bluuebunny/crossref_metadata_2025 huggingface dataset:
Which impact for proton pump inhibitors in SARS-COV-2 pneumonia
Authors: Mazzeo Grazia , Aronne Luigi , Mariniello Domenica Francesca , Allocca Valentino , Palma Maria Ilaria , Cerqua Francesco Saverio , Iadevaia Carlo , Costigliola Adriano , Parrella Roberto , Bianco Andrea , COVID Group Vanvitelli/Monaldi
Published: October 2021

Identification of risk factors for severe outcome of Sars-Cov-2 infection is an important issue in COVID-19 management. Much attention has been focused on comorbidities as well as drugs taken by patients. Usage of proton pump inhibitors (PPIs) appears to potentially influence disease course. These drugs are known to reduce stomach acid and also modulate the immune system. Their use, prior to and during COVID-19 infection, seems to predispose to the development of more severe pneumonia and therefore to a greater risk of mortality. Instead, the use of Histamine receptor 2 antagonists (H2RAs) seems to be associated with a better outcome in patients with COVID-19, in terms of symptoms, risk of intubation and death. As PPIs are essential for treatment of many disorders, usage of these drugs should be balanced considering the benefits and risk ratio, in order to guarantee their correct use for the necessary time. It remains to be clarified whether the detrimental effects, in terms of COVID19 severe outcome, are due to PPIs or to the underlying disease for which they are administered. New controlled-randomized trials are required to better understand their impact in SARS-COV-2 infections. *Vanvitelli/Monaldi COVID Group: Adriano Cristinziano, Carolina Delle Donne, Cecilia Calabrese, Fabio Perrotta, Filippo Scialò, Francesco Lassandro, Gennaro Mazzarella, Giorgio Paoli, Leonardo De Luca, Maria Galdo, Miriam Buonincontro, Roberta Cianci, Rosalba Donizzetti, Stefano Sanduzzi Zamparelli, Tullio Valente, Vito D’Agnano, Vittorio Bisogni
Small mammal assemblages and their ectoparasite prevalence (Acarina) in mangrove forests of Peninsular Malaysia
Authors: Mohd-Taib Farah Shafawati , Asyikha Rosha , Nor Shukor Md
Published: October 2021

The mangrove forest is located in the coastal intertidal zone and plays a vital role in buffering against erosion from storm surges, currents, waves, and tides. This ecosystem also serves for ecotourism due to its heterogeneous habitats, which supported a high diversity of plants and animals. Small mammals are among the abundant but poorly recognised inhabitants in mangrove forests. Apart from their role as primary consumer and prey, they are host to various ectoparasites, which potentially become the primary vector for tick-borne diseases among visitors. Therefore, this study aims to determine the small mammal assemblages and their ectoparasite prevalence in mangroves forests of Peninsular Malaysia. The capture-release method was applied for small mammal sampling, and each captured individual was screened and collected for ectoparasites before released. DNA barcoding using CO1 genes was performed for small mammal species verification, whereby ectoparasite identification was based on morphological identification and molecular verification using 16S rDNA genes. A total of 94 small mammals from 6 species were captured across sites, dominated by Rattus tiomanicus (n=74). From this number, 15 individuals (16% prevalence) were infested by ticks, 22 individuals (23%) were infested by mites, whereas 4 individuals (4%) were infested by both ticks and mites. Five species of ticks and one mite species were identified; Amblyomma cordiferum, Ixodes granulatus, Haemaphysalis hystricis, Dermacentor auratus, Dermacentor atrosignatus, and Laelaps echidninus. This study reveals a relatively poor diversity of small mammals in the mangroves forest, of which highly infested with a diversity of ectoparasites, elucidating the relationship of hostectoparasite associations in the riparian zone. This information is crucial to inform visitors to these areas, ultimately safeguard against ectoparasite-borne disease.
Clinical Practice Patterns Among Health Care Professionals for Instrument-Assisted Soft Tissue Mobilization
Authors: Cheatham Scott William , Baker Russell T. , Larkins Lindsay W. , Baker Jayme G. , Casanova Madeline P.
Published: October 2021

Context

Instrument-assisted soft tissue mobilization (IASTM) is a popular myofascial intervention used by health care professionals.

Objective

To document IASTM clinical practice patterns among health care professionals in the United States.

Design

Cross-sectional study.

Setting

Online survey.

Patients or Other Participants

A total of 853 members of the National Athletic Trainers' Association (n = 249) and the American Physical Therapy Association (n = 604).

Main Outcome Measure(s)

Responses to a 55-item electronic survey that assessed 4 areas, namely, IASTM training and experience, IASTM application, perception of IASTM in practice, and demographic information.

Results

Most (n = 705, 83%) of the 853 respondents used IASTM in their practice, and they had an average of 15 years of work experience. Approximately 86% (n = 731) reported completing some type of formal training, and 61% (n = 518) had completed some type of informal training. Respondents used >34 different IASTM tools. Seventy-one percent (n = 606) indicated either not knowing how to quantify the amount of force applied by the tool during treatment or not trying to quantify. Fifteen percent (n = 128) estimated a force ranging from 100 to 500g. The treatment time for a specific lesion and location ranged from 1 to ≤5 minutes, with an average total treatment time of 14.46 ± 14.70 minutes. Respondents used 31 different interventions before or after IASTM. Approximately 66% (n = 564) reported following treatment recommendations, and 19% (n = 162) described rarely or never following recommendations learned during training. A total of 94% (n = 801) recounted using some type of clinical outcome measure to assess their treatment. Cluster analysis identified 3 distinct cluster groupings among professionals, with most (89%, n = 729/818) indicating that IASTM was an effective treatment.

