18 patients, 8 (8.9%) were having right sided fallopian tube blockage, 8(8.9%) were having bilateral tubal blockage while only 2 (2.2%) showed left sided tube block. Hydrosalpinx was found in 4(4.4%) patients and uterine anomaly in 2(2.2%) patients.
Conclusion: Fallopian tube blockage and hydrosalpinx were common factors of infertility in our study. Hysterosalpingography provides an easy and affordable source for evaluation of infertility factors.
Normal Liver Size In Adults Without Suspicion Of Liver Disease Analyzing The Variable (Age, Weight, & Height) That Has Good Correlation
Authors: Rashid Ali , Ali Abid , Zulfiqar Taiba 
Published: September 2022

Aim/Objective:To determine the normal liver size in adults without suspicion of liver disease analyzing the variable (age, weight, & height) that has good correlation.
Methods: The study was undertaken in Department of Radiology in Services Hospital (SHL)/ Services Institute of Medical Sciences (SIMS) Lahore. It was hospital based study and normal healthy adult without liver disease in the age range from 18 years to 78 years were selected for this study. 207 healthy adults without liver disease & without specification of gender were selected. Non- randomized or consecutive sampling technique was used due to limited time of 3 months from 1st December 2016 to 1st March 2016.
Results: The mean age of total subjects was 34.85±14.67 years. The mean age of male was 35.6± 14.47 years and 33.8±14.95 years for female. There were 83 (40%) subjects in the age range of 18-27 years, 51 (24.6%) subjects in the age range of 28-37 years, 29 (14.1%) subjects in the age range of 38-47 years, 24 (11.6%) subjects in the age range of 48-57 years, 13 (6.3%) subjects in the age range of 58-67 years, 7 (3.4%) subjects in the age range of 68-77 years.The mean longitudinal diameter of liver of total subjects was 14.34±0.79cm (p=0.001). The mean longitudinal diameter of liver was 14.50±0.71cm & 14.1±0.84cm in male and female respectively.
The mean height of total subjects was 163.56±6.7cm. The mean height was 165.74±6.0cm for male & 160.72±6.6 for female respectively.
The distribution of liver sizes in the various age groups is shown in table 3. The result demonstrates that liver sizes increases with age. The results also show that males had larger liver size than females. The size of the liver was correlated with age, weight, and height showed positive and significant correlation with liver size.
Conclusion:Ultrasound has been found to be both accurate and wide spread in clinical use and has no proven health hazard. The sonographic measurement of liver at the midclavicular line was shown to be an easy and practical method for routine use. Sex and body height are the most important factors associated with the diameter of the liver measured at the midclavicular line.
Frequency Of Anterior Abdominal Wall Hernia Diagnosed On Ultrasound In Population Of Gujrat
Authors: Naeem Adrash , Zulfiqar Taiba , Ali Abid , Zafar Khadija 
Published: September 2022

Background: Sonography is a significant noninvasive imaging modality to diagnose types of abdominal wall hernias. Ultrasound imaging could be effective in creating a diagnosis as well as determining the type of hernia and providing additional details like the contents of the hernia and how much of it can be reduced. These findings may influence surgical procedures and reconstruction.
OBJECTIVE: The purpose of this research was to identify the frequency of anterior abdominal wall hernias in Gujrat, Pakistan.
Material And Method: A retrospective study was conducted at the diagnostic clinical setup Azeem ultrasound & digital X-Ray center Gujrat. . A total of 377 female patients who meet the inclusion criteria were enrolled in present study. The duration of the study was 4 months i.e. September 2021 to December 2021.
Results: We observed 377 patients, among these participants age ranged from 1 year as minimum age and 70 years as maximum with mean age was 39±15.7. The maximum frequency of patients 111(29.4%) was found in the age range of 31-40 years following 79(21%) in 21-30 years. Out of these, there were 109 males (28.9%), and 268 females (71.1%). Among 377 patients, there were 59 (15.6%) positive cases who showed anterior wall abdominal hernia where paraumblical hernias and umbilical hernias were the most frequently occurring hernia 20(5.3%) and 19 (5%) patients respectively.
Conclusion: According to the current study, there were more females than men , male dominance was demonstrated in inguinal hernias and female dominance in paraumbilical hernias. In the management plan for patients in whom the diagnosis of an abdominal wall hernia is uncertain, abdominal wall ultrasonography is a useful tool. The ultrasound results can have an impact on treatment choices, allowing for a more rapid and cost-effective clinical procedure.
Frequency Of Upper Extremity Fractures In Patients With Road Traffic Accidents And Its Association With Age
Authors: Haris Abdul , Zulfiqar Taiba , Ali Abid 
Published: September 2022

Background: Upper extremity fractures are the most common musculoskeletal injury seen in the emergency/trauma center. Upper extremity fractures (UEFs) may result in long-term disability.
AIM AND OBJECTIVE
The aim of our study was to assess the frequency of fractures in patients with road traffic accident and its association with age.
Methodology: This prospective cross-sectional study was conducted at X-Ray unit in Aziz Bhatti Trauma Center Gujrat, Pakistan. A total of 200 patients with the history of road traffic accident were enrolled in present study. The duration of this research work was from February 2022 to May 2022. All RTA patients visited us were included. Patients who were admitted in the wards were excluded. Predesigned questionnaire form was used to collect the data. SPSS was used to analyze the data. Frequency of different findings and their associations were found out using the chi square test. These were then graphically portrayed in the form of tables and graphs. P value < 0.05 was considered as significant.
Results: We observed 102(51%) fractures in a total of 200 patients. Higher percentage 98(49%) was found in the age group 16-30 years with male predominance. Injuries due to motorcycle fall 110(55%) were the main cause of upper extremity fractures in case of RTA. Radius and humerus were the most frequently fractured bone 21(10.5%) and 20(10%) respectively.
Conclusion: Our study showed that the frequencies of upper extremity fractures occur mostly in males and mostly due to the motorcycles fall. Our study established the frequency of upper extremity fractures and it can be considered as a useful guide to determine its occurrence in case of RTAs.