bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilan biologique devant une suspicion de polyglobulie
Authors: Gardie Betty , Maaziz Nada , Girodon François
Published: September 2024

La polyglobulie est une pathologie érythrocytaire définie par une augmentation du volume globulaire total. Les étiologies de la polyglobulie sont multiples, pouvant être primaires et résulter d’un défaut intrinsèque dans les cellules progénitrices de la moelle osseuse, ou bien secondaires à une augmentation de la concentration sérique de l’érythropoïétine, facteur de régulation majeur de l’érythropoïèse. Le diagnostic repose sur un bilan d’investigation étendu, visant à explorer les mécanismes connus impliqués dans le développement de la pathologie. Dans un premier temps, il convient d’éliminer les causes les plus courantes de polyglobulie au moyen d’examens élémentaires de routine : détermination de l’hémogramme, recherche d’une mutation JAK2 , dosage d’érythropoïétine, mesure des gaz dans le sang (veineux et artériel), réalisation d’examens d’imagerie. Devant un bilan initial négatif, une exploration moléculaire grâce à des méthodes de séquençage d'ADN de nouvelle génération (NGS) peut préciser le diagnostic en identifiant une cible moléculaire. Toutefois, les causes de la polyglobulie ne sont pas toujours élucidées, ce qui ouvre la voie à de nombreuses opportunités pour la recherche dans le domaine de la polyglobulie idiopathique.
Perception de la politique de crédit de la banque filiale par ses parties prenantes : quelle conséquence en matière de réforme organisationnelle ?
Authors: Mfelam Jean Roger
Published: September 2024

L’objectif de cette recherche est d’appréhender la perception que les parties prenantes ont de la politique de crédit des banques filiales dans un pays en développement. Ainsi, les données de l’étude empirique sont collectées grâce aux entretiens réalisés avec deux catégories de parties prenantes bancaires que sont notamment les clients et les managers intermédiaires de trois filiales bancaires occidentales au Cameroun. Les entretiens ont lieu entre les mois de novembre 2021 et mars 2022, dans les villes de Yaoundé et Douala, où sont concentrées l’essentiel des agences bancaires de l’échantillon. L’analyse de contenu thématique révèle que, la pertinence des problèmes posés par les clients, est déconstruite par les managers intermédiaires des banques. L’étude suppose que cette déconstruction, appréhendée comme une forme voilée de résistance au changement, contribue à complexifier la décision de modification de l’orientation relationnelle des banques filiales dans leur rapport de crédit aux entreprises locales.
Management stratégique des PME : tendances de la recherche scientifique au Maroc.
Authors: Yaouhi Mohamed , Alqoh Mohamed
Published: September 2024

Depuis son introduction dans le domaine des entreprises dans les années cinquante, la stratégie d’entreprises, évolué vers le management stratégique, était depuis toujours un champ de recherche très fertile. La vocation de cet article est de faire une revue de littérature narrative sur les différentes études, aussi bien documentaires qu’empiriques, effectuées sur le management stratégique des PME au Maroc, afin de ressortir les tendances de recherche sur les approches de management stratégique des PME, offrant des opportunités énormes pour la création d’un avantage compétitif durable. Cette revue de littérature portant sur l’analyse des articles les plus pertinents (22 articles), a permis, d’abord, de dresser un éventail détaillé des différents champs de prospections sur le management stratégique des PME au Maroc, et de montrer, ensuite, les insuffisances de ces firmes en matière d’exploitation efficace et efficiente aussi bien des opportunités externes de l’environnement d’affaires que des ressources et capacités internes qui dépendent étroitement du dirigeant ou propriétaire de la PME et de déceler, finalement, les carences de recherches en matière d’approche basée sur les facteurs externes (l’environnement d’affaires) et d’approche axée sur les capacités dynamiques (VBCD) ainsi que d’approche complémentaire rassemblant à la fois les deux approches celle basée sur l’environnement d’affaires et celle fondée sur les ressources (ABR). Des études ultérieures sont fort sollicitées pour compléter cette étude par un benchmark plus large sur les tendances de la recherche scientifique en fondements du management stratégique, ainsi qu’en stratégies suivies par les entreprises, au niveau régional, continental, voire même international.
Transforming Music Education Through Artificial Intelligence: A Systematic Literature Review on Enhancing Music Teaching and Learning
Authors: Zhang Yifang , Beh Wen Fen  , Chao Zhang  , Sheng Pi
Published: September 2024

The advent of artificial intelligence (AI) has brought significant and transformative alterations to traditional music education. This study examines the progress of AI technology in music education by conducting a systematic review using the PRISMA methodology. Articles were selected for inclusion based on the criterion of specifically describing the utilization of AI in the instruction and acquisition of music. The search was performed on April 9, 2024, via the Web of Science and SCOPUS databases. The search terms “music education” and “artificial intelligence” were employed to ascertain relevant scholarly research. The group of papers underwent scrutiny by various researchers to ascertain their adherence to the established criteria. The articles that were verified by a minimum of two researchers were chosen. 31 articles were finally screened, and the results were divided into two sections: the development of AI in music education and innovative music pedagogy based on AI. A key finding is that the implementation of bibliometric analyses suggests that AI research in music education is still in its infancy. Prior research has primarily concentrated on music instruction at the university level, with a particular emphasis on the integration of AI in music education in China. In addition, this study identifies four specific facets of AI through the reshaping of music pedagogy: enhancing personalized music teaching, providing timely feedback on learning, supporting interactive experiences, and providing organized digital materials.
Evaluation of the Relationship Between Meal-Based Dietary Anti-Oxidant Quality Score with Obesity in Apparently Healthy Adults Attended to Health Care Centers in Tehran
Authors: Ramezani Reza , Majd Maryam , Mohammadpour Saba , Nosrani Esmail Alipour , Shahinfar Hossein , Djafari Farhang , Shab-Bidar Sakineh , Djazayery Abolghassem
Published: September 2024

Background:

Studying the dietary antioxidant quality (DAQ) score as a modifiable factor to lessen the negative effects of obesity on health is vital due to the rising global trend of obesity. Therefore, this study aimed to determine how adult obesity and meal-based DAQ scores correlate.

