bluuebunny/crossref_metadata_2025 huggingface dataset:
Adapting to Change: Challenges and Opportunities of Hairdressing Students in A National Secondary Technical School
Authors: Pepito Shiela Kris T. , Saab Raquel A.
Published: March 2024

Students faced significant challenges in acquiring practical hairdressing skills as schools transitioned to distance or blended learning. The findings revealed two themes: transitional challenges and beneficial effects. Challenges during the transition include adjustments, drawback, financial constraints, feeling of inadequacy and limited equipment. The shift from modular to face-to-face learning introduced issues like time management struggles and dissatisfaction with the modular approach. These issues lead to more concerns about academic setbacks and motivation upon the transition to face-to-face classes called new normal. Moreover, financial constraints due posed a challenge. Despite these hurdles, participants found the transition beneficial as they appreciate the enriched learning, hands-on interactions, and engagement in extracurricular activities. The new normal was recognized for its practical engagement, facilitating networking, and attracting clients which led to improving communication skills and creating job and entrepreneurial opportunities. The study's findings strongly support the notion that hairdressing students thrive and excel when immersed in a hands-on, face-to-face learning environment. This suggests the need for further research to better improve their experiences and skill development.
Further Development of Event-based Analysis of X-Ray Polarization Data
Authors: Marshall Herman L.
Published: March 2024

An event-based maximum likelihood method for handling X-ray polarimetry data is extended to include the effects of background and nonuniform sampling of the possible position angle space. While nonuniform sampling in position angle space generally introduces cross terms in the uncertainties of polarization parameters that could create degeneracies, there are interesting cases that engender no bias or parameter covariance. When including background in Poisson-based likelihood formulation, the formula for the minimum detectable polarization has nearly the same form as for the case of Gaussian statistics derived by Elsner et al. in the limiting case of an unpolarized signal. A polarized background is also considered, which demonstrably increases uncertainties in source polarization measurements. In addition, a Kolmogorov-style test of the event position angle distribution is proposed that can provide an unbinned test of models where the polarization angle in Stokes space depends on event characteristics such as time or energy.
Helium Abundance Periods Observed by the Solar Probe Cup on Parker Solar Probe: Encounters 1–14
Authors: Johnson Madisen , Rivera Yeimy J. , Niembro Tatiana , Paulson Kristoff , Badman Samuel T. , Stevens Michael L. , Dieguez Isabella , Case Anthony , Bale Stuart D. , Kasper Justin
Published: March 2024

Parker Solar Probe is a mission designed to explore the properties of the solar wind closer than ever before. Detailed particle observations from the Solar Probe Cup (SPC) have primarily focused on examining the proton population in the solar wind. However, several periods throughout the Parker mission have indicated that SPC has observed a pronounced and distinctive population of fully ionized helium, He2+. Minor ions are imprinted with properties of the solar wind’s source region, as well as mechanisms active during outflow, making them sensitive markers of its origin and formation at the Sun. Through a detailed analysis of the He2+ velocity distributions functions, this work examines periods where significant and persistent He2+ peaks are observed with SPC. We compute the helium abundance and examine the stream’s bulk speed, density, temperature, magnetic field topology, and electron strahl properties to identify distinctive solar-wind features that can provide insight to their solar source. We find that nearly all periods exhibit an elevated mean helium composition (8.34%) compared to typical solar wind and a majority (∼87%) of these periods are connected to coronal mass ejections (CMEs), with the highest abundance reaching 23.1%. The helium abundance and number of events increases as the solar cycle approaches maximum, with a weak dependence on speed. Additionally, the events not associated with a CME are clustered near the heliospheric current sheet, suggesting they are connected to streamer belt outflows. However, there are currently no theoretical explanations that fully describe the range of depleted and elevated helium abundances observed.
Identifying Flare-indicative Photospheric Magnetic Field Parameters from Multivariate Time-series Data of Solar Active Regions
Authors: Alshammari Khaznah , Hamdi Shah Muhammad , Filali Boubrahimi Soukaina
Published: March 2024

Photospheric magnetic field parameters are frequently used to analyze and predict solar events. Observation of these parameters over time, i.e., representing solar events by multivariate time-series (MVTS) data, can determine relationships between magnetic field states in active regions and extreme solar events, e.g., solar flares. We can improve our understanding of these events by selecting the most relevant parameters that give the highest predictive performance. In this study, we propose a two-step incremental feature selection method for MVTS data using a deep-learning model based on long short-term memory (LSTM) networks. First, each MVTS feature (magnetic field parameter) is evaluated individually by a univariate sequence classifier utilizing an LSTM network. Then, the top performing features are combined to produce input for an LSTM-based multivariate sequence classifier. Finally, we tested the discrimination ability of the selected features by training downstream classifiers, e.g., Minimally Random Convolutional Kernel Transform and support vector machine. We performed our experiments using a benchmark data set for flare prediction known as Space Weather Analytics for Solar Flares. We compared our proposed method with three other baseline feature selection methods and demonstrated that our method selects more discriminatory features compared to other methods. Due to the imbalanced nature of the data, primarily caused by the rarity of minority flare classes (e.g., the X and M classes), we used the true skill statistic as the evaluation metric. Finally, we reported the set of photospheric magnetic field parameters that give the highest discrimination performance in predicting flare classes.
Quand le ministère public investit officiellement Twitter
Authors: Huré Isabelle
Published: March 2024

