bluuebunny/crossref_metadata_2025 huggingface dataset:
Bacterial analysis of high vaginal swabs from women of reproductive age at a tertiary hospital in Lucknow
Authors: Verma Sneha , Hassan Sarah , Shukla Priyanka , Ahmad Ayesha , Nag Riya
Published: February 2025

Background: Vaginal infections are prevalent among women, often caused by disruptions in the vaginal microbiota, leading to symptoms like abnormal discharge, itching, and discomfort. Bacterial vaginosis (BV) is a common condition characterized by a shift from Lactobacillus dominance to anaerobic bacteria overgrowth, affecting reproductive-age women significantly. Understanding the microbial ecology and antibiotic susceptibility of vaginal pathogens is crucial for effective management. The study aims to identify bacterial profiles and antibiotic susceptibility patterns from high vaginal swabs. Objectives include determining prevalent pathogenic bacteria and analyzing their antibiotic susceptibility.
Methods: A cross-sectional study at Era’s Lucknow Medical College and Hospital over six months analyzed 73 high vaginal swabs from gynecological clinic attendees. Data collection covered demographics, clinical symptoms, and antibiotic history. Laboratory methods included Gram staining, culture on selective media, biochemical tests, and antibiotic susceptibility testing using the Kirby-Bauer disc diffusion method per CLSI guidelines.
Results: In this study at Era’s Lucknow Medical College and Hospital, 73 high vaginal swab samples were cultured, with 37 (50.7%) testing positive for various pathogens. Escherichia coli was the predominant organism (57%), followed by Enterococcus species (22%), Klebsiella pneumoniae (13%), Staphylococcus aureus (5%), and Pseudomonas aeruginosa (3%). Antibiotic susceptibility testing revealed high effectiveness against Gram-negative bacteria, particularly for imipenem, meropenem, and colistin, with rates exceeding 80%.
Conclusions: Escherichia coli was found to be the most common cause of abnormal vaginal discharge in women of the reproductive age group.
Evaluation heparin binding protein as a prognostic biomarker for diagnosis of sepsis at tertiary care hospital, North India
Authors: Gupta Ashish Kumar , Verma Rajendra Kumar , Giri Richa , Gupta Ajesh Chandra , Gupta Shalini
Published: February 2025

Background: Sepsis is a life-threatening condition marked by an uncontrolled inflammatory response to infection, leading to organ dysfunction and high mortality. In India, severe sepsis burdens ICU resources and impacts patient outcomes. This study aimed to evaluate heparin-binding protein (HBP) as a prognostic biomarker for assessing sepsis severity.
Methods: This prospective study was conducted at the department of medicine, G. S. V. M. medical college, Kanpur, from December 2022 to May 2024, including 113 adult patients suspected of sepsis or septic shock. Demographic data, HBP levels, and correlations with age, sex, disease severity, and other biomarkers C reactive protein (CRP and procalcitonin) were analyzed. Survival rates across different disease severities were also assessed.
Results: The mean age of participants was 53.2±19.3 years. Baseline HBP levels were significantly higher in infection cases compared to non-infection cases (11.21±5.51 ng/ml vs. 4.31±3.72 ng/ml, p<0.001). HBP levels decreased significantly over 72 hours but remained elevated in non-survivors (9.81±6.25 ng/ml vs. 7.17±5.18 ng/ml, p=0.001). HBP was more effective than CRP and procalcitonin in predicting infection severity and outcomes.
Conclusions: HBP is a promising biomarker for assessing sepsis severity and predicting survival. Elevated HBP levels correlate with increased infection severity and mortality. HBP offers an advantage in early diagnosis and prognosis, and further research is needed to optimize its use in sepsis management.
Assessment of age-based variations in physiological and anthropometric metrics in Kashmiri men
Authors: Ahsan Ul Haq Mir , Tiwari Sandhya , Tiwari Sandeep
Published: February 2025

Background: This study investigates age-related variations in physiological and anthropometric metrics among Kashmiri men aged 60-70 years, focusing on cardiovascular and body composition parameters across two age groups (60-65 and 66-70 years).
Methods: Conducted under ethical approval from the university of Delhi, the study included 200 physically active participants, evenly divided into two age groups. Physiological metrics-systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate (RHR), body mass index (BMI), body fat percentage (BFP), waist-to-hip ratio (WHR), and basal metabolic rate (BMR)-were measured using validated tools. Data were analysed using descriptive statistics, independent t-tests, and Pearson’s correlation analysis, with significance set at p<0.05.
Results: Significant differences were observed in RHR and BMR between the age groups. Participants aged 66-70 exhibited higher RHR (82.33±3.71 bm⁻¹) compared to those aged 60-65 (80.88±3.46 bm⁻¹, p=0.01). Conversely, the 60-65 group showed a higher BMR (1555.19±184.65 kcal/day) than the 66-70 group (1487.42±165.96 kcal/day, p=0.01). Non-significant differences were noted for SBP, DBP, BMI, BFP, and WHR, though BFP approached significance (p=0.06). Correlation analysis revealed strong interrelations among BMI, BFP, and BMR, with weaker associations between blood pressure metrics and WHR.
Conclusions: Age-related changes in RHR and BMR highlight physiological adaptations among older Kashmiri men. These findings underscore the need for tailored health interventions addressing cardiovascular and metabolic risks in this demographic.
Effect of surya namaskar on anthropometric parameters and serotonin level in apparently healthy subjects
Authors: More Himani Hanumant , Singh Ajaya Deep , Ghildiyal Archana
Published: February 2025

