bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of allogenic bone block graft in maxillary alveolar ridge reconstruction: A systematic review
Authors: Purohit Aishwarya Ramkishan , Kolte Rajashri Abhay , Kolte Abhay Pandurang , Lathiya Vrushali Nilesh
Published: August 2024

Background:

The purpose of this systematic review was to assess the efficiency of allogenic bone block grafts for maxillary alveolar ridge reconstruction.

Materials and Methods:

An electronic literature search was conducted using the PubMed, Cochrane Library, and Google Scholar databases. In addition, manual searching was done. Randomized controlled trials (RCTs) and prospective clinical trials (non-RCTs) up to December 2022, presenting the outcomes of allogenic bone blocks in maxillary alveolar ridge reconstruction, were identified. The rate of resorption, survival rate of implants, and formation of new bone following ridge augmentation were the outcome parameters. The quality assessment of the studies included was done using Joanna Briggs Institute Critical Appraisal Tool.

Results:

A total of 13 studies that matched the inclusion criteria were included. The average rate of bone resorption ranged from 0.2 to 29.2 mm, with an implant survival rate of 96.87% across the included investigations. On an average, 25.83 mm (18.6–33/mm) of new mature compact osseous tissue was discovered, including viable osteocytes in close contact with the remnant cancellous bone.

Conclusion:

According to the results of the current systematic review, using allogenic bone block graft for reconstruction of atrophic maxillae appears to be an effective and reliable bone substitute for reconstruction of atrophic maxillae.
Serum 25 hydroxycholecalciferol in periodontitis patients with type 2 diabetes mellitus – A socioeconomic and clinicobiochemical study in Chhattisgarh
Authors: Gazala M. P. , Mishra Supriya , Gupta Vineeta , Rahman Waheda , Khiraiya Nupoor , Dahiya Sheetal
Published: August 2024

Background:

Very few studies have examined the impact of the concurrent presence of periodontitis (PD) and type 2 diabetes mellitus (T2DM) on serum Vitamin D levels, particularly in developing nations like India, and needs further investigation.

Aim:

This study aims to assess the relationship between serum Vitamin D values and PD in T2DM patients and to study the correlation between socioeconomic and demographic variables that influence the serum Vitamin D levels and the extent of PD in patients with T2DM.

Materials and Methods:

This was a cross-sectional, hospital-based research. Medical, dental, and diet histories were obtained from the participants, and their socioeconomic status (SES) was determined. Clinical parameters – plaque index (PI), gingival index (GI), sites with gingival bleeding, probing pocket depth (PPD), and clinical attachment level (CAL) were compared among three groups -patients with generalized Stage III Grade B PD with T2DM (n=35), patients with generalized stage III Grade B PD (n=35) and healthy controls (n=35) and the clinical parameters - plaque index(PI), gingival index(GI), sites with gingival bleeding, probing pocket depth(PPD), and clinical attachment level(CAL) were measured. Biochemical tests included the evaluation of serum 25-hydroxyvitamin D (25[OH] D) and hemoglobin A1C (HbA1c) levels.

Statistical Analysis:

Periodontal and biochemical parameters were compared using a one-way analysis of variance across the three groups. The association between clinical parameters, SES, and 25(OH)D was examined using Pearson’s correlation coefficient test and linear regression analysis.

Results:

The serum 25(OH)D levels were lowest in the subjects with generalized Stage III Grade B PD with T2DM (13.54 ± 3.31 ng/mL). Furthermore, there was a significant (P < 0.01) negative correlation between serum 25(OH)D and periodontal parameters, PI (−0.442), PPD (−0.474), CAL (−0.459), sites with gingival bleeding (−0.354), and GI (−0.346) among the groups. The regression analyses showed that an increase in periodontal parameters (PI, GI, PPD, and CAL) and a higher HbA1c was linked to a lower 25(OH)D. However, the periodontal parameters and 25(OH)D levels showed no correlation with socioeconomic and demographic parameters in the study.

Conclusion:

Serum Vitamin D values are negatively influenced by the synergistic effect of PD and T2DM or by the presence of PD alone. However, the association of SES on serum Vitamin D values in individuals with PD and T2DM or PD alone could not be demonstrated.
Osteogenic assessment of leukocyte platelet-rich fibrin and injectable platelet-rich fibrin in the human osteosarcoma MG – 63 cell line in chronic periodontitis patients: An in vitro study
Authors: Dolly A. Sheryl , Rajula Prem Blaisie , Shankar P. L. Ravi , Lochini S. , Rashik Mohamed , Raja Sindhujaa
Published: August 2024

Background:

The burgeoning interest in implant and regenerative dental care has led to a notable upsurge in the utilization of regenerative modalities. The intent of the present investigation was to evaluate the osteogenic ability of two different concentrated platelet groups at various concentrations in the human osteosarcoma MG–63 cell line.

Materials and Methods:

Blood samples from 21 volunteers with chronic periodontitis were collected which were then centrifuged in accordance with the protocols of Choukroun et al. and Miron et al. to produce leukocyte- and platelet-rich fibrin (L-PRF) and injectable platelet-rich fibrin (I-PRF), respectively. Following MG-63 cell culture, the osteogenic ability of 0, 4%, and 20% concentrations of both L-PRF and I-PRF were determined using the real-time polymerase chain reaction assay.

Results:

The results showed that 20% I-PRF (1.52 ± 0.24) and 4% L-PRF (1.42 ± 0.37) had the highest amount of bone morphogenetic protein 2 and osteocalcin, respectively.