Depuis 2020, un nombre toujours croissant de procureurs rejoignent le réseau social Twitter. Si la communication avec les médias relève de leurs missions conformément à l’article 11 du code de procédure pénale, leur présence sur ce réseau social soulève de nouveaux enjeux. En effet, il s’agit moins d’assouvir la curiosité du public concernant une affaire ou un procès que de rendre l’institution judiciaire visible, compréhensible et proche des citoyens. Dans ce contexte, l’étude présente les origines et la manière dont se sont diffusées ces nouvelles pratiques communicationnelles et en quoi la présence des procureurs dans l’espace interdiscursif que représente Twitter constitue une défense de l’action des tribunaux et de sa légitimité, tendant à se transformer en action elle-même. Cependant, si le rapprochement de la justice avec les citoyens est un objectif partagé, les usages du réseau social et leurs finalités sont plus diversifiés et parfois inattendus.
The variables of “Management By skills”: A new management logic. Application within some Tunisian companies
Authors: Chouchane Achouak
Published: March 2024

La gestion des ressources humaines est très importante dans le processus de l’emploi, elle est constituée d’un ensemble de variables ayant pour finalité d’aider l’entreprise, efficacement et avec pertinence, à trouver des solutions aux problèmes rencontrés. À ce niveau, la gestion des ressources humaines a connu deux concepts de gestion : la gestion des compétences et la gestion par les compétences. Cette dernière se caractérise par un climat psychologique particulièrement adapté et stimulant pour le déploiement des compétences des salariés dans le travail. Elle entraine une nouvelle logique de gestion. L'autonomie, la responsabilité, la formation, l’évaluation et le contrôle ont établi des principes et régissent la nouvelle image des employés.
Mauvais sang ne saurait mentir. La pureté de sang à l’âge moderne : un dispositif neuf assis sur une longue tradition
Authors: Schaub Jean-Frédéric
Published: March 2024

Dans une historiographie qui enrichit et ouvre l’histoire des processus de racialisation, cet article analyse l’institution des règlements de pureté de sang dans les pays ibériques. Si ce mode de régulation des métiers et corps sociaux n’a pas d’équivalent dans d’autres sociétés européennes et coloniales, il doit être néanmoins compris comme la trace d’une norme plus largement partagée selon laquelle les défauts des ascendants se transmettent à leurs descendants sans possibilité d’effacement.
Prospective Science Student Teachers’ Online Learning Environment Experiences: Measurement Based on the Net Promoter Score
Authors: Mahdiannur Muhamad Arif , Martini  , Astriani Dyah , Rosdiana Laily , Fauziah An Nuril Maulida
Published: March 2024

Personalization is used in online learning to help students achieve SDG 4.C and Education 4.0 indicators. Not many studies have revealed prospective science student teachers’ online learning experiences. A good experience will provide positive and constructive self-knowledge for prospective science student teachers in designing 21st-century digital learning. This study aimed to inquire into prospective science student teachers’ views on online learning using the Net Promoter Score survey. This study involved 29 prospective science student teachers at one of the public universities in Indonesia. This study revealed that online learning provides freedom to express opinions and ideas freely, helps evaluate learning outcomes, online educational resources help understand the contents, and online simulations help understand concepts. The negative experiences in the online learning environment include the lack of interaction with lecturers, online learning has not yet built creative, innovative, and critical thinking skills and has not supported competency development. There is a significant difference between positive and negative online learning experiences, demonstrating how experiences can impact future teacher conception. Based on our findings, recommendations were provided to assist university lecturers in creating and designing an online learning environment to develop the professional competencies of prospective science student teachers.
A Study of the Factors Influencing Teachers' Willingness to Use Generative Artificial Intelligence Based on the UTAUT Model
Authors: Zhang Xinhua , Wareewanich Thitinant
Published: March 2024

The advancement of wireless communication and mobile computing technologies has paved the way for the extensive application of Artificial Intelligence across diverse sectors, including electronics, automotive, medical, industrial, and educational fields. Employing the Unified Theory of Acceptance and Use of Technology, this study investigates the key determinants influencing preschool teachers’ willingness to utilize Generative Artificial Intelligence (GAI) in Jiangsu Province, China. The research, involving 154 participants, analyzes their inclination towards GAI adoption through four dimensions: performance expectancy, effort expectancy, social influence, and facilitating conditions. Findings reveal that performance expectancy, social influence, and facilitating conditions significantly enhance their willingness to adopt GAI. Additionally, teaching experience and IT proficiency were found to moderate the effects of certain variables on this willingness. This aligns with the broader goal of integrating digital technology into education, which is a vital element of the nexus between digital technology development and innovation.
The Effect of Using Microsoft Teams on the Achievement and Self-Learning Skills among Undergraduate Students in the School of Educational Sciences at the University of Jordan
Authors: Al-Shboul Muhannad
Published: March 2024