Background: Although surya namaskar was not considered an asana or part of classical yoga, it is now part of modern yoga practise. It consists of twelve postures. Surya namaskar has a profound calming effect and helps to detoxify the deep-seated organs through abundant oxygenation. The purpose of this study was to investigate how surya namaskar affects anthropometric measures, serotonin levels, and anxiety (as measured by the DASS 21 score).
Methods: Using inclusion and exclusion criteria, 80 healthy overweight participants (BMI of 23.0-24.9 kg/m2) were selected for the study. They were between 20 and 45 years of age. The subjects practiced surya namaskar 5 days a week for 6 months. Anthropometric characteristics such as height, weight, waist, hip and sagittal abdominal circumference were measured before and surya namaskar sessions. The psychological status of the patients was then assessed using the DASS-21 questionnaire at the time of subject enrolment and after 6 months of surya namaskar.
Results: After surya namaskar, there were significant changes in weight (kg), waist circumference (cm), BMI (kg/m2), sagittal abdominal circumference (cm), and WHR were significantly reduced. Hips circumference was mildly increased. Increase in serotonin levels was seen. After surya namaskar, mild depression, severe anxiety and moderate stress were significantly reduced.
Conclusions: Surya namaskar has an effect on the physiological, psychological and physical properties of the body. It is recommended to apply surya namaskar in clinical settings to treat psychological stress and obesity.
A retrospective analysis of outcomes of rhino-orbito-cerebral mucormycosis at tertiary care hospital
Authors: Bellary Radhika , Channashetti Gajanan , K. Sharath Babu , S. R. Lavanya , Dhage Vaishnavi Suresh
Published: February 2025

Background: This study aimed to report outcomes of rhino-orbital-cerebral mucormycosis (ROCM) at tertiary care centre.
Methods: Retrospective analysis of in-patients diagnosed to have ROCM during the year 2021 was done. Diagnosis was confirmed based on lab and MRI investigations. Clinical features and management outcomes were noted.
Results: Among 113 suspected cases, 81 were confirmed to have ROCM. Majority of the patients had suffered COVID-19 disease. 67 cases out of 81 underwent maxillectomy with sinus debridement. Among the 67 cases,11 patients had orbital involvement with no PL, orbital exenteration was performed. Among remaining 14 patients, mortality due to cardiac and respiratory illness was seen in 3 patients, 7 went against advice and 4 had CNS involvement. All the patients were treated with liposomal amphotericin-B.
Conclusions: Early diagnosis, surgical intervention followed by amphotericin B in ROCM has favourable outcome. CNS involvement has a high mortality rate.
Comparative efficacy of diclofenac sodium gel and urea cream in preventing capecitabine-induced hand-foot syndrome: a randomized interventional study
Authors: Tandel Pinakin T. , Krishnan Chandralekha , Anandanarayanan Anand Praveen Kumar , Kaur Navjot , Nagalingam Sathiyamoorthy Pattanam , Ravel Naveen
Published: February 2025

Background: The oral prodrug of 5-fluorouracil, capecitabine, is frequently used to treat breast and colorectal malignancies. The effectiveness of therapy is compromised by hand-foot syndrome (HFS), a typical dose-limiting hazard that frequently requires dose adjustments. Topical agents such as diclofenac sodium gel and urea cream have shown promise as prophylactic options for managing HFS. To compare the efficacy of diclofenac sodium gel and urea cream in preventing capecitabine-induced HFS.
Methods: This randomized, open-label, double-arm interventional study included 100 adult patients with breast or gastrointestinal malignancies receiving capecitabine chemotherapy. Arm A (diclofenac sodium gel) and Arm B (urea cream) were the two groups into which participants were randomly assigned. According to the Common Terminology Criteria for Adverse Events (CTCAE v5.0), the main goal was to prevent grade 2 or above HFS during a 12-week period. HFS severity, modifications in capecitabine dosage and therapy discontinuations were secondary outcomes. Both descriptive and inferential techniques were used in the statistical analysis.
Results: HFS developed in 48% of participants, with no significant difference between the diclofenac arm (26 participants) and the urea arm (22 participants) (p=0.42). Grade 1 HFS was most prevalent (41%), while grades 2 and 3 were infrequent (6%). Treatment interruptions due to HFS occurred in 6% of participants and capecitabine dose modifications were required in 5%, with no significant differences between the two arms. Both interventions demonstrated comparable efficacy in HFS prevention.
Conclusions: Diclofenac sodium gel and urea cream are equally effective in preventing capecitabine-induced HFS, reducing its severity and maintaining treatment adherence.
Prescription patterns of antibiotics and analgesics in postoperative care at government cancer hospital: a prospective observational study
Authors: Pal Avinash D. , Baig Mirza S. , Gaikwad Arvind
Published: February 2025

