bluuebunny/crossref_metadata_2025 huggingface dataset:
Étude de trois situations de vulnérabilité chez les personnes âgées de 55 à 85 ans en France
Authors: Léon Christophe , Pin Stéphanie , Roscoät Enguerrand du
Published: June 2022

L’objectif de cet article est d’identifier le profil de personnes âgées de 55 à 85 ans vulnérables et les facteurs de vulnérabilités associés. À partir des données du Baromètre santé 2010, trois situations de vulnérabilité ont ainsi été définies : l’absence de lien social récent, la faiblesse des revenus du foyer et la forte limitation fonctionnelle dans les activités de la vie quotidienne. Plus d’une personne âgée de 55-85 ans sur dix est vulnérable du fait de l’absence de lien social récent ou d’une limitation fonctionnelle forte, et un quart financièrement. Des inégalités sociales existent et les vulnérabilités sont associées à des comportements de santé moins favorables. Ainsi, l’absence de lien social concerne davantage les hommes, les fumeurs réguliers et les personnes ayant des troubles psychiques. Les faibles revenus du foyer concernent davantage les moins diplômés et s’accentuent avec l’avancée en âge. La forte limitation fonctionnelle est plus probable en cas de revenus peu élevés et quand les personnes vivent seules, elle est associée également à des habitudes de vie défavorables à la santé et à des troubles psychiques. Enfin, le cumul de ces situations de vulnérabilité est amplifié par de mauvaises habitudes de vie, de la détresse psychologique, des pensées suicidaires et un moindre accès aux soins.Cet article souligne, dans une approche de promotion de la santé, qu’il est utile de cibler les personnes âgées vulnérables, en adoptant une perspective large de la vulnérabilité ne se limitant pas aux seules dimensions physiques des personnes.
Introduction. Un premier numéro sur le handicap : réflexion sur le concept et les enjeux
Authors: Dejoux Virginie
Published: June 2022

La notion de vulnérabilité, vue comme une situation ou comme un processus, intègre pleinement les questions de handicap1. Longtemps assimilé à l’infirmité de la personne, le handicap est davantage perçu aujourd’hui comme une situation résultant de l’interaction entre plusieurs facteurs, notamment des facteurs personnels et des facteurs environnementaux. Le glissement de la responsabilité du handicap de l’individu vers les obstacles, qu’ils soient environnementaux, politiques, culturels ou techniques, est visible d’une part dans l’évolution de la définition du handicap et des modèles tentant de l’expliquer et le comprendre et d’autre part dans les actions politiques mises en œuvre et les lois adoptées. Aussi, comme l’ensemble des vulnérabilités, les situations de handicap sont-elles fonction du temps et de l’espace, notamment des contextes historiques, politiques et sociaux. Résultant donc d’une interaction entre de nombreux facteurs, la situation de handicap est une notion complexe et difficile à appréhender et mesurer. Au travers de perspectives historique, législative, scientifique et contextuelle, nous allons présenter l’intérêt et les objectifs de ce premier numéro de la revue Populations vulnérables consacré au champ du handicap.
Les femmes et les hommes migrant‑e‑s d’Afrique subsaharienne face au VIH-SIDA en France : des réseaux sexuels et des pratiques de protection genrés
Authors: Marsicano Élise
Published: June 2022

Les femmes et les hommes migrant‑e‑s d’Afrique subsaharienne sont très touchés par l’épidémie de VIH-SIDA en France. En mobilisant une enquête quantitative menée en 2005 auprès de 973 femmes et 901 hommes nés en Afrique subsaharienne et vivant en Île-de-France, cet article se propose de montrer que la ségrégation des réseaux sexuels et le multipartenariat contribuent à rendre compte de la diffusion de l’épidémie parmi ces migrant‑e‑s. La ségrégation des réseaux sexuels conduit à des relations entre des migrant‑e‑s originaires de pays à faible prévalence et à prévalence élevée. En outre, les hommes et les femmes de cette enquête n’ont pas les mêmes réseaux sexuels : les femmes ont plus souvent des partenaires d’Afrique subsaharienne et ont également plus souvent des partenaires sexuels ayant plus de partenaires qu’elles, ce qui peut entraîner des situations d’exposition au risque majorée pour les femmes. Quant aux hommes, ils sont engagés dans des relations simultanées de longue durée, ce qui peut constituer un contexte propice à la transmission.
La custodia compartida en España: análisis desde el modelo push-pull
Authors: Becerril-Ruíz Diego , Jiménez-Cabello José , Puertas-Cañaveral Inmaculada , Paniza-Prados José Luis
Published: June 2022

El presente artículo pretende conocer bajo el enfoque teórico push and pull y para el caso de España, cómo influyen las variables sociales en la asignación de la modalidad compartida de la custodia, distinguiendo entre sociodemográficas (características del matrimonio), por un lado, y contextuales (estructurales-económicas y opinión pública), por otro. La metodología utilizada para el estudio de los datos ha sido de corte cuantitativo, utilizando como técnica de análisis la regresión lineal múltiple. La base de datos explotada ha sido generada a partir de la Estadística de Nulidades, Separaciones y Divorcios del Instituto Nacional de Estadística (INE) y de diferentes tasas obtenidas del INE y del Centro de Investigaciones Sociológicas. La conclusión principal es que, si bien los dos modelos de regresión obtenidos explican la asignación de la custodia compartida, las variables que presentan mayor poder explicativo son las contextuales y, concretamente, el producto interior bruto de cada comunidad autónoma.
Developing an International Undergraduate Business Degree in Southeast Asia Utilizing Competency-Based Outcomes
Authors: Takamine Kurt
Published: June 2022