Conclusion:

I-PRF appears to promote the initial differentiation of cells.
The Relationship between Maternal anti-A\-B Titers and the Severity of Positive Direct Antiglobulin Test ABO-Hemolytic Disease of the Newborn in a Syrian Population
Authors: Mahfood Mohamad A. , Alshemali Suzanne , AWAMA Mohamad Ayman
Published: August 2024

AIMS:

The aim of this study was to investigate the relationship between maternal anti-A\-B titers and the values of hemoglobin and indirect bilirubin in ABO-hemolytic disease of the newborn (ABO-HDN) afflicted newborns and to develop a cutoff of total and immunoglobulin G (IgG) antibodies for treatment needs in neonates in Latakia.

STUDY DESIGN:

A case–control study of 40 positive direct antiglobulin test (DAT) neonates who were ABO incompatible with their mothers and 20 healthy DAT-negative ABO incompatible neonates. Total and IgG anti-A\-B titers were compared between the two groups, and their correlation with newborns' hemoglobin and indirect bilirubin and the need for treatment were evaluated.

RESULTS:

Both the maternal anti-A\-B total and IgG titers in the ABO-HDN group were significantly higher than in the control group (P < 0001). A significant correlation between maternal IgG titers and indirect bilirubin was found, but not between total antibody titers and indirect bilirubin. A negative correlation between total and IgG titers and hemoglobin was also documented. The IgG cutoff value for ABO-HDN incidence and the need for treatment was 128 with sensitivity and specificity of 92.5% and 95%, and the total antibodies cutoff value was 64, with a sensitivity and specificity of 62.5% and 90%, respectively.

CONCLUSION:

Maternal total and IgG anti-A\-B can be an important prediction for the occurrence of ABO-HDN and evaluation of the neonates' hyperbilirubinemia after birth. Therefore, the routine detection of the titer of these antibodies and especially in mothers who have a high antibodies titer and a record of a previous jaundiced neonate can be an additional step in the ABO-HDN assessment of neonate.
Do We Need Local Guidelines for the Diagnosis and Management of Immune Thrombocytopenia in Iraq?
Authors: Mjali Ahmed , Matti Bassam Francis , Abbas Nareen Tawfeeq , Abood Nassrullah Hassan Ali , Naji Alaadin Sahham , Alwan Alaa Fadhil , Al-Tameemi Waseem Fadhil , Jaleel Al-Shammari Haider Hasan , Saleh Tareq Abdullah , Al Qayyim Mohammed Kamil , Mohammed Amer Shareef
Published: August 2024

AIMS:

Immune thrombocytopenia (ITP), also known as immune thrombocytopenic purpura, is an autoimmune disorder characterized by a low platelet count in the blood. This study aimed to assess the health infrastructure in Iraq regarding the diagnosis and management of patients with immune thrombocytopenia (ITP), with a focus on the use of guidelines in ITP management.

SETTINGS AND DESIGN:

This was a cross-sectional study carried out between October and November 2022 to assess ITP diagnosis, management, and the use of guidelines in 18 governorates in Iraq.

MATERIALS AND METHODS:

Invited to this study were 79 hematologists who were registered in the Iraqi Society of Hematology and who practiced in the 18 governorates. Out of the 79 hematologists, 65 participated in this survey. Data were collected using a questionnaire.

STATISTICAL ANALYSIS USED:

IBM SPSS 28 for Windows was used for the analysis and Microsoft Excel was used for creating the graphs. Descriptive statistics were presented in the form of numbers and percentages as all variables were categorical.

RESULTS:

The most requested routine tests were manual assessment of platelet count (83.1%), blood film (98.5%), virology screen (90.9%), connective tissue screen (85.9%), and prothrombin time and partial thromboplastin time (78.5%). More than 80% of the hematologists request bone marrow aspiration for the patients who have no response to the first-line treatment. Only the genetic test and the quantitative immunoglobulin level testing were available in the private sector both by (100%), while the other tests were available in both sectors. More than 85% treat the patients as outpatients. Active bleeding, not platelet count, was the indication for hospitalization for 60% of the hematologists. Corticosteroids were chosen as the first choice as initial treatment by (93.8%), intravenous immunoglobulin the second choice by (6.2%). In the second-line treatment, rituximab was chosen as the first choice by (75.3%), and eltrombopag as the second choice (65%). Only 83% of the hematologists referred to a guideline, and the American Society of Hematology guideline was the most referred to.

CONCLUSIONS:

These results showed the need to establish national guidelines for the Diagnosis and Management of Immune Thrombocytopenia in Iraq to be able to effectively treat the laboratory findings and physical symptoms of ITP in addition to address the patient's emotional and mental health needs.
Evaluation of the Serum Level of Vascular Endothelial Growth Factor in Patients with Beta-Thalassemia Major and Sickle/Beta-Thalassemia, and its Correlation with Clinical and Laboratory Parameters
Authors: Abdul Mohsin Sara Anmar , Al-Bayaa Israa M. , Al-Badran Ihsan Mardan
Published: August 2024

BACKGROUND:

The most prevalent inherited disorders of red blood cells are hemoglobinopathies, with thalassemia and sickle cell diseases (SCDs) being the most common. In SCD and thalassemia major, angiogenesis has been identified as a substantial contributor to vascular-mediated tissue damage. Vascular endothelial growth factor (VEGF) is the master regulator of angiogenesis. This study aims to assess the circulating level of serum VEGF in beta-thalassemia (β-thal) and sickle β-thal patients and also to explore the correlation with clinical and laboratory data.

