bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, Attitude, and Practice Regarding Dyslipidemia among Adult Patients Visiting Medicine Outpatient Department of a Tertiary Care Teaching Hospital in Delhi
Authors: Arun Anamika , Aggarwal Amitesh , Raizada Alpana , Sharma Rahul
Published: May 2024

Background:

Dyslipidemia, a key risk factor for atherosclerosis, affects 25%–30% of urban and 15%–20% of rural individuals in India, as per the Indian Heart Watch study. Despite its association with cardiovascular diseases, there is insufficient understanding among the public. Given the scarcity of studies on knowledge, attitudes, and practices of dyslipidemia among the Indian population, this study aims to fill that gap.

Materials and Methods:

A cross-sectional observational study was conducted from September 2022 to February 2024. A total of 288 adult patients visiting the medicine outpatient department were included in the study through convenience sampling. A structured questionnaire consisting of 42 questions was designed, pretested, and administered to the participants to assess their knowledge, attitude, and practices regarding dyslipidemia. Data regarding lipid profile tests (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein) were collected, and medication adherence was also asked from the patients.

Results:

The study revealed a lack of knowledge, negative attitudes, and poor practices regarding dyslipidemia among the participants. The study included 288 participants with an average age of 40 years, predominantly males (53.1%). The majority of participants lacked knowledge about dyslipidemia (81.9%), with a prevalent misconception identified, with many participants incorrectly associating dyslipidemia exclusively with obesity. Among dyslipidemic patients, medication adherence was suboptimal, with a significant proportion discontinuing medication over time (87.3%). Factors associated with better knowledge of dyslipidemia included younger age, male gender, higher education level, professional occupation, higher income, unmarried status (who tend to be younger), urban residence, absence of comorbidities, and lower body mass index.

Conclusion:

The findings reveal significant gaps in awareness, negative attitudes, and suboptimal practices related to dyslipidemia and its management among the study participants. The majority of participants lacked knowledge about dyslipidemia, with a prevalent misconception associating it primarily with obesity.
Magnetic Resonance Imaging Evaluation of Wolffian Duct Anomalies – OHVIRA and OSVIRA
Authors: Bansal Lukshay , Arora Suryansh , Prasad Akhila
Published: May 2024

ABSTRACT

Herlyn–Werner–Wunderlich syndrome in females, also known as obstructed haemivagina and ipsilateral renal agenesis (OHVIRA), and Zinner’s syndrome, also known as OSVIRA in males, are two rare congenital syndromes affecting the urogenital tract. OHVIRA is obstructed haemivagina and ipsilateral renal agenesis and OSVIRA abbreviation stands for obstructed seminal vesicle and ipsilateral renal agenesis. For a long, these syndromes were considered different entities, owing to our poor understanding of underlying embryopathogenesis; however, in light of the recent acceptance of the Wolffian origin of the vagina in its entirety, these two syndromes are considered to be cut from the same cloth. In this case series, we present magnetic resonance imaging features of two cases each of OHVIRA and OSVIRA and discuss the similarities in embryopathogenesis behind them while debunking the old concepts. A deep understanding of embryopathogenesis allows a clinician and radiologist to predict the disease manifestation, and its outcome and also acts as a guide to screen for potential subtle defects, which would otherwise have been missed.
Assessing the relationship between health literacy intervention and hypertension self-management: A 7-year systematic review from January 2016 to December 2022
Authors: Bamidele Feyisayo Iyabo , Bello Cecilia Bukola , Akinwale Oladayo Damilola , Falana Mubo Stella
Published: May 2024

Hypertension (HTN) is one of the most common chronic diseases affecting over 30% of the adult population globally, with a growing incidence rate. This review assesses the relationship between health literacy (HL) intervention and hypertension (HTN) self-management among people with HTN. The study design was a systematic review of empirical research articles using a well-defined strategy. Online journals were accessed through databases such as PubMed, CINAHL, Google Scholar, ProQuest, Global Health, WHOLIS, Embase, and EbscoHost, spanning from January 2016 to December 2022 as the scope of the study. Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample, Phenomenon of Interest, Design, Evaluation, Research Type framework for systematic review, focusing on criteria related to the sample, the phenomenon of interest, study design, evaluation, and research type. Out of 180 studies initially identified in the database search, 20 studies were ultimately included in the review. The findings were reported based on these five emerging themes: Relationship between HL and HTN self-management; Effect of HL intervention on HTN self-management; Factors predicting self-care behaviors among HTN patients with low HL; Effect of HL and self-management efficacy on health-related quality of life (HRQoL); and level of self-care practices. This review highlights a relationship between HL, self-efficacy, self-care, and HRQoL, underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.
Effectiveness of aromatherapy with lavender compared to progressive muscle relaxation on anxiety and vital signs in patients under spinal anesthesia: A randomized clinical trial
Authors: Amini Nazanin , Omidvar Safoora , Zamenjani Masoomeh Noruzi , Harorani Mehdi , Modir Hesameddin
Published: May 2024

Objective:

This study aimed to determine the effectiveness of aromatherapy with lavender essential oil compared to progressive muscle relaxation (PMR) on anxiety and vital signs of patients under spinal anesthesia.

