bluuebunny/crossref_metadata_2025 huggingface dataset:
The Accuracy of Sensorineural Acuity Level Test in Predicting Bone Conduction Thresholds in Unilateral Hearing Loss Cases
Authors: Awang Mahamad Almyzan , Zakaria Mohd. Normani , Rashid Mohd. Fadzil Nor , Salim Rosdan , Othman Nik Adilah Nik
Published: October 2023

The sensorineural acuity level (SAL) test is useful to determine the type of hearing loss if overmasking occurs in pure-tone audiometry (PTA) testing. In this article, we report two unilateral hearing loss cases to highlight the accuracy of the SAL test in predicting bone conduction (BC) thresholds in unilateral hearing loss cases, as well as the importance of using the appropriate SAL normative data. As found, the estimated BC thresholds (provided by the SAL test) were in good agreement with the actual BC thresholds (from the PTA) (i.e. within ± 5 dB) for both sensorineural hearing loss and conductive hearing loss cases. The accuracy of the SAL test is adequate to support the PTA results. Implementing inappropriate normative data may result in the misdiagnosis of the type of hearing loss.
Leukoaraiosis and Dizziness: Are They Related? – A Case Series
Authors: Karthikeyan D. Anand , Kumar Poornima
Published: October 2023

Dizziness and imbalance are one of the most common complaints seen in elderly people. Age-related ischemic diseases have varying degrees of manifestations and imbalance problems. Cerebral small vessel white matter disease has recently been a topic of interest in view of its association with geriatric syndromes–development of cognitive decline, dementia, falls, etc., but the association between small vessel disease and dizziness has not established clearly yet. Magnetic resonance imaging (MRI) brain is the most commonly used imaging modality for neurological disorders. White matter hyperintensities (WMHs) on T2-weighted sequences on MRI are known as leukoaraiosis (LA) and are suggestive of small vessel white matter disease and represent a high risk of cerebral, cerebellar, and brainstem stroke. The purpose of the present study is to investigate the correlation between unexplained vertigo and radiological changes of LA (small vessel disease) and videonystagmography (VNG) findings of such patients. First patient, a 55-year-old male patient had complaints of short-lasting episodes of spinning sensation and imbalance for the past 2 years. MRI brain showed small vessel ischemic changes (leukoaraiosis) with right vascular loop type 3 (anterior inferior cerebellar artery) without compressive symptoms. VNG showed broken smooth pursuit in horizontal and vertical planes; a hypometric saccades tracing in both planes and microsaccadic oscillations in spontaneous gaze. Second patient, a 60-year-old male had recurrent episodes of vertigo for the past 15 years. His VNG showed micro-oscillations in the saccades and impaired smooth pursuit. MRI revealed bilateral symmetrical T2 FLAIR hyperintensities in white matter and lateral ventricles. Third patient, a 69-year-old female presented with giddiness, nausea, and vomiting for 5 days. Pure-tone audiogram showed mild sensorineural hearing loss. MRI brain showed diffuse cerebral atrophy with small vessel ischemic changes. VNG showed impaired smooth pursuit and microsaccadic oscillations when the gaze was fixed. All three patients were managed successfully by vestibular rehabilitation and antioxidants and Coenzyme Q10. Through this study, we would like to highlight the possibility of a relation between leukoaraiosis and unexplained dizziness among elderly patients.
Luliconazole: A Novel Potent Imidazole Activity against Aspergillus niger and Aspergillus flavus Causing Otomycosis
Authors: Sukumar Bavadharani , Premamalini Thayanidhi , Sasikumar Nivetha Shree , Lakhmanan Somu , Kindo Anupma Jyoti
Published: October 2023

Background:

Aspergillus
niger and Aspergillus
flavus are the most common causative agents of otomycosis with worldwide distribution. Extensive surgical debridement and systemic antifungal therapy are needed in cases of refractory otomycosis. Luliconazole is currently confirmed for the topical therapy of dermatophytosis. Moreover, it is found that luliconazole has in vitro activity against some molds and yeast species.

Objectives:

The aim of the present study was to evaluate the efficacy of luliconazole in comparison to routinely used triazole antifungals on Aspergillus isolates, obtained from otomycosis cases using microbroth dilution method.

Materials and Methods:

This study was carried out in the department of microbiology, from March 2020 to February 2022. A total of 55 strains of Aspergillus isolates obtained from otomycosis cases were confirmed based on macroscopic and microscopic identification. Antifungal susceptibility patterns of itraconazole, voriconazole, posaconazole and luliconazole were determined by broth microdilution method as per the Clinical Laboratory Standards Institute M38-A2 guidelines.

Results:

Among the azoles tested, the lowest minimum inhibitory concentration (MIC) geometric mean (0.00309 μg/ml), MIC50 (0.00098 μg/ml), and MIC90 (0.00781 μg/ml) values were attributed to luliconazole. Being the drug of choice for aspergillosis, voriconazole had a slightly higher MIC50 and MIC90 value of 1 μg/ml and 2 μg/ml, respectively. Even for the pan azole resistant isolates (n = 3), luliconazole was found to be more effective with lower MIC values.