Conclusions

This survey documented the IASTM practice patterns of health care professionals. Cluster profiles characterized group differences in IASTM training and clinical application. The gaps among research, clinical practice, and training need to be bridged to establish IASTM best practices.
Progressive Rehabilitation of a Professional Soccer Player After an Anterior Cruciate Ligament Reconstruction in Phase 1: Clinical Perspective with Video Demonstration
Authors: Núñez Sánchez Francisco Javier , Cabrera Francisco Ignacio Martínez , Abad Fernando Hernandez , Suarez-Arrones Luis
Published: October 2021

We outline a case of success in the rehabilitation of a Romanian first-division soccer player who sustained an anterior cruciate ligament (ACL) rupture with a meniscal tear during competition in the 2012–2013 season. The ligament was reconstructed with an autologous hamstrings graft and partial meniscectomy was performed. The player returned to same-level competition in 7 months and has remained at that level, free of knee injury, to the present (6 years later). Based on postoperative phase 1 as proposed by the Royal Dutch Society for Physical Therapy, we proposed a clinical progression of exercises with video demonstrations to address body functions and structures and the level of activities and participation. All phase 1 objectives were achieved, and all criteria needed to advance to phase 2 of the ACL rehabilitation process were attained.
Développement d'un système d'alerte précoce pour les tremblements de terre du Québec
Authors: Lamontagne M
Published: October 2021

Several regions of the world already have or are in the process of developing an early warning system (EWS) for earthquakes. As is well known, earthquakes cannot be predicted in the short term. However, an EWS is based on the principle that when a strong
earthquake occurs, the initial seismic waves detected by seismographs near the epicentre can be quickly analysed. Once analyzed automatically, an alarm signal can be sent to more distant areas before damaging seismic waves arrive. This alert can then be used to take action before the seismic waves
arrive (such as stopping industrial activities for example). In Canada, these technologies are being developed for the Pacific region and Eastern Canada. Quebec is particularly interesting because earthquakes of magnitude 5 are felt at great distances, which increases the warning time when an
earthquake occurs. Natural Resources Canada (NRCan) will lead this initiative, in partnership with provincial collaborators. The private sector will also be involved through the development of software and applications. NRCan is therefore reaching out to potential partners in such an earthquake
warning system.
Determinants of the risk of intraoperative complications in phacoemulsification among patients with pseudoexfoliation
Authors: Vazquez-Ferreiro Pedro , Carrera-Hueso Francisco J. , Rodriguez Lidia Barreiro , Diaz-Rey Marta , Barrios María Auxiliadora Ramón , Jornet Jaime E. Poquet
Published: October 2021

PURPOSE:

The purpose of the study was to study the relationship between pseudoexfoliation (PES) and other predictors in the development of complications in cataract surgery by phacoemulsification in patients with PES.

METHODS:

A retrospective cohort study of patients undergoing cataract surgery by phacoemulsification in the health area of Cee in northwestern Spain during the 2-year period from 2009 to 2010. Capsule rupture, choroidal hemorrhage, and vitreous loss were included as complications and intraoperative nucleus or lens dislocation as the independent variable. PES, age, hardness, type of cataract, myopia, preoperative visual acuity, antiplatelet use, anticoagulant uses, alpha agonist use, mydriasis prior to surgery, anterior chamber depth, and axial length were included as predictor variables. All predictive hierarchical models were tested using as a selection criterion the one minimizing the Akaike index.

RESULTS:

A total of 551 patients were initially identified from hospital register, of which 48 were excluded due to the presence of an exclusion factor. After the initial selection, the final sample was 681 eyes of 503 patients. Of the 8192 possible models, a model with the following seven variables was selected: PES, steroid use, alpha agonist use, nuclear hardness, mydriasis, anterior chamber depth, and axial length. The selected model had an Akaike index of 435.4 and an area under the curve of 0.7895 corresponding to a sensitivity of 6.2% and a specificity of 98.5%.

CONCLUSION:

PES, nuclear hardness, and alpha agonist use are risk factors strongly predictive of complications.
Analyses on the distribution and influence of higher-order aberrations both clinically and experimentally among varied refractive errors
Authors: Kalikivayi Venkataramana , Kalikivayi Lavanya , Ganesan A. R.
Published: October 2021

PURPOSE:

The aim of this work is to determine and compare the distribution and influence of higher-order aberrations (HOAs) both clinically and experimentally between different refractive errors.

METHODS:

Commercially available Shack–Hartmann aberrometer was employed to measure the HOA clinically in human eyes. Experimentally, HOA was measured in a model eye by simulating various refractive errors by constructing an aberrometer based on the same Shack Hartmann principle. One-way analyses of variance and simple regression were employed to analyze the distribution and influence of HOA among various refractive errors.

RESULTS:

A total of 100 eyes were clinically measured for aberrations, of which 35, 50, and 15 eyes were emmetropes, myopes, and hyperopes, respectively. Out of the total root mean square (RMS) value, the HOAs found in the human eyes were 23%, 7%, and 26% and in the model eye, it was 20%, 8%, and 10% between emmetropes, myopes, and hyperopes, respectively. The mean higher-order RMS was almost similar between the groups and among various refractive errors. There was no statistical significance between the individual Zernikes except for the coma in both human and model eyes.

