bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Micronucleus Scoring in Cervical Papanicolaou Smears
Authors: Tiwana Kanwardeep Kaur , Kaur Mohanvir , Goyal Shaina , Bhandhari Lachhima
Published: November 2022

Aims and Objectives:

To compare the micronucleus (MN) score in all the major diagnostic categories as per “The Bethesda System for Reporting Cervical Cytology” 2014 including negative for intraepithelial lesions and malignancy (NILM), inflammatory, abnormal squamous cells of undetermined significance (ASC-US), abnormal squamous cells cannot exclude high-grade squamous intraepithelial lesion (HSIL) (ASC-H), low-grade squamous intraepithelial lesion (LSIL), HSIL, and invasive carcinoma (IC) and to assess the role of MN scoring as a biomarker for predicting risk of carcinoma.

Materials and Methods:

A total of 1000 conventional cervical smears stained with Papanicolaou (Pap) stain, comprising unsatisfactory for evaluation (86), NILM (140), inflammatory (696), ASC-US (23), ASC-H (16), LSIL (18), HSIL (15), and IC (6) were studied independently by two pathologists, and the number of MN cells per 1000 epithelial cells in high-power (×400) and oil immersion (×1000) was counted and expressed as MN score per 1000 cells.

Results:

The mean MN score ± standard deviation was found to be 0.99 ± 0.744 in NILM cases, 0.67 ± 0.782 in inflammatory cases, 1.57 ± 0.507 in ASC-US cases, 1.63 ± 0.50 in ASC-H cases, 1.56 ± 0.511 in LSIL cases, 2.47 ± 0.516 in HSIL cases, and 3.0 ± 0.00 in IC cases. A step-wise increase was observed in MN score from inflammatory to IC categories.

Conclusions:

MN score is a reliable and easy test that can be used in conjunction with routine cervical PAP to assess the risk of malignant transformation in the uterine cervix as a biomarker for predicting the risk of carcinoma.
Spinal Anesthesia for Elective Cesarean Section – Comparison of Levobupivacaine and Ropivacaine with Hyperbaric Racemic Bupivacaine
Authors: George Melwin , Ipe Shalini Miriam , Ipe Shaloo , Abraham Saramma P.
Published: November 2022

Background:

Spinal anesthesia is a popular technique for cesarean section, the commonly used drug being hyperbaric bupivacaine. Levobupivacaine and ropivacaine are newer local anesthetics in the Indian market with similar sensory block profile, lesser cardiotoxicity, but shorter duration of motor block.

Aim:

To determine the efficacy and safety of hypobaric levobupivacaine and ropivacaine and to compare it with hyperbaric bupivacaine all with fentanyl for spinal anesthesia in elective cesarean section.

Study Design:

This was a prospective, randomized controlled, double-blinded study.

Methodology:

Ninety pregnant patients were allocated to three groups of 30 each. Group A (control) received 0.5% hyperbaric bupivacaine 1.8 ml with 25 μg fentanyl, Group B (study) received 0.5% levobupivacaine 1.8 ml with 25 μg fentanyl, and Group C (study) received 0.75% ropivacaine 1.8 ml with 25 μg fentanyl. The efficacy and safety were assessed and analyzed using SPSS version 22.

Results:

Our study showed that ropivacaine is noninferior to hyperbaric bupivacaine, with a similar efficacy of 96.7%. Hyperbaric bupivacaine and ropivacaine are superior to levobupivacaine with a success rate of 96.7% versus 80%, with a P = 0.02 for superiority (one-sided). Duration of motor block was shorter in levobupivacaine (P < 0.001) and ropivacaine (P = 0.016) groups compared to bupivacaine group. Mean duration of analgesia was shorter in levobupivacaine (P = 0.001) and ropivacaine (P = 0.010) groups when compared to bupivacaine group. Although the percentage of patients having hypotension were similar among the groups, episodes of intraoperative hypotension and the amount of ephedrine consumed were higher in ropivacaine group compared to bupivacaine group (P = 0.039).

Conclusion:

Ropivacaine 0.75% appeared noninferior to hyperbaric bupivacaine 0.5% in terms of efficacy and safety. Levobupivacaine 0.5% was found to be inferior to bupivacaine and ropivacaine in terms of efficacy.
Effect of Dental Fluorosis on Oral Health-Related Quality of Life and Daily Performances Among 12- and 15-year-old School-going Children Residing in High- and Low-Fluoridated Areas of Meerut District
Authors: Varshney Shivangi , Menon Ipseeta , Gupta Ritu , Arora Vikram , Sharma Anubhav , Rohatgi Lavanya
Published: November 2022

Introduction:

Dental fluorosis is a clinical situation that leads to changes in esthetic appearance in teeth. Oral health problems can cause problems in performing daily activities and social well-being, which may affect individual's quality of life (QOL).

Aim:

To assess the effect of dental fluorosis on oral health-related QOL and condition-specific oral impact on daily performance (CS-OIDP) among 12- and 15-year-old children residing in high and low fluoridated areas of Meerut district, UP.

Methodology:

A cross-sectional study was conducted among 200 12- and 15-year-old school-going children residing in high- and low--fluoridated areas of Meerut district. Dean's fluorosis index was used to evaluate dental fluorosis. A pretested questionnaire, CS-OIDP index, was used to assess the dental fluorosis effect on the oral health-related QOL and daily performances.