Background: The prescription patterns of antibiotics and analgesics in postoperative care are critical for optimal recovery. This study aims to analyse the utilization of these medications in postoperative cancer patients at a government cancer hospital.
Methods: A prospective, cross-sectional observational study was conducted at the government cancer hospital, Aurangabad, from March 2023 to August 2024. Prescription data were collected from 321 postoperative cancer patients, focusing on demographic details, drug classes, monotherapy versus combination therapy, and adherence to WHO prescribing indicators.
Results: A total of 321 patients were included, resulting in a male-to-female ratio of 1.23. Antibiotics were prescribed 612 times, with inj. Metro being the most frequently used (33.01%), followed by inj. Augmentin (26.80%). Analgesics totalled 600 prescriptions, led by inj. PCM at 42.17% and inj. tramadol at 31.33%. Monotherapy accounted for 33.96% of antibiotic prescriptions and 16.82% of analgesics, while combination therapy was more common (41.43% for antibiotics and 83.18% for analgesics). Opioid analgesics comprised 58.33% of analgesic prescriptions, highlighting their role in postoperative pain management. Brand drugs were predominantly prescribed, 76.24% of the total. The average number of drugs per prescription was 3.78, and nearly all prescribed drugs (98.84%) were from the NLEM of India.
Conclusions: The prescribing patterns adhered to WHO-DUS parameters, highlighting a strong preference for generic medications. Nitroimidazole and non-opioid analgesics were the most frequently prescribed drug classes, indicating a structured approach to postoperative care in cancer patients.
Optimizing surgical outcomes through preoperative parathyroid localization
Authors: Pal Banyeswar
Published: February 2025

Preoperative parathyroid localization is pivotal in ensuring surgical precision and optimizing outcomes in patients with parathyroid disorders. Advances in imaging techniques have significantly enhanced diagnostic accuracy and reduced complications. A systematic search strategy was designed to identify relevant literature published between June 2014 and September 2024. Databases including PubMed, Scopus, and Google Scholar were utilized, using search terms such as "preoperative localization," "parathyroid imaging," "parathyroidectomy outcomes," "ultrasonography," "SPECT," and "4D-CT." Inclusion criteria encompassed studies focusing on preoperative imaging modalities for parathyroid localization, those evaluating surgical outcomes, and original research articles in English. The qualitative synthesis emphasized patterns in imaging efficacy and surgical outcomes across different studies. Among the imaging techniques, 4D-CT demonstrated the highest localization accuracy (95%), followed by SPECT (89%) and ultrasonography (80%). Patients with precise preoperative localization experienced shorter operative times, fewer complications, and higher rates of surgical success compared to those without effective localization. Integrating advanced imaging modalities into preoperative planning significantly improves surgical precision and outcomes in parathyroid surgery. These findings advocate for their routine use in clinical practice to enhance patient care.
Clinical spectrum and outcome of nocardiosis in Oman: a case series from a single center
Authors: Deodhar Divya , Hassan Kowthar Salman , Rawahi Ghada N. Al
Published: February 2025

Nocardiosis is an opportunistic bacterial infection caused by aerobic Gram-positive bacteria belonging to the actinomycetes group. With the increase in the population of immunocompromised patients, these infections have been identified in the middle east countries. In a retrospective study of 13 years, we found ten patients who were culture confirmed nocardiosis. Among this series, pulmonary nocardiosis predominated with 80%. Most of the species of Nocardia were identified using the molecular testing, 16S rRNA gene sequencing and drug susceptibilities were performed in 70% and 60% respectively. Treatment is usually based on susceptibility testing which give a better clinical cure and outcome. Cotrimoxazole formed the back bone of the treatment. Although, small in number, this case series is the largest reported from the any middle east country and it can assist the clinicians with high clinical suspicion of infection and early treatment.
Amyand's hernia: a finding in the diagnosis of inguinal hernia
Authors: Rodriguez Mayra Cristina Castro , Ordaz David Eduardo Torres , Lugo Leonel Lozano , Romero José Alfonso Martínez , Montes José Ignacio Diego Pérez , Ortiz Daniela Garcia
Published: February 2025

Amyand's hernia is defined as the presence of a cecal appendix in the context of an inguinal hernia sac, which may be found with or without signs of aggravation. Since the very beginning in the medical history its defined as a rare entity, the epidemiology and outcomes are diverse, since the pathophysiologic mechanism is not fully understood it should always be considered in conjunction with the presentation of a right inguinal hernia, the initial diagnostic methods do not represent a sufficient specificity to be suspected in all cases, but within the surgical findings either with data of exacerbation or not, it is recommended to evaluate the underlying cecal tissue. The final objective of this present case is to bring light about the complexity in the diagnosis and the outcome of late diagnosis in a comorbid based population, since is time dependent about diagnostic resources and clinical suspicion become the last and fundamental utility for the clinician.
A rare beta chain variant hemoglobin Deer Lodge; a chance discovery in an Indian family while testing HbA1c by high-performance liquid chromatography
Authors: Dhanani Hiren J. , Shashtri Gaurav D. , Tandel Bharat D. , Modi Hardik , Kothia Jaysukh D. , Sukhadiya Mittal C. , Patel Asmita , Dhanani Srushti C. , Dhanani Nandini H.
Published: February 2025