Materials and Methods:

A cross-sectional study including 850 men and women in Tehran was conducted. Three 24-hour dietary recalls were used to evaluate dietary consumption. Based on the design of DAQs, the meal-based DAQ score was evaluated. Higher scores indicate better DAQ. The overall DAQ score varied from 0 to 5. To investigate the relationship between DAQs and obesity in each meal, logistic regression analysis was utilized.

Results:

There was no correlation between a higher breakfast DAQ score and being overweight or obese (for overweight: OR = 0.69; 95% CI: 0.38–1.24/for obesity: OR = 0.65; CI 95%: 0.31–1.37). In the basic model, a higher lunch DAQ score was inversely related to probabilities of being overweight (OR: 0.62; 95% CI: 0.39–0.99) Such a connection remained significant after relevant confounders were considered (OR: 0.48; 95% CI: 0.27-0.84). In both the raw and fully adjusted models, there was no discernible correlation between the meal DAQ score and overweight or obesity.

Conclusion:

We discovered that a higher DAQ score for lunch was substantially associated with a lower risk of being overweight but not obese. To verify our findings, additional prospective research in various populations is required.
The Prevalence of PD-L1 Expression in Triple-Negative Breast Cancer Patients and Its Correlation with Survival Rates and Other Prognostic Factors: A Survival Analysis
Authors: Izadi Arefeh , Naimi Azar , Amjadi Elham , Beheshtiparvar Dorsa , Soltan Maryam
Published: September 2024

Background:

Triple-negative breast cancer (TNBC) is a leading cause of cancer-related mortality among women, with a poor prognosis. The programmed cell death 1 (PD-1) pathway has emerged as a potential immunotherapy target. This study aimed to assess PD-L1 expression in TNBC patients and its relationship with prognostic variables.

Materials and Methods:

This cross-sectional study included 107 TNBC patients recruited between 2016 and 2020. Patient age, tumor grade, and Ki67 expression were obtained from pathology reports. Immunohistochemistry was utilized to determine PD-L1 status, and 2-year survival data were collected through telephone follow-up.

Results:

PD-L1 expression frequency in TNBC patients was 76.6%. Grade 3 was the most common cancer grade, significantly more prevalent in the PD-L1 positive group (P = 0.01). High Ki67 expression (≥14%) was observed in 89% of patients, significantly higher in the PD-L1 positive group (P = 0.003). The 2-year survival rates for the PD-L1 positive and negative groups were 84.1% and 92%, respectively, with no significant difference between the groups (P = 0.512).

Conclusion:

This study investigated PD-L1 expression prevalence in TNBC patients and its correlation with prognostic variables. PD-L1 expression was associated with higher tumor grade and elevated Ki67 expression, indicating a potential role in tumor aggressiveness. However, despite these associations, PD-L1 expression did not significantly impact the 2-year survival rate in TNBC patients. These results emphasize the complexity of the immune microenvironment in TNBC and the necessity for further research to elucidate the precise role of PD-L1 in disease progression and patient outcomes.
Comparison of the Cardiovascular Response to Sedation with Dexmedetomidine, Midazolam, and Etomidate in Phacoemulsification under Local Topical Anesthesia; A Double-Blind Randomized Controlled Clinical Trial
Authors: Shoraibi Mohadese , Masoudifar Mehrdad , Shetabi Hamidreza
Published: September 2024

Background:

The present study aimed to compare the cardiovascular response to sedation with dexmedetomidine, midazolam, and etomidate during phacoemulsification under local Topical anesthesia.

Materials and Methods:

In this double-blind randomized clinical trial, a total of 90 cataract surgery candidates undergoing phacoemulsification were selected and divided into three groups. The first group received 1 µg/kg dexmedetomidine over 10 minutes, followed by an infusion of dexmedetomidine at a rate of 0.5 µg/kg/h. The second group received 0.05 mg/kg midazolam, and the third group received 0.2 mg/kg slow IV etomidate. Hemodynamic parameters, sedation level, and adverse effects were recorded before anesthesia, during surgery, and during recovery.

Results:

The results of this study showed that in the 10thminute of surgery, the systolic blood pressure (SBP) in the etomidate group was significantly higher than the other groupsPvalue = 0.029). The pulse rate (PR) in the etomidate group at the 15thminute during surgery, 10th, 20th, and 30thminute in the recovery period (mean 70.33 ± 10.34 bpm, 72.10 ± 10.18 bpm, 73.70 ± 10.18 bpm, and 75.03 ± 6.73 bpm, respectively) was significantly higher than the other two groups (Pvalue < 0.05). No adverse effects such as dizziness, restlessness, vomiting, or nausea were observed in the midazolam group. However, decreased heart rate was significantly higher in the dexmedetomidine group (26.7%) compared to the etomidate (3.3%) and midazolam (6.7%) groups (Pvalue = 0.021).