Results:

The mean CS-OIDP score among high-fluoridated area was 39.85 and a significant correlation was found between dental fluorosis, CS-OIDP, and oral health-related QOL (P < 0.005).

Conclusion:

The results of the present study can act as an alarm for dentists to carry out epidemiological investigation at village and district level to evaluate the risk factors and possible treatment and preventive measures.
Determination of Atogepant Using RP-HPLC in Bulk and Table ts
Authors: Kumar H. Mundarinti Sudheer , Chandrasekhar Kothapalli Bannoth
Published: November 2022

Context:

Around one in seven individuals worldwide suffers from migraine, a highly prevalent and chronic neurological disease. In the prevention and treatment of migraines, 'gepants' are a class of receptor antagonist molecules that block calcitonin gene-related peptide (CGRP) receptors. Atogepant (ATO) is the first and only oral CGRP receptor antagonist (gepant) that was developed exclusively for the prevention and treatment of episodic migraines.

Aim

A stability-indicating reverse phase high performance liquid chromatography (RP-HPLC) method for the determination of ATO has been developed and validated in bulk and tablet dosage forms.

Materials and Methods

The chromatographic analysis was carried out on a Waters C18 Column with 250 mm × 4.6 mm and a particle size of 5 μm, using an isocratic mobile phase of Phosphate Buffer pH 3.6: Methanol: 0.5% Formic acid 60:38:2 v/v at a flow rate of 0.8 mL/min, and the eluents were monitored at an isosbestic point of 217 nm.

Results

The specificity, precision, accuracy, linearity, and robustness of the proposed method were all validated according to the ICH standards. Forced degradation studies confirmed the method's stability-indicating nature. ATO had retention time of 3.58 min. The current method was found to be accurate, precise, and sensitive. ATO linearity was achieved between 105 and 315 μg/mL, while LOD and LOQ were found to be 4.33 and 14.44 μg/mL, respectively.

Conclusion

As a result, the suggested RP-HPLC method for the quantification of ATO was reliable, reproducible, accurate, and sensitive.
Prior Experience of Physiotherapy Treatment Among the General Public
Authors: Gayathri K. , Hariharan S. , Anbupriya M.
Published: November 2022

Background:

Physiotherapy services continue to be an essential component in patient recovery throughout hospital care, from acute to subacute, palliative extended care and outpatient services. Physiotherapists are also concerned as their role in working with a physical or mental condition that limits a person's movement as they deal through active rehabilitation and health promotions. The physiotherapists gain experience through volunteer work with local senior care centre or local clinic. This study aims to find out the Prior experience of Physiotherapy treatment among General public.

Methodology

A qualitative study conducted with 105 willing participants aged more than 40 years, of both sexes who had a prior experience of physiotherapy treatment at least once in recent 2 years. A self-reported questionnaire was given and the responses recorded.

Results

It shows that Domain (D1-45, D2 -59, D4-53, D5-59, D6-61, D7-60, D8-57, D9-55) participants reported maximum responses towards agreeing, whereas Domain D3 received maximum responses of 46 participants towards disagreeing.

Conclusion

The study concluded that the Prior experience of Physiotherapy treatment among General public using a self-administered questionnaire showed more positive responses towards the Physiotherapy treatment and Physiotherapists.
Prospective clinical study to evaluate role of centchroman in regression of mastalgia in rural population
Authors: Mishra Shashi Prakash , Singh Somendra Pal , Singh Shailendra Pal , Gupta Vipin , Gupta Prashant , Sharma Anil Kumar , Kumar Shesh , Agarwal Manish
Published: November 2022

Background:

Mastalgia in the reproductive age group is common among women. Treatment is not yet standardized for these conditions. The majority of treatments used for mastalgia is costly and have side effects. The aim of our study was to find the efficacy of centchroman for regression of mastalgia in a predominantly rural population, measured by the visual analog scale (VAS).

Materials and Methods:

A total of 140 patients were randomized into two groups: Group 1 (n = 70) patients treated with centchroman and Group 2 (n = 70) patients treated with placebo for 12 weeks. The main outcomes are evaluated after one week to look for any intolerance, followed by repeated follow-ups at four, twelve, and twenty-four weeks to evaluate the treatment response using the VAS score and the side effects.

Results:

The mean age of patients in Group 1 was 29.63 ± 9.67 years and 32.32 ± 9.74 years in Group 2. The baseline mean VAS score was 6.40 ± 1.65 and 5.83 ± 1.69, respectively. After 2, 4, 8, 12, and 24 weeks of follow-up, the mean VAS score was significantly decreased in patients treated with centchroman. On intragroup comparison, the mean VAS score was significantly decreased at baseline to 2, 4, 8, 12, and 24 weeks of follow-ups. In both the groups, gastritis and headache were comparable, and delayed menstruation was significantly more in patients treated with centchroman.

Conclusion:

Centchroman has substantial efficacy, with a marginal effect on regression, of mastalgia in women of the reproductive age group, and it can be used as the first line of treatment.
Effect of COVID-19 on sleep pattern, mobile usage, and serum melatonin level among 1st -year medical students
Authors: Hnamte Lalmalsawma , Phurailatpam Jayshree , Laishram Memeeka
Published: November 2022

Background:

The COVID-19 pandemic has enforced a new norm in the world with maximum dependence on technology in day-to-day living as well as the academic atmosphere. Globally, students are profoundly affected but more specifically medical students are subjected to immense stress, which is bound to affect their sleep and thus the sleep-regulating hormone, melatonin. Young medical students right at the entry to their professional career have, therefore, been hit by the changing scenario with most classes becoming online and increasing dependence on technological gadgets such as smartphones and laptops.