Materials and Methods:

This clinical trial was conducted on 120 spinal anesthesia candidates who were randomly assigned into three groups of 40 including control, PMR (Jacobsen group), and aromatherapy. The state-trait anxiety inventory was completed on surgery day and 15 min after the end of the intervention by the samples of all three groups, and at the same time as completing the questionnaire, vital signs were also measured and recorded.

Results:

The mean score of anxiety after intervention was lower than that before the intervention in the aromatherapy group (P < 0.001). The mean score of anxiety in the aromatherapy group was significantly lower than that in the Jacobsen group (P < 0.001). Moreover, data analysis showed a significant decrease in the mean arterial blood pressure scores of the PMR (P = 008) and aromatherapy (P < 0.001) groups and a statistically significant increase in the mean heart rate scores in the control group (P = 0.002).

Conclusion:

The use of aromatherapy with lavender is more effective than PMR therapy in reducing the anxiety level of patients undergoing spinal anesthesia. Due to the high level of anxiety and its serious effects on the patient’s hemodynamics, aromatherapy with lavender can be used as an easy and cheap method to reduce anxiety in operation rooms.
Study of Clinical, Laboratory Profile, and Outcome of Patients with Acute Pyelonephritis in a Tertiary Care Hospital
Authors: Wani Athar Rashid , Koul Rakesh Kumar , Dar Musaib Ahmad , Farooq Shaika
Published: May 2024

Aims:

This study aims to study the clinical profile of patients with acute pyelonephritis (APN), yield of urine culture in APN; common causative agents and their antibiotic sensitivity pattern and to study the outcome of patients with APN in terms of mortality, duration of hospital stay, need of intensive care unit (ICU) care and necessitation of urological intervention.

Materials and Methods:

This study was a prospective observational study of patients who were admitted to the Postgraduate Department of General Medicine, Shri Maharaja Hari-Singh Hospital, an associated hospital of Government Medical College Srinagar as clinically suspected cases of APN and then proven radiologically. The study was conducted over a period of 2 years from August 2018 to August 2020 and a total of 200 patients fulfilling the selection criteria were included in the study.

Results:

Classical triad of fever, dysuria, and flank pain was seen in 55% of our patients with fever as the predominant symptom seen in 92% of patients. In our study, 70% were diabetic, 11% had nephrolithiasis, 8% of patients had obstructive uropathy, 7% were immunosuppressed, 3% had indwelling catheters while as 9% were documented cases of chronic kidney disease. Out of all positive urine cultures, 60% were Escherichia coli, 16.6 were Enterococcus, 13.3% were klebsiella, and 10% were Pseudomonas.

Conclusion:

Fever is predominant symptom in APN 23. Diabetes is the most common underlying predisposing condition. Yield of urine culture is very low with E. coli is the predominant organism. USG has less sensitivity for diagnosing APN than CT. The outcome of patients in terms of duration of hospital stay and need of ICU care is poor in diabetic patients. In our study, USG underestimated the cases of APN; detected only 132 out of 184 cases of computed tomography-proven nonemphysematous pyelonephritis and only 8 out of 16 patients of emphysematous pyelonephritis with an overall sensitivity of 70%. In our study, 3% of patients needed ICU care while 46% and 4% develop acute kidney injury and multiple organ dysfunction syndromes, respectively. Eleven percent of patients required urological intervention. Unfortunately, 2 out of 200 patients died during disease in the hospital.
Immune-Boosting Phytochemicals in Nigeria
Authors: Olaniyan Mathew Folaranmi , Muhibi Musa Abidemi , Olaniyan Tolulope Busayo
Published: May 2024

The immune-boosting potential of phytochemicals from plant products in Nigeria has gained significant attention in recent years. Phytochemicals are bioactive compounds found in plants that have been shown to possess immunomodulatory properties. Nigeria is a country with rich biodiversity, and its traditional medicine practices rely heavily on the use of plant products for various health purposes, including immune enhancement. This review aims to summarize the existing literature on immune-boosting phytochemicals in Nigeria and their activities. Relevant and accurate literature were sourced from WHO. CDC, NCDC, PubMed, Scopus, PLoS One Crossref, Google Scholar, and NATURE Journals. Several studies have identified various phytochemicals with immunomodulatory properties from Nigerian medicinal plants, including alkaloids, flavonoids, terpenoids, phenolic compounds, and polysaccharides. These phytochemicals have been shown to exhibit diverse mechanisms of action, such as antioxidant, anti-inflammatory, antimicrobial, and immunostimulatory activities, which can potentially support the immune system and improve overall health. However, there are still knowledge gaps that need to be addressed in this field. Further research is needed to elucidate the molecular mechanisms underlying the immunomodulatory activities of these phytochemicals and their safety and efficacy in human subjects. To ensure consistency and reproducibility of results, it is crucial to standardize the methods used for extracting, isolating, and characterizing phytochemicals from Nigerian plant products. Quality control measures must also be put in place. Moreover, studies on the sustainable sourcing, cultivation, and conservation of medicinal plants in Nigeria are crucial to ensure their availability for future generations. Bridging these knowledge gaps will facilitate the development of evidence-based interventions using immune-boosting phytochemicals from Nigerian plant products for the management of immune-related health conditions. Further exploration of the immunomodulatory potential of Nigerian plant products and their phytochemicals has the potential to contribute to the development of novel strategies for enhancing immune function and improving overall health.
Bioactivities of Osbeckia octandra DC. Extracts
Authors: Vivekanandarajah Saravanan , Shanmugalingam Vinujan , Rajamanoharan Pholtan
Published: May 2024