PATIENTS, MATERIALS AND METHODS:

This is a cross-sectional study conducted on 80 individuals, clinical data were gathered, complete blood count, serum ferritin, and serum VEGF tests were done.

RESULTS:

Patients' age ranged from 1.5 to 17.5 years, males formed (70%). Platelet count was significantly higher in β-thal compared to sickle/β-thal (S/β-thal) patients, with a P = 0.015. Mean serum ferritin in patients was significantly higher in β-thal compared to S/β-thal patients, P < 0.001. Patients' serum VEGF levels were noticeably higher than controls with P = 0.01. Strong positive correlation of serum VEGF with platelet count among the patients (r = 0.603, P < 0.001). A significant positive correlation was observed between serum VEGF and the age of starting chelation therapy in thalassemic patients (r = 0.475, P = 0.006).

CONCLUSIONS:

Serum VEGF levels were significantly higher in patients compared to healthy controls, and there is a significant positive correlation between serum VEGF levels and the age at which iron chelation therapy was initiated as well as between serum VEGF levels and platelet counts in patients.
Unveiling the Gravity: Ventricular Septal Rupture as Lethal Sequelae in Myocardial Infarction – A Case Series Analysis and Review of Literature
Authors: Chaudhary Prakash , Malani S. K. , Sridevi Chigullapalli , Nalawade Digvijay
Published: August 2024

In the prethrombolytic era, ventricular septal rupture (VSR) complicated 1%–3% of all acute myocardial infarctions (AMIs). However, since the introduction of reperfusion therapy, the incidence of VSR has decreased, complicating 0.17%–0.31% of AMIs. Despite a reduction in incidence, mortality of patients with VSR remains high (41%–80%). It is important to identify this rare, but lethal complication at the earliest, as it is associated with high morbidity and mortality. Even with early diagnosis, the survival rate is not good. The management of this fatal complication is also a topic of debate. Even after much research, the management of this fatal complication is not standardized. Here, we present a case series of nine patients who developed VSR as a postmyocardial infarction complication and discuss management options for this rare lethal complication. Cases: We present 9 cases of VSR as a postmyocardial infarction complication. Among these nine patients with VSR, three patients underwent surgical repair, whereas 6 were treated conservatively for various reasons. These cases illustrate the challenges confronted in the diagnosis and management of postmyocardial infarction VSR as one of the rare but lethal complications of myocardial infarction. VSR is a rare but fatal complication of myocardial infraction that poses a challenge in diagnosis and management due to its varying presentation. Therefore, increased awareness of key diagnostic features is crucial for the early recognition of this complication and its effective management.
Risk Factors for Cardiac Involvement in Children with Severe Acute Respiratory Syndrome Coronavirus 2-related Multisystem Inflammatory Syndrome in Children: A Prospective Observational Study
Authors: Chinchilu R. V. , Narayanan Kiran , Joseph Susy , Krishnan A. S. Ajith
Published: August 2024

Introduction:

Our study aims to investigate the association between cardiac involvement in multisystem inflammatory syndrome in children (MIS-C) and the patient’s epidemiological, clinical, and investigative profile. Identifying such associations could facilitate the early detection and management of cardiac complications, potentially leading to improved patient outcomes.

Materials and Methods:

The study was conducted as a prospective observational study at SAT Hospital, Government Medical College, Thiruvananthapuram. It included all children aged 0–12 years admitted during the study period who met the criteria for the diagnosis of MIS-C as per the guidelines provided by the World Health Organization. Exclusion criteria comprised children with a confirmed alternative diagnosis, preexisting heart disease, and those whose parents declined consent for participation. Despite aiming for a sample size of 55 based on previous studies, only 50 samples were obtained within the study period. Ethical considerations were met and no funding was involved in our study. A well-structured pro forma was used for data collection.

Results:

Our study included 50 children aged under 12 years, with a median age of 7 years, and an interquartile range of 4.6 years. Of these participants, 54% were male, and the remaining 46% were female. According to the operational definition utilized in our study, 62% of the children exhibited cardiac involvement, while 38% had a normal cardiac status. In our investigation, the median values for C-reactive protein and erythrocyte sedimentation rate were found to be 10 mg/dl and 60 mm/h, respectively. Furthermore, the median platelet count was observed to be 1.87 lakhs/mm3, while the median absolute lymphocyte count was recorded as 1472 cells/mm3. Serum albumin and NT-pro BNP were identified to have a statistically significant association with cardiac involvement, exhibiting significance at the 1% level.

Conclusion:

Our findings suggest that serum albumin and NT-pro BNP have a statistically significant association with cardiac involvement in MIS-C. Furthermore, hemodynamic instability in MIS-C may result primarily from vasculopathy rather than cardiac dysfunction.
Prognostic Significance of Left Atrial Volume Index in Patients with Acute Coronary Syndrome
Authors: Bhupal V. S. R. , Kumar Sampath
Published: August 2024

Background:

Patients with acute coronary syndrome (ACS) and increased left atrial volume index (LAVI) have worse long-term prognosis. The present study was designed to evaluate the association between LAVI and the clinical characteristics of the patients with ACS at admission and at follow-up.

Materials and Methods:

A prospective cohort study was conducted at a tertiary care center in India between April 2018 and December 2019. A total of 80 patients (aged >18 years) having chest pain or its equivalent with a diagnosis of ACS were enrolled as the case group and 30 healthy controls (aged >18 years) were enrolled as the control group. The case group was further classified into two groups based on LAVI values (i.e., LAVI <31 mL/m2 and LAVI ≥31 mL/m2). Baseline demographics, clinical characteristics, and echocardiographic characteristics were recorded of all the patients at admission. The patients were followed up at 1 month and 6 months.