Aims and Objectives:

The purpose of the study was to determine the sleep pattern of 1st-year medical students, survey their mobile phone use, and to estimate their serum melatonin levels during the COVID-19 pandemic.

Materials and Methods:

This cross-sectional study was done in a Northeast India Medical Institute using standard questionnaires, Pittsburgh's Sleep Quality Index (PSQI) and Problematic Mobile Phone Usage Questionnaire among medical students and estimating their early morning serum melatonin level by ELISA assay.

Statistical Analysis:

Data collected were entered in SSPS version 21 and analyzed using descriptive measures, and statistical significances were set at P < 0.05.

Results:

One hundred and one students (Male: 49 and Female: 52) in the age range of 18–23 years responded to the study which recorded poor sleep quality in 53.5% and good sleep in 46.5%. Poor sleep quality as indicated by PSQI score >5 was reported in 63.5% of females and 42.9% of males which was statistically significant (P = 0.04). Out of these poor sleepers, 66.7% of males and 54.5% of females reported mobile phone usage for more than 2 up to 6 h. Comparatively, poor sleep quality was reported in only 19% of male students as compared to 27% of females among those using mobiles beyond 6 h. Besides, 14% of males and 18% of females among poor sleepers reported using mobiles <2 h. Further, in 80 respondents (Male: 40 and Female: 40) randomly selected for estimation of their early morning sample, serum melatonin level was estimated as 99.25 ± 72.07 pg/ml in males and 109.76 ± 84.54 pg/ml in females.

Conclusion:

Nearly 2/3rd of poor sleeper, 1st-year medical male students use mobiles for 2–6 h daily during the pandemic while Only ½ of the females do. However, among those poor sleepers using mobiles beyond 6 h daily, females outnumbered males. Estimated Serum smelatonin levels were also relatively higher than those reported in nonpandemic studies.
Epidemiological survey of fatal road traffic accident in Imphal, Manipur
Authors: Nandeibam Pabitramala , Pradipkumar Khangembam , Keisham Supriya , Nabachandra Huidrom
Published: November 2022

Background:

Approximately 1.3 million people die each year as a result of road traffic accidents (RTAs). According to the National Crime Record Bureau, a total of 368,828 traffic accidents were reported in the country in 2020, and out of these, 96% of the cases were due to RTAs with 354,796 cases and 37% fatality.

Objectives:

The objective is to study the demographic profile of victims of fatal road accidents.

Materials and Methods:

A cross-sectional study was carried out in the department of forensic medicine of a tertiary care teaching hospital in Imphal on all cases of fatal RTA brought in between October 2015 and September 2018. All data including the postmortem findings were analyzed and presented.

Results:

Out of 478 medicolegal autopsies conducted during the study period, 159 (33.3%) were vehicular accident fatalities. The majority of the victims were males in the age group of >20–30 years (22.64%) and pedestrians (30.82%). Most of the accidents (40.88%) occurred during the afternoon period between 12 Noon and 6 PM and in the winter months (50.9%), with maximum cases occurring on national highways (55.3%). The cause of death of the victims was due to head injuries in 42.14%.

Conclusions:

Several factors are responsible for RTAs. There is clearly a need for road safety education among road users. The licensing authorities should adopt stricter, more comprehensive, and scientifically based test.
A complex odontoma of the anterior maxilla associated with an unerupted maxillary central incisor
Authors: Shukla Abhishek , Rai Bhagavandas , Gupta Himanshu , Gadhiya Viral , Patel Kunjan
Published: November 2022

Odontomas are the most common odontogenic tumors. They are usually asymptomatic and are often discovered during routine radiography. We report a case of complex odontoma in the maxillary anterior region that caused pain and prevented the eruption of a maxillary central incisor. This case is significant as there are very few reports of complex odontoma erupting in the maxillary anterior region of the oral cavity.
A retrospective analysis of drowning deaths in Imphal
Authors: Supriya K. , Pabitramala N. , Singh Khangembam Pradipkumar , James D. W. S. , Deepen C.
Published: November 2022

Background:

Drowning is a major cause of death worldwide and it is the third leading cause of unintentional injury deaths accounting for 7% of all injury-related deaths. Different factors are responsible for causing death due to drowning.

Objectives:

The objective of this study was to find out the prevalence of death due to drowning in relation to epidemiological factors and to find out postmortem examination findings and manner of death of such cases.

Materials and Methods:

A retrospective study of drowning deaths brought to the Department of Forensic Medicine and Toxicology of a tertiary care teaching hospital in Imphal was conducted for 10 years. Data obtained were entered in a pro forma and later analyzed statistically.

Results:

In this study period, there were 110 cases of drowning cases. Male: female ratio was 10:1. The highest number of victims was observed in the age group of 21-30 years and the maximum number occurred in rivers, i.e., 54.54%. In 67.27% of the cases, there were signs of asphyxia and in 40% of the cases, froth was present around the mouth and nostrils. Cadaveric spasm which was considered the surest sign of antemortem drowning was observed in only 2.72%. Lungs were found to be voluminous in 77.27% of the cases. Maximum occurred in the rainy season.