Competency-based education (CBE) is an innovative, self-paced approach that evaluates the mastery of learning from a performance basis. Those individuals with vast work and life experiences in their background can demonstrate competency-based outcomes as prescribed by academic and industrial standards. Utilizing a case study approach, this chapter explores the process that one American university adopted to serve a Southeast Asian nontraditional population, with the course corrections experienced because of the COVID-19 global pandemic disruption. In addition to board and administrative strategic planning, a competency-based curriculum with that country's industry outcomes is presented, and competency identification is evaluated and described. This disruptive innovation highlights the linkages between global pandemic influences, industry expectations, academic curriculum, and accreditation standards in a CBE program.
The COVID-19 Pandemic Has Forced the Digital Transformation of Learning and Teaching Practices
Authors: Nuninger Walter
Published: June 2022

Like any organization, Higher Education Institutions (HEIs) had to adapt quickly to limit the impact of the COVID pandemic. In France, HEIs complied with the regulation and followed the evolving framework imposed by the state to face the health crisis. First, the universities reacted to provide means to support barrier measures; second, they adapted functioning with teleworking and decrease of audience gauge; finally, they accelerated IT integration in the learning to develop hybrid solutions and online learning. The emergency decision-making aimed at maintaining the training offer, but, over the sanitary containment measures, the needs for the accompaniment of the people became obvious. Based on a set of collected data and quality surveys, this chapter presents the local deployment in an engineer school, putting the focus on the effort to provide means. Then the impact of their usage on the teaching practices. Without claiming to generalize, the goal is to propose the perspectives for a lasting change in higher education training, following the dynamics of a changing society.
An ACO-Based Clustering Algorithm With Chaotic Function Mapping
Authors: Yang Lei , Hu Xin , Wang Hui , Zhang Wensheng , Huang Kang , Wang Dongya
Published: June 2022

To overcome shortcomings when the ant colony optimization clustering algorithm (ACOC) deal with the clustering problem, this paper introduces a novel ant colony optimization clustering algorithm with chaos. The main idea of the algorithm is to apply the chaotic mapping function in the two stages of ant colony optimization: pheromone initialization and pheromone update. The application of chaotic mapping function in the pheromone initialization phase can encourage ants to be distributed in as many different initial states as possible. Applying the chaotic mapping function in the pheromone update stage can add disturbance factors to the algorithm, prompting the ants to explore new paths more, avoiding premature convergence and premature convergence to suboptimal solutions. Extensive experiments on the traditional and proposed algorithms on four widely used benchmarks are conducted to investigate the performance of the new algorithm. These experiments results demonstrate the competitive efficiency, effectiveness, and stability of the proposed algorithm.
Condições potencialmente ameaçadoras à vida no ciclo gravídico-puerperal/ Potentially life-threatening conditions determinants in pregnancy-puerperal cycle
Authors: Mendes Lise Maria Carvalho , Leite de Oliveira Lara , Vieira Silva Jordania , Paixão Meneses Angelica , Siraiama Marques Duarte Manuela
Published: June 2022

Objetivo: Descrever as principais condições potencialmente ameaçadoras à vida de mulheres durante o ciclo gravídico e puerperal e variáveis relacionadas a esses agravos. Método: Estudo do tipo documental, descritivo e quantitativo, realizado com prontuários de gestantes, parturientes e puérperas internadas em hospital de média complexidade, que apresentaram Condições Potencialmente Ameaçadoras à Vida (CPAV). Foram excluídos os de acesso impossibilitado por estarem sob judice. A amostra foi temporal e a análise univariada. Resultados: Inclui-se 181 prontuários. A maioria das condições ocorreu em mulheres de 16 a 34 anos de idade (61,3%), união estável (60,8%), pardas (31,5%), sem renda ocupacional (29,2%), multíparas (28,87%), com complicações no primeiro trimestre gestacional (32,6%). Verificaram-se a realização de um número insuficiente de consultas (13,8%), dados referentes ao pré-natal ignorados (68%). As principais CPAV foram as síndromes hemorrágicas (28,2%), hipertensivas (25,4%) e infecção (13,3%). Como desfecho, foram observados prevalência de aborto não especificado (22,1%), morte perinatal por doença infecciosa e parasitária da mãe (2,2%). Conclusão: As principais CPAV foram as síndromes hemorrágicas, hipertensivas e infecções. Como desfecho, foram observados alta hospitalar, aborto, referenciamento à UTI, morte perinatal e morte materna.
Enfermagem em saúde pública no monitoramento do near miss materno: reflexões da teoria de enfermagem/Public health nursing in the monitoring of maternal near miss: reflections of nursing theory
Authors: Osis Gonçalves Glaucia , De Souza Freire Márcia Helena , Herreira Trigueiro Tatiane , Loewen Wall Marilene
Published: June 2022