Conclusion:

According to the results of this study, the sedation level achieved by dexmedetomidine, midazolam, and etomidate was similar. However, etomidate seemed to have a better effect on maintaining blood pressure and pulse rate compared to the other two drugs.
Jujube Oxymel for the Treatment of Chronic Spontaneous Urticaria: Efficacy and Safety
Authors: Shirazi Maryam Taghavi , Goodarzi Azadeh , Ghobadi Ali , Eghbalian Fatemeh
Published: September 2024

Background:

Chronic spontaneous urticaria (CSU) is a challenging disorder that severely impacts the quality of life. The current study objective was to evaluate the efficacy and safety of jujube oxymel (JO) for treating CSU.

Materials and Methods:

In this randomized double-blind controlled trial, 92 patients (aged 12–65) with CSU were randomly allocated to JO or placebo groups. They received 30cc of each syrup three times daily with 10 mg cetirizine for 28 days, subsequently taking 10 mg cetirizine alone for the next 4 weeks. Outcomes were evaluated using the weekly urticaria activity score (UAS-7) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL).

Results:

After four weeks, the UAS-7 score mean and standard deviation in the JO group significantly decreased to 10.89 ± 4.87 compared to the placebo group at 15.06 ± 7.55 (P: 0.002). In the follow-up period, JO group participants achieved a score of 10.28 (4.67), while a significant increase occurred in the control group (18.33 ± 6.29) (P = 0.001). On day 28, there was a notable improvement in the quality of life within the JO group (P < 0.05). By the eighth week, both groups experienced an increase in CU-Q2oL score, but the changes in the control group were statistically significant (18.09 (5.96) vs 41.31 (10.34) (P: 0.001).

Conclusion:

JO, as part of integrated therapy, exhibited potentially longer-lasting efficacy than cetirizine alone, contributing to enhanced quality of life and increased patient satisfaction due to minimal side effects.
Open Anterior Subscapularis Release for Adduction and Medial Rotation Shoulder Contracture in Neonatal Brachial Plexus Palsy
Authors: Boubkraoui Mohamed El Mahdi , Rouaghi Hajar , Cherqaoui Yassine , Bjitro Chafik , Aboumaarouf Mustapha , Cherqaoui Abdelmounim
Published: September 2024

Introduction:

Adduction and medial rotation shoulder contracture are prevalent in unresolved neonatal brachial plexus palsy (NBPP). Various surgical options exist, including open anterior subscapularis release, to address this condition. This study assessed the outcomes of this procedure.

Materials and Methods:

This cross-sectional, observational study focused on a cohort of children aged over 12 months who underwent open anterior subscapularis release to remedy residual shoulder contracture from upper or global NBPP over 11 years. The Mallet score was utilised to appraise deficits in shoulder function.

Results:

The study included 32 patients. The sex ratio was 0.78. The median age at surgery was 36 months (25; 56). The right side was affected in 75% of cases. The median improvement in the Mallet score after subscapularis release was 4 (2; 6). This enhancement was statistically significant (P < 0.001), with a median follow-up duration of 78 months (72; 82). There was a substantial increase in shoulder abduction (P < 0.001) and lateral rotation (P < 0.001). Hand-to-mouth (P < 0.001) and hand-to-head (P < 0.001) manoeuvres exhibited significant enhancement. The hand-to-spine manoeuvre did not show a substantial alteration. A significant correlation was found between the injury severity and the enhancement of the Mallet score post-surgery (P = 0.009).

Conclusion:

Open anterior subscapularis release yielded significant mid-term functional enhancements in shoulder motion, with no modification in medial rotation. Improvements were observed even in children beyond 4 years of age, with those having more severe injuries showing greater functional recovery.
Flexible Endoscopic Management of Tracheo-oesophageal Magnet Foreign Bodies with Acquired Fistula in a Toddler
Authors: Jallouli Mohamed , Zoriquat Ehab Nicolas , Kamel Terez Boshra
Published: September 2024

Aerodigestive foreign bodies (FBs) aspiration is a common problem in children; however, simultaneous aerodigestive localisation is rare. Ingestion of multiple magnetic FBs can lead to serious complications, especially tracheo-oesophageal fistula and recurrent chest infections. These depend on the duration of foreign-body ingestion/aspiration, prompt intervention and adequate technique for foreign-body retrieval. A 1.8-year-old female child was found to have two magnetic FBs lodged simultaneously in the oesophagus and trachea. The magnetic FBs in the aerodigestive tract in children were removed in the same session using flexible endoscopes.
Role of Interstitial Cells of Cajal in Congenital Ureteropelvic Junction Obstruction
Authors: Meher Sanjib Kumar , Jena Pradeep Kumar , Tripathy Prasanta Kumar , Mohanty Lity , Mohanty Pramod Kumar , Pattnaik Kaumudee
Published: September 2024

Background:

Although congenital ureteropelvic junction (UPJ) obstruction is the most common cause of neonatal hydronephrosis, aetiopathogenesis is still inconclusive. Recently, the paucity of interstitial cells of Cajal (ICC) at the narrow adynamic part of UPJ has been implicated as a causative factor.

Materials and Methods:

This prospective study was conducted between October 2019 and March 2022 to find out the density of ICC by the immunohistochemical method using CD117 (c-kit) antibody, in resected segments of UPJ in obstruction patients and in renal tumour patients as control. ICC/high power field (hpf) was also studied from the margins of the resected segment in the obstruction group. The pre-operative and post-operative sonographic and renal scintigraphic features were compared.