Conclusion:

The manner of death could not be ascertained in the present study however from history, most of the cases seem to be accidental. Public awareness and water safety measures need to be improved to prevent drowning deaths.
Prevalence of nonadherence to iron and folic acid supplementation among pregnant women in Bishnupur district of Manipur
Authors: Debbarma Bikash , Konjengbam Shantibala , Elangbam Vijaya , Christina Soubam , Akoijam Brogen Singh
Published: November 2022

Context:

Iron and folic acid (IFA) supplementation is an important strategy to reduce the prevalence of iron-deficiency anemia (IDA) during pregnancy. Consequently, it reduces risk of maternal mortality, neonatal mortality, and poor birth outcomes. Nonadherence to IFA supplementation is a challenging factor in combating IDA.

Aims:

The aim of this study was to determine the prevalence of nonadherence to IFA supplementation among pregnant women and identify the factors associated with it.

Subjects and Methods:

A cross-sectional study was conducted among pregnant women attending public health facilities of Bishnupur district, Manipur. Pregnant women with ≥20 weeks of period of gestation were recruited consecutively from the antenatal care clinics of the selected public health facilities. Face-to-face interviews were conducted using a pretested semi-structured interview schedule. Association between nonadherence to IFA supplementation and background characteristics and antenatal profile was analyzed using Chi-square test.

Results:

The mean age of the participants was 28 ± 5.7 years, and 69% were multigravida. Among 396 women who were currently consuming IFA tablets, 25% were nonadherent. Bad taste, side effects, and inadequate supply were cited as the main reasons for irregular intake. The presence of comorbidities (P < 0.001), government supply as source of IFA tablets (P = 0.001), and adequate knowledge about IFA tablets (P = 0.04) were found to be significantly associated with nonadherence. Other associated factors were religion, education, socioeconomic status, and period of gestation.

Conclusions:

The prevalence of nonadherence was high among pregnant women in Bishnupur district. The importance of IFA supplementation and its adherence should be emphasized to pregnant women.
Neural Networks Application for the Data of LQG Regulator for the Flexible Joint Robot
Authors: Danh Nguyen Cong
Published: November 2022

This paper describes the investigation of a flexible robotic arm with Degree of Freedom (DOF) through Linear Quadratic Gaussian (LQG) regulator under the influence of noise signals with using diagrams below. The derived model is based on the Euler-Lagrange approach while LQG mode is proposed as a modern control method. A flexible robotic arm that is test in the modern regulator is essential for applications. This is even more interesting while these arms have joints that work independently of each other, but they still ensure a tight connection between the joints. Testing the stability characteristics of the system through this regulator helps readers determine the output signals of a system exactly. From here, the author came up with strategies the match the requirements. Although the initial stage of the operating cycle is not stable with the use of LQG regulator, most of later stages of this process of closed systems of robotic systems gradually become stable. In particular, adjusting LQG for flexible joint robot gives satisfactory simulation results. This promises a positive result of other joint robot. Neural networks applied in this paper have proven its effectiveness in information security issues. It is also very useful for tight control of possible situations such as a large scale attack on network systems, automated control systems. The main contributions of this paper have been clearly demonstrated through two strategies that need to be addressed: LQG, neural networks for the data of LQG regulator.The methods described above have not been previously published for this model. Therefore, this article was born to outline the above objectives and the plans have been satisfactorily implemented. These studies are important because they serve as a necessary database in the selection of control strategies according to the requirements. Simulation results are done by Matlab. The purpose of the study of this paper: the author has searched for a stability of the system through the above methods. The applied method is a thorough study of the structure of the system as well as the construction of algorithms to form the regulator. The result ia a reliable simulation of events after the system is controlled by these regulators.
On minimal ideals in pseudo-finite semigroups
Authors: Gould Victoria , Miller Craig , Quinn-Gregson Thomas , Ruškuc Nik
Published: November 2022

A semigroupSis said to be right pseudo-finite if the universal right congruence can be generated by a finite set$U\subseteq S\times S$, and there is a bound on the length of derivations for an arbitrary pair$(s,t)\in S\times S$as a consequence of those inU. This article explores the existence and nature of a minimal ideal in a right pseudo-finite semigroup. Continuing the theme started in an earlier work by Dandan et al., we show that in several natural classes of monoids, right pseudo-finiteness implies the existence of a completely simple minimal ideal. This is the case for orthodox monoids, completely regular monoids, and right reversible monoids, which include all commutative monoids. We also show that certain other conditions imply the existence of a minimal ideal, which need not be completely simple; notably, this is the case for semigroups in which one of the Green’s preorders${\leq _{\mathcal {L}}}$or${\leq _{\mathcal {J}}}$is left compatible with multiplication. Finally, we establish a number of examples of pseudo-finite monoids without a minimal ideal. We develop an explicit construction that yields such examples with additional desired properties, for instance, regularity or${\mathcal {J}}$-triviality.
Early Treatment with Fluvoxamine among Patients with COVID-19: A Cost-Consequence Model
Authors: Mills Fergal P. , Reis Gilmar , Wilson Lindsay A. , Thorlund Kristian , Forrest Jamie I. , Guo Christina M. , Boulware David R. , Mills Edward J. , _ _
Published: November 2022