Objetivo: refletir, na perspectiva da Teoria de Enfermagem de Florence Nightingale, a respeito do Processo de Enfermagem no monitoramento do near miss materno. Método: trata-se de estudo reflexivo comparativo entre a análise do processo de monitoramento dos casos de near miss materno e os metaparadigmas da Teoria de Enfermagem de Florence Nightingale, aplicados a um ambiente de gestão em saúde pública e atuação do enfermeiro, a partir da análise de Teorias de Enfermagem em uma disciplina de mestrado. Resultados: na teoria de Florence são veiculados os conceitos de saúde, doença, enfermagem e ambiente. E, na trajetória da reflexão, revisitam-se os princípios elementares da profissão desenvolvidos por Florence, os quais identificam a assistência (enfermagem), a gestão (saúde/doença) e o monitoramento do near miss materno na saúde pública (ambiente). Para o monitoramento de near miss materno, identificam-se os conceitos para atuação e análise. Considerações Finais: o estudo proporcionou relacionar a perspectiva expressa na teoria de Florence Nightingale com a atuação do enfermeiro no monitoramento do near miss materno, a partir dos metaparadigmas.
Fatores de estresse em estudantes de enfermagem na realização de atividades teórico-práticas da formação acadêmica / Stress factors in nursing students in the realization of theoretical-practical activities of academic training
Authors: Santos Ingrid Loise Cruz dos , Oliveira Luana Paula de , Lima Helder de Pádua , Aratani Nathan , Lopes Soraia Geraldo Rozza , Arruda Bianca Cristina Ciccone Giacon
Published: June 2022

Objetivo: verificar os fatores de estresse comumente vivenciados por estudantes do curso de Enfermagem na realização de atividades teóricas e práticas da formação acadêmica. Método: estudo descritivo, transversal, desenvolvido com 142 discentes do curso de Enfermagem de uma universidade pública localizada em Mato Grosso do Sul, Brasil. Os dados foram coletados em fevereiro de 2020 por meio de questionário sociodemográfico/acadêmico e da escala de Avaliação de Estresse em Estudantes de Enfermagem e, posteriormente, analisados de maneira descritiva, segundo a moda e percentis superiores e inferiores à moda das variáveis. Resultados: medo de cometer erros durante a assistência ao paciente (57,4%), sentimento de ter adquirido pouco conhecimento para fazer provas práticas (52,1%), insegurança ou medo de fazer provas teóricas (44,7%) e obrigatoriedade de realizar trabalhos extraclasse (41,5%) foram fatores que provocaram níveis muito altos de estresse entre os estudantes. Conclusão: os resultados podem auxiliar faculdades de Enfermagem no planejamento e fortalecimento de intervenções preventivas com foco no gerenciamento do estresse e seu enfrentamento.
Infecção primária da corrente sanguínea associada ao cateter venoso central em neonatos/ Central venous catheter-associated primary bloodstream infection in neonates
Authors: Gomes Resende de Souza da Silva Alexsandra , Bisinoto Alves Sergiane , Carneiro Cunha Nevess Heliny , Martins Mendonça Katiane , Santos Silvana , Carmo Moreira Maria Auxiliadora
Published: June 2022

Objetivo: analisar a infecção primária da corrente sanguínea associada ao cateter venoso central em neonatos internados em unidades de terapia intensiva. Método: tratou-se de um estudo ecológico realizado em 2017 a partir de notificações de infecção primária da corrente sanguínea associada ao cateter venoso central ocorridas na capital de um estado da região Centro-Oeste do Brasil. Os dados foram coletados por meio de um formulário a partir de dois bancos de dados, municipal (2012 a 2016) e nacional (2014 a 2016). Resultados: a tendência temporal da densidade de incidência de infecção foi decrescente (p=0,019), com taxa de utilização de cateter venoso central de 45%. Os patógenos mais frequentes foram Klebsiella pneumoniae, Staphylococcus coagulase negativo e Enterobacter spp. Aumento de resistência às cefalosporinas e à oxacilina ocorreu para bactérias Gram-negativo e Gram-positivo, respectivamente. Conclusão: Conclui-se que houve uma redução na taxa de IPCS associada ao cateter em neonatos no período avaliado e os episódios infecciosos foram predominantemente causados por bactérias Gram-negativo, incluindo isolados multirresistentes aos antimicrobianos. Esses achados apontam para a importância e necessidade de estratégias educacionais para a equipe multiprofissional sobre vigilância de infecção, medidas preventivas e uso racional de antimicrobianos.
Alboserpin, the Main Salivary Anticoagulant from the Disease Vector Aedes albopictus, Displays Anti–FXa-PAR Signaling In Vitro and In Vivo
Authors: Shrivastava Gaurav , Valenzuela-Leon Paola Carolina , Chagas Andrezza Campos , Kern Olivia , Botello Karina , Zhang Yixiang , Martin-Martin Ines , Oliveira Markus Berger , Tirloni Lucas , Calvo Eric
Published: June 2022

Blood-feeding arthropods secrete potent salivary molecules, which include platelet aggregation inhibitors, vasodilators, and anticoagulants. Among these molecules, Alboserpin, the major salivary anticoagulant from the mosquito vector Aedes albopictus, is a specific inhibitor of the human coagulation factor Xa (FXa). In this study, we investigated the anti-inflammatory properties of Alboserpin, in vitro and in vivo. In vitro, Alboserpin inhibited FXa-induced protease-activated receptor (PAR)-1, PAR-2, PAR-3, VCAM, ICAM, and NF-κB gene expression in primary dermal microvascular endothelial cells. Alboserpin also prevented FXa-stimulated ERK1/2 gene expression and subsequent inflammatory cytokine release (MCP-1, TNF-α, IL-6, IL-8, IL-1β, IL-18). In vivo, Alboserpin reduced paw edema induced by FXa and subsequent release of inflammatory cytokines (CCL2, MCP-1, IL-1α, IL-6, IL-1β). Alboserpin also reduced FXa-induced endothelial permeability in vitro and in vivo. These findings show that Alboserpin is a potent anti-inflammatory molecule, in vivo and in vitro, and may play a significant role in blood feeding.
Role of low dose computed tomography on lung cancer detection and mortality - an updated systematic review and meta-analysis
Authors: Agrawal Sumita , Goel Akhil Dhanesh , Gupta Nitesh , Lohiya Ayush
Published: June 2022