Conclusion:

The results of this study showed that luliconazole had an excellent in vitro activity with a lower MIC values than the triazoles tested. Hence, this novel imidazole antifungal agent can be considered an appropriate candidate for the treatment of otomycosis caused by A.
niger and A.
flavus strains. Furthermore, luliconazole showed better efficacy with lower MIC values for pan azole resistant isolates, suggesting that it could be a potential antifungal for treating aspergillosis caused by pan azole resistant isolates.
Screening for Hearing Loss in High-Risk Neonates Using Otoacoustic Emissions
Authors: Chawla Deeksha , Verma Rohit , Bhargava Siddharth , Munjal Manish , Dhawan Anshuman , Singh Udeyana
Published: October 2023

Context:

The development and maturation of the hearing process begin in the fetal stage and progresses up to 6 months of age. Neonatal screening is therefore an essential method to screen for hearing loss at an early age. As there is a paucity of literature on the use of otoacoustic emissions (OAEs) and brainstem evoked response (BERA) tests for screening, hence we conducted a prospective observational study to screen the high-risk neonates admitted to neonatal intensive care unit (NICU) using OAE and further BERA (wherever indicated).

Aims:

The primary objective was to estimate the incidence of hearing loss in high-risk neonates admitted to NICU using OAEs as a screening tool. A secondary objective was to determine the risk factors predictive of hearing impairment in these neonates.

Settings and Design:

It was a prospective observational study conducted in a tertiary care hospital.

Subjects and Methods:

The study was conducted over a period of 1 year from April 1, 2021, to March 31, 2022. Fifty neonates with high-risk factors who fulfilled the inclusion criteria were enrolled and subjected to a two-staged OAE screening test and further BERA (in neonates where overall OAE result was REFER).

Statistical Analysis Used:

Continuous data variables were presented as means and standard deviations. Categorical data were presented as percentages and Chi-square test was used to derive comparisons. For all statistical testing, P < 0.05 was considered statistically significant.

Results:

Of 50 neonates enrolled in the study, 22 (44%) passed the Stage I OAE. The remaining 28 (56%) underwent Stage II OAE, out of which 17 (34%) passed the Stage II screening. Eleven neonates with overall OAE results as REFER were taken up for BERA. Three neonates (6%) had a hearing loss on BERA while in 8 (16%) BERA was normal. The overall incidence of hearing loss was 6%. The variables with a statistically significant correlation with the results of OAE were - APGAR score and perinatal asphyxia at a low APGAR score.

Conclusions:

The incidence of hearing loss in this study was 6%. APGAR score and perinatal asphyxia at a low APGAR score at 1 and 5 min had statistically significant correlation with the outcomes of OAE screening.
Are We Teaching Evidence-Based and Inclusive Practices in Gender-Affirming Care? Perspectives From Plastic Surgery In-Service Examinations
Authors: Aryanpour Zain , Min-Tran Dominic , Ghafoor Essie , Wojcik Christopher , Peters Blair R.
Published: October 2023

Background Resident physicians take annual in-service examinations (ISEs) as part of continuing medical education, which set educational priorities, allow for formative feedback, and guide preparation for final board examinations. Gender-affirming care is provided in many specialties but has been an underrepresented area in medical education. Plastic surgeons provide a large portion of gender-affirming surgical care. Educational gaps in standardized ISEs may contribute to ongoing health care disparities for transgender and gender diverse people.

Objective To evaluate the quality of content pertaining to gender-affirming surgery (GAS) on plastic surgery ISEs.

Methods Plastic surgery ISEs from years 2012 to 2020 were accessed online through the American Council of Academic Plastic Surgeons website in June 2022. All 5 gender diverse authors analyzed examinations for the presence of GAS questions; identified questions were analyzed for quantity, organization based on content category, affirming language, and accuracy against current guidelines.

Results Of 1959 ISE questions available for review, 11 GAS questions were identified for a total frequency of 0.56%. Most GAS questions (6 of 11, 55%) were miscategorized. Inappropriate language, including misgendering of patients, occurred in 7 of 11 (64%) questions. No questions discussed GAS beyond chest or genital surgery, or common variations of these procedures. Transgender identities were represented as only binary, with no mention of nonbinary or gender-fluid individuals.

Conclusions Our study illustrates that there are significant gaps in educational content pertaining to gender-affirming care on plastic surgery ISEs.
Human growth hormone, a marker for HIV infection among adult Igbo Nigerians: relationship between human growth hormone and CD4+ count with viral load
Authors: U Obi Collins , U Achukwu Peter , N Okwuosa Chukwugozie , S Aladeyelu Okikioluwa , N Agbiogwu Ijeoma , C Agu Nneka , O Udeh Mercy , A Arusiwon Joseph
Published: October 2023

Routine viral load and CD4+ testing is key to monitoring the extent of danger caused by HIV and response to antiretroviral therapy (ART) for HIV individuals, but its availability has been limited in low and middle-income countries. The study sort to ascertain relationship between serum Human Growth Hormone (HGH) gold standard with CD4 cells and viral load in HIV-infected patients. CD4+ T-cells, HIV viral load, and HGH were assayed in HIV- infected patients from May to December 2020. 460 subjects were engaged and separated into two groups: the HIV-infected untreated (Pre-ART) and the control groups. An interventional study was conducted for the Pre-Art group after six months. Serum HGH was assayed by the ELISA method, CD4 cell count was examined by BD-FACScan flow cytometer, and HIV viral load was assessed using RT-PCR. The CD4 count and serum HGH of Pre-ART HIV-infected subjects were significantly low (p<0.05), while the viral load was significantly high compared to those treated with ART for 6months (p<0.05). CD4 count and serum HGH were significantly higher (p<0.05) in females than in males. It also reveals that CD4 count correlates positively with HGH level (r= 0.191**). Serum HGH could serve as a surrogate marker and valuable index in monitoring HIV patients.