Results:

The median age of patients in the study group (n = 25) was 36 months and in the control group was 39 months. The mean ICC/hpf at the stenotic part of UPJ in the study group was 3.56 ± 1.26 and in the control group was 12.56 ± 1.89 (P = 0.0001). ICC density from the proximal and distal margins of the resected segment was 11.12 ± 2.12 and 11.68 ± 1.62, respectively (P < 0.001). The post-operative antero-posterior diameter of the renal pelvis and differential renal function showed significant improvement in comparison to the pre-operative value (P = 0.0045 and 0.0005, respectively).

Conclusions:

The significant decrease in the density of ICC at the stenotic part of UPJ compared to controls suggests a pacemaker role of these cells in ureteral peristalsis and the aetiopathogenesis of UPJ obstruction. Histopathological analysis of ICC should not only be limited to the stenotic part of UPJ but also should focus on the anastomosed ends of the ureter, which reflects post-pyeloplasty outcome.
Appendicitis in Children: Does Age Really Matter?
Authors: El Haissoufi Kamal , Hadi El Hassan , Habib Salaheddine , Aissaoui Hanane , Atassi Mariam , Ammor Abdelouhab , Benhaddou Houssain
Published: September 2024

Background:

Acute appendicitis (AA) is a frequent and emergent surgical abdominal condition that presents some particularities and challenges in young children.

Patients and Methods:

Data of 402 children aged <16 years with a confirmed diagnosis of AA were retrospectively reviewed. Included patients were divided into two groups: Group A (preschool children aged ≤5 years, n = 44) and Group B (school children aged >5 years, n = 358). Clinical presentation, biological findings, calculated diagnosis scores (paediatric appendicitis score [PAS] and Alvarado score), intraoperative findings and outcomes were comparatively analysed between the two groups.

Results:

Children of Group A had more likely fever, bowel disorders, diffuse abdominal pain and diffuse tenderness than those of Group B (P = 0.001, P = 0.005, P = 0.006 and P = 0.001, respectively). Regarding biomarkers, the mean of white blood cell count and C-reactive protein levels was higher in Group A than in Group B (18,849 cell/mm3 and 162.8 mg/L in Group A versus 15,938 cell/mm3 and 86.7 mg/L in Group B, P = 0.003 and < 0.001, respectively). The mean of calculated PAS and Alvarado scores was higher in Group A than in Group B (8.2 ± 1.1 and 8.2 ± 1 vs. 7.5 ± 1.4 and 7.4 ± 1.5, P = 0.003 and P = 0.001, respectively). Most children with a calculated PAS and Alvarado score equal to or higher than 8 belonged to Group A (PAS: 84.1% vs. 58.4%, P = 0.001, Alvarado score: 84.1% vs. 55.6%, P < 0.001). The perforation of the appendix was seen in 77.3% of Group A patients and only in 41.5% of children in Group B (P < 0.0001). The mean length of stay was 5.1 ± 1.9 days in Group A and 4.3 ± 2.8 days in Group B but without any statistical difference between the two groups (P = 0.094).

Conclusion:

AA in preschool children is associated with atypical presentation and rapid progression of the disease making the early diagnosis mostly challenging in our settings.
The Saudi Thoracic Society Evidence-based guidelines for the diagnosis and management of chronic obstructive pulmonary disease
Authors: Al-Jahdali Hamdan , Al-Lehebi Riyad , Lababidi Hani , Alhejaili Faris F. , Habis Yahya , Alsowayan Waleed A. , Idrees Majdy M. , Zeitouni Mohammed O. , Alshimemeri Abdullah , Al Ghobain Mohammed , Alaraj Ali , Alhamad Esam H.
Published: September 2024

The Saudi Thoracic Society (STS) developed an updated evidence-based guideline for diagnosing and managing chronic obstructive pulmonary disease (COPD) in Saudi Arabia. This guideline aims to provide a comprehensive and unbiased review of current evidence for assessing, diagnosing, and treating COPD. While epidemiological data on COPD in Saudi Arabia are limited, the STS panel believes that the prevalence is increasing due to rising rates of tobacco smoking. The key objectives of the guidelines are to facilitate accurate diagnosis of COPD, identify the risk for COPD exacerbations, and provide recommendations for relieving and reducing COPD symptoms in stable patients and during exacerbations. A unique aspect of this guideline is its simplified, practical approach to classifying patients into three classes based on symptom severity using the COPD Assessment Test and the risk of exacerbations and hospitalizations. The guideline provides the reader with an executive summary of recommended COPD treatments based on the best available evidence and also addresses other major aspects of COPD management and comorbidities. This guideline is primarily intended for use by internists and general practitioners in Saudi Arabia.
Recent advances in treatment of prurigo nodularis
Authors: Chen Chieh-Hsun , Hu Stephen Chu-Sung
Published: September 2024