CONCLUSION:

The mean HOA is similar amidst the different refractive errors. The presence of 23% HOA in emmetropes signifies that larger part of the human eye is capable of complying with HOA without compromising the image quality. This work signifies that HOA does not play an important role in image clarity for human eyes with regular refractive surface unlike irregular refractive surfaces.
Isolation of unusual bacteria in canaliculitis
Authors: Vempuluru Vijitha S. , Mitra Sanchita , Tripathy Devjyoti , Mohapatra Samir , Rath Suryasnata
Published: October 2021

With increased availability of sophisticated microbiological techniques for isolation, growth and identification of micro-organisms the spectrum of organisms is rapidly. Herein we report four cases of canaliculitis with unusual organisms and highlight their clinical significance. To the best of our knowledge, there are no reports of isolation of Brucella melitensis and Leuconostoc species reported in English literature; and only one report of isolation of Myroides species from canaliculitis exists. Sphingomonas paucimobilis, is an uncommon isolate in canaliculitis. Extremes of age and occupational exposure may be possible risk factors for infection with uncommon organisms. Clinical features at presentation do not vary greatly with uncommon or multi drug resistant organisms' hence sampling and microbiological assessment is warranted. The benefit of curettage in canaliculitis is manifold. Unusual organisms and opportunistic pathogens can be multi-drug resistant and determination of antibiotic susceptibility is important to initiate targeted therapy to ensure disease cure and prevent recurrences.
Tropicamide and anaphylaxis
Authors: Sefi-Yurdakul Nazife , Sancakli Özlem
Published: October 2021

A 6-month-old boy was brought to the ophthalmology outpatient clinic of our hospital by his parents with the suspicion of esotropia of his left eye. He was able to follow the objects, pupillary light reactions were normal, orthophoric in primary position with corneal light reflex (Hirschberg) test, ductions and versions were normal in all gaze positions. One drop of tropicamide (1%) was instilled in both eyes of the infant for cycloplegic retinoscopy and fundus examinations. After 10 min, anaphylaxis, respiratory and circulatory failure developed. He was immediately examined by the pediatrician, and emergency code was announced. At the 5th min of treatment, he regained consciousness, his respiratory and circulatory symptoms started to improve, and blood pressure returned to normal. In this case report, we aim to point out that tropicamide may rarely lead to life-threatening complications
Uveitis and autoimmune hepatitis, a real entity? A case report with review of the literature
Authors: Alshahrani Saeed , Aljumah Abdulrahman A. , Alluhaidan Adel
Published: October 2021

A 63-year-old man presented with a 10-day history of severe pain, redness of the right eye, and reduced vision in both eyes. In addition, he had been diagnosed incidentally with liver cirrhosis and splenomegaly 1 week before he was admitted to our center. The patient was found to have severe intraocular inflammation that initially involved the right eye and then progressed to bilateral panuveitis. The presenting visual acuity was 20/60 for the left eye and lumbar puncture (LP) for the right eye. Vitreous tap revealed a nonturbid, yellow fluid that was negative for organism culture, polymerase chain reaction (PCR), and tumor markers. Oral prednisolone significantly improved the clinical status of both ocular and hepatic inflammation. During the admission period, the patient developed several medical comorbid complications that temporarily altered the management of our case. After a full evaluation of uveitis causes, the patient was diagnosed with biopsy-proven autoimmune hepatitis. In addition to a high-dose oral steroid, azathioprine was given for 3 months before the patient developed decompensated liver failure, which was successfully managed with a liver transplant. The patient was stable for 1 year following the transplant but eventually developed blindness of the right eye and visual acuity of 20/30 in the left eye.
A new gene mutation in a family with idiopathic infantile nystagmus
Authors: Galvez-Ruiz Alberto , Galindo-Ferreiro Alicia , Lehner Anthony J.
Published: October 2021

Idiopathic infantile nystagmus (IIN) is an inherited disease, which can occur through a number of different inheritance patterns (autosomal dominant, recessive, or X-linked). The most common of these is X-linked inheritance with incomplete penetrance and variable expressivity, and can also be dominant or recessive. To date, only two mutations have been described: the first, affecting the FPR143 gene, which is associated with ocular albinism type I, and located on chromosome Xp22, and the second, affecting the FRMD7 gene located on chromosome X26-q27. To date, a causative gene on locus Xp11.3p11.4 has not yet been identified. The most common cause of IIN is due to mutations in the FRMD7 gene, located on chromosome Xq26. We present a case of a new mutation found in three siblings from a family with FRMD7-related infantile nystagmus, whose parents are consanguineously related in the first degree. A complex mutation has occurred in this family, which, to date, has not been previously reported in the scientific literature. The complex mutation consists of the presence of three consecutive 1 bp deletions in exon 12 (c.1248delT; 1299del C; and 1312delT), causing a secondary deletion (c. 1340–2145 + 214del), and resulting in a truncated protein. We also present a 7-year-old patient from a different family, with periodic alternating nystagmus, having no mutation in the FRMD7 gene, which we assume may be an example of non-FRMD7-related IIN. This patient does not have a family history of nystagmus.
Effects of a ceramic active self-ligating bracket on retraction/tipping/ rotation of canine, premolar mesialization, and transverse arch dimensions
Authors: Moradinejad Mehrnaz , Ghorani Nasim , Heidarpour Majid , Noori Meysam , Rakhshan Vahid
Published: October 2021

Background:

There is no clinical study on ceramic self-ligating brackets (SLBs). Therefore, this preliminary study was conducted for the first time to address its effects.