Keywords: Viral load; HIV/AIDS; human growth hormone.
Biological parameters determining the effectiveness of monitoring of HIV / AIDS infected patients in Morocco
Authors: Echchakery Mohamed , Boumezzough Ali , Boussaa Samia
Published: October 2023

Background & objective: Human Immunodeficiency Virus (HIV) remains one of the world's most serious health challenges. The development of therapeutic regimens has significantly increased survival and reduced HIV-associated morbidities in HIV-infected individuals. However, some people living with HIV may not respond as expected, resulting in treatment failure. The objective of this study is to identify and characterize, by immunological (T-cell CD4) and virological (viral load) parameters, HIV infected patients with therapeutic failure in Morocco.

Methods: Prospective cross-sectional studies were conducted over a 5-years period (between January 2015 and December 2019) at the referral center of Ibn Zohr Hospital, Marrakech, Morocco. A total, of 1088 HIV-infected patients diagnosed by the rapid test (Immunochromatography) in addition to Western Blot analysis, was recruited. All patients were under the antiretroviral therapy (ART) for at least six months and followed every six months. Sociodemographic, clinical, and biological data as well as information on patient adherence were collected.

Results: Out of 1088 patients, 92.46% were under treatment based on non-nucleoside reverse transcriptase inhibitors (NNRTIs) including 26.20% first line first intention and 66.26% first line second intention, and 7.54% of patients on a protease inhibitor (PI) therapy. Regarding the immunological and virological status, 76% of HIV-infected patients had a CD4 count > 200 cells/μl and 24% had a CD4 count < 200 cells / μl, while 69.5% had an undetectable viral load and 30.05% had a detectable viral load (including 11.86% with viral load < 1000 copies / ml and 18.20% viral load > 1000 copies / ml) (P-values < 0.05).

Conclusion: In our study, we showed a therapeutic failure rate of 18.2% in HIV-infected patients under treatment in Marrakech region. These failures were mainly related to poor adherence and low CD4+ rates at the initiation of treatment. We concluded that immunological monitoring alone is insufficient to predict virological suppression and therapeutic success. Consequently, we recommend the HIV plasma viral load test be accessible as a routine exam.

Keywords: HIV; viral load; CD4; therapeutic failure; antiretroviral treatment; Morocco.
Risk factors for pancreatitis occurrence after gallstone treatment using endoscopic retrograde cholangiopancreatography
Authors: Jiang Feibao , Zhang Jilong , Hu Zhenghua
Published: October 2023

Background: Patients with gallstones are prone to pancreatitis after treatment using endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to explore the risk factors for pancreatitis occurrence after gallstone treatment using ERCP.

Methods: A total of 193 patients treated from October 2017 to October 2020 were assigned into pancreatitis group (n=55) and non-pancreatitis group (n=138). Multivariate logistic regression analysis was utilized to analyse the risk factors for post-ERCP pancreatitis. The discrimination and accuracy of an established nomogram model were evaluated using receiver operating characteristic and calibration curves, respectively.

Results: The incidence rate of pancreatitis was 28.50% (55/193). Young age, long course of disease, gallbladder wall thickness >3 mm, sand-like stones, history of pancreatic disease, number of intubation ≥2 and absence of pancreatic duct stenting were risk factors for post-ERCP pancreatitis (P<0.05). The established model had high discrimination and accuracy. The incidence rates of pancreatitis in patients with and without pancreatic duct stenting were 11.84% (9/76) and 39.31% (46/117), respectively. The patients undergoing pancreatic duct stenting had lower serum amylase levels 6, 12 and 24 h after ERCP than those of patients who did not.

Conclusion: Patients with gallstones have a higher risk of developing pancreatitis. Young age, long course of disease, gallbladder wall thickness >3 mm, sand-like stones, history of pancreatic disease, pancreatic duct visualization and number of intubation ≥2 are risk factors for post-ERCP pancreatitis.

Keywords: risk factor; endoscopic retrograde cholangiopancreatography; pancreatitis; gallstone; pancreatic duct stenting.
Cardiac surgery in East Africa: a profile of cases and referral to physiotherapy
Authors: R Makalla Abdallah , Karachi Farhana , S Phillips Joliana
Published: October 2023

Background: A significant increase in cardiac surgery has been observed globally, with prolonged length of stay (LOS) still prevalent due to post-operative complications. Physiotherapy pre and post cardiac surgery is known to reduce these complications and LOS, however cases referred for physiotherapy is unknown.

Objective: The study aimed to describe the profile and pre- and post-operative referrals to physiotherapy of patients admittedto the cardiothoracic unit at a selected hospital in Tanzania over a four-year period.

Method: Descriptive, retrospective design. A data extraction sheet was used to capture demographic, cardiac disease, ICU andhospital LOS, post-operative complications and physiotherapy referral data of all patients ≥18 years of age.

Results: 105 cardiac surgeries were performed. Patients’ mean age was 30.6 years (SD=10.48) and 54.3% (n=57/105) were female.Cardiac surgeries performed declined from 48.6% (n=51/105) in 2010 to 10.5% (n=11/105) in 2013. Cardiac arrest (33%, n=7/21), pneumonia (19%, n=4/21) and lung collapse (4.8%, n=1/21) were the notable documented post-operative complications. ICU mortality was highest (72,7%, n=8/11). Only 1% (n=1/105) of cases were referred pre-operatively versus 77.7% (n=80/103) post-operatively for physiotherapy.

Conclusion: Cardiac surgeries were reduced annually but the post-operative complications need to be reduced. Pre-operativephysiotherapy referral may reduce pneumonia and lung collapse following cardiac surgery.