Results:

The mean age of the case group was 54.7 ± 11.6 years and males were predominant (78.8%). Mean LAVI was 31.1 ± 9.0 mL/m2 in the case group and 24.2 ± 3.1 mL/m2 in the control group. Grade II (30%) and Grade III diastolic dysfunction (30%) were predominant in patients with LAVI ≥31 mL/m2. At 1-month follow-up, mortality was reported in 2 (5%) patients with LAVI <31 mL/m2 and in 5 (12.5%) patients with LAVI ≥31 mL/m2, whereas there was no mortality at 6-months follow-up. A positive correlation was observed between LAVI and E/e’ (P = 0.001), left ventricular end-diastolic diameter (P = 0.001), and left ventricular end-systolic diameter (P = 0.001). The area under the curve for detection of mortality based on LAVI values was 0.776 (95% confidence interval of 0.692–0.860; P = 0.001).

Conclusion:

The present study demonstrated that LAVI acts as a prognostic marker of adverse events and mortality in patients with ACS.
Correlation of diaphragmatic mobility and thickening assessed by lung ultrasound with severity of interstitial lung disease
Authors: Banerjee Saikat , Sanjan Ganesh , Sharma Prakhar , Prakash S , Sherwani Poonam , Sindhwani Girish
Published: August 2024

Background:

Studies conducted in interstitial lung disease (ILD) patients to assess diaphragmatic excursion and thickening fraction suggest a weak to strong correlation with pulmonary function parameters. However, diaphragmatic excursion velocity, a novel imaging marker, has not been correlated with pulmonary function and high-resolution computed tomography (HRCT) fibrosis score in ILD patients previously.

Methods:

We conducted a cross-sectional analytical study in 40 ILD patients during quiet (QB) and deep breathing (DB) to measure diaphragmatic thickening, excursion and excursion velocity using transthoracic ultrasound and correlated them with pulmonary function parameters and HRCT fibrosis score.

Results:

Most diaphragm parameters in DB correlated more strongly with lung function parameters compared to quiet breathing. Right diaphragmatic excursion, during QB and DB, showed positive correlations with forced vital capacity (FVC) z-score (r = 0.591, 0.676) and diffusion capacity of the lung for carbon monoxide (DLCO) z-score (r = 0.437, 0.438), and negative correlations with HRCT fibrosis score (r = −0.439, −0.425), respectively. In addition, right diaphragmatic velocity exhibited positive correlations with FVC z-score (r = 0.388, 0.667) and DLCO
z-score (r = 0.139, 0.412), and negative correlations with HRCT fibrosis score (r = −0.454, −0.445). Right diaphragm thickening fraction showed positive correlations with FVC z-score (r = 0.330, 0.460) and DLCO
z-score (r = 0.400, 0.426), and negative correlations with HRCT fibrosis score (r = −0.199, −0.237). Similarly, right diaphragmatic thickness indicated positive correlations with FVC z-score (r = 0.526, 0.614) and DLCO
z-score (r = 0.298, 0.298), and negative correlations with HRCT fibrosis score (r = −0.398, −0.401).

Conclusion:

Diaphragmatic excursion velocity during DB showed a weak to moderate correlation with pulmonary function parameters and HRCT fibrosis score and may be utilized as a surrogate marker in ILD patients unable to perform pulmonary function tests or undergo sequential HRCT thorax in follow-up.
Assessment of obstructive airway disease in the multicenter SWORD survey India
Authors: Singh Sheetu , Sharma Bharat Bhushan , Sharma Arvind Kumar , Singh Nishtha , Singh Aradhana , Sharma Krishna Kumar , Mahmood Tariq , Samaria Kumar Utsav , Sundaramurthy A. , Kant Surya , Singh Tejraj , Koul Parvaiz A. , Singh Virendra ,   SWORD study group*
Published: August 2024

Background and Objectives:

The study aimed to assess the control of asthma and the severity of chronic obstructive pulmonary disease (COPD) and evaluate the adequacy of treatment in patients presenting to the outpatient department (OPD) across India. The secondary aim was to assess the risk factors associated with poorly controlled asthma and severe COPD.

Materials and Methods:

This is the analysis of Phase IV of the multicenter questionnaire-based point prevalence SWORD survey, conducted in May 2018, and designed to capture details on disease control and treatment as per the global initiative for asthma and the global initiative for chronic obstructive lung disease guidelines.

Results:

Of the 5,311 respiratory disease patients presenting to the OPD, there were 1,419 and 412 patients with asthma and COPD, respectively, across 290 sites in India. There were 1,022 (72%) patients having well-controlled asthma, 293 (20.6%) patients with partly controlled asthma, and 104 (7.4%) patients with poorly controlled asthma. Of the 412 patients with COPD, there were 307 (74.5%) in A, 54 (13.1%) in B, and 51 (12.4%) in the E category. In spite of poor control or severe disease, 34.8% of asthmatic and 25.7% of patients in the B and E categories of COPD were not using any medicine. Risk factors for partly and poorly controlled asthma included rain wetting (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.02–2.47) and gastroesophageal reflux disease (AOR: 1.50, 95%CI: 1.08–2.10).