Chest low dose computed tomography (LDCT) is reported to be a sensitive tool for the detection of lung cancer at asymptomatic stage, thus reducing mortality. The review assesses the effect of LDCT screening on all-cause mortality, lung cancer mortality and incidence rates. We conducted literature searches of PubMed, SCOPUS, and the Cochrane Library from inception through January 2020 to identify relevant studies assessing the diagnostic accuracy of LDCT for lung cancer. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for reporting this meta-analysis and review. The inclusion criteria were a) Randomized control trials, b) Comparing LDCT to any other form of screening or standard of care, and (c) Primary outcome studied: all-cause mortality, lung cancer-specific mortality, rate of early detection of lung cancer. A total of 11 studies encompassing 97,248 patients were included. When compared with controls (no screening or CXR), LDCT screening was associated with statistically significant reduction in lung cancer mortality (pooled RR 0.86; 95% CI 0.75-0.98); low heterogeneity was observed (I2= 27.86). However, LDCT screening was not associated with statistically significant reduction in all-cause mortality (RR =0.96; 95% CI: 0.92 -1.01). Notably, the LDCT screening was associated with statistically significant increase in lung cancer detection (RR =1.76; 95% CI: 1.14-2.72). LDCT screening has the potential to reduce mortality due to lung cancer among high-risk individuals. LDCT could be considered as a screening modality after careful assessment of other factors like prevalence of TB, proportion of high-risk population, cost, access and availability of LDCT.
Bladder Exstrophy
Authors: Agbara Kouamé Soroboua , Moulot Olivier Martial , Ehua Manuela Adjoba , Konan Jean Marie , Kouamé Guy Serge Yapo , Traoré Ibrahim , Anon Ghislain Anon , Ajoumissi Idalia , Konvolbo Josaphat , Bankolé Roumanatou Sanni
Published: June 2022

Introduction:

Bladder exstrophy is a major malformation in paediatric urology. The treatment results are not still completely satisfactory, and their management is an enormous problem in Sub-Saharan Africa. While outlining our challenges, we report our management experience to improve our results.

Subjects and Methods:

We retrospectively reviewed the records of patients undergoing surgical repair of classic bladder exstrophy at our department between January 2010 and December 2019 (10 years). Epidemiological, clinical, therapeutic and evolution data were analysed.

Results:

Twenty-five children with classic bladder exstrophy were treated. Our series included 16 boys and 9 girls with a sex ratio of 1.7. Age ranged from 0 day to 6 years. Twenty-five bladder closures were performed, associated to pelvic osteotomy in 11 cases. Epispadias repair was performed on nine boys. Eight cases of bladder neck reconstruction and three cases of bladder enlargement were performed. We observed six bladder fistulas, four wound dehiscence, of which three partial, two parietal suppurations and six cases of urinary tract infection. Eight children had a continence of 1–2 h.

Conclusion:

The treatment of bladder exstrophy in our context is still limited because of financial difficulties encountered by the population and the insufficient technical platform in our country.
Elastic Stable Intramedullary Fixation Using Epibloc versus Crossed Kirschner Wires Fixation for Distal Forearm Fractures in Children
Authors: De Vitis Rocco , D'Orio Marco , Passiatore Marco , Perna Andrea , Cilli Vitale , Taccardo Giuseppe
Published: June 2022

Background:

Childrens' distal forearm fractures (DFFs) could be treated conservatively with closed reduction and immobilisation, but post-reduction displacements often occur. Displaced DFF should be surgically fixed, to avoid further displacement. Nevertheless, immobilisation after surgery is recommended. Epibloc system (ES), a system of stable elastic nail fixation, is widely used to stabilise adults extra-articular distal radius fractures, with advantages to not requiring post-surgical immobilisation. The present investigation represents a retrospective analysis of paediatric patients with DFF treated with ES applied with a minimal technical variation, to fix both ulna and radius fractures using a unique device.

Materials and Methods:

A retrospective analysis was performed on 44 children (age 6–11 years) who underwent closed reduction and internal fixation because of DFF (both ulna and radius). Group A (21 patients): ES fixation. Group B (23 patients): K-wires and short arm cast fixation. The primary outcome was the subsistence of reduction monitored through X-rays. The secondary outcome was the measurement of active range of motion (AROM) and the time of recovery.

Results:

No differences were observed comparing Group A and B in terms of the maintenance of reduction (P > 0.05). Seven days after the implant removal, patients in Group A reached significantly better results compared to patients in Group B in terms of AROM (P < 0.05). No differences were revealed in terms of complications between the two groups.

Conclusion:

ES applied with a minimal technical variation is safe and effective in treating distal ulna and radius fractures, with minimal requirement of post-surgical rehabilitation.
Laparoscopic Fundoplication after Oesophageal Atresia Repair
Authors: Scarpa Maria-Grazia , Codrich Daniela , Duci Miriam , Olenik Damiana , Schleef Jürgen
Published: June 2022

Background:

Esophageal atresia (EA) is a rare congenital malformation. A high incidence of GER unresponsive to medical management is noted with EA. Literature suggests that complications from GER can persist in adulthood. In paediatric age, laparoscopic treatment is a valid option even if recurrence rate is not negligible.