Keywords: Profile; cardiac surgery; cardiac disease; hospital stay; physiotherapy referral.
Appropriateness and diagnostic yield of open access gastroscopy in two tertiary centers in South-western Nigeria
Authors: A Odeghe Emuobor , O Owoseni Opeyemi , S Chukwudike Evaristus , F Adeniyi Oluwafunmilayo , E Adigun Babatunde , K Oyeleke Ganiyat , O Oluyemi Aderemi , A Lesi Olufunmilayo
Published: October 2023

Background: There is need for the appropriate use of gastroscopy.

Objective: To determine the appropriateness of upper gastrointestinal endoscopy, and its association with significant endoscopyfindings in our environment.

Methods: This was a prospective study of subjects who underwent gastroscopy at two centers in south-western Nigeria betweenAugust 2020 and August 2021. Indications were classified as either appropriate or inappropriate according to the ASGE guidelines, gastroscopic findings as either significant or not significant, patients as either elderly (≥ 60 years) or not, inpatients or outpatients, and referrals as either gastroenterologist referral, or not.

Results: There were 227 subjects, 131 (57.7%) females, mean age 45 ± 13.7 years. Fifteen percent were elderly, 65.6% were gastroenterologist referrals, 14.1% were inpatients, while 45.8% had co-morbidities. Endoscopy was appropriately indicated in 81.9%, and significant endoscopy findings were detected in 95.6%. Appropriateness was not associated with significant endoscopy findings. The sensitivity, specificity and AUROC of the ASGE guidelines were 10%, 82%, and 0.46 respectively.

Conclusion: According to our study, most procedures are appropriately indicated. However, appropriateness did not determineendoscopy yield. Larger studies are needed to determine the utility of the ASGE guidelines in our environment.

Keywords: Appropriateness; endoscopy; Nigeria.
Prevalence of late antenatal care booking among pregnant women attending public health facilities of Kigamboni Municipality in Dar es Salaam region, Tanzania
Authors: Ndomba Alana , Ntabaye Moshi , Semali Innocent , Kabalimu Titus , Ndossi Godwin , Mashalla Yohana
Published: October 2023

Background: Good care during pregnancy is important for the health of mothers and development of the unborn baby. The study determined the prevalence and factors associated with late ANC booking among pregnant women at health facilities in Kigamboni Municipality in Dar es Salaam, Tanzania.

Methods: This was an analytical cross-sectional study among pregnant women attending ANC services during second and third trimester in the selected health facilities. The study recruited 204 through convenient sampling. Multi-stage cluster sampling was used to select health facilities. A Standardised questionnaire was used to collect information through face-to-face interviews. Data was analysed using SPSS version 25.0. Proportions were used to estimate the magnitude of late ANC booking while bivariate and multivariate analyses were performed to determine factors associated with the magnitude of late ANC booking.

Results: Late ANC bookings were high 174 (85.3%) among pregnant women who attended clinic week 13 and later compared to those who attended earlier than 13 weeks 30 (14.7%). Factors associated with likelihood for late ANC booking during the initial visit included tertiary education [AOR= 10.174, 95%CI: 1.002-103.301] and primigravida [AOR=0.101, 95%CI: 0.170-0.605].

Conclusion: Majority of the pregnant women started ANC later than the recommended time. Health education provision at all community levels on the advantages and disadvantages of early and late ANC booking respectively should be strengthened.

Keywords: Pregnant women; ANC; booking; parity; education.
Exclusive breastfeeding knowledge and practice among nursing mothers in selected healthcare facilities in Kaduna Metropolis, Nigeria
Authors: I Yakubu Musa , U Odesanya Rachael , Y Abbas Medinat , K Lawal Basira
Published: October 2023

Background: Exclusive breast feeding (EBF) in the first six months of life is recognized as an indispensable component of survival, physical and mental development of children. Despite the enormous benefits of EBF, only 39% of infants less than 6 months of age are exclusively breastfed globally.

Objectives: This study assessed EBF knowledge, practice and associated factors among nursing mothers attending health facilitiesin Kaduna metropolis.

Methods: Descriptive and cross-sectional study carried out with the aid of a structured questionnaire at the Barau Dikko Teaching Hospital and Gwamna Awwal General Hospital in Kaduna. The participants were recruited by simple random sampling technique with the assistance of trained research assistants for four consecutive weeks in each of the hospital. Data were analysed using SPSS version 16.

Results: Majority of the participants were in the age range of 21-30 years. Their main source of information on breastfeeding was from ante-natal clinics (78.3%). Most (86.6%) of the participants had a good knowledge and awareness about EBF, 69.1% of them initiated breastfeeding immediately after birth (within an hour) and 70% of the participants practiced EBF. Insufficient milk, belief that infants require extra fluid, fear of alteration in the breast figure, cultural practice and societal beliefs were identified as the most common barriers to the practice of EBF.

Conclusions: Findings from this study showed that most of the participants had a very good knowledge of EBF and are practicing it.

Keywords: Exclusive breastfeeding; knowledge; initiation of breastfeeding; nursing mothers.
Chinese pediatric Tuina can prevent premature infant feeding intolerance and is conducive to weight gain: a prospective randomized controlled study
Authors: Li Shao-Shu , Lin Xiu-Yao , Li Xin , Zhang Ya-Di , Wang Li-Qiong , Lai Su-xian
Published: October 2023

Objective: Preterm birth is one of the most important health problems in the world. Feeding intolerance is one of the most common and serious complications of premature infant. The purpose of this study was to explore the effect of Chinese pediatric Tuina on the prevention of feeding intolerance in favour of weight gain in premature infants.