Osbeckia octandra DC. is a small shrub that belongs to the Melastomataceae family. This plant species has been used in Sri Lankan Ayurvedic medicine to treat diabetes, hemorrhoids, hepatitis, ascites, jaundice, other liver disorders, and hyperlipidemia. This work aims to present a comprehensive, systematic review of O. octandra. The electronic databases, including the Web of Science, Scopus, ScienceDirect, PubMed, and Semantic Scholar, were employed to identify the related published studies of O. octandra up to December 2023. Both in vitro and in vivo studies show that O. octandra has antihepatotoxic activity, immunomodulatory activity, antioxidant activity, cholinesterase inhibitory activity, protease inhibitory activity, and hepatoprotective activity. On the other hand, the phytochemistry of O. octandra is unknown. Furthermore, none of the active compounds have been identified for their reported pharmacological activities. Hence, further in vitro, in vivo, and clinical studies should be conducted on extracts, and active compounds should be identified from these extracts. Only limited scientific evidence is available for the ethnopharmacological uses of O. octandra. Therefore, this work provides the basis for carrying out further pharmacological activity research and phytochemistry analyses of this plant species.
Identification and Content Determination of Toxic Alkaloids in Aconitum brachypodum
Authors: Peng Haiyan , Yang Fulin , Luo Yumei , Ma Xiaoxia , Zhou Zhihong
Published: May 2024

Objective:

The aim of this study was to identify and determine the content of toxic components (diester-type alkaloids) in Aconitum
brachypodum, providing scientific support for the safe clinical use of this medicinal herb and offering a basis for quality control.

Methods:

Acidic water was used to extract the alkaloids from Aconitum
brachypodum, which were then extracted with petroleum ether. Toxic components were separated and extracted with chloroform from the acid water, with the phenolic acidic fractions absorbed by alkaline oxidized alumina. The toxic components were identified by thin-layer chromatography (TLC), and the content was measured by ultraviolet (UV)–visible spectrophotometry.

Results:

A method for special thin-layer identification of toxic components and general determination of total alkaloid content in Aconitum
brachypodum was established. The mean content of toxic diterpenoid alkaloids in Aconitum
brachypodum cultivated in the Dongchuan district of Kunming was approximately 0.30%.

Conclusion:

Selective extraction of toxic alkaloids in Aconitum
brachypodum by chemical methods, identification by TLC, and content determination by UV–visible spectrophotometry can control the toxicity of this herb, guide production, and ensure clinical safety.
The Frequency of Occipital Spurs in Relation to the Cephalic Index: An Anatomorphometric Cone Beam CT Study
Authors: Çağlayan F , Güller H , Öncü E , Kuzey N , Dalcı HLT
Published: May 2024

Background:

The occipital spur (OS) can be described as an abnormal elongation of the external occipital protuberance (EOP). The cephalic index (CI) refers to the ratio of width to length in any skull.

Aim:

The aim of the present study was to evaluate the frequency and types of OS. It also aimed to determine the mean CI and the distribution of skull types using cone beam computed tomography (CBCT). And to determine if there was a relationship between the cephalic index and the presence and types of OS.

Methods:

CBCT scans from 523 patients were included in the study. OSs were classified as type 1 (flat), type 2 (crest), and type 3 (spine). Skull length and width were measured on axial sections and the CI was calculated. Based on the cephalic index (CI), skull types were classified as dolichocephalic (CI < 75), mesocephalic (75 < CI < 80), brachycephalic (80 < CI < 85), and hyperbrachycephalic (CI > 85).

Results:

The most common cranial types in the study group were brachycephalic (44.7%), mesocephalic (28.3%), hyperbrachycephalic (21.2%), and dolichocephalic (5.7%). Regarding the presence of OS, 54.3% of the participants had no OS, 23.1% had flat type, 15.3% had crest type, and 7.2% had spin type OS. There was a statistically significant difference (P < 0.05) in the frequency of OS according to skull type.

Conclusion:

This study, the first to evaluate CI and OS using CBCT, concludes that brachycephaly is the most common cranial type. OS is more common in mesocephalic and dolichocephalic skulls, at older ages, and in males.
Effect of Neurostimulator Usage on Block Success in Costoclavicular Block: A Randomized Controlled Trial
Authors: Soylu S , Moralar DG , Şehirlioğlu SŞ , Yaman Ü , Türkmen ÜA
Published: May 2024

Background:

The need of a neurostimulator for a successful nerve block was questioned in different block types after ultrasound had become standard.

Aim:

To determine the effect of neurostimulator use on block success in the costoclavicular block (CCB).