The study aimed to investigate the effect of using Microsoft Teams on the achievement and self-learning skills among undergraduate students in the School of Educational Sciences at the University of Jordan. The study used the quasi-experimental approach, and the number of study members was (88) students of the Computerized Children’s Programs course, who were divided into two groups. They were intentionally chosen and randomly distributed. The first one was the experimental group that underwent teaching using the Microsoft Teams application, with (46) students; the second one was the control group that underwent teaching using the traditional method, with (42) students, during the first semester of 2022/2023. An achievement test consisting of (25) questions was prepared, as well as a self-learning skills scale consisting of (30) items. Both study tools were applied to the sample and their validity and reliability were verified. The results showed that there were statistically significant differences between the average scores of students in the achievement test and the self-learning scale post measurement, which was attributed to the teaching method variable and in favor of the experimental group that used the Microsoft Teams application. The study recommended implementing teaching methods using the Microsoft Teams application in the event of remote learning and to employ in the rest of the other educational courses and at all levels, editing courses to fit with the use of the Microsoft Teams application.
Patterns of treatment of high-risk BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) patients among Arab urologists
Authors: Moussa Mohamad , Abou Chakra Mohamad , Shore Neal D. , Papatsoris Athanasios , Farahat Yasser , O’Donnell Michael A.
Published: March 2024

Purpose: To understand the treatment plans suggested for BCG-unresponsive non-muscle invasive disease (NMIBC) patients in the Arab countries and therapeutic decisions applied for BCG-naive patients during BCG shortage time.Methods: A 10-minute online survey was distributed through the Arab Association of Urology (AAU) office to urologists in the Arab countries who treat patients with NMIBC. Results: One hundred six urologists responded to the survey. The majority of urologists had treated, in the past 6 months, > 10 patients with NMIBC who were considered BCG-unresponsive (55% of respondents). Radical cystectomy (RC) was the most popular treatment option (recommended by 50%) for these patients. This was followed by intravesical chemotherapy (30%), repeat BCG therapy (12%), resection with ongoing surveillance (8%). Clinical trials and intravenous checkpoint inhibitors were never selected. The most preferred intravesical chemotherapy was by ranking: 60% gemcitabine, 19% mitomycin C, 8% docetaxel, 8% gemcitabine/docetaxel, 4% sequential gemcitabine/mitomycin C, and 1% valrubicin. The use of intravesical chemotherapy appears limited by Arab urologists due to concerns regarding clinical efficacy (fear of progression) and the lack of clear recommendations by urology societies. Given the BCG shortage, which may vary per Arab country, Arab urologists have adjusted by prioritizing BCG for T1 and carcinoma in situ (CIS) patients over Ta, adapting intravesical chemotherapy, and reducing the dose/strength of BCG administered. Most physicians report an eagerness to utilize novel therapies to address the BCG deficit, especially to try intravesical chemotherapy. Conclusions: Even though Arab urologists are in the majority of cases selecting RC for BCG-unresponsive cases, one-third of them are most recently initiating intravesical chemotherapy as an alternative option. To further assist Arab urologists in the appropriate selection of BCG unresponsive high risk NMIBC patient treatments, enhanced education and pathway protocols are needed.
Office-based management of Non-Muscle Invasive Bladder Cancer (NMIBC): A position paper on current state of the art and future perspectives
Authors: Leonardi Rosario , Ambrosini Francesca , Cafarelli Angelo , Calarco Alessandro , Colombo Renzo , Tuzzolo Domenico , De Marco Ferdinando , Ferrari Giovanni , Ludovico Giuseppe , Pecoraro Stefano , De Cobelli Ottavio , Terrone Carlo , Mantica Guglielmo
Published: March 2024

To the Editor, Bladder cancer is one of the most common cancers in humans, representing the 7th and 17th type of neoplasm in both genders. Its incidence and mortality are quite heterogeneous in different countries and are due to different risk factors, quality and prevalence of healthcare and the possibility of early diagnosis and treatment of the tumor and its potential recurrences [...]
Covert, Grandiose, and Dysfunctional Subtype of Narcissistic Personality Disorder
Authors: Annigeri Bindu , Raman Rajesh , Manohar Shivananda , Sardesai Sopan
Published: March 2024

Narcissistic personality disorder(NPD) is described in the DSM-IV-TR as “a pervasive pattern of grandiosity, need for admiration and lack of empathy.” The other features are: grandiose sense of self-importance and grandiose fantasies, belief in being special and unique, need for admiring attention, sense of entitlement, exploitation, arrogance, lack of empathy, and envy of others or belief that others envy them. Other features are: vulnerable self-esteem; feelings of shame, sensitivity and intense reactions of humiliation, emptiness or disdain to criticism or defeat; and vocational irregularities resulting from difficulties tolerating criticism or competition. Hence, NPD should be understood from the context of grandiosity and self esteem dysregulation. The subtypes of NPD i.e. the shy, covert, besides the arrogant, overt, grandiose and unempathetic helps emphasise the phenomenologic range of narcissism. We report a case of narcissistic personality disorder, who presented with the unusual subtype with shyness, covertness, poor functioning, but grandiose.
Atypical Antipsychotics and Sexual Functions in Schizophrenia: A Cross-sectional Study
Authors: Singh Charanpreet , Sharma Rachit , Rakesh C.
Published: March 2024

Background:

Antipsychotics are associated with sexual dysfunction. However, studies selectively exploring the sexual impact of atypical antipsychotics in a standardized male population are limited, and further more in the Indian context. Thus, a need was felt to understand, explore and assess the impact of atypical antipsychotics on sexual wellness in a standardized male population suffering from Schizophrenia.