Methods: A prospective randomized controlled study was conducted in the Department of Neonatology in our hospital. Premature infants were recruited and randomly assigned to an intervention group or a control group. Premature infants in the intervention group received a Chinese pediatric Tuina intervention by professional chiropractors, while premature infants in the control group received standard care. The incidence of feeding intolerance and weight gain situation were compared between the two groups.

Result: After 1 week of intervention, the body weight (2.5±0.5 vs 2.0±0.4, p=0.038), head circumference (32.8±1.7 vs 29.9±1.4, p=0.041), albumin (34.6±5.8 vs 28.4±6.1, p-0.026) and prealbumin (155.8±35.2 vs 113.6±36.8, p=0.021) of preterm infants in the intervention group were significantly better than those in the control group. The incidence of feeding intolerance (7 vs 15, p=0.032) in the intervention group was significantly lower than that in the control group. Although there were no statistically significant differences (P>0.05), the incidences of gastrointestinal bleeding, necrotizing enterocolitis, and liver insufficiency were lower in the intervention group than in the control group.

Conclusion: Chinese pediatric Tuina can effectively prevent the occurrence of feeding intolerance in premature infants and beconducive to the weight gain and improving nutritional status of premature infants.

Keywords: Chinese pediatric Tuina; wremature infant; feeding intolerance; weight gain; nutritional status.
Predictors of fertility awareness among selected married women of childbearing age in Nigeria: a cross-sectional survey
Authors: Uchenna Mosanya Adaobi , Oyine Aluh Deborah , Anosike Chibueze , Ogochukwu Akunne Maureen , Gloria Anene-Okeke Chigozie , Isah Abdulmuminu
Published: October 2023

Background: Increased fertility awareness can help infertile couples to achieve pregnancy.

Objectives: This study aimed to determine both the predictors and levels of fertility awareness among married Nigerian women of childbearing age.

Methods: A nationwide cross-sectional survey. Data were collected via online and face to face questionnaires. Descriptive and inferential analysis were done with SPSS 25.

Results: Most respondents married between ages 24-29 years old (40%) and just over half had good fertility awareness (53%). The associated factors were age at menarche (X2 = 9.962, p = 0.007), geopolitical zone of residence (X2 = 17.301, p = 0.008), level of education (X2 = 64.843, p < 0.001), employment status (X2 = 9.319 p = 0.025) menstrual cycle charting (X2 = 66.392, p < 0.001), use of internet to increase awareness (X2 = 39.849, p < 0.001) and books (X2 = 58.855, p < 0.001). Fertility awareness was lower for those with secondary education than postgraduates (AOR=0.213, 95% CI 0.116-0.390, p < 0.001). Moreover, the odds of having good fertility awareness were less in those who did not chart their menstrual cycle (AOR=0.363, 95% CI 0.245-0.538, p < 0.001).

Conclusion: Menstrual cycle charting and level of education were predictors of fertility awareness.

Keywords: Nigeria; fertility; educational status; menstrual cycle; internet.
mHealth app usage amongst paediatric department doctors in South Africa
Authors: Mahmood Shahid , Coovadia Ashraf , E Laher Abdullah , Adam Ahmed
Published: October 2023

Background: Smartphone and mobile health (mHealth) applications (apps) have become an integral part of the day-to-day function of healthcare professionals, allowing quick, comprehensive, and up-to-date access to current clinical guidelines and other reference material.

Objective: To evaluate the extent and nature of use of mHealth apps by paediatric department doctors in South Africa.

Methods: E-mails requesting study participation were sent out to 285 paediatric department doctors employed at six hospitals affiliated to the University of the Witwatersrand. Willing participants were directed to complete the online study questionnaire.

Results: A total of 150 respondents completed the questionnaire. All respondents owned a mobile device and already had one or more mHealth apps, 95.3% were unaware of any regulatory body responsible for regulating the use of mHealth apps, 86.0% did not have access to free Wi-Fi at work and 87.3% used an mHealth app at least once daily. Drug dosing (81.3%), diagnostic (59.3%) and clinical decision-making (44.7%) apps were the most common app categories with Medscape® (62.0%) and EMGuidance® (41.3%) being the most frequently used apps. Peer recommendation (76.0%), app credibility (74.0%) and app functionality (66.0%) were the most common factors that were considered by respondents prior to downloading or using an mHealth app.

Conclusion: Medical apps are frequently used among paediatric medical doctors of all ranks. Drug dosing, diagnostic and clinical decision-making apps are the most common app categories in use. Improved awareness of the regulations pertaining to the use of mHealth apps amongst doctors is required.

Keywords: Medical apps; mHealth; mobile health; smartphone health; information technology; drug dosing app; medical diagnostic app.
Clinicopathological pattern of breast lesions in children and adolescents
Authors: Charles Nwafor Chukwuemeka , Uwaemechi Umeh Kingsley , Benjamin Etuk Emmanuel , Brian Eziagu Uchechukwu , Jonathan Kudamnya Ikwo , Ekwo Esther
Published: October 2023

Background: Breast lesions are not common in children and adolescents. The aim of this study is to retrospectively survey the clinicopathological pattern of breast lesions in children and adolescents in our setting.

Materials and method: This is a retrospective study of all breast specimens from children and adolescents that were histopathologically diagnosed in University of Uyo Teaching Hospital.