Materials and Methods:

This split-mouth randomized trial was performed on 32 quadrants in 16 orthodontic patients needing extraction of maxillary premolars and distalization of canines. In each blinded patient, right/left sides were randomized into control (ceramic bracket) and experimental (ceramic SLB) groups. Dental stone models were taken before canine retraction and 3 months into retraction. Models were digitized as three-dimensional models. Changes were measured on superimposed models. Groups were compared using Wilcoxon signed-rank test (α = 0.05, β = 0.1).

Results:

Both bracket types caused significant changes after 3 months in terms of all assessed clinical outcomes (P ≤ 0.002). Compared to conventional ceramic brackets (control), ceramic SLBs reduced retraction rate (P = 0.001), canine rotation (P = 0.001), canine tipping (P = 0.002), and arch expansion at the canine site (P = 0.003). However, the extents of anchorage loss (P = 0.796) and arch constriction in the premolar area (P = 0.605) were not statistically different between the bracket types.

Conclusion:

Compared to conventional metal-lined ceramic brackets, active ceramic SLB can increase the duration of canine distalization, while reducing canine rotation and tipping (inducing more bodily movements). The loss of anchorage with ceramic SLB was similar to that of conventional ceramic bracket after 3 months of treatment (considering the lower rate of SLB canine retraction during that time). Both brackets similarly constricted the arch at the premolar site. In the canine area, they expanded the arch, with the SLB causing smaller extents of expansion.
Comparison of full rotation and reciprocating movements in regaining apical patency during endodontic retreatment
Authors: Nouri Hadi , Amini Kamal , Jahromi Maryam Zare
Published: October 2021

Background:

This study aimed to compare the continuous rotation and reciprocating movements of rotary files in achieving apical patency in root canal retreatment.

Materials and Methods:

This in vitro, experimental study evaluated 64 extracted mandibular molars. The teeth were prepared up to F3 with ProTaper Universal and obturated using lateral compaction technique. The teeth were divided into four groups (n = 16) based on the mesiobuccal canal curvature (Schneider's method) and type of rotational movement. Groups 1 and 2 included straight canal teeth retreated with WaveOne Gold and ProTaper Universal Retreatment system, respectively. Groups 3 and 4 included teeth with moderately curved root canals retreated with WaveOne Gold and ProTaper Universal, respectively. Apical patency was ensured by observing the tip of a hand K-file at the apical foramen. Data were analyzed using the Fisher's exact test. P < 0.05 was considered statistically significant.

Results:

Apical patency was successfully achieved in all 16 teeth in group 1 (100%) and 15 teeth in group 2 (93.75%). No significant difference was noted between continuous rotation and reciprocating movements in straight canals (P = 1.00). Apical patency was successfully achieved in 15 teeth in group 3 (93.75%) and 12 teeth in group 4 (75%). No significant difference was noted between continuous rotation and reciprocating movements in moderately curved canals either (P = 0.333).

Conclusion:

Both continuous rotation and reciprocating movements are equally effective in achieving apical patency in straight or moderately curved mesiobuccal canal of mandibular molars.
Regeneration of dentin-pulp complex by using dental pulp stem cells in dog
Authors: Nazhvani Fatemeh Dehghani , Kazempour Setareh , Hosseini Seyed-Mojtaba , Nazhvani Ali Dehghani , Haddadi Pardis
Published: October 2021

Introduction:

Although missing tooth is not life-threatening, it affects the quality of daily life. Stem cells have emerged as an important player in the generation and maintenance of many tissues. The role of scaffolds has changed from a passive carrier to a bioactive matrix, which can be used to induce cellular behavior. The aim of this study was to determine the possibility of regeneration of dentin-pulp complex with dental pulp stem cells (DPSCs) in an animal model.

Materials and Methods:

In this animal study after extraction of DPSCs and cultivation, 10 types of scaffolds were made by using platelet-rich plasma (PRP), cancellous bone, and collagen pad. They were inserted in different parts of the dog's mouth. After the 4th month, the area was operated, and the scaffolds were removed.

Results:

Microscopic examination revealed no sign of cell differentiation and formation of new structures in those models which used collagen scaffolds. However, the dentin-pulp complex emerged in models that the combination of bone scaffolds and PRP or stem cells was used.

Conclusion:

Using bone scaffolds in combination with PRP or DPSCs to regenerate dentin-pulp complex in dog helped odontoblastic and pulpal differentiation as well as the formation of predentin and tubular dentin.
Effect of Streptococcus mutans on the flexural strength of resin-based restorative materials
Authors: Haghi Haleh Valizadeh , Peeri-Dogaheh Hadi , Fazlalizadeh Sheida , Abazari Malek , Mohammadhosseini Reza
Published: October 2021

Background:

There are a limited number of studies about the effects of microbial aging on the mechanical properties of restorative materials. Therefore, this study aimed to evaluate the effect of simulated aging with Streptococcus mutans on the flexural strength of different resin-based materials.

Materials and Methods:

This experimental study was performed on the blocks of different types of restorative materials including composite resin, giomer, and a resin-modified glass ionomer (RMGI). Moreover, three types of aging, such as 30-day storage in distilled water, S. mutans, and germ-free culture medium, were used in this study. The three-point bending flexural strength of the specimens before and after aging was measured according to the International Organization for Standardization-4049 standard. Data were analyzed by two-way ANOVA and post hoc Tukey's tests. A P < 0.05 was considered statistically significant.