To date, two published randomized trials have indicated a clinical benefit of early treatment with fluvoxamine versus placebo for adults with symptomatic COVID-19. Using the results of the largest of these trials, the TOGETHER trial, we conducted a cost–consequence analysis to assess the health system benefits of preventing progression to severe COVID-19 in outpatient populations in the United States. A decision-analytic model in the form of a decision tree was constructed to evaluate two treatment strategies for high-risk patients with confirmed, symptomatic COVID-19 in the primary analysis: treatment with a 10-day course of fluvoxamine (100 mg twice daily) and current standard-of-care. A secondary analysis comparing a 5-day course of nirmatrelvir–ritonavir was also conducted. We used a time horizon of 28 days. Reported outcomes included cost-savings and hospitalization days avoided. The results of our analysis indicated that administration of fluvoxamine to symptomatic outpatients at high risk of progressing to severe COVID-19 was substantially cost-saving, in the amount of $232 per eligible patient and prevented an average of 0.15 hospital days per patient treated, compared with standard of care. Nirmatrelvir–ritonavir was also shown to be cost-saving despite its higher acquisition cost and provided savings to the healthcare system of $625 per patient treated. These findings suggest that fluvoxamine is likely to be a cost-effective addition to frontline COVID-19 mitigation strategies in many settings, particularly where access to nirmaltrevir–ritonavir or monoclonal antibodies is limited.
EDITORIAL COP27 Climate Change Conference: urgent action needed for Africa and the world
Authors: Atwoli Lukoye , E Erhabor Gregory , A Gbakima Aiah , Haileamlak Abraham , Kayembe Ntumba Jean-Marie , Kigera James , Laybourn-Langton Laurie , Mash Bob , Muhia Joy , Mavis Mulaudzi Fhumulani , Ofori-Adjei David , Okonofua Friday , Rashidian Arash , El-Adawy Maha , Sidibé Siaka , Snouber Abdelmadjid , K Tumwine James , Sahar Yassien Mohammad , Yonga Paul , Zakhama Lilia , Zielinski Chris
Published: November 2022

NIL.
The effect of liraglutide on renal function in type 2 diabetes: a meta-analysis of randomized controlled studies
Authors: Luo Cheng , He Dongjuan , Yang HongBin , Zhu Chunyan , Zhu Jiajun , Hu Zhaohui
Published: November 2022

Introduction: The efficacy of liraglutide on renal function in type 2 diabetes remains controversial. We conduct a systematic review and meta-analysis to explore the influence of liraglutide versus placebo on renal function in type 2 diabetes.

Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2020 for randomized controlled trials (RCTs) assessing the effect of liraglutide versus placebo on renal function in type 2 diabetes. This meta-analysis is performed using the random-effect model.

Results: Seven RCTs are included in the meta-analysis. Overall, compared with control group in type 2 diabetes, liraglutide treatment shows no obvious effect on GFR (SMD=0.02; 95% CI=-0.43 to 0.47; P=0.94), RBF (SMD=-0.28; 95% CI=-0.80 to 0.24; P=0.29) or death (RR=1.93; 95% CI=0.71 to 5.21; P=0.20), but is associated with significantly decreased ACR (SMD=-0.82; 95% CI=-1.39 to -0.26; P=0.004) and systolic blood pressure (MD=-9.60; 95% CI=-17.46 to -1.73; P=0.02), as well as increased heart rate (MD=5.39; 95% CI=3.26 to 7.52; P<0.00001).

Conclusions: Liraglutide treatment may provide some benefits for protecting renal function in type 2 diabetes.

Keywords: Liraglutide; renal function; type 2 diabetes; randomized controlled trials.
Assessment of electrolytes, markers of glycaemic control and renal dysfunction among adult Nigerians recently diagnosed with type 2 diabetes mellitus
Authors: A Ekun Oloruntoba , F Fagbemi Oloruntoba , N Adejumo Esther , O Ekun Oyeronke , S Wojuade Kehinde , M Oshundun Folu , O Adefolaju Florence , R Oyegbami Sade
Published: November 2022

Background: Diabetes mellitus is a chronic and progressive endocrine disorder that may result in macro and microvascular complications.

Objective: This study assessed some biochemical analytes in Nigerians who were recently (≤ 6 months) diagnosed with Type 2 diabetes mellitus (T2DM).

Methods: 160 T2DM and 90 non-diabetic control participated in this study. Blood samples were collected and analyzed for Heart-type fatty acid-binding protein (HFABP), high sensitivity C-reactive protein (hs-CRP), electrolytes, lipid and renal profile parameters, glycated haemoglobin (HBA1C) and fasting blood glucose (FBG), using standard guidelines.

Result: The body mass index (BMI) of the T2DM volunteers was higher than control (P <0.001). The lipid profile, potassium, glucose, HBA1C, urea and creatinine values were elevated (P <0.001) while estimated glomerular filtration rate (eGFR) was lower (P<0.05) in diabetes. The median HFABP and hs-CRP were raised (P <0.05) in T2DM. Positive associations existed between FBG and urea (P <0.001), Creatinine and HBAIC (P <0.001). A logistic regression analysis, shows that an increased BMI, HBA1C, FBG, Cholesterol, urea and creatinine were associated with higher odds (p<0.001) of cardiovascular and renal complications.

Conclusion: Elevated hs-CRP, glycated haemoglobin, urea and creatinine among T2DM increase the odds of cardiovascular and renal insults in this population.