Results: The youngest patients seen were 11 years old, with mean age of 17.1 ± 1.91. The commonest clinical diagnoses were fibroadenoma (n=134, 72.4%). Thirty-five-point seven percent of the patients presented within 6 months of noticing the lump. The mean size of the lumps was 6.2cm ± 3.9. Fibroadenoma was the most common benign diagnosis and the most common histopathologic diagnosis in this study. The mean age of patients with fibroadenoma was 17.15±1.83.

Conclusion: The pattern of breast lesions in adolescents in Uyo is similar to that from other parts of Nigeria.

Keywords: Adolescents; benign; breast lesions; fibroadenoma.
Assessment of risk factors associated with multi-drug resistant tuberculosis (MDR-TB) in Gulu regional referral hospital
Authors: Omona Kizito , Mucha Opiyo Albert
Published: October 2023

Background: Multi-drug resistant tuberculosis (MDR-TB) is increasingly recognized as emerging infectious disease of publichealth concern. Globally, 206030 people were diagnosed with MDR-TB in 2019, representing a 10% increase from 186883peoplewho had it in 2018. In Uganda, the prevalence of MDR among new TB cases is 4.4% and 17.7% among previously treatedTB cases.

Aim: To determine the risk factors associated with MDR-TB among tuberculosis patients in Gulu regional referral hospital.

Material and Methods: A cross-sectional analytical study using both quantitative and qualitative methods of data collectionand analysis was used. Data was collected from 384 TB patients using data extraction form and 6 Key informant interviewsconducted. Analysis using Pearson chi-square test was run.

Results: HIV positive patients were 2.6 times more likely to be infected with MDR-TB than HIV negative patients [AOR=2.6:95% CI 1.34– 5.85: P=0.006]. Previously treated TB patients were 2.8 times more likely to be infected with MDR-TB than newlydiagnosed TB patients [AOR=2.8: 95% CI 1.33– 5.85: P=0.006]. Defaulting TB patients were 3.1 times more likely to be infectedwith MDR-TB than the non-defaulting TB patients [AOR=3.1]

Conclusion: There is high prevalence of drug resistance among patients attending TB treatment at the facility.

Keywords: MDR-TB; tuberculosis; HIV; Gulu Regional Referral Hospital.
Evaluation of socio-demographic profile and basic risk factors of tuberculosis patients in South 24 Parganas district of West Bengal, India: a hospital-based study
Authors: Kumar Bhunia Sujay , Dey Sananda , Pal Amitava , Giri Biplab
Published: October 2023

Aim: To study and analyse the socio-demographic profile and basic risk factors of tuberculosis(TB) patients and their relationwith the current epidemiological status of TB registered under the RNTEP program in the study area.

Subjects and Methods: This prospective study was conducted on 1743 newly registered tuberculosis patients at TB-DOT centerof South 24 Parganas, West Bengal, India from 2011-2014. Socio-demographic variables and baseline characteristics of theparticipants were noted by a semi-structured questionnaire.

Results: Our study results indicate that more than 95% of the TB patients were from lower socioeconomic class, and hadpoor literacy status and tuberculosis was observed highest in non-agricultural labour and cultivators. Among the young adult’smajority of the affected population were females from the lower/upper-lower socioeconomic class. Our analysis revealed that,in successful tuberculosis therapy, men were more defaulters than women.

Conclusion: Our study provides a socioeconomic profile and the risk factors of tuberculosis in patients such as the status oftherapeutic intervention, involvement of other chronic diseases, age, sex and malnutrition. The findings of this study can beused to plan future studies with specific risk factors of the region and also for implementing the intervention and evaluating itseffectiveness.Keywords: Mycobacterium tuberculosis; socio-demographic factors; multi-drug resistance; pulmonary tuberculosis; extra-pulmonarytuberculosis.
Epidemiological features of tuberculosis in the Middle East and North Africa from 1990 to 2019: results from the global burden of disease Study 2019
Authors: Moradinazar Mehdi , Mohseni Afshar Zienab , Ramazani Uosef , Shakiba Mohammad , Shirvani Maria , Darvishi Sara
Published: October 2023

Introduction: Tuberculosis (TB) is a preventable and curable disease, although, it still causes more than one million deaths annually. Therefore, the aim of this study was to measure the epidemiological status and the burden of TB in the Middle East and North Africa (MENA) countries.

Methods: The study population included 21 countries in the MENA region, covering a population of about 400 million. The Global Burden of Disease (GBD) 2019 database was used. The case definition comprises all forms of TB, containing pulmonary and extra pulmonary TB, which are bacteriologically approved or clinically diagnosed. The prevalence, incidence, death, and the disability-adjusted life years (DALYs) rates per 100,000 people for all national locations by standardized age rates (ASR) were measured.

Results: In 2019, Afghanistan had the highest TB-related incidence 85.09 (95% UI, 73.69_98.46), death 21.91 (95% UI, 13.44_29.78), and DALYs rate 695.21 (95% UI, 454.34_939.49). The highest prevalence rates of TB were in Egypt 28935.42 (95% UI, 26125.54_32251.01). The highest TB-related DALYs rate was attributed to alcohol use, high fasting plasma glucose, and smoking were related to Tunisia, Qatar, and Lebanon, respectively. Between 1990 and 2019, TB- related incidence, prevalence, death, and DALYs rate have decreased by 53%, 42.19%, 76.20%, and 75.95% in MENA region, respectively.