This case report documents the first reported instance of hemoglobin (Hb) Deer Lodge in an Indian family, discovered during routine HbA1c testing using high-performance liquid chromatography (HPLC). A 34-year-old clinically asymptomatic male (proband) showed an unexpected peak on HPLC, indicative of a Hb variant. Subsequent family screening revealed the same variant in the proband's mother. Multiple analytical platforms (HPLC and capillary electrophoresis) identified a Hb variant with migration patterns inconsistent with common variants. Genetic sequencing confirmed the HBB:c.8A>G mutation in the β-globin gene, corresponding to Hb Deer Lodge, a rare variant previously reported in non-Indian populations. Additional single nucleotide variants (SNVs), including HBB:c.9T>C, were identified in the family, with some showing high prevalence in the eastern Indian population. Functional analysis suggests that Hb Deer Lodge slightly alters oxygen affinity but remains clinically silent. This report emphasizes the importance of comprehensive analysis for Hb variants detected during routine screening, especially in regions with high genetic diversity. Furthermore, it highlights the potential for rare variants to complicate HbA1c measurements, necessitating confirmatory testing and cautious interpretation in clinical practice.
An elusive diagnosis: a case of Plummer-Vinson syndrome
Authors: Muhammed Haneen , C. N. Arun Raj , Legha R. , Peter George
Published: February 2025

Plummer-Vinson syndrome (PVS), also known as sideropenic dysphagia or Paterson-Brown-Kelly syndrome, is a rare medical disorder characterised by triad of iron deficiency anaemia, dysphagia, and oesophageal webs, more often seen in middle-aged females. We present a case of a 37-year-old female who came with complaints of difficulty in swallowing food, fatigue, and generalised body weakness for the past 6 months. Her hematological workup revealed microcytic hypochromic anaemia and barium studies showed smooth concentric narrowing of the cervical oesophagus at the level of the C5-C6 vertebrae (post-cricoid oesophageal web). Hence a diagnosis of Plummer -Vinson syndrome was made. Endoscopic dilatation was done to treat her dysphagia. Her iron deficiency anaemia was corrected with 1-unit prbc transfusion and intravenous iron sucrose supplementation. She was encouraged to eat an iron-rich diet. When she came for a follow-up after six weeks of oral iron supplementation, her condition was satisfactory, and dysphagia had improved.
Revolutionizing medical research with artificial intelligence: opportunities, challenges, and strategies: a review
Authors: Mohammed Abudasir Anas , Saeed Abdullah , Bin Saeed Abdulrahman , Mohammed Abudasir Abdulaziz , Yahya Alhayani Ali , Saeed Aldlham Khalid , E. Mustafa Ahmed Ghassan , Abdullah Alqahtani Razan
Published: February 2025

This article provides an in-depth exploration of the growing role of artificial intelligence (AI) in medical research, identifying potential applications, key case studies, challenges, strategies for implementation, and future perspectives. AI presents immense opportunities to revolutionize medical research, offering tools for efficient data analysis, accurate prediction of outcomes, and enhanced research efficiency. Specific areas such as genomics, drug discovery, clinical trials, and epidemiology can especially benefit from AI's application, as evidenced by various case studies. However, the journey towards full AI integration in medical research is not without obstacles. Data privacy issues, the necessity for specialized knowledge, rigorous validation of AI models, and algorithm interpretability emerge as significant hurdles. Moreover, ethical considerations, such as the risk of bias in AI algorithms, add another layer of complexity. Realizing these challenges demands ongoing innovation, research, and collaboration across various stakeholders. AI's intersection with medical research heralds a new era of potential scientific discoveries and improved patient outcomes. The article calls for a joint effort from researchers, practitioners, and policymakers to embrace this potential, navigate the challenges, and shape a future where AI serves as an invaluable tool in the pursuit of improved healthcare for all.
The use of autologous fat grafting in facial and body rejuvenation: efficacy, innovative techniques and complications
Authors: Suárez-Fuentes Sergio M. , Flores-Chávez Luis A. , Martinez-López Eduardo M. , Castrejón-Cardona Christian D. , Menéndez-Goti Laís L.
Published: February 2025

Autologous fat grafting has revolutionized facial and body rejuvenation by providing natural, biocompatible, and long-lasting results. This review explores recent advancements in harvesting, processing, and injection techniques, emphasizing their efficacy, safety, and aesthetic outcomes. Fat grafting not only restores volume but also demonstrates regenerative properties due to adipose-derived stem cells (ADSCs), enhancing skin texture and elasticity. Modern methods, such as nanofat grafting, offer promising results for delicate areas and scar treatment. Additionally, fat grafting has gained popularity in body contouring, breast reconstruction, and soft-tissue repair, with reported fat retention rates between 60% and 80%. However, complications like fat necrosis, cyst formation, and partial resorption are not uncommon. Rare but severe risks, such as fat embolism, underscore the need for meticulous technique and careful patient evaluation. This review highlights the importance of patient selection and optimized protocols to achieve consistent outcomes, minimize risks, and explore the regenerative potential of fat grafting for emerging applications in medicine.
Superior vena cava syndrome: a comprehensive review
Authors: Sasikumar Aswin , Kothiwale V. A.
Published: February 2025

Superior vena cava syndrome (SVCS) is a condition resulting from obstruction or compression of the superior vena cava, leading to venous congestion of the head, neck, and upper extremities. This review provides a comprehensive discussion on the etiology, pathophysiology, clinical presentation, diagnostic approach, and management strategies for SVCS. Advances in imaging and endovascular interventions have improved the diagnosis and treatment of SVCS. Although malignancies remain the leading cause, benign etiologies have gained significance in the modern era. Despite these advancements, the treatment of SVCS remains challenging, requiring a multidisciplinary approach.
A comparative study of inotropes and vasopressin in critical care unit
Authors: Bhise Pranjali P. , Gawali Pravin F. , Sugriv Dhakne G. , Tokale Rohit , Bhambre Akshay S.
Published: February 2025