Objective:

To study the effect of Atypical Antipsychotics on Sexual functions in sexually active male patients of Schizophrenia treated with Atypical Antipsychotics.

Materials and Methods:

150 sexually active freshly diagnosed treatment naïve males with Schizophrenia were administered atypical antipsychotics. Their sexual functions were assessed after 1 month using Arizona Sexual Experience Questionnaire (ASEX).

Results:

Olanzapine, risperidone, and clozapine had maximum incidence of sexual dysfunction (SD) while quetiapine and aripiprazole were having the least. 54% had one or more SD, prominent ones being low sexual desire (54%), dissatisfaction with their sexual drive (41.3%), dissatisfaction with orgasm (39.3%) and inability to reach orgasm (32%).

Conclusion:

SD rates are higher among patients of Schizophrenia treated with Atypical Antipsychotics. All the domains of sexual functioning are affected. Clinicians should routinely assess the sexual functioning in patients on treatment with antipsychotics and should incorporate sexual health as a dimension in their treatment plan.
Primary Gastrointestinal Lymphoma: Clinicopathological Study: 10 Years Experience in a Tertiary Care Center in Southern India
Authors: Bhayani Priyansh Deven , Rao Amara Sadguna , Shah Aditya , Natarajan Kartik , Shah Saloni Naresh , Piramanayagam Paramasivan
Published: March 2024

Background:

The gastrointestinal tract (GIT) is a common site for extranodal lymphomas, accounting for 10%–15% of all non-Hodgkin lymphoma cases and 30%–40% of extranodal lymphomas. Regarding the incidence of the various histological subtypes and areas of involvement, there is a lot of heterogeneity in the literature. This study looked into the anatomical distribution, histological subtypes, and locations of primary gastrointestinal tract lymphomas (PGL) that were seen at a tertiary referral hospital in Southern India.

Materials and Methods:

A retrospective analysis of 96 individuals who had been diagnosed with PGL over the course of 10 years (2012–2022) was done. We carried out an audit of the clinicopathological profile of patients with PGL diagnosed over a period of 10 years. All lymphomas were classified according to the World Health Organization’s 2008 classification.

Results:

Of the 96 patients with PGL, 74 (77%) were male. The most common site for PGL was the stomach (50%), followed by the terminal ileum (14.58%). The most common histological subtype was diffuse large B cell lymphoma (DLBCL), which was seen in 85.42% of the patients. The most common symptom was abdominal pain (51.04%). Rituximab–cyclophosphamide–doxorubicin–vincristine–prednisolone was the most commonly used treatment regimen (56.3%).

Conclusion:

In this large single-center retrospective study, we found that the pattern of distribution of PGLs in India is comparable to the Western literature in that the stomach is the most prevalent site of PGL and DLBCL is the most common histological subtype.
Psilocybin for the treatment of posttraumatic stress disorder: A magic to treat a harmony of illusions?
Authors: Khanna Rakesh
Published: March 2024

A review of the literature on posttraumatic stress disorder (PTSD) suggests it to be a complex disorder with many contributing factors. The concept of PTSD has continued to evolve over time. A diagnosis of PTSD may be hard to get right. Studies suggest a wide variation in its presentation and diagnostic stability. It is tempting to explore the possibility of using chemicals that could help shorten the process of reaching the unconscious mind that could lead to more rapid remission. This article aims to review limitations in seeing the effectiveness of psilocybin (magic mushroom)-assisted therapy for PTSD. Psilocybin is supposed to be just a catalyst for treatment, while psychotherapy is considered the mainstay of treatment. The therapy itself is to be nondirective, geared toward providing a sense of safety for the patient in a vulnerable state and allowing the person to direct the support while being in a chemically compromised state. We may repeatedly be falling into the trap of trying to find simple solutions to problems that are by their very nature quite complex. All interactions take place in a certain context, and their effect will depend on how they are taken up by the whole person/world system.
Comparison between using intrauterine misoprostol with oxytocin infusion and oxytocin alone in reduction of blood loss in cesarean delivery
Authors: Abd Almageed Ghada Abd Al R.A. , Al-Noor Iman I. , Halim Hala W.A.
Published: March 2024

Background

Postpartum hemorrhage is an unexpected obstetricity and one of the five major causes of death among women in both developed and nondeveloped countries. Many women over 20 weeks of pregnancy are at risk of experiencing postpartum hemorrhage and its consequences.

Objective

To compare the effectiveness of the combination of intrauterine misoprostol and oxytocin infusion and oxytocin infusion alone in decreasing blood loss at cesarean delivery.