Conclusion: TB has continued to decrease in prevalence, incidence, death, and DALYs rates in the MENA region, although, nowadays with the COVID-19 pandemic, societies may face more challenges for TB prevention, detection, treatment, and rehabilitation.

Keywords: Tuberculosis; disability; burden of disease; DALY; MENA.
Comparison of the effects of different blood conservation techniques in elderly patients undergoing total hip arthroplasty
Authors: Cai Yuanxing , He Xin , Cheng Qinghao
Published: October 2023

Background: To probe into the influences of different blood conservation techniques on the postoperative coagulation function and prognosis of elderly patients receiving Total Hip Arthroplasty (THA).

Methodology: A total of 60 patients were randomly divided into Autologous Blood Transfusion (ABT) group (n=30) and ANH group (n=30). For patients in the ABT group, an autologous blood recovery machine was used to recover, wash and filter the surgical field blood. For those in the Acute Isovolumic Hemodilution (ANH) group, blood was collected preoperatively from the central vein and stored in a citrate anticoagulant blood storage bag, while the same amount of hydroxyethyl starch was injected into the peripheral vein to dilute the blood. After Mai bleeding steps of the operation were completed, the autologous blood of patients was transfused back in both groups. The clinical indicators of patients in each group were observed.

Results: 48 h after operation, the ANH group obtained a higher level of hemoglobin (Hb), shorter Activated Partial Thromboplastin Time (APTT), and a lower expression rate of platelet activating factor CD62P than the ABT group.

Conclusion: The ANH group exhibits higher content of hemoglobin and fewer platelet (Plt)activating factors produced than the ABT group, while no significant difference in the shortened length of hospital stays is found.

Keywords: Hip arthroplasty; blood transfusion; autologous; hemodilution; transfusion of red blood cells; platelet activating factors.
Postpartum resolution of hypertension, proteinuria and acute kidney injury among women with preeclampsia and severe features at Mulago National Referral Hospital, Uganda: a cohort study
Authors: Muteke Kasereka , W Musaba Milton , Mukunya David , Beyeza Jolly , N Wandabwa Julius , Kiondo Paul
Published: October 2023

Background: The resolution of hypertension, proteinuria and AKI postpartum among women with preeclampsia is not well documented in Uganda.

Objective: To determine the time to resolution of hypertension, proteinuria and AKI postpartum until 6 weeks among women with preeclampsia in Mulago Hospital, Uganda.

Methods: Between August 2017 and April 2018, we measured blood pressure, urine protein and serum creatinine on days 1,7,21 and 42 postpartum among 86 women with preeclampsia. The primary outcomes were time to the resolution of hypertension, proteinuria and AKI. We fitted accelerated failure models using Stata 17’s stintreg. command with a log normal distribution and obtained time ratios of selected exposures on time to resolution of hypertension, proteinuria and AKI intervals.

Results: The median time to resolution of hypertension, proteinuria and AKI was seven (7) days (Inter quartile range, IQR 1-21). The time to resolution of hypertension among primiparous women was 3.5 times that of multiparous women [TR 3.5, 95%CI 1.1, 11.3]. No differences were observed in resolution of hypertension, proteinuria and acute kidney injury.

Conclusion: The time to resolution of hypertension, proteinuria and AKI was seven days. We recommend larger studies with longer follow-up beyond six-weeks postpartum to inform revision of our guidelines.

Keywords: Acute kidney injury; preeclampsia with severe features.
Quality of life of patients with traumatic spinal cord injuries: a cross-sectional study at a tertiary hospital in Uganda
Authors: Mugisa Rogers , Luke Kironde Edward , Sabakaki Mwaka Erisa
Published: October 2023

Background: The study aimed to assess the perceived quality of life of patients with traumatic spinal cord injuries.

Methodology: This was a cross sectional study conducted in the Spine Unit of a tertiary hospital in Uganda. The study population comprised of patients with spinal cord injuries. Data were collected using the WHO Quality of Life Brief questionnaire and Functional Independence Measure tool.

Results: 103 patients participated in the study, most were male (73.8%), and had a mean age of 37.7 years. Most participants were married (57.3%), unemployed (72.8%) and had no steady source of income (62.1%). Road traffic accidents accounted for most injuries (59.2%). The mean duration since injury was 20.5 months. Most participants (58.3%) had incomplete spinal cord injuries and 84.5% had complications. The perceived overall quality of life was poor in 87.4% of patients. Being employed (p= 0.02), the presence of complications (p= 0.03), and injury severity (p= 0.003) significantly affected quality of life. Functional independent measure scores were significantly better in individuals less severe injuries and those with lumbar level of injury with mean scores of 113.1±8.9 and 99.9±15.3 respectively.

Conclusion: The overall self-reported quality of life among patients with traumatic spinal cord injury was generally poor.

Keywords: Quality of life; traumatic injury; spinal cord.
Risk factors of recurrent thyroid nodules after radiofrequency ablation
Authors: Xia Yuke , Fu Yuehe , Qian Mengjia , Cui Yiyao
Published: October 2023

Objective: To investigate the risk factors of thyroid nodule recurrence after radiofrequency ablation (RFA).

Methods: The medical record information of 120 patients with thyroid nodules admitted to our hospital from June 2019 to April 2022 was retrospectively analysed. All participants received RFA treatment. According to the results of the postoperative thyroid ultrasoundexamination (USG), the patients were divided into the recurrence group (R, N=16) and the non-recurrence group (NR,N=104). Binary logistic regression analysis was performed to identify the independent risk factors of thyroid nodule recurrenceafter RFA. The receiver operating characteristic (ROC) curve was used to analyse the value of the forecast of each independentfactor and combined model for thyroid nodule recurrence after RFA.