Conclusion:

This study identifies a gap in the treatment of both poorly controlled asthma and severe COPD. A substantial number of patients had poorly controlled asthma and severe COPD, and many were either not taking treatment or taking it inappropriately.
Symptomatic orbital metastasis as an initial presentation of adenocarcinoma lung: A case report and review of literature
Authors: Patidar Yaman , Saldhana Smitha C. , Babu M. C. Suresh , Jacob Linu Abraham , Rudresh A. H. , Lokesh K. N. , Rajeev L. K.
Published: August 2024

Orbital metastasis is a rare entity in oncology. With increasing awareness and advancement, patients with initial ocular presentation can be diagnosed and treated. Ocular metastasis is more common in breast cancer followed by lung cancer. Lung cancer with ocular presentation generally have poor prognosis because of difficult diagnosis, Vision impairment and delayed management. Here, we report one such case of 59 year old female presented with painful periorbital swelling in left eye for 3 months with no pulmonary symptoms. On evaluation, she was diagnosed as ocular metastasis with primary being lung adenocarcinoma. Through this case, we enlighten the epidemiology, presentation, clinical features and evaluation of such patients which might help clinicians in further management.
Comparative Effectiveness of Therapies in 2665 Elderly Patients with Ruptured Intracranial Aneurysms
Authors: Ding Yasuo , Hu Jia , Zhou Bin , Sun Xiaochuan , Song Yanbing , Leng Bing , Zheng Yongtao
Published: August 2024

Background:

The optimal treatment strategy for elderly patients with ruptured intracranial aneurysms (IAs) remains controversial. We evaluated a national, multihospital database to compare the outcomes of aggressive treatment and medical management for those patients.

Methods:

We performed a retrospective analysis of 2665 elderly patients with ruptured IAs admitted to 11 hospitals in China. Patients were divided into three age groups (60–69, 70–79, and 80 years or older). Multiple logistic regression was used to estimate the odds ratio for favorable and unfavorable outcomes.

Results:

Patients between 60 and 69 years old undergoing endovascular treatment (EVT) had significantly decreased morbidity (13.7% versus 19.7% and 29.9%), compared to those who underwent clipping and medical management, similar mortality to patients who underwent clipping (3.6% versus 2.6%), and decreased mortality (3.6% versus 8.7%) to patients who underwent medical management. Coiled patients 70 to 79 years old had lower morbidity (21.3% versus 33.8%) and mortality (2.8% versus 11.3%) compared to patients who underwent medical management and similar mortality (21.3% versus 27.2%) and mortality (2.8% versus 4.8%) to patients who underwent clipping. Multivariate logistic regression analysis demonstrated that factors associated with discharge status were age, poor mFisher grade, poor WFNS grade, hypertension, diabetes, smoking, aneurysms 4 mm or larger, and middle cerebral artery aneurysms.

Conclusions:

Elderly patients treated with EVT had significantly less morbidity and mortality than those treated with clipping and medical management. A comprehensive assessment of the general state of elderly patients and IAs characteristic may help us to predict patients’ prognosis.
Alternative Splicing in Glioblastoma and its Clinical Implication in Outcome Prediction
Authors: Zheng Ping , Zhang Xiaoxue , Ren Dabin , Bai Qingke
Published: August 2024

Background and Objective:

Alternative splicing (AS) offers an important mechanism to form protein polymorphism. A growing body of evidence indicates the correlation between splicing abnormality and carcinoma. Nevertheless, an overall analysis of AS signatures in glioblastoma (GBM) is absent and urgently needed.

Methods:

TCGA SpliceSea data was used to evaluate the AS profiles and further classified into different AS events. The survival analysis was based on these AS events, and AS-related genes were identified and performed with enrichment analysis. At last, the splicing factor–AS regulatory network was established in Cytoscape.

Results:

Eight hundred forty-two splicing events were confirmed as prognostic molecular events in GBM. Furthermore, the final prognostic signature constructed by seven AS events gave good result with an area under the curve (AUC) of receiver operating characteristic (ROC) curve up to 0.935 for five years, showing high potency in predicting patients’ outcome. We built the splicing regulatory network to show the internal relationship of splicing events in GBM. PC4 and SFRS1 interacting protein 1 (PSIP1) and histone H4 acetylation may play a significant part in the prognosis induced by splicing events.

Conclusion:

In our study, a high-efficiency prognostic prediction model was built for GBM patients based on AS events, which could become potential prognostic biomarkers for GBM. Meanwhile, PSIP1 may be a critical target for pharmaceutical treatment.
Montreal Cognitive Assessment (MoCA): Normative Data for the State of Kerala, South India
Authors: Iype Thomas , Raghunath Sreelakshmi P. , Paddick Stella M. , Sudha Lijimol A , Krishnapilla Vijayakumar , Nair Sanjeev , Robinson Louise
Published: August 2024

Background:

Montreal cognitive assessment (MoCA) is a tool that is widely accepted across the world to measure mild cognitive impairment (MCI). The original cut-off score of MoCA falsely screens a large population of Indians as having MCI.

Objective:

The aim of this study was to develop the normative data for MoCA for the older population of Kerala, South India.

Material and Methods:

We conducted the study among 959 cognitively normal older individuals of Kalliyoor village of Thiruvananthapuram district, Kerala. The validated Malayalam version of MoCA [MoCA-M] was administered by trained volunteers. The mean, median, and 10thpercentile of the scores [domain-specific and total] were calculated in various age and educational groups.

Results:

The mean (SD) MoCA score was 19.4 (7.3). The 10thpercentile for the total MoCA score was 9. The 10thpercentile for all domains was zero, except for orientation. As age advanced, MoCA scores significantly reduced. The mean total MoCA scores dropped from 20.1 (7) [for ages between 65 and 75 years] to 7.4 (1.6) [for ages above 85 years]. We also obtained a significant improvement in scores among subjects with higher educational standards.