Patients and methods

The study participants were selected randomly, and a trial was carried out at Al-Zahraa University Hospital in the period between May 2019 to January 2020. A total of 200 pregnant women referred to the cesarean section (CS) were divided randomly into two study groups: group I received 800 μg of misoprostol intrauterine after delivery of placenta, which was inserted at cornual part bilaterally, 400 μg in each group combined with 20 U of oxytocin infusion after delivery of the fetus. Group II was given 20 U of oxytocin infusion after delivery of the fetus. Blood loss during CS was measured. Hemoglobin and hematocrit values were measured preoperatively and 24 h postoperatively.

Results

Intrauterine misoprostol mixed with oxytocin infusion led to a substantial decrease in the intraoperative blood loss in comparison with oxytocin alone (561.42±113.33 vs. 653.60±149.52 ml) (P=0.001). In addition to that, there was a reduction that was statistically significant in the median differences of hemoglobin [1.20 g/dl (0.70–1.5) vs. 1.7 g/dl (1.3–2.2)] (P=0.001) and hematocrit [1.40% (1.1–1.2) vs. 4.5% (3–6.1)] (P=0.001) values when measured before and 24 h after CS. The need for additional uterotonics was highly decreased in the study group (5%) compared with the control group (16%). There was no significant difference in the incidence of adverse effects of misoprostol between the two groups.

Conclusion

The use of 800 µg intrauterine misoprostol combined with oxytocin infusion in CS can significantly reduce blood loss, preserve hemoglobin and hematocrit, and decrease the need for additional uterotonics without significant adverse effects when compared with oxytocin infusion alone.
Role of MRI in evaluation of low back pain in adults
Authors: Elmelegy Rania E.M. , Elfeshawy Mohamed S. , Hasan Rawhia T.
Published: March 2024

Objective

This study aimed to evaluate the causes of low back pain (LBP) by MRI among the adults.

Patients and methods

This was a prospective study carried out at Al-Zahraa University Hospital. Adequate clinical history was taken from patients complaining of LBP, and MRI was performed for these patients, from March 2020 to August 2020. The patients were categorized according to age, sex, characterization of pain, and finding of MRI.

Results

This study was performed on 100 patients ranging in age from 20 to 70 years and revealed that the majority of patients were obese females, representing 52 (52%) patients, and belonged to the age group of more than 45 years [61 (61%) patients]. In most cases, the pain is associated with sciatica [70 (70%) patients], and the most common cause of LBP was spondylodegenerative changes [80 (80%) patients].

Conclusion

LBP is a common health problem in our locality, and MRI is a good diagnostic tool for evaluation of causes of LBP.
Ligasure versus Milligan-Morgan hemorrhoidectomy
Authors: Abdelaziz Heba T. , El Halim Sherif Abd
Published: March 2024

Background

Conventional hemorrhoidectomy for grades III and IV hemorrhoids is a tedious procedure associated with significant morbidity and a prolonged convalescence. We compared LigaSure hemorrhoidectomy with conventional (Milligan-Morgan) hemorrhoidectomy for the treatment of grades III and IV hemorrhoids.

Patients and methods

A total of 80 consecutive patients of grades III and IV hemorrhoids were randomized to either the LigaSure hemorrhoidectomy (40 patients) or Milligan-Morgan hemorrhoidectomy (40 patients). The hemorrhoidal pedicle was coagulated with LigaSure in the LigaSure group and transfixed with 2/0 vicryl in Milligan-Morgan method.

Results

In comparison with Milligan-Morgan method, LigaSure hemorrhoidectomy had a shorter operating time (P<0.001 and was highly statistically significant), less blood loss (P<0.01 and was highly statistically significant), less postoperative pain (highly significant test P<0.01), postoperative complications including hemorrhage (15 vs. 0.0% at 5 days), urinary retention (P=0.169), and faster wound healing at 7 weeks.

Conclusion

Because of its ease of use and less postoperative pain and complication, LigaSure hemorrhoidectomy can be performed as a day-care procedure with less incidence of postoperative complications than Milligan-Morgan method.
Use of prophylactic mesh for prevention of incisional hernia following midline laparotomy
Authors: Mohamed Sawsan S. , Alfy Mohamed O.
Published: March 2024

Background

Incisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh placement may significantly reduce IH but is not widely used. This study aimed to assess the safety and efficacy of prophylactic mesh placement in preventing IH development after midline laparotomy.

Patients and methods

This was a prospective observational study on 83 patients undergoing midline laparotomy admitted to our hospital during the period from August 2017 to January 2020. The patients were randomized into two groups: the suture group (SG), with nonabsorbable running sutures, and the prophylactic mesh group, with fascial closure as in the SG but reinforced with onlay polypropylene mesh.

Results

There was no significant difference observed in mean age, sex, mean BMI, mean hospital stay, and mean follow-up period between both the groups. A statistically significant reduction in IH incidence was demonstrated in the mesh group, with one (2.56%) case, than in the SG, with 11 (25.0%) cases. Surgical site occurrence had higher incidences in the mesh group (25.64%) than in the SG (6.82%).