Results: During the follow-up period, 16 patients recurred, and the recurrence rate was 13.33%. Univariate regression analysisshowed that whether the nodules are solitary (WNS), nodule diameter (ND), the degree of risk of nodular location (DRN),recurrent laryngeal nerve (RLN) injury were associated with thyroid nodule recurrence after RFA (P<0.05). Binary logisticregression analysis showed that WNS, ND, DRN and RLN injury were independent risk factors for the recurrence of thyroidnodules after RFA (P<0.05). ROC analysis of independent factors and combined model showed that solitary nodules, nodulediameter and nodule location risk degree had diagnostic value, while RLN injury had no predictive value. The combined modelis more predictive than the independent factors.

Conclusions: The risk factors of recurrent thyroid nodules after radiofrequency ablation are related to WNS, ND, DRN and so on, which should be paid attention to and preventive measures should be taken.

Keywords: Thyroid nodules; radiofrequency ablation; recurrence; risk factors.
Coexistence of hypertension with diabetes mellitus and its pharmacotherapy
Authors: Moke E.G. , Demaki W.E. , Daubry T.M.E. , Ataikiru O.M. , Agbonifo-Chijiokwu E. , Ofulue O.O. , Ekuerhare B. , Akpoyovwere O. , Edje K.E. , Isibor N.P.
Published: October 2023

Diabetes mellitus and hypertension are common comorbidities, as hypertension is reported to be twice as frequent in diabetic patients as people who are non- diabetics. In diabetic condition, the risk and progression of cardiac disease, peripheral vascular disease, stroke, retinopathy, and nephropathy is greatly increased in the presence of hypertension. Persistent increase in blood pressure termed hypertension, can be either primary hypertension (essential hypertension) or secondary hypertension in nature. Primary or essential hypertension is characterized by elevated blood pressure caused by inherited factors which are characteristic of essential hypertension whereas identifiable causes such as chronic kidney diseases, endocrine disorders, constriction of the kidney arteries, or the use of drugs are among the etiology of secondary hypertension. Diabetes causes hyperinsulinemia which increases the risk of hypertension. This condition increases the amount of sodium that the body absorbs. It also promotes the stimulation of the sympathetic nervous system. Treatment of both conditions is crucial as they are considered risk factors for coronary artery disease, cerebrovascular disease, renal failure and congestive heart failure. In any age group, a considerable increase in systolic blood pressure causes a significant increase in cardiovascular disease. To achieve sufficient blood pressure control, most people with hypertension and diabetes require more than one medication. This review is aimed to discuss hypertension and diabetes mellitus comorbidities and their treatment.
Subsurface structural and stratigraphical evaluation of Sapele Shallow field, Niger Delta, Southern Nigeria
Authors: Mujakperuo B. J. O. , Airen O. J.
Published: October 2023

This research presents the results of the subsurface structural and stratigraphical evaluation of the Sapele Shallow field of the Niger Delta. 3D seismic cube and well log data were used in carrying out this research work. Analysis of the three horizons' structural maps showed the subsurface's structural geometry and the presence of a possible trapping mechanism, which controls the accumulation of hydrocarbons in the studied area. Interpretations of faults that described the structural setting of the field showed three major faults trends from East to West whiles dipping southward with other minor faults. The stratigraphy of the study area thickens from north to south (basinward). Also, the rootmean-square (RMS) amplitude maps analysis of the various horizons reveals that all horizons mapped in the studied area have bright spots (Sweet Spot) except horizon 7.
Biomonitoring of heavy metals pollution in the university of Lagos, Akoka campus environment using the moss Dicranium scorparium Hedw
Authors: Igbar Aramide Dolapo , Amusa Oluwafemi Daniel , Ihejimba Adaobi Jennifer , Ogundipe Oluwatoyin Temitayo
Published: October 2023

ABSTRACTThe level of atmospheric heavy metal deposition in University ofLagos, Akoka campus was investigated using the moss Dicranumscorparium Hedw. Moss samples were collected from unplasteredperimeter walls and rock surfaces at ten sampling sites labeled AJ: UBA Park (A), Ransome Kuti (B). Makama Hall (C), Faculty ofLaw (D), Moremi Car Park (E), Medical Centre (F), Ozoluwa BQs(G), High Rise Buildings (H), Honors Hall (I), Lagoon Front (J). Acontrol sampling was done at First Estate, Amuwo-Odofin LGA.The concentrations of Cadmium (Cd), Lead (Pb), Nickel (Ni),Copper (Cu) and Zinc (Zn) were determined using AtomicAbsorption Spectrophotometer (AAS) Perkin Elmer AA 800. Theresults obtained confirmed the presence of heavy metal in thisorder Zn > Pb > Cd > Cu > Ni. The concentration of Zn, Cd and Pbwere greater than the FME and UNEP threshold limiting values.The analysis of the anthropogenic influence of the pollutants on theenvironment revealed that Zn (4.24mg/L) despite its highestabundance is a moderate contaminant in the study locations.Contamination factor (CF) suggests that locations B, D, F, G and Jare seriously contaminated (C5) while locations A, C, E, H, and Iare extremely contaminated (C6). The index of geo-accumulationrevealed that all the studied locations are in the Igeo7 categoryindicating extremely pollution with the assayed metals. Thedifference in the occurrence of anthropogenic activities was seento be the major factor responsible for the variations in theconcentration of heavy metals accumulated by the mosses.