Conclusion:

The study throws light into the performance of MoCA among the Indian population. This study defines the norms for the Indian population and suggests redefining the threshold for positively screening for MCI using MoCA-M.
Restless Legs Syndrome Affects Sleep in de novo Parkinson’s Disease Patients
Authors: Choi Seong-Min , Cho Bang-Hoon , Cho Soo H , Kim Byeong C
Published: August 2024

Background:

Restless legs syndrome (RLS) is common in Parkinson’s disease (PD) patients and can affect the motor symptoms and non-motor symptoms (NMSs) of PD patients.

Objective:

This study aimed to identify the clinical factors affected by RLS in patients with PD.

Methods:

We included 369 de novo PD patients. RLS was assessed by face-to-face interviews and the motor symptoms and NMSs of the patients were assessed using relevant scales.

Results:

RLS frequency in the patients was 12.2% (45/369). PD patients with RLS (PD-RLS) exhibited a greater global Pittsburgh Sleep Quality Index (PSQI) score than those without RLS (PD-No RLS). PD-RLS exhibited significantly greater scores in the daytime dysfunction and sleep disturbances components of the PSQI than PD-No RLS. PD-RLS exhibited a significantly greater score in the sleep/fatigue domain of the Non-Motor Symptoms Scale than PD-No RLS. The International RLS Study Group rating scale score was significantly related to PSQI components scores in the sleep disturbances, sleep latency, habitual sleep efficiency, and subjective sleep quality.

Conclusions:

RLS frequency in de novo PD patients is higher than that in the general population, and the main NMS affected by RLS in these patients is sleep disturbances. Therefore, it is necessary to manage RLS in PD patients with sleep disturbances.
Sleep in Myasthenia Gravis: A Questionnaire-Based Study
Authors: Kumar Rakesh , Nayak Chetan , Nagappa Madhu , Rao Shivaji , Sinha Sanjib , Taly Arun B
Published: August 2024

Background:

Disturbed sleep and its impact on quality of life (QoL) are underrecognized in myasthenia gravis (MG).

Aims:

To evaluate the quality of sleep in MG using standard sleep questionnaires and assess factors that determine sleep.

Settings and Design:

Prospective, cross-sectional, hospital-based study.

Patients and Methods:

Fifty patients on stable drug therapy for at least 1 month and age- and gender-matched controls were assessed using standard sleep questionnaires [Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and NIMHANS Comprehensive Sleep Disorders Questionnaire (NCSDQ)].

Results:

Myasthenia Gravis Foundation of America (MGFA) grade was I, IIA, IIB, IIIA, IIIB, and IVA in 11, 19, 3, 10, 6, and 1 respectively. The mean PSQI and ESS scores were similar in patients and controls. Patients with abnormal ESS (>10) were older and had greater neck circumference (P = 0.018 and <0.001). Body mass index was greater in patients with PSQI > 5 (P < 0.05). Age, gender, and clinical severity did not affect PSQI. Compared with ESS and PSQI, NCSDQ showed higher frequency of disturbed sleep, snoring, early morning headache, difficulty in initiation, and maintenance of sleep in MG, although the differences between patients and controls were not significant. No correlation was found between QoL and ESS or PSQI.

Conclusion:

Patients of MG with stable clinical course with adequate treatment have sleep quality comparable with healthy controls. Longitudinal assessment of sleep quality at multiple time points throughout the disease course and correlating with cross-sectional disease severity may further delineate the impact of disease on sleep and QoL.
Neutrophil-to-Lymphocyte Ratio, ESR, and CRP Have No Roles as Markers for Disease Severity and Prognosis in Patients with RRMS
Authors: Nikseresht Alireza , Bahrami Zahra
Published: August 2024

Background:

Up to now, there is no definitive prognostic factor for patients with multiple sclerosis.

Objective:

This study aimed to evaluate the neutrophil-to-lymphocyte ratio (N/L ratio) as a cheap, available, and noninvasive marker for disease activity and prognosis.

Material and Methods:

A total of 112 patients, who were diagnosed with relapsing-remitting multiple sclerosis (RRMS), and 61 healthy controls were considered. We evaluated N/L ratio, ESR, CRP in the control, and patients in the first attack of the onset of the disease, 1 month and 6 months later during remission. All patients received interferon or Glatiramer acetate as disease-modifying therapies. The correlation of parameters with Expanded Disability Scale Score (EDSS) and Functional System (FS) involvement was evaluated.

Results:

The N/L ratio was increased significantly in patients with MS in the relapse phase (mean: 2.44 ± 0.68) compared to the healthy controls (mean: 1.84 ± 0.67) (P = 0.04). Also, we found a significant increase in CRP among the aforementioned groups (P = 0.028). A significant correlation was not found between NLR, ESR, or CRP and patient’s EDSS during 6 months of follow-up. For ESR and the type of functional system, a significant difference was found between favorable and unfavorable categories, while the median (IQR) of ESR in the favorable group was 7.7 (4–12) and among unfavorable ones was 13.8 (6–17.75) (P = 0.008).