Methods:

Sixty patients undergoing upper limb surgery were enrolled in the study. Patients using ultrasound and injection pressure manometer were divided as Group USP, and those using ultrasound, injection pressure manometer, and neurostimulator were divided as Group USPN. After block was applied, sensory and motor block levels were measured on a numeric scale. The block was considered successful when the desired score was reached or general anesthesia was not required intraoperatively. The number of successful and unsuccessful blocks for each group was summed up. The successful block rate was compared as the primary objective. Block application time, time to readiness for surgery, the number of needle passes, diaphragm paralysis rate, and complication rate were compared as secondary goals.

Results:

Block success rate was 90% (27/30) in Group USP and 96.7% (29/30) in Group USPN. There was no statistical difference in terms of block success rate. Block application time was significantly shorter in Group USP (207.2 ± 32.7 s) when compared to Group USPN (280.9 ± 70.1 s). Other secondary outcomes were similar.

Conclusion:

Neurostimulator use did not affect block success in the CCB. Neurostimulator utilization prolonged block application time explicitly and did not change the complication rate. Ultrasound and injection pressure manometer are sufficient for a safe and successful CCB.
The Relationship between the Level of Coagulative Function Hypertensive Disorder Complicating Pregnancy
Authors: Lin Z , Fang B , Zhu D , Wang D , Lin X , Yu X , Wang F , Yang C
Published: May 2024

Background and Aim:

Preeclampsia, a pregnancy complication associated with significant maternal and perinatal mortality and morbidity, has been found to be closely linked to dysfunction in the blood coagulation–fibrinolysis system. However, the relationship between hematologic data and severity and onset time of preeclampsia remains unclear. This study aimed to identify specific hematologic parameters in both preeclamptic and normotensive pregnant women and determine their potential significance in the pathogenesis of preeclampsia.

Materials and Methods:

A total of 112 patients with gestational hypertension disease were divided into two groups: early-onset preeclampsia (32 cases) and late-onset preeclampsia (80 cases). A control group of 82 normotensive pregnant women matched for age and parity was also selected. Blood samples were collected from all participants to test for specific hematologic parameters.

Results:

Mild and severe preeclampsia were associated with lower hemoglobin level (P = 0.01 and P = 0.03, respectively), higher mean platelet volume (P = 0.01 and P = 0.01, respectively) and fibrinogen (P = 0.01 and P = 0.01, respectively), and shorter prothrombin time (P = 0.02 and P = 0.01, respectively) and activated partial thromboplastin time (P = 0.01 and P = 0.02, respectively).

Conclusion:

These findings have provided evidence on the hematologic coagulative actors in the pathogenesis and severity of preeclampsia.
Determination of Breast Cancer Risk and Knowledge Levels in Women: The Case of Cyprus
Authors: Mammadov B , Yarıcı F
Published: May 2024

Background:

Breast cancer is the type of cancer that is seen all over the world and ranks first among female cancers in terms of incidence and cause of death.

Objective:

This research was conducted to determine the breast cancer risk level and breast cancer knowledge level in women living in Northern Cyprus.

Methods:

The study, which was planned as a relational survey, was carried out as web-based. The research was completed with 657 adult female participants living in Northern Cyprus who volunteered to participate in the study. In order to collect data, the first section includes the introductory features, the second section includes the "Breast Cancer Risk Assessment Form" for determining breast cancer risk levels, the third section includes the "Comprehensive Breast Cancer Knowledge Test" to determine the breast cancer knowledge levels of the participants, and the fourth section includes the "Champion Health Belief Model Scale” was used.

Results:

It was determined that 95.2% of women were in the low risk group for breast cancer. The knowledge test mean score is 12.05, and it can be said that the scores obtained are above the average (min:4- max:18). It was found that 55.7% of the women knew how to do Breast Self-Examination (BSE), but only 15.4% of them regularly performed BSE every month. It was found that 80.9% of the women never had mammography and their knowledge scores increased with increasing education level (p< 0.001) and there was a significant relationship between non-smokers and their knowledge levels (p< 0.01).

Implications for Practice:

Despite the high scores of women in knowledge tests, it was observed that the frequency of applying BSE and having mammography was very low. Regardless of the risk factors for breast cancer, the importance of regular check-ups and BSE for every woman should be taught to women by health professionals, and group trainings should be planned for women who do not have training on this subject.
Considerations, challenges and gaps on mandatory childhood vaccination programs: A comprehensive analysis
Authors: Shen Jianyong , Ji Chai , Chen Fuxing , Luo Xiaofu , Hu Yu
Published: May 2024

Childhood vaccine coverage rates are not optimal for controlling vaccine-preventable diseases (VPDs), as outbreaks of VPDs occur from time to time globally. To address this gap, many countries have enacted and strengthened childhood vaccination programs, which are often mandatory. Mandatory vaccination programs are often controversial because they may reduce or eliminate individual choice. A standard approach for evaluating the mandatory vaccination program is not available. Vaccine types, target age groups, program rigidity, incentives or penalties, enforcement, and compensation mechanism for adverse events following immunization vary across the world. This article reviewed the mandatory childhood vaccination, and presented examples to illustrate the variations among different programs, outcomes, and key considerations when contemplating these programs. Before implementing mandatory childhood vaccination programs, it is critical to ensure financial sustainability, a steady supply of vaccines, equitable access for all target population, and tailored implementation to fit the local culture and context.
Parental Knowledge and Attitudes to Childhood Hearing Loss and Hearing Services in the Kingdom of Saudi Arabia
Authors: Khurayzi Tawfiq A. , Gadi Wala H. , Alandijani Hamza A. , Almutairi Abdulaziz. B , Zogel Basem A. , Akoor Atheer A. , Hakami Alshomokh M. , Alsallum Manar H.
Published: May 2024

Background:

Childhood hearing is critical to the development of speech, language, and social skills. Hearing loss (HL) can interfere with learning and requires early detection and management. This study aimed to evaluate parental knowledge with attitudes toward childhood HL, and available hearing services across the Kingdom of Saudi Arabia.