In critical care, inotropes and vasopressin are key agents for addressing hemodynamic instability. This article evaluates their effectiveness, safety, and clinical outcomes in conditions like septic shock, cardiogenic shock, and post-cardiac arrest syndrome. Inotropes such as dobutamine and epinephrine enhance cardiac performance but may pose risks like arrhythmias and increased myocardial oxygen consumption. Vasopressin, acting as a non-catecholamine vasopressor, promotes vasoconstriction without significantly impacting heart rate or myocardial contractility, often complementing catecholamine therapy to reduce their dosage requirements. Studies indicate vasopressin can lower the reliance on high-dose catecholamines and may decrease cardiovascular complications, though further investigation is needed in specific groups, such as patients with kidney impairment. The discussion underscores the importance of tailoring treatment to individual patient needs and stresses the necessity for more research to refine dosing strategies and identify response predictors. This review supports clinicians in improving the management of critically ill patients with circulatory challenges.
Health-related quality of life in TB patients: a narrative review
Authors: Tanwar Deepika , Sikka Gitanjali , Rajput Meena , Kumar Vipul , Meetu
Published: February 2025

Tuberculosis (TB) continues to pose a substantial global health challenge, profoundly impacting patients' health-related quality of life (HRQoL). This narrative review provides a comprehensive analysis of published research comparing HRQoL in individuals diagnosed with pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). It delves into the nuanced differences in HRQoL experienced by these two patient groups, exploring physical, psychological, and social dimensions. Beyond comparing HRQoL outcomes, the review identifies key factors that influence these differences, such as disease severity, treatment duration, presence of comorbidities, and socioeconomic status. Furthermore, it examines the implications of these findings for clinical practice, including personalized treatment approaches, targeted support services, and strategies to address specific HRQoL challenges. Finally, the review highlights critical gaps in the current research and proposes potential directions for future studies, emphasizing the need for longitudinal research, standardized HRQoL assessment tools, and interventions aimed at improving the well-being of all TB patients, irrespective of disease presentation. By synthesizing existing evidence, this review aims to deepen our understanding of the distinct challenges faced by individuals with different forms of TB and inform the development of tailored interventions to optimize their overall well-being.
Correlation between Glasgow prognostic score and tumor-node-metastasis staging in colorectal cancer
Authors: Yazdani Asif , Masum Nazmul Hoque , Parveen Rumana , Sazzad Hossain M. , Hafizur Rahman Dipu M.
Published: February 2025

Background: Colorectal cancer (CRC) prognosis is closely linked to clinical stage, with early-stage CRC offering better survival. This study aims to evaluate the relationship between the Glasgow prognostic score (GPS) and tumor-node-metastasis (TNM) staging in CRC. The aim of the study was to evaluate the relationship between the GPS and TNM staging in colorectal cancer
Methods: This cross-sectional study, conducted from June 2018 to May 2019 in the Department of Surgery at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, included 100 colorectal cancer patients. It assessed the correlation between GPS and TNM staging. Data on demographics, tumor site, GPS, and TNM stage were analyzed using Chi-square tests in statistical package for the social sciences (SPSS) version 22.0, with significance set at p<0.05.
Results: The study included 100 participants, predominantly male (59%), with a mean age of 65±10 years. The most common tumor sites were the left colon (42%) and rectum (29%). Elevated CRP levels (>10 mg/l) were observed in 25% of participants, and 34% had low albumin levels (≤35 g/l). Most participants had a GPS of 0 (56%), with 29% and 15% having GPS 1 and 2, respectively. Half of the participants were classified as TNM stage III, and 26% as stage IV. Higher GPS values significantly correlated with advanced TNM stages (p=0.0123).
Conclusions: The study demonstrated a significant relationship between the GPS and TNM staging in colorectal cancer, highlighting GPS as a potential tool for assessing disease progression.
A randomized controlled study on early and delayed laparoscopic cholecystectomy in acute calculus cholecystitis
Authors: S. Shetty Harshika , D. N. Amar
Published: February 2025

Background: Acute calculus cholecystitis, characterized by inflammation of the gallbladder due to gallstone obstruction, is a common emergency requiring effective management. Laparoscopic cholecystectomy is the gold standard treatment, but optimal timing remains debated. This study evaluates outcomes of early versus delayed laparoscopic cholecystectomy in patients with acute calculus cholecystitis.
Methods: A prospective, randomized controlled trial conducted at Srinivas Institute of Medical Sciences, Mangalore, from July 2022 to July 2023. Ninety-six patients diagnosed with acute calculus cholecystitis were randomized into early (surgery within 72 hours) or delayed (surgery after 6-12 weeks) laparoscopic cholecystectomy groups. Outcomes assessed included operative time, hospital stay, intraoperative bleeding, conversion to open surgery and complications.
Results: The early group had significantly longer mean operative time (95.47±11.41 minutes) compared to delayed group (73.69±17.67 minutes, p=0.04) but a shorter hospital stay (5.2±1.40 days vs. 7.8±1.65 days, p=0.04). The early group experienced higher intraoperative bleeding rates (38 (79.16%) versus 26 (54.16%, p˂0.001). Conversion to open surgery 8 (16.66%) versus 3 (6.25%) p=0.156) and bile duct injuries (2 (4.16%) versus 0%, p=0.241) were slightly more frequent in the early group, though not statistically significant.
Conclusions: Early laparoscopic cholecystectomy is associated with longer operative time and higher bleeding rates but offers shorter hospital stay compared to delayed surgery. Both approaches are safe and the choice should be guided by individual patient factors and surgical expertise. Early surgery can be a viable option, potentially reducing hospital length of stay without significantly worsening postoperative outcomes.
A prospective cohort study of clinical presentation and outcomes of acute pancreatitis at tertiary care center
Authors: Pahuja Vivek , Rani Nisha , Singla Girish , Dugg Pankaj , Singh Sarabjit
Published: February 2025