Prurigo nodularis is a chronic skin condition which has significant negative impacts on the psychosocial function and quality of life of affected patients. It is a heterogeneous disease with complex underlying pathogenic mechanisms, and the clinical efficacy of traditional treatment options is often limited. Recently, great advances have been made in the pathogenesis of prurigo nodularis, which have enabled the development of novel targeted therapies for this disease. Various clinical trials have investigated the therapeutic efficacy of biologics which target the Th2 pathway. Dupilumab, a monoclonal antibody targeting interleukin 4 (IL-4) receptor α, has shown clinical efficacy and obtained United States Food and Drug Administration approval for prurigo nodularis. In addition, nemolizumab (IL-31 receptor A antagonist) and vixarelimab (oncostatin M receptor β antagonist) have shown therapeutic efficacy in clinical trials for prurigo nodularis. Small-molecule inhibitors with clinical promise which are currently under investigation include nalbuphine (opioid receptor modulator), Janus kinase inhibitors, and aprepitant and serlopitant (neurokinin-1 receptor antagonists). The recent development of new biologics and small-molecule inhibitors targeting various immunological and neurological signaling pathways have provided great hope that we are entering a new era of targeted therapies for this challenging clinical condition. In addition, recent advances in RNA sequencing technology may enable the identification of unique signaling pathways and the development of novel treatments for this disease in the future. In this review article, we summarize the current knowledge of the pathogenesis of prurigo nodularis, and discuss recent advances in treatment for this challenging clinical condition.
Awareness of oral health status among parents and caretakers of adults with intellectual disabilities: A cross-sectional study
Authors: Reddy R. Naveen , Vempalli Swetha , Murali P. S. , Mulla Mushir , Sahoo Kajal Kiran , Mulla Munaz
Published: September 2024

Introduction:

Intellectual disability or mental retardation is general systemic disorder characterized by significant impairment in cognitive functions as well as deficits in adaptation-related behaviors. It affects the mind and body along with skills related to day-to-day life such as thought processes, speaking, and self-care. Individuals with any form of disability need extra assistance for attaining and preserving their health including oral health.

Materials and Methods:

This cross-sectional prospective study was conducted on 100 parents and caretakers of adults with intellectual disabilities. Ethical approval was obtained from the institutional ethical committee. Written informed consent was obtained from all participants. Inclusion criteria for disabled subjects were (a) individuals older than 12 years of age, (b) individuals with intellectual and cognitive disabilities, (c) disabled individuals who were under the care of full-term persons, and (d) subjects who provided complete cooperation during intraoral examinations. The inclusion criterion for caregivers and parents was that they provided assistance on a daily basis. A questionnaire was circulated among all the participants that contained questions on demographics, knowledge, and perception regarding oral health. Statistical analysis: Statistical tools paired “t” and Pearson’s correlation tests were used for performing statistical analysis using SPSS version 21.0 software.

Results:

Statistically significant knowledge levels and perceptions were obtained from all the study participants regarding the importance of maintaining sound oral health in persons with disabilities, i.e., intellectual disabilities.

Conclusion:

It is important to educate and reinforce the importance of oral health among caretakers and parents of intellectually disabled adults.

The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, and Systems-based practice.
Effect of training program on the performance of orthopedic nurses regarding upper femoral fracture management by using the proximal femoral nailing technique
Authors: Ali Mohammed Tariq , Hachain Feten , Jasim Bashar
Published: September 2024

Introduction:

Hip fractures pose a significant global health-care challenge due to the increasing number of older adults, necessitating accurate and comprehensive nursing care.

Materials and Methods:

Quasi-experimental design, purposive study was carried out at three teaching Hospitals in Mosul City in Iraq from the period of January 2022 to December 2022, forty nurses from orthopedic wards were the subject to this study, all nurses were evaluated according specialized checklist “Iraqi Ministry of Health guide for organizing nursing operations and practices inside the hospitals and medical departments” then they attended the training program.

Results:

Approximately 50% of the study sample had a poor level of performance in the initial evaluation preintervention of the program, then after implementing the training program, the performance and practices of the nursing staff have improved significantly.

Conclusion:

The study concluded that there is a significant and poor performance and practices of the nursing staff toward upper femoral fractures in the orthopedic wards, and that the training program greatly and successfully improve their performance and practices.

The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Interpersonal and communication skills.
Lymphocytic Pleural Effusion in a 16 Year Old Immunocompetent Girl − A Rare Etiology: Case Report
Authors: Deepak T.H. , Joseph Ananthu , Santhakumar S. , Venugopal J.
Published: September 2024

This report presents a case study of a 16-year-old female patient with history of asthma who presented with left-sided consolidation and associated exudative lymphocytic pleural effusion that failed to respond to standard antibiotics and hence required decortication. Subsequent diagnostic evaluations revealed a diagnosis of Allergic Broncho Pulmonary Aspergillosis (ABPA), a condition that rarely involves pleural complications. Our case study serves to illustrate one such an instance of pleural involvement in ABPA.
Clinical-Epidemiological Profile and Distribution of Interstitial Lung Diseases: A Tertiary Care Centre Experience from North India
Authors: Singh Anubhuti , Verma Ajay K. , Kishore Kislay , Kant Surya
Published: September 2024