Conclusion

Reinforcement of the midline closure by onlay mesh has been proved to be an effective and safe method for avoidance of IH in high-risk patients in both elective and emergency operations during the follow-up period.
Comparative study between tracheal ultrasound and pleural ultrasound for confirmation of endotracheal tube position
Authors: Amin Mohamed A. , Abdelraouf Hesham S. , Ahmed Abdullah H.
Published: March 2024

Background and aim

Ensuring the correct position of the endotracheal tube (ETT) at the right time can make a big difference in patient safety. Ultrasonography (USG) has become an essential element in the field of anesthesia and intensive care. The primary outcome of this study was to measure the time needed for confirmation of proper placement of ETT using tracheal ultrasonography (TUS) and pleural USG, whereas secondary outcome was evaluation the accuracy of USG for that purpose.

Patients and methods

This study was conducted on 80 patients with physical status American Society of Anesthesiologists I–II, aged 20–60 years, of both sexes, and subjected to elective surgery requiring ETT for general anesthesia. Patients were randomly assigned into two equal groups according to the ultrasound technique, which was used for identifying endotracheal intubation, in addition to routine use of auscultation and capnography in all patients. Groups are group T, in which USG was used for visualization of ‘comet tail sign,’ and group P, in which USG was used for visualization of ‘sliding lung sign’ on bilateral lung fields. The time needed for confirmation of tracheal intubation by USG, auscultation, and capnography was recorded for each group.

Results

The time needed by TUS in group T (7.90±0.84 s) was less than that needed by pleural ultrasound in group P [14.39±1.47 s (P<0.001)] and less than auscultation and capnography in both groups. The accuracy was 92.5 and 87.5% for USG technique in groups T and P, respectively.

Conclusion

USG is a rapid technique for identification of ETT placement. The time taken for detection of ETT position was less in case of TUS than other methods. Both tracheal and pleural ultrasounds are reliable methods in detecting the proper positioning of ETT.
Evaluation of serum magnesium level in patients with type 2 diabetes mellitus with and without diabetic retinopathy
Authors: Amer Sara A.E.A.E. , ALAshry Samia H. , Saleh Nashwa M.L.
Published: March 2024

Background

Diabetes mellitus (DM) is a worldwide, growing epidemic, with an estimated 415 million adults globally. Patients with diabetes are at increased risk of death and a triad of serious diabetes-specific complications (neuropathy, nephropathy, and retinopathy) and other associated complications. So, it becomes important to prioritize research on prevention and primary care of diabetic complications. Poor glycemic control has been associated with retinopathy. Hence, we evaluated serum magnesium level in type 2 DM with and without retinopathy. Magnesium is an intracellular cation and coenzyme for various reactions of glycolytic pathway, so hypomagnesemia has been shown to precipitate hyperglycemia.

Objectives

To assess serum magnesium level in type 2 diabetic patients and its correlation with retinopathy.

Patients and methods

This is a cross-sectional study that was carried out on 25 patients of type 2 diabetes with retinopathy and 25 patients of type 2 diabetes without retinopathy attending ophthalmology clinic of Al-Zahraa University Hospital. All patients were subjected to the following: detailed history taking, full ophthalmological examination, and investigations like fundus fluorescein angiography and serum magnesium.

Results

The results of the study revealed that there was a significant more decrease in serum magnesium level in diabetic patients with retinopathy than diabetic patients without retinopathy (P=0.028).

Conclusion

As magnesium level decreases in patients with type 2 DM, the prevalence of retinopathy increases. Hypomagnesemia correlated significantly with glycated hemoglobin. Timely monitoring of serum magnesium levels and glycated hemoglobin as well as appropriate interventions would be beneficial in early detection and treatment of diabetic retinopathy.
Comparative study between endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in diagnosis of biliary obstruction
Authors: Salama Saham M. , Elaziz Mona R. Abd , Alfathah Sabry Abd , Elgendy Naglaa A.
Published: March 2024

Introduction

Endoscopic ultrasound (EUS) is a diagnostic procedure that continues to have greater clinical applications. EUS performed before endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice can reduce morbidity and mortality.

Aim

This study aimed to compare the diagnostic accuracy of both EUS and ERCP as combined or individual procedures in 30 patients diagnosed with biliary obstruction.

Patients and methods

From January 2017 to December 2019 in Al Azhar University Hospitals in Cairo, we recruited 30 patients with obstructive jaundice. All the patients underwent clinical examination, laboratory investigations, and abdominal US followed by EUS and ERCP procedures at the same session, and EUS findings were compared with that of ERCP.

Results

The diagnostic accuracy of EUS was as follows: choledocholithiasis in 92%, and malignant lesions in 95%. EUS showed pathology in 47.3% of patients who had an unknown pathology in biliary system at initial investigations. The overall diagnostic performance of EUS shows that the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90.9, 89, 91.7, 95, and 93.5%, respectively. Regarding common bile duct stone (s), by ERCP, it was present in 13 (43.3%) cases, whereas by EUS, it was present in 12 (40%) cases. Regarding malignant lesions (ampullary tumor, cholangiocarcinoma, and pancreatic tumor), by ERCP, they were present in four (13.3%), seven (23.3%), three (10%) cases, respectively, whereas by EUS, they were present in five (16.6), six (20%), and five (16.6) cases, respectively. The complication rate was 3.3%.