Methods:

This cross-sectional study was conducted among parents of children from different regions of Saudi Arabia. Data were collected using an online self-administered questionnaire and analyzed using SPSS version 23. This study examined the relationships among socio-demographic characteristics and knowledge and attitudes toward HL using a Chi-square test.

Results:

Assessment of the prevalence of various aspects of knowledge and attitudes among parents toward childhood HL revealed that 732 (58.4%) participants had a good level of knowledge, while 521 (41.6%) had poor knowledge. Furthermore, the attitude analysis revealed that 871 (69.5%) participants expressed a good attitude, whereas 382 (29.5%) had a poor attitude. A significant association was noted between age group and attitude (P = 0.005).

Conclusion:

The findings demonstrated a gap in the level of knowledge and significant variation regarding a certain set of risk factors responsible for HL, which highlighted the need for establishing educational programs across the Kingdom to mitigate these harms and promote parental awareness. Parental attitudes toward auditory services were satisfactory; however, efforts are needed to familiarize parents with newborn hearing screening programs that are widely available in the Kingdom.
Nocturia, nocturnal polyuria, and nocturnal enuresis in adults: What we know and what we do not know
Authors: Chang Tien-Lin , Kuo Hann-Chorng
Published: May 2024

ABSTRACT

Nocturia is defined as the nocturnal frequency of one or more voiding episodes per night. It increases with aging and has an impact on sleep quality and the risks of falling and mortality. Nocturia disorder involves nighttime frequency, nocturnal polyuria, and nocturnal enuresis. In older adults with nocturia disorder, multiple factors could contribute to nocturia severity and characteristics, including poor sleep quality, lower urinary tract dysfunction, and excessive fluid output. Several nonurological medical diseases have been found to result in nocturia, such as hypertension, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease, metabolic syndrome, and diabetes. Urological and medical assessments should be performed to diagnose nocturia disorder. A frequency volume chart to evaluate the nocturnal polyuria index, functional bladder capacity, and urodynamic study can reveal the presence of nocturnal polyuria and lower urinary tract dysfunction. Treatment should be based on multiple nocturia etiologies, and a combination of multiple therapies for individual pathophysiology will achieve a better treatment outcome.
Mitigative effect of Naringenin in bleomycin induced systemic sclerosis model; role of Notch signaling pathway
Authors: Morshedy Dina I M , Atef Marwa M , Soliman Nema A , Fouda Abdallah M
Published: May 2024

Background

An immunological, proinflammatory, and vascular disorder called systemic sclerosis (SSc) frequently leading to progressive tissue fibrosis. Reactive oxidizing species are thought to have a substantial influence on disease initiation and progression, based on a variety of studies. Also, Notch signaling is known to modulate fibroblast homeostasis, angiogenesis, and lymphocyte development.

Aim

This experimental study was designed to shed light on the possible ameliorating mechanism of naringenin as antioxidant in bleomycin-induced SSc model via focusing on Notch signaling cascade.

Materials and methods

50 male albino mice were employed for the test, while being allocated randomly to one of five equal groups as follows: Control group (group I), Naringenin-treated group (group II), Bleomycin-treated group (group III), and group IV (Naringenin/Bleomycin co-treated group) and group V (Bleomycin followed by Naringenin treated group). Plasma hydrogen peroxide level, skin tissue hydrogen peroxide and hydroxyproline levels were measured using colorimetric assay. A Disintegrin and metalloproteinase domain containing protein 17 and neuregulin 1 levels in skin tissue were measured by Enzyme-linked immunosorbent assay. Histological evaluation was also performed.

Results

Plasma hydrogen peroxide, skin tissue hydrogen peroxide, hydroxyproline, a Disintegrin and metalloproteinase domain containing protein 17 and neuregulin 1 levels in the bleomycin-treated group were significantly increased than other studied groups. Naringenin administration in parallel with the induction mitigated the obtained biochemical changes and protected against the chemical induction of SSc.

Conclusion

Naringenin could protect against bleomycin-induced SSc through its antioxidant role.
Long-term outcome of local muscles transposition for the functional restoration of large upper or lower lip defects
Authors: Alsharkawy Kareem , Mostafa Ibrahim , Elmelegy Nader
Published: May 2024

Background

Although more than 200 techniques have been reported for the reconstruction of their and lower lip defects since 1000 BC, none of them is ideal.

Local flaps come at the expense of extra skin scarring and, in some cases, the surgeon may be confronted with the lack of sufficient tissues for the reconstruction of large defects.