Conclusions:

The results showed the effect of the innate immune system and inflammation during MS attacks. We considered that neutrophils, ESR, and CRP cannot predict disease severity or prognosis at least without a combination of other biomarkers.
Evaluation of Excess Deaths in a Tertiary Hospital in Urban Northern Nigeria during the COVID-19 Pandemic (EDiK-2020 Study)
Authors: Galadanci Hadiza S. , Abubakar Isa S. , Musa Baba M. , Adamu Aishatu , Gadanya Muktar A. , Tsiga-Ahmed Fatimah , Kwaku Aminatu A. , Jalo Rabiu I. , Bashir Usman , Abdullahi Hadiza M. , Farouk Zubaida , Dankishiya Faisal S. , Amole Taiwo G. , Aliyu Muktar H.
Published: August 2024

Context:

The morbidity and mortality arising from the COVID-19 pandemic in low- and middle-income countries were further worsened by the disruption in health systems and diversion of strained health resources for emergency response.

Aim:

This study ascertained whether there was an increase in the number of deaths recorded in Kano, Nigeria, during the pandemic, compared to the preceding 3 years and identified the potential causes of these deaths.

Materials and Methods:

Using a retrospective design, data were collected from a tertiary hospital in Kano from January to June 2020. Data on number and date of deaths, as well as clinical information of the deceased, were retrieved from hospital records. Comparison data were collected on all deaths and admissions in the hospital within a similar period (January–June) of 2017–2019.

Results:

The age of the deceased ranged from one day to 115 years, with the majority being males (n = 414; 63.2%) and adults (n = 491; 75.0%). The majority did not have history of recent travel (n = 570; 87.0%), contact with COVID-19 suspected cases (n = 622; 95.0%), or confirmed COVID-19 (n = 625; 95.4%). Slightly less than half (n = 262; 46.2%) died within 24h of admission. The majority (n = 452; 79.7%) died within 7 days of admission. The most common cause of death recorded on admission was sepsis (n = 66; 10.1%), while 53 (8.1%) were brought in dead. SARS-CoV-2 infection was the documented cause of death in twelve patients (1.8%). More than half (n = 378; 57.7%) had underlying medical conditions, of which hypertension (n = 172; 45.5%) was the most common. The highest annual average deaths (178) and admissions (2179) were recorded in 2019, while 135 deaths and 1532 admissions were recorded in 2020. Most deaths occurred in April 2020 (208), while the highest number of admissions was recorded in March 2020. Mortality was higher in April of 2020 (14.1%, 95% CI: 12.4%–16.0%) compared to the same month in 2017 (7.6%, 95% CI: 5.9%–9.7%), 2018 (8.4%, 95% CI 7.0%–10.2%), and 2019 (8.5%, 95% CI 7.3–9.8%).

Conclusion:

In summary, we found excess mortality rates during the COVID-19 pandemic in Kano, Nigeria, consistent with prior studies.
A Multicenter Retrospective Study on Magnitude, Distribution, Socio-Demographic, and other Risk Factors Associated with Hemodialysis in Jigawa State, Northwest Nigeria
Authors: Ibrahim Usman Muhammad , Jibo Abubakar Mohammed , Bashir Usman , Aliyu Muhammad Sabiu , Jalo Rabiu Ibrahim , Zubairu Zahrau , Muazu Salisu , Buba Luka Fitto , Lawrence Ademola Babatunde , Sidi Kamalu Shehu , Abdulsalam Kabiru , Karkarna Mustapha Zakariyya
Published: August 2024

Context:

There is a growing concern regarding increasing cases of kidney diseases in Jigawa state, with most conditions requiring hemodialysis or other forms of renal replacement therapy.

Aim:

This study aimed to find the magnitude, distribution, socio-demographic, and other factors associated with hemodialysis in Jigawa state, Northwest Nigeria.

Materials and Methods:

It was a retrospective multicenter analysis of secondary data from hemodialysis centers of the randomly selected public hospitals in northwest Nigeria.

Statistical Analysis:

Data were analyzed using IBM SPSS Statistics for Windows, version 22.0, with statistical significance set atP≤ 0.05.

Results:

A total of 1,329 patients were enrolled for dialysis in Kano and Jigawa states, between 2019 and 2022, out of which more than one-third (509, 38.3%) were from Jigawa state. Dutse, Jahun, Gumel, and Hadejia local government areas (LGAs) of Jigawa state had 86 (16.8%), 64 (12.6%), 48 (9.4%), and 44 (8.6%) respectively. The respondent's ages ranged from 1 − 100 years with a median age of 48 (interquartile range [IQR] = 31, 60) years. Chronic kidney disease (CKD) was found among 403 (79.2%) patients, acute on chronic kidney disease (AOCCKD) in 87 (17.1%) patients, and acute kidney injury (AKI) in 19 (3.7%) patients. The major risk factors identified were hypertension, diabetes, and chronic glomerulonephritis (CGN) among 329 (64.6%), 69 (13.6%), and 66 (13.0%) patients, respectively. Hypertension was a significantly higher risk factor among patients from Jigawa state compared with other states (46.8%,P< 0.001), hypertensives from Jigawa state were twice more likely to develop kidney disease requiring hemodialysis (adjusted odds ratio [aOR] = 2.2, 95% confidence interval [CI] = 1.7–2.8) compared with non-hypertensive etiologies.

Conclusion:

The burden of kidney diseases requiring hemodialysis in Jigawa state is high, with hypertension and diabetes being the major risk factors for hemodialysis. The government and other stakeholders should develop strategies for early identification and proper management of the risk factors.
Prevalence and Pattern of Premenstrual Syndrome among Secondary School Students in Kaduna State
Authors: Suleiman Aisha , Yahya Anisah , Oguntayo Adekunle O.
Published: August 2024

Context:

Menstruation may be associated with somatic and psychological symptoms of premenstrual syndrome.