Conclusions

EUS established high diagnostic accuracy in diagnosing the causes of obstructive jaundice, with no statistically significant difference between ERCP and EUS findings. This accurately guided ERCP need and avoided needless ERCP. EUS and ERCP in a single session for treatment of obstructive jaundice is scientifically valuable.
Bone mineral density in relation to polycystic ovary syndrome
Authors: Fawzy Olfat , Elghaffar Nagwa A. , Mahmoud Eman , Helmy Abeer
Published: March 2024

Background and aim

Polycystic ovary syndrome (PCOS) is a complex metabolic and endocrine disorder. The influence of different metabolic and endocrine changes in women with PCOS and their relevance to bone status remains to be documented. Irisin is a newly identified adipo-myokine, which may play a role in the etiopathogenesis of PCOS as well as bone metabolism. The aim of the study was to assess bone mineral density (BMD) and serum irisin level in women with PCOS and to determine BMD relationship with irisin and other hormonal parameters.

Patients and methods

The study enrolled 80 women of reproductive age having PCOS and 15 age-matched and BMI-matched healthy women to serve as controls. A metabolic panel, reproductive hormones, and serum irisin level were measured. In addition, BMD of the spine and femur was also assessed using dual-energy X-ray absorptiometry.

Results

Serum irisin level, fasting insulin, and homeostatic model assessment of insulin resistance were significantly higher in the PCOS group compared with the control group. Receiver operating characteristic curve for serum irisin was done for the PCOS group and the control group and demonstrated that the cut-off value for serum irisin was 0.161 μg /dl. There was also a statistically significant difference between the PCOS group and the control group in BMD of spine and femur, being higher in the PCOS group. Logistic regression analysis has shown that serum irisin level, waist circumference, and fasting serum insulin were predictors for the z-score of spine in the PCOS group.

Conclusion

Serum irisin level may be considered as a novel biomarker for PCOS diagnosis. Circulating irisin in PCOS is strongly related to BMD. This suggests that irisin as an adipo-myokine may also be associated with bone metabolism.
Effect of intradialytic exercise on quality of life of patients with end-stage renal disease on hemodialysis
Authors: Ali Noha H. , Eltokhy Hanan M. , Hassan Maha A. , El-Nahas Nesreen G.
Published: March 2024

Background

Up to 90% of patients diagnosed with end-stage renal disease (ESRD) regularly receive hemodialysis (HD) as renal replacement therapy. Patients with ESRD have a diminished physical function, so physical therapy during HD sessions can be a significant part of physical rehabilitation for these patients. The improvement in quality of life (QoL) is regarded as a main target in the management of patients with ESRD.

Aim

The aim of the study was to evaluate the effect of a physical therapy program on the QoL in patients with ESRD on HD.

Patients and methods

This sectional study was conducted on 60 ESRD patients on regular HD who are allocated from the HD unit, Internal Medicine Department of El-Zahraa University Hospital from March 2018 to August 2018. The patients were subjected to anthropometric measurements including weight, height, and BMI; all laboratory variables were recorded. The QoL was assessed using the short-form 36 questionnaire and the score was calculated at the beginning of the study and after 6 months.

Results

There was a statistically significant decrease in blood urea (49.54±15.62 to 33.92±13.89) and plasma creatinine (6.19±1.43 to 4.20±1.95) after 6 months of starting intradialytic exercise in comparison to the baseline. There is statistically significant improvement in the results of some items of the short-form 36 health questionnaire after 6 months from the start of the study.

Conclusion

Exercise program during the intradialytic period can provide a significant improvement of QoL and physical ability of patients with chronic kidney disease.
Letrozole versus clomiphene in prevention of premature LH surge in women undergoing intrauterine insemination
Authors: Hafiz Doaa M.S. , Elshinawy Nashwa M.N. , Elebesy Hanaa A.-E. , Elmadbouly Asmaa A.-A.A.
Published: March 2024

Introduction

Soft stimulation protocols were developed to impart a less stressful and less expensive mode of stimulation for patient insemination.

Aim

To evaluate the effect of letrozole versus clomiphene citrate (CC) in prevention of premature luteinizing hormone (LH) surge.

Patients and methods

This is a prospective comparative study held at Obstetrics and Gynecology Department, Alzahraa University Hospital. A total of 90 infertile patients between 18 and 35 years of age with unexplained infertility or mild male factor were included. Overall, 30 patients had induction by human menopausal gonadotropin and then CC from seventh day of the cycle; 30 patients had induction by human menopausal gonadotropin and then letrozole from seventh day of the cycle, and 30 patients had induction by human menopausal gonadotropin only and were evaluated according to LH and estradiol (E2) on triggering day, folliculometry, and pregnancy outcome.

Results

We found that the letrozole was associated with lesser LH on triggering day and higher endometrial thickness than the other two groups, and CC was associated with higher E2 on triggering day and number of mature follicles than the other two groups. The difference between the study groups in LH, E2, number of mature follicles, and endometrial thickness was statistically significant, whereas the differences in pregnancy rate was statistically insignificant.