Aims and Objectives:

To evaluate our experience with gastro-esophageal reflux (GER) treatment after esophageal atresia (EA) repair.

Materials and Methods:

We retrospectively analysed 29 consecutive patients treated for EA at birth and studied for GER at our Institute in a period of 11 years.

Results:

24/29 (82,7%) cases had symptoms of reflux, 17/29 (58,6%) cases were treated with laparoscopic fundoplication (LF). Three infants were younger than 6 months and had apparent life threatening events (ALTE) condition as principal indication for surgery. No intra-operative complications occurred. 3/17 LF had open surgical conversion due to technical problems. 2/17 cases required a second operation. At the last follow-up: (1) 6/17 (35,3%) of patients healed after the last operation, (2) 8/17 (47,1%) have GER improvement (four still in medical treatment), (3)2/17 (11,8%) have persistent GER, (4)1/17 (5,9%) died for causes not related to antireflux surgery.

Conclusions:

According to literature and to our retrospective analysis, LF for GER after EA repair is feasible, even if recurrence risk is not negligible. Infants less than 6 months old with associated conditions (malformations, gastrostomy/jejunostomy) seem to have a higher failure rate with a greater risk of conversion. Longer follow-up and multicenter experiences would guarantee an adequate surveillance for patients with EA.
Problematic Internet Use among Adolescents and the Impact of COVID-19 Pandemic on Mental Health
Authors: Joe Avinash , Safeekh A. T. , Malarmathi S.
Published: June 2022

Adolescents are a vulnerable population to problematic Internet use. Although it is considered a behavioral addiction, there is a lack of unified definition and criteria, and the current models are derived from substance dependence and their validity is yet to be established. At present, the Internet has become an integral part of everyday life and further explication is needed on what constitutes problematic Internet use. Unrealistic expectations, the need for excitement, risky behaviors, addictive temptations, and late bedtime in adolescents can lead to addiction. The Internet provides anonymity and at the same time a sense of belongingness and social acceptability to them. The prevalence of Internet addiction (IA) varies across cultures and countries. More than 90% of students stayed at home due to coronavirus disease 2019 pandemic and the technology became necessary to access education and gather information. Flexible daily routine, unlimited Internet access, less parental interference, boredom, and the natural tendency of this age group to use the Internet have led to an increase in IA. Unsupervised screen time and Internet access, lack of identification of at-risk individuals, lack of appropriate interventional strategies, and lack of awareness of mental health have made the scenario more complex, which is often overlooked. Treatment of problematic Internet use is an evolving field and the traditional model of abstinence is not feasible for the management of IA. Cognitive behavioral approaches are promising when combined with other treatments. Psychotropic drugs are found to be effective on comorbid conditions, which, in turn, can help in mitigating the symptoms of IA.
The Effectiveness of Mind Mapping as a Learning Strategy in Promoting Information Retrieval among II MBBS Students
Authors: Vaddatti Tejeswini , Chaitra B. , Kiran Pretesh , Renuka Inuganti V. , Laxmi Kasula , Potti Ramya
Published: June 2022

In medical curriculum, shift to self-directed student-centered learning is required. The mind maps are multisensory tools that help students organize, integrate, and retain information. This study was conducted to evaluate the effectiveness of mind mapping in information retrieval and assess the perceptions of II MBBS students. An interventional crossover study conducted on II MBBS students who were divided into two equal groups. One group learned by conventional reading and the other group by mind mapping. The groups were swapped for the second topic. Knowledge gained assessed before the study, immediately after the session and after 1 month. The scores analyzed by independent t-test with P < 0.05 considered significant. Effect size was calculated and Cohen's d scores equal to 0.2 considered small effect, while 0.5 as moderate and 0.8 as large effect. A validated questionnaire used to assess perceptions of students. This study showed that the knowledge gained in immediate posttest and the information retrieved after 1 month for both topics were higher with mind mapping than traditional learning. Effect size also showed that mind mapping as more effective learning strategy over conventional reading. The majority of the students were positive toward mind mapping. It was evident from this study that the gain in knowledge and information retrieval is better by mind mapping. Students perceived mind mapping as a useful and effective learning strategy, which can be implemented as a routine method.
Giant Sacral Xanthoma in Familial Hypercholesterolemia
Authors: Singh Abha , Aggarwal Neha , Misra Sunayana
Published: June 2022

A 28-year-old male patient presented with multiple large, superficial, nodular masses in his elbows, buttocks, knees, Achilles tendons, feet, shoulders, and hands along with small xanthomatous lesions on the face, inner epicanthal region; largest mass being in the sacral region measuring 15 cm × 12 cm × 8 cm. The patient also presented with an elevated level of low-density lipoprotein cholesterol and was diagnosed with familial hypercholesterolemia (FH) presenting with multiple xanthomas. Local surgical excision was performed to remove the massive xanthoma from the sacrum, histopathology of which showed sheets of foamy lipid-laden histiocytes dissecting through the dermis and subcutaneous fat. The presence of long standing and/or multiple xanthomas often indicates severe and long-term FH. A thorough systemic workup is needed for such patients, especially to rule out cardiovascular complications so that lipid-lowering agents and dietary modifications can be initiated early on. We present the case of a young male patient with FH presenting with multiple large tuberous xanthomas all over the body.
Indications and Prescription Pattern of Electroconvulsive Therapy
Authors: Kota V. Subbalakshmi , Settem V. V. Jagadeesh , Roy Khyati
Published: June 2022

Background and Aim:

With the advent of pharmacological agents, there were many changes in prescription patterns for modified electroconvulsive therapy (MECT) over time across the globe. This study aims to evaluate the main indications and prescription patterns of MECT in a tertiary care center.