Background: Acute pancreatitis present with varied symptoms and etiologies and had variety of outcomes based on severity. The study was conducted to see the clinical presentation and outcomes of acute pancreatitis at tertiary care center.
Methods: The study was carried out on 47 patients of acute pancreatitis. The clinical presentations and outcomes were noted. The severity is assessed by modified computed tomography severity index (MCTSI). Statistical analysis was done on Microsoft Excel version 21. P value<0.05 is considered significant.
Results: The mean age of patients was 36.94±10.63 years with male to female ratio of 2.6:1. Alcohol was the common etiological factor seen in 59.57% (n=28). MCTSI score was significant in detecting necrosis (p=0.00001) and predicting mortality (p value=0.000048).
Conclusions: Severe acute pancreatitis has high mortality. MCTSI is good prognostic factor for assessing morbidity and mortality.
A clinical study of the role of split-thickness skin autograft in management of wounds and identification of factors influencing the graft uptake
Authors: Haris Shafiqa , Nema Prashant Kumar , Charokar Kailash , Gupta Nitin
Published: February 2025

Background: Wound management is a significant concern in surgical care, with split-thickness skin grafting (STSG) being a common treatment option. To evaluate the clinical outcomes of STSG in wound management and identify factors influencing graft uptake.
Methods: This observational descriptive study was conducted at a tertiary care center among patients requiring STSG for wound management. Patients were followed up for 3 months post-STSG.
Results: A total of 40 patients were enrolled. Diabetes, hypoproteinemia, and positive wound culture was significantly associated with partial graft loss (p<0.05). The duration of the ulcer was significantly longer in patients with graft loss (p<0.05). Pain scores improved significantly after grafting in both patients with and without graft loss. Complications such as serous discharge were more common in patients with partial graft loss.
Conclusions: This study highlights the importance of optimizing wound conditions and addressing underlying comorbidities to improve graft outcomes. Diabetes, hypoproteinemia, and positive wound culture were identified as significant factors influencing graft uptake.
A study of the incidence of malignancy and clinicopathological correlation of incidence of malignancy in peptic perforation disease
Authors: Chatterjee Jishnu , Singh Manju , Shrimor Prachi , Chandrakar Jayanti
Published: February 2025

Background: Gastrointestinal perforation, a common emergency in surgery, often results from peptic ulcer disease but can also be caused by gastric cancer. Peptic ulcers, with a lifetime risk of 10%, are more prevalent in developing countries and linked to factors like H. pylori infection, NSAID use, smoking, and stress. Complications include bleeding, perforation, obstruction, and cancer. Perforation leads to peritonitis, requiring treatment via perforation closure. Although gastric cancer accounts for 10-16% of perforations, many patients don't undergo post-operative biopsy, potentially missing cancer diagnoses. This study aimed to determine the true incidence of malignancy in perforation cases as well as in specific demographics and identify contributing factors.
Methods: The present study was aimed at determining the true incidence of malignancy in perforation cases as well as in specific demographics and identify contributing factors. Biopsies taken from the margins of gastric (antral) perforation during the operation, were subjected to histopathological examination.
Results: Our study found only 1 case of perforation in a male patient, in the 61-70-year age bracket with history of both smoking as well as alcohol, to have an associated malignancy.
Conclusions: The incidence of malignancy in gastric perforation is very low and as a result, often goes undiagnosed, resulting in lack of appropriate treatment of the underlying cancer.
Retained Endoloop ligature plastic tube, an unusual complication post appendicectomy
Authors: Bricknell Lana , Goh Ian Y. , Lewin Joel , Siriwardhane Mehan
Published: February 2025

Laparoscopic appendicectomies are one of the most common emergency operations. The use of ligatures is considered a safe technique for securing the appendiceal base. We describe a rare but important complication of this technique, with retention of the plastic tube from a polydioxanone (PDS) ligature in the abdominal cavity of a patient. A 64-year-old male presented with acute on chronic abdominal pain seven months following a laparoscopic appendicectomy. A CT demonstrated a bizarre linear tract extending from the bowel mesentery and right liver with associated pleural effusion. The patient underwent an exploratory laparoscopy, which identified a chronic peritonealised tract containing a plastic Endoloop® (Ethicon, Bridgewater, NJ, USA) sheath, traversing through the small and large bowel mesentery, through the right liver and diaphragm. The hard plastic tube was retrieved from the abdomen and the diaphragm repaired laparoscopically. The patient’s severe chronic pain resolved immediately postoperatively. The use of Endoloop® ligatures provides a simple and affordable method for appendiceal stump closure. Notably in many Australian hospitals, the Endoloop® plastic sheaths are not part of the final instrument count in an appendicectomy. Retention of the plastic ligature tube is a rare complication, with the literature only reporting one other case of this occurring following a cholecystectomy. This rare case of retention of the Endoloop® plastic sheath led to significant pain and morbidity and a second operation in this patient. This is the first reported case of this complication in the literature following an appendicectomy.
Enhancing intraoperative precision: transillumination technique for identification of small gut arteriovenous malformation
Authors: Bashir Shahbaz , Sheikh Mudassir Khurshid  , Amin Aqib , Ahrar Naiem , Kangoo Abid
Published: February 2025