Conclusion

The study shows that clomiphene and letrozole are available options to prevent LH surge.
Efficacy and efficiency of hepatitis B core antibody in the diagnosis of occult hepatitis B in hemodialysis patients
Authors: Rashed AL-Sayed M. , Mohamed Emad A. , AL-Dahshan Magdy A. , Said Mohamed A. , AL-Shorbagy Mohamed S.
Published: March 2024

Background

Occult hepatitis B viral infection (OHBI) is defined as hepatitis B virus (HBV) DNA detection in serum by sensitive diagnostic tests in hepatitis B surface antigen (HBsAg) negative patients with or without serological markers of previous viral infection.

Aim

This study aimed to evaluate hidden infection of hepatitis B among HBsAg negative chronic kidney disease patients on regular hemodialysis (HD) using hepatitis B core antibody as a marker in the sera of these patients, HBV DNA by PCR, and to evaluate the efficacy and efficiency of hepatitis B core antibodies in the diagnosis of occult hepatitis B in HD patients.

Patients and methods

Eighty chronic kidney disease patients on regular HD were included in this study; the mean age of studied patients was 41.8±12.72 years. They were recruited from HD Unit, Internal Medicine Department, Bab Alshearia University Hospital, Al-Azhar University, Cairo, Egypt, after exclusion of HBsAg positive, HBV antibody positive, intravenous drug users, and alcoholic patients. All patients were subjected to a full assessment of history, blood chemistry, HBsAg by ELISA, hepatitis B core immunoglobulin G (anti-HBcIgG), HB DNA by PCR, hepatitis C antibody (HCV Ab) by ELISA, and abdominal ultrasound.

Results

Our results showed that HCV Abs were positive in 50% of cases (40 cases); of these patients, 30% (12 cases) were positive for HBcIgG, whereas 50% of the cases (40 cases) were negative for HCV Ab. Of these, 20% (eight cases) were positive for HBcIgG, but the remaining 32 patients were negative for both HCV Abs and HBcIgG. All these results showed negative PCR in all cases (0% of cases).

Conclusion

OHBI among Egyptian HD patients is low, with a 0% prevalence by PCR; 6 months of repeated PCR is recommended as liver biopsy is difficult in HD patients and HBc Abs are not sufficient for the diagnosis of OHBI in HD patients.
The impact of preformatted medical order sheet on decreasing the incidence of medication errors in NICU
Authors: El Akber Hanan S. , AbuShady Mariam , Elbaz Mona Z.
Published: March 2024

Back

ground Medication errors are one of the most common types of medical errors. Medication errors can occur at different phases of the medication administration process.

Aim

This study was planned to identify the incidence of medication errors in neonates in the neonatal intensive care unit (NICU) of El Sadat Central Hospital (SCH) and design a new preformatted medical order sheet (PMOS), and then evaluate its effect on reducing the incidence of medication errors in NICU of the same hospital.

Patients and method

The study was a three-phase interventional study in which PMOS was used. The study took 3 months for detection of medication errors among neonates and then 1 month for construction of PMOS. This was followed by training of health care workers for the use of PMOS for another 1 month, and after which detection of medication errors among all neonates admitted to NICU was done for another 3 months.

Results

A total of 270 medication errors in phase I and 97 in phase III were analyzed. The rate of medication errors decreased significantly from 89.1% in phase I to 31.5% in phase III (P<0.05). Compared with phase I, prescription, transcription, dispensing, and administration errors decreased in phase III from 41.9 to 12.9% (P<0.05), 19.1 to 7.14% (P<0.05), 4.62 to 1.29% (P<0.05), and 23.1% to 10.1 (P<0.05), respectively.

Conclusion

The application of PMOS in NICU of El Sadat Central Hospital resulted in marked reduction in total medication errors.
High-resolution ultrasound versus MRI in evaluation of triangular fibrocartilage complex
Authors: Elreweiny Nahla M.M.A. , Abd-Elaziz Emam M. , Khaled Manal F.
Published: March 2024

Introduction

Pain on the ulnar side of the wrist is a complex diagnostic dilemma and the triangular fibrocartilage complex provides much needed support to the wrist, and extensor carpi ulnaris (ECU) tendon is part of the complex. The most important investigations to diagnose wrist pathologies include ultrasound, computed tomography, and MRI.

Aim

The aim of this study is to evaluate the diagnostic performance of both ultrasonography and MRI findings in ECU tendon part of triangular fibrocartilage complex.

Patients and methods

This control study was carried out on 50 patients with ulnar side wrist pain. The study was conducted in the period from May 2018 to May 2020 at the Radiology Department and approved by the Ethics Committee, and all patients gave their informed consent before inclusion in the study. Results were collected then analyzed using a specialized computer statistical program.

Results

MRI detected ECU injury in 13 joints, whereas ultrasound detected it in 17 joints. They both agreed in 46 joints. MRI missed four joints with ECU injury detected by ultrasound. Statistical analysis of the results showed a highly significant agreement (P value) between both MRI and ultrasound in the detection of ECU injury.

Conclusion

Both MRI and musculoskeletal ultrasound have complimentary roles in the evaluation of different causes of ulnar sided wrist pain. Musculoskeletal ultrasound is highly recommended for the examination of tendons and inflammatory changes of the wrist.