Materials and Methods:

A retrospective medical record review was done in a tertiary care hospital after the institutional ethics committee approval, accessing the MECT records of 310 patients who underwent the procedure during the 5-year study period using a semi-structured pro forma.

Results:

In our file review, we found that the most common diagnosis, for which MECT was prescribed, was schizophrenia 146 cases (47%), and the common indication was augmentation of therapy/to speed up the rate of improvement. Depressive disorder was the primary diagnosis in 81 (26%) cases followed by mania in 46 (15%) cases. Among the major symptomatology which led to the primary use of MECT, suicidality accounted for 72 (23.2%) cases and catatonia in 34 (11%) cases. The mean number of MECTs during the course was 6.4 (2.5) in bipolar disorder, and in schizophrenia, it was 6.3 (2.3). A response rate of 85% was observed. Patient acceptability of MECT was good as only seven (2.3%) patients withdrew consent after initiation of treatment.

Conclusion:

Most common diagnosis, for which MECT was prescribed, was schizophrenia followed by depression. MECT was most commonly used as an augmentation strategy; however, in case of depression, it was used as first line of management. Response rate to MECT and acceptability were good in majority.
Big Data in Clinical Sciences-Value, Impact, and Fallacies
Authors: Abraham Liya , Vilanilam George C.
Published: June 2022

The ever-burgeoning healthcare enigmata may find their answers in Big Data. When data cannot be collected, curated, managed, and processed by commonly used software tools within a requisite time frame, they are referred to as Big Data. We put forth a narrative review on the evolution and spectrum of the clinical applications of Big Data across medical and surgical sciences, evaluating their impact and cautioning about their potential fallibilities. There is an explosion of health care data generated as a byproduct of clinical care and research in the digital information era. The challenge lies in converting these unstructured datasets into clinical wisdom and practice-defining insights. Big data provides information on the quality of health care, resource utilization, public health deficiencies, research hypothesis creation, and overall holds the potential to revolutionize clinical sciences. Several fallacies of big data like data inaccuracies, privacy, confidentiality, proprietary concerns, and caveats in data analysis algorithms may misdirect the lessons from big data.
Effect of Foam Rolling of Quadriceps, Hamstring, and IT Band on Knee Passive Range of Motion and Physical Function in Patients with Patellofemoral Pain Syndrome - Randomized Controlled Trial
Authors: Vaidya Shlesha Maulik
Published: June 2022

Background and Aim:

There are several techniques for limited and painful knee flexion, but there are very few evidences about the effect of foam rolling in patients with patellofemoral pain syndrome (PFPS). A Randomized control study was designed to determine the effect of foam rolling as well as of stretching on knee passive range of motion (ROM) and functional status in patients with patellofemoral pain and to compare the effect with that of static stretching.

Materials and Methods:

Thirty patients diagnosed with chronic knee pain were randomized into two groups (experimental and controlled groups) with 15 subjects in each group. The experimental group received foam rolling exercises on quadriceps, hamstring, and IT band muscles. Passive stretching of all the abovementioned muscles was given to the controlled group. The intervention was given for 3 alternate days per week for 4 weeks per patient. Strengthening exercises were given to both the groups. Outcome measures were passive ROM and knee injury and osteoarthritis outcome score scale.

Results:

Within-group analysis (P < 0.05) showed that both the interventions had a significant effect on passive range of motion and physical function in patients with PFPS. However, intergroup analysis (P > 0.05) showed that there is no significant difference between the two groups in terms of outcome measure.

Conclusion:

Both foam rolling and conventional treatment (stretching) are effective in improving knee ROM and functional status in patients with PFPS. However, the myofascial release (foam rolling) treatment showed slightly better (however, not significant) clinical improvement in terms of improving knee ROM and functional status in patients with PFPS.
Gastrointestinal Stromal Tumor of Jejunum Presenting as a Pelvic Mass
Authors: Bairwa Banwari Lal
Published: June 2022

Gastrointestinal stromal tumors (GISTs) are mesenchymal in origin and quite rare in the gastrointestinal system. Jejunal GISTs are extremely rare, approximately 0.1%–3% of all gastrointestinal (GI) tumors. The stomach is the most common site while small intestine (usually duodenum) is the second most common site in the GI tract. The clinical manifestations of GISTs range from asymptomatic to mild abdominal pain, mass, mechanical obstruction, and intestinal hemorrhage as well as perforation. Final diagnosis is made by combined histopathological examination (HPE) and immunohistochemistry (IHC) examination of resected specimen. Here, we present the rare case of jejunal GIST as pelvis mass in 48-year-old gentleman. The patient presented with pain abdomen and heaviness in lower abdomen. On contrast-enhanced computed tomography abdomen, diagnosis of pelvic mass was made. Exploratory laparotomy was done. A solid mass measuring 6 cm × 8 cm arising from antimesenteric border of proximal jejunum found into pelvic cavity. Jejunal segment with tumor resected and anastomosis done. HPE and IHC confirmed intermediate grade GIST of the jejunum. Imatinib mesylate was initiated due to probability of disease recurrence (24%). Carefully complete surgical excision and adjuvant therapy with imatinib is the cornerstone of intermediate to high degree GISTs.
Effect of Hand Arm Bimanual Intensive Therapy on Upper Limb Function in Young Stroke
Authors: Shah Shradha , Kale Ashwini , Tiwari Vibhuti
Published: June 2022