Keywords: Type 2 diabetes mellitus; renal disease; glycated haemoglobin; high sensitivity C-reactive protein.
Spontaneous intrapleural rupture of mediastinal teratoma in child
Authors: Trabelsi Ines , Zarrad Marwa , Ben Romdhane Manel , Boudaya Sadok , Khalsi Fatma , Boussetta Khedija
Published: November 2022

Introduction: Mediastinal teratomas are rare in children. Nevertheless, they represent the most frequent mediastinal germ cell tumor. Most often, they are discovered incidentally in older children or adolescents on chest X-ray. There are other signs of discovery but less frequent: chest pain, hemoptysis and signs of mediastinal compression. Rupture into pleural space, pericardium or tracheobronchial tree are exceptional.

Case presentation: We report the case of 7-years old girl admitted for chest pain. The chest x-ray showed a mediastinal mass with calcifications and pleural effusion. Chest CT scan revealed a well limited heterogeneous anterior mediastinal mass with calcifications and a left pleural effusion. She underwent a median sternotomy and the tumor was completely excised. Histopathology confirmed the diagnosis of mature teratoma.

Conclusion: Intrapleural rupture is a rare complication of mature teratoma. Calcifications on chest imaging in afebrile children with pleural effusion should be suspected of mediastinal teratoma.

Keyswords: Teratoma; tumor; mediastinum; child; rupture.
Association between serum lipid profile, body mass index and osteoporosis in postmenopausal Sudanese women
Authors: Osman Alfahal Asgad , Eltoum Ali Abdalla , Osman Modawe Gadallah , Mohialddin Doush Wael
Published: November 2022

Background: Epidemiological observations suggest links between osteoporosis and the risk of acute cardiovascular events. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. The reduction of bone density and osteoporosis in postmenopausal women contributes to elevated lipid parameters and body mass index (BMI).

Objective: To investigate the relationship between serum lipid profile, BMI and osteoporosis in postmenopausal women.

Materials and Methods: A prospective analytical case control-study conducted in Khartoum north hospital at Khartoum city, capital of the Sudan from April 2017 to March 2018 after ethical approval obtained from the local Research Ethics Committee of Faculty of Medical Laboratories, Alzaeim Alazhary University on the committee meeting number (109) on Wednesday 15th February 2017. A written informed consent was obtained from all participants to participate in the study.Two hundred postmenopausal women were enrolled in the study. The age was studied in one hundred osteoporosis postmenopausal women as a case group and one hundred non-osteoporosis postmenopausal women as control group. The serum lipid profiles were estimated using spectrophotometers (Mandry) and BMI calculated using Quetelet index formula. The data were analysed using SPSS version 16.

Results: The BMI, serum total cholesterol, triglyceride, HDL and LDL in case group respectively were (24.846±2.1647, 251.190±27.0135 mg/dl, 168.790 ±45.774 mg/dl, 50.620 ± 7.174 mg/dl, 166.868 ±28.978 mg/dl). While the BMI, serum total cholesterol, triglyceride, HDL and LDL in control group respectively were (25.378 ±3.8115, 187.990 ± 26.611 mg/dl, 139.360±20.290 mg/dl, 49.480 ±4.659 mg/dl, 111.667 ±28.0045 mg/dl). All serum lipid profiles significantly increased (p=0.000) in the case group compared to the controlgroup, except serum HDL was insignificant different between the case and control group and also BMI was insignificant different between the case and control group. There was a positive Pearson’s correlation between BMD and serum total cholesterol (r= 0.832, P<0.01), serum LDL (r = 0.782, P<0.01) and serum triglyceride (r = 0.72, P<0.01).

Conclusions: Osteoporotic postmenopausal women had a significant increase in serum lipid profile and BMI. Moreover, we found a positive link between women with cardiovascular diseases and stroke.

Keywords: Osteoporosis; Postmenopausal women; Serum lipid profile; Sudan.
Surgical management of camel-related craniofacial injuries
Authors: Balac Korana , A Al-Ali Mohamed , F Hefny Ashraf , K Mohamed Baraa , M Abu-Zidan Fikri
Published: November 2022

Background: There are no studies focused on the types and management of camel-related craniofacial injuries.

Objectives: We aimed to analyze the pattern of injuries that required surgical management and their specific operative treatment.

Methods: We prospectively collected data of all patients who were admitted to Al Ain Hospital with camel-related craniofacial injuries that were treated operatively during the period of January 2015 to January 2020.

Results: Eleven patients were studied; all were males having a median (range) age of 29 (19–66) years. Falling from a camel was the most common mechanism of injury (45.5 %) followed by camel bite (36.4 %). The most common injured region was the middle third of the face, which accounted for 56.5% of the bony fractures. Zygomatico-maxillary complex fractures were present in 60% of patients who fell while riding a camel. The most common surgical procedure performed in our patients was an open reduction with internal fixation (54.5%). There was no mortality.

Conclusions: camel-related craniofacial injuries are complex. The main mechanism of injury is falling from a camel on the face causing fractures of the zygomatico-maxillary complex. These fractures usually need open reduction with internal fixation. Taking safety precautions may help in injury prevention.

Keywords: Camel; face injury; head injury; surgery.
Evaluation of treatment efficacy after switching to dolutegravir-lamivudine dual therapy in people living with HIV
Authors: Ergen Pınar , Bektas Begüm , Aydın Özlem , Keskin Havva , Canan Üçışık Ayşe , Yılmaz Karadağ Fatma , Cağ Yasemin
Published: November 2022

Background: People living with HIV need to use antiretroviral therapy throughout their lives.