Background: The Interstitial Lung Disease (ILD) India registry, which included more than 1000 patients across 27 centers of the country, reported Hypersensitivity Pneumonitis (HP) to be the most common ILD in India, followed by Connective Tissue Disease-related ILD (CTD-ILD) and Idiopathic Pulmonary Fibrosis (IPF). This study was carried out to evaluate whether the spectrum of ILDs at our center conforms to the national data. Aims: To evaluate the clinical and epidemiological profile, distribution of various ILDs, and any association of the type of ILD with clinical parameters. Materials and methods: A prospective, observational study was carried out at a tertiary care center in North India, where patients having symptoms and radiological features suggestive of ILD were evaluated for clinical, radiological features and spirometric indices. Results: A total of 83 patients with ILD were evaluated. The mean age was 53.76 ± 13.07 years. The male-to-female ratio was 0.97. The mean FEV1 was 1.41 ± 0.38 L, mean FVC was 1.57 ± 0.43 L and the mean FEV1/FVC was 90.26 ± 8.99%. The mean 6 MWD was 270.85 ± 110.52 m. Reticulation and honeycombing were the most common radiological features. IPF was the most common ILD (28.9%). Conclusion: IPF was the most common ILD at our center. A statistically significant association was found between type of ILD and age, gender, past ATT intake, HTN, clubbing, and FEV1/FVC%.
A case report of primary complex anal fistula with six external openings (Shataponaka bhagandara) treated with interception of fistulous tract with application of Ksharasutra technique
Authors: Pandey Awadhesh Kumar , Aadithyaraj K. T. , Habeeb Nasrin
Published: September 2024

Complex anal fistulae, particularly those with six external openings, are rare, with limited documented cases in medical literature, highlighting the clinical novelty of such presentations. Managing these complex fistulae possesses a significant challenge, often requiring intricate surgical procedures that carry a heightened risk of postoperative damage and recurrence, with traditional approaches potentially compromising patients’ quality of life due to the risk of anal incontinence. In this report, a unique case of a 65-year-old male admitted with recurrent perianal boils and on-and-off pain fortwo years is presented. Visual and digital rectal examinations revealed a complex fistula-in-ano with six external openings, emphasizing the rarity of such cases. Conventional treatments were deemed suboptimal for this complex presentation. The patient underwent the Interception of the Fistulous Tract with Application of Ksharasutra (IFTAK) procedure, involving the interception of the fistulous tract and the application of Ksharasutra. Postoperative care included sitz bath, topical application of Jatyadi taila, and oral administration of Triphala guggulu. The patient’s recovery was marked by a gradual reduction in discharge, drying of external openings, and complete healing within eight weeks, with no recurrence observed at the six month follow-up. The IFTAK procedure proves to be a promising and effective intervention for managing rare cases of complex anal fistulae with multiple external openings, showcasing its potential in achieving satisfactory outcomes and rapid wound healing.
Management of fallopian tube blockage through Ayurveda: An experience
Authors: Buduru Pushpalatha , Kadam Sujata , Bharathi K. , Malsariya Swati
Published: September 2024

A woman’s and her family’s psychological and physical health both are impacted by infertility. Tubal blockage is the common cause of female infertility, resulting in the obstruction of the fallopian tubes and preventing the natural fertilization process. In modern science, the treatment available is surgery, which is quite expensive and, at times, unacceptable by the families. In this case report, a successful management of tubal blockage in a 27-year-old female patient is presented who was seeking for fertility. Uttarabasti and Ayurveda formulations including Pushpadhanva rasa, Phalasarpi, tablet Leptadene, Chandraprabha vati, Punarnava mandura, Ashokarishta, and Jatiphala churna were used internally. After five cycles of Uttarabasti and five months of internal Ayurvedic medications, tubal patency restored Uttarabasti along with oral Ayurveda medications has emerged as a minimally invasive and effective management option for selected cases of tubal blockage.
High-dose dexamethasone regulates microglial polarization via the GR/JAK1/STAT3 signaling pathway after traumatic brain injury
Authors: Yang Mengshi , Bai Miao , Zhuang Yuan , Lu Shenghua , Ge Qianqian , Li Hao , Deng Yu , Wu Hongbin , Xu Xiaojian , Niu Fei , Dong Xinlong , Zhang Bin , Liu Baiyun
Published: September 2024

JOURNAL/nrgr/04.03/01300535-202509000-00023/figure1/v/2024-12-31T000210Z/r/image-tiff

Although microglial polarization and neuroinflammation are crucial cellular responses after traumatic brain injury, the fundamental regulatory and functional mechanisms remain insufficiently understood. As potent anti-inflammatory agents, the use of glucocorticoids in traumatic brain injury is still controversial, and their regulatory effects on microglial polarization are not yet known. In the present study, we sought to determine whether exacerbation of traumatic brain injury caused by high-dose dexamethasone is related to its regulatory effects on microglial polarization and its mechanisms of action. In vitro cultured BV2 cells and primary microglia and a controlled cortical impact mouse model were used to investigate the effects of dexamethasone on microglial polarization. Lipopolysaccharide, dexamethasone, RU486 (a glucocorticoid receptor antagonist), and ruxolitinib (a Janus kinase 1 antagonist) were administered. RNA-sequencing data obtained from a C57BL/6 mouse model of traumatic brain injury were used to identify potential targets of dexamethasone. The Morris water maze, quantitative reverse transcription-polymerase chain reaction, western blotting, immunofluorescence and confocal microscopy analysis, and TUNEL, Nissl, and Golgi staining were performed to investigate our hypothesis. High-throughput sequencing results showed that arginase 1, a marker of M2 microglia, was significantly downregulated in the dexamethasone group compared with the traumatic brain injury group at 3 days post–traumatic brain injury. Thus dexamethasone inhibited M1 and M2 microglia, with a more pronounced inhibitory effect on M2 microglia in vitro and in vivo. Glucocorticoid receptor plays an indispensable role in microglial polarization after dexamethasone treatment following traumatic brain injury. Additionally, glucocorticoid receptor activation increased the number of apoptotic cells and neuronal death, and also decreased the density of dendritic spines. A possible downstream receptor signaling mechanism is the GR/JAK1/STAT3 pathway. Overactivation of glucocorticoid receptor by high-dose dexamethasone reduced the expression of M2 microglia, which plays an anti-inflammatory role. In contrast, inhibiting the activation of glucocorticoid receptor reduced the number of apoptotic glia and neurons and decreased the loss of dendritic spines after traumatic brain injury. Dexamethasone may exert its neurotoxic effects by inhibiting M2 microglia through the GR/JAK1/STAT3 signaling pathway.
Inhibitory gamma-aminobutyric acidergic neurons in the anterior cingulate cortex participate in the comorbidity of pain and emotion
Authors: Guan Lu , Qiu Mengting , Li Na , Zhou Zhengxiang , Ye Ru , Zhong Liyan , Xu Yashuang , Ren Junhui , Liang Yi , Shao Xiaomei , Fang Jianqiao , Fang Junfan , Du Junying
Published: September 2024