Arteriovenous malformations (AVMs) in the small intestine, though rare, are significant causes of obscure gastrointestinal (GI) bleeding. This report discusses the use of a transillumination technique to enhance intraoperative localization and precision in the surgical management of a mid-ileum AVM. A 23-year-old male presented with a two-year history of melena and transfusion-dependent anemia. Despite normal findings on upper and lower GI endoscopy, CT enterography revealed multiple tortuous vascular channels in the mid-ileum. Surgical resection was performed, and intraoperative localization of the AVM was achieved using the transillumination technique. Postoperative recovery was uneventful, and the patient remained stable at follow-up. This case highlights the diagnostic challenges of small gut AVMs and the effectiveness of transillumination as a method to enhance intraoperative precision for identifying AVMs, complementing other diagnostic techniques such as CT enterography and video capsule endoscopy.
The deep circumflex iliac artery flap for central arch mandibular reconstruction in a patient of peripheral vascular disease: a case report
Authors: Naskar Sukanya , Ghosh Subhabrata , Guha Rajdeep , Adak Arnab , Tripathy Anannya
Published: February 2025

Carcinoma of oral cavity requires resection followed by reconstruction. For the carcinoma of alveolus, lower gingivo-buccal sulcus or gingivo-lingual sulcus of middle 3rd bony reconstruction is required. Generally free fibula flap is preferred. But free fibula cannot be harvested if there is peripheral vascular disease. Here we present a case of carcinoma alveolus of mandible middle 3rd in a case of peripheral vascular disease. Deep circumflex illiac artery used instead of free fibula flap. Patient had a very good outcome, facial cosmesis was good, no hernia in the donor site.
Compliance with occupational safety and health practice among medical laboratory staff at Kenyatta National Hospital, Nairobi city county, Kenya
Authors: Mukiti Augustine Mutisya , Warutere Peterson , Mathenge Scholastica
Published: February 2025

Background: This study sought to assess compliance with occupational safety and health among medical laboratory workers in Kenyatta national hospital in Nairobi city county, Kenya. The study focused on potential hazards, occupational safety and health compliance and health system factors associated with compliance to occupational safety and health among medical laboratory workers.
Methods: The study used analytical cross-sectional design. The study used a sample size of 148 respondents. Data was collected using semi-structured questionnaires and key informant interview schedules. Descriptive data was analyzed using statistical package for social sciences version 25.0 with the aid of Microsoft excel program to generate frequency tables. The study employed chi-square tests to establish the association between study variables.
Results: The findings showed that there was association between years worked and exposure to biological hazards (χ2 (1) = 4.167, p<0.05) respectively. There was no association with age, (χ2 (2) = 8.001, p<0.05), education level, (χ2 (1) = 8.06, p<0.05) and years worked (χ2 (2) = 9.248, p<0.05) and exposure to physical hazards. Staff workload was significant factor influencing compliance (χ² = 155.376, p<0.001), and significant relationship between the provision of personal protective equipment and occupational safety and health compliance (χ² = 155.030, p<0.001).
Conclusions: The hospital has made significant efforts in implementing various health and safety programs which can be adopted across different departments. This includes programs such as safety audit, safety trainings and occupational health surveillance.
Low hepatitis D co-infection among hepatitis B virus surface antigen-positive blood donors in Kenya
Authors: Langat Benard , Kimutai Kutto Elisha , Andonov Anton , Borlang Jamie , Bii Kipngetich Andison , Osiowy Carla , Mutai Alex , Kirwa Edward , Kimoloi Sammy , Maritim Songok Elijah
Published: February 2025

Background: Hepatitis delta virus (HDV) is a highly pathogenic virus, and causes rapid disease progression from fulminant hepatitis (FH) to development of hepatocellular carcinoma (HCC) in patients co-infected with hepatitis B virus (HBV). However, its exact global burden of HBV-HDV co-infections remains largely obscure, particularly in sub-Saharan Africa. The objective of this study was to determine the prevalence of anti-hepatitis delta virus (anti-HDV) in hepatitis B virus surface antigen (HBsAg)-positive blood donors from Kenya.
Methods: A total of 239 HBsAg-positive serum samples, obtained from healthy Kenyan blood donors from June 2014 to November 2017 were analyzed in this cross-sectional study. ELISA was done using the International Immunodiagnostics HDV Ab EIA kit, according to the instructions of the manufacturer, for anti-HDV immunoglobulin G (IgG) determination.
Results: Of the 239 HBsAg-positive blood donors, 187 (78.24%) were male, and 52 (21.76%) were female. The average age of the study participants was 24.11 years. Serological analysis revealed that 3/239 (1.26%) study participants were HDV seropositive.
Conclusions: Our data suggest that HDV infection is rare among blood donors in Kenya, with anti-HDV positivity rates being relatively lower compared to other countries. Nonetheless, ongoing surveillance is essential to track any potential changes in prevalence over time.
Factors influencing uptake of human papillomavirus vaccine among school-going adolescent girls (10-14 years) in Kibra Sub County, Nairobi City County, Kenya
Authors: Kinya Edith , Kariuki John G.
Published: February 2025