It has been reported that several methods exist for performing near-total lip reconstruction. Currently, free micro-vascular tissue transfer and local flap repair (the Bernard von Burrow-Webster method) are the two most prominent methods.

Aim

To evaluate the functional results of using local muscles transposition-assisted dermal fat flap and muco-buccal flap to treat upper or lower lip defects.

Patients and methods

This study was carried out on 128 patients, who presented to us with malignant tumors affecting the lips.

Results

Lip defect sizes ranged from four to 6 cm in length. There was no evidence of flap failure, and the aesthetic and functional outcomes are very well. All patients healed successfully, and 100% of the flaps survived. No cases of microstomia were reported.

Conclusion

The use of local muscle transposition, assisted with dermal fat flap and muco-buccal flap technique, showed excellent results in regaining, oral competence, and lip mobility, and as much as possible, increasing the aesthetic outcome.
Ear keloid treatment using subepidermal excision-assisted electrophotobiomodulation
Authors: Alsharkawy Kareem , Mostafa Ibrahim , Elmelegy Nader
Published: May 2024

Background

Keloids are challenging problems that have an aesthetic and psychological impact on patients who are genetically susceptible, especially in exposed areas. Moreover, treatment modalities are known to have a high incidence of recurrence.

Aim

We present our experience in subepidermal excision combined with E-light therapy (electrophotobiomodulation) in the treatment of ear keloids.

Patients and methods

Thirty-five patients who were presented with ear keloids were included. Under local anesthesia, a flap of keloid epidermis and a thin layer of the scar underneath were raised from the fibrous keloid core which, in turn, was extirpated leaving a thin margin of scar tissue (subepidermal excision).

2 weeks later after complete healing, all patients were subjected to a combination of radiofrequency (RF) and intense pulsed light (IPL) sessions (E-light). The outcome was assessed by the incidence of keloid recurrence at any time within the 2-year follow-up.

Result

The age of the patients ranged from 12 to 52 years with a median age of 34 years. There were 25 females (71%) and 10 males (29%). The average number of E-light therapy sessions was 6 (range 4–8 treatment sessions) at 4-week intervals. Keloid size had an average of 1 × 3 cm. In the 2-year follow-up, only two cases reported keloid recurrence. Of the patients, 33 did not report recurrence with a success rate of 95%.

Conclusions

Subepidermal keloid excision with a combination of radiofrequency and intense pulsed light is a promising multimodality treatment for ear keloids.
Histological study of the effect of hydroxychloroquine sulfate on the retina and the possible protective role of propolis in adult male albino rats
Authors: Noseir Ghada Adel Fetoh , Elkaliny Heba Hassan , Elhafez Amal Ali Ahmed Abd , Salah Ehsan Farouk
Published: May 2024

Background

Hydroxychloroquine sulfate (HCS) is a widely used antimalarial drug. Recently, it garnered attention about its possible effect against COVID-19. Retinopathy is one of its dangerous side effects which may be untreated. Propolis is a substance made by honeybees and has a neuroprotective effect.

Aim

The study aimed to assess the impact of HCS on the retina and the possible ameliorative role of propolis in adult male albino rats.

Materials and methods

In all, 32 adult male albino rats were separated into four groups; group (I): the control group, group II: rats had received 100 mg/kg propolis for 12 weeks, group III: the HCS dose of 55 mg/kg/day had been administered to the rats for a period of 10 days, group IV: rats had received 55 mg/kg/day of HCS concomitant with 100 mg/kg propolis for 10 days and then propolis was continued to complete 12 weeks. Retinal specimens were obtained and processed for histological and morphometric analyses.

Results

Group III revealed vacuolations of photoreceptors; nuclei are widely separated in the outer and inner nuclear layers Also nuclei are darkly pigmented in the inner nuclear layer and the ganglion cell layer. Statistical analysis showed that there was a significant drop in the average number of ganglion cells when contrasted with the control group. These changes were markedly ameliorated in group HCS and propolis-treated group.

Conclusion

Hydroxychloroquine sulfate induced damaging effects on the rat retina and receiving propolis could attenuate these effects.
Predictive accuracy of ultrasonography on upper ends of radius and ulna in age estimation in a sample of Egyptian population
Authors: Seada Donia A A , Fayed Manar M , Elkhouly Radwa M , Hashem Ahmed A
Published: May 2024

Background

Forensic age estimation is considered a prime focus of forensic anthropological analysis of living and human skeletal remains.

Aim

This study aimed to assess the accuracy of ultrasonography (US) in bone age estimation and to compare the predictability of age detection using ultrasound on the upper ends of the radius and ulna in a sample of Egyptian population.

Patients and methods

This cross-sectional study was conducted on 111 Egyptian volunteers of both sexes aged from 10 to 25 years old and subjected to the sonographic examination of the elbow joint. The volunteers were grouped into three age groups: group 1 (from 10 up to <12 years), group 2 (from 12 up to 16 years), and group 3 (> 16 up to 25 years).

Results

There was no statistically significant difference between both sexes concerning the age groups suggested by the stage of the epiphyseal union of the upper ends of the radius and ulna detected by US examination. The Kappa agreement test showed that there was a good agreement between the age estimated by the US examination based on the stage of the epiphyseal union of proximal ends of radius and ulna and the official age (Kappa=0.756, and 0.630, respectively).