Objectives: Studies on the efficacy and safety of dual therapy are limited in Turkey. We sought to evaluate the treatment efficacy and side effects among patients who were given a combination of dolutegravir (DTG) and lamivudine (3TC) as a maintenance therapy.

Methods: This retrospective, single-centre study included individuals with viral suppression who were older than 18 years of age, living with HIV, switched from a combination antiretroviral therapy regimen to DTG-3TC dual therapy, and followed up for at least 6 months.

Results: The study included 63 patients living with HIV. The median age was 42 years (interquartile range (IQR): 36-51 years). The median follow-up under the DTG-3TC regimen was 10.4 months (7.1-16.0 months). In the course of dual therapy, no patients developed any serious adverse effects that would necessitate a therapy switch, but virological blips were seen in two patients. Two patients lost their lives, with one dying from suicide and one dying from respiratory failure associated with the underlying chronic obstructive pulmonary disease.

Conclusion: The DTG-3TC dual-therapy regimen is a promising and effective therapy that can be used as a treatment of choice for eligible patients.

Keywords: Dolutegravir; lamivudine; dual; antiretroviral therapy; efficacy.
HIV/AIDS services quality in health centers of East Shoa zone, Oromia, Ethiopia
Authors: Aferu Temesgen , Beedemariam Gebremedhin , Gedif Teferi
Published: November 2022

Background: HIV/AIDS is a major public health, social and economic problem in Ethiopia. However, little has been done on assessment of the quality of the services given to patients in this country.

Objective: To assess the quality of HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia.

Method: Cross sectional survey was undertaken in selected health centers of East Shoa Zone between February and May, 2017. Data was collected using researcher administered structured questionnaire, logistics indicators assessment tool and observation check list. SPSS for windows version 20 was utilized in the analysis of the collected data.

Results: The study facilities were providing various services to HIV/AIDS patients. All (100%) and 6(75%) facilities respectively had shortage of trained human power required to give ART and TB services. Regarding ARV medicines availability, majority of the study facilities, 5 (62.50%) reported that they had the stockout of AZT300/3TC150/NVP200 in six months prior to study while 4 (66.7%) of the facilities had the stockout of NVP 240ml (50mg/5ml) syrup on day of visit. Among anti-TB medicines, E100 was out of stock in three facilities (37.5%) on day of visit and INH100 had been out of stock in 4 (50%) of the facilities in six months prior to the study. From OIs medicines, Cotrimoxazole 960mg tablet stockedout in 4 (66.70%) on day of visit and in5 (83.30%) health centers in six months prior to the study. Considerable number of study facilities, 4 (66.70%) had the stockout of tramadol 50mg tablet on day of visit and ibuprofen 400mg tablet in six months prior to the study, 5 (71.40%).

Conclusion: The studied facilities were challenged by different factors including, scarcity of human power, stockout of various HIV/AIDS related medicines and inability to make patients adhere to the services given by the facilities. The consequences of these factors can be dangerous to the patients as well as to the wider public and hence making available the appropriate human resource and HIV/AIDS related commodities including medicines should be the priority for the health facilities and the region to improve the quality of HIV/AIDS services in the study area.

Keywords: HIV/AIDS; Services quality; Health center; East Shoa Zone.
Barriers and facilitators to adherence for antiretroviral therapy: the perspectives of patients from a wellness center in the Mpumalanga Province, South Africa
Authors: T Simelane Portia , S Simelane Maswati , Y Amoateng Acheampong
Published: November 2022

Introduction: Patients’ non-adherence to antiretroviral treatment remains a public health concern in many developing countries, especially in South Africa.

Objectives: The objective of the study was to explore the barriers and facilitators of patients' ART adherence in one health care facility in Mpumalanga Province, South Africa.

Methods: A qualitative, exploratory, and descriptive design was employed to collect data using a semi-structured interview guide through individual in-depth interviews among twenty (20) purposively selected patients. The thematic analysis approach was used to generate themes from the data.

Results: A majority of the participants were female (n=12, 60%), married (n=13, 65%), and employed (n=12, 60%). Barriers to ART adherence include insufficient medical staff at the health center and waiting time being too long. Facilitators included service providers' positive attitude, clear instructions for taking medication, benefits of adhering to ART, and dangers of defaulting treatment.

Conclusion: Barriers and facilitators for adherence included several factors related to the health system, health care workers, and the patients. Achievement of optimal adherence to ART requires the commitment of both patients and providers.

Keywords: ART; Barriers; Facilitators; HIV/AIDS; South Africa.
Factors associated with death among hospitalized COVID-19 patients in Lagos State, Nigeria: a retrospective cross-sectional study
Authors: Adedeji Adejumo Olusola , Ogunniyan Tope , Valentina Adetola Adeife , Chizoba Mba Sandra , Ogunbayo Olakunle , David Oladokun Oluwaseun , Bamidele Oluwadun Oluwayemisi , Erinoso Olufemi , Adesola Sunday , Bowale Abimbola
Published: November 2022

Background: Lagos State has the highest burden of COVID-19 in Nigeria. We assessed associated factors with death from COVID-19 among hospitalized patients in Lagos, Nigeria.

Methods: A retrospective cross-sectional study was conducted using de-identified records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos State between February 27, 2020, and September 30, 2020.