Young stroke comprises of 10%–15% of all stroke patients. However, compared with stroke in older adults, stroke in the young have disproportionately large economic impact by leaving victims disabled before their most productive years. Stroke leads to chronic functional impairments of upper limb and hand. Hence, we aimed to explore the effect of hand-arm bimanual intensive training (HABIT) on the recovery of upper limb function in young stroke patient. The study is a case of a 30-year-old male patient admitted to the outpatient department with right-sided hemiplegia and sensory aphasia. The patient was engaged in HABIT for 2 h a day for a continuous duration of 3 months and the training showed remarkable improvement in Fugl-Meyer assessment-upper extremity and Motor Activity Log scores. The results suggest that HABIT appears to be efficacious in improving upper limb function in young stroke.
Immunoglobulin G4-Related Ophthalmic Disease and Aortitis
Authors: Cai Mingshu , Voutnis Demetrius , Nair Balakrishnan R.
Published: June 2022

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated inflammatory condition which is a relatively new clinical entity that can have various clinical manifestations. Our understanding of its pathogenesis is rapidly evolving and many theories have been proposed. The determinants of clinical phenotypes in various populations remain unclear. We report a case of IgG4-RD involving the extraocular muscles and aorta in an elderly male who improved with oral prednisolone. We also provided an overview of the current literature on the disease.
Blood Use in Haematological Malignancies in Calabar
Authors: Akaba Kingsley , Igwilo Hilary , Akaba Edakabasi
Published: June 2022

Background:

Patients with haematological malignancies are often multiply transfused. Blood use by this patient has both medical, economic, and social implications, and the frequency of blood transfusion among this cohort of patients is being scrutinized.

Aim:

The study aimed at profiling the blood use by patients with haematological malignancies managed at the University of Calabar Teaching Hospital (UCTH).

Materials and Methods:

A retrospective study that was conducted based on the frequency of blood use among haematological malignancies patients at UCTH, Calabar. Data on blood use by haematologic malignancies (HM) patients at the UCTH from July 2019 to June 2021 were retrieved from the medical records in terms of sex, age, type of HM, and frequency of blood use during the period of review. The data and results collated were analyzed using Microsoft Excel 2016 and IBM SPSS version 21. The data were analyzed using simple statistics (frequencies and percentages), and the results were presented in tables and charts.

Results:

A total of 48 HMs patients managed in our facility were included in the cohort, and a total of 102 blood was used during the period of review. Overall, the frequency of blood transfusion varies from one type of HM to another. Patients with non-Hodgkin's lymphoma (NHL), chronic myeloid leukaemia (CML), chronic lymphatic leukaemia (CLL), and acute myeloid leukaemia (AML) account for 92.2% of blood transfused, whereas Hodgkin's lymphoma (HL), multiple myeloma (MM), and acute lymphoblastic leukaemia (ALL) represent 7.8%. The male-to-female ratio was 1.5:1. Overall age ranges from 20 to 89 years, the mode was 54 years, and the median age was 53 years. NHL is said to consume 45 units of the whole, followed by CLL and AML, both used 17 units each, whereas CML and HL were said to have used 15 units and 8 units, respectively, with MM and ALL nil. There is also a significant association between type of haematological malignancies and blood transfusion (P = 0.0016).

Conclusion:

This study presents an overview of blood transfusion use in patients with haematological malignancies. The implication of blood utilization is the shortage of blood and increased incidence of blood complications such as transfusion-transmissible infections and alloimmunization with HM patients. Furthermore, the financial burden on the patient, the cost implication of procuring a unit of whole blood which is between 20 and 30 dollars, especially in a low-resource country, where remuneration blood donation is still the major source as compared to the standard voluntary donation in a low-resource setting like ours where the poor attitude toward blood donation still remains a great challenge.
Broken Hand Sewing Needle Injuries in the Northeastern Region of Nigeria – A Five-Year Retrospective Review
Authors: Dabkana Theophilus Maksha , Nyaku Friday Titus , Obagwu Nicholas , Musa Suleiman Yakubu , Ndrimbula Habila Pogu
Published: June 2022

Background:

In the Northern part of Nigeria, the North-East in particular, the weaving of traditional caps by the people is a common practice and it is associated with injuries to various parts of the body.

Aim:

The study is aimed at finding out how common is broken hand-sewing needle injuries amongst these group of artisans and why and what part of the body is usually involved and suggest a way out.

Materials and Methods:

All the case note of the patients who had broken hand sewing needles removed from any part of their bodies were retrieved and analyzed.

Results:

A total of 192 case notes were retrieved. One hundred and twenty eight, (66.7%), were females while 64, (33.3%) were males, giving a male to female ratio of 1:2. All were aged 1 to 60 years. One hundred and fifty two, (79.2%) of all the patients were below the age of 30 years while 38 (19.8%) were age 31 to 50 years. Those aged above 50 years accounted for 2 (1%). Children of school going age who were out of school accounted for 77 (40.1%), followed by those in school 47 (24.5%). Pre-school age group and those above fifty years of age accounted for 34 (17.7%) and 10 (5.2%) respectively; The foot accounted for 81 (42.2%), followed by the knee 47 (24.5%), hand 31 (16.1%), gluteal area 17, (8.9%), thigh 7 (3.6%), elbow 5 (2.6%) and ankle (2.1%); There was no complication in 168 (87.5%) of the cases after the removal of the broken piece (s), 22 (11.5%) had some degree of wound infection that delayed healing and 2 (1%) had tetanus that required longer hospital stay but were eventually discharged home; 190 (99.9%) of the patients had removal attempted elsewhere before coming to us. Only 2 (1.0 %%) came with no attempt at removal and 2 (1%) came with symptoms of tetanus.