Results:

Results showed that the 30-day aging with the S. mutans significantly reduced the flexural strength of all three types of materials (P = 0.00). In all restorative materials, storage in a bacteria-free culture medium acted the same as distilled water, and there was no significant difference between these two solutions in terms of the flexural strength of the material, compared to the before-aging strength (P > 0.05). Furthermore, no significant difference was observed between S. mutans-based aging and distilled water aging regarding RMGI (P = 0.75).

Conclusion:

It can be concluded that aging by S. mutans reduced the flexural strength in all three restorative materials.
Bone health in HIV-infected children on antiretroviral therapy
Authors: Bhise Shruti , Jain Ashish , Savardekar Lalita , Shetty Naman S. , Shah Ira
Published: October 2021

Aim:

The aim of this study is to determine the bone health in HIV-infected children on antiretroviral therapy (ART).

Materials and Methods:

This cross-sectional study was carried out in 31 HIV-infected children aged 5–18 years. Each patient underwent testing for serum calcium, phosphorous, alkaline phosphatase, and 25(OH) Vitamin D. Bone mineral density (BMD) was done using a DXA scanner. Patients' z scores for BMD of the lumbar spine and left femoral neck were noted. The factors associated with low BMD were analyzed.

Results:

Seven (22.6%) children had a low spinal BMD and 6 (19.4%) had low femoral neck BMD. Low serum calcium was seen in 6 (19.4%) patients and high alkaline phosphatase was seen in 15 (48.4%) patients. Low serum 25 (OH) Vitamin D levels were present in 30 (96.8%) patients, whereas all the patients had normal serum phosphorous. Duration of ART in those with low spinal BMD was 4.6 ± 3.4 years as compared to 6.4 ± 3.2 years in those with normal spinal BMD (P = 0.235) and for low left femoral neck BMD was 3.9 ± 2 years as compared to 6.5 ± 3.4 years for those with normal femoral neck BMD (P = 0.031). Mean 25(OH) Vitamin D levels were 8.4 ± 2.8 ng/ml in those with low femoral neck BMD as compared to 13.6 ± 8.3 ng/ml in those with normal femoral neck BMD (P = 0.015). Type of ART did not have any association with low BMD.

Conclusion:

Over 95% of HIV-infected children have low 25(OH) Vitamin D levels which affect the appendicular BMD. BMD is affected more in children who have been on ART for a shorter time. No particular ART regimen is associated with low BMD.
Bilateral Breast Hamartoma
Authors: Pandiaraja Jayabal
Published: October 2021

Breast hamartoma is a rare benign tumor of the breast, and it is classified based on the variable tissue components. It is more common during the lactating period and premenopausal period. Bilateral breast hamartoma is rarely reported in the literature. It might create diagnostic difficulty based on fine-needle aspiration cytology and core needle biopsy. Radiological investigation sometimes might have overlaying findings with malignant disease. It is always better to undergo an excision biopsy for the confirmation of the diagnosis.
Methods of Dietary Sodium Estimation
Authors: Aparna P. , Salve Harshal Ramesh , Krishnan Anand , Lakshmy Ramakrishnan , Gupta Sanjeev Kumar , Nongkynrih Baridalyne
Published: October 2021

Excessive dietary sodium intake is found to be associated with high blood pressure and its consequences such as cardiovascular disease and stroke. Daily sodium intake is found to vary from place to place as it is dependent on geography, ethnicity, socioeconomic factors, etc. In this review, we summarize the various methods of assessment of daily sodium intake such as dietary estimation methods using 24-h dietary recall, food frequency questionnaire and diet record, and biochemical methods using 24-h urine sodium or spot urine sodium estimation. Daily sodium intake estimated with spot urine sodium is dependent on the equation used to convert spot urine sodium to 24-h urine sodium. To identify the appropriate equation, validation studies need to be conducted. Population level sodium intake and it's monitoring is important for reduction of noncommunicable diseases.
Bone Marrow Aspiration Using 18g Lumbar Puncture Needle
Authors: Panda Sasmita , Besra Kusumbati , Kar Asaranti , Dasnayak Goutami , Dash Sashibhusan , Samantaray Sagarika , Rout Niranjan
Published: October 2021

INTRODUCTION:

Bone marrow aspiration (BMA) has an important role in the investigation and diagnosis of hematologic as well as nonhematologic malignancies and various other diseases. The procedure varies from one setting and person to the other.

AIMS:

The aim of the study is to study the role of 18G lumbar puncture (LP) needle in the diagnosis of bone marrow involvement in hematologic malignancies and metastasis for certain solid tumors.

MATERIALS AND METHODS:

During this hospital-based retrospective study, 708 patients who clinically and histopathologically diagnosed with the malignant lesion and subsequently undergone BMA were included in this study.

RESULTS:

BMA was done in 607 patients diagnosed with hematologic malignancies and 101 patients diagnosed with nonhematologic malignancies. Adequate marrow material was obtained in the first attempt in 683 (96.5%) cases. Multiple aspirations were needed in 25 (3.5%) cases. The majority (86.3%) of the patients experienced less pain by the 18 G LP needle compared to their previous experience with the conventional BMA needle. Needle breakage was not seen in any of the cases.