Results: A total of 2,858 COVID -19 patients were included in this study. The mean age of the patients was 41.9±15.5 years. A higher proportion of patients were males (65.8%), asymptomatic (55.5%), had no comorbid condition (72.2%) and had the mild disease (73.8%). The case fatality rate was 6.5%. The odds of death from COVID-19 infection increased by 4% with every increase in age (AOR 1.04, 95%CI 1.03–1.05, p<0.001). The chance of dying was 50% fold more among males (AOR 1.5, 95%CI 1.0 – 2.2, p = 0.042), 60% fold more among patients with comorbidity (AOR 1.6, 95%CI 1.3 – 2.4, p = 0.037) and 9 fold more among patients with severe COVID-19 infection (AOR 9.6, 95% CI 4.9 – 19.1, p <0.001).

Conclusion: The odds of dying was higher among males, the elderly, patients with comorbidity and severe COVID-19.

Keywords: COVID-19; Associated factors; deaths; Lagos; Nigeria.
Tool for the assessment spiritual care after the COVID-19 pandemic: a sequential exploratory study
Authors: Bostani Khalesi Zahra , Pourmohammad Mohsen
Published: November 2022

Background: The present study aimed to develop a tool to assess spiritual care after the COVID-19 Pandemic.

Materials and methods: This study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative phase, through 14 in-depth semi-structured individual interviews with clerics, specialists in Islamic jurisprudence and principles, specialists in education and health promotion, and using the content analysis approach, tool items were designed. Purposeful sampling was performed with maximum diversity of experts and enthusiasts in the field of spiritual health.

Results: Content analysis of the data obtained from interviews led to explaining the concept of spiritual care after the COVID-19 Pandemic in four main themes: spiritual care needs, spiritual care characteristics, outcomes of spiritual care, and the challenge of providing spiritual care. The average content validity index of the tool was 0.94. Exploratory factor analysis showed 4 factors that explained more than 62.83% of the variance. The correlation of spiritual cares scale score for COVID-19 Pandemic with spiritual care tool was (0.86, p <0.001).

Conclusion: Spiritual care tool is a valid and reliable tool, with 38 items to assess the spiritual care after the COVID-19 Pandemic.

Keywords: COVID-19; Spiritual care; Factor analysis.
A Survey on the seroprevalence of toxocariasis and related risk factors in Eosinophilic Children of Northwest Iran
Authors: Pourgholaminejad Arash , Razipour Habib , Heydarian Peyman , Ashrafi Keyhan , Atrkar Roushan Zahra , Sharifdini Meysam
Published: November 2022

Background: Toxocariasis is a serious zoonotic helminthic disease caused by the nematodes; Toxocara species.

Aim: A cross-sectional study was conducted to determine the seroprevalence of toxocariasis and related risk factors in eosinophilic children referred to the pediatrics hospital of Qazvin province northwest Iran during 2019-2020.

Methods: A total of 200 blood samples were collected from eosinophilic children referred to the Qods Pediatrics Hospital. Demographic data, clinical symptoms, and dogs- and soil-contact history were collected. The presence of anti-Toxocara IgG antibody was evaluated by T. canis IgG ELISA kit.

Results: Anti-Toxocara IgG antibodies were detected in 14 (7%) of the total eosinophilic children. The seropositive rate of toxocariasis in hyper-eosinophilic children (>1000/mm3) was 15.1%, while the seropositivity was 4.1% in children with eosinophilia status (500-999/mm3). There was a significant association between the eosinophilia rate and seropositivity (P<0.05). Also, seroprevalence in asymptomatic eosinophilic children was 4.4%, while in children with clinical symptoms it was 17.1%. Accordingly, a statistically significant difference was found between clinical symptoms and Toxocara infection (P<0.05).

Conclusion: The prevalence of toxocariasis in eosinophilic children is a serious health problem in the study area. Therefore, serologic evaluation for the diagnosis of Toxocara infection is recommended for eosinophilic children.

Keywords: Seroprevalence; Toxocariasis; anti-Toxocara antibody; Eosinophilia children; Qazvin; Iran.
The effect of mobile-based training on maternal breastfeeding self-efficacy: a randomized clinical trial
Authors: Seddighi Aazam , Bostani Khalesi Zahra , Majidi Soheila
Published: November 2022

Background: The Aim of this study is to determine the effect of mobile-based training on maternal breastfeeding self-efficacy.

Materials and Methods: This trial was conducted from November May to December 2020 on 198 women referring to healthcare centers in Guilan, Iran. The samples of this study were selected using the convenience sampling method, and random block sampling was used for the allocation of groups.The data collection tool was a two-part questionnaire including questions about demographic data and Dennis's self-efficacy. The questionnaires were completedbefore and 8 weeks after the intervention in both groups.

Results: The mean and standard deviation of self-efficacy before the education in the experiment and control group were 48.26+ 6.49 and 49.11 + 7.36, respectively. After the education, the experimental group was 53.78 + 12.61 and control group was 41.90 + 17.98. The difference between the pretest and posttest scores indicated that the breastfeeding educational intervention increased the women’s self-efficacy in breastfeeding (p<0/001).

Conclusion: The results showed that mobile-based training could improve maternal breastfeeding self-efficacy. It is therefore recommended, this training program as an available and convenient method to improve breastfeeding self-efficacy.

Keywords: Self-efficacy; breastfeeding; cell phone; mobile applications; education.