Conclusion:

The art of producing native caps by hand has come to stay. The dangers associated with the art may just be getting worse. Government must do something about it.
Influence of Diabetes Mellitus on Electrocardiographic Abnormalities in Stroke Cases
Authors: Osarenkhoe John Osaretin
Published: June 2022

Background:

Stroke or cerebrovascular accident according to the World Health Organization is a focal or global neurological deficit of vascular origin lasting more than 24 h or resulting in death before 24 h. In Sub-Saharan Africa as well as around the globe, stroke is the other leading cause of death among noncommunicable diseases, with the victims mainly in the productive age ranges. Notably, strokes are preceded by modifiable risk factors such as hypertension, diabetes mellitus, obesity, smoking, and alcohol ingestion. The use of electrocardiography (ECG) in addition to controlling these risk factors would reduce the occurrence, morbidity, and mortality of stroke in at-risk patients as ECG is both a preventive and prognostic tool. The knowledge of data regarding abnormalities present in this group of patients will offer knowledge that will enhance physicians' patient management and provide data for future research.

Aim:

The aim of this study is to evaluate the influence of diabetes mellitus on ECG abnormalities in stroke cases at University of Benin Teaching Hospital (UBTH).

Materials and Methods:

This was a cross-sectional analytical study carried out in UBTH, Benin, between January 2010 and 2013. The study subjects consisted of consecutive 120 admitted stroke patients who met the inclusion criteria. History and physical examination were carried out for all patients with laboratory investigations and electrocardiographic examinations also performed on all patients. Data were analyzed using SPSS version 22 software with a P < 0.05 considered significant for all comparisons.

Results:

In this study, stroke was less in diabetic 28 (23.33%) than in nondiabetic 92 (76.67%). Four (14.3%) and 24 (26.1%) of diabetic and nondiabetic cases, respectively, in this study, had no ECG abnormalities. Sixty-eight (85.70%) and 24 (73.90%) of diabetic and nondiabetic, respectively, had ECG abnormalities; this was not significant P = 0.196.

Conclusion:

The only significant ECG abnormalities noted in diabetic and nondiabetic stroke cases were left atrial enlargement and nonspecific intraventricular block, which were seen more in diabetic stroke cases.
Maternal, Obstetric, and Foetal Risk Factors for Perinatal Asphyxia
Authors: Awoyesuku Peter Abiye , John Dickson H. , Josiah Appollus E. , Sapira-Ordu Leesi
Published: June 2022

Background:

Perinatal asphyxia is a common global neonatal problem which significantly contributes to both morbidity and mortality of newborns, particularly in developing countries, with different risk factors predominating in different settings.

Aims:

The aims of this study were to investigate the prevalence, risk factors, and outcome of Apgar score-defined perinatal asphyxia at the Rivers State University Teaching Hospital (RSUTH).

Materials and Methods:

This was a retrospective case–control study in term newborns, with perinatal asphyxia defined as Apgar score <7 at five minutes, over a three-year period between January 2018 and December 2020. A matched control group with Apgar score ≥7 was used for comparison. Data were retrieved from hospital records of all the participants using a structured pro forma. Analysis was done using SPSS version 20 and statistical significance set at P < 0.05.

Results:

There were 5979 live births, of which 75 babies had perinatal asphyxia, giving a prevalence of 12.5 per 1000 live births. Foetal distress was significantly associated with perinatal asphyxia, with odds ratio (OR) = 19.9 (95% confidence interval [CI]: 6.53–60.64). The significant finding on bivariate analysis of mode of delivery (P = 0.003) and prolonged labour (P = 0.001) as risk factors lost significance on multivariate analysis. The case fatality in asphyxiated newborns was 32.1% and Sarnat Stage III was a significant risk factor for mortality, with OR = 195.0 (95% CI: 11.06–3437).

Conclusion:

The study has shown that perinatal asphyxia is a common problem at the RSUTH, with a high mortality rate. The most significant risk factor was foetal distress in labour. This can be reduced with good obstetric intervention in terms of adequate foetal monitoring in pregnancy and during labour.
Pregnancy and a Live Birth Following Laparoscopic Ovarian Drilling
Authors: Onoh Robinson Chukwudi , Ekwedigwe Kenneth Chinedu , Ezeonu Paul Olisaemeka
Published: June 2022

A case of laparoscopic ovarian drilling (LOD) in a 28-year-old nulligravida diagnosed of primary infertility secondary to polycystic ovarian syndrome (PCOS) with clomiphene citrate resistance, letrozole, and gonadotrophin failure is reported. Her husband's seminal fluid analysis was within the normal range. Laparoscopy and dye test showed copious bilateral tubal spillage of dye. LOD was performed, following which pregnancy was achieved. She was delivered of a live female baby that weighed 3.8 kg. Her postpartum period was uneventful. The literature on polycystic ovaries, infertility, and ovarian drilling was reviewed.