Pain is often comorbid with emotional disorders such as anxiety and depression. Hyperexcitability of the anterior cingulate cortex has been implicated in pain and pain-related negative emotions that arise from impairments in inhibitory gamma-aminobutyric acid neurotransmission. This review primarily aims to outline the main circuitry (including the input and output connectivity) of the anterior cingulate cortex and classification and functions of different gamma-aminobutyric acidergic neurons; it also describes the neurotransmitters/neuromodulators affecting these neurons, their intercommunication with other neurons, and their importance in mental comorbidities associated with chronic pain disorders. Improving understanding on their role in pain-related mental comorbidities may facilitate the development of more effective treatments for these conditions. However, the mechanisms that regulate gamma-aminobutyric acidergic systems remain elusive. It is also unclear as to whether the mechanisms are presynaptic or postsynaptic. Further exploration of the complexities of this system may reveal new pathways for research and drug development.
Pigmented basal cell carcinoma
Authors: Palaniappan Vijayasankar , Sadhasivamohan Anusuya , Karthikeyan Kaliaperumal
Published: September 2024

Pigmented basal cell carcinoma (pBCC) is an uncommon clinical and histopathological variant that is more frequent in darker skin types. The increased number of melanocytes and the subsequent melanin production are responsible for the increased pigmentation in this variant. Clinically, pBCC has a polychromatic nature. The most common clinical mimic of this entity is malignant melanoma. This article focuses on providing dermatologists with insights into this condition.
A Large Cardiac Hydatid Cyst in the Interventricular Septum with Hepatic Involvement in Young Male: A Rare Case Presentation
Authors: Goyal Amit , Bansal Ashish
Published: September 2024

Hydatid disease is a parasitic infestation caused by larvae of the Echinococcus tapeworm. It mainly affects the liver and lungs. Cardiac hydatid cyst is uncommon and involvement of the interventricular septum is even rarer. It may lead to various complications because of rupture and embolization. We report the case of a 24-year-old man who was diagnosed to have a large interventricular hydatid cyst associated with cysts in the liver which mimics like acute coronary syndrome. This case is of particular interest because of the rarity of septal localization of a hydatid cyst, and concurrent involvement of the liver and cardiac is uncommon.
Right Ventricular Thrombosis in a Young Female with Crohn’s Disease
Authors: Alizadehasl Azin , Yalameh Azam , Bahramnejad Alia , Dousti Amir , Bagheri Yaghoob , Afsari Yasamin , Shemshadi Sara
Published: September 2024

This case report presents the clinical findings and management of an 18-year-old female patient with a known history of Crohn’s disease who developed right ventricular (RV) thrombosis. Despite presenting with prolonged fever and inconclusive initial evaluations, subsequent cardiac imaging confirmed the presence of a mobile RV mass. The patient’s complex medical history, including a history of gastrointestinal bleeding, necessitated a multidisciplinary approach to treatment. This case underscores the importance of considering atypical cardiac complications in patients with chronic inflammatory conditions like Crohn’s disease and highlights the challenges and choices in managing RV thrombosis in such cases.
Post chemoembolization of hepatocellular carcinoma: a role of computed tomography and MRI in prediction of treatment response
Authors: Khamis Eman R.H. , Sherif Mohamed F. , Teama Atef H. , Abd-Elhalim Kareem M.
Published: September 2024

Background

Hepatocellular carcinoma (HCC) is the most prevalent and lethal form of primary liver cancer on a global scale.

Aim

To assess the tumor response to transarterial chemoembolization (TACE) by comparing computed tomography (CT) and magnetic resonance imaging (MRI) findings in patients with HCC.

Patients and methods

This prospective cohort research included 30 patients, aged from 40 to 77 years, with HCC, had TACE, good renal and liver functions, and were divided into two groups: the responders’ group and the nonresponders’ group. Patients had pre- and post-TACE examinations.

Results

There was a significant difference regarding the lesion criteria such as multiplicity, size, margins, involvement of both hepatic lobes, and pattern of arterial phase enhancement in both triphasic CT and dynamic MRI. Agreement between triphasic CT results and MRI results was in 26 patients. Disagreement as: two patients were categorized as complete response by triphasic CT versus partial response (PR) by MRI, one was categorized as PR by triphasic CT versus stable disease by MRI, and one was categorized as PR by triphasic CT versus PD by MRI. MRI was considered as the gold standard. Regarding the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of Triphasic CT in the studied patients, it was 89, 91, 90, 80, and 95%, respectively.