Background: The human papillomavirus (HPV) vaccine, which is administered to young girls prior to the initiation of sexual activity, is a crucial primary preventive measure against cervical cancer. Cervical cancer is the primary cause of cancer death and the most common cancer among Kenyan women. The study aimed to assess factors Influencing uptake of human papillomavirus vaccine among school-going adolescent girls (10-14yrs) in Kibra Sub County, Nairobi City County, Kenya.
Methods: The study used an analytical cross-sectional where both qualitative and quantitative data were obtained for triangulation purposes. Both chi-square and binary logistic regression were employed to determine the association between the independent and dependent variables. Qualitative data was analyzed thematically.
Results: The uptake of the HPV vaccine in this study was 29.9% which is a public health concern. Attending a private school (OR=2,95%CI=1.17-3.26), having guardians aged between 34-40 years (OR=4.7,95%CI=0.09-0.53), having a positive perception of the HPV vaccine (OR=2.4,95%CI=0.26-0.66) and easy access to HPV vaccination services (OR=2.7,95%CI=0.22-0.65) increased the odds of the HPV vaccine uptake. Study respondents' guardians who had a primary level of education (OR=4,95%CI=1.97-8.04), being Muslim (OR=1.9,95%CI=0.30-0.94), and the absence of HPV vaccination programs targeting school-going girls (OR=2.2,95%CI=1.36-3.46) reduced the odds of HPV vaccine uptake.
Conclusions: The uptake of the HPV vaccine was suboptimal. Attending a private school, easy access to HPV vaccination services, having guardians aged between 34-40 years, and having a positive perception of the HPV vaccine increased the odds of the HPV vaccine uptake. Multifaceted efforts should be put in place to enhance the uptake of HPV vaccines.
Asthma knowledge and management practices of pharmacists in Greater Accra
Authors: Atiemo Mawuli , Wutor Victor Collins , Ayisi-Boateng Nana Kwame , Banga N’Guessan Benoit
Published: February 2025

Background: Asthma continues to be a global public health problem, and community pharmacists are at the center of drug therapy in areas such as Greater Accra, Ghana.
Methods: This study determined what 177 community pharmacists knew about managing asthma and what barriers they faced in their practice. Data were collected using a structured questionnaire regarding demographics, asthma knowledge, daily management practices, and perceived barriers.
Results: Most pharmacists (55.93%) had a good understanding of asthma management, 42.37% had moderate knowledge, and 1.69% had poor knowledge, the results showed. More specific to asthma were pharmacists (100%), were well versed in asthma pathophysiology (100%), triggers (93.22%), and use of peak expiratory flow (PEF) meters (94.92%). However, some inconsistencies in practice were present. While inhalation techniques were assessed by 73.68%, treatment side effects were discussed by 79.31%; however, only 49.15% were routinely counselled on inhaled corticosteroids (ICS). In addition, only 18.64 percent ensured patients had written asthma action plans. Asthma Action Plans were lacking in 81.4%; there were inadequate training opportunities (64.4%); designated consultation areas were lacking (52.5%); pharmacists had insufficient time to care (52.5%) and had time constraints to care (55.9%). Our findings are consistent with global observations and highlight system-level challenges that impede effective asthma management.
Conclusions: Although the Greater Accra pharmacists are knowledgeable enough based on their low rates of noncompliance indicated by their blood pressure scores, we believe that gaps in their practices and barriers to narrowing these gaps must be bridged.
Prevalence and factors associated with teenage pregnancy in Nepal
Authors: Bhusal Hari Prasad , Neupane Sabitra , Bhusal Simran
Published: February 2025

Background: Every year, approximately 16 million adolescents give birth globally, accounting for 11% of all births worldwide. 95% of these births take place in low- and middle-income nations. The objective of this study was to assess the prevalence and contributing factors related to teenage pregnancy in Nepal.
Methods: Standardized data was sourced from the NDHS 2016. This cross-sectional survey was representative of the national population, utilizing a multistage cluster sampling method. Data collection was carried out through three sets of structured questionnaires. Authorization for data usage has been secured from the relevant agency. Statistical analyses were performed using STATA.
Results: NDHS 2016 reported a teenage pregnancy prevalence was 16.7%. Among those aged 15 to 19, 61% were married. The incidence of teenage pregnancy was notably low among Brahmin/Chhetri (11.5%), highest among Muslims (22.7%), and lowest among Buddhists (12.8%). The middle wealth category exhibited the highest prevalence. Additionally, teenage pregnancy was more prevalent in rural areas, particularly in Terai. A significant association was found between the age of respondents and teenage pregnancy and the employment status of respondents (p<0.05). However, the educational attainment of respondents did not demonstrate any significant association with teenage pregnancy.
Conclusions: The prevalence was highest among the Madhesi community followed by Muslims. The age of the respondents or marriage before the age of 19, economic status of the respondents, rural place of residence, and occupation of the respondents were significantly associated with teenage pregnancy in Nepal.