CONCLUSION:

The results of this study suggest that the 18G LP needle can be easily adopted for BMA and could be a great help in significantly reducing pain and complications in patients undergoing BMA.
Cerebral Venous Thrombosis in Nucleophosmin Gene-Mutated Acute Myeloid Leukemia
Authors: Pandit Sudarshan , Wasekar Niles , Badarkhe Girish , Ramesh Yasam Venkata , Nagarkar Raj
Published: October 2021

Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underlying mechanism involved in thrombus formations is largely unknown with limited published data. Our patient was presented with complaints of continuous headache and persistent projectile vomiting. After initial tests, a magnetic resonance imaging of the brain performed revealed cerebral venous sinus thrombosis. Anticoagulant and anticonvulsant prophylaxis was initiated, and further treatment was planned. In such rare cases, early diagnosis and management are desirable. The role of clinicians in identifying the clinically suspicious signs and symptoms can help in identifying such rare conditions before developing severe thromboembolic complications. In the present study, we report a rare case of cerebral venous thrombosis, its associated treatment, and complications in a patient diagnosed with nucleophosmin gene-mutated acute myeloid leukemia.

Similar Cases Published:

None.
Diagnosis and Management of Hematological Manifestations of Gaucher Disease
Authors: Owaidah Tarek , Alabbas Fahad , Alhazmi Iman , Al Saeed Hussain , Balelah Saud , ElYamany Ghaleb , Kashari Ohoud , Qari Mohamad , Saleh Mahasen , Roushdy Sherif , ElBagoury Marwan
Published: October 2021

Gaucher disease (GD) is a lysosomal storage disorder that occurs due to an inherited inborn error of metabolism. GD manifested due to the deficient activity of the glucocerebrosidase enzyme that results in the accumulation of the harmful glucocerebrosides glycolipids in different body cells. There are three main types of GD that differ from each other in their clinical presentations. Type I characterized by the absence of any neurological involvement, unlike Type II and Type III. Patients with Gaucher can be presented with visceral manifestations (including splenomegaly, hepatomegaly, or abdominal pain), hematological manifestation (anemia or thrombocytopenia or bleeding diathesis), bone manifestations (painful limbs or pathological fractures), or neurological manifestations (including neck rigidity, swallowing disorder, or oculomotor paralysis). In the Middle East, especially Saudi Arabia, a higher prevalence of genetic diseases was observed compared to reported rates in Europe and the United States. However, published data on the characteristics and treatment patterns of Gaucher patients in Saudi Arabia are still lacking in the literature. Therefore, the present manuscript aimed to present an overview of the GD situation in Saudi Arabia by bringing together a panel of Saudi hematology experts to share their views on current trends and practices in Saudi Arabia regarding GD. The experts agreed that there is no available data regarding the prevalence and incidence of GD in Saudi Arabia, therefore the experts recommend establishing a national registry for Gaucher cases. The diagnosis of GD is challenging as the disease is rare and obscure, even to hematologists. The experts also recommend shifting from the dried blood spots test to genetic testing in the future to confirm the diagnosis of GD. The experts agreed on the need to organize awareness campaigns to familiarize the primary care physicians and junior hematologists about the common presentations and management of GD.
The Efficacy of Pentazocine + Diclofenac Versus Paracetamol + Diclofenac for Post- Caesarean Section Analgesia
Authors: Garba Jamila Abubakar , Panti Abubakar Abubakar , Nnadi Daniel C. , Ango Ibrahim G. , Tunau Karima A. , Bello Saratu , Zubairu Saad , Nasir Asmau'u Muhammad , Ibrahim Rukayya
Published: October 2021

Background:

The most common major obstetric procedure is caesarean section (CS) and one of the greatest concerns for women after CS is to have optimal pain relief.

Aim:

This study aims to compare the efficacy of pentazocine + diclofenac and paracetamol + diclofenac on post-operative analgesia after CS.

Methodology:

This was a single-blind, randomised trial. Pregnant women that had CS were randomized into two groups. Group A received intramuscular pentazocine + rectal diclofenac postoperatively. Group B received intramuscular paracetamol + rectal diclofenac postoperatively. Post-operative pain was assessed by numeric rating scale at 1 h after the surgery, at 6 h, 12 h and 24 h. The result obtained was analysed using SPSS Version 22 and P < 0.05 was considered statistically significant.

Results:

The median pain scores in both groups ranged from 2 to 3 across all periods of assessment. The pain relief was slightly better in the pentazocine + diclofenac group with no significant difference in the pain score between the two groups at all periods of assessment. The satisfaction level was good in 66.3% and 69.5% of the participants in the pentazocine + diclofenac and paracetamol + diclofenac group respectively but the difference was not statistically significant (χ2 = 4.14, P = 0. 12). Nausea, vomiting and drowsiness were significantly more in the pentazocine + diclofenac combination (P < 0.001).

Conclusion:

Both combination of analgesics provided adequate analgesia but pentazocine + diclofenac combination had better pain relief but was more associated with side effects.
Monopolar Transurethral Resection of the Prostate Using Water as the Irrigation Fluid
Authors: Jeje Emmanuel A. , Alabi Taiwo O. , Ojewola Rufus W. , Ogunjimi Moses A. , Tijani Kehinde H. , Asiyanbi Gabriel K.
Published: October 2021

Background:

Monopolar transurethral resection of the prostate (M-TURP) has been the gold standard of surgical intervention in patients with benign prostatic hyperplasia with the indication for surgery. This can be achieved using varieties of irrigation fluids.

Objectives:

To document our experience with M-TURP using water as irrigation fluid in 123 consecutive patients.

Materials and Methods:

A retrospective study of all patients who had M-TURP with water as irrigation fluid was performed between January 2017 and July 2019. Information retrieved from theatre records and case notes includes patient's socio-demographic data, indications for surgery, intra-operative findings, the volume of resected chips and irrigation fluid used, post-operative complications and patient's satisfaction with the outcome of the procedure. These data were analysed using SPSS version 23.