Conclusion

Triphasic CT is considered as the most used imaging techniques for predicting and evaluating the therapeutic response in HCC patients after TACE as referenced to dynamic MRI which is considered as the best imaging modality with high diagnostic standard in assessment of HCC before and after TACE.
Correlation between allergic rhinitis and otitis media with effusion in children
Authors: El Anany Amal F. A. , Ammar Mostafa E. , Rahman Amer Mohamed A. A. , Hegazy Hassan M.
Published: September 2024

Background

One of the most prevalent disorders in children is allergic rhinitis (AR), which can provoke other linked illnesses as asthma, rhinosinusitis, conjunctivitis, and otitis media. The most frequent ear condition in pediatrics and the leading cause of hearing loss in them is otitis media with effusion.

Aim

The aim of this work was to assess the correlation between AR and otitis media with effusion in a specific pediatric age group.

Patients and methods

This prospective, cohort observational work was performed on 60 cases divided into two groups equally: the patient group: diagnosed with otitis media with effusion based on clinical and tympanometry data (type B) and the control group: children who were recruited from the out-patient clinic from the same age group if they are not complaining of any otological diseases.

Results

Higher prevalence of AR symptoms in the patient group with otitis media with effusion than control group. Immunoglobulin E level was significantly greater in the patient group compared with control group. There was also a statistically major correlation between serum immunoglobulin E level, age and AR symptoms in patient group such as rhinorrhea and nasal obstruction.

Conclusions

AR may have a strong role in the pathogenesis and development of otitis media with effusion in children.
Ultrasonographic evaluation of fetal thymus size in normal and in diabetic pregnant women
Authors: Naga Diaa A. , Howidy Medhat S. , Mahfouz Amal E. , Omar Mona K.
Published: September 2024

Background

In the 12 week of gestation, the thymus moves to its ventral location, which is between the aortic arch and the bottom of the heart.

Aim

This study aimed to compare the fetal thymus diameters of two groups of pregnant women: one with gestational diabetes mellitus (GDM) and another without the condition, using ultrasonography as the method of measurement. There was also an attempt to establish a correlation between maternal blood glucose levels and the size of the fetal thymus.

Patients and methods

This case-control study included 110 pregnant women, aged from 20 to 35 years, who were experiencing singleton pregnancies from 24 to 28 weeks of gestation. The participants were separated into two groups of equal size. The study group consisted of pregnant women diagnosed with GDM, whereas the control group included healthy pregnant women.

Results

The study group had considerably decreased thymus diameter and TT ratio compared with the control group (P <0.001). A substantial negative association exists between fetal thymus size and maternal blood glucose levels (r= –0.253, P =0.007) and postprandial blood glucose (r= –0.565, P <0.001). Fetal thymus diameter predicts GDM (area under the curve=0.856, P <0.001) with 80% sensitivity and 74.55% specificity. TT ratio predicts GDM with 78.18% sensitivity and 67.27% specificity (area under the curve=0.836, P <0.001). Fasting and postprandial blood glucose levels were considerably higher in the study group compared with the control group (P<0.001).

Conclusions

Fetal thymus size measured ultrasonographically may serve as a potential indicator for the presence of GDM.
Intestinal Protozoa, Helminth Infection, and Associated Factors among Tuberculosis Patients and Nontuberculosis Persons in Bobo-Dioulasso City, Burkina Faso
Authors: Djibougou Diakourga Arthur , Mensah Gloria Ivy , Cissé Mamoudou , Inoussa Toé , Sawadogo Leon Tinnoga , Combary Adjima , Sanou Adama , Bonfoh Bassirou , Addo Kennedy Kwasi , Belem Adrien Marie Gaston , Meda Clément Ziemlé , Dabiré Roch Konbobr , Kaboré Achille , Diagbouga Potiandi Serge
Published: September 2024

We report the frequency and associated factors of tuberculosis (TB) and parasite coinfection from newly diagnosed pulmonary TB patients (TB+) and non-TB participants (TB−) from the Regional Tuberculosis Control Center, households, and health facilities in Bobo-Dioulasso from 2019 to 2021. Biological samples were examined for parasite infection using direct microscopy, concentration techniques, and the immunochromatographic rapid test. Data were analyzed using STATA 14. Of a total of 192 participants involved, 95 were TB+ and 97 were non-TB. There was no statistically significant difference in parasitic infections between the two groups, although it was higher in TB+ than TB− (69.5% [66/95] versus 55.7% [54/97]; P = 0.07). Protozoal infection prevalence was significantly higher in patients with TB+ than in those TB− (61.1% versus 37.1%; P = 0.001). Specifically, Entamoeba spp. and Cryptosporidium spp. followed this pattern with 35.8% versus 19.6% (P = 0.01) and 22.1% versus 8.3% (P = 0.007), respectively. Although higher in TB+ patients, helminthiasis frequency was not significantly different between the two groups (23.2% versus 15.5%; P = 0.2). Helminth species were Schistosomia mansoni (17.9% versus 12.4%), Dicrocoelium dendriticum (3.2% versus 1.0%), Enterobius vermicularis (2.1% versus 2.1%), Wuchereria bancrofti (1.1% versus 0.0%), and Hymenolepis nana (1.1% versus 0.0%). Illiteracy (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.0–6.1), smoking (aOR: 2.4; 95% CI: 1.1–5.3), and handwashing after defecation (aOR: 2.4; 95% CI: 1.2–4.7) were associated with parasites. This study reported a high frequency of parasite coinfection in TB patients. These findings suggest the need for adequate health education for behavioral change and systematic diagnosing of parasites in TB patients for better coinfection management.