Conclusion

US can be used as a suitable alternative modality for age estimation. The studied bone ends showed good agreement between the official age and the US estimated age. The proximal radius was with the highest agreement.
Histological study on the toxic effect of titanium dioxide nanoparticles on the prostate gland of adult albino rats and the protective role of coenzyme Q10
Authors: Elewa Nourhan G , Elabd Shereen S , Moustafa Khaled A , Shalaby Nawar M
Published: May 2024

Background

Titanium dioxide nanoparticles have numerous clinical and commercial applications. Coenzyme Q10 has antioxidant and free radical-scavenging capabilities in addition to functions like vitamins.

Aim

To identify changes in the ventral prostatic lobe of adult albino rats exposed to titanium dioxide nanoparticles and to evaluate the possible protective role of coenzyme Q 10.

Materials and methods

Forty adult male albino rats were used in this study. Group I was the control, Group II received coenzyme Q10 at a dose of 20 mg/kg, Group III received titanium dioxide nanoparticles at a dose of 600 mg/kg, and Group IV received both coenzyme Q10 and nanoparticles. Prostate glands sections were stained with hematoxylin and eosin. A morphometric study and statistical analysis were performed on the epithelial height.

Results

Sections of group III showed some histological abnormalities in the form of widely spaced prostatic acini, an increase in the amount of connective tissue stroma, with numerous dilated blood vessels and perivascular cellular infiltration. The mean height of the prostatic epithelium in group III was significantly higher than in the control group. Prostatic epithelial height was found to be significantly lower in group IV as compared to group III.

Conclusion

Titanium dioxide nanoparticles induce changes in the prostatic ventral lobe which can be ameliorated by coenzyme Q10 supplementation.
Efficacy of corneal debridement combined with intrastromal voriconazole injection as adjunctive therapy for recalcitrant fungal keratitis
Authors: Elmohamedy Sarah E , Ghoneim Ahmed M , Sabry Moataz M , Khater Mohammad M
Published: May 2024

Background

Fungal keratitis is a serious cause of blindness worldwide, especially in developing countries. Many trial were done to accelerate healing and improve outcome of recalcitrant fungal keratitis unresponsive to standard clinical treatment.

Aim

To evaluate the efficacy of corneal debridement combined with intrastromal voriconazole injection as an adjunctive treatment for recalcitrant mycotic keratitis.

Patients and methods

This prospective randomized interventional study was carried out on 40 eyes of 40 patients with resistant fungal corneal ulcers. Patients were equally divided into two groups: in one group, corneal debridement combined with intrastromal voriconazole in the same setting (group A) was done as adjunctive therapy to topical treatment, and in the other group, only topical antifungal therapy was used guided with culture and sensitivity results (group B). All patients were subjected to ophthalmic examination and were followed-up daily for the first week then weekly till complete healing.

Results

Healing was achieved in 95% of cases of group A at the fourth week while healing was achieved in group B in only 55% of cases at the same duration with a statistically significant difference between both groups (X2=14.983,P= 0.002). No cases required amniotic membrane transplantation (AMT) in group A while 4 cases in group B required AMT due to thinning.

Conclusions

Corneal debridement combined with intrastromal injection of voriconazole may offer a good option as adjunctive therapy to traditional topical therapy for recalcitrant fungal keratitis and may shorten the duration of the treatment with faster recovery of vision.
The beneficial effects of Berberine on experimental model of Acrylamide induced nephrotoxicity
Authors: El Gendy Dalia A M , Nasef Nahla A , El-Ghaffar Heabah Nehal A , Gaafar Nagah K , Dawood Lamees M
Published: May 2024

Background

Acrylamide (AA) is an industrial monomer which is used in many industries. Dietary or occupational exposure affects high percentage of population. It causes multi-organ toxicity including neurotoxicity, hepatotoxicity and nephrotoxicity via induction of oxidative stress and inflammation. AA induced nephrotoxicity is a major health problem that needs our concern. Berberine (BBR) is an alkaloid that has nephroprotective effects as being an antioxidant and an anti-inflammatory.

Aim

The aim of this work was to shed light on autophagy and nucleotide binding oligomerization domain like receptor family pyrin domain containing 3 (NLRP3) inflammasome formation and to assess the ameliorating effect of BBR as antioxidant, anti-inflammatory and autophagy modulator on experimental model of AA induced nephrotoxicity.

Materials and methods

This study was done on 50 male rats, which were randomly divided equally into 5 groups: control group; Acrylamide group (received AA only); Berberine-Acrylamide co-treatment group (received AA and BBR simultaneously); prophylaxis group (given BBR alone for 10 days followed by BBR and AA for another 10 days); and Berberine group (received BBR only).

Results

Administration of BBR as a prophylactic agent enhanced kidney function, restored electrolyte balance, suppressed oxidative stress and NLRP3 inflammasome and induced mitophagy. However, its administration as a co-treatment with AA showed ameliorating effect. The histopathological changes were consistent with the biochemical results.