Results:

Data from 123 patients were analysed and presented. The age range was 44–96 years with a mean of 69 years. Prostate volume ranges from 13.9 to 276.00 mls with a mean of 95.69 mls while resected prostate volume ranges from 2.0 to 158.0 mls with a mean of 56.68 mls. Volume of the sterile water used as irrigation fluid ranged from 5.0 L to 174.0 L with a mean of 68.7 L. Mean reduction in International Prostate Symptoms Score, improvement in Q-max and reduction in post-void residual urine were 22.1, 16.9 and 141.6 mls, respectively. Transfusion rate was 6.5% while the duration of admission ranges from 1 to 6 days, with a mean of 2.5 days. The overall complication rate was 26.0%. Ninety-six percent were satisfied with the outcome.

Conclusion:

M-TURP using water as irrigation fluid is safe and is as good as using the more rather expensive glycine or normal saline in bipolar TURP.
Profile of Bacterial Pathogens Causing Infections in Children with Sickle Cell Anaemia in Maiduguri
Authors: Ibrahim Halima Abubakar , Yakubu Yakubu Mohammed , Farouk Abubakar Garba , Ambe Pwavimbo , Gadzama Galadima Bala
Published: October 2021

Background:

Sickle cell disease (SCD) is a major cause of morbidity and mortality in African children. Infection has been found to be a major cause of hospitalisation, a major precipitant of crises and one of the greatest causes of death among SCD patients at all ages.

Objectives:

The objective of the study was to determine the prevalence of bacterial infection, pattern of the isolates and the antibiotic sensitivity of isolated bacteria among children with sickle cell anaemia (SCA).

Materials and Methods:

A cross-sectional study carried out in the University of Maiduguri Teaching Hospital. A total of 242 hospitalised children with SCA with symptoms and signs of infection were recruited for the study using consecutive sampling technique. Sociodemographic and clinical data were obtained. Blood, urine, aspirates, swabs and cerebrospinal fluid samples were collected based on their clinical presentation and subjected to microbiological analysis.

Results:

A total of 242 patients were studied. The age range was 9 months–15 years, with a mean age of 6.36 years ± 3.75 years. Male-to-female ratio was 1:1.14, with 41.7% of them belonging to low social class. Seventy seven of the 242 had confirmed bacterial infection giving an incidence of bacterial infection in SCA patients of 31.8%. Gram-negative organisms accounted for 64.5% of the isolates and they include Salmonella, Klebsiella, Escherichia coli and Coliforms. However, Staphylococcus aureus (32.9%) was the most frequent microorganism isolated, followed by Salmonella, (20.3%), Klebsiella (12.6%) and Coliforms (12.6%). Amoxicillin-clavulanate, cefixime and gentamicin showed more than 50% activity against the isolated bacterial pathogens while chloramphenicol was found to have low activity against Salmonella.

Conclusion:

High index of suspicion of bacterial infection should be borne in mind of the attending physician when children with SCA present with features of infection. Detailed clinical evaluation and appropriate sample collection for microbiological analysis are recommended. Empirical treatment should be started on SCA patients who have clinical evidence of infection and should be broad enough to cover for common bacterial pathogens.
The Efficacy of Oral Naproxen and Cervical Lidocaine Spray on Perceived Pain during Hysterosalpingography
Authors: Jayeola David Kehinde , Bello Temitope Olugbenga , Oyedepo Victor Olufemi , Famurewa Olusola Comfort
Published: October 2021

Objective:

This study was carried out to evaluate the efficacy of the combined use of oral naproxen and cervical lidocaine spray during hysterosalpingography (HSG) compared to the use of oral naproxen or cervical lidocaine spray alone. Materials and Methods: This prospective randomised controlled study was carried out using a total of 240 patients who were randomly assigned to four groups. Group 1 received cervical lidocaine spray only, Group 2 received oral naproxen only, Group 3 received cervical lidocaine spray and naproxen tablet, whereas Group 4 was the control group. A visual analogue scale was used for subjective pain assessment at three pre-defined steps.

Results:

The mean pain scores of the patients in each of the four groups are Group 1 (3.6 ± 2.0, 5.1 ± 1.8, 5.8 ± 2.2); Group 2 (2.7 ± 1.4, 3.6 ± 2.0 and 3.9 ± 1.9); Group 3 (2.8 ± 1.5, 3.4 ± 2.0 and 4.2 ± 2.3); Group 4 (4.7 ± 1.7, 5.9 ± 1.7 and 5.3 ± 1.7) at T1, T2 and T3, respectively. Pain perception was statistically significantly reduced by naproxen and combined naproxen plus lidocaine spray at all the stages of HSG while cervical lidocaine spray had a statistically significant reduction in pain perception only during cervical instrumentation.

Conclusion:

Oral naproxen and combined naproxen plus cervical lidocaine spray were effective in reducing HSG-associated pain during all the stages of HSG. However, combined oral naproxen and lidocaine spray did not show superior efficacy over oral naproxen alone. Cervical lidocaine spray was not an effective method.
Factors Determining Sexual Behaviour amongst Siddi Tribe Migrating to Udupi District, India
Authors: Dmello Mackwin Kenwood , Kumar Sudeep , Badiger Sanjeev , Purushottam Jagannath
Published: October 2021

Background:

Afro-Indians, locally known as Siddi, are the tribal community descended from the Bantu populace from eastern Africa found in Goa, Gujarat and Karnataka along the Indian west coast. This study determines knowledge, attitude and sexual behaviour amongst the Siddi population in the Udupi district.