Aims:

We determined the awareness, prevalence, and pattern of premenstrual syndrome among female students in secondary schools in Kaduna state. Association of premenstrual syndrome with sociodemographic profile of respondents and healthcare evaluation and intervention sought by students with premenstrual syndromes were also explored.

Materials and Methods:

It was a cross-sectional observational study conducted on 300 students enrolled in secondary schools in Sabon Gari Local Government Area in Kaduna state. A pretested questionnaire was used to obtain data. The data were analysed using SPSS 20 with P < .05 considered as significant.

Results:

The mean age of participants was 16.2 ± 1.6 years. The prevalence of premenstrual syndrome was 226 (75.3%). Dysmenorrhea was the most common physical manifestation of premenstrual syndrome and occurred in 183 (81.0%) of the respondents with premenstrual syndrome with a median pain score of 3.0, while mood swings were the most common emotional manifestation of premenstrual syndrome present among respondents 132 (58.4%). Healthcare evaluation was sought by only 15.4% of those affected; however, a good number (42.5%) sought for some form of intervention for their symptoms. There was no significant association between the occurrence of premenstrual syndrome and the sociodemographic profile of the respondents.

Conclusion:

The self-reported prevalence rate of premenstrual syndrome among the study population is high with dysmenorrhea being the most common symptom. There was no association found between the occurrence of premenstrual syndrome and sociodemographic profile of those affected. Most of the students affected did not seek for any form of healthcare evaluation.
Routine Immunization Uptake and Knowledge of Caregivers in Selected Rural Communities in Northwestern Nigeria
Authors: Ameen Hafsat A. , Musa Shehu , Ibraheem Rasheedat M. , Oladiji Femi , Musa Omotosho I. , Salaudeen Adekunle G.
Published: August 2024

Context:

Childhood immunization remains a public health problem in Nigeria, as the status did not improve substantially during the last two decades, especially in northern Nigeria. Understanding the level of routine immunization uptake of children among caregivers is important if a healthy community is to be maintained.

Aim:

This study aimed to investigate the knowledge and level of routine immunization uptake among caregivers in Bukkuyum Local Government of Zamfara State, Nigeria.

Settings and Design:

A descriptive cross-sectional study involving 320 caregivers selected using a multistage sampling technique was conducted.

Materials and Methods:

Sociodemographics, vaccination details, and knowledge were obtained via a semi-structured interviewer-administered questionnaire.

Statistical Analysis Used:

Data collected was analyzed using Statistical Package for Social Sciences (SPSS) statistics for Windows, version 21.0.

Results:

Findings show abysmally low levels of uptake of routine immunization antigens, namely, Bacille Calmette- Guerine (BCG) (26.1%), Oral Polio Vaccine LGAs= Local Government Areas (OPV) (42.5%), pentavalent vaccine (18.9%), and measles (13.0%). Only 80 (25.0%) children were fully immunized, 93 (29.0%) partially immunized, and 147 (46.0%) nonimmunized. Most respondents had poor knowledge (308 (96.2%)) and poor attitudinal disposition (173 (54.1%)) toward routine immunization.

Conclusion:

The vaccination uptake and knowledge of immunization among caregivers in the study area are poor. Caregivers' continual health education and a step-up of mobile health education activities by healthcare providers are crucial to improve routine immunization uptake in the study area.
Improving Access to HIV/AIDS and Sexual and Reproductive Health Information and Services among Adolescents with Hearing Impairment in Ibadan, Nigeria: Protocol for a Pilot Cluster Randomized Controlled Trial
Authors: Adebayo Emmanuel , Olumide Adesola , Olaniyan Halimat , Oluwagbayela Babatunde
Published: August 2024

Context:

Adolescents with hearing impairment are generally neglected in the design and implementation of most HIV information interventions. However, this group of adolescents significantly contributes to the rising incidence of HIV among adolescents.

Aim:

This study presents the protocol for a study that pilots an intervention to provide Sexual and Reproductive Health (SRH) and HIV information for adolescents with hearing impairment.

Settings and Design:

The study will be a cluster randomized control trial. The study will be conducted in two phases.

Materials and Methods:

Phase one will include information gathering about the current services available to adolescents generally and adolescents with hearing impairment across selected primary healthcare centers. The information obtained during this will be used to design the intervention. Phase two will be a pilot of the intervention to increase the comprehensive knowledge of HIV among adolescents with hearing impairment and link them to existing services. A pre-post intervention survey will be conducted to measure knowledge of SRH and HIV among the participants. Post-intervention surveys will occur immediately after and one-month post-intervention.

Conclusion:

This study will provide baseline information for a more robust study on improving access to information and services among adolescents with hearing impairment.
Childhood cataract in Indian subcontinent: Challenges and strategies
Authors: Parija Sucheta , Mahajan Preetam B , Kar Anmol
Published: August 2024

Cataracts in children are one of the leading causes of visual impairment and if not treated timely have an impact on the neurobiological development of the child, leading to amblyopia. Cataracts in children are either congenital, developmental, or traumatic. A comprehensive ocular, systemic examination, age of onset, morphology, and laterality of cataracts are essential factors to be considered during management. Innovations, technology, and expert surgical techniques have made surgery uneventful with good visual outcomes. In this article, we summarize the current situation, barriers, challenges, and recommendations for the management of congenital cataracts in India. Strategies for managing congenital cataracts must be adapted and developed according to regional conditions. A basic framework for acceptable outcomes must focus on developing systems to address the critical components of education, access, quality care, and good follow-up.