Conclusion:

BBR could protect against AA induced nephrotoxicity through reduction of oxidative stress, suppression of NLRP3 inflammasome and induction of mitophagy. The usage of BBR as a protective drug against the progression of nephrotoxicity seems to be promising.
Economic Burden of Type 2 Diabetes Mellitus Management
Authors: Eshwari K. , Kamath Veena G. , Rao Chythra R. , Kamath Asha
Published: May 2024

Expenditure on diabetes mellitus is increasing worldwide and is determined by multiple factors and knowledge about these factors may help to improve patient management and reduce health-care cost. The present study aims to determine the factors influencing the expenditure incurred by patients with type 2 diabetes mellitus (T2DM). A cross-sectional survey was conducted among 809 patients with T2DM from a coastal community in Southern India. Expenditure incurred for the management of T2DM in the previous year was collected using a predesigned survey tool. Duration of disease, source of diabetes care, presence of comorbidities, hospitalization, and adherence to medications were studied as potential cost predictors. Age, gender, education, occupation, and socioeconomic status as key determinants were evaluated. Expenditure incurred by patients with T2DM was estimated to be INR 5041 (2516–11,224) annually while the presence of comorbidities led to higher expenditure, INR 9133 (4034–19,053). Medication and hospitalization were the major drivers of direct cost. Subjects visiting private health facilities had a higher median cost with respect to diabetes-related care. Advancing age, male gender, high socioeconomic status, higher literacy, and longer duration of diabetes were identified as significant independent predictors of cost on multivariate analysis. The high cost of diabetes supports the need for strengthening public and private primary care facilities to provide standard care for diabetes.
Factors Associated with Anxiety and Depression among Chronic Obstructive Pulmonary Disease Outpatients in Ho Chi Minh City, Vietnam
Authors: Quynh Nguyen Nhung Thi , Ngoc Huynh Van Anh , To Quyen G , To Kien G
Published: May 2024

This study investigates the prevalence of and associated factors with depression and anxiety among chronic obstructive pulmonary disease (COPD) outpatients at Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam. A cross-sectional study was conducted between March and May 2020 at the hospital's outpatient department. Those aged ≥18 years, diagnosed with COPD and undergoing COPD treatment, were eligible. The Hospital Anxiety and Depression Scale was used to measure depression and anxiety. Dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Among 392 patients, 381 (97%) participated in the study. The number of patients with depression and anxiety was 33.1% and 21.3%, respectively. Compared to men, women were more likely to experience depression (adjusted odds ratio [aOR] = 2.12, 95% confidence interval [CI] = 1.06–4.24) and anxiety (aOR = 4.11, 95% CI = 1.90–8.87). Those not having caregivers were more likely to experience depression (aOR = 3.03, 95% CI = 1.27–7.20) and anxiety (aOR = 3.47, 95% CI = 1.26–9.60). Having mMRC dyspnea scale ≥2 was associated with higher odds of experiencing depression (aOR = 5.94, 95% CI = 3.63–9.72) and anxiety (aOR = 6.78, 95% CI = 3.48–13.18). Those not adhering to medication treatment (aOR = 2.32, 95% CI = 1.15–4.70) and having comorbidity (aOR = 2.02, 95% CI = 1.10–3.73) were more likely to experience anxiety. Routine screening of COPD patients for depression and anxiety is necessary so that early interventions could be provided.
Early Career Psychiatry Section – World Association of Social Psychiatry – History and Future Directions
Authors: Enara Arun , Banerjee Debanjan , Tripathi Adarsh
Published: May 2024

Early Career Psychiatry (ECP) sections have had a considerable impact on the way psychiatric associations function around the world. Early inclusion and participation of young professionals in an association's activities often is beneficial to both the participants and objective of the Association. The World Association of Social Psychiatry (WASP) has incorporated activities for early career psychiatrists uring many of its Congresses right from the early days. This article will look at the evolution of the ECP section of the WASP, its vision, the activities, and the need for a potential shift in the way early career organizations function around the world. It also highlights the WASP-ECP section program held in the recent WASP Asia Pacific Hybrid Congress 2021.
Learnings from Ancient India
Authors: Chadda Rakesh Kumar , Rajhans Pallavi
Published: May 2024

India is one of the oldest civilizations in the world and has a rich cultural heritage. Ancient Indian scriptures (Vedas, Upanishads, and Bhagavad Gita) and epics (Ramayana and Mahabharata) are a great source of knowledge. Some of the principles, described in these texts, have applicability to the discipline of psychiatry in the contemporary scene. Ayurveda, the Indian system of medicine with history dating back to the Vedic period, also recognizes mental disorders, giving their descriptions, and explaining their etiology and management. Bhagavad Gita has given detailed description of crisis management and dealing with anxiety, stress, and depression and elucidated the principles of psychotherapy. Buddhism, one of the religions with origin in India, describes the principles of meditation and ways of dealing with stress and anxiety. Yoga, an important gift of ancient India, has been found to be effective in the management of anxiety and psychosomatic disorders. Various meditation techniques practiced today make the use of principles that date back to ancient India. Epics such as Ramayana and Mahabharata include multiple descriptions of dealing with stress and mental health issues which have relevance in the contemporary psychiatry. The methods of stress and crisis management as described in the ancient Indian literature have also applicability in dealing with certain mental health issues during the crisis situations such as the COVID-19 pandemic.