Materials and Methods:

A cross-sectional study was conducted from October 2018 to September 2019; men and women aged above 18 years who lived in the locality at the time of the survey were included in the study.

Results:

A total of 108 Siddi individuals participated in this study. The mean age of the respondents was 31.8 ± 9.5 years. More than half (51.8%) of the respondents received information on sexual matters through friends. Awareness regarding the usage of condoms and other preventive measures was poor (34.7%). Around 65.7% of the respondents felt that sex education in school encourages sex amongst youngsters. The mean age at the first sexual intercourse amongst men and women was 20.3 years and 16.2 years, respectively. About 18.7% of the respondents had sex with a new partner in the migrated place within the last 1 month, of which 80% were married. Only 5% of the respondents used condoms while indulging in sex with a new partner at the migrated place. Factors such as age at marriage, age at the first sexual act and attitude towards sexual activity were significantly associated with a new sex partner at the arrival site.

Conclusion:

There is a high prevalence of unsafe sexual practices amongst the migrated Siddi tribe at the place of destination. This poses the risk of sexually transmitted infections amongst the migrant tribes and local communities at the place of destination and the location of origin. The study finding shows that measures should be taken to create awareness, and change in attitude towards sexual matter should be channelised at an early age amongst the Siddi population.
Unusual Presentation of Embryonal Rhabdomyosarcoma of the Middle Ear Presenting as Chronic Otomastoiditis and its Complication
Authors: Almuqati Wejdan Qublan , Badr Khalid , Alghamdi Saeed , Abouissa Ahmed , Moulana Amna , El Tahmody Mohamed
Published: October 2021

As one of the most frequently occurring soft-tissue sarcomas among the pediatric population, Rhabdomyosarcoma (RMS) is an extremely rare malignant neoplasm that originates from striated muscles. RMS is rarely known to occur in the mastoid and middle ear. RMS symptoms occurring in-ear are typically similar to that of chronic suppurative otitis media, which are unresponsive to conventional treatment. Consequently, this contributes to delayed diagnosis of RMS of the ear/temporal bone. This case pertains to an 8-year-old boy presenting with facial nerve palsy, chronic mastoiditis, and abducent nerve palsy. On biopsy, RMS was found in his middle ear.
A -seeley-extension-theorem for Bastiani’s differential calculus
Authors: Hanusch Maximilian
Published: October 2021

We generalize a classical extension result by Seeley in the context of Bastiani’s differential calculus to infinite dimensions. The construction follows Seeley’s original approach, but is significantly more involved as not only$C^k$-maps (for) on (subsets of) half spaces are extended, but also continuous extensions of their differentials to some given piece of boundary of the domains under consideration. A further feature of the generalization is that we construct families of extension operators (instead of only one single extension operator) that fulfill certain compatibility (and continuity) conditions. Various applications are discussed as well.
The Impact of Trainee and Standardized Patient Race and Gender on Internal Medicine Resident Communication Assessment Scores
Authors: Heath Janae K. , Dine C. Jessica , LaMarra Denise , Cardillo Serena
Published: October 2021

Background

Standardized patient (SP) encounters are commonly used to assess communication skills in medical training. The impact of SP and resident demographics on the standardized communication ratings in residents has not been evaluated.

Objective

To examine the impact of gender and race on SP assessments of internal medicine (IM) residents' communication skills during postgraduate year (PGY) 1.

Methods

We performed a retrospective cohort study of all SP assessments of IM PGY-1 residents for a standardized communication exercise from 2012 to 2018. We performed descriptive analyses of numeric communication SP ratings by gender, race, and age (for residents and SPs). A generalized estimating equation model, clustered on individual SP, was used to determine the association of gender (among SP and residents) with communication ratings. A secondary analysis was performed to determine the impact of residents and SP racial concordance in communication scores.

Results

There were 1356 SP assessments of 379 IM residents (199 male residents [53%] and 178 female residents [47%]). There were significant differences in average numeric communication rating (mean 3.40 vs 3.34, P = .009) by gender of resident, with higher scores in female residents. There were no significant interactions between SP and resident gender across the communication domains. There were no significant interactions noted with racial concordance between interns and SPs.

Conclusions

Our data demonstrate an association of resident gender on ratings in standardized communication exercises, across multiple communication skills. There was not an interaction impact for gender or racial concordance between SPs and interns.
DESIGNING AND 3D PRINTED PLA BASED IMPLANT USED IN TREATMENT FOR UNILATERAL VOCAL CORD PARALYSIS
Authors: ÇİFTÇİ Fatih , AYAN Sümeyra , USTUNDAG Cem
Published: October 2021

Vocal cord paralysis (VCP) is considered as a closure of glottal cavity during phonation. Vibration impairment in the vocal mucosa to loss of voice is as a result of the glottic space not closing. Many implant biomaterials are used for VCP. These implants, which can be applied to restore the cord function of the paralyzed cord and to improve the sound quality, are applied in Medialization thyroplasty (MT) type 1 surgeon. The aim of this study is to produce customizable poly (lactic-acid) (PLA) based vocal cord (VC), also called as vocal fold, implant by using 3D printer and compare this implant with other biomaterials. This VC 3D PLA implant (VC3DPLAI) biomaterial can be specially designed and manufactured for the individual.